| Drug Name | Month Dispensed | Quantity Dispensed | Average Reimbursement Amount | Average NADAC Amount | Affiliate Pharmacy | State or Local Government Plan |
|---|---|---|---|---|---|---|
| ADDERALL XR 15 MG CAPSULE | 2021-01 | 11,040 | $6.70 | $3.07 | No | Yes |
| ALBUTEROL HFA 90 MCG INHALER | 2021-01 | 1,445 | $5.00 | $3.71 | Yes | No |
| ALBUTEROL HFA 90 MCG INHALER | 2021-01 | 59.50 | $5.33 | $3.71 | Yes | Yes |
| BASAGLAR 100 UNIT/ML KWIKPEN | 2021-01 | 300 | $18.78 | $20.95 | Yes | No |
| BEYAZ 28 TABLET | 2021-01 | 28,924 | $7.77 | $6.20 | No | Yes |
| BREO ELLIPTA 100-25 MCG INH | 2021-01 | 72,900 | $5.14 | $5.96 | Yes | Yes |
| BUTRANS 20 MCG/HR PATCH | 2021-01 | 4 | $148.64 | $134.12 | No | No |
| BUTRANS 5 MCG/HR PATCH | 2021-01 | 1,456 | $41.66 | $47.91 | No | Yes |
| CARAFATE 1 GM/10 ML SUSP | 2021-01 | 601,380 | $0.36 | $0.53 | No | Yes |
| CARBATROL ER 300 MG CAPSULE | 2021-01 | 120 | $1.75 | $1.40 | No | No |
| CHILD DELSYM COUGH 30 MG/5 ML | 2021-01 | 89 | $0.15 | $0.09 | No | No |
| CIPRODEX OTIC SUSPENSION | 2021-01 | 2,730 | $19.67 | $25.36 | No | Yes |
| COLACE 100 MG CAPSULE | 2021-01 | 80 | $0.02 | $0.02 | No | No |
| COLACE-T 100 MG CAPSULE | 2021-01 | 30 | $0.02 | $0.02 | No | No |
| COPAXONE 40 MG/ML SYRINGE | 2021-01 | 9,612 | $474.00 | $272.40 | Yes | Yes |
| COSOPT PF EYE DROPS | 2021-01 | 7,380 | $2.48 | $1.91 | Yes | Yes |
| CYCLOSET 0.8 MG TABLET | 2021-01 | 540 | $3.98 | $4.63 | No | No |
| CYTOMEL 5 MCG TABLET | 2021-01 | 46,560 | $1.85 | $1.61 | No | Yes |
| DELSYM 30 MG/5 ML SUSPENSION | 2021-01 | 1,222 | $0.13 | $0.09 | No | No |
| DEPAKOTE DR 125 MG TABLET | 2021-01 | 180 | $0.18 | $1.71 | No | No |
| DEPO-SUBQ PROVERA 104 SYRINGE | 2021-01 | 85.80 | $315.28 | $77.22 | No | Yes |
| DEPO-TESTOSTERONE 200 MG/ML | 2021-01 | 6 | $18.42 | $14.58 | No | No |
| DROSP-EE-LEVOMEF 3-0.02-0.451 | 2021-01 | 588 | $4.30 | $3.33 | Yes | No |
| DROSP-EE-LEVOMEF 3-0.02-0.451 | 2021-01 | 22,176 | $4.18 | $3.08 | Yes | Yes |
| ELESTRIN 0.06% GEL | 2021-01 | 26 | $4.05 | $2.95 | No | No |
| ELESTRIN 0.06% GEL | 2021-01 | 32,292 | $3.89 | $3.01 | No | Yes |
| ELIDEL 1% CREAM | 2021-01 | 95,820 | $9.57 | $8.56 | No | Yes |
| ENBREL 50 MG/ML SYRINGE | 2021-01 | 528 | $1,667.08 | $1,452.85 | No | Yes |
| ESTRACE 0.01% CREAM | 2021-01 | 5,610 | $6.98 | $7.78 | No | Yes |
| ESTRADIOL 0.0375MG PATCH(1/WK) | 2021-01 | 24 | $17.52 | $13.32 | Yes | No |
| ESTRADIOL 0.05 MG PATCH (1/WK) | 2021-01 | 12 | $15.34 | $12.92 | Yes | No |
| ESTRADIOL 0.05 MG PATCH (1/WK) | 2021-01 | 3,660 | $15.25 | $12.57 | Yes | Yes |
| ESTRADIOL 0.1 MG PATCH (1/WK) | 2021-01 | 1,716 | $16.33 | $13.80 | Yes | Yes |
| ETONOGESTREL-EE VAGINAL RING | 2021-01 | 7,345 | $125.12 | $111.99 | Yes | Yes |
| EVEKEO 10 MG TABLET | 2021-01 | 240 | $6.73 | $3.66 | No | No |
| EVEKEO 10 MG TABLET | 2021-01 | 38,100 | $6.74 | $3.23 | No | Yes |
| FEVERALL 80 MG SUPPOSITORY | 2021-01 | 12 | $0.38 | $0.70 | No | No |
| FLEET ENEMA | 2021-01 | 266 | $0.01 | $0.01 | No | No |
| FLOVENT HFA 220 MCG INHALER | 2021-01 | 8,352 | $26.36 | $32.99 | Yes | Yes |
| FLUTICASONE-SALMETEROL 100-50 | 2021-01 | 71,280 | $3.00 | $2.04 | Yes | Yes |
| FLUTICASONE-SALMETEROL 250-50 | 2021-01 | 23,760 | $2.23 | $2.53 | Yes | Yes |
| FLUTICASONE-SALMETEROL 500-50 | 2021-01 | 23,760 | $4.90 | $3.50 | Yes | Yes |
| GLATIRAMER 40 MG/ML SYRINGE | 2021-01 | 72 | $359.14 | $125.47 | Yes | No |
| GLATIRAMER 40 MG/ML SYRINGE | 2021-01 | 7,152 | $262.15 | $125.47 | Yes | Yes |
| GLEEVEC 400 MG TABLET | 2021-01 | 10,920 | $344.99 | $5.73 | Yes | Yes |
| HUMULIN N 100 UNIT/ML VIAL | 2021-01 | 130 | $12.80 | $14.33 | Yes | No |
| HUMULIN R 100 UNIT/ML VIAL | 2021-01 | 130 | $12.80 | $14.30 | Yes | No |
| INVOKAMET 150-500 MG TABLET | 2021-01 | 180 | $7.37 | $8.68 | No | Yes |
| ISENTRESS 400 MG TABLET | 2021-01 | 480 | $21.80 | $28.00 | No | No |
| KENALOG-40 40 MG/ML VIAL | 2021-01 | 232 | $7.96 | $9.00 | No | Yes |
| KLOR-CON 10 MEQ TABLET | 2021-01 | 30 | $0.26 | $0.16 | No | No |
| KLOR-CON 10 MEQ TABLET | 2021-01 | 41,640 | $0.37 | $0.17 | No | Yes |
| KLOR-CON 20 MEQ PACKET | 2021-01 | 60 | $4.96 | $3.76 | No | No |
| KLOR-CON M10 TABLET | 2021-01 | 850 | $0.31 | $0.27 | No | No |
| KLOR-CON M10 TABLET | 2021-01 | 381,990 | $0.31 | $0.27 | No | Yes |
| LAMICTAL XR 300 MG TABLET | 2021-01 | 23,760 | $35.79 | $39.98 | No | Yes |
| LASIX 40 MG TABLET | 2021-01 | 90 | $0.95 | $1.06 | No | No |
| LATUDA 20 MG TABLET | 2021-01 | 827 | $37.63 | $43.00 | No | No |
| LEVEMIR 100 UNIT/ML VIAL | 2021-01 | 200 | $22.14 | $29.57 | No | No |
| LEVOTHYROXINE 100 MCG TABLET | 2021-01 | 368,868 | $0.38 | $0.27 | Yes | Yes |
| LEVOTHYROXINE 112 MCG TABLET | 2021-01 | 310,764 | $0.46 | $0.31 | Yes | Yes |
| LEVOTHYROXINE 125 MCG TABLET | 2021-01 | 379,332 | $0.45 | $0.33 | Yes | Yes |
| LEVOTHYROXINE 137 MCG TABLET | 2021-01 | 159,750 | $0.48 | $0.33 | Yes | Yes |
| LEVOTHYROXINE 150 MCG TABLET | 2021-01 | 2,125 | $0.25 | $0.33 | Yes | No |
| LEVOTHYROXINE 150 MCG TABLET | 2021-01 | 202,187 | $0.48 | $0.33 | Yes | Yes |
| LEVOTHYROXINE 175 MCG TABLET | 2021-01 | 104,148 | $0.56 | $0.37 | Yes | Yes |
| LEVOTHYROXINE 200 MCG TABLET | 2021-01 | 1,038 | $0.32 | $0.44 | Yes | No |
| LEVOTHYROXINE 200 MCG TABLET | 2021-01 | 103,266 | $0.57 | $0.43 | Yes | Yes |
| LEVOTHYROXINE 25 MCG TABLET | 2021-01 | 2,873 | $0.23 | $0.21 | Yes | No |
| LEVOTHYROXINE 25 MCG TABLET | 2021-01 | 246,501 | $0.31 | $0.21 | Yes | Yes |
| LEVOTHYROXINE 50 MCG TABLET | 2021-01 | 637,224 | $0.34 | $0.22 | Yes | Yes |
| LEVOTHYROXINE 75 MCG TABLET | 2021-01 | 434,118 | $0.41 | $0.26 | Yes | Yes |
| LEVOTHYROXINE 88 MCG TABLET | 2021-01 | 246,618 | $0.39 | $0.26 | Yes | Yes |
| LEVOXYL 100 MCG TABLET | 2021-01 | 30 | $0.50 | $0.25 | No | No |
| LEVOXYL 100 MCG TABLET | 2021-01 | 62,920 | $0.69 | $0.26 | No | Yes |
| LEVOXYL 100 MCG TABLET | 2021-01 | 90 | $0.40 | $0.25 | Yes | No |
| LEVOXYL 100 MCG TABLET | 2021-01 | 25,962 | $0.40 | $0.25 | Yes | Yes |
| LEVOXYL 112 MCG TABLET | 2021-01 | 79,860 | $0.83 | $0.31 | No | Yes |
| LEVOXYL 125 MCG TABLET | 2021-01 | 60 | $0.76 | $0.32 | No | No |
| LEVOXYL 125 MCG TABLET | 2021-01 | 56,456 | $0.78 | $0.33 | No | Yes |
| LEVOXYL 125 MCG TABLET | 2021-01 | 11,088 | $0.47 | $0.33 | Yes | Yes |
| LEVOXYL 137 MCG TABLET | 2021-01 | 30 | $1.08 | $0.33 | No | No |
| LEVOXYL 137 MCG TABLET | 2021-01 | 18,084 | $0.94 | $0.33 | No | Yes |
| LEVOXYL 175 MCG TABLET | 2021-01 | 11,848 | $1.04 | $0.37 | No | Yes |
| LEVOXYL 175 MCG TABLET | 2021-01 | 90 | $1.15 | $0.37 | Yes | No |
| LEVOXYL 175 MCG TABLET | 2021-01 | 11,880 | $0.58 | $0.37 | Yes | Yes |
| LEVOXYL 200 MCG TABLET | 2021-01 | 30 | $1.27 | $0.42 | No | No |
| LEVOXYL 200 MCG TABLET | 2021-01 | 6,960 | $1.25 | $0.46 | No | Yes |
| LEVOXYL 25 MCG TABLET | 2021-01 | 18,090 | $0.41 | $0.20 | No | Yes |
| LEVOXYL 25 MCG TABLET | 2021-01 | 45 | $0.31 | $0.22 | Yes | No |
| LEVOXYL 50 MCG TABLET | 2021-01 | 90 | $0.79 | $0.22 | No | No |
| LEVOXYL 50 MCG TABLET | 2021-01 | 39,720 | $0.71 | $0.22 | No | Yes |
| LEVOXYL 50 MCG TABLET | 2021-01 | 90 | $0.71 | $0.22 | Yes | No |
| LEVOXYL 75 MCG TABLET | 2021-01 | 17,880 | $0.60 | $0.26 | No | Yes |
| LEVOXYL 75 MCG TABLET | 2021-01 | 90 | $0.79 | $0.26 | Yes | No |
| LEVOXYL 75 MCG TABLET | 2021-01 | 20,880 | $0.42 | $0.26 | Yes | Yes |
| LEVOXYL 88 MCG TABLET | 2021-01 | 210 | $0.65 | $0.25 | No | No |
