2017 FormulAry
oF Covered
PresCriPtion drugs
SelectHealth
Effective 4/1/2017- 6/31/2017
Any questions? Call toll-free
1-866-469-7774
TTY: 711
8 am to 6 pm, Monday - Friday
1250 Broadway, 11th Floor, New York, NY 10001
www.vnsnychoice.org/selecthealth
© 2016 VNSNY Choice
VNSNY CHOICE SelectHealth Formulary
April 2017
Foreword
MedImpact is a Pharmacy Benefit Manager for VNSNY CHOICE SelectHealth. This document represents
the efforts of the MedImpact Healthcare Systems Pharmacy and Therapeutics (P & T) and Formulary
Committees to provide physicians and pharmacists with a method to evaluate the safety, efficacy and costeffectiveness of commercially available drug products. A structured approach to the drug selection process is
essential in ensuring continuing patient access to rational drug therapies.
This is accomplished through the auspices of the MedImpact P & T and Formulary Committees. These
committees meet quarterly and more often as warranted to ensure clinical relevancy of the Formulary. To
accommodate changes to this document, updates are made accessible as necessary.
Access to the most current version of the VNSNY CHOICE SelectHealth Formulary can be obtained by
visiting www.vnsnychoice.org
The MedImpact P & T and Formulary Committees use the following criteria in the evaluation of drug
selection for VNSNY CHOICE SelectHealth Formulary:
● Drug safety profile
● Drug efficacy
● Comparison of relevant therapeutic benefits to current formulary agents of similar use, and to minimize
therapeutic duplication where possible
● Cost-effectiveness relative to comparable therapies
How to Use the Formulary
The Formulary is a list of medications available to VNSNY CHOICE SelectHealth members under their
pharmacy benefit. All drugs are listed by their generic names and most common proprietary (branded) name.
The Formulary may be accessed by using the index, either by generic or proprietary name and by therapeutic
drug category. In situations where an FDA approved generic equivalent is available, brand names are listed
for reference purposes only, and do not denote coverage for the brand, unless specifically noted.
All drugs are listed in each category in alphabetical order by generic name. Where an FDA approved generic
is available for the listed generic name, the generic name is bolded.
For certain agents within the Formulary, a recommended prescribing guideline may apply. These are denoted
throughout the document using the following symbols:
AGE
G
PA
QL
Age Edit
Gender Edit
Prior Authorization
Quantity Limit
ST
Step Therapy
Coverage may depend on patient age
Coverage may depend on patient gender
Requires specific physician request process
Coverage may be limited to specific quantities
per prescription and/or time period
Coverage may depend on previous use of another drug
Please refer to the prescribing guideline appendix within this document for details regarding specific agents.
VNSNY
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Benefit Coverage and Limitations
This printed Formulary does not provide information regarding the specific coverage and limitations an
individual member may be subject to. Many members have specific benefit inclusions, exclusions, copays,
or a lack of coverage, which are not reflected in the Formulary.
The Formulary applies only to outpatient drugs provided to members, and does not apply to medications used
in inpatient settings. If a member has any specific questions regarding their coverage, they should contact
VNSNY CHOICE SelectHealth Member Services at 1-866-469-7774 Monday through Friday, 8:00 am to
6:00 pm. TTY users call 711.
Depending upon a member’s specific benefit parameters, the following topics may apply:
1. Generic Substitution
When available, FDA approved generic drugs are to be used in all situations, regardless of the brand
name indicated. The generic names are bolded in the formulary listing wherever an FDA approved
generic drug product is available. Greater economy is realized through the use of generic equivalents.
This policy is not meant to preclude or supplant any state statutes that may exist. All drugs that are or
become available generically are subject to review by MedImpact’s Pharmacy and Therapeutics
Committee. MedImpact approves such multi-source drugs for addition to the MAC list based on the
following criteria:
●
●
●
A multi-source drug product manufactured by at least one (1) nationally marketed company.
At least one (1) of the generic manufacturer’s products must have an “A” rating or the generic product
has been determined to be unassociated with efficacy, safety or bioequivalence concerns by the
MedImpact P & T Committee.
Drug product will be approved for generic substitution by the MedImpact P & T Committee.
This list is reviewed and updated periodically based on the clinical literature and pharmacokinetic
characteristics of currently available versions of these drug products.
If a member or physician requests a brand name product in lieu of an approved generic, and physician
determines that there is a documented medical need for the brand equivalent, a request for coverage may
be made using the medication request process at 1-888-678-7741, 24 hours a day, and 7 days a week.
2. Tier Benefit Design
The Formulary may be applied to a tier benefit design, where the member shares the cost of prescription
drug therapy based on the drug’s tier and copayment or coinsurance. In most instances, generically
available drugs will be covered in a separate lower tier (low copay), preferred branded drugs listed on the
Formulary will be covered under a higher tier, and branded drugs not on the Formulary will be covered
under a separate non-preferred branded drug copay tier. Essential health benefit/preventative
medications, if available on your plans formulary (applies to new and non-grandfathered plans), will be
covered without cost sharing (zero copay).
TIER DEFINITIONS:
TIER 1: Preferred generic medications (formulary agents)
TIER 2: Preferred brand medications (formulary agents)
TIER 3: Non-preferred medications (non-formulary agents)
TIER 4: Zero Copay/Preventative medications
TIER 5: Over the Counter (OTC)
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3. Medication Request Process
Depending upon plan benefit design, a medication request process may apply as follows:
A. Coverage Exceptions:
Drugs that are listed in the Formulary with associated Prior Authorization (PA) require evaluation, per
MedImpact P & T Committee Prior Authorization guidelines prior to dispensing at a network
pharmacy. Each request will be reviewed on an individual patient need basis. If the request does not
meet the guidelines established by the P & T Committee, the request will not be approved and
alternative therapy may be recommended.
B. Obtaining Coverage
Coverage, questions or information regarding the medication request or formulary process may be
obtained by:
1.
Faxing a completed Medication Request Form to MedImpactat 1-858-790-7100.
2. Contacting MedImpact at 1-888-678-7741and providing all necessary information requested.
MedImpact will provide an authorization number, specific for the medical need, for all approved
requests. Non-approved requests may be appealed. The prescriber must provide information to
support the appeal on the basis of medical necessity. Prior Authorization is generally not available for
drugs that are specifically excluded by benefit design.
4. General Exclusions
A. Drugs specifically listed as not covered.
B. Any drug products used for cosmetic purposes.
C. Experimental drug products or any drug product used in an experimental manner.
D. Replacement of lost or stolen medication.
E. Non-self-administered injectable drug products unless otherwise specified in the Formulary listing.
F. Foreign sourced drugs or drugs not approved by the United States Food & Drug Administration,
except in certain cases of drug shortage, when allowed under the individual’s pharmacy benefit.
The P & T and Formulary Committees recognize that not all medical needs can be met with this
document and encourage inquiries about alternative therapies.
5. Pharmacist and Physician Communication
The Formulary is a tool to promote cost-effective prescription drug use. The P & T and Formulary
Committees have made every attempt to create a document that meets all therapeutic needs; however, the
art of medicine makes this a formidable task. MedImpact welcomes the participation of physicians,
pharmacists, and ancillary medical providers, in this dynamic process. Physicians and pharmacists are
encouraged to direct any suggestions, comments or formulary additions to MedImpact at the following
address:
Chairperson, Pharmacy & Therapeutics Committee
MedImpact Healthcare Systems, Inc.
10181 Scripps Gateway Court
San Diego, CA 92131
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Medication Request Form (MRF)
MedImpact Healthcare Systems, Inc.
DO NOT WRITE IN
BLOCKED AREAS
FOR INTERNAL USE ONLY
Contacted:
Physician:
Pharmacy:
Patient:
Attn: Prior Authorization
Department
10181 Scripps Gateway Court
San Diego, CA 92131
Phone 1-888-678-7741
Phone: 1-888-678-7741
Fax: 858-790-7100
DO NOT WRITE IN
BLOCKED AREAS
FOR INTERNAL USE ONLY
Approved:
Denied:
Returned:
PA #:
Instructions:
This form is to be used by participating physicians and providers to obtain coverage for a non-formulary drug
for which there is no suitable alternative available. Please complete this form and fax to MedImpact
Healthcare Systems, Inc. at 1-858 790-7100 or please call 1-888-678-7741 with this information. If you have
any questions regarding this process, please contact MedImpact’s Customer Service at 1-888-678-7741), 24
hours a day, 7 days a week.
Review Criteria:
The following guidelines are used in reviewing medication requests:
1. The use of Formulary Drug Products is contraindicated in the patient.
2. The patient has failed an appropriate trial of Formulary or related agents.
3. The choices available in the Formulary are not suited for the present patient care need and the drug
selected is required for patient safety.
4. The use of a Formulary Drug Product may provoke an underlying medical condition, which would be
detrimental to patient care
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Medication Request Information (please complete each section of this form prior to transmittal):
Patient’s Health Plan (required):
Patient Name (required):
Patient ID # (required):
Physician Name/Specialty:
Physician ID#/DEA#:
Patient DOB (required):
Physician Area Code and Telephone Number:
(
Diagnosis (required):
-
Physician Area Code and Fax Number (required):
(
Pharmacy used by Member:
)
)
-
Pharmacy Area Code and Telephone Number:
(
)
-
Drug Requested:
Quantity (per month):
Dose:
Length of Treatment (please be specific):
Strength:
Dosage Form (e.g., Oral, Injection):
Reason for Medication Request (please be specific, give detail):
Other Medications Tried and/or Failed (please be specific, give detail including reason for failure):
Other Pertinent History (relative or pertaining to this request):
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Formulario de VNSNY CHOICE SelectHealth
Abril de 2017
Prólogo
MedImpact es un administrador del beneficio de farmacia para VNSNY CHOICE SelectHealth. Este
documento representa los esfuerzos de los Comités de Farmacia y Terapéutica de MedImpact Healthcare
Systems (Pharmacy and Therapeutics, P & T) y el Formulario para proporcionar a los médicos y
farmacéuticos un método para evaluar la seguridad, eficacia y rentabilidad de los productos medicinales
disponibles comercialmente. Un enfoque estructurado al proceso de selección del medicamento es esencial
para asegurar el acceso continuo del paciente a las terapias racionales de medicamentos.
Esto se lleva a cabo a través de los auspicios de los Comités de P & T y la Lista de medicamentos de
MedImpact. Estos comités se reúnen trimestralmente y con más frecuencia si es necesario para asegurar la
relevancia clínica de la lista de medicamentos. Para adaptar los cambios a este documento, las
actualizaciones se encuentran accesibles según sea necesario.
El acceso a la versión más actualizada del Formulario de VNSNY CHOICE SelectHealth se puede
obtener visitando www.vnsnychoice.org
Los Comités de P & T y de la Lista de medicamentos de MedImpact usan los siguientes criterios en la
evaluación de selección de medicamentos para la Lista de medicamentos de VNSNY CHOICE SelectHealth:
• Perfil de seguridad del medicamento
• Eficacia del medicamento
• Comparación de beneficios terapéuticos relevantes con agentes actuales de uso similar de la Lista de
medicamentos, y para minimizar duplicidad terapéutica cuando sea posible
• Costo-efectividad en relación a terapias comparables
Cómo usar la Lista de medicamentos
La Lista de medicamentos es un listado de medicamentos disponibles para los afiliados de VNSNY CHOICE
SelectHealth bajo su beneficio de farmacia. Todos los medicamentos están listados por sus nombres
genéricos y nombre comercial más común (marca). Puede obtener acceso a la Lista de medicamentos usando
el índice, ya sea por nombre genérico o comercial y por categoría terapéutica del medicamento. En
situaciones en las que un genérico equivalente aprobado por la FDA esté disponible, los nombres de marca
se encuentran listados únicamente por motivos de referencia y no denotan cobertura de la marca, a menos
que se especifique.
Todos los medicamentos se encuentran listados en cada categoría en orden alfabético por nombre genérico.
Cuando un medicamento genérico aprobado por la FDA está disponible para el nombre genérico listado, el
nombre genérico se encuentra en negrita.
Para ciertos agentes dentro de la Lista de medicamentos, puede aplicar un lineamiento de prescripción
recomendada. Estos se indican en todo el documento usando los siguientes símbolos:
EDAD
G
PA
QL
Editar la edad
Editar el género
Autorización previa
Límite de cantidad
ST
Terapia de pasos
La cobertura puede depender de la edad del paciente
La cobertura puede depender del género del paciente
Requiere de un proceso específico de solicitud del médico
La cobertura puede estar limitada a cantidades específicas
por receta médica o por período de tiempo
La cobertura puede depender del uso previo de otro medicamento
Consulte el apéndice de lineamientos de recetas en este documento para obtener detalles sobre agentes
específicos.
Cobertura de beneficios y limitaciones
Este formulario impreso no proporciona información relacionada con la cobertura y limitaciones específicas
a las que un afiliado individual puede estar sujeto. Muchos afiliados tienen inclusiones de beneficios,
exclusiones, copagos específicos o falta de cobertura, los cuales no se reflejan en la Lista de medicamentos.
La Lista de medicamentos aplica únicamente a los medicamentos para pacientes ambulatorios
proporcionados a afiliados y no aplica a los medicamentos que se usan en entornos para pacientes
hospitalizados. Si un afiliado tiene preguntas específicas en relación a su cobertura, deberá comunicarse a
Servicios del afiliado de VNSNY CHOICE SelectHealth al 1-866-469-7774, de lunes a viernes de 8:00 a. m.
a 6:00 p. m. Los usuarios de TTY deben llamar al 711.
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Dependiendo de los parámetros de beneficios específicos del afiliado, los siguientes temas pueden
aplicar:
1. Sustitución de genéricos
Cuando se encuentren disponibles, los medicamentos genéricos aprobados por la FDA se usarán en todos
los casos, independientemente del nombre de marca indicado. Los nombres genéricos se encuentran en
negrita en la lista de medicamentos donde se encuentre un producto medicinal genérico aprobado por la
FDA que esté disponible. Se obtiene mayor ahorro con el uso de equivalentes genéricos. Esta política no
tiene el propósito de excluir o reemplazar los estatutos del estado que puedan existir. Todos los
medicamentos que se encuentran o lleguen a estar disponibles como genéricos están sujetos a revisión por
parte del Comité de farmacia y terapéutica de MedImpact. MedImpact aprueba dichos medicamentos de
múltiples fuentes para agregarlos a la lista MAC con base en los siguientes criterios:
• Producto medicinal de múltiple fuente fabricado por al menos una (1) empresa comercializada a nivel
nacional.
• Al menos uno (1) de los productos genéricos del fabricante debe tener una calificación “A” o que se
haya determinado que el producto genérico no está asociado con problemas de eficacia, seguridad o
bioequivalencia por parte del Comité de P & T de MedImpact.
• El producto medicinal será aprobado para sustitución genérica por parte del Comité de P & T de
MedImpact.
Esta lista se revisa y actualiza periódicamente con base en la literatura clínica y características
farmacocinéticas de las versiones disponibles actualmente de estos productos medicinales.
Si un afiliado o médico solicita un producto de marca en lugar de un genérico aprobado, y el médico
determina que existe una necesidad médica documentada de la marca equivalente, se puede realizar una
solicitud de cobertura usando el proceso de solicitud de medicamentos al 1-888-678-7741, las 24 horas
del día, los 7 días de la semana.
2. Diseño de beneficios por nivel
La Lista de medicamentos se puede aplicar a un diseño de beneficios por niveles, donde el afiliado
comparte el costo de la terapia con medicamentos con receta médica con base en el nivel del
medicamento, copago o coaseguro. En la mayoría de los casos, los medicamentos genéricos disponibles
serán cubiertos en un nivel más bajo por separado (copago bajo), los medicamentos preferidos de marca
listados en la Lista de medicamentos serán cubiertos bajo un nivel más alto, y los medicamentos de marca
que no se encuentran en el formulario serán cubiertos bajo un nivel de copago de medicamento de marca
no preferida por separado. Los medicamentos esenciales para la salud de beneficio o preventiva, si están
disponibles en el formulario de sus planes (aplica a planes nuevos y que no cuentan con derechos
adquiridos), serán cubiertos sin costo compartido (cero copago).
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DEFINICIONES DE LOS NIVELES:
NIVEL 1: Medicamentos genéricos preferidos (agentes de la Lista de medicamentos)
NIVEL 2: Medicamentos de marca preferidos (agentes de la Lista de medicamentos)
NIVEL 3: Medicamentos no preferidos (agentes que no son de la Lista de medicamentos)
NIVEL 4: Medicamentos con cero copago o de prevención
NIVEL 5: De venta libre (OTC)
3. Proceso de solicitud de medicamentos
Dependiendo del diseño de beneficios del plan, puede aplicar un proceso de solicitud de medicamentos de la
siguiente forma:
A. Excepciones de cobertura:
Los medicamentos que se listan en el formulario de autorización previa asociado (PA) requieren evaluación,
según las pautas de autorización previa del Comité de P & T de MedImpact antes de su distribución en una
farmacia de la red. Cada solicitud será revisada en base a la necesidad individual del paciente. Si la solicitud
no cumple con los lineamientos establecidos por el Comité de P & T, la solicitud no será aprobada y puede
que se recomiende terapia alternativa.
B. Obtención de cobertura
La cobertura, preguntas o información con respecto a la solicitud de medicamentos o proceso del formulario
pueden obtenerse:
1. Enviando por fax un Formulario de solicitud de medicamentos a MedImpact al 1-858-790-7100.
2. Comunicándose a MedImpact al 1-888-678-7741 y proporcionando toda la información necesaria que
se le solicite.
MedImpact le proporcionará un número de autorización, especifico para la necesidad médica, para todas las
solicitudes aprobadas. Las solicitudes no aprobadas pueden ser apeladas. La persona que escribe las recetas
debe proporcionar información para apoyar la apelación basándose en la necesidad médica. La autorización
previa generalmente no está disponible para medicamentos que están excluidos específicamente por el diseño
de los beneficios.
4.
Exclusiones generales
A. Medicamentos específicamente listados como no cubiertos.
B. Cualquier producto medicinal usado para propósitos cosméticos.
C. Productos medicinales experimentales o cualquier producto medicinal usado de forma experimental.
D. Reposición de medicamento perdido o robado.
E. Productos medicinales inyectables no autoadministrables, a menos que se especifique de otra manera
en la Lista de medicamentos.
F. Medicamentos de fuentes extranjeras o medicamentos no aprobados por la Administración de
Alimentos y Medicamentos de los Estados Unidos, excepto en ciertos casos de escasez de
medicamentos, cuando sea permitido bajo beneficio de la farmacia de la persona.
Los Comités de P & T y de la Lista de medicamentos reconocen que no todas las necesidades médicas se
pueden cubrir con este documento y fomentan las investigaciones sobre terapias alternativas.
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5. Comunicación del farmacéutico y el médico
La Lista de medicamentos es una herramienta para promover que el uso de medicamentos con receta médica
sea rentable. Los Comités de P & T y de la Lista de medicamentos han realizado todos los esfuerzos para
crear un documento que cumpla con todas las necesidades terapéuticas; sin embargo, el arte de la medicina
hace de esto una tarea enorme. MedImpact da la bienvenida a la participación de médicos, farmacéuticos y
proveedores de servicios médicos auxiliares, en este proceso dinámico. Exhortamos a los médicos y
farmacéuticos a dirigir cualquier sugerencia, comentarios o adiciones a la Lista de medicamentos a
MedImpact a la siguiente dirección:
Chairperson, Pharmacy & Therapeutics Committee
MedImpact Healthcare Systems, Inc.
10181 Scripps Gateway Court
San Diego, CA 92131
Formulario de Solicitud de Medicamentos (MRF) de MedImpact Healthcare Systems, Inc.
NO ESCRIBA EN LAS ÁREAS Attn: Prior Authorization
BLOQUEADAS
Department
ÚNICAMENTE PARA USO
INTERNO
NO ESCRIBA EN LAS ÁREAS
BLOQUEADAS
ÚNICAMENTE PARA USO
INTERNO
Contactado:
10181 Scripps Gateway Court
San Diego, CA 92131
Aprobado:
Médico:
Farmacia:
Paciente:
Teléfono 1-888-678-7741
Teléfono: 1-888-678-7741
Fax: 858-790-7100
Denegado:
Devuelto:
N.º de PA:
Instrucciones:
Esta lista de medicamentos es para el uso de los médicos y proveedores participantes para obtener cobertura
para un medicamento que no se encuentre en la lista de medicamentos para el cual no existe una alternativa
adecuada disponible. Llene este formulario y envíelo por fax a MedImpact Healthcare Systems, Inc. al 1858-790-7100 o llame al 1-888-678-7741 con esta información. Si tiene preguntas en relación a este
proceso, comuníquese a Servicio al Cliente de MedImpact al 1-888-678-7741, las 24 horas del día, los 7 días
de la semana.
Criterios de revisión:
Los siguientes lineamientos se usan al revisar las solicitudes de medicamentos:
1. El uso de los productos medicinales de la lista de medicamentos está contraindicado para el paciente.
2. El paciente ha fallado una prueba adecuada de los agentes de la lista de medicamentos o agentes
relacionados.
3. Las opciones disponibles en la Lista de medicamentos no son adecuadas para las necesidades de atención
presentes del paciente y el medicamento elegido se requiere por seguridad del paciente.
4. El uso del producto medicinal de la lista de medicamentos puede provocar una condición médica
subyacente, que sería en detrimento de la atención al paciente.
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Información de solicitud de medicación (por favor, llene cada sección de este formulario previo a su
transmisión):
Nombre del paciente (obligatorio):
N.º de Id. del paciente (obligatorio):
Plan de salud del paciente (obligatorio):
Nombre del médico/especialidad:
N.° de Id. del médico /N.° de DEA:
Fecha de nacimiento del paciente (requerida):
Código de área y número telefónico del médico:
(
Diagnóstico (obligatorio):
Código de área y número de fax del médico
(obligatorio):
(
Farmacia que usa el afiliado:
)
)
Código de área y número telefónico de la farmacia:
(
)
Medicamento solicitado:
Cantidad (por mes):
Dosis:
Duración del tratamiento (especifique):
Concentración:
Presentación (por ejemplo: oral, inyección):
Motivo de la solicitud del medicamento (especifique, proporcione detalles):
Otros medicamentos que se hayan probado o hayan fallado (especifique, dé detalles incluyendo la razón
del fallo):
Otros pertinentes a la historia (relacionados o pertenecientes a esta solicitud):
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ALLERGY
T4
2ND GEN ANTIHISTAMINE & DECONGESTANT
COMBINATIONS
T5 CETIRIZINE
ZYRTEC-D
HCL/PSEUDOEPHED
RINE
T1 FEXOFENADINE/PSE ALLEGRA-D 12
UDOEPHEDRINE
HOUR (60MG-120MG)
(TAB ER 12H) (OTC)
T1 FEXOFENADINE/PSE ALLEGRA-D 24
UDOEPHEDRINE
HOUR (180-240MG)
(TAB ER 24H)
T1 FEXOFENADINE/PSE ALLEGRA-D 24
UDOEPHEDRINE
HOUR (180-240MG)
(TAB ER 24H) (OTC)
T5 LORATADINE/PSEU CLARITIN-D 12
DOEPHEDRINE
HOUR
T5 LORATADINE/PSEU CLARITIN-D 24
DOEPHEDRINE
HOUR
ALLERGENIC EXTRACTS, THERAPEUTICS
T2 GR POL-ORC/SW
ORALAIR (100 IR)
VER/RYE/KENT/TIM (TAB SUBL)
T2 GR POL-ORC/SW
ORALAIR (300 IR)
VER/RYE/KENT/TIM (TAB SUBL)
T2 GRASS POLLENGRASTEK
TIMOTHY,
STANDARD
T2 WEED POLLENRAGWITEK
SHORT RAGWEED
ANTIHISTAMINES - 1ST GENERATION
T1 CARBINOXAMINE CLISTIN (4 MG)
MALEATE
(TABLET)
T4 CARBINOXAMINE CLISTIN (4 MG/5 ML)
MALEATE
(LIQUID)
T4 CHLORPHENIRAMI CHLOR-TRIMETON
NE MALEATE
T1 CHLORPHENIRAMI CHLOR-TRIMETON
NE MALEATE
ALLERGY
T4 CLEMASTINE
TAVIST
FUMARATE
T1 CLEMASTINE
TAVIST-1
FUMARATE
T1 CYPROHEPTADINE PERIACTIN
HCL
T4 DIPHENHYDRAMIN ALLERGY RELIEF
E HCL
T5 DIPHENHYDRAMIN BENADRYL
E HCL
(12.5MG/5ML)
(ELIXIR) (OTC)
T4 DIPHENHYDRAMIN BENADRYL
E HCL
(12.5MG/5ML)
(SYRUP) (OTC)
T4 DIPHENHYDRAMIN BENADRYL (25 MG)
E HCL
(CAPSULE) (OTC)
T4 DIPHENHYDRAMIN BENADRYL (25 MG)
E HCL
(TABLET) (OTC)
T4 DIPHENHYDRAMIN BENADRYL (50 MG)
E HCL
(CAPSULE) (OTC)
T4 DIPHENHYDRAMIN BENADRYL
E HCL
ALLERGY
VNSNY
T5
T4
T4
T4
T1
T1
T1
T4
T1
PA
T4
PA
T1
PA
PA
DIPHENHYDRAMIN CHILDREN'S
E HCL
BENADRYL
ALLERGY
(12.5MG/5ML)
(LIQUID) (OTC)
DIPHENHYDRAMIN CHILD'S BENADRYL
E HCL
ALLERGY
DIPHENHYDRAMIN ZZZQUIL
E HCL
HYDROXYZINE HCL ATARAX
HYDROXYZINE
VISTARIL
PAMOATE
PROMETHAZINE
PHENERGAN (12.5
HCL
MG) (TABLET)
PROMETHAZINE
PHENERGAN (25 MG)
HCL
(TABLET)
PROMETHAZINE
PHENERGAN (25
HCL
MG/ML) (SYRINGE)
PROMETHAZINE
PHENERGAN (25
HCL
MG/ML) (VIAL)
PROMETHAZINE
PHENERGAN (50 MG)
HCL
(TABLET)
PROMETHAZINE
PHENERGAN (50
HCL
MG/ML) (VIAL)
PROMETHAZINE
PHENERGAN VC
HCL
ANTIHISTAMINES - 2ND GENERATION
T1 CETIRIZINE HCL
CETIRIZINE HCL
T1 CETIRIZINE HCL
CHILDREN'S ZYRTEC
T1 CETIRIZINE HCL
ZYRTEC (1 MG/ML)
(SOLUTION)
T1 DESLORATADINE
CLARINEX (5 MG)
QL
(TABLET)
T1 FEXOFENADINE
ALLEGRA (180 MG)
HCL
(TABLET) (OTC)
T1 FEXOFENADINE
ALLEGRA (60 MG)
HCL
(TABLET) (OTC)
T1 LEVOCETIRIZINE XYZAL (2.5 MG/5ML) ST, QL
DIHYDROCHLORID (SOLUTION)
E
T1 LEVOCETIRIZINE XYZAL (5 MG)
DIHYDROCHLORID (TABLET)
E
T5 LORATADINE
CHILDREN'S
CLARITIN (5 MG/5
ML) (SOLUTION)
(OTC)
T5 LORATADINE
CLARITIN (10 MG)
(TAB RAPDIS) (OTC)
T5 LORATADINE
CLARITIN (10 MG)
(TABLET) (OTC)
T5 LORATADINE
CLARITIN (5 MG/5
ML) (SOLUTION)
(OTC)
NASAL ANTIHISTAMINE
T1 AZELASTINE HCL ASTELIN
T1 OLOPATADINE HCL PATANASE
NASAL ANTI-INFLAMMATORY STEROIDS
T2 BECLOMETHASONE QNASL
DIPROPIONATE
QL
ST, QL
ST, QL
Page 13 of 116
T1
T1
FLUNISOLIDE
FLUTICASONE
PROPIONATE
T1
FLUTICASONE
PROPIONATE
FLUTICASONE
PROPIONATE
MOMETASONE
FUROATE
T1
T1
NASALIDE
QL
CHILDREN'S
QL
FLONASE ALLERGY
RLF
FLONASE
QL
FLONASE ALLERGY QL
RELIEF
MOMETASONE
QL
FUROATE
ANTIEMESIS/ANTIVERTIGO
ANTIEMETIC/ANTIVERTIGO AGENTS
T2 APREPITANT
EMEND (125 MG
QL
CAPSULE)
T1 APREPITANT
EMEND (125-80-80
QL
MG PACK)
T2 APREPITANT
EMEND (40 MG
QL
CAPSULE)
T1 APREPITANT
EMEND (80 MG
QL
CAPSULE)
T5 DIMENHYDRINATE DRAMAMINE (50
MG) (TABLET) (OTC)
T1 DRONABINOL
MARINOL
ST, QL
T1 GRANISETRON HCL KYTRIL
ST, QL
T1 MECLIZINE HCL
ANTIVERT
T2 NETUPITANT/PALON AKYNZEO
QL
OSETRON HCL
T1 ONDANSETRON
ZOFRAN ODT
T1 ONDANSETRON HCLZOFRAN (24 MG)
(TABLET)
T1 ONDANSETRON HCLZOFRAN (4 MG)
(TABLET)
T1 ONDANSETRON HCLZOFRAN (4 MG/5 ML) QL
(SOLUTION)
T1 ONDANSETRON HCLZOFRAN (8 MG)
(TABLET)
T1 PROCHLORPERAZI COMPAZINE
NE
T1 PROCHLORPERAZI COMPAZINE
NE MALEATE
T1 PROMETHAZINE
PHENERGAN
HCL
T1 TRIMETHOBENZAM TIGAN
IDE HCL
ASTHMA AND COPD
ANTICHOLINERGIC, ORALLY INHALED SHORT
ACTING
T1 IPRATROPIUM
ATROVENT
BROMIDE
T2 IPRATROPIUM
ATROVENT HFA
QL
BROMIDE
ANTICHOLINERGICS, ORALLY INHALED LONG
ACTING
T2 TIOTROPIUM
SPIRIVA RESPIMAT QL
BROMIDE
T2 UMECLIDINIUM
INCRUSE ELLIPTA QL
BROMIDE
VNSNY
BETA-ADRENERGIC AGENTS
T1 METAPROTERENOL ALUPENT
SULFATE
BETA-ADRENERGIC AGENTS, INHALED, SHORT
ACTING
T1 ALBUTEROL
ACCUNEB
SULFATE
T1 ALBUTEROL
ALBUTEROL
SULFATE
SULFATE
T1 ALBUTEROL
PROVENTIL
SULFATE
T2 ALBUTEROL
VENTOLIN HFA
SULFATE
T1 LEVALBUTEROL
XOPENEX
HCL
T1 LEVALBUTEROL
XOPENEX
HCL
CONCENTRATE
T1 TERBUTALINE
BRETHINE
SULFATE
BETA-ADRENERGIC AGENTS, INHALED, ULTRALONG ACTING
T2 OLODATEROL HCL STRIVERDI
QL
RESPIMAT
BETA-ADRENERGIC AGENTS, ORALLY
INHALED,LONG ACTING
T2 FORMOTEROL
PERFOROMIST
FUMARATE
QL
BETA-ADRENERGIC AND ANTICHOLINERGIC
COMBINATIONS
T2 IPRATROPIUM/ALBU COMBIVENT
TEROL SULFATE
RESPIMAT
T1 IPRATROPIUM/ALB DUONEB
UTEROL SULFATE
T2 TIOTROPIUM
STIOLTO RESPIMAT QL
BR/OLODATEROL
HCL
T2 UMECLIDINIUM
ANORO ELLIPTA
QL
BRM/VILANTEROL
TR
BETA-ADRENERGIC AND GLUCOCORTICOID
COMBINATIONS
T2 FLUTICASONE/SALM ADVAIR DISKUS
ETEROL
T2 FLUTICASONE/SALM ADVAIR HFA
ETEROL
T2 FLUTICASONE/VILA BREO ELLIPTA
NTEROL
T2 MOMETASONE/FORM DULERA
OTEROL
QL
QL
QL
QL
GLUCOCORTICOIDS, ORALLY INHALED
T1 BUDESONIDE
PULMICORT
QL
(0.25MG/2ML)
(AMPUL-NEB)
T1 BUDESONIDE
PULMICORT (0.5
QL
MG/2ML) (AMPULNEB)
T1 BUDESONIDE
PULMICORT (1 MG/2 QL
ML) (AMPUL-NEB)
Page 14 of 116
T2
FLUTICASONE
FUROATE
ARNUITY ELLIPTA
QL
LEUKOTRIENE RECEPTOR ANTAGONISTS
T1 MONTELUKAST
SINGULAIR
SODIUM
T1 ZAFIRLUKAST
ACCOLATE
T1
T1
T1
INHALER, ASSIST
DEVICES
INHALER, ASSIST
DEVICES
INHALER, ASSIST
DEVICES
INHALER, ASSIST
DEVICES
INHALER, ASSIST
DEVICES
INHALER, ASSIST
DEVICES
INHALER, ASSIST
DEVICES
INHALER,ASSIST
DEVICE,ACCESORY
INHALER,ASSIST
DEVICE,ACCESORY
INHALER,ASSIST
DEVICE,ACCESORY
INHALER,ASSIST
DEVICE,ACCESORY
INHALER,ASSIST
DEVICE,ACCESORY
INHALER,ASSIST
DEVICE,ACCESORY
INHALER,ASSIST
DEVICE,ACCESORY
INHALER,ASSIST
DEVICE,ACCESORY
INHALER,ASSIST
DEVICE,ACCESORY
MUCUS CLEARING
DEVICE
MUCUS CLEARING
DEVICE
NASAL AIRFLOW
STRIPS
NASAL AIRFLOW
STRIPS
NEBULIZER
NEBULIZER
T1
NEBULIZER
T1
NEBULIZER
T1
NEBULIZER
T1
NEBULIZER
T1
NEBULIZER
T1
T1
NEBULIZER
NEBULIZER
T1
T1
NEBULIZER
NEBULIZER
T1
T1
T1
MAST CELL STABILIZERS
T1 CROMOLYN
GASTROCROM
SODIUM
T1
MAST CELL STABILIZERS, ORALLY INHALED
T1 CROMOLYN
CROMOLYN SODIUM
SODIUM
T1
PHOSPHODIESTERASE-4 (PDE4) INHIBITORS
T2 ROFLUMILAST
DALIRESP
ST, QL
RESPIRATORY AIDS,DEVICES,EQUIPMENT
T1 COMPRESSOR, FOR DEVILBISS
NEBULIZER
COMPACT
T1 COMPRESSOR, FOR DEVILBISS PULMONEBULIZER
AIDE
T1 COMPRESSOR, FOR DEVILBISS
NEBULIZER
PULMOMATE
T1 COMPRESSOR, FOR DEVILBLISS
NEBULIZER
T1 COMPRESSOR, FOR PULMO-AIDE
NEBULIZER
T1 COMPRESSOR, FOR SUNRISE
NEBULIZER
COMPRESSORNEBULIZER
T1 INHALER, ASSIST
ACE AEROSOL
DEVICES
CLOUD ENHANCER
T1 INHALER, ASSIST
AEROCHAMBER
DEVICES
MINI (SPACER)
T1 INHALER, ASSIST
AEROCHAMBER MV
DEVICES
T1 INHALER, ASSIST
AEROCHAMBER
DEVICES
PLUS FLOW-VU
(SPACER)
T1 INHALER, ASSIST
AEROCHAMBER
DEVICES
WITH FLOWSIGNAL
T1 INHALER, ASSIST
AEROCHAMBER ZDEVICES
STAT PLUS
T1 INHALER, ASSIST
AEROTRACH PLUS
DEVICES
T1 INHALER, ASSIST
BREATHERITE
DEVICES
T1 INHALER, ASSIST
BREATHRITE
DEVICES
T1 INHALER, ASSIST
EASIVENT
DEVICES
T1 INHALER, ASSIST
E-Z SPACER
DEVICES
T1 INHALER, ASSIST
LITEAIRE
DEVICES
T1 INHALER, ASSIST
MICROCHAMBER
DEVICES
(SPACER)
T1 INHALER, ASSIST
MICROSPACER
DEVICES
(SPACER)
T1 INHALER, ASSIST
OPTICHAMBER
DEVICES
DIAMOND
VNSNY
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T5
T5
POCKET CHAMBER
PRIMEAIRE
PROCHAMBER
RITEFLO
VORTEX
VORTEX VHC FROG
MASK
VORTEX VHC
LADYBUG MASK
EASIVENT
LITETOUCH
MOUTHPIECE
ONE WAY
MOUTHPIECE
OPTICHAMBER
PANDA MASK
PEDIATRIC PANDA
MASK
SIDESTREAM
PEDIATRIC
SILICONE MASK
FLUTTER
QUAKE
BREATHE RIGHT
NASAL STRIPS
AEROECLIPSE II
AIRS DISPOSABLE
NEBULIZER
ALTERA NEBULIZER
(EACH)
BABY NEBULIZER
(EACH)
COMPACT
COMPRESSOR
NEBULIZER
COMPACT
ULTRASONIC
NEBULIZER
DEVILBISS
DISPOSABLE
NEBULIZER
ERAPID NEBULIZER
LC D NEBULIZER
SET (EACH)
LC PLUS (EACH)
LC SPRINT
NEBULIZER
Page 15 of 116
T1
T1
NEBULIZER
NEBULIZER
T1
NEBULIZER
T1
T1
T1
NEBULIZER
NEBULIZER
NEBULIZER
T1
T1
NEBULIZER
NEBULIZER AND
COMPRESSOR
NEBULIZER AND
COMPRESSOR
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
NEBULIZER AND
COMPRESSOR
NEBULIZER AND
COMPRESSOR
NEBULIZER AND
COMPRESSOR
NEBULIZER AND
COMPRESSOR
NEBULIZER AND
COMPRESSOR
NEBULIZER AND
COMPRESSOR
NEBULIZER AND
COMPRESSOR
NEBULIZER AND
COMPRESSOR
NEBULIZER AND
COMPRESSOR
NEBULIZER AND
COMPRESSOR
T1
PEAK FLOW METER
T1
T1
T1
PEAK FLOW METER
PEAK FLOW METER
PEAK FLOW METER
T1
T1
PEAK FLOW METER
PEAK FLOW METER
T1
PEAK FLOW METER
T1
T1
T1
T1
T1
PEAK FLOW METER
PEAK FLOW METER
PEAK FLOW METER
PEAK FLOW METER
PEAK FLOW METER
T1
PEAK FLOW
METER/INH ASSIT
DEV
PEAK FLOW
METER/INH ASSIT
DEV
T1
VNSNY
MICRO AIR
MINI PLUS
NEBULIZER
PARI LC SPRINT
SINUS
PRODIGY MINI-MIST
SIDESTREAM (EACH)
SIDESTREAM
NEBULIZER
SIDESTREAM PLUS
COMP-AIR ELITE
COMPRESSOR SYST
COMP-AIR
NEBULIZER
COMPRESSOR
DEVILBISS
TRAVELER
INNOSPIRE
ELEGANCE
INNOSPIRE ESSENCE
(EACH)
PARI SINUS
AEROSOL SYSTEM
PRONEB ULTRA II
PULMONEB LT
COMPRESSOR
NEBUL
SAMI THE SEAL
TREK S COMBO
PACK
TREK S COMPACT
COMPRESSOR
VIOS AEROSOL
DELIVERY SYSTEM
(EACH)
AIRZONE PEAK
FLOW METER
ASTHMA CHECK
ASTHMAMENTOR
IN-CHECK NASAL
WITH MASK
IN-CHECK ORAL
MICROLIFE PEAK
FLOW
MINI-WRIGHT PEAK
FLOW METER
(EACH)
PEAK-AIR
PERSONAL BEST
PIKO 1
POCKET PEAK
TRUZONE PEAK
FLOW METER
(EACH)
AEROGEAR ASTHMA
ACTION KIT
ASTHMAPACK
CHILDREN'S
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
SPIROMETERS AND
ACCESSORIES
SPIROMETERS AND
ACCESSORIES
SPIROMETERS AND
ACCESSORIES
SPIROMETERS AND
ACCESSORIES
SPIROMETERS AND
ACCESSORIES
VAPORIZER
IN-CHECK DIAL
PFLEX TRAINER
THRESHOLD IMT
THRESHOLD PEP
WINDMILL TRAINER
VAPORIZER (EACH)
(OTC)
VAPORIZER
VICKS WARM
STEAM VAPORIZER
(EACH) (OTC)
VAPORIZER
WARM STEAM
VAPORIZER
VAPORIZERVAPORIZER
HUMIDIFIER SUPPLY CLEANING TABLETS
VAPORIZERVAPORIZER
HUMIDIFIER SUPPLY INHALANT
XANTHINES
T1 CAFFEINE CITRATE
T1 THEOPHYLLINE
ANHYDROUS
T1 THEOPHYLLINE
ANHYDROUS
T2 THEOPHYLLINE
ANHYDROUS
T1 THEOPHYLLINE
ANHYDROUS
T1 THEOPHYLLINE
ANHYDROUS
CAFFEINE CITRATE
ELIXOPHYLLIN
SLO-PHYLLIN
THEO-24
THEO-DUR
UNIPHYL
AUTONOMIC NERVOUS SYSTEM
DISORDERS
ALZHEIMER'S THERAPY, NMDA RECEPTOR
ANTAGONISTS
T1 MEMANTINE HCL NAMENDA (10 MG) QL
(TABLET)
T1 MEMANTINE HCL NAMENDA (2
QL
MG/ML) (SOLUTION)
T1 MEMANTINE HCL NAMENDA (5 MG)
QL
(TABLET)
T1 MEMANTINE HCL NAMENDA (5 MG-10 QL
MG) (TAB DS PK)
T2 MEMANTINE HCL
NAMENDA XR (14
QL
MG) (CAP SPR 24)
T2 MEMANTINE HCL
NAMENDA XR (21
QL
MG) (CAP SPR 24)
T2 MEMANTINE HCL
NAMENDA XR (28
QL
MG) (CAP SPR 24)
T2 MEMANTINE HCL
NAMENDA XR (7
QL
MG) (CAP SPR 24)
T2 MEMANTINE HCL
NAMENDA XR (7-14- QL
21-28) (CAP24 DSPK)
ALZHEIMER'S THX,NMDA RECEPT ANTAG &
CHOLINES INHIB
T2 MEMANTINE
NAMZARIC (14MG- ST, QL
HCL/DONEPEZIL HCL 10MG) (CAP SPR 24)
Page 16 of 116
T2
T2
T2
T2
MEMANTINE
NAMZARIC (21 MGHCL/DONEPEZIL HCL 10MG) (CAP SPR 24)
MEMANTINE
NAMZARIC (28 MGHCL/DONEPEZIL HCL 10MG) (CAP SPR 24)
MEMANTINE
NAMZARIC (7 MG-10
HCL/DONEPEZIL HCL MG) (CAP SPR 24)
MEMANTINE
NAMZARIC (7-10/14HCL/DONEPEZIL HCL 10) (CAP24 DSPK)
ST, QL
T4
ST, QL
T4
ST, QL
T4
T4
T4
T4
ST, QL
CHOLINESTERASE INHIBITORS
T1 DONEPEZIL HCL
ARICEPT
T1 DONEPEZIL HCL
ARICEPT ODT
T1 GALANTAMINE HBRRAZADYNE (12 MG) QL
(TABLET)
T1 GALANTAMINE HBRRAZADYNE (4 MG) QL
(TABLET)
T1 GALANTAMINE HBRRAZADYNE (4
QL
MG/ML) (SOLUTION)
T1 GALANTAMINE HBRRAZADYNE (8 MG) QL
(TABLET)
T1 GALANTAMINE HBRRAZADYNE ER
QL
T1 PYRIDOSTIGMINE MESTINON (180 MG)
BROMIDE
(TABLET ER)
T1 PYRIDOSTIGMINE MESTINON (60 MG)
BROMIDE
(TABLET)
T2 PYRIDOSTIGMINE
MESTINON (60 MG/5
BROMIDE
ML) (SYRUP)
T1 RIVASTIGMINE
EXELON
QL
T1 RIVASTIGMINE
RIVASTIGMINE
TARTRATE
TARTRATE
BEHAVIORAL HEALTH ANTIDEPRESSANTS
ALPHA-2 RECEPTOR ANTAGONIST
ANTIDEPRESSANTS
T4 MIRTAZAPINE
REMERON
MAOIS - NON-SELECTIVE & IRREVERSIBLE
T4 ISOCARBOXAZID
MARPLAN
T4 PHENELZINE
NARDIL
SULFATE
T4 TRANYLCYPROMIN PARNATE
E SULFATE
NOREPINEPHRINE AND DOPAMINE REUPTAKE
INHIB (NDRIS)
T4 BUPROPION HBR
APLENZIN
ST, QL
T4 BUPROPION HCL
WELLBUTRIN
T4 BUPROPION HCL
WELLBUTRIN SR
T4 BUPROPION HCL
WELLBUTRIN XL
SELECTIVE SEROTONIN REUPTAKE INHIBITOR
(SSRIS)
T4 CITALOPRAM
CELEXA
HYDROBROMIDE
T4 ESCITALOPRAM
LEXAPRO
OXALATE
T4 FLUOXETINE HCL
FLUOXETINE HCL
T4 FLUOXETINE HCL PROZAC
T4 FLUOXETINE HCL PROZAC WEEKLY
T4 FLUOXETINE HCL
SARAFEM
VNSNY
T4
T4
FLUVOXAMINE
MALEATE
FLUVOXAMINE
MALEATE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE
MESYLATE
PAROXETINE
MESYLATE
SERTRALINE HCL
LUVOX
LUVOX CR
ST, QL
PAXIL
PAXIL
PAXIL CR
BRISDELLE
ST, QL
PEXEVA
ST, QL
ZOLOFT
SEROTONIN-2 ANTAGONIST/REUPTAKE INHIBITORS
(SARIS)
T4 NEFAZODONE HCL SERZONE
T4 TRAZODONE HCL DESYREL
SEROTONIN-NOREPINEPHRINE REUPTAKE-INHIB
(SNRIS)
T4 DESVENLAFAXINE DESVENLAFAXINE ST, QL
ER
T4 DESVENLAFAXINE KHEDEZLA
ST, QL
T4 DESVENLAFAXINE DESVENLAFAXINE ST, QL
FUMARATE
FUMARATE ER
T4 DESVENLAFAXINE PRISTIQ
ST, QL
SUCCINATE
T4 DULOXETINE HCL CYMBALTA
QL
T4 LEVOMILNACIPRAN FETZIMA
ST, QL
HCL
T4 VENLAFAXINE HCL EFFEXOR
T4 VENLAFAXINE HCL EFFEXOR XR
T4 VENLAFAXINE HCL VENLAFAXINE HCL
SSRI & 5HT1A PARTIAL AGONIST ANTIDEPRESSANT
T4 VILAZODONE HCL VIIBRYD (10 MG)
ST, QL
(TABLET)
T4 VILAZODONE HCL VIIBRYD (20 MG)
ST, QL
(TABLET)
T4 VILAZODONE HCL VIIBRYD (40 MG)
ST, QL
(TABLET)
SSRI & SEROTONIN RECEPTOR MODULATOR
ANTIDEPRESSANT
T4 VORTIOXETINE
TRINTELLIX
ST, QL
HYDROBROMIDE
TRICYCLIC ANTIDEPRESSANT/BENZODIAZEPINE
COMBINATNS
T4 AMITRIPTYLINE/CH LIMBITROL
LORDIAZEPOXIDE
T4 AMITRIPTYLINE/CH LIMBITROL DS
LORDIAZEPOXIDE
TRICYCLIC ANTIDEPRESSANT/PHENOTHIAZINE
COMBINATNS
T4 PERPHENAZINE/AM ETRAFON-A
ITRIPTYLINE HCL
T4 PERPHENAZINE/AM TRIAVIL 2-10
ITRIPTYLINE HCL
T4 PERPHENAZINE/AM TRIAVIL 2-25
ITRIPTYLINE HCL
T4 PERPHENAZINE/AM TRIAVIL 4-25
ITRIPTYLINE HCL
Page 17 of 116
T4
PERPHENAZINE/AM TRIAVIL 4-50
ITRIPTYLINE HCL
TRICYCLIC ANTIDEPRESSANTS & REL. NON-SEL.
RU-INHIB
T4 AMITRIPTYLINE
ELAVIL
HCL
T4 AMOXAPINE
ASENDIN
T4 CLOMIPRAMINE
ANAFRANIL
HCL
T4 DESIPRAMINE HCL DESIPRAMINE HCL
T4 DESIPRAMINE HCL NORPRAMIN
T4 DOXEPIN HCL
SINEQUAN
T4 IMIPRAMINE HCL TOFRANIL
T4 IMIPRAMINE
TOFRANIL-PM
PAMOATE
T4 MAPROTILINE HCL LUDIOMIL
T4 NORTRIPTYLINE
PAMELOR
HCL
T4 PROTRIPTYLINE
VIVACTIL
HCL
T4 TRIMIPRAMINE
SURMONTIL
MALEATE
T4 TRIMIPRAMINE
SURMONTIL
MALEATE
BEHAVIORAL HEALTH - OTHER
ADRENERGICS, AROMATIC, NON-CATECHOLAMINE
T1 DEXTROAMPHETA DEXEDRINE (10 MG) QL
MINE SULFATE
(CAPSULE ER)
T1 DEXTROAMPHETA DEXEDRINE (10 MG) QL
MINE SULFATE
(TABLET)
T1 DEXTROAMPHETA DEXEDRINE (15 MG) QL
MINE SULFATE
(CAPSULE ER)
T1 DEXTROAMPHETA DEXEDRINE (5 MG) QL
MINE SULFATE
(CAPSULE ER)
T1 DEXTROAMPHETA DEXEDRINE (5 MG) QL
MINE SULFATE
(TABLET)
T1 DEXTROAMPHETA PROCENTRA
QL
MINE SULFATE
T2 DEXTROAMPHETAMI ZENZEDI (2.5 MG)
ST, QL
NE SULFATE
(TABLET)
T2 DEXTROAMPHETAMI ZENZEDI (7.5 MG)
ST, QL
NE SULFATE
(TABLET)
T1 DEXTROAMPHETA ADDERALL
QL
MINE/AMPHETAMIN
E
T1 DEXTROAMPHETA ADDERALL XR (10 QL
MINE/AMPHETAMIN MG) (CAP ER 24H)
E
T1 DEXTROAMPHETA ADDERALL XR (15 QL
MINE/AMPHETAMIN MG) (CAP ER 24H)
E
T1 DEXTROAMPHETA ADDERALL XR (20 QL
MINE/AMPHETAMIN MG) (CAP ER 24H)
E
T1 DEXTROAMPHETA ADDERALL XR (25 QL
MINE/AMPHETAMIN MG) (CAP ER 24H)
E
T1 DEXTROAMPHETA ADDERALL XR (30 QL
MINE/AMPHETAMIN MG) (CAP ER 24H)
E
VNSNY
T1
T2
T2
T2
T2
T2
T2
T2
T1
DEXTROAMPHETA ADDERALL XR (5
MINE/AMPHETAMIN MG) (CAP ER 24H)
E
LISDEXAMFETAMINEVYVANSE (10 MG)
DIMESYLATE
(CAPSULE)
LISDEXAMFETAMINEVYVANSE (20 MG)
DIMESYLATE
(CAPSULE)
LISDEXAMFETAMINEVYVANSE (30 MG)
DIMESYLATE
(CAPSULE)
LISDEXAMFETAMINEVYVANSE (40 MG)
DIMESYLATE
(CAPSULE)
LISDEXAMFETAMINEVYVANSE (50 MG)
DIMESYLATE
(CAPSULE)
LISDEXAMFETAMINEVYVANSE (60 MG)
DIMESYLATE
(CAPSULE)
LISDEXAMFETAMINEVYVANSE (70 MG)
DIMESYLATE
(CAPSULE)
METHAMPHETAMINDESOXYN
E HCL
QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
QL
ANTI-ALCOHOLIC PREPARATIONS
T1 DISULFIRAM
ANTABUSE
T2 NALTREXONE
VIVITROL
MICROSPHERES
ANTI-ANXIETY DRUGS
T4 ALPRAZOLAM
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
ALPRAZOLAM
INTENSOL
ALPRAZOLAM
NIRAVAM
ALPRAZOLAM
XANAX
ALPRAZOLAM
XANAX XR
BUSPIRONE HCL
BUSPAR
CHLORDIAZEPOXID LIBRIUM
E HCL
CLORAZEPATE
CLORAZEPATE
DIPOTASSIUM
DIPOTASSIUM
CLORAZEPATE
TRANXENE T-TAB
DIPOTASSIUM
DIAZEPAM
DIAZEPAM
DIAZEPAM
DIAZEPAM
INTENSOL
DIAZEPAM
VALIUM (5 MG/5 ML)
(SOLUTION)
LORAZEPAM
ATIVAN
LORAZEPAM
LORAZEPAM
INTENSOL
MEPROBAMATE
MEPROBAMATE
OXAZEPAM
SERAX
ANTI-MANIA DRUGS
T4 CARBAMAZEPINE
T4 LITHIUM
CARBONATE
T4 LITHIUM
CARBONATE
T4 LITHIUM
CARBONATE
T4 LITHIUM
CARBONATE
T4 LITHIUM
CARBONATE
T4 LITHIUM CITRATE
EQUETRO
ESKALITH
ESKALITH CR
LITHIUM
CARBONATE
LITHOBID
LITHOTABS
LITHIUM CITRATE
Page 18 of 116
ANTIPSYCH,DOPAMINE
ANTAG.,DIPHENYLBUTYLPIPERIDINES
T4 PIMOZIDE
ORAP
T4
LURASIDONE HCL
T4
LURASIDONE HCL
ANTIPSYCHOTICS, ATYP, D2 PARTIAL AGONIST/5HT
MIXED
T4 ARIPIPRAZOLE
ABILIFY (1 MG/ML) ST, QL
(SOLUTION)
T4 ARIPIPRAZOLE
ABILIFY (10 MG)
QL
(TABLET)
T4 ARIPIPRAZOLE
ABILIFY (15 MG)
QL
(TABLET)
T4 ARIPIPRAZOLE
ABILIFY (2 MG)
QL
(TABLET)
T4 ARIPIPRAZOLE
ABILIFY (20 MG)
QL
(TABLET)
T4 ARIPIPRAZOLE
ABILIFY (30 MG)
QL
(TABLET)
T4 ARIPIPRAZOLE
ABILIFY (5 MG)
QL
(TABLET)
T4 ARIPIPRAZOLE
ABILIFY DISCMELT ST, QL
(10 MG) (TAB
RAPDIS)
T4 ARIPIPRAZOLE
ABILIFY DISCMELT ST, QL
(15 MG) (TAB
RAPDIS)
T2 ARIPIPRAZOLE
ABILIFY MAINTENA QL
T4
LURASIDONE HCL
T4
OLANZAPINE
T4
OLANZAPINE
T4
OLANZAPINE
T4
OLANZAPINE
T4
OLANZAPINE
T4
OLANZAPINE
T4
T2
OLANZAPINE
OLANZAPINE
PAMOATE
T2
OLANZAPINE
PAMOATE
T2
OLANZAPINE
PAMOATE
T4
PALIPERIDONE
T4
PALIPERIDONE
T4
PALIPERIDONE
T4
PALIPERIDONE
T2
T4
PALIPERIDONE
PALMITATE
QUETIAPINE
FUMARATE
QUETIAPINE
FUMARATE
QUETIAPINE
FUMARATE
QUETIAPINE
FUMARATE
QUETIAPINE
FUMARATE
QUETIAPINE
FUMARATE
RISPERIDONE
T4
RISPERIDONE
T4
RISPERIDONE
T4
RISPERIDONE
T4
RISPERIDONE
T4
RISPERIDONE
ANTIPSYCHOTICS, DOPAMINE & SEROTONIN
ANTAGONISTS
T2 LOXAPINE
ADASUVE
T4 LOXAPINE
LOXITANE
SUCCINATE
ANTIPSYCHOTICS,ATYPICAL,DOPAMINE,&
SEROTONIN ANTAG
T4 ASENAPINE
SAPHRIS
MALEATE
T4 CLOZAPINE
CLOZAPINE
T4 CLOZAPINE
CLOZARIL
T4 CLOZAPINE
FAZACLO
T4 CLOZAPINE
VERSACLOZ
T4 ILOPERIDONE
FANAPT (1 MG)
(TABLET)
T4 ILOPERIDONE
FANAPT (10 MG)
(TABLET)
T4 ILOPERIDONE
FANAPT (12 MG)
(TABLET)
T4 ILOPERIDONE
FANAPT (1-2-4-6MG)
(TAB DS PK)
T4 ILOPERIDONE
FANAPT (2 MG)
(TABLET)
T4 ILOPERIDONE
FANAPT (4 MG)
(TABLET)
T4 ILOPERIDONE
FANAPT (6 MG)
(TABLET)
T4 ILOPERIDONE
FANAPT (8 MG)
(TABLET)
T4 LURASIDONE HCL
LATUDA (120 MG)
(TABLET)
T4 LURASIDONE HCL
LATUDA (20 MG)
(TABLET)
VNSNY
ST, QL
QL
QL
ST, QL
ST, QL
ST, QL
T4
T4
T4
ST, QL
T4
ST, QL
T4
ST, QL
T4
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
LATUDA (40 MG)
ST, QL
(TABLET)
LATUDA (60 MG)
ST, QL
(TABLET)
LATUDA (80 MG)
ST, QL
(TABLET)
ZYPREXA (10 MG) QL
(TABLET)
ZYPREXA (15 MG) QL
(TABLET)
ZYPREXA (2.5 MG) QL
(TABLET)
ZYPREXA (20 MG) QL
(TABLET)
ZYPREXA (5 MG)
QL
(TABLET)
ZYPREXA (7.5 MG) QL
(TABLET)
ZYPREXA ZYDIS
QL
ZYPREXA
QL
RELPREVV (210 MG)
(VIAL)
ZYPREXA
QL
RELPREVV (300 MG)
(VIAL)
ZYPREXA
QL
RELPREVV (405 MG)
(VIAL)
INVEGA (1.5 MG)
ST, QL
(TAB ER 24)
INVEGA (3 MG) (TAB ST, QL
ER 24)
INVEGA (6 MG) (TAB ST, QL
ER 24)
INVEGA (9 MG) (TAB ST, QL
ER 24)
INVEGA SUSTENNA QL
SEROQUEL
QL
SEROQUEL XR (150 QL
MG) (TAB ER 24H)
SEROQUEL XR (200 QL
MG) (TAB ER 24H)
SEROQUEL XR (300 QL
MG) (TAB ER 24H)
SEROQUEL XR (400 QL
MG) (TAB ER 24H)
SEROQUEL XR (50 QL
MG) (TAB ER 24H)
RISPERDAL (0.25
QL
MG) (TABLET)
RISPERDAL (0.5 MG) QL
(TABLET)
RISPERDAL (1 MG) QL
(TABLET)
RISPERDAL (1
QL
MG/ML) (SOLUTION)
RISPERDAL (2 MG) QL
(TABLET)
RISPERDAL (3 MG) QL
(TABLET)
Page 19 of 116
T4
RISPERIDONE
T4
T4
T2
RISPERIDONE
RISPERIDONE
RISPERIDONE
MICROSPHERES
ZIPRASIDONE HCL GEODON
ZIPRASIDONE
GEODON
MESYLATE
T4
T4
RISPERDAL (4 MG)
(TABLET)
RISPERDAL M-TAB
RISPERIDONE ODT
RISPERDAL CONSTA
QL
T2
QL
QL
QL
T1
QL
ANTIPSYCHOTICS,DOPAMINE ANTAGONISTS,
THIOXANTHENES
T4 THIOTHIXENE
NAVANE
ANTIPSYCHOTICS,DOPAMINE
ANTAGONISTS,BUTYROPHENONES
T4 HALOPERIDOL
HALDOL
T4 HALOPERIDOL
HALDOL
DECANOATE
T4 HALOPERIDOL
HALDOL
DECANOATE
DECANOATE 100
T4 HALOPERIDOL
HALDOL
DECANOATE
DECANOATE 50
T4 HALOPERIDOL
HALDOL
LACTATE
ANTI-PSYCHOTICS,PHENOTHIAZINES
T4 CHLORPROMAZINE THORAZINE
HCL
T4 FLUPHENAZINE
FLUPHENAZINE
DECANOATE
DECANOATE
T4 FLUPHENAZINE
PROLIXIN
HCL
T4 PERPHENAZINE
TRILAFON
T4 THIORIDAZINE HCL MELLARIL
T4 TRIFLUOPERAZINE STELAZINE
HCL
BARBITURATES
T4 BUTABARBITAL
SODIUM
T4 PHENOBARBITAL
T4 SECOBARBITAL
SODIUM
HYPNOTICS, MELATONIN MT1/MT2 RECEPTOR
AGONISTS
T4 RAMELTEON
ROZEREM
ST, QL
T4 TASIMELTEON
HETLIOZ
PA
QL
NARCOLEPSY AND SLEEP DISORDER THERAPY
AGENTS
T1 MODAFINIL
PROVIGIL
PA
VNSNY
SEDATIVE-HYPNOTICS,NON-BARBITURATE
T4 DIPHENHYDRAMIN ALLERGY RELIEF
E HCL
T4 DIPHENHYDRAMIN BENADRYL (25 MG)
E HCL
(CAPSULE) (OTC)
T4 DIPHENHYDRAMIN BENADRYL (25 MG)
E HCL
(TABLET) (OTC)
T4 DIPHENHYDRAMIN ZZZQUIL (25 MG)
E HCL
(CAPSULE) (OTC)
T4 DOXEPIN HCL
SILENOR
T4 ESTAZOLAM
PROSOM
T4 ESZOPICLONE
LUNESTA
T4 FLURAZEPAM HCL DALMANE
T1 MIDAZOLAM HCL VERSED
T4 QUAZEPAM
DORAL
T4 SUVOREXANT
BELSOMRA
T4 TEMAZEPAM
RESTORIL
T4 TRIAZOLAM
HALCION
T4 ZALEPLON
SONATA
T4 ZOLPIDEM
AMBIEN
TARTRATE
T4 ZOLPIDEM
AMBIEN CR
TARTRATE
T4 ZOLPIDEM
EDLUAR
TARTRATE
T4 ZOLPIDEM
INTERMEZZO
TARTRATE
T4 ZOLPIDEM
ZOLPIMIST
TARTRATE
QL
ST, QL
QL
ST, QL
QL
QL
QL
ST, QL
QL
ST, QL
TX FOR ADHD - SELECTIVE ALPHA-2A RECEPTOR
AGONIST
T1 CLONIDINE HCL
KAPVAY
QL
T1 GUANFACINE HCL GUANFACINE HCL QL
PHENOBARBITAL
SECONAL SODIUM
NARCOTIC ANTAGONISTS
T1 NALOXONE HCL
NARCAN (0.4
MG/ML) (SYRINGE)
T1 NALOXONE HCL
NARCAN (0.4
MG/ML) (VIAL)
T1 NALOXONE HCL
NARCAN (1 MG/ML)
(SYRINGE)
NARCAN (4 MG)
(SPRAY)
NALTREXONE HCL REVIA
SSRI &ANTIPSYCH,ATYP,DOPAMINE&SEROTONIN
ANTAG COMB
T4 OLANZAPINE/FLUO SYMBYAX
QL
XETINE HCL
BUTISOL SODIUM
MONOAMINE OXIDASE(MAO) INHIBITORS
T4 SELEGILINE
EMSAM
NALOXONE HCL
TX FOR ATTENTION DEFICITHYPERACT(ADHD)/NARCOLEPSY
T1 DEXMETHYLPHENI FOCALIN
DATE HCL
T1 DEXMETHYLPHENI FOCALIN XR
DATE HCL
T1 METHYLPHENIDAT CONCERTA (18 MG)
E HCL
(TAB ER 24)
T1 METHYLPHENIDAT CONCERTA (27 MG)
E HCL
(TAB ER 24)
T1 METHYLPHENIDAT CONCERTA (36 MG)
E HCL
(TAB ER 24)
T1 METHYLPHENIDAT CONCERTA (54 MG)
E HCL
(TAB ER 24)
T1 METHYLPHENIDAT METADATE CD (10
E HCL
MG) (CPBP 30-70)
T1 METHYLPHENIDAT METADATE CD (20
E HCL
MG) (CPBP 30-70)
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
Page 20 of 116
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T2
T1
T2
T1
T1
T1
T1
METHYLPHENIDAT
E HCL
METHYLPHENIDAT
E HCL
METHYLPHENIDAT
E HCL
METHYLPHENIDAT
E HCL
METHYLPHENIDAT
E HCL
METHYLPHENIDAT
E HCL
METHYLPHENIDAT
E HCL
METHYLPHENIDAT
E HCL
METHYLPHENIDAT
E HCL
METHYLPHENIDAT
E HCL
METHYLPHENIDAT
E HCL
METHYLPHENIDATE
HCL
METADATE CD (30
MG) (CPBP 30-70)
METADATE CD (40
MG) (CPBP 30-70)
METADATE CD (50
MG) (CPBP 30-70)
METADATE CD (60
MG) (CPBP 30-70)
METADATE ER (10
MG) (TABLET ER)
METADATE ER (20
MG) (TABLET ER)
METHYLIN (10 MG)
(TAB CHEW)
METHYLIN (10 MG/5
ML) (SOLUTION)
METHYLIN (2.5 MG)
(TAB CHEW)
METHYLIN (5 MG)
(TAB CHEW)
METHYLIN (5 MG/5
ML) (SOLUTION)
QUILLIVANT XR (5
MG/ML) (SU ER
RC24)
METHYLPHENIDAT RITALIN
E HCL
METHYLPHENIDATE RITALIN LA (10 MG)
HCL
(CPBP 50-50)
METHYLPHENIDAT RITALIN LA (20 MG)
E HCL
(CPBP 50-50)
METHYLPHENIDAT RITALIN LA (30 MG)
E HCL
(CPBP 50-50)
METHYLPHENIDAT RITALIN LA (40 MG)
E HCL
(CPBP 50-50)
METHYLPHENIDAT RITALIN-SR
E HCL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
QL
QL
T1
T2
T1
T1
T1
T1
T1
T1
T1
DISOPYRAMIDE
NORPACE
PHOSPHATE
DISOPYRAMIDE
NORPACE CR
PHOSPHATE
DOFETILIDE
TIKOSYN
DRONEDARONE HCL MULTAQ
FLECAINIDE
TAMBOCOR
ACETATE
MEXILETINE HCL MEXITIL
PROPAFENONE HCL PROPAFENONE HCL
PROPAFENONE HCL RYTHMOL
PROPAFENONE HCL RYTHMOL SR
QUINIDINE
QUINAGLUTE
GLUCONATE
QUINIDINE
QUINIDINE SULFATE
SULFATE
QUINIDINE
QUINORA
SULFATE
QL
CARDIOVASCULAR DISEASE CARDIAC STIMULANT
ST, QL
ADRENERGIC AGENTS,CATECHOLAMINES
T1 EPINEPHRINE
EPIPEN
QL
DIGITALIS GLYCOSIDES
T1 DIGOXIN
DIGOXIN (125 MCG)
(TABLET)
T1 DIGOXIN
DIGOXIN (250 MCG)
(TABLET)
T2 DIGOXIN
DIGOXIN (50
MCG/ML)
(SOLUTION)
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
AGE,
QL
CARDIOVASCULAR DISEASE ARRHYTHMIA
VNSNY
T2
T1
TX FOR ATTENTION DEFICIT-HYPERACT.(ADHD),
NRI-TYPE
T2 ATOMOXETINE HCL STRATTERA (10 MG) QL
(CAPSULE)
T2 ATOMOXETINE HCL STRATTERA (100
QL
MG) (CAPSULE)
T2 ATOMOXETINE HCL STRATTERA (18 MG) QL
(CAPSULE)
T2 ATOMOXETINE HCL STRATTERA (25 MG) QL
(CAPSULE)
T2 ATOMOXETINE HCL STRATTERA (40 MG) QL
(CAPSULE)
T2 ATOMOXETINE HCL STRATTERA (60 MG) QL
(CAPSULE)
T2 ATOMOXETINE HCL STRATTERA (80 MG) QL
(CAPSULE)
ANTIARRHYTHMICS
T1 AMIODARONE HCL CORDARONE
T1 AMIODARONE HCL PACERONE
T1
CARDIOVASCULAR DISEASE HYPERTENSION
ACE INHIBITOR/CALCIUM CHANNEL BLOCKER
COMBINATION
T1 AMLODIPINE
LOTREL
BESYLATE/BENAZE
PRIL
T1 TRANDOLAPRIL/VE TARKA
RAPAMIL HCL
ACE INHIBITOR/THIAZIDE & THIAZIDE-LIKE
DIURETIC
T1 BENAZEPRIL/HYDR LOTENSIN HCT
OCHLOROTHIAZID
E
T1 CAPTOPRIL/HYDRO CAPOZIDE
CHLOROTHIAZIDE
T1 ENALAPRIL/HYDRO VASERETIC
CHLOROTHIAZIDE
T1 FOSINOPRIL/HYDR MONOPRIL-HCT
OCHLOROTHIAZID
E
T1 LISINOPRIL/HYDRO ZESTORETIC
CHLOROTHIAZIDE
T1 MOEXIPRIL/HYDRO UNIRETIC
CHLOROTHIAZIDE
T1 QUINAPRIL/HYDRO ACCURETIC
CHLOROTHIAZIDE
Page 21 of 116
ALPHA/BETA-ADRENERGIC BLOCKING AGENTS
T1 CARVEDILOL
COREG
T2 CARVEDILOL
COREG CR
PHOSPHATE
T1 LABETALOL HCL
TRANDATE
ALPHA-ADRENERGIC BLOCKING AGENTS
T1 DOXAZOSIN
CARDURA
MESYLATE
T1 PHENOXYBENZAMI DIBENZYLINE
NE HCL
T1 PRAZOSIN HCL
MINIPRESS
T1 TERAZOSIN HCL
HYTRIN
ANGIOTEN.RECEPTR ANTAG./CAL.CHANL
BLKR/THIAZIDE CB
T1 AMLODIPINE/VALSAEXFORGE HCT
RTAN/HCTHIAZID
ST
ANGIOTENSIN II RECEPTOR BLOCKER-BETA
BLOCKER COMB.
T2 NEBIVOLOL
BYVALSON
HCL/VALSARTAN
ANGIOTENSIN RECEPTOR ANTAG./THIAZIDE
DIURETIC COMB
T1 IRBESARTAN/HYDR AVALIDE
OCHLOROTHIAZID
E
T1 LOSARTAN/HYDROCHYZAAR
HLOROTHIAZIDE
T1 OLMESARTAN/HYD BENICAR HCT
ST
ROCHLOROTHIAZI
DE
T1 VALSARTAN/HYDRO DIOVAN HCT
CHLOROTHIAZIDE
ANGIOTENSIN RECEPTOR ANTGNST &
CALC.CHANNEL BLOCKR
T1 AMLODIPINE/VALSAEXFORGE
RTAN
ST
ANTIHYPERTENSIVES, ACE INHIBITORS
T1 BENAZEPRIL HCL LOTENSIN
T1 ENALAPRIL
VASOTEC
MALEATE
T1 FOSINOPRIL
MONOPRIL
SODIUM
T1 LISINOPRIL
PRINIVIL
T1 LISINOPRIL
ZESTRIL
T1 MOEXIPRIL HCL
UNIVASC
T1 PERINDOPRIL
ACEON
ERBUMINE
T1 PERINDOPRIL
PERINDOPRIL
ERBUMINE
ERBUMINE
T1 QUINAPRIL HCL
ACCUPRIL
T1 RAMIPRIL
ALTACE
T1 TRANDOLAPRIL
MAVIK
ANTIHYPERTENSIVES, ANGIOTENSIN RECEPTOR
ANTAGONIST
T1 IRBESARTAN
AVAPRO
T1 LOSARTAN
COZAAR
POTASSIUM
VNSNY
T1
T1
T1
OLMESARTAN
MEDOXOMIL
TELMISARTAN
VALSARTAN
BENICAR
ST
MICARDIS
DIOVAN
ANTIHYPERTENSIVES, SYMPATHOLYTIC
T1 CLONIDINE
CATAPRES-TTS 1
T1 CLONIDINE
CATAPRES-TTS 2
T1 CLONIDINE
CATAPRES-TTS 3
T1 CLONIDINE HCL
CATAPRES
T1 CLONIDINE
COMBIPRES (0.1MGHCL/CHLORTHALID 15MG) (TABLET)
ONE
T1 CLONIDINE
COMBIPRES (0.2HCL/CHLORTHALID 15MG) (TABLET)
ONE
T1 GUANFACINE HCL GUANFACINE HCL
T1 METHYLDOPA
ALDOMET
T1 METHYLDOPA/HYD ALDORIL 15
ROCHLOROTHIAZI
DE
T1 METHYLDOPA/HYD ALDORIL 25
ROCHLOROTHIAZI
DE
T1 RESERPINE
SANDRIL
ANTIHYPERTENSIVES, VASODILATORS
T1 HYDRALAZINE HCL APRESOLINE
T1 MINOXIDIL
LONITEN
BETA-ADRENERGIC BLOCKING AGENTS
T1 ACEBUTOLOL HCL ACEBUTOLOL HCL
T1 ATENOLOL
TENORMIN
T1 BETAXOLOL HCL KERLONE
T1 BISOPROLOL
BISOPROLOL
FUMARATE
FUMARATE
T1 METOPROLOL
TOPROL XL
SUCCINATE
T1 METOPROLOL
LOPRESSOR
TARTRATE
T1 METOPROLOL
METOPROLOL
TARTRATE
TARTRATE (25 MG)
(TABLET)
T2 NEBIVOLOL HCL
BYSTOLIC
T1 PINDOLOL
VISKEN
T1 PROPRANOLOL
INDERAL
HCL
T1 PROPRANOLOL
INDERAL LA
HCL
T1 SOTALOL HCL
SOTALOL HCL
T1 TIMOLOL MALEATEBLOCADREN
BETA-ADRENERGIC BLOCKING AGENTS/THIAZIDE
& RELATED
T1 ATENOLOL/CHLOR TENORETIC 100
THALIDONE
T1 ATENOLOL/CHLOR TENORETIC 50
THALIDONE
T1 BISOPROL/HYDROC ZIAC
HLOROTHIAZIDE
T1 METOPROLOL/HYD LOPRESSOR HCT
ROCHLOROTHIAZI
DE
Page 22 of 116
T1
T1
T1
NADOLOL/BENDRO CORZIDE
FLUMETHIAZIDE
PROPRANOLOL/HY INDERIDE-40/25
DROCHLOROTHIAZ
ID
PROPRANOLOL/HY INDERIDE-80/25
DROCHLOROTHIAZ
ID
CALCIUM CHANNEL BLOCKING AGENTS
T1 AMLODIPINE
NORVASC
BESYLATE
T1 DILTIAZEM HCL
CARDIZEM
T1 DILTIAZEM HCL
CARDIZEM CD
T1 DILTIAZEM HCL
CARDIZEM SR
T1 DILTIAZEM HCL
DILACOR XR
T1 DILTIAZEM HCL
TIAZAC
T1 FELODIPINE
PLENDIL
T1 ISRADIPINE
DYNACIRC
T1 NICARDIPINE HCL CARDENE
T1 NIFEDIPINE
ADALAT CC (30 MG)
(TABLET ER)
T1 NIFEDIPINE
ADALAT CC (60 MG)
(TABLET ER)
T1 NIFEDIPINE
NIFEDIPINE
T1 NIFEDIPINE
PROCARDIA
T1 NIFEDIPINE
PROCARDIA XL (30
MG) (TAB ER 24)
T1 NIFEDIPINE
PROCARDIA XL (60
MG) (TAB ER 24)
T1 NIFEDIPINE
PROCARDIA XL (90
MG) (TAB ER 24)
T1 NIMODIPINE
NIMOTOP
T2 NIMODIPINE
NYMALIZE
PA
T1 VERAPAMIL HCL
CALAN
T1 VERAPAMIL HCL
CALAN SR
T1 VERAPAMIL HCL
VERELAN
T1 VERAPAMIL HCL
VERELAN PM
LOOP DIURETICS
T1 BUMETANIDE
T1 FUROSEMIDE
T1 TORSEMIDE
BUMEX
LASIX
DEMADEX
POTASSIUM SPARING DIURETICS
T1 AMILORIDE HCL
MIDAMOR
T1 SPIRONOLACTONE ALDACTONE
POTASSIUM SPARING DIURETICS IN COMBINATION
T1 AMILORIDE/HYDRO MODURETIC 5-50
CHLOROTHIAZIDE
T1 SPIRONOLACT/HYD ALDACTAZIDE (25
ROCHLOROTHIAZI MG-25MG) (TABLET)
D
T1 TRIAMTERENE/HYD DYAZIDE
ROCHLOROTHIAZI
D
T1 TRIAMTERENE/HYD MAXZIDE
ROCHLOROTHIAZI
D
T1 TRIAMTERENE/HYD MAXZIDE-25 MG
ROCHLOROTHIAZI
D
VNSNY
PULM ANTI-HTN,SOLUBLE GUANYLATE CYCLASE
STIMULATOR
T2 RIOCIGUAT
ADEMPAS
PA
PULM.ANTI-HTN,SEL.C-GMP PHOSPHODIESTERASE
T5 INHIB
T2 SILDENAFIL CITRATEREVATIO (10 MG/ML) PA
(SUSP RECON)
T1 SILDENAFIL
REVATIO (20 MG)
PA
CITRATE
(TABLET)
T2 TADALAFIL
ADCIRCA
PA
PULMONARY ANTI-HTN, ENDOTHELIN RECEPTOR
ANTAGONIST
T2 AMBRISENTAN
LETAIRIS
PA
T2 BOSENTAN
TRACLEER
PA
T2 MACITENTAN
OPSUMIT
PA
PULMONARY ANTIHYPERTENSIVES,
PROSTACYCLIN-TYPE
T2 ILOPROST
VENTAVIS
TROMETHAMINE
T2 SELEXIPAG
UPTRAVI
T2 TREPROSTINIL
TYVASO
T2 TREPROSTINIL
ORENITRAM ER
DIOLAMINE
T2 TREPROSTINIL
REMODULIN
SODIUM
T2 TREPROSTINIL/NEB TYVASO REFILL KIT
ACCESSORIES
T2 TREPROSTINIL/NEBU TYVASO
LIZER/ACCESOR
INSTITUTIONAL
START KIT
T2 TREPROSTINIL/NEBU TYVASO STARTER
LIZER/ACCESOR
KIT
PA
PA
PA
PA
PA
PA
PA
PA
THIAZIDE AND RELATED DIURETICS
T1 CHLOROTHIAZIDE DIURIL (250 MG)
(TABLET)
T1 CHLOROTHIAZIDE DIURIL (500 MG)
(TABLET)
T1 CHLORTHALIDONE HYGROTON
T1 HYDROCHLOROTHI HYDROCHLOROTHI
AZIDE
AZIDE
T1 HYDROCHLOROTHI HYDRODIURIL
AZIDE
T1 HYDROCHLOROTHI MICROZIDE
AZIDE
T1 INDAPAMIDE
LOZOL
T1 METHYCLOTHIAZI METHYCLOTHIAZID
DE
E
T1 METOLAZONE
ZAROXOLYN
VASODILATORS, COMBINATION
T2 ISOSORBIBE
BIDIL
DINIT/HYDRALAZIN
E
Page 23 of 116
CARDIOVASCULAR DISEASE - LIPID
IRREGULARITY
ANTIHYPERLIPIDEMIC - APO B-100 SYNTHESIS
INHIBITOR
T2 MIPOMERSEN
KYNAMRO
PA
SODIUM
ANTIHYPERLIPIDEMIC - HMG COA REDUCTASE
INHIBITORS
T1 ATORVASTATIN
LIPITOR
CALCIUM
T1 LOVASTATIN
MEVACOR
T1 PRAVASTATIN
PRAVACHOL
SODIUM
T1 ROSUVASTATIN
CRESTOR
QL
CALCIUM
T1 SIMVASTATIN
ZOCOR (10 MG)
(TABLET)
T1 SIMVASTATIN
ZOCOR (20 MG)
(TABLET)
T1 SIMVASTATIN
ZOCOR (40 MG)
(TABLET)
T1 SIMVASTATIN
ZOCOR (5 MG)
(TABLET)
T1 SIMVASTATIN
ZOCOR (80 MG)
ST
(TABLET)
ANTIHYPERLIPIDEMIC - MTP INHIBITOR
T2 LOMITAPIDE
JUXTAPID
MESYLATE
PA
ANTIHYPERLIPIDEMIC - PCSK9 INHIBITORS
T2 EVOLOCUMAB
REPATHA
PA
PUSHTRONEX
T2 EVOLOCUMAB
REPATHA
PA
SURECLICK
T2 EVOLOCUMAB
REPATHA SYRINGE PA
BILE SALT SEQUESTRANTS
T1 CHOLESTYRAMINE QUESTRAN
(WITH SUGAR)
T1 CHOLESTYRAMINE/ QUESTRAN LIGHT
ASPARTAME
T2 COLESEVELAM HCL WELCHOL
T1 COLESTIPOL HCL COLESTID (1 G)
(TABLET)
T1 COLESTIPOL HCL COLESTID (5 G)
(GRANULES)
T1 COLESTIPOL HCL COLESTID (5 G)
(PACKET)
LIPOTROPICS
T1 EZETIMIBE
T1 FENOFIBRATE
T1
FENOFIBRATE
T1
FENOFIBRATE
T1
FENOFIBRATE
VNSNY
ZETIA
FENOFIBRATE (120
MG) (TABLET)
FENOFIBRATE (160
MG) (TABLET)
FENOFIBRATE (40
MG) (TABLET)
FENOFIBRATE (54
MG) (TABLET)
T1
T2
T1
T1
T1
T1
T2
T2
T1
T1
T1
FENOFIBRATE
TRICOR
NANOCRYSTALLIZE
D
FENOFIBRATE
TRIGLIDE
ST
NANOCRYSTALLIZED
FENOFIBRATE,MIC FENOFIBRATE,MICR
RONIZED
ONIZED
FENOFIBRIC ACID FIBRICOR
FENOFIBRIC ACID TRILIPIX
(CHOLINE)
GEMFIBROZIL
LOPID
ICOSAPENT ETHYL VASCEPA (0.5 GRAM) QL
(CAPSULE)
ICOSAPENT ETHYL VASCEPA (1 G)
QL
(CAPSULE)
NIACIN
NIACOR
NIACIN
NIASPAN
ST
OMEGA-3 ACID
LOVAZA
QL
ETHYL ESTERS
NIACIN PREPARATIONS
T1 NIACIN
NIACIN SA
CARDIOVASCULAR DISEASE MISCELLANEOUS AGENTS
ADRENERGIC VASOPRESSOR AGENTS
T2 DROXIDOPA
NORTHERA
T1 MIDODRINE HCL
PROAMATINE
PA
ANGIOTENSIN RECEPT-NEPRILYSIN INHIBITOR
COMB(ARNI)
T2 SACUBITRIL/VALSAR ENTRESTO
QL
TAN
ANTIANGINAL & ANTI-ISCHEMIC AGENTS,NONHEMODYNAMIC
T2 RANOLAZINE
RANEXA (1000 MG) QL
(TAB ER 12H)
T2 RANOLAZINE
RANEXA (500 MG) QL
(TAB ER 12H)
ANTIHYPERLIP - HMG-COA&CALCIUM CHANNEL
BLOCKER CB
T1 AMLODIPINE/ATOR AMLODIPINE/ATORV QL
VASTATIN
ASTATIN
CARDIOVASCULAR DISEASE VASODILATION
QL
VASODILATORS,CORONARY
T1 AMYL NITRITE
AMYL NITRITE
T1 ISOSORBIDE
ISOCHRON
DINITRATE
T1 ISOSORBIDE
ISORDIL (10 MG)
DINITRATE
(TABLET)
T1 ISOSORBIDE
ISORDIL (20 MG)
DINITRATE
(TABLET)
T1 ISOSORBIDE
ISORDIL (30 MG)
DINITRATE
(TABLET)
T2 ISOSORBIDE
ISORDIL (40 MG)
DINITRATE
(TABLET)
Page 24 of 116
T1
T2
T1
ISOSORBIDE
DINITRATE
ISOSORBIDE
MONONITRATE
ISOSORBIDE
MONONITRATE
NITROGLYCERIN
NITROGLYCERIN
T1
NITROGLYCERIN
T2
NITROGLYCERIN
T1
T1
T1
NITROGLYCERIN
T1
NITROGLYCERIN
T2
NITROGLYCERIN
T1
T1
NITROGLYCERIN
NITROGLYCERIN
ISORDIL TITRADOSE
T4
IMDUR
T4
MONOKET
T4
NITRO-BID
NITRO-DUR
(0.1MG/HR) (PATCH
TD24)
NITRO-DUR
(0.2MG/HR) (PATCH
TD24)
NITRO-DUR (0.3
MG/HR) (PATCH
TD24)
NITRO-DUR
(0.4MG/HR) (PATCH
TD24)
NITRO-DUR
(0.6MG/HR) (PATCH
TD24)
NITRO-DUR
(0.8MG/HR) (PATCH
TD24)
NITROSTAT
NITRO-TIME
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
VASODILATORS,PERIPHERAL
T1 ERGOLOID
HYDERGINE
MESYLATES
T1 ISOXSUPRINE HCL ISOXSUPRINE HCL
T1 ISOXSUPRINE HCL VASODILAN
T1 PAPAVERINE HCL PAPAVERINE HCL
T4
T4
T4
CONTRACEPTION/OXYTOCICS
CONTRACEPTIVES, INTRAVAGINAL, SYSTEMIC
T4 ETONOGESTREL/ETH NUVARING
QL
INYL ESTRADIOL
CONTRACEPTIVES,INJECTABLE
T4 MEDROXYPROGEST DEPO-PROVERA
ERONE ACETATE
T4 MEDROXYPROGESTE DEPO-SUBQ
RONE ACETATE
PROVERA 104
CONTRACEPTIVES,ORAL
T4 DESOGMIRCETTE
E.ESTRADIOL/E.EST
RADIOL
T4 DESOGESTRELCYCLESSA
ETHINYL
ESTRADIOL
T4 DESOGESTRELDESOGEN
ETHINYL
ESTRADIOL
T4 DROSPIR/ETH
BEYAZ
ESTRA/LEVOMEFOL
CA
T4 DROSPIR/ETH
SAFYRAL
ESTRA/LEVOMEFOL
CA
VNSNY
QL
QL
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
ST
T4
ST
T4
ESTRADIOL
NATAZIA
VALERATE/DIENOGE
ST
ETHINYL
YASMIN 28
ESTRADIOL/DROSPI
RENONE
ETHINYL
YAZ
ESTRADIOL/DROSPI
RENONE
ETHYNODIOL DDEMULEN
ETHINYL
ESTRADIOL
ETHYNODIOL DDEMULEN 1-50-21
ETHINYL
ESTRADIOL
ETHYNODIOL DETHYNODIOL DETHINYL
ETHINYL
ESTRADIOL
ESTRADIOL
LEVONORGESTREL AFTERA
LEVONORGESTREL PLAN B ONE-STEP
LEVONORGESTREL TAKE ACTION
LEVONORGESTREL- AMETHYST
ETHIN ESTRADIOL
LEVONORGESTREL- AVIANE
ETHIN ESTRADIOL
LEVONORGESTREL- LEVONORGESTRELETHIN ESTRADIOL ETHIN ESTRADIOL
LEVONORGESTREL- NORDETTE-28
ETHIN ESTRADIOL
LEVONORGESTREL- SEASONALE
ETHIN ESTRADIOL
LEVONORGESTREL- TRIVORA
ETHIN ESTRADIOL
LLOSEASONIQUE
NORGEST/E.ESTRAD
IOL-E.ESTRAD
LQUARTETTE
NORGEST/E.ESTRADI
OL-E.ESTRAD
LSEASONIQUE
NORGEST/E.ESTRAD
IOL-E.ESTRAD
NORETH-ETHINYL FEMCON FE
ESTRADIOL/IRON
NORETH-ETHINYL GENERESS FE
ESTRADIOL/IRON
NORETHINDRONE ORTHO MICRONOR
NORETHINDRONE LOESTRIN
AC-ETH ESTRADIOL
NORETHINDRONE- ESTROSTEP FE
E.ESTRADIOL-IRON
NORETHINDRONE- LO LOESTRIN FE
E.ESTRADIOL-IRON
NORETHINDRONE- LOESTRIN FE
E.ESTRADIOL-IRON
NORETHINDRONE- MICROGESTIN 24 FE
E.ESTRADIOL-IRON
NORETHINDRONE- MINASTRIN 24 FE
E.ESTRADIOL-IRON
NORETHINDRONE- NORETHINDRONEETHINYL ESTRAD ETHINYL ESTRAD
ST
ST
QL
QL
QL
Page 25 of 116
T4
T4
T4
T4
T4
T4
T4
T4
NORETHINDRONEMESTRANOL
NORGESTIMATEETHINYL
ESTRADIOL
NORGESTIMATEETHINYL
ESTRADIOL
NORGESTIMATEETHINYL
ESTRADIOL
NORGESTRELETHINYL
ESTRADIOL
NORGESTRELETHINYL
ESTRADIOL
NORGESTRELETHINYL
ESTRADIOL
ULIPRISTAL
ACETATE
ORTHO TRI-CYCLEN
ORTHO TRI-CYCLEN
LO
ANTITUSSIVES,NON-NARCOTIC
T1 BENZONATATE
TESSALON
T1 BENZONATATE
TESSALON PERLE
ORTHO-CYCLEN
DECONGESTANT-EXPECTORANT COMBINATIONS
T1 GUAIFENESIN/PHEN GUAIFENESIN/PHEN
YLEPHRINE HCL
YLEPHRINE HCL
(400MG-10MG)
(TABLET) (OTC)
T1 GUAIFENESIN/PSEU GUAIFENESIN/PSEU
DOEPHEDRNE HCL DOEPHEDRNE HCL
(400MG-40MG)
(TABLET) (OTC)
T1 GUAIFENESIN/PSEU GUAIFENESIN/PSEU
DOEPHEDRNE HCL DOEPHEDRNE HCL
(400MG-60MG)
(TABLET) (OTC)
T1 GUAIFENESIN/PSEU GUAIFENESIN/PSEU
DOEPHEDRNE HCL DOEPHEDRNE HCL
(600MG-60MG) (TAB
ER 12H) (OTC)
LO-OVRAL-28
LO-OVRAL-8
NORGESTRELETHINYL
ESTRADIOL
ELLA
CONTRACEPTIVES,TRANSDERMAL
T4 NORELGESTROMIN/ ORTHO EVRA
ETHIN.ESTRADIOL
DIAPHRAGMS/CERVICAL CAP
T4 DIAPHRAGMS, WIDE WIDE SEAL
SEAL
DIAPHRAGM
COUGH AND COLD
1ST GEN ANTIHISTAMINE & DECONGESTANT
COMBINATIONS
T1 BROMPHENIRAMIN BROMPHENIRAMINE
E/PHENYLEPHRINE /PHENYLEPHRINE
(6MG-10MG/5) (ORAL
SUSP) (OTC)
T1 CHLORPHENIRAMI CHLORPHENIRAMIN
NE/PHENYLEPHRIN E/PHENYLEPHRINE
E
(1MG-2MG/ML)
(DROPS)
T1 CHLORPHENIRAMI CHLORPHENIRAMIN
NE/PHENYLEPHRIN E/PHENYLEPHRINE
E
(4-10MG/5ML)
(LIQUID) (OTC)
T1 CHLORPHENIRAMI CHLORPHENIRAMIN
NE/PSEUDOEPHED E/PSEUDOEPHED (4
MG-60 MG) (TABLET)
(OTC)
T1 PHENYLEPHRINE PHENERGAN VC
HCL/PROMETH HCL
T1 PHENYLEPHRINE PHEN-TUSS AD
HCL/PROMETH HCL
T1 PHENYLEPHRINE/DI PHENYLEPHRINE/DI
PHENHYDRAMINE PHENHYDRAMINE
T1 TRIPROLIDINE/PSE TRIPROLIDINE/PSEU
UDOEPHEDRINE
DOEPHEDRINE
(2.5MG-60MG)
(TABLET) (OTC)
VNSNY
1ST GEN ANTIHIST-DECONGESTANTICHOLINERGIC COMB
T1 PSEUDOEPHED/CHL PSEUDOEPHED/CHL
OR-MAL/BELL ALK OR-MAL/BELL ALK
NORINYL 1+50
QL
DECONGESTANTS, ORAL
T5 PSEUDOEPHEDRINE PSEUDOEPHEDRINE
HCL
HCL (120 MG)
(TABLET ER) (OTC)
T5 PSEUDOEPHEDRINE PSEUDOEPHEDRINE
HCL
HCL (30 MG)
(TABLET) (OTC)
EXPECTORANTS
T5 GUAIFENESIN
T1
GUAIFENESIN
T5
GUAIFENESIN
GUAIFENESIN (100
MG/5ML) (LIQUID)
(OTC)
GUAIFENESIN (200
MG) (TABLET) (OTC)
GUAIFENESIN (600
MG) (TAB ER 12H)
(OTC)
NARCOTIC ANTITUSS-1ST GEN. ANTIHISTAMINEDECONGEST
T1 BROMPHENIRA/PSE BROMPHENIRA/PSE
UDOEPHED/CODEIN UDOEPHED/CODEIN
T1 HYDROCODONE/CP ZUTRIPRO
M/PSEUDOEPHED
T1 PROMETHAZINE/PH PENTAZINE VC
ENYLEPH/CODEINE WITH CODEINE
T1 PROMETHAZINE/PH PHENERGAN VC
ENYLEPH/CODEINE WITH CODEINE
NARCOTIC ANTITUSS-DECONGESTANTEXPECTORANT COMB
T1 PSEUDOEPHED/COD TUSNEL C
EINE/GUAIFEN
NARCOTIC ANTITUSSIVE-1ST GENERATION
ANTIHISTAMINE
T1 HYDROCODONE/CH TUSSIONEX
LORPHEN P-STIREX
Page 26 of 116
T1
PROMETHAZINE
HCL/CODEINE
PHENERGAN WITH
CODEINE
NARCOTIC ANTITUSSIVE-ANTICHOLINERGIC
COMB.
