Opioids, Long-Acting

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PDL Reference Documents

Drug Use Review Documents

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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 Carveout
‐ Bill FFS		 Current Drug Use Criteria
00093365721 BUPRENORPHINE buprenorphine PATCH TDWK 10 mcg/hour N Y N Pharmacy PA
00093365740 BUPRENORPHINE buprenorphine PATCH TDWK 10 mcg/hour N Y N Pharmacy PA
42858049340 BUPRENORPHINE buprenorphine PATCH TDWK 10 mcg/hour N Y N Pharmacy PA
47781040704 BUPRENORPHINE buprenorphine PATCH TDWK 10 mcg/hour N Y N Pharmacy PA
50742037401 BUPRENORPHINE buprenorphine PATCH TDWK 10 mcg/hour N Y N Pharmacy PA
50742037404 BUPRENORPHINE buprenorphine PATCH TDWK 10 mcg/hour N Y N Pharmacy PA
69238120302 BUPRENORPHINE buprenorphine PATCH TDWK 10 mcg/hour N Y N Pharmacy PA
59011075104 BUTRANS buprenorphine PATCH TDWK 10 mcg/hour N Y N Pharmacy PA
00093365821 BUPRENORPHINE buprenorphine PATCH TDWK 15 mcg/hour N Y N Pharmacy PA
00093365840 BUPRENORPHINE buprenorphine PATCH TDWK 15 mcg/hour N Y N Pharmacy PA
42858058640 BUPRENORPHINE buprenorphine PATCH TDWK 15 mcg/hour N Y N Pharmacy PA
47781041904 BUPRENORPHINE buprenorphine PATCH TDWK 15 mcg/hour N Y N Pharmacy PA
50742037501 BUPRENORPHINE buprenorphine PATCH TDWK 15 mcg/hour N Y N Pharmacy PA
50742037504 BUPRENORPHINE buprenorphine PATCH TDWK 15 mcg/hour N Y N Pharmacy PA
69238120402 BUPRENORPHINE buprenorphine PATCH TDWK 15 mcg/hour N Y N Pharmacy PA
59011075804 BUTRANS buprenorphine PATCH TDWK 15 mcg/hour N Y N Pharmacy PA
00093365921 BUPRENORPHINE buprenorphine PATCH TDWK 20 mcg/hour N Y N Pharmacy PA
00093365940 BUPRENORPHINE buprenorphine PATCH TDWK 20 mcg/hour N Y N Pharmacy PA
42858083940 BUPRENORPHINE buprenorphine PATCH TDWK 20 mcg/hour N Y N Pharmacy PA
47781040804 BUPRENORPHINE buprenorphine PATCH TDWK 20 mcg/hour N Y N Pharmacy PA
50742037601 BUPRENORPHINE buprenorphine PATCH TDWK 20 mcg/hour N Y N Pharmacy PA
50742037604 BUPRENORPHINE buprenorphine PATCH TDWK 20 mcg/hour N Y N Pharmacy PA
69238120502 BUPRENORPHINE buprenorphine PATCH TDWK 20 mcg/hour N Y N Pharmacy PA
59011075204 BUTRANS buprenorphine PATCH TDWK 20 mcg/hour N Y N Pharmacy PA
00093365621 BUPRENORPHINE buprenorphine PATCH TDWK 5 mcg/hour N Y N Pharmacy PA
00093365640 BUPRENORPHINE buprenorphine PATCH TDWK 5 mcg/hour N Y N Pharmacy PA
42858075040 BUPRENORPHINE buprenorphine PATCH TDWK 5 mcg/hour N Y N Pharmacy PA
47781040604 BUPRENORPHINE buprenorphine PATCH TDWK 5 mcg/hour N Y N Pharmacy PA
50742037201 BUPRENORPHINE buprenorphine PATCH TDWK 5 mcg/hour N Y N Pharmacy PA
50742037204 BUPRENORPHINE buprenorphine PATCH TDWK 5 mcg/hour N Y N Pharmacy PA
69238120202 BUPRENORPHINE buprenorphine PATCH TDWK 5 mcg/hour N Y N Pharmacy PA
59011075004 BUTRANS buprenorphine PATCH TDWK 5 mcg/hour N Y N Pharmacy PA
00093323921 BUPRENORPHINE buprenorphine PATCH TDWK 7.5 mcg/hour N Y N Pharmacy PA
