MDwise HIP Formulary · MDwise HIP Formulary. 2016. Table of Contents. T a b l e o f C n t e sANALGESIC AND ANTIHISTAMINE COMBINATION..... 3

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7 . , = , ; , 1 : L < 1 * = 2 * + - L 0 ; - 4 : ; - . , + 4 2 , 4 L - : r , : ; = 1 , < : , ; - + w s , - . , + 4 2 , + - 1 , ; = - . w 4 ; < - . , + 4 2 ,< 0 + 4 = , 9 0 1 2 4 + - . , s 1 4 ; < ; 4 2 , < 1 * = M•

7 . , / J x . 4 + = : r , ; 4 ; � x � 1 4 - : ; = L 0 2 K 4 1 , < - 0 - . , s 1 4 ; < ; 4 2 , < 1 * = 4 ; < - . * + - . , = , ; , 1 : L < 1 * = : +< , - , 1 2 : ; , < - 0 s , - . , 1 4 K , * - : L 4 3 3 5 s : 0 , | * : r 4 3 , ; - M•

} . , ; - . , 4 s 0 r , - 8 0 L 1 : - , 1 : 4 4 1 , 2 , - w 4 = , ; , 1 : L L 4 ; s , + * s + - : - * - , < 8 : - . - . , 9 * 3 3 , q K , L - 4 - : 0 ; - . 4 -- . , + * s + - : - * - , < K 1 0 < * L - 8 : 3 3 K 1 0 < * L , - . , + 4 2 , L 3 : ; : L 4 3 , 9 9 , L - 4 ; < + 4 9 , - 5 K 1 0 9 : 3 , 4 + - . , K 1 , + L 1 : s , <K 1 0 < * L - Mi A A B I B G H D E � @ � � B � @ � @ H I n� 0 2 , L 0 r , 1 , < < 1 * = + 2 4 5 . 4 r , 4 < < : - : 0 ; 4 3 1 , | * : 1 , 2 , ; - + 0 1 3 : 2 : - + 0 ; L 0 r , 1 4 = , M 7 . , + , 1 , | * : 1 , 2 , ; - +4 ; < 3 : 2 : - + 2 4 5 : ; L 3 * < , >

� � � B G � i � I k G � B � D I B G H � � J 8 : + , 1 , | * : 1 , + 5 0 * 0 1 5 0 * 1 K . 5 + : L : 4 ; - 0 = , - K 1 : 0 1 4 * - . 0 1 : � 4 - : 0 ; 9 0 1L , 1 - 4 : ; < 1 * = + M 7 . : + 2 , 4 ; + - . 4 - 5 0 * 8 : 3 3 ; , , < - 0 = , - 4 K K 1 0 r 4 3 9 1 0 2 - . , K . 4 1 2 4 L 5 s , ; , 9 : - +2 4 ; 4 = , 1 y � , < p 2 K 4 L - z s , 9 0 1 , 5 0 * 9 : 3 3 5 0 * 1 K 1 , + L 1 : K - : 0 ; + M p 9 5 0 * < 0 ; � - = , - 4 K K 1 0 r 4 3 w - . , < 1 * =2 4 5 ; 0 - s , L 0 r , 1 , < M J 1 * = + - . 4 - 4 1 , + * s � , L - - 0 4 K 1 : 0 1 4 * - . 0 1 : � 4 - : 0 ; 8 : 3 3 . 4 r , 4 � � x � + 5 2 s 0 3; , q - - 0 - . , < 1 * = M � . 5 + : L : 4 ; + � � . 4 1 2 4 L : , + L 4 3 3 y � � � z � � � { � � � � 0 1 / x � > y � � � z � � � { � � � �� D H I B I � m B � B I n � / 0 1 L , 1 - 4 : ; < 1 * = + w - . , K 3 4 ; 3 : 2 : - + - . , 4 2 0 * ; - 0 9 - . , < 1 * = - . 4 - : + L 0 r , 1 , < MJ 1 * = + - . 4 - 4 1 , + * s � , L - - 0 4 | * 4 ; - : - 5 3 : 2 : - 8 : 3 3 . 4 r , 4 � � u � + 5 2 s 0 3 ; , q - - 0 - . , < 1 * = M� � @ � B E E m B � B I D I B G H n � � 1 , + L 1 : K - : 0 ; + 2 4 5 s , 1 , 9 : 3 3 , < 8 . , ; � � 0 1 2 0 1 , 0 9 - . , < 4 5 + � + * K K 3 5. 4 + s , , ; * + , < M� ¡ I @ j ¢ k @ � D j � � p ; + 0 2 , L 4 + , + w - . , K 3 4 ; 1 , | * : 1 , + 5 0 * - 0 9 : 1 + - - 1 5 L , 1 - 4 : ; < 1 * = + - 0 - 1 , 4 - 5 0 * 12 , < : L 4 3 L 0 ; < : - : 0 ; s , 9 0 1 , : - 8 : 3 3 L 0 r , 1 4 ; 0 - . , 1 < 1 * = 9 0 1 - . 4 - L 0 ; < : - : 0 ; M / 0 1 , q 4 2 K 3 , w : 9 J 1 * =x 4 ; < J 1 * = t s 0 - . - 1 , 4 - 5 0 * 1 2 , < : L 4 3 L 0 ; < : - : 0 ; w 8 , 2 4 5 ; 0 - L 0 r , 1 J 1 * = t * ; 3 , + + 5 0 * - 1 5J 1 * = x 9 : 1 + - M p 9 J 1 * = x < 0 , + ; 0 - 8 0 1 h 9 0 1 5 0 * w 8 , 8 : 3 3 - . , ; L 0 r , 1 J 1 * = t M J 1 * = + - . 4 - 4 1 ,+ * s � , L - - 0 � - , K 7 . , 1 4 K 5 8 : 3 3 . 4 r , 4 � � 7 � + 5 2 s 0 3 ; , q - - 0 - . , < 1 * = M� i o @ m B � B I � p ; + 0 2 , L 4 + , + w < 1 * = + 4 1 , 0 ; 3 5 4 r 4 : 3 4 s 3 , - 0 4 2 , 2 s , 1 : ; 4 + , 3 , L - 4 = , L 4 - , = 0 1 5 MJ 1 * = + - . 4 - 4 1 , + * s � , L - - 0 4 ; x = , u : 2 : - 8 : 3 3 . 4 r , 4 ; � x ~ £ � + 5 2 s 0 3 ; , q - - 0 - . , < 1 * = M� ¤ @ H A @ � m B � B I � � 0 2 , < 1 * = + 4 1 , 0 ; 3 5 4 r 4 : 3 4 s 3 , - 0 2 , 2 s , 1 + 0 9 4 L , 1 - 4 : ; = , ; < , 1 M J 1 * = + - . 4 -4 1 , 4 r 4 : 3 4 s 3 , - 0 0 ; 3 5 4 L , 1 - 4 : ; = , ; < , 1 8 : 3 3 . 4 r , 4 � ~ � + 5 2 s 0 3 ; , q - - 0 - . , < 1 * = M ¥ 0 * L 4 ; 9 : ; <0 * - : 9 5 0 * 1 < 1 * = . 4 + 4 ; 5 4 < < : - : 0 ; 4 3 1 , | * : 1 , 2 , ; - + 0 1 3 : 2 : - + s 5 3 0 0 h : ; = : ; - . , 9 0 1 2 * 3 4 1 5+ - 4 1 - : ; = 0 ; - . , ; , q - K 4 = , Mp 9 5 0 * . 4 r , 4 ; 5 4 < < : - : 0 ; 4 3 | * , + - : 0 ; + w K 3 , 4 + , r : + : - 0 * 1 8 , s + : - , 4 - 2 < 8 : + , M 0 1 = 0 1 L 0 ; - 4 L - - . , L * + - 0 2 , 1+ , 1 r : L , L , ; - , 1 4 - y � � � z � � � { � � � � M

MDwise HIP Formulary2016

Table of Contents

Table of Contents

ANALGESIC AND ANTIHISTAMINE COMBINATION .................................................................................................................................................................................................. 3ANALGESICS ........................................................................................................................................................................................................................................................................................................................... 3ANESTHETICS .................................................................................................................................................................................................................................................................................................................... 12ANTIARTHRITICS ......................................................................................................................................................................................................................................................................................................... 15ANTIASTHMATICS ...................................................................................................................................................................................................................................................................................................... 17ANTIBIOTICS ....................................................................................................................................................................................................................................................................................................................... 19ANTICOAGULANTS .................................................................................................................................................................................................................................................................................................... 28ANTIDOTES ............................................................................................................................................................................................................................................................................................................................ 29ANTIFUNGALS ................................................................................................................................................................................................................................................................................................................... 30ANTIHISTAMINE AND DECONGESTANT COMBINATION ............................................................................................................................................................................... 32ANTIHISTAMINES ........................................................................................................................................................................................................................................................................................................ 34ANTIHYPERGLYCEMICS .................................................................................................................................................................................................................................................................................. 37ANTIINFECTIVES .......................................................................................................................................................................................................................................................................................................... 40ANTIINFECTIVES/MISCELLANEOUS .............................................................................................................................................................................................................................................. 39ANTINEOPLASTICS .................................................................................................................................................................................................................................................................................................... 40ANTIPARKINSON DRUGS .................................................................................................................................................................................................................................................................................. 45ANTIPLATELET DRUGS ...................................................................................................................................................................................................................................................................................... 46ANTIVIRALS .......................................................................................................................................................................................................................................................................................................................... 46AUTONOMIC DRUGS ................................................................................................................................................................................................................................................................................................ 50BIOLOGICALS .................................................................................................................................................................................................................................................................................................................... 52BLOOD ........................................................................................................................................................................................................................................................................................................................................... 57CARDIAC DRUGS ........................................................................................................................................................................................................................................................................................................... 59CARDIOVASCULAR ................................................................................................................................................................................................................................................................................................... 61CNS DRUGS ............................................................................................................................................................................................................................................................................................................................. 67COLONY STIMULATING FACTORS ................................................................................................................................................................................................................................................... 70CONTRACEPTIVES ..................................................................................................................................................................................................................................................................................................... 71COUGH/COLD PREPARATIONS ............................................................................................................................................................................................................................................................... 75DIAGNOSTIC ......................................................................................................................................................................................................................................................................................................................... 85DIURETICS .............................................................................................................................................................................................................................................................................................................................. 86EENT PREPS ........................................................................................................................................................................................................................................................................................................................... 88ELECT/CALORIC/H2O ............................................................................................................................................................................................................................................................................................ 93GASTROINTESTINAL ........................................................................................................................................................................................................................................................................................... 101HERBALS ................................................................................................................................................................................................................................................................................................................................ 113HORMONES ......................................................................................................................................................................................................................................................................................................................... 116IMMUNOSUPPRESANT ...................................................................................................................................................................................................................................................................................... 121MISCELLANEOUS MEDICAL SUPPLIES, DEVICES, NON-DRUG ......................................................................................................................................................... 122MUSCLE RELAXANTS ......................................................................................................................................................................................................................................................................................... 138PRE-NATAL VITAMINS ...................................................................................................................................................................................................................................................................................... 139PSYCHOTHERAPEUTIC DRUGS .......................................................................................................................................................................................................................................................... 143SEDATIVE/HYPNOTICS ..................................................................................................................................................................................................................................................................................... 148SKIN PREPS ......................................................................................................................................................................................................................................................................................................................... 150SMOKING DETERRENTS ................................................................................................................................................................................................................................................................................ 162THYROID PREPS .......................................................................................................................................................................................................................................................................................................... 162UNCLASSIFIED DRUG PRODUCTS ................................................................................................................................................................................................................................................... 163VITAMINS .............................................................................................................................................................................................................................................................................................................................. 172

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MDwise HIP Formulary2016

Drug Name Tier Notes

ANALGESIC AND ANTIHISTAMINE COMBINATIONACETA-GESIC 1

ACETAMINOPHEN PM 1

diphenhydramine-acetaminophen 1

DOLOGESIC ORAL LIQUID 2

DOLOGESIC ORAL TABLET 1

EXCEDRIN PM 2

HEADACHE PM 1

MAPAP PM 1

NON-ASA EX ST PAIN/SLEEP AID 1

NON-ASPIRIN NIGHTIME 1

NON-ASPIRIN PM 1

PAIN RELIEF PM 1

PAIN RELIEF PM RAPID RELEASE 1

PAIN RELIEVER AM/PM 1

PAIN RELIEVER PM EX ST 1

PAIN RELIEVER PM EX-STRENGTH 1

PAIN RELIEVER PM ORAL TABLET 25-500 MG 1

STAFLEX (BROMPHENIRA-ACETAMIN) 2

TYLENOL PM EXTRA STRENGTH 1

ZFLEX 1

ANALGESICS8 HOUR PAIN RELIEVER 1

ABSTRAL 2 PA; QL (4 EA per 1 day)

ACEPHEN 1

acetaminophen oral liquid 160 mg/5 ml 1

acetaminophen oral solution 1

acetaminophen oral tablet 1

acetaminophen oral tablet extended release 1

acetaminophen rectal 1

acetaminophen-codeine oral solution 1

acetaminophen-codeine oral tablet 1

ACTIQ 2 PA; QL (4 EA per 1 day)

ADDED STRENGTH HEADACHE RELIEF 1

ALFENTA 2

3

Drug Name Tier Notesalfentanil 1

ALSUMA 2 QL (1 ML per 14 days)

AMERGE 2 QL (3 EA per 5 days)

ARTHRITIS PAIN RELIEF (ACETAM) 1

ARTHRITIS PAIN RELIEVER 1

ASCOMP WITH CODEINE 1

ASCRIPTIN 2

ASPIR-81 3

ASPIRIN LOW DOSE 3

ASPIRIN LOW-STRENGTH 3

aspirin oral tablet 325 mg 3

aspirin oral tablet,chewable 3

aspirin oral tablet,delayed release (dr/ec) 325 mg, 81 mg 3

aspirin rectal 1

ASPIR-LOW 3

AVINZA ORAL CAPSULE, ER MULTIPHASE 24 HR 120 MG

2 QL (2 EA per 1 day)

AVINZA ORAL CAPSULE, ER MULTIPHASE 24 HR 30 MG, 45 MG, 60 MG, 75 MG, 90 MG


AXERT 2 ST; QL (2 EA per 5 days)

BACKACHE RELIEF EXTRA STRENGTH 1

belladonna alkaloids-opium 1

BELLADONNA-OPIUM 1

BUFFERIN EXTRA STRENGTH 1

BUFFERIN ORAL TABLET 325 MG 1

BUFFERIN ORAL TABLET 81 MG 2

BUPAP ORAL TABLET 50-300 MG 2

buprenorphine hcl injection 1

BUTALBITAL COMPOUND 1

BUTALBITAL COMPOUND W/CODEINE 1

butalbital-acetaminop-caf-cod 1

butalbital-acetaminophen 1

butalbital-acetaminophen-caff 1

butalbital-aspirin-caffeine 1

butorphanol tartrate 1

BUTRANS 2 QL (1 EA per 7 days)

CAFERGOT 2 QL (10 EA per 7 days)

CAMBIA 2 QL (3 EA per 10 days)

CAPACET 1

CAPITAL WITH CODEINE 2

carisoprodol-asa-codeine 1

CATAFLAM 2

CHILDREN'S ACETAMINOPHEN ORAL SUSPENSION 160 MG/5 ML

1

CHILDREN'S ASPIRIN 3

4

Drug Name Tier NotesCHILDREN'S MAPAP 1

CHILDREN'S PAIN & FEVER RELIEF 1

CHILDREN'S PAIN RELIEF ORAL SUSPENSION 1

CHILDREN'S PAIN RELIEVER ORAL SUSPENSION 1

CHILDREN'S PAIN RELIEVER ORAL TABLET,DISINTEGRATING

1

CHILDREN'S Q-PAP 1

CHILDREN'S SILAPAP 1

CHILDREN'S TRIAMINIC FEVER 1

choline,magnesium salicylate 1

clonidine (pf) 1

codeine sulfate oral tablet 1

CONZIP ORAL CAPSULE,ER BIPHASE 24 HR 25-75 200 MG

2 ST; QL (1 EA per 1 day)

D.H.E.45 2 QL (15 ML per 14 days)

DEMEROL (PF) 2

DEMEROL INJECTION 2

DEMEROL ORAL 2 QL (6 EA per 1 day)

diclofenac potassium 1

diflunisal 1

dihydrocode-acetaminophen-caff oral capsule 1 QL (10 EA per 1 day)

dihydrocodeine-aspirin-caff 1

dihydroergotamine injection 1 QL (15 ML per 14 days)

dihydroergotamine nasal 1 QL (8 ML per 28 days)

DILAUDID 2

DILAUDID (PF) 2

DILAUDID-HP (PF) 2

DISKETS 2 PA

DOAN'S EXTRA STRENGTH 1

DOAN'S PM BACK PAIN RELIEF 2

DOLOPHINE ORAL 2 PA

DURACLON (PF) 2

DURAGESIC 2 PA; QL (1 EA per 3 days)

DURAMORPH (PF) 2

E.C. PRIN 3

ED-APAP 1

EFFERVESCENT PAIN RELIEF 1

ELMIRON 2

EMBEDA ORAL CAPSULE,ORAL ONLY,EXT.REL PELL 100-4 MG


EMBEDA ORAL CAPSULE,ORAL ONLY,EXT.REL PELL 20-0.8 MG, 30-1.2 MG, 50-2 MG, 60-2.4 MG, 80-3.2 MG


ENDOCET ORAL TABLET 10-325 MG, 2.5-325 MG, 5-325 MG, 7.5-325 MG


ENDODAN 1

5

Drug Name Tier Notesergotamine-caffeine 1 QL (10 EA per 7 days)

ESGIC 2

EXALGO ER ORAL TABLET EXTENDED RELEASE 24 HR 12 MG, 16 MG, 8 MG

2 PA; QL (1 EA per 1 day)

EXALGO ER ORAL TABLET EXTENDED RELEASE 24 HR 32 MG


EXCEDRIN BACK & BODY 2

EXCEDRIN EXTRA STRENGTH 2

EXCEDRIN MENSTRUAL COMPLETE 2

EXCEDRIN TENSION HEADACHE 2

EXTENDED PAIN RELIEF 1

fentanyl 1 PA; QL (1 EA per 3 days)

fentanyl citrate 1 PA; QL (4 EA per 1 day)

fentanyl citrate (pf) injection 1

fentanyl citrate (pf) intravenous syringe 100 mcg/2 ml (50 mcg/ml)

1

FENTORA 2 PA; QL (4 EA per 1 day)

FEVER REDUCER 1

FEVERALL RECTAL SUPPOSITORY 120 MG, 325 MG, 650 MG

1

FEVERALL RECTAL SUPPOSITORY 80 MG 2

FIORICET ORAL CAPSULE 2

FIORICET WITH CODEINE ORAL CAPSULE 50-300-40-30 MG

2

FIORINAL 2

FIORINAL-CODEINE #3 2

FROVA 2 ST; QL (3 EA per 5 days)

GOODY'S HEADACHE POWDER 2

HEADACHE FORMULA ADDED STR 1

HEADACHE RELIEF 1

HEADACHE RELIEF (ASA-ACET-CAF) 1

HISTAFLEX 2

HYCET 2 QL (184 ML per 1 day)

hydrocodone-acetaminophen oral solution 10-325 mg/15 ml(15 ml), 5-163 mg/7.5ml(7.5ml)

1 QL (184 ML per 1 day)

hydrocodone-acetaminophen oral solution 2.5-167 mg/5 ml 1 QL (120 ML per 1 day)

hydrocodone-acetaminophen oral tablet 10-300 mg, 5-300 mg, 7.5-300 mg








hydrocodone-acetaminophen oral tablet 2.5-325 mg 1

hydrocodone-acetaminophen oral tablet 7.5-750 mg 1 QL (5 EA per 1 day)

hydrocodone-ibuprofen 1

6

Drug Name Tier Noteshydromorphone (pf) 1

hydromorphone in 0.9 % nacl intravenous pt controlled analgesia syring 10 mg/50 ml (0.2 mg/ml)

1

hydromorphone in 0.9 % nacl intravenous solution 0.2 mg/ml

1

hydromorphone injection 1

hydromorphone oral liquid 1

hydromorphone oral tablet 1

hydromorphone oral tablet extended release 24 hr 12 mg, 16 mg, 8 mg


hydromorphone oral tablet extended release 24 hr 32 mg 1 PA; QL (2 EA per 1 day)

hydromorphone rectal 1

HYSINGLA ER 2 QL (1 EA per 1 day)

IBUDONE 2

IBUPROFEN PM ORAL TABLET 1

ibuprofen-oxycodone 1

IMITREX NASAL 2 QL (6 EA per 15 days)

IMITREX ORAL 2 QL (3 EA per 5 days)

IMITREX STATDOSE KIT REFILL 2 QL (1 ML per 14 days)

IMITREX STATDOSE PEN 2 QL (1 ML per 14 days)

IMITREX SUBCUTANEOUS 2 QL (1 ML per 14 days)

INFANT PAIN RELIEVER 1

INFANTS MAPAP 1

INFANTS' PAIN & FEVER 1

INFANTS' PAIN RELIEF 1

INFANT'S PAIN RELIEF ORAL DROPS,SUSPENSION 80 MG/0.8 ML

1

INFANT'S PAIN RELIEVER 1

INFANTS' TRIAMINIC FEVER 1

INFUMORPH P/F 2

IONSYS 2

isometh-dichloral-acetaminophn 1

isomethepten-caf-acetaminophen 1

JR. STR NON-ASPIRIN PAIN 1

JUNIOR MAPAP 1

KADIAN ORAL CAPSULE,EXTEND.RELEASE PELLETS 10 MG, 130 MG, 150 MG, 20 MG, 40 MG, 50 MG, 60 MG, 70 MG, 80 MG


KADIAN ORAL CAPSULE,EXTEND.RELEASE PELLETS 200 MG


ketorolac injection cartridge 1

ketorolac injection solution 15 mg/ml, 30 mg/ml (1 ml) 1

ketorolac injection syringe 30 mg/ml 1

ketorolac intramuscular solution 1

ketorolac oral 1

LAZANDA 2 PA; QL (1 EA per 2 days)

7

Drug Name Tier Noteslevorphanol tartrate 1

LITE COAT ASPIRIN 3

LORCET (HYDROCODONE) 1 QL (12 EA per 1 day)

LORCET HD 1 QL (12 EA per 1 day)

LORCET PLUS ORAL TABLET 7.5-325 MG 1 QL (12 EA per 1 day)

LORTAB 10-325 2 QL (12 EA per 1 day)

LORTAB 5-325 2 QL (12 EA per 1 day)

LORTAB 7.5-325 2 QL (12 EA per 1 day)

LORTAB ELIXIR ORAL SOLUTION 10-300 MG/15 ML 2

MAGNACET ORAL TABLET 2.5-400 MG 2 QL (10 EA per 1 day)

MAPAP (ACETAMINOPHEN) ORAL CAPSULE 1

MAPAP (ACETAMINOPHEN) ORAL DROPS,SUSPENSION

1

MAPAP (ACETAMINOPHEN) ORAL ELIXIR 1

MAPAP (ACETAMINOPHEN) ORAL LIQUID 1

MAPAP (ACETAMINOPHEN) ORAL SUSPENSION 1

MAPAP (ACETAMINOPHEN) ORAL TABLET 1

MAPAP (ACETAMINOPHEN) ORAL TABLET,CHEWABLE

1

MAPAP ARTHRITIS PAIN 1

MAPAP EXTRA STRENGTH 1

MAPAP INFANTS' 1

MARGESIC 1

MARTEN-TAB 1

MAXALT 2 QL (3 EA per 5 days)

MAXALT-MLT 2 QL (3 EA per 5 days)

MAXIDONE 2 QL (5 EA per 1 day)

mefenamic acid 1

MENSTRUAL RELIEF 1

meperidine (pf) injection solution 100 mg/ml, 25 mg/ml, 50 mg/ml

1

meperidine in 0.9 % nacl intravenous pt controlled analgesia syring 250 mg/25 ml (10 mg/ml), 550 mg/55 ml (10 mg/ml)

1

meperidine in 0.9 % nacl intravenous solution 1

meperidine injection cartridge 1

meperidine oral solution 1 QL (30 ML per 1 day)

meperidine oral tablet 1 QL (6 EA per 1 day)

MEPERITAB 1 QL (6 EA per 1 day)

methadone injection 1 PA

METHADONE INTENSOL 1 PA

methadone oral concentrate 1 PA

methadone oral solution 1 PA

methadone oral tablet 1 PA

methadone oral tablet,soluble 1 PA

8

Drug Name Tier NotesMETHADOSE ORAL CONCENTRATE 2 PA

METHADOSE ORAL TABLET,SOLUBLE 1 PA

MIGERGOT 2 QL (5 EA per 7 days)

MIGRAINE FORMULA 1

MIGRAINE RELIEF 1

MIGRANAL 2 QL (8 ML per 28 days)

MINIPRIN 3

morphine (pf) injection solution 0.5 mg/ml, 1 mg/ml 1

morphine (pf) intravenous 1

morphine concentrate oral solution 1

morphine in 0.9 % nacl intravenous solution 1 mg/ml 1

morphine injection solution 10 mg/ml, 15 mg/ml, 8 mg/ml 1

morphine injection syringe 10 mg/ml, 2 mg/ml, 4 mg/ml, 5 mg/ml, 8 mg/ml

1

morphine intravenous 1

morphine oral capsule, er multiphase 24 hr 120 mg 1 QL (2 EA per 1 day)

morphine oral capsule, er multiphase 24 hr 30 mg, 45 mg, 60 mg, 75 mg, 90 mg


morphine oral capsule,extend.release pellets 10 mg, 20 mg, 50 mg, 60 mg, 80 mg


morphine oral solution 1

morphine oral tablet 2

morphine oral tablet extended release 1 QL (3 EA per 1 day)

morphine rectal 1

MS CONTIN 2 QL (3 EA per 1 day)

nalbuphine 1

naratriptan 1 QL (3 EA per 5 days)

NODOLOR 1

NON-ASPIRIN EXTRA STRENGTH ORAL TABLET 1

NON-ASPIRIN ORAL TABLET 1

NON-ASPIRIN PAIN RELIEF ORAL TABLET 500 MG 1

NORCO 2 QL (12 EA per 1 day)

NUCYNTA 2 QL (6 EA per 1 day)

NUCYNTA ER 2 QL (2 EA per 1 day)

OPANA 2

OPANA ER ORAL TABLET,ORAL ONLY,EXT.REL.12 HR 10 MG, 15 MG, 20 MG, 5 MG, 7.5 MG


OPANA ER ORAL TABLET,ORAL ONLY,EXT.REL.12 HR 30 MG, 40 MG


OXECTA 2

oxycodone oral capsule 1

oxycodone oral concentrate 1

oxycodone oral solution 1

oxycodone oral tablet 1

oxycodone oral tablet extended release 12 hr 1 QL (2 EA per 1 day)

9

Drug Name Tier Notesoxycodone oral tablet,oral only,ext.rel.12 hr 10 mg, 20 mg, 40 mg


oxycodone oral tablet,oral only,ext.rel.12 hr 80 mg 1 QL (4 EA per 1 day)

oxycodone-acetaminophen oral capsule 1 QL (8 EA per 1 day)

oxycodone-acetaminophen oral tablet 10-325 mg, 2.5-325 mg, 5-325 mg, 7.5-325 mg


oxycodone-acetaminophen oral tablet 10-650 mg 1 QL (6 EA per 1 day)

oxycodone-acetaminophen oral tablet 7.5-500 mg 1 QL (8 EA per 1 day)

oxycodone-aspirin 1

OXYCONTIN ORAL TABLET,ORAL ONLY,EXT.REL.12 HR 10 MG, 15 MG, 20 MG, 30 MG, 40 MG, 60 MG


OXYCONTIN ORAL TABLET,ORAL ONLY,EXT.REL.12 HR 80 MG


oxymorphone oral tablet 1

oxymorphone oral tablet extended release 12 hr 10 mg, 15 mg, 20 mg, 5 mg, 7.5 mg


oxymorphone oral tablet extended release 12 hr 30 mg, 40 mg


PAIN & FEVER 1

PAIN RELIEF EXTRA STRENGTH 1

PAIN RELIEF ORAL TABLET 1

PAIN RELIEF ORAL TABLET EXTENDED RELEASE 1

PAIN RELIEF REGULAR STRENGTH 1

PAIN RELIEVER 1

PAIN RELIEVER EXTRA STRENGTH 1

PAIN RELIEVER PLUS 1

pentazocine-acetaminophen 1

pentazocine-naloxone 1

PERCOCET ORAL TABLET 10-325 MG, 2.5-325 MG, 5-325 MG, 7.5-325 MG


PERCODAN 2

PHARBETOL 1

PHRENILIN FORTE 2

PONSTEL 2

PRE-MENSTRUAL RELIEF 1

PRIALT 2

PRIMLEV 2 QL (13 EA per 1 day)

propoxyphene 1

propoxyphene n-acetaminophen oral tablet 100-650 mg 1 QL (6 EA per 1 day)

propoxyphene-acetaminophen 1

Q-PAP 1

Q-PAP EXTRA STRENGTH 1

RELPAX ORAL TABLET 20 MG 2 ST; QL (2 EA per 5 days)

REPREXAIN 1

RIMSO-50 2

10

Drug Name Tier Notesrizatriptan 1 QL (3 EA per 5 days)

ROXICET ORAL SOLUTION 1 QL (61 ML per 1 day)

ROXICET ORAL TABLET 5-325 MG 1 QL (12 EA per 1 day)

ROXICET ORAL TABLET 5-500 MG 1 QL (8 EA per 1 day)

ROXICODONE 2

SILAPAP 1

SPRIX 2 QL (1 EA per 6 days)

SUBLIMAZE (PF) 2

SUBSYS 2 PA; QL (4 EA per 1 day)

SUFENTA 2

sufentanil citrate 1

sumatriptan 1 QL (6 EA per 15 days)

sumatriptan succinate oral 1 QL (3 EA per 5 days)

sumatriptan succinate subcutaneous cartridge 1 QL (1 ML per 14 days)

sumatriptan succinate subcutaneous pen injector 1 QL (1 ML per 14 days)

sumatriptan succinate subcutaneous solution 1 QL (1 ML per 14 days)

sumatriptan succinate subcutaneous syringe 6 mg/0.5 ml 1 QL (1 ML per 14 days)

SUMAVEL DOSEPRO SUBCUTANEOUS NEEDLE-FREE INJECTOR 4 MG/0.5 ML

2 ST; QL (4 ML per 28 days)

SUMAVEL DOSEPRO SUBCUTANEOUS NEEDLE-FREE INJECTOR 6 MG/0.5 ML


SYNALGOS-DC 2

TACTINAL 1

TACTINAL EXTRA STRENGTH 1

TALWIN 2

TENSION HEADACHE 1

tramadol oral capsule,er biphase 24 hr 17-83 1 ST; QL (1 EA per 1 day)

tramadol oral capsule,er biphase 24 hr 25-75 100 mg, 200 mg


tramadol oral tablet 1

tramadol oral tablet extended release 24 hr 1

tramadol oral tablet, er multiphase 24 hr 1

tramadol-acetaminophen 1

TRIAMINIC FEVER REDUCER 1

TRI-BUFFERED ASPIRIN 1

TYLENOL-CODEINE #3 2

TYLENOL-CODEINE #4 2

ULTIVA 2

ULTRACET 2

ULTRAM 2

ULTRAM ER 2

VANATOL LQ 2

VICODIN ES 1 QL (13 EA per 1 day)

VICODIN HP ORAL TABLET 10-300 MG 1 QL (13 EA per 1 day)

VICODIN ORAL TABLET 5-300 MG 1 QL (13 EA per 1 day)

11

Drug Name Tier NotesVICOPROFEN 2

XARTEMIS XR 2 QL (12 EA per 1 day)

XODOL 10/300 2 QL (13 EA per 1 day)

XODOL 5/300 2 QL (13 EA per 1 day)

XODOL 7.5/300 2 QL (13 EA per 1 day)

XYLON 10 1

ZAMICET 2 QL (184 ML per 1 day)

ZEBUTAL ORAL CAPSULE 50-325-40 MG 1

ZEBUTAL ORAL CAPSULE 50-500-40 MG 2

ZECUITY 2

ZIPSOR 2 ST; QL (4 EA per 1 day)

ZOHYDRO ER 2 QL (2 EA per 1 day)

ZOMIG NASAL SPRAY,NON-AEROSOL 2.5 MG 2 ST; QL (12 EA per 30 days)

ZOMIG NASAL SPRAY,NON-AEROSOL 5 MG 2 ST; QL (6 EA per 15 days)

ZOMIG ORAL TABLET 2.5 MG 2 ST; QL (2 EA per 5 days)

ZOMIG ZMT 2 ST; QL (2 EA per 5 days)

ANESTHETICSAMIDATE 2

AZO 1

AZO-GESIC 1

BABY TEETHING GEL 1

BREVITAL INJECTION RECON SOLN 2.5 GRAM, 500 MG

2

BUFFERED LIDOCAINE INJECTION SYRINGE 1 % (1 ML)

2

bupivacaine 1

bupivacaine (pf) injection solution 1

bupivacaine in nacl(pf) epidural solution 0.125 % (1,250 mcg/ml)

1

bupivacaine-dextrose-water(pf) 1

bupivacaine-epinephrine 1

bupivacaine-epinephrine (pf) 1

bupivacaine-epinephrine bitart 1

BURN RELIEF 1

CARBOCAINE 2

CARBOCAINE (PF) 2

CEPACOL SENSATIONS COOLING 2

CEPACOL SENSATIONS HYDRA 2

CEPACOL SORE THROAT (BENZ-MEN) 2

CEPACOL ULTRA 1

chloroprocaine (pf) 1

cocaine 1

dibucaine 1

DIPRIVAN 2

EMLA 2

12

Drug Name Tier Notesetomidate 1

FORANE 2

GLYDO 1

KETALAR 2

ketamine injection 1

LANACANE ANTI-ITCH 2

LANACANE FIRST AID 2

LDO PLUS 2

lidocaine 1

lidocaine (pf) in d7.5w 1

lidocaine (pf) injection solution 1

lidocaine hcl injection solution 1

lidocaine hcl laryngotracheal 1

lidocaine hcl mucous membrane 1

lidocaine hcl topical cream 1

LIDOCAINE VISCOUS 1

lidocaine-epinephrine 1

lidocaine-epinephrine (pf) 1

lidocaine-epinephrine bit injection cartridge 2 %-1:100,000 2

lidocaine-epinephrine bit injection cartridge 2 %-1:50,000 1

lidocaine-prilocaine 1

LIDODERM 2

LUSEDRA 2

MARCAINE 2

MARCAINE (PF) 2

MARCAINE SPINAL (PF) 2

MARCAINE-EPINEPHRINE 2

MARCAINE-EPINEPHRINE (PF) 2

mepivacaine (pf) 1

midazolam (pf) in 0.9 % nacl 1

midazolam (pf) injection 1

midazolam in 0.9 % nacl intravenous syringe 2 mg/2 ml (1 mg/ml)

1

midazolam injection 1

NAROPIN (PF) INJECTION SOLUTION 10 MG/ML (1 %), 2 MG/ML (0.2 %), 7.5 MG/ML (0.75 %)

2

NESACAINE 2

NESACAINE-MPF INJECTION SOLUTION 20 MG/ML (2 %)

1

NESACAINE-MPF INJECTION SOLUTION 30 MG/ML (3 %)

2

NUPERCAINAL 2

ORAL PAIN RELIEF MUCOUS MEMBRANE GEL 1

ORAL PAIN RELIEF MUCOUS MEMBRANE LIQUID 1

ORASEP 2

13

Drug Name Tier NotesPAIN RELIEF ANESTHETIC 1

PHENASEPTIC 1

phenazopyridine oral tablet 100 mg, 200 mg 1

PLIAGLIS 2

POLOCAINE 1

POLOCAINE-MPF 1

PONTOCAINE (PF) INJECTION RECON SOLN 2

propofol intravenous emulsion 1

PYRIDIUM 2

ropivacaine (pf) in 0.9 % nacl local infiltration elastomeric pump,hi var rate

1

ropivacaine (pf) injection 1

SARNA SENSITIVE 1

SENSORCAINE 2

SENSORCAINE/EPINEPHRINE 1

SENSORCAINE-MPF INJECTION SOLUTION 0.25 % (2.5 MG/ML), 0.5 % (5 MG/ML)

2

SENSORCAINE-MPF INJECTION SOLUTION 0.75 % (7.5 MG/ML)

1

SENSORCAINE-MPF SPINAL 1

SENSORCAINE-MPF/EPINEPHRINE INJECTION SOLUTION 0.25 %-1:200,000, 0.75 %-1:200,000

1

SENSORCAINE-MPF/EPINEPHRINE INJECTION SOLUTION 0.5 %-1:200,000

2

sevoflurane 1

SORE THROAT 1

SORE THROAT (BENZOCAINE-MENTH) MUCOUS MEMBRANE LOZENGE 15-3.6 MG

1

SORE THROAT (PHENOL) 1

SUPRANE 2

SYNERA 2

tetracaine hcl (pf) injection 1

THROAT SPRAY 1

ULTANE 2

URINARY PAIN RELIEF 1

XYLOCAINE INJECTION 2

XYLOCAINE JELLY 2

XYLOCAINE MUCOUS MEMBRANE SOLUTION 2

XYLOCAINE-EPINEPHRINE 2

XYLOCAINE-MPF INJECTION SOLUTION 15 MG/ML (1.5 %), 40 MG/ML (4 %)

2

XYLOCAINE-MPF INJECTION SOLUTION 5 MG/ML (0.5 %)

1

XYLOCAINE-MPF/EPINEPHRINE INJECTION SOLUTION 1 %-1:200,000, 2 %-1:200,000

2

ZINGO 2

14


ANTIARTHRITICSALL DAY PAIN RELIEF 1

ALL DAY RELIEF 1

allopurinol 1

ALOPRIM 2

ANAPROX 2

ANAPROX DS 2

ARAVA 2

ARTHROTEC 50 2

ARTHROTEC 75 2

CALDOLOR INTRAVENOUS RECON SOLN 800 MG/8 ML (100 MG/ML)

2

CELEBREX ORAL CAPSULE 100 MG, 200 MG, 50 MG 2

celecoxib oral capsule 100 mg, 200 mg, 50 mg 1

CHILD IBUPROFEN 1

CHILDREN'S IBUPROFEN 1

colchicine oral capsule 1 QL (2 EA per 1 day)

colchicine oral tablet 1

colchicine-probenecid 1

COLCRYS 2

CUPRIMINE 2

DAYPRO 2

DEPEN TITRATABS 2

diclofenac sodium oral 1

diclofenac-misoprostol 1

DISALCID 2

DUEXIS 2 ST; QL (3 EA per 1 day)

DYLOJECT 2

EC-NAPROSYN 2

ELITEK 2

ENBREL 2 PA

ENBREL SURECLICK 2 PA

etodolac 1

FELDENE 2

fenoprofen oral capsule 2

fenoprofen oral tablet 1

flurbiprofen 1

glucosam su dip-chondroit-c-mn 1

glucosam-chondr msm#6-manganes 2

glucosamine sulfate oral capsule 500 mg 1

HUMIRA 2 PA

HUMIRA PEDIATRIC CROHN'S START 2 PA

HUMIRA PEN 2 PA

HUMIRA PEN CROHN'S-UC-HS START 2 PA

15

Drug Name Tier NotesHUMIRA PEN PSORIASIS STARTER 2 PA

IBU-DROPS 1

IBUPROFEN IB 1

IBUPROFEN JR STRENGTH 1

ibuprofen oral capsule 1

ibuprofen oral suspension 1

ibuprofen oral tablet 200 mg, 400 mg, 600 mg, 800 mg 1

INDOCIN 2

indomethacin oral 1

INFANTS IBU-DROPS 1

INFANT'S IBUPROFEN 1

ketoprofen oral capsule 1

ketoprofen oral capsule,ext rel. pellets 24 hr 200 mg 1

KINERET 2 PA

leflunomide 1

meclofenamate oral 1

meloxicam 1

MITIGARE 2 QL (2 EA per 1 day)

MOBIC 2

MYOCHRYSINE 2

nabumetone 1

NALFON ORAL CAPSULE 400 MG 2

NAPRELAN CR 2

NAPRELAN CR DOSE CARD 2

NAPROSYN 2

naproxen 1

naproxen sodium oral capsule 1

naproxen sodium oral tablet 1

naproxen sodium oral tablet, er multiphase 24 hr 1

ORENCIA 2 PA

ORENCIA (WITH MALTOSE) 2

OTEZLA 2 PA

OTEZLA STARTER 2 PA

oxaprozin 1

piroxicam 1

probenecid 1

PROVIL 1

RASUVO (PF) SUBCUTANEOUS AUTO-INJECTOR 15 MG/0.3 ML

2 ST; QL (1.2 ML per 28 days)

RHEUMATREX 2

RIDAURA 2

salsalate 1

SIMPONI 2 PA

SIMPONI ARIA 2

16

Drug Name Tier Notessulindac oral 1

TIVORBEX 2

tolmetin 1

ULORIC 2 ST; QL (30 EA per 30 days)

VIMOVO ORAL TABLET,IR & DELAY REL,BIPHASIC 375-20 MG

2 ST

VOLTAREN-XR 2

XELJANZ 2 PA

ZORVOLEX 2 ST; QL (3 EA per 1 day)

ZYLOPRIM 2

ANTIASTHMATICSACCOLATE 2

acetylcysteine 1

ADVAIR DISKUS INHALATION BLISTER WITH DEVICE 100-50 MCG/DOSE, 250-50 MCG/DOSE

2 QL (2 EA per 30 days)

ADVAIR DISKUS INHALATION BLISTER WITH DEVICE 500-50 MCG/DOSE


ADVAIR HFA 2 QL (12 GM per 30 days)

AEROSPAN 2 QL (17.8 GM per 30 days)

albuterol sulfate inhalation solution for nebulization 1

albuterol sulfate oral 1

ALVESCO 2 ST; QL (12.2 GM per 25 days)

aminophylline intravenous 1

aminophylline oral tablet 1

ANORO ELLIPTA 2 QL (60 EA per 30 days)

ARCAPTA NEOHALER 2 ST; QL (1 EA per 1 day)

ARNUITY ELLIPTA 2 ST; QL (30 EA per 30 days)

ASMANEX HFA 2 QL (13 GM per 30 days)

ASMANEX TWISTHALER INHALATION AEROSOL POWDR BREATH ACTIVATED 110 MCG (30 DOSES), 220 MCG (120 DOSES), 220 MCG (14 DOSES), 220 MCG (30 DOSES), 220 MCG (60 DOSES)

2 ST; QL (1 EA per 30 days)

ASTHMANEFRIN REFILL 2

ATROVENT HFA 2 QL (25.8 GM per 28 days)

BREO ELLIPTA 2 QL (60 EA per 30 days)

BROVANA 2 QL (60 ML per 15 days)

budesonide inhalation suspension for nebulization 0.25 mg/2 ml, 0.5 mg/2 ml

1 QL (60 ML per 15 days)

budesonide inhalation suspension for nebulization 1 mg/2 ml


COMBIVENT RESPIMAT 2

cromolyn inhalation 1

cromolyn nasal 1

cromolyn oral 1

DULERA 2 QL (13 GM per 30 days)

DUONEB 2

17

Drug Name Tier NotesELIXOPHYLLIN ORAL ELIXIR 80 MG/15 ML 1

FLOVENT DISKUS INHALATION BLISTER WITH DEVICE 100 MCG/ACTUATION, 50 MCG/ACTUATION


FLOVENT DISKUS INHALATION BLISTER WITH DEVICE 250 MCG/ACTUATION


FLOVENT HFA INHALATION HFA AEROSOL INHALER 110 MCG/ACTUATION

2 ST; QL (12 GM per 30 days)


2 ST; QL (24 GM per 30 days)


2 ST; QL (21.2 GM per 30 days)

FORADIL AEROLIZER 2 ST; QL (60 EA per 30 days)

GASTROCROM 2

INCRUSE ELLIPTA 2 QL (30 EA per 30 days)

ipratropium bromide inhalation 1

ipratropium-albuterol 1

levalbuterol hcl 1

LUFYLLIN ORAL TABLET 200 MG 2

metaproterenol oral 1

montelukast 1

PERFOROMIST 2 QL (120 ML per 30 days)

PROAIR HFA 2

PROAIR RESPICLICK 2

PROVENTIL HFA 2

PULMICORT FLEXHALER 2 ST; QL (1 EA per 30 days)

PULMICORT INHALATION SUSPENSION FOR NEBULIZATION 0.25 MG/2 ML, 0.5 MG/2 ML


PULMICORT INHALATION SUSPENSION FOR NEBULIZATION 1 MG/2 ML


QVAR 2 ST; QL (174 GM per 300 days)

racepinephrine 2

S2 RACEPINEPHRINE 2

SEREVENT DISKUS 2 ST; QL (60 EA per 30 days)

SINGULAIR 2

SPIRIVA RESPIMAT INHALATION MIST 1.25 MCG/ACTUATION

2

SPIRIVA RESPIMAT INHALATION MIST 2.5 MCG/ACTUATION

2 QL (4 GM per 30 days)

SPIRIVA WITH HANDIHALER 2 QL (1 EA per 1 day)

STIOLTO RESPIMAT 2

STRIVERDI RESPIMAT 2 QL (4 GM per 30 days)

SYMBICORT 2 ST; QL (10.2 GM per 30 days)

terbutaline oral 1

terbutaline subcutaneous 1

THEO-24 2

theophylline in dextrose 5 % 1

18

Drug Name Tier Notestheophylline oral solution 1

theophylline oral tablet extended release 1

theophylline oral tablet extended release 12 hr 1

VENTOLIN HFA 2

VOSPIRE ER 2

XOLAIR 2 QL (1 EA per 5 days)

XOPENEX 2

XOPENEX CONCENTRATE 2

XOPENEX HFA 2

zafirlukast 1

ZYFLO 2

ZYFLO CR 2

ANTIBIOTICSADOXA ORAL CAPSULE 2 ST; QL (2 EA per 1 day)

AK-POLY-BAC 1

amikacin injection solution 1,000 mg/4 ml, 500 mg/2 ml 1

amoxicillin oral capsule 1

amoxicillin oral suspension for reconstitution 1

amoxicillin oral tablet 1

amoxicillin oral tablet, er multiphase 24 hr 1

amoxicillin oral tablet,chewable 125 mg, 250 mg 1

amoxicillin-pot clavulanate 1

ampicillin 1

ampicillin sodium 1

ampicillin-sulbactam 1

ANTIBIOTIC (BACITRACIN ZINC) 1

ANTIBIOTIC PLUS (PRAMOXINE) 1

AUGMENTIN ES-600 2

AUGMENTIN ORAL SUSPENSION FOR RECONSTITUTION 125-31.25 MG/5 ML, 250-62.5 MG/5 ML

2

AUGMENTIN ORAL TABLET 500-125 MG, 875-125 MG

2

AUGMENTIN XR 2

AVAR 2

AVAR LS 2

AVAR-E 2

AVAR-E GREEN 2

AVAR-E LS 2

AVELOX 2

AVELOX ABC PACK 2

AVELOX IN NACL (ISO-OSMOTIC) 2

AVYCAZ 2

AZACTAM 2

AZACTAM IN DEXTROSE (ISO-OSM) 2

19

Drug Name Tier NotesAZASITE 2

azithromycin 1

aztreonam 1

AZUPHEN MB 1

BACIIM 1

bacitracin 1

bacitracin zinc 1

bacitracin-polymyxin b 1

BACTRIM 2

BACTRIM DS 2

BACTROBAN 2

BACTROBAN NASAL 2

BENZAMYCIN 2

BESIVANCE 2

BETHKIS 2 PA

BIAXIN ORAL SUSPENSION FOR RECONSTITUTION 250 MG/5 ML

2

BIAXIN ORAL TABLET 2

BICILLIN C-R 2

BICILLIN L-A 2

BLEPH-10 1

BLEPHAMIDE 2

BLEPHAMIDE S.O.P. 2

BP 10-1 1

CAPASTAT 2

CAYSTON 2 PA; QL (84 ML per 56 days)

CEDAX 2

cefaclor oral capsule 1

cefaclor oral suspension for reconstitution 125 mg/5 ml, 250 mg/5 ml, 375 mg/5 ml

1

cefaclor oral tablet extended release 12 hr 1

cefadroxil oral capsule 1

cefadroxil oral suspension for reconstitution 250 mg/5 ml, 500 mg/5 ml

1

cefadroxil oral tablet 1

cefazolin in 0.9% sod chloride intravenous solution 1

cefazolin in dextrose (iso-os) intravenous piggyback 2 gram/50 ml

1

cefazolin in dextrose 5 % 1

cefazolin injection recon soln 1 gram, 10 gram, 20 gram, 500 mg

1

cefazolin intravenous 1

cefdinir 1

cefepime 1

cefepime in dextrose 5 % 2

20

Drug Name Tier Notescefepime in dextrose,iso-osm 2

cefixime 1

cefotaxime injection recon soln 1 gram, 2 gram, 500 mg 1

cefotetan 1

cefotetan in dextrose, iso-osm 1

cefoxitin 1

cefoxitin in dextrose, iso-osm 1

cefpodoxime 1

cefprozil 1

ceftazidime 1

ceftazidime in d5w 2

ceftibuten 1

CEFTIN ORAL SUSPENSION FOR RECONSTITUTION 2

CEFTIN ORAL TABLET 250 MG, 500 MG 2

ceftriaxone in dextrose,iso-os intravenous piggyback 2 gram/50 ml

2

ceftriaxone injection recon soln 1 gram, 10 gram, 2 gram, 250 mg, 500 mg

1

ceftriaxone intravenous recon soln 1

cefuroxime axetil oral tablet 1

cefuroxime sodium injection recon soln 1.5 gram, 750 mg 1

cefuroxime sodium injection recon soln 75 gram 2

cefuroxime sodium intravenous 1

CENTANY 2

CENTANY AT 2

cephalexin 1

chloramphenicol sod succinate 1

CILOXAN 2

CIPRO HC 2

CIPRO IN D5W INTRAVENOUS PIGGYBACK 400 MG/200 ML

2

CIPRO ORAL SUSPENSION,MICROCAPSULE RECON 2

CIPRO ORAL TABLET 250 MG, 500 MG 2

CIPRO XR 2

CIPRODEX 2

ciprofloxacin 1

ciprofloxacin (mixture) 1

ciprofloxacin hcl 1

ciprofloxacin in 5 % dextrose 1

ciprofloxacin lactate 1

CLAFORAN INJECTION 2

CLAFORAN INTRAVENOUS RECON SOLN 2

clarithromycin 1

CLEANSING WASH TOPICAL CLEANSER 1

CLENIA EMOLLIENT 1

21

Drug Name Tier NotesCLENIA FOAMING WASH 1

CLEOCIN 2

CLEOCIN IN 5 % DEXTROSE 2

CLEOCIN T 2

CLINDACIN ETZ 2

CLINDACIN P 2

CLINDACIN PAC 2

clindamycin hcl 1

clindamycin in 5 % dextrose 1

clindamycin palmitate hcl 1

CLINDAMYCIN PEDIATRIC 1

clindamycin phosphate injection 1

clindamycin phosphate intravenous 1

clindamycin phosphate topical 1

clindamycin phosphate vaginal 1

CLINDESSE 2

colistin (colistimethate na) 1

COLY-MYCIN M PARENTERAL 2

COLY-MYCIN S 2

CORTISPORIN TOPICAL 2

CORTISPORIN-TC 2

CORTOMYCIN 1

CUBICIN 2

cycloserine 1

DALVANCE 2

dapsone 1

demeclocycline oral 1

dicloxacillin 1

DIFICID 2 ST; QL (20 EA per 30 days)

DORIBAX 2

DORYX ORAL TABLET,DELAYED RELEASE (DR/EC) 150 MG, 50 MG


DORYX ORAL TABLET,DELAYED RELEASE (DR/EC) 200 MG


DOUBLE ANTIBIOTIC 1

DOUBLE ANTIBIOTIC (B.TRACN ZN) 1

DOXY-100 1

doxycycline hyclate intravenous 1

doxycycline hyclate oral capsule 1 ST; QL (2 EA per 1 day)

doxycycline hyclate oral tablet 100 mg 1 ST; QL (2 EA per 1 day)

doxycycline hyclate oral tablet,delayed release (dr/ec) 1 ST; QL (2 EA per 1 day)

doxycycline monohydrate oral capsule 1 QL (2 EA per 1 day)

doxycycline monohydrate oral capsule,ir & delay rel,biphase


doxycycline monohydrate oral suspension for reconstitution 1

22

Drug Name Tier Notesdoxycycline monohydrate oral tablet 1 QL (2 EA per 1 day)

DYNACIN ORAL TABLET 100 MG 2

E.E.S. 400 ORAL TABLET 1

E.E.S. GRANULES 1

ERY PADS 1

ERYGEL 2

ERYPED 200 2

ERYPED 400 2

ERY-TAB ORAL TABLET,DELAYED RELEASE (DR/EC) 250 MG, 500 MG

1

ERY-TAB ORAL TABLET,DELAYED RELEASE (DR/EC) 333 MG

2

ERYTHROCIN (AS STEARATE) ORAL TABLET 250 MG

1

ERYTHROCIN INTRAVENOUS RECON SOLN 500 MG 2

erythromycin ethylsuccinate oral tablet 1

erythromycin ophthalmic 1

erythromycin oral capsule,delayed release(dr/ec) 1

erythromycin oral tablet 1

erythromycin with ethanol 1

erythromycin-benzoyl peroxide 1

ethambutol 1

EVOCLIN 2

FLAGYL 2

FORTAZ 2

FORTAZ IN DEXTROSE 5 % 2

FURADANTIN 2

GARAMYCIN 2

gatifloxacin 1

GENTAK OPHTHALMIC OINTMENT 1

gentamicin 1

gentamicin in nacl (iso-osm) intravenous piggyback 100 mg/100 ml, 100 mg/50 ml, 120 mg/100 ml, 60 mg/50 ml, 70 mg/50 ml, 80 mg/100 ml, 80 mg/50 ml, 90 mg/100 ml

1

gentamicin sulfate (ped) (pf) 1

gentamicin sulfate (pf) 1

HIPREX 2

HYOLEV MB 1

ILOTYCIN 2

imipenem-cilastatin 1

INDIOMIN MB 1

INVANZ 2

IQUIX 2

ISONARIF 1

isoniazid 1

23

Drug Name Tier Noteskanamycin 1

KEFLEX ORAL CAPSULE 2

KETEK 2

KITABIS PAK 2 PA

LEVAQUIN IN 5 % DEXTROSE 2

LEVAQUIN ORAL 2

levofloxacin 1

levofloxacin in d5w 1

LINCOCIN 2

linezolid intravenous 1

linezolid oral tablet 1 PA

linezolid-0.9% sodium chloride 1

MACROBID 2

MACRODANTIN 2

mafenide acetate 1

MAXIPIME 2

MAXITROL 2

MEFOXIN IN DEXTROSE (ISO-OSM) 2

meropenem 1

meropenem-0.9% sodium chloride 1

MERREM 2

methenamine hippurate 1

methenamine mandelate 1

METRO I.V. 2

METROGEL VAGINAL 2

metronidazole in nacl (iso-os) 1

metronidazole oral 1

metronidazole vaginal 1

MINOCIN INTRAVENOUS 2

minocycline oral capsule 1

minocycline oral tablet 1

minocycline oral tablet extended release 24 hr 1 ST; QL (1 EA per 1 day)

MONUROL 2

MORGIDOX 2 ST; QL (2 EA per 1 day)

MORGIDOX 1X100 2 ST; QL (1 EA per 30 days)

MORGIDOX 2X100 2 ST; QL (1 EA per 30 days)

MOXATAG 2

MOXEZA 2

moxifloxacin 1

moxifloxacin-sod.ace,sul-water 1

mupirocin 1

mupirocin calcium 1

MYAMBUTOL 2

MYCOBUTIN 2

24

Drug Name Tier Notesnafcillin 1

nafcillin in dextrose iso-osm 1

NEO-FRADIN 1

neomycin 1

neomycin-bacitracin-poly-hc 1

neomycin-bacitracin-polymyxin 1

neomycin-polymyxin b-dexameth 1

neomycin-polymyxin-gramicidin 1

neomycin-polymyxin-hc 1

NEO-POLYCIN HC 1

NEOSPORIN (NEO-POLYM-GRAMICID) 2

NEO-SYNALAR 2 ST

NEO-SYNALAR KIT 2 ST

nitrofurantoin macrocrystal 1

nitrofurantoin monohyd/m-cryst 1

nitrofurantoin oral 1

NUVESSA 2

OCUFLOX 2

ofloxacin 1

ORACEA 2 ST; QL (1 EA per 1 day)

ORBACTIV 2

oxacillin 1

oxacillin in dextrose(iso-osm) 1

PASER 2

PCE 2

penicillin g pot in dextrose 1

penicillin g potassium 1

penicillin g procaine 1

penicillin g sodium 1

penicillin v potassium 1

PFIZERPEN-G 1

piperacillin-tazobactam 1

POLYCIN 1

polymyxin b sulfate 1

polymyxin b sulf-trimethoprim 1

POLYTRIM 2

PRASCION 1

PRASCION FC 1

PRASCION RA 1

PRED-G 2

PRED-G S.O.P. 2

PRIFTIN 2

PRIMAXIN IV 2

PRIMSOL 2

25

Drug Name Tier NotesPROQUIN XR 2

pyrazinamide 1

QUIXIN 2

rifabutin 1

RIFADIN 2

RIFAMATE 2

rifampin intravenous 1

rifampin oral 1

RIFATER 2

ROCEPHIN INJECTION RECON SOLN 1 GRAM 2

ROSANIL 2

ROSULA 2

ROSULA CLEANSING CLOTHS 2

SEROMYCIN 2

SILVADENE 2

silver sulfadiazine 1

SIRTURO 2 PA

SIVEXTRO INTRAVENOUS 2

SIVEXTRO ORAL 2 PA

SOLODYN ORAL TABLET EXTENDED RELEASE 24 HR 105 MG, 115 MG, 55 MG, 65 MG, 80 MG


SSD 1

SSS 10-5 TOPICAL CREAM 1

streptomycin intramuscular 1

sulfacetamide sodium ophthalmic 1

sulfacetamide sodium-sulfur topical cleanser 1

sulfacetamide sodium-sulfur topical cream 10-2 %, 10-5 % (w/w)

1

sulfacetamide sodium-sulfur topical lotion 10-5 % (w/v), 10-5 % (w/w)

1

sulfacetamide sodium-sulfur topical pads, medicated 1

sulfacetamide sodium-sulfur topical suspension 1

sulfacetamide sod-sulfur-urea topical cleanser 1

sulfacetamide-prednisolone 1

sulfacetamide-sulfur-cleansr23 1

SULFACLEANSE 8-4 1

sulfact na-sul-avobnz-otn-ocsa 1

sulfadiazine oral 1

sulfamethoxazole-trimethoprim 1

SULFAMIDE 1

SULFAMYLON 2

SULFATRIM 1

SUMADAN 2

SUMADAN XLT 2

SUMAXIN 2

26

Drug Name Tier NotesSUMAXIN CP 2

SUMAXIN TS 2

SUPRAX 2

SYNERCID 2

TAZICEF 1

TEFLARO 2

tetracycline 1

THALOMID 2 PA; QL (2 EA per 1 day)

TOBI 2 PA; QL (5 ML per 1 day)

TOBI PODHALER 2 PA

TOBRADEX 2

TOBRADEX ST 2

tobramycin 1

tobramycin in 0.225 % nacl 1 PA; QL (5 ML per 1 day)

tobramycin in 0.9 % nacl intravenous piggyback 80 mg/100 ml

1

tobramycin sulfate 1

tobramycin-dexamethasone 1

TOBREX 2

TRECATOR 2

trimethoprim 1

TRIOXIN 2

TRIPLE ANTIBIOTIC (PRAM) EXTRA 1

TRIPLE ANTIBIOTIC PLUS 1

TRIPLE ANTIBIOTIC TOPICAL OINTMENT 1

TRIPLE ANTIBIOTIC TOPICAL OINTMENT IN PACKET

1

TYGACIL 2

UNASYN 2

UR N-C 1

URAMIT MB 1

URELLE 2

URIMAR-T 1

URIN DS 2

UROGESIC-BLUE 1

URO-L 1

UROLET MB 1

UROPHEN MB 1

UTIRA-C 2

VANCOCIN 2 QL (40 EA per 30 days)

vancomycin in 0.9% sodium cl intravenous solution 1.25 gram/250 ml, 1.5 gram/250 ml

1

vancomycin in d5w intravenous piggyback 1

vancomycin in d5w intravenous solution 1.5 gram/250 ml 1

vancomycin in dextrose iso-osm 1

27

Drug Name Tier Notesvancomycin intravenous 1

vancomycin oral 1 QL (40 EA per 30 days)

VANDAZOLE 2

VIBATIV 2

VIBRAMYCIN ORAL CAPSULE 100 MG 2 ST; QL (2 EA per 1 day)

VIBRAMYCIN ORAL SUSPENSION FOR RECONSTITUTION

2

VIBRAMYCIN ORAL SYRUP 2

VIGAMOX 2

VIRTI-SULF 1

XIFAXAN ORAL TABLET 200 MG 2

XIFAXAN ORAL TABLET 550 MG 2 QL (2 EA per 1 day)

ZERBAXA 2

ZINACEF 2

ZINACEF IN STERILE WATER 2

ZITHROMAX 2

ZITHROMAX TRI-PAK 2

ZITHROMAX Z-PAK 2

ZMAX 2

ZOSYN 2

ZOSYN IN DEXTROSE (ISO-OSM) 2

ZYLET 2

ZYMAXID 2

ZYVOX INTRAVENOUS 2

ZYVOX ORAL SUSPENSION FOR RECONSTITUTION 2

ZYVOX ORAL TABLET 2 PA

ANTICOAGULANTSANGIOMAX 2

argatroban 2

argatroban in 0.9 % sod chlor 2

argatroban in nacl (iso-os) 2

ARIXTRA SUBCUTANEOUS SYRINGE 10 MG/0.8 ML 2 QL (8 ML per 30 days)

ARIXTRA SUBCUTANEOUS SYRINGE 2.5 MG/0.5 ML 2 QL (5 ML per 30 days)

ARIXTRA SUBCUTANEOUS SYRINGE 5 MG/0.4 ML 2 QL (4 ML per 30 days)

ARIXTRA SUBCUTANEOUS SYRINGE 7.5 MG/0.6 ML 2 QL (6 ML per 30 days)

bivalirudin 1

COUMADIN 2

ELIQUIS ORAL TABLET 2.5 MG 2 QL (60 EA per 30 days)

ELIQUIS ORAL TABLET 5 MG 2 QL (74 EA per 30 days)

enoxaparin subcutaneous solution 1 QL (30 ML per 30 days)

enoxaparin subcutaneous syringe 100 mg/ml, 150 mg/ml 1 QL (20 ML per 30 days)

enoxaparin subcutaneous syringe 120 mg/0.8 ml, 80 mg/0.8 ml


enoxaparin subcutaneous syringe 30 mg/0.3 ml 1 QL (6 ML per 30 days)

28

Drug Name Tier Notesenoxaparin subcutaneous syringe 40 mg/0.4 ml 1 QL (8 ML per 30 days)

enoxaparin subcutaneous syringe 60 mg/0.6 ml 1 QL (12 ML per 30 days)

fondaparinux subcutaneous syringe 10 mg/0.8 ml 1 QL (8 ML per 30 days)

fondaparinux subcutaneous syringe 2.5 mg/0.5 ml 1 QL (5 ML per 30 days)

fondaparinux subcutaneous syringe 5 mg/0.4 ml 1 QL (4 ML per 30 days)

fondaparinux subcutaneous syringe 7.5 mg/0.6 ml 1 QL (6 ML per 30 days)

FRAGMIN SUBCUTANEOUS SOLUTION 2 QL (7.6 ML per 30 days)

FRAGMIN SUBCUTANEOUS SYRINGE 10,000 ANTI-XA UNIT/ML


FRAGMIN SUBCUTANEOUS SYRINGE 12,500 ANTI-XA UNIT/0.5 ML





2 QL (7.2 ML per 30 days)

FRAGMIN SUBCUTANEOUS SYRINGE 2,500 ANTI-XA UNIT/0.2 ML, 5,000 ANTI-XA UNIT/0.2 ML




HEP FLUSH-10 (PF) 1

heparin (porcine) in 5 % dex 1

heparin (porcine) in nacl (pf) intravenous parenteral solution 1,000 unit/500 ml, 2,000 unit/1,000 ml

1

heparin (porcine) injection cartridge 1

heparin (porcine) injection solution 1

heparin(porcine) in 0.45% nacl intravenous parenteral solution 12,500 unit/250 ml, 25,000 unit/500 ml

2

heparin, porcine (pf) injection 1

heparin, porcine (pf) intravenous solution 1

INNOHEP 2

IPRIVASK 2 PA; QL (6 EA per 30 days)

JANTOVEN 1

LOVENOX SUBCUTANEOUS SOLUTION 2 QL (30 ML per 30 days)

LOVENOX SUBCUTANEOUS SYRINGE 100 MG/ML, 150 MG/ML


LOVENOX SUBCUTANEOUS SYRINGE 120 MG/0.8 ML, 80 MG/0.8 ML


LOVENOX SUBCUTANEOUS SYRINGE 30 MG/0.3 ML 2 QL (6 ML per 30 days)



PRADAXA ORAL CAPSULE 75 MG 2 ST; QL (2 EA per 1 day)

SAVAYSA ORAL TABLET 15 MG 2 ST; QL (30 EA per 30 days)

warfarin 1

XARELTO ORAL TABLET 10 MG, 20 MG 2 QL (1 EA per 1 day)

XARELTO ORAL TABLETS,DOSE PACK 2 QL (51 EA per 30 days)

ANTIDOTESEVZIO 2 QL (0.8 ML per 365 days)

29

Drug Name Tier NotesMOVANTIK 2 QL (1 EA per 1 day)

naloxone 1

naltrexone oral 1

RELISTOR 2 PA

ANTIFUNGALS3 DAY VAGINAL 1

3-DAY VAGINAL 1

ABELCET 2

ALEVAZOL 2

ALOE VESTA ANTIFUNGAL (MICON) 1

AMBISOME 2

AMPHOTEC 2

amphotericin b 1

ANCOBON 2

ANTIFUNGAL (CLOTRIMAZOLE) 1

ANTIFUNGAL (TOLNAFTATE) TOPICAL CREAM 1

ANTIFUNGAL (TOLNAFTATE) TOPICAL POWDER 1

ANTIFUNGAL CREAM 1

ANTIFUNGAL SPRAY 1

ANTIFUNGAL TOPICAL SOLUTION 1

ATHLETE'S FOOT (CLOTRIMAZOLE) 1

ATHLETE'S FOOT (TERBINAFINE) 1

ATHLETE'S FOOT (TOLNAFTATE) TOPICAL AEROSOL,SPRAY

1

ATHLETE'S FOOT AF 1

BAZA ANTIFUNGAL 1

BENSAL HP TOPICAL OINTMENT 3-6 % 2

CANCIDAS 2

CICLODAN 2

CICLODAN KIT 2

ciclopirox 1

ciclopirox-ure-camph-menth-euc 1

ciclopirox-vite-nail lacq remo 1

CLOTRIMAZOLE 3 DAY 1

clotrimazole mucous membrane 1

clotrimazole topical 1

clotrimazole vaginal cream 1

CLOTRIMAZOLE-3 1

clotrimazole-betamethasone 1

CNL 8 NAIL 2

CRESEMBA 2

CRITIC-AID CLEAR AF 1

CRUEX PRESCRIPTION STRENGTH 1

DERMAFUNGAL 1

30

Drug Name Tier NotesDESENEX TOPICAL POWDER 1

DIFLUCAN 2

econazole topical 1

ERAXIS(WATER DILUENT) 2

ERTACZO 2

EXELDERM 2

EXTINA 2

fluconazole 1

fluconazole in dextrose(iso-o) 1

fluconazole in nacl (iso-osm) intravenous piggyback 200 mg/100 ml, 400 mg/200 ml

1

flucytosine 1

FUNGOID TINCTURE 2

FUNGOID-D 1

griseofulvin microsize 1

griseofulvin ultramicrosize 1

GRIS-PEG (ULTRAMICROSIZE) 2

GYNAZOLE-1 2

INZO ANTIFUNGAL 1

itraconazole 1

JOCK ITCH 1

JUBLIA 2 PA

KERYDIN 2 PA

ketoconazole 1

KETODAN 1

KETODAN KIT 2

LAMISIL (AEROSOL) 2

LAMISIL AF DEFENSE 1

LAMISIL AF TOPICAL AEROSOL POWDER 1

LAMISIL AT 2

LAMISIL ORAL 2

LOPROX TOPICAL SHAMPOO 2

LOTRISONE TOPICAL CREAM 2

LUZU 2 ST; QL (60 GM per 28 days)

MENTAX 2

MICONAZOLE 7 1

miconazole nitrate topical 1

miconazole nitrate vaginal 1

MICONAZOLE-3 1

MICONAZORB AF 1

MICRO-GUARD 1

MYCAMINE 2

naftifine 1

NAFTIN 2

31

Drug Name Tier NotesNATACYN 2

NIZORAL TOPICAL SHAMPOO 2

NOXAFIL 2

NYAMYC 1

nystatin oral suspension 1

nystatin oral tablet 1

nystatin topical 1

nystatin-triamcinolone 1

NYSTOP 1

ONMEL 2

ORAVIG 2

OXISTAT 2

PEDIADERM AF 2

PENLAC 2

REMEDY ANTIFUNGAL 1

REMEDY PHYTOPLEX ANTIFUNGAL 1

SECURA ANTIFUNGAL 1

SECURA ANTIFUNGAL EXTRA THICK 1

SPORANOX 2

SPORANOX PULSEPAK 2

TERAZOL 3 2

TERAZOL 7 2

terbinafine hcl 1

terconazole 1

tioconazole 1

TIOCONAZOLE-1 1

tolnaftate topical cream 1

tolnaftate topical powder 1

tolnaftate topical solution 1

VAGISTAT-1 1

VAGISTAT-3 1

VFEND 2

VFEND IV 2

voriconazole 1

VUSION 2

ZEASORB (MICONAZOLE) 1

ANTIHISTAMINE AND DECONGESTANT COMBINATIONALA-HIST PE 2

ALL DAY ALLERGY-D 1

ALLEGRA-D 12 HOUR 2

ALLEGRA-D 24 HOUR 2

ALLERCLEAR D-12HR 1

ALLERCLEAR D-24HR 1

32

Drug Name Tier NotesALLERFED COLD & ALLERGY 1

ALLERGY & CONGESTION RELIEF 1

ALLERGY COMPLETE-D 1

ALLERGY D-12 1

ALLERGY RELIEF & NASAL DECONGE 1

ALLERGY RELIEF D-24 1

APRODINE 1

BROHIST D 1

BROTAPP 1

BROVEX PEB 2

BROVEX PSB ORAL LIQUID 4-20 MG/5 ML 2

cetirizine-pseudoephedrine 1

CHILD DELSYM NIGHTTIME C-C 1

CHILD TRIAMINIC COLD & ALLERGY 1

CHILDREN'S COLD-ALLERGY (PE) 1

CHILDS TRIACTING COLD & COUGH 1

CLARINEX-D 12 HOUR 2 ST; QL (2 EA per 1 day)

COLD & ALLERGY ORAL SOLUTION 1

COLD & ALLERGY ORAL TABLET 4-10 MG 1

COLD & ALLERGY PE 1

CONEX ORAL SOLUTION 2

CONEX ORAL TABLET 1

DALLERGY (CHLORCYCLIZINE-PE) ORAL LIQUID 2

DALLERGY (CHLORCYCLIZINE-PE) ORAL TABLET,CHEWABLE

2

DALLERGY (CHLORPHENIRAMINE-PE) ORAL DROPS 1-2.5 MG/ML

1

DALLERGY (DEXBROMPHENIRAMN-PE) 2

DELSYM NIGHT TIME COUGH & COLD 1

DIMAPHEN (PE) 1

ED A-HIST 1

ED A-HIST PSE 1

ED CHLORPED D 2

fexofenadine-pseudoephedrine 1

HISTEX PE 1

J-TAN D PD 1

LODRANE D 2

LOHIST - D 1

LOHIST-PEB 1

LORATA-DINE D 1

LORATADINE-D 1

LORTUSS LQ 2

NASOPEN PE 2

NOHIST-LQ 1

33

Drug Name Tier NotesPOLY HIST FORTE (DOXYLAMINE) 2

POLY HIST PD 2

PROMETHAZINE VC 1

promethazine-phenylephrine 1

pyrilamine-phenylephrine 1

Q-TAPP 1

RESCON 2

RU-HIST D 1

RU-HIST-D (WITH PYRILAMINE) ORAL LIQUID 2

RU-HIST-D (WITH PYRILAMINE) ORAL TABLET 1

RYMED (DEXCHLORPHENIRAMINE-PE) 2

RYNEX PE 1

RYNEX PSE 1

SEMPREX-D 2

SILAFED 1

SINUS & ALLERGY PE 1

SINUS & ALLERGY(PHENYLEPHRINE) 1

STAHIST AD 2

SUDOGEST COLD & ALLERGY 1

SUDOGEST SINUS & ALLERGY 1

TRIAMINIC 2

TRIAMINIC COLD & COUGH NT (PE) 2

TRIAMINIC COLD- ALLERGY PE 2

ANTIHISTAMINESAHIST (CHLORCYCLIZINE) 2

ALA-HIST IR 1

ALAWAY 1

ALL DAY ALLERGY (CETIRIZINE) 1

ALLEGRA ORAL SUSPENSION 2 QL (10 EA per 1 day)

ALLER-CHLOR 1

ALLER-EASE 1

ALLER-G-TIME 1

ALLERGY (CHLORPHENIRAMINE) 1

ALLERGY (DIPHENHYDRAMINE) ORAL CAPSULE 1

ALLERGY (DIPHENHYDRAMINE) ORAL TABLET 1

ALLERGY 4-HOUR 1

ALLERGY EYE (KETOTIFEN) 1

ALLERGY MEDICINE ORAL CAPSULE 1

ALLERGY MEDICINE ORAL TABLET 1

ALLERGY RELIEF (CETIRIZINE) ORAL TABLET 1

ALLERGY RELIEF (CLEMASTINE) 1

ALLERGY RELIEF (FEXOFENADINE) ORAL TABLET 180 MG

1

ALLERGY RELIEF (LORATADINE) 1

34

Drug Name Tier NotesALLERGY RELIEF(CHLORPHENIRAMN) 1

ALLERGY RELIEF(DIPHENHYDRAMIN) ORAL LIQUID

1

ALLERGY RELIEF(DIPHENHYDRAMIN) ORAL TABLET

1

ALLERGY-TIME 1

ALLERHIST-1 1

ARBINOXA 1

azelastine ophthalmic 1

BANOPHEN 1

BANOPHEN ALLERGY 1

BEPREVE 2

carbinoxamine maleate 1

cetirizine oral solution 1 mg/ml 1

cetirizine oral tablet 1

cetirizine oral tablet,chewable 1

CHILD ALLERGY RELF(CETIRIZINE) ORAL SOLUTION

1

CHILDREN'S ALAWAY 1

CHILDREN'S ALLERGY (DIPHENHYD) ORAL LIQUID 1

CHILDREN'S ALLERGY COMPLETE 1

CHILDREN'S ALLERGY MEDICINE 1

CHILDREN'S CETIRIZINE 1

CHILD'S ALL DAY ALLERGY(CETIR) 1

chlorpheniramine maleate oral tablet 1

chlorpheniramine maleate oral tablet extended release 1

CLARINEX ORAL SYRUP 2 ST; QL (10 ML per 1 day)

CLARINEX ORAL TABLET 2 QL (1 EA per 1 day)

clemastine oral 1

COMPLETE ALLERGY MEDICINE 1

COMPLETE ALLERGY ORAL CAPSULE 1

COMPLETE ALLERGY ORAL LIQUID 1

cyproheptadine 1

DAYHIST ALLERGY 1

desloratadine oral tablet 1 QL (1 EA per 1 day)

desloratadine oral tablet,disintegrating 1 ST; QL (1 EA per 1 day)

dexchlorpheniramine maleate 1

DIPHEDRYL 1

DIPHENHIST 1

diphenhydramine hcl injection solution 50 mg/ml 1

diphenhydramine hcl injection syringe 1

diphenhydramine hcl oral capsule 1

ED CHLORPED JR 1

ED-CHLORPED 1

ED-CHLORTAN 1

35

Drug Name Tier NotesELESTAT 2

EMADINE 2

epinastine 1

EYE ITCH RELIEF 1

fexofenadine oral suspension 1 QL (10 ML per 1 day)

fexofenadine oral tablet 180 mg, 60 mg 1

HISTEX (TRIPROLIDINE) 2

HISTEX PD 2

hydroxyzine hcl intramuscular 1

hydroxyzine hcl oral solution 10 mg/5 ml 1

hydroxyzine hcl oral tablet 1

hydroxyzine pamoate oral capsule 100 mg 1

ITCHY EYE DROPS 1

J-TAN PD 2

KARBINAL ER 2 ST; QL (960 ML per 30 days)

ketotifen fumarate 1

LASTACAFT 2

levocetirizine oral solution 1 ST; QL (10 ML per 1 day)

levocetirizine oral tablet 1

loratadine 1

MUCINEX ALLERGY 1

NON-DROWSY ALLERGY 1

OPTIVAR 2

PATADAY 2

PATANOL 2

PAZEO 2 ST; QL (2.5 ML per 30 days)