| LEVOXYL 88 MCG TABLET | 2021-01 | 5,190 | $0.77 | $0.25 | No | Yes |
| LEVOXYL 88 MCG TABLET | 2021-01 | 90 | $0.80 | $0.25 | Yes | No |
| LIDODERM 5% PATCH | 2021-01 | 3,960 | $1.22 | $2.24 | No | Yes |
| LOKELMA 5 GRAM POWDER PACKET | 2021-01 | 3,960 | $20.24 | $22.76 | No | Yes |
| MINASTRIN 24 FE CHEWABLE TAB | 2021-01 | 18,480 | $6.00 | $3.01 | No | Yes |
| MINIVELLE 0.05 MG PATCH | 2021-01 | 4,224 | $19.81 | $12.01 | No | Yes |
| MIRVASO 0.33% GEL PUMP | 2021-01 | 30 | $19.98 | $16.80 | No | No |
| MUCINEX D ER 600-60 MG TABLET | 2021-01 | 18 | $0.76 | $0.41 | No | No |
| MUCINEX DM ER 1,200-60 MG TAB | 2021-01 | 84 | $1.00 | $0.82 | No | No |
| MUCINEX DM ER 600-30 MG TABLET | 2021-01 | 360 | $0.62 | $0.42 | No | No |
| MUCINEX ER 1,200 MG TABLET | 2021-01 | 14 | $1.10 | $0.76 | No | No |
| MUCINEX ER 600 MG TABLET | 2021-01 | 88 | $0.44 | $0.34 | No | No |
| NASONEX 50 MCG NASAL SPRAY | 2021-01 | 17 | $16.86 | $14.19 | No | No |
| NIACIN ER 500 MG TABLET | 2021-01 | 540 | $1.82 | $0.31 | Yes | No |
| NIACIN ER 500 MG TABLET | 2021-01 | 23,760 | $1.76 | $0.31 | Yes | Yes |
| NORVIR 100 MG TABLET | 2021-01 | 60 | $1.14 | $8.39 | No | No |
| ORENCIA 125 MG/ML SYRINGE | 2021-01 | 3,840 | $1,301.96 | $1,177.53 | No | Yes |
| PACERONE 100 MG TABLET | 2021-01 | 180 | $3.27 | $1.74 | Yes | No |
| PACERONE 100 MG TABLET | 2021-01 | 11,880 | $3.18 | $1.70 | Yes | Yes |
| PACERONE 200 MG TABLET | 2021-01 | 30 | $0.22 | $0.14 | No | No |
| PACERONE 200 MG TABLET | 2021-01 | 33,720 | $0.24 | $0.14 | No | Yes |
| PAXIL CR 12.5 MG TABLET | 2021-01 | 1,230 | $7.01 | $1.18 | No | Yes |
| PLAVIX 75 MG TABLET | 2021-01 | 11,880 | $5.80 | $6.80 | No | Yes |
| PREZISTA 600 MG TABLET | 2021-01 | 60 | $15.87 | $28.60 | No | No |
| PROAIR HFA 90 MCG INHALER | 2021-01 | 5,916 | $3.19 | $5.63 | No | Yes |
| PROCTOSOL-HC 2.5% CREAM | 2021-01 | 56.70 | $0.87 | $0.38 | No | No |
| PROCTOSOL-HC 2.5% CREAM | 2021-01 | 17,114.40 | $0.77 | $0.38 | No | Yes |
| PROLIA 60 MG/ML SYRINGE | 2021-01 | 465 | $1,359.01 | $1,234.97 | Yes | Yes |
| PULMICORT 90 MCG FLEXHALER | 2021-01 | 792 | $161.72 | $183.78 | Yes | Yes |
| RASUVO 20 MG/0.4 ML AUTOINJ | 2021-01 | 211.20 | $259.75 | $300.42 | Yes | Yes |
| REFRESH P.M. OINTMENT | 2021-01 | 3.50 | $2.80 | $2.45 | No | No |
| SENOKOT 8.6 MG TABLET | 2021-01 | 12 | $0.04 | $0.02 | No | No |
| SILENOR 6 MG TABLET | 2021-01 | 3,960 | $2.50 | $7.62 | No | Yes |
| SOLU-CORTEF 100 MG ACT-O-VIAL | 2021-01 | 1 | $17.59 | $14.79 | No | No |
| STRATTERA 60 MG CAPSULE | 2021-01 | 3,960 | $0.35 | $1.97 | No | Yes |
| SUBOXONE 2 MG-0.5 MG SL FILM | 2021-01 | 23,270 | $4.78 | $3.54 | No | Yes |
| SUBOXONE 4 MG-1 MG SL FILM | 2021-01 | 120 | $8.36 | $4.66 | No | No |
| SUBOXONE 8 MG-2 MG SL FILM | 2021-01 | 425 | $8.67 | $5.97 | No | No |
| SUPREP BOWEL PREP KIT | 2021-01 | 46,728 | $0.25 | $0.29 | Yes | Yes |
| SYNTHROID 100 MCG TABLET | 2021-01 | 503 | $1.21 | $0.89 | Yes | No |
| SYNTHROID 112 MCG TABLET | 2021-01 | 2,655 | $1.29 | $1.11 | No | No |
| SYNTHROID 112 MCG TABLET | 2021-01 | 315 | $1.22 | $1.06 | Yes | No |
| SYNTHROID 125 MCG TABLET | 2021-01 | 270 | $1.19 | $0.82 | Yes | No |
| SYNTHROID 137 MCG TABLET | 2021-01 | 1,230 | $1.31 | $1.18 | No | No |
| SYNTHROID 137 MCG TABLET | 2021-01 | 435 | $1.21 | $0.98 | Yes | No |
| SYNTHROID 150 MCG TABLET | 2021-01 | 1,950 | $1.26 | $0.83 | No | No |
| SYNTHROID 175 MCG TABLET | 2021-01 | 1,055 | $1.28 | $1.01 | No | No |
| SYNTHROID 200 MCG TABLET | 2021-01 | 984 | $1.31 | $1.18 | No | No |
| SYNTHROID 200 MCG TABLET | 2021-01 | 180 | $1.21 | $0.88 | Yes | No |
| SYNTHROID 200 MCG TABLET | 2021-01 | 11,880 | $1.15 | $1.30 | Yes | Yes |
| SYNTHROID 25 MCG TABLET | 2021-01 | 1,155 | $1.30 | $0.93 | No | No |
| SYNTHROID 25 MCG TABLET | 2021-01 | 180 | $1.22 | $0.76 | Yes | No |
| SYNTHROID 50 MCG TABLET | 2021-01 | 1,662 | $1.31 | $1.10 | No | No |
| SYNTHROID 50 MCG TABLET | 2021-01 | 720 | $1.20 | $1.03 | Yes | No |
| SYNTHROID 75 MCG TABLET | 2021-01 | 1,917 | $1.32 | $1.10 | No | No |
| SYNTHROID 75 MCG TABLET | 2021-01 | 270 | $1.19 | $0.78 | Yes | No |
| SYNTHROID 88 MCG TABLET | 2021-01 | 1,790 | $1.32 | $1.12 | No | No |
| TAMIFLU 75 MG CAPSULE | 2021-01 | 410 | $0.85 | $2.13 | No | Yes |
| TRANSDERM-SCOP 1.5 MG (1MG/3D) | 2021-01 | 2,772 | $13.73 | $15.76 | No | Yes |
| ULORIC 40 MG TABLET | 2021-01 | 16,110 | $10.26 | $5.52 | No | Yes |
| UNITHROID 100 MCG TABLET | 2021-01 | 150 | $0.45 | $0.26 | No | No |
| UNITHROID 100 MCG TABLET | 2021-01 | 115,350 | $0.34 | $0.25 | No | Yes |
| UNITHROID 112 MCG TABLET | 2021-01 | 176 | $0.39 | $0.31 | No | No |
| UNITHROID 112 MCG TABLET | 2021-01 | 173,715 | $0.43 | $0.31 | No | Yes |
| UNITHROID 112 MCG TABLET | 2021-01 | 90 | $0.11 | $0.31 | Yes | No |
| UNITHROID 25 MCG TABLET | 2021-01 | 90 | $0.23 | $0.21 | No | No |
| UNITHROID 25 MCG TABLET | 2021-01 | 18,570 | $0.30 | $0.20 | No | Yes |
| UNITHROID 50 MCG TABLET | 2021-01 | 330 | $0.34 | $0.23 | No | No |
| UNITHROID 50 MCG TABLET | 2021-01 | 112,392 | $0.53 | $0.22 | No | Yes |
| UNITHROID 75 MCG TABLET | 2021-01 | 375 | $0.39 | $0.26 | No | No |
| UNITHROID 75 MCG TABLET | 2021-01 | 175,140 | $0.40 | $0.26 | No | Yes |
| UNITHROID 75 MCG TABLET | 2021-01 | 90 | $0.11 | $0.26 | Yes | No |
| UNITHROID 88 MCG TABLET | 2021-01 | 478 | $0.43 | $0.26 | No | No |
| UNITHROID 88 MCG TABLET | 2021-01 | 104,442 | $0.33 | $0.25 | No | Yes |
| UNITHROID 88 MCG TABLET | 2021-01 | 84 | $0.65 | $0.25 | Yes | No |
| VANIQA 13.9% CREAM | 2021-01 | 135 | $4.21 | $3.53 | No | No |
| VIREAD 300 MG TABLET | 2021-01 | 13,920 | $43.35 | $20.72 | Yes | Yes |
| VRAYLAR 6 MG CAPSULE | 2021-01 | 300 | $31.06 | $40.52 | No | No |
| WELLBUTRIN XL 150 MG TABLET | 2021-01 | 63,750 | $50.90 | $45.20 | No | Yes |
| XULTOPHY 100 UNIT-3.6MG/ML PEN | 2021-01 | 10,440 | $57.42 | $69.79 | Yes | Yes |
| ABILIFY MAINTENA ER 300 MG SYR | 2021-02 | 2 | $1,894.36 | $1,714.39 | No | No |
| ABILIFY MAINTENA ER 400 MG VL | 2021-02 | 1 | $2,722.85 | $2,288.06 | No | No |
| ADDERALL XR 15 MG CAPSULE | 2021-02 | 7,200 | $6.87 | $0.85 | No | Yes |
| ADHANSIA XR 45 MG CAPSULE | 2021-02 | 30 | $7.62 | $10.08 | No | Yes |
| ADVAIR HFA 230-21 MCG INHALER | 2021-02 | 1,584 | $37.49 | $42.71 | Yes | Yes |
| ALBUTEROL HFA 90 MCG INHALER | 2021-02 | 1,496 | $4.96 | $3.72 | Yes | No |
| APLENZIN ER 522 MG TABLET | 2021-02 | 60 | $136.18 | $154.33 | No | No |
| ATRIPLA TABLET | 2021-02 | 34,680 | $93.77 | $76.93 | No | Yes |
| BEPREVE 1.5% EYE DROPS | 2021-02 | 10 | $23.52 | $46.33 | No | No |
| BEYAZ 28 TABLET | 2021-02 | 84 | $7.46 | $3.71 | Yes | No |
| BIDIL 20 MG-37.5 MG TABLET | 2021-02 | 360 | $3.09 | $3.66 | No | No |
| BREO ELLIPTA 200-25 MCG INH | 2021-02 | 136,800 | $4.87 | $5.96 | Yes | Yes |
| BRIMONIDINE TARTRATE 0.15% DRP | 2021-02 | 1,980 | $24.53 | $21.31 | Yes | Yes |
| BYSTOLIC 20 MG TABLET | 2021-02 | 55,080 | $4.49 | $5.05 | Yes | Yes |
| CARAFATE 1 GM/10 ML SUSP | 2021-02 | 186,020 | $0.42 | $0.53 | No | Yes |
| CARBATROL ER 300 MG CAPSULE | 2021-02 | 120 | $1.75 | $1.33 | No | No |
| CARBATROL ER 300 MG CAPSULE | 2021-02 | 23,760 | $2.13 | $1.70 | No | Yes |
| CELESTONE SOLUSPAN 30 MG/5 ML | 2021-02 | 5 | $8.53 | $7.19 | No | No |
| CEPACOL SORE THROAT LOZENGE | 2021-02 | 48 | $0.17 | $0.15 | No | No |
| CHILD DELSYM COUGH 30 MG/5 ML | 2021-02 | 178 | $0.15 | $0.09 | No | No |
