Prime Detailed Formulary Guide - Silverback Rx...2 Prime Detailed Formulary Guide The Prime...

Bold Upper Case = Brand-name drug QL Quantity Limits SP Specialty Program Lower Case = generic drug INJ Injectable ST Step Therapy

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writing by an authorized representative of Pharmacy Data Management, Inc. v. 2019-01

Prime Detailed Formulary

Guide

v. 2019

2

Prime Detailed Formulary Guide

The Prime Formulary Guide outlines the tier coverage and suggested limitations of the most commonly prescribed medications. A formulary is the list of drugs available for certain conditions and organized by tiers (cost levels).

Drug Tier Types of Drugs Included Cost

1 Generic Drugs Lowest Copay

2 Preferred Brand Name Drugs Medium Copay

3 Non-Preferred Brand Name Drugs Higher Copay

Limits Description

INJ – Injectable Drug Product is administered via an injectable route of administration and may be subject to a separate benefit.

QL – Quantity Limit Drug is subject to a specific quantity per days supply due to patient safety or cost containment measures.

SP – Specialty Program Drug is designated as a specialty drug and may be subject to a separate specialty benefit.

ST – Step Therapy A more cost-effective option must be tried before a Step Therapy drug may be covered.

Preferred and non-preferred brand name medications are listed to help identify clinically appropriate and cost-effective options within drug categories. Unless specifically indicated, drug list products will include all dosage forms. This is not an all-inclusive list and does not guarantee coverage. Medications listed may change to a lower tier at any time. Medications may also be moved to non-preferred status twice a year on January 1 and July 1. A brand-name drug for which a generic product becomes available may be designated as a non-preferred option upon release of the generic product to the market. Products recently approved by the U.S. Food and Drug Administration (FDA) may not be covered upon release to the market. When a medication changes tiers, the member may have to pay a different amount for that medication. The member's specific prescription benefit plan design may not cover certain products or categories regardless of their appearance in this document. For the most up-to-date list call customer service at the toll-free member phone number on the ID card. Need assistance finding a drug on this formulary guide? An alphabetical index is included at the end of the formulary listing. You may also press Control + F to search for the product name.

Drug Name Drug Tier Limits Drug Name Drug Tier Limits

Bold Upper Case = Brand-name drug QL Quantity Limits SP Specialty Program

Lower Case = generic drug INJ Injectable ST Step Therapy

3

ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREXIANTS

ADDERALL 3

ADDERALL XR 3

ADIPEX-P 3

ADZENYS ER 3

ADZENYS XR-ODT 3

amphetamine sulfate 1

amphetamine/dextroampheta 1

APTENSIO XR 3

armodafinil 1

atomoxetine 1

atomoxetine hydrochloride 1

BELVIQ 3

BELVIQ XR 3

caffeine citrate 1

clonidine hcl er 1

clonidine hydrochloride 1

clonidine hydrochloride e 1

CONCERTA 3

CONTRAVE 3

COTEMPLA XR-ODT 3

DAYTRANA 2

dexmethylphenidate hcl 1

dexmethylphenidate hcl er 1

dexmethylphenidate hydroc 1

dextroamphetamine sulfate 1

diethylpropion hcl 1

diethylpropion hcl er 1

DYANAVEL XR 3

EVEKEO 2

FOCALIN 3

FOCALIN XR 3

guanfacine er 1

guanfacine hydrochloride 1

INTUNIV 3

LOMAIRA 3

metadate er 1

methamphetamine hcl 1

METHYLIN 3

methylphenid cap 30mg er 1

METHYLPHENID CAP 60MG LA 2

modafinil 1

MYDAYIS 2

NUVIGIL 3

phendimetrazine tartrate 1

phentermine hcl 1

PROVIGIL 3

QSYMIA 3

QUILLICHEW ER 2

QUILLIVANT XR 2

RITALIN 3

RITALIN LA 3

SAXENDA 3 INJ

STRATTERA 3

VYVANSE 2

ZENZEDI 3

ALLERGENIC EXTRACTS/BIOLOGICALS MISC

GRASTEK 2

ODACTRA 2

RAGWITEK 2

Amebicides

SOLOSEC 3

Aminoglycosides

gentamicin sulfate 1 INJ

neomycin sulfate 1

paromomycin sulfate 1

TOBI PODHALER 2 SP

tobramycin 1 SP

ANALGESICS - ANTI-INFLAMMATORY

ACTEMRA 2 INJ SP

ARTHROTEC 75 3

CELEBREX 3

celecoxib 1

diclofenac potassium 1

diclofenac sodium dr 1

diclofenac sodium er 1

diclofenac sodium/misopro 1

DUEXIS 3

ENBREL 2 INJ SP

ENBREL MINI 2 INJ SP

ENBREL SURECLICK 2 INJ SP




4

etodolac 1

etodolac er 1

fenoprofen tab 600mg 1

FENOPROFEN CAP 400MG 3

FENORTHO 3

flurbiprofen 1

HUMIRA 2 INJ SP

HUMIRA PEDIATRIC CROHNS D 2 INJ SP

HUMIRA PEN 2 INJ SP

HUMIRA PEN-CD/UC/HS START 2 INJ SP

HUMIRA PEN-PS/UV STARTER 2 INJ SP

ibu 1

ibuprofen 1

ILARIS 2 INJ SP

INDOCIN 3

indomethacin 1

indomethacin er 1

KETOPROFEN 3

ketoprofen er 1

ketorolac tromethamine 1 QL

KEVZARA 3 INJ SP

KINERET 3 INJ SP

leflunomide 1

meclofenamate sodium 1

mefenamic acid 1

meloxicam 1

nabumetone 1

NAPRELAN 3

naproxen 1

naproxen dr 1

naproxen sodium 1

naproxen sodium cr 1

naproxen sodium er 1

OLUMIANT 3 SP

ORENCIA 3 INJ SP

ORENCIA CLICKJECT 3 INJ SP

OTEZLA 2 SP

OTREXUP 2 INJ

oxaprozin 1

piroxicam 1

RASUVO 2 INJ

RIDAURA 2

SIMPONI INJ 100MG/ML 2 INJ SP

SIMPONI INJ 50/0.5ML 3 INJ SP

SIMPONI ARIA 3 INJ SP

SPRIX 3

sulindac 1

TIVORBEX 3

tolmetin sodium 1

VIMOVO 3

VIVLODEX 3

XELJANZ 2 SP

XELJANZ XR 2 SP

ZIPSOR 3

ZORVOLEX 3

ANALGESICS - NonNarcotic

bupap 1

butalbital/acetaminophen 1

butalbital/acetaminophen/ 1

BUT/ASA/CAF TAB 2

diflunisal 1

esgic 1

FIORICET 3

FIORINAL 3

salsalate 1

VANATOL LQ 3

ANALGESICS - OPIOID

ABSTRAL 3

acetaminophen/caffeine/di 1

acetaminophen/codeine 1

acetaminophen/codeine #3 1

acetaminophen/codeine pho 1

ARYMO ER 3

ascomp/codeine 1

BELBUCA 2

BUNAVAIL 3

BUPRENORPHINE 3

buprenorphine hcl 1

buprenorphine hcl/naloxon 1

buprenorphine hydrochlori 1

but/asa/caf/ cap cod 30mg 1

butorphanol tartrate 1 QL

BUTRANS 2

codeine sulfate 1




5

CONZIP 3

DURAGESIC 3

EMBEDA 3

endocet 1

fentanyl 1

fentanyl citrate 1 INJ

fentanyl citrate oral tra 1

FENTORA 3

hydrocodone bitartrate/ac 1

hydrocodone/acetaminophen 1

hydrocodone/ibuprofen 1

hydromorphone hcl 1

hydromorphone hcl dosette 1 INJ

hydromorphone hcl er 1

HYSINGLA ER 2

IBUDONE 3

LEVORPHANOL TARTRATE 2

lorcet 1

lorcet hd 1

lorcet plus 1

LORTAB 3

meperidine hcl 1

METHADONE SOL 5MG/5ML 2

methadone tab 10mg 1

MORPHABOND ER 3

morphine sulfate 1

morphine sulfate er 1

NORCO 3

NUCYNTA 2

NUCYNTA ER 2

OXAYDO 3

oxycodone hcl 1

OXYCODONE HCL ER 3

oxycodone hydrochloride 1

oxycodone/acetaminophen 1

oxycodone/aspirin 1

OXYCONTIN 2

oxymorphone hydrochloride 1

pentazocine/naloxone hcl 1

PERCOCET 3

ROXICODONE 3

SUBOXONE 2

tramadol hcl 1

tramadol hcl tab 200mg er 1

TRAMADOL HCL CAP 150MG ER 3

tramadol hydrochloride/ac 1

TYLENOL/CODEINE #3 3

TYLENOL/CODEINE #4 3

ULTRAM 3

vicodin 1

vicodin es 1

vicodin hp 1

XTAMPZA ER 3

ZOHYDRO ER 3

ZUBSOLV 2

ANDROGENS-ANABOLIC

ANDRODERM 2

ANDROGEL GEL 1%(50MG) 3

ANDROGEL GEL 1.62% 2

ANDROGEL PUMP 2

AVEED 3 INJ SP

danazol 1

DEPO-TESTOSTERONE 3 INJ

FORTESTA 3

methyltestosterone 1

NATESTO 3

oxandrolone 1

STRIANT 3

TESTIM 3

TESTOPEL 3 INJ SP

testosterone cypionate 1 INJ

testosterone enanthate 1 INJ

testosterone topical solu 1

ANORECTAL AGENTS

ANALPRAM HC 3

ANALPRAM HC SINGLES 3

ANALPRAM-HC 3

anucort-hc 1

anusol-hc 1

colocort 1

CORTIFOAM 3

hemmorex-hc 1

hydrocortisone acetate 1

hydrocortisone acetate/pr 1




6

lidocaine hcl/hydrocortis 1

PROCTOCORT 3

PROCTOFOAM HC 3

procto-med hc 1

procto-pak 1

proctosol hc 1

proctozone-hc 1

RECTIV 2

UCERIS AER 2MG/ACT 3

Anthelmintics

albendazole 1

ALBENZA 2

BILTRICIDE 3

EMVERM 2

ivermectin 1

praziquantel 1

STROMECTOL 3

ANTIANGINAL AGENTS

isosorbide dinitrate 1

isosorbide mononitrate 1

isosorbide mononitrate er 1

NITRO-BID 2

NITRO-DUR 3

nitroglycerin 1

nitroglycerin er 1

nitroglycerin lingual 1

nitroglycerin transdermal 1

NITROSTAT 3

nitro-time 1

RANEXA 2

ANTIANXIETY AGENTS

alprazolam 1

alprazolam er 1

alprazolam odt 1

alprazolam xr 1

ATIVAN 3

buspirone hcl 1

buspirone hydrochloride 1

chlordiazepoxide hcl 1

clorazepate dipotassium 1

diazepam 1

diazepam intensol 1

hydroxyzine hcl 1

hydroxyzine hydrochloride 1

hydroxyzine pamoate 1

lorazepam 1

lorazepam intensol 1

oxazepam 1

VALIUM 3

XANAX 3

ANTIARRHYTHMICS

amiodarone hcl 1

amiodarone hydrochloride 1

disopyramide phosphate 1

dofetilide 1

flecainide acetate 1

mexiletine hcl 1

MULTAQ 3

NORPACE CR 3

pacerone 1

propafenone hcl 1

propafenone hcl er 1

propafenone hydrochloride 1

quinidine gluconate cr 1

RYTHMOL SR 3

TIKOSYN 3

ANTIASTHMATIC AND BRONCHODILATOR AGENTS

ADVAIR DISKUS 2

ADVAIR HFA 2

AIRDUO RESPICLICK 113/14 3



albuterol sulfate 1

albuterol sulfate er 1

ALVESCO 3

ANORO ELLIPTA 2

ARCAPTA NEOHALER 2

ARNUITY ELLIPTA 2

ASMANEX HFA 2

ASMANEX TWISTHALER 120 ME 2

ASMANEX TWISTHALER 14 MET 2






7

ATROVENT HFA 2

BEVESPI AEROSPHERE 2

BREO ELLIPTA 2

BROVANA 3

budesonide 1

COMBIVENT RESPIMAT 2

cromolyn sodium 1

DALIRESP 2

DULERA 2

FASENRA 2 INJ SP

FLOVENT DISKUS 2

FLOVENT HFA 2

FLUTICASONE PROPIONATE/SA 2

INCRUSE ELLIPTA 2

ipratropium bromide/albut 1

levalbuterol 1

levalbuterol hcl 1

levalbuterol hydrochlorid 1

LEVALBUTEROL TARTRATE HFA 3

montelukast sodium 1

NUCALA 2 INJ SP

PERFOROMIST 2

PROAIR HFA 2

PROAIR RESPICLICK 2

PROVENTIL HFA 3

PULMICORT 3

PULMICORT FLEXHALER 2

QVAR REDIHALER 2

SEEBRI NEOHALER 2

SEREVENT DISKUS 2

SINGULAIR 3

SPIRIVA HANDIHALER 2

SPIRIVA RESPIMAT 2

STIOLTO RESPIMAT 2

STRIVERDI RESPIMAT 2

SYMBICORT 2

terbutaline sulfate 1

THEO-24 3

theophylline er 1

TRELEGY ELLIPTA 2

TUDORZA PRESSAIR 2

UTIBRON NEOHALER 2

VENTOLIN HFA 2

XOLAIR 2 INJ SP

XOPENEX 3

XOPENEX HFA 3

zafirlukast 1

zileuton er 1

ZYFLO 3 ST

ZYFLO CR 3 ST

ANTICOAGULANTS

COUMADIN 3

ELIQUIS 2

ELIQUIS STARTER PACK 2

enoxaparin sodium 1 INJ

fondaparinux sodium 1 INJ SP

FRAGMIN 2 INJ SP

heparin lock flush 1 INJ

heparin lock flush/nacl f 1 INJ

heparin sodium 1 INJ

heparin sodium dcu 1 INJ

heparin sodium lock flush 1 INJ

HEPARIN SODIUM/SODIUM CHL 3 INJ

jantoven 1

LOVENOX 3 INJ

PRADAXA 3

SAVAYSA 3

warfarin sodium 1

XARELTO 2

XARELTO STARTER PACK 2

ANTICONVULSANTS

APTIOM 3

BANZEL 2

BRIVIACT 3

carbamazepine 1

carbamazepine er 1

CARBATROL 3

CELONTIN 2

clobazam 1

clonazepam 1

clonazepam odt 1

DEPAKOTE 3

DEPAKOTE ER 3

DIASTAT ACUDIAL 3




8

DIAZEPAM RECTAL GEL 2

DILANTIN CAP 100MG 3

DILANTIN CAP 30MG 2

DILANTIN INFATABS 3

divalproex sodium 1

divalproex sodium dr 1

divalproex sodium er 1

epitol 1

ethosuximide 1

felbamate 1

FYCOMPA 2

gabapentin 1

KEPPRA 3

KEPPRA XR 3

KLONOPIN 3

LAMICTAL 3

LAMICTAL ODT 3

LAMICTAL XR 3

lamotrigine 1

lamotrigine er 1

lamotrigine odt 1

lamotrigine starter kit/o 1

levetiracetam 1

levetiracetam er 1

LYRICA 2

MYSOLINE 3

NEURONTIN 3

ONFI 2

oxcarbazepine 1

OXTELLAR XR 3

PHENYTEK 3

phenytoin 1

phenytoin infatabs 1

phenytoin sodium extended 1

primidone 1

QUDEXY XR 2

SABRIL 2 SP

SPRITAM 3

subvenite 1

TEGRETOL 3

TEGRETOL-XR 3

tiagabine hydrochloride 1

TOPAMAX 3

TOPAMAX SPRINKLE 3

topiramate 1

TOPIRAMATE ER 3

TRILEPTAL 3

TROKENDI XR 3

valproic acid 1

vigabatrin 1 SP

VIMPAT 2

ZARONTIN 3

ZONEGRAN 3

zonisamide 1

ANTIDEPRESSANTS

amitriptyline hcl 1

amitriptyline hydrochlori 1

APLENZIN 3 ST

bupropion hcl 1

bupropion hcl er 1

bupropion hcl sr 1

bupropion hcl xl 1

bupropion hydrochloride 1

bupropion hydrochloride e 1

bupropion hydrochloride s 1

bupropion hydrochloride x 1

CELEXA 3

citalopram 1

citalopram hydrobromide 1

clomipramine hcl 1

CYMBALTA 3

desipramine hcl 1

desipramine hydrochloride 1

desvenlafax tab 100mg er 1

DESVENLAFAX TAB 50MG ER 3

doxepin hcl 1

duloxetine hcl 1

duloxetine hydrochloride 1

EFFEXOR XR 3

EMSAM 3

escitalopram oxalate 1

FETZIMA 2 ST

FETZIMA TITRATION PACK 2 ST

fluoxetine dr 1




9

fluoxetine hcl 1

fluoxetine tab 10mg 1

FLUOXETINE TAB 60MG 2

fluvoxamine maleate 1

fluvoxamine maleate er 1

FORFIVO XL 3

imipramine hcl 1

imipramine hydrochloride 1

imipramine pamoate 1

LEXAPRO 3

maprotiline hcl 1

MARPLAN 3

mirtazapine 1

mirtazapine odt 1

nefazodone hcl 1

nefazodone hydrochloride 1

nortriptyline hcl 1

paroxetine hcl 1

paroxetine hcl er 1

paroxetine hydrochloride 1

PAXIL 3

PAXIL CR 3

phenelzine sulfate 1

PRISTIQ 3

protriptyline hcl 1

PROZAC 3

REMERON 3

sertraline hcl 1

sertraline hydrochloride 1

tranylcypromine sulfate 1

trazodone hydrochloride 1

trimipramine maleate 1

TRINTELLIX 3 ST

venlafaxine hcl 1

venlafaxine hcl er 1

venlafaxine hydrochloride 1

VIIBRYD 2 ST

VIIBRYD STARTER PACK 2 ST

WELLBUTRIN SR 3

WELLBUTRIN XL 3

ZOLOFT 3

ANTIDIABETICS

acarbose 1

ACTOPLUS MET XR 3

ADLYXIN 3 INJ

ADLYXIN STARTER PACK 3 INJ

ADMELOG 3 INJ

ADMELOG SOLOSTAR 3 INJ

AFREZZA 3

ALOGLIPTIN 3 ST

ALOGLIPTIN/METFORMIN HCL 3 ST

ALOGLIPTIN/PIOGLITAZONE 3

AMARYL 3

APIDRA 3 INJ

APIDRA SOLOSTAR 3 INJ

AVANDIA 3

BASAGLAR KWIKPEN 3 INJ

BYDUREON 2 INJ

BYDUREON BCISE 2 INJ

BYDUREON PEN 2 INJ

BYETTA 2 INJ

chlorpropamide 1

CYCLOSET 3

FARXIGA 2

FIASP 2 INJ

FIASP FLEXTOUCH 2 INJ

glimepiride 1

glipizide 1

glipizide er 1

glipizide xl 1

glipizide/metformin hcl 1

GLUCAGEN HYPOKIT 2 INJ

GLUCAGON EMERGENCY KIT 2 INJ

GLUCOPHAGE 3

GLUCOPHAGE XR 3

GLUCOTROL XL 3

GLUMETZA 3

glyburide 1

glyburide micronized 1

glyburide/metformin hcl 1

GLYXAMBI 2

HUMALOG 2 INJ

HUMALOG JUNIOR KWIKPEN 2 INJ

HUMALOG KWIKPEN 2 INJ




10

HUMALOG MIX 50/50 KWIKPEN 2 INJ

HUMALOG MIX 75/25 2 INJ

HUMALOG MIX 75/25 KWIKPEN 2 INJ

HUMULIN R U-500 (CONCENTR 2 INJ

HUMULIN R U-500 KWIKPEN 2 INJ

INVOKAMET 2

INVOKAMET XR 2

INVOKANA 2

JANUMET 2

JANUMET XR 2

JANUVIA 2

JARDIANCE 2

JENTADUETO 2

JENTADUETO XR 2

KAZANO 3 ST

KOMBIGLYZE XR 3 ST

LANTUS 2 INJ

LANTUS SOLOSTAR 2 INJ

LEVEMIR 2 INJ

LEVEMIR FLEXTOUCH 2 INJ

metformin hcl 1

metformin hcl er 1

metformin hydrochloride 1

metformin hydrochloride e 1

miglitol 1

nateglinide 1

NESINA 3 ST

NOVOLOG 2 INJ

NOVOLOG FLEXPEN 2 INJ

NOVOLOG MIX 70/30 2 INJ

NOVOLOG MIX 70/30 PREFILL 2 INJ

NOVOLOG PENFILL 2 INJ

ONGLYZA 3 ST

OSENI 3

OZEMPIC 2 INJ

pioglitazone hcl 1

pioglitazone hcl/metformi 1

PROGLYCEM 2

QTERN 3

repaglinide 1

RIOMET 3

SEGLUROMET 2

SOLIQUA 100/33 2 INJ

STEGLATRO 2

STEGLUJAN 3

SYMLINPEN 120 2 INJ

SYMLINPEN 60 2 INJ

SYNJARDY 2

SYNJARDY XR 2

TOUJEO MAX SOLOSTAR 2 INJ

TOUJEO SOLOSTAR 2 INJ

TRADJENTA 2

TRESIBA FLEXTOUCH 2 INJ

TRULICITY 2 INJ

VICTOZA 2 INJ

XIGDUO XR 2

XULTOPHY 100/3.6 2 INJ

ANTIDIARRHEAL/PROBIOTIC AGENTS

diphenoxylate/atropine 1

loperamide hcl 1

MOTOFEN 3

MYTESI 3

opium 1

opium tincture 1

paregoric 1

RESTORA RX 3

VSL#3 DS 3

Antidotes and Specific Antagonists

CHEMET 2

EXJADE 2 SP

JADENU 2 SP

JADENU SPRINKLE 2 SP

naloxone hcl 1 INJ

naltrexone hcl 1

NARCAN 2

VIVITROL 2 INJ SP

ANTIEMETICS

AKYNZEO 2

aprepitant 1 QL

BONJESTA 3

DICLEGIS 3

dronabinol 1




11

EMEND 3 QL

granisetron hcl 1

meclizine hcl 1

meclizine hydrochloride 1

ondansetron hcl 1

ondansetron hydrochloride 1

ondansetron odt 1

SANCUSO 2

TRANSDERM-SCOP 3

trimethobenzamide hcl 1

VARUBI 2

ZOFRAN 3

ZUPLENZ 3

Antifungals

ABELCET 2 INJ

amphotericin b 1 INJ

CRESEMBA 2 SP

DIFLUCAN 3

fluconazole 1

griseofulvin microsize 1

griseofulvin ultramicrosi 1

itraconazole 1

ketoconazole 1

NOXAFIL 2

nystatin 1

SPORANOX 2

terbinafine hcl 1

terbinafine hydrochloride 1

voriconazole 1 INJ

ANTIHISTAMINES

carbinoxamine maleate 1

CLARINEX 3

clemastine fumarate 1

cyproheptadine hcl 1

desloratadine 1

desloratadine odt 1

diphenhydramine hcl 1

levocetirizine dihydrochl 1

phenadoz 1

promethazine hcl 1

promethazine hcl plain 1

promethazine hydrochlorid 1

promethegan 1

ryvent 1

ANTIHYPERLIPIDEMICS

ANTARA 3

atorvastatin calcium 1

cholestyramine 1

cholestyramine light 1

colesevelam hydrochloride 1

COLESTID 3

colestipol hcl 1

CRESTOR 3

ezetimibe 1

ezetimibe/simvastatin 1

fenofibrate tab 48mg 1

FENOFIBRATE CAP 50MG 3

fenofibrate micronized 1

FENOFIBRIC ACID 2

fenofibric acid dr 1

fluvastatin 1

fluvastatin sodium er 1

gemfibrozil 1

LESCOL XL 3

LIPITOR 3

LIPOFEN 2

LIVALO 2 ST

lovastatin 1

LOVAZA 3

niacin er 1

NIACOR 3

NIASPAN 3

omega-3-acid ethyl esters 1

PRALUENT 2 INJ SP

PRAVACHOL 3

pravastatin sodium 1

prevalite 1

QUESTRAN LIGHT 3

REPATHA 2 INJ SP

REPATHA PUSHTRONEX SYSTEM 2 INJ SP

REPATHA SURECLICK 2 INJ SP

rosuvastatin calcium 1

simvastatin 1

TRICOR 3




12

TRIGLIDE 3

TRILIPIX 3

VASCEPA 2

VYTORIN 3

WELCHOL 3

ZETIA 3

ANTIHYPERTENSIVES

ACCUPRIL 3

amlodipine besylate/benaz 1

amlodipine besylate/valsa 1

amlodipine/olmesartan med 1

amlodipine/valsartan/hctz 1

atenolol/chlorthalidone 1

AVAPRO 3

AZOR 3

benazepril hcl 1

benazepril hcl/hydrochlor 1

BENICAR 3

BENICAR HCT 3

bisoprolol fumarate/hydro 1

BYVALSON 2 ST

candesartan cilexetil 1

candesartan cilexetil/hyd 1

captopril 1

captopril/hydrochlorothia 1

CATAPRES-TTS-1 3

CATAPRES-TTS-3 3

clonidine hcl 1

COZAAR 3

DIOVAN 3

DIOVAN HCT 3

doxazosin mesylate 1

DUTOPROL 3

EDARBI 2 ST

EDARBYCLOR 2 ST

enalapril maleate 1

enalapril maleate/hydroch 1

EPANED 3

eplerenone 1

eprosartan mesylate 1

fosinopril sodium 1

fosinopril sodium/hydroch 1

guanfacine hcl 1

hydralazine hcl 1

HYZAAR 3

irbesartan 1

irbesartan/hydrochlorothi 1

lisinopril 1

lisinopril/hydrochlorothi 1

losartan potassium 1

losartan potassium/hydroc 1

LOTREL 3

methyldopa 1

methyldopa/hydrochlorothi 1

metoprolol/hydrochlorothi 1

MICARDIS 3

MICARDIS HCT 3

minoxidil 1

moexipril hcl 1

nadolol/bendroflumethiazi 1

olmesartan medoxomil 1

olmesartan medoxomil/amlo 1

olmesartan medoxomil/hydr 1

perindopril erbumine 1

prazosin hcl 1

propranolol/hydrochloroth 1

QBRELIS 3

quinapril hcl 1

quinapril hydrochloride 1

quinapril/hydrochlorothia 1

ramipril 1

TEKTURNA 2

TEKTURNA HCT 2

telmisartan 1

telmisartan/amlodipine 1

telmisartan/hydrochloroth 1

terazosin hcl 1

trandolapril 1

trandolapril/verapamil hc 1

TRIBENZOR 3

valsartan 1

valsartan/hydrochlorothia 1

ZESTRIL 3

Anti-infective Agents - Misc.




