Edwards Air Force Base

Pharmacy

Formulary Current as of 1 Oct 2011

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Table of Contents

Welcome Letter from Flight Commander 4

General Pharmacy Information 5

How do I get my Refills? 6

Pharmacy Benefits 7

New to our Formulary 9

Formulary Listing by alphabetical order (generic names) 10

Listing by Common Use (not a complete listing) 21

Quick Reference Phone Guide 22

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Welcome to Edwards AFB and the 95th Medical Group!

We, the military and civilian pharmacy staff at the 95th Medical Group, are always striving to

provide you and your family the best pharmaceutical care available. All of us are committed to

providing quality services, and to ensure that the care you receive is and continues to be the best

you’ve ever experienced.

The pharmacy handbook/frequently asked questions has been created to hopefully make

accessing pharmacy services easier and less confusing for beneficiaries. While it does not

answer every question, it does provide guidance on most of our services.

I would like to extend on behalf of my staff and self, a special thank you to all of you in

uniform who are defending our country and to all the veterans who have made major

contributions to our nation. We also thank the families who have and continue to support all of

you.

Vanthy Pham Vanthy B. Pham, Maj, USAF, BSC, PharmD

Diagnostics and Therapeutics Flight Commander

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Pharmacy General Information

What are the hours for the Pharmacy? Pharmacy hours are below.

Monday 0730-1630

Tuesday 0730-1630

Wednesday 0730-1630

Thursday 0730-1630

Friday 0730-1630

Closed the first Monday of each month, weekends, federal holidays, AFMC approved

family days and Military down days.

Where is the Pharmacy? The Pharmacy is located in the main clinic on 30 Nightingale Rd in building 5525.

It is located in the south end of the first floor.

Eligible beneficiaries include:

Active duty service members and their families

Activated National Guard and Reserve Members and their families (on Title 10 or Title

32 [federal] orders)

Retired service members and their families

Survivors, widows/widowers and certain former spouses

Medal of Honor recipients and their families

Beneficiaries enrolled in TRICARE Reserve Select or the Continued Health Care Benefit

Program

Other beneficiaries listed in DEERS as eligible for TRICARE, including foreign force

members and their families

When updating DEERS with your personal information, be sure to update your address with a

physical address.

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How do I get medication refills?

If you have an existing prescription that is still active with refills left, call the Pharmacy

at 661-277-9896. Prescriptions called into the refill line will be available for pickup within

two duty days at the main pharmacy or at the APM located in BX lobby (*certain medications

only*). If you present to the pharmacy window for a refill you may be asked to come back later

or the next duty day. Please make every effort to call in prescription refills to avoid delays.

Typically, if you’re running out of a medication (down to last refill or last set of doses), it

means your provider is expecting you to follow-up for a re-evaluation. Please make a follow-up

appointment prior to running out so your provider can see how you are doing.

If your prescription has expired or you have no refills left and you see a provider on base,

please call PCC at 661-277-7118 at least one week prior to running out of your medication.

Ask to leave a telephone consult for your provider’s nurse. Please have the name and dosage of

the medication ready to provide to the phone clerk, as it makes renewing your prescription

easier. As long as the provider determines that you do not need a follow-up appointment prior

to prescription renewal, your refill request will typically be taken care of within 72 business

hours.

If you see a civilian provider off base you will have to contact your provider for a new

prescription. The pharmacy does NOT accept fax or phone-in prescription orders or refills.

Any questions regarding your medications that can be handled by the pharmacy should be

directed to their staff at 661-277-9896 (option 1 clinic pharmacy, option 5 speak to pharmacy

personnel)

Can’t make it to the pharmacy during normal duty hours? Sign up today to use our

Automated Prescription Machine (APM) located in the BX food lobby to pick up your

prescription refills. The APM is available during BX hours including weekends.

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YOUR PHARMACY Benefits

All formulary medication at EDWARDS Pharmacy:

$0 cost for up to a 90 day Supply

Other Military Treatment Facility (MTF) Pharmacies

An MTF pharmacy provides those medications listed on its local formulary (drug listing). Most

MTF pharmacies accept prescriptions written by both civilian and military providers.

To check the availability of a particular drug, contact you’re nearest MTF if not stationed at

Edwards AFB in person or by phone.

TRICARE Mail Order Pharmacy (TMOP)

You can receive up to a 90-day supply* for most medications you take regularly (for instance,

drugs for high blood-pressure, asthma or oral contraceptives) using TMOP.

When you use the TMOP service you get:

• Savings: You can save up to 66% of retail costs, because your

co-payment for a 90-day supply is the same as for a 30-day supply at a retail pharmacy.

• Convenience and safety: Your medication is mailed to your home in a weather-resistant

pouch for your privacy and protection and there is no charge for postage.

To use the TMOP service, just follow these steps:

1) Ask your doctor for a prescription (for up to a 90-day supply*,plus refills for up to one year,

if appropriate).

2) Complete the TMOP registration/order form which can be downloaded from their website at:

http://www.express-scripts.com/TRICARE/

3) Insert your prescription, completed TMOP registration form, and co-payment, if needed, into

the pre-addressed, postage paid envelope (attached to the registration form — use this envelope

only for your TMOP registration) and mail them. Your prescriptions will be mailed to you

within 14 days.

• For more details on TMOP, please visit www.express-scripts.com/TRICARE or call 1-

877-363-1303.

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DoD TRICARE Retail Pharmacy (TRRx) Network

Another option for filling your prescription is to use a DoD TRRx network retail pharmacy.

Simply give the network pharmacist your written prescription and your uniformed services

identification (ID) card.

You will pay a co-payment of:

$0 for formulary generic for 30-day supply

$9 for formulary brand-name for 30-day supply

$25 for non-formulary drugs for 30-day supply.

To find a DoD TRICARE Retail Pharmacy near you:

• Visit www.express-scripts.com/TRICARE.

The online pharmacy locator is updated on the first day of each month. If a pharmacy joined

after the first day of the month, it might not appear on the locator until the following month.

• Call 1.877.363.1303).

Non-Network Retail Pharmacy

Your medications will cost the most at non-network retail pharmacies because they do not

belong to the DoD TRRx network. At non-network pharmacies you will pay full price for your

medication. To be reimbursed for non-network pharmacy claims, you must fill out the enclosed

claim form (DD 2642),attach the required paperwork as described on the DD2642,and mail it

to:

Express Scripts

P.O. Box 66518

St. Louis, MO 63166-6518

You can download additional claim forms (DD 2642) at www.express-scripts.com/TRICARE

or www.tricare.osd.mil/ pharmacy/claims.cfm. Claim forms may also be obtained at

TRICARE Service Centers and MTFs.

