Preferred Drug List - mibluecrosscomplete.com · Blue Cross Complete participates in the Michigan...

Preferred Drug List

Blue Cross Complete participates in the Michigan Common Formulary

PH-ANR-13Rev122319

Preferred Drug List

Effective January 1, 2020

This Preferred Drug List is a list of medicines that are covered by your pharmacy benefit. The list includes prescription and non-prescription medicines. In addition to this list, you can use our online search tool. You’ll also find the Preferred Drug List Quick Reference on our website at mibluecrosscomplete.com. This is an easy-to-use summary of the medicines we cover.

If you have questions, please contact Blue Cross Complete of Michigan Pharmacy Services at 1-888-288-3231. You can call this number from 8:30 a.m. until 6 p.m., Monday through Friday.

Encl: Nondiscrimination Notice and Language Services

AL = Age Limit F = Formulary OTC = Over The Counter

PA = Prior Authorization QL = Quantity Limit ST = Step Therapy

State Carve Out = Carve-out medications must be billed to Medicaid Fee For Service. For billing assistance call

the Magellan Clinical Call Center at 877-864-9014.

Reviewed and Updated December 2019

1

Tier Status Notes

Drug Tier Status Notes

Alternative Therapy

Alternative Therapy - Antioxidant

50 Plus Adult Eye Health F

Antioxidant A/C/E/Selenium F

Antioxidant Formula (selenium) F

E-400 C-500 and Beta Carotene F

Healthy Eyes SuperVision F

ICaps AREDS F

I-Vite Protect F

Multi-Betic F

PreserVision AREDS F

SAVision F

Super Antioxidant F

Analgesic, Anti-Inflammatory Or

Antipyretic

Analgesic Opioid Agonists

codeine sulfate oral tablet F QL; AL

fentanyl transdermal patch 72 hour 100 mcg/hr,

12 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr F PA; QL

hydromorphone oral liquid F QL

hydromorphone oral tablet 2 mg, 4 mg F QL

hydromorphone rectal F QL

meperidine oral F QL; AL

methadone oral concentrate F QL

methadone oral solution F QL

methadone oral tablet F QL

morphine concentrate oral solution F QL

morphine oral solution F QL

morphine oral tablet F QL

morphine oral tablet extended release F QL

oxycodone oral solution F QL






2


oxycodone oral tablet 5 mg F QL

tramadol oral tablet F QL; AL

Analgesic Opioid Codeine

Combinations

acetaminophen-codeine oral solution 120-12 mg/5

mL F QL; AL

acetaminophen-codeine oral tablet F QL; AL

Butalbital Compound W/Codeine F QL; AL

butalbital-acetaminop-caf-cod oral capsule 50-

325-40-30 mg F QL; AL

codeine-butalbital-ASA-caff F QL; AL

Analgesic Opioid Hydrocodone And

Non-Salicylate Combinations

hydrocodone-acetaminophen oral solution 7.5-

325 mg/15 mL F QL

hydrocodone-acetaminophen oral tablet 10-325

mg, 5-325 mg, 7.5-325 mg F QL

Analgesic Opioid Hydrocodone And

Nsaid Combinations

hydrocodone-ibuprofen oral tablet 5-200 mg, 7.5-

200 mg F QL

Analgesic Opioid Hydrocodone

Combinations

hydrocodone-acetaminophen oral solution 7.5-

325 mg/15 mL F QL

hydrocodone-acetaminophen oral tablet 10-325

mg, 5-325 mg, 7.5-325 mg F QL

hydrocodone-ibuprofen oral tablet 5-200 mg, 7.5-

200 mg F QL

Analgesic Opioid Oxycodone And Non-

Salicylate Combinations

oxycodone-acetaminophen oral tablet 10-325 mg,

5-325 mg, 7.5-325 mg F QL

Analgesic Opioid Oxycodone

Combinations






3


oxycodone-acetaminophen oral tablet 10-325 mg,

5-325 mg, 7.5-325 mg F QL

Analgesic Opioid Partial-Mixed

Agonists

pentazocine-naloxone F QL

Analgesic Or Antipyretic Non-Opioid

8 Hour Pain Reliever F OTC

Acetaminophen Extra Strength F OTC

acetaminophen oral elixir F OTC

acetaminophen oral liquid 160 mg/5 mL, 500

mg/5 mL F OTC

acetaminophen oral solution 160 mg/5 mL (5 mL) F OTC

acetaminophen oral suspension 160 mg/5 mL F OTC; QL

acetaminophen oral tablet F OTC

acetaminophen oral tablet extended release F OTC

acetaminophen oral tablet,disintegrating F OTC

Acetaminophen Pain Relief F OTC

acetaminophen rectal F OTC

Arthritis Pain Relief (acetam) F OTC

Arthritis Pain Reliever F OTC

Children's Acetaminophen oral suspension 160

mg/5 mL (5 mL) F OTC

Children's Acetaminophen oral

tablet,disintegrating F OTC

Children's Easy-Melts F OTC

Children's Pain-Fever Relief oral

tablet,disintegrating F OTC

Feverall rectal suppository 325 mg F OTC

Infant's Non-Aspirin oral drops F OTC

Jr. Acetaminophen F OTC

Jr. Str Non-Aspirin Pain F OTC

Jr. Strength Pain Reliever F OTC

Mapap (acetaminophen) oral capsule F OTC

Mapap Arthritis Pain F OTC






4


Non-Aspirin Extra Strength oral tablet F OTC

Non-Aspirin oral elixir F OTC

Pain Relief Extra Strength F OTC

Pain Relief oral tablet extended release F OTC

Tylenol Arthritis Pain F OTC

Tylenol Extra Strength oral tablet F OTC

Analgesic Or Antipyretic Non-

Opioid/Sedative Combinations

butalbital-acetaminophen oral tablet 50-325 mg F AL

butalbital-acetaminophen-caff oral tablet 50-325-

40 mg F AL

Anti-Inflammatory - Interleukin-1 Beta

Blockers

Ilaris (PF) subcutaneous solution State Carve Out

Anti-Inflammatory - Interleukin-1

Receptor Antagonist

Arcalyst State Carve Out

Anti-Inflammatory Tumor Necrosis

Factor Inhibiting Agnts,Non-Seiective

Enbrel F PA; QL

Enbrel Mini F PA; QL

Enbrel SureClick F PA; QL

Anti-Inflammatory Tumor Necrosis

Factor Inhibiting Agnts,Tnf-Alpha Sel

CIMZIA 2X200 MG/ML SYRINGE KIT F PA; QL

Cimzia Powder for Reconst F PA; QL

Cimzia Starter Kit F PA; QL

Humira F PA; QL

Humira Pediatric Crohns Start F PA; QL

Humira Pen F PA; QL

Humira Pen Crohns-UC-HS Start F PA; QL

Humira Pen Psor-Uveits-Adol HS F PA; QL

Humira(CF) F PA; QL






5


Humira(CF) Pedi Crohns Starter F PA; QL

Humira(CF) Pen F PA; QL

Humira(CF) Pen Crohns-UC-HS F PA; QL

Humira(CF) Pen Psor-Uv-Adol HS F PA; QL

Dmard - Anti-Inflammatory Tumor

Necrosis Factor Inhibiting Agents




Enbrel F PA; QL

Enbrel Mini F PA; QL

Enbrel SureClick F PA; QL

Humira F PA; QL


Humira Pen F PA; QL



Humira(CF) F PA; QL

Humira(CF) Pedi Crohns Starter subcutaneous

syringe kit 80 mg/0.8 mL F PA; QL




Dmard - Antimalarials

hydroxychloroquine F

Dmard - Antimetabolites

methotrexate sodium oral F

Xatmep F PA

Dmard - Antinflammatory, Select.

Costimulation Modulator,T-Cell Inhib.

Orencia F PA; QL

Orencia ClickJect F PA; QL






6


Dmard - Immunosuppressives

azathioprine F QL

cyclophosphamide oral capsule F PA

cyclosporine modified oral capsule F

cyclosporine modified oral solution F AL

cyclosporine oral capsule F

mycophenolate mofetil oral capsule F

mycophenolate mofetil oral suspension for

reconstitution F AL

mycophenolate mofetil oral tablet F

Dmard - Interleukin-1 Receptor

Antagonist (Il-1Ra)

Kineret State Carve Out

Dmard - Interleukin-6 (Il-6) Receptor

Inhibitors, Monoclonal Antibody

Actemra ACTPen F PA; QL

Actemra subcutaneous F PA; QL

Dmard - Janus Kinase (Jak) Inhibitors

Olumiant oral tablet 2 mg F PA; QL

Xeljanz oral tablet 5 mg F PA; QL

Xeljanz XR F PA; QL

Dmard - Other

minocycline oral capsule F

sulfasalazine F

Dmard - Phosphodiesterase-4 (Pde4)

Inhibitors

Otezla F PA

Otezla Starter F PA; QL

Dmard - Pyrimidine Synthesis

Inhibitors

leflunomide F QL






7


Nsaid Analgesic, Cyclooxygenase-2

(Cox-2) Selective Inhibitors

celecoxib F QL

Nsaid Analgesics (Cox Non-Specific) -

Other

ketorolac oral F AL

nabumetone F QL

sulindac F


Oxicam Derivatives

meloxicam oral tablet F QL

piroxicam F QL


Phenylacetic Acid Derivatives

diclofenac sodium oral F


Propionic Acid Derivatives

Children's Ibuprofen F OTC; QL

flurbiprofen oral tablet 100 mg F

Ibuprofen IB oral tablet,chewable F OTC

Ibuprofen Jr Strength F OTC

ibuprofen oral capsule F OTC; QL

ibuprofen oral drops,suspension F OTC

ibuprofen oral suspension F OTC; QL

ibuprofen oral tablet 100 mg, 200 mg F OTC

ibuprofen oral tablet 400 mg, 600 mg, 800 mg F

ibuprofen oral tablet,chewable F OTC

Infant's Ibuprofen F OTC

Infant's Motrin F OTC

naproxen oral suspension F PA; AL

naproxen oral tablet F

naproxen oral tablet,delayed release (DR/EC) F

naproxen sodium oral capsule F OTC






8


naproxen sodium oral tablet 220 mg F OTC; QL

Nsaid Analgesics, (Cox Non-Specific) -

Indole Acetic Acid Derivatives

etodolac oral capsule F QL

etodolac oral tablet F QL

indomethacin oral F AL

Salicylate Analgesic And Sedative

Combinations

butalbital-aspirin-caffeine oral capsule F QL; AL

Salicylate Analgesic Combinations

choline,magnesium salicylate F

Salicylate Analgesics

aspirin oral tablet F OTC; QL; AL

aspirin oral tablet,chewable F OTC; QL

aspirin oral tablet,delayed release (DR/EC) 325

mg F OTC; QL; AL

aspirin oral tablet,delayed release (DR/EC) 81 mg F OTC; QL

aspirin rectal F OTC

Anesthetics

General Anesthetic - Parenteral,

Benzodiazepines

midazolam (PF) injection solution 5 mg/mL F QL

midazolam injection solution 5 mg/mL F QL

General Anesthetic Adjuncts -

Neuroleptic, Butyrophenone Derivative

droperidol injection solution State Carve Out

Antidotes And Other Reversal Agents

Antidote - Acetaminophen Poisoning

acetylcysteine F

Chelating Agents - Lead Poisoning

Chemet F






9


Opioid Reversal Agents - Opioid

Antagonists

naloxone F QL

naltrexone State Carve Out

Narcan nasal spray,non-aerosol 4 mg/actuation F QL

Anti-Infective Agents

Amebicides

paromomycin F

Aminoglycoside Antibiotic

neomycin F

Aminopenicillin Antibiotic

amoxicillin oral capsule F

amoxicillin oral suspension for reconstitution F AL

amoxicillin oral tablet F

amoxicillin oral tablet,chewable 125 mg, 250 mg F AL

ampicillin oral capsule F

Aminopenicillin Antibiotic - Beta-

Lactamase Inhibitor Combinations

amoxicillin-pot clavulanate oral suspension for

reconstitution F AL

amoxicillin-pot clavulanate oral tablet F

amoxicillin-pot clavulanate oral tablet extended

release 12 hr F

amoxicillin-pot clavulanate oral tablet,chewable F AL

Anthelmintic Agents - Macrocyclic

Lactones

ivermectin oral F

Anthelmintic Agents Other

ivermectin oral F

Antibacterial Folate Antagonist - Other

Combinations

sulfamethoxazole-trimethoprim oral F






10


Sulfatrim F

Antibacterial Folate Antagonist Others

trimethoprim F

Antibacterial Nitrofuran Derivatives

nitrofurantoin F AL

nitrofurantoin macrocrystal oral capsule 100 mg,

50 mg F QL; AL

nitrofurantoin monohyd/m-cryst F QL; AL

Antifungal - Allylamines

terbinafine HCl oral F QL

Antifungal - Amphoteric Polyene

Macrolides

nystatin oral tablet F

Antifungal - Imidazoles

ketoconazole oral F QL

Antifungal - Triazoles

fluconazole oral suspension for reconstitution F AL

fluconazole oral tablet F

itraconazole oral capsule F

Antifungal Other

griseofulvin microsize F

griseofulvin ultramicrosize F

Antileprotic - Immunomodulators

Thalomid F PA

Antileprotic - Sulfone Agents

dapsone oral F

Antimalarials

chloroquine phosphate F QL

Daraprim Specialty PA

hydroxychloroquine F

Krintafel F PA; QL; AL

mefloquine F PA; QL






11


primaquine F

Antiprotozoal Agents - Nitroimidazole

Derivatives

benznidazole F PA

Antiprotozoal Agents - Other

atovaquone F PA

Antiprotozoal-Antibacterial 1St

Generation 2-Methyl-5-Nitroimidazole

metronidazole oral tablet F

Antiprotozoal-Antibacterial 2Nd

Generation 2-Methyl-5-Nitroimidazole

tinidazole F

Antiretroviral - Anti-Cd4 Domain 2

Monoclonal Antibody

Trogarzo State Carve Out

Antiretroviral - Ccr5 Co-Receptor

Antagonist

Selzentry oral tablet 150 mg, 300 mg State Carve Out

Antiretroviral - Hiv-1 Fusion Inhibitors

Fuzeon subcutaneous recon soln State Carve Out

Antiretroviral - Hiv-1 Integrase Strand

Transfer Inhibitors

Isentress State Carve Out

Tivicay State Carve Out

Antiretroviral - Integrase Inhibitor And

Nnrti Combinations

Juluca State Carve Out

Antiretroviral - Integrase Inhibitor And

Nrti Combinations

Dovato State Carve Out

Antiretroviral - Non-Nucleoside Reverse

Transcriptase Inhib (Nnrti)






12


Edurant State Carve Out

Intelence State Carve Out

Rescriptor oral tablet State Carve Out

Sustiva State Carve Out

Viramune State Carve Out

Viramune XR oral tablet extended release 24 hr

400 mg State Carve Out

Antiretroviral - Nucleoside And

Nucleotide Analog Rtis Combinations

Descovy State Carve Out

Truvada State Carve Out

Antiretroviral - Nucleoside Reverse

Transcriptase Inhibitors (Nrti)

abacavir oral tablet State Carve Out

didanosine State Carve Out

Emtriva State Carve Out

Epivir oral solution State Carve Out

lamivudine oral tablet 150 mg, 300 mg State Carve Out

Retrovir intravenous State Carve Out

stavudine oral capsule State Carve Out

Videx 2 gram Pediatric State Carve Out

Zerit oral capsule 30 mg State Carve Out

Ziagen oral solution State Carve Out

zidovudine State Carve Out

Antiretroviral - Nucleotide Analog

Reverse Transcriptase Inhibitors

Viread State Carve Out

Antiretroviral Combinations - Protease

Inhibitors

Evotaz State Carve Out

Kaletra oral tablet State Carve Out

lopinavir-ritonavir State Carve Out

Prezcobix State Carve Out






13


Antiretroviral- Nucleoside And

Nucleotide Analogs,Integrase Inhibitors

Genvoya State Carve Out

Stribild State Carve Out

Antiretroviral- Nucleoside And

Nucleotide Analogs,Protease Inhibitors

Symtuza State Carve Out

Antiretroviral-Nucleoside Analogs And

Integrase Inhibitor Combinations

Triumeq State Carve Out

Antiretroviral-Nucleoside Reverse

Transcriptase Inhibitors (Nrti) Comb

abacavir-lamivudine-zidovudine State Carve Out

Epzicom State Carve Out

lamivudine-zidovudine State Carve Out

Antiretroviral-Nucleoside, Nucleotide

Analogs And Non-Nucleoside Rti

Atripla State Carve Out

Complera State Carve Out

Odefsey State Carve Out

Symfi State Carve Out

Symfi Lo State Carve Out

Antitubercular - D-Alanine Analogs

cycloserine F

Antitubercular - Isonicotinic Acid

Derivatives

isoniazid oral solution F AL

isoniazid oral tablet F

Antitubercular - Niacinamide

Derivatives

pyrazinamide F






14


Antitubercular - Rifamycin And

Derivatives

rifabutin F

rifampin oral F

Antitubercular Agents Other

ethambutol F

Trecator F

Cephalosporin Antibiotics - 1St

Generation

cefadroxil oral capsule F

cefadroxil oral suspension for reconstitution 250

mg/5 mL, 500 mg/5 mL F AL

cefadroxil oral tablet F

cephalexin oral capsule 250 mg, 500 mg F

cephalexin oral suspension for reconstitution F AL

Cephalosporin Antibiotics - 2Nd

Generation

cefaclor oral capsule F

cefaclor oral suspension for reconstitution 125

mg/5 mL, 250 mg/5 mL, 375 mg/5 mL F AL

cefprozil oral suspension for reconstitution F AL

cefprozil oral tablet F

cefuroxime axetil oral tablet F

Cephalosporin Antibiotics - 3Rd

Generation

cefdinir oral capsule F

cefdinir oral suspension for reconstitution F AL

cefixime oral suspension for reconstitution F AL

cefpodoxime oral suspension for reconstitution F AL

cefpodoxime oral tablet F

Suprax oral capsule F

Suprax oral suspension for reconstitution 500

mg/5 mL F AL






15


Cmv Antiviral Agent - Nucleoside

Analogs

valganciclovir oral tablet F PA; QL

Fluoroquinolone Antibiotics

ciprofloxacin F AL

ciprofloxacin HCl oral tablet 250 mg, 500 mg,

750 mg F

levofloxacin oral solution F AL

levofloxacin oral tablet F

moxifloxacin oral F

ofloxacin oral tablet 400 mg F

Glycopeptide Antibiotics

Firvanq F

vancomycin intravenous recon soln 1,000 mg, 10

gram, 5 gram, 500 mg, 750 mg Specialty

vancomycin oral capsule F

Hepatitis B Treatment- Nucleoside

Analogs (Antiviral)

entecavir F QL

lamivudine oral tablet 100 mg F QL

Hepatitis B Treatment- Nucleotide

Analogs (Antiviral)

adefovir Specialty QL

Vemlidy F PA; QL

Viread State Carve Out

Hepatitis C - Interferons

Pegasys State Carve Out QL

PegIntron subcutaneous kit 50 mcg/0.5 mL State Carve Out QL

Hepatitis C - Ns5a Inhibitor And

Ns3/4A Protease Inhibitor Combination

Mavyret State Carve Out

Zepatier State Carve Out






16


Hepatitis C - Ns5a, Ns3/4A Protease,

Nucleo.Ns5b Polymerase Inhib Comb

Vosevi State Carve Out

Hepatitis C - Ns5b Polymerase And

Ns5a Inhibitor Combinations

Harvoni oral tablet 90-400 mg State Carve Out

Hepatitis C - Nucleos(T)Ide Analog

Ns5b Polymerase Inhibitors

Sovaldi oral tablet 400 mg State Carve Out

Hepatitis C - Nucleoside Analogs

Ribasphere oral capsule State Carve Out

Ribasphere oral tablet 600 mg State Carve Out

Ribasphere RibaPak oral tablets,dose pack 600

mg (7)- 400 mg (7), 600 mg (7)- 600 mg (7), 600-

400 mg (28)-mg (28), 600-600 mg (28)-mg (28)

State Carve Out

ribavirin oral capsule State Carve Out

ribavirin oral tablet 200 mg State Carve Out

Hepatitis C- Ns5a, Ns3/4A Protease

And Non-Nucleo.Ns5b Poly Inh. Comb

Viekira Pak State Carve Out

Herpes Antiviral Agent - Purine

Analogs

acyclovir oral capsule F QL

acyclovir oral suspension 200 mg/5 mL F AL

acyclovir oral tablet F QL

valacyclovir F QL

Herpes Antiviral Agent - Thymidine

Analogs

famciclovir F QL

Influenza Antiviral Agents -

Neuraminidase Inhibitors

oseltamivir oral capsule F QL

Relenza Diskhaler F QL; AL






17


Tamiflu oral suspension for reconstitution F QL; AL

Influenza-A Antiviral Agents

rimantadine F

Lincosamide Antibiotics

clindamycin HCl F

clindamycin palmitate HCl F AL

Macrolide Antibiotics

azithromycin oral packet F QL

azithromycin oral suspension for reconstitution F AL

azithromycin oral tablet F

clarithromycin oral suspension for reconstitution F AL

clarithromycin oral tablet F

Dificid F PA

Misc Anti-Infective

methenamine hippurate F

methenamine mandelate F

Misc Anti-Infective Combinations

Uretron D-S oral tablet 81.6-10.8-40.8 mg F

Utira-C F

Oxazolidinone Antibiotics

linezolid F PA

Penicillin Antibiotic - Natural

penicillin V potassium oral recon soln F AL

penicillin V potassium oral tablet F

Penicillin Antibiotic - Penicillinase-

Resistant

dicloxacillin F

Protease Inhibitors (Non-Peptidic)

Antiretroviral

Aptivus State Carve Out

Prezcobix State Carve Out

Prezista oral suspension State Carve Out






18


Prezista oral tablet 150 mg, 600 mg, 75 mg, 800

mg State Carve Out

Protease Inhibitors (Peptidic)

Antiretroviral

Crixivan oral capsule 200 mg, 400 mg State Carve Out

Evotaz State Carve Out

Invirase oral tablet State Carve Out

Lexiva State Carve Out

Norvir State Carve Out

Reyataz oral capsule 150 mg, 200 mg, 300 mg State Carve Out

Reyataz oral powder in packet State Carve Out

Viracept oral tablet State Carve Out

Rifamycins And Related Derivative

Antibiotics

rifabutin F

rifampin oral F

Tetracycline Antibiotics

doxycycline hyclate oral capsule F

doxycycline hyclate oral tablet 100 mg F

doxycycline monohydrate oral capsule 100 mg,

50 mg F

doxycycline monohydrate oral suspension for

reconstitution F AL

doxycycline monohydrate oral tablet 100 mg, 50

mg F

minocycline oral capsule F

tetracycline F

Antineoplastics

Antineoplasic-Epiderm.Growth Factor-

Egfr (Erbb1),Her-2 (Erbb2)R.Inhib

Tykerb State Carve Out

Antineoplastic - Cyp17 (17 Alpha-

Hydroxylase/C17,20-Lyase) Inhibitor






19


Yonsa F PA

Zytiga Specialty PA; QL

Antineoplastic - 1St Generation Egfr

Tyrosine Kinase Inhibitor

Tarceva State Carve Out

Antineoplastic - 2Nd Generation Egfr

Tyrosine Kinase Inhibitor

Gilotrif State Carve Out

Antineoplastic - Alkylating Agent -

Alkyl Sulfonates

Myleran F PA


Methylhydrazines

Matulane F PA


Nitrogen Mustards

Alkeran F PA

cyclophosphamide oral capsule F PA

Leukeran F PA


Nitrosoureas

Gleostine oral capsule 10 mg, 100 mg, 40 mg Specialty PA


Triazenes

Temodar oral Specialty PA

temozolomide Specialty PA

Antineoplastic - Anaplastic Lymphoma

Kinase (Alk) Inhibitors

Alunbrig oral tablet 30 mg State Carve Out

Xalkori State Carve Out

Antineoplastic - Antiadrenals

Lysodren F PA






20


Antineoplastic - Antiandrogens

bicalutamide F PA

Erleada F PA; QL

flutamide F PA

nilutamide F PA

Nubeqa F PA

Xtandi Specialty PA; QL

Yonsa F PA

Zytiga Specialty PA; QL

Antineoplastic - Antimetabolite - Folic

Acid Analogs

methotrexate sodium F

methotrexate sodium (PF) injection solution F

Xatmep F PA

Antineoplastic - Antimetabolite - Purine

Analogs

mercaptopurine F

Tabloid F PA

Antineoplastic - Antimetabolite -

Pyrimidine Analogs

capecitabine F PA

Antineoplastic - Antimetabolite - Urea

Derivatives

hydroxyurea F

Antineoplastic - Antimetabolites -

Pyrimidine Analog Combinations

Lonsurf Specialty PA

Antineoplastic - Aromatase Inhibitors

anastrozole F

exemestane F

letrozole F QL; AL






21


Antineoplastic - B-Cell Lymphoma-2

(Bcl-2) Inhibitors

Venclexta Specialty PA

Venclexta Starting Pack Specialty PA

Antineoplastic - Braf Kinase Inhibitors

Braftovi F PA

Tafinlar State Carve Out

Zelboraf State Carve Out

Antineoplastic - Bruton's Tyrosine

Kinase (Btk) Inhibitor

Imbruvica oral capsule 140 mg State Carve Out

Antineoplastic - Cyclin-Dependent

Kinase (Cdk) 4/6 Inhibitors

Ibrance State Carve Out

Kisqali State Carve Out

Verzenio State Carve Out

Antineoplastic - Epipodophyllotoxins

etoposide oral Specialty PA

Antineoplastic - Estrogens

Emcyt F PA

Antineoplastic - Exportin-1 (Xpo1)

Inhibitors

Xpovio F PA

Antineoplastic - Hedgehog Pathway

Inhibitor

Daurismo Specialty PA

Erivedge Specialty PA; QL

Odomzo F PA

Antineoplastic - Histone Deacetylase

(Hdac) Inhibitors

Farydak F PA

Zolinza Specialty PA






22


Antineoplastic - Interferons

Intron A injection Specialty PA

Antineoplastic - Janus Kinase (Jak)

Inhibitors

Jakafi Specialty PA; QL

Antineoplastic - Lhrh (Gnrh) Agonist

Analog Pituitary Suppressants

leuprolide subcutaneous kit F PA

Antineoplastic - Mek1 And Mek2

Kinase Inhibitors

Cotellic State Carve Out

Mekinist State Carve Out

Antineoplastic - Mtor Kinase Inhibitors

Afinitor Disperz Specialty PA; QL

Afinitor oral tablet 10 mg, 2.5 mg, 5 mg Specialty PA; QL

Afinitor oral tablet 7.5 mg Specialty PA

Antineoplastic - Multikinase Inhibitors

Cometriq State Carve Out

Iclusig State Carve Out

Nexavar State Carve Out

Antineoplastic - Mutant Isocitrate

Dehydrogenase 1 (Midh1) Inhibitors

Tibsovo F PA

Antineoplastic - Mutant Isocitrate

Dehydrogenase 2 (Midh2) Inhibitors

Idhifa F PA

Antineoplastic - Phosphatidylinositol 3-

Kinase (Pi3k) Inhibitors

Zydelig State Carve Out

Antineoplastic - Pi3k-Delta Inhibitors

Zydelig State Carve Out






23


Antineoplastic - Poly (Adp-Ribose)

Polymerase (Parp) Inhibitors

Rubraca oral tablet 250 mg State Carve Out

Zejula State Carve Out

Antineoplastic - Progestins

megestrol oral tablet F

Antineoplastic - Proteasome Enzyme

Inhibitors

Kyprolis intravenous recon soln 60 mg State Carve Out

Velcade State Carve Out

Antineoplastic - Protein-Tyrosine

Kinase Inhibitors

Bosulif oral tablet 500 mg State Carve Out

Caprelsa State Carve Out

Gleevec State Carve Out

Imbruvica oral capsule 140 mg State Carve Out

Inlyta State Carve Out

Lenvima oral capsule 10 mg/day (10 mg x 1), 14

mg/day(10 mg x 1-4 mg x 1), 20 mg/day (10 mg x

2), 24 mg/day(10 mg x 2-4 mg x 1)

State Carve Out

Sprycel State Carve Out

Sutent State Carve Out

Tasigna oral capsule 150 mg, 200 mg State Carve Out

Votrient State Carve Out

Antineoplastic - Retinoids

tretinoin (chemotherapy) Specialty PA

Antineoplastic - Selective Estrogen

Receptor Modulators (Serms)

tamoxifen F QL

toremifene F PA

Antineoplastic - Selective Inhibitiors Of

Nuclear Export (Sine)

Xpovio F PA






24


Antineoplastic - Selective Retinoid X

Receptor Agonists

bexarotene F PA

Targretin oral Specialty

Antineoplastic - Thalidomide Analogs

Pomalyst F PA

Revlimid oral capsule 10 mg, 15 mg, 25 mg, 5 mg Specialty PA; QL

Revlimid oral capsule 2.5 mg, 20 mg Specialty PA

Thalomid F PA

Antineoplastic - Topoisomerase I

Inhibitors

Hycamtin oral Specialty PA

Methotrexate Rescue Agents

leucovorin calcium oral F

Methotrexate Rescue Agents - Folic

Acid Antagonist Type

leucovorin calcium oral F

Urinary Tract Protective Agents Used

In Conjunction With Chemotherapy

Mesnex oral F PA

Antiseptics And Disinfectants

Antiseptic - Alcohols

alcohol swabs F OTC; QL

Biologicals

Antiviral Monoclonal Antibodies

Synagis F PA

Antiviral Monoclonal Antibodies -

Respiratory Syncytial Virus (Rsv)