13

ALINIA 2

atovaquone 1

CAYSTON 2

clindamycin hcl 1

clindamycin hydrochloride 1

clindamycin palmitate hcl 1

dapsone 1

FIRST-METRONIDAZOLE 100 3

FIRST-METRONIDAZOLE 50 3

FIRST-VANCOMYCIN 25 3


FIRVANQ 3

LINCOCIN 3 INJ

linezolid 1

meropenem 1 INJ

SIVEXTRO 3 SP

sulfamethoxazole/trimetho 1

sulfatrim pediatric 1

tinidazole 1

trimethoprim 1

vancomycin hcl 1 INJ

XIFAXAN 2

Antimalarials

atovaquone/proguanil hcl 1

chloroquine phosphate 1

COARTEM 2

hydroxychloroquine sulfat 1

MALARONE 3

mefloquine hcl 1

PLAQUENIL 3

quinine sulfate 1

Antimyasthenic/Cholinergic Agents

MESTINON TIMESPAN 3

pyridostigmine bromide 1

pyridostigmine bromide er 1

Antimycobacterial Agents

ethambutol hcl 1

isoniazid 1

PRIFTIN 2

rifabutin 1

rifampin 1

ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES

AFINITOR 2 SP

ALECENSA 2 SP

ALUNBRIG 3 SP

anastrozole 1

AROMASIN 3

AVASTIN 2 INJ SP

azacitidine 1 INJ SP

bicalutamide 1

BOSULIF 2 SP

BRAFTOVI 3 SP

CABOMETYX 2 SP

capecitabine 1 SP

CAPRELSA 2 SP

CYCLOPHOSPH CAP 25MG 2

cyclophosph cap 50mg 1

ELIGARD 2 INJ SP

ERIVEDGE 2 SP

etoposide 1 SP

exemestane 1

FASLODEX 2 INJ SP

flutamide 1

GLEEVEC 3 SP

GLEOSTINE 2 SP

HERCEPTIN 2 INJ SP

hydroxyurea 1

IBRANCE 2 SP

ICLUSIG 2 SP

imatinib mesylate 1 SP

IMBRUVICA 2 SP

INLYTA 2 SP

INTRON A 2 INJ SP

JAKAFI 2 SP

KEYTRUDA 2 INJ SP

KISQALI 3 SP

KISQALI FEMARA 600 DOSE 3 SP

LENVIMA 12MG DAILY DOSE 2 SP

letrozole 1

leucovor ca tab 5mg 1

LEUCOVOR CA TAB 10MG 2

LEUKERAN 2




14

leuprolide acetate 1 INJ SP

LONSURF 2 SP

LUPRON DEPOT INJ 3.75MG 2 INJ SP




LUPRON DEPOT (4-MONTH) 3 INJ SP

LUPRON DEPOT (6-MONTH) 3 INJ SP

LYNPARZA 2 SP

MATULANE 2 SP

megestrol acetate 1

MEKINIST 2 SP

MEKTOVI 3 SP

mercaptopurine 1 SP

methotrexate 1

methotrexate sodium 1 INJ

NERLYNX 2 SP

NEXAVAR 2 SP

NINLARO 2 SP

OPDIVO 2 INJ SP

PERJETA 2 INJ SP

POMALYST 2 SP

PURIXAN 2 SP

RITUXAN 2 INJ SP

RUBRACA 2 SP

RYDAPT 2 SP

SPRYCEL 2 SP

STIVARGA 2 SP

SUTENT 2 SP

TABLOID 2 SP

TAFINLAR 2 SP

TAGRISSO 2 SP

TALZENNA 3 SP

tamoxifen citrate 1

TARCEVA 2 SP

TASIGNA 2 SP

temozolomide 1 SP

TREXALL 3

VELCADE 2 INJ SP

VENCLEXTA 2 SP

VENCLEXTA STARTING PACK 2 SP

VERZENIO 2 SP

VOTRIENT 2 SP

XALKORI 2 SP

XTANDI 2 SP

ZEJULA 2 SP

ZELBORAF 2 SP

ZOLADEX 2 INJ SP

ZYTIGA 2 SP

ANTIPARKINSON AND RELATED THERAPY AGENTS

amantadine hcl 1

APOKYN 2 INJ SP

AZILECT 3

benztropine mesylate 1

bromocriptine mesylate 1

carbidopa 1

carbidopa/levodopa 1

carbidopa/levodopa er 1

carbidopa/levodopa odt 1

CARB/LEVO 75 TAB /ENTACAP 2

carb/levo100 tab /entacap 1

entacapone 1

GOCOVRI 3 SP

MIRAPEX 3

NEUPRO 3

pramipexole dihydrochlori 1

rasagiline mesylate 1

REQUIP 3

REQUIP XL 3

ropinirole er 1

ropinirole hcl 1

RYTARY 3

selegiline hcl 1

trihexyphenidyl hcl 1

ANTIPSYCHOTICS/ANTIMANIC AGENTS

ABILIFY 3

ABILIFY MAINTENA 2 INJ

aripiprazole 1

aripiprazole odt 1

ARISTADA 2 INJ SP

chlorpromazine hcl 1 INJ

clozapine 1




15

CLOZAPINE TAB 200/ODT 3

clozapine tab 25mg odt 1

compro 1

FANAPT 3 ST

fluphenazine decanoate 1 INJ

fluphenazine hcl 1

GEODON 3

haloperidol 1

haloperidol decanoate 1 INJ

haloperidol lactate 1 INJ

INVEGA 3

INVEGA SUSTENNA 3 INJ

INVEGA TRINZA 3 INJ

LATUDA 2 ST

lithium carbonate 1

lithium carbonate er 1

loxapine 1

loxapine succinate 1

olanzapine 1

olanzapine odt 1

paliperidone er 1

perphenazine 1

prochlorperazine 1

prochlorperazine maleate 1

quetiapine fumarate 1

quetiapine fumarate er 1

REXULTI 3

RISPERDAL 3

RISPERDAL CONSTA 2 INJ

risperidone 1

risperidone odt 1

SAPHRIS 3

SEROQUEL 3

SEROQUEL XR 3

thioridazine hcl 1

thiothixene 1

trifluoperazine hcl 1

VRAYLAR 3 SP ST

ziprasidone hcl 1

ZYPREXA 3

ZYPREXA ZYDIS 3

Antiseptics & Disinfectants

formaldehyde 1

HYDROGEN PEROXIDE 2

ANTIVIRALS

abacavir 1 SP

abacavir/lamivudine 1 SP

acyclovir 1

atazanavir 1 SP

atazanavir sulfate 1 SP

ATRIPLA 2 SP

BARACLUDE 3 SP

BIKTARVY 2 SP

cidofovir 1 INJ SP

COMPLERA 2 SP

DESCOVY 2 SP

EDURANT 2 SP

efavirenz 1 SP

entecavir 1 SP

EPCLUSA 2 SP

EVOTAZ 3 SP

famciclovir 1

GENVOYA 2 SP

HARVONI 2 SP

ISENTRESS 2 SP

JULUCA 3 SP

KALETRA 2 SP

lamivudine 1 SP

lamivudine/zidovudine 1 SP

MAVYRET 2 SP

NORVIR 3 SP

ODEFSEY 2 SP

oseltamivir phosphate 1 QL

PEGASYS 2 INJ SP

PREZCOBIX 3 SP

PREZISTA 2 SP

RELENZA DISKHALER 2 QL

REYATAZ 3 SP

ribavirin 1 SP

ritonavir 1 SP

SITAVIG 3

STRIBILD 2 SP

SUSTIVA 3 SP

TAMIFLU 3 QL




16

tenofovir disoproxil fuma 1 SP

TIVICAY 2 SP

TRIUMEQ 2 SP

TRUVADA 2 SP

valacyclovir hcl 1

valacyclovir hydrochlorid 1

VALCYTE 3 SP

valganciclovir 1 SP

valganciclovir hydrochlor 1 SP

VALTREX 3

VEMLIDY 2 SP

VIREAD 3 SP

VOSEVI 2 SP

ZEPATIER 2 SP

zidovudine 1 SP

BETA BLOCKERS

acebutolol hcl 1

acebutolol hydrochloride 1

atenolol 1

BETAPACE 3

betaxolol hcl 1

bisoprolol fumarate 1

BYSTOLIC 2 ST

carvedilol 1

carvedilol phosphate 1

COREG 3

COREG CR 3

CORGARD 3

INDERAL LA 3

INDERAL XL 3 ST

INNOPRAN XL 3 ST

labetalol hcl 1

labetalol hydrochloride 1

metoprolol succinate er 1

metoprol tar tab 25mg 1

METOPROLOL TAB 75MG 2

nadolol 1

pindolol 1

propranolol hcl 1

propranolol hcl er 1

propranolol hydrochloride 1

sotalol hcl 1

sotalol hcl (af) 1

sotalol hydrochloride (af 1

sotalol hydrocholride 1

SOTYLIZE 2

TENORMIN 3

timolol maleate 1

TOPROL XL 3

Calcium Channel Blockers

amlodipine besylate 1

CARDIZEM LA 3

cartia xt 1

diltiazem hcl 1

diltiazem hcl cd 1

diltiazem hcl er 1

diltiazem hydrochloride e 1

dilt-xr 1

felodipine er 1

isradipine 1

matzim la 1

nifedipine 1

nifedipine er 1

nimodipine 1

nisoldipine er 1

NORVASC 3

PROCARDIA XL 3

taztia xt 1

TIAZAC 3

verapamil hcl 1

verapamil hcl er 1

verapamil hcl sr 1

verapamil hydrochloride 1

CARDIOTONICS

digitek 1

digox 1

digoxin 1

CARDIOVASCULAR AGENTS - MISC.