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New to our formulary!

Budesonide/formoterol (Symbicort) for Asthma or COPD

Cetirizine (Zyrtec) chewable tablets for allergies

Cetirizine/pseudoephedrine (Zyrtec-D) for allergies

Insulin glargine pen (Lantus SoloStar Pen) for diabetes mellitus

Scopalamine patches (Transderm Scop) for motion sickness

Tamsulosin (Flomax) for enlarged prostate or BPH

Valsartan (Diovan) for hypertension

Valsartan/HCTZ (DiovanHCT) for hypertension

Ciprofloxacin/Dexamethasone (Ciprodex) for ear infection

Famotidine (Pepcid) for heartburn, GERD

Fenofibrate 54mg and 160mg for hyperlipidemia (replacing Fenoglide)

Fenofibrate (Tricor) 48mg and 145mg for hyperlipidemia

Rovustatin (Crestor) for hyperlipidemia *DoD requires Prior Authorization

Mometasone/Formoterol (Dulera) Inhaler for asthma or COPD

Ergocalciferol (Vitamin D) 50,000 units for Vit D supplements

Calcium Carbonate + Vit D 500mg (Oscal+D) for calcium supplements

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Diclofenac (Voltaren) 1% topical gel for pain

Lidocaine (Lidoderm) 5% patch-for pain

Detemir (Levemir) Insulin-for diabetes

Pantoprazole (Protonix)-for GERD

Clindamycin (Cleocin T) 1% Pads-for acne

Aspart (Novolog FlexPen) Insulin Pen-for diabetes

No longer on formulary!

Rosiglitazone (Avandia) for diabetes

Rosiglitazone/Metformin (Avandamet) for diabetes

Ciprofloxacin/Hydrocortisone (CiproHC) for ear infection

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Edwards AFB Pharmacy Formulary

Alphabetically Listed by Generic Name

Generic Name Brand Name How Supplied

ACETAMINOPHEN Tylenol Tabs: 325 mg, 650mg

Infant Drops: 80 mg/0.8 ml

Soln: 160 mg/5 ml.

Supps: 120mg, 650 mg

ACETAMINOPHEN/BUTALBITAL/

CAFFEINE Fioricet Tabs: 325mg/50mg/40mg

ACETAMINOPHEN/CODEINE

PHOSPHATE Tylenol w/Codeine C-III Tabs: 30mg/300mg

Elixir: 12mg/120 mg/5 ml

ACETAZOLAMIDE Diamox Tabs: 250 mg, 500mg

ACETIC ACID Domeboro Powder Packets

ACYCLOVIR Zovirax Caps: 200mg Tabs: 400mg, 800mg

Susp: 200mg/5ml

Oint: 15 g

ADAPALENE GEL Differin 0.1% Gel: 45g

ALBUTEROL HFA Ventolin HFA Inhaler: 90mcg, 200 sprays/unit

Neb Soln: 0.5%, 0.083%

Oral Liq: 5mg/5ml.

ALBUTEROL/ IPRATROPIUM Combivent Inhaler: 200 sprays/unit

ALENDRONATE

ALENDRONATE/VITAMIN D

Fosamax

Fosamax Plus D

Tabs: 5mg, 10 mg, 35 mg, 70 mg

Soln: 70mg/75ml

Tabs: 70mg/2800 IU, 70mg/5600 IU

ALFUZOSIN Uroxatral Tabs: 10mg

ALLOPURINOL Zyloprim Tabs: 100mg, 300mg

ALPRAZOLAM Xanax C-IV Tabs: 0.25mg, 0.5mg, 1mg, 2mg

ALUMINUM CHLORIDE

HEXAHYDRATE Drysol Liq: 37.5ml

AMANTADINE Symmetrel Tabs: 100mg

Syrup: 50mg/5 ml

AMIODARONE Cordarone/Pacerone Tabs: 200mg, 400mg

AMITRIPTYLINE Elavil Tabs: all strengths

AMLODIPINE Norvasc Tabs: all strengths

AMLODIPINE/BENAZEPRIL Lotrel Caps: all strengths

AMMONIUM LACTATE Lac-Hydrin Lotion: 12%

AMOXICILLIN Amoxil Susp:125mg/5ml, 250 mg/5ml, 400 mg/5 ml

Caps: 250mg, 500mg

AMOXICILLIN/ CLAVULANATE Augmentin

Susp: 200mg/5ml, 250mg/5ml, 400mg/5ml

ES Susp: 600 mg/5 ml

Tabs: 250mg/125mg, 500mg/125mg,

875mg/125mg

Chew Tabs: 250/62.5mg

XR: 1000 mg

AMPHETAMINE/

DEXTROAMPHETAMINE Adderall C-II

Adderall XR C-II

Tabs: 5, 10, 30 mg

XR Caps: all strengths

AMPICILLIN Ampicillin Caps: 500 mg

ANTIPYRINE/

BENZOCAINE/GLYCERIN Auralgan Otic soln: 15 ml

ASPIRIN ENTERIC COATED Ecotrin Tabs: 81mg, 325mg

ATENOLOL Tenormin Tabs: all strengths

ATOMOXETINE Strattera Caps: all strengths

ATORVASTATIN Lipitor Tabs: all strengths

AZELASTINE Astelin Nasal spray: 137mcg/spray

**DoD Quantity limit 2 per 30 days**

AZITHROMYCIN Zithromax Tabs: 250mg, 500mg Packet: 1g

Susp: 100mg/5ml, 200mg/5ml

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BACITRACIN Bacitracin Oph oint

Topical oint

BACITRACIN/NEOMYCIN/

POLYMYXIN Polysporin Oph oint

BACLOFEN Lioresal Tabs: all strenghts

BELLADONNA ALKALOIDS Donnatal Tabs: 16.2mg

Liq: 16.2mg/5ml

BENAZEPRIL Lotensin Tabs: all strengths

BENZONATATE Tessalon Perles Caps: all strengths

BENZOYL PEROXIDE GEL,

BENZOYL PEROXIDE WASH Benzac Gel: 42.5g (10%)

Sol: 227g (10%)

BENZOYL PEROXIDE/

CLINDAMYCIN Benzaclin Gel: 25 g (1-5%)

BENZTROPINE Cogentin Tabs: all strengths

BETAMETHASONE

DIPROPRIONATE Diprosone Cream: 0.05%, 45 g

Oint: 0.05%, 15 g

BETAMETHASONE VALERATE Valisone Cream: 0.1%, 15 g, 45 g

BETAXOLOL Betoptic S Oph susp: 0.5%, 5 ml.

