2016 FormulAry oF Covered PresCriPtion drugs

Transcripción

2016 Formulary
of Covered
Prescription Drugs
SelectHealth
Updated April 2016
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 2016
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
Page 1 of 75
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)
DO NOT WRITE IN
BLOCKED AREAS
FOR INTERNAL USE ONLY
Contacted:
Physician:
Pharmacy:
Patient:
Attn: Prior Authorization
Department
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):
VNSNY
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Formulario de VNSNY CHOICE SelectHealth
Abril de 2016
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
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:
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):
Plan de salud del paciente (obligatorio):
N.º de Id. 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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Page 10 of 73
T1 levocetirizine
dihydrochloride
ALLERGY
2nd Gen Antihistamine & Decongestant
T1 levocetirizine
dihydrochloride
Combinations
T5 loratadine
T5 loratadine
T5 cetirizine
hcl/pseudoephedrine
CETIRIZINEPSEUDOEPHEDRINE
ER(OTC)
T1 fexofenadine/pseudoephALLERGY RELIEFedrine
D(OTC)
T5 loratadine/pseudoephed CLARITIN-D 12
rine
HOUR(OTC)
T5 loratadine/pseudoephed CLARITIN-D 24
rine
HOUR(OTC)
Nasal Antihistamine
T1 azelastine hcl
T1 olopatadine hcl
ORALAIR
PA
GRASTEK
PA
RAGWITEK
PA
T2
T2
T2
T2
T5
T1
T1
T1
T1
T2
T1
T1
T1
T1
T1
T1
T1
QL, ST
QL
QL
QL
QL
CETIRIZINE HCL
CETIRIZINE
HCL(OTC)
DESLORATADINE
FEXOFENADINE
HCL(OTC)
aprepitant
aprepitant
aprepitant
aprepitant
dimenhydrinate
EMEND(CAP DS PK) QL
EMEND(CAP)(125 MG) QL
MOTION
SICKNESS(OTC)
dronabinol
DRONABINOL
QL, ST
granisetron hcl
GRANISETRON HCL QL, ST
meclizine hcl
MECLIZINE HCL
meclizine hcl
MECLIZINE HCL(OTC)
netupitant/palonosetron AKYNZEO
QL
hcl
ondansetron
ONDANSETRON ODT
ondansetron hcl
ONDANSETRON
QL
HCL(SOLUTION)
ondansetron hcl
ONDANSETRON
HCL(TAB)
prochlorperazine
PROCHLORPERAZINE
prochlorperazine
PROCHLORPERAZINE
maleate
MALEATE
promethazine hcl
PROMETHEGAN
trimethobenzamide hcl TRIMETHOBENZAMI
DE HCL
ASTHMA AND COPD
Adrenergic Agents,catecholamines
T1 epinephrine
EPINEPHRINE
Anticholinergic, Orally Inhaled Short Acting
Antihistamines - 2nd Generation
VNSNY
T2 beclomethasone
QNASL
dipropionate
T1 flunisolide
FLUNISOLIDE
T1 fluticasone propionate FLUTICASONE
PROPIONATE
PROPIONATE(OTC)
T2 mometasone furoate
NASONEX
Antiemetic/antivertigo Agents
T1 brompheniramine
J-TAN PD(OTC)
maleate
T4 carbinoxamine maleate CARBINOXAMINE
MALEATE(LIQUID)
T1 carbinoxamine maleate CARBINOXAMINE
MALEATE(TAB)
T4 chlorpheniramine
ALLERGY(OTC)
maleate
T4 clemastine fumarate
CLEMASTINE
FUMARATE
T1 clemastine fumarate
CLEMASTINE
FUMARATE(OTC)
T1 cyproheptadine hcl
CYPROHEPTADINE
HCL
T4 diphenhydramine hcl DIPHENHYDRAMINE
HCL(CAP)(OTC)
HCL(ELIXIR)(OTC)
HCL(LIQUID)(OTC)
HCL(SYRUP)(OTC)
HCL(TAB)(OTC)
T4 hydroxyzine hcl
HYDROXYZINE HCL
T4 hydroxyzine pamoate HYDROXYZINE
PAMOATE
T4 hydroxyzine pamoate VISTARIL
T4 promethazine hcl
PHENERGAN
T1 promethazine hcl
PROMETHAZINE HCL
T1 desloratadine
T1 fexofenadine hcl
QL
QL, ST
ANTIEMESIS/ANTIVERTIGO
Antihistamines - 1st Generation
T1 cetirizine hcl
T1 cetirizine hcl
AZELASTINE HCL
OLOPATADINE HCL
Nasal Anti-inflammatory Steroids
Allergenic Extracts, Therapeutics
T2 gr pol-orc/sw
ver/rye/kent/tim
T2 grass pollen-timothy,
standard
T2 weed pollen-short
ragweed
LEVOCETIRIZINE
QL, ST
DIHYDROCHLORIDE
(SOLUTION)
LEVOCETIRIZINE
DIHYDROCHLORIDE
(TAB)
CLARITIN(OTC)
LORATADINE(OTC)
T2 ipratropium bromide
QL
ATROVENT HFA
IPRATROPIUM
BROMIDE
QL
Anticholinergics, Orally Inhaled Long Acting
T2 tiotropium bromide
T2 umeclidinium bromide
SPIRIVA RESPIMAT
INCRUSE ELLIPTA
QL
QL
Page 11 of 75
Beta-adrenergic Agents
T1 metaproterenol sulfate METAPROTERENOL
SULFATE
Beta-adrenergic Agents, Inhaled, Short Acting
T1 albuterol sulfate
T2 albuterol sulfate
T1 levalbuterol hcl
T1 terbutaline sulfate
ALBUTEROL
SULFATE
VENTOLIN HFA
LEVALBUTEROL HCL
TERBUTALINE
SULFATE
Beta-adrenergic Agents, Inhaled, Ultra-long Acting
T2 olodaterol hcl
STRIVERDI
RESPIMAT
QL
Beta-adrenergic Agents, Orally Inhaled,long Acting
T2 formoterol fumarate
PERFOROMIST
QL
Beta-adrenergic And Anticholinergic Combinations
T2 ipratropium/albuterol
sulfate
T1 ipratropium/albuterol
sulfate
T2 tiotropium br/olodaterol
hcl
T2 umeclidinium
brm/vilanterol tr
COMBIVENT
RESPIMAT
IPRATROPIUMALBUTEROL
STIOLTO RESPIMAT
QL
ANORO ELLIPTA
QL
Beta-adrenergic And Glucocorticoid Combinations
T2
T2
T2
T2
fluticasone/salmeterol
fluticasone/salmeterol
fluticasone/vilanterol
mometasone/formoterol
ADVAIR DISKUS
ADVAIR HFA
BREO ELLIPTA
DULERA
QL
QL
QL
QL
Glucocorticoids, Orally Inhaled
T1 budesonide
T1 budesonide
T1 budesonide
T2 flunisolide
BUDESONIDE(AMPUL QL
-NEB)(0.25MG/2ML)
BUDESONIDE(AMPUL QL
-NEB)(0.5 MG/2ML)
BUDESONIDE(AMPUL QL
-NEB)(1 MG/2 ML)
AEROSPAN
QL
Leukotriene Receptor Antagonists
T1 montelukast sodium
T1 zafirlukast
MONTELUKAST
SODIUM
ZAFIRLUKAST
Mast Cell Stabilizers
T1 cromolyn sodium
CROMOLYN SODIUM
Phosphodiesterase-4 (pde4) Inhibitors
T2 roflumilast
DALIRESP
Respiratory Aids,devices,equipment
T1 compressor, for nebulizer DEVILBISS
COMPACT(OTC)
T1 compressor, for nebulizer DEVILBISS PULMOAIDE
T1 compressor, for nebulizer DEVILBISS PULMOAIDE(OTC)
VNSNY
QL, ST
T1 compressor, for nebulizer DEVILBISS
PULMOMATE(OTC)
T1 compressor, for nebulizer PULMO-AIDE
T1 compressor, for nebulizer PULMO-AIDE(OTC)
T1 compressor, for nebulizer SUNRISE
COMPRESSORNEBULIZER
T1 inhaler, assist devices
ACE AEROSOL
CLOUD ENHANCER
AEROCHAMBER MINI
AEROCHAMBER MV
AEROCHAMBER
PLUS FLOW-VU
AEROCHAMBER
WITH FLOWSIGNAL
AEROCHAMBER ZSTAT PLUS
AEROTRACH PLUS
BREATHERITE
BREATHRITE
EASIVENT
E-Z SPACER
LITEAIRE
MICROCHAMBER
MICROSPACER
OPTICHAMBER
DIAMOND
POCKET CHAMBER
PRIMEAIRE
PROCHAMBER
RITEFLO
VORTEX
VORTEX VHC FROG
MASK
VORTEX VHC
LADYBUG MASK
T1 inhaler,assist
EASIVENT
device,accesory
T1 inhaler,assist
LITETOUCH
device,accesory
T1 inhaler,assist
MOUTHPIECE(OTC)
device,accesory
T1 inhaler,assist
ONE WAY
device,accesory
MOUTHPIECE(OTC)
T1 inhaler,assist
OPTICHAMBER
device,accesory
T1 inhaler,assist
PANDA MASK(OTC)
device,accesory
T1 inhaler,assist
PEDIATRIC PANDA
device,accesory
MASK(OTC)
T1 inhaler,assist
SIDESTREAM
device,accesory
PEDIATRIC(OTC)
T1 inhaler,assist
SILICONE MASK
device,accesory
T1 inhaler,assist
SILICONE
device,accesory
MASK(OTC)
T1 mucus clearing device FLUTTER
T1 mucus clearing device QUAKE
T5 nasal airflow strips
BREATHE
RIGHT(OTC)
T5 nasal airflow strips
NASAL STRIPS(OTC)
T1 nebulizer
AEROECLIPSE II
T1 nebulizer
AIRS DISPOSABLE
NEBULIZER(OTC)
Page 12 of 75
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1
T1
T1
T1
T1
nebulizer
nebulizer
nebulizer
nebulizer
nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer
T1 nebulizer/compressor
T1
T1
T1
T1
T1
nebulizer/compressor
VNSNY
ALTERA NEBULIZER
BABY NEBULIZER
COMPACT
COMPRESSOR
NEBULIZER(OTC)
COMPACT
ULTRASONIC
NEBULIZER(OTC)
COMPMIST
COMPRESSOR
NEBULIZER(OTC)
DEVILBISS
DISPOSABLE
NEBULIZER(OTC)
ERAPID NEBULIZER
INSPIRATION
LC D NEBULIZER SET
LC PLUS
LC SPRINT
NEBULIZER
MICRO AIR(OTC)
MICRO PLUS
MINI PLUS
NEBULIZER
MINICOMP
COMPRESSOR
NEBULIZER(OTC)
PARI LC SPRINT
SINUS
PRODIGY MINI-MIST
SIDESTREAM
SIDESTREAM
NEBULIZER
SIDESTREAM PLUS
COMP-AIR ELITE
COMPRESSOR SYST
COMP-AIR ELITE
COMPRESSOR
SYST(OTC)
COMP-AIR
NEBULIZER
COMPRESSOR
COMP-AIR
NEBULIZER
COMPRESSOR(OTC)
DEVILBISS
TRAVELER
INNOSPIRE
ELEGANCE
INNOSPIRE ESSENCE
INSPIRATION ELITE
MICRO ELITE
MINIELITE
PARI SINUS AEROSOL
SYSTEM
PRONEB ULTRA II
PULMONEB LT
COMPRESSOR
NEBUL(OTC)
SAMI THE SEAL
TREK S COMBO PACK
TREK S COMPACT
COMPRESSOR
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
VIOS AEROSOL
DELIVERY SYSTEM
peak flow meter
AIRZONE PEAK FLOW
METER(OTC)
peak flow meter
ASSESS(OTC)
peak flow meter
ASTHMA
CHECK(OTC)
peak flow meter
ASTHMAMENTOR(OT
C)
peak flow meter
IN-CHECK NASAL
WITH MASK(OTC)
peak flow meter
IN-CHECK
ORAL(OTC)
peak flow meter
MICROLIFE PEAK
FLOW(OTC)
peak flow meter
MINI-WRIGHT PEAK
FLOW METER
peak flow meter
PEAK-AIR(OTC)
peak flow meter
PERSONAL
BEST(OTC)
peak flow meter
PIKO 1(OTC)
peak flow meter
POCKET PEAK(OTC)
peak flow meter
TRUZONE PEAK
FLOW METER
peak flow meter/inh asst AEROGEAR ASTHMA
dev
ACTION KIT
peak flow meter/inh asst ASTHMAPACK
dev
CHILDREN'S
spirometers and
IN-CHECK DIAL(OTC)
accessories
spirometers and
PFLEX TRAINER
accessories
spirometers and
THRESHOLD IMT
accessories
spirometers and
THRESHOLD PEP
accessories
spirometers and
WINDMILL
accessories
TRAINER(OTC)
vaporizer
VAPORIZER(OTC)
vaporizer
VICKS WARM STEAM
VAPORIZER(OTC)
vaporizer
WARM STEAM
VAPORIZER(OTC)
vaporizer-humidifier
VAPORIZER
supply
CLEANING
TABLETS(OTC)
vaporizer-humidifier
VAPORIZER
supply
INHALANT(OTC)
Xanthines
T1 caffeine citrated
CAFFEINE CITRATE
T2 theophylline anhydrous THEO-24
T1 theophylline anhydrous THEOPHYLLINE
ANHYDROUS
AUTONOMIC NERVOUS SYSTEM
DISORDERS
Alzheimer's Therapy, Nmda Receptor Antagonists
T1 memantine hcl
T1 memantine hcl
MEMANTINE
HCL(SOLUTION)
MEMANTINE
HCL(TAB DS PK)
QL
QL
Page 13 of 75
T1 memantine hcl
T2 memantine hcl
T2 memantine hcl
MEMANTINE
QL
HCL(TAB)
NAMENDA XR(CAP 24 QL
DSPK)
NAMENDA XR(CAP QL
SPR 24)
Alzheimer's Thx,nmda Recept Antag & Cholines
Inhib
T2 memantine hcl/donepezil NAMZARIC
hcl
QL, ST
Cholinesterase Inhibitors
TRAZODONE HCL
Serotonin-norepinephrine Reuptake-inhib
T4 desvenlafaxine
DESVENLAFAXINE
ER
T4 desvenlafaxine
KHEDEZLA
T4 desvenlafaxine fumarate DESVENLAFAXINE
FUMARATE ER
T4 desvenlafaxine succinate PRISTIQ ER
T4 duloxetine hcl
CYMBALTA
T4 duloxetine hcl
DULOXETINE HCL
T4 levomilnacipran
FETZIMA
hydrochloride
T4 venlafaxine hcl
VENLAFAXINE HCL
ER
T1 donepezil hcl
T1 galantamine hbr
QL
Ssri & 5ht1a Partial Agonist Antidepressant
T1
QL
T4 vilazodone hydrochlorideVIIBRYD
T2
T1
T1
T1
DONEPEZIL HCL
GALANTAMINE
HBR(CAP24H PEL)
galantamine hbr
GALANTAMINE
HBR(TAB)
pyridostigmine bromide MESTINON
pyridostigmine bromidePYRIDOSTIGMINE
BROMIDE
rivastigmine
RIVASTIGMINE
rivastigmine tartrate RIVASTIGMINE
T4 trazodone hcl
QL, ST
QL, ST
QL, ST
QL, ST
QL
QL
QL, ST
QL, ST
Ssri & Serotonin Receptor Modulator
Antidepressant
QL
T4 vortioxetine
hydrobromide
BRINTELLIX
QL, ST
BEHAVIORAL HEALTH -
Tricyclic Antidepressant/phenothiazine Combinatns
ANTIDEPRESSANTS
T4 perphenazine/amitripty PERPHENAZINEline hcl
AMITRIPTYLINE
Alpha-2 Receptor Antagonist Antidepressants
T4 mirtazapine
T4 mirtazapine
MIRTAZAPINE
REMERON
Maois - Non-selective & Irreversible
T4 isocarboxazid
T4 phenelzine sulfate
MARPLAN
PHENELZINE
SULFATE
T4 tranylcypromine sulfatePARNATE
Norepinephrine And Dopamine Reuptake Inhib
T4 bupropion hbr
APLENZIN
QL, ST
Selective Serotonin Reuptake Inhibitor
T4 citalopram
hydrobromide
T4 citalopram
hydrobromide
T4 escitalopram oxalate
T4
T4
T4
T4
T4
escitalopram oxalate
fluoxetine hcl
fluoxetine hcl
fluoxetine hcl
fluvoxamine maleate
T4
T4
T4
T4
T4
paroxetine hcl
paroxetine hcl
paroxetine mesylate
paroxetine mesylate
sertraline hcl
VNSNY
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
amitriptyline hcl
amoxapine
clomipramine hcl
desipramine hcl
doxepin hcl
imipramine hcl
imipramine pamoate
maprotiline hcl
nortriptyline hcl
nortriptyline hcl
protriptyline hcl
trimipramine maleate
trimipramine maleate
CELEXA
AMITRIPTYLINE HCL
AMOXAPINE
ANAFRANIL
NORPRAMIN
DOXEPIN HCL
IMIPRAMINE HCL
TOFRANIL-PM
MAPROTILINE HCL
NORTRIPTYLINE HCL
PAMELOR
PROTRIPTYLINE HCL
SURMONTIL
TRIMIPRAMINE
MALEATE
BEHAVIORAL HEALTH - OTHER
CITALOPRAM HBR
ESCITALOPRAM
OXALATE
LEXAPRO
FLUOXETINE HCL
PROZAC
SARAFEM
FLUVOXAMINE
MALEATE
PAXIL
PAXIL CR
BRISDELLE
PEXEVA
SERTRALINE HCL
Adrenergics, Aromatic, Non-catecholamine
T1 dextroamphetamine
sulfate
sulfate
sulfate
QL, ST
QL, ST
Serotonin-2 Antagonist/reuptake Inhibitors
T4 nefazodone hcl
T4 trazodone hcl
Tricyclic Antidepressants & Rel. Non-sel. Ru-inhib
NEFAZODONE HCL
OLEPTRO ER
DEXTROAMPHETAMI
NE
SULFATE(SOLUTION)
DEXTROAMPHETAMI
NE SULFATE(TAB)(10
MG)
DEXTROAMPHETAMI
NE SULFATE(TAB)(5
MG)
ZENZEDI
QL
QL
QL
QL, ST
sulfate
T1 dextroamphetamine/am DEXTROAMPHETAMI QL
phetamine
NE-AMPHETAMINE
T2 lisdexamfetamine
VYVANSE
QL, ST
dimesylate
QL, ST
Page 14 of 75
T1 methamphetamine hcl METHAMPHETAMINE QL
HCL
Anti-alcoholic Preparations
T1 disulfiram
DISULFIRAM
T2 naltrexone microspheres VIVITROL
Anti-anxiety Drugs
T4 buspirone hcl
T4 lithium carbonate
T4 lithium citrate
EQUETRO
LITHIUM
CARBONATE
LITHOBID
LITHIUM
Antipsych,dopamine
Antag.,diphenylbutylpiperidines
T4 pimozide
Antipsychotics,dopamine Antagonists,
Thioxanthenes
T4 thiothixene
THIOTHIXENE
Antagonists,butyrophenones
T4 haloperidol
HALOPERIDOL
T4 haloperidol decanoate HALDOL
DECANOATE 50
T4 haloperidol decanoate HALOPERIDOL
DECANOATE
T4 haloperidol lactate
HALOPERIDOL
LACTATE
Anti-psychotics,phenothiazines
T4 chlorpromazine hcl
ORAP
Antipsychotics, Atyp, D2 Partial Agonist/5ht Mixed
T4
T4 aripiprazole
T2 aripiprazole
T4 aripiprazole
T4
T4
T4
T4
ABILIFY
QL, ST
ABILIFY MAINTENA
ARIPIPRAZOLE
QL, ST
Antipsychotics, Dopamine & Serotonin Antagonists
T2 loxapine
T4 loxapine succinate
GEODON
Antipsychotics,dopamine
BUSPIRONE HCL
Anti-mania Drugs
T4 carbamazepine
T4 lithium carbonate
T4 ziprasidone mesylate
ADASUVE
LOXAPINE
CHLORPROMAZINE
HCL
fluphenazine decanoate FLUPHENAZINE
DECANOATE
fluphenazine hcl
FLUPHENAZINE HCL
perphenazine
PERPHENAZINE
thioridazine hcl
THIORIDAZINE HCL
trifluoperazine hcl
TRIFLUOPERAZINE
HCL
Hypnotics, Melatonin Mt1/mt2 Receptor Agonists
Antipsychotics,atypical,dopamine,& Serotonin
T4 ramelteon
T4 tasimelteon
Antag
Monoamine Oxidase(mao) Inhibitors
T4
T4
T4
T4
T4
T4
T4
T4 selegiline
T4
T4
T4
T4
T4
T2
T4
T4
T4
T4
T2
T4
T4
T4
T4
T2
T4
asenapine maleate
clozapine
clozapine
clozapine
iloperidone
iloperidone
lurasidone hcl
SAPHRIS
QL, ST
CLOZAPINE
QL
CLOZARIL
QL
VERSACLOZ
QL, ST
FANAPT(TAB DS PK) QL, ST
FANAPT(TAB)
QL, ST
LATUDA(TAB)(120
QL, ST
MG)
lurasidone hcl
LATUDA(TAB)(20 MG) QL, ST
lurasidone hcl
lurasidone hcl
lurasidone hcl
olanzapine
ZYPREXA
QL
olanzapine pamoate
ZYPREXA RELPREVV
paliperidone
INVEGA(TAB ER
QL, ST
24H)(1.5 MG)
paliperidone
INVEGA(TAB ER
QL, ST
24H)(3 MG)
paliperidone
INVEGA(TAB ER
QL, ST
24H)(6 MG)
paliperidone
INVEGA(TAB ER
QL, ST
24H)(9 MG)
paliperidone palmitate INVEGA SUSTENNA
quetiapine fumarate
SEROQUEL
QL
quetiapine fumarate
SEROQUEL XR
QL, ST
risperidone
RISPERDAL(SOLUTIO QL
N)
risperidone
RISPERDAL(TAB)
QL
risperidone microspheres RISPERDAL CONSTA
ziprasidone hcl
GEODON
QL
VNSNY
ROZEREM
HETLIOZ
QL, ST
PA
EMSAM
QL
Narcolepsy And Sleep Disorder Therapy Agents
T1 modafinil
MODAFINIL
PA
NALOXONE HCL
NARCAN
NALTREXONE HCL
QL
Narcotic Antagonists
T1 naloxone hcl
T2 naloxone hcl
T1 naltrexone hcl
Sedative-hypnotics,non-barbiturate
T4 diphenhydramine hcl
T4
T4
T4
T4
T4
T4
T4
T4
T4
diphenhydramine hcl
doxepin hcl
eszopiclone
suvorexant
zaleplon
zolpidem tartrate
zolpidem tartrate
zolpidem tartrate
zolpidem tartrate
NIGHTTIME SLEEP
AID(OTC)
ZZZQUIL(OTC)
SILENOR
QL, ST
LUNESTA
QL
BELSOMRA
QL, ST
SONATA
QL
EDLUAR
QL, ST
INTERMEZZO
QL, ST
ZOLPIDEM TARTRATEQL
ZOLPIMIST
QL, ST
Ssri &antipsych,atyp,dopamine&serotonin Antag
Comb
T4 olanzapine/fluoxetine
hcl
T4 olanzapine/fluoxetine
hcl
OLANZAPINEFLUOXETINE HCL
SYMBYAX
QL
QL
Page 15 of 75
Tx For Adhd - Selective Alpha-2a Receptor Agonist
T1 clonidine hcl
T1 guanfacine hcl
CLONIDINE HCL ER QL
GUANFACINE HCL ER QL
Tx For Attention Deficit-hyperact(adhd)/narcolepsy
T1 dexmethylphenidate hcl DEXMETHYLPHENID AGE,
ATE HCL ER
QL
T2 dexmethylphenidate hcl FOCALIN XR
AGE,
QL
T1 methylphenidate hcl
METHYLPHENIDATE AGE,
ER(CPBP 50-50)(20
QL
MG)
ER(CPBP 50-50)(30
QL
MG)
ER(CPBP 50-50)(40
QL
MG)
ER(TAB ER 24H)(18
QL
MG)
ER(TAB ER 24H)(27
QL
MG)
ER(TAB ER 24H)(36
QL
MG)
ER(TAB ER 24H)(54
QL
MG)
ER(TAB ER)(10 MG) QL
ER(TAB ER)(20 MG) QL
QUILLIVANT XR
QL, ST
RITALIN LA
AGE,
QL
Tx For Attention Deficit-hyperact.(adhd), Nri-type
T2 atomoxetine hcl
T2 atomoxetine hcl
T2 atomoxetine hcl
T2 atomoxetine hcl
T2 atomoxetine hcl
T2 atomoxetine hcl
T2 atomoxetine hcl
STRATTERA(CAP)(10 QL
MG)
MG)
MG)
MG)
MG)
MG)
MG)
T2 dofetilide
T2 dronedarone hcl
T1 flecainide acetate
T1 mexiletine hcl
T1 propafenone hcl
T1 quinidine gluconate
T1 quinidine sulfate
TIKOSYN
MULTAQ
FLECAINIDE
ACETATE
MEXILETINE HCL
PROPAFENONE HCL
QUINIDINE
GLUCONATE
QUINIDINE SULFATE
CARDIOVASCULAR DISEASE CARDIAC STIMULANT
Digitalis Glycosides
T2 digoxin
T1 digoxin
DIGOXIN(SOLUTION)
DIGOXIN(TAB)
CARDIOVASCULAR DISEASE HYPERTENSION
Ace Inhibitor/calcium Channel Blocker
Combination
T1 amlodipine
besylate/benazepril
AMLODIPINE
BESYLATEBENAZEPRIL
T1 trandolapril/verapamil TRANDOLAPRILhcl
VERAPAMIL ER
Ace Inhibitor/thiazide & Thiazide-like Diuretic
T1 benazepril/hydrochloro BENAZEPRILthiazide
HYDROCHLOROTHIA
ZIDE
T1 captopril/hydrochlorothCAPTOPRILiazide
HYDROCHLOROTHIA
ZIDE
T1 enalapril/hydrochloroth ENALAPRILiazide
HYDROCHLOROTHIA
ZIDE
T1 fosinopril/hydrochlorot FOSINOPRILhiazide
HYDROCHLOROTHIA
ZIDE
T1 lisinopril/hydrochloroth LISINOPRILiazide
HYDROCHLOROTHIA
ZIDE
T1 moexipril/hydrochlorot MOEXIPRILhiazide
HYDROCHLOROTHIA
ZIDE
T1 quinapril/hydrochlorot QUINAPRILhiazide
HYDROCHLOROTHIA
ZIDE
CARDIOVASCULAR DISEASE -
Alpha/beta-adrenergic Blocking Agents
ARRHYTHMIA
T1 carvedilol
T2 carvedilol phosphate
T1 labetalol hcl
Antiarrhythmics
T1 amiodarone hcl
T1 disopyramide
phosphate
T2 disopyramide phosphate
VNSNY
AMIODARONE HCL
DISOPYRAMIDE
PHOSPHATE
NORPACE CR
CARVEDILOL
COREG CR
LABETALOL HCL
Alpha-adrenergic Blocking Agents
T1 doxazosin mesylate
DOXAZOSIN
MESYLATE
T1 phenoxybenzamine hcl phenoxybenzamine hcl
Page 16 of 75
T1 prazosin hcl
T1 terazosin hcl
PRAZOSIN HCL
TERAZOSIN HCL
Antihypertensives, Vasodilators
Angioten.receptr Antag./cal.chanl Blkr/thiazide Cb
T1 hydralazine hcl
T1 minoxidil
T1 amlodipine/valsartan/h AMLODIPINEcthiazid
VALSARTAN-HCTZ
Beta-adrenergic Blocking Agents
ST
Angiotensin Receptor Antag./thiazide Diuretic
Comb
T1 irbesartan/hydrochlorotIRBESARTANhiazide
HYDROCHLOROTHIA
ZIDE
T1 losartan/hydrochlorothi LOSARTANazide
HYDROCHLOROTHIA
ZIDE
T2 olmesartan/hydrochlorot BENICAR HCT
ST
hiazide
T1 valsartan/hydrochlorot VALSARTANhiazide
HYDROCHLOROTHIA
ZIDE
Angiotensin Receptor Antgnst & Calc.channel
Blockr
T1 amlodipine/valsartan
AMLODIPINEVALSARTAN
ST
Antihypertensives, Ace Inhibitors
T1 benazepril hcl
T1 enalapril maleate
T1
T1
T1
T1
fosinopril sodium
lisinopril
moexipril hcl
perindopril erbumine
T1 quinapril hcl
T1 ramipril
T1 trandolapril
BENAZEPRIL HCL
ENALAPRIL
MALEATE
FOSINOPRIL SODIUM
LISINOPRIL
MOEXIPRIL HCL
PERINDOPRIL
ERBUMINE
QUINAPRIL HCL
RAMIPRIL
TRANDOLAPRIL
T1
T1
T1
T1
acebutolol hcl
atenolol
betaxolol hcl
bisoprolol fumarate
T1 metoprolol succinate
T1 metoprolol tartrate
T2
T1
T1
T1
T1
nebivolol hcl
pindolol
propranolol hcl
sotalol hcl
timolol maleate
Related
T1 atenolol/chlorthalidone ATENOLOLCHLORTHALIDONE
T1 bisoprolol
BISOPROLOLfumarate/hctz
HYDROCHLOROTHIA
ZIDE
T1 metoprolol/hydrochloro METOPROLOLthiazide
HYDROCHLOROTHIA
ZIDE
T1 nadolol/bendroflumethi NADOLOLazide
BENDROFLUMETHIA
ZIDE
T1 propranolol/hydrochlor PROPRANOLOLothiazid
HYDROCHLOROTHIA
ZID
Calcium Channel Blocking Agents
T1 amlodipine besylate
Antagonist
T1
T1
T1
T1
T1
T1
T2
T1
T2 olmesartan medoxomil
T1 telmisartan
T1 valsartan
IRBESARTAN
LOSARTAN
POTASSIUM
BENICAR
TELMISARTAN
VALSARTAN
ST
diltiazem hcl
felodipine
isradipine
nicardipine hcl
nifedipine
nimodipine
nimodipine
verapamil hcl
Antihypertensives, Sympatholytic
Loop Diuretics
T1 clonidine
CLONIDINE
T1 clonidine hcl
CLONIDINE HCL
T1 clonidine
CLORPRES
hcl/chlorthalidone
T1 guanfacine hcl
GUANFACINE HCL
T1 methyldopa
METHYLDOPA
T1 methyldopa/hydrochlor METHYLDOPAothiazide
HYDROCHLOROTHIA
ZIDE
T1 reserpine
RESERPINE
T1 bumetanide
T1 furosemide
T1 torsemide
VNSNY
ACEBUTOLOL HCL
ATENOLOL
BETAXOLOL HCL
BISOPROLOL
FUMARATE
METOPROLOL
SUCCINATE
METOPROLOL
TARTRATE
BYSTOLIC
PINDOLOL
PROPRANOLOL HCL
SOTALOL
TIMOLOL MALEATE
Beta-adrenergic Blocking Agents/thiazide &
Antihypertensives, Angiotensin Receptor
T1 irbesartan
T1 losartan potassium
HYDRALAZINE HCL
MINOXIDIL
AMLODIPINE
BESYLATE
CARTIA XT
FELODIPINE ER
ISRADIPINE
NICARDIPINE HCL
NIFEDIPINE ER
NIMODIPINE
NYMALIZE
VERAPAMIL ER
PA
BUMETANIDE
FUROSEMIDE
TORSEMIDE
Potassium Sparing Diuretics
T1 amiloride hcl
T1 spironolactone
AMILORIDE HCL
SPIRONOLACTONE
Potassium Sparing Diuretics In Combination
T1 amiloride/hydrochlorot AMILORIDEhiazide
HYDROCHLOROTHIA
ZIDE
Page 17 of 75
T1 spironolact/hydrochloro SPIRONOLACTONEthiazid
HCTZ
T1 triamterene/hydrochlor TRIAMTERENEothiazid
HYDROCHLOROTHIA
ZID
T2 rosuvastatin calcium
Pulm Anti-htn,soluble Guanylate Cyclase
T1 simvastatin
Stimulator
T2 riociguat
ADEMPAS
PA
T1 simvastatin
Pulm.anti-htn,sel.c-gmp Phosphodiesterase T5
T1 simvastatin
Inhib
T1 simvastatin
T2
T2
T1
T2
ambrisentan
sildenafil citrate
sildenafil citrate
tadalafil
LETAIRIS
REVATIO
SILDENAFIL
ADCIRCA
PA
PA
PA
PA
Pulmonary Anti-htn, Endothelin Receptor
Antihyperlipidemic - Mtp Inhibitor
T2 lomitapide mesylate
Antagonist
T2 bosentan
T2 macitentan
T1 simvastatin
CRESTOR(TAB)(10
QL, ST
MG)
CRESTOR(TAB)(20
QL, ST
MG)
CRESTOR(TAB)(40
QL, ST
MG)
CRESTOR(TAB)(5 MG) QL, ST
SIMVASTATIN(TAB)
(10 MG)
SIMVASTATIN(TAB)
(20 MG)
SIMVASTATIN(TAB)
(40 MG)
SIMVASTATIN(TAB)(5
MG)
SIMVASTATIN(TAB) ST
(80 MG)
JUXTAPID
PA
Antihyperlipidemic - PCSK9 Inhibitor
TRACLEER
OPSUMIT
PA
PA
T2 evolocumab
T2 evolocumab
REPATHA SURECLICKPA
REPATHA SYRINGE PA
Pulmonary Antihypertensives, Prostacyclin-type
Antihyperlipidemic-hmg Coa Reductase
T2
T2
T2
T2
T2
T2
Inhib.&niacin
iloprost tromethamine
selexipag
treprostinil
treprostinil diolamine
treprostinil sodium
treprostinil/neb
accessories
T2 treprostinil/nebulizer/acc
esor
VENTAVIS
UPTRAVI
TYVASO
ORENITRAM ER
REMODULIN
TYVASO
PA
PA
PA
PA
PA
PA
TYVASO
PA
T2 niacin/simvastatin
Thiazide And Related Diuretics
T1 chlorothiazide
T1 chlorthalidone
T1 hydrochlorothiazide
Bile Salt Sequestrants
CHLOROTHIAZIDE
CHLORTHALIDONE
HYDROCHLOROTHIA
ZIDE
INDAPAMIDE
METHYCLOTHIAZIDE
METOLAZONE
Vasodilators, Combination
T1 cholestyramine (with
sugar)
T1 cholestyramine/asparta
me
T2 colesevelam hcl
T1 colestipol hcl
T2 isosorb dinit/hydralazine BIDIL
hcl
Lipotropics
T1 indapamide
T1 methyclothiazide
T1 metolazone
CARDIOVASCULAR DISEASE - LIPID
IRREGULARITY
Antihyperlipidemic - Apo B-100 Synthesis Inhibitor
T2 mipomersen sodium
KYNAMRO
Antihyperlipidemic - Hmg Coa Reductase
Inhibitors
T1 atorvastatin calcium
T1 lovastatin
T1 pravastatin sodium
VNSNY
ATORVASTATIN
CALCIUM
LOVASTATIN
PRAVASTATIN
SODIUM
PA
SIMCOR(TBMP
24HR)(1000-20MG)
SIMCOR(TBMP
24HR)(1000-40 MG)
SIMCOR(TBMP
24HR)(500MG-20MG)
SIMCOR(TBMP
24HR)(500MG-40MG)
SIMCOR(TBMP
24HR)(750MG-20MG)
QL, ST
QL, ST
QL, ST
QL, ST
QL, ST
CHOLESTYRAMINE
PREVALITE
WELCHOL
COLESTIPOL HCL
T2 ezetimibe
ZETIA
T1 fenofibrate
FENOFIBRATE
T1 fenofibrate
FENOFIBRATE
nanocrystallized
T2 fenofibrate
TRIGLIDE
nanocrystallized
T1 fenofibrate,micronized FENOFIBRATE
T1 fenofibric acid
FENOFIBRIC ACID
T1 fenofibric acid (choline) FENOFIBRIC ACID
T1 gemfibrozil
GEMFIBROZIL
T2 icosapent ethyl
VASCEPA
T1 niacin
NIACIN ER
T1 omega-3 acid ethyl
OMEGA-3 ACID
esters
ETHYL ESTERS
QL
ST
QL
ST
QL
Page 18 of 75
Niacin Preparations
T1 niacin
Contraceptives,oral
NIACIN(OTC)
CARDIOVASCULAR DISEASE MISCELLANEOUS AGENTS
Adrenergic Vasopressor Agents
T2 droxidopa
T1 midodrine hcl
NORTHERA
MIDODRINE HCL
PA
Antianginal & Anti-ischemic Agents,nonhemodynamic
T2 ranolazine
T2 ranolazine
RANEXA(TAB ER
12H)(1000 MG)
RANEXA(TAB ER
12H)(500 MG)
QL
QL
Antihyperlip - Hmg-coa&calcium Channel Blocker
Cb
T1 amlodipine/atorvastatinAMLODIPINEATORVASTATIN
QL
CARDIOVASCULAR DISEASE VASODILATION
Vasodilators,coronary
T1 amyl nitrite
T2 isosorbide dinitrate
T1 isosorbide dinitrate
T1
T2
T2
T1
T2
AMYL NITRITE
ISORDIL
ISOSORBIDE
DINITRATE
isosorbide mononitrate ISOSORBIDE
MONONITRATE ER
nitroglycerin
NITRO-BID
nitroglycerin
NITRO-DUR
nitroglycerin
NITROGLYCERIN
PATCH
nitroglycerin
NITROSTAT
Vasodilators,peripheral
T1 ergoloid mesylates
T1 isoxsuprine hcl
T1 papaverine hcl
ERGOLOID
MESYLATES
ISOXSUPRINE HCL
PAPAVERINE HCL
VNSNY
BEYAZ
ST
SAFYRAL
ST
NATAZIA
OCELLA
ST
KELNOR 1-35
MY WAY(OTC)
LEVORA-28
CAMRESE
QL
QUARTETTE
NORETHIN-ETH
ESTRA FERROUS FUM
NORA-BE
LOESTRIN
MICROGESTIN
LO LOESTRIN FE
MICROGESTIN FE
MINASTRIN 24 FE
NECON
ORTHO-NOVUM
NORINYL 1+50
SPRINTEC
CRYSELLE
ELLA
QL
Diaphragms/cervical Cap
QL
T4 diaphragms, wide seal
WIDE SEAL
DIAPHRAGM
Oxytocics
Contraceptives,injectable
T4 medroxyprogesterone
acetate
T4 medroxyprogesterone
acetate
APRI
T4 norelgestromin/ethin.es ORTHO EVRA
tradiol
Contraceptives, Intravaginal, Systemic
NUVARING
AZURETTE
Contraceptives,transdermal
CONTRACEPTION/OXYTOCICS
T4 etonogestrel/ethinyl
estradiol
T4 desoge.estradiol/e.estradiol
T4 desogestrel-ethinyl
estradiol
T4 drospir/eth
estra/levomefol ca
T4 drospir/eth
estra/levomefol ca
T4 estradiol
valerate/dienogest
T4 ethinyl
estradiol/drospirenone
T4 ethynodiol d-ethinyl
estradiol
T4 levonorgestrel
T4 levonorgestrel-ethin
estradiol
T4 l-norgest/e.estradione.estrad
T4 l-norgest/e.estradione.estrad
T4 noreth-ethinyl
estradiol/iron
T4 norethindrone
T4 norethindrone ac-eth
estradiol
T4 norethindrone ac-eth
estradiol
T4 norethindronee.estradiol-iron
T4 norethindrone-ethinyl
estrad
T4 norethindrone-ethinyl
estrad
T4 norethindronemestranol
T4 norgestimate-ethinyl
estradiol
T4 norgestrel-ethinyl
estradiol
T4 ulipristal acetate
DEPO-PROVERA
QL
DEPO-SUBQ
PROVERA 104
QL
T1 methylergonovine
maleate
METHYLERGONOVIN
E MALEATE
Page 19 of 75
COUGH AND COLD
1st Gen Antihistamine & Decongestant
Astringents
T5 aluminum acetate
Combinations
Rosacea Agents, Topical
T1 phenylephrine
PROMETHAZINE VC
hcl/prometh hcl
T1 triprolidine/pseudoephe APRODINE(OTC)
drine
T1 metronidazole
Antitussives,non-narcotic
T1 benzonatate
BENZONATATE
Decongestant-expectorant Combinations
T1 guaifenesin/phenylephriCHEST CONGESTION
ne hcl
RELIEF PE(OTC)
Decongestants, Oral
T5 pseudoephedrine hcl
SINUS 12 HOUR(OTC)
Expectorants
T5 guaifenesin
Q-TUSSIN(OTC)
T1 benzalkonium chloride REVITADERM(OTC)
T1 chloroxylenol
PERICLEAN(OTC)
T1 hydrocortisone/iodoqui HYDROCORTISONEnol
IODOQUINOL
T1 iodine/potassium iodide IODINE(OTC)
T1 methylbenzethonium BEDSIDE-CARE(OTC)
chloride
T5 silver
SILVASORB(OTC)
T5 silver
SILVERMED(OTC)
T1 silver chloride
SILVER GEL(OTC)
T1 silver nitrate
SILVER NITRATE
T5 silver/sodium alginate ARGLAES(OTC)
DERMATOLOGY - ANTIINFECTIVE
Topical Antibiotics
decongest
T5 bacitracin
T5 bacitracin zinc
T1
T1
T1
Non-narc Antitussive-1st Gen Antihistamine Comb.
T2
T1 promethazine/dextrome PROMETHAZINE-DM
thorphan
T1
Non-narcotic Antitussive And Expectorant Comb.