T1 HYDROCODONE
TUSSIGON
BIT/HOMATROP MEBR
NARCOTIC ANTITUSSIVE-EXPECTORANT
COMBINATION
T1 CODEINE
CODEINE
PHOSPHATE/GUAIF PHOSPHATE/GUAIFE
ENESIN
NESIN (10-100MG/5)
(LIQUID) (OTC)
T1 CODEINE
CODEINE
PHOSPHATE/GUAIF PHOSPHATE/GUAIFE
ENESIN
NESIN (10-200MG/5)
(LIQUID) (OTC)
T1 CODEINE
CODEINE
PHOSPHATE/GUAIF PHOSPHATE/GUAIFE
ENESIN
NESIN (6.3-100/5)
(LIQUID) (OTC)
T1 CODEINE
CODEINE
PHOSPHATE/GUAIF PHOSPHATE/GUAIFE
ENESIN
NESIN (7.5-225/5)
(LIQUID) (OTC)
T1 CODEINE
CODEINE
PHOSPHATE/GUAIF PHOSPHATE/GUAIFE
ENESIN
NESIN (8-200 MG/5)
(LIQUID) (OTC)
NON-NARC ANTITUSS-1ST GEN. ANTIHISTAMINEDECONGEST
T1 BROMPHENIRAM/P BROMPHENIRAM/PH
HENYLEPHRINE/DM ENYLEPHRINE/DM
(2-5-10MG/5)
(LIQUID) (OTC)
T1 BROMPHENIRAM/P BROMPHENIRAM/PH
HENYLEPHRINE/DM ENYLEPHRINE/DM
(4-10-20/5) (LIQUID)
(OTC)
T1 BROMPHENIRAM/P BROMPHENIRAM/PH
HENYLEPHRINE/DM ENYLEPHRINE/DM
(4-7.5-15/5) (LIQUID)
(OTC)
T1 BROMPHENIRAMIN BROMFED DM
E/PSEUDOEPHED/D
M
T1 BROMPHENIRAMIN BROMPHENIRAMINE
E/PSEUDOEPHED/D /PSEUDOEPHED/DM
M
(2-30-10/5) (SYRUP)
T1 BROMPHENIRAMIN BROMPHENIRAMINE
E/PSEUDOEPHED/D /PSEUDOEPHED/DM
M
(3-30-15/5) (LIQUID)
(OTC)
T1 CHLORPHENIRAMI CHLORPHENIRAMIN
NE/PHENYLEPH/DM E/PHENYLEPH/DM
(1-2-3MG/ML)
(DROPS)
T1 CHLORPHENIRAMI CHLORPHENIRAMIN
NE/PHENYLEPH/DM E/PHENYLEPH/DM
(2-5-15MG/5)
(LIQUID) (OTC)
VNSNY
T1
T1
CHLORPHENIRAMI CHLORPHENIRAMIN
NE/PHENYLEPH/DM E/PHENYLEPH/DM
(4-10-15/5) (LIQUID)
(OTC)
DDMETHORPHAN/PE/D METHORPHAN/PE/D
EXBROMPHENIR
EXBROMPHENIR
NON-NARC ANTITUSSIVE-1ST GEN ANTIHISTAMINE
COMB.
T1 PROMETHAZINE/DE PHEN TUSS DM
XTROMETHORPHA
N
NON-NARCOTIC ANTITUSS-DECONGESTANTEXPECTORANT CMB
T1 GUAIFEN/DEXTROM GUAIFEN/DEXTROM
ETHORPHAN/PE
ETHORPHAN/PE
(200-30-10) (LIQUID)
(OTC)
T1 GUAIFEN/DEXTROM GUAIFEN/DEXTROM
ETHORPHAN/PE
ETHORPHAN/PE
(400-20-10) (TABLET)
(OTC)
T1 GUAIFENESIN/DM/P GUAIFENESIN/DM/PS
SEUDOEPHEDRINE EUDOEPHEDRINE
(150-15-30) (LIQUID)
(OTC)
T1 GUAIFENESIN/DM/P GUAIFENESIN/DM/PS
SEUDOEPHEDRINE EUDOEPHEDRINE
(400-20-40) (TABLET)
(OTC)
NON-NARCOTIC ANTITUSSIVE AND EXPECTORANT
COMB.
T5 GUAIFENESIN/DEXT GUAIFENESIN/DEXT
ROMETHORPHAN ROMETHORPHAN
(100-10MG/5)
(LIQUID) (OTC)
T5 GUAIFENESIN/DEXT GUAIFENESIN/DEXT
ROMETHORPHAN ROMETHORPHAN
(100-10MG/5)
(SYRUP) (OTC)
T5 GUAIFENESIN/DEXT GUAIFENESIN/DEXT
ROMETHORPHAN ROMETHORPHAN
(100-5 MG/5)
(LIQUID) (OTC)
T5 GUAIFENESIN/DEXT GUAIFENESIN/DEXT
ROMETHORPHAN ROMETHORPHAN
(200-30MG/5)
(LIQUID) (OTC)
NON-NARCOTIC ANTITUSSIVE-DECONGESTANTANALGESIC CB
T5 DM/PSEUDOEPHED/ DM/PSEUDOEPHED/
ACETAMINOPHEN ACETAMINOPHEN
(5-15-160MG)
(DROPS) (OTC)
NOSE PREPARATIONS, VASOCONSTRICTORS(OTC)
T5 OXYMETAZOLINE OXYMETAZOLINE
HCL
HCL
Page 27 of 116
SYMPATHOMIMETIC AGENTS
T5 PSEUDOEPHEDRINE NEXAFED
HCL
T5 PSEUDOEPHEDRINE PSEUDOEPHEDRINE
HCL
HCL (120 MG)
(TABLET ER) (OTC)
T5 PSEUDOEPHEDRINE PSEUDOEPHEDRINE
HCL
HCL (30 MG)
(TABLET) (OTC)
T1 PSEUDOEPHEDRINE PSEUDOEPHEDRINE
HCL
HCL (60 MG)
(TABLET) (OTC)
DERMATOLOGY - ANTIINFECTIVE
INSECT REPELLANTS
T5 DIETHYLTOLUAMID DIETHYLTOLUAMID QL
E
E (25 %) (AERO
POWD) (OTC)
TOPICAL ANTIBIOTICS
T5 BACITRACIN
T5 BACITRACIN ZINC
T5
DERMATOLOGY - ACNE
ACNE AGENTS,SYSTEMIC
T1 ISOTRETINOIN
ISOTRETINOIN
T5
ACNE AGENTS,TOPICAL
T1 CLINDAMYCIN
BENZACLIN (1 %-5
PHOS/BENZOYL
%) (GEL (GRAM))
PEROX
T1 CLINDAMYCIN
DUAC
PHOS/BENZOYL
PEROX
T1
ROSACEA AGENTS, TOPICAL
T1 METRONIDAZOLE METROCREAM
T1 METRONIDAZOLE METROGEL
T1 METRONIDAZOLE METROLOTION
T1 METRONIDAZOLE ROSADAN
TOPICAL PREPARATIONS,ANTIBACTERIALS
T1 BENZALKONIUM
REVITADERM
CHLORIDE
T1 CHLOROXYLENOL PERIGIENE
T1 HYDROCORTISONE/ DERMAZENE
IODOQUINOL
T1 HYDROCORTISONE/ HYDROCORTISONE/I
IODOQUINOL
ODOQUINOL
T1 IODINE/POTASSIUM IODINE
IODIDE
T1 IODINE/POTASSIUM LUGOL'S
IODIDE
T1 METHYLBENZETHO METHYLBENZETHO
NIUM CHLORIDE
NIUM CHLORIDE
T5 SILVER
SILVASORB
T5 SILVER
SILVERMED (GEL
ER(ML)) (OTC)
T1 SILVER CHLORIDE SILVER CHLORIDE
T1 SILVER NITRATE
SILVER NITRATE
T5 SILVER/SODIUM
ARGLAES
ALGINATE
VITAMIN A DERIVATIVES
T1 TRETINOIN
T1 TRETINOIN
MICROSPHERES
T1 TRETINOIN
MICROSPHERES
T1
TRETINOIN
MICROSPHERES
VNSNY
RETIN-A
RETIN-A MICRO
RETIN-A MICRO
PUMP (0.04 %) (GEL
W/PUMP)
RETIN-A MICRO
PUMP (0.1 %) (GEL
W/PUMP)
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
BACITRACIN
BACITRACIN ZINC
(500 UNIT/G) (OINT.
(G)) (OTC)
BACITRACIN ZINC BACITRACIN ZINC
(500 UNIT/G)
(PACKET) (OTC)
BACITRACIN ZINC
BACITRACIN ZINC
(500 UNIT/G)
(PACKET) (OTC)
BACITRACIN/POLY BACITRACIN/POLYM
MYXIN B SULFATE YXIN B SULFATE
(500-10K/G) (OINT.
(G)) (OTC)
CLINDAMYCIN
CLEOCIN T
PHOSPHATE
CLINDAMYCIN
CLINDACIN ETZ
PHOSPHATE
CLINDAMYCIN
CLINDACIN P
PHOSPHATE
CLINDAMYCIN
EVOCLIN
PHOSPHATE
ERYTHROMYCIN
ERY
BASE/ETHANOL
ERYTHROMYCIN
ERYGEL
BASE/ETHANOL
ERYTHROMYCIN
ERYMAX
BASE/ETHANOL
ERYTHROMYCIN/BE BENZAMYCIN
NZOYL PEROXIDE
GENTAMICIN
GENTAMICIN
SULFATE
SULFATE
MUPIROCIN
CENTANY
MUPIROCIN
BACTROBAN
CALCIUM
NEOMYCN/BACITRC NEOMYCN/BACITRC/
/POLYMYX/PRAMOX POLYMYX/PRAMOX
(3.5-10K-10) (OINT.
(G)) (OTC)
TOPICAL
ANTIFUNGAL/ANTIINFLAMMATORY,STERIOD
AGENT
T1 CLOTRIMAZOLE/BE LOTRISONE
TAMETHASONE DIP
TOPICAL ANTIFUNGALS
T1 CICLOPIROX
T1 CICLOPIROX
T1 CICLOPIROX
T1 CICLOPIROX
OLAMINE
T1 CICLOPIROX
OLAMINE
CICLODAN
LOPROX
PENLAC
CICLODAN
LOPROX
Page 28 of 116
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T1
T1
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T1
T1
T2
T1
T1
T1
T1
T1
T1
T1
T1
T2
T2
T5
T5
T5
T5
T5
CICLOPIROX/URE/C CICLODAN
AMPH/MENTH/EUC
CLOTRIMAZOLE
LOTRIMIN
CLOTRIMAZOLE
LOTRIMIN AF
ECONAZOLE
SPECTAZOLE
NITRATE
GENTIAN
GENTIAN
VIOLET/BRGREEN/P VIOLET/BRGREEN/P
ROFLAV
ROFLAV
KETOCONAZOLE
EXTINA (2 %)
(FOAM)
KETOCONAZOLE
NIZORAL
MICONAZOLE
MICONAZOLE
NITRATE
NITRATE (2 %)
(CREAM(ML)) (OTC)
MICONAZOLE
NUZOLE
NITRATE
NAFTIFINE HCL
NAFTIN (1 %)
(CREAM (G))
NAFTIFINE HCL
NAFTIN (1 %) (GEL
(GRAM))
NAFTIFINE HCL
NAFTIN (2 %)
(CREAM (G))
NYSTATIN
MYCOSTATIN
NYSTATIN
NYAMYC
NYSTATIN
NYSTATIN
NYSTATIN
NYSTEX
NYSTATIN
NYSTOP
NYSTATIN/TRIAMCI MYCOGEN II
N
SODIUM
VERSICLEAR
THIOSULFATE/SAL
ACID
SULCONAZOLE
EXELDERM
NITRATE
TERBINAFINE HCL LAMISIL
TOLNAFTATE
TOLNAFTATE (1 %)
(AERO POWD) (OTC)
TOLNAFTATE
TOLNAFTATE (1 %)
(CREAM (G)) (OTC)
TOLNAFTATE
TOLNAFTATE (1 %)
(PACKET) (OTC)
TOLNAFTATE
TOLNAFTATE (1 %)
(POWDER) (OTC)
TOLNAFTATE
TOLNAFTATE (1 %)
(SOLUTION) (OTC)
TOPICAL ANTIPARASITICS
T2 CROTAMITON
EURAX
T5 DIETHYLTOLUAMID DIETHYLTOLUAMID
E
E (15 %) (AERO
POWD) (OTC)
T5 DIETHYLTOLUAMID DIETHYLTOLUAMID
E
E (15 %) (SPRAY)
(OTC)
T5 DIETHYLTOLUAMID DIETHYLTOLUAMID
E
E (25 %) (SPRAY)
(OTC)
T5 DIETHYLTOLUAMID DIETHYLTOLUAMID
E
E (40 %) (SPRAY)
(OTC)
VNSNY
T5
T5
T5
T1
T5
T1
T5
T5
DIETHYLTOLUAMID DIETHYLTOLUAMID QL
E
E (7 %) (SPRAY)
(OTC)
ICARIDIN
INSECT REPELLENT QL
ICARIDIN
NATRAPEL
QL
LINDANE
KWELL
PERMETHRIN
PERMETHRIN (1 %)
(LIQUID) (OTC)
PERMETHRIN
PERMETHRIN (5 %)
(CREAM (G))
PIPERONYL
PIPERONYL
BUTOXIDE/PYRETH BUTOXIDE/PYRETHR
RINS
INS (4%-0.33%)
(SHAMPOO) (OTC)
PIPERONYL
PIPERONYL
BUTOXIDE/PYRETH BUTOXIDE/PYRETHR
RINS
INS (LIQUID) (OTC)
TOPICAL ANTIVIRALS
T2 ACYCLOVIR
T1
ACYCLOVIR
T5
DOCOSANOL
ZOVIRAX (5 %)
(CREAM (G))
ZOVIRAX (5 %)
(OINT. (G))
ABREVA
TOPICAL SULFONAMIDES
T1 SILVER
SILVADENE
SULFADIAZINE
T1 SILVER
THERMAZENE
SULFADIAZINE
DERMATOLOGY ANTIINFLAMMATORY
TOPICAL
ANTIBIOTICS/ANTIINFLAMMATORY,STEROIDAL
T2 NEOMYC/BACIT/POL CORTISPORIN
YMYX/HYDROCORT
T2 NEOMYCIN/POLYMY CORTISPORIN
XIN B/HYDROCORT
QL
QL
QL
QL
TOPICAL ANTI-INFLAMMATORY STEROIDAL
T1 ALCLOMETASONE ACLOVATE
DIPROPIONATE
T1 AMCINONIDE
CYCLOCORT
T1 BETAMETHASONE BETAMETHASONE
DIPROPIONATE
DIPROPIONATE
T1 BETAMETHASONE VALISONE
VALERATE
T1 BETAMETHASONE/P BETAMETHASONE/P
ROPYLENE GLYC
ROPYLENE GLYC
T1 CLOBETASOL
CLOBEX
PROPIONATE
T1 CLOBETASOL
CLODAN
PROPIONATE
T1 CLOBETASOL
OLUX
PROPIONATE
T1 CLOBETASOL
TEMOVATE
PROPIONATE
T1 CLOBETASOL
OLUX-E
PROPIONATE/EMOL
L
Page 29 of 116
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T1
T1
T1
T1
T2
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T1
T1
T1
T1
T1
T1
T1
T2
T1
T1
T1
T1
T1
T2
T1
T1
T1
T5
T5
T1
T5
T5
T1
T1
T1
T1
CLOBETASOL
TEMOVATE E
PROPIONATE/EMOL
L
CLOCORTOLONE
CLODERM
PIVALATE
DESONIDE
DESONIDE
DESOXIMETASONE TOPICORT (0.05 %)
(CREAM (G))
DESOXIMETASONE TOPICORT (0.25 %)
(CREAM (G))
DIFLORASONE
APEXICON E
DIACETATE/EMOLL
FLUOCINOLONE
DERMA-SMOOTHEACETONIDE
FS
FLUOCINOLONE
SYNALAR
ACETONIDE
FLUOCINOLONE/SH DERMA-SMOOTHEOWER CAP
FS
FLUOCINONIDE
LIDEX
FLUOCINONIDE
VANOS
FLUOCINONIDE/EM LIDEX-E
OLLIENT BASE
FLURANDRENOLID CORDRAN (0.05 %)
E
(CREAM (G))
FLURANDRENOLID CORDRAN (0.05 %)
E
(LOTION)
FLURANDRENOLID CORDRAN (0.05 %)
E
(OINT. (G))
FLURANDRENOLIDE CORDRAN (4MCG/SQ
CM) (MED. TAPE)
FLUTICASONE
CUTIVATE (0.005 %)
PROPIONATE
(OINT. (G))
FLUTICASONE
CUTIVATE (0.05 %)
PROPIONATE
(CREAM (G))
HALOBETASOL
ULTRAVATE (0.05 %)
PROPIONATE
(CREAM (G))
HALOBETASOL
ULTRAVATE (0.05 %)
PROPIONATE
(OINT. (G))
HC/MINERAL
HYDROCORTISONE
OIL/PETROLAT,WHT
HYDROCORT/SAL
SCALACORT DK
ACID/SULF/SHAMP1
HYDROCORTISONE ALACORT
HYDROCORTISONE ANUSOL HC
HYDROCORTISONE CORTAID (1 %)
(OINT. (G))
HYDROCORTISONE CORTISONE-10
HYDROCORTISONE CORTIZONE-10
HYDROCORTISONE HYDROCORTISONE
(1 %) (CREAM (G))
HYDROCORTISONE HYDROCORTISONE
(1 %) (CREAM (G))
(OTC)
HYDROCORTISONE HYDROCORTISONE
(1 %) (OINT. (G))
(OTC)
HYDROCORTISONE HYDROCORTISONE
(2.5 %) (CREAM (G))
HYDROCORTISONE HYDROCORTISONE
(2.5 %) (CRM/PE APP)
HYDROCORTISONE HYTONE
HYDROCORTISONE NUCORT
VNSNY
T1
T2
T5
HYDROCORTISONE
HYDROCORTISONE
HYDROCORTISONE
ACETATE
T5
HYDROCORTISONE
ACETATE
T1
HYDROCORTISONE
ACETATE
T1
HYDROCORTISONE
ACETATE
T1
HYDROCORTISONE
BUTYRATE
HYDROCORTISONE
BUTYRATE
HYDROCORTISONE
BUTYRATE
HYDROCORTISONE
PROBUTATE
HYDROCORTISONE HYDROCORTISONE
VALERATE
VALERATE
HYDROCORTISONE WESTCORT
VALERATE
HYDROCORTISONE/ HYDROCORTISONE/
ALOE VERA
ALOE VERA (1 %)
(CREAM (G)) (OTC)
HYDROCORTISONE/ HYDROCORTISONE/
ALOE/VIT.E/A/D
ALOE/VIT.E/A/D
HYDROCORTISONE/ HYDROCORTISONE/
OATMEAL/ALOE/E OATMEAL/ALOE/E
MOMETASONE
MOMETASONE
FUROATE
FUROATE
PREDNICARBATE
DERMATOP
TRIAMCINOLONE KENALOG
ACETONIDE
TRIAMCINOLONE TRIAMCINOLONE
ACETONIDE
ACETONIDE
T1
T1
T2
T1
T1
T5
T5
T5
T1
T1
T1
T1
SCALACORT
TEXACORT
HYDROCORTISONE
ACETATE (1 %)
(CREAM (G)) (OTC)
HYDROCORTISONE
ACETATE (1 %)
(OINT. (G)) (OTC)
HYDROCORTISONE
ACETATE (25 MG)
(SUPP.RECT)
HYDROCORTISONE
ACETATE (30 MG)
(SUPP.RECT)
LOCOID (0.1 %)
(CREAM (G))
LOCOID (0.1 %)
(OINT. (G))
LOCOID (0.1 %)
(SOLUTION)
PANDEL
TOPICAL ANTI-INFLAMMATORY, NSAIDS
T1 DICLOFENAC
PENNSAID (1.5 %)
SODIUM
(DROPS)
T1 DICLOFENAC
VOLTAREN
SODIUM
DERMATOLOGY - MISCELLANEOUS
ANTISEBORRHEIC AGENTS
T1 EMOLLIENT
EMOLLIENT
COMBINATION
COMBINATION
NO.85
NO.85
T1 SELENIUM SULFIDE SELENIUM SULFIDE
(2.25 %) (SHAMPOO)
T1 SELENIUM SULFIDE SELSUN
T1 SULFACETAMIDE
SULFACETAMIDE
SODIUM
SODIUM (10 %)
(CLNSR GEL)
ANTISEPTICS,GENERAL
T2 ALCOHOL
ALCOHOL PREP
ANTISEPTIC PADS
SWABS
Page 30 of 116
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T1
T2
T2
T2
T2
T1
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T1
T1
T1
ALCOHOL
ANTISEPTIC PADS
ALCOHOL
ANTISEPTIC PADS
ALCOHOL
ANTISEPTIC PADS
ALCOHOL
ANTISEPTIC PADS
ALCOHOL
ANTISEPTIC PADS
ALCOHOL
ANTISEPTIC PADS
ALCOHOL
ANTISEPTIC PADS
ALCOHOL
ANTISEPTIC PADS
ALCOHOL
ANTISEPTIC PADS
ALCOHOL
ANTISEPTIC PADS
ALCOHOL
ANTISEPTIC PADS
DEODORANTS
T5 OSTOMY SUPPLY
T5 OSTOMY SUPPLY
T5 OSTOMY SUPPLY
T5
T1
OSTOMY SUPPLY
SODIUM CITRATE
CARETOUCH
ALCOHOL PREP PAD
CURITY ALCOHOL
PREPS
INCONTROL
ALCOHOL PADS
IV ANTISEPTIC
WIPES
IV PREP WIPES
T1
PRO COMFORT
ALCOHOL PADS
SINGLE USE SWAB
T1
T1
T1
T1
SURE COMFORT
ALCOHOL
SURE-PREP
ALCOHOL PREP
PADS
ULTILET ALCOHOL
SWAB
WEBCOL
T1
T1
T1
T1
FRESHNET
HEX-ON LIGHT
ODOR ELIMINATOR
DROPS
ULTRA-FRESH
M9
EMOLLIENTS
T1 ALOE
ALOE VESTA
VERA/COLLAGEN
T1 ALOE
ALOE VESTA
VERA/COLLAGEN
CLEANSING
T1 ALOE
PERISCENT
VERA/COLLAGEN
T1 ALOE
SENSI-CARE
VERA/COLLAGEN
T1 ALOE/LA/CERAMID/S SILICONE SCAR
ILICONES/TAPE
T1 ALOE/LAC
HYPER-HEAL
AC/CERAMIDES
3,3B,6,1
T1 AMMONIUM
AMMONIUM
LACTATE
LACTATE (12 %)
(CREAM (G)) (OTC)
T1 AMMONIUM
LAC-HYDRIN
LACTATE
T1 AMMONIUM
LAC-HYDRIN
LACTATE
TWELVE
T1 EMOL53/NAMGFS/H EMOL53/NAMGFS/H
A/NAHYPOCHLORIT A/NAHYPOCHLORIT
T1 EMOLLIENT
DERMAPLEX
#56/HYALURONIC
ACID
T1 EMOLLIENT
BIAFINE
COMBINATION
NO.10
VNSNY
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
EMOLLIENT
EMOLLIENT
COMBINATION
COMBINATION
NO.32
NO.32
EMOLLIENT
EMOLLIENT
COMBINATION
COMBINATION
NO.35
NO.35
EMOLLIENT
RESTORE SKIN
COMBINATION NO.36 CONDITIONING
EMOLLIENT
ATRAPRO
COMBINATION NO.60 HYDROGEL
EMOLLIENT
ATRAPRO CP
COMBOS NO.47,
NO.60
GLYCERIN/DIMETHIGLYCERIN/DIMETHI
CONE
CONE (LOTION)
(OTC)
LACTIC ACID
LACTIC ACID
LANOLIN
EUCERIN
ALCOHOL/MO/W.PE
T/CERES
LANOLIN/ALOE
SOOTHE & COOL
VERA/PROP GLY
PERINEAL WASH
(LIQ. SOAP) (OTC)
MINERAL
MINERAL
OIL/PETROLATUM, OIL/PETROLATUM,W
WHITE
HITE (CREAM (G))
(OTC)
MINERAL,LANOLIN BALNEOL
OILS/PROP GLYC
PANTOTHENIC
PANTOTHENIC
ACID/ALOE VERA ACID/ALOE VERA
PETROLATUM,WHITPETROLATUM,WHIT
E
E (OINT. (G)) (OTC)
SILICONES/ADHESIV SILICONE DISC
E TAPE
SILICONES/ADHESIV SILICONE ROLL
E TAPE
SILICONES/ADHESIV SILICONE SHEET
E TAPE
(COMBO. PKG) (OTC)
SILICONES/ADHESIV SILICONE SHEET
E TAPE
(COMBO. PKG) (OTC)
SILICONES/ADHESIV SILICONE TAPE
E TAPE
VITAMIN E
VITAMIN E (OIL)
(OTC)
VITAMIN E/ALOE
WOUND GEL
VERA
VITE
ATOPICLAIR
AC/GRAPE/HYALUR
ONIC ACID
IRRIGANTS
T1 ACETIC ACID
ACETIC ACID
T1 MANNITOL/SORBIT MANNITOL/SORBITO
OL SOLUTION
L SOLUTION
T1 NACL
NACL
IRRIGAT/DECYL
IRRIGAT/DECYL
GLUCOSIDE
GLUCOSIDE
T1 NEOMYCIN
NEOSPORIN G.U.
SULF/POLYMYXIN B IRRIGANT
SULF
T1 PHYSIOLOGICAL
PHYSIOLYTE
IRRIG SOLN NO.1
Page 31 of 116
T1
PHYSIOLOGICAL
PHYSIOSOL
IRRIG SOLN NO.1
RINGERS SOLUTIONRINGERS SOLUTION
SODIUM CHLORIDE SODIUM CHLORIDE
IRRIG SOLUTION
IRRIG SOLUTION (0.9
%) (IRRIG SOLN)
SORBITOL
SORBITOL
SOLUTION
SOLUTION
WATER FOR
WATER FOR
IRRIGATION,STERIL IRRIGATION,STERIL
E
E
T1
SALICYLIC ACID
T1
SALICYLIC ACID
T1
SALICYLIC ACID
T1
SALICYLIC ACID
T1
SALICYLIC
ACID/CERAMIDE
CMB #1
IRRITANTS/COUNTER-IRRITANTS
T1 MEMESALICYLATE/ISOPR SALICYLATE/ISOPRO
OP.ALCOHOL
P.ALCOHOL (LIQUID)
(OTC)
T1 METHYL
METHYL
SALICYLATE
SALICYLATE
(LIQUID) (OTC)
T1 METHYL
METHYL
SALICYLATE
SALICYLATE (OIL)
(OTC)
T1
T1
T1
T1
T1
T1
T1
SILVER NITRATE
SILVER NITRATE
APPLICATOR
UREA
UREA
UREA
UREA
UREA
T1
UREA
KERATOLYTICS
T5 BENZOYL PEROXIDE ACNE MEDICATION
T1 BENZOYL
BENZOYL PEROXIDE
PEROXIDE
(10 %) (CLEANSER)
(OTC)
T5 BENZOYL
BENZOYL PEROXIDE
PEROXIDE
(10 %) (CREAM (G))
(OTC)
T5 BENZOYL
BENZOYL PEROXIDE
PEROXIDE
(10 %) (GEL (GRAM))
(OTC)
T5 BENZOYL
BENZOYL PEROXIDE
PEROXIDE
(10 %) (LOTION)
(OTC)
T1 BENZOYL
BENZOYL PEROXIDE
PEROXIDE
(2.5 %) (GEL (GRAM))
(OTC)
T1 BENZOYL
BENZOYL PEROXIDE
PEROXIDE
(4 %-5 %) (KIT) (OTC)
T1 BENZOYL
BENZOYL PEROXIDE
PEROXIDE
(5 %) (CLEANSER)
(OTC)
T2 PODOFILOX
CONDYLOX (0.5 %)
(GEL (GRAM))
T1 PODOFILOX
CONDYLOX (0.5 %)
(SOLUTION)
T1 PODOPHYLLUM
PODOPHYLLUM
RESIN
RESIN
T1 POTASSIUM
POTASSIUM
HYDROXIDE
HYDROXIDE
T1 SALICYLIC ACID
SALICYLIC ACID (26
%) (LIQUID)
T1 SALICYLIC ACID
SALICYLIC ACID
(27.5 %) (LIQ-FILM)
T1 SALICYLIC ACID
SALICYLIC ACID (6
%) (CREAM (G))
T1 SALICYLIC ACID
SALICYLIC ACID (6
%) (CRM ER (G))
T1
T1
T1
T1
T1
UREA
UREA
UREA
UREA
UREA/LACTIC
AC/ZN
UNDECYLENATE
UREA/LACTIC
KEROL
ACID/SALICYLIC AC
T1
T1
T1
T1
VNSNY
T1
OXIDIZING AGENTS
T1 HYDROGEN
PEROXIDE
T1
HYDROGEN
PEROXIDE
PROTECTIVES
T1 BENZETHONIUM
CHLORIDE
T1 BENZOIN
T1
T1
T1
T1
T1
T1
T1
T1
SALICYLIC ACID (6
%) (GEL (GRAM))
SALICYLIC ACID (6
%) (LOTION ER)
SALICYLIC ACID (6
%) (LOTION)
SALICYLIC ACID (6
%) (SHAMPOO)
SALICYLIC
ACID/CERAMIDE
CMB #1 (6 %)
(COMBO. PKG)
SILVER NITRATE
SILVER NITRATE
APPLICATOR
HYDRO 40
KERALAC
REA LO 39
REA LO 40
URAMAXIN (45 %)
(CREAM (G))
URAMAXIN (45 %)
(GEL (ML))
URAMAXIN GT
UREA
URE-K
X-VIATE
UREA/LACTIC AC/ZN
UNDECYLENATE
HYDROGEN
PEROXIDE (1.5 %)
(SOLUTION) (OTC)
HYDROGEN
PEROXIDE (3 %)
(SOLUTION) (OTC)
NEW SKIN (0.2 %)
(LIQ-FILM) (OTC)
BENZOIN
(TINCTURE) (OTC)
GENADUR
CARBIT/EQUIS
XT/ETHAN/CHIT/MS
M
DIMETHICONE
DIMETHICONE (2 %)
(LOTION) (OTC)
HYALURONATE
BIONECT (0.2 %)
SODIUM
(CREAM (G))
HYALURONATE
BIONECT (0.2 %)
SODIUM
(GEL (GRAM))
HYALURONATE/ALL RADIAPLEXRX
ANTOIN/ALOE EXT
PETROLATUM,WHITPETROLATUM,WHIT
E
E (OINT PACK)
PETROLATUM,WHITPETROLATUM,WHIT
E
E (OINT PACK) (OTC)
PETROLATUM,WHITPETROLATUM,WHIT
E
E (OINT. (G)) (OTC)
Page 32 of 116
T1
T1
PROTECT
CMB2/CERAMIDE
1,3,6-11
ZINC
ACETATE/MEADOW
SWEET/OAK
PROTECT
CMB2/CERAMIDE
1,3,6-11
ZINC
ACETATE/MEADOWS
WEET/OAK
TOPICAL ANTI-INFLAMMATORY STEROID-LOCAL
ANESTHETIC
T2 HYDROCORTISONE/P ANALPRAM HC
RAMOXINE
T2 HYDROCORTISONE/P PRAMOSONE (1 %-1
RAMOXINE
%) (LOTION)
T2 HYDROCORTISONE/P PRAMOSONE (1 %-1
RAMOXINE
%) (OINT. (G))
T1 HYDROCORTISONE/ PRAMOSONE (2.5 %PRAMOXINE
1 %) (CREAM (G))
T2 HYDROCORTISONE/P PRAMOSONE (2.5 %RAMOXINE
1 %) (LOTION)
T2 HYDROCORTISONE/P PRAMOSONE (2.5 %RAMOXINE
1 %) (OINT. (G))
T1 LIDOCAINE/HYDRO LIDAMANTLE HC
CORTISONE AC
TOPICAL ANTINEOPLASTIC & PREMALIGNANT
LESION AGNTS
T2 ALITRETINOIN
PANRETIN
T2 BEXAROTENE
TARGRETIN
PA
T1 DICLOFENAC
SOLARAZE
PA, QL
SODIUM
T1 FLUOROURACIL
CARAC
T1 FLUOROURACIL
EFUDEX
T2 INGENOL MEBUTATE PICATO (0.015 %)
QL
(GEL (EA))
T2 INGENOL MEBUTATE PICATO (0.05 %) (GEL QL
(EA))
T2 MECHLORETHAMINE VALCHLOR
PA
HCL
TOPICAL LOCAL ANESTHETICS
T1 COCAINE HCL
COCAINE HCL
T1 ETHYL CHLORIDE ETHYL CHLORIDE
T1 LIDOCAINE
LIDODERM
T1 LIDOCAINE
XYLOCAINE
T1 LIDOCAINE HCL
CIDALEAZE
T1 LIDOCAINE HCL
LIDO-K
T1 LIDOCAINE HCL
LIDOPIN (3 %)
(CREAM (G))
T1 LIDOCAINE HCL
PRE-ATTACHED LTA
KIT
T1 LIDOCAINE
REGENECARE
HCL/COLLAGEN
T1 LIDOCAINE/PRILOC EMLA
AINE
T1 VIT
REGENECARE
E/LIDOCAINE/ALOE/
COLLAGEN
TOPICAL PREPARATIONS,MISCELLANEOUS
T1 BENZETHONIUM
BENZETHONIUM
CHLORIDE
CHLORIDE (0.1 %)
(CLEANSER) (OTC)
VNSNY
T1
T1
T1
T1
T1
T1
T1
T1
CALCIUM CARB/SOD NAIL SCRUB
HYPOCHLORITE
HONEY
MEDIHONEY (100 %)
(PASTE (ML)) (OTC)
POVIDONE-IODINE BETADINE (7.5 %)
(CLEANSER) (OTC)
POVIDONE-IODINE POVIDONE-IODINE
(10 %) (LIQUID PKT)
(OTC)
POVIDONE-IODINE POVIDONE-IODINE
(10 %) (SOLUTION)
(OTC)
POVIDONE-IODINE POVIDONE-IODINE
(10 %) (SPRAY) (OTC)
POVIDONE-IODINE POVIDONE-IODINE
(7.5 %) (SOLUTION)
(OTC)
SKIN CLEANSER
PROSHIELD FOAM &
COMB NO.34
SPRAY
DERMATOLOGY - PIGMENTATION
DISORDERS
HYPOPIGMENTATION AGENTS
T1 HYDROQUINONE
HYDROQUINONE
T1 HYDROQUINONE
HYDROQUINONE
MICROSPHERES
MICROSPHERES
T1 HYDROQUINONE/O HYDROQUINONE/OX
XYBEN/OCTINOXAT YBEN/OCTINOXATE
E
T1 HYDROQUINONE/SU HYDROQUINONE/SU
NSCREEN(FER OX) NSCREEN(FER OX)
DERMATOLOGY PSORIASIS/ECZEMA
ANTIPSORIATIC AGENTS,SYSTEMIC
T1 ACITRETIN
SORIATANE
T1 METHOXSALEN
METHOXSALEN (10
MG) (CAP LQ RAP)
T2 SECUKINUMAB
COSENTYX (2
SYRINGES)
T2 SECUKINUMAB
COSENTYX PEN
T2 SECUKINUMAB
COSENTYX PEN (2
PENS)
T2 SECUKINUMAB
COSENTYX
SYRINGE
ANTIPSORIATICS AGENTS
T2 ANTHRALIN
DRITHOCREME HP
T1 CALCIPOTRIENE
DOVONEX
T1 CALCITRIOL
VECTICAL
T2 TAZAROTENE
TAZORAC
PA
PA
PA
PA
ST
ST
ST
TOPICAL AGENTS,MISCELLANEOUS
T1 COLLAGEN,BOVINE COLLAGEN,BOVINE
T1 SKIN CLEANSER
PERIANAL
CLEANSING
T1 SKIN CLEANSER
PERIFRESH
T1 SKIN CLEANSER
RESTORE SKIN
COMB NO.20
CLEANSER
Page 33 of 116
T1
SKIN CLEANSER
COMB NO.21
RESTORE WOUND
CLEANSER
TOPICAL IMMUNOSUPPRESSIVE AGENTS
T1 TACROLIMUS
TACROLIMUS
ST,
AGE
TOPICAL VIT D ANALOG/ANTIINFLAMMATORY,
STEROIDAL
T1 CALCIPOTRIENE/BE TACLONEX (0.005- ST
TAMETHASONE
.064) (OINT. (G))
DIABETES
ANTIHYPERGLY, (DPP-4) INHIBITOR & BIGUANIDE
COMB.
T2 LINAGLIPTIN/METFO JENTADUETO
QL
RMIN HCL
T2 LINAGLIPTIN/METFO JENTADUETO XR
QL
RMIN HCL
(2.5-1000MG) (TAB BP
24H)
T2 LINAGLIPTIN/METFO JENTADUETO XR
QL
RMIN HCL
(5MG-1000MG) (TAB
BP 24H)
T2 SITAGLIPTIN
JANUMET
QL
PHOS/METFORMIN
HCL
T2 SITAGLIPTIN
JANUMET XR (100- QL
PHOS/METFORMIN 1000MG) (TBMP
HCL
24HR)
T2 SITAGLIPTIN
JANUMET XR (50QL
PHOS/METFORMIN 1000 MG) (TBMP
HCL
24HR)
T2 SITAGLIPTIN
JANUMET XR (50MG- QL
PHOS/METFORMIN 500MG) (TBMP 24HR)
HCL
ANTIHYPERGLY,INCRETIN MIMETIC(GLP-1
RECEP.AGONIST)
T2 DULAGLUTIDE
TRULICITY
T2 LIRAGLUTIDE
VICTOZA 2-PAK
T2 LIRAGLUTIDE
VICTOZA 3-PAK
ANTIHYPERGLYCEMC-SOD/GLUC
COTRANSPORT2(SGLT2)INHIB
T2 CANAGLIFLOZIN
INVOKANA
T2 EMPAGLIFLOZIN
JARDIANCE
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ANTIHYPERGLYCEMIC, ALPHA-GLUCOSIDASE
INHIB (N-S)
T1 ACARBOSE
PRECOSE
ANTIHYPERGLYCEMIC, AMYLIN ANALOG-TYPE
T2 PRAMLINTIDE
SYMLINPEN 120
ACETATE
T2 PRAMLINTIDE
SYMLINPEN 60
ACETATE
ANTIHYPERGLYCEMIC, DPP-4 INHIBITORS
T2 LINAGLIPTIN
TRADJENTA
T2 SITAGLIPTIN
JANUVIA
PHOSPHATE
VNSNY
QL
QL
ANTIHYPERGLYCEMIC, INSULIN-RELEASE
STIMULANT TYPE
T1 CHLORPROPAMIDE DIABINESE
T1 GLIMEPIRIDE
AMARYL
T1 GLIPIZIDE
GLUCOTROL
T1 GLIPIZIDE
GLUCOTROL XL
T1 GLYBURIDE
GLYBURIDE
T1 GLYBURIDE,MICRO GLYNASE
NIZED
T1 NATEGLINIDE
STARLIX
T1 REPAGLINIDE
REPAGLINIDE
T1 TOLAZAMIDE
TOLINASE (250 MG)
(TABLET)
T1 TOLBUTAMIDE
ORINASE
ANTIHYPERGLYCEMIC, INSULIN-RESPONSE
ENHANCER (N-S)
T1 PIOGLITAZONE
ACTOS
HCL
ANTIHYPERGLYCEMIC, SGLT-2 & DPP-4 INHIBITOR
COMB.
T2 EMPAGLIFLOZIN/LIN GLYXAMBI
ST, QL
AGLIPTIN
ANTIHYPERGLYCEMIC,BIGUANIDE TYPE(NONSULFONYLUREA)
T1 METFORMIN HCL GLUCOPHAGE
T1 METFORMIN HCL GLUCOPHAGE XR
T2 METFORMIN HCL
RIOMET
ANTIHYPERGLYCEMIC,INSULIN-REL STIM.&
BIGUANIDE CMB
T1 GLIPIZIDE/METFOR METAGLIP
MIN HCL
T1 GLYBURIDE/METFO GLUCOVANCE
RMIN HCL
T1 REPAGLINIDE/METF PRANDIMET
ORMIN HCL
ANTIHYPERGLYCEMIC-GLUCOCORTICOID
RECEPTOR BLOCKER
T2 MIFEPRISTONE
KORLYM
PA
ANTIHYPERGLYCEMIC-SGLT2 INHIBITOR &
BIGUANIDE COMB
T2 CANAGLIFLOZIN/ME INVOKAMET
ST, QL
TFORMIN HCL
T2 CANAGLIFLOZIN/ME INVOKAMET XR
ST, QL
TFORMIN HCL
T2 EMPAGLIFLOZIN/ME SYNJARDY
ST, QL
TFORMIN HCL
ANTIHYPERGLYCM,INSUL-RESP.ENHANCER &
BIGUANIDE CMB
T1 PIOGLITAZONE
ACTOPLUS MET
ST
HCL/METFORMIN
HCL
T2 PIOGLITAZONE
ACTOPLUS MET XR ST
HCL/METFORMIN
HCL
Page 34 of 116
BLOOD SUGAR DIAGNOSTICS
T2 BLOOD SUGAR
FREESTYLE
DIAGNOSTIC
INSULINX (STRIP)
(OTC)
T2 BLOOD SUGAR
FREESTYLE
DIAGNOSTIC
INSULINX TEST
STRIPS
T2 BLOOD SUGAR
FREESTYLE LITE
DIAGNOSTIC
STRIPS (STRIP) (OTC)
T2 BLOOD SUGAR
FREESTYLE TEST
DIAGNOSTIC
STRIPS (STRIP) (OTC)
T2 BLOOD SUGAR
PRECISION XTRA
DIAGNOSTIC
(STRIP) (OTC)
T1
DIABETIC SUPPLIES
T1 BLOOD GLUCOSE
AGAMATRIX
CNTL HIGH,NORMAL CONTROL
T1 BLOOD GLUCOSE
ASSURE DOSE
CNTL HIGH,NORMAL
T2 BLOOD GLUCOSE
ASSURE PRISM
CNTL HIGH,NORMAL
T1 BLOOD GLUCOSE
BLOOD GLUCOSE
CNTL HIGH,NORMAL CONTROL
T2 BLOOD GLUCOSE
CARESENS
CNTL HIGH,NORMAL
T2 BLOOD GLUCOSE
EMBRACE PRO
CNTL HIGH,NORMAL
T1 BLOOD GLUCOSE
GLUCOCARD 01
CNTL HIGH,NORMAL CONTROL
T1 BLOOD GLUCOSE
ON CALL PLUS
CNTL HIGH,NORMAL CONTROL
T1 BLOOD GLUCOSE
ON CALL VIVID
CNTL HIGH,NORMAL CONTROL
T2 BLOOD GLUCOSE
OPTUMRX
CNTL HIGH,NORMAL
T1 BLOOD GLUCOSE
ACCU-CHEK
CONTROL HIGH,LOW
T2 BLOOD GLUCOSE
ACCU-CHEK
CONTROL HIGH,LOW COMPACT PLUS
CONTROL
T2 BLOOD GLUCOSE
ACCU-CHEK GUIDE
CONTROL HIGH,LOW CONTROL SOLN
T1 BLOOD GLUCOSE
ACCUTREND
CONTROL HIGH,LOW GLUCOSE
T1 BLOOD GLUCOSE
EVENCARE
CONTROL HIGH,LOW
T2 BLOOD GLUCOSE
HEALTHPRO
CONTROL HIGH,LOW GLUCOSE CONTROL
SOLN
T1 BLOOD GLUCOSE
MICRODOT
CONTROL HIGH,LOW
T1 BLOOD GLUCOSE
TELCARE CONTROL
CONTROL HIGH,LOW SOLUTION
T1 BLOOD GLUCOSE
ULTRATRAK
CONTROL HIGH,LOW ULTIMATE
T1 BLOOD GLUCOSE
MYGLUCOHEALTH
CTL HIGH,NML,LOW CONTROL
SOLUTION
T2 BLOOD GLUCOSE
ON CALL EXPRESS
CTL HIGH,NML,LOW CONTROL SOLN
T1 BLOOD
NOVAMAX PLUS
GLUCOSE,KETONE GLU-KET
CNTRL NML
T1
VNSNY
T5
T1
T2
T1
T2
T1
T1
T1
T1
T1
T1
T1
T2
T2
T2
T2
T1
T2
T2
T2
T2
T1
T2
T1
T1
T1
BLOOD-GLUC
PARADIGM REALTRANSMITTER/SENS TIME
OR
BLOODADVOCATE REDIGLUC.METER, WRIST CODE DUO
BP MON
BLOOD-GLUCOSE
ASSURE 4
CALIB. CONTROL
BLOOD-GLUCOSE
MEDISENSE
CALIB. CONTROL
CONTROL
BLOOD-GLUCOSE
MEDISENSE
CALIB. CONTROL
GLUCOSE KETONE
BLOOD-GLUCOSE
PRECISION
CALIB. CONTROL
BLOOD-GLUCOSE
PRECISION
CALIB. CONTROL
GLUCOSE CONTROL
BLOOD-GLUCOSE
ADVOCATE
CONTROL, HIGH
CONTROL
SOLUTION
BLOOD-GLUCOSE
ADVOCATE REDICONTROL, HIGH
CODE+ CTRL SOLN
BLOOD-GLUCOSE
AGAMATRIX
CONTROL, HIGH
CONTROL
BLOOD-GLUCOSE
BREEZE 2
CONTROL, HIGH
BLOOD-GLUCOSE
CLEVER CHOICE
CONTROL, HIGH
CONTROL
SOLUTION
BLOOD-GLUCOSE
CONTOUR
CONTROL, HIGH
BLOOD-GLUCOSE
CONTROL
CONTROL, HIGH
SOLUTION
BLOOD-GLUCOSE
COOL CONTROL
CONTROL, HIGH
SOLUTION
BLOOD-GLUCOSE
DIATRUE
CONTROL, HIGH
BLOOD-GLUCOSE
EASY STEP
CONTROL, HIGH
BLOOD-GLUCOSE
ELEMENT COMPACT
CONTROL, HIGH
CONTROL SOLN
BLOOD-GLUCOSE
ELEMENT CONTROL
CONTROL, HIGH
SOLUTION
BLOOD-GLUCOSE
EMBRACE
CONTROL, HIGH
BLOOD-GLUCOSE
EZ SMART
CONTROL, HIGH
BLOOD-GLUCOSE
FORACARE GDH
CONTROL, HIGH
BLOOD-GLUCOSE
FORTISCARE
CONTROL, HIGH
BLOOD-GLUCOSE
GLUCOCOM
CONTROL, HIGH
CONTROL
SOLUTION
BLOOD-GLUCOSE
GMATE CONTROL
CONTROL, HIGH
SOLUTION
BLOOD-GLUCOSE
INFINITY CONTROL
CONTROL, HIGH
SOLUTION
BLOOD-GLUCOSE
ONETOUCH VERIO
CONTROL, HIGH
BLOOD-GLUCOSE
REFUAH PLUS
CONTROL, HIGH
GLUCOSE CONTROL
Page 35 of 116
T1
T1
T2
T2
T1
T1
T2
T2
T1
T1
T1
T1
T1
T1
T1
T2
T2
T1
T1
T1
T2
T1
T2
T2
T2
T1
T1
T1
T1
BLOOD-GLUCOSE
CONTROL, HIGH
BLOOD-GLUCOSE
CONTROL, HIGH
BLOOD-GLUCOSE
CONTROL, HIGH
BLOOD-GLUCOSE
CONTROL, HIGH
BLOOD-GLUCOSE
CONTROL, HIGH
BLOOD-GLUCOSE
CONTROL, HIGH
BLOOD-GLUCOSE
CONTROL, HIGH
BLOOD-GLUCOSE
CONTROL, HIGH
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
VNSNY
RIGHTEST CONTROL
SOLUTION
SOLUS V2 CONTROL
SOLUTION
TD GOLD LEVEL 3
CONTROL SOL
TRUE METRIX
T2
TRUECONTROL
T2
TRUETEST GLUCOSE
CONTROL
UNISTRIP
T2
VOCAL POINT
GLUCOSE CONTROL
ADVOCATE
CONTROL
SOLUTION
ADVOCATE REDICODE+ CTRL SOLN
BREEZE 2
T1
T2
T1
T1
T1
T1
T1
T1
T2
CLEVER CHOICE
CONTROL
SOLUTION
CONTOUR
T1
T1
CONTOUR NEXT
CONTROL
SOLUTION
CONTROL
SOLUTION
DIATRUE
T1
T1
T2
EASY STEP
T2
EASYMAX
T2
EASYMAX 15
T2
ELEMENT CONTROL
SOLUTION
EMBRACE EVO
T2
T1
EMBRACE GLUCOSE
CONTROL SOLN
EZ SMART
T1
T2
FORACARE GDH
T1
FORTISCARE
T2
INFINITY CONTROL
SOLUTION
LIBERTY LEV 1
GLUCOSE CONTROL
PRODIGY CONTROL
SOLUTION
SOLUS V2 CONTROL
SOLUTION
T2
T1
T2
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, LOW
BLOOD-GLUCOSE
CONTROL, NORMAL
BLOOD-GLUCOSE
CONTROL, NORMAL
BLOOD-GLUCOSE
CONTROL, NORMAL
BLOOD-GLUCOSE
CONTROL, NORMAL
BLOOD-GLUCOSE
CONTROL, NORMAL
BLOOD-GLUCOSE
CONTROL, NORMAL
BLOOD-GLUCOSE
CONTROL, NORMAL
TD GOLD LEVEL 1
CONTROL SOL
TRUE METRIX
TRUECONTROL
TRUETEST GLUCOSE
CONTROL
UNISTRIP
VOCALPOINT
GLUCOSE CONTROL
ACCU-CHEK
SMARTVIEW
ASSURE DOSE
BLOOD-GLUCOSE
CONTROL
BREEZE 2
CARESENS
CHOICEDM CLARUS
CONTROL SOLN
CLEVER CHOICE
CONTROL
SOLUTION
CONTOUR
BLOOD-GLUCOSE
CONTROL, NORMAL
BLOOD-GLUCOSE
CONTOUR NEXT
CONTROL, NORMAL CONTROL
SOLUTION
BLOOD-GLUCOSE
CONTROL
CONTROL, NORMAL SOLUTION
BLOOD-GLUCOSE
COOL CONTROL
CONTROL, NORMAL SOLUTION
BLOOD-GLUCOSE
DIATRUE
CONTROL, NORMAL
BLOOD-GLUCOSE
EASY STEP
CONTROL, NORMAL
BLOOD-GLUCOSE
EASY TRAK
CONTROL, NORMAL
BLOOD-GLUCOSE
EASYGLUCO PLUS
CONTROL, NORMAL CONTROL NORMAL
BLOOD-GLUCOSE
EASYMAX
CONTROL, NORMAL
BLOOD-GLUCOSE
EASYMAX 15
CONTROL, NORMAL
BLOOD-GLUCOSE
ELEMENT COMPACT
CONTROL, NORMAL CONTROL SOLN
BLOOD-GLUCOSE
ELEMENT CONTROL
CONTROL, NORMAL SOLUTION
BLOOD-GLUCOSE
EMBRACE EVO
CONTROL, NORMAL
BLOOD-GLUCOSE
EVENCARE MINI
CONTROL, NORMAL GLUCOSE CONTROL
BLOOD-GLUCOSE
EVOLUTION
CONTROL, NORMAL CONTROL
SOLUTION
BLOOD-GLUCOSE
EZ SMART
CONTROL, NORMAL
Page 36 of 116
T2
T2
T1
T1
T2
T1
T1
T1
T2
T1
T1
T1
T2
T1
T1
T1
T1
T2
T1
T1
T2
T2
T1
T1
T5
T2
T2
BLOOD-GLUCOSE
CONTROL, NORMAL
BLOOD-GLUCOSE
CONTROL, NORMAL
BLOOD-GLUCOSE
CONTROL, NORMAL
FORACARE GDH
T2
FORTISCARE
T2
FREESTYLE
CONTROL
SOLUTION
BLOOD-GLUCOSE
GLUCOCARD 01
CONTROL, NORMAL CONTROL
BLOOD-GLUCOSE
GLUCOCARD SHINE
CONTROL, NORMAL
BLOOD-GLUCOSE
GLUCOCOM
CONTROL, NORMAL CONTROL
SOLUTION
BLOOD-GLUCOSE
GLUCOSE CONTROL
CONTROL, NORMAL
BLOOD-GLUCOSE
GLUCOSE CONTROL
CONTROL, NORMAL SOLUTION
BLOOD-GLUCOSE
GMATE CONTROL
CONTROL, NORMAL SOLUTION
BLOOD-GLUCOSE
INFINITY CONTROL
CONTROL, NORMAL SOLUTION
BLOOD-GLUCOSE
LIBERTY LEV 2
CONTROL, NORMAL GLUCOSE CONTROL
BLOOD-GLUCOSE
MEDISENSE
CONTROL, NORMAL GLUCOSE KETONE
CONTR
BLOOD-GLUCOSE
METER-CHECK
CONTROL, NORMAL
BLOOD-GLUCOSE
NOVA MAX
CONTROL, NORMAL GLUCOSE CONTROL
SOLN
BLOOD-GLUCOSE
ONETOUCH ULTRA
CONTROL, NORMAL CONTROL SOLN
BLOOD-GLUCOSE
ONETOUCH VERIO
CONTROL, NORMAL
BLOOD-GLUCOSE
RIGHTEST CONTROL
CONTROL, NORMAL SOLUTION
BLOOD-GLUCOSE
RIGHTEST GC250S
CONTROL, NORMAL CONTROL SOLN
BLOOD-GLUCOSE
SMARTEST
CONTROL, NORMAL
BLOOD-GLUCOSE
SURE-TEST
CONTROL, NORMAL EASYPLUS MINI
BLOOD-GLUCOSE
TD GOLD LEVEL 2
CONTROL, NORMAL CONTROL SOL
BLOOD-GLUCOSE
TRUE METRIX
CONTROL, NORMAL
BLOOD-GLUCOSE
TRUETEST GLUCOSE
CONTROL, NORMAL CONTROL
BLOOD-GLUCOSE
WAVESENSE
CONTROL, NORMAL CONTROL
SOLUTION
BLOOD-GLUCOSE
EVENCARE MINI
METER
MONITOR SYSTEM
(EACH) (OTC)
BLOOD-GLUCOSE
FREESTYLE
METER
FREEDOM LITE (KIT)
(OTC)
BLOOD-GLUCOSE
FREESTYLE
METER
INSULINX (EACH)
(OTC)
VNSNY
T1
T5
T5
T5
T1
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T1
T1
T1
BLOOD-GLUCOSE
METER
BLOOD-GLUCOSE
METER
BLOOD-GLUCOSE
TRANSMITTER
BOLUS INSULIN
PUMP, 200 UNIT
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
DIABETIC
SUPPLIES,MISCELL
INFUSION SET FOR
INSULIN PUMP
INFUSION SET FOR
INSULIN PUMP
T5
INFUSION SET FOR
INSULIN PUMP
INFUSION SET FOR
INSULIN PUMP
INFUSION SET FOR
INSULIN PUMP
INFUSION SET FOR
INSULIN PUMP
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
T5
LANCING DEVICE
LANCING DEVICE
T5
LANCING DEVICE
T1
T1
T1
FREESTYLE LITE
METER (KIT) (OTC)
PRECISION XTRA
(EACH) (OTC)
MINILINK REALTIME TRANSMITTER
ONETOUCH VIA
ALKALINE
BATTERIES
CHEMSTRIP BG
DIARY
DIABETIC
SUPPLIES,MISCELL
EZ-VAC
GUARDIAN
TRANSMITTER TAPE
INSUL-CAP
INSUL-EZE
MAGNI-GUIDE
MAGNIFIER
MEDTRONIC
REMOTE CONTROL
MINIMED
PARADIGM REMOTE
CONTROL
SIL-SERTER
SOF-SERTER
COMFORT
(INFUS.SET)
CONTACT DETACH
INFUSION SET
(INFUS.SET)
MINIMED
MIO INFUSION SET
QUICK-SET
PARADIGM
SURE-T PARADIGM
(INFUS.SET)
ADJUSTABLE
LANCING DEVICE
ADVOCATE
LANCING DEVICE
ADVOCATE RAPIDSAFE
ALTERNATE SITE
LANCING DEVICE
AQUA LANCE
LANCING DEVICE
AUTO-LANCET MINI
AUTOLET LANCING
DEVICE
AUTOLET PLUS
Page 37 of 116
T5
LANCING DEVICE
T5
T5
LANCING DEVICE
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
T5
LANCING DEVICE
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
T5
T5
T5
LANCING DEVICE
LANCING DEVICE
LANCING DEVICE
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
LANCING DEVICE
T5
T5
LANCING DEVICE
LANCING DEVICE
T5
LANCING DEVICE
T5
T5
T5
T5
T5
LANCING DEVICE
LANCING DEVICE
LANCING DEVICE
LANCING DEVICE
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
T5
T5
T5
T5
T5
T5
T5
T5
VNSNY
CARELANCE ULT
LANCING DEVICE
CAREONE
CARESENS PREM
LANCING DEVICE
CARETOUCH
LANCING DEVICE
DROPLET LANCING
DEVICE
EASY CLICK
EASY MINI EJECT
LANCING DEVICE
EASY TOUCH
LANCING DEVICE
FORA LANCING
DEVICE
GMATE LANCING
DEVICE
HEALTHY ACCENTS
AUTOLET
INCONTROL
LANCING DEVICE
LANCING DEVICE
LANCING SYSTEM
LITE TOUCH
MINI LANCING
DEVICE
ON CALL LANCING
DEVICE
ON CALL PLUS
LANCING DEVICE
PRODIGY LANCING
DEVICE
RELIAMED MINI
LANCING DEVICE
RIGHTEST GD500
SMARTDIABETES
VANTAGE
SURE COMFORT
LANCING PEN
SUREFLEX
SURE-PEN
TRUEDRAW
ULTI-LANCE
ACCU-CHEK
ACCU-CHEK
FASTCLIX
ACCU-CHEK
SOFTCLIX
ADVANCED
LANCING DEVICE
AUTOLET
IMPRESSION
HYPOLANCE
T5
T5
T5
T5
T5
T5
T5
T5
T2
T5
T5
T5
T5
T5
T1
T1
T1
T1
T1
T1
LANZO
MICROLET 2
SUB-Q INSULIN
DEVICE, 20 UNIT
SUB-Q INSULIN
DEVICE, 30 UNIT
SUB-Q INSULIN
DEVICE, 40 UNIT
MULTI-LANCET
ONETOUCH DELICA
ONETOUCH
SURESOFT
SOLUS V2 LANCING
DEVICE
SUREFLEX
ULTI-LANCE
UNISTIK 2
UNISTIK 2 EXTRA
UNISTIK 2 NORMAL
(KIT)
UNISTIK 2 NORMAL
(KIT) (OTC)
UNISTIK 3
UNISTIK 3 COMFORT
UNISTIK 3
NEONATAL
SAFE-CLIP
OMNIPOD
ONETOUCH PING
REVEL
PROGRAMMABLE
PUMP
VGO 20
VGO 30
VGO 40
DIABETIC ULCER PREPARATIONS,TOPICAL
T2 BECAPLERMIN
REGRANEX
HYPERGLYCEMICS
T5 DEXTROSE
T5
T5
T5
T2
LANCING DEVICE
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
LANCING
DEVICE/LANCETS
NEEDLE CLIP AND
STORAGE DEVICE
SUBCUTANEOUS
INSULIN PUMP
SUBCUTANEOUS
INSULIN PUMP
SUBCUTANEOUS
INSULIN PUMP
DEXTROSE (4 G)
(TAB CHEW) (OTC)
DEXTROSE
DEXTROSE (40 %)
(GEL (GRAM)) (OTC)
DEXTROSE
DEXTROSE (TAB
CHEW) (OTC)
DEXTROSE/DEXTRI DEXTROSE/DEXTRIN
N/MALTOSE
/MALTOSE (24 G/31
G) (GEL (GRAM))
(OTC)
GLUCAGON,HUMAN GLUCAGON
RECOMBINANT
EMERGENCY KIT
INSULINS
T2 INSULIN
BASAGLAR
GLARGINE,HUM.REC.KWIKPEN U-100
ANLOG
QL
Page 38 of 116
T2
T2
T2
T2
T2
T2
T2
T2
T2
T5
T5
T5
T5
T5
T5
T2
INSULIN
TOUJEO SOLOSTAR
GLARGINE,HUM.REC.
ANLOG
INSULIN LISPRO
HUMALOG (100/ML)
(CARTRIDGE)
INSULIN LISPRO
HUMALOG (100/ML)
(VIAL)
INSULIN LISPRO
HUMALOG
KWIKPEN U-100
INSULIN LISPRO
HUMALOG
KWIKPEN U-200
INSULIN LISPRO
HUMALOG MIX 50PROTAMIN/LISPRO 50
INSULIN LISPRO
HUMALOG MIX 50PROTAMIN/LISPRO 50 KWIKPEN
INSULIN LISPRO
HUMALOG MIX 75PROTAMIN/LISPRO 25
INSULIN LISPRO
HUMALOG MIX 75PROTAMIN/LISPRO 25 KWIKPEN
INSULIN NPH
HUMULIN 70/30
HUM/REG INSULIN KWIKPEN
HM
INSULIN NPH
HUMULIN 70-30
HUM/REG INSULIN
HM
INSULIN NPH
HUMULIN N
HUMAN ISOPHANE
INSULIN NPH
HUMULIN N
HUMAN ISOPHANE KWIKPEN
INSULIN REGULAR, HUMULIN R
HUMAN
INSULIN REGULAR, HUMULIN R U-500
HUMAN
INSULIN REGULAR, HUMULIN R U-500
HUMAN
KWIKPEN
QL
T1
QL
OTIC PREPARATIONS,ANTI-INFLAMMATORYANTIBIOTICS
T2 CIPROFLOXACIN
CIPRODEX
HCL/DEXAMETH
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
URINE GLUCOSE TEST AIDS
T1 URINE GLUCOSE
DIASTIX REAGENT
TEST STRIP
(STRIP) (OTC)
URINE GLUCOSE/ACETONE TEST AIDS,STRIPS
T1 URINE GLUCOSECHEMSTRIP UGK
ACET TEST STRIP
T1 URINE GLUCOSEKETO-DIASTIX
ACET TEST STRIP
REAGENT
EAR - GENERAL DISORDERS
EAR PREPARATIONS ANTI-INFLAMMATORY
T1 FLUOCINOLONE
DERMOTIC
ACETONIDE OIL
EAR PREPARATIONS, MISC. ANTI-INFECTIVES
T1 ACETIC ACID
VOSOL
T1 ACETIC
VOSOL HC
ACID/HYDROCORTI
SONE
EAR PREPARATIONS,ANTIBIOTICS
T1 CIPROFLOXACIN
CETRAXAL
HCL
T1 NEOMYCIN/POLYM NEOMYCIN/POLYMY
YXIN
XIN B/HYDROCORT
B/HYDROCORT
VNSNY
OFLOXACIN
FLOXIN
ELECTROLYTE REGULATION
ELECTROLYTE DEPLETERS
T1 CALCIUM ACETATE CALCIUM ACETATE
(667 MG) (CAPSULE)
T1 CALCIUM ACETATE ELIPHOS
T1 CALCIUM ACETATE PHOSLO
T1 CALCIUM
CALCIUM
CARB/MAG
CARB/MAG
CARB/FOLIC AC
CARB/FOLIC AC
T2 SEVELAMER
RENVELA
CARBONATE
T2 SEVELAMER HCL
RENAGEL
T1 SODIUM
SODIUM
POLYSTYRENE
POLYSTYRENE
SULFON/SORB
SULFON/SORB
T1 SODIUM
SODIUM
POLYSTYRENE
POLYSTYRENE
SULFONATE
SULFONATE
POTASSIUM REPLACEMENT
T1 POT CHLORIDE/POT POT CHLORIDE/POT
BICARB/CIT AC
BICARB/CIT AC
T1 POTASSIUM
KLOR-CON-EF
BICARBONATE/CIT
AC
T1 POTASSIUM
KLOR-CON (20 MEQ)
CHLORIDE
(PACKET)
T1 POTASSIUM
KLOR-CON 10
CHLORIDE
T1 POTASSIUM
KLOR-CON 8
CHLORIDE
T1 POTASSIUM
K-TAB ER
CHLORIDE
T1 POTASSIUM
MICRO-K
CHLORIDE
T1 POTASSIUM
POTASSIUM
CHLORIDE
CHLORIDE
SODIUM/SALINE PREPARATIONS
T1 0.9 % SODIUM
0.9 % SODIUM
CHLORIDE
CHLORIDE (0.9 %)
(IV SOLN)
T1 0.9 % SODIUM
0.9 % SODIUM
CHLORIDE
CHLORIDE (0.9 %)
(SYRINGE)
T1 0.9 % SODIUM
0.9 % SODIUM
CHLORIDE
CHLORIDE (0.9 %)
(VIAL)
T1 0.9 % SODIUM
0.9 % SODIUM
CHLORIDE
CHLORIDE (PGGYBK
PRT)
T1 0.9 % SODIUM
0.9 % SODIUM
CHLORIDE
CHLORIDE (PGY VL
PRT)
T1 SODIUM CHLORIDE SODIUM CHLORIDE
0.45 %
0.45 %
Page 39 of 116
ENDOCRINE DISORDER - OTHER
ANTIDIURETIC AND VASOPRESSOR HORMONES
T1 DESMOPRESSIN
DESMOPRESSIN
(NONREFRIGERATE (NONREFRIGERATE
D)
D)
T1 DESMOPRESSIN
DESMOPRESSIN
ACETATE
ACETATE
ANTINEOPLASTIC LHRH(GNRH)
AGONIST,PITUITARY SUPPR.
T2 GOSERELIN ACETATEZOLADEX
T2 LEUPROLIDE
ELIGARD
ACETATE
T1 LEUPROLIDE
LEUPROLIDE
ACETATE
ACETATE
PA
PA
BONE FORMATION STIM. AGENTS - PARATHYROID
HORMONE
T2 TERIPARATIDE
FORTEO
QL
BONE RESORPTION INHIBITOR & VITAMIN D
COMBINATIONS
T2 ALENDRONATE
FOSAMAX PLUS D
SODIUM/VITAMIN D3
BONE RESORPTION INHIBITORS
T1 ALENDRONATE
FOSAMAX (10 MG)
SODIUM
(TABLET)
T1 ALENDRONATE
FOSAMAX (35 MG)
SODIUM
(TABLET)
T1 ALENDRONATE
FOSAMAX (40 MG)
SODIUM
(TABLET)
T1 ALENDRONATE
FOSAMAX (5 MG)
SODIUM
(TABLET)
T1 ALENDRONATE
FOSAMAX (70 MG)
SODIUM
(TABLET)
T1 ALENDRONATE
FOSAMAX (70
SODIUM
MG/75ML)
(SOLUTION)
T1 CALCITONIN,SALM MIACALCIN
ON,SYNTHETIC
(200/SPRAY)
(SPRAY/PUMP)
T1 ETIDRONATE
DIDRONEL
DISODIUM
T1 IBANDRONATE
BONIVA
SODIUM
T1 RALOXIFENE HCL EVISTA
T2
T2
SOMATROPIN
SOMATROPIN
VNSNY
PA
LEPTIN HORMONE ANALOGS
T2 METRELEPTIN
MYALEPT
QL
LHRH(GNRH) AGONIST ANALOG PITUITARY
SUPPRESSANTS
T2 HISTRELIN ACETATE VANTAS
T1 LEUPROLIDE
LEUPROLIDE
ACETATE
ACETATE
T2 LEUPROLIDE
LUPRON DEPOT
ACETATE
T2 LEUPROLIDE
LUPRON DEPOT-PED
ACETATE
T2 NAFARELIN ACETATESYNAREL
PITUITARY SUPPRESSIVE AGENTS
T1 CABERGOLINE
DOSTINEX
T1 DANAZOL
DANOCRINE
ENDOCRINE DISORDER - THYROID
QL
ANTITHYROID PREPARATIONS
T1 METHIMAZOLE
TAPAZOLE
T1 PROPYLTHIOURACI PROPYLTHIOURACIL
L
IODINE CONTAINING AGENTS
T1 POTASSIUM IODIDE POTASSIUM IODIDE
T1 POTASSIUM
POTASSIUM
IODIDE/IODINE
IODIDE/IODINE
PA, QL
THYROID HORMONES
T1 LEVOTHYROXINE
SODIUM
T1 LIOTHYRONINE
SODIUM
T2 THYROID,PORK
T2
THYROID,PORK
T2
THYROID,PORK
T2
THYROID,PORK
PA
T1
THYROID,PORK
PA
PA
T2
THYROID,PORK
T2
THYROID,PORK
GROWTH HORMONE RECEPTOR ANTAGONISTS
T2 PEGVISOMANT
SOMAVERT
NORDITROPIN
FLEXPRO
SEROSTIM
ZORBTIVE
INSULIN-LIKE GROWTH FACTOR-1 (IGF-1)
HORMONES
T2 MECASERMIN
INCRELEX
LHRH(GNRH)AGNST PIT.SUP-CENTRAL
PRECOCIOUS PUBERTY
T2 HISTRELIN ACETATE SUPPRELIN LA
CALCIMIMETIC,PARATHYROID CALCIUM
ENHANCER
T2 CINACALCET HCL
SENSIPAR
GROWTH HORMONES
T2 SOMATROPIN
HYPERPARATHYROID TX AGENTS - VITAMIN D
ANALOG-TYPE
T1 DOXERCALCIFERO HECTOROL
L
T1 PARICALCITOL
ZEMPLAR
LEVOTHYROXINE
SODIUM
LIOTHYRONINE
SODIUM
ARMOUR THYROID
(120 MG) (TABLET)
ARMOUR THYROID
(15 MG) (TABLET)
ARMOUR THYROID
(180 MG) (TABLET)
ARMOUR THYROID
(240 MG) (TABLET)
ARMOUR THYROID
(30 MG) (TABLET)
ARMOUR THYROID
(30 MG) (TABLET)
ARMOUR THYROID
(300 MG) (TABLET)
Page 40 of 116
T1
THYROID,PORK
T2
THYROID,PORK
T1
THYROID,PORK
T2
THYROID,PORK
T1
T1
THYROID,PORK
THYROID,PORK
ARMOUR THYROID
(60 MG) (TABLET)
ARMOUR THYROID
(60 MG) (TABLET)
ARMOUR THYROID
(90 MG) (TABLET)
ARMOUR THYROID
(90 MG) (TABLET)
THYROID,PORK
WP THYROID
EYE - GENERAL DISORDERS
EYE ANTIBIOTIC-CORTICOID COMBINATIONS
T1 NEOMYCIN/BACIT/P NEOMYCIN/BACIT/P-MYX/HYDROCORT MYX/HYDROCORT
T1 NEOMYCIN/POLYM NEOMYCIN/POLYMY
YXIN
XIN B/DEXAMETHA
B/DEXAMETHA
T1 NEOMYCIN/POLYM NEOMYCIN/POLYMY
YXIN
XIN B/HYDROCORT
B/HYDROCORT
T1 TOBRAMYCIN/DEX TOBRADEX (0.3 %AMETHASONE
0.1%) (DROPS SUSP)
T2 TOBRAMYCIN/DEXA TOBRADEX (0.3 %METHASONE
0.1%) (OINT. (G))
T2 TOBRAMYCIN/LOTEP ZYLET
RED ETAB
EYE ANTIHISTAMINES
T1 AZELASTINE HCL OPTIVAR
T1 EPINASTINE HCL
ELESTAT
T1 OLOPATADINE HCL PATANOL
EYE ANTIINFLAMMATORY AGENTS
T1 DEXAMETHASONE DEXASOL
SOD PHOSPHATE
T1 DICLOFENAC
VOLTAREN
SODIUM
T2 DIFLUPREDNATE
DUREZOL
T1 FLUOROMETHOLO FML
NE
T2 FLUOROMETHOLON FML FORTE
E
T2 FLUOROMETHOLON FML S.O.P.
E
T2 FLUOROMETHOLON FLAREX
E ACETATE
T1 FLURBIPROFEN
OCUFEN
SODIUM
T1 KETOROLAC
ACULAR
TROMETHAMINE
T1 KETOROLAC
ACULAR LS
TROMETHAMINE
T2 LOTEPREDNOL
ALREX
ETABONATE
T2 LOTEPREDNOL
LOTEMAX
ETABONATE
T2 NEPAFENAC
ILEVRO
T2 NEPAFENAC
NEVANAC
T1 PREDNISOLONE
OMNIPRED
ACETATE
VNSNY
T1
T2
T1
PREDNISOLONE
ACETATE
PREDNISOLONE
ACETATE
PREDNISOLONE
SOD PHOSPHATE
EYE ANTIVIRALS
T2 GANCICLOVIR
T1 TRIFLURIDINE
PRED FORTE
PRED MILD
PREDNISOLONE SOD
PHOSPHATE
ZIRGAN
VIROPTIC
EYE LOCAL ANESTHETICS
T1 BENOXINATE
FLUORESCEINHCL/FLUORESCEIN BENOXINATE
NA
T1 BENOXINATE
FLUROX
HCL/FLUORESCEIN
NA
T1 PROPARACAINE
PROPARACAINE HCL
HCL
T1 PROPARACAINE/FL PROPARACAINE/FLU
UORESCEIN SOD
ORESCEIN SOD
T1 TETRACAINE HCL TETCAINE
T1 TETRACAINE
TETRACAINE
HCL/PF
HYDROCHLORIDE
EYE SULFONAMIDES
T1 SULFACETAMIDE
SODIUM
T2 SULFACETAMIDE/PR
EDNISOLONE
T2 SULFACETAMIDE/PR
EDNISOLONE
T1 SULFACETAMIDE/P
REDNISOLONE SP
SODIUM SULAMYD
BLEPHAMIDE
BLEPHAMIDE S.O.P.
SULFACETAMIDE/PR
EDNISOLONE SP
EYE VASOCONSTRICTORS (RX ONLY)
T1 PHENYLEPHRINE MYDFRIN
HCL
T1 PHENYLEPHRINE PHENYLEPHRINE
HCL
HCL
OPHTHALMIC ANTIBIOTICS
T1 BACITRACIN
BACITRACIN
T1 BACITRACIN/POLY BACITRACIN/POLYM
MYXIN B SULFATE YXIN B SULFATE
T2 BESIFLOXACIN HCL BESIVANCE
T1 CIPROFLOXACIN
CILOXAN (0.3 %)
HCL
(DROPS)
T2 CIPROFLOXACIN HCLCILOXAN (0.3 %)
(OINT. (G))
T1 ERYTHROMYCIN
ERYTHROMYCIN
BASE
BASE
T1 GATIFLOXACIN
ZYMAXID
T1 GENTAMICIN
GARAMYCIN
SULFATE
T1 LEVOFLOXACIN
LEVOFLOXACIN
T2 MOXIFLOXACIN HCL MOXEZA
T2 MOXIFLOXACIN HCL VIGAMOX
T1 NEOMYCIN
NEO-POLYCIN
SU/BACITRA/POLYM
YXIN
T1 NEOMYCIN/POLYM NEOMYCIN/POLYMY
YXN B/GRAMICIDIN XN B/GRAMICIDIN
Page 41 of 116
T1
T1
T1
T2
OFLOXACIN
OCUFLOX
POLYMYXIN B
POLYTRIM
SULF/TRIMETHOPR
IM
TOBRAMYCIN
TOBREX (0.3 %)
(DROPS)
TOBRAMYCIN
TOBREX (0.3 %)
(OINT. (G))
OPHTHALMIC ANTI-INFLAMMATORY
IMMUNOMODULATOR-TYPE
T2 LIFITEGRAST
XIIDRA
T1
T2
QL
MYDRIATICS
T1 ATROPINE SULFATE ATROPINE SULFATE
T1 CYCLOPENTOLATE CYCLOGYL
HCL
T1 HOMATROPINE HBRISOPTO
HOMATROPINE
T1 TROPICAMIDE
MYDRIACYL
QL
OPHTHALMIC MAST CELL STABILIZERS
T1 CROMOLYN
OPTICROM
SODIUM
T2 LODOXAMIDE
ALOMIDE
TROMETHAMINE
T2 NEDOCROMIL
ALOCRIL
SODIUM
OPHTHALMIC PREPARATIONS, MISCELLANEOUS
T5 SODIUM CHLORIDE SODIUM CHLORIDE
EYE - GLAUCOMA
CARBONIC ANHYDRASE INHIBITORS
T1 ACETAZOLAMIDE DIAMOX
T1 ACETAZOLAMIDE DIAMOX SEQUELS
MIOTICS/OTHER INTRAOC. PRESSURE REDUCERS
T1 APRACLONIDINE
IOPIDINE (0.5 %)
HCL
(DROPS)
T1 BETAXOLOL HCL BETOPTIC
T2 BETAXOLOL HCL
BETOPTIC S
T2 BIMATOPROST
LUMIGAN (0.01 %) QL
(DROPS)
T1 BIMATOPROST
LUMIGAN (0.03 %) QL
(DROPS)
T1 BRIMONIDINE
ALPHAGAN
TARTRATE
T2 BRIMONIDINE
ALPHAGAN P (0.1 %)
TARTRATE
(DROPS)
T1 BRIMONIDINE
ALPHAGAN P (0.15
TARTRATE
%) (DROPS)
T2 BRIMONIDINE
COMBIGAN
TARTRATE/TIMOLOL
T2 BRINZOLAMIDE
AZOPT
T2 BRINZOLAMIDE/BRI SIMBRINZA
MONIDINE TART
T1 CARTEOLOL HCL OCUPRESS
T1 DORZOLAMIDE
TRUSOPT
HCL
T1 DORZOLAMIDE
COSOPT
HCL/TIMOLOL
MALEAT
T1 LATANOPROST
XALATAN
T1 LEVOBUNOLOL
BETAGAN
HCL
T1 METIPRANOLOL
OPTIPRANOLOL
T1 PILOCARPINE HCL ISOPTO CARPINE
T2 TIMOLOL
BETIMOL
T1 TIMOLOL MALEATETIMOPTIC
VNSNY
TIMOLOL MALEATETIMOPTIC-XE
TRAVOPROST
TRAVATAN Z
EYE - MISCELLANEOUS
ARTIFICIAL TEARS
T5 DEXTRAN
DEXTRAN
70/HYPROMELLOSE 70/HYPROMELLOSE
T5 DEXTRAN
BION TEARS
70/HYPROMELLOSE/P
F
T5 DEXTRAN
DEXTRAN
70/HYPROMELLOSE/ 70/HYPROMELLOSE/
PF
PF
T5 DEXTRAN
GENTEAL TEARS
70/HYPROMELLOSE/P
F
T5 DEXTRAN/HYPROME GENTEAL TEARS
LLOSE/GLYCERIN
T5 DEXTRAN/HYPROME TEARS NATURALE
LLOSE/GLYCERIN
FORTE
T5 GLYCERIN/PROPYL GLYCERIN/PROPYLE
ENE GLYCOL
NE GLYCOL (0.3%1%) (DROPS) (OTC)
T5 MINERAL
MINERAL
OIL/PETROLATUM, OIL/PETROLATUM,W
WHITE
HITE
T5 POLYVINYL
POLYVINYL
ALCOHOL
ALCOHOL
T5 POLYVINYL
POLYVINYL
ALCOHOL/POVIDON ALCOHOL/POVIDON
E
E (0.5%-0.6%)
(DROPS) (OTC)
EYE DIAGNOSTIC AGENTS
T1 FLUORESCEIN
FLUORESCEIN
SODIUM
SODIUM
T1 LISSAMINE GREEN LISSAMINE GREEN
EYE IRRIGATIONS
T1 BALANCED SALT
BALANCED SALT
SOLN NON-SURG #6 SOLN NON-SURG #6
EYE PREPARATIONS, MISCELLANEOUS (OTC)
T5 EYELID CLEANSER CLEANSING EYELID
COMBINATION #5
PADS
T5 EYELID CLEANSER CLEANSING EYELID
COMBINATION #5
WIPES
T5 EYELID CLEANSER EYELID WIPES
COMBINATION #6
T5 LANOLIN/MINERAL LANOLIN/MINERAL
OIL/PETROLATUM OIL/PETROLATUM
T5 MINERAL OIL,
MINERAL OIL,
LIGHT/MINERAL
LIGHT/MINERAL OIL
OIL
Page 42 of 116
T5
T5
T5
T5
T5
T5
MINERAL
MINERAL
OIL/PETROLATUM, OIL/PETROLATUM,W
WHITE
HITE (3 %-94 %)
(OINT. (G)) (OTC)
MINERAL
MINERAL
OIL/PETROLATUM, OIL/PETROLATUM,W
WHITE
HITE (41.5-56.8%)
(OINT. (G)) (OTC)
MINERAL
MINERAL
OIL/PETROLATUM, OIL/PETROLATUM,W
WHITE
HITE (42.5-57.3%)
(OINT. (G)) (OTC)
MINERAL
MINERAL
OIL/PETROLATUM, OIL/PETROLATUM,W
WHITE
HITE (OINT. (G))
(OTC)
MINERAL
REFRESH LACRIOIL/PETROLATUM,W LUBE
HITE
MINERAL
REFRESH P.M.