PEDIAVENT 2

PHARBEDRYL 1

PHENERGAN INJECTION 2

promethazine injection 1

promethazine oral 1

Q-DRYL 1

QUENALIN 1

SILADRYL SA 1

SILPHEN COUGH 1

TRIAMINIC ALLERGY 2

TRIAMINIC COUGH/RUNNY NOSE 2

VALU-DRYL ALLERGY ORAL CAPSULE 1

VANAHIST PD 2

VICKS QLEARQUIL ALLERGY 1

VICKS QLEARQUIL NIGHTTIME RLF 1

VISTARIL 2

WAL-ITIN ORAL TABLET,DISINTEGRATING 1

XYZAL ORAL TABLET 2

36

Drug Name Tier NotesZADITOR 2

ANTIHYPERGLYCEMICSacarbose 1

ACTOPLUS MET XR 2 ST

ACTOS 2

AFREZZA INHALATION CARTRIDGE, W/INHALATION DEVICE 4 UNIT

2 PA; QL (180 EA per 28 days)

AFREZZA INHALATION CARTRIDGE, W/INHALATION DEVICE 4 UNIT (30)/ 8 UNIT (60), 4 UNIT (60)/ 8 UNIT (30)


AFREZZA INHALATION CARTRIDGE, W/INHALATION DEVICE 8 UNIT (60)/ 12 UNIT (30)


AMARYL 2

APIDRA 2 ST; QL (40 ML per 28 days)

APIDRA SOLOSTAR 2 ST; QL (30 ML per 28 days)

AVANDAMET 2 ST

AVANDARYL 2 ST

AVANDIA 2 ST

BYDUREON SUBCUTANEOUS PEN INJECTOR 2 ST; QL (1 EA per 7 days)

chlorpropamide 1

CYCLOSET 2 ST

DIABETA 2

DUETACT 2 ST

FARXIGA ORAL TABLET 5 MG 2 ST; QL (1 EA per 1 day)

FORTAMET 2 ST

glimepiride 1

glipizide 1

glipizide-metformin 1

GLUCOPHAGE 2

GLUCOPHAGE XR 2

GLUCOTROL 2

GLUCOTROL XL 2

GLUCOVANCE 2

GLUMETZA 2 ST

glyburide 1

glyburide micronized 1

glyburide-metformin 1

GLYNASE 2

GLYSET 2

GLYXAMBI 2 ST; QL (1 EA per 1 day)

HUMALOG KWIKPEN SUBCUTANEOUS INSULIN PEN 100 UNIT/ML


HUMALOG KWIKPEN SUBCUTANEOUS INSULIN PEN 200 UNIT/ML (3 ML)


HUMALOG MIX 50-50 2 QL (40 ML per 28 days)

37

Drug Name Tier NotesHUMALOG MIX 50-50 KWIKPEN 2 QL (30 ML per 28 days)

HUMALOG MIX 75-25 2 QL (40 ML per 28 days)

HUMALOG MIX 75-25 KWIKPEN 2 QL (30 ML per 28 days)

HUMALOG SUBCUTANEOUS CARTRIDGE 2 QL (30 ML per 28 days)

HUMALOG SUBCUTANEOUS SOLUTION 2 QL (40 ML per 28 days)

HUMULIN 70/30 2 QL (40 ML per 28 days)

HUMULIN 70/30 KWIKPEN 2 QL (30 ML per 28 days)

HUMULIN 70/30 PEN 2 QL (30 ML per 28 days)

HUMULIN N 2 QL (40 ML per 28 days)

HUMULIN N KWIKPEN 2 QL (30 ML per 28 days)

HUMULIN N PEN 2 QL (30 ML per 28 days)

HUMULIN R 2 QL (40 ML per 28 days)

HUMULIN R U-500 (CONCENTRATED) 2 QL (40 ML per 28 days)

INVOKAMET 2 ST; QL (2 EA per 1 day)

INVOKANA 2 ST; QL (30 EA per 30 days)

JANUMET 2 QL (2 EA per 1 day)

JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR 100-1,000 MG


JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR 50-1,000 MG, 50-500 MG


JANUVIA 2 QL (1 EA per 1 day)

JENTADUETO 2 QL (2 EA per 1 day)

KAZANO 2 ST; QL (2 EA per 1 day)

KOMBIGLYZE XR ORAL TABLET, ER MULTIPHASE 24 HR 2.5-1,000 MG


KOMBIGLYZE XR ORAL TABLET, ER MULTIPHASE 24 HR 5-1,000 MG, 5-500 MG


KORLYM 2 PA; QL (4 EA per 1 day)

LANTUS 2 QL (40 ML per 28 days)

LANTUS SOLOSTAR 2 QL (30 ML per 28 days)

LEVEMIR 2 QL (40 ML per 28 days)

LEVEMIR FLEXPEN 2 QL (30 ML per 28 days)

LEVEMIR FLEXTOUCH 2 QL (30 ML per 28 days)

metformin oral tablet 1

metformin oral tablet extended release 24 hr 1

metformin oral tablet extended release 24hr 1 ST

nateglinide 1

NESINA 2 ST; QL (1 EA per 1 day)

NOVOLIN 70/30 2 QL (40 ML per 28 days)

NOVOLIN N 2 QL (40 ML per 28 days)

NOVOLIN R 2 QL (40 ML per 28 days)

NOVOLOG 2 ST; QL (40 ML per 28 days)

NOVOLOG FLEXPEN 2 ST; QL (30 ML per 28 days)

NOVOLOG MIX 70-30 2 ST; QL (40 ML per 28 days)

NOVOLOG MIX 70-30 FLEXPEN 2 ST; QL (30 ML per 28 days)

38

Drug Name Tier NotesNOVOLOG PENFILL 2 ST; QL (30 ML per 28 days)

ONGLYZA 2 ST; QL (1 EA per 1 day)

OSENI 2 ST; QL (1 EA per 1 day)

pioglitazone 1

PRANDIMET 2

PRANDIN 2

PRECOSE 2

repaglinide 1

RIOMET 2

STARLIX 2

SYMLINPEN 120 2

SYMLINPEN 60 2

SYNJARDY 2

tolazamide 1

tolbutamide 1

TOUJEO SOLOSTAR 2 QL (7.5 ML per 28 days)

TRADJENTA 2 QL (1 EA per 1 day)

TRULICITY 2 ST; QL (2 ML per 28 days)

VICTOZA 2-PAK 2 ST; QL (9 ML per 30 days)

VICTOZA 3-PAK 2 ST; QL (9 ML per 30 days)

XIGDUO XR 2 ST; QL (2 EA per 1 day)

ANTIINFECTIVES/MISCELLANEOUSALBENZA 2

ALCOHOL-BENZOCAINE 1

ALINIA 2

atovaquone 1

atovaquone-proguanil 1

BILTRICIDE 2

chloroquine phosphate oral 1

COARTEM 2

COLD SORE TREATMENT TOPICAL SOLUTION 1

DARAPRIM 2

FEM PH 2

formaldehyde 1

GLYCINE UROLOGIC 2

hydroxychloroquine oral 1

isopropyl alcohol topical spray,non-aerosol 2

isopropyl alcohol-benzocaine 1

ivermectin oral 1

MALARONE 2

MALARONE PEDIATRIC 2

mefloquine 1

MEPRON 2

NEBUPENT 2

39

Drug Name Tier NotesPAIN RELIEF ALCOHOL-BENZOCAINE 1

paromomycin 1

PENTAM 2

PLAQUENIL 2

primaquine 2

QUALAQUIN 2

quinine sulfate 1

STROMECTOL 2

sulfur 2

SUMMER'S EVE DOUCHE 2

TINDAMAX 2

tinidazole 1

ANTIINFECTIVESAVC VAGINAL 2

ANTINEOPLASTICSABRAXANE 2

ACTIMMUNE 2

ADCETRIS 2

ADRUCIL 1

AFINITOR DISPERZ 2 PA

AFINITOR ORAL TABLET 10 MG, 2.5 MG, 5 MG 2 PA; QL (1 EA per 1 day)

AFINITOR ORAL TABLET 7.5 MG 2 PA

ALIMTA 2

ALKERAN 2

anastrozole 1

ARIMIDEX 2

AROMASIN 2 PA

ARRANON 2

ARZERRA 2

AVASTIN 2

azacitidine 1

BELEODAQ 2

bexarotene 1 PA

bicalutamide 1

BICNU 2

bleomycin 1

BLINCYTO 2

BOSULIF ORAL TABLET 100 MG 2 PA; QL (4 EA per 1 day)

BOSULIF ORAL TABLET 500 MG 2 PA; QL (1 EA per 1 day)

BUSULFEX 2

CAMPATH 2

CAMPTOSAR 2

capecitabine oral tablet 150 mg 1 PA; QL (28 EA per 21 days)

capecitabine oral tablet 500 mg 1 PA; QL (112 EA per 21 days)

40

Drug Name Tier NotesCAPRELSA ORAL TABLET 100 MG 2 PA; QL (2 EA per 1 day)

CAPRELSA ORAL TABLET 300 MG 2 PA; QL (1 EA per 1 day)

CARAC 2

carboplatin intravenous solution 1

CASODEX 2

CEENU ORAL CAPSULE 10 MG, 40 MG 2

cisplatin 1

cladribine 1

CLOLAR 2

COMETRIQ 2 PA; QL (4 EA per 1 day)

COSMEGEN 2

cyclophosphamide intravenous 1

cyclophosphamide oral capsule 2

cyclophosphamide oral tablet 1

CYRAMZA 2

cytarabine 1

cytarabine (pf) injection solution 1

dacarbazine 1

DACOGEN 2

daunorubicin intravenous solution 1

DAUNOXOME 2

decitabine 1

DEPOCYT (PF) 2

diclofenac sodium topical gel 1 PA; QL (100 GM per 1 FILL)

DOCEFREZ INTRAVENOUS RECON SOLN 20 MG 2

docetaxel intravenous solution 10 mg/ml 2

docetaxel intravenous solution 140 mg/7 ml (20 mg/ml), 160 mg/16 ml (10 mg/ml), 160 mg/8 ml (20 mg/ml), 20 mg/2 ml (10 mg/ml), 20 mg/2 ml (final), 20 mg/ml (1 ml), 80 mg/4 ml (20 mg/ml), 80 mg/8 ml (10 mg/ml), 80 mg/8 ml (final)

1

DOXIL 2

doxorubicin 1

doxorubicin, peg-liposomal 1

EFUDEX TOPICAL CREAM 2

ELIGARD 2 PA

ELLENCE 2

ELOXATIN INTRAVENOUS SOLUTION 100 MG/20 ML, 50 MG/10 ML (5 MG/ML)

2

EMCYT 2

epirubicin intravenous solution 1

ERBITUX 2

ERIVEDGE 2 PA; QL (1 EA per 1 day)

ERWINAZE 2

ETOPOPHOS 2

41

Drug Name Tier Notesetoposide 1

exemestane 1 PA

FARESTON 2 PA

FARYDAK 2 PA

FASLODEX 2

FEMARA 2

FIRMAGON KIT W DILUENT SYRINGE SUBCUTANEOUS RECON SOLN 120 MG


FIRMAGON KIT W DILUENT SYRINGE SUBCUTANEOUS RECON SOLN 80 MG


floxuridine 1

fludarabine 1

fluorouracil 1

flutamide 1

FOLOTYN 2

GAZYVA 2

gemcitabine 1

GEMZAR 2

GILOTRIF 2 PA

GLEEVEC 2 PA; QL (2 EA per 1 day)

GLEOSTINE ORAL CAPSULE 10 MG, 100 MG, 40 MG 2

GLIADEL WAFER 2

HALAVEN 2

HERCEPTIN 2

HEXALEN 2

HYCAMTIN 2

HYDREA 2

hydroxyurea 1

IBRANCE 2 PA

ICLUSIG ORAL TABLET 15 MG 2 PA; QL (2 EA per 1 day)

ICLUSIG ORAL TABLET 45 MG 2 PA; QL (1 EA per 1 day)

IDAMYCIN PFS 2

idarubicin 1

IFEX 2

ifosfamide 1

IMBRUVICA 2 PA

INLYTA ORAL TABLET 1 MG 2 PA; QL (6 EA per 1 day)

INLYTA ORAL TABLET 5 MG 2 PA; QL (2 EA per 1 day)

INTRON A INJECTION 2 PA

IRESSA 2

irinotecan 1

ISTODAX 2

IXEMPRA 2

JAKAFI 2 PA; QL (2 EA per 1 day)

42

Drug Name Tier NotesJEVTANA 2

KADCYLA 2

KEYTRUDA 2

KYPROLIS 2

LENVIMA 2 PA

letrozole 1

LEUKERAN 2

leuprolide subcutaneous kit 1

LIPODOX 1

LIPODOX 50 1

lomustine 1

LUPRON DEPOT (3 MONTH) INTRAMUSCULAR SYRINGE KIT 22.5 MG

2

LUPRON DEPOT (4 MONTH) 2

LUPRON DEPOT (6 MONTH) 2

LUPRON DEPOT INTRAMUSCULAR SYRINGE KIT 7.5 MG

2

LYNPARZA 2 PA; QL (16 EA per 1 day)

LYSODREN 2

MARQIBO 2

MATULANE 2

megestrol oral tablet 1

MEKINIST 2 PA

melphalan hcl 1

mercaptopurine 1

methotrexate sodium 1

methotrexate sodium (pf) 1

mitomycin 1

mitoxantrone 1

MUSTARGEN 2

MYLERAN 2

NAVELBINE 2

NEXAVAR 2 PA; QL (4 EA per 1 day)

NILANDRON 2

NIPENT 2

ODOMZO 2

ONCASPAR 2

ONTAK 2

OPDIVO 2

oxaliplatin 1

paclitaxel 1

PANRETIN 2

PERJETA 2

PICATO TOPICAL GEL 0.015 % 2 QL (3 EA per 28 days)

43

Drug Name Tier NotesPICATO TOPICAL GEL 0.05 % 2 QL (2 EA per 28 days)

POMALYST 2 PA

PROLEUKIN 2

PURIXAN 2 ST

REVLIMID 2 PA; QL (1 EA per 1 day)

RITUXAN 2

SOLARAZE 2 PA; QL (100 GM per 1 FILL)

SOLTAMOX 2

SPRYCEL ORAL TABLET 100 MG, 140 MG, 50 MG, 70 MG, 80 MG


SPRYCEL ORAL TABLET 20 MG 2 PA; QL (2 EA per 1 day)

STIVARGA 2 PA; QL (3 EA per 1 day)

SUTENT 2 PA; QL (1 EA per 1 day)

SYLATRON 2 QL (1 EA per 28 days)

SYLATRON 4-PACK SUBCUTANEOUS KIT 200 MCG, 300 MCG


SYLVANT 2

SYNRIBO 2 PA

TABLOID 2

TAFINLAR 2 PA

tamoxifen 1

TARCEVA 2 PA; QL (1 EA per 1 day)

TARGRETIN 2 PA

TASIGNA 2 PA; QL (4 EA per 1 day)

TAXOTERE INTRAVENOUS SOLUTION 20 MG/ML (1 ML), 80 MG/4 ML (20 MG/ML)

2

TEMODAR INTRAVENOUS 2

TEMODAR ORAL 2 PA

temozolomide 1 PA

teniposide 1

thiotepa 1

TOLAK 2

TOPOSAR 1

topotecan 1

TORISEL 2

TREANDA 2

TRELSTAR 2

TRELSTAR DEPOT 2

TRELSTAR LA 2

tretinoin (chemotherapy) 1

TREXALL 2

TRISENOX 2

TYKERB 2 PA

UNITUXIN 2

VALCHLOR 2 PA

44

Drug Name Tier NotesVALSTAR 2

vandetanib oral tablet 100 mg 2 PA; QL (2 EA per 1 day)

vandetanib oral tablet 300 mg 2 PA; QL (1 EA per 1 day)

VANTAS 2

VECTIBIX 2

VELCADE 2

VIDAZA 2

vinblastine intravenous solution 1

VINCASAR PFS 1

vincristine 1

vinorelbine 1

VOTRIENT 2 PA; QL (4 EA per 1 day)

XALKORI 2 PA; QL (2 EA per 1 day)

XELODA ORAL TABLET 150 MG 2 PA; QL (28 EA per 21 days)

XELODA ORAL TABLET 500 MG 2 PA; QL (112 EA per 21 days)

XTANDI 2 PA; QL (4 EA per 1 day)

YERVOY 2

ZALTRAP 2

ZANOSAR 2

ZELBORAF 2 PA; QL (8 EA per 1 day)

ZEVALIN (Y-90) 2

ZOLADEX 2

ZOLINZA 2

ZYDELIG 2 PA

ZYKADIA 2 PA

ZYTIGA 2 PA; QL (4 EA per 1 day)

ANTIPARKINSON DRUGSamantadine hcl 1

APOKYN 2 PA; QL (2 ML per 1 day)

AZILECT 2 QL (1 EA per 1 day)

benztropine 1

bromocriptine 1

carbidopa 1

carbidopa-levodopa 1

carbidopa-levodopa-entacapone 1

COMTAN 2

DUOPA 2 PA

ELDEPRYL 2

entacapone 1

LODOSYN 2

MIRAPEX 2

MIRAPEX ER ORAL TABLET EXTENDED RELEASE 24 HR 1.5 MG, 2.25 MG, 3 MG, 3.75 MG, 4.5 MG


NEUPRO 2 ST; QL (1 EA per 1 day)

45

Drug Name Tier NotesPARCOPA 2

pramipexole oral tablet 1

pramipexole oral tablet extended release 24 hr 1.5 mg, 3 mg, 4.5 mg


REQUIP 2

REQUIP XL 2 ST; QL (1 EA per 1 day)

ropinirole oral tablet 1

RYTARY 2 ST; QL (10 EA per 1 day)

selegiline hcl 1

SINEMET 2

SINEMET CR 2

STALEVO 100 2

STALEVO 125 2

STALEVO 150 2

STALEVO 200 2

STALEVO 50 2

STALEVO 75 2

TASMAR ORAL TABLET 100 MG 2 ST; QL (3 EA per 1 day)

tolcapone 1 ST; QL (3 EA per 1 day)

trihexyphenidyl 1

ZELAPAR 2 QL (2 EA per 1 day)

ANTIPLATELET DRUGSAGGRASTAT IN SODIUM CHLORIDE 2

AGGRENOX 2

AGRYLIN 2

anagrelide 1

aspirin-dipyridamole 1

BRILINTA 2 QL (2 EA per 1 day)

cilostazol 1

clopidogrel oral tablet 300 mg 1 QL (4 EA per 30 days)

clopidogrel oral tablet 75 mg 1

dipyridamole oral 1

EFFIENT 2 QL (1 EA per 1 day)

INTEGRILIN 2

KENGREAL 2

PERSANTINE 2

PLAVIX ORAL TABLET 300 MG 2 QL (4 EA per 30 days)

PLAVIX ORAL TABLET 75 MG 2

PLETAL 2

REOPRO 2

ticlopidine 1

ZONTIVITY 2 QL (1 EA per 1 day)

ANTIVIRALSabacavir 1 QL (60 EA per 30 days)

46

Drug Name Tier Notesabacavir-lamivudine-zidovudine 1

ABREVA 2

acyclovir oral capsule 1

acyclovir oral suspension 200 mg/5 ml 1

acyclovir oral tablet 1

acyclovir sodium intravenous recon soln 500 mg 1

acyclovir sodium intravenous solution 1

acyclovir topical 1

adefovir 1

APTIVUS 2

ATRIPLA 2 QL (30 EA per 30 days)

BARACLUDE 2

cidofovir 1

COMBIVIR 2 QL (60 EA per 30 days)

COMPLERA 2

COPEGUS 2

CRIXIVAN ORAL CAPSULE 200 MG, 400 MG 2

CYTOVENE 2

DAKLINZA 2 PA

DENAVIR 2

didanosine oral capsule,delayed release(dr/ec) 125 mg, 200 mg


didanosine oral capsule,delayed release(dr/ec) 250 mg, 400 mg

1

EDURANT 2

EMTRIVA ORAL CAPSULE 2 QL (30 EA per 30 days)

EMTRIVA ORAL SOLUTION 2 QL (720 ML per 30 days)

entecavir 1

EPIVIR HBV 2

EPIVIR ORAL SOLUTION 2 QL (900 ML per 30 days)

EPIVIR ORAL TABLET 150 MG 2 QL (60 EA per 30 days)

EPIVIR ORAL TABLET 300 MG 2 QL (30 EA per 30 days)

EPZICOM 2 QL (30 EA per 30 days)

EVOTAZ 2 QL (1 EA per 1 day)

famciclovir 1

FAMVIR 2

FLUMADINE ORAL TABLET 2

foscarnet 1

FUZEON SUBCUTANEOUS RECON SOLN 2 QL (60 EA per 30 days)

ganciclovir sodium 1

HARVONI 2 PA

HEPSERA 2

INTELENCE 2

INVIRASE ORAL CAPSULE 2 QL (300 EA per 30 days)

47

Drug Name Tier NotesINVIRASE ORAL TABLET 2 QL (120 EA per 30 days)

ISENTRESS 2

KALETRA ORAL SOLUTION 2 QL (390 ML per 30 days)

KALETRA ORAL TABLET 100-25 MG 2 QL (300 EA per 30 days)

KALETRA ORAL TABLET 200-50 MG 2 QL (120 EA per 30 days)

lamivudine oral solution 1 QL (900 ML per 30 days)

lamivudine oral tablet 100 mg 1

lamivudine oral tablet 150 mg 1 QL (60 EA per 30 days)

lamivudine oral tablet 300 mg 1 QL (30 EA per 30 days)

lamivudine-zidovudine 1 QL (60 EA per 30 days)

LEXIVA 2

MODERIBA 2

MODERIBA DOSE PACK 2 ST

nevirapine oral suspension 1 QL (1200 ML per 30 days)

nevirapine oral tablet 1 QL (60 EA per 30 days)

nevirapine oral tablet extended release 24 hr 400 mg 1

NORVIR ORAL CAPSULE 2 QL (360 EA per 30 days)

NORVIR ORAL SOLUTION 2 QL (450 ML per 30 days)

NORVIR ORAL TABLET 2 QL (360 EA per 30 days)

OLYSIO 2 PA

PEGASYS 2 PA

PEGASYS PROCLICK 2 PA

PEGINTRON 2 PA

PEGINTRON REDIPEN 2 PA

PREZCOBIX 2 QL (1 EA per 1 day)

PREZISTA ORAL SUSPENSION 2 QL (240 ML per 30 days)

PREZISTA ORAL TABLET 150 MG 2 QL (240 EA per 30 days)




RAPIVAB 2

REBETOL 2

RELENZA DISKHALER 2 QL (40 EA per 183 days)

RESCRIPTOR 2

RETROVIR INTRAVENOUS 2

RETROVIR ORAL CAPSULE 2 QL (180 EA per 30 days)

RETROVIR ORAL SYRUP 2 QL (1800 ML per 30 days)

REYATAZ ORAL CAPSULE 150 MG, 200 MG, 300 MG 2

REYATAZ ORAL POWDER IN PACKET 2

RIBASPHERE ORAL CAPSULE 1

RIBASPHERE ORAL TABLET 200 MG 1

RIBASPHERE ORAL TABLET 400 MG, 600 MG 1 ST

RIBASPHERE RIBAPAK 1 ST

ribavirin oral capsule 1

48

Drug Name Tier Notesribavirin oral tablet 200 mg 1

rimantadine 1

SELZENTRY 2

SITAVIG 2 ST; QL (4 EA per 365 days)

SOVALDI 2 PA

stavudine oral capsule 1 QL (60 EA per 30 days)

stavudine oral recon soln 1 QL (2400 ML per 30 days)

STRIBILD 2 QL (30 EA per 30 days)

SUSTIVA 2

SYNAGIS 2

TAMIFLU ORAL CAPSULE 30 MG 2 QL (40 EA per 183 days)

TAMIFLU ORAL CAPSULE 45 MG, 75 MG 2 QL (20 EA per 183 days)

TAMIFLU ORAL SUSPENSION FOR RECONSTITUTION


TECHNIVIE 2 PA

TIVICAY 2

trifluridine 1

TRIUMEQ 2 QL (1 EA per 1 day)

TRIZIVIR 2

TRUVADA 2 QL (30 EA per 30 days)

TYZEKA 2

valacyclovir 1

VALCYTE 2

valganciclovir 1

VALTREX 2

VEREGEN 2

VICTRELIS 2 PA

VIDEX 2 GRAM PEDIATRIC 2 QL (1200 ML per 30 days)

VIDEX 4 GRAM PEDIATRIC 2 QL (1200 ML per 30 days)

VIDEX EC ORAL CAPSULE,DELAYED RELEASE(DR/EC) 125 MG, 200 MG


VIDEX EC ORAL CAPSULE,DELAYED RELEASE(DR/EC) 250 MG, 400 MG

2

VIEKIRA PAK 2 PA

VIRACEPT 2

VIRAMUNE ORAL SUSPENSION 2 QL (1200 ML per 30 days)

VIRAMUNE ORAL TABLET 2 QL (60 EA per 30 days)

VIRAMUNE XR 2

VIRAZOLE 2

VIREAD ORAL POWDER 2 QL (225 GM per 30 days)

VIREAD ORAL TABLET 2 QL (30 EA per 30 days)

VIROPTIC 2

VISTIDE 2

VITEKTA 2 QL (1 EA per 1 day)

XERESE 2 ST; QL (10 GM per 365 days)

49

Drug Name Tier NotesZERIT ORAL CAPSULE 2 QL (60 EA per 30 days)

ZERIT ORAL RECON SOLN 2 QL (2400 ML per 30 days)

ZIAGEN ORAL SOLUTION 2 QL (900 ML per 30 days)

ZIAGEN ORAL TABLET 2 QL (60 EA per 30 days)

zidovudine oral capsule 1 QL (180 EA per 30 days)

zidovudine oral syrup 1 QL (1800 ML per 30 days)

zidovudine oral tablet 1 QL (60 EA per 30 days)

ZIRGAN 2

ZOVIRAX 2

AUTONOMIC DRUGSADDERALL 2 QL (3 EA per 1 day)

ADDERALL XR ORAL CAPSULE,EXTENDED RELEASE 24HR 10 MG, 15 MG, 5 MG


ADDERALL XR ORAL CAPSULE,EXTENDED RELEASE 24HR 20 MG, 25 MG, 30 MG


ADRENACLICK 2

ADRENALIN INJECTION 2

AMPHETAMINE SALT COMBO 1 QL (3 EA per 1 day)

ANECTINE 2

ARICEPT 2

ARICEPT ODT 2

atracurium 1

AUVI-Q 2 ST

bethanechol chloride 1

BOTOX 2

cevimeline 1

cisatracurium 1

DESOXYN 2

DEXEDRINE ORAL TABLET 10 MG 2 QL (180 EA per 30 days)

DEXEDRINE ORAL TABLET 5 MG 2 QL (90 EA per 30 days)

DEXEDRINE SPANSULE ORAL CAPSULE, EXTENDED RELEASE 10 MG





2

dexpanthenol 1

dextroamphetamine oral capsule, extended release 10 mg 1 QL (60 EA per 30 days)

dextroamphetamine oral capsule, extended release 15 mg 1 QL (120 EA per 30 days)

dextroamphetamine oral capsule, extended release 5 mg 1

dextroamphetamine oral solution 1 QL (1800 ML per 30 days)

dextroamphetamine oral tablet 10 mg 1 QL (180 EA per 30 days)

dextroamphetamine oral tablet 5 mg 1 QL (90 EA per 30 days)

dextroamphetamine-amphetamine oral capsule,extended release 24hr 10 mg, 15 mg, 5 mg


50

Drug Name Tier Notesdextroamphetamine-amphetamine oral capsule,extended release 24hr 20 mg, 25 mg, 30 mg


donepezil 1

dopamine in 5 % dextrose 1

dopamine intravenous solution 1

DYSPORT 2

ENLON 1

epinephrine hcl (pf) 1

epinephrine injection auto-injector 1

epinephrine injection solution 1

epinephrine injection syringe 0.1 mg/ml (1:10,000) 1

EPIPEN 2

EPIPEN 2-PAK 2

EPIPEN JR 2

EPIPEN JR 2-PAK 2

EPISNAP 2

EVEKEO 2 PA

EVOXAC 2

EXELON ORAL CAPSULE 2

EXELON TRANSDERMAL 2 QL (30 EA per 30 days)

galantamine oral capsule,ext rel. pellets 24 hr 1 QL (30 EA per 30 days)

galantamine oral solution 1 QL (200 ML per 30 days)

galantamine oral tablet 1 QL (60 EA per 30 days)

guanidine 1

ISUPREL 2

LEVOPHED (BITARTRATE) 2

MESTINON ORAL 2

MESTINON TIMESPAN 2

methamphetamine 1

midodrine 1

MYOBLOC 2

neostigmine methylsulfate injection 1

neostigmine methylsulfate intravenous solution 2

NIMBEX 2

norepinephrine bitartrate 1

NORTHERA 2 PA

pancuronium 1

phenoxybenzamine 1

physostigmine salicylate 1

pilocarpine hcl oral 1

PROCENTRA 2 QL (1800 ML per 30 days)

pyridostigmine bromide 1

QUELICIN INJECTION SOLUTION 20 MG/ML 2

RAZADYNE ER 2 QL (30 EA per 30 days)

51

Drug Name Tier NotesRAZADYNE ORAL SOLUTION 2 QL (200 ML per 30 days)

RAZADYNE ORAL TABLET 2 QL (60 EA per 30 days)

REGONOL 2

rivastigmine 1 QL (30 EA per 30 days)

rivastigmine tartrate 1

rocuronium 1

SALAGEN 2

URECHOLINE 2

vecuronium bromide 1

XEOMIN 2

ZEMURON 2

ZENZEDI ORAL TABLET 10 MG 1 QL (180 EA per 30 days)

ZENZEDI ORAL TABLET 15 MG 2 QL (3 EA per 1 day)

ZENZEDI ORAL TABLET 2.5 MG, 7.5 MG 2 QL (90 EA per 30 days)

ZENZEDI ORAL TABLET 20 MG, 30 MG 2 QL (2 EA per 1 day)

ZENZEDI ORAL TABLET 5 MG 1 QL (90 EA per 30 days)

BIOLOGICALSACTHIB (PF) 2

ADACEL(TDAP ADOLESN/ADULT)(PF) 3 QL (0.5 ML per 365 days)

adenovirus vac live type-4, 7 2

adenovirus vaccine live type-4 2

adenovirus vaccine live type-7 2

AFLURIA 2010-2011 (PF) 2

AFLURIA 2011-2012 2

AFLURIA 2011-2012 (PF) 2

AFLURIA 2012-2013 2

AFLURIA 2012-2013 (PF) 2

AFLURIA 2013-2014 2

AFLURIA 2013-2014 (PF) 2

AFLURIA 2014-2015 3 QL (0.5 ML per 180 days)

AFLURIA 2014-2015 (PF) 3 QL (0.5 ML per 180 days)

AFLURIA 2015-2016 3 QL (0.5 ML per 180 days)

AFLURIA 2015-2016 (PF) 3 QL (0.5 ML per 180 days)

AGRIFLU 2010-2011 (PF) 2

all xt-weed pol-russian thistl 2

aller ext-tree poll,black waln 2

aller ext-tree poll,red cedar 2

aller ext-tree pollen-bayberry 2

aller ext-tree pollen-mesquite 2

aller xt-tree poll,shagbk hick 2

aller xt-tree pollen-am.sycamo 2

aller xt-tree pollen-box elder 2

aller xt-tree pollen-red birch 2

aller xt-tree pollen-white ash 2

52

Drug Name Tier Notesaller xt-weed pollen-sagebrush 2

allerg ext-tree pollen-pecan 2

allerg ext-weed pollen-mugwort 2

allerg ex-weed pol-rgh pigweed 2

allerg xt-sheep sor,yellw dock 2

allergen ext-candida albicans 2

allergen ext-english plantain 2

allergen ext-virginia live oak 2

allergen xt-grass pollen-bahia 2

allergenic ex-horse epithelium 2

allergen-weed-lambsquarters 2

ANASCORP 2

antivenin latrodectus mactans 2

antivenin micrurus fulvius 2

APLISOL 2

ATGAM 2

bcg vaccine, live (pf) 2

BEXSERO (PF) 2

BIOTHRAX 2

BIVIGAM 2

BOOSTRIX TDAP 3 QL (0.5 ML per 365 days)

CARIMUNE NF NANOFILTERED 2

CERVARIX VACCINE (PF) INTRAMUSCULAR SUSPENSION

2

CERVARIX VACCINE (PF) INTRAMUSCULAR SYRINGE

3 QL (1.5 ML per 365 days)

COMVAX (PF) 2

CYTOGAM INTRAVENOUS SOLUTION 50 MG/ML 2

DAPTACEL (DTAP PEDIATRIC) (PF) 2

DECAVAC (PF) 3 QL (0.5 EA per 365 days)

ENGERIX-B (PF) 3 QL (3 ML per 365 days)

ENGERIX-B PEDIATRIC (PF) 2

EZ FLU 2015-16(FLUCELVAX)(PF) 2

FLEBOGAMMA DIF 2

FLUARIX 2010-2011 (PF) 2

FLUARIX 2011-2012 (PF) 2

FLUARIX 2012-2013 (PF) 2

FLUARIX 2013-2014 (PF) 2

FLUARIX 2014-2015 (PF) 3 QL (0.5 ML per 180 days)

FLUARIX QUAD 2013-2014 (PF) 2

FLUARIX QUAD 2014-2015 (PF) 3 QL (0.5 ML per 180 days)

FLUARIX QUAD 2015-2016 (PF) 3 QL (0.5 ML per 180 days)

FLUBLOK 2012-2013 (PF) 2

FLUBLOK 2013-2014 (PF) 2

53

Drug Name Tier NotesFLUBLOK 2014-2015 (PF) 3 QL (0.5 ML per 180 days)

FLUBLOK 2015-2016 (PF) 3 QL (0.5 ML per 180 days)

FLUCELVAX (PF) 2

FLUCELVAX 2013-2014 (PF) 2

FLUCELVAX 2014-2015 (PF) 3 QL (0.5 ML per 180 days)

FLUCELVAX 2015-2016 (PF) 3 QL (0.5 ML per 180 days)

FLULAVAL 2010-2011 2




FLULAVAL 2014-2015 3 QL (0.5 ML per 180 days)

FLULAVAL 2014-2015 (PF) 3 QL (0.5 ML per 180 days)

FLULAVAL QUAD 2013-2014 2

FLULAVAL QUAD 2014-2015 3 QL (0.5 ML per 180 days)

FLULAVAL QUAD 2014-2015 (PF) 3 QL (0.5 ML per 180 days)

FLULAVAL QUAD 2015-2016 3 QL (0.5 ML per 180 days)

FLUMIST 2010-2011 2

FLUMIST 2011-2012 2

FLUMIST 2012-2013 2

FLUMIST 2013-2014 2

FLUMIST QUAD 2014-2015 3 QL (1 EA per 180 days)

FLUMIST QUAD 2015-2016 3 QL (1 EA per 180 days)

FLUVIRIN 2010-2011 2

FLUVIRIN 2010-2011 (PF) 2







FLUVIRIN 2014-2015 3 QL (0.5 ML per 180 days)

FLUVIRIN 2014-2015 (PF) 3 QL (0.5 ML per 180 days)

FLUVIRIN 2015-2016 3 QL (0.5 ML per 180 days)

FLUVIRIN 2015-2016 (PF) 3 QL (0.5 ML per 180 days)

FLUZONE 2010-2011 2

FLUZONE 2010-2011 (PF) 2

FLUZONE 2011-2012 2

FLUZONE 2011-2012 (PF) 2

FLUZONE 2012-2013 2

FLUZONE 2012-2013 (PF) 2

FLUZONE 2013-2014 2

FLUZONE 2013-2014 (PF) 2

FLUZONE 2014-2015 3 QL (0.5 ML per 180 days)

FLUZONE 2014-2015 (PF) 3 QL (0.5 ML per 180 days)

54

Drug Name Tier NotesFLUZONE 2015-2016 3 QL (0.5 ML per 180 days)

FLUZONE HIGH-DOSE 2010-11 (PF) 2




FLUZONE HIGH-DOSE 2014-15 (PF) 3 QL (0.5 ML per 180 days)

FLUZONE HIGH-DOSE 2015-16 (PF) 3 QL (0.5 ML per 180 days)

FLUZONE INTRADERM 2011-12 (PF) 2



FLUZONE INTRADERM 2014-15 (PF) 3 QL (0.1 ML per 180 days)

FLUZONE INTRADERM QUAD 2015-16 3 QL (0.1 ML per 180 days)

FLUZONE PEDI 2012 -2013 (PF) 2

FLUZONE PEDI 2013-2014 (PF) 2

FLUZONE QUAD 2013-2014 (PF) 2

FLUZONE QUAD 2014-2015 3 QL (0.5 ML per 180 days)

FLUZONE QUAD 2014-2015 (PF) 3 QL (0.5 ML per 180 days)

FLUZONE QUAD 2015-2016 3 QL (0.5 ML per 180 days)

FLUZONE QUAD 2015-2016 (PF) 3 QL (0.5 ML per 180 days)

FLUZONE QUAD PEDI 2013-14 (PF) 2



GAMASTAN S/D 2

GAMMAGARD S/D 2

GAMMAGARD S-D (IGA &LT< 1 MCG/ML) 2

GAMMAKED 2 PA

GAMMAPLEX 2

GAMUNEX 2

GAMUNEX-C INJECTION SOLUTION 1 GRAM/10 ML (10 %), 10 GRAM/100 ML (10 %), 2.5 GRAM/25 ML (10 %), 20 GRAM/200 ML (10 %), 5 GRAM/50 ML (10 %)

2 PA

GAMUNEX-C INJECTION SOLUTION 40 GRAM/400 ML (10 %)

2

GARDASIL (PF) 3 QL (1.5 ML per 365 days)

GARDASIL 9 (PF) 3 QL (1.5 ML per 365 days)

GRASTEK 2 PA

HAVRIX (PF) 2

HEPAGAM B 2

HIZENTRA 2 PA

HYPERHEP B S/D 2

HYPERHEP B S-D NEONATAL 2

HYPERRAB S/D (PF) 2

HYPERRHO S/D 2

HYPERTET S/D (PF) 2

HYQVIA 2 PA

55

Drug Name Tier NotesIMOGAM RABIES-HT (PF) 2

IMOVAX RABIES VACCINE (PF) 2

INFANRIX (DTAP) (PF) 2

influenza a (h1n1) vac 09 (pf) 2

influenza a (h1n1) vac 2009 2

IPOL 2

IXIARO (PF) 2

JE-VAX 2

KINRIX (PF) 2

MENACTRA (PF) 2

MENHIBRIX (PF) 2

MENOMUNE - A/C/Y/W-135 2

MENOMUNE - A/C/Y/W-135 (PF) 2

MENVEO A-C-Y-W-135-DIP (PF) 2

MENVEO MENA COMPONENT (PF) 2

MENVEO MENCYW-135 COMPNT (PF) 2

MICRHOGAM ULTRA-FILTERED 2

MICRHOGAM ULTRA-FILTERED PLUS 2

NABI-HB 2

OCTAGAM 2

ORALAIR 2 PA

PEDIARIX (PF) 2

PEDVAX HIB (PF) 2

PENTACEL (PF) 2

PENTACEL ACTHIB COMPONENT (PF) 2

PENTACEL DTAP-IPV COMPNT (PF) 2

PHYSICIANS EZ USE FLU 2012-13 2

PNEUMOVAX 23 3 QL (0.5 ML per 365 days)

PREVNAR 13 (PF) 3 QL (0.5 ML per 365 days)

PRIVIGEN 2

PROQUAD (PF) 3 QL (2 EA per 365 days)

QUADRACEL (PF) 2

RABAVERT (PF) 2

RAGWITEK 2 PA

RECOMBIVAX HB (PF) INTRAMUSCULAR SUSPENSION 10 MCG/ML, 40 MCG/ML


RECOMBIVAX HB (PF) INTRAMUSCULAR SUSPENSION 5 MCG/0.5 ML

2

RECOMBIVAX HB (PF) INTRAMUSCULAR SYRINGE 10 MCG/ML


RECOMBIVAX HB (PF) INTRAMUSCULAR SYRINGE 5 MCG/0.5 ML

2

RHOGAM ULTRA-FILTERED 2

RHOGAM ULTRA-FILTERED PLUS 2

RHOPHYLAC 2

56

Drug Name Tier NotesROTARIX 2

ROTATEQ VACCINE 2

SINGLE USE EZ FLU 2012-13 (PF) 2

SINGLE USE EZ FLU 2013-14 (PF) 2

SINGLE USE EZ FLU 2014-15(PF) 3 QL (0.5 EA per 180 days)

TENIVAC (PF) 3 QL (0.5 ML per 365 days)

tetanus toxoid,adsorbed (pf) 2

tetanus,diphtheria tox ped(pf) 2

tetanus-diphtheria toxoids-td 3 QL (0.5 ML per 365 days)

THYMOGLOBULIN 2

TRIHIBIT (PF) 2

TRIPEDIA (PF) 2

TRUMENBA 2

TUBERSOL 2

TWINRIX (PF) 2

TYPHIM VI 2

VAQTA (PF) 2

VARIVAX (PF) 3 QL (2 EA per 365 days)

VARIZIG 2

VIVAGLOBIN 2

VIVOTIF BERNA VACCINE 2

WINRHO SDF 2

YF-VAX (PF) 2

ZOSTAVAX (PF) 3 QL (1 EA per 365 days)

BLOODACTIVASE 2

ADVATE 2

ALBUKED-25 2

ALBUKED-5 2

albumin, human 25 % 2

albumin, human 5 % 2

ALBUMINAR 25 % 2

ALBUMINAR 5 % 2

ALBURX (HUMAN) 25 % 2

ALBURX (HUMAN) 5 % 2

ALBUTEIN 25 % 2

ALBUTEIN 5 % 2

ALPHANATE 2

ALPHANINE SD 2

ALPROLIX 2

AMICAR 2

aminocaproic acid 1

ATRYN INTRAVENOUS RECON SOLN 1,750 UNIT 2

BEBULIN 2

57

Drug Name Tier NotesBEBULIN VH 2

BENEFIX 2

BUMINATE 25 % 2

BUMINATE 5 % 2

CATHFLO ACTIVASE 2

CEPROTIN (BLUE BAR) 2

CEPROTIN (GREEN BAR) 2

CORIFACT 2

CYKLOKAPRON 2

DROXIA 2

ELOCTATE 2

FEIBA NF 2

FLEXBUMIN 25 % 2

FLEXBUMIN 5 % 2

HELIXATE FS 2

HEMOFIL M HIGH 2

HEMOFIL M LOW 2

HEMOFIL M MID 2

HEMOFIL M SUPER HIGH 2

HESPAN 6 % IN NS 2

hetastarch 6 % in 0.9 % nacl 1

HEXTEND 2

HUMATE-P 2

IXINITY 2

KCENTRA INTRAVENOUS KIT 2

KEDBUMIN 2

KOATE-DVI INTRAVENOUS RECON SOLN 2

KOGENATE FS 2

LMD 10 % IN 0.9 % SODIUM CHLOR 2

LMD 10 % IN 5 % DEXTROSE 2

LYSTEDA 2

MONOCLATE-P 2

MONONINE 2

NOVOEIGHT 2

NOVOSEVEN RT 2

OBIZUR 2

pentoxifylline 1

PLASBUMIN 25 % 2

PLASBUMIN 5 % 2

PLASMANATE 2

PRAXBIND 2

PROFILNINE 2

protamine 1

RECOMBINATE 2

58

Drug Name Tier NotesRECOTHROM 2

RECOTHROM SPRAY KIT 2

RETAVASE 2

RIASTAP 2

RIXUBIS 2

SOLIRIS 2

TACHOSIL 2

THROMBATE III INTRAVENOUS RECON SOLN 500 (+/-) UNIT

2

THROMBIN-JMI 1

TISSEEL VHSD 2

TNKASE 2

tranexamic acid 1

TRETTEN 2

ULTRAFOAM 2

VOLUVEN 6 % 2

WILATE INTRAVENOUS KIT 1,000-1,000 UNIT, 500-500 UNIT

2

XYNTHA 2

XYNTHA SOLOFUSE 2

CARDIAC DRUGSADALAT CC 2

ADENOCARD 2

adenosine 1

AFEDITAB CR 1

amiodarone 1

amiodarone in dextrose 5 % intravenous solution 150 mg/100 ml (1.5 mg/ml)

1

amlodipine 1

CALAN 2

CALAN SR 2

CARDENE IV 2

CARDENE IV IN DEXTROSE 2

CARDENE IV IN SODIUM CHLORIDE 2

cardioplegic soln 1

CARDIZEM CD 2

CARDIZEM LA 2

CARDIZEM ORAL TABLET 120 MG, 30 MG, 60 MG 2

CARTIA XT 1

CLEVIPREX 2

CORDARONE 2

CORLANOR 2

CORVERT 2

COVERA-HS 2

DIGITEK 1

59

Drug Name Tier NotesDIGOX 1

digoxin injection solution 1

digoxin oral solution 50 mcg/ml 2

digoxin oral tablet 1

DILACOR XR ORAL CAPSULE,EXT RELEASE DEGRADABLE 240 MG

2

DILATRATE-SR 2

DILT-CD 1

DILTIA XT 1

diltiazem hcl intravenous 1

diltiazem hcl oral 1

diltiazem in dextrose 5 % intravenous solution 125 mg/125 ml (1 mg/ml)

1

DILT-XR 1

DILTZAC ER 1

disopyramide phosphate oral capsule 1

dobutamine 1

dobutamine in d5w intravenous parenteral solution 1,000 mg/250 ml (4,000 mcg/ml), 250 mg/250 ml (1 mg/ml), 500 mg/250 ml (2,000 mcg/ml)

1

felodipine 1

flecainide 1

ibutilide fumarate 1

IMDUR 2

ISORDIL 2

ISORDIL TITRADOSE ORAL TABLET 5 MG 2

isosorbide dinitrate 1

isosorbide mononitrate 1

isradipine 1

LANOXIN 2

LANOXIN PEDIATRIC 2

lidocaine (pf) intravenous 1

lidocaine in 5 % dextrose (pf) intravenous parenteral solution 4 mg/ml (0.4 %), 8 mg/ml (0.8 %)

1

MATZIM LA 1

mexiletine 1

milrinone 1

milrinone in 5 % dextrose 1

MINITRAN 1

MULTAQ 2

NEXTERONE 2

nicardipine 1

NIFEDICAL XL 1

nifedipine 1

nimodipine 1

60

Drug Name Tier Notesnisoldipine 1

NITRO-BID 2

NITRO-DUR 2

nitroglycerin in 5 % dextrose 1

nitroglycerin intravenous 1

nitroglycerin oral 1

nitroglycerin transdermal patch 24 hour 1

nitroglycerin translingual 1

NITROLINGUAL 2

NITROMIST 2

NITROSTAT 2

NITRO-TIME 1

NORPACE 2

NORPACE CR 2

NORVASC 2

NYMALIZE 2 PA

PACERONE ORAL TABLET 100 MG, 200 MG, 400 MG 1

PLEGISOL 2

procainamide injection 1

PROCARDIA 2

PROCARDIA XL 2

propafenone 1

quinidine gluconate 1

quinidine sulfate oral tablet 1

RANEXA ORAL TABLET EXTENDED RELEASE 12 HR 1,000 MG


RANEXA ORAL TABLET EXTENDED RELEASE 12 HR 500 MG


RYTHMOL ORAL TABLET 150 MG, 225 MG 2

RYTHMOL SR 2

SULAR ORAL TABLET EXTENDED RELEASE 24 HR 17 MG, 34 MG, 8.5 MG

2

TAZTIA XT 1

TIAZAC 2

TIKOSYN 2

verapamil 1

VERELAN 2

VERELAN PM 2

XYLOCAINE (CARDIAC) (PF) 1

CARDIOVASCULARACCUPRIL 2

ACCURETIC 2

acebutolol 1

ADCIRCA 2 PA

ADEMPAS 2 PA

61

Drug Name Tier NotesADVICOR ORAL TABLET, ER MULTIPHASE 24 HR 1,000-20 MG, 750-20 MG


ADVICOR ORAL TABLET, ER MULTIPHASE 24 HR 1,000-40 MG, 500-20 MG


alprostadil 1

ALTACE 2

ALTOPREV 2 ST; QL (1 EA per 1 day)

amlodipine-atorvastatin 1 QL (1 EA per 1 day)

amlodipine-benazepril 1

AMTURNIDE ORAL TABLET 300-10-12.5 MG, 300-10-25 MG, 300-5-12.5 MG, 300-5-25 MG

2 PA

ANTARA ORAL CAPSULE 30 MG, 43 MG, 90 MG 2 ST

ASCLERA 2

ATACAND 2

ATACAND HCT 2

atenolol 1

atenolol-chlorthalidone 1

atorvastatin 1

AVALIDE 2

AVAPRO 2

benazepril 1

benazepril-hydrochlorothiazide 1

BENICAR ORAL TABLET 5 MG 2 ST

BETAPACE AF 2

BETAPACE ORAL TABLET 120 MG, 160 MG, 80 MG 2

betaxolol oral 1

BIDIL 2

bisoprolol fumarate 1

bisoprolol-hydrochlorothiazide 1

BREVIBLOC IN NACL (ISO-OSM) 2

BREVIBLOC INTRAVENOUS SOLUTION 100 MG/10 ML (10 MG/ML)

2

BYSTOLIC 2

CADUET 2 QL (1 EA per 1 day)

candesartan 1

candesartan-hydrochlorothiazid 1

captopril 1

captopril-hydrochlorothiazide 1

CARDURA 2

CARDURA XL 2

carvedilol 1

CATAPRES 2

CATAPRES-TTS-1 2

CATAPRES-TTS-2 2

CATAPRES-TTS-3 2

62

Drug Name Tier Notescholestyramine (with sugar) 1

CHOLESTYRAMINE LIGHT 1

clonidine 1

clonidine hcl oral tablet 1

CLORPRES 1

COLESTID 2

COLESTID FLAVORED 2

colestipol 1

COREG 2

COREG CR 2

CORGARD 2

CORLOPAM 2

CORZIDE 2

COZAAR 2

CRESTOR 2 ST; QL (1 EA per 1 day)

DEMSER 2

DIOVAN 2

DIOVAN HCT 2

doxazosin 1

DUTOPROL 2

EDARBYCLOR ORAL TABLET 40-25 MG 2 ST

enalapril maleate 1

enalaprilat intravenous solution 1

enalapril-hydrochlorothiazide 1

ENTRESTO 2 PA

EPANED 2 ST; QL (1200 ML per 30 days)

epoprostenol (glycine) 1

eprosartan 1 ST

ergoloid 1

esmolol intravenous solution 1

EXFORGE 2 ST

EXFORGE HCT ORAL TABLET 10-160-25 MG 2 ST

fenofibrate 1

fenofibrate micronized 1

fenofibrate nanocrystallized 1

fenofibric acid 1

fenofibric acid (choline) 1

FENOGLIDE 2 ST

FIBRICOR 2

FLOLAN 2

fosinopril 1

fosinopril-hydrochlorothiazide 1

gemfibrozil oral 1

guanfacine oral tablet 1

63

Drug Name Tier NotesHEMANGEOL 2 ST; QL (360 ML per 30 days)

hydralazine 1

HYZAAR 2

INDERAL LA 2

INDERAL XL 2 ST

indomethacin sodium 1

INNOPRAN XL 2 ST

irbesartan 1

irbesartan-hydrochlorothiazide 1

JUXTAPID ORAL CAPSULE 10 MG, 5 MG 2 PA; QL (1 EA per 1 day)

JUXTAPID ORAL CAPSULE 20 MG 2 PA; QL (3 EA per 1 day)

JUXTAPID ORAL CAPSULE 30 MG, 40 MG, 60 MG 2 PA

KYNAMRO 2 PA

labetalol intravenous solution 1

labetalol intravenous syringe 20 mg/4 ml (5 mg/ml) 1

labetalol oral 1

LESCOL ORAL CAPSULE 40 MG 2 ST; QL (2 EA per 1 day)

LETAIRIS 2 PA

LIPITOR 2

LIPOFEN 2 ST

LIPTRUZET ORAL TABLET 10-20 MG, 10-40 MG, 10-80 MG


lisinopril 1

lisinopril-hydrochlorothiazide 1

LOFIBRA 2

LOPID 2

LOPRESSOR 2

LOPRESSOR HCT 2

losartan 1

losartan-hydrochlorothiazide 1

LOTENSIN HCT 2

LOTENSIN ORAL TABLET 20 MG, 40 MG 2

LOTREL 2

lovastatin 1

MAVIK 2

methyldopa 1

methyldopa-hydrochlorothiazide 1

methyldopate 1

metoprolol succinate 1

metoprolol ta-hydrochlorothiaz 1

metoprolol tartrate 1

MEVACOR 2

MICARDIS 2

MICARDIS HCT 2

64

Drug Name Tier NotesMINIPRESS 2

minoxidil oral 1

moexipril 1

moexipril-hydrochlorothiazide 1

morrhuate sodium 1

nadolol 1

nadolol-bendroflumethiazide 1

NATRECOR 2

NEOPROFEN (IBUPROFEN LYSN)(PF) 2

NIACOR 1

NIASPAN EXTENDED-RELEASE 2 ST

NITROPRESS 2

OPSUMIT 2 PA

ORENITRAM 2 PA

papaverine injection solution 1

perindopril erbumine 1

phenylephrine hcl in 0.9% nacl intravenous solution 50 mg/250 ml (200 mcg/ml)

1

phenylephrine hcl injection 1

pindolol 1

PRALUENT PEN 2 PA

PRALUENT SYRINGE 2 PA

PRAVACHOL 2

pravastatin 1

prazosin oral 1

PREVALITE 1

PRINIVIL ORAL TABLET 10 MG, 20 MG, 5 MG 2

propranolol 1

propranolol-hydrochlorothiazid 1

PROSTIN VR PEDIATRIC 2

QUESTRAN 2

QUESTRAN LIGHT 2

quinapril 1

quinapril-hydrochlorothiazide 1

ramipril 1

REMODULIN 2 PA

REPATHA SURECLICK 2 PA

reserpine 1

REVATIO INTRAVENOUS 2

REVATIO ORAL SUSPENSION FOR RECONSTITUTION


REVATIO ORAL TABLET 2 QL (3 EA per 1 day)

SECTRAL 2

sildenafil intravenous 1

65

Drug Name Tier Notessildenafil oral 1 QL (3 EA per 1 day)

SIMCOR ORAL TABLET, ER MULTIPHASE 24 HR 1,000-20 MG, 750-20 MG


SIMCOR ORAL TABLET, ER MULTIPHASE 24 HR 1,000-40 MG, 500-20 MG, 500-40 MG


simvastatin oral tablet 10 mg, 20 mg, 40 mg, 5 mg 1

simvastatin oral tablet 80 mg 1 ST

SORINE 1

SOTALOL AF 1

sotalol intravenous 2

sotalol oral 1

SOTRADECOL INTRAVENOUS SOLUTION 1 % (10 MG/ML)

2

SOTRADECOL INTRAVENOUS SOLUTION 3 % (30 MG/ML)

1

TARKA 2

TEKAMLO ORAL TABLET 150-10 MG, 150-5 MG, 300-10 MG

2 PA

TEKTURNA 2 PA

TEKTURNA HCT 2 PA

telmisartan 1

telmisartan-amlodipine 1

telmisartan-hydrochlorothiazid 1

TENEX 2

TENORETIC 100 2

TENORETIC 50 2

TENORMIN 2

terazosin 1

TEVETEN 2 ST

TEVETEN HCT 2 ST

timolol maleate oral 1

TOPROL XL 2

TRACLEER 2 PA

TRANDATE ORAL 2

trandolapril 1

trandolapril-verapamil 1

TRICOR 2

TRIGLIDE ORAL TABLET 160 MG 2 ST

TRILIPIX 2

TWYNSTA 2

TYVASO 2 PA

TYVASO INSTITUTIONAL START KIT 2 PA

TYVASO REFILL KIT 2 PA

TYVASO STARTER KIT 2 PA

UNIVASC 2

66

Drug Name Tier Notesvalsartan 1

valsartan-hydrochlorothiazide 1

VASERETIC 2

VASOTEC 2

VECAMYL 2 PA

VELETRI 2

VENTAVIS 2 PA

VYTORIN 10-20 2 ST; QL (1 EA per 1 day)



WELCHOL 2

ZEBETA 2

ZESTORETIC 2

ZESTRIL 2

ZETIA 2 QL (1 EA per 1 day)

ZIAC 2

ZOCOR ORAL TABLET 10 MG, 20 MG, 40 MG, 5 MG 2

ZOCOR ORAL TABLET 80 MG 2 ST

CNS DRUGSALERTNESS AID 1

ammonia aromatic inhalation solution 1

AMPYRA 2 PA

APTIOM ORAL TABLET 200 MG, 600 MG 2 ST; QL (2 EA per 1 day)

APTIOM ORAL TABLET 400 MG 2 ST; QL (3 EA per 1 day)

APTIOM ORAL TABLET 800 MG 2 ST; QL (1 EA per 1 day)

AUBAGIO 2 PA

AVONEX 2 PA

AVONEX (WITH ALBUMIN) 2 PA

BANZEL 2 ST

BETASERON SUBCUTANEOUS KIT 2 PA

CAFCIT 2

caffeine citrated intravenous 1

caffeine citrated oral 1

caffeine-sodium benzoate 1

carbamazepine oral capsule, er multiphase 12 hr 1

carbamazepine oral suspension 100 mg/5 ml 1

carbamazepine oral tablet 1

carbamazepine oral tablet extended release 12 hr 1

carbamazepine oral tablet,chewable 1

CARBATROL 2

CELONTIN ORAL CAPSULE 300 MG 2

CEREBYX 2

clonazepam 1

COPAXONE SUBCUTANEOUS SYRINGE 2 PA

67

Drug Name Tier NotesDEHYDRATED ALCOHOL 2

DEPACON 2

DEPAKENE 2

DEPAKOTE 2

DEPAKOTE ER 2

DEPAKOTE SPRINKLES 2

DIASTAT 2 QL (1 EA per 1 FILL)

DIASTAT ACUDIAL 2 QL (1 EA per 1 FILL)

diazepam rectal 1 QL (1 EA per 1 FILL)

DILANTIN 2

DILANTIN EXTENDED 2

DILANTIN INFATABS 2

DILANTIN-125 2

divalproex 1

DOPRAM 2

EPITOL 1

ethanol (ethyl alcohol) 1

ethosuximide 1

EXTAVIA 2 PA

FELBATOL ORAL TABLET 2 ST

fosphenytoin 1

FYCOMPA ORAL TABLET 10 MG, 12 MG, 8 MG 2 ST; QL (30 EA per 30 days)

FYCOMPA ORAL TABLET 2 MG 2 ST; QL (120 EA per 30 days)

FYCOMPA ORAL TABLET 4 MG, 6 MG 2 ST; QL (60 EA per 30 days)

gabapentin oral capsule 1

gabapentin oral solution 1

gabapentin oral tablet 600 mg, 800 mg 1

GABITRIL ORAL TABLET 12 MG, 2 MG, 4 MG 2 ST; QL (4 EA per 1 day)

GABITRIL ORAL TABLET 16 MG 2 ST; QL (3 EA per 1 day)

GILENYA 2 PA

GLATOPA 1 PA

GRALISE 2 ST; QL (3 EA per 1 day)

GRALISE 30-DAY STARTER PACK 2 ST; QL (39 EA per 15 days)

HORIZANT ORAL TABLET EXTENDED RELEASE 300 MG


HORIZANT ORAL TABLET EXTENDED RELEASE 600 MG


KEPPRA 2

KEPPRA XR 2

KLONOPIN 2

LAMICTAL 2

LAMICTAL ODT 2 ST

LAMICTAL ODT STARTER (BLUE) 2 ST

LAMICTAL ODT STARTER (GREEN) 2 ST

68

Drug Name Tier NotesLAMICTAL ODT STARTER (ORANGE) 2 ST

LAMICTAL STARTER (BLUE) KIT 2

LAMICTAL STARTER (GREEN) KIT 2

LAMICTAL STARTER (ORANGE) KIT 2

LAMICTAL XR 2 ST

LAMICTAL XR STARTER (BLUE) 2 ST

LAMICTAL XR STARTER (GREEN) 2 ST

LAMICTAL XR STARTER (ORANGE) 2 ST

lamotrigine oral tablet 1

lamotrigine oral tablet extended release 24hr 250 mg 1 ST

lamotrigine oral tablet, chewable dispersible 1

lamotrigine oral tablets,dose pack 25 mg (35) 1

LEMTRADA 2

levetiracetam 1

levetiracetam in nacl (iso-os) 1

LYRICA 2

memantine oral solution 1 QL (300 ML per 30 days)

memantine oral tablet 1 QL (60 EA per 30 days)

memantine oral tablets,dose pack 1 QL (2 EA per 1 day)

MYSOLINE 2

NAMENDA ORAL SOLUTION 2 QL (300 ML per 30 days)

NAMENDA ORAL TABLET 2 QL (60 EA per 30 days)

NAMENDA TITRATION PAK 2 QL (2 EA per 1 day)

NAMENDA XR ORAL CAP,SPRINKLE,ER 24HR DOSE PACK


NAMENDA XR ORAL CAPSULE,SPRINKLE,ER 24HR 2 QL (30 EA per 30 days)

NAMZARIC 2 ST; QL (1 EA per 1 day)

NEURONTIN 2

NO DOZ 1

NUEDEXTA 2 PA

ONFI ORAL SUSPENSION 2 ST; QL (480 ML per 30 days)

ONFI ORAL TABLET 5 MG 2 ST; QL (2 EA per 1 day)

oxcarbazepine 1

OXTELLAR XR 2 ST

PEGANONE 2

PHENYTEK 2

phenytoin oral suspension 1

phenytoin oral tablet,chewable 1

phenytoin sodium 1

phenytoin sodium extended 1

PLEGRIDY 2 PA

POTIGA ORAL TABLET 200 MG, 300 MG, 400 MG 2 ST; QL (3 EA per 1 day)

POTIGA ORAL TABLET 50 MG 2 ST

primidone 1

69

Drug Name Tier NotesQUDEXY XR 2 ST; QL (2 EA per 1 day)

REBIF (WITH ALBUMIN) 2 PA

REBIF REBIDOSE 2 PA

REBIF TITRATION PACK 2 PA

RILUTEK 2

riluzole 1

SABRIL 2 QL (6 EA per 1 day)

STAY AWAKE 1

STAY AWAKE MAXIMUM STRENGTH 1

TECFIDERA 2 PA

TEGRETOL ORAL SUSPENSION 2

TEGRETOL ORAL TABLET 2

TEGRETOL XR 2

tetrabenazine 1

TOPAMAX 2

topiramate oral capsule, sprinkle 1

topiramate oral capsule,sprinkle,er 24hr 1 ST; QL (2 EA per 1 day)

topiramate oral tablet 1

TRILEPTAL 2

TROKENDI XR 2 ST; QL (2 EA per 1 day)

valproate sodium 1

valproic acid 1

valproic acid (as sodium salt) oral solution 1

VIMPAT INTRAVENOUS 2

XENAZINE 2

ZARONTIN 2

ZONEGRAN ORAL CAPSULE 100 MG, 25 MG 2

zonisamide 1

COLONY STIMULATING FACTORSARANESP (IN POLYSORBATE) 2 PA

EPOGEN INJECTION SOLUTION 10,000 UNIT/ML, 2,000 UNIT/ML, 20,000 UNIT/2 ML, 20,000 UNIT/ML, 3,000 UNIT/ML, 4,000 UNIT/ML

2 PA

GRANIX 2 PA

LEUKINE INJECTION RECON SOLN 2 PA

MIRCERA 2 PA

MOZOBIL 2

NEULASTA SUBCUTANEOUS SYRINGE 2 PA

NEULASTA SUBCUTANEOUS SYRINGE, W/ WEARABLE INJECTOR

2

NEUMEGA 2

NEUPOGEN 2 PA

NPLATE 2

PROCRIT 2 PA

PROMACTA 2 PA; QL (1 EA per 1 day)

70

Drug Name Tier NotesZARXIO 2

CONTRACEPTIVESAFTERA 3

ALTAVERA (28) 3

ALYACEN 1/35 (28) 3

ALYACEN 7/7/7 (28) 3

AMETHIA 3 QL (91 EA per 84 days)

AMETHIA LO 3 QL (91 EA per 84 days)

AMETHYST 2 ST

APRI 3

ARANELLE (28) 3

ASHLYNA 3 QL (91 EA per 84 days)

AUBRA 3

AVIANE 3

AZURETTE (28) 3

BALZIVA (28) 3

BREVICON (28) 3

BRIELLYN 3

CAMILA 3

CAMRESE 3 QL (91 EA per 84 days)

CAMRESE LO 3 QL (91 EA per 84 days)

CAYA CONTOURED 3

CAZIANT (28) 3

CHATEAL 3

CRYSELLE (28) 3

CYCLAFEM 1/35 (28) 3

CYCLAFEM 7/7/7 (28) 3

CYCLESSA (28) 2 ST

CYRED 3

DASETTA 1/35 (28) 3

DASETTA 7/7/7 (28) 3

DAYSEE 3 QL (91 EA per 84 days)

DEBLITANE 3

DELYLA (28) 3

DEPO-PROVERA INTRAMUSCULAR SUSPENSION 2 QL (1 ML per 84 days)

DEPO-PROVERA INTRAMUSCULAR SYRINGE 2 QL (1 ML per 84 days)

DEPO-SUBQ PROVERA 104 2 QL (0.65 ML per 84 days)

desog-e.estradiol/e.estradiol 3

DESOGEN 2 ST

desogestrel-ethinyl estradiol 3

ECONTRA EZ 3

ELINEST 3

ELLA 2

EMOQUETTE 3

71

Drug Name Tier NotesENPRESSE 3

ENSKYCE 3

ERRIN 3

ESTARYLLA 3

ESTROSTEP FE-28 2 ST

FALLBACK SOLO 3

FALMINA (28) 3

FEMCON FE 2 ST

GENERESS FE 2

GILDAGIA 3

GILDESS 3

GILDESS 24 FE 3

GILDESS FE 3

HEATHER 3

IMPLANON 2

INTROVALE 3 QL (91 EA per 84 days)

JENCYCLA 3

JOLESSA 3 QL (91 EA per 84 days)

JOLIVETTE 3

JULEBER 3

JUNEL 1.5/30 (21) 3

JUNEL 1/20 (21) 3

JUNEL FE 1.5/30 (28) 3

JUNEL FE 1/20 (28) 3

JUNEL FE 24 3

KARIVA (28) 3

KELNOR 1/35 (28) 3

KIMIDESS (28) 3

KURVELO 3

l norgest/e.estradiol-e.estrad 3 QL (91 EA per 84 days)

LARIN 1.5/30 (21) 3

LARIN 1/20 (21) 3

LARIN 24 FE 3

LARIN FE 3

LAYOLIS FE 1

LEENA 28 3

LESSINA 3

LEVONEST (28) 3

levonorgestrel 3

levonorgestrel-ethinyl estrad oral tablet 0.1-20 mg-mcg, 0.15-0.03 mg

3

levonorgestrel-ethinyl estrad oral tablet 90-20 mcg 1

levonorgestrel-ethinyl estrad oral tablets,dose pack,3 month 3 QL (91 EA per 84 days)

LEVORA-28 3

72

Drug Name Tier NotesLO LOESTRIN FE 2 ST

LO MINASTRIN FE 2

LOESTRIN 1.5/30 (21) 2 ST

LOESTRIN 1/20 (21) 2 ST

LOESTRIN 24 FE 2

LOESTRIN FE 1.5/30 (28-DAY) 2 ST

LOESTRIN FE 1/20 (28-DAY) 2 ST

LOMEDIA 24 FE 3

LORYNA (28) 3 ST

LOSEASONIQUE 2 ST; QL (91 EA per 84 days)

LOW-OGESTREL (28) 3

LUTERA (28) 3

LYZA 3

MARLISSA 3

medroxyprogesterone intramuscular 1 QL (1 ML per 84 days)

MICROGESTIN 1.5/30 (21) 3

MICROGESTIN 1/20 (21) 3

MICROGESTIN FE 1.5/30 (28) 3

MICROGESTIN FE 1/20 (28) 3

MINASTRIN 24 FE 2

MIRCETTE (28) 2 ST

MODICON (28) 2 ST

MONO-LINYAH 3

MONONESSA (28) 3

MY WAY 3

MYZILRA 3

NECON 0.5/35 (28) 3

NECON 1/35 (28) 3

NECON 1/50 (28) 3

NECON 10/11 (28) 3

NECON 7/7/7 (28) 3

NEXPLANON 2

NEXT CHOICE 3

NEXT CHOICE ONE DOSE 3

NORA-BE 3

noreth-ethinyl estradiol-iron oral tablet,chewable 0.4mg-35mcg(21) and 75 mg (7)

3

noreth-ethinyl estradiol-iron oral tablet,chewable 0.8mg-25mcg(24) and 75 mg (4)

1

norethindrone (contraceptive) 3

norethindrone ac-eth estradiol oral tablet 1-20 mg-mcg 3

norethindrone-e.estradiol-iron 3

norgestimate-ethinyl estradiol 3

NORINYL 1+35 (28) 3

73

Drug Name Tier NotesNORINYL 1+50 (28) 2 ST

NORLYROC 3

NOR-QD 2 ST

NORTREL 0.5/35 (28) 3

NORTREL 1/35 (21) 3

NORTREL 1/35 (28) 3

NORTREL 7/7/7 (28) 3

NUVARING 2 ST; QL (1 EA per 28 days)

OGESTREL (28) 3

OPCICON ONE-STEP 3

ORSYTHIA 3

ORTHO ALL-FLEX FITTING SET 3

ORTHO DIAPHRAGM ALL-FLEX 65 3




ORTHO EVRA 2 ST; QL (3 EA per 28 days)

ORTHO MICRONOR 2 ST

ORTHO TRI-CYCLEN (28) 2 ST

ORTHO-CEPT (28) 2 ST

ORTHO-CYCLEN (28) 2 ST

ORTHO-NOVUM 1/35 (28) 2 ST

ORTHO-NOVUM 7/7/7 (28) 2 ST

OVCON-35 (28) 2 ST

PARAGARD T 380A 2

PHILITH 3

PIMTREA (28) 3

PIRMELLA 3

PORTIA 3

PREVIFEM 3

QUARTETTE 2

QUASENSE 3 QL (91 EA per 84 days)

RECLIPSEN (28) 3

SAFYRAL 2 ST

SEASONIQUE 2 ST; QL (91 EA per 84 days)

SETLAKIN 3 QL (91 EA per 84 days)

SHAROBEL 3

SPRINTEC (28) 3

SRONYX 3

SYEDA 3 ST

TAKE ACTION 3

TARINA FE 3

TILIA FE 3

TRI-ESTARYLLA 3

74

Drug Name Tier NotesTRI-LEGEST FE 3

TRI-LINYAH 3

TRINESSA (28) 3

TRI-NORINYL (28) 2 ST

TRI-PREVIFEM (28) 3

TRI-SPRINTEC (28) 3

TRIVORA (28) 3

VELIVET TRIPHASIC REGIMEN (28) 3

VIORELE (28) 3

VYFEMLA (28) 3

WERA (28) 3

WIDE-SEAL DIAPHRAGM 60 3








WYMZYA FE 3

XULANE 1 QL (3 EA per 28 days)

YASMIN (28) 2 ST

YAZ (28) 2 ST

ZARAH 3 ST

ZENCHENT (28) 3

ZENCHENT FE 3

ZEOSA 3

ZOVIA 1/35E (28) 3

ZOVIA 1/50E (28) 3

COUGH/COLD PREPARATIONSADULT TUSSIN CHEST CONGESTION 1

ADULT TUSSIN COUGH CONGEST DM 1

ADULT TUSSIN DM 1

ADULT TUSSIN MULTI-SYMP COLD 1

AIRACOF 1

ALA-HIST AC 2

ALA-HIST DM 2

ALLERGY & COLD PE 1

ALLERGY MULTI-SYMPTOM 1

ALLERGY SINUS HEADACHE (PE) ORAL TABLET 12.5-5-325 MG

1

ALLFEN DM 2

ALL-NITE COLD-FLU 1

AP-HIST DM 1

75

Drug Name Tier NotesAQUANAZ 2

benzonatate 1

BICLORA 2

BROMFED DM 1

brompheniramine-pseudoeph-dm oral syrup 1

BROTAPP DM 1

BROVEX PEB DM 2

BROVEX PSB ORAL LIQUID 4-20-20 MG/5 ML 2

CAPCOF 2

CAPMIST DM 2

CAPRON DM 2

CENTUSSIN DHC 1

CEPACOL SORETHROAT-COUGH 2

CHERATUSSIN AC 1

CHERATUSSIN DAC 1

CHEST CONGESTION RELIEF 1

CHEST CONGESTION RELIEF + DM 1

CHEST CONGESTION RELIEF PE 1

CHEST CONGESTION-COUGH RELIEF 1

CHEST-SINUS CONGESTION RELIEF 1

CHILD COLD-COUGH DAY-NIGHT 1

CHILD DELSYM COUGH+CHEST DM 1

CHILD DELSYM COUGH+COLD 2

CHILD MUCINEX CHEST CONGESTION 1

CHILD MUCINEX CONGESTION-COUGH 2

CHILD MUCINEX M-S COLD DAY-NTE 2

CHILD MUCINEX STUFFY NOSE-COLD 2

CHILD MUCUS RELIEF COUGH 1

CHILD MUCUS RELIEF EXPECTORANT 1

CHILD PLUS COUGH & RUNNY NOSE 1

CHILD TRIAMINIC COUGH-CONGEST 1

CHILD TRIAMINIC COUGH-SORE THR 1

CHILD TRIAMINIC MS FEVER-COLD 1

CHILDREN'S COLD & COUGH 1

CHILDREN'S COLD & COUGH DM 1

CHILDREN'S MAPAP COUGH-SINUS 1

CHILDREN'S M-S COLD DAY-NIGHT 1

CHILDREN'S MUCINEX COLD-FEVER 2

CHILDREN'S MUCINEX COUGH 1

CHILDREN'S MUCINEX MULTI-SYMP 2

CHILDREN'S MUCINEX NIGHT TIME 2

CHILDRENS PLUS MULTI-SYMP COLD 1

CHILDREN'S SILFEDRINE 1

CHILDREN'S TRIAMINIC-D MS COLD 2

76

Drug Name Tier NotesCHLO HIST 2

CHLO TUSS 2

CHLO TUSS EX 2

CLOFERA 2

codeine-guaifenesin 1

CODITUSS DM 1

COLD & COUGH DM 1

COLD & COUGH ELIXIR 1

COLD & COUGH ORAL LIQUID 2.5-5 MG/5 ML 1

COLD & FLU SEVERE 1

COLD HEAD CONGESTION DAY/NITE 1

COLD HEAD CONGESTION DAYTIME 1

COLD HEAD CONGESTION NIGHTTIME 1

COLD HEAD CONGESTION SEVER DAY 1

COLD MULTI-SYMPTOM 1

COLD MULTI-SYMPTOM (CHLORPHEN) 1

COLD MULTI-SYMPTOM DAY/NIGHT 1

COLD RELIEF ORAL TABLET, EFFERVESCENT 1

COLD RELIEF PLUS 1

COLD SEVERE CONGESTION 1

COLD-SINUS RELIEF 1

COMTREX COLD-COUGH 2

COMTREX DAY/NI SEV COLD-SINUS 2

COMTREX DAY/NIGHT COLD & COUGH 2

COMTREX DEEP CHEST COLD 1

COMTREX FLU THERAPY 2

COMTREX NIGHTTIME COLD & COUGH 2

CONGESTAC 1

CONGESTION RELIEF (IBUPROF-PE) 1

COUGH & COLD BP 1

COUGH & COLD ORAL TABLET 1

COUGH & SORE THROAT 1

COUGH CONTROL (DEXTROMETHORPH) 1

COUGH CONTROL (GUAIFENESIN) 1

COUGH CONTROL CF (PE) 1

COUGH CONTROL DM 1

COUGH CONTROL DM MAX 1

COUGH DM ER 1

COUGH DROPS MUCOUS MEMBRANE LOZENGE 5.4 MG, 5.8 MG

1

COUGH RELIEF ORAL LIQUID 1

COUGH SUPPRESSANT 1

COUGH SUPPRESSANT-EXPECTORANT 1

COUGH SYRUP 1

77

Drug Name Tier NotesCOUGH SYRUP DM 1

COUGH-SORE THROAT NIGHT 1

COUGHTAB 1

COUGHTAB 400 1

cpm-pseudoephed-hydrocodone 1

DAY TIME PE 1

DAYTIME COLD & FLU RELIEF (PE) ORAL LIQUID 1

DAYTIME COLD-FLU 1

DAY-TIME COUGH 1

DAYTIME MUCUS RELIEF DM 1

DAYTIME SINUS 1

DAYTIME SINUS RELIEF ORAL CAPSULE 5-325 MG 1

DAYTIME-NIGHTTIME 1

DE-CHLOR DM 1

DECONEX 2

DECONEX DM 2

DECONEX DMX 2

DECONEX IR 2

DELSYM 12 HOUR 2

DELSYM COUGH+CHEST CONGEST DM 1

DELSYM COUGH+COLD DAYTIME 2

DELSYM COUGH+COLD NIGHTTIME 2

DELSYM COUGH+SOOTHING ACTION 2

DELSYM NIGHTTIME MULTI-SYMPTOM 1

DESGEN DM (PSEUDOEPHEDRINE) 1

dextromethorphan polistirex 1

dextromethorphan-guaifenesin oral syrup 1

DIABETIC SILTUSSIN DAS-NA 1

DIABETIC SILTUSSIN-DM 1

DIABETIC SILTUSSIN-DM MAX STR 1

DICEL CD 2

DIMAPHEN DM 1

DIMETANE-DX 2

DIMETAPP DM COLD-COUGH (PE) 2

DONATUSS DC 2

DONATUSSIN 2

DONATUSSIN DM 2

DONATUSSIN PEDI (REFORMULATED) 2

DONATUSSIN PEDIATRIC 2

DRYMAX 1

DRYMAX AF 2

DURAFLU ORAL TABLET 60-20-200-500 MG 2

DURAVENT DM 2

DURAVENT PE 2

78

Drug Name Tier NotesED A-HIST DM 1

ED BRON GP 1

ENDACOF - DM 1

ENDACOF-C 1

ENTRE-COUGH 1

ENTRE-S 1

ephedrine sulfate in 0.9% nacl intravenous syringe 50 mg/5 ml (10 mg/ml)