ADCIRCA 3 SP

ADEMPAS 2 SP

amlodipine besylate/atorv 1

BIDIL 3

CADUET 3




17

CAVERJECT IMPULSE 2 INJ QL

CIALIS 2 QL

CORLANOR 2

EDEX 3 INJ QL

ENTRESTO 2

LETAIRIS 2 SP

LEVITRA 3 QL ST

MUSE 2 QL

OPSUMIT 2 SP

ORENITRAM 3 SP

papaverine hcl 1 INJ

REMODULIN 2 INJ SP

REVATIO 3 SP

sildenafil 1 SP

sildenafil citrate 1 QL

STAXYN 3 QL ST

STENDRA 3 QL ST

tadalafil 1 QL

TRACLEER 2 SP

TYVASO 2 SP

TYVASO REFILL 2 SP

UPTRAVI 2 SP

vardenafil hydrochloride 1 QL

VIAGRA 3 QL

CEPHALOSPORINS

cefaclor 1

cefadroxil 1

cefdinir 1

cefepime 1 INJ

cefixime 1

cefpodoxime proxetil 1

cefprozil 1

ceftriaxone sodium 1 INJ

cefuroxime axetil 1

CEPHALEXIN TAB 250MG 2

cephalexin tab 500mg 1

SUPRAX 3

TEFLARO 2 INJ

CONTRACEPTIVES

altavera 1

alyacen 1/35 1

alyacen 7/7/7 1

amethia 1

amethia lo 1

amethyst 1

apri 1

aranelle 1

ashlyna 1

aubra 1

aubra eq 1

aviane 1

azurette 1

BALCOLTRA 3

balziva 1

bekyree 1

BEYAZ 3

blisovi 24 fe 1

blisovi fe 1.5/30 1

blisovi fe 1/20 1

briellyn 1

camila 1

camrese 1

camrese lo 1

caziant 1

chateal 1

cryselle-28 1

cyclafem 1/35 1

cyclafem 7/7/7 1

cyred 1

cyred eq 1

dasetta 1/35 1

dasetta 7/7/7 1

daysee 1

deblitane 1

DEPO-PROVERA CONTRACEPTIV 3 INJ

DEPO-SUBQ PROVERA 104 3 INJ

desogestrel/ethinyl estra 1

drospirenone/ethinyl estr 1

elinest 1

ELLA 3

emoquette 1

enpresse-28 1

enskyce 1

errin 1




18

estarylla 1

ESTROSTEP FE 3

ethynodiol diacetate/ethi 1

falmina 1

fayosim 1

femynor 1

GENERESS FE 3

gianvi 1

heather 1

introvale 1

isibloom 1

jencycla 1

jolessa 1

jolivette 1

juleber 1

junel 1.5/30 1

junel 1/20 1

junel fe 1.5/30 1

junel fe 1/20 1

junel fe 24 1

kaitlib fe 1

kariva 1

kelnor 1/35 1

kelnor 1/50 1

kurvelo 1

KYLEENA 2

larin 1.5/30 1

larin 1/20 1

larin 24 fe 1

larin fe 1.5/30 1

larin fe 1/20 1

larissia 1

layolis fe 1

leena 1

lessina 1

levonest 1

levonorgestrel and ethiny 1

levonorgestrel/ethinyl es 1

levora 0.15/30-28 1

LILETTA 3

lillow 1

LO LOESTRIN FE 2

LOESTRIN 1.5/30-21 3

LOESTRIN 1/20-21 3

LOESTRIN FE 1.5/30 3

LOESTRIN FE 1/20 3

loryna 1

LOSEASONIQUE 3

low-ogestrel 1

lutera 1

lyza 1

marlissa 1

medroxyprogesterone aceta 1 INJ

melodetta 24 fe 1

mibelas 24 fe 1

microgestin 1.5/30 1

microgestin 1/20 1

microgestin fe 1

microgestin fe 1.5/30 1

mili 1

MINASTRIN 24 FE 3

MIRCETTE 3

MIRENA 2

mono-linyah 1

mononessa 1

myzilra 1

NATAZIA 3

necon 0.5/35-28 1

NEXPLANON 2 INJ

nikki 1

nora-be 1

norethindrone 1

norethindrone & ethinyl e 1

norethindrone acetate/eth 1

norethindrone/ethinyl est 1

norgestimate/ethinyl estr 1

norlyda 1

nortrel 0.5/35 (28) 1

nortrel 1/35 1

nortrel 7/7/7 1

NUVARING 2

ocella 1

ogestrel 1

orsythia 1




19

ORTHO MICRONOR 3

ORTHO TRI-CYCLEN LO 3

ORTHO-CYCLEN 3

ORTHO-NOVUM 1/35 3

PARAGARD INTRAUTERINE COP 3

philith 1

pimtrea 1

pirmella 1/35 1

pirmella 7/7/7 1

portia-28 1

previfem 1

QUARTETTE 3

quasense 1

rajani 1

reclipsen 1

rivelsa 1

SAFYRAL 3

SEASONIQUE 3

setlakin 1

sharobel 1

SKYLA 2

sprintec 28 1

sronyx 1

syeda 1

tarina fe 1/20 1

tarina fe 1/20 eq 1

TAYTULLA 2

tilia fe 1

tri femynor 1

tri-estarylla 1

tri-legest fe 1

tri-linyah 1

tri-lo-estarylla 1

tri-lo-marzia 1

tri-lo-sprintec 1

tri-previfem 1

tri-sprintec 1

trivora-28 1

tri-vylibra 1

tulana 1

tydemy 1

velivet 1

vienva 1

viorele 1

vyfemla 1

vylibra 1

wera 1

wymzya fe 1

XULANE 2

YASMIN 28 3

YAZ 3

zarah 1

zovia 1/35e 1

CORTICOSTEROIDS

betamethasone sodium phos 1 INJ

budesonide er 1

BUPIVILOG KIT 3 INJ

CORTEF 3

DEPO-MEDROL 3 INJ

DEXAMETHASON SOL 0.5/5ML 2

dexamethason tab 0.75mg 1

DEXAMETHASONE INTENSOL 2

DEXPAK 10 DAY 3

DEXPAK 6 DAY 3

EMFLAZA 3 SP

ENTOCORT EC 3

fludrocortisone acetate 1

hydrocortisone 1

KENALOG-10 3 INJ

KENALOG-40 3 INJ

MEDROL 3

MEDROL DOSEPAK 3

methylprednisolone 1

methylprednisolone acetat 1 INJ

methylprednisolone dose p 1

methylprednisolone sodium 1 INJ

MILLIPRED TAB 5MG 2

MILLIPRED SOL 10MG/5ML 3

ORAPRED ODT 3

PHYSICIANS EZ USE JOINT T 3

PHYSICIANS EZ USE M-PRED 3 INJ

prednisolone 1

prednisolone sol 15mg/5ml 1

PREDNISOLONE SOL 25MG/5ML 2




20

prednisone tab 20mg 1

PREDNISONE PAK 5MG 2

PREDNISONE INTENSOL 2

RAYOS 3

SOLU-CORTEF 2 INJ

SOLU-MEDROL 3 INJ

TAPERDEX 6-DAY 3

UCERIS TAB 9MG 2

VERIPRED 20 2

COUGH/COLD/ALLERGY

acetylcysteine 1

benzonatate 1

bromfed dm 1

bromphen/pseudoephedrine 1

CLARINEX-D 12 HOUR 3

GILTUSS TR 3

hydrocodone bitartrate/ch 1

hydrocodone bitartrate/ho 1

hydrocodone polistirex/ch 1

hydrocodone/homatropine 1

hydromet 1

HYPERSAL 3

nebusal 1

promethazine/codeine 1

promethazine/dextromethor 1

promethazine/phenylephrin 1

promethazine-dm 1

SEMPREX-D 3

SSKI 3

TUZISTRA XR 3

DERMATOLOGICALS

ABSORICA 2

ACANYA 2

acitretin 1 SP

ACUICYN DAILY EYELID & EY 2

ACZONE 3

adapalene 1

adapalene pump 1

adapalene/benzoyl peroxid 1

AKTIPAK 3

ALA SCALP 3

ALA-QUIN 3

alclometasone dipropionat 1

ALCORTIN A 3

ALDARA 3

ALEVICYN ANTIPRURITIC SG 3

ALTABAX 3

amcinonide 1

amnesteem 1

ARZOL SILVER NITRATE APP 2

ASTERO 3

augmented betamethasone d 1

avar cleanser 1

AVAR LS 3

AVAR LS CLEANSER 3

avar-e green 1

AVAR-E LS 3

AVENOVA 3

avita 1

AZELEX 3

BENSAL HP 3

BENZACLIN 3

BENZACLIN WITH PUMP 3

BENZEFOAM 3

BENZEFOAM ULTRA 3

benzepro 1

benzepro creamy wash 1

benzepro foaming cloths 1

benzepro short contact 1

betamethasone dipropionat 1

betamethasone valerate 1

BIAFINE 3

bimatoprost 1

BIONECT 3

BOTOX COSMETIC 3 INJ SP

bp 10-1 1

bp foam 1

bp wash 1

BPO 2

calcipotriene 1

calcipotriene/betamethaso 1

calcitrene 1

CAPEX 3

celacyn 1




21

CERACADE 3

ceramax 1

ciclopirox 1

ciclopirox nail lacquer 1

ciclopirox olamine 1

claravis 1

CLINDACIN PAC 3

CLINDAGEL 3

clindamycin phosphate 1

CLINDAMYCIN PHOSPHATE/BEN 3

clindamycin phosphate/tre 1

clindamycin/benzoyl perox 1

clobetasol propionate 1

clobetasol propionate e 1

clobetasol propionate emo 1

CLOBEX 3

CLOCORTOLONE PIVALATE 3

CLOCORTOLONE PIVALATE PUM 3

clodan 1

CLODERM 3

CLODERM PUMP 3

clotrimazole/betamethason 1

COAL TAR 2

CONDYLOX 3

CORDRAN 3

CORTISPORIN 3

COSENTYX 2 INJ SP

COSENTYX SENSOREADY PEN 2 INJ SP

DENAVIR 3

DERMACINRX LEXITRAL PHARM 3

dermacinrx prizopak 1

DERMACINRX ZRM PAK 3

DERMA-SMOOTHE/FS SCALP 3

DERMASORB HC 3

DERMASORB XM 3

dermazene 1

DESONATE 3

desonide 1

desoximetasone 1

diclofenac sodium 1

DIFFERIN 3

diflorasone diacetate 1

doxepin hydrochloride 1

DOXYCYCLINE CAP 40MG 3

DRITHO-CREME HP 2

DRYSOL 3

DUAC 3

DUPIXENT 2 INJ SP

econazole nitrate 1

ECOZA 3

EFUDEX 3

ELETONE 2

ELETONE TWINPACK 2

ELIDEL 2

ELOCON 3

EMULSION SB 2

ENSTILAR 2

ENTTY SPRAY EMULSION 3

EPICERAM 3

EPIDUO 3

EPIDUO FORTE 2

EPIFOAM 3

ERTACZO 3 ST

ery 1

erythromycin 1

erythromycin/benzoyl pero 1

ethyl chloride/medium jet 1

ethyl chloride/medium str 1

EUCRISA 3

FABIOR 3

FINACEA 2

FLECTOR 2

fluocinolone acetonide 1

fluocinolone acetonide bo 1

fluocinolone acetonide sc 1

fluocinonide 1

fluocinonide emulsified 1

fluocinonide emulsified b 1

FLUOROPLEX 3

fluorouracil 1

flurandrenolide 1

GENADUR 3

halobetasol propionate 1

HALOG 3




22

HPR PLUS 2

HPR PLUS HYDROGEL KIT 2

HYCLODEX 3

hydrocortisone acetate & 1

hydrocortisone butyrate 1

hydrocortisone butyrate ( 1

hydrocortisone valerate 1

hydrocortisone/iodoquinol 1

hydroquinone 1

hydroquinone time release 1

HYLATOPIC PLUS 3

imiquimod 1

IMIQUIMOD PUMP 3

IMPOYZ 3

isotretinoin 1

JUBLIA 3 ST

KAMDOY 3

KERALAC 3

KERALYT 3

KERALYT SCALP 3

KERYDIN 3 ST

LATISSE 3

LEVICYN 3

levicyn dermal spray 1

LEVULAN KERASTICK 3

lidocaine 1

LIDOCAINE AND TETRACAINE 3

lidocaine hcl 1

lidocaine hcl jelly 1

lidocaine/prilocaine 1

lidocaine-prilocaine-crea 1

LIDODERM 3

lidopril 1

LIDORX 3

LIDOTRAL 3

lidozion 1

LOCOID 3

LOYON 3

LULICONAZOLE 3 ST

LUXAMEND 2

LUXIQ 3

LUZU 3 ST

malathion 1

MENTAX 3

methoxsalen 1

METROGEL 3

metronidazole 1

MICORT-HC 3

MIRVASO 2

mometasone furoate 1

mupirocin 1

myorisan 1

naftifine hcl 1

naftifine hydrochloride 1

NAFTIN 3 ST

NATROBA 3

NEO-SYNALAR 3

NEUAC KIT 3

NIVATOPIC PLUS 2

nolix 1

NORITATE 3

NUVAIL 3

nyamyc 1

nystatin/triamcinolone 1

nystatin/triamcinolone ac 1

nystop 1

OLUX-E 3

ONEXTON 2

ORACEA 2

OVACE PLUS 3

OVACE PLUS WASH 3

OVACE WASH 3

oxiconazole nitrate 1

OXISTAT 3 ST

PENLAC NAIL LACQUER 3

PENNSAID 3

permethrin 1

PICATO 2

PLEXION 3

PLEXION CLEANSER 3

PODOCON 25 IN BENZOIN TIN 3

podofilox 1

PRAMOSONE 3

prednicarbate 1




23

PROMISEB 3

PROPECIA 3

PROTOPIC 3

PRUMYX 2

PSORCON 3

QBREXZA 3

RECEDO 2

REGENECARE 3

REGRANEX 2

RENOVA 3

RETIN-A 3

RETIN-A MICRO 3

RETIN-A MICRO PUMP 3

RHOFADE 3

RIAX 3

rosadan 1

SALEX 3

SALEX CREAM 3

SALEX LOTION 3

salicylic acid 1

salicylic acid er 1

salicylic acid wart remov 1

SANTYL 2

selenium sulfide 1

selenium sulfide shampoo 1

SERNIVO 3

SILIQ 3 INJ SP

SIL-K PAD/LARGE 3

SILVADENE 3

SILVASORB 2

silver sulfadiazine 1

SKLICE 3

sodium sulfacetamide wash 1

SOD SUL/SULF EMU 10-5% 2

sod sul/sulf pad 10-4% 1

SOOLANTRA 2

SORILUX 3

SPINOSAD 2

ssd 1

SSS 10-5 2

STELARA INJ 45MG/0.5 2 INJ SP

sulfacetamid lot 10% 1

sulfacetamide sodium/sulf 1

sulfacleanse 8/4 1

SUMADAN WASH 3

SUMAXIN 3

SYNALAR 3

SYNERA 3

SYNERDERM 3

TACLONEX 2

tacrolimus 1

TALTZ 3 INJ SP

tazarotene 1

TAZORAC GEL 0.1% 2

TAZORAC CRE 0.1% 3

TEMOVATE 3

TETRIX 3

TEXACORT 3

TOLAK 3

TOPICORT 3

TREMFYA 2 INJ SP

tretinoin 1

tretinoin microsphere 1

tretinoin microsphere pum 1

triamcinolone acetonide 1

TRIANEX 2

triderm 1

TRIDESILON 3

TRI-LUMA 3

ULESFIA 3

ULTRAVATE 3

urea 1

urea nail 1

URE-K 3

UTOPIC 3

VANIQA 3

vanoxide-hc 1

VECTICAL 3

VELTIN 3

VENELEX 3

VERDESO 3

VEREGEN 3

VIRASAL 3

VOLTAREN 3




24

VUSION 3

VYTONE 3

XERAC AC 3

XERESE 3

XEROFORM OCCLUSIVE PETROL 2

XOLEGEL 3 ST

XRYLIX 3

ZIANA 3

ZITHRANOL 3

ZONALON 3

ZOVIRAX 2

ZTLIDO 3

ZYCLARA 3

ZYCLARA PUMP 3

DIAGNOSTIC PRODUCTS

THYROGEN 2 INJ SP

TUBERSOL 2 INJ

DIETARY PRODUCTS/DIETARY MANAGEMENT PRODUCTS

CEREFOLIN NAC 3

DEPLIN 15 3

DEPLIN 7.5 3

ELFOLATE TAB 15MG 3

ELFOLATE TAB 7.5MG 2

ENLYTE 3

ENTERAGAM 3

folbic 1

FOLBIC RF 3

FOLTANX 2

FOLTANX RF 3

FOLTX 3

FOSTEUM PLUS 3

LEVOMEFOLATE CALCIUM ALGA 3

LEVOMEFOLATE CALCIUM/N-AC 3

LEVOMEFOLATE CALCIUM/PYRI 3

LIMBREL 3

L-METHYL-B6-B12 2

L-METHYLFOLATE 2

L-METHYLFOLATE CA/S-ALGAL 3

L-METHYLFOLATE CALCIUM 2

L-METHYLFOLATE FORTE 3

L-METHYL-MC NAC 2

MEBOLIC 3

METAFOLBIC PLUS 2

METAFOLBIC PLUS RF 3

METANX 3

NICAPRIN 3

niva-fol 1

PODIAPN 3

RHEUMATE 3

VASCULERA 3

VAYARIN 3

VAYARIN PLUS 3

VISBIOME 3

XYZBAC 3

ZYVIT 3

DIGESTIVE AIDS

CREON 2

PANCREAZE 3

PERTZYE 3

SUCRAID 2 SP

VIOKACE 2

ZENPEP 2

DIURETICS

acetazolamide 1

acetazolamide er 1

ALDACTAZIDE 3

ALDACTONE 3

amiloride hcl 1

amiloride/hydrochlorothia 1

bumetanide 1

CAROSPIR 3

chlorothiazide 1

chlorthalidone 1

DIURIL 3

DYAZIDE 3

DYRENIUM 3

ethacrynic acid 1

furosemide 1

hydrochlorothiazide 1

indapamide 1

LASIX 3

MAXZIDE 3

methazolamide 1




25

methyclothiazide 1

metolazone 1

spironolactone 1

spironolactone/hydrochlor 1

torsemide 1

triamterene/hydrochloroth 1

ENDOCRINE AND METABOLIC AGENTS - MISC.

ALENDRONATE TAB 40MG 2

alendronate tab 35mg 1

BONIVA 3

cabergoline 1

calcitonin salmon 1

calcitonin-salmon 1

calcitriol 1

CARNITOR 3

CETROTIDE 2 INJ SP

chorionic gonadotropin 1 INJ SP

clomiphene citrate 1

desmopressin acetate 1

doxercalciferol 1 SP

EVISTA 3

FABRAZYME 2 INJ SP

FOLLISTIM AQ 3 INJ SP

FORTEO 2 INJ SP

FOSAMAX PLUS D 3 ST

GANIRELIX ACETATE 3 INJ SP

GENOTROPIN 2 INJ SP

GENOTROPIN MINIQUICK 2 INJ SP

GONAL-F 2 INJ SP

GONAL-F RFF REDIJECT 2 INJ SP

H.P. ACTHAR 3 INJ SP

HUMATROPE 2 INJ SP

ibandronate sodium 1

KUVAN 2 SP

levocarnitine 1

LUPANETA PACK 3 SP

LUPRON DEPOT-PED (1-MONTH 2 INJ SP

LUPRON DEPOT-PED (3-MONTH 2 INJ SP

MENOPUR 2 INJ SP

NATPARA 2 INJ SP

NOCTIVA 3

NORDITROPIN FLEXPRO 2 INJ SP

NOVAREL 2 INJ SP

NUTROPIN AQ NUSPIN 10 3 INJ SP

NUTROPIN AQ NUSPIN 20 3 INJ SP

octreotide acetate 1 INJ SP

OMNITROPE 3 INJ SP

ORILISSA 3

OSPHENA 3

OVIDREL 2 INJ SP

paricalcitol 1 SP

PREGNYL W/DILUENT BENZYL 3 INJ SP

PROLIA 3 INJ SP

raloxifene hydrochloride 1

RAVICTI 2 SP

RAYALDEE 3

risedronate sodium 1

risedronate sodium dr 1

ROCALTROL 3

SANDOSTATIN LAR DEPOT 2 INJ SP

SENSIPAR 2 SP

SOMATULINE DEPOT 2 INJ SP

SOMAVERT 2 INJ SP

STIMATE 2 SP

SUPPRELIN LA 3 INJ SP

SYNAREL 2 SP

TYMLOS 2 INJ SP

XGEVA 2 INJ SP

zoledronic acid 1 INJ SP

ZOMACTON 3 INJ SP

Estrogens

ALORA 3

amabelz 1

ANGELIQ 3

CLIMARA 3

CLIMARA PRO 3

COMBIPATCH 2

DELESTROGEN 3 INJ

DEPO-ESTRADIOL 2 INJ

DIVIGEL 2

DUAVEE 2

eemt 1

eemt hs 1




26

esterified estrogens/meth 1

estradiol valerate 1 INJ

estradiol/norethindrone a 1

ESTROGEL 3

EVAMIST 3

fyavolv 1

jevantique lo 1

jinteli 1

lopreeza 1

MENEST 3

MENOSTAR 3

mimvey 1

MINIVELLE 2

PREMARIN 2

PREMPHASE 2

PREMPRO 2

VIVELLE-DOT 3

Fluoroquinolones

BAXDELA 3

CIPRO 3

ciprofloxacin er 1

ciprofloxacin hcl 1

ciprofloxacin hydrochlori 1

LEVAQUIN 3

levofloxacin 1

levofloxacin in d5w 1 INJ

moxifloxacin hcl 1

GASTROINTESTINAL AGENTS - MISC.

alosetron hydrochloride 1

AMITIZA 2

APRISO 3

ASACOL HD 2

AURYXIA 3

AZULFIDINE EN-TABS 3

balsalazide disodium 1

calcium acetate 1

CANASA 2

CIMZIA 3 INJ SP

CIMZIA STARTER KIT 3 INJ SP

DELZICOL 2

DIPENTUM 3

ENTYVIO 2 INJ SP

enulose 1

FOSRENOL 3

generlac 1

INFLECTRA 3 INJ SP

lanthanum carbonate 1

LIALDA 3

LINZESS 2

mesalamine 1

mesalamine dr 1

metoclopramide hcl 1

metoclopramide hydrochlor 1

METOCLOPRAMIDE ODT 2

MOVANTIK 2

OCALIVA 2 SP

PENTASA 2

RELISTOR 3 SPQL

REMICADE 2 INJ SP

RENAGEL 3

RENVELA 3

sevelamer carbonate 1

STELARA INJ 5MG/ML 3 INJ SP

sulfasalazine 1

SYMPROIC 2

TRULANCE 3

URSO 250 3

URSO FORTE 3

ursodiol 1

VELPHORO 2 SP

VIBERZI 2

XERMELO 2 SP

GENERAL ANESTHETICS

ketamine hcl 1 INJ

GENITOURINARY AGENTS - MISCELLANEOUS

acetic acid 0.25% 1

alfuzosin hcl er 1

AVODART 3 QL

CARDURA XL 3

dutasteride 1 QL

dutasteride/tamsulosin hc 1

dutasteride/tamsulosin hy 1




27

ELMIRON 2

finasteride 1

FLOMAX 3

JALYN 3

K-PHOS NO 2 3

ORACIT 3

phenazopyridine hcl 1

phenazopyridine hydrochlo 1

potassium citrate er 1

potassium citrate/citric 1

PROSCAR 3

PYRIDIUM 3

RAPAFLO 2

RIMSO-50 3 INJ

sodium chloride 0.9% 1

sodium chloride 0.9% 1

sodium citrate/citric aci 1

tamsulosin hcl 1

tamsulosin hydrochloride 1

THIOLA 3

tricitrates 1

UROCIT-K 10 3

Gout Agents

allopurinol 1

COLCHICINE CAP 0.6MG 3

COLCHICINE TAB 0.6MG 2

COLCRYS 2

KRYSTEXXA 2 INJ SP

MITIGARE 2

probenecid 1

probenecid/colchicine 1

ULORIC 2 ST

HEMATOLOGICAL AGENTS - MISC.