OIL/PETROLATUM,W
HITE
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
OPHTHALMIC CYSTINE DEPLETING AGENTS
T2 CYSTEAMINE HCL CYSTARAN
PA
FLUID REPLACEMENT
T2
T2
T2
NUCLEIC ACID/NUCLEOTIDE SUPPLEMENTS
T2 URIDINE
XURIDEN
PA
TRIACETATE
T2
T2
GOUT AND RELATED DISEASES
T2
COLCHICINE
T1 COLCHICINE
COLCRYS
QL
T1 PROBENECID/COLC PROBENECID/COLC
HICINE
HICINE
HYPERURICEMIA TX - PURINE INHIBITORS
T1 ALLOPURINOL
ZYLOPRIM
T2 FEBUXOSTAT
ULORIC
URICOSURIC AGENTS
T1 PROBENECID
QL
HEMATOLOGICAL DISORDERS
ANTIFIBRINOLYTIC AGENTS
T1 TRANEXAMIC ACID LYSTEDA
ANTIHEMOPHILIC FACTORS
T2 ANTIHEM.FVIII,SIN- AFSTYLA
CHN,B-DM TRU
T2 ANTIHEMO.FVIII,FUL ADYNOVATE
L LENGTH PEG
T2 ANTIHEMOPH.FVIII ELOCTATE (1000
REC,FC FUSION
UNIT) (VIAL)
T2 ANTIHEMOPH.FVIII ELOCTATE (1500
REC,FC FUSION
UNIT) (VIAL)
T2 ANTIHEMOPH.FVIII ELOCTATE (2000
REC,FC FUSION
UNIT) (VIAL)
VNSNY
T2
T2
BENEMID
ANTICOAGULANTS,COUMARIN TYPE
T1 WARFARIN SODIUM WARFARIN SODIUM
T2
T2
T2
T2
ANTIHEMOPH.FVIII ELOCTATE (250
REC,FC FUSION
UNIT) (VIAL)
ANTIHEMOPH.FVIII ELOCTATE (3000
REC,FC FUSION
UNIT) (VIAL)
ANTIHEMOPH.FVIII ELOCTATE (500
REC,FC FUSION
UNIT) (VIAL)
ANTIHEMOPH.FVIII ELOCTATE (750
REC,FC FUSION
UNIT) (VIAL)
ANTIHEMOPH.FVIII,B NOVOEIGHT
-DOM TRUNCAT
ANTIHEMOPH.FVIII,B XYNTHA
-DOMAIN DEL
ANTIHEMOPH.FVIII,B XYNTHA SOLOFUSE
-DOMAIN DEL
ANTIHEMOPH.FVIII,F ADVATE
ULL LENGTH
ANTIHEMOPH.FVIII,F HELIXATE FS
ULL LENGTH
ANTIHEMOPH.FVIII,F KOGENATE FS
ULL LENGTH
ANTIHEMOPH.FVIII,F KOVALTRY
ULL LENGTH
ANTIHEMOPH.FVIII,H NUWIQ
EK B-DELETE
ANTIHEMOPHILIC
RECOMBINATE
FACTOR, HUM REC
ANTIHEMOPHILIC
HEMOFIL M
FACTOR, HUMAN
ANTIHEMOPHILIC
KOATE
FACTOR, HUMAN
ANTIHEMOPHILIC
KOATE-DVI
FACTOR, HUMAN
ANTIHEMOPHILIC
MONOCLATE-P
FACTOR, HUMAN
ANTIHEMOPHILIC
ALPHANATE
FACTOR/VWF
ANTIHEMOPHILIC
HUMATE-P
FACTOR/VWF
ANTIHEMOPHILIC
WILATE
FACTOR/VWF
ANTIHEMOPHILIC
OBIZUR
FVIII,REC PORC
ANTI-INHIBITOR
FEIBA NF
COAGULANT COMP.
COAGULATION
NOVOSEVEN RT
FACTOR
VIIA,RECOMB
BLOOD FACTORS,MISCELLANEOUS
T2 FACTOR XIII
CORIFACT
CITRATES AS ANTICOAGULANTS
T1 CITRATE
CITRATE
PHOSPHATE
PHOSPHATE
DEXTROS SOLN
DEXTROS SOLN
T1 SODIUM CITRATE SODIUM CITRATE (4
G/100 ML)
(SOLUTION)
DIRECT FACTOR XA INHIBITORS
T2 APIXABAN
ELIQUIS (2.5 MG)
(TABLET)
QL
Page 43 of 116
T2
APIXABAN
T2
RIVAROXABAN
T2
RIVAROXABAN
T2
RIVAROXABAN
T2
RIVAROXABAN
ELIQUIS (5 MG)
(TABLET)
XARELTO (10 MG)
(TABLET)
XARELTO (15 MG)
(TABLET)
XARELTO (15 MG20MG) (TAB DS PK)
XARELTO (20 MG)
(TABLET)
QL
T2
QL
T2
QL
T2
QL
QL
FACTOR IX PREPARATIONS
T2 FACTOR IX
ALPHANINE SD
T2 FACTOR IX
MONONINE
T2 FACTOR IX
PROFILNINE
CPLX(PCC)#4,
3FACTOR
T2 FACTOR IX
BEBULIN
CPLX(PCC)#6,
3FACTOR
T2 FACTOR IX HUMAN BENEFIX
RECOMBINANT
T2 FACTOR IX HUMAN RIXUBIS
RECOMBINANT
T2 FACTOR IX REC, FC ALPROLIX
FUSION PROTN
FACTOR XIII PREPARATIONS
T2 FACTOR XIII ATRETTEN
SUBUNIT,RECOMB
HEMATINICS,OTHER
T2 EPOETIN ALFA
T2
EPOETIN ALFA
T2
EPOETIN ALFA
T2
EPOETIN ALFA
T2
EPOETIN ALFA
T2
EPOETIN ALFA
T2
EPOETIN ALFA
PROCRIT (10000/ML) PA
(VIAL)
PROCRIT (2000/ML) PA
(VIAL)
PROCRIT (20000/2ML)PA
(VIAL)
PROCRIT (20000/ML) PA
(VIAL)
PROCRIT (3000/ML) PA
(VIAL)
PROCRIT (4000/ML) PA
(VIAL)
PROCRIT (40000/ML) PA
(VIAL)
HEMORRHEOLOGIC AGENTS
T1 PENTOXIFYLLINE TRENTAL
HEPARIN AND RELATED PREPARATIONS
T2 DALTEPARIN
FRAGMIN (10000/ML) QL
SODIUM,PORCINE
(SYRINGE)
T2 DALTEPARIN
FRAGMIN (12500/0.5) QL
SODIUM,PORCINE
(SYRINGE)
T2 DALTEPARIN
FRAGMIN (15000/0.6) QL
SODIUM,PORCINE
(SYRINGE)
T2 DALTEPARIN
FRAGMIN
QL
SODIUM,PORCINE
(18000/0.72)
(SYRINGE)
T2 DALTEPARIN
FRAGMIN
QL
SODIUM,PORCINE
(2500/0.2ML)
(SYRINGE)
VNSNY
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
DALTEPARIN
SODIUM,PORCINE
DALTEPARIN
SODIUM,PORCINE
FRAGMIN (25000/ML) QL
(VIAL)
FRAGMIN
QL
(5000/0.2ML)
(SYRINGE)
DALTEPARIN
FRAGMIN
QL
SODIUM,PORCINE
(7500/0.3ML)
(SYRINGE)
ENOXAPARIN
LOVENOX (100
QL
SODIUM
MG/ML) (SYRINGE)
ENOXAPARIN
LOVENOX
QL
SODIUM
(120MG/.8ML)
(SYRINGE)
ENOXAPARIN
LOVENOX (150
QL
SODIUM
MG/ML) (SYRINGE)
ENOXAPARIN
LOVENOX
QL
SODIUM
(300MG/3ML) (VIAL)
ENOXAPARIN
LOVENOX
QL
SODIUM
(30MG/0.3ML)
(SYRINGE)
ENOXAPARIN
LOVENOX
QL
SODIUM
(40MG/0.4ML)
(SYRINGE)
ENOXAPARIN
LOVENOX
QL
SODIUM
(60MG/0.6ML)
(SYRINGE)
ENOXAPARIN
LOVENOX
QL
SODIUM
(80MG/0.8ML)
(SYRINGE)
FONDAPARINUX
ARIXTRA
QL
SODIUM
(10MG/0.8ML)
(SYRINGE)
FONDAPARINUX
ARIXTRA (2.5
QL
SODIUM
MG/0.5) (SYRINGE)
FONDAPARINUX
ARIXTRA
QL
SODIUM
(5MG/0.4ML)
(SYRINGE)
FONDAPARINUX
ARIXTRA (7.5MG/0.6) QL
SODIUM
(SYRINGE)
HEPARIN
HEPARIN
SOD,PORCINE/0.9 % SOD,PORCINE/0.9 %
NACL
NACL
HEPARIN
HEPARIN
SODIUM,PORCINE SODIUM,PORCINE
HEPARIN
HEPARIN
SODIUM,PORCINE/D SODIUM,PORCINE/D
5W
5W
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(1 UNIT/ML)
(SYRINGE)
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(10 UNIT/ML)
(SYRINGE)
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(10 UNIT/ML) (VIAL)
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(100/ML (1))
(SYRINGE)
Page 44 of 116
T1
T1
T1
T1
T1
T1
T1
VITAMIN K PREPARATIONS
T2 PHYTONADIONE (VIT MEPHYTON
K1)
T1 PHYTONADIONE
PHYTONADIONE
(VIT K1)
(VIT K1) (10 MG/ML)
(AMPUL)
T1 PHYTONADIONE
PHYTONADIONE
(VIT K1)
(VIT K1) (1MG/0.5ML)
(AMPUL)
T1 PHYTONADIONE
PHYTONADIONE
(VIT K1)
(VIT K1) (1MG/0.5ML)
(SYRINGE)
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(100/ML (1)) (VIAL)
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(1000/10 ML)
(SYRINGE)
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(1000/ML) (VIAL)
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(200/2 ML)
(SYRINGE)
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(300/3 ML)
(SYRINGE)
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(500/5 ML)
(SYRINGE)
HEPARIN
HEPARIN
SODIUM,PORCINE/P SODIUM,PORCINE/PF
F
(5000/0.5ML)
(SYRINGE)
LEUKOCYTE (WBC) STIMULANTS
T2 FILGRASTIM
NEUPOGEN
T2 PEGFILGRASTIM
NEULASTA
(6MG/0.6ML)
(SYRINGE)
T2 SARGRAMOSTIM
LEUKINE
T2 TBO-FILGRASTIM
GRANIX
PLATELET AGGREGATION INHIBITORS
T5 ASPIRIN
ASPIRIN
T5 ASPIRIN
BAYER CHEWABLE
ASPIRIN
T5 ASPIRIN
ECOTRIN
T1 CILOSTAZOL
PLETAL
T1 CLOPIDOGREL
PLAVIX (300 MG)
BISULFATE
(TABLET)
T1 CLOPIDOGREL
PLAVIX (75 MG)
BISULFATE
(TABLET)
T1 DIPYRIDAMOLE
PERSANTINE
T2 PRASUGREL HCL
EFFIENT
T2 TICAGRELOR
BRILINTA
T1 TICLOPIDINE HCL TICLID
HORMONAL DEFICIENCY
PA
PA
PA
PA
QL
QL
QL
QL
QL
QL
PLATELET REDUCING AGENTS
T1 ANAGRELIDE HCL AGRYLIN
THROMBIN INHIBITORS,SEL.,DIRECT,&REV.HIRUDIN TYPE
T2 DESIRUDIN
IPRIVASK
PA, QL
THROMBOPOIETIN RECEPTOR AGONISTS
T2 ELTROMBOPAG
PROMACTA
OLAMINE
TOPICAL HEMOSTATICS
T1 THROMBIN
THROMBIN
(BOVINE)
(BOVINE)
VNSNY
PA
ANDROGENIC AGENTS
T1 FLUOXYMESTERON HALOTESTIN
QL
E
T1 METHYLTESTOSTE ANDROID
PA
RONE
T2 METHYLTESTOSTER METHITEST
PA
ONE
T1 METHYLTESTOSTE TESTRED
PA
RONE
T1 OXANDROLONE
OXANDRIN
PA
T2 TESTOSTERONE
ANDRODERM
PA
T2 TESTOSTERONE
ANDROGEL (1.25G- PA
1.62) (GEL PACKET)
T1 TESTOSTERONE
ANDROGEL
PA
(12.5/1.25G) (GEL MD
PMP)
T2 TESTOSTERONE
ANDROGEL (2.5GPA
1.62%) (GEL PACKET)
T2 TESTOSTERONE
ANDROGEL
PA
(20.25/1.25) (GEL MD
PMP)
T1 TESTOSTERONE
ANDROGEL
PA
(25MG(1%)) (GEL
PACKET)
T1 TESTOSTERONE
ANDROGEL (50 MG PA
(1%)) (GEL PACKET)
T2 TESTOSTERONE
AXIRON
PA
T1 TESTOSTERONE
FORTESTA
PA
T1 TESTOSTERONE
TESTIM
PA
T1 TESTOSTERONE
VOGELXO
PA
T1 TESTOSTERONE
DEPOPA
CYPIONATE
TESTOSTERONE
T1 TESTOSTERONE
DELATESTRYL
PA
ENANTHATE
T2 TESTOSTERONE
AVEED
PA
UNDECANOATE
ESTROGEN & SELECTIVE ESTROGEN RECEPT
MOD(SERM)COMB
T2 ESTROGENS,CONJ/BADUAVEE
ZEDOXIFENE
ESTROGEN/ANDROGEN COMBINATIONS
T1 ESTROGEN,ESTER/ COVARYX
ME-TESTOSTERONE
T1 ESTROGEN,ESTER/ COVARYX H.S.
ME-TESTOSTERONE
Page 45 of 116
T1
ESTROGEN,ESTER/ ESTROGEN,ESTER/M
ME-TESTOSTERONE E-TESTOSTERONE
T2
ESTROGENIC AGENTS
T1 ESTRADIOL
CLIMARA
QL
T1 ESTRADIOL
ESTRACE
T1 ESTRADIOL
VIVELLE-DOT
QL
T2 ESTRADIOL
DEPO-ESTRADIOL
CYPIONATE
T1 ESTRADIOL
DELESTROGEN (20
VALERATE
MG/ML) (VIAL)
T1 ESTRADIOL
DELESTROGEN (40
VALERATE
MG/ML) (VIAL)
T1 ESTRADIOL/NORET ACTIVELLA
HINDRONE ACET
T2 ESTRADIOL/NORETH COMBIPATCH
QL
INDRONE ACET
T2 ESTROGEN,CON/M- PREMPHASE
PROGEST ACET
T2 ESTROGEN,CON/M- PREMPRO
PROGEST ACET
T2 ESTROGENS,
PREMARIN (0.3 MG)
CONJUGATED
(TABLET)
T2 ESTROGENS,
PREMARIN (0.45MG)
CONJUGATED
(TABLET)
T2 ESTROGENS,
PREMARIN (0.625
CONJUGATED
MG) (TABLET)
T2 ESTROGENS,
PREMARIN (0.9 MG)
CONJUGATED
(TABLET)
T2 ESTROGENS,
PREMARIN (1.25 MG)
CONJUGATED
(TABLET)
T2 ESTROGENS,ESTERIF MENEST
IED
T1 ESTROPIPATE
OGEN 2.5
T1 ESTROPIPATE
ORTHO-EST
T1 NORETHINDRONE FEMHRT
AC-ETH ESTRADIOL
T1 NORETHINDRONE JEVANTIQUE
AC-ETH ESTRADIOL
T1 NORETHINDRONE JEVANTIQUE LO
AC-ETH ESTRADIOL
PA
GAMUNEX-C
PA
INFLUENZA VIRUS VACCINES
T2 FLU VACC QV LIVE FLUMIST QUAD
2016(2-49YRS)
2016-2017
IMMUNOSUPPRESSION/MODULATIO
N
IMMUNOMODULATORS
T1 IMIQUIMOD
T2 INTERFERON ALFA2B,RECOMB.
T2 INTERFERON ALFAN3
T2 INTERFERON
GAMMA1B,RECOMB.
ALDARA
INTRON A
PA, QL
PA
ALFERON N
ACTIMMUNE
IMMUNOSUPPRESSIVES
T1 AZATHIOPRINE
IMURAN
T1 CYCLOSPORINE
CYCLOSPORINE
T2 CYCLOSPORINE
SANDIMMUNE (100
MG/ML) (SOLUTION)
T1 CYCLOSPORINE,
CYCLOSPORINE,
MODIFIED
MODIFIED
T1 CYCLOSPORINE,
GENGRAF
MODIFIED
T2 EVEROLIMUS
ZORTRESS
T1 MYCOPHENOLATE CELLCEPT
MOFETIL
T1 MYCOPHENOLATE MYFORTIC
SODIUM
T2 SIROLIMUS
RAPAMUNE (1
MG/ML) (SOLUTION)
T1 SIROLIMUS
SIROLIMUS
T2 TACROLIMUS
ASTAGRAF XL
T1 TACROLIMUS
TACROLIMUS
ABSORBABLE SULFONAMIDES
T1 SULFAMETHOXAZO BACTRIM
LE/TRIMETHOPRIM
T1 SULFAMETHOXAZO BACTRIM DS
LE/TRIMETHOPRIM
T1 SULFAMETHOXAZO SULFAMETHOXAZO
LE/TRIMETHOPRIM LE/TRIMETHOPRIM
T1 SULFAMETHOXAZO SULFATRIM
LE/TRIMETHOPRIM
IMMUNIZATION
VNSNY
GAMMAKED
INFECTIOUS DISEASE - BACTERIAL
PROGESTATIONAL AGENTS
T1 MEDROXYPROGEST PROVERA
ERONE ACETATE
T1 NORETHINDRONE AYGESTIN
ACETATE
T1 PROGESTERONE
PROGESTERONE
T1 PROGESTERONE,
PROMETRIUM
MICRONIZED
ANTISERA
T2 IGG/HYALURONIDAS HYQVIA
E,RECOMBINANT
T2 IMMUN GLOB
GAMMAGARD
G(IGG)/GLY/IGA OV50 LIQUID
T2 IMMUN GLOB
HYQVIA IG
G(IGG)/GLY/IGA OV50 COMPONENT
T2 IMMUN GLOB
HIZENTRA
G(IGG)/PRO/IGA 0-50
T2
IMMUNE GLOBUL
G/GLY/IGA AVG 46
IMMUNE GLOBUL
G/GLY/IGA AVG 46
PA
PA
PA
PA
BETALACTAMS
T2 AZTREONAM LYSINE CAYSTON
PA
CEPHALOSPORINS - 1ST GENERATION
T1 CEFADROXIL
DURICEF
T1 CEPHALEXIN
KEFLEX
CEPHALOSPORINS - 2ND GENERATION
T1 CEFACLOR
CECLOR
Page 46 of 116
T1
T1
T2
CEFACLOR
CEFPROZIL
CEFUROXIME
AXETIL
T1
CEFUROXIME
AXETIL
CEFUROXIME
AXETIL
T2
T1
CEFUROXIME
AXETIL
CECLOR CD
CEFZIL
CEFTIN (125
MG/5ML) (SUSP
RECON)
CEFTIN (250 MG)
(TABLET)
CEFTIN (250
MG/5ML) (SUSP
RECON)
CEFUROXIME
AXETIL
CEPHALOSPORINS - 3RD GENERATION
T1 CEFDINIR
OMNICEF
T1 CEFDITOREN
SPECTRACEF
PIVOXIL
T2 CEFIXIME
SUPRAX (100 MG)
(TAB CHEW)
T1 CEFIXIME
SUPRAX (100
MG/5ML) (SUSP
RECON)
T2 CEFIXIME
SUPRAX (200 MG)
(TAB CHEW)
T1 CEFIXIME
SUPRAX (200
MG/5ML) (SUSP
RECON)
T2 CEFIXIME
SUPRAX (400 MG)
(CAPSULE)
T2 CEFIXIME
SUPRAX (500
MG/5ML) (SUSP
RECON)
T1 CEFPODOXIME
VANTIN
PROXETIL
T1 CEFTIBUTEN
CEDAX
CHEMOTHERAPEUTICS, ANTIBACTERIAL, MISC.
T1 METH/MEBLUE/SOD METH/MEBLUE/SOD
PHOS/PSAL/HYOS
PHOS/PSAL/HYOS
T2 METH/MEBLUE/SOD PHOSPHASAL
PHOS/PSAL/HYOS
T2 METH/MEBLUE/SOD URETRON D-S
PHOS/PSAL/HYOS
T2 METH/MEBLUE/SOD URIN D.S.
PHOS/PSAL/HYOS
T1 METHEN/MBLUE/SA METHEN/MBLUE/SA
L/SOD PHOS/HYOS L/SOD PHOS/HYOS
T1 METHENAM/M.BLU METHENAM/M.BLUE
E/SALICYL/HYOSCY /SALICYL/HYOSCY
T1 METHENAM/SOD
URYL
PHOS/MBLUE/HYOS
CY
T1 METHENAMINE
HIPREX
HIPPURATE
T1 METHENAMINE
MANDELAMINE
MANDELATE
T2 TRIMETHOPRIM
PRIMSOL
T1 TRIMETHOPRIM
PROLOPRIM
KETOLIDES
T2 TELITHROMYCIN
VNSNY
KETEK
MACROLIDES
T1 AZITHROMYCIN
T1 AZITHROMYCIN
T2
T1
T1
T1
T2
T1
T1
T2
T1
T1
T2
T1
T1
T2
ZITHROMAX
ZITHROMAX TRIPAK
AZITHROMYCIN
ZMAX
CLARITHROMYCIN BIAXIN
CLARITHROMYCIN BIAXIN XL
ERYTHROMYCIN
ERYC
BASE
ERYTHROMYCIN
ERY-TAB
BASE
ERYTHROMYCIN
ERYTHRCIN
BASE
STEARATE
ERYTHROMYCIN
ERYTHROMYCIN
BASE
BASE
ERYTHROMYCIN
PCE
BASE
ERYTHROMYCIN
E.E.S. 400
ETHYLSUCCINATE
ERYTHROMYCIN
ERYPED 200
ETHYLSUCCINATE
ERYTHROMYCIN
ERYPED 400
ETHYLSUCCINATE
ERYTHROMYCIN
ERYTHROMYCIN
ETHYLSUCCINATE ETHYLSUCCINATE
ERYTHROMYCIN
ERYTHRCIN
STEARATE
STEARATE
FIDAXOMICIN
DIFICID
ST, QL
NITROFURAN DERIVATIVES
T1 NITROFURANTOIN FURADANTIN
T1 NITROFURANTOIN MACRODANTIN
MACROCRYSTAL
T1 NITROFURANTOIN MACROBID
MONOHYD/MCRYST
OXAZOLIDINONES
T1 LINEZOLID
T1
LINEZOLID
T2
TEDIZOLID
PHOSPHATE
ZYVOX (100
MG/5ML) (SUSP
RECON)
ZYVOX (600 MG)
(TABLET)
SIVEXTRO
PA
PA
PENICILLINS
T1 AMOXICILLIN
AMOXIL
T2 AMOXICILLIN/POTAS AUGMENTIN (125SIUM CLAV
31.25/) (SUSP RECON)
T1 AMOXICILLIN/POTA AUGMENTIN (200SSIUM CLAV
28.5/5) (SUSP RECON)
T1 AMOXICILLIN/POTA AUGMENTIN (200SSIUM CLAV
28.5MG) (TAB CHEW)
T1 AMOXICILLIN/POTA AUGMENTIN (250SSIUM CLAV
125 MG) (TABLET)
T1 AMOXICILLIN/POTA AUGMENTIN (250SSIUM CLAV
62.5/5) (SUSP RECON)
T1 AMOXICILLIN/POTA AUGMENTIN (400SSIUM CLAV
57MG) (TAB CHEW)
T1 AMOXICILLIN/POTA AUGMENTIN (400SSIUM CLAV
57MG/5) (SUSP
RECON)
Page 47 of 116
T1
T1
T1
T1
T1
T1
T2
T1
T1
AMOXICILLIN/POTA AUGMENTIN (500SSIUM CLAV
125 MG) (TABLET)
AMOXICILLIN/POTA AUGMENTIN (875SSIUM CLAV
125 MG) (TABLET)
AMOXICILLIN/POTA AUGMENTIN ES-600
SSIUM CLAV
AMOXICILLIN/POTA AUGMENTIN XR
SSIUM CLAV
AMPICILLIN
AMPICILLIN
TRIHYDRATE
DICLOXACILLIN
PATHOCIL
SODIUM
PENICILLIN G
BICILLIN L-A
BENZATHINE
PENICILLIN V
PENICILLIN V
POTASSIUM
POTASSIUM
PENICILLIN V
VEETIDS
POTASSIUM
QUINOLONES
T1 CIPROFLOXACIN
T1 CIPROFLOXACIN
HCL
T1 CIPROFLOXACIN/CI
PROFLOXA HCL
T1 LEVOFLOXACIN
T1 MOXIFLOXACIN
HCL
T1 OFLOXACIN
T1 OFLOXACIN
CIPRO
CIPRO
CIPRO XR
LEVAQUIN
AVELOX
FLOXIN
OFLOXACIN
TETRACYCLINES
T1 DEMECLOCYCLINE DECLOMYCIN
HCL
T2 DOXYCYCLINE
VIBRAMYCIN
CALCIUM
T1 DOXYCYCLINE
MORGIDOX
QL
HYCLATE
T1 DOXYCYCLINE
VIBRAMYCIN
QL
HYCLATE
T1 DOXYCYCLINE
VIBRA-TABS
QL
HYCLATE
T1 DOXYCYCLINE
ADOXA (150 MG)
QL
MONOHYDRATE
(TABLET)
T1 DOXYCYCLINE
AVIDOXY
QL
MONOHYDRATE
T1 DOXYCYCLINE
MONDOXYNE NL
QL
MONOHYDRATE
(100 MG) (CAPSULE)
T1 DOXYCYCLINE
MONDOXYNE NL (50 QL
MONOHYDRATE
MG) (CAPSULE)
T1 DOXYCYCLINE
MONODOX (100 MG) QL
MONOHYDRATE
(CAPSULE)
T1 DOXYCYCLINE
MONODOX (50 MG) QL
MONOHYDRATE
(CAPSULE)
T1 DOXYCYCLINE
MONODOX (50 MG) QL
MONOHYDRATE
(TABLET)
T1 DOXYCYCLINE
MONODOX (75 MG) QL
MONOHYDRATE
(TABLET)
T1 DOXYCYCLINE
ORACEA
ST, QL
MONOHYDRATE
T1 DOXYCYCLINE
VIBRAMYCIN
MONOHYDRATE
T1 MINOCYCLINE HCL DYNACIN
VNSNY
T1
T1
T1
MINOCYCLINE HCL MINOCIN
TETRACYCLINE
PANMYCIN
HCL
TETRACYCLINE
SUMYCIN
HCL
INFECTIOUS DISEASE - FUNGAL
ANTIFUNGAL AGENTS
T1 CLOTRIMAZOLE
T1 FLUCONAZOLE
T1 FLUCYTOSINE
T2 ITRACONAZOLE
T1
T1
T1
T1
MYCELEX
DIFLUCAN
ANCOBON
SPORANOX (10
MG/ML) (SOLUTION)
ITRACONAZOLE
SPORANOX (100 MG)
(CAPSULE)
KETOCONAZOLE
NIZORAL
TERBINAFINE HCL LAMISIL
VORICONAZOLE
VFEND
ANTIFUNGAL ANTIBIOTICS
T1 GRISEOFULVIN,
GRIFULVIN V (125
MICROSIZE
MG/5ML) (ORAL
SUSP)
T1 NYSTATIN
MYCOSTATIN
T1 NYSTATIN
NYSTATIN
INFECTIOUS DISEASE MISCELLANEOUS
AMINOGLYCOSIDES
T1 NEOMYCIN
SULFATE
T2 TOBRAMYCIN
T1 TOBRAMYCIN IN
0.225% NACL
NEOMYCIN SULFATE
TOBI PODHALER
TOBI
PA
PA
ANTIBACTERIAL AGENTS,MISCELLANEOUS
T1 GLYCINE
AMINOACETIC ACID
UROLOGIC
SOLUTION
ANTILEPROTICS
T1 DAPSONE
T2 THALIDOMIDE
DAPSONE
THALOMID
PA, QL
ANTI-MYCOBACTERIUM AGENTS
T4 AMINOSALICYLIC
PASER
ACID
T4 ETHAMBUTOL HCL MYAMBUTOL
T4 ETHIONAMIDE
TRECATOR
T4 ISONIAZID
HYZYD
T4 ISONIAZID
RIMIFON
T4 PYRAZINAMIDE
PYRAZINAMIDE
T4 RIFABUTIN
MYCOBUTIN
ANTITUBERCULAR ANTIBIOTICS
T4 BEDAQUILINE
SIRTURO
FUMARATE
T4 CYCLOSERINE
SEROMYCIN
T4 RIFAMPIN
RIFADIN
T4 RIFAMPIN/ISONIAZID RIFAMATE
T4 RIFAPENTINE
PRIFTIN
PA
Page 48 of 116
LINCOSAMIDES
T1 CLINDAMYCIN HCL CLEOCIN HCL
T1 CLINDAMYCIN
CLEOCIN
PALMITATE HCL
PALMITATE
RIFAMYCINS AND RELATED DERIVATIVE
ANTIBIOTICS
T2 RIFAXIMIN
XIFAXAN (550 MG)
(TABLET)
T1
T1
T2
PA
VANCOMYCIN AND DERIVATIVES
T1 VANCOMYCIN HCL VANCOCIN HCL (125 QL
MG) (CAPSULE)
T1 VANCOMYCIN HCL VANCOCIN HCL (250 QL
MG) (CAPSULE)
INFECTIOUS DISEASE - PARASITIC
2ND GEN. ANAEROBIC ANTIPROTOZOALANTIBACTERIAL
T1 TINIDAZOLE
TINIDAZOLE
AMEBACIDES
T1 PAROMOMYCIN
SULFATE
HUMATIN
ANAEROBIC ANTIPROTOZOAL-ANTIBACTERIAL
AGENTS
T1 METRONIDAZOLE FLAGYL
T2 METRONIDAZOLE
FLAGYL ER
ANTHELMINTICS
T1 IVERMECTIN
T2 MEBENDAZOLE
T2 PRAZIQUANTEL
STROMECTOL
EMVERM
BILTRICIDE
ANTIMALARIAL DRUGS
T1 ATOVAQUONE/PROG MALARONE
UANIL HCL
T1 CHLOROQUINE
ARALEN
PHOSPHATE
T1 CHLOROQUINE
CHLOROQUINE
PHOSPHATE
PHOSPHATE
T1 HYDROXYCHLORO PLAQUENIL
QUINE SULFATE
T1 MEFLOQUINE HCL LARIAM
T2 PRIMAQUINE
PRIMAQUINE
PHOSPHATE
T2 PYRIMETHAMINE
DARAPRIM
T1 QUININE SULFATE QUALAQUIN
ANTIPROTOZOAL DRUGS,MISCELLANEOUS
T1 ATOVAQUONE
MEPRON
T2 MILTEFOSINE
IMPAVIDO
T2 PENTAMIDINE
NEBUPENT
ISETHIONATE
PA
ANTIVIRALS, GENERAL
T1 ACYCLOVIR
T1 FAMCICLOVIR
VNSNY
ZOVIRAX
FAMCICLOVIR
T1
T1
T1
T1
TAMIFLU (30 MG)
(CAPSULE)
TAMIFLU (45 MG)
(CAPSULE)
TAMIFLU (6 MG/ML)
(SUSP RECON)
TAMIFLU (75 MG)
(CAPSULE)
VIRAZOLE
FLUMADINE
VALTREX
QL
QL
QL
QL
VALCYTE (450 MG)
(TABLET)
ANTIVIRALS, HIV-SPEC, NON-PEPTIDIC PROTEASE
INHIB
T2 DARUNAVIR
PREZISTA (100
QL
ETHANOLATE
MG/ML) (ORAL
SUSP)
T2 DARUNAVIR
PREZISTA (150 MG) QL
ETHANOLATE
(TABLET)
T2 DARUNAVIR
PREZISTA (600 MG) QL
ETHANOLATE
(TABLET)
T2 DARUNAVIR
PREZISTA (75 MG)
QL
ETHANOLATE
(TABLET)
T2 DARUNAVIR
PREZISTA (800 MG) QL
ETHANOLATE
(TABLET)
T2 DARUNAVIR/COBICIS PREZCOBIX
QL
TAT
T2 TIPRANAVIR
APTIVUS
QL
T2 TIPRANAVIR/VITAMI APTIVUS
QL
N E TPGS
ANTIVIRALS, HIV-SPEC, NUCLEOSIDE-NUCLEOTIDE
ANALOG
T2 EMTRICITABINE/TEN DESCOVY
QL
OFOV ALAFENAM
T2 EMTRICITABINE/TEN TRUVADA
QL
OFOVIR (TDF)
PA
PA
INFECTIOUS DISEASE - VIRAL
ANTIVIRAL MONOCLONAL ANTIBODIES
T2 PALIVIZUMAB
SYNAGIS
T1
OSELTAMIVIR
PHOSPHATE
OSELTAMIVIR
PHOSPHATE
OSELTAMIVIR
PHOSPHATE
OSELTAMIVIR
PHOSPHATE
RIBAVIRIN
RIMANTADINE HCL
VALACYCLOVIR
HCL
VALGANCICLOVIR
HCL
PA
ANTIVIRALS, HIV-SPEC., NUCLEOSIDE ANALOG, RTI
COMB
T1 ABACAVIR
EPZICOM
QL
SULFATE/LAMIVUDI
NE
T1 ABACAVIR/LAMIVU TRIZIVIR
QL
DINE/ZIDOVUDINE
T1 LAMIVUDINE/ZIDO COMBIVIR
QL
VUDINE
ANTIVIRALS, HIV-SPECIFIC, CCR5 CO-RECEPTOR
ANTAG.
T2 MARAVIROC
SELZENTRY (150
QL
MG) (TABLET)
T2 MARAVIROC
SELZENTRY (25 MG) QL
(TABLET)
T2 MARAVIROC
SELZENTRY (300
QL
MG) (TABLET)
T2 MARAVIROC
SELZENTRY (75 MG) QL
(TABLET)
ANTIVIRALS, HIV-SPECIFIC, FUSION INHIBITORS
T2 ENFUVIRTIDE
FUZEON
QL
Page 49 of 116
ANTIVIRALS, HIV-SPECIFIC, NON-NUCLEOSIDE, RTI
T2 DELAVIRDINE
RESCRIPTOR
MESYLATE
T2 EFAVIRENZ
SUSTIVA
T2 ETRAVIRINE
INTELENCE (100 MG) QL
(TABLET)
T2 ETRAVIRINE
INTELENCE (200 MG) QL
(TABLET)
T2 ETRAVIRINE
INTELENCE (25 MG) QL
(TABLET)
T1 NEVIRAPINE
VIRAMUNE (200 MG) QL
(TABLET)
T1 NEVIRAPINE
VIRAMUNE (50 MG/5 QL
ML) (ORAL SUSP)
T1 NEVIRAPINE
VIRAMUNE XR (100 QL
MG) (TAB ER 24H)
T1 NEVIRAPINE
VIRAMUNE XR (400 QL
MG) (TAB ER 24H)
T2 RILPIVIRINE HCL
EDURANT
QL
ANTIVIRALS, HIV-SPECIFIC, NUCLEOSIDE ANALOG,
RTI
T2 ABACAVIR SULFATE ZIAGEN (20 MG/ML) QL
(SOLUTION)
T1 ABACAVIR SULFATE ZIAGEN (300 MG)
QL
(TABLET)
T2 DIDANOSINE
VIDEX
QL
T1 DIDANOSINE
VIDEX EC (125 MG) QL
(CAPSULE DR)
T1 DIDANOSINE
VIDEX EC (200 MG) QL
(CAPSULE DR)
T1 DIDANOSINE
VIDEX EC (250 MG) QL
(CAPSULE DR)
T1 DIDANOSINE
VIDEX EC (400 MG) QL
(CAPSULE DR)
T2 EMTRICITABINE
EMTRIVA (10
QL
MG/ML) (SOLUTION)
T2 EMTRICITABINE
EMTRIVA (200 MG) QL
(CAPSULE)
T1 LAMIVUDINE
EPIVIR (10 MG/ML) QL
(SOLUTION)
T1 LAMIVUDINE
EPIVIR (150 MG)
QL
(TABLET)
T1 LAMIVUDINE
EPIVIR (300 MG)
QL
(TABLET)
T1 STAVUDINE
STAVUDINE (1
QL
MG/ML) (SOLN
RECON)
T1 STAVUDINE
STAVUDINE (15 MG) QL
(CAPSULE)
T1 STAVUDINE
STAVUDINE (20 MG) QL
(CAPSULE)
T1 STAVUDINE
STAVUDINE (30 MG) QL
(CAPSULE)
T1 STAVUDINE
STAVUDINE (40 MG) QL
(CAPSULE)
T1 ZIDOVUDINE
RETROVIR (10
QL
MG/ML) (SYRUP)
T1 ZIDOVUDINE
RETROVIR (100 MG) QL
(CAPSULE)
T1 ZIDOVUDINE
RETROVIR (300 MG) QL
(TABLET)
VNSNY
ANTIVIRALS, HIV-SPECIFIC, NUCLEOTIDE ANALOG,
RTI
T2 TENOFOVIR
VIREAD (150 MG)
QL
DISOPROXIL
(TABLET)
FUMARATE
T2 TENOFOVIR
VIREAD (200 MG)
QL
DISOPROXIL
(TABLET)
FUMARATE
T2 TENOFOVIR
VIREAD (250 MG)
QL
DISOPROXIL
(TABLET)
FUMARATE
T2 TENOFOVIR
VIREAD (300 MG)
QL
DISOPROXIL
(TABLET)
FUMARATE
T2 TENOFOVIR
VIREAD
QL
DISOPROXIL
(40MG/SCOOP)
FUMARATE
(POWDER)
ANTIVIRALS, HIV-SPECIFIC, PROTEASE INHIBITOR
COMB
T2 LOPINAVIR/RITONAVIKALETRA (100MG- QL
R
25MG) (TABLET)
T2 LOPINAVIR/RITONAVIKALETRA (200MG- QL
R
50MG) (TABLET)
T1 LOPINAVIR/RITONA KALETRA (400-100/5) QL
VIR
(SOLUTION)
ANTIVIRALS, HIV-SPECIFIC, PROTEASE INHIBITORS
T2 ATAZANAVIR
REYATAZ (150 MG) QL
SULFATE
(CAPSULE)
T2 ATAZANAVIR
REYATAZ (200 MG) QL
SULFATE
(CAPSULE)
T2 ATAZANAVIR
REYATAZ (300 MG) QL
SULFATE
(CAPSULE)
T2 ATAZANAVIR
REYATAZ (50 MG)
QL
SULFATE
(POWD PACK)
T2 ATAZANAVIR
EVOTAZ
QL
SULFATE/COBICISTA
T
T2 FOSAMPRENAVIR
LEXIVA (50 MG/ML) QL
CALCIUM
(ORAL SUSP)
T2 FOSAMPRENAVIR
LEXIVA (700 MG)
QL
CALCIUM
(TABLET)
T2 INDINAVIR SULFATE CRIXIVAN
T2 NELFINAVIR
VIRACEPT
MESYLATE
T2 RITONAVIR
NORVIR (100 MG)
QL
(CAPSULE)
T2 RITONAVIR
NORVIR (100 MG)
QL
(TABLET)
T2 RITONAVIR
NORVIR (80 MG/ML) QL
(SOLUTION)
T2 SAQUINAVIR
INVIRASE (200 MG) QL
MESYLATE
(CAPSULE)
T2 SAQUINAVIR
INVIRASE (500 MG) QL
MESYLATE
(TABLET)
ANTIVIRALS,HIV-1 INTEGRASE STRAND TRANSFER
INHIBTR
T2 DOLUTEGRAVIR
TIVICAY
QL
SODIUM
T2 RALTEGRAVIR
ISENTRESS (100 MG) QL
POTASSIUM
(POWD PACK)
Page 50 of 116
T2
T2
T2
RALTEGRAVIR
POTASSIUM
RALTEGRAVIR
POTASSIUM
RALTEGRAVIR
POTASSIUM
ISENTRESS (100 MG) QL
(TAB CHEW)
ISENTRESS (25 MG) QL
(TAB CHEW)
ISENTRESS (400 MG) QL
(TABLET)
ARTV CMB NUCLEOSIDE,NUCLEOTIDE,&NONNUCLEOSIDE RTI
T2 EFAVIRENZ/EMTRICI ATRIPLA
QL
TAB/TENOFOVIR
T2 EMTRICITA/RILPIVIR COMPLERA
QL
INE/TENOF DF
T2 EMTRICITAB/RILPIVI ODEFSEY
QL
RI/TENOF ALA
ARV CMB-NRTI,N(T)RTI, INTEGRASE INHIBITOR
T2 ELVITEG/COBI/EMTR GENVOYA
QL
IC/TENOFO ALA
T2 ELVITEG/COBI/EMTR STRIBILD
QL
IC/TENOFO DIS
ARV COMB-NRTIS & INTEGRASE INHIBITOR
T2 ABACAVIR/DOLUTEG TRIUMEQ
QL
RAVIR/LAMIVUDI
CYTOCHROME P450 INHIBITORS
T2 COBICISTAT
TYBOST
QL
HEP C VIRUS - NS5A & NS5B POLYMERASE INHIB.
COMBO.
T2 SOFOSBUVIR/VELPATEPCLUSA
PA
ASVIR
HEP C VIRUS,NUCLEOTIDE ANALOG NS5B
POLYMERASE INH
T2 SOFOSBUVIR
SOVALDI
PA
HEPATITIS B TREATMENT AGENTS
T1 ADEFOVIR
HEPSERA
QL
DIPIVOXIL
T2 ENTECAVIR
BARACLUDE (0.05
QL
MG/ML) (SOLUTION)
T1 ENTECAVIR
BARACLUDE (0.5
QL
MG) (TABLET)
T1 ENTECAVIR
BARACLUDE (1 MG) QL
(TABLET)
T1 LAMIVUDINE
EPIVIR HBV (100 MG)QL
(TABLET)
T2 LAMIVUDINE
EPIVIR HBV (25 MG/5 QL
ML) (SOLUTION)
HEPATITIS C TREATMENT AGENTS
T2 PEGINTERFERON
PEGASYS
PA
ALFA-2A
T2 PEGINTERFERON
PEGASYS PROCLICK PA
ALFA-2A
T1 RIBAVIRIN
COPEGUS
T1 RIBAVIRIN
MODERIBA (200 MG)
(TABLET)
T1 RIBAVIRIN
REBETOL (200 MG)
(CAPSULE)
T2 RIBAVIRIN
REBETOL (40
MG/ML) (SOLUTION)
VNSNY
HEPATITIS C VIRUS- NS5A AND NS3/4A INHIBITOR
COMB
T2 ELBASVIR/GRAZOPR ZEPATIER
PA
EVIR
INFLAMMATORY DISEASE
ANTI-ARTHRITIC AND CHELATING AGENTS
T2 PENICILLAMINE
CUPRIMINE
T2 PENICILLAMINE
DEPEN
PA
PA
ANTI-ARTHRITIC, FOLATE ANTAGONIST AGENTS
T2 METHOTREXATE/PF RASUVO
ST, QL
(10MG/0.2ML) (AUTO
INJCT)
T2 METHOTREXATE/PF RASUVO (12.5/0.25) ST, QL
(AUTO INJCT)
T2 METHOTREXATE/PF RASUVO
ST, QL
(15MG/0.3ML) (AUTO
INJCT)
T2 METHOTREXATE/PF RASUVO (17.5/0.35) ST, QL
(AUTO INJCT)
T2 METHOTREXATE/PF RASUVO
ST, QL
(20MG/0.4ML) (AUTO
INJCT)
T2 METHOTREXATE/PF RASUVO (22.5/0.45) ST, QL
(AUTO INJCT)
T2 METHOTREXATE/PF RASUVO
ST, QL
(25MG/0.5ML) (AUTO
INJCT)
T2 METHOTREXATE/PF RASUVO (27.5/0.55) ST, QL
(AUTO INJCT)
T2 METHOTREXATE/PF RASUVO
ST, QL
(30MG/0.6ML) (AUTO
INJCT)
T2 METHOTREXATE/PF RASUVO (7.5MG/0.15)ST, QL
(AUTO INJCT)
ANTI-FLAM. INTERLEUKIN-1 RECEPTOR
ANTAGONIST
T2 RILONACEPT
ARCALYST
ANTI-INFLAMMATORY TUMOR NECROSIS FACTOR
INHIBITOR
T2 ETANERCEPT
ENBREL
PA
T2 GOLIMUMAB
SIMPONI
PA
ANTI-INFLAMMATORY, PYRIMIDINE SYNTHESIS
INHIBITOR
T1 LEFLUNOMIDE
ARAVA
ANTI-INFLAMMATORY,PHOSPHODIESTERASE4(PDE4) INHIB.
T2 APREMILAST
OTEZLA
PA
ANTINFLAMMATORY, SEL.COSTIM.MOD.,T-CELL
INHIBITOR
T2 ABATACEPT
ORENCIA
PA
T2 ABATACEPT
ORENCIA
PA
CLICKJECT
BRADYKININ B2 RECEPTOR ANTAGONISTS
T2 ICATIBANT ACETATE FIRAZYR
PA
Page 51 of 116
C1 ESTERASE INHIBITORS
T2 C1 ESTERASE
BERINERT
INHIBITOR
T2 C1 ESTERASE
CINRYZE
INHIBITOR
T2 C1 ESTERASE
RUCONEST
INHIBITOR, RECOMB
GLUCOCORTICOIDS
T1 BUDESONIDE
T1 CORTISONE
ACETATE
T1 DEXAMETHASONE
T1 DEXAMETHASONE
T1 DEXAMETHASONE
T1 HYDROCORTISONE
T1 METHYLPREDNISO
LONE
T2 METHYLPREDNISOL
ONE
T1 METHYLPREDNISO
LONE
T1 METHYLPREDNISO
LONE
T1 METHYLPREDNISO
LONE
T1 METHYLPREDNISO
LONE
T2 PREDNISOLONE
T2 PREDNISOLONE
T1 PREDNISOLONE
T1 PREDNISOLONE
SOD PHOSPHATE
T1 PREDNISOLONE
SOD PHOSPHATE
T1 PREDNISOLONE
SOD PHOSPHATE
T1 PREDNISOLONE
SOD PHOSPHATE
T1 PREDNISONE
T1 PREDNISONE
T2 PREDNISONE
GOLD SALTS
T2 AURANOFIN
PA
PA
PA
ENTOCORT EC
CORTONE
DECADRON
DEXAMETHASONE
HEXADROL
CORTEF
MEDROL (16 MG)
(TABLET)
MEDROL (2 MG)
(TABLET)
MEDROL (32 MG)
(TABLET)
MEDROL (4 MG)
(TAB DS PK)
MEDROL (4 MG)
(TABLET)
MEDROL (8 MG)
(TABLET)
MILLIPRED
MILLIPRED DP
ORAPRED
ORAPRED
ORAPRED ODT
PEDIAPRED
PREDNISOLONE SOD
PHOSPHATE
DELTASONE
PREDNISONE
PREDNISONE
INTENSOL
RIDAURA
INTERLEUKIN-6 (IL-6) RECEPTOR INHIBITORS
T2 TOCILIZUMAB
ACTEMRA
PA
JANUS KINASE (JAK) INHIBITORS
T2 TOFACITINIB
XELJANZ
CITRATE
T2 TOFACITINIB
XELJANZ XR
CITRATE
PA
PA
MINERALOCORTICOIDS
T1 FLUDROCORTISON FLORINEF
E ACETATE
NSAIDS, CYCLOOXYGENASE 2 INHIBITOR - TYPE
T1 CELECOXIB
CELEBREX
VNSNY
NSAIDS, CYCLOOXYGENASE INHIBITOR-TYPE
T1 CELECOXIB
CELEBREX
T1 DICLOFENAC
CATAFLAM
POTASSIUM
T1 DICLOFENAC
VOLTAREN
SODIUM
T1 DICLOFENAC
VOLTAREN-XR
SODIUM
T1 ETODOLAC
LODINE
T1 ETODOLAC
LODINE XL
T1 FENOPROFEN
FENORTHO (200 MG)
CALCIUM
(CAPSULE)
T1 FENOPROFEN
NALFON (600 MG)
CALCIUM
(TABLET)
T1 FLURBIPROFEN
ANSAID
T5 IBUPROFEN
ADVIL (200 MG)
(TABLET) (OTC)
T5 IBUPROFEN
CHILDREN'S ADVIL
T5 IBUPROFEN
CHILDREN'S
MOTRIN
T1 IBUPROFEN
MOTRIN (100
MG/5ML) (ORAL
SUSP)
T1 IBUPROFEN
MOTRIN (400 MG)
(TABLET)
T1 IBUPROFEN
MOTRIN (600 MG)
(TABLET)
T1 IBUPROFEN
MOTRIN (800 MG)
(TABLET)
T5 IBUPROFEN
MOTRIN IB
T1 INDOMETHACIN
INDOCIN (25 MG)
(CAPSULE)
T2 INDOMETHACIN
INDOCIN (25 MG/5
ML) (ORAL SUSP)
T1 INDOMETHACIN
INDOCIN (50 MG)
(CAPSULE)
T2 INDOMETHACIN
INDOCIN (50 MG)
(SUPP.RECT)
T1 INDOMETHACIN
INDOCIN (75 MG)
(CAPSULE ER)
T1 KETOPROFEN
ORUDIS
T1 KETOPROFEN
ORUVAIL
T1 KETOROLAC
TORADOL (10 MG)
TROMETHAMINE
(TABLET)
T1 KETOROLAC
TORADOL (15
TROMETHAMINE
MG/ML)
(CARTRIDGE)
T1 KETOROLAC
TORADOL (15
TROMETHAMINE
MG/ML) (VIAL)
T1 KETOROLAC
TORADOL (30
TROMETHAMINE
MG/ML)
(CARTRIDGE)
T1 KETOROLAC
TORADOL (30
TROMETHAMINE
MG/ML) (VIAL)
T1 KETOROLAC
TORADOL
TROMETHAMINE
(30MG/ML(1)) (VIAL)
T1 KETOROLAC
TORADOL (60 MG/2
TROMETHAMINE
ML) (VIAL)
T1 MECLOFENAMATE MECLOMEN
SODIUM
T1 MELOXICAM
MOBIC
T1 NABUMETONE
RELAFEN
Page 52 of 116
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
NAPROXEN
EC-NAPROSYN
NAPROXEN
NAPROSYN
NAPROXEN SODIUM ANAPROX
NAPROXEN SODIUM ANAPROX DS
NAPROXEN SODIUM NAPRELAN (500 MG)
(TBMP 24HR)
OXAPROZIN
DAYPRO
PIROXICAM
FELDENE
SULINDAC
CLINORIL
TOLMETIN SODIUM TOLECTIN
TOLMETIN SODIUM TOLECTIN DS
LOCAL ANESTHESIA
LOCAL ANESTHETICS
T1 LIDOCAINE HCL
T1 LIDOCAINE HCL
T1 LIDOCAINE HCL
T1 LIDOCAINE HCL
GLYDO
LIDOCAINE HCL
XYLOCAINE
XYLOCAINE VISCOU
S
LOWER GASTROINTESTINAL
DISORDERS - BOWEL INFLAMMAT
BOWEL ANTIINFLAMATORY AGENTS
T1 SULFADIAZINE
SULFADIAZINE
CHRONIC INFLAM. COLON DX, 5-ASALICYLAT,RECTAL TX
T2 MESALAMINE
CANASA
T1 MESALAMINE
SFROWASA
T1 MESALAMINE
ROWASA
W/CLEANSING
WIPES
DRUG TX-CHRONIC INFLAM. COLON DX,5AMINOSALICYLAT
T1 BALSALAZIDE
COLAZAL
DISODIUM
T2 MESALAMINE
APRISO
T1 SULFASALAZINE
AZULFIDINE
DRUGS TO TX CHRONIC INFLAMM. DISEASE OF
COLON
T2 CERTOLIZUMAB
CIMZIA
PA
PEGOL
HEMORRHOIDAL PREP, ANTI-INFAM
STEROID/LOCAL ANESTH
T1 HYDROCORTISONE/ ANA-LEX HC
LIDOCAINE/ALOE
T1 HYDROCORTISONE/ ANAMANTLE HC
LIDOCAINE/ALOE
T1 HYDROCORTISONE/ HYDROCORTISONE/
LIDOCAINE/ALOE LIDOCAINE/ALOE
T1 HYDROCORTISONE/ RECTAGEL HC
LIDOCAINE/ALOE
T1 HYDROCORTISONE/ ANALPRAM HC (2.5
PRAMOXINE
%-1 %)
(CREAM/APPL)
T1 HYDROCORTISONE/ PRAMCORT
PRAMOXINE
VNSNY
T2
T1
T1
HYDROCORTISONE/P PROCTOFOAM-HC
RAMOXINE
LIDOCAINE/HYDRO ANAMANTLE HC
CORTISONE AC
LIDOCAINE/HYDRO ANAMANTLE HC
CORTISONE AC
FORTE
IRRITABLE BOWEL AGENTS,GUANYLATE CYLASE-C
AGONIST
T2 LINACLOTIDE
LINZESS
QL
RECTAL/LOWER BOWEL PREP.,GLUCOCORT. (NONHEMORR)
T1 HYDROCORTISONE CORTENEMA
LOWER GASTROINTESTINAL
DISORDERS - OTHER
AMMONIA INHIBITORS
T2 CARGLUMIC ACID
T2 GLYCEROL
PHENYLBUTYRATE
T1 LACTULOSE
T1 SODIUM
PHENYLBUTYRATE
T2 SODIUM
PHENYLBUTYRATE
ANTIDIARRHEALS
T5 BISMUTH
SUBSALICYLATE
CARBAGLU
RAVICTI
CHRONULAC
BUPHENYL (0.94
G/G) (POWDER)
BUPHENYL (500 MG)
(TABLET)
BISMUTH
SUBSALICYLATE
(262 MG) (TAB
CHEW) (OTC)
BISMUTH
SUBSALICYLATE
(262 MG) (TABLET)
(OTC)
BISMUTH
SUBSALICYLATE
(262MG/15ML) (ORAL
SUSP) (OTC)
LOMOTIL
T5
BISMUTH
SUBSALICYLATE
T5
BISMUTH
SUBSALICYLATE
T1
DIPHENOXYLATE
HCL/ATROPINE
LOPERAMIDE HCL IMODIUM
LOPERAMIDE HCL LOPERAMIDE HCL (1
MG/5 ML) (LIQUID)
(OTC)
LOPERAMIDE HCL LOPERAMIDE HCL (2
MG) (CAPSULE)
(OTC)
OPIUM TINCTURE OPIUM TINCTURE
PAREGORIC
PAREGORIC
T1
T5
T1
T1
T1
BILE SALTS
T1 URSODIOL
T1 URSODIOL
T1 URSODIOL
PA
ACTIGALL
URSO
URSO FORTE
FARNESOID X RECEPTOR (FXR) AGONIST, BILE AC
ANALOG
T2 OBETICHOLIC ACID OCALIVA
PA
LAXATIVES AND CATHARTICS
T5 BISACODYL
CORRECTOL
Page 53 of 116
T5
T5
BISACODYL
CASTOR OIL
T5
T5
T1
DOCUSATE SODIUM
DOCUSATE SODIUM
DOCUSATE SODIUM
T5
DOCUSATE SODIUM
DULCOLAX
CASTOR OIL (OIL)
(OTC)
COLACE
COLACE CLEAR
DOCUSATE SODIUM
(100 MG) (CAPSULE)
(OTC)
DOCUSATE SODIUM
(100 MG) (TABLET)
(OTC)
DOCUSATE SODIUM
(50 MG/5 ML)
(LIQUID) (OTC)
SOF-LAX
FIBER-STAT
T5
DOCUSATE SODIUM
T5
T1
DOCUSATE SODIUM
FRUCTOOLIGOSACC
H/MALTODEXTRIN
FRUCTOOLIGOSACC FIBER-STAT
HARIDES/POLYDEX
LACTULOSE
CHRONULAC
LACTULOSE
KRISTALOSE
LUBIPROSTONE
AMITIZA
QL
MAGNESIUM
PHILLIPS' MILK OF
HYDROXIDE
MAGNESIA
METHYLCELLULOS CITRUCEL
E
MINERAL OIL
MINERAL OIL
MINERAL OIL
MINERAL OIL
PEG3350/SOD
COLYTE WITH
SULF,BICARB,CL/KC FLAVOR PACKETS
L
PEG3350/SOD
GOLYTELY (227.1SULF,BICARB,CL/KC 21.5) (POWD PACK)
L
PEG3350/SOD
GOLYTELY (236SULF,BICARB,CL/KC 22.74G) (SOLN
L
RECON)
POLYETHYLENE
GAVILAX
GLYCOL 3350
POLYETHYLENE
MIRALAX
GLYCOL 3350
PSYLLIUM HUSK
NATURAL
(WITH SUGAR)
VEGETABLE FIBER
(3.4 G/7 G) (POWDER)
(OTC)
PSYLLIUM HUSK
PSYLLIUM HUSK
(WITH SUGAR)
(WITH SUGAR) (3.4
G/12 G) (POWDER)
(OTC)
PSYLLIUM HUSK
PSYLLIUM HUSK
(WITH SUGAR)
(WITH SUGAR) (3.4
G/7 G) (POWDER)
(OTC)
PSYLLIUM HUSK
WAL-MUCIL
(WITH SUGAR)
PSYLLIUM
KONSYL (3.5G/5.8G)
HUSK/ASPARTAME (POWDER) (OTC)
PSYLLIUM
METAMUCIL
HUSK/ASPARTAME MULTIHEALTH
FIBER
PSYLLIUM
PSYLLIUM
HUSK/ASPARTAME HUSK/ASPARTAME
T1
T1
T2
T2
T5
T5
T5
T5
T1
T2
T1
T1
T1
T5
T5
T5
T5
T5
T5
T5
VNSNY
T5
T5
T5
T5
T5
T5
T5
T1
PSYLLIUM
HUSK/ASPARTAME
PSYLLIUM SEED
WAL-MUCIL
PSYLLIUM SEED
(3.4G/5.8G)
(POWDER) (OTC)
PSYLLIUM SEED
PSYLLIUM SEED
(POWDER) (OTC)
PSYLLIUM SEED
PSYLLIUM SEED
(WITH DEXTROSE) (WITH DEXTROSE)
PSYLLIUM SEED
PSYLLIUM SEED
(WITH SUGAR)
(WITH SUGAR)
PSYLLIUM
PSYLLIUM
SEED/ASPARTAME SEED/ASPARTAME
SENNOSIDES
SENOKOT (8.6 MG)
(TABLET) (OTC)
SODIUM
NULYTELY WITH
CHLORIDE/NAHCO3 FLAVOR PACKS
/KCL/PEG
LAXATIVES, LOCAL/RECTAL
T5 BISACODYL
DULCOLAX
T5 DOCUSATE SODIUM DOCUSATE SODIUM
(283 MG) (ENEMA)
(OTC)
T5 DOCUSATE SODIUM DOCUSATE SODIUM
(283 MG/5ML)
(ENEMA) (OTC)
NARCOTIC ANTAGONISTS, PERIPHERALLY-ACTING
T2 NALOXEGOL
MOVANTIK
QL
OXALATE
SBS - GLUCAGON-LIKE PEPTIDE-2 (GLP-2) ANALOGS
T2 TEDUGLUTIDE
GATTEX
PA
MISCELLANEOUS AGENTS
ANAPHYLAXIS THERAPY AGENTS
T1 EPINEPHRINE
ADRENACLICK
T1 EPINEPHRINE
EPIPEN
T1 EPINEPHRINE
EPIPEN 2-PAK
T1 EPINEPHRINE
EPIPEN JR 2-PAK
PARASYMPATHETIC AGENTS
T1 BETHANECHOL
URECHOLINE
CHLORIDE
T1 GUANIDINE HCL
GUANIDINE
T1 PILOCARPINE HCL SALAGEN
SYSTEMIC ENZYME INHIBITORS
T2 ALPHA-1ARALAST NP
PROTEINASE
INHIBITOR
T2 ALPHA-1PROLASTIN C
PROTEINASE
INHIBITOR
T2 ALPHA-1ZEMAIRA
PROTEINASE
INHIBITOR
NEOPLASTIC DISEASE
ALKYLATING AGENTS
T2 ALTRETAMINE
HEXALEN
Page 54 of 116
T2
T2
T2
T2
T1
T2
T2
T1
BUSULFAN
MYLERAN
CARMUSTINE IN
GLIADEL
POLIFEPROSAN 20
CHLORAMBUCIL
LEUKERAN
CYCLOPHOSPHAMID CYCLOPHOSPHAMI
E
DE
HYDROXYUREA
HYDREA
LOMUSTINE
GLEOSTINE (5 MG)
(CAPSULE)
MELPHALAN
ALKERAN
TEMOZOLOMIDE TEMODAR
PA
ANTIANDROGENIC AGENTS
T2 ABIRATERONE
ZYTIGA
ACETATE
T1 BICALUTAMIDE
CASODEX
T2 ENZALUTAMIDE
XTANDI
T1 FLUTAMIDE
EULEXIN
T1 NILUTAMIDE
NILANDRON
PA, QL
PA, QL
ANTINEOPLASTIC - MEK1 AND MEK2 KINASE
INHIBITORS
T2 COBIMETINIB
COTELLIC
PA, QL
FUMARATE
T2 TRAMETINIB
MEKINIST
PA
DIMETHYL
SULFOXIDE
ANTINEOPLASTIC - MTOR KINASE INHIBITORS
T2 EVEROLIMUS
AFINITOR (10 MG) PA, QL
(TABLET)
T2 EVEROLIMUS
AFINITOR (2.5 MG) PA, QL
(TABLET)
T2 EVEROLIMUS
AFINITOR (5 MG)
PA, QL
(TABLET)
T2 EVEROLIMUS
AFINITOR (7.5 MG) PA, QL
(TABLET)
T2 EVEROLIMUS
AFINITOR DISPERZ PA
QL
ANTIMETABOLITES
T1 CAPECITABINE
ANTINEOPLASTIC - TOPOISOMERASE I INHIBITORS
T2 TOPOTECAN HCL
HYCAMTIN
PA, QL
T1
PA, QL
ANTINEOPLASTIC IMMUNOMODULATOR AGENTS
T2 LENALIDOMIDE
REVLIMID
PA, QL
T2 PEGINTERFERON
SYLATRON
QL
ALFA-2B
T2 POMALIDOMIDE
POMALYST
PA
T1
T2
T1
T2
T2
T1
T2
T2
T1
T2
T2
XELODA (150 MG)
(TABLET)
CAPECITABINE
XELODA (500 MG)
(TABLET)
MERCAPTOPURINE PURINETHOL
MERCAPTOPURINE PURIXAN
METHOTREXATE
FOLEX
SODIUM
METHOTREXATE
TREXALL (10 MG)
SODIUM
(TABLET)
METHOTREXATE
TREXALL (15 MG)
SODIUM
(TABLET)
METHOTREXATE
TREXALL (2.5 MG)
SODIUM
(TABLET)
METHOTREXATE
TREXALL (5 MG)
SODIUM
(TABLET)
METHOTREXATE
TREXALL (7.5 MG)
SODIUM
(TABLET)
METHOTREXATE
FOLEX
SODIUM/PF
THIOGUANINE
TABLOID
TRIFLURIDINE/TIPIR LONSURF
ACIL HCL
ST
ANTINEOPLASTIC LHRH(GNRH)
ANTAGONIST,PITUIT.SUPPRS
T2 DEGARELIX
FIRMAGON (120 MG) QL
ACETATE
(VIAL)
T2 DEGARELIX
FIRMAGON (80 MG) QL
ACETATE
(VIAL)
PA
ANTINEOPLASTIC AROMATASE INHIBITORS
T1 ANASTROZOLE
ARIMIDEX
T1 EXEMESTANE
AROMASIN
T1 LETROZOLE
FEMARA
ANTINEOPLASTIC - HEDGEHOG PATHWAY
INHIBITOR
T2 SONIDEGIB
ODOMZO
PHOSPHATE
T2 VISMODEGIB
ERIVEDGE
ANTINEOPLASTIC - JANUS KINASE (JAK)
INHIBITORS
T2 RUXOLITINIB
JAKAFI
PHOSPHATE
VNSNY
PA
PA, QL
PA, QL
ANTINEOPLASTIC SYSTEMIC ENZYME INHIBITORS
T2 AFATINIB
GILOTRIF
PA
DIMALEATE
T2 ALECTINIB HCL
ALECENSA
PA, QL
T2 AXITINIB
INLYTA (1 MG)
PA, QL
(TABLET)
T2 AXITINIB
INLYTA (5 MG)
PA, QL
(TABLET)
T2 BOSUTINIB
BOSULIF (100 MG) PA, QL
(TABLET)
T2 BOSUTINIB
BOSULIF (500 MG) PA, QL
(TABLET)
T2 CABOZANTINIB SCABOMETYX
PA
MALATE
T2 CABOZANTINIB SCOMETRIQ
PA, QL
MALATE
T2 CERITINIB
ZYKADIA
PA
T2 CRIZOTINIB
XALKORI
PA, QL
T2 DABRAFENIB
TAFINLAR
PA
MESYLATE
T2 DASATINIB
SPRYCEL (100 MG) PA, QL
(TABLET)
T2 DASATINIB
SPRYCEL (140 MG) PA, QL
(TABLET)
T2 DASATINIB
SPRYCEL (20 MG)
PA, QL
(TABLET)
T2 DASATINIB
SPRYCEL (50 MG)
PA, QL
(TABLET)
Page 55 of 116
T2
T2
T2
T2
T2
T2
T2
T2
T1
T1
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
DASATINIB
SPRYCEL (70 MG)
(TABLET)
DASATINIB
SPRYCEL (80 MG)
(TABLET)
ERLOTINIB HCL
TARCEVA (100 MG)
(TABLET)
ERLOTINIB HCL
TARCEVA (150 MG)
(TABLET)
ERLOTINIB HCL
TARCEVA (25 MG)
(TABLET)
GEFITINIB
IRESSA
IBRUTINIB
IMBRUVICA
IDELALISIB
ZYDELIG
IMATINIB
GLEEVEC (100 MG)
MESYLATE
(TABLET)
IMATINIB
GLEEVEC (400 MG)
MESYLATE
(TABLET)
IXAZOMIB CITRATE NINLARO
LAPATINIB
TYKERB
DITOSYLATE
LENVATINIB
LENVIMA
MESYLATE
NILOTINIB HCL
TASIGNA
OLAPARIB
LYNPARZA
OSIMERTINIB
TAGRISSO
MESYLATE
PALBOCICLIB
IBRANCE
PAZOPANIB HCL
VOTRIENT
PONATINIB HCL
ICLUSIG (15 MG)
(TABLET)
PONATINIB HCL
ICLUSIG (45 MG)
(TABLET)
REGORAFENIB
STIVARGA
SORAFENIB
NEXAVAR
TOSYLATE
SUNITINIB MALATE SUTENT
VANDETANIB
CAPRELSA (100 MG)
(TABLET)
VANDETANIB
CAPRELSA (300 MG)
(TABLET)
VEMURAFENIB
ZELBORAF
ANTINEOPLASTIC,HISTONE DEACETYLASE
INHIBITORS,HDIS
T2 PANOBINOSTAT
FARYDAK
LACTATE
T2 VORINOSTAT
ZOLINZA
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA
PA
PA
PA, QL
PA, QL
PA
PA
PA
PA, QL
PA, QL
PA, QL
PA
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA
ANTINEOPLASTIC-B CELL LYMPHOMA-2(BCL-2)
INHIBITORS
T2 VENETOCLAX
VENCLEXTA
PA
T2 VENETOCLAX
VENCLEXTA
PA
STARTING PACK
ANTINEOPLASTICS,MISCELLANEOUS
T1 ETOPOSIDE
VEPESID
T2 MITOTANE
LYSODREN
T2 OMACETAXINE
SYNRIBO
MEPESUCCINATE
T2 PROCARBAZINE HCL MATULANE
VNSNY
PA
CHEMOTHERAPY RESCUE/ANTIDOTE AGENTS
T1 LEUCOVORIN
WELLCOVORIN
CALCIUM
T2 URIDINE
VISTOGARD
QL
TRIACETATE
INTRAPLEURAL SCLEROSING AGENTS,
ANTINEOPLAST. ADJ.
T1 TALC
STERITALC
SELECTIVE ESTROGEN RECEPTOR MODULATORS
(SERM)
T1 TAMOXIFEN
NOLVADEX
CITRATE
T2 TAMOXIFEN CITRATESOLTAMOX
T2 TOREMIFENE
FARESTON
PA
CITRATE
SELECTIVE RETINOID X RECEPTOR AGONISTS
(RXR)
T1 BEXAROTENE
TARGRETIN
PA
STEROID ANTINEOPLASTICS
T2 ESTRAMUSTINE
EMCYT
PHOSPHATE SODIUM
T1 MEGESTROL
MEGACE
ACETATE
NEUROLOGICAL DISEASE MISCELLANEOUS
AGENTS TO TREAT MULTIPLE SCLEROSIS
T2 DIMETHYL
TECFIDERA
FUMARATE
T2 FINGOLIMOD HCL
GILENYA
T1 GLATIRAMER
COPAXONE (20
ACETATE
MG/ML) (SYRINGE)
T2 GLATIRAMER
COPAXONE (40
ACETATE
MG/ML) (SYRINGE)
T2 INTERFERON BETA- AVONEX
1A
T2 INTERFERON BETA- AVONEX PEN
1A
T2 INTERFERON BETA- AVONEX
1A/ALBUMIN
T2 INTERFERON BETA- REBIF
1A/ALBUMIN
T2 INTERFERON BETA- REBIF REBIDOSE
1A/ALBUMIN
T2 TERIFLUNOMIDE
AUBAGIO
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
AMYOTROPHIC LATERAL SCLEROSIS AGENTS
T1 RILUZOLE
RILUTEK
FIBROMYALGIA AGENTS,SEROTONIN-NOREPINEPH
RU INHIB
T2 MILNACIPRAN HCL SAVELLA
MOVEMENT DISORDERS(DRUG THERAPY)
T1 TETRABENAZINE XENAZINE
PA
Page 56 of 116
ORAL/PHARYNGEAL DISORDERS
DENTAL AIDS AND PREPARATIONS
T1 CHLORHEXIDINE PERIDEX
GLUCONATE
T1 TRIAMCINOLONE KENALOG IN
ACETONIDE
ORABASE
NOSE PREPARATIONS ANTIBIOTICS
T2 MUPIROCIN
BACTROBAN NASAL
CALCIUM
NOSE PREPARATIONS, MISCELLANEOUS (RX)
T1 IPRATROPIUM
ATROVENT
BROMIDE
PERIODONTAL COLLAGENASE INHIBITORS
T1 DOXYCYCLINE
PERIOSTAT
HYCLATE
OTHER DRUGS
ANTIOXIDANT AGENTS
T5 B-CAROTENE/VIT
C/E/LUT/MIN 29
T5 BETACAROTENE(A)C,E/SELENIUM
T1
T5
T1
T1
T1
T1
T1
T1
T1
MACUVITE WITH
LUTEIN
BETA-CAROTENE(A)C,E/SELENIUM
(CAPSULE) (OTC)
APPETITE STIM. FOR
ANOREXIA,CACHEXIA,WASTING SYND.
T1 MEGESTROL
MEGACE
ACETATE
T1 MEGESTROL
MEGACE ES
ACETATE
DIETARY SUPPLEMENT, MISCELLANEOUS
T1 ALBUMEN (EGG
ALBUMEN (EGG
WHITE)
WHITE)
T1 AMINO AC/PROTEIN AMINO AC/PROTEIN PA
HYDR/WHEY PRO HYDR/WHEY PRO
(10G-100/30) (LIQUID)
(OTC)
T1 AMINO AC/PROTEIN PROSOURCE PLUS PA
HYDR/WHEY PRO
T1 AMINO
PROSOURCE ZAC
PA
ACID/PROTEIN/VIT
C/ZINC
T1 AMINO
G-PREPROTEIN (15 PA
ACIDS/PROTEIN
G-60/30) (LIQUID)
HYDROLYS
(OTC)
T1 AMINO
PRE-PROTEIN (15 G- PA
ACIDS/PROTEIN
60/30) (LIQUID) (OTC)
HYDROLYS
T1 AMINO
PROSOURCE NO
PA
ACIDS/PROTEIN
CARB
HYDROLYS
T1 APPLE JUICE
APPLE JUICE
T1 B3/AZEL/QUER/TUR/ NICAZEL FORTE
FA/B6/ZN/COPP
T1 CALORIC
DUOCAL
PA
SUPPLEMENT
T1 CRANBERRY JUICE THICKENUP
VNSNY
T5
T1
T1
T1
T1
T1
T1
T1
T1
T5
T1
T5
T1
T1
T1
T1
T1
DIETARY
SUPPLEMENT
DIETARY
SUPPLEMENT
(CAPSULE) (OTC)
DIETARY
DIETARY
PA
SUPPLEMENT
SUPPLEMENT
(POWDER) (OTC)
FA/MV,CALC,IRON/P FA/MV,CALC,IRON/P
OLLEN/HERB101
OLLEN/HERB101
FISH OIL/OMFISH OIL/OM3/E/FOLIC/B6-B12
3/E/FOLIC/B6-B12
LACTOSE-REDUCED ENSURE ACTIVE
PA
FOOD
CLEAR (LIQUID)
(OTC)
LACTOSE-REDUCED ENSURE ACTIVE
PA
FOOD
MUSCLE HEALTH
LACTOSE-REDUCED ENSURE MUSCLE
PA
FOOD
HEALTH
LACTOSE-REDUCED ENSURE POWDER
PA
FOOD
LACTOSE-REDUCED ISOSOURCE HN (0.05 PA
FOOD
G-1.2) (LIQUID) (OTC)
LACTOSE-REDUCED LACTOSE-REDUCED PA
FOOD
FOOD (0.04G-1.05)
(LIQUID) (OTC)
LACTOSE-REDUCED LACTOSE-REDUCED PA
FOOD
FOOD (0.05 G-1.5)
(LIQUID) (OTC)
LACTOSE-REDUCED LACTOSE-REDUCED PA
FOOD
FOOD (LIQUID)
(OTC)
LACTOSE-REDUCED ENSURE WITH FIBERPA
FOOD/FIBER
LACTOSE-REDUCED ISOSOURCE 1.5 CAL PA
FOOD/FIBER
TUBE FEED
LACTOSE-REDUCED JEVITY 1.2 CAL (0.06 PA
FOOD/FIBER
G-1.2) (LIQUID) (OTC)
LACTOSE-REDUCED JEVITY 1.5 CAL (0.06 PA
FOOD/FIBER
G-1.5) (LIQUID) (OTC)
MILK BASED
MILK BASED
PA
FORMULA
FORMULA
MILK BASED
THICKENUP (0.03 GFORMULA/CORN
0.7) (LIQUID) (OTC)
STARCH
MULTIVITMULTIVITMIN/IRON/FOLIC/HRMIN/IRON/FOLIC/HR
B186
B186 (3.3 MG-25)
(TABLET) (OTC)
MULTIVITMULTIVITMIN43/LUT/OM3/DH MIN43/LUT/OM3/DH
A/EPA
A/EPA
MV-MINS/FOLIC
MV-MINS/FOLIC
ACID/GUARANA/CAFACID/GUARANA/CAF
NUT TX, LACTBOOST VHC
PA
REDUCED, IRON
NUT.SUP,SPEC,LAC- NUT.SUP,SPEC,LAC- PA
FREE,IRON/FOS
FREE,IRON/FOS
NUT.SUP,SPEC,LAC- TWOCAL HN (0.08G- PA
FREE,IRON/FOS
2/ML) (LIQUID) (OTC)
NUT.TX. METABOLIC POLYCAL
PA
DISORDER,REG
NUT.TX.COMP.
IMPACT 1 CAL
PA
IMMUNE SYSTM,REG
Page 57 of 116
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
NUT.TX.COMP.
PIVOT 1.5 CAL
PA
IMMUNE SYSTM,REG
NUT.TX.IMPAIR
PEPTAMEN 1.5 CAL PA
DIGES/INULIN/FOS WITH PREBIO1
(0.068G-1.5) (LIQUID)
(OTC)
NUT.TX.IMPAIR
PEPTAMEN JUNIOR PA
DIGES/INULIN/FOS 1.5 (0.045G-1.5)
(LIQUID) (OTC)
NUT.TX.IMPAIRED
ENSURE CLEAR
PA
DIGEST FXN
(0.035-1/ML) (LIQUID)
(OTC)
NUT.TX.IMPAIRED NUT.TX.IMPAIRED PA
RENAL FXN,SOY
RENAL FXN,SOY
NUTRIT
FIBERSOURCE HN PA
SUPP/INULIN/FOS/FIB (0.05 G-1.2) (LIQUID)
ER
(OTC)
NUTRITIONAL
PEPTAMEN JUNIOR PA
SUPP/INULIN/FOS
WITH PREBIO1
(0.03G-1/ML)
(LIQUID) (OTC)
NUTRITIONAL
EO28 SPLASH
PA
SUPPLEMENT
NUTRITIONAL
HI-CAL
PA
SUPPLEMENT
NUTRITIONAL
NUTRAMENT
PA
SUPPLEMENT
NUTRITIONAL
OSMOLITE 1.5 CAL PA
SUPPLEMENT
(0.06 G-1.5) (LIQUID)
(OTC)
NUTRITIONAL
PEDIASURE PEPTIDE PA
SUPPLEMENT
1.0 CAL
NUTRITIONAL
PEDIASURE PEPTIDE PA
SUPPLEMENT
1.5 CAL (0.045G-1.5)
(LIQUID) (OTC)
NUTRITIONAL
PROMOTE WITH
PA
SUPPLEMENT/FIBER FIBER (0.06G-1/ML)
(LIQUID) (OTC)
NUTRITIONAL
NUTRITIONAL
PA
SUPPLEMENT/MCT SUPPLEMENT/MCT
ORANGE JUICE
ORANGE JUICE
PEDI
COMPLEAT
PA
NUTRIT,IRON,LAC- PEDIATRIC
FREE,FIBR
PEDI
PEDIASURE 1.5 WITH PA
NUTRIT,IRON,LAC- FIBER
FREE,FIBR
PEDI
PEDIASURE
PA
NUTRIT,IRON,LAC- ENTERAL WITH
FREE,FIBR
FIBER
PEDI
PEDIASURE
PA
NUTRIT,IRON,LAC- SIDEKICKS
FREE,FIBR
PEDI
PEDIASURE WITH
PA
NUTRIT,IRON,LAC- FIBER
FREE,FIBR
PEDI
PEDIASMART
PA
NUTRIT.,SOY,IRON,LF ORGANIC DAIRY
/FIBER
PEDI
PEDIASMART
PA
NUTRIT.,SOY,IRON,LF ORGANIC SOY
/FIBER
VNSNY
T1
T1
T1
T1
T1
T1
T1
T5
PEDI
PEDI
PA
NUTRITION,IRON,L NUTRITION,IRON,LA
ACT-FREE
CT-FREE (0.03G1/ML) (LIQUID) (OTC)
PEDI
PEDI
PA
NUTRITION,IRON,L NUTRITION,IRON,LA
ACT-FREE
CT-FREE (0.04G-1.5)
(LIQUID) (OTC)
PEDI
PEDIASURE 1.5
PA
NUTRITION,IRON,LA
CT-FREE
PEDI
PEDIASURE
PA
NUTRITION,MILK
SIDEKICKS
BASED,IRON
PROTEIN
PROTEIN
PA
SUPPLEMENT
SUPPLEMENT
(LIQUID) (OTC)
PROTEIN
PROTEIN
PA
SUPPLEMENT
SUPPLEMENT
(POWDER) (OTC)
SOY PROTEIN
SOY PROTEIN
PA
VIT C/VIT E
VIT C/VIT E
AC/SELENIUM/GINK AC/SELENIUM/GINK
GO
GO
DRUGS TO TREAT HEREDITARY TYROSINEMIA
T2 NITISINONE
ORFADIN
PA
DRUGS TO TX GAUCHER DX-TYPE 1, SUBSTRATE
REDUCING
T2 ELIGLUSTAT
CERDELGA
PA
TARTRATE
T2 MIGLUSTAT
ZAVESCA
PA
HYDROPHILIC CREAM/OINTMENT BASES
T1 HYDROPHILIC
TRIAD
CREAM
INFANT FORMULAS
T1 INF FORM FOR
INF FORM FOR
TYROSINEMIA,
TYROSINEMIA, IRON
IRON
T1 INF FORM,
GLUTAREX-1
GLUTARIC ACIDURIA
I
T1 INF.FORM,METAB,IR INF.FORM,METAB,IR
ON METHION-FR
ON METHION-FR
(16.2G-500)
(POWDER) (OTC)
T1 INF.FORMULA,UREA INF.FORMULA,UREA
CYCLE DISORDR
CYCLE DISORDR
T1 INFANT
INFANT
FORM,PROPIONIC FORM,PROPIONIC
ACIDEMIA
ACIDEMIA
T1 INFANT FORMULA INFANT FORMULA
WITH IRON
WITH IRON
(POWDER) (OTC)
T1 INFANT FORMULA BCAD 1
WITH IRON, MSUD
T1 INFANT FORMULA, NEOCATE INFANT
IRON/DHA/ARA
DHA-ARA (2.8 G5.1G) (POWDER)
(OTC)
Page 58 of 116
T1
INFANT FORMULA, INFANT FORMULA,
METABOLIC,IRON METABOLIC,IRON
METABOLIC DEFICIENCY AGENTS
T2 BETAINE
CYSTADANE
T1 LEVOCARNITINE
LEVOCARNITINE
T1 LEVOCARNITINE
LEVOCARNITINE
(WITH SUGAR)
(WITH SUGAR)
METABOLIC DISEASE ENZYME REPLACE,
HYPOPHOSPHATASIA
T2 ASFOTASE ALFA
STRENSIQ
PA
NUT.TX FOR PKU
WITH IRON NO.35
T1
NUT.TX FOR PKU
WITH IRON NO.4
NUT.TX FOR PKU
WITH IRON NO.4
NUT.TX FOR PKU
WITH IRON NO.4
NUT.TX FOR PKU
WITH IRON NO.40
NUT.TX FOR PKU
WITH IRON NO.42
NUT.TX FOR PKU
WITH IRON NO.45
NUT.TX FOR PKU
WITH IRON NO.45
NUT.TX FOR PKU
WITH IRON NO.50
T1
T1
T1
PA
METALLIC POISON,AGENTS TO TREAT
T2 DEFERASIROX
EXJADE
T2 DEFERIPRONE
FERRIPROX
T1 DEFEROXAMINE
DESFERAL
MESYLATE
T1 DEFEROXAMINE
DESFERAL
MESYLATE
MESYLATE
NEUTRALIZING AGENTS FOR DISINFECTANT
CLEANERS
T5 GLYCINE/SODIUM
HYDE-OUT
HYDROXIDE
NOSE PREPARATIONS, MISCELLANEOUS (OTC)
T1 0.9 % SODIUM
0.9 % SODIUM
CHLORIDE
CHLORIDE
T5 SODIUM CHLORIDE SODIUM CHLORIDE
(0.65 %) (DROPS)
(OTC)
T5 SODIUM CHLORIDE SODIUM CHLORIDE
(0.65 %) (SPRAY)
(OTC)
NUT.TX PHENYLKETONURIA (PKU) FORMULATIONS
T1 INFANT FORMULA PHENEX-1
PA
PKU,IRON NO.2
T1 NUT. TX FOR PKU
PKU TRIO
PA
WITH IRON #48
T1 NUT. TX FOR PKU
PERIFLEX JUNIOR PA
WITH IRON NO.3
T1 NUT. TX FOR PKU
XPHE MAXAMAID PA
WITH IRON NO.5
T1 NUT. TX FOR PKU
XPHE MAXAMUM PA
WITH IRON NO.6
(40G-305) (POWDER)
(OTC)
T1 NUT.THERAPY FOR PHENEX-2
PA
PKU, IRON NO.1
T1 NUT.TX FOR PKU
PERIFLEX ADVANCE PA
WITH IRON NO.20
T1 NUT.TX FOR PKU
PKU 2
PA
WITH IRON NO.21
T1 NUT.TX FOR PKU
PKU 3
PA
WITH IRON NO.21
T1 NUT.TX FOR PKU
PHENYLADE
PA
WITH IRON NO.27
T1 NUT.TX FOR PKU
PHENYLADE60 (60G- PA
WITH IRON NO.27
295) (POWDER) (OTC)
T1 NUT.TX FOR PKU
PHENYLADE60 (60G- PA
WITH IRON NO.27
327) (POWDER) (OTC)
VNSNY
T1
T1
T1
T1
T1
PHENYLADE
PA
ESSENTIAL (25G-390)
(POWDER) (OTC)
PKU COOLER 10
PA
PKU COOLER 15
PA
PKU COOLER 20
PA
PKU LOPHLEX
PA
PKU LOPHLEX
PA
PHENYL-FREE 2
PA
PHENYL-FREE 2HP
PA
PHENYLADE RTD
PKU 10
PA
NUTRITIONAL THERAPY, MED COND SPECIAL
FORMULATION
T1 NUT TX FOR
I-VALEX-2
PA
ISOVALERIC
ACIDEMIA
T1 NUT TX FOR
NUT TX FOR
PA
ISOVALERIC
ISOVALERIC
ACIDEMIA
ACIDEMIA (16.2G500) (POWDER) (OTC)
T1 NUT TX FOR
TYR LOPHLEX
PA
TYROSINEMIA WIRON
T1 NUT TX FOR
TYREX-2
PA
TYROSINEMIA WIRON
T1 NUT TX FOR
TYROS 2
PA
TYROSINEMIA WIRON
T1 NUT. TX FOR
NUT. TX FOR
PA
PROPIONIC
PROPIONIC
ACIDEMIA
ACIDEMIA
T1 NUT. TX FOR
OA2
PA
PROPIONIC
ACIDEMIA
T1 NUT. TX FOR
OS 2
PA
PROPIONIC
ACIDEMIA
T1 NUT. TX FOR
PROPIMEX-2
PA
PROPIONIC
ACIDEMIA
T1 NUT.GLUC INT,LACT- GLUCO BURST
PA
FREE/FOS/DHA
T1 NUT.SOY,LACPEPTAMEN
PA
RED/DHA/EPA/FOS/IN BARIATRIC
T1 NUT.THERAP.GLUTA GLUTAREX-2
PA
RIC ACIDURIA 1
T1 NUT.THERAP.GLUTA NUT.THERAP.GLUTA PA
RIC ACIDURIA 1
RIC ACIDURIA 1
T1 NUT.TX
KETOCAL 4:1 (14.4 G- PA
KETOGENIC,MILK- 701) (POWDER) (OTC)
BASE/SOY
Page 59 of 116
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
NUT.TX
KETOCAL 4:1 (3.09 G- PA
KETOGENIC,MILK- 150) (LIQUID) (OTC)
BASE/SOY
NUT.TX,ELEMENTAL, XTRACAL PLUS
PA
LAC-FREE/MCT
NUT.TX,IMPAIRED
RENA START
PA
RENAL FXN,WHEY
NUT.TX,METAB.DIS,L LEU-FREE COOLER PA
EUCINE-FREE
NUT.TX,METABOLIC HCU COOLER
PA
DIS,METHIO-FR
NUT.TX,METABOLIC HCU LOPHLEX
PA
DIS,METHIO-FR
NUT.TX,METABOLIC HOMINEX-2
PA
DIS,METHIO-FR
NUT.TX,METABOLIC NUT.TX,METABOLIC PA
DIS,METHIO-FR
DIS,METHIO-FR
NUT.TX. METABOLIC HCU COOLER
PA
DISORDER,REG
NUT.TX. METABOLIC HCU COOLER20
PA
DISORDER,REG
NUT.TX. METABOLIC TYR COOLER
PA
DISORDER,REG
NUT.TX. METABOLIC TYR COOLER20
PA
DISORDER,REG
NUT.TX. METABOLIC PERATIVE (0.067G- PA
DISORDER,SOY
1.3) (LIQUID) (OTC)
NUT.TX. METABOLIC PFD 2
PA
DISORDER,SOY
NUT.TX., UREA
CYCLINEX-2
PA
CYCLE DISORDER
NUT.TX., UREA
UCD ANAMIX
PA
CYCLE DISORDER
JUNIOR (12 G-385)
(POWDER) (OTC)
NUT.TX., UREA
UCD TRIO
PA
CYCLE DISORDER
NUT.TX., UREA
WND 2
PA
CYCLE DISORDER
NUT.TX.COMP.
