| Fosamax + D |
| Generic Step Therapy HPGST Prostaglandin 10 2019 |
| Generic Step Therapy PGST October 2019 |
| Generic Step Therapy PGST October 2019 |
| Hysingla |
| Inova |
| Kadian |
| Klaron |
| Lumigan |
| Methadone |
| Minolira |
| MS Contin |
| Nucynta ER |
| Onexton |
| Opana ER |
| OpioidIR 3 DayCombo AcutePainDurationLimit19andUnderPolicy2888… |
| OpioidIR 3 DayCombo AcutePainDurationLimit19andUnderPolicy2888… |
| OpioidIR 3 DayCombo AcutePainDurationLimit19andUnderPolicy2888… |
| OpioidIR 3 DayCombo AcutePainDurationLimit19andUnderPolicy2888… |
| OpioidIR 3 DayCombo AcutePainDurationLimit19andUnderPolicy2888… |