ADVATE 2 INJ SP

AGGRENOX 3

anagrelide hydrochloride 1

aspirin/dipyridamole 1

BENEFIX 2 INJ SP

BRILINTA 2

cilostazol 1

clopidogrel 1

dipyridamole 1

EFFIENT 3

ELOCTATE 3 INJ SP

FIRAZYR 2 INJ SP

IDELVION 3 INJ SP

pentoxifylline er 1

PLAVIX 3

prasugrel 1

RUCONEST 2 INJ SP

TAVALISSE 3 SP

YOSPRALA 3

ZONTIVITY 2

HEMATOPOIETIC AGENTS

ARANESP ALBUMIN FREE 2 INJ SP

CENTRATEX 2

CERDELGA 2 SP

chromagen 1

corvita 150 1

CORVITE FE 3

cyanocobalamin 1 INJ

DROXIA 2

EPOGEN 3 INJ SP

fabb 1

FERAHEME 2 INJ

FERIVA 21/7 3

ferocon 1

FERRALET 90 3

FERRAPLUS 90 2

folbee 1

folic acid/vitamin b-6/vi 1

FOLIVANE-F 2

FOLIVANE-PLUS 2

FUSION PLUS 3

GRANIX 2 INJ SP

HEMATOGEN FA 2

hematogen forte 1

HEMOCYTE PLUS 3

hemocyte-f 1

hydroxocobalamin 1 INJ

iferex 150 forte 1

INTEGRA F 3

INTEGRA PLUS 3




28

IROSPAN 24/6 3

MULPLETA 3 SP

MULTIGEN 2

MULTIGEN PLUS 2

NASCOBAL 2

NEULASTA 2 INJ SP

NEULASTA ONPRO KIT 2 INJ SP

NEUPOGEN 2 INJ SP

NIFEREX 3

NOXIFOL-D 3

PHYSICIANS EZ USE B-12 CO 3 INJ

poly-iron 150 forte 1

PROCRIT 2 INJ SP

PROMACTA 2 SP

REVESTA 3

se-tan plus 1

tl gard rx 1

trigels-f forte 1

VENOFER 2 INJ SP

virt-gard 1

VPRIV 3 INJ SP

ZARXIO 2 INJ SP

HEMOSTATICS

AMICAR 2

tranexamic acid 1

HYPNOTICS/SEDATIVES/SLEEP DISORDER AGENTS

AMBIEN 3 QL

AMBIEN CR 3 QL

BELSOMRA 3 QL ST

DORAL 3

EDLUAR 3 QL ST

estazolam 1

eszopiclone 1 QL

flurazepam hcl 1

HALCION 3 QL

INTERMEZZO 3 QL

LUNESTA 3 QL

midazolam hcl 1

phenobarbital 1

ROZEREM 2 QL ST

SILENOR 3 ST

temazepam 1

triazolam 1 QL

zaleplon 1 QL

zolpidem tartrate 1 QL

zolpidem tartrate er 1 QL

LAXATIVES

CLENPIQ 2

COLYTE-FLAVOR PACKS 3

constulose 1

gavilyte-c 1

gavilyte-g 1

gavilyte-n/flavor pack 1

GOLYTELY 3

KRISTALOSE 3

lactulose 1

MOVIPREP 3

NULYTELY/FLAVOR PACKS 3

OSMOPREP 3

peg-3350/electrolytes 1

peg-3350/nacl/na bicarbon 1

PLENVU 3

polyethylene glycol 3350 1

PREPOPIK 2

SUPREP BOWEL PREP KIT 2

trilyte 1

LOCAL ANESTHETICS-Parenteral

bupivacaine hcl 1 INJ

MARCAINE 3 INJ

MARLIDO KIT 3 INJ

XYLOCAINE 3 INJ

XYLOCAINE-MPF 3 INJ

MACROLIDES

azithromycin sus 200/5ml 1

AZITHROMYCIN POW 1GM PAK 2

clarithromycin 1

clarithromycin er 1

DIFICID 3

e.e.s. 400 1

E.E.S. GRANULES 3

ERYPED 400 3

ERY-TAB 2

ERYTHROCIN STEARATE 2




29

erythromycin base 1

erythromycin ethylsuccina 1

ZITHROMAX 3

ZITHROMAX Z-PAK 3

MEDICAL DEVICES AND SUPPLIES

CAYA 3

Migraine Products

AIMOVIG 2 INJ QL

AJOVY 3 INJ QL

almotriptan 1 QL

almotriptan malate 1 QL

CAMBIA 3 QL

dihydroergot inj 1mg/ml 1 INJ QL

DIHYDROERGOT SPR 4MG/ML 2 QL

eletriptan hydrobromide 1 QL

EMGALITY 3 INJ

ERGOMAR 3

ergotamine tartrate/caffe 1

FROVA 3 QL

frovatriptan succinate 1 QL

IMITREX 3 QL

IMITREX STATDOSE REFILL 3 INJ QL

IMITREX STATDOSE SYSTEM 3 INJ QL

MAXALT 3 QL

MAXALT-MLT 3 QL

naratriptan hcl 1 QL

ONZETRA XSAIL 3 QL ST

RELPAX 3 QL

rizatriptan benzoate 1 QL

rizatriptan benzoate odt 1 QL

sumatriptan 1 QL

sumatriptan succinate 1 INJ QL

sumatriptan succinate ref 1 INJ QL

sumatriptan/naproxen sodi 1 QL

TREXIMET 3 QL

ZEMBRACE SYMTOUCH 3 INJ QL ST

zolmitriptan 1 QL

zolmitriptan odt 1 QL

ZOMIG TAB 5MG 3 QL

ZOMIG SPR 5MG 2 QL

ZOMIG ZMT 3 QL

MINERALS AND ELECTROLYTES

bd posiflush 1 INJ

effer-k tab 25meq ef 1

EFFER-K TAB 20MEQ 3

effervescent pot chloride 1

FLUORABON 3

fluoride 1

FLURA-DROPS 3

GALZIN 3

iodine strong 1

k-effervescent 1

klor-con 1

klor-con 10 1

klor-con 8 1

klor-con m10 1

KLOR-CON M15 2

klor-con m20 1

klor-con sprinkle 1

klor-con/ef 1

K-PHOS 2

K-TAB TAB 8MEQ CR 2

K-TAB TAB 20MEQ 3

k-vescent 1

lactated ringers 1 INJ

ludent 1

monoject pharma grade flu 1 INJ

normal saline flush 1 INJ

normal saline flush for f 1 INJ

normal saline i.v. flush 1 INJ

phospha 250 neutral 1

phosphorous 1

phospho-trin 250 neutral 1

potassium chloride 1

potassium chloride cr 1

pot chloride tab 10meq er 1

POT CHLORIDE TAB 20MEQ ER 2

potassium chloride sr 1

saline flush 1 INJ

sodium chloride flush 1 INJ

sodium fluoride 1

virt-phos 250 neutral 1

Miscellaneous Therapeutic Classes




30

ASTAGRAF XL 3 SP

AZASAN 3 SP

azathioprine 1

BENLYSTA 2 INJ SP

CELLCEPT 3 SP

cyclosporine 1

cyclosporine cap 25mg mod 1

CYCLOSPORINE CAP 50MG MOD 2

ENVARSUS XR 3 SP

gengraf 1

HYLAFEM 3

HYLENEX 3 INJ

kionex 1

mycophenolate mofetil 1 SP

mycophenolic acid dr 1 SP

MYFORTIC 3 SP

NEORAL 3

PROGRAF 3 SP

PROSTIN VR PEDIATRIC 3 INJ

RAPAMUNE TAB 1MG 3 SP

RAPAMUNE SOL 1MG/ML 2 SP

REVLIMID 2 SP

SANDIMMUNE 2

sirolimus 1 SP

sodium polystyrene sulfon 1

sps 1

sterile water irrigation 1

SYPRINE 3

trientine hydrochloride 1

VELTASSA 2

XIAFLEX 2 INJ SP

ZORTRESS 2 SP

MOUTH/THROAT/DENTAL AGENTS

ARESTIN 3

CAPHOSOL 3

cevimeline hcl 1

chlorhexidine gluconate 1

clinpro 5000 1

clotrimazole 1

DEBACTEROL 3

denta 5000 plus 1

dentagel 1

FIRST-MOUTHWASH BLM 2

GELCLAIR 3

lidocaine viscous 1

MUGARD 3

NEUTRASAL 3

ORAMAGICRX 3

paroex 1

pilocarpine hcl 1

pilocarpine hydrochloride 1

PREVIDENT 5000 BOOSTER PL 3

PREVIDENT 5000 DRY MOUTH 3

PREVIDENT 5000 ENAMEL PRO 3

PREVIDENT 5000 PLUS 3

PREVIDENT 5000 SENSITIVE 3

PREVIDENT FLUORIDE 3

PREVIDENT RINSE 3

SALAGEN 3

SALIVAMAX 3

sf 1

sf 5000 plus 1

triamcinolone acetonide d 1

MULTIVITAMINS

CITRANATAL 90 DHA 3

CITRANATAL ASSURE 3

CITRANATAL B-CALM 3

CITRANATAL BLOOM 3

CITRANATAL DHA 3

CITRANATAL HARMONY 3

CITRANATAL RX 3

complete natal dha 1

completenate 1

CONCEPT DHA 3

CONCEPT OB 3

dialyvite 1

DIALYVITE/ZINC 2

elite-ob 1

ENBRACE HR 3

FLORIVA PLUS 3

folbee plus 1

FOLGARD OS 3

multi-vit/iron/fluoride 1




31

multivitamin with fluorid 1

multivit/fl dro 0.25mg 1

MULTIVIT/FL CHW 0.5MG 3

MULTIVIT/FL CHW 0.25MG 2

multi-vitamin/fluoride dr 1

multi-vitamin/fluoride/ir 1

NEEVO DHA 3

NEPHRO-VITE RX 2

NESTABS DHA 3

NESTABS ONE 3

NICADAN 3

NICOMIDE 3

NIVA-PLUS 3

OB COMPLETE ONE 3

OB COMPLETE PETITE 3

OB COMPLETE PREMIER 3

OB COMPLETE/DHA 3

PNV PRENATAL TAB PLUS 2

PRENATAL PLS MIS MV + DHA 3

PNV TABS 29-1 2

pnv-dha 1

PNV-DHA+DOCUSATE 2

POLY-VI-FLOR 3

PRENA 1 TRUE 2

PRENA1 PEARL 2

PRENAISSANCE 2

PRENATA 3

prenatabs rx 1

PRENATAL 2

PRENATAL 19 TAB 29-1MG 3

prenatal 19 chw tab 1

PRENATAL PLUS 2

PRENATAL PLUS IRON 2

PRENATAL VITAMINS PLUS LO 2

PRENATE 3

PRENATE DHA 3

PRENATE ELITE 3

PRENATE ENHANCE 3

PRENATE ESSENTIAL 3

PRENATE MINI 3

PRENATE PIXIE 3

PRENATE RESTORE 3

PREPLUS 2

PRIMACARE 3

PROVIDA DHA 3

PROVIDA OB 3

renal caps 1

reno caps 1

SELECT-OB+DHA 3

se-natal 19 1

TARON-C DHA 2

THRIVITE RX 3

TL G-FOL OS 2

TRICARE PRENATAL DHA ONE/ 3

trinatal rx 1 1

triphrocaps 1

TRISTART DHA 3

tri-vitamin/fluoride 1

ultimatecare one 1

v-c forte 1

VINATE M 2

vinate one 1

VIRT-C DHA 2

virt-caps 1

VIRT-PN 2

VIRT-PN DHA 2

VITAFOL 3

VITAFOL FE+ 3

VITAFOL GUMMIES 3

VITAFOL ULTRA 3

VITAFOL-NANO 3

VITAFOL-OB 3

VITAFOL-OB+DHA 3

VITAFOL-ONE 3

VITAMEDMD ONE RX/QUATREFO 3

VITAMEDMD REDICHEW RX 3

vitamins a/c/d/fluoride 1

VITAPEARL 3

VITATRUE 3

VOL-PLUS 2

VOL-TAB RX 2

VP-PNV-DHA 3

ZATEAN-PN DHA 2

ZATEAN-PN PLUS 2




32

MUSCULOSKELETAL THERAPY AGENTS

AMRIX 3 QL

baclofen tab 20mg 1

BACLOFEN TAB 5MG 3

carisoprodol 1

chlorzoxazon tab 500mg 1

CHLORZOXAZON TAB 250MG 2

cyclobenzaprine hcl 1

cyclobenzaprine hydrochlo 1

dantrolene sodium 1

EUFLEXXA 2 INJ SP

FIRST-BACLOFEN 5 2

GABLOFEN 2 INJ

GEL-ONE 3 INJ SP

HYALGAN 3 INJ SP

HYMOVIS 3 INJ SP

LORZONE 3

METAXALONE TAB 400MG 2

metaxalone tab 800mg 1

methocarbamol 1

MONOVISC 2 INJ SP

orphenadrine citrate er 1

ORTHOVISC 2 INJ SP

ROBAXIN-750 3

SOMA 3

SUPARTZ FX 3 INJ SP

SYNVISC 3 INJ SP

SYNVISC ONE 3 INJ SP

tizanidine hcl 1

tizanidine hydrochloride 1

NASAL AGENTS - SYSTEMIC AND TOPICAL

ADRENALIN SOL 1:1000 3

ASTEPRO 3

azelastine hcl 1

azelastine hydrochloride 1

BECONASE AQ 3 ST

DYMISTA 2 ST

FLONASE 3

flunisolide 1

fluticasone propionate 1

ipratropium bromide 1

NASONEX 3

PATANASE 3 ST

QNASL 2 ST

QNASL CHILDRENS 2 ST

SINUVA 3 SP

XHANCE 3

ZETONNA 3 ST

NEUROMUSCULAR AGENTS

BOTOX 2 INJ SP

DYSPORT 3 INJ SP

MYOBLOC 2 INJ SP

riluzole 1 SP

SPINRAZA 2 INJ SP

NUTRIENTS

dextrose 20% 1 INJ

dextrose 5% 1 INJ

intralipid 1 INJ

OPHTHALMIC AGENTS

ACULAR 3

ACULAR LS 3

ACUVAIL 3

ALOCRIL 3

ALPHAGAN P SOL 0.15% 3


ALREX 2

apraclonidine 1

atropine sulfate 1

AZASITE 2

AZOPT 3

BACITRACIN 2

bacitracin/polymyxin b 1

BEPREVE 2

BESIVANCE 3

BETIMOL 3

BETOPTIC-S 3

BLEPHAMIDE 3

BLEPHAMIDE S.O.P. 3

brimonidine tartrate 1

bromfenac 1

BROMSITE 3

carteolol hcl 1




33

CILOXAN 3

COMBIGAN 2

COSOPT 3

COSOPT PF 3

CYCLOMYDRIL 3

cyclopentolate hcl 1

cyclopentolate hydrochlor 1

dorzolamide hcl 1

dorzolamide hcl/timolol m 1

dorzolamide hydrochloride 1

DUREZOL 3

epinastine hcl 1

EYLEA 2 SP

fluorometholone 1

flurbiprofen sodium 1

FML 3

FML FORTE 3

FML LIQUIFILM 3

gatifloxacin 1

GENTAK 2

homatropine hbr 1

ILEVRO 2

IOPIDINE 3

ISTALOL 3

LACRISERT 3

LASTACAFT 3

latanoprost 1

levobunolol hcl 1

LOTEMAX 2

LUMIGAN 2

MAXIDEX 3

MOXEZA 2

moxifloxacin hydrochlorid 1

NATACYN 2

neomycin/bacitracin/polym 1

neomycin/polymyxin/bacitr 1

neomycin/polymyxin/dexame 1

neomycin/polymyxin/gramic 1

neo-polycin 1

neo-polycin hc 1

NEOSPORIN 3

NEVANAC 2

OCUFLOX 3

ofloxacin 1

olopatadine hcl 1

olopatadine hydrochloride 1

OZURDEX 2 SP

PATADAY 3

PATANOL 3

PAZEO 2

PHOSPHOLINE IODIDE 2

polycin 1

polymyxin b sulfate/trime 1

POLYTRIM 3

PRED FORTE 3

PRED MILD 3

PRED-G S.O.P. 3

prednisolone acetate 1

PROLENSA 2

proparacaine hcl 1

RESTASIS 2

RESTASIS MULTIDOSE 2

RHOPRESSA 2

SIMBRINZA 3

sodium sulfacetamide 1

SULFACET SOD OIN 10% OP 2

sulfacetamide sodium/pred 1

tetracaine hcl 1

tetracaine hydrochloride 1

TIMOLOL GEL SOL 0.5% OP 3

timolol gel sol 0.25% op 1

TIMOPTIC 3

TIMOPTIC OCUDOSE 3

TOBRADEX SUS 0.3-0.1% 3

TOBRADEX OIN 0.3-0.1% 2

TOBRADEX ST 2

tobramycin sulfate 1

tobramycin/dexamethasone 1

TOBREX 3

TRAVATAN Z 2

trifluridine 1

trimethoprim sulfate/poly 1

tropicamide 1

TRUSOPT 3




34

VIGAMOX 3

VYZULTA 3

XALATAN 3

XIIDRA 2

ZIOPTAN 3

ZIRGAN 3

ZYLET 2

ZYMAXID 3

OTIC AGENTS

acetic acid 1

CIPRO HC 3

CIPRODEX 2

CIPROFLOXACIN 2

COLY-MYCIN S 3

hydrocortisone/acetic aci 1

neomycin/polymyxin/hc 1

neomycin/polymyxin/hydroc 1

OTOVEL 2

Oxytocics

methergine 1

methylergonovine maleate 1

PASSIVE IMMUNIZING AND TREATMENT AGENTS

FLEBOGAMMA DIF 3 INJ SP

HIZENTRA 2 INJ SP

HYPERRHO S/D 2 INJ SP

RHOGAM ULTRA-FILTERED PLU 3 INJ SP

SYNAGIS 2 INJ SP

PENICILLINS

amoxicillin 1

amoxicillin/clavulanate p 1

ampicillin 1

AUGMENTIN 2

BICILLIN L-A 2 INJ

dicloxacillin sodium 1

MOXATAG 3

penicillin v potassium 1

piperacillin/tazobactam 1 INJ

Progestins

hydroxyprogesterone capro 1 INJ SP

MAKENA INJ 250MG/ML 2 INJ SP

MAKENA INJ 275MG 3 INJ SP

norethindrone acetate 1

progesterone 1

PROMETRIUM 3

PROVERA 3

Psychotherapeutic and Neurological Agents - Misc.

acamprosate calcium dr 1

ADDYI 3 SP

AMPYRA 2 SP

AUBAGIO 3 SP

AUSTEDO 3 SP

AVONEX 2 INJ SP

AVONEX PEN 2 INJ SP

BETASERON 2 INJ SP

BRISDELLE 3

CHANTIX 2 QL

CHANTIX CONTINUING MONTH 2 QL

CHANTIX STARTING MONTH PA 2 QL

chlordiazepoxide/amitript 1

COPAXONE INJ 40MG/ML 2 INJ SP

COPAXONE INJ 20MG/ML 3 INJ SP

dalfampridine er 1 SP

disulfiram 1

donepezil hcl 1

donepezil hydrochloride 1

EXTAVIA 2 INJ SP

fluoxetine 1

galantamine hydrobromide 1

GILENYA 2 SP

glatiramer acetate 1 INJ SP

glatopa 1 INJ SP

GRALISE 2

GRALISE STARTER 2

HORIZANT 3

INGREZZA 3 SP

LYRICA CR 3

memantine hcl 1

memantine hcl titration p 1

memantine hydrochloride 1

memantine hydrochloride e 1

NAMENDA 3




35

NAMENDA XR 3

NAMZARIC 2

NICOTROL INHALER 3

NICOTROL NS 3

NUEDEXTA 2

OCREVUS 2 INJ SP

olanzapine/fluoxetine 1

ORAP 3

paroxetine 1

perphenazine/amitriptylin 1

pimozide 1

PLEGRIDY 2 INJ SP

REBIF 2 INJ SP

REBIF REBIDOSE 2 INJ SP

REBIF REBIDOSE TITRATION 2 INJ SP

rivastigmine tartrate 1

rivastigmine transdermal 1

SAVELLA 2

SAVELLA TITRATION PACK 2

TECFIDERA 2 SP

TECFIDERA STARTER PACK 2 SP

tetrabenazine 1 SP

TYSABRI 2 INJ SP

XENAZINE 3 SP

XYREM 2 SP

Respiratory Agents - Misc.