Synagis F PA

Gene Therapy Agents - Smn Protein

Deficiency

Zolgensma State Carve Out






25


Hepatitis A Vaccine - Single Agents

Havrix (PF) intramuscular suspension 1,440

ELISA unit/mL F AL

Havrix (PF) intramuscular syringe F AL

Vaqta (PF) F AL

Live Vaccine And Live Virus

Formulations

M-M-R II (PF) F QL

Toxoid Vaccine Combinations

Adacel(Tdap Adolesn/Adult)(PF) F

Boostrix Tdap F

Vaccine Bacterial - Gram Positive Cocci

Pneumovax 23 injection solution F

Pneumovax 23 injection syringe F QL

Prevnar 13 (PF) F

Vaccine Viral - Influenza A And B

Afluria Qd 2019-20(3yr up)(PF) F QL; AL

Afluria Qd 2019-20(6-35mo)(PF) F QL; AL

Afluria Quad 2019-20(6mo up) F QL; AL

Fluarix Quad 2019-2020 (PF) F QL; AL

Flublok Quad 2019-2020 (PF) F QL; AL

Flulaval Quad 2019-2020 F QL; AL

Flulaval Quad 2019-2020 (PF) F QL; AL

Fluzone High-Dose 2019-20 (PF) F QL; AL

Fluzone Quad 2019-2020 F QL; AL

Fluzone Quad 2019-2020 (PF) F QL; AL

Fluzone Quad Pedi 2019-20 (PF) F QL; AL

Vaccine Viral - Measles

M-M-R II (PF) F QL

Vaccine Viral - Mumps And Related

M-M-R II (PF) F QL

Vaccine Viral - Rubella






26


M-M-R II (PF) F QL

Vaccine Viral - Varicella

Shingrix (PF) F QL; AL

Shingrix gE Antigen Component F QL; AL

Vaccine Viral Combinations

M-M-R II (PF) F QL

Cardiovascular Therapy Agents

Ace Inhibitor And Calcium Channel

Blocker Combinations

amlodipine-benazepril F

Ace Inhibitor And Diuretic

Combinations

enalapril-hydrochlorothiazide F

lisinopril-hydrochlorothiazide F

quinapril-hydrochlorothiazide F

Ace Inhibitors

benazepril F

enalapril maleate F

Epaned oral solution F

fosinopril F

lisinopril F

perindopril erbumine oral tablet 2 mg, 4 mg F

Qbrelis F AL

quinapril F

ramipril F

trandolapril F

Aldosterone Receptor Antagonists

spironolactone F

Alpha-Beta Blockers

carvedilol F

labetalol oral F






27


Angiotensin Ii Receptor Blocker (Arb)-

Calcium Channel Blocker Comb.

amlodipine-valsartan F

Angiotensin Ii Receptor Blocker (Arb)-

Diuretic Combinations

irbesartan-hydrochlorothiazide F

losartan-hydrochlorothiazide F

valsartan-hydrochlorothiazide oral tablet 160-12.5

mg, 160-25 mg, 80-12.5 mg F QL

valsartan-hydrochlorothiazide oral tablet 320-12.5

mg, 320-25 mg F

Angiotensin Ii Receptor Blocker-

Neprilysin Inhibitor Comb. (Arni)

Entresto F QL; AL

Angiotensin Ii Receptor Blockers (Arbs)

irbesartan F

losartan F

valsartan F QL

Antianginal - Coronary Vasodilators

(Nitrates)

isosorbide dinitrate oral F

isosorbide mononitrate oral tablet F

isosorbide mononitrate oral tablet extended

release 24 hr F QL

Nitro-Bid F

nitroglycerin oral capsule, extended release 2.5

mg, 6.5 mg F

nitroglycerin sublingual tablet 0.4 mg F

nitroglycerin transdermal patch 24 hour F QL

nitroglycerin translingual spray,non-aerosol F ST

Nitrostat F

Nitro-Time oral capsule, extended release 9 mg F






28


Antianginal And Anti-Ischemic Agents,

Non-Hemodynamic

Ranexa F PA

Antiarrhythmic - Class Ia

disopyramide phosphate oral capsule F AL

quinidine sulfate oral tablet F

Antiarrhythmic - Class Ib

mexiletine F

phenytoin sodium State Carve Out

Antiarrhythmic - Class Ic

flecainide F

propafenone oral tablet F

Antiarrhythmic - Class Ii

Sotalol AF F

sotalol oral F QL

Antiarrhythmic - Class Iii

amiodarone oral F

Antiarrhythmic - Class Iv

verapamil oral tablet F

Antihyperlipidemic - Bile Acid

Sequestrants

cholestyramine (with sugar) oral powder F QL

cholestyramine (with sugar) oral powder in packet F

Cholestyramine Light F

colestipol oral granules F

colestipol oral tablet F

Antihyperlipidemic - Fibric Acid

Derivatives

fenofibrate micronized oral capsule 134 mg, 200

mg, 43 mg, 67 mg F QL

fenofibrate nanocrystallized oral tablet 145 mg,

48 mg F QL






29


fenofibrate oral capsule 50 mg F QL

fenofibrate oral tablet 160 mg, 54 mg F QL

fenofibric acid (choline) F QL

gemfibrozil F QL

Antihyperlipidemic - Hmg Coa

Reductase Inhibitors (Statins)

atorvastatin F QL

lovastatin F QL

pravastatin F QL

rosuvastatin F QL

simvastatin F QL

Antihyperlipidemic - Omega-3 Fatty

Acid Type

omega-3 acid ethyl esters F PA

Antihyperlipidemic - Selective

Cholesterol Absorption Inhibitor

ezetimibe F PA; QL

Antihyperlipidemic Agents - Dietary

Source

choline bitartrate F

omega-3 acid ethyl esters F PA

omega-3 fatty acids oral capsule F

Prenatal DHA oral capsule 200 mg F

Antihyperlipidemic Agents - Dietary

Source Combinations

Fish Oil Extra Strength F

Fish Oil oral capsule 100-160-1,000 mg, 120-180-

500 mg, 183.3 mg-75 mg -91.6 mg-306 mg, 300-

500 mg, 340-1,000 mg

F

omega 3-dha-epa-fish oil oral capsule 1,000 mg

(120 mg-180 mg), 1,200 (144-216) mg, 300-1,000

mg, 500-1,000 mg, 60-90-500 mg

F

omega 3-dha-epa-fish oil oral capsule,delayed

release(DR/EC) 300-1,000 mg F






30


omega-3 fatty acids-fish oil oral capsule 300-

1,000 mg, 360-1,200 mg F

vitamin E oral capsule 100 unit, 400 unit F

Beta Blockers Cardiac Selective

atenolol F

betaxolol oral F

bisoprolol fumarate F QL

metoprolol succinate F QL

metoprolol tartrate oral tablet 100 mg, 25 mg, 50

mg F QL

Beta Blockers Cardiac Selective,

Intrinsic Sympathomimetic Activity

acebutolol F

Beta Blockers Non-Cardiac Selective

Hemangeol F AL

nadolol F

propranolol oral capsule,extended release 24 hr F QL

propranolol oral solution F

propranolol oral tablet F

Sotalol AF F

sotalol oral F QL

Calcium Channel Blockers -

Benzothiazepines

diltiazem HCl oral capsule,ext.rel 24h degradable F QL

diltiazem HCl oral capsule,extended release 24 hr F QL

diltiazem HCl oral capsule,extended release 24hr

120 mg, 180 mg, 240 mg, 300 mg F QL

diltiazem HCl oral tablet F

diltiazem HCl oral tablet extended release 24 hr

180 mg, 300 mg F QL


Dihydropyridines

amlodipine F QL






31


felodipine F QL

isradipine F QL

nicardipine oral F QL

nifedipine oral capsule F QL; AL

nifedipine oral tablet extended release F QL

nifedipine oral tablet extended release 24hr F QL


Dihydropyridines - Cerebrovascular

Specific

nimodipine F QL


Phenylakylamines

verapamil oral capsule, 24 hr ER pellet CT F QL

verapamil oral capsule,ext rel. pellets 24 hr 120

mg, 180 mg, 240 mg F QL

verapamil oral tablet F

verapamil oral tablet extended release F QL

Cardiac Selective Beta Blocker-Thiazide

Diuretic And Related Comb.

atenolol-chlorthalidone F

bisoprolol-hydrochlorothiazide F QL

Cardiovascular Sympathomimetic -

Anaphylaxis Therapy Single Agents

epinephrine injection auto-injector F QL

Symjepi injection syringe 0.3 mg/0.3 mL F QL

Cardiovascular Sympathomimetics

midodrine F QL

Central Alpha-2 Agonists-Thiazide

Diuretic And Related Comb.

methyldopa-hydrochlorothiazide F

Central Alpha-2 Receptor Agonists

clonidine F QL

clonidine HCl oral tablet F






32


guanfacine oral tablet F QL

methyldopa F AL

Digitalis Glycosides

digoxin oral tablet F

Direct Acting Vasodilators

hydralazine injection F

hydralazine oral F QL

minoxidil oral F

Diuretic - Aldosterone Receptor

Antagonist, Non-Selective

spironolactone F

Diuretic - Carbonic Anhydrase

Inhibitors

acetazolamide F

Diuretic - Loop

bumetanide oral F

furosemide oral solution 10 mg/mL, 40 mg/5 mL

(8 mg/mL) F AL

furosemide oral tablet F

torsemide oral F

Diuretic - Potassium Sparing

amiloride F QL

Diuretic - Potassium Sparing-Thiazide

And Related Combinations

amiloride-hydrochlorothiazide F QL

spironolacton-hydrochlorothiaz F QL

triamterene-hydrochlorothiazid oral capsule 37.5-

25 mg F

triamterene-hydrochlorothiazid oral tablet F

Diuretic - Thiazides And Related

chlorothiazide oral tablet 500 mg F

chlorthalidone oral tablet 25 mg, 50 mg F QL






33


Diuril F AL

hydrochlorothiazide F

indapamide F QL

metolazone F QL

Peripheral Alpha-1 Receptor Blockers

doxazosin F QL

prazosin F QL

terazosin F QL

Plasma Kallikrein Inhibitor Agents

Kalbitor State Carve Out

Plasma Kallikrein Inhibitor Agents,

Recombinant Protein

Kalbitor State Carve Out

Pulmonary Antihypertensive Agents-

Soluble Guanylate Cyclase Stimulator

Adempas Specialty PA; QL

Pulmonary Arterial Hypertension -

Endothelin Receptor Antagonists

Letairis Specialty PA; QL

Tracleer oral tablet Specialty PA; QL

Tracleer oral tablet for suspension F PA; AL

Pulmonary Arterial Hypertension

Agents-Selective Cgmp-Pde5 Inhibitors

sildenafil (pulm.hypertension) oral tablet F PA

tadalafil (pulm. hypertension) F PA; QL

Renin Inhibitor, Direct

Tekturna F PA; QL

Renin Inhibitor, Direct And Diuretic

Combinations

Tekturna HCT oral tablet 300-12.5 mg, 300-25

mg F PA; QL

Central Nervous System Agents






34


Antianxiety Agent - Antihistamine Type

hydroxyzine HCl oral solution 10 mg/5 mL F AL

hydroxyzine HCl oral tablet F AL

hydroxyzine pamoate oral capsule 25 mg, 50 mg F AL

Antianxiety Agent - Benzodiazepines

Alprazolam Intensol State Carve Out

alprazolam oral tablet 0.25 mg, 0.5 mg, 1 mg State Carve Out

alprazolam oral tablet extended release 24 hr 0.5

mg, 1 mg, 2 mg State Carve Out

alprazolam oral tablet,disintegrating State Carve Out

chlordiazepoxide HCl State Carve Out

clonazepam oral tablet 1 mg, 2 mg State Carve Out

clonazepam oral tablet,disintegrating State Carve Out

clorazepate dipotassium State Carve Out

diazepam injection State Carve Out

Diazepam Intensol State Carve Out

diazepam oral solution State Carve Out

diazepam oral tablet State Carve Out

Klonopin oral tablet 0.5 mg State Carve Out

Lorazepam Intensol State Carve Out

lorazepam oral tablet State Carve Out

oxazepam State Carve Out

Xanax oral tablet 2 mg State Carve Out

Xanax XR oral tablet extended release 24 hr 3 mg State Carve Out

Antianxiety Agent - Dicarbamate Type

meprobamate State Carve Out

Antianxiety Agent - Non-

Benzodiazepine

buspirone State Carve Out

Anticonvulsant - Ampa-Type Glutamate

Receptor Antagonists

Fycompa oral tablet State Carve Out






35


Anticonvulsant - Barbiturates And

Derivatives

phenobarbital State Carve Out

phenobarbital sodium injection solution State Carve Out

primidone State Carve Out

Anticonvulsant - Benzodiazepines



Diastat AcuDial State Carve Out

diazepam rectal kit 2.5 mg State Carve Out


Onfi oral suspension State Carve Out

Onfi oral tablet 10 mg, 20 mg State Carve Out

Anticonvulsant - Cannabinoid Type

Epidiolex State Carve Out

Anticonvulsant - Carbamates

Felbatol State Carve Out

Anticonvulsant - Carboxylic Acid

Derivatives

Depacon State Carve Out

Depakote ER oral tablet extended release 24 hr


Depakote Sprinkles State Carve Out

divalproex oral tablet extended release 24 hr 500

mg State Carve Out

divalproex oral tablet,delayed release (DR/EC) State Carve Out

valproic acid State Carve Out

Anticonvulsant - Functionalized Amino

Acid

Vimpat State Carve Out

Anticonvulsant - Gaba Analogs

gabapentin oral capsule 300 mg State Carve Out






36


gabapentin oral solution 250 mg/5 mL (5 mL),

300 mg/6 mL (6 mL) State Carve Out

gabapentin oral tablet 600 mg, 800 mg State Carve Out

Lyrica State Carve Out

Neurontin oral capsule 100 mg, 400 mg State Carve Out

Neurontin oral solution State Carve Out

Anticonvulsant - Gaba Re-Uptake

Inhibitor, Nipecotic Acid Derivatives

Gabitril oral tablet 12 mg, 16 mg, 4 mg State Carve Out

tiagabine oral tablet 2 mg, 4 mg State Carve Out

Anticonvulsant - Gaba Transaminase

(Gaba-T) Inhibitor

Sabril State Carve Out

vigabatrin oral tablet State Carve Out

Anticonvulsant - Hydantoins

Cerebyx State Carve Out

Dilantin State Carve Out

Dilantin Extended State Carve Out

Dilantin Infatabs State Carve Out

Peganone State Carve Out

Phenytek State Carve Out

phenytoin oral suspension State Carve Out

phenytoin sodium State Carve Out

Anticonvulsant - Iminostilbene

Derivatives

Aptiom State Carve Out

carbamazepine oral capsule, ER multiphase 12 hr State Carve Out

carbamazepine oral tablet,chewable State Carve Out

Equetro State Carve Out

oxcarbazepine State Carve Out

Oxtellar XR State Carve Out

Tegretol oral suspension State Carve Out

Tegretol oral tablet State Carve Out






37


Tegretol XR State Carve Out

Anticonvulsant - Monosaccharide

Derivatives

Qudexy XR State Carve Out

topiramate oral capsule, sprinkle State Carve Out

topiramate oral tablet State Carve Out

Trokendi XR State Carve Out

Anticonvulsant - Phenyltriazine

Derivatives

Lamictal ODT State Carve Out

Lamictal ODT Starter (Blue) State Carve Out

Lamictal ODT Starter (Green) State Carve Out

Lamictal ODT Starter (Orange) State Carve Out

Lamictal oral tablet State Carve Out

Lamictal oral tablet, chewable dispersible 25 mg State Carve Out

Lamictal Starter (Blue) Kit State Carve Out

Lamictal Starter (Green) Kit State Carve Out

Lamictal Starter (Orange) Kit State Carve Out

Lamictal XR oral tablet extended release 24hr

200 mg, 250 mg, 300 mg State Carve Out

Lamictal XR Starter (Blue) State Carve Out

Lamictal XR Starter (Green) State Carve Out

Lamictal XR Starter (Orange) State Carve Out

lamotrigine oral tablet extended release 24hr 100


lamotrigine oral tablet, chewable dispersible 5 mg State Carve Out

Anticonvulsant - Pyrrolidine

Derivatives

levetiracetam in NaCl (iso-os) State Carve Out

levetiracetam intravenous State Carve Out

levetiracetam oral solution 100 mg/mL State Carve Out

levetiracetam oral tablet State Carve Out

levetiracetam oral tablet extended release 24 hr State Carve Out






38


Anticonvulsant - Succinimides

Celontin oral capsule 300 mg State Carve Out

ethosuximide State Carve Out

Anticonvulsant - Sulfonamide

Derivatives

zonisamide State Carve Out

Anticonvulsant - Triazole Derivatives

Banzel State Carve Out

Antidepressant - Alpha-2 Receptor

Antagonists (Nassa)

mirtazapine State Carve Out

Antidepressant - Mao Inhibitor

Nonselective And Irreversible-Types

A,B

Emsam State Carve Out

Marplan State Carve Out

phenelzine State Carve Out

tranylcypromine State Carve Out

Antidepressant - N-Methyl D-Aspartate

(Nmda) Receptor Antagonist

Spravato State Carve Out

Antidepressant - Selective Serotonin

Reuptake Inhibitors (Ssris)

citalopram State Carve Out

escitalopram oxalate State Carve Out

fluoxetine oral capsule 10 mg, 40 mg State Carve Out

fluoxetine oral solution State Carve Out

fluoxetine oral tablet 10 mg, 60 mg State Carve Out

fluvoxamine State Carve Out

paroxetine HCl oral tablet State Carve Out

paroxetine HCl oral tablet extended release 24 hr State Carve Out

Paxil oral suspension State Carve Out






39


Pexeva State Carve Out

Prozac oral capsule 20 mg State Carve Out

Sarafem oral tablet 20 mg State Carve Out

sertraline oral concentrate State Carve Out

sertraline oral tablet 25 mg, 50 mg State Carve Out

Zoloft oral tablet 100 mg State Carve Out

Antidepressant - Serotonin-2

Antagonist-Reuptake Inhibitors (Saris)

nefazodone State Carve Out

trazodone State Carve Out

Antidepressant - Serotonin-

Norepinephrine Reuptake Inhibitors

(Snris)

Cymbalta oral capsule,delayed release(DR/EC)


desvenlafaxine State Carve Out

duloxetine oral capsule,delayed release(DR/EC)

20 mg, 30 mg State Carve Out

Effexor XR oral capsule,extended release 24hr


Fetzima State Carve Out

Pristiq State Carve Out

venlafaxine oral capsule,extended release 24hr

37.5 mg, 75 mg State Carve Out

venlafaxine oral tablet State Carve Out

venlafaxine oral tablet extended release 24hr State Carve Out

Antidepressant - Ssri And 5Ht1a Partial

Agonist

Viibryd oral tablet State Carve Out

Viibryd oral tablets,dose pack 10 mg (7)- 20 mg

(23) State Carve Out

Antidepressant - Ssri And Serotonin (5-

Ht) Receptor Modulator

Trintellix State Carve Out






40


Antidepressant - Tricyclic And

Antipsychotic, Phenothiazine Comb

perphenazine-amitriptyline State Carve Out

Antidepressant - Tricyclic-

Benzodiazepine Combinations

amitriptyline-chlordiazepoxide State Carve Out

Antidepressant- Ssri And Atypical

Antipsych,Dopamine,Serotonin

Antagon

olanzapine-fluoxetine oral capsule 12-25 mg, 12-

50 mg, 3-25 mg, 6-25 mg State Carve Out

Symbyax oral capsule 6-50 mg State Carve Out

Antidepressant-Norepinephrine And

Dopamine Reuptake Inhibitors (Ndris)

Aplenzin State Carve Out

bupropion HCl oral tablet State Carve Out

bupropion HCl oral tablet extended release 24 hr


bupropion HCl oral tablet sustained-release 12 hr

150 mg F QL



Forfivo XL State Carve Out

Wellbutrin SR oral tablet sustained-release 12 hr


Antidepressant-Tricyclics And Related

(Non-Select Reuptake Inhibitors)

amitriptyline State Carve Out

amoxapine State Carve Out

clomipramine State Carve Out

desipramine State Carve Out

doxepin oral State Carve Out

imipramine HCl State Carve Out

imipramine pamoate State Carve Out






41


maprotiline State Carve Out

nortriptyline State Carve Out

protriptyline State Carve Out

trimipramine oral capsule 100 mg, 50 mg State Carve Out

Antiparkinson - Dopaminerg-Peripheral

Dopa-Decarboxylase Inhibit Comb

carbidopa-levodopa F

Antiparkinson Therapy -

Anticholinergic Agents

benztropine State Carve Out

trihexyphenidyl State Carve Out

Antiparkinson Therapy - Ergot

Alkaloids And Derivatives

bromocriptine F QL

Antiparkinson Therapy - Monoamine

Oxidase Inhibitor(Mao-B)

selegiline HCl oral capsule F QL

Antiparkinson Therapy - Non-Ergot

Dopamine Agonist Agents

amantadine HCl oral capsule F QL

amantadine HCl oral solution F QL

pramipexole oral tablet F QL

ropinirole oral tablet F QL

Antipsychotic - Atyp Dopamine-

Serotonin Antag Dibenzo-Oxepino

Pyrroles

Saphris sublingual tablet 2.5 mg State Carve Out

Antipsychotic - Atypical Dopamine-

Serotonin Antag- Benzisothiazolones

Geodon intramuscular State Carve Out

Geodon oral capsule 20 mg, 40 mg, 80 mg State Carve Out

Latuda State Carve Out

ziprasidone HCl oral capsule 60 mg State Carve Out






42



Serotonin Antag- Benzisoxazole Deriv

Fanapt State Carve Out

Invega State Carve Out

Invega Sustenna State Carve Out

Invega Trinza State Carve Out

Risperdal Consta State Carve Out

risperidone oral solution State Carve Out

risperidone oral tablet State Carve Out

risperidone oral tablet,disintegrating State Carve Out


Serotonin Antag-Dibenzodiazepine Der

clozapine oral tablet State Carve Out

clozapine oral tablet,disintegrating 100 mg, 12.5


Versacloz State Carve Out

Antipsychotic - Butyrophenone

Derivatives

haloperidol State Carve Out

haloperidol decanoate State Carve Out

haloperidol lactate injection State Carve Out

haloperidol lactate oral State Carve Out

Antipsychotic - Dibenzoxazepine

Derivatives

Adasuve State Carve Out

loxapine succinate State Carve Out

Antipsychotic - Phenothiazines,

Aliphatic

chlorpromazine State Carve Out


Piperazine

fluphenazine decanoate State Carve Out

fluphenazine HCl State Carve Out






43


perphenazine State Carve Out

prochlorperazine maleate F QL

trifluoperazine State Carve Out


Piperidine

thioridazine State Carve Out

Antipsychotic - Thioxanthenes

thiothixene State Carve Out

Antipsychotic -Atypical Dopamine-

Serotonin Antag-Dibenzothiazepine Der

quetiapine State Carve Out

Seroquel XR oral tablet, Ext Rel 24hr dose pack State Carve Out

Antipsychotic -Atypical Dopamine-

Serotonin Antag-

Thienobenzodiazepines

olanzapine intramuscular State Carve Out

olanzapine oral tablet 10 mg, 15 mg, 2.5 mg, 20

mg, 7.5 mg State Carve Out

olanzapine oral tablet,disintegrating State Carve Out




Zyprexa oral tablet 5 mg State Carve Out

Zyprexa Relprevv State Carve Out

Antipsychotic-Atypical,D2 Receptor

Partial Agonist-5Ht Serotonin Mixed

Abilify Maintena State Carve Out

Abilify oral tablet State Carve Out

aripiprazole oral tablet State Carve Out

Aristada intramuscular suspension,extended rel

syring 1,064 mg/3.9 mL State Carve Out

Rexulti State Carve Out






44


Antipsychotic-Atypical,D3/D2 Receptor

Partial Agonist-Serotonin Mixed

Vraylar State Carve Out

Attention Deficit-Hyperact. Disorder

(Adhd)- Alpha-2 Receptor Agonist

clonidine HCl oral tablet extended release 12 hr State Carve Out

guanfacine oral tablet extended release 24 hr State Carve Out

Intuniv ER State Carve Out

Kapvay State Carve Out

Attention Deficit-Hyperactivity (Adhd)

Therapy, Stimulant-Type

Adderall State Carve Out

Adderall XR State Carve Out

Adzenys ER State Carve Out

Adzenys XR-ODT State Carve Out

amphetamine sulfate oral tablet 5 mg State Carve Out

Aptensio XR State Carve Out

Concerta State Carve Out

Cotempla XR-ODT State Carve Out

Daytrana State Carve Out

dexmethylphenidate State Carve Out

dextroamphetamine oral capsule, extended release State Carve Out

dextroamphetamine oral tablet State Carve Out

dextroamphetamine-amphetamine State Carve Out

Dyanavel XR State Carve Out

Evekeo State Carve Out

Focalin State Carve Out

Focalin XR State Carve Out

Metadate ER State Carve Out

methamphetamine State Carve Out

Methylin oral solution State Carve Out

methylphenidate HCl State Carve Out

Mydayis State Carve Out






45


QuilliChew ER State Carve Out

Quillivant XR State Carve Out

Relexxii State Carve Out

Ritalin State Carve Out

Ritalin LA oral capsule,ER biphasic 50-50 10 mg,

20 mg, 30 mg, 40 mg State Carve Out

Vyvanse State Carve Out

Zenzedi oral tablet 15 mg, 2.5 mg, 20 mg, 30 mg,

7.5 mg State Carve Out

Attention Deficit-Hyperactivity

Disorder (Adhd) Therapy, Nri-Type

atomoxetine State Carve Out

Strattera State Carve Out

Benzodiazepines

Alprazolam Intensol State Carve Out

alprazolam oral tablet 0.25 mg, 0.5 mg, 1 mg State Carve Out

alprazolam oral tablet extended release 24 hr 0.5


alprazolam oral tablet,disintegrating State Carve Out

amitriptyline-chlordiazepoxide State Carve Out

chlordiazepoxide HCl State Carve Out



clorazepate dipotassium State Carve Out

Diastat AcuDial State Carve Out

diazepam injection State Carve Out

Diazepam Intensol State Carve Out

diazepam oral solution State Carve Out

diazepam oral tablet State Carve Out

diazepam rectal kit 2.5 mg State Carve Out

estazolam State Carve Out

flurazepam State Carve Out







46


lorazepam injection State Carve Out

Lorazepam Intensol State Carve Out

lorazepam oral tablet State Carve Out

midazolam (PF) injection solution 5 mg/mL F QL

midazolam injection solution 5 mg/mL F QL

midazolam oral syrup 2 mg/mL State Carve Out

Onfi oral suspension State Carve Out

Onfi oral tablet 10 mg, 20 mg State Carve Out

oxazepam State Carve Out

temazepam State Carve Out

triazolam State Carve Out

Xanax oral tablet 2 mg State Carve Out

Xanax XR oral tablet extended release 24 hr 3 mg State Carve Out

Bipolar Therapy Agents -

Anticonvulsant Type

carbamazepine oral capsule, ER multiphase 12 hr State Carve Out

carbamazepine oral tablet,chewable State Carve Out



Depakote Sprinkles State Carve Out


mg State Carve Out

divalproex oral tablet,delayed release (DR/EC) State Carve Out

Equetro State Carve Out

Lamictal ODT State Carve Out

Lamictal ODT Starter (Blue) State Carve Out

Lamictal ODT Starter (Green) State Carve Out

Lamictal ODT Starter (Orange) State Carve Out

Lamictal Starter (Blue) Kit State Carve Out

Lamictal Starter (Green) Kit State Carve Out

Lamictal Starter (Orange) Kit State Carve Out

Tegretol oral suspension State Carve Out

Tegretol oral tablet State Carve Out






47


Tegretol XR oral tablet extended release 12 hr


valproic acid State Carve Out

Bipolar Therapy Agents - Atypical

Antipsychotics

Abilify oral tablet State Carve Out

aripiprazole oral tablet State Carve Out

Geodon intramuscular State Carve Out

Geodon oral capsule 20 mg, 40 mg, 80 mg State Carve Out

olanzapine intramuscular State Carve Out

olanzapine oral tablet 10 mg, 15 mg, 2.5 mg, 20

mg, 7.5 mg State Carve Out

olanzapine oral tablet,disintegrating State Carve Out



quetiapine State Carve Out

risperidone oral solution State Carve Out

risperidone oral tablet State Carve Out

risperidone oral tablet,disintegrating State Carve Out

Saphris sublingual tablet 2.5 mg State Carve Out


Vraylar State Carve Out

ziprasidone HCl oral capsule 60 mg State Carve Out

Zyprexa oral tablet 5 mg State Carve Out

Bipolar Therapy Agents - Lithium

lithium carbonate State Carve Out

lithium citrate oral solution 8 mEq/5 mL State Carve Out

Cannabis And Cannabinoid Receptor

Agonists

dronabinol F PA

Cns And Respiratory Stimulant

Dopram State Carve Out

doxapram State Carve Out






48


Cns Stimulant - Amphetamine

Combinations


Adderall XR State Carve Out

Adzenys ER State Carve Out

Adzenys XR-ODT State Carve Out

dextroamphetamine-amphetamine State Carve Out

Dyanavel XR State Carve Out

Mydayis State Carve Out

Cns Stimulant - Amphetamines


dextroamphetamine State Carve Out


methamphetamine State Carve Out



Cns Stimulant - Analeptics

caffeine citrate oral F AL

Dopram State Carve Out

doxapram State Carve Out

Cns Stimulant - Analeptics,

Methylxanthine-Type

caffeine citrate oral F AL

Cns Stimulant Others

ammonia aromatic inhalation spirit State Carve Out OTC

Diabetic Peripheral Neuropathy Agents

Lyrica CR State Carve Out

Fibromyalgia Agents - Gaba Analogs

Lyrica State Carve Out

Fibromyalgia Agents - Serotonin-

Norepinephrine Reuptake-Inhib (Snris)