00093323940 BUPRENORPHINE buprenorphine PATCH TDWK 7.5 mcg/hour N Y N Pharmacy PA
42858035340 BUPRENORPHINE buprenorphine PATCH TDWK 7.5 mcg/hour N Y N Pharmacy PA
50742037301 BUPRENORPHINE buprenorphine PATCH TDWK 7.5 mcg/hour N Y N Pharmacy PA
50742037304 BUPRENORPHINE buprenorphine PATCH TDWK 7.5 mcg/hour N Y N Pharmacy PA
69238150502 BUPRENORPHINE buprenorphine PATCH TDWK 7.5 mcg/hour N Y N Pharmacy PA
59011075704 BUTRANS buprenorphine PATCH TDWK 7.5 mcg/hour N Y N Pharmacy PA
59385002201 BELBUCA buprenorphine HCl FILM 150 mcg N Y N Pharmacy PA
59385002260 BELBUCA buprenorphine HCl FILM 150 mcg N Y N Pharmacy PA
59385002301 BELBUCA buprenorphine HCl FILM 300 mcg N Y N Pharmacy PA
59385002360 BELBUCA buprenorphine HCl FILM 300 mcg N Y N Pharmacy PA
59385002401 BELBUCA buprenorphine HCl FILM 450 mcg N Y N Pharmacy PA
59385002460 BELBUCA buprenorphine HCl FILM 450 mcg N Y N Pharmacy PA
59385002501 BELBUCA buprenorphine HCl FILM 600 mcg N Y N Pharmacy PA
59385002560 BELBUCA buprenorphine HCl FILM 600 mcg N Y N Pharmacy PA
59385002101 BELBUCA buprenorphine HCl FILM 75 mcg N Y N Pharmacy PA
59385002160 BELBUCA buprenorphine HCl FILM 75 mcg N Y N Pharmacy PA
59385002601 BELBUCA buprenorphine HCl FILM 750 mcg N Y N Pharmacy PA
59385002660 BELBUCA buprenorphine HCl FILM 750 mcg N Y N Pharmacy PA
59385002701 BELBUCA buprenorphine HCl FILM 900 mcg N Y N Pharmacy PA
59385002760 BELBUCA buprenorphine HCl FILM 900 mcg N Y N Pharmacy PA
00378912416 FENTANYL fentanyl PATCH TD72 100 mcg/hour Y Y N Pharmacy PA
00378912498 FENTANYL fentanyl PATCH TD72 100 mcg/hour Y Y N Pharmacy PA
00406910076 FENTANYL fentanyl PATCH TD72 100 mcg/hour Y Y N Pharmacy PA
47781042811 FENTANYL fentanyl PATCH TD72 100 mcg/hour Y Y N Pharmacy PA
47781042847 FENTANYL fentanyl PATCH TD72 100 mcg/hour Y Y N Pharmacy PA
50742055601 FENTANYL fentanyl PATCH TD72 100 mcg/hour Y Y N Pharmacy PA
50742055605 FENTANYL fentanyl PATCH TD72 100 mcg/hour Y Y N Pharmacy PA
00378911916 FENTANYL fentanyl PATCH TD72 12 mcg/hour Y Y N Pharmacy PA
00378911998 FENTANYL fentanyl PATCH TD72 12 mcg/hour Y Y N Pharmacy PA
00406911276 FENTANYL fentanyl PATCH TD72 12 mcg/hour Y Y N Pharmacy PA
47781042311 FENTANYL fentanyl PATCH TD72 12 mcg/hour Y Y N Pharmacy PA
47781042347 FENTANYL fentanyl PATCH TD72 12 mcg/hour Y Y N Pharmacy PA
50742054901 FENTANYL fentanyl PATCH TD72 12 mcg/hour Y Y N Pharmacy PA
50742054905 FENTANYL fentanyl PATCH TD72 12 mcg/hour Y Y N Pharmacy PA
00378912116 FENTANYL fentanyl PATCH TD72 25 mcg/hour Y Y N Pharmacy PA
00378912198 FENTANYL fentanyl PATCH TD72 25 mcg/hour Y Y N Pharmacy PA
00406912576 FENTANYL fentanyl PATCH TD72 25 mcg/hour Y Y N Pharmacy PA
47781042411 FENTANYL fentanyl PATCH TD72 25 mcg/hour Y Y N Pharmacy PA
47781042447 FENTANYL fentanyl PATCH TD72 25 mcg/hour Y Y N Pharmacy PA
50742055001 FENTANYL fentanyl PATCH TD72 25 mcg/hour Y Y N Pharmacy PA