1

ephedrine sulfate injection solution 1

ephedrine sulfate oral 1

EXCEDRIN SINUS HEADACHE 2

EXECLEAR-C 1

EXEFEN DMX 1

FLOWTUSS 2 ST; QL (600 ML per 10 days)

FLU & SEVERE COLD-DAYTIME 1

FLU & SORE THROAT 1

FLU BP 1

FLU-SEVERE COLD-COUGH DAYTIME 1

FLU-SEVERE COLD-COUGH NIGHT 1

GUAIATUSSIN AC 1

guaifenesin 1

GUAIFENESIN AC 1

GUAIFENESIN DAC 1

GUAIFENESIN DM 1

HISTEX DM 2

HISTEX-AC 2

HYCOFENIX 2

hydrocodone-chlorpheniramine 1

hydrocodone-homatropine oral syrup 5-1.5 mg/5 ml 1

hydrocodone-homatropine oral tablet 1

HYDROMET 1

IBUPROFEN COLD 1

IBUPROFEN COLD-SINUS(WITH PSE) 1

INTENSE COUGH RELIEVER ORAL LIQUID 20-300 MG/5 ML

1

IOPHEN C-NR 1

IOPHEN DM-NR 1

IOPHEN-NR 1

J-COF DHC 1

J-MAX 1

J-MAX DHC 1

KIDKARE COUGH/COLD 1

LEXUSS 210 1

LOHIST PEB DM 1

79

Drug Name Tier NotesLOHIST-DM 1

LORTUSS DM 2

LORTUSS EX ORAL SYRUP 1

LUSAIR 1

MAPAP COLD FORMULA 1

MAPAP SINUS MAX STRENGTH (PE) 1

MAR-COF BP 1

MAR-COF CG 1

MAXIPHEN 2

MAXIPHEN DM 2

M-CLEAR WC 2

M-END DMX 2

M-END MAX D 2

M-END PE 2

M-END WC 2

MUCAPHED 1

MUCINEX 2

MUCINEX COLD & SINUS 2

MUCINEX COLD-FLU & SORE THROAT 2

MUCINEX COUGH MINI-MELTS 2

MUCINEX D 2

MUCINEX D MAXIMUM STRENGTH 2

MUCINEX DM 2

MUCINEX FAST-MAX COLD-FLU-THRT ORAL CAPSULE

2

MUCINEX FAST-MAX COLD-FLU-THRT ORAL POWDER IN PACKET

2

MUCINEX FAST-MAX COLD-FLU-THRT ORAL TABLET

1

MUCINEX FAST-MAX COLD-SINUS 1

MUCINEX FAST-MAX CONGEST-COUGH ORAL LIQUID

2

MUCINEX FAST-MAX CONGEST-COUGH ORAL TABLET

1

MUCINEX FAST-MAX DAY-NITE COLD 2

MUCINEX FAST-MAX DAY-NITE CONG 2

MUCINEX FAST-MAX DAY-NT(DOXYL) 2

MUCINEX FAST-MAX DM MAX 1

MUCINEX FAST-MAX NITE (DOXYL) 1

MUCINEX FAST-MAX NITE COLD-FLU ORAL LIQUID

2

MUCINEX FAST-MAX NITE COLD-FLU ORAL TABLET

1

MUCINEX FAST-MAX SEV CLD-SINUS 1

MUCINEX FAST-MAX SEVERE COLD ORAL LIQUID 2

MUCINEX FAST-MAX SEVERE COLD ORAL TABLET 1

80

Drug Name Tier NotesMUCINEX FST-MX DY-NT CLD (DPH) 2

MUCINEX MINI-MELTS ORAL GRANULES IN PACKET 100 MG

2

MUCINEX SINUS-MAX D-N (DIPHEN) 2

MUCINEX SINUS-MAX DY-NT (DXYL) 2

MUCINEX SINUS-MAX NITE CONGEST 2

MUCINEX SINUS-MAX PRESSUR-PAIN ORAL LIQUID

2

MUCINEX SINUS-MAX PRESSUR-PAIN ORAL TABLET

1

MUCINEX SINUS-MAX SEV CONG(DM) 2

MUCINEX SINUS-MAX SEV CONGESTN ORAL LIQUID

2

MUCINEX SINUS-MAX SEV CONGESTN ORAL TABLET

1

MUCOSA 1

MUCOSA DM 1

MUCUS RELIEF 1

MUCUS RELIEF COLD & SINUS ORAL TABLET 1

MUCUS RELIEF COLD-FLU-SORE THR ORAL TABLET

1

MUCUS RELIEF COUGH 1

MUCUS RELIEF DM 1

MUCUS RELIEF ER ORAL TABLET EXTENDED RELEASE 12HR

1

MUCUS RELIEF PE 1

MUCUS RELIEF SEV CONGEST-COLD 1

MUCUS RELIEF SINUS 1

MULTI-SYMPTOM COLD (PE) 1

MULTI-SYMPTOM COLD NIGHT TIME 1

NASAL DECONGESTANT (PE) ORAL TABLET 10 MG 1

NASAL DECONGESTANT (PSEUDOEPH) 1

NEO AC 2

NEO DM 2

NIGHT TIME (DOXY-DM-ACETAM) 1

NIGHT TIME COLD & FLU RELIEF 1

NIGHT TIME COLD ORAL LIQUID 1

NIGHT TIME COLD-FLU ORAL LIQUID 1

NIGHT TIME COLD-FLU RELIEF ORAL LIQUID 12.5-30-1,000 MG/30 ML

1

NIGHT-TIME 1

NIGHTTIME COLD-FLU 1

NIGHTTIME COLD-FLU RELIEF 1

NIGHTTIME COUGH 1

NIGHTTIME SINUS 1

NINJACOF 2

81

Drug Name Tier NotesNINJACOF-A 2

NINJACOF-XG 1

NITE TIME 1

NITE TIME COLD-FLU RELIEF ORAL LIQUID 1

NITE TIME COUGH 1

NITE TIME-D COLD-FLU RELIEF 1

NITE-TIME COLD-FLU 1

NIVA-HIST DM 1

NIVANEX DMX 1

NOHIST-DM 1

NOREL AD 2

NOREL CS 2

NU-COPD 1

NYQUIL D 1

ORGAN-I NR 1

PAIN RELIEF ALLERGY SINUS 1

PAIN RELIEF COLD 1

PAIN RELIEF COLD & COUGH 1

PAIN RELIEF SINUS PE 1

PEDIA RELIEF COUGH-COLD 1

PEDIATRIC COUGH & COLD ORAL LIQUID 1-15-5 MG/5 ML

1

PHENYLHISTINE DH 1

PLURATUSS 1

POLY HIST DHC 2

POLY HIST NC 2

POLY HIST PD 2

POLY-HIST DM (THONZYLAMINE) 2

POLY-TUSSIN 1

POLY-TUSSIN AC ORAL LIQUID 4-10-10 MG/5 ML 2

POLY-TUSSIN D 1

POLY-TUSSIN EX 2

POLY-VENT DM ORAL TABLET 60-20-380 MG 2

POLY-VENT IR ORAL TABLET 60-380 MG 2

PRO-CHLO 2

PRO-CLEAR AC 2

PROMETHAZINE VC-CODEINE 1

promethazine-codeine 1

promethazine-dm 1

promethazine-phenyleph-codeine 1

PRO-RED AC (W/ DEXCHLORPHENIR) 2

pseudoephedrine hcl oral liquid 1

pseudoephedrine hcl oral tablet 1

Q-TAPP DM 1

82

Drug Name Tier NotesQ-TUSSIN 1

Q-TUSSIN DM 1

RELCOF C 1

RESCON-DM 2

RESCON-GG 2

RESPAIRE-30 2

REZIRA 2

ROBAFEN 1

ROBAFEN AC 1

ROBAFEN CF ORAL LIQUID 1

ROBAFEN COUGH 1

ROBAFEN DM 1

ROBAFEN DM CLEAR 1

ROBAFEN DM COUGH 1

ROBAFEN DM MAX 1

RYDEX 1

RYNEX DM 1

SEVERE COLD & FLU (PE) ORAL TABLET 1

SEVERE COLD PE 1

SILPHEN DM COUGH 1

SILTUSSIN DAS 1

SILTUSSIN DM DAS 1

SILTUSSIN SA 1

SILTUSSIN-DM 1

SINUS & COLD-D 1

SINUS 12 HOUR 1

SINUS CONG & PAIN DAY-NIGHT 1

SINUS CONGESTION & PAIN 1

SINUS CONGESTION & PAIN(GUAIF) 1

SINUS CONGESTION&PAIN(CHLORPH) 1

SINUS PAIN RELIEF 1

SORE THROAT & COUGH 1

STATUSS GREEN (CODEINE) 2

SUDOGEST 12-HOUR 1

SUDOGEST CHILDRENS 1

SUDOGEST ORAL TABLET 60 MG 1

SUDOGEST PE 1

SUPHEDRIN 12 HOUR 1

SUPHEDRIN ORAL TABLET 1

SUPHEDRINE 1

SUPHEDRINE 12 HOUR 1

TAB TUSSIN 1

TAB TUSSIN DM 1

TESSALON PERLES 2

83

Drug Name Tier NotesTHERAFLU COLD-COUGH 2

THERAFLU COLD-SORE THROAT (PE) 2

THERAFLU FLU-SORE THROAT 2

THERAFLU MAX-D SEVERE COLD-FLU 2

THERAFLU MULTI-SYMPTOM COLD 2

THERAFLU NIGHT SEVERE COLD-CGH 2

THERAFLU NIGHTTIME SEVERE COLD 2

THERAFLU SINUS & COLD 2

THERAFLU WARMING RELIEF 2

TRIACTING COUGH & COLD 1

TRIAMINIC 2

TRIAMINIC CHEST &NASAL CONGEST 2

TRIAMINIC COLD & COUGH (PE) ORAL LIQUID 1

TRIAMINIC COLD & COUGH (PE) ORAL STRIP 2

TRIAMINIC COLD-STUFFY NOSE 2

TRIAMINIC COUGH 1

TRIAMINIC COUGH-SORE THROAT 2

TRIAMINIC FLU-COUGH-FEVER 2

TRIAMINIC SOFTCHEWS 2

TUSNEL C 2

TUSNEL NEW FORMULA ORAL TABLET 2

TUSNEL PEDIATRIC 2

TUSNEL-DM PEDIATRIC 2

TUSSICAPS 2

TUSSIGON 2

TUSSIN 1

TUSSIN CF COUGH-COLD 1

TUSSIN CF MAX 1

TUSSIN CF ORAL LIQUID 1

TUSSIN CHEST CONGESTION 1

TUSSIN COUGH (DM ONLY) ORAL LIQUID 1

TUSSIN DM CLEAR 1

TUSSIN DM COUGH & CHEST ORAL SYRUP 1

TUSSIN DM MAX ORAL LIQUID 10-200 MG/5 ML 1

TUSSIN DM ORAL LIQUID 1

TUSSIN DM ORAL SYRUP 10-100 MG/5 ML 1

TUSSIN DM ORAL TABLET 1

TUSSIN EXPECTORANT 1

TUSSIONEX PENNKINETIC ER 2

VANACOF 2

VANACOF DM 2

VANACOF-8 2

VICKS CHILDREN'S NYQUIL COLD 2

VICKS DAYQUIL COLD&FLU RELIEF 1

84

Drug Name Tier NotesVICKS DAYQUIL COUGH 1

VICKS DAYQUIL MUCUS CONTROL DM 2

VICKS DAYQUIL SEVERE COLD-FLU 1

VICKS NYQUIL COLD/FLU (CPM) 2

VICKS NYQUIL COLD/FLU LIQUICAP 1

VICKS NYQUIL COUGH 2

VICKS NYQUIL NIGHTTIME RELIEF 2

VICKS NYQUIL SEVERE COLD-FLU ORAL LIQUID 1

VICKS NYQUIL SEVERE COLD-FLU ORAL TABLET 2

VICKS QLEARQUIL DAYTIME SINUS 2

VICKS QLEARQUIL NIGHTIME SINUS 2

VICKS VAPODROPS 2

VICKS VAPOSTEAM 2

VIRTUSSIN AC 1

VIRTUSSIN DAC 1

VITUZ 2

ZONATUSS 2

Z-TUSS AC 2

Z-TUSS E 2

ZUTRIPRO 2

DIAGNOSTICABLAVAR 2

ACETEST 2

ADENOSCAN 2

adenosine (diagnostic) 1

AK-FLUOR 2

ALBUSTIX REAGENT 2

aminohippurate sodium 2

AZO TEST STRIPS 2

CARDIOLITE 2

CHEMSTRIP 2 2

CHEMSTRIP K 2

CHEMSTRIP MICRAL 2

CHEMSTRIP UGK 2

CLINISTIX 2

CLINITEST REAGENT 2

CYSVIEW 2

DEFINITY 2

DIASCREEN 10 2

DIASCREEN 1G REAGENT 2

DIASCREEN 1K REAGENT 2

DIASCREEN 2GK REAGENT 2

DIASCREEN 3 REAGENT 2

DIASCREEN 4OBL REAGENT 2

85

Drug Name Tier NotesDIASCREEN 5 REAGENT 2





DIASTIX 2

dipyridamole intravenous 1

EOVIST 2

FUL-GLO 2

GADAVIST 2

GLUCAGEN DIAGNOSTIC KIT 2

glucagon hcl 2

IC GREEN 2

INDIGO CARMINE 1

isosulfan blue 1

KETO-DIASTIX 2

KETONE CARE 2

KETONE URINE TEST 2

KETOSTIX 2

LEXISCAN 2

MAGNEVIST 2

MICRO-BUMINTEST 2

NITRATEST PAPER 2

NITRATEST PAPER WITH DISPENSER 2

NO-STICK GLUCOSE 2

OMNIPAQUE 140 2

OMNIPAQUE 180 2

OMNIPAQUE 240 2

OMNIPAQUE 300 INTRAVENOUS 2

OMNIPAQUE 350 2

OMNISCAN 2

OMNISCAN PREFILL PLUS 2

OPTISON 2

PRO DNA COLLECTION 2

PROSTASCINT 2

REVEAL COLON DISEASE TEST 2

REVEAL UTI TEST STRIP 2

R-GENE 10 2

ULTRAVIST 2

URINARY TRACT INF.TEST (WBCS) 2

VISIPAQUE INTRAVENOUS 2

DIURETICSacetazolamide 1

acetazolamide sodium 1

86

Drug Name Tier NotesALDACTAZIDE 2

ALDACTONE 2

amiloride oral 1

amiloride-hydrochlorothiazide 1

ammonium chloride 1

bumetanide 1

chlorothiazide 1

chlorothiazide sodium 1

chlorthalidone oral tablet 25 mg, 50 mg 1

DEMADEX 2

DIAMOX SEQUELS 2

DIURIL 2

DYAZIDE 2

EDECRIN 2

eplerenone 1

ethacrynate sodium 1

furosemide injection 1

furosemide oral solution 10 mg/ml, 40 mg/5 ml 1

furosemide oral tablet 1

hydrochlorothiazide 1

indapamide 1

INSPRA 2

LASIX 2

mannitol 10 % 1

mannitol 20 % 1

mannitol 25 % intravenous solution 1

mannitol 5 % 1

MAXZIDE 2

MAXZIDE-25MG 2

methazolamide oral 1

methyclothiazide 1

metolazone 1

MICROZIDE 2

NEPTAZANE 2

OSMITROL 10 % 2

OSMITROL 15 % 2

OSMITROL 20 % 2

OSMITROL 5 % 2

RESECTISOL 2

SAMSCA ORAL TABLET 15 MG 2 QL (30 EA per 365 days)

SAMSCA ORAL TABLET 30 MG 2 QL (60 EA per 365 days)

SODIUM EDECRIN 2

spironolactone 1

spironolacton-hydrochlorothiaz 1

87

Drug Name Tier NotesTHALITONE 2

torsemide 1

triamterene-hydrochlorothiazid 1

VAPRISOL 2

ZAROXOLYN ORAL TABLET 5 MG 2

EENT PREPS12 HOUR NASAL SPRAY 1

4 WAY 1

ACETASOL HC 1

acetic acid otic 1

acetic acid-aluminum acetate 1

ACULAR 2

ACULAR LS 2

ACUVAIL (PF) 2

ADVANCED FORMULA EYE DROPS 1

AKORN BALANCED SALT 2

AKTEN (PF) 2

AKWA TEARS 1

AKWA TEARS (POLYVINYL ALCOHOL) 1

ALCAINE 1

ALOCRIL 2

ALOMIDE 2

ALPHAGAN P 2

ALREX 2

ANEFRIN NASAL SPRAY,NON-AEROSOL 1

antipyrine-benzocaine otic drops 5.4-1.4 % 1

ANTISEPTIC MOUTH RINSE 1

apraclonidine 1

ARTIFICIAL TEARS (PETRO/MIN) 1

ARTIFICIAL TEARS (POLYVIN ALC) 1

ARTIFICIAL TEARS OPHTHALMIC DROPS 0.5-0.6 % 1

ASTELIN 2 QL (60 ML per 30 days)

ASTEPRO NASAL SPRAY,NON-AEROSOL 2 ST; QL (60 ML per 30 days)

atropine ophthalmic 1

ATROVENT 2

AURAX 1

AURODEX 1

AUROGUARD 1

azelastine nasal 1 QL (60 ML per 30 days)

AZOPT 2

BALANCED SALT 1

BECONASE AQ 2 ST; QL (25 GM per 30 days)

BENZEDREX 2

BETADINE OPHTHALMIC PREP 2

88

Drug Name Tier NotesBETAGAN OPHTHALMIC DROPS 0.5 % 2

betaxolol ophthalmic 1

BETIMOL 2

BETOPTIC S 2

bimatoprost 1 QL (1 ML per 12 days)

BION TEARS (PF) 1

brimonidine 1

bromfenac 1

BSS 2

BSS PLUS 2

carteolol 1

CLEANSING EYELID 2

COMBIGAN 2

COSOPT 2

COSOPT (PF) 2 ST; QL (2 EA per 1 day)

cromolyn ophthalmic 1

CYCLOGYL 2

CYCLOMYDRIL 2

cyclopentolate 1

CYSTARAN 2 PA

DERMOTIC OIL 2

dexamethasone sodium phosphate ophthalmic 1

diclofenac sodium ophthalmic 1

dorzolamide 1

dorzolamide-timolol 1

DRY EYES 1

DUREZOL 2

DYMISTA 2 ST; QL (23 GM per 30 days)

EAR DROPS (CARBAMIDE PEROXIDE) 1

EAR WAX REMOVAL DROPS 1

EAR WAX REMOVAL KIT 1

EAR WAX REMOVAL SYSTEM OTIC DROPS 1

EAR WAX TREATMENT 1

ENTSOL NASAL SPRAY 2

EYE DROPS (TETRAHYDROZOLINE) 1

EYE DROPS ADVANCED RELIEF 1

EYE DROPS ALLERGY RELIEF 1

EYE IRRIGATING SOLUTION 1

EYE STREAM 1

EYE WASH OPHTHALMIC IRRIGATION SOLUTION 1

EYELID WIPES 2

EYLEA 2

FLAREX 2

FLONASE 2 QL (16 GM per 30 days)

89

Drug Name Tier NotesFLONASE ALLERGY RELIEF 2 QL (16 ML per 30 days)

flunisolide nasal spray,non-aerosol 25 mcg (0.025 %) 1 QL (25 ML per 30 days)

fluocinolone acetonide oil 1

fluorescein-benoxinate 2

fluorometholone 1

flurbiprofen sodium 1

FLURESS 2

fluticasone nasal 1 QL (16 GM per 30 days)

FML FORTE 2

FML LIQUIFILM 2

FML S.O.P. 2

FRESHKOTE 2

GENTEAL MILD TO MODERATE 2

GENTEAL GEL 2

GENTEAL MILD 2

GENTEAL PM 2

GENTEAL SEVERE 2

GONAK 1

hydrocortisone-acetic acid 1

HYPOTEARS 1

ILEVRO 2

ILUVIEN 2

IOPIDINE 2

ipratropium bromide nasal 1

ISOPTO CARPINE 2

ISOPTO TEARS 1

ISTALOL 2

JETREA (PF) 2

ketorolac ophthalmic 1

LACRISERT 2

latanoprost 1

levobunolol ophthalmic drops 0.5 % 1

LIQUITEARS 1

LOTEMAX 2

LUBRICANT EYE (CMC-GLYCERIN) 1

LUBRICANT EYE (PG-PEG 400) 1

LUBRICANT EYE DROPS OPHTHALMIC DROPS 1

LUBRICANT EYE OPHTHALMIC OINTMENT 57.3-42.5 %

1

LUBRICATING PLUS 1

LUBRIFRESH PM 1

LUCENTIS 2

LUMIGAN 2 QL (1 ML per 12 days)

MACUGEN 2

90

Drug Name Tier NotesMAXIDEX 2

metipranolol 1

MIOCHOL-E 2

MIOSTAT 2

MOUTH RINSE 1

MUCINEX FULL FORCE 2

MUCINEX MOISTURE SMART 2

MUCINEX SINUS-MAX 1

MURO 128 1

MYDRIACYL 2

naphazoline 1

NAPHCON-A 2

NASACORT AQ 2 QL (11 GM per 20 days)

NASAL ALLERGY 1

NASAL DECONGESTANT (OXYMETAZL) 1

NASAL FOUR 1

NASAL SPRAY (OXYMETAZOLINE) 1

NASAL SPRAY 12 HOUR 1

NASAL SPRAY EXTRA MOISTURIZING 1

NASAL SPRAY LONG ACTING 1

NASAL SPRAY SINUS 1

NASAL SPRAY X-MOIST 1

NASONEX 2 QL (17 GM per 30 days)

NATURAL BALANCE 1

NATURE'S TEARS 1

NEVANAC 2

NO DRIP 1

NOSE DROPS 1

NOSE DROPS EXTRA STRENGTH 1

NRS NASAL RELIEF 1

OCUFEN 2

olopatadine 1 ST; QL (30.5 GM per 30 days)

OMIDRIA 2

OMNARIS 2 ST; QL (5 GM per 12 days)

OMNIPRED 2

OPTI-CLEAR 1

ORIGINAL NASAL SPRAY 1

OTIC CARE (ANTIPYRINE) 2

OTOZIN 2

OZURDEX 2

PAREMYD 2

PATANASE 2 ST; QL (30.5 GM per 30 days)

phenylephrine hcl ophthalmic 1

PHOSPHOLINE IODIDE 2

91

Drug Name Tier Notespilocarpine hcl ophthalmic drops 1 %, 2 %, 4 % 1

PINNACAINE 1

PRAMOXINE-HC 1

PRED FORTE 2

PRED MILD 2

prednisolone acetate 1

prednisolone sodium phosphate ophthalmic 1

PROLENSA 2

proparacaine 1

PURALUBE 1

QNASL NASAL HFA AEROSOL INHALER 40 MCG/ACTUATION


QNASL NASAL HFA AEROSOL INHALER 80 MCG/ACTUATION


REDNESS RELIEF OPHTHALMIC DROPS 0.012-0.2 % 1

REFRESH CELLUVISC 2

REFRESH CLASSIC (PF) 2

REFRESH LACRI-LUBE 2

REFRESH LIQUIGEL 2

REFRESH OPTIVE ADVANCED 2

REFRESH OPTIVE ADVANCED (PF) 2

REFRESH OPTIVE OPHTHALMIC DROPS 2

REFRESH OPTIVE SENSITIVE (PF) 2

REFRESH P.M. 2

REFRESH PLUS 2

REFRESH TEARS 2

RESTASIS 2 QL (64 EA per 30 days)

RETISERT 2

RHINOCORT AQUA 2 ST; QL (43 GM per 75 days)

SIMBRINZA 2

SINEX ULTRA FINE MIST 12-HOUR 1

SINUS NASAL SPRAY 1

SINUS RELIEF (OXYMETAZOLINE) NASAL MIST 1

SINUS WASH NASAL PACKET 700-2,300 MG 1

sodium chloride ophthalmic 1

STERILE EYE DROPS OPHTHALMIC DROPS 0.05 % 1

STERILUBE 1

SWIM EAR 2

SYSTANE 2

SYSTANE (PF) 2

SYSTANE BALANCE 2

SYSTANE GEL 2

SYSTANE NIGHTTIME 1

SYSTANE ULTRA 2

92

Drug Name Tier NotesSYSTANE ULTRA (PF) 2

TEARS NATURALE FORTE 2

TEARS NATURALE FREE (PF) 1

TEARS NATURALE II 2

TEARS PURE 1

tetracaine hcl 1

tetracaine hcl (pf) ophthalmic 1

tetrahydrozoline ophthalmic 1

timolol maleate ophthalmic 1

TIMOPTIC 2

TIMOPTIC OCUDOSE (PF) 2 ST; QL (2 EA per 1 day)

TIMOPTIC-XE 2

TRAVATAN Z 2 QL (1 ML per 12 days)

travoprost (benzalkonium) 1 QL (1 ML per 12 days)

triamcinolone acetonide nasal 1 QL (11 GM per 20 days)

TRIAMINIC (XYLOMETAZOLINE) 2

TRIESENCE (PF) 2

tropicamide ophthalmic 1

TRUSOPT 2

TYZINE NASAL DROPS 0.05 % 2

ULTRA LUBRICANT EYE 1

VERAMYST 2 ST; QL (10 GM per 30 days)

VEXOL 2

VICKS QLEARQUIL(OXYMETAZOLINE) 1

VICKS SINEX 12-HOUR 1

VOLTAREN OPHTHALMIC 2

VOSOL 2

VOSOL-HC 2

XALATAN 2

ZETONNA 2 ST; QL (6.1 GM per 30 days)

ZIOPTAN (PF) 2 ST; QL (1 EA per 1 day)

ELECT/CALORIC/H2OACTIVE FE 2

ADDAMEL N 1

AMINO ACIDS 15 % 2

AMINOSYN 10 % 2

AMINOSYN 7 % WITH ELECTROLYTES 2

AMINOSYN 8.5 % 2

AMINOSYN 8.5 %-ELECTROLYTES 2

AMINOSYN II 10 % 2

AMINOSYN II 15 % 2

AMINOSYN II 7 % 2

AMINOSYN II 8.5 % 2

AMINOSYN II 8.5 %-ELECTROLYTES 2

93

Drug Name Tier NotesAMINOSYN M 3.5 % 2

AMINOSYN-HBC 7% 2

AMINOSYN-PF 10 % 2

AMINOSYN-PF 7 % (SULFITE-FREE) 2

AMINOSYN-RF 5.2 % 2

ammonium molybdate 1

ANTICAVITY FLUORIDE RINSE 1

AURYXIA 2 QL (12 EA per 1 day)

BIFERA RX 2

BIOTENE 2

CALCARB 600 WITH VITAMIN D ORAL TABLET 600 MG(1,500MG) -400 UNIT

1

CALCIUM 600 WITH VITAMIN D3 ORAL CAPSULE 600 MG(1,500MG) -400 UNIT

1

calcium acetate oral capsule 1

calcium acetate oral tablet 667 mg 1

calcium carbonate oral suspension 1

calcium carbonate oral tablet 500 mg calcium (1,250 mg) 1

calcium carbonate-vitamin d3 oral tablet 500 mg(1,250mg) -200 unit, 600 mg(1,500mg) -800 unit

1

calcium chloride intravenous 1

calcium gluconate in 0.9% nacl intravenous solution 1 gram/100 ml

1

calcium gluconate intravenous 1

calcium gluconate oral tablet 45 mg (500 mg) 1

CALCIUM MAGNESIUM 1

CALCIUM-FOLIC ACID-VITAMIN D 1

CALPHRON 1

CENTRATEX 2

chromium chloride 1

CLINIMIX 5%/D15W SULFITE FREE 2

CLINIMIX 5%/D25W SULFITE-FREE 2

CLINIMIX 2.75%/D5W SULFIT FREE 2

CLINIMIX 4.25%/D10W SULF FREE 2

CLINIMIX 4.25%/D5W SULFIT FREE 2

CLINIMIX 4.25%-D20W SULF-FREE 2

CLINIMIX 4.25%-D25W SULF-FREE 2

CLINIMIX 5%-D20W(SULFITE-FREE) 2

CLINIMIX E 2.75%/D10W SUL FREE 2

CLINIMIX E 2.75%/D5W SULF FREE 2



CLINIMIX E 4.25%/D5W SULF FREE 2

CLINIMIX E 5%/D15W SULFIT FREE 2

CLINIMIX E 5%/D20W SULFIT FREE 2

94

Drug Name Tier NotesCLINIMIX E 5%/D25W SULFIT FREE 2

CLINISOL SF 15 % 2

COPPER CHLORIDE 1

CORVITA 150 1

CORVITE 150 ORAL TABLET 150 MG IRON- 1 MG 2

CORVITE FE ORAL TABLET 150 MG IRON- 1 MG 2

cupric sulfate 1

cysteine (l-cysteine) intravenous solution 1

CYTRA K CRYSTALS 1

d10 % & 0.45 % sodium chloride 1

d2.5 %-0.45 % sodium chloride 1

d5 % and 0.9 % sodium chloride 1

d5 %-0.45 % sodium chloride 1

DELFLEX WITH 2.5 % DEXTROSE 2

DELFLEX-LC/1.5% DEXTROSE 2



DELFLEX-SM WITH 1.5% DEXTROSE 2

DENTA 5000 PLUS 1

DENTAGEL 1

DEX4 GLUCOSE ORAL TABLET,CHEWABLE 1

DEXFERRUM 1

dextrose 10 % and 0.2 % nacl 1

dextrose 10 % in water (d10w) 1






dextrose 5 %-lactated ringers 1

dextrose 5%-0.2 % sod chloride 1

dextrose 5%-0.3 % sod.chloride 1



dextrose oral gel in packet 1

dextrose oral liquid 15 gram/59 ml 1

DIABETISWEET 2

DIANEAL PD-2 WITH 2.5 % DEX 2

DIANEAL PD-2 WITH 4.25 % DEX 2

DIANEAL PD-2/1.5% DEXTROSE 2

DIANEAL WITH 1.5% DEXTROSE 2

DIANEAL WITH 4.25 % DEXTROSE 2

EFFER-K ORAL TABLET, EFFERVESCENT 10 MEQ, 20 MEQ

2

95

Drug Name Tier NotesEFFER-K ORAL TABLET, EFFERVESCENT 25 MEQ 1

electrolyte-48 in d5w 1

ELIPHOS 1

EXTRANEAL 7.5 % 2

FE C 1

FE C PLUS 1

FERAHEME 2

FERIVA 2

FERIVA 21-7 TABLET 2

FERIVA FA (SUMALATE) 2

FERIVA FA (WITH QUATREFOLIC) 2

FERRALET 90 DUAL-IRON DELIVERY 2

FERRAPLUS 90 1

FERRETTS 1

FERRLECIT 2

ferrous gluconate oral tablet 256 mg (28 mg iron), 324 mg (38 mg iron)

1

ferrous sulfate oral tablet 325 mg (65 mg iron) 1

ferrous sulfate oral tablet,delayed release (dr/ec) 324 mg (65 mg iron)

1

FLUOR-A-DAY 2

FLUOR-A-DAY (WITH XYLITOL) 2

fluoride toothpaste 2

FOCALGIN DSS 1

FOLIVANE-F 1

FOSRENOL 2

FOSTEUM 2

FREAMINE HBC 6.9 % 2

FREAMINE III 10 % 2

FUSION PLUS 2

FUSION SPRINKLES 2

GLUCAGEN 2

GLUCAGEN HYPOKIT 2

GLUCAGON EMERGENCY KIT (HUMAN) 2

glucose oral tablet,chewable 4 gram 1

GLUCOSE POWDER 1

GLYCOPHOS 1

GLYTACTIN 20PE BETTERMILK LITE 2

HEMATOGEN 1

HEMATOGEN FA 1

HEMATOGEN FORTE 1

HEMETAB 1

HEMOCYTE 1

HEMOCYTE-F 2

96

Drug Name Tier NotesHEMOCYTE-PLUS 2

HEPATAMINE 8% 2

HYPERLYTE CR 2

IFEREX 150 1

IFEREX 150 FORTE 1

INFED 2

INJECTAFER 2

INSTA-GLUCOSE 1

INTEGRA 2

INTEGRA F 2

INTEGRA PLUS 2

IODOPEN 1

IONOSOL-B IN D5W 2

IONOSOL-MB IN D5W 2

iron aspgly&ps-c-b12-fa-ca-suc 1

iron aspgly-c-b12-ca-suc-stoma 1

iron fum & ag-c-b12-fa-ca-succ 1

IROSPAN 24/6 2

ISOLYTE S PH 7.4 2

ISOLYTE-P IN 5 % DEXTROSE 2

ISOLYTE-S 2

KABIVEN 2

KAYEXALATE 2

K-EFFERVESCENT 1

KIONEX 1

KLOR-CON 2

KLOR-CON 10 2

KLOR-CON 8 2

KLOR-CON M10 1

KLOR-CON M15 1

KLOR-CON M20 1

KLOR-CON SPRINKLE 1

KLOR-CON/25 2

KLOR-CON/EF 2

K-PHOS NO 2 2

K-PHOS ORIGINAL 2

K-PHOS-NEUTRAL 2

K-SOL 2

K-TAB 2

lactated ringers intravenous 2

LUDENT FLUORIDE 2

MAGNEBIND 300 2

MAGNEBIND 400 1

magnesium chloride injection 1

97

Drug Name Tier Notesmagnesium oxide oral tablet 400 mg, 420 mg 1

magnesium sulfate in d5w intravenous piggyback 1 gram/100 ml

1

magnesium sulfate in water 1

magnesium sulfate injection 1

manganese chloride 1

MAXARON FORTE 1

MAXFE 2

MICRO-K 2

MULTITRACE-4 1

MULTITRACE-4 CONCENTRATE 1

MULTITRACE-4 NEONATAL 1

MULTITRACE-4 PEDIATRIC 1

MULTITRACE-5 1

MULTITRACE-5 CONCENTRATE 1

NEPHRAMINE 5.4 % 2

NEPHRON FA 1

NEUT 2

NIRON KOMPLETE 2

NORMOSOL-M IN 5 % DEXTROSE 2

NORMOSOL-R 2

NORMOSOL-R IN 5 % DEXTROSE 2

NORMOSOL-R PH 7.4 2

NULECIT 1

NUTRESTORE 2

NUTRILYTE 2

NUTRILYTE II 2

NUTRITIONAL SHAKE 1

NUTRITIONAL SHAKE PLUS ORAL LIQUID 0.05-1.5 GRAM-KCAL/ML

1

ORACIT 2

OYSTERCAL-D 1

PEDIATRIC ELECTROLYTE ORAL SOLUTION 1

PEDITRACE 1

PERIKABIVEN 2

PHENACTIN AA PLUS 20 PE 2

PHOSLO 2

PHOSLYRA 2

PHOSPHA 250 NEUTRAL 1

PLASMA-LYTE 148 2

PLASMA-LYTE A 2

PLASMA-LYTE-56 IN 5 % DEXTROSE 2

POLYSACCHARIDE IRON 1

pot & sod citrate-citric acid 1

98

Drug Name Tier Notespotassium acetate intravenous 1

potassium bicarb and chloride 1

potassium bicarb-citric acid 1

potassium chlorid-d5-0.45%nacl 1

potassium chloride 1

potassium chloride in 0.9%nacl intravenous parenteral solution 20 meq/l, 40 meq/l

1

potassium chloride in 5 % dex intravenous parenteral solution 20 meq/l, 30 meq/l, 40 meq/l

1

potassium chloride in lr-d5 1

potassium chloride-0.45 % nacl 1

potassium chloride-d5-0.2%nacl intravenous parenteral solution 20 meq/l, 30 meq/l, 40 meq/l

1

potassium chloride-d5-0.3%nacl intravenous parenteral solution 20 meq/l

1

potassium chloride-d5-0.9%nacl 1

potassium citrate 1

potassium citrate-citric acid 1

potassium gluconate oral tablet 595 mg (99 mg) 1

potassium phosphate m-/d-basic 1

PREMASOL 10 % 2

PREMASOL 6 % 2

PROCALAMINE 3% 2

PROGLYCEM 2

PROSOL 20 % 2

PUREVIT DUALFE PLUS 2

RENACIDIN 2

RENAGEL 2

RENVELA 2

ringers intravenous 1

saccharin 2

saccharin sodium 2

selenium intravenous 1

SE-TAN PLUS 1

sevelamer carbonate 1

SF 1

SF 5000 PLUS 1

SLOW RELEASE IRON ORAL TABLET EXTENDED RELEASE 160 MG (50 MG IRON)

1

sodium acetate intravenous 1

sodium bicarbonate intravenous 1

sodium chloride 0.45 % intravenous 1

sodium chloride 0.9 % injection solution 1

sodium chloride 0.9 % injection syringe 1

sodium chloride 0.9 % intravenous 1

99

Drug Name Tier Notessodium chloride 3 % 1

sodium chloride 5 % 1

sodium chloride intravenous 1

sodium citrate-citric acid 1

sodium ferric gluconat-sucrose 1

sodium fluoride oral drops 3

sodium fluoride oral tablet,chewable 3

sodium lactate intravenous 1

sodium phosphate 1

SODIUM POLYSTYRENE (SORB FREE) 1

sodium polystyrene sulfonate 1

sorbitol powder 2

SPS ORAL 1

SPS RECTAL 2

SSKI 1

stannous fluoride 1

sucrose crystals 2

TANDEM DUAL ACTION 2

TANDEM PLUS 2

TARON FORTE 1

THAM 2

TL G-FOL OS 1

TL ICON 1

TL-FOL 500 1

TL-HEM 150 1

TPN ELECTROLYTES 2

TRACE ELEMENTS 4/PEDIATRIC 1

TRAVASOL 10 % 2

TRICITRATES 1

TRICON 1

TRIGELS-F FORTE 1

TROPHAMINE 10 % 2

TROPHAMINE 6% 2

ULTRABAG/DIANEAL PD-2/1.5% DEX 2

ULTRABAG/DIANEAL PD-2/2.5% DEX 2

ULTRABAG/DIANEAL PD-2/4.25%DEX 2

ULTRABAG/DIANEAL/2.5% DEXTROSE 2

UROCIT-K 10 2

UROCIT-K 15 2

UROCIT-K 5 2

VELPHORO 2

VENOFER 2

VILACTIN AA PLUS 20 PE 2

VIRT-PHOS 250 NEUTRAL 1

100

Drug Name Tier NotesVIRTRATE-2 1

VIRTRATE-3 1

VIRTRATE-K 1

VITAFOL 1

VP-GSTN 1

WEE CARE 1

WHEY PROTEIN CONCENTRATE 2

zinc chloride 1

zinc sulfate intravenous 1

zinc sulfate oral capsule 1

GASTROINTESTINALABATINEX 2

ACID CONTROL (RANITIDINE) 1

ACID CONTROLLER 1

ACID GONE ANTACID 1

ACID GONE ANTACID E.STRENGTH 1

ACID REDUCER (CIMETIDINE) 1

ACID REDUCER (FAMOTIDINE) 1

ACID REDUCER (RANITIDINE) 1

ACIPHEX SPRINKLE 2 ST; QL (1 EA per 1 day)

ACTIGALL 2

ADVANCED ANTACID-ANTIGAS 1

AKYNZEO 2 QL (1 EA per 28 days)

ALMACONE MLT 1

ALMACONE ORAL SUSPENSION 1

ALMACONE ORAL TABLET,CHEWABLE 2

ALMACONE-2 1

alosetron 1

ALOXI 2

aluminum hydroxide gel oral suspension 320 mg/5 ml 1

AMITIZA 2 QL (2 EA per 1 day)

AMMONUL 2

amoxicil-clarithromy-lansopraz 1 QL (112 EA per 10 days)

ANA-LEX 2

ANA-LEX KIT 2

ANALPRAM E 2

ANALPRAM-HC RECTAL CREAM 2

ANALPRAM-HC SINGLES RECTAL CREAM 2.5-1 % (4G)

2

ANASPAZ 2

ANTACID 1

ANTACID ANTI-GAS DOUBLE STR 1

ANTACID ANTI-GAS ORAL SUSPENSION 1

101

Drug Name Tier NotesANTACID CALCIUM ORAL TABLET,CHEWABLE 215 MG CALCIUM (500 MG)

1

ANTACID EXST (CA CARB-MAG HYD) 1

ANTACID EXST (MAG CARB-AL HYD) 1

ANTACID EXT STR (CALCIUM CARB) 1

ANTACID EXTRA-STRENGTH ORAL SUSPENSION 200-200-20 MG/5 ML

1

ANTACID EXTRA-STRENGTH ORAL TABLET,CHEWABLE 200 MG CALCIUM (500 MG), 300 MG (750 MG)

1

ANTACID MAXIMUM STRENGTH ORAL SUSPENSION

1

ANTACID PLUS ANTI-GAS 1

ANTACID ULTRA STRENGTH ORAL TABLET,CHEWABLE 1,177 MG

1

ANTACID-ANTIGAS 1

ANTACID-SIMETHICONE 1

ANTI-DIARRHEA 1

ANTI-DIARRHEAL (LOPERAMIDE) 1

ANTI-NAUSEA 1

ANTIVERT 2

ANUCORT-HC 1

ANU-MED 1

ANUSOL-HC 2

ANZEMET INTRAVENOUS 2

ANZEMET ORAL TABLET 100 MG 2 ST; QL (4 EA per 1 FILL)

ANZEMET ORAL TABLET 50 MG 2 ST; QL (8 EA per 1 FILL)

APRISO 2

ASACOL 2

ASACOL HD 2

atropine in 0.9 % sod chloride intravenous syringe 0.8 mg/2 ml (0.4 mg/ml)

1

atropine injection 1

atropine injection syringe 0.05 mg/ml, 0.1 mg/ml 1

AZULFIDINE 2

AZULFIDINE EN-TABS 2

balsalazide 1

BENEFIBER SUGAR FREE (DEXTRIN) ORAL POWDER 3 GRAM/4 GRAM

2

BENTYL INTRAMUSCULAR 2

BENTYL ORAL CAPSULE 2

BENTYL ORAL TABLET 2

BISAC-EVAC 1

bisacodyl oral 1

bisacodyl rectal 1

BISCOLAX 1

102

Drug Name Tier NotesBISMATROL 1

BISMUTH MAXIMUM STRENGTH 1

BISMUTH ORAL SUSPENSION 1

BUPHENYL 2

CALCIUM ANTACID 1

CALCIUM ANTACID ULTRA MAX ST 1

calcium carbonate oral tablet 260 mg calcium (648 mg) 1

CAL-GEST ANTACID 1

CANASA 2

CANTIL 2

CARAFATE 2

castor oil oral oil , 100 % 1

CESAMET 2 ST; QL (6 EA per 1 day)

CHENODAL 2

CHILDREN'S PEPTO 1

chlordiazepoxide-clidinium 1

CHOLBAM 2 PA

cimetidine 1

cimetidine hcl oral 1

CIMZIA 2 PA

CIMZIA POWDER FOR RECONST 2 PA

CIMZIA STARTER KIT 2 PA

CITRUCEL 2

CITRUCEL SUGAR FREE 2

CLEARLAX ORAL POWDER 1

COLACE 1

COLACE CLEAR 2

COLAZAL 2

COLYTE WITH FLAVOR PACKS 2

COMPLETE ORAL TABLET,CHEWABLE 1

COMPRO 1

CONSTULOSE 1

CREON 2

CUVPOSA 2

CYCLIVERT 2

CYTOTEC 2

DELZICOL 2

DEWEE'S CARMINATIVE 2

DEXILANT ORAL CAPSULE,BIPHASE DELAYED RELEAS 30 MG


DICLEGIS 2 QL (4 EA per 1 day)

dicyclomine oral capsule 1

dicyclomine oral solution 1

dicyclomine oral tablet 1

103

Drug Name Tier Notesdimenhydrinate injection solution 1

dimenhydrinate oral 1

DIOCTO 1

DIPENTUM 2

diphenoxylate-atropine 1

DISPOSABLE ENEMA 1

DOC-Q-LACE 1

DOC-Q-LAX 1

DOCU 1

docusate calcium 1

docusate sodium oral capsule 1

docusate sodium oral liquid 1

docusate sodium oral tablet 1

DOCUSIL 1

DOCUSOL 1

DOCUSOL KIDS 2

DOCUSOL PLUS 2

DOK 1

DOK PLUS 1

DONNATAL ORAL ELIXIR 16.2-0.1037 -0.0194 MG/5 ML

2

DONNATAL ORAL TABLET 2

DRIMINATE 1

DUCODYL 1

DULCOLAX (BISACODYL) ORAL 2

ED-SPAZ 1

EMEND INTRAVENOUS 2

EMEND ORAL CAPSULE 125 MG 2 QL (1 EA per 1 FILL)



EMEND ORAL CAPSULE,DOSE PACK 2 QL (3 EA per 1 FILL)

ENEMA DISPOSABLE 1

ENEMA RECTAL ENEMA 19-7 GRAM/118 ML 1

ENTEREG 2

ENTYVIO 2

ENULOSE 1

esomeprazole sodium 1

esomeprazole strontium oral capsule,delayed release(dr/ec) 24.65 mg


EX-LAX (SENNOSIDES) ORAL TABLET 1

EX-LAX MAXIMUM STRENGTH 2

EX-LAX MILK OF MAGNESIA 1

EX-LAX ULTRA 1

famotidine 1

104

Drug Name Tier Notesfamotidine (pf) 1

famotidine (pf)-nacl (iso-os) 1

FEMATROL LAXATIVE 1

FIBER (CALCIUM POLYCARBOPHIL) 1

FIBER (PSYLLIUM HUSK) 1

FIBER (PSYLLIUM HUSK/SUGAR) 1

FIBER (WITH ASPARTAME) 1

FIBER LAXATIVE (CA POLYCARBO) 1

FIBER LAXATIVE (METHYLCELLULO) 1

FIBER LAXATIVE (PSYLLIUM HUSK) 1

FIBER ORAL POWDER 1

FIBER SMOOTH 1

FIBER SMOOTH (SUCROSE) 1

FIBER THERAPY (PSYLLIUM SEED) 1

FIBER THERAPY ORAL POWDER 2 GRAM/19 GRAM 1

FIBER-LAX 1

FIBERTAB 1

FISH OIL ORAL CAPSULE 360-1,200 MG 1

FISH OIL ORAL CAPSULE,DELAYED RELEASE(DR/EC) 300-1,000 MG

1

FLEET BISACODYL 2

FLEET ENEMA 2

FLEET GLYCERIN (ADULT) 1

FLEET GLYCERIN (CHILD) 1

FLEET GLYCERIN LAXATIVE 2

FLEET LAXATIVE 1

FLEET MINERAL OIL 2

FLEET PEDIATRIC 2

FLORA-Q 2

FLORA-Q(2) 2

FORMULA EM 1

FULYZAQ 2 ST; QL (2 EA per 1 day)

GAS FREE EXTRA STRENGTH 1

GAS RELIEF 1

GAS RELIEF EXTRA STRENGTH ORAL CAPSULE 1

GAS RELIEF MAXIMUM STRENGTH 1

GAS RELIEF ULTRA STRENGTH 1

GAS-X EXTRA STRENGTH ORAL TABLET,CHEWABLE

2

GAS-X ORAL TABLET,CHEWABLE 2

GAS-X ULTRA-STRENGTH 1

GAS-X WITH MAALOX 2

GATTEX 30-VIAL 2 PA; QL (1 EA per 30 days)

GATTEX ONE-VIAL 2 PA; QL (30 EA per 30 days)

105

Drug Name Tier NotesGAVILAX ORAL POWDER 2

GAVILYTE-C 1

GAVILYTE-G 1

GAVILYTE-H AND BISACODYL 1

GAVILYTE-N 1

GAVISCON 2

GAVISCON EXTRA STRENGTH 2

GENERLAC 1

GENTLE LAXATIVE 1

GIAZO 2

glycerin (adult) 1

glycerin (child) 1

GLYCOLAX ORAL POWDER 1

glycopyrrolate injection 1

glycopyrrolate oral 1

GOLYTELY 2

granisetron (pf) 1

granisetron hcl intravenous 1

HEALTHYLAX 1

HEARTBURN RELIEF (CIMETIDINE) 1

HEARTBURN RELIEF (FAMOTIDINE) 1

HEARTBURN RELIEF (RANITIDINE) 1

HEARTBURN RELIEF 24 HOUR 1

HEARTBURN TREATMENT 24 HOUR 1

HEMMOREX-HC 2

HEMORRHOID RECTAL 1

HEMORRHOIDAL (PHENYLEPH-COCOA) RECTAL SUPPOSITORY 0.25-88.44 %

1

HEMORRHOIDAL COOLING 1

HEMORRHOIDAL CREAM 1

HEMORRHOIDAL RECTAL OINTMENT 1

HEMORRHOIDAL RECTAL SUPPOSITORY 0.25-3 % 1

HEMORRHOIDAL SUPPOSITORY 2

HEMRIL-30 1

hydrocortisone acetate rectal suppository 1

hydrocortisone-pramox-e-pram#1 1

hydrocortisone-pramoxine rectal 1

HYGIENIC (WITCH HAZEL) CLEANS 1

hyoscyamine sulfate oral drops 1

hyoscyamine sulfate oral elixir 1

hyoscyamine sulfate oral tablet 1

hyoscyamine sulfate oral tablet,disintegrating 1

hyoscyamine sulfate sublingual 1

HYOSYNE 1

106

Drug Name Tier NotesINFANTS GAS RELIEF 1

INTRALIPID INTRAVENOUS EMULSION 20 %, 30 % 2

KAO-TIN (BISMUTH SUBSALICYLAT) 1

KAO-TIN (DOCUSATE CALCIUM) 1

KEPIVANCE 2

KONSYL (SUGAR) 1

KONSYL EASY MIX 2

KONSYL FIBER 1

KONSYL FORMULA-D 2

KONSYL SUGAR-FREE (ASPARTAME) ORAL POWDER IN PACKET

2

KONSYL-D 2

KRISTALOSE 2

lactulose oral solution 10 gram/15 ml (15 ml), 20 gram/30 ml

1

lansoprazole oral capsule,delayed release(dr/ec) 1

LAXATIVE (BISACODYL) 1

LAXATIVE (SENNOSIDES) ORAL TABLET 25 MG 1

LAXATIVE FEMININE 1

LAXATIVE MAXIMUM STRENGTH 1

LAXATIVE PLUS STOOL SOFTENER 1

LEVSIN 2

LEVSIN/SL 2

LIALDA 2

LIBRAX (WITH CLIDINIUM) 2

lidocaine hcl-hydrocortison ac rectal 1

lidocaine-hydrocortisone-aloe 1

LINZESS 2 QL (1 EA per 1 day)

LIPOSYN II 2

LIPOSYN III INTRAVENOUS EMULSION 10 %, 20 % 2

LIQUID ANTACID ORAL SUSPENSION 200-200-20 MG/5 ML

1

LITHOSTAT 2

LOMOTIL 2

loperamide oral capsule 1

loperamide oral liquid 1

LOTRONEX 2

LOVAZA 2 QL (4 EA per 1 day)

MAALOX ADVANCED ORAL SUSPENSION 1

MAALOX ADVANCED ORAL TABLET,CHEWABLE 2

MAALOX MAX QUICK DISSOLVE 2

MAALOX RS 2

MAALOX TOTAL RELIEF (BISMUTH) 1

MAG-AL 2

MAG-AL PLUS 1

107

Drug Name Tier NotesMAG-AL PLUS EXTRA STRENGTH 1

magnesium citrate oral solution 1

MAJOR-PREP (PHENYLEPHRINE-FAT) 1

MAJOR-PREP HEMORRHOIDAL 1

MARINOL 2 ST; QL (2 EA per 1 day)

MASANTI DOUBLE STRENGTH 1

meclizine oral tablet 12.5 mg, 25 mg 1

meclizine oral tablet,chewable 1

MEDICATED PADS TOPICAL PADS, MEDICATED 50 %

1

ME-PB-HYOS 1

mesalamine rectal 1

mesalamine with cleansing wipe 1

METAMUCIL (WITH SUGAR) ORAL POWDER 3.4 GRAM/7 GRAM

2

METAMUCIL (WITH SUGAR) ORAL POWDER IN PACKET

2

METAMUCIL FIBER SINGLES 2

METAMUCIL MULTIHEALTH FIBER 2

METAMUCIL ORAL POWDER 2

METAMUCIL SUGAR FREE 2

METAMUCIL SUGAR-FREE (ASPART) ORAL POWDER 3.3 GRAM/5.95 GRAM

2

METAMUCIL SUNRISE 2

methscopolamine oral 1

metoclopramide hcl injection 1

metoclopramide hcl oral solution 1

metoclopramide hcl oral tablet 1

metoclopramide hcl oral tablet,disintegrating 5 mg 1

METOZOLV ODT 2

MI-ACID 1

MI-ACID GAS RELIEF 1

MILK OF MAGNESIA 1

MILK OF MAGNESIA CONCENTRATED 2

MINERAL OIL LAXATIVE 1

mineral oil rectal 1

MINTOX 1

MINTOX MAXIMUM STRENGTH 1

MINTOX PLUS 1

misoprostol 1

MOTION RELIEF (MECLIZINE) 1

MOTION SICKNESS 1

MOTION SICKNESS (MECLIZINE) 1

MOTION SICKNESS RELIEF 1

MOTION-TIME 1

108

Drug Name Tier NotesMOVIPREP 2

MYTAB GAS 1

MYTAB GAS MAXIMUM STRENGTH 1

NATURAL FIBER LAXATIVE 1

NATURAL FIBER LAXATIVE (SUGAR) ORAL POWDER 3.4 GRAM/12 GRAM, 3.4 GRAM/7 GRAM

1

NATURAL FIBER LAXATIVE THERAPY 1

NATURAL VEG LAXATIVE(SENNOSID) 1

NEXIUM IV 2

NEXIUM PACKET 2 ST; QL (1 EA per 1 day)

nizatidine 1

NULEV 2

NULYTELY WITH FLAVOR PACKS 2

NUTRILIPID 2

OMECLAMOX-PAK 2

omega-3 acid ethyl esters 1 QL (4 EA per 1 day)

omeprazole 1

omeprazole magnesium 1

ondansetron 1

ondansetron (pf) in dextrose 1

ondansetron hcl (pf) 1

ondansetron hcl intravenous 1

ondansetron hcl oral solution 1 QL (50 ML per 15 days)

ondansetron hcl oral tablet 1

opium tincture 1

OSCIMIN 1

OSCIMIN SL 1

OSCIMIN SR 1

OSMOPREP 2

PAMINE 2

PAMINE FORTE 2

PANCREAZE 2

PANCRELIPASE 5000 1

pantoprazole 1

paregoric 1

PEDIA-LAX 2

PEDIA-LAX STOOL SOFTENER 1

peg 3350-electrolytes 1

PEG3350 1

PEG-3350 WITH FLAVOR PACKS 1

peg-electrolyte soln 1

PENTASA 2

PEPCID 2

PEPCID COMPLETE 2

109

Drug Name Tier NotesPEPTIC RELIEF 1

PEPTO-BISMOL 2

PEPTO-BISMOL MAX ST 2

PEPTO-BISMOL TO-GO 2

PERDIEM OVERNIGHT RELIEF 1

PERI-COLACE 1

PERTZYE 2

PHAZYME 2

PHENADOZ 1

PHENERGAN RECTAL 2

phenobarb-hyoscy-atropine-scop oral tablet 1

PHOSPHATE LAXATIVE ORAL SOLUTION 1

PINK BISMUTH MAXIMUM STRENGTH 1

PINK BISMUTH ORAL SUSPENSION 1

PINK BISMUTH ORAL TABLET,CHEWABLE 1

polyethylene glycol 3350 oral 1

PRAMCORT 2

pramoxine topical 1

PREP-HEM (PHENYLEPHRINE) 2

PREPOPIK 2

PREVACID 2

PREVACID 24HR 2

PREVACID SOLUTAB 2 ST

PREVPAC 2 QL (112 EA per 10 days)

PRILOSEC 2

PRILOSEC OTC 2

prochlorperazine 1

prochlorperazine edisylate injection solution 10 mg/2 ml (5 mg/ml)

1

prochlorperazine maleate oral 1

PROCORT 2

PROCTOCORT 2

PROCTOCREAM-HC 2

PROCTOFOAM 2

PROCTOFOAM HC 2

PROCTO-PAK 1

PROCTOSOL HC 1

PROCTOZONE-HC 1

promethazine rectal 1

PROMETHEGAN 1

propantheline 1

PROTONIX INTRAVENOUS 2

PROTONIX ORAL TABLET,DELAYED RELEASE (DR/EC)

2

110

Drug Name Tier NotesPYLERA 2

QUADRAPAX 1

rabeprazole 1 QL (1 EA per 1 day)

ranitidine hcl 1

RAVICTI 2 PA

READY-TO-USE ENEMA 1

READY-TO-USE ENEMA (MIN OIL) 1

RECTIV 2

REGLAN ORAL 2

REGULOID 1

REGULOID, SUGAR FREE 1

REMICADE 2

RESTORA RX 2

RESTORA SPRINKLES 2

RI-MAG PLUS 1

ROBINUL 2

ROBINUL FORTE 2

ROWASA 2

RULOX 2

SANCUSO 2 ST; QL (1 EA per 7 days)

SANI-SUPP (ADULT) 1

SANI-SUPP (CHILD) 1

SANI-SUPP (INFANT) 1

scopolamine hbr 1

SE-DONNA PB HYOS 1

SENEXON 1

SENEXON-S 1

SENNA LAX 1

SENNA LAXATIVE ORAL TABLET 25 MG, 8.6 MG 1

SENNA ORAL SYRUP 8.8 MG/5 ML 1

SENNA ORAL TABLET 1

SENNA PLUS 1

SENNA PROMPT 2

SENNA SOFT 2

SENNA WITH DOCUSATE SODIUM 1

SENNA-GEN 1

SENNALAX-S 1

SENNA-S 1

SENNA-TIME S 1

SENNO 1

sennosides-docusate sodium 1

SENOKOT 2

SENOKOT TO GO 2

SENOKOT-S 1

111

Drug Name Tier NotesSENOKOTXTRA 2

SFROWASA 2

SILACE 1

simethicone oral capsule 180 mg 1

simethicone oral drops,suspension 1

simethicone oral tablet,chewable 1

SMOOTH ANTACID 1

sodium bicarbonate oral 1

sodium phenylbutyrate 1

SOF-LAX 2

STOMACH RELIEF 1

STOMACH RELIEF MAX STRENGTH 1

STOMACH RELIEF ORIGINAL 1

STOOL SOFTENER ORAL CAPSULE 100 MG, 240 MG, 250 MG

1

STOOL SOFTENER-LAXATIVE 1

STOOL SOFTENER-STIMULANT LAXAT 1

SUCLEAR 2

sucralfate oral tablet 1

sulfasalazine 1

SULFAZINE 1

SULFAZINE EC 1

SUPERIOR DIGESTIVE ENZYME 2

SUPREP BOWEL PREP KIT 2

SYMAX FASTABS 2

SYMAX-SL 2

TIGAN INTRAMUSCULAR 2

TIGAN ORAL CAPSULE 300 MG 2

TRANSDERM-SCOP 2

TRAVEL SICKNESS 1

TRAVEL SICKNESS (MECLIZINE) 1

TRILYTE WITH FLAVOR PACKETS 1

trimethobenzamide intramuscular solution 1

trimethobenzamide oral 1

TUMS 2

TUMS E-X 2

TUMS EXTRA STRENGTH SMOOTHIES 2

TUMS FRESHERS 2

TUMS ULTRA ORAL TABLET,CHEWABLE 1,177 MG 1

TUMS ULTRA ORAL TABLET,CHEWABLE 400 MG (1,000 MG)

2

ULTRA STRENGTH ANTACID 1

ULTRESA 2

URSO 250 2

112

Drug Name Tier NotesURSO FORTE 2

ursodiol 1

VARUBI 2

VASCEPA 2 QL (4 EA per 1 day)

VIOKACE 2

VISICOL 2

WAL-MUCIL FIBER (ASPARTAME) 2

WAL-MUCIL FIBER (SUGAR) 2

WAL-ZAN 75 1

WOMEN'S GENTLE LAXATIVE(BISAC) 1

WOMEN'S LAXATIVE (BISACODYL) ORAL TABLET 1

ZANTAC 75 2

ZANTAC INJECTION 2

ZANTAC MAXIMUM STRENGTH 2

ZANTAC ORAL TABLET 2

ZEGERID ORAL CAPSULE 2 ST; QL (1 EA per 1 day)

ZENPEP 2

ZOFRAN (AS HYDROCHLORIDE) INTRAVENOUS 2

ZOFRAN (AS HYDROCHLORIDE) ORAL SOLUTION 2 QL (50 ML per 15 days)

ZOFRAN (AS HYDROCHLORIDE) ORAL TABLET 2

ZOFRAN ODT 2

ZUPLENZ ORAL FILM 4 MG 2 ST; QL (2 EA per 3 days)

ZYPRAM 2

HERBALSalfalfa oral tablet 600 mg, 650 mg 2

aloe vera oral 2

ANAMU ORAL CAPSULE 450 MG 2

ANTI-NAUSEA GINGER 2

arnica 2

asafetida 2

AZO BLADDER CONTROL 2

AZO CRANBERRY 2

AZO CRANBERRY + PROBIOTIC 2

bilberry 2

bilberry fruit extract 2

black cohosh oral capsule 40 mg, 540 mg 2

black cohosh root extract oral capsule 160 mg 2

blue-green algae (spirulina) 2

calcium-cranberry fruit 2

CARB CUTTER 2

CARDIO TEA 2

catnip 2

cat's claw (uncaria tomentosa) oral capsule 350 mg, 400 mg 2

CHLOROPHYLL (WITH ALFALFA) 2

113

Drug Name Tier NotesCINNAMON 2

cinnamon bark 2

CINNAMON OIL 2

cranberry conc-ascorbic acid oral capsule 4,200-20 mg 2

CRANBERRY CONCENTRATE ORAL CAPSULE 140-100 MG

2

cranberry extract oral capsule 200 mg, 425 mg 2

cranberry extract oral tablet 300 mg 2

cranberry fruit oral tablet 400 mg 2

cranberry oral capsule 500 mg 2

CRANBERRY ORAL TABLET 2

CRANBERRY PLUS VITAMIN C 2

CRAN-MAX 500 MG 2

DETOX DIETARY 2

DETOXAREX 2

DIURETIC 2

echinacea 2

ECHINACEA & GOLDENSEAL ORAL TABLET 2

ECHINACEA 1X 2

echinacea angust-purpr root xt 2

ECHINACEA HERB 2

echinacea oral tablet 167 mg 2

ECHINACEA PLUS 2

echinacea purpurea extract 2

echinacea purpurea root 2

ECHINACEA ROOT 2

echinacea-golden seal oral capsule 180-45 mg, 350-100 mg 2

echinacea-golden seal roots 2

ELLURA 2

EVENING PRIMROSE 2

evening primrose oil 2

feverfew 2

flaxseed oil 2

flaxseed oral powder 2

GARLIC OIL ORAL CAPSULE 1,000 MG 2

garlic oral capsule , 2,000 mg, 345 mg, 580 mg 2

garlic oral tablet , 200 mg, 400 mg, 500 mg 2

GARLIPURE 2

GARLIQUE 2

ginger (zingiber officinalis) 2

GINGER EXTRACT 2

GINKGO 2

ginkgo biloba 2

ginkgo biloba extract 2

114

Drug Name Tier Notesginkgo biloba leaf extract oral capsule 30 mg, 60 mg 2

ginkgo biloba-ginkgo biloba ex 2

GINSENG KOREAN 2

ginseng oral capsule 200 mg 2

grape seed extract oral capsule 100 mg 2

grape seed extract oral tablet 2

grape seed xt-bioflav,citrus 2

GREEN COFFEE BEAN ORAL TABLET 2

GREEN TEA COMPLEX ORAL TABLET 1,000 MG 2

green tea leaf ext-green tea 2

GREEN TEA ORAL CAPSULE 2

green tea-hoodia gordonii 2

hawthorn 2

IBGARD 2

IMMUNE JUMP 2

IMUHANCE 2

INFLUDO 2

INNERMOST NATURE FOR MEN 2

kava root extract 2

KOREAN GINSENG 2

korean ginseng root extract 2

lavender oil 2

licorice 2

LINSEED OIL 2

LIVER COMPLEX 2

MARJORAM 2

MILK THISTLE EXTRACT 2

milk thistle oral capsule 150 mg, 200 mg 2

milk thistle oral tablet 2

milk thistle seed extract oral capsule 175 mg, 200 mg, 87.5 mg

2

MILK THISTLE XTRA 2

myrrh 2

NATURAL HERBAL DIURETIC 2

NONI 2

ODOR FREE GARLIC ORAL TABLET 100 MG 2

ODORLESS GARLIC ORAL CAPSULE 2

ODORLESS GARLIC ORAL TABLET 1250 MG 2

peppermint oil 2

peppermint spirit 2

PETADOLEX 2

PETADOLEX 75 2

PHYTOFUSION 2

pomegranate fruit extract 2

115

Drug Name Tier NotesPOMEGRANATE-EGCG & GRAPE SEED 2

PRIMROSE OIL 2

PROBIOTIC PLUS & CRANBERRY 2

raspberry ketone 2

red yeast rice oral capsule 2

REFEX 2

RETAINE FLAX 2

rosemary oil 2

saffron extract 2

sage leaf (bulk) 2

saw palmetto fruit 2

saw palmetto oral capsule 160 mg, 500 mg 2

saw palmetto-pumpkin seed oil 2

SERENAGEN 2

SOOTHING SLEEP 2

SOUTH AFRICAN HOODIA 2

SUPER POTENT YOHIMBE 2

TART CHERRY EXTRACT 2

THERACRAN HP FOR KIDS 2

TOTAL BODY CLEANSE 2

TUMERSAID 2

turmeric root extract 2

valerian root oral capsule 250 mg, 450 mg, 500 mg 2

VP-PRECIP 2

WHOLE BODY JOINT SUPPORT 2

YOHIMBE 2

yohimbe bark 2

HORMONESACTHAR H.P. 2

ACTHREL 2

ACTIVELLA 2

A-HYDROCORT 1

ALORA 2 QL (2 EA per 7 days)

ANADROL-50 2 PA

ANDRODERM 2 PA; QL (1 EA per 1 day)

ANDROGEL TRANSDERMAL GEL IN METERED-DOSE PUMP 1.25 GRAM/ ACTUATION (1 %)

2 PA; QL (300 GM per 30 days)

ANDROGEL TRANSDERMAL GEL IN METERED-DOSE PUMP 20.25 MG/1.25 GRAM (1.62 %)

2 PA; QL (5 GM per 1 day)

ANDROGEL TRANSDERMAL GEL IN PACKET 1 % (25 MG/2.5GRAM), 1.62 % (40.5 MG/2.5 GRAM)


ANDROGEL TRANSDERMAL GEL IN PACKET 1 % (50 MG/5 GRAM)


116

Drug Name Tier NotesANDROGEL TRANSDERMAL GEL IN PACKET 1.62 % (20.25 MG/1.25 GRAM)

2 PA; QL (1.25 GM per 1 day)

ANDROID 2

ANDROXY 1 QL (120 EA per 30 days)

ANGELIQ 2

ARISTOSPAN INTRA-ARTICULAR 2

ARISTOSPAN INTRALESIONAL 2

AVEED 2

AXIRON 2 PA; QL (6 ML per 1 day)

AYGESTIN 2

BAYCADRON 1

betamethasone acet,sod phos 1

budesonide oral 1

cabergoline 1

calcitonin (salmon) 1

CELESTONE SOLUSPAN 2

CENESTIN ORAL TABLET 0.3 MG, 0.625 MG, 0.9 MG, 1.25 MG

2

CERVIDIL 2

CLIMARA 2 QL (1 EA per 7 days)

CLIMARA PRO 2 QL (1 EA per 7 days)

COLOCORT 1

COMBIPATCH 2 QL (2 EA per 7 days)

CORTEF 2

CORTENEMA 2

CORTIFOAM 2

cortisone 1

CORTROSYN 2

cosyntropin injection 1

COVARYX 1

COVARYX H.S. 1

CRINONE VAGINAL GEL 4 % 2

danazol oral 1

DDAVP 2

DELATESTRYL 2 PA; QL (5 EA per 30 days)

DELESTROGEN 2

DEPO-ESTRADIOL 2

DEPO-MEDROL 2

DEPO-PROVERA INTRAMUSCULAR SOLUTION 2

DEPO-TESTOSTERONE INTRAMUSCULAR OIL 100 MG/ML

2 PA; QL (10 ML per 30 days)

desmopressin injection 1

desmopressin nasal 1

desmopressin oral 1

dexamethasone 1

117

Drug Name Tier NotesDEXAMETHASONE INTENSOL 2

dexamethasone sodium phos (pf) 1

dexamethasone sodium phosphate injection solution 1

DEXPAK 10 DAY 2

DEXPAK 13 DAY 2

DEXPAK 6 DAY 2

DIVIGEL 2

DUAVEE 2

EEMT 1

EEMT HS 1

EGRIFTA 2 PA; QL (2 EA per 1 day)

ELESTRIN 2

ENJUVIA ORAL TABLET 0.3 MG, 0.45 MG, 0.9 MG, 1.25 MG

2

ENTOCORT EC 2

ESTRACE 2

estradiol oral 1

estradiol transdermal patch semiweekly 1 QL (2 EA per 7 days)

estradiol transdermal patch weekly 1 QL (1 EA per 7 days)

estradiol valerate 1

estradiol-norethindrone acet 1

ESTRING 2 QL (1 EA per 90 days)

estrogens-methyltestosterone 1

estropipate 1

EVAMIST 2

FEMHRT LOW DOSE 2

FEMRING 2 QL (1 EA per 84 days)

FLO-PRED 2

fludrocortisone 1

FORTESTA 2 PA; QL (4 GM per 1 day)

FORTICAL 2

GENOTROPIN 2 PA

GENOTROPIN MINIQUICK 2 PA

HEMABATE 2

HUMATROPE 2 PA

hydrocortisone oral 1

hydrocortisone rectal enema 1

INCRELEX 2 PA

JINTELI 1

KENALOG INJECTION 2

LOPREEZA 1

LUPANETA PACK (1 MONTH) 2

LUPANETA PACK (3 MONTH) 2

118

Drug Name Tier NotesLUPRON DEPOT (3 MONTH) INTRAMUSCULAR SYRINGE KIT 11.25 MG

2

LUPRON DEPOT INTRAMUSCULAR SYRINGE KIT 3.75 MG

2

LUPRON DEPOT-PED 2

LUPRON DEPOT-PED (3 MONTH) 2

MAKENA 2

MEDROL 2

MEDROL (PAK) 2

medroxyprogesterone oral 1

melatonin oral tablet 3 mg 1

melatonin oral tablet,disintegrating 3 mg 1

melatonin sublingual tablet 10 mg 1

melatonin-lemon balm leaf extr 1

MENEST 2

MENOSTAR 2 QL (1 EA per 7 days)

METHITEST 2

methylergonovine 1

methylprednisolone 1

methylprednisolone acetate 1

methylprednisolone sodium succ injection recon soln 125 mg, 40 mg

1

methylprednisolone sodium succ intravenous 1

methyltestosterone oral capsule 1

MIACALCIN 2

MILLIPRED 2

MILLIPRED DP 2

MIMVEY 1

MIMVEY LO 1

MINIVELLE 2 QL (2 EA per 7 days)

MYALEPT 2 QL (1 EA per 1 day)

NATESTO 2

NATPARA 2 PA

NORDITROPIN FLEXPRO 2 PA

NORDITROPIN NORDIFLEX 2 PA

norethindrone acetate 1

norethindrone ac-eth estradiol oral tablet 0.5-2.5 mg-mcg, 1-5 mg-mcg

1

NUTROPIN 2 PA

NUTROPIN AQ NUSPIN 2 PA

NUTROPIN AQ SUBCUTANEOUS CARTRIDGE 2 PA

octreotide acetate 1

OMNITROPE 2 PA

ORAPRED 2

ORAPRED ODT 2

119

Drug Name Tier Notesoxandrolone 1 PA

oxytocin injection solution 2

PEDIAPRED 2

PITOCIN 2

PITRESSIN 2

prednisolone oral solution 15 mg/5 ml 1

prednisolone sodium phosphate oral solution 15 mg/5 ml, 25 mg/5 ml (5 mg/ml), 5 mg base/5 ml (6.7 mg/5 ml)

1

prednisolone sodium phosphate oral tablet,disintegrating 1

PREDNISONE INTENSOL 2

prednisone oral 1

PREFEST 2

PREMARIN 2

PREMPHASE 2

PREMPRO 2

PREPIDIL 2

progesterone 1

PROGESTERONE IN OIL 1

progesterone micronized 1

PROMETRIUM 2

PROSTIN E2 2

PROVERA 2

RAYOS 2 ST

SAIZEN 2 PA

SAIZEN CLICK.EASY 2 PA

SANDOSTATIN 2

SANDOSTATIN LAR DEPOT 2

SEROSTIM SUBCUTANEOUS RECON SOLN 4 MG, 5 MG, 6 MG

2 PA

SIGNIFOR 2 PA

SIGNIFOR LAR 2

SOLU-CORTEF 2

SOLU-CORTEF (PF) 2

SOLU-MEDROL 2

SOLU-MEDROL (PF) 2

SOMATULINE DEPOT 2

STIMATE 2

STRIANT 2 PA; QL (2 EA per 1 day)

SUPPRELIN LA 2

SYNAREL 2

TESTIM 2 PA; QL (300 GM per 30 days)

TESTOPEL 2

testosterone cypionate intramuscular oil 100 mg/ml 1 PA; QL (10 ML per 30 days)

testosterone enanthate 1 PA; QL (5 ML per 30 days)

120

Drug Name Tier Notestestosterone transdermal gel 1 PA; QL (300 GM per 30 days)

testosterone transdermal gel in metered-dose pump 1.25 gram/ actuation (1 %)


testosterone transdermal gel in metered-dose pump 10 mg/0.5 gram /actuation


testosterone transdermal gel in packet 1 % (25 mg/2.5gram) 1 PA; QL (5 GM per 1 day)

testosterone transdermal gel in packet 1 % (50 mg/5 gram) 1 PA; QL (300 GM per 30 days)

TESTRED 2

triamcinolone acetonide injection 1

UCERIS ORAL 2

UCERIS RECTAL 2 ST

VAGIFEM 2

vasopressin 1

VASOSTRICT 2

VERIPRED 20 2

VIVELLE-DOT 2 QL (2 EA per 7 days)

VOGELXO 2 PA; QL (300 GM per 30 days)

