| Abilify | Brand | 5,496 of 5,496 | 100% | 1.5% | Tier 5 |
| Abiraterone | Generic | 5,496 of 5,496 | 100% | 78.3% | Tier 4 |
| Abrysvo | Brand | 5,496 of 5,496 | 100% | 44.3% | Tier 3 |
| Acarbose | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Acebutolol | Generic | 5,461 of 5,496 | 99.4% | 0% | Tier 2 |
| Acetaminophen / Hydrocodone | Generic | 5,496 of 5,496 | 100% | 1.8% | Tier 3 |
| Acetaminophen / Oxycodone | Generic | 5,496 of 5,496 | 100% | 1.8% | Tier 3 |
| Acetaminophen / Tramadol | Generic | 3,704 of 5,496 | 67.4% | 2.6% | Tier 2 |
| Acetazolamide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Acyclovir | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Adacel | Brand | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Adderall | Brand | 2 of 5,496 | <0.1% | 0% | Tier 1 |
| Admelog | Brand | 682 of 5,496 | 12.4% | 1.2% | Tier 3 |
| Advair | Brand | 3,661 of 5,496 | 66.6% | 0% | Tier 3 |
| Aimovig | Brand | 4,382 of 5,496 | 79.7% | 99% | Tier 3 |
| Ajovy | Brand | 138 of 5,496 | 2.5% | 17.4% | Tier 4 |
| Albuterol | Generic | 5,496 of 5,496 | 100% | 5.2% | Tier 2 |
| Albuterol / Ipratropium | Generic | 5,496 of 5,496 | 100% | 93.6% | Tier 2 |
| Alendronate | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Alfuzosin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Allopurinol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Alogliptin | Generic | 81 of 5,496 | 1.5% | 9.9% | Tier 1 |
| Alphagan | Brand | 1,403 of 5,496 | 25.5% | 0% | Tier 3 |
| Alprazolam | Generic | 5,408 of 5,496 | 98.4% | 30.7% | Tier 2 |
| Alvesco | Brand | 1,675 of 5,496 | 30.5% | 0% | Tier 4 |
| Amantadine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Amiloride | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Amiodarone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Amitriptyline | Generic | 5,496 of 5,496 | 100% | 50.7% | Tier 4 |
| Amlodipine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Amlodipine / Atorvastatin | Generic | 4,446 of 5,496 | 80.9% | 0% | Tier 1 |
| Amlodipine / Benazepril | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Amlodipine / Hydrochlorothiazide / Olmesartan | Generic | 4,910 of 5,496 | 89.3% | 0% | Tier 1 |
| Amlodipine / Olmesartan | Generic | 5,016 of 5,496 | 91.3% | 0% | Tier 1 |
| Amlodipine / Valsartan | Generic | 5,281 of 5,496 | 96.1% | 0% | Tier 1 |
| Amoxicillin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Amphetamine Aspartate / Amphetamine Sulfate / Dextroamphetamine Saccharate / Dextroamphetamine Sulfate | Generic | 5,496 of 5,496 | 100% | 18.4% | Tier 3 |
| Anastrozole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Anoro | Brand | 4,330 of 5,496 | 78.8% | 0% | Tier 3 |
| Arexvy | Brand | 5,496 of 5,496 | 100% | 44.3% | Tier 3 |
| Aripiprazole | Generic | 5,496 of 5,496 | 100% | 4.6% | Tier 3 |
| Aristada | Brand | 5,059 of 5,496 | 92% | 2% | Tier 5 |
| Armodafinil | Generic | 4,440 of 5,496 | 80.8% | 98.5% | Tier 4 |
| Arnuity | Brand | 4,992 of 5,496 | 90.8% | 0% | Tier 3 |
| Aspirin / Dipyridamole | Generic | 4,538 of 5,496 | 82.6% | 0% | Tier 4 |
| Atenolol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Atenolol / Chlorthalidone | Generic | 5,488 of 5,496 | 99.9% | 0% | Tier 1 |
| Atomoxetine | Generic | 5,496 of 5,496 | 100% | 0.2% | Tier 4 |
| Atorvastatin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Atropine | Generic | 5,399 of 5,496 | 98.2% | 0% | Tier 3 |
| Atropine / Diphenoxylate | Generic | 5,449 of 5,496 | 99.1% | 24.7% | Tier 4 |
| Atrovent | Brand | 4,005 of 5,496 | 72.9% | 22.4% | Tier 4 |
| Austedo | Brand | 4,879 of 5,496 | 88.8% | 98% | Tier 5 |
| Azathioprine | Generic | 5,496 of 5,496 | 100% | 100% | Tier 2 |
| Azelastine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Azelastine / Fluticasone | Generic | 227 of 5,496 | 4.1% | 0% | Tier 4 |
| Azithromycin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Baclofen | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Balsalazide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Basaglar | Brand | 49 of 5,496 | 0.9% | 16.3% | Tier 3 |
| Belbuca | Brand | 367 of 5,496 | 6.7% | 54.2% | Tier 3 |
| Belsomra | Brand | 3,156 of 5,496 | 57.4% | 7.1% | Tier 3 |
| Benazepril | Generic | 5,495 of 5,496 | >99.9% | 0% | Tier 1 |
| Benazepril / Hydrochlorothiazide | Generic | 5,378 of 5,496 | 97.9% | 0% | Tier 1 |
| Benztropine | Generic | 5,496 of 5,496 | 100% | 60.9% | Tier 2 |
| Betamethasone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Betamethasone / Clotrimazole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Bethanechol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Bevespi | Brand | 1,917 of 5,496 | 34.9% | 0% | Tier 3 |
| Bicalutamide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Biktarvy | Brand | 5,496 of 5,496 | 100% | 0% | Tier 5 |
| Bimatoprost | Generic | 5,392 of 5,496 | 98.1% | 0% | Tier 3 |
| Bisoprolol | Generic | 5,494 of 5,496 | >99.9% | 0% | Tier 2 |
| Bisoprolol / Hydrochlorothiazide | Generic | 5,454 of 5,496 | 99.2% | 0% | Tier 2 |
