QualChoice (A6) Essentialuserfiles/pdfs/Pharmacy/2019...ESSENTIAL FORMULARY 2019 Comprehensive Medication List Effective Date: August 1, 2019This document has information about the

ESSENTIAL FORMULARY 2019 Comprehensive Medication List

Effective Date: August 1, 2019This document has information about the drugs

covered in your plan. Please read carefully.

1810 CR 015_03 08/2019

1810 CR 015_01 2019 Essential Comprehensive Medication List

How We Develop Our FormularyQualChoice uses a Pharmacy and Therapeutics Committee made up of practicing doctors, pharmacists, and nurses to make sure our drug list is clinically sound and gives the best value to our members. This committee reviews FDA-approved drugs that are newly approved and those that are currently on the market. Drugs are chosen based on safety, effectiveness, and cost in comparison to other drugs in their class.

Formulary DesignOur Enhanced formulary includes generic drugs, preferred and non-preferred drugs, specialty drugs and ACA (Affordable Care Act) preventive drugs. Our Enhanced formulary is a closed formulary. This means that coverage is limited to those products listed in the different tiers. There are 4 tiers on the formulary, along with the preventive drugs.

Tier 1 This tier has the lowest member cost share. Most, but not all, generic medications are in Tier 1.

Tier 2 This tier contains some higher cost generic drugs and preferred brand-name drugs. Preferred brand-name drugs generally have lower copayments than non-preferred brand-name drugs.

Tier 3 This tier may contain some higher cost generic drugs but is mostly non-preferred brand drugs. Non-preferred drugs generally have higher copayments than preferred brand-name drugs.

Tier 5 This tier contains specialty drugs and has the highest copayment and cost. These drugs are used to treat complex or rare health problems.

ACA Preventive Drugs Drugs listed as ‘Preventive’ may have coverage and no copayment when health care reform requirements are met for age, gender, and/or risk factors.

Medical ManagementWe use reasonable medical and utilization management to determine whether a medication is medically necessary. These may include prior authorization, quantity limits, and step therapy as described below. Those drugs are listed as:

PA – Prior Authorization QL – Quantity Limits ST – Step Therapy

1

Table of Contents

Analgesics - Drugs for Pain ................................................................................................................................................... 3

Analgesics - Drugs for Pain and Inflammation ................................................................................................................... 4

Anesthetics .............................................................................................................................................................................. 5

Anti-Addiction / Substance Abuse Treatment Agents ....................................................................................................... 6

Antibacterials ........................................................................................................................................................................... 6

Anticoagulants ......................................................................................................................................................................... 8

Anticonvulsants - Drugs for Seizures .................................................................................................................................. 8

Antidementia Agents - Drugs for Alzheimer's Disease and Dementia ........................................................................... 9

Antidepressants ...................................................................................................................................................................... 9

Antiemetics - Drugs for Nausea and Vomiting ................................................................................................................. 10

Antifungals ............................................................................................................................................................................. 11

Antigout Agents ..................................................................................................................................................................... 11

Antimigraine Agents ............................................................................................................................................................. 11

Antimyasthenic Agents ........................................................................................................................................................ 12

Antimycobacterials ............................................................................................................................................................... 12

Antineoplastics - Drugs for Cancer .................................................................................................................................... 12

Antiparasitics ......................................................................................................................................................................... 14

Antiparkinson Agents ........................................................................................................................................................... 14

Antiplatelets ........................................................................................................................................................................... 14

Antipsychotics - Drugs for Mood Disorders ...................................................................................................................... 14

Antivirals ................................................................................................................................................................................. 15

Anxiolytics - Drugs for Anxiety ............................................................................................................................................ 16

Bipolar Agents - Drugs for Mood Disorders ...................................................................................................................... 17

Blood Products / Modifiers / Volume Expanders - Drugs for Bleeding Disorders ...................................................... 17

Cardiovascular Agents - Drugs for Heart and Circulation Conditions .......................................................................... 17

Central Nervous System Agents - Drugs for Attention Deficit Disorder ..................................................................... 21

Central Nervous System Agents - Drugs for Multiple Sclerosis .................................................................................... 21

Central Nervous System Agents - Miscellaneous ........................................................................................................... 21

Dental and Oral Agents - Drugs for Mouth and Throat Conditions ............................................................................... 22

Dermatological Agents - Drugs for Skin Conditions ........................................................................................................ 22

Diabetes - Antidiabetic Agents ........................................................................................................................................... 26

Diabetes - Glucose Monitoring ........................................................................................................................................... 27

Diabetes - Glycemic Agents ................................................................................................................................................ 28

Diabetes - Insulins ................................................................................................................................................................ 28

Electrolytes / Minerals / Metals / Vitamins ........................................................................................................................ 29

Gastrointestinal Agents - Drugs for Acid Reflux and Ulcer ............................................................................................ 31

Gastrointestinal Agents - Drugs for Bowel, Intestine and Stomach Conditions ......................................................... 32

Genetic or Enzyme Disorder - Drugs for Replacement, Modification, Treatment ...................................................... 33

Genitourinary Agents - Drugs for Bladder, Genital and Kidney Conditions ................................................................ 33

Genitourinary Agents - Drugs for Prostate Conditions ................................................................................................... 34

Hormonal Agents - Adrenal ................................................................................................................................................. 34

Hormonal Agents - Men's Health ....................................................................................................................................... 34

Hormonal Agents - Osteoporosis ....................................................................................................................................... 35

Hormonal Agents - Parathyroid .......................................................................................................................................... 35

Hormonal Agents - Pituitary ................................................................................................................................................ 35

Hormonal Agents - Prostaglandins .................................................................................................................................... 35

Hormonal Agents - Sex Hormones and Birth Control ..................................................................................................... 36

Hormonal Agents - Thyroid ................................................................................................................................................. 39

Immunological Agents - Drugs for Immune System Stimulation or Suppression....................................................... 39

Immunological Agents - Drugs for Vaccination ................................................................................................................ 40

Inflammatory Bowel Disease Agents ................................................................................................................................. 41

2

Metabolic Bone Disease Agents - Drugs for Osteoporosis ............................................................................................ 41

Miscellaneous Therapeutic Agents .................................................................................................................................... 42

Ophthalmic Agents - Drugs for Eye Allergy, Infection and Inflammation ..................................................................... 43

Ophthalmic Agents - Drugs for Glaucoma ........................................................................................................................ 44

Ophthalmic Agents - Drugs for Miscellaneous Eye Conditions ..................................................................................... 44

Otic Agents - Drugs for Ear Conditions ............................................................................................................................. 45

Respiratory Tract / Pulmonary Agents - Drugs for Allergies, Cough, Cold ................................................................. 45

Respiratory Tract / Pulmonary Agents - Drugs for Asthma and Other Lung Conditions .......................................... 46

Respiratory Tract / Pulmonary Agents - Drugs for Cystic Fibrosis ............................................................................... 47

Respiratory Tract / Pulmonary Agents - Drugs for Pulmonary Hypertension ............................................................. 47

Skeletal Muscle Relaxants - Drugs for Muscle Pain and Spasm .................................................................................. 48

Sleep Disorder Agents ......................................................................................................................................................... 48

3

Drug Name Drug Tier Notes Drug Name Drug Tier Notes

Analgesics - Drugs

for Pain fentanyl transdermal

patch 72 hour 100

mcg/hr, 12 mcg/hr, 25


mcg/hr

1

PA; QL acetaminophen-

codeine 1 QL

acetaminophen-

codeine #2 1 QL hydrocodone-

acetaminophen 1 QL

acetaminophen-

codeine #3 1 QL hydrocodone-ibuprofen 1

hydromorphone hcl er 1 PA acetaminophen-

codeine #4 1 QL

hydromorphone hcl oral 1

ascomp-codeine 1 hydromorphone hcl

rectal 1

buprenorphine

transdermal patch

weekly 10 mcg/hr, 15


mcg/hr

1

levorphanol tartrate oral 1

lorcet 1 QL

lorcet hd 1 QL

lorcet plus 1 QL BUPRENORPHINE

TRANSDERMAL

PATCH WEEKLY 7.5

MCG/HR

1

LORTAB 3

MEDROX-RX 3

meperidine hcl injection 1 butalbital-

acetaminophen oral

tablet 50-325 mg

1

meperidine hcl oral 1

methadone hcl intensol 1

butalbital-apap 1 methadone hcl oral 1

butalbital-apap-caff-cod

oral capsule 50-300-40-

30 mg

1

methadose oral tablet

soluble 1

mitigo injection solution

200 mg/20ml (10

mg/ml)

1

butalbital-apap-caff-cod

oral capsule 50-325-40-

30 mg

1

QL

morphine sulfate

(concentrate) oral

solution 100 mg/5ml,

20 mg/ml

1

butalbital-apap-caffeine 1

butalbital-asa-caff-

codeine 1

morphine sulfate er

beads 1 PA butalbital-aspirin-

caffeine 1

morphine sulfate er oral

capsule extended

release 24 hour 10 mg,

100 mg, 20 mg, 30 mg,

50 mg, 60 mg, 80 mg

1

PA

butorphanol tartrate

nasal 1 QL

carisoprodol-aspirin-

codeine 1

codeine sulfate 1 morphine sulfate er oral

capsule extended

release 24 hour 40 mg

1

endocet 1 QL

esgic oral capsule 1

morphine sulfate er oral

tablet extended release 1 PA fentanyl citrate buccal

lozenge on a handle 1 PA; QL

4


morphine sulfate

injection solution 2

mg/ml, 4 mg/ml, 5

mg/ml

1

vicodin 1 QL

vicodin es 1 QL

vicodin hp 1 QL

zebutal 1 morphine sulfate

intramuscular 1

Analgesics - Drugs

for Pain and

Inflammation

morphine sulfate oral 1

morphine sulfate rectal 1 aspirin adult 1

OXYCODONE HCL ER 2 PA aspirin adult low

strength oral tablet

delayed release

1

oxycodone hcl oral

capsule 1

oxycodone hcl oral

concentrate 100

mg/5ml

1

aspirin childrens 1

aspirin ec low dose 1

aspirin ec low strength 1 oxycodone hcl oral

solution 1

aspirin low dose 1

oxycodone hcl oral

tablet 1

aspirin oral tablet 1

aspirin oral tablet

delayed release 325

mg

1

oxycodone-

acetaminophen 1 QL

oxycodone-aspirin 1 bayer aspirin 1

oxycodone-ibuprofen 1 bayer aspirin ec low

dose 1

OXYCONTIN 2 PA

celecoxib oral capsule

100 mg, 200 mg, 50 mg 2

oxymorphone hcl 1

oxymorphone hcl er 1 PA choline-mag

trisalicylate 1

pentazocine-naloxone

hcl 1

DICLOFENAC

EPOLAMINE 3 PA phrenilin forte 1

PRIALT 5 diclofenac potassium 1

PRIMLEV ORAL

TABLET 5-300 MG,

7.5-300 MG

3

QL

diclofenac sodium er 1

diclofenac sodium oral 1

diclofenac sodium

transdermal gel 1 % 1

tencon 1

tramadol hcl er

(biphasic) 1 PA diclofenac sodium

transdermal solution 1

tramadol hcl er oral

tablet extended release

24 hour

1

PA diclofenac-misoprostol 1

diflunisal oral 1

tramadol hcl ir 1 ec-naproxen 1

tramadol-

acetaminophen 1 QL

etodolac 1

etodolac er 1

VANATOL LQ 3 fenoprofen calcium oral

capsule 200 mg 1

VANATOL S 3

5


fenoprofen calcium oral

tablet 1

bupivacaine hcl

injection solution 0.25

%, 0.5 %

1

fenortho 1

bupivacaine-

epinephrine 1

FLECTOR 3 PA

flurbiprofen oral 1 bupivacaine-

epinephrine (pf) 1

ibu 1

ibuprofen oral

suspension 1

chloroprocaine hcl (pf) 1

cocaine hcl external 1 ibuprofen oral tablet

400 mg, 600 mg, 800

mg

1

dermacinrx empricaine 1

dermacinrx prizopak 1

indomethacin er 1 ethyl chloride 1

indomethacin oral 1 GEBAUERS PAIN

EASE 3

ketorolac tromethamine

injection 1

GEBAUERS SPRAY

AND STRETCH 3


intramuscular 1

glydo 1


oral 1

lido bdk 1

lidocaine external

ointment 3 QL

meclofenamate sodium

oral 1

lidocaine external patch 1

medique aspirin 1 lidocaine hcl (pf) 1

mefenamic acid oral 1 lidocaine hcl external

cream 3 % 1

meloxicam oral 1

nabumetone oral 1 lidocaine hcl external

lotion 1

naproxen dr 1

lidocaine hcl external

solution 1

naproxen oral 1

naproxen sodium oral

tablet 275 mg, 550 mg 1

lidocaine hcl injection

solution 1

oxaprozin 1 lidocaine hcl

urethral/mucosal 1

piroxicam oral 1

qc aspirin low dose oral

tablet delayed release 1

lidocaine-epinephrine

injection 1

salsalate oral 1 lidocaine-prilocaine 1

sulindac oral 1 lidopin external cream

3 % 1

tolmetin sodium 1

Anesthetics lidopril 1

agoneaze 1 lidopril xr 1

anodyne lpt 1 lido-prilo caine pack 1

bupivacaine hcl (pf)


%, 0.5 %

1

LIDO-SORB 3

LIDOZION 3

6


livixil pak 1 buprenorphine hcl-

naloxone hcl sublingual

tablet sublingual

1

NUVAKAAN 1

polocaine 1 bupropion hcl er

(smoking det) 1

polocaine-mpf 1

premium lidocaine 3 QL CHANTIX 3 PA

prilolid 1 CHANTIX

CONTINUING MONTH

PAK

3

PA prilovix 1

PRILOVIX LITE 1

CHANTIX STARTING

MONTH PAK 3 PA prilovix plus 1

priloxx lp 1 disulfiram oral 1

relador pak 1 naloxone hcl injection 1

relador pak plus 1 naltrexone hcl oral 5

ropivacaine hcl


mg/ml, 5 mg/ml, 7.5

mg/ml

1

VIVITROL 5 PA

Antibacterials

AEMCOLO 3 PA; QL

ropivacaine hcl


mg/ml

5

ALTABAX 3

amikacin sulfate

injection 1

sensorcaine 1 amoxicillin 1

sensorcaine/epinephrin

e 1

amoxicillin-potassium

clavulanate er 1

sensorcaine-mpf


%, 0.5 %

1


clavulanate oral 1

ampicillin 1 sensorcaine-

mpf/epinephrine

injection solution 0.25%

-1:200000, 0.5% -

1:200000

1

ARIKAYCE 5 PA

AUGMENTIN ORAL

SUSPENSION

RECONSTITUTED

125-31.25 MG/5ML

3

SENSORCAINE-

MPF/EPINEPHRINE

INJECTION

SOLUTION 0.75-

1:200000 %

3

avidoxy 1

azithromycin oral 1

baciim 1

SYNERA 3 bacitracin intramuscular 1

vexatrol 1 BAXDELA ORAL 3

xylocaine dental 1 benzalkonium chloride

external solution 1

Anti-Addiction /

Substance Abuse

Treatment Agents

cefaclor 1

cefaclor er 1

acamprosate calcium 1 cefadroxil 1

buprenorphine hcl

sublingual 1

cefdinir 1

7


cefditoren pivoxil 1 doxycycline

monohydrate oral

capsule 100 mg, 50

mg, 75 mg

1

cefixime 1

cefpodoxime proxetil 1

cefprozil 1 doxycycline

monohydrate oral

suspension

reconstituted

1

ceftriaxone sodium

injection solution

reconstituted 1 gm, 2

gm, 250 mg, 500 mg

1

doxycycline

monohydrate oral tablet 1

ceftriaxone sodium

intravenous solution

reconstituted 1 gm, 2

gm

1

e.e.s. 400 1

ERY-TAB 3

erythromycin base oral

capsule delayed

release particles

1

cefuroxime axetil 1

cephalexin oral capsule

250 mg, 500 mg 1

erythromycin base oral

tablet 1

cephalexin oral

suspension

reconstituted

1

erythromycin

ethylsuccinate oral 1

CIPRO ORAL

SUSPENSION

RECONSTITUTED 250

MG/5ML (5%)

3

gentamicin sulfate

external 1

gentamicin sulfate

injection 1

ciprofloxacin hcl oral 1

iodine tincture external

tincture 2 % 1

ciprofloxacin oral 1

clarithromycin er 1 levofloxacin oral 1

clarithromycin oral 1 linezolid oral 1

CLEOCIN VAGINAL

SUPPOSITORY 3

lugols 1

mafenide acetate

external 1

clindamycin hcl oral 1

clindamycin palmitate

hcl 1

methenamine hippurate 1

methenamine

mandelate oral 1

clindamycin phosphate

vaginal 1

metronidazole oral 1 CLINDESSE 3

metronidazole vaginal 1 colistimethate sodium

(cba) 5

minocycline hcl oral

capsule 1

demeclocycline hcl 1

mondoxyne nl 1 dicloxacillin sodium 1

MONUROL 3 DIFICID 3 PA; QL

morgidox oral 1 doxycycline hyclate oral

capsule 1

moxifloxacin hcl oral 1

doxycycline hyclate oral

tablet 1

mupirocin calcium 1

mupirocin external 1

8


neomycin sulfate oral 1 VIBRAMYCIN ORAL

SYRUP 3

neomycin-polymyxin b

gu 1

XIFAXAN ORAL

TABLET 200 MG 3

nitrofurantoin 1

XIFAXAN ORAL

TABLET 550 MG 3 PA nitrofurantoin

macrocrystal oral 1

Anticoagulants nitrofurantoin

monohydrate

macrocrystals

1

BEVYXXA 3

ELIQUIS 2

ofloxacin oral 1 ELIQUIS STARTER

PACK 2

okebo 1

paromomycin sulfate

oral 1

enoxaparin sodium 5

fondaparinux sodium 5

penicillin g procaine 1 FRAGMIN

SUBCUTANEOUS

SOLUTION 10000

UNIT/ML, 12500

UNIT/0.5ML, 15000

UNIT/0.6ML, 18000

UNT/0.72ML, 2500

UNIT/0.2ML, 5000

UNIT/0.2ML, 7500

UNIT/0.3ML

5

penicillin v potassium 1

polymyxin b sulfate

injection 1

PRIMSOL 3

silver nitrate external 1

silver sulfadiazine

external 1

SIVEXTRO ORAL 3 heparin (porcine) in

nacl injection 1

ssd 1

streptomycin sulfate

intramuscular 1

jantoven 1

PRADAXA 3 sulfadiazine oral 1

THROMBATE III 5 sulfamethoxazole-

trimethoprim oral 1

warfarin sodium oral 1

XARELTO 2 SULFAMYLON

EXTERNAL CREAM 3

XARELTO STARTER

PACK 2

sulfatrim pediatric 1

Anticonvulsants -

Drugs for Seizures

SUPRAX ORAL

TABLET CHEWABLE 3

BANZEL 3 tetracycline hcl oral 2

BRIVIACT ORAL 3 PA tinidazole oral 1

carbamazepine er 1 tobramycin sulfate


mg/ml, 80 mg/2ml

1

carbamazepine oral 1

CELONTIN 3

trimethoprim oral 1 clobazam 1 PA

vancomycin hcl oral 1 diazepam rectal gel 10

mg, 20 mg 2

vandazole 1

9


diazepam rectal gel 2.5

mg 1

Antidementia Agents

- Drugs for

Alzheimer's Disease

and Dementia DILANTIN 3

DILANTIN INFATABS 3 donepezil hcl oral tablet

10 mg, 5 mg 1

divalproex sodium er 1

divalproex sodium oral 1 donepezil hcl oral tablet

23 mg 2 PA

EPIDIOLEX 3 PA

epitol 1 donepezil hcl oral tablet

dispersible 1

EQUETRO 3 QL

galantamine

hydrobromide 1

ethosuximide oral 1

felbamate 1 galantamine

hydrobromide er 1

FYCOMPA 3 PA

gabapentin oral 1 memantine hcl er 1

lamotrigine er 1 memantine hcl oral 1

lamotrigine oral 1 rivastigmine 1

levetiracetam er 1 rivastigmine tartrate 1

levetiracetam oral 1 Antidepressants

oxcarbazepine 1 amitriptyline hcl oral 1

OXTELLAR XR 3 amoxapine 1

PEGANONE 3 bupropion hcl er (sr) 1

phenobarbital oral 1 bupropion hcl er (xl)