ZOMACTON 2 PA

ZORBTIVE 2 PA

IMMUNOSUPPRESANTACTEMRA INTRAVENOUS 2

ACTEMRA SUBCUTANEOUS 2 PA

ASTAGRAF XL 2

AZASAN 2

azathioprine 1

CELLCEPT 2

CELLCEPT INTRAVENOUS 2

cyclosporine intravenous 1

cyclosporine modified 1

cyclosporine oral 1

ELIDEL 2 ST

GENGRAF 1

HECORIA 2

IMURAN 2

mycophenolate mofetil 1

mycophenolate sodium 1

MYFORTIC 2

NEORAL 2

NULOJIX 2

ORTHOCLONE OKT3 2

PROGRAF 2

RAPAMUNE 2

SANDIMMUNE 2

SIMULECT 2

121

Drug Name Tier Notessirolimus 1

STELARA SUBCUTANEOUS SYRINGE 2 PA

tacrolimus oral 1

tacrolimus topical 1 ST

ZORTRESS 2

MISCELLANEOUS MEDICAL SUPPLIES, DEVICES, NON-DRUG1ST TIER UNIFINE PENTIPS 2

1ST TIER UNIFINE PENTIPS PLUS 2

3M NEXCARE DURAPORE 2

ABSORBENT COTTON BALLS 2

ACCU-CHEK FASTCLIX KIT 2

ACCU-CHEK MULTICLIX LANCET KIT 2

ACCU-CHEK SOFT DEV LANCETS 2

ACCU-CHEK SOFTCLIX LANCET DEV 2

ACE AEROSOL CLOUD ENHANCER 2

adhesive bandage 2

adhesive bandage-adhes remov#1 2

ADHESIVE DRESSING 2

ADHESIVE GAUZE PAD 2

ADHESIVE PADS 2

adhesive remover 2

adhesive tape 2

ADVANCED ANTIBACTERIAL BANDAGE 2

ADVOCATE PEN NEEDLES 2

ADVOCATE SYRINGES 2

AEROCHAMBER MINI 2

AEROCHAMBER MV 2

AEROCHAMBER PLUS FLOW-VU 2

AEROCHAMBER PLUS FLOW-VU,L MSK 2

AEROCHAMBER PLUS FLOW-VU,M MSK 2

AEROCHAMBER PLUS FLOW-VU,S MSK 2

AEROCHAMBER PLUS Z STAT 2

AEROCHAMBER PLUS Z STAT LG MSK 2

AEROCHAMBER PLUS Z STAT MD MSK 2

AEROCHAMBER PLUS Z STAT SM MSK 2

AEROCHAMBER WITH FLOWSIGNAL 2

AEROCHAMBER Z-STAT PLUS-FLW SG 2

AEROTRACH PLUS 2

AGIE-GRX 2

AIMSCO INSULIN SYRINGE 2

AIMSCO ULTRA THIN II 2

ALLEVYN ADHESIVE DRESSING TOPICAL BANDAGE 9 X 9 "

2

122

Drug Name Tier NotesALLEVYN CAVITY DRESSING 2

ALLEVYN CAVITY WOUND DRESS 2

ALLEVYN PLUS ADHESIVE 2

ALLEVYN SACRUM DRESSING 2

ALLEVYN TOPICAL BANDAGE 6 X 5.375 " 2

ALLKARE ADHESIVE REMOVER WIPES 2

ALL-PURPOSE DRESSINGS 2

ANTIBACTERIAL BANDAGES 2

ANTIBACTERIAL PAD 2

AQUACEL FOAM SACRAL 2

AQUACEL FOAM TOPICAL BANDAGE 3.2 X 3.2 ", 8 X 5.5 ", 8 X 7 "

2

AQUAFLO 2

ARCH BANDAGE 2

ARGLAES 3.25"X 14" FILM 2

ARTHRITIS HEATWRAPS 2

ASSURE ID INSULIN SAFETY 2

ATHLETIC TAPE 2

AVOGEL 2

AVOGEL DRESSING 2

B&L SENSITIVE EYES 2

BANDAGE 2

BANDAGES 2

BANDAGES FLEXIBLE FABRIC 2

BANDAGES SHEER 2

BANDAGES/FLEXIBLE/ASSORTED 2

BANDAGES/PLASTIC 2

BAND-AID ACTIVE FLEX 2

BAND-AID BUTTERFLY CLOSURE 2

BAND-AID CLEAR SPOTS 2

BAND-AID CLOTH TAPE 2

BAND-AID FLEXIBLE 2

BAND-AID FLEXIBLE FABRIC 2

BAND-AID GAUZE PADS 2

BAND-AID HANDYMAN 2

BAND-AID HURT-FREE 2

BAND-AID MIRASORB GAUZE 2

BAND-AID NON-STICK PADS 2

BAND-AID PAPER TAPE 2

BAND-AID PLASTIC 2

BAND-AID PLUS ANTIBIOTIC 2

BAND-AID ROLLED GAUZE 2

BAND-AID SECURE-FLEX 2

BAND-AID SHEER STRIPS 2

123

Drug Name Tier NotesBAND-AID SURGIPAD 2

BAND-AID TOUGH PADS 2

BAND-AID TOUGH STRIPS 2

BAND-AID WATERPROOF 2

BAND-AID WATERPROOF PAD 2

BARD ADHESIVE REMOVER WIPES 2

BARD TWO-SIDED ADHESIVE STRIP 2

BD AUTOSHIELD DUO PEN NEEDLE 2

BD AUTOSHIELD PEN NEEDLE 2

BD ECLIPSE LUER-LOK SYRINGE 1 ML 30 X 1/2" 2

BD INSULIN PEN NEEDLE UF MINI 2

BD INSULIN PEN NEEDLE UF ORIG 2

BD INSULIN PEN NEEDLE UF SHORT 2

BD INSULIN SYRINGE 2

BD INSULIN SYRINGE HALF UNIT 2

BD INSULIN SYRINGE MICRO-FINE 2

BD INSULIN SYRINGE SAFETY-LOK 2

BD INSULIN SYRINGE SLIP TIP 2

BD INSULIN SYRINGE ULT-FINE II 2

BD INSULIN SYRINGE ULTRA-FINE 2

BD INTEGRA INSULIN SYRINGE 2

BD LO-DOSE MICRO-FINE IV 2

BD LO-DOSE ULTRA-FINE 2

BD SAFETYGLIDE INSULIN SYRINGE 2

BD SAFETYGLIDE SYRINGE SYRINGE 1 ML 27 X 5/8"

2

BD ULTRA-FINE NANO PEN NEEDLES 2

BIATAIN HEEL ADH FOAM DRESSING 2

BIATAIN NON-ADHESIVEFOAM ROUND 2

BIO TRUE 2

BIOBRANE 2

BIOBRANE DRESSING 2

BIOBRANE-L 2

BIOBRANE-L DRESSING 2

BLENDERM SURGICAL 2

BLENDERM WATERPROOF SURG TAPE 2

BLISTER RELIEF BANDAGES 2

BLISTERFILM DRESSING 2

BORDERED GAUZE 2

BOSTON CLEANER 2

BOSTON CONDITIONING 2

BOSTON ONE STEP (PF) 2

BOSTON REWETTING 2

BOSTON SIMPLUS 2

124

Drug Name Tier NotesBREATHERITE MDI SPACER 2

BREATHERITE RIGID SPACER& MASK 2

BREATHERITE SPACER& MASK,ADULT 2

BREATHERITE SPACER& MASK,CHILD 2

BREATHERITE SPACER&MASK,INFANT 2

BREATHERITE SPACER&MASK,S.CHLD 2

BREATHERITE VALVED MDI CHAMBER 2

BREATHERITE VALVED MDI SPACER 2

BREATHERITE WITH MASK, LARGE 2

BREATHERITE WITH MASK, MEDIUM 2

BREATHERITE WITH MASK, SMALL 2

BULKEE II 2

BUTTERFLY CLOSURES 2

CALLUS CUSHION 2

CALLUS PADS 2

CAMO BANDAGES 2

CARBOFLEX ODOR CONTROL DRESSIN 2

CAREFINE PEN NEEDLE 2

CAREFREE PANTILINERS 2

CAREFREE PANTY SHIELD 2

CAREONE ULTIGUARD 2

CARRASYN HYDROGEL WOUND DRESS 2

CHEMSTRIP (CALIBRATION) 2

CLEAR BANDAGES 2

CLEAR SPOT BANDAGES 2

CLEAR STRIPS 2

CLEAR TAPE 2

CLEAR WATERPROOF STRIPS 2

CLERZ PLUS 2

CLICKFINE 2

CLOTH FIRST AID TAPE 2

CLOTH TAPE 2

COACH SPORTS 2

COBAN 2

COBAN ACTION WRAP 2

COBAN SELF-ADHERENT WRAP 2

COBAN STERILE SELF-ADHERENT 2

COMBINE ABD 2

COMFEEL PURILON 2

COMFORT EZ PEN NEEDLES 2

COMFORT EZ SYRINGE 2

COMPACT SPACE CHAMBER PLUS 2

CONFORM 2

CONFORMANT 2 2

125

Drug Name Tier NotesCONTACT LENS RELIEF 2

COOLMAGIC 2

COOLMAGIC FENESTRATED 2

CORN CUSHION 2

COSMETIC BALLS 2

COSMETIC PUFFS 2

COSMETIC SQUARES 2

COTTON BALLS 2

COTTON BALLS STERILE 2

COTTON SQUARES 2

COTTON SWABS 2

COTTON, STERILE 2

COVRSITE 2

COVRSITE PLUS 2

CURAD GAUZE PAD 2

CURAD NON-STICK PAD 2

CURAD SHEER SPOTS 2

CURAFIL GEL WOUND 2

CURASILK CLOTH 2

CURASOL HYDROGEL DRESSING 2

CURASOL WOUND DRESSING 2

CURI-STRIP WOUND CLOSURES 2

CURITY ABDOMINAL PAD 2

CURITY ABSORBENT WADDING 2

CURITY AMD 2

CURITY AMD (WITH POLYHEXAMETH) 2

CURITY BANDAGE 2

CURITY COTTON PREP BALLS 2

CURITY COTTON TIP APPLICATOR 2

CURITY COVER 2

CURITY DETECTABLE LAP 2

CURITY DISP LAP SPONGE POUCH 2

CURITY DISP LAP SPONGE TRAY 2

CURITY DRESSING TOPICAL BANDAGE 4 1/2 X 3600 ", 9 X 100 "-YARD

2

CURITY GAUZE 2

CURITY GAUZE BURN DRESSING 2

CURITY IODOFORM PACKING STRIP 2

CURITY LAKESIDE COTTON ROLL 2

CURITY MATERNITY PADS 2

CURITY MULTI-TRAUMA DRESSING 2

CURITY NON-ADHERENT STRIP 2

CURITY NON-ADHERING DRESSING 2

CURITY PLAIN PACKING STRIP 2

126

Drug Name Tier NotesCURITY READY-CUT GAUZE 2

CURITY STANDARD POROUS 2

CURITY SURGICAL DRESSING 2

CURITY WET DRESSING 2

DENTAL TRAVEL PACK 2

denture care products 2

DERMACEA 2

DERMACEA I.V. 2

DERMACEA NON-WOVEN 2

DERMACEA STRETCH 2

DERMAGAUZE 2

DERMAGAUZE HYDROGEL DRESSING 2

DERMA-GEL 2

DERMAGRAN HYDROGEL DRESSING 2

DERMAGRAN HYDROPHILIC DRESSING 2

DERMASYN 2

DERMAVIEW 2

DERMAVIEW II 2

DISINFECTING SOLUTION 2

DOME-PASTE BANDAGES 2

DRESSING SPONGES 2

DRYNET WOUND VEIL 2

DUODERM HYDROACTIVE TOPICAL GEL 2

DUODERM HYDROACTIVE TOPICAL PASTE 2

DURAPORE CLOTH SURGICAL TAPE 2

DURAPORE SURGICAL 2

EAR POPPER INFLATION DEVICE 2

EASIVENT HOLDING CHAMBER 2

EASIVENT MASK LARGE 2

EASIVENT MASK MEDIUM 2

EASIVENT MASK SMALL 2

EASY COMFORT INSULIN SYRINGE 2

EASY COMFORT PEN NEEDLES 2

EASY TOUCH INSULIN SAFETY SYR 2

EASY TOUCH INSULIN SYRINGE 2

EASY TOUCH NEEDLE 2

elastic bandage 2

ELASTIC STRETCH NET 2

ELASTO-GEL 2

ELASTO-GEL CAST-SPLINT PADDING 2

ELASTO-GEL CIRCLE DRESSING 2

ELASTO-GEL FACE DRESSING 2

ELASTO-GEL PLUS 2

EVERYDAY LONG PANTILINERS 2

127

Drug Name Tier NotesEXCILON 2

EXCILON AMD (WITH POLYHEXAMET) 2

EXCILON DRAIN 2

EXCILON I.V. 2

EXEL INSULIN 2

EXPANDOVER BANDAGE 2

EXU-DRY ADULT DRESSING 2

EXU-DRY ARM DRESSING 2

EXU-DRY BOOT-FOOT DRESSING 2

EXU-DRY BURN JACKET-LARGE 2

EXU-DRY BURN JACKET-MEDIUM 2

EXU-DRY BURN JACKET-SMALL 2

EXU-DRY BURN VEST-LARGE 2

EXU-DRY BURN VEST-SMALL 2

EXU-DRY ELBOW-KNEE-HEEL 2

EXU-DRY FACE DRESSING 2

EXU-DRY HAND DRESSING, LARGE 2

EXU-DRY HAND DRESSING, MEDIUM 2

EXU-DRY HAND DRESSING, SMALL 2

EXU-DRY INCISION DRESSING 2

EXU-DRY LARGE BOOT DRESSING 2

EXU-DRY LEG DRESSING 2

EXU-DRY NECK DRESSING 2

EXU-DRY SCALP DRESSING 2

EXU-DRY WOUND DRESSING 2

E-Z SPACER 2

EZO CUSHIONS LOWER HEAVY 2

EZO CUSHIONS LOWER REGULAR 2

EZO CUSHIONS UPPER HEAVY 2

EZO CUSHIONS UPPER REGULAR 2

FABRIC BANDAGES 2

FABRIC KNUCKLE-FINGER BANDAGE 2

FABRIC STRIP EXTRA LARGE 2

FINGER SLEEVES 2

FIRST AID CLOTH TAPE 2

FIRST AID HURT-FREE WRAP 2

FIRST AID PAPER TAPE 2

FIRST AID PLASTIC TAPE 2

FIRST AID SKINTONE PAPER 2

FIRST AID WATERPROOF TAPE 2

FLEX BANDAGE 2

FLEX FABRIC BANDAGE 2

FLEX FINGER BANDAGE 2

FLEXIBLE 2

128

Drug Name Tier NotesFLEXIBLE DRESSING 2

FLEXIBLE FABRIC BANDAGES 2

FLEXIBLE FOAM 2

FLEXICHAMBER 2

FLEXIGEL 2

FLEX-WRAP 2

FLEXZAN WOUND DRESSING TOPICAL BANDAGE 2 X 3 ", 4 X 8 "

2

foam bandage 2

FOAM TOE BANDAGE 2

FREESTYLE PRECISION 2

gauze bandage 2

GAUZE PAD 2

GAUZE ROLL 2

GAUZE SPONGES 2

GEL CORN PROTECTORS 2

GEL TOE PROTECTOR 2

GEL TOE SPACERS 2

GELPAD 2

GENTLE TAPE 2

GLUCOPRO 2

GRX FOAM DRESSING 2

GRX HYDROGEL GAUZE 2

GRX WOUND GEL 2

HEALTHY ACCENTS UNIFINE PENTIP 2

HEAT THERAPY 2

HEATWRAPS 2

HEATWRAPS BACK & HIP PADS 2

HEAVY DUTY FABRIC STRIPS 2

HURRIVIEW 2

HURRIVIEW II 2

HYDE-OUT ALDEHYDE NEUTRALIZER 2

HYDRESS 2

hydrocol dress-adhesive rem#1 2

HYDROPHOR 2

HYPAFIX 2

HYPO-ALLERGENIC BANDAGES 2

IN-CHECK DIAL TRAINING DEVICE 2

INCONTROL PEN NEEDLE 2

INS SYRINGE/NEEDLE 0.5CC/27G 2

INSPIRACHAMBER 2

INSPIRACHAMBER WITH MASK-MED 2

INSPIRACHAMBER WITH MASK-SMALL 2

INSPIREASE 2

129

Drug Name Tier NotesINSPIREASE BAGS 2

INSPIREASE MOUTHPIECE 2

INSPIREASE RESERVOIR BAGS 2

INSULIN SYRINGE MICROFINE 2

insulin syringe needleless 2

INSULIN SYRINGE SYRINGE 1 ML 28 X 1/2", 1 ML 29 X 1/2", 1 ML 30 X 5/16", 1/2 ML 28 X 1/2", 1/2 ML 29 X 1/2", 1/2 ML 30 X 5/16"

2

INSULIN SYRINGE ULTRAFINE 2

insulin syringe-needle u-100 2

insulin syringes (disposable) 2

INSUMED 2

INSUPEN 2

INTERSORB 2

INTRASITE GEL DRESSING 2

ISLAND GARD-GRX 2

IV 3000 2

IV3000 FRAME DELIVERY DRESSING 2

J & J FIRST AID TAPE PAPER 2

J & J NON-STICK PADS LARGE 2

J & J NON-STICK PADS MEDIUM 2

KENDALL 2

KENDALL CLOTH 2

KENDALL FOAM BORDER 2

KENDALL PAPER TAPE 2

KERLIX 2

KERLIX AMD 2

KERLIX BURN PACK 2

KERLIX LITE 2

KERLIX PACKING SPONGE 2

KLING ROLLS 2

KOTEX FRESH & DRY 2

KOTEX OVERNIGHT 2

LISCO 2

LITE TOUCH INSULIN PEN NEEDLES 2

LITE TOUCH INSULIN SYRINGE 2

LITE TOUCH-MEDIUM MASK 2

LITEAIRE MDI CHAMBER 2

LITETOUCH-LARGE MASK 2

LITETOUCH-SMALL MASK 2

LUBRICATING & REWETTING 2

MAGELLAN INSULIN SAFETY SYRNG 2

MAGELLAN SYRINGE SYRINGE 0.3 ML 30 X 5/16", 0.5 ML 30 X 5/16"

2

MAXI DEODORANT 2

130

Drug Name Tier NotesMAXI PAD REGULAR 2

MAXI PAD SUPER 2

MAXI-COMFORT INSULIN SYRINGE 2

MAXI-PADS 2

MAXORB 2

MAXORB EXTRA DRESSING 2

MAXORB ROPE 2

MEDFIX 2

MEDFIX EZ DRESSING 2

MEDIGRIP 2

MEDIGRIP ELASTICATED SUPPORT 2

MEDIGRIP TUBULAR 2

MEDIPORE 2

MEDIPORE DRESS-IT COVER 2

MEDIPORE H 2

MEDIPORE SOFT CLOTH TAPE 2

MEFIX 2

MEPILEX BORDER 2

MEPILEX BORDER SACRUM 2

MEPITEL 2

MICROCHAMBER 2

MICROFOAM SURGICAL 2

MICROPORE FIRST AID CLOTH 2

MICROPORE FIRST AID PAPER 2

MICROPORE FIRST AID PLASTIC 2

MICROPORE FIRST AID SKINTONE 2

MICROPORE FIRST AID WATERPROOF 2

MICROPORE PAPER SURGICAL TAPE 2

MICROPORE SURGICAL 2

MICROSPACER 2

MICROSPONGE 2

MINI ULTRA-THIN II 2

MIRASORB 2

MISTASSIST 2

MONAGHAN Z STAT CHAMBER 2

MONAGHAN Z STAT CHAMBER-LG MSK 2

MONAGHAN Z STAT CHAMBER-MD MSK 2

MONAGHAN Z STAT CHAMBER-SM MSK 2

MONOJECT INSULIN SAFETY SYRING 2

MONOJECT INSULIN SYRINGE 2

MONOJECT SYRINGE SYRINGE 1/2 ML 28 2

MONOJECT ULTRA COMFORT INSULIN 2

MOUTHPIECE 2

131

Drug Name Tier NotesMPM FOAM DRESSING TOPICAL BANDAGE 4 X 4 ", 6 X 6 "

2

MULTIPURPOSE CONTACT LENS 2

MULTI-PURPOSE SOFT CONTACT LEN 2

NATURAL CARE BANDAGES 2

NEEDLE-PRO EDGE 2

NESSI SPACER 2

NEW GENERATION 2

NEXCARE GENTLE PAPER TAPE 2

NEXCARE TEGADERM 2

non-adherent bandage 2

NON-ADHESIVE PAD 2

NON-STICK DRESSINGS 2

NON-STICK PAD 2

NO-STING SKIN-PREP 2

NOVOFINE 30 2

NOVOFINE 32 2

NOVOFINE AUTOCOVER 2

NOVOFINE PLUS 2

NOVOTWIST 2

ONE FLOW SPIROMETER PC CABLE 2

ONE FLOW SPIROMETER SOFTWARE 2

ONE FLOW TESTER MOUTHPIECE 2

ONE FLOW TESTER SPIROMETER 2

ONE STEP AT A TIME 2

ONE WAY VALVED MOUTHPIECE 2

OPSITE 2

OPSITE ADHESIVE DRESSING 2

OPSITE FLEXIFIX 2

OPSITE FLEXIGRID 2

OPSITE FLEXIGRID DRESSING 2

OPSITE IV 3000 2

OPTICHAMBER ADULT MASK-LARGE 2

OPTICHAMBER ADVANTAGE 2

OPTICHAMBER ADVANTAGE-LG MASK 2

OPTICHAMBER ADVANTAGE-MED MASK 2

OPTICHAMBER ADVANTAGE-SML MSK 2

OPTICHAMBER DIAMOND LG MASK 2

OPTICHAMBER DIAMOND VHC 2

OPTICHAMBER DIAMOND-MED MSK 2

OPTICHAMBER DIAMOND-SML MASK 2

OPTICHAMBER LARGE FACE MASK 2

OPTICHAMBER MEDIUM FACE MASK 2

OPTICHAMBER SMALL FACE MASK 2

132

Drug Name Tier NotesOPTI-FREE 2

OPTI-FREE EXPRESS 2

OPTI-FREE REPLENISH 2

OPTI-FREE REWETTING DROPS 2

OPTIHALER DRUG DELIVERY SYSTEM 2

ORSINI INSULIN SYRINGE 2

PAIN FREE TAPE 2

PAIN FREE WRAP 2

PANDA MASK 2

PANTILINERS 2

PAPER FIRST AID TAPE 2

PAPER TAPE 2

PAPER TAPE, HYPOALLERGENIC 2

PEDIATRIC MEDIUM MASK 2

PEDIATRIC PANDA MASK 2

PEDIATRIC SMALL MASK 2

PEDI-PRE 2

PEDI-PRE TAPE SPRAY 2

PEDI-SKIN ADHERENT #2 2

PEN NEEDLE 2

pen needle, diabetic needle 29 gauge x 1/2", 31 gauge x 1/3", 31 gauge x 1/4", 31 gauge x 1/6", 31 gauge x 5/16"

2

PENTIPS 2

PETROLATUM GAUZE 2

PFLEX INSPIRATORY TRAINER 2

PLASTIC STRIPS 2

PLASTIC SWABS 2

POCKET CHAMBER 2

POLYSKIN II 2

POWER CLEANER 2

PRIMAPORE IV 2

PRIMEAIRE 2

PRIMER MODIFIED UNNA BOOT 2

PRO SPORTS TAPE 2

PROCHAMBER 2

PRODIGY INSULIN SYRINGE 2

PRODIGY PEN NEEDLE 2

PURE COTTON 2

Q-TIPS/SINGLE-TIP 2

Q-TIPS/SINGLE-TIP APPLICATOR 2

QWIK-STRIP 2

RADIADRES GEL 2

RELION NEEDLES 2

RELION PEN NEEDLES 2

133

Drug Name Tier NotesREMOVE 2

RENU DISINFECTING 2

RENU MULTIPLUS 2

RENU REWETTING DROPS 2

RESTON 2

RESTON HIGH SUPPORT PAD 2

RESTON LIGHT SUPPORT ROLL 2

RESTON MEDIUM SUPPORT PAD 2

RESTORE CONTACT LAYER 2

RESTORE CONTACT LAYER SILVER 2

RESTORE DUO 2

RESTORE FOAM HEEL DRESSING 2

RESTORE HYDROGEL DRESSING 2

RESTORE HYDROGEL GAUZE 2

RESTORE HYDROGEL GAUZE SPONGE 2

RESTORE ODOR-ABSORBENT BANDAGE 6 X 10 " 2

RESTORE TOPICAL BANDAGE 2 1/2 X 2 1/2 ", 2 X 2 ", 4 X 4 ", 4 X 5 ", 8 X 12 "

2

RESTORE TRIO 2

RITEFLO AEROCHAMBER 2

ROLLED ABSORBENT COTTON 2

ROLLED GAUZE 2

RONDIC 2

SAFESNAP INSULIN SYRINGE 2

SAF-GEL 2

SALINE 4 2

SALINE SENSITIVE 2

SALINE SENSITIVE EYES 2

SALINE SOLUTION 2

SALINE SOLUTION,STERILE PRESRV 2

SCANPOR TAPE 2

SELF ADHERENT WRAP 2

SELF-ADHERANT GENTLE WRAP 2

SELF-ADHERING BANDAGE 2

SELFGRIP 2

SELF-GRIP 2

SENSI-CARE ADHESI REMOVER WIPE 2

SENSITIVE EYES 2

SENSITIVE EYES DAILY CLEANER 2

SENSITIVE EYES PLUS SALINE 2

SENSODYNE 2

SHEER ADHESIVE 2

SHEER BANDAGE 2

SHEER BANDAGES 2

134

Drug Name Tier NotesSHEER PLASTIC STRIP 2

SHEER SPOT BANDAGES 2

SHEER STRIP 2

SHEER STRIP EXTRA LARGE 2

SHEER STRIPS 2

SHEER STRIPS ASSORTED 2

SIDESTREAM PEDIATRIC FACE MASK 2

SILICONE MASK - INFANT 2

SILICONE MASK - PEDIATRIC 2

SKIN CLOSURE STRIPS 2

SKINTEGRITY HYDROGEL 2

SKINTEGRITY HYDROGEL DRESSING 2

SOF-SET ADHESIVE PATCH 2

SOFT CLOTH 2

SOLOSITE 2

SOLOSITE WOUND GEL 2

SOOTHING NON-STICK 2

SORESPOT 2

SPACE CHAMBER PLUS 2

SPECTRAGEL 2

SPORTS TAPE 2

STAYFREE MAXI-PAD 2

STAYFREE SUREFIT 2

STAYFREE ULTRA THIN 2

STERILE GAUZE PAD 2

STERILE PADS 2

STERILE SALINE 2

STERILE STRETCH GAUZE BANDAGE 2

STERI-STRIP 2

STERI-STRIP DRESSING 2

STERI-STRIP SKIN CLOSURE 2

STERI-STRIP SKIN CLOSURES 2

STIK IT 2

STRATASORB COMPOSITE WOUND 2

STRATASORB ISLAND DRESSING 2

STRETCH BANDAGE 2

STRETCH GAUZE BANDAGE 2

STRONG STRIPS 2

STRONG STRIPS X-LARGE 2

SUPER STRIP BANDAGES 2

SURE COMFORT INS. SYR. U-100 2

SURE COMFORT INSULIN SYRINGE 2

SURE COMFORT PEN NEEDLE 2

SURE-FINE PEN NEEDLES 2

135

Drug Name Tier NotesSURE-JECT INSULIN SYRINGE 2

SUREPRESS ABSORBENT PADDING 2

SUREPRESS HIGH COMPRESSION 2

SURESITE 2

SURESITE FLEXIGRID 2

SURESITE IV 2

SURESITE MATRIX 2

SURESITE WINDOW 2

SURGICAL DRESSING 2

SURGICAL DRESSING EXTR PROTCT 2

SURGICAL PADS 2

SYSTANE CONTACTS 2

TEGADERM 2

TEGADERM ABSORBENT 2

TEGADERM FIRST AID STYLE 2

TEGADERM FRAME STYLE 2

TEGADERM HP FRAME STYLE 2

TEGADERM HYDROGEL 2

TEGADERM I.V. 2

TEGADERM TRANSPARENT DRESSING 2

TELFA 2

TELFA (WITH POLYHEXAMETH) 2

TELFA AMD 2

TELFA CLEAR WOUND DRESSING 2

TELFA ISLAND DRESSING 2

TELFA OUCHLESS NON-ADHERENT 2

TENA SERENITY 2

TENDER TAPE 2

TENDERSKIN 2

TENDERSORB 2

TENDERWET ACTIVE CAVITY DRESS 2

TENDERWET ACTIVE DRESSING 2

TENDERWET SYSTEM 2

TENDERWRAP UNNA BOOT 2

TENSOR 2

TERUMO INS SYRINGE 0.5CC/27G 2

TERUMO INSULIN SYRINGE 2

TERUMO SURGUARD 2

THERMACARE HAND/WRIST 2

THERMACARE KNEE/ELBOW 2

THERMACARE LARGE/XLGE BACK/HIP 2

THERMACARE MENSTRUAL 2

THERMACARE NECK/WRIST/SHOULDER 2

THERMACARE SMALL/MED BACK/HIP 2

136

Drug Name Tier NotesTHINPRO INSULIN SYRINGE 2

THONG LINER 2

THRESHOLD IMT TRAINER 2

THRESHOLD PEP DEVICE 2

TOE AID DRESSING 2

TOOTHETTE 2

toothpaste 2

TOPCARE CLICKFINE 2

TOPCARE ULTRA COMFORT 2

transparent dressings 2

TRANSPARENT THIN FILM DRESSING 2

TRANSPORE 2

TRANSPORE SURGICAL 2

TRIPLE HELIX COLLAGEN TOPICAL BANDAGE 2

TRUEPLUS INSULIN 2

ULTICARE NEEDLE 2

ULTICARE SYRINGE 0.3 ML 29 X 1/2", 0.3 ML 30 X 1/2", 0.3 ML 30 X5/16 ", 0.3 ML 31 X 5/16", 1 ML 29 X 1/2", 1 ML 30 X 1/2", 1 ML 30 X 5/16 ", 1 ML 31 X 5/16", 1/2 ML 29 X 1/2 ", 1/2 ML 30 X 1/2", 1/2 ML 31 X 5/16", 1/2 ML30 X 5/16 "

2

ULTILET INSULIN SYRINGE 2

ULTILET PEN NEEDLE 2

ULTRA CMFT INS SYR HALF UNIT 2

ULTRA COMFORT INSULIN SYRINGE 2

ULTRACOMFORT 2

ULTRACOMFORT W/ CONTAINER 2

ULTRA-THIN II (SHORT) INS SYR 2

ULTRA-THIN II (SHORT) PEN NDL 2

ULTRA-THIN II INS PEN NEEDLES 2

ULTRA-THIN II INSULIN SYRINGE 2

UNIFINE PENTIPS 2

UNIFINE PENTIPS PLUS 2

UNISOL 4 2

UNI-SOLVE ADHESIVE REMOVER 2

UNISOLVE ADHESIVE REMOVER WIPE 2

UNISTIK 2 EXTRA 2

UNISTIK 2 NORMAL LANCET 2

UNIVERSAL REMOVER WIPES 2

UNNA-FLEX ELASTIC UNNA BOOT 2

VANISHPOINT SYRINGE SYRINGE 1 ML 29 X 1/2", 1/2 ML 30 X 1/2"

2

VARNAL 2

VASCUDERM HYDROGEL WOUND 2

VASELINE PETROLATUM GAUZE 2

137

Drug Name Tier NotesVERSALON 2

VERSALON NONWOVEN ALL-PURPOSE 2

VERSIVA XC TOPICAL BANDAGE 10 X 8 ", 4 1/4 X 4 1/4 ", 5 1/2 X 5 1/2 ", 7 1/2 X 7 1/2 ", 8 X 7 "

2

VIASORB ABSORBENT DRESSING 2

VIGILON PRIMARY WOUND DRESSING 2

VISCOPASTE PB7 2

VISINE FOR CONTACTS 2

VISTEC X-RAY DETECT 2

VORTEX ADULT MASK 2

VORTEX FROG MASK-CHILD 2

VORTEX HOLDING CHAMBER 2

VORTEX HOLDING CHAMBER CHILD 2

VORTEX HOLDING CHAMBER TODDLER 2

VORTEX LADYBUG MASK-TODDLER 2

VORTEX VHC FROG MASK-CHILD 2

VORTEX VHC LADYBUG MASK-TODDLR 2

WATCHHALER 2

WATER SHIELD BANDAGES 2

WATERPROOF STRONG STRIPS 2

WEBRIL 2

WEBRIL II 2

WET-PRUF 2

WINDMILL TRAINER 2

WOUNDGARD GAUZE 2

WOUN'DRES HYDROGEL WOUND DRESS 2

ZAROSEN DESENSITIZER 2

MUSCLE RELAXANTSAMRIX 2

baclofen 1

carisoprodol 1

carisoprodol-aspirin 1

chlorzoxazone 1

cyclobenzaprine oral tablet 1

DANTRIUM 2

dantrolene 1

FEXMID 2

GABLOFEN 2

LIORESAL 2

LORZONE 2

metaxalone 1

methocarbamol 1

orphenadrine citrate injection 1

orphenadrine citrate oral 1

138

Drug Name Tier NotesPARAFON FORTE DSC 2

REVONTO 1

ROBAXIN 2

ROBAXIN-750 2

RYANODEX 2

SKELAXIN 2

SOMA 2

tizanidine 1

ZANAFLEX 2

PRE-NATAL VITAMINSACTIVE OB 2

BAL-CARE DHA 1

BAL-CARE DHA ESSENTIAL 1

B-NEXA 2

CALCIUM PNV 1

CAVAN-ALPHA KIT 1

CAVAN-EC SOD DHA 1

CITRANATAL (DUAL-IRON) 2

CITRANATAL 90 DHA (ALGAL OIL) 2

CITRANATAL 90 DHA (NEW FORMULA 2

CITRANATAL ASSURE 2

CITRANATAL B-CALM 2

CITRANATAL B-CALM (FE GLUC) 2

CITRANATAL DHA (ALGAL OIL) 2

CITRANATAL DHA (NEW FORMULA) 2

CITRANATAL HARMONY 2

CITRANATAL HARMONY (IRON FUM) 2

CITRANATAL RX (NEW FORMULA) 2

C-NATE DHA 1

COMPLETE NATAL DHA 2

COMPLETENATE 1

CONCEPT DHA 2

CONCEPT OB 2

DOTHELLE DHA 1

DUET DHA EC-OM 3 2

DUET DHA WITH OMEGA-3 2

ELITE-OB ORAL TABLET 2

ENBRACE HR 2

EXTRA-VIRT PLUS DHA 1

FOCALGIN 90 DHA 1

FOCALGIN CA 1

FOLCAL DHA 1

FOLCAPS CARE ONE 1

FOLCAPS OMEGA-3 (ASPARTO-GLY) 1

139

Drug Name Tier NotesFOLIVANE-OB 1

FOLIVANE-PRX DHA NF 1

GESTICARE DHA 2

HEMENATAL OB 1

HEMENATAL OB + DHA 1

INATAL ADVANCE 1

INATAL ULTRA 1

MARNATAL-F 1

NATA KOMPLETE 2

NATAFORT (NEW FORMULA 2011) 2

NATELLE ONE 2

NESTABS 2

NESTABS ABC 2

NESTABS DHA 2

NEXA PLUS 2

NEXA SELECT ORAL CAPSULE 29 MG IRON- 1.25 MG-55 MG

2

NIVA-PLUS 1

NUTRI-TAB OB 1

NUTRI-TAB OB + DHA 1

OB COMPLETE 2

OB COMPLETE 400 2

OB COMPLETE ONE 2

OB COMPLETE PETITE 2

OB COMPLETE PREMIER 2

OB COMPLETE WITH DHA 2

O-CAL FA 1

O-CAL PRENATAL 1

PAIRE OB PLUS DHA 1

PNV 29-1 1

PNV FOLIC ACID + IRON 1

PNV OB+DHA ORAL COMBO PACK 27-1-50-250 MG 2

PNV-DHA 1

PNV-FERROUS FUMARATE-DOCU-FA 1

PNV-FIRST 1

PNV-SELECT 1

PNV-VP-U 1

PR NATAL 400 1

PR NATAL 400 EC 1

PR NATAL 430 1

PR NATAL 430 EC 1

PREFERA-OB 2

PREFERA-OB ONE 2

PREFERA-OB PLUS DHA 2

140

Drug Name Tier NotesPRENAISSANCE 1

PRENAISSANCE PLUS 1

PRENATA 2

PRENATAL PLUS (CALCIUM CARB) 1

PRENATAL PLUS WITH IRON (CA) 1

PRENATAL WITH DHA & FOLIC ACID 1

PRENATE AM 2

PRENATE CHEWABLE 2

PRENATE DHA 2

PRENATE DHA (FERR ASP GLYCIN) 2

PRENATE ELITE 2

PRENATE ELITE (IRON ASP GLYC) 2

PRENATE ENHANCE 2

PRENATE ESSENTIAL 2

PRENATE ESSENTIAL(IRON-ASP-GL) 2

PRENATE MINI 2

PRENATE MINI (FERR ASP GLYCIN) 2

PRENATE PIXIE 2

PRENATE RESTORE 2

PRENATE STAR 2

PRENEXA 2

PREPLUS 1

PREQUE 10 2

PRETAB 1

PROVIDA DHA 2

PROVIDA OB 2

PUREFE OB PLUS 1

PUREFE PLUS 1

REAPHIRM 1

RELNATE DHA 1

RULAVITE DHA 1

SE-CARE 1

SELECT-OB 1

SELECT-OB (FOLIC ACID) 1

SELECT-OB + DHA 2

SE-NATAL 19 1

SE-NATAL 19 (WITH DOCUSATE) 1

SE-NATAL ONE 1

SE-TAN DHA 1

TANDEM DHA 2

TANDEM OB 2

TARON-BC 1

TARON-C DHA 1

TARON-PREX PRENATAL-DHA 1

141

Drug Name Tier NotesTL FOLATE 1

TL-CARE DHA 1

TL-SELECT 1

TL-SELECT DHA 1

TRIADVANCE 1

TRICARE 2

TRICARE PRENATAL COMPLEAT 2

TRICARE PRENATAL DHA ONE 2

TRINATAL GT 1

TRINATAL RX 1 2

TRINATAL ULTRA 1

TRISTART DHA 2

TRIVEEN-DUO DHA 1

TRIVEEN-PRX RNF 1

ULTIMATE OB DHA 1

ULTIMATECARE ONE 1

ULTIMATECARE ONE NF 1

VEMAVITE-PRX-2 1

VENA-BAL DHA 1

VINATE C 1

VINATE GT 1

VIRT NATE 1

VIRT-ADVANCE 1

VIRT-BAL DHA PLUS 1

VIRT-C DHA 1

VIRT-CARE ONE 1

VIRT-NATE 1

VIRT-PN 1

VIRT-PN DHA 1

VIRT-PN PLUS 1

VIRTPREX 1

VIRT-SELECT 1

VIRT-VITE GT 1

VITAFOL NANO 1

VITAFOL ULTRA 2

VITAFOL-OB 2

VITAFOL-OB+DHA 1

VITAFOL-ONE 2

VITAFOL-PLUS 2

VIVA CT 1

V-NATAL 1

VOL-NATE 1

VOL-PLUS 1

VP CH ULTRA 1

142

Drug Name Tier NotesVP-CH PLUS 1

VP-CH-PNV 1

VP-GGR-B6 1

VP-HEME OB 1

VP-HEME ONE 1

VP-PNV-DHA 1

ZATEAN-CH 1

ZATEAN-PN 1

ZATEAN-PN DHA 1

ZATEAN-PN PLUS 1

ZINGIBER 1

PSYCHOTHERAPEUTIC DRUGSABILIFY DISCMELT ORAL TABLET,DISINTEGRATING 10 MG


ABILIFY DISCMELT ORAL TABLET,DISINTEGRATING 15 MG


ABILIFY INTRAMUSCULAR 2

ABILIFY MAINTENA 2

ABILIFY ORAL SOLUTION 2 QL (30 ML per 1 day)

ABILIFY ORAL TABLET 10 MG, 15 MG, 2 MG, 30 MG 2 QL (1 EA per 1 day)

ABILIFY ORAL TABLET 20 MG, 5 MG 2 QL (2 EA per 1 day)

ADASUVE 2

alprazolam 1

ALPRAZOLAM INTENSOL 2

amitriptyline 1

amitriptyline-chlordiazepoxide 1

amoxapine 1

ANAFRANIL 2

APLENZIN 2 QL (1 EA per 1 day)

APTENSIO XR 2

aripiprazole oral solution 1 QL (30 ML per 1 day)

aripiprazole oral tablet 10 mg, 15 mg, 2 mg, 30 mg 1 QL (1 EA per 1 day)

aripiprazole oral tablet 20 mg, 5 mg 1 QL (2 EA per 1 day)

aripiprazole oral tablet,disintegrating 10 mg 1 QL (3 EA per 1 day)

aripiprazole oral tablet,disintegrating 15 mg 1 QL (2 EA per 1 day)

ARISTADA 2

ATIVAN ORAL 2

BRINTELLIX 2 QL (1 EA per 1 day)

BRISDELLE 2 ST; QL (1 EA per 1 day)

bupropion hcl oral tablet 1

bupropion hcl oral tablet extended release 100 mg, 200 mg 1

bupropion hcl oral tablet extended release 24 hr 1

buspirone 1

CELEXA ORAL TABLET 2

143

Drug Name Tier Noteschlordiazepoxide hcl 1

chlorpromazine 1

citalopram 1

clomipramine 1

clonidine hcl oral tablet extended release 12 hr 1 QL (120 EA per 30 days)

clorazepate dipotassium 1

clozapine oral tablet 100 mg 1 QL (6 EA per 1 day)

clozapine oral tablet 200 mg, 25 mg, 50 mg 1 QL (3 EA per 1 day)

clozapine oral tablet,disintegrating 100 mg 1 QL (6 EA per 1 day)

clozapine oral tablet,disintegrating 12.5 mg, 150 mg, 200 mg, 25 mg


CLOZARIL ORAL TABLET 100 MG 2 QL (6 EA per 1 day)

CLOZARIL ORAL TABLET 25 MG 2 QL (3 EA per 1 day)

CONCERTA ORAL TABLET EXTENDED RELEASE 24HR 18 MG, 27 MG, 54 MG


CONCERTA ORAL TABLET EXTENDED RELEASE 24HR 36 MG


CYMBALTA 2 QL (2 EA per 1 day)

DAYTRANA 2 QL (1 EA per 30 days)

desipramine oral 1

desvenlafaxine fumarate oral tablet extended release 24hr 100 mg


desvenlafaxine fumarate oral tablet extended release 24hr 50 mg


desvenlafaxine oral tablet extended release 24 hr 100 mg 2 QL (2 EA per 1 day)

desvenlafaxine oral tablet extended release 24 hr 50 mg 2 QL (1 EA per 1 day)

desvenlafaxine oral tablet extended release 24hr 1 QL (1 EA per 1 day)

dexmethylphenidate oral capsule,er biphasic 50-50 1 QL (1 EA per 1 day)

dexmethylphenidate oral tablet 10 mg 1 QL (4 EA per 1 day)

dexmethylphenidate oral tablet 2.5 mg, 5 mg 1 QL (2 EA per 1 day)

diazepam injection 1

DIAZEPAM INTENSOL 1

diazepam oral concentrate 1

diazepam oral solution 5 mg/5 ml (1 mg/ml) 1

diazepam oral tablet 1

doxepin oral 1

droperidol injection solution 1

duloxetine 1 QL (2 EA per 1 day)

EFFEXOR XR 2

EMSAM 2 QL (1 EA per 1 day)

EQUETRO 2

escitalopram oxalate 1

FANAPT 2 QL (2 EA per 1 day)

FAZACLO ORAL TABLET,DISINTEGRATING 100 MG 2 QL (6 EA per 1 day)

FAZACLO ORAL TABLET,DISINTEGRATING 12.5 MG, 150 MG, 200 MG, 25 MG


144

Drug Name Tier NotesFETZIMA 2 QL (1 EA per 1 day)

fluoxetine oral capsule 1

fluoxetine oral capsule,delayed release(dr/ec) 1

fluoxetine oral solution 1

fluoxetine oral tablet 10 mg, 20 mg 1

fluoxetine oral tablet 60 mg 2

fluphenazine decanoate 1

fluphenazine hcl 1

fluvoxamine oral capsule,extended release 24hr 1 QL (2 EA per 1 day)

fluvoxamine oral tablet 1

FOCALIN ORAL TABLET 10 MG 2 QL (4 EA per 1 day)

FOCALIN ORAL TABLET 2.5 MG, 5 MG 2 QL (2 EA per 1 day)

FOCALIN XR 2 QL (1 EA per 1 day)

FORFIVO XL 2 QL (1 EA per 1 day)

GEODON INTRAMUSCULAR 2

GEODON ORAL CAPSULE 20 MG, 40 MG 2 QL (2 EA per 1 day)

GEODON ORAL CAPSULE 60 MG, 80 MG 2 QL (3 EA per 1 day)

guanfacine oral tablet extended release 24 hr 1 QL (1 EA per 1 day)

HALDOL 2

HALDOL DECANOATE 2

haloperidol 1

haloperidol decanoate 1

haloperidol lactate 1

imipramine hcl 1

imipramine pamoate 1

INTUNIV ER 2 QL (1 EA per 1 day)

INVEGA ORAL TABLET EXTENDED RELEASE 24HR 1.5 MG, 3 MG, 9 MG


INVEGA ORAL TABLET EXTENDED RELEASE 24HR 6 MG


INVEGA SUSTENNA 2

INVEGA TRINZA 2

IRENKA 2 QL (2 EA per 1 day)

KAPVAY 2 QL (120 EA per 30 days)

KHEDEZLA 2 QL (1 EA per 1 day)

LATUDA ORAL TABLET 120 MG, 20 MG, 40 MG, 60 MG


LATUDA ORAL TABLET 80 MG 2 QL (60 EA per 30 days)

LEXAPRO 2

lithium carbonate 1

lithium citrate oral solution 8 meq/5 ml 1

LITHOBID 2

LORAZEPAM INTENSOL 1

lorazepam oral 1

loxapine succinate 1

145

Drug Name Tier NotesLOXITANE 2

LUVOX CR 2 QL (2 EA per 1 day)

maprotiline 1

MARPLAN 2

meprobamate 1

METADATE CD ORAL CAPSULE, ER BIPHASIC 30-70 10 MG, 20 MG, 40 MG, 50 MG, 60 MG


METADATE CD ORAL CAPSULE, ER BIPHASIC 30-70 30 MG


METHYLIN ORAL SOLUTION 2

METHYLIN ORAL TABLET,CHEWABLE 2 QL (90 EA per 30 days)

methylphenidate oral capsule, er biphasic 30-70 10 mg, 20 mg, 40 mg, 50 mg, 60 mg


methylphenidate oral capsule, er biphasic 30-70 30 mg 1 QL (2 EA per 1 day)

methylphenidate oral capsule,er biphasic 50-50 1

methylphenidate oral solution 1

methylphenidate oral tablet 1 QL (90 EA per 30 days)

methylphenidate oral tablet extended release 10 mg 1

methylphenidate oral tablet extended release 20 mg 1 QL (90 EA per 30 days)

methylphenidate oral tablet extended release 24hr 18 mg, 27 mg, 54 mg


methylphenidate oral tablet extended release 24hr 36 mg 1 QL (2 EA per 1 day)

methylphenidate oral tablet,chewable 1 QL (90 EA per 30 days)

mirtazapine 1

modafinil 1

NARDIL 2

nefazodone 1

NIRAVAM 2

NORPRAMIN 2

nortriptyline 1

NUVIGIL 2

olanzapine intramuscular 1

olanzapine oral tablet 10 mg, 15 mg 1 QL (2 EA per 1 day)

olanzapine oral tablet 2.5 mg, 5 mg, 7.5 mg 1

olanzapine oral tablet 20 mg 1 QL (3 EA per 1 day)

olanzapine oral tablet,disintegrating 10 mg, 15 mg 1 QL (2 EA per 1 day)

olanzapine oral tablet,disintegrating 20 mg 1 QL (3 EA per 1 day)

olanzapine oral tablet,disintegrating 5 mg 1

olanzapine-fluoxetine 1 QL (1 EA per 1 day)

OLEPTRO ER 2 QL (3 EA per 2 days)

ORAP 2

oxazepam 1

paliperidone oral tablet extended release 24hr 1.5 mg, 3 mg, 9 mg


paliperidone oral tablet extended release 24hr 6 mg 1 QL (2 EA per 1 day)

146

Drug Name Tier NotesPAMELOR 2

PARNATE 2

paroxetine hcl oral tablet 1

paroxetine hcl oral tablet extended release 24 hr 1

PAXIL 2

PAXIL CR 2

perphenazine 1

perphenazine-amitriptyline 1

PEXEVA 2 QL (1 EA per 1 day)

phenelzine 1

pimozide 1

PRISTIQ ORAL TABLET EXTENDED RELEASE 24 HR 100 MG


PRISTIQ ORAL TABLET EXTENDED RELEASE 24 HR 25 MG, 50 MG


protriptyline 1

PROVIGIL 2

PROZAC ORAL CAPSULE 2

PROZAC WEEKLY 2

quetiapine oral tablet 100 mg, 200 mg, 25 mg, 50 mg 1 QL (3 EA per 1 day)

quetiapine oral tablet 300 mg, 400 mg 1 QL (4 EA per 1 day)

QUILLIVANT XR 2 QL (12 ML per 1 day)

REMERON 2

REMERON SOLTAB 2

REXULTI 2

RISPERDAL CONSTA 2

RISPERDAL M-TAB 2 QL (2 EA per 1 day)

RISPERDAL ORAL SOLUTION 2

RISPERDAL ORAL TABLET 2 QL (2 EA per 1 day)

risperidone oral solution 1

risperidone oral tablet 1 QL (2 EA per 1 day)

risperidone oral tablet,disintegrating 1 QL (2 EA per 1 day)

RITALIN 2 QL (90 EA per 30 days)

RITALIN LA 2

SAPHRIS 2 QL (2 EA per 1 day)

SAPHRIS (BLACK CHERRY) 2 QL (2 EA per 1 day)

SARAFEM ORAL TABLET 10 MG, 20 MG 2

SEROQUEL ORAL TABLET 100 MG, 200 MG, 25 MG, 50 MG


SEROQUEL ORAL TABLET 300 MG, 400 MG 2 QL (4 EA per 1 day)

SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR 150 MG, 200 MG


SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR 300 MG


SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR 400 MG


147

Drug Name Tier NotesSEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR 50 MG


sertraline 1

STRATTERA ORAL CAPSULE 10 MG, 18 MG, 25 MG, 40 MG


STRATTERA ORAL CAPSULE 100 MG, 60 MG, 80 MG 2 QL (30 EA per 30 days)

SURMONTIL 2

SYMBYAX 2 QL (1 EA per 1 day)

thioridazine 1

thiothixene 1

TOFRANIL 2

TOFRANIL-PM 2

TRANXENE T-TAB 2

tranylcypromine 1

trazodone 1

trifluoperazine 1

trimipramine 1

venlafaxine oral capsule,extended release 24hr 1

venlafaxine oral tablet 1

VERSACLOZ 2 QL (18 ML per 1 day)

VIIBRYD 2 QL (1 EA per 1 day)

VYVANSE 2 QL (1 EA per 1 day)

WELLBUTRIN 2

WELLBUTRIN SR 2

WELLBUTRIN XL 2

XANAX 2

XANAX XR 2

ziprasidone hcl oral capsule 20 mg, 40 mg 1 QL (2 EA per 1 day)

ziprasidone hcl oral capsule 60 mg, 80 mg 1 QL (3 EA per 1 day)

ZOLOFT 2

ZYPREXA INTRAMUSCULAR 2

ZYPREXA ORAL TABLET 10 MG, 15 MG 2 QL (2 EA per 1 day)

ZYPREXA ORAL TABLET 2.5 MG, 5 MG, 7.5 MG 2

ZYPREXA ORAL TABLET 20 MG 2 QL (3 EA per 1 day)

ZYPREXA RELPREVV 2

ZYPREXA ZYDIS ORAL TABLET,DISINTEGRATING 10 MG, 15 MG


ZYPREXA ZYDIS ORAL TABLET,DISINTEGRATING 20 MG


ZYPREXA ZYDIS ORAL TABLET,DISINTEGRATING 5 MG

2

SEDATIVE/HYPNOTICSAMBIEN 2 QL (1 EA per 1 day)

AMBIEN CR 2 QL (1 EA per 1 day)

AMYTAL 1

148

Drug Name Tier NotesATIVAN INJECTION 2

BELSOMRA 2 QL (1 EA per 1 day)

BUTISOL ORAL TABLET 30 MG 2

dexmedetomidine 1

EDLUAR 2 QL (1 EA per 1 day)

estazolam 1

eszopiclone 1 QL (1 EA per 1 day)

flurazepam 1

HALCION ORAL TABLET 0.25 MG 2

HETLIOZ 2 PA

INTERMEZZO 2 QL (1 EA per 1 day)

lorazepam injection solution 4 mg/ml 1

lorazepam injection syringe 1

LUNESTA 2 QL (1 EA per 1 day)

midazolam oral syrup 2 mg/ml 1

NIGHTTIME SLEEP AID (DIPHEN) 1

NYTOL 1

phenobarbital 1

phenobarbital sodium injection solution 1

PRECEDEX 2

PRECEDEX IN 0.9 % SODIUM CHLOR 2

RESTFULLY SLEEP 1

RESTORIL 2

ROZEREM 2 QL (1 EA per 1 day)

SECONAL SODIUM 2

SILENOR 2 QL (1 EA per 1 day)

SLEEP 1

SLEEP AID (DIPHENHYDRAMINE) ORAL CAPSULE 50 MG

1

SLEEP AID (DIPHENHYDRAMINE) ORAL TABLET 1

SLEEP AID (DOXYLAMINE) 1

SLEEP AID MAX STR (DIPHENHYDR) 1

SLEEP TIME 1

SLEEP-TABS 1

SOMINEX 1

SONATA 2 QL (1 EA per 1 day)

temazepam 1

triazolam 1

XYREM 2

zaleplon 1 QL (1 EA per 1 day)

zolpidem 1 QL (1 EA per 1 day)

ZOLPIMIST 2

Z-SLEEP 1

ZZZQUIL 2

149


SKIN PREPS4-N-1 NO RINSE WASH 1

8-MOP 2

ABSORICA 2 ST

ACANYA 2

acetic acid irrigation 1

acitretin 1

ACLARO 2

ACLOVATE 2

ACNE MEDICATION TOPICAL GEL 10 % 1

ACNE MEDICATION TOPICAL LOTION 10 % 1

ACNE MEDICATION TOPICAL LOTION 5 % 2

ACNE TREATMENT (BENZOYL PEROX) TOPICAL CREAM

1

ACNEFREE ACNE CLEARING SYSTEM 1

ACNEFREE SEVERE ACNE CLEARING 2

ACZONE 2

adapalene topical cream 1

adapalene topical gel 1

adapalene topical gel with pump 1

ALA-QUIN 2

alclometasone 1

ALCOHOL PADS 2

ALCOHOL PREP PADS 2

ALCOHOL PREP SWABS 2

alcohol swabs 2

ALCOHOL WIPES 2

ALCORTIN A TOPICAL GEL IN PACKET 2

ALDARA 2 PA; QL (24 EA per 30 days)

ALICLEN 1

ALOE VESTA 2

ALOE VESTA BATHING CLOTHS 2

ALOE VESTA SKIN CONDITIONER 2 1

ALOQUIN 2

ALTABAX 2

ALUVEA 2

A-MANTLE 2

amcinonide 1

ammonium and potassium iodides 1

ammonium lactate topical 1

AMNESTEEM 1

AMPHADASE 2

ANALGESIC CREME 1

ANALPRAM-HC TOPICAL 2

150

Drug Name Tier NotesANTI-DANDRUFF 1

ANTI-DANDRUFF (COAL TAR) 1

ANTI-ITCH (DIPHENHYDRAMINE) TOPICAL AEROSOL,SPRAY

1

ANTI-ITCH (HC) TOPICAL CREAM 1

ANTI-ITCH(DIPHENHYD) WITH ZINC TOPICAL AEROSOL,SPRAY

1

ANTI-ITCH(DIPHENHYD) WITH ZINC TOPICAL CREAM 2-0.1 %

1

ANTISEPTIC GEL 2

APEXICON 2

APEXICON E 2

AQUA GLYCOLIC CLEANSER 2

ARGLAES TOPICAL POWDER 2

ARTHRICREAM 1

ARTHRICREAM RUB 1

ARTHRITIS 1

ARTHRITIS PAIN RELIEF(CAPSAIC) TOPICAL CREAM 0.1 %

1

ARTISS 2

ARTISS-DUPLOJECT SYSTEM 2

ASTRINGENT 1

ATRALIN 2

AVEENO BABY TOPICAL CLEANSER 2

AVITA 1

AZELEX 2

BABY WASH 2

BANOPHEN ANTI-ITCH 1

BAZA CLEANSE & PROTECT TOPICAL LOTION 1

BAZA CLEANSE & PROTECT TOPICAL SPRAY,NON-AEROSOL

1

BAZA CLEAR 2

BAZA PROTECT 2

BD ALCOHOL SWABS 2

BEAUTY BAR 2

BEDSIDE-CARE 1

BEDSIDE-CARE PERINEAL 2

BENSAL HP TOPICAL OINTMENT 3 % 2

BENZACLIN 2

BENZACLIN PUMP 2

BENZEPRO (MICROSPHERES) 1

BENZEPRO TOPICAL FOAM 1

BENZOIN COMPOUND TOPICAL TINCTURE 10-2-8-4 %

1

benzoyl peroxide topical cleanser 10 %, 2.5 %, 5 %, 6 %, 7 %

1

151

Drug Name Tier Notesbenzoyl peroxide topical foam 1

benzoyl peroxide topical gel 10 %, 2.5 %, 5 % 1

benzoyl peroxide topical gel,alcohol based 1

benzoyl peroxide topical lotion 1

BETADINE 2

BETADINE SKIN CLEANSER 2

BETADINE SPRAY 2

BETADINE SURGICAL SCRUB 2

BETADINE SWABSTICKS 2

betamethasone dipropionate 1

betamethasone valerate 1

betamethasone, augmented 1

BETASEPT SURGICAL SCRUB 1

BLUE GEL 1

BODI BATH 2

BODI CARE 2

BODI LINE ALMOND SKIN CARE 2

BP TOPICAL CLEANSER 1

BP TOPICAL LOTION 1

BP TOPICAL SUSPENSION 1

BP-50% UREA 1

BPO CREAMY WASH PACK 1

BPO TOPICAL TOWELETTE 1

calamine 1

CALAMINE MEDICATED 1

calamine phenolated 1

calamine-zinc oxide topical lotion 8-8 % 1

calamine-zinc oxide-phenol 1

calcipotriene 1 ST

CALCITRENE 1 ST

calcitriol topical 1 ST

calcium acetate-aluminum sulf 2

CALDYPHEN CLEAR 1

CALDYPHEN TOPICAL LOTION 1-8 % 1

CALLERGY CLEAR 1

camphor (bulk) 2

CAMPHOR BLOCKS 2

camphor topical 1

CAPEX 2

capsaicin topical cream 0.025 %, 0.1 % 1

CARLESTA 2

CARMOL 10 2

CARMOL 20 2

CARRINGTON MOIST BARRIER-ZINC 2

152

Drug Name Tier NotesCARRINGTON MOISTURE BARRIER CR 2

CASTELLANI PAINT MODIFIED 2

CASTILE 2

CAVILON SKIN CLEANSER 2

CEM-UREA 1

CERAVE BABY MOISTURIZING 2

CERAVE SUNSCREEN 2

CETA-KLENZ GENTLE 2

CETAPHIL ANTIBACTERIAL 2

CETAPHIL DAILY FACIAL 2

CETAPHIL DERMACONTROL 2

CETAPHIL RESTORADERM TOPICAL CLEANSER 2

CETAPHIL TOPICAL CLEANSER 2

CHEST RUB 1

CHLOROPHYLL 2

CLARAVIS 1

clindamycin-benzoyl peroxide 1

clobetasol 1

clobetasol-emollient 1

CLOBEX 2

clocortolone pivalate 1

CLODAN 2

CLODAN KIT 2

CLODERM 2

COLD & HOT PAIN RELIEF TOPICAL ADHESIVE PATCH,MEDICATED

1

COLD SORE TREATMNT (CAMP-PHEN) 1

COMPLETE LICE TREATMENT 1

CONDYLOX 2

CORDRAN TAPE LARGE ROLL 2

CORDRAN TAPE SMALL ROLL 2

CORMAX TOPICAL OINTMENT 1

CORMAX TOPICAL SOLUTION 1

CORTIZONE-10 TOPICAL CREAM 1

COSENTYX 2 PA

COSENTYX (2 SYRINGES) 2 PA

COSENTYX PEN 2 PA

COSENTYX PEN (2 PENS) 2 PA

CRITIC-AID CLEAR 2

CURITY ALCOHOL SWABS 2

CUTIVATE TOPICAL CREAM 2

CUTIVATE TOPICAL LOTION 2

DEL-CLENS 2

DEODORANT SOAP 2

153

Drug Name Tier NotesDERMA STAT 2

DERMACINRX SILAZONE 2

DERMAL WOUND CLEANSER TOPICAL CLEANSER 2

DERMAL WOUND CLEANSER TOPICAL CLEANSER 0.13 %

1

DERMASARRA 1

DERMASEPTIN 1

DERMA-SMOOTHE/FS BODY OIL 2

DERMA-SMOOTHE/FS SCALP OIL 2

DERMATOP 2

DESONATE 2

desonide 1

DESOWEN 2

desoximetasone 1

DESQUAM-X TOPICAL CLEANSER 10 % 2

DHS 2

DHS TAR 2

DHS TAR GEL 2

DHS ZINC 1

DIAPER RASH RELIEF 1

DIAPER RASH TOPICAL OINTMENT 1

diclofenac sodium topical drops 1

DIFFERIN 2

diflorasone 1

DIPROLENE 2

DIPROLENE AF 2

DOVONEX 2 ST

DR. SMITH'S ADULT BARRIER 2

DR. SMITH'S DIAPER 1

DR. SMITH'S DIAPER RASH 2

DR. SMITH'S RASH-SKIN 2

DUAC 2

DYNA-HEX 1

DYNA-HEX (ISOPROPYL ALCOHOL) 1

EASY TOUCH ALCOHOL PREP PADS 2

ELIMITE 2

ELOCON 2

ELTA LITE TAR 1

ELTA SEAL MOISTURE BARRIER 2

ELTA TAR 2

EPI-CLENZ TOPICAL FOAM 2

EPIDUO 2

EPIDUO FORTE 2

EPIFOAM 2

154

Drug Name Tier NotesESOTERICA FADE 2

ethyl alcohol 2

EURAX 2

FABIOR 2

FINACEA 2

FINACEA PLUS 2

FLECTOR 2

fluocinolone 1

fluocinolone-shower cap 1

fluocinonide 1

FLUOCINONIDE-E 1

fluocinonide-emollient 1

fluticasone topical 1

FRESHNET 2

GEL-STAT 2

GENTLE RAIN 1

GERI-LAV 2

GLUCOPRO ALCOHOL 2

GRANULEX 1

guaiacol 2

halobetasol propionate 1

HALOG 2

HAND SANITIZER 2

HAND SANITIZING WIPES 2

HEX-ON LIGHT ODOR 2

hydrocortisone acetate topical cream 1

hydrocortisone butyrate 1

hydrocortisone butyr-emollient 1

HYDROCORTISONE PLUS 1

hydrocortisone topical 1

hydrocortisone valerate 1

hydrocortisone-aloe vera topical cream 1 % 1

hydrocortisone-min oil-wht pet 1

hydrocortisone-pramoxine topical 1

hydrogen peroxide solution 3 % 1

hydrogen peroxide topical towelette 1

hydroquinone 1

hydroquinone microspheres 1

hydroquinone with sunscreen 1

HYDROSKIN 1

HYDROSKIN WITH ALOE 1

HYGIENIC CLEANSING 1

ICY HOT MEDICATED SLEEVE 2

imiquimod 1 PA; QL (24 EA per 30 days)

155

Drug Name Tier NotesINVISIBLE ACNE 1

IODIDES TINCTURE 1

iodine-sodium iodide topical tincture 2 % 1

iodoquinol-hc 1

ISAGEL 2

ISAGEL NO RINSE 2

ISOPROPYL ALCOHOL-WINTERGREEN 1

ITCH RELIEF TOPICAL CREAM 2-0.1 % 1

ITCH-X TOPICAL GEL 2

ITCH-X TOPICAL SPRAY,NON-AEROSOL 2

IV PREP WIPES 2

KENALOG TOPICAL 2

KENDALL 2-IN-1 2

KLARON 2

LAC-HYDRIN 2

lactated ringers irrigation 2

lactic acid (bulk) liquid 2

LAZERCREME 2

LICE EGG REMOVER 1

LICE KILLING 1

LICE SOLUTION 1

LICE TREATMENT (PERMETHRIN) 1

LICE TREATMENT TOPICAL LIQUID 1 % 1

LICE TREATMENT TOPICAL SHAMPOO 1

lidocaine hcl-hydrocortison ac topical 1

lindane 1

LUSTRA 2

LUSTRA-AF 2

LUXIQ 2

malathion 1

MEDI PADS 1

MEDICATED BODY 1

MEDICATED BODY POWDER TOPICAL POWDER 0.15 %

2

MEDICATED BODY POWDER TOPICAL POWDER 0.15-1 %

1

MEDICATED CHEST RUB 1

MEDICATED WIPES TOPICAL PAD 2

MEDICATED WIPES WITH ALOE 1

MEDIPLAST CORN-CALLUS-WART 1

MENCAPS 2

methoxsalen rapid 1

METROCREAM 2

METROGEL TOPICAL GEL 1 % 2

156

Drug Name Tier NotesMETROGEL TOPICAL GEL WITH PUMP 2

METROLOTION 2

metronidazole topical 1

MIRVASO 2 QL (30 GM per 30 days)

MOBISYL 1

MOISTURE RECOVERY 2

mometasone 1

MUSCLE RUB (WITH CAMPHOR) 1

MUSCLE RUB TOPICAL CREAM 15-10 % 1

MUSCLE RUB ULTRA-STRENGTH 1

MYOFLEX 1

MYORISAN 1

NATROBA 2

NATURE'S WASH PLUS WHIRLPOOL 2

neomycin-polymyxin b gu 1

NEOSPORIN DAILY BODY 2

NEOSPORIN GU IRRIGANT 2

NEUAC 1

NEUAC KIT 2

NEUTROGENA RAINBATH 2

NEUTROGENA TONER 2

NO STING BARRIER FILM 2

NORITATE 2

OATMEAL BATH REGULAR 1

OCUSOFT FACIAL-SKIN CLEANSER 2

ODOR ELIMINATOR DROPS 2

OLUX 2

OLUX-E 2

ONEXTON 2

ORAL PEROXIDE 1

OVACE 2

OVACE PLUS SHAMPOO 2

OVACE PLUS TOPICAL CLEANSER,EXTENDED RELEASE

2

OVACE PLUS TOPICAL CREAM 2

OVACE PLUS TOPICAL FOAM 2

OVACE PLUS TOPICAL LOTION 2 ST

OVACE PLUS WASH 2

OVIDE 2

OXSORALEN 2

OXSORALEN ULTRA 2

PACNEX HP 2

PACNEX LP 2

PACNEX MX 2

157

Drug Name Tier NotesPAIN RELIEF INSTANT ANTISEPTIC 1

PAIN RELIEVING (MENTHOL) TOPICAL GEL 3.5 % 2

PAIN RELIEVING RUB 1

PANDEL 2

PANOXYL TOPICAL BAR 2

PANOXYL TOPICAL CLEANSER 1

PANOXYL TOPICAL CREAM 2

PANOXYL-4 1

PEDIADERM HC 2

PEDIADERM TA 2

PEDI-BORO SOAK 1

PENNSAID 2 ST

PERIFRESH 2

PERIGIENE 2

PERIGUARD 1

PERISCENT 2

permethrin 1

PHISOHEX 2

PHYSIOLYTE 2

PHYSIOSOL IRRIGATION 2

pine tar (bulk) 2

PODOCON 1

podofilox 1

povidone-iodine topical ointment 1

povidone-iodine topical solution 10 % 1

PRAMEGEL ANTI-ITCH 2

PRAMOSONE 2

PRAMOSONE E 2

prednicarbate 1

PROSHIELD PLUS 1

PROSHIELD PLUS SKIN PROTECTANT 2

PROSHIELD PROTECTIVE HAND 2

PRUDOXIN 2

PSORCON 2

PYRETHRIN LICE TREATMENT M 1

QUTENZA 2 PA

REA LO 30 2

REGRANEX 2

REHYLA HAIR-BODY 2

REMEDY 4-IN-1 CLEANSER 1

REMEDY CALAZIME PROTECT PASTE TOPICAL PASTE 3.5-0.2-69-16.5 %

2

REMEDY CLEAR-AID PROTECT 2

REMEDY DIMETHICONE CREAM 2

158

Drug Name Tier NotesREMEDY NUTRASHIELD SKIN PROTEC 2

REMEDY PHYTOPLEX Z-GUARD 2

REMEDY PHYTOPLEX Z-GUARD (ZN) 2

REMEDY SKIN REPAIR 2

RENEWAL HAND SANITIZER 2

RETIN-A 2

RETIN-A MICRO 2

RETIN-A MICRO PUMP 2

ringers irrigation 1

ROSADAN TOPICAL CREAM 1

ROSADAN TOPICAL GEL 2

ROSADAN TOPICAL KIT, CLEANSER & GEL 2

ROSADAN TOPICAL KIT,CLEANSER AND CREAM 2

RUBBING ALCOHOL (ETHANOL) 2

SALACTIC FILM 1

SALEX 2

salicylic acid sr-ceramides topical kit,cleanser & cream er 1

salicylic acid topical cream 1

salicylic acid topical film forming liquid w/appl 27.5 % 1

salicylic acid topical foam 1

salicylic acid topical gel 1

salicylic acid topical liquid 26 % 1

salicylic acid topical lotion 1

salicylic acid topical shampoo 1

SAL-PLANT 1

SANI-PADS 1

SANTYL 2

SARNA ANTI-ITCH 2

SCALPICIN ANTI-ITCH 1

SE BPO TOPICAL KIT,CLEANSER AND CREAM 1

SEBEX 1

SEB-PREV 1

SECURA DIMETHICONE TOPICAL CREAM 1

SECURA EXTRA PROTECTIVE 2

SECURA MOISTURIZING TOPICAL CLEANSER 1

SECURA PERSONAL 1

SECURA PERSONAL SKIN CARE 2

SECURA PROTECTIVE TOPICAL CREAM 2

SECURA PROTECTIVE TOPICAL OINTMENT 1

SECURA STARTER KIT 2

SECURA TOTAL BODY CLEANSER 2

SECURA TWO-STEP KIT 2

selenium sulfide 1

SELSUN BLUE (SALICYLIC ACID) 1

159

Drug Name Tier NotesSELSUN BLUE MOISTURIZING 2

SELSUN BLUE NATURALS 1

SENSI-CARE (FOAM) 2

SENSI-CARE MOISTURIZING 2 2

silver nitrate topical solution 0.5 % 1

SILVERMED TOPICAL CLEANSER 2

SKIN CLEANSER 2

SKINTEGRITY WOUND CLEANSER 2

SKLICE 2

sodium chloride irrigation 1

SOOLANTRA 2

SOOTHE & COOL BODY POWDER 2

SOOTHE & COOL FREE MEDSEPTIC 2

SOOTHE & COOL INZO BARRIER 2

SOOTHE & COOL MEDSEPTIC 2

SOOTHE & COOL MOISTURE BARRIER 2

SOOTHE & COOL SKIN PASTE 1

SOOTHE & COOL TOPICAL SOAP 2

sorbitol irrigation 1

sorbitol-mannitol 1

SORIATANE ORAL CAPSULE 10 MG, 17.5 MG, 25 MG 2

SORILUX 2 ST

spinosad 1

sulfacetamide sodium (acne) 1

sulfacetamide sodium topical 1

sulfacetamide sodium-urea 1

SURE COMFORT ALCOHOL PREP PADS 2

SURE-PREP ALCOHOL PREP PADS 2

SYNALAR 2

SYNALAR CREAM KIT 2

SYNALAR OINTMENT KIT 2

SYNALAR TS 2

TAZORAC 2

TEMOVATE 2

TEMOVATE E 2

TEXACORT 2

THERA-GEL 1

THERA-GESIC PLUS 2

THERA-GESIC TOPICAL CREAM 15-1 % 1

THERAPEUTIC MINERAL ICE 1

THERASEAL 1

TOPICORT TOPICAL CREAM 2

TOPICORT TOPICAL GEL 2

TOPICORT TOPICAL OINTMENT 2

160

Drug Name Tier NotesTOPICORT TOPICAL SPRAY,NON-AEROSOL 2 ST

TRANS-VER-SAL PLANTARPATCH 2

tretinoin microspheres 1

tretinoin topical 1

triamcinolone acetonide topical 1

TRIANEX 1

TRI-LUMA 2

TRIXAICIN 1

TRIXAICIN HP 1

trolamine salicylate 1

U-CORT 1

ULESFIA 2

ULTILET ALCOHOL SWAB 2

ULTRACIN T 1

ULTRA-FRESH TOPICAL 2

ULTRAVATE 2

ULTRAVATE PAC 2

ULTRAVATE X 2

UMECTA NAIL FILM PEN 2

UMECTA PD 2

UMECTA TOPICAL EMULSION 2

UMECTA TOPICAL FOAM 1

UMECTA TOPICAL NAIL FILM SUSPENSION 2

URAMAXIN GT 2

URAMAXIN TOPICAL CREAM 2

URAMAXIN TOPICAL FOAM 2

URAMAXIN TOPICAL LOTION 2

urea topical cream 39 %, 40 % 1

urea topical foam 1

urea topical gel 1

urea topical lotion 40 %, 45 % 1

urea topical nail film suspension 1

VANOS 2

VAPORX BALM 2

VECTICAL 2 ST

VELTIN 2

VICKS VAPORUB TOPICAL OINTMENT 4.7-1.2-2.6 % 2

VICKS VAPORUB TOPICAL OINTMENT 4.8-1.2-2.6 % 1

vitamin a and d 1

VITRASE 2

vits a and d-white pet-lanolin topical ointment in packet 1

VOLTAREN TOPICAL 2

water for irrigation, sterile 1

WEBCOL 2

161

Drug Name Tier NotesWESTCORT TOPICAL OINTMENT 2

WITCH HAZEL 1

witch hazel leaf (hamamelis) 1

WOUND & SKIN CLEANSER 2

WOUND CLEANSER 2

WOUND GEL 2

XERAC AC 2

ZENATANE 1

ZIANA 2

ZIKS ARTHRITIS PAIN RELIEF 2

zinc oxide topical ointment 20 % 1

ZONALON 2

ZYCLARA TOPICAL CREAM IN METERED-DOSE PUMP 2.5 %

2 PA; QL (7.5 GM per 1 day)

ZYCLARA TOPICAL CREAM IN METERED-DOSE PUMP 3.75 %

2 PA; QL (7.5 GM per 28 days)

ZYCLARA TOPICAL CREAM IN PACKET 2 PA; QL (1 EA per 1 day)

SMOKING DETERRENTSBUPROBAN 1

CHANTIX 2 QL (2 EA per 1 day)

CHANTIX CONTINUING MONTH BOX 2 QL (2 EA per 1 day)

CHANTIX STARTING MONTH BOX 2 QL (2 EA per 1 day)

NICODERM CQ TRANSDERMAL PATCH 24 HOUR 14 MG/24 HR, 7 MG/24 HR

2

NICORELIEF 1

NICORETTE BUCCAL GUM 4 MG 2

NICORETTE BUCCAL LOZENGE 2

nicotine (polacrilex) 1

nicotine transdermal patch 24 hour 14 mg/24 hr, 21 mg/24 hr, 7 mg/24 hr

1

nicotine transdermal patch, td daily, sequential 2

NICOTROL 2 QL (1008 EA per 90 days)

NICOTROL NS 2 QL (160 ML per 90 days)

ZYBAN 2

THYROID PREPSARMOUR THYROID 2

CYTOMEL 2

levothyroxine 1

LEVOXYL ORAL TABLET 100 MCG, 112 MCG, 125 MCG, 137 MCG, 150 MCG, 175 MCG, 200 MCG, 25 MCG, 50 MCG, 75 MCG, 88 MCG

2

liothyronine 1

methimazole oral tablet 10 mg, 5 mg 1

NP THYROID 1

propylthiouracil 1

162

Drug Name Tier NotesSYNTHROID 2

TAPAZOLE 2

THYROGEN 2

THYROLAR-1 2

THYROLAR-1/2 2

THYROLAR-1/4 2

THYROLAR-2 2

THYROLAR-3 2

TIROSINT 2

TRIOSTAT 2

UNITHROID 2

UNCLASSIFIED DRUG PRODUCTSacamprosate 1

ACETADOTE 2

acetone 2

acetylcysteine intravenous 1

ACTIDOSE/SORBITOL 2

ACTIDOSE-AQUA 1

ACTONEL ORAL TABLET 35 MG 2 ST; QL (1 EA per 7 days)

ADAGEN 2

adipic acid 2

ADVANCED EYE HEALTH 1

ALCOHOL, DENATURED 2

alcohol, reagent 2

ALDURAZYME 2

alendronate oral solution 1 QL (75 ML per 7 days)

alendronate oral tablet 1

alfuzosin 1

almond oil, sweet (bulk) 2

aluminum monostearate 2

amaranth 2

amifostine crystalline 1

anise 2

ANTABUSE 2

APPLE FLAVORING 2

APPLE-ADE FLAVOR 2

AQUA LUBE 2

AQUA LUBE ADVANCED FORMULA GEL 2

AQUABASE 2

AR CAPS 2

ARALAST NP 2

ARCALYST 2

ATELVIA 2 ST; QL (1 EA per 7 days)

