| A-Spas | 1 | | |
| A/B Otic | 1 | | |
| Aber-Fed | 1 | | |
| Aber-Tuss DR | 1 | | |
| Aber-Tuss HC | 1 | | |
| Abilify | 3PA | | |
| Abilify Disc | 3PA | | |
| Acanya | 3PA | | |
| Accolate | 3 | 60 | |
| Accu-Chek Active Glucose Cont | 3 | | |
| Accu-Chek Active Strips | 3 | 150 | |
| Accu-Chek Advantage Control | 3 | | |
| Accu-Chek Advantage Test | 3 | 150 | |
| Accu-Chek Comfort Curve | 3 | 150 | |
| Accu-Chek Comfort Curve Linear | 3 | | |
| Accu-Chek Compact Glucose Cont | 3 | | |
| Accu-Chek Compact Strips | 3 | 150 | |
| Accu-Chek Compact Test Drum | 3 | 150 | |
| Accu-Chek Easy Glucose Control | 3 | | |
| Accu-Chek Easy Test | 3 | 150 | |
| Accu-Chek II/IIM/III Control | 3 | | |
| Accu-Chek Instant Control | 3 | | |
| Accu-Chek Instant Glucose Test | 3 | 150 | |
| Accu-Chek Instant Plus Test | 3 | 150 | |
| Accu-Chek S Controls | 3 | | |
| Accu-Chek Simplicity Test Strp | 3 | 150 | |
| Accu-Chek Softclix Lancet Dev | 2 | | |
| Accuhist DM Pediatric* | 3 | | |
| Accuhist DM* | 3 | | |
| Accuhist LA* | 3 | | |
| Accuhist PDX* | 3 | | |
| Accuhist* | 3 | | |
| AccuNeb* | 2 | | |
| Accupril* | 3 | 30 | |
| Accuretic* | 3 | 30 | |
| Accusure Insulin Syringe | 2 | | |
| Accutane* | 3 | | |
| Accuzyme SE | 3 | | |
| Accuzyme* | 3 | | |
| Acebutolol HCl | 1 | | |
| Aceon | 3 | | |
| Acetaminophen-Codeine | 1 | | |
| Acetaminophen-Codeine #2 | 1 | | |
| Acetaminophen-Codeine #4 | 1 | | |
| Acetasol HC | 1 | | |
| AcetaZOLAMIDE | 1 | | |
| Acetic Acid | 1 | | |
| Acetic Acid-Aluminum Acetate | 1 | | |
| Acetylcysteine | 1 | | |
| Acid Jelly | 3 | | |
| Acidic Vaginal Jelly | 1 | | |
| Aciphex | 3PA | 30 | ST |
| Aclovate* | 2 | | |
| Acticin | 1 | | |
| Actigall* | 3 | | |
| Actiq | 3PA | | |
| Active Test | 3 | 150 | |
| Activella | 3 | | |
| Actonel 150mg | 3 | 1 | |
| Actonel 35mg | 3 | 4 | |
| Actonel 5mg, 30mg | 3 | 30 | |
| Actonel 75mg | 3 | 2 | |
| Actonel with Calcium | 3 | | |
| ActoPlus Met | 2 | 60 | |
| Actos | 2 | 30 | |
| Acuflex | 3 | | |
| Acular | 3 | | |
| Acular LS | 3 | | |
| Acular PF | 3 | | |
| Acuvail 0.45% | 3 | | |
| Acyclovir | 1 | | |
| Aczone | 3PA | | |
| Adalat CC* | 2 | 30 | |
| Adcirca | - | | New to Market Policy |
| Adderall XR* | 3 | 60 | |
| Adderall* | 3 | | |
| Adjustable Lancing Device | 2 | | |
| Adoxa Pak 1/100* | 3 | | |
| Adoxa Pak 1/150* | 3 | | |
| Adoxa Pak 2/100* | 3 | | |