oral tablet extended

release 24 hour 150

mg, 300 mg

1

phenobarbital sodium


mg/ml

1

phenytoin infatabs 1 bupropion hcl oral 1

phenytoin oral 1 chlordiazepoxide-

amitriptyline 1

phenytoin sodium

extended 1

citalopram

hydrobromide 1

primidone oral 1

clomipramine hcl oral 1 roweepra 1

desipramine hcl oral 1 roweepra xr 1

DESVENLAFAXINE

ER 3

subvenite 1

tiagabine hcl 1 desvenlafaxine

succinate er oral tablet

extended release 24

hour 100 mg, 50 mg

1

QL

topiramate er 1

topiramate oral 1

valproic acid oral 1

desvenlafaxine

succinate er oral tablet

extended release 24

hour 25 mg

1

vigabatrin 1

vigadrone 1

VIMPAT ORAL 3

zonisamide oral 1 doxepin hcl oral 1

10


duloxetine hcl oral

capsule delayed

release particles 20

mg, 30 mg, 60 mg

2

QL

venlafaxine hcl er oral

capsule extended

release 24 hour

1

VIIBRYD 3

EMSAM 3 QL VIIBRYD STARTER

PACK 3

escitalopram oxalate 1

fluoxetine hcl (pmdd) 1 Antiemetics - Drugs

for Nausea and

Vomiting

fluoxetine hcl oral

capsule 1

AKYNZEO ORAL 3 fluoxetine hcl oral

capsule delayed

release

1

ANZEMET 3 QL

aprepitant 1 QL

fluoxetine hcl oral

solution 1

CESAMET 3

compro 1 fluoxetine hcl oral tablet

10 mg 1

dimenhydrinate

injection 1

fluvoxamine maleate 1 dronabinol 1

fluvoxamine maleate er 1 droperidol injection 1

imipramine hcl oral 1 EMEND ORAL

SUSPENSION

RECONSTITUTED

3

imipramine pamoate 1

KHEDEZLA 3

maprotiline hcl 1 granisetron hcl oral 1 QL

MARPLAN 3 meclizine hcl oral tablet 1

mirtazapine oral 1 metoclopramide hcl

oral solution 1

nefazodone hcl 1

metoclopramide hcl

oral tablet 1

nortriptyline hcl oral 1

olanzapine-fluoxetine

hcl 1 QL ondansetron hcl oral

tablet 24 mg 1 QL

paroxetine hcl 1 ondansetron hcl oral

tablet 4 mg, 8 mg 1

paroxetine hcl er 1

perphenazine-

amitriptyline 1

ondansetron odt oral

tablet dispersible 4 mg 1

phenelzine sulfate oral 1 ondansetron odt oral

tablet dispersible 8 mg 1 QL

protriptyline hcl 1

sertraline hcl oral 1 perphenazine oral 1

tranylcypromine sulfate 1 prochlorperazine 1

trazodone hcl oral 1 prochlorperazine

maleate oral 1

trimipramine maleate

oral 1

scopolamine 1

venlafaxine hcl 1 QL SYNDROS 3 PA

trimethobenzamide hcl

oral 1

11


VARUBI 3 QL nystatin external 1

Antifungals nystatin mouth/throat 1

AVC VAGINAL 3 nystatin oral 1

BIO-STATIN ORAL

CAPSULE 3

nystatin-triamcinolone 1

nystop 1

bio-statin oral powder 1 ORAVIG 3 PA

ciclodan 1 oxiconazole nitrate 1 QL

ciclopirox 1 OXISTAT EXTERNAL

LOTION 3 QL

ciclopirox olamine

external 1

terbinafine hcl oral 1

ciclopirox treatment 1 terconazole 1

clotrimazole external 1 voriconazole oral 1

clotrimazole

mouth/throat 1

XOLEGEL 3

Antigout Agents CRESEMBA ORAL 5 PA

allopurinol oral 1 econazole nitrate

external 1

COLCHICINE ORAL 3

colchicine-probenecid 1 ERTACZO 3

COLCRYS 3 EXELDERM 3

febuxostat 1 fluconazole oral

suspension

reconstituted

1

MITIGARE 3

probenecid 1

fluconazole oral tablet

100 mg, 200 mg, 50 mg 1

Antimigraine Agents

AIMOVIG 2 PA fluconazole oral tablet

150 mg 1 QL almotriptan malate 2 PA; QL

dihydroergotamine

mesylate nasal 3 QL flucytosine oral 1

griseofulvin microsize

oral 1

eletriptan hydrobromide 1 PA; QL

EMGALITY 300 DOSE 2 PA griseofulvin

ultramicrosize 1

EMGALITY

SUBCUTANEOUS

SOLUTION AUTO-

INJECTOR

2

PA GYNAZOLE-1 3

itraconazole oral 1

ketoconazole external 1 ERGOMAR 3

ketoconazole oral 1 PA ergotamine-caffeine 1

MENTAX 3 frovatriptan succinate 2 PA; QL

miconazole 3 vaginal

suppository 1

MIGERGOT 3

naratriptan hcl 1 QL NAFTIN EXTERNAL

GEL 1 % 3

rizatriptan benzoate 1 QL

sumatriptan nasal 1 QL NOXAFIL ORAL 3 PA

nyamyc 1

12


sumatriptan succinate

oral 1 QL

BOSULIF 5 PA

BRAFTOVI 5 PA

sumatriptan succinate

refill 1 QL CABOMETYX 5 PA

CALQUENCE 5 PA sumatriptan succinate

subcutaneous 1 QL capecitabine 5

CAPRELSA 5 PA zolmitriptan oral 1 QL

COMETRIQ (100 MG

DAILY DOSE) 5 PA ZOMIG NASAL

SOLUTION 5 MG 3 QL

COMETRIQ (140 MG

DAILY DOSE) 5 PA Antimyasthenic

Agents

COMETRIQ (60 MG

DAILY DOSE) 5 PA GUANIDINE HCL 1

pyridostigmine bromide

er 1

COPIKTRA 5 PA

COTELLIC 5 PA pyridostigmine bromide

oral solution 1

cyclophosphamide oral 5

pyridostigmine bromide

oral tablet 60 mg 1

DAURISMO 5 PA

DROXIA 3

Antimycobacterials EMCYT 5

cycloserine oral 1 ERIVEDGE 5 PA

dapsone oral 1 ERLEADA 5 PA

ethambutol hcl oral 1 erlotinib hcl 5 PA

isoniazid oral 1 etoposide oral 5

PASER 3 exemestane 5

PRIFTIN 3 FARYDAK 5 PA

pyrazinamide oral 1 flutamide 5

rifabutin 1 fulvestrant 5

RIFAMATE 3 GILOTRIF 5 PA

rifampin oral 1 GLEOSTINE 5

RIFATER 3 HYCAMTIN ORAL 3

TRECATOR 3 hydroxyurea oral 1

Antineoplastics -

Drugs for Cancer

IBRANCE 5 PA

ICLUSIG 5 PA abiraterone acetate 5 PA

IDHIFA 5 PA AFINITOR 5 PA

imatinib mesylate 5 PA AFINITOR DISPERZ 5 PA

IMBRUVICA 5 PA ALECENSA 5 PA

INLYTA 5 PA ALUNBRIG 5 PA

IRESSA 5 PA anastrozole oral 1

JAKAFI 5 PA bexarotene 5 PA

KISQALI 200 DOSE 5 PA bicalutamide 5

13


KISQALI FEMARA 200

DOSE 5 PA

nilutamide 5

NINLARO 5 PA

KISQALI FEMARA 400

DOSE 5 PA ODOMZO 5 PA

PANRETIN 3 KISQALI FEMARA 600

DOSE 5 PA POMALYST 5 PA

POTELIGEO 5 PA LENVIMA 10 MG

DAILY DOSE 5 PA

REVLIMID 5

LENVIMA 12 MG

DAILY DOSE 5 PA

RUBRACA 5 PA

RYDAPT 5 PA

LENVIMA 14 MG

DAILY DOSE 5 PA SIKLOS 3 QL

SOLTAMOX 3 LENVIMA 18 MG

DAILY DOSE 5 PA SPRYCEL 5 PA

STIVARGA 5 PA LENVIMA 20 MG

DAILY DOSE 5 PA

SUTENT 5 PA

LENVIMA 24 MG

DAILY DOSE 5 PA

SYLATRON 5 PA

TABLOID 5

LENVIMA 4 MG DAILY

DOSE 5 PA TAFINLAR 5 PA

TAGRISSO 5 PA LENVIMA 8 MG DAILY

DOSE 5 PA TALZENNA 5 PA

tamoxifen citrate oral 1 letrozole oral 1

TARGRETIN

EXTERNAL 3

leucovorin calcium

injection solution

reconstituted 100 mg,

200 mg, 350 mg, 50 mg

1

TASIGNA 5 PA

temozolomide 5

leucovorin calcium oral 1 THALOMID 5

LEUKERAN 3 TIBSOVO 5 PA

LONSURF 5 PA toremifene citrate 5

LORBRENA 5 PA tretinoin oral 5

LYNPARZA 5 PA TYKERB 5 PA

LYSODREN 3 VENCLEXTA 5 PA

MATULANE 5 VENCLEXTA

STARTING PACK 5 PA

MEKINIST 5 PA

MEKTOVI 5 PA VERZENIO 5 PA

melphalan 1 VITRAKVI 5 PA

mercaptopurine oral 1 VIZIMPRO 5 PA

MESNEX ORAL 3 VOTRIENT 5

MYLERAN 3 XALKORI 5 PA

NERLYNX 5 PA XOSPATA 5 PA

NEXAVAR 5 PA XTANDI 5 PA

14


YONSA 5 PA ULESFIA 3

ZEJULA 5 PA Antiparkinson Agents

ZELBORAF 5 PA amantadine hcl oral 1

ZOLINZA 5 PA benztropine mesylate

oral 1

ZYDELIG 5 PA

bromocriptine mesylate

oral 1

ZYKADIA ORAL

CAPSULE 5 PA

carbidopa oral 1 ZYTIGA ORAL

TABLET 500 MG 5 PA

carbidopa-levodopa 1

Antiparasitics carbidopa-levodopa er 1

albendazole oral 1 QL carbidopa-levodopa-

entacapone 1

ALINIA 3

entacapone 1 ARAKODA 3

INBRIJA 3 PA atovaquone oral 1

NEUPRO 3 PA atovaquone-proguanil

hcl 1

pramipexole

dihydrochloride 1

BENZNIDAZOLE 3 PA

pramipexole

dihydrochloride er 1

chloroquine phosphate

oral 1

rasagiline mesylate oral 1 COARTEM 3

ropinirole hcl 1 crotan 1

ropinirole hcl er 1 DARAPRIM 3

selegiline hcl oral 1 EURAX EXTERNAL

CREAM 3

tolcapone 1

hydroxychloroquine

sulfate oral 1

trihexyphenidyl hcl 1

ZELAPAR 3

ivermectin oral 1 Antiplatelets

KRINTAFEL 3 aspirin-dipyridamole er 1

lindane 1 BRILINTA 3

malathion 1 cilostazol 1

mefloquine hcl 1 clopidogrel bisulfate

oral 1

NATROBA 3

NEBUPENT 3 dipyridamole oral 1

pentamidine isethionate 1 prasugrel hcl 1

permethrin external 1 ZONTIVITY 3

praziquantel oral 1 Antipsychotics -

Drugs for Mood

Disorders

primaquine phosphate 1

quinine sulfate oral 1 ABILIFY MAINTENA 3

spinosad 3 aripiprazole 1 QL

sulfurated lime 1 ARISTADA 3

15


ARISTADA INITIO 3 trifluoperazine hcl 1

chlorpromazine hcl


mg/2ml

1

VRAYLAR 3 PA

ziprasidone hcl 1 QL

ZYPREXA RELPREVV 3 chlorpromazine hcl oral 1

Antivirals clozapine oral tablet 1 QL

abacavir sulfate 1 clozapine oral tablet

dispersible 100 mg,

12.5 mg, 25 mg

1

QL abacavir sulfate-

lamivudine 1

abacavir-lamivudine-

zidovudine 1

clozapine oral tablet

dispersible 150 mg,

200 mg

1

acyclovir external 1

FANAPT 3 QL acyclovir oral 1

FANAPT TITRATION

PACK 3 QL

adefovir dipivoxil 5

APTIVUS 3

fluphenazine

decanoate injection 1

atazanavir sulfate 1

ATRIPLA 2 fluphenazine hcl oral 1

BARACLUDE ORAL

SOLUTION 5

haloperidol decanoate

intramuscular 1

BIKTARVY 3 haloperidol lactate 1

CIMDUO 3 haloperidol oral 1

COMPLERA 3 INVEGA SUSTENNA 3

CRIXIVAN 3 INVEGA TRINZA 3

DELSTRIGO 3 LATUDA 3 QL

DENAVIR 2 loxapine succinate 1

DESCOVY 3 NUPLAZID ORAL

CAPSULE 3

didanosine 1

DOVATO 3 NUPLAZID ORAL

TABLET 3 PA

EDURANT 3

olanzapine oral 1 QL efavirenz 1

paliperidone er 1 QL EMTRIVA 3

PERSERIS 3 entecavir 5

pimozide 1 EPIVIR HBV ORAL

SOLUTION 5

quetiapine fumarate 1 QL

EVOTAZ 3 quetiapine fumarate er 1 QL

famciclovir 1 REXULTI 3 PA

fosamprenavir calcium 1 RISPERDAL CONSTA 5

FUZEON 5 risperidone 1 QL

GENVOYA 3 SAPHRIS 3 PA; QL

INTELENCE 2 thioridazine hcl oral 1

INTRON A 5 thiothixene 1

16


INVIRASE 2 RIBASPHERE

RIBAPAK ORAL

TABLET THERAPY

PACK 200 & 400 MG

5

ISENTRESS 3

ISENTRESS HD 3

KALETRA ORAL

TABLET 2

ribasphere ribapak oral

tablet therapy pack 400

& 600 mg

5

lamivudine oral solution 1

lamivudine oral tablet

100 mg 5

ribavirin oral 5

rimantadine hcl 1

lamivudine oral tablet

150 mg, 300 mg 1

ritonavir 1

SELZENTRY 3 lamivudine-zidovudine 1

SOFOSBUVIR-

VELPATASVIR 5 PA LEXIVA ORAL

SUSPENSION 3

stavudine 1 lopinavir-ritonavir 1

STRIBILD 3 MAVYRET 5 PA

SYMFI 3 nevirapine 1

SYMFI LO 3 nevirapine er 1 PA

SYMTUZA 3 NORVIR ORAL

PACKET 2

tenofovir disoproxil

fumarate 1

NORVIR ORAL

SOLUTION 2

TIVICAY 3

TRIUMEQ 3 ODEFSEY 3

TRUVADA 2 oseltamivir phosphate

oral 1

TYBOST 3

PEGASYS 5 valacyclovir hcl oral 1

PEGASYS PROCLICK 5 valganciclovir hcl 1

PEGINTRON 5 VEMLIDY 5

PIFELTRO 3 VIDEX 3

PREVYMIS ORAL 5 VIRACEPT 3

PREZCOBIX 3 VIREAD ORAL

POWDER 2

PREZISTA 2

VIREAD ORAL

TABLET 150 MG, 200

MG, 250 MG

2

REBETOL 5

RELENZA DISKHALER 3

RESCRIPTOR 3 VOSEVI 5 PA

REYATAZ ORAL

PACKET 2

zidovudine 1

Anxiolytics - Drugs

for Anxiety

ribasphere 5

ribasphere ribapak oral

tablet 5

alprazolam er 1

ALPRAZOLAM

INTENSOL 1

alprazolam oral 1

17


alprazolam xr 1 MIRCERA INJECTION

SOLUTION

PREFILLED SYRINGE

100 MCG/0.3ML, 200

MCG/0.3ML, 50

MCG/0.3ML, 75

MCG/0.3ML

5

buspirone hcl oral 1

chlordiazepoxide hcl 1

clonazepam oral 1

clorazepate

dipotassium 1

MIRCERA INJECTION

SOLUTION

PREFILLED SYRINGE

150 MCG/0.3ML, 30

MCG/0.3ML

5

QL

diazepam intensol 1

diazepam oral 1

DORAL 3

estazolam 1

MOZOBIL 5 hydroxyzine hcl

intramuscular solution

50 mg/ml

1

NEULASTA 2

NEULASTA ONPRO 2

hydroxyzine hcl oral 1 NIVESTYM

INJECTION

SOLUTION

5

hydroxyzine pamoate

oral 1

lorazepam injection 1 NIVESTYM

INJECTION

SOLUTION

PREFILLED SYRINGE

2

lorazepam intensol 1

lorazepam oral 1

meprobamate 1 NPLATE 5

oxazepam 1 PROCRIT 5

quazepam 1 PROMACTA 5

triazolam 1 RETACRIT 5

Bipolar Agents -

Drugs for Mood

Disorders

TAVALISSE 5 PA

tranexamic acid oral 1 QL

UDENYCA 2 lithium 1

ZARXIO 2 lithium carbonate er 1

Cardiovascular

Agents - Drugs for

Heart and Circulation

Conditions

lithium carbonate oral 1

Blood Products /

Modifiers / Volume

Expanders - Drugs for

Bleeding Disorders

acebutolol hcl oral 1

acetazolamide oral

tablet 125 mg 1

aminocaproic acid oral 1

anagrelide hcl 1 acetazolamide sodium 1

ASTRINGYN 3 ALDACTAZIDE ORAL

TABLET 50-50 MG 3

EPOGEN 5

LEUKINE

INTRAVENOUS

SOLUTION

RECONSTITUTED 250

MCG

5

PA

aliskiren fumarate 1 QL

alprostadil injection 1

amiloride hcl oral 1

18


amiloride-

hydrochlorothiazide 1

clonidine 1

clonidine hcl oral 1

amiodarone hcl oral 1 colesevelam hcl 1

amlodipine besylate

oral 1

colestipol hcl 1

DEMSER 3 amlodipine besylate-

benazepril hcl 1

digitek 1

digox 1 amlodipine besylate-

valsartan 1

digoxin oral 1

AMLODIPINE-

ATORVASTATIN 1

DILATRATE-SR 3

diltiazem hcl er beads 1

amlodipine-olmesartan 1 diltiazem hcl er coated

beads 1

amlodipine-valsartan-

hctz 1

diltiazem hcl er oral

capsule extended

release 12 hour

1

atenolol oral 1

atenolol-chlorthalidone 1

diltiazem hcl er oral

capsule extended

release 24 hour 180

mg, 240 mg

1

atorvastatin calcium

oral 1

benazepril hcl oral 1

benazepril-


diltiazem hcl oral 1

dilt-xr 1 betaxolol hcl oral 1

disopyramide

phosphate 1

BIDIL 3 QL

bisoprolol fumarate 1 DIURIL 3

bisoprolol-


dofetilide 1

doxazosin mesylate

oral 1

bumetanide 1

BYSTOLIC 3 DUTOPROL 3

candesartan cilexetil 1 DYRENIUM 3

candesartan cilexetil-

hctz 1

EDARBI ORAL

TABLET 40 MG 3 PA; QL

captopril oral 1 EDARBI ORAL

TABLET 80 MG 3 PA

captopril-


EDARBYCLOR 3 PA

cartia xt 1 enalapril maleate oral 1

carvedilol 1 enalapril-


carvedilol phosphate er 1

chlorothiazide 1 ENTRESTO 2

chlorthalidone 1 ephedrine sulfate

injection 1

cholestyramine light 1

cholestyramine oral 1

choline fenofibrate 2

19


epinephrine pf injection

solution prefilled

syringe

1

isosorbide dinitrate er 1

isosorbide mononitrate 1

isosorbide mononitrate

er 1

eplerenone 1

eprosartan mesylate 1 isradipine 1

ethacrynic acid 1 labetalol hcl oral 1

ezetimibe 1 lisinopril oral 1

ezetimibe-simvastatin 1 PA lisinopril-


felodipine er 1

fenofibrate micronized

oral capsule 130 mg 2

LIVALO 3 PA

losartan potassium 1

fenofibrate micronized

oral capsule 134 mg,

200 mg, 43 mg, 67 mg

1

losartan potassium-hctz 1

lovastatin 1

matzim la 1 fenofibrate oral capsule 1

methyldopa 1 fenofibrate oral tablet

145 mg, 160 mg, 40

mg, 48 mg, 54 mg

1

methyldopa-


fenofibric acid oral

capsule delayed

release

2

metolazone 1

metoprolol succinate er 1

metoprolol tartrate oral

tablet 100 mg, 25 mg,

50 mg

1

fenofibric acid oral

tablet 1

FIBRICOR 3 METOPROLOL-HCTZ

ER 3

flecainide acetate 1

fluvastatin sodium 1 metoprolol-


fluvastatin sodium er 1

mexiletine hcl oral 1 fosinopril sodium 1

midodrine hcl 1 fosinopril sodium-hctz 1

minitran 1 furosemide oral 1

minoxidil oral 1 gemfibrozil oral 1

moexipril hcl 1 guanfacine hcl 1

MULTAQ 3 hydralazine hcl oral 1

nadolol oral 1 hydrochlorothiazide

oral 1

niacin er

(antihyperlipidemic) 1

indapamide 1

nicardipine hcl oral 1 irbesartan 1

nifedipine er 1 irbesartan-


nifedipine er osmotic

release 1

ISORDIL TITRADOSE

ORAL TABLET 40 MG 3

nifedipine oral 1

isosorbide dinitrate 1 nimodipine oral 1

20


nisoldipine er 1 propranolol hcl oral 1

NITRO-BID 3 propranolol-hctz 1

NITRO-DUR

TRANSDERMAL

PATCH 24 HOUR 0.3

MG/HR, 0.8 MG/HR

3

quinapril hcl 1

quinapril-


quinidine gluconate er 1 nitroglycerin sublingual 1

quinidine sulfate 1 nitroglycerin

transdermal 1

ramipril 1

ranolazine er 1 nitroglycerin

translingual 1

RECTIV 3

NITROMIST 3 REPATHA 3 PA; QL

nitro-time 1 REPATHA

PUSHTRONEX

SYSTEM

3

PA NORPACE CR 3

NYMALIZE 3 REPATHA

SURECLICK 3 PA; QL olmesartan medoxomil

oral tablet 20 mg, 40

mg

1

rosuvastatin calcium 2

simvastatin oral tablet

10 mg, 20 mg, 40 mg, 5

mg

1

olmesartan medoxomil

oral tablet 5 mg 1 QL

olmesartan medoxomil-

hctz oral tablet 20-12.5

mg

1

QL simvastatin oral tablet

80 mg 1 PA

sorine 1 olmesartan medoxomil-

hctz oral tablet 40-12.5

mg, 40-25 mg

1

sotalol hcl (af) 1

sotalol hcl oral 1

olmesartan-amlodipine-

hctz 1

spironolactone oral 1

spironolactone-hctz 1 omega-3-acid ethyl

esters 1

taztia xt 1

TEKTURNA HCT 3 QL pacerone 1

telmisartan 1 QL pentoxifylline er 1

telmisartan-amlodipine 1 perindopril erbumine 1

telmisartan-hctz 1 QL phenoxybenzamine hcl

oral 1

timolol maleate oral 1

pindolol 1 torsemide 1

PRALUENT 3 PA trandolapril 1

pravastatin sodium 1 trandolapril-verapamil

hcl er 1

prazosin hcl oral 1

triamterene-hctz 1 prevalite 1

valsartan oral tablet

160 mg, 320 mg, 40 mg 1

propafenone hcl 1

propafenone hcl er 1

propranolol hcl er 1

21


valsartan oral tablet 80

mg 1 QL

methylphenidate hcl er


release 10 mg, 18 mg,

20 mg, 27 mg, 36 mg,

54 mg

2

QL valsartan-


verapamil hcl er 1 methylphenidate hcl er


release 24 hour

2

QL verapamil hcl oral 1

Central Nervous

System Agents -

Drugs for Attention

Deficit Disorder

methylphenidate hcl

oral tablet 1 QL

methylphenidate hcl

oral tablet chewable 1 QL amphetamine-

dextroamphetamine 1 QL

QUILLIVANT XR 3 QL amphetamine-

dextroamphetamine er 2 QL VYVANSE ORAL

CAPSULE 10 MG 3 PA

atomoxetine hcl 1 QL VYVANSE ORAL

CAPSULE 20 MG, 30

MG, 40 MG, 50 MG, 60

MG, 70 MG

3

PA; QL

DAYTRANA 3 PA; QL

dexmethylphenidate hcl 1

dexmethylphenidate hcl

er oral capsule

extended release 24

hour 10 mg, 20 mg, 25

mg, 35 mg, 5 mg

1

QL

VYVANSE ORAL

TABLET CHEWABLE 3 PA

zenzedi oral tablet 10

mg, 5 mg 1 QL

dexmethylphenidate hcl

er oral capsule

extended release 24

hour 15 mg, 30 mg, 40

mg

2

QL

Central Nervous

System Agents -

Drugs for Multiple

Sclerosis

AUBAGIO 5 dextroamphetamine

sulfate er 2 QL AVONEX PEN 5

AVONEX PREFILLED 5 dextroamphetamine

sulfate oral solution 1

BETASERON 5

dextroamphetamine

sulfate oral tablet 1 QL

COPAXONE 5

dalfampridine er 5 PA

guanfacine hcl er 1 PA GILENYA 5

metadate er 2 QL glatiramer acetate 5

methamphetamine hcl 1 QL glatopa 5


(cd) 2 QL TECFIDERA 5

Central Nervous

System Agents -

Miscellaneous


(la) oral capsule

extended release 24

hour 10 mg, 20 mg, 30

mg, 40 mg

2

QL

caffeine citrate oral 1

LYRICA ORAL

SOLUTION 3

NUEDEXTA 3 PA

22


pregabalin oral capsule 1 PA pilocarpine hcl oral 1

pregabalin oral solution 1 prevident mouth/throat 1

riluzole 5 SALIVAMAX 3

SAVELLA 3 sf 1

SAVELLA TITRATION

PACK 3

sf 5000 plus 1

sodium fluoride 5000

plus 1

tetrabenazine 5 PA

TIGLUTIK 3 sodium fluoride dental 1

Dental and Oral

Agents - Drugs for

Mouth and Throat

Conditions

topex topical anesthetic 1

triamcinolone acetonide

mouth/throat 1

Dermatological