BISACODYL Dulcolax Tabs: 5 mg

BRIMONIDE Alphagan P Oph soln: 0.15%, 0.2%

BROMOCRIPTINE Parlodel Tabs: all strengths

BUDESONIDE Pulmicort Respules Neb Sol: all strengths

BUDESONIDE/FORMOTEROL Symbicort Inhaler: 160/4.5, 80/4.5 mcg

BUPROPRION Wellbutrin Tabs: 75, 100mg

BUPROPRION Wellbutrin SR SR Tabs: 100mg, 150mg

BUPROPRION Zyban SR Tabs: 150 mg

BUSPIRONE HCL Buspar Tabs: all strengths

CALCIUM CARB+VIT D OSCAL+D Tabs: 500mg

CANDESARTAN Atacand Tabs: all strenghts

CANDESATAN/HCTZ Atacand HCT Tabs: 16/12.5, 32/12.5mg

CAPTOPRIL Capoten Tabs: all strengths

CARBAMAZEPINE Tegretol

Tegretol XR

Chewable tabs: 100mg Tabs: 200mg

XR tabs: all strengths

Liq: 100mg/5ml

CARBIDOPA/LEVODOPA Sinemet

Sinemet CR

Tabs: 10/100, 25/100, 25/250 mg

CR: 25/100 mg

CARBOXYMETHYLCELLULOSE Celluvisc Boxes of 30

CARISOPRODOL Soma Tabs: 350 mg

CARVEDILOL Coreg Tabs: all strengths

CEFADROXIL Duricef Susp: 250 mg/5 ml

CEFDINIR Omnicef Susp: 125 mg/5 ml & 250 mg/5 ml

CEFPODOXIME Vantin Susp: 100 mg/5 ml

CEFUROXIME Ceftin Susp: 250 mg/5 ml

Tabs: 250, 500 mg

CELECOXIB Celebrex Caps: all strengths

CEPHALEXIN Keflex Caps: all strengths

Susp: 250mg/5ml

CETIRIZINE Zyrtec Tabs: 10 mg Liquid: 5 mg/5 ml Chewable: 5mg

CETIRIZINE/PSEUDOEPHEDRINE Zyrtec-D Tabs: 5/120 mg

CHLORAL HYDRATE Noctec Syrup: 500 mg/5 ml

CHLORHEXIDINE RINSE Peridex Rinse: 0.12%

CHLOROQUINE Aralen Tabs: 250, 500 mg

CHLORTHALIDONE Hygroton Tabs: all strengths

CIMETIDINE Tagamet Tabs: all strengths

CIPROFLOXACIN Cipro Tabs: all strengths

Susp: 5gm/100ml

CIPROFLOXACIN Ciloxan Opth: 0.3%/2.5 ml

CIPROFLOXACIN/DEXAMETHASONE CiproDex Soln: 7.5 ml

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CITALOPRAM Celexa Tabs: all strengths

Soln: 10mg/5ml

CLARITHROMYCIN Biaxin Tabs: 250, 500 mg

CLINDAMYCIN Cleocin Caps: all strengths

Susp: 75 mg/5 ml

Top Soln: 1%, 60 ml

Top Pads: 1%

Vaginal Cream: 2%(40 gm)

CLINDINIUM/

CHLORDIAZEPOXIDE Librax Caps: 2.5 mg/5 mg

CLOBETASOL PROPRIONATE Temovate 0.05% Cream: 15g, 45g

0.05% Oint, 0.05% Soln

CLOMIPHENE Clomid Tabs: 50 mg

CLONAZEPAM Klonopin C-IV Tabs: all strengths

CLONIDINE Catapres Tabs: all strengths

CLOPIDOGREL Plavix Tabs: 75 mg

CLOTRIMAZOLE Lotrimin 1% Cream: 30 g

1% Topical soln

CLOTRIMAZOLE / BETAMETHASONE

DIP Lotrisone Cream: 15, 45 g

CODEINE SULFATE Codeine C-III Tabs: 30 mg

CODEINE/ GUAIFENESIN Robitussin AC C-V Liq: 10/100 mg per 5 ml (120 ml)

