Diabetes, Miscellaneous Antidiabetic Agents

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PDL Status Values

Y = preferred
N = non-preferred. Non-preferred drugs listed as N but without clinical drug use criteria are subject to the Non-Preferred Drugs in Select PDL Classes prior authorization criteria. New drugs will be listed as N until reviewed by the P&T Committee and are subject to the New Drug Policy.
V = voluntary non-preferred. Non-preferred mental health drugs are listed as V and prior authorization is not required.
Null (i.e. blank) = indicates the class or specific drug has not been reviewed for PDL placement.

To request a Prior Authorization, please use this form.

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NDC Brand Name Generic Name Form Strength PDL
Status		 Rebate Current Drug Use Criteria
00054014225 ACARBOSE acarbose TABLET 100 mg N Y  
23155014901 ACARBOSE acarbose TABLET 100 mg N Y  
62135045590 ACARBOSE acarbose TABLET 100 mg N Y  
64380076006 ACARBOSE acarbose TABLET 100 mg N Y  
69543012210 ACARBOSE acarbose TABLET 100 mg N Y  
69543012211 ACARBOSE acarbose TABLET 100 mg N Y  
00054014025 ACARBOSE acarbose TABLET 25 mg N Y  
23155014701 ACARBOSE acarbose TABLET 25 mg N Y  
23155014705 ACARBOSE acarbose TABLET 25 mg N Y  
62135045390 ACARBOSE acarbose TABLET 25 mg N Y  
64380075806 ACARBOSE acarbose TABLET 25 mg N Y  
69543012010 ACARBOSE acarbose TABLET 25 mg N Y  
69543012011 ACARBOSE acarbose TABLET 25 mg N Y  
00054014125 ACARBOSE acarbose TABLET 50 mg N Y  
23155014801 ACARBOSE acarbose TABLET 50 mg N Y  
62135045490 ACARBOSE acarbose TABLET 50 mg N Y  
64380075906 ACARBOSE acarbose TABLET 50 mg N Y  
69543012110 ACARBOSE acarbose TABLET 50 mg N Y  
69543012111 ACARBOSE acarbose TABLET 50 mg N Y  
00093745501 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 2.5 mg-250 mg N Y  
23155011501 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 2.5 mg-250 mg N Y  
62135073160 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 2.5 mg-250 mg N Y  
68382018401 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 2.5 mg-250 mg N Y  
00093745601 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 2.5 mg-500 mg N Y  
23155011601 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 2.5 mg-500 mg N Y  
62135073260 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 2.5 mg-500 mg N Y  
68382018501 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 2.5 mg-500 mg N Y  
00093745701 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 5 mg-500 mg N Y  
23155011701 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 5 mg-500 mg N Y  
62135073360 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 5 mg-500 mg N Y  
68382018601 GLIPIZIDE-METFORMIN glipizide/metformin HCl TABLET 5 mg-500 mg N Y  
23155023301 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 1.25 mg-250 mg N Y  
55111069501 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 1.25 mg-250 mg N Y  
57237002301 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 1.25 mg-250 mg N Y  
65862008001 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 1.25 mg-250 mg N Y  
65862008005 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 1.25 mg-250 mg N Y  
00093726105 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 2.5 mg-500 mg N Y  
23155023401 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 2.5 mg-500 mg N Y  
50268035611 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 2.5 mg-500 mg N Y  
50268035615 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 2.5 mg-500 mg N Y  
57237002401 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 2.5 mg-500 mg N Y  
57237002405 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 2.5 mg-500 mg N Y  
65862008101 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 2.5 mg-500 mg N Y  
65862008105 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 2.5 mg-500 mg N Y  
00093726205 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 5 mg-500 mg N Y  
23155023501 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 5 mg-500 mg N Y  
57237002501 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 5 mg-500 mg N Y  
57237002505 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 5 mg-500 mg N Y  
65862008201 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 5 mg-500 mg N Y  
65862008205 GLYBURIDE-METFORMIN HCL glyburide/metformin HCl TABLET 5 mg-500 mg N Y  
31722004247 METFORMIN HCL metformin HCl SOLUTION 500 mg/5 mL N Y  
42571036007 METFORMIN HCL metformin HCl SOLUTION 500 mg/5 mL N Y  
42571036010 METFORMIN HCL metformin HCl SOLUTION 500 mg/5 mL N Y  
52817082005 METFORMIN HCL metformin HCl SOLUTION 500 mg/5 mL N Y  
52817082050 METFORMIN HCL metformin HCl SOLUTION 500 mg/5 mL N Y  
66689031816 METFORMIN HCL metformin HCl SOLUTION 500 mg/5 mL N Y  
69452038088 METFORMIN HCL metformin HCl SOLUTION 500 mg/5 mL N Y  
71656001704 METFORMIN HCL metformin HCl SOLUTION 500 mg/5 mL N Y  
00378600191 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 1,000 mg N Y  
00591272060 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 1,000 mg N Y  
27241018960 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 1,000 mg N Y  
29033003206 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 1,000 mg N Y  
42806040660 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 1,000 mg N Y  
50228050460 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 1,000 mg N Y  
50742063460 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 1,000 mg N Y  
59651004360 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 1,000 mg N Y  
68180033707 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 1,000 mg N Y  
00378600291 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 500 mg N Y  
00591271960 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 500 mg N Y  
27241018860 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 500 mg N Y  
29033003106 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 500 mg N Y  
42806040560 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 500 mg N Y  
50228050360 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 500 mg N Y  
50742063360 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 500 mg N Y  
59651004260 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 500 mg N Y  
68180033607 METFORMIN ER OSMOTIC metformin HCl TAB ER 24 500 mg N Y  
29033005501 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
29300038901 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