| Boostrix | Brand | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Breo | Brand | 5,364 of 5,496 | 97.6% | 0% | Tier 3 |
| Breyna | Brand | 2,980 of 5,496 | 54.2% | 0% | Tier 3 |
| Breztri | Brand | 4,848 of 5,496 | 88.2% | 0% | Tier 3 |
| Brilinta | Brand | 171 of 5,496 | 3.1% | 0% | Tier 3 |
| Brimonidine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Brimonidine / Timolol | Generic | 5,016 of 5,496 | 91.3% | 0% | Tier 3 |
| Brinzolamide | Generic | 3,944 of 5,496 | 71.8% | 0% | Tier 4 |
| Briviact | Brand | 3,504 of 5,496 | 63.8% | 78.4% | Tier 5 |
| Bromfenac | Generic | 2,508 of 5,496 | 45.6% | 0% | Tier 3 |
| Brukinsa | Brand | 5,496 of 5,496 | 100% | 98.2% | Tier 5 |
| Budesonide | Generic | 5,496 of 5,496 | 100% | 12.4% | Tier 4 |
| Budesonide / Formoterol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Bumetanide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Buprenorphine | Generic | 5,496 of 5,496 | 100% | 1.4% | Tier 2 |
| Buprenorphine / Naloxone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Bupropion | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Buspirone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Cabergoline | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Calcipotriene | Generic | 5,496 of 5,496 | 100% | 26.3% | Tier 3 |
| Calcitriol | Generic | 5,496 of 5,496 | 100% | 31.2% | Tier 2 |
| Calcium Acetate | Generic | 1,996 of 5,496 | 36.3% | 70.8% | Tier 3 |
| Calquence | Brand | 5,496 of 5,496 | 100% | 97.9% | Tier 5 |
| Candesartan | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Candesartan / Hydrochlorothiazide | Generic | 5,030 of 5,496 | 91.5% | 0% | Tier 1 |
| Caplyta | Brand | 5,496 of 5,496 | 100% | 28.7% | Tier 5 |
| Captopril | Generic | 5,433 of 5,496 | 98.9% | 0% | Tier 1 |
| Carbamazepine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Carbidopa / Levodopa | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Carisoprodol | Generic | 699 of 5,496 | 12.7% | 28.2% | Tier 2 |
| Cartia | Brand | 5,471 of 5,496 | 99.5% | 0% | Tier 2 |
| Carvedilol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Cefadroxil | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Cefdinir | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Cefepime | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Cefpodoxime | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Ceftriaxone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Cefuroxime | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Celecoxib | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Cephalexin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Cequa | Brand | 153 of 5,496 | 2.8% | 8.5% | Tier 3 |
| Cevimeline | Generic | 2,732 of 5,496 | 49.7% | 0% | Tier 4 |
| Chlordiazepoxide | Generic | 1,443 of 5,496 | 26.3% | 45.9% | Tier 4 |
| Chlorhexidine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Chlorpromazine | Generic | 5,496 of 5,496 | 100% | 22.9% | Tier 4 |
| Chlorthalidone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Cholestyramine Resin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Ciclopirox | Generic | 5,484 of 5,496 | 99.8% | 0% | Tier 2 |
| Cilostazol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Cimetidine | Generic | 3,666 of 5,496 | 66.7% | 0% | Tier 2 |
| Cinacalcet | Generic | 5,496 of 5,496 | 100% | 47% | Tier 4 |
| Ciprofloxacin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Ciprofloxacin / Dexamethasone | Generic | 4,365 of 5,496 | 79.4% | 0% | Tier 4 |
| Citalopram | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Clarithromycin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Clenpiq | Brand | 2,140 of 5,496 | 38.9% | 0% | Tier 4 |
| Clindamycin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Clobazam | Generic | 5,496 of 5,496 | 100% | 88% | Tier 4 |
| Clobetasol | Generic | 5,342 of 5,496 | 97.2% | 0% | Tier 4 |
| Clomipramine | Generic | 5,496 of 5,496 | 100% | 56.4% | Tier 4 |
| Clonazepam | Generic | 5,496 of 5,496 | 100% | 2.6% | Tier 2 |
| Clonidine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Clopidogrel | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Clorazepate | Generic | 5,496 of 5,496 | 100% | 55.3% | Tier 4 |
| Clotrimazole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Clozapine | Generic | 5,496 of 5,496 | 100% | 20.3% | Tier 3 |
| Colchicine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Colesevelam | Generic | 4,046 of 5,496 | 73.6% | 0% | Tier 3 |
| Colestipol | Generic | 5,495 of 5,496 | >99.9% | 0% | Tier 3 |
| Combigan | Brand | 3,625 of 5,496 | 66% | 0% | Tier 3 |
| Combivent | Brand | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Constulose | Brand | 5,358 of 5,496 | 97.5% | 0% | Tier 2 |
| Cosentyx | Brand | 4,157 of 5,496 | 75.6% | 97.5% | Tier 5 |
| Creon | Brand | 5,347 of 5,496 | 97.3% | 0% | Tier 3 |
| Crestor | Brand | 2 of 5,496 | <0.1% | 0% | Tier 1 |
| Cromolyn | Generic | 5,496 of 5,496 | 100% | 0.5% | Tier 2 |
| Cyclobenzaprine | Generic | 5,478 of 5,496 | 99.7% | 67.6% | Tier 2 |
| Cyclosporine | Generic | 5,496 of 5,496 | 100% | 17% | Tier 3 |