NUT.TX.COMP.
PA
IMMUNE
IMMUNE
SYSTM,REG
SYSTM,REG (0.08G1.4) (LIQUID) (OTC)
NUT.TX.COMP.IMMU NUT.TX.COMP.IMMU PA
NE SYS/SOY FIB
NE SYS/SOY FIB
NUT.TX.GLUC
BOOST GLUCOSE
PA
INTOL,LF,SOY/FIBER CONTROL (0.06 G1.1) (LIQUID) (OTC)
NUT.TX.GLUC
DIABETISOURCE AC PA
INTOL,LF,SOY/FIBER
NUT.TX.GLUC
NUT.TX.GLUC
PA
INTOL,LF,SOY/FIBE INTOL,LF,SOY/FIBER
R
(0.07 G-0.8) (LIQUID)
(OTC)
NUT.TX.IMPAIRED
EO28 SPLASH
PA
DIGEST FXN
NUT.TX.IMPAIRED
LIPISTART
PA
DIGEST FXN
NUT.TX.IMPAIRED
NEOCATE JUNIOR
PA
DIGEST FXN
NUT.TX.IMPAIRED
NEOCATE NUTRA
PA
DIGEST FXN
VNSNY
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
NUT.TX.IMPAIRED
DIGEST FXN,SOY
VIVONEX RTF
PA
(0.05G-1/ML)
(LIQUID) (OTC)
NUT.TX.IMPAIRED
NEOCATE JUNIOR
PA
DIGEST/FIBER
WITH PREBIOTICS
(16 G-459) (POWDER)
(OTC)
NUT.TX.IMPAIRED
NEOCATE JUNIOR
PA
DIGEST/FIBER
WITH PREBIOTICS
(16G-478) (POWDER)
(OTC)
NUT.TX.IMPAIRED
VITAL 1.0 CAL
PA
DIGEST/FIBER
(0.04G-1/ML)
(LIQUID) (OTC)
NUT.TX.IMPAIRED
VITAL 1.5 CAL (0.07 PA
DIGEST/FIBER
G-1.5) (LIQUID) (OTC)
NUT.TX.IMPAIRED
VITAL AF 1.2 CAL
PA
DIGEST/FIBER
(0.08 G-1.2) (LIQUID)
(OTC)
NUT.TX.IMPAIRED
NEPRO CARB
PA
RENAL FXN,SOY
STEADY (0.08G-1.80)
(LIQUID) (OTC)
NUT.TX.IMPAIRED
SUPLENA CARB
PA
RENAL FXN,SOY
STEADY (0.04G-1.79)
(LIQUID) (OTC)
NUT.TX.PULM.DISOR OXEPA (0.06 G-1.5) PA
D.REG,LAC-FR
(LIQUID) (OTC)
NUT.TX.PULM.DISO NUT.TX.PULM.DISOR PA
RD.SOY,LACFREE
D.SOY,LACFREE
(LIQUID) (OTC)
NUTRIT.THERAPY,
BCAD 2
PA
MSUD WITH IRON
NUTRIT.THERAPY,
KETONEX-2
PA
MSUD WITH IRON
NUTRIT.THERAPY,
MSUD COOLER
PA
MSUD WITH IRON
NUTRIT.THERAPY,
MSUD COOLER20
PA
MSUD WITH IRON
NUTRIT.THERAPY,
MSUD EXPRESS
PA
MSUD WITH IRON
COOLER
NUTRIT.THERAPY,
MSUD LOPHLEX
PA
MSUD WITH IRON
NUTRIT.THERAPY, NUTRIT.THERAPY, PA
MSUD WITH IRON MSUD WITH IRON
NUTRITIONAL TX, NUTRITIONAL TX, PA
KETOGENIC,MILK KETOGENIC,MILK
NUTRITIONAL TX,
KETOVOLVE
PA
KETOGENIC,WHEY
OINTMENT/CREAM BASES
T1 EMOLLIENT BASE
RADIAGEL
T1 PETROLATUM,
PETROLATUM
YELLOW
T1 PETROLATUM,WHITE PETROLEUM JELLY
(JELLY (G)) (OTC)
T1 PETROLATUM,WHITE VASELINE
T1 PETROLATUM,WHITE WHITE PETROLEUM
PKU TX AGENT-COFACTOR OF PHENYLALANINE
HYDROXYLASE
T2 SAPROPTERIN
KUVAN
PA
DIHYDROCHLORIDE
Page 60 of 116
PROTEIN REPLACEMENT
T1 AMINO
AMINO
AC/MULTIVITAC/MULTIVITMIN/HERB 139
MIN/HERB 139
T1 AMINO ACIDS/RICE AMINO ACIDS/RICE
PROTEIN/MV-MN
PROTEIN/MV-MN
T1 INFANT FORM.IRON ELECARE
LAC-F/DHA/ARA
T1 NUT.TX.IMPAIRED
ELECARE JR
PA
DIGEST FXN
T1 WHEY
WHEY
SOLVENTS
T1 BACTERIOSTATIC
SODIUM CHLORIDE
T1 ISOPROPYL
ALCOHOL
T1 ISOPROPYL
ALCOHOL
T1
ISOPROPYL
ALCOHOL
T1
ISOPROPYL
ALCOHOL
T1
ISOPROPYL
ALCOHOL
T1
T1
ISOPROPYL
ALCOHOL
ISOPROPYL
ALCOHOL
T5
T5
MINERAL OIL
MINERAL OIL
T5
MINERAL OIL
THICKENING AGENTS, ORAL
T1 CELLULOSE GUM
THIK & CLEAR
(PACKET) (OTC)
T1 CELLULOSE GUM
THIK & CLEAR
(POWDER) (OTC)
T1 CORN STARCH
RESOURCE
THICKENUP
(POWDER) (OTC)
T1 CORN STARCH
THICKENUP
T1 STARCH
THICK NOW
T1 STARCH
THICK-IT
T1 STARCH
THICK-IT #2
T1 XANTHAN GUM
SIMPLYTHICK
TOPICAL ANTISEPTIC DRYING AGENTS
T1 FORMALDEHYDE FORMALDEHYDE
VNSNY
OTHER RESPIRATORY DISORDERS
ANTIFIBROTIC THERAPY - PYRIDONE ANALOGS
T2 PIRFENIDONE
ESBRIET
PA
CYSTIC FIB.TRANSMEMB
CONDUCT.REG.(CFTR)POTENTIATOR
T2 IVACAFTOR
KALYDECO
CYSTIC FIBROSIS-CFTR POTENTIATOR &
CORRECTOR COMB.
T2 LUMACAFTOR/IVACA ORKAMBI
FTOR
BACTERIOSTATIC
SODIUM CHLORIDE
ISOPROPANOL (70 %)
(SOLUTION) (OTC)
ISOPROPYL
ALCOHOL (70 %)
(SOLUTION) (OTC)
ISOPROPYL
ALCOHOL (70 %)
(SOLUTION) (OTC)
ISOPROPYL
ALCOHOL (91 %)
(SOLUTION) (OTC)
ISOPROPYL
ALCOHOL (99 %)
(SOLUTION) (OTC)
ISOPROPYL
RUBBING ALCOHOL
RUBBING ALCOHOL
(70 %) (SOLUTION)
(OTC)
MINERAL OIL
MINERAL OIL
HEAVY
MINERAL OIL LIGHT
SOMATOSTATIC AGENTS
T1 OCTREOTIDE
OCTREOTIDE
ACETATE
ACETATE
T2 PASIREOTIDE
SIGNIFOR
DIASPARTATE
WOUND HEALING AGENTS, LOCAL
T1 BALSAM
VENELEX (87PERU/CASTOR OIL
788MG/G) (OINT. (G))
MUCOLYTICS
T1 ACETYLCYSTEINE MUCOMYST
T2 DORNASE ALFA
PULMOZYME
PA
PA
PA
PULMONARY FIBROSIS - SYSTEMIC ENZYME
INHIBITORS
T2 NINTEDANIB
OFEV
PA
ESYLATE
PAIN MANAGEMENT - ANALGESICS
ANALGESIC, NON-SALICYLATE & BARBITURATE
COMB.
T1 BUTALBITAL/ACETA BUTAPAP
MINOPHEN
ANALGESIC, SALICYLATE, BARBITURATE,&
XANTHINE CMB
T1 BUTALBITAL/ASPIRI FIORINAL
N/CAFFEINE
PA
ANALGESIC,NONSALICYLATE,BARBITURATE,&XANTHINE CMB
T1 BUTALB/ACETAMIN ESGIC
OPHEN/CAFFEINE
T1 BUTALB/ACETAMIN FIORICET
OPHEN/CAFFEINE
ANALGESIC/ANTIPYRETICS, SALICYLATES
T5 ASPIRIN
ASPIRIN (300 MG)
(SUPP.RECT) (OTC)
T5 ASPIRIN
ASPIRIN (325 MG)
QL
(TABLET DR) (OTC)
T5 ASPIRIN
ASPIRIN (325 MG)
QL
(TABLET) (OTC)
T5 ASPIRIN
ASPIRIN (600 MG)
(SUPP.RECT) (OTC)
T5 ASPIRIN/CALCIUM ASPIRIN/CALCIUM
CARBONATE/MAG CARBONATE/MAG
T1 CHOLINE
CHOLINE
SALICYL/MAG
SALICYL/MAG
SALICYLATE
SALICYLATE
T1 DIFLUNISAL
DOLOBID
T1 SALSALATE
DISALCID
Page 61 of 116
ANALGESIC/ANTIPYRETICS,NON-SALICYLATE
T5 ACETAMINOPHEN ACETAMINOPHEN
(100 MG/ML)
(DROPS) (OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(120 MG)
(SUPP.RECT) (OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(160 MG) (TAB
CHEW) (OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(160 MG/5ML)
(ELIXIR) (OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(160 MG/5ML)
(LIQUID) (OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(325 MG)
(SUPP.RECT) (OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(500 MG) (CAPSULE)
(OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(500 MG) (TABLET)
(OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(650 MG)
(SUPP.RECT) (OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(80 MG) (TAB CHEW)
(OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(80MG/0.8ML)
(DROPS SUSP) (OTC)
T5 ACETAMINOPHEN ACETAMINOPHEN
(80MG/0.8ML)
(DROPS) (OTC)
T5 ACETAMINOPHEN CHILDREN'S
TYLENOL
T5 ACETAMINOPHEN INFANTS' TYLENOL
T5 ACETAMINOPHEN TYLENOL
T5 ACETAMINOPHEN TYLENOL EXTRA
STRENGTH
ANALGESICS, NARCOTIC AGONIST AND NSAID
COMBINATION
T1 HYDROCODONE/IBUIBUDONE
PROFEN
T1 HYDROCODONE/IBUREPREXAIN
PROFEN
T1 HYDROCODONE/IBUVICOPROFEN
PROFEN
T1 IBUPROFEN/OXYCO COMBUNOX
DONE HCL
ANALGESICS,NARCOTICS
T1 ASPIRIN/CAFFEIN/D SYNALGOS-DC
IHYDROCODEINE
T2 BUPRENORPHINE
BUTRANS
QL
T1 BUTORPHANOL
STADOL
TARTRATE
T1 CARISOPRODOL/AS CARISOPRODOL/ASP
PIRIN/CODEINE
IRIN/CODEINE
VNSNY
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
CODEINE SULFATE CODEINE
FENTANYL
DURAGESIC (100
PA, QL
MCG/HR) (PATCH
TD72)
FENTANYL
DURAGESIC (12
PA, QL
MCG/HR) (PATCH
TD72)
FENTANYL
DURAGESIC (25
PA, QL
MCG/HR) (PATCH
TD72)
FENTANYL
DURAGESIC
PA, QL
(50MCG/HR) (PATCH
TD72)
FENTANYL
DURAGESIC
PA, QL
(75MCG/HR) (PATCH
TD72)
FENTANYL CITRATEACTIQ
PA
HYDROCODONE/AC HYCET (7.5-325/15) QL
ETAMINOPHEN
(SOLUTION)
HYDROCODONE/AC LORTAB (10MGQL
ETAMINOPHEN
325MG) (TABLET)
HYDROCODONE/AC LORTAB (5 MGQL
ETAMINOPHEN
325MG) (TABLET)
HYDROCODONE/AC LORTAB (7.5-325 MG) QL
ETAMINOPHEN
(TABLET)
HYDROCODONE/AC NORCO
QL
ETAMINOPHEN
HYDROCODONE/AC VERDROCET
ETAMINOPHEN
HYDROCODONE/AC ZAMICET (10-325/15) QL
ETAMINOPHEN
(SOLUTION)
HYDROCODONE/AC ZAMICET (5-163/7.5) QL
ETAMINOPHEN
(SOLUTION)
HYDROMORPHONE DILAUDID
HCL
(0.5MG/.5ML)
(SYRINGE)
HYDROMORPHONE DILAUDID (1
HCL
MG/ML) (LIQUID)
HYDROMORPHONE DILAUDID (1
HCL
MG/ML) (SYRINGE)
HYDROMORPHONE DILAUDID (2 MG)
HCL
(TABLET)
HYDROMORPHONE DILAUDID (2
HCL
MG/ML) (SYRINGE)
HYDROMORPHONE DILAUDID (2
HCL
MG/ML) (VIAL)
HYDROMORPHONE DILAUDID (3 MG)
HCL
(SUPP.RECT)
HYDROMORPHONE DILAUDID (4 MG)
HCL
(TABLET)
HYDROMORPHONE DILAUDID (4
HCL
MG/ML) (SYRINGE)
HYDROMORPHONE DILAUDID (8 MG)
HCL
(TABLET)
HYDROMORPHONE EXALGO (12 MG)
PA, QL
HCL
(TAB ER 24H)
HYDROMORPHONE EXALGO (16 MG)
PA, QL
HCL
(TAB ER 24H)
HYDROMORPHONE EXALGO (32 MG)
PA, QL
HCL
(TAB ER 24H)
HYDROMORPHONE EXALGO (8 MG) (TABPA, QL
HCL
ER 24H)
Page 62 of 116
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T2
T1
HYDROMORPHONE HYDROMORPHONE
HCL
HCL (1 MG/ML)
(AMPUL)
HYDROMORPHONE HYDROMORPHONE
HCL
HCL (2 MG/ML)
(AMPUL)
HYDROMORPHONE HYDROMORPHONE
HCL
HCL (4 MG/ML)
(AMPUL)
HYDROMORPHONE HYDROMORPHONE
HCL/PF
HCL/PF
LEVORPHANOL
LEVO-DROMORAN
TARTRATE
MEPERIDINE HCL DEMEROL (10
MG/ML)
(CARTRIDGE)
MEPERIDINE
DEMEROL (100
HCL/PF
MG/ML) (VIAL)
MEPERIDINE
DEMEROL (25
HCL/PF
MG/ML) (VIAL)
MEPERIDINE
DEMEROL (50
HCL/PF
MG/ML) (VIAL)
METHADONE HCL DISKETS (40 MG)
ST
(TABLET SOL)
METHADONE HCL DOLOPHINE HCL
ST
MORPHINE
AVINZA (120 MG)
QL
SULFATE
(CPMP 24HR)
MORPHINE
AVINZA (30 MG)
QL
SULFATE
(CPMP 24HR)
MORPHINE
AVINZA (45 MG)
QL
SULFATE
(CPMP 24HR)
MORPHINE
AVINZA (60 MG)
QL
SULFATE
(CPMP 24HR)
MORPHINE
AVINZA (75 MG)
QL
SULFATE
(CPMP 24HR)
MORPHINE
AVINZA (90 MG)
QL
SULFATE
(CPMP 24HR)
MORPHINE
KADIAN (100 MG)
QL
SULFATE
(CAP ER PEL)
MORPHINE
KADIAN (20 MG)
QL
SULFATE
(CAP ER PEL)
MORPHINE
KADIAN (30 MG)
QL
SULFATE
(CAP ER PEL)
MORPHINE
KADIAN (50 MG)
QL
SULFATE
(CAP ER PEL)
MORPHINE
KADIAN (60 MG)
QL
SULFATE
(CAP ER PEL)
MORPHINE
KADIAN (80 MG)
QL
SULFATE
(CAP ER PEL)
MORPHINE
MORPHINE SULFATE
SULFATE
(10 MG/ML)
(CARTRIDGE)
MORPHINE
MORPHINE SULFATE
SULFATE
(10 MG/ML)
(SYRINGE)
MORPHINE
MORPHINE SULFATE
SULFATE
(10MG/0.7ML) (PEN
INJCTR)
MORPHINE SULFATE MORPHINE SULFATE
(15 MG) (TABLET)
MORPHINE
MORPHINE SULFATE
SULFATE
(15 MG/ML) (VIAL)
VNSNY
T1
T2
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T2
T1
T2
T1
T2
T1
T1
MORPHINE
SULFATE
MORPHINE SULFATE
(2 MG/ML)
(SYRINGE)
MORPHINE SULFATE MORPHINE SULFATE
(30 MG) (TABLET)
MORPHINE
MORPHINE SULFATE
SULFATE
(4 MG/ML)
(CARTRIDGE)
MORPHINE
MORPHINE SULFATE
SULFATE
(4 MG/ML)
(SYRINGE)
MORPHINE
MORPHINE SULFATE
SULFATE
(8 MG/ML)
(SYRINGE)
MORPHINE
MORPHINE SULFATE
SULFATE
(8 MG/ML) (VIAL)
MORPHINE
MS CONTIN
QL
SULFATE
MORPHINE
MSIR
SULFATE
MORPHINE
RMS
SULFATE
MORPHINE
ROXANOL
SULFATE
MORPHINE
MORPHINE
SULFATE/PF
SULFATE/PF (0.5
MG/ML) (AMPUL)
MORPHINE
MORPHINE
SULFATE/PF
SULFATE/PF (0.5
MG/ML) (VIAL)
MORPHINE
MORPHINE
SULFATE/PF
SULFATE/PF (1
MG/ML) (VIAL)
MORPHINE
MORPHINE
SULFATE/PF
SULFATE/PF
(150MG/30ML) (PCA
VIAL)
MORPHINE
MORPHINE
SULFATE/PF
SULFATE/PF (30
MG/30ML) (PCA
VIAL)
NALBUPHINE HCL NALBUPHINE HCL
OPIUM/BELLADONN OPIUM/BELLADONN
A ALKALOIDS
A ALKALOIDS
OXYCODONE HCL ETH-OXYDOSE
OXYCODONE HCL OXY IR
OXYCODONE HCL OXYCONTIN (10 MG) QL
(TAB ER 12H)
OXYCODONE HCL
OXYCONTIN (15 MG) QL
(TAB ER 12H)
OXYCODONE HCL OXYCONTIN (20 MG) QL
(TAB ER 12H)
OXYCODONE HCL
OXYCONTIN (30 MG) QL
(TAB ER 12H)
OXYCODONE HCL OXYCONTIN (40 MG) QL
(TAB ER 12H)
OXYCODONE HCL
OXYCONTIN (60 MG) QL
(TAB ER 12H)
OXYCODONE HCL OXYCONTIN (80 MG) QL
(TAB ER 12H)
OXYCODONE HCL ROXICODONE
Page 63 of 116
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T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T2
T2
T1
T1
T1
T1
T1
T1
OXYCODONE
PERCOCET
HCL/ACETAMINOPH
EN
OXYCODONE
ROXICET
HCL/ACETAMINOPH
EN
OXYCODONE
ENDODAN
HCL/ASPIRIN
OXYCODONE
PERCODAN
HCL/ASPIRIN
OXYMORPHONE
OPANA (10 MG)
HCL
(TABLET)
OXYMORPHONE
OPANA (5 MG)
HCL
(TABLET)
OXYMORPHONE
OPANA ER (10 MG)
HCL
(TAB ER 12H)
OXYMORPHONE
OPANA ER (15 MG)
HCL
(TAB ER 12H)
OXYMORPHONE
OPANA ER (20 MG)
HCL
(TAB ER 12H)
OXYMORPHONE
OPANA ER (30 MG)
HCL
(TAB ER 12H)
OXYMORPHONE
OPANA ER (40 MG)
HCL
(TAB ER 12H)
OXYMORPHONE
OPANA ER (5 MG)
HCL
(TAB ER 12H)
OXYMORPHONE
OPANA ER (7.5 MG)
HCL
(TAB ER 12H)
PENTAZOCINE
TALWIN NX
HCL/NALOXONE
HCL
TAPENTADOL HCL NUCYNTA
TAPENTADOL HCL NUCYNTA ER
TRAMADOL HCL
CONZIP (150 MG)
(CPBP 25-75)
TRAMADOL HCL
RYZOLT
TRAMADOL HCL
TRAMADOL HCL
TRAMADOL HCL
ULTRAM
TRAMADOL HCL
ULTRAM ER
TRAMADOL
ULTRACET
HCL/ACETAMINOPH
EN
ANTIMIGRAINE PREPARATIONS
T1 DIHYDROERGOTAM D.H.E. 45
INE MESYLATE
T1 DIHYDROERGOTAM D.H.E.45
INE MESYLATE
T1 DIHYDROERGOTAM MIGRANAL
INE MESYLATE
T1 ERGOTAMINE
CAFERGOT
TARTRATE/CAFFEIN
E
T1 ISOMETHEPT/DICH MIDRIN
LPHN/ACETAMINOP
T1 RIZATRIPTAN
MAXALT
BENZOATE
T1 RIZATRIPTAN
MAXALT MLT
BENZOATE
T1 SUMATRIPTAN
IMITREX
T1 SUMATRIPTAN
IMITREX (100 MG)
SUCCINATE
(TABLET)
VNSNY
QL
T1
T1
QL
T1
SUMATRIPTAN
SUCCINATE
T1
SUMATRIPTAN
SUCCINATE
SUMATRIPTAN
SUCCINATE
T1
T1
SUMATRIPTAN
SUCCINATE
T1
SUMATRIPTAN
SUCCINATE
T1
T2
SUMATRIPTAN
SUCCINATE
ZOLMITRIPTAN
T2
ZOLMITRIPTAN
QL
QL
SUMATRIPTAN
SUCCINATE
SUMATRIPTAN
SUCCINATE
QL
QL
QL
QL
QL
QL
QL
ST, QL
QL
QL
QL
QL
QL
QL
QL
IMITREX (25 MG)
(TABLET)
IMITREX (4
MG/0.5ML)
(CARTRIDGE)
IMITREX (4
MG/0.5ML) (PEN
INJCTR)
IMITREX (50 MG)
(TABLET)
IMITREX (6
MG/0.5ML)
(CARTRIDGE)
IMITREX (6
MG/0.5ML) (PEN
INJCTR)
IMITREX (6
MG/0.5ML)
(SYRINGE)
IMITREX (6
MG/0.5ML) (VIAL)
ZOMIG (2.5 MG)
(SPRAY)
ZOMIG (5 MG)
(SPRAY)
QL
QL
QL
QL
QL
QL
QL
QL
ST, QL
ST, QL
NARC.& NON-SAL.ANALGESIC,BARBITURATE
&XANTHINE CMB
T1 BUTALBIT/ACETAMI FIORICET WITH
N/CAFF/CODEINE
CODEINE
NARCOTIC & SALICYLATE ANALGESICS, BARB.&
XANTHINE
T1 CODEINE/BUTALBIT FIORINAL WITH
AL/ASA/CAFFEIN
CODEINE #3
NARCOTIC ANALGESIC & NON-SALICYLATE
ANALGESIC COMB
T1 ACETAMINOPHEN ACETAMINOPHEN
WITH CODEINE
WITH CODEINE
(300MG-15MG)
(TABLET)
T2 ACETAMINOPHEN
CAPITAL WWITH CODEINE
CODEINE
T1 ACETAMINOPHEN TYLENOL WITH
WITH CODEINE
CODEINE (12012MG/5) (SOLUTION)
T1 ACETAMINOPHEN TYLENOL-CODEINE
WITH CODEINE
NO.3
T1 ACETAMINOPHEN TYLENOL-CODEINE
WITH CODEINE
NO.4
NARCOTIC WITHDRAWAL THERAPY AGENTS
T1 BUPRENORPHINE BUPRENEX (0.3
HCL
MG/ML) (VIAL)
T1 BUPRENORPHINE BUPRENORPHINE
HCL
HCL
T1 BUPRENORPHINE SUBUTEX
HCL
T2 BUPRENORPHINE
BUNAVAIL (2.1-0.3
HCL/NALOXONE HCL MG) (FILM)
T2 BUPRENORPHINE
BUNAVAIL (4.2-0.7
HCL/NALOXONE HCL MG) (FILM)
QL
QL
QL
QL
Page 64 of 116
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T2
T2
T1
T2
T2
T1
T2
T2
T2
T2
T2
T2
BUPRENORPHINE
BUNAVAIL (6.3MG- QL
HCL/NALOXONE HCL 1MG) (FILM)
BUPRENORPHINE
SUBOXONE (12 MG-3 QL
HCL/NALOXONE HCL MG) (FILM)
BUPRENORPHINE
SUBOXONE (2 MG- QL
HCL/NALOXONE HCL 0.5MG) (FILM)
BUPRENORPHINE SUBOXONE (2 MG- QL
HCL/NALOXONE
0.5MG) (TAB SUBL)
HCL
BUPRENORPHINE
SUBOXONE (4MG- QL
HCL/NALOXONE HCL 1MG) (FILM)
BUPRENORPHINE
SUBOXONE (8 MG-2 QL
HCL/NALOXONE HCL MG) (FILM)
BUPRENORPHINE SUBOXONE (8 MG-2 QL
HCL/NALOXONE
MG) (TAB SUBL)
HCL
BUPRENORPHINE
ZUBSOLV (0.7QL
HCL/NALOXONE HCL 0.18MG) (TAB SUBL)
BUPRENORPHINE
ZUBSOLV (1.4QL
HCL/NALOXONE HCL 0.36MG) (TAB SUBL)
BUPRENORPHINE
ZUBSOLV (11.4QL
HCL/NALOXONE HCL 2.9MG) (TAB SUBL)
BUPRENORPHINE
ZUBSOLV (2.9QL
HCL/NALOXONE HCL 0.71MG) (TAB SUBL)
BUPRENORPHINE
ZUBSOLV (5.7-1.4
QL
HCL/NALOXONE HCL MG) (TAB SUBL)
BUPRENORPHINE
ZUBSOLV (8.6-2.1
QL
HCL/NALOXONE HCL MG) (TAB SUBL)
PARKINSONS DISEASE
ANTIPARKINSONISM DRUGS,ANTICHOLINERGIC
T4 BENZTROPINE
COGENTIN
MESYLATE
T4 TRIHEXYPHENIDYL ARTANE
HCL
ANTIPARKINSONISM DRUGS,OTHER
T1 AMANTADINE HCL SYMMETREL
T2 APOMORPHINE HCL APOKYN
T1 BROMOCRIPTINE PARLODEL
MESYLATE
T1 CARBIDOPA/LEVOD PARCOPA
OPA
T1 CARBIDOPA/LEVOD SINEMET 10-100
OPA
T1 CARBIDOPA/LEVOD SINEMET 25-100
OPA
T1 CARBIDOPA/LEVOD SINEMET 25-250
OPA
T1 CARBIDOPA/LEVOD SINEMET CR
OPA
T1 CARBIDOPA/LEVOD STALEVO 100
OPA/ENTACAPONE
T1 CARBIDOPA/LEVOD STALEVO 125
OPA/ENTACAPONE
T1 CARBIDOPA/LEVOD STALEVO 150
OPA/ENTACAPONE
T1 CARBIDOPA/LEVOD STALEVO 200
OPA/ENTACAPONE
T1 CARBIDOPA/LEVOD STALEVO 50
OPA/ENTACAPONE
VNSNY
T1
T1
T1
T1
T1
T1
T2
T1
CARBIDOPA/LEVOD
OPA/ENTACAPONE
ENTACAPONE
PRAMIPEXOLE DIHCL
RASAGILINE
MESYLATE
ROPINIROLE HCL
ROPINIROLE HCL
ROTIGOTINE
SELEGILINE HCL
STALEVO 75
COMTAN
MIRAPEX
AZILECT
QL
REQUIP
REQUIP XL
NEUPRO
ELDEPRYL
ST, QL
ST, QL
DECARBOXYLASE INHIBITORS
T1 CARBIDOPA
LODOSYN
SEIZURE DISORDER
ANTICONVULSANTS
T1 CARBAMAZEPINE
T4
CARBAMAZEPINE
T4
CARBAMAZEPINE
T1
CARBAMAZEPINE
T4
CARBAMAZEPINE
T4
CARBAMAZEPINE
T4
CARBAMAZEPINE
T4
CARBAMAZEPINE
T4
CARBAMAZEPINE
T4
CARBAMAZEPINE
T4
CARBAMAZEPINE
T4
T4
T4
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
T4
T4
T4
T4
DIAZEPAM
DIAZEPAM
DIAZEPAM
DIVALPROEX
SODIUM
DIVALPROEX
SODIUM
DIVALPROEX
SODIUM
ESLICARBAZEPINE
ACETATE
PA, QL
T4
T4
T4
CARBAMAZEPINE
(100 MG) (CPMP
12HR)
CARBAMAZEPINE
(100 MG) (TAB ER
12H)
CARBAMAZEPINE
(100 MG/5ML) (ORAL
SUSP)
CARBAMAZEPINE
(200 MG) (CPMP
12HR)
CARBAMAZEPINE
(200 MG) (TAB ER
12H)
CARBAMAZEPINE
(200 MG) (TABLET)
CARBAMAZEPINE
(300 MG) (CPMP
12HR)
CARBAMAZEPINE
(400 MG) (TAB ER
12H)
CARBATROL (300
MG) (CPMP 12HR)
TEGRETOL (100 MG)
(TAB CHEW)
TEGRETOL XR (100
MG) (TAB ER 12H)
CLONAZEPAM
KLONOPIN
KLONOPIN RAPIDLY
DISINTEGRATING
DIASTAT
QL
DIASTAT ACUDIAL QL
DIAZEPAM
QL
DEPAKOTE (250 MG)
(TABLET DR)
DEPAKOTE (500 MG)
(TABLET DR)
DIVALPROEX
SODIUM
APTIOM (200 MG)
ST, QL
(TABLET)
Page 65 of 116
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ESLICARBAZEPINE
ACETATE
ESLICARBAZEPINE
ACETATE
ESLICARBAZEPINE
ACETATE
ETHOSUXIMIDE
ETHOSUXIMIDE
ETHOTOIN
EZOGABINE
T4
EZOGABINE
T4
EZOGABINE
T4
EZOGABINE
T4
FELBAMATE
T4
FELBAMATE
T4
FELBAMATE
T4
T4
T4
T1
T1
GABAPENTIN
GABAPENTIN
GABAPENTIN
T4
LACOSAMIDE
T4
LACOSAMIDE
T4
LACOSAMIDE
T4
LACOSAMIDE
T4
LACOSAMIDE
T4
T4
T4
T4
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
VNSNY
APTIOM (400 MG)
(TABLET)
APTIOM (600 MG)
(TABLET)
APTIOM (800 MG)
(TABLET)
ETHOSUXIMIDE
ZARONTIN
PEGANONE
POTIGA (200 MG)
(TABLET)
POTIGA (300 MG)
(TABLET)
POTIGA (400 MG)
(TABLET)
POTIGA (50 MG)
(TABLET)
FELBAMATE (400
MG) (TABLET)
FELBAMATE (600
MG) (TABLET)
FELBAMATE (600
MG/5ML) (ORAL
SUSP)
GABAPENTIN
NEURONTIN (250
MG/5ML)
(SOLUTION)
NEURONTIN (300
MG/6ML)
(SOLUTION)
VIMPAT (10 MG/ML)
(SOLUTION)
VIMPAT (100 MG)
(TABLET)
VIMPAT (150 MG)
(TABLET)
VIMPAT (200 MG)
(TABLET)
VIMPAT (50 MG)
(TABLET)
LAMICTAL
LAMICTAL (BLUE)
LAMICTAL (GREEN)
LAMICTAL
(ORANGE)
LAMICTAL ODT (100
MG) (TAB RAPDIS)
LAMICTAL ODT (200
MG) (TAB RAPDIS)
LAMICTAL ODT (25
MG) (TAB RAPDIS)
LAMICTAL ODT (50
MG) (TAB RAPDIS)
LAMICTAL ODT
(BLUE)
LAMICTAL ODT
(GREEN)
LAMICTAL ODT
(ORANGE)
LAMICTAL XR
(BLUE)
ST, QL
T4
LAMOTRIGINE
ST, QL
T4
LAMOTRIGINE
ST, QL
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
LAMOTRIGINE
ST, QL
T4
LAMOTRIGINE
ST, QL
T4
LAMOTRIGINE
ST, QL
T4
LAMOTRIGINE
ST, QL
T4
LAMOTRIGINE
ST, QL
T4
LAMOTRIGINE
T4
LAMOTRIGINE
T4
T4
T4
T4
T4
T4
T4
T4
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
METHSUXIMIDE
OXCARBAZEPINE
OXCARBAZEPINE
T4
OXCARBAZEPINE
T4
OXCARBAZEPINE
ST
T4
T4
OXCARBAZEPINE
PERAMPANEL
ST
T4
PERAMPANEL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST
ST
LAMICTAL XR
ST
(GREEN)
LAMICTAL XR
ST
(ORANGE)
LAMOTRIGINE (100 ST, QL
MG) (TAB ER 24)
LAMOTRIGINE (100 ST, QL
MG) (TAB RAPDIS)
LAMOTRIGINE (100
MG) (TABLET)
LAMOTRIGINE (150
MG) (TABLET)
LAMOTRIGINE (200 ST, QL
MG) (TAB ER 24)
LAMOTRIGINE (200 ST, QL
MG) (TAB RAPDIS)
LAMOTRIGINE (200
MG) (TABLET)
LAMOTRIGINE (25 ST, QL
MG) (TAB ER 24)
LAMOTRIGINE (25 ST, QL
MG) (TAB RAPDIS)
LAMOTRIGINE (25
MG) (TABLET)
LAMOTRIGINE (25
MG) (TB CHW DSP)
LAMOTRIGINE
ST
(25(21)-50) (TB RD
DSPK)
LAMOTRIGINE (250 ST, QL
MG) (TAB ER 24)
LAMOTRIGINE (25- ST
50-100) (TB RD DSPK)
LAMOTRIGINE (300 ST, QL
MG) (TAB ER 24)
LAMOTRIGINE (5
MG) (TB CHW DSP)
LAMOTRIGINE (50 ST, QL
MG) (TAB ER 24)
LAMOTRIGINE (50 ST, QL
MG) (TAB RAPDIS)
LAMOTRIGINE
ST
(50(42)-100) (TB RD
DSPK)
KEPPRA
KEPPRA
KEPPRA XR
LEVETIRACETAM
ROWEEPRA
CELONTIN
OXCARBAZEPINE
OXTELLAR XR (150 ST, QL
MG) (TAB ER 24H)
OXTELLAR XR (300 ST, QL
MG) (TAB ER 24H)
OXTELLAR XR (600 ST, QL
MG) (TAB ER 24H)
TRILEPTAL
FYCOMPA (10 MG) ST, QL
(TABLET)
FYCOMPA (12 MG) ST, QL
(TABLET)
Page 66 of 116
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T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
PERAMPANEL
FYCOMPA (2 MG)
ST, QL
(TABLET)
PERAMPANEL
FYCOMPA (4 MG)
ST, QL
(TABLET)
PERAMPANEL
FYCOMPA (6 MG)
ST, QL
(TABLET)
PERAMPANEL
FYCOMPA (8 MG)
ST, QL
(TABLET)
PHENYTOIN
DILANTIN
PHENYTOIN
DILANTIN-125
PHENYTOIN
DILANTIN-125
PHENYTOIN
PHENYTOIN
PHENYTOIN SODIUM DILANTIN
EXTENDED
PHENYTOIN SODIUM PHENYTEK
EXTENDED
PHENYTOIN
PHENYTOIN
SODIUM EXTENDED SODIUM EXTENDED
PREGABALIN
LYRICA
PRIMIDONE
MYSOLINE
PRIMIDONE
PRIMIDONE
RUFINAMIDE
BANZEL (200 MG)
ST, QL
(TABLET)
RUFINAMIDE
BANZEL (40 MG/ML) ST, QL
(ORAL SUSP)
RUFINAMIDE
BANZEL (400 MG)
ST, QL
(TABLET)
TIAGABINE HCL
GABITRIL (12 MG) ST, QL
(TABLET)
TIAGABINE HCL
GABITRIL (16 MG) ST, QL
(TABLET)
TIAGABINE HCL
GABITRIL (2 MG)
ST, QL
(TABLET)
TIAGABINE HCL
GABITRIL (4 MG)
ST, QL
(TABLET)
TIAGABINE HCL
TIAGABINE HCL
ST, QL
TOPIRAMATE
QUDEXY XR (100
ST, QL
MG) (CAP SPR 24)
TOPIRAMATE
QUDEXY XR (150
ST, QL
MG) (CAP SPR 24)
TOPIRAMATE
QUDEXY XR (200
ST, QL
MG) (CAP SPR 24)
TOPIRAMATE
QUDEXY XR (25 MG) ST, QL
(CAP SPR 24)
TOPIRAMATE
QUDEXY XR (50 MG) ST, QL
(CAP SPR 24)
TOPIRAMATE
TOPAMAX
TOPIRAMATE
TOPIRAMATE (100 ST, QL
MG) (CAP SPR 24)
TOPIRAMATE
TOPIRAMATE (100
MG) (TABLET)
TOPIRAMATE
TOPIRAMATE (15
MG) (CAP SPRINK)
TOPIRAMATE
TOPIRAMATE (150 ST, QL
MG) (CAP SPR 24)
TOPIRAMATE
TOPIRAMATE (200 ST, QL
MG) (CAP SPR 24)
TOPIRAMATE
TOPIRAMATE (200
MG) (TABLET)
TOPIRAMATE
TOPIRAMATE (25
ST, QL
MG) (CAP SPR 24)
VNSNY
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
TOPIRAMATE
TOPIRAMATE (25
MG) (CAP SPRINK)
TOPIRAMATE
TOPIRAMATE (25
MG) (TABLET)
TOPIRAMATE
TOPIRAMATE (50
MG) (CAP SPR 24)
TOPIRAMATE
TOPIRAMATE (50
MG) (TABLET)
TOPIRAMATE
TROKENDI XR (100
MG) (CAP ER 24H)
TOPIRAMATE
TROKENDI XR (200
MG) (CAP ER 24H)
TOPIRAMATE
TROKENDI XR (25
MG) (CAP ER 24H)
TOPIRAMATE
TROKENDI XR (50
MG) (CAP ER 24H)
VALPROIC ACID
VALPROIC ACID
VALPROIC ACID (AS DEPAKENE
SODIUM SALT)
(500MG/10ML)
(SOLUTION)
VALPROIC ACID (AS VALPROIC ACID (AS
SODIUM SALT)
SODIUM SALT)
VIGABATRIN
SABRIL
ZONISAMIDE
ZONEGRAN
ZONISAMIDE
ZONEGRAN
ZONISAMIDE
ZONISAMIDE
BENZODIAZEPINES
T4 CLOBAZAM
T4
CLOBAZAM
T4
CLOBAZAM
ONFI (10 MG)
(TABLET)
ONFI (2.5 MG/ML)
(ORAL SUSP)
ONFI (20 MG)
(TABLET)
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
QL
ST, QL
ST, QL
ST, QL
SKELETAL MUSCLE DISORDER
AGENTS TO TX PERIODIC PARALYSIS - CARBON
ANHYD INH
T2 DICHLORPHENAMID KEVEYIS
PA
E
SKELETAL MUSCLE RELAXANTS
T1 BACLOFEN
LIORESAL
T1 CARISOPRODOL
SOMA
T1 CARISOPRODOL/AS SOMA COMPOUND
PIRIN
T1 CHLORZOXAZONE PARAFON FORTE
DSC
T1 CYCLOBENZAPRIN FEXMID
E HCL
T1 CYCLOBENZAPRIN FLEXERIL
E HCL
T1 DANTROLENE
DANTRIUM
SODIUM
T1 METHOCARBAMOL ROBAXIN
T1 METHOCARBAMOL ROBAXIN-750
T1 ORPHENADRINE
NORFLEX
CITRATE
T1 TIZANIDINE HCL
ZANAFLEX (2 MG)
(TABLET)
T1 TIZANIDINE HCL
ZANAFLEX (4 MG)
(TABLET)
Page 67 of 116
SMOKING CESSATION
T2
SMOKING DETERRENT AGENTS (GANGLIONIC
STIM,OTHERS)
T5 NICOTINE
NICODERM CQ
T5 NICOTINE
NICOTINE PATCH
T2 NICOTINE
NICOTROL
QL
T2 NICOTINE
NICOTROL NS
QL
T5 NICOTINE
PROSTEP
T5 NICOTINE
NICORETTE
POLACRILEX
SMOKING DETERRENT-NICOTINIC
RECEPT.PARTIAL AGONIST
T4 VARENICLINE
CHANTIX
TARTRATE
EMETICS
T1 IPECAC
ANTACIDS
T5 ALUMINUM
HYDROXIDE
T5 CALCIUM
CARBONATE
T5
T5
UPPER GASTROINTESTINAL
DISORDERS - DIGESTIVE
T5
T5
SUCRAID
PA
PANCREATIC ENZYMES
T2 LIPASE/PROTEASE/A CREON
MYLASE
T2 LIPASE/PROTEASE/A ZENPEP
MYLASE
UPPER GASTROINTESTINAL
DISORDERS - SPASTIC DISEASE
ANTICHOLINERGICS/ANTISPASMODICS
T1 DICYCLOMINE HCL BENTYL
T1 DICYCLOMINE HCL DICYCLOMINE HCL
BELLADONNA ALKALOIDS
T1 HYOSCYAMINE
HYOSYNE
SULFATE
T1 HYOSCYAMINE
LEVBID
SULFATE
T1 HYOSCYAMINE
LEVSIN
SULFATE
T1 HYOSCYAMINE
LEVSIN-SL
SULFATE
T1 HYOSCYAMINE
NULEV
SULFATE
T1 HYOSCYAMINE
SYMAX
SULFATE
T1 HYOSCYAMINE
SYMAX-SL
SULFATE
T1 HYOSCYAMINE
SYMAX-SR
SULFATE
T1 METHSCOPOLAMIN PAMINE
E BROMIDE
T1 METHSCOPOLAMIN PAMINE FORTE
E BROMIDE
T2 PHENOBARB/HYOSC DONNATAL (16.2 MG)
Y/ATROPINE/SCOP
(TABLET)
VNSNY
IPECAC
UPPER GASTROINTESTINAL
DISORDERS - ULCER DISEASE
QL
SMOKING DETERRENTS, OTHER
T4 BUPROPION HCL
ZYBAN
GASTRIC ENZYMES
T2 SACROSIDASE
PHENOBARB/HYOSC PHENOHYTRO
Y/ATROPINE/SCOP
T5
T5
CALCIUM
CARBONATE
CALCIUM
CARBONATE
CALCIUM
CARBONATE
MAG
HYDROX/ALUMINU
M HYD/SIMETH
ALUMINUM
HYDROXIDE
CALCIUM
CARBONATE
(320MG(750)) (TAB
CHEW) (OTC)
TUMS (300MG(750))
(TAB CHEW) (OTC)
TUMS SMOOTHIES
TUMS X-STR
MAG
HYDROX/ALUMINU
M HYD/SIMETH (200200-20) (ORAL SUSP)
(OTC)
MAG/ALUMINUM/SO MAG/ALUMINUM/SO
D BICARB/ALGINC D BICARB/ALGINC
SODIUM
SODIUM
BICARBONATE
BICARBONATE (650
MG) (TABLET) (OTC)
ANTICHOLINERGICS,QUATERNARY AMMONIUM
T1 CHLORDIAZEPOXID LIBRAX
E/CLIDINIUM BR
T1 GLYCOPYRROLATE ROBINUL
T1 GLYCOPYRROLATE ROBINUL FORTE
T1 PROPANTHELINE
PRO-BANTHINE
BROMIDE
ANTI-ULCER PREPARATIONS
T1 MISOPROSTOL
CYTOTEC
T1 SUCRALFATE
CARAFATE (1 G)
(TABLET)
T2 SUCRALFATE
CARAFATE (1 G/10
ML) (ORAL SUSP)
ANTI-ULCER-H.PYLORI AGENTS
T1 LANSOPRAZOLE/A PREVPAC
MOXICILN/CLARIT
H
QL
HISTAMINE H2-RECEPTOR INHIBITORS
T1 CIMETIDINE
TAGAMET
T5 CIMETIDINE
TAGAMET HB
T1 CIMETIDINE HCL TAGAMET
T1 FAMOTIDINE
PEPCID (20 MG)
(TABLET)
T1 FAMOTIDINE
PEPCID (40 MG)
(TABLET)
T5 FAMOTIDINE
PEPCID AC
T1 NIZATIDINE
AXID
Page 68 of 116
T1
RANITIDINE HCL
T1
RANITIDINE HCL
T1
RANITIDINE HCL
T5
RANITIDINE HCL
T1
RANITIDINE HCL
T1
RANITIDINE HCL
T5
RANITIDINE HCL
ZANTAC (15 MG/ML)
(SYRUP)
ZANTAC (150 MG)
(CAPSULE)
ZANTAC (150 MG)
(TABLET)
ZANTAC (150 MG)
(TABLET) (OTC)
ZANTAC (300 MG)
(CAPSULE)
ZANTAC (300 MG)
(TABLET)
ZANTAC 75
T1
T1
T1
KIDNEY STONE AGENTS
T2 CYSTEAMINE
PROCYSBI
BITARTRATE
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
ST, QL
URINARY PH MODIFIERS
T1 CITRIC
ACID/SODIUM
CITRATE
T1 POTASSIUM
CITRATE
T1 POTASSIUM
CITRATE/CITRIC
ACID
T1 SOD PHOS DI,
MONO/K PHOS
MONO
T1 SOD/POT/K CIT/SOD
CIT/CIT ACID
T1 SOD/POT/K CIT/SOD
CIT/CIT ACID
PA
CYTRA-2
UROCIT-K
CYTRA-K
SOD PHOS DI,
MONO/K PHOS
MONO
CYTRA-3
TRICITRATES
ST, QL
URINARY TRACT ANALGESIC AGENTS
T2 PENTOSAN
ELMIRON
POLYSULFATE
SODIUM
ST
URINARY TRACT ANESTHETIC/ANALGESIC AGNT
(AZO-DYE)
T1 PHENAZOPYRIDINE PYRIDIUM
HCL
ST
URINARY TRACT ANTISPASMODIC, M(3) SELECTIVE
ANTAG.
T2 SOLIFENACIN
VESICARE
ST
SUCCINATE
URINARY TRACT
ANTISPASMODIC/ANTIINCONTINENCE AGENT
T2 FESOTERODINE
TOVIAZ
ST
FUMARATE
T1 FLAVOXATE HCL
URISPAS
T1 OXYBUTYNIN
DITROPAN
CHLORIDE
T1 OXYBUTYNIN
DITROPAN XL
CHLORIDE
T1 TOLTERODINE
DETROL
ST
TARTRATE
QL
URINARY TRACT - FUNCTIONAL
DISORDERS
BENIGN PROSTATIC HYPERTROPHY/MICTURITION
AGENTS
T1 ALFUZOSIN HCL
UROXATRAL
VNSNY
AVODART
PROSCAR
FLOMAX
BPH AGENTS,5-ALPHA-RED INH & ALPHA-1-ADR
ANTG CMB
T1 DUTASTERIDE/TAM JALYN
ST
SULOSIN HCL
INTESTINAL MOTILITY STIMULANTS
T1 METOCLOPRAMIDE REGLAN
HCL
PROTON-PUMP INHIBITORS
T2 ESOMEPRAZOLE
NEXIUM (10 MG)
MAGNESIUM
(SUSPDR PKT)
T2 ESOMEPRAZOLE
NEXIUM (2.5 MG)
MAGNESIUM
(SUSPDR PKT)
T1 ESOMEPRAZOLE
NEXIUM (20 MG)
MAGNESIUM
(CAPSULE DR)
T2 ESOMEPRAZOLE
NEXIUM (20 MG)
MAGNESIUM
(SUSPDR PKT)
T1 ESOMEPRAZOLE
NEXIUM (40 MG)
MAGNESIUM
(CAPSULE DR)
T2 ESOMEPRAZOLE
NEXIUM (40 MG)
MAGNESIUM
(SUSPDR PKT)
T2 ESOMEPRAZOLE
NEXIUM (5 MG)
MAGNESIUM
(SUSPDR PKT)
T1 LANSOPRAZOLE
PREVACID (15 MG)
(CAPSULE DR)
T2 LANSOPRAZOLE
PREVACID (15 MG)
(TAB RAP DR)
T1 LANSOPRAZOLE
PREVACID (30 MG)
(CAPSULE DR)
T2 LANSOPRAZOLE
PREVACID (30 MG)
(TAB RAP DR)
T1 LANSOPRAZOLE
PREVACID 24HR
T1 OMEPRAZOLE
PRILOSEC (10 MG)
(CAPSULE DR)
T1 OMEPRAZOLE
PRILOSEC (20 MG)
(CAPSULE DR)
T5 OMEPRAZOLE
PRILOSEC (20 MG)
(TABLET DR) (OTC)
T1 OMEPRAZOLE
PRILOSEC (40 MG)
(CAPSULE DR)
T1 PANTOPRAZOLE
PROTONIX (20 MG)
SODIUM
(TABLET DR)
T1 PANTOPRAZOLE
PROTONIX (40 MG)
SODIUM
(TABLET DR)
T1 RABEPRAZOLE
ACIPHEX
SODIUM
DUTASTERIDE
FINASTERIDE
TAMSULOSIN HCL
VAGINAL DISORDERS
VAGINAL ANTIBIOTICS
T1 CLINDAMYCIN
PHOSPHATE
T1 METRONIDAZOLE
CLEOCIN (2 %)
(CREAM/APPL)
METROGELVAGINAL
Page 69 of 116
VAGINAL ANTIFUNGALS
T2 BUTOCONAZOLE
GYNAZOLE 1
NITRATE
T5 MICONAZOLE
MICONAZOLE
NITRATE
NITRATE (100 MG)
(SUPP.VAG) (OTC)
T5 MICONAZOLE
MICONAZOLE
NITRATE
NITRATE (200 MG-2
%) (CMB PF CRM)
(OTC)
T1 MICONAZOLE
MONISTAT 3 (200
NITRATE
MG) (SUPP.VAG)
T5 MICONAZOLE
MONISTAT 3 (200
NITRATE
MG-2 %) (CMB PF
CRM) (OTC)
T5 MICONAZOLE
MONISTAT 3 (200
NITRATE
MG-2 %) (KIT) (OTC)
T5 MICONAZOLE
MONISTAT 3 (200
NITRATE
MG-2 %) (KIT) (OTC)
T5 MICONAZOLE/CLEA MICONAZOLE/CLEA
NSER 17 ON WIPE
NSER 17 ON WIPE
(200 MG-2 %) (KIT)
(OTC)
T1 TERCONAZOLE
TERAZOL 3
T1 TERCONAZOLE
TERAZOL 7
T1 TERCONAZOLE
TERCONAZOLE
VAGINAL ESTROGEN PREPARATIONS
T2 ESTRADIOL
ESTRACE
T1 ESTRADIOL
VAGIFEM
T2 ESTROGENS,
PREMARIN
CONJUGATED
VAGINAL SULFONAMIDES
T2 SULFANILAMIDE
AVC
VITAMIN AND/OR MINERAL
DEFICIENCY
ANTIOXIDANT MULTIVITAMIN COMBINATIONS
T5 VIT A/VIT C/VIT
VIT A/VIT C/VIT
E/ZINC/COPPER
E/ZINC/COPPER
(7160-113) (TABLET)
(OTC)
T5 VITS
VITS
A,C,E/LUTEIN/MINE A,C,E/LUTEIN/MINE
RALS
RALS
T5 VITS
VITS
A,C,E/ZINC/COPPER A,C,E/ZINC/COPPER
CALCIUM REPLACEMENT
T5 CALCIUM CARB,
CALCIUM CARB,
GLUCONATE/VIT D2 GLUCONATE/VIT D2
T5 CALCIUM CARB,
PARVA-CAL 500
GLUCONATE/VIT D2
T5 CALCIUM
CALCIUM
CARBONATE
CARBONATE (600
MG) (TABLET) (OTC)
T5 CALCIUM
CALTRATE 600
CARBONATE
T5 CALCIUM
CALCIUM
CARBONATE/VITAM CARBONATE/VITAMI
IN D2
N D2
VNSNY
T5
T5
T5
T5
T5
T5
T5
T5
T1
T5
CALCIUM
CALCIUM
CARBONATE/VITAM CARBONATE/VITAMI
IN D3
N D3 (250 MG-125)
(TABLET) (OTC)
CALCIUM
CALCIUM
CARBONATE/VITAM CARBONATE/VITAMI
IN D3
N D3 (500 MG-200)
(TABLET) (OTC)
CALCIUM
CALCIUM
CARBONATE/VITAM CARBONATE/VITAMI
IN D3
N D3 (500 MG-400)
(TABLET) (OTC)
CALCIUM
CALCIUM
CARBONATE/VITAM CARBONATE/VITAMI
IN D3
N D3 (500 MG-600)
(TABLET) (OTC)
CALCIUM
CALCIUM
CARBONATE/VITAM CARBONATE/VITAMI
IN D3
N D3 (600 MG-200)
(TABLET) (OTC)
CALCIUM
CALCIUM
CARBONATE/VITAM CARBONATE/VITAMI
IN D3
N D3 (600 MG-400)
(TABLET) (OTC)
CALCIUM
CALCIUM
CARBONATE/VITAM CARBONATE/VITAMI
IN D3
N D3 (600 MG-800)
(TABLET) (OTC)
CALCIUM CITRATE CALCIUM CITRATE
(200(950)MG)
(TABLET) (OTC)
CALCIUM/MAG/D3/B CALCIUM/MAG/D3/B
12/FA/B6/BORON
12/FA/B6/BORON
CALCIUM/MULTIVI CALCIUM/MULTIVIT
TAMIN WITH IRON AMIN WITH IRON
FLUORIDE PREPARATIONS
T2 SODIUM FLUORIDE FLURA-DROPS
T1 SODIUM FLUORIDE SODIUM FLUORIDE
T1 SODIUM
SODIUM
FLUORIDE/POTASSI FLUORIDE/POTASSIU
UM NIT
M NIT
T1 STANNOUS
STANNOUS
FLUORIDE
FLUORIDE
FOLIC ACID PREPARATIONS
T1 FOLIC ACID
FOLIC ACID (1 MG)
(TABLET)
T1 FOLIC ACID
FOLIC ACID (1 MG)
(TABLET) (OTC)
T1 FOLIC ACID
FOLIC ACID (5
MG/ML) (VIAL)
T5 MULTIVITBIOCEL
MIN/FA/LYCOPEN/L
UTEIN
GERIATRIC VITAMIN PREPARATIONS
T5 MULTIVIT WITH
MULTIVIT WITH
IRON-MINERALS
IRON-MINERALS
(TABLET) (OTC)
T5 MULTIVIT WITH
MULTIVIT WITH
MINERALS/LUTEIN MINERALS/LUTEIN
Page 70 of 116
T5
T5
MULTIVITMIN/FA/LYCOPEN/L
UTEIN
MULTIVITMIN36/IRON/FOLIC
ACID
IRON REPLACEMENT
T1 FERROUS FUM/VIT
C/B12/STOMC
T1 FERROUS FUM/VIT
C/B12-IF/FOLIC
T1 FERROUS
FUMARATE/FOLIC
ACID
T5 FERROUS SULFATE
T5 FERROUS SULFATE
T5
T5
T5
T5
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
MULTIVITMIN/FA/LYCOPEN/LU
TEIN
MULTIVITMIN36/IRON/FOLIC
ACID
T1
T1
FERROUS FUM/VIT
C/B12/STOMC
FERROUS FUM/VIT
C/B12-IF/FOLIC
HEMOCYTE-F
FER-IN-SOL
FERROUS SULFATE
(220 (44)/5) (ELIXIR)
(OTC)
FERROUS SULFATE FERROUS SULFATE
(220 (44)/5)
(SOLUTION) (OTC)
FERROUS SULFATE FERROUS SULFATE
(324(65)MG) (TABLET
DR) (OTC)
FERROUS SULFATE FERROUS SULFATE
(325(65) MG)
(TABLET DR) (OTC)
FERROUS SULFATE FERROUS SULFATE
(325(65) MG)
(TABLET) (OTC)
FERROUS
FERROUS
SULFATE/VIT
SULFATE/VIT
C/FOLIC AC
C/FOLIC AC
IRON
IRON
ASPGLY,PS/C/B12/FA/ ASPGLY,PS/C/B12/FA/
CA/SUC
CA/SUC
IRON
IRON
ASPGLY,PS/C/SUCCI ASPGLY,PS/C/SUCCI
NIC ACID
NIC ACID
IRON
IRON
ASPGLY/C/B12/FA/C ASPGLY/C/B12/FA/CA
A-TH/SUC
-TH/SUC
IRON
IRON
BG,PS/VITC/B12/FA/C BG,PS/VITC/B12/FA/C
ALCIUM
ALCIUM
IRON
FERRALET 90
CARB,GL/FA/B12/C/D
OCUSATE
IRON FM,PS
PUREVIT DUALFE
NO.1/FOLIC/MV
PLUS
NO.18
IRON FM,PS
TANDEM PLUS
NO.1/FOLIC/MV
NO.18
IRON
IRON
FUM,AG/C/B12/FOLI FUM,AG/C/B12/FOLIC
C/CA/SUC
/CA/SUC
IRON FUM,PS/FA/VIT INTEGRA PLUS
B WITH C #9
IRON FUM,PS/FOLIC INTEGRA F
ACID/VITC/B3
VNSNY
T1
T5
T1
T2
T1
T1
T1
T1
T1
T1
T1
T1
T5
T5
T5
T5
IRON
IRON
FUM/DOCUSAT/FOLI FUM/DOCUSAT/FOLI
C/BCOMP,C
C/BCOMP,C
IRON
IRON
FUMARATE/VIT
FUMARATE/VIT
C/VIT B12/FA
C/VIT B12/FA
IRON
BIFERA RX
POLYSAC/IRON
HEME/FA/B12
IRON
IRON
POLYSACCHARIDE POLYSACCHARIDE
COMPLEX
COMPLEX (150 MG)
(CAPSULE) (OTC)
IRON PS CMPLX/VIT NIFEREX-150 FORTE
B12/FA
IRON,CARB/FA#6/MV, CORVITE 150
MIN NO.41
IRON,CARB/VIT
IRON,CARB/VIT
C/VIT B12/FOLIC
C/VIT B12/FOLIC
IRON/C/B12/CALCIU/ IRON/C/B12/CALCIU/
STOMACH CONC
STOMACH CONC
IRON/C/FOLIC
IRON/C/FOLIC
ACD/MV
ACD/MV
CMB11/CALC
CMB11/CALC
IRON/CALCIUM/E/F IRON/CALCIUM/E/FO
OLIC ACID/MVIT
LIC ACID/MVIT
IRON/DSS/B12HEMATRON-AF
IF/FOLIC AC/MV-MN
IRON/FOLIC AC/VIT IRON/FOLIC AC/VIT
BCOMP,C/MIN
BCOMP,C/MIN
IRON/FOLIC
IRON/FOLIC
ACID/B12/C/DOCUSA ACID/B12/C/DOCUSA
TE
TE
IRON/FOLIC
IRON/FOLIC
ACID/C/B6/B12/ZINC ACID/C/B6/B12/ZINC
IRON/LIVER
IRON/LIVER EXT/VIT
EXT/VIT
BCOMP,C/MIN
BCOMP,C/MIN
IRON/MV,STRESS
IRON/MV,STRESS
FORM
FORM
VIT B
VIT B
COMP/C/FA/IRON
COMP/C/FA/IRON
SULF/VITE
SULF/VITE
VIT B
VIT B
COMP/C/FA/IRON/VI COMP/C/FA/IRON/VI
TE
TE
MAGNESIUM SALTS REPLACEMENT
T5 MAGNESIUM
MAGNESIUM (250
MG) (TABLET) (OTC)
T5 MAGNESIUM OXIDE MAGNESIUM OXIDE
(250 MG) (TABLET)
(OTC)
T5 MAGNESIUM OXIDE MAGNESIUM OXIDE
(500 MG) (CAPSULE)
(OTC)
T5 MAGNESIUM OXIDE MAGNESIUM OXIDE
(500 MG) (TABLET)
(OTC)
MINERAL REPLACEMENT,MISCELLANEOUS
T1 MINERALS/PROTEIN PROVIMIN
SUPPLEMENT
Page 71 of 116
MULTIVITAMIN PREPARATIONS
T5 A/C/E/ZINC/SOD
A/C/E/ZINC/SOD
SELENATE/COPPER SELENATE/COPPER
T1 AMINO
AMINO
ACIDS/MV,TX,IRON, ACIDS/MV,TX,IRON,
MINERAL
MINERAL (LIQUID)
(OTC)
T1 B-COMPLEX WITH B-COMPLEX WITH
VITAMIN C
VITAMIN C
(CAPSULE) (OTC)
T5 B-COMPLEX WITH B-COMPLEX WITH
VITAMIN C
VITAMIN C (TABLET)
(OTC)
T5 BETABETA-CAROTENE(A)CAROTENE(A)-VITS VITS C,E/MINS
C,E/MINS
(TABLET) (OTC)
T5 CAL/MAG/B
CAL/MAG/B
COMP/VIT D3/HRB61 COMP/VIT D3/HRB61
T5 FA/MV,CA,IRON,MIN FA/MV,CA,IRON,MIN/
/LYCOPENE/LUT
LYCOPENE/LUT
T1 FERROUS
FERROUS
FUM/FOLIC
FUM/FOLIC
ACID/BCOMP,C
ACID/BCOMP,C
T5 FOLIC
FOLIC
ACID/MULTIVITACID/MULTIVITMIN/LUTEIN
MIN/LUTEIN (0.4MG250) (TABLET) (OTC)
T5 FOLIC
FOLIC
ACID/MV,IRON,MIN ACID/MV,IRON,MIN
T5 FOLIC
FOLIC
ACID/MV,IRON,MIN/ ACID/MV,IRON,MIN/
LUTEIN
LUTEIN
T5 MULTIVIT WITH
MULTIVIT WITH
CALCIUM,IRON,MIN CALCIUM,IRON,MIN
T5 MULTIVIT WITH
TAB A VITE
CALCIUM,IRON,MIN
T5 MULTIVIT WITH
MULTIVIT WITH
IRON,HEMATINIC IRON,HEMATINIC
T5 MULTIVIT WITH
MULTIVIT WITH
IRON-MINERALS
IRON-MINERALS
(TABLET) (OTC)
T5 MULTIVIT WITH
MULTIVIT WITH
MINERALS/HERBS MINERALS/HERBS
T5 MULTIVIT,CALC,MI MULTIVIT,CALC,MIN
NS/IRON/FOLIC
S/IRON/FOLIC
(27MG-400) (TABLET)
(OTC)
T5 MULTIVIT,CALC,MI MULTIVIT,CALC,MIN
NS/IRON/FOLIC
S/IRON/FOLIC (45018-0.4) (TABLET)
(OTC)
T5 MULTIVIT,CALC,MI MULTIVIT,CALC,MIN
NS/IRON/FOLIC
S/IRON/FOLIC (50018-0.4) (TABLET)
(OTC)
T5 MULTIVIT,CALC,MI MULTIVIT,CALC,MIN
NS/IRON/FOLIC
S/IRON/FOLIC (9MG400MCG) (TABLET)
(OTC)
T5 MULTIVIT,CALC,MIN ONE-A-DAY
S/IRON/FOLIC
WOMEN'S
T1 MULTIVIT,IRON,MINMULTIVIT,IRON,MIN
5/FOLIC ACID
5/FOLIC ACID
VNSNY
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
MULTIVIT,IRON,MINS CENTRUM
/FOLIC ACID
SPECIALIST HEART
MULTIVIT,IRON,MINCENTURY CARDIO
S/FOLIC ACID
MULTIVIT,STRESS STRESS FORMULA
FORMULA/ZINC
WITH ZINC
MULTIVIT,TX WITH MULTIVIT,TX WITH
IRON,MINERALS
IRON,MINERALS
MULTIVIT/IRON/FO MULTIVIT/IRON/FOL
LIC ACID/HB179
IC ACID/HB179
MULTIVITAMIN
MULTIVITAMIN
(LIQUID) (OTC)
MULTIVITAMIN
MULTIVITAMIN
(TABLET) (OTC)
MULTIVITAMIN
MULTIVITAMIN
WITH IRON
WITH IRON
MULTIVITAMIN
MULTIVITAMIN
WITH MINERALS
WITH MINERALS
(CAPSULE) (OTC)
MULTIVITAMIN
MULTIVITAMIN
WITH MINERALS
WITH MINERALS
(TABLET) (OTC)
MULTIVITAMIN,STR MULTIVITAMIN,STR
ESS FORMULA
ESS FORMULA
MULTIVITAMIN,THEMULTIVITAMIN,THE
R AND MINERALS R AND MINERALS
(TABLET) (OTC)
MULTIVITAMIN,THEMULTIVITAMIN,THE
RAPEUTIC
RAPEUTIC
MULTIVITAMIN/IRO MULTIVITAMIN/IRO
N/FOLIC ACID
N/FOLIC ACID
MULTIVITICAPS MV
MIN/FA/LUTEIN/ZEA
XANT
MULTIVITCENTRUM SILVER
MIN/FA/LYCOPEN/L
UTEIN
MULTIVITCENTRUM SILVER
MIN/FA/LYCOPEN/LU MEN
TEIN
MULTIVITCENTRUM SILVER
MIN/FA/LYCOPEN/L ULTRA MEN'S
UTEIN
MULTIVITMULTIVITMIN/FA/LYCOPEN/L MIN/FA/LYCOPEN/LU
UTEIN
TEIN
MULTIVITMULTIVITMIN/FOLIC
MIN/FOLIC ACID/VIT
ACID/VIT K1
K1
MULTIVITMULTIVITMIN/IRON/FA/P.GINS MIN/IRON/FA/P.GINS
ENG
ENG
MULTIVITCENTRUM SILVER
MIN/IRON/FOLIC/LUT WOMEN
EIN
MULTIVITMULTIVITMIN/IRON/FOLIC/LU MIN/IRON/FOLIC/LU
TEIN
TEIN
MULTIVITMULTIVITMINERALS/FA/LYCO MINERALS/FA/LYCO
PENE
PENE (0.4 MG-600)
(TABLET) (OTC)
Page 72 of 116
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T5
T1
T1
T5
T5
T5
MULTIVITMULTIVITMINERALS/FA/LYCO MINERALS/FA/LYCO
PENE
PENE (400-300MCG)
(TABLET) (OTC)
MULTIVITONE-A-DAY MEN'S
MINERALS/FA/LYCOP
ENE
MULTIVITMULTIVITMINERALS/FOLIC MINERALS/FOLIC
ACID
ACID (0.4 MG)
(TABLET) (OTC)
MULTIVITONE DAILY
MINERALS/FOLIC/G
INKGO
MULTIVIT-MINS
MULTIVIT-MINS
NO.20/IRON/FOLIC NO.20/IRON/FOLIC
MULTIVIT-MINS
MULTIVIT-MINS
NO.7/FOLIC ACID
NO.7/FOLIC ACID
MULTIVITCENTRUM MEN
MINS/IRON/FOLIC/L
YCOP
MULTIVITCENTRUM ULTRA
MINS/IRON/FOLIC/L MEN'S
YCOP
MV,CA,MIN/IRON/FA ONE-A-DAY
/GUARANA/CAFF
WOMEN'S
MV,CAL,MIN/IRON/F MV,CAL,MIN/IRON/F
OLIC ACID/LUT
OLIC ACID/LUT
MV,CALCIUM,MIN/I MV,CALCIUM,MIN/IR
RON/FOLIC/VITK
ON/FOLIC/VITK
MV,IRON,MIN/GINK MV,IRON,MIN/GINKG
GO/PAN.GINSENG O/PAN.GINSENG
MV,IRON,MIN/LUTEI MV,IRON,MIN/LUTEI
N
N
MMVIT,TX,IRON,MINS/C VIT,TX,IRON,MINS/C
ALC/FOLIC
ALC/FOLIC
MVMV-MIN/IRON/FOLIC
MIN/IRON/FOLIC
AC/VIT K/LUT
AC/VIT K/LUT
MVMVMINS/FOLIC/LYCOP MINS/FOLIC/LYCOPE
ENE/GINKGO
NE/GINKGO
MV-MN/FOLIC
MV-MN/FOLIC
ACID/LUTEIN/HRB17 ACID/LUTEIN/HRB17
8
8
OMANIMI-3
3/DHA/EPA/B12/FA/B6
/PHYTOST
OMEG3/CALCIUM/D OMEG3/CALCIUM/D3
3/FOLIC/MVIT 13
/FOLIC/MVIT 13
VIT A/VIT C/VIT
VIT A/VIT C/VIT
E/ZINC/COPPER
E/ZINC/COPPER
VITB,C/IRON
VITB,C/IRON
FUM/FA/VIT E/AA 16 FUM/FA/VIT E/AA 16
VITS
VITS
A,C,E/LUTEIN/MINE A,C,E/LUTEIN/MINE
RALS
RALS
PEDIATRIC VITAMIN PREPARATIONS
T1 FLUORIDE/IRON/VI FLUORIDE/IRON/VIT
TAMINS A,C,D
AMINS A,C,D
VNSNY
T5
MULTIVIT WITH
IRON-MINERALS
T1
PED MVIT A,C,D3
NO.21/FLUORIDE
PEDI MULTIVIT
45/FLUORIDE/IRON
PEDI MULTIVIT
75/FLUORIDE/IRON
PEDI MULTIVIT 84
WITH FLUORIDE
PEDI MULTIVIT
A,C,AND D3 NO.21
PEDI MULTIVIT
NO.12 W-FLUORIDE
PEDI MULTIVIT
NO.16 W-FLUORIDE
PEDI MULTIVIT
NO.17 W-FLUORIDE
PEDI MULTIVIT
NO.2 W-FLUORIDE
PEDI MULTIVIT
NO.46/IRON SULF
PEDI MULTIVIT
NO.82 W-FLUORIDE
PEDI MULTIVIT
NO.83 W-FLUORIDE
PEDIATRIC
MULTIVITAMIN
NO.20
VIT A
PALMITATE/VIT
C/VIT D3
T1
T1
T1
T5
T1
T1
T1
T1
T5
T1
T1
T5
T5
MULTIVIT WITH
IRON-MINERALS
(LIQUID) (OTC)
PED MVIT A,C,D3
NO.21/FLUORIDE
PEDI MULTIVIT
45/FLUORIDE/IRON
PEDI MULTIVIT
75/FLUORIDE/IRON
PEDI MULTIVIT 84
WITH FLUORIDE
PEDI MULTIVIT
A,C,AND D3 NO.21
PEDI MULTIVIT
NO.12 W-FLUORIDE
PEDI MULTIVIT
NO.16 W-FLUORIDE
PEDI MULTIVIT
NO.17 W-FLUORIDE
PEDI MULTIVIT NO.2
W-FLUORIDE
PEDI MULTIVIT
NO.46/IRON SULF
PEDI MULTIVIT
NO.82 W-FLUORIDE
PEDI MULTIVIT
NO.83 W-FLUORIDE
PEDIATRIC
MULTIVITAMIN
NO.20
VIT A
PALMITATE/VIT
C/VIT D3
PRENATAL VITAMIN PREPARATIONS
T1 IRON,CARB/VIT
IRON,CARB/VIT
C/VIT B12/FOLIC
C/VIT B12/FOLIC
T1 PNV #14/FERROUS PNV #14/FERROUS
FUM/FOLIC ACID
FUM/FOLIC ACID
T1 PNV #15/IRON
CONCEPT OB
FUM,PS/FOLIC ACID
T1 PNV #8/IRON PS
PNV #8/IRON PS
CMP,ASPG/FA/DHA CMP,ASPG/FA/DHA
T1 PNV #87/IRON
NESTABS DHA
BISGLY/FA/DHA
T1 PNV 11-IRON FUM- PNV 11-IRON FUMFOLIC ACID-OM3
FOLIC ACID-OM3
T1 PNV 16/IRON
CONCEPT DHA
FUM,PS/FOLIC/OM-3
T1 PNV 19/IRON
PREFERA-OB ONE
PS,HEME/FOLIC/DH
A
T1 PNV 21/IRON
PREFERA OB
PS,HEME
PPEP/FOLIC
T1 PNV 22/IRON
PNV 22/IRON
CBN,GLUC/FOLIC/D CBN,GLUC/FOLIC/DS
SS
S
T1 PNV COMBO
PREFERA-OB PLUS
#22/IRON/FA/OM3/D DHA
HA
Page 73 of 116
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T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
PNV
PNV
COMBO#47/IRON/FA COMBO#47/IRON/FA
#1/DHA
#1/DHA
PNV NO.115/IRON
PNV NO.115/IRON
FUMARATE/FA
FUMARATE/FA
PNV NO.118/IRON
PNV NO.118/IRON
FUMARATE/FA
FUMARATE/FA
PNV
PNV
NO.66/IRON,CARB/F NO.66/IRON,CARB/F
OLIC/DHA
OLIC/DHA
PNV
OBTREX DHA
NO12/IRON/FOLIC/D
SS/OM-3
PNV W-CA #40/IRON PNV W-CA #40/IRON
FUM/FA CMB#1
FUM/FA CMB#1
PNV WITH CA
PNV WITH CA
#68/IRON/FA#1/DHA #68/IRON/FA#1/DHA
PNV WITH CA
PNV WITH CA
NO.65/IRON POLY/FA NO.65/IRON POLY/FA
PNV WITH
PNV WITH
CA#74/IRON/FOLIC CA#74/IRON/FOLIC
ACID
ACID
PNV WITH
PNV WITH
CA,NO.62/IRON/FA/D CA,NO.62/IRON/FA/D
HA
HA
PNV WITH
NATELLE ONE
CA,NO.70/IRON/FA/D
HA
PNV WITH
PNV WITH
CA,NO.72/IRON,CAR CA,NO.72/IRON,CAR
B/FA
B/FA
PNV WITH
PNV WITH
CA,NO.72/IRON/FA CA,NO.72/IRON/FA
PNV W-O CA
PNV W-O CA
NO5/IRON
NO5/IRON
FUM/FOLIC
FUM/FOLIC
PNV#79/IRON/FA/LM NEEVO DHA (27-1.13
FOLATE CA/DHA
MG) (CAPSULE)
PNV,CALC
PNV,CALC
35/IRON/FOLIC/DSS/ 35/IRON/FOLIC/DSS/
OM3
OM3
PNV,CALCIUM37/IR PNV,CALCIUM37/IRO
ON/FOLIC/OMEG3 N/FOLIC/OMEG3
PNV/FERROUS
PNV/FERROUS
FUM/DOCUSATE/FO FUM/DOCUSATE/FOL
LIC
IC
PNV/FERROUS
PNV/FERROUS
FUM/FOLIC
FUM/FOLIC
ACID/SEL
ACID/SEL
PNV/IRON,CARB/DO PNV/IRON,CARB/DO
CUSAT/FOLIC AC
CUSAT/FOLIC AC
PNV115/IRON
PNV115/IRON
FUMARATE/FA/DSS FUMARATE/FA/DSS
PNV119/IRON
PNV119/IRON
FUMARATE/FA/DSS FUMARATE/FA/DSS
PNV19/IRON
PNV19/IRON
BG,S.P/FOLIC
BG,S.P/FOLIC
AC/OM3
AC/OM3
PNV34/IRON,CARBO CITRANATAL
NYL/FA/DSS/DHA
HARMONY
PNV39/IRON
PNV39/IRON
FUMARATE/FA/DSS/ FUMARATE/FA/DSS/
DHA
DHA
VNSNY
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T5
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
PNV53/IRON B-G
HCL-P/FA/OMEGA3
PNV54/IRON B-G
HCL-P/FA/OMEGA3
PNV59/IRON,CARBO
NYL/FA/DSS/DHA
PNV66/IRON
FUMARATE/FA/DSS/
DHA
PNV66/IRON
FUMARATE/FA/DSS/
DHA
PNV69/IRON,CARBO
NYL/FA/DSS/DHA
PNV69/IRON,CARBO
NYL/FA/DSS/DHA
PNV7/IRON ASP
GLY/DOCUS/FOLIC
PNV80/IRON
FUMARATE/FA/DSS/
DHA
PNV81/IRON
EDTA,PS/FOLIC/OM
EG3
PNV95/FERROUS
FUM/FOLIC ACID
PNV53/IRON B-G
HCL-P/FA/OMEGA3
PNV54/IRON B-G
HCL-P/FA/OMEGA3
CITRANATAL
HARMONY
PNV66/IRON
FUMARATE/FA/DSS/
DHA
PRENEXA
CITRANATAL
HARMONY
PNV69/IRON,CARBO
NYL/FA/DSS/DHA
PNV7/IRON ASP
GLY/DOCUS/FOLIC
NEXA SELECT
PNV81/IRON
EDTA,PS/FOLIC/OME
G3
PNV95/FERROUS
FUM/FOLIC ACID
(28MG-0.8MG)
(TABLET) (OTC)
PRENAT VIT
PRENAT VIT
17/IRON/FOLIC/OM3, 17/IRON/FOLIC/OM3,
6
6
PRENAT VIT
PRENAT VIT
COMB.10/IRON/FA/D COMB.10/IRON/FA/D
HA
HA
PRENATAL
PRENATAL
#57/IRON/FA/DSS/DH #57/IRON/FA/DSS/DH
A
A
PRENATAL COMB VITAMEDMD
NO.42/FOLIC ACID REDICHEW RX
PRENATAL
PRENATAL
NO.13/IRON PS/FA
NO.13/IRON PS/FA
CB#1
CB#1
PRENATAL
PRENATAL
NO.52/IRON/FA/DHA NO.52/IRON/FA/DHA
PRENATAL
PRENATAL
NO.75/IRON/FOLATE NO.75/IRON/FOLATE
#1
#1
PRENATAL VIT
PRENATAL VIT
#76/IRON,CARB/FA #76/IRON,CARB/FA
PRENATAL VIT
PRENATAL VIT
15/IRON CB/FA/DSS 15/IRON CB/FA/DSS
PRENATAL VIT
PRENATAL VIT
16/IRON CB/FA/DSS 16/IRON CB/FA/DSS
PRENATAL VIT
PRENATAL VIT
18/IRON CB/FA/DSS 18/IRON CB/FA/DSS
PRENATAL VIT
PRENATAL VIT
55/IRON/FOLIC/OM3 55/IRON/FOLIC/OM3
PRENATAL VIT 7PRENATAL VIT 7IRON-FOLIC-DHA
IRON-FOLIC-DHA
PRENATAL VIT
PRENATAL VIT
NO.109/IRON/FA
NO.109/IRON/FA
Page 74 of 116
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T5
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T1
T1
T1
T1
T1
T1
T1
PRENATAL VIT
NO.127/IRON/FA
PRENATAL VIT
NO.129/IRON/FA
PRENATAL VIT
NO.73/IRON/FA
PRENATAL VIT
NO.78/IRON/FA
PRENATAL
VIT#4/IRON
FUM,PS/FA
PRENATAL
VIT#86/IRON
BISGLY/FA
PRENATAL
VIT#96/FERROUS
FUM/FA
PRENATAL
VIT/IRON
BISGLYCIN/FA
PRENATAL
VIT/IRON
FUMARATE/FA
PRENATAL
VIT/IRON
FUMARATE/FA
PRENATAL VIT
NO.127/IRON/FA
PRENATAL VIT
NO.129/IRON/FA
PRENATAL VIT
NO.73/IRON/FA
PRENATAL VIT
NO.78/IRON/FA
PRENATAL
VIT#4/IRON
FUM,PS/FA
NESTABS
PRENATAL
VIT#96/FERROUS
FUM/FA
PRENATAL VIT/IRON
BISGLYCIN/FA
LACTOCAL-F
PRENATAL VIT/IRON
FUMARATE/FA
(27MG-0.8MG)
(TABLET) (OTC)
PRENATAL
PRENATAL VIT/IRON
VIT/IRON
FUMARATE/FA
FUMARATE/FA
(28MG-0.8MG)
(TABLET) (OTC)
PRENATAL
PRENATAL VIT/IRON
VIT/IRON
FUMARATE/FA (65
FUMARATE/FA
MG-1 MG)
(CAPSULE)
PRENATAL
PRENATAL VIT/IRON
VIT/IRON
FUMARATE/FA (66FUMARATE/FA
1MG) (TABLET)
PRENATAL
PRENATAL
VIT100/IRON/FOLIC/ VIT100/IRON/FOLIC/
OM3
OM3
PRENATAL
TRINATAL RX 1
VIT27,CALCIUM/IRO
N/FA
PRENATAL
PRENATAL
VITS#4/IRON
VITS#4/IRON FUM/FA
FUM/FA
PRENATAL64/IRON/L NEEVODHA
MFOLATE/ALGAL
PV W-O CAL/IRON PV W-O CAL/IRON PS
PS CPLX/FOLIC
CPLX/FOLIC
PRENATAL VITAMINS WITHOUT IRON
T1 PNV W-O
PREMESIS RX
IRON/FA/CALCIUM/
B6/B12
T1 PNV/FOLIC
PNV/FOLIC
AC/B6/CALCIUM/GI AC/B6/CALCIUM/GIN
NGER
GER
VNSNY
VITAMIN A PREPARATIONS
T5 VITAMIN A
VITAMIN A (10000
UNIT) (CAPSULE)
(OTC)
T5 VITAMIN A
VITAMIN A (8000
UNIT) (CAPSULE)
(OTC)
VITAMIN B PREPARATIONS
T1 B CMPLX 4/VIT
B CMPLX 4/VIT
D3/C/FA/ZINC OX
D3/C/FA/ZINC OX
T1 B COMPLEX W-C
NEPHROCAPS
NO.20/FOLIC ACID
T1 B12/LEVOMEFOLAT FOLTX
E CALCIUM/B-6
T1 CYANOCOBALAMIN/CYANOCOBALAMIN/
FOLIC AC/VIT B6
FOLIC AC/VIT B6
(0.5-2.2-25) (TABLET)
T1 CYANOCOBALAMIN/CYANOCOBALAMIN/
FOLIC AC/VIT B6
FOLIC AC/VIT B6 (12.2-25MG) (TABLET)
T1 CYANOCOBALAMIN/CYANOCOBALAMIN/
FOLIC AC/VIT B6
FOLIC AC/VIT B6 (12.2-25MG) (TABLET)
(OTC)
T1 CYANOCOBALAMIN/CYANOCOBALAMIN/
FOLIC AC/VIT B6
FOLIC AC/VIT B6 (12.5-25MG) (TABLET)
T1 CYANOCOBALAMIN/CYANOCOBALAMIN/
FOLIC AC/VIT B6
FOLIC AC/VIT B6 (22.5-25MG) (TABLET)
T5 FOLIC AC/VIT
DIALYVITE 800BCOMP,C/ZN/VIT D3 ULTRA D
T5 FOLIC ACID/B
FOLIC ACID/B
CMPLX C/RICE
CMPLX C/RICE
BRAN
BRAN (400MCG-500)
(TABLET) (OTC)
T1 FOLIC ACID/B
FOLIC ACID/B
COMPLEX C NO.17 COMPLEX C NO.17
T1 FOLIC ACID/B
FOLIC ACID/B
CPLX/C/SELEN/ZINC CPLX/C/SELEN/ZINC
T5 FOLIC ACID/VIT B FOLIC ACID/VIT B
COMPLEX AND C
COMPLEX AND C
(400 MCG) (TABLET)
(OTC)
T1 FOLIC ACID/VIT B FOLIC ACID/VIT B
COMPLEX AND C
COMPLEX AND C (5
MG) (TABLET)
T1 FOLIC ACID/VIT
FOLIC ACID/VIT
BCOMP,C/CU/ZINC BCOMP,C/CU/ZINC
T1 VIT B CMPLX
VIT B CMPLX
3/FOLIC AC/C/BIOT 3/FOLIC AC/C/BIOT
T1 VIT B CMPLX
VIT B CMPLX
NO3/FA/C/BIOT/ZINC NO3/FA/C/BIOT/ZINC
T5 VIT B COMPLEX 100 VIT B COMPLEX 100
CMB #2/HERBS
CMB #2/HERBS
T5 VIT B COMPLEX 100 VIT B COMPLEX 100
NO.3/HERBAL
NO.3/HERBAL
T1 VITAMIN B
VITAMIN B
COMPLEX
COMPLEX
(CAPSULE) (OTC)
Page 75 of 116
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T5
T1
VITAMIN B
COMPLEX
VITAMIN B
COMPLEX (TABLET)
(OTC)
VITAMIN B
VITAMIN B
COMPLEX/MINERA COMPLEX/MINERAL
LS
S
VITAMINS
VITAMINS
B1,B2,B3,B5,AND B6 B1,B2,B3,B5,AND B6
VITAMIN B1 PREPARATIONS
T5 THIAMINE HCL
THIAMINE HCL (100
MG) (TABLET) (OTC)
T1 THIAMINE HCL
THIAMINE HCL (100
MG/ML) (VIAL)
T5 THIAMINE HCL
THIAMINE HCL (50
MG) (TABLET) (OTC)
T5 THIAMINE
THIAMINE
MONONITRATE
MONONITRATE
VITAMIN B12 PREPARATIONS
T1 CYANOCOBALAMIN CYANOCOBALAMIN
(VITAMIN B-12)
(VITAMIN B-12)
(1000MCG/ML)
(VIAL)
T1 CYANOCOBALAMIN/CYANOCOBALAMIN/
MECOBALAMIN
MECOBALAMIN
T1 HYDROXOCOBALA HYDROXOCOBALA
MIN
MIN
VITAMIN D PREPARATIONS
T1 CALCITRIOL
ROCALTROL
T5 CHOLECALCIFERO CHOLECALCIFEROL AGE
L (VITAMIN D3)
(VITAMIN D3) (400
UNIT) (CAPSULE)
(OTC)
T5 CHOLECALCIFERO CHOLECALCIFEROL AGE
L (VITAMIN D3)
(VITAMIN D3) (400
UNIT) (TABLET)
(OTC)
T1 ERGOCALCIFEROL ERGOCALCIFEROL
(VITAMIN D2)
(VITAMIN D2) (50000
UNIT) (CAPSULE)
T5 ERGOCALCIFEROL ERGOCALCIFEROL
(VITAMIN D2)
(VITAMIN D2)
(8000/ML) (DROPS)
(OTC)
ZINC REPLACEMENT
T1 ZINC SULFATE
ZINC SULFATE
VITAMIN B6 PREPARATIONS
T5 PYRIDOXINE HCL PYRIDOXINE HCL
(VITAMIN B6)
(VITAMIN B6) (100
MG) (TABLET) (OTC)
T1 PYRIDOXINE HCL PYRIDOXINE HCL
(VITAMIN B6)
(VITAMIN B6) (100
MG/ML) (VIAL)
T5 PYRIDOXINE HCL PYRIDOXINE HCL
(VITAMIN B6)
(VITAMIN B6) (25
MG) (TABLET) (OTC)
T5 PYRIDOXINE HCL PYRIDOXINE HCL
(VITAMIN B6)
(VITAMIN B6) (50
MG) (TABLET) (OTC)
VITAMIN C PREPARATIONS
T5 ASCORBIC ACID
ASCORBIC ACID (250
MG) (TAB CHEW)
(OTC)
T5 ASCORBIC ACID
ASCORBIC ACID (500
MG) (TAB CHEW)
(OTC)
T5 ASCORBIC ACID
ASCORBIC ACID (500
MG) (TABLET ER)
(OTC)
T5 ASCORBIC ACID
ASCORBIC ACID (500
MG) (TABLET) (OTC)
T1 ASCORBIC ACID
ASCORBIC ACID (500
MG/ML) (VIAL)
T1 ASCORBIC ACID
ASCORBIC ACID
(GRANULES) (OTC)
T5 ASCORBIC
ASCORBIC
ACID/ASCORBATE ACID/ASCORBATE
SODIUM
SODIUM (500 MG)
(WAFER) (OTC)
VNSNY
Page 76 of 116
Medication Prescribing Limitations
AGE RESTRICTIONS
• CHOLECALCIFEROL (VITAMIN
D3) (400 UNIT) (CAPSULE) (OTC) >= 65 YEARS
• CHOLECALCIFEROL (VITAMIN
D3) (400 UNIT) (TABLET) (OTC) >= 65 YEARS
• CONCERTA (18 MG) (TAB ER 24) <= 18 YEARS
• CONCERTA (27 MG) (TAB ER 24) <= 18 YEARS
• CONCERTA (36 MG) (TAB ER 24) <= 18 YEARS
• CONCERTA (54 MG) (TAB ER 24) <= 18 YEARS
• FOCALIN XR
<= 18 YEARS
• METADATE CD (10 MG) (CPBP
30-70)
<= 18 YEARS
• METADATE CD (20 MG) (CPBP
30-70)
<= 18 YEARS
• METADATE CD (30 MG) (CPBP
30-70)
<= 18 YEARS
• METADATE CD (40 MG) (CPBP
30-70)
<= 18 YEARS
• METADATE CD (50 MG) (CPBP
30-70)
<= 18 YEARS
• METADATE CD (60 MG) (CPBP
30-70)
<= 18 YEARS
• METADATE ER (10 MG)
(TABLET ER)
<= 18 YEARS
• METADATE ER (20 MG)
(TABLET ER)
<= 18 YEARS
• RITALIN LA (10 MG) (CPBP 5050)
<= 18 YEARS
• RITALIN LA (20 MG) (CPBP 5050)
<= 18 YEARS
• RITALIN LA (30 MG) (CPBP 5050)
<= 18 YEARS
• RITALIN LA (40 MG) (CPBP 5050)
<= 18 YEARS
• RITALIN-SR
<= 18 YEARS
• TACROLIMUS
>= 2 YEARS
VNSNY
Page 77 of 116
Medication Prescribing Limitations
QUANTITY RESTRICTIONS
• ABILIFY (1 MG/ML)
(SOLUTION)
• ABILIFY (10 MG) (TABLET)
• ABILIFY (15 MG) (TABLET)
• ABILIFY (2 MG) (TABLET)
• ABILIFY (20 MG) (TABLET)
• ABILIFY (30 MG) (TABLET)
• ABILIFY (5 MG) (TABLET)
• ABILIFY DISCMELT (10 MG)
(TAB RAPDIS)
• ABILIFY DISCMELT (15 MG)
(TAB RAPDIS)
• ABILIFY MAINTENA
• ACIPHEX
• ADDERALL
• ADDERALL XR (10 MG) (CAP
ER 24H)
• ADDERALL XR (15 MG) (CAP
ER 24H)
• ADDERALL XR (20 MG) (CAP
ER 24H)
• ADDERALL XR (25 MG) (CAP
ER 24H)
• ADDERALL XR (30 MG) (CAP
ER 24H)
• ADDERALL XR (5 MG) (CAP ER
24H)
• ADOXA (150 MG) (TABLET)
• ADVAIR DISKUS
• ADVAIR HFA
• AFINITOR (10 MG) (TABLET)
• AFINITOR (2.5 MG) (TABLET)
• AFINITOR (5 MG) (TABLET)
• AFINITOR (7.5 MG) (TABLET)
• AKYNZEO
• ALDARA
• ALECENSA
• AMBIEN
• AMBIEN CR
• AMITIZA
• AMLODIPINE/ATORVASTATIN
• ANORO ELLIPTA
• APLENZIN
• APOKYN
• APTIOM (200 MG) (TABLET)
• APTIOM (400 MG) (TABLET)
• APTIOM (600 MG) (TABLET)
• APTIOM (800 MG) (TABLET)
• APTIVUS
• APTIVUS
• ARIXTRA (10MG/0.8ML)
(SYRINGE)
• ARIXTRA (2.5 MG/0.5)
(SYRINGE)
• ARIXTRA (5MG/0.4ML)
(SYRINGE)
• ARIXTRA (7.5MG/0.6)
(SYRINGE)
• ARNUITY ELLIPTA
VNSNY
30mL IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
3 IN 1 DAY
2 IN 1 DAY
1 IN 26 DAYS
1 IN 1 DAY
2 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
1 IN 1 DAY
2 IN 1 DAY
60 IN 30 DAYS
12 IN 30 DAYS
2 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
2 IN 1 DAY
1 IN 28 DAYS
24 IN 30 DAYS
240 IN 30 DAYS
1 IN 1 DAY
1 IN 1 DAY
2 IN 1 DAY
1 IN 1 DAY
60 IN 30 DAYS
1 IN 1 DAY
2 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
380mL IN 30 DAYS
4 IN 1 DAY
8 IN 30 DAYS
5 IN 30 DAYS
4 IN 30 DAYS
6 IN 30 DAYS
30 IN 30 DAYS
• ASPIRIN
100 PER FILL
• ASPIRIN (325 MG) (TABLET DR)
(OTC)
100 PER FILL
• ASPIRIN (325 MG) (TABLET)
(OTC)
100 PER FILL
• ASTELIN
60 IN 30 DAYS
• ATRIPLA
1 IN 1 DAY
• ATROVENT HFA
25.8 IN 30 DAYS
• AVIDOXY
2 IN 1 DAY
• AVINZA (120 MG) (CPMP 24HR) 2 IN 1 DAY
• AVINZA (30 MG) (CPMP 24HR) 1 IN 1 DAY
• AVINZA (45 MG) (CPMP 24HR) 1 IN 1 DAY
• AVINZA (60 MG) (CPMP 24HR) 1 IN 1 DAY
• AVINZA (75 MG) (CPMP 24HR) 1 IN 1 DAY
• AVINZA (90 MG) (CPMP 24HR) 1 IN 1 DAY
• AZILECT
1 IN 1 DAY
• BANZEL (200 MG) (TABLET)
16 IN 1 DAY
• BANZEL (40 MG/ML) (ORAL
SUSP)
80mL IN 1 DAY
• BANZEL (400 MG) (TABLET)
8 IN 1 DAY
• BARACLUDE (0.05 MG/ML)
(SOLUTION)
630mL IN 30 DAYS
• BARACLUDE (0.5 MG) (TABLET) 1 IN 1 DAY
• BARACLUDE (1 MG) (TABLET) 1 IN 1 DAY
• BASAGLAR KWIKPEN U-100
30 IN 28 DAYS
• BAYER CHEWABLE ASPIRIN
100 PER FILL
• BELSOMRA
1 IN 1 DAY
• BOSULIF (100 MG) (TABLET)
4 IN 1 DAY
• BOSULIF (500 MG) (TABLET)
1 IN 1 DAY
• BREO ELLIPTA
60 IN 30 DAYS
• BRILINTA
2 IN 1 DAY
• BRISDELLE
1 IN 1 DAY
• BUNAVAIL (2.1-0.3 MG) (FILM) 3 IN 1 DAY
• BUNAVAIL (4.2-0.7 MG) (FILM) 3 IN 1 DAY
• BUNAVAIL (6.3MG-1MG) (FILM) 3 IN 1 DAY
• BUPRENORPHINE HCL
3 IN 1 DAY
• BUTRANS
1 IN 7 DAYS
• CAFERGOT
10 IN 7 DAYS
• CAPRELSA (100 MG) (TABLET) 2 IN 1 DAY
• CAPRELSA (300 MG) (TABLET) 1 IN 1 DAY
• CHANTIX
2 IN 1 DAY
• CHILDREN'S FLONASE
ALLERGY RLF
16 IN 30 DAYS
• CLARINEX (5 MG) (TABLET)
1 IN 1 DAY
• CLIMARA
1 IN 7 DAYS
• CLOZAPINE
3 IN 1 DAY
• CLOZARIL
3 IN 1 DAY
• COLCRYS
4 IN 1 DAY
• COMBIPATCH
2 IN 7 DAYS
• COMBIVIR
2 IN 1 DAY
• COMETRIQ
112 IN 28 DAYS
• COMPLERA
1 IN 1 DAY
• CONCERTA (18 MG) (TAB ER 24) 1 IN 1 DAY
• CONCERTA (27 MG) (TAB ER 24) 1 IN 1 DAY
• CONCERTA (36 MG) (TAB ER 24) 2 IN 1 DAY
• CONCERTA (54 MG) (TAB ER 24) 1 IN 1 DAY
• CONZIP (150 MG) (CPBP 25-75) 1 IN 1 DAY
• COTELLIC
63 IN 28 DAYS
Page 78 of 116
Medication Prescribing Limitations
• CRESTOR
• CYMBALTA
• D.H.E.45
• DALIRESP
• DEPO-PROVERA
• DEPO-SUBQ PROVERA 104
• DESCOVY
• DESOXYN
• DESVENLAFAXINE ER
• DESVENLAFAXINE FUMARATE
ER
• DEXEDRINE (10 MG) (CAPSULE
ER)
• DEXEDRINE (10 MG) (TABLET)
• DEXEDRINE (15 MG) (CAPSULE
ER)
• DEXEDRINE (5 MG) (CAPSULE
ER)
• DEXEDRINE (5 MG) (TABLET)
• DIASTAT
• DIASTAT ACUDIAL
• DIAZEPAM
• DIETHYLTOLUAMIDE (15 %)
(AERO POWD) (OTC)
• DIETHYLTOLUAMIDE (15 %)
(SPRAY) (OTC)
• DIETHYLTOLUAMIDE (25 %)
(AERO POWD) (OTC)
• DIETHYLTOLUAMIDE (25 %)
(SPRAY) (OTC)
• DIETHYLTOLUAMIDE (40 %)
(SPRAY) (OTC)
• DIETHYLTOLUAMIDE (7 %)
(SPRAY) (OTC)
• DIFICID
• DULERA
• DURAGESIC (100 MCG/HR)
(PATCH TD72)
• DURAGESIC (12 MCG/HR)
(PATCH TD72)
• DURAGESIC (25 MCG/HR)
(PATCH TD72)
• DURAGESIC (50MCG/HR)
(PATCH TD72)
• DURAGESIC (75MCG/HR)
(PATCH TD72)
• ECOTRIN
• EDLUAR
• EDURANT
• EFFIENT
• ELIQUIS (2.5 MG) (TABLET)
• ELIQUIS (5 MG) (TABLET)
• EMEND (125 MG CAPSULE)
• EMEND (125-80-80 MG PACK)
• EMEND (40 MG CAPSULE)
• EMEND (80 MG CAPSULE)
• EMSAM
• EMTRIVA (10 MG/ML)
(SOLUTION)
• EMTRIVA (200 MG) (CAPSULE)
• ENTRESTO
VNSNY
1 IN 1 DAY
2 IN 1 DAY
15 IN 14 DAYS
1 IN 1 DAY
1 IN 84 DAYS
0.65 IN 84 DAYS
1 IN 1 DAY
150 IN 30 DAYS
1 IN 1 DAY
1 IN 1 DAY
60 IN 30 DAYS
180 IN 30 DAYS
120 IN 30 DAYS
60 IN 30 DAYS
90 IN 30 DAYS
1 PER FILL
1 PER FILL
1 PER FILL
142 IN 180 DAYS
340 IN 180 DAYS
226 IN 180 DAYS
340 IN 180 DAYS
368 IN 180 DAYS
354 IN 180 DAYS
20 IN 30 DAYS
13 IN 30 DAYS
1 IN 3 DAYS
1 IN 3 DAYS
1 IN 3 DAYS
1 IN 3 DAYS
1 IN 3 DAYS
100 PER FILL
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
2 IN 1 DAY
74 IN 30 DAYS
1 IN 21 DAYS
3 IN 21 DAYS
1 IN 28 DAYS
2 IN 21 DAYS
1 IN 1 DAY
850mL IN 30 DAYS
1 IN 1 DAY
2 IN 1 DAY
• EPIVIR (10 MG/ML) (SOLUTION) 960mL IN 30 DAYS
• EPIVIR (150 MG) (TABLET)
2 IN 1 DAY
• EPIVIR (300 MG) (TABLET)
1 IN 1 DAY
• EPIVIR HBV (100 MG) (TABLET) 1 IN 1 DAY
• EPIVIR HBV (25 MG/5 ML)
(SOLUTION)
720mL IN 30 DAYS
• EPZICOM
1 IN 1 DAY
• ERIVEDGE
1 IN 1 DAY
• EVISTA
1 IN 1 DAY
• EVOTAZ
1 IN 1 DAY
• EXALGO (12 MG) (TAB ER 24H) 1 IN 1 DAY
• EXALGO (16 MG) (TAB ER 24H) 1 IN 1 DAY
• EXALGO (32 MG) (TAB ER 24H) 2 IN 1 DAY
• EXALGO (8 MG) (TAB ER 24H) 1 IN 1 DAY
• EXELON
30 IN 30 DAYS
• FANAPT (1 MG) (TABLET)
2 IN 1 DAY
• FANAPT (10 MG) (TABLET)
2 IN 1 DAY
• FANAPT (12 MG) (TABLET)
2 IN 1 DAY
• FANAPT (1-2-4-6MG) (TAB DS
PK)
8 IN 28 DAYS
• FANAPT (2 MG) (TABLET)
2 IN 1 DAY
• FANAPT (4 MG) (TABLET)
2 IN 1 DAY
• FANAPT (6 MG) (TABLET)
2 IN 1 DAY
• FANAPT (8 MG) (TABLET)
2 IN 1 DAY
• FAZACLO
3 IN 1 DAY
• FELBAMATE (400 MG) (TABLET)9 IN 1 DAY
• FELBAMATE (600 MG) (TABLET)6 IN 1 DAY
• FELBAMATE (600 MG/5ML)
(ORAL SUSP)
30mL IN 1 DAY
• FETZIMA
1 IN 1 DAY
• FIRMAGON (120 MG) (VIAL)
2 IN 365 DAYS
• FIRMAGON (80 MG) (VIAL)
1 IN 30 DAYS
• FLONASE
16 IN 30 DAYS
• FLONASE ALLERGY RELIEF
16 IN 30 DAYS
• FOCALIN
2 IN 1 DAY
• FOCALIN XR
1 IN 1 DAY
• FORTEO
2.4 IN 28 DAYS
• FOSAMAX (70 MG/75ML)
(SOLUTION)
75mL IN 7 DAYS
• FRAGMIN (10000/ML)
(SYRINGE)
10 IN 30 DAYS
• FRAGMIN (12500/0.5) (SYRINGE)5 IN 30 DAYS
• FRAGMIN (15000/0.6) (SYRINGE)6 IN 30 DAYS
• FRAGMIN (18000/0.72)
(SYRINGE)
7.2 IN 30 DAYS
• FRAGMIN (2500/0.2ML)
(SYRINGE)
2 IN 30 DAYS
• FRAGMIN (25000/ML) (VIAL)
7.6 IN 30 DAYS
• FRAGMIN (5000/0.2ML)
(SYRINGE)
2 IN 30 DAYS
• FRAGMIN (7500/0.3ML)
(SYRINGE)
3 IN 30 DAYS
• FUZEON
2 IN 1 DAY
• FYCOMPA (10 MG) (TABLET)
30 IN 30 DAYS
• FYCOMPA (12 MG) (TABLET)
30 IN 30 DAYS
• FYCOMPA (2 MG) (TABLET)
120 IN 30 DAYS
• FYCOMPA (4 MG) (TABLET)
60 IN 30 DAYS
• FYCOMPA (6 MG) (TABLET)
60 IN 30 DAYS
• FYCOMPA (8 MG) (TABLET)
30 IN 30 DAYS
• GABITRIL (12 MG) (TABLET)
4 IN 1 DAY
• GABITRIL (16 MG) (TABLET)
3 IN 1 DAY
Page 79 of 116
Medication Prescribing Limitations
• GABITRIL (2 MG) (TABLET)
4 IN 1 DAY
• GABITRIL (4 MG) (TABLET)
4 IN 1 DAY
• GENVOYA
1 IN 1 DAY
• GEODON
2 IN 1 DAY
• GLEEVEC (100 MG) (TABLET) 3 IN 1 DAY
• GLEEVEC (400 MG) (TABLET) 2 IN 1 DAY
• GLYXAMBI
1 IN 1 DAY
• GUANFACINE HCL
1 IN 1 DAY
• HALOTESTIN
120 IN 30 DAYS
• HEPSERA
1 IN 1 DAY
• HUMALOG (100/ML)
(CARTRIDGE)
30 IN 28 DAYS
• HUMALOG (100/ML) (VIAL)
40 IN 28 DAYS
• HUMALOG KWIKPEN U-100
30 IN 28 DAYS
• HUMALOG KWIKPEN U-200
12 IN 28 DAYS
• HUMALOG MIX 50-50
40 IN 28 DAYS
• HUMALOG MIX 50-50 KWIKPEN 30 IN 28 DAYS
• HUMALOG MIX 75-25
40 IN 28 DAYS
• HUMALOG MIX 75-25 KWIKPEN 30 IN 28 DAYS
• HUMULIN 70/30 KWIKPEN
30 IN 28 DAYS
• HUMULIN 70-30
40 IN 28 DAYS
• HUMULIN N
40 IN 28 DAYS
• HUMULIN N KWIKPEN
30 IN 28 DAYS
• HUMULIN R
40 IN 28 DAYS
• HUMULIN R U-500
40 IN 28 DAYS
• HUMULIN R U-500 KWIKPEN
24 IN 28 DAYS
• HYCET (7.5-325/15) (SOLUTION) 184mL IN 1 DAY
• ICLUSIG (15 MG) (TABLET)
2 IN 1 DAY
• ICLUSIG (45 MG) (TABLET)
1 IN 1 DAY
• IMITREX
6 IN 15 DAYS
• IMITREX (100 MG) (TABLET)
3 IN 5 DAYS
• IMITREX (25 MG) (TABLET)
3 IN 5 DAYS
• IMITREX (4 MG/0.5ML)
(CARTRIDGE)
1 IN 14 DAYS
• IMITREX (4 MG/0.5ML) (PEN
INJCTR)
1 IN 14 DAYS
• IMITREX (50 MG) (TABLET)
3 IN 5 DAYS
• IMITREX (6 MG/0.5ML)
(CARTRIDGE)
1 IN 14 DAYS
• IMITREX (6 MG/0.5ML) (PEN
INJCTR)
1 IN 14 DAYS
• IMITREX (6 MG/0.5ML)
(SYRINGE)
1 IN 14 DAYS
• IMITREX (6 MG/0.5ML) (VIAL) 1 IN 14 DAYS
• INCRUSE ELLIPTA
30 IN 30 DAYS
• INLYTA (1 MG) (TABLET)
6 IN 1 DAY
• INLYTA (5 MG) (TABLET)
4 IN 1 DAY
• INSECT REPELLENT
236 IN 180 DAYS
• INTELENCE (100 MG) (TABLET) 4 IN 1 DAY
• INTELENCE (200 MG) (TABLET) 2 IN 1 DAY
• INTELENCE (25 MG) (TABLET) 4 IN 1 DAY
• INTERMEZZO
1 IN 1 DAY
• INVEGA (1.5 MG) (TAB ER 24) 1 IN 1 DAY
• INVEGA (3 MG) (TAB ER 24)
1 IN 1 DAY
• INVEGA (6 MG) (TAB ER 24)
2 IN 1 DAY
• INVEGA (9 MG) (TAB ER 24)
1 IN 1 DAY