29300038905 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
33342023944 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
42385097701 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
42385097705 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
42385097711 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
42385097790 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
42806063201 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
42806063205 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
49483062301 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
49483062309 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
49483062310 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
49483062350 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
50268055011 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
50268055015 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
60687064001 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
60687064011 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
62756014201 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
62756014202 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
67877015901 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
67877015905 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
67877015910 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
67877041301 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
67877041305 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
67877041390 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
68094090450 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
68094090460 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
68645059559 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
69238212507 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
69315041001 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
69315041005 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
70010049101 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
70010049105 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
70010049109 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
70010049110 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
76385012810 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
82009011710 METFORMIN HCL ER metformin HCl TAB ER 24H 500 mg Y Y  
29033005601 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
29300039901 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
42385097801 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
42806063301 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
49483062401 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
49483062450 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
50268055111 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
50268055115 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
62756014301 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
67877041401 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
68094080450 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
68094080460 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
69238212601 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
70010049201 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
70010049210 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
72578003601 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
76385012901 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
76385012950 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
82009011801 METFORMIN HCL ER metformin HCl TAB ER 24H 750 mg Y Y  
68012000316 GLUMETZA metformin HCl TABERGR24H 1,000 mg N Y  
27241024190 METFORMIN ER GASTRIC metformin HCl TABERGR24H 1,000 mg N Y  
42571033490 METFORMIN ER GASTRIC metformin HCl TABERGR24H 1,000 mg N Y  
47335030688 METFORMIN ER GASTRIC metformin HCl TABERGR24H 1,000 mg N Y  
50228044690 METFORMIN ER GASTRIC metformin HCl TABERGR24H 1,000 mg N Y  
60505470109 METFORMIN ER GASTRIC metformin HCl TABERGR24H 1,000 mg N Y  
68180033909 METFORMIN ER GASTRIC metformin HCl TABERGR24H 1,000 mg N Y  
68462052190 METFORMIN ER GASTRIC metformin HCl TABERGR24H 1,000 mg N Y  
70010049709 METFORMIN ER GASTRIC metformin HCl TABERGR24H 1,000 mg N Y  
68012000450 GLUMETZA metformin HCl TABERGR24H 500 mg N Y  
27241024001 METFORMIN ER GASTRIC metformin HCl TABERGR24H 500 mg N Y  
42571033301 METFORMIN ER GASTRIC metformin HCl TABERGR24H 500 mg N Y  
47335030588 METFORMIN ER GASTRIC metformin HCl TABERGR24H 500 mg N Y  
50228044501 METFORMIN ER GASTRIC metformin HCl TABERGR24H 500 mg N Y  
60505470001 METFORMIN ER GASTRIC metformin HCl TABERGR24H 500 mg N Y  
68180033801 METFORMIN ER GASTRIC metformin HCl TABERGR24H 500 mg N Y  
68462052001 METFORMIN ER GASTRIC metformin HCl TABERGR24H 500 mg N Y  
70010049601 METFORMIN ER GASTRIC metformin HCl TABERGR24H 500 mg N Y  
00378718705 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
00904560389 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
00904716461 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
23155084301 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
23155084305 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
23155084310 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
42385094901 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
42385094905 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
42385094911 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
43547035910 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
43547035950 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
49483062001 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
49483062010 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
49483062050 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
49483062081 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
50228010701 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
50228010705 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
50228010710 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
50228010730 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
57664047488 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
59651085601 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
59651085605 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
59651085699 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
60687016201 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
60687016211 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