50742055005 FENTANYL fentanyl PATCH TD72 25 mcg/hour Y Y N Pharmacy PA
00378912516 FENTANYL fentanyl PATCH TD72 37.5 mcg/hour N Y N Pharmacy PA
00378912598 FENTANYL fentanyl PATCH TD72 37.5 mcg/hour N Y N Pharmacy PA
00406903776 FENTANYL fentanyl PATCH TD72 37.5 mcg/hour N Y N Pharmacy PA
50742055101 FENTANYL fentanyl PATCH TD72 37.5 mcg/hour N Y N Pharmacy PA
50742055105 FENTANYL fentanyl PATCH TD72 37.5 mcg/hour N Y N Pharmacy PA
00378912216 FENTANYL fentanyl PATCH TD72 50 mcg/hour Y Y N Pharmacy PA
00378912298 FENTANYL fentanyl PATCH TD72 50 mcg/hour Y Y N Pharmacy PA
00406915076 FENTANYL fentanyl PATCH TD72 50 mcg/hour Y Y N Pharmacy PA
47781042611 FENTANYL fentanyl PATCH TD72 50 mcg/hour Y Y N Pharmacy PA
47781042647 FENTANYL fentanyl PATCH TD72 50 mcg/hour Y Y N Pharmacy PA
50742055201 FENTANYL fentanyl PATCH TD72 50 mcg/hour Y Y N Pharmacy PA
50742055205 FENTANYL fentanyl PATCH TD72 50 mcg/hour Y Y N Pharmacy PA
00378912616 FENTANYL fentanyl PATCH TD72 62.5 mcg/hour N Y N Pharmacy PA
00378912698 FENTANYL fentanyl PATCH TD72 62.5 mcg/hour N Y N Pharmacy PA
00406906276 FENTANYL fentanyl PATCH TD72 62.5 mcg/hour N Y N Pharmacy PA
50742055301 FENTANYL fentanyl PATCH TD72 62.5 mcg/hour N Y N Pharmacy PA
50742055305 FENTANYL fentanyl PATCH TD72 62.5 mcg/hour N Y N Pharmacy PA
00378912316 FENTANYL fentanyl PATCH TD72 75 mcg/hour Y Y N Pharmacy PA
00378912398 FENTANYL fentanyl PATCH TD72 75 mcg/hour Y Y N Pharmacy PA
00406917576 FENTANYL fentanyl PATCH TD72 75 mcg/hour Y Y N Pharmacy PA
47781042711 FENTANYL fentanyl PATCH TD72 75 mcg/hour Y Y N Pharmacy PA
47781042747 FENTANYL fentanyl PATCH TD72 75 mcg/hour Y Y N Pharmacy PA
50742055401 FENTANYL fentanyl PATCH TD72 75 mcg/hour Y Y N Pharmacy PA
50742055405 FENTANYL fentanyl PATCH TD72 75 mcg/hour Y Y N Pharmacy PA
00378912716 FENTANYL fentanyl PATCH TD72 87.5 mcg/hour N Y N Pharmacy PA
00378912798 FENTANYL fentanyl PATCH TD72 87.5 mcg/hour N Y N Pharmacy PA
50742055501 FENTANYL fentanyl PATCH TD72 87.5 mcg/hour N Y N Pharmacy PA
50742055505 FENTANYL fentanyl PATCH TD72 87.5 mcg/hour N Y N Pharmacy PA
47781040960 HYDROCODONE BITARTRATE ER hydrocodone bitartrate CAP ER 12H 10 mg N Y N Pharmacy PA
47781041060 HYDROCODONE BITARTRATE ER hydrocodone bitartrate CAP ER 12H 15 mg N Y N Pharmacy PA
47781041160 HYDROCODONE BITARTRATE ER hydrocodone bitartrate CAP ER 12H 20 mg N Y N Pharmacy PA
47781041260 HYDROCODONE BITARTRATE ER hydrocodone bitartrate CAP ER 12H 30 mg N Y N Pharmacy PA
47781041360 HYDROCODONE BITARTRATE ER hydrocodone bitartrate CAP ER 12H 40 mg N Y N Pharmacy PA
47781041460 HYDROCODONE BITARTRATE ER hydrocodone bitartrate CAP ER 12H 50 mg N Y N Pharmacy PA
47781039760 HYDROCODONE BITARTRATE ER hydrocodone bitartrate TAB ER 24H 100 mg N Y N Pharmacy PA
59011027660 HYSINGLA ER hydrocodone bitartrate TAB ER 24H 100 mg N Y N Pharmacy PA
47781039860 HYDROCODONE BITARTRATE ER hydrocodone bitartrate TAB ER 24H 120 mg N Y N Pharmacy PA