ESBRIET 2 SP

OFEV 2 SP

ORKAMBI 2 SP

PROLASTIN-C 2 INJ SP

PULMOZYME 2 SP

SYMDEKO 2 SP

Tetracyclines

ACTICLATE 3

demeclocycline hcl 1

DORYX MPC 3

doxycycline sus 25mg/5ml 1

doxycycline hyclate 1

doxycycline hyclate dr 1

doxycycline monohydrate 1

minocycline hcl 1

minocycline hcl er 1

minocycline hydrochloride 1

okebo 1

SOLODYN 2

TARGADOX 3

tetracycline hydrochlorid 1

VIBRAMYCIN 3

XIMINO 3

THYROID AGENTS

ARMOUR THYROID 2

CYTOMEL 3

levothyroxine sodium 1

levothyroxine/liothyronin 1

levoxyl 1

liothyronine sodium 1

methimazole 1

NATURE-THROID 2

NATURE-THROID NT-2.5 2

np thyroid 120 1

np thyroid 15 1

np thyroid 30 1

np thyroid 60 1

np thyroid 90 1

propylthiouracil 1

SYNTHROID 3

TIROSINT 3

unithroid 1

WESTHROID 2

WP THYROID 3

Toxoids

ADACEL 2 INJ

BOOSTRIX 2 INJ

INFANRIX 2 INJ

TENIVAC 3 INJ

TETANUS/DIPHTHERIA TOXOID 2 INJ

ULCER DRUGS/ANTISPASMODICS/ANTICHOLINERGICS

ACIPHEX 3 QL

belladonna & opium 1

belladonna alkaloids & op 1

CARAFATE 2

chlordiazepoxide hcl/clid 1




36

cimetidine 1

cimetidine hcl 1

CUVPOSA 3

CYTOTEC 3

DEXILANT 3 QL ST

dicyclomine hcl 1

dicyclomine hydrochloride 1

DONNATAL 3

esomeprazole magnesium 1 QL

esomeprazole magnesium dr 1 QL

ESOMEPRAZOLE STRONTIUM 3

famotidine 1

FIRST-LANSOPRAZOLE 2 QL

FIRST-OMEPRAZOLE 2 QL

glycopyrrolate 1

hyoscyamine sulfate 1

hyoscyamine sulfate er 1

hyoscyamine sulfate odt 1

hyoscyamine sulfate sr 1

hyosyne 1

lansoprazole 1 QL

lansoprazole/amoxicillin/ 1

LEVSIN 3

LEVSIN/SL 3

methscopolamine bromide 1

misoprostol 1

NEXIUM GRA 10MG DR 2 QL

NEXIUM CAP 40MG 3 QL

nizatidine cap 150mg 1

NIZATIDINE SOL 15MG/ML 2

OMECLAMOX-PAK 3

omeprazole 1 QL

omeprazole dr 1 QL

omeprazole/sodium bicarbo 1

oscimin 1

oscimin sr 1

pantoprazole sodium 1 QL

pantoprazole sodium dr 1 QL

phenohytro 1

PREVACID 3 QL

PREVACID SOLUTAB 3 QL

PRILOSEC 3 QL

propantheline bromide 1

PROTONIX 3 QL

PYLERA 2

rabeprazole sodium 1 QL

ranitidine hcl 1

ranitidine hydrochloride 1

sucralfate tab 1gm 1

SUCRALFATE SUS 1GM/10ML 2

SYMAX DUOTAB 3

ZEGERID 3

Urinary Anti-infectives

HYOPHEN 2

MACROBID 3

MACRODANTIN 3

me/naphos/mb/hyo 1 1

methenamine hippurate 1

methenamine mandelate 1

MONUROL 3

nitrofurantoin 1

nitrofurantoin macrocryst 1

nitrofurantoin monohydrat 1

phosphasal 1

urelle 1

uribel 1

URIMAR-T 2

uro-458 1

UROGESIC-BLUE 2

uro-mp 1

ustell 1

vilamit mb 1

Urinary Antispasmodics

bethanechol chloride 1

darifenacin hydrobromide 1 QL

DETROL 3 QL

DETROL LA 3 QL

flavoxate hcl 1

GELNIQUE 2

MYRBETRIQ 2

oxybutynin chloride 1

oxybutynin chloride er 1 QL

tolterodine tartrate 1 QL

tolterodine tartrate er 1 QL




37

TOVIAZ 2 QL

trospium chloride 1 QL

trospium chloride er 1 QL

VESICARE 2 QL

VACCINES

AFLURIA 2018-2019 2 INJ

AFLURIA PF 2018-2019 2 INJ

AFLURIA QUADRIVALENT 2018 2 INJ

BEXSERO 2 INJ

ENGERIX-B 2 INJ

FLUAD 2018-2019 2 INJ

FLUARIX QUADRIVALENT 2018 2 INJ

FLUBLOK QUADRIVALENT 2018 2 INJ

FLUCELVAX QUADRIVALENT 20 2 INJ

FLULAVAL QUADRIVALENT 201 2 INJ

FLUMIST QUADRIVALENT 2

FLUZONE HIGH-DOSE PF 2018 2 INJ

FLUZONE QUADRIVALENT 2018 2 INJ

GARDASIL 9 2 INJ

HAVRIX 2 INJ

IMOVAX RABIES (H.D.C.V.) 2 INJ

IPOL INACTIVATED IPV 2 INJ

IXIARO 2 INJ

MENACTRA 2 INJ

MENVEO 3 INJ

M-M-R II 2 INJ

PNEUMOVAX 23 2 INJ

PNEUMOVAX 23/1 DOSE 2 INJ

PREVNAR 13 2 INJ

RABAVERT 2 INJ

RECOMBIVAX HB 2 INJ

SHINGRIX 2 INJ

STAMARIL 2 INJ

TRUMENBA 2 INJ

TWINRIX 2 INJ

TYPHIM VI 2 INJ

VAQTA 3 INJ

VARIVAX 2 INJ

VAXCHORA 2

VIVOTIF 2

YF-VAX 2 INJ

ZOSTAVAX 3 INJ

VAGINAL PRODUCTS

AVC 3

CLEOCIN 3

CLINDESSE 3

CRINONE 2

ENDOMETRIN 3

ESTRACE 3

estradiol 1

ESTRING 2

FEM PH 2

FEMRING 3

FIRST-PROGESTERONE VGS 10 3

FIRST-PROGESTERONE VGS 20 3

GYNAZOLE-1 3

IMVEXXY MAINTENANCE PACK 3

IMVEXXY STARTER PACK 3

INTRAROSA 3

metronidazole vaginal 1

MICONAZOLE 3 2

NUVESSA 3

terconazole 1

VAGIFEM 3

vandazole 1

yuvafem 1

Vasopressors

ADRENALIN INJ 30/30ML 2 INJ

AUVI-Q 3 INJ SP

EPIPEN 2-PAK 2 INJ

EPIPEN-JR 2-PAK 2 INJ

midodrine hcl 1

midodrine hydrochloride 1

NORTHERA 3 SP

VITAMINS

ergocalciferol 1

MEPHYTON 3

phytonadione 1

vitamin k1 1 INJ

38

A

abacavir ____________ 15

abacavir/lamivudine __ 15

ABELCET ____________ 11

ABILIFY _____________ 14

ABILIFY MAINTENA ___ 14

ABSORICA __________ 20

ABSTRAL _____________ 4

acamprosate calcium dr 34

ACANYA ____________ 20

acarbose _____________ 9

ACCUPRIL ___________ 12

acebutolol hcl ________ 16

acebutolol hydrochloride

_________________ 16

acetaminophen/caffeine/di

__________________ 4

acetaminophen/codeine 4

acetaminophen/codeine

#3 ________________ 4

acetaminophen/codeine

pho ______________ 4

acetazolamide _______ 24

acetazolamide er _____ 24

acetic acid___________ 34

acetic acid 0.25% _____ 26

acetylcysteine _______ 20

ACIPHEX ____________ 35

acitretin ____________ 20

ACTEMRA ____________ 3

ACTICLATE __________ 35

ACTOPLUS MET XR ____ 9

ACUICYN DAILY EYELID &

EY _______________ 20

ACULAR ____________ 32

ACULAR LS __________ 32

ACUVAIL ____________ 32

acyclovir ____________ 15

ACZONE ____________ 20

ADACEL_____________ 35

adapalene ___________ 20

adapalene pump _____ 20

adapalene/benzoyl peroxid

_________________ 20

ADCIRCA ____________ 16

ADDERALL ___________ 3

ADDERALL XR _________ 3

ADDYI ______________ 34

ADEMPAS ___________ 16

ADHD/ANTI-

NARCOLEPSY/ANTI-

OBESITY/ANOREXIANTS

__________________ 3

ADIPEX-P ____________ 3

ADLYXIN _____________ 9

ADLYXIN STARTER PACK 9

ADMELOG ___________ 9

ADMELOG SOLOSTAR __ 9

ADRENALIN INJ 30/30ML

_________________ 37

ADRENALIN SOL 1

1000 _____________ 32

ADVAIR DISKUS _______ 6

ADVAIR HFA __________ 6

ADVATE ____________ 27

ADZENYS ER __________ 3

ADZENYS XR-ODT ______ 3

AFINITOR ___________ 13

AFLURIA 2018-2019 ___ 37

AFLURIA PF 2018-2019 37

AFLURIA QUADRIVALENT

2018 _____________ 37

AFREZZA _____________ 9

AGGRENOX __________ 27

AIMOVIG ___________ 29

AIRDUO RESPICLICK

113/14 ____________ 6

AIRDUO RESPICLICK

232/14 ____________ 6

AIRDUO RESPICLICK 55/14

__________________ 6

AJOVY ______________ 29

AKTIPAK ____________ 20

AKYNZEO ___________ 10

ALA SCALP __________ 20

ALA-QUIN ___________ 20

albendazole __________ 6

ALBENZA _____________ 6

albuterol sulfate _______ 6

albuterol sulfate er _____ 6

alclometasone dipropionat

_________________ 20

ALCORTIN A _________ 20

ALDACTAZIDE ________ 24

ALDACTONE _________ 24

ALDARA ____________ 20

ALECENSA ___________ 13

alendronate tab 35mg _ 25

ALENDRONATE TAB 40MG

_________________ 25

ALEVICYN ANTIPRURITIC

SG _______________ 20

alfuzosin hcl er _______ 26

ALINIA ______________ 13

ALLERGENIC

EXTRACTS/BIOLOGICAL

S MISC ____________ 3

allopurinol __________ 27

almotriptan __________ 29

almotriptan malate ___ 29

ALOCRIL ____________ 32

ALOGLIPTIN __________ 9

ALOGLIPTIN/METFORMIN

HCL _______________ 9

ALOGLIPTIN/PIOGLITAZON

E _________________ 9

ALORA ______________ 25

alosetron hydrochloride 26


ALPHAGAN P SOL 0.15%

_________________ 32

alprazolam ___________ 6

alprazolam er _________ 6

alprazolam odt ________ 6

alprazolam xr _________ 6

ALREX ______________ 32

ALTABAX ____________ 20

altavera _____________ 17

ALUNBRIG ___________ 13

ALVESCO _____________ 6

alyacen 1/35 _________ 17

alyacen 7/7/7 ________ 17

amabelz _____________ 25

amantadine hcl _______ 14

AMARYL _____________ 9

AMBIEN _____________ 28

AMBIEN CR __________ 28

amcinonide __________ 20

Amebicides ___________ 3

amethia _____________ 17

amethia lo ___________ 17

amethyst ____________ 17

AMICAR _____________ 28

amiloride hcl _________ 24

amiloride/hydrochlorothia

_________________ 24

Aminoglycosides ______ 3

amiodarone hcl ________ 6

amiodarone hydrochloride

__________________ 6

AMITIZA ____________ 26

amitriptyline hcl _______ 8

amitriptyline hydrochlori 8

amlodipine besylate ___ 16

amlodipine besylate/atorv

_________________ 16

amlodipine besylate/benaz

_________________ 12

amlodipine besylate/valsa

_________________ 12

amlodipine/olmesartan

med _____________ 12

amlodipine/valsartan/hctz

_________________ 12

amnesteem __________ 20

amoxicillin ___________ 34

amoxicillin/clavulanate p 34

amphetamine sulfate ___ 3

amphetamine/dextroamph

eta _______________ 3

amphotericin b _______ 11

ampicillin ____________ 34

AMPYRA ____________ 34

AMRIX ______________ 32

anagrelide hydrochloride

_________________ 27

ANALGESICS - ANTI-

INFLAMMATORY ____ 3

ANALGESICS - NonNarcotic

__________________ 4

ANALGESICS - OPIOID ___ 4

ANALPRAM HC ________ 5

ANALPRAM HC SINGLES _ 5

ANALPRAM-HC ________ 5

anastrozole __________ 13

ANDRODERM _________ 5

ANDROGEL GEL

1%(50MG) _________ 5

ANDROGEL GEL 1.62% 5

ANDROGEL PUMP______ 5

ANDROGENS-ANABOLIC 5

ANGELIQ ____________ 25

ANORECTAL AGENTS ___ 5

ANORO ELLIPTA _______ 6

ANTARA _____________ 11

Anthelmintics _________ 6

ANTIANGINAL AGENTS __ 6

ANTIANXIETY AGENTS __ 6

ANTIARRHYTHMICS ____ 6

ANTIASTHMATIC AND

BRONCHODILATOR

AGENTS ___________ 6

ANTICOAGULANTS _____ 7

ANTICONVULSANTS ____ 7

ANTIDEPRESSANTS _____ 8

ANTIDIABETICS ________ 9

ANTIDIARRHEAL/PROBIOT

IC AGENTS ________ 10

Antidotes and Specific

Antagonists _______ 10

ANTIEMETICS ________ 10

Antifungals __________ 11

ANTIHISTAMINES _____ 11

ANTIHYPERLIPIDEMICS 11

ANTIHYPERTENSIVES __ 12

Anti-infective Agents -

Misc. _____________ 12

Antimalarials _________ 13

Antimyasthenic/Cholinergi

c Agents __________ 13

Antimycobacterial Agents

_________________ 13

ANTINEOPLASTICS AND

ADJUNCTIVE

THERAPIES ________ 13

ANTIPARKINSON AND

RELATED THERAPY

AGENTS __________ 14

ANTIPSYCHOTICS/ANTIMA

NIC AGENTS _______ 14

39

Antiseptics & Disinfectants

_________________ 15

ANTIVIRALS _________ 15

anucort-hc ___________ 5

anusol-hc ____________ 5

APIDRA ______________ 9

APIDRA SOLOSTAR ____ 9

APLENZIN ____________ 8

APOKYN ____________ 14

apraclonidine ________ 32

aprepitant __________ 10

apri ________________ 17

APRISO _____________ 26

APTENSIO XR _________ 3

APTIOM _____________ 7

aranelle_____________ 17

ARANESP ALBUMIN FREE

_________________ 27

ARCAPTA NEOHALER ___ 6

ARESTIN ____________ 30

aripiprazole _________ 14

aripiprazole odt ______ 14

ARISTADA ___________ 14

armodafinil ___________ 3

ARMOUR THYROID ___ 35

ARNUITY ELLIPTA______ 6

AROMASIN __________ 13

ARTHROTEC 75 _______ 3

ARYMO ER ___________ 4

ARZOL SILVER NITRATE

APP _____________ 20

ASACOL HD _________ 26

ascomp/codeine ______ 4

ashlyna _____________ 17

ASMANEX HFA ________ 6

ASMANEX TWISTHALER

120 ME ___________ 6

ASMANEX TWISTHALER 14

MET ______________ 6


MET ______________ 6


MET ______________ 6

aspirin/dipyridamole __ 27

ASTAGRAF XL ________ 30

ASTEPRO ___________ 32

ASTERO ____________ 20

atazanavir ___________ 15

atazanavir sulfate _____ 15

atenolol ____________ 16

atenolol/chlorthalidone 12

ATIVAN ______________ 6

atomoxetine __________ 3

atomoxetine hydrochloride

__________________ 3

atorvastatin calcium __ 11

atovaquone _________ 13

atovaquone/proguanil hcl

_________________ 13

ATRIPLA ____________ 15

atropine sulfate ______ 32

ATROVENT HFA _______ 7

AUBAGIO ___________ 34

aubra _______________ 17

aubra eq ____________ 17

augmented

betamethasone d __ 20

AUGMENTIN _________ 34

AURYXIA ____________ 26

AUSTEDO ___________ 34

AUVI-Q _____________ 37

AVANDIA ____________ 9

AVAPRO ____________ 12

avar cleanser ________ 20

AVAR LS ____________ 20

AVAR LS CLEANSER ___ 20

avar-e green _________ 20

AVAR-E LS ___________ 20

AVASTIN ____________ 13

AVC ________________ 37

AVEED _______________ 5

AVENOVA ___________ 20

aviane ______________ 17

avita _______________ 20

AVODART ___________ 26

AVONEX ____________ 34

AVONEX PEN ________ 34

azacitidine ___________ 13

AZASAN ____________ 30

AZASITE ____________ 32

azathioprine _________ 30

azelastine hcl ________ 32

azelastine hydrochloride 32

AZELEX _____________ 20

AZILECT _____________ 14

AZITHROMYCIN POW 1GM

PAK _____________ 28

azithromycin sus 200/5ml

_________________ 28

AZOPT ______________ 32

AZOR _______________ 12

AZULFIDINE EN-TABS __ 26

azurette ____________ 17

B

BACITRACIN _________ 32

bacitracin/polymyxin b 32

baclofen tab 20mg __ 32

BACLOFEN TAB 5MG 32

BALCOLTRA _________ 17

balsalazide disodium __ 26

balziva ______________ 17

BANZEL ______________ 7

BARACLUDE _________ 15

BASAGLAR KWIKPEN ___ 9

BAXDELA____________ 26

bd posiflush _________ 29

BECONASE AQ _______ 32

bekyree _____________ 17

BELBUCA _____________ 4

belladonna & opium ___ 35

belladonna alkaloids & op

_________________ 35

BELSOMRA __________ 28

BELVIQ ______________ 3

BELVIQ XR ____________ 3

benazepril hcl ________ 12

benazepril hcl/hydrochlor

_________________ 12

BENEFIX_____________ 27

BENICAR ____________ 12

BENICAR HCT ________ 12

BENLYSTA ___________ 30

BENSAL HP __________ 20

BENZACLIN __________ 20

BENZACLIN WITH PUMP 20

BENZEFOAM _________ 20

BENZEFOAM ULTRA ___ 20

benzepro ____________ 20

benzepro creamy wash 20

benzepro foaming cloths 20

benzepro short contact 20

benzonatate _________ 20

benztropine mesylate __ 14

BEPREVE ____________ 32

BESIVANCE __________ 32

BETA BLOCKERS ______ 16

betamethasone

dipropionat _______ 20

betamethasone sodium

phos _____________ 19

betamethasone valerate 20

BETAPACE ___________ 16

BETASERON _________ 34

betaxolol hcl _________ 16

bethanechol chloride __ 36

BETIMOL ____________ 32

BETOPTIC-S __________ 32

BEVESPI AEROSPHERE __ 7

BEXSERO ____________ 37

BEYAZ ______________ 17

BIAFINE _____________ 20

bicalutamide _________ 13

BICILLIN L-A _________ 34

BIDIL _______________ 16

BIKTARVY ___________ 15

BILTRICIDE ___________ 6

bimatoprost _________ 20

BIONECT ____________ 20

bisoprolol fumarate ___ 16

bisoprolol fumarate/hydro

_________________ 12

BLEPHAMIDE ________ 32

BLEPHAMIDE S.O.P. ___ 32

blisovi 24 fe __________ 17

blisovi fe 1.5/30 ______ 17

blisovi fe 1/20 ________ 17

BONIVA _____________ 25

BONJESTA ___________ 10

BOOSTRIX ___________ 35

BOSULIF _____________ 13

BOTOX ______________ 32

BOTOX COSMETIC ____ 20

bp 10-1 _____________ 20

bp foam _____________ 20

bp wash _____________ 20

BPO ________________ 20

BRAFTOVI ___________ 13

BREO ELLIPTA _________ 7

briellyn ______________ 17

BRILINTA ____________ 27

brimonidine tartrate ___ 32

BRISDELLE ___________ 34

BRIVIACT _____________ 7

bromfed dm _________ 20

bromfenac ___________ 32

bromocriptine mesylate 14

bromphen/pseudoephedri

ne _______________ 20

BROMSITE ___________ 32

BROVANA ____________ 7

budesonide ___________ 7

budesonide er ________ 19

bumetanide __________ 24

BUNAVAIL ____________ 4

bupap _______________ 4

bupivacaine hcl _______ 28

BUPIVILOG KIT _______ 19

BUPRENORPHINE ______ 4

buprenorphine hcl _____ 4

buprenorphine hcl/naloxon

__________________ 4

buprenorphine hydrochlori

__________________ 4

bupropion hcl _________ 8

bupropion hcl er _______ 8

bupropion hcl sr _______ 8

bupropion hcl xl _______ 8

bupropion hydrochloride 8

bupropion hydrochloride e

__________________ 8

bupropion hydrochloride s

__________________ 8

bupropion hydrochloride x

__________________ 8

buspirone hcl __________ 6

buspirone hydrochloride 6

BUT/ASA/CAF TAB _____ 4

but/asa/caf/ cap cod 30mg

__________________ 4

butalbital/acetaminophen4

butalbital/acetaminophen/

__________________ 4

butorphanol tartrate ____ 4

BUTRANS _____________ 4

BYDUREON ___________ 9

BYDUREON BCISE ______ 9

BYDUREON PEN _______ 9

BYETTA ______________ 9

40

BYSTOLIC ___________ 16

BYVALSON __________ 12

C

cabergoline__________ 25

CABOMETYX ________ 13

CADUET ____________ 16

caffeine citrate ________ 3

calcipotriene ________ 20

calcipotriene/betamethaso

_________________ 20

calcitonin salmon _____ 25

calcitonin-salmon _____ 25

calcitrene ___________ 20

calcitriol ____________ 25

calcium acetate ______ 26

Calcium Channel Blockers

_________________ 16

CAMBIA ____________ 29

camila ______________ 17

camrese ____________ 17

camrese lo __________ 17

CANASA ____________ 26

candesartan cilexetil __ 12

candesartan cilexetil/hyd

_________________ 12

capecitabine _________ 13

CAPEX ______________ 20

CAPHOSOL __________ 30

CAPRELSA ___________ 13

captopril ____________ 12

captopril/hydrochlorothia

_________________ 12

CARAFATE __________ 35

CARB/LEVO 75 TAB

/ENTACAP ________ 14

carb/levo100 tab /entacap

_________________ 14

carbamazepine ________ 7

carbamazepine er _____ 7

CARBATROL __________ 7

carbidopa ___________ 14

carbidopa/levodopa___ 14

carbidopa/levodopa er 14

carbidopa/levodopa odt 14

carbinoxamine maleate 11

CARDIOTONICS ______ 16

CARDIOVASCULAR

AGENTS - MISC. ___ 16

CARDIZEM LA ________ 16

CARDURA XL ________ 26

carisoprodol _________ 32

CARNITOR __________ 25

CAROSPIR ___________ 24

carteolol hcl _________ 32

cartia xt ____________ 16

carvedilol ___________ 16

carvedilol phosphate __ 16

CATAPRES-TTS-1 _____ 12

CATAPRES-TTS-3 _____ 12

CAVERJECT IMPULSE __ 17

CAYA _______________ 29

CAYSTON ___________ 13

caziant ______________ 17

cefaclor _____________ 17

cefadroxil ___________ 17

cefdinir _____________ 17

cefepime ____________ 17

cefixime ____________ 17

cefpodoxime proxetil __ 17

cefprozil ____________ 17

ceftriaxone sodium ___ 17

cefuroxime axetil _____ 17

celacyn _____________ 20

CELEBREX ____________ 3

celecoxib _____________ 3

CELEXA ______________ 8

CELLCEPT ___________ 30

CELONTIN ____________ 7

CENTRATEX _________ 27

CEPHALEXIN TAB 250MG

_________________ 17

cephalexin tab 500mg 17

CEPHALOSPORINS ____ 17

CERACADE __________ 21

ceramax ____________ 21

CERDELGA___________ 27

CEREFOLIN NAC ______ 24

CETROTIDE __________ 25

cevimeline hcl ________ 30

CHANTIX ____________ 34

CHANTIX CONTINUING

MONTH __________ 34

CHANTIX STARTING

MONTH PA _______ 34

chateal _____________ 17

CHEMET ____________ 10

chlordiazepoxide hcl ___ 6

chlordiazepoxide hcl/clid 35

chlordiazepoxide/amitript

_________________ 34

chlorhexidine gluconate 30

chloroquine phosphate 13

chlorothiazide ________ 24

chlorpromazine hcl ____ 14

chlorpropamide _______ 9

chlorthalidone _______ 24

CHLORZOXAZON TAB

250MG ___________ 32

chlorzoxazon tab 500mg 32

cholestyramine _______ 11

cholestyramine light ___ 11

chorionic gonadotropin 25

chromagen __________ 27

CIALIS ______________ 17

ciclopirox ___________ 21

ciclopirox nail lacquer _ 21

ciclopirox olamine ____ 21

cidofovir ____________ 15

cilostazol ____________ 27

CILOXAN ____________ 33

cimetidine ___________ 36

cimetidine hcl ________ 36

CIMZIA _____________ 26

CIMZIA STARTER KIT __ 26

CIPRO ______________ 26

CIPRO HC____________ 34

CIPRODEX ___________ 34

CIPROFLOXACIN ______ 34

ciprofloxacin er _______ 26

ciprofloxacin hcl ______ 26

ciprofloxacin hydrochlori 26

citalopram ____________ 8

citalopram hydrobromide 8

CITRANATAL 90 DHA __ 30

CITRANATAL ASSURE __ 30

CITRANATAL B-CALM __ 30

CITRANATAL BLOOM __ 30

CITRANATAL DHA _____ 30

CITRANATAL HARMONY 30

CITRANATAL RX ______ 30

claravis _____________ 21

CLARINEX ___________ 11

CLARINEX-D 12 HOUR _ 20

clarithromycin ________ 28

clarithromycin er _____ 28

clemastine fumarate___ 11

CLENPIQ ____________ 28

CLEOCIN ____________ 37

CLIMARA ____________ 25

CLIMARA PRO ________ 25

CLINDACIN PAC ______ 21

CLINDAGEL __________ 21

clindamycin hcl _______ 13

clindamycin hydrochloride

_________________ 13

clindamycin palmitate hcl

_________________ 13

clindamycin phosphate 21

CLINDAMYCIN

PHOSPHATE/BEN __ 21

clindamycin phosphate/tre

_________________ 21

clindamycin/benzoyl perox

_________________ 21

CLINDESSE ___________ 37

clinpro 5000 _________ 30

clobazam _____________ 7

clobetasol propionate _ 21

clobetasol propionate e 21

clobetasol propionate emo

_________________ 21

CLOBEX _____________ 21

CLOCORTOLONE PIVALATE

_________________ 21

CLOCORTOLONE PIVALATE

PUM _____________ 21

clodan ______________ 21

CLODERM ___________ 21