| Cyproheptadine | Generic | 3,130 of 5,496 | 57% | 72.2% | Tier 4 |
| Dabigatran Etexilate | Generic | 5,410 of 5,496 | 98.4% | 0% | Tier 4 |
| Dalfampridine | Generic | 4,598 of 5,496 | 83.7% | 74.6% | Tier 3 |
| Dapagliflozin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Dapsone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Daptomycin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 5 |
| Descovy | Brand | 5,496 of 5,496 | 100% | 0% | Tier 5 |
| Desloratadine | Generic | 4,143 of 5,496 | 75.4% | 0% | Tier 3 |
| Desmopressin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Desonide | Generic | 4,489 of 5,496 | 81.7% | 0% | Tier 4 |
| Desvenlafaxine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Dexamethasone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Dexamethasone / Neomycin / Polymyxin B | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Dexamethasone / Tobramycin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Dexlansoprazole | Generic | 2,213 of 5,496 | 40.3% | 0% | Tier 4 |
| Diazepam | Generic | 5,496 of 5,496 | 100% | 57.3% | Tier 2 |
| Diclofenac | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Dicyclomine | Generic | 5,496 of 5,496 | 100% | 54.5% | Tier 4 |
| Difluprednate | Generic | 2,970 of 5,496 | 54% | 0% | Tier 4 |
| Digoxin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Dilantin | Brand | 5,496 of 5,496 | 100% | 5.9% | Tier 4 |
| Dilt | Brand | 5,471 of 5,496 | 99.5% | 0% | Tier 2 |
| Diltiazem | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Dofetilide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Donepezil | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Dorzolamide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Dorzolamide / Timolol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Dotti | Brand | 4,262 of 5,496 | 77.5% | 5.5% | Tier 3 |
| Dovato | Brand | 5,496 of 5,496 | 100% | 0% | Tier 5 |
| Doxazosin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Doxepin | Generic | 5,496 of 5,496 | 100% | 25% | Tier 3 |
| Doxycycline | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Dulera | Brand | 3,194 of 5,496 | 58.1% | 4.6% | Tier 4 |
| Duloxetine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Dupixent | Brand | 5,496 of 5,496 | 100% | 100% | Tier 5 |
| Dutasteride | Generic | 5,450 of 5,496 | 99.2% | 0% | Tier 2 |
| Dutasteride / Tamsulosin | Generic | 3,691 of 5,496 | 67.2% | 0% | Tier 3 |
| Econazole | Generic | 3,897 of 5,496 | 70.9% | 0% | Tier 4 |
| Edarbi | Brand | 2,567 of 5,496 | 46.7% | 0% | Tier 4 |
| Edarbyclor | Brand | 2,807 of 5,496 | 51.1% | 0% | Tier 4 |
| Eliquis | Brand | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Emgality | Brand | 4,302 of 5,496 | 78.3% | 99% | Tier 3 |
| Emtricitabine / Tenofovir Disoproxil | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Enalapril | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Enalapril / Hydrochlorothiazide | Generic | 5,379 of 5,496 | 97.9% | 0% | Tier 1 |
| Enbrel | Brand | 5,496 of 5,496 | 100% | 98.1% | Tier 5 |
| Enoxaparin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Entacapone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Entecavir | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Entresto | Brand | 5,496 of 5,496 | 100% | 1.8% | Tier 3 |
| Enulose | Brand | 5,484 of 5,496 | 99.8% | 0% | Tier 2 |
| Epinephrine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Eplerenone | Generic | 4,439 of 5,496 | 80.8% | 0% | Tier 3 |
| Ertapenem | Generic | 5,496 of 5,496 | 100% | 1.9% | Tier 4 |
| Erythromycin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Escitalopram | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Esomeprazole | Generic | 5,199 of 5,496 | 94.6% | 0% | Tier 3 |
| Estradiol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Estradiol / Norethindrone | Generic | 4,103 of 5,496 | 74.7% | 5.6% | Tier 4 |
| Estring | Brand | 3,361 of 5,496 | 61.2% | 0% | Tier 4 |
| Eszopiclone | Generic | 2,954 of 5,496 | 53.7% | 3.6% | Tier 4 |
| Ethambutol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Etodolac | Generic | 5,275 of 5,496 | 96% | 0% | Tier 3 |
| Exemestane | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Ezetimibe | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Ezetimibe / Simvastatin | Generic | 5,191 of 5,496 | 94.5% | 0% | Tier 1 |
| Famciclovir | Generic | 5,418 of 5,496 | 98.6% | 0% | Tier 3 |
| Famotidine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Farxiga | Brand | 3,162 of 5,496 | 57.5% | 0% | Tier 3 |
| Febuxostat | Generic | 4,449 of 5,496 | 80.9% | 6.9% | Tier 3 |
| Felodipine | Generic | 5,395 of 5,496 | 98.2% | 0% | Tier 2 |
| Fenofibrate | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Fentanyl | Generic | 5,496 of 5,496 | 100% | 47.7% | Tier 4 |
| Fesoterodine | Generic | 2,913 of 5,496 | 53% | 0.3% | Tier 3 |
| Fiasp | Brand | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Finasteride | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Flecainide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Fluconazole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Fludrocortisone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Fluocinolone | Generic | 5,495 of 5,496 | >99.9% | 0% | Tier 3 |