BACTERIOSTATIC WATER(PARABENS) 1

163

Drug Name Tier NotesBAL IN OIL 2

BANANA CONCENTRATE 2

BANANA CREAM FLAVOR 2

banana flavor (bulk) 2

BASE, PCCA SYRUP VEHICLE 2

BEEF FLAVOR 2

BENLYSTA 2

bentonite 2

benzaldehyde 2

bergamot oil, imitation 2

BERINERT INTRAVENOUS KIT 2 PA

BHT 2

BINOSTO 2 ST; QL (1 EA per 7 days)

bitter mask flavoring (bulk) 2

BITTERNESS MASK FLAVOR 2

BLUEBERRY FLAVOR 2

BODI LOTION 2

BONIVA INTRAVENOUS 2 ST

BONIVA ORAL 2

BRIJ 30 2

BRIJ 35 POWDER 2

BRIJ 58 2

BRIJ 78 2

BRIJ 99 2

BUBBLE GUM CONCENTRATE 2

BUBBLE GUM FLAVORING 2

bubblegum flavor (bulk) 2

BUNAVAIL BUCCAL FILM 2.1-0.3 MG 2 PA; QL (1 EA per 1 day)

BUNAVAIL BUCCAL FILM 4.2-0.7 MG, 6.3-1 MG 2 PA; QL (2 EA per 1 day)

buprenorphine hcl sublingual 1 PA; QL (3 EA per 1 day)

buprenorphine-naloxone 1 PA; QL (3 EA per 1 day)

BUTTER RUM FLAVORING 2

BUTTERSCOTCH FLAVORING 2

butylated hydroxytoluene 2

calcipotriene-betamethasone 1 ST

CALCIUM DISODIUM VERSENATE 2

CAMPRAL 2

CAMPRAL DOSE PAK 2

CAPSUBLEND-H 2

CAPSUBLEND-P 2

CAPSUBLEND-S 2

CAPSULE #0 2

CAPSULE #0 (CELLULOSE) 2

CAPSULE #0 (HYPROMELLOSE) 2

164

Drug Name Tier NotesCAPSULE #0 DRCAPS 2

CAPSULE #00 2



CAPSULE #1 2



CAPSULE #1 DRCAPS 2

CAPSULE #10 2

CAPSULE #11 2

CAPSULE #12 2

CAPSULE #13 2

CAPSULE #2 2


CAPSULE #3 2



CAPSULE #4 2

CAPSULE #5 2

CAPSULE #7 2

CAPSULE CONI-SNAP #0 (GELATIN) 2

CAPSULE CONI-SNAP #0(HYPROMEL) 2

CAPSULE CONI-SNAP #00 (GELATIN 2

CAPSULE CONI-SNAP #000 2







CAPSULE,WHITE OPAQUE GELATN #1 2

CARBAGLU 2

CARBOMER 934P RESIN 2

carbomer 940 (bulk) 2

carbomer homopolymer c (bulk) 2

carmine 2

CARNITOR 2

CARNITOR SUGAR-FREE 2

CARTICEL 2

castor oil 2

cellulose (bulk) powder 2

CERDELGA 2 PA

CEREZYME 2

cheesecake flavor (bulk) 2

165

Drug Name Tier NotesCHEMET 2

chlorhexidine gluconate mucous membrane 1

chocolate flavor (bulk) liquid 2

cholesterol 2

CINNAMON FLAVORING 2

CINRYZE 2 PA

citric acid 2

citronella oil 2

CLOVE FLAVORING 2

CO Q-10 ORAL CAPSULE 100 MG 1

cocoa butter 2

cocoa butter (bulk) 2

cocoa butter (bulk) topical bar 2

coconut oil (bulk) 2

cottonseed oil (bulk) 2

cpd vehicle sus.sugar-free #12 2

cream de menthe (bulk) 2

CREME DE MENTHE FLAVORING 2

CRYOSERV 2

CUROSURF 2

CYSTADANE 2

CYSTAGON 2

deferoxamine 1

DELBASE COMPOUNDING 2

DERMABASE 2

DERMAFIX TOPICAL OINTMENT 2

DERMANIC 2

DESFERAL 2

DETROL 2 ST

DETROL LA 2 ST

dexrazoxane hcl 1

DIAFOODS THICK-IT 2

DIAFOODS THICK-IT #2 2

DILUENT FOR EPOPROSTENOL/FLOLA 1

DILUENT FOR YF-VAX (1 DOSE) 2

DILUENT FOR YF-VAX (5 DOSE) 2

DILUENT-MERCK LIVE VIRUS VACC 2

disulfiram 1

DITROPAN XL 2

DIVISTA 2

doxercalciferol 1

doxycycline hyclate oral tablet 20 mg 1

ELAPRASE 2

ELELYSO 2

166

Drug Name Tier NotesENABLEX 2 ST

ENGLISH TOFFEE FLAVOR 2

ESBRIET 2 PA

ethyl acetate 2

ethyl vanillin 2

etidronate disodium 1

eucalyptol 2

EUCALYPTUS FLAVOR 2

eucalyptus oil oil 100 % 2

EVISTA 2 QL (1 EA per 1 day)

EXJADE 2

EZ CHAR 2

FABRAZYME 2

FATTIBASE 2

FATTYBLEND 2

FERRIPROX 2

finasteride oral tablet 5 mg 1

FIRAZYR 2 PA

FLAVOR BLEND 2 IN 1 2

FLAVOR PACKETS 2

FLAVOR PLUS 2

FLAVOR SWEET 2

FLAVOR SWEET-SF 2

FLAVORX 2

FLAVOUR PAC 2

flavoxate 1

FLOMAX 2

flumazenil 1

fomepizole 1

FORTEO 2 QL (2.4 ML per 28 days)

FOSAMAX ORAL TABLET 70 MG 2

FOSAMAX PLUS D 2

FP NATURAL LOTION 2

FUSILEV 2

GALZIN 2

gelatin (bulk) 2

gelatin oral capsule 650 mg 2

GELFILM IMPLANT 2

GELNIQUE 2 ST

GLASSIA 2

glutathione (bulk) 2

glyceryl monostearate 2

GRAPEFRUIT 2

guar gum 2

167

Drug Name Tier Notesguava flavor (bulk) 2

HECTOROL 2

HICON 2

hydrophilic 2

HYDROPHILIC OINTMENT BASE(FAG) 2

HYDROPHILIC PETROLATUM 2

hydroxypropyl cellulose 2

HYLENEX 2

hypromellose 2

ibandronate intravenous solution 1 ST

ibandronate oral 1

ILARIS (PF) 2

INSTA-CHAR 1

INSTA-CHAR-SORBITOL 1

INSTACLEAN 2

INSTANT FOOD THICKENER 2

isopropyl alcohol solution 70 %, 91 % 2

isopropyl palmitate 2

JADENU 2

JOHNSON'S BABY LOTION 2

JOHNSON'S BODY CARE 2

KALBITOR 2

KALYDECO 2 PA; QL (2 EA per 1 day)

KEVEYIS 2

KUVAN 2

lanolin anhydrous 2

LEMON EXTRACT FLAVOR 2

lemon flavor extract (bulk) 2

LEMON FLAVORING 2

leucovorin calcium injection recon soln 1

leucovorin calcium oral 1

levocarnitine (with sugar) 1

levocarnitine intravenous 1

levocarnitine oral tablet 1

levoleucovorin calcium 1

LIME FLAVOR 2

LIP TREATMENT 2

LUMIZYME 2

MAGNASWEET 110 2

MAGNASWEET 135 2

magnesium stearate 2

marshmallow flavor (bulk) 2

MEGACE 2

MEGACE ES 2

168

Drug Name Tier Notesmegestrol oral suspension 1

mesna 1

MESNEX 2

METHAZEL 2

METHOCEL E 4 M 2

methyl alcohol 2

methylcellulose 2

methylcellulose 1500cps (bulk) 2

methylcellulose 4000cps (bulk) 2

methylene blue (antidote) 1

methylene blue (bulk-solid) 2

MINERAL OIL HEAVY 2

MURI-LUBE 2

mustard oil 2

MYOZYME 2

NAGLAZYME 2

NESTLE FLAVOR 2

NIACIN-AZE AC-TURMER-FA-B6-ZN 1

NICADAN 2

nutmeg oil 2

OFEV 2 PA

oleic acid 2

OMEGA-3 IQ CHILDREN'S 2

ORAL MIX 2

ORAL MIX SF 2

ORAL SUSPEND 2

ORAL SYRUP 2

ORAL SYRUP SF 2

ORALONE 1

orange 2

ORANGE CONCENTRATE 2

orange oil 2

ORA-PLUS 2

ORA-SWEET 2

ORA-SWEET SF 2

ORFADIN 2

ORKAMBI 2 PA

OSPHENA 2 QL (1 EA per 1 day)

oxybutynin chloride oral 1

OXYTROL 2 ST

pamidronate 1

PANHEMATIN 2

paraffin 2

paricalcitol hemodialysis port injection 2

169

Drug Name Tier Notesparicalcitol oral 1

PCCA-PLUS BASE 2

PEANUT BUTTER FLAVOR 2

PENTRAVAN 2

PEPPERMINT FLAVORING 2

petrolatum, yellow (bulk) 2

PETROLEUM JELLY 2

PETROLEUM JELLY, WHITE 2

polyethylene glycol 8000(bulk) powder 100 % 2

polyoxyl 40 stearate 2

polyoxyl 40 stearate (bulk) 2

polysorbate 40 2

polysorbate 60 2

polysorbate 80 2

PROCYSBI 2 PA

PRODERM 1

PROLASTIN-C 2

PROLIA 2

propylene glycol 2

propylene glycol (bulk) 2

PROSCAR 2

PROTOPAM CHLORIDE 2

PULMOZYME 2 PA; QL (5 ML per 1 day)

PUMPKIN FLAVOR 2

Q-CARE RX Q2 2

Q-CARE RX Q4 2

Q-GEL WITH ALPHA LIPOIC ACID 2

RADIAGEL 2

raloxifene 1 QL (1 EA per 1 day)

RAPAFLO ORAL CAPSULE 4 MG 2 ST

raspberry 2

raspberry flavor, artificial 2

RASPBERRY FLAVORING 2

RECLAST 2

resveratrol oral capsule 250 mg 2

risedronate oral tablet,delayed release (dr/ec) 1 ST; QL (1 EA per 7 days)

root beer flavor (bulk) 2

rose oil 2

ROSE WATER 2

rosin (bulk) powder 2

RUCONEST 2 PA

sassafras oil 2

SAVELLA 2

SENSIPAR 2

170

Drug Name Tier Notessesame oil 2

silica 2

simple syrup 2

SIMPLYTHICK ORAL GEL 2

sodium bisulfite 2

sodium chloride inhalation 1

sodium silicate 2

sodium succinate 2

SOMAVERT 2

SORBIDON HYDRATE 2

sorbitol solution 2

SPEARMINT FLAVORING 2

spearmint oil 2

stearic acid 2

stearyl alcohol 2

STERILE WATER FOR INJECTION 1

strawberry flavor (bulk) 2

STRAWBERRY FLAVORING 2

SUBOXONE SUBLINGUAL FILM 12-3 MG 2 PA; QL (2 EA per 1 day)

SUBOXONE SUBLINGUAL FILM 2-0.5 MG, 4-1 MG, 8-2 MG


SURFAXIN 2

SURVANTA 2

SUSPENDOL-S 2

SWEET-SF 2

SYPRINE 2

SYRPALTA VEHICLE 2

SYRSPEND SF 2

SYRSPEND SF ALKA 2

SYRSPEND SF LIQUID 2

SYRUP VEHICLE SF 2

TACLONEX 2 ST

tamsulosin 1

TANGERINE OIL, NATURAL 2

THICK NOW 2

THICKEN UP CLEAR 2

THICKENUP LEMON HONEY 2

THICKENUP LEMON NECTAR 2

THICK-IT 2

THICK-IT #2 2

THIOLA 2

tolterodine 1 ST

tolu balsam 2

TOVIAZ 2 ST

171

Drug Name Tier NotesTOZAL 2

tragacanth powder 2

triamcinolone acetonide dental 1

trospium 1 ST

tutti-frutti flavor (bulk) 2

TYBOST 2 PA

TYSABRI 2

UROXATRAL 2

VANILLA BUTTERNUT FLAVOR 2

vanilla butternut flavor(bulk) 2

vanillin (bulk) 2

VASELINE 2

VERSA FREE 2

VERSA PLUS 2

VESICARE 2 ST

VIMIZIM 2

VISUDYNE 2

VIVITROL 2

VPRIV 2

VP-ZEL 1

water for inject, bacteriostat 1

water for injection, sterile 1

WATERMELON FLAVORING 2

WHITE WAX (BEESWAX) 2

wild cherry flavor (bulk) 2

WINTERGREEN FLAVORING 2

WITEPSOL H-15 2

XGEVA 2

XIAFLEX 2

XOFIGO 2

YELLOW WAX (BEESWAX) 2

ZAVESCA 2 PA

ZEMAIRA 2

ZEMPLAR 2

zinc stearate 2

ZINECARD (AS HCL) 2

zoledronic acid 1

zoledronic acid-mannitol-water 1

ZOMETA 2

ZUBSOLV SUBLINGUAL TABLET 1.4-0.36 MG, 11.4-2.9 MG, 5.7-1.4 MG, 8.6-2.1 MG

2 PA

VITAMINSADULT MULTIVITAMIN (W-LUTEIN) 1

ADVANCED AM-PM 1

172

Drug Name Tier NotesAQUASOL A 2

ascorbic acid injection 1

B COMPLEX 100 INJECTION 1

BABY VITAMIN D3 1

BACMIN 1

CALCIJEX 2

calcitriol intravenous solution 1 mcg/ml 1

calcitriol oral 1

CENTRUM FLAVOR BURST ADULT 2

cholecalciferol (vitamin d3) oral capsule 10,000 unit 1

cod liver oil oral oil 1

COD LIVER OIL PLUS VIT A & D3 1

CORVITA 2

CORVITE 2

CORVITE FREE 2

cyanocobalamin (vitamin b-12) injection 1

DECARA ORAL CAPSULE 25,000 UNIT 2

DECARA ORAL CAPSULE 50,000 UNIT 1

DIALYVITE 1

DIALYVITE 3000 1

DIALYVITE 5000 2

DIALYVITE SUPREME D 2

DRISDOL ORAL CAPSULE 2

ENLYTE (FERROUS GLYCINE) 2

ergocalciferol (vitamin d2) oral capsule 1

ergocalciferol (vitamin d2) oral drops 1

ESCAVITE 2

ESCAVITE D 2

ESCAVITE LQ 2

FABB 1

FALESSA 2

fa-niacinamide-cupric ox-zinc 1

FLORIVA ORAL TABLET,CHEWABLE 0.25MG FLUORIDE (0.55 MG)

2

FOLASTIN 1

FOLCAPS 1

FOLGARD 2

folic acid injection 1

folic acid oral tablet 1 mg 1

FOLTRATE 2

hydroxocobalamin 1

INFUVITE ADULT 2

INFUVITE PEDIATRIC 2

levomefolate calcium 1

173

Drug Name Tier NotesL-METHYL-B6-B12 1

L-METHYL-MC 1

L-METHYL-MC NAC 1

M.V.I. ADULT 2

M.V.I. PEDIATRIC 2

M.V.I.-12 (WITHOUT VITAMIN K) 2

MEN'S MULTIVITAMIN GUMMIES 1

MEPHYTON 2

MI-OMEGA NF 1

MULTI-VIT WITH FLUORIDE & IRON 1

MULTIVITAMIN WITH FLUORIDE 1

MULTI-VITAMIN WITH FLUORIDE 1

MULTIVITAMINS WITH FLUORIDE 1

multivit-min-iron fum-folic ac 2

MVC-FLUORIDE ORAL TABLET,CHEWABLE 0.25 MG, 0.5 MG

1

NASCOBAL 2

NEPHPLEX RX 1

NEPHROCAPS 1

NEPHRONEX-SL 2

niacin oral capsule, extended release 250 mg, 500 mg 1

niacin oral powder 2

niacin oral tablet 500 mg 1

niacin oral tablet extended release 500 mg 1

NICOMIDE 2

NICOMIDE (SELENIUM-CHROMIUM) 2

NIVA-FOL 2

phytonadione injection 1

PURALOR CI 2

pyridoxine injection 1

QUFLORA PEDIATRIC 1

QUFLORA PEDIATRIC DROPS 1

RENAL CAPS 1

RENO CAPS 1

ROCALTROL 2

STROVITE FORTE 1

STROVITE ONE 2

SUPER B MAXI COMPLEX 1

thiamine hcl injection 1

THRIVITE RX 2

TL GARD RX 1

TL-FLUORIVITE 1

TRIPHROCAPS 1

TRIPLE VITAMIN WITH FLUORIDE 1

174

Drug Name Tier NotesTRI-VIT WITH FLUORIDE & IRON 1

TRI-VITAMIN WITH FLUORIDE 1

TROPICAL LIQUID NUTRITION 2

UDAMIN SP 2

VASCULERA 2

VIRT-CAPS 1

VIRT-VITE 1

VIRT-VITE FORTE 1

VIRT-VITE PLUS 1

VIT 3 1

VITAL-D RX 1

VITAMIN B-12 ORAL TABLET 1,000 MCG 1

VITAMIN D2 1

VITAMIN D3 ORAL TABLET 1,000 UNIT, 2,000 UNIT 1

vitamin e (dl, acetate) oral capsule 400 unit 1

VITAMIN K INJECTION 1

VITAMIN K1 INJECTION 1

VITAMINS A,C,D & FLUORIDE 1

VOL-CARE RX 1

VP-VITE RX 1

WOMEN'S MULTIVITAMIN GUMMIES 1

ZAVARA 2

175

176

Index

Index

12 HOUR NASAL SPRAY .............................. 881ST TIER UNIFINE PENTIPS ................. 1221ST TIER UNIFINE PENTIPS PLUS...................................................................................................... 1223 DAY VAGINAL .................................................... 303-DAY VAGINAL .................................................... 303M NEXCARE DURAPORE ..................... 1224 WAY ................................................................................... 884-N-1 NO RINSE WASH ............................... 1508 HOUR PAIN RELIEVER ................................ 38-MOP ................................................................................. 150abacavir ................................................................................. 46abacavir-lamivudine-zidovudine ................. 47ABATINEX ................................................................... 101ABELCET .......................................................................... 30ABILIFY .......................................................................... 143ABILIFY DISCMELT ....................................... 143ABILIFY MAINTENA ..................................... 143ABLAVAR ........................................................................ 85ABRAXANE ................................................................... 40ABREVA ............................................................................. 47ABSORBENT COTTON BALLS ......... 122ABSORICA ................................................................... 150ABSTRAL ............................................................................. 3acamprosate ................................................................... 163ACANYA ........................................................................ 150acarbose ................................................................................. 37ACCOLATE .................................................................... 17ACCU-CHEK FASTCLIX ............................ 122ACCU-CHEK MULTICLIX LANCET...................................................................................................... 122ACCU-CHEK SOFT DEV LANCETS...................................................................................................... 122ACCU-CHEK SOFTCLIX LANCET DEV ....................................................................................... 122ACCUPRIL ....................................................................... 61ACCURETIC .................................................................. 61ACE AEROSOL CLOUD ENHANCER...................................................................................................... 122acebutolol ............................................................................ 61ACEPHEN ............................................................................. 3ACETADOTE ............................................................. 163ACETA-GESIC ................................................................ 3acetaminophen ................................................................... 3ACETAMINOPHEN PM ....................................... 3acetaminophen-codeine ............................................ 3ACETASOL HC .......................................................... 88acetazolamide .................................................................. 86acetazolamide sodium ............................................. 86ACETEST ........................................................................... 85acetic acid .............................................................. 88, 150acetic acid-aluminum acetate .......................... 88acetone ................................................................................ 163acetylcysteine ..................................................... 17, 163ACID CONTROL (RANITIDINE) ....... 101ACID CONTROLLER ....................................... 101ACID GONE ANTACID ................................ 101ACID GONE ANTACID E.STRENGTH...................................................................................................... 101ACID REDUCER (CIMETIDINE) ....... 101ACID REDUCER (FAMOTIDINE) .... 101ACID REDUCER (RANITIDINE) ....... 101ACIPHEX SPRINKLE ...................................... 101

Index

acitretin ............................................................................... 150ACLARO ......................................................................... 150ACLOVATE ................................................................. 150ACNE MEDICATION ....................................... 150ACNE TREATMENT (BENZOYL PEROX) ............................................................................. 150ACNEFREE ACNE CLEARING SYSTEM .......................................................................... 150ACNEFREE SEVERE ACNE CLEARING ................................................................... 150ACTEMRA .................................................................... 121ACTHAR H.P. ............................................................ 116ACTHIB (PF) .................................................................. 52ACTHREL ...................................................................... 116ACTIDOSE/SORBITOL ................................. 163ACTIDOSE-AQUA .............................................. 163ACTIGALL ................................................................... 101ACTIMMUNE ............................................................... 40ACTIQ ....................................................................................... 3ACTIVASE ....................................................................... 57ACTIVE FE ...................................................................... 93ACTIVE OB ................................................................. 139ACTIVELLA ............................................................... 116ACTONEL ...................................................................... 163ACTOPLUS MET XR ........................................... 37ACTOS .................................................................................. 37ACULAR ............................................................................. 88ACULAR LS ................................................................... 88ACUVAIL (PF) ............................................................ 88acyclovir ............................................................................... 47acyclovir sodium .......................................................... 47ACZONE .......................................................................... 150ADACEL(TDAP ADOLESN/ADULT)(PF) .................................. 52ADAGEN ........................................................................ 163ADALAT CC .................................................................. 59adapalene .......................................................................... 150ADASUVE ..................................................................... 143ADCETRIS ....................................................................... 40ADCIRCA .......................................................................... 61ADDAMEL N ................................................................ 93ADDED STRENGTH HEADACHE RELIEF ..................................................................................... 3ADDERALL .................................................................... 50ADDERALL XR ......................................................... 50adefovir .................................................................................. 47ADEMPAS ........................................................................ 61ADENOCARD .............................................................. 59ADENOSCAN ............................................................... 85adenosine ............................................................................. 59adenosine (diagnostic) ............................................ 85adenovirus vac live type-4, 7 ........................... 52adenovirus vaccine live type-4 ...................... 52adenovirus vaccine live type-7 ...................... 52adhesive bandage ..................................................... 122adhesive bandage-adhes remov#1 ........... 122ADHESIVE DRESSING ................................. 122ADHESIVE GAUZE PAD ............................ 122ADHESIVE PADS ................................................. 122adhesive remover ..................................................... 122adhesive tape ................................................................. 122adipic acid ........................................................................ 163ADOXA ................................................................................ 19

Index

ADRENACLICK ........................................................ 50ADRENALIN ................................................................. 50ADRUCIL .......................................................................... 40ADULT MULTIVITAMIN (W-LUTEIN)...................................................................................................... 172ADULT TUSSIN CHEST CONGESTION ............................................................. 75ADULT TUSSIN COUGH CONGEST DM ............................................................................................. 75ADULT TUSSIN DM ............................................ 75ADULT TUSSIN MULTI-SYMP COLD......................................................................................................... 75ADVAIR DISKUS .................................................... 17ADVAIR HFA ............................................................... 17ADVANCED AM-PM ....................................... 172ADVANCED ANTACID-ANTIGAS...................................................................................................... 101ADVANCED ANTIBACTERIAL BANDAGE .................................................................... 122ADVANCED EYE HEALTH .................... 163ADVANCED FORMULA EYE DROPS......................................................................................................... 88ADVATE ............................................................................. 57ADVICOR .......................................................................... 62ADVOCATE PEN NEEDLES .................. 122ADVOCATE SYRINGES .............................. 122AEROCHAMBER MINI ................................. 122AEROCHAMBER MV ..................................... 122AEROCHAMBER PLUS FLOW-VU...................................................................................................... 122AEROCHAMBER PLUS FLOW-VU,L MSK ...................................................................................... 122AEROCHAMBER PLUS FLOW-VU,M MSK ...................................................................................... 122AEROCHAMBER PLUS FLOW-VU,S MSK ...................................................................................... 122AEROCHAMBER PLUS Z STAT ....... 122AEROCHAMBER PLUS Z STAT LG MSK ...................................................................................... 122AEROCHAMBER PLUS Z STAT MD MSK ...................................................................................... 122AEROCHAMBER PLUS Z STAT SM MSK ...................................................................................... 122AEROCHAMBER WITH FLOWSIGNAL ......................................................... 122AEROCHAMBER Z-STAT PLUS-FLW SG ............................................................................................ 122AEROSPAN ..................................................................... 17AEROTRACH PLUS .......................................... 122AFEDITAB CR ............................................................ 59AFINITOR ......................................................................... 40AFINITOR DISPERZ ............................................ 40AFLURIA 2010-2011 (PF) ............................... 52AFLURIA 2011-2012 ............................................. 52AFLURIA 2011-2012 (PF) ............................... 52AFLURIA 2012-2013 ............................................. 52AFLURIA 2012-2013 (PF) ............................... 52AFLURIA 2013-2014 ............................................. 52AFLURIA 2013-2014 (PF) ............................... 52AFLURIA 2014-2015 ............................................. 52AFLURIA 2014-2015 (PF) ............................... 52AFLURIA 2015-2016 ............................................. 52AFLURIA 2015-2016 (PF) ............................... 52

177

Index

AFREZZA .......................................................................... 37AFTERA .............................................................................. 71AGGRASTAT IN SODIUM CHLORIDE......................................................................................................... 46AGGRENOX ................................................................... 46AGIE-GRX .................................................................... 122AGRIFLU 2010-2011 (PF) ............................... 52AGRYLIN .......................................................................... 46AHIST (CHLORCYCLIZINE) .................... 34A-HYDROCORT .................................................... 116AIMSCO INSULIN SYRINGE ................ 122AIMSCO ULTRA THIN II ........................... 122AIRACOF ........................................................................... 75AK-FLUOR ...................................................................... 85AKORN BALANCED SALT ........................ 88AK-POLY-BAC ........................................................... 19AKTEN (PF) .................................................................... 88AKWA TEARS ............................................................ 88AKWA TEARS (POLYVINYL ALCOHOL) ...................................................................... 88AKYNZEO .................................................................... 101ALA-HIST AC .............................................................. 75ALA-HIST DM ............................................................. 75ALA-HIST IR ................................................................. 34ALA-HIST PE ................................................................ 32ALA-QUIN .................................................................... 150ALAWAY .......................................................................... 34ALBENZA ......................................................................... 39ALBUKED-25 ............................................................... 57ALBUKED-5 ................................................................... 57albumin, human 25 % ............................................. 57albumin, human 5 % ................................................ 57ALBUMINAR 25 % ................................................ 57ALBUMINAR 5 % ................................................... 57ALBURX (HUMAN) 25 % .............................. 57ALBURX (HUMAN) 5 % ................................. 57ALBUSTIX REAGENT ...................................... 85ALBUTEIN 25 % ....................................................... 57ALBUTEIN 5 % .......................................................... 57albuterol sulfate ............................................................. 17ALCAINE ........................................................................... 88alclometasone .............................................................. 150ALCOHOL PADS .................................................. 150ALCOHOL PREP PADS ................................ 150ALCOHOL PREP SWABS ........................... 150alcohol swabs ............................................................... 150ALCOHOL WIPES ............................................... 150ALCOHOL, DENATURED ......................... 163alcohol, reagent .......................................................... 163ALCOHOL-BENZOCAINE ........................... 39ALCORTIN A ............................................................ 150ALDACTAZIDE ......................................................... 87ALDACTONE ............................................................... 87ALDARA ......................................................................... 150ALDURAZYME ...................................................... 163alendronate ...................................................................... 163ALERTNESS AID ..................................................... 67ALEVAZOL .................................................................... 30alfalfa .................................................................................... 113ALFENTA ............................................................................. 3alfentanil .................................................................................. 4alfuzosin ............................................................................ 163ALICLEN ........................................................................ 150ALIMTA .............................................................................. 40ALINIA ................................................................................. 39ALKERAN ........................................................................ 40

Index

ALL DAY ALLERGY (CETIRIZINE)......................................................................................................... 34ALL DAY ALLERGY-D ................................... 32ALL DAY PAIN RELIEF ................................. 15ALL DAY RELIEF ................................................... 15all xt-weed pol-russian thistl ............................ 52ALLEGRA ......................................................................... 34ALLEGRA-D 12 HOUR ..................................... 32ALLEGRA-D 24 HOUR ..................................... 32aller ext-tree poll,black waln ........................... 52aller ext-tree poll,red cedar ................................ 52aller ext-tree pollen-bayberry .......................... 52aller ext-tree pollen-mesquite ......................... 52aller xt-tree poll,shagbk hick ........................... 52aller xt-tree pollen-am.sycamo ...................... 52aller xt-tree pollen-box elder ........................... 52aller xt-tree pollen-red birch ............................. 52aller xt-tree pollen-white ash ........................... 52aller xt-weed pollen-sagebrush ...................... 53ALLER-CHLOR .......................................................... 34ALLERCLEAR D-12HR .................................... 32ALLERCLEAR D-24HR .................................... 32ALLER-EASE ................................................................ 34ALLERFED COLD & ALLERGY .......... 33allerg ext-tree pollen-pecan ............................... 53allerg ext-weed pollen-mugwort .................. 53allerg ex-weed pol-rgh pigweed ................... 53allerg xt-sheep sor,yellw dock ........................ 53allergen ext-candida albicans .......................... 53allergen ext-english plantain ............................ 53allergen ext-virginia live oak ........................... 53allergen xt-grass pollen-bahia ......................... 53allergenic ex-horse epithelium ....................... 53allergen-weed-lambsquarters ........................... 53ALLER-G-TIME ......................................................... 34ALLERGY & COLD PE ..................................... 75ALLERGY & CONGESTION RELIEF......................................................................................................... 33ALLERGY (CHLORPHENIRAMINE)......................................................................................................... 34ALLERGY (DIPHENHYDRAMINE)......................................................................................................... 34ALLERGY 4-HOUR ............................................... 34ALLERGY COMPLETE-D ............................. 33ALLERGY D-12 ......................................................... 33ALLERGY EYE (KETOTIFEN) ............... 34ALLERGY MEDICINE ....................................... 34ALLERGY MULTI-SYMPTOM ............... 75ALLERGY RELIEF & NASAL DECONGE ........................................................................ 33ALLERGY RELIEF (CETIRIZINE) ...... 34ALLERGY RELIEF (CLEMASTINE)......................................................................................................... 34ALLERGY RELIEF (FEXOFENADINE)......................................................................................................... 34ALLERGY RELIEF (LORATADINE)......................................................................................................... 34ALLERGY RELIEF D-24 ................................. 33ALLERGY RELIEF(CHLORPHENIRAMN) ............... 35ALLERGY RELIEF(DIPHENHYDRAMIN) ................ 35ALLERGY SINUS HEADACHE (PE)......................................................................................................... 75ALLERGY-TIME ...................................................... 35ALLERHIST-1 .............................................................. 35

Index

ALLEVYN ..................................................................... 123ALLEVYN ADHESIVE DRESSING...................................................................................................... 122ALLEVYN CAVITY DRESSING ........ 123ALLEVYN CAVITY WOUND DRESS...................................................................................................... 123ALLEVYN PLUS ADHESIVE ................ 123ALLEVYN SACRUM DRESSING ..... 123ALLFEN DM .................................................................. 75ALLKARE ADHESIVE REMOVER WIPES ................................................................................. 123ALL-NITE COLD-FLU ....................................... 75allopurinol ........................................................................... 15ALL-PURPOSE DRESSINGS .................. 123ALMACONE ............................................................... 101ALMACONE MLT ............................................... 101ALMACONE-2 ......................................................... 101almond oil, sweet (bulk) ................................... 163ALOCRIL ........................................................................... 88aloe vera ............................................................................ 113ALOE VESTA ............................................................ 150ALOE VESTA ANTIFUNGAL (MICON) ............................................................................. 30ALOE VESTA BATHING CLOTHS...................................................................................................... 150ALOE VESTA SKIN CONDITIONER 2...................................................................................................... 150ALOMIDE ......................................................................... 88ALOPRIM .......................................................................... 15ALOQUIN ...................................................................... 150ALORA .............................................................................. 116alosetron ............................................................................ 101ALOXI ................................................................................ 101ALPHAGAN P .............................................................. 88ALPHANATE ................................................................ 57ALPHANINE SD ........................................................ 57alprazolam ....................................................................... 143ALPRAZOLAM INTENSOL ..................... 143ALPROLIX ....................................................................... 57alprostadil ............................................................................ 62ALREX .................................................................................. 88ALSUMA ............................................................................... 4ALTABAX ..................................................................... 150ALTACE .............................................................................. 62ALTAVERA (28) ....................................................... 71ALTOPREV ..................................................................... 62aluminum hydroxide gel ................................... 101aluminum monostearate .................................... 163ALUVEA ......................................................................... 150ALVESCO ......................................................................... 17ALYACEN 1/35 (28) .............................................. 71ALYACEN 7/7/7 (28) ............................................ 71amantadine hcl ............................................................... 45A-MANTLE .................................................................. 150amaranth ............................................................................ 163AMARYL ........................................................................... 37AMBIEN .......................................................................... 148AMBIEN CR ................................................................ 148AMBISOME .................................................................... 30amcinonide ...................................................................... 150AMERGE ............................................................................... 4AMETHIA ......................................................................... 71AMETHIA LO ............................................................... 71AMETHYST .................................................................... 71AMICAR ............................................................................. 57AMIDATE ......................................................................... 12

178

Index

amifostine crystalline ........................................... 163amikacin ................................................................................ 19amiloride .............................................................................. 87amiloride-hydrochlorothiazide ...................... 87AMINO ACIDS 15 % ............................................ 93aminocaproic acid ....................................................... 57aminohippurate sodium ......................................... 85aminophylline ................................................................. 17AMINOSYN 10 % .................................................... 93AMINOSYN 7 % WITH ELECTROLYTES ..................................................... 93AMINOSYN 8.5 % ................................................... 93AMINOSYN 8.5 %-ELECTROLYTES......................................................................................................... 93AMINOSYN II 10 % .............................................. 93AMINOSYN II 15 % .............................................. 93AMINOSYN II 7 % .................................................. 93AMINOSYN II 8.5 % ............................................. 93AMINOSYN II 8.5 %-ELECTROLYTES......................................................................................................... 93AMINOSYN M 3.5 % ........................................... 94AMINOSYN-HBC 7% .......................................... 94AMINOSYN-PF 10 % ........................................... 94AMINOSYN-PF 7 % (SULFITE-FREE)......................................................................................................... 94AMINOSYN-RF 5.2 % ........................................ 94amiodarone ........................................................................ 59amiodarone in dextrose 5 % ............................. 59AMITIZA ........................................................................ 101amitriptyline .................................................................. 143amitriptyline-chlordiazepoxide .................. 143amlodipine .......................................................................... 59amlodipine-atorvastatin ......................................... 62amlodipine-benazepril ............................................ 62ammonia aromatic ...................................................... 67ammonium and potassium iodides ......... 150ammonium chloride .................................................. 87ammonium lactate ................................................... 150ammonium molybdate ............................................ 94AMMONUL ................................................................. 101AMNESTEEM ........................................................... 150amoxapine ....................................................................... 143amoxicil-clarithromy-lansopraz ................ 101amoxicillin .......................................................................... 19amoxicillin-pot clavulanate ............................... 19AMPHADASE ........................................................... 150AMPHETAMINE SALT COMBO .......... 50AMPHOTEC ................................................................... 30amphotericin b ................................................................ 30ampicillin ............................................................................. 19ampicillin sodium ........................................................ 19ampicillin-sulbactam ................................................ 19AMPYRA ........................................................................... 67AMRIX .............................................................................. 138AMTURNIDE ................................................................ 62AMYTAL ........................................................................ 148ANADROL-50 ........................................................... 116ANAFRANIL .............................................................. 143anagrelide ............................................................................ 46ANA-LEX ....................................................................... 101ANA-LEX KIT .......................................................... 101ANALGESIC CREME ...................................... 150ANALPRAM E ......................................................... 101ANALPRAM-HC ...................................... 101, 150ANALPRAM-HC SINGLES ....................... 101ANAMU ........................................................................... 113

Index

ANAPROX ........................................................................ 15ANAPROX DS .............................................................. 15ANASCORP .................................................................... 53ANASPAZ ...................................................................... 101anastrozole .......................................................................... 40ANCOBON ....................................................................... 30ANDRODERM .......................................................... 116ANDROGEL ................................................... 116, 117ANDROID ...................................................................... 117ANDROXY ................................................................... 117ANECTINE ....................................................................... 50ANEFRIN ........................................................................... 88ANGELIQ ....................................................................... 117ANGIOMAX ................................................................... 28anise ....................................................................................... 163ANORO ELLIPTA .................................................... 17ANTABUSE ................................................................. 163ANTACID ....................................................................... 101ANTACID ANTI-GAS ..................................... 101ANTACID ANTI-GAS DOUBLE STR...................................................................................................... 101ANTACID CALCIUM ...................................... 102ANTACID EXST (CA CARB-MAG HYD) .................................................................................... 102ANTACID EXST (MAG CARB-AL HYD) .................................................................................... 102ANTACID EXT STR (CALCIUM CARB) ................................................................................ 102ANTACID EXTRA-STRENGTH .......... 102ANTACID MAXIMUM STRENGTH...................................................................................................... 102ANTACID PLUS ANTI-GAS .................... 102ANTACID ULTRA STRENGTH .......... 102ANTACID-ANTIGAS ....................................... 102ANTACID-SIMETHICONE ....................... 102ANTARA ............................................................................ 62ANTIBACTERIAL BANDAGES ......... 123ANTIBACTERIAL PAD ................................ 123ANTIBIOTIC (BACITRACIN ZINC)......................................................................................................... 19ANTIBIOTIC PLUS (PRAMOXINE)......................................................................................................... 19ANTICAVITY FLUORIDE RINSE ....... 94ANTI-DANDRUFF ............................................... 151ANTI-DANDRUFF (COAL TAR) ....... 151ANTI-DIARRHEA ................................................ 102ANTI-DIARRHEAL (LOPERAMIDE)...................................................................................................... 102ANTIFUNGAL ............................................................. 30ANTIFUNGAL (CLOTRIMAZOLE) ... 30ANTIFUNGAL (TOLNAFTATE) ............ 30ANTIFUNGAL CREAM .................................... 30ANTIFUNGAL SPRAY ...................................... 30ANTI-ITCH (DIPHENHYDRAMINE)...................................................................................................... 151ANTI-ITCH (HC) .................................................... 151ANTI-ITCH(DIPHENHYD) WITH ZINC...................................................................................................... 151ANTI-NAUSEA ....................................................... 102ANTI-NAUSEA GINGER ............................. 113antipyrine-benzocaine ............................................. 88ANTISEPTIC GEL ................................................ 151ANTISEPTIC MOUTH RINSE ................... 88antivenin latrodectus mactans ......................... 53antivenin micrurus fulvius .................................. 53ANTIVERT ................................................................... 102

Index

ANUCORT-HC ......................................................... 102ANU-MED ..................................................................... 102ANUSOL-HC .............................................................. 102ANZEMET ..................................................................... 102APEXICON ................................................................... 151APEXICON E ............................................................. 151AP-HIST DM .................................................................. 75APIDRA ............................................................................... 37APIDRA SOLOSTAR ........................................... 37APLENZIN .................................................................... 143APLISOL ............................................................................. 53APOKYN ............................................................................ 45APPLE FLAVORING ........................................ 163APPLE-ADE FLAVOR .................................... 163apraclonidine .................................................................... 88APRI ......................................................................................... 71APRISO ............................................................................. 102APRODINE ...................................................................... 33APTENSIO XR ......................................................... 143APTIOM .............................................................................. 67APTIVUS ............................................................................ 47AQUA GLYCOLIC CLEANSER .......... 151AQUA LUBE .............................................................. 163AQUA LUBE ADVANCED FORMULA GEL ........................................................................................ 163AQUABASE ................................................................ 163AQUACEL FOAM ................................................ 123AQUACEL FOAM SACRAL .................... 123AQUAFLO ..................................................................... 123AQUANAZ ....................................................................... 76AQUASOL A .............................................................. 173AR CAPS ......................................................................... 163ARALAST NP ............................................................ 163ARANELLE (28) ........................................................ 71ARANESP (IN POLYSORBATE) ........... 70ARAVA ................................................................................ 15ARBINOXA ..................................................................... 35ARCALYST ................................................................. 163ARCAPTA NEOHALER ................................... 17ARCH BANDAGE ................................................ 123argatroban ........................................................................... 28argatroban in 0.9 % sod chlor ......................... 28argatroban in nacl (iso-os) .................................. 28ARGLAES ...................................................................... 151ARGLAES 3.25"X 14" FILM .................... 123ARICEPT ............................................................................ 50ARICEPT ODT ............................................................. 50ARIMIDEX ....................................................................... 40aripiprazole ..................................................................... 143ARISTADA ................................................................... 143ARISTOSPAN INTRA-ARTICULAR...................................................................................................... 117ARISTOSPAN INTRALESIONAL ..... 117ARIXTRA .......................................................................... 28ARMOUR THYROID ........................................ 162arnica .................................................................................... 113ARNUITY ELLIPTA ............................................. 17AROMASIN .................................................................... 40ARRANON ....................................................................... 40ARTHRICREAM .................................................... 151ARTHRICREAM RUB ..................................... 151ARTHRITIS .................................................................. 151ARTHRITIS HEATWRAPS ....................... 123ARTHRITIS PAIN RELIEF (ACETAM)............................................................................................................ 4

179

Index

ARTHRITIS PAIN RELIEF(CAPSAIC)...................................................................................................... 151ARTHRITIS PAIN RELIEVER ..................... 4ARTHROTEC 50 ........................................................ 15ARTHROTEC 75 ........................................................ 15ARTIFICIAL TEARS ............................................ 88ARTIFICIAL TEARS (PETRO/MIN)......................................................................................................... 88ARTIFICIAL TEARS (POLYVIN ALC)......................................................................................................... 88ARTISS .............................................................................. 151ARTISS-DUPLOJECT SYSTEM .......... 151ARZERRA ......................................................................... 40ASACOL .......................................................................... 102ASACOL HD ............................................................... 102asafetida ............................................................................. 113ASCLERA .......................................................................... 62ASCOMP WITH CODEINE .............................. 4ascorbic acid .................................................................. 173ASCRIPTIN ......................................................................... 4ASHLYNA ........................................................................ 71ASMANEX HFA ........................................................ 17ASMANEX TWISTHALER ........................... 17ASPIR-81 ............................................................................... 4aspirin ......................................................................................... 4ASPIRIN LOW DOSE ............................................. 4ASPIRIN LOW-STRENGTH ........................... 4aspirin-dipyridamole ................................................ 46ASPIR-LOW ....................................................................... 4ASSURE ID INSULIN SAFETY ........... 123ASTAGRAF XL ....................................................... 121ASTELIN ............................................................................ 88ASTEPRO .......................................................................... 88ASTHMANEFRIN REFILL ........................... 17ASTRINGENT ........................................................... 151ATACAND ....................................................................... 62ATACAND HCT ........................................................ 62ATELVIA ........................................................................ 163atenolol .................................................................................. 62atenolol-chlorthalidone .......................................... 62ATGAM ................................................................................ 53ATHLETE'S FOOT (CLOTRIMAZOLE)......................................................................................................... 30ATHLETE'S FOOT (TERBINAFINE)......................................................................................................... 30ATHLETE'S FOOT (TOLNAFTATE)......................................................................................................... 30ATHLETE'S FOOT AF ........................................ 30ATHLETIC TAPE .................................................. 123ATIVAN .............................................................. 143, 149atorvastatin ......................................................................... 62atovaquone ......................................................................... 39atovaquone-proguanil ............................................. 39atracurium ........................................................................... 50ATRALIN ....................................................................... 151ATRIPLA ............................................................................ 47atropine ..................................................................... 88, 102atropine in 0.9 % sod chloride .................... 102ATROVENT .................................................................... 88ATROVENT HFA ..................................................... 17ATRYN ................................................................................. 57AUBAGIO ......................................................................... 67AUBRA ................................................................................. 71AUGMENTIN ................................................................ 19AUGMENTIN ES-600 .......................................... 19AUGMENTIN XR ..................................................... 19

Index

AURAX ................................................................................ 88AURODEX ....................................................................... 88AUROGUARD ............................................................. 88AURYXIA ......................................................................... 94AUVI-Q ................................................................................ 50AVALIDE .......................................................................... 62AVANDAMET ............................................................. 37AVANDARYL .............................................................. 37AVANDIA ......................................................................... 37AVAPRO ............................................................................. 62AVAR ..................................................................................... 19AVAR LS ............................................................................ 19AVAR-E ............................................................................... 19AVAR-E GREEN ....................................................... 19AVAR-E LS ..................................................................... 19AVASTIN ........................................................................... 40AVC VAGINAL .......................................................... 40AVEED .............................................................................. 117AVEENO BABY ..................................................... 151AVELOX ............................................................................. 19AVELOX ABC PACK .......................................... 19AVELOX IN NACL (ISO-OSMOTIC)......................................................................................................... 19AVIANE .............................................................................. 71AVINZA .................................................................................. 4AVITA ................................................................................ 151AVOGEL ......................................................................... 123AVOGEL DRESSING ....................................... 123AVONEX ............................................................................ 67AVONEX (WITH ALBUMIN) .................... 67AVYCAZ ............................................................................ 19AXERT ..................................................................................... 4AXIRON ........................................................................... 117AYGESTIN ................................................................... 117azacitidine ........................................................................... 40AZACTAM ....................................................................... 19AZACTAM IN DEXTROSE (ISO-OSM)......................................................................................................... 19AZASAN .......................................................................... 121AZASITE ............................................................................ 20azathioprine .................................................................... 121azelastine .................................................................... 35, 88AZELEX ........................................................................... 151AZILECT ............................................................................ 45azithromycin ..................................................................... 20AZO .......................................................................................... 12AZO BLADDER CONTROL ..................... 113AZO CRANBERRY ............................................ 113AZO CRANBERRY + PROBIOTIC...................................................................................................... 113AZO TEST STRIPS ................................................. 85AZO-GESIC ..................................................................... 12AZOPT .................................................................................. 88aztreonam ............................................................................ 20AZULFIDINE ............................................................. 102AZULFIDINE EN-TABS ............................... 102AZUPHEN MB ............................................................. 20AZURETTE (28) ......................................................... 71B COMPLEX 100 ................................................... 173B&L SENSITIVE EYES ................................. 123BABY TEETHING GEL .................................... 12BABY VITAMIN D3 .......................................... 173BABY WASH ............................................................. 151BACIIM ................................................................................ 20bacitracin .............................................................................. 20bacitracin zinc ................................................................. 20

Index

bacitracin-polymyxin b .......................................... 20BACKACHE RELIEF EXTRA STRENGTH ........................................................................ 4baclofen .............................................................................. 138BACMIN .......................................................................... 173BACTERIOSTATIC WATER(PARABENS) ...................................... 163BACTRIM .......................................................................... 20BACTRIM DS ............................................................... 20BACTROBAN ............................................................... 20BACTROBAN NASAL ....................................... 20BAL IN OIL .................................................................. 164BALANCED SALT ................................................. 88BAL-CARE DHA ................................................... 139BAL-CARE DHA ESSENTIAL .............. 139balsalazide ....................................................................... 102BALZIVA (28) .............................................................. 71BANANA CONCENTRATE ...................... 164BANANA CREAM FLAVOR .................. 164banana flavor (bulk) .............................................. 164BANDAGE .................................................................... 123BANDAGES ................................................................ 123BANDAGES FLEXIBLE FABRIC ..... 123BANDAGES SHEER .......................................... 123BANDAGES/FLEXIBLE/ASSORTED...................................................................................................... 123BANDAGES/PLASTIC ................................... 123BAND-AID ACTIVE FLEX ....................... 123BAND-AID BUTTERFLY CLOSURE...................................................................................................... 123BAND-AID CLEAR SPOTS ...................... 123BAND-AID CLOTH TAPE ......................... 123BAND-AID FLEXIBLE ................................... 123BAND-AID FLEXIBLE FABRIC ......... 123BAND-AID GAUZE PADS ......................... 123BAND-AID HANDYMAN .......................... 123BAND-AID HURT-FREE ............................. 123BAND-AID MIRASORB GAUZE ....... 123BAND-AID NON-STICK PADS ........... 123BAND-AID PAPER TAPE ........................... 123BAND-AID PLASTIC ....................................... 123BAND-AID PLUS ANTIBIOTIC .......... 123BAND-AID ROLLED GAUZE ............... 123BAND-AID SECURE-FLEX ...................... 123BAND-AID SHEER STRIPS ..................... 123BAND-AID SURGIPAD ................................. 124BAND-AID TOUGH PADS ........................ 124BAND-AID TOUGH STRIPS ................... 124BAND-AID WATERPROOF ..................... 124BAND-AID WATERPROOF PAD ...... 124BANOPHEN .................................................................... 35BANOPHEN ALLERGY ................................... 35BANOPHEN ANTI-ITCH ............................. 151BANZEL .............................................................................. 67BARACLUDE ............................................................... 47BARD ADHESIVE REMOVER WIPES...................................................................................................... 124BARD TWO-SIDED ADHESIVE STRIP...................................................................................................... 124BASE, PCCA SYRUP VEHICLE ......... 164BAYCADRON .......................................................... 117BAZA ANTIFUNGAL ......................................... 30BAZA CLEANSE & PROTECT ............. 151BAZA CLEAR ........................................................... 151BAZA PROTECT ................................................... 151bcg vaccine, live (pf) ............................................... 53

180

Index

BD ALCOHOL SWABS ................................. 151BD AUTOSHIELD DUO PEN NEEDLE...................................................................................................... 124BD AUTOSHIELD PEN NEEDLE ...... 124BD ECLIPSE LUER-LOK ............................ 124BD INSULIN PEN NEEDLE UF MINI...................................................................................................... 124BD INSULIN PEN NEEDLE UF ORIG...................................................................................................... 124BD INSULIN PEN NEEDLE UF SHORT...................................................................................................... 124BD INSULIN SYRINGE ................................ 124BD INSULIN SYRINGE HALF UNIT...................................................................................................... 124BD INSULIN SYRINGE MICRO-FINE...................................................................................................... 124BD INSULIN SYRINGE SAFETY-LOK...................................................................................................... 124BD INSULIN SYRINGE SLIP TIP ..... 124BD INSULIN SYRINGE ULT-FINE II...................................................................................................... 124BD INSULIN SYRINGE ULTRA-FINE...................................................................................................... 124BD INTEGRA INSULIN SYRINGE...................................................................................................... 124BD LO-DOSE MICRO-FINE IV ............ 124BD LO-DOSE ULTRA-FINE .................... 124BD SAFETYGLIDE INSULIN SYRINGE ........................................................................ 124BD SAFETYGLIDE SYRINGE .............. 124BD ULTRA-FINE NANO PEN NEEDLES ....................................................................... 124BEAUTY BAR .......................................................... 151BEBULIN ........................................................................... 57BEBULIN VH ................................................................ 58BECONASE AQ ......................................................... 88BEDSIDE-CARE .................................................... 151BEDSIDE-CARE PERINEAL ................... 151BEEF FLAVOR ........................................................ 164BELEODAQ .................................................................... 40belladonna alkaloids-opium ................................. 4BELLADONNA-OPIUM ...................................... 4BELSOMRA ................................................................ 149benazepril ............................................................................ 62benazepril-hydrochlorothiazide .................... 62BENEFIBER SUGAR FREE (DEXTRIN) ................................................................... 102BENEFIX ............................................................................ 58BENICAR ........................................................................... 62BENLYSTA .................................................................. 164BENSAL HP ...................................................... 30, 151bentonite ............................................................................ 164BENTYL .......................................................................... 102BENZACLIN ............................................................... 151BENZACLIN PUMP ........................................... 151benzaldehyde ................................................................ 164BENZAMYCIN ............................................................ 20BENZEDREX ................................................................ 88BENZEPRO .................................................................. 151BENZEPRO (MICROSPHERES) .......... 151BENZOIN COMPOUND ................................ 151benzonatate ........................................................................ 76benzoyl peroxide ......................................... 151, 152benztropine ........................................................................ 45BEPREVE .......................................................................... 35bergamot oil, imitation ....................................... 164

Index

BERINERT .................................................................... 164BESIVANCE ................................................................... 20BETADINE ................................................................... 152BETADINE OPHTHALMIC PREP ........ 88BETADINE SKIN CLEANSER .............. 152BETADINE SPRAY ............................................ 152BETADINE SURGICAL SCRUB ......... 152BETADINE SWABSTICKS ....................... 152BETAGAN ........................................................................ 89betamethasone acet,sod phos ....................... 117betamethasone dipropionate .......................... 152betamethasone valerate ...................................... 152betamethasone, augmented ............................ 152BETAPACE ..................................................................... 62BETAPACE AF ........................................................... 62BETASEPT SURGICAL SCRUB ......... 152BETASERON ................................................................. 67betaxolol ..................................................................... 62, 89bethanechol chloride ................................................ 50BETHKIS ............................................................................ 20BETIMOL .......................................................................... 89BETOPTIC S ................................................................... 89bexarotene ........................................................................... 40BEXSERO (PF) ............................................................ 53BHT ....................................................................................... 164BIATAIN HEEL ADH FOAM DRESSING .................................................................... 124BIATAIN NON-ADHESIVEFOAM ROUND ............................................................................. 124BIAXIN ................................................................................. 20bicalutamide ...................................................................... 40BICILLIN C-R ............................................................... 20BICILLIN L-A ............................................................... 20BICLORA ........................................................................... 76BICNU ................................................................................... 40BIDIL ...................................................................................... 62BIFERA RX ..................................................................... 94bilberry ................................................................................ 113bilberry fruit extract ............................................... 113BILTRICIDE ................................................................... 39bimatoprost ........................................................................ 89BINOSTO ........................................................................ 164BIO TRUE ...................................................................... 124BIOBRANE ................................................................... 124BIOBRANE DRESSING ................................ 124BIOBRANE-L ............................................................ 124BIOBRANE-L DRESSING .......................... 124BION TEARS (PF) ................................................... 89BIOTENE ........................................................................... 94BIOTHRAX ...................................................................... 53BISAC-EVAC ............................................................. 102bisacodyl ........................................................................... 102BISCOLAX ................................................................... 102BISMATROL .............................................................. 103BISMUTH ....................................................................... 103BISMUTH MAXIMUM STRENGTH...................................................................................................... 103bisoprolol fumarate .................................................... 62bisoprolol-hydrochlorothiazide ..................... 62bitter mask flavoring (bulk) ........................... 164BITTERNESS MASK FLAVOR ............ 164bivalirudin ........................................................................... 28BIVIGAM ........................................................................... 53black cohosh .................................................................. 113black cohosh root extract ................................. 113BLENDERM SURGICAL ............................. 124

Index

BLENDERM WATERPROOF SURG TAPE .................................................................................... 124bleomycin ............................................................................ 40BLEPH-10 .......................................................................... 20BLEPHAMIDE ............................................................. 20BLEPHAMIDE S.O.P. .......................................... 20BLINCYTO ...................................................................... 40BLISTER RELIEF BANDAGES ........... 124BLISTERFILM DRESSING ....................... 124BLUE GEL ..................................................................... 152BLUEBERRY FLAVOR ................................. 164blue-green algae (spirulina) ........................... 113B-NEXA ........................................................................... 139BODI BATH ................................................................. 152BODI CARE ................................................................. 152BODI LINE ALMOND SKIN CARE...................................................................................................... 152BODI LOTION .......................................................... 164BONIVA ........................................................................... 164BOOSTRIX TDAP .................................................... 53BORDERED GAUZE ........................................ 124BOSTON CLEANER .......................................... 124BOSTON CONDITIONING ....................... 124BOSTON ONE STEP (PF) ............................ 124BOSTON REWETTING ................................. 124BOSTON SIMPLUS ............................................ 124BOSULIF ............................................................................ 40BOTOX ................................................................................. 50BP ............................................................................................ 152BP 10-1 .................................................................................. 20BP-50% UREA .......................................................... 152BPO ........................................................................................ 152BPO CREAMY WASH PACK ................. 152BREATHERITE MDI SPACER .............. 125BREATHERITE RIGID SPACER& MASK ................................................................................. 125BREATHERITE SPACER& MASK,ADULT ......................................................... 125BREATHERITE SPACER& MASK,CHILD ........................................................... 125BREATHERITE SPACER&MASK,INFANT ......................... 125BREATHERITE SPACER&MASK,S.CHLD .......................... 125BREATHERITE VALVED MDI CHAMBER .................................................................... 125BREATHERITE VALVED MDI SPACER ........................................................................... 125BREATHERITE WITH MASK, LARGE...................................................................................................... 125BREATHERITE WITH MASK, MEDIUM ......................................................................... 125BREATHERITE WITH MASK, SMALL...................................................................................................... 125BREO ELLIPTA ......................................................... 17BREVIBLOC .................................................................. 62BREVIBLOC IN NACL (ISO-OSM) .... 62BREVICON (28) ......................................................... 71BREVITAL ....................................................................... 12BRIELLYN ....................................................................... 71BRIJ 30 ............................................................................... 164BRIJ 35 ............................................................................... 164BRIJ 58 ............................................................................... 164BRIJ 78 ............................................................................... 164BRIJ 99 ............................................................................... 164BRILINTA ......................................................................... 46

181

Index

brimonidine ....................................................................... 89BRINTELLIX ............................................................. 143BRISDELLE ................................................................. 143BROHIST D ..................................................................... 33BROMFED DM ........................................................... 76bromfenac ........................................................................... 89bromocriptine .................................................................. 45brompheniramine-pseudoeph-dm ............... 76BROTAPP .......................................................................... 33BROTAPP DM .............................................................. 76BROVANA ....................................................................... 17BROVEX PEB ............................................................... 33BROVEX PEB DM .................................................. 76BROVEX PSB ..................................................... 33, 76BSS ............................................................................................ 89BSS PLUS .......................................................................... 89BUBBLE GUM CONCENTRATE ....... 164BUBBLE GUM FLAVORING ................. 164bubblegum flavor (bulk) ................................... 164budesonide ............................................................ 17, 117BUFFERED LIDOCAINE ................................ 12BUFFERIN ........................................................................... 4BUFFERIN EXTRA STRENGTH ............... 4BULKEE II .................................................................... 125bumetanide ......................................................................... 87BUMINATE 25 % ..................................................... 58BUMINATE 5 % ......................................................... 58BUNAVAIL .................................................................. 164BUPAP ...................................................................................... 4BUPHENYL ................................................................. 103bupivacaine ........................................................................ 12bupivacaine (pf) ............................................................ 12bupivacaine in nacl(pf) .......................................... 12bupivacaine-dextrose-water(pf) .................... 12bupivacaine-epinephrine ...................................... 12bupivacaine-epinephrine (pf) .......................... 12bupivacaine-epinephrine bitart ...................... 12buprenorphine hcl ............................................. 4, 164buprenorphine-naloxone ................................... 164BUPROBAN ................................................................ 162bupropion hcl ............................................................... 143BURN RELIEF ............................................................. 12buspirone .......................................................................... 143BUSULFEX ..................................................................... 40BUTALBITAL COMPOUND .......................... 4BUTALBITAL COMPOUND W/CODEINE ...................................................................... 4butalbital-acetaminop-caf-cod ........................... 4butalbital-acetaminophen ........................................ 4butalbital-acetaminophen-caff ........................... 4butalbital-aspirin-caffeine ...................................... 4BUTISOL ........................................................................ 149butorphanol tartrate ....................................................... 4BUTRANS ............................................................................ 4BUTTER RUM FLAVORING .................. 164BUTTERFLY CLOSURES .......................... 125BUTTERSCOTCH FLAVORING ........ 164butylated hydroxytoluene ................................ 164BYDUREON ................................................................... 37BYSTOLIC ....................................................................... 62cabergoline ...................................................................... 117CADUET ............................................................................. 62CAFCIT ................................................................................ 67CAFERGOT ........................................................................ 4caffeine citrated ............................................................. 67caffeine-sodium benzoate ................................... 67

Index

calamine ............................................................................. 152CALAMINE MEDICATED ......................... 152calamine phenolated .............................................. 152calamine-zinc oxide ............................................... 152calamine-zinc oxide-phenol .......................... 152CALAN ................................................................................. 59CALAN SR ....................................................................... 59CALCARB 600 WITH VITAMIN D ..... 94CALCIJEX ..................................................................... 173calcipotriene .................................................................. 152calcipotriene-betamethasone ........................ 164calcitonin (salmon) ................................................. 117CALCITRENE ........................................................... 152calcitriol ................................................................ 152, 173CALCIUM 600 WITH VITAMIN D3......................................................................................................... 94calcium acetate ............................................................... 94calcium acetate-aluminum sulf .................. 152CALCIUM ANTACID ...................................... 103CALCIUM ANTACID ULTRA MAX ST...................................................................................................... 103calcium carbonate .......................................... 94, 103calcium carbonate-vitamin d3 ........................ 94calcium chloride ........................................................... 94CALCIUM DISODIUM VERSENATE...................................................................................................... 164calcium gluconate ....................................................... 94calcium gluconate in 0.9% nacl .................... 94CALCIUM MAGNESIUM .............................. 94CALCIUM PNV ....................................................... 139calcium-cranberry fruit ....................................... 113CALCIUM-FOLIC ACID-VITAMIN D......................................................................................................... 94CALDOLOR .................................................................... 15CALDYPHEN ............................................................ 152CALDYPHEN CLEAR ..................................... 152CAL-GEST ANTACID ..................................... 103CALLERGY CLEAR .......................................... 152CALLUS CUSHION ........................................... 125CALLUS PADS ........................................................ 125CALPHRON .................................................................... 94CAMBIA ................................................................................. 4CAMILA .............................................................................. 71CAMO BANDAGES ........................................... 125CAMPATH ....................................................................... 40camphor ............................................................................. 152camphor (bulk) ........................................................... 152CAMPHOR BLOCKS ........................................ 152CAMPRAL .................................................................... 164CAMPRAL DOSE PAK .................................. 164CAMPTOSAR ............................................................... 40CAMRESE ........................................................................ 71CAMRESE LO .............................................................. 71CANASA ......................................................................... 103CANCIDAS ...................................................................... 30candesartan ........................................................................ 62candesartan-hydrochlorothiazid .................... 62CANTIL ............................................................................ 103CAPACET ............................................................................. 4CAPASTAT ..................................................................... 20CAPCOF .............................................................................. 76capecitabine ....................................................................... 40CAPEX ............................................................................... 152CAPITAL WITH CODEINE ............................. 4CAPMIST DM ............................................................... 76CAPRELSA ...................................................................... 41

Index

CAPRON DM ................................................................ 76capsaicin ............................................................................ 152CAPSUBLEND-H .................................................. 164CAPSUBLEND-P ................................................... 164CAPSUBLEND-S ................................................... 164CAPSULE #0 ............................................................... 164CAPSULE #0 (CELLULOSE) .................. 164CAPSULE #0 (HYPROMELLOSE) ... 164CAPSULE #0 DRCAPS ................................... 165CAPSULE #00 ........................................................... 165CAPSULE #00 (CELLULOSE) ............... 165CAPSULE #00 (HYPROMELLOSE)...................................................................................................... 165CAPSULE #1 ............................................................... 165CAPSULE #1 (CELLULOSE) .................. 165CAPSULE #1 (HYPROMELLOSE) ... 165CAPSULE #1 DRCAPS ................................... 165CAPSULE #10 ........................................................... 165CAPSULE #11 ........................................................... 165CAPSULE #12 ........................................................... 165CAPSULE #13 ........................................................... 165CAPSULE #2 ............................................................... 165CAPSULE #2 (HYPROMELLOSE) ... 165CAPSULE #3 ............................................................... 165CAPSULE #3 (CELLULOSE) .................. 165CAPSULE #3 (HYPROMELLOSE) ... 165CAPSULE #4 ............................................................... 165CAPSULE #5 ............................................................... 165CAPSULE #7 ............................................................... 165CAPSULE CONI-SNAP #0 (GELATIN)...................................................................................................... 165CAPSULE CONI-SNAP #0(HYPROMEL) ..................................................... 165CAPSULE CONI-SNAP #00 (GELATIN...................................................................................................... 165CAPSULE CONI-SNAP #000 ................... 165CAPSULE CONI-SNAP #1 (GELATIN)...................................................................................................... 165CAPSULE CONI-SNAP #1(HYPROMEL) ..................................................... 165CAPSULE CONI-SNAP #2 (GELATIN)...................................................................................................... 165CAPSULE CONI-SNAP #3 (GELATIN)...................................................................................................... 165CAPSULE CONI-SNAP #3(HYPROMEL) ..................................................... 165CAPSULE CONI-SNAP #4 (GELATIN)...................................................................................................... 165CAPSULE,WHITE OPAQUE GELATN #1 .............................................................................................. 165captopril ................................................................................ 62captopril-hydrochlorothiazide ........................ 62CARAC ................................................................................. 41CARAFATE ................................................................. 103CARB CUTTER ....................................................... 113CARBAGLU ................................................................ 165carbamazepine ................................................................ 67CARBATROL ................................................................ 67carbidopa .............................................................................. 45carbidopa-levodopa ................................................... 45carbidopa-levodopa-entacapone ................... 45carbinoxamine maleate .......................................... 35CARBOCAINE ............................................................. 12CARBOCAINE (PF) ............................................... 12CARBOFLEX ODOR CONTROL DRESSIN ......................................................................... 125

182

Index

CARBOMER 934P RESIN ........................... 165carbomer 940 (bulk) .............................................. 165carbomer homopolymer c (bulk) .............. 165carboplatin .......................................................................... 41CARDENE IV ................................................................ 59CARDENE IV IN DEXTROSE ................... 59CARDENE IV IN SODIUM CHLORIDE......................................................................................................... 59CARDIO TEA ............................................................ 113CARDIOLITE ................................................................ 85cardioplegic soln .......................................................... 59CARDIZEM ..................................................................... 59CARDIZEM CD .......................................................... 59CARDIZEM LA ........................................................... 59CARDURA ....................................................................... 62CARDURA XL ............................................................. 62CAREFINE PEN NEEDLE .......................... 125CAREFREE PANTILINERS ...................... 125CAREFREE PANTY SHIELD ................. 125CAREONE ULTIGUARD ............................. 125CARIMUNE NF NANOFILTERED ...... 53carisoprodol ................................................................... 138carisoprodol-asa-codeine ........................................ 4carisoprodol-aspirin ............................................... 138CARLESTA .................................................................. 152carmine ............................................................................... 165CARMOL 10 ................................................................ 152CARMOL 20 ................................................................ 152CARNITOR ................................................................... 165CARNITOR SUGAR-FREE ........................ 165CARRASYN HYDROGEL WOUND DRESS ................................................................................ 125CARRINGTON MOIST BARRIER-ZINC ...................................................... 152CARRINGTON MOISTURE BARRIER CR ............................................................................................ 153carteolol ................................................................................. 89CARTIA XT ..................................................................... 59CARTICEL .................................................................... 165carvedilol ............................................................................. 62CASODEX ........................................................................ 41CASTELLANI PAINT MODIFIED .... 153CASTILE ......................................................................... 153castor oil ............................................................... 103, 165CATAFLAM ....................................................................... 4CATAPRES ...................................................................... 62CATAPRES-TTS-1 .................................................. 62CATAPRES-TTS-2 .................................................. 62CATAPRES-TTS-3 .................................................. 62CATHFLO ACTIVASE ....................................... 58catnip .................................................................................... 113cat's claw (uncaria tomentosa) .................... 113CAVAN-ALPHA KIT ........................................ 139CAVAN-EC SOD DHA ................................... 139CAVILON SKIN CLEANSER ................. 153CAYA CONTOURED .......................................... 71CAYSTON ........................................................................ 20CAZIANT (28) .............................................................. 71CEDAX ................................................................................. 20CEENU .................................................................................. 41cefaclor .................................................................................. 20cefadroxil ............................................................................. 20cefazolin ................................................................................ 20cefazolin in 0.9% sod chloride ....................... 20cefazolin in dextrose (iso-os) .......................... 20cefazolin in dextrose 5 % .................................... 20

Index

cefdinir ................................................................................... 20cefepime ................................................................................ 20cefepime in dextrose 5 % .................................... 20cefepime in dextrose,iso-osm .......................... 21cefixime ................................................................................. 21cefotaxime .......................................................................... 21cefotetan ................................................................................ 21cefotetan in dextrose, iso-osm ........................ 21cefoxitin ................................................................................ 21cefoxitin in dextrose, iso-osm ......................... 21cefpodoxime ..................................................................... 21cefprozil ................................................................................ 21ceftazidime ......................................................................... 21ceftazidime in d5w ..................................................... 21ceftibuten ............................................................................. 21CEFTIN ................................................................................. 21ceftriaxone .......................................................................... 21ceftriaxone in dextrose,iso-os ......................... 21cefuroxime axetil ......................................................... 21cefuroxime sodium .................................................... 21CELEBREX ..................................................................... 15celecoxib .............................................................................. 15CELESTONE SOLUSPAN .......................... 117CELEXA .......................................................................... 143CELLCEPT .................................................................... 121CELLCEPT INTRAVENOUS ................... 121cellulose (bulk) ........................................................... 165CELONTIN ....................................................................... 67CEM-UREA .................................................................. 153CENESTIN .................................................................... 117CENTANY ........................................................................ 21CENTANY AT .............................................................. 21CENTRATEX ................................................................ 94CENTRUM FLAVOR BURST ADULT...................................................................................................... 173CENTUSSIN DHC .................................................... 76CEPACOL SENSATIONS COOLING......................................................................................................... 12CEPACOL SENSATIONS HYDRA ...... 12CEPACOL SORE THROAT (BENZ-MEN) ................................................................. 12CEPACOL SORETHROAT-COUGH......................................................................................................... 76CEPACOL ULTRA .................................................. 12cephalexin ........................................................................... 21CEPROTIN (BLUE BAR) ................................ 58CEPROTIN (GREEN BAR) ............................ 58CERAVE BABY MOISTURIZING .... 153CERAVE SUNSCREEN ................................. 153CERDELGA ................................................................. 165CEREBYX ......................................................................... 67CEREZYME ................................................................. 165CERVARIX VACCINE (PF) ......................... 53CERVIDIL ...................................................................... 117CESAMET ..................................................................... 103CETA-KLENZ GENTLE ................................ 153CETAPHIL .................................................................... 153CETAPHIL ANTIBACTERIAL ............. 153CETAPHIL DAILY FACIAL .................... 153CETAPHIL DERMACONTROL ........... 153CETAPHIL RESTORADERM ................. 153cetirizine ............................................................................... 35cetirizine-pseudoephedrine ................................ 33cevimeline ........................................................................... 50CHANTIX ....................................................................... 162

Index

CHANTIX CONTINUING MONTH BOX ....................................................................................... 162CHANTIX STARTING MONTH BOX...................................................................................................... 162CHATEAL ......................................................................... 71cheesecake flavor (bulk) ................................... 165CHEMET ......................................................................... 166CHEMSTRIP (CALIBRATION) ............ 125CHEMSTRIP 2 .............................................................. 85CHEMSTRIP K ............................................................ 85CHEMSTRIP MICRAL ....................................... 85CHEMSTRIP UGK .................................................. 85CHENODAL ................................................................ 103CHERATUSSIN AC ............................................... 76CHERATUSSIN DAC .......................................... 76CHEST CONGESTION RELIEF .............. 76CHEST CONGESTION RELIEF + DM......................................................................................................... 76CHEST CONGESTION RELIEF PE ..... 76CHEST CONGESTION-COUGH RELIEF ................................................................................. 76CHEST RUB ................................................................ 153CHEST-SINUS CONGESTION RELIEF......................................................................................................... 76CHILD ALLERGY RELF(CETIRIZINE)......................................................................................................... 35CHILD COLD-COUGH DAY-NIGHT......................................................................................................... 76CHILD DELSYM COUGH+CHEST DM......................................................................................................... 76CHILD DELSYM COUGH+COLD ....... 76CHILD DELSYM NIGHTTIME C-C ... 33CHILD IBUPROFEN ............................................. 15CHILD MUCINEX CHEST CONGESTION ............................................................. 76CHILD MUCINEX CONGESTION-COUGH ................................... 76CHILD MUCINEX M-S COLD DAY-NTE .......................................................................... 76CHILD MUCINEX STUFFY NOSE-COLD .................................................................. 76CHILD MUCUS RELIEF COUGH ......... 76CHILD MUCUS RELIEF EXPECTORANT ........................................................ 76CHILD PLUS COUGH & RUNNY NOSE ....................................................................................... 76CHILD TRIAMINIC COLD & ALLERGY ......................................................................... 33CHILD TRIAMINIC COUGH-CONGEST ............................................... 76CHILD TRIAMINIC COUGH-SORE THR ........................................................................................... 76CHILD TRIAMINIC MS FEVER-COLD......................................................................................................... 76CHILDREN'S ACETAMINOPHEN .......... 4CHILDREN'S ALAWAY .................................. 35CHILDREN'S ALLERGY (DIPHENHYD) ............................................................. 35CHILDREN'S ALLERGY COMPLETE......................................................................................................... 35CHILDREN'S ALLERGY MEDICINE......................................................................................................... 35CHILDREN'S ASPIRIN ......................................... 4CHILDREN'S CETIRIZINE ........................... 35CHILDREN'S COLD & COUGH ............. 76

183

Index

CHILDREN'S COLD & COUGH DM......................................................................................................... 76CHILDREN'S COLD-ALLERGY (PE)......................................................................................................... 33CHILDREN'S IBUPROFEN ........................... 15CHILDREN'S MAPAP ............................................ 5CHILDREN'S MAPAP COUGH-SINUS......................................................................................................... 76CHILDREN'S M-S COLD DAY-NIGHT......................................................................................................... 76CHILDREN'S MUCINEX COLD-FEVER .............................................................. 76CHILDREN'S MUCINEX COUGH ....... 76CHILDREN'S MUCINEX MULTI-SYMP .............................................................. 76CHILDREN'S MUCINEX NIGHT TIME......................................................................................................... 76CHILDREN'S PAIN & FEVER RELIEF............................................................................................................ 5CHILDREN'S PAIN RELIEF ........................... 5CHILDREN'S PAIN RELIEVER .................. 5CHILDREN'S PEPTO ........................................ 103CHILDRENS PLUS MULTI-SYMP COLD ...................................................................................... 76CHILDREN'S Q-PAP ................................................ 5CHILDREN'S SILAPAP ........................................ 5CHILDREN'S SILFEDRINE .......................... 76CHILDREN'S TRIAMINIC FEVER ......... 5CHILDREN'S TRIAMINIC-D MS COLD......................................................................................................... 76CHILD'S ALL DAY ALLERGY(CETIR)......................................................................................................... 35CHILDS TRIACTING COLD & COUGH......................................................................................................... 33CHLO HIST ..................................................................... 77CHLO TUSS .................................................................... 77CHLO TUSS EX ......................................................... 77chloramphenicol sod succinate ...................... 21chlordiazepoxide hcl ............................................. 144chlordiazepoxide-clidinium ........................... 103chlorhexidine gluconate .................................... 166CHLOROPHYLL .................................................... 153CHLOROPHYLL (WITH ALFALFA)...................................................................................................... 113chloroprocaine (pf) .................................................... 12chloroquine phosphate ........................................... 39chlorothiazide .................................................................. 87chlorothiazide sodium ............................................. 87chlorpheniramine maleate ................................... 35chlorpromazine ........................................................... 144chlorpropamide .............................................................. 37chlorthalidone ................................................................. 87chlorzoxazone .............................................................. 138chocolate flavor (bulk) ........................................ 166CHOLBAM ................................................................... 103cholecalciferol (vitamin d3) .......................... 173cholesterol ....................................................................... 166cholestyramine (with sugar) ............................. 63CHOLESTYRAMINE LIGHT ..................... 63choline,magnesium salicylate ............................ 5chromium chloride ..................................................... 94CICLODAN ...................................................................... 30CICLODAN KIT ......................................................... 30ciclopirox ............................................................................. 30ciclopirox-ure-camph-menth-euc ................ 30ciclopirox-vite-nail lacq remo ........................ 30