CLODERM PUMP ______ 21

clomiphene citrate ____ 25

clomipramine hcl_______ 8

clonazepam ___________ 7

clonazepam odt ________ 7

clonidine hcl _________ 12

clonidine hcl er ________ 3

clonidine hydrochloride _ 3

clonidine hydrochloride e 3

clopidogrel ___________ 27

clorazepate dipotassium _ 6

clotrimazole __________ 30

clotrimazole/betamethaso

n ________________ 21

clozapine ____________ 14

CLOZAPINE TAB

200/ODT __________ 15

clozapine tab 25mg odt

_________________ 15

COAL TAR ___________ 21

COARTEM ___________ 13

codeine sulfate ________ 4

COLCHICINE CAP 0.6MG

_________________ 27

COLCHICINE TAB 0.6MG

_________________ 27

COLCRYS ____________ 27

colesevelam hydrochloride

_________________ 11

COLESTID ____________ 11

colestipol hcl _________ 11

colocort ______________ 5

COLY-MYCIN S ________ 34

COLYTE-FLAVOR PACKS 28

COMBIGAN __________ 33

COMBIPATCH ________ 25

COMBIVENT RESPIMAT _ 7

COMPLERA __________ 15

complete natal dha ____ 30

completenate ________ 30

compro _____________ 15

CONCEPT DHA ________ 30

CONCEPT OB _________ 30

CONCERTA____________ 3

CONDYLOX __________ 21

constulose ___________ 28

CONTRACEPTIVES _____ 17

CONTRAVE ___________ 3

CONZIP ______________ 5

COPAXONE INJ

20MG/ML _________ 34

COPAXONE INJ

40MG/ML _________ 34

CORDRAN ___________ 21

COREG ______________ 16

COREG CR ___________ 16

CORGARD ___________ 16

CORLANOR __________ 17

CORTEF _____________ 19

CORTICOSTEROIDS ____ 19

41

CORTIFOAM __________ 5

CORTISPORIN ________ 21

corvita 150 __________ 27

CORVITE FE _________ 27

COSENTYX __________ 21

COSENTYX SENSOREADY

PEN _____________ 21

COSOPT ____________ 33

COSOPT PF __________ 33

COTEMPLA XR-ODT ____ 3

COUGH/COLD/ALLERGY 20

COUMADIN __________ 7

COZAAR ____________ 12

CREON _____________ 24

CRESEMBA __________ 11

CRESTOR ___________ 11

CRINONE ___________ 37

cromolyn sodium ______ 7

cryselle-28 __________ 17

CUVPOSA ___________ 36

cyanocobalamin ______ 27

cyclafem 1/35________ 17

cyclafem 7/7/7 _______ 17

cyclobenzaprine hcl ___ 32

cyclobenzaprine hydrochlo

_________________ 32

CYCLOMYDRIL _______ 33

cyclopentolate hcl ____ 33

cyclopentolate hydrochlor

_________________ 33

CYCLOPHOSPH CAP 25MG

_________________ 13

cyclophosph cap 50mg 13

CYCLOSET ____________ 9

cyclosporine _________ 30

cyclosporine cap 25mg

mod _____________ 30

CYCLOSPORINE CAP 50MG

MOD ____________ 30

CYMBALTA ___________ 8

cyproheptadine hcl ___ 11

cyred _______________ 17

cyred eq ____________ 17

CYTOMEL ___________ 35

CYTOTEC ____________ 36

D

dalfampridine er _____ 34

DALIRESP ____________ 7

danazol ______________ 5

dantrolene sodium____ 32

dapsone ____________ 13

darifenacin hydrobromide

_________________ 36

dasetta 1/35 _________ 17

dasetta 7/7/7 ________ 17

daysee _____________ 17

DAYTRANA ___________ 3

DEBACTEROL ________ 30

deblitane ____________ 17

DELESTROGEN _______ 25

DELZICOL ___________ 26

demeclocycline hcl ____ 35

DENAVIR ____________ 21

denta 5000 plus ______ 30

dentagel ____________ 30

DEPAKOTE ___________ 7

DEPAKOTE ER _________ 7

DEPLIN 15 ___________ 24

DEPLIN 7.5 __________ 24

DEPO-ESTRADIOL _____ 25

DEPO-MEDROL _______ 19

DEPO-PROVERA

CONTRACEPTIV ____ 17

DEPO-SUBQ PROVERA 104

_________________ 17

DEPO-TESTOSTERONE __ 5

DERMACINRX LEXITRAL

PHARM __________ 21

dermacinrx prizopak __ 21

DERMACINRX ZRM PAK 21

DERMA-SMOOTHE/FS

SCALP ____________ 21

DERMASORB HC______ 21

DERMASORB XM _____ 21

DERMATOLOGICALS __ 20

dermazene __________ 21

DESCOVY ___________ 15

desipramine hcl _______ 8

desipramine hydrochloride

__________________ 8

desloratadine ________ 11

desloratadine odt _____ 11

desmopressin acetate _ 25

desogestrel/ethinyl estra17

DESONATE __________ 21

desonide ____________ 21

desoximetasone ______ 21

desvenlafax tab 100mg er

__________________ 8

DESVENLAFAX TAB 50MG

ER ________________ 8

DETROL _____________ 36

DETROL LA __________ 36

DEXAMETHASON SOL

0.5/5ML __________ 19

dexamethason tab 0.75mg

_________________ 19

DEXAMETHASONE

INTENSOL ________ 19

DEXILANT ___________ 36

dexmethylphenidate hcl 3

dexmethylphenidate hcl er

__________________ 3

dexmethylphenidate

hydroc ____________ 3

DEXPAK 10 DAY ______ 19

DEXPAK 6 DAY _______ 19

dextroamphetamine

sulfate ____________ 3

dextrose 20% ________ 32

dextrose 5% _________ 32

DIAGNOSTIC PRODUCTS 24

dialyvite _____________ 30

DIALYVITE/ZINC ______ 30

DIASTAT ACUDIAL _____ 7

diazepam _____________ 6

diazepam intensol______ 6

DIAZEPAM RECTAL GEL _ 8

DICLEGIS ____________ 10

diclofenac potassium ___ 3

diclofenac sodium _____ 21

diclofenac sodium dr ___ 3

diclofenac sodium er ___ 3

diclofenac sodium/misopro

__________________ 3

dicloxacillin sodium ___ 34

dicyclomine hcl _______ 36

dicyclomine hydrochloride

_________________ 36

DIETARY

PRODUCTS/DIETARY

MANAGEMENT

PRODUCTS ________ 24

diethylpropion hcl______ 3

diethylpropion hcl er ___ 3

DIFFERIN ____________ 21

DIFICID _____________ 28

diflorasone diacetate __ 21

DIFLUCAN ___________ 11

diflunisal _____________ 4

DIGESTIVE AIDS ______ 24

digitek ______________ 16

digox _______________ 16

digoxin ______________ 16

dihydroergot inj 1mg/ml 29

DIHYDROERGOT SPR

4MG/ML _________ 29

DILANTIN CAP 100MG 8

DILANTIN CAP 30MG _ 8

DILANTIN INFATABS ____ 8

diltiazem hcl _________ 16

diltiazem hcl cd _______ 16

diltiazem hcl er _______ 16

diltiazem hydrochloride e

_________________ 16

dilt-xr _______________ 16

DIOVAN _____________ 12

DIOVAN HCT _________ 12

DIPENTUM __________ 26

diphenhydramine hcl __ 11

diphenoxylate/atropine 10

dipyridamole _________ 27

disopyramide phosphate 6

disulfiram ___________ 34

DIURETICS ___________ 24

DIURIL ______________ 24

divalproex sodium _____ 8

divalproex sodium dr ___ 8

divalproex sodium er ___ 8

DIVIGEL _____________ 25

dofetilide _____________ 6

donepezil hcl _________ 34

donepezil hydrochloride 34

DONNATAL __________ 36

DORAL ______________ 28

DORYX MPC _________ 35

dorzolamide hcl _______ 33

dorzolamide hcl/timolol m

_________________ 33

dorzolamide hydrochloride

_________________ 33

doxazosin mesylate ____ 12

doxepin hcl ___________ 8

doxepin hydrochloride _ 21

doxercalciferol________ 25

DOXYCYCLINE CAP 40MG

_________________ 21

doxycycline sus 25mg/5ml

_________________ 35

doxycycline hyclate ____ 35

doxycycline hyclate dr__ 35

doxycycline monohydrate

_________________ 35

DRITHO-CREME HP ____ 21

dronabinol ___________ 10

drospirenone/ethinyl estr

_________________ 17

DROXIA _____________ 27

DRYSOL _____________ 21

DUAC _______________ 21

DUAVEE _____________ 25

DUEXIS_______________ 3

DULERA ______________ 7

duloxetine hcl _________ 8

duloxetine hydrochloride 8

DUPIXENT ___________ 21

DURAGESIC ___________ 5

DUREZOL ____________ 33

dutasteride __________ 26

dutasteride/tamsulosin hc

_________________ 26

dutasteride/tamsulosin hy

_________________ 26

DUTOPROL __________ 12

DYANAVEL XR _________ 3

DYAZIDE ____________ 24

DYMISTA ____________ 32

DYRENIUM __________ 24

DYSPORT ____________ 32

E

e.e.s. 400 ____________ 28

E.E.S. GRANULES ______ 28

econazole nitrate _____ 21

ECOZA ______________ 21

EDARBI _____________ 12

42

EDARBYCLOR ________ 12

EDEX _______________ 17

EDLUAR ____________ 28

EDURANT ___________ 15

eemt _______________ 25

eemt hs _____________ 25

efavirenz ____________ 15

EFFER-K TAB 20MEQ 29

effer-k tab 25meq ef 29

effervescent pot chloride

_________________ 29

EFFEXOR XR __________ 8

EFFIENT ____________ 27

EFUDEX _____________ 21

ELETONE ____________ 21

ELETONE TWINPACK __ 21

eletriptan hydrobromide 29

ELFOLATE TAB 15MG 24

ELFOLATE TAB 7.5MG 24

ELIDEL ______________ 21

ELIGARD ____________ 13

elinest ______________ 17

ELIQUIS ______________ 7

ELIQUIS STARTER PACK _ 7

elite-ob _____________ 30

ELLA _______________ 17

ELMIRON ___________ 27

ELOCON ____________ 21

ELOCTATE ___________ 27

EMBEDA _____________ 5

EMEND _____________ 11

EMFLAZA ___________ 19

EMGALITY __________ 29

emoquette __________ 17

EMSAM _____________ 8

EMULSION SB _______ 21

EMVERM ____________ 6

enalapril maleate _____ 12

enalapril maleate/hydroch

_________________ 12

ENBRACE HR ________ 30

ENBREL ______________ 3

ENBREL MINI _________ 3

ENBREL SURECLICK ____ 3

endocet _____________ 5

ENDOCRINE AND

METABOLIC AGENTS -

MISC. ____________ 25

ENDOMETRIN _______ 37

ENGERIX-B __________ 37

ENLYTE _____________ 24

enoxaparin sodium ____ 7

enpresse-28 _________ 17

enskyce _____________ 17

ENSTILAR ___________ 21

entacapone _________ 14

entecavir ___________ 15

ENTERAGAM ________ 24

ENTOCORT EC _______ 19

ENTRESTO __________ 17

ENTTY SPRAY EMULSION

_________________ 21

ENTYVIO ____________ 26

enulose _____________ 26

ENVARSUS XR________ 30

EPANED ____________ 12

EPCLUSA ____________ 15

EPICERAM ___________ 21

EPIDUO _____________ 21

EPIDUO FORTE _______ 21

EPIFOAM ___________ 21

epinastine hcl ________ 33

EPIPEN 2-PAK ________ 37

EPIPEN-JR 2-PAK _____ 37

epitol ________________ 8

eplerenone __________ 12

EPOGEN ____________ 27

eprosartan mesylate __ 12

ergocalciferol ________ 37

ERGOMAR __________ 29

ergotamine tartrate/caffe

_________________ 29

ERIVEDGE ___________ 13

errin _______________ 17

ERTACZO ____________ 21

ery _________________ 21

ERYPED 400 _________ 28

ERY-TAB ____________ 28

ERYTHROCIN STEARATE 28

erythromycin ________ 21

erythromycin base ____ 29

erythromycin ethylsuccina

_________________ 29

erythromycin/benzoyl pero

_________________ 21

ESBRIET _____________ 35

escitalopram oxalate ___ 8

esgic ________________ 4

esomeprazole magnesium

_________________ 36

esomeprazole magnesium

dr _______________ 36

ESOMEPRAZOLE

STRONTIUM ______ 36

estarylla ____________ 18

estazolam ___________ 28

esterified estrogens/meth

_________________ 26

ESTRACE ____________ 37

estradiol ____________ 37

estradiol valerate _____ 26

estradiol/norethindrone a

_________________ 26

ESTRING ____________ 37

ESTROGEL ___________ 26

Estrogens ___________ 25

ESTROSTEP FE _______ 18

eszopiclone __________ 28

ethacrynic acid _______ 24

ethambutol hcl _______ 13

ethosuximide _________ 8

ethyl chloride/medium jet

_________________ 21

ethyl chloride/medium str

_________________ 21

ethynodiol diacetate/ethi

_________________ 18

etodolac _____________ 4

etodolac er ___________ 4

etoposide ___________ 13

EUCRISA ____________ 21

EUFLEXXA ___________ 32

EVAMIST ____________ 26

EVEKEO ______________ 3

EVISTA ______________ 25

EVOTAZ _____________ 15

exemestane__________ 13

EXJADE _____________ 10

EXTAVIA ____________ 34

EYLEA ______________ 33

ezetimibe ___________ 11

ezetimibe/simvastatin _ 11

F

fabb ________________ 27

FABIOR _____________ 21

FABRAZYME _________ 25

falmina _____________ 18

famciclovir ___________ 15

famotidine___________ 36

FANAPT _____________ 15

FARXIGA _____________ 9

FASENRA _____________ 7

FASLODEX ___________ 13

fayosim _____________ 18

felbamate ____________ 8

felodipine er _________ 16

FEM PH _____________ 37

FEMRING ____________ 37

femynor _____________ 18

FENOFIBRATE CAP 50MG

_________________ 11

fenofibrate tab 48mg __ 11

fenofibrate micronized _ 11

FENOFIBRIC ACID _____ 11

fenofibric acid dr ______ 11

FENOPROFEN CAP

400MG ____________ 4

fenoprofen tab 600mg _ 4

FENORTHO ___________ 4

fentanyl ______________ 5

fentanyl citrate ________ 5

fentanyl citrate oral tra _ 5

FENTORA _____________ 5

FERAHEME __________ 27

FERIVA 21/7 _________ 27

ferocon _____________ 27

FERRALET 90 _________ 27

FERRAPLUS 90 _______ 27

FETZIMA _____________ 8

FETZIMA TITRATION PACK

__________________ 8

FIASP ________________ 9

FIASP FLEXTOUCH ______ 9

FINACEA ____________ 21

finasteride ___________ 27

FIORICET _____________ 4

FIORINAL _____________ 4

FIRAZYR _____________ 27

FIRST-BACLOFEN 5 ____ 32

FIRST-LANSOPRAZOLE _ 36

FIRST-METRONIDAZOLE

100 ______________ 13

FIRST-METRONIDAZOLE 50

_________________ 13

FIRST-MOUTHWASH BLM

_________________ 30

FIRST-OMEPRAZOLE ___ 36

FIRST-PROGESTERONE

VGS 10 ___________ 37

FIRST-PROGESTERONE

VGS 20 ___________ 37



FIRVANQ ____________ 13

flavoxate hcl _________ 36

FLEBOGAMMA DIF ____ 34

flecainide acetate ______ 6

FLECTOR ____________ 21

FLOMAX ____________ 27

FLONASE ____________ 32

FLORIVA PLUS ________ 30

FLOVENT DISKUS ______ 7

FLOVENT HFA _________ 7

FLUAD 2018-2019 _____ 37

FLUARIX QUADRIVALENT

2018 _____________ 37

FLUBLOK QUADRIVALENT

2018 _____________ 37

FLUCELVAX

QUADRIVALENT 20 _ 37

fluconazole __________ 11

fludrocortisone acetate 19

FLULAVAL QUADRIVALENT

201 ______________ 37

FLUMIST QUADRIVALENT

_________________ 37

flunisolide ___________ 32

fluocinolone acetonide _ 21

fluocinolone acetonide bo

_________________ 21

fluocinolone acetonide sc

_________________ 21

fluocinonide _________ 21

fluocinonide emulsified 21

fluocinonide emulsified b

_________________ 21

FLUORABON _________ 29

fluoride _____________ 29

43

fluorometholone _____ 33

FLUOROPLEX ________ 21

Fluoroquinolones ____ 26

fluorouracil __________ 21

fluoxetine ___________ 34

fluoxetine tab 10mg ___ 9

FLUOXETINE TAB 60MG 9

fluoxetine dr __________ 8

fluoxetine hcl _________ 9

fluphenazine decanoate 15

fluphenazine hcl ______ 15

FLURA-DROPS _______ 29

flurandrenolide ______ 21

flurazepam hcl _______ 28

flurbiprofen __________ 4

flurbiprofen sodium ___ 33

flutamide ___________ 13

fluticasone propionate 32

FLUTICASONE

PROPIONATE/SA ___ 7

fluvastatin __________ 11

fluvastatin sodium er __ 11

fluvoxamine maleate ___ 9

fluvoxamine maleate er _ 9

FLUZONE HIGH-DOSE PF

2018 _____________ 37

FLUZONE QUADRIVALENT

2018 _____________ 37

FML ________________ 33

FML FORTE __________ 33

FML LIQUIFILM ______ 33

FOCALIN _____________ 3

FOCALIN XR __________ 3

folbee ______________ 27

folbee plus __________ 30

folbic _______________ 24

FOLBIC RF ___________ 24

FOLGARD OS ________ 30

folic acid/vitamin b-6/vi 27

FOLIVANE-F _________ 27

FOLIVANE-PLUS ______ 27

FOLLISTIM AQ _______ 25

FOLTANX ___________ 24

FOLTANX RF _________ 24

FOLTX ______________ 24

fondaparinux sodium ___ 7

FORFIVO XL __________ 9

formaldehyde ________ 15

FORTEO ____________ 25

FORTESTA ____________ 5

FOSAMAX PLUS D ____ 25

fosinopril sodium _____ 12

fosinopril sodium/hydroch

_________________ 12

FOSRENOL __________ 26

FOSTEUM PLUS ______ 24

FRAGMIN ____________ 7

FROVA _____________ 29

frovatriptan succinate _ 29

furosemide __________ 24

FUSION PLUS ________ 27

fyavolv _____________ 26

FYCOMPA ____________ 8

G

gabapentin ___________ 8

GABLOFEN __________ 32

galantamine hydrobromide

_________________ 34

GALZIN _____________ 29

GANIRELIX ACETATE __ 25

GARDASIL 9 _________ 37

GASTROINTESTINAL

AGENTS - MISC. ____ 26

gatifloxacin __________ 33

gavilyte-c ___________ 28

gavilyte-g ___________ 28

gavilyte-n/flavor pack _ 28

GELCLAIR ___________ 30

GELNIQUE ___________ 36

GEL-ONE ____________ 32

gemfibrozil __________ 11

GENADUR ___________ 21

GENERAL ANESTHETICS 26

GENERESS FE ________ 18

generlac ____________ 26

gengraf _____________ 30

GENITOURINARY AGENTS -

MISCELLANEOUS ___ 26

GENOTROPIN ________ 25

GENOTROPIN MINIQUICK

_________________ 25

GENTAK ____________ 33

gentamicin sulfate _____ 3

GENVOYA ___________ 15

GEODON ____________ 15

gianvi_______________ 18

GILENYA ____________ 34

GILTUSS TR __________ 20

glatiramer acetate ____ 34

glatopa _____________ 34

GLEEVEC ____________ 13

GLEOSTINE __________ 13

glimepiride ___________ 9

glipizide ______________ 9

glipizide er ___________ 9

glipizide xl ____________ 9

glipizide/metformin hcl _ 9

GLUCAGEN HYPOKIT ___ 9

GLUCAGON EMERGENCY

KIT _______________ 9

GLUCOPHAGE _________ 9

GLUCOPHAGE XR ______ 9

GLUCOTROL XL ________ 9

GLUMETZA ___________ 9

glyburide _____________ 9

glyburide micronized ___ 9

glyburide/metformin hcl 9

glycopyrrolate _______ 36

GLYXAMBI ____________ 9

GOCOVRI ____________ 14

GOLYTELY ___________ 28

GONAL-F ____________ 25

GONAL-F RFF REDIJECT 25

Gout Agents _________ 27

GRALISE _____________ 34

GRALISE STARTER _____ 34

granisetron hcl _______ 11

GRANIX _____________ 27

GRASTEK _____________ 3

griseofulvin microsize __ 11

griseofulvin ultramicrosi 11

guanfacine er _________ 3

guanfacine hcl ________ 12

guanfacine hydrochloride 3

GYNAZOLE-1 _________ 37

H

H.P. ACTHAR _________ 25

HALCION ____________ 28

halobetasol propionate 21

HALOG______________ 21

haloperidol __________ 15

haloperidol decanoate _ 15

haloperidol lactate ____ 15

HARVONI ___________ 15

HAVRIX _____________ 37

heather _____________ 18

HEMATOGEN FA ______ 27

hematogen forte ______ 27

HEMATOLOGICAL AGENTS

- MISC. ___________ 27

HEMATOPOIETIC AGENTS

_________________ 27

hemmorex-hc _________ 5

HEMOCYTE PLUS _____ 27

hemocyte-f __________ 27

HEMOSTATICS _______ 28

heparin lock flush ______ 7

heparin lock flush/nacl f _ 7

heparin sodium ________ 7

heparin sodium dcu ____ 7

heparin sodium lock flush 7

HEPARIN

SODIUM/SODIUM CHL 7

HERCEPTIN __________ 13

HIZENTRA ___________ 34

homatropine hbr _____ 33

HORIZANT ___________ 34

HPR PLUS ___________ 22

HPR PLUS HYDROGEL KIT

_________________ 22

HUMALOG ___________ 9

HUMALOG JUNIOR

KWIKPEN __________ 9

HUMALOG KWIKPEN ___ 9

HUMALOG MIX 50/50

KWIKPEN _________ 10

HUMALOG MIX 75/25 _ 10

HUMALOG MIX 75/25

KWIKPEN _________ 10

HUMATROPE _________ 25

HUMIRA _____________ 4

HUMIRA PEDIATRIC

CROHNS D _________ 4

HUMIRA PEN __________ 4

HUMIRA PEN-CD/UC/HS

START _____________ 4

HUMIRA PEN-PS/UV

STARTER ___________ 4

HUMULIN R U-500

(CONCENTR _______ 10

HUMULIN R U-500

KWIKPEN _________ 10

HYALGAN ___________ 32

HYCLODEX ___________ 22

hydralazine hcl _______ 12

hydrochlorothiazide ___ 24

hydrocodone bitartrate/ac

__________________ 5

hydrocodone bitartrate/ch

_________________ 20

hydrocodone bitartrate/ho

_________________ 20

hydrocodone polistirex/ch

_________________ 20

hydrocodone/acetaminoph

en ________________ 5

hydrocodone/homatropine

_________________ 20

hydrocodone/ibuprofen _ 5

hydrocortisone _______ 19

hydrocortisone acetate __ 5

hydrocortisone acetate &

_________________ 22

hydrocortisone acetate/pr

__________________ 5

hydrocortisone butyrate 22

hydrocortisone butyrate (

_________________ 22

hydrocortisone valerate 22

hydrocortisone/acetic aci

_________________ 34

hydrocortisone/iodoquinol

_________________ 22

HYDROGEN PEROXIDE _ 15

hydromet ____________ 20

hydromorphone hcl ____ 5

hydromorphone hcl

dosette ____________ 5

hydromorphone hcl er __ 5

hydroquinone ________ 22

hydroquinone time release

_________________ 22

hydroxocobalamin ____ 27

hydroxychloroquine sulfat

_________________ 13

44

hydroxyprogesterone

capro ____________ 34

hydroxyurea _________ 13

hydroxyzine hcl _______ 6

hydroxyzine hydrochloride

__________________ 6

hydroxyzine pamoate __ 6

HYLAFEM ___________ 30

HYLATOPIC PLUS _____ 22

HYLENEX ____________ 30

HYMOVIS ___________ 32

HYOPHEN ___________ 36

hyoscyamine sulfate __ 36

hyoscyamine sulfate er 36

hyoscyamine sulfate odt 36

hyoscyamine sulfate sr 36

hyosyne ____________ 36

HYPERRHO S/D ______ 34

HYPERSAL ___________ 20

HYPNOTICS/SEDATIVES/SL

EEP DISORDER AGENTS

_________________ 28

HYSINGLA ER _________ 5

HYZAAR ____________ 12

I

ibandronate sodium __ 25

IBRANCE ____________ 13

ibu __________________ 4

IBUDONE ____________ 5

ibuprofen ____________ 4

ICLUSIG _____________ 13

IDELVION ___________ 27

iferex 150 forte ______ 27

ILARIS _______________ 4

ILEVRO _____________ 33

imatinib mesylate ____ 13

IMBRUVICA _________ 13

imipramine hcl ________ 9

imipramine hydrochloride 9

imipramine pamoate ___ 9

imiquimod __________ 22

IMIQUIMOD PUMP ___ 22

IMITREX ____________ 29

IMITREX STATDOSE REFILL

_________________ 29

IMITREX STATDOSE

SYSTEM __________ 29

IMOVAX RABIES (H.D.C.V.)