| Fluocinonide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Fluorometholone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Fluorouracil | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Fluoxetine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Fluphenazine | Generic | 5,496 of 5,496 | 100% | 5.9% | Tier 2 |
| Fluticasone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Fluticasone / Salmeterol | Generic | 5,394 of 5,496 | 98.1% | 0% | Tier 3 |
| Fluticasone / Vilanterol | Generic | 5,373 of 5,496 | 97.8% | 0% | Tier 3 |
| Fluvoxamine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Fosfomycin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Fosinopril | Generic | 5,380 of 5,496 | 97.9% | 0% | Tier 1 |
| Furosemide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Gabapentin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Galantamine | Generic | 5,393 of 5,496 | 98.1% | 0% | Tier 4 |
| GaviLyte-C | Brand | 5,482 of 5,496 | 99.7% | 0% | Tier 2 |
| Gavilyte-G | Brand | 5,169 of 5,496 | 94.1% | 0% | Tier 2 |
| Gemfibrozil | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Gemtesa | Brand | 4,411 of 5,496 | 80.3% | 0.3% | Tier 4 |
| Gentamicin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Genvoya | Brand | 5,496 of 5,496 | 100% | 0% | Tier 5 |
| Glimepiride | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Glipizide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Glipizide / Metformin | Generic | 5,488 of 5,496 | 99.9% | 0% | Tier 1 |
| Glyburide | Generic | 1,348 of 5,496 | 24.5% | 7.4% | Tier 2 |
| Glyburide / Metformin | Generic | 1,215 of 5,496 | 22.1% | 8.1% | Tier 1 |
| Glycopyrronium | Generic | 5,496 of 5,496 | 100% | 17.2% | Tier 2 |
| Glyxambi | Brand | 4,806 of 5,496 | 87.4% | 0.1% | Tier 3 |
| Guanfacine | Generic | 5,237 of 5,496 | 95.3% | 31.2% | Tier 2 |
| Halobetasol | Generic | 4,570 of 5,496 | 83.2% | 0% | Tier 4 |
| Haloperidol | Generic | 5,496 of 5,496 | 100% | 4.7% | Tier 2 |
| Humalog | Brand | 2,270 of 5,496 | 41.3% | 0.4% | Tier 3 |
| Humalog Mix | Brand | 2,124 of 5,496 | 38.6% | 0.4% | Tier 3 |
| Humira | Brand | 2,901 of 5,496 | 52.8% | 100% | Tier 5 |
| Humulin | Brand | 2,311 of 5,496 | 42% | 0.3% | Tier 3 |
| Humulin N | Brand | 2,311 of 5,496 | 42% | 0.3% | Tier 3 |
| Humulin R | Brand | 5,215 of 5,496 | 94.9% | 0.7% | Tier 3 |
| Hydralazine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Hydrochlorothiazide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Hydrochlorothiazide / Irbesartan | Generic | 5,379 of 5,496 | 97.9% | 0% | Tier 1 |
| Hydrochlorothiazide / Lisinopril | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Hydrochlorothiazide / Losartan | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Hydrochlorothiazide / Olmesartan | Generic | 5,334 of 5,496 | 97.1% | 0% | Tier 1 |
| Hydrochlorothiazide / Spironolactone | Generic | 5,470 of 5,496 | 99.5% | 0% | Tier 2 |
| Hydrochlorothiazide / Telmisartan | Generic | 4,856 of 5,496 | 88.4% | 0% | Tier 1 |
| Hydrochlorothiazide / Triamterene | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Hydrochlorothiazide / Valsartan | Generic | 5,494 of 5,496 | >99.9% | 0% | Tier 1 |
| Hydrocortisone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Hydromorphone | Generic | 5,470 of 5,496 | 99.5% | 1.8% | Tier 3 |
| Hydroxychloroquine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Hydroxyurea | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Hydroxyzine | Generic | 5,496 of 5,496 | 100% | 69.5% | Tier 4 |
| Ibandronate | Generic | 5,350 of 5,496 | 97.3% | 12.9% | Tier 2 |
| Ibrance | Brand | 5,496 of 5,496 | 100% | 98.2% | Tier 5 |
| Ibu | Brand | 5,471 of 5,496 | 99.5% | 0% | Tier 1 |
| Ibuprofen | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Icosapent Ethyl | Generic | 5,496 of 5,496 | 100% | 0.3% | Tier 3 |
| Imatinib | Generic | 5,496 of 5,496 | 100% | 78.5% | Tier 4 |
| Imbruvica | Brand | 5,496 of 5,496 | 100% | 97.9% | Tier 5 |
| Imipramine | Generic | 5,496 of 5,496 | 100% | 34.4% | Tier 2 |
| Imiquimod | Generic | 5,496 of 5,496 | 100% | 4.7% | Tier 3 |
| Incruse | Brand | 3,605 of 5,496 | 65.6% | 0% | Tier 3 |
| Indapamide | Generic | 5,488 of 5,496 | 99.9% | 0% | Tier 1 |
| Indomethacin | Generic | 3,162 of 5,496 | 57.5% | 11.7% | Tier 2 |
| Ingrezza | Brand | 2,733 of 5,496 | 49.7% | 96.4% | Tier 5 |
| Insulin Aspart, Human | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Insulin Lispro | Generic | 4,002 of 5,496 | 72.8% | 0% | Tier 3 |
| Invega | Brand | 5,496 of 5,496 | 100% | 2.9% | Tier 4 |
| Invokana | Brand | 724 of 5,496 | 13.2% | 0% | Tier 4 |
| Ipratropium | Generic | 5,496 of 5,496 | 100% | 9.1% | Tier 2 |
| Irbesartan | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Isosorbide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Isosorbide Dinitrate | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Jakafi | Brand | 5,496 of 5,496 | 100% | 98.2% | Tier 5 |