Agents - Drugs for

Skin Conditions

ARESTIN 3

BOCASAL 3

cavarest 1 acitretin 1

cevimeline hcl 1 ACZONE EXTERNAL

GEL 7.5 % 3

chlorhexidine gluconate

mouth/throat 1

adapalene external

cream 1

clinpro 5000 1

adapalene external gel 1 DEBACTEROL 3

adapalene-benzoyl

peroxide 1

denta 5000 plus 1

dentagel 1 ala-cort 1

easygel 1 alclometasone

dipropionate 1

fluoridex 1

fluoridex daily renewal 1 ALTRENO 3

fluoridex enhanced

whitening 1

ALUMINUM

CHLORIDE

ANHYDROUS

3

fluoridex sensitivity

relief 1

ALUMINUM

CHLORIDE

HEXAHYDRATE

POWDER

3

lidocaine hcl

mouth/throat 1

lidocaine viscous

mouth/throat solution 2

%

1

amcinonide 1

ammonium lactate

external 1

MUCOSITISRX 3

NAFRINSE DAILY

ACIDULATED 3

amnesteem 1

ANACAINE 3

neutral sodium fluoride 1 APEXICON E 3

NEUTRASAL 3 arzol silver nit

applicators 1

oralone 1

paroex 1 AVAGE 3

periogard 1 avar cleanser 1

23


AVAR LS CLEANSER 3 CARAC 3

avar-e emollient 1 cem-urea 1

avar-e green 1 cerovel 1

AVAR-E LS 3 claravis 1

avita 1 clindacin etz external

swab 1

azelaic acid external 1

clindacin-p 1 AZELEX 3

clindamycin phosphate-

benzoyl peroxide 1

BENSAL HP 3

benzepro 1 clindamycin phosphate

external foam 1

benzepro creamy wash 1

benzepro foaming

cloths 1


external lotion 1

benzepro short contact 1 clindamycin phosphate

external solution 1

BENZIQ 3

BENZIQ LS 3 clindamycin phosphate

external swab 1

benzoin 1

CLINDAMYCIN

PHOSPHATE GEL 1 %

EXTERNAL

3

benzoin compound 1

BENZOYL PEROX-

HYDROCORTISONE 3


gel 1 % external 1

benzoyl peroxide

external foam 9.8 % 1

clindamycin-tretinoin 1 benzoyl peroxide-

erythromycin 1

clobetasol prop

emollient base 1

beser external lotion 1 clobetasol propionate e 1

betamethasone

dipropionate aug 1

clobetasol propionate

emulsion 1

betamethasone

dipropionate external 1

clobetasol propionate

external 1

betamethasone

valerate external 1

clodan external

shampoo 1

bp 10-1 1 CLODERM 3

bp foam 1 CLODERM PUMP 3

bp wash external liquid

2.5 %, 7 % 1

clotrimazole-

betamethasone 1

CALAMINE 3 coal tar external 1

calcipotriene 1 CONDYLOX 3

calcipotriene-betameth

diprop 1

CORDRAN

EXTERNAL TAPE 3

calcitrene 1 CORTISPORIN 3

calcitriol external 1 dapsone external 1

CAPEX 3 DESONATE 3

24


desonide external 1 FLUOROURACIL

EXTERNAL CREAM

0.5 %

3

desoximetasone

external cream 1

fluorouracil external

cream 5 % 1

desoximetasone

external gel 1

fluorouracil external

solution 1

desoximetasone

external ointment 1

flurandrenolide external

cream 1

diclofenac sodium

transdermal gel 3 % 3 PA; QL

flurandrenolide external

lotion 1

diflorasone diacetate 1

doxepin hcl external 3 PA; QL fluticasone propionate

external 1

DRITHO-CREME HP 3

DUPIXENT

SUBCUTANEOUS

SOLUTION

PREFILLED SYRINGE

300 MG/2ML

5

PA

GENADUR EXTERNAL 3

glycolic acid solution 1

GORDOFILM 3

GORDONS UREA

EXTERNAL

OINTMENT 40 %

3

ENSTILAR 3

EPIFOAM 3

grafco silver nit

applicator 1

ery 1

erythromycin external 1 halobetasol propionate

external cream 1

EUCRISA 3 PA

FABIOR 3 halobetasol propionate

external ointment 1

fluocinolone acetonide

body 1

HALOG 3


external 1

hydrocortisone butyr

lipo base 1


scalp 1

hydrocortisone butyrate

external cream 1

fluocinonide emulsified

base 1


external ointment 1

fluocinonide external

cream 0.05 % 1


external solution 1


cream 0.1 % 1 QL hydrocortisone external

cream 1 %, 2.5 % 1


gel 1

hydrocortisone external

lotion 2.5 % 1


ointment 1

hydrocortisone external

ointment 1 %, 2.5 % 1


solution 1

hydrocortisone valerate 1

HYLATOPIC PLUS

EXTERNAL LOTION 3

FLUOROPLEX 2

25


HYLIRA EXTERNAL

LOTION 3

rosadan external gel 1

ROSADAN EXTERNAL

KIT 0.75 % (GEL) 3

imiquimod external 1

isotretinoin oral 1 salicylic acid external

cream 1

KERALYT SCALP 3

salicylic acid external

foam 1

lactic acid e 1

lactic acid external 1 salicylic acid external

gel 1

LATRIX XM 3

LEVULAN KERASTICK 3 salicylic acid external

lotion 1

methoxsalen oral 1

methoxsalen rapid 1 salicylic acid external

shampoo 1

methyl salicylate

external liquid 1

salicylic acid external

solution 26 % 1

metronidazole external 1

salicylic acid-cleanser 1 mometasone furoate

external 1

salimez 1

myorisan 1 SANTYL 3

NEOSALUS

EXTERNAL LOTION 3

selenium sulfide

external lotion 1

NEO-SYNALAR

EXTERNAL CREAM 3

selenium sulfide

external shampoo 2.25

%

1

neuac external gel 1

sodium hyaluronate

external 1

nolix 1

NUCORT 3 sodium sulfacetamide 1

OVACE PLUS

EXTERNAL CREAM 3

sodium sulfacetamide

wash 1

OVACE PLUS

EXTERNAL

SHAMPOO

3

SOOLANTRA 3

sss 10-5 external

cream 1

PICATO 3

sulfacetamide sodium

(acne) 1

pimecrolimus 1

podocon 1 sulfacetamide sodium

external liquid 1

podofilox external 1

pr benzoyl peroxide

wash 1

sulfacetamide sodium-

sulfur external cream

10-2 %, 10-5 %

1

pramox 1

prednicarbate 1 sulfacetamide sodium-

sulfur external emulsion 1

PSORCON 1


sulfur external liquid

10-2 %, 9-4 %

1

pyrogallic acid 1

REGRANEX 3 PA

rosadan external cream 1

26



sulfur external lotion

10-5 %

1

urea in zn undecyl-

lactic acid 1

urea-c40 1


sulfur external pad 1

uremez-40 1

VANOXIDE-HC 3 sulfacetamide sodium-

sulfur external

suspension 10-5 %

1

VEREGEN 3

XERAC AC 3

sulfacetamide sod-

sulfur wash 1

ZACLIR CLEANSING 3

zenatane 1

sulfacetamide-sulfur in

urea 1

Diabetes -

Antidiabetic Agents

sulfamez wash 1 acarbose oral 1

SUMADAN 3 BYDUREON 2

SUMAXIN CP 3 BYDUREON BCISE

AUTOINJECTOR 2

TACLONEX

EXTERNAL

SUSPENSION

3

BYETTA 10 MCG PEN 2

BYETTA 5 MCG PEN 2 tacrolimus external 1

glimepiride 1 tazarotene external 1

glipizide er 1 TAZORAC EXTERNAL

CREAM 0.05 % 3

glipizide ir 1

glipizide xl 1 TAZORAC EXTERNAL

GEL 3

glipizide-metformin hcl 1

TEXACORT 3 glyburide micronized 1

TOLAK 3 glyburide oral 1

tretinoin (emollient) 1 glyburide-metformin 1

tretinoin external 1 GLYXAMBI 2

tretinoin microsphere 1 INVOKAMET 2 PA

tretinoin microsphere

pump 1

INVOKAMET XR 2 PA

INVOKANA 2 PA

triamcinolone acetonide

external 1

JANUMET 2 PA

JANUMET XR 2 PA TRI-CHLOR 3

JANUVIA 2 PA triderm 1

JARDIANCE 2 PA turpentine external 1

JENTADUETO 2 PA umecta mousse 1

JENTADUETO XR 2 PA urea external cream 40

%, 45 % 1

metformin hcl er 1

METFORMIN HCL

ORAL SOLUTION 3

urea external lotion 1

urea external

suspension 1

metformin hcl oral

tablet 1

urea hydrating 1

27


miglitol 1 ACCU-CHEK SOFT

TOUCH LANCETS 2

nateglinide 1

ACCU-CHEK

SOFTCLIX LANCET

DEVICE KIT

2

OZEMPIC 2

pioglitazone hcl 1

pioglitazone hcl-

glimepiride 1

ACCU-CHEK

SOFTCLIX LANCETS 2

pioglitazone hcl-

metformin hcl 1

AUTOLET II

CLINISAFE 3

repaglinide 1 CARETOUCH

LANCING/EJECTOR 3

repaglinide-metformin

hcl 1

DIATHRIVE LANCING

DEVICE 3

RIOMET 3

SYMLINPEN 120 3 GENTEEL LANCING

KIT (BLUE) 3

SYMLINPEN 60 3

INPEN 100-BLUE-

LILLY 3

SYNJARDY 2 PA

SYNJARDY XR 2 PA INPEN 100-BLUE-

NOVO 3

tolbutamide 1

TRADJENTA 2 PA INPEN 100-GRAY-

LILLY 3

VICTOZA 2

Diabetes - Glucose

Monitoring

INPEN 100-GREY-

NOVO 3

ACCU-CHEK AVIVA IN

VITRO 2

INPEN 100-PINK-

LILLY 3

ACCU-CHEK AVIVA

PLUS TEST STRIPS 2

INPEN 100-PINK-

NOVO 3

ACCU-CHEK

COMPACT PLUS

TEST STRIPS

2

LANCETS 3

MICROLET NEXT

LANCING DEVICE 3

ACCU-CHEK

FASTCLIX LANCET

KIT

2

MULTI-LANCET

DEVICE 2 3

NOVOPEN ECHO 3 ACCU-CHEK

FASTCLIX LANCETS 2

ONETOUCH DELICA

LANCING DEV 2

ACCU-CHEK GUIDE

TEST STRIPS 2

ONETOUCH DELICA

PLUS LANCING 3

ACCU-CHEK

MULTICLIX LANCET

DEVICE KIT

2

ONETOUCH ULTRA

BLUE TEST STRIPS 2

ONETOUCH VERIO

TEST STRIPS 2

ACCU-CHEK

MULTICLIX LANCETS 2

RELION LANCET

DEVICES 30G 3

ACCU-CHEK

SMARTVIEW TEST

STRIPS

2

UNISTIK 2 EXTRA 3

28


UNISTIK 2 SUPER 3 HUMALOG KWIKPEN 3

V-GO 20 3 HUMALOG MIX 50/50

KWIKPEN 3

V-GO 30 3

HUMALOG MIX 50/50

VIAL 3

V-GO 40 3

VIVAGUARD

LANCING DEVICE 3

HUMALOG MIX 75/25

KWIKPEN 3

Diabetes - Glycemic

Agents

HUMALOG MIX 75/25

VIAL 3

GLUCAGEN HYPOKIT 3 HUMALOG U-100

JUNIOR KWIKPEN 3

GLUCAGON

EMERGENCY 3

HUMALOG U-100 VIAL

AND CARTRIDGE 3

PROGLYCEM 3

Diabetes - Insulins HUMULIN 70/30

KWIKPEN 3

ADMELOG 3

ADMELOG

SOLOSTAR 3

HUMULIN 70/30 VIAL 3

HUMULIN N KWIKPEN 3

APIDRA SOLOSTAR 3 HUMULIN N VIAL 3

APIDRA VIAL 3 HUMULIN R U-500

KWIKPEN 3

BD AUTOSHIELD DUO

PEN NEEDLES 3

HUMULIN R U-500

VIAL

(CONCENTRATED)

3

BD ULTRA-FINE

INSULIN SYRINGES 3

BD ULTRA-FINE PEN

NEEDLES 3

HUMULIN R VIAL 3

INSULIN LISPRO 3

COMFORT EZ MICRO

PEN NEEDLES 3

INSULIN PEN

NEEDLES 29G X

12.7MM , 29G X 12MM

, 30G X 8 MM , 31G X

5 MM , 31G X 6 MM ,

31G X 8 MM , 32G X 4

MM , 32G X 6 MM ,

33G X 4 MM

3

COMFORT EZ SHORT

PEN NEEDLES 3

DROPSAFE SAFETY

PEN NEEDLES 31G X

8 MM

3

EASY TOUCH

SAFETY PEN

NEEDLES

3

GOODSENSE

CLICKFINE PEN

NEEDLE

3

GOODSENSE PEN

NEEDLE PENFINE 3

HEALTHWISE

INSULIN SYR/NEEDLE 3

HEALTHWISE

MICRON PEN

NEEDLES

3

29


INSULIN SYRINGES

28G X 1/2" 0.5 ML,

28G X 1/2" 1 ML, 29G

0.3 ML, 29G X 1/2" 0.3

ML, 29G X 1/2" 0.5 ML,

29G X 1/2" 1 ML, 30G

X 1/2" 0.3 ML, 30G X

1/2" 0.5 ML, 30G X 1/2"

1 ML, 30G X 5/16" 0.3

ML, 30G X 5/16" 0.5

ML, 30G X 5/16" 1 ML,

31G X 15/64" 0.3 ML,

31G X 15/64" 0.5 ML,

31G X 5/16" 0.3 ML,

31G X 5/16" 0.5 ML,

31G X 5/16" 1 ML, 32G

X 5/16" 0.5 ML, 32G X

5/16" 1 ML

3

NOVOLIN R VIAL 2

NOVOLOG FLEXPEN 2

NOVOLOG MIX 70/30

FLEXPEN 2

NOVOLOG MIX 70/30

VIAL 2

NOVOLOG PENFILL 2

NOVOLOG U-100 VIAL 2

NOVOTWIST PEN

NEEDLE 3

PREVENT SAFETY

PEN NEEDLES 3

SECURESAFE

INSULIN SYRINGE 3

TOUJEO MAX

SOLOSTAR 2

LANTUS SOLOSTAR 2

TOUJEO SOLOSTAR 2 LANTUS U-100 VIAL 2

TRESIBA 2 LEVEMIR U-100

FLEXTOUCH 2

TRESIBA

FLEXTOUCH 2

LEVEMIR U-100 VIAL 2

TRUEPLUS 5-BEVEL

PEN NEEDLES 3

MAXICOMFORT II

PEN NEEDLE 3

ULTRACARE PEN

NEEDLES 3

MAXI-COMFORT

SAFETY PEN NEEDLE 3

Electrolytes / Minerals

/ Metals / Vitamins

MAXICOMFORT SYR

27G X 1/2" 3

alcohol 1 NOVOFINE

AUTOCOVER PEN

NEEDLE

3

argyle sterile saline 1

argyle sterile water 1

NOVOFINE PEN

NEEDLE 3

CALCIFOL 3

CALCIUM-FOLIC ACID

PLUS D 1

NOVOFINE PLUS PEN

NEEDLE 3

CARBAGLU 5 PA NOVOLIN 70/30

FLEXPEN 2

CHEMET 3

cyanocobalamin


mcg/ml

1

NOVOLIN 70/30

FLEXPEN RELION 2

NOVOLIN 70/30

RELION 2

cytra k crystals 1

d3 high potency oral

capsule 1

NOVOLIN 70/30 VIAL 2

NOVOLIN N RELION 2 d3 super strength 1

NOVOLIN N VIAL 2 d3 vitamin 1

NOVOLIN R RELION 2

30


decara oral capsule

10000 unit, 50000 unit 1

K-PHOS 3

K-PHOS NO 2 3

DECARA ORAL

CAPSULE 25000 UNIT 2

k-prime 1

lactated ringers

irrigation 1

deferasirox 5 PA

dehydrated alcohol 1 levocarnitine oral

solution 1

EFFER-K ORAL

TABLET

EFFERVESCENT 10

MEQ, 20 MEQ

3

levocarnitine oral tablet 1

ludent 1

MAGNEBIND 400 3 effer-k oral tablet

effervescent 25 meq 1

MAGNESIUM

CARBONATE HEAVY 3

elite-ob 1

MAGNESIUM

CARBONATE

POWDER

3

ergocalciferol oral

capsule 1

FERRIPROX 5 PA MIFEPREX 3

ferrous sulfate oral

solution 1

mifepristone 1

M-NATAL PLUS 2 FLUORABON 3

multi prenatal 1 fluoritab 1

n-acetyl-l-cysteine oral 1 FLURA-DROPS 3

nafrinse 1 folic acid injection 1

nafrinse drops 1 folic acid oral tablet 1

NASCOBAL 2 GALZIN 3

NESTABS 2 gnp folic acid 1

ORACIT 3 hydroxocobalamin

acetate 1

phospha 250 neutral 1

iodine strong oral 1 phosphorous 1

JADENU 5 PA phospho-trin 250

neutral 1

JADENU SPRINKLE 5 PA

physiolyte 1 JYNARQUE ORAL

TABLET 3

physiosol irrigation 1

kids first vitamin d3

gummies 1

pnv prenatal plus

multivit+dha 1

kionex 1 pot bicarb-pot chloride 1

klor-con 1 potassium bicarbonate

oral 1

klor-con 10 1

potassium chloride crys

er 1

klor-con m10 1

KLOR-CON M15 3 potassium chloride er 1

klor-con m20 1 potassium chloride oral 1

klor-con sprinkle 1 potassium citrate er 1

klor-con/ef 1

31


potassium citrate-citric

acid 1

tryptophan oral 1

VELTASSA 3 QL

PREMESISRX 2 virt-phos 250 neutral 1

PRENAISSANCE 2 VITAFOL-OB+DHA 2

PRENATA 2 vitamin d

(cholecalciferol) oral

capsule 400 unit

1

prenatal multi +dha oral

capsule 27-0.8-228 mg 1

prenatal oral tablet 27-

0.8 mg, 27-1 mg 1

vitamin d

(cholecalciferol) oral

tablet 1000 unit

1

prenatal oral tablet 28-

0.8 mg 2

vitamin d

(ergocalciferol) oral

capsule 50000 unit

1

prenatal plus iron 1

RELNATE DHA 2 vitamin d3 oral capsule

10000 unit, 2000 unit,

5000 unit

1

ringers irrigation 1

saline bacteriostatic 1

SALINE-PHENOL 3 vitamin d3 oral tablet

1000 unit, 2000 unit,

400 unit, 5000 unit

1

SAMSCA 3

SELECT-OB ORAL

TABLET CHEWABLE

29-1 MG

2

vp-pnv-dha 1

Gastrointestinal

Agents - Drugs for

Acid Reflux and Ulcer

sm vitamin d3 oral

capsule 5000 unit 1

CARAFATE ORAL

SUSPENSION 3

sod citrate-citric acid 1

sodium chloride

bacteriostatic 1

cimetidine hcl 1

cimetidine oral tablet

300 mg, 400 mg, 800

mg

1

sodium chloride

injection solution 0.9 % 1

sodium chloride

irrigation 1

famotidine oral

suspension

reconstituted

1

sodium fluoride oral 1

sodium polystyrene

sulfonate oral 1

famotidine oral tablet

20 mg, 40 mg 1

sps 1 lansoprazole oral

capsule delayed

release

2

sterile water for

irrigation 1

taron-crystals 1 lansoprazole oral tablet

dispersible 1

tis-u-sol 1

misoprostol oral 1 TRICARE PRENATAL

DHA ONE 2

nizatidine 2

tricitrates 1 omeprazole oral

capsule delayed

release

1

trientine hcl 1

trinate 1

32


pantoprazole sodium

oral 1

gavilyte-n with flavor

pack 1

rabeprazole sodium

oral tablet delayed

release

2

generlac 1

GIALAX 3

glycopyrrolate injection

solution 0.2 mg/ml 1

ranitidine hcl injection 1

ranitidine hcl oral syrup 1 glycopyrrolate oral

tablet 1 mg, 2 mg 1

ranitidine hcl oral tablet

150 mg, 300 mg 1

GLYCOPYRROLATE

ORAL TABLET 1.5 MG 1

sucralfate oral tablet 1

Gastrointestinal

Agents - Drugs for

Bowel, Intestine and

Stomach Conditions

GOLYTELY ORAL

SOLUTION

RECONSTITUTED

227.1 GM

3

alosetron hcl 1 hyoscyamine sulfate er 1

AMITIZA 3 PA hyoscyamine sulfate

oral 1

amoxicill-clarithro-

lansopraz 1

hyoscyamine sulfate sl 1

atropine sulfate

injection solution

prefilled syringe 0.5

mg/5ml, 1 mg/10ml

1

hyoscyamine sulfate

sublingual 1

KRISTALOSE 3

lactulose 1 belladonna alkaloids-

opium 1

lactulose

encephalopathy 1

cascara sagrada oral

fluid extract 1

LEVSIN INJECTION 3

LINZESS 2 PA CHENODAL 3

loperamide hcl oral

capsule 1

CHOLBAM 5 PA

COLYTE WITH

FLAVOR PACKS 3

methscopolamine

bromide oral 1

constulose 1 MOVANTIK 2 PA

cromolyn sodium oral 1 MOVIPREP 3

CUVPOSA 3 nulev 1

dicyclomine hcl

intramuscular 1

oscimin 1

oscimin sr 1 dicyclomine hcl oral 1

OSMOPREP 3 diphenoxylate-atropine 1

peg 3350/electrolytes 1 ed-spaz 1

peg 3350-kcl-na bicarb-

nacl 1

ENTEREG 3

enulose 1 peg-3350/electrolytes 1

gavilyte-c 1 peg-prep 1

gavilyte-g 1 PLENVU 3

gavilyte-h 1

33


PREPOPIK 3 AURYXIA 3

propantheline bromide

oral 1

bethanechol chloride

oral 1

PYLERA 3 calcium acetate (phos

binder) 1

RELISTOR

SUBCUTANEOUS 5 PA; QL

CAVERJECT 3 PA; QL

SUPREP BOWEL

PREP KIT 3

CAVERJECT

IMPULSE 3 PA; QL

SYMAX DUOTAB 3 QL darifenacin

hydrobromide er 1 PA

symax-sr 1

DEPEN TITRATABS 3 SYMPROIC 2 PA

D-PENAMINE 3 trilyte 1

EDEX 3 PA; QL ursodiol oral 1

ELMIRON 2 XERMELO 5 PA

FEM PH 3 Genetic or Enzyme

Disorder - Drugs for

Replacement,

Modification,

Treatment

flavoxate hcl 1

glycine irrigation 1

glycine urologic 1

hyophen 1 CERDELGA 5 PA

INTRAROSA 3 PA CREON 2

lanthanum carbonate 1 CYSTADANE 3

LITHOSTAT 3 CYSTAGON 3

me/naphos/mb/hyo1 1 ELELYSO 5 PA

MUSE 3 PA; QL KUVAN ORAL

PACKET 100 MG 5 PA

MYRBETRIQ 3 PA

KUVAN ORAL TABLET

SOLUBLE 5 PA

oxybutynin chloride er 1

oxybutynin chloride oral 1

miglustat 5 penicillamine oral 1

NITYR 5 PA phenazo oral tablet 200

mg 1

PALYNZIQ 5 PA

sodium phenylbutyrate

oral tablet 1

phenazopyridine hcl

oral tablet 100 mg, 200

mg

1

STRENSIQ 5 PA

PHOSLYRA 3 SUCRAID 3 PA

phosphasal 1 ZENPEP 2

RENACIDIN 3 Genitourinary Agents

- Drugs for Bladder,

Genital and Kidney

Conditions

sevelamer carbonate 1

sevelamer hcl 1

sildenafil citrate oral

tablet 100 mg, 25 mg,

50 mg

1

PA; QL acetic acid irrigation 1

aminoacetic acid 1

34


solifenacin succinate 1 PA DEXAMETHASONE

INTENSOL 1

tadalafil oral 1 PA; QL

dexamethasone oral

elixir 1

THIOLA 3

tolterodine tartrate 1 dexamethasone oral

solution 1

tolterodine tartrate er 1

trospium chloride 1 dexamethasone oral

tablet 1

trospium chloride er 1

uretron d/s 1 dexamethasone sod

phosphate pf 1

uribel 1

dexamethasone

sodium phosphate

injection

1

urin ds 1

uro-458 1

uro-mp 1 fludrocortisone acetate

oral 1

uryl 1

ustell 1 hydrocortisone oral 1

uticap 1 MEDROL ORAL

TABLET 2 MG 3

utira-c 1

methylprednisolone

acetate injection

suspension 40 mg/ml,

80 mg/ml

1

utrona-c 1

vilamit mb 1

vilevev mb 1

Genitourinary Agents

- Drugs for Prostate

Conditions

methylprednisolone

oral 1

prednisolone oral

solution 1

alfuzosin hcl er 1

CARDURA XL 3 prednisolone sodium

phosphate oral 1

dutasteride oral 1

PREDNISONE

INTENSOL 1

dutasteride-tamsulosin

hcl 1

prednisone oral 1 finasteride oral tablet 5

mg 1

Hormonal Agents -

Men's Health

silodosin 1

ANADROL-50 3 tamsulosin hcl 1

danazol oral 1 terazosin hcl 1

methyltestosterone oral 1 Hormonal Agents -

Adrenal

oxandrolone oral 1

betamethasone sod

phos & acet injection

suspension 6 (3-3)

mg/ml

1

TESTOSTERONE

CYPIONATE & PROP 2 PA

TESTOSTERONE

CYPIONATE

INJECTION

2

PA

cortisone acetate oral 1

deltasone 1 testosterone cypionate

intramuscular 2 PA

35


TESTOSTERONE

ENANTHATE

INJECTION

2

PA

leuprolide acetate

injection 5

LUPANETA PACK 5

testosterone enanthate

intramuscular 2 PA LUPRON DEPOT (1-

MONTH) 5

TESTOSTERONE

PROPIONATE

INJECTION

2

PA

LUPRON DEPOT (3-

MONTH) 5

LUPRON DEPOT (4-

MONTH)