| Adoxa* | 3 | | |
| Adrenalin | 3 | | |
| Advair Diskus | 3 | | |
| Advair HFA | 3 | | |
| Advance Intuition Control | 3 | | |
| Advance Intuition Test | 3 | 150 | |
| Advance Micro-Draw Control | 3 | | |
| Advance Micro-Draw Normal | 3 | | |
| Advance Micro-Draw Test | 3 | 150 | |
| Advantage Control | 3 | | |
| Advicor | 3 | | |
| Aero Otic HC | 1 | | |
| Aerobid | 3 | | |
| Aerobid-M | 3 | | |
| Aerohist | 3 | | |
| Aerohist Plus | 1 | | |
| AeroKid* | 3 | | |
| Afeditab CR | 1 | 30 | |
| Afinitor | 3PA | | Specialty Pharmacy |
| Agenerase | 2 | | |
| Aggrenox | 3 | | |
| Agrylin* | 2PA | | |
| AH-Chew | 1 | | |
| AH-Chew D* | 3 | | |
| AH-Chew II | 3 | | |
| AH-Chew Susp | 3 | | |
| Aimsco Insulin Syringe | 2 | | |
| Aimsco Insulin Syringe Mx-Com | 2 | | |
| Aimsco Ultra Thin Lancets | 2 | | |
| Airet | 1 | | |
| AK-Con | 1 | | |
| AK-Dilate | 1 | | |
| AK-Pentolate | 1 | | |
| AK-Poly-Bac | 1 | | |
| AK-Pred | 1 | | |
| AK-Tob | 1 | | |
| Akineton | 3 | | |
| Akne-Mycin | 2 | | |
| Akorn Balanced Salt | 1 | | |
| Ala-Cort | 1 | | |
| Ala-Hist | 3 | | |
| Ala-Quin | 3 | | |
| Ala-Scalp | 3 | | |
| Alacol DM | 3 | | |
| Alamast | 3 | | |
| Alba-3 | 3 | | |
| Albalon* | 3 | | |
| Albatussin CF | 3 | | |
| Albatussin CF Pediatric | 3 | | |
| Albatussin DM Pediatric | 3 | | |
| Albatussin EX | 3 | | |
| Albatussin NN | 1 | | |
| Albatussin Pediatric Drops | 3 | | |
| Albatussin Pediatric Liqd | 1 | | |
| Albatussin Pediatric Syr | 3 | | |
| Albatussin SR | 3 | | |
| Albatussin SR F | 3 | | |
| Albenza | 3 | | |
| Albertsons Insulin Syringe | 2 | | |
| Albertsons Niacin | 1 | | |
| Albertsons Niacin SA | 1 | | |
| Albertsons Test Strip | 3 | 150 | |
| Albertsons Ultra Thin Lancets | 2 | | |
| Albuterol | 1 | | |
| Albuterol Sulfate | 1 | | |
| Albuterol/Ipratrop Nebs | 1 | | |
| Alcet | 3 | | |
| Alclometasone Dipropionate | 1 | | |
| Alcortin | 3 | | |
| Aldactazide* | 3 | | |
| Aldactone* | 3 | | |
| Aldara | 3 | | 48 pkt per year |
| Aldex G | 3 | | |
| Aldex* | 3 | | |
| Aldoclor | 3 | | |
| Aldoril D30 | 3 | | |
| Aldoril D50 | 3 | | |
| Aldoril-15* | 3 | | |
| Aldoril-25* | 3 | | |
| Alendronate 35mg, 70mg | 1 | 4 | |
| Alendronate 5, 10, 40 | 1 | 30 | |
| Alesse (28)* | 3 | | |
| Alferon N | 3PA | | |
| Ali-flex | 1 | | |
| Alinia | 3 | | |
| Alkabel-SR | 1 | | |
| Alkeran | 3 | | |
