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Name Manufacture
{7 (lamotrigine 100 MG Oral Tablet [Subvenite]) / 42 (lamotrigine 25 MG Oral Tablet [Subvenite]) } Pack [Subvenite Orange (for Patients Not Taking Carbamazepine, Phenytoin, Phenobarbital, Primidone, or Valproate)] BPCK
{7 (lamotrigine 100 MG Oral Tablet) / 42 (lamotrigine 25 MG Oral Tablet) } Pack GPCK
{7 (lamotrigine 100 MG Oral Tablet) / 42 (lamotrigine 25 MG Oral Tablet) } Pack GPCK
{7 (lamotrigine 100 MG Oral Tablet) / 42 (lamotrigine 25 MG Oral Tablet) } Pack GPCK
{7 (lamotrigine 100 MG Oral Tablet) / 42 (lamotrigine 25 MG Oral Tablet) } Pack GPCK
{7 (mitapivat 20 MG Oral Tablet [Pyrukynd]) / 7 (mitapivat 5 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 5 MG / 20 MG Taper] BPCK
{7 (mitapivat 20 MG Oral Tablet [Pyrukynd]) / 7 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 20 MG / 50 MG Taper] BPCK
{7 (mitapivat 20 MG Oral Tablet) / 7 (mitapivat 5 MG Oral Tablet) } Pack GPCK
{7 (mitapivat 20 MG Oral Tablet) / 7 (mitapivat 50 MG Oral Tablet) } Pack GPCK
{7 (mitapivat 5 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 5 MG Taper] BPCK
{7 (mitapivat 5 MG Oral Tablet) } Pack GPCK
{7 (siponimod 0.25 MG Oral Tablet [Mayzent]) } Pack [Mayzent 1 MG Starter Pack] BPCK
{7 (siponimod 0.25 MG Oral Tablet) } Pack GPCK
{7 (valbenazine 40 MG Oral Capsule [Ingrezza]) / 21 (valbenazine 80 MG Oral Capsule [Ingrezza]) } Pack [Ingrezza] BPCK
{7 (valbenazine 40 MG Oral Capsule) / 21 (valbenazine 80 MG Oral Capsule) } Pack GPCK
{7 (vilazodone hydrochloride 10 MG Oral Tablet [Viibryd]) / 23 (vilazodone hydrochloride 20 MG Oral Tablet [Viibryd]) } Pack [Viibryd Starter Pack 10/20 30 Day Pack] BPCK
{7 (vilazodone hydrochloride 10 MG Oral Tablet [Viibryd]) / 7 (vilazodone hydrochloride 20 MG Oral Tablet [Viibryd]) / 16 (vilazodone hydrochloride 40 MG Oral Tablet [Viibryd]) } Pack [Viibryd 10/20/40 30 Day Pack] BPCK
{7 (vilazodone hydrochloride 10 MG Oral Tablet) / 23 (vilazodone hydrochloride 20 MG Oral Tablet) } Pack GPCK
{7 (vilazodone hydrochloride 10 MG Oral Tablet) / 7 (vilazodone hydrochloride 20 MG Oral Tablet) / 16 (vilazodone hydrochloride 40 MG Oral Tablet) } Pack GPCK
{70 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES/ML Injection [Elevidys]) } Pack [Elevidys Kit > 69.5 KG] BPCK
{70 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES/ML Injection) } Pack GPCK
{74 (apixaban 5 MG Oral Tablet [Eliquis]) } Pack [Eliquis 30-Day Starter Pack] BPCK
{74 (apixaban 5 MG Oral Tablet) } Pack GPCK
{8 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 11.6 - 12.0 kg] BPCK
{8 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES/ML Injection) } Pack GPCK
{8 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 8 Tablet Pack] BPCK
{8 (cladribine 10 MG Oral Tablet) } Pack GPCK
{8 (estradiol 0.004 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 4 MCG Maintenance Pack] BPCK
{8 (estradiol 0.004 MG Vaginal Insert [Imvexxy]) } Pack [Imvexxy 4 MCG Maintenance Pack] BPCK
{8 (estradiol 0.004 MG Vaginal Insert) } Pack GPCK