| CIPRODEX OTIC SUSPENSION | 2021-02 | 22.50 | $32.28 | $26.00 | No | No |
| CIPRODEX OTIC SUSPENSION | 2021-02 | 1,980 | $22.33 | $26.22 | No | Yes |
| CITRANATAL DHA PACK | 2021-02 | 7,920 | $2.06 | $1.85 | No | Yes |
| CLIMARA 0.1 MG/DAY PATCH | 2021-02 | 1,584 | $14.17 | $35.05 | No | Yes |
| COLACE 100 MG CAPSULE | 2021-02 | 30 | $0.02 | $0.02 | No | No |
| CONCERTA ER 36 MG TABLET | 2021-02 | 150 | $12.20 | $6.75 | No | No |
| CONCERTA ER 54 MG TABLET | 2021-02 | 5,190 | $13.33 | $10.51 | No | Yes |
| CONTRAVE ER 8-90 MG TABLET | 2021-02 | 3,654 | $2.53 | $2.29 | No | No |
| COPAXONE 40 MG/ML SYRINGE | 2021-02 | 4,860 | $474.00 | $272.40 | Yes | Yes |
| CYTOMEL 5 MCG TABLET | 2021-02 | 90 | $1.69 | $0.58 | No | No |
| DAYTRANA 20 MG/9 HOUR PATCH | 2021-02 | 13,920 | $11.25 | $13.43 | No | Yes |
| DELSYM 30 MG/5 ML SUSPENSION | 2021-02 | 1,070 | $0.10 | $0.08 | No | No |
| DEPAKOTE DR 125 MG TABLET | 2021-02 | 180 | $0.18 | $1.71 | No | No |
| DEPO-TESTOSTERONE 200 MG/ML | 2021-02 | 1,420 | $20.05 | $16.53 | No | Yes |
| DERMOTIC OIL 0.01% EAR DROPS | 2021-02 | 820 | $1.49 | $1.35 | No | Yes |
| DROSP-EE-LEVOMEF 3-0.02-0.451 | 2021-02 | 896 | $4.44 | $3.81 | Yes | No |
| DROSP-EE-LEVOMEF 3-0.02-0.451 | 2021-02 | 53,508 | $3.12 | $3.71 | Yes | Yes |
| DUEXIS 800-26.6 MG TABLET | 2021-02 | 240 | $32.90 | $26.33 | No | Yes |
| EFFEXOR XR 75 MG CAPSULE | 2021-02 | 90 | $14.24 | $0.13 | No | No |
| ELESTRIN 0.06% GEL | 2021-02 | 104 | $4.22 | $3.09 | No | No |
| ELESTRIN 0.06% GEL | 2021-02 | 68,276 | $4.18 | $3.09 | No | Yes |
| ELIDEL 1% CREAM | 2021-02 | 210 | $9.51 | $7.99 | No | No |
| ELIDEL 1% CREAM | 2021-02 | 59,790 | $9.47 | $7.52 | No | Yes |
| ENBREL 50 MG/ML SYRINGE | 2021-02 | 528 | $1,667.08 | $1,452.85 | No | Yes |
| ESTRACE 0.01% CREAM | 2021-02 | 9,860 | $6.73 | $7.78 | No | Yes |
| ESTRADIOL 0.1 MG PATCH (1/WK) | 2021-02 | 2,784 | $16.33 | $12.01 | Yes | Yes |
| ETONOGESTREL-EE VAGINAL RING | 2021-02 | 3,327 | $125.10 | $111.03 | Yes | Yes |
| EVAMIST 1.53 MG/SPRAY | 2021-02 | 8.10 | $13.58 | $15.23 | No | No |
| EVEKEO 10 MG TABLET | 2021-02 | 60 | $6.65 | $1.16 | No | No |
| EVEKEO 10 MG TABLET | 2021-02 | 34,140 | $6.74 | $3.41 | No | Yes |
| FLUTICASONE-SALMETEROL 100-50 | 2021-02 | 23,760 | $3.00 | $2.07 | Yes | Yes |
| FOCALIN 10 MG TABLET | 2021-02 | 45 | $1.25 | $0.27 | No | No |
| GLATIRAMER 40 MG/ML SYRINGE | 2021-02 | 84 | $363.86 | $125.47 | Yes | No |
| GLATIRAMER 40 MG/ML SYRINGE | 2021-02 | 4,368 | $262.15 | $125.47 | Yes | Yes |
| GLEEVEC 400 MG TABLET | 2021-02 | 14,880 | $345.72 | $121.75 | Yes | Yes |
| HUMALOG MIX 75-25 KWIKPEN | 2021-02 | 19,905 | $29.83 | $33.95 | Yes | Yes |
| ISENTRESS 400 MG TABLET | 2021-02 | 600 | $23.26 | $28.07 | No | No |
| KEPPRA 750 MG TABLET | 2021-02 | 7,380 | $9.59 | $10.84 | No | Yes |
| KLOR-CON 10 MEQ TABLET | 2021-02 | 30 | $0.26 | $0.16 | No | No |
| KLOR-CON 10 MEQ TABLET | 2021-02 | 10,920 | $0.37 | $0.16 | No | Yes |
| KLOR-CON 20 MEQ PACKET | 2021-02 | 3 | $7.21 | $3.29 | No | No |
| KLOR-CON 20 MEQ PACKET | 2021-02 | 11,878 | $3.23 | $1.80 | No | Yes |
| KLOR-CON 20 MEQ PACKET | 2021-02 | 450 | $6.36 | $1.80 | Yes | No |
| KLOR-CON 20 MEQ PACKET | 2021-02 | 47,520 | $5.43 | $1.80 | Yes | Yes |
| KLOR-CON M10 TABLET | 2021-02 | 770 | $0.33 | $0.27 | No | No |
| KLOR-CON M10 TABLET | 2021-02 | 432,660 | $0.32 | $0.27 | No | Yes |
| KLOR-CON M20 TABLET | 2021-02 | 1,029 | $0.33 | $0.24 | No | No |
| KLOR-CON M20 TABLET | 2021-02 | 311,316 | $0.32 | $0.24 | No | Yes |
| KLOR-CON M20 TABLET | 2021-02 | 2,250 | $0.34 | $0.24 | Yes | No |
| KLOR-CON M20 TABLET | 2021-02 | 157,680 | $0.44 | $0.24 | Yes | Yes |
| LASIX 40 MG TABLET | 2021-02 | 90 | $1.02 | $0.03 | No | Yes |
| LEVEMIR 100 UNIT/ML VIAL | 2021-02 | 9,060 | $25.61 | $29.57 | Yes | Yes |
| LEVOTHYROXINE 100 MCG TABLET | 2021-02 | 385,752 | $0.39 | $0.27 | Yes | Yes |
| LEVOTHYROXINE 112 MCG TABLET | 2021-02 | 2,280 | $0.27 | $0.31 | Yes | No |
| LEVOTHYROXINE 112 MCG TABLET | 2021-02 | 304,290 | $0.46 | $0.31 | Yes | Yes |
| LEVOTHYROXINE 125 MCG TABLET | 2021-02 | 240,276 | $0.44 | $0.31 | Yes | Yes |
| LEVOTHYROXINE 137 MCG TABLET | 2021-02 | 128,700 | $0.46 | $0.33 | Yes | Yes |
| LEVOTHYROXINE 150 MCG TABLET | 2021-02 | 177,996 | $0.49 | $0.34 | Yes | Yes |
| LEVOTHYROXINE 175 MCG TABLET | 2021-02 | 1,441 | $0.25 | $0.37 | Yes | No |
| LEVOTHYROXINE 175 MCG TABLET | 2021-02 | 72,900 | $0.52 | $0.37 | Yes | Yes |
| LEVOTHYROXINE 200 MCG TABLET | 2021-02 | 990 | $0.27 | $0.43 | Yes | No |
| LEVOTHYROXINE 200 MCG TABLET | 2021-02 | 11,880 | $0.58 | $0.42 | Yes | Yes |
| LEVOTHYROXINE 25 MCG TABLET | 2021-02 | 140,656 | $0.30 | $0.21 | Yes | Yes |
| LEVOTHYROXINE 50 MCG TABLET | 2021-02 | 770,466 | $0.34 | $0.22 | Yes | Yes |
| LEVOTHYROXINE 75 MCG TABLET | 2021-02 | 393,066 | $0.41 | $0.25 | Yes | Yes |
| LEVOTHYROXINE 88 MCG TABLET | 2021-02 | 315,930 | $0.38 | $0.26 | Yes | Yes |
| LEVOXYL 100 MCG TABLET | 2021-02 | 36,870 | $0.57 | $0.27 | No | Yes |
| LEVOXYL 100 MCG TABLET | 2021-02 | 11,880 | $0.40 | $0.25 | Yes | Yes |
| LEVOXYL 112 MCG TABLET | 2021-02 | 32,760 | $0.77 | $0.31 | No | Yes |
| LEVOXYL 112 MCG TABLET | 2021-02 | 20,880 | $0.47 | $0.31 | Yes | Yes |
| LEVOXYL 125 MCG TABLET | 2021-02 | 120 | $0.84 | $0.32 | No | No |
| LEVOXYL 125 MCG TABLET | 2021-02 | 43,680 | $0.90 | $0.33 | No | Yes |
| LEVOXYL 137 MCG TABLET | 2021-02 | 210 | $0.92 | $0.34 | No | No |
| LEVOXYL 137 MCG TABLET | 2021-02 | 20,880 | $0.48 | $0.33 | Yes | Yes |
| LEVOXYL 150 MCG TABLET | 2021-02 | 15,840 | $0.91 | $0.31 | No | Yes |
| LEVOXYL 175 MCG TABLET | 2021-02 | 23,728 | $1.03 | $0.37 | No | Yes |
| LEVOXYL 200 MCG TABLET | 2021-02 | 30 | $1.25 | $0.44 | No | No |
| LEVOXYL 200 MCG TABLET | 2021-02 | 6,960 | $1.25 | $0.44 | No | Yes |
| LEVOXYL 200 MCG TABLET | 2021-02 | 90 | $1.16 | $0.42 | Yes | No |
| LEVOXYL 25 MCG TABLET | 2021-02 | 30 | $0.70 | $0.22 | No | No |
| LEVOXYL 25 MCG TABLET | 2021-02 | 14,400 | $0.39 | $0.22 | No | Yes |
| LEVOXYL 50 MCG TABLET | 2021-02 | 60 | $0.80 | $0.22 | No | No |
| LEVOXYL 50 MCG TABLET | 2021-02 | 24,780 | $0.75 | $0.22 | No | Yes |
| LEVOXYL 50 MCG TABLET | 2021-02 | 90 | $0.35 | $0.22 | Yes | No |
| LEVOXYL 75 MCG TABLET | 2021-02 | 36,720 | $0.57 | $0.26 | No | Yes |
| LEVOXYL 75 MCG TABLET | 2021-02 | 84 | $0.79 | $0.26 | Yes | No |
| LEVOXYL 88 MCG TABLET | 2021-02 | 60 | $0.66 | $0.26 | No | No |
| LEVOXYL 88 MCG TABLET | 2021-02 | 7,650 | $0.81 | $0.26 | No | Yes |
| LIALDA DR 1.2 GM TABLET | 2021-02 | 73,200 | $6.79 | $8.96 | No | Yes |
| LIVALO 4 MG TABLET | 2021-02 | 270 | $9.14 | $10.22 | No | No |
| LUMIFY 0.025% EYE DROP | 2021-02 | 7.50 | $3.58 | $2.98 | No | No |
| LUMIGAN 0.01% EYE DROPS | 2021-02 | 1,740 | $69.08 | $83.32 | Yes | Yes |
| MINASTRIN 24 FE CHEWABLE TAB | 2021-02 | 3,696 | $6.12 | $0.64 | No | Yes |
| MINIVELLE 0.05 MG PATCH | 2021-02 | 4,952 | $21.50 | $9.81 | No | Yes |
| MONUROL 3 GM SACHET | 2021-02 | 892 | $87.38 | $77.26 | No | Yes |
| MUCINEX D ER 600-60 MG TABLET | 2021-02 | 36 | $0.90 | $0.42 | No | No |
| MUCINEX DM ER 600-30 MG TABLET | 2021-02 | 248 | $0.80 | $0.40 | No | No |
| MUCINEX ER 1,200 MG TABLET | 2021-02 | 66 | $1.29 | $0.76 | No | No |
| MUCINEX ER 600 MG TABLET | 2021-02 | 362 | $0.65 | $0.35 | No | No |
| MYDAYIS ER 12.5 MG CAPSULE | 2021-02 | 60 | $8.54 | $9.86 | No | No |