49


Cymbalta oral capsule,delayed release(DR/EC)


duloxetine oral capsule,delayed release(DR/EC)


Hypnotics - Melatonin M1/M2 Receptor

Agonists

Hetlioz State Carve Out

Rozerem State Carve Out

Migraine Therapy - Calcitonin Gene-

Related Peptide Inhibitors

Aimovig Autoinjector F PA; QL; AL

Migraine Therapy - Carboxylic Acid

Derivatives




mg State Carve Out

Migraine Therapy - Cgrp Receptor

Blockers, Monoclonal Antibody

Aimovig Autoinjector F PA; QL; AL

Migraine Therapy - Selective Serotonin

Agonists 5-Ht(1)

naratriptan F QL

rizatriptan F QL

sumatriptan F PA; QL

sumatriptan succinate oral F QL

sumatriptan succinate subcutaneous cartridge F PA; QL

sumatriptan succinate subcutaneous pen injector F PA; QL

sumatriptan succinate subcutaneous solution F PA; QL

zolmitriptan F ST; QL

Narcolepsy And Cataplexy Therapy

Agents - Sedative-Type

Xyrem F PA; QL






50


Narcolepsy Therapy Agents - Non-

Sympathomimetic

armodafinil oral tablet 200 mg State Carve Out

modafinil State Carve Out

Nuvigil oral tablet 150 mg, 250 mg, 50 mg State Carve Out

Narcolepsy Therapy Agents - Stimulant-

Type, Piperadine Derivative

Methylin oral solution State Carve Out

methylphenidate HCl oral solution State Carve Out

methylphenidate HCl oral tablet State Carve Out

methylphenidate HCl oral tablet,chewable State Carve Out

Ritalin State Carve Out

Narcolepsy Therapy Agents- Stimulant-

Type,Sympathomimetic,Amphetamines



dextroamphetamine oral capsule, extended release State Carve Out

dextroamphetamine oral tablet State Carve Out

dextroamphetamine-amphetamine oral tablet State Carve Out




Neuropathic Pain Therapy


Postherpetic Neuralgia Agents


Sedative-Hypnotic - Antihistamines

diphenhydramine HCl oral capsule F OTC; AL

diphenhydramine HCl oral tablet 25 mg F OTC; AL

Unisom (doxylamine) State Carve Out OTC

Unisom SleepGels State Carve Out OTC

Unisom SleepMelts State Carve Out OTC






51


Sedative-Hypnotic - Barbiturates

Amytal State Carve Out

pentobarbital sodium injection solution State Carve Out

phenobarbital State Carve Out

phenobarbital sodium injection solution State Carve Out

Seconal Sodium State Carve Out

Sedative-Hypnotic - Benzodiazepines

estazolam State Carve Out

flurazepam State Carve Out

lorazepam injection State Carve Out

midazolam oral syrup 2 mg/mL State Carve Out

temazepam State Carve Out

triazolam State Carve Out

Sedative-Hypnotic - Gaba-Receptor

Modulators

Edluar State Carve Out

eszopiclone State Carve Out

zaleplon State Carve Out

zolpidem oral State Carve Out

Sedative-Hypnotic - Orexin Receptor

Antagonist

Belsomra State Carve Out

Sedative-Hypnotic - Selective Alpha2-

Adrenoreceptor Agonists

Precedex State Carve Out

Precedex in 0.9 % sodium chlor State Carve Out

Sedative-Hypnotic - Tricyclic

Antidepressant Type

Silenor State Carve Out

Chemical Dependency, Agents To Treat

Agents For Opioid Withdrawal, Central

Alpha-2 Adrenergic Agonist-Type






52


Lucemyra F PA; QL; AL

Agents For Opioid Withdrawal, Opioid-

Type

Bunavail State Carve Out

buprenorphine HCl sublingual State Carve Out

buprenorphine-naloxone State Carve Out

Sublocade State Carve Out

Suboxone State Carve Out

Zubsolv sublingual tablet 0.7-0.18 mg State Carve Out QL

Zubsolv sublingual tablet 1.4-0.36 mg, 11.4-2.9

mg, 2.9-0.71 mg, 5.7-1.4 mg, 8.6-2.1 mg State Carve Out

Alcohol Abstinence Therapy -

Glutamate And Gaba System Type

acamprosate State Carve Out

Alcohol Abstinence Therapy - Opioid

Receptor Antagonist-Type

Vivitrol State Carve Out

Alcohol Deterrents

Antabuse oral tablet 500 mg State Carve Out

disulfiram oral tablet 250 mg State Carve Out

Smoking Deterrents - Ne And

Dopamine Reuptake Inhibitor (Ndri)-

Type


150 mg F QL

Smoking Deterrents - Nicotine-Type

nicotine (polacrilex) F OTC

nicotine transdermal patch 24 hour 14 mg/24 hr,

21 mg/24 hr, 7 mg/24 hr F OTC

nicotine transdermal patch, TD daily, sequential F OTC; QL

Nicotrol F

Nicotrol NS F






53


Smoking Deterrents - Nicotinic

Receptor Partial Agonist, Alpha4beta2

Chantix F QL

Chantix Continuing Month Box F QL

Chantix Starting Month Box F QL

Chemicals-Pharmaceutical Adjuvants

Pharmaceutical Adjuvant - Inhalation

Vehicles

sodium chloride inhalation solution for

nebulization 0.9 %, 3 %, 7 % F

Cognitive Disorder Therapy

Alzheimer's Disease Therapy -

Cholinesterase Inhibitors

donepezil oral tablet 10 mg, 5 mg F QL; AL

donepezil oral tablet 23 mg F QL

galantamine F QL

rivastigmine tartrate F QL; AL

Alzheimer's Disease Therapy - Nmda


memantine oral tablet F QL; AL

memantine oral tablets,dose pack F QL; AL

Contraceptives

Contraceptive Injectable - Progestin

medroxyprogesterone intramuscular F QL

Contraceptive Oral - Biphasic

desog-e.estradiol/e.estradiol F

Contraceptive Oral - Monophasic

Alyacen 1/35 (28) F

Aubra F

Aubra EQ F

Aviane F

Balziva (28) F






54


Blisovi 24 Fe F

Blisovi Fe 1.5/30 (28) F

Blisovi Fe 1/20 (28) F

Briellyn F

Cyclafem 1/35 (28) F

Dasetta 1/35 (28) F

desogestrel-ethinyl estradiol F

drospirenone-ethinyl estradiol F

Falmina (28) F

Hailey 24 Fe F

Junel 1/20 (21) F

Junel FE 1.5/30 (28) F

Junel FE 1/20 (28) F

Junel Fe 24 F

Kaitlib Fe F

Larin 1/20 (21) F

Larin 24 Fe F

Larin Fe 1.5/30 (28) F

Larin Fe 1/20 (28) F

Larissia F

Lessina F

levonorgestrel-ethinyl estrad F

Low-Ogestrel (28) F

Lutera (28) F

Mibelas 24 Fe F

Microgestin 1.5/30 (21) F

Microgestin 1/20 (21) F

Microgestin Fe 1.5/30 (28) F

Microgestin FE 1/20 (28) F

Necon 0.5/35 (28) F

noreth-ethinyl estradiol-iron F

norethindrone ac-eth estradiol oral tablet 1-20

mg-mcg F






55


norethindrone-e.estradiol-iron oral tablet 1 mg-20

mcg (21)/75 mg (7) F

norethindrone-e.estradiol-iron oral

tablet,chewable F

norgestimate-ethinyl estradiol oral tablet 0.25-35

mg-mcg F

norgestrel-ethinyl estradiol F

Nortrel 0.5/35 (28) F

Nortrel 1/35 (21) F

Ocella F

Orsythia F

Philith F

Pirmella oral tablet 1-35 mg-mcg F

Sronyx F

Syeda F

Tarina Fe 1/20 (28) F

Tarina Fe 1-20 EQ (28) F

Vienva F

Vyfemla (28) F

Wera (28) F

Wymzya Fe F

Zarah F

Zovia 1/35E (28) F

Contraceptive Oral - Progestin

norethindrone (contraceptive) F

Contraceptive Oral - Triphasic

Aranelle (28) F

Caziant (28) F

Leena 28 F

levonorg-eth estrad triphasic F

norgestimate-ethinyl estradiol oral tablet

0.18/0.215/0.25 mg-25 mcg, 0.18/0.215/0.25 mg-

35 mcg (28)

F

Nortrel 7/7/7 (28) F






56


Tilia Fe F

Tri Femynor F

Tri-Estarylla F

Tri-Legest Fe F

Tri-Linyah F

Tri-Lo-Estarylla F

Tri-Lo-Marzia F

Tri-Lo-Sprintec F

Tri-Previfem (28) F

Tri-Sprintec (28) F

Velivet Triphasic Regimen (28) F

Contraceptive Transdermal

Combinations

Xulane F QL

Contraceptive Transdermal

Combinations - Estrogen And Progestin

Comb.

Xulane F QL

Contraceptives - Intravaginal, Systemic

NuvaRing F

Contraceptives - Intravaginal, Systemic

- Estrogen And Progestin Comb.

NuvaRing F

Emergency Contraceptives

Aftera F OTC; QL

EContra EZ F OTC; QL

Econtra One-Step F OTC; QL

levonorgestrel oral tablet 1.5 mg F OTC; QL

My Choice F OTC; QL

My Way F OTC; QL

New Day F OTC; QL

Opcicon One-Step F OTC; QL






57


Option-2 F OTC; QL

Emergency Contraceptives - Progestin

Type

Aftera F OTC; QL

EContra EZ F OTC; QL

Econtra One-Step F OTC; QL

levonorgestrel oral tablet 1.5 mg F OTC; QL

My Choice F OTC; QL

My Way F OTC; QL

New Day F OTC; QL

Opcicon One-Step F OTC; QL

Option-2 F OTC; QL

Spermicides

Gynol II F OTC

Today Contraceptive Sponge F OTC

Vaginal Contraceptive Foam F OTC

Dermatological

Acne Therapy Systemic - Retinoids And

Derivatives

Amnesteem F PA; QL

Claravis F PA; QL

isotretinoin F PA; QL

Myorisan F PA; QL

Zenatane F PA; QL

Acne Therapy Topical - Anti-Infective

clindamycin phosphate topical gel F

clindamycin phosphate topical lotion F

clindamycin phosphate topical solution F

clindamycin phosphate topical swab F

erythromycin with ethanol topical solution F

metronidazole topical cream F






58


Acne Therapy Topical - Anti-Infective-

Keratolytic Combinations

clindamycin-benzoyl peroxide topical gel 1.2 %(1

% base) -5 % F QL; AL

sulfacetamide sodium-sulfur topical cleanser 10-5

% (w/w) F

Acne Therapy Topical - Keratolytic

benzoyl peroxide topical cleanser 5 % F OTC

benzoyl peroxide topical gel 10 % F OTC; QL

benzoyl peroxide topical gel 5 % F OTC

Acne Therapy Topical - Retinoids And

Derivatives

Differin topical gel 0.1 % F OTC; QL

tretinoin topical cream 0.025 % F ST; QL; AL

Antipsoriatic Agents-Interleukin-17 (Il-

17) Antagonist, Mc Antibody

Siliq F PA; QL

Dermatological - Antibacterial

Aminoglycosides

gentamicin topical F

Dermatological - Antibacterial Mixtures

Triple Antibiotic topical ointment F OTC

Triple Antibiotic topical ointment in packet F OTC

Dermatological - Antibacterial Other

mupirocin F QL

Dermatological - Antibacterial

Polymyxins And Derivatives

bacitracin topical F OTC

bacitracin zinc F OTC

Dermatological - Antibacterial-Local

Anesthetic Combinations

Neosporin Plus PainRelief(bac) F OTC






59


Dermatological - Antifungal

Allylamines

terbinafine HCl topical F OTC


Amphoteric Polyene Macrolides

nystatin topical cream F

nystatin topical ointment F

nystatin topical powder F QL


Hydroxypyridinone

ciclopirox topical solution F QL

Dermatological - Antifungal Imidazole

And Related Agents

clotrimazole topical F OTC

econazole F QL

ketoconazole topical cream F QL

ketoconazole topical shampoo F QL

miconazole nitrate topical cream F OTC


Thiocarbamate

Antifungal (tolnaftate) topical cream F OTC

tolnaftate topical aerosol powder F OTC

tolnaftate topical powder F OTC

Dermatological - Antifungal-

Glucocorticoid Combinations

clotrimazole-betamethasone topical cream F

clotrimazole-betamethasone topical lotion F QL

nystatin-triamcinolone F QL

Dermatological - Antineoplastic

Antimetabolites

fluorouracil topical cream F PA

Dermatological - Antineoplastic Or

Premalignant Lesions - Nsaid's






60


diclofenac sodium topical gel 3 % F PA

Dermatological - Antipsoriatic Agents

Systemic, Vitamin A Derivatives

acitretin F PA; QL

Dermatological - Antipsoriatic Agents

Topical

calcipotriene F PA; QL

Dermatological - Antipsoriatics

Systemic, Phosphodiesterase 4 Inhib.

Otezla F PA

Otezla Starter F PA; QL

Dermatological - Antiseborrheic

selenium sulfide topical lotion F

Dermatological - Antiviral, Herpes

Abreva F OTC

Dermatological - Burn Products Anti-

Infective

silver sulfadiazine F

SSD F

Dermatological - Calcineurin Inhibitors

Elidel F PA; QL

tacrolimus topical F PA; QL

Dermatological - Emollients

ammonium lactate F OTC; QL

Dermatological - Enzymes

Santyl F QL

Dermatological - Glucocorticoid

Anti-Itch (HC) topical ointment F OTC

betamethasone dipropionate F QL

betamethasone valerate topical cream F QL

betamethasone valerate topical lotion F QL

betamethasone valerate topical ointment F QL






61


betamethasone, augmented F QL

clobetasol scalp F PA; QL

clobetasol topical cream F PA; QL

clobetasol topical ointment F PA; QL

Cortizone-10 topical ointment F OTC

fluocinonide topical cream 0.05 % F QL

fluocinonide topical ointment F QL

fluocinonide topical solution F QL

Fluocinonide-E F QL

fluticasone propionate topical cream F QL

fluticasone propionate topical ointment F QL

halobetasol propionate topical cream F QL

halobetasol propionate topical ointment F QL

hydrocortisone acetate topical cream F OTC

hydrocortisone acetate topical ointment F OTC

hydrocortisone topical cream 0.5 %, 1 % F OTC

hydrocortisone topical cream 2.5 % F

hydrocortisone topical lotion 2.5 % F

hydrocortisone topical ointment 0.5 %, 1 % F OTC

hydrocortisone topical ointment 2.5 % F

hydrocortisone valerate topical cream F QL

mometasone topical F QL

Noble Formula HC topical cream F OTC

Soothing Care (hydrocortisone) F OTC

triamcinolone acetonide topical cream F QL

triamcinolone acetonide topical lotion 0.025 % F

triamcinolone acetonide topical lotion 0.1 % F QL

triamcinolone acetonide topical ointment 0.025

%, 0.1 % F QL

triamcinolone acetonide topical ointment 0.5 % F

Dermatological - Immunomodulator -

Imidazoquinolinamines

imiquimod topical cream in packet F QL






62


Dermatological - Keratolytic-

Antimitotic Single Agents

podofilox F

Dermatological - Local Anesthetic

Combinations

lidocaine-prilocaine topical cream F QL

Dermatological - Nsaid Single Agents

diclofenac sodium topical gel 1 % F QL

Dermatological - Rosacea Therapy,

Topical

metronidazole topical cream F

metronidazole topical gel 0.75 % F

Dermatological - Topical Local

Anesthetic Amides

Aspercreme (lidocaine) topical adhesive

patch,medicated F OTC; QL

ASPERCREME LIDOCAINE 4% CREAM F OTC; QL

lidocaine HCl mucous membrane jelly F

lidocaine HCl mucous membrane jelly in

applicator F

lidocaine topical adhesive patch,medicated 5 % F PA; QL

Dermatological Irritants-Counter-

Irritant Single Agents

capsaicin topical cream 0.025 % F OTC

Scabicide And Pediculicide

Combinations

Lice Killing F OTC; QL

Scabicide And Pediculicide Single

Agents

lindane topical shampoo F QL

malathion F ST; QL

permethrin topical cream F QL

Diagnostic Agents






63


Diagnostic Drugs - Pituitary Function

Acthrel State Carve Out

cosyntropin State Carve Out

Eating Disorder Therapy

Appetite Stimulants - Cannabinoids

dronabinol F PA

Appetite Stimulants - Progestin

Hormone Type

megestrol oral suspension 400 mg/10 mL (10

mL), 400 mg/10 mL (40 mg/mL) F

Electrolyte Balance-Nutritional

Products

Amino Acid - Carnitine Derivatives

levocarnitine oral tablet State Carve Out OTC

Amino Acids, Single Ingredient, Oral

(Non-Injectable)

Endari F PA

B-Complex Vitamin Combinations

Alba-Lybe F

Apetex F

Apetigen F

B Complex Plus Vitamin C F

B complex-vitamin C-folic acid oral tablet F

B-100 Complex oral tablet extended release F

Balanced B-100 Complex oral tablet extended

release 100 mg F

B-Complex Plus Vit C (calcium) F

B-complex with vitamin C oral tablet F

B-complex with vitamin C oral tablet 400-500

mcg-mg F

B-complex with vitamin C oral tablet extended

release F

Biopetit F






64


Complex B-100 oral tablet extended release 400

mcg F

Complex B-50 F

DIALYVITE 3000 F

Dialyvite 800 oral tablet F

Dialyvite 800 Plus D F

Dialyvite 800 with Zinc 15 F

Dialyvite 800 with Zinc 50 F

Dialyvite 800-Ultra D F

Dialyvite oral tablet 100-1 mg F

Dialyvite Supreme D F

Folbee AR F

Folbee Plus F

Lysiplex Plus oral tablet F

Medtycholl-B Complex-Liver F

Natural B-100 Complex F

Nephronex F

Nephronex-SL F

ProRenal F

Quin B Strong F

Renal Caps F

Reno Caps F

Stress B Plus Zinc F

Stress B With Zinc F

Stress Formula 600 C F

Stress Formula With Iron(sulf) F

Stress Formula with Zinc F

Super B Complex-Vitamin C F

Superplex-T F

Supervite F

Total B/C F

Triphrocaps F

Virt-Vite Plus F






65


Vita-Bee with C F

vitamin B complex-folic acid F

Vitamins B Complex oral tablet 500 mg-400

mcg- 18 mg iron F

Vitamins for Hair oral tablet F

B-Complex Vitamins

B Complex 100 injection F

B Complex sublingual F

B Complex-Vitamin B12 F

Balanced B-50 oral tablet F

Complex B-100 oral tablet extended release F

Folgard F

PoDiaPN F

Super B-50 Complex F

Super B-50 Complex Plus F

Super Quints B-50 F

Ultra B-100 Complex oral tablet extended release F

vitamin B complex F

Vitamins B Complex oral capsule F

Vitamins B Complex oral tablet F

B-Complex Vitamins And

Combinations

Apetigen Plus oral liquid F

Dialyvite oral tablet 1-100-300-50 mg-mg-mcg-

mg F

Nephplex Rx F

Rena-Vite Rx F

Brewers Yeast

Brewer's Yeast oral tablet 500 mg (7.5 gr) F OTC

Brewer's Yeast oral tablet 680 mg F

yeast F OTC

Dietary Product - Dietary Supplements

choline dihydrogen citrate F






66


NicAzel Forte F

Electrolyte Depleters - Ion Exchange

Resin

sodium polystyrene sulfonate oral powder F

sodium polystyrene sulfonate rectal F

Geriatric Vitamins

Central-Vite Select F OTC

Centravites 50 Plus oral tablet F

Complete Senior oral tablet F

Daily Multivitamin-Minerals F

Multivitamin 50 Plus F

multivitamin with minerals oral tablet F

REQ49+ F

Minerals And Electrolytes - Calcium

Replacement

Calcitrate F

calcium acetate oral tablet 667 mg F OTC

calcium carbonate oral suspension F OTC

calcium carbonate oral tablet 500 mg calcium

(1,250 mg), 600 mg calcium (1,500 mg) F

calcium carbonate oral tablet,chewable 260 mg

calcium (650 mg) F


(750 mg) F OTC

calcium citrate oral tablet 200 mg (950 mg) F


Replacement Combinations

Biocal F

Calcium 600 + Minerals oral tablet 600 mg

calcium- 400 unit F

Calcium 600-D3 Plus (mag-zinc) F

calcium carbonate-vit D3-min oral tablet F

Calcium Magnesium + D oral tablet 400-167-133

mg-mg-unit F






67


Pro-Cal oral tablet F


Replacement/Vitamin D Combinations

Calcet Petites F

Cal-Citrate F

Calcium 500 + D oral tablet 500 mg(1,250mg) -

200 unit F

Calcium 600 + D(3) oral tablet 600-125 mg-unit F

calcium carbonate-vitamin D3 oral capsule 600

mg(1,500mg) -400 unit F

calcium carbonate-vitamin D3 oral tablet 500

mg(1,250mg) -125 unit, 500mg (1,250mg) -600

unit, 600 mg(1,500mg) -200 unit, 600

mg(1,500mg) -400 unit, 600 mg(1,500mg) -800

unit

F

calcium carbonate-vitamin D3 oral

tablet,chewable 500-100 mg-unit F

calcium citrate-vitamin D3 oral tablet 200 mg

calcium -250 unit, 315 mg- 250 unit, 315-200 mg-

unit

F

calcium phosphate-vitamin D3 oral

tablet,chewable 200 mg calcium- 200 unit, 250

mg calcium -200 unit

F

Caltrate with Vitamin D3 F

Citracal + D Maximum F

Hi-Cal Plus Vit D F

Os-Cal 500 + D3 F

Oysco 500/D oral tablet F

Oyster Shell Calcium-Vit D2 oral tablet 250

(625)-125 mg-unit F OTC

Oyster Shell Calcium-Vit D3 oral tablet F

Minerals And Electrolytes - Iron

Auryxia F

Feosol oral tablet 325 mg (65 mg iron) F

FeroSul oral tablet F






68


ferrous gluconate oral tablet 236 mg (27 mg iron),

240 mg (27 mg iron), 324 mg (37.5 mg iron), 324

mg (38 mg iron)

F

ferrous sulfate oral drops F AL

ferrous sulfate oral elixir F

ferrous sulfate oral liquid F AL

ferrous sulfate oral solution F AL

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

ferrous sulfate oral tablet,delayed release

(DR/EC) F

FerrouSul F

Iron (dried) F

Iron 100 Plus F AL

iron oral tablet extended release 159 mg (45 mg

iron) F

Slow Release Iron oral tablet extended release

142 mg (45 mg iron), 159 mg (45 mg iron), 160

mg (50 mg iron)