| Jantoven | Brand | 5,356 of 5,496 | 97.5% | 0% | Tier 1 |
| Janumet | Brand | 5,232 of 5,496 | 95.2% | 0.1% | Tier 3 |
| Januvia | Brand | 4,948 of 5,496 | 90% | 0.1% | Tier 3 |
| Jardiance | Brand | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Jentadueto | Brand | 4,868 of 5,496 | 88.6% | 0.1% | Tier 3 |
| Jublia | Brand | 1,011 of 5,496 | 18.4% | 6.8% | Tier 4 |
| Juluca | Brand | 5,496 of 5,496 | 100% | 0% | Tier 5 |
| Kerendia | Brand | 5,496 of 5,496 | 100% | 59.9% | Tier 3 |
| Ketoconazole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Ketorolac | Generic | 5,496 of 5,496 | 100% | 0.1% | Tier 2 |
| Klor-Con | Brand | 5,464 of 5,496 | 99.4% | 0% | Tier 2 |
| Labetalol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Lacosamide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Lactulose | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Lagevrio | Brand | 1,510 of 5,496 | 27.5% | 0% | Tier 3 |
| Lamotrigine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Lansoprazole | Generic | 5,123 of 5,496 | 93.2% | 0% | Tier 2 |
| Lantus | Brand | 5,337 of 5,496 | 97.1% | 0% | Tier 3 |
| Latanoprost | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Leflunomide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Lenalidomide | Generic | 5,496 of 5,496 | 100% | 97.6% | Tier 5 |
| Letrozole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Leucovorin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Levalbuterol | Generic | 4,676 of 5,496 | 85.1% | 30.1% | Tier 3 |
| Levetiracetam | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Levobunolol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Levocetirizine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Levofloxacin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Levothyroxine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Levoxyl | Brand | 5,149 of 5,496 | 93.7% | 0% | Tier 1 |
| Lidocaine | Generic | 5,496 of 5,496 | 100% | 1.1% | Tier 2 |
| Lidocaine / Prilocaine | Generic | 5,474 of 5,496 | 99.6% | 26.6% | Tier 3 |
| Linezolid | Generic | 5,496 of 5,496 | 100% | 1.9% | Tier 4 |
| Linzess | Brand | 5,496 of 5,496 | 100% | 0.3% | Tier 3 |
| Liothyronine | Generic | 5,476 of 5,496 | 99.6% | 0% | Tier 2 |
| Lisdexamfetamine | Generic | 2,710 of 5,496 | 49.3% | 10.1% | Tier 4 |
| Lisinopril | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Lithium Carbonate | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Livalo | Brand | 904 of 5,496 | 16.4% | 0% | Tier 3 |
| Lokelma | Brand | 5,338 of 5,496 | 97.1% | 4.4% | Tier 3 |
| Loperamide | Generic | 5,381 of 5,496 | 97.9% | 0% | Tier 2 |
| Lorazepam | Generic | 5,496 of 5,496 | 100% | 21.6% | Tier 2 |
| Losartan | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Loteprednol Etabonate | Generic | 4,845 of 5,496 | 88.2% | 0.1% | Tier 3 |
| Lovastatin | Generic | 5,495 of 5,496 | >99.9% | 0% | Tier 1 |
| Lubiprostone | Generic | 5,426 of 5,496 | 98.7% | 0% | Tier 3 |
| Lumigan | Brand | 5,043 of 5,496 | 91.8% | 0% | Tier 3 |
| Lurasidone | Generic | 5,496 of 5,496 | 100% | 7.1% | Tier 4 |
| Lyumjev | Brand | 1,773 of 5,496 | 32.3% | 0.5% | Tier 3 |
| Matzim | Brand | 3,195 of 5,496 | 58.1% | 0% | Tier 2 |
| Meclizine | Generic | 5,469 of 5,496 | 99.5% | 34.2% | Tier 2 |
| Medroxyprogesterone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Megestrol | Generic | 5,496 of 5,496 | 100% | 20.3% | Tier 3 |
| Meloxicam | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Memantine | Generic | 5,496 of 5,496 | 100% | 82.4% | Tier 2 |
| Mesalamine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Metformin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Metformin / Pioglitazone | Generic | 5,024 of 5,496 | 91.4% | 0% | Tier 1 |
| Methadone | Generic | 5,442 of 5,496 | 99% | 36% | Tier 3 |
| Methenamine | Generic | 5,424 of 5,496 | 98.7% | 0% | Tier 3 |
| Methimazole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Methocarbamol | Generic | 3,985 of 5,496 | 72.5% | 15.6% | Tier 2 |
| Methotrexate | Generic | 5,496 of 5,496 | 100% | 8.3% | Tier 1 |
| Methylphenidate | Generic | 5,496 of 5,496 | 100% | 23.3% | Tier 3 |
| Methylprednisolone | Generic | 5,496 of 5,496 | 100% | 0.4% | Tier 2 |
| Metoclopramide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Metolazone | Generic | 5,461 of 5,496 | 99.4% | 0% | Tier 2 |
| Metoprolol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Metronidazole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Mexiletine | Generic | 2,964 of 5,496 | 53.9% | 0% | Tier 3 |
| Midodrine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Miebo | Brand | 4,524 of 5,496 | 82.3% | 4.7% | Tier 3 |
| Minocycline | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Minoxidil | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Mirabegron | Generic | 5,456 of 5,496 | 99.3% | 0% | Tier 3 |
| Mirtazapine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Misoprostol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Modafinil | Generic | 5,490 of 5,496 | 99.9% | 82.5% | Tier 3 |