62135068405 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
62135068418 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
62135068490 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
65862001001 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
65862001005 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
65862001046 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
65862001099 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
67877056301 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
67877056305 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
67877056310 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
67877093205 METFORMIN HCL metformin HCl TABLET 1,000 mg Y  
68094048060 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
68094048070 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
68382076001 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
68382076005 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
68382076010 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
68462016118 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
68645030059 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
68645054559 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
68645058459 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
69367018201 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
69367018205 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
69367018210 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
69367038301 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
69367038305 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
69367038310 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
70010006501 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
70010006505 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
70010006509 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
70010006510 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
70010006599 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
71093013404 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
71093013405 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
82009004710 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
82009017510 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
83301001001 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
83301001002 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
83301001003 METFORMIN HCL metformin HCl TABLET 1,000 mg Y Y  
00378718505 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
00904716261 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
23155010206 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
23155084101 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
23155084105 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
23155084110 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
42385094701 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
42385094705 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
42385094711 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
42806021305 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
43547035710 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
43547035711 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
43547035750 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
49483062201 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
49483062210 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
49483062250 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
49483062281 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
50228010501 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
50228010505 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
50228010510 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
50228010530 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
59651085401 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
59651085405 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
59651085499 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
60687015501 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
60687015511 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
62135068005 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
62135068018 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
62135068090 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
65862000801 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
65862000805 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
65862000899 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
67877056101 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
67877056105 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
67877056110 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
67877093001 METFORMIN HCL metformin HCl TABLET 500 mg Y  
67877093005 METFORMIN HCL metformin HCl TABLET 500 mg Y  
68094068860 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
68094068870 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
68382075801 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
68382075805 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
68382075810 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
68645054459 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
68645058259 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
69367018001 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
69367018005 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
69367018010 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
69367038101 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
69367038105 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
69367038110 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
70010006301 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
70010006305 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
70010006309 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
70010006310 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
71093013204 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
71093013205 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
71093013206 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
82009004610 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
82009017410 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
83301000801 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
83301000802 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