**Qty must be in equivalents of 120 ml**

COLESTIPOL Colestid Tabs: 1 g Powder Packets: Box of 90

COLOCHICINE Colchicine Tabs: 0.6 mg

CONJUGATED ESTROGENS Premarin Tabs: all strengths

Vaginal cream 0.625mg/gm

CONJUGATED ESTROGEN/

MEDROXYPROGESTERONE Prempro Tabs: all strengths

CROMOLYN SODIUM Crolom Oph Soln: 4%, 15 ml

CYCLOBENZAPRINE Flexeril Tabs: all strengths

CYCLOPENTOLATE Cyclogel Oph Soln: 0.1%, 5 ml

CYPROHEPTADINE Periactin Tabs: 4 mg

Syrp: 2mg/5ml

DESIPRAMINE Norpramin Tabs: all strengths

DESMOPRESSIN DDAVP Tabs: 0.2 mg

DESOGESTREL/ETHINYL

ESTRADIOL (Biphasic) Mircette 28 day packs

DESOGESTREL/ETHINYL ESTRADIOL Desogen 28 day packs

DETEMIR Levemir Insulin vial

DEXAMETHASONE Decadron Tabs: 0.5 mg, 4 mg

DEXTROAMPHETAMINE Dexedrine C-II Tabs: 5, 10 mg

SR Caps: 5 mg, 15mg

DIAGNOSTIC STRIPS Precision Xtra

AccuChek Aviva

Boxes of 50

DIAZEPAM Valium C-IV Tabs: all strengths

DICLOFENAC SODIUM Voltaren Tabs: 50, 75 mg

Oph soln: 0.1%

Top Gel: 1%

DICLOXACILLIN Dynapen Caps: all strengths

DICYCLOMINE Bentyl Tabs: all strengths

Soln: 10mg/5ml

DIGOXIN Lanoxin Tabs: all strengths

Soln: 0.05mg/ml

DILTIAZEM Tiazac Tabs: 60 mg

ER Caps: all strengths

DIPHENOXYLATE W/ATROPINE Lomotil C-V Tabs: 2.5/0.025 mg

DIPHENYDRAMINE Benadryl Caps: 25 mg, 50 mg Liq: 12.5 mg/5 ml

DISOPYRAMINE Norpace Caps: 100 mg

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DIVALPROEX Depakote

Depakote Sprinkles

Depakote ER

Tabs: all strengths

Caps: 125 mg

ER tabs: all strengths

DOCUSATE SODIUM Colace Caps: 100 mg

DONEPEZIL Aricept Tabs: all strengths

DORZOLAMIDE Trusopt 2% Oph soln: 10 ml

DORZOLAMIDE / TIMOLOL Cosopt Oph soln: 2%-0.05%

DOXAZOSIN Cardura Tabs: all strengths

DOXEPIN Adapin Caps: all strengths

Soln: 10mg/ml

DOXYCYCLINE HYCLATE Vibramycin Tabs: 100 mg

Caps: 50, 100mg

EPINEPHRINE Epi-Pen/Epi-Pen Jr

Twinject

Auto-injector 0.15mg/dose, 0.3mg/dose

EPINEPHRINE Ephfrin 2% Oph soln: 15 ml

ERGOTAMINE TARTRATE

W/CAFFEINE Cafergot Tabs: 100 mg/1 mg

ERYTHROMYCIN Erythrocin

Romycin

Tabs: all strengths

Susp: 200 mg/5 ml

Oph oint: 0.5% 5 mg/gm

2% Topical soln: 60 ml

2% gel

ERGOCALCIFEROL Vitamin D Gel Caps: 50,000 units

ESOMEPERZOLE Nexium Caps: all strengths

ESTRADIOL Estrace

Estraderm

Vivelle Dot

Esclim

Tabs: all strengths

Patch: all strengths

ESTROGEN/

METHYLTESTOSTERONE Estratest HS Tabs: 0.625/1.25 mg

ETHAMBUTOL Myambutol Tabs: all strengths

ETHINYL ESTRADIOL/ DESOGESTREL Orthocept (Reclipsen) 0.03 mg EE/.015 mg D

28 day packs

ETHINYL ESTRADIOL/

DROSPIRENONE Yasmin

Yaz

Tabs: 30 mcg/3 mg; 28 day packs

Tabs: 20 mcg/3 mg; 28 day packs

ETHINYL ESTRADIOL/

ETONOGESTREL Nuvaring Vaginal ring

ETHINYL ESTRADIOL

LEVONORGESTREL TriLevlen, TriPhasil, Alesse,

Lutera

Tabs:

28 day packs

ETHINYL ESTRADIOL/

LEVONORGESTREL Nordette, Mircette 28 day packs

ETHINYL ESTRADIOL/

NORELGESTROMIL Ortho Evra Transdermal patch

ETHINYL ESTRADIOL/

NORETHINDRONE

Ortho-Novum

Loestrin 1/20 FE

Necon 1/35

28 day packs

ETHINYL ESTRADIOL/

NORGESTIMATE

Ortho-Cyclen

Ortho Tri-cyclen

Ortho Tri-cyclen LO

28 day packs

ETHINYL ESTRADIOL/ NORGESTREL Ovral, LoOvral

28 day packs

ETONORGESTREL Implanon IM device

EZETMIBE Zetia Tabs: 10 mg

FAMOTIDINE Pepcid Tabs: 20mg and 40mg

FELODIPINE Plendil Tabs: all strengths

FENOFIBRATE Lofibra, Tricor Tabs: 48mg, 54mg, 145mg, and 160 mg

FERROUS SULFATE FeoSol Soln: 25 mg/ml, 50ml.

Tabs: 325 mg

FEXOFENADINE Allegra Tabs: 60, 180 mg

FINASTERIDE Proscar Tabs: 5 mg

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FLUCONAZOLE Diflucan Tabs: all strengths