INTRAMUSCULAR KIT

30MG

5

testosterone

transdermal gel 20.25

mg/1.25gm (1.62%),

20.25 mg/act (1.62%),

40.5 mg/2.5gm (1.62%)

1

PA

LUPRON DEPOT (6-

MONTH)

INTRAMUSCULAR KIT

45MG

5

Hormonal Agents -

Osteoporosis

OSPHENA 3 PA LUPRON DEPOT-PED

(1-MONTH) 5 PA

raloxifene hcl 1

Hormonal Agents -

Parathyroid

LUPRON DEPOT-PED

(3-MONTH) 5 PA

cinacalcet hcl 5 MENOPUR 5 PA

Hormonal Agents -

Pituitary

NORDITROPIN

FLEXPRO

SUBCUTANEOUS

SOLUTION 10

MG/1.5ML, 30

MG/3ML, 5 MG/1.5ML

5

PA cabergoline 1

CETROTIDE 5 PA

chorionic gonadotropin

intramuscular 5 PA

octreotide acetate 5

desmopressin ace

spray refrig 1

ORILISSA 3 PA; QL

OVIDREL 5 PA desmopressin acetate

injection 1

pregnyl 5 PA

SANDOSTATIN LAR

DEPOT 5

desmopressin acetate

oral 1

SIGNIFOR 5 desmopressin acetate

spray 1

SOMATULINE DEPOT 5

EGRIFTA 5 PA SOMAVERT 5

ELIGARD 5 STIMATE 3

FOLLISTIM AQ 5 PA SUPPRELIN LA 5 PA

ganirelix acetate 5 PA SYNAREL 5

GONAL-F 5 PA TRELSTAR MIXJECT 5

GONAL-F RFF 5 PA Hormonal Agents -

Prostaglandins

GONAL-F RFF

REDIJECT 5 PA

KORLYM 5 PA

INCRELEX 5 PA

36


Hormonal Agents -

Sex Hormones and

Birth Control

cryselle-28 1

cyclafem 1/35 1

cyclafem 7/7/7 1 afirmelle 1

cyred 1 altavera 1

cyred eq 1 alyacen 1/35 1

dasetta 1/35 1 alyacen 7/7/7 1

dasetta 7/7/7 1 amabelz 1

daysee 1 amethia 1

deblitane 1 amethia lo 1

delyla 1 amethyst 1

DEPO-ESTRADIOL 3 apri 1

DEPO-SUBQ

PROVERA 104 3 QL aranelle 1

ashlyna 1 desogestrel-ethinyl

estradiol 1

aubra 1

aubra eq 1 DIVIGEL 3

aurovela 1.5/30 1 dotti 1

aurovela 1/20 1 drospiren-eth estrad-

levomefol 1

aurovela 24 fe 1

drospirenone-ethinyl

estradiol 1

aurovela fe 1.5/30 1

aurovela fe 1/20 1 DUAVEE 3 PA

aviane 1 ELESTRIN 3

ayuna 1 elinest 1

azurette 1 ELLA 3

balziva 1 emoquette 1

bekyree 1 ENDOMETRIN 3

BIJUVA 3 enpresse-28 1

blisovi 24 fe 1 enskyce 1

blisovi fe 1.5/30 1 errin 1

briellyn 1 estarylla 1

camila 1 estradiol oral 1

camrese 1 estradiol transdermal 1

camrese lo 1 estradiol vaginal 1

caziant 1 estradiol valerate

intramuscular 1

chateal 1

chateal eq 1 estradiol-norethindrone

acet 1

CLIMARA PRO 2

COMBIPATCH 3 ESTRING 3

CRINONE 3 ESTROGEL 3

37


ethynodiol diac-eth

estradiol 1

kelnor 1/50 1

kurvelo 1

EVAMIST 3 larin 1.5/30 1

falmina 1 larin 1/20 1

fayosim 1 larin 24 fe 1

FEMRING 3 larin fe 1.5/30 1

femynor 1 larin fe 1/20 1

FIRST-

PROGESTERONE

VGS

3

larissia 1

layolis fe 1

leena 1 fyavolv 1

lessina 1 gianvi 1

levonest 1 hailey 24 fe 1

levonorgest-eth est &

eth est 1

heather 1

hydroxyprogesterone

caproate intramuscular

oil

5

PA levonorgest-eth estrad

91-day 1

levonorgestrel 1 hydroxyprogesterone

caproate intramuscular

solution

5

levonorgestrel-ethinyl

estrad 1

IMVEXXY

MAINTENANCE PACK 3

levonorg-eth estrad

triphasic 1

IMVEXXY STARTER

PACK 3

levora 0.15/30 (28) 1

lillow 1

incassia 1 LO LOESTRIN FE 3

introvale 1 lopreeza 1

isibloom 1 loryna 1

jasmiel 1 low-ogestrel 1

jencycla 1 lo-zumandimine 1

jinteli 1 lutera 1

jolessa 1 lyza 1

juleber 1 marlissa 1

junel 1.5/30 1 medroxyprogesterone

acetate intramuscular 1 QL

junel 1/20 1

junel fe 1.5/30 1 medroxyprogesterone

acetate oral 1

junel fe 1/20 1

megestrol acetate oral 1 junel fe 24 1

melodetta 24 fe 1 kaitlib fe 1

MENEST 3 kalliga 1

MENOSTAR 3 kariva 1

mibelas 24 fe 1 kelnor 1/35 1

38


microgestin 1.5/30 1 portia-28 1

microgestin 1/20 1 PREFEST 3

microgestin fe 1.5/30 1 PREMARIN 2

microgestin fe 1/20 1 PREMPHASE 2

mili 1 PREMPRO 2

mimvey 1 preventeza 1

mimvey lo 1 previfem 1

mono-linyah 1 progesterone

intramuscular 1

NATAZIA 2

progesterone

micronized oral 1

necon 0.5/35 (28) 1

nikki 1 reclipsen 1

nora-be 1 rivelsa 1

norethin ace-eth

estrad-fe 1

setlakin 1

sharobel 1 norethindrone acetate

oral 1

simliya 1

norethindrone acet-

ethinyl est 1

simpesse 1

sprintec 28 1

norethindrone oral 1 sronyx 1

norethindrone-eth

estradiol 1

syeda 1

tarina 24 fe 1 norethin-eth estradiol-fe 1

tarina fe 1/20 1 norgestimate-eth

estradiol 1

tarina fe 1/20 eq 1

tilia fe 1 norgestimate-ethinyl

estradiol triphasic 1

tri femynor 1

norlyda 1 tri-estarylla 1

norlyroc 1 tri-legest fe 1

nortrel 0.5/35 (28) 1 tri-linyah 1

nortrel 1/35 (21) 1 tri-lo-estarylla 1

nortrel 1/35 (28) 1 tri-lo-marzia 1

nortrel 7/7/7 1 tri-lo-mili 1

NUVARING 2 tri-lo-sprintec 1

ocella 1 tri-mili 1

ogestrel 1 tri-previfem 1

orsythia 1 tri-sprintec 1

philith 1 trivora (28) 1

pimtrea 1 tri-vylibra 1

pirmella 1/35 1 tri-vylibra lo 1

pirmella 7/7/7 1 tulana 1

39


tydemy 1 THYROLAR-3 2

velivet 1 TIROSINT ORAL

CAPSULE 100 MCG,

112 MCG, 13 MCG, 25

MCG, 50 MCG, 75

MCG, 88 MCG

1

vienva 1

viorele 1

vyfemla 1

vylibra 1 unithroid 1

wera 1 WESTHROID 2

wymzya fe 1 WP THYROID 2

xulane 2 Immunological

Agents - Drugs for

Immune System

Stimulation or

Suppression

yuvafem 1

zarah 1

zovia 1/35e (28) 1

zumandimine 1 ACTEMRA ACTPEN 5 PA

Hormonal Agents -

Thyroid

ACTEMRA

SUBCUTANEOUS 5 PA

ARMOUR THYROID 3 ACTIMMUNE 5 PA

euthyrox 1 ALFERON N 5 PA

levo-t 1 ASTAGRAF XL 3 PA

levothyroxine sodium

oral 1

AZASAN 3

azathioprine oral 1

levothyroxine-

liothyronine oral tablet

120 mg, 15 mg, 60 mg,

90 mg

1

BENLYSTA

SUBCUTANEOUS 5 PA

CIMZIA 5 PA

CIMZIA PREFILLED

KIT 5 PA LEVOTHYROXINE-

LIOTHYRONINE ORAL

TABLET 30 MG

1

CIMZIA STARTER KIT 5 PA

levoxyl 1 CINRYZE 5 PA

liothyronine sodium oral 1 COSENTYX 150

MG/ML 5 PA

methimazole oral 1

COSENTYX 300 DOSE 5 PA NATURE-THROID 2

COSENTYX

SENSOREADY 300

DOSE

5

PA

np thyroid oral tablet

120 mg, 15 mg, 60 mg,

90 mg

1

COSENTYX

SENSOREADY PEN 5 PA NP THYROID ORAL

TABLET 30 MG 1

CUVITRU 5 PA propylthiouracil oral 1

cyclosporine modified 1 THYROLAR-1 2

cyclosporine oral 1 THYROLAR-1/2 2

CYTOGAM 5 PA THYROLAR-1/4 2

ENBREL 5 PA THYROLAR-2 2

ENBREL SURECLICK 5 PA

40


ENVARSUS XR 3 PA SIMPONI

SUBCUTANEOUS

SOLUTION AUTO-

INJECTOR 100 MG/ML

5

gengraf 1

HAEGARDA 5 PA

HEPAGAM B 5 SIMPONI

SUBCUTANEOUS

SOLUTION AUTO-

INJECTOR 50

MG/0.5ML

5

PA

HIZENTRA 5 PA

HUMIRA 5 PA

HUMIRA PEDIATRIC

CROHNS START 5 PA

SIMPONI

SUBCUTANEOUS

SOLUTION

PREFILLED SYRINGE

100 MG/ML

5

HUMIRA PEN 5 PA

HUMIRA PEN-

CD/UC/HS STARTER 5 PA

HUMIRA PEN-

PS/UV/ADOL HS

START

SUBCUTANEOUS

PEN-INJECTOR KIT

40 MG/0.8ML

5

PA

SIMPONI

SUBCUTANEOUS

SOLUTION

PREFILLED SYRINGE

50 MG/0.5ML

5

PA

HYPERHEP B S/D 5 sirolimus oral tablet 1

HYQVIA 5 PA STELARA

SUBCUTANEOUS 5 PA

ILUMYA 5 PA

SYNAGIS 5 PA KEVZARA 5 PA

tacrolimus oral 1 KINERET 5 PA

TALTZ 5 PA leflunomide oral 1

TREMFYA 5 PA methotrexate (anti-

rheumatic) 1

TREXALL 3

methotrexate oral 1 XELJANZ 5 PA

methotrexate sodium 1 XELJANZ XR 5 PA

methotrexate sodium

(pf) 1

ZORTRESS 3

Immunological

Agents - Drugs for

Vaccination

mycophenolate mofetil 1

mycophenolate sodium 1

ACTHIB 3 NABI-HB 5

AFLURIA 3 QL OLUMIANT 5 PA

AFLURIA

PRESERVATIVE

FREE

3

ORENCIA 5 PA

ORENCIA CLICKJECT 5 PA

OTEZLA 5 PA AFLURIA

QUADRIVALENT 3

PROGRAF ORAL

PACKET 3 QL

BEXSERO 3

RIDAURA 3 BOOSTRIX 3

SANDIMMUNE ORAL

SOLUTION 3

ENGERIX-B 3

41


EZ FLU SHOT-

FLUCELVAX QUAD 3

ROTATEQ 3

TRUMENBA 3

FLUAD 3 TWINRIX 3

FLUARIX

QUADRIVALENT 3

VAQTA 3

VARIVAX 3 FLUBLOK

QUADRIVALENT 2

Inflammatory Bowel

Disease Agents

FLUCELVAX

QUADRIVALENT

INTRAMUSCULAR

SUSPENSION

2

ana-lex 1

APRISO 2

balsalazide disodium 1

FLUCELVAX

QUADRIVALENT

INTRAMUSCULAR

SUSPENSION

PREFILLED SYRINGE

3

budesonide er 1

budesonide oral 1

colocort 1

CORTIFOAM 2

FLULAVAL

QUADRIVALENT 3

hydrocortisone ace-

pramoxine rectal cream

1-1 %

1

FLUMIST

QUADRIVALENT 3 QL

hydrocortisone rectal 1

FLUZONE HIGH-

DOSE 3

lidocaine-

hydrocortisone ace

rectal

1

FLUZONE

QUADRIVALENT 3

mesalamine oral tablet

delayed release 1

GARDASIL 9 3

HAVRIX 3 mesalamine rectal 1

HEPLISAV-B 3 mesalamine-cleanser 1

HIBERIX 3 PENTASA 3

INFANRIX 3 PROCORT 3

IPOL 3 PROCTOFOAM HC 2

KINRIX 3 procto-med hc 1

MENACTRA 3 procto-pak 1

MENVEO 3 proctosol hc 1

M-M-R II 3 proctozone-hc 1

PEDIARIX 3 SFROWASA 2

PEDVAX HIB 3 sulfasalazine oral 1

PNEUMOVAX 23 3 UCERIS RECTAL 3

PREVNAR 13 3 Metabolic Bone

Disease Agents -

Drugs for

Osteoporosis

PROQUAD 3

QUADRACEL 3

RECOMBIVAX HB 3 alendronate sodium 1

ROTARIX 3 calcitonin (salmon) 1

42


calcitriol oral 1 EASIVENT 3

doxercalciferol oral 1 ergoloid mesylates oral 1

etidronate disodium 1 FEMCAP 3

FORTEO 5 PA FLEXICHAMBER

ADULT MASK/SMALL 3

ibandronate sodium

oral 3 PA

FLEXICHAMBER

CHILD MASK/LARGE 3

NATPARA 5 PA

FLEXICHAMBER

CHILD MASK/SMALL 3

paricalcitol oral 1

PROLIA 5 PA GELCLAIR 3

risedronate sodium 1 HYLENEX 3

TYMLOS 5 PA INSPIREASE

RESERVOIR BAGS 3

Miscellaneous

Therapeutic Agents

methergine 1 ANDEXXA

INTRAVENOUS

SOLUTION

RECONSTITUTED 100

MG

3

methylene blue

injection 1

methylergonovine

maleate 1

arnica flower 1 MUCOTROL 3

bacteriostatic

water(benz alc) solution

injection

1

MYOBLOC 5 PA

NEXAVIR 3

ORAMAGICRX 3 BACTERIOSTATIC

WATER(BENZ ALC)