| Allclenz | 3 | | |
| Allegra Susp | 3 | 150 | |
| Allegra ODT | 3 | 30 | |
| Allegra Tabs* | 3 | 30 | |
| Allegra-D 12 Hour* | 3 | 30 | |
| Allegra-D 24 Hour | 3 | 30 | |
| Allergen | 1 | | |
| AllerScript | 3 | | |
| Allersol | 1 | | |
| Allerx | 3 | | |
| Allerx DF | 3 | | |
| Allerx Dose Pack | 3 | | |
| Allerx-D* | 3 | | |
| Allfen | 3 | | |
| Allfen C | 3 | | |
| Allfen Jr* | 3 | | |
| Allfen-DM* | 3 | | |
| Allopurinol | 1 | | |
| Alocril | 3 | | |
| Alomide | 3 | | |
| Alora | 3 | 8 | |
| Alphagan P | 2 | | |
| AlphaTrex | 1 | | |
| Alprazolam | 1 | | |
| Alprazolam Intensol | 3 | | |
| Alprazolam XR* | 1 | 30 | |
| Alrex | 2 | | |
| Altabax | 3 | | |
| Altace | 3 | | |
| Altafrin | 1 | | |
| Altex-PSE | 1 | | |
| Altoprev | 3 | | |
| Aluminum Chloride Hexahydrate | 1 | | |
| Alupent | 3 | | |
| Alvesco | 3PA | | |
| Amantadine HCl | 1 | | |
| Amaryl* | 3 | | |
| Ambi 1000/55 | 1 | | |
| Ambi 45/800 | 1 | | |
| Ambi 45/800/30 | 1 | | |
| Ambi 5/15/100 | 3 | | |
| Ambi 60/580* | 3 | | |
| Ambi 60/580/30* | 3 | | |
| Ambi 80/700 | 1 | | |
| Ambi 80/700/40 | 1 | | |
| Ambi 80/780 | 1 | | |
| Ambi 80/780/40 | 1 | | |
| Ambien CR | 3PA | 9 | |
| Ambien* | 2 | 30 | |
| Ambifed-G | 3 | | |
| Ambifed-G DM | 3 | | |
| Amcinonide Crm, Lotn | 1 | | |
| Amcinonide Oint | 3 | | |
| Amdry-C | 1 | | |
| Amdry-D | 1 | | |
| Amerge | 3PA | 9 | |
| Americaine Anesthetic | 3 | | |
| Americet | 1 | | |
| Amerifed | 3 | | |
| Amerifed DM | 3 | | |
| Amerituss AD | 3 | | |
| Ames Gluco System | 2 | | |
| Ames Gluco System High Control | 3 | | |
| Ames Gluco System Low Control | 3 | | |
| Ames Gluco System Normal | 3 | | |
| Ami-Tex LA | 1 | | |
| Amibid DM | 1 | | |
| Amicar* | 3 | | |
| Amidal | 1 | | |
| Amidrine | 1 | | |
| Amigesic | 1 | | |
| Amiloride HCl | 1 | | |
| Amiloride-Hydrochlorothiazide | 1 | | |
| Amino Acid Cervical | 1 | | |
| Amino-Cerv* | 3 | | |
| Aminobenzoate Potassium | 1 | | |
| Aminocaproic Acid | 1 | | |
| Aminophylline | 1 | | |
| Amiodarone HCl | 1 | | |
| Amitex PSE | 1 | | |
| Amitiza | 3PA | | |
| Amitriptyline HCl | 1 | | |
| Amlodipine | 1 | 30 | |
| Amlodipine-Benazepril | 1 | | |
| Amnesteem | 1 | | |
| Amoclan | 1 | | |
| Amoxapine | 3 | | |
| Amoxicillin | 1 | | |
| Amoxicillin 400mg Chew | 3 | | |
| Amoxicillin-Pot Clavulanate | 1 | | |
| Amoxil* | 3 | | |
| Amphetamine Salt Combo | 1 | | |