| Mometasone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Montelukast | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Morphine | Generic | 5,496 of 5,496 | 100% | 3.6% | Tier 3 |
| Mounjaro | Brand | 5,343 of 5,496 | 97.2% | 100% | Tier 3 |
| Movantik | Brand | 5,263 of 5,496 | 95.8% | 2.9% | Tier 3 |
| Moxifloxacin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Multaq | Brand | 5,082 of 5,496 | 92.5% | 0.1% | Tier 3 |
| Mupirocin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Mycophenolate Mofetil | Generic | 5,496 of 5,496 | 100% | 100% | Tier 3 |
| Myrbetriq | Brand | 4,392 of 5,496 | 79.9% | 0% | Tier 3 |
| Nabumetone | Generic | 5,462 of 5,496 | 99.4% | 0% | Tier 2 |
| Nadolol | Generic | 5,046 of 5,496 | 91.8% | 0% | Tier 4 |
| Naloxone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Naltrexone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Namzaric | Brand | 2,096 of 5,496 | 38.1% | 1.1% | Tier 4 |
| Naproxen | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Naratriptan | Generic | 5,217 of 5,496 | 94.9% | 0% | Tier 2 |
| Nateglinide | Generic | 5,470 of 5,496 | 99.5% | 0% | Tier 1 |
| Nebivolol | Generic | 5,313 of 5,496 | 96.7% | 0% | Tier 3 |
| Neupro | Brand | 1,839 of 5,496 | 33.5% | 1.3% | Tier 4 |
| Nexium | Brand | 2 of 5,496 | <0.1% | 0% | Tier 1 |
| Nexletol | Brand | 5,411 of 5,496 | 98.5% | 69.7% | Tier 3 |
| Nexlizet | Brand | 4,923 of 5,496 | 89.6% | 67.5% | Tier 3 |
| Niacin | Generic | 5,428 of 5,496 | 98.8% | 0% | Tier 3 |
| Nifedipine | Generic | 5,462 of 5,496 | 99.4% | 0% | Tier 2 |
| Nitrofurantoin | Generic | 5,454 of 5,496 | 99.2% | 0% | Tier 3 |
| Nitroglycerin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Norethindrone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Nortriptyline | Generic | 5,496 of 5,496 | 100% | 17% | Tier 2 |
| Novolin | Brand | 4,249 of 5,496 | 77.3% | 0% | Tier 3 |
| Novolin N | Brand | 4,245 of 5,496 | 77.2% | 0% | Tier 3 |
| Novolin R | Brand | 5,490 of 5,496 | 99.9% | 0% | Tier 3 |
| NovoLog | Brand | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| NovoLog Mix | Brand | 4,297 of 5,496 | 78.2% | 0% | Tier 3 |
| Nuedexta | Brand | 5,311 of 5,496 | 96.6% | 99.9% | Tier 5 |
| Nuplazid | Brand | 5,496 of 5,496 | 100% | 98.2% | Tier 5 |
| Nurtec | Brand | 4,443 of 5,496 | 80.8% | 97.2% | Tier 3 |
| Nyamyc | Brand | 5,337 of 5,496 | 97.1% | 0% | Tier 3 |
| Nystatin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Nystatin / Triamcinolone | Generic | 2,750 of 5,496 | 50% | 0% | Tier 4 |
| Nystop | Brand | 5,452 of 5,496 | 99.2% | 0% | Tier 2 |
| Odefsey | Brand | 5,496 of 5,496 | 100% | 0% | Tier 5 |
| Ofev | Brand | 1,959 of 5,496 | 35.6% | 100% | Tier 5 |
| Ofloxacin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Olanzapine | Generic | 5,496 of 5,496 | 100% | 20.2% | Tier 2 |
| Olmesartan | Generic | 5,361 of 5,496 | 97.5% | 0% | Tier 1 |
| Omeprazole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Omeprazole / Sodium Bicarbonate | Generic | 61 of 5,496 | 1.1% | 9.8% | Tier 4 |
| Ondansetron | Generic | 5,496 of 5,496 | 100% | 87.4% | Tier 2 |
| Orencia | Brand | 1,251 of 5,496 | 22.8% | 92% | Tier 5 |
| Orgovyx | Brand | 5,496 of 5,496 | 100% | 97.9% | Tier 5 |
| Oseltamivir | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Otezla | Brand | 3,257 of 5,496 | 59.3% | 97% | Tier 5 |
| Oxcarbazepine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Oxybutynin | Generic | 5,496 of 5,496 | 100% | 15.6% | Tier 2 |
| Oxycodone | Generic | 5,474 of 5,496 | 99.6% | 2% | Tier 3 |
| Oxycontin | Brand | 216 of 5,496 | 3.9% | 60.6% | Tier 4 |
| Ozempic | Brand | 5,445 of 5,496 | 99.1% | 100% | Tier 3 |
| Paliperidone | Generic | 5,496 of 5,496 | 100% | 0.4% | Tier 4 |
| Pantoprazole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Paroxetine | Generic | 5,496 of 5,496 | 100% | 29.7% | Tier 2 |
| Penicillin V | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Pentoxifylline | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Permethrin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Perphenazine | Generic | 5,496 of 5,496 | 100% | 20.3% | Tier 4 |
| Phenobarbital | Generic | 5,496 of 5,496 | 100% | 49.9% | Tier 2 |
| Phenytoin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Pilocarpine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Pioglitazone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Pitavastatin | Generic | 3,507 of 5,496 | 63.8% | 0% | Tier 3 |
| Polymyxin B / Trimethoprim | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Potassium Chloride | Generic | 5,496 of 5,496 | 100% | 0.5% | Tier 2 |
| Potassium Citrate | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Praluent | Brand | 625 of 5,496 | 11.4% | 100% | Tier 3 |
| Pramipexole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Prasugrel | Generic | 5,405 of 5,496 | 98.3% | 0% | Tier 3 |
| Pravastatin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Prazosin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Prednisolone | Generic | 5,496 of 5,496 | 100% | 11.7% | Tier 2 |