T1
T5 guaifenesin/dextrometh Q-TUSSIN DM(OTC)
orphan
Nose Preparations, Vasoconstrictors
T5 oxymetazoline hcl
NASAL SPRAY(OTC)
METRONIDAZOLE
Topical Preparations,antibacterials
Non-narc Antituss-1st Gen. AntihistamineT1 brompheniram/phenyle NIVA-HIST DM(OTC)
phrine/dm
T1 brompheniramine/pseu BROMPHENIRAMINEdoephed/dm
PSEUDOEPHED-DM
T1 chlorpheniramine/phen NOHIST-DM(OTC)
yleph/dm
ALUMINUM
ACETATE(OTC)
T1
T1
T1
BACITRACIN(OTC)
BACITRACIN
ZINC(OTC)
bacitracin/polymyxin b BACITRACINsulfate
POLYMYXIN(OTC)
clindamycin phosphate CLINDAMYCIN
PHOSPHATE
erythromycin
ERYTHROMYCIN
base/ethanol
erythromycin/benzoyl BENZAMYCINPAK
peroxide
erythromycin/benzoyl ERYTHROMYCINperoxide
BENZOYL PEROXIDE
gentamicin sulfate
GENTAMICIN
SULFATE
mupirocin
MUPIROCIN
mupirocin calcium
MUPIROCIN
neomycn/baci zn/pmyx TRIPLE ANTIBIOTIC
bs/pramox
PLUS(OTC)
Sympathomimetic Agents
Topical Antifungal/antiinflammatory,steriod Agent
T1 clotrimazole/betametha CLOTRIMAZOLEsone dip
BETAMETHASONE
NEXAFED(OTC)
SUDOGEST(TAB
ER)(OTC)
SUDOGEST(TAB)(30
MG)(OTC)
SUDOGEST(TAB)(60
MG)(OTC)
DERMATOLOGY - ACNE
Acne Agents,systemic
T1 isotretinoin
CLARAVIS
Acne Agents,topical
T1 clindamycin
phos/benzoyl perox
VNSNY
CLINDAMYCINBENZOYL PEROXIDE
Topical Antifungals
T1 ciclopirox
CICLOPIROX
T1 ciclopirox olamine
CICLOPIROX
T1 ciclopirox/ure/camph/m CICLOPIROX
enth/euc
T1 clotrimazole
CLOTRIMAZOLE
T1 clotrimazole
CLOTRIMAZOLE(OT
C)
T1 econazole nitrate
ECONAZOLE
NITRATE
T1 gentian viol/brlnt
TRIPLE DYE
grn/proflav
T1 ketoconazole
KETOCONAZOLE
T1 miconazole nitrate
MICONAZOLE
NITRATE(OTC)
Page 20 of 75
T1
T2
T1
T1
T1
T2
T2
T5
naftifine hcl
naftifine hcl
nystatin
nystatin/triamcin
NAFTIFINE HCL
NAFTIN
NYSTATIN
NYSTATINTRIAMCINOLONE
sodium thiosulfate/sal EXODERM
acid
sulconazole nitrate
EXELDERM
terbinafine hcl
LAMISIL(OTC)
tolnaftate
TOLNAFTATE(OTC)
Topical Antiparasitics
T2
T1
T1
T5
T5
crotamiton
lindane
permethrin
permethrin
piperonyl
butoxide/pyrethrins
EURAX
LINDANE
PERMETHRIN
PERMETHRIN(OTC)
LICE KILLING(OTC)
Topical Antivirals
T1 acyclovir
T2 acyclovir
T5 docosanol
ACYCLOVIR
ZOVIRAX
ABREVA(OTC)
Topical Sulfonamides
T1 mafenide acetate
T1 silver sulfadiazine
MAFENIDE ACETATE
SILVER
SULFADIAZINE
DERMATOLOGY ANTIINFLAMMATORY
Topical Antibiotics/antiinflammatory,steroidal
T2 neomycin/bacitra/polymyCORTISPORIN
xin/hc
T2 neomycin/polymyxin b CORTISPORIN
sulf/hc
T1 fluocinonide/emollient FLUOCINONIDE-E
base
T2 flurandrenolide
CORDRAN
PROPIONATE
T1 halobetasol propionate HALOBETASOL
PROPIONATE
T1 hc/mineral
HYDROCORTISONE
oil/petrolat,wht
T2 hydrocort/sal
SCALACORT DK
acid/sulf/shmp#1
T1 hydrocortisone
HYDROCORTISONE
T5 hydrocortisone
HYDROCORTISONE(O
TC)
T2 hydrocortisone
TEXACORT
T5 hydrocortisone acetate HYDROCORTISONE
ACETATE(OTC)
T1 hydrocortisone
U-CORT
acetate/urea
T1 hydrocortisone
HYDROCORTISONE
butyrate
BUTYRATE
T2 hydrocortisone probutate PANDEL
T1 hydrocortisone valerate HYDROCORTISONE
VALERATE
T5 hydrocortisone/aloe
HYDROCORTISONEvera
ALOE(OTC)
T5 hydrocortisone/aloe/vit. ANTI-ITCH
e/a/d
CREME(OTC)
T5 hydrocortisone/oatmeal AVEENO(OTC)
/aloe/e
T1 mometasone furoate
MOMETASONE
FUROATE
T1 prednicarbate
PREDNICARBATE
T1 triamcinolone acetonideTRIAMCINOLONE
ACETONIDE
Topical Anti-inflammatory, Nsaids
T1 diclofenac sodium
DICLOFENAC
SODIUM
VOLTAREN
Topical Anti-inflammatory Steroidal
T1 alclometasone
ALCLOMETASONE
dipropionate
DIPROPIONATE
T1 amcinonide
AMCINONIDE
T1 betamethasone
BETAMETHASONE
dipropionate
DIPROPIONATE
T1 betamethasone valerate BETAMETHASONE
VALERATE
T1 betamethasone/propyle BETAMETHASONE
ne glyc
DIPROPIONATE
T1 clobetasol propionate CLOBETASOL
PROPIONATE
T1 clobetasol
CLOBETASOL
propionate/emoll
EMOLLIENT
T1 clocortolone pivalate CLOCORTOLONE
PIVALATE
T1 desonide
DESONIDE
T1 desoximetasone
DESOXIMETASONE
T2 diflorasone
APEXICON E
diacetate/emoll
T1 fluocinolone acetonide FLUOCINOLONE
ACETONIDE
T1 fluocinolone/shower capFLUOCINOLONE
ACETONIDE
T1 fluocinonide
FLUOCINONIDE
DERMATOLOGY - MISCELLANEOUS
VNSNY
Antiseborrheic Agents
T1 emollient combination LOUTREX
no.85
T1 selenium sulfide
SELENIUM SULFIDE
T1 sulfacetamide sodium SODIUM
SULFACETAMIDE
Antiseptics,general
T1 alcohol antiseptic pads
ALCOHOL PADS(OTC)
ALCOHOL PREP
PADS(OTC)
ALCOHOL PREP
SWABS(OTC)
ALCOHOL
SWAB(OTC)
ALCOHOL
SWABS(OTC)
ALCOHOL
WIPES(OTC)
CURITY ALCOHOL
PREPS(OTC)
Page 21 of 75
EASY TOUCH
ALCOHOL PREP
PADS(OTC)
IV ANTISEPTIC
WIPES(OTC)
IV PREP WIPES(OTC)
SINGLE USE
SWAB(OTC)
SURE COMFORT
ALCOHOL(OTC)
SURE-PREP
ALCOHOL PREP
PADS(OTC)
ULTILET ALCOHOL
SWAB(OTC)
WEBCOL(OTC)
Deodorants
T5 ostomy supply
T5 ostomy supply
T5 ostomy supply
T5 ostomy supply
T1 sodium citrate
FRESHNET(OTC)
HEX-ON LIGHT(OTC)
ODOR ELIMINATOR
DROPS(OTC)
ULTRA-FRESH(OTC)
M9(OTC)
Emollients
T1 aloe vera/collagen
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
ALOE VESTA
CLEANSING(OTC)
aloe vera/collagen
ALOE VESTA(OTC)
aloe vera/collagen
PERISCENT(OTC)
aloe vera/collagen
SENSI-CARE(OTC)
aloe/la/ceramide/silicone SILICONE SCAR(OTC)
&tape
aloe/lac ac/ceramides
HYPER-HEAL(OTC)
3,3b,6,1
ammonium lactate
AMMONIUM
LACTATE
ammonium lactate
AMMONIUM
LACTATE(OTC)
emol53/namgfs/ha/nahy HPR PLUS-MB
pochlorit
HYDROGEL
emollient #56/hyaluronic DERMAPLEX(OTC)
acid
emollient combination PRUTECT
no.10
emollient combination EMULSION SB
no.32
emollient combination PRUMYX
no.35
emollient combination RESTORE SKIN
no.36
CONDITIONING(OTC)
emollient combination HPR PLUS
no.53
emollient combination ATRAPRO HYDROGEL
no.60
emollient combo no.47 &ATRAPRO CP
no.60
glycerin/dimethicone SENSITIVE SKIN
MOISTURE(OTC)
lactic acid
LACTIC ACID
lanolin
DRY SKIN
alcohol/mo/w.pet/ceres THERAPY(OTC)
T1 lanolin/aloe vera/prop
gly
T1 mineral oil/lan oil/prop
gly
T1 mineral
oil/petrolatum,white
T1 pantothenic acid/aloe
vera
T1 petrolatum,white
T1 silicones/adhesive tape
T1
T1
T1
T1
silicones/adhesive tape
vitamin e
vitamin e/aloe vera
vite
ac/grape/hyaluronic
acid
HYDROCERIN(OTC)
EXCEL-GEL(OTC)
SECURA
PROTECTIVE(OTC)
SILICONE DISC(OTC)
SILICONE ROLL(OTC)
SILICONE
SHEET(OTC)
SILICONE TAPE(OTC)
VITAMIN E(OTC)
WOUND GEL(OTC)
PRUCLAIR
Irrigants
T1 acetic acid
ACETIC ACID
T1 mannitol/sorbitol
SORBITOLsolution
MANNITOL
T1 nacl irrigat/decyl
SEA-CLENS(OTC)
glucoside
T1 neomycin su/polymyx b NEOMYCINsulf
POLYMYXIN B
T1 ringers solution
RINGERS IRRIGATION
T1 sodium chloride irrig SODIUM CHLORIDE
solution
T1 sorbitol solution
SORBITOL
T1 water for
WATER
irrigation,sterile
Irritants/counter-irritants
T1 methyl salicylate
T1 methyl
salicylate/isopropanol
METHYL
SALICYLATE(OTC)
ISOPROPYLWINTERGREEN(OTC)
Keratolytics
T5 benzoyl peroxide
T1 benzoyl peroxide
T5 benzoyl peroxide
T1 benzoyl peroxide
T5 benzoyl peroxide
T2
T1
T1
T1
podofilox
podofilox
podophyllum resin
potassium hydroxide
T1 salicylic acid
VNSNY
SOOTHE & COOL
PERINEAL
WASH(OTC)
BALNEOL(OTC)
ACNE
MEDICATION(OTC)
BENZOYL
PEROXIDE(CLEANSE
R)(OTC)
BENZOYL
PEROXIDE(GEL)(10
%)(OTC)
BENZOYL
PEROXIDE(GEL)(2.5
%)(OTC)
BENZOYL
PEROXIDE(LOTION)
(OTC)
CONDYLOX
PODOFILOX
PODOCON-25
POTASSIUM
HYDROXIDE
SALICYLIC ACID
Page 22 of 75
T1 salicylic acid/ceramide SALICYLIC ACID
cmb #1
T1 silver nitrate applicator SILVER NITRATE
APPLICATOR
T1 urea
UREA
T1 urea/hyaluronate
UREA
sodium
T1 urea/lactic ac/zn
BP-50% UREA
undecylenate
T1 urea/lactic acid/salicylic LATRIX
ac
Oxidizing Agents
T1 hydrogen peroxide
HYDROGEN
PEROXIDE(OTC)
Protectives
T1 benzethonium chloride
T1 benzoin
T1 carbit/equis
xt/ethan/chit/msm
T1 dimethicone
T1 hyaluron
sod/allantoin/aloe xt
T1 hyaluronate sodium
T1 petrolatum,white
NEW SKIN(OTC)
BENZOIN(OTC)
GENADUR
ONE STEP
PERINEAL(OTC)
RADIAPLEXRX
BIONECT
WHITE
PETROLATUM(OTC)
T1 protect cmb2/ceramide PR CREAM
1,3,6-11
T1 zinc
AMERIGEL(OTC)
acetate/meadowsweet/o
ak
GRX RINSEFREE(OTC)
Topical Agents,miscellaneous
T1 urea
CARB-O-PHILIC
Topical Anti-inflammatory Steroid-local Anesthetic
T2 hydrocortisone/pramoxin ANALPRAM HC
e
T1 hydrocortisone/pramox HYDROCORTISONEine
PRAMOXINE HCL
T2 hydrocortisone/pramoxin PRAMOSONE
e
T1 lidocaine/hydrocortison LIDOCAINEe ac
HYDROCORTISONE
Topical Antineoplastic & Premalignant Lesion
Agnts
T2 bexarotene
T1
T2
T2
T2
fluorouracil
ingenol mebutate
ingenol mebutate
mechlorethamine hcl
T1 dyclonine
hcl/benzethonium cl
T1 ethyl chloride
T1 lidocaine
T1 lidocaine hcl
T1 lidocaine hcl/collagen
T1 lidocaine/prilocaine
T1 vit e/lidocain/alo
ver/colagn
Topical Preparations,miscellaneous
T1 benzethonium chloride BEDSIDE-CARE
PERINEAL(OTC)
T1 calcium carbonate/na
NAIL SCRUB(OTC)
hypochlor
T1 honey
MEDIHONEY(OTC)
T1 povidone-iodine
BETADINE(OTC)
T1 povidone-iodine
POVIDONEIODINE(OTC)
T1 skin cleanser comb no.34 PROSHIELD FOAM &
SPRAY(OTC)
Topical/mucous Membr./subcut. Enzymes
T1 trypsin/balsam
peru/castor oil
GRANULEX
DERMATOLOGY - PIGMENTATION
DISORDERS
TARGRETIN
PA
DICLOFENAC
PA
SODIUM
FLUOROURACIL
PICATO(GEL)(0.015 %) QL
PICATO(GEL)(0.05 %) QL
VALCHLOR
PA
T1 hydroquinone
T1 hydroquinone
microspheres
T1 hydroquinone/ferric
oxide
T1 oxybenzone/octinox/hquinone
HYDROQUINONE
HYDROQUINONE
MELPAQUE HP
ALPHAQUIN HP
Topical Hyperpigmentation Agents
T2 methoxsalen
OXSORALEN
DERMATOLOGY PSORIASIS/ECZEMA
Antipsoriatic Agents,systemic
T2 methoxsalen
T1 methoxsalen, rapid
T2 secukinumab
T2 secukinumab
T2 secukinumab
T2 secukinumab
8-MOP
METHOXSALEN
COSENTYX (2
SYRINGES)
COSENTYX PEN
COSENTYX PEN (2
PENS)
COSENTYX SYRINGE
PA
PA
PA
PA
Antipsoriatics Agents
T2 anthralin
T1 calcipotriene
T1 calcitriol
VNSNY
LIQUID
BANDAGE(OTC)
ETHYL CHLORIDE
LIDOCAINE
LIDOCAINE HCL
REGENECARE
LIDOCAINEPRILOCAINE
REGENECARE
Hypopigmentation Agents
Shampoos/lotion
T1 soap
Topical Local Anesthetics
DRITHOCREME HP
CALCIPOTRIENE
CALCITRIOL
ST
ST
ST
Page 23 of 75
T2 tazarotene
TAZORAC
T1 repaglinide
T1 tolazamide
T1 tolbutamide
Topical Agents,miscellaneous
T1 collagen,bovine
Antihyperglycemic, Insulin-response Enhancer
T1
T1 pioglitazone hcl
T1
T1
T1
TRIPLE HELIX
COLLAGEN(OTC)
skin cleanser
PERIANAL
CLEANSING(OTC)
skin cleanser
PERIFRESH(OTC)
skin cleanser comb no.20 RESTORE SKIN
CLEANSER(OTC)
skin cleanser comb no.21 RESTORE WOUND
CLEANSER(OTC)
REPAGLINIDE
TOLAZAMIDE
TOLBUTAMIDE
Antihyperglycemic, Sglt-2 & Dpp-4 Inhibitor Comb.
T2 empagliflozin/linagliptin GLYXAMBI
TACROLIMUS
T1 metformin hcl
T2 metformin hcl
AGE,
ST
Topical Vit D Analog/antiinflammatory, Steroidal
T1 calcipotriene/betamethaCALCIPOTRIENEST
sone
BETAMETHASONE DP
DIABETES
Antihypergly, (dpp-4) Inhibitor & Biguanide Comb.
T2 linagliptin/metformin hcl JENTADUETO
T2 sitagliptin
JANUMET
phos/metformin hcl
T2 sitagliptin
JANUMET XR(TBMP
phos/metformin hcl
24HR)(100-1000MG)
T2 sitagliptin
JANUMET XR(TBMP
phos/metformin hcl
24HR)(50-1000 MG)
T2 sitagliptin
JANUMET XR(TBMP
phos/metformin hcl
24HR)(50MG-500MG)
QL
QL
QL
QL
QL
Antihypergly,incretin Mimetic
T2 albiglutide
T2 dulaglutide
TANZEUM
TRULICITY
QL, ST
QL, ST
Antihyperglycemc-sod/gluc
Cotransport2(sglt2)inhib
T2 canagliflozin
T2 empagliflozin
INVOKANA
JARDIANCE
QL, ST
QL, ST
Antihyperglycemic, Alpha-glucosidase Inhib
T1 acarbose
TRADJENTA
JANUVIA
QL
QL
Antihyperglycemic, Insulin-release Stimulant Type
T1
T1
T1
T2
T1
T1
chlorpropamide
glimepiride
glipizide
glyburide
glyburide
glyburide,micronized
T1 nateglinide
VNSNY
CHLORPROPAMIDE
GLIMEPIRIDE
GLIPIZIDE
DIABETA
GLYBURIDE
GLYBURIDE
MICRONIZED
NATEGLINIDE
T1 glipizide/metformin hcl GLIPIZIDEMETFORMIN
T1 glyburide/metformin GLYBURIDEhcl
METFORMIN HCL
T1 repaglinide/metformin REPAGLINIDEhcl
METFORMIN HCL
Antihyperglycemic-glucocorticoid Receptor Blocker
T2 mifepristone
KORLYM
PA
Antihyperglycemic-sglt2 Inhibitor & Biguanide
Comb
T2 canagliflozin/metformin INVOKAMET
hcl
T2 empagliflozin/metformin SYNJARDY
hcl
QL, ST
QL, ST
Antihyperglycm,insul-resp.enhancer & Biguanide
Cmb
T2 pioglitazone
hcl/metformin hcl
T1 pioglitazone
hcl/metformin hcl
ACTOPLUS MET XR
ST
PIOGLITAZONEMETFORMIN
ST
Blood Sugar Diagnostics
T2 blood sugar diagnostic
Antihyperglycemic, Dpp-4 Inhibitors
T2 linagliptin
T2 sitagliptin phosphate
Cmb
SYMLINPEN 120
SYMLINPEN 60
METFORMIN HCL
RIOMET
Antihyperglycemic,insulin-rel Stim.& Biguanide
ACARBOSE
Antihyperglycemic, Amylin Analog-type
T2 pramlintide acetate
T2 pramlintide acetate
QL, ST
Antihyperglycemic,biguanide Type
Topical Immunosuppressive Agents
T1 tacrolimus
PIOGLITAZONE HCL
FREESTYLE
INSULINX(OTC)
FREESTYLE
LITE(OTC)
FREESTYLE(OTC)
PRECISION
XTRA(OTC)
Diabetic Supplies
T1 blood glucose ctl
high,nml&low
T2
T1
T5
T1
MYGLUCOHEALTH
CONTROL
SOLUTION(OTC)
blood glucose ctl
ON CALL EXPRESS
high,nml&low
CONTROL SOLN(OTC)
blood-gluc
PARADIGM REALtransmitter/sensor
TIME
blood-gluc.meter& wrist ADVOCATE REDIbp mon
CODE DUO(OTC)
blood-glucose & ketone NOVAMAX PLUS
ctl nml
GLU-KET(OTC)
Page 24 of 75
T5 blood-glucose meter
T5 lancing device
T2
T5 lancing device
T2
T2
T2
T1
T1
T1
T1
T1
T1
T1
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
T5
EVENCARE MINI
MONITOR
SYSTEM(OTC)
blood-glucose meter
FREESTYLE
FREEDOM LITE(OTC)
blood-glucose meter
FREESTYLE
INSULINX(OTC)
blood-glucose meter
FREESTYLE LITE
METER(OTC)
blood-glucose meter
PRECISION
XTRA(OTC)
blood-glucose transmitterMINILINK REALTIME TRANSMITTER
infusion set for insulin COMFORT
pump
infusion set for insulin CONTACT DETACH
pump
INFUSION SET
infusion set for insulin MINIMED
pump
infusion set for insulin MIO INFUSION SET
pump
infusion set for insulin QUICK-SET
pump
PARADIGM
infusion set for insulin SURE-T PARADIGM
pump
lancing device
ADJUSTABLE
LANCING
DEVICE(OTC)
lancing device
ADVOCATE LANCING
DEVICE(OTC)
lancing device
ADVOCATE RAPIDSAFE(OTC)
lancing device
ALTERNATE SITE
LANCING
DEVICE(OTC)
lancing device
AQUA LANCE
LANCING
DEVICE(OTC)
lancing device
AUTO-LANCET
MINI(OTC)
lancing device
AUTOLET LANCING
DEVICE(OTC)
lancing device
CARELANCE ULT
LANCING
DEVICE(OTC)
lancing device
CAREONE(OTC)
lancing device
CARESENS PREM
LANCING
DEVICE(OTC)
lancing device
DROPLET LANCING
DEVICE(OTC)
lancing device
EASY CLICK(OTC)
lancing device
EASY TOUCH
LANCING
DEVICE(OTC)
lancing device
FORA LANCING
DEVICE(OTC)
lancing device
GLUCOLET 2(OTC)
lancing device
GMATE LANCING
DEVICE(OTC)
lancing device
HEALTHY ACCENTS
AUTOLET(OTC)
VNSNY
T5 lancing device
T5 lancing device
T5 lancing device
T5 lancing device
T5 lancing device
T5 lancing device
T5 lancing device
T5 lancing device
T5 lancing device
T5 lancing device
T5 lancing device
T5 lancing device
T5
T5
T5
T5
T5
lancing device
lancing device
lancing device
lancing device
lancing device/lancets
T5 lancing device/lancets
T5
T5
T5
T5
INCONTROL
LANCING
DEVICE(OTC)
LANCET
DEVICE(OTC)
LANCING
DEVICE(OTC)
LANCING
SYSTEM(OTC)
LITE TOUCH(OTC)
MINI LANCING
DEVICE(OTC)
ON CALL LANCING
DEVICE(OTC)
ON CALL PLUS
LANCING
DEVICE(OTC)
PRODIGY LANCING
DEVICE(OTC)
RELIAMED MINI
LANCING
DEVICE(OTC)
RIGHTEST
GD500(OTC)
SMARTDIABETES
VANTAGE(OTC)
SOFTCLIX(OTC)
SURE COMFORT
LANCING PEN(OTC)
SUREFLEX(OTC)
SURE-PEN(OTC)
TRUEDRAW(OTC)
ULTI-LANCE(OTC)
ACCU-CHEK
FASTCLIX(OTC)
ACCU-CHEK
SOFTCLIX(OTC)
ACCU-CHEK(OTC)
ADVANCED LANCING
DEVICE(OTC)
AUTOLET
IMPRESSION(OTC)
GLUCOLET 2(OTC)
HYPOLANCE(OTC)
LANCING
DEVICE(OTC)
LANZO(OTC)
MICROLET 2(OTC)
MULTI-LANCET(OTC)
ONETOUCH
DELICA(OTC)
ONETOUCH
SURESOFT(OTC)
PENLET PLUS BLOOD
SAMPLER(OTC)
SOLUS V2 LANCING
DEVICE(OTC)
SUREFLEX(OTC)
ULTI-LANCE(OTC)
UNISTIK 2
EXTRA(OTC)
UNISTIK 2 NORMAL
UNISTIK 2
NORMAL(OTC)
Page 25 of 75
T1 subcutaneous insulin
pump
pump
pump
pump
pump
UNISTIK 2(OTC)
UNISTIK 3
COMFORT(OTC)
UNISTIK 3
NEONATAL(OTC)
UNISTIK 3(OTC)
ANIMAS 2020
T5 insulin regular, human
T5 insulin regular, human
INSULIN PUMP
Urine Glucose/acetone Test Aids,strips
OMNIPOD
T1 urine gluc-acet
comb.tst,strip
T1 urine gluc-acet
comb.tst,strip
T1 urine glucose test,strip
DIASTIX
REAGENT(OTC)
T1 urine glucose test,tablet CLINITEST
REAGENT(OTC)
ONETOUCH PING
Ear Preparations Anti-inflammatory
T1 fluocinolone acetonide FLUOCINOLONE
oil
ACETONIDE OIL
Ear Preparations, Misc. Anti-infectives
T1 acetic acid
T1 acetic acid/aluminum
acetate
T1 acetic
acid/hydrocortisone
REGRANEX
Hyperglycemics
T1 ciprofloxacin hcl
CIPROFLOXACIN HCL
T1 neomycin/polymyxin b NEOMYCINsulf/hc
POLYMYXIN-HC
Otic Preparations,anti-inflammatory-antibiotics
Insulins
T2 insulin lispro
T2 insulin lispro
T2 insulin lispro
protamin/lispro
T2 insulin lispro
protamin/lispro
T2 insulin lispro
protamin/lispro
T2 insulin lispro
protamin/lispro
T5 insulin nph hum/reg
insulin hm
T5 insulin nph hum/reg
insulin hm
T5 insulin nph human
isophane
T5 insulin nph human
isophane
VNSNY
ACETIC ACID
ACETIC ACIDALUMINUM
HYDROCORTISONEACETIC ACID
Ear Preparations,antibiotics
T5 dextrose
GLUCOSE(OTC)
T5 dextrose/dextrin/maltos INSTAe
GLUCOSE(OTC)
T2 glucagon,human
GLUCAGON
recombinant
EMERGENCY KIT
T2 insulin lispro
CHEMSTRIP
UGK(OTC)
KETO-DIASTIX
REAGENT(OTC)
EAR - GENERAL DISORDERS
Diabetic Ulcer Preparations,topical
T2 insulin
glargine,hum.rec.anlog
T2 insulin
T2 insulin
T2 insulin lispro
LANTUS
QL
T2 ciprofloxacin
hcl/dexameth
LANTUS SOLOSTAR
QL
ELECTROLYTE REGULATION
TOUJEO SOLOSTAR
QL
Electrolyte Depleters
HUMALOG KWIKPEN
U-100
HUMALOG KWIKPEN
U-200
HUMALOG(CARTRID
GE)
HUMALOG(VIAL)
HUMALOG MIX 50-50
QL
T1 calcium acetate
T1 calcium carbonate/mag
carb/fa
T2 sevelamer carbonate
T2 sevelamer hcl
T1 sodium polystyrene
sulfonate
QL
QL
QL
QL
HUMALOG MIX 50-50 QL
KWIKPEN
KWIKPEN
HUMULIN 70/30
QL
KWIKPEN(OTC)
HUMULIN 70-30(OTC) QL
HUMULIN N
KWIKPEN(OTC)
HUMULIN N(OTC)
QL
QL
Urine Glucose Test Aids
REVEL
PROGRAMMABLE
PUMP
T1 sub-q insulin device, 20 VGO 20
unit
unit
unit
T2 becaplermin
HUMULIN R U-500
HUMULIN R(OTC)
QL
CIPRODEX
CALCIUM ACETATE
MAGNEBIND 400 RX
RENVELA
RENAGEL
KIONEX
Potassium Replacement
T1 pot chloride/pot
bicarb/cit ac
T1 potassium
bicarbonate/cit ac
T1 potassium chloride
POTASSIUM
CHLORIDE
EFFER-K
POTASSIUM
CHLORIDE
Sodium/saline Preparations
T1 0.9 % sodium chloride NORMAL SALINE
FLUSH
T1 sodium chloride 0.45 % SODIUM CHLORIDE
QL
Page 26 of 75
ENDOCRINE DISORDER - OTHER
Antidiuretic And Vasopressor Hormones
T1 desmopressin
(nonrefrigerated)
T1 desmopressin acetate
T1 desmopressin acetate
T1 danazol
DANAZOL
ENDOCRINE DISORDER - THYROID
Antithyroid Preparations
DESMOPRESSIN
ACETATE
DDAVP
DESMOPRESSIN
ACETATE
T1 methimazole
T1 propylthiouracil
METHIMAZOLE
PROPYLTHIOURACIL
Iodine Containing Agents
Antineoplastic Lhrh(gnrh) Agonist,pituitary Suppr.
T1 potassium iodide
SSKI
T1 potassium iodide/iodine STRONG IODINE
T2 leuprolide acetate
T1 leuprolide acetate
Thyroid Hormones
ELIGARD
LEUPROLIDE
ACETATE
PA
T1 levothyroxine sodium
Bone Formation Stim. Agents - Parathyroid
T1 liothyronine sodium
Hormone
T2 teriparatide
FORTEO
QL
T2 thyroid,pork
T1 thyroid,pork
LEVOTHYROXINE
SODIUM
LIOTHYRONINE
SODIUM
ARMOUR THYROID
NATURE-THROID
Bone Resorption Inhibitor & Vitamin D
EYE - GENERAL DISORDERS
Combinations
Eye Antibiotic-corticoid Combinations
T2 alendronate
sodium/vitamin d3
FOSAMAX PLUS D
T1 neo/polymyx b
sulf/dexameth
Bone Resorption Inhibitors
T1 alendronate sodium
T1
T1
T1
T1
T1
ALENDRONATE
QL
SODIUM(SOLUTION)
alendronate sodium
ALENDRONATE
SODIUM(TAB)
calcitonin,salmon,synth CALCITONINetic
SALMON
etidronate disodium
ETIDRONATE
DISODIUM
ibandronate sodium
IBANDRONATE
SODIUM
raloxifene hcl
RALOXIFENE HCL
PA, QL
Growth Hormones
T2 somatropin
T2 somatropin
T2 somatropin
T2 somatropin
T2 somatropin
NORDITROPIN
FLEXPRO
SEROSTIM(VIAL)(4
MG)
SEROSTIM(VIAL)(5
MG)
SEROSTIM(VIAL)(6
MG)
ZORBTIVE
PA
PA
PA
PA
PA
Hyperparathyroid Tx Agents - Vitamin D Analogtype
T1 doxercalciferol
T1 paricalcitol
DOXERCALCIFEROL
PARICALCITOL
Insulin-like Growth Factor-1 (igf-1) Hormones
T2 mecasermin
INCRELEX
PA
Leptin Hormone Analogs
T2 metreleptin
MYALEPT
QL
T1
T2
T1
T2
NEOMYCINPOLYMYXINDEXAMETH
neomycin su/baci
NEOMYCINzn/poly/hc
BACITRACIN-POLYHC
tobramycin/dexamethaso TOBRADEX
ne
tobramycin/dexamethasTOBRAMYCINone
DEXAMETHASONE
tobramycin/lotepred etab ZYLET
Eye Antihistamines
T1 azelastine hcl
T1 epinastine hcl
T1 olopatadine hcl
Eye Antiinflammatory Agents
T1 dexamethasone sod
phosphate
T2 difluprednate
T1 fluorometholone
T2 fluorometholone
T2 fluorometholone
T2 fluorometholone acetate
T1 flurbiprofen sodium
T1
T2
T2
T2
T2
T2
T1
T1
DEXAMETHASONE
SODIUM PHOSPHATE
DUREZOL
FLUOROMETHOLONE
FML FORTE
FML S.O.P.
FLAREX
FLURBIPROFEN
SODIUM
ketorolac tromethamineKETOROLAC
TROMETHAMINE
loteprednol etabonate
ALREX
loteprednol etabonate
LOTEMAX
nepafenac
ILEVRO
nepafenac
NEVANAC
prednisolone acetate
PRED MILD
prednisolone acetate
PREDNISOLONE
ACETATE
prednisolone sod
PREDNISOLONE
phosphate
SODIUM PHOSPHATE
Pituitary Suppressive Agents
Eye Antivirals
T1 cabergoline
T2 ganciclovir
VNSNY
CABERGOLINE
AZELASTINE HCL
EPINASTINE HCL
OLOPATADINE HCL
ZIRGAN
Page 27 of 75
T1 trifluridine
TRIFLURIDINE
EYE - GLAUCOMA
Eye Local Anesthetics
Carbonic Anhydrase Inhibitors
T1 benoxinate
ALTAFLUOR
hcl/fluorescein na
T1 proparacaine hcl
PROPARACAINE HCL
T1 proparacaine/fluorescei FLUCAINE
n sod
T1 tetracaine hcl
TETRACAINE HCL
T1 tetracaine hcl/pf
TETRACAINE HCL
T1 acetazolamide
Miotics/other Intraoc. Pressure Reducers
T1 apraclonidine hcl
T1
T2
T1
T2
T2
T1
Eye Sulfonamides
T1 sulfacetamide sodium
SULFACETAMIDE
SODIUM
T1 sulfacetamide/prednisol SULFACETAMIDEone sp
PREDNISOLONE
T2 sulfacetm na/prednisol acBLEPHAMIDE
T2 sulfacetm na/prednisol acBLEPHAMIDE S.O.P.
NAPHAZOLINE HCL
PHENYLEPHRINE
HCL
Ophthalmic Antibiotics
T1 bacitracin/polymyxin b
sulfate
T2 besifloxacin hcl
T1 erythromycin base
T1 gatifloxacin
T1 gentamicin sulfate
T1
T2
T2
T1
levofloxacin
moxifloxacin hcl
moxifloxacin hcl
neomycin
su/bacitra/polymyxin
T1 neomycin/polymyxn
b/gramicidin
T1 ofloxacin
T1 polymyxin b
sulf/trimethoprim
T1 tobramycin
T2 tobramycin
AK-POLY-BAC
BESIVANCE
CILOXAN
CIPROFLOXACIN HCL
ERYTHROMYCIN
GATIFLOXACIN
GENTAMICIN
SULFATE
LEVOFLOXACIN
MOXEZA
VIGAMOX
NEOMYCINBACITRACINPOLYMYXIN
NEOMYCINPOLYMYXINGRAMICIDIN
OFLOXACIN
POLYMYXIN B SULTRIMETHOPRIM
TOBRAMYCIN
TOBREX
T1 atropine sulfate
T1 cyclopentolate hcl
T1 homatropine hbr
T1 tropicamide
Ophthalmic Mast Cell Stabilizers
T1 cromolyn sodium
T2 lodoxamide
tromethamine
T2 nedocromil sodium
CROMOLYN SODIUM
ALOMIDE
ALOCRIL
Ophthalmic Preparations, Miscellaneous
T5 sodium chloride
VNSNY
SODIUM
CHLORIDE(OTC)
ATROPINE SULFATE
CYCLOPENTOLATE
HCL
HOMATROPAIRE
TROPICAMIDE
EYE - MISCELLANEOUS
Artificial Tears
type
RESTASIS
QL
QL
Mydriatics
Ophthalmic Anti-inflammatory ImmunomodulatorT2 cyclosporine
betaxolol hcl
betaxolol hcl
bimatoprost
bimatoprost
brimonidine tartrate
brimonidine tartrate
APRACLONIDINE
HCL
BETAXOLOL HCL
BETOPTIC S
BIMATOPROST
LUMIGAN
ALPHAGAN P
BRIMONIDINE
TARTRATE
COMBIGAN
T2 brimonidine
tartrate/timolol
T2 brinzolamide
AZOPT
T2 brinzolamide/brimonidin SIMBRINZA
e tart
T1 carteolol hcl
CARTEOLOL HCL
T1 dorzolamide hcl
DORZOLAMIDE HCL
T1 dorzolamide hcl/timolol DORZOLAMIDEmaleat
TIMOLOL
T1 latanoprost
LATANOPROST
T1 levobunolol hcl
LEVOBUNOLOL HCL
T1 metipranolol
METIPRANOLOL
T1 pilocarpine hcl
PILOCARPINE HCL
T2 timolol
BETIMOL
T1 timolol maleate
TIMOLOL MALEATE
T2 travoprost
TRAVATAN Z
QL
T1 travoprost
TRAVOPROST
QL
(benzalkonium)
Eye Vasoconstrictors
T1 naphazoline hcl
T1 phenylephrine hcl
ACETAZOLAMIDE
QL
T5 dextran
ARTIFICIAL
70/hypromellose
TEARS(OTC)
T5 dextran
ARTIFICIAL
70/hypromellose/pf
TEARS(OTC)
T5 dextran
BION TEARS(OTC)
70/hypromellose/pf
T5 dextran/hypromellose/gly TEARS NATURALE
cerin
FORTE(OTC)
T5 glycerin/propylene
ARTIFICIAL
glycol
TEARS(OTC)
T5 hypromellose
NATURAL BALANCE
TEARS(OTC)
T5 petrolat,wht/min oil/sod LUBRICANT
chl
EYE(OTC)
T5 polyvinyl alcohol
ARTIFICIAL
TEARS(OTC)
T5 polyvinyl
ARTIFICIAL
alcohol/povidone
TEARS(OTC)
Page 28 of 75
T2 rivaroxaban
Eye Diagnostic Agents
T1 fluorescein sodium
BIOGLO
T2 rivaroxaban
Eye Irrigations
T2 factor ix
T2 factor ix human
recombinant
Eye Preparations, Miscellaneous
CLEANSING EYELID
PADS(OTC)
CLEANSING EYELID
WIPES(OTC)
EYELID WIPES(OTC)
T2 epoetin alfa
T1 pentoxifylline
ARTIFICIAL
TEARS(OTC)
REFRESH LACRILUBE(OTC)
REFRESH P.M.(OTC)
PA
Colchicine
COLCHICINE
PROBENECIDCOLCHICINE
QL
Hyperuricemia Tx - Purine Inhibitors
T1 allopurinol
T2 febuxostat
ALLOPURINOL
ULORIC
QL
PROBENECID
HEMATOLOGICAL DISORDERS
Anticoagulants,coumarin Type
T1 warfarin sodium
T1 tranexamic acid
AMINOCAPROIC
ACID
TRANEXAMIC ACID
CITRATE PHOSPHATE
DEXTROSE
SODIUM CITRATE
Direct Factor Xa Inhibitors
T2
T2
T2
T2
apixaban
apixaban
rivaroxaban
rivaroxaban
VNSNY
T1 enoxaparin sodium
Citrates As Anticoagulants
T1 citrate phosphate
dextros soln
T1 sodium citrate
WARFARIN SODIUM
Antifibrinolytic Agents
T1 aminocaproic acid
T2 dalteparin
sodium,porcine
T2 dalteparin
sodium,porcine
T2 dalteparin
sodium,porcine
T2 dalteparin
sodium,porcine
T2 dalteparin
sodium,porcine
T2 dalteparin
sodium,porcine
T2 dalteparin
sodium,porcine
T2 dalteparin
sodium,porcine
Uricosuric Agents
T1 probenecid
PROCRIT
PA
PENTOXIFYLLINE
Heparin And Related Preparations
GOUT AND RELATED DISEASES
T1 colchicine
T1 colchicine/probenecid
ALPHANINE SD
BENEFIX
Hemorrheologic Agents
ARTIFICIAL
TEARS(OTC)
SOOTHE XP(OTC)
CYSTARAN
QL
Hematinics,other
Ophthalmic Cystine Depleting Agents
T2 cysteamine hcl
QL
Factor Ix Preparations
T1 balanced salt soln non- EYE WASH(OTC)
surg #6
T5 eyelid cleanser
combination #5
T5 eyelid cleanser
combination #5
T5 eyelid cleanser
combination #6
T5 lanolin/min
oil/petrolat,wht
T5 mineral oil,
light/mineral oil
T5 mineral
T5 mineral
T5 mineral
XARELTO(TAB)(15
MG)
XARELTO(TAB)(20
MG)
ELIQUIS(TAB)(2.5 MG)QL
ELIQUIS(TAB)(5 MG) QL
XARELTO(TAB DS PK) QL
XARELTO(TAB)(10
QL
MG)
T1 fondaparinux sodium
FRAGMIN(SYRINGE)
(10000/ML)
FRAGMIN(SYRINGE)
(12500/0.5)
FRAGMIN(SYRINGE)
(15000/0.6)
FRAGMIN(SYRINGE)
(18000/0.72)
FRAGMIN(SYRINGE)
(2500/0.2ML)
FRAGMIN(SYRINGE)
(5000/0.2ML)
FRAGMIN(SYRINGE)
(7500/0.3ML)
FRAGMIN(VIAL)
QL
ENOXAPARIN
SODIUM(SYRINGE)
(100 MG/ML)
ENOXAPARIN
SODIUM(SYRINGE)
(120MG/.8ML)
ENOXAPARIN
SODIUM(SYRINGE)
(150 MG/ML)
ENOXAPARIN
SODIUM(SYRINGE)
(30MG/0.3ML)
ENOXAPARIN
SODIUM(SYRINGE)
(40MG/0.4ML)
ENOXAPARIN
SODIUM(SYRINGE)
(60MG/0.6ML)
ENOXAPARIN
SODIUM(SYRINGE)
(80MG/0.8ML)
ENOXAPARIN
SODIUM(VIAL)
FONDAPARINUX
SODIUM(SYRINGE)
(10MG/0.8ML)
FONDAPARINUX
SODIUM(SYRINGE)
(2.5 MG/0.5)
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
QL
Page 29 of 75
QL
T1
QL
T1
T1
T1
T1
T1
FONDAPARINUX
SODIUM(SYRINGE)
(5MG/0.4ML)
fondaparinux sodium FONDAPARINUX
SODIUM(SYRINGE)
(7.5MG/0.6)
heparin sod,porcine/0.9 HEPARIN FLUSH
% nacl
heparin sodium,porcine HEPARIN SODIUM
heparin
HEPARIN SODIUMsodium,porcine/d5w
D5W
heparin
HEPARIN SODIUMsodium,porcine/ns/pf 0.9% NACL
heparin
HEPARIN FLUSH
sodium,porcine/pf
filgrastim
pegfilgrastim
sargramostim
tbo-filgrastim
NEUPOGEN
NEULASTA
LEUKINE
GRANIX
T1 clopidogrel bisulfate
T1
T2
T2
T1
dipyridamole
prasugrel hcl
ticagrelor
ticlopidine hcl
PA
PA
PA
PA
ANAGRELIDE HCL
PA, QL
Thrombopoietin Receptor Agonists
T2 eltrombopag olamine
PROMACTA
PA
Topical Hemostatics
T1 thrombin (bovine)
THROMBIN-JMI
Vitamin K Preparations
T2 phytonadione
T1 phytonadione
MEPHYTON
VITAMIN K1
T1 estradiol
QL
T1
QL
T1
T2
T1
T2
T2
T2
T2
T1
T1
ESTRADIOL(PATCH
TDSW)
estradiol
ESTRADIOL(PATCH
TDWK)
estradiol
ESTRADIOL(TAB)
estradiol/norethindrone COMBIPATCH
acet
estradiol/norethindrone ESTRADIOLacet
NORETHINDRONE
ACETAT
estrogen,con/m-progest PREMPHASE
acet
estrogen,con/m-progest PREMPRO
acet
estrogens, conjugated
PREMARIN
estrogens,esterified
MENEST
estropipate
ESTROPIPATE
norethindrone ac-eth JINTELI
estradiol
T1 medroxyprogesterone MEDROXYPROGESTE
acetate
RONE ACETATE
T1 norethindrone acetate NORETHINDRONE
ACETATE
T1 progesterone
PROGESTERONE
T1 progesterone,micronize PROGESTERONE
d
IMMUNIZATION
Androgenic Agents
T2 igg/hyaluronidase,recom
binant
T2 immun glob g
(igg)/gly/iga 50+
T2 immun glob g
(igg)/gly/iga 50+
T2 immun glob g
(igg)/gly/iga 50+
T2 immun glob
g(igg)/pro/iga 0-50
T2 testosterone
T2 testosterone
T2 testosterone
VNSNY
ANDROXY
QL
METHYLTESTOSTEROPA
NE
OXANDROLONE
PA
ANDROGEL(GEL MD PA
PMP)(1.25G (1%))
ANDROGEL(GEL MD PA
PMP)(20.25/1.25)
ANDROGEL(GEL
PA
PACKET)(1.25G-1.62)
ANDROGEL(GEL
PA
PACKET)(2.5G-1.62%)
QL
Progestational Agents
Antisera
T1 oxandrolone
T1 testosterone
PA
Estrogenic Agents
HORMONAL DEFICIENCY
T1 fluoxymesterone
T1 methyltestosterone
PA
PA
PA
T2 estrogens,conj/bazedoxif DUAVEE
ene
CILOSTAZOL
CLOPIDOGREL(TAB) QL
(300 MG)
CLOPIDOGREL(TAB)
(75 MG)
DIPYRIDAMOLE
EFFIENT
QL
BRILINTA
QL
TICLOPIDINE HCL
IPRIVASK
PA
Mod(serm)comb
Thrombin Inhibitors,sel.,direct,&rev.-hirudin Type
T2 desirudin
ANDROGEL(GEL
PACKET)(25MG(1%))
testosterone
ANDROGEL(GEL
PACKET)(50 MG (1%))
testosterone
AXIRON
testosterone
TESTOSTERONE
testosterone cypionate TESTOSTERONE
CYPIONATE
testosterone enanthate TESTOSTERONE
ENANTHATE
Estrogen & Selective Estrogen Recept
Platelet Reducing Agents
T1 anagrelide hcl
T1
T1
Platelet Aggregation Inhibitors
T1 cilostazol
T1 clopidogrel bisulfate
PA
T2
T1
T1
Leukocyte (wbc) Stimulants
T2
T2
T2
T2
T1 testosterone
HYQVIA
PA
GAMMAGARD
LIQUID
GAMMAKED
PA
GAMUNEX-C
PA
HIZENTRA
PA
PA
Page 30 of 75
IMMUNOSUPPRESSION/MODULATIO
N
Immunomodulators
T1 imiquimod
T2 interferon alfa2b,recomb.
IMIQUIMOD
INTRON A
PA, QL
PA
Immunosuppressives
T1
T1
T2
T1
azathioprine
cyclosporine
cyclosporine
cyclosporine, modified
AZATHIOPRINE
CYCLOSPORINE
SANDIMMUNE
CYCLOSPORINE
MODIFIED
T2 everolimus
ZORTRESS
T1 mycophenolate mofetil MYCOPHENOLATE
MOFETIL
T1 mycophenolate sodium MYCOPHENOLIC
ACID
T2 sirolimus
RAPAMUNE
T1 sirolimus
SIROLIMUS
T2 tacrolimus
ASTAGRAF XL
T1 tacrolimus
TACROLIMUS
Ketolides
T2 telithromycin
Absorbable Sulfonamides
T1 sulfamethoxazole/trime SULFAMETHOXAZOL
thoprim
E-TRIMETHOPRIM
Betalactams
Cephalosporins - 1st Generation
T1 cefadroxil
T1 cephalexin
CEFADROXIL
CEPHALEXIN
Cephalosporins - 2nd Generation
T1
T1
T2
T1
cefaclor
cefprozil
cefuroxime axetil
cefuroxime axetil
T1
T2
T1
T2
T1
T2
T1
azithromycin
azithromycin
clarithromycin
erythromycin base
erythromycin base
erythromycin base
erythromycin
ethylsuccinate
T2 erythromycin
ethylsuccinate
T1 erythromycin stearate
T2 fidaxomicin
CAYSTON
CEFACLOR
CEFPROZIL
CEFTIN
CEFUROXIME
KETEK
Macrolides
INFECTIOUS DISEASE - BACTERIAL
T2 aztreonam lysine
T2 methenam/me
PROSED-DS
blue/ba/salicy/hyo
T1 methenamine hippurateMETHENAMINE
HIPPURATE
T1 methenamine
METHENAMINE
mandelate
MANDELATE
T2 mth/me blue/sod
PHOSPHASAL
phos/phen/hyos
T2 mth/me blue/sod
URETRON D-S
phos/phen/hyos
T2 mth/me blue/sod
URIN D.S.
phos/phen/hyos
T1 mth/me blue/sod
URO-MP
phos/phen/hyos
T2 trimethoprim
PRIMSOL
T1 trimethoprim
TRIMETHOPRIM
PA
AZITHROMYCIN
ZMAX
CLARITHROMYCIN
ERY-TAB
ERYTHROMYCIN
PCE
E.E.S. 200
ERYPED 400
ERYTHROCIN
STEARATE
DIFICID
Nitrofuran Derivatives
T1 nitrofurantoin
T1 nitrofurantoin
macrocrystal
T1 nitrofurantoin
monohyd/m-cryst
NITROFURANTOIN
NITROFURANTOIN
NITROFURANTOIN
MONO-MACRO
Oxazolidinones
T1 linezolid
T2 tedizolid phosphate
LINEZOLID
SIVEXTRO
Cephalosporins - 3rd Generation
Penicillins
T1 cefdinir
T1 cefditoren pivoxil
T1 amoxicillin
AMOXICILLIN
T1 amoxicillin/potassium AMOXICILLINclav
CLAVULANATE
POTASS
T2 amoxicillin/potassium AUGMENTIN
clav
T1 ampicillin trihydrate AMPICILLIN
TRIHYDRATE
T1 dicloxacillin sodium
DICLOXACILLIN
SODIUM
T2 penicillin g benzathine BICILLIN L-A
T1 penicillin v potassium PENICILLIN V
POTASSIUM
T1 cefixime
T2 cefixime
T1 cefpodoxime proxetil
T1 ceftibuten
CEFDINIR
CEFDITOREN
PIVOXIL
CEFIXIME
SUPRAX
CEFPODOXIME
PROXETIL
CEFTIBUTEN
Chemotherapeutics, Antibacterial, Misc.