47781039260 HYDROCODONE BITARTRATE ER hydrocodone bitartrate TAB ER 24H 20 mg N Y N Pharmacy PA
59011027160 HYSINGLA ER hydrocodone bitartrate TAB ER 24H 20 mg N Y N Pharmacy PA
47781039360 HYDROCODONE BITARTRATE ER hydrocodone bitartrate TAB ER 24H 30 mg N Y N Pharmacy PA
59011027260 HYSINGLA ER hydrocodone bitartrate TAB ER 24H 30 mg N Y N Pharmacy PA
47781039460 HYDROCODONE BITARTRATE ER hydrocodone bitartrate TAB ER 24H 40 mg N Y N Pharmacy PA
59011027360 HYSINGLA ER hydrocodone bitartrate TAB ER 24H 40 mg N Y N Pharmacy PA
47781039560 HYDROCODONE BITARTRATE ER hydrocodone bitartrate TAB ER 24H 60 mg N Y N Pharmacy PA
59011027460 HYSINGLA ER hydrocodone bitartrate TAB ER 24H 60 mg N Y N Pharmacy PA
47781039660 HYDROCODONE BITARTRATE ER hydrocodone bitartrate TAB ER 24H 80 mg N Y N Pharmacy PA
59011027560 HYSINGLA ER hydrocodone bitartrate TAB ER 24H 80 mg N Y N Pharmacy PA
00574029401 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 12 mg N Y N Pharmacy PA
13811070210 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 12 mg N Y N Pharmacy PA
31722012001 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 12 mg N Y N Pharmacy PA
00574029501 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 16 mg N Y N Pharmacy PA
13811070310 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 16 mg N Y N Pharmacy PA
31722012101 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 16 mg N Y N Pharmacy PA
13811070410 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 32 mg N Y N Pharmacy PA
31722012201 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 32 mg N Y N Pharmacy PA
00574029301 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 8 mg N Y N Pharmacy PA
13811070110 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 8 mg N Y N Pharmacy PA
31722011901 HYDROMORPHONE ER hydromorphone HCl TAB ER 24H 8 mg N Y N Pharmacy PA
00054043825 LEVORPHANOL TARTRATE levorphanol tartrate TABLET 2 mg N Y N Pharmacy PA
00406222401 LEVORPHANOL TARTRATE levorphanol tartrate TABLET 2 mg N Y N Pharmacy PA
00527323637 LEVORPHANOL TARTRATE levorphanol tartrate TABLET 2 mg N Y N Pharmacy PA
57664076288 LEVORPHANOL TARTRATE levorphanol tartrate TABLET 2 mg N Y N Pharmacy PA
69543041710 LEVORPHANOL TARTRATE levorphanol tartrate TABLET 2 mg N Y N Pharmacy PA
72989041710 LEVORPHANOL TARTRATE levorphanol tartrate TABLET 2 mg N Y N Pharmacy PA
00527323737 LEVORPHANOL TARTRATE levorphanol tartrate TABLET 3 mg N Y N Pharmacy PA
57664005888 LEVORPHANOL TARTRATE levorphanol tartrate TABLET 3 mg N Y N Pharmacy PA
00054039168 METHADONE HCL methadone HCl ORAL CONC 10 mg/mL N Y N Pharmacy PA
00054039268 METHADONE HCL methadone HCl ORAL CONC 10 mg/mL N Y N Pharmacy PA
00406412303 METHADONE HCL methadone HCl ORAL CONC 10 mg/mL N Y N Pharmacy PA
00406412310 METHADONE HCL methadone HCl ORAL CONC 10 mg/mL N Y N Pharmacy PA