| Prednisone | Generic | 5,496 of 5,496 | 100% | 39.1% | Tier 1 |
| Pregabalin | Generic | 5,496 of 5,496 | 100% | 26.4% | Tier 3 |
| Premarin | Brand | 4,901 of 5,496 | 89.2% | 0% | Tier 3 |
| Prezcobix | Brand | 5,496 of 5,496 | 100% | 0% | Tier 5 |
| Primidone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Probenecid | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Prochlorperazine | Generic | 5,496 of 5,496 | 100% | 31.8% | Tier 2 |
| Procrit | Brand | 3,784 of 5,496 | 68.9% | 96.3% | Tier 3 |
| Procto-Med | Brand | 5,334 of 5,496 | 97.1% | 0% | Tier 2 |
| Progesterone | Generic | 5,271 of 5,496 | 95.9% | 0.6% | Tier 2 |
| Prolensa | Brand | 449 of 5,496 | 8.2% | 0% | Tier 3 |
| Prolia | Brand | 2,501 of 5,496 | 45.5% | 20.1% | Tier 4 |
| Promethazine | Generic | 5,496 of 5,496 | 100% | 45% | Tier 4 |
| Propafenone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Propranolol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Pulmicort | Brand | 517 of 5,496 | 9.4% | 41.2% | Tier 4 |
| Pyridostigmine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Quetiapine | Generic | 5,496 of 5,496 | 100% | 4.7% | Tier 2 |
| Qulipta | Brand | 4,016 of 5,496 | 73.1% | 97% | Tier 3 |
| Qvar | Brand | 1,757 of 5,496 | 32% | 0% | Tier 3 |
| Rabeprazole | Generic | 4,012 of 5,496 | 73% | 0% | Tier 3 |
| Raloxifene | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Ramelteon | Generic | 3,972 of 5,496 | 72.3% | 0% | Tier 4 |
| Ramipril | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Ranolazine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Rasagiline | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Repaglinide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Repatha | Brand | 5,073 of 5,496 | 92.3% | 77.5% | Tier 3 |
| Restasis | Brand | 3,304 of 5,496 | 60.1% | 0% | Tier 3 |
| Revlimid | Brand | 228 of 5,496 | 4.1% | 100% | Tier 5 |
| Rexulti | Brand | 5,496 of 5,496 | 100% | 30.6% | Tier 5 |
| Rhopressa | Brand | 5,024 of 5,496 | 91.4% | 0.2% | Tier 3 |
| Rifampin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Rinvoq | Brand | 5,402 of 5,496 | 98.3% | 98.1% | Tier 5 |
| Risedronate | Generic | 4,864 of 5,496 | 88.5% | 0% | Tier 3 |
| Risperidone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Rivastigmine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Rizatriptan | Generic | 5,433 of 5,496 | 98.9% | 0% | Tier 2 |
| Rocklatan | Brand | 4,914 of 5,496 | 89.4% | 0.2% | Tier 3 |
| Roflumilast | Generic | 5,496 of 5,496 | 100% | 30% | Tier 4 |
| Ropinirole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Rosuvastatin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Rytary | Brand | 787 of 5,496 | 14.3% | 0.1% | Tier 4 |
| Santyl | Brand | 5,383 of 5,496 | 97.9% | 30.9% | Tier 4 |
| Savella | Brand | 1,761 of 5,496 | 32% | 12.3% | Tier 3 |
| Scopolamine | Generic | 5,496 of 5,496 | 100% | 40.8% | Tier 4 |
| Semglee | Brand | 3 of 5,496 | <0.1% | 0% | Tier 1 |
| Sertraline | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Sevelamer | Generic | 1,911 of 5,496 | 34.8% | 74% | Tier 4 |
| Shingrix | Brand | 5,496 of 5,496 | 100% | 15.4% | Tier 1 |
| Sildenafil | Generic | 5,496 of 5,496 | 100% | 100% | Tier 3 |
| Silodosin | Generic | 3,406 of 5,496 | 62% | 0% | Tier 3 |
| Silver Sulfadiazine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Simbrinza | Brand | 4,494 of 5,496 | 81.8% | 0.2% | Tier 4 |
| Simvastatin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Skyrizi | Brand | 5,413 of 5,496 | 98.5% | 98% | Tier 5 |
| Sodium Chloride | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Solifenacin | Generic | 5,356 of 5,496 | 97.5% | 16% | Tier 2 |
| Soliqua | Brand | 5,035 of 5,496 | 91.6% | 0% | Tier 3 |
| Sotalol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Spiriva | Brand | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Spironolactone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| SPS | Brand | 5,381 of 5,496 | 97.9% | 0% | Tier 3 |
| SSD | Brand | 5,443 of 5,496 | 99% | 0% | Tier 2 |
| Stelara | Brand | 3,646 of 5,496 | 66.3% | 97.3% | Tier 5 |
| Stiolto | Brand | 3,482 of 5,496 | 63.4% | 0% | Tier 3 |
| Suboxone | Brand | 883 of 5,496 | 16.1% | 0% | Tier 4 |
| Sucralfate | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Sulfamethoxazole / Trimethoprim | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Sulfasalazine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Sulindac | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Sumatriptan | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Sutab | Brand | 3,298 of 5,496 | 60% | 0% | Tier 3 |
| Symbicort | Brand | 1,914 of 5,496 | 34.8% | 0% | Tier 3 |
| Synjardy | Brand | 3,609 of 5,496 | 65.7% | 0% | Tier 3 |
| Synthroid | Brand | 5,074 of 5,496 | 92.3% | 0% | Tier 3 |
| Tacrolimus | Generic | 5,496 of 5,496 | 100% | 57.5% | Tier 4 |
| Tadalafil | Generic | 5,496 of 5,496 | 100% | 100% | Tier 4 |
| Tamoxifen | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Tamsulosin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Telmisartan | Generic | 5,327 of 5,496 | 96.9% | 0% | Tier 1 |