SOLUTION

INJECTION

3

POCKET SPACER 3

pralidoxime chloride

intramuscular 1

bal in oil 1 SALICEPT 3

BOTOX 5 PA SORBITOL

IRRIGATION

SOLUTION 3 %

3

BREATHE EASE

LARGE 3

sorbitol irrigation

solution 3.3 % 1

BREATHE EASE

MEDIUM 3

sorbitol-mannitol 1 BREATHE EASE

SMALL 3

sterile water for

injection injection 1

BREATHERITE 3

TAKHZYRO 5 PA BROMELAIN 3

THYROGEN 5 CARDIOVID PLUS 3

vcf vaginal

contraceptive vaginal

gel

1

CAYA 3

CHARCOAL

ACTIVATED 3

VITRASE 3 chlorhexidine gluconate

solution 20 % 1

WIDE-SEAL

DIAPHRAGM 60 3

DYSPORT 5 PA

43


XEOMIN

INTRAMUSCULAR

SOLUTION

RECONSTITUTED 100

UNIT, 50 UNIT

3

fluorometholone 1

flurbiprofen sodium 1

FML 2

FML FORTE 2

XEOMIN

INTRAMUSCULAR

SOLUTION

RECONSTITUTED 200

UNIT

3

PA

gatifloxacin ophthalmic 1

gentak 1

gentamicin sulfate

ophthalmic 1

ILEVRO 3 Ophthalmic Agents -

Drugs for Eye Allergy,

Infection and

Inflammation

INVELTYS 3


ophthalmic 1

ALOCRIL 3 KLARITY-A 3

ALOMIDE 3 levofloxacin ophthalmic 1

ALREX 3 LOTEMAX

OPHTHALMIC GEL 3

AZASITE 3

azelastine hcl

ophthalmic 1

LOTEMAX

OPHTHALMIC

OINTMENT

3

bacitracin ophthalmic 1

loteprednol etabonate 1 BEPREVE 3

MAXIDEX 3 BESIVANCE 3

MOXEZA 2 BETADINE

OPHTHALMIC PREP 3

moxifloxacin hcl

ophthalmic 1

bromfenac sodium

(once-daily) 1

NATACYN 3

CILOXAN

OPHTHALMIC

OINTMENT

3

NEVANAC 3

ofloxacin ophthalmic 1

olopatadine hcl

ophthalmic 1

ciprofloxacin hcl

ophthalmic 1

PAZEO 2 cromolyn sodium

ophthalmic 1

POVIDONE-IODINE

OPHTHALMIC 3

dexamethasone

sodium phosphate

ophthalmic

1

PRED MILD 2

prednisolone acetate

ophthalmic 1

diclofenac sodium

ophthalmic 1

prednisolone acetate p-

f 1

DUREZOL 3

prednisolone sodium

phosphate ophthalmic 1

epinastine hcl 1

erythromycin

ophthalmic 1

sulfacetamide sodium

ophthalmic 1

FLAREX 3 tobramycin ophthalmic 1

44


TOBREX

OPHTHALMIC

OINTMENT

3

TIMOPTIC OCUDOSE

OPHTHALMIC

SOLUTION 0.25 %

2

trifluridine 1 TIMOPTIC OCUDOSE

OPHTHALMIC

SOLUTION 0.5 %

3

ZIRGAN 3

Ophthalmic Agents -

Drugs for Glaucoma

TRAVATAN Z 2

Ophthalmic Agents -

Drugs for

Miscellaneous Eye

Conditions

acetazolamide er 1

acetazolamide oral

tablet 250 mg 1

ALPHAGAN P

OPHTHALMIC

SOLUTION 0.1 %

2

ak-poly-bac 1

AKTEN 3

altacaine 1 apraclonidine hcl 1

altafluor benox 1 AZOPT 2

altafrin 1 betaxolol hcl

ophthalmic 1

atropine sulfate

ophthalmic ointment 1

BETIMOL 3

atropine sulfate

ophthalmic solution 1

BETOPTIC-S 2

bimatoprost ophthalmic 1 bacitracin-polymyxin b

ophthalmic 1

brimonidine tartrate

ophthalmic 1

bacitra-neomycin-

polymyxin-hc 1

carteolol hcl 1

COMBIGAN 2 BLEPHAMIDE 3

dorzolamide hcl

ophthalmic 1

BLEPHAMIDE S.O.P. 3

CEQUA 3 PA dorzolamide hcl-timolol

mal 1

CYCLOMYDRIL 3

cyclopentolate hcl

ophthalmic 1

dorzolamide hcl-timolol

mal pf 1

homatropaire 1 IOPIDINE 3

homatropine hbr 1 latanoprost ophthalmic 1

LACRISERT 3 levobunolol hcl 1

LASTACAFT 3 LUMIGAN 2

neomycin-bacitracin zn-

polymyx 1

methazolamide oral 1

PHOSPHOLINE

IODIDE 2

neomycin-polymyxin-

dexameth ophthalmic

ointment

1

pilocarpine hcl

ophthalmic 1

neomycin-polymyxin-

dexameth ophthalmic

suspension 3.5-10000-

0.1

1

SIMBRINZA 2

timolol maleate

ophthalmic 1

45


neomycin-polymyxin-

gramicidin 1

CIPRODEX 2

ciprofloxacin hcl otic 1

neomycin-polymyxin-hc

ophthalmic 1

COLY-MYCIN S 3

flac 1 neo-polycin 1


otic 1

neo-polycin hc 1

OMIDRIA 3 hydrocortisone-acetic

acid 1

OXERVATE 5 PA

phenylephrine hcl

ophthalmic 1

neomycin-polymyxin-hc

otic 1

polycin 1 ofloxacin otic 1

polymyxin b-

trimethoprim 1

Respiratory Tract /

Pulmonary Agents -

Drugs for Allergies,

Cough, Cold

PRED-G 3

PRED-G S.O.P. 3 ADRENALIN NASAL 3

proparacaine hcl

ophthalmic 1

allergy childrens oral

syrup 1

RESTASIS 2 PA allergy relief oral tablet

10 mg 1

RESTASIS

MULTIDOSE

OPHTHALMIC

EMULSION 0.05 %

2

PA azelastine hcl nasal

solution 0.1 %, 137

mcg/spray

1

sulfacetamide-

prednisolone

ophthalmic solution

1

BECONASE AQ 3

benzonatate 1

tetcaine 1 bromfed dm 1

tetracaine hcl

ophthalmic 1

brompheniramine

tannate 1

tetravisc 1 carbinoxamine maleate

oral tablet 1

tetravisc forte 1

cetirizine hcl oral

solution 1

TOBRADEX

OPHTHALMIC

OINTMENT

3

clemastine fumarate

oral tablet 2.68 mg 1

TOBRADEX ST 3

CUROSURF 3 tobramycin-

dexamethasone 1

cyproheptadine hcl oral 1

tropicamide ophthalmic 1 desloratadine 2

XIIDRA 2 PA dexchlorpheniramine

maleate oral 1

ZYLET 3

diphenhydramine hcl

oral elixir 1

Otic Agents - Drugs

for Ear Conditions

flunisolide nasal 1 acetic acid otic 1

CIPRO HC 3

46


fluticasone propionate

nasal 1

RYCLORA 1

sodium chloride

inhalation 1

hm loratadine 1

hydrocodone polst-cpm

polst er 1

SSKI 3

SURVANTA 3

hydrocodone-

homatropine 1

XOLAIR 5 PA

Respiratory Tract /

Pulmonary Agents -

Drugs for Asthma and

Other Lung

Conditions

hydromet 1

HYPERSAL

INHALATION

NEBULIZATION

SOLUTION 3.5 %

3

acetylcysteine

inhalation 1

ipratropium bromide

nasal 1

ADVAIR DISKUS 2

levocetirizine

dihydrochloride oral 2

ADVAIR HFA 2

albuterol sulfate er 1 loratadine oral tablet 1

albuterol sulfate

inhalation 1

mometasone furoate

nasal 1 PA

albuterol sulfate oral 1 nebusal inhalation

nebulization solution 3

%

1

ANORO ELLIPTA 2

ARNUITY ELLIPTA 2

NUCALA

SUBCUTANEOUS

SOLUTION

RECONSTITUTED

5

PA

ATROVENT HFA 3

BREO ELLIPTA 2

BROVANA 3

budesonide inhalation 1 phenadoz 1 QL

COMBIVENT

RESPIMAT 3

phenylephrine-

guaifenesin oral liquid 1

cromolyn sodium

inhalation 1

promethazine hcl oral

syrup 1

DALIRESP 3 PA promethazine hcl oral

tablet 1

difil-g forte 1

promethazine hcl rectal 1 QL ELIXOPHYLLIN ELIXIR

80 MG/15ML ORAL 1

promethazine-codeine 1

ELIXOPHYLLIN ELIXIR

80 MG/15ML ORAL 2

promethazine-dm 1

promethazine-

phenyleph-codeine 1

EPINEPHRINE

SOLUTION AUTO-

INJECTOR 0.15

MG/0.3ML INJECTION

2

promethazine-

phenylephrine 1

promethegan 1 QL EPINEPHRINE

SOLUTION AUTO-

INJECTOR 0.15

MG/0.3ML INJECTION

2

QL

pseudoephedrine-

bromphen-dm 1

pulmosal 1

47


EPINEPHRINE

SOLUTION AUTO-

INJECTOR 0.3

MG/0.3ML INJECTION

2

SPIRIVA RESPIMAT 2

STIOLTO RESPIMAT 2

STRIVERDI

RESPIMAT 3

EPINEPHRINE

SOLUTION AUTO-

INJECTOR 0.3

MG/0.3ML INJECTION

2

QL

SYMBICORT 2

SYMJEPI INJECTION

SOLUTION

PREFILLED SYRINGE

0.3 MG/0.3ML

3

ESBRIET 5 PA

FLOVENT DISKUS 2 terbutaline sulfate

injection 1

FLOVENT HFA 2

fluticasone-salmeterol

inhalation aerosol

powder breath

activated 100-50

mcg/dose, 250-50

mcg/dose, 500-50

mcg/dose

1

terbutaline sulfate oral 1

THEO-24 3

theochron 1

theophylline er 1

TRELEGY ELLIPTA 3 PA

VENTOLIN HFA 2 FLUTICASONE-

SALMETEROL

INHALATION

AEROSOL POWDER

BREATH ACTIVATED

113-14 MCG/ACT, 232-

14 MCG/ACT, 55-14

MCG/ACT

1

wixela inhub 1

zafirlukast 1

zileuton er 1 PA

ZYFLO 3 PA

Respiratory Tract /

Pulmonary Agents -

Drugs for Cystic

Fibrosis

INCRUSE ELLIPTA 2

ipratropium bromide

inhalation 1

CAYSTON 5

ipratropium-albuterol 1 KALYDECO ORAL

PACKET 50 MG, 75

MG

5

PA levalbuterol hcl

inhalation 1

KALYDECO ORAL

TABLET 5 PA metaproterenol sulfate

oral 1

ORKAMBI 5 PA montelukast sodium

oral 1

PULMOZYME 5

OFEV 5 PA SYMDEKO ORAL

TABLET THERAPY

PACK 100-150 & 150

MG

5

PA PERFOROMIST 3

PROAIR HFA 2

PROAIR RESPICLICK 2 tobramycin inhalation 5

PULMICORT

FLEXHALER 2

Respiratory Tract /

Pulmonary Agents -

Drugs for Pulmonary

Hypertension

SEREVENT DISKUS 2

SPIRIVA

HANDIHALER 2

ADEMPAS 5 PA

48


alyq 5 PA eszopiclone 2 QL

ambrisentan 5 PA flurazepam hcl 1

bosentan 5 PA modafinil 1 PA; QL

OPSUMIT 5 PA ramelteon 1 QL

sildenafil citrate oral

suspension

reconstituted

5

PA

ROZEREM 3 QL

SECONAL 3

SILENOR 3 PA; QL sildenafil citrate oral

tablet 20 mg 5 PA temazepam 1

XYREM 5 PA tadalafil (pah) 5 PA

zaleplon 1 QL TRACLEER ORAL

TABLET SOLUBLE 5 PA

zolpidem tartrate er 2 QL

TYVASO 5 PA zolpidem tartrate oral 1 QL

TYVASO REFILL 5 PA

TYVASO STARTER 5 PA

UPTRAVI 5 PA; QL

VENTAVIS 5 PA

Skeletal Muscle

Relaxants - Drugs for

Muscle Pain and

Spasm

baclofen oral tablet 10

mg, 20 mg 1

carisoprodol oral tablet

350 mg 1

carisoprodol-aspirin 1

chlorzoxazone oral

tablet 500 mg 1

cyclobenzaprine hcl

oral 1

dantrolene sodium oral 1

metaxall 2 PA

metaxalone oral tablet

800 mg 2 PA

methocarbamol oral 1

orphenadrine citrate er 1

tizanidine hcl oral tablet 1

Sleep Disorder

Agents

AMYTAL SODIUM 3

armodafinil 1 PA; QL

BUTISOL SODIUM 3

49

Index of Drugs

abacavir sulfate ............................. 15

abacavir sulfate-lamivudine ........ 15

abacavir-lamivudine-

zidovudine ...................................... 15

ABILIFY MAINTENA .................... 14

abiraterone acetate....................... 12

acamprosate calcium ..................... 6

acarbose......................................... 26

ACCU-CHEK AVIVA DEVICE...27

ACCU-CHEK AVIVA PLUS ......... 27

ACCU-CHEK COMPACT

PLUS TEST STRIPS .................... 27

ACCU-CHEK FASTCLIX

LANCET KIT .................................. 27

ACCU-CHEK FASTCLIX

LANCETS....................................... 27

ACCU-CHEK GUIDE ................... 27

ACCU-CHEK MULTICLIX

LANCET DEVICE KIT .................. 27

ACCU-CHEK MULTICLIX

LANCETS....................................... 27

ACCU-CHEK SMARTVIEW

TEST STRIPS ............................... 27

ACCU-CHEK SOFT TOUCH

LANCETS....................................... 27

ACCU-CHEK SOFTCLIX

LANCET DEVICE KIT .................. 27

ACCU-CHEK SOFTCLIX

LANCETS....................................... 27

acebutolol hcl................................. 17

acetaminophen-codeine ................ 3

acetaminophen-codeine #2 ........... 3



acetazolamide..................... 17, 44

acetazolamide er........................... 44

acetazolamide sodium ................. 17

acetic acid........................... 33, 45

acetylcysteine ................................ 46

acitretin ........................................... 22

ACTEMRA ..................................... 39

ACTEMRA ACTPEN .................... 39

ACTHIB .......................................... 40

ACTIMMUNE ................................. 39

acyclovir ......................................... 15

ACZONE ........................................ 22

adapalene ...................................... 22

adapalene-benzoyl peroxide ....... 22

adefovir dipivoxil ........................... 15

ADEMPAS ..................................... 47

ADMELOG ..................................... 28

ADMELOG SOLOSTAR .............. 28

ADRENALIN .................................. 45

ADVAIR DISKUS ......................... 46

ADVAIR HFA ................................ 46

AEMCOLO ....................................... 6

AFINITOR ...................................... 12

AFINITOR DISPERZ ................... 12

afirmelle ......................................... 36

AFLURIA ....................................... 40

AFLURIA PRESERVATIVE

FREE .............................................. 40

AFLURIA QUADRIVALENT ....... 40

agoneaze .......................................... 5

AIMOVIG ....................................... 11

ak-poly-bac .................................... 44

AKTEN ........................................... 44

AKYNZEO ..................................... 10

ala-cort ........................................... 22

albendazole ................................... 14

albuterol sulfate ............................ 46

albuterol sulfate er ....................... 46

alclometasone dipropionate ....... 22

alcohol ............................................ 29

ALDACTAZIDE ............................. 17

ALECENSA ................................... 12

alendronate sodium ..................... 41

ALFERON N ................................. 39

alfuzosin hcl er ............................. 34

ALINIA ............................................ 14

aliskiren fumarate ......................... 17

allergy childrens ........................... 45

allergy relief ................................... 45

allopurinol ...................................... 11

almotriptan malate ....................... 11

ALOCRIL ....................................... 43

ALOMIDE ...................................... 43

alosetron hcl.................................. 32

ALPHAGAN P ............................... 44

alprazolam ..................................... 16

alprazolam er ................................ 16

ALPRAZOLAM INTENSOL ........ 16

alprazolam xr ................................ 17

alprostadil ...................................... 17

ALREX ........................................... 43

ALTABAX ......................................... 6

altacaine ........................................ 44

altafluor benox .............................. 44

altafrin ............................................ 44

altavera .......................................... 36

ALTRENO ..................................... 22

ALUMINUM CHLORIDE

ANHYDROUS ............................... 22

ALUMINUM CHLORIDE

HEXAHYDRATE .......................... 22

ALUNBRIG .................................... 12

alyacen 1/35 .................................. 36

alyacen 7/7/7 ................................. 36

alyq ................................................. 48

amabelz .......................................... 36

amantadine hcl ............................. 14

ambrisentan ................................... 48

amcinonide .................................... 22

amethia .......................................... 36

amethia lo ...................................... 36

amethyst ........................................ 36

amikacin sulfate .............................. 6

amiloride hcl .................................. 17

amiloride-hydrochlorothiazide... 18

aminoacetic acid ........................... 33

aminocaproic acid ........................ 17

amiodarone hcl ............................. 18

AMITIZA ......................................... 32

amitriptyline hcl ............................... 9

amlodipine besylate ..................... 18

amlodipine besylate-benazepril

hcl .................................................... 18

amlodipine besylate-valsartan.. 18

AMLODIPINE-

ATORVASTATIN .......................... 18

amlodipine-olmesartan ................ 18

amlodipine-valsartan-hctz ........... 18

ammonium lactate ........................ 22

amnesteem .................................... 22

amoxapine ....................................... 9

amoxicill-clarithro-lansopraz ....... 32

amoxicillin ........................................ 6


clavulanate ...................................... 6


clavulanate er .................................. 6

amphetamine-

dextroamphetamine ..................... 21

amphetamine-

dextroamphetamine er ................. 21

ampicillin .......................................... 6

AMYTAL SODIUM ........................ 48

ANACAINE .................................... 22

ANADROL-50 ................................ 34

anagrelide hcl ................................ 17

ana-lex ............................................ 41

anastrozole .................................... 12

ANDEXXA ...................................... 42

anodyne lpt ...................................... 5

ANORO ELLIPTA ......................... 46

ANZEMET ...................................... 10

APEXICON E ................................ 22

APIDRA SOLOSTAR ................... 28

APIDRA VIAL ................................ 28

50

apraclonidine hcl ........................... 44

aprepitant ....................................... 10

apri .................................................. 36

APRISO .......................................... 41

APTIVUS ........................................ 15

ARAKODA ..................................... 14

aranelle ........................................... 36

ARESTIN ........................................ 22

argyle sterile saline ...................... 29

argyle sterile water ....................... 29

ARIKAYCE ....................................... 6

aripiprazole .................................... 14

ARISTADA ..................................... 14

ARISTADA INITIO ........................ 15

armodafinil ..................................... 48

ARMOUR THYROID .................... 39

arnica flower .................................. 42

ARNUITY ELLIPTA ...................... 46

arzol silver nit applicators ............ 22

ascomp-codeine .............................. 3

ashlyna ........................................... 36

aspirin ............................................... 4

aspirin adult ..................................... 4

aspirin adult low strength .............. 4

aspirin childrens .............................. 4

aspirin ec low dose ......................... 4

aspirin ec low strength ................... 4

aspirin low dose .............................. 4

aspirin-dipyridamole er................. 14

ASTAGRAF XL ............................. 39

ASTRINGYN .................................. 17

atazanavir sulfate ......................... 15

atenolol ........................................... 18

atenolol-chlorthalidone ................. 18

atomoxetine hcl ............................. 21

atorvastatin calcium ..................... 18

atovaquone .................................... 14

atovaquone-proguanil hcl ............ 14

ATRIPLA ........................................ 15

atropine sulfate................... 32, 44

ATROVENT HFA .......................... 46

AUBAGIO ....................................... 21

aubra ............................................... 36

aubra eq ......................................... 36

AUGMENTIN ................................... 6

aurovela 1.5/30 ............................. 36

aurovela 1/20 ................................. 36

aurovela 24 fe ................................ 36

aurovela fe 1.5/30 ......................... 36

aurovela fe 1/20 ............................ 36

AURYXIA ....................................... 33

AUTOLET II CLINISAFE ............. 27

AVAGE ........................................... 22

avar cleanser ................................ 22

AVAR LS CLEANSER ................ 23

avar-e emollient ............................ 23

avar-e green.................................. 23

AVAR-E LS ................................... 23

AVC VAGINAL.............................. 11

aviane ............................................. 36

avidoxy .............................................. 6

avita ................................................ 23

AVONEX PEN .............................. 21

AVONEX PREFILLED ................. 21

ayuna ............................................. 36

AZASAN ........................................ 39

AZASITE ........................................ 43

azathioprine ................................... 39

azelaic acid ................................... 23

azelastine hcl...................... 43, 45

AZELEX ......................................... 23

azithromycin ..................................... 6

AZOPT ........................................... 44

azurette .......................................... 36

baciim ................................................ 6

bacitracin...............................6, 43

bacitracin-polymyxin b ................. 44

bacitra-neomycin-polymyxin-hc 44

baclofen ......................................... 48

bacteriostatic water(benz alc)... 42

BACTERIOSTATIC

WATER(BENZ ALC) ................... 42

bal in oil.......................................... 42

balsalazide disodium ................... 41

balziva ............................................ 36

BANZEL ............................................ 8

BARACLUDE ................................ 15

BAXDELA ......................................... 6

bayer aspirin .................................... 4

bayer aspirin ec low dose .............. 4

BD AUTOSHIELD DUO PEN

NEEDLES ...................................... 28

BD ULTRA-FINE INSULIN

SYRINGES .................................... 28

BD ULTRA-FINE PEN

NEEDLES ...................................... 28

BECONASE AQ ........................... 45

bekyree .......................................... 36

belladonna alkaloids-opium ........ 32

benazepril hcl................................ 18

benazepril-hydrochlorothiazide. 18

BENLYSTA ................................... 39

BENSAL HP .................................. 23

benzalkonium chloride ................... 6

benzepro ........................................ 23

benzepro creamy wash ............... 23

benzepro foaming cloths ............. 23

benzepro short contact ................ 23

BENZIQ .......................................... 23

BENZIQ LS .................................... 23

BENZNIDAZOLE .......................... 14

benzoin ........................................... 23

benzoin compound ....................... 23

benzonatate ................................... 45

BENZOYL PEROX-

HYDROCORTISONE ................... 23

benzoyl peroxide .......................... 23

benzoyl peroxide-erythromycin. 23

benztropine mesylate ................... 14

BEPREVE ...................................... 43

beser ............................................... 23

BESIVANCE .................................. 43

BETADINE OPHTHALMIC

PREP .............................................. 43

betamethasone dipropionate ...... 23

betamethasone dipropionate

aug .................................................. 23

betamethasone sod phos &

acet ................................................. 34

betamethasone valerate .............. 23

BETASERON ................................ 21

betaxolol hcl........................ 18, 44

bethanechol chloride .................... 33

BETIMOL ....................................... 44

BETOPTIC-S ................................. 44

BEVYXXA ........................................ 8

bexarotene ..................................... 12

BEXSERO ..................................... 40

bicalutamide .................................. 12

BIDIL ............................................... 18

BIJUVA ........................................... 36

BIKTARVY ..................................... 15

bimatoprost .................................... 44

BIO-STATIN .................................. 11

bio-statin ........................................ 11

bisoprolol fumarate ....................... 18

bisoprolol-hydrochlorothiazide.. 18

BLEPHAMIDE ............................... 44

BLEPHAMIDE S.O.P. .................. 44

blisovi 24 fe .................................... 36

blisovi fe 1.5/30 ............................. 36

BOCASAL ...................................... 22

BOOSTRIX .................................... 40

bosentan ........................................ 48

BOSULIF ........................................ 12

BOTOX ........................................... 42

bp 10-1 ........................................... 23

bp foam .......................................... 23

bp wash .......................................... 23

51

BRAFTOVI ..................................... 12

BREATHE EASE LARGE ............ 42

BREATHE EASE MEDIUM ......... 42

BREATHE EASE SMALL ............ 42

BREATHERITE ............................. 42

BREO ELLIPTA............................. 46

briellyn ............................................ 36

BRILINTA ....................................... 14

brimonidine tartrate ...................... 44

BRIVIACT......................................... 8

BROMELAIN ................................. 42

bromfed dm .................................... 45

bromfenac sodium (once-daily).43

bromocriptine mesylate ............... 14

brompheniramine tannate ........... 45

BROVANA ..................................... 46

budesonide......................... 41, 46

budesonide er ............................... 41

bumetanide .................................... 18

bupivacaine hcl ............................... 5

bupivacaine hcl (pf) ........................ 5

bupivacaine-epinephrine ............... 5

bupivacaine-epinephrine (pf) ........ 5

buprenorphine ................................. 3

BUPRENORPHINE ........................ 3

buprenorphine hcl ........................... 6

buprenorphine hcl-naloxone

hcl ...................................................... 6

bupropion hcl ................................... 9

bupropion hcl er (smoking det)... 6

bupropion hcl er (sr) ....................... 9

bupropion hcl er (xl) ........................ 9

buspirone hcl ................................. 17

butalbital-acetaminophen .............. 3

butalbital-apap ................................. 3

butalbital-apap-caff-cod ................. 3

butalbital-apap-caffeine ................. 3

butalbital-asa-caff-codeine ............ 3

butalbital-aspirin-caffeine ............... 3

BUTISOL SODIUM ....................... 48

butorphanol tartrate ........................ 3

BYDUREON .................................. 26

BYDUREON BCISE

AUTOINJECTOR .......................... 26

BYETTA 10 MCG PEN ................ 26

BYETTA 5 MCG PEN .................. 26

BYSTOLIC ..................................... 18

cabergoline .................................... 35

CABOMETYX ................................ 12

caffeine citrate ............................... 21

CALAMINE..................................... 23

CALCIFOL ..................................... 29

calcipotriene................................... 23

calcipotriene-betameth diprop...23

calcitonin (salmon) ....................... 41

calcitrene ....................................... 23

calcitriol............................... 23, 42

calcium acetate (phos binder)... 33

CALCIUM-FOLIC ACID PLUS

D ..................................................... 29

CALQUENCE ............................... 12

camila ............................................. 36

camrese ......................................... 36

camrese lo ..................................... 36

candesartan cilexetil .................... 18

candesartan cilexetil-hctz ........... 18

capecitabine .................................. 12

CAPEX ........................................... 23

CAPRELSA ................................... 12

captopril ......................................... 18

captopril-hydrochlorothiazide ..... 18

CARAC .......................................... 23

CARAFATE ................................... 31

CARBAGLU .................................. 29

carbamazepine ................................ 8

carbamazepine er ........................... 8

carbidopa ....................................... 14

carbidopa-levodopa ..................... 14

carbidopa-levodopa er ................ 14

carbidopa-levodopa-

entacapone ................................... 14

carbinoxamine maleate ............... 45

CARDIOVID PLUS ...................... 42

CARDURA XL .............................. 34

CARETOUCH

LANCING/EJECTOR ................... 27

carisoprodol ................................... 48

carisoprodol-aspirin...................... 48

carisoprodol-aspirin-codeine ......... 3

carteolol hcl ................................... 44

cartia xt .......................................... 18

carvedilol ....................................... 18

carvedilol phosphate er ............... 18

cascara sagrada ........................... 32

cavarest ......................................... 22

CAVERJECT ................................. 33

CAVERJECT IMPULSE .............. 33

CAYA ............................................. 42

CAYSTON ..................................... 47

caziant ............................................ 36

cefaclor ............................................. 6

cefaclor er ......................................... 6

cefadroxil .......................................... 6

cefdinir .............................................. 6

cefditoren pivoxil ............................. 7

cefixime ............................................. 7

cefpodoxime proxetil ...................... 7

cefprozil ............................................ 7

ceftriaxone sodium ......................... 7

cefuroxime axetil ............................. 7

celecoxib .......................................... 4

CELONTIN ...................................... 8

cem-urea ........................................ 23

cephalexin ........................................ 7

CEQUA .......................................... 44

CERDELGA ................................... 33

cerovel ............................................ 23

CESAMET ..................................... 10

cetirizine hcl ................................... 45

CETROTIDE .................................. 35

cevimeline hcl ................................ 22

CHANTIX ......................................... 6

CHANTIX CONTINUING

MONTH PAK ................................... 6

CHANTIX STARTING MONTH

PAK ................................................... 6

CHARCOAL ACTIVATED ........... 42

chateal ............................................ 36

chateal eq ...................................... 36

CHEMET ........................................ 29

CHENODAL................................... 32

chlordiazepoxide hcl .................... 17

chlordiazepoxide-amitriptyline ...... 9

chlorhexidine gluconate...... 22, 42

chloroprocaine hcl (pf) ................... 5

chloroquine phosphate ................ 14

chlorothiazide ................................ 18

chlorpromazine hcl ....................... 15

chlorthalidone ................................ 18

chlorzoxazone ............................... 48

CHOLBAM ..................................... 32

cholestyramine .............................. 18

cholestyramine light ..................... 18

choline fenofibrate ........................ 18

choline-mag trisalicylate ................ 4

chorionic gonadotropin ................ 35

ciclodan .......................................... 11

ciclopirox ........................................ 11

ciclopirox olamine ......................... 11

ciclopirox treatment ...................... 11

cilostazol ........................................ 14

CILOXAN ....................................... 43

CIMDUO ........................................ 15

cimetidine ....................................... 31

cimetidine hcl ................................ 31

CIMZIA ........................................... 39

CIMZIA PREFILLED KIT ............. 39

CIMZIA STARTER KIT ................ 39

cinacalcet hcl ................................. 35

52

CINRYZE ....................................... 39

CIPRO .............................................. 7

CIPRO HC ..................................... 45

CIPRODEX .................................... 45

ciprofloxacin ..................................... 7

ciprofloxacin hcl.............. 7, 43, 45

citalopram hydrobromide ............... 9

claravis ........................................... 23

clarithromycin .................................. 7

clarithromycin er ............................. 7

clemastine fumarate ..................... 45

CLEOCIN ......................................... 7

CLIMARA PRO ............................. 36

clindacin etz ................................... 23

clindacin-p ...................................... 23

clindamycin hcl ................................ 7

clindamycin palmitate hcl .............. 7

clindamycin phosphate......... 7, 23

CLINDAMYCIN PHOSPHATE.. 23

clindamycin phosphate-

benzoyl peroxide ........................... 23

clindamycin-tretinoin ..................... 23

CLINDESSE .................................... 7

clinpro 5000 ................................... 22

clobazam .......................................... 8

clobetasol prop emollient base. 23

clobetasol propionate ................... 23

clobetasol propionate e ............... 23

clobetasol propionate emulsion 23

clodan ............................................. 23

CLODERM ..................................... 23

CLODERM PUMP ........................ 23

clomipramine hcl ............................. 9

clonazepam ................................... 17

clonidine ......................................... 18

clonidine hcl ................................... 18

clopidogrel bisulfate ..................... 14

clorazepate dipotassium .............. 17

clotrimazole .................................... 11

clotrimazole-betamethasone ....... 23

clozapine ........................................ 15

coal tar ............................................ 23

COARTEM ..................................... 14

cocaine hcl ....................................... 5

codeine sulfate ................................ 3

COLCHICINE ................................ 11

colchicine-probenecid .................. 11

COLCRYS ...................................... 11

colesevelam hcl ............................ 18

colestipol hcl .................................. 18

colistimethate sodium (cba) .......... 7

colocort ........................................... 41

COLY-MYCIN S ............................ 45

COLYTE WITH FLAVOR

PACKS ........................................... 32

COMBIGAN ................................... 44

COMBIPATCH .............................. 36

COMBIVENT RESPIMAT ........... 46

COMETRIQ (100 MG DAILY

DOSE) ............................................ 12


DOSE) ............................................ 12


DOSE) ............................................ 12

COMFORT EZ MICRO PEN

NEEDLES ...................................... 28

COMFORT EZ SHORT PEN

NEEDLES ...................................... 28

COMPLERA .................................. 15

compro ........................................... 10

CONDYLOX .................................. 23

constulose ..................................... 32

COPAXONE .................................. 21

COPIKTRA .................................... 12

CORDRAN .................................... 23

CORTIFOAM ................................ 41

cortisone acetate .......................... 34

CORTISPORIN ............................. 23

COSENTYX 150 MG/ML ............ 39

COSENTYX 300 DOSE .............. 39

COSENTYX SENSOREADY

300 DOSE ..................................... 39

COSENTYX SENSOREADY

PEN ................................................ 39

COTELLIC ..................................... 12

CREON .......................................... 33

CRESEMBA .................................. 11

CRINONE ...................................... 36

CRIXIVAN ..................................... 15

cromolyn sodium........... 32, 43, 46

crotan ............................................. 14

cryselle-28 ..................................... 36

CUROSURF .................................. 45

CUVITRU ....................................... 39

CUVPOSA ..................................... 32

cyanocobalamin............................ 29

cyclafem 1/35 ................................ 36

cyclafem 7/7/7 ............................... 36

cyclobenzaprine hcl ..................... 48

CYCLOMYDRIL............................ 44

cyclopentolate hcl ......................... 44

cyclophosphamide ....................... 12

cycloserine .................................... 12

cyclosporine .................................. 39

cyclosporine modified .................. 39

cyproheptadine hcl ....................... 45

cyred ............................................... 36