| MYFORTIC 180 MG TABLET | 2021-02 | 240 | $5.83 | $0.79 | No | No |
| NAPHCON-A EYE DROPS | 2021-02 | 10 | $0.54 | $0.60 | No | No |
| NARCAN 4 MG NASAL SPRAY | 2021-02 | 56 | $50.31 | $59.99 | No | No |
| NASONEX 50 MCG NASAL SPRAY | 2021-02 | 17 | $16.86 | $14.19 | No | No |
| NEXIUM DR 2.5 MG PACKET | 2021-02 | 180 | $8.23 | $9.22 | No | No |
| NEXIUM DR 40 MG CAPSULE | 2021-02 | 90 | $10.46 | $8.81 | No | No |
| NORVIR 100 MG TABLET | 2021-02 | 60 | $1.14 | $8.39 | No | No |
| NORVIR 100 MG TABLET | 2021-02 | 1,230 | $8.27 | $1.89 | No | Yes |
| NUCYNTA ER 250 MG TABLET | 2021-02 | 2,460 | $25.19 | $30.02 | No | Yes |
| PACERONE 200 MG TABLET | 2021-02 | 30 | $0.28 | $0.14 | No | No |
| PACERONE 200 MG TABLET | 2021-02 | 21,840 | $0.25 | $0.14 | No | Yes |
| PAXIL 10 MG/5 ML SUSPENSION | 2021-02 | 150 | $1.07 | $1.40 | No | No |
| PAXIL CR 12.5 MG TABLET | 2021-02 | 1,230 | $7.01 | $0.93 | No | Yes |
| PREMPRO 0.45-1.5 MG TABLET | 2021-02 | 11,088 | $6.41 | $7.31 | Yes | Yes |
| PREVACID 30 MG SOLUTAB | 2021-02 | 30 | $10.96 | $8.77 | No | No |
| PREZISTA 600 MG TABLET | 2021-02 | 240 | $21.40 | $29.89 | No | No |
| PROAIR HFA 90 MCG INHALER | 2021-02 | 34 | $7.02 | $5.63 | No | No |
| PROAIR HFA 90 MCG INHALER | 2021-02 | 5,916 | $1.16 | $7.54 | No | Yes |
| PROCTOSOL-HC 2.5% CREAM | 2021-02 | 85.05 | $0.92 | $0.38 | No | No |
| PROCTOSOL-HC 2.5% CREAM | 2021-02 | 4,904.55 | $0.55 | $0.38 | No | Yes |
| PROLIA 60 MG/ML SYRINGE | 2021-02 | 929 | $1,438.81 | $1,307.50 | Yes | Yes |
| QUILLICHEW ER 30 MG CHEW TAB | 2021-02 | 90 | $10.58 | $11.91 | No | No |
| RASUVO 25 MG/0.5 ML AUTOINJ | 2021-02 | 528 | $207.80 | $237.63 | Yes | Yes |
| REFRESH P.M. OINTMENT | 2021-02 | 3.50 | $2.80 | $2.45 | No | No |
| RENVELA 800 MG TABLET | 2021-02 | 43,560 | $0.39 | $5.70 | No | Yes |
| SILENOR 6 MG TABLET | 2021-02 | 3,960 | $2.50 | $8.03 | No | Yes |
| SOLU-CORTEF 100 MG ACT-O-VIAL | 2021-02 | 3 | $17.59 | $14.79 | No | No |
| SOLU-CORTEF 100 MG VIAL | 2021-02 | 2 | $13.01 | $10.83 | No | No |
| SOOLANTRA 1% CREAM | 2021-02 | 16,425 | $10.95 | $12.84 | No | Yes |
| SPIRIVA 18 MCG CP-HANDIHALER | 2021-02 | 180 | $12.04 | $15.29 | No | No |
| STRATTERA 60 MG CAPSULE | 2021-02 | 3,960 | $0.35 | $1.82 | No | Yes |
| SUBOXONE 2 MG-0.5 MG SL FILM | 2021-02 | 45,310 | $4.74 | $4.10 | No | Yes |
| SUBOXONE 4 MG-1 MG SL FILM | 2021-02 | 30 | $7.79 | $4.60 | No | No |
| SUBOXONE 8 MG-2 MG SL FILM | 2021-02 | 376 | $8.66 | $6.58 | No | No |
| SUBOXONE 8 MG-2 MG SL FILM | 2021-02 | 166,415 | $8.60 | $7.74 | No | Yes |
| SUBOXONE 8 MG-2 MG SL FILM | 2021-02 | 13,920 | $7.41 | $8.61 | Yes | Yes |
| SYNTHROID 100 MCG TABLET | 2021-02 | 1,849 | $1.31 | $1.19 | No | No |
| SYNTHROID 100 MCG TABLET | 2021-02 | 360 | $1.20 | $0.79 | Yes | No |
| SYNTHROID 112 MCG TABLET | 2021-02 | 1,924 | $1.31 | $1.08 | No | No |
| SYNTHROID 112 MCG TABLET | 2021-02 | 953 | $1.21 | $0.81 | Yes | No |
| SYNTHROID 125 MCG TABLET | 2021-02 | 540 | $1.22 | $0.91 | Yes | No |
| SYNTHROID 137 MCG TABLET | 2021-02 | 795 | $1.32 | $1.12 | No | No |
| SYNTHROID 137 MCG TABLET | 2021-02 | 450 | $1.22 | $1.06 | Yes | No |
| SYNTHROID 150 MCG TABLET | 2021-02 | 1,410 | $1.30 | $0.89 | No | No |
| SYNTHROID 150 MCG TABLET | 2021-02 | 90 | $1.22 | $0.31 | Yes | No |
| SYNTHROID 175 MCG TABLET | 2021-02 | 945 | $1.29 | $1.08 | No | No |
| SYNTHROID 175 MCG TABLET | 2021-02 | 135 | $1.21 | $0.84 | Yes | No |
| SYNTHROID 200 MCG TABLET | 2021-02 | 725 | $1.32 | $1.11 | No | No |
| SYNTHROID 200 MCG TABLET | 2021-02 | 45 | $1.21 | $0.42 | Yes | No |
| SYNTHROID 25 MCG TABLET | 2021-02 | 927 | $1.31 | $0.92 | No | No |
| SYNTHROID 300 MCG TABLET | 2021-02 | 30 | $1.36 | $0.60 | No | No |
| SYNTHROID 50 MCG TABLET | 2021-02 | 1,657 | $1.30 | $1.04 | No | No |
| SYNTHROID 75 MCG TABLET | 2021-02 | 2,268 | $1.32 | $1.10 | No | No |
| SYNTHROID 75 MCG TABLET | 2021-02 | 270 | $1.22 | $0.96 | Yes | No |
| SYNTHROID 88 MCG TABLET | 2021-02 | 1,992 | $1.31 | $1.07 | No | No |
| SYSTANE COMPLETE 0.6% EYE DROP | 2021-02 | 20 | $1.16 | $1.02 | No | No |
| TIMOPTIC 0.5% OCUDOSE DROP | 2021-02 | 15,840 | $6.83 | $8.56 | No | Yes |
| TOVIAZ ER 4 MG TABLET | 2021-02 | 30 | $9.90 | $11.47 | No | Yes |
| TRANSDERM-SCOP 1.5 MG (1MG/3D) | 2021-02 | 1,320 | $3.70 | $14.39 | No | Yes |
| TRESIBA 100 UNIT/ML VIAL | 2021-02 | 30 | $28.42 | $32.54 | No | No |
| TRI-LUMA CREAM | 2021-02 | 150 | $7.69 | $6.47 | No | No |
| TYMLOS 80 MCG DOSE PEN INJECTR | 2021-02 | 1.56 | $1,445.22 | $1,309.76 | Yes | No |
| ULORIC 40 MG TABLET | 2021-02 | 13,920 | $10.49 | $6.10 | No | Yes |
| UNITHROID 100 MCG TABLET | 2021-02 | 180 | $0.39 | $0.28 | No | No |
| UNITHROID 100 MCG TABLET | 2021-02 | 107,010 | $0.36 | $0.28 | No | Yes |
| UNITHROID 100 MCG TABLET | 2021-02 | 90 | $0.11 | $0.28 | Yes | No |
| UNITHROID 112 MCG TABLET | 2021-02 | 120 | $0.36 | $0.31 | No | No |
| UNITHROID 112 MCG TABLET | 2021-02 | 40,410 | $0.39 | $0.31 | No | Yes |
| UNITHROID 112 MCG TABLET | 2021-02 | 3,690 | $0.47 | $0.31 | Yes | Yes |
| UNITHROID 25 MCG TABLET | 2021-02 | 45,504 | $0.32 | $0.22 | No | Yes |
| UNITHROID 50 MCG TABLET | 2021-02 | 60 | $0.37 | $0.23 | No | No |
| UNITHROID 50 MCG TABLET | 2021-02 | 44,910 | $0.39 | $0.23 | No | Yes |
| UNITHROID 75 MCG TABLET | 2021-02 | 150 | $0.38 | $0.26 | No | No |
| UNITHROID 75 MCG TABLET | 2021-02 | 62,054 | $0.40 | $0.26 | No | Yes |
| UNITHROID 75 MCG TABLET | 2021-02 | 180 | $0.43 | $0.26 | Yes | No |
| UNITHROID 88 MCG TABLET | 2021-02 | 160 | $0.42 | $0.26 | No | No |
| UNITHROID 88 MCG TABLET | 2021-02 | 61,722 | $0.56 | $0.26 | No | Yes |
| VAGIFEM 10 MCG VAGINAL TAB | 2021-02 | 3,168 | $20.51 | $14.22 | No | Yes |
| VANIQA 13.9% CREAM | 2021-02 | 180 | $4.21 | $3.53 | No | No |
| VIAGRA 100 MG TABLET | 2021-02 | 3,312 | $53.06 | $75.46 | No | Yes |
| VIMOVO DR 500-20 MG TABLET | 2021-02 | 60 | $38.95 | $15.85 | No | No |
| VIMPAT 200 MG TABLET | 2021-02 | 23,760 | $13.90 | $15.82 | Yes | Yes |
| VRAYLAR 6 MG CAPSULE | 2021-02 | 330 | $33.16 | $40.52 | No | No |
| XOFLUZA 40 MG TAB (80 MG DOSE) | 2021-02 | 4 | $65.50 | $73.54 | No | No |
| XOPENEX HFA 45 MCG INHALER | 2021-02 | 15 | $3.64 | $4.35 | No | No |
| XTAMPZA ER 13.5 MG CAPSULE | 2021-02 | 176 | $6.72 | $7.59 | No | No |
| ZOHYDRO ER 15 MG CAPSULE | 2021-02 | 8,330 | $9.90 | $7.76 | No | Yes |
| ZOLOFT 100 MG TABLET | 2021-02 | 90 | $10.90 | $0.06 | No | No |
| ACIPHEX DR 20 MG TABLET | 2021-03 | 20,880 | $14.51 | $16.76 | No | Yes |
| ADDERALL XR 15 MG CAPSULE | 2021-03 | 7,110 | $6.82 | $0.66 | No | Yes |
| AKLIEF 0.005% CREAM | 2021-03 | 16,380 | $11.08 | $12.42 | No | Yes |
| ALBUTEROL HFA 90 MCG INHALER | 2021-03 | 2,006 | $5.09 | $3.78 | Yes | No |
| ALBUTEROL HFA 90 MCG INHALER | 2021-03 | 9,290.50 | $5.25 | $3.82 | Yes | Yes |
| ATRIPLA TABLET | 2021-03 | 90 | $84.58 | $72.62 | No | No |
| ATRIPLA TABLET | 2021-03 | 34,680 | $92.74 | $77.04 | No | Yes |
| ATRIPLA TABLET | 2021-03 | 22,800 | $102.28 | $92.34 | Yes | Yes |
| BANZEL 40 MG/ML SUSPENSION | 2021-03 | 106,720 | $1.85 | $3.23 | No | Yes |
| BEPREVE 1.5% EYE DROPS | 2021-03 | 10 | $51.06 | $46.33 | No | No |
| BEYAZ 28 TABLET | 2021-03 | 84 | $6.96 | $7.94 | No | No |
| BREZTRI AEROSPHERE INHALER | 2021-03 | 117.70 | $47.69 | $53.07 | No | No |
| BUTRANS 15 MCG/HR PATCH | 2021-03 | 928 | $114.58 | $93.65 | No | Yes |