F

Minerals And Electrolytes - Iron

Combinations

Parvlex F

Siderol oral tablet F

Minerals And Electrolytes - Magnesium

Mag 64 F

Mag Glycinate F

Mag-G F

Maginex F

magnesium F

Magnesium (oxide/AA chelate) F

magnesium amino acid chelate oral tablet 100 mg F

magnesium chloride injection F

magnesium chloride oral tablet,delayed release

(DR/EC) 64 mg F

magnesium citrate oral tablet F






69


magnesium gluconate F

magnesium oxide oral capsule F

magnesium oxide oral tablet 250 mg magnesium,

420 mg, 500 mg F

magnesium oxide oral tablet 400 mg (241.3 mg

magnesium) F OTC

magnesium sulfate in D5W intravenous

piggyback 1 gram/100 mL F

magnesium sulfate in water F

magnesium sulfate injection Specialty

Magonate (magnesium carb) F

MagOx F

Magtab F

Phillips F

Slow-Mag F

Uro-Mag F

Minerals And Electrolytes - Magnesium

Combinations

Beelith F

Minerals And Electrolytes - Oral

Electrolytes

Oralyte F

Pediatric Electrolyte oral solution F

Pediatric Freezer Pops F

PediaVance F

Minerals And Electrolytes - Phosphate

Glycophos F

Phos-NaK F

potassium phosphate m-/d-basic F

sodium phosphate F

Minerals And Electrolytes - Potassium,

Oral

potassium chloride oral capsule, extended release F






70


potassium chloride oral tablet extended release 10

mEq, 8 mEq F

potassium chloride oral tablet,ER

particles/crystals F

Multivitamin And Mineral

Combinations

50 Plus Adult Eye Health F

A Thru Z F

A Thru Z Men's Ultimate F

A Thru Z Select oral tablet 300-600-300 mcg,

500-300-250 mcg F

A Thru Z Select Women's F

Actical F

Adult Multivitamin Gummies F

Adult One Daily Gummies F

Antioxidant A/C/E/Selenium F

Antioxidant Formula (selenium) F

AquADEKs oral tablet,chewable F

Bacmin F

Bio-35, Gluten Free F

Biocel (with Lutein) F

Biotin Plus-Calcium and Vit D3 F

Body, Hair, Skin and Nails F

Central-Vite Cardio F OTC

Central-Vite Select F OTC

Central-Vite Women's Mature F

Centravites F

Centrum Men F

Centrum Silver oral tablet,chewable F

Centrum Silver Ultra Men's F

Centrum Silver Women F

Centrum Specialist Heart F

Centrum Ultra Men's F






71


Century Cardio F

Century Ultimate Men's F

Century Ultimate Women's oral tablet 8 mg iron-

400 mcg-300 mcg F

Certa Plus F

Compete F OTC

Complete Multi F

Complete Multi 50+ F

Complete Multivitamin oral tablet F

Complete oral tablet 18-500-300-250 mg-mcg-

mcg-mcg F

Complete Premium Vitamin F

Corvite Free F

Daily Gummies F

Daily Multiple oral tablet , 400-120 mcg-mg F

Daily Multivitamin F

Daily Multivitamin-Minerals F

Daily Multi-Vitamins/Iron F OTC

DAILY VITAMIN FORMULA-MINERALS F

Daily Vitamin with Iron F

Daily Vites/Iron F

Daily-Vite F

Diabetes Health Formula F

Dialyvite 5000 F

ESSENTIAL Balance with Lutein F

ESSENTIAL Daily F

ESSENTIAL Man F

ESSENTIAL Man 50+ F

Essential Woman 50+ F

Fosfree F

Freedavite F

Hair Vitamins F

Hair, Skin and Nails-Argan Oil F






72


Hair,Skin and Nails F

Hair,Skin and Nails(FA-biotin) oral tablet 66.7-

1,000 mcg F

Healthy Eyes SuperVision F

I-Caps F

ICaps AREDS F

Icaps MV F

Icaps Plus F OTC

I-Vite Protect F

K-Pax Immune Support F

K-PAX oral capsule F OTC

Macuvite Eye Care F

MAXIMUM DAILY GREEN F OTC

Maximum Daily Multivitamin F

Mega Multi for Women F

Mega Multiple/Chelated Mineral F

Mega Multivitamin For Men F

Mega Multivitamin with Mineral oral tablet 13.5-

200-250 mg-mcg-mcg F

Men's Daily F

Men's Daily Multivit-Mineral F

Men's Multivitamin Gummies F

Men's One Daily F

Monocaps F

Multi For Her oral tablet F

Multi-Betic F

Multi-Delyn with Iron F

Multiple Vitamin-Minerals F

multivitamin with iron F

multivitamin with minerals oral tablet F

mv-min-folic acid-lutein F

My-Vitalife F

Ocutabs F






73


Omnicap F

One Daily Calcium/Iron F

One Daily Complete F

One Daily Energy oral tablet F

One Daily Essential oral tablet 0.4 mg F

One Daily For Men F

One Daily For Women F

One Daily Healthy Weight F

One Daily Maximum F

One Daily Mens 50 Plus(ginkgo) F OTC

One Daily Multi-Vit w-Mineral oral tablet F

One Daily oral tablet 0.4-600 mg-mcg F

One Daily Plus Minerals F

One Daily With Iron F

One Daily Women 50 Plus F

One Daily Womens 50 Plus F

One Daily Women's oral tablet 27-0.4 mg F

One-A-Day Cholesterol Plus F

One-A-Day Maximum Formula F

One-A-Day Men VitaCraves F

One-A-Day Menopause Formula F

One-A-Day Men's 50 Plus F

One-A-Day Men's Multivitamin F

One-A-Day Teen Advantage oral tablet 9 mg

iron-400 mcg F

One-A-Day VitaCraves F

One-A-Day Vitacraves Immunity F

One-A-Day Vitacraves Omega-3 F

One-A-Day WeightSmart F

One-A-Day Women VitaCraves F

One-A-Day Women's Active F

One-A-Day Women's Healthy Skin F

Optisource F






74


Opurity Multivitamin F

PreserVision AREDS F

PreserVision Lutein F

Prevent F

ProCerv HP F

ProRenal QD F

Prosight with Lutein F

Protect Cardio AF F

Protect Plus SO F

Quintabs-M F

Quintabs-M Iron Free F

REQ49+ F

SAVision F

Sentry Senior oral tablet 500-300-250 mcg F

Solo F

Spectravite Adult 50 Plus(lut) F

Spectravite Men's F

Spectravite Senior oral tablet 500-300-250 mcg F

Spectravite Ultra Men 50+ F

Spectravite Ultra Men's Sr F

Spectravite Ultra Women's Sr F

Strovite Forte F

Strovite One F

Sunvite F

Super Antioxidant F

Super Ginseng Multivitamin F

Super Multiple F

Super Multiple - Low Iron F

Super Thera Vite M F

Tab-A-Vite/Iron F

Thera M Plus (ferrous fumarat) F

Theragran-M Premier 50 Plus F

Theralogix Companion F






75


Thera-M F

Therapeutic-M oral tablet 9 mg iron-400 mcg F

Thera-Tabs M F

Theratrum Complete with Lutein F

Therems F

Therems-H F

Therems-M F

Thrivite-19 F OTC

TRUEplus Diabetic Multivitamin F

Ultimate Men's Complete 50+ F

Ultimate Women's Complete 50+ F

Ultra Freeda F

Unicomplex-M F

V-C Forte F

VIC-Forte F

Vision F

Vitacel (with Lutein) F

Vital-D Rx F

Vitalee F

Vitamins A-D-E selenium F

Vitamins and Minerals F

Vitatrum F

Vitrum Senior oral tablet 500-300-250 mcg F

Women's Complex F

Women's Daily Caplet F

Women's Daily Formula oral tablet 27-0.4 mg F

Women's Daily Multivitamin F OTC

Women's Multivitamin Gummies F

Multivitamins

A Thru Z Advanced Formula F

Centrum Complete F

Century oral tablet 18-400 mg-mcg F






76


Century Ultimate Women's oral tablet 18-400

mg-mcg F

Cerefolin F

Cerovite Advanced Formula F

Certavite-Antioxidant F

Chewable-Vite F

Complete Multivitamin-Mineral oral tablet F

Daily Multiple For Women F

Daily Multiple oral tablet , 18-400 mg-mcg F

Daily Multi-Vitamin F

Daily Multivitamin with Iron F

Daily Value F

Daily Vitamin Formula F

Daily Vitamin Formula-Iron F

Daily-Vite F

Decubi Vite F

E-400 C-500 and Beta Carotene F

Essentia F

ESSENTIAL Balance with Lutein F

Fortavit F

L-Methyl-MC F

Metafolbic F

Multi Complete with Iron F

Multi-Day with Iron F

Multiple Vitamins F

multivitamin F

Multi-Vite (with folic acid) F OTC

Once Daily F

Oncovite F

One Daily Energy oral tablet 9 mg iron-400 mcg-

200 mg F

One Daily Essential oral tablet , 400 mcg F

One Daily For Men 50+ Advanced F






77


One Daily Men's 50 Plus Memory F

One Daily Multivitamin oral tablet F

One Daily Multivit-Iron(folic) F

One Daily Plus Iron oral tablet 18-400 mg-mcg F

One Daily Women's Health F

One Daily Women's oral tablet 18 mg iron-400

mcg-450 mg Ca F

One-A-Day Energy F

One-A-Day Essential F

One-A-Day Maximum Formula F

One-A-Day Men 50 Plus (ginkgo) F

One-A-Day Teen Advantage oral tablet 18-400

mg-mcg F

One-A-Day Womens Formula oral tablet 18 mg

iron-400 mcg-500 mg Ca F

One-A-Day Women's Petites F

Quintabs F

Sentry F

Spectravite Advanced Formula oral tablet 18-400

mg-mcg F

Spectravite Ultra Women F

Super Multivitamin F

Tab-A-Vite F

Thera F

Thera-Tabs F

Therems F

Vitamins for Hair oral tablet F

Women's One Daily F

Yelets F

Nutritional Product - Medical Condition

Specific Formulation

Endari F PA

Pediatric Vitamins






78


ANIMAL CHEWS F

Animal Shape Vitamins F

Chewable-Vite F

Child Multivitamins F

Children's Chewable F OTC

Children's Chewable Multivitmn F

Children's Chewable Vitamin F

Children's Chewables F

Children's Chewables Extra C F

Children's Chewables with Iron F

Childs Chew Vite F

Dino-Life F

Dino-Life with Extra C F

Dino-Life with Iron-Zinc F

Flintstones Gummies F

Flintstones Gummies Omega-3 F

Flintstones Multivitamin F

Flintstones/Extra C oral tablet,chewable F

Honey Bears with Iron-Zinc F

MVW Complete Formul Multivit oral capsule

1,500-800 unit-mcg F QL

MVW Complete Formul Pediatric F

MVW Complete Formulation D3000 oral capsule F QL

One-A-Day Teen Him VitaCraves F

Poly-Vitamins F

Tri-Vi-Sol F

Zoo Friends oral tablet,chewable F

Zoo Friends Plus Iron F OTC

Pediatric Vitamins And Mineral

Combinations

Animal Shapes Complete oral tablet,chewable 18

mg iron F

AquADEKs Pediatric F






79


Cerovite Jr oral tablet,chewable F OTC

Chewable-Vite with Iron F

Child Complete Multivitamin F

Children's Chew Multivit-Iron F

Children's Complete Vitamin F OTC

Child's Chewable Vitamins/Iron oral

tablet,chewable F

Childs/Iron F

Dino-Life with Iron-Zinc F

Flintstones Complete (iron) F

Flintstones Plus Calcium F

Flintstones with Iron F

Honey Bears with Iron-Zinc F

NovaFerrum Pediatric F

Poly-Vi-Sol oral drops F

Poly-Vi-Sol with Iron F

Polyvitamin with Iron F

Scooby-Doo One A Day F

Pediatric Vitamins With Fluoride And

Minerals Combinations

Multi-Vit with Fluoride-Iron F QL; AL

Pediatric Vitamins With Fluoride

Combinations

Multi-Vit with Fluoride-Iron F QL; AL

Multivitamin With Fluoride F QL; AL

Multi-Vitamin With Fluoride F QL; AL

Multivitamins With Fluoride oral tablet,chewable

1 mg F QL; AL

Mvc-Fluoride F QL; AL

Quflora Pediatric F

Triple Vitamin with Fluoride F OTC; QL; AL

Tri-Vitamin With Fluoride oral drops 0.25 mg

fluor. (0.55 mg)/mL F QL; AL






80


Vitamins A,C,D and Fluoride oral drops 0.25 mg

fluor. (0.55 mg)/mL F QL

Prenatal Vitamins And Minerals

CompleteNate F QL; AL

Mynatal Advance F QL; AL

Mynatal oral tablet F QL; AL

Mynatal Plus F QL; AL

Mynatal-Z F QL; AL

Mynate 90 Plus F QL; AL

Nestabs F QL; AL

Nestabs DHA F QL; AL

NewGen F QL; AL

Obstetrix DHA F QL; AL

Obstetrix EC F QL; AL

PNV 29-1 F QL; AL

Prenatabs FA F QL; AL

Prenatabs Rx F QL; AL

Prenatal 19 F QL; AL

Prenatal Complete F QL; AL

Prenatal Gummy F QL; AL

Prenatal Low Iron F QL; AL

Prenatal oral tablet 28 mg iron- 800 mcg F QL; AL

Prenatal Plus F QL; AL

Prenatal Plus (calcium carb) F QL; AL

Prenatal Tablet F QL; AL

Prenatal Vitamin oral tablet 27 mg iron- 0.8 mg F QL; AL

Prenatal Vitamin Plus Low Iron F QL; AL

Prenatal Vitamin with Minerals F QL; AL

prenatal vit-iron fum-folic ac F QL; AL

Prenatal-U F QL; AL

PrePlus F QL; AL

PreTAB F QL; AL

TheraNatal oral tablet F QL; AL






81


Thrivite-19 F OTC

TriAdvance F QL; AL

TriCare F QL; AL

Trinatal Rx 1 F QL; AL

Trinate F QL; AL

Vinate GT F QL; AL

Vinate II F QL; AL

Vinate M F QL; AL

Vinate One F QL; AL

Vinate Ultra F QL; AL

Vitamins - B Preparation Combinations

B Complex w-Vit C F

B-Complex With B-12 F

Cerefolin NAC (algal oil) F

FaBB F

Folbee F

Folbic F

Folgard RX F

Folinic-Plus F

Folplex 2.2 F

Foltabs 800 F

Foltanx F

Homocysteine Formula F

Lmefol Ca-acetyl-meB12-algal F

L-Methyl-B6-B12 F

Metafolbic Plus RF F

Niva-Fol F

Virt-Vite F

Vita-Respa F

Vitamins - B-1, Thiamine And

Derivatives

Arkaliox F

thiamine HCl (vitamin B1) oral tablet 100 mg F






82


Vitamin B-1 (mononitrate) F

Vitamin B-1 oral tablet 100 mg, 50 mg F

Vitamins - B-12, Cyanocobalamin And

Derivatives

cyanocobalamin (vitamin B-12) injection F

Vitamins - B-2, Riboflavin And

Derivatives

Vitamin B-2 oral tablet 25 mg F

Vitamins - B-3, Niacin And Derivatives

Endur-Acin oral tablet extended release 500 mg F

niacin (inositol niacinate) oral capsule 400 mg

niacin (500 mg), 500 mg F

niacin (inositol niacinate) oral tablet F

Niacin Flush Free oral capsule 750 mg F

niacin oral capsule, extended release 125 mg F OTC

niacin oral capsule, extended release 250 mg F

niacin oral tablet 100 mg, 250 mg, 50 mg F

niacin oral tablet extended release 1,000 mg, 250

mg, 500 mg F

niacinamide oral tablet 500 mg F

niacinamide oral tablet extended release F

Slo-Niacin oral tablet extended release 500 mg,

750 mg F

Vitamins - B-6, Pyridoxine And

Derivatives

pyridoxine (vitamin B6) oral tablet 100 mg, 25

mg, 50 mg F

Vitamins - Biotin

biotin oral capsule 1 mg, 2,500 mcg, 5 mg F

biotin oral tablet F

Cyto B7 F

Hard Nails F

Mega Biotin F






83


Meribin F

Vitamins - D Derivatives

calcitriol oral capsule F QL

calcitriol oral solution F AL

cholecalciferol (vitamin D3) oral capsule 1,250

mcg (50,000 unit), 125 mcg (5,000 unit), 25 mcg

(1,000 unit)

F

cholecalciferol (vitamin D3) oral drops 10

mcg/mL (400 unit/mL) F

cholecalciferol (vitamin D3) oral tablet 125 mcg

(5,000 unit), 2,000 unit, 25 mcg (1,000 unit) F

cholecalciferol (vitamin D3) oral tablet,chewable

400 unit F

D3-2000 F

Delta D3 F

Dialyvite Vitamin D F

Dialyvite Vitamin D3 Max F

ergocalciferol (vitamin D2) oral capsule 1,250

mcg (50,000 unit) F

Thera-D F

Vital-D Rx F

Vitamin D3 oral capsule 25 mcg (1,000 unit), 400

unit, 50 mcg (2,000 unit) F

Vitamin D3 oral tablet 10 mcg (400 unit), 125

mcg (5,000 unit), 2,000 unit F

Vitamins - E

Aqua-E F

vitamin E (dl, acetate) oral capsule 1,000 unit,

200 unit, 400 unit F

vitamin E (dl, acetate) oral drops 100 unit/0.25

mL F

vitamin E acetate F

vitamin E mixed F

vitamin E oral F

vitamin E succinate F






84


wheat germ oil oral capsule F OTC

wheat germ oil oral oil F

Vitamins - Folic Acid And Derivatives

folic acid oral tablet 1 mg F OTC

folic acid oral tablet 400 mcg, 800 mcg F

Vitamins - Folic Acid Combinations

FaBB F

Folbee F

Folbic F

Folgard RX F

Folplex 2.2 F

Niva-Fol F

Virt-Vite F

Vita-Respa F

Vitamins - K, Phytonadione And

Derivatives

phytonadione (vitamin K1) oral tablet 5 mg F QL

Endocrine

Agents To Treat Hypoglycemia

(Hyperglycemics)

Dex4 Glucose oral tablet,chewable F

dextrose oral liquid F

GlucaGen HypoKit F QL

Glucagon Emergency Kit (human) F QL

Glucose Gel F

glucose oral tablet,chewable F OTC

glucose oral tablet,chewable 4 gram F

Proglycem F

Amyloidosis Agents- Transthyretin

(Ttr) Stabilizer

Vyndamax F PA; QL; AL

Vyndaqel F PA; QL; AL






85


Androgen - Single Agents

testosterone cypionate intramuscular oil 100

mg/mL, 200 mg/mL Specialty

testosterone transdermal gel in packet 1 % (25

mg/2.5gram), 1 % (50 mg/5 gram) F PA; QL

testosterone transdermal solution in metered

pump w/app F PA; QL

Antidiuretic And Vasopressor

Hormones

desmopressin nasal spray with pump F PA

desmopressin nasal spray,non-aerosol F PA

desmopressin oral F QL

Stimate F PA

Antihyperglycemic - Alpha-Glucosidase

Inhibitors

acarbose F QL

Antihyperglycemic - Dipeptidyl

Peptidase-4 (Dpp-4) Inhibitors

alogliptin F ST

Januvia F PA; QL

Tradjenta F PA; QL

Antihyperglycemic - Meglitinide

Analogs

nateglinide F QL

repaglinide F QL

Antihyperglycemic - Sglt-2 Inhibitor

And Biguanide Combinations

Invokamet F PA; QL

Invokamet XR F PA; QL

Segluromet F PA

Synjardy F PA; QL

Synjardy XR F PA; QL






86


Antihyperglycemic - Sglt-2 Inhibitor

And Dpp-4 Inhibitor Combinations

Steglujan F PA; AL

Antihyperglycemic - Sodium Glucose

Cotransporter-2 (Sglt2) Inhibitors

Invokana F PA; QL

Jardiance F PA; QL

Steglatro F PA

Antihyperglycemic - Sulfonylurea And

Biguanide Combinations

glipizide-metformin F

glyburide-metformin F

Antihyperglycemic - Sulfonylurea

Derivatives

glimepiride F

glipizide F

glyburide F

glyburide micronized oral tablet 1.5 mg, 3 mg F

glyburide micronized oral tablet 6 mg F QL

Antihyperglycemic, Incretin

Mimetic,Glp-1 Receptor Agonist

Analog-Type

Ozempic F PA; QL

Trulicity subcutaneous pen injector 0.75 mg/0.5

mL F PA; QL

Trulicity subcutaneous pen injector 1.5 mg/0.5

mL F PA

Victoza 2-Pak F PA; QL

Victoza 3-Pak F PA; QL

Antihyperglycemic-Dipeptidyl

Peptidase-4 Inhibit And

Thiazolidinedione

alogliptin-pioglitazone F ST; QL






87


Antihyperglycemic-Dipeptidyl

Peptidase-4(Dpp-4)Inhibitor And

Biguanide

alogliptin-metformin oral tablet 12.5-1,000 mg F ST

alogliptin-metformin oral tablet 12.5-500 mg F PA

Janumet F PA; QL

Janumet XR F PA; QL

Jentadueto F PA; QL

Antithyroid Agents, Thionamides -

Imidazole Derivatives

methimazole oral tablet 10 mg, 5 mg F

Antithyroid Agents, Thionamides -

Thiouracil Derivatives

propylthiouracil F

Bone Formation Stimulating Agents -

Parathyroid Hormone Rel Peptides

Tymlos F PA

Bone Formation Stimulating Agents -

Parathyroid Hormone-Type

Forteo F PA; QL

Bone Resorption Inhibitors -

Bisphosphonates

alendronate oral tablet 10 mg, 35 mg, 5 mg, 70

mg F QL

ibandronate oral F QL

Calcimimetic, Parathyroid Calcium

Receptor Sensitivity Enhancer

Sensipar F PA; QL

Calcitonins

calcitonin (salmon) F QL

Estrogen-Progestin

estradiol-norethindrone acet F






88


norethindrone ac-eth estradiol oral tablet 0.5-2.5

mg-mcg, 1-5 mg-mcg F QL

Premphase F QL

Prempro F QL

Estrogens

estradiol oral F

estradiol transdermal patch semiweekly 0.025

mg/24 hr, 0.0375 mg/24 hr, 0.075 mg/24 hr, 0.1

mg/24 hr

F QL

estradiol transdermal patch semiweekly 0.05

mg/24 hr F

estradiol transdermal patch weekly F QL

Menest oral tablet 0.3 mg, 0.625 mg, 1.25 mg F

Premarin oral F QL

Glucocorticoids

dexamethasone oral elixir F

dexamethasone oral solution F

dexamethasone oral tablet F

hydrocortisone oral F

methylprednisolone F

prednisolone oral solution 15 mg/5 mL F

prednisolone sodium phosphate oral solution 15

mg/5 mL (3 mg/mL), 5 mg base/5 mL (6.7 mg/5

mL)

F

prednisone F

Gonadotropin Inhibitor Pituitary

Suppressants

danazol F

Growth Hormones

Norditropin FlexPro F PA

Human Insulins - Fixed Combinations

Humulin 70/30 U-100 Insulin F OTC; QL

Humulin 70/30 U-100 KwikPen F OTC; QL; AL

Novolin 70/30 U-100 Insulin F OTC; QL






89


Human Insulins - Intermediate Acting

Humulin N NPH Insulin KwikPen F OTC; QL; AL

Humulin N NPH U-100 Insulin F OTC; QL

Novolin N NPH U-100 Insulin F OTC; QL

Human Insulins - Short Acting

Humulin R Regular U-100 Insuln F OTC; QL

Humulin R U-500 (Conc) Insulin F PA

Novolin R Regular U-100 Insuln F OTC; QL

Insulin Analogs - Fixed Combinations

Humalog Mix 50-50 Insuln U-100 F QL

Humalog Mix 50-50 KwikPen F QL; AL

Humalog Mix 75-25 KwikPen F QL; AL

Humalog Mix 75-25(U-100)Insuln F QL

Novolog Mix 70-30 U-100 Insuln F QL

Novolog Mix 70-30FlexPen U-100 F QL; AL

Insulin Analogs - Long Acting

Basaglar KwikPen U-100 Insulin F QL

Insulin Analogs - Rapid Acting

Admelog SoloStar U-100 Insulin F QL; AL

Admelog U-100 Insulin lispro F QL

Humalog U-100 Insulin subcutaneous solution F PA

Insulin Response Enhancers -

Biguanides

metformin oral tablet F QL

metformin oral tablet extended release 24 hr F

Insulin Response Enhancers -

Thiazolidinediones (Ppar-Gamma

Agonists)

pioglitazone F QL

Insulin-Like Growth Factor-1 (Igf-1)

Increlex Specialty PA

Leptin Hormone Analogs






90


Myalept State Carve Out

Lhrh (Gnrh) Antagonists

Orilissa F PA

Menopausal Symptoms Suppressant-

Ssri Antidepressant Type

Brisdelle State Carve Out

Mineralocorticoids

fludrocortisone F

Oxytocic - Ergot Alkaloids

Methergine F QL; AL

Progestins

medroxyprogesterone oral F

norethindrone acetate F QL

progesterone micronized F QL

Prolactin Inhibitor - Ergot Derivative

Dopamine Receptor Agonists

cabergoline F

Selective Estrogen Receptor Modulators

(Serms)

raloxifene F QL; AL

Somatostatic Agents

octreotide acetate injection solution 1,000

mcg/mL, 100 mcg/mL, 200 mcg/mL, 50 mcg/mL Specialty PA

Thyroid Hormones - Animal Source

(Porcine)

Armour Thyroid oral tablet 180 mg, 240 mg, 30

mg, 300 mg, 60 mg, 90 mg F

Nature-Throid F

NP Thyroid F

thyroid (pork) oral tablet 120 mg, 15 mg F

Westhroid oral tablet 130 mg, 195 mg, 32.5 mg,

65 mg, 97.5 mg F

WP Thyroid F






91


Thyroid Hormones - Synthetic T3

(Triiodothyronine)

liothyronine oral F

Thyroid Hormones - Synthetic T4

(Thyroxine)

levothyroxine oral F

Levoxyl oral tablet 100 mcg, 112 mcg, 125 mcg,

137 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg,

50 mcg, 75 mcg, 88 mcg

F

Gastrointestinal Therapy Agents

Antacid - Alginate Combinations

Foaming Antacid oral tablet,chewable F OTC

Antacid - Aluminum

aluminum hydroxide gel oral suspension 320

mg/5 mL F OTC

Antacid - Antacid Combinations

Acid Gone Antacid F OTC

Acid Gone Antacid E.Strength F OTC

Antacid ExSt (mag carb-Al hyd) F OTC

Foaming Antacid oral suspension F OTC

Gaviscon Extra Strength F OTC

Heartburn Antacid F OTC

Heartburn Relief oral tablet,chewable F OTC

Antacid - Bicarbonate

sodium bicarbonate oral F OTC

Antacid - Calcium

Antacid (calcium carbonate) oral tablet,chewable

200 mg calcium (500 mg) F OTC

Antacid Calcium oral tablet,chewable 215 mg

calcium (500 mg) F OTC

Calcium Antacid oral tablet,chewable 200 mg

calcium (500 mg), 320 mg calcium (750 mg) F OTC

calcium carbonate oral suspension F OTC






92



calcium (500 mg), 300 mg (750 mg), 400 mg

calcium (1,000 mg)

F OTC

Cal-Gest Antacid F OTC

Tums Freshers F OTC

Tums oral tablet,chewable 200 mg calcium (500

mg) F OTC

Antacid - Magnesium

magnesium oxide oral tablet 400 mg (241.3 mg

magnesium) F OTC

Antacid - Simethicone Combinations

Antacid Anti-Gas (ca carb-sim) F OTC

Antacid Anti-Gas oral suspension 200-200-20

mg/5 mL F OTC

Antacid-Simethicone F OTC

Maalox Advanced oral tablet,chewable F OTC

Antidiarrheal - Antiperistaltic Agents

Diamode F OTC

loperamide oral capsule F OTC

loperamide oral liquid 1 mg/7.5 mL F OTC

loperamide oral tablet F OTC

Antidiarrheal - Bismuth Agents

Bismatrol oral suspension 525 mg/15 mL F OTC

Bismatrol oral tablet,chewable F OTC

Bismuth oral tablet F OTC

bismuth subsalicylate oral suspension F OTC

Diotame F OTC

Kaopectate Ex Str (bismuth ss) F OTC

Peptic Relief oral tablet,chewable F OTC

Pepto-Bismol Max St F OTC

Pink Bismuth Maximum Strength F OTC

Pink Bismuth oral suspension 525 mg/15 mL F OTC

Pink Bismuth oral tablet F OTC






93


Pink Bismuth oral tablet,chewable F OTC

Soothe (bismuth subsalicylate) oral tablet F OTC

Stomach Relief Max Strength F OTC

Stomach Relief oral suspension 525 mg/15 mL F OTC

Stomach Relief oral tablet F OTC

Stomach Relief oral tablet,chewable F OTC

Antidiarrheal Antiperistaltic-

Anticholinergic Combinations

diphenoxylate-atropine oral tablet F

Antiemetic - Anticholinergics

scopolamine base F QL

Antiemetic - Antihistamines

dimenhydrinate oral F OTC

meclizine oral tablet 12.5 mg, 25 mg F OTC

meclizine oral tablet,chewable F OTC

Motion Sickness (meclizine) F OTC

Motion Sickness Relief(mecliz) F OTC

Travel Sickness (meclizine) F OTC

Antiemetic - Cannabinoid Type

dronabinol F PA

Antiemetic - Dopamine (D2)/5-Ht3

Antagonists

trimethobenzamide oral F

Antiemetic - Phenothiazines

prochlorperazine F QL

prochlorperazine maleate F QL

promethazine oral F AL

promethazine rectal suppository 12.5 mg, 25 mg F AL

Antiemetic - Selective Serotonin 5-Ht3

Antagonists

granisetron HCl oral F ST; QL

ondansetron F QL






94


ondansetron HCl oral solution F QL; AL

ondansetron HCl oral tablet F QL

Colonic Acidifier (Ammonia Inhibitor)

Enulose State Carve Out

Generlac State Carve Out

lactulose oral solution 10 gram/15 mL (15 mL) F

Digestive Enzyme Mixtures

Creon F QL

Pancreaze oral capsule,delayed release(DR/EC)

10,500-35,500- 61,500 unit, 16,800-56,800-

98,400 unit, 2,600-6,200- 10,850 unit, 21,000-

54,700- 83,900 unit, 4,200-14,200- 24,600 unit

F QL

Pertzye oral capsule,delayed release(DR/EC)

16,000-57,500- 60,500 unit, 24,000-86,250-

90,750 unit, 8,000-28,750- 30,250 unit

F QL

Viokace F QL

Zenpep oral capsule,delayed release(DR/EC)

10,000-32,000 -42,000 unit, 15,000-47,000 -

63,000 unit, 20,000-63,000- 84,000 unit, 25,000-

79,000- 105,000 unit, 3,000-10,000 -14,000-unit,

40,000-126,000- 168,000 unit, 5,000-17,000-

24,000 unit

F QL

Digestive Enzymes

lactase State Carve Out

Lactase Fast Acting oral tablet State Carve Out

Gallstone Solubilizing (Litholysis)

Agents

ursodiol oral capsule F QL

ursodiol oral tablet F

Gastric Acid Secretion Reducers -

Histamine H2-Receptor Antagonists

Acid Controller F OTC

Acid Reducer (famotidine) F OTC

cimetidine oral tablet 200 mg F OTC

cimetidine oral tablet 300 mg, 400 mg, 800 mg F






95


famotidine oral tablet 10 mg, 20 mg F OTC

famotidine oral tablet 40 mg F

Heartburn Prevention F OTC

Heartburn Relief (cimetidine) F OTC

Heartburn Relief (famotidine) F OTC

ranitidine HCl oral syrup F QL

ranitidine HCl oral tablet 150 mg, 75 mg F OTC

ranitidine HCl oral tablet 300 mg F

Gastric Acid Secretion Reducing Agents

- Proton Pump Inhibitors (Ppis)

lansoprazole oral capsule,delayed release(DR/EC)

15 mg F ST; OTC; QL

lansoprazole oral capsule,delayed release(DR/EC)