cyred eq ......................................... 36

CYSTADANE ................................ 33

CYSTAGON .................................. 33

CYTOGAM..................................... 39

cytra k crystals .............................. 29

d3 high potency ............................ 29

d3 super strength ......................... 29

d3 vitamin ...................................... 29

dalfampridine er ............................ 21

DALIRESP ..................................... 46

danazol ........................................... 34

dantrolene sodium ........................ 48

dapsone.............................. 12, 23

DARAPRIM .................................... 14

darifenacin hydrobromide er ...... 33

dasetta 1/35 ................................... 36

dasetta 7/7/7 ................................. 36

DAURISMO ................................... 12

daysee ............................................ 36

DAYTRANA ................................... 21

DEBACTEROL .............................. 22

deblitane ........................................ 36

decara ............................................ 30

DECARA ........................................ 30

deferasirox ..................................... 30

dehydrated alcohol ....................... 30

DELSTRIGO .................................. 15

deltasone ....................................... 34

delyla .............................................. 36

demeclocycline hcl ......................... 7

DEMSER ........................................ 18

DENAVIR ....................................... 15

denta 5000 plus ............................ 22

dentagel ......................................... 22

DEPEN TITRATABS .................... 33

DEPO-ESTRADIOL ..................... 36

DEPO-SUBQ PROVERA 104... 36

dermacinrx empricaine .................. 5

dermacinrx prizopak ...................... 5

DESCOVY ..................................... 15

desipramine hcl............................... 9

desloratadine ................................. 45

desmopressin ace spray refrig.. 35

desmopressin acetate ................. 35

desmopressin acetate spray ...... 35

desogestrel-ethinyl estradiol ....... 36

DESONATE ................................... 23

desonide ........................................ 24

desoximetasone ............................ 24

DESVENLAFAXINE ER ................ 9

desvenlafaxine succinate er ......... 9

dexamethasone ............................ 34

53

DEXAMETHASONE

INTENSOL ..................................... 34

dexamethasone sod

phosphate pf .................................. 34

dexamethasone sodium

phosphate........................... 34, 43

dexchlorpheniramine maleate... 45

dexmethylphenidate hcl ............... 21

dexmethylphenidate hcl er .......... 21

dextroamphetamine sulfate ......... 21

dextroamphetamine sulfate er.. 21

DIATHRIVE LANCING

DEVICE .......................................... 27

diazepam.......................... 8, 9, 17

diazepam intensol ......................... 17

DICLOFENAC EPOLAMINE ......... 4

diclofenac potassium ...................... 4

diclofenac sodium........... 4, 24, 43

diclofenac sodium er ...................... 4

diclofenac-misoprostol ................... 4

dicloxacillin sodium ......................... 7

dicyclomine hcl .............................. 32

didanosine ...................................... 15

DIFICID............................................. 7

difil-g forte ...................................... 46

diflorasone diacetate .................... 24

diflunisal ........................................... 4

digitek ............................................. 18

digox ............................................... 18

digoxin ............................................ 18

dihydroergotamine mesylate ....... 11

DILANTIN ......................................... 9

DILANTIN INFATABS .................... 9

DILATRATE-SR ............................ 18

diltiazem hcl ................................... 18

diltiazem hcl er .............................. 18

diltiazem hcl er beads .................. 18

diltiazem hcl er coated beads... 18

dilt-xr ............................................... 18

dimenhydrinate .............................. 10

diphenhydramine hcl .................... 45

diphenoxylate-atropine ................. 32

dipyridamole .................................. 14

disopyramide phosphate ............. 18

disulfiram .......................................... 6

DIURIL ............................................ 18

divalproex sodium ........................... 9

divalproex sodium er ...................... 9

DIVIGEL ......................................... 36

dofetilide ......................................... 18

donepezil hcl .................................... 9

DORAL ........................................... 17

dorzolamide hcl ............................. 44

dorzolamide hcl-timolol mal ........ 44

dorzolamide hcl-timolol mal pf.. 44

dotti ................................................. 36

DOVATO ....................................... 15

doxazosin mesylate ..................... 18

doxepin hcl............................ 9, 24

doxercalciferol ............................... 42

doxycycline hyclate ......................... 7

doxycycline monohydrate .............. 7

D-PENAMINE ............................... 33

DRITHO-CREME HP ................... 24

dronabinol ...................................... 10

droperidol ....................................... 10

DROPSAFE SAFETY PEN

NEEDLES ...................................... 28

drospiren-eth estrad-levomefol. 36

drospirenone-ethinyl estradiol... 36

DROXIA ......................................... 12

DUAVEE ........................................ 36

duloxetine hcl ................................ 10

DUPIXENT .................................... 24

DUREZOL ..................................... 43

dutasteride ..................................... 34

dutasteride-tamsulosin hcl .......... 34

DUTOPROL .................................. 18

DYRENIUM ................................... 18

DYSPORT ..................................... 42

e.e.s. 400 .......................................... 7

EASIVENT ..................................... 42

EASY TOUCH SAFETY PEN

NEEDLES ...................................... 28

easygel ........................................... 22

ec-naproxen ..................................... 4

econazole nitrate .......................... 11

EDARBI ......................................... 18

EDARBYCLOR ............................. 18

EDEX ............................................. 33

ed-spaz .......................................... 32

EDURANT ..................................... 15

efavirenz ........................................ 15

EFFER-K ....................................... 30

effer-k ............................................. 30

EGRIFTA ....................................... 35

ELELYSO ...................................... 33

ELESTRIN ..................................... 36

eletriptan hydrobromide .............. 11

ELIGARD ....................................... 35

elinest ............................................. 36

ELIQUIS ............................................ 8

ELIQUIS STARTER PACK ........... 8

elite-ob ........................................... 30

ELIXOPHYLLIN ............................ 46

ELLA ............................................... 36

ELMIRON ...................................... 33

EMCYT ........................................... 12

EMEND .......................................... 10

EMGALITY .................................... 11

EMGALITY 300 DOSE ................ 11

emoquette ...................................... 36

EMSAM .......................................... 10

EMTRIVA ....................................... 15

enalapril maleate .......................... 18

enalapril-hydrochlorothiazide ...... 18

ENBREL ......................................... 39

ENBREL SURECLICK ................ 39

endocet ............................................ 3

ENDOMETRIN .............................. 36

ENGERIX-B ................................... 40

enoxaparin sodium ......................... 8

enpresse-28 .................................. 36

enskyce .......................................... 36

ENSTILAR ..................................... 24

entacapone .................................... 14

entecavir ........................................ 15

ENTEREG ..................................... 32

ENTRESTO ................................... 18

enulose ........................................... 32

ENVARSUS XR ............................ 40

ephedrine sulfate .......................... 18

EPIDIOLEX ...................................... 9

EPIFOAM ....................................... 24

epinastine hcl ................................ 43

EPINEPHRINE....................46, 47

epinephrine pf ............................... 19

epitol ................................................. 9

EPIVIR HBV .................................. 15

eplerenone ..................................... 19

EPOGEN ........................................ 17

eprosartan mesylate .................... 19

EQUETRO ....................................... 9

ergocalciferol ................................. 30

ergoloid mesylates ....................... 42

ERGOMAR .................................... 11

ergotamine-caffeine ..................... 11

ERIVEDGE .................................... 12

ERLEADA ...................................... 12

erlotinib hcl .................................... 12

errin ................................................. 36

ERTACZO ...................................... 11

ery ................................................... 24

ERY-TAB ......................................... 7

erythromycin....................... 24, 43

erythromycin base .......................... 7

erythromycin ethylsuccinate ......... 7

ESBRIET ........................................ 47

escitalopram oxalate .................... 10

54

esgic .................................................. 3

estarylla .......................................... 36

estazolam ....................................... 17

estradiol .......................................... 36

estradiol valerate........................... 36

estradiol-norethindrone acet ....... 36

ESTRING ....................................... 36

ESTROGEL ................................... 36

eszopiclone .................................... 48

ethacrynic acid .............................. 19

ethambutol hcl ............................... 12

ethosuximide ................................... 9

ethyl chloride ................................... 5

ethynodiol diac-eth estradiol ....... 37

etidronate disodium ...................... 42

etodolac ............................................ 4

etodolac er ....................................... 4

etoposide ........................................ 12

EUCRISA ....................................... 24

EURAX ........................................... 14

euthyrox .......................................... 39

EVAMIST ....................................... 37

EVOTAZ ......................................... 15

EXELDERM ................................... 11

exemestane ................................... 12

EZ FLU SHOT-FLUCELVAX

QUAD ............................................. 41

ezetimibe ........................................ 19

ezetimibe-simvastatin ................... 19

FABIOR .......................................... 24

falmina ............................................ 37

famciclovir ...................................... 15

famotidine....................................... 31

FANAPT ......................................... 15

FANAPT TITRATION PACK ....... 15

FARYDAK ...................................... 12

fayosim ........................................... 37

febuxostat....................................... 11

felbamate ......................................... 9

felodipine er ................................... 19

FEM PH .......................................... 33

FEMCAP ........................................ 42

FEMRING....................................... 37

femynor........................................... 37

fenofibrate ...................................... 19

fenofibrate micronized .................. 19

fenofibric acid ................................ 19

fenoprofen calcium..................4, 5

fenortho ............................................ 5

fentanyl ............................................. 3

fentanyl citrate ................................. 3

FERRIPROX .................................. 30

ferrous sulfate ................................ 30

FIBRICOR ..................................... 19

finasteride ...................................... 34

FIRST-PROGESTERONE

VGS ................................................ 37

flac .................................................. 45

FLAREX ......................................... 43

flavoxate hcl .................................. 33

flecainide acetate ......................... 19

FLECTOR ......................................... 5

FLEXICHAMBER ADULT

MASK/SMALL ............................... 42

FLEXICHAMBER CHILD

MASK/LARGE .............................. 42

FLEXICHAMBER CHILD

MASK/SMALL ............................... 42

FLOVENT DISKUS ...................... 47

FLOVENT HFA ............................. 47

FLUAD ........................................... 41

FLUARIX QUADRIVALENT ....... 41

FLUBLOK QUADRIVALENT ...... 41

FLUCELVAX

QUADRIVALENT ......................... 41

fluconazole .................................... 11

flucytosine ..................................... 11

fludrocortisone acetate ................ 34

FLULAVAL QUADRIVALENT... 41

FLUMIST QUADRIVALENT ....... 41

flunisolide ....................................... 45

fluocinolone acetonide........ 24, 45

fluocinolone acetonide body ...... 24

fluocinolone acetonide scalp ...... 24

fluocinonide ................................... 24

fluocinonide emulsified base ...... 24

FLUORABON................................ 30

fluoridex ......................................... 22

fluoridex daily renewal ................ 22

fluoridex enhanced whitening... 22

fluoridex sensitivity relief ............. 22

fluoritab .......................................... 30

fluorometholone ............................ 43

FLUOROPLEX.............................. 24

FLUOROURACIL ......................... 24

fluorouracil ..................................... 24

fluoxetine hcl ................................. 10

fluoxetine hcl (pmdd) ................... 10

fluphenazine decanoate .............. 15

fluphenazine hcl ........................... 15

FLURA-DROPS ............................ 30

flurandrenolide .............................. 24

flurazepam hcl .............................. 48

flurbiprofen ....................................... 5

flurbiprofen sodium ...................... 43

flutamide ........................................ 12

fluticasone propionate......... 24, 46

fluticasone-salmeterol .................. 47

FLUTICASONE-

SALMETEROL .............................. 47

fluvastatin sodium......................... 19

fluvastatin sodium er .................... 19

fluvoxamine maleate .................... 10

fluvoxamine maleate er ............... 10

FLUZONE HIGH-DOSE .............. 41

FLUZONE QUADRIVALENT ...... 41

FML ................................................. 43

FML FORTE .................................. 43

folic acid ......................................... 30

FOLLISTIM AQ ............................. 35

fondaparinux sodium ..................... 8

FORTEO ........................................ 42

fosamprenavir calcium ................ 15

fosinopril sodium........................... 19

fosinopril sodium-hctz .................. 19

FRAGMIN ........................................ 8

frovatriptan succinate .................. 11

fulvestrant ...................................... 12

furosemide ..................................... 19

FUZEON ........................................ 15

fyavolv ............................................ 37

FYCOMPA ....................................... 9

gabapentin ....................................... 9

galantamine hydrobromide ........... 9

galantamine hydrobromide er ...... 9

GALZIN .......................................... 30

ganirelix acetate ........................... 35

GARDASIL 9 ................................. 41

gatifloxacin ..................................... 43

gavilyte-c ........................................ 32

gavilyte-g ........................................ 32

gavilyte-h ........................................ 32

gavilyte-n with flavor pack .......... 32

GEBAUERS PAIN EASE .............. 5

GEBAUERS SPRAY AND

STRETCH ........................................ 5

GELCLAIR ..................................... 42

gemfibrozil ..................................... 19

GENADUR ..................................... 24

generlac ......................................... 32

gengraf ........................................... 40

gentak ............................................. 43

gentamicin sulfate................. 7, 43

GENTEEL LANCING KIT

(BLUE) ............................................ 27

GENVOYA ..................................... 15

GIALAX .......................................... 32

gianvi .............................................. 37

GILENYA ....................................... 21

55

GILOTRIF....................................... 12

glatiramer acetate ......................... 21

glatopa ............................................ 21

GLEOSTINE .................................. 12

glimepiride ...................................... 26

glipizide er ...................................... 26

glipizide ir ....................................... 26

glipizide xl....................................... 26

glipizide-metformin hcl ................. 26

GLUCAGEN HYPOKIT ................ 28

GLUCAGON EMERGENCY ....... 28

glyburide ......................................... 26

glyburide micronized .................... 26

glyburide-metformin ...................... 26

glycine............................................. 33

glycine urologic ............................. 33

glycolic acid ................................... 24

glycopyrrolate ................................ 32

GLYCOPYRROLATE ................... 32

glydo ................................................. 5

GLYXAMBI..................................... 26

gnp folic acid .................................. 30

GOLYTELY .................................... 32

GONAL-F ....................................... 35

GONAL-F RFF .............................. 35

GONAL-F RFF REDIJECT.......... 35

GOODSENSE CLICKFINE

PEN NEEDLE ................................ 28

GOODSENSE PEN NEEDLE

PENFINE ........................................ 28

GORDOFILM ................................. 24

GORDONS UREA ........................ 24

grafco silver nit applicator ........... 24

granisetron hcl ............................... 10

griseofulvin microsize ................... 11

griseofulvin ultramicrosize ........... 11

guanfacine hcl ............................... 19

guanfacine hcl er .......................... 21

GUANIDINE HCL .......................... 12

GYNAZOLE-1 ................................ 11

HAEGARDA................................... 40

hailey 24 fe .................................... 37

halobetasol propionate................. 24

HALOG ........................................... 24

haloperidol ..................................... 15

haloperidol decanoate .................. 15

haloperidol lactate......................... 15

HAVRIX .......................................... 41

HEALTHWISE INSULIN

SYR/NEEDLE ................................ 28

HEALTHWISE MICRON PEN

NEEDLES ...................................... 28

heather ........................................... 37

HEPAGAM B ................................. 40

heparin (porcine) in nacl ................ 8

HEPLISAV-B ................................. 41

HIBERIX ........................................ 41

HIZENTRA .................................... 40

hm loratadine ................................ 46

homatropaire ................................. 44

homatropine hbr ........................... 44

HUMALOG KWIKPEN ................ 28

HUMALOG MIX 50/50

KWIKPEN ...................................... 28

HUMALOG MIX 50/50 VIAL ....... 28

HUMALOG MIX 75/25

KWIKPEN ...................................... 28

HUMALOG MIX 75/25 VIAL ....... 28

HUMALOG U-100 JUNIOR

KWIKPEN ...................................... 28

HUMALOG U-100 VIAL AND

CARTRIDGE ................................. 28

HUMIRA ......................................... 40

HUMIRA PEDIATRIC

CROHNS START ......................... 40

HUMIRA PEN ............................... 40

HUMIRA PEN-CD/UC/HS

STARTER ...................................... 40

HUMIRA PEN-PS/UV/ADOL

HS START ..................................... 40

HUMULIN 70/30 KWIKPEN ....... 28

HUMULIN 70/30 VIAL ................. 28

HUMULIN N KWIKPEN .............. 28

HUMULIN N VIAL ........................ 28

HUMULIN R U-500 KWIKPEN..28

HUMULIN R U-500 VIAL

(CONCENTRATED) .................... 28

HUMULIN R VIAL ........................ 28

HYCAMTIN ................................... 12

hydralazine hcl.............................. 19

hydrochlorothiazide ...................... 19

hydrocodone polst-cpm polst

er ..................................................... 46

hydrocodone-acetaminophen ........ 3

hydrocodone-homatropine .......... 46

hydrocodone-ibuprofen .................. 3

hydrocortisone.............. 24, 34, 41

hydrocortisone ace-pramoxine..41

hydrocortisone butyr lipo base.. 24

hydrocortisone butyrate .............. 24

hydrocortisone valerate ............... 24

hydrocortisone-acetic acid .......... 45

hydromet ........................................ 46

hydromorphone hcl ......................... 3

hydromorphone hcl er .................... 3

hydroxocobalamin acetate ......... 30

hydroxychloroquine sulfate ......... 14

hydroxyprogesterone caproate. 37

hydroxyurea ................................... 12

hydroxyzine hcl ............................. 17

hydroxyzine pamoate .................. 17

HYLATOPIC PLUS ...................... 24

HYLENEX ...................................... 42

HYLIRA .......................................... 25

hyophen ......................................... 33

hyoscyamine sulfate .................... 32

hyoscyamine sulfate er ............... 32

hyoscyamine sulfate sl ................ 32

HYPERHEP B S/D ....................... 40

HYPERSAL ................................... 46

HYQVIA .......................................... 40

ibandronate sodium ..................... 42

IBRANCE ....................................... 12

ibu ..................................................... 5

ibuprofen .......................................... 5

ICLUSIG ......................................... 12

IDHIFA ............................................ 12

ILEVRO .......................................... 43

ILUMYA .......................................... 40

imatinib mesylate .......................... 12

IMBRUVICA................................... 12

imipramine hcl ............................... 10

imipramine pamoate .................... 10

imiquimod ...................................... 25

IMVEXXY MAINTENANCE

PACK .............................................. 37

IMVEXXY STARTER PACK ....... 37

INBRIJA ......................................... 14

incassia .......................................... 37

INCRELEX ..................................... 35

INCRUSE ELLIPTA ..................... 47

indapamide .................................... 19

indomethacin ................................... 5

indomethacin er .............................. 5

INFANRIX ...................................... 41

INLYTA ........................................... 12

INPEN 100-BLUE-LILLY ............. 27

INPEN 100-BLUE-NOVO ............ 27

INPEN 100-GRAY-LILLY ............ 27

INPEN 100-GREY-NOVO ........... 27

INPEN 100-PINK-LILLY .............. 27

INPEN 100-PINK-NOVO ............. 27

INSPIREASE RESERVOIR

BAGS .............................................. 42

INSULIN LISPRO ......................... 28

INSULIN PEN NEEDLES ........... 28

INSULIN SYRINGES ................... 29

INTELENCE .................................. 15

INTRAROSA ................................. 33

56

INTRON A ...................................... 15

introvale .......................................... 37

INVEGA SUSTENNA ................... 15

INVEGA TRINZA .......................... 15

INVELTYS ...................................... 43

INVIRASE ...................................... 16

INVOKAMET ................................. 26

INVOKAMET XR ........................... 26

INVOKANA .................................... 26

iodine strong .................................. 30

iodine tincture .................................. 7

IOPIDINE ....................................... 44

IPOL ................................................ 41

ipratropium bromide............ 46, 47

ipratropium-albuterol .................... 47

irbesartan ....................................... 19

irbesartan-hydrochlorothiazide..19

IRESSA .......................................... 12

ISENTRESS .................................. 16

ISENTRESS HD ........................... 16

isibloom .......................................... 37

isoniazid ......................................... 12

ISORDIL TITRADOSE ................. 19

isosorbide dinitrate ....................... 19

isosorbide dinitrate er ................... 19

isosorbide mononitrate................. 19

isosorbide mononitrate er ............ 19

isotretinoin ...................................... 25

isradipine ........................................ 19

itraconazole ................................... 11

ivermectin ....................................... 14

JADENU ......................................... 30

JADENU SPRINKLE .................... 30

JAKAFI ........................................... 12

jantoven ............................................ 8

JANUMET ...................................... 26

JANUMET XR ............................... 26

JANUVIA ........................................ 26

JARDIANCE .................................. 26

jasmiel............................................. 37

jencycla........................................... 37

JENTADUETO .............................. 26

JENTADUETO XR ........................ 26

jinteli ................................................ 37

jolessa............................................. 37

juleber ............................................. 37

junel 1.5/30 .................................... 37

junel 1/20 ........................................ 37

junel fe 1.5/30 ................................ 37

junel fe 1/20 ................................... 37

junel fe 24 ...................................... 37

JYNARQUE ................................... 30

kaitlib fe .......................................... 37

KALETRA ...................................... 16

kalliga ............................................. 37

KALYDECO ................................... 47

kariva .............................................. 37

kelnor 1/35 .................................... 37

kelnor 1/50 .................................... 37

KERALYT SCALP ........................ 25

ketoconazole ................................. 11

ketorolac tromethamine........ 5, 43

KEVZARA ...................................... 40

KHEDEZLA ................................... 10

kids first vitamin d3 gummies .... 30

KINERET ....................................... 40

KINRIX ........................................... 41

kionex ............................................. 30

KISQALI 200 DOSE .................... 12

KISQALI FEMARA 200 DOSE.. 13



KLARITY-A .................................... 43

klor-con .......................................... 30

klor-con 10 .................................... 30

klor-con m10 ................................. 30

KLOR-CON M15 .......................... 30

klor-con m20 ................................. 30

klor-con sprinkle ........................... 30

klor-con/ef ...................................... 30

KORLYM ....................................... 35

K-PHOS ......................................... 30

K-PHOS NO 2 .............................. 30

k-prime ........................................... 30

KRINTAFEL .................................. 14

KRISTALOSE ............................... 32

kurvelo ........................................... 37

KUVAN ........................................... 33

labetalol hcl ................................... 19

LACRISERT .................................. 44

lactated ringers ............................. 30

lactic acid ....................................... 25

lactic acid e ................................... 25

lactulose ......................................... 32

lactulose encephalopathy ........... 32

lamivudine ..................................... 16

lamivudine-zidovudine ................. 16

lamotrigine ........................................ 9

lamotrigine er ................................... 9

LANCETS ...................................... 27

lansoprazole .................................. 31

lanthanum carbonate ................... 33

LANTUS SOLOSTAR ................. 29

LANTUS U-100 VIAL .................. 29

larin 1.5/30 ..................................... 37

larin 1/20 ........................................ 37

larin 24 fe ....................................... 37

larin fe 1.5/30 ................................ 37

larin fe 1/20 .................................... 37

larissia ............................................ 37

LASTACAFT .................................. 44

latanoprost ..................................... 44

LATRIX XM ................................... 25

LATUDA ......................................... 15

layolis fe ......................................... 37

leena ............................................... 37

leflunomide .................................... 40

LENVIMA 10 MG DAILY

DOSE ............................................. 13

LENVIMA 12 MG DAILY

DOSE ............................................. 13

LENVIMA 14 MG DAILY

DOSE ............................................. 13

LENVIMA 18 MG DAILY

DOSE ............................................. 13

LENVIMA 20 MG DAILY

DOSE ............................................. 13

LENVIMA 24 MG DAILY

DOSE ............................................. 13

LENVIMA 4 MG DAILY DOSE.. 13

LENVIMA 8 MG DAILY DOSE.. 13

lessina ............................................ 37

letrozole .......................................... 13

leucovorin calcium ........................ 13

LEUKERAN ................................... 13

LEUKINE ........................................ 17

leuprolide acetate ......................... 35

levalbuterol hcl .............................. 47

LEVEMIR U-100 FLEXTOUCH.29

LEVEMIR U-100 VIAL ................. 29

levetiracetam ................................... 9

levetiracetam er .............................. 9

levobunolol hcl .............................. 44

levocarnitine .................................. 30

levocetirizine dihydrochloride ..... 46

levofloxacin........................... 7, 43

levonest .......................................... 37

levonorgest-eth est & eth est ..... 37

levonorgest-eth estrad 91-day.. 37

levonorgestrel ................................ 37

levonorgestrel-ethinyl estrad ...... 37

levonorg-eth estrad triphasic ...... 37

levora 0.15/30 (28) ....................... 37

levorphanol tartrate ........................ 3

levo-t ............................................... 39

levothyroxine sodium ................... 39

levothyroxine-liothyronine ........... 39

LEVOTHYROXINE-

LIOTHYRONINE ........................... 39

57

levoxyl ............................................. 39

LEVSIN ........................................... 32

LEVULAN KERASTICK ............... 25

LEXIVA ........................................... 16

lido bdk ............................................. 5

lidocaine ........................................... 5

lidocaine hcl.......................... 5, 22

lidocaine hcl (pf) .............................. 5

lidocaine hcl urethral/mucosal ...... 5

lidocaine viscous ........................... 22

lidocaine-epinephrine ..................... 5

lidocaine-hydrocortisone ace ...... 41

lidocaine-prilocaine ......................... 5

lidopin ............................................... 5

lidopril ............................................... 5

lidopril xr ........................................... 5

lido-prilo caine pack ........................ 5

LIDO-SORB ..................................... 5

LIDOZION ........................................ 5

lillow ................................................ 37

lindane ............................................ 14

linezolid............................................. 7

LINZESS ........................................ 32

liothyronine sodium....................... 39

lisinopril........................................... 19

lisinopril-hydrochlorothiazide ....... 19

lithium ............................................. 17

lithium carbonate........................... 17

lithium carbonate er ...................... 17

LITHOSTAT ................................... 33

LIVALO ........................................... 19

livixil pak ........................................... 6

LO LOESTRIN FE ........................ 37

LONSURF ...................................... 13

loperamide hcl ............................... 32

lopinavir-ritonavir ........................... 16

lopreeza .......................................... 37

loratadine ....................................... 46

lorazepam ...................................... 17

lorazepam intensol ....................... 17

LORBRENA ................................... 13

lorcet ................................................. 3

lorcet hd ............................................ 3

lorcet plus ......................................... 3

LORTAB ........................................... 3

loryna .............................................. 37

losartan potassium ....................... 19

losartan potassium-hctz............... 19

LOTEMAX ...................................... 43

loteprednol etabonate .................. 43

lovastatin ........................................ 19

low-ogestrel ................................... 37

loxapine succinate ........................ 15

lo-zumandimine ............................ 37

ludent ............................................. 30

lugols ................................................. 7

LUMIGAN ...................................... 44

LUPANETA PACK ....................... 35

LUPRON DEPOT (1-MONTH).. 35

LUPRON DEPOT (3-MONTH).. 35

LUPRON DEPOT (4-MONTH)