Index

cidofovir ................................................................................ 47cilostazol .............................................................................. 46CILOXAN .......................................................................... 21cimetidine ........................................................................ 103cimetidine hcl ............................................................... 103CIMZIA ............................................................................. 103CIMZIA POWDER FOR RECONST...................................................................................................... 103CIMZIA STARTER KIT ................................. 103CINNAMON ................................................................ 114cinnamon bark ............................................................. 114CINNAMON FLAVORING ........................ 166CINNAMON OIL ................................................... 114CINRYZE ........................................................................ 166CIPRO .................................................................................... 21CIPRO HC ......................................................................... 21CIPRO IN D5W ............................................................ 21CIPRO XR ......................................................................... 21CIPRODEX ....................................................................... 21ciprofloxacin .................................................................... 21ciprofloxacin (mixture) .......................................... 21ciprofloxacin hcl ........................................................... 21ciprofloxacin in 5 % dextrose ......................... 21ciprofloxacin lactate ................................................. 21cisatracurium .................................................................... 50cisplatin ................................................................................. 41citalopram ........................................................................ 144CITRANATAL (DUAL-IRON) ............... 139CITRANATAL 90 DHA (ALGAL OIL)...................................................................................................... 139CITRANATAL 90 DHA (NEW FORMULA .................................................................... 139CITRANATAL ASSURE ............................... 139CITRANATAL B-CALM .............................. 139CITRANATAL B-CALM (FE GLUC)...................................................................................................... 139CITRANATAL DHA (ALGAL OIL)...................................................................................................... 139CITRANATAL DHA (NEW FORMULA) .................................................................. 139CITRANATAL HARMONY ...................... 139CITRANATAL HARMONY (IRON FUM) .................................................................................... 139CITRANATAL RX (NEW FORMULA)...................................................................................................... 139citric acid .......................................................................... 166citronella oil ................................................................... 166CITRUCEL .................................................................... 103CITRUCEL SUGAR FREE .......................... 103cladribine ............................................................................. 41CLAFORAN .................................................................... 21CLARAVIS ................................................................... 153CLARINEX ...................................................................... 35CLARINEX-D 12 HOUR .................................. 33clarithromycin ................................................................. 21CLEANSING EYELID ........................................ 89CLEANSING WASH ............................................. 21CLEAR BANDAGES ......................................... 125CLEAR SPOT BANDAGES ....................... 125CLEAR STRIPS ....................................................... 125CLEAR TAPE ............................................................ 125CLEAR WATERPROOF STRIPS ........ 125CLEARLAX ................................................................. 103clemastine ........................................................................... 35CLENIA EMOLLIENT ........................................ 21CLENIA FOAMING WASH ......................... 22

Index

CLEOCIN ........................................................................... 22CLEOCIN IN 5 % DEXTROSE .................. 22CLEOCIN T ..................................................................... 22CLERZ PLUS .............................................................. 125CLEVIPREX ................................................................... 59CLICKFINE .................................................................. 125CLIMARA ...................................................................... 117CLIMARA PRO ....................................................... 117CLINDACIN ETZ ..................................................... 22CLINDACIN P .............................................................. 22CLINDACIN PAC ..................................................... 22clindamycin hcl ............................................................. 22clindamycin in 5 % dextrose ............................ 22clindamycin palmitate hcl ................................... 22CLINDAMYCIN PEDIATRIC .................... 22clindamycin phosphate .......................................... 22clindamycin-benzoyl peroxide ................... 153CLINDESSE .................................................................... 22CLINIMIX 5%/D15W SULFITE FREE......................................................................................................... 94CLINIMIX 5%/D25W SULFITE-FREE......................................................................................................... 94CLINIMIX 2.75%/D5W SULFIT FREE......................................................................................................... 94CLINIMIX 4.25%/D10W SULF FREE......................................................................................................... 94CLINIMIX 4.25%/D5W SULFIT FREE......................................................................................................... 94CLINIMIX 4.25%-D20W SULF-FREE......................................................................................................... 94CLINIMIX 4.25%-D25W SULF-FREE......................................................................................................... 94CLINIMIX 5%-D20W(SULFITE-FREE)......................................................................................................... 94CLINIMIX E 2.75%/D10W SUL FREE......................................................................................................... 94CLINIMIX E 2.75%/D5W SULF FREE......................................................................................................... 94CLINIMIX E 4.25%/D10W SUL FREE......................................................................................................... 94CLINIMIX E 4.25%/D25W SUL FREE......................................................................................................... 94CLINIMIX E 4.25%/D5W SULF FREE......................................................................................................... 94CLINIMIX E 5%/D15W SULFIT FREE......................................................................................................... 94CLINIMIX E 5%/D20W SULFIT FREE......................................................................................................... 94CLINIMIX E 5%/D25W SULFIT FREE......................................................................................................... 95CLINISOL SF 15 % ................................................. 95CLINISTIX ....................................................................... 85CLINITEST REAGENT ..................................... 85clobetasol .......................................................................... 153clobetasol-emollient .............................................. 153CLOBEX .......................................................................... 153clocortolone pivalate ............................................. 153CLODAN ......................................................................... 153CLODAN KIT ............................................................ 153CLODERM .................................................................... 153CLOFERA .......................................................................... 77CLOLAR ............................................................................. 41clomipramine ................................................................ 144clonazepam ........................................................................ 67clonidine ............................................................................... 63clonidine (pf) ....................................................................... 5

184

Index

clonidine hcl ........................................................ 63, 144clopidogrel .......................................................................... 46clorazepate dipotassium .................................... 144CLORPRES ...................................................................... 63CLOTH FIRST AID TAPE ........................... 125CLOTH TAPE ............................................................ 125clotrimazole ....................................................................... 30CLOTRIMAZOLE 3 DAY ............................... 30CLOTRIMAZOLE-3 ............................................... 30clotrimazole-betamethasone ............................. 30CLOVE FLAVORING ...................................... 166clozapine ........................................................................... 144CLOZARIL .................................................................... 144C-NATE DHA ............................................................ 139CNL 8 NAIL .................................................................... 30CO Q-10 ............................................................................ 166COACH SPORTS ................................................... 125COARTEM ....................................................................... 39COBAN ............................................................................. 125COBAN ACTION WRAP .............................. 125COBAN SELF-ADHERENT WRAP...................................................................................................... 125COBAN STERILE SELF-ADHERENT...................................................................................................... 125cocaine .................................................................................... 12cocoa butter .................................................................... 166cocoa butter (bulk) .................................................. 166coconut oil (bulk) ..................................................... 166cod liver oil .................................................................... 173COD LIVER OIL PLUS VIT A & D3...................................................................................................... 173codeine sulfate ................................................................... 5codeine-guaifenesin .................................................. 77CODITUSS DM ........................................................... 77COLACE .......................................................................... 103COLACE CLEAR .................................................. 103COLAZAL ...................................................................... 103colchicine ............................................................................. 15colchicine-probenecid ............................................. 15COLCRYS ......................................................................... 15COLD & ALLERGY .............................................. 33COLD & ALLERGY PE ..................................... 33COLD & COUGH ...................................................... 77COLD & COUGH DM ......................................... 77COLD & COUGH ELIXIR .............................. 77COLD & FLU SEVERE ...................................... 77COLD & HOT PAIN RELIEF ................... 153COLD HEAD CONGESTION DAY/NITE ........................................................................ 77COLD HEAD CONGESTION DAYTIME ......................................................................... 77COLD HEAD CONGESTION NIGHTTIME ................................................................... 77COLD HEAD CONGESTION SEVER DAY .......................................................................................... 77COLD MULTI-SYMPTOM ............................ 77COLD MULTI-SYMPTOM (CHLORPHEN) ............................................................ 77COLD MULTI-SYMPTOM DAY/NIGHT ................................................................... 77COLD RELIEF .............................................................. 77COLD RELIEF PLUS ............................................ 77COLD SEVERE CONGESTION ............... 77COLD SORE TREATMENT ......................... 39COLD SORE TREATMNT (CAMP-PHEN) .......................................................... 153

Index

COLD-SINUS RELIEF ........................................ 77COLESTID ........................................................................ 63COLESTID FLAVORED ................................... 63colestipol .............................................................................. 63colistin (colistimethate na) ................................. 22COLOCORT ................................................................. 117COLY-MYCIN M PARENTERAL ......... 22COLY-MYCIN S ........................................................ 22COLYTE WITH FLAVOR PACKS .... 103COMBIGAN .................................................................... 89COMBINE ABD ...................................................... 125COMBIPATCH ......................................................... 117COMBIVENT RESPIMAT .............................. 17COMBIVIR ....................................................................... 47COMETRIQ ..................................................................... 41COMFEEL PURILON ....................................... 125COMFORT EZ PEN NEEDLES ............. 125COMFORT EZ SYRINGE ............................ 125COMPACT SPACE CHAMBER PLUS...................................................................................................... 125COMPLERA .................................................................... 47COMPLETE ................................................................. 103COMPLETE ALLERGY .................................... 35COMPLETE ALLERGY MEDICINE......................................................................................................... 35COMPLETE LICE TREATMENT ....... 153COMPLETE NATAL DHA ......................... 139COMPLETENATE ................................................ 139COMPRO ........................................................................ 103COMTAN ........................................................................... 45COMTREX COLD-COUGH .......................... 77COMTREX DAY/NI SEV COLD-SINUS......................................................................................................... 77COMTREX DAY/NIGHT COLD & COUGH ................................................................................ 77COMTREX DEEP CHEST COLD .......... 77COMTREX FLU THERAPY ......................... 77COMTREX NIGHTTIME COLD & COUGH ................................................................................ 77COMVAX (PF) ............................................................. 53CONCEPT DHA ...................................................... 139CONCEPT OB ........................................................... 139CONCERTA ................................................................. 144CONDYLOX ............................................................... 153CONEX ................................................................................. 33CONFORM .................................................................... 125CONFORMANT 2 ................................................. 125CONGESTAC ................................................................ 77CONGESTION RELIEF (IBUPROF-PE)......................................................................................................... 77CONSTULOSE ......................................................... 103CONTACT LENS RELIEF ........................... 126CONZIP ................................................................................... 5COOLMAGIC ............................................................ 126COOLMAGIC FENESTRATED ............ 126COPAXONE .................................................................... 67COPEGUS .......................................................................... 47COPPER CHLORIDE ........................................... 95CORDARONE .............................................................. 59CORDRAN TAPE LARGE ROLL ....... 153CORDRAN TAPE SMALL ROLL ...... 153COREG ................................................................................. 63COREG CR ....................................................................... 63CORGARD ....................................................................... 63CORIFACT ....................................................................... 58CORLANOR ................................................................... 59

Index

CORLOPAM ................................................................... 63CORMAX ....................................................................... 153CORN CUSHION ................................................... 126CORTEF ........................................................................... 117CORTENEMA ........................................................... 117CORTIFOAM ............................................................. 117cortisone ............................................................................ 117CORTISPORIN ............................................................ 22CORTISPORIN-TC ................................................. 22CORTIZONE-10 ...................................................... 153CORTOMYCIN ........................................................... 22CORTROSYN ............................................................ 117CORVERT ......................................................................... 59CORVITA ....................................................................... 173CORVITA 150 ............................................................... 95CORVITE ........................................................................ 173CORVITE 150 ............................................................... 95CORVITE FE .................................................................. 95CORVITE FREE ...................................................... 173CORZIDE ........................................................................... 63COSENTYX ................................................................. 153COSENTYX (2 SYRINGES) ..................... 153COSENTYX PEN ................................................... 153COSENTYX PEN (2 PENS) ....................... 153COSMEGEN ................................................................... 41COSMETIC BALLS ............................................ 126COSMETIC PUFFS .............................................. 126COSMETIC SQUARES ................................... 126COSOPT .............................................................................. 89COSOPT (PF) ................................................................. 89cosyntropin ..................................................................... 117COTTON BALLS ................................................... 126COTTON BALLS STERILE ...................... 126COTTON SQUARES .......................................... 126COTTON SWABS ................................................. 126COTTON, STERILE ............................................ 126cottonseed oil (bulk) ............................................. 166COUGH & COLD ...................................................... 77COUGH & COLD BP ............................................ 77COUGH & SORE THROAT .......................... 77COUGH CONTROL (DEXTROMETHORPH) .................................... 77COUGH CONTROL (GUAIFENESIN)......................................................................................................... 77COUGH CONTROL CF (PE) ....................... 77COUGH CONTROL DM ................................... 77COUGH CONTROL DM MAX ................. 77COUGH DM ER .......................................................... 77COUGH DROPS ......................................................... 77COUGH RELIEF ........................................................ 77COUGH SUPPRESSANT ................................. 77COUGH SUPPRESSANT-EXPECTORANT ........ 77COUGH SYRUP ......................................................... 77COUGH SYRUP DM ............................................. 78COUGH-SORE THROAT NIGHT .......... 78COUGHTAB ................................................................... 78COUGHTAB 400 ....................................................... 78COUMADIN ................................................................... 28COVARYX .................................................................... 117COVARYX H.S. ...................................................... 117COVERA-HS .................................................................. 59COVRSITE .................................................................... 126COVRSITE PLUS .................................................. 126COZAAR ............................................................................. 63cpd vehicle sus.sugar-free #12 .................... 166

185

Index

cpm-pseudoephed-hydrocodone .................. 78cranberry ........................................................................... 114CRANBERRY ............................................................ 114cranberry conc-ascorbic acid ........................ 114CRANBERRY CONCENTRATE ......... 114cranberry extract ....................................................... 114cranberry fruit .............................................................. 114CRANBERRY PLUS VITAMIN C ..... 114CRAN-MAX 500 MG ........................................ 114cream de menthe (bulk) ..................................... 166CREME DE MENTHE FLAVORING...................................................................................................... 166CREON .............................................................................. 103CRESEMBA .................................................................... 30CRESTOR .......................................................................... 63CRINONE ....................................................................... 117CRITIC-AID CLEAR ......................................... 153CRITIC-AID CLEAR AF .................................. 30CRIXIVAN ....................................................................... 47cromolyn .................................................................... 17, 89CRUEX PRESCRIPTION STRENGTH......................................................................................................... 30CRYOSERV ................................................................. 166CRYSELLE (28) ......................................................... 71CUBICIN ............................................................................. 22cupric sulfate .................................................................... 95CUPRIMINE ................................................................... 15CURAD GAUZE PAD ...................................... 126CURAD NON-STICK PAD ......................... 126CURAD SHEER SPOTS ................................. 126CURAFIL GEL WOUND .............................. 126CURASILK CLOTH ........................................... 126CURASOL HYDROGEL DRESSING...................................................................................................... 126CURASOL WOUND DRESSING ........ 126CURI-STRIP WOUND CLOSURES...................................................................................................... 126CURITY ABDOMINAL PAD .................. 126CURITY ABSORBENT WADDING...................................................................................................... 126CURITY ALCOHOL SWABS .................. 153CURITY AMD ........................................................... 126CURITY AMD (WITH POLYHEXAMETH) ............................................ 126CURITY BANDAGE .......................................... 126CURITY COTTON PREP BALLS ....... 126CURITY COTTON TIP APPLICATOR...................................................................................................... 126CURITY COVER .................................................... 126CURITY DETECTABLE LAP ................. 126CURITY DISP LAP SPONGE POUCH...................................................................................................... 126CURITY DISP LAP SPONGE TRAY...................................................................................................... 126CURITY DRESSING .......................................... 126CURITY GAUZE .................................................... 126CURITY GAUZE BURN DRESSING...................................................................................................... 126CURITY IODOFORM PACKING STRIP...................................................................................................... 126CURITY LAKESIDE COTTON ROLL...................................................................................................... 126CURITY MATERNITY PADS ................ 126CURITY MULTI-TRAUMA DRESSING...................................................................................................... 126

Index

CURITY NON-ADHERENT STRIP...................................................................................................... 126CURITY NON-ADHERING DRESSING...................................................................................................... 126CURITY PLAIN PACKING STRIP ... 126CURITY READY-CUT GAUZE ........... 127CURITY STANDARD POROUS .......... 127CURITY SURGICAL DRESSING ....... 127CURITY WET DRESSING ......................... 127CUROSURF ................................................................. 166CUTIVATE ................................................................... 153CUVPOSA ..................................................................... 103cyanocobalamin (vitamin b-12) ................. 173CYCLAFEM 1/35 (28) ......................................... 71CYCLAFEM 7/7/7 (28) ....................................... 71CYCLESSA (28) ......................................................... 71CYCLIVERT ............................................................... 103cyclobenzaprine ......................................................... 138CYCLOGYL .................................................................... 89CYCLOMYDRIL ....................................................... 89cyclopentolate ................................................................. 89cyclophosphamide ...................................................... 41cycloserine .......................................................................... 22CYCLOSET ..................................................................... 37cyclosporine ................................................................... 121cyclosporine modified ......................................... 121CYKLOKAPRON ...................................................... 58CYMBALTA ............................................................... 144cyproheptadine ............................................................... 35CYRAMZA ....................................................................... 41CYRED ................................................................................. 71CYSTADANE ............................................................ 166CYSTAGON ................................................................ 166CYSTARAN .................................................................... 89cysteine (l-cysteine) .................................................. 95CYSVIEW .......................................................................... 85cytarabine ............................................................................ 41cytarabine (pf) ................................................................. 41CYTOGAM ...................................................................... 53CYTOMEL .................................................................... 162CYTOTEC ...................................................................... 103CYTOVENE .................................................................... 47CYTRA K CRYSTALS ....................................... 95D.H.E.45 .................................................................................. 5d10 % & 0.45 % sodium chloride ............... 95d2.5 %-0.45 % sodium chloride ................... 95d5 % and 0.9 % sodium chloride ................. 95d5 %-0.45 % sodium chloride ........................ 95dacarbazine ........................................................................ 41DACOGEN ....................................................................... 41DAKLINZA ...................................................................... 47DALLERGY (CHLORCYCLIZINE-PE)......................................................................................................... 33DALLERGY (CHLORPHENIRAMINE-PE) ..................... 33DALLERGY (DEXBROMPHENIRAMN-PE) ................. 33DALVANCE ................................................................... 22danazol ................................................................................ 117DANTRIUM ................................................................. 138dantrolene ........................................................................ 138dapsone .................................................................................. 22DAPTACEL (DTAP PEDIATRIC) (PF)......................................................................................................... 53DARAPRIM ..................................................................... 39DASETTA 1/35 (28) ............................................... 71

Index

DASETTA 7/7/7 (28) ............................................. 71daunorubicin ..................................................................... 41DAUNOXOME ............................................................ 41DAY TIME PE .............................................................. 78DAYHIST ALLERGY .......................................... 35DAYPRO ............................................................................. 15DAYSEE .............................................................................. 71DAYTIME COLD & FLU RELIEF (PE)......................................................................................................... 78DAYTIME COLD-FLU ....................................... 78DAY-TIME COUGH .............................................. 78DAYTIME MUCUS RELIEF DM ........... 78DAYTIME SINUS .................................................... 78DAYTIME SINUS RELIEF ............................ 78DAYTIME-NIGHTTIME .................................. 78DAYTRANA ............................................................... 144DDAVP .............................................................................. 117DEBLITANE ................................................................... 71DECARA ......................................................................... 173DECAVAC (PF) .......................................................... 53DE-CHLOR DM .......................................................... 78decitabine ............................................................................. 41DECONEX ........................................................................ 78DECONEX DM ............................................................ 78DECONEX DMX ....................................................... 78DECONEX IR ................................................................ 78deferoxamine ................................................................ 166DEFINITY ......................................................................... 85DEHYDRATED ALCOHOL ......................... 68DELATESTRYL ...................................................... 117DELBASE COMPOUNDING ................... 166DEL-CLENS ................................................................ 153DELESTROGEN ..................................................... 117DELFLEX WITH 2.5 % DEXTROSE......................................................................................................... 95DELFLEX-LC/1.5% DEXTROSE ........... 95DELFLEX-LC/2.5% DEXTROSE ........... 95DELFLEX-LC/4.25% DEXTROSE ........ 95DELFLEX-SM WITH 1.5% DEXTROSE......................................................................................................... 95DELSYM 12 HOUR ................................................ 78DELSYM COUGH+CHEST CONGEST DM ............................................................................................. 78DELSYM COUGH+COLD DAYTIME......................................................................................................... 78DELSYM COUGH+COLD NIGHTTIME......................................................................................................... 78DELSYM COUGH+SOOTHING ACTION ............................................................................... 78DELSYM NIGHT TIME COUGH & COLD ...................................................................................... 33DELSYM NIGHTTIME MULTI-SYMPTOM ................................................ 78DELYLA (28) ................................................................. 71DELZICOL .................................................................... 103DEMADEX ....................................................................... 87demeclocycline .............................................................. 22DEMEROL ........................................................................... 5DEMEROL (PF) .............................................................. 5DEMSER ............................................................................. 63DENAVIR .......................................................................... 47DENTA 5000 PLUS ................................................ 95DENTAGEL .................................................................... 95DENTAL TRAVEL PACK ........................... 127denture care products ........................................... 127DEODORANT SOAP ........................................ 153

186

Index

DEPACON ........................................................................ 68DEPAKENE ..................................................................... 68DEPAKOTE ..................................................................... 68DEPAKOTE ER ........................................................... 68DEPAKOTE SPRINKLES ................................ 68DEPEN TITRATABS ............................................ 15DEPOCYT (PF) ............................................................ 41DEPO-ESTRADIOL ............................................ 117DEPO-MEDROL ..................................................... 117DEPO-PROVERA ........................................ 71, 117DEPO-SUBQ PROVERA 104 ...................... 71DEPO-TESTOSTERONE .............................. 117DERMA STAT .......................................................... 154DERMABASE ........................................................... 166DERMACEA ............................................................... 127DERMACEA I.V. ................................................... 127DERMACEA NON-WOVEN .................... 127DERMACEA STRETCH ................................ 127DERMACINRX SILAZONE ...................... 154DERMAFIX .................................................................. 166DERMAFUNGAL ..................................................... 30DERMAGAUZE ...................................................... 127DERMAGAUZE HYDROGEL DRESSING .................................................................... 127DERMA-GEL ............................................................. 127DERMAGRAN HYDROGEL DRESSING .................................................................... 127DERMAGRAN HYDROPHILIC DRESSING .................................................................... 127DERMAL WOUND CLEANSER ......... 154DERMANIC ................................................................. 166DERMASARRA ...................................................... 154DERMASEPTIN ...................................................... 154DERMA-SMOOTHE/FS BODY OIL...................................................................................................... 154DERMA-SMOOTHE/FS SCALP OIL...................................................................................................... 154DERMASYN ............................................................... 127DERMATOP ................................................................ 154DERMAVIEW ........................................................... 127DERMAVIEW II ..................................................... 127DERMOTIC OIL ........................................................ 89DESENEX .......................................................................... 31DESFERAL ................................................................... 166DESGEN DM (PSEUDOEPHEDRINE)......................................................................................................... 78desipramine .................................................................... 144desloratadine .................................................................... 35desmopressin ................................................................ 117desog-e.estradiol/e.estradiol ............................. 71DESOGEN ......................................................................... 71desogestrel-ethinyl estradiol ............................. 71DESONATE ................................................................. 154desonide ............................................................................. 154DESOWEN .................................................................... 154desoximetasone .......................................................... 154DESOXYN ........................................................................ 50DESQUAM-X ............................................................. 154desvenlafaxine ............................................................. 144desvenlafaxine fumarate ................................... 144DETOX DIETARY ............................................... 114DETOXAREX ............................................................ 114DETROL .......................................................................... 166DETROL LA ................................................................ 166DEWEE'S CARMINATIVE ........................ 103DEX4 GLUCOSE ....................................................... 95

Index

dexamethasone ............................................................ 117DEXAMETHASONE INTENSOL ....... 118dexamethasone sodium phos (pf) ............ 118dexamethasone sodium phosphate............................................................................................ 89, 118dexchlorpheniramine maleate ......................... 35DEXEDRINE .................................................................. 50DEXEDRINE SPANSULE .............................. 50DEXFERRUM ............................................................... 95DEXILANT ................................................................... 103dexmedetomidine ..................................................... 149dexmethylphenidate ............................................... 144DEXPAK 10 DAY ................................................. 118DEXPAK 13 DAY ................................................. 118DEXPAK 6 DAY .................................................... 118dexpanthenol .................................................................... 50dexrazoxane hcl ......................................................... 166dextroamphetamine ................................................... 50dextroamphetamine-amphetamine ... 50, 51dextromethorphan polistirex ............................ 78dextromethorphan-guaifenesin ...................... 78dextrose ................................................................................. 95dextrose 10 % and 0.2 % nacl ......................... 95dextrose 10 % in water (d10w) ...................... 95dextrose 20 % in water (d20w) ...................... 95dextrose 25 % in water (d25w) ...................... 95dextrose 30 % in water (d30w) ...................... 95dextrose 40 % in water (d40w) ...................... 95dextrose 5 % in water (d5w) ............................ 95dextrose 5 %-lactated ringers .......................... 95dextrose 5%-0.2 % sod chloride ................... 95dextrose 5%-0.3 % sod.chloride ................... 95dextrose 50 % in water (d50w) ...................... 95dextrose 70 % in water (d70w) ...................... 95DHS ....................................................................................... 154DHS TAR ........................................................................ 154DHS TAR GEL .......................................................... 154DHS ZINC ...................................................................... 154DIABETA ........................................................................... 37DIABETIC SILTUSSIN DAS-NA ........... 78DIABETIC SILTUSSIN-DM ......................... 78DIABETIC SILTUSSIN-DM MAX STR......................................................................................................... 78DIABETISWEET ....................................................... 95DIAFOODS THICK-IT .................................... 166DIAFOODS THICK-IT #2 ............................ 166DIALYVITE ................................................................. 173DIALYVITE 3000 .................................................. 173DIALYVITE 5000 .................................................. 173DIALYVITE SUPREME D .......................... 173DIAMOX SEQUELS .............................................. 87DIANEAL PD-2 WITH 2.5 % DEX ....... 95DIANEAL PD-2 WITH 4.25 % DEX .... 95DIANEAL PD-2/1.5% DEXTROSE ...... 95DIANEAL WITH 1.5% DEXTROSE ... 95DIANEAL WITH 4.25 % DEXTROSE......................................................................................................... 95DIAPER RASH ......................................................... 154DIAPER RASH RELIEF ................................. 154DIASCREEN 10 .......................................................... 85DIASCREEN 1G REAGENT ........................ 85DIASCREEN 1K REAGENT ........................ 85DIASCREEN 2GK REAGENT ................... 85DIASCREEN 3 REAGENT ............................. 85DIASCREEN 4OBL REAGENT ............... 85DIASCREEN 5 REAGENT ............................. 86

Index

DIASCREEN 6 REAGENT ............................. 86DIASCREEN 7 REAGENT ............................. 86DIASCREEN 8 REAGENT ............................. 86DIASCREEN 9 REAGENT ............................. 86DIASTAT ........................................................................... 68DIASTAT ACUDIAL ............................................ 68DIASTIX ............................................................................. 86diazepam ................................................................. 68, 144DIAZEPAM INTENSOL ................................ 144dibucaine .............................................................................. 12DICEL CD ......................................................................... 78DICLEGIS ...................................................................... 103diclofenac potassium ................................................... 5diclofenac sodium ...................... 15, 41, 89, 154diclofenac-misoprostol .......................................... 15dicloxacillin ....................................................................... 22dicyclomine .................................................................... 103didanosine ........................................................................... 47DIFFERIN ....................................................................... 154DIFICID ................................................................................ 22diflorasone ....................................................................... 154DIFLUCAN ...................................................................... 31diflunisal .................................................................................. 5DIGITEK ............................................................................. 59DIGOX .................................................................................. 60digoxin .................................................................................... 60dihydrocode-acetaminophen-caff ................... 5dihydrocodeine-aspirin-caff ................................. 5dihydroergotamine ......................................................... 5DILACOR XR ............................................................... 60DILANTIN ........................................................................ 68DILANTIN EXTENDED ................................... 68DILANTIN INFATABS ...................................... 68DILANTIN-125 ............................................................ 68DILATRATE-SR ........................................................ 60DILAUDID ........................................................................... 5DILAUDID (PF) ............................................................. 5DILAUDID-HP (PF) .................................................. 5DILT-CD ............................................................................. 60DILTIA XT ....................................................................... 60diltiazem hcl ..................................................................... 60diltiazem in dextrose 5 % .................................... 60DILT-XR ............................................................................. 60DILTZAC ER ................................................................. 60DILUENT FOR EPOPROSTENOL/FLOLA .......................... 166DILUENT FOR YF-VAX (1 DOSE)...................................................................................................... 166DILUENT FOR YF-VAX (5 DOSE)...................................................................................................... 166DILUENT-MERCK LIVE VIRUS VACC...................................................................................................... 166DIMAPHEN (PE) ....................................................... 33DIMAPHEN DM ........................................................ 78dimenhydrinate ........................................................... 104DIMETANE-DX ......................................................... 78DIMETAPP DM COLD-COUGH (PE)......................................................................................................... 78DIOCTO ........................................................................... 104DIOVAN .............................................................................. 63DIOVAN HCT ............................................................... 63DIPENTUM .................................................................. 104DIPHEDRYL .................................................................. 35DIPHENHIST ................................................................. 35diphenhydramine hcl ............................................... 35diphenhydramine-acetaminophen .................. 3

187

Index

diphenoxylate-atropine ....................................... 104DIPRIVAN ........................................................................ 12DIPROLENE ................................................................ 154DIPROLENE AF ..................................................... 154dipyridamole .......................................................... 46, 86DISALCID ......................................................................... 15DISINFECTING SOLUTION .................... 127DISKETS ................................................................................ 5disopyramide phosphate ....................................... 60DISPOSABLE ENEMA ................................... 104disulfiram ......................................................................... 166DITROPAN XL ........................................................ 166DIURETIC ...................................................................... 114DIURIL ................................................................................. 87divalproex ........................................................................... 68DIVIGEL .......................................................................... 118DIVISTA .......................................................................... 166DOAN'S EXTRA STRENGTH ....................... 5DOAN'S PM BACK PAIN RELIEF .......... 5dobutamine ........................................................................ 60dobutamine in d5w .................................................... 60DOCEFREZ ..................................................................... 41docetaxel .............................................................................. 41DOC-Q-LACE ............................................................ 104DOC-Q-LAX ................................................................ 104DOCU .................................................................................. 104docusate calcium ....................................................... 104docusate sodium ........................................................ 104DOCUSIL ........................................................................ 104DOCUSOL ..................................................................... 104DOCUSOL KIDS .................................................... 104DOCUSOL PLUS ................................................... 104DOK ...................................................................................... 104DOK PLUS .................................................................... 104DOLOGESIC ...................................................................... 3DOLOPHINE ..................................................................... 5DOME-PASTE BANDAGES .................... 127DONATUSS DC ......................................................... 78DONATUSSIN ............................................................. 78DONATUSSIN DM ................................................. 78DONATUSSIN PEDI (REFORMULATED) ............................................. 78DONATUSSIN PEDIATRIC ......................... 78donepezil .............................................................................. 51DONNATAL ................................................................ 104dopamine .............................................................................. 51dopamine in 5 % dextrose .................................. 51DOPRAM ........................................................................... 68DORIBAX .......................................................................... 22DORYX ................................................................................ 22dorzolamide ....................................................................... 89dorzolamide-timolol ................................................. 89DOTHELLE DHA .................................................. 139DOUBLE ANTIBIOTIC ..................................... 22DOUBLE ANTIBIOTIC (B.TRACN ZN)......................................................................................................... 22DOVONEX .................................................................... 154doxazosin ............................................................................. 63doxepin ............................................................................... 144doxercalciferol ............................................................ 166DOXIL ................................................................................... 41doxorubicin ........................................................................ 41doxorubicin, peg-liposomal .............................. 41DOXY-100 ........................................................................ 22doxycycline hyclate ..................................... 22, 166doxycycline monohydrate ......................... 22, 23

Index

DR. SMITH'S ADULT BARRIER ........ 154DR. SMITH'S DIAPER ..................................... 154DR. SMITH'S DIAPER RASH ................. 154DR. SMITH'S RASH-SKIN ......................... 154DRESSING SPONGES ..................................... 127DRIMINATE ............................................................... 104DRISDOL ........................................................................ 173droperidol ......................................................................... 144DROXIA .............................................................................. 58DRY EYES ........................................................................ 89DRYMAX .......................................................................... 78DRYMAX AF ................................................................ 78DRYNET WOUND VEIL .............................. 127DUAC .................................................................................. 154DUAVEE ......................................................................... 118DUCODYL .................................................................... 104DUET DHA EC-OM 3 ....................................... 139DUET DHA WITH OMEGA-3 ................ 139DUETACT ......................................................................... 37DUEXIS ................................................................................ 15DULCOLAX (BISACODYL) .................... 104DULERA ............................................................................. 17duloxetine ........................................................................ 144DUODERM HYDROACTIVE ................. 127DUONEB ............................................................................ 17DUOPA ................................................................................. 45DURACLON (PF) ......................................................... 5DURAFLU ........................................................................ 78DURAGESIC ..................................................................... 5DURAMORPH (PF) ................................................... 5DURAPORE CLOTH SURGICAL TAPE...................................................................................................... 127DURAPORE SURGICAL .............................. 127DURAVENT DM ....................................................... 78DURAVENT PE .......................................................... 78DUREZOL ......................................................................... 89DUTOPROL .................................................................... 63DYAZIDE .......................................................................... 87DYLOJECT ...................................................................... 15DYMISTA .......................................................................... 89DYNACIN ......................................................................... 23DYNA-HEX ................................................................. 154DYNA-HEX (ISOPROPYL ALCOHOL)...................................................................................................... 154DYSPORT .......................................................................... 51E.C. PRIN ............................................................................... 5E.E.S. 400 ........................................................................... 23E.E.S. GRANULES .................................................. 23EAR DROPS (CARBAMIDE PEROXIDE) ..................................................................... 89EAR POPPER INFLATION DEVICE...................................................................................................... 127EAR WAX REMOVAL DROPS ............... 89EAR WAX REMOVAL KIT .......................... 89EAR WAX REMOVAL SYSTEM .......... 89EAR WAX TREATMENT ............................... 89EASIVENT HOLDING CHAMBER...................................................................................................... 127EASIVENT MASK LARGE ....................... 127EASIVENT MASK MEDIUM .................. 127EASIVENT MASK SMALL ....................... 127EASY COMFORT INSULIN SYRINGE...................................................................................................... 127EASY COMFORT PEN NEEDLES .... 127EASY TOUCH ........................................................... 127

Index

EASY TOUCH ALCOHOL PREP PADS...................................................................................................... 154EASY TOUCH INSULIN SAFETY SYR...................................................................................................... 127EASY TOUCH INSULIN SYRINGE...................................................................................................... 127echinacea .......................................................................... 114ECHINACEA & GOLDENSEAL .......... 114ECHINACEA 1X .................................................... 114echinacea angust-purpr root xt ................... 114ECHINACEA HERB ........................................... 114ECHINACEA PLUS ............................................ 114echinacea purpurea extract ............................. 114echinacea purpurea root ..................................... 114ECHINACEA ROOT .......................................... 114echinacea-golden seal .......................................... 114echinacea-golden seal roots ........................... 114EC-NAPROSYN ......................................................... 15econazole ............................................................................. 31ECONTRA EZ ............................................................... 71ED A-HIST ........................................................................ 33ED A-HIST DM ........................................................... 79ED A-HIST PSE .......................................................... 33ED BRON GP ................................................................. 79ED CHLORPED D .................................................... 33ED CHLORPED JR ................................................. 35ED-APAP ............................................................................... 5EDARBYCLOR ........................................................... 63ED-CHLORPED .......................................................... 35ED-CHLORTAN ......................................................... 35EDECRIN ........................................................................... 87EDLUAR .......................................................................... 149ED-SPAZ ......................................................................... 104EDURANT ........................................................................ 47EEMT .................................................................................. 118EEMT HS ........................................................................ 118EFFER-K ................................................................... 95, 96EFFERVESCENT PAIN RELIEF ................ 5EFFEXOR XR ............................................................ 144EFFIENT ............................................................................. 46EFUDEX .............................................................................. 41EGRIFTA ........................................................................ 118ELAPRASE ................................................................... 166elastic bandage ............................................................ 127ELASTIC STRETCH NET ........................... 127ELASTO-GEL ............................................................ 127ELASTO-GEL CAST-SPLINT PADDING ....................................................................... 127ELASTO-GEL CIRCLE DRESSING...................................................................................................... 127ELASTO-GEL FACE DRESSING ....... 127ELASTO-GEL PLUS .......................................... 127ELDEPRYL ...................................................................... 45electrolyte-48 in d5w ............................................... 96ELELYSO ....................................................................... 166ELESTAT ........................................................................... 36ELESTRIN ..................................................................... 118ELIDEL ............................................................................. 121ELIGARD ........................................................................... 41ELIMITE .......................................................................... 154ELINEST ............................................................................. 71ELIPHOS ............................................................................. 96ELIQUIS .............................................................................. 28ELITEK ................................................................................. 15ELITE-OB ....................................................................... 139ELIXOPHYLLIN ....................................................... 18

188

Index

ELLA ....................................................................................... 71ELLENCE .......................................................................... 41ELLURA .......................................................................... 114ELMIRON ............................................................................. 5ELOCON .......................................................................... 154ELOCTATE ...................................................................... 58ELOXATIN ...................................................................... 41ELTA LITE TAR .................................................... 154ELTA SEAL MOISTURE BARRIER...................................................................................................... 154ELTA TAR ..................................................................... 154EMADINE ......................................................................... 36EMBEDA ............................................................................... 5EMCYT ................................................................................. 41EMEND ............................................................................. 104EMLA ..................................................................................... 12EMOQUETTE ............................................................... 71EMSAM ............................................................................ 144EMTRIVA .......................................................................... 47ENABLEX ...................................................................... 167enalapril maleate .......................................................... 63enalaprilat ............................................................................ 63enalapril-hydrochlorothiazide ......................... 63ENBRACE HR ........................................................... 139ENBREL .............................................................................. 15ENBREL SURECLICK ....................................... 15ENDACOF - DM ........................................................ 79ENDACOF-C .................................................................. 79ENDOCET ............................................................................ 5ENDODAN .......................................................................... 5ENEMA ............................................................................. 104ENEMA DISPOSABLE ................................... 104ENGERIX-B (PF) ....................................................... 53ENGERIX-B PEDIATRIC (PF) .................. 53ENGLISH TOFFEE FLAVOR .................. 167ENJUVIA ........................................................................ 118ENLON ................................................................................. 51ENLYTE (FERROUS GLYCINE) ........ 173enoxaparin ................................................................ 28, 29ENPRESSE ....................................................................... 72ENSKYCE ......................................................................... 72entacapone .......................................................................... 45entecavir ................................................................................ 47ENTEREG ...................................................................... 104ENTOCORT EC ....................................................... 118ENTRE-COUGH ......................................................... 79ENTRE-S ............................................................................. 79ENTRESTO ...................................................................... 63ENTSOL NASAL SPRAY ............................... 89ENTYVIO ....................................................................... 104ENULOSE ...................................................................... 104EOVIST ................................................................................ 86EPANED .............................................................................. 63ephedrine sulfate .......................................................... 79ephedrine sulfate in 0.9% nacl ....................... 79EPI-CLENZ ................................................................... 154EPIDUO ............................................................................ 154EPIDUO FORTE ..................................................... 154EPIFOAM ....................................................................... 154epinastine ............................................................................. 36epinephrine ........................................................................ 51epinephrine hcl (pf) ................................................... 51EPIPEN ................................................................................. 51EPIPEN 2-PAK ............................................................. 51EPIPEN JR ......................................................................... 51EPIPEN JR 2-PAK .................................................... 51

Index

epirubicin ............................................................................. 41EPISNAP ............................................................................. 51EPITOL ................................................................................. 68EPIVIR .................................................................................. 47EPIVIR HBV ................................................................... 47eplerenone ........................................................................... 87EPOGEN .............................................................................. 70epoprostenol (glycine) ............................................ 63eprosartan ............................................................................ 63EPZICOM ........................................................................... 47EQUETRO ...................................................................... 144ERAXIS(WATER DILUENT) ..................... 31ERBITUX ........................................................................... 41ergocalciferol (vitamin d2) ............................. 173ergoloid .................................................................................. 63ergotamine-caffeine ...................................................... 6ERIVEDGE ....................................................................... 41ERRIN .................................................................................... 72ERTACZO ......................................................................... 31ERWINAZE ..................................................................... 41ERY PADS ........................................................................ 23ERYGEL .............................................................................. 23ERYPED 200 .................................................................. 23ERYPED 400 .................................................................. 23ERY-TAB ........................................................................... 23ERYTHROCIN ............................................................. 23ERYTHROCIN (AS STEARATE) ........... 23erythromycin .................................................................... 23erythromycin ethylsuccinate ............................ 23erythromycin with ethanol ................................. 23erythromycin-benzoyl peroxide .................... 23ESBRIET .......................................................................... 167ESCAVITE .................................................................... 173ESCAVITE D .............................................................. 173ESCAVITE LQ .......................................................... 173escitalopram oxalate .............................................. 144ESGIC ........................................................................................ 6esmolol ................................................................................... 63esomeprazole sodium ........................................... 104esomeprazole strontium ..................................... 104ESOTERICA FADE ............................................. 155ESTARYLLA ................................................................. 72estazolam .......................................................................... 149ESTRACE ....................................................................... 118estradiol .............................................................................. 118estradiol valerate ....................................................... 118estradiol-norethindrone acet .......................... 118ESTRING ........................................................................ 118estrogens-methyltestosterone ....................... 118estropipate ....................................................................... 118ESTROSTEP FE-28 ................................................. 72eszopiclone ..................................................................... 149ethacrynate sodium .................................................... 87ethambutol .......................................................................... 23ethanol (ethyl alcohol) ............................................ 68ethosuximide .................................................................... 68ethyl acetate ................................................................... 167ethyl alcohol .................................................................. 155ethyl vanillin ................................................................. 167etidronate disodium ............................................... 167etodolac ................................................................................. 15etomidate .............................................................................. 13ETOPOPHOS ................................................................. 41etoposide .............................................................................. 42eucalyptol ......................................................................... 167EUCALYPTUS FLAVOR ............................. 167

Index

eucalyptus oil ............................................................... 167EURAX .............................................................................. 155EVAMIST ....................................................................... 118EVEKEO ............................................................................. 51EVENING PRIMROSE .................................... 114evening primrose oil ............................................. 114EVERYDAY LONG PANTILINERS...................................................................................................... 127EVISTA ............................................................................. 167EVOCLIN ........................................................................... 23EVOTAZ ............................................................................. 47EVOXAC ............................................................................ 51EVZIO .................................................................................... 29EXALGO ER ...................................................................... 6EXCEDRIN BACK & BODY .......................... 6EXCEDRIN EXTRA STRENGTH ............. 6EXCEDRIN MENSTRUAL COMPLETE............................................................................................................ 6EXCEDRIN PM .............................................................. 3EXCEDRIN SINUS HEADACHE ........... 79EXCEDRIN TENSION HEADACHE ..... 6EXCILON ....................................................................... 128EXCILON AMD (WITH POLYHEXAMET) ................................................ 128EXCILON DRAIN ................................................. 128EXCILON I.V. ........................................................... 128EXECLEAR-C .............................................................. 79EXEFEN DMX ............................................................. 79EXEL INSULIN ....................................................... 128EXELDERM .................................................................... 31EXELON ............................................................................. 51exemestane ......................................................................... 42EXFORGE ......................................................................... 63EXFORGE HCT .......................................................... 63EXJADE ........................................................................... 167EX-LAX (SENNOSIDES) ............................. 104EX-LAX MAXIMUM STRENGTH ... 104EX-LAX MILK OF MAGNESIA .......... 104EX-LAX ULTRA .................................................... 104EXPANDOVER BANDAGE ..................... 128EXTAVIA .......................................................................... 68EXTENDED PAIN RELIEF .............................. 6EXTINA ............................................................................... 31EXTRANEAL 7.5 % ............................................... 96EXTRA-VIRT PLUS DHA ........................... 139EXU-DRY ADULT DRESSING ............ 128EXU-DRY ARM DRESSING .................... 128EXU-DRY BOOT-FOOT DRESSING...................................................................................................... 128EXU-DRY BURN JACKET-LARGE...................................................................................................... 128EXU-DRY BURN JACKET-MEDIUM...................................................................................................... 128EXU-DRY BURN JACKET-SMALL...................................................................................................... 128EXU-DRY BURN VEST-LARGE ........ 128EXU-DRY BURN VEST-SMALL ....... 128EXU-DRY ELBOW-KNEE-HEEL ...... 128EXU-DRY FACE DRESSING .................. 128EXU-DRY HAND DRESSING, LARGE...................................................................................................... 128EXU-DRY HAND DRESSING, MEDIUM ......................................................................... 128EXU-DRY HAND DRESSING, SMALL...................................................................................................... 128EXU-DRY INCISION DRESSING ..... 128

189

Index

EXU-DRY LARGE BOOT DRESSING...................................................................................................... 128EXU-DRY LEG DRESSING ...................... 128EXU-DRY NECK DRESSING ................. 128EXU-DRY SCALP DRESSING .............. 128EXU-DRY WOUND DRESSING ......... 128EYE DROPS (TETRAHYDROZOLINE)......................................................................................................... 89EYE DROPS ADVANCED RELIEF ..... 89EYE DROPS ALLERGY RELIEF ........... 89EYE IRRIGATING SOLUTION ............... 89EYE ITCH RELIEF .................................................. 36EYE STREAM .............................................................. 89EYE WASH ...................................................................... 89EYELID WIPES .......................................................... 89EYLEA .................................................................................. 89EZ CHAR ........................................................................ 167EZ FLU 2015-16(FLUCELVAX)(PF)......................................................................................................... 53E-Z SPACER ............................................................... 128EZO CUSHIONS LOWER HEAVY...................................................................................................... 128EZO CUSHIONS LOWER REGULAR...................................................................................................... 128EZO CUSHIONS UPPER HEAVY ..... 128EZO CUSHIONS UPPER REGULAR...................................................................................................... 128FABB ................................................................................... 173FABIOR ............................................................................ 155FABRAZYME ........................................................... 167FABRIC BANDAGES ....................................... 128FABRIC KNUCKLE-FINGER BANDAGE .................................................................... 128FABRIC STRIP EXTRA LARGE ......... 128FALESSA ........................................................................ 173FALLBACK SOLO .................................................. 72FALMINA (28) ............................................................. 72famciclovir ......................................................................... 47famotidine ........................................................................ 104famotidine (pf) ............................................................ 105famotidine (pf)-nacl (iso-os) ....................... 105FAMVIR .............................................................................. 47FANAPT ........................................................................... 144fa-niacinamide-cupric ox-zinc .................... 173FARESTON ..................................................................... 42FARXIGA .......................................................................... 37FARYDAK ........................................................................ 42FASLODEX ..................................................................... 42FATTIBASE ................................................................. 167FATTYBLEND ......................................................... 167FAZACLO ...................................................................... 144FE C .......................................................................................... 96FE C PLUS ........................................................................ 96FEIBA NF .......................................................................... 58FELBATOL ...................................................................... 68FELDENE .......................................................................... 15felodipine ............................................................................. 60FEM PH ................................................................................ 39FEMARA ............................................................................ 42FEMATROL LAXATIVE ............................. 105FEMCON FE ................................................................... 72FEMHRT LOW DOSE ...................................... 118FEMRING ....................................................................... 118fenofibrate ........................................................................... 63fenofibrate micronized ........................................... 63fenofibrate nanocrystallized ............................. 63

Index

fenofibric acid ................................................................. 63fenofibric acid (choline) ....................................... 63FENOGLIDE ................................................................... 63fenoprofen ........................................................................... 15fentanyl ..................................................................................... 6fentanyl citrate ................................................................... 6fentanyl citrate (pf) ....................................................... 6FENTORA ............................................................................. 6FERAHEME .................................................................... 96FERIVA ................................................................................ 96FERIVA 21-7 TABLET ....................................... 96FERIVA FA (SUMALATE) ........................... 96FERIVA FA (WITH QUATREFOLIC)......................................................................................................... 96FERRALET 90 DUAL-IRON DELIVERY ....................................................................... 96FERRAPLUS 90 .......................................................... 96FERRETTS ....................................................................... 96FERRIPROX ................................................................ 167FERRLECIT .................................................................... 96ferrous gluconate ......................................................... 96ferrous sulfate .................................................................. 96FETZIMA ........................................................................ 145FEVER REDUCER ..................................................... 6FEVERALL ......................................................................... 6feverfew ............................................................................. 114FEXMID ........................................................................... 138fexofenadine ..................................................................... 36fexofenadine-pseudoephedrine ...................... 33FIBER .................................................................................. 105FIBER (CALCIUM POLYCARBOPHIL)...................................................................................................... 105FIBER (PSYLLIUM HUSK) ...................... 105FIBER (PSYLLIUM HUSK/SUGAR)...................................................................................................... 105FIBER (WITH ASPARTAME) ................ 105FIBER LAXATIVE (CA POLYCARBO)...................................................................................................... 105FIBER LAXATIVE (METHYLCELLULO) ...................................... 105FIBER LAXATIVE (PSYLLIUM HUSK)...................................................................................................... 105FIBER SMOOTH .................................................... 105FIBER SMOOTH (SUCROSE) ................ 105FIBER THERAPY ................................................. 105FIBER THERAPY (PSYLLIUM SEED)...................................................................................................... 105FIBER-LAX .................................................................. 105FIBERTAB .................................................................... 105FIBRICOR ......................................................................... 63FINACEA ........................................................................ 155FINACEA PLUS ...................................................... 155finasteride ........................................................................ 167FINGER SLEEVES .............................................. 128FIORICET ............................................................................. 6FIORICET WITH CODEINE ........................... 6FIORINAL ............................................................................ 6FIORINAL-CODEINE #3 .................................... 6FIRAZYR ........................................................................ 167FIRMAGON KIT W DILUENT SYRINGE ........................................................................... 42FIRST AID CLOTH TAPE ........................... 128FIRST AID HURT-FREE WRAP .......... 128FIRST AID PAPER TAPE ............................ 128FIRST AID PLASTIC TAPE ...................... 128FIRST AID SKINTONE PAPER ............ 128

Index

FIRST AID WATERPROOF TAPE .... 128FISH OIL ......................................................................... 105FLAGYL .............................................................................. 23FLAREX .............................................................................. 89FLAVOR BLEND 2 IN 1 ............................... 167FLAVOR PACKETS ........................................... 167FLAVOR PLUS ........................................................ 167FLAVOR SWEET .................................................. 167FLAVOR SWEET-SF ........................................ 167FLAVORX ..................................................................... 167FLAVOUR PAC ...................................................... 167flavoxate ............................................................................ 167flaxseed .............................................................................. 114flaxseed oil ...................................................................... 114FLEBOGAMMA DIF ............................................ 53flecainide .............................................................................. 60FLECTOR ....................................................................... 155FLEET BISACODYL ......................................... 105FLEET ENEMA ....................................................... 105FLEET GLYCERIN (ADULT) ................. 105FLEET GLYCERIN (CHILD) ................... 105FLEET GLYCERIN LAXATIVE .......... 105FLEET LAXATIVE ............................................. 105FLEET MINERAL OIL .................................... 105FLEET PEDIATRIC ............................................ 105FLEX BANDAGE .................................................. 128FLEX FABRIC BANDAGE ........................ 128FLEX FINGER BANDAGE ........................ 128FLEXBUMIN 25 % .................................................. 58FLEXBUMIN 5 % ..................................................... 58FLEXIBLE ..................................................................... 128FLEXIBLE DRESSING ................................... 129FLEXIBLE FABRIC BANDAGES ..... 129FLEXIBLE FOAM ................................................ 129FLEXICHAMBER ................................................. 129FLEXIGEL ..................................................................... 129FLEX-WRAP .............................................................. 129FLEXZAN WOUND DRESSING ......... 129FLOLAN .............................................................................. 63FLOMAX ........................................................................ 167FLONASE .......................................................................... 89FLONASE ALLERGY RELIEF ................. 90FLO-PRED ..................................................................... 118FLORA-Q ........................................................................ 105FLORA-Q(2) ................................................................ 105FLORIVA ........................................................................ 173FLOVENT DISKUS ................................................ 18FLOVENT HFA ........................................................... 18FLOWTUSS ..................................................................... 79floxuridine .......................................................................... 42FLU & SEVERE COLD-DAYTIME ..... 79FLU & SORE THROAT ..................................... 79FLU BP .................................................................................. 79FLUARIX 2010-2011 (PF) ............................... 53FLUARIX 2011-2012 (PF) ............................... 53FLUARIX 2012-2013 (PF) ............................... 53FLUARIX 2013-2014 (PF) ............................... 53FLUARIX 2014-2015 (PF) ............................... 53FLUARIX QUAD 2013-2014 (PF) .......... 53FLUARIX QUAD 2014-2015 (PF) .......... 53FLUARIX QUAD 2015-2016 (PF) .......... 53FLUBLOK 2012-2013 (PF) ............................. 53FLUBLOK 2013-2014 (PF) ............................. 53FLUBLOK 2014-2015 (PF) ............................. 54FLUBLOK 2015-2016 (PF) ............................. 54FLUCELVAX (PF) ................................................... 54

190

Index

FLUCELVAX 2013-2014 (PF) .................... 54FLUCELVAX 2014-2015 (PF) .................... 54FLUCELVAX 2015-2016 (PF) .................... 54fluconazole ......................................................................... 31fluconazole in dextrose(iso-o) ........................ 31fluconazole in nacl (iso-osm) .......................... 31flucytosine .......................................................................... 31fludarabine .......................................................................... 42fludrocortisone ............................................................ 118FLULAVAL 2010-2011 ...................................... 54FLULAVAL 2011-2012 ...................................... 54FLULAVAL 2012-2013 ...................................... 54FLULAVAL 2013-2014 ...................................... 54FLULAVAL 2014-2015 ...................................... 54FLULAVAL 2014-2015 (PF) ......................... 54FLULAVAL QUAD 2013-2014 ................. 54FLULAVAL QUAD 2014-2015 ................. 54FLULAVAL QUAD 2014-2015 (PF) .... 54FLULAVAL QUAD 2015-2016 ................. 54FLUMADINE ................................................................. 47flumazenil ........................................................................ 167FLUMIST 2010-2011 ............................................. 54FLUMIST 2011-2012 ............................................. 54FLUMIST 2012-2013 ............................................. 54FLUMIST 2013-2014 ............................................. 54FLUMIST QUAD 2014-2015 ........................ 54FLUMIST QUAD 2015-2016 ........................ 54flunisolide ........................................................................... 90fluocinolone ................................................................... 155fluocinolone acetonide oil .................................. 90fluocinolone-shower cap ................................... 155fluocinonide ................................................................... 155FLUOCINONIDE-E ............................................. 155fluocinonide-emollient ........................................ 155FLUOR-A-DAY .......................................................... 96FLUOR-A-DAY (WITH XYLITOL) .... 96fluorescein-benoxinate ........................................... 90fluoride toothpaste ...................................................... 96fluorometholone ............................................................ 90fluorouracil ........................................................................ 42fluoxetine .......................................................................... 145fluphenazine decanoate ...................................... 145fluphenazine hcl ........................................................ 145flurazepam ....................................................................... 149flurbiprofen ........................................................................ 15flurbiprofen sodium .................................................. 90FLURESS ........................................................................... 90FLU-SEVERE COLD-COUGH DAYTIME ......................................................................... 79FLU-SEVERE COLD-COUGH NIGHT......................................................................................................... 79flutamide .............................................................................. 42fluticasone ............................................................. 90, 155FLUVIRIN 2010-2011 .......................................... 54FLUVIRIN 2010-2011 (PF) ............................. 54FLUVIRIN 2011-2012 .......................................... 54FLUVIRIN 2011-2012 (PF) ............................. 54FLUVIRIN 2012-2013 .......................................... 54FLUVIRIN 2012-2013 (PF) ............................. 54FLUVIRIN 2013-2014 .......................................... 54FLUVIRIN 2013-2014 (PF) ............................. 54FLUVIRIN 2014-2015 .......................................... 54FLUVIRIN 2014-2015 (PF) ............................. 54FLUVIRIN 2015-2016 .......................................... 54FLUVIRIN 2015-2016 (PF) ............................. 54fluvoxamine ................................................................... 145

Index

FLUZONE 2010-2011 ........................................... 54FLUZONE 2010-2011 (PF) .............................. 54FLUZONE 2011-2012 ........................................... 54FLUZONE 2011-2012 (PF) .............................. 54FLUZONE 2012-2013 ........................................... 54FLUZONE 2012-2013 (PF) .............................. 54FLUZONE 2013-2014 ........................................... 54FLUZONE 2013-2014 (PF) .............................. 54FLUZONE 2014-2015 ........................................... 54FLUZONE 2014-2015 (PF) .............................. 54FLUZONE 2015-2016 ........................................... 55FLUZONE HIGH-DOSE 2010-11 (PF)......................................................................................................... 55FLUZONE HIGH-DOSE 2011-12 (PF)......................................................................................................... 55FLUZONE HIGH-DOSE 2012-13 (PF)......................................................................................................... 55FLUZONE HIGH-DOSE 2013-14 (PF)......................................................................................................... 55FLUZONE HIGH-DOSE 2014-15 (PF)......................................................................................................... 55FLUZONE HIGH-DOSE 2015-16 (PF)......................................................................................................... 55FLUZONE INTRADERM 2011-12 (PF)......................................................................................................... 55FLUZONE INTRADERM 2012-13 (PF)......................................................................................................... 55FLUZONE INTRADERM 2013-14 (PF)......................................................................................................... 55FLUZONE INTRADERM 2014-15 (PF)......................................................................................................... 55FLUZONE INTRADERM QUAD 2015-16 .................................................................................. 55FLUZONE PEDI 2012 -2013 (PF) ........... 55FLUZONE PEDI 2013-2014 (PF) ............. 55FLUZONE QUAD 2013-2014 (PF) ......... 55FLUZONE QUAD 2014-2015 ...................... 55FLUZONE QUAD 2014-2015 (PF) ......... 55FLUZONE QUAD 2015-2016 ...................... 55FLUZONE QUAD 2015-2016 (PF) ......... 55FLUZONE QUAD PEDI 2013-14 (PF)......................................................................................................... 55FLUZONE QUAD PEDI 2014-15 (PF)......................................................................................................... 55FLUZONE QUAD PEDI 2015-16 (PF)......................................................................................................... 55FML FORTE ................................................................... 90FML LIQUIFILM ....................................................... 90FML S.O.P. ....................................................................... 90foam bandage ............................................................... 129FOAM TOE BANDAGE ................................ 129FOCALGIN 90 DHA .......................................... 139FOCALGIN CA ........................................................ 139FOCALGIN DSS ........................................................ 96FOCALIN ........................................................................ 145FOCALIN XR ............................................................. 145FOLASTIN .................................................................... 173FOLCAL DHA ........................................................... 139FOLCAPS ....................................................................... 173FOLCAPS CARE ONE ..................................... 139FOLCAPS OMEGA-3 (ASPARTO-GLY)...................................................................................................... 139FOLGARD ..................................................................... 173folic acid ............................................................................ 173FOLIVANE-F ................................................................. 96FOLIVANE-OB ........................................................ 140

Index

FOLIVANE-PRX DHA NF .......................... 140FOLOTYN ......................................................................... 42FOLTRATE ................................................................... 173fomepizole ....................................................................... 167fondaparinux .................................................................... 29FORADIL AEROLIZER .................................... 18FORANE ............................................................................. 13FORFIVO XL .............................................................. 145formaldehyde ................................................................... 39FORMULA EM ........................................................ 105FORTAMET .................................................................... 37FORTAZ .............................................................................. 23FORTAZ IN DEXTROSE 5 % ..................... 23FORTEO ........................................................................... 167FORTESTA ................................................................... 118FORTICAL .................................................................... 118FOSAMAX .................................................................... 167FOSAMAX PLUS D ............................................ 167foscarnet ................................................................................ 47fosinopril .............................................................................. 63fosinopril-hydrochlorothiazide ...................... 63fosphenytoin ..................................................................... 68FOSRENOL ..................................................................... 96FOSTEUM ......................................................................... 96FP NATURAL LOTION ................................. 167FRAGMIN ......................................................................... 29FREAMINE HBC 6.9 % ..................................... 96FREAMINE III 10 % .............................................. 96FREESTYLE PRECISION ........................... 129FRESHKOTE ................................................................. 90FRESHNET ................................................................... 155FROVA ..................................................................................... 6FUL-GLO ........................................................................... 86FULYZAQ ...................................................................... 105FUNGOID TINCTURE ....................................... 31FUNGOID-D ................................................................... 31FURADANTIN ............................................................. 23furosemide .......................................................................... 87FUSILEV ......................................................................... 167FUSION PLUS .............................................................. 96FUSION SPRINKLES ........................................... 96FUZEON .............................................................................. 47FYCOMPA ........................................................................ 68gabapentin ........................................................................... 68GABITRIL ......................................................................... 68GABLOFEN ................................................................. 138GADAVIST ...................................................................... 86galantamine ....................................................................... 51GALZIN ............................................................................ 167GAMASTAN S/D ...................................................... 55GAMMAGARD S/D ............................................... 55GAMMAGARD S-D (IGA < 1 MCG/ML) ........................................................................... 55GAMMAKED ................................................................ 55GAMMAPLEX ............................................................. 55GAMUNEX ...................................................................... 55GAMUNEX-C ............................................................... 55ganciclovir sodium ..................................................... 47GARAMYCIN ............................................................... 23GARDASIL (PF) ......................................................... 55GARDASIL 9 (PF) .................................................... 55garlic ..................................................................................... 114GARLIC OIL ............................................................... 114GARLIPURE ............................................................... 114GARLIQUE ................................................................... 114GAS FREE EXTRA STRENGTH ......... 105

191

Index

GAS RELIEF ............................................................... 105GAS RELIEF EXTRA STRENGTH ... 105GAS RELIEF MAXIMUM STRENGTH...................................................................................................... 105GAS RELIEF ULTRA STRENGTH ... 105GASTROCROM .......................................................... 18GAS-X ................................................................................ 105GAS-X EXTRA STRENGTH .................... 105GAS-X ULTRA-STRENGTH ................... 105GAS-X WITH MAALOX .............................. 105gatifloxacin ........................................................................ 23GATTEX 30-VIAL ............................................... 105GATTEX ONE-VIAL ........................................ 105gauze bandage ............................................................. 129GAUZE PAD ............................................................... 129GAUZE ROLL ........................................................... 129GAUZE SPONGES ............................................... 129GAVILAX ...................................................................... 106GAVILYTE-C ............................................................ 106GAVILYTE-G ............................................................ 106GAVILYTE-H AND BISACODYL .... 106GAVILYTE-N ............................................................ 106GAVISCON .................................................................. 106GAVISCON EXTRA STRENGTH ...... 106GAZYVA ............................................................................ 42GEL CORN PROTECTORS ....................... 129GEL TOE PROTECTOR ................................ 129GEL TOE SPACERS .......................................... 129gelatin .................................................................................. 167gelatin (bulk) ................................................................. 167GELFILM ........................................................................ 167GELNIQUE ................................................................... 167GELPAD .......................................................................... 129GEL-STAT ..................................................................... 155gemcitabine ....................................................................... 42gemfibrozil ......................................................................... 63GEMZAR ............................................................................ 42GENERESS FE ............................................................. 72GENERLAC ................................................................. 106GENGRAF ..................................................................... 121GENOTROPIN .......................................................... 118GENOTROPIN MINIQUICK .................... 118GENTAK ............................................................................. 23gentamicin .......................................................................... 23gentamicin in nacl (iso-osm) ........................... 23gentamicin sulfate (ped) (pf) ........................... 23gentamicin sulfate (pf) ........................................... 23GENTEAL MILD TO MODERATE .... 90GENTEAL GEL ........................................................... 90GENTEAL MILD ....................................................... 90GENTEAL PM .............................................................. 90GENTEAL SEVERE .............................................. 90GENTLE LAXATIVE ....................................... 106GENTLE RAIN ......................................................... 155GENTLE TAPE ........................................................ 129GEODON ........................................................................ 145GERI-LAV ..................................................................... 155GESTICARE DHA ................................................ 140GIAZO ................................................................................ 106GILDAGIA ....................................................................... 72GILDESS ............................................................................. 72GILDESS 24 FE ........................................................... 72GILDESS FE ................................................................... 72GILENYA .......................................................................... 68GILOTRIF .......................................................................... 42ginger (zingiber officinalis) ........................... 114

Index

GINGER EXTRACT ........................................... 114GINKGO .......................................................................... 114ginkgo biloba ................................................................ 114ginkgo biloba extract ............................................ 114ginkgo biloba leaf extract ................................ 115ginkgo biloba-ginkgo biloba ex ................. 115ginseng ................................................................................ 115GINSENG KOREAN .......................................... 115GLASSIA ........................................................................ 167GLATOPA ......................................................................... 68GLEEVEC .......................................................................... 42GLEOSTINE ................................................................... 42GLIADEL WAFER .................................................. 42glimepiride ......................................................................... 37glipizide ................................................................................. 37glipizide-metformin .................................................. 37GLUCAGEN ................................................................... 96GLUCAGEN DIAGNOSTIC KIT ............ 86GLUCAGEN HYPOKIT .................................... 96GLUCAGON EMERGENCY KIT (HUMAN) .......................................................................... 96glucagon hcl ...................................................................... 86GLUCOPHAGE ........................................................... 37GLUCOPHAGE XR ................................................ 37GLUCOPRO ................................................................. 129GLUCOPRO ALCOHOL ............................... 155glucosam su dip-chondroit-c-mn ................. 15glucosam-chondr msm#6-manganes ....... 15glucosamine sulfate ................................................... 15glucose .................................................................................... 96GLUCOSE POWDER ........................................... 96GLUCOTROL ................................................................ 37GLUCOTROL XL ..................................................... 37GLUCOVANCE .......................................................... 37GLUMETZA ................................................................... 37glutathione (bulk) ..................................................... 167glyburide .............................................................................. 37glyburide micronized ............................................... 37glyburide-metformin ................................................ 37glycerin (adult) ........................................................... 106glycerin (child) ........................................................... 106glyceryl monostearate .......................................... 167GLYCINE UROLOGIC ....................................... 39GLYCOLAX ................................................................ 106GLYCOPHOS ................................................................ 96glycopyrrolate .............................................................. 106GLYDO ................................................................................. 13GLYNASE ......................................................................... 37GLYSET .............................................................................. 37GLYTACTIN 20PE BETTERMILK LITE .......................................................................................... 96GLYXAMBI .................................................................... 37GOLYTELY ................................................................. 106GONAK ................................................................................ 90GOODY'S HEADACHE POWDER .......... 6GRALISE ............................................................................ 68GRALISE 30-DAY STARTER PACK......................................................................................................... 68granisetron (pf) ........................................................... 106granisetron hcl ............................................................. 106GRANIX .............................................................................. 70GRANULEX ................................................................ 155grape seed extract .................................................... 115grape seed xt-bioflav,citrus ............................ 115GRAPEFRUIT ........................................................... 167GRASTEK ......................................................................... 55

Index

GREEN COFFEE BEAN ................................ 115GREEN TEA ................................................................ 115GREEN TEA COMPLEX .............................. 115green tea leaf ext-green tea ............................ 115green tea-hoodia gordonii ................................ 115griseofulvin microsize ............................................ 31griseofulvin ultramicrosize ................................ 31GRIS-PEG (ULTRAMICROSIZE) .......... 31GRX FOAM DRESSING ............................... 129GRX HYDROGEL GAUZE ........................ 129GRX WOUND GEL ............................................. 129guaiacol .............................................................................. 155GUAIATUSSIN AC ................................................ 79guaifenesin ......................................................................... 79GUAIFENESIN AC ................................................. 79GUAIFENESIN DAC ............................................ 79GUAIFENESIN DM ............................................... 79guanfacine ............................................................. 63, 145guanidine .............................................................................. 51guar gum ........................................................................... 167guava flavor (bulk) ................................................. 168GYNAZOLE-1 .............................................................. 31HALAVEN ........................................................................ 42HALCION ....................................................................... 149HALDOL ......................................................................... 145HALDOL DECANOATE ............................... 145halobetasol propionate ........................................ 155HALOG ............................................................................. 155haloperidol ...................................................................... 145haloperidol decanoate .......................................... 145haloperidol lactate ................................................... 145HAND SANITIZER ............................................. 155HAND SANITIZING WIPES .................... 155HARVONI ......................................................................... 47HAVRIX (PF) ................................................................. 55hawthorn ........................................................................... 115HEADACHE FORMULA ADDED STR............................................................................................................ 6HEADACHE PM ........................................................... 3HEADACHE RELIEF .............................................. 6HEADACHE RELIEF (ASA-ACET-CAF) ....................................................... 6HEALTHY ACCENTS UNIFINE PENTIP .............................................................................. 129HEALTHYLAX ....................................................... 106HEARTBURN RELIEF (CIMETIDINE)...................................................................................................... 106HEARTBURN RELIEF (FAMOTIDINE)...................................................................................................... 106HEARTBURN RELIEF (RANITIDINE)...................................................................................................... 106HEARTBURN RELIEF 24 HOUR ....... 106HEARTBURN TREATMENT 24 HOUR...................................................................................................... 106HEAT THERAPY .................................................. 129HEATHER ......................................................................... 72HEATWRAPS ............................................................ 129HEATWRAPS BACK & HIP PADS...................................................................................................... 129HEAVY DUTY FABRIC STRIPS ........ 129HECORIA ....................................................................... 121HECTOROL ................................................................. 168HELIXATE FS .............................................................. 58HEMABATE ................................................................ 118HEMANGEOL .............................................................. 64HEMATOGEN .............................................................. 96

192

Index

HEMATOGEN FA .................................................... 96HEMATOGEN FORTE ....................................... 96HEMENATAL OB ................................................ 140HEMENATAL OB + DHA ........................... 140HEMETAB ........................................................................ 96HEMMOREX-HC .................................................. 106HEMOCYTE ................................................................... 96HEMOCYTE-F ............................................................. 96HEMOCYTE-PLUS ................................................ 97HEMOFIL M HIGH ................................................ 58HEMOFIL M LOW .................................................. 58HEMOFIL M MID .................................................... 58HEMOFIL M SUPER HIGH .......................... 58HEMORRHOID ....................................................... 106HEMORRHOIDAL ............................................... 106HEMORRHOIDAL (PHENYLEPH-COCOA) ................................ 106HEMORRHOIDAL COOLING ............... 106HEMORRHOIDAL CREAM ..................... 106HEMORRHOIDAL SUPPOSITORY...................................................................................................... 106HEMRIL-30 .................................................................. 106HEP FLUSH-10 (PF) .............................................. 29HEPAGAM B ................................................................. 55heparin (porcine) .......................................................... 29heparin (porcine) in 5 % dex ........................... 29heparin (porcine) in nacl (pf) ........................... 29heparin(porcine) in 0.45% nacl ..................... 29heparin, porcine (pf) ................................................. 29HEPATAMINE 8% .................................................. 97HEPSERA .......................................................................... 47HERCEPTIN ................................................................... 42HESPAN 6 % IN NS ............................................... 58hetastarch 6 % in 0.9 % nacl ............................ 58HETLIOZ ........................................................................ 149HEXALEN ........................................................................ 42HEX-ON LIGHT ODOR ................................. 155HEXTEND ........................................................................ 58HICON ................................................................................ 168HIPREX ................................................................................ 23HISTAFLEX ....................................................................... 6HISTEX (TRIPROLIDINE) ............................ 36HISTEX DM .................................................................... 79HISTEX PD ...................................................................... 36HISTEX PE ....................................................................... 33HISTEX-AC ..................................................................... 79HIZENTRA ....................................................................... 55HORIZANT ...................................................................... 68HUMALOG ...................................................................... 38HUMALOG KWIKPEN ..................................... 37HUMALOG MIX 50-50 ...................................... 37HUMALOG MIX 50-50 KWIKPEN ...... 38HUMALOG MIX 75-25 ...................................... 38HUMALOG MIX 75-25 KWIKPEN ...... 38HUMATE-P ...................................................................... 58HUMATROPE ........................................................... 118HUMIRA ............................................................................. 15HUMIRA PEDIATRIC CROHN'S START ................................................................................... 15HUMIRA PEN ............................................................... 15HUMIRA PEN CROHN'S-UC-HS START ................................................................................... 15HUMIRA PEN PSORIASIS STARTER......................................................................................................... 16HUMULIN 70/30 ........................................................ 38HUMULIN 70/30 KWIKPEN ....................... 38

Index

HUMULIN 70/30 PEN ......................................... 38HUMULIN N .................................................................. 38HUMULIN N KWIKPEN .................................. 38HUMULIN N PEN .................................................... 38HUMULIN R .................................................................. 38HUMULIN R U-500 (CONCENTRATED) .............................................. 38HURRIVIEW .............................................................. 129HURRIVIEW II ........................................................ 129HYCAMTIN .................................................................... 42HYCET ..................................................................................... 6HYCOFENIX ................................................................. 79HYDE-OUT ALDEHYDE NEUTRALIZER ....................................................... 129hydralazine ......................................................................... 64HYDREA ............................................................................ 42HYDRESS ...................................................................... 129hydrochlorothiazide .................................................. 87hydrocodone-acetaminophen .............................. 6hydrocodone-chlorpheniramine .................... 79hydrocodone-homatropine ................................. 79hydrocodone-ibuprofen ............................................ 6hydrocol dress-adhesive rem#1 ................. 129hydrocortisone ............................................... 118, 155hydrocortisone acetate ........................... 106, 155hydrocortisone butyrate ..................................... 155hydrocortisone butyr-emollient ................. 155HYDROCORTISONE PLUS ...................... 155hydrocortisone valerate ...................................... 155hydrocortisone-acetic acid ................................. 90hydrocortisone-aloe vera .................................. 155hydrocortisone-min oil-wht pet ................. 155hydrocortisone-pramox-e-pram#1 .......... 106hydrocortisone-pramoxine ................. 106, 155hydrogen peroxide .................................................. 155HYDROMET .................................................................. 79hydromorphone ................................................................. 7hydromorphone (pf) ..................................................... 7hydromorphone in 0.9 % nacl ............................ 7hydrophilic ...................................................................... 168HYDROPHILIC OINTMENT BASE(FAG) .................................................................. 168HYDROPHILIC PETROLATUM ......... 168HYDROPHOR ........................................................... 129hydroquinone ................................................................ 155hydroquinone microspheres .......................... 155hydroquinone with sunscreen ...................... 155HYDROSKIN ............................................................. 155HYDROSKIN WITH ALOE ....................... 155hydroxocobalamin ................................................... 173hydroxychloroquine .................................................. 39hydroxypropyl cellulose .................................... 168hydroxyurea ...................................................................... 42hydroxyzine hcl ............................................................. 36hydroxyzine pamoate .............................................. 36HYGIENIC (WITCH HAZEL) CLEANS...................................................................................................... 106HYGIENIC CLEANSING ............................. 155HYLENEX ..................................................................... 168HYOLEV MB ................................................................. 23hyoscyamine sulfate .............................................. 106HYOSYNE ..................................................................... 106HYPAFIX ........................................................................ 129HYPERHEP B S/D ................................................... 55HYPERHEP B S-D NEONATAL ............. 55HYPERLYTE CR ...................................................... 97

Index

HYPERRAB S/D (PF) ........................................... 55HYPERRHO S/D ........................................................ 55HYPERTET S/D (PF) ............................................ 55HYPO-ALLERGENIC BANDAGES...................................................................................................... 129HYPOTEARS ................................................................. 90hypromellose ................................................................ 168HYQVIA .............................................................................. 55HYSINGLA ER ............................................................... 7HYZAAR ............................................................................ 64ibandronate ..................................................................... 168IBGARD ........................................................................... 115IBRANCE ........................................................................... 42IBUDONE ............................................................................. 7IBU-DROPS ..................................................................... 16ibuprofen .............................................................................. 16IBUPROFEN COLD ............................................... 79IBUPROFEN COLD-SINUS(WITH PSE)......................................................................................................... 79IBUPROFEN IB ........................................................... 16IBUPROFEN JR STRENGTH ...................... 16IBUPROFEN PM ........................................................... 7ibuprofen-oxycodone .................................................. 7ibutilide fumarate ........................................................ 60IC GREEN ......................................................................... 86ICLUSIG .............................................................................. 42ICY HOT MEDICATED SLEEVE ...... 155IDAMYCIN PFS ......................................................... 42idarubicin ............................................................................. 42IFEREX 150 ..................................................................... 97IFEREX 150 FORTE .............................................. 97IFEX ......................................................................................... 42ifosfamide ........................................................................... 42ILARIS (PF) .................................................................. 168ILEVRO ................................................................................ 90ILOTYCIN ........................................................................ 23ILUVIEN ............................................................................. 90IMBRUVICA .................................................................. 42IMDUR .................................................................................. 60imipenem-cilastatin ................................................... 23imipramine hcl ............................................................ 145imipramine pamoate .............................................. 145imiquimod ....................................................................... 155IMITREX ................................................................................ 7IMITREX STATDOSE KIT REFILL ....... 7IMITREX STATDOSE PEN .............................. 7IMMUNE JUMP ...................................................... 115IMOGAM RABIES-HT (PF) ......................... 56IMOVAX RABIES VACCINE (PF) ...... 56IMPLANON ..................................................................... 72IMUHANCE ................................................................. 115IMURAN .......................................................................... 121INATAL ADVANCE .......................................... 140INATAL ULTRA .................................................... 140IN-CHECK DIAL TRAINING DEVICE...................................................................................................... 129INCONTROL PEN NEEDLE .................... 129INCRELEX .................................................................... 118INCRUSE ELLIPTA ............................................... 18indapamide ......................................................................... 87INDERAL LA ................................................................ 64INDERAL XL ................................................................ 64INDIGO CARMINE ................................................ 86INDIOMIN MB ............................................................ 23INDOCIN ............................................................................ 16indomethacin .................................................................... 16