FLUDROCORTISONE Florinef Tabs: 0.1 mg

FLUNISOLIDE Nasarel Nasal spray: 25 mcg. 200 sprays/unit

FLUOCINOLONE Synalar Soln: 1%, 60 ml

FLUOCINONIDE Lidex *Cream: 0.05%, 15 g, 60 g

Gel: 0.05%, 60 g

Oint: 0.05%, 60 g

FLUORIDE Prevident 5000+, Luride Gel: 1.1%, 2oz

Drops: 1.1 mg/ml

Tabs: 1.1 mg

FLUOROMETHOLONE Fluor-Op, FML Susp: 0.1%, 15 ml

FLUOXETINE Prozac Caps: 10, 20, 40 mg

Soln: 20mg/5ml

FLUTICASONE Flonase Nasal spray: 50 mcg, 120 sprays/unit

FLUTICASONE HFA Flovent HFA Inhaler: 44, 110, 220 mcg

**Qty limit 2 per 30 days**

FLUTICASONE Diskus Flovent Diskus Inhaler

FLUTICASONE/ SALMETEROL Advair

Advair HFA

Inhaler: 100/50 mcg, 250/50mcg, 500/50 mcg

Inhaler: 45/21 mcg, 115/21 mcg, 230/21 mcg

FOLIC ACID Folic Acid Tabs: 1 mg

FUROSEMIDE Lasix Tabs: all strengths

Soln: 10mg/ml

GABAPENTIN Neurontin Caps: all strengths

GEMFIBROZIL Lopid Tabs: 600 mg

GENTAMICIN SULFATE Geramicin Oph soln: 0.3%, 5 ml

Oph oint: 3.5 g

GLIPIZIDE Glucotrol

Glucotrol XL

*Tabs: all strengths

XL Tabs: all strengths

GLYBURIDE

GLYBURIDE MICRONIZED Micronase Tabs: all strengths

Micronized: all strengths

GLYBURIDE/ METFORMIN Glucovance Tabs: all strengths

GLYCOPYRROLATE Robinul Tabs: 1 mg

GOSERELIN Zoladex Implants: 3.6 mg, 10.8 mg

GRAMICIDIN/NEOMYCIN/POLYMYXIN

B Soln: 0.025mg/2.5mg/10000unit/ml

GRISEOFULVIN Grispeg, Grifulvin V Tabs: 125, 250 mg Susp: 125 mg/5 ml

GUAIFENESIN Mucinex Tabs: 600 mg

GUAIFENESIN/PSE MucinexD Tabs: 600/60 mg,

GUAIFENSIN/DEXTROMETHORPHAN Robitussin DM Liq: 100/10 mg per 5 ml

HALOPERIDOL Haldol Caps: 1 mg, 10 mg

HOMATROPINE Isopto Homatropine Liq: 5%, 5 ml

HYALURONIC ACID Atopiclair Topical cream

HYDRALAZINE Apresoline Tabs: 10, 25, 50 mg

HYDROCHLOROTHIAZIDE HCTZ Caps 12.5 mg Tabs 25, 50 mg

HYDROCODONE/

ACETAMINOPHEN Vicodin

Vicodin ES

*Tabs: 5/500 mg

ES Tabs: 7.5/750 mg

HYDROCORTISONE Anusol HC Cream: 2.5%

Supps: 25 mg

HYDROCORTISONE ACETATE/

PRAMOXINE Proctofoam Foam: 1%, 10 g

Cream: 30 g

HYDROCORTISONE VALERATE Westcort 0.2% Cream: 15 g, 60 g

0.2% Oint: 45 g

HYDROCORTISONE/

ACETIC ACID Vosol HC Susp: 10 ml

HYDROXYAMPHETAMINE/

TROPICAMIDE Paremyd Soln: 1%/0.25%

HYDROXYCHLOROQUINE Plaquenil Tabs: 200 mg

HYDROXYZINE Atarax Tabs: all strengths Liq: 10 mg/5 ml

IBANDRONATE Boniva Tabs: all strengths

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IBUPROFEN Motrin Tabs: all strengths

Susp: 100 mg/5 ml

IMIPRAMINE Tofranil Tabs: all strengths

INDOMETHACIN Indocin *Caps: all strengths

ER Cap: 75 mg

INSULIN ASPART Novolog, Novolog Flexpen 100 units/ml, 10 ml vial

INSULIN GLARGINE Lantus, Lantus SoloStar Pen 100 units/ml, 10 ml vial

100 units/ml, pen

INSULIN NPH/REGULAR 70/30 Novolin 70/30 100 units/ml, 10 ml vial

INSULIN HUMAN NPH Novolin N 100 units/ml, 10 ml vial

INSULIN HUMAN 70/30 Novolog Mix 70/30 100 units/ml, 10 ml vial

INSULIN HUMAN REGULAR Novolin R 100 units/ml, 10 ml vial

INSULIN SYRINGES

INSULIN PEN NEEDLES Boxes of 100: 0.5 ml, 1 ml 29 G,½”