INTRAMUSCULAR KIT 30MG..35

LUPRON DEPOT (6-MONTH)

INTRAMUSCULAR KIT 45MG..35

LUPRON DEPOT-PED (1-

MONTH) ........................................ 35

LUPRON DEPOT-PED (3-

MONTH) ........................................ 35

lutera .............................................. 37

LYNPARZA ................................... 13

LYRICA .......................................... 21

LYSODREN .................................. 13

lyza ................................................. 37

mafenide acetate ............................ 7

MAGNEBIND 400 ........................ 30

MAGNESIUM CARBONATE ..... 30

MAGNESIUM CARBONATE

HEAVY ........................................... 30

malathion ....................................... 14

maprotiline hcl .............................. 10

marlissa ......................................... 37

MARPLAN ..................................... 10

MATULANE ................................... 13

matzim la ....................................... 19

MAVYRET ..................................... 16

MAXICOMFORT II PEN

NEEDLE ........................................ 29

MAXI-COMFORT SAFETY

PEN NEEDLE ............................... 29

MAXICOMFORT SYR 27G X

1/2" ................................................. 29

MAXIDEX ...................................... 43

me/naphos/mb/hyo1 .................... 33

meclizine hcl ................................. 10

meclofenamate sodium .................. 5

medique aspirin ............................... 5

MEDROL ....................................... 34

MEDROX-RX ................................... 3

medroxyprogesterone acetate.. 37

mefenamic acid ............................... 5

mefloquine hcl .............................. 14

megestrol acetate ........................ 37

MEKINIST ..................................... 13

MEKTOVI ...................................... 13

melodetta 24 fe............................. 37

meloxicam ........................................ 5

melphalan ...................................... 13

memantine hcl ................................. 9

memantine hcl er ............................ 9

MENACTRA .................................. 41

MENEST ........................................ 37

MENOPUR .................................... 35

MENOSTAR .................................. 37

MENTAX ........................................ 11

MENVEO ....................................... 41

meperidine hcl ................................. 3

meprobamate ................................ 17

mercaptopurine ............................. 13

mesalamine ................................... 41

mesalamine-cleanser ................... 41

MESNEX ........................................ 13

metadate er ................................... 21

metaproterenol sulfate ................. 47

metaxall .......................................... 48

metaxalone .................................... 48

metformin hcl er ............................ 26

METFORMIN HCL IR .................. 26

metformin hcl ir ............................. 26

methadone hcl ................................ 3

methadone hcl intensol .................. 3

methadose ....................................... 3

methamphetamine hcl ................. 21

methazolamide .............................. 44

methenamine hippurate ................. 7

methenamine mandelate ............... 7

methergine ..................................... 42

methimazole .................................. 39

methocarbamol ............................. 48

methotrexate ................................. 40

methotrexate (anti-rheumatic)... 40

methotrexate sodium ................... 40

methotrexate sodium (pf) ............ 40

methoxsalen .................................. 25

methoxsalen rapid ........................ 25

methscopolamine bromide .......... 32

methyl salicylate ........................... 25

methyldopa .................................... 19

methyldopa-

hydrochlorothiazide ...................... 19

methylene blue .............................. 42

methylergonovine maleate .......... 42

methylphenidate hcl ..................... 21

methylphenidate hcl er ................ 21

methylphenidate hcl er (cd) ........ 21

methylphenidate hcl er (la) ......... 21

methylprednisolone ...................... 34

methylprednisolone acetate ........ 34

methyltestosterone ....................... 34

metoclopramide hcl ...................... 10

58

metolazone .................................... 19

metoprolol succinate er ................ 19

metoprolol tartrate......................... 19

METOPROLOL-HCTZ ER........... 19

metoprolol-hydrochlorothiazide. 19

metronidazole....................... 7, 25

mexiletine hcl ................................. 19

mibelas 24 fe ................................. 37

miconazole 3 ................................. 11

microgestin 1.5/30 ........................ 38

microgestin 1/20 ............................ 38

microgestin fe 1.5/30 .................... 38

microgestin fe 1/20 ....................... 38

MICROLET NEXT LANCING

DEVICE .......................................... 27

midodrine hcl ................................. 19

MIFEPREX..................................... 30

mifepristone ................................... 30

MIGERGOT ................................... 11

miglitol............................................. 27

miglustat ......................................... 33

mili ................................................... 38

mimvey ........................................... 38

mimvey lo ....................................... 38

minitran ........................................... 19

minocycline hcl ................................ 7

minoxidil ......................................... 19

MIRCERA....................................... 17

mirtazapine .................................... 10

misoprostol..................................... 31

MITIGARE ...................................... 11

mitigo ................................................ 3

M-M-R II ......................................... 41

M-NATAL PLUS ............................ 30

modafinil ......................................... 48

moexipril hcl ................................... 19

mometasone furoate........... 25, 46

mondoxyne nl .................................. 7

mono-linyah ................................... 38

montelukast sodium ..................... 47

MONUROL....................................... 7

morgidox........................................... 7

morphine sulfate ............................. 4

morphine sulfate (concentrate)... 3

morphine sulfate er ......................... 3

morphine sulfate er beads ............. 3

MOVANTIK .................................... 32

MOVIPREP .................................... 32

MOXEZA ........................................ 43

moxifloxacin hcl.....................7, 43

MOZOBIL ....................................... 17

MUCOSITISRX ............................. 22

MUCOTROL .................................. 42

MULTAQ ........................................ 19

multi prenatal ................................ 30

MULTI-LANCET DEVICE 2 ....... 27

mupirocin .......................................... 7

mupirocin calcium ........................... 7

MUSE ............................................. 33

mycophenolate mofetil ................ 40

mycophenolate sodium ............... 40

MYLERAN ..................................... 13

MYOBLOC .................................... 42

myorisan ........................................ 25

MYRBETRIQ ................................. 33

NABI-HB ........................................ 40

nabumetone ..................................... 5

n-acetyl-l-cysteine ........................ 30

nadolol ........................................... 19

nafrinse .......................................... 30

NAFRINSE DAILY

ACIDULATED ............................... 22

nafrinse drops ............................... 30

NAFTIN .......................................... 11

naloxone hcl ..................................... 6

naltrexone hcl .................................. 6

naproxen ........................................... 5

naproxen dr ...................................... 5

naproxen sodium............................. 5

naratriptan hcl ............................... 11

NASCOBAL ................................... 30

NATACYN ..................................... 43

NATAZIA ....................................... 38

nateglinide ..................................... 27

NATPARA ..................................... 42

NATROBA ..................................... 14

NATURE-THROID ....................... 39

NEBUPENT ................................... 14

nebusal .......................................... 46

necon 0.5/35 (28) ......................... 38

nefazodone hcl ............................. 10

neomycin sulfate ............................. 8

neomycin-bacitracin zn-

polymyx .......................................... 44

neomycin-polymyxin b gu .............. 8

neomycin-polymyxin-dexameth 44

neomycin-polymyxin-

gramicidin ...................................... 45

neomycin-polymyxin-hc ............... 45

neo-polycin .................................... 45

neo-polycin hc .............................. 45

NEOSALUS ................................... 25

NEO-SYNALAR ............................ 25

NERLYNX ..................................... 13

NESTABS ...................................... 30

neuac ............................................. 25

NEULASTA .................................... 17

NEULASTA ONPRO .................... 17

NEUPRO ........................................ 14

neutral sodium fluoride ................ 22

NEUTRASAL ................................. 22

NEVANAC ..................................... 43

nevirapine ...................................... 16

nevirapine er .................................. 16

NEXAVAR ...................................... 13

NEXAVIR ....................................... 42

niacin er (antihyperlipidemic) ...... 19

nicardipine hcl ............................... 19

nifedipine ........................................ 19

nifedipine er ................................... 19

nifedipine er osmotic release ..... 19

nikki ................................................. 38

nilutamide ...................................... 13

nimodipine ..................................... 19

NINLARO ....................................... 13

nisoldipine er ................................. 20

NITRO-BID .................................... 20

NITRO-DUR .................................. 20

nitrofurantoin ................................... 8

nitrofurantoin macrocrystal ............ 8

nitrofurantoin monohydrate

macrocrystals .................................. 8

nitroglycerin ................................... 20

NITROMIST ................................... 20

nitro-time ........................................ 20

NITYR ............................................. 33

NIVESTYM .................................... 17

nizatidine ........................................ 31

nolix ................................................ 25

nora-be ........................................... 38

NORDITROPIN FLEXPRO ......... 35

norethin ace-eth estrad-fe ........... 38

norethindrone ................................ 38

norethindrone acetate .................. 38

norethindrone acet-ethinyl est...38

norethindrone-eth estradiol ......... 38

norethin-eth estradiol-fe .............. 38

norgestimate-eth estradiol .......... 38

norgestimate-ethinyl estradiol

triphasic .......................................... 38

norlyda ............................................ 38

norlyroc .......................................... 38

NORPACE CR .............................. 20

nortrel 0.5/35 (28) ......................... 38

nortrel 1/35 (21) ............................ 38

nortrel 1/35 (28) ............................ 38

nortrel 7/7/7 ................................... 38

nortriptyline hcl .............................. 10

NORVIR ......................................... 16

59

NOVOFINE AUTOCOVER

PEN NEEDLE ............................... 29

NOVOFINE PEN NEEDLE ......... 29

NOVOFINE PLUS PEN

NEEDLE ......................................... 29

NOVOLIN 70/30 FLEXPEN ........ 29

NOVOLIN 70/30 FLEXPEN

RELION .......................................... 29

NOVOLIN 70/30 RELION ........... 29

NOVOLIN 70/30 VIAL .................. 29

NOVOLIN N RELION ................... 29

NOVOLIN N VIAL ......................... 29

NOVOLIN R RELION ................... 29

NOVOLIN R VIAL ......................... 29

NOVOLOG FLEXPEN ................. 29

NOVOLOG MIX 70/30

FLEXPEN ....................................... 29

NOVOLOG MIX 70/30 VIAL ....... 29

NOVOLOG PENFILL ................... 29

NOVOLOG U-100 VIAL ............... 29

NOVOPEN ECHO ........................ 27

NOVOTWIST PEN NEEDLE ...... 29

NOXAFIL ........................................ 11

np thyroid ....................................... 39

NP THYROID ................................ 39

NPLATE ......................................... 17

NUCALA ......................................... 46

NUCORT ........................................ 25

NUEDEXTA ................................... 21

nulev ............................................... 32

NUPLAZID ..................................... 15

NUVAKAAN ..................................... 6

NUVARING .................................... 38

nyamyc ........................................... 11

NYMALIZE ..................................... 20

nystatin ........................................... 11

nystatin-triamcinolone .................. 11

nystop ............................................. 11

ocella .............................................. 38

octreotide acetate ......................... 35

ODEFSEY ...................................... 16

ODOMZO ....................................... 13

OFEV .............................................. 47

ofloxacin.......................... 8, 43, 45

ogestrel ........................................... 38

okebo ................................................ 8

olanzapine ...................................... 15

olanzapine-fluoxetine hcl ............. 10

olmesartan medoxomil ................. 20

olmesartan medoxomil-hctz ........ 20

olmesartan-amlodipine-hctz ........ 20

olopatadine hcl .............................. 43

OLUMIANT .................................... 40

omega-3-acid ethyl esters .......... 20

omeprazole ................................... 31

OMIDRIA ....................................... 45

ondansetron hcl ............................ 10

ondansetron odt ........................... 10

ONE TOUCH VERIO KIT

W/DEVICE ..................................... 27

ONETOUCH DELICA

LANCING DEV ............................. 27

ONETOUCH DELICA PLUS

LANCING ....................................... 27

ONETOUCH ULTRA BLUE

TEST STRIPS ............................... 27

OPSUMIT ...................................... 48

ORACIT ......................................... 30

oralone ........................................... 22

ORAMAGICRX ............................. 42

ORAVIG ......................................... 11

ORENCIA ...................................... 40

ORENCIA CLICKJECT ............... 40

ORILISSA ...................................... 35

ORKAMBI ...................................... 47

orphenadrine citrate er ................ 48

orsythia .......................................... 38

oscimin ........................................... 32

oscimin sr ...................................... 32

oseltamivir phosphate ................. 16

OSMOPREP ................................. 32

OSPHENA ..................................... 35

OTEZLA ......................................... 40

OVACE PLUS ............................... 25

OVIDREL ....................................... 35

oxandrolone .................................. 34

oxaprozin .......................................... 5

oxazepam ...................................... 17

oxcarbazepine ................................. 9

OXERVATE ................................... 45

oxiconazole nitrate ....................... 11

OXISTAT ....................................... 11

OXTELLAR XR ................................ 9

oxybutynin chloride ...................... 33

oxybutynin chloride er ................. 33

oxycodone hcl .................................. 4

OXYCODONE HCL ER ................. 4

oxycodone-acetaminophen ........... 4

oxycodone-aspirin ........................... 4

oxycodone-ibuprofen ...................... 4

OXYCONTIN .................................... 4

oxymorphone hcl ............................. 4

oxymorphone hcl er ........................ 4

OZEMPIC ...................................... 27

pacerone ........................................ 20

paliperidone er .............................. 15

PALYNZIQ ..................................... 33

PANRETIN .................................... 13

pantoprazole sodium ................... 32

paricalcitol ...................................... 42

paroex ............................................ 22

paromomycin sulfate ...................... 8

paroxetine hcl ................................ 10

paroxetine hcl er ........................... 10

PASER ........................................... 12

PAZEO ........................................... 43

PEDIARIX ...................................... 41

PEDVAX HIB ................................. 41

peg 3350/electrolytes .................. 32

peg 3350-kcl-na bicarb-nacl ....... 32

peg-3350/electrolytes................... 32

PEGANONE .................................... 9

PEGASYS ...................................... 16

PEGASYS PROCLICK ................ 16

PEGINTRON ................................. 16

peg-prep ......................................... 32

penicillamine .................................. 33

penicillin g procaine ....................... 8

penicillin v potassium ..................... 8

pentamidine isethionate .............. 14

PENTASA ...................................... 41

pentazocine-naloxone hcl ............. 4

pentoxifylline er ............................. 20

PERFOROMIST ........................... 47

perindopril erbumine .................... 20

periogard ........................................ 22

permethrin ...................................... 14

perphenazine ................................ 10

perphenazine-amitriptyline .......... 10

PERSERIS .................................... 15

phenadoz ....................................... 46

phenazo ......................................... 33

phenazopyridine hcl ..................... 33

phenelzine sulfate ........................ 10

phenobarbital .................................. 9

phenobarbital sodium .................... 9

phenoxybenzamine hcl ................ 20

phenylephrine hcl ......................... 45

phenylephrine-guaifenesin .......... 46

phenytoin ......................................... 9

phenytoin infatabs .......................... 9

phenytoin sodium extended ......... 9

philith .............................................. 38

PHOSLYRA ................................... 33

phospha 250 neutral .................... 30

phosphasal .................................... 33

PHOSPHOLINE IODIDE ............. 44

phosphorous .................................. 30

phospho-trin 250 neutral ............. 30

60

phrenilin forte ................................... 4

physiolyte ....................................... 30

physiosol irrigation ........................ 30

PICATO .......................................... 25

PIFELTRO ..................................... 16

pilocarpine hcl..................... 22, 44

pimecrolimus ................................. 25

pimozide ......................................... 15

pimtrea ............................................ 38

pindolol ........................................... 20

pioglitazone hcl ............................. 27

pioglitazone hcl-glimepiride ........ 27

pioglitazone hcl-metformin hcl.. 27

pirmella 1/35 .................................. 38

pirmella 7/7/7 ................................. 38

piroxicam .......................................... 5

PLENVU ......................................... 32

PNEUMOVAX 23 .......................... 41

pnv prenatal plus multivit+dha.. 30

POCKET SPACER ....................... 42

podocon .......................................... 25

podofilox ......................................... 25

polocaine .......................................... 6

polocaine-mpf .................................. 6

polycin............................................. 45

polymyxin b sulfate ......................... 8

polymyxin b-trimethoprim ............ 45

POMALYST ................................... 13

portia-28 ......................................... 38

pot bicarb-pot chloride ................. 30

potassium bicarbonate................. 30

potassium chloride ....................... 30

potassium chloride crys er .......... 30

potassium chloride er ................... 30

potassium citrate er ...................... 30

potassium citrate-citric acid ........ 31

POTELIGEO .................................. 13

POVIDONE-IODINE ..................... 43

pr benzoyl peroxide wash ........... 25

PRADAXA ........................................ 8

pralidoxime chloride ..................... 42

PRALUENT .................................... 20

pramipexole dihydrochloride ....... 14

pramipexole dihydrochloride er. 14

pramox ............................................ 25

prasugrel hcl .................................. 14

pravastatin sodium ....................... 20

praziquantel ................................... 14

prazosin hcl ................................... 20

PRED MILD ................................... 43

PRED-G ......................................... 45

PRED-G S.O.P. ............................ 45

prednicarbate................................. 25

prednisolone ................................. 34

prednisolone acetate ................... 43

prednisolone acetate p-f ............. 43

prednisolone sodium

phosphate........................... 34, 43

prednisone ..................................... 34

PREDNISONE INTENSOL ......... 34

PREFEST ...................................... 38

pregabalin ...................................... 22

pregnyl ........................................... 35

PREMARIN ................................... 38

PREMESISRX .............................. 31

premium lidocaine ........................... 6

PREMPHASE ............................... 38

PREMPRO .................................... 38

PRENAISSANCE ......................... 31

PRENATA ..................................... 31

prenatal .......................................... 31

prenatal multi +dha ...................... 31

prenatal plus iron .......................... 31

PREPOPIK .................................... 33

prevalite ......................................... 20

PREVENT SAFETY PEN

NEEDLES ...................................... 29

preventeza ..................................... 38

prevident ........................................ 22

previfem ......................................... 38

PREVNAR 13 ............................... 41

PREVYMIS .................................... 16

PREZCOBIX ................................. 16

PREZISTA ..................................... 16

PRIALT ............................................. 4

PRIFTIN ......................................... 12

prilolid ................................................ 6

prilovix ............................................... 6

PRILOVIX LITE ............................... 6

prilovix plus ...................................... 6

priloxx lp ............................................ 6

primaquine phosphate ................. 14

primidone .......................................... 9

PRIMLEV .......................................... 4

PRIMSOL ......................................... 8

PROAIR HFA ................................ 47

PROAIR RESPICLICK ................ 47

probenecid ..................................... 11

prochlorperazine ........................... 10

prochlorperazine maleate ........... 10

PROCORT .................................... 41

PROCRIT ...................................... 17

PROCTOFOAM HC ..................... 41

procto-med hc ............................... 41

procto-pak ..................................... 41

proctosol hc ................................... 41

proctozone-hc ............................... 41

progesterone ................................. 38

progesterone micronized ............ 38

PROGLYCEM ............................... 28

PROGRAF ..................................... 40

PROLIA .......................................... 42

PROMACTA .................................. 17

promethazine hcl .......................... 46

promethazine-codeine ................. 46

promethazine-dm .......................... 46

promethazine-phenyleph-

codeine ........................................... 46

promethazine-phenylephrine ...... 46

promethegan ................................. 46

propafenone hcl ............................ 20

propafenone hcl er ....................... 20

propantheline bromide ................. 33

proparacaine hcl ........................... 45

propranolol hcl .............................. 20

propranolol hcl er.......................... 20

propranolol-hctz ............................ 20

propylthiouracil .............................. 39

PROQUAD .................................... 41

protriptyline hcl .............................. 10

pseudoephedrine-bromphen-

dm ................................................... 46

PSORCON .................................... 25

PULMICORT FLEXHALER ......... 47

pulmosal ......................................... 46

PULMOZYME ............................... 47

PYLERA ......................................... 33

pyrazinamide ................................. 12

pyridostigmine bromide ............... 12

pyridostigmine bromide er ........... 12

pyrogallic acid ............................... 25

qc aspirin low dose ........................ 5

QUADRACEL ................................ 41

quazepam ...................................... 17

quetiapine fumarate ..................... 15

quetiapine fumarate er ................ 15

QUILLIVANT XR ........................... 21

quinapril hcl ................................... 20

quinapril-hydrochlorothiazide ...... 20

quinidine gluconate er ................. 20

quinidine sulfate ............................ 20

quinine sulfate ............................... 14

rabeprazole sodium ...................... 32

raloxifene hcl ................................. 35

ramelteon ....................................... 48

ramipril ............................................ 20

ranitidine hcl .................................. 32

ranolazine er ................................. 20

rasagiline mesylate ...................... 14

61

REBETOL ...................................... 16

reclipsen ......................................... 38

RECOMBIVAX HB ........................ 41

RECTIV .......................................... 20

REGRANEX................................... 25

relador pak ....................................... 6

relador pak plus .............................. 6

RELENZA DISKHALER ............... 16

RELION LANCET DEVICES

30G ................................................. 27

RELISTOR ..................................... 33

RELNATE DHA ............................. 31

RENACIDIN ................................... 33

repaglinide ..................................... 27

repaglinide-metformin hcl ............ 27

REPATHA ...................................... 20

REPATHA PUSHTRONEX

SYSTEM......................................... 20

REPATHA SURECLICK .............. 20

RESCRIPTOR ............................... 16

RESTASIS ..................................... 45

RESTASIS MULTIDOSE ............. 45

RETACRIT ..................................... 17

REVLIMID ...................................... 13

REXULTI ........................................ 15

REYATAZ....................................... 16

ribasphere ...................................... 16

ribasphere ribapak ........................ 16

RIBASPHERE RIBAPAK ............. 16

ribavirin ........................................... 16

RIDAURA ....................................... 40

rifabutin ........................................... 12

RIFAMATE ..................................... 12

rifampin ........................................... 12

RIFATER ........................................ 12

riluzole ............................................ 22

rimantadine hcl .............................. 16

ringers irrigation ............................ 31

RIOMET ......................................... 27

risedronate sodium ....................... 42

RISPERDAL CONSTA ................ 15

risperidone ..................................... 15

ritonavir ........................................... 16

rivastigmine ...................................... 9

rivastigmine tartrate ........................ 9

rivelsa ............................................. 38

rizatriptan benzoate ...................... 11

ropinirole hcl .................................. 14

ropinirole hcl er ............................. 14

ropivacaine hcl ................................ 6

rosadan........................................... 25

ROSADAN ..................................... 25

rosuvastatin calcium..................... 20

ROTARIX ....................................... 41

ROTATEQ ..................................... 41

roweepra ........................................... 9

roweepra xr ...................................... 9

ROZEREM .................................... 48

RUBRACA ..................................... 13

RYCLORA ..................................... 46

RYDAPT ........................................ 13

SALICEPT ..................................... 42

salicylic acid .................................. 25