193

Index

indomethacin sodium .............................................. 64INFANRIX (DTAP) (PF) ................................... 56INFANT PAIN RELIEVER ................................ 7INFANTS GAS RELIEF ................................. 107INFANTS IBU-DROPS ....................................... 16INFANT'S IBUPROFEN .................................... 16INFANTS MAPAP ...................................................... 7INFANTS' PAIN & FEVER ............................... 7INFANTS' PAIN RELIEF .................................... 7INFANT'S PAIN RELIEF .................................... 7INFANT'S PAIN RELIEVER ........................... 7INFANTS' TRIAMINIC FEVER .................. 7INFED .................................................................................... 97INFLUDO ....................................................................... 115influenza a (h1n1) vac 09 (pf) ........................ 56influenza a (h1n1) vac 2009 ............................. 56INFUMORPH P/F ......................................................... 7INFUVITE ADULT .............................................. 173INFUVITE PEDIATRIC ................................. 173INJECTAFER ................................................................. 97INLYTA ............................................................................... 42INNERMOST NATURE FOR MEN...................................................................................................... 115INNOHEP ........................................................................... 29INNOPRAN XL ........................................................... 64INS SYRINGE/NEEDLE 0.5CC/27G...................................................................................................... 129INSPIRACHAMBER .......................................... 129INSPIRACHAMBER WITH MASK-MED ................................................................ 129INSPIRACHAMBER WITH MASK-SMALL ......................................................... 129INSPIREASE ............................................................... 129INSPIREASE BAGS ........................................... 130INSPIREASE MOUTHPIECE .................. 130INSPIREASE RESERVOIR BAGS ..... 130INSPRA ................................................................................ 87INSTA-CHAR ............................................................ 168INSTA-CHAR-SORBITOL ......................... 168INSTACLEAN ........................................................... 168INSTA-GLUCOSE ................................................... 97INSTANT FOOD THICKENER ............. 168INSULIN SYRINGE ........................................... 130INSULIN SYRINGE MICROFINE ..... 130insulin syringe needleless ................................ 130INSULIN SYRINGE ULTRAFINE ..... 130insulin syringe-needle u-100 ........................ 130insulin syringes (disposable) ........................ 130INSUMED ...................................................................... 130INSUPEN ........................................................................ 130INTEGRA ........................................................................... 97INTEGRA F ..................................................................... 97INTEGRA PLUS ......................................................... 97INTEGRILIN .................................................................. 46INTELENCE ................................................................... 47INTENSE COUGH RELIEVER ................. 79INTERMEZZO .......................................................... 149INTERSORB ................................................................ 130INTRALIPID ............................................................... 107INTRASITE GEL DRESSING ................. 130INTRON A ........................................................................ 42INTROVALE .................................................................. 72INTUNIV ER ............................................................... 145INVANZ .............................................................................. 23INVEGA ........................................................................... 145INVEGA SUSTENNA ....................................... 145

Index

INVEGA TRINZA ................................................. 145INVIRASE ............................................................... 47, 48INVISIBLE ACNE ................................................ 156INVOKAMET ................................................................ 38INVOKANA .................................................................... 38INZO ANTIFUNGAL ........................................... 31IODIDES TINCTURE ....................................... 156iodine-sodium iodide ............................................ 156IODOPEN ........................................................................... 97iodoquinol-hc ............................................................... 156IONOSOL-B IN D5W ........................................... 97IONOSOL-MB IN D5W ..................................... 97IONSYS ................................................................................... 7IOPHEN C-NR .............................................................. 79IOPHEN DM-NR ........................................................ 79IOPHEN-NR .................................................................... 79IOPIDINE ........................................................................... 90IPOL ......................................................................................... 56ipratropium bromide ....................................... 18, 90ipratropium-albuterol ............................................... 18IPRIVASK ......................................................................... 29IQUIX ..................................................................................... 23irbesartan .............................................................................. 64irbesartan-hydrochlorothiazide ...................... 64IRENKA ........................................................................... 145IRESSA ................................................................................. 42irinotecan ............................................................................. 42iron aspgly&ps-c-b12-fa-ca-suc ................... 97iron aspgly-c-b12-ca-suc-stoma ................... 97iron fum & ag-c-b12-fa-ca-succ ................... 97IROSPAN 24/6 .............................................................. 97ISAGEL ............................................................................. 156ISAGEL NO RINSE ............................................. 156ISENTRESS ..................................................................... 48ISLAND GARD-GRX ....................................... 130ISOLYTE S PH 7.4 ................................................... 97ISOLYTE-P IN 5 % DEXTROSE ............. 97ISOLYTE-S ...................................................................... 97isometh-dichloral-acetaminophn ..................... 7isomethepten-caf-acetaminophen ................... 7ISONARIF ......................................................................... 23isoniazid ................................................................................ 23isopropyl alcohol ............................................ 39, 168isopropyl alcohol-benzocaine ......................... 39ISOPROPYL ALCOHOL-WINTERGREEN .................. 156isopropyl palmitate ................................................. 168ISOPTO CARPINE .................................................. 90ISOPTO TEARS .......................................................... 90ISORDIL .............................................................................. 60ISORDIL TITRADOSE ....................................... 60isosorbide dinitrate ..................................................... 60isosorbide mononitrate ........................................... 60isosulfan blue ................................................................... 86isradipine .............................................................................. 60ISTALOL ............................................................................ 90ISTODAX ........................................................................... 42ISUPREL ............................................................................. 51ITCH RELIEF ............................................................. 156ITCH-X .............................................................................. 156ITCHY EYE DROPS .............................................. 36itraconazole ....................................................................... 31IV 3000 ............................................................................... 130IV PREP WIPES ...................................................... 156IV3000 FRAME DELIVERY DRESSING .................................................................... 130

Index

ivermectin ........................................................................... 39IXEMPRA .......................................................................... 42IXIARO (PF) ................................................................... 56IXINITY ............................................................................... 58J & J FIRST AID TAPE PAPER ............. 130J & J NON-STICK PADS LARGE ....... 130J & J NON-STICK PADS MEDIUM...................................................................................................... 130JADENU ........................................................................... 168JAKAFI ................................................................................. 42JANTOVEN ..................................................................... 29JANUMET ......................................................................... 38JANUMET XR .............................................................. 38JANUVIA ........................................................................... 38J-COF DHC ...................................................................... 79JENCYCLA ...................................................................... 72JENTADUETO ............................................................. 38JETREA (PF) .................................................................. 90JE-VAX ................................................................................. 56JEVTANA .......................................................................... 43JINTELI ............................................................................. 118J-MAX .................................................................................... 79J-MAX DHC .................................................................... 79JOCK ITCH ...................................................................... 31JOHNSON'S BABY LOTION ................... 168JOHNSON'S BODY CARE ......................... 168JOLESSA ............................................................................ 72JOLIVETTE ..................................................................... 72JR. STR NON-ASPIRIN PAIN ....................... 7J-TAN D PD ..................................................................... 33J-TAN PD ........................................................................... 36JUBLIA ................................................................................. 31JULEBER ........................................................................... 72JUNEL 1.5/30 (21) .................................................... 72JUNEL 1/20 (21) ......................................................... 72JUNEL FE 1.5/30 (28) ........................................... 72JUNEL FE 1/20 (28) ................................................ 72JUNEL FE 24 .................................................................. 72JUNIOR MAPAP ........................................................... 7JUXTAPID ........................................................................ 64KABIVEN .......................................................................... 97KADCYLA ....................................................................... 43KADIAN ................................................................................. 7KALBITOR ................................................................... 168KALETRA ......................................................................... 48KALYDECO ................................................................ 168kanamycin ........................................................................... 24KAO-TIN (BISMUTH SUBSALICYLAT) ................................................ 107KAO-TIN (DOCUSATE CALCIUM)...................................................................................................... 107KAPVAY ......................................................................... 145KARBINAL ER ........................................................... 36KARIVA (28) ................................................................. 72kava root extract ........................................................ 115KAYEXALATE ........................................................... 97KAZANO ............................................................................ 38KCENTRA ........................................................................ 58KEDBUMIN .................................................................... 58K-EFFERVESCENT ............................................... 97KEFLEX .............................................................................. 24KELNOR 1/35 (28) ................................................... 72KENALOG ....................................................... 118, 156KENDALL ..................................................................... 130KENDALL 2-IN-1 ................................................. 156KENDALL CLOTH ............................................. 130

194

Index

KENDALL FOAM BORDER .................... 130KENDALL PAPER TAPE ............................ 130KENGREAL .................................................................... 46KEPIVANCE ............................................................... 107KEPPRA .............................................................................. 68KEPPRA XR ................................................................... 68KERLIX ............................................................................ 130KERLIX AMD ........................................................... 130KERLIX BURN PACK ..................................... 130KERLIX LITE ............................................................ 130KERLIX PACKING SPONGE ................. 130KERYDIN .......................................................................... 31KETALAR ......................................................................... 13ketamine ................................................................................ 13KETEK .................................................................................. 24ketoconazole ..................................................................... 31KETODAN ........................................................................ 31KETODAN KIT ........................................................... 31KETO-DIASTIX ......................................................... 86KETONE CARE .......................................................... 86KETONE URINE TEST ...................................... 86ketoprofen ........................................................................... 16ketorolac ........................................................................ 7, 90KETOSTIX ....................................................................... 86ketotifen fumarate ....................................................... 36KEVEYIS ........................................................................ 168KEYTRUDA ................................................................... 43KHEDEZLA ................................................................. 145KIDKARE COUGH/COLD ............................. 79KIMIDESS (28) ............................................................ 72KINERET ........................................................................... 16KINRIX (PF) ................................................................... 56KIONEX .............................................................................. 97KITABIS PAK ............................................................... 24KLARON ......................................................................... 156KLING ROLLS ......................................................... 130KLONOPIN ...................................................................... 68KLOR-CON ...................................................................... 97KLOR-CON 10 ............................................................. 97KLOR-CON 8 ................................................................. 97KLOR-CON M10 ....................................................... 97KLOR-CON M15 ....................................................... 97KLOR-CON M20 ....................................................... 97KLOR-CON SPRINKLE .................................... 97KLOR-CON/25 ............................................................. 97KLOR-CON/EF ............................................................ 97KOATE-DVI ................................................................... 58KOGENATE FS ........................................................... 58KOMBIGLYZE XR ................................................. 38KONSYL (SUGAR) ............................................. 107KONSYL EASY MIX ........................................ 107KONSYL FIBER ..................................................... 107KONSYL FORMULA-D ................................ 107KONSYL SUGAR-FREE (ASPARTAME) ........................................................ 107KONSYL-D ................................................................... 107KOREAN GINSENG .......................................... 115korean ginseng root extract ............................ 115KORLYM ........................................................................... 38KOTEX FRESH & DRY ................................. 130KOTEX OVERNIGHT ..................................... 130K-PHOS NO 2 ................................................................ 97K-PHOS ORIGINAL .............................................. 97K-PHOS-NEUTRAL ............................................... 97KRISTALOSE ............................................................ 107K-SOL .................................................................................... 97

Index

K-TAB .................................................................................... 97KURVELO ........................................................................ 72KUVAN ............................................................................. 168KYNAMRO ...................................................................... 64KYPROLIS ....................................................................... 43l norgest/e.estradiol-e.estrad ............................. 72labetalol ................................................................................. 64LAC-HYDRIN ........................................................... 156LACRISERT .................................................................... 90lactated ringers .................................................. 97, 156lactic acid (bulk) ....................................................... 156lactulose ............................................................................. 107LAMICTAL ...................................................................... 68LAMICTAL ODT ...................................................... 68LAMICTAL ODT STARTER (BLUE)......................................................................................................... 68LAMICTAL ODT STARTER (GREEN)......................................................................................................... 68LAMICTAL ODT STARTER (ORANGE) ........................................................................ 69LAMICTAL STARTER (BLUE) KIT......................................................................................................... 69LAMICTAL STARTER (GREEN) KIT......................................................................................................... 69LAMICTAL STARTER (ORANGE) KIT......................................................................................................... 69LAMICTAL XR ........................................................... 69LAMICTAL XR STARTER (BLUE) .... 69LAMICTAL XR STARTER (GREEN)......................................................................................................... 69LAMICTAL XR STARTER (ORANGE)......................................................................................................... 69LAMISIL ............................................................................. 31LAMISIL (AEROSOL) ........................................ 31LAMISIL AF ................................................................... 31LAMISIL AF DEFENSE .................................... 31LAMISIL AT .................................................................. 31lamivudine .......................................................................... 48lamivudine-zidovudine .......................................... 48lamotrigine ......................................................................... 69LANACANE ANTI-ITCH ................................ 13LANACANE FIRST AID .................................. 13lanolin anhydrous ..................................................... 168LANOXIN .......................................................................... 60LANOXIN PEDIATRIC ..................................... 60lansoprazole ................................................................... 107LANTUS .............................................................................. 38LANTUS SOLOSTAR .......................................... 38LARIN 1.5/30 (21) .................................................... 72LARIN 1/20 (21) ......................................................... 72LARIN 24 FE .................................................................. 72LARIN FE .......................................................................... 72LASIX .................................................................................... 87LASTACAFT ................................................................. 36latanoprost .......................................................................... 90LATUDA ......................................................................... 145lavender oil ..................................................................... 115LAXATIVE (BISACODYL) ....................... 107LAXATIVE (SENNOSIDES) .................... 107LAXATIVE FEMININE ................................. 107LAXATIVE MAXIMUM STRENGTH...................................................................................................... 107LAXATIVE PLUS STOOL SOFTENER...................................................................................................... 107LAYOLIS FE .................................................................. 72LAZANDA ........................................................................... 7

Index

LAZERCREME ........................................................ 156LDO PLUS ........................................................................ 13LEENA 28 .......................................................................... 72leflunomide ........................................................................ 16LEMON EXTRACT FLAVOR ................ 168lemon flavor extract (bulk) ............................. 168LEMON FLAVORING ..................................... 168LEMTRADA ................................................................... 69LENVIMA ......................................................................... 43LESCOL ............................................................................... 64LESSINA ............................................................................. 72LETAIRIS .......................................................................... 64letrozole ................................................................................. 43leucovorin calcium ................................................. 168LEUKERAN .................................................................... 43LEUKINE ........................................................................... 70leuprolide ............................................................................. 43levalbuterol hcl .............................................................. 18LEVAQUIN ...................................................................... 24LEVAQUIN IN 5 % DEXTROSE ............ 24LEVEMIR .......................................................................... 38LEVEMIR FLEXPEN ........................................... 38LEVEMIR FLEXTOUCH ................................. 38levetiracetam .................................................................... 69levetiracetam in nacl (iso-os) .......................... 69levobunolol ........................................................................ 90levocarnitine .................................................................. 168levocarnitine (with sugar) ................................ 168levocetirizine .................................................................... 36levofloxacin ....................................................................... 24levofloxacin in d5w ................................................... 24levoleucovorin calcium ...................................... 168levomefolate calcium ........................................... 173LEVONEST (28) ......................................................... 72levonorgestrel .................................................................. 72levonorgestrel-ethinyl estrad ........................... 72LEVOPHED (BITARTRATE) ..................... 51LEVORA-28 .................................................................... 72levorphanol tartrate ....................................................... 8levothyroxine ................................................................ 162LEVOXYL ..................................................................... 162LEVSIN ............................................................................. 107LEVSIN/SL ................................................................... 107LEXAPRO ...................................................................... 145LEXISCAN ....................................................................... 86LEXIVA ............................................................................... 48LEXUSS 210 ................................................................... 79LIALDA ............................................................................ 107LIBRAX (WITH CLIDINIUM) ............... 107LICE EGG REMOVER .................................... 156LICE KILLING ......................................................... 156LICE SOLUTION ................................................... 156LICE TREATMENT ............................................ 156LICE TREATMENT (PERMETHRIN)...................................................................................................... 156licorice ................................................................................. 115lidocaine ................................................................................ 13lidocaine (pf) in d7.5w ......................................... 13lidocaine (pf) .......................................................... 13, 60lidocaine hcl ...................................................................... 13lidocaine hcl-hydrocortison ac ...... 107, 156lidocaine in 5 % dextrose (pf) ......................... 60LIDOCAINE VISCOUS ..................................... 13lidocaine-epinephrine .............................................. 13lidocaine-epinephrine (pf) .................................. 13lidocaine-epinephrine bit ..................................... 13

195

Index

lidocaine-hydrocortisone-aloe ..................... 107lidocaine-prilocaine ................................................... 13LIDODERM ..................................................................... 13LIME FLAVOR ........................................................ 168LINCOCIN ........................................................................ 24lindane ................................................................................. 156linezolid ................................................................................. 24linezolid-0.9% sodium chloride .................... 24LINSEED OIL ............................................................ 115LINZESS .......................................................................... 107LIORESAL .................................................................... 138liothyronine .................................................................... 162LIP TREATMENT ................................................. 168LIPITOR .............................................................................. 64LIPODOX ........................................................................... 43LIPODOX 50 .................................................................. 43LIPOFEN ............................................................................. 64LIPOSYN II .................................................................. 107LIPOSYN III ................................................................ 107LIPTRUZET .................................................................... 64LIQUID ANTACID .............................................. 107LIQUITEARS ................................................................. 90LISCO ................................................................................. 130lisinopril ................................................................................ 64lisinopril-hydrochlorothiazide ........................ 64LITE COAT ASPIRIN ............................................. 8LITE TOUCH INSULIN PEN NEEDLES...................................................................................................... 130LITE TOUCH INSULIN SYRINGE ... 130LITE TOUCH-MEDIUM MASK ........... 130LITEAIRE MDI CHAMBER ..................... 130LITETOUCH-LARGE MASK .................. 130LITETOUCH-SMALL MASK ................. 130lithium carbonate ...................................................... 145lithium citrate ............................................................... 145LITHOBID ..................................................................... 145LITHOSTAT ................................................................ 107LIVER COMPLEX ............................................... 115LMD 10 % IN 0.9 % SODIUM CHLOR......................................................................................................... 58LMD 10 % IN 5 % DEXTROSE ................ 58L-METHYL-B6-B12 ........................................... 174L-METHYL-MC ...................................................... 174L-METHYL-MC NAC ...................................... 174LO LOESTRIN FE .................................................... 73LO MINASTRIN FE ............................................... 73LODOSYN ........................................................................ 45LODRANE D .................................................................. 33LOESTRIN 1.5/30 (21) ........................................ 73LOESTRIN 1/20 (21) ............................................. 73LOESTRIN 24 FE ...................................................... 73LOESTRIN FE 1.5/30 (28-DAY) .............. 73LOESTRIN FE 1/20 (28-DAY) ................... 73LOFIBRA ........................................................................... 64LOHIST - D ...................................................................... 33LOHIST PEB DM ...................................................... 79LOHIST-DM ................................................................... 80LOHIST-PEB .................................................................. 33LOMEDIA 24 FE ....................................................... 73LOMOTIL ....................................................................... 107lomustine .............................................................................. 43loperamide ....................................................................... 107LOPID .................................................................................... 64LOPREEZA ................................................................... 118LOPRESSOR .................................................................. 64LOPRESSOR HCT ................................................... 64

Index

LOPROX ............................................................................. 31loratadine ............................................................................. 36LORATA-DINE D .................................................... 33LORATADINE-D ...................................................... 33lorazepam ............................................................ 145, 149LORAZEPAM INTENSOL .......................... 145LORCET (HYDROCODONE) ........................ 8LORCET HD ...................................................................... 8LORCET PLUS ............................................................... 8LORTAB 10-325 ............................................................ 8LORTAB 5-325 ............................................................... 8LORTAB 7.5-325 .......................................................... 8LORTAB ELIXIR ......................................................... 8LORTUSS DM .............................................................. 80LORTUSS EX ................................................................ 80LORTUSS LQ ................................................................ 33LORYNA (28) ............................................................... 73LORZONE ...................................................................... 138losartan ................................................................................... 64losartan-hydrochlorothiazide ........................... 64LOSEASONIQUE ..................................................... 73LOTEMAX ....................................................................... 90LOTENSIN ....................................................................... 64LOTENSIN HCT ........................................................ 64LOTREL .............................................................................. 64LOTRISONE ................................................................... 31LOTRONEX ................................................................. 107lovastatin .............................................................................. 64LOVAZA ......................................................................... 107LOVENOX ........................................................................ 29LOW-OGESTREL (28) ........................................ 73loxapine succinate ................................................... 145LOXITANE ................................................................... 146LUBRICANT EYE ................................................... 90LUBRICANT EYE (CMC-GLYCERIN)......................................................................................................... 90LUBRICANT EYE (PG-PEG 400) .......... 90LUBRICANT EYE DROPS ............................ 90LUBRICATING & REWETTING ........ 130LUBRICATING PLUS ......................................... 90LUBRIFRESH PM .................................................... 90LUCENTIS ........................................................................ 90LUDENT FLUORIDE ........................................... 97LUFYLLIN ....................................................................... 18LUMIGAN ........................................................................ 90LUMIZYME ................................................................. 168LUNESTA ...................................................................... 149LUPANETA PACK (1 MONTH) .......... 118LUPANETA PACK (3 MONTH) .......... 118LUPRON DEPOT ......................................... 43, 119LUPRON DEPOT (3 MONTH) ..... 43, 119LUPRON DEPOT (4 MONTH) ................... 43LUPRON DEPOT (6 MONTH) ................... 43LUPRON DEPOT-PED .................................... 119LUPRON DEPOT-PED (3 MONTH)...................................................................................................... 119LUSAIR ................................................................................ 80LUSEDRA ......................................................................... 13LUSTRA ........................................................................... 156LUSTRA-AF ................................................................ 156LUTERA (28) ................................................................. 73LUVOX CR ................................................................... 146LUXIQ ................................................................................ 156LUZU ...................................................................................... 31LYNPARZA .................................................................... 43LYRICA ............................................................................... 69

Index

LYSODREN .................................................................... 43LYSTEDA .......................................................................... 58LYZA ...................................................................................... 73M.V.I. ADULT .......................................................... 174M.V.I. PEDIATRIC .............................................. 174M.V.I.-12 (WITHOUT VITAMIN K)...................................................................................................... 174MAALOX ADVANCED ................................ 107MAALOX MAX QUICK DISSOLVE...................................................................................................... 107MAALOX RS .............................................................. 107MAALOX TOTAL RELIEF (BISMUTH)...................................................................................................... 107MACROBID .................................................................... 24MACRODANTIN ...................................................... 24MACUGEN ...................................................................... 90mafenide acetate ........................................................... 24MAG-AL .......................................................................... 107MAG-AL PLUS ........................................................ 107MAG-AL PLUS EXTRA STRENGTH...................................................................................................... 108MAGELLAN INSULIN SAFETY SYRNG .............................................................................. 130MAGELLAN SYRINGE ................................. 130MAGNACET ...................................................................... 8MAGNASWEET 110 .......................................... 168MAGNASWEET 135 .......................................... 168MAGNEBIND 300 .................................................... 97MAGNEBIND 400 .................................................... 97magnesium chloride .................................................. 97magnesium citrate .................................................... 108magnesium oxide ......................................................... 98magnesium stearate ................................................ 168magnesium sulfate ...................................................... 98magnesium sulfate in d5w .................................. 98magnesium sulfate in water .............................. 98MAGNEVIST ................................................................. 86MAJOR-PREP (PHENYLEPHRINE-FAT) ........................... 108MAJOR-PREP HEMORRHOIDAL .... 108MAKENA ....................................................................... 119MALARONE .................................................................. 39MALARONE PEDIATRIC .............................. 39malathion .......................................................................... 156manganese chloride ................................................... 98mannitol 10 % ................................................................. 87mannitol 20 % ................................................................. 87mannitol 25 % ................................................................. 87mannitol 5 % .................................................................... 87MAPAP (ACETAMINOPHEN) ..................... 8MAPAP ARTHRITIS PAIN ............................... 8MAPAP COLD FORMULA ........................... 80MAPAP EXTRA STRENGTH ........................ 8MAPAP INFANTS' ..................................................... 8MAPAP PM ......................................................................... 3MAPAP SINUS MAX STRENGTH (PE)......................................................................................................... 80maprotiline ...................................................................... 146MARCAINE .................................................................... 13MARCAINE (PF) ....................................................... 13MARCAINE SPINAL (PF) .............................. 13MARCAINE-EPINEPHRINE ....................... 13MARCAINE-EPINEPHRINE (PF) .......... 13MAR-COF BP ................................................................ 80MAR-COF CG ............................................................... 80MARGESIC ......................................................................... 8

196

Index

MARINOL ...................................................................... 108MARJORAM ............................................................... 115MARLISSA ...................................................................... 73MARNATAL-F ......................................................... 140MARPLAN .................................................................... 146MARQIBO ........................................................................ 43marshmallow flavor (bulk) ............................. 168MARTEN-TAB ................................................................ 8MASANTI DOUBLE STRENGTH ..... 108MATULANE ................................................................... 43MATZIM LA .................................................................. 60MAVIK ................................................................................. 64MAXALT ............................................................................... 8MAXALT-MLT .............................................................. 8MAXARON FORTE ............................................... 98MAXFE ................................................................................. 98MAXI DEODORANT ........................................ 130MAXI PAD REGULAR ................................... 131MAXI PAD SUPER ............................................. 131MAXI-COMFORT INSULIN SYRINGE...................................................................................................... 131MAXIDEX ........................................................................ 91MAXIDONE ....................................................................... 8MAXI-PADS ................................................................ 131MAXIPHEN ..................................................................... 80MAXIPHEN DM ........................................................ 80MAXIPIME ...................................................................... 24MAXITROL ..................................................................... 24MAXORB ....................................................................... 131MAXORB EXTRA DRESSING ............. 131MAXORB ROPE ..................................................... 131MAXZIDE ......................................................................... 87MAXZIDE-25MG ...................................................... 87M-CLEAR WC .............................................................. 80meclizine ........................................................................... 108meclofenamate ............................................................... 16MEDFIX ........................................................................... 131MEDFIX EZ DRESSING ............................... 131MEDI PADS ................................................................. 156MEDICATED BODY ......................................... 156MEDICATED BODY POWDER ........... 156MEDICATED CHEST RUB ....................... 156MEDICATED PADS ........................................... 108MEDICATED WIPES ........................................ 156MEDICATED WIPES WITH ALOE...................................................................................................... 156MEDIGRIP .................................................................... 131MEDIGRIP ELASTICATED SUPPORT...................................................................................................... 131MEDIGRIP TUBULAR ................................... 131MEDIPLAST CORN-CALLUS-WART...................................................................................................... 156MEDIPORE ................................................................... 131MEDIPORE DRESS-IT COVER ........... 131MEDIPORE H ............................................................ 131MEDIPORE SOFT CLOTH TAPE ...... 131MEDROL ........................................................................ 119MEDROL (PAK) ..................................................... 119medroxyprogesterone ................................ 73, 119mefenamic acid ................................................................. 8MEFIX ................................................................................ 131mefloquine .......................................................................... 39MEFOXIN IN DEXTROSE (ISO-OSM)......................................................................................................... 24MEGACE ........................................................................ 168MEGACE ES ............................................................... 168

Index

megestrol ................................................................ 43, 169MEKINIST ........................................................................ 43melatonin .......................................................................... 119melatonin-lemon balm leaf extr ................ 119meloxicam .......................................................................... 16melphalan hcl .................................................................. 43memantine .......................................................................... 69MENACTRA (PF) ..................................................... 56MENCAPS ..................................................................... 156M-END DMX ................................................................. 80M-END MAX D .......................................................... 80M-END PE ......................................................................... 80M-END WC ...................................................................... 80MENEST .......................................................................... 119MENHIBRIX (PF) ..................................................... 56MENOMUNE - A/C/Y/W-135 ..................... 56MENOMUNE - A/C/Y/W-135 (PF) ....... 56MENOSTAR ................................................................ 119MEN'S MULTIVITAMIN GUMMIES...................................................................................................... 174MENSTRUAL RELIEF .......................................... 8MENTAX ........................................................................... 31MENVEO A-C-Y-W-135-DIP (PF) ........ 56MENVEO MENA COMPONENT (PF)......................................................................................................... 56MENVEO MENCYW-135 COMPNT (PF) ............................................................................................ 56ME-PB-HYOS ............................................................ 108meperidine ............................................................................. 8meperidine (pf) .................................................................. 8meperidine in 0.9 % nacl ........................................ 8MEPERITAB ..................................................................... 8MEPHYTON ................................................................ 174MEPILEX BORDER ........................................... 131MEPILEX BORDER SACRUM ............. 131MEPITEL ........................................................................ 131mepivacaine (pf) ........................................................... 13meprobamate ................................................................ 146MEPRON ............................................................................ 39mercaptopurine .............................................................. 43meropenem ........................................................................ 24meropenem-0.9% sodium chloride ............ 24MERREM ........................................................................... 24mesalamine ..................................................................... 108mesalamine with cleansing wipe .............. 108mesna .................................................................................... 169MESNEX ......................................................................... 169MESTINON ...................................................................... 51MESTINON TIMESPAN ................................... 51METADATE CD ..................................................... 146METAMUCIL ............................................................ 108METAMUCIL (WITH SUGAR) ............ 108METAMUCIL FIBER SINGLES ........... 108METAMUCIL MULTIHEALTH FIBER...................................................................................................... 108METAMUCIL SUGAR FREE .................. 108METAMUCIL SUGAR-FREE (ASPART) ....................................................................... 108METAMUCIL SUNRISE ............................... 108metaproterenol ................................................................ 18metaxalone ...................................................................... 138metformin ............................................................................ 38methadone .............................................................................. 8METHADONE INTENSOL ............................... 8METHADOSE .................................................................. 9methamphetamine ....................................................... 51

Index

METHAZEL ................................................................. 169methazolamide ............................................................... 87methenamine hippurate ......................................... 24methenamine mandelate ....................................... 24methimazole .................................................................. 162METHITEST ................................................................ 119methocarbamol ........................................................... 138METHOCEL E 4 M .............................................. 169methotrexate sodium ................................................ 43methotrexate sodium (pf) .................................... 43methoxsalen rapid .................................................... 156methscopolamine ...................................................... 108methyclothiazide .......................................................... 87methyl alcohol ............................................................. 169methylcellulose .......................................................... 169methylcellulose 1500cps (bulk) ................. 169methylcellulose 4000cps (bulk) ................. 169methyldopa ........................................................................ 64methyldopa-hydrochlorothiazide ................. 64methyldopate .................................................................... 64methylene blue (antidote) ................................ 169methylene blue (bulk-solid) ........................... 169methylergonovine .................................................... 119METHYLIN .................................................................. 146methylphenidate ........................................................ 146methylprednisolone ................................................ 119methylprednisolone acetate ........................... 119methylprednisolone sodium succ ............. 119methyltestosterone .................................................. 119metipranolol ...................................................................... 91metoclopramide hcl ............................................... 108metolazone ......................................................................... 87metoprolol succinate ................................................ 64metoprolol ta-hydrochlorothiaz .................... 64metoprolol tartrate ...................................................... 64METOZOLV ODT ................................................. 108METRO I.V. ..................................................................... 24METROCREAM ...................................................... 156METROGEL ................................................... 156, 157METROGEL VAGINAL .................................... 24METROLOTION .................................................... 157metronidazole .................................................... 24, 157metronidazole in nacl (iso-os) ........................ 24MEVACOR ....................................................................... 64mexiletine ............................................................................ 60MIACALCIN ............................................................... 119MI-ACID .......................................................................... 108MI-ACID GAS RELIEF ................................... 108MICARDIS ....................................................................... 64MICARDIS HCT ........................................................ 64MICONAZOLE 7 ....................................................... 31miconazole nitrate ....................................................... 31MICONAZOLE-3 ...................................................... 31MICONAZORB AF ................................................. 31MICRHOGAM ULTRA-FILTERED .... 56MICRHOGAM ULTRA-FILTERED PLUS ........................................................................................ 56MICRO-BUMINTEST .......................................... 86MICROCHAMBER .............................................. 131MICROFOAM SURGICAL ........................ 131MICROGESTIN 1.5/30 (21) ........................... 73MICROGESTIN 1/20 (21) ................................ 73MICROGESTIN FE 1.5/30 (28) .................. 73MICROGESTIN FE 1/20 (28) ....................... 73MICRO-GUARD ........................................................ 31MICRO-K ........................................................................... 98

197

Index

MICROPORE FIRST AID CLOTH .... 131MICROPORE FIRST AID PAPER ...... 131MICROPORE FIRST AID PLASTIC...................................................................................................... 131MICROPORE FIRST AID SKINTONE...................................................................................................... 131MICROPORE FIRST AID WATERPROOF ....................................................... 131MICROPORE PAPER SURGICAL TAPE .................................................................................... 131MICROPORE SURGICAL ........................... 131MICROSPACER ...................................................... 131MICROSPONGE ..................................................... 131MICROZIDE ................................................................... 87midazolam ............................................................. 13, 149midazolam (pf) ............................................................... 13midazolam (pf) in 0.9 % nacl .......................... 13midazolam in 0.9 % nacl ..................................... 13midodrine ............................................................................. 51MIGERGOT ........................................................................ 9MIGRAINE FORMULA ........................................ 9MIGRAINE RELIEF .................................................. 9MIGRANAL ....................................................................... 9MILK OF MAGNESIA ..................................... 108MILK OF MAGNESIA CONCENTRATED ............................................... 108milk thistle ...................................................................... 115MILK THISTLE EXTRACT ...................... 115milk thistle seed extract ..................................... 115MILK THISTLE XTRA ................................... 115MILLIPRED ................................................................. 119MILLIPRED DP ....................................................... 119milrinone .............................................................................. 60milrinone in 5 % dextrose ................................... 60MIMVEY ......................................................................... 119MIMVEY LO .............................................................. 119MINASTRIN 24 FE ................................................. 73mineral oil ........................................................................ 108MINERAL OIL HEAVY ................................ 169MINERAL OIL LAXATIVE ...................... 108MINI ULTRA-THIN II ..................................... 131MINIPRESS ..................................................................... 65MINIPRIN ............................................................................. 9MINITRAN ....................................................................... 60MINIVELLE ................................................................ 119MINOCIN ........................................................................... 24minocycline ....................................................................... 24minoxidil .............................................................................. 65MINTOX .......................................................................... 108MINTOX MAXIMUM STRENGTH...................................................................................................... 108MINTOX PLUS ........................................................ 108MIOCHOL-E ................................................................... 91MI-OMEGA NF ........................................................ 174MIOSTAT .......................................................................... 91MIRAPEX .......................................................................... 45MIRAPEX ER ................................................................ 45MIRASORB .................................................................. 131MIRCERA .......................................................................... 70MIRCETTE (28) .......................................................... 73mirtazapine ..................................................................... 146MIRVASO ...................................................................... 157misoprostol ..................................................................... 108MISTASSIST .............................................................. 131MITIGARE ....................................................................... 16mitomycin ........................................................................... 43

Index

mitoxantrone .................................................................... 43MOBIC .................................................................................. 16MOBISYL ....................................................................... 157modafinil ........................................................................... 146MODERIBA .................................................................... 48MODERIBA DOSE PACK .............................. 48MODICON (28) ........................................................... 73moexipril .............................................................................. 65moexipril-hydrochlorothiazide ...................... 65MOISTURE RECOVERY ............................. 157mometasone ................................................................... 157MONAGHAN Z STAT CHAMBER...................................................................................................... 131MONAGHAN Z STAT CHAMBER-LG MSK ...................................................................................... 131MONAGHAN Z STAT CHAMBER-MD MSK ...................................................................................... 131MONAGHAN Z STAT CHAMBER-SM MSK ...................................................................................... 131MONOCLATE-P ........................................................ 58MONOJECT INSULIN SAFETY SYRING ............................................................................ 131MONOJECT INSULIN SYRINGE ...... 131MONOJECT SYRINGE ................................... 131MONOJECT ULTRA COMFORT INSULIN .......................................................................... 131MONO-LINYAH ........................................................ 73MONONESSA (28) .................................................. 73MONONINE .................................................................... 58montelukast ....................................................................... 18MONUROL ...................................................................... 24MORGIDOX ................................................................... 24MORGIDOX 1X100 ............................................... 24MORGIDOX 2X100 ............................................... 24morphine .................................................................................. 9morphine (pf) ...................................................................... 9morphine concentrate ................................................. 9morphine in 0.9 % nacl ............................................. 9morrhuate sodium ....................................................... 65MOTION RELIEF (MECLIZINE) ........ 108MOTION SICKNESS ......................................... 108MOTION SICKNESS (MECLIZINE)...................................................................................................... 108MOTION SICKNESS RELIEF ................. 108MOTION-TIME ....................................................... 108MOUTH RINSE ........................................................... 91MOUTHPIECE .......................................................... 131MOVANTIK .................................................................... 30MOVIPREP ................................................................... 109MOXATAG ...................................................................... 24MOXEZA ........................................................................... 24moxifloxacin .................................................................... 24moxifloxacin-sod.ace,sul-water .................... 24MOZOBIL .......................................................................... 70MPM FOAM DRESSING .............................. 132MS CONTIN ....................................................................... 9MUCAPHED ................................................................... 80MUCINEX ......................................................................... 80MUCINEX ALLERGY ........................................ 36MUCINEX COLD & SINUS ......................... 80MUCINEX COLD-FLU & SORE THROAT ............................................................................. 80MUCINEX COUGH MINI-MELTS ....... 80MUCINEX D .................................................................. 80MUCINEX D MAXIMUM STRENGTH......................................................................................................... 80

Index

MUCINEX DM ............................................................ 80MUCINEX FAST-MAX COLD-FLU-THRT ................................................... 80MUCINEX FAST-MAX COLD-SINUS......................................................................................................... 80MUCINEX FAST-MAX CONGEST-COUGH ............................................... 80MUCINEX FAST-MAX DAY-NITE COLD ...................................................................................... 80MUCINEX FAST-MAX DAY-NITE CONG ..................................................................................... 80MUCINEX FAST-MAX DAY-NT(DOXYL) ................................................... 80MUCINEX FAST-MAX DM MAX ....... 80MUCINEX FAST-MAX NITE (DOXYL)......................................................................................................... 80MUCINEX FAST-MAX NITE COLD-FLU ....................................................................... 80MUCINEX FAST-MAX SEV CLD-SINUS ..................................................................... 80MUCINEX FAST-MAX SEVERE COLD......................................................................................................... 80MUCINEX FST-MX DY-NT CLD (DPH) ...................................................................................... 81MUCINEX FULL FORCE ............................... 91MUCINEX MINI-MELTS ................................ 81MUCINEX MOISTURE SMART ............ 91MUCINEX SINUS-MAX .................................. 91MUCINEX SINUS-MAX D-N (DIPHEN) ........................................................................... 81MUCINEX SINUS-MAX DY-NT (DXYL) ................................................................................. 81MUCINEX SINUS-MAX NITE CONGEST ......................................................................... 81MUCINEX SINUS-MAX PRESSUR-PAIN ......................................................... 81MUCINEX SINUS-MAX SEV CONG(DM) ...................................................................... 81MUCINEX SINUS-MAX SEV CONGESTN .................................................................... 81MUCOSA ........................................................................... 81MUCOSA DM ............................................................... 81MUCUS RELIEF ........................................................ 81MUCUS RELIEF COLD & SINUS ........ 81MUCUS RELIEF COLD-FLU-SORE THR ........................................................................................... 81MUCUS RELIEF COUGH ............................... 81MUCUS RELIEF DM ............................................ 81MUCUS RELIEF ER .............................................. 81MUCUS RELIEF PE ............................................... 81MUCUS RELIEF SEV CONGEST-COLD ..................................................... 81MUCUS RELIEF SINUS ................................... 81MULTAQ ........................................................................... 60MULTIPURPOSE CONTACT LENS...................................................................................................... 132MULTI-PURPOSE SOFT CONTACT LEN ........................................................................................ 132MULTI-SYMPTOM COLD (PE) .............. 81MULTI-SYMPTOM COLD NIGHT TIME ........................................................................................ 81MULTITRACE-4 ....................................................... 98MULTITRACE-4 CONCENTRATE ..... 98MULTITRACE-4 NEONATAL ................. 98MULTITRACE-4 PEDIATRIC ................... 98MULTITRACE-5 ....................................................... 98

198

Index

MULTITRACE-5 CONCENTRATE ..... 98MULTI-VIT WITH FLUORIDE & IRON...................................................................................................... 174MULTIVITAMIN WITH FLUORIDE...................................................................................................... 174MULTI-VITAMIN WITH FLUORIDE...................................................................................................... 174MULTIVITAMINS WITH FLUORIDE...................................................................................................... 174multivit-min-iron fum-folic ac .................... 174mupirocin ............................................................................. 24mupirocin calcium ...................................................... 24MURI-LUBE ................................................................ 169MURO 128 ........................................................................ 91MUSCLE RUB .......................................................... 157MUSCLE RUB (WITH CAMPHOR)...................................................................................................... 157MUSCLE RUB ULTRA-STRENGTH...................................................................................................... 157mustard oil ...................................................................... 169MUSTARGEN .............................................................. 43MVC-FLUORIDE .................................................. 174MY WAY ............................................................................ 73MYALEPT ..................................................................... 119MYAMBUTOL ............................................................ 24MYCAMINE ................................................................... 31MYCOBUTIN ................................................................ 24mycophenolate mofetil ....................................... 121mycophenolate sodium ....................................... 121MYDRIACYL ................................................................ 91MYFORTIC .................................................................. 121MYLERAN ....................................................................... 43MYOBLOC ....................................................................... 51MYOCHRYSINE ....................................................... 16MYOFLEX .................................................................... 157MYORISAN ................................................................. 157MYOZYME .................................................................. 169myrrh .................................................................................... 115MYSOLINE ...................................................................... 69MYTAB GAS .............................................................. 109MYTAB GAS MAXIMUM STRENGTH...................................................................................................... 109MYZILRA .......................................................................... 73NABI-HB ............................................................................ 56nabumetone ....................................................................... 16nadolol .................................................................................... 65nadolol-bendroflumethiazide ........................... 65nafcillin .................................................................................. 25nafcillin in dextrose iso-osm ............................ 25naftifine ................................................................................. 31NAFTIN ................................................................................ 31NAGLAZYME .......................................................... 169nalbuphine .............................................................................. 9NALFON ............................................................................. 16naloxone ................................................................................ 30naltrexone ............................................................................ 30NAMENDA ...................................................................... 69NAMENDA TITRATION PAK .................. 69NAMENDA XR ........................................................... 69NAMZARIC .................................................................... 69naphazoline ........................................................................ 91NAPHCON-A ................................................................. 91NAPRELAN CR .......................................................... 16NAPRELAN CR DOSE CARD ................... 16NAPROSYN .................................................................... 16naproxen ............................................................................... 16

Index

naproxen sodium .......................................................... 16naratriptan .............................................................................. 9NARDIL ........................................................................... 146NAROPIN (PF) ............................................................. 13NASACORT AQ ......................................................... 91NASAL ALLERGY ................................................. 91NASAL DECONGESTANT (OXYMETAZL) .......................................................... 91NASAL DECONGESTANT (PE) ............. 81NASAL DECONGESTANT (PSEUDOEPH) ............................................................. 81NASAL FOUR .............................................................. 91NASAL SPRAY (OXYMETAZOLINE)......................................................................................................... 91NASAL SPRAY 12 HOUR .............................. 91NASAL SPRAY EXTRA MOISTURIZING ........................................................ 91NASAL SPRAY LONG ACTING ............ 91NASAL SPRAY SINUS ...................................... 91NASAL SPRAY X-MOIST ............................. 91NASCOBAL ................................................................. 174NASONEX ........................................................................ 91NASOPEN PE ................................................................ 33NATA KOMPLETE ............................................. 140NATACYN ....................................................................... 32NATAFORT (NEW FORMULA 2011)...................................................................................................... 140nateglinide .......................................................................... 38NATELLE ONE ....................................................... 140NATESTO ...................................................................... 119NATPARA ..................................................................... 119NATRECOR .................................................................... 65NATROBA .................................................................... 157NATURAL BALANCE ....................................... 91NATURAL CARE BANDAGES ........... 132NATURAL FIBER LAXATIVE ............. 109NATURAL FIBER LAXATIVE (SUGAR) .......................................................................... 109NATURAL FIBER LAXATIVE THERAPY ...................................................................... 109NATURAL HERBAL DIURETIC ........ 115NATURAL VEG LAXATIVE(SENNOSID) .............................. 109NATURE'S TEARS ................................................. 91NATURE'S WASH PLUS WHIRLPOOL...................................................................................................... 157NAVELBINE .................................................................. 43NEBUPENT ..................................................................... 39NECON 0.5/35 (28) .................................................. 73NECON 1/35 (28) ....................................................... 73NECON 1/50 (28) ....................................................... 73NECON 10/11 (28) ................................................... 73NECON 7/7/7 (28) ..................................................... 73NEEDLE-PRO EDGE ........................................ 132nefazodone ...................................................................... 146NEO AC ............................................................................... 81NEO DM .............................................................................. 81NEO-FRADIN ............................................................... 25neomycin .............................................................................. 25neomycin-bacitracin-poly-hc ........................... 25neomycin-bacitracin-polymyxin .................. 25neomycin-polymyxin b gu .............................. 157neomycin-polymyxin b-dexameth ............. 25neomycin-polymyxin-gramicidin ............... 25neomycin-polymyxin-hc ...................................... 25NEO-POLYCIN HC ................................................ 25

Index

NEOPROFEN (IBUPROFEN LYSN)(PF)......................................................................................................... 65NEORAL .......................................................................... 121NEOSPORIN (NEO-POLYM-GRAMICID) ........................ 25NEOSPORIN DAILY BODY .................... 157NEOSPORIN GU IRRIGANT .................. 157neostigmine methylsulfate ................................. 51NEO-SYNALAR ......................................................... 25NEO-SYNALAR KIT ............................................ 25NEPHPLEX RX ........................................................ 174NEPHRAMINE 5.4 % ........................................... 98NEPHROCAPS ......................................................... 174NEPHRON FA .............................................................. 98NEPHRONEX-SL .................................................. 174NEPTAZANE ................................................................. 87NESACAINE .................................................................. 13NESACAINE-MPF ................................................... 13NESINA ................................................................................ 38NESSI SPACER ....................................................... 132NESTABS ....................................................................... 140NESTABS ABC ........................................................ 140NESTABS DHA ....................................................... 140NESTLE FLAVOR ............................................... 169NEUAC .............................................................................. 157NEUAC KIT ................................................................. 157NEULASTA ..................................................................... 70NEUMEGA ....................................................................... 70NEUPOGEN .................................................................... 70NEUPRO ............................................................................. 45NEURONTIN ................................................................. 69NEUT ...................................................................................... 98NEUTROGENA RAINBATH ................... 157NEUTROGENA TONER ............................... 157NEVANAC ....................................................................... 91nevirapine ............................................................................ 48NEW GENERATION ......................................... 132NEXA PLUS ................................................................ 140NEXA SELECT ........................................................ 140NEXAVAR ....................................................................... 43NEXCARE GENTLE PAPER TAPE...................................................................................................... 132NEXCARE TEGADERM .............................. 132NEXIUM IV ................................................................. 109NEXIUM PACKET .............................................. 109NEXPLANON ............................................................... 73NEXT CHOICE ............................................................ 73NEXT CHOICE ONE DOSE ......................... 73NEXTERONE ................................................................ 60niacin .................................................................................... 174NIACIN-AZE AC-TURMER-FA-B6-ZN...................................................................................................... 169NIACOR .............................................................................. 65NIASPAN EXTENDED-RELEASE ...... 65NICADAN ...................................................................... 169nicardipine .......................................................................... 60NICODERM CQ ...................................................... 162NICOMIDE ................................................................... 174NICOMIDE (SELENIUM-CHROMIUM)...................................................................................................... 174NICORELIEF .............................................................. 162NICORETTE ................................................................ 162nicotine ............................................................................... 162nicotine (polacrilex) .............................................. 162NICOTROL ................................................................... 162NICOTROL NS ......................................................... 162

199

Index

NIFEDICAL XL .......................................................... 60nifedipine ............................................................................. 60NIGHT TIME (DOXY-DM-ACETAM)......................................................................................................... 81NIGHT TIME COLD ............................................. 81NIGHT TIME COLD & FLU RELIEF......................................................................................................... 81NIGHT TIME COLD-FLU ............................... 81NIGHT TIME COLD-FLU RELIEF ...... 81NIGHT-TIME ................................................................. 81NIGHTTIME COLD-FLU ................................ 81NIGHTTIME COLD-FLU RELIEF ........ 81NIGHTTIME COUGH .......................................... 81NIGHTTIME SINUS .............................................. 81NIGHTTIME SLEEP AID (DIPHEN)...................................................................................................... 149NILANDRON ................................................................ 43NIMBEX .............................................................................. 51nimodipine .......................................................................... 60NINJACOF ........................................................................ 81NINJACOF-A ................................................................. 82NINJACOF-XG ............................................................ 82NIPENT ................................................................................ 43NIRAVAM ..................................................................... 146NIRON KOMPLETE .............................................. 98nisoldipine .......................................................................... 61NITE TIME ....................................................................... 82NITE TIME COLD-FLU RELIEF ............ 82NITE TIME COUGH ............................................. 82NITE TIME-D COLD-FLU RELIEF ..... 82NITE-TIME COLD-FLU .................................... 82NITRATEST PAPER ............................................. 86NITRATEST PAPER WITH DISPENSER .................................................................... 86NITRO-BID ...................................................................... 61NITRO-DUR ................................................................... 61nitrofurantoin ................................................................... 25nitrofurantoin macrocrystal ............................... 25nitrofurantoin monohyd/m-cryst .................. 25nitroglycerin ...................................................................... 61nitroglycerin in 5 % dextrose .......................... 61NITROLINGUAL ...................................................... 61NITROMIST .................................................................... 61NITROPRESS ................................................................ 65NITROSTAT ................................................................... 61NITRO-TIME ................................................................. 61NIVA-FOL ..................................................................... 174NIVA-HIST DM .......................................................... 82NIVANEX DMX ........................................................ 82NIVA-PLUS ................................................................. 140nizatidine .......................................................................... 109NIZORAL ........................................................................... 32NO DOZ ............................................................................... 69NO DRIP ............................................................................. 91NO STING BARRIER FILM ...................... 157NODOLOR ........................................................................... 9NOHIST-DM ................................................................... 82NOHIST-LQ .................................................................... 33non-adherent bandage .......................................... 132NON-ADHESIVE PAD .................................... 132NON-ASA EX ST PAIN/SLEEP AID ..... 3NON-ASPIRIN ................................................................. 9NON-ASPIRIN EXTRA STRENGTH .... 9NON-ASPIRIN NIGHTIME .............................. 3NON-ASPIRIN PAIN RELIEF ....................... 9NON-ASPIRIN PM ..................................................... 3

Index

NON-DROWSY ALLERGY .......................... 36NONI .................................................................................... 115NON-STICK DRESSINGS ........................... 132NON-STICK PAD .................................................. 132NORA-BE .......................................................................... 73NORCO .................................................................................... 9NORDITROPIN FLEXPRO ........................ 119NORDITROPIN NORDIFLEX ................ 119NOREL AD ...................................................................... 82NOREL CS ........................................................................ 82norepinephrine bitartrate ...................................... 51noreth-ethinyl estradiol-iron ............................. 73norethindrone (contraceptive) ......................... 73norethindrone acetate ........................................... 119norethindrone ac-eth estradiol ........... 73, 119norethindrone-e.estradiol-iron ........................ 73norgestimate-ethinyl estradiol ........................ 73NORINYL 1+35 (28) .............................................. 73NORINYL 1+50 (28) .............................................. 74NORITATE ................................................................... 157NORLYROC ................................................................... 74NORMOSOL-M IN 5 % DEXTROSE......................................................................................................... 98NORMOSOL-R ............................................................ 98NORMOSOL-R IN 5 % DEXTROSE......................................................................................................... 98NORMOSOL-R PH 7.4 ........................................ 98NORPACE ......................................................................... 61NORPACE CR .............................................................. 61NORPRAMIN ............................................................. 146NOR-QD .............................................................................. 74NORTHERA .................................................................... 51NORTREL 0.5/35 (28) .......................................... 74NORTREL 1/35 (21) ............................................... 74NORTREL 1/35 (28) ............................................... 74NORTREL 7/7/7 (28) ............................................. 74nortriptyline ................................................................... 146NORVASC ........................................................................ 61NORVIR .............................................................................. 48NOSE DROPS ............................................................... 91NOSE DROPS EXTRA STRENGTH ... 91NO-STICK GLUCOSE ........................................ 86NO-STING SKIN-PREP .................................. 132NOVOEIGHT ................................................................. 58NOVOFINE 30 .......................................................... 132NOVOFINE 32 .......................................................... 132NOVOFINE AUTOCOVER ........................ 132NOVOFINE PLUS ................................................. 132NOVOLIN 70/30 ......................................................... 38NOVOLIN N ................................................................... 38NOVOLIN R ................................................................... 38NOVOLOG ....................................................................... 38NOVOLOG FLEXPEN ........................................ 38NOVOLOG MIX 70-30 ....................................... 38NOVOLOG MIX 70-30 FLEXPEN ........ 38NOVOLOG PENFILL ........................................... 39NOVOSEVEN RT ..................................................... 58NOVOTWIST ............................................................. 132NOXAFIL ........................................................................... 32NP THYROID ............................................................ 162NPLATE .............................................................................. 70NRS NASAL RELIEF ........................................... 91NU-COPD .......................................................................... 82NUCYNTA ........................................................................... 9NUCYNTA ER ................................................................. 9NUEDEXTA .................................................................... 69

Index

NULECIT ........................................................................... 98NULEV .............................................................................. 109NULOJIX ........................................................................ 121NULYTELY WITH FLAVOR PACKS...................................................................................................... 109NUPERCAINAL ......................................................... 13nutmeg oil ........................................................................ 169NUTRESTORE ............................................................. 98NUTRILIPID ............................................................... 109NUTRILYTE ................................................................... 98NUTRILYTE II ............................................................ 98NUTRI-TAB OB ...................................................... 140NUTRI-TAB OB + DHA ................................ 140NUTRITIONAL SHAKE ................................... 98NUTRITIONAL SHAKE PLUS ................. 98NUTROPIN ................................................................... 119NUTROPIN AQ ........................................................ 119NUTROPIN AQ NUSPIN .............................. 119NUVARING .................................................................... 74NUVESSA ......................................................................... 25NUVIGIL ......................................................................... 146NYAMYC .......................................................................... 32NYMALIZE ..................................................................... 61NYQUIL D ........................................................................ 82nystatin ................................................................................... 32nystatin-triamcinolone ............................................ 32NYSTOP .............................................................................. 32NYTOL .............................................................................. 149OATMEAL BATH REGULAR ............... 157OB COMPLETE ...................................................... 140OB COMPLETE 400 ........................................... 140OB COMPLETE ONE ....................................... 140OB COMPLETE PETITE ............................... 140OB COMPLETE PREMIER ........................ 140OB COMPLETE WITH DHA ................... 140OBIZUR ............................................................................... 58O-CAL FA ...................................................................... 140O-CAL PRENATAL ............................................ 140OCTAGAM ...................................................................... 56octreotide acetate ...................................................... 119OCUFEN ............................................................................. 91OCUFLOX ........................................................................ 25OCUSOFT FACIAL-SKIN CLEANSER...................................................................................................... 157ODOMZO ........................................................................... 43ODOR ELIMINATOR DROPS ............... 157ODOR FREE GARLIC ..................................... 115ODORLESS GARLIC ........................................ 115OFEV ................................................................................... 169ofloxacin ............................................................................... 25OGESTREL (28) ......................................................... 74olanzapine ........................................................................ 146olanzapine-fluoxetine .......................................... 146oleic acid ........................................................................... 169OLEPTRO ER ............................................................ 146olopatadine ......................................................................... 91OLUX .................................................................................. 157OLUX-E ............................................................................ 157OLYSIO ................................................................................ 48OMECLAMOX-PAK ......................................... 109omega-3 acid ethyl esters ................................. 109OMEGA-3 IQ CHILDREN'S ...................... 169omeprazole ...................................................................... 109omeprazole magnesium ..................................... 109OMIDRIA ........................................................................... 91OMNARIS ......................................................................... 91

200

Index

OMNIPAQUE 140 .................................................... 86OMNIPAQUE 180 .................................................... 86OMNIPAQUE 240 .................................................... 86OMNIPAQUE 300 .................................................... 86OMNIPAQUE 350 .................................................... 86OMNIPRED ..................................................................... 91OMNISCAN .................................................................... 86OMNISCAN PREFILL PLUS ...................... 86OMNITROPE .............................................................. 119ONCASPAR .................................................................... 43ondansetron .................................................................... 109ondansetron (pf) in dextrose ......................... 109ondansetron hcl .......................................................... 109ondansetron hcl (pf) ............................................... 109ONE FLOW SPIROMETER PC CABLE...................................................................................................... 132ONE FLOW SPIROMETER SOFTWARE ................................................................. 132ONE FLOW TESTER MOUTHPIECE...................................................................................................... 132ONE FLOW TESTER SPIROMETER...................................................................................................... 132ONE STEP AT A TIME ................................... 132ONE WAY VALVED MOUTHPIECE...................................................................................................... 132ONEXTON .................................................................... 157ONFI ........................................................................................ 69ONGLYZA ........................................................................ 39ONMEL ................................................................................ 32ONTAK ................................................................................. 43OPANA .................................................................................... 9OPANA ER .......................................................................... 9OPCICON ONE-STEP .......................................... 74OPDIVO ............................................................................... 43opium tincture .............................................................. 109OPSITE .............................................................................. 132OPSITE ADHESIVE DRESSING ......... 132OPSITE FLEXIFIX ............................................... 132OPSITE FLEXIGRID ......................................... 132OPSITE FLEXIGRID DRESSING ....... 132OPSITE IV 3000 ...................................................... 132OPSUMIT ........................................................................... 65OPTICHAMBER ADULT MASK-LARGE ......................................................... 132OPTICHAMBER ADVANTAGE ......... 132OPTICHAMBER ADVANTAGE-LG MASK ................................................................................. 132OPTICHAMBER ADVANTAGE-MED MASK ................................................................................. 132OPTICHAMBER ADVANTAGE-SML MSK ...................................................................................... 132OPTICHAMBER DIAMOND LG MASK...................................................................................................... 132OPTICHAMBER DIAMOND VHC ... 132OPTICHAMBER DIAMOND-MED MSK ...................................................................................... 132OPTICHAMBER DIAMOND-SML MASK ................................................................................. 132OPTICHAMBER LARGE FACE MASK...................................................................................................... 132OPTICHAMBER MEDIUM FACE MASK ................................................................................. 132OPTICHAMBER SMALL FACE MASK...................................................................................................... 132OPTI-CLEAR ................................................................. 91OPTI-FREE ................................................................... 133

Index

OPTI-FREE EXPRESS ..................................... 133OPTI-FREE REPLENISH .............................. 133OPTI-FREE REWETTING DROPS .... 133OPTIHALER DRUG DELIVERY SYSTEM .......................................................................... 133OPTISON ............................................................................ 86OPTIVAR ........................................................................... 36ORACEA ............................................................................. 25ORACIT ............................................................................... 98ORAL MIX .................................................................... 169ORAL MIX SF ........................................................... 169ORAL PAIN RELIEF ............................................ 13ORAL PEROXIDE ................................................ 157ORAL SUSPEND ................................................... 169ORAL SYRUP ........................................................... 169ORAL SYRUP SF .................................................. 169ORALAIR .......................................................................... 56ORALONE ..................................................................... 169orange .................................................................................. 169ORANGE CONCENTRATE ...................... 169orange oil .......................................................................... 169ORAP ................................................................................... 146ORA-PLUS .................................................................... 169ORAPRED ..................................................................... 119ORAPRED ODT ...................................................... 119ORASEP .............................................................................. 13ORA-SWEET .............................................................. 169ORA-SWEET SF ..................................................... 169ORAVIG .............................................................................. 32ORBACTIV ...................................................................... 25ORENCIA .......................................................................... 16ORENCIA (WITH MALTOSE) .................. 16ORENITRAM ................................................................ 65ORFADIN ....................................................................... 169ORGAN-I NR ................................................................. 82ORIGINAL NASAL SPRAY ......................... 91ORKAMBI ..................................................................... 169orphenadrine citrate ............................................... 138ORSINI INSULIN SYRINGE .................... 133ORSYTHIA ...................................................................... 74ORTHO ALL-FLEX FITTING SET ...... 74ORTHO DIAPHRAGM ALL-FLEX 65......................................................................................................... 74ORTHO DIAPHRAGM ALL-FLEX 70......................................................................................................... 74ORTHO DIAPHRAGM ALL-FLEX 75......................................................................................................... 74ORTHO DIAPHRAGM ALL-FLEX 80......................................................................................................... 74ORTHO EVRA ............................................................. 74ORTHO MICRONOR ........................................... 74ORTHO TRI-CYCLEN (28) ........................... 74ORTHO-CEPT (28) .................................................. 74ORTHOCLONE OKT3 ..................................... 121ORTHO-CYCLEN (28) ....................................... 74ORTHO-NOVUM 1/35 (28) ........................... 74ORTHO-NOVUM 7/7/7 (28) ......................... 74OSCIMIN ........................................................................ 109OSCIMIN SL ............................................................... 109OSCIMIN SR ............................................................... 109OSENI .................................................................................... 39OSMITROL 10 % ...................................................... 87OSMITROL 15 % ...................................................... 87OSMITROL 20 % ...................................................... 87OSMITROL 5 % .......................................................... 87OSMOPREP ................................................................. 109

Index

OSPHENA ...................................................................... 169OTEZLA .............................................................................. 16OTEZLA STARTER ............................................... 16OTIC CARE (ANTIPYRINE) ....................... 91OTOZIN ............................................................................... 91OVACE .............................................................................. 157OVACE PLUS ............................................................ 157OVACE PLUS SHAMPOO ......................... 157OVACE PLUS WASH ...................................... 157OVCON-35 (28) ........................................................... 74OVIDE ................................................................................ 157oxacillin ................................................................................. 25oxacillin in dextrose(iso-osm) ........................ 25oxaliplatin ........................................................................... 43oxandrolone ................................................................... 120oxaprozin ............................................................................. 16oxazepam .......................................................................... 146oxcarbazepine ................................................................. 69OXECTA ................................................................................ 9OXISTAT ........................................................................... 32OXSORALEN ............................................................ 157OXSORALEN ULTRA .................................... 157OXTELLAR XR .......................................................... 69oxybutynin chloride ............................................... 169oxycodone .................................................................... 9, 10oxycodone-acetaminophen ................................ 10oxycodone-aspirin ...................................................... 10OXYCONTIN ................................................................ 10oxymorphone ................................................................... 10oxytocin ............................................................................. 120OXYTROL ..................................................................... 169OYSTERCAL-D .......................................................... 98OZURDEX ........................................................................ 91PACERONE ..................................................................... 61paclitaxel .............................................................................. 43PACNEX HP ................................................................ 157PACNEX LP ................................................................ 157PACNEX MX .............................................................. 157PAIN & FEVER ........................................................... 10PAIN FREE TAPE ................................................. 133PAIN FREE WRAP .............................................. 133PAIN RELIEF ................................................................ 10PAIN RELIEF ALCOHOL-BENZOCAINE ........................... 40PAIN RELIEF ALLERGY SINUS .......... 82PAIN RELIEF ANESTHETIC ..................... 14PAIN RELIEF COLD ............................................ 82PAIN RELIEF COLD & COUGH ............ 82PAIN RELIEF EXTRA STRENGTH .... 10PAIN RELIEF INSTANT ANTISEPTIC...................................................................................................... 158PAIN RELIEF PM ........................................................ 3PAIN RELIEF PM RAPID RELEASE .... 3PAIN RELIEF REGULAR STRENGTH......................................................................................................... 10PAIN RELIEF SINUS PE .................................. 82PAIN RELIEVER ....................................................... 10PAIN RELIEVER AM/PM .................................. 3PAIN RELIEVER EXTRA STRENGTH......................................................................................................... 10PAIN RELIEVER PLUS ..................................... 10PAIN RELIEVER PM ............................................... 3PAIN RELIEVER PM EX ST ........................... 3PAIN RELIEVER PM EX-STRENGTH............................................................................................................ 3PAIN RELIEVING (MENTHOL) ......... 158

201

Index

PAIN RELIEVING RUB ................................ 158PAIRE OB PLUS DHA .................................... 140paliperidone ................................................................... 146PAMELOR ..................................................................... 147pamidronate ................................................................... 169PAMINE ........................................................................... 109PAMINE FORTE .................................................... 109PANCREAZE ............................................................. 109PANCRELIPASE 5000 ..................................... 109pancuronium ..................................................................... 51PANDA MASK ......................................................... 133PANDEL .......................................................................... 158PANHEMATIN ......................................................... 169PANOXYL ..................................................................... 158PANOXYL-4 ............................................................... 158PANRETIN ....................................................................... 43PANTILINERS .......................................................... 133pantoprazole .................................................................. 109papaverine ........................................................................... 65PAPER FIRST AID TAPE ............................ 133PAPER TAPE .............................................................. 133PAPER TAPE, HYPOALLERGENIC...................................................................................................... 133paraffin ................................................................................ 169PARAFON FORTE DSC ................................ 139PARAGARD T 380A ............................................. 74PARCOPA ......................................................................... 46paregoric ........................................................................... 109PAREMYD ....................................................................... 91paricalcitol ......................................................... 169, 170PARNATE ...................................................................... 147paromomycin ................................................................... 40paroxetine hcl ............................................................... 147PASER ................................................................................... 25PATADAY ........................................................................ 36PATANASE ..................................................................... 91PATANOL ......................................................................... 36PAXIL ................................................................................. 147PAXIL CR ...................................................................... 147PAZEO .................................................................................. 36PCCA-PLUS BASE .............................................. 170PCE ............................................................................................ 25PEANUT BUTTER FLAVOR .................. 170PEDIA RELIEF COUGH-COLD .............. 82PEDIADERM AF ....................................................... 32PEDIADERM HC ................................................... 158PEDIADERM TA ................................................... 158PEDIA-LAX ................................................................. 109PEDIA-LAX STOOL SOFTENER ....... 109PEDIAPRED ................................................................ 120PEDIARIX (PF) ........................................................... 56PEDIATRIC COUGH & COLD ................. 82PEDIATRIC ELECTROLYTE .................... 98PEDIATRIC MEDIUM MASK ............... 133PEDIATRIC PANDA MASK .................... 133PEDIATRIC SMALL MASK ..................... 133PEDIAVENT ................................................................... 36PEDI-BORO SOAK ............................................. 158PEDI-PRE ....................................................................... 133PEDI-PRE TAPE SPRAY .............................. 133PEDI-SKIN ADHERENT #2 ...................... 133PEDITRACE ................................................................... 98PEDVAX HIB (PF) .................................................. 56peg 3350-electrolytes ........................................... 109PEG3350 ........................................................................... 109

Index

PEG-3350 WITH FLAVOR PACKS...................................................................................................... 109PEGANONE .................................................................... 69PEGASYS .......................................................................... 48PEGASYS PROCLICK ........................................ 48peg-electrolyte soln ................................................ 109PEGINTRON .................................................................. 48PEGINTRON REDIPEN .................................... 48PEN NEEDLE ............................................................ 133pen needle, diabetic ............................................... 133penicillin g pot in dextrose ................................ 25penicillin g potassium ............................................. 25penicillin g procaine ................................................. 25penicillin g sodium .................................................... 25penicillin v potassium ............................................. 25PENLAC .............................................................................. 32PENNSAID .................................................................... 158PENTACEL (PF) ........................................................ 56PENTACEL ACTHIB COMPONENT (PF) ............................................................................................ 56PENTACEL DTAP-IPV COMPNT (PF)......................................................................................................... 56PENTAM ............................................................................. 40PENTASA ....................................................................... 109pentazocine-acetaminophen .............................. 10pentazocine-naloxone ............................................. 10PENTIPS .......................................................................... 133pentoxifylline ................................................................... 58PENTRAVAN ............................................................ 170PEPCID .............................................................................. 109PEPCID COMPLETE ......................................... 109PEPPERMINT FLAVORING .................... 170peppermint oil .............................................................. 115peppermint spirit ....................................................... 115PEPTIC RELIEF ...................................................... 110PEPTO-BISMOL ..................................................... 110PEPTO-BISMOL MAX ST .......................... 110PEPTO-BISMOL TO-GO .............................. 110PERCOCET ...................................................................... 10PERCODAN .................................................................... 10PERDIEM OVERNIGHT RELIEF ....... 110PERFOROMIST .......................................................... 18PERI-COLACE ......................................................... 110PERIFRESH ................................................................. 158PERIGIENE .................................................................. 158PERIGUARD .............................................................. 158PERIKABIVEN ............................................................ 98perindopril erbumine ............................................... 65PERISCENT ................................................................. 158PERJETA ............................................................................ 43permethrin ....................................................................... 158perphenazine ................................................................. 147perphenazine-amitriptyline ............................ 147PERSANTINE ............................................................... 46PERTZYE ....................................................................... 110PETADOLEX ............................................................. 115PETADOLEX 75 ..................................................... 115PETROLATUM GAUZE ................................ 133petrolatum, yellow (bulk) ................................ 170PETROLEUM JELLY ....................................... 170PETROLEUM JELLY, WHITE ............... 170PEXEVA .......................................................................... 147PFIZERPEN-G .............................................................. 25PFLEX INSPIRATORY TRAINER .... 133PHARBEDRYL ........................................................... 36PHARBETOL ................................................................. 10

Index

PHAZYME .................................................................... 110PHENACTIN AA PLUS 20 PE ................... 98PHENADOZ ................................................................. 110PHENASEPTIC ........................................................... 14phenazopyridine ............................................................ 14phenelzine ........................................................................ 147PHENERGAN .................................................. 36, 110phenobarb-hyoscy-atropine-scop ............. 110phenobarbital ................................................................ 149phenobarbital sodium ........................................... 149phenoxybenzamine .................................................... 51phenylephrine hcl .............................................. 65, 91phenylephrine hcl in 0.9% nacl ..................... 65PHENYLHISTINE DH ........................................ 82PHENYTEK ..................................................................... 69phenytoin ............................................................................. 69phenytoin sodium ........................................................ 69phenytoin sodium extended .............................. 69PHILITH .............................................................................. 74PHISOHEX .................................................................... 158PHOSLO .............................................................................. 98PHOSLYRA ..................................................................... 98PHOSPHA 250 NEUTRAL ............................. 98PHOSPHATE LAXATIVE ........................... 110PHOSPHOLINE IODIDE .................................. 91PHRENILIN FORTE .............................................. 10PHYSICIANS EZ USE FLU 2012-13......................................................................................................... 56PHYSIOLYTE ............................................................ 158PHYSIOSOL IRRIGATION ....................... 158physostigmine salicylate ...................................... 51PHYTOFUSION ...................................................... 115phytonadione ................................................................ 174PICATO ...................................................................... 43, 44pilocarpine hcl ...................................................... 51, 92pimozide ............................................................................ 147PIMTREA (28) .............................................................. 74pindolol .................................................................................. 65pine tar (bulk) .............................................................. 158PINK BISMUTH ..................................................... 110PINK BISMUTH MAXIMUM STRENGTH .................................................................. 110PINNACAINE ............................................................... 92pioglitazone ....................................................................... 39piperacillin-tazobactam ......................................... 25PIRMELLA ....................................................................... 74piroxicam ............................................................................. 16PITOCIN .......................................................................... 120PITRESSIN .................................................................... 120PLAQUENIL ................................................................... 40PLASBUMIN 25 % .................................................. 58PLASBUMIN 5 % ..................................................... 58PLASMA-LYTE 148 .............................................. 98PLASMA-LYTE A ................................................... 98PLASMA-LYTE-56 IN 5 % DEXTROSE......................................................................................................... 98PLASMANATE ........................................................... 58PLASTIC STRIPS .................................................. 133PLASTIC SWABS ................................................. 133PLAVIX ................................................................................ 46PLEGISOL ........................................................................ 61PLEGRIDY ....................................................................... 69PLETAL ............................................................................... 46PLIAGLIS .......................................................................... 14PLURATUSS .................................................................. 82PNEUMOVAX 23 ..................................................... 56

202

Index

PNV 29-1 ......................................................................... 140PNV FOLIC ACID + IRON ......................... 140PNV OB+DHA .......................................................... 140PNV-DHA ....................................................................... 140PNV-FERROUS FUMARATE-DOCU-FA ................................ 140PNV-FIRST ................................................................... 140PNV-SELECT ............................................................. 140PNV-VP-U ...................................................................... 140POCKET CHAMBER ........................................ 133PODOCON .................................................................... 158podofilox ........................................................................... 158POLOCAINE .................................................................. 14POLOCAINE-MPF ................................................... 14POLY HIST DHC ...................................................... 82POLY HIST FORTE (DOXYLAMINE)......................................................................................................... 34POLY HIST NC ........................................................... 82POLY HIST PD .................................................. 34, 82POLYCIN ........................................................................... 25polyethylene glycol 3350 ................................. 110polyethylene glycol 8000(bulk) ................. 170POLY-HIST DM (THONZYLAMINE)......................................................................................................... 82polymyxin b sulfate ................................................... 25polymyxin b sulf-trimethoprim ..................... 25polyoxyl 40 stearate ............................................... 170polyoxyl 40 stearate (bulk) ............................. 170POLYSACCHARIDE IRON .......................... 98POLYSKIN II .............................................................. 133polysorbate 40 ............................................................. 170polysorbate 60 ............................................................. 170polysorbate 80 ............................................................. 170POLYTRIM ...................................................................... 25POLY-TUSSIN ............................................................. 82POLY-TUSSIN AC .................................................. 82POLY-TUSSIN D ....................................................... 82POLY-TUSSIN EX .................................................. 82POLY-VENT DM ...................................................... 82POLY-VENT IR .......................................................... 82POMALYST .................................................................... 44pomegranate fruit extract ................................. 115POMEGRANATE-EGCG & GRAPE SEED .................................................................................... 116PONSTEL ........................................................................... 10PONTOCAINE (PF) ................................................ 14PORTIA ................................................................................ 74pot & sod citrate-citric acid ............................... 98potassium acetate ......................................................... 99potassium bicarb and chloride ........................ 99potassium bicarb-citric acid .............................. 99potassium chlorid-d5-0.45%nacl ................. 99potassium chloride ..................................................... 99potassium chloride in 0.9%nacl .................... 99potassium chloride in 5 % dex ....................... 99potassium chloride in lr-d5 ................................ 99potassium chloride-0.45 % nacl .................... 99potassium chloride-d5-0.2%nacl ................. 99potassium chloride-d5-0.3%nacl ................. 99potassium chloride-d5-0.9%nacl ................. 99potassium citrate ........................................................... 99potassium citrate-citric acid .............................. 99potassium gluconate ................................................. 99potassium phosphate m-/d-basic .................. 99POTIGA ................................................................................ 69povidone-iodine ......................................................... 158

Index

POWER CLEANER ............................................. 133PR NATAL 400 ......................................................... 140PR NATAL 400 EC .............................................. 140PR NATAL 430 ......................................................... 140PR NATAL 430 EC .............................................. 140PRADAXA ........................................................................ 29PRALUENT PEN ....................................................... 65PRALUENT SYRINGE ....................................... 65PRAMCORT ................................................................ 110PRAMEGEL ANTI-ITCH ............................. 158pramipexole ....................................................................... 46PRAMOSONE ........................................................... 158PRAMOSONE E ...................................................... 158pramoxine ........................................................................ 110PRAMOXINE-HC ..................................................... 92PRANDIMET ................................................................. 39PRANDIN .......................................................................... 39PRASCION ....................................................................... 25PRASCION FC ............................................................. 25PRASCION RA ............................................................ 25PRAVACHOL ............................................................... 65pravastatin ........................................................................... 65PRAXBIND ...................................................................... 58prazosin ................................................................................. 65PRECEDEX .................................................................. 149PRECEDEX IN 0.9 % SODIUM CHLOR...................................................................................................... 149PRECOSE ........................................................................... 39PRED FORTE ................................................................ 92PRED MILD .................................................................... 92PRED-G ................................................................................ 25PRED-G S.O.P. ............................................................. 25prednicarbate ................................................................ 158prednisolone .................................................................. 120prednisolone acetate ................................................. 92prednisolone sodium phosphate ...... 92, 120prednisone ....................................................................... 120PREDNISONE INTENSOL ......................... 120PREFERA-OB ............................................................ 140PREFERA-OB ONE ............................................ 140PREFERA-OB PLUS DHA .......................... 140PREFEST ......................................................................... 120PREMARIN .................................................................. 120PREMASOL 10 % ..................................................... 99PREMASOL 6 % ........................................................ 99PRE-MENSTRUAL RELIEF ........................ 10PREMPHASE ............................................................. 120PREMPRO ..................................................................... 120PRENAISSANCE ................................................... 141PRENAISSANCE PLUS ................................. 141PRENATA ...................................................................... 141PRENATAL PLUS (CALCIUM CARB)...................................................................................................... 141PRENATAL PLUS WITH IRON (CA)...................................................................................................... 141PRENATAL WITH DHA & FOLIC ACID .................................................................................... 141PRENATE AM .......................................................... 141PRENATE CHEWABLE ................................ 141PRENATE DHA ....................................................... 141PRENATE DHA (FERR ASP GLYCIN)...................................................................................................... 141PRENATE ELITE .................................................. 141PRENATE ELITE (IRON ASP GLYC)...................................................................................................... 141PRENATE ENHANCE ..................................... 141