| Temazepam | Generic | 5,277 of 5,496 | 96% | 34.8% | Tier 3 |
| Tenofovir Disoproxil | Generic | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Terazosin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Terbinafine | Generic | 5,496 of 5,496 | 100% | 12.2% | Tier 2 |
| Terconazole | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Testosterone | Generic | 5,496 of 5,496 | 100% | 44.1% | Tier 2 |
| Theophylline | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Tiadylt | Brand | 5,267 of 5,496 | 95.8% | 0% | Tier 2 |
| Timolol | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Tiotropium | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Tirosint | Brand | 50 of 5,496 | 0.9% | 2% | Tier 4 |
| Tivicay | Brand | 5,496 of 5,496 | 100% | 0% | Tier 5 |
| Tizanidine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Tobramycin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Tolterodine | Generic | 5,403 of 5,496 | 98.3% | 0.2% | Tier 3 |
| Topiramate | Generic | 5,496 of 5,496 | 100% | 6.8% | Tier 2 |
| Torsemide | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Toujeo | Brand | 4,970 of 5,496 | 90.4% | 0% | Tier 3 |
| Tradjenta | Brand | 5,018 of 5,496 | 91.3% | 0.1% | Tier 3 |
| Tramadol | Generic | 5,476 of 5,496 | 99.6% | 1.8% | Tier 2 |
| Trandolapril | Generic | 5,337 of 5,496 | 97.1% | 0% | Tier 1 |
| Travoprost | Generic | 4,968 of 5,496 | 90.4% | 0.2% | Tier 3 |
| Trazodone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Trelegy | Brand | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Tresiba | Brand | 1,307 of 5,496 | 23.8% | 0.6% | Tier 3 |
| Tretinoin | Generic | 5,496 of 5,496 | 100% | 92.4% | Tier 4 |
| Triamcinolone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Triazolam | Generic | 970 of 5,496 | 17.6% | 65.3% | Tier 4 |
| Trihexyphenidyl | Generic | 5,256 of 5,496 | 95.6% | 20.9% | Tier 2 |
| Trijardy | Brand | 4,472 of 5,496 | 81.4% | 0.2% | Tier 3 |
| Trimethoprim | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Trintellix | Brand | 5,496 of 5,496 | 100% | 27.2% | Tier 4 |
| Triumeq | Brand | 5,496 of 5,496 | 100% | 0% | Tier 4 |
| Trospium | Generic | 4,828 of 5,496 | 87.8% | 0.2% | Tier 3 |
| Trulance | Brand | 1,670 of 5,496 | 30.4% | 1% | Tier 3 |
| Trulicity | Brand | 5,265 of 5,496 | 95.8% | 100% | Tier 3 |
| Twinrix | Brand | 5,496 of 5,496 | 100% | 1% | Tier 1 |
| Tyrvaya | Brand | 1,069 of 5,496 | 19.5% | 0.1% | Tier 4 |
| Ubrelvy | Brand | 4,370 of 5,496 | 79.5% | 97% | Tier 3 |
| Unithroid | Brand | 4,920 of 5,496 | 89.5% | 0% | Tier 3 |
| Ursodeoxycholate | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Valacyclovir | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Valganciclovir | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Valproate | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Valsartan | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Vancomycin | Generic | 5,496 of 5,496 | 100% | 3.9% | Tier 4 |
| Varenicline | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Vascepa | Brand | 4,171 of 5,496 | 75.9% | 0% | Tier 3 |
| Velphoro | Brand | 277 of 5,496 | 5% | 5.4% | Tier 5 |
| Veltassa | Brand | 1,840 of 5,496 | 33.5% | 5.5% | Tier 4 |
| Vemlidy | Brand | 3,153 of 5,496 | 57.4% | 5.5% | Tier 5 |
| Venclexta | Brand | 5,496 of 5,496 | 100% | 98.2% | Tier 3 |
| Venlafaxine | Generic | 5,496 of 5,496 | 100% | 0% | Tier 2 |
| Ventolin | Brand | 3,901 of 5,496 | 71% | 0% | Tier 3 |
| Verapamil | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Victoza | Brand | 6 of 5,496 | 0.1% | 100% | Tier 3 |
| Vilazodone | Generic | 5,496 of 5,496 | 100% | 21.2% | Tier 4 |
| Vraylar | Brand | 5,496 of 5,496 | 100% | 24.6% | Tier 5 |
| Vyndamax | Brand | 3,084 of 5,496 | 56.1% | 96.7% | Tier 5 |
| Vyvanse | Brand | 12 of 5,496 | 0.2% | 83.3% | Tier 4 |
| Vyzulta | Brand | 4,226 of 5,496 | 76.9% | 0.2% | Tier 4 |
| Warfarin | Generic | 5,496 of 5,496 | 100% | 0% | Tier 1 |
| Wegovy | Brand | 175 of 5,496 | 3.2% | 100% | Tier 3 |
| Wixela | Brand | 4,922 of 5,496 | 89.6% | 0% | Tier 3 |
| Xarelto | Brand | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Xcopri | Brand | 5,496 of 5,496 | 100% | 38.8% | Tier 4 |
| Xeljanz | Brand | 1,612 of 5,496 | 29.3% | 100% | Tier 5 |
| XIFAXAN | Brand | 5,496 of 5,496 | 100% | 94.4% | Tier 4 |
| Xigduo | Brand | 5,143 of 5,496 | 93.6% | 0% | Tier 3 |
| Xiidra | Brand | 3,978 of 5,496 | 72.4% | 5.5% | Tier 3 |
| Xtampza | Brand | 980 of 5,496 | 17.8% | 3.8% | Tier 4 |
| Xtandi | Brand | 5,496 of 5,496 | 100% | 98.2% | Tier 5 |
| Xultophy | Brand | 1,870 of 5,496 | 34% | 0% | Tier 3 |
| Yuvafem | Brand | 4,508 of 5,496 | 82% | 0% | Tier 4 |
| Zafirlukast | Generic | 5,278 of 5,496 | 96% | 0% | Tier 4 |
| Zaleplon | Generic | 4,212 of 5,496 | 76.6% | 20.5% | Tier 3 |
| Zenpep | Brand | 5,153 of 5,496 | 93.8% | 0% | Tier 4 |
| Ziprasidone | Generic | 5,496 of 5,496 | 100% | 0% | Tier 3 |
| Zolpidem | Generic | 5,496 of 5,496 | 100% | 27.8% | Tier 2 |
| Zonisamide | Generic | 5,496 of 5,496 | 100% | 6.8% | Tier 2 |