salicylic acid-cleanser ................. 25

salimez ........................................... 25

saline bacteriostatic ..................... 31

SALINE-PHENOL ........................ 31

SALIVAMAX .................................. 22

salsalate ............................................ 5

SAMSCA ....................................... 31

SANDIMMUNE ............................. 40

SANDOSTATIN LAR DEPOT... 35

SANTYL ......................................... 25

SAPHRIS ....................................... 15

SAVELLA ....................................... 22

SAVELLA TITRATION PACK... 22

scopolamine .................................. 10

SECONAL ..................................... 48

SECURESAFE INSULIN

SYRINGE ...................................... 29

SELECT-OB .................................. 31

selegiline hcl ................................. 14

selenium sulfide ............................ 25

SELZENTRY ................................. 16

sensorcaine ...................................... 6

sensorcaine/epinephrine ................ 6

sensorcaine-mpf .............................. 6

sensorcaine-mpf/epinephrine ........ 6

SENSORCAINE-

MPF/EPINEPHRINE ....................... 6

SEREVENT DISKUS ................... 47

sertraline hcl .................................. 10

setlakin ........................................... 38

sevelamer carbonate ................... 33

sevelamer hcl ................................ 33

sf ..................................................... 22

sf 5000 plus ................................... 22

SFROWASA ................................. 41

sharobel ......................................... 38

SIGNIFOR ..................................... 35

SIKLOS .......................................... 13

sildenafil citrate................... 33, 48

SILENOR ....................................... 48

silodosin ......................................... 34

silver nitrate ...................................... 8

silver sulfadiazine ............................ 8

SIMBRINZA ................................... 44

simliya ............................................ 38

simpesse ........................................ 38

SIMPONI ........................................ 40

simvastatin ..................................... 20

sirolimus ......................................... 40

SIVEXTRO ...................................... 8

sm vitamin d3 ................................ 31

sod citrate-citric acid .................... 31

sodium chloride................... 31, 46

sodium chloride bacteriostatic...31

sodium fluoride....................22, 31

sodium fluoride 5000 plus 22

sodium hyaluronate ...................... 25

sodium phenylbutyrate ................ 33

sodium polystyrene sulfonate... 31

sodium sulfacetamide .................. 25

sodium sulfacetamide wash ....... 25

SOFOSBUVIR-VELPATASVIR.16

solifenacin succinate .................... 34

SOLTAMOX................................... 13

SOMATULINE DEPOT ................ 35

SOMAVERT .................................. 35

SOOLANTRA ................................ 25

SORBITOL .................................... 42

sorbitol ............................................ 42

sorbitol-mannitol ........................... 42

sorine .............................................. 20

sotalol hcl ....................................... 20

sotalol hcl (af) ................................ 20

spinosad ......................................... 14

SPIRIVA HANDIHALER .............. 47

SPIRIVA RESPIMAT ................... 47

spironolactone ............................... 20

spironolactone-hctz ...................... 20

sprintec 28 ..................................... 38

SPRYCEL ...................................... 13

sps .................................................. 31

sronyx ............................................. 38

ssd .................................................... 8

SSKI ................................................ 46

sss 10-5 ......................................... 25

stavudine ........................................ 16

STELARA ...................................... 40

sterile water for injection ............. 42

sterile water for irrigation ............ 31

STIMATE ....................................... 35

STIOLTO RESPIMAT .................. 47

STIVARGA .................................... 13

STRENSIQ .................................... 33

streptomycin sulfate ....................... 8

STRIBILD ....................................... 16

STRIVERDI RESPIMAT .............. 47

62

subvenite .......................................... 9

SUCRAID ....................................... 33

sucralfate ........................................ 32

sulfacetamide sodium......... 25, 43

sulfacetamide sodium (acne) ...... 25

sulfacetamide sodium-sulfur25, 26

sulfacetamide sod-sulfur wash..26

sulfacetamide-prednisolone 45

sulfacetamide-sulfur in urea ........ 26

sulfadiazine ...................................... 8

sulfamethoxazole-trimethoprim... 8

sulfamez wash............................... 26

SULFAMYLON ................................ 8

sulfasalazine .................................. 41

sulfatrim pediatric ............................ 8

sulfurated lime ............................... 14

sulindac ............................................ 5

SUMADAN ..................................... 26

sumatriptan .................................... 11

sumatriptan succinate .................. 12

sumatriptan succinate refill ......... 12

SUMAXIN CP ................................ 26

SUPPRELIN LA ............................ 35

SUPRAX........................................... 8

SUPREP BOWEL PREP KIT ..... 33

SURVANTA ................................... 46

SUTENT ......................................... 13

syeda .............................................. 38

SYLATRON ................................... 13

SYMAX DUOTAB ......................... 33

symax-sr ......................................... 33

SYMBICORT ................................. 47

SYMDEKO ..................................... 47

SYMFI ............................................. 16

SYMFI LO ...................................... 16

SYMJEPI ........................................ 47

SYMLINPEN 120 .......................... 27

SYMLINPEN 60 ............................ 27

SYMPROIC .................................... 33

SYMTUZA ...................................... 16

SYNAGIS ....................................... 40

SYNAREL ...................................... 35

SYNDROS ..................................... 10

SYNERA........................................... 6

SYNJARDY .................................... 27

SYNJARDY XR ............................. 27

TABLOID ........................................ 13

TACLONEX ................................... 26

tacrolimus............................26, 40

tadalafil ........................................... 34

tadalafil (pah) ................................. 48

TAFINLAR ...................................... 13

TAGRISSO .................................... 13

TAKHZYRO ................................... 42

TALTZ ............................................ 40

TALZENNA ................................... 13

tamoxifen citrate ........................... 13

tamsulosin hcl ............................... 34

TARGRETIN ................................. 13

tarina 24 fe .................................... 38

tarina fe 1/20 ................................. 38

tarina fe 1/20 eq ........................... 38

taron-crystals ................................ 31

TASIGNA ....................................... 13

TAVALISSE ................................... 17

tazarotene ..................................... 26

TAZORAC ..................................... 26

taztia xt .......................................... 20

TECFIDERA .................................. 21

TEKTURNA HCT ......................... 20

telmisartan ..................................... 20

telmisartan-amlodipine ................ 20

telmisartan-hctz ............................ 20

temazepam ................................... 48

temozolomide ............................... 13

tencon ............................................... 4

tenofovir disoproxil fumarate ...... 16

terazosin hcl .................................. 34

terbinafine hcl ............................... 11

terbutaline sulfate ......................... 47

terconazole .................................... 11

testosterone .................................. 35

TESTOSTERONE

CYPIONATE ................................. 34

testosterone cypionate ................ 34

TESTOSTERONE

CYPIONATE & PROP ................. 34

TESTOSTERONE

ENANTHATE ................................ 35

testosterone enanthate ............... 35

TESTOSTERONE

PROPIONATE .............................. 35

tetcaine .......................................... 45

tetrabenazine ................................ 22

tetracaine hcl ................................. 45

tetracycline hcl ................................. 8

tetravisc ......................................... 45

tetravisc forte ................................ 45

TEXACORT ................................... 26

THALOMID .................................... 13

THEO-24 ....................................... 47

theochron ....................................... 47

theophylline er .............................. 47

THIOLA .......................................... 34

thioridazine hcl.............................. 15

thiothixene ..................................... 15

THROMBATE III ............................. 8

THYROGEN .................................. 42

THYROLAR-1 ............................... 39

THYROLAR-1/2 ............................ 39

THYROLAR-1/4 ............................ 39

THYROLAR-2 ............................... 39

THYROLAR-3 ............................... 39

tiagabine hcl .................................... 9

TIBSOVO ....................................... 13

TIGLUTIK ....................................... 22

tilia fe .............................................. 38

timolol maleate.................... 20, 44

TIMOPTIC OCUDOSE ................ 44

tinidazole .......................................... 8

TIROSINT ...................................... 39

tis-u-sol ........................................... 31

TIVICAY ......................................... 16

tizanidine hcl ................................. 48

TOBRADEX ................................... 45

TOBRADEX ST ............................ 45

tobramycin.......................... 43, 47

tobramycin sulfate .......................... 8

tobramycin-dexamethasone ....... 45

TOBREX ........................................ 44

TOLAK ............................................ 26

tolbutamide .................................... 27

tolcapone ....................................... 14

tolmetin sodium............................... 5

tolterodine tartrate ........................ 34

tolterodine tartrate er ................... 34

topex topical anesthetic............... 22

topiramate ........................................ 9

topiramate er ................................... 9

toremifene citrate .......................... 13

torsemide ....................................... 20

TOUJEO MAX SOLOSTAR ....... 29

TOUJEO SOLOSTAR ................. 29

TRACLEER ................................... 48

TRADJENTA ................................. 27

tramadol hcl er ................................ 4

tramadol hcl er (biphasic) ............. 4

tramadol hcl ir ................................. 4

tramadol-acetaminophen ............... 4

trandolapril ..................................... 20

trandolapril-verapamil hcl er ....... 20

tranexamic acid............................. 17

tranylcypromine sulfate ............... 10

TRAVATAN Z ................................ 44

trazodone hcl................................. 10

TRECATOR ................................... 12

TRELEGY ELLIPTA ..................... 47

TRELSTAR MIXJECT ................. 35

TREMFYA ...................................... 40

63

TRESIBA ........................................ 29

TRESIBA FLEXTOUCH............... 29

tretinoin............................... 13, 26

tretinoin (emollient) ....................... 26

tretinoin microsphere .................... 26

tretinoin microsphere pump ........ 26

TREXALL ....................................... 40

tri femynor ...................................... 38

triamcinolone acetonide...... 22, 26

triamterene-hctz ............................ 20

triazolam ......................................... 17

TRICARE PRENATAL DHA

ONE ................................................ 31

TRI-CHLOR ................................... 26

tricitrates ......................................... 31

triderm............................................. 26

trientine hcl..................................... 31

tri-estarylla ..................................... 38

trifluoperazine hcl .......................... 15

trifluridine ........................................ 44

trihexyphenidyl hcl ........................ 14

tri-legest fe ..................................... 38

tri-linyah .......................................... 38

tri-lo-estarylla ................................. 38

tri-lo-marzia .................................... 38

tri-lo-mili .......................................... 38

tri-lo-sprintec .................................. 38

trilyte ............................................... 33

trimethobenzamide hcl ................. 10

trimethoprim ..................................... 8

tri-mili .............................................. 38

trimipramine maleate .................... 10

trinate .............................................. 31

tri-previfem ..................................... 38

tri-sprintec ...................................... 38

TRIUMEQ....................................... 16

trivora (28) ...................................... 38

tri-vylibra ......................................... 38

tri-vylibra lo..................................... 38

tropicamide .................................... 45

trospium chloride........................... 34

trospium chloride er ...................... 34

TRUEPLUS 5-BEVEL PEN

NEEDLES ...................................... 29

TRUMENBA ................................... 41

TRUVADA ...................................... 16

tryptophan ...................................... 31

tulana .............................................. 38

turpentine ....................................... 26

TWINRIX ........................................ 41

TYBOST ......................................... 16

tydemy ............................................ 39

TYKERB ......................................... 13

TYMLOS ........................................ 42

TYVASO ........................................ 48

TYVASO REFILL ......................... 48

TYVASO STARTER .................... 48

UCERIS ......................................... 41

UDENYCA ..................................... 17

ULESFIA ........................................ 14

ULTRACARE PEN NEEDLES.. 29

umecta mousse ............................ 26

UNISTIK 2 EXTRA ....................... 27

UNISTIK 2 SUPER ...................... 28

unithroid ......................................... 39

UPTRAVI ....................................... 48

urea ................................................ 26

urea hydrating ............................... 26

urea in zn undecyl-lactic acid .... 26

urea-c40 ......................................... 26

uremez-40 ..................................... 26

uretron d/s ..................................... 34

uribel ............................................... 34

urin ds ............................................ 34

uro-458 ........................................... 34

uro-mp ............................................ 34

ursodiol .......................................... 33

uryl .................................................. 34

ustell ............................................... 34

uticap .............................................. 34

utira-c ............................................. 34

utrona-c .......................................... 34

valacyclovir hcl ............................. 16

valganciclovir hcl .......................... 16

valproic acid ..................................... 9

valsartan............................. 20, 21

valsartan-hydrochlorothiazide... 21

VANATOL LQ .................................. 4

VANATOL S ..................................... 4

vancomycin hcl ................................ 8

vandazole ......................................... 8

VANOXIDE-HC ............................. 26

VAQTA ........................................... 41

VARIVAX ....................................... 41

VARUBI ......................................... 11

vcf vaginal contraceptive ............ 42

velivet ............................................. 39

VELTASSA .................................... 31

VEMLIDY ....................................... 16

VENCLEXTA ................................. 13

VENCLEXTA STARTING

PACK ............................................. 13

venlafaxine hcl .............................. 10

venlafaxine hcl er ......................... 10

VENTAVIS ..................................... 48

VENTOLIN HFA ........................... 47

verapamil hcl ................................. 21

verapamil hcl er ............................ 21

VEREGEN ..................................... 26

VERZENIO .................................... 13

vexatrol ............................................. 6

V-GO 20 ......................................... 28

V-GO 30 ......................................... 28

V-GO 40 ......................................... 28

VIBRAMYCIN .................................. 8

vicodin .............................................. 4

vicodin es ......................................... 4

vicodin hp ......................................... 4

VICTOZA ....................................... 27

VIDEX ............................................. 16

vienva ............................................. 39

vigabatrin ......................................... 9

vigadrone ......................................... 9

VIIBRYD ......................................... 10

VIIBRYD STARTER PACK......... 10

vilamit mb ....................................... 34

vilevev mb ...................................... 34

VIMPAT ............................................ 9

viorele ............................................. 39

VIRACEPT ..................................... 16

VIREAD .......................................... 16

virt-phos 250 neutral .................... 31

VITAFOL-OB+DHA ...................... 31

vitamin d (cholecalciferol) ........... 31

vitamin d (ergocalciferol) ............. 31

vitamin d3 ...................................... 31

VITRAKVI ...................................... 13

VITRASE ........................................ 42

VIVAGUARD LANCING

DEVICE .......................................... 28

VIVITROL ........................................ 6

VIZIMPRO ..................................... 13

voriconazole .................................. 11

VOSEVI .......................................... 16

VOTRIENT..................................... 13

vp-pnv-dha ..................................... 31

VRAYLAR ...................................... 15

vyfemla ........................................... 39

vylibra ............................................. 39

VYVANSE ...................................... 21

warfarin sodium .............................. 8

wera ................................................ 39

WESTHROID ................................ 39

WIDE-SEAL DIAPHRAGM 60.. 42

wixela inhub ................................... 47

WP THYROID ............................... 39

wymzya fe ...................................... 39

XALKORI ....................................... 13

XARELTO ........................................ 8

64

XARELTO STARTER PACK ........ 8

XELJANZ ....................................... 40

XELJANZ XR ................................. 40

XEOMIN ......................................... 43

XERAC AC..................................... 26

XERMELO ..................................... 33

XIFAXAN .......................................... 8

XIIDRA ............................................ 45

XOLAIR .......................................... 46

XOLEGEL ...................................... 11

XOSPATA ...................................... 13

XTANDI .......................................... 13

xulane ............................................. 39

xylocaine dental .............................. 6

XYREM ........................................... 48

YONSA ........................................... 14

yuvafem .......................................... 39

ZACLIR CLEANSING................... 26

zafirlukast ....................................... 47

zaleplon .......................................... 48

zarah ............................................... 39

ZARXIO .......................................... 17

zebutal .............................................. 4

ZEJULA .......................................... 14

ZELAPAR ....................................... 14

ZELBORAF .................................... 14

zenatane......................................... 26

ZENPEP ......................................... 33

zenzedi ........................................... 21

zidovudine ...................................... 16

zileuton er....................................... 47

ziprasidone hcl .............................. 15

ZIRGAN .......................................... 44

ZOLINZA ........................................ 14

zolmitriptan..................................... 12

zolpidem tartrate ........................... 48

zolpidem tartrate er ...................... 48

ZOMIG ............................................ 12

zonisamide ....................................... 9

ZONTIVITY .................................... 14

ZORTRESS ................................... 40

zovia 1/35e (28) ............................ 39

zumandimine ................................. 39

ZYDELIG ........................................ 14

ZYFLO ............................................ 47

ZYKADIA ........................................ 14

ZYLET............................................. 45

ZYPREXA RELPREVV ................ 15

ZYTIGA........................................... 14

53379208.1

Non-Discrimination and Accessibility Notice

QualChoice complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. QualChoice does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

QualChoice:

Provides free aids and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o Written information in other formats (large print, audio, accessible electronic formats, other formats)

Provides free language services to people whose primary language is not English, such as: o Qualified interpreters o Information written in other languages

If you need these services, contact Customer Service at (501) 228-7111. If you believe that QualChoice has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:

QualChoice Civil Rights Coordinator QualChoice P.O. Box 25610 Little Rock, AR 72221-5610 (501) 228-7111 Fax #: 501-707-6729 [email protected]

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the QualChoice Civil Rights Coordinator is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-868-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. Notice of Discrimination Grievance Procedures

It is the policy of QualChoice not to discriminate on the basis of race, color, national origin, sex, age or disability. QualChoice has adopted an internal grievance procedure providing for prompt and equitable resolution of complaints alleging any action prohibited by Section 1557 of the Affordable Care Act (42 U.S.C. 18116) and its implementing regulations at 45 CFR part 92, issued by the U.S. Department of Health and Human Services. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities. Section 1557 and its implementing regulations may be examined in the office of the QualChoice Civil Rights Coordinator, who has been designated to coordinate the efforts of QualChoice to comply with Section 1557 (the “Section 1557 Coordinator”):

QualChoice Civil Rights Coordinator QualChoice P.O. Box 25610 Little Rock, AR 72221-5610 (501) 228-7111 Fax #: 501-707-6729 [email protected]

Any person who believes someone has been subjected to discrimination on the basis of race, color, national origin, sex, age or disability may file a grievance under this procedure. It is against the law for QualChoice to retaliate against anyone who opposes discrimination, files a grievance, or participates in the investigation of a grievance.

Procedure:

Grievances must be submitted to the Section 1557 Coordinator within sixty (60) days of the date the person filing the grievance becomes aware of the alleged discriminatory action.

A complaint must be in writing, containing the name and address of the person filing it. The complaint must state the problem or action alleged to be discriminatory and the remedy or relief sought.

The Section 1557 Coordinator (or her/his designee) shall conduct an investigation of the complaint. This investigation may be informal, but it will be thorough, affording all interested persons an opportunity to submit evidence relevant to the complaint. The Section 1557 Coordinator will maintain the files and records of QualChoice relating to such grievances. To the extent possible, and in accordance with applicable law, the Section 1557 Coordinator will take appropriate steps to preserve the confidentiality of files and records relating to grievances and will share them only with those who have a need to know.

The Section 1557 Coordinator will issue a written decision on the grievance, based on a preponderance of the evidence, no later than thirty (30) days after its filing, including a notice to the complainant of their right to pursue further administrative or legal remedies.

The person filing the grievance may appeal the decision of the Section 1557 Coordinator by writing to the Vice President Corporate Responsibility within fifteen (15) days of receiving the Section 1557 Coordinator’s decision. The Vice President Corporate Responsibility shall issue a written decision in response to the appeal no later than thirty (30) days after its filing.

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http://www.hhs.gov/ocr/office/file/index.html

The availability and use of this grievance procedure does not prevent a person from pursuing other legal or administrative remedies, including filing a complaint of discrimination on the basis of race, color, national origin, sex, age or disability in court or with the U.S. Department of Health and Human Services, Office for Civil Rights. A person can file a complaint of discrimination electronically through the Office for Civil Rights Complaint Portal, which is available at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf , or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201.

Complaint forms are available at: http://www.hhs.gov/ocr/office/file/index.html. Such complaints must be filed within 180 days of the date of the alleged discrimination. QualChoice will make appropriate arrangements to ensure that individuals with disabilities and individuals with limited English proficiency are provided auxiliary aids and services or language assistance services, respectively, if needed to participate in this grievance process. Such arrangements may include, but are not limited to, providing qualified interpreters, providing taped cassettes of material for individuals with low vision, or assuring a barrier-free location for the proceedings. The Section 1557 Coordinator will be responsible for such arrangements. QualChoice offers help for members with limited English proficiency (LEP). The following statement is printed in the top languages used in

Arkansas, as required by the Federal government:

ATTENTION: Language assistance services, free of charge, are available to you. Call 1-800-235-7111 (TTY: 711).

Spanish ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-235-7111 (TTY: 711). Vietnamese CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-235-7111 (TTY: 711). Marshallese LALE: Ñe kwōj kōnono Kajin Ṃajōḷ, kwomaroñ bōk jerbal in jipañ ilo kajin ṇe aṃ ejjeḷọk wōṇāān. Kaalọk 1-800-235-7111 (TTY: 711). Chinese 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-800-235-7111 (TTY: 711).

Lao

ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວ ້ າພາສາ ລາວ, ການບໍ ລິ ການຊ່ວຍເຫ ຼື ອດ້ານພາສາ, ໂດຍບໍ່ ເສັຽຄ່າ, ແມ່ນມີ ພ້ອມໃຫ້ທ່ານ. ໂທຣ 1-800-235-7111 (TTY: 711). Tagalog PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-800-235-7111 (TTY: 711). Arabic

.(117)رقمهاتف الصم والبكم: 7111-235-800-1ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم German ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-800-235-7111 (TTY: 711). French ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-800-235-7111 (ATS: 711). Hmong LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau 1-800-235-7111 (TTY: 711). Korean

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-800-235-7111 (TTY: 711) 번으로 전화해 주십시오. Portuguese ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-800-235-7111 (TTY: 711). Japanese 注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。1-800-235-7111 (TTY: 711)s まで、お電話にてご連絡ください。

Hindi

ध्यान दें: यदद आप द िंदी बोलते ैं तो आपके ललए मुफ्त में भाषा स ायता सेवाएिं उपलब्ध ैं। 1-800-235-7111 (TTY: 711) पर कॉल करें। Gujarati

સચુના: જો તમે ગજુરાતી બોલતા હો, તો નન:શલુ્ક ભાષા સહાય સવેાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 1-800-235-7111 (TTY: 711).

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https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

http://www.hhs.gov/ocr/office/file/index.html

800.235.7111 | 501 228.7111 | FAX 501.228.0135 | QualChoice.com

1810 CR 015_03 08/2019

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