• INVEGA SUSTENNA
1 IN 21 DAYS
• INVIRASE (200 MG) (CAPSULE) 10 IN 1 DAY
• INVIRASE (500 MG) (TABLET) 4 IN 1 DAY
• INVOKAMET
2 IN 1 DAY
VNSNY
• INVOKAMET XR
2 IN 1 DAY
• INVOKANA
30 IN 30 DAYS
• IPRIVASK
2 IN 1 DAY
• ISENTRESS (100 MG) (POWD
PACK)
2 IN 1 DAY
• ISENTRESS (100 MG) (TAB
CHEW)
6 IN 1 DAY
• ISENTRESS (25 MG) (TAB
CHEW)
6 IN 1 DAY
• ISENTRESS (400 MG) (TABLET) 2 IN 1 DAY
• JAKAFI
2 IN 1 DAY
• JANUMET
2 IN 1 DAY
• JANUMET XR (100-1000MG)
(TBMP 24HR)
1 IN 1 DAY
• JANUMET XR (50-1000 MG)
(TBMP 24HR)
2 IN 1 DAY
• JANUMET XR (50MG-500MG)
(TBMP 24HR)
2 IN 1 DAY
• JANUVIA
1 IN 1 DAY
• JARDIANCE
1 IN 1 DAY
• JENTADUETO
2 IN 1 DAY
• JENTADUETO XR (2.5-1000MG)
(TAB BP 24H)
2 IN 1 DAY
• JENTADUETO XR (5MG1000MG) (TAB BP 24H)
1 IN 1 DAY
• KADIAN (100 MG) (CAP ER PEL) 2 IN 1 DAY
• KADIAN (20 MG) (CAP ER PEL) 2 IN 1 DAY
• KADIAN (30 MG) (CAP ER PEL) 2 IN 1 DAY
• KADIAN (50 MG) (CAP ER PEL) 2 IN 1 DAY
• KADIAN (60 MG) (CAP ER PEL) 2 IN 1 DAY
• KADIAN (80 MG) (CAP ER PEL) 2 IN 1 DAY
• KALETRA (100MG-25MG)
(TABLET)
2 IN 1 DAY
• KALETRA (200MG-50MG)
(TABLET)
4 IN 1 DAY
• KALETRA (400-100/5)
(SOLUTION)
480mL IN 30 DAYS
• KAPVAY
120 IN 30 DAYS
• KHEDEZLA
1 IN 1 DAY
• KYTRIL
8 IN 30 DAYS
• LAMICTAL ODT (100 MG) (TAB
RAPDIS)
3 IN 1 DAY
• LAMICTAL ODT (200 MG) (TAB
RAPDIS)
2 IN 1 DAY
• LAMICTAL ODT (25 MG) (TAB
RAPDIS)
6 IN 1 DAY
• LAMICTAL ODT (50 MG) (TAB
RAPDIS)
6 IN 1 DAY
• LAMOTRIGINE (100 MG) (TAB
ER 24)
3 IN 1 DAY
• LAMOTRIGINE (100 MG) (TAB
RAPDIS)
3 IN 1 DAY
• LAMOTRIGINE (200 MG) (TAB
ER 24)
2 IN 1 DAY
• LAMOTRIGINE (200 MG) (TAB
RAPDIS)
2 IN 1 DAY
• LAMOTRIGINE (25 MG) (TAB ER
24)
6 IN 1 DAY
• LAMOTRIGINE (25 MG) (TAB
RAPDIS)
6 IN 1 DAY
• LAMOTRIGINE (250 MG) (TAB
ER 24)
2 IN 1 DAY
Page 80 of 116
Medication Prescribing Limitations
• LAMOTRIGINE (300 MG) (TAB
ER 24)
2 IN 1 DAY
• LAMOTRIGINE (50 MG) (TAB ER
24)
6 IN 1 DAY
• LAMOTRIGINE (50 MG) (TAB
RAPDIS)
6 IN 1 DAY
• LATUDA (120 MG) (TABLET)
30 IN 30 DAYS
• LATUDA (20 MG) (TABLET)
30 IN 30 DAYS
• LATUDA (40 MG) (TABLET)
30 IN 30 DAYS
• LATUDA (60 MG) (TABLET)
30 IN 30 DAYS
• LATUDA (80 MG) (TABLET)
60 IN 30 DAYS
• LEXIVA (50 MG/ML) (ORAL
SUSP)
1800mL IN 30 DAYS
• LEXIVA (700 MG) (TABLET)
4 IN 1 DAY
• LINZESS
1 IN 1 DAY
• LORTAB (10MG-325MG)
(TABLET)
12 IN 1 DAY
• LORTAB (5 MG-325MG)
(TABLET)
12 IN 1 DAY
• LORTAB (7.5-325 MG) (TABLET) 12 IN 1 DAY
• LOSEASONIQUE
91 IN 84 DAYS
• LOVAZA
4 IN 1 DAY
• LOVENOX (100 MG/ML)
(SYRINGE)
20 IN 30 DAYS
• LOVENOX (120MG/.8ML)
(SYRINGE)
16 IN 30 DAYS
• LOVENOX (150 MG/ML)
(SYRINGE)
20 IN 30 DAYS
• LOVENOX (300MG/3ML) (VIAL) 30 IN 30 DAYS
• LOVENOX (30MG/0.3ML)
(SYRINGE)
6 IN 30 DAYS
• LOVENOX (40MG/0.4ML)
(SYRINGE)
8 IN 30 DAYS
• LOVENOX (60MG/0.6ML)
(SYRINGE)
12 IN 30 DAYS
• LOVENOX (80MG/0.8ML)
(SYRINGE)
16 IN 30 DAYS
• LUMIGAN (0.01 %) (DROPS)
1 IN 12 DAYS
• LUMIGAN (0.03 %) (DROPS)
1 IN 12 DAYS
• LUNESTA
1 IN 1 DAY
• LUVOX CR
2 IN 1 DAY
• LYNPARZA
16 IN 1 DAY
• MARINOL
2 IN 1 DAY
• MAXALT
3 IN 5 DAYS
• MAXALT MLT
3 IN 5 DAYS
• METADATE CD (10 MG) (CPBP
30-70)
1 IN 1 DAY
• METADATE CD (20 MG) (CPBP
30-70)
1 IN 1 DAY
• METADATE CD (30 MG) (CPBP
30-70)
2 IN 1 DAY
• METADATE CD (40 MG) (CPBP
30-70)
1 IN 1 DAY
• METADATE CD (50 MG) (CPBP
30-70)
1 IN 1 DAY
• METADATE CD (60 MG) (CPBP
30-70)
1 IN 1 DAY
• METADATE ER (10 MG)
(TABLET ER)
3 IN 1 DAY
• METADATE ER (20 MG)
(TABLET ER)
3 IN 1 DAY
VNSNY
• METHYLIN (10 MG) (TAB
CHEW)
90 IN 30 DAYS
• METHYLIN (2.5 MG) (TAB
CHEW)
90 IN 30 DAYS
• METHYLIN (5 MG) (TAB CHEW) 90 IN 30 DAYS
• MIGRANAL
8 IN 28 DAYS
• MOMETASONE FUROATE
17 IN 30 DAYS
• MONDOXYNE NL (100 MG)
(CAPSULE)
2 IN 1 DAY
• MONDOXYNE NL (50 MG)
(CAPSULE)
2 IN 1 DAY
• MONODOX (100 MG) (CAPSULE)2 IN 1 DAY
• MONODOX (50 MG) (CAPSULE) 2 IN 1 DAY
• MONODOX (50 MG) (TABLET) 2 IN 1 DAY
• MONODOX (75 MG) (TABLET) 2 IN 1 DAY
• MORGIDOX
2 IN 1 DAY
• MOVANTIK
1 IN 1 DAY
• MS CONTIN
3 IN 1 DAY
• MYALEPT
1 IN 1 DAY
• NAMENDA (10 MG) (TABLET) 60 IN 30 DAYS
• NAMENDA (2 MG/ML)
(SOLUTION)
300mL IN 30 DAYS
• NAMENDA (5 MG) (TABLET)
60 IN 30 DAYS
• NAMENDA (5 MG-10 MG) (TAB
DS PK)
49 IN 28 DAYS
• NAMENDA XR (14 MG) (CAP
SPR 24)
30 IN 30 DAYS
• NAMENDA XR (21 MG) (CAP
SPR 24)
30 IN 30 DAYS
• NAMENDA XR (28 MG) (CAP
SPR 24)
30 IN 30 DAYS
• NAMENDA XR (7 MG) (CAP SPR
24)
30 IN 30 DAYS
• NAMENDA XR (7-14-21-28)
(CAP24 DSPK)
28 IN 28 DAYS
• NAMZARIC (14MG-10MG) (CAP
SPR 24)
1 IN 1 DAY
• NAMZARIC (21 MG-10MG) (CAP
SPR 24)
1 IN 1 DAY
• NAMZARIC (28 MG-10MG) (CAP
SPR 24)
1 IN 1 DAY
• NAMZARIC (7 MG-10 MG) (CAP
SPR 24)
1 IN 1 DAY
• NAMZARIC (7-10/14-10) (CAP24
DSPK)
28 IN 28 DAYS
• NARCAN (4 MG) (SPRAY)
4 IN 30 DAYS
• NASALIDE
25 IN 30 DAYS
• NATRAPEL
354 IN 180 DAYS
• NEUPRO
1 IN 1 DAY
• NEXAVAR
4 IN 1 DAY
• NEXIUM (10 MG) (SUSPDR PKT) 1 IN 1 DAY
• NEXIUM (2.5 MG) (SUSPDR
PKT)
1 IN 1 DAY
• NEXIUM (20 MG) (CAPSULE DR)1 IN 1 DAY
• NEXIUM (20 MG) (SUSPDR PKT) 1 IN 1 DAY
• NEXIUM (40 MG) (CAPSULE DR)1 IN 1 DAY
• NEXIUM (40 MG) (SUSPDR PKT) 1 IN 1 DAY
• NEXIUM (5 MG) (SUSPDR PKT) 1 IN 1 DAY
• NICOTROL
1008 IN 90 DAYS
• NICOTROL NS
160 IN 90 DAYS
• NILANDRON
150 AFTER 30 DAYS
Page 81 of 116
Medication Prescribing Limitations
• NORCO
• NORVIR (100 MG) (CAPSULE)
• NORVIR (100 MG) (TABLET)
• NORVIR (80 MG/ML)
(SOLUTION)
• NUCYNTA
• NUCYNTA ER
• NUVARING
• ODEFSEY
• ONFI (10 MG) (TABLET)
• ONFI (2.5 MG/ML) (ORAL SUSP)
• ONFI (20 MG) (TABLET)
• OPANA ER (10 MG) (TAB ER
12H)
• OPANA ER (15 MG) (TAB ER
12H)
• OPANA ER (20 MG) (TAB ER
12H)
• OPANA ER (30 MG) (TAB ER
12H)
• OPANA ER (40 MG) (TAB ER
12H)
• OPANA ER (5 MG) (TAB ER 12H)
• OPANA ER (7.5 MG) (TAB ER
12H)
• ORACEA
• ORTHO EVRA
• OXTELLAR XR (150 MG) (TAB
ER 24H)
• OXTELLAR XR (300 MG) (TAB
ER 24H)
• OXTELLAR XR (600 MG) (TAB
ER 24H)
• OXYCONTIN (10 MG) (TAB ER
12H)
• OXYCONTIN (15 MG) (TAB ER
12H)
• OXYCONTIN (20 MG) (TAB ER
12H)
• OXYCONTIN (30 MG) (TAB ER
12H)
• OXYCONTIN (40 MG) (TAB ER
12H)
• OXYCONTIN (60 MG) (TAB ER
12H)
• OXYCONTIN (80 MG) (TAB ER
12H)
• PATANASE
• PERCOCET
• PERFOROMIST
• PEXEVA
• PICATO (0.015 %) (GEL (EA))
• PICATO (0.05 %) (GEL (EA))
• PLAVIX (300 MG) (TABLET)
• POTIGA (200 MG) (TABLET)
• POTIGA (300 MG) (TABLET)
• POTIGA (400 MG) (TABLET)
• POTIGA (50 MG) (TABLET)
• PREVPAC
• PREZCOBIX
VNSNY
12 IN 1 DAY
12 IN 1 DAY
12 IN 1 DAY
480mL IN 30 DAYS
6 IN 1 DAY
2 IN 1 DAY
1 IN 28 DAYS
1 IN 1 DAY
2 IN 1 DAY
480mL IN 30 DAYS
2 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
4 IN 1 DAY
4 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
1 IN 1 DAY
3 IN 28 DAYS
1 IN 1 DAY
1 IN 1 DAY
4 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
4 IN 1 DAY
30.5 IN 30 DAYS
12 IN 1 DAY
120 IN 30 DAYS
1 IN 1 DAY
3 IN 28 DAYS
2 IN 28 DAYS
4 IN 30 DAYS
3 IN 1 DAY
3 IN 1 DAY
3 IN 1 DAY
9 IN 1 DAY
112 IN 10 DAYS
1 IN 1 DAY
• PREZISTA (100 MG/ML) (ORAL
SUSP)
240mL IN 30 DAYS
• PREZISTA (150 MG) (TABLET) 240 IN 30 DAYS
• PREZISTA (600 MG) (TABLET) 60 IN 30 DAYS
• PREZISTA (75 MG) (TABLET)
480 IN 30 DAYS
• PREZISTA (800 MG) (TABLET) 30 IN 30 DAYS
• PRISTIQ
1 IN 1 DAY
• PROCENTRA
1800mL IN 30 DAYS
• PULMICORT (0.25MG/2ML)
(AMPUL-NEB)
120 IN 30 DAYS
• PULMICORT (0.5 MG/2ML)
(AMPUL-NEB)
120 IN 30 DAYS
• PULMICORT (1 MG/2 ML)
(AMPUL-NEB)
60 IN 30 DAYS
• QNASL
8.7 IN 30 DAYS
• QUDEXY XR (100 MG) (CAP SPR
24)
1 IN 1 DAY
• QUDEXY XR (150 MG) (CAP SPR
24)
2 IN 1 DAY
• QUDEXY XR (200 MG) (CAP SPR
24)
2 IN 1 DAY
• QUDEXY XR (25 MG) (CAP SPR
24)
1 IN 1 DAY
• QUDEXY XR (50 MG) (CAP SPR
24)
1 IN 1 DAY
• QUILLIVANT XR (5 MG/ML) (SU
ER RC24)
10 IN 1 DAY
• RANEXA (1000 MG) (TAB ER
12H)
60 IN 30 DAYS
• RANEXA (500 MG) (TAB ER 12H)120 IN 30 DAYS
• RASUVO (10MG/0.2ML) (AUTO
INJCT)
0.8 IN 28 DAYS
• RASUVO (12.5/0.25) (AUTO
INJCT)
1 IN 28 DAYS
• RASUVO (15MG/0.3ML) (AUTO
INJCT)
1.2 IN 28 DAYS
• RASUVO (17.5/0.35) (AUTO
INJCT)
1.4 IN 28 DAYS
• RASUVO (20MG/0.4ML) (AUTO
INJCT)
1.6 IN 28 DAYS
• RASUVO (22.5/0.45) (AUTO
INJCT)
1.8 IN 28 DAYS
• RASUVO (25MG/0.5ML) (AUTO
INJCT)
2 IN 28 DAYS
• RASUVO (27.5/0.55) (AUTO
INJCT)
2.2 IN 28 DAYS
• RASUVO (30MG/0.6ML) (AUTO
INJCT)
2.4 IN 28 DAYS
• RASUVO (7.5MG/0.15) (AUTO
INJCT)
0.6 IN 28 DAYS
• RAZADYNE (12 MG) (TABLET) 60 IN 30 DAYS
• RAZADYNE (4 MG) (TABLET) 60 IN 30 DAYS
• RAZADYNE (4 MG/ML)
(SOLUTION)
200mL IN 30 DAYS
• RAZADYNE (8 MG) (TABLET) 60 IN 30 DAYS
• RAZADYNE ER
30 IN 30 DAYS
• REQUIP XL
1 IN 1 DAY
• RETROVIR (10 MG/ML) (SYRUP) 1920mL IN 30 DAYS
• RETROVIR (100 MG) (CAPSULE) 6 IN 1 DAY
• RETROVIR (300 MG) (TABLET) 2 IN 1 DAY
• REVLIMID
1 IN 1 DAY
• REYATAZ (150 MG) (CAPSULE) 2 IN 1 DAY
Page 82 of 116
Medication Prescribing Limitations
• REYATAZ (200 MG) (CAPSULE) 2 IN 1 DAY
• REYATAZ (300 MG) (CAPSULE) 1 IN 1 DAY
• REYATAZ (50 MG) (POWD PACK) 5 IN 1 DAY
• RISPERDAL (0.25 MG) (TABLET) 2 IN 1 DAY
• RISPERDAL (0.5 MG) (TABLET) 2 IN 1 DAY
• RISPERDAL (1 MG) (TABLET)
2 IN 1 DAY
• RISPERDAL (1 MG/ML)
(SOLUTION)
8mL IN 1 DAY
• RISPERDAL (2 MG) (TABLET)
2 IN 1 DAY
• RISPERDAL (3 MG) (TABLET)
2 IN 1 DAY
• RISPERDAL (4 MG) (TABLET)
2 IN 1 DAY
• RISPERDAL CONSTA
1 IN 14 DAYS
• RISPERDAL M-TAB
2 IN 1 DAY
• RISPERIDONE ODT
2 IN 1 DAY
• RITALIN
90 IN 30 DAYS
• RITALIN LA (10 MG) (CPBP 5050)
1 IN 1 DAY
• RITALIN LA (20 MG) (CPBP 5050)
1 IN 1 DAY
• RITALIN LA (30 MG) (CPBP 5050)
2 IN 1 DAY
• RITALIN LA (40 MG) (CPBP 5050)
1 IN 1 DAY
• RITALIN-SR
90 IN 30 DAYS
• ROXICET
61mL IN 1 DAY
• ROZEREM
1 IN 1 DAY
• SABRIL
6 IN 1 DAY
• SAPHRIS
2 IN 1 DAY
• SEASONALE
91 IN 84 DAYS
• SEASONIQUE
91 IN 84 DAYS
• SELZENTRY (150 MG) (TABLET) 2 IN 1 DAY
• SELZENTRY (25 MG) (TABLET) 4 IN 1 DAY
• SELZENTRY (300 MG) (TABLET) 4 IN 1 DAY
• SELZENTRY (75 MG) (TABLET) 2 IN 1 DAY
• SEROQUEL
3 IN 1 DAY
• SEROQUEL XR (150 MG) (TAB
ER 24H)
1 IN 1 DAY
• SEROQUEL XR (200 MG) (TAB
ER 24H)
1 IN 1 DAY
• SEROQUEL XR (300 MG) (TAB
ER 24H)
1 IN 1 DAY
• SEROQUEL XR (400 MG) (TAB
ER 24H)
1 IN 1 DAY
• SEROQUEL XR (50 MG) (TAB ER
24H)
1 IN 1 DAY
• SILENOR
1 IN 1 DAY
• SOLARAZE
100 PER FILL
• SONATA
1 IN 1 DAY
• SPIRIVA RESPIMAT
4 IN 30 DAYS
• SPRYCEL (100 MG) (TABLET)
1 IN 1 DAY
• SPRYCEL (140 MG) (TABLET)
1 IN 1 DAY
• SPRYCEL (20 MG) (TABLET)
2 IN 1 DAY
• SPRYCEL (50 MG) (TABLET)
1 IN 1 DAY
• SPRYCEL (70 MG) (TABLET)
1 IN 1 DAY
• SPRYCEL (80 MG) (TABLET)
1 IN 1 DAY
• STAVUDINE (1 MG/ML) (SOLN
RECON)
2400mL IN 30 DAYS
• STAVUDINE (15 MG) (CAPSULE) 2 IN 1 DAY
• STAVUDINE (20 MG) (CAPSULE) 2 IN 1 DAY
• STAVUDINE (30 MG) (CAPSULE) 2 IN 1 DAY
• STAVUDINE (40 MG) (CAPSULE) 2 IN 1 DAY
VNSNY
• STIOLTO RESPIMAT
4 IN 30 DAYS
• STIVARGA
3 IN 1 DAY
• STRATTERA (10 MG) (CAPSULE)60 IN 30 DAYS
• STRATTERA (100 MG)
(CAPSULE)
30 IN 30 DAYS
• STRATTERA (18 MG) (CAPSULE)60 IN 30 DAYS
• STRATTERA (25 MG) (CAPSULE)60 IN 30 DAYS
• STRATTERA (40 MG) (CAPSULE)60 IN 30 DAYS
• STRATTERA (60 MG) (CAPSULE)30 IN 30 DAYS
• STRATTERA (80 MG) (CAPSULE)30 IN 30 DAYS
• STRIBILD
1 IN 1 DAY
• STRIVERDI RESPIMAT
4 IN 30 DAYS
• SUBOXONE (12 MG-3 MG)
(FILM)
3 IN 1 DAY
• SUBOXONE (2 MG-0.5MG)
(FILM)
3 IN 1 DAY
• SUBOXONE (2 MG-0.5MG) (TAB
SUBL)
3 IN 1 DAY
• SUBOXONE (4MG-1MG) (FILM) 3 IN 1 DAY
• SUBOXONE (8 MG-2 MG) (FILM) 3 IN 1 DAY
• SUBOXONE (8 MG-2 MG) (TAB
SUBL)
3 IN 1 DAY
• SUBUTEX
3 IN 1 DAY
• SUTENT
1 IN 1 DAY
• SYLATRON
1 IN 28 DAYS
• SYMBYAX
1 IN 1 DAY
• SYNJARDY
2 IN 1 DAY
• TAGRISSO
1 IN 1 DAY
• TAMIFLU (30 MG) (CAPSULE) 40 IN 183 DAYS
• TAMIFLU (45 MG) (CAPSULE) 20 IN 183 DAYS
• TAMIFLU (6 MG/ML) (SUSP
RECON)
360mL IN 183 DAYS
• TAMIFLU (75 MG) (CAPSULE) 20 IN 183 DAYS
• TARCEVA (100 MG) (TABLET) 3 IN 1 DAY
• TARCEVA (150 MG) (TABLET) 3 IN 1 DAY
• TARCEVA (25 MG) (TABLET)
2 IN 1 DAY
• TASIGNA
4 IN 1 DAY
• THALOMID
2 IN 1 DAY
• TIAGABINE HCL
4 IN 1 DAY
• TIVICAY
2 IN 1 DAY
• TOPIRAMATE (100 MG) (CAP
SPR 24)
1 IN 1 DAY
• TOPIRAMATE (150 MG) (CAP
SPR 24)
2 IN 1 DAY
• TOPIRAMATE (200 MG) (CAP
SPR 24)
2 IN 1 DAY
• TOPIRAMATE (25 MG) (CAP SPR
24)
1 IN 1 DAY
• TOPIRAMATE (50 MG) (CAP SPR
24)
1 IN 1 DAY
• TOUJEO SOLOSTAR
13.5 IN 28 DAYS
• TRADJENTA
1 IN 1 DAY
• TRAVATAN Z
1 IN 12 DAYS
• TRINTELLIX
1 IN 1 DAY
• TRIUMEQ
1 IN 1 DAY
• TRIZIVIR
2 IN 1 DAY
• TROKENDI XR (100 MG) (CAP
ER 24H)
1 IN 1 DAY
• TROKENDI XR (200 MG) (CAP
ER 24H)
2 IN 1 DAY
Page 83 of 116
Medication Prescribing Limitations
• TROKENDI XR (25 MG) (CAP ER
24H)
• TROKENDI XR (50 MG) (CAP ER
24H)
• TRULICITY
• TRUVADA
• TYBOST
• ULORIC
• VANCOCIN HCL (125 MG)
(CAPSULE)
• VANCOCIN HCL (250 MG)
(CAPSULE)
• VASCEPA (0.5 GRAM)
(CAPSULE)
• VASCEPA (1 G) (CAPSULE)
• VERSACLOZ
• VIBRAMYCIN
• VIBRA-TABS
• VICTOZA 2-PAK
• VICTOZA 3-PAK
• VIDEX
• VIDEX EC (125 MG) (CAPSULE
DR)
• VIDEX EC (200 MG) (CAPSULE
DR)
• VIDEX EC (250 MG) (CAPSULE
DR)
• VIDEX EC (400 MG) (CAPSULE
DR)
• VIIBRYD (10 MG) (TABLET)
• VIIBRYD (20 MG) (TABLET)
• VIIBRYD (40 MG) (TABLET)
• VIMPAT (10 MG/ML)
(SOLUTION)
• VIMPAT (100 MG) (TABLET)
• VIMPAT (150 MG) (TABLET)
• VIMPAT (200 MG) (TABLET)
• VIMPAT (50 MG) (TABLET)
• VIRAMUNE (200 MG) (TABLET)
• VIRAMUNE (50 MG/5 ML)
(ORAL SUSP)
• VIRAMUNE XR (100 MG) (TAB
ER 24H)
• VIRAMUNE XR (400 MG) (TAB
ER 24H)
• VIREAD (150 MG) (TABLET)
• VIREAD (200 MG) (TABLET)
• VIREAD (250 MG) (TABLET)
• VIREAD (300 MG) (TABLET)
• VIREAD (40MG/SCOOP)
(POWDER)
• VISTOGARD
• VIVELLE-DOT
• VOTRIENT
• VYVANSE (10 MG) (CAPSULE)
• VYVANSE (20 MG) (CAPSULE)
• VYVANSE (30 MG) (CAPSULE)
• VYVANSE (40 MG) (CAPSULE)
• VYVANSE (50 MG) (CAPSULE)
• VYVANSE (60 MG) (CAPSULE)
• VYVANSE (70 MG) (CAPSULE)
VNSNY
1 IN 1 DAY
1 IN 1 DAY
2 IN 28 DAYS
1 IN 1 DAY
1 IN 1 DAY
30 IN 30 DAYS
40 IN 30 DAYS
80 IN 30 DAYS
8 IN 1 DAY
4 IN 1 DAY
18mL IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
9 IN 30 DAYS
9 IN 30 DAYS
600mL IN 30 DAYS
2 IN 1 DAY
2 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1200mL IN 30 DAYS
2 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
2 IN 1 DAY
1200mL IN 30 DAYS
3 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
240 IN 30 DAYS
24 IN 14 DAYS
2 IN 7 DAYS
4 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
• XALKORI
• XARELTO (10 MG) (TABLET)
• XARELTO (15 MG) (TABLET)
• XARELTO (15 MG-20MG) (TAB
DS PK)
• XARELTO (20 MG) (TABLET)
• XELODA (150 MG) (TABLET)
• XELODA (500 MG) (TABLET)
• XIIDRA
• XTANDI
• XYZAL (2.5 MG/5ML)
(SOLUTION)
• ZAMICET (10-325/15)
(SOLUTION)
• ZAMICET (5-163/7.5)
(SOLUTION)
• ZELBORAF
• ZENZEDI (2.5 MG) (TABLET)
• ZENZEDI (7.5 MG) (TABLET)
• ZETIA
• ZIAGEN (20 MG/ML)
(SOLUTION)
• ZIAGEN (300 MG) (TABLET)
• ZOFRAN (4 MG/5 ML)
(SOLUTION)
• ZOLPIMIST
• ZOMIG (2.5 MG) (SPRAY)
• ZOMIG (5 MG) (SPRAY)
• ZUBSOLV (0.7-0.18MG) (TAB
SUBL)
• ZUBSOLV (1.4-0.36MG) (TAB
SUBL)
• ZUBSOLV (11.4-2.9MG) (TAB
SUBL)
• ZUBSOLV (2.9-0.71MG) (TAB
SUBL)
• ZUBSOLV (5.7-1.4 MG) (TAB
SUBL)
• ZUBSOLV (8.6-2.1 MG) (TAB
SUBL)
• ZYPREXA (10 MG) (TABLET)
• ZYPREXA (15 MG) (TABLET)
• ZYPREXA (2.5 MG) (TABLET)
• ZYPREXA (20 MG) (TABLET)
• ZYPREXA (5 MG) (TABLET)
• ZYPREXA (7.5 MG) (TABLET)
• ZYPREXA RELPREVV (210 MG)
(VIAL)
• ZYPREXA RELPREVV (300 MG)
(VIAL)
• ZYPREXA RELPREVV (405 MG)
(VIAL)
• ZYPREXA ZYDIS
• ZYTIGA
2 IN 1 DAY
1 IN 1 DAY
42 IN 21 DAYS THEN 1
IN 1 DAY
51 IN 30 DAYS
1 IN 1 DAY
28 IN 21 DAYS
112 IN 21 DAYS
60 IN 30 DAYS
4 IN 1 DAY
10mL IN 1 DAY
184mL IN 1 DAY
184mL IN 1 DAY
8 IN 1 DAY
90 IN 30 DAYS
90 IN 30 DAYS
1 IN 1 DAY
960mL IN 30 DAYS
2 IN 1 DAY
50mL IN 15 DAYS
7.7 IN 30 DAYS
12 IN 30 DAYS
6 IN 15 DAYS
3 IN 1 DAY
3 IN 1 DAY
3 IN 1 DAY
3 IN 1 DAY
3 IN 1 DAY
3 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 1 DAY
1 IN 14 DAYS
1 IN 14 DAYS
1 IN 28 DAYS
1 IN 1 DAY
4 IN 1 DAY
Page 84 of 116
Medication Prescribing Limitations
STEP THERAPY EDITS
• ABILIFY (1 MG/ML) (SOLUTION)
• ABILIFY DISCMELT (10 MG) (TAB
RAPDIS)
• ABILIFY DISCMELT (15 MG) (TAB
RAPDIS)
• ACTOPLUS MET
• ACTOPLUS MET XR
• APLENZIN
• APTIOM (200 MG) (TABLET)
• APTIOM (400 MG) (TABLET)
• APTIOM (600 MG) (TABLET)
• APTIOM (800 MG) (TABLET)
• BANZEL (200 MG) (TABLET)
• BANZEL (40 MG/ML) (ORAL SUSP)
• BANZEL (400 MG) (TABLET)
• BELSOMRA
VNSNY
At least 2 prior prescriptions for Abilify Maintena, Abilify, Brisdelle, Citalopram
Hydrobromide, Clozapine, Duloxetine HCL, Escitalopram Oxalate, Fluoxetine HCL,
Olanzapine, Paroxetine HCL, Paxil, Pexeva, Quetiapine Fumarate, Risperidone,
Sarafem, Seroquel XR, Sertraline HCL, Venlafaxine HCL, Versacloz, or Ziprasidone
HCL in 365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Brisdelle,
Citalopram Hydrobromide, Clozapine, Duloxetine HCL, Escitalopram Oxalate,
Fluoxetine HCL, Olanzapine, Paroxetine HCL, Paxil, Pexeva, Quetiapine Fumarate,
Risperidone, Sarafem, Seroquel XR, Sertraline HCL, Venlafaxine HCL, Versacloz, or
Ziprasidone HCL in 365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Brisdelle,
Citalopram Hydrobromide, Clozapine, Duloxetine HCL, Escitalopram Oxalate,
Fluoxetine HCL, Olanzapine, Paroxetine HCL, Paxil, Pexeva, Quetiapine Fumarate,
Risperidone, Sarafem, Seroquel XR, Sertraline HCL, Venlafaxine HCL, Versacloz, or
Ziprasidone HCL in 365 days
Prior prescription for Avandamet, Avandaryl, Avandia, Chlorpropamide, Diabeta,
Fortamet, Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide,
Glyburide/metformin HCL, Metformin HCL, Riomet, Tolazamide, or Tolbutamide in
120 days
Prior prescription for Avandamet, Avandaryl, Avandia, Chlorpropamide, Diabeta,
Fortamet, Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide,
Glyburide/metformin HCL, Metformin HCL, Riomet, Tolazamide, or Tolbutamide in
120 days
Prior prescription for Bupropion HCL or Forfivo XL in 120 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid (as Sodium Salt), Valproic Acid, or
Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid (as Sodium Salt), Valproic Acid, or
Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid (as Sodium Salt), Valproic Acid, or
Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid (as Sodium Salt), Valproic Acid, or
Zonisamide in 365 days
Prior prescription for Divalproex Sodium, Lamictal (blue), Lamictal (green),
Lamictal (orange), Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange),
Lamictal, Lamotrigine, Stavzor, Topiramate, Trokendi XR, or Valproic Acid in 120
days
Prior prescription for Divalproex Sodium, Lamictal (blue), Lamictal (green),
Lamictal (orange), Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange),
Lamictal, Lamotrigine, Stavzor, Topiramate, Trokendi XR, or Valproic Acid in 120
days
Prior prescription for Divalproex Sodium, Lamictal (blue), Lamictal (green),
Lamictal (orange), Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange),
Lamictal, Lamotrigine, Stavzor, Topiramate, Trokendi XR, or Valproic Acid in 120
days
Prior prescription for Eszopiclone, Zaleplon, or Zolpidem Tartrate in 120 days
Page 85 of 116
Medication Prescribing Limitations
• BENICAR
• BENICAR HCT
• BEYAZ
• BRISDELLE
• CONZIP (150 MG) (CPBP 25-75)
• DALIRESP
• DESVENLAFAXINE ER
• DESVENLAFAXINE FUMARATE ER
• DETROL
• DIFICID
• DISKETS (40 MG) (TABLET SOL)
• DOLOPHINE HCL
• DOVONEX
• DRITHOCREME HP
• EDLUAR
• EXFORGE
Prior prescription for Amlodipine Bes/olmesartan Med, Amlodipine
Besylate/benazepril, Benazepril HCL, Benazepril/hydrochlorothiazide, Captopril,
Captopril/hydrochlorothiazide, Enalapril Maleate, Enalapril/hydrochlorothiazide,
Epaned, Fosinopril Sodium, Fosinopril/hydrochlorothiazide, Irbesartan,
Irbesartan/hydrochlorothiazide, Lisinopril, Lisinopril/hydrochlorothiazide, Losartan
Potassium, Losartan/hydrochlorothiazide, Moexipril HCL,
Moexipril/hydrochlorothiazide, Olmesartan/amlodipin/hcthiazid,
Olmesartan/hydrochlorothiazide, Perindopril Erbumine, Qbrelis, Quinapril HCL,
Quinapril/hydrochlorothiazide, Ramipril, Trandolapril, Trandolapril/verapamil HCL,
or Valsartan/hydrochlorothiazide in 120 days
Prior prescription for Amlodipine Bes/olmesartan Med, Amlodipine
Besylate/benazepril, Benazepril HCL, Benazepril/hydrochlorothiazide, Captopril,
Captopril/hydrochlorothiazide, Enalapril Maleate, Enalapril/hydrochlorothiazide,
Epaned, Fosinopril Sodium, Fosinopril/hydrochlorothiazide, Irbesartan,
Irbesartan/hydrochlorothiazide, Lisinopril, Lisinopril/hydrochlorothiazide, Losartan
Potassium, Losartan/hydrochlorothiazide, Moexipril HCL,
Moexipril/hydrochlorothiazide, Olmesartan Medoxomil,
Olmesartan/amlodipin/hcthiazid, Perindopril Erbumine, Qbrelis, Quinapril HCL,
Quinapril/hydrochlorothiazide, Ramipril, Trandolapril, Trandolapril/verapamil HCL,
or Valsartan/hydrochlorothiazide in 120 days
At least 2 prior prescriptions for Desog-e.estradiol/e.estradiol, Desogestrel-ethinyl
Estradiol, Ethynodiol D-ethinyl Estradiol, L-norgest/e.estradiol-e.estrad,
Levonorgestrel-ethin Estradiol, Lo Loestrin Fe, Minastrin 24 Fe, Noreth-ethinyl
Estradiol/iron, Norethindrone Ac-eth Estradiol, Norethindrone, Norethindronee.estradiol-iron, Norethindrone-ethinyl Estrad, Norethindrone-mestranol,
Norgestimate-ethinyl Estradiol, Norgestrel-ethinyl Estradiol, or Ovcon-50 in 365
days
Prior prescription for Paroxetine HCL, Paxil, or Venlafaxine HCL in 120 days
Prior prescription for Tramadol HCL in 120 days
Prior prescription for Advair Diskus, Breo Ellipta, Dulera, Incruse Ellipta, Spiriva
Respimat, or Striverdi Respimat in 120 days
At least 2 prior prescriptions for Bupropion HCL, Citalopram Hydrobromide,
Escitalopram Oxalate, Fluoxetine HCL, Forfivo XL, Mirtazapine, Paroxetine HCL,
Paxil, Sarafem, Sertraline HCL, or Venlafaxine HCL in 365 days
At least 2 prior prescriptions for Bupropion HCL, Citalopram Hydrobromide,
Escitalopram Oxalate, Fluoxetine HCL, Forfivo XL, Mirtazapine, Paroxetine HCL,
Paxil, Sarafem, Sertraline HCL, or Venlafaxine HCL in 365 days
Prior prescription for Oxybutynin Chloride in 120 days
Prior prescription for Vancomycin HCL in 120 days
Prior prescription for Methadone tablets (5 or 10mg) OR oral solution (5mg/5mL or
10mg/5mL) in 120 days
Prior prescription for an extended-release opioid in 120 days
Prior prescription for a Topical Anti-inflammatory Steroidal in 120 days
Prior prescription for a Topical Anti-inflammatory Steroidal in 120 days
Prior prescription for Zolpidem Tartrate in 180 days
Prior prescription for Amlodipine Besylate/benazepril,
Amlodipine/valsartan/hcthiazid, Benazepril HCL, Benazepril/hydrochlorothiazide,
Captopril, Captopril/hydrochlorothiazide, Enalapril Maleate,
Enalapril/hydrochlorothiazide, Epaned, Fosinopril Sodium,
Fosinopril/hydrochlorothiazide, Irbesartan, Irbesartan/hydrochlorothiazide,
Lisinopril, Lisinopril/hydrochlorothiazide, Losartan Potassium,
Losartan/hydrochlorothiazide, Moexipril HCL, Moexipril/hydrochlorothiazide,
Perindopril Erbumine, Qbrelis, Quinapril HCL, Quinapril/hydrochlorothiazide,
Ramipril, Trandolapril, Trandolapril/verapamil, or Valsartan/hydrochlorothiazide in
120 days
• EXFORGE HCT
Prior prescriptions for Amlodipine Besylate/benazepril, Amlodipine/valsartan,
Benazepril HCL, Benazepril/hydrochlorothiazide, Captopril,
Captopril/hydrochlorothiazide, Enalapril Maleate, Enalapril/hydrochlorothiazide,
Epaned, Fosinopril Sodium, Fosinopril/hydrochlorothiazide, Irbesartan,
Irbesartan/hydrochlorothiazide, Lisinopril, Lisinopril/hydrochlorothiazide, Losartan
Potassium, Losartan/hydrochlorothiazide, Moexipril HCL,
Moexipril/hydrochlorothiazide, Perindopril Erbumine, Qbrelis, Quinapril HCL,
VNSNY
Page 86 of 116
Medication Prescribing Limitations
• FANAPT (1 MG) (TABLET)
• FANAPT (10 MG) (TABLET)
• FANAPT (12 MG) (TABLET)
• FANAPT (1-2-4-6MG) (TAB DS PK)
• FANAPT (2 MG) (TABLET)
• FANAPT (4 MG) (TABLET)
• FANAPT (6 MG) (TABLET)
• FANAPT (8 MG) (TABLET)
• FAZACLO
• FELBAMATE (400 MG) (TABLET)
• FELBAMATE (600 MG) (TABLET)
• FELBAMATE (600 MG/5ML) (ORAL
SUSP)
• FETZIMA
• FYCOMPA (10 MG) (TABLET)
• FYCOMPA (12 MG) (TABLET)
• FYCOMPA (2 MG) (TABLET)
• FYCOMPA (4 MG) (TABLET)
• FYCOMPA (6 MG) (TABLET)
VNSNY
Quinapril/hydrochlorothiazide, Ramipril, Trandolapril, Trandolapril/verapamil HCL,
or Valsartan/hydrochlorothiazide in 120 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Risperidone, Seroquel XR, Versacloz, or
Ziprasidone HCL in 365 days
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), Lamictal
XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal, Lamotrigine,
Topiramate, or Trokendi XR in 120 days
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), Lamictal
XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal, Lamotrigine,
Topiramate, or Trokendi XR in 120 days
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), Lamictal
XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal, Lamotrigine,
Topiramate, or Trokendi XR in 120 days
At least 2 prior prescriptions for Bupropion HCL, Citalopram Hydrobromide,
Escitalopram Oxalate, Fluoxetine HCL, Forfivo XL, Mirtazapine, Paroxetine HCL,
Paxil, Sarafem, Sertraline HCL, or Venlafaxine HCL in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Page 87 of 116
Medication Prescribing Limitations
• FYCOMPA (8 MG) (TABLET)
• GABITRIL (12 MG) (TABLET)
• GABITRIL (16 MG) (TABLET)
• GABITRIL (2 MG) (TABLET)
• GABITRIL (4 MG) (TABLET)
• GLYXAMBI
• INVEGA (1.5 MG) (TAB ER 24)
• INVEGA (3 MG) (TAB ER 24)
• INVEGA (6 MG) (TAB ER 24)
• INVEGA (9 MG) (TAB ER 24)
• INVOKAMET
• INVOKAMET XR
• INVOKANA
• JALYN
VNSNY
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
Prior prescription for Actoplus Met XR, Chlorpropamide, Diabeta, Fortamet,
Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide, Glyburide micronized,
Glyburide/metformin HCL, Metformin HCL, Pioglitazone HCL, Pioglitazone
HCL/glimepiride, Pioglitazone HCL/metformin HCL, Riomet, Tolazamide, or
Tolbutamide in 120 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Seroquel XR, Versacloz, or Ziprasidone HCL in
365 days
Prior prescription for Actoplus Met XR, Chlorpropamide, Diabeta, Fortamet,
Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide, Glyburide micronized,
Glyburide/metformin HCL, Metformin HCL, Pioglitazone HCL, Pioglitazone
HCL/glimepiride, Pioglitazone HCL/metformin HCL, Riomet, Tolazamide, or
Tolbutamide in 120 days
Prior prescription for Actoplus Met XR, Chlorpropamide, Diabeta, Fortamet,
Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide, Glyburide micronized,
Glyburide/metformin HCL, Metformin HCL, Pioglitazone HCL, Pioglitazone
HCL/glimepiride, Pioglitazone HCL/metformin HCL, Riomet, Tolazamide, or
Tolbutamide in 120 days
Prior prescription for Actoplus Met XR, Chlorpropamide, Diabeta, Fortamet,
Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide, Glyburide micronized,
Glyburide/metformin HCL, Metformin HCL, Pioglitazone HCL, Pioglitazone
HCL/glimepiride, Pioglitazone HCL/metformin HCL, Riomet, Tolazamide, or
Tolbutamide in 120 days
Prior prescription for Alfuzosin HCL, Doxazosin Mesylate, Finasteride, Prazosin
HCL, Rapaflo, Tamsulosin HCL, or Terazosin HCL in 120 days
Page 88 of 116
Medication Prescribing Limitations
• JARDIANCE
Prior prescription for Actoplus Met XR, Chlorpropamide, Diabeta, Fortamet,
Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide, Glyburide micronized,
Glyburide/metformin HCL, Metformin HCL, Pioglitazone HCL, Pioglitazone
HCL/glimepiride, Pioglitazone HCL/metformin HCL, Riomet, Tolazamide, or
Tolbutamide in 120 days
• KHEDEZLA
At least 2 prior prescriptions for Bupropion HCL, Citalopram Hydrobromide,
Desvenlafaxine, Escitalopram Oxalate, Fluoxetine HCL, Forfivo XL, Mirtazapine,
Paroxetine HCL, Paxil, Sarafem, Sertraline HCL, or Venlafaxine HCL in 365 days
• KYTRIL
Prior prescription for Ondansetron or Ondansetron HCL in 120 days
• LAMICTAL ODT (100 MG) (TAB
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
RAPDIS)
Lamotrigine in 120 days
• LAMICTAL ODT (200 MG) (TAB
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
RAPDIS)
Lamotrigine in 120 days
• LAMICTAL ODT (25 MG) (TAB RAPDIS)Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMICTAL ODT (50 MG) (TAB RAPDIS)Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMICTAL ODT (BLUE)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMICTAL ODT (GREEN)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMICTAL ODT (ORANGE)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMICTAL XR (BLUE)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMICTAL XR (GREEN)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMICTAL XR (ORANGE)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (100 MG) (TAB ER 24) Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (100 MG) (TAB RAPDIS)Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (200 MG) (TAB ER 24) Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (200 MG) (TAB RAPDIS)Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (25 MG) (TAB ER 24)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (25 MG) (TAB RAPDIS) Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (25(21)-50) (TB RD
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
DSPK)
Lamotrigine in 120 days
• LAMOTRIGINE (250 MG) (TAB ER 24) Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (25-50-100) (TB RD
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
DSPK)
Lamotrigine in 120 days
• LAMOTRIGINE (300 MG) (TAB ER 24) Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (50 MG) (TAB ER 24)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (50 MG) (TAB RAPDIS) Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
Lamotrigine in 120 days
• LAMOTRIGINE (50(42)-100) (TB RD
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), or
DSPK)
Lamotrigine in 120 days
• LATUDA (120 MG) (TABLET)
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Risperidone, Seroquel XR, Versacloz, or
Ziprasidone HCL in 365 days
• LATUDA (20 MG) (TABLET)
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Risperidone, Seroquel XR, Versacloz, or
Ziprasidone HCL in 365 days
VNSNY
Page 89 of 116
Medication Prescribing Limitations
• LATUDA (40 MG) (TABLET)
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Risperidone, Seroquel XR, Versacloz, or
Ziprasidone HCL in 365 days
• LATUDA (60 MG) (TABLET)
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Risperidone, Seroquel XR, Versacloz, or
Ziprasidone HCL in 365 days
• LATUDA (80 MG) (TABLET)
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Risperidone, Seroquel XR, Versacloz, or
Ziprasidone HCL in 365 days
• LUVOX CR
Prior prescription for Citalopram Hydrobromide, Escitalopram Oxalate, Fluoxetine
HCL, Fluvoxamine Maleate, Paroxetine HCL, Paxil, Sarafem, or Sertraline HCL in
120 days
• MARINOL
At least 3 prior prescriptions for Anzemet, Aprepitant, Dexamethasone Intensol,
Dexamethasone, Dexpak, Granisetron HCL, Maxidex, Medrol, Methylprednisolone,
Ondansetron HCL, Ondansetron, Ozurdex, Sancuso, Sustol, Zonacort, or Zuplenz in
365 days
• NAMZARIC (14MG-10MG) (CAP SPR
At least 2 prior prescriptions for Donepezil HCL, Memantine HCL, or Namenda XR
24)
in 365 days
• NAMZARIC (21 MG-10MG) (CAP SPR At least 2 prior prescriptions for Donepezil HCL, Memantine HCL, or Namenda XR
24)
in 365 days
• NAMZARIC (28 MG-10MG) (CAP SPR At least 2 prior prescriptions for Donepezil HCL, Memantine HCL, or Namenda XR
24)
in 365 days
• NAMZARIC (7 MG-10 MG) (CAP SPR
At least 2 prior prescriptions for Donepezil HCL, Memantine HCL, or Namenda XR
24)
in 365 days
• NAMZARIC (7-10/14-10) (CAP24 DSPK) At least 2 prior prescriptions for Donepezil HCL, Memantine HCL, or Namenda XR
in 365 days
• NEUPRO
Prior prescription for Ropinirole HCL or Pramipexole Di-HCL in 120 days
• NEXIUM (10 MG) (SUSPDR PKT)
Prior prescription for Lansoprazole, Omeprazole, Pantoprazole Sodium, Prevacid,
Prilosec OTC, or Protonix in 120 days
• NEXIUM (2.5 MG) (SUSPDR PKT)
Prior prescription for Lansoprazole, Omeprazole, Pantoprazole Sodium, Prevacid,
Prilosec OTC, or Protonix in 120 days
• NEXIUM (20 MG) (CAPSULE DR)
Prior prescription for Lansoprazole, Omeprazole, Pantoprazole Sodium, Prevacid,
Prilosec OTC, or Protonix in 120 days
• NEXIUM (20 MG) (SUSPDR PKT)
Prior prescription for Lansoprazole, Omeprazole, Pantoprazole Sodium, Prevacid,
Prilosec OTC, or Protonix in 120 days
• NEXIUM (40 MG) (CAPSULE DR)
Prior prescription for Lansoprazole, Omeprazole, Pantoprazole Sodium, Prevacid,
Prilosec OTC, or Protonix in 120 days
• NEXIUM (40 MG) (SUSPDR PKT)
Prior prescription for Lansoprazole, Omeprazole, Pantoprazole Sodium, Prevacid,
Prilosec OTC, or Protonix in 120 days
• NEXIUM (5 MG) (SUSPDR PKT)
Prior prescription for Lansoprazole, Omeprazole, Pantoprazole Sodium, Prevacid,
Prilosec OTC, or Protonix in 120 days
• NIASPAN
Prior prescription for Altoprev, Antara, Atorvastatin Calcium, Fenofibrate
Nanocrystallized, Fenofibrate, Fenofibrate micronized, Gemfibrozil, Lovastatin,
Pravastatin Sodium, Simvastatin, or Triglide in 365 days
• ONFI (10 MG) (TABLET)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), Lamictal
XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal, Lamotrigine,
Topiramate, or Trokendi XR in 120 days
• ONFI (2.5 MG/ML) (ORAL SUSP)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), Lamictal
XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal, Lamotrigine,
Topiramate, or Trokendi XR in 120 days
• ONFI (20 MG) (TABLET)
Prior prescription for Lamictal (blue), Lamictal (green), Lamictal (orange), Lamictal
XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal, Lamotrigine,
Topiramate, or Trokendi XR in 120 days
• ORACEA
Prior prescription for Doxycycline Monohydrate in 120 days
• OXTELLAR XR (150 MG) (TAB ER 24H) At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Spritam, Stavzor, Topiramate, Trokendi
XR, Valproic Acid, or Zonisamide in 365 days
• OXTELLAR XR (300 MG) (TAB ER 24H)
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
VNSNY
Page 90 of 116
Medication Prescribing Limitations
Lamotrigine, Levetiracetam, Oxcarbazepine, Spritam, Stavzor, Topiramate, Trokendi
XR, Valproic Acid, or Zonisamide in 365 days
• OXTELLAR XR (600 MG) (TAB ER 24H) At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Spritam, Stavzor, Topiramate, Trokendi
XR, Valproic Acid, or Zonisamide in 365 days
• PATANASE
Prior prescription for Azelastine HCL in 120 days
• PEXEVA
Prior prescription for Paroxetine HCL or Paxil in 120 days
• POTIGA (200 MG) (TABLET)
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
• POTIGA (300 MG) (TABLET)
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
• POTIGA (400 MG) (TABLET)
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
• POTIGA (50 MG) (TABLET)
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
• PREVACID (15 MG) (TAB RAP DR)
Prior prescription for Lansoprazole, Omeprazole, or Pantoprazole Sodium in 120
days
• PREVACID (30 MG) (TAB RAP DR)
Prior prescription for Lansoprazole, Omeprazole, or Pantoprazole Sodium in 120
days
• PRISTIQ
At least 2 prior prescriptions for Bupropion HCL, Citalopram Hydrobromide,
Escitalopram Oxalate, Fluoxetine HCL, Forfivo XL, Mirtazapine, Paroxetine HCL,
Paxil, Sarafem, Sertraline HCL, or Venlafaxine HCL in 365 days
• PURIXAN
Prior prescription for Mercaptopurine in 120 days
• QNASL
Prior prescription for Fluticasone Propionate or Flunisolide in 120 days
• QUDEXY XR (100 MG) (CAP SPR 24)
Prior prescription for Topiramate in 120 days
• QUDEXY XR (150 MG) (CAP SPR 24)
Prior prescription for Topiramate in 120 days
• QUDEXY XR (200 MG) (CAP SPR 24)
Prior prescription for Topiramate in 120 days
• QUDEXY XR (25 MG) (CAP SPR 24)
Prior prescription for Topiramate in 120 days
• QUDEXY XR (50 MG) (CAP SPR 24)
Prior prescription for Topiramate in 120 days
• QUILLIVANT XR (5 MG/ML) (SU ER
RC24)
Prior prescription for Methylphenidate HCL or Ritalin LA in 120 days
• RASUVO (10MG/0.2ML) (AUTO INJCT) Prior prescription for Methotrexate Sodium, Methotrexate Sodium/pf, Rheumatrex,
or Trexall in 120 days
• RASUVO (12.5/0.25) (AUTO INJCT)
Prior prescription for Methotrexate Sodium, Methotrexate Sodium/pf, Rheumatrex,
or Trexall in 120 days
• RASUVO (15MG/0.3ML) (AUTO INJCT) Prior prescription for Methotrexate Sodium, Methotrexate Sodium/pf, Rheumatrex,
or Trexall in 120 days
• RASUVO (17.5/0.35) (AUTO INJCT)
Prior prescription for Methotrexate Sodium, Methotrexate Sodium/pf, Rheumatrex,
or Trexall in 120 days
• RASUVO (20MG/0.4ML) (AUTO INJCT) Prior prescription for Methotrexate Sodium, Methotrexate Sodium/pf, Rheumatrex,
or Trexall in 120 days
• RASUVO (22.5/0.45) (AUTO INJCT)
Prior prescription for Methotrexate Sodium, Methotrexate Sodium/pf, Rheumatrex,
or Trexall in 120 days
• RASUVO (25MG/0.5ML) (AUTO INJCT) Prior prescription for Methotrexate Sodium, Methotrexate Sodium/pf, Rheumatrex,
or Trexall in 120 days
• RASUVO (27.5/0.55) (AUTO INJCT)
Prior prescription for Methotrexate Sodium, Methotrexate Sodium/pf, Rheumatrex,
or Trexall in 120 days
VNSNY
Page 91 of 116
Medication Prescribing Limitations
• RASUVO (30MG/0.6ML) (AUTO INJCT) Prior prescription for Methotrexate Sodium, Methotrexate Sodium/pf, Rheumatrex,
or Trexall in 120 days
• RASUVO (7.5MG/0.15) (AUTO INJCT) Prior prescription for Methotrexate Sodium, Methotrexate Sodium/pf, Rheumatrex,
or Trexall in 120 days
• REQUIP XL
Prior prescription for Ropinirole HCL or Pramipexole Di-HCL in 120 days
• ROZEREM
Prior prescription for Eszopiclone, Zaleplon, or Zolpidem Tartrate in 120 days
• SAFYRAL
At least 2 prior prescriptions for Desog-e.estradiol/e.estradiol, Drospir/eth
Estra/levomefol Ca, Ethynodiol D-ethinyl Estradiol, L-norgest/e.estradiol-e.estrad,
Levonorgestrel-ethin Estradiol, Lo Loestrin Fe, Noreth-ethinyl Estradiol/iron,
Norethindrone Ac-eth Estradiol, Norethindrone, Norethindrone-e.estradiol-iron,
Norethindrone-ethinyl Estrad, Norethindrone-mestranol, Norgestimate-ethinyl
Estradiol, Norgestrel-ethinyl Estradiol, or Ovcon-50 in 365 days
• SAPHRIS
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Risperidone, Seroquel XR, Versacloz, or
Ziprasidone HCL in 365 days
• SILENOR
Prior prescription for Eszopiclone, Zaleplon, or Zolpidem Tartrate in 120 days
• SYNJARDY
Prior prescription for Actoplus Met XR, Chlorpropamide, Diabeta, Fortamet,
Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide, Glyburide micronized,
Glyburide/metformin HCL, Metformin HCL, Pioglitazone HCL, Pioglitazone
HCL/glimepiride, Pioglitazone HCL/metformin HCL, Riomet, Tolazamide, or
Tolbutamide in 120 days
• TACLONEX (0.005-.064) (OINT. (G))
Prior prescription for a Topical Anti-inflammatory Steroidal in 120 days
• TACROLIMUS
Prior prescription for a Topical Anti-inflammatory Steroidal in 120 days
• TIAGABINE HCL
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
• TOPIRAMATE (100 MG) (CAP SPR 24) Prior prescription for Topiramate in 120 days
• TOPIRAMATE (150 MG) (CAP SPR 24) Prior prescription for Topiramate in 120 days
• TOPIRAMATE (200 MG) (CAP SPR 24) Prior prescription for Topiramate in 120 days
• TOPIRAMATE (25 MG) (CAP SPR 24)
Prior prescription for Topiramate in 120 days
• TOPIRAMATE (50 MG) (CAP SPR 24)
Prior prescription for Topiramate in 120 days
• TOVIAZ
Prior prescription for Oxybutynin Chloride in 120 days
• TRIGLIDE
Prior prescription for Antara, Fenofibrate Nanocrystallized, Fenofibrate, Fenofibrate
micronized, or Gemfibrozil in 120 days
• TRINTELLIX
At least 2 prior prescriptions for Bupropion HCL, Citalopram Hydrobromide,
Escitalopram Oxalate, Fluoxetine HCL, Forfivo XL, Mirtazapine, Paroxetine HCL,
Paxil, Sarafem, Sertraline HCL, or Venlafaxine HCL in 365 days
• TROKENDI XR (100 MG) (CAP ER 24H) Prior prescription for Topiramate in 120 days
• TROKENDI XR (200 MG) (CAP ER 24H) Prior prescription for Topiramate in 120 days
• TROKENDI XR (25 MG) (CAP ER 24H) Prior prescription for Topiramate in 120 days
• TROKENDI XR (50 MG) (CAP ER 24H) Prior prescription for Topiramate in 120 days
• TRULICITY
Prior prescription for Actoplus Met XR, Chlorpropamide, Diabeta, Fortamet,
Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide, Glyburide micronized,
Glyburide/metformin HCL, Metformin HCL, Pioglitazone HCL, Pioglitazone
HCL/glimepiride, Pioglitazone HCL/metformin HCL, Riomet, Tolazamide, or
Tolbutamide in 120 days
• VECTICAL
Prior prescription for a Topical Anti-inflammatory Steroidal in 120 days
• VERSACLOZ
At least 2 prior prescriptions for Abilify Maintena, Abilify, Aripiprazole, Clozapine,
Olanzapine, Quetiapine Fumarate, Risperidone, Seroquel XR, or Ziprasidone HCL in
365 days
• VESICARE
Prior prescription for Oxybutynin Chloride in 120 days
• VICTOZA 2-PAK
Prior prescription for Actoplus Met XR, Chlorpropamide, Diabeta, Fortamet,
Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide, Glyburide micronized,
Glyburide/metformin HCL, Metformin HCL, Pioglitazone HCL, Pioglitazone
HCL/glimepiride, Pioglitazone HCL/metformin HCL, Riomet, Tolazamide, or
Tolbutamide in 120 days
• VICTOZA 3-PAK
Prior prescription for Actoplus Met XR, Chlorpropamide, Diabeta, Fortamet,
Glimepiride, Glipizide, Glipizide/metformin HCL, Glyburide, Glyburide micronized,
Glyburide/metformin HCL, Metformin HCL, Pioglitazone HCL, Pioglitazone
VNSNY
Page 92 of 116
Medication Prescribing Limitations
• VIIBRYD (10 MG) (TABLET)
• VIIBRYD (20 MG) (TABLET)
• VIIBRYD (40 MG) (TABLET)
• VIMPAT (10 MG/ML) (SOLUTION)
• VIMPAT (100 MG) (TABLET)
• VIMPAT (150 MG) (TABLET)
• VIMPAT (200 MG) (TABLET)
• VIMPAT (50 MG) (TABLET)
• VYVANSE (10 MG) (CAPSULE)
• VYVANSE (20 MG) (CAPSULE)
• VYVANSE (30 MG) (CAPSULE)
• VYVANSE (40 MG) (CAPSULE)
• VYVANSE (50 MG) (CAPSULE)
• VYVANSE (60 MG) (CAPSULE)
VNSNY
HCL/glimepiride, Pioglitazone HCL/metformin HCL, Riomet, Tolazamide, or
Tolbutamide in 120 days
At least 2 prior prescriptions for Bupropion HCL, Citalopram Hydrobromide,
Escitalopram Oxalate, Fluoxetine HCL, Forfivo XL, Mirtazapine, Paroxetine HCL,
Paxil, Sarafem, Sertraline HCL, or Venlafaxine HCL in 365 days
At least 2 prior prescriptions for Bupropion HCL, Citalopram Hydrobromide,
Escitalopram Oxalate, Fluoxetine HCL, Forfivo XL, Mirtazapine, Paroxetine HCL,
Paxil, Sarafem, Sertraline HCL, or Venlafaxine HCL in 365 days
At least 2 prior prescriptions for Bupropion HCL, Citalopram Hydrobromide,
Escitalopram Oxalate, Fluoxetine HCL, Forfivo XL, Mirtazapine, Paroxetine HCL,
Paxil, Sarafem, Sertraline HCL, or Venlafaxine HCL in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, or Valproic Acid in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
At least 2 prior prescriptions for Carbamazepine, Divalproex Sodium, Equetro,
Fanatrex, Gabapentin, Gralise, Lamictal (blue), Lamictal (green), Lamictal (orange),
Lamictal XR (blue), Lamictal XR (green), Lamictal XR (orange), Lamictal,
Lamotrigine, Levetiracetam, Oxcarbazepine, Oxtellar XR, Spritam, Stavzor,
Topiramate, Trokendi XR, Valproic Acid, or Zonisamide in 365 days
Prior prescription for Aptensio XR, Citalopram Hydrobromide,
Dextroamphetamine/amphetamine, Escitalopram Oxalate, Fluoxetine HCL,
Fluvoxamine Maleate, Methylphenidate HCL, Paroxetine HCL, Paxil, Quillichew
ER, Quillivant XR, Ritalin LA, Sarafem, Sertraline HCL, Topiramate, or Trokendi
XR in 120 days
Prior prescription for Aptensio XR, Citalopram Hydrobromide,
Dextroamphetamine/amphetamine, Escitalopram Oxalate, Fluoxetine HCL,
Fluvoxamine Maleate, Methylphenidate HCL, Paroxetine HCL, Paxil, Quillichew
ER, Quillivant XR, Ritalin LA, Sarafem, Sertraline HCL, Topiramate, or Trokendi
XR in 120 days
Prior prescription for Aptensio XR, Citalopram Hydrobromide,
Dextroamphetamine/amphetamine, Escitalopram Oxalate, Fluoxetine HCL,
Fluvoxamine Maleate, Methylphenidate HCL, Paroxetine HCL, Paxil, Quillichew
ER, Quillivant XR, Ritalin LA, Sarafem, Sertraline HCL, Topiramate, or Trokendi
XR in 120 days
Prior prescription for Aptensio XR, Citalopram Hydrobromide,
Dextroamphetamine/amphetamine, Escitalopram Oxalate, Fluoxetine HCL,
Fluvoxamine Maleate, Methylphenidate HCL, Paroxetine HCL, Paxil, Quillichew
ER, Quillivant XR, Ritalin LA, Sarafem, Sertraline HCL, Topiramate, or Trokendi
XR in 120 days
Prior prescription for Aptensio XR, Citalopram Hydrobromide,
Dextroamphetamine/amphetamine, Escitalopram Oxalate, Fluoxetine HCL,
Fluvoxamine Maleate, Methylphenidate HCL, Paroxetine HCL, Paxil, Quillichew
ER, Quillivant XR, Ritalin LA, Sarafem, Sertraline HCL, Topiramate, or Trokendi
XR in 120 days
Prior prescription for Aptensio XR, Citalopram Hydrobromide,
Dextroamphetamine/amphetamine, Escitalopram Oxalate, Fluoxetine HCL,
Page 93 of 116
Medication Prescribing Limitations
• VYVANSE (70 MG) (CAPSULE)
• XYZAL (2.5 MG/5ML) (SOLUTION)
• YASMIN 28
• YAZ
• ZENZEDI (2.5 MG) (TABLET)
• ZENZEDI (7.5 MG) (TABLET)
• ZOCOR (80 MG) (TABLET)
• ZOLPIMIST
• ZOMIG (2.5 MG) (SPRAY)
• ZOMIG (5 MG) (SPRAY)
VNSNY
Fluvoxamine Maleate, Methylphenidate HCL, Paroxetine HCL, Paxil, Quillichew
ER, Quillivant XR, Ritalin LA, Sarafem, Sertraline HCL, Topiramate, or Trokendi
XR in 120 days
Prior prescription for Aptensio XR, Citalopram Hydrobromide,
Dextroamphetamine/amphetamine, Escitalopram Oxalate, Fluoxetine HCL,
Fluvoxamine Maleate, Methylphenidate HCL, Paroxetine HCL, Paxil, Quillichew
ER, Quillivant XR, Ritalin LA, Sarafem, Sertraline HCL, Topiramate, or Trokendi
XR in 120 days
Prior prescription for Desloratadine in 120 days
At least 2 prior prescriptions for Desog-e.estradiol/e.estradiol, Desogestrel-ethinyl
Estradiol, Ethynodiol D-ethinyl Estradiol, L-norgest/e.estradiol-e.estrad,
Levonorgestrel-ethin Estradiol, Lo Loestrin Fe, Minastrin 24 Fe, Noreth-ethinyl
Estradiol/iron, Norethindrone Ac-eth Estradiol, Norethindrone, Norethindronee.estradiol-iron, Norethindrone-ethinyl Estrad, Norethindrone-mestranol,
Norgestimate-ethinyl Estradiol, Norgestrel-ethinyl Estradiol, or Ovcon-50 in 365
days
At least 2 prior prescriptions for Desog-e.estradiol/e.estradiol, Desogestrel-ethinyl
Estradiol, Ethynodiol D-ethinyl Estradiol, L-norgest/e.estradiol-e.estrad,
Levonorgestrel-ethin Estradiol, Lo Loestrin Fe, Minastrin 24 Fe, Noreth-ethinyl
Estradiol/iron, Norethindrone Ac-eth Estradiol, Norethindrone, Norethindronee.estradiol-iron, Norethindrone-ethinyl Estrad, Norethindrone-mestranol,
Norgestimate-ethinyl Estradiol, Norgestrel-ethinyl Estradiol, or Ovcon-50 in 365
days
Prior prescription for Dextroamphetamine Sulfate in 120 days
Prior prescription for Dextroamphetamine Sulfate in 120 days
Prior prescription for Vytorin in 365 days
Prior prescription for Zolpidem Tartrate in 120 days
Prior prescription for Rizatriptan Benzoate or Sumatriptan Succinate in 180 days
Prior prescription for Rizatriptan Benzoate or Sumatriptan Succinate in 180 days
Page 94 of 116
Medication Prescribing Limitations
PRIOR AUTHORIZATION RESTRICTIONS
• ACTEMRA
• ACTIQ
• ADCIRCA
• ADEMPAS
• AFINITOR (10 MG) (TABLET)
• AFINITOR (2.5 MG) (TABLET)
• AFINITOR (5 MG) (TABLET)
• AFINITOR (7.5 MG) (TABLET)
• AFINITOR DISPERZ
• ALDARA
• ALECENSA
• AMINO AC/PROTEIN HYDR/WHEY PRO (10G-100/30)
(LIQUID) (OTC)
• ANDRODERM
• ANDROGEL (1.25G-1.62) (GEL PACKET)
• ANDROGEL (12.5/1.25G) (GEL MD PMP)
• ANDROGEL (2.5G-1.62%) (GEL PACKET)
• ANDROGEL (20.25/1.25) (GEL MD PMP)
• ANDROGEL (25MG(1%)) (GEL PACKET)
• ANDROGEL (50 MG (1%)) (GEL PACKET)
• ANDROID
• APOKYN
• AUBAGIO
• AVEED
• AVONEX
• AVONEX PEN
• AXIRON
• BCAD 2
• BERINERT
• BOOST GLUCOSE CONTROL (0.06 G-1.1) (LIQUID)
(OTC)
• BOOST VHC
• BOSULIF (100 MG) (TABLET)
• BOSULIF (500 MG) (TABLET)
• CABOMETYX
• CAPRELSA (100 MG) (TABLET)
• CAPRELSA (300 MG) (TABLET)
• CAYSTON
• CERDELGA
• CIMZIA
• CINRYZE
• COMETRIQ
• COMPLEAT PEDIATRIC
• COPAXONE (20 MG/ML) (SYRINGE)
• COPAXONE (40 MG/ML) (SYRINGE)
• COSENTYX (2 SYRINGES)
• COSENTYX PEN
• COSENTYX PEN (2 PENS)
• COSENTYX SYRINGE
• COTELLIC
• CUPRIMINE
• CYCLINEX-2
• CYSTARAN
• DARAPRIM
• DELATESTRYL
• DEPEN
• DEPO-TESTOSTERONE
• DIABETISOURCE AC
VNSNY
• DIETARY SUPPLEMENT (POWDER) (OTC)
• DUOCAL
• DURAGESIC (100 MCG/HR) (PATCH TD72)
• DURAGESIC (12 MCG/HR) (PATCH TD72)
• DURAGESIC (25 MCG/HR) (PATCH TD72)
• DURAGESIC (50MCG/HR) (PATCH TD72)
• DURAGESIC (75MCG/HR) (PATCH TD72)
• ELECARE JR
• ELIGARD
• EMVERM
• ENBREL
• ENSURE ACTIVE CLEAR (LIQUID) (OTC)
• ENSURE ACTIVE MUSCLE HEALTH
• ENSURE CLEAR (0.035-1/ML) (LIQUID) (OTC)
• ENSURE MUSCLE HEALTH
• ENSURE POWDER
• ENSURE WITH FIBER
• EO28 SPLASH
• EPCLUSA
• ERIVEDGE
• ESBRIET
• EVISTA
• EXALGO (12 MG) (TAB ER 24H)
• EXALGO (16 MG) (TAB ER 24H)
• EXALGO (32 MG) (TAB ER 24H)
• EXALGO (8 MG) (TAB ER 24H)
• FARESTON
• FARYDAK
• FIBERSOURCE HN (0.05 G-1.2) (LIQUID) (OTC)
• FIRAZYR
• FORTESTA
• GAMMAGARD LIQUID
• GAMMAKED
• GAMUNEX-C
• GATTEX
• GILENYA
• GILOTRIF
• GLEEVEC (100 MG) (TABLET)
• GLEEVEC (400 MG) (TABLET)
• GLUCO BURST
• GLUTAREX-2
• G-PREPROTEIN (15 G-60/30) (LIQUID) (OTC)
• GRANIX
• GRASTEK
• HCU COOLER
• HCU COOLER20
• HCU LOPHLEX
• HETLIOZ
• HI-CAL
• HIZENTRA
• HOMINEX-2
• HYQVIA
• HYQVIA IG COMPONENT
• IBRANCE
• ICLUSIG (15 MG) (TABLET)
• ICLUSIG (45 MG) (TABLET)
• IMBRUVICA
• IMPACT 1 CAL
Page 95 of 116
Medication Prescribing Limitations
• IMPAVIDO
• INCRELEX
• INLYTA (1 MG) (TABLET)
• INLYTA (5 MG) (TABLET)
• INTRON A
• IPRIVASK
• IRESSA
• ISOSOURCE 1.5 CAL TUBE FEED
• ISOSOURCE HN (0.05 G-1.2) (LIQUID) (OTC)
• I-VALEX-2
• JAKAFI
• JEVITY 1.2 CAL (0.06 G-1.2) (LIQUID) (OTC)
• JEVITY 1.5 CAL (0.06 G-1.5) (LIQUID) (OTC)
• JUXTAPID
• KALYDECO
• KETOCAL 4:1 (14.4 G-701) (POWDER) (OTC)
• KETOCAL 4:1 (3.09 G-150) (LIQUID) (OTC)
• KETONEX-2
• KETOVOLVE
• KEVEYIS
• KORLYM
• KUVAN
• KYNAMRO
• LACTOSE-REDUCED FOOD (0.04G-1.05) (LIQUID)
(OTC)
• LACTOSE-REDUCED FOOD (0.05 G-1.5) (LIQUID) (OTC)
• LACTOSE-REDUCED FOOD (LIQUID) (OTC)
• LENVIMA
• LETAIRIS
• LEU-FREE COOLER
• LEUKINE
• LEVOCARNITINE
• LIPISTART
• LONSURF
• LYNPARZA
• MEKINIST
• METHITEST
• MILK BASED FORMULA
• MSUD COOLER
• MSUD COOLER20
• MSUD EXPRESS COOLER
• MSUD LOPHLEX
• NEOCATE JUNIOR
• NEOCATE JUNIOR WITH PREBIOTICS (16 G-459)
(POWDER) (OTC)
• NEOCATE JUNIOR WITH PREBIOTICS (16G-478)
(POWDER) (OTC)
• NEOCATE NUTRA
• NEPRO CARB STEADY (0.08G-1.80) (LIQUID) (OTC)
• NEULASTA (6MG/0.6ML) (SYRINGE)
• NEUPOGEN
• NEXAVAR
• NINLARO
• NORDITROPIN FLEXPRO
• NORTHERA
• NUT TX FOR ISOVALERIC ACIDEMIA (16.2G-500)
(POWDER) (OTC)
• NUT. TX FOR PROPIONIC ACIDEMIA
• NUT.SUP,SPEC,LAC-FREE,IRON/FOS
• NUT.THERAP.GLUTARIC ACIDURIA 1
VNSNY
• NUT.TX,METABOLIC DIS,METHIO-FR
• NUT.TX.COMP. IMMUNE SYSTM,REG (0.08G-1.4)
(LIQUID) (OTC)
• NUT.TX.COMP.IMMUNE SYS/SOY FIB
• NUT.TX.GLUC INTOL,LF,SOY/FIBER (0.07 G-0.8)
(LIQUID) (OTC)
• NUT.TX.IMPAIRED RENAL FXN,SOY
• NUT.TX.PULM.DISORD.SOY,LACFREE (LIQUID) (OTC)
• NUTRAMENT
• NUTRIT.THERAPY, MSUD WITH IRON
• NUTRITIONAL SUPPLEMENT/MCT
• NUTRITIONAL TX, KETOGENIC,MILK
• NYMALIZE
• OA2
• OCALIVA
• ODOMZO
• OFEV
• OPSUMIT
• ORALAIR (100 IR) (TAB SUBL)
• ORALAIR (300 IR) (TAB SUBL)
• ORENCIA
• ORENCIA CLICKJECT
• ORENITRAM ER
• ORFADIN
• ORKAMBI
• OS 2
• OSMOLITE 1.5 CAL (0.06 G-1.5) (LIQUID) (OTC)
• OTEZLA
• OXANDRIN
• OXEPA (0.06 G-1.5) (LIQUID) (OTC)
• PEDI NUTRITION,IRON,LACT-FREE (0.03G-1/ML)
(LIQUID) (OTC)
• PEDI NUTRITION,IRON,LACT-FREE (0.04G-1.5)
(LIQUID) (OTC)
• PEDIASMART ORGANIC DAIRY
• PEDIASMART ORGANIC SOY
• PEDIASURE 1.5
• PEDIASURE 1.5 WITH FIBER
• PEDIASURE ENTERAL WITH FIBER
• PEDIASURE PEPTIDE 1.0 CAL
• PEDIASURE PEPTIDE 1.5 CAL (0.045G-1.5) (LIQUID)
(OTC)
• PEDIASURE SIDEKICKS
• PEDIASURE WITH FIBER
• PEGASYS
• PEGASYS PROCLICK
• PEPTAMEN 1.5 CAL WITH PREBIO1 (0.068G-1.5)
(LIQUID) (OTC)
• PEPTAMEN BARIATRIC
• PEPTAMEN JUNIOR 1.5 (0.045G-1.5) (LIQUID) (OTC)
• PEPTAMEN JUNIOR WITH PREBIO1 (0.03G-1/ML)
(LIQUID) (OTC)
• PERATIVE (0.067G-1.3) (LIQUID) (OTC)
• PERIFLEX ADVANCE
• PERIFLEX JUNIOR
• PFD 2
• PHENEX-1
• PHENEX-2
• PHENYLADE
• PHENYLADE ESSENTIAL (25G-390) (POWDER) (OTC)
• PHENYLADE RTD PKU 10
Page 96 of 116
Medication Prescribing Limitations
• PHENYLADE60 (60G-295) (POWDER) (OTC)
• PHENYLADE60 (60G-327) (POWDER) (OTC)
• PHENYL-FREE 2
• PHENYL-FREE 2HP
• PIVOT 1.5 CAL
• PKU 2
• PKU 3
• PKU COOLER 10
• PKU COOLER 15
• PKU COOLER 20
• PKU LOPHLEX
• PKU TRIO
• POLYCAL
• POMALYST
• PRE-PROTEIN (15 G-60/30) (LIQUID) (OTC)
• PROCRIT (10000/ML) (VIAL)
• PROCRIT (2000/ML) (VIAL)
• PROCRIT (20000/2ML) (VIAL)
• PROCRIT (20000/ML) (VIAL)
• PROCRIT (3000/ML) (VIAL)
• PROCRIT (4000/ML) (VIAL)
• PROCRIT (40000/ML) (VIAL)
• PROCYSBI
• PROMACTA
• PROMOTE WITH FIBER (0.06G-1/ML) (LIQUID) (OTC)
• PROPIMEX-2
• PROSOURCE NO CARB
• PROSOURCE PLUS
• PROSOURCE ZAC
• PROTEIN SUPPLEMENT (LIQUID) (OTC)
• PROTEIN SUPPLEMENT (POWDER) (OTC)
• PROVIGIL
• PULMOZYME
• RAGWITEK
• RAVICTI
• REBIF
• REBIF REBIDOSE
• REMODULIN
• RENA START
• REPATHA PUSHTRONEX
• REPATHA SURECLICK
• REPATHA SYRINGE
• REVATIO (10 MG/ML) (SUSP RECON)
• REVATIO (20 MG) (TABLET)
• REVLIMID
• RUCONEST
• SEROSTIM
• SIGNIFOR
• SIMPONI
• SIRTURO
• SIVEXTRO
• SOLARAZE
• SOVALDI
• SOY PROTEIN
• SPRYCEL (100 MG) (TABLET)
• SPRYCEL (140 MG) (TABLET)
• SPRYCEL (20 MG) (TABLET)
• SPRYCEL (50 MG) (TABLET)
• SPRYCEL (70 MG) (TABLET)
• SPRYCEL (80 MG) (TABLET)
VNSNY
• STIVARGA
• STRENSIQ
• SUCRAID
• SUPLENA CARB STEADY (0.04G-1.79) (LIQUID) (OTC)
• SUTENT
• SYNAGIS
• SYNRIBO
• TAFINLAR
• TAGRISSO
• TARCEVA (100 MG) (TABLET)
• TARCEVA (150 MG) (TABLET)
• TARCEVA (25 MG) (TABLET)
• TARGRETIN
• TASIGNA
• TECFIDERA
• TEMODAR
• TESTIM
• TESTRED
• THALOMID
• TOBI
• TOBI PODHALER
• TRACLEER
• TWOCAL HN (0.08G-2/ML) (LIQUID) (OTC)
• TYKERB
• TYR COOLER
• TYR COOLER20
• TYR LOPHLEX
• TYREX-2
• TYROS 2
• TYVASO
• TYVASO INSTITUTIONAL START KIT
• TYVASO REFILL KIT
• TYVASO STARTER KIT
• UCD ANAMIX JUNIOR (12 G-385) (POWDER) (OTC)
• UCD TRIO
• UPTRAVI
• VALCHLOR
• VENCLEXTA
• VENCLEXTA STARTING PACK
• VENTAVIS
• VITAL 1.0 CAL (0.04G-1/ML) (LIQUID) (OTC)
• VITAL 1.5 CAL (0.07 G-1.5) (LIQUID) (OTC)
• VITAL AF 1.2 CAL (0.08 G-1.2) (LIQUID) (OTC)
• VIVONEX RTF (0.05G-1/ML) (LIQUID) (OTC)
• VOGELXO
• VOTRIENT
• WND 2
• XALKORI
• XELJANZ
• XELJANZ XR
• XELODA (150 MG) (TABLET)
• XELODA (500 MG) (TABLET)
• XENAZINE
• XIFAXAN (550 MG) (TABLET)
• XPHE MAXAMAID
• XPHE MAXAMUM (40G-305) (POWDER) (OTC)
• XTANDI
• XTRACAL PLUS
• XURIDEN
• ZAVESCA
Page 97 of 116
Medication Prescribing Limitations
• ZELBORAF
• ZEPATIER
• ZOLADEX
• ZORBTIVE
• ZYDELIG
• ZYKADIA
• ZYTIGA
• ZYVOX (600 MG) (TABLET)
VNSNY
Page 98 of 116
Index
-#0.9 % SODIUM CHLORIDE...................................... 39, 59
0.9 % SODIUM CHLORIDE (0.9 %) (IV SOLN)............39
0.9 % SODIUM CHLORIDE (0.9 %) (SYRINGE).......... 39
0.9 % SODIUM CHLORIDE (0.9 %) (VIAL)..................39
0.9 % SODIUM CHLORIDE (PGGYBK PRT)................39
0.9 % SODIUM CHLORIDE (PGY VL PRT)..................39
-AA/C/E/ZINC/SOD SELENATE/COPPER.........................72
ABACAVIR SULFATE..................................................... 50
ABACAVIR SULFATE/LAMIVUDINE...........................49
ABACAVIR/DOLUTEGRAVIR/LAMIVUDI.................. 51
ABACAVIR/LAMIVUDINE/ZIDOVUDINE...................49
ABATACEPT.....................................................................51
ABILIFY (1 MG/ML) (SOLUTION)....................19, 78, 85
ABILIFY (10 MG) (TABLET)....................................19, 78
ABILIFY (15 MG) (TABLET)....................................19, 78
ABILIFY (2 MG) (TABLET)......................................19, 78
ABILIFY (20 MG) (TABLET)....................................19, 78
ABILIFY (30 MG) (TABLET)....................................19, 78
ABILIFY (5 MG) (TABLET)......................................19, 78
ABILIFY DISCMELT (10 MG) (TAB RAPDIS)...... 19,
78,
85
ABILIFY DISCMELT (15 MG) (TAB RAPDIS)...... 19,
78,
85
ABILIFY MAINTENA............................................... 19, 78
ABIRATERONE ACETATE............................................. 55
ABREVA........................................................................... 29
ACARBOSE...................................................................... 34
ACCOLATE.......................................................................15
ACCU-CHEK.............................................................. 35, 38
ACCU-CHEK COMPACT PLUS CONTROL..................35
ACCU-CHEK FASTCLIX................................................ 38
ACCU-CHEK GUIDE CONTROL SOLN........................35
ACCU-CHEK SMARTVIEW........................................... 36
ACCU-CHEK SOFTCLIX................................................ 38
ACCUNEB........................................................................ 14
ACCUPRIL........................................................................22
ACCURETIC.....................................................................21
ACCUTREND GLUCOSE................................................35
ACE AEROSOL CLOUD ENHANCER...........................15
ACEBUTOLOL HCL........................................................ 22
ACEON..............................................................................22
ACETAMINOPHEN......................................................... 62
ACETAMINOPHEN (100 MG/ML) (DROPS) (OTC)......