83301000803 METFORMIN HCL metformin HCl TABLET 500 mg Y Y  
62135068130 METFORMIN HCL metformin HCl TABLET 625 mg Y  
72336006430 METFORMIN HCL metformin HCl TABLET 625 mg Y  
72336009530 METFORMIN HCL metformin HCl TABLET 750 mg N Y  
00378718605 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
00904716361 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
23155010306 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
23155084201 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
23155084205 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
23155084210 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
42385094801 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
42385094805 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
42385094811 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
43547035810 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
43547035850 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
49483062101 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
49483062110 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
49483062150 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
49483062181 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
50228010601 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
50228010605 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
50228010630 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
59651085501 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
59651085505 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
60687014301 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
60687014311 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
62135068318 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
62135068330 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
62135068390 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
65862000901 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
65862000905 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
67877056201 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
67877056205 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
67877056210 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
67877093101 METFORMIN HCL metformin HCl TABLET 850 mg Y  
68094058060 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
68094058070 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
68382075901 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
68382075905 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
68382075910 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
68645054759 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
68645058359 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
69367018101 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
69367018105 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
69367038201 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
69367038205 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
69367038210 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
70010006401 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
70010006405 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
70010006409 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
70010006410 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
70010006499 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
71093013304 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
71093013305 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
83301000901 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
83301000902 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
83301000903 METFORMIN HCL metformin HCl TABLET 850 mg Y Y  
69367030501 MIGLITOL miglitol TABLET 100 mg N Y  
69367030301 MIGLITOL miglitol TABLET 25 mg N Y  
69367030401 MIGLITOL miglitol TABLET 50 mg N Y  
00591335501 NATEGLINIDE nateglinide TABLET 120 mg N Y  
16571075909 NATEGLINIDE nateglinide TABLET 120 mg N Y  
55111032990 NATEGLINIDE nateglinide TABLET 120 mg N Y  
60687068411 NATEGLINIDE nateglinide TABLET 120 mg N Y  
60687068421 NATEGLINIDE nateglinide TABLET 120 mg N Y  
64380016802 NATEGLINIDE nateglinide TABLET 120 mg N Y  
68382072216 NATEGLINIDE nateglinide TABLET 120 mg N Y  
72241000304 NATEGLINIDE nateglinide TABLET 120 mg N Y  
72241000305 NATEGLINIDE nateglinide TABLET 120 mg N Y  
75834020601 NATEGLINIDE nateglinide TABLET 120 mg N Y  
16571075809 NATEGLINIDE nateglinide TABLET 60 mg N Y  
55111032890 NATEGLINIDE nateglinide TABLET 60 mg N Y  
60687067311 NATEGLINIDE nateglinide TABLET 60 mg N Y  
60687067321 NATEGLINIDE nateglinide TABLET 60 mg N Y  
64380016702 NATEGLINIDE nateglinide TABLET 60 mg N Y  
68382072116 NATEGLINIDE nateglinide TABLET 60 mg N Y  
72241000204 NATEGLINIDE nateglinide TABLET 60 mg N Y  
72241000205 NATEGLINIDE nateglinide TABLET 60 mg N Y  
75834020501 NATEGLINIDE nateglinide TABLET 60 mg N Y  
00310661502 SYMLINPEN 60 pramlintide acetate PEN INJCTR 1,500 mcg/1.5 mL N Y  
00310662702 SYMLINPEN 120 pramlintide acetate PEN INJCTR 2,700 mcg/2.7 mL N Y  
33342024811 REPAGLINIDE repaglinide TABLET 0.5 mg N Y  
57237015701 REPAGLINIDE repaglinide TABLET 0.5 mg N Y  
62135094690 REPAGLINIDE repaglinide TABLET 0.5 mg N Y  
65862067001 REPAGLINIDE repaglinide TABLET 0.5 mg N Y  
72603081001 REPAGLINIDE repaglinide TABLET 0.5 mg N Y  
33342024911 REPAGLINIDE repaglinide TABLET 1 mg N Y  
57237015801 REPAGLINIDE repaglinide TABLET 1 mg N Y  
57664074513 REPAGLINIDE repaglinide TABLET 1 mg N Y  
57664074588 REPAGLINIDE repaglinide TABLET 1 mg N Y  
60687056011 REPAGLINIDE repaglinide TABLET 1 mg N Y  
60687056021 REPAGLINIDE repaglinide TABLET 1 mg N Y  
62135094790 REPAGLINIDE repaglinide TABLET 1 mg N Y  
65862067101 REPAGLINIDE repaglinide TABLET 1 mg N Y  
72603081101 REPAGLINIDE repaglinide TABLET 1 mg N Y  
33342025011 REPAGLINIDE repaglinide TABLET 2 mg N Y  
57237015901 REPAGLINIDE repaglinide TABLET 2 mg N Y  
57664074713 REPAGLINIDE repaglinide TABLET 2 mg N Y  
57664074788 REPAGLINIDE repaglinide TABLET 2 mg N Y  
62135094890 REPAGLINIDE repaglinide TABLET 2 mg N Y  
65862067201 REPAGLINIDE repaglinide TABLET 2 mg N Y  
72603081201 REPAGLINIDE repaglinide TABLET 2 mg N Y  
73650031601 TZIELD teplizumab-mzwv VIAL 2 mg/2 mL (1 mg/mL) N Y PA Document
73650031610 TZIELD teplizumab-mzwv VIAL 2 mg/2 mL (1 mg/mL) N Y PA Document
73650031614 TZIELD teplizumab-mzwv VIAL 2 mg/2 mL (1 mg/mL) N Y PA Document
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