T1 methen/m-blue/sal/na USTELL
phos/hyos
T1 methen/sod phos/meth UROGESIC-BLUE
blue/hyos
T1 methenam/me
HYOPHEN
blue/ba/salicy/hyo
VNSNY
QL, ST
PA
Quinolones
T1 ciprofloxacin
CIPROFLOXACIN
CIPROFLOXACIN HCL
Page 31 of 75
T1 ciprofloxacin/ciprofloxa CIPROFLOXACIN ER
hcl
T1 levofloxacin
LEVOFLOXACIN
T1 moxifloxacin hcl
MOXIFLOXACIN HCL
T1 ofloxacin
OFLOXACIN
Tetracyclines
T1 demeclocycline hcl
T2 doxycycline calcium
T1 doxycycline hyclate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 doxycycline
monohydrate
T1 minocycline hcl
T1 tetracycline hcl
DEMECLOCYCLINE
HCL
VIBRAMYCIN
DOXYCYCLINE
QL, ST
HYCLATE
DOXYCYCLINE
QL
MONOHYDRATE(CA
P)
DOXYCYCLINE
MONOHYDRATE(SUS
P RECON)
DOXYCYCLINE
QL, ST
MONOHYDRATE(TAB)
(100 MG)
DOXYCYCLINE
QL
MONOHYDRATE(TAB)
(150 MG)
DOXYCYCLINE
QL
MONOHYDRATE(TAB)
(50 MG)
DOXYCYCLINE
QL
MONOHYDRATE(TAB)
(75 MG)
MINOCYCLINE HCL
TETRACYCLINE HCL
INFECTIOUS DISEASE - FUNGAL
clotrimazole
fluconazole
flucytosine
itraconazole
itraconazole
ketoconazole
terbinafine hcl
terbinafine hcl
voriconazole
T1 dapsone
T2 thalidomide
DAPSONE
THALOMID
PA, QL
Anti-mycobacterium Agents
T4
T4
T4
T4
T4
T4
T4
aminosalicylic acid
ethambutol hcl
ethambutol hcl
ethionamide
isoniazid
pyrazinamide
rifabutin
PASER
ETHAMBUTOL HCL
MYAMBUTOL
TRECATOR
ISONIAZID
PYRAZINAMIDE
MYCOBUTIN
Antitubercular Antibiotics
T4
T4
T4
T4
T4
bedaquiline fumarate
cycloserine
rifampin
rifampin/isoniazid
rifapentine
SIRTURO
CYCLOSERINE
RIFAMPIN
RIFAMATE
PRIFTIN
PA
Lincosamides
T1 clindamycin hcl
CLINDAMYCIN HCL
T1 clindamycin palmitate CLINDAMYCIN
hcl
PALMITATE HCL
Rifamycins And Related Derivative Antibiotics
T2 rifaximin
XIFAXAN
PA
Vancomycin And Derivatives
T1 vancomycin hcl
VANCOMYCIN HCL
QL
INFECTIOUS DISEASE - PARASITIC
2nd Gen. Anaerobic Antiprotozoal-antibacterial
Antifungal Agents
T1
T1
T1
T1
T2
T1
T2
T1
T1
Antileprotics
T1 tinidazole
CLOTRIMAZOLE
FLUCONAZOLE
FLUCYTOSINE
ITRACONAZOLE
SPORANOX
KETOCONAZOLE
LAMISIL
TERBINAFINE HCL
VORICONAZOLE
Antifungal Antibiotics
T1 griseofulvin, microsize GRISEOFULVIN
T1 nystatin
NYSTATIN
INFECTIOUS DISEASE -
TINIDAZOLE
Amebacides
T1 paromomycin sulfate
PAROMOMYCIN
SULFATE
Anaerobic Antiprotozoal-antibacterial Agents
T2 metronidazole
T1 metronidazole
FLAGYL ER
METRONIDAZOLE
Anthelmintics
T1 ivermectin
T2 praziquantel
IVERMECTIN
BILTRICIDE
Antimalarial Drugs
T1 neomycin sulfate
NEOMYCIN SULFATE
T2 tobramycin
TOBI PODHALER
PA
T1 tobramycin in 0.225% TOBRAMYCIN
PA
nacl
T1 atovaquone/proguanil ATOVAQUONEhcl
PROGUANIL HCL
T1 chloroquine phosphate CHLOROQUINE
PHOSPHATE
T1 hydroxychloroquine
HYDROXYCHLOROQ
sulfate
UINE SULFATE
T1 mefloquine hcl
MEFLOQUINE HCL
T2 primaquine phosphate PRIMAQUINE
T2 pyrimethamine
DARAPRIM
PA
T1 quinine sulfate
QUININE SULFATE
Antibacterial Agents,miscellaneous
Antiprotozoal Drugs,miscellaneous
T1 glycine urologic
solution
T1 atovaquone
ATOVAQUONE
T2 pentamidine isethionate NEBUPENT
MISCELLANEOUS
Aminoglycosides
VNSNY
GLYCINE
Page 32 of 75
INFECTIOUS DISEASE - VIRAL
T1 nevirapine
T2 rilpivirine hcl
Antiviral Monoclonal Antibodies
Antivirals, Hiv-specific, Nucleoside Analog, Rti
T2 palivizumab
SYNAGIS
PA
Antivirals, General
T1 acyclovir
T1 famciclovir
T2 oseltamivir phosphate
T2
T1
T1
T1
ribavirin
rimantadine hcl
valacyclovir hcl
valganciclovir hcl
ACYCLOVIR
FAMCICLOVIR
TAMIFLU(CAP)(30
MG)
TAMIFLU(CAP)(45
MG)
TAMIFLU(CAP)(75
MG)
TAMIFLU(SUSP
RECON)
VIRAZOLE
RIMANTADINE HCL
VALACYCLOVIR
VALGANCICLOVIR
HCL
T1 didanosine
QL
QL
QL
QL
QL
T2
QL
T2
T2
T2
T2
T2
T2
QL
QL
QL
QL
QL
Antivirals, Hiv-spec, Nucleoside-nucleotide Analog
T2 emtricitabine/tenofovir
TRUVADA
QL
Antivirals, Hiv-spec., Nucleoside Analog, Rti Comb
T2 abacavir
EPZICOM
sulfate/lamivudine
T1 abacavir/lamivudine/zi ABACAVIRdovudine
LAMIVUDINEZIDOVUDINE
T1 lamivudine/zidovudine LAMIVUDINEZIDOVUDINE
QL
QL
Antivirals, Hiv-specific, Ccr5 Co-receptor Antag.
T2 maraviroc
SELZENTRY
Antivirals, Hiv-specific, Fusion Inhibitors
T2 enfuvirtide
FUZEON
QL
Antivirals, Hiv-specific, Non-nucleoside, Rti
T2
T2
T2
T1
delavirdine mesylate
efavirenz
etravirine
nevirapine
VNSNY
RESCRIPTOR
SUSTIVA
INTELENCE
NEVIRAPINE(ORAL
SUSP)
T1 didanosine
T2
T2
T2
T1
didanosine
emtricitabine
emtricitabine
lamivudine
T1 lamivudine
T2 darunavir ethanolate
T2
T1 didanosine
T1 lamivudine
Antivirals, Hiv-spec, Non-peptidic Protease Inhib
PREZISTA(ORAL
SUSP)
darunavir ethanolate
PREZISTA(TAB)(150
MG)
PREZISTA(TAB)(400
MG)
PREZISTA(TAB)(600
MG)
PREZISTA(TAB)(75
MG)
PREZISTA(TAB)(800
MG)
darunavir/cobicistat
PREZCOBIX
tipranavir
APTIVUS
tipranavir/vitamin e tpgs APTIVUS
T1 abacavir sulfate
T2 abacavir sulfate
T1 didanosine
T1 stavudine
T1 stavudine
T1 zidovudine
T1 zidovudine
T1 zidovudine
NEVIRAPINE(TAB)
EDURANT
QL
ABACAVIR
QL
ZIAGEN
QL
DIDANOSINE(CAP
QL
DR)(125 MG)
DIDANOSINE(CAP
QL
DR)(200 MG)
DIDANOSINE(CAP
DR)(250 MG)
DIDANOSINE(CAP
DR)(400 MG)
VIDEX
QL
EMTRIVA(CAP)
QL
EMTRIVA(SOLUTION) QL
LAMIVUDINE(SOLUTIQL
ON)
LAMIVUDINE(TAB) QL
(150 MG)
LAMIVUDINE(TAB) QL
(300 MG)
STAVUDINE(CAP)
QL
STAVUDINE(SOLN
QL
RECON)
ZIDOVUDINE(CAP)
QL
ZIDOVUDINE(SYRUP) QL
ZIDOVUDINE(TAB)
QL
Antivirals, Hiv-specific, Nucleotide Analog, Rti
T2 tenofovir disoproxil
fumarate
T2 tenofovir disoproxil
fumarate
VIREAD(POWDER)
QL
VIREAD(TAB)
QL
Antivirals, Hiv-specific, Protease Inhibitor Comb
T2 lopinavir/ritonavir
KALETRA(SOLUTIO
N)
KALETRA(TAB)
(100MG-25MG)
KALETRA(TAB)
(200MG-50MG)
QL
QL
QL
Antivirals, Hiv-specific, Protease Inhibitors
T2 atazanavir sulfate
T2 atazanavir
sulfate/cobicistat
T2 fosamprenavir calcium
T2 indinavir sulfate
T2 nelfinavir mesylate
T2 ritonavir
T2 ritonavir
T2 ritonavir
T2 saquinavir mesylate
T2 saquinavir mesylate
REYATAZ
EVOTAZ
QL
LEXIVA
CRIXIVAN
VIRACEPT
NORVIR(CAP)
NORVIR(SOLUTION)
NORVIR(TAB)
INVIRASE(CAP)
INVIRASE(TAB)
QL
QL
QL
QL
QL
Antivirals,hiv-1 Integrase Strand Transfer Inhibtr
T2 dolutegravir sodium
T2 elvitegravir
T2 raltegravir potassium
TIVICAY
VITEKTA
ISENTRESS
QL
QL
Page 33 of 75
Artv Cmb Nucleoside,nucleotide,&non-nucleoside
T2 methotrexate/pf
Rti
T2 methotrexate/pf
T2 efavirenz/emtricitab/teno ATRIPLA
fovir
T2 emtricitab/rilpiviri/tenofo ODEFSEY
ala
T2 emtricitab/rilpivirine/ten COMPLERA
ofov
QL
T2 methotrexate/pf
QL
T2 methotrexate/pf
TYBOST
QL
Anti-inflammatory, Pyrimidine Synthesis Inhibitor
T1 leflunomide
PA
PA
Inh
T2 abatacept
PA
T2 c1 esterase inhibitor
T2 c1 esterase inhibitor
T2 c1 esterase inhibitor,
recomb
T2 lamivudine
T1 lamivudine
T1
T1
T1
T1
T2
T1
Hepatitis C Treatment Agents
peginterferon alfa-2a
peginterferon alfa-2a
ribavirin
ribavirin
PEGASYS
PA
PEGASYS PROCLICK PA
REBETOL
RIBASPHERE
INFLAMMATORY DISEASE
Anti-arthritic And Chelating Agents
T2 penicillamine
T2 penicillamine
CUPRIMINE
DEPEN
Anti-arthritic, Folate Antagonist Agents
T2 methotrexate/pf
T2 methotrexate/pf
T2 methotrexate/pf
T2 methotrexate/pf
T2 methotrexate/pf
T2 methotrexate/pf
VNSNY
RASUVO(AUTO
INJECT)(10MG/0.2ML)
RASUVO(AUTO
INJECT)(12.5/0.25)
RASUVO(AUTO
INJECT)(15MG/0.3ML)
RASUVO(AUTO
INJECT)(17.5/0.35)
RASUVO(AUTO
INJECT)(20MG/0.4ML)
RASUVO(AUTO
INJECT)(22.5/0.45)
QL, ST
ORENCIA
PA
BERINERT
CINRYZE
RUCONEST
PA
PA
PA
budesonide
cortisone acetate
dexamethasone
hydrocortisone
methylprednisolone
methylprednisolone
T2
T2
T1
T1
prednisolone
prednisolone
prednisolone
prednisolone sod
phosphate
T1 prednisone
T2 prednisone
BUDESONIDE EC
CORTISONE ACETATE
DEXAMETHASONE
HYDROCORTISONE
MEDROL
METHYLPREDNISOL
ONE
MILLIPRED
MILLIPRED DP
PREDNISOLONE
PREDNISOLONE
SODIUM PHOSPHATE
PREDNISONE
PREDNISONE
INTENSOL
Interleukin-6 (il-6) Receptor Inhibitors
T2 tocilizumab
ACTEMRA
Janus Kinase (jak) Inhibitors
QL, ST
T2 tofacitinib citrate
QL, ST
QL, ST
PA
FIRAZYR
QL, ST
QL, ST
PA
C1 Esterase Inhibitors
Glucocorticoids
EPIVIR HBV
LAMIVUDINE HBV
OTEZLA
Bradykinin B2 Receptor Antagonists
Hepatitis B Treatment Agents
T2
T2
T2
T1
LEFLUNOMIDE
Antinflammatory, Sel.costim.mod.,t-cell Inhibitor
T2 icatibant acetate
SOVALDI
PA
Inhib.
T2 apremilast
Hep C Virus,nucleotide Analog Ns5b Polymerase
T2 sofosbuvir
SIMPONI
Anti-inflammatory,phosphodiesterase-4(pde4)
QL
Combo.
HARVONI
QL, ST
T2 golimumab
Hep C Virus - Ns5a & Ns5b Polymerase Inhib.
T2 ledipasvir/sofosbuvir
QL, ST
QL
Cytochrome P450 Inhibitors
T2 cobicistat
QL, ST
Inhibitor
Arv Comb-nrtis & Integrase Inhibitor
T2 abacavir/dolutegravir/lamTRIUMEQ
ivudi
QL, ST
Anti-inflammatory Tumor Necrosis Factor
Arv Cmb-nrti,n(t)rti, Integrase Inhibitor
T2 elviteg/cobi/emtric/tenof GENVOYA
o ala
T2 elvitegr/cobicist/emtric/te STRIBILD
nof
RASUVO(AUTO
INJECT)(25MG/0.5ML)
RASUVO(AUTO
INJECT)(27.5/0.55)
RASUVO(AUTO
INJECT)(30MG/0.6ML)
RASUVO(AUTO
INJECT)(7.5MG/0.15)
PA
XELJANZ
PA
Mineralocorticoids
T1 fludrocortisone acetate FLUDROCORTISONE
ACETATE
Nsaids, Cyclooxygenase 2 Inhibitor - Type
T1 celecoxib
CELECOXIB
Page 34 of 75
Nsaids, Cyclooxygenase Inhibitor-type
Hemorrhoidal Prep, Anti-infam Steroid/local
T1 diclofenac potassium
Anesth
T1
T1 hydrocort/pramoxin/em HYDROCORTISONEol/pram#1
PRAMOXINE
T1 hydrocortisone/lidocain LIDOCAINEe/aloe
HYDROCORTISONE
T1 hydrocortisone/pramox ANALPRAM HC
ine
T1 hydrocortisone/pramox HYDROCORTISONEine
PRAMOXINE
T2 hydrocortisone/pramoxin PROCTOFOAM-HC
e
T1 lidocaine/hydrocortison LIDOCAINEe ac
HYDROCORTISONE
T1
T2
T1
T1
T5
T1
T5
T2
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
DICLOFENAC
POTASSIUM
diclofenac sodium
DICLOFENAC
SODIUM
etodolac
ETODOLAC
fenoprofen calcium
FENOPROFEN
CALCIUM(CAP)
fenoprofen calcium
FENOPROFEN
CALCIUM(TAB)
flurbiprofen
FLURBIPROFEN
ibuprofen
CHILDREN'S
MOTRIN(OTC)
ibuprofen
IBUPROFEN
ibuprofen
IBUPROFEN(OTC)
indomethacin
INDOCIN
indomethacin
INDOMETHACIN
ketoprofen
KETOPROFEN
ketorolac tromethamineKETOROLAC
TROMETHAMINE
meclofenamate sodium MECLOFENAMATE
SODIUM
meloxicam
MELOXICAM
nabumetone
NABUMETONE
naproxen
NAPROXEN
naproxen sodium
NAPROXEN SODIUM
oxaprozin
OXAPROZIN
piroxicam
PIROXICAM
sulindac
SULINDAC
tolmetin sodium
TOLMETIN SODIUM
Irritable Bowel Agents,guanylate Cylase-c Agonist
T2 linaclotide
T1 hydrocortisone
PROCTOZONE-HC
T1 hydrocortisone acetate HYDROCORTISONE
ACETATE
Rectal/lower Bowel Prep.,glucocort.
T1 hydrocortisone
DISORDERS - OTHER
Ammonia Inhibitors
T2 glycerol phenylbutyrate RAVICTI
T1 lactulose
GENERLAC
LIDOCAINE HCL
VISCOUS
T5 bismuth subsalicylate
DISORDERS - BOWEL INFLAMMAT
T5 bismuth subsalicylate
T1 loperamide hcl
T1 loperamide hcl
Bowel Antiinflamatory Agents
T5 loperamide hcl
SULFADIAZINE
Chronic Inflam. Colon Dx, 5-a-salicylat,rectal Tx
T2 mesalamine
CANASA
T1 mesalamine
MESALAMINE
T1 mesalamine w/cleansing MESALAMINE
wipes
T5
T5
T5
T1
T1
BALSALAZIDE
DISODIUM
APRISO
SULFASALAZINE
Drugs To Tx Chronic Inflamm. Disease Of Colon
VNSNY
CIMZIA
URSODIOL
Laxatives And Cathartics
aminosalicylat
T2 certolizumab pegol
PEPTO-BISMOL TOGO(OTC)
PINK BISMUTH(OTC)
LOPERAMIDE
LOPERAMIDE(CAP)
(OTC)
LOPERAMIDE(LIQUI
D)(OTC)
Bile Salts
T1 ursodiol
Drug Tx-chronic Inflam. Colon Dx,5-
T2 mesalamine
T1 sulfasalazine
PA
Antidiarrheals
LOWER GASTROINTESTINAL
T1 balsalazide disodium
HYDROCORTISONE
LOWER GASTROINTESTINAL
Local Anesthetics
T1 sulfadiazine
QL
Rectal Preparations
LOCAL ANESTHESIA
T1 lidocaine hcl
LINZESS
PA
T2
T1
T2
T5
bisacodyl
castor oil
docusate sodium
fos/maltodextrin
fructooligosaccharides/p
olydex
lactulose
lactulose
lubiprostone
magnesium hydroxide
T5 methylcellulose
T5 mineral oil
BISACODYL(OTC)
CASTOR OIL(OTC)
DOC-Q-LACE(OTC)
FIBER-STAT(OTC)
FIBER-STAT(OTC)
KRISTALOSE
LACTULOSE
AMITIZA
PHILLIPS' MILK OF
MAGNESIA(OTC)
CITRUCEL(OTC)
MINERAL OIL(OTC)
QL
Page 35 of 75
T1 peg 3350/na
sulf,bicarb,cl/kcl
T2 peg 3350/na
sulf,bicarb,cl/kcl
T1 polyethylene glycol
3350
T1 polyethylene glycol
3350
T5 psyllium husk
T5 psyllium husk (with
sugar)
T5 psyllium husk (with
sugar)
T5 psyllium husk/aspartame
T5 psyllium husk/aspartame
GAVILYTE-C
T2 enzalutamide
T1 flutamide
T2 nilutamide
GOLYTELY
WAL-MUCIL(OTC)
PA, QL
T1
PA, QL
T2
CAPECITABINE(TAB)
(150 MG)
capecitabine
CAPECITABINE(TAB)
(500 MG)
mercaptopurine
MERCAPTOPURINE
mercaptopurine
PURIXAN
methotrexate sodium METHOTREXATE
methotrexate sodium
TREXALL
methotrexate sodium/pf METHOTREXATE
SODIUM
trifluridine/tipiracil hcl LONSURF
T1 anastrozole
T1 exemestane
T1 letrozole
ANASTROZOLE
EXEMESTANE
LETROZOLE
T2 vismodegib
ERIVEDGE
PA, QL
Antineoplastic - Janus Kinase (jak) Inhibitors
T2 ruxolitinib phosphate
JAKAFI
PA, QL
Antineoplastic - Mek1 And Mek2 Kinase Inhibitors
T2 cobimetinib fumarate
COTELLIC
PA, QL
Antineoplastic - Mtor Kinase Inhibitors
BISAC-EVAC(OTC)
ENEMEEZ(OTC)
T2 everolimus
T2 everolimus
MOVANTIK
T2 everolimus
QL
GATTEX
T2 everolimus
T2 everolimus
PA
AFINITOR DISPERZ PA
AFINITOR(TAB)(10
PA, QL
MG)
AFINITOR(TAB)(2.5 PA, QL
MG)
AFINITOR(TAB)(5 MG)PA, QL
AFINITOR(TAB)(7.5 PA
MG)
MISCELLANEOUS AGENTS
Antineoplastic Immunomodulator Agents
Anaphylaxis Therapy Agents
T2 lenalidomide
T2 peginterferon alfa-2b
T2 pomalidomide
EPINEPHRINE
EPIPEN JR 2-PAK
T1 guanidine hcl
T1 pilocarpine hcl
T2 degarelix acetate
BETHANECHOL
CHLORIDE
GUANIDINE HCL
PILOCARPINE HCL
T2 degarelix acetate
T2
T2
T2
T2
T2
Alkylating Agents
altretamine
hydroxyurea
melphalan
temozolomide
HEXALEN
HYDROXYUREA
ALKERAN
TEMOZOLOMIDE
PA
Antiandrogenic Agents
T2 abiraterone acetate
T1 bicalutamide
VNSNY
ZYTIGA
BICALUTAMIDE
PA, QL
QL
PA
FIRMAGON(VIAL)(120 QL
MG)
FIRMAGON(VIAL)(80 QL
MG)
Antineoplastic Systemic Enzyme Inhibitors
NEOPLASTIC DISEASE
T2
T1
T2
T1
REVLIMID
SYLATRON
POMALYST
Antineoplastic Lhrh(gnrh) Antagonist,pituit.supprs
Parasympathetic Agents
T1 bethanechol chloride
PA
Antineoplastic - Hedgehog Pathway Inhibitor
Sbs - Glucagon-like Peptide-2 (glp-2) Analogs
T1 epinephrine
T2 epinephrine
ST
Antineoplastic Aromatase Inhibitors
Narcotic Antagonists, Peripherally-acting
T2 teduglutide
QL
T1 capecitabine
T1
T2
T1
T2
T1
Laxatives, Local/rectal
T2 naloxegol oxalate
PA, QL
Antimetabolites
POLYETHYLENE
GLYCOL 3350
POLYETHYLENE
GLYCOL 3350(OTC)
KONSYL(OTC)
METAMUCIL(OTC)
KONSYL(OTC)
METAMUCIL
MULTIHEALTH
FIBER(OTC)
T5 psyllium
METAMUCIL SUGARhusk/aspartame
FREE(OTC)
T5 psyllium husk/aspartame WAL-MUCIL(OTC)
T5 psyllium seed
REGULOID(OTC)
T5 psyllium seed (with
NATURAL
dextrose)
FIBER(OTC)
T5 psyllium seed (with
REGULOID(OTC)
sugar)
T5 psyllium
NATURAL
seed/aspartame
FIBER(OTC)
T5 sennosides
SENNA LAX(OTC)
T1 sodium
GAVILYTE-N
chloride/nahco3/kcl/peg
T5 bisacodyl
T5 docusate sodium
XTANDI
FLUTAMIDE
NILANDRON
PA, QL
afatinib dimaleate
alectinib hydrochloride
axitinib
axitinib
bosutinib
T2 bosutinib
T2 cabozantinib s-malate
T2 ceritinib
T2 crizotinib
GILOTRIF
ALECENSA
INLYTA(TAB)(1 MG)
INLYTA(TAB)(5 MG)
BOSULIF(TAB)(100
MG)
BOSULIF(TAB)(500
MG)
COMETRIQ
ZYKADIA
XALKORI
PA
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA, QL
PA
PA, QL
Page 36 of 75
T2 dabrafenib mesylate
T2 dasatinib
T2 dasatinib
T2 dasatinib
T2 dasatinib
T2 dasatinib
T2 dasatinib
T2
T2
T2
T2
T1
erlotinib hcl
gefitinib
ibrutinib
idelalisib
imatinib mesylate
T1 imatinib mesylate
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
T2
ixazomib citrate
lapatinib ditosylate
lenvatinib mesylate
nilotinib hcl
olaparib
osimertinib mesylate
palbociclib
pazopanib hcl
ponatinib hcl
ponatinib hcl
regorafenib
sorafenib tosylate
sunitinib malate
trametinib dimethyl
sulfoxide
T2 vandetanib
T2 vandetanib
T2 vemurafenib
TAFINLAR
PA
SPRYCEL(TAB)(100
PA, QL
MG)
SPRYCEL(TAB)(140
PA, QL
MG)
SPRYCEL(TAB)(20
PA, QL
MG)
SPRYCEL(TAB)(50
PA, QL
MG)
SPRYCEL(TAB)(70
PA, QL
MG)
SPRYCEL(TAB)(80
PA, QL
MG)
TARCEVA
PA, QL
IRESSA
PA
IMBRUVICA
PA
ZYDELIG
PA
IMATINIB
PA, QL
MESYLATE(TAB)(100
MG)
IMATINIB
PA, QL
MESYLATE(TAB)(400
MG)
NINLARO
PA
TYKERB
PA
LENVIMA
PA
TASIGNA
PA, QL
LYNPARZA
PA, QL
TAGRISSO
PA, QL
IBRANCE
PA
VOTRIENT
PA, QL
ICLUSIG(TAB)(15 MG) PA, QL
ICLUSIG(TAB)(45 MG) PA, QL
STIVARGA
PA, QL
NEXAVAR
PA, QL
SUTENT
PA, QL
MEKINIST
PA
Selective Retinoid X Receptor Agonists
CAPRELSA(TAB)(100 PA, QL
MG)
CAPRELSA(TAB)(300 PA, QL
MG)
ZELBORAF
PA, QL
Movement Disorders
T1 bexarotene
BEXAROTENE
Steroid Antineoplastics
T1 megestrol acetate
MEGESTROL
ACETATE
NEUROLOGICAL DISEASE MISCELLANEOUS
Agents To Treat Multiple Sclerosis
T2
T2
T2
T1
T2
T2
T2
dimethyl fumarate
fingolimod hcl
glatiramer acetate
glatiramer acetate
interferon beta-1a
interferon beta-1a
interferon beta1a/albumin
T2 interferon beta1a/albumin
T2 interferon beta1a/albumin
T2 teriflunomide
TECFIDERA
GILENYA
COPAXONE
GLATOPA
AVONEX
AVONEX PEN
AVONEX
ADMINISTRATION
PACK
REBIF
PA
PA
PA
PA
PA
PA
PA
REBIF REBIDOSE
PA
AUBAGIO
PA
Blkr
T2 dalfampridine
AMPYRA
PA
Fibromyalgia Agents,serotonin-norepineph Ru
Inhib
T2 milnacipran hcl
T1 tetrabenazine
SAVELLA
TETRABENAZINE
T2 panobinostat lactate
PA
T1 chlorhexidine gluconate CHLORHEXIDINE
GLUCONATE
T1 triamcinolone acetonideTRIAMCINOLONE
ACETONIDE
PA
Nose Preparations Antibiotics
T1 etoposide
T2 omacetaxine
mepesuccinate
ETOPOSIDE
SYNRIBO
Chemotherapy Rescue/antidote Agents
T1 leucovorin calcium
LEUCOVORIN
CALCIUM
T2 mupirocin calcium
STERILE TALC
BACTROBAN NASAL
Nose Preparations, Miscellaneous
Intrapleural Sclerosing Agents, Antineoplast. Adj.
T1 talc
IPRATROPIUM
BROMIDE
OTHER DRUGS
Selective Estrogen Receptor Modulators
Dietary Supplement, Miscellaneous
T2 tamoxifen citrate
T1 tamoxifen citrate
T2 toremifene citrate
T1 Albumen (Egg White) EGG-PRO
T1 Amino Ac/Protein
PROSOURCE PLUS
Hydr/Whey Pro
VNSNY
SOLTAMOX
TAMOXIFEN CITRATE
FARESTON
PA
PA
ORAL/PHARYNGEAL DISORDERS
Dental Aids And Preparations
Antineoplastics,miscellaneous
PA
Agts Tx Neuromusc Transmission Dis,pot-chan
Antineoplastic,histone Deacetylase Inhibitors,hdis
FARYDAK
PA
PA
PA
Page 37 of 75
T1 Amino Acid/Protein/Vit
C/Zinc
T1 Amino Acids/Protein
Hydrolys
T1 Amino Acids/Protein
Hydrolys
T1 Apple Juice
T1 Caloric Supplement
T1 Cranberry Juice
T1 Dietary Supplement
T1 Glucose Polymers
T1 Lactose-Reduced Food
PROSOURCE ZAC
PA
PROSOURCE NO
PA
CARB
PROSOURCE NO
PA
CARB
THICKENUP
PA
BENECALORIE
PA
THICKENUP
PA
SCANDISHAKE
PA
VITAJOULE
PA
ENSURE ACTIVE
PA
MUSCLE HEALTH
T1 Lactose-Reduced Food ENSURE BONE
PA
HEALTH
T1 Lactose-Reduced Food NUTRIHEAL
PA
T1 Lactose-Reduced Food NUTRITIONAL
PA
SHAKE
T1 Lactose-Reduced Food NUTRITIONAL
PA
SHAKE PLUS
T1 Lactose-Reduced Food PORTAGEN
PA
T1 Lactose-Reduced
ISOSOURCE 1.5 CAL PA
Food/Fiber
T1 Lactose-Reduced
JEVITY 1.2 CAL
PA
Food/Fiber
T1 Maltodextrin
SOL CARB
PA
T1 Milk Based Formula COMPLEAT
PA
PEDIATRIC
T1 Milk Based
THICKENUP
PA
Formula/Corn Starch
T1 Ns Comb1/Fos/Inulin
PEPTAMEN AF
PA
T1 Nut Tx, Lact-Reduced, BOOST VHC
PA
Iron
T1 Nutrit
NUTREN 1.5 FIBER
PA
Supp/Inulin/Fos/Fiber
T1 Nutrit
NUTREN JUNIOR
PA
Supp/Inulin/Fos/Fiber FIBER
T1 Nutrit
PEPTAMEN JUNIOR PA
Supp/Inulin/Fos/Fiber FIBER
T1 Nutritional Supplement NUTREN JUNIOR
PA
T1 Nutritional Supplement PEDIASURE PEPTIDE PA
1.5 CAL
T1 Nutritional Supplement PEPTAMEN
PA
T1 Nutritional
REPLETE WITH FIBER PA
Supplement/Fiber
T1 Orange Juice
THICKENUP
PA
T1 Pedi
PEDIASMART
PA
Nutrit.,Soy,Iron,Lf/Fiber ORGANIC DAIRY
T1 Pediatric Nut,Milk
PEDIASURE
PA
Based,Iron
SIDEKICKS
T1 Pediatric
COMPLEAT
PA
Nutrit,Iron,Lf&Fiber PEDIATRIC REDUCED
CAL
T1 Pediatric
PEDIASURE 1.5 WITH PA
Nutrit,Iron,Lf&Fiber
FIBER
T1 Pediatric Nutrition, Iron, PEDIASURE 1.5
PA
Lf
T1 Protein Supplement
PROSOURCE
PA
T1 Soy Protein
ULTRAMINO
PA
Infant Formulas
T1 Infant Form,Fe,LacFr,Hypoalr1
VNSNY
PRODUCT 3232A
PA
T1 Infant Form,Propionic OA 1
Acidemia
T1 Infant Formula,
NEOCATE INFANT
Iron/Dha/Ara
DHA-ARA
PA
PA
Metabolic Disease Enzyme Replace,
Hypophosphatasia
T2 asfotase alfa
STRENSIQ
PA
Nut.Tx Phenylketonuria (Pku) Formulations
T1 Nut. Therapy For Pku,
No.49
T1 Nut. Tx For Pku With
Iron #20
Iron #27
Iron #3
Iron #35
Iron #4
Iron #40
Iron #42
Iron #45
Iron #45
Iron #48
Iron #50
Iron, #26
T1 Nut. Tx For Pku, #46
CAMINO-PRO
PA
RESTORE
PERIFLEX ADVANCE PA
PHENYLADE60
PA
PERIFLEX JUNIOR
PA
PHENYLADE
ESSENTIAL
PKU COOLER 10
PA
PKU LOPHLEX
PA
PKU LOPHLEX
PA
PHENYL-FREE 2
PA
PHENYL-FREE 2HP
PA
PKU TRIO
PA
PHENYLADE RTD
PKU 10
CAMINO PRO 15
PA
CAMINO-PRO
RESTORE
PA
PA
PA
Nutritional Therapy, Med Cond Special
Formulation
T1 Nut Sup,Glucose
RESOURCE
Intolerance #1
DIABETISHIELD
T1 Nut Tx For Isovaleric LMD
Acidemia
T1 Nut Tx For Tyrosinemia TYR LOPHLEX
W-Iron
T1 Nut Tx Imp.Digest
PEPTINEX DT
Fxn,Soy&Fib1
T1 Nut Tx, Sulfite Ox. Def., XMET XCYS
Iron
MAXAMAID
T1 Nut. Tx For Propionic MMA-PA COOLER
Acidemia
T1 Nut. Tx For Propionic OA2
Acidemia
T1 Nut. Tx For Propionic OS 2
Acidemia
T1 Nut.Soy,Lacfree/Fos/Dha PEPTAMEN
/Epa/In
BARIATRIC
T1 Nut.Tx Ketogenic,Milk- KETOCAL 4:1
Base/Soy
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
Page 38 of 75
T1 Nut.Tx,Impaired Renal RENA START
PA
Fxn,Whey
T1 Nut.Tx,Metab.Dis,LeucinLEU-FREE COOLER PA
e-Free
T1 Nut.Tx,Metabolic
HCU COOLER
PA
Dis,Methio-Fr
T1 Nut.Tx,Metabolic
HCU LOPHLEX
PA
Dis,Methio-Fr
T1 Nut.Tx,Metabolic
HCY 2
PA
Dis,Methio-Fr
T1 Nut.Tx,Metabolic
HOM 2
PA
Dis,Methio-Fr
T1 Nut.Tx,Metabolic
HOMINEX-2
PA
Dis,Methio-Fr
T1 Nut.Tx,Metabolic
METHIONAID
PA
Dis,Methio-Fr
T1 Nut.Tx,Metabolic
XMET MAXAMAID PA
Dis,Methio-Fr
T1 Nut.Tx,Metabolic
XMET MAXAMUM
PA
Dis,Methio-Fr
T1 Nut.Tx. Metabolic
HCU COOLER
PA
Disorder,Reg
PERATIVE
PA
Disorder,Soy
PFD 2
PA
Disorder,Soy
T1 Nut.Tx., Urea Cycle
UCD ANAMIX JUNIOR PA
Disorder
T1 Nut.Tx., Urea Cycle
UCD TRIO
PA
Disorder
T1 Nut.Tx.,Elemental,Lac- XTRACAL PLUS
PA
Free/Mct
T1 Nut.Tx.Comp. Immune IMPACT PEPTIDE 1.5 PA
Systm,Reg
CAL
T1 Nut.Tx.Comp. Immune CRUCIAL
PA
Systm,Soy
T1 Nut.Tx.Glu Int/Fos/Dha GLUCO BURST
PA
T1 Nut.Tx.Gluc
BOOST GLUCOSE
PA
Intol,Lf,Soy/Fiber
CONTROL
T1 Nut.Tx.Gluc
DIABETISOURCE AC PA
Intol,Lf,Soy/Fiber
T1 Nut.Tx.Gluc.Intoler,LacGLYTROL
PA
-Fr,Soy
T1 Nut.Tx.Glucose
RESOURCE DIABETIC PA
Intolerance,Soy
TF
T1 Nut.Tx.Imp.Renal
RENALCAL
PA
Fxn,Lac-Free
T1 Nut.Tx.Impaired Digest ENSURE CLEAR
PA
Fxn
T1 Nut.Tx.Impaired Digest EO28 SPLASH
PA
Fxn
T1 Nut.Tx.Impaired Digest NEOCATE
PA
Fxn
T1 Nut.Tx.Impaired Digest NEOCATE NUTRA
PA
Fxn
T1 Nut.Tx.Impaired Digest PEPTAMEN JUNIOR PA
Fxn
T1 Nut.Tx.Impaired Digest F-A-A
PA
Fxn,Soy
T1 Nut.Tx.Impaired Digest PEPTAMEN OS
PA
Fxn,Soy
T1 Nut.Tx.Impaired
NEOCATE JUNIOR
PA
Digest/Fiber
WITH PREBIOTICS
VNSNY
T1 Nut.Tx.Impaired
VITAL 1.0 CAL
Digest/Fiber
T1 Nut.Tx.Impaired
VITAL 1.5 CAL
Digest/Fiber
T1 Nut.Tx.Impaired
VITAL AF 1.2 CAL
Digest/Fiber
T1 Nut.Tx.Impaired
NUTRIHEP
Hepatic Fxn
T1 Nut.Tx.Impaired Renal NEPRO
Fxn,Soy
T1 Nut.Tx.Pulm.Disord.Re NUTRIVENT 1.5
g,Lac-Fr
T1 Nut.Tx.Pulm.Disord.So PULMOCARE
y,Lac-Fr
T1 Nutrit.Therapy, Msud ACERFLEX
With Iron
T1 Nutrit.Therapy, Msud
BCAD 2
With Iron
CAMINO PRO 15
With Iron
MSUD LOPHLEX
With Iron
T1 Nutritional Tx,
KETOCAL 3:1
Ketogenic,Milk
T1 Nutritional Tx,
KETOVOLVE
Ketogenic,Whey
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
Protein Replacement
T1 Casein/Milk, Nf,
Skim/Palm Oil
T1 Infant Form. W-Iron
Lf/Dha/Ara
T1 Nut.Tx.Impaired Digest
Fxn
T1 Whey
PRO-CAL
PA
ELECARE
PA
ELECARE JR
PA
IMMULIFE
PA
Thickening Agents, Oral
T1 Cellulose Gum
T1 Corn Starch
T1
T1
T1
T1
Corn Starch
Starch
Starch
Xanthan Gum
THIK & CLEAR
RESOURCE
THICKENUP
THICKENUP
THICK NOW
THICK-IT
SIMPLYTHICK
PA
PA
PA
PA
PA
PA
OTHER RESPIRATORY DISORDERS
Antifibrotic Therapy - Pyridone Analogs
T2 pirfenidone
ESBRIET
PA
Cystic Fib.transmemb Conduct.reg.(cftr)potentiator
T2 ivacaftor
KALYDECO
PA
Cystic Fibrosis-cftr Potentiator & Corrector Comb.
T2 lumacaftor/ivacaftor
ORKAMBI
PA
ACETYLCYSTEINE
PULMOZYME
PA
Mucolytics
T1 acetylcysteine
T2 dornase alfa
Pulmonary Fibrosis - Systemic Enzyme Inhibitors
T2 nintedanib esylate
OFEV
PA
Page 39 of 75
PAIN MANAGEMENT - ANALGESICS
Analgesic, Non-salicylate & Barbiturate Comb.
T1 butalbital/acetaminoph BUTALBITALen
ACETAMINOPHEN
Analgesic,non-salicylate,barbiturate,&xanthine
T1 morphine sulfate
T1 morphine sulfate
T1 morphine sulfate
MORPHINE SULFATE
ER(CPMP 24HR)(60
MG)
MORPHINE SULFATE
ER(CPMP 24HR)(75
MG)
MORPHINE SULFATE
ER(CPMP 24HR)(90
MG)
MORPHINE SULFATE
ER(TAB ER)
NALBUPHINE HCL
OXYCONTIN
OXYCODONEACETAMINOPHEN
NUCYNTA
NUCYNTA ER
Cmb
T1 morphine sulfate
T1 butalb/acetaminophen/c BUTALBITALaffeine
ACETAMINOPHENCAFFE(CAP)(50-30040)
T1 butalb/acetaminophen/c BUTALBITALaffeine
ACETAMINOPHENCAFFE(TAB)
T1 nalbuphine hcl
T2 oxycodone hcl
T1 oxycodone
hcl/acetaminophen
T2 tapentadol hcl
T2 tapentadol hcl
Analgesic/antipyretics, Salicylates
Antimigraine Preparations
T5 aspirin
T5 aspirin/calcium
carbonate/mag
T1 choline sal/mag
salicylate
T1 diflunisal
T1 salsalate
ASPIRIN EC(OTC)
TRI-BUFFERED
ASPIRIN(OTC)
CHOLINE MAG
TRISALICYLATE
DIFLUNISAL
SALSALATE
QL
Analgesic/antipyretics,non-salicylate
T5 acetaminophen
MAPAP(OTC)
Analgesics,narcotics
T2
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
T1
buprenorphine
BUTRANS
QL
fentanyl
FENTANYL
PA, QL
fentanyl citrate
FENTANYL CITRATE PA
hydrocodone/acetamino HYDROCODONEQL
phen
ACETAMINOPHEN(SO
LUTION)(10-325/15)
phen
ACETAMINOPHEN(SO
LUTION)(5-163/7.5)
phen
ACETAMINOPHEN(SO
LUTION)(7.5-325/15)
phen
ACETAMINOPHEN(TA
B)(10MG-325MG)
phen
ACETAMINOPHEN(TA
B)(5 MG-325MG)
phen
ACETAMINOPHEN(TA
B)(7.5-325MG)
morphine sulfate
MORPHINE SULFATE QL
ER(CAP ER PEL)
morphine sulfate
MORPHINE SULFATE QL
ER(CPMP 24HR)(120
MG)
morphine sulfate
MORPHINE SULFATE QL
ER(CPMP 24HR)(30
MG)
morphine sulfate
MORPHINE SULFATE QL
ER(CPMP 24HR)(45
MG)
VNSNY
T1 dihydroergotamine
mesylate
mesylate
QL
QL
QL
QL
QL
QL
QL
QL
DIHYDROERGOTAMI QL
NE
MESYLATE(AMPUL)
DIHYDROERGOTAMI QL
NE
MESYLATE(SPRAY/PU
MP)
DIHYDROERGOTAMI
NE MESYLATE(VIAL)
CAFERGOT
QL
mesylate
T2 ergotamine
tartrate/caffeine
T1 rizatriptan benzoate
RIZATRIPTAN
QL
T1 sumatriptan
SUMATRIPTAN
QL
T1 sumatriptan succinate SUMATRIPTAN
QL
SUCCINATE(CARTRID
GE)
QL
SUCCINATE(PEN
INJCTR)
QL
SUCCINATE(TAB)
QL
SUCCINATE(VIAL)
T2 zolmitriptan
ZOMIG(SPRAY)(2.5
QL, ST
MG)
T2 zolmitriptan
ZOMIG(SPRAY)(5 MG) QL, ST
Narcotic Withdrawal Therapy Agents
T2 buprenorphine
hcl/naloxone hcl
T2 buprenorphine
hcl/naloxone hcl
BUNAVAIL
PA
ZUBSOLV
PA
PARKINSONS DISEASE
Antiparkinsonism Drugs,anticholinergic
T4 benztropine mesylate
T4 trihexyphenidyl hcl
BENZTROPINE
MESYLATE
TRIHEXYPHENIDYL
HCL
Antiparkinsonism Drugs,other
T1 amantadine hcl
T2 apomorphine hcl
AMANTADINE
APOKYN
PA, QL
Page 40 of 75
T1 bromocriptine mesylate BROMOCRIPTINE
MESYLATE
T1 carbidopa/levodopa
CARBIDOPALEVODOPA
T1 carbidopa/levodopa/ent CARBIDOPAacapone
LEVODOPAENTACAPONE
T1 entacapone
ENTACAPONE
T1 pramipexole di-hcl
PRAMIPEXOLE
DIHYDROCHLORIDE
T2 rasagiline mesylate
AZILECT
QL
T1 ropinirole hcl
ROPINIROLE HCL
T2 rotigotine
NEUPRO
QL, ST
T1 selegiline hcl
SELEGILINE HCL
Decarboxylase Inhibitors
T1 carbidopa
T4 carbamazepine
T4 carbamazepine
T4 carbamazepine
T4 carbamazepine
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
carbamazepine
carbamazepine
clobazam
clobazam
clonazepam
diazepam
diazepam
diazepam
divalproex sodium
divalproex sodium
T4 eslicarbazepine acetate
T4
T4
T4
T4
T4
T4
T4
T4
ethosuximide
ethosuximide
ethotoin
ezogabine
ezogabine
ezogabine
ezogabine
felbamate
T4 felbamate
VNSNY
T4
T4
T4
T4
T4
T4
T4
T4
T4
gabapentin
lacosamide
lacosamide
lamotrigine
lamotrigine
lamotrigine
lamotrigine
lamotrigine
lamotrigine
T4 lamotrigine
T4 lamotrigine
T4 lamotrigine
T4 lamotrigine
Anticonvulsants
T1 carbamazepine
T4 gabapentin
T1 gabapentin
CARBIDOPA
SEIZURE DISORDER
T1 carbamazepine
T4 felbamate
CARBAMAZEPINE(CP
MP 12HR)(100 MG)
CARBAMAZEPINE(CP
MP 12HR)(200 MG)
CARBAMAZEPINE(CP
MP 12HR)(300 MG)
CARBAMAZEPINE(OR
AL SUSP)
CARBAMAZEPINE(TA
B CHEW)
CARBAMAZEPINE(TA
B)
CARBATROL
TEGRETOL XR
ONFI(ORAL SUSP)
QL, ST
ONFI(TAB)
QL, ST
KLONOPIN
DIASTAT
DIASTAT ACUDIAL
DIAZEPAM
DEPAKOTE
DIVALPROEX
SODIUM ER
APTIOM(TAB)(200
QL, ST
MG)
APTIOM(TAB)(400
QL, ST
MG)
APTIOM(TAB)(600
QL, ST
MG)
APTIOM(TAB)(800
QL, ST
MG)
ETHOSUXIMIDE
ZARONTIN
PEGANONE
POTIGA(TAB)(200 MG)QL, ST
POTIGA(TAB)(50 MG) QL, ST
FELBAMATE(ORAL QL, ST
SUSP)
FELBAMATE(TAB)(400 QL, ST
MG)
T4 lamotrigine
T4
T4
T4
T4
T4
T4
T4
lamotrigine
levetiracetam
levetiracetam
levetiracetam
methsuximide
oxcarbazepine
oxcarbazepine
T4 oxcarbazepine
T4 oxcarbazepine
T4 oxcarbazepine
T4 perampanel
T4 perampanel
T4 perampanel
T4 perampanel
T4 perampanel
T4 perampanel
T4
T4
T4
T4
T4
T4
T4
T4
T4
T4
phenytoin
phenytoin
phenytoin
phenytoin sodium
extended
phenytoin sodium
extended
phenytoin sodium
extended
primidone
primidone
rufinamide
rufinamide
FELBAMATE(TAB)(600 QL, ST
MG)
GABAPENTIN(CAP)
GABAPENTIN(SOLUTI
ON)
GABAPENTIN(TAB)
VIMPAT(SOLUTION) QL, ST
VIMPAT(TAB)
QL, ST
LAMICTAL
LAMICTAL (BLUE)
LAMICTAL (GREEN)
LAMICTAL (ORANGE)
LAMICTAL ODT
LAMICTAL ODT
(BLUE)
LAMICTAL ODT
(GREEN)
LAMICTAL ODT
(ORANGE)
LAMICTAL XR (BLUE)ST
LAMICTAL XR
ST
(GREEN)
LAMICTAL XR
ST
(ORANGE)
LAMOTRIGINE
KEPPRA
KEPPRA XR
LEVETIRACETAM
CELONTIN
OXCARBAZEPINE
OXTELLAR XR(TAB QL, ST
ER 24H)(150 MG)
ER 24H)(300 MG)
ER 24H)(600 MG)
TRILEPTAL
FYCOMPA(TAB)(10
QL, ST
MG)
FYCOMPA(TAB)(12
QL, ST
MG)
FYCOMPA(TAB)(2
QL, ST
MG)
FYCOMPA(TAB)(4
QL, ST
MG)
FYCOMPA(TAB)(6
QL, ST
MG)
FYCOMPA(TAB)(8
QL, ST
MG)
DILANTIN
DILANTIN-125
PHENYTOIN
DILANTIN
PHENYTEK
PHENYTOIN SODIUM
EXTENDED
MYSOLINE
PRIMIDONE
BANZEL(ORAL SUSP) QL, ST
BANZEL(TAB)(200
QL, ST
MG)
Page 41 of 75
T4 rufinamide
T4 tiagabine hcl
T4 tiagabine hcl
T4
T4
T4
T4
T4
T4
T4
tiagabine hcl
tiagabine hcl
tiagabine hcl
topiramate
topiramate
topiramate
topiramate
T4 topiramate
T4 topiramate
T4 topiramate
T4 valproic acid
T4 valproic acid (as
sodium salt)
T4 vigabatrin
T4 zonisamide
T4 zonisamide
BANZEL(TAB)(400
QL, ST
MG)
GABITRIL(TAB)(12
QL, ST
MG)
GABITRIL(TAB)(16
QL, ST
MG)
GABITRIL(TAB)(2 MG)
GABITRIL(TAB)(4 MG)
TIAGABINE HCL
QL, ST
QUDEXY XR
TOPAMAX
TOPIRAMATE
TROKENDI XR(CAP QL, ST
ER 24H)(100 MG)
ER 24H)(200 MG)
ER 24H)(25 MG)
ER 24H)(50 MG)
VALPROIC ACID
VALPROIC ACID
SABRIL
ZONEGRAN
ZONISAMIDE
QL
SKELETAL MUSCLE DISORDER
UPPER GASTROINTESTINAL
DISORDERS - DIGESTIVE
Gastric Enzymes
T2 sacrosidase
T2 lipase/protease/amylase CREON
T1 lipase/protease/amylase PANCRELIPASE 5,000
T2 lipase/protease/amylase ZENPEP
DISORDERS - SPASTIC DISEASE
Anticholinergics/antispasmodics
T1 dicyclomine hcl
T1 hyoscyamine sulfate
HYOSCYAMINE
SULFATE
T1 methscopolamine
METHSCOPOLAMINE
bromide
BROMIDE
T2 phenobarb/hyoscy/atropi DONNATAL
ne/scop
Inh
T1 ipecac
PA
Skeletal Muscle Relaxants
T1 baclofen
T1 chlorzoxazone
T1 cyclobenzaprine hcl
T1 dantrolene sodium
T1 methocarbamol
T1 orphenadrine citrate
T1 tizanidine hcl
DICYCLOMINE HCL
Belladonna Alkaloids
Emetics
KEVEYIS
PA
Pancreatic Enzymes
Agents To Tx Periodic Paralysis - Carbon Anhyd
T2 dichlorphenamide
SUCRAID
IPECAC(OTC)
DISORDERS - ULCER DISEASE
BACLOFEN
CHLORZOXAZONE
CYCLOBENZAPRINE
HCL
DANTROLENE
SODIUM
METHOCARBAMOL
ORPHENADRINE
CITRATE
TIZANIDINE HCL
Antacids
T5 aluminum hydroxide
T5 calcium carbonate
ALUMINUM
HYDROXIDE(OTC)
ANTACID EXTRA
STRENGTH(OTC)
MI ACID(OTC)
T5 mag hydrox/al
hydrox/simeth
T5 mg
FOAMING
trisilicate/alh/nahco3/aa ANTACID(OTC)
T5 sodium bicarbonate
SODIUM
BICARBONATE(OTC)
SMOKING CESSATION
Smoking Deterrent Agents
Anticholinergics,quaternary Ammonium
T5 nicotine
T5 nicotine polacrilex
Smoking Deterrent-nicotinic Recept.partial Agonist
T1 glycopyrrolate
GLYCOPYRROLATE
T1 propantheline bromide PROPANTHELINE
BROMIDE
T4 varenicline tartrate
Anti-ulcer Preparations
NICODERM CQ(OTC)
NICORETTE(OTC)
CHANTIX
Smoking Deterrents, Other
T4 bupropion hcl
BUPROBAN
QL
T1 misoprostol
T2 sucralfate
T1 sucralfate
MISOPROSTOL
CARAFATE
SUCRALFATE
Anti-ulcer-h.pylori Agents
T1 lansoprazole/amoxiciln/ LANSOPRAZOLclarith
AMOXICILCLARITHRO
VNSNY
QL
Page 42 of 75
Histamine H2-receptor Inhibitors
Urinary Tract Analgesic Agents
T1
T5
T1
T1
T5
T1
T1
T5
T2 pentosan polysulfate
sodium
cimetidine
cimetidine
cimetidine hcl
famotidine
famotidine
nizatidine
ranitidine hcl
ranitidine hcl
CIMETIDINE
CIMETIDINE(OTC)
CIMETIDINE
FAMOTIDINE
FAMOTIDINE(OTC)
NIZATIDINE
RANITIDINE HCL
RANITIDINE
HCL(OTC)
ELMIRON
Urinary Tract Anesthetic/analgesic Agnt
T1 phenazopyridine hcl
PHENAZOPYRIDINE
HCL
Urinary Tract Antispasmodic, M(3) Selective Antag.