| Ampicillin | 1 | | |
| Amrix | 3PA | | |
| Anabar | 3 | | |
| Anacaine | 3 | | |
| Anadrol | 3PA | | |
| Anafranil* | 3 | | |
| Anagrelide HCl | 1PA | | |
| Analpram-HC* | 2 | | |
| AnaMantle HC Forte | 3 | | |
| AnaMantle HC* | 3 | | |
| Anaplex DM* | 3 | | |
| Anaplex DMX | 3 | | |
| Anaplex HD* | 3 | | |
| Anaprox DS* | 3 | | |
| Anaprox* | 3 | | |
| Anaspaz* | 3 | | |
| Ancobon | 3 | | |
| Andehist DM NR | 1 | | |
| Andehist NR | 1 | | |
| Androderm | 3 | 30 | |
| AndroGel | 3 | | |
| AndroGel Pump | 3 | | |
| Android | 3 | | |
| Androxy | 3 | | |
| Anestacon | 1 | | |
| Anestafoam | 3 | | |
| Anexsia* | 3PA | | |
| Anextuss | 1 | | |
| Angeliq | 3 | | |
| Anolor 300 | 1 | | |
| Ansaid* | 3 | | |
| Antabuse | 2 | | |
| Antara | 3 | | |
| Anthralin | 1 | | |
| Anti-Spas | 1 | | |
| Anti-Stick Insulin Syringe | 2 | | |
| Antiben | 1 | | |
| Antibiotic Ear | 1 | | |
| Antipyrine-Benzocaine | 1 | | |
| Antispasmodic | 1 | | |
| Antivert* | 3 | | |
| Anucort-HC | 1 | | |
| Anusol-HC* | 3 | | |
| Anzemet | 2 | 3 | |
| ApexiCon | 1 | | |
| Apexicon E Crm | 3 | | |
| ApexiCon E Oint | 1 | | |
| Aphrodyne | 1 | | |
| Aphthasol | 3 | | |
| Apidra Cartridge | 3PA | | |
| Apidra Vial | 3 | | |
| Aplenzin | 3PA | | |
| Apokyn | 3PA | | |
| Apri | 1 | | |
| Apriso | 3PA | | |
| Aptivus | 3 | | |
| Aquabid-DM | 1 | | |
| Aquachloral | 3 | | |
| Aquatab C* | 3 | | |
| Aquatab D* | 3 | | |
| Aquatab DM* | 3 | | |
| Aralen* | 3 | | |
| Aranelle | 1 | | |
| Aranesp | 3PA | | Specialty Pharmacy |
| Arava* | 2 | | |
| Arcalyst | 3PA | | Specialty Pharmacy |
| Aricept | 2 | | |
| Aricept ODT | 2 | | |
| Arimidex | 2 | | |
| Aristocort | 3 | | |
| Aristocort A* | 3 | | |
| Arixtra | 3 | | Limit 14 day supply |
| Armour Thyroid* | 2 | | |
| Aromasin | 3 | | |
| Arthrotec 50 | 3 | | |
| Arthrotec 75 | 3 | | |
| Asacol | 2 | | |
| Ascensia Autodisc Control | 3 | | |
| Ascensia Autodisc Strips | 3 | 150 | |
| Ascensia Elite Control | 3 | | |
| Ascensia Elite Test Strips | 3 | 150 | |
| Ascensia Microfill Low/High | 3 | | |
| Ascensia Microfill Normal | 3 | | |
| Ascensia Microfill Test | 3 | 150 | |
| Ascensia Microlet | 2 | | |
| Ascomp-Codeine | 1 | | |
| Asmanex 120 Metered Doses | 3 | | |
| Asmanex 14 Metered Doses | 3 | | |
| Asmanex 30 Metered Doses | 3 | | |
| Asmanex 60 Metered Doses | 3 | | |
| ASP 300/200/20 | 1 | | |