62
ACETAMINOPHEN (120 MG) (SUPP.RECT) (OTC)......
62
ACETAMINOPHEN (160 MG) (TAB CHEW) (OTC)......
62
ACETAMINOPHEN (160 MG/5ML) (ELIXIR) (OTC)......
62
ACETAMINOPHEN (160 MG/5ML) (LIQUID) (OTC)
........................................................................................... 62
ACETAMINOPHEN (325 MG) (SUPP.RECT) (OTC)......
62
ACETAMINOPHEN (500 MG) (CAPSULE) (OTC)....... 62
ACETAMINOPHEN (500 MG) (TABLET) (OTC).......... 62
ACETAMINOPHEN (650 MG) (SUPP.RECT) (OTC)......
62
ACETAMINOPHEN (80 MG) (TAB CHEW) (OTC).......62
ACETAMINOPHEN (80MG/0.8ML) (DROPS SUSP)
(OTC).................................................................................62
ACETAMINOPHEN (80MG/0.8ML) (DROPS) (OTC)......
62
ACETAMINOPHEN WITH CODEINE........................... 64
ACETAMINOPHEN WITH CODEINE (300MG-15MG)
(TABLET)..........................................................................64
ACETAZOLAMIDE..........................................................42
ACETIC ACID............................................................ 31, 39
ACETIC ACID/HYDROCORTISONE............................. 39
ACETYLCYSTEINE........................................................ 61
ACIPHEX.................................................................... 69, 78
ACITRETIN...................................................................... 33
ACLOVATE....................................................................... 29
ACNE MEDICATION.......................................................32
ACTEMRA.................................................................. 52, 95
ACTIGALL....................................................................... 53
ACTIMMUNE...................................................................46
ACTIQ......................................................................... 62, 95
ACTIVELLA..................................................................... 46
ACTOPLUS MET....................................................... 34, 85
ACTOPLUS MET XR.................................................34, 85
ACTOS.............................................................................. 34
ACULAR........................................................................... 41
ACULAR LS..................................................................... 41
ACYCLOVIR.............................................................. 29, 49
ADALAT CC (30 MG) (TABLET ER)............................. 23
ADALAT CC (60 MG) (TABLET ER)............................. 23
ADASUVE........................................................................ 19
ADCIRCA................................................................... 23, 95
VNSNY
ADDERALL................................................................18, 78
ADDERALL XR (10 MG) (CAP ER 24H).................18, 78
ADDERALL XR (15 MG) (CAP ER 24H).................18, 78
ADDERALL XR (20 MG) (CAP ER 24H).................18, 78
ADDERALL XR (25 MG) (CAP ER 24H).................18, 78
ADDERALL XR (30 MG) (CAP ER 24H).................18, 78
ADDERALL XR (5 MG) (CAP ER 24H)...................18, 78
ADEFOVIR DIPIVOXIL.................................................. 51
ADEMPAS...................................................................23, 95
ADJUSTABLE LANCING DEVICE................................37
ADOXA (150 MG) (TABLET)................................... 48, 78
ADRENACLICK............................................................... 54
ADVAIR DISKUS....................................................... 14, 78
ADVAIR HFA..............................................................14, 78
ADVANCED LANCING DEVICE................................... 38
ADVATE............................................................................ 43
ADVIL (200 MG) (TABLET) (OTC)................................52
ADVOCATE CONTROL SOLUTION....................... 35, 36
ADVOCATE LANCING DEVICE................................... 37
ADVOCATE RAPID-SAFE.............................................. 37
ADVOCATE REDI-CODE DUO......................................35
ADVOCATE REDI-CODE+ CTRL SOLN.................35, 36
ADYNOVATE....................................................................43
AEROCHAMBER MINI (SPACER)................................ 15
AEROCHAMBER MV..................................................... 15
AEROCHAMBER PLUS FLOW-VU (SPACER).............15
AEROCHAMBER WITH FLOWSIGNAL.......................15
AEROCHAMBER Z-STAT PLUS.................................... 15
AEROECLIPSE II............................................................. 15
AEROGEAR ASTHMA ACTION KIT ............................ 16
AEROTRACH PLUS.........................................................15
AFATINIB DIMALEATE................................................. 55
AFINITOR (10 MG) (TABLET)........................... 55, 78, 95
AFINITOR (2.5 MG) (TABLET).......................... 55, 78, 95
AFINITOR (5 MG) (TABLET)............................. 55, 78, 95
AFINITOR (7.5 MG) (TABLET).......................... 55, 78, 95
AFINITOR DISPERZ................................................. 55, 95
AFSTYLA......................................................................... 43
AFTERA............................................................................25
AGAMATRIX CONTROL................................................35
AGRYLIN..........................................................................45
AIRS DISPOSABLE NEBULIZER..................................15
AIRZONE PEAK FLOW METER....................................16
AKYNZEO.................................................................. 14, 78
ALACORT.........................................................................30
ALBUMEN (EGG WHITE)..............................................57
ALBUTEROL SULFATE.................................................. 14
ALCLOMETASONE DIPROPIONATE........................... 29
ALCOHOL ANTISEPTIC PADS............................... 30, 31
ALCOHOL PREP SWABS............................................... 30
ALDACTAZIDE (25 MG-25MG) (TABLET).................. 23
ALDACTONE................................................................... 23
ALDARA...............................................................46, 78, 95
ALDOMET........................................................................22
ALDORIL 15.....................................................................22
ALDORIL 25.....................................................................22
ALECENSA.......................................................... 55, 78, 95
ALECTINIB HCL............................................................. 55
ALENDRONATE SODIUM............................................. 40
ALENDRONATE SODIUM/VITAMIN D3......................40
ALFERON N..................................................................... 46
ALFUZOSIN HCL............................................................ 69
ALITRETINOIN............................................................... 33
ALKALINE BATTERIES................................................. 37
ALKERAN........................................................................ 55
ALLEGRA (180 MG) (TABLET) (OTC)......................... 13
ALLEGRA (60 MG) (TABLET) (OTC)........................... 13
ALLEGRA-D 12 HOUR (60MG-120MG) (TAB ER 12H)
(OTC).................................................................................13
ALLEGRA-D 24 HOUR (180-240MG) (TAB ER 24H)
........................................................................................... 13
ALLEGRA-D 24 HOUR (180-240MG) (TAB ER 24H)
(OTC).................................................................................13
ALLERGY RELIEF.................................................... 13, 20
ALLOPURINOL............................................................... 43
ALOCRIL.......................................................................... 42
ALOE VERA/COLLAGEN.............................................. 31
ALOE VESTA................................................................... 31
ALOE VESTA CLEANSING........................................... 31
ALOE/LA/CERAMID/SILICONES/TAPE...................... 31
ALOE/LAC AC/CERAMIDES 3,3B,6,1.......................... 31
ALOMIDE.........................................................................42
ALPHA-1-PROTEINASE INHIBITOR............................ 54
ALPHAGAN..................................................................... 42
ALPHAGAN P (0.1 %) (DROPS).....................................42
ALPHAGAN P (0.15 %) (DROPS)...................................42
ALPHANATE....................................................................43
ALPHANINE SD.............................................................. 44
ALPRAZOLAM................................................................ 18
ALPRAZOLAM INTENSOL........................................... 18
ALPROLIX........................................................................44
ALREX.............................................................................. 41
ALTACE............................................................................ 22
ALTERA NEBULIZER (EACH)...................................... 15
ALTERNATE SITE LANCING DEVICE.........................37
ALTRETAMINE................................................................54
ALUMINUM HYDROXIDE............................................ 68
ALUPENT......................................................................... 14
AMANTADINE HCL........................................................65
AMARYL.......................................................................... 34
AMBIEN......................................................................20, 78
AMBIEN CR............................................................... 20, 78
AMBRISENTAN...............................................................23
AMCINONIDE..................................................................29
AMETHYST......................................................................25
AMILORIDE HCL............................................................23
AMILORIDE/HYDROCHLOROTHIAZIDE................... 23
AMINO AC/MULTIVIT-MIN/HERB 139........................61
AMINO AC/PROTEIN HYDR/WHEY PRO....................57
AMINO AC/PROTEIN HYDR/WHEY PRO (10G-100/30)
(LIQUID) (OTC)......................................................... 57, 95
AMINO ACID/PROTEIN/VIT C/ZINC............................57
AMINO ACIDS/MV,TX,IRON,MINERAL......................72
AMINO ACIDS/MV,TX,IRON,MINERAL (LIQUID)
(OTC).................................................................................72
AMINO ACIDS/PROTEIN HYDROLYS......................... 57
AMINO ACIDS/RICE PROTEIN/MV-MN...................... 61
AMINOACETIC ACID..................................................... 48
AMINOSALICYLIC ACID.............................................. 48
AMIODARONE HCL....................................................... 21
AMITIZA.................................................................... 54, 78
AMITRIPTYLINE HCL................................................... 18
AMITRIPTYLINE/CHLORDIAZEPOXIDE................... 17
AMLODIPINE BESYLATE............................................. 23
AMLODIPINE BESYLATE/BENAZEPRIL.................... 21
AMLODIPINE/ATORVASTATIN...............................24, 78
AMLODIPINE/VALSARTAN.......................................... 22
AMLODIPINE/VALSARTAN/HCTHIAZID................... 22
AMMONIUM LACTATE..................................................31
AMMONIUM LACTATE (12 %) (CREAM (G)) (OTC)
........................................................................................... 31
AMOXAPINE................................................................... 18
AMOXICILLIN.................................................................47
AMOXICILLIN/POTASSIUM CLAV........................ 47, 48
AMOXIL........................................................................... 47
AMPICILLIN.................................................................... 48
AMPICILLIN TRIHYDRATE.......................................... 48
AMYL NITRITE............................................................... 24
ANAFRANIL.................................................................... 18
ANAGRELIDE HCL.........................................................45
ANA-LEX HC................................................................... 53
ANALPRAM HC.............................................................. 33
ANALPRAM HC (2.5 %-1 %) (CREAM/APPL)............. 53
ANAMANTLE HC............................................................53
ANAMANTLE HC FORTE.............................................. 53
ANAPROX........................................................................ 53
ANAPROX DS.................................................................. 53
ANASTROZOLE.............................................................. 55
ANCOBON........................................................................48
ANDRODERM............................................................45, 95
ANDROGEL (1.25G-1.62) (GEL PACKET).............. 45, 95
ANDROGEL (12.5/1.25G) (GEL MD PMP).............. 45, 95
ANDROGEL (2.5G-1.62%) (GEL PACKET).............45, 95
ANDROGEL (20.25/1.25) (GEL MD PMP)...............45, 95
ANDROGEL (25MG(1%)) (GEL PACKET)..............45, 95
ANDROGEL (50 MG (1%)) (GEL PACKET)............45, 95
ANDROID................................................................... 45, 95
ANIMI-3............................................................................ 73
ANORO ELLIPTA...................................................... 14, 78
ANSAID............................................................................ 52
ANTABUSE...................................................................... 18
ANTHRALIN.................................................................... 33
ANTIHEM.FVIII,SIN-CHN,B-DM TRU......................... 43
ANTIHEMO.FVIII,FULL LENGTH PEG....................... 43
ANTIHEMOPH.FVIII REC,FC FUSION.........................43
ANTIHEMOPH.FVIII,B-DOM TRUNCAT..................... 43
ANTIHEMOPH.FVIII,B-DOMAIN DEL.........................43
ANTIHEMOPH.FVIII,FULL LENGTH...........................43
ANTIHEMOPH.FVIII,HEK B-DELETE......................... 43
ANTIHEMOPHILIC FACTOR, HUM REC.....................43
ANTIHEMOPHILIC FACTOR, HUMAN........................43
ANTIHEMOPHILIC FACTOR/VWF...............................43
ANTIHEMOPHILIC FVIII,REC PORC...........................43
ANTI-INHIBITOR COAGULANT COMP.......................43
ANTIVERT........................................................................14
ANUSOL HC.....................................................................30
APEXICON E....................................................................30
APIXABAN.................................................................43, 44
APLENZIN............................................................17, 78, 85
APOKYN...............................................................65, 78, 95
APOMORPHINE HCL..................................................... 65
APPLE JUICE................................................................... 57
APRACLONIDINE HCL.................................................. 42
APREMILAST.................................................................. 51
Page 99 of 116
Index
APREPITANT................................................................... 14
APRESOLINE...................................................................22
APRISO............................................................................. 53
APTIOM (200 MG) (TABLET)............................ 65, 78, 85
APTIOM (400 MG) (TABLET)............................ 66, 78, 85
APTIOM (600 MG) (TABLET)............................ 66, 78, 85
APTIOM (800 MG) (TABLET)............................ 66, 78, 85
APTIVUS.................................................................... 49, 78
AQUA LANCE LANCING DEVICE............................... 37
ARALAST NP...................................................................54
ARALEN........................................................................... 49
ARAVA.............................................................................. 51
ARCALYST.......................................................................51
ARGLAES.........................................................................28
ARICEPT...........................................................................17
ARICEPT ODT................................................................. 17
ARIMIDEX....................................................................... 55
ARIPIPRAZOLE...............................................................19
ARIXTRA (10MG/0.8ML) (SYRINGE).................... 44, 78
ARIXTRA (2.5 MG/0.5) (SYRINGE)........................ 44, 78
ARIXTRA (5MG/0.4ML) (SYRINGE)...................... 44, 78
ARIXTRA (7.5MG/0.6) (SYRINGE)......................... 44, 78
ARMOUR THYROID (120 MG) (TABLET)................... 40
ARMOUR THYROID (15 MG) (TABLET)..................... 40
ARMOUR THYROID (180 MG) (TABLET)................... 40
ARMOUR THYROID (240 MG) (TABLET)................... 40
ARMOUR THYROID (30 MG) (TABLET)..................... 40
ARMOUR THYROID (300 MG) (TABLET)................... 40
ARMOUR THYROID (60 MG) (TABLET)..................... 41
ARMOUR THYROID (90 MG) (TABLET)..................... 41
ARNUITY ELLIPTA.................................................. 15, 78
AROMASIN...................................................................... 55
ARTANE............................................................................65
ASCORBIC ACID.............................................................76
ASCORBIC ACID (250 MG) (TAB CHEW) (OTC)........ 76
ASCORBIC ACID (500 MG) (TAB CHEW) (OTC)........ 76
ASCORBIC ACID (500 MG) (TABLET ER) (OTC)....... 76
ASCORBIC ACID (500 MG) (TABLET) (OTC)............. 76
ASCORBIC ACID (500 MG/ML) (VIAL)....................... 76
ASCORBIC ACID (GRANULES) (OTC)........................ 76
ASCORBIC ACID/ASCORBATE SODIUM....................76
ASCORBIC ACID/ASCORBATE SODIUM (500 MG)
(WAFER) (OTC)................................................................76
ASENAPINE MALEATE..................................................19
ASENDIN..........................................................................18
ASFOTASE ALFA............................................................ 59
ASPIRIN................................................................45, 61, 78
ASPIRIN (300 MG) (SUPP.RECT) (OTC)....................... 61
ASPIRIN (325 MG) (TABLET DR) (OTC)................ 61, 78
ASPIRIN (325 MG) (TABLET) (OTC).......................61, 78
ASPIRIN (600 MG) (SUPP.RECT) (OTC)....................... 61
ASPIRIN/CAFFEIN/DIHYDROCODEINE..................... 62
ASPIRIN/CALCIUM CARBONATE/MAG..................... 61
ASSURE 4......................................................................... 35
ASSURE DOSE...........................................................35, 36
ASSURE PRISM............................................................... 35
ASTAGRAF XL................................................................ 46
ASTELIN.....................................................................13, 78
ASTHMA CHECK............................................................16
ASTHMAMENTOR..........................................................16
ASTHMAPACK CHILDREN'S........................................ 16
ATARAX........................................................................... 13
ATAZANAVIR SULFATE.................................................50
ATAZANAVIR SULFATE/COBICISTAT......................... 50
ATENOLOL...................................................................... 22
ATENOLOL/CHLORTHALIDONE.................................22
ATIVAN............................................................................. 18
ATOMOXETINE HCL......................................................21
ATOPICLAIR.................................................................... 31
ATORVASTATIN CALCIUM........................................... 24
ATOVAQUONE.................................................................49
ATOVAQUONE/PROGUANIL HCL................................ 49
ATRAPRO CP................................................................... 31
ATRAPRO HYDROGEL.................................................. 31
ATRIPLA.....................................................................51, 78
ATROPINE SULFATE...................................................... 42
ATROVENT.................................................................14, 57
ATROVENT HFA........................................................14, 78
AUBAGIO................................................................... 56, 95
AUGMENTIN (125-31.25/) (SUSP RECON).................. 47
AUGMENTIN (200-28.5/5) (SUSP RECON).................. 47
AUGMENTIN (200-28.5MG) (TAB CHEW)...................47
AUGMENTIN (250-125 MG) (TABLET)........................ 47
AUGMENTIN (250-62.5/5) (SUSP RECON).................. 47
AUGMENTIN (400-57MG) (TAB CHEW)......................47
AUGMENTIN (400-57MG/5) (SUSP RECON)............... 47
AUGMENTIN (500-125 MG) (TABLET)........................ 48
AUGMENTIN (875-125 MG) (TABLET)........................ 48
AUGMENTIN ES-600...................................................... 48
AUGMENTIN XR.............................................................48
AURANOFIN.................................................................... 52
AUTO-LANCET MINI..................................................... 37
VNSNY
AUTOLET IMPRESSION................................................ 38
AUTOLET LANCING DEVICE...................................... 37
AUTOLET PLUS.............................................................. 37
AVALIDE...........................................................................22
AVAPRO............................................................................ 22
AVC................................................................................... 70
AVEED........................................................................ 45, 95
AVELOX............................................................................48
AVIANE.............................................................................25
AVIDOXY................................................................... 48, 78
AVINZA (120 MG) (CPMP 24HR).............................63, 78
AVINZA (30 MG) (CPMP 24HR)...............................63, 78
AVINZA (45 MG) (CPMP 24HR)...............................63, 78
AVINZA (60 MG) (CPMP 24HR)...............................63, 78
AVINZA (75 MG) (CPMP 24HR)...............................63, 78
AVINZA (90 MG) (CPMP 24HR)...............................63, 78
AVODART.........................................................................69
AVONEX..................................................................... 56, 95
AVONEX PEN.............................................................56, 95
AXID................................................................................. 68
AXIRON...................................................................... 45, 95
AXITINIB..........................................................................55
AYGESTIN........................................................................46
AZATHIOPRINE.............................................................. 46
AZELASTINE HCL....................................................13, 41
AZILECT.....................................................................65, 78
AZITHROMYCIN.............................................................47
AZOPT.............................................................................. 42
AZTREONAM LYSINE....................................................46
AZULFIDINE....................................................................53
-BB CMPLX 4/VIT D3/C/FA/ZINC OX.............................. 75
B COMPLEX W-C NO.20/FOLIC ACID......................... 75
B12/LEVOMEFOLATE CALCIUM/B-6..........................75
B3/AZEL/QUER/TUR/FA/B6/ZN/COPP......................... 57
BABY NEBULIZER (EACH)...........................................15
BACITRACIN............................................................. 28, 41
BACITRACIN ZINC......................................................... 28
BACITRACIN ZINC (500 UNIT/G) (OINT. (G)) (OTC)
........................................................................................... 28
BACITRACIN ZINC (500 UNIT/G) (PACKET) (OTC)......
28
BACITRACIN/POLYMYXIN B SULFATE............... 28, 41
BACITRACIN/POLYMYXIN B SULFATE (500-10K/G)
(OINT. (G)) (OTC)............................................................ 28
BACLOFEN...................................................................... 67
BACTERIOSTATIC SODIUM CHLORIDE.................... 61
BACTRIM......................................................................... 46
BACTRIM DS................................................................... 46
BACTROBAN................................................................... 28
BACTROBAN NASAL..................................................... 57
BALANCED SALT SOLN NON-SURG #6..................... 42
BALNEOL.........................................................................31
BALSALAZIDE DISODIUM...........................................53
BALSAM PERU/CASTOR OIL....................................... 61
BANZEL (200 MG) (TABLET)............................ 67, 78, 85
BANZEL (40 MG/ML) (ORAL SUSP)................ 67, 78, 85
BANZEL (400 MG) (TABLET)............................ 67, 78, 85
BARACLUDE (0.05 MG/ML) (SOLUTION)............ 51, 78
BARACLUDE (0.5 MG) (TABLET).......................... 51, 78
BARACLUDE (1 MG) (TABLET)............................. 51, 78
BASAGLAR KWIKPEN U-100................................. 38, 78
BAYER CHEWABLE ASPIRIN................................. 45, 78
BCAD 1............................................................................. 58
BCAD 2....................................................................... 60, 95
B-CAROTENE/VIT C/E/LUT/MIN 29.............................57
B-COMPLEX WITH VITAMIN C................................... 72
B-COMPLEX WITH VITAMIN C (CAPSULE) (OTC)
........................................................................................... 72
B-COMPLEX WITH VITAMIN C (TABLET) (OTC)......
72
BEBULIN.......................................................................... 44
BECAPLERMIN............................................................... 38
BECLOMETHASONE DIPROPIONATE........................ 13
BEDAQUILINE FUMARATE.......................................... 48
BELSOMRA..........................................................20, 78, 85
BENADRYL (12.5MG/5ML) (ELIXIR) (OTC)............... 13
BENADRYL (12.5MG/5ML) (SYRUP) (OTC)................13
BENADRYL (25 MG) (CAPSULE) (OTC)................13, 20
BENADRYL (25 MG) (TABLET) (OTC)...................13, 20
BENADRYL (50 MG) (CAPSULE) (OTC)......................13
BENADRYL ALLERGY.................................................. 13
BENAZEPRIL HCL.......................................................... 22
BENAZEPRIL/HYDROCHLOROTHIAZIDE................. 21
BENEFIX.......................................................................... 44
BENEMID......................................................................... 43
BENICAR....................................................................22, 86
BENICAR HCT...........................................................22, 86
BENOXINATE HCL/FLUORESCEIN NA...................... 41
BENTYL............................................................................68
BENZACLIN (1 %-5 %) (GEL (GRAM))........................ 28
BENZALKONIUM CHLORIDE...................................... 28
BENZAMYCIN.................................................................28
BENZETHONIUM CHLORIDE................................ 32, 33
BENZETHONIUM CHLORIDE (0.1 %) (CLEANSER)
(OTC).................................................................................33
BENZOIN..........................................................................32
BENZOIN (TINCTURE) (OTC).......................................32
BENZONATATE............................................................... 26
BENZOYL PEROXIDE.................................................... 32
BENZOYL PEROXIDE (10 %) (CLEANSER) (OTC)......
32
BENZOYL PEROXIDE (10 %) (CREAM (G)) (OTC)......
32
BENZOYL PEROXIDE (10 %) (GEL (GRAM)) (OTC)
........................................................................................... 32
BENZOYL PEROXIDE (10 %) (LOTION) (OTC).......... 32
BENZOYL PEROXIDE (2.5 %) (GEL (GRAM)) (OTC)
........................................................................................... 32
BENZOYL PEROXIDE (4 %-5 %) (KIT) (OTC).............32
BENZOYL PEROXIDE (5 %) (CLEANSER) (OTC).......32
BENZTROPINE MESYLATE.......................................... 65
BERINERT.................................................................. 52, 95
BESIFLOXACIN HCL......................................................41
BESIVANCE..................................................................... 41
BETA-CAROTENE(A)-C,E/SELENIUM.........................57
BETA-CAROTENE(A)-C,E/SELENIUM (CAPSULE)
(OTC).................................................................................57
BETA-CAROTENE(A)-VITS C,E/MINS.........................72
BETA-CAROTENE(A)-VITS C,E/MINS (TABLET)
(OTC).................................................................................72
BETADINE (7.5 %) (CLEANSER) (OTC).......................33
BETAGAN.........................................................................42
BETAINE...........................................................................59
BETAMETHASONE DIPROPIONATE........................... 29
BETAMETHASONE VALERATE................................... 29
BETAMETHASONE/PROPYLENE GLYC..................... 29
BETAXOLOL HCL.....................................................22, 42
BETHANECHOL CHLORIDE.........................................54
BETIMOL..........................................................................42
BETOPTIC........................................................................ 42
BETOPTIC S..................................................................... 42
BEXAROTENE........................................................... 33, 56
BEYAZ........................................................................ 25, 86
BIAFINE............................................................................31
BIAXIN............................................................................. 47
BIAXIN XL....................................................................... 47
BICALUTAMIDE............................................................. 55
BICILLIN L-A...................................................................48
BIDIL.................................................................................23
BIFERA RX.......................................................................71
BILTRICIDE..................................................................... 49
BIMATOPROST................................................................42
BIOCEL.............................................................................70
BION TEARS....................................................................42
BIONECT (0.2 %) (CREAM (G)).....................................32
BIONECT (0.2 %) (GEL (GRAM))..................................32
BISACODYL...............................................................53, 54
BISMUTH SUBSALICYLATE........................................ 53
BISMUTH SUBSALICYLATE (262 MG) (TAB CHEW)
(OTC).................................................................................53
BISMUTH SUBSALICYLATE (262 MG) (TABLET)
(OTC).................................................................................53
BISMUTH SUBSALICYLATE (262MG/15ML) (ORAL
SUSP) (OTC)..................................................................... 53
BISOPROL/HYDROCHLOROTHIAZIDE...................... 22
BISOPROLOL FUMARATE............................................ 22
BLEPHAMIDE..................................................................41
BLEPHAMIDE S.O.P........................................................41
BLOCADREN...................................................................22
BLOOD GLUCOSE CNTL HIGH,NORMAL................. 35
BLOOD GLUCOSE CONTROL...................................... 35
BLOOD GLUCOSE CONTROL HIGH,LOW................. 35
BLOOD GLUCOSE CTL HIGH,NML,LOW...................35
BLOOD GLUCOSE,KETONE CNTRL NML................. 35
BLOOD SUGAR DIAGNOSTIC......................................35
BLOOD-GLUC TRANSMITTER/SENSOR....................35
BLOOD-GLUC.METER, WRIST BP MON.................... 35
BLOOD-GLUCOSE CALIB. CONTROL........................ 35
BLOOD-GLUCOSE CONTROL...................................... 36
BLOOD-GLUCOSE CONTROL, HIGH.................... 35, 36
BLOOD-GLUCOSE CONTROL, LOW........................... 36
BLOOD-GLUCOSE CONTROL, NORMAL.............36, 37
BLOOD-GLUCOSE METER........................................... 37
BLOOD-GLUCOSE TRANSMITTER.............................37
BOLUS INSULIN PUMP, 200 UNIT............................... 37
BONIVA............................................................................ 40
BOOST GLUCOSE CONTROL (0.06 G-1.1) (LIQUID)
(OTC)...........................................................................60, 95
BOOST VHC...............................................................57, 95
BOSENTAN...................................................................... 23
BOSULIF (100 MG) (TABLET)........................... 55, 78, 95
BOSULIF (500 MG) (TABLET)........................... 55, 78, 95
Page 100 of 116
Index
BOSUTINIB...................................................................... 55
BREATHE RIGHT............................................................ 15
BREATHERITE................................................................ 15
BREATHRITE...................................................................15
BREEZE 2................................................................... 35, 36
BREO ELLIPTA..........................................................14, 78
BRETHINE........................................................................14
BRILINTA................................................................... 45, 78
BRIMONIDINE TARTRATE............................................42
BRIMONIDINE TARTRATE/TIMOLOL........................ 42
BRINZOLAMIDE.............................................................42
BRINZOLAMIDE/BRIMONIDINE TART...................... 42
BRISDELLE..........................................................17, 78, 86
BROMFED DM.................................................................27
BROMOCRIPTINE MESYLATE..................................... 65
BROMPHENIRA/PSEUDOEPHED/CODEIN.................26
BROMPHENIRAM/PHENYLEPHRINE/DM................. 27
BROMPHENIRAM/PHENYLEPHRINE/DM (2-510MG/5) (LIQUID) (OTC)................................................27
BROMPHENIRAM/PHENYLEPHRINE/DM (4-10-20/5)
(LIQUID) (OTC)............................................................... 27
BROMPHENIRAM/PHENYLEPHRINE/DM (4-7.5-15/5)
(LIQUID) (OTC)............................................................... 27
BROMPHENIRAMINE/PHENYLEPHRINE.................. 26
BROMPHENIRAMINE/PHENYLEPHRINE (6MG10MG/5) (ORAL SUSP) (OTC)........................................26
BROMPHENIRAMINE/PSEUDOEPHED/DM............... 27
BROMPHENIRAMINE/PSEUDOEPHED/DM (2-30-10/5)
(SYRUP)............................................................................ 27
BROMPHENIRAMINE/PSEUDOEPHED/DM (3-30-15/5)
(LIQUID) (OTC)............................................................... 27
BUDESONIDE............................................................14, 52
BUMETANIDE................................................................. 23
BUMEX.............................................................................23
BUNAVAIL (2.1-0.3 MG) (FILM).............................. 64, 78
BUNAVAIL (4.2-0.7 MG) (FILM).............................. 64, 78
BUNAVAIL (6.3MG-1MG) (FILM)............................65, 78
BUPHENYL (0.94 G/G) (POWDER)............................... 53
BUPHENYL (500 MG) (TABLET).................................. 53
BUPRENEX (0.3 MG/ML) (VIAL)..................................64
BUPRENORPHINE.......................................................... 62
BUPRENORPHINE HCL........................................... 64, 78
BUPRENORPHINE HCL/NALOXONE HCL........... 64, 65
BUPROPION HBR............................................................17
BUPROPION HCL......................................................17, 68
BUSPAR............................................................................ 18
BUSPIRONE HCL............................................................ 18
BUSULFAN.......................................................................55
BUTABARBITAL SODIUM.............................................20
BUTALB/ACETAMINOPHEN/CAFFEINE.................... 61
BUTALBIT/ACETAMIN/CAFF/CODEINE.................... 64
BUTALBITAL/ACETAMINOPHEN................................ 61
BUTALBITAL/ASPIRIN/CAFFEINE.............................. 61
BUTAPAP..........................................................................61
BUTISOL SODIUM..........................................................20
BUTOCONAZOLE NITRATE......................................... 70
BUTORPHANOL TARTRATE.........................................62
BUTRANS...................................................................62, 78
BYSTOLIC........................................................................22
BYVALSON...................................................................... 22
-CC1 ESTERASE INHIBITOR............................................ 52
C1 ESTERASE INHIBITOR, RECOMB..........................52
CABERGOLINE............................................................... 40
CABOMETYX............................................................ 55, 95
CABOZANTINIB S-MALATE.........................................55
CAFERGOT................................................................ 64, 78
CAFFEINE CITRATE.......................................................16
CAL/MAG/B COMP/VIT D3/HRB61.............................. 72
CALAN..............................................................................23
CALAN SR........................................................................23
CALCIPOTRIENE............................................................ 33
CALCIPOTRIENE/BETAMETHASONE........................ 34
CALCITONIN,SALMON,SYNTHETIC..........................40
CALCITRIOL..............................................................33, 76
CALCIUM ACETATE.......................................................39
CALCIUM ACETATE (667 MG) (CAPSULE)................ 39
CALCIUM CARB, GLUCONATE/VIT D2..................... 70
CALCIUM CARB/MAG CARB/FOLIC AC....................39
CALCIUM CARB/SOD HYPOCHLORITE.................... 33
CALCIUM CARBONATE.......................................... 68, 70
CALCIUM CARBONATE (320MG(750)) (TAB CHEW)
(OTC).................................................................................68
CALCIUM CARBONATE (600 MG) (TABLET) (OTC)
........................................................................................... 70
CALCIUM CARBONATE/VITAMIN D2........................ 70
CALCIUM CARBONATE/VITAMIN D3........................ 70
CALCIUM CARBONATE/VITAMIN D3 (250 MG-125)
(TABLET) (OTC).............................................................. 70
CALCIUM CARBONATE/VITAMIN D3 (500 MG-200)
(TABLET) (OTC).............................................................. 70
VNSNY
CALCIUM CARBONATE/VITAMIN D3 (500 MG-400)
(TABLET) (OTC).............................................................. 70
CALCIUM CARBONATE/VITAMIN D3 (500 MG-600)
(TABLET) (OTC).............................................................. 70
CALCIUM CARBONATE/VITAMIN D3 (600 MG-200)
(TABLET) (OTC).............................................................. 70
CALCIUM CARBONATE/VITAMIN D3 (600 MG-400)
(TABLET) (OTC).............................................................. 70
CALCIUM CARBONATE/VITAMIN D3 (600 MG-800)
(TABLET) (OTC).............................................................. 70
CALCIUM CITRATE....................................................... 70
CALCIUM CITRATE (200(950)MG) (TABLET) (OTC)
........................................................................................... 70
CALCIUM/MAG/D3/B12/FA/B6/BORON...................... 70
CALCIUM/MULTIVITAMIN WITH IRON.................... 70
CALORIC SUPPLEMENT............................................... 57
CALTRATE 600................................................................ 70
CANAGLIFLOZIN........................................................... 34
CANAGLIFLOZIN/METFORMIN HCL......................... 34
CANASA........................................................................... 53
CAPECITABINE...............................................................55
CAPITAL W-CODEINE................................................... 64
CAPOZIDE........................................................................21
CAPRELSA (100 MG) (TABLET)....................... 56, 78, 95
CAPRELSA (300 MG) (TABLET)....................... 56, 78, 95
CAPTOPRIL/HYDROCHLOROTHIAZIDE....................21
CARAC..............................................................................33
CARAFATE (1 G) (TABLET)...........................................68
CARAFATE (1 G/10 ML) (ORAL SUSP)........................ 68
CARBAGLU......................................................................53
CARBAMAZEPINE................................................... 18, 65
CARBAMAZEPINE (100 MG) (CPMP 12HR)............... 65
CARBAMAZEPINE (100 MG) (TAB ER 12H)............... 65
CARBAMAZEPINE (100 MG/5ML) (ORAL SUSP)......
65
CARBAMAZEPINE (200 MG) (CPMP 12HR)............... 65
CARBAMAZEPINE (200 MG) (TAB ER 12H)............... 65
CARBAMAZEPINE (200 MG) (TABLET)......................65
CARBAMAZEPINE (300 MG) (CPMP 12HR)............... 65
CARBAMAZEPINE (400 MG) (TAB ER 12H)............... 65
CARBATROL (300 MG) (CPMP 12HR)..........................65
CARBIDOPA.....................................................................65
CARBIDOPA/LEVODOPA.............................................. 65
CARBIDOPA/LEVODOPA/ENTACAPONE................... 65
CARBINOXAMINE MALEATE......................................13
CARBIT/EQUIS XT/ETHAN/CHIT/MSM......................32
CARDENE........................................................................ 23
CARDIZEM...................................................................... 23
CARDIZEM CD................................................................23
CARDIZEM SR.................................................................23
CARDURA........................................................................22
CARELANCE ULT LANCING DEVICE........................ 38
CAREONE........................................................................ 38
CARESENS.................................................................35, 36
CARESENS PREM LANCING DEVICE........................ 38
CARETOUCH ALCOHOL PREP PAD............................31
CARETOUCH LANCING DEVICE................................ 38
CARGLUMIC ACID.........................................................53
CARISOPRODOL.............................................................67
CARISOPRODOL/ASPIRIN............................................ 67
CARISOPRODOL/ASPIRIN/CODEINE......................... 62
CARMUSTINE IN POLIFEPROSAN 20......................... 55
CARTEOLOL HCL...........................................................42
CARVEDILOL.................................................................. 22
CARVEDILOL PHOSPHATE.......................................... 22
CASODEX........................................................................ 55
CASTOR OIL.................................................................... 54
CASTOR OIL (OIL) (OTC).............................................. 54
CATAFLAM...................................................................... 52
CATAPRES........................................................................22
CATAPRES-TTS 1............................................................ 22
CATAPRES-TTS 2............................................................ 22
CATAPRES-TTS 3............................................................ 22
CAYSTON................................................................... 46, 95
CECLOR............................................................................46
CECLOR CD..................................................................... 47
CEDAX..............................................................................47
CEFACLOR.................................................................46, 47
CEFADROXIL...................................................................46
CEFDINIR.........................................................................47
CEFDITOREN PIVOXIL..................................................47
CEFIXIME........................................................................ 47
CEFPODOXIME PROXETIL........................................... 47
CEFPROZIL...................................................................... 47
CEFTIBUTEN...................................................................47
CEFTIN (125 MG/5ML) (SUSP RECON)....................... 47
CEFTIN (250 MG) (TABLET)..........................................47
CEFTIN (250 MG/5ML) (SUSP RECON)....................... 47
CEFUROXIME AXETIL.................................................. 47
CEFZIL..............................................................................47
CELEBREX.......................................................................52
CELECOXIB..................................................................... 52
CELEXA............................................................................17
CELLCEPT........................................................................46
CELLULOSE GUM.......................................................... 61
CELONTIN....................................................................... 66
CENTANY.........................................................................28
CENTRUM MEN.............................................................. 73
CENTRUM SILVER......................................................... 72
CENTRUM SILVER MEN............................................... 72
CENTRUM SILVER ULTRA MEN'S...............................72
CENTRUM SILVER WOMEN.........................................72
CENTRUM SPECIALIST HEART...................................72
CENTRUM ULTRA MEN'S............................................. 73
CENTURY CARDIO........................................................ 72
CEPHALEXIN.................................................................. 46
CERDELGA................................................................ 58, 95
CERITINIB........................................................................55
CERTOLIZUMAB PEGOL.............................................. 53
CETIRIZINE HCL............................................................ 13
CETIRIZINE HCL/PSEUDOEPHEDRINE..................... 13
CETRAXAL...................................................................... 39
CHANTIX................................................................... 68, 78
CHEMSTRIP BG DIARY.................................................37
CHEMSTRIP UGK........................................................... 39
CHILDREN'S ADVIL.......................................................52
CHILDREN'S BENADRYL ALLERGY (12.5MG/5ML)
(LIQUID) (OTC)............................................................... 13
CHILDREN'S CLARITIN (5 MG/5 ML) (SOLUTION)
(OTC).................................................................................13
CHILDREN'S FLONASE ALLERGY RLF............... 14, 78
CHILDREN'S MOTRIN....................................................52
CHILDREN'S TYLENOL.................................................62
CHILDREN'S ZYRTEC....................................................13
CHILD'S BENADRYL ALLERGY.................................. 13
CHLORAMBUCIL........................................................... 55
CHLORDIAZEPOXIDE HCL.......................................... 18
CHLORDIAZEPOXIDE/CLIDINIUM BR...................... 68
CHLORHEXIDINE GLUCONATE..................................57
CHLOROQUINE PHOSPHATE....................................... 49
CHLOROTHIAZIDE.........................................................23
CHLOROXYLENOL........................................................ 28
CHLORPHENIRAMINE MALEATE...............................13
CHLORPHENIRAMINE/PHENYLEPH/DM.................. 27
CHLORPHENIRAMINE/PHENYLEPH/DM (1-23MG/ML) (DROPS).......................................................... 27
CHLORPHENIRAMINE/PHENYLEPH/DM (2-515MG/5) (LIQUID) (OTC)................................................27
CHLORPHENIRAMINE/PHENYLEPH/DM (4-10-15/5)
(LIQUID) (OTC)............................................................... 27
CHLORPHENIRAMINE/PHENYLEPHRINE................ 26
CHLORPHENIRAMINE/PHENYLEPHRINE (1MG2MG/ML) (DROPS).......................................................... 26
CHLORPHENIRAMINE/PHENYLEPHRINE (410MG/5ML) (LIQUID) (OTC)..........................................26
CHLORPHENIRAMINE/PSEUDOEPHED.....................26
CHLORPHENIRAMINE/PSEUDOEPHED (4 MG-60
MG) (TABLET) (OTC)..................................................... 26
CHLORPROMAZINE HCL..............................................20
CHLORPROPAMIDE....................................................... 34
CHLORTHALIDONE.......................................................23
CHLOR-TRIMETON........................................................13
CHLOR-TRIMETON ALLERGY.................................... 13
CHLORZOXAZONE........................................................ 67
CHOICEDM CLARUS CONTROL SOLN...................... 36
CHOLECALCIFEROL (VITAMIN D3)........................... 76
CHOLECALCIFEROL (VITAMIN D3) (400 UNIT)
(CAPSULE) (OTC)..................................................... 76, 77
CHOLECALCIFEROL (VITAMIN D3) (400 UNIT)
(TABLET) (OTC)........................................................ 76, 77
CHOLESTYRAMINE (WITH SUGAR).......................... 24
CHOLESTYRAMINE/ASPARTAME.............................. 24
CHOLINE SALICYL/MAG SALICYLATE.................... 61
CHRONULAC.............................................................53, 54
CICLODAN.................................................................28, 29
CICLOPIROX....................................................................28
CICLOPIROX OLAMINE................................................ 28
CICLOPIROX/URE/CAMPH/MENTH/EUC...................29
CIDALEAZE..................................................................... 33
CILOSTAZOL................................................................... 45
CILOXAN (0.3 %) (DROPS)............................................ 41
CILOXAN (0.3 %) (OINT. (G))........................................ 41
CIMETIDINE.................................................................... 68
CIMETIDINE HCL........................................................... 68
CIMZIA....................................................................... 53, 95
CINACALCET HCL......................................................... 40
CINRYZE.................................................................... 52, 95
CIPRO................................................................................48
CIPRO XR......................................................................... 48
CIPRODEX....................................................................... 39
CIPROFLOXACIN............................................................48
CIPROFLOXACIN HCL.......................................39, 41, 48
CIPROFLOXACIN HCL/DEXAMETH........................... 39
CIPROFLOXACIN/CIPROFLOXA HCL.........................48
Page 101 of 116
Index
CITALOPRAM HYDROBROMIDE................................ 17
CITRANATAL HARMONY............................................. 74
CITRATE PHOSPHATE DEXTROS SOLN.................... 43
CITRIC ACID/SODIUM CITRATE................................. 69
CITRUCEL........................................................................ 54
CLARINEX (5 MG) (TABLET)................................. 13, 78
CLARITHROMYCIN....................................................... 47
CLARITIN (10 MG) (TAB RAPDIS) (OTC)....................13
CLARITIN (10 MG) (TABLET) (OTC)........................... 13
CLARITIN (5 MG/5 ML) (SOLUTION) (OTC).............. 13
CLARITIN-D 12 HOUR................................................... 13
CLARITIN-D 24 HOUR................................................... 13
CLEANSING EYELID PADS.......................................... 42
CLEANSING EYELID WIPES........................................ 42
CLEMASTINE FUMARATE........................................... 13
CLEOCIN (2 %) (CREAM/APPL)................................... 69
CLEOCIN HCL................................................................. 49
CLEOCIN PALMITATE................................................... 49
CLEOCIN T.......................................................................28
CLEVER CHOICE CONTROL SOLUTION............. 35, 36
CLIMARA...................................................................46, 78
CLINDACIN ETZ............................................................. 28
CLINDACIN P.................................................................. 28
CLINDAMYCIN HCL...................................................... 49
CLINDAMYCIN PALMITATE HCL................................49
CLINDAMYCIN PHOS/BENZOYL PEROX.................. 28
CLINDAMYCIN PHOSPHATE................................. 28, 69
CLINORIL.........................................................................53
CLISTIN (4 MG) (TABLET)............................................ 13
CLISTIN (4 MG/5 ML) (LIQUID)................................... 13
CLOBAZAM..................................................................... 67
CLOBETASOL PROPIONATE.........................................29
CLOBETASOL PROPIONATE/EMOLL....................29, 30
CLOBEX........................................................................... 29
CLOCORTOLONE PIVALATE........................................30
CLODAN...........................................................................29
CLODERM........................................................................30
CLOMIPRAMINE HCL................................................... 18
CLONAZEPAM................................................................ 65
CLONIDINE......................................................................22
CLONIDINE HCL.......................................................20, 22
CLONIDINE HCL/CHLORTHALIDONE....................... 22
CLOPIDOGREL BISULFATE..........................................45
CLORAZEPATE DIPOTASSIUM.................................... 18
CLOTRIMAZOLE...................................................... 29, 48
CLOTRIMAZOLE/BETAMETHASONE DIP................. 28
CLOZAPINE............................................................... 19, 78
CLOZARIL..................................................................19, 78
COAGULATION FACTOR VIIA,RECOMB................... 43
COBICISTAT.....................................................................51
COBIMETINIB FUMARATE...........................................55
COCAINE HCL.................................................................33
CODEINE..........................................................................62
CODEINE PHOSPHATE/GUAIFENESIN.......................27
CODEINE PHOSPHATE/GUAIFENESIN (10-100MG/5)
(LIQUID) (OTC)............................................................... 27
CODEINE PHOSPHATE/GUAIFENESIN (10-200MG/5)
(LIQUID) (OTC)............................................................... 27
CODEINE PHOSPHATE/GUAIFENESIN (6.3-100/5)
(LIQUID) (OTC)............................................................... 27
CODEINE PHOSPHATE/GUAIFENESIN (7.5-225/5)
(LIQUID) (OTC)............................................................... 27
CODEINE PHOSPHATE/GUAIFENESIN (8-200 MG/5)
(LIQUID) (OTC)............................................................... 27
CODEINE SULFATE........................................................ 62
CODEINE/BUTALBITAL/ASA/CAFFEIN..................... 64
COGENTIN.......................................................................65
COLACE........................................................................... 54
COLACE CLEAR............................................................. 54
COLAZAL.........................................................................53
COLCHICINE................................................................... 43
COLCRYS................................................................... 43, 78
COLESEVELAM HCL..................................................... 24
COLESTID (1 G) (TABLET)............................................24
COLESTID (5 G) (GRANULES)..................................... 24
COLESTID (5 G) (PACKET)............................................24
COLESTIPOL HCL.......................................................... 24
COLLAGEN,BOVINE...................................................... 33
COLYTE WITH FLAVOR PACKETS.............................. 54
COMBIGAN......................................................................42
COMBIPATCH............................................................46, 78
COMBIPRES (0.1MG-15MG) (TABLET)....................... 22
COMBIPRES (0.2-15MG) (TABLET)..............................22
COMBIVENT RESPIMAT............................................... 14
COMBIVIR................................................................. 49, 78
COMBUNOX.................................................................... 62
COMETRIQ.......................................................... 55, 78, 95
COMFORT (INFUS.SET).................................................37
COMPACT COMPRESSOR NEBULIZER......................15
COMPACT ULTRASONIC NEBULIZER....................... 15
COMP-AIR ELITE COMPRESSOR SYST..................... 16
COMP-AIR NEBULIZER COMPRESSOR..................... 16
VNSNY
COMPAZINE.................................................................... 14
COMPLEAT PEDIATRIC...........................................58, 95
COMPLERA................................................................51, 78
COMPRESSOR, FOR NEBULIZER................................15
COMTAN.......................................................................... 65
CONCEPT DHA............................................................... 73
CONCEPT OB...................................................................73
CONCERTA (18 MG) (TAB ER 24).....................20, 77, 78
CONCERTA (27 MG) (TAB ER 24).....................20, 77, 78
CONCERTA (36 MG) (TAB ER 24).....................20, 77, 78
CONCERTA (54 MG) (TAB ER 24).....................20, 77, 78
CONDYLOX (0.5 %) (GEL (GRAM))............................. 32
CONDYLOX (0.5 %) (SOLUTION).................................32
CONTACT DETACH INFUSION SET (INFUS.SET)......
37
CONTOUR.................................................................. 35, 36
CONTOUR NEXT CONTROL SOLUTION....................36
CONTROL SOLUTION..............................................35, 36
CONZIP (150 MG) (CPBP 25-75)........................ 64, 78, 86
COOL CONTROL SOLUTION..................................35, 36
COPAXONE (20 MG/ML) (SYRINGE).....................56, 95
COPAXONE (40 MG/ML) (SYRINGE).....................56, 95
COPEGUS......................................................................... 51
CORDARONE...................................................................21
CORDRAN (0.05 %) (CREAM (G))................................ 30
CORDRAN (0.05 %) (LOTION)...................................... 30
CORDRAN (0.05 %) (OINT. (G)).................................... 30
CORDRAN (4MCG/SQ CM) (MED. TAPE)................... 30
COREG..............................................................................22
COREG CR....................................................................... 22
CORIFACT........................................................................ 43
CORN STARCH................................................................61
CORRECTOL....................................................................53
CORTAID (1 %) (OINT. (G))............................................30
CORTEF............................................................................ 52
CORTENEMA...................................................................53
CORTISONE ACETATE...................................................52
CORTISONE-10................................................................30
CORTISPORIN................................................................. 29
CORTIZONE-10................................................................30
CORTONE.........................................................................52
CORVITE 150................................................................... 71
CORZIDE.......................................................................... 23
COSENTYX (2 SYRINGES)......................................33, 95
COSENTYX PEN....................................................... 33, 95
COSENTYX PEN (2 PENS)....................................... 33, 95
COSENTYX SYRINGE..............................................33, 95
COSOPT............................................................................ 42
COTELLIC............................................................ 55, 78, 95
COVARYX.........................................................................45
COVARYX H.S................................................................. 45
COZAAR...........................................................................22
CRANBERRY JUICE....................................................... 57
CREON..............................................................................68
CRESTOR................................................................... 24, 79
CRIXIVAN........................................................................ 50
CRIZOTINIB.....................................................................55
CROMOLYN SODIUM.............................................. 15, 42
CROTAMITON................................................................. 29
CUPRIMINE............................................................... 51, 95
CURITY ALCOHOL PREPS............................................31
CUTIVATE (0.005 %) (OINT. (G))...................................30
CUTIVATE (0.05 %) (CREAM (G)).................................30
CYANOCOBALAMIN (VITAMIN B-12)........................76
CYANOCOBALAMIN (VITAMIN B-12) (1000MCG/ML)
(VIAL)............................................................................... 76
CYANOCOBALAMIN/FOLIC AC/VIT B6..................... 75
CYANOCOBALAMIN/FOLIC AC/VIT B6 (0.5-2.2-25)
(TABLET)..........................................................................75
CYANOCOBALAMIN/FOLIC AC/VIT B6 (1-2.2-25MG)
(TABLET)..........................................................................75
CYANOCOBALAMIN/FOLIC AC/VIT B6 (1-2.2-25MG)
(TABLET) (OTC).............................................................. 75
CYANOCOBALAMIN/FOLIC AC/VIT B6 (1-2.5-25MG)
(TABLET)..........................................................................75
CYANOCOBALAMIN/FOLIC AC/VIT B6 (2-2.5-25MG)
(TABLET)..........................................................................75
CYANOCOBALAMIN/MECOBALAMIN...................... 76
CYCLESSA.......................................................................25
CYCLINEX-2..............................................................60, 95
CYCLOBENZAPRINE HCL............................................67
CYCLOCORT................................................................... 29
CYCLOGYL......................................................................42
CYCLOPENTOLATE HCL.............................................. 42
CYCLOPHOSPHAMIDE................................................. 55
CYCLOSERINE................................................................48
CYCLOSPORINE............................................................. 46
CYCLOSPORINE, MODIFIED........................................46
CYMBALTA................................................................17, 79
CYPROHEPTADINE HCL............................................... 13
CYSTADANE....................................................................59
CYSTARAN................................................................ 43, 95
CYSTEAMINE BITARTRATE.........................................69
CYSTEAMINE HCL.........................................................43
CYTOTEC......................................................................... 68
CYTRA-2.......................................................................... 69
CYTRA-3.......................................................................... 69
CYTRA-K..........................................................................69
-DD.H.E. 45........................................................................... 64
D.H.E.45...................................................................... 64, 79
DABRAFENIB MESYLATE............................................ 55
DALIRESP............................................................ 15, 79, 86
DALMANE....................................................................... 20
DALTEPARIN SODIUM,PORCINE................................ 44
DANAZOL........................................................................ 40
DANOCRINE.................................................................... 40
DANTRIUM...................................................................... 67
DANTROLENE SODIUM................................................ 67
DAPSONE......................................................................... 48
DARAPRIM................................................................ 49, 95
DARUNAVIR ETHANOLATE......................................... 49
DARUNAVIR/COBICISTAT............................................ 49
DASATINIB................................................................ 55, 56
DAYPRO............................................................................53
DECADRON..................................................................... 52
DECLOMYCIN.................................................................48
DEFERASIROX................................................................ 59
DEFERIPRONE................................................................ 59
DEFEROXAMINE MESYLATE...................................... 59
DEGARELIX ACETATE.................................................. 55
DELATESTRYL..........................................................45, 95
DELAVIRDINE MESYLATE...........................................50
DELESTROGEN (20 MG/ML) (VIAL)........................... 46
DELESTROGEN (40 MG/ML) (VIAL)........................... 46
DELTASONE.................................................................... 52
DEMADEX....................................................................... 23
DEMECLOCYCLINE HCL..............................................48
DEMEROL (10 MG/ML) (CARTRIDGE)........................63
DEMEROL (100 MG/ML) (VIAL)...................................63
DEMEROL (25 MG/ML) (VIAL).....................................63
DEMEROL (50 MG/ML) (VIAL).....................................63
DEMULEN........................................................................25
DEMULEN 1-50-21.......................................................... 25
DEPAKENE (500MG/10ML) (SOLUTION)....................67
DEPAKOTE (250 MG) (TABLET DR).............................65
DEPAKOTE (500 MG) (TABLET DR).............................65
DEPEN........................................................................ 51, 95
DEPO-ESTRADIOL......................................................... 46
DEPO-PROVERA....................................................... 25, 79
DEPO-SUBQ PROVERA 104.....................................25, 79
DEPO-TESTOSTERONE........................................... 45, 95
DERMAPLEX...................................................................31
DERMA-SMOOTHE-FS...................................................30
DERMATOP......................................................................30
DERMAZENE...................................................................28
DERMOTIC.......................................................................39
DESCOVY...................................................................49, 79
DESFERAL....................................................................... 59
DESFERAL MESYLATE................................................. 59
DESIPRAMINE HCL....................................................... 18
DESIRUDIN...................................................................... 45
DESLORATADINE...........................................................13
DESMOPRESSIN (NONREFRIGERATED)................... 40
DESMOPRESSIN ACETATE........................................... 40
DESOG-E.ESTRADIOL/E.ESTRADIOL........................ 25
DESOGEN.........................................................................25
DESOGESTREL-ETHINYL ESTRADIOL..................... 25
DESONIDE....................................................................... 30
DESOXIMETASONE....................................................... 30
DESOXYN.................................................................. 18, 79
DESVENLAFAXINE........................................................17
DESVENLAFAXINE ER......................................17, 79, 86
DESVENLAFAXINE FUMARATE................................. 17
DESVENLAFAXINE FUMARATE ER............... 17, 79, 86
DESVENLAFAXINE SUCCINATE................................. 17
DESYREL......................................................................... 17
DETROL......................................................................69, 86
DEVILBISS COMPACT................................................... 15
DEVILBISS DISPOSABLE NEBULIZER...................... 15
DEVILBISS PULMO-AIDE............................................. 15
DEVILBISS PULMOMATE............................................. 15
DEVILBISS TRAVELER..................................................16
DEVILBLISS.................................................................... 15
DEXAMETHASONE........................................................52
DEXAMETHASONE SOD PHOSPHATE.......................41
DEXASOL.........................................................................41
DEXEDRINE (10 MG) (CAPSULE ER)....................18, 79
DEXEDRINE (10 MG) (TABLET).............................18, 79
DEXEDRINE (15 MG) (CAPSULE ER)....................18, 79
DEXEDRINE (5 MG) (CAPSULE ER)......................18, 79
DEXEDRINE (5 MG) (TABLET)...............................18, 79
DEXMETHYLPHENIDATE HCL....................................20
Page 102 of 116
Index
DEXTRAN 70/HYPROMELLOSE.................................. 42
DEXTRAN 70/HYPROMELLOSE/PF.............................42
DEXTRAN/HYPROMELLOSE/GLYCERIN.................. 42
DEXTROAMPHETAMINE SULFATE............................ 18
DEXTROAMPHETAMINE/AMPHETAMINE................ 18
DEXTROSE.......................................................................38
DEXTROSE (4 G) (TAB CHEW) (OTC)......................... 38
DEXTROSE (40 %) (GEL (GRAM)) (OTC).................... 38
DEXTROSE (TAB CHEW) (OTC)................................... 38
DEXTROSE/DEXTRIN/MALTOSE................................ 38
DEXTROSE/DEXTRIN/MALTOSE (24 G/31 G) (GEL
(GRAM)) (OTC)................................................................38
DIABETIC SUPPLIES,MISCELL....................................37
DIABETISOURCE AC............................................... 60, 95
DIABINESE...................................................................... 34
DIALYVITE 800-ULTRA D............................................. 75
DIAMOX........................................................................... 42
DIAMOX SEQUELS.........................................................42
DIAPHRAGMS, WIDE SEAL..........................................26
DIASTAT..................................................................... 65, 79
DIASTAT ACUDIAL.................................................. 65, 79
DIASTIX REAGENT (STRIP) (OTC)..............................39
DIATRUE.................................................................... 35, 36
DIAZEPAM........................................................... 18, 65, 79
DIAZEPAM INTENSOL.................................................. 18
DIBENZYLINE.................................................................22
DICHLORPHENAMIDE.................................................. 67
DICLOFENAC POTASSIUM........................................... 52
DICLOFENAC SODIUM............................... 30, 33, 41, 52
DICLOXACILLIN SODIUM............................................48
DICYCLOMINE HCL...................................................... 68
DIDANOSINE...................................................................50
DIDRONEL....................................................................... 40
DIETARY SUPPLEMENT................................................57
DIETARY SUPPLEMENT (CAPSULE) (OTC)...............57
DIETARY SUPPLEMENT (POWDER) (OTC)..........57, 95
DIETHYLTOLUAMIDE.............................................28, 29
DIETHYLTOLUAMIDE (15 %) (AERO POWD) (OTC)
..................................................................................... 29, 79
DIETHYLTOLUAMIDE (15 %) (SPRAY) (OTC)...... 29,
79
DIETHYLTOLUAMIDE (25 %) (AERO POWD) (OTC)
..................................................................................... 28, 79
DIETHYLTOLUAMIDE (25 %) (SPRAY) (OTC)...... 29,
79
DIETHYLTOLUAMIDE (40 %) (SPRAY) (OTC)...... 29,
79
DIETHYLTOLUAMIDE (7 %) (SPRAY) (OTC)....... 29, 79
DIFICID.................................................................47, 79, 86
DIFLORASONE DIACETATE/EMOLL.......................... 30
DIFLUCAN....................................................................... 48
DIFLUNISAL....................................................................61
DIFLUPREDNATE........................................................... 41
DIGOXIN.......................................................................... 21
DIGOXIN (125 MCG) (TABLET).................................... 21
DIGOXIN (250 MCG) (TABLET).................................... 21
DIGOXIN (50 MCG/ML) (SOLUTION)..........................21
DIHYDROERGOTAMINE MESYLATE......................... 64
DILACOR XR................................................................... 23
DILANTIN........................................................................ 67
DILANTIN-125.................................................................67
DILAUDID (0.5MG/.5ML) (SYRINGE)..........................62
DILAUDID (1 MG/ML) (LIQUID).................................. 62
DILAUDID (1 MG/ML) (SYRINGE)...............................62
DILAUDID (2 MG) (TABLET)........................................ 62
DILAUDID (2 MG/ML) (SYRINGE)...............................62
DILAUDID (2 MG/ML) (VIAL).......................................62
DILAUDID (3 MG) (SUPP.RECT)...................................62
DILAUDID (4 MG) (TABLET)........................................ 62
DILAUDID (4 MG/ML) (SYRINGE)...............................62
DILAUDID (8 MG) (TABLET)........................................ 62
DILTIAZEM HCL.............................................................23
DIMENHYDRINATE....................................................... 14
DIMETHICONE................................................................32
DIMETHICONE (2 %) (LOTION) (OTC)........................32
DIMETHYL FUMARATE................................................56
DIOVAN............................................................................ 22
DIOVAN HCT................................................................... 22
DIPHENHYDRAMINE HCL..................................... 13, 20
DIPHENOXYLATE HCL/ATROPINE............................. 53
DIPYRIDAMOLE............................................................. 45
DISALCID.........................................................................61
DISKETS (40 MG) (TABLET SOL)...........................63, 86
DISOPYRAMIDE PHOSPHATE..................................... 21
DISULFIRAM...................................................................18
DITROPAN........................................................................69
DITROPAN XL................................................................. 69
DIURIL (250 MG) (TABLET).......................................... 23
DIURIL (500 MG) (TABLET).......................................... 23
DIVALPROEX SODIUM..................................................65
DM/PSEUDOEPHED/ACETAMINOPHEN.................... 27
VNSNY
DM/PSEUDOEPHED/ACETAMINOPHEN (5-15-160MG)
(DROPS) (OTC)................................................................ 27
D-METHORPHAN/PE/DEXBROMPHENIR.................. 27
DOCOSANOL...................................................................29
DOCUSATE SODIUM......................................................54
DOCUSATE SODIUM (100 MG) (CAPSULE) (OTC)......