Index

PRENATE ESSENTIAL ................................. 141PRENATE ESSENTIAL(IRON-ASP-GL)...................................................................................................... 141PRENATE MINI ...................................................... 141PRENATE MINI (FERR ASP GLYCIN)...................................................................................................... 141PRENATE PIXIE .................................................... 141PRENATE RESTORE ....................................... 141PRENATE STAR .................................................... 141PRENEXA ...................................................................... 141PREP-HEM (PHENYLEPHRINE) ....... 110PREPIDIL ....................................................................... 120PREPLUS ........................................................................ 141PREPOPIK ..................................................................... 110PREQUE 10 .................................................................. 141PRETAB ........................................................................... 141PREVACID ................................................................... 110PREVACID 24HR .................................................. 110PREVACID SOLUTAB ................................... 110PREVALITE .................................................................... 65PREVIFEM ....................................................................... 74PREVNAR 13 (PF) ................................................... 56PREVPAC ....................................................................... 110PREZCOBIX ................................................................... 48PREZISTA ......................................................................... 48PRIALT ................................................................................. 10PRIFTIN ............................................................................... 25PRILOSEC ..................................................................... 110PRILOSEC OTC ...................................................... 110PRIMAPORE IV ...................................................... 133primaquine .......................................................................... 40PRIMAXIN IV .............................................................. 25PRIMEAIRE ................................................................. 133PRIMER MODIFIED UNNA BOOT...................................................................................................... 133primidone ............................................................................. 69PRIMLEV ........................................................................... 10PRIMROSE OIL ...................................................... 116PRIMSOL ........................................................................... 25PRINIVIL ........................................................................... 65PRISTIQ ........................................................................... 147PRIVIGEN ......................................................................... 56PRO DNA COLLECTION ............................... 86PRO SPORTS TAPE ........................................... 133PROAIR HFA ................................................................ 18PROAIR RESPICLICK ........................................ 18probenecid .......................................................................... 16PROBIOTIC PLUS & CRANBERRY...................................................................................................... 116procainamide .................................................................... 61PROCALAMINE 3% ............................................. 99PROCARDIA ................................................................. 61PROCARDIA XL ....................................................... 61PROCENTRA ................................................................ 51PROCHAMBER ....................................................... 133PRO-CHLO ....................................................................... 82prochlorperazine ....................................................... 110prochlorperazine edisylate .............................. 110prochlorperazine maleate ................................. 110PRO-CLEAR AC ........................................................ 82PROCORT ...................................................................... 110PROCRIT ............................................................................ 70PROCTOCORT ......................................................... 110PROCTOCREAM-HC ....................................... 110PROCTOFOAM ....................................................... 110PROCTOFOAM HC ............................................ 110

203

Index

PROCTO-PAK ........................................................... 110PROCTOSOL HC ................................................... 110PROCTOZONE-HC ............................................. 110PROCYSBI .................................................................... 170PRODERM .................................................................... 170PRODIGY INSULIN SYRINGE ............ 133PRODIGY PEN NEEDLE ............................. 133PROFILNINE ................................................................. 58progesterone .................................................................. 120PROGESTERONE IN OIL ........................... 120progesterone micronized ................................... 120PROGLYCEM ............................................................... 99PROGRAF ...................................................................... 121PROLASTIN-C ......................................................... 170PROLENSA ..................................................................... 92PROLEUKIN .................................................................. 44PROLIA ............................................................................. 170PROMACTA ................................................................... 70promethazine ...................................................... 36, 110PROMETHAZINE VC ......................................... 34PROMETHAZINE VC-CODEINE .......... 82promethazine-codeine ............................................. 82promethazine-dm ......................................................... 82promethazine-phenyleph-codeine ............... 82promethazine-phenylephrine ........................... 34PROMETHEGAN .................................................. 110PROMETRIUM ........................................................ 120propafenone ....................................................................... 61propantheline ................................................................ 110proparacaine ...................................................................... 92propofol ................................................................................. 14propoxyphene .................................................................. 10propoxyphene n-acetaminophen .................. 10propoxyphene-acetaminophen ....................... 10propranolol ......................................................................... 65propranolol-hydrochlorothiazid .................... 65propylene glycol ........................................................ 170propylene glycol (bulk) ...................................... 170propylthiouracil .......................................................... 162PROQUAD (PF) .......................................................... 56PROQUIN XR ............................................................... 26PRO-RED AC (W/ DEXCHLORPHENIR) ......................................... 82PROSCAR ...................................................................... 170PROSHIELD PLUS .............................................. 158PROSHIELD PLUS SKIN PROTECTANT ......................................................... 158PROSHIELD PROTECTIVE HAND...................................................................................................... 158PROSOL 20 % ............................................................... 99PROSTASCINT ........................................................... 86PROSTIN E2 ................................................................ 120PROSTIN VR PEDIATRIC ............................. 65protamine ............................................................................. 58PROTONIX ................................................................... 110PROTOPAM CHLORIDE ............................. 170protriptyline ................................................................... 147PROVENTIL HFA .................................................... 18PROVERA ..................................................................... 120PROVIDA DHA ....................................................... 141PROVIDA OB ............................................................ 141PROVIGIL ...................................................................... 147PROVIL ................................................................................ 16PROZAC .......................................................................... 147PROZAC WEEKLY ............................................. 147PRUDOXIN .................................................................. 158

Index

pseudoephedrine hcl ................................................. 82PSORCON ...................................................................... 158PULMICORT ................................................................. 18PULMICORT FLEXHALER ......................... 18PULMOZYME .......................................................... 170PUMPKIN FLAVOR .......................................... 170PURALOR CI ............................................................. 174PURALUBE ..................................................................... 92PURE COTTON ....................................................... 133PUREFE OB PLUS ............................................... 141PUREFE PLUS .......................................................... 141PUREVIT DUALFE PLUS .............................. 99PURIXAN .......................................................................... 44PYLERA ........................................................................... 111pyrazinamide .................................................................... 26PYRETHRIN LICE TREATMENT M...................................................................................................... 158PYRIDIUM ....................................................................... 14pyridostigmine bromide ........................................ 51pyridoxine ........................................................................ 174pyrilamine-phenylephrine ................................... 34Q-CARE RX Q2 ....................................................... 170Q-CARE RX Q4 ....................................................... 170Q-DRYL ............................................................................... 36Q-GEL WITH ALPHA LIPOIC ACID...................................................................................................... 170QNASL .................................................................................. 92Q-PAP ..................................................................................... 10Q-PAP EXTRA STRENGTH ........................ 10Q-TAPP ................................................................................. 34Q-TAPP DM .................................................................... 82Q-TIPS/SINGLE-TIP .......................................... 133Q-TIPS/SINGLE-TIP APPLICATOR...................................................................................................... 133Q-TUSSIN .......................................................................... 83Q-TUSSIN DM ............................................................. 83QUADRACEL (PF) ................................................. 56QUADRAPAX ........................................................... 111QUALAQUIN ................................................................ 40QUARTETTE ................................................................. 74QUASENSE ..................................................................... 74QUDEXY XR ................................................................. 70QUELICIN ........................................................................ 51QUENALIN ...................................................................... 36QUESTRAN .................................................................... 65QUESTRAN LIGHT ............................................... 65quetiapine ......................................................................... 147QUFLORA PEDIATRIC ................................. 174QUFLORA PEDIATRIC DROPS ......... 174QUILLIVANT XR ................................................. 147quinapril ................................................................................ 65quinapril-hydrochlorothiazide ........................ 65quinidine gluconate ................................................... 61quinidine sulfate ........................................................... 61quinine sulfate ................................................................. 40QUIXIN ................................................................................ 26QUTENZA ..................................................................... 158QVAR ..................................................................................... 18QWIK-STRIP .............................................................. 133RABAVERT (PF) ...................................................... 56rabeprazole ...................................................................... 111racepinephrine ................................................................ 18RADIADRES GEL ................................................ 133RADIAGEL ................................................................... 170RAGWITEK .................................................................... 56raloxifene .......................................................................... 170

Index

ramipril .................................................................................. 65RANEXA ............................................................................ 61ranitidine hcl ................................................................. 111RAPAFLO ...................................................................... 170RAPAMUNE ............................................................... 121RAPIVAB ........................................................................... 48raspberry ........................................................................... 170raspberry flavor, artificial ................................ 170RASPBERRY FLAVORING ...................... 170raspberry ketone ........................................................ 116RASUVO (PF) ............................................................... 16RAVICTI .......................................................................... 111RAYOS .............................................................................. 120RAZADYNE ................................................................... 52RAZADYNE ER ......................................................... 51REA LO 30 .................................................................... 158READY-TO-USE ENEMA .......................... 111READY-TO-USE ENEMA (MIN OIL)...................................................................................................... 111REAPHIRM .................................................................. 141REBETOL .......................................................................... 48REBIF (WITH ALBUMIN) ............................. 70REBIF REBIDOSE ................................................... 70REBIF TITRATION PACK ............................ 70RECLAST ....................................................................... 170RECLIPSEN (28) ........................................................ 74RECOMBINATE ........................................................ 58RECOMBIVAX HB (PF) ................................... 56RECOTHROM .............................................................. 59RECOTHROM SPRAY KIT .......................... 59RECTIV ............................................................................. 111red yeast rice ................................................................. 116REDNESS RELIEF .................................................. 92REFEX ............................................................................... 116REFRESH CELLUVISC .................................... 92REFRESH CLASSIC (PF) ................................ 92REFRESH LACRI-LUBE ................................. 92REFRESH LIQUIGEL .......................................... 92REFRESH OPTIVE ................................................. 92REFRESH OPTIVE ADVANCED .......... 92REFRESH OPTIVE ADVANCED (PF)......................................................................................................... 92REFRESH OPTIVE SENSITIVE (PF)......................................................................................................... 92REFRESH P.M. ............................................................ 92REFRESH PLUS ......................................................... 92REFRESH TEARS .................................................... 92REGLAN .......................................................................... 111REGONOL ........................................................................ 52REGRANEX ................................................................ 158REGULOID ................................................................... 111REGULOID, SUGAR FREE ....................... 111REHYLA HAIR-BODY ................................... 158RELCOF C ........................................................................ 83RELENZA DISKHALER .................................. 48RELION NEEDLES ............................................. 133RELION PEN NEEDLES ............................... 133RELISTOR ........................................................................ 30RELNATE DHA ...................................................... 141RELPAX .............................................................................. 10REMEDY 4-IN-1 CLEANSER ................. 158REMEDY ANTIFUNGAL ............................... 32REMEDY CALAZIME PROTECT PASTE ................................................................................ 158REMEDY CLEAR-AID PROTECT .... 158

204

Index

REMEDY DIMETHICONE CREAM...................................................................................................... 158REMEDY NUTRASHIELD SKIN PROTEC ........................................................................... 159REMEDY PHYTOPLEX ANTIFUNGAL......................................................................................................... 32REMEDY PHYTOPLEX Z-GUARD...................................................................................................... 159REMEDY PHYTOPLEX Z-GUARD (ZN) ....................................................................................... 159REMEDY SKIN REPAIR .............................. 159REMERON .................................................................... 147REMERON SOLTAB ........................................ 147REMICADE .................................................................. 111REMODULIN ................................................................ 65REMOVE ........................................................................ 134RENACIDIN ................................................................... 99RENAGEL ......................................................................... 99RENAL CAPS ............................................................ 174RENEWAL HAND SANITIZER ........... 159RENO CAPS ................................................................ 174RENU DISINFECTING ................................... 134RENU MULTIPLUS ........................................... 134RENU REWETTING DROPS ................... 134RENVELA ......................................................................... 99REOPRO .............................................................................. 46repaglinide .......................................................................... 39REPATHA SURECLICK .................................. 65REPREXAIN ................................................................... 10REQUIP ................................................................................ 46REQUIP XL ..................................................................... 46RESCON .............................................................................. 34RESCON-DM ................................................................. 83RESCON-GG .................................................................. 83RESCRIPTOR ................................................................ 48RESECTISOL ................................................................ 87reserpine ................................................................................ 65RESPAIRE-30 ................................................................ 83RESTASIS ......................................................................... 92RESTFULLY SLEEP .......................................... 149RESTON ........................................................................... 134RESTON HIGH SUPPORT PAD .......... 134RESTON LIGHT SUPPORT ROLL ... 134RESTON MEDIUM SUPPORT PAD...................................................................................................... 134RESTORA RX ........................................................... 111RESTORA SPRINKLES ................................. 111RESTORE ....................................................................... 134RESTORE CONTACT LAYER .............. 134RESTORE CONTACT LAYER SILVER...................................................................................................... 134RESTORE DUO ....................................................... 134RESTORE FOAM HEEL DRESSING...................................................................................................... 134RESTORE HYDROGEL DRESSING...................................................................................................... 134RESTORE HYDROGEL GAUZE ........ 134RESTORE HYDROGEL GAUZE SPONGE ........................................................................... 134RESTORE ODOR-ABSORBENT ......... 134RESTORE TRIO ...................................................... 134RESTORIL ..................................................................... 149resveratrol ........................................................................ 170RETAINE FLAX ..................................................... 116RETAVASE ..................................................................... 59RETIN-A .......................................................................... 159

Index

RETIN-A MICRO .................................................. 159RETIN-A MICRO PUMP ............................... 159RETISERT ......................................................................... 92RETROVIR ....................................................................... 48REVATIO ........................................................................... 65REVEAL COLON DISEASE TEST ...... 86REVEAL UTI TEST STRIP ........................... 86REVLIMID ....................................................................... 44REVONTO ..................................................................... 139REXULTI ........................................................................ 147REYATAZ ......................................................................... 48REZIRA ................................................................................ 83R-GENE 10 ....................................................................... 86RHEUMATREX .......................................................... 16RHINOCORT AQUA ............................................ 92RHOGAM ULTRA-FILTERED ................. 56RHOGAM ULTRA-FILTERED PLUS......................................................................................................... 56RHOPHYLAC ............................................................... 56RIASTAP ............................................................................ 59RIBASPHERE ............................................................... 48RIBASPHERE RIBAPAK ................................ 48ribavirin ....................................................................... 48, 49RIDAURA .......................................................................... 16rifabutin ................................................................................. 26RIFADIN ............................................................................. 26RIFAMATE ...................................................................... 26rifampin ................................................................................. 26RIFATER ............................................................................ 26RILUTEK ........................................................................... 70riluzole .................................................................................... 70RI-MAG PLUS .......................................................... 111rimantadine ........................................................................ 49RIMSO-50 .......................................................................... 10ringers ........................................................................ 99, 159RIOMET .............................................................................. 39risedronate ....................................................................... 170RISPERDAL ................................................................ 147RISPERDAL CONSTA .................................... 147RISPERDAL M-TAB ......................................... 147risperidone ....................................................................... 147RITALIN .......................................................................... 147RITALIN LA ............................................................... 147RITEFLO AEROCHAMBER .................... 134RITUXAN .......................................................................... 44rivastigmine ....................................................................... 52rivastigmine tartrate .................................................. 52RIXUBIS ............................................................................. 59rizatriptan ............................................................................. 11ROBAFEN ......................................................................... 83ROBAFEN AC .............................................................. 83ROBAFEN CF ............................................................... 83ROBAFEN COUGH ............................................... 83ROBAFEN DM ............................................................ 83ROBAFEN DM CLEAR ..................................... 83ROBAFEN DM COUGH ................................... 83ROBAFEN DM MAX ........................................... 83ROBAXIN ...................................................................... 139ROBAXIN-750 .......................................................... 139ROBINUL ....................................................................... 111ROBINUL FORTE ................................................ 111ROCALTROL ............................................................. 174ROCEPHIN ....................................................................... 26rocuronium ......................................................................... 52ROLLED ABSORBENT COTTON .... 134ROLLED GAUZE .................................................. 134

Index

RONDIC ........................................................................... 134root beer flavor (bulk) ......................................... 170ropinirole .............................................................................. 46ropivacaine (pf) ............................................................. 14ropivacaine (pf) in 0.9 % nacl ........................ 14ROSADAN .................................................................... 159ROSANIL ........................................................................... 26rose oil ................................................................................. 170ROSE WATER .......................................................... 170rosemary oil ................................................................... 116rosin (bulk) ..................................................................... 170ROSULA ............................................................................. 26ROSULA CLEANSING CLOTHS .......... 26ROTARIX .......................................................................... 57ROTATEQ VACCINE .......................................... 57ROWASA ........................................................................ 111ROXICET ........................................................................... 11ROXICODONE ............................................................ 11ROZEREM ..................................................................... 149RUBBING ALCOHOL (ETHANOL)...................................................................................................... 159RUCONEST ................................................................. 170RU-HIST D ....................................................................... 34RU-HIST-D (WITH PYRILAMINE) .... 34RULAVITE DHA ................................................... 141RULOX .............................................................................. 111RYANODEX ............................................................... 139RYDEX ................................................................................. 83RYMED (DEXCHLORPHENIRAMINE-PE) ....... 34RYNEX DM ..................................................................... 83RYNEX PE ........................................................................ 34RYNEX PSE .................................................................... 34RYTARY ............................................................................. 46RYTHMOL ....................................................................... 61RYTHMOL SR ............................................................. 61S2 RACEPINEPHRINE ....................................... 18SABRIL ................................................................................ 70saccharin ............................................................................... 99saccharin sodium ......................................................... 99SAFESNAP INSULIN SYRINGE ........ 134saffron extract .............................................................. 116SAF-GEL ......................................................................... 134SAFYRAL .......................................................................... 74sage leaf (bulk) ........................................................... 116SAIZEN ............................................................................. 120SAIZEN CLICK.EASY .................................... 120SALACTIC FILM .................................................. 159SALAGEN ......................................................................... 52SALEX ............................................................................... 159salicylic acid .................................................................. 159salicylic acid sr-ceramides .............................. 159SALINE 4 ........................................................................ 134SALINE SENSITIVE .......................................... 134SALINE SENSITIVE EYES ....................... 134SALINE SOLUTION .......................................... 134SALINE SOLUTION,STERILE PRESRV ........................................................................... 134SAL-PLANT ................................................................ 159salsalate ................................................................................. 16SAMSCA ............................................................................. 87SANCUSO ..................................................................... 111SANDIMMUNE ....................................................... 121SANDOSTATIN ...................................................... 120SANDOSTATIN LAR DEPOT ................ 120SANI-PADS .................................................................. 159

205

Index

SANI-SUPP (ADULT) ...................................... 111SANI-SUPP (CHILD) ........................................ 111SANI-SUPP (INFANT) .................................... 111SANTYL .......................................................................... 159SAPHRIS ......................................................................... 147SAPHRIS (BLACK CHERRY) ................ 147SARAFEM ..................................................................... 147SARNA ANTI-ITCH ........................................... 159SARNA SENSITIVE .............................................. 14sassafras oil .................................................................... 170SAVAYSA ........................................................................ 29SAVELLA ...................................................................... 170saw palmetto ................................................................. 116saw palmetto fruit .................................................... 116saw palmetto-pumpkin seed oil ................. 116SCALPICIN ANTI-ITCH ............................... 159SCANPOR TAPE .................................................... 134scopolamine hbr ........................................................ 111SE BPO .............................................................................. 159SEASONIQUE .............................................................. 74SEBEX ............................................................................... 159SEB-PREV ..................................................................... 159SE-CARE ......................................................................... 141SECONAL SODIUM .......................................... 149SECTRAL .......................................................................... 65SECURA ANTIFUNGAL ................................. 32SECURA ANTIFUNGAL EXTRA THICK .................................................................................... 32SECURA DIMETHICONE .......................... 159SECURA EXTRA PROTECTIVE ........ 159SECURA MOISTURIZING ......................... 159SECURA PERSONAL ...................................... 159SECURA PERSONAL SKIN CARE...................................................................................................... 159SECURA PROTECTIVE ................................ 159SECURA STARTER KIT .............................. 159SECURA TOTAL BODY CLEANSER...................................................................................................... 159SECURA TWO-STEP KIT ........................... 159SE-DONNA PB HYOS ..................................... 111SELECT-OB ................................................................. 141SELECT-OB (FOLIC ACID) ..................... 141SELECT-OB + DHA ........................................... 141selegiline hcl ..................................................................... 46selenium ................................................................................ 99selenium sulfide ......................................................... 159SELF ADHERENT WRAP ........................... 134SELF-ADHERANT GENTLE WRAP...................................................................................................... 134SELF-ADHERING BANDAGE .............. 134SELFGRIP ...................................................................... 134SELF-GRIP .................................................................... 134SELSUN BLUE (SALICYLIC ACID)...................................................................................................... 159SELSUN BLUE MOISTURIZING ....... 160SELSUN BLUE NATURALS ................... 160SELZENTRY .................................................................. 49SEMPREX-D .................................................................. 34SE-NATAL 19 ............................................................ 141SE-NATAL 19 (WITH DOCUSATE)...................................................................................................... 141SE-NATAL ONE ..................................................... 141SENEXON ...................................................................... 111SENEXON-S ................................................................ 111SENNA .............................................................................. 111SENNA LAX ............................................................... 111

Index

SENNA LAXATIVE ........................................... 111SENNA PLUS ............................................................ 111SENNA PROMPT .................................................. 111SENNA SOFT ............................................................ 111SENNA WITH DOCUSATE SODIUM...................................................................................................... 111SENNA-GEN .............................................................. 111SENNALAX-S ........................................................... 111SENNA-S ........................................................................ 111SENNA-TIME S ....................................................... 111SENNO .............................................................................. 111sennosides-docusate sodium ......................... 111SENOKOT ...................................................................... 111SENOKOT TO GO ................................................ 111SENOKOT-S ................................................................ 111SENOKOTXTRA ................................................... 112SENSI-CARE (FOAM) ..................................... 160SENSI-CARE ADHESI REMOVER WIPE .................................................................................... 134SENSI-CARE MOISTURIZING 2 ....... 160SENSIPAR ..................................................................... 170SENSITIVE EYES ................................................. 134SENSITIVE EYES DAILY CLEANER...................................................................................................... 134SENSITIVE EYES PLUS SALINE ..... 134SENSODYNE ............................................................. 134SENSORCAINE .......................................................... 14SENSORCAINE/EPINEPHRINE ............. 14SENSORCAINE-MPF .......................................... 14SENSORCAINE-MPF SPINAL ................. 14SENSORCAINE-MPF/EPINEPHRINE......................................................................................................... 14SERENAGEN ............................................................. 116SEREVENT DISKUS ............................................ 18SEROMYCIN ................................................................. 26SEROQUEL .................................................................. 147SEROQUEL XR .......................................... 147, 148SEROSTIM .................................................................... 120sertraline ............................................................................ 148sesame oil ......................................................................... 171SE-TAN DHA ............................................................. 141SE-TAN PLUS .............................................................. 99SETLAKIN ....................................................................... 74sevelamer carbonate ................................................. 99SEVERE COLD & FLU (PE) ........................ 83SEVERE COLD PE ................................................. 83sevoflurane ......................................................................... 14SF ................................................................................................. 99SF 5000 PLUS ................................................................ 99SFROWASA ................................................................ 112SHAROBEL ..................................................................... 74SHEER ADHESIVE ............................................. 134SHEER BANDAGE ............................................. 134SHEER BANDAGES .......................................... 134SHEER PLASTIC STRIP ............................... 135SHEER SPOT BANDAGES ........................ 135SHEER STRIP ............................................................ 135SHEER STRIP EXTRA LARGE ............ 135SHEER STRIPS ........................................................ 135SHEER STRIPS ASSORTED .................... 135SIDESTREAM PEDIATRIC FACE MASK ................................................................................. 135SIGNIFOR ...................................................................... 120SIGNIFOR LAR ....................................................... 120SILACE ............................................................................. 112SILADRYL SA ............................................................. 36

Index

SILAFED ............................................................................. 34SILAPAP ............................................................................. 11sildenafil ..................................................................... 65, 66SILENOR ........................................................................ 149silica ....................................................................................... 171SILICONE MASK - INFANT ................... 135SILICONE MASK - PEDIATRIC ......... 135SILPHEN COUGH ................................................... 36SILPHEN DM COUGH ....................................... 83SILTUSSIN DAS ........................................................ 83SILTUSSIN DM DAS ........................................... 83SILTUSSIN SA ............................................................ 83SILTUSSIN-DM .......................................................... 83SILVADENE ................................................................... 26silver nitrate ................................................................... 160silver sulfadiazine ....................................................... 26SILVERMED .............................................................. 160SIMBRINZA ................................................................... 92SIMCOR .............................................................................. 66simethicone .................................................................... 112simple syrup .................................................................. 171SIMPLYTHICK ........................................................ 171SIMPONI ............................................................................. 16SIMPONI ARIA ........................................................... 16SIMULECT ................................................................... 121simvastatin .......................................................................... 66SINEMET ........................................................................... 46SINEMET CR ................................................................ 46SINEX ULTRA FINE MIST 12-HOUR......................................................................................................... 92SINGLE USE EZ FLU 2012-13 (PF) ..... 57SINGLE USE EZ FLU 2013-14 (PF) ..... 57SINGLE USE EZ FLU 2014-15(PF) ...... 57SINGULAIR .................................................................... 18SINUS & ALLERGY PE .................................... 34SINUS & ALLERGY(PHENYLEPHRINE) .............. 34SINUS & COLD-D ................................................... 83SINUS 12 HOUR ........................................................ 83SINUS CONG & PAIN DAY-NIGHT......................................................................................................... 83SINUS CONGESTION & PAIN ................ 83SINUS CONGESTION & PAIN(GUAIF)......................................................................................................... 83SINUS CONGESTION&PAIN(CHLORPH) ..... 83SINUS NASAL SPRAY ...................................... 92SINUS PAIN RELIEF ........................................... 83SINUS RELIEF (OXYMETAZOLINE)......................................................................................................... 92SINUS WASH ............................................................... 92sirolimus ............................................................................ 122SIRTURO ........................................................................... 26SITAVIG ............................................................................. 49SIVEXTRO ....................................................................... 26SKELAXIN ................................................................... 139SKIN CLEANSER ................................................. 160SKIN CLOSURE STRIPS ............................. 135SKINTEGRITY HYDROGEL .................. 135SKINTEGRITY HYDROGEL DRESSING .................................................................... 135SKINTEGRITY WOUND CLEANSER...................................................................................................... 160SKLICE ............................................................................. 160SLEEP ................................................................................. 149

206

Index

SLEEP AID (DIPHENHYDRAMINE)...................................................................................................... 149SLEEP AID (DOXYLAMINE) ................ 149SLEEP AID MAX STR (DIPHENHYDR)...................................................................................................... 149SLEEP TIME ............................................................... 149SLEEP-TABS .............................................................. 149SLOW RELEASE IRON .................................... 99SMOOTH ANTACID ......................................... 112sodium acetate ................................................................ 99sodium bicarbonate ...................................... 99, 112sodium bisulfite ......................................................... 171sodium chloride ..................... 92, 100, 160, 171sodium chloride 0.45 % ........................................ 99sodium chloride 0.9 % ............................................ 99sodium chloride 3 % ............................................. 100sodium chloride 5 % ............................................. 100sodium citrate-citric acid .................................. 100SODIUM EDECRIN ............................................... 87sodium ferric gluconat-sucrose .................. 100sodium fluoride .......................................................... 100sodium lactate .............................................................. 100sodium phenylbutyrate ....................................... 112sodium phosphate .................................................... 100SODIUM POLYSTYRENE (SORB FREE) .................................................................................. 100sodium polystyrene sulfonate ...................... 100sodium silicate ............................................................ 171sodium succinate ....................................................... 171SOF-LAX ........................................................................ 112SOF-SET ADHESIVE PATCH ................ 135SOFT CLOTH ............................................................ 135SOLARAZE ..................................................................... 44SOLIRIS ............................................................................... 59SOLODYN ........................................................................ 26SOLOSITE ..................................................................... 135SOLOSITE WOUND GEL ........................... 135SOLTAMOX ................................................................... 44SOLU-CORTEF ....................................................... 120SOLU-CORTEF (PF) .......................................... 120SOLU-MEDROL ..................................................... 120SOLU-MEDROL (PF) ....................................... 120SOMA ................................................................................. 139SOMATULINE DEPOT .................................. 120SOMAVERT ................................................................ 171SOMINEX ...................................................................... 149SONATA .......................................................................... 149SOOLANTRA ............................................................ 160SOOTHE & COOL ................................................ 160SOOTHE & COOL BODY POWDER...................................................................................................... 160SOOTHE & COOL FREE MEDSEPTIC...................................................................................................... 160SOOTHE & COOL INZO BARRIER...................................................................................................... 160SOOTHE & COOL MEDSEPTIC ......... 160SOOTHE & COOL MOISTURE BARRIER ........................................................................ 160SOOTHE & COOL SKIN PASTE ........ 160SOOTHING NON-STICK ............................. 135SOOTHING SLEEP ............................................. 116SORBIDON HYDRATE ................................. 171sorbitol ...................................................... 100, 160, 171sorbitol-mannitol ...................................................... 160SORE THROAT .......................................................... 14SORE THROAT & COUGH .......................... 83

Index

SORE THROAT (BENZOCAINE-MENTH) ............................... 14SORE THROAT (PHENOL) .......................... 14SORESPOT ................................................................... 135SORIATANE ............................................................... 160SORILUX ........................................................................ 160SORINE ................................................................................ 66sotalol ...................................................................................... 66SOTALOL AF ............................................................... 66SOTRADECOL ............................................................ 66SOUTH AFRICAN HOODIA .................... 116SOVALDI ........................................................................... 49SPACE CHAMBER PLUS ........................... 135SPEARMINT FLAVORING ....................... 171spearmint oil .................................................................. 171SPECTRAGEL .......................................................... 135spinosad ............................................................................. 160SPIRIVA RESPIMAT ........................................... 18SPIRIVA WITH HANDIHALER .............. 18spironolactone ................................................................. 87spironolacton-hydrochlorothiaz .................... 87SPORANOX .................................................................... 32SPORANOX PULSEPAK ................................. 32SPORTS TAPE .......................................................... 135SPRINTEC (28) ............................................................ 74SPRIX ..................................................................................... 11SPRYCEL ........................................................................... 44SPS ......................................................................................... 100SRONYX ............................................................................. 74SSD ............................................................................................ 26SSKI ...................................................................................... 100SSS 10-5 ............................................................................... 26STAFLEX (BROMPHENIRA-ACETAMIN) ................. 3STAHIST AD ................................................................. 34STALEVO 100 .............................................................. 46STALEVO 125 .............................................................. 46STALEVO 150 .............................................................. 46STALEVO 200 .............................................................. 46STALEVO 50 ................................................................. 46STALEVO 75 ................................................................. 46stannous fluoride ....................................................... 100STARLIX ............................................................................ 39STATUSS GREEN (CODEINE) ................ 83stavudine .............................................................................. 49STAY AWAKE ............................................................ 70STAY AWAKE MAXIMUM STRENGTH ..................................................................... 70STAYFREE MAXI-PAD ................................ 135STAYFREE SUREFIT ...................................... 135STAYFREE ULTRA THIN ......................... 135stearic acid ...................................................................... 171stearyl alcohol .............................................................. 171STELARA ....................................................................... 122STERILE EYE DROPS ....................................... 92STERILE GAUZE PAD ................................... 135STERILE PADS ....................................................... 135STERILE SALINE ................................................. 135STERILE STRETCH GAUZE BANDAGE .................................................................... 135STERILE WATER FOR INJECTION...................................................................................................... 171STERILUBE .................................................................... 92STERI-STRIP .............................................................. 135STERI-STRIP DRESSING ........................... 135STERI-STRIP SKIN CLOSURE ............ 135

Index

STERI-STRIP SKIN CLOSURES ......... 135STIK IT .............................................................................. 135STIMATE ........................................................................ 120STIOLTO RESPIMAT .......................................... 18STIVARGA ...................................................................... 44STOMACH RELIEF ............................................ 112STOMACH RELIEF MAX STRENGTH...................................................................................................... 112STOMACH RELIEF ORIGINAL .......... 112STOOL SOFTENER ............................................ 112STOOL SOFTENER-LAXATIVE ........ 112STOOL SOFTENER-STIMULANT LAXAT .............................................................................. 112STRATASORB COMPOSITE WOUND...................................................................................................... 135STRATASORB ISLAND DRESSING...................................................................................................... 135STRATTERA .............................................................. 148strawberry flavor (bulk) ..................................... 171STRAWBERRY FLAVORING ............... 171streptomycin ..................................................................... 26STRETCH BANDAGE ..................................... 135STRETCH GAUZE BANDAGE ............ 135STRIANT ........................................................................ 120STRIBILD .......................................................................... 49STRIVERDI RESPIMAT .................................. 18STROMECTOL ........................................................... 40STRONG STRIPS .................................................. 135STRONG STRIPS X-LARGE ................... 135STROVITE FORTE .............................................. 174STROVITE ONE ..................................................... 174SUBLIMAZE (PF) .................................................... 11SUBOXONE ................................................................ 171SUBSYS ............................................................................... 11SUCLEAR ...................................................................... 112sucralfate ........................................................................... 112sucrose ................................................................................. 100SUDOGEST ..................................................................... 83SUDOGEST 12-HOUR ........................................ 83SUDOGEST CHILDRENS .............................. 83SUDOGEST COLD & ALLERGY .......... 34SUDOGEST PE ............................................................ 83SUDOGEST SINUS & ALLERGY ......... 34SUFENTA .......................................................................... 11sufentanil citrate ........................................................... 11SULAR .................................................................................. 61sulfacetamide sodium ................................ 26, 160sulfacetamide sodium (acne) ........................ 160sulfacetamide sodium-sulfur ............................ 26sulfacetamide sodium-urea ............................. 160sulfacetamide sod-sulfur-urea ......................... 26sulfacetamide-prednisolone .............................. 26sulfacetamide-sulfur-cleansr23 ..................... 26SULFACLEANSE 8-4 .......................................... 26sulfact na-sul-avobnz-otn-ocsa ...................... 26sulfadiazine ........................................................................ 26sulfamethoxazole-trimethoprim .................... 26SULFAMIDE .................................................................. 26SULFAMYLON .......................................................... 26sulfasalazine .................................................................. 112SULFATRIM .................................................................. 26SULFAZINE ................................................................ 112SULFAZINE EC ...................................................... 112sulfur ........................................................................................ 40sulindac .................................................................................. 17SUMADAN ...................................................................... 26

207

Index

SUMADAN XLT ........................................................ 26sumatriptan ........................................................................ 11sumatriptan succinate .............................................. 11SUMAVEL DOSEPRO ........................................ 11SUMAXIN ......................................................................... 26SUMAXIN CP ............................................................... 27SUMAXIN TS ............................................................... 27SUMMER'S EVE DOUCHE .......................... 40SUPER B MAXI COMPLEX ..................... 174SUPER POTENT YOHIMBE .................... 116SUPER STRIP BANDAGES ...................... 135SUPERIOR DIGESTIVE ENZYME...................................................................................................... 112SUPHEDRIN ................................................................... 83SUPHEDRIN 12 HOUR ...................................... 83SUPHEDRINE .............................................................. 83SUPHEDRINE 12 HOUR .................................. 83SUPPRELIN LA ...................................................... 120SUPRANE .......................................................................... 14SUPRAX .............................................................................. 27SUPREP BOWEL PREP KIT .................... 112SURE COMFORT ALCOHOL PREP PADS .................................................................................... 160SURE COMFORT INS. SYR. U-100...................................................................................................... 135SURE COMFORT INSULIN SYRINGE...................................................................................................... 135SURE COMFORT PEN NEEDLE ........ 135SURE-FINE PEN NEEDLES ..................... 135SURE-JECT INSULIN SYRINGE ....... 136SURE-PREP ALCOHOL PREP PADS...................................................................................................... 160SUREPRESS ABSORBENT PADDING...................................................................................................... 136SUREPRESS HIGH COMPRESSION...................................................................................................... 136SURESITE ..................................................................... 136SURESITE FLEXIGRID ................................. 136SURESITE IV ............................................................. 136SURESITE MATRIX .......................................... 136SURESITE WINDOW ....................................... 136SURFAXIN ................................................................... 171SURGICAL DRESSING ................................. 136SURGICAL DRESSING EXTR PROTCT ........................................................................... 136SURGICAL PADS ................................................. 136SURMONTIL .............................................................. 148SURVANTA ................................................................ 171SUSPENDOL-S ........................................................ 171SUSTIVA ............................................................................ 49SUTENT .............................................................................. 44SWEET-SF ..................................................................... 171SWIM EAR ....................................................................... 92SYEDA .................................................................................. 74SYLATRON .................................................................... 44SYLATRON 4-PACK ........................................... 44SYLVANT ......................................................................... 44SYMAX FASTABS .............................................. 112SYMAX-SL ................................................................... 112SYMBICORT ................................................................. 18SYMBYAX ................................................................... 148SYMLINPEN 120 ...................................................... 39SYMLINPEN 60 ......................................................... 39SYNAGIS ........................................................................... 49SYNALAR ..................................................................... 160SYNALAR CREAM KIT ............................... 160

Index

SYNALAR OINTMENT KIT .................... 160SYNALAR TS ............................................................ 160SYNALGOS-DC ......................................................... 11SYNAREL ...................................................................... 120SYNERA ............................................................................. 14SYNERCID ....................................................................... 27SYNJARDY ..................................................................... 39SYNRIBO ........................................................................... 44SYNTHROID .............................................................. 163SYPRINE ......................................................................... 171SYRPALTA VEHICLE .................................... 171SYRSPEND SF ......................................................... 171SYRSPEND SF ALKA ..................................... 171SYRSPEND SF LIQUID ................................. 171SYRUP VEHICLE SF ........................................ 171SYSTANE .......................................................................... 92SYSTANE (PF) ............................................................ 92SYSTANE BALANCE ......................................... 92SYSTANE CONTACTS .................................. 136SYSTANE GEL ........................................................... 92SYSTANE NIGHTTIME ................................... 92SYSTANE ULTRA .................................................. 92SYSTANE ULTRA (PF) ..................................... 93TAB TUSSIN .................................................................. 83TAB TUSSIN DM ..................................................... 83TABLOID ........................................................................... 44TACHOSIL ....................................................................... 59TACLONEX ................................................................. 171tacrolimus ........................................................................ 122TACTINAL ....................................................................... 11TACTINAL EXTRA STRENGTH .......... 11TAFINLAR ....................................................................... 44TAKE ACTION ........................................................... 74TALWIN .............................................................................. 11TAMIFLU .......................................................................... 49tamoxifen ............................................................................. 44tamsulosin ........................................................................ 171TANDEM DHA ........................................................ 141TANDEM DUAL ACTION ......................... 100TANDEM OB ............................................................. 141TANDEM PLUS ...................................................... 100TANGERINE OIL, NATURAL ............... 171TAPAZOLE .................................................................. 163TARCEVA ........................................................................ 44TARGRETIN .................................................................. 44TARINA FE ..................................................................... 74TARKA ................................................................................. 66TARON FORTE ....................................................... 100TARON-BC ................................................................... 141TARON-C DHA ....................................................... 141TARON-PREX PRENATAL-DHA ..... 141TART CHERRY EXTRACT ...................... 116TASIGNA ........................................................................... 44TASMAR ............................................................................ 46TAXOTERE ..................................................................... 44TAZICEF ............................................................................. 27TAZORAC ..................................................................... 160TAZTIA XT ..................................................................... 61TEARS NATURALE FORTE ...................... 93TEARS NATURALE FREE (PF) .............. 93TEARS NATURALE II ....................................... 93TEARS PURE ................................................................ 93TECFIDERA ................................................................... 70TECHNIVIE .................................................................... 49TEFLARO .......................................................................... 27TEGADERM ................................................................ 136

Index

TEGADERM ABSORBENT ...................... 136TEGADERM FIRST AID STYLE ........ 136TEGADERM FRAME STYLE ................. 136TEGADERM HP FRAME STYLE ...... 136TEGADERM HYDROGEL ......................... 136TEGADERM I.V. .................................................... 136TEGADERM TRANSPARENT DRESSING .................................................................... 136TEGRETOL ...................................................................... 70TEGRETOL XR ........................................................... 70TEKAMLO ....................................................................... 66TEKTURNA .................................................................... 66TEKTURNA HCT ..................................................... 66TELFA ................................................................................ 136TELFA (WITH POLYHEXAMETH)...................................................................................................... 136TELFA AMD ............................................................... 136TELFA CLEAR WOUND DRESSING...................................................................................................... 136TELFA ISLAND DRESSING .................... 136TELFA OUCHLESS NON-ADHERENT...................................................................................................... 136telmisartan .......................................................................... 66telmisartan-amlodipine .......................................... 66telmisartan-hydrochlorothiazid ..................... 66temazepam ...................................................................... 149TEMODAR ....................................................................... 44TEMOVATE ................................................................ 160TEMOVATE E .......................................................... 160temozolomide .................................................................. 44TENA SERENITY ................................................. 136TENDER TAPE ........................................................ 136TENDERSKIN ........................................................... 136TENDERSORB ......................................................... 136TENDERWET ACTIVE CAVITY DRESS ................................................................................ 136TENDERWET ACTIVE DRESSING...................................................................................................... 136TENDERWET SYSTEM ................................ 136TENDERWRAP UNNA BOOT .............. 136TENEX .................................................................................. 66teniposide ............................................................................. 44TENIVAC (PF) ............................................................. 57TENORETIC 100 ....................................................... 66TENORETIC 50 ........................................................... 66TENORMIN ..................................................................... 66TENSION HEADACHE ..................................... 11TENSOR ........................................................................... 136TERAZOL 3 ..................................................................... 32TERAZOL 7 ..................................................................... 32terazosin ................................................................................ 66terbinafine hcl ................................................................. 32terbutaline ........................................................................... 18terconazole ......................................................................... 32TERUMO INS SYRINGE 0.5CC/27G...................................................................................................... 136TERUMO INSULIN SYRINGE .............. 136TERUMO SURGUARD .................................. 136TESSALON PERLES ............................................ 83TESTIM ............................................................................. 120TESTOPEL .................................................................... 120testosterone ..................................................................... 121testosterone cypionate ......................................... 120testosterone enanthate .......................................... 120TESTRED ....................................................................... 121tetanus toxoid,adsorbed (pf) ............................. 57

208

Index

tetanus,diphtheria tox ped(pf) ......................... 57tetanus-diphtheria toxoids-td ........................... 57tetrabenazine .................................................................... 70tetracaine hcl .................................................................... 93tetracaine hcl (pf) ............................................... 14, 93tetracycline ......................................................................... 27tetrahydrozoline ............................................................ 93TEVETEN .......................................................................... 66TEVETEN HCT ........................................................... 66TEXACORT ................................................................. 160THALITONE .................................................................. 88THALOMID .................................................................... 27THAM ................................................................................. 100THEO-24 ............................................................................. 18theophylline ....................................................................... 19theophylline in dextrose 5 % ........................... 18THERACRAN HP FOR KIDS .................. 116THERAFLU COLD-COUGH ....................... 84THERAFLU COLD-SORE THROAT (PE) ............................................................................................ 84THERAFLU FLU-SORE THROAT ....... 84THERAFLU MAX-D SEVERE COLD-FLU ....................................................................... 84THERAFLU MULTI-SYMPTOM COLD......................................................................................................... 84THERAFLU NIGHT SEVERE COLD-CGH ...................................................................... 84THERAFLU NIGHTTIME SEVERE COLD ...................................................................................... 84THERAFLU SINUS & COLD ...................... 84THERAFLU WARMING RELIEF .......... 84THERA-GEL ............................................................... 160THERA-GESIC ......................................................... 160THERA-GESIC PLUS ....................................... 160THERAPEUTIC MINERAL ICE ........... 160THERASEAL .............................................................. 160THERMACARE HAND/WRIST ........... 136THERMACARE KNEE/ELBOW .......... 136THERMACARE LARGE/XLGE BACK/HIP ..................................................................... 136THERMACARE MENSTRUAL ............ 136THERMACARE NECK/WRIST/SHOULDER ...................... 136THERMACARE SMALL/MED BACK/HIP ..................................................................... 136thiamine hcl ................................................................... 174THICK NOW ............................................................... 171THICKEN UP CLEAR ...................................... 171THICKENUP LEMON HONEY ............ 171THICKENUP LEMON NECTAR ......... 171THICK-IT ........................................................................ 171THICK-IT #2 ............................................................... 171THINPRO INSULIN SYRINGE ............. 137THIOLA ............................................................................ 171thioridazine ..................................................................... 148thiotepa .................................................................................. 44thiothixene ....................................................................... 148THONG LINER ........................................................ 137THRESHOLD IMT TRAINER ................. 137THRESHOLD PEP DEVICE ...................... 137THRIVITE RX ........................................................... 174THROAT SPRAY ...................................................... 14THROMBATE III ...................................................... 59THROMBIN-JMI ....................................................... 59THYMOGLOBULIN ............................................. 57THYROGEN ................................................................ 163

Index

THYROLAR-1 ........................................................... 163THYROLAR-1/2 ...................................................... 163THYROLAR-1/4 ...................................................... 163THYROLAR-2 ........................................................... 163THYROLAR-3 ........................................................... 163TIAZAC ................................................................................ 61ticlopidine ........................................................................... 46TIGAN ................................................................................ 112TIKOSYN ........................................................................... 61TILIA FE ............................................................................. 74timolol maleate .................................................... 66, 93TIMOPTIC ........................................................................ 93TIMOPTIC OCUDOSE (PF) .......................... 93TIMOPTIC-XE ............................................................. 93TINDAMAX .................................................................... 40tinidazole .............................................................................. 40tioconazole ......................................................................... 32TIOCONAZOLE-1 ................................................... 32TIROSINT ...................................................................... 163TISSEEL VHSD .......................................................... 59TIVICAY ............................................................................. 49TIVORBEX ...................................................................... 17tizanidine .......................................................................... 139TL FOLATE ................................................................. 142TL GARD RX ............................................................. 174TL G-FOL OS ............................................................. 100TL ICON ........................................................................... 100TL-CARE DHA ........................................................ 142TL-FLUORIVITE ................................................... 174TL-FOL 500 .................................................................. 100TL-HEM 150 ................................................................ 100TL-SELECT .................................................................. 142TL-SELECT DHA .................................................. 142TNKASE .............................................................................. 59TOBI ........................................................................................ 27TOBI PODHALER ................................................... 27TOBRADEX .................................................................... 27TOBRADEX ST .......................................................... 27tobramycin .......................................................................... 27tobramycin in 0.225 % nacl .............................. 27tobramycin in 0.9 % nacl ..................................... 27tobramycin sulfate ...................................................... 27tobramycin-dexamethasone .............................. 27TOBREX ............................................................................. 27TOE AID DRESSING ........................................ 137TOFRANIL .................................................................... 148TOFRANIL-PM ........................................................ 148TOLAK ................................................................................. 44tolazamide ........................................................................... 39tolbutamide ........................................................................ 39tolcapone .............................................................................. 46tolmetin .................................................................................. 17tolnaftate ............................................................................... 32tolterodine ........................................................................ 171tolu balsam ...................................................................... 171TOOTHETTE .............................................................. 137toothpaste ......................................................................... 137TOPAMAX ....................................................................... 70TOPCARE CLICKFINE .................................. 137TOPCARE ULTRA COMFORT ............ 137TOPICORT ....................................................... 160, 161topiramate ........................................................................... 70TOPOSAR .......................................................................... 44topotecan .............................................................................. 44TOPROL XL ................................................................... 66TORISEL ............................................................................. 44

Index

torsemide .............................................................................. 88TOTAL BODY CLEANSE ........................... 116TOUJEO SOLOSTAR ........................................... 39TOVIAZ ............................................................................ 171TOZAL ............................................................................... 172TPN ELECTROLYTES .................................... 100TRACE ELEMENTS 4/PEDIATRIC...................................................................................................... 100TRACLEER ..................................................................... 66TRADJENTA ................................................................. 39tragacanth ......................................................................... 172tramadol ................................................................................ 11tramadol-acetaminophen ...................................... 11TRANDATE .................................................................... 66trandolapril ......................................................................... 66trandolapril-verapamil ............................................ 66tranexamic acid .............................................................. 59TRANSDERM-SCOP ......................................... 112transparent dressings ............................................. 137TRANSPARENT THIN FILM DRESSING .................................................................... 137TRANSPORE .............................................................. 137TRANSPORE SURGICAL ........................... 137TRANS-VER-SAL PLANTARPATCH...................................................................................................... 161TRANXENE T-TAB ........................................... 148tranylcypromine ......................................................... 148TRAVASOL 10 % .................................................. 100TRAVATAN Z .............................................................. 93TRAVEL SICKNESS ......................................... 112TRAVEL SICKNESS (MECLIZINE)...................................................................................................... 112travoprost (benzalkonium) ................................. 93trazodone .......................................................................... 148TREANDA ........................................................................ 44TRECATOR ..................................................................... 27TRELSTAR ...................................................................... 44TRELSTAR DEPOT ............................................... 44TRELSTAR LA ............................................................ 44tretinoin .............................................................................. 161tretinoin (chemotherapy) ..................................... 44tretinoin microspheres ......................................... 161TRETTEN .......................................................................... 59TREXALL .......................................................................... 44TRIACTING COUGH & COLD ................ 84TRIADVANCE ......................................................... 142triamcinolone acetonide................................................................. 93, 121, 161, 172TRIAMINIC ........................................................... 34, 84TRIAMINIC (XYLOMETAZOLINE)......................................................................................................... 93TRIAMINIC ALLERGY .................................... 36TRIAMINIC CHEST &NASAL CONGEST ......................................................................... 84TRIAMINIC COLD & COUGH (PE) ... 84TRIAMINIC COLD & COUGH NT (PE)......................................................................................................... 34TRIAMINIC COLD- ALLERGY PE ..... 34TRIAMINIC COLD-STUFFY NOSE ... 84TRIAMINIC COUGH ........................................... 84TRIAMINIC COUGH/RUNNY NOSE......................................................................................................... 36TRIAMINIC COUGH-SORE THROAT......................................................................................................... 84TRIAMINIC FEVER REDUCER ............. 11TRIAMINIC FLU-COUGH-FEVER ..... 84

209

Index

TRIAMINIC SOFTCHEWS ........................... 84triamterene-hydrochlorothiazid ..................... 88TRIANEX ....................................................................... 161triazolam ........................................................................... 149TRI-BUFFERED ASPIRIN ............................. 11TRICARE ........................................................................ 142TRICARE PRENATAL COMPLEAT...................................................................................................... 142TRICARE PRENATAL DHA ONE .... 142TRICITRATES .......................................................... 100TRICON ............................................................................ 100TRICOR ............................................................................... 66TRIESENCE (PF) ...................................................... 93TRI-ESTARYLLA .................................................... 74trifluoperazine ............................................................. 148trifluridine ........................................................................... 49TRIGELS-F FORTE ............................................ 100TRIGLIDE ......................................................................... 66trihexyphenidyl .............................................................. 46TRIHIBIT (PF) .............................................................. 57TRI-LEGEST FE ......................................................... 75TRILEPTAL .................................................................... 70TRI-LINYAH ................................................................. 75TRILIPIX ............................................................................ 66TRI-LUMA .................................................................... 161TRILYTE WITH FLAVOR PACKETS...................................................................................................... 112trimethobenzamide ................................................. 112trimethoprim ..................................................................... 27trimipramine .................................................................. 148TRINATAL GT ......................................................... 142TRINATAL RX 1 ................................................... 142TRINATAL ULTRA ........................................... 142TRINESSA (28) ........................................................... 75TRI-NORINYL (28) ................................................ 75TRIOSTAT .................................................................... 163TRIOXIN ............................................................................. 27TRIPEDIA (PF) ............................................................ 57TRIPHROCAPS ....................................................... 174TRIPLE ANTIBIOTIC .......................................... 27TRIPLE ANTIBIOTIC (PRAM) EXTRA......................................................................................................... 27TRIPLE ANTIBIOTIC PLUS ........................ 27TRIPLE HELIX COLLAGEN ................... 137TRIPLE VITAMIN WITH FLUORIDE...................................................................................................... 174TRI-PREVIFEM (28) ............................................. 75TRISENOX ....................................................................... 44TRI-SPRINTEC (28) ............................................... 75TRISTART DHA ..................................................... 142TRIUMEQ .......................................................................... 49TRIVEEN-DUO DHA ....................................... 142TRIVEEN-PRX RNF .......................................... 142TRI-VIT WITH FLUORIDE & IRON...................................................................................................... 175TRI-VITAMIN WITH FLUORIDE ..... 175TRIVORA (28) .............................................................. 75TRIXAICIN ................................................................... 161TRIXAICIN HP ........................................................ 161TRIZIVIR ........................................................................... 49TROKENDI XR ........................................................... 70trolamine salicylate ................................................ 161TROPHAMINE 10 % ......................................... 100TROPHAMINE 6% .............................................. 100TROPICAL LIQUID NUTRITION ..... 175tropicamide ........................................................................ 93

Index

trospium ............................................................................. 172TRUEPLUS INSULIN ....................................... 137TRULICITY ..................................................................... 39TRUMENBA ................................................................... 57TRUSOPT .......................................................................... 93TRUVADA ....................................................................... 49TUBERSOL ..................................................................... 57TUMERSAID .............................................................. 116TUMS .................................................................................. 112TUMS E-X ..................................................................... 112TUMS EXTRA STRENGTH SMOOTHIES .............................................................. 112TUMS FRESHERS ............................................... 112TUMS ULTRA .......................................................... 112turmeric root extract .............................................. 116TUSNEL C ........................................................................ 84TUSNEL NEW FORMULA ........................... 84TUSNEL PEDIATRIC .......................................... 84TUSNEL-DM PEDIATRIC ............................. 84TUSSICAPS ..................................................................... 84TUSSIGON ....................................................................... 84TUSSIN ................................................................................. 84TUSSIN CF ....................................................................... 84TUSSIN CF COUGH-COLD ......................... 84TUSSIN CF MAX ...................................................... 84TUSSIN CHEST CONGESTION .............. 84TUSSIN COUGH (DM ONLY) .................. 84TUSSIN DM .................................................................... 84TUSSIN DM CLEAR ............................................. 84TUSSIN DM COUGH & CHEST ............. 84TUSSIN DM MAX ................................................... 84TUSSIN EXPECTORANT ............................... 84TUSSIONEX PENNKINETIC ER ........... 84tutti-frutti flavor (bulk) ....................................... 172TWINRIX (PF) .............................................................. 57TWYNSTA ....................................................................... 66TYBOST ........................................................................... 172TYGACIL ........................................................................... 27TYKERB ............................................................................. 44TYLENOL PM EXTRA STRENGTH ..... 3TYLENOL-CODEINE #3 ................................. 11TYLENOL-CODEINE #4 ................................. 11TYPHIM VI ...................................................................... 57TYSABRI ........................................................................ 172TYVASO ............................................................................. 66TYVASO INSTITUTIONAL START KIT ............................................................................................. 66TYVASO REFILL KIT ........................................ 66TYVASO STARTER KIT ................................. 66TYZEKA ............................................................................. 49TYZINE ................................................................................ 93UCERIS ............................................................................. 121U-CORT ............................................................................ 161UDAMIN SP ................................................................ 175ULESFIA ......................................................................... 161ULORIC ............................................................................... 17ULTANE ............................................................................. 14ULTICARE .................................................................... 137ULTILET ALCOHOL SWAB ................... 161ULTILET INSULIN SYRINGE .............. 137ULTILET PEN NEEDLE ............................... 137ULTIMATE OB DHA ........................................ 142ULTIMATECARE ONE ................................. 142ULTIMATECARE ONE NF ....................... 142ULTIVA ............................................................................... 11

Index

ULTRA CMFT INS SYR HALF UNIT...................................................................................................... 137ULTRA COMFORT INSULIN SYRINGE ........................................................................ 137ULTRA LUBRICANT EYE ........................... 93ULTRA STRENGTH ANTACID .......... 112ULTRABAG/DIANEAL PD-2/1.5% DEX ....................................................................................... 100ULTRABAG/DIANEAL PD-2/2.5% DEX ....................................................................................... 100ULTRABAG/DIANEAL PD-2/4.25%DEX ...................................................... 100ULTRABAG/DIANEAL/2.5% DEXTROSE .................................................................. 100ULTRACET ..................................................................... 11ULTRACIN T ............................................................. 161ULTRACOMFORT .............................................. 137ULTRACOMFORT W/ CONTAINER...................................................................................................... 137ULTRAFOAM .............................................................. 59ULTRA-FRESH ....................................................... 161ULTRAM ............................................................................ 11ULTRAM ER .................................................................. 11ULTRA-THIN II (SHORT) INS SYR...................................................................................................... 137ULTRA-THIN II (SHORT) PEN NDL...................................................................................................... 137ULTRA-THIN II INS PEN NEEDLES...................................................................................................... 137ULTRA-THIN II INSULIN SYRINGE...................................................................................................... 137ULTRAVATE ............................................................. 161ULTRAVATE PAC .............................................. 161ULTRAVATE X ...................................................... 161ULTRAVIST ................................................................... 86ULTRESA ....................................................................... 112UMECTA ........................................................................ 161UMECTA NAIL FILM PEN ....................... 161UMECTA PD .............................................................. 161UNASYN ............................................................................ 27UNIFINE PENTIPS .............................................. 137UNIFINE PENTIPS PLUS ............................ 137UNISOL 4 ....................................................................... 137UNI-SOLVE ADHESIVE REMOVER...................................................................................................... 137UNISOLVE ADHESIVE REMOVER WIPE .................................................................................... 137UNISTIK 2 EXTRA ............................................. 137UNISTIK 2 NORMAL LANCET&DEVICE ............................................. 137UNITHROID ................................................................ 163UNITUXIN ....................................................................... 44UNIVASC .......................................................................... 66UNIVERSAL REMOVER WIPES ....... 137UNNA-FLEX ELASTIC UNNA BOOT...................................................................................................... 137UR N-C .................................................................................. 27URAMAXIN ................................................................ 161URAMAXIN GT ..................................................... 161URAMIT MB .................................................................. 27urea ......................................................................................... 161URECHOLINE ............................................................. 52URELLE .............................................................................. 27URIMAR-T ....................................................................... 27URIN DS ............................................................................. 27URINARY PAIN RELIEF ................................ 14

210

Index

URINARY TRACT INF.TEST (WBCS)......................................................................................................... 86UROCIT-K 10 ............................................................ 100UROCIT-K 15 ............................................................ 100UROCIT-K 5 ................................................................ 100UROGESIC-BLUE ................................................... 27URO-L .................................................................................... 27UROLET MB .................................................................. 27UROPHEN MB ............................................................ 27UROXATRAL ............................................................ 172URSO 250 ....................................................................... 112URSO FORTE ............................................................ 113ursodiol ............................................................................... 113UTIRA-C ............................................................................. 27VAGIFEM ...................................................................... 121VAGISTAT-1 ................................................................. 32VAGISTAT-3 ................................................................. 32valacyclovir ....................................................................... 49VALCHLOR .................................................................... 44VALCYTE ......................................................................... 49valerian root ................................................................... 116valganciclovir .................................................................. 49valproate sodium .......................................................... 70valproic acid ..................................................................... 70valproic acid (as sodium salt) ......................... 70valsartan ................................................................................ 67valsartan-hydrochlorothiazide ........................ 67VALSTAR ......................................................................... 45VALTREX ......................................................................... 49VALU-DRYL ALLERGY ................................ 36VANACOF ........................................................................ 84VANACOF DM ........................................................... 84VANACOF-8 .................................................................. 84VANAHIST PD ............................................................ 36VANATOL LQ ............................................................. 11VANCOCIN ..................................................................... 27vancomycin ....................................................................... 28vancomycin in 0.9% sodium cl ..................... 27vancomycin in d5w ................................................... 27vancomycin in dextrose iso-osm ................. 27VANDAZOLE ............................................................... 28vandetanib ........................................................................... 45VANILLA BUTTERNUT FLAVOR...................................................................................................... 172vanilla butternut flavor(bulk) ....................... 172vanillin (bulk) .............................................................. 172VANISHPOINT SYRINGE ......................... 137VANOS .............................................................................. 161VANTAS ............................................................................. 45VAPORX BALM .................................................... 161VAPRISOL ....................................................................... 88VAQTA (PF) ................................................................... 57VARIVAX (PF) ............................................................ 57VARIZIG ............................................................................. 57VARNAL ......................................................................... 137VARUBI ........................................................................... 113VASCEPA ...................................................................... 113VASCUDERM HYDROGEL WOUND...................................................................................................... 137VASCULERA ............................................................. 175VASELINE .................................................................... 172VASELINE PETROLATUM GAUZE...................................................................................................... 137VASERETIC ................................................................... 67vasopressin ...................................................................... 121VASOSTRICT ........................................................... 121

Index

VASOTEC ......................................................................... 67VECAMYL ....................................................................... 67VECTIBIX ......................................................................... 45VECTICAL .................................................................... 161vecuronium bromide ................................................ 52VELCADE ......................................................................... 45VELETRI ............................................................................ 67VELIVET TRIPHASIC REGIMEN (28)......................................................................................................... 75VELPHORO ................................................................. 100VELTIN ............................................................................. 161VEMAVITE-PRX-2 ............................................. 142VENA-BAL DHA .................................................. 142venlafaxine ...................................................................... 148VENOFER ...................................................................... 100VENTAVIS ....................................................................... 67VENTOLIN HFA ....................................................... 19VERAMYST ................................................................... 93verapamil ............................................................................. 61VEREGEN ......................................................................... 49VERELAN ......................................................................... 61VERELAN PM .............................................................. 61VERIPRED 20 ............................................................ 121VERSA FREE ............................................................. 172VERSA PLUS ............................................................. 172VERSACLOZ ............................................................. 148VERSALON ................................................................. 138VERSALON NONWOVEN ALL-PURPOSE ........................................................ 138VERSIVA XC ............................................................. 138VESICARE .................................................................... 172VEXOL ................................................................................. 93VFEND .................................................................................. 32VFEND IV ......................................................................... 32VIASORB ABSORBENT DRESSING...................................................................................................... 138VIBATIV ............................................................................. 28VIBRAMYCIN ............................................................. 28VICKS CHILDREN'S NYQUIL COLD&C ............................................................................ 84VICKS DAYQUIL COLD&FLU RELIEF ................................................................................. 84VICKS DAYQUIL COUGH ........................... 85VICKS DAYQUIL MUCUS CONTROL DM ............................................................................................. 85VICKS DAYQUIL SEVERE COLD-FLU......................................................................................................... 85VICKS NYQUIL COLD/FLU (CPM)......................................................................................................... 85VICKS NYQUIL COLD/FLU LIQUICAP ......................................................................... 85VICKS NYQUIL COUGH ............................... 85VICKS NYQUIL NIGHTTIME RELIEF......................................................................................................... 85VICKS NYQUIL SEVERE COLD-FLU......................................................................................................... 85VICKS QLEARQUIL ALLERGY ........... 36VICKS QLEARQUIL DAYTIME SINUS......................................................................................................... 85VICKS QLEARQUIL NIGHTIME SINUS ..................................................................................... 85VICKS QLEARQUIL NIGHTTIME RLF......................................................................................................... 36VICKS QLEARQUIL(OXYMETAZOLINE) .... 93VICKS SINEX 12-HOUR ................................. 93

Index

VICKS VAPODROPS ........................................... 85VICKS VAPORUB ............................................... 161VICKS VAPOSTEAM .......................................... 85VICODIN ............................................................................ 11VICODIN ES .................................................................. 11VICODIN HP .................................................................. 11VICOPROFEN .............................................................. 12VICTOZA 2-PAK ...................................................... 39VICTOZA 3-PAK ...................................................... 39VICTRELIS ...................................................................... 49VIDAZA .............................................................................. 45VIDEX 2 GRAM PEDIATRIC .................... 49VIDEX 4 GRAM PEDIATRIC .................... 49VIDEX EC ......................................................................... 49VIEKIRA PAK .............................................................. 49VIGAMOX ........................................................................ 28VIGILON PRIMARY WOUND DRESSING .................................................................... 138VIIBRYD ......................................................................... 148VILACTIN AA PLUS 20 PE ...................... 100VIMIZIM ......................................................................... 172VIMOVO ............................................................................. 17VIMPAT .............................................................................. 70VINATE C ...................................................................... 142VINATE GT ................................................................. 142vinblastine ........................................................................... 45VINCASAR PFS ......................................................... 45vincristine ............................................................................ 45vinorelbine .......................................................................... 45VIOKACE ....................................................................... 113VIORELE (28) ............................................................... 75VIRACEPT ....................................................................... 49VIRAMUNE .................................................................... 49VIRAMUNE XR ......................................................... 49VIRAZOLE ....................................................................... 49VIREAD ............................................................................... 49VIROPTIC ......................................................................... 49VIRT NATE .................................................................. 142VIRT-ADVANCE .................................................. 142VIRT-BAL DHA PLUS ................................... 142VIRT-C DHA .............................................................. 142VIRT-CAPS .................................................................. 175VIRT-CARE ONE .................................................. 142VIRTI-SULF .................................................................... 28VIRT-NATE ................................................................. 142VIRT-PHOS 250 NEUTRAL ..................... 100VIRT-PN .......................................................................... 142VIRT-PN DHA .......................................................... 142VIRT-PN PLUS ........................................................ 142VIRTPREX .................................................................... 142VIRTRATE-2 .............................................................. 101VIRTRATE-3 .............................................................. 101VIRTRATE-K ............................................................. 101VIRT-SELECT .......................................................... 142VIRTUSSIN AC .......................................................... 85VIRTUSSIN DAC ..................................................... 85VIRT-VITE .................................................................... 175VIRT-VITE FORTE ............................................. 175VIRT-VITE GT ......................................................... 142VIRT-VITE PLUS .................................................. 175VISCOPASTE PB7 ............................................... 138VISICOL .......................................................................... 113VISINE FOR CONTACTS ........................... 138VISIPAQUE ..................................................................... 86VISTARIL .......................................................................... 36VISTEC X-RAY DETECT ........................... 138

211

Index

VISTIDE .............................................................................. 49VISUDYNE ................................................................... 172VIT 3 ..................................................................................... 175VITAFOL ........................................................................ 101VITAFOL NANO ................................................... 142VITAFOL ULTRA ................................................ 142VITAFOL-OB ............................................................. 142VITAFOL-OB+DHA .......................................... 142VITAFOL-ONE ........................................................ 142VITAFOL-PLUS ...................................................... 142VITAL-D RX ............................................................... 175vitamin a and d ........................................................... 161VITAMIN B-12 ......................................................... 175VITAMIN D2 .............................................................. 175VITAMIN D3 .............................................................. 175vitamin e (dl, acetate) .......................................... 175VITAMIN K ................................................................. 175VITAMIN K1 .............................................................. 175VITAMINS A,C,D & FLUORIDE ....... 175VITEKTA ........................................................................... 49VITRASE ........................................................................ 161vits a and d-white pet-lanolin ...................... 161VITUZ .................................................................................... 85VIVA CT .......................................................................... 142VIVAGLOBIN .............................................................. 57VIVELLE-DOT ......................................................... 121VIVITROL ..................................................................... 172VIVOTIF BERNA VACCINE ...................... 57V-NATAL ....................................................................... 142VOGELXO .................................................................... 121VOL-CARE RX ........................................................ 175VOL-NATE ................................................................... 142VOL-PLUS .................................................................... 142VOLTAREN ....................................................... 93, 161VOLTAREN-XR ......................................................... 17VOLUVEN 6 % ............................................................ 59voriconazole ...................................................................... 32VORTEX ADULT MASK ............................ 138VORTEX FROG MASK-CHILD ........... 138VORTEX HOLDING CHAMBER ....... 138VORTEX HOLDING CHAMBER CHILD ................................................................................ 138VORTEX HOLDING CHAMBER TODDLER ...................................................................... 138VORTEX LADYBUG MASK-TODDLER ................................................ 138VORTEX VHC FROG MASK-CHILD...................................................................................................... 138VORTEX VHC LADYBUG MASK-TODDLR .................................................... 138VOSOL .................................................................................. 93VOSOL-HC ...................................................................... 93VOSPIRE ER .................................................................. 19VOTRIENT ....................................................................... 45VP CH ULTRA ......................................................... 142VP-CH PLUS ............................................................... 143VP-CH-PNV ................................................................. 143VP-GGR-B6 .................................................................. 143VP-GSTN ........................................................................ 101VP-HEME OB ............................................................ 143VP-HEME ONE ........................................................ 143VP-PNV-DHA ............................................................ 143VP-PRECIP ................................................................... 116VPRIV ................................................................................. 172VP-VITE RX ................................................................ 175VP-ZEL .............................................................................. 172

Index

VUSION ............................................................................... 32VYFEMLA (28) ........................................................... 75VYTORIN 10-20 ......................................................... 67VYTORIN 10-40 ......................................................... 67VYTORIN 10-80 ......................................................... 67VYVANSE ..................................................................... 148WAL-ITIN ......................................................................... 36WAL-MUCIL FIBER (ASPARTAME)...................................................................................................... 113WAL-MUCIL FIBER (SUGAR) ............ 113WAL-ZAN 75 ............................................................. 113warfarin ................................................................................. 29WATCHHALER ...................................................... 138water for inject, bacteriostat .......................... 172water for injection, sterile ................................ 172water for irrigation, sterile .............................. 161WATER SHIELD BANDAGES .............. 138WATERMELON FLAVORING ............. 172WATERPROOF STRONG STRIPS .... 138WEBCOL ........................................................................ 161WEBRIL ........................................................................... 138WEBRIL II ..................................................................... 138WEE CARE ................................................................... 101WELCHOL ....................................................................... 67WELLBUTRIN ......................................................... 148WELLBUTRIN SR ............................................... 148WELLBUTRIN XL ............................................... 148WERA (28) ........................................................................ 75WESTCORT ................................................................. 162WET-PRUF ................................................................... 138WHEY PROTEIN CONCENTRATE...................................................................................................... 101WHITE WAX (BEESWAX) ....................... 172WHOLE BODY JOINT SUPPORT ..... 116WIDE-SEAL DIAPHRAGM 60 ................. 75WIDE-SEAL DIAPHRAGM 65 ................. 75WIDE-SEAL DIAPHRAGM 70 ................. 75WIDE-SEAL DIAPHRAGM 75 ................. 75WIDE-SEAL DIAPHRAGM 80 ................. 75WIDE-SEAL DIAPHRAGM 85 ................. 75WIDE-SEAL DIAPHRAGM 90 ................. 75WIDE-SEAL DIAPHRAGM 95 ................. 75WILATE .............................................................................. 59wild cherry flavor (bulk) ................................... 172WINDMILL TRAINER .................................... 138WINRHO SDF ............................................................... 57WINTERGREEN FLAVORING ............ 172WITCH HAZEL ....................................................... 162witch hazel leaf (hamamelis) ....................... 162WITEPSOL H-15 .................................................... 172WOMEN'S GENTLE LAXATIVE(BISAC) ........................................... 113WOMEN'S LAXATIVE (BISACODYL)...................................................................................................... 113WOMEN'S MULTIVITAMIN GUMMIES ..................................................................... 175WOUND & SKIN CLEANSER ............... 162WOUND CLEANSER ....................................... 162WOUND GEL ............................................................ 162WOUNDGARD GAUZE ................................ 138WOUN'DRES HYDROGEL WOUND DRESS ................................................................................ 138WYMZYA FE ................................................................ 75XALATAN ........................................................................ 93XALKORI .......................................................................... 45XANAX ............................................................................. 148

Index

XANAX XR .................................................................. 148XARELTO ......................................................................... 29XARTEMIS XR ........................................................... 12XELJANZ ........................................................................... 17XELODA ............................................................................. 45XENAZINE ...................................................................... 70XEOMIN ............................................................................. 52XERAC AC ................................................................... 162XERESE ............................................................................... 49XGEVA ............................................................................. 172XIAFLEX ........................................................................ 172XIFAXAN .......................................................................... 28XIGDUO XR ................................................................... 39XODOL 10/300 ............................................................ 12XODOL 5/300 ................................................................ 12XODOL 7.5/300 ........................................................... 12XOFIGO ........................................................................... 172XOLAIR ............................................................................... 19XOPENEX ......................................................................... 19XOPENEX CONCENTRATE ...................... 19XOPENEX HFA .......................................................... 19XTANDI .............................................................................. 45XULANE ............................................................................. 75XYLOCAINE ................................................................. 14XYLOCAINE (CARDIAC) (PF) ............... 61XYLOCAINE JELLY ............................................ 14XYLOCAINE-EPINEPHRINE .................... 14XYLOCAINE-MPF .................................................. 14XYLOCAINE-MPF/EPINEPHRINE ..... 14XYLON 10 ........................................................................ 12XYNTHA ............................................................................ 59XYNTHA SOLOFUSE ........................................ 59XYREM ............................................................................. 149XYZAL ................................................................................. 36YASMIN (28) ................................................................. 75YAZ (28) ............................................................................. 75YELLOW WAX (BEESWAX) ................. 172YERVOY ............................................................................ 45YF-VAX (PF) ................................................................. 57YOHIMBE ...................................................................... 116yohimbe bark ................................................................ 116ZADITOR ........................................................................... 37zafirlukast ............................................................................ 19zaleplon .............................................................................. 149ZALTRAP .......................................................................... 45ZAMICET .......................................................................... 12ZANAFLEX ................................................................. 139ZANOSAR ........................................................................ 45ZANTAC .......................................................................... 113ZANTAC 75 ................................................................. 113ZANTAC MAXIMUM STRENGTH...................................................................................................... 113ZARAH ................................................................................. 75ZARONTIN ...................................................................... 70ZAROSEN DESENSITIZER ...................... 138ZAROXOLYN .............................................................. 88ZARXIO ............................................................................... 71ZATEAN-CH .............................................................. 143ZATEAN-PN ............................................................... 143ZATEAN-PN DHA ............................................... 143ZATEAN-PN PLUS ............................................. 143ZAVARA ......................................................................... 175ZAVESCA ...................................................................... 172ZEASORB (MICONAZOLE) ....................... 32ZEBETA .............................................................................. 67ZEBUTAL .......................................................................... 12

212

Index

ZECUITY ........................................................................... 12ZEGERID ........................................................................ 113ZELAPAR .......................................................................... 46ZELBORAF ..................................................................... 45ZEMAIRA ...................................................................... 172ZEMPLAR ..................................................................... 172ZEMURON ....................................................................... 52ZENATANE ................................................................. 162ZENCHENT (28) ........................................................ 75ZENCHENT FE ........................................................... 75ZENPEP ............................................................................ 113ZENZEDI ............................................................................ 52ZEOSA .................................................................................. 75ZERBAXA ........................................................................ 28ZERIT ..................................................................................... 50ZESTORETIC ................................................................ 67ZESTRIL ............................................................................. 67ZETIA ..................................................................................... 67ZETONNA ........................................................................ 93ZEVALIN (Y-90) ....................................................... 45ZFLEX ....................................................................................... 3ZIAC ........................................................................................ 67ZIAGEN ............................................................................... 50ZIANA ................................................................................ 162zidovudine .......................................................................... 50ZIKS ARTHRITIS PAIN RELIEF ........ 162ZINACEF ............................................................................ 28ZINACEF IN STERILE WATER ............. 28zinc chloride .................................................................. 101zinc oxide ......................................................................... 162zinc stearate ................................................................... 172zinc sulfate ...................................................................... 101ZINECARD (AS HCL) ..................................... 172ZINGIBER ...................................................................... 143ZINGO ................................................................................... 14ZIOPTAN (PF) .............................................................. 93ziprasidone hcl ............................................................ 148ZIPSOR ................................................................................. 12ZIRGAN ............................................................................... 50ZITHROMAX ................................................................ 28ZITHROMAX TRI-PAK .................................... 28ZITHROMAX Z-PAK ........................................... 28ZMAX .................................................................................... 28ZOCOR ................................................................................. 67ZOFRAN (AS HYDROCHLORIDE)...................................................................................................... 113ZOFRAN ODT ........................................................... 113ZOHYDRO ER ............................................................. 12ZOLADEX ........................................................................ 45zoledronic acid ............................................................ 172zoledronic acid-mannitol-water ................. 172ZOLINZA ........................................................................... 45ZOLOFT ........................................................................... 148zolpidem ............................................................................ 149ZOLPIMIST .................................................................. 149ZOMACTON ............................................................... 121ZOMETA ......................................................................... 172ZOMIG .................................................................................. 12ZOMIG ZMT .................................................................. 12ZONALON .................................................................... 162ZONATUSS ..................................................................... 85ZONEGRAN ................................................................... 70zonisamide .......................................................................... 70ZONTIVITY .................................................................... 46ZORBTIVE .................................................................... 121ZORTRESS ................................................................... 122

Index

ZORVOLEX .................................................................... 17ZOSTAVAX (PF) ....................................................... 57ZOSYN .................................................................................. 28ZOSYN IN DEXTROSE (ISO-OSM) ... 28ZOVIA 1/35E (28) ..................................................... 75ZOVIA 1/50E (28) ..................................................... 75ZOVIRAX .......................................................................... 50Z-SLEEP ........................................................................... 149Z-TUSS AC ...................................................................... 85Z-TUSS E ............................................................................ 85ZUBSOLV ...................................................................... 172ZUPLENZ ....................................................................... 113ZUTRIPRO ....................................................................... 85ZYBAN .............................................................................. 162ZYCLARA ..................................................................... 162ZYDELIG ........................................................................... 45ZYFLO .................................................................................. 19ZYFLO CR ........................................................................ 19ZYKADIA .......................................................................... 45ZYLET ................................................................................... 28ZYLOPRIM ...................................................................... 17ZYMAXID ........................................................................ 28ZYPRAM ......................................................................... 113ZYPREXA ...................................................................... 148ZYPREXA RELPREVV .................................. 148ZYPREXA ZYDIS ................................................. 148ZYTIGA ............................................................................... 45ZYVOX ................................................................................. 28ZZZQUIL ........................................................................ 149

213

Documents

MDwise HIP Formulary · MDwise HIP Formulary. 2016. Table of Contents. T a b l e o f C n t e sANALGESIC AND ANTIHISTAMINE COMBINATION..... 3