00527192736 METHADONE HCL methadone HCl ORAL CONC 10 mg/mL N Y N Pharmacy PA
66689069479 METHADONE HCL methadone HCl ORAL CONC 10 mg/mL N Y N Pharmacy PA
66689069579 METHADONE HCL methadone HCl ORAL CONC 10 mg/mL N Y N Pharmacy PA
00054355344 METHADONE INTENSOL methadone HCl ORAL CONC 10 mg/mL N Y N Pharmacy PA
00406052710 METHADOSE methadone HCl ORAL CONC 10 mg/mL N Y N Pharmacy PA
00406872510 METHADOSE methadone HCl ORAL CONC 10 mg/mL N Y N Pharmacy PA
00054355663 METHADONE HCL methadone HCl SOLUTION 10 mg/5 mL N Y N Pharmacy PA
00406622105 METHADONE HCL methadone HCl SOLUTION 10 mg/5 mL N Y N Pharmacy PA
00054355563 METHADONE HCL methadone HCl SOLUTION 5 mg/5 mL N Y N Pharmacy PA
00406622505 METHADONE HCL methadone HCl SOLUTION 5 mg/5 mL N Y N Pharmacy PA
60687081840 METHADONE HCL methadone HCl SOLUTION 5 mg/5 mL N Y N Pharmacy PA
60687081846 METHADONE HCL methadone HCl SOLUTION 5 mg/5 mL N Y N Pharmacy PA
60687081886 METHADONE HCL methadone HCl SOLUTION 5 mg/5 mL N Y N Pharmacy PA
68094003159 METHADONE HCL methadone HCl SOLUTION 5 mg/5 mL N Y N Pharmacy PA
68094003162 METHADONE HCL methadone HCl SOLUTION 5 mg/5 mL N Y N Pharmacy PA
00054071020 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
00054071025 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
00054855411 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
00378327201 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
00406577101 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
00406577123 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
00406577162 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
00904741761 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
31722094701 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
64850060401 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
66689082010 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
66689083699 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
67877011601 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
67877066001 METHADONE HCL methadone HCl TABLET 10 mg N Y N Pharmacy PA
00054070920 METHADONE HCL methadone HCl TABLET 5 mg N Y N Pharmacy PA
00054070925 METHADONE HCL methadone HCl TABLET 5 mg N Y N Pharmacy PA
00054855311 METHADONE HCL methadone HCl TABLET 5 mg N Y N Pharmacy PA
00378326001 METHADONE HCL methadone HCl TABLET 5 mg N Y N Pharmacy PA
00406575501 METHADONE HCL methadone HCl TABLET 5 mg N Y N Pharmacy PA
00406575523 METHADONE HCL methadone HCl TABLET 5 mg N Y N Pharmacy PA
00406575562 METHADONE HCL methadone HCl TABLET 5 mg N Y N Pharmacy PA
31722094601 METHADONE HCL methadone HCl TABLET 5 mg N Y N Pharmacy PA
64850060301 METHADONE HCL methadone HCl TABLET 5 mg N Y N Pharmacy PA
67877065901 METHADONE HCL methadone HCl TABLET 5 mg N Y N Pharmacy PA
00054854725 METHADONE HCL methadone HCl TABLET SOL 40 mg N Y N Pharmacy PA
00406254001 METHADONE HCL methadone HCl TABLET SOL 40 mg N Y N Pharmacy PA