T2 solifenacin succinate
VESICARE
ST
Intestinal Motility Stimulants
Urinary Tract Antispasmodic/antiincontinence
T1 metoclopramide hcl
Agent
METOCLOPRAMIDE
HCL
QL, ST
T2 fesoterodine fumarate
T1 flavoxate hcl
T1 oxybutynin chloride
QL, ST
T1 tolterodine tartrate
Proton-pump Inhibitors
T1 esomeprazole
magnesium
T2 esomeprazole
magnesium
T1 lansoprazole
T1 lansoprazole
T2
T1
T5
T1
lansoprazole
omeprazole
omeprazole
pantoprazole sodium
T1 rabeprazole sodium
ESOMEPRAZOLE
MAGNESIUM
NEXIUM
LANSOPRAZOLE
LANSOPRAZOLE(OT
C)
PREVACID
ST
OMEPRAZOLE
OMEPRAZOLE(OTC)
PANTOPRAZOLE
SODIUM
RABEPRAZOLE
QL
SODIUM
TOVIAZ
FLAVOXATE HCL
OXYBUTYNIN
CHLORIDE
TOLTERODINE
TARTRATE
Vaginal Antibiotics
T1 clindamycin phosphate CLINDAMYCIN
PHOSPHATE
T1 metronidazole
METRONIDAZOLE
Vaginal Antifungals
DISORDERS
Benign Prostatic Hypertrophy/micturition Agents
Vaginal Estrogen Preparations
T1
T1
T1
T1
T2 estradiol
T2 estradiol
T2 estrogens, conjugated
alfuzosin hcl
dutasteride
finasteride
tamsulosin hcl
ALFUZOSIN HCL ER
DUTASTERIDE
G, ST
FINASTERIDE
TAMSULOSIN HCL
butoconazole nitrate
miconazole nitrate
miconazole nitrate
miconazole nitrate
terconazole
GYNAZOLE 1
MICONAZOLE 3
MICONAZOLE 3(OTC)
MONISTAT 3(OTC)
TERCONAZOLE
ESTRACE
VAGIFEM
PREMARIN
Vaginal Sulfonamides
Bph Agents,5-alpha-red Inh & Alpha-1-adr Antg
T2 sulfanilamide
Cmb
VITAMIN AND/OR MINERAL
T1 dutasteride/tamsulosin DUTASTERIDEhcl
TAMSULOSIN
G, ST
Kidney Stone Agents
T2 cysteamine bitartrate
SODIUM CITRATE &
CITRIC ACID
PHOSPHA 250
NEUTRAL
T1 potassium citrate
POTASSIUM CITRATE
ER
T1 potassium citrate/citric CYTRA-K
acid
T1 sod/pot/k cit/sod cit/cit TRICITRATES
acid
VNSNY
AVC
DEFICIENCY
Antioxidant Multivitamin Combinations
PROCYSBI
Urinary Ph Modifiers
T1 citric acid/sodium
citrate
T1 phosphorus #1
ST
VAGINAL DISORDERS
T2
T1
T5
T5
T1
URINARY TRACT - FUNCTIONAL
ST
PA
T5 beta-carotene(a) w-c &
e/zn/cu
T5 vit a,c &
e/lutein/minerals
T5 vit a/vit c/vit
e/zinc/copper
VISION-VITE +
ZINC(OTC)
I-VITE(OTC)
PRESERVISION
AREDS(OTC)
Calcium Replacement
T5 calcium carb
&gluconate/vit d2
T5 calcium carbonate
T5 calcium
carbonate/vitamin d2
PARVA-CAL 500(OTC)
CALCIUM(OTC)
OYSTER SHELL
CALCIUM W-VIT
D(OTC)
Page 43 of 75
T5 calcium
carbonate/vitamin d3
OYSTER SHELL
CALCIUM W-VIT
D(OTC)
T5 calcium citrate
CALCITRATE(OTC)
T1 calcium/mag/d3/b12/fa/ TL G-FOL OS
b6/boron
T5 calcium/multivitamin FOSFREE(OTC)
with iron
Fluoride Preparations
T1
T2
T2
T1
sodium fluoride
sodium fluoride
sodium fluoride
sodium
fluoride/potassium nit
T1 stannous fluoride
FLUORIDE
FLUORITAB
FLURA-DROPS
FLUORIDEX
SENSITIVITY RELIEF
GEL-KAM(OTC)
Folic Acid Preparations
T1 folic acid
T1 folic acid
T5 multivitmin/fa/lycopen/lutein
FOLIC ACID
FOLIC ACID(OTC)
BIOCEL(OTC)
Geriatric Vitamin Preparations
T5 multivit with ironminerals
T5 multivitamin with
minerals
minerals/lut
T5 multivitmin/fa/lycopen/lutein
T5 mv, min
#36/iron,carbonyl/fa
SPECTRAVITE
SENIOR(OTC)
ONE DAILY 50
PLUS(OTC)
CEROVITE
SENIOR(OTC)
CERTAVITE SENIORANTIOXIDANT(OTC)
GERITOL
COMPLETE(OTC)
Iron Replacement
T1 fe
fumarate/cal/e/fa/multi
vit
T1 fe
fumarate/doss/fa/bcom
p,c
T1 fe fumarate/vit
c/b12/stomc
T1 fe fumarate/vit c/b12if/fa
T1 ferrous fumarate/folic
acid
T5 ferrous sulfate
T5 ferrous sulfate
T1
T1
T1
T1
T1
T1
VITAFOL
NEPHRON FA
HEMATOGEN
Magnesium Salts Replacement
FEROCON
T5 magnesium
T5 magnesium oxide
HEMATINIC WITH
FOLIC ACID
FER-IN-SOL(OTC)
FERROUS
SULFATE(OTC)
ferrous sulfate/vit c/fa FOLITAB 500(OTC)
iron ag&fum/c/fa/mv FERREX 28
cmb11/ca-t
iron
MULTIGEN
ag/c/b12/ca/suc.acid/sto
m
iron
FERREX 150 FORTE
aspgly&ps/c/b12/fa/ca/s PLUS
uc
iron aspgly,ps/c/succinic FERREX 150
acid
PLUS(OTC)
iron aspgly/c/b12/fa/ca- MULTIGEN FOLIC
th/suc
VNSNY
T1 iron
TARON FORTE
bg,ps/vitc/b12/fa/calciu
m
T1 iron
FOCALGIN DSS
carb,gl/fa/b12/c/docusat
e
T1 iron fum &
MULTIGEN PLUS
ag/c/b12/fa/ca/succ
T1 iron fum & ps
FOLIVANE-F
cmp/fa/vit c/b3
T1 iron
SE-TAN PLUS
fum&polysac#1/fa/mv
no.18
T1 iron fum,ps/fa/vit b
FOLIVANE-PLUS
with c #9
T1 iron fumarate/vit c/vit TRIGELS-F FORTE
b12/fa
T1 iron polysac/iron
HEMETAB
heme/fa/b12
T5 iron polysaccharide
FERREX 150(OTC)
complex
T1 iron ps cmplx/vit b12/fa POLY-IRON 150 FORTE
T1 iron, carbonyl/fa/c/b- CORVITA 150
6/b12/zn
T1 iron,carb/dss/b12if/fa/m TL-HEM 150
v-mn
T2 iron,carb/fa#6/mv, min CORVITE 150
no.41
T1 iron,carbonyl/vit c/vit IRON 100 PLUS(OTC)
b12/fa
T1 iron/fa/b12/c/docusate FERRAPLUS 90
sodium
T1 iron/fa/vit
HEMATINIC PLUS
bcomp,c/minerals
T5 iron/liver ext/vit
SIDEROL(OTC)
bcomp,c/min
T5 iron/mv,stress form
STRESS FORMULA
WITH IRON(OTC)
T5 vit b comp/c/fa/iron
STRESS FORMULA
sulf/vite
WITH IRON(OTC)
T5 vit b comp/c/fa/iron/vit STRESS FORMULA
e
WITH IRON(OTC)
MAGNESIUM(OTC)
MAGNESIUM
OXIDE(OTC)
Mineral Replacement,miscellaneous
T1 minerals/protein
supplement
PROVIMIN(OTC)
Multivitamin Preparations
T5 a/c/e/zinc/sod
PROSIGHT(OTC)
selenate/copper
T1 amino acids/mv,th w- TYR COOLER(OTC)
fe,mn
T1 b complex with vitamin VITAMIN B-COMPLEX
c
WITH VIT
C(CAP)(OTC)
T5 b complex with vitamin VITAMIN B-COMPLEX
c
WITH VIT
C(TAB)(OTC)
Page 44 of 75
T5 beta-carotene(a) w-c & OCUTABS(OTC)
e/min
T5 cal/mag/b comp/vit
WOMEN'S
d3/hrb61
COMPLEX(OTC)
T5 fa/mv,ca,iron,min/lycop MULTIVITAL(OTC)
ene/lut
T1 fe fumarate/fa/vit
DIALYVITE 800 WITH
bcomp,c
IRON
T5 folic acid/multivitESSENTIAL WOMAN
min/lutein
50+(OTC)
T5 folic acid/mv,fe,min
ONE DAILY FOR
WOMEN(OTC)
T5 folic
CERTA PLUS(OTC)
acid/mv,fe,min/lutein
T5 multivit with
MULTIVITAMINS Wcalcium,iron,min
CALCIUM-IRON(OTC)
T5 multivit with ironMULTILEX(OTC)
minerals
T1 multivit, iron, min #5, STROVITE FORTE
fa
T1 multivit, min
BACMIN
cmb#20/iron/fa
T5 multivit,ca,iron,min/fa/ DAILY ENERGY(OTC)
hrb146
T5 multivit,tx,iron/calcm/f THERA-M(OTC)
a/mins
T5 multivitamin
TAB-A-VITE(OTC)
T1 multivitamin no.44/vit MULTIVITAMINSd3/k
A,B,D,E,K,ZN
T5 multivitamin with iron TAB-A-VITE WITH
IRON(OTC)
MULTIVITAMINS
minerals
WITH
MINERALS(OTC)
T5 multivitamin,stress
STRESS
formula
FORMULA(OTC)
T5 multivitamin,stress
STRESS FORMULA
formula/zn
WITH ZINC(OTC)
T5 multivitamin,ther and VITAMIN AND
minerals
MINERALS(OTC)
T5 multivitamin,therapeuti THERA(OTC)
c
T5 multivitamin/iron/folic CEROVITE
acid
ADVANCED
FORMULA(OTC)
T1 multivitamin-minerals V-C FORTE
no.7/fa
T5 multivitICAPS MV(OTC)
min/fa/lutein/zeaxant
T5 multivitCENTRUM SILVER
min/fa/lycopen/lutein
ULTRA MEN'S(OTC)
T5 multivitSENTRY
min/fa/lycopen/lutein SENIOR(OTC)
T5 multivit-min/folic
TRUEPLUS
acid/vit k1
MULTIVITAMIN(OTC)
T5 multivit-min/herbal
MEN'S
drugs
BIOMULTIPLE(OTC)
T5 multivitCENTURY ENERGY
min/iron/fa/ginseng
METABOLISM(OTC)
T5 multivitCENTRUM SILVER
min/iron/folic/lutein
WOMEN(OTC)
T5 multivitSPECTRAVITE ULTRA
min/iron/folic/lutein
WOMEN'S(OTC)
VNSNY
T5 multivitONE-A-DAY
minerals/fa/lycopene MEN'S(OTC)
T5 multivit-minerals/folic ONE DAILY
acid
ESSENTIAL(OTC)
T5 multivitDAILY
minerals/folic/ginkgo MULTIPLE(OTC)
T5 multivits wCENTRAL-VITE(OTC)
iron,hematinic
T5 multivits,ca,min/iron/fa SPECTRAVITE
/lycop
MEN'S(OTC)
T5 multivits,ca,minerals/iron ONE-A-DAY
/fa
WOMEN'S(OTC)
T5 multivits,ca,minerals/ir THERA-M(OTC)
on/fa
T5 multivits,th w-ca,fe,oth THERAPEUTIC
min
M(OTC)
T5 multivits,th w-fe,other THEREMS-M(OTC)
min
T1 multivits,therap wB-PLEX PLUS
fe,hematin
T5 mv wMEGA
ca/iron/fa/lutein/hrb#17 MULTIVITAMIN(OTC)
9
T5 mv,ca,iron,min/fa/phyto CENTRAL-VITE
sterol
CARDIO(OTC)
T5 mv,ca,iron,min/fa/phytostCENTRUM
erol
SPECIALIST
HEART(OTC)
T5 mv,ca,min/iron
COMPLETE(OTC)
fum/fa/lyco/lut
T5 mv,ca,min/iron
MULTI FOR HER(OTC)
fum/fa/vit k
T5 mv,ca,min/iron/fa/guar ONE-A-DAY
ana/caff
WOMEN'S(OTC)
T5 mv,ca,min/iron/fa/lyc/lut/ SPECTRAVITE
phyt
CARDIO
HEALTH(OTC)
T5 mv,fe,min/gr tea lfxt
DAILY
MULTIPLE(OTC)
T5 mv,fe,min/lutein
THERATRUM
COMPLETE(OTC)
T5 mv,minerals/fa/lycopen DAILY
e/ginkgo
MULTIPLE(OTC)
T5 mv/gnk bi ex/k.ginsg CENTRAL VITE(OTC)
T5 mv-min/iron
SUNVITE(OTC)
fum/fa/k/lyco/lutn
T5 mvMEGA MULTI(OTC)
mn/fa/lycopene/lut/hb#
178
T1 om-3/calcium/d3/fa/mv ADVANCED AM/PM
cmb 13
T1 omVIT 3
3/dha/epa/b12/fa/b6/ph
ytost
T5 vit a/vit c/vit
ICAPS(OTC)
e/zinc/copper
T5 vitb&c/iron fum/fa/vit STRESS FORMULA
e/aa#16
ENERGY(OTC)
Pediatric Vitamin Preparations
T1 fluoride/iron/vitamins TRI-VIT WITH
a,c,d
FLUORIDE-IRON
T5 multivit with ironLYSIPLEX PLUS(OTC)
minerals
Page 45 of 75
T5 ped multivit #46/iron
sulfate
T1 ped mv a,c,d3 #21 wfluoride
T1 ped mv a,c,d3 #38 wfluoride
T1 pedi m.vit no.17 with
fluoride
T1 pedi multivit #65/vit
d3/vit k
T1 pedi multivit no.2 wfluoride
T5 pedi multivits a,c,&d3
no.21
T1 pedi mv
#45/fluoride/iron
T1 pedi mv
#75/fluoride/iron
T1 pedi mv no.83 with
fluoride
T1 pedi mv no.84 with
fluoride
T1 pedi mvi no.12/sodium
fluoride
T1 pedi mvi no.16 with
fluoride
T1 pedi mvi no.82 with
fluoride
T5 pediatric multivitamin
no.20
T5 vit a palmitate/vit c/vit
d3
POLYVITAMIN WITH
IRON(OTC)
TRI-VITAMIN WITH
FLUORIDE
TRI-VI-FLORO
MULTIVITAMIN WITH
FLUORIDE
MULTIVITAMINSA,B,D,E,K,ZN
MULTIVITAMINS
WITH FLUORIDE
TRI-VITAMIN(OTC)
MULTIVITAMINS WFLUORIDE-IRON
MULTIVITAMINS WFLUORIDE-IRON
QUFLORA
QUFLORA
MVC-FLUORIDE
MULTIVITAMINS
WITH FLUORIDE
MULTIVITAMINS
WITH FLUORIDE
POLY-VITAMIN(OTC)
TRI-VI-SOL(OTC)
Prenatal Vitamin Preparations
T1 iron,carbonyl/vit c/vit
b12/fa
T1 pn vit.w-o ca #7,
iron,fa,dha
T1 pnv #14/ferrous
fum/folic acid
T1 pnv #15/iron
fum,ps/folic acid
T1 pnv #19/iron
ps&heme/folic/dha
T1 pnv #8/iron ps
cmp,aspg/fa/dha
T1 pnv #87/iron
bisgly/fa/dha
T1 pnv 11-iron fum-folic
acid-om3
T1 pnv combo
#22/iron/fa/om3/dha
T1 pnv combo#47/iron/fa
#1/dha
T1 pnv no.115/iron
fumarate/fa
T1 pnv no.118/iron
fumarate/fa
T1 pnv no.22/iron
cbn&gluc/fa/dss
T1 pnv
no.66/iron,carbonyl/fa/
dha
VNSNY
ICAR-C PLUS
ELITE OB DHA
COMPLETENATE
FOLIVANE-OB
VP-HEME ONE
PAIRE OB PLUS DHA
TRI-TABS DHA
C-NATE DHA
HEMENATAL OB +
DHA
PNV-DHA
PRENATAL 19
PRENATAL 19(OTC)
VINACAL
R-NATAL OB
T1 pnv no10/iron
SE-TAN DHA
fum&p/fa/omega-3
T1 pnv
OBSTETRIX DHA
no12/iron,carb/fa/dss/o
m-3
T1 pnv w-ca #40/iron
PNV-SELECT
fum/fa cmb#1
T1 pnv w-ca
ULTIMATECARE ONE
no.37/iron/fa/omega-3
T1 pnv wPNV-IRON
ca8/iron/fa/lmefolate ca
T1 pnv with ca
VIRT-PN PLUS
#68/iron/fa#1/dha
T1 pnv with ca no.65/iron MARNATAL-F
poly/fa
T1 pnv with
VOL-PLUS
ca#74/iron/folic acid
T1 pnv with
TRIVEEN-ONE
ca,no.62/iron/fa/dha
T1 pnv with
CALCIUM PNV
ca,no.70/iron/fa/dha
T1 pnv with
PRENATAL PLUS
ca,no.72/iron,carb/fa
T1 pnv with
PRENATAL PLUS
ca,no.72/iron/fa
T1 pnv w-o ca no5/fe
PRENATAL-U
fumarate/fa
T1 pnv#16/iron fum &
TARON-C DHA
ps/fa/om-3
T1 pnv#21/iron ps& heme HEMENATAL OB
polyp/fa
T1 pnv#64/iron/lmfolate/al VINATE DHA RF
gal/soy
T1 pnv#79/iron/fa/lmfolate VINATE DHA
ca/dha
T1 pnv,ca,no.35/iron/fa/ds/ ULTIMATECARE ONE
omeg-3
NF
T1 pnv/ferrous
MYNATE 90 PLUS
fumarate/doss/fa
T1 pnv/ferrous
VINATE-M
fumarate/fa/se
T1 pnv/iron,carbonyl/docu MYNATAL
sate/fa
T1 pnv100/iron
BAL-CARE DHA
edta&ps/fa/omega3
ESSENTIAL
T1 pnv115/iron
PRENATAL 19
fumarate/fa/dss
T1 pnv119/iron
SE-NATAL 19
fumarate/fa/dss
T1 pnv17/iron/fa/fish
ELITE-OB 400
oil/dha/om
T1 pnv19/iron bg hc&succ- PR NATAL 400 EC
p/fa/om3
T1 pnv34/iron,carbonyl/fa/ VP-CH-PNV
dss/dha
T1 pnv39/iron
TARON-PREX
fumarate/fa/dss/dha
PRENATAL
T1 pnv53/iron b-g hclTRIVEEN-DUO DHA
p/fa/omega3
T1 pnv54/iron b-g hclPR NATAL 430
p/fa/omega3
T1 pnv55/iron bg hc&succ- PR NATAL 430 EC
p/fa/om3
Page 46 of 75
T1 pnv59/iron,carbonyl/fa/ VP-CH PLUS
dss/dha
T1 pnv66/iron
VIRTPREX
fumarate/fa/dss/dha
T1 pnv69/iron,carbonyl/fa/ PRENAISSANCE PLUS
dss/dha
T1 pnv7/fe asp
VINATE PN CARE
gly/docusate/fa
T1 pnv80/iron
PRENAISSANCE
fumarate/fa/dss/dha
T1 pnv81/sod iron edta& BAL-CARE DHA
ps/fa/om3
T5 pnv95/ferrous
PRENATAL(OTC)
fumarate/fa
T1 prenat vit
VITAFOL-OB+DHA
comb.10/iron/fa/dha
T1 prenatal
EXTRA-VIRT PLUS
#57/iron/fa/dss/dha
DHA
T1 prenatal comb
PRENA1 CHEW
no.42/folic acid
T1 prenatal no.13/iron
SELECT-OB
ps/fa cb#1
T1 prenatal
VP-PNV-DHA
no.52/iron/fa/dha
T1 prenatal
VITAFOL NANO
no.75/iron/folate #1
T1 prenatal vit
VOL-TAB RX
#76/iron,carb/fa
T1 prenatal vit 15/iron
VIRT-ADVANCE
cb/fa/dss
VIRT-VITE GT
cb/fa/dss
INATAL ULTRA
cb/fa/dss
T1 prenatal vit
VINATE CARE
no.109/iron/fa
T1 prenatal vit
O-CAL PRENATAL
no.127/iron/fa
T5 prenatal vit
PRENATAL ONE
no.129/iron/fa
DAILY(OTC)
T1 prenatal vit
TRINATE
no.73/iron/fa
T1 prenatal vit
PRENATABS FA
no.78/iron/fa
T1 prenatal vit#4/iron
PUREFE OB PLUS
fum,ps/fa
T1 prenatal vit#86/iron
NEWGEN
bisgly/fa
T5 prenatal vit#96/ferrous PRENATAL(OTC)
fum/fa
T1 prenatal vit/iron
VINATE II
bisglycin/fa
T5 prenatal vit/iron
PRENATAL
fumarate/fa
VITAMINS(OTC)
T1 prenatal
VINATE ONE
vit27,calcium/iron/fa
T1 prenatal vits#4/iron
PUREFE PLUS
fum/fa
T1 pv w-o cal/iron ps
SELECT-OB
cplx/fa
Prenatal Vitamins Without Iron
T1 pnv w-o
FOLBECAL
iron/fa/calcium/b6/b12
VNSNY
T1 pnv/fa/b6/calcium
carb/ginger
T1 pnv/fa/b6/calcium
phos/ginger
PRENAISSANCE
NEXT-B
PRENAISSANCE
NEXT
Vitamin A Preparations
T5 vitamin a
T5 vitamin a palmitate
VITAMIN A(OTC)
VITAMIN A(OTC)
Vitamin B Preparations
T1 b cmplx 4/vit
VITAL-D RX
d3/c/fa/zinc ox
T1 b complex & c
RENO CAPS
no.20/folic acid
T1 b12/levomefolate
FOLBIC RF
calcium/b-6
T1 cyanocobalamin/fa/pyri FOLBIC
doxine
T1 cyanocobalamin/fa/pyri FOLBIC(OTC)
doxine
T5 fa/vit b complex &
VITAMIN B-COMPLEX
c/rice bran
WITH VIT C(OTC)
T5 fa/vit
DIALYVITE 800bcomp,c/zinc/vitamin d3 ULTRA D(OTC)
T1 folic acid/b complex & c VIRT-VITE PLUS
no.17
T1 folic acid/b
DIALYVITE 3000
cplx/c/selen/zinc
T1 folic acid/vit bcomp,c DIALYVITE
T1 folic acid/vit
FOLBEE PLUS CZ
bcomp,c/cu/znox
T1 vit b cmplx 3/fa/vit
RENA-VITE RX
c/biotin
T1 vit b cmplx
NEPHPLEX RX
no3/fa/c/biot/zinc
T5 vit b complex 100 cmb NATURAL BALANCED
#2/herbs
B-100(OTC)
T5 vit b complex 100 cmb BALANCED B#3/herbs
100(OTC)
T1 vit b cplx
DIALYVITE ZINC
#11/fa/c/biot/zn ox
T1 vitamin b complex
VITAMIN B
COMPLEX(CAP)(OTC)
T5 vitamin b complex
VITAMIN B
COMPLEX(TAB)(OTC)
T5 vitamin b
STRESS
complex/minerals
FORMULA(OTC)
T1 vitamins b1,b2,b3,b5,& B-COMPLEX
b6
Vitamin B1 Preparations
T5 thiamine hcl
VITAMIN B-1(OTC)
T5 thiamine mononitrate VITAMIN B-1(OTC)
T1 cyanocobalamin
CYANOCOBALAMIN
(vitamin b-12)
INJECTION
T1 cyanocobalamin/mecob NEURIN-SL
alamin
T1 hydroxocobalamin
HYDROXOCOBALAMI
N
T5 pyridoxine hcl
VITAMIN B-6(OTC)
Page 47 of 75
Vitamin C Preparations
T5 ascorbic acid
VITAMIN C(OTC)
T5 ascorbic acid/ascorbate ACEROLA C(OTC)
sodium
Vitamin D Preparations
T1 calcitriol
CALCITRIOL
T5 cholecalciferol (vitamin VITAMIN D(OTC)
d3)
T5 cholecalciferol (vitamin VITAMIN D3(OTC)
d3)
T1 ergocalciferol (vitamin VITAMIN D2
d2)
AGE
AGE
Zinc Replacement
T1 zinc sulfate
VNSNY
ZINC SULFATE(OTC)
Page 48 of 75
Preferred Drug List Medication Prescribing Limitations
AGE RESTRICTIONS
• DEXMETHYLPHENIDATE HCL
ER
• FOCALIN XR
• METHYLPHENIDATE ER(CPBP
50-50)(20 MG)
50-50)(30 MG)
50-50)(40 MG)
• METHYLPHENIDATE ER(TAB
ER 24H)(18 MG)
ER 24H)(27 MG)
ER 24H)(36 MG)
ER 24H)(54 MG)
ER)(10 MG)
ER)(20 MG)
• RITALIN LA
• TACROLIMUS
• VITAMIN D(OTC)
• VITAMIN D3(OTC)
VNSNY
<= 18 years
<= 18 years
<= 18 years
<= 18 years
<= 18 years
<= 18 years
<= 18 years
<= 18 years
<= 18 years
<= 18 years
<= 18 years
<= 18 years
>= 2 years
>= 65 years
>= 65 years
Page 49 of 75
QUANTITY RESTRICTIONS
• ABACAVIR
• ABILIFY
• ABILIFY
• ADVAIR DISKUS
• ADVAIR HFA
• AEROSPAN
• AFINITOR(TAB)(10 MG)
• AFINITOR(TAB)(2.5 MG)
• AKYNZEO
• ALECENSA
• ALENDRONATE
SODIUM(SOLUTION)
• AMITIZA
• AMLODIPINE-ATORVASTATIN
• ANDROXY
• ANORO ELLIPTA
• APLENZIN
• APOKYN
• APTIOM(TAB)(200 MG)
• ARIPIPRAZOLE
• ASPIRIN EC(OTC)
• ATRIPLA
• ATROVENT HFA
• AZELASTINE HCL
• AZILECT
• BANZEL(ORAL SUSP)
• BANZEL(TAB)(200 MG)
• BELSOMRA
• BIMATOPROST
• BOSULIF(TAB)(100 MG)
• BREO ELLIPTA
• BRILINTA
• BRINTELLIX
• BRISDELLE
• BUDESONIDE(AMPULNEB)(0.25MG/2ML)
• BUDESONIDE(AMPUL-NEB)(0.5
MG/2ML)
• BUDESONIDE(AMPUL-NEB)(1
MG/2 ML)
• BUTRANS
• CAFERGOT
• CAMRESE
• CAPECITABINE(TAB)(150 MG)
• CAPRELSA(TAB)(100 MG)
• CHANTIX
• CLONIDINE HCL ER
• CLOPIDOGREL(TAB)(300 MG)
• CLOZAPINE
• CLOZARIL
• COLCHICINE
• COMBIPATCH
• COMETRIQ
• COTELLIC
VNSNY
60 units per 30 days
1 tablet per day
Solution 30mL per day
12 gm per 30 days
17.8 gm per 30 days
1 unit per 1 day
1 unit per 1 day
1 unit per 1 day
1 unit per 28 days
240 capsules per 30 days
75 ml per 7 days
2 units per 1 day
1 unit per 1 day
1 unit per 1 day
2 ml per 1 day
1 unit per 1 day
1 unit per 1 day
2 units per 1 day
2 units per 1 day
1 unit per 1 day
100 units per fill
25.8 gm per 30 days
60 ml per 30 days
1 unit per 1 day
80 ml per 1 day
16 units per 1 day
8 units per 1 day
1 unit per 1 day
1 ml per 12 days
4 units per 1 day
1 unit per 1 day
2 units per 1 day
1 unit per 1 day
1 unit per 1 day
120 ml per 30 days
120 ml per 30 days
60 ml per 30 days
1 unit per 7 days
10 units per 7 days
91 unit per 84 days
28 units per 21 day
112 units per 21 day
2 units per 1 day
1 unit per 1 day
2 units per 1 day
4 units per 30 days
3 units per 1 day
3 units per 1 day
4 units per 1 day
2 units per 7 days
4 units per 1 day
63 tablets per 28 days
• CRESTOR(TAB)(10 MG)
1 unit per 1 day
1 unit per 1 day
1 unit per 1 day
1 unit per 1 day
• CYMBALTA
2 units per 1 day
• DALIRESP
1 unit per 1 day
• DEPO-PROVERA
1 ml per 84 days
• DEPO-SUBQ PROVERA 104
.65 ml per 84 days
• DESLORATADINE
1 unit per 1 day
• DESVENLAFAXINE ER
1 unit per 1 day
• DESVENLAFAXINE FUMARATE
ER
1 unit per 1 day
• DEXMETHYLPHENIDATE HCL
ER
1 unit per 1 day
• DEXTROAMPHETAMINE
SULFATE(SOLUTION)
1800 ml per 30 days
SULFATE(TAB)(10 MG)
SULFATE(TAB)(5 MG)
• DEXTROAMPHETAMINEAMPHETAMINE
2 units per 1 day
• DIDANOSINE(CAP DR)(125 MG) 60 units per 30 days
• DIDANOSINE(CAP DR)(200 MG) 60 units per 30 days
• DIFICID
• DIHYDROERGOTAMINE
MESYLATE(AMPUL)
15 ml per 14 days
• DIHYDROERGOTAMINE
MESYLATE(SPRAY/PUMP)
8 ml per 28 days
• DOXYCYCLINE HYCLATE
2 units per 1 day
• DOXYCYCLINE
MONOHYDRATE(CAP)
2 units per 1 day
• DOXYCYCLINE
MONOHYDRATE(TAB)(100 MG) 2 units per 1 day
• DOXYCYCLINE
MONOHYDRATE(TAB)(150 MG) 2 units per 1 day
• DOXYCYCLINE
MONOHYDRATE(TAB)(50 MG)
2 units per 1 day
• DOXYCYCLINE
2 units per 1 day
• DRONABINOL
2 units per 1 day
• DULERA
13 gm per 30 days
• DULOXETINE HCL
2 units per 1 day
• EDLUAR
1 unit per 1 day
• EFFIENT
1 unit per 1 day
• ELIQUIS(TAB)(2.5 MG)
2 units per 1 day
• ELIQUIS(TAB)(5 MG)
• EMEND(CAP DS PK)
3 units per 21 day
• EMEND(CAP)(125 MG)
3 units per 21 day
1 unit per 28 days
2 units per 21 day
• EMSAM
1 unit per 1 day
• EMTRIVA(CAP)
• EMTRIVA(SOLUTION)
720 ml per 30 days
• ENOXAPARIN
SODIUM(SYRINGE)(100 MG/ML) 20 ml per 30 days
• ENOXAPARIN
SODIUM(SYRINGE)(120MG/.8ML) 16 ml per 30 days
• ENOXAPARIN
SODIUM(SYRINGE)(150 MG/ML) 20 ml per 30 days
• ENOXAPARIN
SODIUM(SYRINGE)(30MG/0.3ML) 6 ml per 30 days
Page 50 of 75
• ENOXAPARIN
• ENOXAPARIN
• ENOXAPARIN
• ENOXAPARIN SODIUM(VIAL) 30 ml per 30 days
• EPZICOM
• ERIVEDGE
1 unit per 1 day
• ESOMEPRAZOLE MAGNESIUM 1 unit per 1 day
• ESTRADIOL(PATCH TDSW)
2 units per 7 days
• ESTRADIOL(PATCH TDWK)
1 unit per 7 days
• EVOTAZ
1 unit per 1 day
• FANAPT(TAB DS PK)
8 units per 28 days
• FANAPT(TAB)
2 units per 1 day
• FELBAMATE(ORAL SUSP)
30 ml per 1 day
• FELBAMATE(TAB)(400 MG)
9 units per 1 day
6 units per 1 day
• FENTANYL
1 unit per 3 days
• FETZIMA
1 unit per 1 day
• FIRMAGON(VIAL)(120 MG)
• FIRMAGON(VIAL)(80 MG)
1 unit per 30 days
• FLUNISOLIDE
25 ml per 30 days
• FLUTICASONE PROPIONATE
16 gm per 30 days
• FLUTICASONE
PROPIONATE(OTC)
16 ml per 30 days
• FOCALIN XR
1 unit per 1 day
• FONDAPARINUX
• FONDAPARINUX
SODIUM(SYRINGE)(2.5 MG/0.5) 5 ml per 30 days
• FONDAPARINUX
• FONDAPARINUX
SODIUM(SYRINGE)(7.5MG/0.6) 6 ml per 30 days
• FORTEO
2.4 ml per 28 days
• FRAGMIN(SYRINGE)(10000/ML) 10 ml per 30 days
• FRAGMIN(SYRINGE)(12500/0.5) 5 ml per 30 days
• FRAGMIN(SYRINGE)(15000/0.6) 6 ml per 30 days
• FRAGMIN(SYRINGE)(18000/0.72)7.2 ml per 30 days
•
FRAGMIN(SYRINGE)(2500/0.2ML) 2 ml per 30 days
•
•
• FRAGMIN(VIAL)
7.6 ml per 30 days
• FUZEON
• FYCOMPA(TAB)(10 MG)
• GABITRIL(TAB)(12 MG)
4 units per 1 day
3 units per 1 day
• GALANTAMINE HBR(CAP24H
PEL)
• GALANTAMINE HBR(TAB)
• GENVOYA
1 tablet per day
• GEODON
2 units per 1 day
• GLYXAMBI
1 unit per 1 day
• GRANISETRON HCL
8 units per 30 days
• GUANFACINE HCL ER
1 unit per 1 day
VNSNY
• HUMALOG KWIKPEN U-100
30 ml per 28 days
• HUMALOG KWIKPEN U-200
12 ml per 28 days
• HUMALOG MIX 50-50
40 ml per 28 days
• HUMALOG MIX 50-50 KWIKPEN 30 ml per 28 days
• HUMALOG MIX 75-25
40 ml per 28 days
• HUMALOG MIX 75-25 KWIKPEN 30 ml per 28 days
• HUMALOG(CARTRIDGE)
30 ml per 28 days
• HUMALOG(VIAL)
40 ml per 28 days
• HUMULIN 70/30 KWIKPEN(OTC) 30 ml per 28 days
• HUMULIN 70-30(OTC)
40 ml per 28 days
• HUMULIN N KWIKPEN(OTC)
30 ml per 28 days
• HUMULIN N(OTC)
40 ml per 28 days
• HUMULIN R U-500
40 ml per 28 days
• HUMULIN R(OTC)
40 ml per 28 days
• HYDROCODONEACETAMINOPHEN(SOLUTION)
(10-325/15)
184 ml per 1 day
• HYDROCODONEACETAMINOPHEN(SOLUTION)(5163/7.5)
184 ml per 1 day
• HYDROCODONEACETAMINOPHEN(SOLUTION)
(7.5-325/15)
184 ml per 1 day
• HYDROCODONEACETAMINOPHEN(TAB)(10MG325MG)
12 units per 1 day
• HYDROCODONEACETAMINOPHEN(TAB)(5 MG325MG)
12 units per 1 day
• HYDROCODONEACETAMINOPHEN(TAB)(7.5325MG)
12 units per 1 day
• ICLUSIG(TAB)(15 MG)
2 units per 1 day
1 unit per 1 day
• IMATINIB MESYLATE(TAB)(100
MG)
3 tablets per day
• IMATINIB MESYLATE(TAB)(400
MG)
2 tablets per day
• IMIQUIMOD
• INCRUSE ELLIPTA
• INLYTA(TAB)(1 MG)
6 units per 1 day
2 units per 1 day
• INTERMEZZO
1 unit per 1 day
• INVEGA(TAB ER 24H)(1.5 MG) 1 unit per 1 day
• INVEGA(TAB ER 24H)(3 MG)
1 unit per 1 day
2 units per 1 day
1 unit per 1 day
• INVIRASE(CAP)
• INVIRASE(TAB)
• INVOKAMET
2 units per 1 day
• INVOKANA
• IPRIVASK
6 units per 30 days
• JAKAFI
2 units per 1 day
• JANUMET
2 units per 1 day
• JANUMET XR(TBMP 24HR)(1001000MG)
1 unit per 1 day
• JANUMET XR(TBMP 24HR)(501000 MG)
2 units per 1 day
• JANUMET XR(TBMP
24HR)(50MG-500MG)
2 units per 1 day
• JANUVIA
1 unit per 1 day
• JARDIANCE
1 unit per 1 day
• JENTADUETO
2 units per 1 day
• KALETRA(SOLUTION)
390 ml per 30 days
Page 51 of 75
• KALETRA(TAB)(100MG-25MG) 300 units per 30 days
• KALETRA(TAB)(200MG-50MG) 120 units per 30 days
• KHEDEZLA
1 unit per 1 day
• LAMIVUDINE(SOLUTION)
900 ml per 30 days
• LAMIVUDINE(TAB)(150 MG)
• LAMIVUDINE(TAB)(300 MG)
• LAMIVUDINE-ZIDOVUDINE
• LANSOPRAZOL-AMOXICILCLARITHRO
• LANTUS
40 ml per 28 days
• LANTUS SOLOSTAR
30 ml per 28 days
• LATUDA(TAB)(120 MG)
• LEVOCETIRIZINE
DIHYDROCHLORIDE(SOLUTION) 10 ml per 1 day
• LINZESS
1 unit per 1 day
• LUMIGAN
1 ml per 12 days
• LUNESTA
1 unit per 1 day
• LYNPARZA
16 units per 1 day
• MEMANTINE HCL(SOLUTION) 300 ml per 30 days
• MEMANTINE HCL(TAB DS PK) 49 units per 28 days
• MEMANTINE HCL(TAB)
• METHAMPHETAMINE HCL
50-50)(20 MG)
1 unit per 1 day
50-50)(30 MG)
2 units per 1 day
50-50)(40 MG)
1 unit per 1 day
ER 24H)(18 MG)
1 unit per 1 day
ER 24H)(27 MG)
1 unit per 1 day
ER 24H)(36 MG)
2 units per 1 day
ER 24H)(54 MG)
1 unit per 1 day
ER)(10 MG)
3 units per 1 day
ER)(20 MG)
• MORPHINE SULFATE ER(CAP
ER PEL)
2 units per 1 day
• MORPHINE SULFATE ER(CPMP
24HR)(120 MG)
2 units per 1 day
24HR)(30 MG)
1 unit per 1 day
24HR)(45 MG)
1 unit per 1 day
24HR)(60 MG)
1 unit per 1 day
24HR)(75 MG)
1 unit per 1 day
24HR)(90 MG)
1 unit per 1 day
• MORPHINE SULFATE ER(TAB
ER)
3 units per 1 day
• MOVANTIK
1 unit per 1 day
• MYALEPT
1 unit per 1 day
• NAMENDA XR(CAP 24 DSPK)
• NAMENDA XR(CAP SPR 24)
VNSNY
• NAMZARIC
• NARCAN
1 unit per 1 day
4 nasal sprays per 30
days
17 gm per 30 days
1 unit per 1 day
1200 ml per 30 days
4 units per 1 day
1 unit per 1 day
150 units after 30 days
450 ml per 30 days
6 units per 1 day
2 units per 1 day
1 unit per 28 days
1 unit per 1 day
• NASONEX
• NEUPRO
• NEVIRAPINE(ORAL SUSP)
• NEVIRAPINE(TAB)
• NEXAVAR
• NEXIUM
• NILANDRON
• NORVIR(CAP)
• NORVIR(SOLUTION)
• NORVIR(TAB)
• NUCYNTA
• NUCYNTA ER
• NUVARING
• ODEFSEY
• OLANZAPINE-FLUOXETINE
HCL
1 unit per 1 day
• OLEPTRO ER
3 units per 2 days
• OLOPATADINE HCL
30.5 gm per 30 days
• OMEGA-3 ACID ETHYL ESTERS 4 units per 1 day
• ONDANSETRON
HCL(SOLUTION)
50 ml per 15 days
• ONFI(ORAL SUSP)
480 ml per 30 days
• ONFI(TAB)
2 units per 1 day
• ORTHO EVRA
3 units per 28 days
• OXTELLAR XR(TAB ER 24H)(150
MG)
1 unit per 1 day
MG)
1 unit per 1 day
MG)
4 units per 1 day
• OXYCODONEACETAMINOPHEN
12 units per 1 day
• OXYCONTIN
2 capsules per day
• OXYCONTIN
4 capsules per day
• PERFOROMIST
120 ml per 30 days
• PEXEVA
1 unit per 1 day
• PICATO(GEL)(0.015 %)
3 units per 28 days
• PICATO(GEL)(0.05 %)
2 units per 28 days
• POTIGA(TAB)(200 MG)
3 units per 1 day
3 units per 1 day
3 units per 1 day
9 units per 1 day
• PREZCOBIX
1 unit per 1 day
• PREZISTA(ORAL SUSP)
240 ml per 30 days
• PREZISTA(TAB)(150 MG)
• PRISTIQ ER
1 unit per 1 day
• QNASL
8.7 gm per 30 days
• QUILLIVANT XR
360mL in 30 days
• QUILLIVANT XR
240mL per 30 days
• QUILLIVANT XR
300mL per 30 days
• QUILLIVANT XR
60mL in 30 days,
• RABEPRAZOLE SODIUM
1 unit per 1 day
• RALOXIFENE HCL
1 unit per 1 day
• RANEXA(TAB ER 12H)(1000 MG)60 units per 30 days
• RANEXA(TAB ER 12H)(500 MG) 120 units per 30 days
• RASUVO(AUTO
INJECT)(10MG/0.2ML)
.8 ml per 28 days
Page 52 of 75
• RASUVO(AUTO
INJECT)(12.5/0.25)
• RASUVO(AUTO
INJECT)(15MG/0.3ML)
• RASUVO(AUTO
INJECT)(17.5/0.35)
• RASUVO(AUTO
INJECT)(20MG/0.4ML)
• RASUVO(AUTO
INJECT)(22.5/0.45)
• RASUVO(AUTO
INJECT)(25MG/0.5ML)
• RASUVO(AUTO
INJECT)(27.5/0.55)
• RASUVO(AUTO
INJECT)(30MG/0.6ML)
• RASUVO(AUTO
INJECT)(7.5MG/0.15)
• RESTASIS
• REVLIMID
• RISPERDAL(SOLUTION)
• RISPERDAL(TAB)
• RITALIN LA
• RIVASTIGMINE
• RIZATRIPTAN
• ROZEREM
• SABRIL
• SAPHRIS
• SEROQUEL
• SEROQUEL XR
• SILENOR
• SIMCOR(TBMP 24HR)(100020MG)
• SIMCOR(TBMP 24HR)(1000-40
MG)
• SIMCOR(TBMP 24HR)(500MG20MG)
• SONATA
• SPIRIVA RESPIMAT
• SPRYCEL(TAB)(100 MG)
• STAVUDINE(CAP)
• STAVUDINE(SOLN RECON)
• STIOLTO RESPIMAT
• STIVARGA
• STRATTERA(CAP)(10 MG)
• STRIBILD
• STRIVERDI RESPIMAT
• SUMATRIPTAN
VNSNY
1 ml per 28 days
1.2 ml per 28 days
1.4 ml per 28 days
1.6 ml per 28 days
1.8 ml per 28 days
2 ml per 28 days
2.2 ml per 28 days
2.4 ml per 28 days
.6 ml per 28 days
1 unit per 1 day
8 ml per 1 day
2 units per 1 day
1 unit per 1 day
3 units per 5 days
1 unit per 1 day
6 units per 1 day
2 units per 1 day
3 units per 1 day
1 unit per 1 day
1 unit per 1 day
2 units per 1 day
1 unit per 1 day
1 unit per 1 day
1 unit per 1 day
2 units per 1 day
1 unit per 1 day
4 gm per 30 days
1 unit per 1 day
1 unit per 1 day
2 units per 1 day
1 unit per 1 day
1 unit per 1 day
1 unit per 1 day
2400 ml per 30 days
4 gm per 30 days
3 units per 1 day
4 gm per 30 days
6 units per 15 days
• SUMATRIPTAN
SUCCINATE(CARTRIDGE)
1 ml per 14 days
• SUMATRIPTAN SUCCINATE(PEN
INJCTR)
1 ml per 14 days
• SUMATRIPTAN
SUCCINATE(TAB)
3 units per 5 days
• SUMATRIPTAN
SUCCINATE(VIAL)
1 ml per 14 days
• SUTENT
1 unit per 1 day
• SYLATRON
1 unit per 28 days
• SYMBYAX
1 unit per 1 day
• SYNJARDY
2 units per 1 day
• TAGRISSO
1 tablet per day
• TAMIFLU(CAP)(30 MG)
• TAMIFLU(SUSP RECON)
360 ml per 183 days
• TANZEUM
4 units per 28 days
• TARCEVA
1 unit per 1 day
• TASIGNA
4 units per 1 day
• THALOMID
2 units per 1 day
• TIAGABINE HCL
4 units per 1 day
• TOUJEO SOLOSTAR
7.5 ml per 28 days
• TRADJENTA
1 unit per 1 day
• TRAVATAN Z
1 ml per 12 days
• TRAVOPROST
1 ml per 12 days
• TRIUMEQ
1 unit per 1 day
• TROKENDI XR(CAP ER 24H)(100
MG)
1 unit per 1 day
MG)
2 units per 1 day
MG)
1 unit per 1 day
MG)
1 unit per 1 day
• TRULICITY
2 ml per 28 days
• TRUVADA
• ULORIC
• VANCOMYCIN HCL
• VASCEPA
4 units per 1 day
• VERSACLOZ
18 ml per 1 day
• VIDEX
1200 ml per 30 days
• VIIBRYD
1 unit per 1 day
• VIMPAT(SOLUTION)
1200 ml per 30 days
• VIMPAT(TAB)
2 units per 1 day
• VIREAD(POWDER)
225 gm per 30 days
• VIREAD(TAB)
• VITEKTA
1 unit per 1 day
• VOTRIENT
4 units per 1 day
• VYVANSE
1 unit per 1 day
• XALKORI
2 units per 1 day
• XARELTO(TAB DS PK)
51 unit per 30 days
• XARELTO(TAB)(10 MG)
1 unit per 1 day
42 tablets for the first 21
days; followed by 30
tablets per 30 days
1 unit per 1 day
• XTANDI
4 units per 1 day
• ZELBORAF
8 units per 1 day
• ZENZEDI
• ZETIA
1 unit per 1 day
• ZIAGEN
900 ml per 30 days
• ZIDOVUDINE(CAP)
• ZIDOVUDINE(SYRUP)
1800 ml per 30 days
Page 53 of 75
• ZIDOVUDINE(TAB)
• ZOLPIDEM TARTRATE
• ZOLPIMIST
• ZOMIG(SPRAY)(2.5 MG)
• ZOMIG(SPRAY)(5 MG)
• ZYPREXA
• ZYTIGA
VNSNY
1 unit per 1 day
7.7 ml per 30 days
6 units per 15 days
1 unit per 1 day
4 units per 1 day
Page 54 of 75
STEP THERAPY EDITS
• ABILIFY
• ABILIFY
• ACTOPLUS MET XR
• ADASUVE
• AMLODIPINE-VALSARTAN
• AMLODIPINE-VALSARTAN-HCTZ
• APLENZIN
• ARIPIPRAZOLE
• BANZEL(ORAL SUSP)
• BELSOMRA
• BENICAR
• BENICAR HCT
• BEYAZ
VNSNY
Trial of 2 of the following: olanzapine, quetiapine IR, risperidone, risperidone ODT,
ziprasidone, venlafaxine, paroxetine, sertraline, citalopram, fluoxetine, or
escitalopram in the past 365 days.