| BUTRANS 5 MCG/HR PATCH | 2021-03 | 1,056 | $65.30 | $47.02 | No | Yes |
| BYSTOLIC 2.5 MG TABLET | 2021-03 | 11,880 | $4.44 | $5.05 | Yes | Yes |
| BYSTOLIC 5 MG TABLET | 2021-03 | 35,730 | $4.48 | $5.05 | Yes | Yes |
| CARAFATE 1 GM/10 ML SUSP | 2021-03 | 840 | $0.47 | $0.53 | No | Yes |
| CARVEDILOL ER 20 MG CAPSULE | 2021-03 | 90 | $4.80 | $5.96 | Yes | No |
| CARVEDILOL ER 20 MG CAPSULE | 2021-03 | 3,960 | $6.73 | $5.97 | Yes | Yes |
| CEPACOL SORE THROAT LOZENGE | 2021-03 | 16 | $0.17 | $0.15 | No | No |
| CETIRIZINE HCL 1 MG/ML SYRUP | 2021-03 | 39,600 | $0.06 | $0.02 | No | Yes |
| CHILD DELSYM COUGH 30 MG/5 ML | 2021-03 | 237 | $0.14 | $0.08 | No | No |
| CIPRODEX OTIC SUSPENSION | 2021-03 | 1,740 | $14.67 | $31.84 | No | Yes |
| CITRANATAL DHA PACK | 2021-03 | 7,920 | $2.06 | $1.85 | No | Yes |
| COLACE-T 100 MG CAPSULE | 2021-03 | 40 | $0.02 | $0.02 | No | No |
| COSOPT PF EYE DROPS | 2021-03 | 360 | $2.34 | $2.65 | No | No |
| COSOPT PF EYE DROPS | 2021-03 | 41,760 | $2.32 | $2.65 | No | Yes |
| COSOPT PF EYE DROPS | 2021-03 | 7,380 | $2.48 | $1.76 | Yes | Yes |
| COZAAR 50 MG TABLET | 2021-03 | 13,110 | $3.42 | $2.74 | No | Yes |
| CRESTOR 10 MG TABLET | 2021-03 | 120 | $8.56 | $4.44 | No | No |
| CYTOMEL 5 MCG TABLET | 2021-03 | 137,304 | $1.89 | $1.68 | No | Yes |
| DELESTROGEN 100 MG/5 ML VIAL | 2021-03 | 5 | $32.17 | $19.20 | No | No |
| DELSYM 30 MG/5 ML SUSPENSION | 2021-03 | 788 | $0.15 | $0.09 | No | No |
| DEPO-TESTOSTERONE 200 MG/ML | 2021-03 | 2,080 | $19.70 | $16.88 | No | Yes |
| DILANTIN 100 MG CAPSULE | 2021-03 | 180 | $0.84 | $1.37 | No | No |
| DILANTIN 100 MG CAPSULE | 2021-03 | 270 | $1.28 | $0.17 | Yes | No |
| DOVATO 50-300 MG TABLET | 2021-03 | 270 | $71.89 | $81.35 | No | No |
| ELESTRIN 0.06% GEL | 2021-03 | 30,524 | $4.05 | $3.09 | No | Yes |
| ELESTRIN 0.06% GEL | 2021-03 | 36,192 | $4.22 | $3.09 | Yes | Yes |
| ELIDEL 1% CREAM | 2021-03 | 90 | $9.38 | $7.37 | No | No |
| ELIDEL 1% CREAM | 2021-03 | 136,500 | $9.49 | $7.07 | No | Yes |
| ESTRADIOL 0.05 MG PATCH (1/WK) | 2021-03 | 8,032 | $15.63 | $12.80 | Yes | Yes |
| ESTRADIOL 0.1 MG PATCH (1/WK) | 2021-03 | 24 | $16.50 | $12.91 | Yes | No |
| ETONOGESTREL-EE VAGINAL RING | 2021-03 | 7,462 | $128.69 | $110.39 | Yes | Yes |
| EVAMIST 1.53 MG/SPRAY | 2021-03 | 32.40 | $13.80 | $15.41 | No | No |
| EVEKEO 10 MG TABLET | 2021-03 | 27,720 | $6.65 | $2.62 | No | Yes |
| FETZIMA ER 20 MG CAPSULE | 2021-03 | 20,880 | $11.98 | $13.83 | No | Yes |
| FLECTOR 1.3% PATCH | 2021-03 | 60 | $11.91 | $9.60 | No | Yes |
| FLOVENT 100 MCG DISKUS | 2021-03 | 23,760 | $2.79 | $3.18 | Yes | Yes |
| FLUCONAZOLE 150 MG TABLET | 2021-03 | 396 | $1.95 | $1.08 | No | Yes |
| FLUTICASONE-SALMETEROL 100-50 | 2021-03 | 23,760 | $3.00 | $2.13 | Yes | Yes |
| FOCALIN 10 MG TABLET | 2021-03 | 45 | $0.11 | $0.28 | No | No |
| GLATIRAMER 40 MG/ML SYRINGE | 2021-03 | 60 | $363.86 | $125.47 | Yes | No |
| GLATIRAMER 40 MG/ML SYRINGE | 2021-03 | 1,584 | $262.15 | $125.47 | Yes | Yes |
| GLEEVEC 400 MG TABLET | 2021-03 | 18,840 | $346.46 | $43.38 | Yes | Yes |
| HUMULIN 70-30 VIAL | 2021-03 | 80 | $12.50 | $14.30 | Yes | No |
| HUMULIN N 100 UNIT/ML VIAL | 2021-03 | 70 | $11.64 | $14.33 | Yes | No |
| HUMULIN R 100 UNIT/ML VIAL | 2021-03 | 660 | $12.65 | $14.30 | No | No |
| HUMULIN R 100 UNIT/ML VIAL | 2021-03 | 100 | $12.46 | $14.30 | Yes | No |
| HYSINGLA ER 40 MG TABLET | 2021-03 | 7,920 | $16.45 | $19.61 | No | Yes |
| INVEGA SUSTENNA 78 MG/0.5 ML | 2021-03 | 0.50 | $2,453.90 | $1,886.45 | No | No |
| INVOKANA 300 MG TABLET | 2021-03 | 11,880 | $15.27 | $17.38 | Yes | Yes |
| ISENTRESS 400 MG TABLET | 2021-03 | 600 | $23.35 | $28.07 | No | No |
| KLOR-CON 20 MEQ PACKET | 2021-03 | 150 | $4.40 | $2.22 | No | No |
| KLOR-CON 20 MEQ PACKET | 2021-03 | 14,586 | $3.02 | $2.44 | No | Yes |
| KLOR-CON M10 TABLET | 2021-03 | 703 | $0.33 | $0.27 | No | No |
| KLOR-CON M10 TABLET | 2021-03 | 348,216 | $0.34 | $0.27 | No | Yes |
| KLOR-CON M20 TABLET | 2021-03 | 3,360 | $0.31 | $0.24 | No | No |
| KLOR-CON M20 TABLET | 2021-03 | 806,129 | $0.39 | $0.24 | No | Yes |
| KLOR-CON M20 TABLET | 2021-03 | 2,970 | $0.35 | $0.24 | Yes | No |
| KLOR-CON M20 TABLET | 2021-03 | 300,330 | $0.41 | $0.24 | Yes | Yes |
| LAMICTAL ODT 200 MG TABLET | 2021-03 | 59,400 | $13.14 | $15.19 | No | Yes |
| LANTUS 100 UNIT/ML VIAL | 2021-03 | 500 | $21.48 | $27.20 | No | No |
| LATISSE 0.03% EYELASH SOLUTION | 2021-03 | 6 | $48.86 | $41.50 | No | No |
| LEVEMIR 100 UNIT/ML VIAL | 2021-03 | 430 | $23.39 | $29.57 | No | No |
| LEVOTHYROXINE 100 MCG TABLET | 2021-03 | 461,850 | $0.39 | $0.26 | Yes | Yes |
| LEVOTHYROXINE 112 MCG TABLET | 2021-03 | 255,150 | $0.45 | $0.30 | Yes | Yes |
| LEVOTHYROXINE 125 MCG TABLET | 2021-03 | 467,466 | $0.44 | $0.31 | Yes | Yes |
| LEVOTHYROXINE 137 MCG TABLET | 2021-03 | 150,918 | $0.47 | $0.33 | Yes | Yes |
| LEVOTHYROXINE 150 MCG TABLET | 2021-03 | 2,165 | $0.36 | $0.31 | Yes | No |
| LEVOTHYROXINE 150 MCG TABLET | 2021-03 | 281,862 | $0.47 | $0.31 | Yes | Yes |
| LEVOTHYROXINE 175 MCG TABLET | 2021-03 | 1,434 | $0.30 | $0.39 | Yes | No |
| LEVOTHYROXINE 175 MCG TABLET | 2021-03 | 119,160 | $0.58 | $0.41 | Yes | Yes |
| LEVOTHYROXINE 200 MCG TABLET | 2021-03 | 1,165 | $0.33 | $0.41 | Yes | No |
| LEVOTHYROXINE 200 MCG TABLET | 2021-03 | 99,540 | $0.56 | $0.41 | Yes | Yes |
| LEVOTHYROXINE 25 MCG TABLET | 2021-03 | 135,270 | $0.30 | $0.21 | Yes | Yes |
| LEVOTHYROXINE 300 MCG TABLET | 2021-03 | 180 | $0.78 | $0.47 | Yes | No |
| LEVOTHYROXINE 50 MCG TABLET | 2021-03 | 7,109 | $0.24 | $0.22 | Yes | No |
| LEVOTHYROXINE 50 MCG TABLET | 2021-03 | 601,110 | $0.34 | $0.22 | Yes | Yes |
| LEVOTHYROXINE 75 MCG TABLET | 2021-03 | 6,429 | $0.26 | $0.23 | Yes | No |
| LEVOTHYROXINE 75 MCG TABLET | 2021-03 | 679,418 | $0.40 | $0.23 | Yes | Yes |
| LEVOTHYROXINE 88 MCG TABLET | 2021-03 | 320,130 | $0.39 | $0.25 | Yes | Yes |
| LEVOXYL 100 MCG TABLET | 2021-03 | 210 | $0.64 | $0.26 | No | No |
| LEVOXYL 100 MCG TABLET | 2021-03 | 48,266 | $0.74 | $0.26 | No | Yes |
| LEVOXYL 100 MCG TABLET | 2021-03 | 90 | $0.40 | $0.26 | Yes | No |
| LEVOXYL 100 MCG TABLET | 2021-03 | 22,272 | $0.40 | $0.26 | Yes | Yes |
| LEVOXYL 112 MCG TABLET | 2021-03 | 33,990 | $0.87 | $0.30 | No | Yes |
| LEVOXYL 112 MCG TABLET | 2021-03 | 11,880 | $0.47 | $0.30 | Yes | Yes |
| LEVOXYL 125 MCG TABLET | 2021-03 | 62,456 | $0.80 | $0.31 | No | Yes |
| LEVOXYL 137 MCG TABLET | 2021-03 | 120 | $1.02 | $0.31 | No | No |
| LEVOXYL 137 MCG TABLET | 2021-03 | 36,720 | $0.81 | $0.32 | No | Yes |
| LEVOXYL 137 MCG TABLET | 2021-03 | 180 | $0.96 | $0.34 | Yes | No |
| LEVOXYL 150 MCG TABLET | 2021-03 | 14,880 | $0.76 | $0.30 | No | Yes |
| LEVOXYL 175 MCG TABLET | 2021-03 | 15,840 | $1.18 | $0.39 | No | Yes |
| LEVOXYL 200 MCG TABLET | 2021-03 | 6,960 | $1.25 | $0.40 | No | Yes |
| LEVOXYL 200 MCG TABLET | 2021-03 | 270 | $1.16 | $0.42 | Yes | No |
| LEVOXYL 25 MCG TABLET | 2021-03 | 30 | $0.70 | $0.21 | No | No |
| LEVOXYL 25 MCG TABLET | 2021-03 | 18,360 | $0.39 | $0.20 | No | Yes |
| LEVOXYL 25 MCG TABLET | 2021-03 | 90 | $0.63 | $0.21 | Yes | No |
| LEVOXYL 50 MCG TABLET | 2021-03 | 90 | $0.78 | $0.21 | No | No |
| LEVOXYL 50 MCG TABLET | 2021-03 | 18,840 | $0.72 | $0.21 | No | Yes |
| LEVOXYL 50 MCG TABLET | 2021-03 | 270 | $0.71 | $0.21 | Yes | No |
| LEVOXYL 75 MCG TABLET | 2021-03 | 90 | $0.81 | $0.24 | No | No |