30 mg F ST; QL

Nexium 24HR oral capsule,delayed

release(DR/EC) F OTC

omeprazole magnesium F OTC; QL

omeprazole oral capsule,delayed release(DR/EC) F QL

pantoprazole oral F QL

Prevacid SoluTab F QL; AL

Gastric Mucosa - Cytoprotective

Prostaglandin Analogs

misoprostol F QL

Gastrointestinal - Prokinetic Agents - 5-

Ht4 Receptor Agonists

Motegrity F PA; QL; AL

Gastrointestinal Antiflatulents

Gas Relief 80 F OTC

Gas Relief Extra Strength oral tablet,chewable F OTC

Gas Relief oral drops,suspension F OTC

Gas Relief oral tablet,chewable F OTC

Gas-X Extra Strength oral tablet,chewable F OTC

Infants Gas Relief F OTC






96


Mi-Acid Gas Relief F OTC

simethicone oral drops,suspension F OTC

simethicone oral tablet,chewable F OTC

Gastrointestinal Prokinetic Agents - D2

Antagonist/5-Ht4 Agonists

metoclopramide HCl oral solution F

metoclopramide HCl oral tablet F

Gi Antispasmodic - Belladonna

Alkaloids

hyoscyamine sulfate oral F AL

hyoscyamine sulfate sublingual F

Gi Antispasmodic - Quaternary

Ammonium Compounds

glycopyrrolate oral tablet 1 mg, 2 mg F

propantheline F

Gi Antispasmodic - Synthetic Tertiary

Amines

dicyclomine oral capsule F AL

dicyclomine oral solution F AL

dicyclomine oral tablet F AL

Ibs Agent - Gastrointestinal Chloride

Channel Activator Agents

Amitiza F PA; QL; AL

Inflammatory Bowel Agent -

Aminosalicylates And Related Agents

Apriso F ST

balsalazide F

Canasa F

Delzicol oral capsule (with del rel tablets) F ST; QL

Dipentum F QL

mesalamine oral tablet,delayed release (DR/EC) F ST; QL

mesalamine rectal enema F

Pentasa F ST; QL






97


sulfasalazine F

Inflammatory Bowel Agent -

Glucocorticoids

hydrocortisone rectal F

Inflammatory Bowel Agent - Janus

Kinase (Jak) Inhibitors

XELJANZ 10 MG TABLET F PA; QL

Xeljanz oral tablet 5 mg F PA; QL

Inflammatory Bowel Agent - Tumor

Necrosis Factor Alpha Blockers




Humira F PA; QL


Humira Pen F PA; QL



Humira(CF) F PA; QL

Humira(CF) Pedi Crohns Starter F PA; QL




Irritable Bowel Syndrome (Ibs) Agents

Amitiza F PA; QL; AL

Laxative - Bulk Forming

Daily Fiber F OTC

Fiber (psyllium husk/sugar) oral powder 3.4

gram/11 gram, 3.4 gram/12 gram F OTC

Fiber (with aspartame) oral powder 3.4 gram/5.8

gram F OTC

Fiber Laxative (ca polycarbo) F OTC

fiber oral powder F OTC






98


Fiber Smooth F OTC

Fiber Smooth (sucrose) F OTC

Fiber Supplement (inulin) F OTC

Fiber-Tabs F OTC

Hydrocil F OTC

Konsyl (sugar) oral powder 3.4 gram/12 gram F OTC

Metamucil (sugar) F OTC

Metamucil (with sugar) oral powder 3.4 gram/12

gram F OTC

Metamucil MultiHealth Fiber F OTC

Metamucil Sugar-Free (aspart) oral powder 3.4

gram/5.8 gram F OTC

Natural Fiber Laxative F OTC

Natural Fiber Laxative (sugar) oral powder 3.4

gram/12 gram, 3.4 gram/7 gram F OTC

Natural Fiber Laxative Therapy F OTC

Natural Fiber Laxative(aspart) oral powder F OTC

Natural Vegetable F OTC

Natural Vegetable (psyllium) F OTC

Natural Vegetable Powder F OTC

psyllium husk oral capsule 0.52 gram F OTC

Reguloid, Sugar Free F OTC

Wal-Mucil Natural Fiber Lax F OTC

Laxative - Lubricant

Mineral Oil Extra Heavy F OTC

Mineral Oil Heavy oral F OTC

mineral oil oral F OTC

mineral oil rectal F OTC

Ready-To-Use Enema (min oil) F OTC

Laxative - Saline And Osmotic

Fleet Glycerin (Adult) F OTC

Fleet Glycerin (Child) F OTC

glycerin (adult) F OTC






99


glycerin (child) F OTC

Laxative (glycerin-pediatric) F OTC

magnesium citrate oral solution F OTC

Milk of Magnesia F OTC

Milk Of Magnesia Concentrated F OTC

Pedia-Lax rectal F OTC

polyethylene glycol 3350 oral powder F OTC

Laxative - Saline/Osmotic Mixtures

Enema Disposable F OTC

Enema rectal enema 19-7 gram/118 mL F OTC

Fleet Enema F OTC

Fleet Enema Extra F OTC

Fleet Pediatric F OTC

Gavilyte-C F

GaviLyte-G F

GaviLyte-N F

Golytely oral recon soln F

peg 3350-electrolytes oral recon soln 236-22.74-

6.74 -5.86 gram F

PEG-3350 with flavor packs F

peg-electrolyte soln F

Ready-To-Use Enema F OTC

TriLyte With Flavor Packets F

Laxative - Stimulant

bisacodyl F OTC; QL

Correctol F OTC

Ex-Lax (sennosides) oral tablet F OTC

Ex-Lax Maximum Strength F OTC

Fleet Bisacodyl F OTC

Geri-kot F OTC

Laxative (bisacodyl) oral tablet F OTC

Laxative (sennosides) oral tablet 25 mg F OTC

Laxative Feminine F OTC






100


Laxative Maximum Strength F OTC

Laxative Pills F OTC

Laxative Pills Regular F OTC

Natural Veg Laxative(sennosid) F OTC

Perdiem Overnight Relief F OTC

Senna Lax F OTC

Senna Laxative oral tablet 8.6 mg F OTC

senna oral syrup 8.8 mg/5 mL F OTC

senna oral tablet F OTC

Senno F OTC

Senokot F OTC

Sen-O-Tab F OTC

Vegetable Laxative F OTC

Woman's Laxative oral tablet F OTC

Women's Laxative (bisacodyl) oral tablet F OTC

Laxative - Stimulant And Surfactant

Combinations

sennosides-docusate sodium F OTC

Laxative - Surfactant

Colace Clear F OTC

Col-Rite oral capsule 100 mg F OTC

Diocto oral syrup F OTC

Dioctyl F OTC

Docuprene F OTC

docusate calcium F OTC

docusate sodium oral F OTC

Docusil F OTC; QL

DOK F OTC

Dulcolax Stool Softener (dss) F OTC

Enemeez F OTC

Enemeez Plus F OTC

Pedia-Lax Stool Softener F OTC

Phillips' Liqui-Gels F OTC






101


Promolaxin F OTC

Silace oral syrup F OTC

Stool Softener (docusate cal) F OTC

Stool Softener oral capsule F OTC

Stool Softener oral syrup F OTC

Stool Softener oral tablet F OTC

Surfak F OTC

Peptic Ulcer - Gastric Lumen Adherent

Cytoprotectives

sucralfate oral tablet F QL

Short Bowel Syndrome (Sbs) Agents

Endari F PA

octreotide acetate injection solution 1,000

mcg/mL, 100 mcg/mL, 200 mcg/mL, 50 mcg/mL Specialty PA

Genitourinary Therapy

Interstitial Cystitis Agents

Elmiron F PA; QL

Phosphate Binders

Auryxia F

calcium acetate oral capsule F


Calphron F

Fosrenol oral powder in packet F

Fosrenol oral tablet,chewable F PA

lanthanum F PA

sevelamer carbonate oral tablet F PA

sevelamer HCl oral tablet 800 mg F PA

Velphoro F

Phosphate Binders - Calcium-Based

calcium acetate oral capsule F


Calphron F






102


Phosphate Binders - Iron-Based

Auryxia F

Velphoro F

Prostatic Hypertrophy Agent - Alpha-1-

Adrenoceptor Antagonists

alfuzosin F

tamsulosin F QL

Prostatic Hypertrophy Agent - Type Ii

5-Alpha Reductase Inhibitors

finasteride oral tablet 5 mg F QL

Urinary Acidifier - Bacterial Urease

Inhibitor

Lithostat State Carve Out

Urinary Acidifier - Phosphates

K-Phos No 2 F

K-Phos Original F

Urinary Alkalinizer - Citrates

Cytra K Crystals F

Cytra-2 F

potassium citrate oral tablet extended release 10

mEq (1,080 mg), 5 mEq (540 mg) F

potassium citrate-citric acid oral solution F

sodium citrate-citric acid F

Tricitrates F

Urocit-K 10 F

Urocit-K 5 F

Virtrate-3 F

Urinary Analgesics

phenazopyridine oral tablet 100 mg, 200 mg F

Urinary Antibacterial - Methenamine

And Salts

methenamine hippurate F






103


methenamine mandelate F

Urinary Antibacterial - Nitrofuran

Derivatives

nitrofurantoin F AL

nitrofurantoin macrocrystal oral capsule 100 mg,

50 mg F QL; AL

nitrofurantoin monohyd/m-cryst F QL; AL

Urinary Anti-Infective Methenamine-

Antispas-Analg Combinations

Uretron D-S oral tablet 81.6-10.8-40.8 mg F

Utira-C F

Urinary Antispasmodic -

Anticholinergics, Non-Selective

hyoscyamine sulfate oral F AL

hyoscyamine sulfate sublingual F

Urinary Antispasmodic - Smooth

Muscle Relaxants

flavoxate F

oxybutynin chloride F QL

Oxytrol For Women F OTC

tolterodine F ST; QL

trospium F ST; QL

Urinary Retention Therapy -

Parasympathomimetic Agents

bethanechol chloride F QL

Gout And Hyperuricemia Therapy

Gout Acute Therapy - Antimitotics

colchicine F QL

Gout And Hyperuricemia - Antimitotic-

Uricosuric Combinations

probenecid-colchicine F

Hyperuricemia Therapy - Uricosurics






104


probenecid F

Hyperuricemia Therapy - Xanthine

Oxidase Inhibitors

allopurinol F QL

febuxostat F PA; QL

Hematological Agents

Anticoagulants - Coumarin

warfarin F

Anti-Inhibitor Coagulation Complex

Feiba NF intravenous recon soln 1,750-3,250

unit, 350-650 unit, 700-1,300 unit State Carve Out

C1 Esterase Inhibitor Agents

Berinert State Carve Out

Cinryze State Carve Out

Ruconest State Carve Out

Direct Factor Xa Inhibitors

Eliquis F QL; AL

Eliquis DVT-PE Treat 30D Start F QL; AL

Xarelto oral tablet 10 mg, 15 mg, 20 mg F QL; AL

Xarelto oral tablets,dose pack F QL; AL

Erythropoietins

Aranesp (in polysorbate) F PA

Epogen injection solution 10,000 unit/mL, 2,000

unit/mL, 20,000 unit/2 mL, 20,000 unit/mL, 3,000

unit/mL, 4,000 unit/mL

F PA

Procrit F PA

Retacrit Specialty PA

Factor Ix Complex (Prothrombin

Complex Concentrate) Preparations

Kcentra State Carve Out

Factor Ix Preparations

AlphaNine SD intravenous recon soln 1,500 (+/-)

unit, 500 (+/-) unit State Carve Out






105


Alprolix intravenous recon soln 1,000 unit, 2,000

unit, 3,000 unit, 500 unit State Carve Out

Ixinity State Carve Out

Mononine State Carve Out

Profilnine State Carve Out

Rixubis State Carve Out

Factor Vii Preparations

Novoseven RT State Carve Out

Factor Viii Preparations (Ahf)

Advate intravenous recon soln 1,500 (+/-) unit,

4,000 (+/-) unit State Carve Out

Adynovate intravenous solution 1,500 (+/-) unit,

3,000 (+/-) unit, 750 (+/-) unit State Carve Out

Afstyla intravenous recon soln 1,500 (+/-) unit

range State Carve Out

Alphanate State Carve Out

Eloctate State Carve Out

Hemofil M High State Carve Out

Hemofil M Low State Carve Out

Hemofil M Mid State Carve Out

Hemofil M Super High State Carve Out

Humate-P State Carve Out

Koate intravenous recon soln 250 (+/-) unit, 500

(+/-) unit State Carve Out

Kogenate FS State Carve Out

Novoeight State Carve Out

Obizur State Carve Out

Recombinate State Carve Out

Wilate intravenous recon soln 450-450 unit, 900-

900 unit State Carve Out

Xyntha State Carve Out

Xyntha Solofuse State Carve Out

Factor Viii-Mimetic Agent, Monoclonal

Antibody






106


Hemlibra State Carve Out

Factor Xiii Preparations

Corifact State Carve Out

Tretten State Carve Out

Granulocyte Colony-Stimulating Factor

(G-Csf)

Fulphila Specialty PA

Granix Specialty PA

Neupogen F PA

Nivestym subcutaneous F PA

Zarxio F PA

Hematorheologic Agents

pentoxifylline F

Hemostatic Systemic - Antifibrinolytic

Agents

aminocaproic acid intravenous State Carve Out

Cyklokapron State Carve Out

RiaSTAP State Carve Out

tranexamic acid oral State Carve Out

Heparins

heparin (porcine) injection solution 10,000

unit/mL, 5,000 unit/mL F

Human Albumin

Albuminar 25 % State Carve Out

Albuminar 5 % State Carve Out

Buminate 25 % State Carve Out

Plasbumin 5 % State Carve Out

Human Monoclonal Antibody

Complement (C5) Inhibitors

Soliris State Carve Out

Low Molecular Weight Heparins

enoxaparin subcutaneous syringe F PA






107


Plasma Fractions

Octaplas (Blood Group A) State Carve Out

Octaplas (Blood Group AB) State Carve Out

Octaplas (Blood Group B) State Carve Out

Octaplas (Blood Group O) State Carve Out

Plasmanate State Carve Out

Plasma Proteins Which Facilitate

Anticoagulation

ATryn State Carve Out

Thrombate III State Carve Out

Platelet Aggregation Inhibitors -

Phosphodiesterase Iii Inhibitors

cilostazol F QL


Quinazoline Agents

anagrelide F


Salicylates

aspirin oral tablet F OTC; QL; AL

aspirin oral tablet,chewable F OTC; QL

aspirin oral tablet,delayed release (DR/EC) 325

mg F OTC; QL; AL

aspirin oral tablet,delayed release (DR/EC) 81 mg F OTC; QL


Thienopyridine Agents

clopidogrel F QL

Platelet Aggregation Inhib-Pdesterase

And Adenosine Deaminase Inhibitr

dipyridamole oral F QL

Protein C Preparations

Ceprotin (Blue Bar) State Carve Out

Ceprotin (Green Bar) State Carve Out






108


Sickle Cell Anemia Agents

Droxia F

Endari F PA

Sickle Cell Anemia Agents, Others

Droxia F

Endari F PA

Thrombin Inhibitor - Selective Direct

And Reversible

Pradaxa oral capsule 150 mg, 75 mg F QL

Immunosuppressive Agents

Immunosuppressive - Calcineurin

Inhibitors

cyclosporine modified oral capsule F

cyclosporine modified oral solution F AL

cyclosporine oral capsule F

tacrolimus oral F

Immunosuppressive - Inosine

Monophosphate Dehydrogenase

Inhibitors

mycophenolate mofetil oral capsule F

mycophenolate mofetil oral suspension for

reconstitution F AL

mycophenolate mofetil oral tablet F

mycophenolate sodium F ST

Immunosuppressive - Mammalian

Target Of Rapamycin (Mtor) Inhibitors

sirolimus oral tablet F

Immunosuppressive - Purine Analogs

azathioprine F QL

Locomotor System

Als Agents - Benzathiazoles

riluzole F






109


Antimyasthenic Agent - Reversible

Cholinesterase Inhibitors

pyridostigmine bromide oral tablet 60 mg F

pyridostigmine bromide oral tablet extended

release F

Duchenne Muscular Dystrophy - Exon

Skipping Antisense Oligonucleotide

Exondys 51 State Carve Out

Skeletal Muscle Relaxant - Central

Muscle Relaxants

baclofen oral tablet 10 mg, 20 mg F

chlorzoxazone oral tablet 500 mg F AL

cyclobenzaprine oral tablet 10 mg, 5 mg F AL

methocarbamol oral F AL

orphenadrine citrate oral F QL; AL

tizanidine oral tablet F AL

Skeletal Muscle Relaxant - Direct

Muscle Relaxants

dantrolene oral F QL

Spinal Muscular Atrophy - Exon

Inclusion Antisense Oligonucleotide

Spinraza (PF) State Carve Out

Medical Supplies And Durable Medical

Equipment (Dme)

Medical Supplies And Dme - Blood

Glucose Tests

Accu-Chek Aviva Plus test strp F OTC; QL

Accu-Chek Guide F OTC; QL

Accu-Chek SmartView Test Strip F OTC; QL

Medical Supplies And Dme - Cervical

Caps

FemCap vaginal device 26 mm, 30 mm F QL






110


Medical Supplies And Dme -

Diaphragms

Caya Contoured F

Wide-Seal Diaphragm 60 F








Medical Supplies And Dme - Female

Condoms

FC2 Female Condom F OTC; QL

Medical Supplies And Dme - Glucose

Monitoring Test Supplies

Accu-Chek Aviva Control Soln F OTC

Accu-Chek FastClix Lancing Dev F OTC

Accu-Chek Guide Glucose Meter F OTC; QL

Accu-Chek Guide L1-L2 Ctrl Sol F OTC

Accu-Chek Guide Me Glucose Mtr F OTC; QL

Accu-Chek Multiclix Lancet F OTC; QL

Accu-Chek Multiclix Lancet kit F OTC

Accu-Chek SmartView Contrl Sol F OTC

Accu-Chek Soft Dev Lancets F OTC

Accu-Chek Softclix Lancet Dev F OTC

Accu-Chek Softclix Lancets F OTC; QL

Smart Sense Lancets 26 gauge F OTC

Soft Touch Lancets F OTC; QL

Medical Supplies And Dme - Hearing

Aid Supplies And Batteries

Hearing Aid Batteries F OTC; QL






111


Medical Supplies And Dme - Insulin

Needles-Syringes And Admin Supplies

Advocate Syringes syringe 1 mL 30 gauge x 5/16 F OTC

BD AutoShield Duo Pen Needle F OTC

BD INS SYR 0.3 ML 8MMX31G(1/2) F OTC

BD INS SYR UF 0.3 ML 12.7MMX30G F OTC


BD INS SYRN UF 1 ML 12.7MMX30G F OTC

BD INS SYRNG UF 0.3 ML 8MMX31G F OTC


BD INSULIN SYR UF 1 ML 8MMX31G F OTC

BD Insulin Syringe Half Unit syringe 0.3 mL 31

gauge x 5/16" F OTC; QL

BD Insulin Syringe Micro-Fine syringe 1 mL 28


BD Insulin Syringe syringe 1 mL 28 gauge x 1/2" F OTC; QL

BD Insulin Syringe U-500 F

BD Insulin Syringe Ultra-Fine syringe 0.3 mL 30

gauge x 1/2", 0.3 mL 31 gauge x 5/16", 0.5 mL

30 gauge x 1/2", 0.5 mL 31 gauge x 5/16", 1 mL

30 gauge x 1/2", 1 mL 31 gauge x 5/16

F OTC; QL

BD Nano 2nd Gen Pen Needle F OTC

BD UF MICRO PEN NEEDLE 6MMX32G F OTC

BD UF MINI PEN NEEDLE 5MMX31G F OTC

BD UF NANO PEN NEEDLE 4MMX32G F OTC

BD UF ORIG PEN NDL 12.7MMX29G F OTC

BD UF SHORT PEN NEEDLE 8MMX31G F OTC

BD Ultra-Fine Micro Pen Needle needle 32 gauge

x 1/4" F OTC; QL

BD Ultra-Fine Mini Pen Needle needle 31 gauge

x 3/16" F OTC; QL

BD Ultra-Fine Nano Pen Needle needle 32 gauge

x 5/32" F OTC; QL

BD Ultra-Fine Orig Pen Needle needle 29 gauge

x 1/2" F OTC; QL






112


BD Ultra-Fine Short Pen Needle needle 31 gauge

x 5/16" F OTC; QL

BD VEO INS SYRING 1 ML 6MMX31G F OTC

BD VEO INS SYRN 0.3 ML 6MMX31G F OTC


BD Veo Insulin Syr Half Unit F OTC

Easy Comfort Insulin Syringe syringe 1 mL 30

gauge x 5/16 F OTC

Easy Touch Insulin Syringe syringe 1 mL 28

gauge x 1/2", 1 mL 31 gauge x 5/16 F OTC; QL

insulin syringe-needle U-100 syringe 1 mL 29

gauge x 1/2", 1 mL 30 gauge x 3/8", 1 mL 31

gauge x 5/16

F OTC; QL

Sure-Ject Insulin Syringe syringe 1 mL 28 gauge

x 1/2" F OTC; QL

UltiCare syringe 1 mL 30 gauge x 1/2" F OTC; QL

Ultra Comfort Insulin Syringe syringe 1 mL 28

gauge F OTC

Medical Supplies And Dme - Male

Condoms

Aimsco Latex Condom F OTC; QL

Condoms-Prem Lubricated F OTC; QL

Durex Avanti Bare Real Feel F OTC; QL

Fantasy Condom F OTC; QL

Kimono Condoms(Non-lubricated) F OTC; QL

Kimono Maxx Condoms F OTC; QL

Kimono MicroThin Aqua Lube Con F OTC; QL

Kimono MicroThin Condoms F OTC; QL

Kimono MicroThin Large Condoms F OTC; QL

Kimono Textured Condoms F OTC; QL

Trustex Latex Condom F OTC; QL

Trustex Lubricated Condoms F OTC; QL

Trustex Non-Lub Condoms F OTC; QL

Trustex-RIA Lub/Spermicide F OTC; QL






113


Trustex-RIA Lubricated Condoms F OTC; QL

Trustex-RIA Non-Lub Condoms F OTC; QL


Miscellaneous Other

blood pressure test kit-large F OTC; QL

blood pressure test kit-medium F OTC

blood pressure test kit-wrist F OTC

Sharps Container F OTC

Medical Supplies And Dme - Needles

And Syringes

SafeSnap Syringe syringe 1 mL 25 gauge x 5/8",

1 mL 27 gauge x 1/2", 3 mL F OTC

Medical Supplies And Dme - Peak Flow

Meters

Aerogear Action Asthma Kit F QL

Airzone Peak Flow Meter F OTC; QL

Asthma Check Meter F OTC; QL

Asthmapack Children's F QL

In-Check Nasal With Mask F OTC; QL

In-Check Oral Flow Meter F OTC; QL

Microlife Peak Flow Meter F OTC; QL

Mini Wright Peak Flow Meter F QL

Peak Air Peak Flow Meter F OTC

Personal Best Full Range F OTC; QL

Piko 1 F OTC; QL

Pocket Peak Flow Meter F OTC; QL

Truzone Peak Flow Meter F QL


Respiratory Therapy Supplies

Ace Aerosol Cloud Enhancer F QL

Aerochamber Mini F QL

Aerochamber MV F QL

Aerochamber Plus Flow-Vu F QL






114


Aerochamber Plus Flow-Vu,L Msk F QL

Aerochamber Plus Flow-Vu,M Msk F QL

Aerochamber Plus Flow-Vu,S Msk F QL

Aerochamber Plus Z Stat F QL

AeroChamber Plus Z Stat Lg Msk F QL

AeroChamber Plus Z Stat Md Msk F QL

AeroChamber Plus Z Stat Sm Msk F QL

Aerochamber with Flowsignal F QL

AeroChamber Z-Stat Plus-Flw Sg F QL

AeroTrach Plus F QL

BreatheRite MDI Spacer F QL

BreatheRite Spacer-Mask, Neo. F QL

BreatheRite Spacer-Mask,Adult F QL

BreatheRite Spacer-Mask,Child F QL

BreatheRite Spacer-Mask,Infant F QL

BreatheRite Spacer-Mask,S.Chld F QL

BreatheRite Valved MDI Chamber F QL

BreatheRite Valved MDI Spacer F QL

Clever Choice Chamber-Lrg Mask F QL

Clever Choice Chamber-Med Mask F QL

Clever Choice Chamber-Sm Mask F QL

Compact Space Chamber Plus F QL

Compact Space Chamber-Lrg Mask F QL

Compact Space Chamber-Med Mask F QL

Compact Space Chamber-Sm Mask F QL

EasiVent Holding Chamber F QL

EasiVent Mask Large F QL

EasiVent Mask Medium F QL

EasiVent Mask Small F QL

Flexichamber-Lg Child Mask F QL

Flexichamber-Sm Adult Mask F QL

Flexichamber-Sm Child Mask F QL

InspiraChamber F QL






115


InspiraChamber with Mask-Large F QL

InspiraChamber with Mask-Med F QL

InspiraChamber with Mask-Small F QL

Lite Touch-Medium Mask F QL

LiteAire MDI Chamber F QL

LiteTouch-Large Mask F QL

LiteTouch-Small Mask F QL

Microchamber F QL

Microspacer F QL

Mouthpiece F OTC; QL

One Way Valved Mouthpiece F OTC; QL

Optichamber Adult Mask-Large F QL

OptiChamber Diamond Lg Mask F QL

OptiChamber Diamond VHC F QL

OptiChamber Diamond-Med Msk F QL

OptiChamber Diamond-Sml Mask F QL

Panda Mask F OTC; QL

Pediatric Medium Mask F OTC; QL

Pediatric Panda Mask F OTC; QL

Pediatric Small Mask F OTC; QL

POCKET CHAMBER F QL

PrimeAire F QL

Pro Comfort Spacer-Adult Mask F QL

Pro Comfort Spacer-Child Mask F QL

ProChamber F QL

RiteFlo Aerochamber F QL

Sidestream Pediatric Face Mask F OTC; QL

Silicone Mask - Infant F QL

Silicone Mask - Pediatric F OTC; QL

Space Chamber Plus F QL

Vortex Adult Mask F OTC; QL

Vortex Frog Mask-Child F OTC; QL

Vortex Holding Chamber F QL






116


Vortex Holding Chamber Child F QL

Vortex Holding Chamber Toddler F QL

Vortex Ladybug Mask-Toddler F OTC; QL

Vortex VHC Frog Mask-Child F QL

Vortex VHC Ladybug Mask-Toddlr F QL

Medical Supplies And Dme - Urine

Ketone Tests

Ketone Care F OTC

Ketone Urine Test F OTC

Ketostix F OTC

TRUEplus Ketone F OTC

Medical Supply, Fdb Superset

Medical Supply, Fdb Superset

Accu-Chek Aviva Control Soln F OTC

Accu-Chek Aviva Plus test strp F OTC; QL

Accu-Chek FastClix Lancing Dev F OTC

Accu-Chek Guide F OTC; QL

Accu-Chek Guide Glucose Meter F OTC; QL

Accu-Chek Guide L1-L2 Ctrl Sol F OTC

Accu-Chek Guide Me Glucose Mtr F OTC; QL

Accu-Chek Multiclix Lancet F OTC; QL

Accu-Chek Multiclix Lancet kit F OTC

Accu-Chek SmartView Contrl Sol F OTC

Accu-Chek SmartView Test Strip F OTC; QL

Accu-Chek Soft Dev Lancets F OTC

Accu-Chek Softclix Lancet Dev F OTC

Accu-Chek Softclix Lancets F OTC; QL

Ace Aerosol Cloud Enhancer F QL

Advocate Syringes syringe 1 mL 30 gauge x 5/16 F OTC

Aerochamber Mini F QL

Aerochamber MV F QL

Aerochamber Plus Flow-Vu F QL






117


Aerochamber Plus Flow-Vu,L Msk F QL

Aerochamber Plus Flow-Vu,M Msk F QL

Aerochamber Plus Flow-Vu,S Msk F QL

Aerochamber Plus Z Stat F QL

AeroChamber Plus Z Stat Lg Msk F QL

AeroChamber Plus Z Stat Md Msk F QL

AeroChamber Plus Z Stat Sm Msk F QL

Aerochamber with Flowsignal F QL

AeroChamber Z-Stat Plus-Flw Sg F QL

Aerogear Action Asthma Kit F QL

AeroTrach Plus F QL

Aimsco Latex Condom F OTC; QL

Airzone Peak Flow Meter F OTC; QL

Asthma Check Meter F OTC; QL

Asthmapack Children's F QL

BD AutoShield Duo Pen Needle F OTC

BD INS SYR 0.3 ML 8MMX31G(1/2) F OTC



BD INS SYRN UF 1 ML 12.7MMX30G F OTC



BD INSULIN SYR UF 1 ML 8MMX31G F OTC

BD Insulin Syringe Half Unit syringe 0.3 mL 31


BD Insulin Syringe Micro-Fine syringe 1 mL 28


BD Insulin Syringe syringe 1 mL 28 gauge x 1/2" F OTC; QL

BD Insulin Syringe U-500 F

BD Insulin Syringe Ultra-Fine syringe 0.3 mL 30

gauge x 1/2", 0.3 mL 31 gauge x 5/16", 0.5 mL

30 gauge x 1/2", 0.5 mL 31 gauge x 5/16", 1 mL

30 gauge x 1/2", 1 mL 31 gauge x 5/16

F OTC; QL

BD Nano 2nd Gen Pen Needle F OTC






118


BD UF MICRO PEN NEEDLE 6MMX32G F OTC

BD UF MINI PEN NEEDLE 5MMX31G F OTC

BD UF NANO PEN NEEDLE 4MMX32G F OTC

BD UF ORIG PEN NDL 12.7MMX29G F OTC

BD UF SHORT PEN NEEDLE 8MMX31G F OTC

BD Ultra-Fine Micro Pen Needle needle 32 gauge

x 1/4" F OTC; QL

BD Ultra-Fine Mini Pen Needle needle 31 gauge

x 3/16" F OTC; QL

BD Ultra-Fine Nano Pen Needle needle 32 gauge

x 5/32" F OTC; QL

BD Ultra-Fine Orig Pen Needle needle 29 gauge

x 1/2" F OTC; QL

BD Ultra-Fine Short Pen Needle needle 31 gauge

x 5/16" F OTC; QL

BD VEO INS SYRING 1 ML 6MMX31G F OTC



BD Veo Insulin Syr Half Unit F OTC

blood pressure test kit-large F OTC; QL

blood pressure test kit-medium F OTC

blood pressure test kit-wrist F OTC

BreatheRite MDI Spacer F QL

BreatheRite Spacer-Mask, Neo. F QL

BreatheRite Spacer-Mask,Adult F QL

BreatheRite Spacer-Mask,Child F QL

BreatheRite Spacer-Mask,Infant F QL

BreatheRite Spacer-Mask,S.Chld F QL

BreatheRite Valved MDI Chamber F QL

BreatheRite Valved MDI Spacer F QL

Caya Contoured F

Clever Choice Chamber-Lrg Mask F QL

Clever Choice Chamber-Med Mask F QL

Clever Choice Chamber-Sm Mask F QL






119


Compact Space Chamber Plus F QL

Compact Space Chamber-Lrg Mask F QL

Compact Space Chamber-Med Mask F QL

Compact Space Chamber-Sm Mask F QL

Condoms-Prem Lubricated F OTC; QL

Durex Avanti Bare Real Feel F OTC; QL

EasiVent Holding Chamber F QL

EasiVent Mask Large F QL

EasiVent Mask Medium F QL

EasiVent Mask Small F QL

Easy Comfort Insulin Syringe syringe 1 mL 30

gauge x 5/16 F OTC

Easy Touch Insulin Syringe syringe 1 mL 28

gauge x 1/2", 1 mL 31 gauge x 5/16 F OTC; QL

Fantasy Condom F OTC; QL

FC2 Female Condom F OTC; QL

FemCap vaginal device 26 mm, 30 mm F QL

Flexichamber-Lg Child Mask F QL

Flexichamber-Sm Adult Mask F QL

Flexichamber-Sm Child Mask F QL

Hearing Aid Batteries F OTC; QL

In-Check Nasal With Mask F OTC; QL

In-Check Oral Flow Meter F OTC; QL

InspiraChamber F QL

InspiraChamber with Mask-Large F QL

InspiraChamber with Mask-Med F QL

InspiraChamber with Mask-Small F QL

insulin syringe-needle U-100 syringe 1 mL 29

gauge x 1/2", 1 mL 30 gauge x 3/8", 1 mL 31

gauge x 5/16

F OTC; QL

Ketone Care F OTC

Ketone Urine Test F OTC

Ketostix F OTC

Kimono Condoms(Non-lubricated) F OTC; QL






120


Kimono Maxx Condoms F OTC; QL

Kimono MicroThin Aqua Lube Con F OTC; QL

Kimono MicroThin Condoms F OTC; QL

Kimono MicroThin Large Condoms F OTC; QL

Kimono Textured Condoms F OTC; QL

Lite Touch-Medium Mask F QL

LiteAire MDI Chamber F QL

LiteTouch-Large Mask F QL

LiteTouch-Small Mask F QL

Microchamber F QL

Microlife Peak Flow Meter F OTC; QL

Microspacer F QL

Mini Wright Peak Flow Meter F QL

Mouthpiece F OTC; QL

One Way Valved Mouthpiece F OTC; QL

Optichamber Adult Mask-Large F QL

OptiChamber Diamond Lg Mask F QL

OptiChamber Diamond VHC F QL

OptiChamber Diamond-Med Msk F QL

OptiChamber Diamond-Sml Mask F QL

Panda Mask F OTC; QL

Peak Air Peak Flow Meter F OTC

Pediatric Medium Mask F OTC; QL

Pediatric Panda Mask F OTC; QL

Pediatric Small Mask F OTC; QL

Personal Best Full Range F OTC; QL

Piko 1 F OTC; QL

POCKET CHAMBER F QL

Pocket Peak Flow Meter F OTC; QL

PrimeAire F QL

Pro Comfort Spacer-Adult Mask F QL

Pro Comfort Spacer-Child Mask F QL

ProChamber F QL






121


RiteFlo Aerochamber F QL

SafeSnap Syringe syringe 1 mL 25 gauge x 5/8",

1 mL 27 gauge x 1/2", 3 mL F OTC

Sharps Container F OTC

Sidestream Pediatric Face Mask F OTC; QL

Silicone Mask - Infant F QL

Silicone Mask - Pediatric F OTC; QL

Smart Sense Lancets 26 gauge F OTC

Soft Touch Lancets F OTC; QL

Space Chamber Plus F QL

Sure-Ject Insulin Syringe syringe 1 mL 28 gauge

x 1/2" F OTC; QL

TRUEplus Ketone F OTC

Trustex Latex Condom F OTC; QL

Trustex Lubricated Condoms F OTC; QL

Trustex Non-Lub Condoms F OTC; QL

Trustex-RIA Lub/Spermicide F OTC; QL

Trustex-RIA Lubricated Condoms F OTC; QL

Trustex-RIA Non-Lub Condoms F OTC; QL

Truzone Peak Flow Meter F QL

UltiCare syringe 1 mL 30 gauge x 1/2" F OTC; QL

Ultra Comfort Insulin Syringe syringe 1 mL 28

gauge F OTC

Vortex Adult Mask F OTC; QL

Vortex Frog Mask-Child F OTC; QL

Vortex Holding Chamber F QL

Vortex Holding Chamber Child F QL

Vortex Holding Chamber Toddler F QL

Vortex Ladybug Mask-Toddler F OTC; QL

Vortex VHC Frog Mask-Child F QL

Vortex VHC Ladybug Mask-Toddlr F QL








122








Metabolic Disease Enzyme Replacement

Agents

Metabolic Disease Enzyme

Replacement, Fabry's Disease

Fabrazyme State Carve Out


Replacement, Gaucher's Disease

Cerezyme intravenous recon soln 400 unit State Carve Out

Elelyso State Carve Out

VPRIV State Carve Out


Replacement, Mucopolysaccharidosis

Aldurazyme State Carve Out

Elaprase State Carve Out

Naglazyme State Carve Out

Vimizim State Carve Out


Replacement, Pompe Disease

Lumizyme State Carve Out

Metabolic Modifiers

Hyperparathyroid Treatment Agents -

Vitamin D Analog-Type

calcitriol oral capsule F QL

calcitriol oral solution F AL

Metabolic Modifier - Carnitine

Replenisher Agents






123


Carnitor (sugar-free) State Carve Out

Carnitor intravenous State Carve Out

levocarnitine (with sugar) State Carve Out

levocarnitine oral tablet State Carve Out OTC

Metabolic Modifier - Gaucher's Disease,

Type-1, Substrate Reduction Tx

Cerdelga State Carve Out

Zavesca State Carve Out

Metabolic Modifier - Hereditary

Tyrosinemia Treatment Agents

Orfadin oral capsule 10 mg, 2 mg, 5 mg State Carve Out

Metabolic Modifier - Homocystinuria

Treatment Agents

Cystadane State Carve Out

Metabolic Modifier - Urea Cycle

Disorder Agents-Conjugating Agents

Ammonul State Carve Out

Buphenyl oral tablet State Carve Out

Ravicti State Carve Out

sodium phenylbutyrate oral powder State Carve Out

Metabolic Modifier-Carbamoyl

Phosphate Synthetase 1 (Cps 1)