54
DOCUSATE SODIUM (100 MG) (TABLET) (OTC)...... 54
DOCUSATE SODIUM (283 MG) (ENEMA) (OTC)....... 54
DOCUSATE SODIUM (283 MG/5ML) (ENEMA) (OTC)
........................................................................................... 54
DOCUSATE SODIUM (50 MG/5 ML) (LIQUID) (OTC)
........................................................................................... 54
DOFETILIDE.................................................................... 21
DOLOBID......................................................................... 61
DOLOPHINE HCL..................................................... 63, 86
DOLUTEGRAVIR SODIUM............................................50
DONEPEZIL HCL............................................................ 17
DONNATAL (16.2 MG) (TABLET)................................. 68
DORAL..............................................................................20
DORNASE ALFA............................................................. 61
DORZOLAMIDE HCL..................................................... 42
DORZOLAMIDE HCL/TIMOLOL MALEAT.................42
DOSTINEX....................................................................... 40
DOVONEX..................................................................33, 86
DOXAZOSIN MESYLATE.............................................. 22
DOXEPIN HCL........................................................... 18, 20
DOXERCALCIFEROL..................................................... 40
DOXYCYCLINE CALCIUM........................................... 48
DOXYCYCLINE HYCLATE..................................... 48, 57
DOXYCYCLINE MONOHYDRATE...............................48
DRAMAMINE (50 MG) (TABLET) (OTC)..................... 14
DRITHOCREME HP.................................................. 33, 86
DRONABINOL................................................................. 14
DRONEDARONE HCL.................................................... 21
DROPLET LANCING DEVICE.......................................38
DROSPIR/ETH ESTRA/LEVOMEFOL CA.................... 25
DROXIDOPA.................................................................... 24
DUAC................................................................................ 28
DUAVEE............................................................................45
DULAGLUTIDE............................................................... 34
DULCOLAX..................................................................... 54
DULERA..................................................................... 14, 79
DULOXETINE HCL......................................................... 17
DUOCAL.....................................................................57, 95
DUONEB...........................................................................14
DURAGESIC (100 MCG/HR) (PATCH TD72)...... 62, 79,
95
DURAGESIC (12 MCG/HR) (PATCH TD72)...... 62, 79,
95
DURAGESIC (25 MCG/HR) (PATCH TD72)...... 62, 79,
95
DURAGESIC (50MCG/HR) (PATCH TD72).......62, 79, 95
DURAGESIC (75MCG/HR) (PATCH TD72).......62, 79, 95
DUREZOL.........................................................................41
DURICEF.......................................................................... 46
DUTASTERIDE................................................................ 69
DUTASTERIDE/TAMSULOSIN HCL.............................69
DYAZIDE.......................................................................... 23
DYNACIN......................................................................... 48
DYNACIRC....................................................................... 23
-EE.E.S. 400.......................................................................... 47
EASIVENT........................................................................15
EASY CLICK....................................................................38
EASY MINI EJECT LANCING DEVICE........................38
EASY STEP.................................................................35, 36
EASY TOUCH LANCING DEVICE............................... 38
EASY TRAK..................................................................... 36
EASYGLUCO PLUS CONTROL NORMAL.................. 36
EASYMAX........................................................................36
EASYMAX 15...................................................................36
EC-NAPROSYN................................................................53
ECONAZOLE NITRATE..................................................29
ECOTRIN.................................................................... 45, 79
EDLUAR............................................................... 20, 79, 86
EDURANT.................................................................. 50, 79
EFAVIRENZ...................................................................... 50
EFAVIRENZ/EMTRICITAB/TENOFOVIR..................... 51
EFFEXOR..........................................................................17
EFFEXOR XR................................................................... 17
EFFIENT..................................................................... 45, 79
EFUDEX............................................................................33
ELAVIL............................................................................. 18
ELBASVIR/GRAZOPREVIR...........................................51
ELDEPRYL....................................................................... 65
ELECARE......................................................................... 61
ELECARE JR.............................................................. 61, 95
ELEMENT COMPACT CONTROL SOLN................35, 36
ELEMENT CONTROL SOLUTION.......................... 35, 36
ELESTAT...........................................................................41
ELIGARD....................................................................40, 95
ELIGLUSTAT TARTRATE...............................................58
ELIPHOS...........................................................................39
ELIQUIS (2.5 MG) (TABLET)................................... 43, 79
ELIQUIS (5 MG) (TABLET)...................................... 44, 79
ELIXOPHYLLIN.............................................................. 16
ELLA................................................................................. 26
ELMIRON......................................................................... 69
ELOCTATE (1000 UNIT) (VIAL).................................... 43
ELOCTATE (1500 UNIT) (VIAL).................................... 43
ELOCTATE (2000 UNIT) (VIAL).................................... 43
ELOCTATE (250 UNIT) (VIAL)...................................... 43
ELOCTATE (3000 UNIT) (VIAL).................................... 43
ELOCTATE (500 UNIT) (VIAL)...................................... 43
ELOCTATE (750 UNIT) (VIAL)...................................... 43
ELTROMBOPAG OLAMINE........................................... 45
ELVITEG/COBI/EMTRIC/TENOFO ALA......................51
ELVITEG/COBI/EMTRIC/TENOFO DIS........................51
EMBRACE........................................................................ 35
EMBRACE EVO............................................................... 36
EMBRACE GLUCOSE CONTROL SOLN......................36
EMBRACE PRO................................................................35
EMCYT............................................................................. 56
EMEND (125 MG CAPSULE)................................... 14, 79
EMEND (125-80-80 MG PACK)................................ 14, 79
EMEND (40 MG CAPSULE)..................................... 14, 79
EMEND (80 MG CAPSULE)..................................... 14, 79
EMLA................................................................................ 33
EMOL53/NAMGFS/HA/NAHYPOCHLORIT................ 31
EMOLLIENT #56/HYALURONIC ACID........................31
EMOLLIENT BASE......................................................... 60
EMOLLIENT COMBINATION NO.10............................31
EMOLLIENT COMBINATION NO.32............................31
EMOLLIENT COMBINATION NO.35............................31
EMOLLIENT COMBINATION NO.36............................31
EMOLLIENT COMBINATION NO.60............................31
EMOLLIENT COMBINATION NO.85............................30
EMOLLIENT COMBOS NO.47, NO.60.......................... 31
EMPAGLIFLOZIN............................................................34
EMPAGLIFLOZIN/LINAGLIPTIN.................................. 34
EMPAGLIFLOZIN/METFORMIN HCL..........................34
EMSAM.......................................................................20, 79
EMTRICITA/RILPIVIRINE/TENOF DF......................... 51
EMTRICITAB/RILPIVIRI/TENOF ALA.........................51
EMTRICITABINE.............................................................50
EMTRICITABINE/TENOFOV ALAFENAM.................. 49
EMTRICITABINE/TENOFOVIR (TDF)..........................49
EMTRIVA (10 MG/ML) (SOLUTION)......................50, 79
EMTRIVA (200 MG) (CAPSULE)............................. 50, 79
EMVERM....................................................................49, 95
ENALAPRIL MALEATE..................................................22
ENALAPRIL/HYDROCHLOROTHIAZIDE................... 21
ENBREL......................................................................51, 95
ENDODAN........................................................................64
ENFUVIRTIDE................................................................. 49
ENOXAPARIN SODIUM................................................. 44
ENSURE ACTIVE CLEAR (LIQUID) (OTC)........... 57, 95
ENSURE ACTIVE MUSCLE HEALTH.................... 57, 95
ENSURE CLEAR (0.035-1/ML) (LIQUID) (OTC)...... 58,
95
ENSURE MUSCLE HEALTH....................................57, 95
ENSURE POWDER.................................................... 57, 95
ENSURE WITH FIBER.............................................. 57, 95
ENTACAPONE................................................................. 65
ENTECAVIR..................................................................... 51
ENTOCORT EC................................................................ 52
ENTRESTO................................................................. 24, 79
ENZALUTAMIDE............................................................ 55
EO28 SPLASH...................................................... 58, 60, 95
EPCLUSA....................................................................51, 95
EPINASTINE HCL........................................................... 41
EPINEPHRINE............................................................21, 54
EPIPEN........................................................................21, 54
EPIPEN 2-PAK..................................................................54
EPIPEN JR 2-PAK.............................................................54
EPIVIR (10 MG/ML) (SOLUTION)...........................50, 79
EPIVIR (150 MG) (TABLET).....................................50, 79
EPIVIR (300 MG) (TABLET).....................................50, 79
EPIVIR HBV (100 MG) (TABLET)........................... 51, 79
EPIVIR HBV (25 MG/5 ML) (SOLUTION).............. 51, 79
EPOETIN ALFA............................................................... 44
EPZICOM....................................................................49, 79
EQUETRO.........................................................................18
ERAPID NEBULIZER......................................................15
ERGOCALCIFEROL (VITAMIN D2)............................. 76
ERGOCALCIFEROL (VITAMIN D2) (50000 UNIT)
(CAPSULE).......................................................................76
ERGOCALCIFEROL (VITAMIN D2) (8000/ML)
(DROPS) (OTC)................................................................ 76
ERGOLOID MESYLATES...............................................25
ERGOTAMINE TARTRATE/CAFFEINE........................ 64
ERIVEDGE........................................................... 55, 79, 95
Page 103 of 116
Index
ERLOTINIB HCL............................................................. 56
ERY....................................................................................28
ERYC.................................................................................47
ERYGEL............................................................................28
ERYMAX.......................................................................... 28
ERYPED 200..................................................................... 47
ERYPED 400..................................................................... 47
ERY-TAB........................................................................... 47
ERYTHRCIN STEARATE................................................47
ERYTHROMYCIN BASE.......................................... 41, 47
ERYTHROMYCIN BASE/ETHANOL............................ 28
ERYTHROMYCIN ETHYLSUCCINATE........................47
ERYTHROMYCIN STEARATE.......................................47
ERYTHROMYCIN/BENZOYL PEROXIDE................... 28
ESBRIET..................................................................... 61, 95
ESCITALOPRAM OXALATE..........................................17
ESGIC................................................................................61
ESKALITH........................................................................18
ESKALITH CR................................................................. 18
ESLICARBAZEPINE ACETATE............................... 65, 66
ESOMEPRAZOLE MAGNESIUM.................................. 69
ESTAZOLAM................................................................... 20
ESTRACE....................................................................46, 70
ESTRADIOL............................................................... 46, 70
ESTRADIOL CYPIONATE.............................................. 46
ESTRADIOL VALERATE................................................ 46
ESTRADIOL VALERATE/DIENOGEST........................ 25
ESTRADIOL/NORETHINDRONE ACET.......................46
ESTRAMUSTINE PHOSPHATE SODIUM.................... 56
ESTROGEN,CON/M-PROGEST ACET.......................... 46
ESTROGEN,ESTER/ME-TESTOSTERONE.............45, 46
ESTROGENS, CONJUGATED.................................. 46, 70
ESTROGENS,CONJ/BAZEDOXIFENE.......................... 45
ESTROGENS,ESTERIFIED............................................. 46
ESTROPIPATE.................................................................. 46
ESTROSTEP FE................................................................25
ESZOPICLONE................................................................ 20
ETANERCEPT.................................................................. 51
ETHAMBUTOL HCL.......................................................48
ETHINYL ESTRADIOL/DROSPIRENONE................... 25
ETHIONAMIDE............................................................... 48
ETHOSUXIMIDE............................................................. 66
ETHOTOIN....................................................................... 66
ETH-OXYDOSE............................................................... 63
ETHYL CHLORIDE......................................................... 33
ETHYNODIOL D-ETHINYL ESTRADIOL....................25
ETIDRONATE DISODIUM..............................................40
ETODOLAC...................................................................... 52
ETONOGESTREL/ETHINYL ESTRADIOL...................25
ETOPOSIDE......................................................................56
ETRAFON-A.....................................................................17
ETRAVIRINE....................................................................50
EUCERIN.......................................................................... 31
EULEXIN.......................................................................... 55
EURAX..............................................................................29
EVENCARE...................................................................... 35
EVENCARE MINI GLUCOSE CONTROL.....................36
EVENCARE MINI MONITOR SYSTEM (EACH) (OTC)
........................................................................................... 37
EVEROLIMUS............................................................46, 55
EVISTA................................................................. 40, 79, 95
EVOCLIN.......................................................................... 28
EVOLOCUMAB............................................................... 24
EVOLUTION CONTROL SOLUTION............................36
EVOTAZ...................................................................... 50, 79
EXALGO (12 MG) (TAB ER 24H)...................... 62, 79, 95
EXALGO (16 MG) (TAB ER 24H)...................... 62, 79, 95
EXALGO (32 MG) (TAB ER 24H)...................... 62, 79, 95
EXALGO (8 MG) (TAB ER 24H)........................ 62, 79, 95
EXELDERM......................................................................29
EXELON..................................................................... 17, 79
EXEMESTANE................................................................. 55
EXFORGE...................................................................22, 86
EXFORGE HCT..........................................................22, 86
EXJADE............................................................................ 59
EXTINA (2 %) (FOAM)................................................... 29
EYELID CLEANSER COMBINATION #5..................... 42
EYELID CLEANSER COMBINATION #6..................... 42
EYELID WIPES................................................................42
EZ SMART..................................................................35, 36
E-Z SPACER..................................................................... 15
EZETIMIBE...................................................................... 24
EZOGABINE.................................................................... 66
EZ-VAC............................................................................. 37
-FFA/MV,CA,IRON,MIN/LYCOPENE/LUT....................... 72
FA/MV,CALC,IRON/POLLEN/HERB101....................... 57
FACTOR IX.......................................................................44
FACTOR IX CPLX(PCC)#4, 3FACTOR.......................... 44
FACTOR IX CPLX(PCC)#6, 3FACTOR.......................... 44
FACTOR IX HUMAN RECOMBINANT.........................44
VNSNY
FACTOR IX REC, FC FUSION PROTN.......................... 44
FACTOR XIII.................................................................... 43
FACTOR XIII A-SUBUNIT,RECOMB............................ 44
FAMCICLOVIR................................................................ 49
FAMOTIDINE...................................................................68
FANAPT (1 MG) (TABLET)................................ 19, 79, 87
FANAPT (10 MG) (TABLET).............................. 19, 79, 87
FANAPT (12 MG) (TABLET).............................. 19, 79, 87
FANAPT (1-2-4-6MG) (TAB DS PK)...................19, 79, 87
FANAPT (2 MG) (TABLET)................................ 19, 79, 87
FANAPT (4 MG) (TABLET)................................ 19, 79, 87
FANAPT (6 MG) (TABLET)................................ 19, 79, 87
FANAPT (8 MG) (TABLET)................................ 19, 79, 87
FARESTON................................................................. 56, 95
FARYDAK...................................................................56, 95
FAZACLO............................................................. 19, 79, 87
FEBUXOSTAT.................................................................. 43
FEIBA NF..........................................................................43
FELBAMATE....................................................................66
FELBAMATE (400 MG) (TABLET).................... 66, 79, 87
FELBAMATE (600 MG) (TABLET).................... 66, 79, 87
FELBAMATE (600 MG/5ML) (ORAL SUSP)...... 66, 79,
87
FELDENE..........................................................................53
FELODIPINE.................................................................... 23
FEMARA...........................................................................55
FEMCON FE..................................................................... 25
FEMHRT........................................................................... 46
FENOFIBRATE.................................................................24
FENOFIBRATE (120 MG) (TABLET)............................. 24
FENOFIBRATE (160 MG) (TABLET)............................. 24
FENOFIBRATE (40 MG) (TABLET)............................... 24
FENOFIBRATE (54 MG) (TABLET)............................... 24
FENOFIBRATE NANOCRYSTALLIZED....................... 24
FENOFIBRATE,MICRONIZED.......................................24
FENOFIBRIC ACID......................................................... 24
FENOFIBRIC ACID (CHOLINE).................................... 24
FENOPROFEN CALCIUM.............................................. 52
FENORTHO (200 MG) (CAPSULE)................................52
FENTANYL.......................................................................62
FENTANYL CITRATE..................................................... 62
FER-IN-SOL......................................................................71
FERRALET 90.................................................................. 71
FERRIPROX......................................................................59
FERROUS FUM/FOLIC ACID/BCOMP,C...................... 72
FERROUS FUM/VIT C/B12/STOMC..............................71
FERROUS FUM/VIT C/B12-IF/FOLIC........................... 71
FERROUS FUMARATE/FOLIC ACID............................71
FERROUS SULFATE........................................................71
FERROUS SULFATE (220 (44)/5) (ELIXIR) (OTC)....... 71
FERROUS SULFATE (220 (44)/5) (SOLUTION) (OTC)
........................................................................................... 71
FERROUS SULFATE (324(65)MG) (TABLET DR) (OTC)
........................................................................................... 71
FERROUS SULFATE (325(65) MG) (TABLET DR)
(OTC).................................................................................71
FERROUS SULFATE (325(65) MG) (TABLET) (OTC)
........................................................................................... 71
FERROUS SULFATE/VIT C/FOLIC AC......................... 71
FESOTERODINE FUMARATE....................................... 69
FETZIMA.............................................................. 17, 79, 87
FEXMID............................................................................ 67
FEXOFENADINE HCL.................................................... 13
FEXOFENADINE/PSEUDOEPHEDRINE...................... 13
FIBERSOURCE HN (0.05 G-1.2) (LIQUID) (OTC)...... 58,
95
FIBER-STAT..................................................................... 54
FIBRICOR.........................................................................24
FIDAXOMICIN.................................................................47
FILGRASTIM................................................................... 45
FINASTERIDE..................................................................69
FINGOLIMOD HCL......................................................... 56
FIORICET......................................................................... 61
FIORICET WITH CODEINE........................................... 64
FIORINAL.........................................................................61
FIORINAL WITH CODEINE #3......................................64
FIRAZYR.................................................................... 51, 95
FIRMAGON (120 MG) (VIAL)..................................55, 79
FIRMAGON (80 MG) (VIAL)....................................55, 79
FISH OIL/OM-3/E/FOLIC/B6-B12.................................. 57
FLAGYL............................................................................49
FLAGYL ER......................................................................49
FLAREX............................................................................41
FLAVOXATE HCL............................................................69
FLECAINIDE ACETATE..................................................21
FLEXERIL........................................................................ 67
FLOMAX.......................................................................... 69
FLONASE................................................................... 14, 79
FLONASE ALLERGY RELIEF................................. 14, 79
FLORINEF........................................................................ 52
FLOXIN.......................................................................39, 48
FLU VACC QV LIVE 2016(2-49YRS).............................46
FLUCONAZOLE.............................................................. 48
FLUCYTOSINE................................................................ 48
FLUDROCORTISONE ACETATE................................... 52
FLUMADINE....................................................................49
FLUMIST QUAD 2016-2017............................................46
FLUNISOLIDE................................................................. 14
FLUOCINOLONE ACETONIDE.....................................30
FLUOCINOLONE ACETONIDE OIL............................. 39
FLUOCINOLONE/SHOWER CAP..................................30
FLUOCINONIDE..............................................................30
FLUOCINONIDE/EMOLLIENT BASE.......................... 30
FLUORESCEIN SODIUM............................................... 42
FLUORESCEIN-BENOXINATE......................................41
FLUORIDE/IRON/VITAMINS A,C,D............................. 73
FLUOROMETHOLONE...................................................41
FLUOROMETHOLONE ACETATE................................ 41
FLUOROURACIL.............................................................33
FLUOXETINE HCL..........................................................17
FLUOXYMESTERONE................................................... 45
FLUPHENAZINE DECANOATE.....................................20
FLUPHENAZINE HCL.................................................... 20
FLURA-DROPS................................................................ 70
FLURANDRENOLIDE.................................................... 30
FLURAZEPAM HCL........................................................ 20
FLURBIPROFEN.............................................................. 52
FLURBIPROFEN SODIUM............................................. 41
FLUROX............................................................................41
FLUTAMIDE.....................................................................55
FLUTICASONE FUROATE............................................. 15
FLUTICASONE PROPIONATE.................................14, 30
FLUTICASONE/SALMETEROL.....................................14
FLUTICASONE/VILANTEROL......................................14
FLUTTER..........................................................................15
FLUVOXAMINE MALEATE...........................................17
FML................................................................................... 41
FML FORTE......................................................................41
FML S.O.P......................................................................... 41
FOCALIN.................................................................... 20, 79
FOCALIN XR....................................................... 20, 77, 79
FOLEX.............................................................................. 55
FOLIC AC/VIT BCOMP,C/ZN/VIT D3........................... 75
FOLIC ACID..................................................................... 70
FOLIC ACID (1 MG) (TABLET)..................................... 70
FOLIC ACID (1 MG) (TABLET) (OTC)..........................70
FOLIC ACID (5 MG/ML) (VIAL)....................................70
FOLIC ACID/B CMPLX C/RICE BRAN.........................75
FOLIC ACID/B CMPLX C/RICE BRAN (400MCG-500)
(TABLET) (OTC).............................................................. 75
FOLIC ACID/B COMPLEX C NO.17..............................75
FOLIC ACID/B CPLX/C/SELEN/ZINC.......................... 75
FOLIC ACID/MULTIVIT-MIN/LUTEIN.........................72
FOLIC ACID/MULTIVIT-MIN/LUTEIN (0.4MG-250)
(TABLET) (OTC).............................................................. 72
FOLIC ACID/MV,IRON,MIN...........................................72
FOLIC ACID/MV,IRON,MIN/LUTEIN........................... 72
FOLIC ACID/VIT B COMPLEX AND C ........................ 75
FOLIC ACID/VIT B COMPLEX AND C (400 MCG)
(TABLET) (OTC).............................................................. 75
FOLIC ACID/VIT B COMPLEX AND C (5 MG)
(TABLET)..........................................................................75
FOLIC ACID/VIT BCOMP,C/CU/ZINC.......................... 75
FOLTX...............................................................................75
FONDAPARINUX SODIUM............................................44
FORA LANCING DEVICE.............................................. 38
FORACARE GDH....................................................... 35-37
FORMALDEHYDE.......................................................... 61
FORMOTEROL FUMARATE.......................................... 14
FORTEO...................................................................... 40, 79
FORTESTA..................................................................45, 95
FORTISCARE..............................................................35-37
FOSAMAX (10 MG) (TABLET)...................................... 40
FOSAMAX (35 MG) (TABLET)...................................... 40
FOSAMAX (40 MG) (TABLET)...................................... 40
FOSAMAX (5 MG) (TABLET)........................................ 40
FOSAMAX (70 MG) (TABLET)...................................... 40
FOSAMAX (70 MG/75ML) (SOLUTION)................40, 79
FOSAMAX PLUS D......................................................... 40
FOSAMPRENAVIR CALCIUM.......................................50
FOSINOPRIL SODIUM................................................... 22
FOSINOPRIL/HYDROCHLOROTHIAZIDE.................. 21
FRAGMIN (10000/ML) (SYRINGE)......................... 44, 79
FRAGMIN (12500/0.5) (SYRINGE).......................... 44, 79
FRAGMIN (15000/0.6) (SYRINGE).......................... 44, 79
FRAGMIN (18000/0.72) (SYRINGE)........................ 44, 79
FRAGMIN (2500/0.2ML) (SYRINGE)...................... 44, 79
FRAGMIN (25000/ML) (VIAL)................................. 44, 79
FRAGMIN (5000/0.2ML) (SYRINGE)...................... 44, 79
FRAGMIN (7500/0.3ML) (SYRINGE)...................... 44, 79
FREESTYLE CONTROL SOLUTION............................ 37
FREESTYLE FREEDOM LITE (KIT) (OTC)................. 37
FREESTYLE INSULINX (EACH) (OTC)....................... 37
FREESTYLE INSULINX (STRIP) (OTC)....................... 35
Page 104 of 116
Index
FREESTYLE INSULINX TEST STRIPS.........................35
FREESTYLE LITE METER (KIT) (OTC)....................... 37
FREESTYLE LITE STRIPS (STRIP) (OTC)................... 35
FREESTYLE TEST STRIPS (STRIP) (OTC).................. 35
FRESHNET....................................................................... 31
FRUCTOOLIGOSACCH/MALTODEXTRIN..................54
FRUCTOOLIGOSACCHARIDES/POLYDEX................ 54
FURADANTIN................................................................. 47
FUROSEMIDE.................................................................. 23
FUZEON......................................................................49, 79
FYCOMPA (10 MG) (TABLET)...........................66, 79, 87
FYCOMPA (12 MG) (TABLET)...........................66, 79, 87
FYCOMPA (2 MG) (TABLET).............................67, 79, 87
FYCOMPA (4 MG) (TABLET).............................67, 79, 87
FYCOMPA (6 MG) (TABLET).............................67, 79, 87
FYCOMPA (8 MG) (TABLET).............................67, 79, 88
-GGABAPENTIN..................................................................66
GABITRIL (12 MG) (TABLET)........................... 67, 79, 88
GABITRIL (16 MG) (TABLET)........................... 67, 79, 88
GABITRIL (2 MG) (TABLET)............................. 67, 80, 88
GABITRIL (4 MG) (TABLET)............................. 67, 80, 88
GALANTAMINE HBR..................................................... 17
GAMMAGARD LIQUID............................................46, 95
GAMMAKED............................................................. 46, 95
GAMUNEX-C.............................................................46, 95
GANCICLOVIR................................................................ 41
GARAMYCIN...................................................................41
GASTROCROM................................................................15
GATIFLOXACIN.............................................................. 41
GATTEX......................................................................54, 95
GAVILAX..........................................................................54
GEFITINIB........................................................................56
GEMFIBROZIL.................................................................24
GENADUR........................................................................32
GENERESS FE................................................................. 25
GENGRAF........................................................................ 46
GENTAMICIN SULFATE...........................................28, 41
GENTEAL TEARS........................................................... 42
GENTIAN VIOLET/BRGREEN/PROFLAV....................29
GENVOYA.................................................................. 51, 80
GEODON.................................................................... 20, 80
GILENYA.................................................................... 56, 95
GILOTRIF................................................................... 55, 95
GLATIRAMER ACETATE............................................... 56
GLEEVEC (100 MG) (TABLET)......................... 56, 80, 95
GLEEVEC (400 MG) (TABLET)......................... 56, 80, 95
GLEOSTINE (5 MG) (CAPSULE)...................................55
GLIADEL.......................................................................... 55
GLIMEPIRIDE..................................................................34
GLIPIZIDE........................................................................ 34
GLIPIZIDE/METFORMIN HCL......................................34
GLUCAGON EMERGENCY KIT................................... 38
GLUCAGON,HUMAN RECOMBINANT.......................38
GLUCO BURST..........................................................59, 95
GLUCOCARD 01 CONTROL....................................35, 37
GLUCOCARD SHINE......................................................37
GLUCOCOM CONTROL SOLUTION......................35, 37
GLUCOPHAGE................................................................ 34
GLUCOPHAGE XR..........................................................34
GLUCOSE CONTROL..................................................... 37
GLUCOSE CONTROL SOLUTION................................ 37
GLUCOTROL................................................................... 34
GLUCOTROL XL............................................................. 34
GLUCOVANCE................................................................ 34
GLUTAREX-1...................................................................58
GLUTAREX-2.............................................................59, 95
GLYBURIDE.....................................................................34
GLYBURIDE,MICRONIZED...........................................34
GLYBURIDE/METFORMIN HCL...................................34
GLYCERIN/DIMETHICONE...........................................31
GLYCERIN/DIMETHICONE (LOTION) (OTC).............31
GLYCERIN/PROPYLENE GLYCOL...............................42
GLYCERIN/PROPYLENE GLYCOL (0.3%-1%) (DROPS)
(OTC).................................................................................42
GLYCEROL PHENYLBUTYRATE................................. 53
GLYCINE UROLOGIC SOLUTION................................48
GLYCINE/SODIUM HYDROXIDE.................................59
GLYCOPYRROLATE....................................................... 68
GLYDO..............................................................................53
GLYNASE......................................................................... 34
GLYXAMBI.......................................................... 34, 80, 88
GMATE CONTROL SOLUTION...............................35, 37
GMATE LANCING DEVICE...........................................38
GOLIMUMAB.................................................................. 51
GOLYTELY (227.1-21.5) (POWD PACK)....................... 54
GOLYTELY (236-22.74G) (SOLN RECON)................... 54
GOSERELIN ACETATE...................................................40
G-PREPROTEIN (15 G-60/30) (LIQUID) (OTC)...... 57,
95
GR POL-ORC/SW VER/RYE/KENT/TIM...................... 13
VNSNY
GRANISETRON HCL...................................................... 14
GRANIX......................................................................45, 95
GRASS POLLEN-TIMOTHY, STANDARD....................13
GRASTEK...................................................................13, 95
GRIFULVIN V (125 MG/5ML) (ORAL SUSP)............... 48
GRISEOFULVIN, MICROSIZE....................................... 48
GUAIFEN/DEXTROMETHORPHAN/PE....................... 27
GUAIFEN/DEXTROMETHORPHAN/PE (200-30-10)
(LIQUID) (OTC)............................................................... 27
GUAIFEN/DEXTROMETHORPHAN/PE (400-20-10)
(TABLET) (OTC).............................................................. 27
GUAIFENESIN................................................................. 26
GUAIFENESIN (100 MG/5ML) (LIQUID) (OTC).......... 26
GUAIFENESIN (200 MG) (TABLET) (OTC)..................26
GUAIFENESIN (600 MG) (TAB ER 12H) (OTC)........... 26
GUAIFENESIN/DEXTROMETHORPHAN.................... 27
GUAIFENESIN/DEXTROMETHORPHAN (100-10MG/5)
(LIQUID) (OTC)............................................................... 27
GUAIFENESIN/DEXTROMETHORPHAN (100-10MG/5)
(SYRUP) (OTC)................................................................ 27
GUAIFENESIN/DEXTROMETHORPHAN (100-5 MG/5)
(LIQUID) (OTC)............................................................... 27
GUAIFENESIN/DEXTROMETHORPHAN (200-30MG/5)
(LIQUID) (OTC)............................................................... 27
GUAIFENESIN/DM/PSEUDOEPHEDRINE...................27
GUAIFENESIN/DM/PSEUDOEPHEDRINE (150-15-30)
(LIQUID) (OTC)............................................................... 27
GUAIFENESIN/DM/PSEUDOEPHEDRINE (400-20-40)
(TABLET) (OTC).............................................................. 27
GUAIFENESIN/PHENYLEPHRINE HCL...................... 26
GUAIFENESIN/PHENYLEPHRINE HCL (400MG10MG) (TABLET) (OTC)................................................. 26
GUAIFENESIN/PSEUDOEPHEDRNE HCL.................. 26
GUAIFENESIN/PSEUDOEPHEDRNE HCL (400MG40MG) (TABLET) (OTC)................................................. 26
GUAIFENESIN/PSEUDOEPHEDRNE HCL (400MG60MG) (TABLET) (OTC)................................................. 26
GUAIFENESIN/PSEUDOEPHEDRNE HCL (600MG60MG) (TAB ER 12H) (OTC)...........................................26
GUANFACINE HCL............................................. 20, 22, 80
GUANIDINE..................................................................... 54
GUANIDINE HCL............................................................ 54
GUARDIAN TRANSMITTER TAPE...............................37
GYNAZOLE 1...................................................................70
-HHALCION......................................................................... 20
HALDOL...........................................................................20
HALDOL DECANOATE 100........................................... 20
HALDOL DECANOATE 50............................................. 20
HALOBETASOL PROPIONATE..................................... 30
HALOPERIDOL............................................................... 20
HALOPERIDOL DECANOATE...................................... 20
HALOPERIDOL LACTATE............................................. 20
HALOTESTIN.............................................................45, 80
HC/MINERAL OIL/PETROLAT,WHT............................ 30
HCU COOLER............................................................60, 95
HCU COOLER20........................................................60, 95
HCU LOPHLEX..........................................................60, 95
HEALTHPRO GLUCOSE CONTROL SOLN................. 35
HEALTHY ACCENTS AUTOLET ...................................38
HECTOROL...................................................................... 40
HELIXATE FS...................................................................43
HEMATRON-AF...............................................................71
HEMOCYTE-F..................................................................71
HEMOFIL M..................................................................... 43
HEPARIN SOD,PORCINE/0.9 % NACL......................... 44
HEPARIN SODIUM,PORCINE....................................... 44
HEPARIN SODIUM,PORCINE/D5W..............................44
HEPARIN SODIUM,PORCINE/PF............................44, 45
HEPARIN SODIUM,PORCINE/PF (1 UNIT/ML)
(SYRINGE)....................................................................... 44
HEPARIN SODIUM,PORCINE/PF (10 UNIT/ML)
(SYRINGE)....................................................................... 44
HEPARIN SODIUM,PORCINE/PF (10 UNIT/ML)
(VIAL)............................................................................... 44
HEPARIN SODIUM,PORCINE/PF (100/ML (1))
(SYRINGE)....................................................................... 44
HEPARIN SODIUM,PORCINE/PF (100/ML (1)) (VIAL)
........................................................................................... 45
HEPARIN SODIUM,PORCINE/PF (1000/10 ML)
(SYRINGE)....................................................................... 45
HEPARIN SODIUM,PORCINE/PF (1000/ML) (VIAL)
........................................................................................... 45
HEPARIN SODIUM,PORCINE/PF (200/2 ML)
(SYRINGE)....................................................................... 45
HEPARIN SODIUM,PORCINE/PF (300/3 ML)
(SYRINGE)....................................................................... 45
HEPARIN SODIUM,PORCINE/PF (500/5 ML)
(SYRINGE)....................................................................... 45
HEPARIN SODIUM,PORCINE/PF (5000/0.5ML)
(SYRINGE)....................................................................... 45
HEPSERA....................................................................51, 80
HETLIOZ.................................................................... 20, 95
HEXADROL..................................................................... 52
HEXALEN........................................................................ 54
HEX-ON LIGHT............................................................... 31
HI-CAL........................................................................58, 95
HIPREX.............................................................................47
HISTRELIN ACETATE.................................................... 40
HIZENTRA................................................................. 46, 95
HOMATROPINE HBR......................................................42
HOMINEX-2............................................................... 60, 95
HONEY............................................................................. 33
HUMALOG (100/ML) (CARTRIDGE)......................39, 80
HUMALOG (100/ML) (VIAL)...................................39, 80
HUMALOG KWIKPEN U-100.................................. 39, 80
HUMALOG KWIKPEN U-200.................................. 39, 80
HUMALOG MIX 50-50..............................................39, 80
HUMALOG MIX 50-50 KWIKPEN.......................... 39, 80
HUMALOG MIX 75-25..............................................39, 80
HUMALOG MIX 75-25 KWIKPEN.......................... 39, 80
HUMATE-P....................................................................... 43
HUMATIN.........................................................................49
HUMULIN 70/30 KWIKPEN.....................................39, 80
HUMULIN 70-30........................................................ 39, 80
HUMULIN N...............................................................39, 80
HUMULIN N KWIKPEN........................................... 39, 80
HUMULIN R...............................................................39, 80
HUMULIN R U-500....................................................39, 80
HUMULIN R U-500 KWIKPEN................................ 39, 80
HYALURONATE SODIUM..............................................32
HYALURONATE/ALLANTOIN/ALOE EXT..................32
HYCAMTIN......................................................................55
HYCET (7.5-325/15) (SOLUTION)........................... 62, 80
HYDE-OUT.......................................................................59
HYDERGINE.................................................................... 25
HYDRALAZINE HCL......................................................22
HYDREA...........................................................................55
HYDRO 40........................................................................ 32
HYDROCHLOROTHIAZIDE.......................................... 23
HYDROCODONE BIT/HOMATROP ME-BR.................27
HYDROCODONE/ACETAMINOPHEN..........................62
HYDROCODONE/CHLORPHEN P-STIREX................. 26
HYDROCODONE/CPM/PSEUDOEPHED..................... 26
HYDROCODONE/IBUPROFEN..................................... 62
HYDROCORT/SAL ACID/SULF/SHAMP1....................30
HYDROCORTISONE........................................... 30, 52, 53
HYDROCORTISONE (1 %) (CREAM (G)).....................30
HYDROCORTISONE (1 %) (CREAM (G)) (OTC)......... 30
HYDROCORTISONE (1 %) (OINT. (G)) (OTC)............. 30
HYDROCORTISONE (2.5 %) (CREAM (G))..................30
HYDROCORTISONE (2.5 %) (CRM/PE APP)............... 30
HYDROCORTISONE ACETATE.....................................30
HYDROCORTISONE ACETATE (1 %) (CREAM (G))
(OTC).................................................................................30
HYDROCORTISONE ACETATE (1 %) (OINT. (G))
(OTC).................................................................................30
HYDROCORTISONE ACETATE (25 MG) (SUPP.RECT)
........................................................................................... 30
HYDROCORTISONE ACETATE (30 MG) (SUPP.RECT)
........................................................................................... 30
HYDROCORTISONE BUTYRATE................................. 30
HYDROCORTISONE PROBUTATE............................... 30
HYDROCORTISONE VALERATE.................................. 30
HYDROCORTISONE/ALOE VERA............................... 30
HYDROCORTISONE/ALOE VERA (1 %) (CREAM (G))
(OTC).................................................................................30
HYDROCORTISONE/ALOE/VIT.E/A/D........................ 30
HYDROCORTISONE/IODOQUINOL.............................28
HYDROCORTISONE/LIDOCAINE/ALOE.................... 53
HYDROCORTISONE/OATMEAL/ALOE/E....................30
HYDROCORTISONE/PRAMOXINE........................ 33, 53
HYDRODIURIL................................................................23
HYDROGEN PEROXIDE.................................................32
HYDROGEN PEROXIDE (1.5 %) (SOLUTION) (OTC)
........................................................................................... 32
HYDROGEN PEROXIDE (3 %) (SOLUTION) (OTC)......
32
HYDROMORPHONE HCL........................................62, 63
HYDROMORPHONE HCL (1 MG/ML) (AMPUL)........ 63
HYDROMORPHONE HCL (2 MG/ML) (AMPUL)........ 63
HYDROMORPHONE HCL (4 MG/ML) (AMPUL)........ 63
HYDROMORPHONE HCL/PF........................................ 63
HYDROPHILIC CREAM................................................. 58
HYDROQUINONE........................................................... 33
HYDROQUINONE MICROSPHERES............................ 33
HYDROQUINONE/OXYBEN/OCTINOXATE............... 33
HYDROQUINONE/SUNSCREEN(FER OX).................. 33
HYDROXOCOBALAMIN................................................76
HYDROXYCHLOROQUINE SULFATE......................... 49
HYDROXYUREA.............................................................55
HYDROXYZINE HCL......................................................13
HYDROXYZINE PAMOATE........................................... 13
Page 105 of 116
Index
HYGROTON..................................................................... 23
HYOSCYAMINE SULFATE.............................................68
HYOSYNE........................................................................ 68
HYPER-HEAL.................................................................. 31
HYPOLANCE................................................................... 38
HYQVIA......................................................................46, 95
HYQVIA IG COMPONENT...................................... 46, 95
HYTONE........................................................................... 30
HYTRIN............................................................................ 22
HYZAAR...........................................................................22
HYZYD............................................................................. 48
-IIBANDRONATE SODIUM...............................................40
IBRANCE....................................................................56, 95
IBRUTINIB....................................................................... 56
IBUDONE......................................................................... 62
IBUPROFEN..................................................................... 52
IBUPROFEN/OXYCODONE HCL.................................. 62
ICAPS MV.........................................................................72
ICARIDIN......................................................................... 29
ICATIBANT ACETATE.................................................... 51
ICLUSIG (15 MG) (TABLET)..............................56, 80, 95
ICLUSIG (45 MG) (TABLET)..............................56, 80, 95
ICOSAPENT ETHYL....................................................... 24
IDELALISIB..................................................................... 56
IGG/HYALURONIDASE,RECOMBINANT................... 46
ILEVRO.............................................................................41
ILOPERIDONE.................................................................19
ILOPROST TROMETHAMINE....................................... 23
IMATINIB MESYLATE................................................... 56
IMBRUVICA...............................................................56, 95
IMDUR.............................................................................. 25
IMIPRAMINE HCL.......................................................... 18
IMIPRAMINE PAMOATE................................................18
IMIQUIMOD.....................................................................46
IMITREX.....................................................................64, 80
IMITREX (100 MG) (TABLET)................................. 64, 80
IMITREX (25 MG) (TABLET)................................... 64, 80
IMITREX (4 MG/0.5ML) (CARTRIDGE)................. 64, 80
IMITREX (4 MG/0.5ML) (PEN INJCTR)..................64, 80
IMITREX (50 MG) (TABLET)................................... 64, 80
IMITREX (6 MG/0.5ML) (CARTRIDGE)................. 64, 80
IMITREX (6 MG/0.5ML) (PEN INJCTR)..................64, 80
IMITREX (6 MG/0.5ML) (SYRINGE)...................... 64, 80
IMITREX (6 MG/0.5ML) (VIAL).............................. 64, 80
IMMUN GLOB G(IGG)/GLY/IGA OV50........................46
IMMUN GLOB G(IGG)/PRO/IGA 0-50.......................... 46
IMMUNE GLOBUL G/GLY/IGA AVG 46...................... 46
IMODIUM.........................................................................53
IMPACT 1 CAL...........................................................57, 95
IMPAVIDO.................................................................. 49, 96
IMURAN........................................................................... 46
IN-CHECK DIAL..............................................................16
IN-CHECK NASAL WITH MASK.................................. 16
IN-CHECK ORAL............................................................ 16
INCONTROL ALCOHOL PADS..................................... 31
INCONTROL LANCING DEVICE..................................38
INCRELEX..................................................................40, 96
INCRUSE ELLIPTA....................................................14, 80
INDAPAMIDE...................................................................23
INDERAL..........................................................................22
INDERAL LA................................................................... 22
INDERIDE-40/25.............................................................. 23
INDERIDE-80/25.............................................................. 23
INDINAVIR SULFATE..................................................... 50
INDOCIN (25 MG) (CAPSULE)......................................52
INDOCIN (25 MG/5 ML) (ORAL SUSP)........................ 52
INDOCIN (50 MG) (CAPSULE)......................................52
INDOCIN (50 MG) (SUPP.RECT)................................... 52
INDOCIN (75 MG) (CAPSULE ER)................................52
INDOMETHACIN............................................................ 52
INF FORM FOR TYROSINEMIA, IRON........................58
INF FORM, GLUTARIC ACIDURIA I............................ 58
INF.FORM,METAB,IRON METHION-FR...................... 58
INF.FORM,METAB,IRON METHION-FR (16.2G-500)
(POWDER) (OTC)............................................................ 58
INF.FORMULA,UREA CYCLE DISORDR.................... 58
INFANT FORM,PROPIONIC ACIDEMIA......................58
INFANT FORM.IRON LAC-F/DHA/ARA...................... 61
INFANT FORMULA PKU,IRON NO.2........................... 59
INFANT FORMULA WITH IRON.................................. 58
INFANT FORMULA WITH IRON (POWDER) (OTC)......
58
INFANT FORMULA WITH IRON, MSUD.....................58
INFANT FORMULA, IRON/DHA/ARA......................... 58
INFANT FORMULA, METABOLIC,IRON.....................59
INFANTS' TYLENOL.......................................................62
INFINITY CONTROL SOLUTION............................ 35-37
INFUSION SET FOR INSULIN PUMP...........................37
INGENOL MEBUTATE....................................................33
INHALER, ASSIST DEVICES.........................................15
VNSNY
INHALER,ASSIST DEVICE,ACCESORY......................15
INLYTA (1 MG) (TABLET)................................. 55, 80, 96
INLYTA (5 MG) (TABLET)................................. 55, 80, 96
INNOSPIRE ELEGANCE................................................ 16
INNOSPIRE ESSENCE (EACH)......................................16
INSECT REPELLENT................................................29, 80
INSUL-CAP...................................................................... 37
INSUL-EZE.......................................................................37
INSULIN GLARGINE,HUM.REC.ANLOG..............38, 39
INSULIN LISPRO.............................................................39
INSULIN LISPRO PROTAMIN/LISPRO.........................39
INSULIN NPH HUM/REG INSULIN HM...................... 39
INSULIN NPH HUMAN ISOPHANE............................. 39
INSULIN REGULAR, HUMAN...................................... 39
INTEGRA F.......................................................................71
INTEGRA PLUS............................................................... 71
INTELENCE (100 MG) (TABLET)............................50, 80
INTELENCE (200 MG) (TABLET)............................50, 80
INTELENCE (25 MG) (TABLET)..............................50, 80
INTERFERON ALFA-2B,RECOMB................................46
INTERFERON ALFA-N3................................................. 46
INTERFERON BETA-1A................................................. 56
INTERFERON BETA-1A/ALBUMIN..............................56
INTERFERON GAMMA-1B,RECOMB.......................... 46
INTERMEZZO............................................................20, 80
INTRON A.................................................................. 46, 96
INVEGA (1.5 MG) (TAB ER 24)......................... 19, 80, 88
INVEGA (3 MG) (TAB ER 24)............................ 19, 80, 88
INVEGA (6 MG) (TAB ER 24)............................ 19, 80, 88
INVEGA (9 MG) (TAB ER 24)............................ 19, 80, 88
INVEGA SUSTENNA................................................ 19, 80
INVIRASE (200 MG) (CAPSULE)............................ 50, 80
INVIRASE (500 MG) (TABLET)............................... 50, 80
INVOKAMET....................................................... 34, 80, 88
INVOKAMET XR.................................................34, 80, 88
INVOKANA.......................................................... 34, 80, 88
IODINE..............................................................................28
IODINE/POTASSIUM IODIDE........................................28
IOPIDINE (0.5 %) (DROPS).............................................42
IPECAC............................................................................. 68
IPRATROPIUM BROMIDE........................................14, 57
IPRATROPIUM/ALBUTEROL SULFATE...................... 14
IPRIVASK............................................................. 45, 80, 96
IRBESARTAN...................................................................22
IRBESARTAN/HYDROCHLOROTHIAZIDE.................22
IRESSA........................................................................56, 96
IRON ASPGLY,PS/C/B12/FA/CA/SUC............................71
IRON ASPGLY,PS/C/SUCCINIC ACID .......................... 71
IRON ASPGLY/C/B12/FA/CA-TH/SUC..........................71
IRON BG,PS/VITC/B12/FA/CALCIUM.......................... 71
IRON CARB,GL/FA/B12/C/DOCUSATE........................ 71
IRON FM,PS NO.1/FOLIC/MV NO.18............................71
IRON FUM,AG/C/B12/FOLIC/CA/SUC..........................71
IRON FUM,PS/FA/VIT B WITH C #9............................. 71
IRON FUM,PS/FOLIC ACID/VITC/B3........................... 71
IRON FUM/DOCUSAT/FOLIC/BCOMP,C..................... 71
IRON FUMARATE/VIT C/VIT B12/FA.......................... 71
IRON POLYSAC/IRON HEME/FA/B12.......................... 71
IRON POLYSACCHARIDE COMPLEX......................... 71
IRON POLYSACCHARIDE COMPLEX (150 MG)
(CAPSULE) (OTC)........................................................... 71
IRON PS CMPLX/VIT B12/FA........................................ 71
IRON,CARB/FA#6/MV, MIN NO.41............................... 71
IRON,CARB/VIT C/VIT B12/FOLIC........................ 71, 73
IRON/C/B12/CALCIU/STOMACH CONC......................71
IRON/C/FOLIC ACD/MV CMB11/CALC.......................71
IRON/CALCIUM/E/FOLIC ACID/MVIT........................ 71
IRON/DSS/B12-IF/FOLIC AC/MV-MN...........................71
IRON/FOLIC AC/VIT BCOMP,C/MIN............................71
IRON/FOLIC ACID/B12/C/DOCUSATE.........................71
IRON/FOLIC ACID/C/B6/B12/ZINC...............................71
IRON/LIVER EXT/VIT BCOMP,C/MIN......................... 71
IRON/MV,STRESS FORM............................................... 71
ISENTRESS (100 MG) (POWD PACK).....................50, 80
ISENTRESS (100 MG) (TAB CHEW)....................... 51, 80
ISENTRESS (25 MG) (TAB CHEW)......................... 51, 80
ISENTRESS (400 MG) (TABLET).............................51, 80
ISOCARBOXAZID...........................................................17
ISOCHRON....................................................................... 24
ISOMETHEPT/DICHLPHN/ACETAMINOP.................. 64
ISONIAZID....................................................................... 48
ISOPROPANOL (70 %) (SOLUTION) (OTC)................. 61
ISOPROPYL ALCOHOL..................................................61
ISOPROPYL ALCOHOL (70 %) (SOLUTION) (OTC)......
61
ISOPROPYL ALCOHOL (91 %) (SOLUTION) (OTC)......
61
ISOPROPYL ALCOHOL (99 %) (SOLUTION) (OTC)......
61
ISOPROPYL RUBBING ALCOHOL...............................61
ISOPTO CARPINE........................................................... 42
ISOPTO HOMATROPINE................................................42
ISORDIL (10 MG) (TABLET)..........................................24
ISORDIL (20 MG) (TABLET)..........................................24
ISORDIL (30 MG) (TABLET)..........................................24
ISORDIL (40 MG) (TABLET)..........................................24
ISORDIL TITRADOSE.................................................... 25
ISOSORBIBE DINIT/HYDRALAZINE.......................... 23
ISOSORBIDE DINITRATE........................................24, 25
ISOSORBIDE MONONITRATE......................................25
ISOSOURCE 1.5 CAL TUBE FEED..........................57, 96
ISOSOURCE HN (0.05 G-1.2) (LIQUID) (OTC).......57, 96
ISOTRETINOIN................................................................28
ISOXSUPRINE HCL........................................................ 25
ISRADIPINE..................................................................... 23
ITRACONAZOLE.............................................................48
IV ANTISEPTIC WIPES.................................................. 31
IV PREP WIPES................................................................31
IVACAFTOR..................................................................... 61
I-VALEX-2.................................................................. 59, 96
IVERMECTIN...................................................................49
IXAZOMIB CITRATE......................................................56
-JJAKAFI..................................................................55, 80, 96
JALYN......................................................................... 69, 88
JANUMET...................................................................34, 80
JANUMET XR (100-1000MG) (TBMP 24HR)..........34, 80
JANUMET XR (50-1000 MG) (TBMP 24HR)...........34, 80
JANUMET XR (50MG-500MG) (TBMP 24HR)....... 34, 80
JANUVIA.................................................................... 34, 80
JARDIANCE......................................................... 34, 80, 89
JENTADUETO............................................................ 34, 80
JENTADUETO XR (2.5-1000MG) (TAB BP 24H)...... 34,
80
JENTADUETO XR (5MG-1000MG) (TAB BP 24H)......
34,
80
JEVANTIQUE................................................................... 46
JEVANTIQUE LO.............................................................46
JEVITY 1.2 CAL (0.06 G-1.2) (LIQUID) (OTC)....... 57, 96
JEVITY 1.5 CAL (0.06 G-1.5) (LIQUID) (OTC)....... 57, 96
JUXTAPID...................................................................24, 96
-KKADIAN (100 MG) (CAP ER PEL)...........................63, 80
KADIAN (20 MG) (CAP ER PEL).............................63, 80
KADIAN (30 MG) (CAP ER PEL).............................63, 80
KADIAN (50 MG) (CAP ER PEL).............................63, 80
KADIAN (60 MG) (CAP ER PEL).............................63, 80
KADIAN (80 MG) (CAP ER PEL).............................63, 80
KALETRA (100MG-25MG) (TABLET).................... 50, 80
KALETRA (200MG-50MG) (TABLET).................... 50, 80
KALETRA (400-100/5) (SOLUTION).......................50, 80
KALYDECO................................................................61, 96
KAPVAY......................................................................20, 80
KEFLEX............................................................................ 46
KENALOG........................................................................ 30
KENALOG IN ORABASE............................................... 57
KEPPRA............................................................................ 66
KEPPRA XR..................................................................... 66
KERALAC.........................................................................32
KERLONE.........................................................................22
KEROL.............................................................................. 32
KETEK.............................................................................. 47
KETOCAL 4:1 (14.4 G-701) (POWDER) (OTC).......59, 96
KETOCAL 4:1 (3.09 G-150) (LIQUID) (OTC)..........60, 96
KETOCONAZOLE..................................................... 29, 48
KETO-DIASTIX REAGENT............................................39
KETONEX-2............................................................... 60, 96
KETOPROFEN..................................................................52
KETOROLAC TROMETHAMINE............................ 41, 52
KETOVOLVE.............................................................. 60, 96
KEVEYIS.................................................................... 67, 96
KHEDEZLA.......................................................... 17, 80, 89
KLONOPIN.......................................................................65
KLONOPIN RAPIDLY DISINTEGRATING...................65
KLOR-CON (20 MEQ) (PACKET).................................. 39
KLOR-CON 10..................................................................39
KLOR-CON 8....................................................................39
KLOR-CON-EF.................................................................39
KOATE.............................................................................. 43
KOATE-DVI...................................................................... 43
KOGENATE FS.................................................................43
KONSYL (3.5G/5.8G) (POWDER) (OTC).......................54
KORLYM.................................................................... 34, 96
KOVALTRY.......................................................................43
KRISTALOSE................................................................... 54
K-TAB ER......................................................................... 39
KUVAN....................................................................... 60, 96
KWELL............................................................................. 29
KYNAMRO................................................................. 24, 96
KYTRIL.................................................................14, 80, 89
-LLABETALOL HCL........................................................... 22
Page 106 of 116
Index
LAC-HYDRIN...................................................................31
LAC-HYDRIN TWELVE..................................................31
LACOSAMIDE................................................................. 66
LACTIC ACID.................................................................. 31
LACTOCAL-F...................................................................75
LACTOSE-REDUCED FOOD......................................... 57
LACTOSE-REDUCED FOOD (0.04G-1.05) (LIQUID)
(OTC)...........................................................................57, 96
LACTOSE-REDUCED FOOD (0.05 G-1.5) (LIQUID)
(OTC)...........................................................................57, 96
LACTOSE-REDUCED FOOD (LIQUID) (OTC).......57, 96
LACTOSE-REDUCED FOOD/FIBER............................. 57
LACTULOSE.............................................................. 53, 54
LAMICTAL....................................................................... 66
LAMICTAL (BLUE)......................................................... 66
LAMICTAL (GREEN)...................................................... 66
LAMICTAL (ORANGE)...................................................66
LAMICTAL ODT (100 MG) (TAB RAPDIS)...... 66, 80,
89
LAMICTAL ODT (200 MG) (TAB RAPDIS)...... 66, 80,
89
LAMICTAL ODT (25 MG) (TAB RAPDIS)........ 66, 80, 89
LAMICTAL ODT (50 MG) (TAB RAPDIS)........ 66, 80, 89
LAMICTAL ODT (BLUE)..........................................66, 89
LAMICTAL ODT (GREEN).......................................66, 89
LAMICTAL ODT (ORANGE)................................... 66, 89
LAMICTAL XR (BLUE)............................................ 66, 89
LAMICTAL XR (GREEN)......................................... 66, 89
LAMICTAL XR (ORANGE)...................................... 66, 89
LAMISIL..................................................................... 29, 48
LAMIVUDINE............................................................50, 51
LAMIVUDINE/ZIDOVUDINE........................................ 49
LAMOTRIGINE................................................................66
LAMOTRIGINE (100 MG) (TAB ER 24)............ 66, 80, 89
LAMOTRIGINE (100 MG) (TAB RAPDIS)........ 66, 80, 89
LAMOTRIGINE (100 MG) (TABLET)............................ 66
LAMOTRIGINE (150 MG) (TABLET)............................ 66
LAMOTRIGINE (200 MG) (TAB ER 24)............ 66, 80, 89
LAMOTRIGINE (200 MG) (TAB RAPDIS)........ 66, 80, 89
LAMOTRIGINE (200 MG) (TABLET)............................ 66
LAMOTRIGINE (25 MG) (TAB ER 24).............. 66, 80, 89
LAMOTRIGINE (25 MG) (TAB RAPDIS).......... 66, 80, 89
LAMOTRIGINE (25 MG) (TABLET).............................. 66
LAMOTRIGINE (25 MG) (TB CHW DSP)..................... 66
LAMOTRIGINE (25(21)-50) (TB RD DSPK)........... 66, 89
LAMOTRIGINE (250 MG) (TAB ER 24)............ 66, 80, 89
LAMOTRIGINE (25-50-100) (TB RD DSPK)...........66, 89
LAMOTRIGINE (300 MG) (TAB ER 24)............ 66, 81, 89
LAMOTRIGINE (5 MG) (TB CHW DSP)....................... 66
LAMOTRIGINE (50 MG) (TAB ER 24).............. 66, 81, 89
LAMOTRIGINE (50 MG) (TAB RAPDIS).......... 66, 81, 89
LAMOTRIGINE (50(42)-100) (TB RD DSPK)......... 66, 89
LANCING DEVICE....................................................37, 38
LANCING DEVICE/LANCETS.......................................38
LANCING SYSTEM.........................................................38
LANOLIN ALCOHOL/MO/W.PET/CERES....................31
LANOLIN/ALOE VERA/PROP GLY.............................. 31
LANOLIN/MINERAL OIL/PETROLATUM................... 42
LANSOPRAZOLE............................................................ 69
LANSOPRAZOLE/AMOXICILN/CLARITH..................68
LANZO..............................................................................38
LAPATINIB DITOSYLATE..............................................56
LARIAM............................................................................49
LASIX................................................................................23
LATANOPROST............................................................... 42
LATUDA (120 MG) (TABLET)............................19, 81, 89
LATUDA (20 MG) (TABLET)..............................19, 81, 89
LATUDA (40 MG) (TABLET)..............................19, 81, 90
LATUDA (60 MG) (TABLET)..............................19, 81, 90
LATUDA (80 MG) (TABLET)..............................19, 81, 90
LC D NEBULIZER SET (EACH).....................................15
LC PLUS (EACH)............................................................. 15
LC SPRINT NEBULIZER................................................ 15
LEFLUNOMIDE...............................................................51
LENALIDOMIDE............................................................. 55
LENVATINIB MESYLATE.............................................. 56
LENVIMA...................................................................56, 96
LETAIRIS....................................................................23, 96
LETROZOLE.................................................................... 55
LEUCOVORIN CALCIUM.............................................. 56
LEU-FREE COOLER................................................. 60, 96
LEUKERAN......................................................................55
LEUKINE.................................................................... 45, 96
LEUPROLIDE ACETATE.................................................40
LEVALBUTEROL HCL................................................... 14
LEVAQUIN....................................................................... 48
LEVBID.............................................................................68
LEVETIRACETAM.......................................................... 66
LEVOBUNOLOL HCL.....................................................42
LEVOCARNITINE..................................................... 59, 96
LEVOCARNITINE (WITH SUGAR)...............................59
LEVOCETIRIZINE DIHYDROCHLORIDE................... 13
VNSNY
LEVO-DROMORAN........................................................ 63
LEVOFLOXACIN.......................................................41, 48
LEVOMILNACIPRAN HCL............................................ 17
LEVONORGESTREL.......................................................25
LEVONORGESTREL-ETHIN ESTRADIOL.................. 25
LEVORPHANOL TARTRATE......................................... 63
LEVOTHYROXINE SODIUM......................................... 40
LEVSIN............................................................................. 68
LEVSIN-SL....................................................................... 68
LEXAPRO......................................................................... 17
LEXIVA (50 MG/ML) (ORAL SUSP)........................50, 81
LEXIVA (700 MG) (TABLET)................................... 50, 81
LIBERTY LEV 1 GLUCOSE CONTROL........................36
LIBERTY LEV 2 GLUCOSE CONTROL........................37
LIBRAX............................................................................ 68
LIBRIUM.......................................................................... 18
LIDAMANTLE HC...........................................................33
LIDEX............................................................................... 30
LIDEX-E............................................................................30
LIDOCAINE......................................................................33
LIDOCAINE HCL.......................................................33, 53
LIDOCAINE HCL/COLLAGEN...................................... 33
LIDOCAINE/HYDROCORTISONE AC....................33, 53
LIDOCAINE/PRILOCAINE.............................................33
LIDODERM...................................................................... 33
LIDO-K..............................................................................33
LIDOPIN (3 %) (CREAM (G)).........................................33
LIFITEGRAST.................................................................. 42
LIMBITROL......................................................................17
LIMBITROL DS................................................................17
LINACLOTIDE................................................................. 53
LINAGLIPTIN.................................................................. 34
LINAGLIPTIN/METFORMIN HCL................................ 34
LINDANE..........................................................................29
LINEZOLID...................................................................... 47
LINZESS..................................................................... 53, 81
LIORESAL........................................................................ 67
LIOTHYRONINE SODIUM.............................................40
LIPASE/PROTEASE/AMYLASE.....................................68
LIPISTART.................................................................. 60, 96
LIPITOR............................................................................ 24
LIRAGLUTIDE.................................................................34
LISDEXAMFETAMINE DIMESYLATE.........................18
LISINOPRIL......................................................................22
LISINOPRIL/HYDROCHLOROTHIAZIDE....................21
LISSAMINE GREEN........................................................42
LITE TOUCH.................................................................... 38
LITEAIRE......................................................................... 15
LITETOUCH..................................................................... 15
LITHIUM CARBONATE..................................................18
LITHIUM CITRATE......................................................... 18
LITHOBID........................................................................ 18
LITHOTABS......................................................................18
L-NORGEST/E.ESTRADIOL-E.ESTRAD...................... 25
LO LOESTRIN FE............................................................ 25
LOCOID (0.1 %) (CREAM (G)).......................................30
LOCOID (0.1 %) (OINT. (G))...........................................30
LOCOID (0.1 %) (SOLUTION)........................................30
LODINE............................................................................ 52
LODINE XL...................................................................... 52
LODOSYN........................................................................ 65
LODOXAMIDE TROMETHAMINE............................... 42
LOESTRIN........................................................................ 25
LOESTRIN FE.................................................................. 25
LOMITAPIDE MESYLATE............................................. 24
LOMOTIL......................................................................... 53
LOMUSTINE.................................................................... 55
LONITEN.......................................................................... 22
LONSURF................................................................... 55, 96
LO-OVRAL-28..................................................................26
LO-OVRAL-8....................................................................26
LOPERAMIDE HCL.........................................................53
LOPERAMIDE HCL (1 MG/5 ML) (LIQUID) (OTC)......
53
LOPERAMIDE HCL (2 MG) (CAPSULE) (OTC).......... 53
LOPID................................................................................24
LOPINAVIR/RITONAVIR................................................ 50
LOPRESSOR.....................................................................22
LOPRESSOR HCT............................................................22
LOPROX............................................................................28
LORATADINE.................................................................. 13
LORATADINE/PSEUDOEPHEDRINE........................... 13
LORAZEPAM................................................................... 18
LORAZEPAM INTENSOL...............................................18
LORTAB (10MG-325MG) (TABLET)....................... 62, 81
LORTAB (5 MG-325MG) (TABLET)........................ 62, 81
LORTAB (7.5-325 MG) (TABLET)............................62, 81
LOSARTAN POTASSIUM............................................... 22
LOSARTAN/HYDROCHLOROTHIAZIDE.....................22
LOSEASONIQUE....................................................... 25, 81
LOTEMAX........................................................................ 41
LOTENSIN........................................................................ 22
LOTENSIN HCT............................................................... 21
LOTEPREDNOL ETABONATE.......................................41
LOTREL............................................................................ 21
LOTRIMIN........................................................................ 29
LOTRIMIN AF..................................................................29
LOTRISONE..................................................................... 28
LOVASTATIN....................................................................24
LOVAZA......................................................................24, 81
LOVENOX (100 MG/ML) (SYRINGE)..................... 44, 81
LOVENOX (120MG/.8ML) (SYRINGE)................... 44, 81
LOVENOX (150 MG/ML) (SYRINGE)..................... 44, 81
LOVENOX (300MG/3ML) (VIAL)............................44, 81
LOVENOX (30MG/0.3ML) (SYRINGE)................... 44, 81
LOVENOX (40MG/0.4ML) (SYRINGE)................... 44, 81
LOVENOX (60MG/0.6ML) (SYRINGE)................... 44, 81
LOVENOX (80MG/0.8ML) (SYRINGE)................... 44, 81
LOXAPINE....................................................................... 19
LOXAPINE SUCCINATE.................................................19
LOXITANE........................................................................19
LOZOL.............................................................................. 23
LUBIPROSTONE..............................................................54
LUDIOMIL........................................................................18
LUGOL'S...........................................................................28
LUMACAFTOR/IVACAFTOR.........................................61
LUMIGAN (0.01 %) (DROPS)................................... 42, 81
LUMIGAN (0.03 %) (DROPS)................................... 42, 81
LUNESTA................................................................... 20, 81
LUPRON DEPOT..............................................................40
LUPRON DEPOT-PED..................................................... 40
LURASIDONE HCL.........................................................19
LUVOX..............................................................................17
LUVOX CR........................................................... 17, 81, 90
LYNPARZA...........................................................56, 81, 96
LYRICA.............................................................................67
LYSODREN...................................................................... 56
LYSTEDA..........................................................................43
-MM9......................................................................................31
MACITENTAN................................................................. 23
MACROBID...................................................................... 47
MACRODANTIN..............................................................47
MACUVITE WITH LUTEIN........................................... 57
MAG HYDROX/ALUMINUM HYD/SIMETH............... 68
MAG HYDROX/ALUMINUM HYD/SIMETH (200-20020) (ORAL SUSP) (OTC)................................................. 68
MAG/ALUMINUM/SOD BICARB/ALGINC................. 68
MAGNESIUM...................................................................71
MAGNESIUM (250 MG) (TABLET) (OTC)....................71
MAGNESIUM HYDROXIDE.......................................... 54
MAGNESIUM OXIDE......................................................71
MAGNESIUM OXIDE (250 MG) (TABLET) (OTC)......
71
MAGNESIUM OXIDE (500 MG) (CAPSULE) (OTC)......
71
MAGNESIUM OXIDE (500 MG) (TABLET) (OTC)......
71
MAGNI-GUIDE MAGNIFIER......................................... 37
MALARONE.....................................................................49
MANDELAMINE............................................................. 47
MANNITOL/SORBITOL SOLUTION............................ 31
MAPROTILINE HCL........................................................18
MARAVIROC....................................................................49
MARINOL.............................................................14, 81, 90
MARPLAN........................................................................17
MATULANE..................................................................... 56
MAVIK.............................................................................. 22
MAXALT.....................................................................64, 81
MAXALT MLT........................................................... 64, 81
MAXZIDE.........................................................................23
MAXZIDE-25 MG............................................................ 23
MEBENDAZOLE............................................................. 49
MECASERMIN.................................................................40
MECHLORETHAMINE HCL..........................................33
MECLIZINE HCL.............................................................14
MECLOFENAMATE SODIUM....................................... 52
MECLOMEN.................................................................... 52
MEDIHONEY (100 %) (PASTE (ML)) (OTC)................ 33
MEDISENSE CONTROL................................................. 35
MEDISENSE GLUCOSE KETONE................................ 35
MEDISENSE GLUCOSE KETONE CONTR.................. 37
MEDROL (16 MG) (TABLET).........................................52
MEDROL (2 MG) (TABLET)...........................................52
MEDROL (32 MG) (TABLET).........................................52
MEDROL (4 MG) (TAB DS PK)...................................... 52
MEDROL (4 MG) (TABLET)...........................................52
MEDROL (8 MG) (TABLET)...........................................52
MEDROXYPROGESTERONE ACETATE................ 25, 46
MEDTRONIC REMOTE CONTROL...............................37
MEFLOQUINE HCL........................................................ 49
MEGACE.....................................................................56, 57
MEGACE ES..................................................................... 57
Page 107 of 116
Index
MEGESTROL ACETATE........................................... 56, 57
MEKINIST.................................................................. 55, 96
MELLARIL....................................................................... 20
MELOXICAM...................................................................52
MELPHALAN...................................................................55
MEMANTINE HCL..........................................................16
MEMANTINE HCL/DONEPEZIL HCL....................16, 17
MENEST........................................................................... 46
MEPERIDINE HCL.......................................................... 63
MEPERIDINE HCL/PF.....................................................63
MEPHYTON..................................................................... 45
MEPROBAMATE............................................................. 18
MEPRON...........................................................................49
MERCAPTOPURINE....................................................... 55
MESALAMINE.................................................................53
MESALAMINE W/CLEANSING WIPES....................... 53
ME-SALICYLATE/ISOPROP.ALCOHOL.......................32
ME-SALICYLATE/ISOPROP.ALCOHOL (LIQUID)
(OTC).................................................................................32
MESTINON (180 MG) (TABLET ER).............................17
MESTINON (60 MG) (TABLET)..................................... 17
MESTINON (60 MG/5 ML) (SYRUP)............................. 17
METADATE CD (10 MG) (CPBP 30-70).............20, 77, 81
METADATE CD (20 MG) (CPBP 30-70).............20, 77, 81
METADATE CD (30 MG) (CPBP 30-70).............21, 77, 81
METADATE CD (40 MG) (CPBP 30-70).............21, 77, 81
METADATE CD (50 MG) (CPBP 30-70).............21, 77, 81
METADATE CD (60 MG) (CPBP 30-70).............21, 77, 81
METADATE ER (10 MG) (TABLET ER)............ 21, 77, 81
METADATE ER (20 MG) (TABLET ER)............ 21, 77, 81
METAGLIP........................................................................34
METAMUCIL MULTIHEALTH FIBER.......................... 54
METAPROTERENOL SULFATE.....................................14
METER-CHECK...............................................................37
METFORMIN HCL.......................................................... 34
METH/MEBLUE/SOD PHOS/PSAL/HYOS................... 47
METHADONE HCL......................................................... 63
METHAMPHETAMINE HCL..........................................18
METHEN/MBLUE/SAL/SOD PHOS/HYOS...................47
METHENAM/M.BLUE/SALICYL/HYOSCY.................47
METHENAM/SOD PHOS/MBLUE/HYOSCY............... 47
METHENAMINE HIPPURATE....................................... 47
METHENAMINE MANDELATE.................................... 47
METHIMAZOLE.............................................................. 40
METHITEST............................................................... 45, 96
METHOCARBAMOL.......................................................67
METHOTREXATE SODIUM...........................................55
METHOTREXATE SODIUM/PF..................................... 55
METHOTREXATE/PF...................................................... 51
METHOXSALEN............................................................. 33
METHOXSALEN (10 MG) (CAP LQ RAP)....................33
METHSCOPOLAMINE BROMIDE................................ 68
METHSUXIMIDE............................................................ 66
METHYCLOTHIAZIDE...................................................23
METHYL SALICYLATE................................................. 32
METHYL SALICYLATE (LIQUID) (OTC).....................32
METHYL SALICYLATE (OIL) (OTC)............................32
METHYLBENZETHONIUM CHLORIDE......................28
METHYLCELLULOSE....................................................54
METHYLDOPA................................................................ 22
METHYLDOPA/HYDROCHLOROTHIAZIDE.............. 22
METHYLIN (10 MG) (TAB CHEW)......................... 21, 81
METHYLIN (10 MG/5 ML) (SOLUTION)......................21
METHYLIN (2.5 MG) (TAB CHEW)........................ 21, 81
METHYLIN (5 MG) (TAB CHEW)........................... 21, 81
METHYLIN (5 MG/5 ML) (SOLUTION)........................21
METHYLPHENIDATE HCL......................................20, 21
METHYLPREDNISOLONE............................................ 52
METHYLTESTOSTERONE.............................................45
METIPRANOLOL............................................................ 42
METOCLOPRAMIDE HCL............................................. 69
METOLAZONE................................................................ 23
METOPROLOL SUCCINATE..........................................22
METOPROLOL TARTRATE............................................22
METOPROLOL TARTRATE (25 MG) (TABLET).......... 22
METOPROLOL/HYDROCHLOROTHIAZIDE...............22
METRELEPTIN................................................................ 40
METROCREAM............................................................... 28
METROGEL......................................................................28
METROGEL-VAGINAL................................................... 69
METROLOTION...............................................................28
METRONIDAZOLE............................................. 28, 49, 69
MEVACOR........................................................................ 24
MEXILETINE HCL.......................................................... 21
MEXITIL...........................................................................21
MIACALCIN (200/SPRAY) (SPRAY/PUMP)................. 40
MICARDIS........................................................................22
MICONAZOLE NITRATE......................................... 29, 70
MICONAZOLE NITRATE (100 MG) (SUPP.VAG) (OTC)
........................................................................................... 70
MICONAZOLE NITRATE (2 %) (CREAM(ML)) (OTC)
........................................................................................... 29
VNSNY
MICONAZOLE NITRATE (200 MG-2 %) (CMB PF
CRM) (OTC)......................................................................70
MICONAZOLE/CLEANSER 17 ON WIPE.....................70
MICONAZOLE/CLEANSER 17 ON WIPE (200 MG-2 %)
(KIT) (OTC)...................................................................... 70
MICRO AIR...................................................................... 16
MICROCHAMBER (SPACER)........................................ 15
MICRODOT...................................................................... 35
MICROGESTIN 24 FE..................................................... 25
MICRO-K.......................................................................... 39
MICROLET 2.................................................................... 38
MICROLIFE PEAK FLOW.............................................. 16
MICROSPACER (SPACER)..............................................15
MICROZIDE..................................................................... 23
MIDAMOR........................................................................23
MIDAZOLAM HCL..........................................................20
MIDODRINE HCL........................................................... 24
MIDRIN.............................................................................64
MIFEPRISTONE...............................................................34
MIGLUSTAT..................................................................... 58
MIGRANAL................................................................64, 81
MILK BASED FORMULA.........................................57, 96
MILK BASED FORMULA/CORN STARCH.................. 57
MILLIPRED...................................................................... 52
MILLIPRED DP................................................................52
MILNACIPRAN HCL.......................................................56
MILTEFOSINE................................................................. 49
MINASTRIN 24 FE...........................................................25
MINERAL OIL........................................................... 54, 61
MINERAL OIL HEAVY................................................... 61
MINERAL OIL LIGHT.................................................... 61
MINERAL OIL, LIGHT/MINERAL OIL........................ 42
MINERAL OIL/PETROLATUM,WHITE............ 31, 42, 43
MINERAL OIL/PETROLATUM,WHITE (3 %-94 %)
(OINT. (G)) (OTC)............................................................ 43
MINERAL OIL/PETROLATUM,WHITE (41.5-56.8%)
(OINT. (G)) (OTC)............................................................ 43
MINERAL OIL/PETROLATUM,WHITE (42.5-57.3%)
(OINT. (G)) (OTC)............................................................ 43
MINERAL OIL/PETROLATUM,WHITE (CREAM (G))
(OTC).................................................................................31
MINERAL OIL/PETROLATUM,WHITE (OINT. (G))
(OTC).................................................................................43
MINERAL,LANOLIN OILS/PROP GLYC...................... 31
MINERALS/PROTEIN SUPPLEMENT.......................... 71
MINI LANCING DEVICE................................................38
MINI PLUS NEBULIZER................................................ 16
MINILINK REAL-TIME TRANSMITTER..................... 37
MINIMED......................................................................... 37
MINIPRESS...................................................................... 22
MINI-WRIGHT PEAK FLOW METER (EACH)............ 16
MINOCIN..........................................................................48
MINOCYCLINE HCL...................................................... 48
MINOXIDIL...................................................................... 22
MIO INFUSION SET........................................................37
MIPOMERSEN SODIUM................................................ 24
MIRALAX.........................................................................54
MIRAPEX......................................................................... 65
MIRCETTE....................................................................... 25
MIRTAZAPINE.................................................................17
MISOPROSTOL................................................................68
MITOTANE....................................................................... 56
MOBIC.............................................................................. 52
MODAFINIL..................................................................... 20
MODERIBA (200 MG) (TABLET).................................. 51
MODURETIC 5-50........................................................... 23
MOEXIPRIL HCL.............................................................22
MOEXIPRIL/HYDROCHLOROTHIAZIDE....................21
MOMETASONE FUROATE.................................14, 30, 81
MOMETASONE/FORMOTEROL....................................14
MONDOXYNE NL (100 MG) (CAPSULE).............. 48, 81
MONDOXYNE NL (50 MG) (CAPSULE)................ 48, 81
MONISTAT 3 (200 MG) (SUPP.VAG)..............................70
MONISTAT 3 (200 MG-2 %) (CMB PF CRM) (OTC)......
70
MONISTAT 3 (200 MG-2 %) (KIT) (OTC)......................70
MONOCLATE-P............................................................... 43
MONODOX (100 MG) (CAPSULE).......................... 48, 81
MONODOX (50 MG) (CAPSULE)............................ 48, 81
MONODOX (50 MG) (TABLET)...............................48, 81
MONODOX (75 MG) (TABLET)...............................48, 81
MONOKET....................................................................... 25
MONONINE......................................................................44
MONOPRIL...................................................................... 22
MONOPRIL-HCT............................................................. 21
MONTELUKAST SODIUM.............................................15
MORGIDOX............................................................... 48, 81
MORPHINE SULFATE.....................................................63
MORPHINE SULFATE (10 MG/ML) (CARTRIDGE)......
63
MORPHINE SULFATE (10 MG/ML) (SYRINGE)......... 63
MORPHINE SULFATE (10MG/0.7ML) (PEN INJCTR)
........................................................................................... 63
MORPHINE SULFATE (15 MG) (TABLET)...................63
MORPHINE SULFATE (15 MG/ML) (VIAL)................. 63
MORPHINE SULFATE (2 MG/ML) (SYRINGE)........... 63
MORPHINE SULFATE (30 MG) (TABLET)...................63
MORPHINE SULFATE (4 MG/ML) (CARTRIDGE)......
63
MORPHINE SULFATE (4 MG/ML) (SYRINGE)........... 63
MORPHINE SULFATE (8 MG/ML) (SYRINGE)........... 63
MORPHINE SULFATE (8 MG/ML) (VIAL)................... 63
MORPHINE SULFATE/PF............................................... 63
MORPHINE SULFATE/PF (0.5 MG/ML) (AMPUL)......
63
MORPHINE SULFATE/PF (0.5 MG/ML) (VIAL)...........63
MORPHINE SULFATE/PF (1 MG/ML) (VIAL)..............63
MORPHINE SULFATE/PF (150MG/30ML) (PCA VIAL)
........................................................................................... 63
MORPHINE SULFATE/PF (30 MG/30ML) (PCA VIAL)
........................................................................................... 63
MOTRIN (100 MG/5ML) (ORAL SUSP)........................ 52
MOTRIN (400 MG) (TABLET)........................................ 52
MOTRIN (600 MG) (TABLET)........................................ 52
MOTRIN (800 MG) (TABLET)........................................ 52
MOTRIN IB.......................................................................52
MOUTHPIECE..................................................................15
MOVANTIK................................................................ 54, 81
MOXEZA.......................................................................... 41
MOXIFLOXACIN HCL..............................................41, 48
MS CONTIN............................................................... 63, 81
MSIR..................................................................................63
MSUD COOLER.........................................................60, 96
MSUD COOLER20.....................................................60, 96
MSUD EXPRESS COOLER.......................................60, 96
MSUD LOPHLEX.......................................................60, 96
MUCOMYST.................................................................... 61
MUCUS CLEARING DEVICE........................................ 15
MULTAQ........................................................................... 21
MULTI-LANCET..............................................................38
MULTIVIT WITH CALCIUM,IRON,MIN...................... 72
MULTIVIT WITH IRON,HEMATINIC........................... 72
MULTIVIT WITH IRON-MINERALS.................70, 72, 73
MULTIVIT WITH IRON-MINERALS (LIQUID) (OTC)
........................................................................................... 73
MULTIVIT WITH IRON-MINERALS (TABLET) (OTC)
..................................................................................... 70, 72
MULTIVIT WITH MINERALS/HERBS......................... 72
MULTIVIT WITH MINERALS/LUTEIN........................ 70
MULTIVIT,CALC,MINS/IRON/FOLIC...........................72
MULTIVIT,CALC,MINS/IRON/FOLIC (27MG-400)
(TABLET) (OTC).............................................................. 72
MULTIVIT,CALC,MINS/IRON/FOLIC (450-18-0.4)
(TABLET) (OTC).............................................................. 72
MULTIVIT,CALC,MINS/IRON/FOLIC (500-18-0.4)
(TABLET) (OTC).............................................................. 72
MULTIVIT,CALC,MINS/IRON/FOLIC (9MG-400MCG)
(TABLET) (OTC).............................................................. 72
MULTIVIT,IRON,MIN 5/FOLIC ACID........................... 72
MULTIVIT,IRON,MINS/FOLIC ACID............................72
MULTIVIT,STRESS FORMULA/ZINC.......................... 72
MULTIVIT,TX WITH IRON,MINERALS.......................72
MULTIVIT/IRON/FOLIC ACID/HB179..........................72
MULTIVITAMIN.............................................................. 72
MULTIVITAMIN (LIQUID) (OTC)................................. 72
MULTIVITAMIN (TABLET) (OTC)................................ 72
MULTIVITAMIN WITH IRON........................................ 72
MULTIVITAMIN WITH MINERALS............................. 72
MULTIVITAMIN WITH MINERALS (CAPSULE) (OTC)
........................................................................................... 72
MULTIVITAMIN WITH MINERALS (TABLET) (OTC)
........................................................................................... 72
MULTIVITAMIN,STRESS FORMULA.......................... 72
MULTIVITAMIN,THER AND MINERALS................... 72
MULTIVITAMIN,THER AND MINERALS (TABLET)
(OTC).................................................................................72
MULTIVITAMIN,THERAPEUTIC..................................72
MULTIVITAMIN/IRON/FOLIC ACID............................ 72
MULTIVIT-MIN/FA/LUTEIN/ZEAXANT...................... 72
MULTIVIT-MIN/FA/LYCOPEN/LUTEIN..................70-72
MULTIVIT-MIN/FOLIC ACID/VIT K1...........................72
MULTIVIT-MIN/IRON/FA/P.GINSENG..........................72
MULTIVIT-MIN/IRON/FOLIC/HRB186.........................57
MULTIVIT-MIN/IRON/FOLIC/HRB186 (3.3 MG-25)
(TABLET) (OTC).............................................................. 57
MULTIVIT-MIN/IRON/FOLIC/LUTEIN.........................72
MULTIVIT-MIN36/IRON/FOLIC ACID..........................71
MULTIVIT-MIN43/LUT/OM3/DHA/EPA....................... 57
MULTIVIT-MINERALS/FA/LYCOPENE................. 72, 73
MULTIVIT-MINERALS/FA/LYCOPENE (0.4 MG-600)
(TABLET) (OTC).............................................................. 72
MULTIVIT-MINERALS/FA/LYCOPENE (400-300MCG)
(TABLET) (OTC).............................................................. 73
Page 108 of 116
Index
MULTIVIT-MINERALS/FOLIC ACID............................73
MULTIVIT-MINERALS/FOLIC ACID (0.4 MG)
(TABLET) (OTC).............................................................. 73
MULTIVIT-MINERALS/FOLIC/GINKGO..................... 73
MULTIVIT-MINS NO.20/IRON/FOLIC.......................... 73
MULTIVIT-MINS NO.7/FOLIC ACID............................ 73
MULTIVIT-MINS/IRON/FOLIC/LYCOP........................ 73
MUPIROCIN..................................................................... 28
MUPIROCIN CALCIUM............................................28, 57
MV,CA,MIN/IRON/FA/GUARANA/CAFF..................... 73
MV,CAL,MIN/IRON/FOLIC ACID/LUT.........................73
MV,CALCIUM,MIN/IRON/FOLIC/VITK....................... 73
MV,IRON,MIN/GINKGO/PAN.GINSENG......................73
MV,IRON,MIN/LUTEIN.................................................. 73
M-VIT,TX,IRON,MINS/CALC/FOLIC............................73
MV-MIN/IRON/FOLIC AC/VIT K/LUT..........................73
MV-MINS/FOLIC ACID/GUARANA/CAF..................... 57
MV-MINS/FOLIC/LYCOPENE/GINKGO.......................73
MV-MN/FOLIC ACID/LUTEIN/HRB178....................... 73
MYALEPT...................................................................40, 81
MYAMBUTOL..................................................................48
MYCELEX........................................................................ 48
MYCOBUTIN................................................................... 48
MYCOGEN II................................................................... 29
MYCOPHENOLATE MOFETIL......................................46
MYCOPHENOLATE SODIUM....................................... 46
MYCOSTATIN............................................................29, 48
MYDFRIN.........................................................................41
MYDRIACYL................................................................... 42
MYFORTIC.......................................................................46
MYGLUCOHEALTH CONTROL SOLUTION...............35
MYLERAN........................................................................55
MYSOLINE.......................................................................67
-NNABUMETONE................................................................52
NACL IRRIGAT/DECYL GLUCOSIDE..........................31
NADOLOL/BENDROFLUMETHIAZIDE.......................23
NAFARELIN ACETATE...................................................40
NAFTIFINE HCL..............................................................29
NAFTIN (1 %) (CREAM (G)).......................................... 29
NAFTIN (1 %) (GEL (GRAM))........................................29
NAFTIN (2 %) (CREAM (G)).......................................... 29
NAIL SCRUB.................................................................... 33
NALBUPHINE HCL......................................................... 63
NALFON (600 MG) (TABLET)....................................... 52
NALOXEGOL OXALATE................................................54
NALOXONE HCL............................................................ 20
NALTREXONE HCL........................................................ 20
NALTREXONE MICROSPHERES..................................18
NAMENDA (10 MG) (TABLET)............................... 16, 81
NAMENDA (2 MG/ML) (SOLUTION)..................... 16, 81
NAMENDA (5 MG) (TABLET)................................. 16, 81
NAMENDA (5 MG-10 MG) (TAB DS PK)................16, 81
NAMENDA XR (14 MG) (CAP SPR 24)................... 16, 81
NAMENDA XR (21 MG) (CAP SPR 24)................... 16, 81
NAMENDA XR (28 MG) (CAP SPR 24)................... 16, 81
NAMENDA XR (7 MG) (CAP SPR 24)..................... 16, 81
NAMENDA XR (7-14-21-28) (CAP24 DSPK).......... 16, 81
NAMZARIC (14MG-10MG) (CAP SPR 24)........16, 81, 90
NAMZARIC (21 MG-10MG) (CAP SPR 24).......17, 81, 90
NAMZARIC (28 MG-10MG) (CAP SPR 24).......17, 81, 90
NAMZARIC (7 MG-10 MG) (CAP SPR 24)........17, 81, 90
NAMZARIC (7-10/14-10) (CAP24 DSPK).......... 17, 81, 90
NAPRELAN (500 MG) (TBMP 24HR)............................53
NAPROSYN...................................................................... 53
NAPROXEN...................................................................... 53
NAPROXEN SODIUM..................................................... 53
NARCAN (0.4 MG/ML) (SYRINGE).............................. 20
NARCAN (0.4 MG/ML) (VIAL)...................................... 20
NARCAN (1 MG/ML) (SYRINGE)................................. 20
NARCAN (4 MG) (SPRAY)....................................... 20, 81
NARDIL............................................................................ 17
NASAL AIRFLOW STRIPS............................................. 15
NASAL STRIPS................................................................ 15
NASALIDE................................................................. 14, 81
NATAZIA.......................................................................... 25
NATEGLINIDE................................................................. 34
NATELLE ONE.................................................................74
NATRAPEL................................................................. 29, 81
NATURAL VEGETABLE FIBER (3.4 G/7 G) (POWDER)
(OTC).................................................................................54
NAVANE............................................................................20
NEBIVOLOL HCL............................................................22
NEBIVOLOL HCL/VALSARTAN................................... 22
NEBULIZER............................................................... 15, 16
NEBULIZER AND COMPRESSOR................................ 16
NEBUPENT...................................................................... 49
NEDOCROMIL SODIUM................................................ 42
NEEDLE CLIP AND STORAGE DEVICE......................38
NEEVO DHA (27-1.13 MG) (CAPSULE)....................... 74
NEEVODHA..................................................................... 75
VNSNY
NEFAZODONE HCL........................................................17
NELFINAVIR MESYLATE.............................................. 50
NEOCATE INFANT DHA-ARA (2.8 G-5.1G) (POWDER)
(OTC).................................................................................58
NEOCATE JUNIOR....................................................60, 96
NEOCATE JUNIOR WITH PREBIOTICS (16 G-459)
(POWDER) (OTC)...................................................... 60, 96
NEOCATE JUNIOR WITH PREBIOTICS (16G-478)
(POWDER) (OTC)...................................................... 60, 96
NEOCATE NUTRA.................................................... 60, 96
NEOMYC/BACIT/POLYMYX/HYDROCORT............... 29
NEOMYCIN SU/BACITRA/POLYMYXIN.....................41
NEOMYCIN SULF/POLYMYXIN B SULF....................31
NEOMYCIN SULFATE.................................................... 48
NEOMYCIN/BACIT/P-MYX/HYDROCORT................. 41
NEOMYCIN/POLYMYXIN B/DEXAMETHA............... 41
NEOMYCIN/POLYMYXIN B/HYDROCORT...... 29, 39,
41
NEOMYCIN/POLYMYXN B/GRAMICIDIN................. 41
NEOMYCN/BACITRC/POLYMYX/PRAMOX.............. 28
NEOMYCN/BACITRC/POLYMYX/PRAMOX (3.5-10K10) (OINT. (G)) (OTC)...................................................... 28
NEO-POLYCIN.................................................................41
NEOSPORIN G.U. IRRIGANT........................................ 31
NEPAFENAC.................................................................... 41
NEPHROCAPS................................................................. 75
NEPRO CARB STEADY (0.08G-1.80) (LIQUID) (OTC)
..................................................................................... 60, 96
NESTABS..........................................................................75
NESTABS DHA................................................................ 73
NETUPITANT/PALONOSETRON HCL......................... 14
NEULASTA (6MG/0.6ML) (SYRINGE)................... 45, 96
NEUPOGEN................................................................45, 96
NEUPRO............................................................... 65, 81, 90
NEURONTIN (250 MG/5ML) (SOLUTION).................. 66
NEURONTIN (300 MG/6ML) (SOLUTION).................. 66
NEVANAC.........................................................................41
NEVIRAPINE................................................................... 50
NEW SKIN (0.2 %) (LIQ-FILM) (OTC).......................... 32
NEXA SELECT.................................................................74
NEXAFED.........................................................................28
NEXAVAR.............................................................56, 81, 96
NEXIUM (10 MG) (SUSPDR PKT).....................69, 81, 90
NEXIUM (2.5 MG) (SUSPDR PKT)....................69, 81, 90
NEXIUM (20 MG) (CAPSULE DR).................... 69, 81, 90
NEXIUM (20 MG) (SUSPDR PKT).....................69, 81, 90
NEXIUM (40 MG) (CAPSULE DR).................... 69, 81, 90
NEXIUM (40 MG) (SUSPDR PKT).....................69, 81, 90
NEXIUM (5 MG) (SUSPDR PKT).......................69, 81, 90
NIACIN............................................................................. 24
NIACIN SA....................................................................... 24
NIACOR............................................................................ 24
NIASPAN.................................................................... 24, 90
NICARDIPINE HCL.........................................................23
NICAZEL FORTE.............................................................57
NICODERM CQ............................................................... 68
NICORETTE..................................................................... 68
NICOTINE.........................................................................68
NICOTINE PATCH........................................................... 68
NICOTINE POLACRILEX...............................................68
NICOTROL................................................................. 68, 81
NICOTROL NS........................................................... 68, 81
NIFEDIPINE..................................................................... 23
NIFEREX-150 FORTE......................................................71
NILANDRON..............................................................55, 81
NILOTINIB HCL.............................................................. 56
NILUTAMIDE...................................................................55
NIMODIPINE....................................................................23
NIMOTOP......................................................................... 23
NINLARO................................................................... 56, 96
NINTEDANIB ESYLATE................................................ 61
NIRAVAM......................................................................... 18
NITISINONE.....................................................................58
NITRO-BID....................................................................... 25
NITRO-DUR (0.1MG/HR) (PATCH TD24)..................... 25
NITRO-DUR (0.2MG/HR) (PATCH TD24)..................... 25
NITRO-DUR (0.3 MG/HR) (PATCH TD24).................... 25
NITRO-DUR (0.4MG/HR) (PATCH TD24)..................... 25
NITRO-DUR (0.6MG/HR) (PATCH TD24)..................... 25
NITRO-DUR (0.8MG/HR) (PATCH TD24)..................... 25
NITROFURANTOIN........................................................ 47
NITROFURANTOIN MACROCRYSTAL....................... 47
NITROFURANTOIN MONOHYD/M-CRYST................47
NITROGLYCERIN........................................................... 25
NITROSTAT...................................................................... 25
NITRO-TIME.................................................................... 25
NIZATIDINE.....................................................................68
NIZORAL....................................................................29, 48
NOLVADEX...................................................................... 56
NORCO....................................................................... 62, 82
NORDETTE-28.................................................................25
NORDITROPIN FLEXPRO........................................40, 96
NORELGESTROMIN/ETHIN.ESTRADIOL.................. 26
NORETH-ETHINYL ESTRADIOL/IRON...................... 25
NORETHINDRONE......................................................... 25
NORETHINDRONE ACETATE....................................... 46
NORETHINDRONE AC-ETH ESTRADIOL.............25, 46
NORETHINDRONE-E.ESTRADIOL-IRON................... 25
NORETHINDRONE-ETHINYL ESTRAD...................... 25
NORETHINDRONE-MESTRANOL............................... 26
NORFLEX.........................................................................67
NORGESTIMATE-ETHINYL ESTRADIOL...................26
NORGESTREL-ETHINYL ESTRADIOL....................... 26
NORINYL 1+50................................................................ 26
NORPACE......................................................................... 21
NORPACE CR...................................................................21
NORPRAMIN................................................................... 18
NORTHERA................................................................24, 96
NORTRIPTYLINE HCL................................................... 18
NORVASC......................................................................... 23
NORVIR (100 MG) (CAPSULE)................................50, 82
NORVIR (100 MG) (TABLET)...................................50, 82
NORVIR (80 MG/ML) (SOLUTION)........................ 50, 82
NOVA MAX GLUCOSE CONTROL SOLN....................37
NOVAMAX PLUS GLU-KET.......................................... 35
NOVOEIGHT.................................................................... 43
NOVOSEVEN RT............................................................. 43
NUCORT........................................................................... 30
NUCYNTA.................................................................. 64, 82
NUCYNTA ER............................................................ 64, 82
NULEV..............................................................................68
NULYTELY WITH FLAVOR PACKS..............................54
NUT TX FOR ISOVALERIC ACIDEMIA....................... 59
NUT TX FOR ISOVALERIC ACIDEMIA (16.2G-500)
(POWDER) (OTC)...................................................... 59, 96
NUT TX FOR TYROSINEMIA W-IRON........................ 59
NUT TX, LACT-REDUCED, IRON................................. 57
NUT. TX FOR PKU WITH IRON #48............................. 59
NUT. TX FOR PKU WITH IRON NO.3.......................... 59
NUT. TX FOR PKU WITH IRON NO.5.......................... 59
NUT. TX FOR PKU WITH IRON NO.6.......................... 59
NUT. TX FOR PROPIONIC ACIDEMIA.................. 59, 96
NUT.GLUC INT,LACT-FREE/FOS/DHA........................59
NUT.SOY,LAC-RED/DHA/EPA/FOS/IN......................... 59
NUT.SUP,SPEC,LAC-FREE,IRON/FOS.................... 57, 96
NUT.THERAP.GLUTARIC ACIDURIA 1................. 59, 96
NUT.THERAPY FOR PKU, IRON NO.1.........................59
NUT.TX FOR PKU WITH IRON NO.20......................... 59
NUT.TX FOR PKU WITH IRON NO.21......................... 59
NUT.TX FOR PKU WITH IRON NO.27......................... 59
NUT.TX FOR PKU WITH IRON NO.35......................... 59
NUT.TX FOR PKU WITH IRON NO.4........................... 59
NUT.TX FOR PKU WITH IRON NO.40......................... 59
NUT.TX FOR PKU WITH IRON NO.42......................... 59
NUT.TX FOR PKU WITH IRON NO.45......................... 59
NUT.TX FOR PKU WITH IRON NO.50......................... 59
NUT.TX KETOGENIC,MILK-BASE/SOY................59, 60
NUT.TX,ELEMENTAL,LAC-FREE/MCT.......................60
NUT.TX,IMPAIRED RENAL FXN,WHEY.....................60
NUT.TX,METAB.DIS,LEUCINE-FREE..........................60
NUT.TX,METABOLIC DIS,METHIO-FR.................60, 96
NUT.TX. METABOLIC DISORDER,REG................ 57, 60
NUT.TX. METABOLIC DISORDER,SOY...................... 60
NUT.TX., UREA CYCLE DISORDER............................ 60
NUT.TX.COMP. IMMUNE SYSTM,REG........... 57, 58, 60
NUT.TX.COMP. IMMUNE SYSTM,REG (0.08G-1.4)
(LIQUID) (OTC)......................................................... 60, 96
NUT.TX.COMP.IMMUNE SYS/SOY FIB................. 60, 96
NUT.TX.GLUC INTOL,LF,SOY/FIBER..........................60
NUT.TX.GLUC INTOL,LF,SOY/FIBER (0.07 G-0.8)
(LIQUID) (OTC)......................................................... 60, 96
NUT.TX.IMPAIR DIGES/INULIN/FOS.......................... 58
NUT.TX.IMPAIRED DIGEST FXN.....................58, 60, 61
NUT.TX.IMPAIRED DIGEST FXN,SOY........................ 60
NUT.TX.IMPAIRED DIGEST/FIBER............................. 60
NUT.TX.IMPAIRED RENAL FXN,SOY............. 58, 60, 96
NUT.TX.PULM.DISORD.REG,LAC-FR......................... 60
NUT.TX.PULM.DISORD.SOY,LACFREE...................... 60
NUT.TX.PULM.DISORD.SOY,LACFREE (LIQUID)
(OTC)...........................................................................60, 96
NUTRAMENT............................................................ 58, 96
NUTRIT SUPP/INULIN/FOS/FIBER.............................. 58
NUTRIT.THERAPY, MSUD WITH IRON................ 60, 96
NUTRITIONAL SUPP/INULIN/FOS.............................. 58
NUTRITIONAL SUPPLEMENT......................................58
NUTRITIONAL SUPPLEMENT/FIBER......................... 58
NUTRITIONAL SUPPLEMENT/MCT......................58, 96
NUTRITIONAL TX, KETOGENIC,MILK................ 60, 96
NUTRITIONAL TX, KETOGENIC,WHEY.................... 60
NUVARING.................................................................25, 82
NUWIQ..............................................................................43
NUZOLE........................................................................... 29
NYAMYC.......................................................................... 29
NYMALIZE................................................................ 23, 96
Page 109 of 116
Index
NYSTATIN.................................................................. 29, 48
NYSTATIN/TRIAMCIN................................................... 29
NYSTEX............................................................................29
NYSTOP............................................................................29
-OOA2..............................................................................59, 96
OBETICHOLIC ACID...................................................... 53
OBIZUR............................................................................ 43
OBTREX DHA..................................................................74
OCALIVA....................................................................53, 96
OCTREOTIDE ACETATE................................................ 61
OCUFEN........................................................................... 41
OCUFLOX.........................................................................42
OCUPRESS....................................................................... 42
ODEFSEY................................................................... 51, 82
ODOMZO....................................................................55, 96
ODOR ELIMINATOR DROPS......................................... 31
OFEV...........................................................................61, 96
OFLOXACIN.........................................................39, 42, 48
OGEN 2.5.......................................................................... 46
OLANZAPINE.................................................................. 19
OLANZAPINE PAMOATE...............................................19
OLANZAPINE/FLUOXETINE HCL............................... 20
OLAPARIB........................................................................56
OLMESARTAN MEDOXOMIL.......................................22
OLMESARTAN/HYDROCHLOROTHIAZIDE...............22
OLODATEROL HCL........................................................ 14
OLOPATADINE HCL................................................. 13, 41
OLUX................................................................................ 29
OLUX-E............................................................................ 29
OM-3/DHA/EPA/B12/FA/B6/PHYTOST......................... 73
OMACETAXINE MEPESUCCINATE............................. 56
OMEG3/CALCIUM/D3/FOLIC/MVIT 13....................... 73
OMEGA-3 ACID ETHYL ESTERS................................. 24
OMEPRAZOLE................................................................ 69
OMNICEF......................................................................... 47
OMNIPOD.........................................................................38
OMNIPRED...................................................................... 41
ON CALL EXPRESS CONTROL SOLN.........................35
ON CALL LANCING DEVICE....................................... 38
ON CALL PLUS CONTROL............................................35
ON CALL PLUS LANCING DEVICE.............................38
ON CALL VIVID CONTROL.......................................... 35
ONDANSETRON..............................................................14
ONDANSETRON HCL.....................................................14
ONE DAILY...................................................................... 73
ONE WAY MOUTHPIECE...............................................15
ONE-A-DAY MEN'S.........................................................73
ONE-A-DAY WOMEN'S............................................ 72, 73
ONETOUCH DELICA......................................................38
ONETOUCH PING........................................................... 38
ONETOUCH SURESOFT................................................ 38
ONETOUCH ULTRA CONTROL SOLN........................ 37
ONETOUCH VERIO.................................................. 35, 37
ONETOUCH VIA............................................................. 37
ONFI (10 MG) (TABLET).................................... 67, 82, 90
ONFI (2.5 MG/ML) (ORAL SUSP)......................67, 82, 90
ONFI (20 MG) (TABLET).................................... 67, 82, 90
OPANA (10 MG) (TABLET)............................................ 64
OPANA (5 MG) (TABLET).............................................. 64
OPANA ER (10 MG) (TAB ER 12H)..........................64, 82
OPANA ER (15 MG) (TAB ER 12H)..........................64, 82
OPANA ER (20 MG) (TAB ER 12H)..........................64, 82
OPANA ER (30 MG) (TAB ER 12H)..........................64, 82
OPANA ER (40 MG) (TAB ER 12H)..........................64, 82
OPANA ER (5 MG) (TAB ER 12H)............................64, 82
OPANA ER (7.5 MG) (TAB ER 12H).........................64, 82
OPIUM TINCTURE..........................................................53
OPIUM/BELLADONNA ALKALOIDS.......................... 63
OPSUMIT....................................................................23, 96
OPTICHAMBER...............................................................15
OPTICHAMBER DIAMOND.......................................... 15
OPTICROM.......................................................................42
OPTIPRANOLOL............................................................. 42
OPTIVAR...........................................................................41
OPTUMRX........................................................................35
ORACEA............................................................... 48, 82, 90
ORALAIR (100 IR) (TAB SUBL).............................. 13, 96
ORALAIR (300 IR) (TAB SUBL).............................. 13, 96
ORANGE JUICE...............................................................58
ORAP.................................................................................19
ORAPRED.........................................................................52
ORAPRED ODT............................................................... 52
ORENCIA....................................................................51, 96
ORENCIA CLICKJECT............................................. 51, 96
ORENITRAM ER....................................................... 23, 96
ORFADIN....................................................................58, 96
ORINASE.......................................................................... 34
ORKAMBI.................................................................. 61, 96
ORPHENADRINE CITRATE...........................................67
ORTHO EVRA............................................................26, 82
VNSNY
ORTHO MICRONOR....................................................... 25
ORTHO TRI-CYCLEN..................................................... 26
ORTHO TRI-CYCLEN LO...............................................26
ORTHO-CYCLEN............................................................ 26
ORTHO-EST..................................................................... 46
ORUDIS.............................................................................52
ORUVAIL.......................................................................... 52
OS 2............................................................................. 59, 96
OSELTAMIVIR PHOSPHATE......................................... 49
OSIMERTINIB MESYLATE............................................56
OSMOLITE 1.5 CAL (0.06 G-1.5) (LIQUID) (OTC)......