| LEVOXYL 75 MCG TABLET | 2021-03 | 28,530 | $0.52 | $0.23 | No | Yes |
| LEVOXYL 75 MCG TABLET | 2021-03 | 3,690 | $0.42 | $0.23 | Yes | Yes |
| LEVOXYL 88 MCG TABLET | 2021-03 | 60 | $0.66 | $0.25 | No | No |
| LEVOXYL 88 MCG TABLET | 2021-03 | 58,830 | $0.77 | $0.25 | No | Yes |
| LEVOXYL 88 MCG TABLET | 2021-03 | 90 | $0.80 | $0.25 | Yes | No |
| LEVOXYL 88 MCG TABLET | 2021-03 | 11,880 | $0.40 | $0.25 | Yes | Yes |
| LIALDA DR 1.2 GM TABLET | 2021-03 | 49,440 | $7.20 | $8.96 | No | Yes |
| LIDODERM 5% PATCH | 2021-03 | 3,960 | $2.64 | $21.02 | No | Yes |
| LOTEMAX 0.5% EYE DROPS | 2021-03 | 410 | $48.61 | $43.11 | No | Yes |
| LUMIFY 0.025% EYE DROP | 2021-03 | 5 | $3.58 | $2.98 | No | No |
| LYRICA 150 MG CAPSULE | 2021-03 | 90 | $6.24 | $8.24 | No | No |
| MEDROL 4 MG DOSEPAK | 2021-03 | 7,644 | $0.32 | $0.29 | No | Yes |
| MINASTRIN 24 FE CHEWABLE TAB | 2021-03 | 10,192 | $6.11 | $4.15 | No | Yes |
| MINIVELLE 0.05 MG PATCH | 2021-03 | 6,264 | $19.57 | $16.19 | No | Yes |
| MIRVASO 0.33% GEL PUMP | 2021-03 | 30 | $19.98 | $16.80 | No | No |
| MUCINEX D ER 600-60 MG TABLET | 2021-03 | 72 | $0.83 | $0.43 | No | No |
| MUCINEX D ER 600-60 MG TABLET | 2021-03 | 28 | $1.20 | $0.43 | No | Yes |
| MUCINEX DM ER 1,200-60 MG TAB | 2021-03 | 70 | $1.12 | $0.86 | No | No |
| MUCINEX DM ER 600-30 MG TABLET | 2021-03 | 154 | $0.76 | $0.41 | No | No |
| MUCINEX ER 1,200 MG TABLET | 2021-03 | 98 | $1.23 | $0.76 | No | No |
| MUCINEX ER 600 MG TABLET | 2021-03 | 330 | $0.62 | $0.35 | No | No |
| MYFORTIC 180 MG TABLET | 2021-03 | 120 | $5.83 | $1.01 | No | No |
| NEXIUM DR 40 MG CAPSULE | 2021-03 | 180 | $9.84 | $8.81 | No | No |
| NORVIR 100 MG TABLET | 2021-03 | 60 | $1.14 | $8.39 | No | No |
| NORVIR 100 MG TABLET | 2021-03 | 1,230 | $8.27 | $1.43 | No | Yes |
| NUCYNTA 75 MG TABLET | 2021-03 | 180 | $7.21 | $8.58 | No | No |
| NUCYNTA ER 250 MG TABLET | 2021-03 | 2,460 | $25.19 | $30.02 | No | Yes |
| OXYCONTIN ER 15 MG TABLET | 2021-03 | 4,920 | $5.25 | $6.27 | No | Yes |
| OXYCONTIN ER 30 MG TABLET | 2021-03 | 406 | $9.61 | $11.07 | No | No |
| OXYTROL FOR WOMEN 3.9 MG/24HR | 2021-03 | 8 | $3.14 | $2.73 | No | No |
| PACERONE 100 MG TABLET | 2021-03 | 90 | $5.51 | $1.51 | Yes | No |
| PATADAY ONCE DAILY 0.7% DROPS | 2021-03 | 10 | $7.59 | $6.10 | No | No |
| PAXIL CR 12.5 MG TABLET | 2021-03 | 13,920 | $6.84 | $0.94 | No | Yes |
| PAZEO 0.7% EYE DROPS | 2021-03 | 2.50 | $93.67 | $78.95 | No | No |
| PENNSAID 2% PUMP | 2021-03 | 336 | $18.53 | $21.29 | No | No |
| PLAVIX 75 MG TABLET | 2021-03 | 3,960 | $0.52 | $0.06 | No | Yes |
| PRALUENT 75 MG/ML PEN | 2021-03 | 2 | $449.90 | $540.47 | No | No |
| PREMARIN 0.9 MG TABLET | 2021-03 | 90 | $4.21 | $5.95 | No | No |
| PREZISTA 600 MG TABLET | 2021-03 | 60 | $15.87 | $29.89 | No | No |
| PROAIR HFA 90 MCG INHALER | 2021-03 | 59.50 | $5.90 | $5.04 | No | No |
| PROAIR HFA 90 MCG INHALER | 2021-03 | 25.50 | $7.13 | $3.82 | Yes | No |
| PROCTOSOL-HC 2.5% CREAM | 2021-03 | 7,702.20 | $0.53 | $0.37 | No | Yes |
| PROGRAF 1 MG CAPSULE | 2021-03 | 315,700 | $5.38 | $6.00 | No | Yes |
| PROLIA 60 MG/ML SYRINGE | 2021-03 | 1,160 | $1,439.02 | $1,307.50 | Yes | Yes |
| PROPECIA 1 MG TABLET | 2021-03 | 180 | $3.53 | $3.19 | No | No |
| PROVENTIL HFA 90 MCG INHALER | 2021-03 | 20.10 | $9.88 | $11.39 | No | No |
| RASUVO 20 MG/0.4 ML AUTOINJ | 2021-03 | 422.40 | $265.76 | $300.42 | Yes | Yes |
| RASUVO 25 MG/0.5 ML AUTOINJ | 2021-03 | 792 | $207.80 | $237.63 | Yes | Yes |
| REFRESH CELLUVISC 1% EYE DROPS | 2021-03 | 30 | $0.37 | $0.33 | No | No |
| REFRESH OPTIVE MEGA-3 DROPS | 2021-03 | 30 | $0.49 | $0.40 | No | No |
| RENVELA 800 MG TABLET | 2021-03 | 43,560 | $0.39 | $0.28 | No | Yes |
| SILENOR 6 MG TABLET | 2021-03 | 3,960 | $2.50 | $7.21 | No | Yes |
| STEGLUJAN 15-100 MG TABLET | 2021-03 | 60 | $15.64 | $17.59 | No | No |
| STRATTERA 60 MG CAPSULE | 2021-03 | 3,960 | $0.35 | $1.81 | No | Yes |
| SUBOXONE 2 MG-0.5 MG SL FILM | 2021-03 | 41,830 | $4.63 | $3.99 | No | Yes |
| SUBOXONE 4 MG-1 MG SL FILM | 2021-03 | 120 | $7.79 | $4.79 | No | No |
| SUBOXONE 8 MG-2 MG SL FILM | 2021-03 | 341 | $8.45 | $5.86 | No | No |
| SUBOXONE 8 MG-2 MG SL FILM | 2021-03 | 206,213 | $8.49 | $7.68 | No | Yes |
| SUMATRIPTAN SUCC 50 MG TABLET | 2021-03 | 27 | $1.78 | $0.57 | No | Yes |
| SYNJARDY XR 10-1,000 MG TABLET | 2021-03 | 180 | $15.29 | $17.55 | No | No |
| SYNJARDY XR 5-1,000 MG TABLET | 2021-03 | 330 | $7.76 | $8.74 | No | No |
| SYNTHROID 112 MCG TABLET | 2021-03 | 2,175 | $1.30 | $1.11 | No | No |
| SYNTHROID 112 MCG TABLET | 2021-03 | 969 | $1.23 | $1.11 | Yes | No |
| SYNTHROID 137 MCG TABLET | 2021-03 | 1,305 | $1.32 | $1.13 | No | No |
| SYNTHROID 150 MCG TABLET | 2021-03 | 1,742 | $1.30 | $1.03 | No | No |
| SYNTHROID 150 MCG TABLET | 2021-03 | 720 | $1.22 | $0.91 | Yes | No |
| SYNTHROID 175 MCG TABLET | 2021-03 | 1,236 | $1.28 | $1.09 | No | No |
| SYNTHROID 25 MCG TABLET | 2021-03 | 810 | $1.32 | $0.89 | No | No |
| SYNTHROID 50 MCG TABLET | 2021-03 | 1,730 | $1.30 | $1.02 | No | No |
| SYNTHROID 50 MCG TABLET | 2021-03 | 360 | $1.22 | $0.76 | Yes | No |
| SYNTHROID 75 MCG TABLET | 2021-03 | 2,271 | $1.30 | $1.03 | No | No |
| SYNTHROID 88 MCG TABLET | 2021-03 | 2,031 | $1.31 | $1.14 | No | No |
| SYNTHROID 88 MCG TABLET | 2021-03 | 255 | $1.22 | $0.78 | Yes | No |
| TIROSINT 50 MCG CAPSULE | 2021-03 | 150 | $3.84 | $4.27 | No | No |
| TOBREX 0.3% EYE OINTMENT | 2021-03 | 3.50 | $44.57 | $58.70 | No | No |
| TOBREX 0.3% EYE OINTMENT | 2021-03 | 3.50 | $46.49 | $58.70 | No | Yes |
| TOVIAZ ER 4 MG TABLET | 2021-03 | 30 | $8.69 | $11.47 | No | Yes |
| TRI-LUMA CREAM | 2021-03 | 120 | $7.69 | $6.47 | No | No |
| TRIJARDY XR 12.5-2.5-1,000 MG | 2021-03 | 180 | $7.30 | $8.78 | No | No |
| ULORIC 40 MG TABLET | 2021-03 | 17,880 | $10.17 | $7.74 | No | Yes |
| UNITHROID 88 MCG TABLET | 2021-03 | 131 | $0.48 | $0.25 | No | No |
| UNITHROID 88 MCG TABLET | 2021-03 | 68,448 | $0.35 | $0.25 | No | Yes |
| UNITHROID 88 MCG TABLET | 2021-03 | 11,880 | $0.40 | $0.25 | Yes | Yes |
| VAGIFEM 10 MCG VAGINAL TAB | 2021-03 | 32 | $19.72 | $15.53 | No | No |
| VAGIFEM 10 MCG VAGINAL TAB | 2021-03 | 2,112 | $20.45 | $15.45 | No | Yes |
| VANIQA 13.9% CREAM | 2021-03 | 45 | $4.21 | $3.53 | No | No |
| VIAGRA 100 MG TABLET | 2021-03 | 6 | $88.71 | $75.46 | No | No |
| VICTOZA 2-PAK 18 MG/3 ML PEN | 2021-03 | 2,376 | $95.19 | $108.34 | Yes | Yes |
| VIMOVO DR 500-20 MG TABLET | 2021-03 | 60 | $38.95 | $15.85 | No | No |
| VIVELLE-DOT 0.1 MG PATCH | 2021-03 | 5,024 | $15.44 | $12.94 | No | Yes |
| VYVANSE 40 MG CAPSULE | 2021-03 | 15,840 | $9.41 | $10.71 | Yes | Yes |
| WELLBUTRIN XL 300 MG TABLET | 2021-03 | 120 | $65.01 | $33.57 | No | No |
| XTAMPZA ER 13.5 MG CAPSULE | 2021-03 | 176 | $6.71 | $7.59 | No | No |
| ZERVIATE 0.24% EYE DROP | 2021-03 | 30 | $5.80 | $7.38 | No | No |
| ZETONNA 37 MCG NASAL SPRAY | 2021-03 | 6.10 | $40.87 | $34.30 | No | No |
| ZOHYDRO ER 15 MG CAPSULE | 2021-03 | 60 | $10.30 | $6.99 | No | No |
| ACIPHEX DR 20 MG TABLET | 2021-04 | 90 | $19.94 | $16.76 | No | No |
| ADDERALL XR 15 MG CAPSULE | 2021-04 | 11,040 | $6.83 | $2.92 | No | Yes |
| ADVAIR HFA 230-21 MCG INHALER | 2021-04 | 4,752 | $37.49 | $42.71 | Yes | Yes |
| ADZENYS XR-ODT 3.1 MG TABLET | 2021-04 | 60 | $12.46 | $13.88 | No | No |
| ALBUTEROL HFA 90 MCG INHALER | 2021-04 | 1,470.50 | $4.97 | $3.83 | Yes | No |