| Aspirin | 1 | | |
| Aspirin EC | 1 | | |
| Aspirin-Codeine #3 | 1 | | |
| Aspirin-Codeine #4 | 1 | | |
| Assure 3 Control | 3 | | |
| Assure 3 Test | 3 | 150 | |
| Assure Check | 3 | 150 | |
| Assure Control | 3 | | |
| Assure II | 3 | 150 | |
| Assure II Check | 3 | 150 | |
| Assure II Control | 3 | | |
| Assure II Control Level 1 & 2 | 3 | | |
| Assure Test | 3 | 150 | |
| Astelin | 3 | | |
| Astepro | 3 | | |
| At Last Control Solution | 3 | | |
| At Last Lancets | 2 | | |
| At Last Test Strips | 3 | 150 | |
| Atacand | 3 | | |
| Atacand HCT | 3 | | |
| Atamet | 1 | | |
| Atarax* | 3 | | |
| Atenolol | 1 | | |
| Atenolol-Chlorthalidone | 1 | | |
| Ativan* | 3 | | |
| Atreza | 1 | | |
| Atripla | 3 | | |
| Atropine Sulfate | 1 | | |
| Atropine-Care | 1 | | |
| Atrovent Aer | 2 | | |
| Atrovent HFA Aer | 2 | | |
| Atrovent Soln* | 2 | | |
| Atuss DR* | 3 | | |
| Atuss G* | 3 | | |
| Atuss HC* | 3 | | |
| Atuss HD | 3 | | |
| Atuss MR* | 3 | | |
| Atuss MS* | 3 | | |
| Atuss NX* | 3 | | |
| Atuss-12 DM | 3 | | |
| Atuss-12 DX | 3 | | |
| Aug Betamethasone Dipropionate | 1 | | |
| Augmentin ES-600* | 3 | | |
| Augmentin XR | 3 | | |
| Augmentin* | 3 | | |
| Aurobiotic-HC | 1 | | |
| Aurodex | 1 | | |
| Auroguard | 1 | | |
| Aurora Healthcare Lancets | 2 | | |
| Auto-Lancet | 2 | | |
| Auto-Lancet Mini | 2 | | |
| Auto-Lancets | 2 | | |
| AutoLancet | 2 | | |
| Autolet | 2 | | |
| Autolet 2 | 2 | | |
| Autolet II Clinisafe | 2 | | |
| Autolet Lancing Device | 2 | | |
| Autolet Lite Clinisafe | 2 | | |
| Autolet Lite Starter Pack | 2 | | |
| Autolet Mini | 2 | | |
| Autopen | 2 | | |
| Avalide | 3 | | |
| Avandamet | 3 | | |
| Avandaryl | 3 | | |
| Avandia | 3 | | |
| Avapro | 3 | | |
| Avar | 3 | | |
| Avar Cleanser | 1 | | |
| Avar Green | 3 | | |
| AVAR-e Emollient | 1 | | |
| AVAR-e Green | 1 | | |
| AVC Vaginal | 3 | | |
| Avelox | 2 | | |
| Avelox ABC Pack | 2 | | |
| Aventyl* | 3 | | |
| Aviane | 1 | | |
| Avinza | 3 | | |
| Avita | 1 | | |
| Avodart | 3 | | |
| Avonex | 2 | | Specialty Pharmacy |
| Axert | 3 | 6 | |
| Axid* | 3 | | |
| Axocet | 1 | | |
| Aygestin* | 3 | | |
| Azasan | 3 | | |
| Azasite | 3 | | |
| Azathioprine | 1 | | |
| Azelex | 3 | | |
| Azilect | 3 | | |
| Azithromycin | 1 | | |
| Azmacort | 3 | | |
| Azopt | 3 | | |
| Azor | 3 | 30 | |
| Azulfidine EN-tabs* | 3 | | |
| Azulfidine* | 3 | | |