Activator

Carbaglu State Carve Out

Pharmacoenhancer - Cytochrome P450

Inhibitors

Tybost State Carve Out

Pharmacological Chaperone Tx -

Alpha-Galactosidase A Enzyme

Stabilizer

Galafold State Carve Out

Phenylketonuria(Pku) Tx Agents -

Cofactor Of Phenylalanine Hydroxylase






124


Kuvan State Carve Out

Mouth-Throat-Dental - Preparations

Dental Product - Fluoride Preparations

Denta 5000 Plus F

DentaGel F AL

fluoride (sodium) oral drops F QL; AL

fluoride (sodium) oral tablet,chewable 0.25

mg(0.55 mg sod. fluoride) F AL

fluoride (sodium) oral tablet,chewable 0.5 mg

(1.1 mg sodium fluorid), 1 mg (2.2 mg sod.

fluoride)

F QL; AL

Fluoritab oral tablet,chewable 1 mg (2.2 mg sod.

fluoride) F AL

Ludent Fluoride F AL

Perio Med F OTC; QL

PreviDent 5000 Plus F

PreviDent dental gel F AL

SF F AL

SF 5000 Plus F

Mouth And Throat - Antifungals

clotrimazole mucous membrane F QL

nystatin oral suspension F QL

Mouth And Throat - Antiseptics

chlorhexidine gluconate mucous membrane F QL

Mouth And Throat - Glucocorticoids

triamcinolone acetonide dental F QL

Mouth And Throat - Local Anesthetic

Amides

lidocaine HCl mucous membrane jelly F

Lidocaine Viscous F

Mouth And Throat - Saliva Stimulants

pilocarpine HCl oral F






125


Periodontal Product - Tetracycline-

Type, Collagenase Inhibitors

doxycycline hyclate oral tablet 20 mg F QL

Multiple Sclerosis Agents

Multiple Sclerosis Agent - Interferons

Avonex (with albumin) Specialty PA; QL

Avonex intramuscular pen injector kit Specialty PA; QL

Avonex intramuscular syringe kit Specialty PA; QL

Multiple Sclerosis Agent - Others

glatiramer Specialty PA; QL

Glatopa subcutaneous syringe 20 mg/mL Specialty PA; QL

Tecfidera Specialty PA; QL

Multiple Sclerosis Agent - Potassium

Channel Blocker

dalfampridine F PA; QL; AL

Firdapse State Carve Out

Multiple Sclerosis Agent - Sphingosine

1-Phosphate Receptor Modulator

Gilenya oral capsule 0.5 mg Specialty PA; QL

Ophthalmic Agents

Artificial Tears And Lubricant

Combinations

Artificial Tears (PF) F OTC

Artificial Tears(dext70-hypro) F OTC

Artificial Tears(glycerin-peg) F OTC

Artificial Tears(pvalch-povid) F OTC

Bion Tears (PF) F OTC

Lubricant (p-glycol-glycerin) F OTC

Lubricant Eye (PG-PEG 400) F OTC

Lubricant Eye ophthalmic (eye) ointment 57.3-

42.5 % F OTC

Lubricant Eye(dextran70-hypml) F OTC






126


Lubricating Relief F OTC

Natural Tears (PF) F OTC

Refresh Lacri-Lube F OTC

Refresh P.M. F OTC

Systane (propylene glycol) F OTC

Systane Gel ophthalmic (eye) drops,gel F OTC

Systane Ultra F OTC

Ultra Lubricant Eye F OTC

Artificial Tears And Lubricant Single

Agents

Artificial Tears (polyvin alc) F OTC

Lubricant Eye Drops ophthalmic (eye)

dropperette F OTC

Lubricant Eye Drops ophthalmic (eye) drops 0.5

% F OTC

polyvinyl alcohol F OTC

Refresh Celluvisc F OTC

Refresh Liquigel F OTC

Refresh Plus F OTC

Refresh Tears F OTC

TheraTears ophthalmic (eye) dropperette,gel F OTC

Miotics - Cholinesterase Inhibitors

Phospholine Iodide F

Miotics - Direct Acting

pilocarpine HCl ophthalmic (eye) drops 1 %, 2 %,

4 % F

Ophthalmic - Antibacterial-


neomycin-bacitracin-poly-HC F

neomycin-polymyxin B-dexameth F

sulfacetamide-prednisolone F

tobramycin-dexamethasone F

Ophthalmic - Anticholinergics






127


atropine ophthalmic (eye) drops F

atropine ophthalmic (eye) ointment F

cyclopentolate ophthalmic (eye) drops 1 %, 2 % F

homatropine HBr F

tropicamide F

Ophthalmic - Antihistamine-

Decongestant Combinations

Allergy Eye (naphazoline-phen) F OTC

Eye Allergy Relief F OTC

Ophthalmic - Antihistamines

azelastine ophthalmic (eye) F QL

ketotifen fumarate F OTC; QL

Ophthalmic - Anti-Inflammatory,

Glucocorticoids

dexamethasone sodium phosphate ophthalmic

(eye) F

fluorometholone F QL

FML Forte F QL

FML S.O.P. F QL

Pred Mild F QL

prednisolone acetate F

prednisolone sodium phosphate ophthalmic (eye) F

Ophthalmic - Anti-Inflammatory,

Nsaids

diclofenac sodium ophthalmic (eye) F

flurbiprofen sodium F

ketorolac ophthalmic (eye) drops 0.5 % F QL

Ophthalmic - Beta Blockers-Carbonic

Anhydrase Inhibitor Combinations

dorzolamide-timolol F QL

Ophthalmic - Carbonic Anhydrase

Inhibitors

dorzolamide F QL






128


Ophthalmic - Decongestants

phenylephrine HCl ophthalmic (eye) drops 2.5 % F

Ophthalmic - Hyperosmolar Agents

Artificial Tears(dext70-hypro) ophthalmic (eye)

drops F OTC

sodium chloride ophthalmic (eye) F OTC

Ophthalmic - Intraocular Pressure

Reducing Agents, Beta-Blockers

betaxolol ophthalmic (eye) F

carteolol F

levobunolol ophthalmic (eye) drops 0.5 % F

metipranolol F

timolol maleate ophthalmic (eye) drops F

Ophthalmic - Local Anesthetic Esters

proparacaine F

Ophthalmic - Mast Cell Stabilizers

cromolyn ophthalmic (eye) F

Ophthalmic Antibacterial Mixtures

bacitracin-polymyxin B ophthalmic (eye) F

neomycin-bacitracin-polymyxin F

neomycin-polymyxin-gramicidin F

polymyxin B sulf-trimethoprim F

Ophthalmic Antibiotic -

Aminoglycosides

gentamicin ophthalmic (eye) F

tobramycin F


Dehydropeptidase Inhibitors

bacitracin ophthalmic (eye) F


Fluoroquinolones

ciprofloxacin HCl ophthalmic (eye) F QL






129


levofloxacin ophthalmic (eye) F

ofloxacin ophthalmic (eye) F

Ophthalmic Antibiotic - Macrolides

erythromycin ophthalmic (eye) F

Ophthalmic Antibiotic - Sulfonamides

sulfacetamide sodium ophthalmic (eye) F

Ophthalmic Antivirals

trifluridine F

Ophthalmic-Intraocular Press.

Reducing, Sel. Alpha Adrenergic

Agonists

apraclonidine F QL

brimonidine ophthalmic (eye) drops 0.2 % F

Ophthalmic-Intraocular Pressure

Reducing Agents, Prostaglandin

Analogs

latanoprost F QL

Otic (Ear)

Otic (Ear) - Anti-Infective-


Ciprodex F QL

neomycin-polymyxin-HC otic (ear) F

Otic (Ear) - Anti-Infectives Other

acetic acid otic (ear) F

Otic (Ear) - Fluoroquinolones

ciprofloxacin HCl otic (ear) F QL

ofloxacin otic (ear) F QL

Otic (Ear) - Glucocorticoids

hydrocortisone-acetic acid F

Respiratory Therapy Agents

2Nd Generation Antihistamine-

Decongestant Combinations






130


All Day Allergy-D F OTC; QL

AllerClear D-24hr F OTC; QL

Allergy and Congestion Relief oral tablet

extended release 24 hr F OTC; QL

Allergy Complete-D F OTC; QL

Allergy Relief D-24hr F OTC; QL

Allergy Relief,Nasal Decongest F OTC; QL

Allergy Relief-D (cetirizine) F OTC; QL

Allergy-Congestion Relief-D oral tablet extended

release 24 hr F OTC; QL

Aller-Tec D F OTC; QL

cetirizine-pseudoephedrine F OTC; QL

Lorata-D F OTC; QL

lorata-dine D F OTC; QL

Loratadine-D oral tablet extended release 24 hr F OTC; QL

Wal-itin D F OTC; QL

Wal-Zyr D F OTC; QL

Antihistamine - 1St Generation -

Alkylamines

chlorpheniramine maleate oral tablet F OTC

chlorpheniramine maleate oral tablet extended

release F OTC


Ethanolamines

carbinoxamine maleate oral liquid F

carbinoxamine maleate oral tablet 4 mg F

clemastine oral tablet F

diphenhydramine HCl injection solution 50

mg/mL F AL

diphenhydramine HCl injection syringe F AL


diphenhydramine HCl oral elixir F OTC

diphenhydramine HCl oral liquid F OTC

diphenhydramine HCl oral syrup F OTC






131




Phenothiazines




Piperidines

cyproheptadine F AL

Antihistamines - 1St Generation

carbinoxamine maleate oral liquid F

carbinoxamine maleate oral tablet 4 mg F

chlorpheniramine maleate oral tablet F OTC

chlorpheniramine maleate oral tablet extended

release F OTC

clemastine oral tablet F

cyproheptadine F AL

diphenhydramine HCl injection solution 50

mg/mL F AL

diphenhydramine HCl injection syringe F AL


diphenhydramine HCl oral elixir F OTC

diphenhydramine HCl oral liquid F OTC

diphenhydramine HCl oral syrup F OTC




Unisom SleepGels State Carve Out OTC

Unisom SleepMelts State Carve Out OTC

Antihistamines - 2Nd Generation

cetirizine oral solution F OTC; QL; AL

cetirizine oral tablet F OTC; QL

Children's Allergy Relief(fex) F OTC

fexofenadine oral suspension F OTC






132


fexofenadine oral tablet 180 mg, 60 mg F OTC

loratadine oral solution F OTC; QL; AL

loratadine oral tablet F OTC; QL

loratadine oral tablet,disintegrating F OTC

Antihistamines - 2Nd Generation -

Piperazines

cetirizine oral solution F OTC; QL; AL

cetirizine oral tablet F OTC; QL

Antihistamines - 2Nd Generation -

Piperidines

Children's Allergy Relief(fex) F OTC

fexofenadine oral suspension F OTC

fexofenadine oral tablet 180 mg, 60 mg F OTC

loratadine oral solution F OTC; QL; AL

loratadine oral tablet F OTC; QL

loratadine oral tablet,disintegrating F OTC

Antitussives - Non-Opioid

benzonatate oral capsule 100 mg, 200 mg F AL

Asthma Therapy - Inhaled

Corticosteroids (Glucocorticoids)

ArmonAir RespiClick inhalation aerosol powdr

breath activated 232 mcg/actuation, 55

mcg/actuation

F QL

budesonide inhalation F QL; AL

Flovent HFA F QL; AL

Pulmicort Flexhaler F QL

Qvar RediHaler F QL

Asthma Therapy - Leukotriene


montelukast oral granules in packet F QL; AL

montelukast oral tablet F QL

montelukast oral tablet,chewable F QL

Asthma Therapy - Mast Cell Stabilizers






133


cromolyn inhalation F

Asthma Therapy - Xanthines

theophylline oral elixir F

theophylline oral solution F

theophylline oral tablet extended release 12 hr F

theophylline oral tablet extended release 24 hr F

Asthma/Copd - Anticholinergic Agents,

Inhaled Long Acting

Incruse Ellipta F QL

Spiriva Respimat inhalation mist 1.25

mcg/actuation F PA; QL; AL

Asthma/Copd - Anticholinergic Agents,

Inhaled Short Acting

Atrovent HFA F QL

ipratropium bromide inhalation F

Asthma/Copd Therapy - Beta 2-

Adrenergic Agents, Inhaled, Long

Acting

Serevent Diskus F QL

Asthma/Copd Therapy - Beta 2-

Adrenergic Agents, Inhaled, Short

Acting

albuterol sulfate inhalation HFA aerosol inhaler F QL

albuterol sulfate inhalation solution for

nebulization 0.63 mg/3 mL, 1.25 mg/3 mL F QL

albuterol sulfate inhalation solution for

nebulization 2.5 mg /3 mL (0.083 %), 2.5 mg/0.5

mL, 5 mg/mL

F

levalbuterol HCl inhalation solution for

nebulization 0.31 mg/3 mL, 0.63 mg/3 mL, 1.25

mg/3 mL

F

levalbuterol tartrate F ST; QL

Asthma/Copd Therapy - Beta

Adrenergic Agents






134


albuterol sulfate oral syrup F

terbutaline oral F


Adrenergic-Anticholinergic

Combinations

Bevespi Aerosphere F ST

Combivent Respimat F QL

ipratropium-albuterol F QL


Adrenergic-Glucocorticoid

Combinations

Dulera F QL; AL

fluticasone propion-salmeterol inhalation aerosol

powdr breath activated F QL

fluticasone propion-salmeterol inhalation blister

with device 100-50 mcg/dose, 250-50 mcg/dose,

500-50 mcg/dose

F QL; AL

Symbicort inhalation HFA aerosol inhaler 160-4.5

mcg/actuation, 80-4.5 mcg/actuation F QL; AL

Wixela Inhub inhalation blister with device 100-

50 mcg/dose, 250-50 mcg/dose, 500-50 mcg/dose F QL; AL

Cystic Fibrosis - Inhaled

Aminoglycosides

Bethkis F PA

Kitabis Pak Specialty

Tobi Podhaler Specialty PA

tobramycin in 0.225 % NaCl Specialty PA

tobramycin with nebulizer Specialty PA

Cystic Fibrosis - Inhaled Monobactams

Cayston Specialty PA

Cystic Fibrosis-Transmembrane

Conductance Regulator (Cftr)

Potentiator

Kalydeco oral granules in packet 50 mg, 75 mg State Carve Out






135


Kalydeco oral tablet State Carve Out

Cystic Fib-Transmemb Conduct.

Reg.(Cftr) Potentiator And Corrector

Cmb

Orkambi oral tablet 200-125 mg State Carve Out

Mucolytics

acetylcysteine F

Pulmozyme Specialty PA; QL

Nasal Anticholinergics

ipratropium bromide nasal F

Nasal Antihistamines

azelastine nasal aerosol,spray F QL

Nasal Corticosteroids

Allergy Relief (fluticasone) F OTC; QL

Flonase Allergy Relief F OTC; QL

flunisolide nasal spray,non-aerosol 25 mcg (0.025

%) F QL

fluticasone propionate nasal F OTC; QL

Nasacort F OTC; QL

Nasal Mast Cell Stabilizers

cromolyn nasal F OTC

Nasalcrom F OTC

Nasal Moisturizers

Baby Ayr Saline F OTC

Nasal Spray (sodium chloride) F OTC

Opioid Antitussive-Expectorant

Combinations

codeine-guaifenesin F OTC; QL; AL

Virtussin AC F OTC; QL; AL

Systemic Sympathomimetic

Decongestants

pseudoephedrine HCl oral tablet 30 mg, 60 mg F OTC; QL; AL






136


Vaginal Products

Vaginal Antibacterial - Lincosamides

clindamycin phosphate vaginal F

Vaginal Antifungal - Imidazoles

Clotrimazole 3 Day F OTC

clotrimazole vaginal cream F OTC

miconazole nitrate vaginal comb pack,prefill appl,

cream F OTC

miconazole nitrate vaginal cream F OTC

Miconazole-3 prefil,cream,wipe F OTC

Miconazole-3 vaginal kit F OTC

Monistat 7 vaginal comb pack,prefill appl, cream F OTC

Vaginal Antifungal - Triazoles

terconazole vaginal cream F

Vaginal Antiprotozoal-Antibacterial -

Nitroimidazole Derivatives

metronidazole vaginal F

Vaginal Estrogens

estradiol vaginal cream F QL

estradiol vaginal tablet F

Yuvafem F

137

Index

INDEX \e " " \c "3" \h "A" \z "1033"