**Limit 300 syringes/90 days**

IPATROPIUM BROMIDE Atrovent

Atrovent HFA

Neb Soln, Nasal spray

Inhaler

ISONIAZID INH Tabs: all strengths Syrup: 50 mg/5 ml

ISOSORBIDE DINITRATE Isordil SR Caps: 40 mg

Tabs: all strengths

ISOSORBIDE MONONITRATE Imdur Tabs: all strengths

ISOTRETINOIN Accutane Caps: all strengths

KETOCONAZOLE Nizoral Cream: 30 g

Shampoo: 4 oz

KETOROLAC TROMETHAMINE Acular Oph soln: 0.5%, 5ml

KETOTIFEN Zaditor Oph soln: 0.025 % 5 ml

LACTULOSE Cepulac Syrup: 10 g/15 ml

LAMOTRIGINE Lamictal Tabs: all strengths

LANCETS Soft-Touch

Accu-chek Soft Clix

Boxes of 200

LANCET DEVICE Soft-Touch Device

LATANOPROST Xalatan Oph soln: 0.005%, 2.5 ml

LEUCOVORIN Leucovorin Tabs: 5 mg

LEVALBUTEROL Xopenex Inhaler: 200 sprays/unit

LEVOBUNOLOL Betagan Oph Soln: 0.5%, 5ml

LEVOCABASTINE Livostin Oph soln: 0.025%, 5 ml

LEVOFLOXACIN Levaquin Tabs: all strengths

Soln: 25mg/ml

LEVONORGESTREL Plan B One-Step

Next Choice

Tabs: 1.5mg

Tabs: 0.75mg

LEVONORGESTREL IUD Mirena IUD *Must have scheduled appt*

LEVOTHYROXINE Synthroid Tabs: all strengths

LIDOCAINE HCL Xylocaine

Lidoderm

Gel: 2%, 30 ml

Soln: 2%, 100 ml

Top Patch: 5%

LISINOPRIL Zestril Tabs: all strengths

LISINOPRIL/HCTZ Zestoretic Tabs: all strengths

LITHIUM CARBONATE Lithium

Lithium citrate

Tabs: all strengths

Syrp: 8mEq/5ml

LOPERAMIDE Imodium Caps: 2 mg

LORATADINE Claritin Tabs: 10 mg

Syrup: 1 mg/ml

LORAZEPAM Ativan Tabs: all strengths

LOSARTAN Cozaar Tabs: all strengths

LOSARTAN/HCTZ Hyzaar Tabs: all strengths

LOTEPREDNOL Alrex Susp: 0.2%, 5 ml

LUBRICANT Lacrilube Opth oint: 3.5 g

LUVOXAMINE Luvox Tabs: 100 mg

MEBENDAZOLE Vermox Chew Tabs: 100 mg

MECLIZINE Antivert Tabs: all strengths

16

MEDROXYPROGESTERONE Depo Provera Injection: 150 mg

**Must have appt for administration**

MEDROXYPROGESTERONE Provera Tabs: all strengths

MEFLOQUINE Lariam Tabs: 250 mg

MELOXICAM Mobic Tabs: 7.5, 15 mg

METAXOLONE Skelaxin Tabs: 800 mg

METFORMIN HCL Glucophage

Glucophage XR

Tabs: all strengths

XR Tabs: all strengths

METHOCARBAMOL Robaxin Tabs: all strengths

METHOTREXATE Rhemstrex Tabs: 2.5 mg

METHYLDOPA Aldomet Tabs: all strengths

METHYLPHENIDATE Ritalin C-II *Tabs: all strengths

SR Tabs: 20 mg

METHYLPHENIDATE XR Concerta C-II Tabs: all strengths

METHYLPREDNISOLONE Medrol Tabs: 4 mg, dosepack

METOCLOPRAMIDE HCL Reglan Tabs: all strengths Liq: 5 mg/5 ml

METOPROLOL Lopressor

Toprol XL

Tabs: all strengths

Tabs: all strengths

METRONIDAZOLE Flagyl Tabs: all strengths

METRONIDAZOLE Metrogel-Vaginal Gel: 0.75%, 70 g

MINOCYCLINE Minocin Caps: all strengths

MI PASTE PLUS MI Paste Dental paste

MOISTURIZING CREAM Eucerin cream Cream

MOMETASONE Elocon Cream: 15g, 30g

MOMETASONE Nasonex

Asmanex

Nasal spray

Twisthaler

MOMETASONE/FORMOTEROL Dulera Inhaler

MONITOR, BLOODGLUCOSE Precision Xtra

AccuCheck Aviva

Kit

MONTELUKAST Singulair Tabs: all strengths

Oral granules: 4 mg

MORPHINE SULFATE IR Morphine C-II Tabs: all strengths

MORPHINE SULFATE ER MS Contin C-II ER Tabs: all strengths

MOXIFLOXACIN Vigamox Oph Soln: 0.5%, 5ml

MULTIVITAMIN PEDIATRIC

SOLUTION W/IRON Poly Vi Sol w/Iron Soln: 50 ml

MULTIVITAMIN W/ FLUORIDE Poly Vi Flor

Soln: 50 ml

Chew Tab: 0.25mg, 0.5 mg

MUPIROCIN Bactroban Oint: 15 g

NAPROXEN

Naprosyn

Naproxen sodium

Tabs: all strengths

Tabs: all strengths

Susp: 125mg/ 5ml

NEFAZODONE Serzone Tabs: 150 mg

NEOMYCIN/POLYMYXIN/HC Cortisporin HC Soln, Susp: 10 ml

NEOMYCIN/POLYMYXIN/

BACITRACIN Neosporin Ophth oint

NEOMYCIN/POLYMYXIN/

GRAMICIDIN Neosporin Oph soln 10 ml

NIACIN Niaspan *CR Tabs: all strengths

NICOTINE Nicoderm Patches: all strengths

NIFEDIPINE Adalat CC

Procardia

*SR Tabs: all strengths

Caps: 10 mg

NITROFURANTOIN Macrobid

Macrodantin

Caps: 100 mg

Caps: all strengths

NITROGLYCERIN Nitrostat, Nitrobid, Nitro

Dur

SL Tabs: 0.4 mg

SL Spray: 0.4 mg

SR Caps: all strengths

Patches: all strengths

NORETHINDRONE Micronor 28 day packs

17

NORTRIPTYLINE Pamelor Caps: all strengths

Soln: 10mg/5ml

NYSTATIN Niastat Cream: 15 g

Oint: 15 g

Powder 100,000 unit

Susp: 100,000 units/60 ml

OFLOXACIN Ocuflox Oph Soln: 0.3% 5 ml

OFLOXACIN Floxin Otic Soln: 5 mL

OLANZAPINE Zyprexa Tabs: all strengths

OLOPATADINE Patanol Oph soln: 0.1 % 5 ml

OMEPRAZOLE Priolosec Caps: all strengths

OXYBUTYNIN Ditropan Tabs: 5mg

OXYBUTYNIN ER Ditropan XL Tabs: all strengths

OXYCODONE/

ACETAMINOPHEN Percocet Tabs: 5/325 mg

OXYMETAZOLINE Afrin nasal spray Soln: 0.05% (15 ml)