_________________ 37

IMPOYZ ____________ 22

IMVEXXY MAINTENANCE

PACK ____________ 37

IMVEXXY STARTER PACK

_________________ 37

INCRUSE ELLIPTA ______ 7

indapamide _________ 24

INDERAL LA _________ 16

INDERAL XL _________ 16

INDOCIN _____________ 4

indomethacin _________ 4

indomethacin er _______ 4

INFANRIX ___________ 35

INFLECTRA __________ 26

INGREZZA ___________ 34

INLYTA _____________ 13

INNOPRAN XL ________ 16

INTEGRA F __________ 27

INTEGRA PLUS _______ 27

INTERMEZZO ________ 28

intralipid ____________ 32

INTRAROSA _________ 37

INTRON A ___________ 13

introvale ____________ 18

INTUNIV _____________ 3

INVEGA _____________ 15

INVEGA SUSTENNA ___ 15

INVEGA TRINZA ______ 15

INVOKAMET _________ 10

INVOKAMET XR ______ 10

INVOKANA __________ 10

iodine strong ________ 29

IOPIDINE ____________ 33

IPOL INACTIVATED IPV 37

ipratropium bromide __ 32

ipratropium bromide/albut

__________________ 7

irbesartan ___________ 12

irbesartan/hydrochlorothi

_________________ 12

IROSPAN 24/6 _______ 28

ISENTRESS __________ 15

isibloom ____________ 18

isoniazid ____________ 13

isosorbide dinitrate ____ 6

isosorbide mononitrate _ 6

isosorbide mononitrate er 6

isotretinoin __________ 22

isradipine ___________ 16

ISTALOL _____________ 33

itraconazole _________ 11

ivermectin ____________ 6

IXIARO _____________ 37

J

JADENU_____________ 10

JADENU SPRINKLE ____ 10

JAKAFI ______________ 13

JALYN ______________ 27

jantoven _____________ 7

JANUMET ___________ 10

JANUMET XR ________ 10

JANUVIA ____________ 10

JARDIANCE __________ 10

jencycla _____________ 18

JENTADUETO ________ 10

JENTADUETO XR _____ 10

jevantique lo _________ 26

jinteli _______________ 26

jolessa ______________ 18

jolivette _____________ 18

JUBLIA ______________ 22

juleber ______________ 18

JULUCA _____________ 15

junel 1.5/30 __________ 18

junel 1/20 ___________ 18

junel fe 1.5/30________ 18

junel fe 1/20 _________ 18

junel fe 24 ___________ 18

K

kaitlib fe ____________ 18

KALETRA ____________ 15

KAMDOY ____________ 22

kariva _______________ 18

KAZANO ____________ 10

k-effervescent ________ 29

kelnor 1/35 __________ 18

kelnor 1/50 __________ 18

KENALOG-10 _________ 19

KENALOG-40 _________ 19

KEPPRA ______________ 8

KEPPRA XR ___________ 8

KERALAC ____________ 22

KERALYT ____________ 22

KERALYT SCALP_______ 22

KERYDIN ____________ 22

ketamine hcl _________ 26

ketoconazole _________ 11

KETOPROFEN _________ 4

ketoprofen er _________ 4

ketorolac tromethamine 4

KEVZARA _____________ 4

KEYTRUDA __________ 13

KINERET _____________ 4

kionex ______________ 30

KISQALI _____________ 13

KISQALI FEMARA 600

DOSE ____________ 13

KLONOPIN ____________ 8

klor-con _____________ 29

klor-con 10 __________ 29

klor-con 8 ___________ 29

klor-con m10 _________ 29

KLOR-CON M15 ______ 29

klor-con m20 _________ 29

klor-con sprinkle ______ 29

klor-con/ef __________ 29

KOMBIGLYZE XR ______ 10

K-PHOS _____________ 29

K-PHOS NO 2 ________ 27

KRISTALOSE _________ 28

KRYSTEXXA __________ 27

K-TAB TAB 20MEQ _ 29

K-TAB TAB 8MEQ CR 29

kurvelo _____________ 18

KUVAN _____________ 25

k-vescent ____________ 29

KYLEENA ____________ 18

L

labetalol hcl __________ 16

labetalol hydrochloride _ 16

LACRISERT ___________ 33

lactated ringers _______ 29

lactulose ____________ 28

LAMICTAL ____________ 8

LAMICTAL ODT ________ 8

LAMICTAL XR _________ 8

lamivudine ___________ 15

lamivudine/zidovudine _ 15

lamotrigine ___________ 8

lamotrigine er _________ 8

lamotrigine odt ________ 8

lamotrigine starter kit/o _ 8

lansoprazole _________ 36

lansoprazole/amoxicillin/

_________________ 36

lanthanum carbonate __ 26

LANTUS _____________ 10

LANTUS SOLOSTAR ____ 10

larin 1.5/30 __________ 18

larin 1/20 ____________ 18

larin 24 fe ___________ 18

larin fe 1.5/30 ________ 18

larin fe 1/20 __________ 18

larissia ______________ 18

LASIX _______________ 24

LASTACAFT __________ 33

latanoprost __________ 33

LATISSE _____________ 22

LATUDA _____________ 15

LAXATIVES ___________ 28

layolis fe ____________ 18

leena _______________ 18

leflunomide ___________ 4

LENVIMA 12MG DAILY

DOSE _____________ 13

LESCOL XL ___________ 11

lessina ______________ 18

LETAIRIS ____________ 17

letrozole ____________ 13

LEUCOVOR CA TAB 10MG

_________________ 13

leucovor ca tab 5mg ___ 13

LEUKERAN ___________ 13

leuprolide acetate _____ 14

levalbuterol ___________ 7

levalbuterol hcl ________ 7

levalbuterol hydrochlorid 7

LEVALBUTEROL TARTRATE

HFA _______________ 7

LEVAQUIN ___________ 26

LEVEMIR ____________ 10

LEVEMIR FLEXTOUCH __ 10

levetiracetam _________ 8

45

levetiracetam er _______ 8

LEVICYN ____________ 22

levicyn dermal spray __ 22

LEVITRA ____________ 17

levobunolol hcl _______ 33

levocarnitine ________ 25

levocetirizine dihydrochl 11

levofloxacin _________ 26

levofloxacin in d5w ___ 26

LEVOMEFOLATE CALCIUM

ALGA ____________ 24

LEVOMEFOLATE

CALCIUM/N-AC ____ 24

LEVOMEFOLATE

CALCIUM/PYRI ____ 24

levonest ____________ 18

levonorgestrel and ethiny

_________________ 18

levonorgestrel/ethinyl es18

levora 0.15/30-28 ____ 18

LEVORPHANOL TARTRATE

__________________ 5

levothyroxine sodium _ 35

levothyroxine/liothyronin

_________________ 35

levoxyl _____________ 35

LEVSIN _____________ 36

LEVSIN/SL ___________ 36

LEVULAN KERASTICK __ 22

LEXAPRO ____________ 9

LIALDA _____________ 26

lidocaine ____________ 22

LIDOCAINE AND

TETRACAINE ______ 22

lidocaine hcl _________ 22

lidocaine hcl jelly _____ 22

lidocaine hcl/hydrocortis 6

lidocaine viscous _____ 30

lidocaine/prilocaine ___ 22

lidocaine-prilocaine-crea 22

LIDODERM __________ 22

lidopril _____________ 22

LIDORX _____________ 22

LIDOTRAL ___________ 22

lidozion _____________ 22

LILETTA _____________ 18

lillow _______________ 18

LIMBREL ____________ 24

LINCOCIN ___________ 13

linezolid ____________ 13

LINZESS _____________ 26

liothyronine sodium ___ 35

LIPITOR _____________ 11

LIPOFEN ____________ 11

lisinopril ____________ 12

lisinopril/hydrochlorothi 12

lithium carbonate ____ 15

lithium carbonate er __ 15

LIVALO _____________ 11

L-METHYL-B6-B12 ____ 24

L-METHYLFOLATE _____ 24

L-METHYLFOLATE CA/S-

ALGAL ___________ 24

L-METHYLFOLATE

CALCIUM _________ 24

L-METHYLFOLATE FORTE

_________________ 24

L-METHYL-MC NAC ___ 24

LO LOESTRIN FE ______ 18

LOCAL ANESTHETICS-

Parenteral ________ 28

LOCOID _____________ 22

LOESTRIN 1.5/30-21 __ 18

LOESTRIN 1/20-21 ____ 18

LOESTRIN FE 1.5/30 ___ 18

LOESTRIN FE 1/20 ____ 18

LOMAIRA ____________ 3

LONSURF ___________ 14

loperamide hcl _______ 10

lopreeza ____________ 26

lorazepam ____________ 6

lorazepam intensol _____ 6

lorcet ________________ 5

lorcet hd _____________ 5

lorcet plus ____________ 5

LORTAB ______________ 5

loryna ______________ 18

LORZONE ___________ 32

losartan potassium ____ 12

losartan potassium/hydroc

_________________ 12

LOSEASONIQUE ______ 18

LOTEMAX ___________ 33

LOTREL _____________ 12

lovastatin ___________ 11

LOVAZA ____________ 11

LOVENOX ____________ 7

low-ogestrel _________ 18

loxapine ____________ 15

loxapine succinate ____ 15

LOYON _____________ 22

ludent ______________ 29

LULICONAZOLE _______ 22

LUMIGAN ___________ 33

LUNESTA ____________ 28

LUPANETA PACK _____ 25

LUPRON DEPOT (4-

MONTH) _________ 14

LUPRON DEPOT (6-

MONTH) _________ 14

LUPRON DEPOT INJ

11.25MG _________ 14

LUPRON DEPOT INJ

22.5MG __________ 14

LUPRON DEPOT INJ

3.75MG __________ 14

LUPRON DEPOT INJ 7.5MG

_________________ 14

LUPRON DEPOT-PED (1-

MONTH __________ 25

LUPRON DEPOT-PED (3-

MONTH __________ 25

lutera _______________ 18

LUXAMEND __________ 22

LUXIQ ______________ 22

LUZU _______________ 22

LYNPARZA ___________ 14

LYRICA _______________ 8

LYRICA CR ___________ 34

lyza ________________ 18

M

MACROBID __________ 36

MACRODANTIN ______ 36

MACROLIDES ________ 28

MAKENA INJ

250MG/ML _______ 34

MAKENA INJ 275MG 34

MALARONE __________ 13

malathion ___________ 22

maprotiline hcl ________ 9

MARCAINE __________ 28

MARLIDO KIT ________ 28

marlissa _____________ 18

MARPLAN ____________ 9

MATULANE __________ 14

matzim la ___________ 16

MAVYRET ___________ 15

MAXALT ____________ 29

MAXALT-MLT ________ 29

MAXIDEX____________ 33

MAXZIDE ____________ 24

me/naphos/mb/hyo 1 _ 36

MEBOLIC ____________ 24

meclizine hcl _________ 11

meclizine hydrochloride 11

meclofenamate sodium _ 4

MEDICAL DEVICES AND

SUPPLIES _________ 29

MEDROL ____________ 19

MEDROL DOSEPAK ____ 19

medroxyprogesterone

aceta _____________ 18

mefenamic acid _______ 4

mefloquine hcl _______ 13

megestrol acetate _____ 14

MEKINIST ___________ 14

MEKTOVI ____________ 14

melodetta 24 fe ______ 18

meloxicam ____________ 4

memantine hcl _______ 34

memantine hcl titration p

_________________ 34

memantine hydrochloride

_________________ 34

memantine hydrochloride

e ________________ 34

MENACTRA __________ 37

MENEST ____________ 26

MENOPUR ___________ 25

MENOSTAR __________ 26

MENTAX ____________ 22

MENVEO ____________ 37

meperidine hcl ________ 5

MEPHYTON __________ 37

mercaptopurine ______ 14

meropenem __________ 13

mesalamine __________ 26

mesalamine dr________ 26

MESTINON TIMESPAN _ 13

metadate er ___________ 3

METAFOLBIC PLUS ____ 24

METAFOLBIC PLUS RF __ 24

METANX ____________ 24

METAXALONE TAB

400MG ___________ 32

metaxalone tab 800mg 32

metformin hcl ________ 10

metformin hcl er ______ 10

metformin hydrochloride

_________________ 10

metformin hydrochloride e

_________________ 10

METHADONE SOL

5MG/5ML __________ 5

methadone tab 10mg __ 5

methamphetamine hcl __ 3

methazolamide _______ 24

methenamine hippurate 36

methenamine mandelate

_________________ 36

methergine __________ 34

methimazole _________ 35

methocarbamol _______ 32

methotrexate ________ 14

methotrexate sodium __ 14

methoxsalen _________ 22

methscopolamine bromide

_________________ 36

methyclothiazide ______ 25

methyldopa __________ 12

methyldopa/hydrochloroth

i _________________ 12

methylergonovine maleate

_________________ 34

METHYLIN ____________ 3

methylphenid cap 30mg er

__________________ 3

METHYLPHENID CAP

60MG LA ___________ 3

methylprednisolone ___ 19

methylprednisolone acetat

_________________ 19

methylprednisolone dose p

_________________ 19

methylprednisolone

sodium ___________ 19

methyltestosterone ____ 5

metoclopramide hcl ___ 26

46

metoclopramide

hydrochlor ________ 26

METOCLOPRAMIDE ODT26

metolazone _________ 25

metoprol tar tab 25mg 16

METOPROLOL TAB 75MG

_________________ 16

metoprolol succinate er 16

metoprolol/hydrochlorothi

_________________ 12

METROGEL __________ 22

metronidazole _______ 22

metronidazole vaginal _ 37

mexiletine hcl _________ 6

mibelas 24 fe ________ 18

MICARDIS ___________ 12

MICARDIS HCT _______ 12

MICONAZOLE 3 ______ 37

MICORT-HC _________ 22

microgestin 1.5/30 ____ 18

microgestin 1/20 _____ 18

microgestin fe _______ 18

microgestin fe 1.5/30 __ 18

midazolam hcl _______ 28

midodrine hcl ________ 37

midodrine hydrochloride 37

miglitol _____________ 10

Migraine Products ____ 29

mili ________________ 18

MILLIPRED SOL

10MG/5ML _______ 19

MILLIPRED TAB 5MG 19

mimvey _____________ 26

MINASTRIN 24 FE ____ 18

MINERALS AND

ELECTROLYTES ____ 29

MINIVELLE __________ 26

minocycline hcl ______ 35

minocycline hcl er ____ 35

minocycline hydrochloride

_________________ 35

minoxidil ____________ 12

MIRAPEX ___________ 14

MIRCETTE ___________ 18

MIRENA ____________ 18

mirtazapine __________ 9

mirtazapine odt _______ 9

MIRVASO ___________ 22

Miscellaneous Therapeutic

Classes ___________ 29

misoprostol _________ 36

MITIGARE ___________ 27

M-M-R II ____________ 37

modafinil ____________ 3

moexipril hcl _________ 12

mometasone furoate __ 22

monoject pharma grade flu

_________________ 29

mono-linyah _________ 18

mononessa __________ 18

MONOVISC __________ 32

montelukast sodium ___ 7

MONUROL __________ 36

MORPHABOND ER _____ 5

morphine sulfate ______ 5

morphine sulfate er ____ 5

MOTOFEN ___________ 10

MOUTH/THROAT/DENTAL

AGENTS __________ 30

MOVANTIK __________ 26

MOVIPREP __________ 28

MOXATAG __________ 34

MOXEZA ____________ 33

moxifloxacin hcl ______ 26

moxifloxacin hydrochlorid

_________________ 33

MUGARD ___________ 30

MULPLETA __________ 28

MULTAQ _____________ 6

MULTIGEN __________ 28

MULTIGEN PLUS ______ 28

MULTIVIT/FL CHW

0.25MG __________ 31

MULTIVIT/FL CHW 0.5MG

_________________ 31

multivit/fl dro 0.25mg _ 31

multi-vit/iron/fluoride _ 30

multivitamin with fluorid 31

multi-vitamin/fluoride dr31

multi-vitamin/fluoride/ir 31

MULTIVITAMINS _____ 30

mupirocin ___________ 22

MUSCULOSKELETAL

THERAPY AGENTS __ 32

MUSE ______________ 17

mycophenolate mofetil 30

mycophenolic acid dr __ 30

MYDAYIS ____________ 3

MYFORTIC __________ 30

MYOBLOC ___________ 32

myorisan ____________ 22

MYRBETRIQ _________ 36

MYSOLINE ___________ 8

MYTESI _____________ 10

myzilra _____________ 18

N

nabumetone __________ 4

nadolol _____________ 16

nadolol/bendroflumethiazi

_________________ 12

naftifine hcl __________ 22

naftifine hydrochloride 22

NAFTIN _____________ 22

naloxone hcl _________ 10

naltrexone hcl ________ 10

NAMENDA __________ 34

NAMENDA XR _______ 35

NAMZARIC __________ 35

NAPRELAN ___________ 4

naproxen _____________ 4

naproxen dr __________ 4

naproxen sodium ______ 4

naproxen sodium cr ____ 4

naproxen sodium er ____ 4

naratriptan hcl _______ 29

NARCAN ____________ 10

NASAL AGENTS -

SYSTEMIC AND

TOPICAL __________ 32

NASCOBAL __________ 28

NASONEX ___________ 32

NATACYN ___________ 33

NATAZIA ____________ 18

nateglinide __________ 10

NATESTO _____________ 5

NATPARA ___________ 25

NATROBA ___________ 22

NATURE-THROID _____ 35

NATURE-THROID NT-2.5 35

nebusal _____________ 20

necon 0.5/35-28 ______ 18

NEEVO DHA _________ 31

nefazodone hcl ________ 9

nefazodone hydrochloride

__________________ 9

neomycin sulfate ______ 3

neomycin/bacitracin/poly

m _______________ 33

neomycin/polymyxin/bacit

r ________________ 33

neomycin/polymyxin/dexa

me ______________ 33

neomycin/polymyxin/gram

ic ________________ 33

neomycin/polymyxin/hc 34

neomycin/polymyxin/hydr

oc _______________ 34

neo-polycin __________ 33

neo-polycin hc _______ 33

NEORAL _____________ 30

NEOSPORIN _________ 33

NEO-SYNALAR _______ 22

NEPHRO-VITE RX _____ 31

NERLYNX ____________ 14

NESINA _____________ 10

NESTABS DHA ________ 31

NESTABS ONE ________ 31

NEUAC KIT __________ 22

NEULASTA ___________ 28

NEULASTA ONPRO KIT _ 28

NEUPOGEN __________ 28

NEUPRO ____________ 14

NEUROMUSCULAR

AGENTS __________ 32

NEURONTIN __________ 8

NEUTRASAL _________ 30

NEVANAC ___________ 33

NEXAVAR ___________ 14

NEXIUM CAP 40MG 36

NEXIUM GRA 10MG DR

_________________ 36

NEXPLANON _________ 18

niacin er _____________ 11

NIACOR _____________ 11

NIASPAN ____________ 11

NICADAN ____________ 31

NICAPRIN ___________ 24

NICOMIDE ___________ 31

NICOTROL INHALER ___ 35

NICOTROL NS ________ 35

nifedipine ___________ 16

nifedipine er _________ 16

NIFEREX _____________ 28

nikki ________________ 18

nimodipine __________ 16

NINLARO ____________ 14

nisoldipine er _________ 16

NITRO-BID ____________ 6

NITRO-DUR ___________ 6

nitrofurantoin ________ 36

nitrofurantoin macrocryst

_________________ 36

nitrofurantoin monohydrat

_________________ 36

nitroglycerin __________ 6

nitroglycerin er ________ 6

nitroglycerin lingual ____ 6

nitroglycerin transdermal 6

NITROSTAT ___________ 6

nitro-time ____________ 6

niva-fol ______________ 24

NIVA-PLUS ___________ 31

NIVATOPIC PLUS ______ 22

nizatidine cap 150mg _ 36

NIZATIDINE SOL

15MG/ML _________ 36

NOCTIVA ____________ 25

nolix ________________ 22

nora-be _____________ 18

NORCO ______________ 5

NORDITROPIN FLEXPRO 25

norethindrone ________ 18

norethindrone & ethinyl e

_________________ 18

norethindrone acetate _ 34

norethindrone acetate/eth

_________________ 18

norethindrone/ethinyl est

_________________ 18

norgestimate/ethinyl estr

_________________ 18

NORITATE ___________ 22

norlyda _____________ 18

normal saline flush ____ 29

normal saline flush for f 29

normal saline i.v. flush _ 29

NORPACE CR __________ 6

NORTHERA __________ 37

47

nortrel 0.5/35 (28) ____ 18

nortrel 1/35 _________ 18

nortrel 7/7/7 ________ 18

nortriptyline hcl _______ 9

NORVASC ___________ 16

NORVIR ____________ 15

NOVAREL ___________ 25

NOVOLOG __________ 10

NOVOLOG FLEXPEN ___ 10

NOVOLOG MIX 70/30 _ 10

NOVOLOG MIX 70/30

PREFILL __________ 10

NOVOLOG PENFILL ___ 10

NOXAFIL ____________ 11

NOXIFOL-D __________ 28

np thyroid 120 _______ 35

np thyroid 15 ________ 35

np thyroid 30 ________ 35

np thyroid 60 ________ 35

np thyroid 90 ________ 35

NUCALA _____________ 7

NUCYNTA ____________ 5

NUCYNTA ER _________ 5

NUEDEXTA __________ 35

NULYTELY/FLAVOR PACKS

_________________ 28

NUTRIENTS __________ 32

NUTROPIN AQ NUSPIN 10

_________________ 25

NUTROPIN AQ NUSPIN 20

_________________ 25

NUVAIL _____________ 22

NUVARING __________ 18

NUVESSA ___________ 37

NUVIGIL _____________ 3

nyamyc _____________ 22

nystatin _____________ 11

nystatin/triamcinolone 22

nystatin/triamcinolone ac

_________________ 22

nystop ______________ 22

O

OB COMPLETE ONE ___ 31

OB COMPLETE PETITE _ 31

OB COMPLETE PREMIER 31

OB COMPLETE/DHA __ 31

OCALIVA ____________ 26

ocella ______________ 18

OCREVUS ___________ 35

octreotide acetate ____ 25

OCUFLOX ___________ 33

ODACTRA ____________ 3

ODEFSEY ____________ 15

OFEV _______________ 35

ofloxacin ____________ 33

ogestrel ____________ 18

okebo ______________ 35

olanzapine __________ 15

olanzapine odt _______ 15

olanzapine/fluoxetine _ 35

olmesartan medoxomil 12

olmesartan

medoxomil/amlo ___ 12

olmesartan

medoxomil/hydr ___ 12

olopatadine hcl _______ 33

olopatadine hydrochloride

_________________ 33

OLUMIANT ___________ 4

OLUX-E _____________ 22

OMECLAMOX-PAK ____ 36

omega-3-acid ethyl esters

_________________ 11

omeprazole __________ 36

omeprazole dr _______ 36

omeprazole/sodium

bicarbo ___________ 36

OMNITROPE _________ 25

ondansetron hcl ______ 11

ondansetron hydrochloride

_________________ 11

ondansetron odt______ 11

ONEXTON ___________ 22

ONFI ________________ 8

ONGLYZA ___________ 10

ONZETRA XSAIL ______ 29

OPDIVO_____________ 14

OPHTHALMIC AGENTS _ 32

opium ______________ 10

opium tincture _______ 10

OPSUMIT ___________ 17

ORACEA ____________ 22

ORACIT _____________ 27

ORAMAGICRX _______ 30

ORAP _______________ 35

ORAPRED ODT _______ 19

ORENCIA _____________ 4

ORENCIA CLICKJECT ____ 4

ORENITRAM _________ 17

ORILISSA ____________ 25

ORKAMBI ___________ 35

orphenadrine citrate er 32

orsythia _____________ 18

ORTHO MICRONOR ___ 19

ORTHO TRI-CYCLEN LO 19

ORTHO-CYCLEN ______ 19

ORTHO-NOVUM 1/35 _ 19

ORTHOVISC _________ 32

oscimin _____________ 36

oscimin sr ___________ 36

oseltamivir phosphate _ 15

OSENI ______________ 10

OSMOPREP __________ 28

OSPHENA ___________ 25

OTEZLA ______________ 4

OTIC AGENTS ________ 34

OTOVEL _____________ 34

OTREXUP ____________ 4

OVACE PLUS _________ 22

OVACE PLUS WASH ___ 22

OVACE WASH ________ 22

OVIDREL ____________ 25

oxandrolone __________ 5

oxaprozin ____________ 4

OXAYDO _____________ 5

oxazepam ____________ 6

oxcarbazepine _________ 8

oxiconazole nitrate ____ 22

OXISTAT ____________ 22

OXTELLAR XR _________ 8

oxybutynin chloride ___ 36

oxybutynin chloride er _ 36

oxycodone hcl _________ 5

OXYCODONE HCL ER ___ 5

oxycodone hydrochloride 5

oxycodone/acetaminophen

__________________ 5

oxycodone/aspirin _____ 5

OXYCONTIN __________ 5

oxymorphone

hydrochloride _______ 5

Oxytocics ___________ 34

OZEMPIC ____________ 10

OZURDEX ___________ 33

P

pacerone _____________ 6

paliperidone er _______ 15

PANCREAZE__________ 24

pantoprazole sodium __ 36

pantoprazole sodium dr 36

papaverine hcl _______ 17

PARAGARD INTRAUTERINE

COP ______________ 19

paregoric ____________ 10

paricalcitol___________ 25

paroex ______________ 30

paromomycin sulfate ___ 3

paroxetine ___________ 35

paroxetine hcl _________ 9

paroxetine hcl er _______ 9

paroxetine hydrochloride 9

PASSIVE IMMUNIZING

AND TREATMENT

AGENTS __________ 34

PATADAY ___________ 33

PATANASE __________ 32

PATANOL ___________ 33

PAXIL ________________ 9

PAXIL CR _____________ 9

PAZEO ______________ 33

peg-3350/electrolytes _ 28

peg-3350/nacl/na bicarbon

_________________ 28

PEGASYS ____________ 15

penicillin v potassium __ 34

PENICILLINS _________ 34

PENLAC NAIL LACQUER 22

PENNSAID ___________ 22

PENTASA ____________ 26

pentazocine/naloxone hcl 5

pentoxifylline er ______ 27

PERCOCET ____________ 5

PERFOROMIST ________ 7

perindopril erbumine __ 12

PERJETA _____________ 14

permethrin __________ 22

perphenazine ________ 15

perphenazine/amitriptylin

_________________ 35

PERTZYE_____________ 24

phenadoz ____________ 11

phenazopyridine hcl ___ 27

phenazopyridine hydrochlo

_________________ 27

phendimetrazine tartrate 3

phenelzine sulfate ______ 9

phenobarbital ________ 28

phenohytro __________ 36

phentermine hcl _______ 3

PHENYTEK ____________ 8

phenytoin ____________ 8

phenytoin infatabs _____ 8

phenytoin sodium

extended __________ 8

philith ______________ 19

phospha 250 neutral ___ 29

phosphasal __________ 36

PHOSPHOLINE IODIDE _ 33

phosphorous _________ 29

phospho-trin 250 neutral

_________________ 29

PHYSICIANS EZ USE B-12

CO _______________ 28

PHYSICIANS EZ USE JOINT

T ________________ 19

PHYSICIANS EZ USE M-

PRED _____________ 19

phytonadione ________ 37

PICATO _____________ 22

pilocarpine hcl ________ 30

pilocarpine hydrochloride

_________________ 30

pimozide ____________ 35

pimtrea _____________ 19

pindolol _____________ 16

pioglitazone hcl _______ 10

pioglitazone hcl/metformi

_________________ 10

piperacillin/tazobactam 34

pirmella 1/35 _________ 19

pirmella 7/7/7 ________ 19

piroxicam _____________ 4

PLAQUENIL __________ 13

PLAVIX ______________ 27

PLEGRIDY____________ 35

PLENVU _____________ 28

48

PLEXION ____________ 22

PLEXION CLEANSER ___ 22

PNEUMOVAX 23 _____ 37

PNEUMOVAX 23/1 DOSE

_________________ 37

PNV PRENATAL TAB PLUS

_________________ 31

PNV TABS 29-1 _______ 31

pnv-dha ____________ 31

PNV-DHA+DOCUSATE _ 31

PODIAPN ___________ 24

PODOCON 25 IN BENZOIN

TIN ______________ 22

podofilox ___________ 22

polycin _____________ 33

polyethylene glycol 3350 28

poly-iron 150 forte ____ 28

polymyxin b sulfate/trime

_________________ 33

POLYTRIM __________ 33

POLY-VI-FLOR________ 31

POMALYST __________ 14

portia-28 ____________ 19

pot chloride tab 10meq er

_________________ 29

POT CHLORIDE TAB

20MEQ ER ________ 29

potassium chloride ___ 29

potassium chloride cr _ 29

potassium chloride sr__ 29

potassium citrate er ___ 27

potassium citrate/citric 27

PRADAXA ____________ 7

PRALUENT __________ 11

pramipexole dihydrochlori

_________________ 14

PRAMOSONE ________ 22

prasugrel ___________ 27

PRAVACHOL _________ 11

pravastatin sodium ___ 11

praziquantel __________ 6

prazosin hcl _________ 12

PRED FORTE _________ 33

PRED MILD __________ 33

PRED-G S.O.P. _______ 33

prednicarbate ________ 22

prednisolone ________ 19

prednisolone acetate __ 33

prednisolone sol 15mg/5ml

_________________ 19

PREDNISOLONE SOL

25MG/5ML _______ 19

PREDNISONE PAK 5MG 20

prednisone tab 20mg _ 20

PREDNISONE INTENSOL 20

PREGNYL W/DILUENT

BENZYL __________ 25

PREMARIN __________ 26

PREMPHASE _________ 26

PREMPRO ___________ 26

PRENA 1 TRUE _______ 31

PRENA1 PEARL _______ 31

PRENAISSANCE ______ 31

PRENATA ___________ 31

prenatabs rx _________ 31

PRENATAL __________ 31

prenatal 19 chw tab __ 31

PRENATAL 19 TAB 29-

1MG _____________ 31

PRENATAL PLS MIS MV +

DHA _____________ 31

PRENATAL PLUS ______ 31

PRENATAL PLUS IRON _ 31

PRENATAL VITAMINS PLUS

LO _______________ 31

PRENATE ____________ 31

PRENATE DHA _______ 31

PRENATE ELITE _______ 31

PRENATE ENHANCE ___ 31

PRENATE ESSENTIAL __ 31

PRENATE MINI _______ 31

PRENATE PIXIE _______ 31

PRENATE RESTORE ____ 31

PREPLUS ____________ 31

PREPOPIK ___________ 28

PREVACID ___________ 36

PREVACID SOLUTAB __ 36

prevalite ____________ 11

PREVIDENT 5000 BOOSTER

PL _______________ 30

PREVIDENT 5000 DRY

MOUTH __________ 30

PREVIDENT 5000 ENAMEL

PRO _____________ 30

PREVIDENT 5000 PLUS _ 30

PREVIDENT 5000

SENSITIVE ________ 30

PREVIDENT FLUORIDE _ 30

PREVIDENT RINSE ____ 30

previfem ____________ 19

PREVNAR 13 _________ 37

PREZCOBIX __________ 15

PREZISTA ___________ 15

PRIFTIN _____________ 13

PRILOSEC ___________ 36

PRIMACARE _________ 31

primidone ____________ 8

PRISTIQ ______________ 9

PROAIR HFA __________ 7

PROAIR RESPICLICK ____ 7

probenecid __________ 27

probenecid/colchicine _ 27

PROCARDIA XL _______ 16

prochlorperazine _____ 15

prochlorperazine maleate

_________________ 15

PROCRIT ____________ 28

PROCTOCORT _________ 6

PROCTOFOAM HC _____ 6

procto-med hc ________ 6

procto-pak____________ 6

proctosol hc __________ 6

proctozone-hc _________ 6

progesterone ________ 34

Progestins ___________ 34

PROGLYCEM _________ 10

PROGRAF ___________ 30

PROLASTIN-C ________ 35

PROLENSA ___________ 33

PROLIA _____________ 25

PROMACTA __________ 28

promethazine hcl _____ 11

promethazine hcl plain _ 11

promethazine hydrochlorid

_________________ 11

promethazine/codeine _ 20

promethazine/dextrometh

or _______________ 20

promethazine/phenylephri

n ________________ 20

promethazine-dm _____ 20

promethegan ________ 11

PROMETRIUM _______ 34

PROMISEB ___________ 23

propafenone hcl _______ 6

propafenone hcl er _____ 6

propafenone hydrochloride

__________________ 6

propantheline bromide 36

proparacaine hcl ______ 33

PROPECIA ___________ 23

propranolol hcl _______ 16

propranolol hcl er _____ 16

propranolol hydrochloride

_________________ 16

propranolol/hydrochloroth

_________________ 12

propylthiouracil ______ 35

PROSCAR ____________ 27

PROSTIN VR PEDIATRIC 30

PROTONIX ___________ 36

PROTOPIC ___________ 23

protriptyline hcl _______ 9

PROVENTIL HFA _______ 7

PROVERA ___________ 34

PROVIDA DHA _______ 31

PROVIDA OB _________ 31

PROVIGIL_____________ 3

PROZAC ______________ 9

PRUMYX ____________ 23

PSORCON ___________ 23

Psychotherapeutic and

Neurological Agents -

Misc. _____________ 34

PULMICORT __________ 7

PULMICORT FLEXHALER _ 7

PULMOZYME ________ 35

PURIXAN ____________ 14

PYLERA _____________ 36

PYRIDIUM ___________ 27

pyridostigmine bromide 13

pyridostigmine bromide er

_________________ 13

Q

QBRELIS _____________ 12

QBREXZA ____________ 23

QNASL ______________ 32

QNASL CHILDRENS ____ 32

QSYMIA ______________ 3

QTERN ______________ 10

QUARTETTE __________ 19

quasense ____________ 19

QUDEXY XR ___________ 8

QUESTRAN LIGHT _____ 11

quetiapine fumarate ___ 15

quetiapine fumarate er _ 15

QUILLICHEW ER _______ 3

QUILLIVANT XR ________ 3

quinapril hcl __________ 12

quinapril hydrochloride 12

quinapril/hydrochlorothia

_________________ 12

quinidine gluconate cr __ 6

quinine sulfate _______ 13

QVAR REDIHALER ______ 7

R

RABAVERT ___________ 37

rabeprazole sodium ___ 36

RAGWITEK ____________ 3

rajani _______________ 19

raloxifene hydrochloride 25

ramipril _____________ 12

RANEXA ______________ 6

ranitidine hcl _________ 36

ranitidine hydrochloride 36

RAPAFLO ____________ 27

RAPAMUNE SOL

1MG/ML __________ 30

RAPAMUNE TAB 1MG 30

rasagiline mesylate ____ 14

RASUVO______________ 4

RAVICTI _____________ 25

RAYALDEE ___________ 25

RAYOS ______________ 20

REBIF _______________ 35

REBIF REBIDOSE ______ 35

REBIF REBIDOSE

TITRATION ________ 35

RECEDO _____________ 23

reclipsen ____________ 19

RECOMBIVAX HB _____ 37

RECTIV _______________ 6

REGENECARE _________ 23

REGRANEX __________ 23

RELENZA DISKHALER __ 15

RELISTOR ____________ 26

49

RELPAX _____________ 29

REMERON ___________ 9

REMICADE __________ 26

REMODULIN _________ 17

RENAGEL ___________ 26

renal caps ___________ 31

reno caps ___________ 31

RENOVA ____________ 23

RENVELA ___________ 26

repaglinide __________ 10

REPATHA ___________ 11

REPATHA PUSHTRONEX

SYSTEM __________ 11

REPATHA SURECLICK __ 11

REQUIP _____________ 14

REQUIP XL __________ 14

Respiratory Agents - Misc.