50 Plus Adult Eye Health, 1, 70

8 Hour Pain Reliever, 3

A Thru Z, 70

A Thru Z Advanced Formula, 75

A Thru Z Men's Ultimate, 70

A Thru Z Select, 70

A Thru Z Select Women's, 70

abacavir, 12

abacavir-lamivudine-zidovudine, 13

Abilify, 43, 47

Abilify Maintena, 43

Abreva, 60

acamprosate, 52

acarbose, 85

Accu-Chek Aviva Control Soln, 110, 116

Accu-Chek Aviva Plus test strp, 109, 116

Accu-Chek FastClix Lancing Dev, 110, 116

Accu-Chek Guide, 109, 116

Accu-Chek Guide Glucose Meter, 110, 116

Accu-Chek Guide L1-L2 Ctrl Sol, 110, 116

Accu-Chek Guide Me Glucose Mtr, 110, 116

Accu-Chek Multiclix Lancet, 110, 116

Accu-Chek SmartView Contrl Sol, 110, 116

Accu-Chek SmartView Test Strip, 109, 116

Accu-Chek Soft Dev Lancets, 110, 116

Accu-Chek Softclix Lancet Dev, 110, 116

Accu-Chek Softclix Lancets, 110, 116

Ace Aerosol Cloud Enhancer, 113, 116

acebutolol, 30

acetaminophen, 3

Acetaminophen Extra Strength, 3

Acetaminophen Pain Relief, 3

acetaminophen-codeine, 2

acetazolamide, 32

acetic acid, 129

acetylcysteine, 8, 135

Acid Controller, 94

Acid Gone Antacid, 91

Acid Gone Antacid E.Strength, 91

Acid Reducer (famotidine), 94

acitretin, 60

Actemra, 6

Actemra ACTPen, 6

Acthrel, 63

Actical, 70

acyclovir, 16

Adacel(Tdap Adolesn/Adult)(PF), 25

Adasuve, 42

Adderall, 44, 48, 50

Adderall XR, 44, 48

adefovir, 15

Adempas, 33

Admelog SoloStar U-100 Insulin, 89

Admelog U-100 Insulin lispro, 89

Adult Multivitamin Gummies, 70

Adult One Daily Gummies, 70

Advate, 105

Advocate Syringes, 111, 116

Adynovate, 105

Adzenys ER, 44, 48

Adzenys XR-ODT, 44, 48

Aerochamber Mini, 113, 116

Aerochamber MV, 113, 116

Aerochamber Plus Flow-Vu, 113, 116

Aerochamber Plus Flow-Vu,L Msk, 114, 117

Aerochamber Plus Flow-Vu,M Msk, 114, 117

Aerochamber Plus Flow-Vu,S Msk, 114, 117

Aerochamber Plus Z Stat, 114, 117

AeroChamber Plus Z Stat Lg Msk, 114, 117

AeroChamber Plus Z Stat Md Msk, 114, 117

AeroChamber Plus Z Stat Sm Msk, 114, 117

Aerochamber with Flowsignal, 114, 117

AeroChamber Z-Stat Plus-Flw Sg, 114, 117

Aerogear Action Asthma Kit, 113, 117

AeroTrach Plus, 114, 117

Afinitor, 22

Afinitor Disperz, 22

Afluria Qd 2019-20(3yr up)(PF), 25

Afluria Qd 2019-20(6-35mo)(PF), 25

Afluria Quad 2019-20(6mo up), 25

Afstyla, 105

Aftera, 56, 57

Aimovig Autoinjector, 49

Aimsco Latex Condom, 112, 117

Airzone Peak Flow Meter, 113, 117

Alba-Lybe, 63

Albuminar 25 %, 106

Albuminar 5 %, 106

albuterol sulfate, 133, 134

alcohol swabs, 24

Aldurazyme, 122

alendronate, 87

alfuzosin, 102

Alkeran, 19

All Day Allergy-D, 130

AllerClear D-24hr, 130

138

Allergy and Congestion Relief, 130

Allergy Complete-D, 130

Allergy Eye (naphazoline-phen), 127

Allergy Relief (fluticasone), 135

Allergy Relief D-24hr, 130

Allergy Relief,Nasal Decongest, 130

Allergy Relief-D (cetirizine), 130

Allergy-Congestion Relief-D, 130

Aller-Tec D, 130

allopurinol, 104

alogliptin, 85

alogliptin-metformin, 87

alogliptin-pioglitazone, 86

Alphanate, 105

AlphaNine SD, 104

alprazolam, 34, 45

Alprazolam Intensol, 34, 45

Alprolix, 105

aluminum hydroxide gel, 91

Alunbrig, 19

Alyacen 1/35 (28), 53

amantadine HCl, 41

amiloride, 32

amiloride-hydrochlorothiazide, 32

aminocaproic acid, 106

amiodarone, 28

Amitiza, 96, 97

amitriptyline, 40

amitriptyline-chlordiazepoxide, 40, 45

amlodipine, 30

amlodipine-benazepril, 26

amlodipine-valsartan, 27

ammonia aromatic, 48

ammonium lactate, 60

Ammonul, 123

Amnesteem, 57

amoxapine, 40

amoxicillin, 9

amoxicillin-pot clavulanate, 9

amphetamine sulfate, 44, 48, 50

ampicillin, 9

Amytal, 51

anagrelide, 107

anastrozole, 20

ANIMAL CHEWS, 78

Animal Shape Vitamins, 78

Animal Shapes Complete, 78

Antabuse, 52

Antacid (calcium carbonate), 91

Antacid Anti-Gas, 92

Antacid Anti-Gas (ca carb-sim), 92

Antacid Calcium, 91

Antacid ExSt (mag carb-Al hyd), 91

Antacid-Simethicone, 92

Antifungal (tolnaftate), 59

Anti-Itch (HC), 60

Antioxidant A/C/E/Selenium, 1, 70

Antioxidant Formula (selenium), 1, 70

Apetex, 63

Apetigen, 63

Apetigen Plus, 65

Aplenzin, 40

apraclonidine, 129

Apriso, 96

Aptensio XR, 44

Aptiom, 36

Aptivus, 17

AquADEKs, 70

AquADEKs Pediatric, 78

Aqua-E, 83

Aranelle (28), 55

Aranesp (in polysorbate), 104

Arcalyst, 4

aripiprazole, 43, 47

Aristada, 43

Arkaliox, 81

armodafinil, 50

ArmonAir RespiClick, 132

Armour Thyroid, 90

Arthritis Pain Relief (acetam), 3

Arthritis Pain Reliever, 3

Artificial Tears (PF), 125

Artificial Tears (polyvin alc), 126

Artificial Tears(dext70-hypro), 125, 128

Artificial Tears(glycerin-peg), 125

Artificial Tears(pvalch-povid), 125

Aspercreme (lidocaine), 62

aspirin, 8, 107

Asthma Check Meter, 113, 117

Asthmapack Children's, 113, 117

atenolol, 30

atenolol-chlorthalidone, 31

atomoxetine, 45

atorvastatin, 29

atovaquone, 11

Atripla, 13

atropine, 127

Atrovent HFA, 133

ATryn, 107

Aubra, 53

139

Aubra EQ, 53

Auryxia, 67, 101, 102

Aviane, 53

Avonex, 125

Avonex (with albumin), 125

azathioprine, 6, 108

azelastine, 127, 135

azithromycin, 17

B Complex, 65

B Complex 100, 65

B Complex Plus Vitamin C, 63

B Complex w-Vit C, 81

B Complex-Vitamin B12, 65

B complex-vitamin C-folic acid, 63

B-100 Complex, 63

Baby Ayr Saline, 135

bacitracin, 58, 128

bacitracin zinc, 58

bacitracin-polymyxin B, 128

baclofen, 109

Bacmin, 70

Balanced B-100 Complex, 63

Balanced B-50, 65

balsalazide, 96

Balziva (28), 53

Banzel, 38

Basaglar KwikPen U-100 Insulin, 89

B-Complex Plus Vit C (calcium), 63

B-Complex With B-12, 81

B-complex with vitamin C, 63

BD AutoShield Duo Pen Needle, 111, 117

BD Insulin Syringe, 111, 117

BD Insulin Syringe Half Unit, 111, 117

BD Insulin Syringe Micro-Fine, 111, 117

BD Insulin Syringe U-500, 111, 117

BD Insulin Syringe Ultra-Fine, 111, 117

BD Nano 2nd Gen Pen Needle, 111, 117

BD Ultra-Fine Micro Pen Needle, 111, 118

BD Ultra-Fine Mini Pen Needle, 111, 118

BD Ultra-Fine Nano Pen Needle, 111, 118

BD Ultra-Fine Orig Pen Needle, 111, 118

BD Ultra-Fine Short Pen Needle, 111, 112, 118

BD Veo Insulin Syr Half Unit, 112, 118

BD Veo Insulin Syringe UF, 112, 118

Beelith, 69

Belsomra, 51

benazepril, 26

benznidazole, 11

benzonatate, 132

benzoyl peroxide, 58

benztropine, 41

Berinert, 104

betamethasone dipropionate, 60

betamethasone valerate, 60

betamethasone, augmented, 61

betaxolol, 30, 128

bethanechol chloride, 103

Bethkis, 134

Bevespi Aerosphere, 134

bexarotene, 24

bicalutamide, 20

Bio-35, Gluten Free, 70

Biocal, 66

Biocel (with Lutein), 70

Bion Tears (PF), 125

Biopetit, 63

biotin, 82

Biotin Plus-Calcium and Vit D3, 70

bisacodyl, 99

Bismatrol, 92

Bismuth, 92

bismuth subsalicylate, 92

bisoprolol fumarate, 30

bisoprolol-hydrochlorothiazide, 31

Blisovi 24 Fe, 54

Blisovi Fe 1.5/30 (28), 54

Blisovi Fe 1/20 (28), 54

blood pressure test kit-large, 113, 118

blood pressure test kit-medium, 113, 118

blood pressure test kit-wrist, 113, 118

Body, Hair, Skin and Nails, 70

Boostrix Tdap, 25

Bosulif, 23

Braftovi, 21

BreatheRite MDI Spacer, 114, 118

BreatheRite Spacer-Mask, Neo., 114, 118

BreatheRite Spacer-Mask,Adult, 114, 118

BreatheRite Spacer-Mask,Child, 114, 118

BreatheRite Spacer-Mask,Infant, 114, 118

BreatheRite Spacer-Mask,S.Chld, 114, 118

BreatheRite Valved MDI Chamber, 114, 118

BreatheRite Valved MDI Spacer, 114, 118

Brewer's Yeast, 65

Briellyn, 54

brimonidine, 129

Brisdelle, 90

bromocriptine, 41

budesonide, 132

bumetanide, 32

Buminate 25 %, 106

140

Bunavail, 52

Buphenyl, 123

buprenorphine HCl, 52

buprenorphine-naloxone, 52

bupropion HCl, 40, 52

buspirone, 34

Butalbital Compound W/Codeine, 2

butalbital-acetaminop-caf-cod, 2

butalbital-acetaminophen, 4

butalbital-acetaminophen-caff, 4

butalbital-aspirin-caffeine, 8

cabergoline, 90

caffeine citrate, 48

Calcet Petites, 67

calcipotriene, 60

calcitonin (salmon), 87

Calcitrate, 66

Cal-Citrate, 67

calcitriol, 83, 122

Calcium 500 + D, 67

Calcium 600 + D(3), 67

Calcium 600 + Minerals, 66

Calcium 600-D3 Plus (mag-zinc), 66

calcium acetate, 66, 101

Calcium Antacid, 91

calcium carbonate, 66, 91, 92

calcium carbonate-vit D3-min, 66

calcium carbonate-vitamin D3, 67

calcium citrate, 66

calcium citrate-vitamin D3, 67

Calcium Magnesium + D, 66

calcium phosphate-vitamin D3, 67

Cal-Gest Antacid, 92

Calphron, 101

Caltrate with Vitamin D3, 67

Canasa, 96

capecitabine, 20

Caprelsa, 23

capsaicin, 62

Carbaglu, 123

carbamazepine, 36, 46

carbidopa-levodopa, 41

carbinoxamine maleate, 130, 131

Carnitor, 123

Carnitor (sugar-free), 123

carteolol, 128

carvedilol, 26

Caya Contoured, 110, 118

Cayston, 134

Caziant (28), 55

cefaclor, 14

cefadroxil, 14

cefdinir, 14

cefixime, 14

cefpodoxime, 14

cefprozil, 14

cefuroxime axetil, 14

celecoxib, 7

Celontin, 38

Central-Vite Cardio, 70

Central-Vite Select, 66, 70

Central-Vite Women's Mature, 70

Centravites, 70

Centravites 50 Plus, 66

Centrum Complete, 75

Centrum Men, 70

Centrum Silver, 70

Centrum Silver Ultra Men's, 70

Centrum Silver Women, 70

Centrum Specialist Heart, 70

Centrum Ultra Men's, 70

Century, 75

Century Cardio, 71

Century Ultimate Men's, 71

Century Ultimate Women's, 71, 76

cephalexin, 14

Ceprotin (Blue Bar), 107

Ceprotin (Green Bar), 107

Cerdelga, 123

Cerebyx, 36

Cerefolin, 76

Cerefolin NAC (algal oil), 81

Cerezyme, 122

Cerovite Advanced Formula, 76

Cerovite Jr, 79

Certa Plus, 71

Certavite-Antioxidant, 76

cetirizine, 131, 132

cetirizine-pseudoephedrine, 130

Chantix, 53

Chantix Continuing Month Box, 53

Chantix Starting Month Box, 53

Chemet, 8

Chewable-Vite, 76, 78

Chewable-Vite with Iron, 79

Child Complete Multivitamin, 79

Child Multivitamins, 78

Children's Acetaminophen, 3

Children's Allergy Relief(fex), 131, 132

Children's Chew Multivit-Iron, 79

141

Children's Chewable, 78

Children's Chewable Multivitmn, 78

Children's Chewable Vitamin, 78

Children's Chewables, 78

Children's Chewables Extra C, 78

Children's Chewables with Iron, 78

Children's Complete Vitamin, 79

Children's Easy-Melts, 3

Children's Ibuprofen, 7

Children's Pain-Fever Relief, 3

Childs Chew Vite, 78

Child's Chewable Vitamins/Iron, 79

Childs/Iron, 79

chlordiazepoxide HCl, 34, 45

chlorhexidine gluconate, 124

chloroquine phosphate, 10

chlorothiazide, 32

chlorpheniramine maleate, 130, 131

chlorpromazine, 42

chlorthalidone, 32

chlorzoxazone, 109

cholecalciferol (vitamin D3), 83

cholestyramine (with sugar), 28

Cholestyramine Light, 28

choline bitartrate, 29

choline dihydrogen citrate, 65

choline,magnesium salicylate, 8

ciclopirox, 59

cilostazol, 107

cimetidine, 94

Cimzia, 4, 5, 97

Cimzia Powder for Reconst, 4, 5, 97

Cimzia Starter Kit, 4, 5, 97

Cinryze, 104

Ciprodex, 129

ciprofloxacin, 15

ciprofloxacin HCl, 15, 128, 129

citalopram, 38

Citracal + D Maximum, 67

Claravis, 57

clarithromycin, 17

clemastine, 130, 131

Clever Choice Chamber-Lrg Mask, 114, 118

Clever Choice Chamber-Med Mask, 114, 118

Clever Choice Chamber-Sm Mask, 114, 118

clindamycin HCl, 17

clindamycin palmitate HCl, 17

clindamycin phosphate, 57, 136

clindamycin-benzoyl peroxide, 58

clobetasol, 61

clomipramine, 40

clonazepam, 34, 35, 45

clonidine, 31

clonidine HCl, 31, 44

clopidogrel, 107

clorazepate dipotassium, 34, 45

clotrimazole, 59, 124, 136

Clotrimazole 3 Day, 136

clotrimazole-betamethasone, 59

clozapine, 42

codeine sulfate, 1

codeine-butalbital-ASA-caff, 2

codeine-guaifenesin, 135

Colace Clear, 100

colchicine, 103

colestipol, 28

Col-Rite, 100

Combivent Respimat, 134

Cometriq, 22

Compact Space Chamber Plus, 114, 119

Compact Space Chamber-Lrg Mask, 114, 119

Compact Space Chamber-Med Mask, 114, 119

Compact Space Chamber-Sm Mask, 114, 119

Compete, 71

Complera, 13

Complete, 71

Complete Multi, 71

Complete Multi 50+, 71

Complete Multivitamin, 71

Complete Multivitamin-Mineral, 76

Complete Premium Vitamin, 71

Complete Senior, 66

CompleteNate, 80

Complex B-100, 64, 65

Complex B-50, 64

Concerta, 44

Condoms-Prem Lubricated, 112, 119

Corifact, 106

Correctol, 99

Cortizone-10, 61

Corvite Free, 71

cosyntropin, 63

Cotellic, 22

Cotempla XR-ODT, 44

Creon, 94

Crixivan, 18

cromolyn, 128, 133, 135

cyanocobalamin (vitamin B-12), 82

Cyclafem 1/35 (28), 54

cyclobenzaprine, 109

142

cyclopentolate, 127

cyclophosphamide, 6, 19

cycloserine, 13

cyclosporine, 6, 108

cyclosporine modified, 6, 108

Cyklokapron, 106

Cymbalta, 39, 49

cyproheptadine, 131

Cystadane, 123

Cyto B7, 82

Cytra K Crystals, 102

Cytra-2, 102

D3-2000, 83

Daily Fiber, 97

Daily Gummies, 71

Daily Multiple, 71, 76

Daily Multiple For Women, 76

Daily Multivitamin, 71

Daily Multi-Vitamin, 76

Daily Multivitamin with Iron, 76

Daily Multivitamin-Minerals, 66, 71

Daily Multi-Vitamins/Iron, 71

Daily Value, 76

Daily Vitamin Formula, 76

Daily Vitamin Formula-Iron, 76

DAILY VITAMIN FORMULA-MINERALS, 71

Daily Vitamin with Iron, 71

Daily Vites/Iron, 71

Daily-Vite, 71, 76

dalfampridine, 125

danazol, 88

dantrolene, 109

dapsone, 10

Daraprim, 10

Dasetta 1/35 (28), 54

Daurismo, 21

Daytrana, 44

Decubi Vite, 76

Delta D3, 83

Delzicol, 96

Denta 5000 Plus, 124

DentaGel, 124

Depacon, 35

Depakote ER, 35, 46, 49

Depakote Sprinkles, 35, 46

Descovy, 12

desipramine, 40

desmopressin, 85

desog-e.estradiol/e.estradiol, 53

desogestrel-ethinyl estradiol, 54

desvenlafaxine, 39

Dex4 Glucose, 84

dexamethasone, 88

dexamethasone sodium phosphate, 127

dexmethylphenidate, 44

dextroamphetamine, 44, 48, 50

dextroamphetamine-amphetamine, 44, 48, 50

dextrose, 84

Diabetes Health Formula, 71

Dialyvite, 64, 65

DIALYVITE 3000, 64

Dialyvite 5000, 71

Dialyvite 800, 64

Dialyvite 800 Plus D, 64

Dialyvite 800 with Zinc 15, 64

Dialyvite 800 with Zinc 50, 64

Dialyvite 800-Ultra D, 64

Dialyvite Supreme D, 64

Dialyvite Vitamin D, 83

Dialyvite Vitamin D3 Max, 83

Diamode, 92

Diastat AcuDial, 35, 45

diazepam, 34, 35, 45

Diazepam Intensol, 34, 45

diclofenac sodium, 7, 60, 62, 127

dicloxacillin, 17

dicyclomine, 96

didanosine, 12

Differin, 58

Dificid, 17

digoxin, 32

Dilantin, 36

Dilantin Extended, 36

Dilantin Infatabs, 36

diltiazem HCl, 30

dimenhydrinate, 93

Dino-Life, 78

Dino-Life with Extra C, 78

Dino-Life with Iron-Zinc, 78, 79

Diocto, 100

Dioctyl, 100

Diotame, 92

Dipentum, 96

diphenhydramine HCl, 50, 130, 131

diphenoxylate-atropine, 93

dipyridamole, 107

disopyramide phosphate, 28

disulfiram, 52

Diuril, 33

divalproex, 35, 46, 49

143

Docuprene, 100

docusate calcium, 100

docusate sodium, 100

Docusil, 100

DOK, 100

donepezil, 53

Dopram, 47, 48

dorzolamide, 127

dorzolamide-timolol, 127

Dovato, 11

doxapram, 47, 48

doxazosin, 33

doxepin, 40

doxycycline hyclate, 18, 125

doxycycline monohydrate, 18

dronabinol, 47, 63, 93

droperidol, 8

drospirenone-ethinyl estradiol, 54

Droxia, 108

Dulcolax Stool Softener (dss), 100

Dulera, 134

duloxetine, 39, 49

Durex Avanti Bare Real Feel, 112, 119

Dyanavel XR, 44, 48

E-400 C-500 and Beta Carotene, 1, 76

EasiVent Holding Chamber, 114, 119

EasiVent Mask Large, 114, 119

EasiVent Mask Medium, 114, 119

EasiVent Mask Small, 114, 119

Easy Comfort Insulin Syringe, 112, 119

Easy Touch Insulin Syringe, 112, 119

econazole, 59

EContra EZ, 56, 57

Econtra One-Step, 56, 57

Edluar, 51

Edurant, 12

Effexor XR, 39

Elaprase, 122

Elelyso, 122

Elidel, 60

Eliquis, 104

Eliquis DVT-PE Treat 30D Start, 104

Elmiron, 101

Eloctate, 105

Emcyt, 21

Emsam, 38

Emtriva, 12

enalapril maleate, 26

enalapril-hydrochlorothiazide, 26

Enbrel, 4, 5

Enbrel Mini, 4, 5

Enbrel SureClick, 4, 5

Endari, 63, 77, 101, 108

Endur-Acin, 82

Enema, 99

Enema Disposable, 99

Enemeez, 100

Enemeez Plus, 100

enoxaparin, 106

entecavir, 15

Entresto, 27

Enulose, 94

Epaned, 26

Epidiolex, 35

epinephrine, 31

Epivir, 12

Epogen, 104

Epzicom, 13

Equetro, 36, 46

ergocalciferol (vitamin D2), 83

Erivedge, 21

Erleada, 20

erythromycin, 129

erythromycin with ethanol, 57

escitalopram oxalate, 38

Essentia, 76

ESSENTIAL Balance with Lutein, 71, 76

ESSENTIAL Daily, 71

ESSENTIAL Man, 71

ESSENTIAL Man 50+, 71

Essential Woman 50+, 71

estazolam, 45, 51

estradiol, 88, 136

estradiol-norethindrone acet, 87

eszopiclone, 51

ethambutol, 14

ethosuximide, 38

etodolac, 8

etoposide, 21

Evekeo, 44, 48, 50

Evotaz, 12, 18

exemestane, 20

Ex-Lax (sennosides), 99

Ex-Lax Maximum Strength, 99

Exondys 51, 109

Eye Allergy Relief, 127

ezetimibe, 29

FaBB, 81, 84

Fabrazyme, 122

Falmina (28), 54

144

famciclovir, 16

famotidine, 95

Fanapt, 42

Fantasy Condom, 112, 119

Farydak, 21

FC2 Female Condom, 110, 119

febuxostat, 104

Feiba NF, 104

Felbatol, 35

felodipine, 31

FemCap, 109, 119

fenofibrate, 29

fenofibrate micronized, 28

fenofibrate nanocrystallized, 28

fenofibric acid (choline), 29

fentanyl, 1

Feosol, 67

FeroSul, 67

ferrous gluconate, 68

ferrous sulfate, 68

FerrouSul, 68

Fetzima, 39

Feverall, 3

fexofenadine, 131, 132

fiber, 97

Fiber (psyllium husk/sugar), 97

Fiber (with aspartame), 97

Fiber Laxative (ca polycarbo), 97

Fiber Smooth, 98

Fiber Smooth (sucrose), 98

Fiber Supplement (inulin), 98

Fiber-Tabs, 98

finasteride, 102

Firdapse, 125

Firvanq, 15

Fish Oil, 29

Fish Oil Extra Strength, 29

flavoxate, 103

flecainide, 28

Fleet Bisacodyl, 99

Fleet Enema, 99

Fleet Enema Extra, 99

Fleet Glycerin (Adult), 98

Fleet Glycerin (Child), 98

Fleet Pediatric, 99

Flexichamber-Lg Child Mask, 114, 119

Flexichamber-Sm Adult Mask, 114, 119

Flexichamber-Sm Child Mask, 114, 119

Flintstones Complete (iron), 79

Flintstones Gummies, 78

Flintstones Gummies Omega-3, 78

Flintstones Multivitamin, 78

Flintstones Plus Calcium, 79

Flintstones with Iron, 79

Flintstones/Extra C, 78

Flonase Allergy Relief, 135

Flovent HFA, 132

Fluarix Quad 2019-2020 (PF), 25

Flublok Quad 2019-2020 (PF), 25

fluconazole, 10

fludrocortisone, 90

Flulaval Quad 2019-2020, 25

Flulaval Quad 2019-2020 (PF), 25

flunisolide, 135

fluocinonide, 61

Fluocinonide-E, 61

fluoride (sodium), 124

Fluoritab, 124

fluorometholone, 127

fluorouracil, 59

fluoxetine, 38

fluphenazine decanoate, 42

fluphenazine HCl, 42

flurazepam, 45, 51

flurbiprofen, 7

flurbiprofen sodium, 127

flutamide, 20

fluticasone propionate, 61, 135

fluticasone propion-salmeterol, 134

fluvoxamine, 38

Fluzone High-Dose 2019-20 (PF), 25

Fluzone Quad 2019-2020, 25

Fluzone Quad 2019-2020 (PF), 25

Fluzone Quad Pedi 2019-20 (PF), 25

FML Forte, 127

FML S.O.P., 127

Foaming Antacid, 91

Focalin, 44

Focalin XR, 44

Folbee, 81, 84

Folbee AR, 64

Folbee Plus, 64

Folbic, 81, 84

Folgard, 65

Folgard RX, 81, 84

folic acid, 84

Folinic-Plus, 81

Folplex 2.2, 81, 84

Foltabs 800, 81

Foltanx, 81

145

Forfivo XL, 40

Fortavit, 76

Forteo, 87

Fosfree, 71

fosinopril, 26

Fosrenol, 101

Freedavite, 71

Fulphila, 106

furosemide, 32

Fuzeon, 11

Fycompa, 34

gabapentin, 35, 36

Gabitril, 36

Galafold, 123

galantamine, 53

Gas Relief, 95

Gas Relief 80, 95

Gas Relief Extra Strength, 95

Gas-X Extra Strength, 95

Gavilyte-C, 99

GaviLyte-G, 99

GaviLyte-N, 99

Gaviscon Extra Strength, 91

gemfibrozil, 29

Generlac, 94

gentamicin, 58, 128

Genvoya, 13

Geodon, 41, 47

Geri-kot, 99

Gilenya, 125

Gilotrif, 19

glatiramer, 125

Glatopa, 125

Gleevec, 23

Gleostine, 19

glimepiride, 86

glipizide, 86

glipizide-metformin, 86

GlucaGen HypoKit, 84

Glucagon Emergency Kit (human), 84

glucose, 84

Glucose Gel, 84

glyburide, 86

glyburide micronized, 86

glyburide-metformin, 86

glycerin (adult), 98

glycerin (child), 99

Glycophos, 69

glycopyrrolate, 96

Golytely, 99

granisetron HCl, 93

Granix, 106

griseofulvin microsize, 10

griseofulvin ultramicrosize, 10

guanfacine, 32, 44

Gynol II, 57

Hailey 24 Fe, 54

Hair Vitamins, 71

Hair, Skin and Nails-Argan Oil, 71

Hair,Skin and Nails, 72

Hair,Skin and Nails(FA-biotin), 72

halobetasol propionate, 61

haloperidol, 42

haloperidol decanoate, 42

haloperidol lactate, 42

Hard Nails, 82

Harvoni, 16

Havrix (PF), 25

Healthy Eyes SuperVision, 1, 72

Hearing Aid Batteries, 110, 119

Heartburn Antacid, 91

Heartburn Prevention, 95

Heartburn Relief, 91

Heartburn Relief (cimetidine), 95

Heartburn Relief (famotidine), 95

Hemangeol, 30

Hemlibra, 106

Hemofil M High, 105

Hemofil M Low, 105

Hemofil M Mid, 105

Hemofil M Super High, 105

heparin (porcine), 106

Hetlioz, 49

Hi-Cal Plus Vit D, 67

homatropine HBr, 127

Homocysteine Formula, 81

Honey Bears with Iron-Zinc, 78, 79

Humalog Mix 50-50 Insuln U-100, 89

Humalog Mix 50-50 KwikPen, 89

Humalog Mix 75-25 KwikPen, 89

Humalog Mix 75-25(U-100)Insuln, 89

Humalog U-100 Insulin, 89

Humate-P, 105

Humira, 4, 5, 97

Humira Pediatric Crohns Start, 4, 5, 97

Humira Pen, 4, 5, 97

Humira Pen Crohns-UC-HS Start, 4, 5, 97

Humira Pen Psor-Uveits-Adol HS, 4, 5, 97

Humira(CF), 4, 5, 97

Humira(CF) Pedi Crohns Starter, 5, 97

146

Humira(CF) Pen, 5, 97

Humira(CF) Pen Crohns-UC-HS, 5, 97

Humira(CF) Pen Psor-Uv-Adol HS, 5, 97

Humulin 70/30 U-100 Insulin, 88

Humulin 70/30 U-100 KwikPen, 88

Humulin N NPH Insulin KwikPen, 89

Humulin N NPH U-100 Insulin, 89

Humulin R Regular U-100 Insuln, 89

Humulin R U-500 (Conc) Insulin, 89

Hycamtin, 24

hydralazine, 32

hydrochlorothiazide, 33

Hydrocil, 98

hydrocodone-acetaminophen, 2

hydrocodone-ibuprofen, 2

hydrocortisone, 61, 88, 97

hydrocortisone acetate, 61

hydrocortisone valerate, 61

hydrocortisone-acetic acid, 129

hydromorphone, 1

hydroxychloroquine, 5, 10

hydroxyurea, 20

hydroxyzine HCl, 34

hydroxyzine pamoate, 34

hyoscyamine sulfate, 96, 103

ibandronate, 87

Ibrance, 21

ibuprofen, 7

Ibuprofen IB, 7

Ibuprofen Jr Strength, 7

I-Caps, 72

ICaps AREDS, 1, 72

Icaps MV, 72

Icaps Plus, 72

Iclusig, 22

Idhifa, 22

Ilaris (PF), 4

Imbruvica, 21, 23

imipramine HCl, 40

imipramine pamoate, 40

imiquimod, 61

In-Check Nasal With Mask, 113, 119

In-Check Oral Flow Meter, 113, 119

Increlex, 89

Incruse Ellipta, 133

indapamide, 33

indomethacin, 8

Infants Gas Relief, 95

Infant's Ibuprofen, 7

Infant's Motrin, 7

Infant's Non-Aspirin, 3

Inlyta, 23

InspiraChamber, 114, 119

InspiraChamber with Mask-Large, 115, 119

InspiraChamber with Mask-Med, 115, 119

InspiraChamber with Mask-Small, 115, 119

insulin syringe-needle U-100, 112, 119

Intelence, 12

Intron A, 22

Intuniv ER, 44

Invega, 42

Invega Sustenna, 42

Invega Trinza, 42

Invirase, 18

Invokamet, 85

Invokamet XR, 85

Invokana, 86

ipratropium bromide, 133, 135

ipratropium-albuterol, 134

irbesartan, 27

irbesartan-hydrochlorothiazide, 27

iron, 68

Iron (dried), 68

Iron 100 Plus, 68

Isentress, 11

isoniazid, 13

isosorbide dinitrate, 27

isosorbide mononitrate, 27

isotretinoin, 57

isradipine, 31

itraconazole, 10

ivermectin, 9

I-Vite Protect, 1, 72

Ixinity, 105

Jakafi, 22

Janumet, 87

Janumet XR, 87

Januvia, 85

Jardiance, 86

Jentadueto, 87

Jr. Acetaminophen, 3

Jr. Str Non-Aspirin Pain, 3

Jr. Strength Pain Reliever, 3

Juluca, 11

Junel 1/20 (21), 54

Junel FE 1.5/30 (28), 54

Junel FE 1/20 (28), 54

Junel Fe 24, 54

Kaitlib Fe, 54

Kalbitor, 33

147

Kaletra, 12

Kalydeco, 134, 135

Kaopectate Ex Str (bismuth ss), 92

Kapvay, 44

Kcentra, 104

ketoconazole, 10, 59

Ketone Care, 116, 119

Ketone Urine Test, 116, 119

ketorolac, 7, 127

Ketostix, 116, 119

ketotifen fumarate, 127

Kimono Condoms(Non-lubricated), 112, 119

Kimono Maxx Condoms, 112, 120

Kimono MicroThin Aqua Lube Con, 112, 120

Kimono MicroThin Condoms, 112, 120

Kimono MicroThin Large Condoms, 112, 120

Kimono Textured Condoms, 112, 120

Kineret, 6

Kisqali, 21

Kitabis Pak, 134

Klonopin, 34, 35, 45

Koate, 105

Kogenate FS, 105

Konsyl (sugar), 98

K-PAX, 72

K-Pax Immune Support, 72

K-Phos No 2, 102

K-Phos Original, 102

Krintafel, 10

Kuvan, 124

Kyprolis, 23

labetalol, 26

lactase, 94

Lactase Fast Acting, 94

lactulose, 94

Lamictal, 37

Lamictal ODT, 37, 46

Lamictal ODT Starter (Blue), 37, 46

Lamictal ODT Starter (Green), 37, 46

Lamictal ODT Starter (Orange), 37, 46

Lamictal Starter (Blue) Kit, 37, 46

Lamictal Starter (Green) Kit, 37, 46

Lamictal Starter (Orange) Kit, 37, 46

Lamictal XR, 37

Lamictal XR Starter (Blue), 37

Lamictal XR Starter (Green), 37

Lamictal XR Starter (Orange), 37