66689089840 METHADONE HCL methadone HCl TABLET SOL 40 mg N Y N Pharmacy PA
00406054034 METHADOSE methadone HCl TABLET SOL 40 mg N Y N Pharmacy PA
00832022500 MORPHINE SULFATE ER morphine sulfate CAP ER PEL 10 mg N Y N Pharmacy PA
00832023300 MORPHINE SULFATE ER morphine sulfate CAP ER PEL 100 mg N Y N Pharmacy PA
00832022600 MORPHINE SULFATE ER morphine sulfate CAP ER PEL 20 mg N Y N Pharmacy PA
00832022700 MORPHINE SULFATE ER morphine sulfate CAP ER PEL 30 mg N Y N Pharmacy PA
00832022800 MORPHINE SULFATE ER morphine sulfate CAP ER PEL 50 mg N Y N Pharmacy PA
00832022900 MORPHINE SULFATE ER morphine sulfate CAP ER PEL 60 mg N Y N Pharmacy PA
00832023000 MORPHINE SULFATE ER morphine sulfate CAP ER PEL 80 mg N Y N Pharmacy PA
00228309311 MORPHINE SULFATE ER morphine sulfate CPMP 24HR 120 mg N Y N Pharmacy PA
00228309011 MORPHINE SULFATE ER morphine sulfate CPMP 24HR 30 mg N Y N Pharmacy PA
00228311611 MORPHINE SULFATE ER morphine sulfate CPMP 24HR 45 mg N Y N Pharmacy PA
00228309111 MORPHINE SULFATE ER morphine sulfate CPMP 24HR 60 mg N Y N Pharmacy PA
00228311711 MORPHINE SULFATE ER morphine sulfate CPMP 24HR 75 mg N Y N Pharmacy PA
00228309211 MORPHINE SULFATE ER morphine sulfate CPMP 24HR 90 mg N Y N Pharmacy PA
00228432311 MORPHINE SULFATE ER morphine sulfate TABLET ER 100 mg Y Y N Pharmacy PA
00406839001 MORPHINE SULFATE ER morphine sulfate TABLET ER 100 mg Y Y N Pharmacy PA
00406839023 MORPHINE SULFATE ER morphine sulfate TABLET ER 100 mg Y Y N Pharmacy PA
00406839062 MORPHINE SULFATE ER morphine sulfate TABLET ER 100 mg Y Y N Pharmacy PA
00904656061 MORPHINE SULFATE ER morphine sulfate TABLET ER 100 mg Y Y N Pharmacy PA
42858080401 MORPHINE SULFATE ER morphine sulfate TABLET ER 100 mg Y Y N Pharmacy PA
63304045201 MORPHINE SULFATE ER morphine sulfate TABLET ER 100 mg Y Y N Pharmacy PA
42858079901 MS CONTIN morphine sulfate TABLET ER 100 mg Y Y N Pharmacy PA
00228427011 MORPHINE SULFATE ER morphine sulfate TABLET ER 15 mg Y Y N Pharmacy PA
00406831501 MORPHINE SULFATE ER morphine sulfate TABLET ER 15 mg Y Y N Pharmacy PA
00406831523 MORPHINE SULFATE ER morphine sulfate TABLET ER 15 mg Y Y N Pharmacy PA
00406831562 MORPHINE SULFATE ER morphine sulfate TABLET ER 15 mg Y Y N Pharmacy PA
00904655761 MORPHINE SULFATE ER morphine sulfate TABLET ER 15 mg Y Y N Pharmacy PA
42858080101 MORPHINE SULFATE ER morphine sulfate TABLET ER 15 mg Y Y N Pharmacy PA
63304045001 MORPHINE SULFATE ER morphine sulfate TABLET ER 15 mg Y Y N Pharmacy PA
68084015701 MORPHINE SULFATE ER morphine sulfate TABLET ER 15 mg Y Y N Pharmacy PA
68084015711 MORPHINE SULFATE ER morphine sulfate TABLET ER 15 mg Y Y N Pharmacy PA
42858051501 MS CONTIN morphine sulfate TABLET ER 15 mg Y Y N Pharmacy PA
00228434711 MORPHINE SULFATE ER morphine sulfate TABLET ER 200 mg Y Y N Pharmacy PA
00406832001 MORPHINE SULFATE ER morphine sulfate TABLET ER 200 mg Y Y N Pharmacy PA