PANTOPRAZOLE Protonix Tabs: 40mg

PAROXETINE Paxil Tabs: all strengths

PENICILLIN VK PenV K, Veetids Susp: 125mg/5ml, 250 mg/5 ml

Tabs: all strengths

PERMETHRIN Elimite, Nix Cream: 5%, 60 g Cream: 1%, twinpack 60 ml

PHENAZOPYRIDINE Pyridium Tabs: all strengths

PHENOBARBITAL Phenobarbital Tabs: 15, 30, 60, 100 mg Liq: 20 mg/5 ml

PHENYLEPHRINE Mycifrin Oph soln: 2.5%, 15 ml

PHENYTOIN Dilantin Caps: 100 mg Tabs Chew: 50 mg

Susp: 125mg/5ml

PILOCARPINE Pilocar Oph Soln: all strengths

Oph Gel 4%

PIMECROLIMUS Elidel Tube: 15 g, 30 g

PIOGLITAZONE Actos Tabs: all strengths

PIOGLITAZONE/

METFORMIN Actoplus met Tabs: 15/850, 15/500 mg

POLYETHYLENE GLYCOL Trilyte Pwd for Reconst: 4 L

POLYETHYLENE GLYCOL 3350 Miralax Powder: 527, 255 g

POLYMYXIN B/TRIMETHOPRIM Polytrim Oph soln: 5 ml

POTASSIUM BICARBONATE/POT

CHLORIDE Klorvess Packets: 20 mEq

Box of 30

POTASSIUM CHLORIDE Klor-con

Micro K

ER Tabs: all strengths

Powder packet: 20 mEq

Soln: 20 mEq/15 ml

CR Caps: 10 mEq

PRAVASTATIN Pravachol Tabs: all strengths

PRAZOSIN Minipress Caps: all strengths

PREDNISOLONE Prelone/Orapred Liq: 15 mg/5 ml

PREDNISOLONE ACETATE Pred Forte

Pred Mild

Oph Susp: 1%, 5 ml

Oph Susp: 0.12%

PREDNISOLONE ACETATE/

SULFACETAMIDE AKCide Oph oint

PREDNISONE Orasone, Deltasone Tabs: all strengths

Syrup: 5mg/5ml

PRENATAL VITAMINS + FOLIC ACID Natalins Tabs : PNV with 1mg folic acid

**Limited to women age 45 and younger**

PRENISOLONE SODIUM PHOSPHATE Inflamase Susp: 1/8%, 1%, 5 ml

PRIMAQUINE Primaquine Tabs: 23.6 mg

PRIMIDONE Mysoline Tabs: all strengths

PROBENECID Benemid Tabs: 500 mg

PROCHLORPERAZINE Compazine Tabs: all strengths Supps: 25 mg

PROGESTERONE Prometrium Caps: 100, 200 mg

18

PROMETHAZINE Phenergan Tabs: all strengths Supps: all strengths

Syrp: 6.25mg/5ml

PROMETHAZINE/DEXTROMETHORPH

AN Phenergan DM Syrp: 120 ml

PROPARACAINE Ophthaine Soln: 0.5%, 15 ml

PROPOXYPHENE/

ACETAMINOPHEN Darvocet-N 100 Tabs: 100/650 mg

PROPRANOLOL Inderal

Inderal LA

Tabs: 10, 40 mg

LA Caps: 80 mg

PROPYLTHIOURACIL PTU Tabs: 50 mg

PSEUDOEPHEDRINE Sudafed Tabs: 30, 120 mg

Liq: 30 mg/5 ml

PYRAZINAMIDE PZA Tabs: 500 mg

PYRIDOSTIGMINE Mestinon Tabs: 60 mg

PYRIDOXINE Vitamin B6 Tabs: all strengths

QUETIAPINE Seroquel

Seroquel XR

Tabs: all strengths

XR: all strengths

RALOXIFENE Evista Tabs: 90 mg

RANITIDINE Zantac Tabs: all strengths

Syrup: 15 mg/ml

RIFAMPIN Rifadin Caps: 300 mg

RIMEXOLONE Vexol Oph Susp: 1%

RISPERIDONE Risperdal Tabs: all strengths

Soln 1mg/ml

RIZATRIPTAN Maxalt

Maxalt MLT

Tabs: all strengths

MLT tabs: all strengths

**DoD Quantity limit 36 tablets/90 days**

ROVUSTATIN Crestor Tabs: all strengths

**DoD requires Prior Authorization from MD

SALICYLIC ACID Clear Away Plasters: 40%

SALINE NASAL SPRAY Sea-mist Soln: 0.65%

SALMETEROL Serevent Diskus

Serevent

*Inhaler: 18 mcg, 200 sprays/unit

Neb Soln: 0.02%/2.5 ml, 30 unit

SALISALATE Disalcid Tabs: 500, 750 mg

SCOPOLAMINE Transderm Scop Patch: 1.5 mg

SELENIUM SULFIDE Selsun Shampoo: 2.5% 120 ml

SERTRALINE Zoloft Tabs: all strengths

Liq: 20mg/ml

SILVER SULFADIAZINE Silvadene 1% cream

SIMVASTATIN Zocor Tabs: all strengths

SIMVASTATIN/EZETIMIBE Vytorin Tabs: all strengths

SODIUM CHLORIDE 0.9% Normal saline 3ml vials for Nebulization

SPACER Optichamber

Optichamber w/mask

Aerochamber w/mask

Device

SPIRONOLACTONE Aldactone Tabs: all strengths

SUCRALFATE Carafate Tabs: 1 g

Liq: 1 g/10 ml

SULFACETAMIDE Sulamyd, Bleph-10 Oph soln: 10%, 15 ml

Opth oint: 3.5 g

SULFACETAMIDE SODIUM/

PREDNISOLONE ACETATE Vasocine Opth oint: 10%/0.5%

SULFACETAMIDE SODIUM/

PREDNISOLONE ACETATE Isopto Catapred Susp: 10%/0.25%, 15ml.

SULFACETAMIDE/

SULFUR CLEANSER Plexion Cleanser: 6oz

SULFAMETHOXAZOLE/

ERYTHROMYCIN Pediazole Susp:600/200 mg/5 ml

19

SULFAMETHOXISOLE/

TRIMETHOPRIM Bactrim, Septra, Bactrim DS

Sulfatrim

Tabs: all strengths

Susp:40/200 mg /5 ml

SULFASALAZINE Azulfidine Tabs: 500 mg

EC Tabs: 500mg

SUMATRIPTAN Imitrex Tabs: 25, 50 mg

**DoD Quantity limit 54 tablets/90 days**

Tabs: 100 mg

**DoD Quantity limit 27 tablets/90 days**

SUMATRIPTAN Imitrex Stat Dose Kit all strengths

TAMOXIFEN Nolvadex Tabs: all strengths

TAMSULOSIN Flomax Caps: 0.4mg

TELMISARTAN

TELMISARTAN/HCTZ Micardis,

Micardis HCT

Tabs: all strengths

Tabs: all strengths

TEMAZEPAM Restoril C-IV Caps: all strengths

TERAZOSIN Hytrin Caps: all strengths

TERBUTALINE Brethine Tabs: 5 mg

TERCONAZOLE Terazol 7 Cream: 0.4%, 20 g

TETRACYCLINE Achromycin Caps: all strengths

THEOPHYLLINE Theo-24

Theodur

Uniphyl

24 hr Caps: all strengths

*12 hr Tabs: all strengths *Liq: 80 mg/15 ml

*24 hr Tabs: 400mg

THIAMINE Vitamin B1 Tabs: all strengths

TIMOLOL MALEATE Timolol

Timoptic XE

Oph soln: all strengths

Gel: all strengths

TIOTROPIUM Spiriva Inh w/ device: 18 mcg

TOBRAMYCIN Tobrex Soln: 0.3%, 5 ml

TOBRAMYCIN/DEXAMETHASONE Tobradex Susp: 0.3%/0.1%, 2.5 ml

Opth Oint: 3.5 g

TOLNAFTATE Tinactin Soln: 1%, 10 ml

TOLTERODINE Detrol LA SR Caps: all strengths

TOPIRAMATE Topamax Tabs: all strengths

TRAMADOL Ultram Tabs: all strengths

**DoD Quantity Limit 240 tabs per 30 days**

TRAZADONE Desyrel Tabs: 50, 100, 150, 300 mg

TRETINOIN Retin A, Avita Cream: all strengths

**Limited to persons <36 yrs of age**

TRIAMCINOLONE Kenalog in Orabase Paste: 0.1% 5 g

T TRIAMCINOLONE Kenalog *Cream: 1%, 5%

Spray: 15 mcg/spray. 63g

Ointment: 1%

TRIAMTERENE/HCTZ Maxzide Tabs: 37.5/25, 75/50 mg

TRIHEXYPHENIDYL Artane Tabs: all strengths *Elixir: 0.4mg/ml

TRIMETHOBENZAMIDE Tigan Caps: 300 mg

TRIMETHOPRIM/POLYMYXIN B Polytrim Soln: 10 ml

TROPICAMIDE Mydriacyl Soln: 1%, 15 ml

VALACYCLOVIR Valtrex Tabs: all strengths

VALPROIC ACID Depakene Liq: 250 mg/5ml

VALSARTAN Diovan Tabs: all strengths

VALSARTAN/HCTZ DiovanHCT Tabs: all strengths

VARDENAFIL Levitra Tabs: all strengths

Under 40? Need prior authorization form

**DoD Quantity limit 18 tablets/90 days**

VARENECLINE Chantix Tabs: Starter pack, continuing treatment pack

(0.5, 1 mg tabs)