lamivudine, 12, 15

lamivudine-zidovudine, 13

lamotrigine, 37

lansoprazole, 95

lanthanum, 101

Larin 1/20 (21), 54

Larin 24 Fe, 54

Larin Fe 1.5/30 (28), 54

Larin Fe 1/20 (28), 54

Larissia, 54

latanoprost, 129

Latuda, 41

Laxative (bisacodyl), 99

Laxative (glycerin-pediatric), 99

Laxative (sennosides), 99

Laxative Feminine, 99

Laxative Maximum Strength, 100

Laxative Pills, 100

Laxative Pills Regular, 100

Leena 28, 55

leflunomide, 6

Lenvima, 23

Lessina, 54

Letairis, 33

letrozole, 20

leucovorin calcium, 24

Leukeran, 19

leuprolide, 22

levalbuterol HCl, 133

levalbuterol tartrate, 133

levetiracetam, 37

levetiracetam in NaCl (iso-os), 37

levobunolol, 128

levocarnitine, 63, 123

levocarnitine (with sugar), 123

levofloxacin, 15, 129

levonorgestrel, 56, 57

levonorgestrel-ethinyl estrad, 54

levonorg-eth estrad triphasic, 55

levothyroxine, 91

Levoxyl, 91

Lexiva, 18

Lice Killing, 62

lidocaine, 62

lidocaine HCl, 62, 124

Lidocaine Viscous, 124

lidocaine-prilocaine, 62

lindane, 62

linezolid, 17

liothyronine, 91

lisinopril, 26

lisinopril-hydrochlorothiazide, 26

Lite Touch-Medium Mask, 115, 120

148

LiteAire MDI Chamber, 115, 120

LiteTouch-Large Mask, 115, 120

LiteTouch-Small Mask, 115, 120

lithium carbonate, 47

lithium citrate, 47

Lithostat, 102

Lmefol Ca-acetyl-meB12-algal, 81

L-Methyl-B6-B12, 81

L-Methyl-MC, 76

Lonsurf, 20

loperamide, 92

lopinavir-ritonavir, 12

Lorata-D, 130

loratadine, 132

lorata-dine D, 130

Loratadine-D, 130

lorazepam, 34, 46, 51

Lorazepam Intensol, 34, 46

losartan, 27

losartan-hydrochlorothiazide, 27

lovastatin, 29

Low-Ogestrel (28), 54

loxapine succinate, 42

Lubricant (p-glycol-glycerin), 125

Lubricant Eye, 125

Lubricant Eye (PG-PEG 400), 125

Lubricant Eye Drops, 126

Lubricant Eye(dextran70-hypml), 125

Lubricating Relief, 126

Lucemyra, 52

Ludent Fluoride, 124

Lumizyme, 122

Lutera (28), 54

Lyrica, 36, 48

Lyrica CR, 48, 50

Lysiplex Plus, 64

Lysodren, 19

Maalox Advanced, 92

Macuvite Eye Care, 72

Mag 64, 68

Mag Glycinate, 68

Mag-G, 68

Maginex, 68

magnesium, 68

Magnesium (oxide/AA chelate), 68

magnesium amino acid chelate, 68

magnesium chloride, 68

magnesium citrate, 68, 99

magnesium gluconate, 69

magnesium oxide, 69, 92

magnesium sulfate, 69

magnesium sulfate in D5W, 69

magnesium sulfate in water, 69

Magonate (magnesium carb), 69

MagOx, 69

Magtab, 69

malathion, 62

Mapap (acetaminophen), 3

Mapap Arthritis Pain, 3

maprotiline, 41

Marplan, 38

Matulane, 19

Mavyret, 15

MAXIMUM DAILY GREEN, 72

Maximum Daily Multivitamin, 72

meclizine, 93

medroxyprogesterone, 53, 90

Medtycholl-B Complex-Liver, 64

mefloquine, 10

Mega Biotin, 82

Mega Multi for Women, 72

Mega Multiple/Chelated Mineral, 72

Mega Multivitamin For Men, 72

Mega Multivitamin with Mineral, 72

megestrol, 23, 63

Mekinist, 22

meloxicam, 7

memantine, 53

Menest, 88

Men's Daily, 72

Men's Daily Multivit-Mineral, 72

Men's Multivitamin Gummies, 72

Men's One Daily, 72

meperidine, 1

meprobamate, 34

mercaptopurine, 20

Meribin, 83

mesalamine, 96

Mesnex, 24

Metadate ER, 44

Metafolbic, 76

Metafolbic Plus RF, 81

Metamucil (sugar), 98

Metamucil (with sugar), 98

Metamucil MultiHealth Fiber, 98

Metamucil Sugar-Free (aspart), 98

metformin, 89

methadone, 1

methamphetamine, 44, 48

methenamine hippurate, 17, 102

149

methenamine mandelate, 17, 103

Methergine, 90

methimazole, 87

methocarbamol, 109

methotrexate sodium, 5, 20

methotrexate sodium (PF), 20

methyldopa, 32

methyldopa-hydrochlorothiazide, 31

Methylin, 44, 50

methylphenidate HCl, 44, 50

methylprednisolone, 88

metipranolol, 128

metoclopramide HCl, 96

metolazone, 33

metoprolol succinate, 30

metoprolol tartrate, 30

metronidazole, 11, 57, 62, 136

mexiletine, 28

Mi-Acid Gas Relief, 96

Mibelas 24 Fe, 54

miconazole nitrate, 59, 136

Miconazole-3, 136

Miconazole-3 prefil,cream,wipe, 136

Microchamber, 115, 120

Microgestin 1.5/30 (21), 54

Microgestin 1/20 (21), 54

Microgestin Fe 1.5/30 (28), 54

Microgestin FE 1/20 (28), 54

Microlife Peak Flow Meter, 113, 120

Microspacer, 115, 120

midazolam, 8, 46, 51

midazolam (PF), 8, 46

midodrine, 31

Milk of Magnesia, 99

Milk Of Magnesia Concentrated, 99

mineral oil, 98

Mineral Oil Extra Heavy, 98

Mineral Oil Heavy, 98

Mini Wright Peak Flow Meter, 113, 120

minocycline, 6, 18

minoxidil, 32

mirtazapine, 38

misoprostol, 95

M-M-R II (PF), 25, 26

modafinil, 50

mometasone, 61

Monistat 7, 136

Monocaps, 72

Mononine, 105

montelukast, 132

morphine, 1

morphine concentrate, 1

Motegrity, 95

Motion Sickness (meclizine), 93

Motion Sickness Relief(mecliz), 93

Mouthpiece, 115, 120

moxifloxacin, 15

Multi Complete with Iron, 76

Multi For Her, 72

Multi-Betic, 1, 72

Multi-Day with Iron, 76

Multi-Delyn with Iron, 72

Multiple Vitamin-Minerals, 72

Multiple Vitamins, 76

Multi-Vit with Fluoride-Iron, 79

multivitamin, 76

Multivitamin 50 Plus, 66

Multivitamin With Fluoride, 79

Multi-Vitamin With Fluoride, 79

multivitamin with iron, 72

multivitamin with minerals, 66, 72

Multivitamins With Fluoride, 79

Multi-Vite (with folic acid), 76

mupirocin, 58

Mvc-Fluoride, 79

mv-min-folic acid-lutein, 72

MVW Complete Formul Multivit, 78

MVW Complete Formul Pediatric, 78

MVW Complete Formulation D3000, 78

My Choice, 56, 57

My Way, 56, 57

Myalept, 90

mycophenolate mofetil, 6, 108

mycophenolate sodium, 108

Mydayis, 44, 48

Myleran, 19

Mynatal, 80

Mynatal Advance, 80

Mynatal Plus, 80

Mynatal-Z, 80

Mynate 90 Plus, 80

Myorisan, 57

My-Vitalife, 72

nabumetone, 7

nadolol, 30

Naglazyme, 122

naloxone, 9

naltrexone, 9

naproxen, 7

naproxen sodium, 7, 8

150

naratriptan, 49

Narcan, 9

Nasacort, 135

Nasal Spray (sodium chloride), 135

Nasalcrom, 135

nateglinide, 85

Natural B-100 Complex, 64

Natural Fiber Laxative, 98

Natural Fiber Laxative (sugar), 98

Natural Fiber Laxative Therapy, 98

Natural Fiber Laxative(aspart), 98

Natural Tears (PF), 126

Natural Veg Laxative(sennosid), 100

Natural Vegetable, 98

Natural Vegetable (psyllium), 98

Natural Vegetable Powder, 98

Nature-Throid, 90

Necon 0.5/35 (28), 54

nefazodone, 39

neomycin, 9

neomycin-bacitracin-poly-HC, 126

neomycin-bacitracin-polymyxin, 128

neomycin-polymyxin B-dexameth, 126

neomycin-polymyxin-gramicidin, 128

neomycin-polymyxin-HC, 129

Neosporin Plus PainRelief(bac), 58

Nephplex Rx, 65

Nephronex, 64

Nephronex-SL, 64

Nestabs, 80

Nestabs DHA, 80

Neupogen, 106

Neurontin, 36

New Day, 56, 57

NewGen, 80

Nexavar, 22

Nexium 24HR, 95

niacin, 82

niacin (inositol niacinate), 82

Niacin Flush Free, 82

niacinamide, 82

nicardipine, 31

NicAzel Forte, 66

nicotine, 52

nicotine (polacrilex), 52

Nicotrol, 52

Nicotrol NS, 52

nifedipine, 31

nilutamide, 20

nimodipine, 31

Nitro-Bid, 27

nitrofurantoin, 10, 103

nitrofurantoin macrocrystal, 10, 103

nitrofurantoin monohyd/m-cryst, 10, 103

nitroglycerin, 27

Nitrostat, 27

Nitro-Time, 27

Niva-Fol, 81, 84

Nivestym, 106

Noble Formula HC, 61

Non-Aspirin, 4

Non-Aspirin Extra Strength, 4

Norditropin FlexPro, 88

noreth-ethinyl estradiol-iron, 54

norethindrone (contraceptive), 55

norethindrone acetate, 90

norethindrone ac-eth estradiol, 54, 88

norethindrone-e.estradiol-iron, 55

norgestimate-ethinyl estradiol, 55

norgestrel-ethinyl estradiol, 55

Nortrel 0.5/35 (28), 55

Nortrel 1/35 (21), 55

Nortrel 7/7/7 (28), 55

nortriptyline, 41

Norvir, 18

NovaFerrum Pediatric, 79

Novoeight, 105

Novolin 70/30 U-100 Insulin, 88

Novolin N NPH U-100 Insulin, 89

Novolin R Regular U-100 Insuln, 89

Novolog Mix 70-30 U-100 Insuln, 89

Novolog Mix 70-30FlexPen U-100, 89

Novoseven RT, 105

NP Thyroid, 90

Nubeqa, 20

NuvaRing, 56

Nuvigil, 50

nystatin, 10, 59, 124

nystatin-triamcinolone, 59

Obizur, 105

Obstetrix DHA, 80

Obstetrix EC, 80

Ocella, 55

Octaplas (Blood Group A), 107

Octaplas (Blood Group AB), 107

Octaplas (Blood Group B), 107

Octaplas (Blood Group O), 107

octreotide acetate, 90, 101

Ocutabs, 72

Odefsey, 13

151

Odomzo, 21

ofloxacin, 15, 129

olanzapine, 43, 47

olanzapine-fluoxetine, 40, 43, 47

Olumiant, 6

omega 3-dha-epa-fish oil, 29

omega-3 acid ethyl esters, 29

omega-3 fatty acids, 29

omega-3 fatty acids-fish oil, 30

omeprazole, 95

omeprazole magnesium, 95

Omnicap, 73

Once Daily, 76

Oncovite, 76

ondansetron, 93

ondansetron HCl, 94

One Daily, 73

One Daily Calcium/Iron, 73

One Daily Complete, 73

One Daily Energy, 73, 76

One Daily Essential, 73, 76

One Daily For Men, 73

One Daily For Men 50+ Advanced, 76

One Daily For Women, 73

One Daily Healthy Weight, 73

One Daily Maximum, 73

One Daily Men's 50 Plus Memory, 77

One Daily Mens 50 Plus(ginkgo), 73

One Daily Multi-Vit w-Mineral, 73

One Daily Multivitamin, 77

One Daily Multivit-Iron(folic), 77

One Daily Plus Iron, 77

One Daily Plus Minerals, 73

One Daily With Iron, 73

One Daily Women 50 Plus, 73

One Daily Women's, 73, 77

One Daily Womens 50 Plus, 73

One Daily Women's Health, 77

One Way Valved Mouthpiece, 115, 120

One-A-Day Cholesterol Plus, 73

One-A-Day Energy, 77

One-A-Day Essential, 77

One-A-Day Maximum Formula, 73, 77

One-A-Day Men 50 Plus (ginkgo), 77

One-A-Day Men VitaCraves, 73

One-A-Day Menopause Formula, 73

One-A-Day Men's 50 Plus, 73

One-A-Day Men's Multivitamin, 73

One-A-Day Teen Advantage, 73, 77

One-A-Day Teen Him VitaCraves, 78

One-A-Day VitaCraves, 73

One-A-Day Vitacraves Immunity, 73

One-A-Day Vitacraves Omega-3, 73

One-A-Day WeightSmart, 73

One-A-Day Women VitaCraves, 73

One-A-Day Women's Active, 73

One-A-Day Womens Formula, 77

One-A-Day Women's Healthy Skin, 73

One-A-Day Women's Petites, 77

Onfi, 35, 46

Opcicon One-Step, 56, 57

Optichamber Adult Mask-Large, 115, 120

OptiChamber Diamond Lg Mask, 115, 120

OptiChamber Diamond VHC, 115, 120

OptiChamber Diamond-Med Msk, 115, 120

OptiChamber Diamond-Sml Mask, 115, 120

Option-2, 57

Optisource, 73

Opurity Multivitamin, 74

Oralyte, 69

Orencia, 5

Orencia ClickJect, 5

Orfadin, 123

Orilissa, 90

Orkambi, 135

orphenadrine citrate, 109

Orsythia, 55

Os-Cal 500 + D3, 67

oseltamivir, 16

Otezla, 6, 60

Otezla Starter, 6, 60

oxazepam, 34, 46

oxcarbazepine, 36

Oxtellar XR, 36

oxybutynin chloride, 103

oxycodone, 1, 2

oxycodone-acetaminophen, 2, 3

Oxytrol For Women, 103

Oysco 500/D, 67

Oyster Shell Calcium-Vit D2, 67

Oyster Shell Calcium-Vit D3, 67

Ozempic, 86

Pain Relief, 4

Pain Relief Extra Strength, 4

Pancreaze, 94

Panda Mask, 115, 120

pantoprazole, 95

paromomycin, 9

paroxetine HCl, 38

Parvlex, 68

152

Paxil, 38

Peak Air Peak Flow Meter, 113, 120

Pedia-Lax, 99

Pedia-Lax Stool Softener, 100

Pediatric Electrolyte, 69

Pediatric Freezer Pops, 69

Pediatric Medium Mask, 115, 120

Pediatric Panda Mask, 115, 120

Pediatric Small Mask, 115, 120

PediaVance, 69

peg 3350-electrolytes, 99

PEG-3350 with flavor packs, 99

Peganone, 36

Pegasys, 15

peg-electrolyte soln, 99

PegIntron, 15

penicillin V potassium, 17

Pentasa, 96

pentazocine-naloxone, 3

pentobarbital sodium, 51

pentoxifylline, 106

Peptic Relief, 92

Pepto-Bismol Max St, 92

Perdiem Overnight Relief, 100

perindopril erbumine, 26

Perio Med, 124

permethrin, 62

perphenazine, 43

perphenazine-amitriptyline, 40

Personal Best Full Range, 113, 120

Pertzye, 94

Pexeva, 39

phenazopyridine, 102

phenelzine, 38

phenobarbital, 35, 51

phenobarbital sodium, 35, 51

phenylephrine HCl, 128

Phenytek, 36

phenytoin, 36

phenytoin sodium, 28, 36

Philith, 55

Phillips, 69

Phillips' Liqui-Gels, 100

Phos-NaK, 69

Phospholine Iodide, 126

phytonadione (vitamin K1), 84

Piko 1, 113, 120

pilocarpine HCl, 124, 126

Pink Bismuth, 92, 93

Pink Bismuth Maximum Strength, 92

pioglitazone, 89

Pirmella, 55

piroxicam, 7

Plasbumin 5 %, 106

Plasmanate, 107

Pneumovax 23, 25

PNV 29-1, 80

POCKET CHAMBER, 115, 120

Pocket Peak Flow Meter, 113, 120

PoDiaPN, 65

podofilox, 62

polyethylene glycol 3350, 99

polymyxin B sulf-trimethoprim, 128

polyvinyl alcohol, 126

Poly-Vi-Sol, 79

Poly-Vi-Sol with Iron, 79

Polyvitamin with Iron, 79

Poly-Vitamins, 78

Pomalyst, 24

potassium chloride, 69, 70

potassium citrate, 102

potassium citrate-citric acid, 102

potassium phosphate m-/d-basic, 69

Pradaxa, 108

pramipexole, 41

pravastatin, 29

prazosin, 33

Precedex, 51

Precedex in 0.9 % sodium chlor, 51

Pred Mild, 127

prednisolone, 88

prednisolone acetate, 127

prednisolone sodium phosphate, 88, 127

prednisone, 88

Premarin, 88

Premphase, 88

Prempro, 88

Prenatabs FA, 80

Prenatabs Rx, 80

Prenatal, 80

Prenatal 19, 80

Prenatal Complete, 80

Prenatal DHA, 29

Prenatal Gummy, 80

Prenatal Low Iron, 80

Prenatal Plus, 80

Prenatal Plus (calcium carb), 80

Prenatal Tablet, 80

Prenatal Vitamin, 80

Prenatal Vitamin Plus Low Iron, 80

153

Prenatal Vitamin with Minerals, 80

prenatal vit-iron fum-folic ac, 80

Prenatal-U, 80

PrePlus, 80

PreserVision AREDS, 1, 74

PreserVision Lutein, 74

PreTAB, 80

Prevacid SoluTab, 95

Prevent, 74

PreviDent, 124

PreviDent 5000 Plus, 124

Prevnar 13 (PF), 25

Prezcobix, 12, 17

Prezista, 17, 18

primaquine, 11

PrimeAire, 115, 120

primidone, 35

Pristiq, 39

Pro Comfort Spacer-Adult Mask, 115, 120

Pro Comfort Spacer-Child Mask, 115, 120

probenecid, 104

probenecid-colchicine, 103

Pro-Cal, 67

ProCerv HP, 74

ProChamber, 115, 120

prochlorperazine, 93

prochlorperazine maleate, 43, 93

Procrit, 104

Profilnine, 105

progesterone micronized, 90

Proglycem, 84

promethazine, 93, 131

Promolaxin, 101

propafenone, 28

propantheline, 96

proparacaine, 128

propranolol, 30

propylthiouracil, 87

ProRenal, 64

ProRenal QD, 74

Prosight with Lutein, 74

Protect Cardio AF, 74

Protect Plus SO, 74

protriptyline, 41

Prozac, 39

pseudoephedrine HCl, 135

psyllium husk, 98

Pulmicort Flexhaler, 132

Pulmozyme, 135

pyrazinamide, 13

pyridostigmine bromide, 109

pyridoxine (vitamin B6), 82

Qbrelis, 26

Qudexy XR, 37

quetiapine, 43, 47

Quflora Pediatric, 79

QuilliChew ER, 45

Quillivant XR, 45

Quin B Strong, 64

quinapril, 26

quinapril-hydrochlorothiazide, 26

quinidine sulfate, 28

Quintabs, 77

Quintabs-M, 74

Quintabs-M Iron Free, 74

Qvar RediHaler, 132

raloxifene, 90

ramipril, 26

Ranexa, 28

ranitidine HCl, 95

Ravicti, 123

Ready-To-Use Enema, 99

Ready-To-Use Enema (min oil), 98

Recombinate, 105

Refresh Celluvisc, 126

Refresh Lacri-Lube, 126

Refresh Liquigel, 126

Refresh P.M., 126

Refresh Plus, 126

Refresh Tears, 126

Reguloid, Sugar Free, 98

Relenza Diskhaler, 16

Relexxii, 45

Renal Caps, 64

Rena-Vite Rx, 65

Reno Caps, 64

repaglinide, 85

REQ49+, 66, 74

Rescriptor, 12

Retacrit, 104

Retrovir, 12

Revlimid, 24

Rexulti, 43

Reyataz, 18

RiaSTAP, 106

Ribasphere, 16

Ribasphere RibaPak, 16

ribavirin, 16

rifabutin, 14, 18

rifampin, 14, 18

154

riluzole, 108

rimantadine, 17

Risperdal Consta, 42

risperidone, 42, 47

Ritalin, 45, 50

Ritalin LA, 45

RiteFlo Aerochamber, 115, 121

rivastigmine tartrate, 53

Rixubis, 105

rizatriptan, 49

ropinirole, 41

rosuvastatin, 29

Rozerem, 49

Rubraca, 23

Ruconest, 104

Sabril, 36

SafeSnap Syringe, 113, 121

Santyl, 60

Saphris, 41, 47

Sarafem, 39

SAVision, 1, 74

Scooby-Doo One A Day, 79

scopolamine base, 93

Seconal Sodium, 51

Segluromet, 85

selegiline HCl, 41

selenium sulfide, 60

Selzentry, 11

senna, 100

Senna Lax, 100

Senna Laxative, 100

Senno, 100

sennosides-docusate sodium, 100

Senokot, 100

Sen-O-Tab, 100

Sensipar, 87

Sentry, 77

Sentry Senior, 74

Serevent Diskus, 133

Seroquel XR, 43

sertraline, 39

sevelamer carbonate, 101

sevelamer HCl, 101

SF, 124

SF 5000 Plus, 124

Sharps Container, 113, 121

Shingrix (PF), 26

Shingrix gE Antigen Component, 26

Siderol, 68

Sidestream Pediatric Face Mask, 115, 121

Silace, 101

sildenafil (pulm.hypertension), 33

Silenor, 51

Silicone Mask - Infant, 115, 121

Silicone Mask - Pediatric, 115, 121

Siliq, 58

silver sulfadiazine, 60

simethicone, 96

simvastatin, 29

sirolimus, 108

Slo-Niacin, 82

Slow Release Iron, 68

Slow-Mag, 69

Smart Sense Lancets, 110, 121

sodium bicarbonate, 91

sodium chloride, 53, 128

sodium citrate-citric acid, 102

sodium phenylbutyrate, 123

sodium phosphate, 69

sodium polystyrene sulfonate, 66

Soft Touch Lancets, 110, 121

Soliris, 106

Solo, 74

Soothe (bismuth subsalicylate), 93

Soothing Care (hydrocortisone), 61

sotalol, 28, 30

Sotalol AF, 28, 30

Sovaldi, 16

Space Chamber Plus, 115, 121

Spectravite Adult 50 Plus(lut), 74

Spectravite Advanced Formula, 77

Spectravite Men's, 74

Spectravite Senior, 74

Spectravite Ultra Men 50+, 74

Spectravite Ultra Men's Sr, 74

Spectravite Ultra Women, 77

Spectravite Ultra Women's Sr, 74

Spinraza (PF), 109

Spiriva Respimat, 133

spironolactone, 26, 32

spironolacton-hydrochlorothiaz, 32

Spravato, 38

Sprycel, 23

Sronyx, 55

SSD, 60

stavudine, 12

Steglatro, 86

Steglujan, 86

Stimate, 85

Stomach Relief, 93

155

Stomach Relief Max Strength, 93

Stool Softener, 101

Stool Softener (docusate cal), 101

Strattera, 45

Stress B Plus Zinc, 64

Stress B With Zinc, 64

Stress Formula 600 C, 64

Stress Formula With Iron(sulf), 64

Stress Formula with Zinc, 64

Stribild, 13

Strovite Forte, 74

Strovite One, 74

Sublocade, 52

Suboxone, 52

sucralfate, 101

sulfacetamide sodium, 129

sulfacetamide sodium-sulfur, 58

sulfacetamide-prednisolone, 126

sulfamethoxazole-trimethoprim, 9

sulfasalazine, 6, 97

Sulfatrim, 10

sulindac, 7

sumatriptan, 49

sumatriptan succinate, 49

Sunvite, 74

Super Antioxidant, 1, 74

Super B Complex-Vitamin C, 64

Super B-50 Complex, 65

Super B-50 Complex Plus, 65

Super Ginseng Multivitamin, 74

Super Multiple, 74

Super Multiple - Low Iron, 74

Super Multivitamin, 77

Super Quints B-50, 65

Super Thera Vite M, 74

Superplex-T, 64

Supervite, 64

Suprax, 14

Sure-Ject Insulin Syringe, 112, 121

Surfak, 101

Sustiva, 12

Sutent, 23

Syeda, 55

Symbicort, 134

Symbyax, 40, 43, 47

Symfi, 13

Symfi Lo, 13

Symjepi, 31

Symtuza, 13

Synagis, 24

Synjardy, 85

Synjardy XR, 85

Systane (propylene glycol), 126

Systane Gel, 126

Systane Ultra, 126

Tab-A-Vite, 77

Tab-A-Vite/Iron, 74

Tabloid, 20

tacrolimus, 60, 108

tadalafil (pulm. hypertension), 33

Tafinlar, 21

Tamiflu, 17

tamoxifen, 23

tamsulosin, 102

Tarceva, 19

Targretin, 24

Tarina Fe 1/20 (28), 55

Tarina Fe 1-20 EQ (28), 55

Tasigna, 23

Tecfidera, 125

Tegretol, 36, 46

Tegretol XR, 37, 47

Tekturna, 33

Tekturna HCT, 33

temazepam, 46, 51

Temodar, 19

temozolomide, 19

terazosin, 33

terbinafine HCl, 10, 59

terbutaline, 134

terconazole, 136

testosterone, 85

testosterone cypionate, 85

tetracycline, 18

Thalomid, 10, 24

theophylline, 133

Thera, 77

Thera M Plus (ferrous fumarat), 74

Thera-D, 83

Theragran-M Premier 50 Plus, 74

Theralogix Companion, 74

Thera-M, 75

TheraNatal, 80

Therapeutic-M, 75

Thera-Tabs, 77

Thera-Tabs M, 75

TheraTears, 126

Theratrum Complete with Lutein, 75

Therems, 75, 77

Therems-H, 75

156

Therems-M, 75

thiamine HCl (vitamin B1), 81

thioridazine, 43

thiothixene, 43

Thrivite-19, 75, 81

Thrombate III, 107

thyroid (pork), 90

tiagabine, 36

Tibsovo, 22

Tilia Fe, 56

timolol maleate, 128

tinidazole, 11

Tivicay, 11

tizanidine, 109

Tobi Podhaler, 134

tobramycin, 128

tobramycin in 0.225 % NaCl, 134

tobramycin with nebulizer, 134

tobramycin-dexamethasone, 126

Today Contraceptive Sponge, 57

tolnaftate, 59

tolterodine, 103

topiramate, 37

toremifene, 23

torsemide, 32

Total B/C, 64

Tracleer, 33

Tradjenta, 85

tramadol, 2

trandolapril, 26

tranexamic acid, 106

tranylcypromine, 38

Travel Sickness (meclizine), 93

trazodone, 39

Trecator, 14

tretinoin, 58

tretinoin (chemotherapy), 23

Tretten, 106

Tri Femynor, 56

TriAdvance, 81

triamcinolone acetonide, 61, 124

triamterene-hydrochlorothiazid, 32

triazolam, 46, 51

TriCare, 81

Tricitrates, 102

Tri-Estarylla, 56

trifluoperazine, 43

trifluridine, 129

trihexyphenidyl, 41

Tri-Legest Fe, 56

Tri-Linyah, 56

Tri-Lo-Estarylla, 56

Tri-Lo-Marzia, 56

Tri-Lo-Sprintec, 56

TriLyte With Flavor Packets, 99

trimethobenzamide, 93

trimethoprim, 10

trimipramine, 41

Trinatal Rx 1, 81

Trinate, 81

Trintellix, 39

Triphrocaps, 64

Triple Antibiotic, 58

Triple Vitamin with Fluoride, 79

Tri-Previfem (28), 56

Tri-Sprintec (28), 56

Triumeq, 13

Tri-Vi-Sol, 78

Tri-Vitamin With Fluoride, 79

Trogarzo, 11

Trokendi XR, 37

tropicamide, 127

trospium, 103

TRUEplus Diabetic Multivitamin, 75

TRUEplus Ketone, 116, 121

Trulicity, 86

Trustex Latex Condom, 112, 121

Trustex Lubricated Condoms, 112, 121

Trustex Non-Lub Condoms, 112, 121

Trustex-RIA Lub/Spermicide, 112, 121

Trustex-RIA Lubricated Condoms, 113, 121

Trustex-RIA Non-Lub Condoms, 113, 121

Truvada, 12

Truzone Peak Flow Meter, 113, 121

Tums, 92

Tums Freshers, 92

Tybost, 123

Tykerb, 18

Tylenol Arthritis Pain, 4

Tylenol Extra Strength, 4

Tymlos, 87

UltiCare, 112, 121

Ultimate Men's Complete 50+, 75

Ultimate Women's Complete 50+, 75

Ultra B-100 Complex, 65

Ultra Comfort Insulin Syringe, 112, 121

Ultra Freeda, 75

Ultra Lubricant Eye, 126

Unicomplex-M, 75

Unisom (doxylamine), 50

157

Unisom SleepGels, 50, 131

Unisom SleepMelts, 50, 131

Uretron D-S, 17, 103

Urocit-K 10, 102

Urocit-K 5, 102

Uro-Mag, 69

ursodiol, 94

Utira-C, 17, 103

Vaginal Contraceptive Foam, 57

valacyclovir, 16

valganciclovir, 15

valproic acid, 35, 47

valsartan, 27

valsartan-hydrochlorothiazide, 27

vancomycin, 15

Vaqta (PF), 25

V-C Forte, 75

Vegetable Laxative, 100

Velcade, 23

Velivet Triphasic Regimen (28), 56

Velphoro, 101, 102

Vemlidy, 15

Venclexta, 21

Venclexta Starting Pack, 21

venlafaxine, 39

verapamil, 28, 31

Versacloz, 42

Verzenio, 21

VIC-Forte, 75

Victoza 2-Pak, 86

Victoza 3-Pak, 86

Videx 2 gram Pediatric, 12

Viekira Pak, 16

Vienva, 55

vigabatrin, 36

Viibryd, 39

Vimizim, 122

Vimpat, 35

Vinate GT, 81

Vinate II, 81

Vinate M, 81

Vinate One, 81

Vinate Ultra, 81

Viokace, 94

Viracept, 18

Viramune, 12

Viramune XR, 12

Viread, 12, 15

Virtrate-3, 102

Virtussin AC, 135

Virt-Vite, 81, 84

Virt-Vite Plus, 64

Vision, 75

Vita-Bee with C, 65

Vitacel (with Lutein), 75

Vital-D Rx, 75, 83

Vitalee, 75

vitamin B complex, 65

vitamin B complex-folic acid, 65

Vitamin B-1, 82

Vitamin B-1 (mononitrate), 82

Vitamin B-2, 82

Vitamin D3, 83

vitamin E, 30, 83

vitamin E (dl, acetate), 83

vitamin E acetate, 83

vitamin E mixed, 83

vitamin E succinate, 83

Vitamins A,C,D and Fluoride, 80

Vitamins A-D-E selenium, 75

Vitamins and Minerals, 75

Vitamins B Complex, 65

Vitamins for Hair, 65, 77

Vita-Respa, 81, 84

Vitatrum, 75

Vitrum Senior, 75

Vivitrol, 52

Vortex Adult Mask, 115, 121

Vortex Frog Mask-Child, 115, 121

Vortex Holding Chamber, 115, 121

Vortex Holding Chamber Child, 116, 121

Vortex Holding Chamber Toddler, 116, 121

Vortex Ladybug Mask-Toddler, 116, 121

Vortex VHC Frog Mask-Child, 116, 121

Vortex VHC Ladybug Mask-Toddlr, 116, 121

Vosevi, 16

Votrient, 23

VPRIV, 122

Vraylar, 44, 47

Vyfemla (28), 55

Vyndamax, 84

Vyndaqel, 84

Vyvanse, 45

Wal-itin D, 130

Wal-Mucil Natural Fiber Lax, 98

Wal-Zyr D, 130

warfarin, 104

Wellbutrin SR, 40

Wera (28), 55

Westhroid, 90

158

wheat germ oil, 84

Wide-Seal Diaphragm 60, 110, 121








Wilate, 105

Wixela Inhub, 134

Woman's Laxative, 100

Women's Complex, 75

Women's Daily Caplet, 75

Women's Daily Formula, 75

Women's Daily Multivitamin, 75

Women's Laxative (bisacodyl), 100

Women's Multivitamin Gummies, 75

Women's One Daily, 77

WP Thyroid, 90

Wymzya Fe, 55

Xalkori, 19

Xanax, 34, 46

Xanax XR, 34, 46

Xarelto, 104

Xatmep, 5, 20

Xeljanz, 6, 97

Xeljanz XR, 6

Xpovio, 21, 23

Xtandi, 20

Xulane, 56

Xyntha, 105

Xyntha Solofuse, 105

Xyrem, 49

yeast, 65

Yelets, 77

Yonsa, 19, 20

Yuvafem, 136

zaleplon, 51

Zarah, 55

Zarxio, 106

Zavesca, 123

Zejula, 23

Zelboraf, 21

Zenatane, 57

Zenpep, 94

Zenzedi, 45, 48, 50

Zepatier, 15

Zerit, 12

Ziagen, 12

zidovudine, 12

ziprasidone HCl, 41, 47

Zolgensma, 24

Zolinza, 21

zolmitriptan, 49

Zoloft, 39

zolpidem, 51

zonisamide, 38

Zoo Friends, 78

Zoo Friends Plus Iron, 78

Zovia 1/35E (28), 55

Zubsolv, 52

Zydelig, 22

Zyprexa, 43, 47

Zyprexa Relprevv, 43

Zytiga, 19, 20

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