42858080501 MORPHINE SULFATE ER morphine sulfate TABLET ER 200 mg Y Y N Pharmacy PA
63304045301 MORPHINE SULFATE ER morphine sulfate TABLET ER 200 mg Y Y N Pharmacy PA
00228427111 MORPHINE SULFATE ER morphine sulfate TABLET ER 30 mg Y Y N Pharmacy PA
00406833001 MORPHINE SULFATE ER morphine sulfate TABLET ER 30 mg Y Y N Pharmacy PA
00406833023 MORPHINE SULFATE ER morphine sulfate TABLET ER 30 mg Y Y N Pharmacy PA
00406833062 MORPHINE SULFATE ER morphine sulfate TABLET ER 30 mg Y Y N Pharmacy PA
00904655861 MORPHINE SULFATE ER morphine sulfate TABLET ER 30 mg Y Y N Pharmacy PA
42858080201 MORPHINE SULFATE ER morphine sulfate TABLET ER 30 mg Y Y N Pharmacy PA
63304045101 MORPHINE SULFATE ER morphine sulfate TABLET ER 30 mg Y Y N Pharmacy PA
68084015801 MORPHINE SULFATE ER morphine sulfate TABLET ER 30 mg Y Y N Pharmacy PA
68084015811 MORPHINE SULFATE ER morphine sulfate TABLET ER 30 mg Y Y N Pharmacy PA
42858063101 MS CONTIN morphine sulfate TABLET ER 30 mg Y Y N Pharmacy PA
00228431111 MORPHINE SULFATE ER morphine sulfate TABLET ER 60 mg Y Y N Pharmacy PA
00406838001 MORPHINE SULFATE ER morphine sulfate TABLET ER 60 mg Y Y N Pharmacy PA
00406838023 MORPHINE SULFATE ER morphine sulfate TABLET ER 60 mg Y Y N Pharmacy PA
00406838062 MORPHINE SULFATE ER morphine sulfate TABLET ER 60 mg Y Y N Pharmacy PA
00904655961 MORPHINE SULFATE ER morphine sulfate TABLET ER 60 mg Y Y N Pharmacy PA
42858080301 MORPHINE SULFATE ER morphine sulfate TABLET ER 60 mg Y Y N Pharmacy PA
63304075801 MORPHINE SULFATE ER morphine sulfate TABLET ER 60 mg Y Y N Pharmacy PA
42858076001 MS CONTIN morphine sulfate TABLET ER 60 mg Y Y N Pharmacy PA
31722010901 OXYCODONE HCL ER oxycodone HCl TAB ER 12H 10 mg N Y N Pharmacy PA
69238229401 OXYCODONE HCL ER oxycodone HCl TAB ER 12H 10 mg N Y N Pharmacy PA
59011041010 OXYCONTIN oxycodone HCl TAB ER 12H 10 mg N Y N Pharmacy PA
59011041020 OXYCONTIN oxycodone HCl TAB ER 12H 10 mg N Y N Pharmacy PA
59011041510 OXYCONTIN oxycodone HCl TAB ER 12H 15 mg N Y N Pharmacy PA
59011041520 OXYCONTIN oxycodone HCl TAB ER 12H 15 mg N Y N Pharmacy PA
31722011001 OXYCODONE HCL ER oxycodone HCl TAB ER 12H 20 mg N Y N Pharmacy PA
69238229601 OXYCODONE HCL ER oxycodone HCl TAB ER 12H 20 mg N Y N Pharmacy PA
59011042010 OXYCONTIN oxycodone HCl TAB ER 12H 20 mg N Y N Pharmacy PA
59011042020 OXYCONTIN oxycodone HCl TAB ER 12H 20 mg N Y N Pharmacy PA
59011043010 OXYCONTIN oxycodone HCl TAB ER 12H 30 mg N Y N Pharmacy PA
59011043020 OXYCONTIN oxycodone HCl TAB ER 12H 30 mg N Y N Pharmacy PA
31722011101 OXYCODONE HCL ER oxycodone HCl TAB ER 12H 40 mg N Y N Pharmacy PA
69238229801 OXYCODONE HCL ER oxycodone HCl TAB ER 12H 40 mg N Y N Pharmacy PA
59011044010 OXYCONTIN oxycodone HCl TAB ER 12H 40 mg N Y N Pharmacy PA
59011044020 OXYCONTIN oxycodone HCl TAB ER 12H 40 mg N Y N Pharmacy PA
59011046010 OXYCONTIN oxycodone HCl TAB ER 12H 60 mg N Y N Pharmacy PA
59011046020 OXYCONTIN oxycodone HCl TAB ER 12H 60 mg N Y N Pharmacy PA