Trial of metformin, metformin ER, sulfonylurea (e.g., glyburide, glipizide) or
pioglitazone within the past 120 days
26411, 26409, 67665, 67663, 67661, 67662, 98524), risperidone (GPID = 16135,
16136, 16137, 16138, 16139, 92872,92872), risperidone ODT (GPID = 19178,
19179, 19541, 25024, 25025,24448), ziprasidone (HICL = 21974), venlafaxine
(HICL=08847), paroxetine (HICL=07344, 25796), sertraline (HICL=06324),
citalopram (HICL=10321), fluoxetine (HICL=01655), or escitalopram
(HICL=24022) in the past 365 days.
Trial of ACE or ACE combination (benazepril,captopril, enalapril, fosinopril,
lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril, amlodipine
besylate/benazepril, fosinopril/hctz, enalapril/hctz, captopril/hctz, quinapril/hctz,
benazepril/hctz, lisinopril/hctz, moexipril/hctz, trandolapril/verapamil) OR ACE
combination or formulary generic ARB or ARB combination (irbesartan, losartan,
losartan/hctz, irbesartan/hctz, valsartan/hctz) within the past 120 days
Trial of bupropion hcl SR or XL within the past 120 days
Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetam
IR or ER, oxcarbazepine, valproic acid or divalproex, topiramate, or zonisamide
required within the past 365 days
Trial of lamotrigine, valproic acid or topiramate within the past 120 days
Trial of zolpidem IR, zaleplon or eszopiclone within the past 120 days
Trial of two different non-drospirenone oral contraceptives (containing
levonorgestrel, norethindrone, norgestimate, norgestrel, desogestrel, or ethinynodiol
ace.) within the past 365 days
Page 55 of 75
• BRINTELLIX
• BRISDELLE
• CALCIPOTRIENE
• CALCIPOTRIENE-BETAMETHASONE
DP
• CALCITRIOL
• DALIRESP
• DESVENLAFAXINE ER
• DESVENLAFAXINE FUMARATE ER
• DIFICID
• DOXYCYCLINE HYCLATE
• DOXYCYCLINE
• DRITHOCREME HP
• DRONABINOL
• DUTASTERIDE
• DUTASTERIDE-TAMSULOSIN
• EDLUAR
• ESOMEPRAZOLE MAGNESIUM
• FANAPT(TAB DS PK)
• FANAPT(TAB)
• FELBAMATE(ORAL SUSP)
• FETZIMA
VNSNY
Trial of two of the following: generic paroxetine, fluoxetine, citalopram, sertraline,
escitalopram, venlafaxine IR, venlafaxine ER, mirtazapine, or bupropion within the
past 365 days
Trial of paroxetine or venlafaxine within the past 120 days
Trial of a topical corticosteroid within the past 120 days
Trial of atorvastatin 40mg or atorvastatin 80mg within the past 120 days
Trial of two of the following: atorvastatin, lovastatin, pravastatin or simvastatin
within the past 365 days
Trial of Spiriva, Incruse, Striverdi, Breo Ellipta, Advair Diskus or Dulera required
past 365 days
past 365 days
Trial of vancomycin capsules within the past 120 days
Trial of doxycycline monohydrate within the past 120 days
Trial of generic doxycycline monohydrate 100mg capsules within the past 120 days
Trial of ondansetron, corticosteroids and Emend within the past 365 days
Trial of Proscar, alfuzosin, doxazosin, prazosin, silodosin, tamsulosin or terazosin
Trial of finasteride 5mg, alfuzosin, doxazosin, prazosin, silodosin, tamsulosin or
terazosin in the last 120 days
Trial of zolpidem IR/ER (Ambien) within the past 180 days
Trial of omeprazole, lansoprazole or pantoprazole within the past 120 days
Trial of two generic atypical antipsychotics: olanzapine/ODT, quetiapine IR,
risperidone/ODT or ziprasidone within the past 365 days
Trial of lamotrigine or topiramate within the past 120 days
past 365 days
Trial of two of the following: carbamzepine, gabapentin, lamotrigine, levetiracetam
IR or ER, oxcarbazepine, valproic acid, divalproex, topiramate or zonisamide within
the past 365 days
Page 56 of 75
• GLYXAMBI
• GRANISETRON HCL
• INTERMEZZO
• INVEGA(TAB ER 24H)(1.5 MG)
• INVOKAMET
• INVOKANA
• JARDIANCE
• KHEDEZLA
• LAMICTAL XR (BLUE)
• LAMICTAL XR (GREEN)
• LAMICTAL XR (ORANGE)
the past 365 days
Trial of metformin/metformin combination OR formulary sulfonylurea OR
pioglitazone/pioglitazone combination in the past 120 days.
Trial of ondansetron tablets or ODT within the past 120 days
Trial of zolpidem IR (Ambien) within the past 120 days
past 365 days
Trial of lamotrigine IR within the past 120 days
• LEVOCETIRIZINE
DIHYDROCHLORIDE(SOLUTION)
• NAMZARIC
• NEUPRO
• NEXIUM
• NIACIN ER
Trial of desloratadine or levocetirizine tablet within the past 120 days
Trial of donepezil and memantine within the past 365 days
Trial of pramipexole IR or ropinirole IR within the past 120 days
Trial of two of the following: generic/multisource statin (atorvastatin, lovastatin,
pravastatin or simvastatin), gemfibrozil or genofibrate within the past 365 days
• OCELLA
• OLEPTRO ER
Trial of immediate release trazodone within the past 120 days
• OLOPATADINE HCL
Trial of Astelin (azelastine) within the past 120 days
• ONFI(ORAL SUSP)
• ONFI(TAB)
• OXTELLAR XR(TAB ER 24H)(150 MG) Trial of two of the following: carbamazepine, gabapentin, lamotrigine, levetiracetam
the past 365 days
the past 365 days
the past 365 days
• PEXEVA
Trial of paroxetine HCL IR within the past 120 days
• PIOGLITAZONE-METFORMIN
Trial of metformin, metformin ER, sulfonylurea (e.g., glyburide, glipizide) or
pioglitazone within the past 120 days
VNSNY
Page 57 of 75
• PREVACID
• PRISTIQ ER
• PURIXAN
• QNASL
• QUILLIVANT XR
• QUILLIVANT XR
• QUILLIVANT XR
• QUILLIVANT XR
• RASUVO(AUTO INJECT)(10MG/0.2ML)
• RASUVO(AUTO INJECT)(12.5/0.25)
• RASUVO(AUTO INJECT)(7.5MG/0.15)
• ROZEREM
• SAFYRAL
• SAPHRIS
• SEROQUEL XR
• SILENOR
• SIMCOR(TBMP 24HR)(1000-20MG)
• SIMCOR(TBMP 24HR)(1000-40 MG)
• SIMCOR(TBMP 24HR)(500MG-20MG)
• SIMVASTATIN(TAB)(80 MG)
• SYNJARDY
• TACROLIMUS
• TANZEUM
• TIAGABINE HCL
VNSNY
the past 365 days
the past 365 days
the past 365 days
the past 365 days
past 365 days
Trial of mercaptopurine tablet within the past 120 days
Trial of fluticasone or flunisolide within the past 365 days
Trial of Ritalin LA or Metadate CD within past 120 days
Trial of methotrexate tablet or solution for injection within the past 120 days
Trial of one of the following: eszopiclone(Lunesta), zolpidem IR (Ambien) or
zaleplon (Sonata) within the past 120 days
Trial of two of the following: olanzapine/ODT, quetiapine IR, risperidone/ODT,
ziprasidone, sertraline, fluoxetine, venlafaxine, paroxetine, citalopram, or
escitalopram within the past 365 days
Trial of one of the following: eszopiclone(Lunesta), zolpidem IR (Ambien) or
zaleplon (Sonata) within the past 120 days
Trial of simvastatin 80mg or Vytorin 10/80mg within the past 120 days
Trial of metformin, metformin ER, sulfonylurea (e.g., glyburide, glipizide),
pioglitazone or a combination product containing any two of the three
aforementioned agents within the past 120 days
the past 365 days
Page 58 of 75
• TOLTERODINE TARTRATE
• TOVIAZ
• TRIGLIDE
• TROKENDI XR(CAP ER 24H)(100 MG)
• TRULICITY
• VERSACLOZ
• VESICARE
• VIIBRYD
• VIMPAT(SOLUTION)
• VIMPAT(TAB)
• VYVANSE
• ZENZEDI
• ZOLPIMIST
• ZOMIG(SPRAY)(2.5 MG)
• ZOMIG(SPRAY)(5 MG)
VNSNY
Trial of oxybutynin IR or obybutynin XL within the past 120 days
Trial of oxybutynin or oxybutynin ER within the past 120 days
Trial of gemifibrozil or generic fenofibrate within the past 120 days
Trial of topiramate IR within the past 120 days
Trial of oxybutynin or oxybutynin ER within the past 120 days
escitalopram, mirtazapine or bupropion, or venlafaxine IR/ER within the past 365
days
the past 365 days
the past 365 days
Trial of one of the following: SSRI, topiramate, generic/multisource mixed
amphetamine salts (Adderall IR/XR), or methylphenidate (IR, ER, LA, CD) within
the past 120 days
Trial of a multisource dextroamphetamine sulfate tablet or dextroamphetamine
solution within the past 120 days
Trial of zolpidem IR (Ambien) within the past 120 days
Trial of sumatriptan or rizatriptan within the past 180 days
Trial of sumatriptan or rizatriptan within the past 180 days
Page 59 of 75
PRIOR AUTHORIZATION RESTRICTIONS
• ACERFLEX
• ACTEMRA
• ADCIRCA
• ADEMPAS
• AFINITOR DISPERZ
• ALECENSA
• AMPYRA
• ANDROGEL(GEL MD PMP)(1.25G (1%))
• ANDROGEL(GEL MD PMP)(20.25/1.25)
• ANDROGEL(GEL PACKET)(1.25G-1.62)
• ANDROGEL(GEL PACKET)(2.5G-1.62%)
• ANDROGEL(GEL PACKET)(25MG(1%))
• ANDROGEL(GEL PACKET)(50 MG (1%))
• APOKYN
• AUBAGIO
• AVONEX
• AVONEX ADMINISTRATION PACK
• AVONEX PEN
• AXIRON
• BCAD 2
• BENECALORIE
• BERINERT
• BEXAROTENE
• BOOST GLUCOSE CONTROL
• BOOST VHC
• BUNAVAIL
• CAMINO PRO 15
• CAMINO-PRO RESTORE
• CAYSTON
• CIMZIA
• CINRYZE
• COMETRIQ
• COMPLEAT PEDIATRIC
• COMPLEAT PEDIATRIC REDUCED CAL
• COPAXONE
• COSENTYX (2 SYRINGES)
• COSENTYX PEN
• COSENTYX PEN (2 PENS)
• COSENTYX SYRINGE
• COTELLIC
• CRUCIAL
• CYSTARAN
• DARAPRIM
• DIABETISOURCE AC
• DICLOFENAC SODIUM
• EGG-PRO
• ELECARE
• ELECARE JR
• ELIGARD
• ENSURE ACTIVE MUSCLE HEALTH
• ENSURE BONE HEALTH
• ENSURE CLEAR
VNSNY
• EO28 SPLASH
• ERIVEDGE
• ESBRIET
• F-A-A
• FARESTON
• FARYDAK
• FENTANYL
• FENTANYL CITRATE
• FIRAZYR
• GAMMAGARD LIQUID
• GAMMAKED
• GAMUNEX-C
• GATTEX
• GILENYA
• GILOTRIF
• GLATOPA
• GLUCO BURST
• GLYTROL
• GRANIX
• GRASTEK
• HARVONI
• HCU COOLER
• HCU LOPHLEX
• HCY 2
• HETLIOZ
• HIZENTRA
• HOM 2
• HOMINEX-2
• HYQVIA
• IBRANCE
• IMATINIB MESYLATE(TAB)(100 MG)
• IMATINIB MESYLATE(TAB)(400 MG)
• IMBRUVICA
• IMIQUIMOD
• IMMULIFE
• IMPACT PEPTIDE 1.5 CAL
• INCRELEX
• INTRON A
• IPRIVASK
• IRESSA
• ISOSOURCE 1.5 CAL
• JAKAFI
• JEVITY 1.2 CAL
• JUXTAPID
• KALYDECO
• KETOCAL 3:1
• KETOCAL 4:1
• KETOVOLVE
• KEVEYIS
• KORLYM
• KYNAMRO
• LENVIMA
• LETAIRIS
• LEU-FREE COOLER
• LEUKINE
• LMD
• LONSURF
• LYNPARZA
Page 60 of 75
• MEKINIST
• METHIONAID
• METHYLTESTOSTERONE
• MMA-PA COOLER
• MODAFINIL
• MSUD LOPHLEX
• NEOCATE
• NEOCATE INFANT DHA-ARA
• NEOCATE JUNIOR WITH PREBIOTICS
• NEOCATE NUTRA
• NEPRO
• NEULASTA
• NEUPOGEN
• NEXAVAR
• NINLARO
• NORDITROPIN FLEXPRO
• NORTHERA
• NUTREN 1.5 FIBER
• NUTREN JUNIOR
• NUTREN JUNIOR FIBER
• NUTRIHEAL
• NUTRIHEP
• NUTRITIONAL SHAKE
• NUTRITIONAL SHAKE PLUS
• NUTRIVENT 1.5
• NYMALIZE
• OA 1
• OA2
• OFEV
• OPSUMIT
• ORALAIR
• ORENCIA
• ORENITRAM ER
• ORKAMBI
• OS 2
• OTEZLA
• OXANDROLONE
• PEDIASMART ORGANIC DAIRY
• PEDIASURE 1.5
• PEDIASURE 1.5 WITH FIBER
• PEDIASURE PEPTIDE 1.5 CAL
• PEDIASURE SIDEKICKS
• PEGASYS
• PEGASYS PROCLICK
• PEPTAMEN
• PEPTAMEN AF
• PEPTAMEN BARIATRIC
• PEPTAMEN JUNIOR
• PEPTAMEN JUNIOR FIBER
• PEPTAMEN OS
• PEPTINEX DT
• PERATIVE
• PERIFLEX ADVANCE
• PERIFLEX JUNIOR
• PFD 2
• PHENYLADE ESSENTIAL
• PHENYLADE RTD PKU 10
• PHENYLADE60
• PHENYL-FREE 2
• PHENYL-FREE 2HP
• PKU COOLER 10
• PKU LOPHLEX
• PKU TRIO
• POMALYST
VNSNY
• PORTAGEN
• PRO-CAL
• PROCRIT
• PROCYSBI
• PRODUCT 3232A
• PROMACTA
• PROSOURCE
• PROSOURCE NO CARB
• PROSOURCE PLUS
• PROSOURCE ZAC
• PULMOCARE
• PULMOZYME
• RAGWITEK
• RALOXIFENE HCL
• RAVICTI
• REBIF
• REBIF REBIDOSE
• REMODULIN
• RENA START
• RENALCAL
• REPATHA SURECLICK
• REPATHA SYRINGE
• REPLETE WITH FIBER
• RESOURCE DIABETIC TF
• RESOURCE DIABETISHIELD
• RESOURCE THICKENUP
• REVATIO
• REVLIMID
• RUCONEST
• SCANDISHAKE
• SEROSTIM(VIAL)(4 MG)
• SILDENAFIL
• SIMPLYTHICK
• SIMPONI
• SIRTURO
• SIVEXTRO
• SOL CARB
• SOVALDI
• STIVARGA
• STRENSIQ
• SUCRAID
• SUTENT
• SYNAGIS
• SYNRIBO
• TAFINLAR
• TAGRISSO
• TARCEVA
• TARGRETIN
• TASIGNA
• TECFIDERA
• TEMOZOLOMIDE
• TESTOSTERONE
• TESTOSTERONE CYPIONATE
• TESTOSTERONE ENANTHATE
• TETRABENAZINE
• THALOMID
Page 61 of 75
• THICK NOW
• THICKENUP
• THICK-IT
• THIK & CLEAR
• TOBI PODHALER
• TOBRAMYCIN
• TRACLEER
• TYBOST
• TYKERB
• TYR LOPHLEX
• TYVASO
• UCD ANAMIX JUNIOR
• UCD TRIO
• ULTRAMINO
• UPTRAVI
• VALCHLOR
• VENTAVIS
• VITAJOULE
• VITAL 1.0 CAL
• VITAL 1.5 CAL
• VITAL AF 1.2 CAL
• VOTRIENT
• XALKORI
• XELJANZ
• XIFAXAN
• XMET MAXAMAID
• XMET MAXAMUM
• XMET XCYS MAXAMAID
• XTANDI
• XTRACAL PLUS
• ZELBORAF
• ZORBTIVE
• ZUBSOLV
• ZYDELIG
• ZYKADIA
• ZYTIGA
VNSNY
Page 62 of 75
GENDER LIMITS
• DUTASTERIDE
• DUTASTERIDE-TAMSULOSIN
VNSNY
Male Only
Male Only
Page 63 of 75
Index
-#0.9 % SODIUM CHLORIDE............................................ 26
8-MOP............................................................................... 23
-AA/C/E/ZINC/SOD SELENATE/COPPER.........................44
ABACAVIR................................................................. 33, 50
ABACAVIR SULFATE..................................................... 33
ABACAVIR SULFATE/LAMIVUDINE...........................33
ABACAVIR/DOLUTEGRAVIR/LAMIVUDI.................. 34
ABACAVIR/LAMIVUDINE/ZIDOVUDINE...................33
ABACAVIR-LAMIVUDINE-ZIDOVUDINE.................. 33
ABATACEPT.....................................................................34
ABILIFY................................................................15, 50, 55
ABILIFY MAINTENA..................................................... 15
ABIRATERONE ACETATE............................................. 36
ABREVA(OTC).................................................................21
ACARBOSE...................................................................... 24
ACCU-CHEK FASTCLIX(OTC)......................................25
ACCU-CHEK SOFTCLIX(OTC)......................................25
ACCU-CHEK(OTC)..........................................................25
ACE AEROSOL CLOUD ENHANCER...........................12
ACEBUTOLOL HCL........................................................ 17
ACERFLEX.................................................................39, 60
ACEROLA C(OTC)...........................................................48
ACETAMINOPHEN......................................................... 40
ACETAZOLAMIDE..........................................................28
ACETIC ACID............................................................ 22, 26
ACETIC ACID/ALUMINUM ACETATE .........................26
ACETIC ACID/HYDROCORTISONE............................. 26
ACETIC ACID-ALUMINUM...........................................26
ACETYLCYSTEINE........................................................ 39
ACNE MEDICATION(OTC)............................................ 22
ACTEMRA.................................................................. 34, 60
ACTOPLUS MET XR.................................................24, 55
ACYCLOVIR.............................................................. 21, 33
ADASUVE.................................................................. 15, 55
ADCIRCA................................................................... 18, 60
ADEMPAS...................................................................18, 60
ADJUSTABLE LANCING DEVICE(OTC)..................... 25
ADVAIR DISKUS....................................................... 12, 50
ADVAIR HFA..............................................................12, 50
ADVANCED AM/PM....................................................... 45
ADVANCED LANCING DEVICE(OTC)........................ 25
ADVOCATE LANCING DEVICE(OTC)......................... 25
ADVOCATE RAPID-SAFE(OTC)................................... 25
ADVOCATE REDI-CODE DUO(OTC)........................... 24
AEROCHAMBER MINI...................................................12
AEROCHAMBER MV..................................................... 12
AEROCHAMBER PLUS FLOW-VU............................... 12
AEROCHAMBER WITH FLOWSIGNAL.......................12
AEROCHAMBER Z-STAT PLUS.................................... 12
AEROECLIPSE II............................................................. 12
AEROGEAR ASTHMA ACTION KIT ............................ 13
AEROSPAN.................................................................12, 50
AEROTRACH PLUS.........................................................12
AFATINIB DIMALEATE................................................. 36
AFINITOR DISPERZ................................................. 36, 60
AFINITOR(TAB)(10 MG).................................... 36, 50, 60
AFINITOR(TAB)(2.5 MG)................................... 36, 50, 60
AFINITOR(TAB)(5 MG)...................................... 36, 50, 60
AFINITOR(TAB)(7.5 MG)......................................... 36, 60
AIRS DISPOSABLE NEBULIZER(OTC)....................... 12
AIRZONE PEAK FLOW METER(OTC)......................... 13
AK-POLY-BAC................................................................. 28
AKYNZEO.................................................................. 11, 50
ALBIGLUTIDE.................................................................24
ALBUMEN (EGG WHITE)..............................................37
ALBUTEROL SULFATE.................................................. 12
ALCLOMETASONE DIPROPIONATE........................... 21
ALCOHOL ANTISEPTIC PADS............................... 21, 22
ALCOHOL PADS(OTC)...................................................21
ALCOHOL PREP PADS(OTC)........................................ 21
ALCOHOL PREP SWABS(OTC).....................................21
ALCOHOL SWAB(OTC)..................................................21
ALCOHOL SWABS(OTC)............................................... 21
ALCOHOL WIPES(OTC).................................................21
ALECENSA.......................................................... 36, 50, 60
ALECTINIB HYDROCHLORIDE................................... 36
ALENDRONATE SODIUM............................................. 27
ALENDRONATE SODIUM(SOLUTION).................27, 50
ALENDRONATE SODIUM(TAB)................................... 27
ALENDRONATE SODIUM/VITAMIN D3......................27
ALFUZOSIN HCL............................................................ 43
ALFUZOSIN HCL ER...................................................... 43
ALKERAN........................................................................ 36
ALLERGY RELIEF-D(OTC)........................................... 11
ALLERGY(OTC).............................................................. 11
ALLOPURINOL............................................................... 29
ALOCRIL.......................................................................... 28
ALOE VERA/COLLAGEN.............................................. 22
ALOE VESTA CLEANSING(OTC)................................. 22
ALOE VESTA(OTC).........................................................22
VNSNY
ALOE/LA/CERAMIDE/SILICONE&TAPE.................... 22
ALOE/LAC AC/CERAMIDES 3,3B,6,1.......................... 22
ALOMIDE.........................................................................28
ALPHAGAN P.................................................................. 28
ALPHANINE SD.............................................................. 29
ALPHAQUIN HP.............................................................. 23
ALREX.............................................................................. 27
ALTAFLUOR.................................................................... 28
ALTERA NEBULIZER.....................................................13
ALTERNATE SITE LANCING DEVICE(OTC).............. 25
ALTRETAMINE................................................................36
ALUMINUM ACETATE...................................................20
ALUMINUM ACETATE(OTC)........................................ 20
ALUMINUM HYDROXIDE............................................ 42
ALUMINUM HYDROXIDE(OTC).................................. 42
AMANTADINE.................................................................40
AMANTADINE HCL........................................................40
AMBRISENTAN...............................................................18
AMCINONIDE..................................................................21
AMERIGEL(OTC)............................................................ 23
AMILORIDE HCL............................................................17
AMILORIDE/HYDROCHLOROTHIAZIDE................... 17
AMILORIDE-HYDROCHLOROTHIAZIDE...................17
AMINO AC/PROTEIN HYDR/WHEY PRO....................37
AMINO ACID/PROTEIN/VIT C/ZINC............................38
AMINO ACIDS/MV,TH W-FE,MN..................................44
AMINO ACIDS/PROTEIN HYDROLYS......................... 38
AMINOCAPROIC ACID.................................................. 29
AMINOSALICYLIC ACID.............................................. 32
AMIODARONE HCL....................................................... 16
AMITIZA.................................................................... 35, 50
AMITRIPTYLINE HCL................................................... 14
AMLODIPINE BESYLATE............................................. 17
AMLODIPINE BESYLATE/BENAZEPRIL.................... 16
AMLODIPINE BESYLATE-BENAZEPRIL....................16
AMLODIPINE/ATORVASTATIN.....................................19
AMLODIPINE/VALSARTAN.......................................... 17
AMLODIPINE/VALSARTAN/HCTHIAZID................... 17
AMLODIPINE-ATORVASTATIN.............................. 19, 50
AMLODIPINE-VALSARTAN.................................... 17, 55
AMLODIPINE-VALSARTAN-HCTZ........................ 17, 55
AMMONIUM LACTATE..................................................22
AMMONIUM LACTATE(OTC)....................................... 22
AMOXAPINE................................................................... 14
AMOXICILLIN.................................................................31
AMOXICILLIN/POTASSIUM CLAV.............................. 31
AMOXICILLIN-CLAVULANATE POTASS................... 31
AMPICILLIN TRIHYDRATE.......................................... 31
AMPYRA.................................................................... 37, 60
AMYL NITRITE............................................................... 19
ANAFRANIL.................................................................... 14
ANAGRELIDE HCL.........................................................30
ANALPRAM HC........................................................ 23, 35
ANASTROZOLE.............................................................. 36
ANDROGEL(GEL MD PMP)(1.25G (1%))............... 30, 60
ANDROGEL(GEL MD PMP)(20.25/1.25).................30, 60
ANDROGEL(GEL PACKET)(1.25G-1.62)................ 30, 60
ANDROGEL(GEL PACKET)(2.5G-1.62%)...............30, 60
ANDROGEL(GEL PACKET)(25MG(1%))................30, 60
ANDROGEL(GEL PACKET)(50 MG (1%))..............30, 60
ANDROXY..................................................................30, 50
ANIMAS 2020...................................................................26
ANORO ELLIPTA...................................................... 12, 50
ANTACID EXTRA STRENGTH(OTC)........................... 42
ANTHRALIN.................................................................... 23
ANTI-ITCH CREME(OTC)..............................................21
APEXICON E....................................................................21
APIXABAN.......................................................................29
APLENZIN............................................................14, 50, 55
APOKYN...............................................................40, 50, 60
APOMORPHINE HCL..................................................... 40
APPLE JUICE................................................................... 38
APRACLONIDINE HCL.................................................. 28
APREMILAST.................................................................. 34
APREPITANT................................................................... 11
APRI.................................................................................. 19
APRISO............................................................................. 35
APRODINE(OTC).............................................................20
APTIOM(TAB)(200 MG)......................................41, 50, 55
APTIOM(TAB)(400 MG)......................................41, 50, 55
APTIOM(TAB)(600 MG)......................................41, 50, 55
APTIOM(TAB)(800 MG)......................................41, 50, 55
APTIVUS.......................................................................... 33
AQUA LANCE LANCING DEVICE(OTC).....................25
ARGLAES(OTC).............................................................. 20
ARIPIPRAZOLE...................................................15, 50, 55
ARMOUR THYROID....................................................... 27
ARTIFICIAL TEARS(OTC)....................................... 28, 29
ASCORBIC ACID.............................................................48
ASCORBIC ACID/ASCORBATE SODIUM....................48
ASENAPINE MALEATE..................................................15
ASFOTASE ALFA............................................................ 38
ASPIRIN............................................................................40
ASPIRIN EC(OTC)..................................................... 40, 50
ASPIRIN/CALCIUM CARBONATE/MAG..................... 40
ASSESS(OTC)...................................................................13
ASTAGRAF XL................................................................ 31
ASTHMA CHECK(OTC)................................................. 13
ASTHMAMENTOR(OTC)............................................... 13
ASTHMAPACK CHILDREN'S........................................ 13
ATAZANAVIR SULFATE.................................................33
ATAZANAVIR SULFATE/COBICISTAT......................... 33
ATENOLOL...................................................................... 17
ATENOLOL/CHLORTHALIDONE.................................17
ATENOLOL-CHLORTHALIDONE.................................17
ATOMOXETINE HCL......................................................16
ATORVASTATIN CALCIUM........................................... 18
ATOVAQUONE.................................................................32
ATOVAQUONE/PROGUANIL HCL................................ 32
ATOVAQUONE-PROGUANIL HCL................................32
ATRAPRO CP................................................................... 22
ATRAPRO HYDROGEL.................................................. 22
ATRIPLA.....................................................................34, 50
ATROPINE SULFATE...................................................... 28
ATROVENT HFA........................................................11, 50
AUBAGIO................................................................... 37, 60
AUGMENTIN................................................................... 31
AUTO-LANCET MINI(OTC)...........................................25
AUTOLET IMPRESSION(OTC)......................................25
AUTOLET LANCING DEVICE(OTC)............................ 25
AVC................................................................................... 43
AVEENO(OTC).................................................................21
AVONEX..................................................................... 37, 60
AVONEX ADMINISTRATION PACK.......................37, 60
AVONEX PEN.............................................................37, 60
AXIRON...................................................................... 30, 60
AXITINIB..........................................................................36
AZATHIOPRINE.............................................................. 31
AZELASTINE HCL..............................................11, 27, 50
AZILECT.....................................................................41, 50
AZITHROMYCIN.............................................................31
AZOPT.............................................................................. 28
AZTREONAM LYSINE....................................................31
AZURETTE.......................................................................19
-BB CMPLX 4/VIT D3/C/FA/ZINC OX.............................. 47
B COMPLEX & C NO.20/FOLIC ACID..........................47
B COMPLEX WITH VITAMIN C................................... 44
B12/LEVOMEFOLATE CALCIUM/B-6..........................47
BABY NEBULIZER......................................................... 13
BACITRACIN................................................................... 20
BACITRACIN ZINC......................................................... 20
BACITRACIN ZINC(OTC).............................................. 20
BACITRACIN(OTC).........................................................20
BACITRACIN/POLYMYXIN B SULFATE............... 20, 28
BACITRACIN-POLYMYXIN(OTC)................................20
BACLOFEN...................................................................... 42
BACMIN............................................................................45
BACTROBAN NASAL..................................................... 37
BALANCED B-100(OTC)................................................ 47
BALANCED SALT SOLN NON-SURG #6..................... 29
BAL-CARE DHA..............................................................47
BAL-CARE DHA ESSENTIAL....................................... 46
BALNEOL(OTC).............................................................. 22
BALSALAZIDE DISODIUM...........................................35
BANZEL(ORAL SUSP)........................................41, 50, 55
BANZEL(TAB)(200 MG)..................................... 41, 50, 55
BANZEL(TAB)(400 MG)..................................... 42, 50, 55
BCAD 2....................................................................... 39, 60
B-COMPLEX.................................................................... 47
BECAPLERMIN............................................................... 26
BECLOMETHASONE DIPROPIONATE........................ 11
BEDAQUILINE FUMARATE.......................................... 32
BEDSIDE-CARE PERINEAL(OTC)................................23
BEDSIDE-CARE(OTC).................................................... 20
BELSOMRA..........................................................15, 50, 55
BENAZEPRIL HCL.......................................................... 17
BENAZEPRIL/HYDROCHLOROTHIAZIDE................. 16
BENAZEPRIL-HYDROCHLOROTHIAZIDE.................16
BENECALORIE..........................................................38, 60
BENEFIX.......................................................................... 29
BENICAR....................................................................17, 55
BENICAR HCT...........................................................17, 55
BENOXINATE HCL/FLUORESCEIN NA...................... 28
BENZALKONIUM CHLORIDE...................................... 20
BENZAMYCINPAK......................................................... 20
BENZETHONIUM CHLORIDE...................................... 23
BENZOIN..........................................................................23
BENZOIN(OTC)............................................................... 23
BENZONATATE............................................................... 20
BENZOYL PEROXIDE.................................................... 22
BENZOYL PEROXIDE(CLEANSER)(OTC)...................22
BENZOYL PEROXIDE(GEL)(10 %)(OTC).................... 22
BENZOYL PEROXIDE(GEL)(2.5 %)(OTC)................... 22
Page 64 of 75
Index
BENZOYL PEROXIDE(LOTION)(OTC)........................ 22
BENZTROPINE MESYLATE.......................................... 40
BERINERT.................................................................. 34, 60
BESIFLOXACIN HCL......................................................28
BESIVANCE..................................................................... 28
BETA-CAROTENE(A) W-C & E/MIN............................ 45
BETA-CAROTENE(A) W-C & E/ZN/CU........................ 43
BETADINE(OTC)............................................................. 23
BETAMETHASONE DIPROPIONATE........................... 21
BETAMETHASONE VALERATE................................... 21
BETAMETHASONE/PROPYLENE GLYC..................... 21
BETAXOLOL HCL.....................................................17, 28
BETHANECHOL CHLORIDE.........................................36
BETIMOL..........................................................................28
BETOPTIC S..................................................................... 28
BEXAROTENE..................................................... 23, 37, 60
BEYAZ........................................................................ 19, 55
BICALUTAMIDE............................................................. 36
BICILLIN L-A...................................................................31
BIDIL.................................................................................18
BILTRICIDE..................................................................... 32
BIMATOPROST..........................................................28, 50
BIOCEL(OTC).................................................................. 44
BIOGLO............................................................................ 29
BION TEARS(OTC)......................................................... 28
BIONECT.......................................................................... 23
BISAC-EVAC(OTC)..........................................................36
BISACODYL...............................................................35, 36
BISACODYL(OTC).......................................................... 35
BISMUTH SUBSALICYLATE........................................ 35
BISOPROLOL FUMARATE............................................ 17
BISOPROLOL FUMARATE/HCTZ.................................17
BISOPROLOL-HYDROCHLOROTHIAZIDE.................17
BLEPHAMIDE..................................................................28
BLEPHAMIDE S.O.P........................................................28
BLOOD GLUCOSE CTL HIGH,NML&LOW.................24
BLOOD SUGAR DIAGNOSTIC......................................24
BLOOD-GLUC TRANSMITTER/SENSOR....................24
BLOOD-GLUC.METER& WRIST BP MON.................. 24
BLOOD-GLUCOSE & KETONE CTL NML.................. 24
BLOOD-GLUCOSE METER........................................... 25
BLOOD-GLUCOSE TRANSMITTER.............................25
BOOST GLUCOSE CONTROL................................. 39, 60
BOOST VHC...............................................................38, 60
BOSENTAN...................................................................... 18
BOSULIF(TAB)(100 MG).................................... 36, 50, 60
BOSULIF(TAB)(500 MG).................................... 36, 50, 60
BOSUTINIB...................................................................... 36
BP-50% UREA..................................................................23
B-PLEX PLUS...................................................................45
BREATHE RIGHT(OTC)..................................................12
BREATHERITE................................................................ 12
BREATHRITE...................................................................12
BREO ELLIPTA..........................................................12, 50
BRILINTA................................................................... 30, 50
BRIMONIDINE TARTRATE............................................28
BRIMONIDINE TARTRATE/TIMOLOL........................ 28
BRINTELLIX........................................................14, 50, 56
BRINZOLAMIDE.............................................................28
BRINZOLAMIDE/BRIMONIDINE TART...................... 28
BRISDELLE..........................................................14, 50, 56
BROMOCRIPTINE MESYLATE..................................... 41
BROMPHENIRAM/PHENYLEPHRINE/DM................. 20
BROMPHENIRAMINE MALEATE................................ 11
BROMPHENIRAMINE/PSEUDOEPHED/DM............... 20
BROMPHENIRAMINE-PSEUDOEPHED-DM...............20
BUDESONIDE............................................................12, 34
BUDESONIDE EC............................................................34
BUDESONIDE(AMPUL-NEB)(0.25MG/2ML).........12, 50
BUDESONIDE(AMPUL-NEB)(0.5 MG/2ML)..........12, 50
BUDESONIDE(AMPUL-NEB)(1 MG/2 ML)............12, 50
BUMETANIDE................................................................. 17
BUNAVAIL..................................................................40, 60
BUPRENORPHINE.......................................................... 40
BUPRENORPHINE HCL/NALOXONE HCL................. 40
BUPROBAN......................................................................42
BUPROPION HBR............................................................14
BUPROPION HCL............................................................42
BUSPIRONE HCL............................................................ 15
BUTALB/ACETAMINOPHEN/CAFFEINE.................... 40
BUTALBITAL/ACETAMINOPHEN................................ 40
BUTALBITAL-ACETAMINOPHEN................................40
BUTALBITAL-ACETAMINOPHEN-CAFFE(CAP)(50300-40)...............................................................................40
BUTALBITAL-ACETAMINOPHEN-CAFFE(TAB)........40
BUTOCONAZOLE NITRATE......................................... 43
BUTRANS...................................................................40, 50
BYSTOLIC........................................................................17
-CC1 ESTERASE INHIBITOR............................................ 34
C1 ESTERASE INHIBITOR, RECOMB..........................34
CABERGOLINE............................................................... 27
VNSNY
CABOZANTINIB S-MALATE.........................................36
CAFERGOT................................................................ 40, 50
CAFFEINE CITRATE.......................................................13
CAFFEINE CITRATED....................................................13
CAL/MAG/B COMP/VIT D3/HRB61.............................. 45
CALCIPOTRIENE...................................................... 23, 56
CALCIPOTRIENE/BETAMETHASONE........................ 24
CALCIPOTRIENE-BETAMETHASONE DP............ 24, 56
CALCITONIN,SALMON,SYNTHETIC..........................27
CALCITONIN-SALMON.................................................27
CALCITRATE(OTC)........................................................ 44
CALCITRIOL........................................................23, 48, 56
CALCIUM ACETATE.......................................................26
CALCIUM CARB &GLUCONATE/VIT D2................... 43
CALCIUM CARBONATE.......................................... 42, 43
CALCIUM CARBONATE/MAG CARB/FA....................26
CALCIUM CARBONATE/NA HYPOCHLOR................23
CALCIUM CARBONATE/VITAMIN D2........................ 43
CALCIUM CARBONATE/VITAMIN D3........................ 44
CALCIUM CITRATE....................................................... 44
CALCIUM PNV................................................................46
CALCIUM(OTC).............................................................. 43
CALCIUM/MAG/D3/B12/FA/B6/BORON...................... 44
CALCIUM/MULTIVITAMIN WITH IRON.................... 44
CALORIC SUPPLEMENT............................................... 38
CAMINO PRO 15................................................. 38, 39, 60
CAMINO-PRO RESTORE......................................... 38, 60
CAMRESE.................................................................. 19, 50
CANAGLIFLOZIN........................................................... 24
CANAGLIFLOZIN/METFORMIN HCL......................... 24
CANASA........................................................................... 35
CAPECITABINE...............................................................36
CAPECITABINE(TAB)(150 MG)........................ 36, 50, 60
CAPECITABINE(TAB)(500 MG)........................ 36, 50, 60
CAPRELSA(TAB)(100 MG)................................ 37, 50, 60
CAPRELSA(TAB)(300 MG)................................ 37, 50, 60
CAPTOPRIL/HYDROCHLOROTHIAZIDE....................16
CAPTOPRIL-HYDROCHLOROTHIAZIDE................... 16
CARAFATE....................................................................... 42
CARBAMAZEPINE................................................... 15, 41
CARBAMAZEPINE(CPMP 12HR)(100 MG)................. 41
CARBAMAZEPINE(ORAL SUSP)................................. 41
CARBAMAZEPINE(TAB CHEW).................................. 41
CARBAMAZEPINE(TAB)............................................... 41
CARBATROL....................................................................41
CARBIDOPA.....................................................................41
CARBIDOPA/LEVODOPA.............................................. 41
CARBIDOPA/LEVODOPA/ENTACAPONE................... 41
CARBIDOPA-LEVODOPA.............................................. 41
CARBIDOPA-LEVODOPA-ENTACAPONE...................41
CARBINOXAMINE MALEATE......................................11
CARBINOXAMINE MALEATE(LIQUID)..................... 11
CARBINOXAMINE MALEATE(TAB)............................11
CARBIT/EQUIS XT/ETHAN/CHIT/MSM......................23
CARB-O-PHILIC.............................................................. 23
CARELANCE ULT LANCING DEVICE(OTC)..............25
CAREONE(OTC).............................................................. 25
CARESENS PREM LANCING DEVICE(OTC)..............25
CARTEOLOL HCL...........................................................28
CARTIA XT...................................................................... 17
CARVEDILOL.................................................................. 16
CARVEDILOL PHOSPHATE.......................................... 16
CASEIN/MILK, NF, SKIM/PALM OIL........................... 39
CASTOR OIL.................................................................... 35
CASTOR OIL(OTC)......................................................... 35
CAYSTON................................................................... 31, 60
CEFACLOR.......................................................................31
CEFADROXIL...................................................................31
CEFDINIR.........................................................................31
CEFDITOREN PIVOXIL..................................................31
CEFIXIME........................................................................ 31
CEFPODOXIME PROXETIL........................................... 31
CEFPROZIL...................................................................... 31
CEFTIBUTEN...................................................................31
CEFTIN............................................................................. 31
CEFUROXIME..................................................................31
CEFUROXIME AXETIL.................................................. 31
CELECOXIB..................................................................... 34
CELEXA............................................................................14
CELLULOSE GUM.......................................................... 39
CELONTIN....................................................................... 41
CENTRAL VITE(OTC).................................................... 45
CENTRAL-VITE CARDIO(OTC)....................................45
CENTRAL-VITE(OTC).................................................... 45
CENTRUM SILVER ULTRA MEN'S(OTC).................... 45
CENTRUM SILVER WOMEN(OTC).............................. 45
CENTRUM SPECIALIST HEART(OTC)........................ 45
CENTURY ENERGY METABOLISM(OTC)..................45
CEPHALEXIN.................................................................. 31
CERITINIB........................................................................36
CEROVITE ADVANCED FORMULA(OTC).................. 45
CEROVITE SENIOR(OTC).............................................. 44
CERTA PLUS(OTC)..........................................................45
CERTAVITE SENIOR-ANTIOXIDANT(OTC)................44
CERTOLIZUMAB PEGOL.............................................. 35
CETIRIZINE HCL............................................................ 11
CETIRIZINE HCL(OTC)..................................................11
CETIRIZINE HCL/PSEUDOEPHEDRINE..................... 11
CETIRIZINE-PSEUDOEPHEDRINE ER(OTC)..............11
CHANTIX................................................................... 42, 50
CHEMSTRIP UGK(OTC).................................................26
CHEST CONGESTION RELIEF PE(OTC)..................... 20
CHILDREN'S MOTRIN(OTC)......................................... 35
CHLORHEXIDINE GLUCONATE..................................37
CHLOROQUINE PHOSPHATE....................................... 32
CHLOROTHIAZIDE.........................................................18
CHLOROXYLENOL........................................................ 20
CHLORPHENIRAMINE MALEATE...............................11
CHLORPHENIRAMINE/PHENYLEPH/DM.................. 20
CHLORPROMAZINE HCL..............................................15
CHLORPROPAMIDE....................................................... 24
CHLORTHALIDONE.......................................................18
CHLORZOXAZONE........................................................ 42
CHOLECALCIFEROL (VITAMIN D3)........................... 48
CHOLESTYRAMINE.......................................................18
CHOLESTYRAMINE (WITH SUGAR).......................... 18
CHOLESTYRAMINE/ASPARTAME.............................. 18
CHOLINE MAG TRISALICYLATE................................ 40
CHOLINE SAL/MAG SALICYLATE..............................40
CICLOPIROX....................................................................20
CICLOPIROX OLAMINE................................................ 20
CICLOPIROX/URE/CAMPH/MENTH/EUC...................20
CILOSTAZOL................................................................... 30
CILOXAN......................................................................... 28
CIMETIDINE.................................................................... 43
CIMETIDINE HCL........................................................... 43
CIMETIDINE(OTC)......................................................... 43
CIMZIA....................................................................... 35, 60
CINRYZE.................................................................... 34, 60
CIPRODEX....................................................................... 26
CIPROFLOXACIN............................................................31
CIPROFLOXACIN ER......................................................32
CIPROFLOXACIN HCL.......................................26, 28, 31
CIPROFLOXACIN HCL/DEXAMETH........................... 26
CIPROFLOXACIN/CIPROFLOXA HCL.........................32
CITALOPRAM HBR........................................................ 14
CITALOPRAM HYDROBROMIDE................................ 14
CITRATE PHOSPHATE DEXTROS SOLN.................... 29
CITRATE PHOSPHATE DEXTROSE............................. 29
CITRIC ACID/SODIUM CITRATE................................. 43
CITRUCEL(OTC)............................................................. 35
CLARAVIS........................................................................20
CLARITHROMYCIN....................................................... 31
CLARITIN(OTC).............................................................. 11
CLARITIN-D 12 HOUR(OTC).........................................11
CLARITIN-D 24 HOUR(OTC).........................................11
CLEANSING EYELID PADS(OTC)................................29
CLEANSING EYELID WIPES(OTC)..............................29
CLEMASTINE FUMARATE........................................... 11
CLEMASTINE FUMARATE(OTC)................................. 11
CLINDAMYCIN HCL...................................................... 32
CLINDAMYCIN PALMITATE HCL................................32
CLINDAMYCIN PHOS/BENZOYL PEROX.................. 20
CLINDAMYCIN PHOSPHATE................................. 20, 43
CLINDAMYCIN-BENZOYL PEROXIDE.......................20
CLINITEST REAGENT(OTC)......................................... 26
CLOBAZAM..................................................................... 41
CLOBETASOL EMOLLIENT..........................................21
CLOBETASOL PROPIONATE.........................................21
CLOBETASOL PROPIONATE/EMOLL..........................21
CLOCORTOLONE PIVALATE........................................21
CLOMIPRAMINE HCL................................................... 14
CLONAZEPAM................................................................ 41
CLONIDINE......................................................................17
CLONIDINE HCL.......................................................16, 17
CLONIDINE HCL ER................................................ 16, 50
CLONIDINE HCL/CHLORTHALIDONE....................... 17
CLOPIDOGREL BISULFATE..........................................30
CLOPIDOGREL(TAB)(300 MG)............................... 30, 50
CLOPIDOGREL(TAB)(75 MG)....................................... 30
CLORPRES....................................................................... 17
CLOTRIMAZOLE...................................................... 20, 32
CLOTRIMAZOLE(OTC)..................................................20
CLOTRIMAZOLE/BETAMETHASONE DIP................. 20
CLOTRIMAZOLE-BETAMETHASONE........................ 20
CLOZAPINE............................................................... 15, 50
CLOZARIL..................................................................15, 50
C-NATE DHA....................................................................46
COBICISTAT.....................................................................34
COBIMETINIB FUMARATE...........................................36
COLCHICINE............................................................. 29, 50
COLCHICINE/PROBENECID......................................... 29
Page 65 of 75
Index
COLESEVELAM HCL..................................................... 18
COLESTIPOL HCL.......................................................... 18
COLLAGEN,BOVINE...................................................... 24
COMBIGAN......................................................................28
COMBIPATCH............................................................30, 50
COMBIVENT RESPIMAT............................................... 12
COMETRIQ.......................................................... 36, 50, 60
COMFORT........................................................................ 25
COMPACT COMPRESSOR NEBULIZER(OTC)........... 13
COMPACT ULTRASONIC NEBULIZER(OTC).............13
COMP-AIR ELITE COMPRESSOR SYST..................... 13
COMP-AIR ELITE COMPRESSOR SYST(OTC)........... 13
COMP-AIR NEBULIZER COMPRESSOR..................... 13
COMP-AIR NEBULIZER COMPRESSOR(OTC)...........13
COMPLEAT PEDIATRIC...........................................38, 60
COMPLEAT PEDIATRIC REDUCED CAL..............38, 60
COMPLERA......................................................................34
COMPLETE(OTC)............................................................45
COMPLETENATE............................................................ 46
COMPMIST COMPRESSOR NEBULIZER(OTC)......... 13
COMPRESSOR, FOR NEBULIZER................................12
CONDYLOX..................................................................... 22
CONTACT DETACH INFUSION SET............................ 25
COPAXONE................................................................37, 60
CORDRAN........................................................................21
COREG CR....................................................................... 16
CORN STARCH................................................................39
CORTISONE ACETATE...................................................34
CORTISPORIN................................................................. 21
CORVITA 150................................................................... 44
CORVITE 150................................................................... 44
COSENTYX (2 SYRINGES)......................................23, 60
COSENTYX PEN....................................................... 23, 60
COSENTYX PEN (2 PENS)....................................... 23, 60
COSENTYX SYRINGE..............................................23, 60
COTELLIC............................................................ 36, 50, 60
CRANBERRY JUICE....................................................... 38
CREON..............................................................................42
CRESTOR(TAB)(10 MG)..................................... 18, 50, 56
CRESTOR(TAB)(20 MG)..................................... 18, 50, 56
CRESTOR(TAB)(40 MG)..................................... 18, 50, 56
CRESTOR(TAB)(5 MG)....................................... 18, 50, 56
CRIXIVAN........................................................................ 33
CRIZOTINIB.....................................................................36
CROMOLYN SODIUM.............................................. 12, 28
CROTAMITON................................................................. 21
CRUCIAL.................................................................... 39, 60
CRYSELLE....................................................................... 19
CUPRIMINE..................................................................... 34
CURITY ALCOHOL PREPS(OTC)................................. 21
CYANOCOBALAMIN (VITAMIN B-12)........................47
CYANOCOBALAMIN INJECTION................................ 47
CYANOCOBALAMIN/FA/PYRIDOXINE...................... 47
CYANOCOBALAMIN/MECOBALAMIN...................... 47
CYCLOBENZAPRINE HCL............................................42
CYCLOPENTOLATE HCL.............................................. 28
CYCLOSERINE................................................................32
CYCLOSPORINE....................................................... 28, 31
CYCLOSPORINE MODIFIED.........................................31
CYCLOSPORINE, MODIFIED........................................31
CYMBALTA................................................................14, 50
CYPROHEPTADINE HCL............................................... 11
CYSTARAN................................................................ 29, 60
CYSTEAMINE BITARTRATE.........................................43
CYSTEAMINE HCL.........................................................29
CYTRA-K..........................................................................43
-DDABRAFENIB MESYLATE............................................ 37
DAILY ENERGY(OTC)....................................................45
DAILY MULTIPLE(OTC).................................................45
DALFAMPRIDINE........................................................... 37
DALIRESP............................................................ 12, 50, 56
DALTEPARIN SODIUM,PORCINE................................ 29
DANAZOL........................................................................ 27
DANTROLENE SODIUM................................................ 42
DAPSONE......................................................................... 32
DARAPRIM................................................................ 32, 60
DARUNAVIR ETHANOLATE......................................... 33
DARUNAVIR/COBICISTAT............................................ 33
DASATINIB...................................................................... 37
DDAVP.............................................................................. 27
DEGARELIX ACETATE.................................................. 36
DELAVIRDINE MESYLATE...........................................33
DEMECLOCYCLINE HCL..............................................32
DEPAKOTE.......................................................................41
DEPEN.............................................................................. 34
DEPO-PROVERA....................................................... 19, 50
DEPO-SUBQ PROVERA 104.....................................19, 50
DERMAPLEX(OTC)........................................................ 22
DESIPRAMINE HCL....................................................... 14
DESIRUDIN...................................................................... 30
DESLORATADINE.....................................................11, 50
VNSNY
DESMOPRESSIN (NONREFRIGERATED)................... 27
DESMOPRESSIN ACETATE........................................... 27
DESOG-E.ESTRADIOL/E.ESTRADIOL........................ 19
DESOGESTREL-ETHINYL ESTRADIOL..................... 19
DESONIDE....................................................................... 21
DESOXIMETASONE....................................................... 21
DESVENLAFAXINE........................................................14
DESVENLAFAXINE ER......................................14, 50, 56
DESVENLAFAXINE FUMARATE................................. 14
DESVENLAFAXINE FUMARATE ER............... 14, 50, 56
DESVENLAFAXINE SUCCINATE................................. 14
DEVILBISS COMPACT(OTC).........................................12
DEVILBISS DISPOSABLE NEBULIZER(OTC)............ 13
DEVILBISS PULMO-AIDE............................................. 12
DEVILBISS PULMO-AIDE(OTC).................................. 12
DEVILBISS PULMOMATE(OTC).................................. 12
DEVILBISS TRAVELER..................................................13
DEXAMETHASONE........................................................34
DEXAMETHASONE SOD PHOSPHATE.......................27
DEXAMETHASONE SODIUM PHOSPHATE............... 27
DEXMETHYLPHENIDATE HCL....................................16
DEXMETHYLPHENIDATE HCL ER................. 16, 49, 50
DEXTRAN 70/HYPROMELLOSE.................................. 28
DEXTRAN 70/HYPROMELLOSE/PF.............................28
DEXTRAN/HYPROMELLOSE/GLYCERIN.................. 28
DEXTROAMPHETAMINE SULFATE............................ 14
DEXTROAMPHETAMINE SULFATE(SOLUTION)......