_________________ 35

RESTASIS ___________ 33

RESTASIS MULTIDOSE _ 33

RESTORA RX _________ 10

RETIN-A ____________ 23

RETIN-A MICRO ______ 23

RETIN-A MICRO PUMP 23

REVATIO ____________ 17

REVESTA ____________ 28

REVLIMID ___________ 30

REXULTI ____________ 15

REYATAZ ____________ 15

RHEUMATE _________ 24

RHOFADE ___________ 23

RHOGAM ULTRA-FILTERED

PLU _____________ 34

RHOPRESSA _________ 33

RIAX _______________ 23

ribavirin ____________ 15

RIDAURA ____________ 4

rifabutin ____________ 13

rifampin ____________ 13

riluzole _____________ 32

RIMSO-50 ___________ 27

RIOMET ____________ 10

risedronate sodium ___ 25

risedronate sodium dr _ 25

RISPERDAL __________ 15

RISPERDAL CONSTA___ 15

risperidone __________ 15

risperidone odt ______ 15

RITALIN______________ 3

RITALIN LA ___________ 3

ritonavir ____________ 15

RITUXAN ___________ 14

rivastigmine tartrate __ 35

rivastigmine transdermal35

rivelsa ______________ 19

rizatriptan benzoate __ 29

rizatriptan benzoate odt 29

ROBAXIN-750 ________ 32

ROCALTROL _________ 25

ropinirole er _________ 14

ropinirole hcl ________ 14

rosadan _____________ 23

rosuvastatin calcium __ 11

ROXICODONE _________ 5

ROZEREM ___________ 28

RUBRACA ___________ 14

RUCONEST __________ 27

RYDAPT _____________ 14

RYTARY _____________ 14

RYTHMOL SR _________ 6

ryvent ______________ 11

S

SABRIL ______________ 8

SAFYRAL ____________ 19

SALAGEN ___________ 30

SALEX ______________ 23

SALEX CREAM ________ 23

SALEX LOTION _______ 23

salicylic acid _________ 23

salicylic acid er _______ 23

salicylic acid wart remov 23

saline flush __________ 29

SALIVAMAX _________ 30

salsalate _____________ 4

SANCUSO ___________ 11

SANDIMMUNE _______ 30

SANDOSTATIN LAR DEPOT

_________________ 25

SANTYL _____________ 23

SAPHRIS ____________ 15

SAVAYSA ____________ 7

SAVELLA ____________ 35

SAVELLA TITRATION PACK

_________________ 35

SAXENDA ____________ 3

SEASONIQUE ________ 19

SEEBRI NEOHALER _____ 7

SEGLUROMET ________ 10

SELECT-OB+DHA ______ 31

selegiline hcl _________ 14

selenium sulfide ______ 23

selenium sulfide shampoo

_________________ 23

SEMPREX-D _________ 20

se-natal 19 __________ 31

SENSIPAR ___________ 25

SEREVENT DISKUS _____ 7

SERNIVO ____________ 23

SEROQUEL __________ 15

SEROQUEL XR ________ 15

sertraline hcl __________ 9

sertraline hydrochloride 9

se-tan plus __________ 28

setlakin _____________ 19

sevelamer carbonate __ 26

sf 30

sf 5000 plus__________ 30

sharobel ____________ 19

SHINGRIX ___________ 37

sildenafil ____________ 17

sildenafil citrate ______ 17

SILENOR ____________ 28

SILIQ _______________ 23

SIL-K PAD/LARGE _____ 23

SILVADENE __________ 23

SILVASORB __________ 23

silver sulfadiazine _____ 23

SIMBRINZA __________ 33

SIMPONI INJ

100MG/ML ________ 4

SIMPONI INJ 50/0.5ML 4

SIMPONI ARIA ________ 4

simvastatin __________ 11

SINGULAIR ___________ 7

SINUVA _____________ 32

sirolimus ____________ 30

SITAVIG _____________ 15

SIVEXTRO ___________ 13

SKLICE ______________ 23

SKYLA ______________ 19

SOD SUL/SULF EMU 10-5%

_________________ 23

sod sul/sulf pad 10-4% _ 23

sodium chloride 0.9% _ 27

sodium chloride 0.9% __ 27

sodium chloride flush __ 29

sodium citrate/citric aci 27

sodium fluoride _______ 29

sodium polystyrene sulfon

_________________ 30

sodium sulfacetamide _ 33

sodium sulfacetamide

wash _____________ 23

SOLIQUA 100/33 _____ 10

SOLODYN ___________ 35

SOLOSEC _____________ 3

SOLU-CORTEF ________ 20

SOLU-MEDROL _______ 20

SOMA ______________ 32

SOMATULINE DEPOT __ 25

SOMAVERT __________ 25

SOOLANTRA _________ 23

SORILUX ____________ 23

sotalol hcl ___________ 16

sotalol hcl (af) ________ 16

sotalol hydrochloride (af 16

sotalol hydrocholride __ 16

SOTYLIZE ____________ 16

SPINOSAD ___________ 23

SPINRAZA ___________ 32

SPIRIVA HANDIHALER __ 7

SPIRIVA RESPIMAT _____ 7

spironolactone _______ 25

spironolactone/hydrochlor

_________________ 25

SPORANOX __________ 11

sprintec 28 __________ 19

SPRITAM _____________ 8

SPRIX ________________ 4

SPRYCEL _____________ 14

sps _________________ 30

sronyx ______________ 19

ssd _________________ 23

SSKI ________________ 20

SSS 10-5 _____________ 23

STAMARIL ___________ 37

STAXYN _____________ 17

STEGLATRO __________ 10

STEGLUJAN __________ 10

STELARA INJ 45MG/0.5

_________________ 23

STELARA INJ 5MG/ML

_________________ 26

STENDRA ____________ 17

sterile water irrigation _ 30

STIMATE ____________ 25

STIOLTO RESPIMAT ____ 7

STIVARGA ___________ 14

STRATTERA ___________ 3

STRIANT______________ 5

STRIBILD ____________ 15

STRIVERDI RESPIMAT ___ 7

STROMECTOL _________ 6

SUBOXONE ___________ 5

subvenite _____________ 8

SUCRAID ____________ 24

SUCRALFATE SUS

1GM/10ML ________ 36

sucralfate tab 1gm ___ 36

SULFACET SOD OIN 10%

OP _______________ 33

sulfacetamid lot 10%___ 23

sulfacetamide

sodium/pred _______ 33

sulfacetamide sodium/sulf

_________________ 23

sulfacleanse 8/4 ______ 23

sulfamethoxazole/trimetho

_________________ 13

sulfasalazine _________ 26

sulfatrim pediatric _____ 13

sulindac ______________ 4

SUMADAN WASH _____ 23

sumatriptan __________ 29

sumatriptan succinate _ 29

sumatriptan succinate ref

_________________ 29

sumatriptan/naproxen sodi

_________________ 29

SUMAXIN ___________ 23

SUPARTZ FX__________ 32

SUPPRELIN LA ________ 25

SUPRAX _____________ 17

SUPREP BOWEL PREP KIT

_________________ 28

SUSTIVA_____________ 15

SUTENT _____________ 14

syeda _______________ 19

50

SYMAX DUOTAB _____ 36

SYMBICORT __________ 7

SYMDEKO ___________ 35

SYMLINPEN 120 ______ 10

SYMLINPEN 60 _______ 10

SYMPROIC __________ 26

SYNAGIS ____________ 34

SYNALAR ___________ 23

SYNAREL ____________ 25

SYNERA ____________ 23

SYNERDERM_________ 23

SYNJARDY __________ 10

SYNJARDY XR ________ 10

SYNTHROID _________ 35

SYNVISC ____________ 32

SYNVISC ONE ________ 32

SYPRINE ____________ 30

T

TABLOID ____________ 14

TACLONEX __________ 23

tacrolimus __________ 23

tadalafil ____________ 17

TAFINLAR ___________ 14

TAGRISSO ___________ 14

TALTZ ______________ 23

TALZENNA __________ 14

TAMIFLU____________ 15

tamoxifen citrate _____ 14

tamsulosin hcl _______ 27

tamsulosin hydrochloride

_________________ 27

TAPERDEX 6-DAY _____ 20

TARCEVA ___________ 14

TARGADOX__________ 35

tarina fe 1/20 ________ 19

tarina fe 1/20 eq _____ 19

TARON-C DHA _______ 31

TASIGNA ____________ 14

TAVALISSE __________ 27

TAYTULLA ___________ 19

tazarotene __________ 23

TAZORAC CRE 0.1% _ 23

TAZORAC GEL 0.1% _ 23

taztia xt _____________ 16

TECFIDERA __________ 35

TECFIDERA STARTER PACK

_________________ 35

TEFLARO ____________ 17

TEGRETOL____________ 8

TEGRETOL-XR _________ 8

TEKTURNA __________ 12

TEKTURNA HCT ______ 12

telmisartan __________ 12

telmisartan/amlodipine 12

telmisartan/hydrochloroth

_________________ 12

temazepam _________ 28

TEMOVATE __________ 23

temozolomide _______ 14

TENIVAC ____________ 35

tenofovir disoproxil fuma

_________________ 16

TENORMIN __________ 16

terazosin hcl _________ 12

terbinafine hcl _______ 11

terbinafine hydrochloride

_________________ 11

terbutaline sulfate _____ 7

terconazole __________ 37

TESTIM ______________ 5

TESTOPEL ____________ 5

testosterone cypionate _ 5

testosterone enanthate _ 5

testosterone topical solu 5

TETANUS/DIPHTHERIA

TOXOID __________ 35

tetrabenazine ________ 35

tetracaine hcl ________ 33

tetracaine hydrochloride 33

tetracycline hydrochlorid

_________________ 35

Tetracyclines ________ 35

TETRIX ______________ 23

TEXACORT __________ 23

THEO-24 _____________ 7

theophylline er ________ 7

THIOLA _____________ 27

thioridazine hcl _______ 15

thiothixene __________ 15

THRIVITE RX _________ 31

THYROGEN __________ 24

THYROID AGENTS ____ 35

tiagabine hydrochloride _ 8

TIAZAC _____________ 16

TIKOSYN _____________ 6

tilia fe ______________ 19

timolol gel sol 0.25% op 33

TIMOLOL GEL SOL 0.5%

OP ______________ 33

timolol maleate ______ 16

TIMOPTIC ___________ 33

TIMOPTIC OCUDOSE __ 33

tinidazole ___________ 13

TIROSINT ___________ 35

TIVICAY _____________ 16

TIVORBEX ____________ 4

tizanidine hcl ________ 32

tizanidine hydrochloride 32

tl gard rx ____________ 28

TL G-FOL OS _________ 31

TOBI PODHALER _______ 3

TOBRADEX OIN 0.3-0.1%

_________________ 33

TOBRADEX SUS 0.3-0.1%

_________________ 33

TOBRADEX ST ________ 33

tobramycin ___________ 3

tobramycin sulfate ____ 33

tobramycin/dexamethason

e ________________ 33

TOBREX _____________ 33

TOLAK ______________ 23

tolmetin sodium _______ 4

tolterodine tartrate ___ 36

tolterodine tartrate er _ 36

TOPAMAX ____________ 8

TOPAMAX SPRINKLE ___ 8

TOPICORT ___________ 23

topiramate ___________ 8

TOPIRAMATE ER _______ 8

TOPROL XL __________ 16

torsemide ___________ 25

TOUJEO MAX SOLOSTAR

_________________ 10

TOUJEO SOLOSTAR ___ 10

TOVIAZ _____________ 37

Toxoids _____________ 35

TRACLEER ___________ 17

TRADJENTA __________ 10

tramadol hcl __________ 5

TRAMADOL HCL CAP

150MG ER _________ 5

tramadol hcl tab 200mg er

__________________ 5

tramadol hydrochloride/ac

__________________ 5

trandolapril __________ 12

trandolapril/verapamil hc

_________________ 12

tranexamic acid_______ 28

TRANSDERM-SCOP ____ 11

tranylcypromine sulfate _ 9

TRAVATAN Z _________ 33

trazodone hydrochloride 9

TRELEGY ELLIPTA ______ 7

TREMFYA ___________ 23

TRESIBA FLEXTOUCH __ 10

tretinoin ____________ 23

tretinoin microsphere__ 23

tretinoin microsphere pum

_________________ 23

TREXALL ____________ 14

TREXIMET ___________ 29

tri femynor __________ 19

triamcinolone acetonide 23

triamcinolone acetonide d

_________________ 30

triamterene/hydrochloroth

_________________ 25

TRIANEX ____________ 23

triazolam ____________ 28

TRIBENZOR __________ 12

TRICARE PRENATAL DHA

ONE/ ____________ 31

tricitrates ____________ 27

TRICOR _____________ 11

triderm _____________ 23

TRIDESILON__________ 23

trientine hydrochloride _ 30

tri-estarylla __________ 19

trifluoperazine hcl _____ 15

trifluridine ___________ 33

trigels-f forte _________ 28

TRIGLIDE ____________ 12

trihexyphenidyl hcl ____ 14

tri-legest fe __________ 19

TRILEPTAL ____________ 8

tri-linyah ____________ 19

TRILIPIX _____________ 12

tri-lo-estarylla ________ 19

tri-lo-marzia __________ 19

tri-lo-sprintec ________ 19

TRI-LUMA ___________ 23

trilyte _______________ 28

trimethobenzamide hcl_ 11

trimethoprim _________ 13

trimethoprim sulfate/poly

_________________ 33

trimipramine maleate ___ 9

trinatal rx 1 __________ 31

TRINTELLIX ___________ 9

triphrocaps __________ 31

tri-previfem __________ 19

tri-sprintec ___________ 19

TRISTART DHA _______ 31

TRIUMEQ ____________ 16

tri-vitamin/fluoride ____ 31

trivora-28 ____________ 19

tri-vylibra ____________ 19

TROKENDI XR _________ 8

tropicamide __________ 33

trospium chloride _____ 37

trospium chloride er ___ 37

TRULANCE ___________ 26

TRULICITY ___________ 10

TRUMENBA __________ 37

TRUSOPT ____________ 33

TRUVADA ___________ 16

TUBERSOL ___________ 24

TUDORZA PRESSAIR ____ 7

tulana_______________ 19

TUZISTRA XR _________ 20

TWINRIX ____________ 37

tydemy______________ 19

TYLENOL/CODEINE #3 __ 5

TYLENOL/CODEINE #4 __ 5

TYMLOS _____________ 25

TYPHIM VI ___________ 37

TYSABRI _____________ 35

TYVASO _____________ 17

TYVASO REFILL _______ 17

U

UCERIS AER 2MG/ACT 6

UCERIS TAB 9MG ___ 20

ULCER

DRUGS/ANTISPASMODI

51

CS/ANTICHOLINERGICS

_________________ 35

ULESFIA ____________ 23

ULORIC _____________ 27

ultimatecare one _____ 31

ULTRAM _____________ 5

ULTRAVATE _________ 23

unithroid____________ 35

UPTRAVI ____________ 17

urea _______________ 23

urea nail ____________ 23

URE-K ______________ 23

urelle ______________ 36

uribel ______________ 36

URIMAR-T __________ 36

Urinary Anti-infectives 36

Urinary Antispasmodics 36

uro-458 _____________ 36

UROCIT-K 10 ________ 27

UROGESIC-BLUE ______ 36

uro-mp _____________ 36

URSO 250 ___________ 26

URSO FORTE ________ 26

ursodiol ____________ 26

ustell _______________ 36

UTIBRON NEOHALER ___ 7

UTOPIC _____________ 23

V

VACCINES ___________ 37

VAGIFEM ___________ 37

VAGINAL PRODUCTS __ 37

valacyclovir hcl _______ 16

valacyclovir hydrochlorid16

VALCYTE ____________ 16

valganciclovir ________ 16

valganciclovir hydrochlor16

VALIUM _____________ 6

valproic acid __________ 8

valsartan ____________ 12

valsartan/hydrochlorothia

_________________ 12

VALTREX ____________ 16

VANATOL LQ _________ 4

vancomycin hcl_______ 13

vandazole ___________ 37

VANIQA ____________ 23

vanoxide-hc _________ 23

VAQTA _____________ 37

vardenafil hydrochloride 17

VARIVAX____________ 37

VARUBI _____________ 11

VASCEPA ___________ 12

VASCULERA _________ 24

Vasopressors ________ 37

VAXCHORA__________ 37

VAYARIN ___________ 24

VAYARIN PLUS _______ 24

v-c forte ____________ 31

VECTICAL ___________ 23

VELCADE ____________ 14

velivet ______________ 19

VELPHORO __________ 26

VELTASSA ___________ 30

VELTIN _____________ 23

VEMLIDY ____________ 16

VENCLEXTA __________ 14

VENCLEXTA STARTING

PACK ____________ 14

VENELEX ____________ 23

venlafaxine hcl ________ 9

venlafaxine hcl er ______ 9

venlafaxine hydrochloride 9

VENOFER ___________ 28

VENTOLIN HFA ________ 7

verapamil hcl ________ 16

verapamil hcl er ______ 16

verapamil hcl sr ______ 16

verapamil hydrochloride 16

VERDESO ___________ 23

VEREGEN ___________ 23

VERIPRED 20 ________ 20

VERZENIO ___________ 14

VESICARE ___________ 37

VIAGRA _____________ 17

VIBERZI _____________ 26

VIBRAMYCIN ________ 35

vicodin ______________ 5

vicodin es ____________ 5

vicodin hp ____________ 5

VICTOZA ____________ 10

vienva ______________ 19

vigabatrin ____________ 8

VIGAMOX ___________ 34

VIIBRYD _____________ 9

VIIBRYD STARTER PACK _ 9

vilamit mb ___________ 36

VIMOVO _____________ 4

VIMPAT ______________ 8

VINATE M ___________ 31

vinate one ___________ 31

VIOKACE ____________ 24

viorele ______________ 19

VIRASAL ____________ 23

VIREAD _____________ 16

VIRT-C DHA __________ 31

virt-caps ____________ 31

virt-gard ____________ 28

virt-phos 250 neutral __ 29

VIRT-PN ____________ 31

VIRT-PN DHA ________ 31

VISBIOME ___________ 24

VITAFOL ____________ 31

VITAFOL FE+ _________ 31

VITAFOL GUMMIES ___ 31

VITAFOL ULTRA ______ 31

VITAFOL-NANO ______ 31

VITAFOL-OB _________ 31

VITAFOL-OB+DHA ____ 31

VITAFOL-ONE ________ 31

VITAMEDMD ONE

RX/QUATREFO _____ 31

VITAMEDMD REDICHEW

RX _______________ 31

vitamin k1 ___________ 37

VITAMINS ___________ 37

vitamins a/c/d/fluoride 31

VITAPEARL __________ 31

VITATRUE ___________ 31

VIVELLE-DOT _________ 26

VIVITROL ____________ 10

VIVLODEX ____________ 4

VIVOTIF _____________ 37

VOL-PLUS ___________ 31

VOL-TAB RX _________ 31

VOLTAREN __________ 23

voriconazole _________ 11

VOSEVI _____________ 16

VOTRIENT ___________ 14

VP-PNV-DHA _________ 31

VPRIV ______________ 28

VRAYLAR ____________ 15

VSL#3 DS ____________ 10

VUSION _____________ 24

vyfemla _____________ 19

vylibra ______________ 19

VYTONE _____________ 24

VYTORIN ____________ 12

VYVANSE _____________ 3

VYZULTA ____________ 34

W

warfarin sodium _______ 7

WELCHOL ___________ 12

WELLBUTRIN SR _______ 9

WELLBUTRIN XL _______ 9

wera _______________ 19

WESTHROID _________ 35

WP THYROID ________ 35

wymzya fe ___________ 19

X

XALATAN ____________ 34

XALKORI ____________ 14

XANAX_______________ 6

XARELTO _____________ 7

XARELTO STARTER PACK 7

XELJANZ _____________ 4

XELJANZ XR ___________ 4

XENAZINE ___________ 35

XERAC AC ___________ 24

XERESE _____________ 24

XERMELO ___________ 26

XEROFORM OCCLUSIVE

PETROL ___________ 24

XGEVA ______________ 25

XHANCE_____________ 32

XIAFLEX _____________ 30

XIFAXAN ____________ 13

XIGDUO XR __________ 10

XIIDRA ______________ 34

XIMINO _____________ 35

XOLAIR ______________ 7

XOLEGEL ____________ 24

XOPENEX _____________ 7

XOPENEX HFA _________ 7

XRYLIX ______________ 24

XTAMPZA ER __________ 5

XTANDI _____________ 14

XULANE _____________ 19

XULTOPHY 100/3.6 ____ 10

XYLOCAINE __________ 28

XYLOCAINE-MPF ______ 28

XYREM ______________ 35

XYZBAC _____________ 24

Y

YASMIN 28 __________ 19

YAZ ________________ 19

YF-VAX ______________ 37

YOSPRALA ___________ 27

yuvafem _____________ 37

Z

zafirlukast ____________ 7

zaleplon _____________ 28

zarah _______________ 19

ZARONTIN ____________ 8

ZARXIO _____________ 28

ZATEAN-PN DHA ______ 31

ZATEAN-PN PLUS _____ 31

ZEGERID _____________ 36

ZEJULA ______________ 14

ZELBORAF ___________ 14

ZEMBRACE SYMTOUCH 29

ZENPEP _____________ 24

ZENZEDI ______________ 3

ZEPATIER ____________ 16

ZESTRIL _____________ 12

ZETIA _______________ 12

ZETONNA ___________ 32

ZIANA ______________ 24

zidovudine ___________ 16

zileuton er ____________ 7

ZIOPTAN ____________ 34

ziprasidone hcl _______ 15

ZIPSOR _______________ 4

ZIRGAN _____________ 34

ZITHRANOL __________ 24

ZITHROMAX _________ 29

ZITHROMAX Z-PAK ____ 29

ZOFRAN _____________ 11

ZOHYDRO ER __________ 5

ZOLADEX ____________ 14

zoledronic acid _______ 25

52

zolmitriptan _________ 29

zolmitriptan odt ______ 29

ZOLOFT ______________ 9

zolpidem tartrate _____ 28

zolpidem tartrate er ___ 28

ZOMACTON _________ 25

ZOMIG SPR 5MG __ 29

ZOMIG TAB 5MG __ 29

ZOMIG ZMT _________ 29

ZONALON ___________ 24

ZONEGRAN ___________ 8

zonisamide ___________ 8

ZONTIVITY __________ 27

ZORTRESS ___________ 30

ZORVOLEX ___________ 4

ZOSTAVAX __________ 37

zovia 1/35e __________ 19

ZOVIRAX ____________ 24

ZTLIDO______________ 24

ZUBSOLV _____________ 5

ZUPLENZ ____________ 11

ZYCLARA ____________ 24

ZYCLARA PUMP ______ 24

ZYFLO _______________ 7

ZYFLO CR _____________ 7

ZYLET _______________ 34

ZYMAXID ____________ 34

ZYPREXA ____________ 15

ZYPREXA ZYDIS _______ 15

ZYTIGA ______________ 14

ZYVIT _______________ 24

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