69238230001 OXYCODONE HCL ER oxycodone HCl TAB ER 12H 80 mg N Y N Pharmacy PA
59011048010 OXYCONTIN oxycodone HCl TAB ER 12H 80 mg N Y N Pharmacy PA
59011048020 OXYCONTIN oxycodone HCl TAB ER 12H 80 mg N Y N Pharmacy PA
64896069701 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 10 mg N Y N Pharmacy PA
64896069713 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 10 mg N Y N Pharmacy PA
64896069801 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 15 mg N Y N Pharmacy PA
64896069813 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 15 mg N Y N Pharmacy PA
64896069901 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 20 mg N Y N Pharmacy PA
64896069913 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 20 mg N Y N Pharmacy PA
64896070001 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 30 mg N Y N Pharmacy PA
64896070013 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 30 mg N Y N Pharmacy PA
64896070101 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 40 mg N Y N Pharmacy PA
64896070113 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 40 mg N Y N Pharmacy PA
64896069501 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 5 mg N Y N Pharmacy PA
64896069513 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 5 mg N Y N Pharmacy PA
64896069601 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 7.5 mg N Y N Pharmacy PA
64896069613 OXYMORPHONE HCL ER oxymorphone HCl TAB ER 12H 7.5 mg N Y N Pharmacy PA
68025007330 CONZIP tramadol HCl CPBP 17-83 300 mg N Y N Pharmacy PA
13811069130 TRAMADOL HCL ER tramadol HCl CPBP 17-83 300 mg N Y N Pharmacy PA
68025007130 CONZIP tramadol HCl CPBP 25-75 100 mg N Y N Pharmacy PA
13811068930 TRAMADOL HCL ER tramadol HCl CPBP 25-75 100 mg N Y N Pharmacy PA
68025007230 CONZIP tramadol HCl CPBP 25-75 200 mg N Y N Pharmacy PA
13811069030 TRAMADOL HCL ER tramadol HCl CPBP 25-75 200 mg N Y N Pharmacy PA
47335085983 TRAMADOL HCL ER tramadol HCl TAB ER 24H 100 mg N Y N Pharmacy PA
68180069706 TRAMADOL HCL ER tramadol HCl TAB ER 24H 100 mg N Y N Pharmacy PA
47335086083 TRAMADOL HCL ER tramadol HCl TAB ER 24H 200 mg N Y N Pharmacy PA
68180069806 TRAMADOL HCL ER tramadol HCl TAB ER 24H 200 mg N Y N Pharmacy PA
47335086183 TRAMADOL HCL ER tramadol HCl TAB ER 24H 300 mg N Y N Pharmacy PA
68180069906 TRAMADOL HCL ER tramadol HCl TAB ER 24H 300 mg N Y N Pharmacy PA
47335053183 TRAMADOL HCL ER tramadol HCl TBMP 24HR 100 mg N Y N Pharmacy PA
47335053188 TRAMADOL HCL ER tramadol HCl TBMP 24HR 100 mg N Y N Pharmacy PA
47335053383 TRAMADOL HCL ER tramadol HCl TBMP 24HR 200 mg N Y N Pharmacy PA
47335053388 TRAMADOL HCL ER tramadol HCl TBMP 24HR 200 mg N Y N Pharmacy PA
47335053783 TRAMADOL HCL ER tramadol HCl TBMP 24HR 300 mg N Y N Pharmacy PA
47335053788 TRAMADOL HCL ER tramadol HCl TBMP 24HR 300 mg N Y N Pharmacy PA
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