| ALPRAZOLAM 1 MG TABLET | 2021-04 | 660 | $0.04 | $0.03 | No | Yes |
| APLENZIN ER 348 MG TABLET | 2021-04 | 30 | $53.57 | $67.58 | No | No |
| ATRIPLA TABLET | 2021-04 | 23,760 | $86.31 | $75.37 | No | Yes |
| AZOPT 1% EYE DROPS | 2021-04 | 5,960 | $26.87 | $32.92 | No | Yes |
| BANZEL 40 MG/ML SUSPENSION | 2021-04 | 106,720 | $1.85 | $3.23 | No | Yes |
| BANZEL 400 MG TABLET | 2021-04 | 420 | $22.47 | $25.30 | No | No |
| BEPREVE 1.5% EYE DROPS | 2021-04 | 25 | $51.12 | $46.33 | No | No |
| BREO ELLIPTA 100-25 MCG INH | 2021-04 | 160,560 | $4.91 | $5.96 | Yes | Yes |
| BROVANA 15 MCG/2 ML SOLUTION | 2021-04 | 120 | $7.12 | $9.00 | No | No |
| CAPLYTA 42 MG CAPSULE | 2021-04 | 90 | $40.10 | $44.60 | No | No |
| CARAFATE 1 GM/10 ML SUSP | 2021-04 | 238,580 | $0.47 | $0.53 | No | Yes |
| CARVEDILOL ER 20 MG CAPSULE | 2021-04 | 11,880 | $6.73 | $5.97 | Yes | Yes |
| CEFDINIR 300 MG CAPSULE | 2021-04 | 820 | $0.70 | $0.49 | No | Yes |
| CELEBREX 200 MG CAPSULE | 2021-04 | 10,380 | $12.91 | $8.28 | No | Yes |
| CEPHALEXIN 500 MG CAPSULE | 2021-04 | 9,280 | $0.28 | $0.12 | No | Yes |
| CHILD DELSYM COUGH 30 MG/5 ML | 2021-04 | 626 | $0.14 | $0.09 | No | No |
| CHILD'S ALAWAY 0.025% EYE DROP | 2021-04 | 15 | $1.23 | $1.50 | No | No |
| CIALIS 5 MG TABLET | 2021-04 | 30 | $13.52 | $11.39 | No | No |
| CITRANATAL DHA PACK | 2021-04 | 7,920 | $2.06 | $1.85 | No | Yes |
| CLIMARA 0.05 MG/DAY PATCH | 2021-04 | 1,584 | $32.30 | $11.90 | No | Yes |
| COLACE 100 MG CAPSULE | 2021-04 | 120 | $0.02 | $0.02 | No | No |
| COLACE-T 100 MG CAPSULE | 2021-04 | 10 | $0.02 | $0.03 | No | No |
| COLCRYS 0.6 MG TABLET | 2021-04 | 90 | $4.26 | $2.95 | No | No |
| CONCERTA ER 27 MG TABLET | 2021-04 | 9,150 | $10.41 | $11.82 | No | Yes |
| CONTRAVE ER 8-90 MG TABLET | 2021-04 | 5,395 | $2.70 | $2.42 | No | No |
| COSOPT PF EYE DROPS | 2021-04 | 7,380 | $2.32 | $2.65 | No | Yes |
| COZAAR 50 MG TABLET | 2021-04 | 1,230 | $3.58 | $0.09 | No | Yes |
| CYCLOSET 0.8 MG TABLET | 2021-04 | 810 | $3.72 | $4.63 | No | No |
| CYTOMEL 5 MCG TABLET | 2021-04 | 120,000 | $1.90 | $1.57 | No | Yes |
| DELSYM 30 MG/5 ML SUSPENSION | 2021-04 | 625 | $0.11 | $0.08 | No | No |
| DELSYM 30 MG/5 ML SUSPENSION | 2021-04 | 89 | $0.16 | $0.09 | Yes | No |
| DEPO-TESTOSTERONE 100 MG/ML VL | 2021-04 | 2,320 | $7.51 | $6.15 | No | Yes |
| DEPO-TESTOSTERONE 200 MG/ML | 2021-04 | 2,376 | $17.18 | $13.43 | No | Yes |
| DEPO-TESTOSTERONE 200 MG/ML | 2021-04 | 1,584 | $18.90 | $16.99 | Yes | Yes |
| DEXILANT DR 30 MG CAPSULE | 2021-04 | 180 | $11.02 | $9.85 | No | No |
| DROSP-EE-LEVOMEF 3-0.02-0.451 | 2021-04 | 1,064 | $4.38 | $3.89 | Yes | No |
| EFFEXOR XR 75 MG CAPSULE | 2021-04 | 90 | $14.20 | $0.13 | No | No |
| EFFEXOR XR 75 MG CAPSULE | 2021-04 | 3,690 | $13.49 | $15.58 | No | Yes |
| ELESTRIN 0.06% GEL | 2021-04 | 78 | $3.88 | $3.09 | No | No |
| ELESTRIN 0.06% GEL | 2021-04 | 45,188 | $4.16 | $3.09 | No | Yes |
| ELIDEL 1% CREAM | 2021-04 | 122,580 | $9.69 | $7.85 | No | Yes |
| ENDOMETRIN 100 MG VAG INSERT | 2021-04 | 28 | $14.94 | $12.42 | No | No |
| ESTRACE 0.01% CREAM | 2021-04 | 7,352.50 | $7.32 | $6.32 | No | Yes |
| ESTRADIOL 0.0375MG PATCH(1/WK) | 2021-04 | 12 | $17.64 | $13.36 | Yes | No |
| ESTRADIOL 0.05 MG PATCH (1/WK) | 2021-04 | 4,152 | $16.29 | $12.40 | Yes | Yes |
| ESTRADIOL 0.1 MG PATCH (1/WK) | 2021-04 | 4,368 | $16.33 | $13.25 | Yes | Yes |
| ETONOGESTREL-EE VAGINAL RING | 2021-04 | 44 | $120.00 | $108.58 | Yes | No |
| ETONOGESTREL-EE VAGINAL RING | 2021-04 | 5,884 | $124.28 | $107.96 | Yes | Yes |
| EVAMIST 1.53 MG/SPRAY | 2021-04 | 24.30 | $13.92 | $15.58 | No | No |
| EVEKEO 10 MG TABLET | 2021-04 | 60 | $6.65 | $1.07 | No | No |
| EVEKEO 10 MG TABLET | 2021-04 | 27,720 | $6.55 | $0.92 | No | Yes |
| FLUCONAZOLE 150 MG TABLET | 2021-04 | 264 | $1.95 | $1.08 | No | Yes |
| FLUTICASONE-SALMETEROL 100-50 | 2021-04 | 23,760 | $3.00 | $2.13 | Yes | Yes |
| FLUTICASONE-SALMETEROL 250-50 | 2021-04 | 23,760 | $2.23 | $2.62 | Yes | Yes |
| GLATIRAMER 40 MG/ML SYRINGE | 2021-04 | 120 | $367.01 | $125.47 | Yes | No |
| GLATIRAMER 40 MG/ML SYRINGE | 2021-04 | 7,152 | $262.15 | $125.47 | Yes | Yes |
| GLEEVEC 400 MG TABLET | 2021-04 | 18,840 | $346.46 | $43.38 | Yes | Yes |
| GRALISE ER 600 MG TABLET | 2021-04 | 180 | $10.84 | $9.18 | No | No |
| HUMULIN R 100 UNIT/ML VIAL | 2021-04 | 2,640 | $11.52 | $14.30 | Yes | Yes |
| INVEGA SUSTENNA 78 MG/0.5 ML | 2021-04 | 0.50 | $2,453.90 | $1,886.45 | No | No |
| INVOKAMET 150-500 MG TABLET | 2021-04 | 180 | $6.50 | $8.68 | No | Yes |
| ISENTRESS 400 MG TABLET | 2021-04 | 448 | $23.41 | $28.07 | No | No |
| KLOR-CON 10 MEQ TABLET | 2021-04 | 77 | $0.25 | $0.16 | No | No |
| KLOR-CON 10 MEQ TABLET | 2021-04 | 66,864 | $0.22 | $0.16 | No | Yes |
| KLOR-CON 20 MEQ PACKET | 2021-04 | 60 | $4.09 | $2.65 | No | No |
| KLOR-CON 20 MEQ PACKET | 2021-04 | 23,098 | $3.07 | $2.67 | No | Yes |
| KLOR-CON M10 TABLET | 2021-04 | 1,174 | $0.29 | $0.27 | No | No |
| KLOR-CON M20 TABLET | 2021-04 | 3,195 | $0.35 | $0.24 | No | No |
| KLOR-CON M20 TABLET | 2021-04 | 956,498 | $0.34 | $0.24 | No | Yes |
| KLOR-CON M20 TABLET | 2021-04 | 3,600 | $0.36 | $0.24 | Yes | No |
| KLOR-CON M20 TABLET | 2021-04 | 306,450 | $0.41 | $0.24 | Yes | Yes |
| LEVEMIR 100 UNIT/ML VIAL | 2021-04 | 260 | $25.23 | $29.57 | No | No |
| LEVOTHYROXINE 100 MCG TABLET | 2021-04 | 454,888 | $0.37 | $0.27 | Yes | Yes |
| LEVOTHYROXINE 112 MCG TABLET | 2021-04 | 361,992 | $0.46 | $0.29 | Yes | Yes |
| LEVOTHYROXINE 125 MCG TABLET | 2021-04 | 3,285 | $0.26 | $0.30 | Yes | No |
| LEVOTHYROXINE 125 MCG TABLET | 2021-04 | 320,946 | $0.45 | $0.30 | Yes | Yes |
| LEVOTHYROXINE 137 MCG TABLET | 2021-04 | 168,030 | $0.48 | $0.31 | Yes | Yes |
| LEVOTHYROXINE 150 MCG TABLET | 2021-04 | 2,061 | $0.24 | $0.30 | Yes | No |
| LEVOTHYROXINE 150 MCG TABLET | 2021-04 | 244,217 | $0.48 | $0.30 | Yes | Yes |
| LEVOTHYROXINE 175 MCG TABLET | 2021-04 | 1,674 | $0.37 | $0.41 | Yes | No |
| LEVOTHYROXINE 175 MCG TABLET | 2021-04 | 83,756 | $0.58 | $0.41 | Yes | Yes |
| LEVOTHYROXINE 200 MCG TABLET | 2021-04 | 894 | $0.31 | $0.40 | Yes | No |
| LEVOTHYROXINE 200 MCG TABLET | 2021-04 | 48,330 | $0.55 | $0.40 | Yes | Yes |
| LEVOTHYROXINE 25 MCG TABLET | 2021-04 | 270,211 | $0.31 | $0.20 | Yes | Yes |
| LEVOTHYROXINE 300 MCG TABLET | 2021-04 | 11,880 | $0.62 | $0.47 | Yes | Yes |
| LEVOTHYROXINE 50 MCG TABLET | 2021-04 | 685,374 | $0.34 | $0.21 | Yes | Yes |
| LEVOTHYROXINE 75 MCG TABLET | 2021-04 | 6,141 | $0.27 | $0.23 | Yes | No |
| LEVOTHYROXINE 75 MCG TABLET | 2021-04 | 424,934 | $0.41 | $0.23 | Yes | Yes |
| LEVOTHYROXINE 88 MCG TABLET | 2021-04 | 3,090 | $0.28 | $0.25 | Yes | No |
| LEVOTHYROXINE 88 MCG TABLET | 2021-04 | 268,380 | $0.39 | $0.25 | Yes | Yes |
| LEVOXYL 100 MCG TABLET | 2021-04 | 27,198 | $0.52 | $0.26 | No | Yes |
| LEVOXYL 100 MCG TABLET | 2021-04 | 24,570 | $0.40 | $0.26 | Yes | Yes |
| LEVOXYL 112 MCG TABLET | 2021-04 | 30 | $1.04 | $0.30 | No | No |
| LEVOXYL 112 MCG TABLET | 2021-04 | 78,630 | $0.84 | $0.29 | No | Yes |
| LEVOXYL 112 MCG TABLET | 2021-04 | 90 | $0.93 | $0.29 | Yes | No |
| LEVOXYL 125 MCG TABLET | 2021-04 | 60 | $1.01 | $0.30 | No | No |
| LEVOXYL 125 MCG TABLET | 2021-04 | 32,760 | $0.77 | $0.30 | No | Yes |
| LEVOXYL 137 MCG TABLET | 2021-04 | 30 | $1.09 | $0.31 | No | No |
| LEVOXYL 137 MCG TABLET | 2021-04 | 5,544 | $0.89 | $0.31 | No | Yes |