14,
50
DEXTROAMPHETAMINE SULFATE(TAB)(10 MG)......
14,
50
DEXTROAMPHETAMINE SULFATE(TAB)(5 MG)......
14,
50
DEXTROAMPHETAMINE/AMPHETAMINE................ 14
DEXTROAMPHETAMINE-AMPHETAMINE..........14, 50
DEXTROSE.......................................................................26
DEXTROSE/DEXTRIN/MALTOSE................................ 26
DIABETA.......................................................................... 24
DIABETISOURCE AC............................................... 39, 60
DIALYVITE...................................................................... 47
DIALYVITE 3000............................................................. 47
DIALYVITE 800 WITH IRON......................................... 45
DIALYVITE 800-ULTRA D(OTC).................................. 47
DIALYVITE ZINC............................................................47
DIAPHRAGMS, WIDE SEAL..........................................19
DIASTAT........................................................................... 41
DIASTAT ACUDIAL........................................................ 41
DIASTIX REAGENT(OTC)............................................. 26
DIAZEPAM....................................................................... 41
DICHLORPHENAMIDE.................................................. 42
DICLOFENAC POTASSIUM........................................... 35
DICLOFENAC SODIUM............................... 21, 23, 35, 60
DICLOXACILLIN SODIUM............................................31
DICYCLOMINE HCL...................................................... 42
DIDANOSINE...................................................................33
DIDANOSINE(CAP DR)(125 MG)............................33, 50
DIDANOSINE(CAP DR)(200 MG)............................33, 50
DIDANOSINE(CAP DR)(250 MG)..................................33
DIDANOSINE(CAP DR)(400 MG)..................................33
DIETARY SUPPLEMENT................................................38
DIFICID.................................................................31, 50, 56
DIFLORASONE DIACETATE/EMOLL.......................... 21
DIFLUNISAL....................................................................40
DIFLUPREDNATE........................................................... 27
DIGOXIN.......................................................................... 16
DIGOXIN(SOLUTION)....................................................16
DIGOXIN(TAB)................................................................ 16
DIHYDROERGOTAMINE MESYLATE......................... 40
DIHYDROERGOTAMINE MESYLATE(AMPUL)...... 40,
50
DIHYDROERGOTAMINE MESYLATE(SPRAY/PUMP)
..................................................................................... 40, 50
DIHYDROERGOTAMINE MESYLATE(VIAL)............. 40
DILANTIN........................................................................ 41
DILANTIN-125.................................................................41
DILTIAZEM HCL.............................................................17
DIMENHYDRINATE....................................................... 11
DIMETHICONE................................................................23
DIMETHYL FUMARATE................................................37
DIPHENHYDRAMINE HCL..................................... 11, 15
DIPHENHYDRAMINE HCL(CAP)(OTC)...................... 11
DIPHENHYDRAMINE HCL(ELIXIR)(OTC)................. 11
DIPHENHYDRAMINE HCL(LIQUID)(OTC)................ 11
DIPHENHYDRAMINE HCL(SYRUP)(OTC)................. 11
DIPHENHYDRAMINE HCL(TAB)(OTC)...................... 11
DIPYRIDAMOLE............................................................. 30
DISOPYRAMIDE PHOSPHATE..................................... 16
DISULFIRAM...................................................................15
DIVALPROEX SODIUM..................................................41
DIVALPROEX SODIUM ER............................................41
DOCOSANOL...................................................................21
DOC-Q-LACE(OTC).........................................................35
DOCUSATE SODIUM................................................35, 36
DOFETILIDE.................................................................... 16
DOLUTEGRAVIR SODIUM............................................33
DONEPEZIL HCL............................................................ 14
DONNATAL...................................................................... 42
DORNASE ALFA............................................................. 39
DORZOLAMIDE HCL..................................................... 28
DORZOLAMIDE HCL/TIMOLOL MALEAT.................28
DORZOLAMIDE-TIMOLOL...........................................28
DOXAZOSIN MESYLATE.............................................. 16
DOXEPIN HCL........................................................... 14, 15
DOXERCALCIFEROL..................................................... 27
DOXYCYCLINE CALCIUM........................................... 32
DOXYCYCLINE HYCLATE............................... 32, 50, 56
DOXYCYCLINE MONOHYDRATE...............................32
DOXYCYCLINE MONOHYDRATE(CAP).............. 32, 50
DOXYCYCLINE MONOHYDRATE(SUSP RECON)......
32
DOXYCYCLINE MONOHYDRATE(TAB)(100 MG)......
32,
50,
56
32,
50
32,
50
32,
50
DRITHOCREME HP.................................................. 23, 56
DRONABINOL..................................................... 11, 50, 56
DRONEDARONE HCL.................................................... 16
DROPLET LANCING DEVICE(OTC)............................ 25
DROSPIR/ETH ESTRA/LEVOMEFOL CA.................... 19
DROXIDOPA.................................................................... 19
DRY SKIN THERAPY(OTC)...........................................22
DUAVEE............................................................................30
DULAGLUTIDE............................................................... 24
DULERA..................................................................... 12, 50
DULOXETINE HCL................................................... 14, 50
DUREZOL.........................................................................27
DUTASTERIDE.................................................... 43, 56, 63
DUTASTERIDE/TAMSULOSIN HCL.............................43
DUTASTERIDE-TAMSULOSIN......................... 43, 56, 63
DYCLONINE HCL/BENZETHONIUM CL.................... 23
-EE.E.S. 200.......................................................................... 31
EASIVENT........................................................................12
EASY CLICK(OTC)......................................................... 25
EASY TOUCH ALCOHOL PREP PADS(OTC).............. 22
EASY TOUCH LANCING DEVICE(OTC)..................... 25
ECONAZOLE NITRATE..................................................20
EDLUAR............................................................... 15, 50, 56
EDURANT........................................................................ 33
EFAVIRENZ...................................................................... 33
EFAVIRENZ/EMTRICITAB/TENOFOVIR..................... 34
EFFER-K........................................................................... 26
EFFIENT..................................................................... 30, 50
EGG-PRO.................................................................... 37, 60
ELECARE................................................................... 39, 60
ELECARE JR.............................................................. 39, 60
ELIGARD....................................................................27, 60
ELIQUIS(TAB)(2.5 MG)............................................ 29, 50
ELIQUIS(TAB)(5 MG)............................................... 29, 50
ELITE OB DHA................................................................ 46
ELITE-OB 400.................................................................. 46
ELLA................................................................................. 19
ELMIRON......................................................................... 43
ELTROMBOPAG OLAMINE........................................... 30
ELVITEG/COBI/EMTRIC/TENOFO ALA......................34
ELVITEGR/COBICIST/EMTRIC/TENOF.......................34
ELVITEGRAVIR............................................................... 33
EMEND(CAP DS PK)................................................ 11, 50
EMEND(CAP)(125 MG).............................................11, 50
EMEND(CAP)(40 MG)...............................................11, 50
EMEND(CAP)(80 MG)...............................................11, 50
EMOL53/NAMGFS/HA/NAHYPOCHLORIT................ 22
EMOLLIENT #56/HYALURONIC ACID........................22
EMOLLIENT COMBINATION NO.10............................22
EMOLLIENT COMBO NO.47 & NO.60......................... 22
EMPAGLIFLOZIN............................................................24
EMPAGLIFLOZIN/LINAGLIPTIN.................................. 24
EMPAGLIFLOZIN/METFORMIN HCL..........................24
EMSAM.......................................................................15, 50
EMTRICITAB/RILPIVIRI/TENOFO ALA......................34
EMTRICITAB/RILPIVIRINE/TENOFOV....................... 34
EMTRICITABINE.............................................................33
EMTRICITABINE/TENOFOVIR..................................... 33
EMTRIVA(CAP)......................................................... 33, 50
EMTRIVA(SOLUTION)............................................. 33, 50
Page 66 of 75
Index
EMULSION SB.................................................................22
ENALAPRIL MALEATE..................................................17
ENALAPRIL/HYDROCHLOROTHIAZIDE................... 16
ENALAPRIL-HYDROCHLOROTHIAZIDE................... 16
ENEMEEZ(OTC).............................................................. 36
ENFUVIRTIDE................................................................. 33
ENOXAPARIN SODIUM................................................. 29
ENOXAPARIN SODIUM(SYRINGE)(100 MG/ML)......
29,
50
ENOXAPARIN SODIUM(SYRINGE)(120MG/.8ML)......
29,
50
ENOXAPARIN SODIUM(SYRINGE)(150 MG/ML)......
29,
50
ENOXAPARIN SODIUM(SYRINGE)(30MG/0.3ML)......
29,
50
29,
51
29,
51
29,
51
ENOXAPARIN SODIUM(VIAL)...............................29, 51
ENSURE ACTIVE MUSCLE HEALTH.................... 38, 60
ENSURE BONE HEALTH......................................... 38, 60
ENSURE CLEAR........................................................39, 60
ENTACAPONE................................................................. 41
ENZALUTAMIDE............................................................ 36
EO28 SPLASH............................................................ 39, 60
EPINASTINE HCL........................................................... 27
EPINEPHRINE............................................................11, 36
EPIPEN JR 2-PAK.............................................................36
EPIVIR HBV..................................................................... 34
EPOETIN ALFA............................................................... 29
EPZICOM....................................................................33, 51
EQUETRO.........................................................................15
ERAPID NEBULIZER......................................................13
ERGOCALCIFEROL (VITAMIN D2)............................. 48
ERGOLOID MESYLATES...............................................19
ERGOTAMINE TARTRATE/CAFFEINE........................ 40
ERIVEDGE........................................................... 36, 51, 60
ERLOTINIB HCL............................................................. 37
ERYPED 400..................................................................... 31
ERY-TAB........................................................................... 31
ERYTHROCIN STEARATE............................................. 31
ERYTHROMYCIN................................................20, 28, 31
ERYTHROMYCIN BASE.......................................... 28, 31
ERYTHROMYCIN BASE/ETHANOL............................ 20
ERYTHROMYCIN ETHYLSUCCINATE........................31
ERYTHROMYCIN STEARATE.......................................31
ERYTHROMYCIN/BENZOYL PEROXIDE................... 20
ERYTHROMYCIN-BENZOYL PEROXIDE................... 20
ESBRIET..................................................................... 39, 60
ESCITALOPRAM OXALATE..........................................14
ESLICARBAZEPINE ACETATE..................................... 41
ESOMEPRAZOLE MAGNESIUM...................... 43, 51, 56
ESSENTIAL WOMAN 50+(OTC)................................... 45
ESTRACE..........................................................................43
ESTRADIOL............................................................... 30, 43
ESTRADIOL VALERATE/DIENOGEST........................ 19
ESTRADIOL(PATCH TDSW)....................................30, 51
ESTRADIOL(PATCH TDWK)................................... 30, 51
ESTRADIOL(TAB)...........................................................30
ESTRADIOL/NORETHINDRONE ACET.......................30
ESTRADIOL-NORETHINDRONE ACETAT..................30
ESTROGEN,CON/M-PROGEST ACET.......................... 30
ESTROGENS, CONJUGATED.................................. 30, 43
ESTROGENS,CONJ/BAZEDOXIFENE.......................... 30
ESTROGENS,ESTERIFIED............................................. 30
ESTROPIPATE.................................................................. 30
ESZOPICLONE................................................................ 15
ETHAMBUTOL HCL.......................................................32
ETHINYL ESTRADIOL/DROSPIRENONE................... 19
ETHIONAMIDE............................................................... 32
ETHOSUXIMIDE............................................................. 41
ETHOTOIN....................................................................... 41
ETHYL CHLORIDE......................................................... 23
ETHYNODIOL D-ETHINYL ESTRADIOL....................19
ETIDRONATE DISODIUM..............................................27
ETODOLAC...................................................................... 35
ETONOGESTREL/ETHINYL ESTRADIOL...................19
ETOPOSIDE......................................................................37
ETRAVIRINE....................................................................33
EURAX..............................................................................21
EVENCARE MINI MONITOR SYSTEM(OTC)............. 25
EVEROLIMUS............................................................31, 36
EVOLOCUMAB............................................................... 18
EVOTAZ...................................................................... 33, 51
EXCEL-GEL(OTC)...........................................................22
EXELDERM......................................................................21
EXEMESTANE................................................................. 36
EXODERM........................................................................21
EXTRA-VIRT PLUS DHA............................................... 47
VNSNY
EYE WASH(OTC).............................................................29
EYELID CLEANSER COMBINATION #5..................... 29
EYELID CLEANSER COMBINATION #6..................... 29
EYELID WIPES(OTC)..................................................... 29
E-Z SPACER..................................................................... 12
EZETIMIBE...................................................................... 18
EZOGABINE.................................................................... 41
-FFA/MV,CA,IRON,MIN/LYCOPENE/LUT....................... 45
FA/VIT B COMPLEX & C/RICE BRAN.........................47
FA/VIT BCOMP,C/ZINC/VITAMIN D3.......................... 47
F-A-A...........................................................................39, 60
FACTOR IX.......................................................................29
FACTOR IX HUMAN RECOMBINANT.........................29
FAMCICLOVIR................................................................ 33
FAMOTIDINE...................................................................43
FAMOTIDINE(OTC)........................................................ 43
FANAPT(TAB DS PK)..........................................15, 51, 56
FANAPT(TAB)......................................................15, 51, 56
FARESTON................................................................. 37, 60
FARYDAK...................................................................37, 60
FE FUMARATE/CAL/E/FA/MULTIVIT......................... 44
FE FUMARATE/DOSS/FA/BCOMP,C............................ 44
FE FUMARATE/FA/VIT BCOMP,C................................ 45
FE FUMARATE/VIT C/B12/STOMC.............................. 44
FE FUMARATE/VIT C/B12-IF/FA.................................. 44
FEBUXOSTAT.................................................................. 29
FELBAMATE....................................................................41
FELBAMATE(ORAL SUSP)................................41, 51, 56
FELBAMATE(TAB)(400 MG)............................. 41, 51, 56
FELBAMATE(TAB)(600 MG)............................. 41, 51, 56
FELODIPINE.................................................................... 17
FELODIPINE ER.............................................................. 17
FENOFIBRATE.................................................................18
FENOFIBRATE NANOCRYSTALLIZED....................... 18
FENOFIBRATE,MICRONIZED.......................................18
FENOFIBRIC ACID......................................................... 18
FENOFIBRIC ACID (CHOLINE).................................... 18
FENOPROFEN CALCIUM.............................................. 35
FENOPROFEN CALCIUM(CAP)....................................35
FENOPROFEN CALCIUM(TAB).................................... 35
FENTANYL...........................................................40, 51, 60
FENTANYL CITRATE............................................... 40, 60
FER-IN-SOL(OTC)........................................................... 44
FEROCON.........................................................................44
FERRAPLUS 90................................................................44
FERREX 150 FORTE PLUS.............................................44
FERREX 150 PLUS(OTC)................................................44
FERREX 150(OTC).......................................................... 44
FERREX 28....................................................................... 44
FERROUS FUMARATE/FOLIC ACID............................44
FERROUS SULFATE........................................................44
FERROUS SULFATE(OTC)............................................. 44
FERROUS SULFATE/VIT C/FA...................................... 44
FESOTERODINE FUMARATE....................................... 43
FETZIMA.............................................................. 14, 51, 56
FEXOFENADINE HCL.................................................... 11
FEXOFENADINE HCL(OTC)......................................... 11
FEXOFENADINE/PSEUDOEPHEDRINE...................... 11
FIBER-STAT(OTC)........................................................... 35
FIDAXOMICIN.................................................................31
FILGRASTIM................................................................... 30
FINASTERIDE..................................................................43
FINGOLIMOD HCL......................................................... 37
FIRAZYR.................................................................... 34, 60
FIRMAGON(VIAL)(120 MG)....................................36, 51
FIRMAGON(VIAL)(80 MG)......................................36, 51
FLAGYL ER......................................................................32
FLAREX............................................................................27
FLAVOXATE HCL............................................................43
FLECAINIDE ACETATE..................................................16
FLUCAINE........................................................................28
FLUCONAZOLE.............................................................. 32
FLUCYTOSINE................................................................ 32
FLUDROCORTISONE ACETATE................................... 34
FLUNISOLIDE..................................................... 11, 12, 51
FLUOCINOLONE ACETONIDE.....................................21
FLUOCINOLONE ACETONIDE OIL............................. 26
FLUOCINOLONE/SHOWER CAP..................................21
FLUOCINONIDE..............................................................21
FLUOCINONIDE/EMOLLIENT BASE.......................... 21
FLUOCINONIDE-E..........................................................21
FLUORESCEIN SODIUM............................................... 29
FLUORIDE........................................................................44
FLUORIDE/IRON/VITAMINS A,C,D............................. 45
FLUORIDEX SENSITIVITY RELIEF.............................44
FLUORITAB..................................................................... 44
FLUOROMETHOLONE...................................................27
FLUOROMETHOLONE ACETATE................................ 27
FLUOROURACIL.............................................................23
FLUOXETINE HCL..........................................................14
FLUOXYMESTERONE................................................... 30
FLUPHENAZINE DECANOATE.....................................15
FLUPHENAZINE HCL.................................................... 15
FLURA-DROPS................................................................ 44
FLURANDRENOLIDE.................................................... 21
FLURBIPROFEN.............................................................. 35
FLURBIPROFEN SODIUM............................................. 27
FLUTAMIDE.....................................................................36
FLUTICASONE PROPIONATE...........................11, 21, 51
FLUTICASONE PROPIONATE(OTC)...................... 11, 51
FLUTICASONE/SALMETEROL.....................................12
FLUTICASONE/VILANTEROL......................................12
FLUTTER..........................................................................12
FLUVOXAMINE MALEATE...........................................14
FML FORTE......................................................................27
FML S.O.P......................................................................... 27
FOAMING ANTACID(OTC)............................................42
FOCALGIN DSS...............................................................44
FOCALIN XR....................................................... 16, 49, 51
FOLBECAL.......................................................................47
FOLBEE PLUS CZ........................................................... 47
FOLBIC............................................................................. 47
FOLBIC RF....................................................................... 47
FOLBIC(OTC)...................................................................47
FOLIC ACID..................................................................... 44
FOLIC ACID(OTC)...........................................................44
FOLIC ACID/B COMPLEX & C NO.17..........................47
FOLIC ACID/B CPLX/C/SELEN/ZINC.......................... 47
FOLIC ACID/MULTIVIT-MIN/LUTEIN.........................45
FOLIC ACID/MV,FE,MIN................................................45
FOLIC ACID/MV,FE,MIN/LUTEIN................................ 45
FOLIC ACID/VIT BCOMP,C........................................... 47
FOLIC ACID/VIT BCOMP,C/CU/ZNOX........................ 47
FOLITAB 500(OTC)......................................................... 44
FOLIVANE-F.................................................................... 44
FOLIVANE-OB................................................................. 46
FOLIVANE-PLUS.............................................................44
FONDAPARINUX SODIUM......................................29, 30
FONDAPARINUX SODIUM(SYRINGE)(10MG/0.8ML)
..................................................................................... 29, 51
FONDAPARINUX SODIUM(SYRINGE)(2.5 MG/0.5)
..................................................................................... 29, 51
FONDAPARINUX SODIUM(SYRINGE)(5MG/0.4ML)
..................................................................................... 30, 51
FONDAPARINUX SODIUM(SYRINGE)(7.5MG/0.6)......
30,
51
FORA LANCING DEVICE(OTC)................................... 25
FORMOTEROL FUMARATE.......................................... 12
FORTEO...................................................................... 27, 51
FOS/MALTODEXTRIN....................................................35
FOSAMAX PLUS D......................................................... 27
FOSAMPRENAVIR CALCIUM.......................................33
FOSFREE(OTC)................................................................44
FOSINOPRIL SODIUM................................................... 17
FOSINOPRIL/HYDROCHLOROTHIAZIDE.................. 16
FOSINOPRIL-HYDROCHLOROTHIAZIDE.................. 16
FRAGMIN(SYRINGE)(10000/ML)........................... 29, 51
FRAGMIN(SYRINGE)(12500/0.5)............................ 29, 51
FRAGMIN(SYRINGE)(15000/0.6)............................ 29, 51
FRAGMIN(SYRINGE)(18000/0.72).......................... 29, 51
FRAGMIN(SYRINGE)(2500/0.2ML)........................ 29, 51
FRAGMIN(VIAL).......................................................29, 51
FREESTYLE FREEDOM LITE(OTC).............................25
FREESTYLE INSULINX(OTC).................................24, 25
FREESTYLE LITE METER(OTC).................................. 25
FREESTYLE LITE(OTC)................................................. 24
FREESTYLE(OTC)...........................................................24
FRESHNET(OTC).............................................................22
FRUCTOOLIGOSACCHARIDES/POLYDEX................ 35
FUROSEMIDE.................................................................. 17
FUZEON......................................................................33, 51
FYCOMPA(TAB)(10 MG).................................... 41, 51, 56
FYCOMPA(TAB)(12 MG).................................... 41, 51, 56
FYCOMPA(TAB)(2 MG)...................................... 41, 51, 56
FYCOMPA(TAB)(4 MG)...................................... 41, 51, 56
FYCOMPA(TAB)(6 MG)...................................... 41, 51, 56
FYCOMPA(TAB)(8 MG)...................................... 41, 51, 56
-GGABAPENTIN..................................................................41
GABAPENTIN(CAP)....................................................... 41
GABAPENTIN(SOLUTION)........................................... 41
GABAPENTIN(TAB)........................................................41
GABITRIL(TAB)(12 MG).................................... 42, 51, 56
GABITRIL(TAB)(16 MG).................................... 42, 51, 57
GABITRIL(TAB)(2 MG).................................................. 42
GABITRIL(TAB)(4 MG).................................................. 42
GALANTAMINE HBR..................................................... 14
GALANTAMINE HBR(CAP24H PEL)..................... 14, 51
GALANTAMINE HBR(TAB).....................................14, 51
GAMMAGARD LIQUID............................................30, 60
GAMMAKED............................................................. 30, 60
Page 67 of 75
Index
GAMUNEX-C.............................................................30, 60
GANCICLOVIR................................................................ 27
GATIFLOXACIN.............................................................. 28
GATTEX......................................................................36, 60
GAVILYTE-C.................................................................... 36
GAVILYTE-N....................................................................36
GEFITINIB........................................................................37
GEL-KAM(OTC).............................................................. 44
GEMFIBROZIL.................................................................18
GENADUR........................................................................23
GENERLAC...................................................................... 35
GENTAMICIN SULFATE...........................................20, 28
GENTIAN VIOL/BRLNT GRN/PROFLAV.....................20
GENVOYA.................................................................. 34, 51
GEODON.................................................................... 15, 51
GERITOL COMPLETE(OTC)..........................................44
GILENYA.................................................................... 37, 60
GILOTRIF................................................................... 36, 60
GLATIRAMER ACETATE............................................... 37
GLATOPA....................................................................37, 60
GLIMEPIRIDE..................................................................24
GLIPIZIDE........................................................................ 24
GLIPIZIDE/METFORMIN HCL......................................24
GLIPIZIDE-METFORMIN...............................................24
GLUCAGON EMERGENCY KIT................................... 26
GLUCAGON,HUMAN RECOMBINANT.......................26
GLUCO BURST..........................................................39, 60
GLUCOLET 2(OTC).........................................................25
GLUCOSE POLYMERS................................................... 38
GLUCOSE(OTC).............................................................. 26
GLYBURIDE.....................................................................24
GLYBURIDE MICRONIZED...........................................24
GLYBURIDE,MICRONIZED...........................................24
GLYBURIDE/METFORMIN HCL...................................24
GLYBURIDE-METFORMIN HCL.................................. 24
GLYCERIN/DIMETHICONE...........................................22
GLYCERIN/PROPYLENE GLYCOL...............................28
GLYCEROL PHENYLBUTYRATE................................. 35
GLYCINE.......................................................................... 32
GLYCINE UROLOGIC SOLUTION................................32
GLYCOPYRROLATE....................................................... 42
GLYTROL................................................................... 39, 60
GLYXAMBI.......................................................... 24, 51, 57
GMATE LANCING DEVICE(OTC)................................ 25
GOLIMUMAB.................................................................. 34
GOLYTELY.......................................................................36
GR POL-ORC/SW VER/RYE/KENT/TIM...................... 11
GRANISETRON HCL.......................................... 11, 51, 57
GRANIX......................................................................30, 60
GRANULEX..................................................................... 23
GRASS POLLEN-TIMOTHY, STANDARD....................11
GRASTEK...................................................................11, 60
GRISEOFULVIN...............................................................32
GRISEOFULVIN, MICROSIZE....................................... 32
GRX RINSE-FREE(OTC).................................................23
GUAIFENESIN................................................................. 20
GUAIFENESIN/DEXTROMETHORPHAN.................... 20
GUAIFENESIN/PHENYLEPHRINE HCL...................... 20
GUANFACINE HCL................................................... 16, 17
GUANFACINE HCL ER.............................................16, 51
GUANIDINE HCL............................................................ 36
GYNAZOLE 1...................................................................43
-HHALDOL DECANOATE 50............................................. 15
HALOBETASOL PROPIONATE..................................... 21
HALOPERIDOL............................................................... 15
HALOPERIDOL DECANOATE...................................... 15
HALOPERIDOL LACTATE............................................. 15
HARVONI................................................................... 34, 60
HC/MINERAL OIL/PETROLAT,WHT............................ 21
HCU COOLER............................................................39, 60
HCU LOPHLEX..........................................................39, 60
HCY 2..........................................................................39, 60
HEALTHY ACCENTS AUTOLET(OTC) ........................ 25
HEMATINIC PLUS...........................................................44
HEMATINIC WITH FOLIC ACID...................................44
HEMATOGEN.................................................................. 44
HEMENATAL OB.............................................................46
HEMENATAL OB + DHA................................................46
HEMETAB........................................................................ 44
HEPARIN FLUSH.............................................................30
HEPARIN SOD,PORCINE/0.9 % NACL......................... 30
HEPARIN SODIUM..........................................................30
HEPARIN SODIUM,PORCINE....................................... 30
HEPARIN SODIUM,PORCINE/D5W..............................30
HEPARIN SODIUM,PORCINE/NS/PF............................30
HEPARIN SODIUM,PORCINE/PF..................................30
HEPARIN SODIUM-0.9% NACL.................................... 30
HEPARIN SODIUM-D5W................................................30
HETLIOZ.................................................................... 15, 60
HEXALEN........................................................................ 36
HEX-ON LIGHT(OTC).................................................... 22
VNSNY
HIZENTRA................................................................. 30, 60
HOM 2......................................................................... 39, 60
HOMATROPAIRE............................................................ 28
HOMATROPINE HBR......................................................28
HOMINEX-2............................................................... 39, 60
HONEY............................................................................. 23
HPR PLUS.........................................................................22
HPR PLUS-MB HYDROGEL.......................................... 22
HUMALOG KWIKPEN U-100.................................. 26, 51
HUMALOG KWIKPEN U-200.................................. 26, 51
HUMALOG MIX 50-50..............................................26, 51
HUMALOG MIX 50-50 KWIKPEN.......................... 26, 51
HUMALOG MIX 75-25..............................................26, 51
HUMALOG MIX 75-25 KWIKPEN.......................... 26, 51
HUMALOG(CARTRIDGE)........................................26, 51
HUMALOG(VIAL).....................................................26, 51
HUMULIN 70/30 KWIKPEN(OTC).......................... 26, 51
HUMULIN 70-30(OTC)..............................................26, 51
HUMULIN N KWIKPEN(OTC).................................26, 51
HUMULIN N(OTC).................................................... 26, 51
HUMULIN R U-500....................................................26, 51
HUMULIN R(OTC).................................................... 26, 51
HYALURON SOD/ALLANTOIN/ALOE XT.................. 23
HYALURONATE SODIUM..............................................23
HYDRALAZINE HCL......................................................17
HYDROCERIN(OTC).......................................................22
HYDROCHLOROTHIAZIDE.......................................... 18
HYDROCODONE/ACETAMINOPHEN..........................40
HYDROCODONE-ACETAMINOPHEN(SOLUTION)(10325/15).........................................................................40, 51
HYDROCODONE-ACETAMINOPHEN(SOLUTION)(5163/7.5)........................................................................40, 51
HYDROCODONEACETAMINOPHEN(SOLUTION)(7.5-325/15).........40, 51
HYDROCODONE-ACETAMINOPHEN(TAB)(10MG325MG)........................................................................40, 51
HYDROCODONE-ACETAMINOPHEN(TAB)(5 MG325MG)........................................................................40, 51
HYDROCODONE-ACETAMINOPHEN(TAB)(7.5325MG)........................................................................40, 51
HYDROCORT/PRAMOXIN/EMOL/PRAM#1................35
HYDROCORT/SAL ACID/SULF/SHMP#1.....................21
HYDROCORTISONE........................................... 21, 34, 35
HYDROCORTISONE ACETATE...............................21, 35
HYDROCORTISONE ACETATE(OTC).......................... 21
HYDROCORTISONE ACETATE/UREA.........................21
HYDROCORTISONE BUTYRATE................................. 21
HYDROCORTISONE PROBUTATE............................... 21
HYDROCORTISONE VALERATE.................................. 21
HYDROCORTISONE(OTC).............................................21
HYDROCORTISONE/ALOE VERA............................... 21
HYDROCORTISONE/ALOE/VIT.E/A/D........................ 21
HYDROCORTISONE/IODOQUINOL.............................20
HYDROCORTISONE/LIDOCAINE/ALOE.................... 35
HYDROCORTISONE/OATMEAL/ALOE/E....................21
HYDROCORTISONE/PRAMOXINE........................ 23, 35
HYDROCORTISONE-ACETIC ACID.............................26
HYDROCORTISONE-ALOE(OTC).................................21
HYDROCORTISONE-IODOQUINOL............................ 20
HYDROCORTISONE-PRAMOXINE.............................. 35
HYDROCORTISONE-PRAMOXINE HCL..................... 23
HYDROGEN PEROXIDE.................................................23
HYDROGEN PEROXIDE(OTC)...................................... 23
HYDROQUINONE........................................................... 23
HYDROQUINONE MICROSPHERES............................ 23
HYDROQUINONE/FERRIC OXIDE...............................23
HYDROXOCOBALAMIN................................................47
HYDROXYCHLOROQUINE SULFATE......................... 32
HYDROXYUREA.............................................................36
HYDROXYZINE HCL......................................................11
HYDROXYZINE PAMOATE........................................... 11
HYOPHEN........................................................................ 31
HYOSCYAMINE SULFATE.............................................42
HYPER-HEAL(OTC)........................................................22
HYPOLANCE(OTC).........................................................25
HYPROMELLOSE........................................................... 28
HYQVIA......................................................................30, 60
-IIBANDRONATE SODIUM...............................................27
IBRANCE....................................................................37, 60
IBRUTINIB....................................................................... 37
IBUPROFEN..................................................................... 35
IBUPROFEN(OTC)...........................................................35
ICAPS MV(OTC).............................................................. 45
ICAPS(OTC)..................................................................... 45
ICAR-C PLUS................................................................... 46
ICATIBANT ACETATE.................................................... 34
ICLUSIG(TAB)(15 MG)....................................... 37, 51, 60
ICLUSIG(TAB)(45 MG)....................................... 37, 51, 60
ICOSAPENT ETHYL....................................................... 18
IDELALISIB..................................................................... 37
IGG/HYALURONIDASE,RECOMBINANT................... 30
ILEVRO.............................................................................27
ILOPERIDONE.................................................................15
ILOPROST TROMETHAMINE....................................... 18
IMATINIB MESYLATE................................................... 37
IMATINIB MESYLATE(TAB)(100 MG)............. 37, 51, 60
IMATINIB MESYLATE(TAB)(400 MG)............. 37, 51, 60
IMBRUVICA...............................................................37, 60
IMIPRAMINE HCL.......................................................... 14
IMIPRAMINE PAMOATE................................................14
IMIQUIMOD.........................................................31, 51, 60
IMMULIFE..................................................................39, 60
IMMUN GLOB G (IGG)/GLY/IGA 50+.......................... 30
IMMUN GLOB G(IGG)/PRO/IGA 0-50.......................... 30
IMPACT PEPTIDE 1.5 CAL.......................................39, 60
INATAL ULTRA............................................................... 47
IN-CHECK DIAL(OTC)................................................... 13
IN-CHECK NASAL WITH MASK(OTC)........................13
IN-CHECK ORAL(OTC)..................................................13
INCONTROL LANCING DEVICE(OTC)....................... 25
INCRELEX..................................................................27, 60
INCRUSE ELLIPTA....................................................11, 51
INDAPAMIDE...................................................................18
INDINAVIR SULFATE..................................................... 33
INDOCIN.......................................................................... 35
INDOMETHACIN............................................................ 35
INFANT FORM,FE,LAC-FR,HYPOALR1...................... 38
INFANT FORM,PROPIONIC ACIDEMIA......................38
INFANT FORM. W-IRON LF/DHA/ARA....................... 39
INFANT FORMULA, IRON/DHA/ARA......................... 38
INFUSION SET FOR INSULIN PUMP...........................25
INGENOL MEBUTATE....................................................23
INHALER, ASSIST DEVICES.........................................12
INHALER,ASSIST DEVICE,ACCESORY......................12
INLYTA(TAB)(1 MG)...........................................36, 51, 60
INLYTA(TAB)(5 MG)...........................................36, 51, 60
INNOSPIRE ELEGANCE................................................ 13
INNOSPIRE ESSENCE.................................................... 13
INSPIRATION...................................................................13
INSPIRATION ELITE.......................................................13
INSTA-GLUCOSE(OTC)..................................................26
INSULIN GLARGINE,HUM.REC.ANLOG....................26
INSULIN LISPRO.............................................................26
INSULIN LISPRO PROTAMIN/LISPRO.........................26
INSULIN NPH HUM/REG INSULIN HM...................... 26
INSULIN NPH HUMAN ISOPHANE............................. 26
INSULIN PUMP............................................................... 26
INSULIN REGULAR, HUMAN...................................... 26
INTELENCE..................................................................... 33
INTERFERON ALFA-2B,RECOMB................................31
INTERFERON BETA-1A................................................. 37
INTERFERON BETA-1A/ALBUMIN..............................37
INTERMEZZO......................................................15, 51, 57
INTRON A.................................................................. 31, 60
INVEGA SUSTENNA...................................................... 15
INVEGA(TAB ER 24H)(1.5 MG).........................15, 51, 57
INVEGA(TAB ER 24H)(3 MG)............................15, 51, 57
INVEGA(TAB ER 24H)(6 MG)............................15, 51, 57
INVEGA(TAB ER 24H)(9 MG)............................15, 51, 57
INVIRASE(CAP)........................................................ 33, 51
INVIRASE(TAB)........................................................ 33, 51
INVOKAMET....................................................... 24, 51, 57
INVOKANA.......................................................... 24, 51, 57
IODINE(OTC)................................................................... 20
IODINE/POTASSIUM IODIDE........................................20
IPECAC............................................................................. 42
IPECAC(OTC)...................................................................42
IPRATROPIUM BROMIDE........................................11, 37
IPRATROPIUM/ALBUTEROL SULFATE...................... 12
IPRATROPIUM-ALBUTEROL........................................12
IPRIVASK............................................................. 30, 51, 60
IRBESARTAN...................................................................17
IRBESARTAN/HYDROCHLOROTHIAZIDE.................17
IRBESARTAN-HYDROCHLOROTHIAZIDE.................17
IRESSA........................................................................37, 60
IRON 100 PLUS(OTC)..................................................... 44
IRON AG&FUM/C/FA/MV CMB11/CA-T......................44
IRON AG/C/B12/CA/SUC.ACID/STOM......................... 44
IRON ASPGLY&PS/C/B12/FA/CA/SUC......................... 44
IRON ASPGLY,PS/C/SUCCINIC ACID .......................... 44
IRON ASPGLY/C/B12/FA/CA-TH/SUC..........................44
IRON BG,PS/VITC/B12/FA/CALCIUM.......................... 44
IRON CARB,GL/FA/B12/C/DOCUSATE........................ 44
IRON FUM & AG/C/B12/FA/CA/SUCC..........................44
IRON FUM & PS CMP/FA/VIT C/B3..............................44
IRON FUM&POLYSAC#1/FA/MV NO.18...................... 44
IRON FUM,PS/FA/VIT B WITH C #9............................. 44
IRON FUMARATE/VIT C/VIT B12/FA.......................... 44
IRON POLYSAC/IRON HEME/FA/B12.......................... 44
IRON POLYSACCHARIDE COMPLEX......................... 44
IRON PS CMPLX/VIT B12/FA........................................ 44
IRON, CARBONYL/FA/C/B-6/B12/ZN...........................44
IRON,CARB/DSS/B12IF/FA/MV-MN............................. 44
Page 68 of 75
Index
IRON,CARB/FA#6/MV, MIN NO.41............................... 44
IRON,CARBONYL/VIT C/VIT B12/FA....................44, 46
IRON/FA/B12/C/DOCUSATE SODIUM......................... 44
IRON/FA/VIT BCOMP,C/MINERALS............................ 44
IRON/LIVER EXT/VIT BCOMP,C/MIN......................... 44
IRON/MV,STRESS FORM............................................... 44
ISENTRESS...................................................................... 33
ISOCARBOXAZID...........................................................14
ISONIAZID....................................................................... 32
ISOPROPYL-WINTERGREEN(OTC)............................. 22
ISORDIL............................................................................19
ISOSORB DINIT/HYDRALAZINE HCL........................18
ISOSORBIDE DINITRATE..............................................19
ISOSORBIDE MONONITRATE......................................19
ISOSORBIDE MONONITRATE ER................................19
ISOSOURCE 1.5 CAL................................................ 38, 60
ISOTRETINOIN................................................................20
ISOXSUPRINE HCL........................................................ 19
ISRADIPINE..................................................................... 17
ITRACONAZOLE.............................................................32
IV ANTISEPTIC WIPES(OTC)........................................22
IV PREP WIPES(OTC)..................................................... 22
IVACAFTOR..................................................................... 39
IVERMECTIN...................................................................32
I-VITE(OTC)..................................................................... 43
IXAZOMIB CITRATE......................................................37
-JJAKAFI..................................................................36, 51, 60
JANUMET...................................................................24, 51
JANUMET XR(TBMP 24HR)(100-1000MG)............24, 51
JANUMET XR(TBMP 24HR)(50-1000 MG).............24, 51
JANUMET XR(TBMP 24HR)(50MG-500MG)......... 24, 51
JANUVIA.................................................................... 24, 51
JARDIANCE......................................................... 24, 51, 57
JENTADUETO............................................................ 24, 51
JEVITY 1.2 CAL.........................................................38, 60
JINTELI.............................................................................30
J-TAN PD(OTC)................................................................ 11
JUXTAPID...................................................................18, 60
-KKALETRA(SOLUTION)............................................ 33, 51
KALETRA(TAB)(100MG-25MG)............................. 33, 52
KALETRA(TAB)(200MG-50MG)............................. 33, 52
KALYDECO................................................................39, 60
KELNOR 1-35...................................................................19
KEPPRA............................................................................ 41
KEPPRA XR..................................................................... 41
KETEK.............................................................................. 31
KETOCAL 3:1.............................................................39, 60
KETOCAL 4:1.............................................................38, 60
KETOCONAZOLE..................................................... 20, 32
KETO-DIASTIX REAGENT(OTC)................................. 26
KETOPROFEN..................................................................35
KETOROLAC TROMETHAMINE............................ 27, 35
KETOVOLVE.............................................................. 39, 60
KEVEYIS.................................................................... 42, 60
KHEDEZLA.......................................................... 14, 52, 57
KIONEX............................................................................ 26
KLONOPIN.......................................................................41
KONSYL(OTC).................................................................36
KORLYM.................................................................... 24, 60
KRISTALOSE................................................................... 35
KYNAMRO................................................................. 18, 60
-LLABETALOL HCL........................................................... 16
LACOSAMIDE................................................................. 41
LACTIC ACID.................................................................. 22
LACTOSE-REDUCED FOOD......................................... 38
LACTOSE-REDUCED FOOD/FIBER............................. 38
LACTULOSE.................................................................... 35
LAMICTAL....................................................................... 41
LAMICTAL (BLUE)......................................................... 41
LAMICTAL (GREEN)...................................................... 41
LAMICTAL (ORANGE)...................................................41
LAMICTAL ODT..............................................................41
LAMICTAL ODT (BLUE)................................................41
LAMICTAL ODT (GREEN).............................................41
LAMICTAL ODT (ORANGE)......................................... 41
LAMICTAL XR (BLUE)............................................ 41, 57
LAMICTAL XR (GREEN)......................................... 41, 57
LAMICTAL XR (ORANGE)...................................... 41, 57
LAMISIL........................................................................... 32
LAMISIL(OTC).................................................................21
LAMIVUDINE............................................................33, 34
LAMIVUDINE HBV........................................................ 34
LAMIVUDINE(SOLUTION)..................................... 33, 52
LAMIVUDINE(TAB)(150 MG)................................. 33, 52
LAMIVUDINE(TAB)(300 MG)................................. 33, 52
LAMIVUDINE/ZIDOVUDINE........................................ 33
LAMIVUDINE-ZIDOVUDINE..................................33, 52
LAMOTRIGINE................................................................41
LANCET DEVICE(OTC)................................................. 25
VNSNY
LANCING DEVICE..........................................................25
LANCING DEVICE(OTC)............................................... 25
LANCING DEVICE/LANCETS.................................25, 26
LANCING SYSTEM(OTC).............................................. 25
LANOLIN ALCOHOL/MO/W.PET/CERES....................22
LANOLIN/ALOE VERA/PROP GLY.............................. 22
LANOLIN/MIN OIL/PETROLAT,WHT.......................... 29
LANSOPRAZOL-AMOXICIL-CLARITHRO........... 42, 52
LANSOPRAZOLE............................................................ 43
LANSOPRAZOLE(OTC)................................................. 43
LANSOPRAZOLE/AMOXICILN/CLARITH..................42
LANTUS......................................................................26, 52
LANTUS SOLOSTAR................................................ 26, 52
LANZO(OTC)................................................................... 25
LAPATINIB DITOSYLATE..............................................37
LATANOPROST............................................................... 28
LATRIX............................................................................. 23
LATUDA(TAB)(120 MG)..................................... 15, 52, 57
LATUDA(TAB)(20 MG)....................................... 15, 52, 57
LATUDA(TAB)(40 MG)....................................... 15, 52, 57
LATUDA(TAB)(60 MG)....................................... 15, 52, 57
LATUDA(TAB)(80 MG)....................................... 15, 52, 57
LC D NEBULIZER SET................................................... 13
LC PLUS........................................................................... 13
LC SPRINT NEBULIZER................................................ 13
LEDIPASVIR/SOFOSBUVIR.......................................... 34
LEFLUNOMIDE...............................................................34
LENALIDOMIDE............................................................. 36
LENVATINIB MESYLATE.............................................. 37
LENVIMA...................................................................37, 60
LETAIRIS....................................................................18, 60
LETROZOLE.................................................................... 36
LEUCOVORIN CALCIUM.............................................. 37
LEU-FREE COOLER................................................. 39, 60
LEUKINE.................................................................... 30, 60
LEUPROLIDE ACETATE.................................................27
LEVALBUTEROL HCL................................................... 12
LEVETIRACETAM.......................................................... 41
LEVOBUNOLOL HCL.....................................................28
LEVOCETIRIZINE DIHYDROCHLORIDE................... 11
LEVOCETIRIZINE DIHYDROCHLORIDE(SOLUTION)
............................................................................... 11, 52, 57
LEVOCETIRIZINE DIHYDROCHLORIDE(TAB)......... 11
LEVOFLOXACIN.......................................................28, 32
LEVOMILNACIPRAN HYDROCHLORIDE.................. 14
LEVONORGESTREL.......................................................19
LEVONORGESTREL-ETHIN ESTRADIOL.................. 19
LEVORA-28...................................................................... 19
LEVOTHYROXINE SODIUM......................................... 27
LEXAPRO......................................................................... 14
LEXIVA............................................................................. 33
LICE KILLING(OTC).......................................................21
LIDOCAINE......................................................................23
LIDOCAINE HCL.......................................................23, 35
LIDOCAINE HCL VISCOUS.......................................... 35
LIDOCAINE HCL/COLLAGEN...................................... 23
LIDOCAINE/HYDROCORTISONE AC....................23, 35