58,
96
OSTOMY SUPPLY........................................................... 31
OTEZLA...................................................................... 51, 96
OXANDRIN................................................................ 45, 96
OXANDROLONE............................................................. 45
OXAPROZIN.....................................................................53
OXAZEPAM......................................................................18
OXCARBAZEPINE.......................................................... 66
OXEPA (0.06 G-1.5) (LIQUID) (OTC).......................60, 96
OXTELLAR XR (150 MG) (TAB ER 24H)......... 66, 82, 90
OXTELLAR XR (300 MG) (TAB ER 24H)......... 66, 82, 90
OXTELLAR XR (600 MG) (TAB ER 24H)......... 66, 82, 91
OXY IR..............................................................................63
OXYBUTYNIN CHLORIDE............................................69
OXYCODONE HCL......................................................... 63
OXYCODONE HCL/ACETAMINOPHEN...................... 64
OXYCODONE HCL/ASPIRIN........................................ 64
OXYCONTIN (10 MG) (TAB ER 12H)..................... 63, 82
OXYCONTIN (15 MG) (TAB ER 12H)..................... 63, 82
OXYCONTIN (20 MG) (TAB ER 12H)..................... 63, 82
OXYCONTIN (30 MG) (TAB ER 12H)..................... 63, 82
OXYCONTIN (40 MG) (TAB ER 12H)..................... 63, 82
OXYCONTIN (60 MG) (TAB ER 12H)..................... 63, 82
OXYCONTIN (80 MG) (TAB ER 12H)..................... 63, 82
OXYMETAZOLINE HCL................................................ 27
OXYMORPHONE HCL................................................... 64
-PPACERONE.......................................................................21
PALBOCICLIB................................................................. 56
PALIPERIDONE............................................................... 19
PALIPERIDONE PALMITATE.........................................19
PALIVIZUMAB................................................................ 49
PAMELOR.........................................................................18
PAMINE............................................................................ 68
PAMINE FORTE............................................................... 68
PANDA MASK................................................................. 15
PANDEL............................................................................30
PANMYCIN...................................................................... 48
PANOBINOSTAT LACTATE............................................56
PANRETIN........................................................................33
PANTOPRAZOLE SODIUM............................................69
PANTOTHENIC ACID/ALOE VERA ..............................31
PAPAVERINE HCL...........................................................25
PARADIGM REAL-TIME................................................35
PARADIGM REMOTE CONTROL................................. 37
PARAFON FORTE DSC...................................................67
PARCOPA..........................................................................65
PAREGORIC..................................................................... 53
PARI LC SPRINT SINUS................................................. 16
PARI SINUS AEROSOL SYSTEM.................................. 16
PARICALCITOL...............................................................40
PARLODEL.......................................................................65
PARNATE..........................................................................17
PAROMOMYCIN SULFATE............................................49
PAROXETINE HCL..........................................................17
PAROXETINE MESYLATE............................................. 17
PARVA-CAL 500...............................................................70
PASER............................................................................... 48
PASIREOTIDE DIASPARTATE....................................... 61
PATANASE............................................................13, 82, 91
PATANOL..........................................................................41
PATHOCIL........................................................................ 48
PAXIL................................................................................17
PAXIL CR..........................................................................17
PAZOPANIB HCL.............................................................56
PCE.................................................................................... 47
PEAK FLOW METER...................................................... 16
PEAK FLOW METER/INH ASSIT DEV.........................16
PEAK-AIR.........................................................................16
PED MVIT A,C,D3 NO.21/FLUORIDE.......................... 73
PEDI MULTIVIT 45/FLUORIDE/IRON..........................73
PEDI MULTIVIT 75/FLUORIDE/IRON..........................73
PEDI MULTIVIT 84 WITH FLUORIDE......................... 73
PEDI MULTIVIT A,C,AND D3 NO.21............................73
PEDI MULTIVIT NO.12 W-FLUORIDE......................... 73
PEDI MULTIVIT NO.16 W-FLUORIDE......................... 73
PEDI MULTIVIT NO.17 W-FLUORIDE......................... 73
PEDI MULTIVIT NO.2 W-FLUORIDE........................... 73
PEDI MULTIVIT NO.46/IRON SULF............................. 73
PEDI MULTIVIT NO.82 W-FLUORIDE......................... 73
PEDI MULTIVIT NO.83 W-FLUORIDE......................... 73
PEDI NUTRIT,IRON,LAC-FREE,FIBR...........................58
PEDI NUTRIT.,SOY,IRON,LF/FIBER............................. 58
PEDI NUTRITION,IRON,LACT-FREE........................... 58
PEDI NUTRITION,IRON,LACT-FREE (0.03G-1/ML)
(LIQUID) (OTC)......................................................... 58, 96
PEDI NUTRITION,IRON,LACT-FREE (0.04G-1.5)
(LIQUID) (OTC)......................................................... 58, 96
PEDI NUTRITION,MILK BASED,IRON........................58
PEDIAPRED..................................................................... 52
PEDIASMART ORGANIC DAIRY............................58, 96
PEDIASMART ORGANIC SOY................................ 58, 96
PEDIASURE 1.5......................................................... 58, 96
PEDIASURE 1.5 WITH FIBER..................................58, 96
PEDIASURE ENTERAL WITH FIBER.................... 58, 96
PEDIASURE PEPTIDE 1.0 CAL............................... 58, 96
PEDIASURE PEPTIDE 1.5 CAL (0.045G-1.5) (LIQUID)
(OTC)...........................................................................58, 96
PEDIASURE SIDEKICKS......................................... 58, 96
PEDIASURE WITH FIBER........................................58, 96
PEDIATRIC MULTIVITAMIN NO.20.............................73
PEDIATRIC PANDA MASK............................................ 15
PEG3350/SOD SULF,BICARB,CL/KCL......................... 54
PEGANONE......................................................................66
PEGASYS....................................................................51, 96
PEGASYS PROCLICK............................................... 51, 96
PEGFILGRASTIM............................................................45
PEGINTERFERON ALFA-2A..........................................51
PEGINTERFERON ALFA-2B..........................................55
PEGVISOMANT...............................................................40
PENICILLAMINE............................................................ 51
PENICILLIN G BENZATHINE........................................48
PENICILLIN V POTASSIUM.......................................... 48
PENLAC............................................................................ 28
PENNSAID (1.5 %) (DROPS).......................................... 30
PENTAMIDINE ISETHIONATE......................................49
PENTAZINE VC WITH CODEINE................................. 26
PENTAZOCINE HCL/NALOXONE HCL....................... 64
PENTOSAN POLYSULFATE SODIUM..........................69
PENTOXIFYLLINE..........................................................44
PEPCID (20 MG) (TABLET)............................................68
PEPCID (40 MG) (TABLET)............................................68
PEPCID AC....................................................................... 68
PEPTAMEN 1.5 CAL WITH PREBIO1 (0.068G-1.5)
(LIQUID) (OTC)......................................................... 58, 96
PEPTAMEN BARIATRIC...........................................59, 96
PEPTAMEN JUNIOR 1.5 (0.045G-1.5) (LIQUID) (OTC)
..................................................................................... 58, 96
PEPTAMEN JUNIOR WITH PREBIO1 (0.03G-1/ML)
(LIQUID) (OTC)......................................................... 58, 96
PERAMPANEL........................................................... 66, 67
PERATIVE (0.067G-1.3) (LIQUID) (OTC)................60, 96
PERCOCET.................................................................64, 82
PERCODAN...................................................................... 64
PERFOROMIST.......................................................... 14, 82
PERIACTIN.......................................................................13
PERIANAL CLEANSING................................................ 33
PERIDEX.......................................................................... 57
PERIFLEX ADVANCE...............................................59, 96
PERIFLEX JUNIOR................................................... 59, 96
PERIFRESH...................................................................... 33
PERIGIENE.......................................................................28
PERINDOPRIL ERBUMINE........................................... 22
PERIOSTAT.......................................................................57
PERISCENT...................................................................... 31
PERMETHRIN..................................................................29
PERMETHRIN (1 %) (LIQUID) (OTC)...........................29
PERMETHRIN (5 %) (CREAM (G))............................... 29
PERPHENAZINE..............................................................20
PERPHENAZINE/AMITRIPTYLINE HCL...............17, 18
PERSANTINE...................................................................45
PERSONAL BEST............................................................ 16
PETROLATUM................................................................. 60
PETROLATUM, YELLOW.............................................. 60
PETROLATUM,WHITE....................................... 31, 32, 60
PETROLATUM,WHITE (OINT PACK)...........................32
PETROLATUM,WHITE (OINT PACK) (OTC)............... 32
PETROLATUM,WHITE (OINT. (G)) (OTC)............. 31, 32
PETROLEUM JELLY (JELLY (G)) (OTC)...................... 60
PEXEVA................................................................ 17, 82, 91
PFD 2........................................................................... 60, 96
PFLEX TRAINER.............................................................16
PHEN TUSS DM...............................................................27
PHENAZOPYRIDINE HCL............................................. 69
PHENELZINE SULFATE................................................. 17
PHENERGAN................................................................... 14
PHENERGAN (12.5 MG) (TABLET).............................. 13
PHENERGAN (25 MG) (TABLET)................................. 13
PHENERGAN (25 MG/ML) (SYRINGE)........................13
PHENERGAN (25 MG/ML) (VIAL)................................13
PHENERGAN (50 MG) (TABLET)................................. 13
PHENERGAN (50 MG/ML) (VIAL)................................13
Page 110 of 116
Index
PHENERGAN VC.......................................................13, 26
PHENERGAN VC WITH CODEINE...............................26
PHENERGAN WITH CODEINE..................................... 27
PHENEX-1.................................................................. 59, 96
PHENEX-2.................................................................. 59, 96
PHENOBARB/HYOSCY/ATROPINE/SCOP.................. 68
PHENOBARBITAL.......................................................... 20
PHENOHYTRO................................................................ 68
PHENOXYBENZAMINE HCL........................................22
PHEN-TUSS AD............................................................... 26
PHENYLADE............................................................. 59, 96
PHENYLADE ESSENTIAL (25G-390) (POWDER)
(OTC)...........................................................................59, 96
PHENYLADE RTD PKU 10.......................................59, 96
PHENYLADE60 (60G-295) (POWDER) (OTC)........59, 97
PHENYLADE60 (60G-327) (POWDER) (OTC)........59, 97
PHENYLEPHRINE HCL..................................................41
PHENYLEPHRINE HCL/PROMETH HCL.....................26
PHENYLEPHRINE/DIPHENHYDRAMINE.................. 26
PHENYL-FREE 2....................................................... 59, 97
PHENYL-FREE 2HP.................................................. 59, 97
PHENYTEK...................................................................... 67
PHENYTOIN.................................................................... 67
PHENYTOIN SODIUM EXTENDED............................. 67
PHILLIPS' MILK OF MAGNESIA.................................. 54
PHOSLO............................................................................39
PHOSPHASAL..................................................................47
PHYSIOLOGICAL IRRIG SOLN NO.1.................... 31, 32
PHYSIOLYTE................................................................... 31
PHYSIOSOL..................................................................... 32
PHYTONADIONE (VIT K1)............................................45
PHYTONADIONE (VIT K1) (10 MG/ML) (AMPUL)......
45
PHYTONADIONE (VIT K1) (1MG/0.5ML) (AMPUL)
........................................................................................... 45
PHYTONADIONE (VIT K1) (1MG/0.5ML) (SYRINGE)
........................................................................................... 45
PICATO (0.015 %) (GEL (EA)).................................. 33, 82
PICATO (0.05 %) (GEL (EA)).................................... 33, 82
PIKO 1............................................................................... 16
PILOCARPINE HCL.................................................. 42, 54
PIMOZIDE........................................................................ 19
PINDOLOL....................................................................... 22
PIOGLITAZONE HCL......................................................34
PIOGLITAZONE HCL/METFORMIN HCL................... 34
PIPERONYL BUTOXIDE/PYRETHRINS.......................29
PIPERONYL BUTOXIDE/PYRETHRINS (4%-0.33%)
(SHAMPOO) (OTC)..........................................................29
PIPERONYL BUTOXIDE/PYRETHRINS (LIQUID)
(OTC).................................................................................29
PIRFENIDONE................................................................. 61
PIROXICAM..................................................................... 53
PIVOT 1.5 CAL...........................................................58, 97
PKU 2.......................................................................... 59, 97
PKU 3.......................................................................... 59, 97
PKU COOLER 10....................................................... 59, 97
PKU COOLER 15....................................................... 59, 97
PKU COOLER 20....................................................... 59, 97
PKU LOPHLEX.......................................................... 59, 97
PKU TRIO................................................................... 59, 97
PLAN B ONE-STEP......................................................... 25
PLAQUENIL..................................................................... 49
PLAVIX (300 MG) (TABLET)................................... 45, 82
PLAVIX (75 MG) (TABLET)........................................... 45
PLENDIL...........................................................................23
PLETAL.............................................................................45
PNV #14/FERROUS FUM/FOLIC ACID........................ 73
PNV #15/IRON FUM,PS/FOLIC ACID........................... 73
PNV #8/IRON PS CMP,ASPG/FA/DHA.......................... 73
PNV #87/IRON BISGLY/FA/DHA...................................73
PNV 11-IRON FUM-FOLIC ACID-OM3........................ 73
PNV 16/IRON FUM,PS/FOLIC/OM-3............................. 73
PNV 19/IRON PS,HEME/FOLIC/DHA........................... 73
PNV 21/IRON PS,HEME PPEP/FOLIC........................... 73
PNV 22/IRON CBN,GLUC/FOLIC/DSS......................... 73
PNV COMBO #22/IRON/FA/OM3/DHA.........................73
PNV COMBO#47/IRON/FA #1/DHA.............................. 74
PNV NO.115/IRON FUMARATE/FA.............................. 74
PNV NO.118/IRON FUMARATE/FA.............................. 74
PNV NO.66/IRON,CARB/FOLIC/DHA.......................... 74
PNV NO12/IRON/FOLIC/DSS/OM-3..............................74
PNV W-CA #40/IRON FUM/FA CMB#1.........................74
PNV WITH CA #68/IRON/FA#1/DHA............................74
PNV WITH CA NO.65/IRON POLY/FA..........................74
PNV WITH CA#74/IRON/FOLIC ACID......................... 74
PNV WITH CA,NO.62/IRON/FA/DHA........................... 74
PNV WITH CA,NO.70/IRON/FA/DHA........................... 74
PNV WITH CA,NO.72/IRON,CARB/FA......................... 74
PNV WITH CA,NO.72/IRON/FA.....................................74
PNV W-O CA NO5/IRON FUM/FOLIC.......................... 74
PNV W-O IRON/FA/CALCIUM/B6/B12......................... 75
PNV#79/IRON/FA/LMFOLATE CA/DHA...................... 74
VNSNY
PNV,CALC 35/IRON/FOLIC/DSS/OM3..........................74
PNV,CALCIUM37/IRON/FOLIC/OMEG3...................... 74
PNV/FERROUS FUM/DOCUSATE/FOLIC.................... 74
PNV/FERROUS FUM/FOLIC ACID/SEL....................... 74
PNV/FOLIC AC/B6/CALCIUM/GINGER.......................75
PNV/IRON,CARB/DOCUSAT/FOLIC AC...................... 74
PNV115/IRON FUMARATE/FA/DSS..............................74
PNV119/IRON FUMARATE/FA/DSS..............................74
PNV19/IRON BG,S.P/FOLIC AC/OM3........................... 74
PNV34/IRON,CARBONYL/FA/DSS/DHA..................... 74
PNV39/IRON FUMARATE/FA/DSS/DHA......................74
PNV53/IRON B-G HCL-P/FA/OMEGA3........................ 74
PNV54/IRON B-G HCL-P/FA/OMEGA3........................ 74
PNV59/IRON,CARBONYL/FA/DSS/DHA..................... 74
PNV66/IRON FUMARATE/FA/DSS/DHA......................74
PNV69/IRON,CARBONYL/FA/DSS/DHA..................... 74
PNV7/IRON ASP GLY/DOCUS/FOLIC.......................... 74
PNV80/IRON FUMARATE/FA/DSS/DHA......................74
PNV81/IRON EDTA,PS/FOLIC/OMEG3........................ 74
PNV95/FERROUS FUM/FOLIC ACID........................... 74
PNV95/FERROUS FUM/FOLIC ACID (28MG-0.8MG)
(TABLET) (OTC).............................................................. 74
POCKET CHAMBER....................................................... 15
POCKET PEAK................................................................ 16
PODOFILOX.....................................................................32
PODOPHYLLUM RESIN.................................................32
POLYCAL................................................................... 57, 97
POLYETHYLENE GLYCOL 3350...................................54
POLYMYXIN B SULF/TRIMETHOPRIM......................42
POLYTRIM....................................................................... 42
POLYVINYL ALCOHOL.................................................42
POLYVINYL ALCOHOL/POVIDONE........................... 42
POLYVINYL ALCOHOL/POVIDONE (0.5%-0.6%)
(DROPS) (OTC)................................................................ 42
POMALIDOMIDE............................................................ 55
POMALYST................................................................ 55, 97
PONATINIB HCL............................................................. 56
POT CHLORIDE/POT BICARB/CIT AC........................ 39
POTASSIUM BICARBONATE/CIT AC.......................... 39
POTASSIUM CHLORIDE................................................ 39
POTASSIUM CITRATE....................................................69
POTASSIUM CITRATE/CITRIC ACID...........................69
POTASSIUM HYDROXIDE.............................................32
POTASSIUM IODIDE...................................................... 40
POTASSIUM IODIDE/IODINE........................................40
POTIGA (200 MG) (TABLET)............................. 66, 82, 91
POTIGA (300 MG) (TABLET)............................. 66, 82, 91
POTIGA (400 MG) (TABLET)............................. 66, 82, 91
POTIGA (50 MG) (TABLET)............................... 66, 82, 91
POVIDONE-IODINE........................................................ 33
POVIDONE-IODINE (10 %) (LIQUID PKT) (OTC).......33
POVIDONE-IODINE (10 %) (SOLUTION) (OTC).........33
POVIDONE-IODINE (10 %) (SPRAY) (OTC)................ 33
POVIDONE-IODINE (7.5 %) (SOLUTION) (OTC)........33
PRAMCORT......................................................................53
PRAMIPEXOLE DI-HCL.................................................65
PRAMLINTIDE ACETATE.............................................. 34
PRAMOSONE (1 %-1 %) (LOTION)...............................33
PRAMOSONE (1 %-1 %) (OINT. (G)).............................33
PRAMOSONE (2.5 %-1 %) (CREAM (G))......................33
PRAMOSONE (2.5 %-1 %) (LOTION)............................33
PRAMOSONE (2.5 %-1 %) (OINT. (G))..........................33
PRANDIMET.................................................................... 34
PRASUGREL HCL........................................................... 45
PRAVACHOL.................................................................... 24
PRAVASTATIN SODIUM.................................................24
PRAZIQUANTEL............................................................. 49
PRAZOSIN HCL...............................................................22
PRE-ATTACHED LTA KIT.............................................. 33
PRECISION.......................................................................35
PRECISION GLUCOSE CONTROL............................... 35
PRECISION XTRA (EACH) (OTC).................................37
PRECISION XTRA (STRIP) (OTC).................................35
PRECOSE..........................................................................34
PRED FORTE....................................................................41
PRED MILD......................................................................41
PREDNICARBATE...........................................................30
PREDNISOLONE............................................................. 52
PREDNISOLONE ACETATE...........................................41
PREDNISOLONE SOD PHOSPHATE...................... 41, 52
PREDNISONE.................................................................. 52
PREDNISONE INTENSOL..............................................52
PREFERA OB................................................................... 73
PREFERA-OB ONE..........................................................73
PREFERA-OB PLUS DHA.............................................. 73
PREGABALIN.................................................................. 67
PREMARIN.......................................................................70
PREMARIN (0.3 MG) (TABLET).................................... 46
PREMARIN (0.45MG) (TABLET)................................... 46
PREMARIN (0.625 MG) (TABLET)................................ 46
PREMARIN (0.9 MG) (TABLET).................................... 46
PREMARIN (1.25 MG) (TABLET).................................. 46
PREMESIS RX..................................................................75
PREMPHASE....................................................................46
PREMPRO.........................................................................46
PRENAT VIT 17/IRON/FOLIC/OM3,6............................74
PRENAT VIT COMB.10/IRON/FA/DHA........................ 74
PRENATAL #57/IRON/FA/DSS/DHA............................. 74
PRENATAL COMB NO.42/FOLIC ACID........................74
PRENATAL NO.13/IRON PS/FA CB#1........................... 74
PRENATAL NO.52/IRON/FA/DHA................................. 74
PRENATAL NO.75/IRON/FOLATE #1............................74
PRENATAL VIT #76/IRON,CARB/FA............................ 74
PRENATAL VIT 15/IRON CB/FA/DSS........................... 74
PRENATAL VIT 16/IRON CB/FA/DSS........................... 74
PRENATAL VIT 18/IRON CB/FA/DSS........................... 74
PRENATAL VIT 55/IRON/FOLIC/OM3..........................74
PRENATAL VIT 7-IRON-FOLIC-DHA...........................74
PRENATAL VIT NO.109/IRON/FA................................. 74
PRENATAL VIT NO.127/IRON/FA................................. 75
PRENATAL VIT NO.129/IRON/FA................................. 75
PRENATAL VIT NO.73/IRON/FA................................... 75
PRENATAL VIT NO.78/IRON/FA................................... 75
PRENATAL VIT#4/IRON FUM,PS/FA............................ 75
PRENATAL VIT#86/IRON BISGLY/FA.......................... 75
PRENATAL VIT#96/FERROUS FUM/FA....................... 75
PRENATAL VIT/IRON BISGLYCIN/FA......................... 75
PRENATAL VIT/IRON FUMARATE/FA........................ 75
PRENATAL VIT/IRON FUMARATE/FA (27MG-0.8MG)
(TABLET) (OTC).............................................................. 75
PRENATAL VIT/IRON FUMARATE/FA (28MG-0.8MG)
(TABLET) (OTC).............................................................. 75
PRENATAL VIT/IRON FUMARATE/FA (65 MG-1 MG)
(CAPSULE).......................................................................75
PRENATAL VIT/IRON FUMARATE/FA (66-1MG)
(TABLET)..........................................................................75
PRENATAL VIT100/IRON/FOLIC/OM3.........................75
PRENATAL VIT27,CALCIUM/IRON/FA........................75
PRENATAL VITS#4/IRON FUM/FA............................... 75
PRENATAL64/IRON/LMFOLATE/ALGAL.................... 75
PRENEXA.........................................................................74
PRE-PROTEIN (15 G-60/30) (LIQUID) (OTC)......... 57, 97
PREVACID (15 MG) (CAPSULE DR).............................69
PREVACID (15 MG) (TAB RAP DR)........................ 69, 91
PREVACID (30 MG) (CAPSULE DR).............................69
PREVACID (30 MG) (TAB RAP DR)........................ 69, 91
PREVACID 24HR............................................................. 69
PREVPAC....................................................................68, 82
PREZCOBIX............................................................... 49, 82
PREZISTA (100 MG/ML) (ORAL SUSP)..................49, 82
PREZISTA (150 MG) (TABLET)............................... 49, 82
PREZISTA (600 MG) (TABLET)............................... 49, 82
PREZISTA (75 MG) (TABLET)................................. 49, 82
PREZISTA (800 MG) (TABLET)............................... 49, 82
PRIFTIN............................................................................ 48
PRILOSEC (10 MG) (CAPSULE DR)............................. 69
PRILOSEC (20 MG) (CAPSULE DR)............................. 69
PRILOSEC (20 MG) (TABLET DR) (OTC).....................69
PRILOSEC (40 MG) (CAPSULE DR)............................. 69
PRIMAQUINE.................................................................. 49
PRIMAQUINE PHOSPHATE...........................................49
PRIMEAIRE......................................................................15
PRIMIDONE..................................................................... 67
PRIMSOL.......................................................................... 47
PRINIVIL.......................................................................... 22
PRISTIQ................................................................ 17, 82, 91
PRO COMFORT ALCOHOL PADS.................................31
PROAMATINE..................................................................24
PRO-BANTHINE.............................................................. 68
PROBENECID.................................................................. 43
PROBENECID/COLCHICINE......................................... 43
PROCARBAZINE HCL.................................................... 56
PROCARDIA.................................................................... 23
PROCARDIA XL (30 MG) (TAB ER 24).........................23
PROCARDIA XL (60 MG) (TAB ER 24).........................23
PROCARDIA XL (90 MG) (TAB ER 24).........................23
PROCENTRA..............................................................18, 82
PROCHAMBER................................................................ 15
PROCHLORPERAZINE...................................................14
PROCHLORPERAZINE MALEATE............................... 14
PROCRIT (10000/ML) (VIAL)...................................44, 97
PROCRIT (2000/ML) (VIAL).....................................44, 97
PROCRIT (20000/2ML) (VIAL).................................44, 97
PROCRIT (20000/ML) (VIAL)...................................44, 97
PROCRIT (3000/ML) (VIAL).....................................44, 97
PROCRIT (4000/ML) (VIAL).....................................44, 97
PROCRIT (40000/ML) (VIAL)...................................44, 97
PROCTOFOAM-HC......................................................... 53
PROCYSBI.................................................................. 69, 97
PRODIGY CONTROL SOLUTION................................. 36
PRODIGY LANCING DEVICE....................................... 38
PRODIGY MINI-MIST.....................................................16
PROFILNINE.................................................................... 44
PROGESTERONE.............................................................46
Page 111 of 116
Index
PROGESTERONE, MICRONIZED..................................46
PROLASTIN C..................................................................54
PROLIXIN.........................................................................20
PROLOPRIM.....................................................................47
PROMACTA................................................................45, 97
PROMETHAZINE HCL............................................. 13, 14
PROMETHAZINE HCL/CODEINE.................................27
PROMETHAZINE/DEXTROMETHORPHAN............... 27
PROMETHAZINE/PHENYLEPH/CODEINE................. 26
PROMETRIUM.................................................................46
PROMOTE WITH FIBER (0.06G-1/ML) (LIQUID) (OTC)
..................................................................................... 58, 97
PRONEB ULTRA II.......................................................... 16
PROPAFENONE HCL...................................................... 21
PROPANTHELINE BROMIDE........................................68
PROPARACAINE HCL.................................................... 41
PROPARACAINE/FLUORESCEIN SOD........................ 41
PROPIMEX-2.............................................................. 59, 97
PROPRANOLOL HCL..................................................... 22
PROPRANOLOL/HYDROCHLOROTHIAZID...............23
PROPYLTHIOURACIL.................................................... 40
PROSCAR......................................................................... 69
PROSHIELD FOAM & SPRAY....................................... 33
PROSOM........................................................................... 20
PROSOURCE NO CARB........................................... 57, 97
PROSOURCE PLUS................................................... 57, 97
PROSOURCE ZAC..................................................... 57, 97
PROSTEP.......................................................................... 68
PROTECT CMB2/CERAMIDE 1,3,6-11..........................33
PROTEIN SUPPLEMENT................................................ 58
PROTEIN SUPPLEMENT (LIQUID) (OTC)............. 58, 97
PROTEIN SUPPLEMENT (POWDER) (OTC).......... 58, 97
PROTONIX (20 MG) (TABLET DR)............................... 69
PROTONIX (40 MG) (TABLET DR)............................... 69
PROTRIPTYLINE HCL....................................................18
PROVENTIL..................................................................... 14
PROVERA......................................................................... 46
PROVIGIL................................................................... 20, 97
PROVIMIN........................................................................71
PROZAC............................................................................17
PROZAC WEEKLY.......................................................... 17
PSEUDOEPHED/CHLOR-MAL/BELL ALK..................26
PSEUDOEPHED/CODEINE/GUAIFEN..........................26
PSEUDOEPHEDRINE HCL.......................................26, 28
PSEUDOEPHEDRINE HCL (120 MG) (TABLET ER)
(OTC)...........................................................................26, 28
PSEUDOEPHEDRINE HCL (30 MG) (TABLET) (OTC)
..................................................................................... 26, 28
PSEUDOEPHEDRINE HCL (60 MG) (TABLET) (OTC)
........................................................................................... 28
PSYLLIUM HUSK (WITH SUGAR)...............................54
PSYLLIUM HUSK (WITH SUGAR) (3.4 G/12 G)
(POWDER) (OTC)............................................................ 54
PSYLLIUM HUSK (WITH SUGAR) (3.4 G/7 G)
(POWDER) (OTC)............................................................ 54
PSYLLIUM HUSK/ASPARTAME................................... 54
PSYLLIUM SEED............................................................ 54
PSYLLIUM SEED (3.4G/5.8G) (POWDER) (OTC)........54
PSYLLIUM SEED (POWDER) (OTC)............................ 54
PSYLLIUM SEED (WITH DEXTROSE)........................ 54
PSYLLIUM SEED (WITH SUGAR)................................54
PSYLLIUM SEED/ASPARTAME.................................... 54
PULMICORT (0.25MG/2ML) (AMPUL-NEB)......... 14, 82
PULMICORT (0.5 MG/2ML) (AMPUL-NEB).......... 14, 82
PULMICORT (1 MG/2 ML) (AMPUL-NEB)............ 14, 82
PULMO-AIDE.................................................................. 15
PULMONEB LT COMPRESSOR NEBUL...................... 16
PULMOZYME............................................................ 61, 97
PUREVIT DUALFE PLUS............................................... 71
PURINETHOL.................................................................. 55
PURIXAN....................................................................55, 91
PV W-O CAL/IRON PS CPLX/FOLIC............................ 75
PYRAZINAMIDE............................................................. 48
PYRIDIUM........................................................................69
PYRIDOSTIGMINE BROMIDE...................................... 17
PYRIDOXINE HCL (VITAMIN B6)................................76
PYRIDOXINE HCL (VITAMIN B6) (100 MG) (TABLET)
(OTC).................................................................................76
PYRIDOXINE HCL (VITAMIN B6) (100 MG/ML)
(VIAL)............................................................................... 76
PYRIDOXINE HCL (VITAMIN B6) (25 MG) (TABLET)
(OTC).................................................................................76
PYRIDOXINE HCL (VITAMIN B6) (50 MG) (TABLET)
(OTC).................................................................................76
PYRIMETHAMINE..........................................................49
-QQNASL.................................................................. 13, 82, 91
QUAKE..............................................................................15
QUALAQUIN....................................................................49
QUARTETTE.................................................................... 25
QUAZEPAM......................................................................20
VNSNY
QUDEXY XR (100 MG) (CAP SPR 24).............. 67, 82, 91
QUDEXY XR (150 MG) (CAP SPR 24).............. 67, 82, 91
QUDEXY XR (200 MG) (CAP SPR 24).............. 67, 82, 91
QUDEXY XR (25 MG) (CAP SPR 24)................ 67, 82, 91
QUDEXY XR (50 MG) (CAP SPR 24)................ 67, 82, 91
QUESTRAN...................................................................... 24
QUESTRAN LIGHT......................................................... 24
QUETIAPINE FUMARATE............................................. 19
QUICK-SET PARADIGM................................................ 37
QUILLIVANT XR (5 MG/ML) (SU ER RC24)...... 21, 82,
91
QUINAGLUTE..................................................................21
QUINAPRIL HCL............................................................. 22
QUINAPRIL/HYDROCHLOROTHIAZIDE.................... 21
QUINIDINE GLUCONATE..............................................21
QUINIDINE SULFATE.....................................................21
QUININE SULFATE.........................................................49
QUINORA......................................................................... 21
-RRABEPRAZOLE SODIUM..............................................69
RADIAGEL....................................................................... 60
RADIAPLEXRX............................................................... 32
RAGWITEK................................................................ 13, 97
RALOXIFENE HCL......................................................... 40
RALTEGRAVIR POTASSIUM...................................50, 51
RAMELTEON................................................................... 20
RAMIPRIL........................................................................ 22
RANEXA (1000 MG) (TAB ER 12H)........................ 24, 82
RANEXA (500 MG) (TAB ER 12H).......................... 24, 82
RANITIDINE HCL........................................................... 69
RANOLAZINE..................................................................24
RAPAMUNE (1 MG/ML) (SOLUTION)......................... 46
RASAGILINE MESYLATE..............................................65
RASUVO (10MG/0.2ML) (AUTO INJCT).......... 51, 82, 91
RASUVO (12.5/0.25) (AUTO INJCT)..................51, 82, 91
RASUVO (15MG/0.3ML) (AUTO INJCT).......... 51, 82, 91
RASUVO (17.5/0.35) (AUTO INJCT)..................51, 82, 91
RASUVO (20MG/0.4ML) (AUTO INJCT).......... 51, 82, 91
RASUVO (22.5/0.45) (AUTO INJCT)..................51, 82, 91
RASUVO (25MG/0.5ML) (AUTO INJCT).......... 51, 82, 91
RASUVO (27.5/0.55) (AUTO INJCT)..................51, 82, 91
RASUVO (30MG/0.6ML) (AUTO INJCT).......... 51, 82, 92
RASUVO (7.5MG/0.15) (AUTO INJCT)............. 51, 82, 92
RAVICTI......................................................................53, 97
RAZADYNE (12 MG) (TABLET)..............................17, 82
RAZADYNE (4 MG) (TABLET)................................17, 82
RAZADYNE (4 MG/ML) (SOLUTION)....................17, 82
RAZADYNE (8 MG) (TABLET)................................17, 82
RAZADYNE ER......................................................... 17, 82
REA LO 39........................................................................ 32
REA LO 40........................................................................ 32
REBETOL (200 MG) (CAPSULE)...................................51
REBETOL (40 MG/ML) (SOLUTION)........................... 51
REBIF.......................................................................... 56, 97
REBIF REBIDOSE..................................................... 56, 97
RECOMBINATE............................................................... 43
RECTAGEL HC................................................................ 53
REFRESH LACRI-LUBE................................................. 43
REFRESH P.M.................................................................. 43
REFUAH PLUS GLUCOSE CONTROL..........................35
REGENECARE.................................................................33
REGLAN........................................................................... 69
REGORAFENIB............................................................... 56
REGRANEX......................................................................38
RELAFEN......................................................................... 52
RELIAMED MINI LANCING DEVICE..........................38
REMERON........................................................................ 17
REMODULIN............................................................. 23, 97
RENA START............................................................. 60, 97
RENAGEL......................................................................... 39
RENVELA.........................................................................39
REPAGLINIDE................................................................. 34
REPAGLINIDE/METFORMIN HCL............................... 34
REPATHA PUSHTRONEX........................................ 24, 97
REPATHA SURECLICK............................................ 24, 97
REPATHA SYRINGE................................................. 24, 97
REPREXAIN.....................................................................62
REQUIP.............................................................................65
REQUIP XL...........................................................65, 82, 92
RESCRIPTOR................................................................... 50
RESERPINE...................................................................... 22
RESOURCE THICKENUP (POWDER) (OTC)...............61
RESTORE SKIN CLEANSER..........................................33
RESTORE SKIN CONDITIONING................................. 31
RESTORE WOUND CLEANSER....................................34
RESTORIL........................................................................ 20
RETIN-A........................................................................... 28
RETIN-A MICRO............................................................. 28
RETIN-A MICRO PUMP (0.04 %) (GEL W/PUMP)......
28
RETIN-A MICRO PUMP (0.1 %) (GEL W/PUMP)........ 28
RETROVIR (10 MG/ML) (SYRUP)........................... 50, 82
RETROVIR (100 MG) (CAPSULE)........................... 50, 82
RETROVIR (300 MG) (TABLET).............................. 50, 82
REVATIO (10 MG/ML) (SUSP RECON)...................23, 97
REVATIO (20 MG) (TABLET)................................... 23, 97
REVEL PROGRAMMABLE PUMP................................ 38
REVIA............................................................................... 20
REVITADERM................................................................. 28
REVLIMID............................................................55, 82, 97
REYATAZ (150 MG) (CAPSULE)............................. 50, 82
REYATAZ (200 MG) (CAPSULE)............................. 50, 83
REYATAZ (300 MG) (CAPSULE)............................. 50, 83
REYATAZ (50 MG) (POWD PACK).......................... 50, 83
RIBAVIRIN................................................................. 49, 51
RIDAURA......................................................................... 52
RIFABUTIN...................................................................... 48
RIFADIN........................................................................... 48
RIFAMATE........................................................................48
RIFAMPIN........................................................................ 48
RIFAMPIN/ISONIAZID................................................... 48
RIFAPENTINE..................................................................48
RIFAXIMIN...................................................................... 49
RIGHTEST CONTROL SOLUTION......................... 36, 37
RIGHTEST GC250S CONTROL SOLN.......................... 37
RIGHTEST GD500........................................................... 38
RILONACEPT...................................................................51
RILPIVIRINE HCL...........................................................50
RILUTEK.......................................................................... 56
RILUZOLE........................................................................56
RIMANTADINE HCL...................................................... 49
RIMIFON.......................................................................... 48
RINGERS SOLUTION..................................................... 32
RIOCIGUAT...................................................................... 23
RIOMET............................................................................ 34
RISPERDAL (0.25 MG) (TABLET)........................... 19, 83
RISPERDAL (0.5 MG) (TABLET)............................. 19, 83
RISPERDAL (1 MG) (TABLET)................................ 19, 83
RISPERDAL (1 MG/ML) (SOLUTION)....................19, 83
RISPERDAL (2 MG) (TABLET)................................ 19, 83
RISPERDAL (3 MG) (TABLET)................................ 19, 83
RISPERDAL (4 MG) (TABLET)................................ 20, 83
RISPERDAL CONSTA............................................... 20, 83
RISPERDAL M-TAB.................................................. 20, 83
RISPERIDONE........................................................... 19, 20
RISPERIDONE MICROSPHERES.................................. 20
RISPERIDONE ODT.................................................. 20, 83
RITALIN......................................................................21, 83
RITALIN LA (10 MG) (CPBP 50-50).................. 21, 77, 83
RITALIN LA (20 MG) (CPBP 50-50).................. 21, 77, 83
RITALIN LA (30 MG) (CPBP 50-50).................. 21, 77, 83
RITALIN LA (40 MG) (CPBP 50-50).................. 21, 77, 83
RITALIN-SR......................................................... 21, 77, 83
RITEFLO...........................................................................15
RITONAVIR...................................................................... 50
RIVAROXABAN...............................................................44
RIVASTIGMINE............................................................... 17
RIVASTIGMINE TARTRATE.......................................... 17
RIXUBIS........................................................................... 44
RIZATRIPTAN BENZOATE............................................ 64
RMS...................................................................................63
ROBAXIN......................................................................... 67
ROBAXIN-750.................................................................. 67
ROBINUL..........................................................................68
ROBINUL FORTE............................................................ 68
ROCALTROL.................................................................... 76
ROFLUMILAST............................................................... 15
ROPINIROLE HCL...........................................................65
ROSADAN........................................................................ 28
ROSUVASTATIN CALCIUM...........................................24
ROTIGOTINE....................................................................65
ROWASA...........................................................................53
ROWEEPRA......................................................................66
ROXANOL........................................................................ 63
ROXICET.................................................................... 64, 83
ROXICODONE................................................................. 63
ROZEREM............................................................ 20, 83, 92
RUBBING ALCOHOL (70 %) (SOLUTION) (OTC)......
61
RUCONEST................................................................ 52, 97
RUFINAMIDE.................................................................. 67
RUXOLITINIB PHOSPHATE.......................................... 55
RYTHMOL........................................................................21
RYTHMOL SR..................................................................21
RYZOLT............................................................................ 64
-SSABRIL....................................................................... 67, 83
SACROSIDASE................................................................ 68
SACUBITRIL/VALSARTAN............................................24
SAFE-CLIP........................................................................38
SAFYRAL................................................................... 25, 92
SALAGEN.........................................................................54
Page 112 of 116
Index
SALICYLIC ACID............................................................32
SALICYLIC ACID (26 %) (LIQUID).............................. 32
SALICYLIC ACID (27.5 %) (LIQ-FILM)........................32
SALICYLIC ACID (6 %) (CREAM (G))......................... 32
SALICYLIC ACID (6 %) (CRM ER (G)).........................32
SALICYLIC ACID (6 %) (GEL (GRAM)).......................32
SALICYLIC ACID (6 %) (LOTION ER)......................... 32
SALICYLIC ACID (6 %) (LOTION)............................... 32
SALICYLIC ACID (6 %) (SHAMPOO)...........................32
SALICYLIC ACID/CERAMIDE CMB #1....................... 32
SALICYLIC ACID/CERAMIDE CMB #1 (6 %)
(COMBO. PKG)................................................................ 32
SALSALATE.....................................................................61
SAMI THE SEAL..............................................................16
SANDIMMUNE (100 MG/ML) (SOLUTION)................46
SANDRIL.......................................................................... 22
SAPHRIS...............................................................19, 83, 92
SAPROPTERIN DIHYDROCHLORIDE......................... 60
SAQUINAVIR MESYLATE............................................. 50
SARAFEM........................................................................ 17
SARGRAMOSTIM........................................................... 45
SAVELLA..........................................................................56
SCALACORT.................................................................... 30
SCALACORT DK............................................................. 30
SEASONALE.............................................................. 25, 83
SEASONIQUE............................................................ 25, 83
SECOBARBITAL SODIUM.............................................20
SECONAL SODIUM........................................................ 20
SECUKINUMAB.............................................................. 33
SELEGILINE.................................................................... 20
SELEGILINE HCL........................................................... 65
SELENIUM SULFIDE......................................................30
SELENIUM SULFIDE (2.25 %) (SHAMPOO)............... 30
SELEXIPAG...................................................................... 23
SELSUN............................................................................ 30
SELZENTRY (150 MG) (TABLET)........................... 49, 83
SELZENTRY (25 MG) (TABLET)............................. 49, 83
SELZENTRY (300 MG) (TABLET)........................... 49, 83
SELZENTRY (75 MG) (TABLET)............................. 49, 83
SENNOSIDES...................................................................54
SENOKOT (8.6 MG) (TABLET) (OTC)...........................54
SENSI-CARE.................................................................... 31
SENSIPAR.........................................................................40
SERAX.............................................................................. 18
SEROMYCIN.................................................................... 48
SEROQUEL.................................................................19, 83
SEROQUEL XR (150 MG) (TAB ER 24H)................19, 83
SEROQUEL XR (200 MG) (TAB ER 24H)................19, 83
SEROQUEL XR (300 MG) (TAB ER 24H)................19, 83
SEROQUEL XR (400 MG) (TAB ER 24H)................19, 83
SEROQUEL XR (50 MG) (TAB ER 24H)..................19, 83
SEROSTIM..................................................................40, 97
SERTRALINE HCL.......................................................... 17
SERZONE......................................................................... 17
SEVELAMER CARBONATE.......................................... 39
SEVELAMER HCL.......................................................... 39
SFROWASA...................................................................... 53
SIDESTREAM (EACH)....................................................16
SIDESTREAM NEBULIZER........................................... 16
SIDESTREAM PEDIATRIC.............................................15
SIDESTREAM PLUS....................................................... 16
SIGNIFOR...................................................................61, 97
SILDENAFIL CITRATE...................................................23
SILENOR.............................................................. 20, 83, 92
SILICONE DISC............................................................... 31
SILICONE MASK.............................................................15
SILICONE ROLL..............................................................31
SILICONE SCAR..............................................................31
SILICONE SHEET (COMBO. PKG) (OTC)....................31
SILICONE TAPE.............................................................. 31
SILICONES/ADHESIVE TAPE....................................... 31
SIL-SERTER..................................................................... 37
SILVADENE......................................................................29
SILVASORB...................................................................... 28
SILVER..............................................................................28
SILVER CHLORIDE........................................................ 28
SILVER NITRATE...................................................... 28, 32
SILVER NITRATE APPLICATOR...................................32
SILVER SULFADIAZINE................................................ 29
SILVER/SODIUM ALGINATE........................................ 28
SILVERMED (GEL ER(ML)) (OTC)............................... 28
SIMBRINZA..................................................................... 42
SIMPLYTHICK.................................................................61
SIMPONI.....................................................................51, 97
SIMVASTATIN..................................................................24
SINEMET 10-100..............................................................65
SINEMET 25-100..............................................................65
SINEMET 25-250..............................................................65
SINEMET CR....................................................................65
SINEQUAN....................................................................... 18
SINGLE USE SWAB........................................................ 31
SINGULAIR......................................................................15
VNSNY
SIROLIMUS...................................................................... 46
SIRTURO.....................................................................48, 97
SITAGLIPTIN PHOS/METFORMIN HCL...................... 34
SITAGLIPTIN PHOSPHATE............................................34
SIVEXTRO..................................................................47, 97
SKIN CLEANSER............................................................ 33
SKIN CLEANSER COMB NO.20....................................33
SKIN CLEANSER COMB NO.21....................................34
SKIN CLEANSER COMB NO.34....................................33
SLO-PHYLLIN................................................................. 16
SMARTDIABETES VANTAGE....................................... 38
SMARTEST.......................................................................37
SOD PHOS DI, MONO/K PHOS MONO........................ 69
SOD/POT/K CIT/SOD CIT/CIT ACID.............................69
SODIUM BICARBONATE...............................................68
SODIUM BICARBONATE (650 MG) (TABLET) (OTC)
........................................................................................... 68
SODIUM CHLORIDE................................................ 42, 59
SODIUM CHLORIDE (0.65 %) (DROPS) (OTC)........... 59
SODIUM CHLORIDE (0.65 %) (SPRAY) (OTC)............59
SODIUM CHLORIDE 0.45 %.......................................... 39
SODIUM CHLORIDE IRRIG SOLUTION..................... 32
SODIUM CHLORIDE IRRIG SOLUTION (0.9 %)
(IRRIG SOLN).................................................................. 32
SODIUM CHLORIDE/NAHCO3/KCL/PEG................... 54
SODIUM CITRATE.................................................... 31, 43
SODIUM CITRATE (4 G/100 ML) (SOLUTION)...........43
SODIUM FLUORIDE.......................................................70
SODIUM FLUORIDE/POTASSIUM NIT........................70
SODIUM PHENYLBUTYRATE...................................... 53
SODIUM POLYSTYRENE SULFON/SORB.................. 39
SODIUM POLYSTYRENE SULFONATE.......................39
SODIUM SULAMYD.......................................................41
SODIUM THIOSULFATE/SAL ACID.............................29
SOF-LAX.......................................................................... 54
SOFOSBUVIR.................................................................. 51
SOFOSBUVIR/VELPATASVIR....................................... 51
SOF-SERTER.................................................................... 37
SOLARAZE.......................................................... 33, 83, 97
SOLIFENACIN SUCCINATE...........................................69
SOLTAMOX...................................................................... 56
SOLUS V2 CONTROL SOLUTION................................ 36
SOLUS V2 LANCING DEVICE...................................... 38
SOMA................................................................................67
SOMA COMPOUND........................................................67
SOMATROPIN.................................................................. 40
SOMAVERT...................................................................... 40
SONATA...................................................................... 20, 83
SONIDEGIB PHOSPHATE.............................................. 55
SOOTHE & COOL PERINEAL WASH (LIQ. SOAP)
(OTC).................................................................................31
SORAFENIB TOSYLATE................................................ 56
SORBITOL SOLUTION...................................................32
SORIATANE..................................................................... 33
SOTALOL HCL.................................................................22
SOVALDI.................................................................... 51, 97
SOY PROTEIN............................................................ 58, 97
SPECTAZOLE...................................................................29
SPECTRACEF...................................................................47
SPIRIVA RESPIMAT.................................................. 14, 83
SPIROMETERS AND ACCESSORIES ........................... 16
SPIRONOLACT/HYDROCHLOROTHIAZID.................23
SPIRONOLACTONE........................................................ 23
SPORANOX (10 MG/ML) (SOLUTION)........................ 48
SPORANOX (100 MG) (CAPSULE)............................... 48
SPRYCEL (100 MG) (TABLET).......................... 55, 83, 97
SPRYCEL (140 MG) (TABLET).......................... 55, 83, 97
SPRYCEL (20 MG) (TABLET)............................ 55, 83, 97
SPRYCEL (50 MG) (TABLET)............................ 55, 83, 97
SPRYCEL (70 MG) (TABLET)............................ 56, 83, 97
SPRYCEL (80 MG) (TABLET)............................ 56, 83, 97
STADOL............................................................................62
STALEVO 100...................................................................65
STALEVO 125...................................................................65
STALEVO 150...................................................................65
STALEVO 200...................................................................65
STALEVO 50.....................................................................65
STALEVO 75.....................................................................65
STANNOUS FLUORIDE..................................................70
STARCH............................................................................61
STARLIX...........................................................................34
STAVUDINE..................................................................... 50
STAVUDINE (1 MG/ML) (SOLN RECON).............. 50, 83
STAVUDINE (15 MG) (CAPSULE)...........................50, 83
STAVUDINE (20 MG) (CAPSULE)...........................50, 83
STAVUDINE (30 MG) (CAPSULE)...........................50, 83
STAVUDINE (40 MG) (CAPSULE)...........................50, 83
STELAZINE......................................................................20
STERITALC...................................................................... 56
STIOLTO RESPIMAT.................................................14, 83
STIVARGA............................................................56, 83, 97
STRATTERA (10 MG) (CAPSULE).......................... 21, 83
STRATTERA (100 MG) (CAPSULE)........................ 21, 83
STRATTERA (18 MG) (CAPSULE).......................... 21, 83
STRATTERA (25 MG) (CAPSULE).......................... 21, 83
STRATTERA (40 MG) (CAPSULE).......................... 21, 83
STRATTERA (60 MG) (CAPSULE).......................... 21, 83
STRATTERA (80 MG) (CAPSULE).......................... 21, 83
STRENSIQ.................................................................. 59, 97
STRESS FORMULA WITH ZINC...................................72
STRIBILD................................................................... 51, 83
STRIVERDI RESPIMAT............................................ 14, 83
STROMECTOL.................................................................49
SUBCUTANEOUS INSULIN PUMP...............................38
SUBOXONE (12 MG-3 MG) (FILM).........................65, 83
SUBOXONE (2 MG-0.5MG) (FILM).........................65, 83
SUBOXONE (2 MG-0.5MG) (TAB SUBL)............... 65, 83
SUBOXONE (4MG-1MG) (FILM).............................65, 83
SUBOXONE (8 MG-2 MG) (FILM)...........................65, 83
SUBOXONE (8 MG-2 MG) (TAB SUBL)................. 65, 83
SUB-Q INSULIN DEVICE, 20 UNIT.............................. 38
SUB-Q INSULIN DEVICE, 30 UNIT.............................. 38
SUB-Q INSULIN DEVICE, 40 UNIT.............................. 38
SUBUTEX...................................................................64, 83
SUCRAID....................................................................68, 97
SUCRALFATE.................................................................. 68
SULCONAZOLE NITRATE.............................................29
SULFACETAMIDE SODIUM.................................... 30, 41
SULFACETAMIDE SODIUM (10 %) (CLNSR GEL)......
30
SULFACETAMIDE/PREDNISOLONE........................... 41
SULFACETAMIDE/PREDNISOLONE SP...................... 41
SULFADIAZINE...............................................................53
SULFAMETHOXAZOLE/TRIMETHOPRIM................. 46
SULFANILAMIDE........................................................... 70
SULFASALAZINE........................................................... 53
SULFATRIM..................................................................... 46
SULINDAC....................................................................... 53
SUMATRIPTAN................................................................64
SUMATRIPTAN SUCCINATE.........................................64
SUMYCIN.........................................................................48
SUNITINIB MALATE...................................................... 56
SUNRISE COMPRESSOR-NEBULIZER........................15
SUPLENA CARB STEADY (0.04G-1.79) (LIQUID)
(OTC)...........................................................................60, 97
SUPPRELIN LA................................................................40
SUPRAX (100 MG) (TAB CHEW).................................. 47
SUPRAX (100 MG/5ML) (SUSP RECON)......................47
SUPRAX (200 MG) (TAB CHEW).................................. 47
SUPRAX (200 MG/5ML) (SUSP RECON)......................47
SUPRAX (400 MG) (CAPSULE)..................................... 47
SUPRAX (500 MG/5ML) (SUSP RECON)......................47
SURE COMFORT ALCOHOL.........................................31
SURE COMFORT LANCING PEN................................. 38
SUREFLEX....................................................................... 38
SURE-PEN........................................................................ 38
SURE-PREP ALCOHOL PREP PADS.............................31
SURE-T PARADIGM (INFUS.SET)................................ 37
SURE-TEST EASYPLUS MINI.......................................37
SURMONTIL.................................................................... 18
SUSTIVA........................................................................... 50
SUTENT................................................................ 56, 83, 97
SUVOREXANT................................................................ 20
SYLATRON.................................................................55, 83
SYMAX.............................................................................68
SYMAX-SL.......................................................................68
SYMAX-SR.......................................................................68
SYMBYAX..................................................................20, 83
SYMLINPEN 120............................................................. 34
SYMLINPEN 60............................................................... 34
SYMMETREL...................................................................65
SYNAGIS.................................................................... 49, 97
SYNALAR.........................................................................30
SYNALGOS-DC............................................................... 62
SYNAREL......................................................................... 40
SYNJARDY...........................................................34, 83, 92
SYNRIBO....................................................................56, 97
-TTAB A VITE ......................................................................72
TABLOID.......................................................................... 55
TACLONEX (0.005-.064) (OINT. (G)).......................34, 92
TACROLIMUS................................................ 34, 46, 77, 92
TADALAFIL..................................................................... 23
TAFINLAR..................................................................55, 97
TAGAMET........................................................................ 68
TAGAMET HB..................................................................68
TAGRISSO............................................................ 56, 83, 97
TAKE ACTION................................................................. 25
TALC................................................................................. 56
TALWIN NX..................................................................... 64
TAMBOCOR..................................................................... 21
TAMIFLU (30 MG) (CAPSULE)............................... 49, 83
TAMIFLU (45 MG) (CAPSULE)............................... 49, 83
Page 113 of 116
Index
TAMIFLU (6 MG/ML) (SUSP RECON)....................49, 83
TAMIFLU (75 MG) (CAPSULE)............................... 49, 83
TAMOXIFEN CITRATE...................................................56
TAMSULOSIN HCL.........................................................69
TANDEM PLUS................................................................71
TAPAZOLE....................................................................... 40
TAPENTADOL HCL.........................................................64
TARCEVA (100 MG) (TABLET)..........................56, 83, 97
TARCEVA (150 MG) (TABLET)..........................56, 83, 97
TARCEVA (25 MG) (TABLET)............................56, 83, 97
TARGRETIN......................................................... 33, 56, 97
TARKA..............................................................................21
TASIGNA.............................................................. 56, 83, 97
TASIMELTEON................................................................ 20
TAVIST.............................................................................. 13
TAVIST-1........................................................................... 13
TAZAROTENE..................................................................33
TAZORAC......................................................................... 33
TBO-FILGRASTIM.......................................................... 45
TD GOLD LEVEL 1 CONTROL SOL............................. 36
TD GOLD LEVEL 2 CONTROL SOL............................. 37
TD GOLD LEVEL 3 CONTROL SOL............................. 36
TEARS NATURALE FORTE........................................... 42
TECFIDERA............................................................... 56, 97
TEDIZOLID PHOSPHATE...............................................47
TEDUGLUTIDE............................................................... 54
TEGRETOL (100 MG) (TAB CHEW)..............................65
TEGRETOL XR (100 MG) (TAB ER 12H)......................65
TELCARE CONTROL SOLUTION.................................35
TELITHROMYCIN...........................................................47
TELMISARTAN................................................................22
TEMAZEPAM...................................................................20
TEMODAR..................................................................55, 97
TEMOVATE...................................................................... 29
TEMOVATE E................................................................... 30
TEMOZOLOMIDE........................................................... 55
TENOFOVIR DISOPROXIL FUMARATE......................50
TENORETIC 100.............................................................. 22
TENORETIC 50................................................................ 22
TENORMIN...................................................................... 22
TERAZOL 3...................................................................... 70
TERAZOL 7...................................................................... 70
TERAZOSIN HCL............................................................ 22
TERBINAFINE HCL.................................................. 29, 48
TERBUTALINE SULFATE.............................................. 14
TERCONAZOLE.............................................................. 70
TERIFLUNOMIDE...........................................................56
TERIPARATIDE............................................................... 40
TESSALON.......................................................................26
TESSALON PERLE..........................................................26
TESTIM.......................................................................45, 97
TESTOSTERONE............................................................. 45
TESTOSTERONE CYPIONATE...................................... 45
TESTOSTERONE ENANTHATE.................................... 45
TESTOSTERONE UNDECANOATE.............................. 45
TESTRED....................................................................45, 97
TETCAINE........................................................................41
TETRABENAZINE...........................................................56
TETRACAINE HCL......................................................... 41
TETRACAINE HCL/PF....................................................41
TETRACAINE HYDROCHLORIDE............................... 41
TETRACYCLINE HCL.................................................... 48
TEXACORT...................................................................... 30
THALIDOMIDE............................................................... 48
THALOMID.......................................................... 48, 83, 97
THEO-24........................................................................... 16
THEO-DUR.......................................................................16
THEOPHYLLINE ANHYDROUS................................... 16
THERMAZENE................................................................ 29
THIAMINE HCL...............................................................76
THIAMINE HCL (100 MG) (TABLET) (OTC)............... 76
THIAMINE HCL (100 MG/ML) (VIAL)......................... 76
THIAMINE HCL (50 MG) (TABLET) (OTC)................. 76
THIAMINE MONONITRATE..........................................76
THICK NOW.....................................................................61
THICKENUP...............................................................57, 61
THICKENUP (0.03 G-0.7) (LIQUID) (OTC)...................57
THICK-IT.......................................................................... 61
THICK-IT #2..................................................................... 61
THIK & CLEAR (PACKET) (OTC)................................. 61
THIK & CLEAR (POWDER) (OTC)................................61
THIOGUANINE................................................................55
THIORIDAZINE HCL...................................................... 20
THIOTHIXENE.................................................................20
THORAZINE.................................................................... 20
THRESHOLD IMT........................................................... 16
THRESHOLD PEP............................................................16
THROMBIN (BOVINE)....................................................45
THYROID,PORK........................................................40, 41
TIAGABINE HCL.................................................67, 83, 92
TIAZAC.............................................................................23
TICAGRELOR.................................................................. 45
VNSNY
TICLID.............................................................................. 45
TICLOPIDINE HCL......................................................... 45
TIGAN...............................................................................14
TIKOSYN..........................................................................21
TIMOLOL......................................................................... 42
TIMOLOL MALEATE................................................22, 42
TIMOPTIC........................................................................ 42
TIMOPTIC-XE..................................................................42
TINIDAZOLE................................................................... 49
TIOTROPIUM BR/OLODATEROL HCL........................ 14
TIOTROPIUM BROMIDE................................................14
TIPRANAVIR....................................................................49
TIPRANAVIR/VITAMIN E TPGS................................... 49
TIVICAY..................................................................... 50, 83
TIZANIDINE HCL........................................................... 67
TOBI............................................................................ 48, 97
TOBI PODHALER......................................................48, 97
TOBRADEX (0.3 %-0.1%) (DROPS SUSP).................... 41
TOBRADEX (0.3 %-0.1%) (OINT. (G)).......................... 41
TOBRAMYCIN.......................................................... 42, 48
TOBRAMYCIN IN 0.225% NACL.................................. 48
TOBRAMYCIN/DEXAMETHASONE............................41
TOBRAMYCIN/LOTEPRED ETAB................................ 41
TOBREX (0.3 %) (DROPS).............................................. 42
TOBREX (0.3 %) (OINT. (G)).......................................... 42
TOCILIZUMAB................................................................52
TOFACITINIB CITRATE................................................. 52
TOFRANIL........................................................................18
TOFRANIL-PM................................................................ 18
TOLAZAMIDE................................................................. 34
TOLBUTAMIDE............................................................... 34
TOLECTIN........................................................................53
TOLECTIN DS..................................................................53
TOLINASE (250 MG) (TABLET).................................... 34
TOLMETIN SODIUM...................................................... 53
TOLNAFTATE.................................................................. 29
TOLNAFTATE (1 %) (AERO POWD) (OTC)..................29
TOLNAFTATE (1 %) (CREAM (G)) (OTC).................... 29
TOLNAFTATE (1 %) (PACKET) (OTC).......................... 29
TOLNAFTATE (1 %) (POWDER) (OTC)........................ 29
TOLNAFTATE (1 %) (SOLUTION) (OTC)..................... 29
TOLTERODINE TARTRATE........................................... 69
TOPAMAX........................................................................ 67
TOPICORT (0.05 %) (CREAM (G)).................................30
TOPICORT (0.25 %) (CREAM (G)).................................30
TOPIRAMATE.................................................................. 67
TOPIRAMATE (100 MG) (CAP SPR 24)............ 67, 83, 92
TOPIRAMATE (100 MG) (TABLET).............................. 67
TOPIRAMATE (15 MG) (CAP SPRINK)........................ 67
TOPIRAMATE (150 MG) (CAP SPR 24)............ 67, 83, 92
TOPIRAMATE (200 MG) (CAP SPR 24)............ 67, 83, 92
TOPIRAMATE (200 MG) (TABLET).............................. 67
TOPIRAMATE (25 MG) (CAP SPR 24).............. 67, 83, 92
TOPIRAMATE (25 MG) (CAP SPRINK)........................ 67
TOPIRAMATE (25 MG) (TABLET)................................ 67
TOPIRAMATE (50 MG) (CAP SPR 24).............. 67, 83, 92
TOPIRAMATE (50 MG) (TABLET)................................ 67
TOPOTECAN HCL...........................................................55
TOPROL XL......................................................................22
TORADOL (10 MG) (TABLET).......................................52
TORADOL (15 MG/ML) (CARTRIDGE)........................52
TORADOL (15 MG/ML) (VIAL).....................................52
TORADOL (30 MG/ML) (CARTRIDGE)........................52
TORADOL (30 MG/ML) (VIAL).....................................52
TORADOL (30MG/ML(1)) (VIAL)................................. 52
TORADOL (60 MG/2 ML) (VIAL)..................................52
TOREMIFENE CITRATE.................................................56
TORSEMIDE.................................................................... 23
TOUJEO SOLOSTAR................................................. 39, 83
TOVIAZ.......................................................................69, 92
TRACLEER.................................................................23, 97
TRADJENTA...............................................................34, 83
TRAMADOL HCL............................................................64
TRAMADOL HCL/ACETAMINOPHEN.........................64
TRAMETINIB DIMETHYL SULFOXIDE......................55
TRANDATE...................................................................... 22
TRANDOLAPRIL.............................................................22
TRANDOLAPRIL/VERAPAMIL HCL............................21
TRANEXAMIC ACID...................................................... 43
TRANXENE T-TAB..........................................................18
TRANYLCYPROMINE SULFATE..................................17
TRAVATAN Z..............................................................42, 83
TRAVOPROST.................................................................. 42
TRAZODONE HCL..........................................................17
TRECATOR.......................................................................48
TREK S COMBO PACK...................................................16
TREK S COMPACT COMPRESSOR.............................. 16
TRENTAL......................................................................... 44
TREPROSTINIL............................................................... 23
TREPROSTINIL DIOLAMINE........................................23
TREPROSTINIL SODIUM...............................................23
TREPROSTINIL/NEB ACCESSORIES...........................23
TREPROSTINIL/NEBULIZER/ACCESOR.....................23
TRETINOIN...................................................................... 28
TRETINOIN MICROSPHERES....................................... 28
TRETTEN..........................................................................44
TREXALL (10 MG) (TABLET)....................................... 55
TREXALL (15 MG) (TABLET)....................................... 55
TREXALL (2.5 MG) (TABLET)...................................... 55
TREXALL (5 MG) (TABLET)......................................... 55
TREXALL (7.5 MG) (TABLET)...................................... 55
TRIAD............................................................................... 58
TRIAMCINOLONE ACETONIDE............................ 30, 57
TRIAMTERENE/HYDROCHLOROTHIAZID................23
TRIAVIL 2-10....................................................................17
TRIAVIL 2-25....................................................................17
TRIAVIL 4-25....................................................................17
TRIAVIL 4-50....................................................................18
TRIAZOLAM....................................................................20
TRICITRATES.................................................................. 69
TRICOR.............................................................................24
TRIFLUOPERAZINE HCL.............................................. 20
TRIFLURIDINE................................................................41
TRIFLURIDINE/TIPIRACIL HCL.................................. 55
TRIGLIDE...................................................................24, 92
TRIHEXYPHENIDYL HCL............................................. 65
TRILAFON........................................................................20
TRILEPTAL...................................................................... 66
TRILIPIX...........................................................................24
TRIMETHOBENZAMIDE HCL...................................... 14
TRIMETHOPRIM.............................................................47
TRIMIPRAMINE MALEATE.......................................... 18
TRINATAL RX 1...............................................................75
TRINTELLIX........................................................ 17, 83, 92
TRIPROLIDINE/PSEUDOEPHEDRINE......................... 26
TRIPROLIDINE/PSEUDOEPHEDRINE (2.5MG-60MG)
(TABLET) (OTC).............................................................. 26
TRIUMEQ................................................................... 51, 83
TRIVORA..........................................................................25
TRIZIVIR.................................................................... 49, 83
TROKENDI XR (100 MG) (CAP ER 24H).......... 67, 83, 92
TROKENDI XR (200 MG) (CAP ER 24H).......... 67, 83, 92
TROKENDI XR (25 MG) (CAP ER 24H)............ 67, 84, 92
TROKENDI XR (50 MG) (CAP ER 24H)............ 67, 84, 92
TROPICAMIDE................................................................ 42
TRUE METRIX...........................................................36, 37
TRUECONTROL.............................................................. 36
TRUEDRAW..................................................................... 38
TRUETEST GLUCOSE CONTROL.......................... 36, 37
TRULICITY.......................................................... 34, 84, 92
TRUSOPT..........................................................................42
TRUVADA...................................................................49, 84
TRUZONE PEAK FLOW METER (EACH).................... 16
TUMS (300MG(750)) (TAB CHEW) (OTC)....................68
TUMS SMOOTHIES........................................................ 68
TUMS X-STR....................................................................68
TUSNEL C........................................................................ 26
TUSSIGON........................................................................27
TUSSIONEX..................................................................... 26
TWOCAL HN (0.08G-2/ML) (LIQUID) (OTC).........57, 97
TYBOST......................................................................51, 84
TYKERB..................................................................... 56, 97
TYLENOL.........................................................................62
TYLENOL EXTRA STRENGTH.....................................62
TYLENOL WITH CODEINE (120-12MG/5)
(SOLUTION).....................................................................64
TYLENOL-CODEINE NO.3............................................ 64
TYLENOL-CODEINE NO.4............................................ 64
TYR COOLER............................................................ 60, 97
TYR COOLER20........................................................ 60, 97
TYR LOPHLEX.......................................................... 59, 97
TYREX-2.....................................................................59, 97
TYROS 2..................................................................... 59, 97
TYVASO......................................................................23, 97
TYVASO INSTITUTIONAL START KIT..................23, 97
TYVASO REFILL KIT............................................... 23, 97
TYVASO STARTER KIT............................................23, 97
-UUCD ANAMIX JUNIOR (12 G-385) (POWDER) (OTC)
..................................................................................... 60, 97
UCD TRIO...................................................................60, 97
ULIPRISTAL ACETATE...................................................26
ULORIC...................................................................... 43, 84
ULTI-LANCE....................................................................38
ULTILET ALCOHOL SWAB........................................... 31
ULTRACET....................................................................... 64
ULTRA-FRESH.................................................................31
ULTRAM...........................................................................64
ULTRAM ER.....................................................................64
ULTRATRAK ULTIMATE............................................... 35
ULTRAVATE (0.05 %) (CREAM (G))..............................30
ULTRAVATE (0.05 %) (OINT. (G))..................................30
UMECLIDINIUM BRM/VILANTEROL TR...................14
Page 114 of 116
Index
UMECLIDINIUM BROMIDE..........................................14
UNIPHYL..........................................................................16
UNIRETIC.........................................................................21
UNISTIK 2........................................................................ 38
UNISTIK 2 EXTRA.......................................................... 38
UNISTIK 2 NORMAL (KIT)............................................38
UNISTIK 2 NORMAL (KIT) (OTC)................................ 38
UNISTIK 3........................................................................ 38
UNISTIK 3 COMFORT.................................................... 38
UNISTIK 3 NEONATAL.................................................. 38
UNISTRIP......................................................................... 36
UNIVASC.......................................................................... 22
UPTRAVI.....................................................................23, 97
URAMAXIN (45 %) (CREAM (G)).................................32
URAMAXIN (45 %) (GEL (ML)).................................... 32
URAMAXIN GT............................................................... 32
UREA................................................................................ 32
UREA/LACTIC AC/ZN UNDECYLENATE....................32
UREA/LACTIC ACID/SALICYLIC AC .......................... 32
URECHOLINE..................................................................54
URE-K............................................................................... 32
URETRON D-S................................................................. 47
URIDINE TRIACETATE............................................ 43, 56
URIN D.S.......................................................................... 47
URINE GLUCOSE TEST STRIP..................................... 39
URINE GLUCOSE-ACET TEST STRIP..........................39
URISPAS........................................................................... 69
UROCIT-K.........................................................................69
UROXATRAL................................................................... 69
URSO.................................................................................53
URSO FORTE................................................................... 53
URSODIOL....................................................................... 53
URYL.................................................................................47
-VVAGIFEM..........................................................................70
VALACYCLOVIR HCL....................................................49
VALCHLOR................................................................ 33, 97
VALCYTE (450 MG) (TABLET)..................................... 49
VALGANCICLOVIR HCL............................................... 49
VALISONE........................................................................29
VALIUM (5 MG/5 ML) (SOLUTION)............................. 18
VALPROIC ACID............................................................. 67
VALPROIC ACID (AS SODIUM SALT)......................... 67
VALSARTAN.................................................................... 22
VALSARTAN/HYDROCHLOROTHIAZIDE.................. 22
VALTREX..........................................................................49
VANCOCIN HCL (125 MG) (CAPSULE)................. 49, 84
VANCOCIN HCL (250 MG) (CAPSULE)................. 49, 84
VANCOMYCIN HCL....................................................... 49
VANDETANIB.................................................................. 56
VANOS.............................................................................. 30
VANTAS............................................................................ 40
VANTIN.............................................................................47
VAPORIZER..................................................................... 16
VAPORIZER (EACH) (OTC)............................................16
VAPORIZER CLEANING TABLETS..............................16
VAPORIZER INHALANT................................................16
VAPORIZER-HUMIDIFIER SUPPLY............................. 16
VARENICLINE TARTRATE............................................ 68
VASCEPA (0.5 GRAM) (CAPSULE).........................24, 84
VASCEPA (1 G) (CAPSULE)..................................... 24, 84
VASELINE........................................................................ 60
VASERETIC......................................................................21
VASODILAN.....................................................................25
VASOTEC..........................................................................22
VECTICAL..................................................................33, 92
VEETIDS...........................................................................48
VEMURAFENIB.............................................................. 56
VENCLEXTA..............................................................56, 97
VENCLEXTA STARTING PACK.............................. 56, 97
VENELEX (87-788MG/G) (OINT. (G))........................... 61
VENETOCLAX................................................................ 56
VENLAFAXINE HCL...................................................... 17
VENTAVIS.................................................................. 23, 97
VENTOLIN HFA.............................................................. 14
VEPESID...........................................................................56
VERAPAMIL HCL........................................................... 23
VERDROCET................................................................... 62
VERELAN.........................................................................23
VERELAN PM..................................................................23
VERSACLOZ........................................................ 19, 84, 92
VERSED............................................................................20
VERSICLEAR...................................................................29
VESICARE..................................................................69, 92
VFEND.............................................................................. 48
VGO 20..............................................................................38
VGO 30..............................................................................38
VGO 40..............................................................................38
VIBRAMYCIN............................................................48, 84
VIBRA-TABS..............................................................48, 84
VNSNY
VICKS WARM STEAM VAPORIZER (EACH) (OTC)......
16
VICOPROFEN.................................................................. 62
VICTOZA 2-PAK..................................................34, 84, 92
VICTOZA 3-PAK..................................................34, 84, 92
VIDEX.........................................................................50, 84
VIDEX EC (125 MG) (CAPSULE DR)......................50, 84
VIDEX EC (200 MG) (CAPSULE DR)......................50, 84
VIDEX EC (250 MG) (CAPSULE DR)......................50, 84
VIDEX EC (400 MG) (CAPSULE DR)......................50, 84
VIGABATRIN................................................................... 67
VIGAMOX........................................................................ 41
VIIBRYD (10 MG) (TABLET)............................. 17, 84, 93
VIIBRYD (20 MG) (TABLET)............................. 17, 84, 93
VIIBRYD (40 MG) (TABLET)............................. 17, 84, 93
VILAZODONE HCL........................................................ 17
VIMPAT (10 MG/ML) (SOLUTION)................... 66, 84, 93
VIMPAT (100 MG) (TABLET)............................. 66, 84, 93
VIMPAT (150 MG) (TABLET)............................. 66, 84, 93
VIMPAT (200 MG) (TABLET)............................. 66, 84, 93
VIMPAT (50 MG) (TABLET)............................... 66, 84, 93
VIOS AEROSOL DELIVERY SYSTEM (EACH)...........16
VIRACEPT........................................................................ 50
VIRAMUNE (200 MG) (TABLET)............................ 50, 84
VIRAMUNE (50 MG/5 ML) (ORAL SUSP)............. 50, 84
VIRAMUNE XR (100 MG) (TAB ER 24H)...............50, 84
VIRAMUNE XR (400 MG) (TAB ER 24H)...............50, 84
VIRAZOLE....................................................................... 49
VIREAD (150 MG) (TABLET).................................. 50, 84
VIREAD (200 MG) (TABLET).................................. 50, 84
VIREAD (250 MG) (TABLET).................................. 50, 84
VIREAD (300 MG) (TABLET).................................. 50, 84
VIREAD (40MG/SCOOP) (POWDER)......................50, 84
VIROPTIC......................................................................... 41
VISKEN.............................................................................22
VISMODEGIB.................................................................. 55
VISTARIL......................................................................... 13
VISTOGARD.............................................................. 56, 84
VIT A PALMITATE/VIT C/VIT D3................................. 73
VIT A/VIT C/VIT E/ZINC/COPPER......................... 70, 73
VIT A/VIT C/VIT E/ZINC/COPPER (7160-113)
(TABLET) (OTC).............................................................. 70
VIT B CMPLX 3/FOLIC AC/C/BIOT.............................. 75
VIT B CMPLX NO3/FA/C/BIOT/ZINC........................... 75
VIT B COMP/C/FA/IRON SULF/VITE........................... 71
VIT B COMP/C/FA/IRON/VIT E..................................... 71
VIT B COMPLEX 100 CMB #2/HERBS......................... 75
VIT B COMPLEX 100 NO.3/HERBAL........................... 75
VIT C/VIT E AC/SELENIUM/GINKGO......................... 58
VIT E/LIDOCAINE/ALOE/COLLAGEN........................ 33
VITAL 1.0 CAL (0.04G-1/ML) (LIQUID) (OTC)...... 60,
97
VITAL 1.5 CAL (0.07 G-1.5) (LIQUID) (OTC).........60, 97
VITAL AF 1.2 CAL (0.08 G-1.2) (LIQUID) (OTC)...... 60,
97
VITAMEDMD REDICHEW RX...................................... 74
VITAMIN A...................................................................... 75
VITAMIN A (10000 UNIT) (CAPSULE) (OTC)............. 75
VITAMIN A (8000 UNIT) (CAPSULE) (OTC)............... 75
VITAMIN B COMPLEX.............................................75, 76
VITAMIN B COMPLEX (CAPSULE) (OTC)..................75
VITAMIN B COMPLEX (TABLET) (OTC).................... 76
VITAMIN B COMPLEX/MINERALS............................. 76
VITAMIN E....................................................................... 31
VITAMIN E (OIL) (OTC)................................................. 31
VITAMIN E/ALOE VERA............................................... 31
VITAMINS B1,B2,B3,B5,AND B6.................................. 76
VITB,C/IRON FUM/FA/VIT E/AA 16.............................73
VITE AC/GRAPE/HYALURONIC ACID ........................ 31
VITS A,C,E/LUTEIN/MINERALS............................ 70, 73
VITS A,C,E/ZINC/COPPER.............................................70
VIVACTIL......................................................................... 18
VIVELLE-DOT........................................................... 46, 84
VIVITROL.........................................................................18
VIVONEX RTF (0.05G-1/ML) (LIQUID) (OTC)...... 60,
97
VOCAL POINT GLUCOSE CONTROL..........................36
VOCALPOINT GLUCOSE CONTROL...........................36
VOGELXO.................................................................. 45, 97
VOLTAREN...........................................................30, 41, 52
VOLTAREN-XR................................................................52
VORICONAZOLE............................................................ 48
VORINOSTAT...................................................................56
VORTEX........................................................................... 15
VORTEX VHC FROG MASK.......................................... 15
VORTEX VHC LADYBUG MASK................................. 15
VORTIOXETINE HYDROBROMIDE............................. 17
VOSOL.............................................................................. 39
VOSOL HC........................................................................39
VOTRIENT............................................................56, 84, 97
VYVANSE (10 MG) (CAPSULE)........................ 18, 84, 93
VYVANSE (20 MG) (CAPSULE)........................ 18, 84, 93
VYVANSE (30 MG) (CAPSULE)........................ 18, 84, 93
VYVANSE (40 MG) (CAPSULE)........................ 18, 84, 93
VYVANSE (50 MG) (CAPSULE)........................ 18, 84, 93
VYVANSE (60 MG) (CAPSULE)........................ 18, 84, 93
VYVANSE (70 MG) (CAPSULE)........................ 18, 84, 94
-WWAL-MUCIL.................................................................... 54
WARFARIN SODIUM...................................................... 43
WARM STEAM VAPORIZER......................................... 16
WATER FOR IRRIGATION,STERILE............................ 32
WAVESENSE CONTROL SOLUTION........................... 37
WEBCOL.......................................................................... 31
WEED POLLEN-SHORT RAGWEED............................ 13
WELCHOL........................................................................24
WELLBUTRIN................................................................. 17
WELLBUTRIN SR........................................................... 17
WELLBUTRIN XL........................................................... 17
WELLCOVORIN.............................................................. 56
WESTCORT...................................................................... 30
WHEY............................................................................... 61
WHITE PETROLEUM......................................................60
WIDE SEAL DIAPHRAGM.............................................26
WILATE............................................................................ 43
WINDMILL TRAINER.................................................... 16
WND 2.........................................................................60, 97
WOUND GEL................................................................... 31
WP THYROID.................................................................. 41
-XXALATAN.........................................................................42
XALKORI............................................................. 55, 84, 97
XANAX............................................................................. 18
XANAX XR...................................................................... 18
XANTHAN GUM............................................................. 61
XARELTO (10 MG) (TABLET)................................. 44, 84
XARELTO (15 MG) (TABLET)................................. 44, 84
XARELTO (15 MG-20MG) (TAB DS PK).................44, 84
XARELTO (20 MG) (TABLET)................................. 44, 84
XELJANZ.................................................................... 52, 97
XELJANZ XR............................................................. 52, 97
XELODA (150 MG) (TABLET)........................... 55, 84, 97
XELODA (500 MG) (TABLET)........................... 55, 84, 97
XENAZINE................................................................. 56, 97
XIFAXAN (550 MG) (TABLET)................................49, 97
XIIDRA....................................................................... 42, 84
XOPENEX.........................................................................14
XOPENEX CONCENTRATE...........................................14
XPHE MAXAMAID................................................... 59, 97
XPHE MAXAMUM (40G-305) (POWDER) (OTC)...... 59,
97
XTANDI................................................................ 55, 84, 97
XTRACAL PLUS........................................................60, 97
XURIDEN................................................................... 43, 97
X-VIATE............................................................................32
XYLOCAINE.............................................................. 33, 53
XYLOCAINE VISCOUS.................................................. 53
XYNTHA.......................................................................... 43
XYNTHA SOLOFUSE..................................................... 43
XYZAL (2.5 MG/5ML) (SOLUTION).................13, 84, 94
XYZAL (5 MG) (TABLET).............................................. 13
-YYASMIN 28................................................................. 25, 94
YAZ..............................................................................25, 94
-ZZAFIRLUKAST................................................................ 15
ZALEPLON.......................................................................20
ZAMICET (10-325/15) (SOLUTION)........................62, 84
ZAMICET (5-163/7.5) (SOLUTION).........................62, 84
ZANAFLEX (2 MG) (TABLET).......................................67
ZANAFLEX (4 MG) (TABLET).......................................67
ZANTAC (15 MG/ML) (SYRUP)..................................... 69
ZANTAC (150 MG) (CAPSULE)..................................... 69
ZANTAC (150 MG) (TABLET)........................................69
ZANTAC (150 MG) (TABLET) (OTC)............................ 69
ZANTAC (300 MG) (CAPSULE)..................................... 69
ZANTAC (300 MG) (TABLET)........................................69
ZANTAC 75.......................................................................69
ZARONTIN....................................................................... 66
ZAROXOLYN................................................................... 23
ZAVESCA................................................................... 58, 97
ZELBORAF...........................................................56, 84, 98
ZEMAIRA......................................................................... 54
ZEMPLAR.........................................................................40
ZENPEP.............................................................................68
ZENZEDI (2.5 MG) (TABLET)............................18, 84, 94
ZENZEDI (7.5 MG) (TABLET)............................18, 84, 94
ZEPATIER................................................................... 51, 98
ZESTORETIC................................................................... 21
ZESTRIL........................................................................... 22
ZETIA..........................................................................24, 84
Page 115 of 116
Index
ZIAC.................................................................................. 22
ZIAGEN (20 MG/ML) (SOLUTION).........................50, 84
ZIAGEN (300 MG) (TABLET)...................................50, 84
ZIDOVUDINE...................................................................50
ZINC ACETATE/MEADOWSWEET/OAK..................... 33
ZINC SULFATE................................................................ 76
ZIPRASIDONE HCL........................................................ 20
ZIPRASIDONE MESYLATE........................................... 20
ZIRGAN............................................................................ 41
ZITHROMAX................................................................... 47
ZITHROMAX TRI-PAK................................................... 47
ZMAX................................................................................47
ZOCOR (10 MG) (TABLET)............................................ 24
ZOCOR (20 MG) (TABLET)............................................ 24
ZOCOR (40 MG) (TABLET)............................................ 24
ZOCOR (5 MG) (TABLET).............................................. 24
ZOCOR (80 MG) (TABLET)...................................... 24, 94
ZOFRAN (24 MG) (TABLET)..........................................14
ZOFRAN (4 MG) (TABLET)............................................14
ZOFRAN (4 MG/5 ML) (SOLUTION)...................... 14, 84
ZOFRAN (8 MG) (TABLET)............................................14
ZOFRAN ODT.................................................................. 14
ZOLADEX.................................................................. 40, 98
ZOLINZA.......................................................................... 56
ZOLMITRIPTAN.............................................................. 64
ZOLOFT............................................................................ 17
ZOLPIDEM TARTRATE.................................................. 20
ZOLPIMIST.......................................................... 20, 84, 94
ZOMIG (2.5 MG) (SPRAY).................................. 64, 84, 94
ZOMIG (5 MG) (SPRAY)..................................... 64, 84, 94
ZONEGRAN..................................................................... 67
ZONISAMIDE.................................................................. 67
ZORBTIVE..................................................................40, 98
ZORTRESS........................................................................46
ZOVIRAX..........................................................................49
ZOVIRAX (5 %) (CREAM (G))....................................... 29
ZOVIRAX (5 %) (OINT. (G))........................................... 29
ZUBSOLV (0.7-0.18MG) (TAB SUBL)..................... 65, 84
ZUBSOLV (1.4-0.36MG) (TAB SUBL)..................... 65, 84
ZUBSOLV (11.4-2.9MG) (TAB SUBL)..................... 65, 84
ZUBSOLV (2.9-0.71MG) (TAB SUBL)..................... 65, 84
ZUBSOLV (5.7-1.4 MG) (TAB SUBL)...................... 65, 84
ZUBSOLV (8.6-2.1 MG) (TAB SUBL)...................... 65, 84
ZUTRIPRO........................................................................ 26
ZYBAN..............................................................................68
ZYDELIG.................................................................... 56, 98
ZYKADIA................................................................... 55, 98
ZYLET...............................................................................41
ZYLOPRIM.......................................................................43
ZYMAXID........................................................................ 41
ZYPREXA (10 MG) (TABLET)................................. 19, 84
ZYPREXA (15 MG) (TABLET)................................. 19, 84
ZYPREXA (2.5 MG) (TABLET)................................ 19, 84
ZYPREXA (20 MG) (TABLET)................................. 19, 84
ZYPREXA (5 MG) (TABLET)................................... 19, 84
ZYPREXA (7.5 MG) (TABLET)................................ 19, 84
ZYPREXA RELPREVV (210 MG) (VIAL)...............19, 84
ZYPREXA RELPREVV (300 MG) (VIAL)...............19, 84
ZYPREXA RELPREVV (405 MG) (VIAL)...............19, 84
ZYPREXA ZYDIS...................................................... 19, 84
ZYRTEC (1 MG/ML) (SOLUTION)................................ 13
ZYRTEC-D........................................................................13
ZYTIGA................................................................ 55, 84, 98
ZYVOX (100 MG/5ML) (SUSP RECON)........................47
ZYVOX (600 MG) (TABLET)....................................47, 98
ZZZQUIL.......................................................................... 13
ZZZQUIL (25 MG) (CAPSULE) (OTC).......................... 20
VNSNY
Page 116 of 116
2016 Formulary
of Covered
Prescription Drugs
SelectHealth
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