| LEVOXYL 150 MCG TABLET | 2021-04 | 10,920 | $0.60 | $0.29 | No | Yes |
| LEVOXYL 175 MCG TABLET | 2021-04 | 7,888 | $1.24 | $0.41 | No | Yes |
| LEVOXYL 200 MCG TABLET | 2021-04 | 6,960 | $1.25 | $0.40 | No | Yes |
| LEVOXYL 25 MCG TABLET | 2021-04 | 30 | $0.70 | $0.19 | No | No |
| LEVOXYL 25 MCG TABLET | 2021-04 | 18,090 | $0.41 | $0.20 | No | Yes |
| LEVOXYL 50 MCG TABLET | 2021-04 | 120 | $0.75 | $0.22 | No | No |
| LEVOXYL 50 MCG TABLET | 2021-04 | 30,780 | $0.69 | $0.21 | No | Yes |
| LEVOXYL 50 MCG TABLET | 2021-04 | 90 | $0.35 | $0.21 | Yes | No |
| LEVOXYL 75 MCG TABLET | 2021-04 | 58,992 | $0.66 | $0.23 | No | Yes |
| LEVOXYL 75 MCG TABLET | 2021-04 | 84 | $0.79 | $0.24 | Yes | No |
| LEVOXYL 75 MCG TABLET | 2021-04 | 20,880 | $0.42 | $0.24 | Yes | Yes |
| LEVOXYL 88 MCG TABLET | 2021-04 | 210 | $0.64 | $0.25 | No | No |
| LEVOXYL 88 MCG TABLET | 2021-04 | 36,720 | $0.80 | $0.25 | No | Yes |
| LIALDA DR 1.2 GM TABLET | 2021-04 | 28,140 | $5.12 | $8.96 | No | Yes |
| LIDODERM 5% PATCH | 2021-04 | 7,920 | $1.84 | $2.16 | No | Yes |
| LIVALO 4 MG TABLET | 2021-04 | 540 | $9.07 | $10.22 | No | No |
| LUMIFY 0.025% EYE DROP | 2021-04 | 2.50 | $3.58 | $2.98 | No | No |
| LYRICA 50 MG CAPSULE | 2021-04 | 90 | $8.28 | $0.10 | No | No |
| MEDROL 4 MG DOSEPAK | 2021-04 | 25,032 | $0.35 | $0.29 | No | Yes |
| MEDROXYPROGESTERONE 150 MG/ML | 2021-04 | 232 | $36.10 | $32.78 | No | Yes |
| METHYLPREDNISOLONE 4 MG DOSEPK | 2021-04 | 2,772 | $0.29 | $0.20 | No | Yes |
| MINIVELLE 0.0375 MG PATCH | 2021-04 | 2,184 | $25.14 | $22.36 | No | Yes |
| MINIVELLE 0.05 MG PATCH | 2021-04 | 3,896 | $24.83 | $9.10 | No | Yes |
| MOVANTIK 25 MG TABLET | 2021-04 | 180 | $10.04 | $11.67 | No | No |
| MUCINEX D ER 600-60 MG TABLET | 2021-04 | 50 | $0.79 | $0.44 | No | No |
| MUCINEX DM ER 1,200-60 MG TAB | 2021-04 | 42 | $1.22 | $0.86 | No | No |
| MUCINEX DM ER 600-30 MG TABLET | 2021-04 | 140 | $0.82 | $0.38 | No | No |
| MUCINEX ER 1,200 MG TABLET | 2021-04 | 28 | $1.41 | $0.76 | No | No |
| MUCINEX ER 600 MG TABLET | 2021-04 | 358 | $0.66 | $0.31 | No | No |
| MUCINEX ER 600 MG TABLET | 2021-04 | 20 | $0.91 | $0.31 | No | Yes |
| MUCINEX ER 600 MG TABLET | 2021-04 | 30 | $0.37 | $0.31 | Yes | No |
| MYFORTIC 180 MG TABLET | 2021-04 | 120 | $5.83 | $0.91 | No | No |
| NAPHCON-A EYE DROPS | 2021-04 | 35 | $0.54 | $0.60 | No | No |
| NARCAN 4 MG NASAL SPRAY | 2021-04 | 56 | $48.36 | $59.94 | No | No |
| NASONEX 50 MCG NASAL SPRAY | 2021-04 | 17 | $12.06 | $2.34 | No | No |
| NORVIR 100 MG TABLET | 2021-04 | 60 | $1.14 | $8.31 | No | No |
| NORVIR 100 MG TABLET | 2021-04 | 1,230 | $8.27 | $1.21 | No | Yes |
| NOVOLOG 100 UNIT/ML FLEXPEN | 2021-04 | 180 | $32.00 | $35.74 | No | No |
| NUCYNTA 75 MG TABLET | 2021-04 | 90 | $6.53 | $8.58 | No | No |
| NUVIGIL 250 MG TABLET | 2021-04 | 60 | $23.44 | $29.85 | No | No |
| ONDANSETRON ODT 4 MG TABLET | 2021-04 | 2,784 | $0.55 | $0.23 | No | Yes |
| PACERONE 100 MG TABLET | 2021-04 | 11,880 | $3.93 | $1.68 | Yes | Yes |
| PENTASA 500 MG CAPSULE | 2021-04 | 990 | $5.11 | $5.83 | No | No |
| PLAVIX 75 MG TABLET | 2021-04 | 11,880 | $5.76 | $6.80 | No | Yes |
| PRED FORTE 1% EYE DROPS | 2021-04 | 1,570 | $30.20 | $9.48 | No | Yes |
| PREMARIN 0.625 MG TABLET | 2021-04 | 11,880 | $5.23 | $5.94 | Yes | Yes |
| PREZISTA 600 MG TABLET | 2021-04 | 120 | $22.88 | $29.89 | No | No |
| PROAIR HFA 90 MCG INHALER | 2021-04 | 6,264.50 | $2.12 | $7.54 | No | Yes |
| PROCTOSOL-HC 2.5% CREAM | 2021-04 | 56.70 | $0.87 | $0.36 | No | No |
| PROCTOSOL-HC 2.5% CREAM | 2021-04 | 13,537.20 | $0.64 | $0.36 | No | Yes |
| PROLIA 60 MG/ML SYRINGE | 2021-04 | 464 | $1,439.02 | $1,307.50 | Yes | Yes |
| PROMETHAZINE 25 MG TABLET | 2021-04 | 6,960 | $0.15 | $0.04 | No | Yes |
| REFRESH CELLUVISC 1% EYE DROPS | 2021-04 | 30 | $0.42 | $0.33 | No | No |
| RENVELA 800 MG TABLET | 2021-04 | 43,560 | $0.39 | $0.32 | No | Yes |
| RISPERDAL CONSTA 37.5 MG VIAL | 2021-04 | 2 | $911.32 | $765.48 | No | No |
| SAPHRIS 5 MG TAB SUBLINGUAL | 2021-04 | 3,960 | $3.50 | $4.11 | No | Yes |
| SAVELLA 25 MG TABLET | 2021-04 | 120 | $5.94 | $6.72 | No | No |
| SOLU-CORTEF 100 MG ACT-O-VIAL | 2021-04 | 5 | $17.60 | $14.79 | No | No |
| SOLU-CORTEF 100 MG VIAL | 2021-04 | 1 | $13.01 | $10.83 | No | No |
| SOOLANTRA 1% CREAM | 2021-04 | 13,725 | $11.13 | $13.32 | No | Yes |
| STEGLUJAN 15-100 MG TABLET | 2021-04 | 60 | $15.31 | $17.59 | No | No |
| STRATTERA 60 MG CAPSULE | 2021-04 | 3,960 | $0.35 | $1.58 | No | Yes |
| SUBOXONE 4 MG-1 MG SL FILM | 2021-04 | 120 | $7.79 | $6.69 | No | No |
| SUBOXONE 8 MG-2 MG SL FILM | 2021-04 | 393 | $7.91 | $5.58 | No | No |
| SYNJARDY 12.5-1,000 MG TABLET | 2021-04 | 120 | $7.85 | $8.80 | No | No |
| SYNJARDY XR 5-1,000 MG TABLET | 2021-04 | 240 | $7.44 | $8.74 | No | No |
| SYNTHROID 100 MCG TABLET | 2021-04 | 670 | $1.22 | $1.10 | Yes | No |
| SYNTHROID 112 MCG TABLET | 2021-04 | 2,743 | $1.28 | $0.99 | No | No |
| SYNTHROID 112 MCG TABLET | 2021-04 | 820 | $1.22 | $1.02 | Yes | No |
| SYNTHROID 137 MCG TABLET | 2021-04 | 1,244 | $1.31 | $1.19 | No | No |
| SYNTHROID 150 MCG TABLET | 2021-04 | 1,406 | $1.28 | $0.94 | No | No |
| SYNTHROID 175 MCG TABLET | 2021-04 | 1,059 | $1.33 | $1.09 | No | No |
| SYNTHROID 175 MCG TABLET | 2021-04 | 45 | $1.21 | $0.42 | Yes | No |
| SYNTHROID 200 MCG TABLET | 2021-04 | 1,021 | $1.31 | $1.15 | No | No |
| SYNTHROID 200 MCG TABLET | 2021-04 | 405 | $1.21 | $1.08 | Yes | No |
| SYNTHROID 25 MCG TABLET | 2021-04 | 1,125 | $1.30 | $1.03 | No | No |
| SYNTHROID 25 MCG TABLET | 2021-04 | 450 | $1.21 | $1.08 | Yes | No |
| SYNTHROID 50 MCG TABLET | 2021-04 | 1,950 | $1.31 | $1.00 | No | No |
| SYNTHROID 75 MCG TABLET | 2021-04 | 1,892 | $1.31 | $1.08 | No | No |
| SYNTHROID 88 MCG TABLET | 2021-04 | 270 | $1.22 | $0.95 | Yes | No |
| SYSTANE COMPLETE 0.6% EYE DROP | 2021-04 | 10 | $1.16 | $1.02 | No | No |
| TOBRADEX EYE OINTMENT | 2021-04 | 7 | $55.49 | $62.66 | No | No |
| TOVIAZ ER 8 MG TABLET | 2021-04 | 120 | $9.56 | $11.46 | No | Yes |
| TRANSDERM-SCOP 1.5 MG (1MG/3D) | 2021-04 | 1,320 | $3.70 | $14.52 | No | Yes |
| TRI-LUMA CREAM | 2021-04 | 210 | $7.69 | $6.47 | No | No |
| TRIJARDY XR 12.5-2.5-1,000 MG | 2021-04 | 60 | $7.64 | $8.78 | No | No |
| ULORIC 40 MG TABLET | 2021-04 | 31,800 | $9.94 | $7.67 | No | Yes |
| UNITHROID 88 MCG TABLET | 2021-04 | 597 | $0.33 | $0.25 | No | No |
| UNITHROID 88 MCG TABLET | 2021-04 | 180,450 | $0.34 | $0.25 | No | Yes |
| UNITHROID 88 MCG TABLET | 2021-04 | 84 | $0.65 | $0.25 | Yes | No |
| VAGIFEM 10 MCG VAGINAL TAB | 2021-04 | 4,224 | $19.77 | $15.69 | No | Yes |
| VANIQA 13.9% CREAM | 2021-04 | 45 | $4.21 | $3.53 | No | No |
| VIAGRA 100 MG TABLET | 2021-04 | 6,348 | $46.31 | $75.46 | No | Yes |
| VIMOVO DR 500-20 MG TABLET | 2021-04 | 60 | $38.95 | $16.28 | No | No |
| VIVELLE-DOT 0.075 MG PATCH | 2021-04 | 1,056 | $16.10 | $7.50 | No | Yes |
| VIVITROL 380 MG VIAL + DILUENT | 2021-04 | 232 | $1,503.89 | $1,366.73 | No | Yes |
| VRAYLAR 6 MG CAPSULE | 2021-04 | 210 | $32.97 | $40.52 | No | No |
| WELLBUTRIN XL 300 MG TABLET | 2021-04 | 180 | $66.80 | $33.57 | No | No |
| XIGDUO XR 10 MG-500 MG TABLET | 2021-04 | 60 | $14.97 | $17.05 | No | No |
| YAZ 28 TABLET | 2021-04 | 84 | $5.06 | $0.36 | No | No |
| ZERVIATE 0.24% EYE DROP | 2021-04 | 30 | $8.71 | $7.38 | No | No |
| ZOHYDRO ER 15 MG CAPSULE | 2021-04 | 60 | $10.30 | $6.99 | No | No |