LIDOCAINE/PRILOCAINE.............................................23
LIDOCAINE-HYDROCORTISONE.......................... 23, 35
LIDOCAINE-PRILOCAINE............................................ 23
LINACLOTIDE................................................................. 35
LINAGLIPTIN.................................................................. 24
LINAGLIPTIN/METFORMIN HCL................................ 24
LINDANE..........................................................................21
LINEZOLID...................................................................... 31
LINZESS..................................................................... 35, 52
LIOTHYRONINE SODIUM.............................................27
LIPASE/PROTEASE/AMYLASE.....................................42
LIQUID BANDAGE(OTC)............................................... 23
LISDEXAMFETAMINE DIMESYLATE.........................14
LISINOPRIL......................................................................17
LISINOPRIL/HYDROCHLOROTHIAZIDE....................16
LISINOPRIL-HYDROCHLOROTHIAZIDE................... 16
LITE TOUCH(OTC)......................................................... 25
LITEAIRE......................................................................... 12
LITETOUCH..................................................................... 12
LITHIUM.......................................................................... 15
LITHIUM CARBONATE..................................................15
LITHIUM CITRATE......................................................... 15
LITHOBID........................................................................ 15
LMD............................................................................ 38, 60
L-NORGEST/E.ESTRADION-E.ESTRAD......................19
LO LOESTRIN FE............................................................ 19
LODOXAMIDE TROMETHAMINE............................... 28
LOESTRIN........................................................................ 19
LOMITAPIDE MESYLATE............................................. 18
LONSURF................................................................... 36, 60
LOPERAMIDE..................................................................35
LOPERAMIDE HCL.........................................................35
LOPERAMIDE(CAP)(OTC).............................................35
LOPERAMIDE(LIQUID)(OTC).......................................35
LOPINAVIR/RITONAVIR................................................ 33
LORATADINE.................................................................. 11
LORATADINE(OTC)........................................................11
LORATADINE/PSEUDOEPHEDRINE........................... 11
LOSARTAN POTASSIUM............................................... 17
LOSARTAN/HYDROCHLOROTHIAZIDE.....................17
LOSARTAN-HYDROCHLOROTHIAZIDE.................... 17
LOTEMAX........................................................................ 27
LOTEPREDNOL ETABONATE.......................................27
LOUTREX.........................................................................21
LOVASTATIN....................................................................18
LOXAPINE....................................................................... 15
LOXAPINE SUCCINATE.................................................15
LUBIPROSTONE..............................................................35
LUBRICANT EYE(OTC)................................................. 28
LUMACAFTOR/IVACAFTOR.........................................39
LUMIGAN.................................................................. 28, 52
LUNESTA................................................................... 15, 52
LURASIDONE HCL.........................................................15
LYNPARZA...........................................................37, 52, 60
LYSIPLEX PLUS(OTC)....................................................45
-MM9(OTC)........................................................................... 22
MACITENTAN................................................................. 18
MAFENIDE ACETATE.................................................... 21
MAG HYDROX/AL HYDROX/SIMETH........................ 42
MAGNEBIND 400 RX..................................................... 26
MAGNESIUM...................................................................44
MAGNESIUM HYDROXIDE.......................................... 35
MAGNESIUM OXIDE......................................................44
MAGNESIUM OXIDE(OTC)........................................... 44
MAGNESIUM(OTC)........................................................ 44
MALTODEXTRIN............................................................ 38
MANNITOL/SORBITOL SOLUTION............................ 22
MAPAP(OTC)................................................................... 40
MAPROTILINE HCL........................................................14
MARAVIROC....................................................................33
MARNATAL-F.................................................................. 46
MARPLAN........................................................................14
MECASERMIN.................................................................27
MECHLORETHAMINE HCL..........................................23
MECLIZINE HCL.............................................................11
MECLIZINE HCL(OTC).................................................. 11
MECLOFENAMATE SODIUM....................................... 35
MEDIHONEY(OTC).........................................................23
MEDROL...........................................................................34
MEDROXYPROGESTERONE ACETATE................ 19, 30
MEFLOQUINE HCL........................................................ 32
MEGA MULTI(OTC)........................................................45
MEGA MULTIVITAMIN(OTC).......................................45
MEGESTROL ACETATE................................................. 37
MEKINIST.................................................................. 37, 61
MELOXICAM...................................................................35
MELPAQUE HP................................................................ 23
MELPHALAN...................................................................36
MEMANTINE HCL....................................................13, 14
MEMANTINE HCL(SOLUTION)............................. 13, 52
MEMANTINE HCL(TAB DS PK)............................. 13, 52
MEMANTINE HCL(TAB)..........................................14, 52
MEMANTINE HCL/DONEPEZIL HCL..........................14
MENEST........................................................................... 30
MEN'S BIOMULTIPLE(OTC)..........................................45
MEPHYTON..................................................................... 30
MERCAPTOPURINE....................................................... 36
MESALAMINE.................................................................35
MESALAMINE W/CLEANSING WIPES....................... 35
MESTINON.......................................................................14
METAMUCIL MULTIHEALTH FIBER(OTC)................36
METAMUCIL SUGAR-FREE(OTC)............................... 36
METAMUCIL(OTC)......................................................... 36
METAPROTERENOL SULFATE.....................................12
METFORMIN HCL.......................................................... 24
METHAMPHETAMINE HCL....................................15, 52
METHEN/M-BLUE/SAL/NA PHOS/HYOS....................31
METHEN/SOD PHOS/METH BLUE/HYOS...................31
METHENAM/ME BLUE/BA/SALICY/HYO.................. 31
METHENAMINE HIPPURATE....................................... 31
METHENAMINE MANDELATE.................................... 31
METHIMAZOLE.............................................................. 27
METHIONAID............................................................39, 61
METHOCARBAMOL.......................................................42
METHOTREXATE........................................................... 36
METHOTREXATE SODIUM...........................................36
METHOTREXATE SODIUM/PF..................................... 36
METHOTREXATE/PF...................................................... 34
METHOXSALEN............................................................. 23
METHOXSALEN, RAPID............................................... 23
METHSCOPOLAMINE BROMIDE................................ 42
METHSUXIMIDE............................................................ 41
METHYCLOTHIAZIDE...................................................18
METHYL SALICYLATE................................................. 22
METHYL SALICYLATE(OTC)....................................... 22
METHYL SALICYLATE/ISOPROPANOL..................... 22
Page 69 of 75
Index
METHYLBENZETHONIUM CHLORIDE......................20
METHYLCELLULOSE....................................................35
METHYLDOPA................................................................ 17
METHYLDOPA/HYDROCHLOROTHIAZIDE.............. 17
METHYLDOPA-HYDROCHLOROTHIAZIDE.............. 17
METHYLERGONOVINE MALEATE............................. 19
METHYLPHENIDATE ER(CPBP 50-50)(20 MG)...... 16,
49,
52
49,
52
49,
52
METHYLPHENIDATE ER(TAB ER 24H)(18 MG)...... 16,
49,
52
49,
52
49,
52
49,
52
METHYLPHENIDATE ER(TAB ER)(10 MG)...... 16, 49,
52
METHYLPHENIDATE ER(TAB ER)(20 MG)...... 16, 49,
52
METHYLPHENIDATE HCL............................................16
METHYLPREDNISOLONE............................................ 34
METHYLTESTOSTERONE.......................................30, 61
METIPRANOLOL............................................................ 28
METOCLOPRAMIDE HCL............................................. 43
METOLAZONE................................................................ 18
METOPROLOL SUCCINATE..........................................17
METOPROLOL TARTRATE............................................17
METOPROLOL/HYDROCHLOROTHIAZIDE...............17
METOPROLOL-HYDROCHLOROTHIAZIDE.............. 17
METRELEPTIN................................................................ 27
METRONIDAZOLE............................................. 20, 32, 43
MEXILETINE HCL.......................................................... 16
MG TRISILICATE/ALH/NAHCO3/AA...........................42
MI ACID(OTC)................................................................. 42
MICONAZOLE 3.............................................................. 43
MICONAZOLE 3(OTC)................................................... 43
MICONAZOLE NITRATE......................................... 20, 43
MICONAZOLE NITRATE(OTC).....................................20
MICRO AIR(OTC)............................................................ 13
MICRO ELITE.................................................................. 13
MICRO PLUS....................................................................13
MICROCHAMBER...........................................................12
MICROGESTIN................................................................ 19
MICROGESTIN FE.......................................................... 19
MICROLET 2(OTC)..........................................................25
MICROLIFE PEAK FLOW(OTC)....................................13
MICROSPACER................................................................12
MIDODRINE HCL........................................................... 19
MIFEPRISTONE...............................................................24
MILK BASED FORMULA...............................................38
MILK BASED FORMULA/CORN STARCH.................. 38
MILLIPRED...................................................................... 34
MILLIPRED DP................................................................34
MILNACIPRAN HCL.......................................................37
MINASTRIN 24 FE...........................................................19
MINERAL OIL................................................................. 35
MINERAL OIL(OTC)....................................................... 35
MINERAL OIL, LIGHT/MINERAL OIL........................ 29
MINERAL OIL/LAN OIL/PROP GLY.............................22
MINERAL OIL/PETROLATUM,WHITE.................. 22, 29
MINERALS/PROTEIN SUPPLEMENT.......................... 44
MINI LANCING DEVICE(OTC)..................................... 25
MINI PLUS NEBULIZER................................................ 13
MINICOMP COMPRESSOR NEBULIZER(OTC)..........13
MINIELITE....................................................................... 13
MINILINK REAL-TIME TRANSMITTER..................... 25
MINIMED......................................................................... 25
MINI-WRIGHT PEAK FLOW METER...........................13
MINOCYCLINE HCL...................................................... 32
MINOXIDIL...................................................................... 17
MIO INFUSION SET........................................................25
MIPOMERSEN SODIUM................................................ 18
MIRTAZAPINE.................................................................14
MISOPROSTOL................................................................42
MMA-PA COOLER.................................................... 38, 61
MODAFINIL............................................................... 15, 61
MOEXIPRIL HCL.............................................................17
MOEXIPRIL/HYDROCHLOROTHIAZIDE....................16
MOEXIPRIL-HYDROCHLOROTHIAZIDE................... 16
MOMETASONE FUROATE.......................................11, 21
MOMETASONE/FORMOTEROL....................................12
MONISTAT 3(OTC).......................................................... 43
MONTELUKAST SODIUM.............................................12
MORPHINE SULFATE.....................................................40
MORPHINE SULFATE ER(CAP ER PEL)................40, 52
MORPHINE SULFATE ER(CPMP 24HR)(120 MG)......
40,
52
VNSNY
MORPHINE SULFATE ER(CPMP 24HR)(30 MG)...... 40,
52
52
52
52
52
MORPHINE SULFATE ER(TAB ER)........................ 40, 52
MOTION SICKNESS(OTC)............................................. 11
MOUTHPIECE(OTC)....................................................... 12
MOVANTIK................................................................ 36, 52
MOXEZA.......................................................................... 28
MOXIFLOXACIN HCL..............................................28, 32
MSUD LOPHLEX.......................................................39, 61
MTH/ME BLUE/SOD PHOS/PHEN/HYOS.................... 31
MUCUS CLEARING DEVICE........................................ 12
MULTAQ........................................................................... 16
MULTI FOR HER(OTC)...................................................45
MULTIGEN.......................................................................44
MULTIGEN FOLIC.......................................................... 44
MULTIGEN PLUS............................................................ 44
MULTI-LANCET(OTC)................................................... 25
MULTILEX(OTC).............................................................45
MULTIVIT WITH CALCIUM,IRON,MIN...................... 45
MULTIVIT WITH IRON-MINERALS.......................44, 45
MULTIVIT, IRON, MIN #5, FA....................................... 45
MULTIVIT, MIN CMB#20/IRON/FA.............................. 45
MULTIVIT,CA,IRON,MIN/FA/HRB146......................... 45
MULTIVIT,TX,IRON/CALCM/FA/MINS....................... 45
MULTIVITAL(OTC).........................................................45
MULTIVITAMIN.............................................................. 45
MULTIVITAMIN NO.44/VIT D3/K.................................45
MULTIVITAMIN WITH FLUORIDE..............................46
MULTIVITAMIN WITH IRON........................................ 45
MULTIVITAMIN WITH MINERALS....................... 44, 45
MULTIVITAMIN WITH MINERALS/LUT.................... 44
MULTIVITAMIN,STRESS FORMULA.......................... 45
MULTIVITAMIN,STRESS FORMULA/ZN....................45
MULTIVITAMIN,THER AND MINERALS................... 45
MULTIVITAMIN,THERAPEUTIC..................................45
MULTIVITAMIN/IRON/FOLIC ACID............................ 45
MULTIVITAMIN-MINERALS NO.7/FA.........................45
MULTIVITAMINS W-CALCIUM-IRON(OTC).............. 45
MULTIVITAMINS W-FLUORIDE-IRON....................... 46
MULTIVITAMINS WITH FLUORIDE............................46
MULTIVITAMINS WITH MINERALS(OTC)................ 45
MULTIVITAMINS-A,B,D,E,K,ZN............................ 45, 46
MULTIVIT-MIN/FA/LUTEIN/ZEAXANT...................... 45
MULTIVIT-MIN/FA/LYCOPEN/LUTEIN................. 44, 45
MULTIVIT-MIN/FOLIC ACID/VIT K1...........................45
MULTIVIT-MIN/HERBAL DRUGS................................ 45
MULTIVIT-MIN/IRON/FA/GINSENG............................ 45
MULTIVIT-MIN/IRON/FOLIC/LUTEIN.........................45
MULTIVIT-MINERALS/FA/LYCOPENE....................... 45
MULTIVIT-MINERALS/FOLIC ACID............................45
MULTIVIT-MINERALS/FOLIC/GINKGO..................... 45
MULTIVITS W-IRON,HEMATINIC................................45
MULTIVITS,CA,MIN/IRON/FA/LYCOP........................ 45
MULTIVITS,CA,MINERALS/IRON/FA......................... 45
MULTIVITS,TH W-CA,FE,OTH MIN.............................45
MULTIVITS,TH W-FE,OTHER MIN.............................. 45
MULTIVITS,THERAP W-FE,HEMATIN........................ 45
MUPIROCIN..................................................................... 20
MUPIROCIN CALCIUM............................................20, 37
MV W-CA/IRON/FA/LUTEIN/HRB#179........................ 45
MV, MIN #36/IRON,CARBONYL/FA............................. 44
MV,CA,IRON,MIN/FA/PHYTOSTEROL........................ 45
MV,CA,MIN/IRON FUM/FA/LYCO/LUT....................... 45
MV,CA,MIN/IRON FUM/FA/VIT K................................ 45
MV,CA,MIN/IRON/FA/GUARANA/CAFF..................... 45
MV,CA,MIN/IRON/FA/LYC/LUT/PHYT........................ 45
MV,FE,MIN/GR TEA LFXT............................................ 45
MV,FE,MIN/LUTEIN....................................................... 45
MV,MINERALS/FA/LYCOPENE/GINKGO....................45
MV/GNK BI EX/K.GINSG...............................................45
MVC-FLUORIDE............................................................. 46
MV-MIN/IRON FUM/FA/K/LYCO/LUTN...................... 45
MV-MN/FA/LYCOPENE/LUT/HB#178.......................... 45
MY WAY(OTC).................................................................19
MYALEPT...................................................................27, 52
MYAMBUTOL..................................................................32
MYCOBUTIN................................................................... 32
MYCOPHENOLATE MOFETIL......................................31
MYCOPHENOLATE SODIUM....................................... 31
MYCOPHENOLIC ACID................................................. 31
MYGLUCOHEALTH CONTROL SOLUTION(OTC)......
24
MYNATAL........................................................................ 46
MYNATE 90 PLUS........................................................... 46
MYSOLINE.......................................................................41
-NNABUMETONE................................................................35
NACL IRRIGAT/DECYL GLUCOSIDE..........................22
NADOLOL/BENDROFLUMETHIAZIDE.......................17
NADOLOL-BENDROFLUMETHIAZIDE...................... 17
NAFTIFINE HCL..............................................................21
NAFTIN.............................................................................21
NAIL SCRUB(OTC)......................................................... 23
NALBUPHINE HCL......................................................... 40
NALOXEGOL OXALATE................................................36
NALOXONE HCL............................................................ 15
NALTREXONE HCL........................................................ 15
NALTREXONE MICROSPHERES..................................15
NAMENDA XR(CAP 24 DSPK)................................ 14, 52
NAMENDA XR(CAP SPR 24)................................... 14, 52
NAMZARIC.......................................................... 14, 52, 57
NAPHAZOLINE HCL...................................................... 28
NAPROXEN...................................................................... 35
NAPROXEN SODIUM..................................................... 35
NARCAN.....................................................................15, 52
NASAL AIRFLOW STRIPS............................................. 12
NASAL SPRAY(OTC)...................................................... 20
NASAL STRIPS(OTC)..................................................... 12
NASONEX.................................................................. 11, 52
NATAZIA.......................................................................... 19
NATEGLINIDE................................................................. 24
NATURAL BALANCE TEARS(OTC).............................28
NATURAL BALANCED B-100(OTC).............................47
NATURAL FIBER(OTC).................................................. 36
NATURE-THROID........................................................... 27
NEBIVOLOL HCL............................................................17
NEBULIZER............................................................... 12, 13
NEBULIZER/COMPRESSOR..........................................13
NEBUPENT...................................................................... 32
NECON..............................................................................19
NEDOCROMIL SODIUM................................................ 28
NEFAZODONE HCL........................................................14
NELFINAVIR MESYLATE.............................................. 33
NEO/POLYMYX B SULF/DEXAMETH.........................27
NEOCATE................................................................... 39, 61
NEOCATE INFANT DHA-ARA................................ 38, 61
NEOCATE JUNIOR WITH PREBIOTICS.................39, 61
NEOCATE NUTRA.................................................... 39, 61
NEOMYCIN SU/BACI ZN/POLY/HC............................. 27
NEOMYCIN SU/BACITRA/POLYMYXIN.....................28
NEOMYCIN SU/POLYMYX B SULF.............................22
NEOMYCIN SULFATE.................................................... 32
NEOMYCIN/BACITRA/POLYMYXIN/HC.................... 21
NEOMYCIN/POLYMYXIN B SULF/HC.................. 21, 26
NEOMYCIN/POLYMYXN B/GRAMICIDIN................. 28
NEOMYCIN-BACITRACIN-POLY-HC...........................27
NEOMYCIN-BACITRACIN-POLYMYXIN....................28
NEOMYCIN-POLYMYXIN B......................................... 22
NEOMYCIN-POLYMYXIN-DEXAMETH..................... 27
NEOMYCIN-POLYMYXIN-GRAMICIDIN................... 28
NEOMYCIN-POLYMYXIN-HC...................................... 26
NEOMYCN/BACI ZN/PMYX BS/PRAMOX..................20
NEPAFENAC.................................................................... 27
NEPHPLEX RX................................................................ 47
NEPHRON FA...................................................................44
NEPRO........................................................................ 39, 61
NETUPITANT/PALONOSETRON HCL......................... 11
NEULASTA.................................................................30, 61
NEUPOGEN................................................................30, 61
NEUPRO............................................................... 41, 52, 57
NEURIN-SL...................................................................... 47
NEVANAC.........................................................................27
NEVIRAPINE................................................................... 33
NEVIRAPINE(ORAL SUSP)..................................... 33, 52
NEVIRAPINE(TAB)................................................... 33, 52
NEW SKIN(OTC)............................................................. 23
NEWGEN.......................................................................... 47
NEXAFED(OTC).............................................................. 20
NEXAVAR.............................................................37, 52, 61
NEXIUM............................................................... 43, 52, 57
NIACIN....................................................................... 18, 19
NIACIN ER................................................................. 18, 57
NIACIN(OTC)................................................................... 19
NIACIN/SIMVASTATIN...................................................18
NICARDIPINE HCL.........................................................17
NICODERM CQ(OTC)..................................................... 42
NICORETTE(OTC)...........................................................42
NICOTINE.........................................................................42
NICOTINE POLACRILEX...............................................42
NIFEDIPINE..................................................................... 17
NIFEDIPINE ER............................................................... 17
NIGHTTIME SLEEP AID(OTC)......................................15
NILANDRON..............................................................36, 52
NILOTINIB HCL.............................................................. 37
NILUTAMIDE...................................................................36
NIMODIPINE....................................................................17
Page 70 of 75
Index
NINLARO................................................................... 37, 61
NINTEDANIB ESYLATE................................................ 39
NITRO-BID....................................................................... 19
NITRO-DUR..................................................................... 19
NITROFURANTOIN........................................................ 31
NITROFURANTOIN MACROCRYSTAL....................... 31
NITROFURANTOIN MONOHYD/M-CRYST................31
NITROFURANTOIN MONO-MACRO........................... 31
NITROGLYCERIN........................................................... 19
NITROGLYCERIN PATCH.............................................. 19
NITROSTAT...................................................................... 19
NIVA-HIST DM(OTC)......................................................20
NIZATIDINE.....................................................................43
NOHIST-DM(OTC)...........................................................20
NORA-BE..........................................................................19
NORDITROPIN FLEXPRO........................................27, 61
NORELGESTROMIN/ETHIN.ESTRADIOL.................. 19
NORETH-ETHINYL ESTRADIOL/IRON...................... 19
NORETHINDRONE......................................................... 19
NORETHINDRONE ACETATE....................................... 30
NORETHINDRONE AC-ETH ESTRADIOL.............19, 30
NORETHINDRONE-E.ESTRADIOL-IRON................... 19
NORETHINDRONE-ETHINYL ESTRAD...................... 19
NORETHINDRONE-MESTRANOL............................... 19
NORETHIN-ETH ESTRA FERROUS FUM....................19
NORGESTIMATE-ETHINYL ESTRADIOL...................19
NORGESTREL-ETHINYL ESTRADIOL....................... 19
NORINYL 1+50................................................................ 19
NORMAL SALINE FLUSH............................................. 26
NORPACE CR...................................................................16
NORPRAMIN................................................................... 14
NORTHERA................................................................19, 61
NORTRIPTYLINE HCL................................................... 14
NORVIR(CAP)............................................................33, 52
NORVIR(SOLUTION)................................................33, 52
NORVIR(TAB)............................................................ 33, 52
NOVAMAX PLUS GLU-KET(OTC)................................24
NS COMB1/FOS/INULIN................................................ 38
NUCYNTA.................................................................. 40, 52
NUCYNTA ER............................................................ 40, 52
NUT SUP,GLUCOSE INTOLERANCE #1......................38
NUT TX FOR ISOVALERIC ACIDEMIA....................... 38
NUT TX FOR TYROSINEMIA W-IRON........................ 38
NUT TX IMP.DIGEST FXN,SOY&FIB1.........................38
NUT TX, LACT-REDUCED, IRON................................. 38
NUT TX, SULFITE OX. DEF., IRON.............................. 38
NUT. THERAPY FOR PKU, NO.49................................ 38
NUT. TX FOR PKU WITH IRON #20............................. 38
NUT. TX FOR PKU WITH IRON #3............................... 38
NUT. TX FOR PKU WITH IRON #4............................... 38
NUT. TX FOR PKU WITH IRON, #26............................ 38
NUT. TX FOR PKU, #46.................................................. 38
NUT. TX FOR PROPIONIC ACIDEMIA........................ 38
NUT.SOY,LACFREE/FOS/DHA/EPA/IN.........................38
NUT.TX KETOGENIC,MILK-BASE/SOY......................38
NUT.TX,IMPAIRED RENAL FXN,WHEY.....................39
NUT.TX,METAB.DIS,LEUCINE-FREE..........................39
NUT.TX,METABOLIC DIS,METHIO-FR.......................39
NUT.TX. METABOLIC DISORDER,REG...................... 39
NUT.TX. METABOLIC DISORDER,SOY...................... 39
NUT.TX., UREA CYCLE DISORDER............................ 39
NUT.TX.,ELEMENTAL,LAC-FREE/MCT......................39
NUT.TX.COMP. IMMUNE SYSTM,REG....................... 39
NUT.TX.COMP. IMMUNE SYSTM,SOY....................... 39
NUT.TX.GLU INT/FOS/DHA.......................................... 39
NUT.TX.GLUC INTOL,LF,SOY/FIBER..........................39
NUT.TX.GLUC.INTOLER,LAC-FR,SOY....................... 39
NUT.TX.GLUCOSE INTOLERANCE,SOY....................39
NUT.TX.IMP.RENAL FXN,LAC-FREE.......................... 39
NUT.TX.IMPAIRED DIGEST FXN.................................39
NUT.TX.IMPAIRED DIGEST FXN,SOY........................ 39
NUT.TX.IMPAIRED DIGEST/FIBER............................. 39
NUT.TX.IMPAIRED HEPATIC FXN............................... 39
NUT.TX.IMPAIRED RENAL FXN,SOY......................... 39
NUT.TX.PULM.DISORD.REG,LAC-FR......................... 39
NUT.TX.PULM.DISORD.SOY,LAC-FR..........................39
NUTREN 1.5 FIBER...................................................38, 61
NUTREN JUNIOR......................................................38, 61
NUTREN JUNIOR FIBER..........................................38, 61
NUTRIHEAL.............................................................. 38, 61
NUTRIHEP..................................................................39, 61
NUTRIT SUPP/INULIN/FOS/FIBER.............................. 38
NUTRIT.THERAPY, MSUD WITH IRON...................... 39
NUTRITIONAL SHAKE............................................ 38, 61
NUTRITIONAL SHAKE PLUS................................. 38, 61
VNSNY
NUTRITIONAL SUPPLEMENT......................................38
NUTRITIONAL SUPPLEMENT/FIBER......................... 38
NUTRITIONAL TX, KETOGENIC,MILK...................... 39
NUTRITIONAL TX, KETOGENIC,WHEY.................... 39
NUTRIVENT 1.5........................................................ 39, 61
NUVARING.................................................................19, 52
NYMALIZE................................................................ 17, 61
NYSTATIN.................................................................. 21, 32
NYSTATIN/TRIAMCIN................................................... 21
NYSTATIN-TRIAMCINOLONE..................................... 21
-OOA 1.............................................................................38, 61
OA2..............................................................................38, 61
OBSTETRIX DHA............................................................46
O-CAL PRENATAL.......................................................... 47
OCELLA......................................................................19, 57
OCUTABS(OTC)...............................................................45
ODEFSEY................................................................... 34, 52
ODOR ELIMINATOR DROPS(OTC)...............................22
OFEV...........................................................................39, 61
OFLOXACIN...............................................................28, 32
OLANZAPINE.................................................................. 15
OLANZAPINE PAMOATE...............................................15
OLANZAPINE/FLUOXETINE HCL............................... 15
OLANZAPINE-FLUOXETINE HCL......................... 15, 52
OLAPARIB........................................................................37
OLEPTRO ER....................................................... 14, 52, 57
OLMESARTAN MEDOXOMIL.......................................17
OLMESARTAN/HYDROCHLOROTHIAZIDE...............17
OLODATEROL HCL........................................................ 12
OLOPATADINE HCL..................................... 11, 27, 52, 57
OM-3/CALCIUM/D3/FA/MV CMB 13............................45
OM-3/DHA/EPA/B12/FA/B6/PHYTOST......................... 45
OMACETAXINE MEPESUCCINATE............................. 37
OMEGA-3 ACID ETHYL ESTERS........................... 18, 52
OMEPRAZOLE................................................................ 43
OMEPRAZOLE(OTC)...................................................... 43
OMNIPOD.........................................................................26
ON CALL EXPRESS CONTROL SOLN(OTC).............. 24
ON CALL LANCING DEVICE(OTC)............................. 25
ON CALL PLUS LANCING DEVICE(OTC).................. 25
ONDANSETRON..............................................................11
ONDANSETRON HCL.....................................................11
ONDANSETRON HCL(SOLUTION)........................ 11, 52
ONDANSETRON HCL(TAB).......................................... 11
ONDANSETRON ODT.................................................... 11
ONE DAILY 50 PLUS(OTC)............................................ 44
ONE DAILY ESSENTIAL(OTC)..................................... 45
ONE DAILY FOR WOMEN(OTC).................................. 45
ONE STEP PERINEAL(OTC).......................................... 23
ONE WAY MOUTHPIECE(OTC).................................... 12
ONE-A-DAY MEN'S(OTC).............................................. 45
ONE-A-DAY WOMEN'S(OTC)....................................... 45
ONETOUCH DELICA(OTC)........................................... 25
ONETOUCH PING........................................................... 26
ONETOUCH SURESOFT(OTC)......................................25
ONFI(ORAL SUSP)..............................................41, 52, 57
ONFI(TAB)............................................................41, 52, 57
OPSUMIT....................................................................18, 61
OPTICHAMBER...............................................................12
OPTICHAMBER DIAMOND.......................................... 12
ORALAIR....................................................................11, 61
ORANGE JUICE...............................................................38
ORAP.................................................................................15
ORENCIA....................................................................34, 61
ORENITRAM ER....................................................... 18, 61
ORKAMBI.................................................................. 39, 61
ORPHENADRINE CITRATE...........................................42
ORTHO EVRA............................................................19, 52
ORTHO-NOVUM..............................................................19
OS 2............................................................................. 38, 61
OSELTAMIVIR PHOSPHATE......................................... 33
OSIMERTINIB MESYLATE............................................37
OSTOMY SUPPLY........................................................... 22
OTEZLA...................................................................... 34, 61
OXANDROLONE....................................................... 30, 61
OXAPROZIN.....................................................................35
OXCARBAZEPINE.......................................................... 41
OXSORALEN................................................................... 23
OXTELLAR XR(TAB ER 24H)(150 MG)........... 41, 52, 57
OXYBENZONE/OCTINOX/H-QUINONE......................23
OXYBUTYNIN CHLORIDE............................................43
OXYCODONE HCL......................................................... 40
OXYCODONE HCL/ACETAMINOPHEN...................... 40
OXYCODONE-ACETAMINOPHEN.........................40, 52
OXYCONTIN..............................................................40, 52
OXYMETAZOLINE HCL................................................ 20
OYSTER SHELL CALCIUM W-VIT D(OTC).......... 43, 44
-PPAIRE OB PLUS DHA..................................................... 46
PALBOCICLIB................................................................. 37
PALIPERIDONE............................................................... 15
PALIPERIDONE PALMITATE.........................................15
PALIVIZUMAB................................................................ 33
PAMELOR.........................................................................14
PANCRELIPASE 5,000.....................................................42
PANDA MASK(OTC)....................................................... 12
PANDEL............................................................................21
PANOBINOSTAT LACTATE............................................37
PANTOPRAZOLE SODIUM............................................43
PANTOTHENIC ACID/ALOE VERA ..............................22
PAPAVERINE HCL...........................................................19
PARADIGM REAL-TIME................................................24
PARI LC SPRINT SINUS................................................. 13
PARI SINUS AEROSOL SYSTEM.................................. 13
PARICALCITOL...............................................................27
PARNATE..........................................................................14
PAROMOMYCIN SULFATE............................................32
PAROXETINE HCL..........................................................14
PAROXETINE MESYLATE............................................. 14
PARVA-CAL 500(OTC).................................................... 43
PASER............................................................................... 32
PAXIL................................................................................14
PAXIL CR..........................................................................14
PAZOPANIB HCL.............................................................37
PCE.................................................................................... 31
PEAK FLOW METER...................................................... 13
PEAK FLOW METER/INH ASST DEV..........................13
PEAK-AIR(OTC).............................................................. 13
PED MULTIVIT #46/IRON SULFATE............................ 46
PED MV A,C,D3 #21 W-FLUORIDE.............................. 46
PED MV A,C,D3 #38 W-FLUORIDE.............................. 46
PEDI M.VIT NO.17 WITH FLUORIDE.......................... 46
PEDI MULTIVIT #65/VIT D3/VIT K.............................. 46
PEDI MULTIVIT NO.2 W-FLUORIDE........................... 46
PEDI MULTIVITS A,C,&D3 NO.21................................46
PEDI MV #45/FLUORIDE/IRON.................................... 46
PEDI MV #75/FLUORIDE/IRON.................................... 46
PEDI MV NO.83 WITH FLUORIDE............................... 46
PEDI MV NO.84 WITH FLUORIDE............................... 46
PEDI MVI NO.12/SODIUM FLUORIDE........................ 46
PEDI MVI NO.16 WITH FLUORIDE..............................46
PEDI MVI NO.82 WITH FLUORIDE..............................46
PEDI NUTRIT.,SOY,IRON,LF/FIBER............................. 38
PEDIASMART ORGANIC DAIRY............................38, 61
PEDIASURE 1.5......................................................... 38, 61
PEDIASURE 1.5 WITH FIBER..................................38, 61
PEDIASURE PEPTIDE 1.5 CAL............................... 38, 61
PEDIASURE SIDEKICKS......................................... 38, 61
PEDIATRIC MULTIVITAMIN NO.20.............................46
PEDIATRIC NUT,MILK BASED,IRON.......................... 38
PEDIATRIC NUTRIT,IRON,LF&FIBER.........................38
PEDIATRIC NUTRITION, IRON, LF..............................38
PEDIATRIC PANDA MASK(OTC)..................................12
PEG 3350/NA SULF,BICARB,CL/KCL.......................... 36
PEGANONE......................................................................41
PEGASYS....................................................................34, 61
PEGASYS PROCLICK............................................... 34, 61
PEGFILGRASTIM............................................................30
PEGINTERFERON ALFA-2A..........................................34
PEGINTERFERON ALFA-2B..........................................36
PENICILLAMINE............................................................ 34
PENICILLIN G BENZATHINE........................................31
PENICILLIN V POTASSIUM.......................................... 31
PENLET PLUS BLOOD SAMPLER(OTC)..................... 25
PENTAMIDINE ISETHIONATE......................................32
PENTOSAN POLYSULFATE SODIUM..........................43
PENTOXIFYLLINE..........................................................29
PEPTAMEN.................................................................38, 61
PEPTAMEN AF.......................................................... 38, 61
PEPTAMEN BARIATRIC...........................................38, 61
PEPTAMEN JUNIOR................................................. 39, 61
PEPTAMEN JUNIOR FIBER..................................... 38, 61
PEPTAMEN OS.......................................................... 39, 61
PEPTINEX DT............................................................ 38, 61
PEPTO-BISMOL TO-GO(OTC).......................................35
PERAMPANEL................................................................. 41
PERATIVE.................................................................. 39, 61
PERFOROMIST.......................................................... 12, 52
PERIANAL CLEANSING(OTC)..................................... 24
PERICLEAN(OTC)...........................................................20
PERIFLEX ADVANCE...............................................38, 61
PERIFLEX JUNIOR................................................... 38, 61
PERIFRESH(OTC)............................................................24
PERINDOPRIL ERBUMINE........................................... 17
PERISCENT(OTC)........................................................... 22
PERMETHRIN..................................................................21
PERMETHRIN(OTC)....................................................... 21
PERPHENAZINE..............................................................15
PERPHENAZINE/AMITRIPTYLINE HCL.....................14
PERPHENAZINE-AMITRIPTYLINE............................. 14
PERSONAL BEST(OTC)................................................. 13
Page 71 of 75
Index
PETROLAT,WHT/MIN OIL/SOD CHL........................... 28
PETROLATUM,WHITE............................................. 22, 23
PEXEVA................................................................ 14, 52, 57
PFD 2........................................................................... 39, 61
PFLEX TRAINER.............................................................13
PHENAZOPYRIDINE HCL............................................. 43
PHENELZINE SULFATE................................................. 14
PHENERGAN................................................................... 11
PHENOBARB/HYOSCY/ATROPINE/SCOP.................. 42
PHENOXYBENZAMINE HCL........................................16
PHENYLADE ESSENTIAL....................................... 38, 61
PHENYLADE RTD PKU 10.......................................38, 61
PHENYLADE60......................................................... 38, 61
PHENYLEPHRINE HCL..................................................28
PHENYLEPHRINE HCL/PROMETH HCL.....................20
PHENYL-FREE 2....................................................... 38, 61
PHENYL-FREE 2HP.................................................. 38, 61
PHENYTEK...................................................................... 41
PHENYTOIN.................................................................... 41
PHENYTOIN SODIUM EXTENDED............................. 41
PHILLIPS' MILK OF MAGNESIA(OTC)........................35
PHOSPHA 250 NEUTRAL.............................................. 43
PHOSPHASAL..................................................................31
PHOSPHORUS #1............................................................ 43
PHYTONADIONE............................................................ 30
PICATO(GEL)(0.015 %)............................................. 23, 52
PICATO(GEL)(0.05 %)............................................... 23, 52
PIKO 1(OTC).....................................................................13
PILOCARPINE HCL.................................................. 28, 36
PIMOZIDE........................................................................ 15
PINDOLOL....................................................................... 17
PINK BISMUTH(OTC).................................................... 35
PIOGLITAZONE HCL......................................................24
PIOGLITAZONE HCL/METFORMIN HCL................... 24
PIOGLITAZONE-METFORMIN............................... 24, 57
PIPERONYL BUTOXIDE/PYRETHRINS.......................21
PIRFENIDONE................................................................. 39
PIROXICAM..................................................................... 35
PKU COOLER 10....................................................... 38, 61
PKU LOPHLEX.......................................................... 38, 61
PKU TRIO................................................................... 38, 61
PN VIT.W-O CA #7, IRON,FA,DHA............................... 46
PNV #14/FERROUS FUM/FOLIC ACID........................ 46
PNV #15/IRON FUM,PS/FOLIC ACID........................... 46
PNV #19/IRON PS&HEME/FOLIC/DHA....................... 46
PNV #8/IRON PS CMP,ASPG/FA/DHA.......................... 46
PNV #87/IRON BISGLY/FA/DHA...................................46
PNV 11-IRON FUM-FOLIC ACID-OM3........................ 46
PNV COMBO #22/IRON/FA/OM3/DHA.........................46
PNV COMBO#47/IRON/FA #1/DHA.............................. 46
PNV NO.115/IRON FUMARATE/FA.............................. 46
PNV NO.118/IRON FUMARATE/FA.............................. 46
PNV NO.22/IRON CBN&GLUC/FA/DSS....................... 46
PNV NO.66/IRON,CARBONYL/FA/DHA...................... 46
PNV NO10/IRON FUM&P/FA/OMEGA-3......................46
PNV NO12/IRON,CARB/FA/DSS/OM-3.........................46
PNV W-CA #40/IRON FUM/FA CMB#1.........................46
PNV W-CA NO.37/IRON/FA/OMEGA-3........................ 46
PNV W-CA8/IRON/FA/LMEFOLATE CA...................... 46
PNV WITH CA #68/IRON/FA#1/DHA............................46
PNV WITH CA NO.65/IRON POLY/FA..........................46
PNV WITH CA#74/IRON/FOLIC ACID......................... 46
PNV WITH CA,NO.62/IRON/FA/DHA........................... 46
PNV WITH CA,NO.70/IRON/FA/DHA........................... 46
PNV WITH CA,NO.72/IRON,CARB/FA......................... 46
PNV WITH CA,NO.72/IRON/FA.....................................46
PNV W-O CA NO5/FE FUMARATE/FA......................... 46
PNV W-O IRON/FA/CALCIUM/B6/B12......................... 47
PNV#16/IRON FUM & PS/FA/OM-3...............................46
PNV#21/IRON PS& HEME POLYP/FA.......................... 46
PNV#64/IRON/LMFOLATE/ALGAL/SOY..................... 46
PNV#79/IRON/FA/LMFOLATE CA/DHA...................... 46
PNV,CA,NO.35/IRON/FA/DS/OMEG-3.......................... 46
PNV/FA/B6/CALCIUM CARB/GINGER........................ 47
PNV/FA/B6/CALCIUM PHOS/GINGER.........................47
PNV/FERROUS FUMARATE/DOSS/FA.........................46
PNV/FERROUS FUMARATE/FA/SE.............................. 46
PNV/IRON,CARBONYL/DOCUSATE/FA......................46
PNV100/IRON EDTA&PS/FA/OMEGA3........................ 46
PNV115/IRON FUMARATE/FA/DSS..............................46
PNV119/IRON FUMARATE/FA/DSS..............................46
PNV17/IRON/FA/FISH OIL/DHA/OM............................46
PNV19/IRON BG HC&SUCC-P/FA/OM3.......................46
PNV34/IRON,CARBONYL/FA/DSS/DHA..................... 46
PNV39/IRON FUMARATE/FA/DSS/DHA......................46
PNV53/IRON B-G HCL-P/FA/OMEGA3........................ 46
PNV54/IRON B-G HCL-P/FA/OMEGA3........................ 46
PNV55/IRON BG HC&SUCC-P/FA/OM3.......................46
PNV7/FE ASP GLY/DOCUSATE/FA.............................. 47
VNSNY
PNV81/SOD IRON EDTA& PS/FA/OM3........................ 47
PNV95/FERROUS FUMARATE/FA................................47
PNV-DHA..........................................................................46
PNV-IRON.........................................................................46
PNV-SELECT....................................................................46
POCKET CHAMBER....................................................... 12
POCKET PEAK(OTC)......................................................13
PODOCON-25...................................................................22
PODOFILOX.....................................................................22
PODOPHYLLUM RESIN.................................................22
POLYETHYLENE GLYCOL 3350...................................36
POLYETHYLENE GLYCOL 3350(OTC)........................ 36
POLY-IRON 150 FORTE.................................................. 44
POLYMYXIN B SULF/TRIMETHOPRIM......................28
POLYMYXIN B SUL-TRIMETHOPRIM........................28
POLYVINYL ALCOHOL.................................................28
POLYVINYL ALCOHOL/POVIDONE........................... 28
POLYVITAMIN WITH IRON(OTC)................................46
POLY-VITAMIN(OTC)..................................................... 46
POMALIDOMIDE............................................................ 36
POMALYST................................................................ 36, 61
PONATINIB HCL............................................................. 37
PORTAGEN.................................................................38, 61
POT CHLORIDE/POT BICARB/CIT AC........................ 26
POTASSIUM BICARBONATE/CIT AC.......................... 26
POTASSIUM CHLORIDE................................................ 26
POTASSIUM CITRATE....................................................43
POTASSIUM CITRATE ER..............................................43
POTASSIUM CITRATE/CITRIC ACID...........................43
POTASSIUM HYDROXIDE.............................................22
POTASSIUM IODIDE...................................................... 27
POTASSIUM IODIDE/IODINE........................................27
POTIGA(TAB)(200 MG)...................................... 41, 52, 58
POTIGA(TAB)(300 MG)...................................... 41, 52, 58
POTIGA(TAB)(400 MG)...................................... 41, 52, 58
POTIGA(TAB)(50 MG)........................................ 41, 52, 58
POVIDONE-IODINE........................................................ 23
POVIDONE-IODINE(OTC)............................................. 23
PR CREAM....................................................................... 23
PR NATAL 400 EC............................................................46
PR NATAL 430..................................................................46
PR NATAL 430 EC............................................................46
PRAMIPEXOLE DI-HCL.................................................41
PRAMIPEXOLE DIHYDROCHLORIDE........................41
PRAMLINTIDE ACETATE.............................................. 24
PRAMOSONE...................................................................23
PRASUGREL HCL........................................................... 30
PRAVASTATIN SODIUM.................................................18
PRAZIQUANTEL............................................................. 32
PRAZOSIN HCL...............................................................17
PRECISION XTRA(OTC).......................................... 24, 25
PRED MILD......................................................................27
PREDNICARBATE...........................................................21
PREDNISOLONE............................................................. 34
PREDNISOLONE ACETATE...........................................27
PREDNISOLONE SOD PHOSPHATE...................... 27, 34
PREDNISOLONE SODIUM PHOSPHATE...............27, 34
PREDNISONE.................................................................. 34
PREDNISONE INTENSOL..............................................34
PREMARIN.................................................................30, 43
PREMPHASE....................................................................30
PREMPRO.........................................................................30
PRENA1 CHEW................................................................47
PRENAISSANCE..............................................................47
PRENAISSANCE NEXT.................................................. 47
PRENAISSANCE NEXT-B.............................................. 47
PRENAISSANCE PLUS...................................................47
PRENAT VIT COMB.10/IRON/FA/DHA........................ 47
PRENATABS FA............................................................... 47
PRENATAL #57/IRON/FA/DSS/DHA............................. 47
PRENATAL 19.................................................................. 46
PRENATAL 19(OTC)........................................................46
PRENATAL COMB NO.42/FOLIC ACID........................47
PRENATAL NO.13/IRON PS/FA CB#1........................... 47
PRENATAL NO.52/IRON/FA/DHA................................. 47
PRENATAL NO.75/IRON/FOLATE #1............................47
PRENATAL ONE DAILY(OTC).......................................47
PRENATAL PLUS.............................................................46
PRENATAL VIT #76/IRON,CARB/FA............................ 47
PRENATAL VIT 15/IRON CB/FA/DSS........................... 47
PRENATAL VIT NO.109/IRON/FA................................. 47
PRENATAL VIT NO.73/IRON/FA................................... 47
PRENATAL VIT NO.78/IRON/FA................................... 47
PRENATAL VIT#4/IRON FUM,PS/FA............................ 47
PRENATAL VIT#86/IRON BISGLY/FA.......................... 47
PRENATAL VIT#96/FERROUS FUM/FA....................... 47
PRENATAL VIT/IRON BISGLYCIN/FA......................... 47
PRENATAL VIT/IRON FUMARATE/FA........................ 47
PRENATAL VIT27,CALCIUM/IRON/FA........................47
PRENATAL VITAMINS(OTC).........................................47
PRENATAL VITS#4/IRON FUM/FA............................... 47
PRENATAL(OTC).............................................................47
PRENATAL-U................................................................... 46
PRESERVISION AREDS(OTC).......................................43
PREVACID.................................................................. 43, 58
PREVALITE...................................................................... 18
PREZCOBIX............................................................... 33, 52
PREZISTA(ORAL SUSP)...........................................33, 52
PREZISTA(TAB)(150 MG).........................................33, 52
PREZISTA(TAB)(400 MG).........................................33, 52
PREZISTA(TAB)(600 MG).........................................33, 52
PREZISTA(TAB)(75 MG)...........................................33, 52
PREZISTA(TAB)(800 MG).........................................33, 52
PRIFTIN............................................................................ 32
PRIMAQUINE.................................................................. 32