**Must be enrolled in Smoking Cessation

class**

VENLAFAXINE Effexor, Effexor XR XR Caps: all strengths

VERAPAMIL Calan Tabs: 80 mg

SR Tabs: all strengths

20

WARFARIN Coumadin Tabs: all strengths

XYLITOL Spry Gum Dental chewing gum

ZIPRASIDONE Geodon Caps: all strengths

ZOLPIDEM Ambien C-IV Tabs: all strengths

ZOMITRIPTAN Zomig/Zomig ZMT Tabs: all strengths/Oral disintegrating tabs

**DoD Quantity limit 36 tablets/90 days**

21

Quick List for Common Uses

For Asthma/Allergies For Blood pressure For Cholesterol

Inhalers: Albuterol (Ventolin/Proventil HFA), levalbuterol (Xopenex) MDI,

salmeterol (Serevent Diskus)

Nebulizer solutions: albuterol,

budesonide (Pulmicort), ipratropium

Other: montelukast (Singulair)

Steroids: fluticasone (Flovent HFA)

mometasone (Asmanex)

Combo: albuterol/salmeterol (Advair &

Advair HFA), budesonide/formoterol (Symbicort)

Allergies: cetirizine (Zyrtec), loratadine (Claritin), fexofenadine (Allegra),

cetirizine/pseudoephedrine (Zyrtec-D)

Nasal: azelastine (Astelin), fluticasone

(Flonase), mometasone (Nasonex), fluocinonide (Nasarel)

ACEs: benazepril (Lotensin), captopril (Capoten), lisinopril (Zestril)

ARBs: candesartan (Atacand), losartan (Cozaar), telmisartan (Micardis),

valsartan (Diovan)

BBs: atenolol (Tenormin), carvedilol

(Coreg), metoprolol succinate (Toprol XL), metoprolol tartrate (Lopressor)

CCBs: amlodipine (Norvasc), diltiazem ER (Tiazac), felodipine (Plendil),

nifedipine SR (Adalat CC), verapamil (Calan SR)

Diuretics: furosemide (Lasix), HCTZ, spironolactone, triamterene/HCTZ

(Maxzide)

Combos: benazepril/amlodipine

(Lotrel), lisinopril/HCTZ (Zestoretic) losartan/HCTZ (Hyzaar),

telmisartan/HCTZ (Micardis HCT), valsartan/HCTZ (Diovan HCT)

Statins: atorvastatin (Lipitor), pravastatin (Pravachol), simvastatin

(Zocor)

Other: Ezetimibe (Zetia), fenofibrate

(Lofibra), niacin (Niaspan), gemfibrozil

(Lopid)

Combo: ezetimibe/simvastatin (Vytorin)

For Diabetes For Migraines Controlled Substances

Oral Agents: Glipizide (Glucotrol & Glucotrol XL), Glyburide (Micronase),

Metformin (Glucophage & Glucophage

XR), pioglitazone (Actos), pioglitazone/metformin (Actoplusmet)

Insulin: Novolog (aspart), Novolin N

(NPH), Novolin R (regular), Novolin

70/30 (NPH/Reg), Novolog Mix 70/30 (NPH/Reg), Lantus (glargine)

Syringes: 0.5 ml, 1ml. BD Sharps

container for disposal. Insulin Pen

needles

Blood glucose monitors/test strips: Accu-chek Aviva, Precision Xtra (box of

50 test strips)

Lancets (box of 200): Accu-chek

Softclix for Aviva Accu-check Soft

touch plus lancet device for Precision Xtra.

Triptans: rizatriptan (Maxalt & Maxalt MLT), sumatriptan (Imitrex),

zolmitriptan (Zomig & Zomig ZMT)

[Please note DoD quantity limitations]

Acetaminophen/butalbital/caffeine (Fioricet)

The state of California requires that controlled substances MUST

be written on a California Security

Prescription pad.

C-II: Adderall and Adderall XR, Ritalin, Concerta, Morphine IR, MS Contin,

Percocet

C-III: Tylenol w/ codeine #3, Codeine

sulfate, Vicodin, and Vicodin ES

C-IV: Alprazolam (Xanax), Clonazepam

(Klonapin), diazepam (Valium), lorazepam (Ativan), temazepam

(Restoril), zolpidem (Ambien).

C-V: Robitussin AC (qty of 120ml),

Lomotil

NOTE: C-II: no refills allowed C-III-V:

prescription only valid for 6 months. Refills are allowed but may not exceed

6 months

22

Quick Reference Telephone List

Emergencies............................................................ 911

Emergencies from cell phone on base................... 661- 277- 4541

Poison Control ...................................................... 800-222-1222

Appointments:

Family practice ...................................................... 661-277-7118, option 1, then 1

Pediatrics................................................................ 661-277-7118, option 1, then 2

Flight Surgeon’s Office.......................................... 661-277-7118, option 1, then 3

Optometry.............................................................. 661-277-7118, option 1, then 4

Physical Therapy.................................................... 661-277-7118, option 1, then 5

Dental Clinic.......................................................... 661-277-2872

Family Advocacy................................................... 661-277-5292

Flight Surgeon’s Office.......................................... 661-277-7118 option 3

Health and Wellness Center.................................... 661-277-8480

Immunizations.........................................................661-277-3427

Laboratory............................................................... 661-277-2306

Mental Health..........................................................661-277-5291

Managed Care......................................................... 661-277-6969

NurseLine................................................................ 661- 275-6877, or

888-762-3842

Patient Administration........................................... 661-275-2668

Pharmacy................................................................ 661-277-9896

Physical Therapy.................................................... 661-277-3891

Primary Care Clinic............................................... 661-277-7118

Public Health.......................................................... 661-275-2694

Radiology................................................................ 661-277-2681 TriWest/TRICARE................................................. 888-874-9378

Base Exchange: Main Store 258-1078

Commissary 277-4589

Family Child Care Program 275-4FCC/275-4322

Golf Course 275-PUTT/275-7888

Information, Tickets and Travel (leisure) 275-TRIP/275-8747

Base Schools Switchboard 258-4411

Security Forces 277-3340

Retiree Activity Office 277-4931