PRIMAQUINE PHOSPHATE...........................................32
PRIMEAIRE......................................................................12
PRIMIDONE..................................................................... 41
PRIMSOL.......................................................................... 31
PRISTIQ ER.......................................................... 14, 52, 58
PROBENECID.................................................................. 29
PROBENECID-COLCHICINE.........................................29
PRO-CAL.................................................................... 39, 61
PROCHAMBER................................................................ 12
PROCHLORPERAZINE...................................................11
PROCHLORPERAZINE MALEATE............................... 11
PROCRIT.....................................................................29, 61
PROCTOFOAM-HC......................................................... 35
PROCTOZONE-HC.......................................................... 35
PROCYSBI.................................................................. 43, 61
PRODIGY LANCING DEVICE(OTC).............................25
PRODIGY MINI-MIST.....................................................13
PRODUCT 3232A....................................................... 38, 61
PROGESTERONE.............................................................30
PROGESTERONE,MICRONIZED...................................30
PROMACTA................................................................30, 61
PROMETHAZINE HCL................................................... 11
PROMETHAZINE VC......................................................20
PROMETHAZINE/DEXTROMETHORPHAN............... 20
PROMETHAZINE-DM.....................................................20
PROMETHEGAN............................................................. 11
PRONEB ULTRA II.......................................................... 13
PROPAFENONE HCL...................................................... 16
PROPANTHELINE BROMIDE........................................42
PROPARACAINE HCL.................................................... 28
PROPARACAINE/FLUORESCEIN SOD........................ 28
PROPRANOLOL HCL..................................................... 17
PROPRANOLOL/HYDROCHLOROTHIAZID...............17
PROPRANOLOL-HYDROCHLOROTHIAZID...............17
PROPYLTHIOURACIL.................................................... 27
PROSED-DS......................................................................31
PROSHIELD FOAM & SPRAY(OTC)............................. 23
PROSIGHT(OTC)............................................................. 44
PROSOURCE.............................................................. 38, 61
PROSOURCE NO CARB........................................... 38, 61
PROSOURCE PLUS................................................... 37, 61
PROSOURCE ZAC..................................................... 38, 61
PROTECT CMB2/CERAMIDE 1,3,6-11..........................23
PROTEIN SUPPLEMENT................................................ 38
PROTRIPTYLINE HCL....................................................14
PROVIMIN(OTC)............................................................. 44
PROZAC............................................................................14
PRUCLAIR........................................................................22
PRUMYX.......................................................................... 22
PRUTECT..........................................................................22
PSEUDOEPHEDRINE HCL.............................................20
PSYLLIUM HUSK........................................................... 36
PSYLLIUM HUSK (WITH SUGAR)...............................36
PSYLLIUM HUSK/ASPARTAME................................... 36
PSYLLIUM SEED............................................................ 36
PSYLLIUM SEED (WITH DEXTROSE)........................ 36
PSYLLIUM SEED (WITH SUGAR)................................36
PSYLLIUM SEED/ASPARTAME.................................... 36
PULMO-AIDE.................................................................. 12
PULMO-AIDE(OTC)........................................................ 12
PULMOCARE.............................................................39, 61
PULMONEB LT COMPRESSOR NEBUL(OTC)............13
PULMOZYME............................................................ 39, 61
PUREFE OB PLUS........................................................... 47
PUREFE PLUS..................................................................47
PURIXAN....................................................................36, 58
PV W-O CAL/IRON PS CPLX/FA................................... 47
PYRAZINAMIDE............................................................. 32
PYRIDOSTIGMINE BROMIDE...................................... 14
PYRIDOXINE HCL.......................................................... 47
PYRIMETHAMINE..........................................................32
-QQNASL.................................................................. 11, 52, 58
Q-TUSSIN DM(OTC)....................................................... 20
Page 72 of 75
Index
Q-TUSSIN(OTC)...............................................................20
QUAKE..............................................................................12
QUARTETTE.................................................................... 19
QUDEXY XR.................................................................... 42
QUETIAPINE FUMARATE............................................. 15
QUFLORA........................................................................ 46
QUICK-SET PARADIGM................................................ 25
QUILLIVANT XR.................................................16, 52, 58
QUINAPRIL HCL............................................................. 17
QUINAPRIL/HYDROCHLOROTHIAZIDE.................... 16
QUINAPRIL-HYDROCHLOROTHIAZIDE....................16
QUINIDINE GLUCONATE..............................................16
QUINIDINE SULFATE.....................................................16
QUININE SULFATE.........................................................32
-RRABEPRAZOLE SODIUM........................................43, 52
RADIAPLEXRX............................................................... 23
RAGWITEK................................................................ 11, 61
RALOXIFENE HCL............................................. 27, 52, 61
RALTEGRAVIR POTASSIUM.........................................33
RAMELTEON................................................................... 15
RAMIPRIL........................................................................ 17
RANEXA(TAB ER 12H)(1000 MG).......................... 19, 52
RANEXA(TAB ER 12H)(500 MG)............................ 19, 52
RANITIDINE HCL........................................................... 43
RANITIDINE HCL(OTC).................................................43
RANOLAZINE..................................................................19
RAPAMUNE..................................................................... 31
RASAGILINE MESYLATE..............................................41
RASUVO(AUTO INJECT)(10MG/0.2ML).......... 34, 52, 58
RASUVO(AUTO INJECT)(12.5/0.25)................. 34, 53, 58
RASUVO(AUTO INJECT)(7.5MG/0.15)............. 34, 53, 58
RAVICTI......................................................................35, 61
REBETOL......................................................................... 34
REBIF.......................................................................... 37, 61
REBIF REBIDOSE..................................................... 37, 61
REFRESH LACRI-LUBE(OTC).......................................29
REFRESH P.M.(OTC)....................................................... 29
REGENECARE.................................................................23
REGORAFENIB............................................................... 37
REGRANEX......................................................................26
REGULOID(OTC)............................................................ 36
RELIAMED MINI LANCING DEVICE(OTC)............... 25
REMERON........................................................................ 14
REMODULIN............................................................. 18, 61
RENA START............................................................. 39, 61
RENAGEL......................................................................... 26
RENALCAL................................................................ 39, 61
RENA-VITE RX................................................................47
RENO CAPS..................................................................... 47
RENVELA.........................................................................26
REPAGLINIDE................................................................. 24
REPAGLINIDE/METFORMIN HCL............................... 24
REPAGLINIDE-METFORMIN HCL............................... 24
REPATHA SURECLICK............................................ 18, 61
REPATHA SYRINGE................................................. 18, 61
REPLETE WITH FIBER............................................ 38, 61
RESCRIPTOR................................................................... 33
RESERPINE...................................................................... 17
RESOURCE DIABETIC TF....................................... 39, 61
RESOURCE DIABETISHIELD................................. 38, 61
RESOURCE THICKENUP.........................................39, 61
RESTASIS................................................................... 28, 53
RESTORE SKIN CLEANSER(OTC)............................... 24
RESTORE SKIN CONDITIONING(OTC)...................... 22
RESTORE WOUND CLEANSER(OTC)......................... 24
REVATIO.....................................................................18, 61
REVEL PROGRAMMABLE PUMP................................ 26
REVITADERM(OTC)....................................................... 20
REVLIMID............................................................36, 53, 61
REYATAZ.......................................................................... 33
RIBASPHERE................................................................... 34
RIBAVIRIN................................................................. 33, 34
RIFABUTIN...................................................................... 32
RIFAMATE........................................................................32
RIFAMPIN........................................................................ 32
RIFAMPIN/ISONIAZID................................................... 32
RIFAPENTINE..................................................................32
RIFAXIMIN...................................................................... 32
RIGHTEST GD500(OTC).................................................25
RILPIVIRINE HCL...........................................................33
RIMANTADINE HCL...................................................... 33
RINGERS IRRIGATION.................................................. 22
RINGERS SOLUTION..................................................... 22
RIOCIGUAT...................................................................... 18
VNSNY
RIOMET............................................................................ 24
RISPERDAL CONSTA..................................................... 15
RISPERDAL(SOLUTION)......................................... 15, 53
RISPERDAL(TAB)..................................................... 15, 53
RISPERIDONE................................................................. 15
RISPERIDONE MICROSPHERES.................................. 15
RITALIN LA......................................................... 16, 49, 53
RITEFLO...........................................................................12
RITONAVIR...................................................................... 33
RIVAROXABAN...............................................................29
RIVASTIGMINE......................................................... 14, 53
RIVASTIGMINE TARTRATE.......................................... 14
RIZATRIPTAN............................................................40, 53
RIZATRIPTAN BENZOATE............................................ 40
R-NATAL OB.................................................................... 46
ROFLUMILAST............................................................... 12
ROPINIROLE HCL...........................................................41
ROSUVASTATIN CALCIUM...........................................18
ROTIGOTINE....................................................................41
ROZEREM............................................................ 15, 53, 58
RUCONEST................................................................ 34, 61
RUFINAMIDE............................................................ 41, 42
RUXOLITINIB PHOSPHATE.......................................... 36
-SSABRIL....................................................................... 42, 53
SACROSIDASE................................................................ 42
SAFYRAL................................................................... 19, 58
SALICYLIC ACID......................................................22, 23
SALICYLIC ACID/CERAMIDE CMB #1....................... 23
SALSALATE.....................................................................40
SAMI THE SEAL..............................................................13
SANDIMMUNE................................................................31
SAPHRIS...............................................................15, 53, 58
SAQUINAVIR MESYLATE............................................. 33
SARAFEM........................................................................ 14
SARGRAMOSTIM........................................................... 30
SAVELLA..........................................................................37
SCALACORT DK............................................................. 21
SCANDISHAKE......................................................... 38, 61
SEA-CLENS(OTC)........................................................... 22
SECUKINUMAB.............................................................. 23
SECURA PROTECTIVE(OTC)........................................22
SELECT-OB...................................................................... 47
SELEGILINE.................................................................... 15
SELEGILINE HCL........................................................... 41
SELENIUM SULFIDE......................................................21
SELEXIPAG...................................................................... 18
SELZENTRY.....................................................................33
SE-NATAL 19....................................................................46
SENNA LAX(OTC).......................................................... 36
SENNOSIDES...................................................................36
SENSI-CARE(OTC)..........................................................22
SENSITIVE SKIN MOISTURE(OTC).............................22
SENTRY SENIOR(OTC).................................................. 45
SEROQUEL.................................................................15, 53
SEROQUEL XR.................................................... 15, 53, 58
SEROSTIM(VIAL)(4 MG)......................................... 27, 61
SEROSTIM(VIAL)(5 MG)......................................... 27, 61
SEROSTIM(VIAL)(6 MG)......................................... 27, 61
SERTRALINE HCL.......................................................... 14
SE-TAN DHA....................................................................46
SE-TAN PLUS...................................................................44
SEVELAMER CARBONATE.......................................... 26
SEVELAMER HCL.......................................................... 26
SIDEROL(OTC)................................................................ 44
SIDESTREAM.................................................................. 13
SIDESTREAM NEBULIZER........................................... 13
SIDESTREAM PEDIATRIC(OTC).................................. 12
SIDESTREAM PLUS....................................................... 13
SILDENAFIL.............................................................. 18, 61
SILDENAFIL CITRATE...................................................18
SILENOR.............................................................. 15, 53, 58
SILICONE DISC(OTC).................................................... 22
SILICONE MASK.............................................................12
SILICONE MASK(OTC).................................................. 12
SILICONE ROLL(OTC)................................................... 22
SILICONE SCAR(OTC)................................................... 22
SILICONE SHEET(OTC)................................................. 22
SILICONE TAPE(OTC).................................................... 22
SILICONES/ADHESIVE TAPE....................................... 22
SILVASORB(OTC)............................................................20
SILVER..............................................................................20
SILVER CHLORIDE........................................................ 20
SILVER GEL(OTC).......................................................... 20
SILVER NITRATE............................................................ 20
SILVER NITRATE APPLICATOR...................................23
SILVER SULFADIAZINE................................................ 21
SILVER/SODIUM ALGINATE........................................ 20
SILVERMED(OTC).......................................................... 20
SIMBRINZA..................................................................... 28
SIMCOR(TBMP 24HR)(1000-20MG)................. 18, 53, 58
SIMCOR(TBMP 24HR)(1000-40 MG)................ 18, 53, 58
SIMCOR(TBMP 24HR)(500MG-20MG)............. 18, 53, 58
SIMPLYTHICK...........................................................39, 61
SIMPONI.....................................................................34, 61
SIMVASTATIN..................................................................18
SIMVASTATIN(TAB)(10 MG)......................................... 18
SIMVASTATIN(TAB)(5 MG)........................................... 18
SIMVASTATIN(TAB)(80 MG)................................... 18, 58
SINGLE USE SWAB(OTC).............................................. 22
SINUS 12 HOUR(OTC).................................................... 20
SIROLIMUS...................................................................... 31
SIRTURO.....................................................................32, 61
SITAGLIPTIN PHOS/METFORMIN HCL...................... 24
SITAGLIPTIN PHOSPHATE............................................24
SIVEXTRO..................................................................31, 61
SKIN CLEANSER............................................................ 24
SKIN CLEANSER COMB NO.20....................................24
SMARTDIABETES VANTAGE(OTC).............................25
SOAP................................................................................. 23
SOD/POT/K CIT/SOD CIT/CIT ACID.............................43
SODIUM BICARBONATE...............................................42
SODIUM BICARBONATE(OTC).................................... 42
SODIUM CHLORIDE.......................................... 22, 26, 28
SODIUM CHLORIDE 0.45 %.......................................... 26
SODIUM CHLORIDE IRRIG SOLUTION..................... 22
SODIUM CHLORIDE(OTC)............................................28
SODIUM CHLORIDE/NAHCO3/KCL/PEG................... 36
SODIUM CITRATE.................................................... 22, 29
SODIUM CITRATE & CITRIC ACID............................. 43
SODIUM FLUORIDE.......................................................44
SODIUM FLUORIDE/POTASSIUM NIT........................44
SODIUM POLYSTYRENE SULFONATE.......................26
SODIUM SULFACETAMIDE.......................................... 21
SODIUM THIOSULFATE/SAL ACID.............................21
SOFOSBUVIR.................................................................. 34
SOFTCLIX(OTC)..............................................................25
SOL CARB..................................................................38, 61
SOLIFENACIN SUCCINATE...........................................43
SOLTAMOX...................................................................... 37
SOLUS V2 LANCING DEVICE(OTC)............................25
SOMATROPIN.................................................................. 27
SONATA...................................................................... 15, 53
SOOTHE & COOL PERINEAL WASH(OTC).................22
SOOTHE XP(OTC)........................................................... 29
SORAFENIB TOSYLATE................................................ 37
SORBITOL........................................................................22
SORBITOL SOLUTION...................................................22
SORBITOL-MANNITOL................................................. 22
SOTALOL..........................................................................17
SOTALOL HCL.................................................................17
SOVALDI.................................................................... 34, 61
SOY PROTEIN.................................................................. 38
SPECTRAVITE CARDIO HEALTH(OTC)......................45
SPECTRAVITE MEN'S(OTC)..........................................45
SPECTRAVITE SENIOR(OTC)....................................... 44
SPECTRAVITE ULTRA WOMEN'S(OTC)..................... 45
SPIRIVA RESPIMAT.................................................. 11, 53
SPIROMETERS AND ACCESSORIES ........................... 13
SPIRONOLACT/HYDROCHLOROTHIAZID.................18
SPIRONOLACTONE........................................................ 17
SPIRONOLACTONE-HCTZ............................................ 18
SPORANOX...................................................................... 32
SPRINTEC........................................................................ 19
SPRYCEL(TAB)(100 MG)....................................37, 53, 61
SPRYCEL(TAB)(140 MG)....................................37, 53, 61
SPRYCEL(TAB)(20 MG)......................................37, 53, 61
SPRYCEL(TAB)(50 MG)......................................37, 53, 61
SPRYCEL(TAB)(70 MG)......................................37, 53, 61
SPRYCEL(TAB)(80 MG)......................................37, 53, 61
SSKI...................................................................................27
STANNOUS FLUORIDE..................................................44
STARCH............................................................................39
STAVUDINE..................................................................... 33
STAVUDINE(CAP).....................................................33, 53
STAVUDINE(SOLN RECON)....................................33, 53
STERILE TALC................................................................ 37
STIOLTO RESPIMAT.................................................12, 53
STIVARGA............................................................37, 53, 61
STRATTERA(CAP)(10 MG)...................................... 16, 53
STRATTERA(CAP)(100 MG).................................... 16, 53
STRATTERA(CAP)(18 MG)...................................... 16, 53
STRATTERA(CAP)(25 MG)...................................... 16, 53
STRATTERA(CAP)(40 MG)...................................... 16, 53
STRATTERA(CAP)(60 MG)...................................... 16, 53
STRATTERA(CAP)(80 MG)...................................... 16, 53
STRENSIQ.................................................................. 38, 61
STRESS FORMULA ENERGY(OTC).............................45
Page 73 of 75
Index
STRESS FORMULA WITH IRON(OTC)........................ 44
STRESS FORMULA WITH ZINC(OTC)........................ 45
STRESS FORMULA(OTC)........................................ 45, 47
STRIBILD................................................................... 34, 53
STRIVERDI RESPIMAT............................................ 12, 53
STRONG IODINE.............................................................27
STROVITE FORTE........................................................... 45
SUBCUTANEOUS INSULIN PUMP...............................26
SUB-Q INSULIN DEVICE, 20 UNIT.............................. 26
SUCRAID....................................................................42, 61
SUCRALFATE.................................................................. 42
SUDOGEST(TAB ER)(OTC)............................................20
SUDOGEST(TAB)(30 MG)(OTC)....................................20
SUDOGEST(TAB)(60 MG)(OTC)....................................20
SULCONAZOLE NITRATE.............................................21
SULFACETAMIDE SODIUM.................................... 21, 28
SULFACETAMIDE/PREDNISOLONE SP...................... 28
SULFACETAMIDE-PREDNISOLONE........................... 28
SULFACETM NA/PREDNISOL AC................................28
SULFADIAZINE...............................................................35
SULFAMETHOXAZOLE/TRIMETHOPRIM................. 31
SULFAMETHOXAZOLE-TRIMETHOPRIM................. 31
SULFANILAMIDE........................................................... 43
SULFASALAZINE........................................................... 35
SULINDAC....................................................................... 35
SUMATRIPTAN..........................................................40, 53
SUMATRIPTAN SUCCINATE.........................................40
SUMATRIPTAN SUCCINATE(CARTRIDGE)..........40, 53
SUMATRIPTAN SUCCINATE(PEN INJCTR).......... 40, 53
SUMATRIPTAN SUCCINATE(TAB).........................40, 53
SUMATRIPTAN SUCCINATE(VIAL).......................40, 53
SUNITINIB MALATE...................................................... 37
SUNRISE COMPRESSOR-NEBULIZER........................12
SUNVITE(OTC)................................................................45
SUPRAX............................................................................31
SURE COMFORT ALCOHOL(OTC).............................. 22
SURE COMFORT LANCING PEN(OTC)....................... 25
SUREFLEX(OTC).............................................................25
SURE-PEN(OTC)..............................................................25
SURE-PREP ALCOHOL PREP PADS(OTC).................. 22
SURE-T PARADIGM....................................................... 25
SURMONTIL.................................................................... 14
SUSTIVA........................................................................... 33
SUTENT................................................................ 37, 53, 61
SUVOREXANT................................................................ 15
SYLATRON.................................................................36, 53
SYMBYAX..................................................................15, 53
SYMLINPEN 120............................................................. 24
SYMLINPEN 60............................................................... 24
SYNAGIS.................................................................... 33, 61
SYNJARDY...........................................................24, 53, 58
SYNRIBO....................................................................37, 61
-TTAB-A-VITE WITH IRON(OTC).................................... 45
TAB-A-VITE(OTC)...........................................................45
TACROLIMUS................................................ 24, 31, 49, 58
TADALAFIL..................................................................... 18
TAFINLAR..................................................................37, 61
TAGRISSO............................................................ 37, 53, 61
TALC................................................................................. 37
TAMIFLU(CAP)(30 MG)........................................... 33, 53
TAMIFLU(CAP)(45 MG)........................................... 33, 53
TAMIFLU(CAP)(75 MG)........................................... 33, 53
TAMIFLU(SUSP RECON)......................................... 33, 53
TAMOXIFEN CITRATE...................................................37
TAMSULOSIN HCL.........................................................43
TANZEUM............................................................ 24, 53, 58
TAPENTADOL HCL.........................................................40
TARCEVA............................................................. 37, 53, 61
TARGRETIN............................................................... 23, 61
TARON FORTE.................................................................44
TARON-C DHA................................................................ 46
TARON-PREX PRENATAL..............................................46
TASIGNA.............................................................. 37, 53, 61
TASIMELTEON................................................................ 15
TAZAROTENE..................................................................24
TAZORAC......................................................................... 24
TBO-FILGRASTIM.......................................................... 30
TEARS NATURALE FORTE(OTC).................................28
TECFIDERA............................................................... 37, 61
TEDIZOLID PHOSPHATE...............................................31
TEDUGLUTIDE............................................................... 36
TEGRETOL XR................................................................ 41
TELITHROMYCIN...........................................................31
TELMISARTAN................................................................17
TEMOZOLOMIDE..................................................... 36, 61
TENOFOVIR DISOPROXIL FUMARATE......................33
TERAZOSIN HCL............................................................ 17
TERBINAFINE HCL.................................................. 21, 32
TERBUTALINE SULFATE.............................................. 12
VNSNY
TERCONAZOLE.............................................................. 43
TERIFLUNOMIDE...........................................................37
TERIPARATIDE............................................................... 27
TESTOSTERONE....................................................... 30, 61
TESTOSTERONE CYPIONATE................................ 30, 61
TESTOSTERONE ENANTHATE.............................. 30, 61
TETRABENAZINE.....................................................37, 61
TETRACAINE HCL......................................................... 28
TETRACAINE HCL/PF....................................................28
TETRACYCLINE HCL.................................................... 32
TEXACORT...................................................................... 21
THALIDOMIDE............................................................... 32
THALOMID.......................................................... 32, 53, 61
THEO-24........................................................................... 13
THEOPHYLLINE ANHYDROUS................................... 13
THERA(OTC)................................................................... 45
THERA-M(OTC)...............................................................45
THERAPEUTIC M(OTC)................................................. 45
THERATRUM COMPLETE(OTC).................................. 45
THEREMS-M(OTC)......................................................... 45
THIAMINE HCL...............................................................47
THIAMINE MONONITRATE..........................................47
THICK NOW...............................................................39, 62
THICKENUP.........................................................38, 39, 62
THICK-IT.................................................................... 39, 62
THIK & CLEAR..........................................................39, 62
THIORIDAZINE HCL...................................................... 15
THIOTHIXENE.................................................................15
THRESHOLD IMT........................................................... 13
THRESHOLD PEP............................................................13
THROMBIN (BOVINE)....................................................30
THROMBIN-JMI.............................................................. 30
THYROID,PORK..............................................................27
TIAGABINE HCL.................................................42, 53, 58
TICAGRELOR.................................................................. 30
TICLOPIDINE HCL......................................................... 30
TIKOSYN..........................................................................16
TIMOLOL......................................................................... 28
TIMOLOL MALEATE................................................17, 28
TINIDAZOLE................................................................... 32
TIOTROPIUM BR/OLODATEROL HCL........................ 12
TIOTROPIUM BROMIDE................................................11
TIPRANAVIR....................................................................33
TIPRANAVIR/VITAMIN E TPGS................................... 33
TIVICAY........................................................................... 33
TIZANIDINE HCL........................................................... 42
TL G-FOL OS....................................................................44
TL-HEM 150..................................................................... 44
TOBI PODHALER......................................................32, 62
TOBRADEX......................................................................27
TOBRAMYCIN.................................................... 28, 32, 62
TOBRAMYCIN IN 0.225% NACL.................................. 32
TOBRAMYCIN/DEXAMETHASONE............................27
TOBRAMYCIN/LOTEPRED ETAB................................ 27
TOBRAMYCIN-DEXAMETHASONE........................... 27
TOBREX........................................................................... 28
TOCILIZUMAB................................................................34
TOFACITINIB CITRATE................................................. 34
TOFRANIL-PM................................................................ 14
TOLAZAMIDE................................................................. 24
TOLBUTAMIDE............................................................... 24
TOLMETIN SODIUM...................................................... 35
TOLNAFTATE.................................................................. 21
TOLNAFTATE(OTC)........................................................21
TOLTERODINE TARTRATE..................................... 43, 59
TOPAMAX........................................................................ 42
TOPIRAMATE.................................................................. 42
TOREMIFENE CITRATE.................................................37
TORSEMIDE.................................................................... 17
TOUJEO SOLOSTAR................................................. 26, 53
TOVIAZ.......................................................................43, 59
TRACLEER.................................................................18, 62
TRADJENTA...............................................................24, 53
TRAMETINIB DIMETHYL SULFOXIDE......................37
TRANDOLAPRIL.............................................................17
TRANDOLAPRIL/VERAPAMIL HCL............................16
TRANDOLAPRIL-VERAPAMIL ER.............................. 16
TRANEXAMIC ACID...................................................... 29
TRANYLCYPROMINE SULFATE..................................14
TRAVATAN Z..............................................................28, 53
TRAVOPROST............................................................ 28, 53
TRAVOPROST (BENZALKONIUM).............................. 28
TRAZODONE HCL..........................................................14
TRECATOR.......................................................................32
TREK S COMBO PACK...................................................13
TREK S COMPACT COMPRESSOR.............................. 13
TREPROSTINIL............................................................... 18
TREPROSTINIL DIOLAMINE........................................18
TREPROSTINIL SODIUM...............................................18
TREPROSTINIL/NEB ACCESSORIES...........................18
TREPROSTINIL/NEBULIZER/ACCESOR.....................18
TREXALL......................................................................... 36
TRIAMCINOLONE ACETONIDE............................ 21, 37
TRIAMTERENE/HYDROCHLOROTHIAZID................18
TRIAMTERENE-HYDROCHLOROTHIAZID............... 18
TRI-BUFFERED ASPIRIN(OTC).................................... 40
TRICITRATES.................................................................. 43
TRIFLUOPERAZINE HCL.............................................. 15
TRIFLURIDINE................................................................28
TRIFLURIDINE/TIPIRACIL HCL.................................. 36
TRIGELS-F FORTE..........................................................44
TRIGLIDE...................................................................18, 59
TRIHEXYPHENIDYL HCL............................................. 40
TRILEPTAL...................................................................... 41
TRIMETHOBENZAMIDE HCL...................................... 11
TRIMETHOPRIM.............................................................31
TRIMIPRAMINE MALEATE.......................................... 14
TRINATE...........................................................................47
TRIPLE ANTIBIOTIC PLUS(OTC).................................20
TRIPLE DYE.....................................................................20
TRIPLE HELIX COLLAGEN(OTC)................................24
TRIPROLIDINE/PSEUDOEPHEDRINE......................... 20
TRI-TABS DHA................................................................ 46
TRIUMEQ................................................................... 34, 53
TRIVEEN-DUO DHA.......................................................46
TRIVEEN-ONE.................................................................46
TRI-VI-FLORO................................................................. 46
TRI-VI-SOL(OTC)............................................................ 46
TRI-VIT WITH FLUORIDE-IRON..................................45
TRI-VITAMIN WITH FLUORIDE.................................. 46
TRI-VITAMIN(OTC)........................................................ 46
TROKENDI XR(CAP ER 24H)(100 MG)............ 42, 53, 59
TROKENDI XR(CAP ER 24H)(200 MG)............ 42, 53, 59
TROKENDI XR(CAP ER 24H)(25 MG).............. 42, 53, 59
TROKENDI XR(CAP ER 24H)(50 MG).............. 42, 53, 59
TROPICAMIDE................................................................ 28
TRUEDRAW(OTC)...........................................................25
TRUEPLUS MULTIVITAMIN(OTC).............................. 45
TRULICITY.......................................................... 24, 53, 59
TRUVADA...................................................................33, 53
TRUZONE PEAK FLOW METER...................................13
TRYPSIN/BALSAM PERU/CASTOR OIL......................23
TYBOST......................................................................34, 62
TYKERB..................................................................... 37, 62
TYR COOLER(OTC)........................................................44
TYR LOPHLEX.......................................................... 38, 62
TYVASO......................................................................18, 62
-UUCD ANAMIX JUNIOR............................................ 39, 62
UCD TRIO...................................................................39, 62
U-CORT.............................................................................21
ULIPRISTAL ACETATE...................................................19
ULORIC...................................................................... 29, 53
ULTI-LANCE(OTC)......................................................... 25
ULTILET ALCOHOL SWAB(OTC).................................22
ULTIMATECARE ONE....................................................46
ULTIMATECARE ONE NF..............................................46
ULTRA-FRESH(OTC)...................................................... 22
ULTRAMINO..............................................................38, 62
UMECLIDINIUM BRM/VILANTEROL TR...................12
UMECLIDINIUM BROMIDE..........................................11
UNISTIK 2 EXTRA(OTC)............................................... 25
UNISTIK 2 NORMAL...................................................... 25
UNISTIK 2 NORMAL(OTC)........................................... 25
UNISTIK 2(OTC)..............................................................26
UNISTIK 3 COMFORT(OTC)..........................................26
UNISTIK 3 NEONATAL(OTC)........................................ 26
UNISTIK 3(OTC)..............................................................26
UPTRAVI.....................................................................18, 62
UREA................................................................................ 23
UREA/HYALURONATE SODIUM..................................23
UREA/LACTIC AC/ZN UNDECYLENATE....................23
UREA/LACTIC ACID/SALICYLIC AC .......................... 23
URETRON D-S................................................................. 31
URIN D.S.......................................................................... 31
URINE GLUC-ACET COMB.TST,STRIP....................... 26
URINE GLUCOSE TEST,STRIP..................................... 26
URINE GLUCOSE TEST,TABLET................................. 26
UROGESIC-BLUE............................................................31
URO-MP............................................................................ 31
URSODIOL....................................................................... 35
USTELL............................................................................ 31
-VVAGIFEM..........................................................................43
VALACYCLOVIR.............................................................33
VALACYCLOVIR HCL....................................................33
VALCHLOR................................................................ 23, 62
VALGANCICLOVIR HCL............................................... 33
VALPROIC ACID............................................................. 42
VALPROIC ACID (AS SODIUM SALT)......................... 42
VALSARTAN.................................................................... 17
VALSARTAN/HYDROCHLOROTHIAZIDE.................. 17
VALSARTAN-HYDROCHLOROTHIAZIDE.................. 17
VANCOMYCIN HCL................................................. 32, 53
Page 74 of 75
Index
VANDETANIB.................................................................. 37
VAPORIZER..................................................................... 13
VAPORIZER CLEANING TABLETS(OTC)................... 13
VAPORIZER INHALANT(OTC)..................................... 13
VAPORIZER(OTC)...........................................................13
VAPORIZER-HUMIDIFIER SUPPLY............................. 13
VARENICLINE TARTRATE............................................ 42
VASCEPA.................................................................... 18, 53
V-C FORTE....................................................................... 45
VEMURAFENIB.............................................................. 37
VENLAFAXINE HCL...................................................... 14
VENLAFAXINE HCL ER................................................ 14
VENTAVIS.................................................................. 18, 62
VENTOLIN HFA.............................................................. 12
VERAPAMIL ER.............................................................. 17
VERAPAMIL HCL........................................................... 17
VERSACLOZ........................................................ 15, 53, 59
VESICARE..................................................................43, 59
VGO 20..............................................................................26
VGO 30..............................................................................26
VGO 40..............................................................................26
VIBRAMYCIN..................................................................32
VICKS WARM STEAM VAPORIZER(OTC).................. 13
VIDEX.........................................................................33, 53
VIGABATRIN................................................................... 42
VIGAMOX........................................................................ 28
VIIBRYD...............................................................14, 53, 59
VILAZODONE HYDROCHLORIDE.............................. 14
VIMPAT(SOLUTION).......................................... 41, 53, 59
VIMPAT(TAB)...................................................... 41, 53, 59
VINACAL..........................................................................46
VINATE CARE................................................................. 47
VINATE DHA................................................................... 46
VINATE DHA RF............................................................. 46
VINATE II......................................................................... 47
VINATE ONE....................................................................47
VINATE PN CARE........................................................... 47
VINATE-M........................................................................ 46
VIOS AEROSOL DELIVERY SYSTEM......................... 13
VIRACEPT........................................................................ 33
VIRAZOLE....................................................................... 33
VIREAD(POWDER)...................................................33, 53
VIREAD(TAB)............................................................ 33, 53
VIRT-ADVANCE.............................................................. 47
VIRT-PN PLUS................................................................. 46
VIRTPREX........................................................................ 47
VIRT-VITE GT..................................................................47
VIRT-VITE PLUS............................................................. 47
VISION-VITE + ZINC(OTC)........................................... 43
VISMODEGIB.................................................................. 36
VISTARIL......................................................................... 11
VIT 3..................................................................................45
VIT A PALMITATE/VIT C/VIT D3................................. 46
VIT A,C & E/LUTEIN/MINERALS................................ 43
VIT A/VIT C/VIT E/ZINC/COPPER......................... 43, 45
VIT B CMPLX 3/FA/VIT C/BIOTIN............................... 47
VIT B CMPLX NO3/FA/C/BIOT/ZINC........................... 47
VIT B COMP/C/FA/IRON SULF/VITE........................... 44
VIT B COMP/C/FA/IRON/VIT E..................................... 44
VIT B COMPLEX 100 CMB #2/HERBS......................... 47
VIT B COMPLEX 100 CMB #3/HERBS......................... 47
VIT B CPLX #11/FA/C/BIOT/ZN OX..............................47
VIT E/LIDOCAIN/ALO VER/COLAGN.........................23
VITAFOL...........................................................................44
VITAFOL NANO.............................................................. 47
VITAFOL-OB+DHA.........................................................47
VITAJOULE................................................................ 38, 62
VITAL 1.0 CAL...........................................................39, 62
VITAL 1.5 CAL...........................................................39, 62
VITAL AF 1.2 CAL.....................................................39, 62
VITAL-D RX..................................................................... 47
VITAMIN A...................................................................... 47
VITAMIN A PALMITATE................................................ 47
VITAMIN A(OTC)............................................................ 47
VITAMIN AND MINERALS(OTC).................................45
VITAMIN B COMPLEX...................................................47
VITAMIN B COMPLEX(CAP)(OTC)..............................47
VITAMIN B COMPLEX(TAB)(OTC)..............................47
VITAMIN B COMPLEX/MINERALS............................. 47
VITAMIN B-1(OTC).........................................................47
VITAMIN B-6(OTC).........................................................47
VITAMIN B-COMPLEX WITH VIT C(CAP)(OTC).......44
VITAMIN B-COMPLEX WITH VIT C(OTC)................. 47
VITAMIN B-COMPLEX WITH VIT C(TAB)(OTC).......44
VITAMIN C(OTC)............................................................ 48
VITAMIN D(OTC)...................................................... 48, 49
VITAMIN D2.................................................................... 48
VITAMIN D3(OTC).................................................... 48, 49
VITAMIN E....................................................................... 22
VITAMIN E(OTC)............................................................ 22
VITAMIN E/ALOE VERA............................................... 22
VITAMIN K1.................................................................... 30
VNSNY
VITAMINS B1,B2,B3,B5,& B6........................................47
VITB&C/IRON FUM/FA/VIT E/AA#16..........................45
VITE AC/GRAPE/HYALURONIC ACID ........................ 22
VITEKTA.................................................................... 33, 53
VIVITROL.........................................................................15
VOL-PLUS........................................................................ 46
VOL-TAB RX....................................................................47
VOLTAREN.......................................................................21
VORICONAZOLE............................................................ 32
VORTEX........................................................................... 12
VORTEX VHC FROG MASK.......................................... 12
VORTEX VHC LADYBUG MASK................................. 12
VORTIOXETINE HYDROBROMIDE............................. 14
VOTRIENT............................................................37, 53, 62
VP-CH PLUS.....................................................................47
VP-CH-PNV...................................................................... 46
VP-HEME ONE................................................................ 46
VP-PNV-DHA................................................................... 47
VYVANSE.............................................................14, 53, 59
-WWAL-MUCIL(OTC).......................................................... 36
WARFARIN SODIUM...................................................... 29
WARM STEAM VAPORIZER(OTC)............................... 13
WATER.............................................................................. 22
WATER FOR IRRIGATION,STERILE............................ 22
WEBCOL(OTC)................................................................ 22
WEED POLLEN-SHORT RAGWEED............................ 11
WELCHOL........................................................................18
WHEY............................................................................... 39
WHITE PETROLATUM(OTC).........................................23
WIDE SEAL DIAPHRAGM.............................................19
WINDMILL TRAINER(OTC)..........................................13
WOMEN'S COMPLEX(OTC).......................................... 45
WOUND GEL(OTC).........................................................22
-XXALKORI............................................................. 36, 53, 62
XANTHAN GUM............................................................. 39
XARELTO(TAB DS PK).............................................29, 53
XARELTO(TAB)(10 MG)...........................................29, 53
XARELTO(TAB)(15 MG)...........................................29, 53
XARELTO(TAB)(20 MG)...........................................29, 53
XELJANZ.................................................................... 34, 62
XIFAXAN....................................................................32, 62
XMET MAXAMAID.................................................. 39, 62
XMET MAXAMUM...................................................39, 62
XMET XCYS MAXAMAID...................................... 38, 62
XTANDI................................................................ 36, 53, 62
XTRACAL PLUS........................................................39, 62
-ZZAFIRLUKAST................................................................ 12
ZALEPLON.......................................................................15
ZARONTIN....................................................................... 41
ZELBORAF...........................................................37, 53, 62
ZENPEP.............................................................................42
ZENZEDI.............................................................. 14, 53, 59
ZETIA..........................................................................18, 53
ZIAGEN.......................................................................33, 53
ZIDOVUDINE...................................................................33
ZIDOVUDINE(CAP).................................................. 33, 53
ZIDOVUDINE(SYRUP)............................................. 33, 53
ZIDOVUDINE(TAB).................................................. 33, 54
ZINC ACETATE/MEADOWSWEET/OAK..................... 23
ZINC SULFATE................................................................ 48
ZINC SULFATE(OTC)......................................................48
ZIPRASIDONE HCL........................................................ 15
ZIPRASIDONE MESYLATE........................................... 15
ZIRGAN............................................................................ 27
ZMAX................................................................................31
ZOLMITRIPTAN.............................................................. 40
ZOLPIDEM TARTRATE............................................ 15, 54
ZOLPIMIST.......................................................... 15, 54, 59
ZOMIG(SPRAY)(2.5 MG).................................... 40, 54, 59
ZOMIG(SPRAY)(5 MG)....................................... 40, 54, 59
ZONEGRAN..................................................................... 42
ZONISAMIDE.................................................................. 42
ZORBTIVE..................................................................27, 62
ZORTRESS........................................................................31
ZOVIRAX..........................................................................21
ZUBSOLV................................................................... 40, 62
ZYDELIG.................................................................... 37, 62
ZYKADIA................................................................... 36, 62
ZYLET...............................................................................27
ZYPREXA...................................................................15, 54
ZYPREXA RELPREVV................................................... 15
ZYTIGA................................................................ 36, 54, 62
ZZZQUIL(OTC)................................................................ 15
Page 75 of 75
2016 Formulary
of Covered
Prescription Drugs
SelectHealth
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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

2016 FormulAry oF Covered PresCriPtion drugs

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