Rebatable OTC Drug List for Maine Medicaid OTC Drugs · Rebatable OTC Drug List for Maine Medicaid...
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Rebatable OTC Drug List for Maine Medicaid OTC Drugs Run Date: 11/15/2017 Note: Some OTC Diabetic Supplies, Nutritionals and Asthma Related DME are covered but not listed. Most over the counter products are subject to State of Maine Maximum Allowable Cost (SMAC) pricing. This list is subject to change and will be updated on a regular basis NDC Product Description Generic Drug Description Brand / Generic DRUG CATEGORY Labeler Name PA Required Acetaminophen Cap 500 MG Generic 00904198760 MAPAP CAP 500MG Generic 49348011610 SM PAIN REL CAP 500MG Acetaminophen Chew Tab 80 MG Generic 00536101407 PAIN & FEVER CHW 80MG Generic 00904525646 MAPAP CHW 80MG Acetaminophen Liquid 160 MG/5ML Generic 00485005708 ED-APAP LIQ 80MG/2.5 Generic 00603083958 Q-PAP LIQ 160/5ML Generic 00603083994 Q-PAP LIQ 160/5ML Generic 00603084094 Q-PAP LIQ 160/5ML Generic 00904198500 MAPAP LIQ 160/5ML Generic 00904198516 MAPAP LIQ 160/5ML Generic 00904198520 MAPAP LIQ 160/5ML Generic 54838014440 CHLD SILAPAP LIQ 160/5ML Generic 54838014470 CHLD SILAPAP LIQ 160/5ML Generic 54838014480 CHLD SILAPAP LIQ 160/5ML Generic 58657052016 ACETAMIN LIQ 160/5ML Acetaminophen Soln 160 MG/5ML Generic 00121065705 ACETAMIN SOL 160/5ML Generic 00121065711 ACETAMIN SOL 160/5ML Generic 00121065721 ACETAMIN SOL 160/5ML Generic 00536012285 PAIN & FEVER SOL 160/5ML Generic 00536012297 PAIN & FEVER SOL 160/5ML Acetaminophen Suppos 120 MG Generic 00713011801 ACEPHEN SUP 120MG Generic 00713011812 ACEPHEN SUP 120MG Generic 00713011850 ACEPHEN SUP 120MG Generic 45802073200 ACETAMIN SUP 120MG Generic 45802073230 ACETAMIN SUP 120MG Generic 45802073233 ACETAMIN SUP 120MG Generic 51672211502 FEVERALL SUP 120MG Generic 51672211504 FEVERALL SUP 120MG Acetaminophen Suppos 325 MG Generic 00713016401 ACEPHEN SUP 325MG Generic 00713016412 ACEPHEN SUP 325MG Generic 00713016450 ACEPHEN SUP 325MG Generic 51672211602 FEVERALL SUP 325MG Generic 51672211604 FEVERALL SUP 325MG Acetaminophen Suppos 650 MG Page 1 of 38 RT23200
Transcript of Rebatable OTC Drug List for Maine Medicaid OTC Drugs · Rebatable OTC Drug List for Maine Medicaid...
Rebatable OTC Drug List for Maine Medicaid OTC Drugs
Run Date: 11/15/2017
Note: Some OTC Diabetic Supplies, Nutritionals and Asthma Related DME are covered but not listed.
Most over the counter products are subject to State of Maine Maximum Allowable Cost (SMAC) pricing.
This list is subject to change and will be updated on a regular basis
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Acetaminophen Cap 500 MG
Generic00904198760 MAPAP CAP 500MG
Generic49348011610 SM PAIN REL CAP 500MG
Acetaminophen Chew Tab 80 MG
Generic00536101407 PAIN & FEVER CHW 80MG
Generic00904525646 MAPAP CHW 80MG
Acetaminophen Liquid 160 MG/5ML
Generic00485005708 ED-APAP LIQ 80MG/2.5
Generic00603083958 Q-PAP LIQ 160/5ML
Generic00603083994 Q-PAP LIQ 160/5ML
Generic00603084094 Q-PAP LIQ 160/5ML
Generic00904198500 MAPAP LIQ 160/5ML
Generic00904198516 MAPAP LIQ 160/5ML
Generic00904198520 MAPAP LIQ 160/5ML
Generic54838014440 CHLD SILAPAP LIQ 160/5ML
Generic54838014470 CHLD SILAPAP LIQ 160/5ML
Generic54838014480 CHLD SILAPAP LIQ 160/5ML
Generic58657052016 ACETAMIN LIQ 160/5ML
Acetaminophen Soln 160 MG/5ML
Generic00121065705 ACETAMIN SOL 160/5ML
Generic00121065711 ACETAMIN SOL 160/5ML
Generic00121065721 ACETAMIN SOL 160/5ML
Generic00536012285 PAIN & FEVER SOL 160/5ML
Generic00536012297 PAIN & FEVER SOL 160/5ML
Acetaminophen Suppos 120 MG
Generic00713011801 ACEPHEN SUP 120MG
Generic00713011812 ACEPHEN SUP 120MG
Generic00713011850 ACEPHEN SUP 120MG
Generic45802073200 ACETAMIN SUP 120MG
Generic45802073230 ACETAMIN SUP 120MG
Generic45802073233 ACETAMIN SUP 120MG
Generic51672211502 FEVERALL SUP 120MG
Generic51672211504 FEVERALL SUP 120MG
Acetaminophen Suppos 325 MG
Generic00713016401 ACEPHEN SUP 325MG
Generic00713016412 ACEPHEN SUP 325MG
Generic00713016450 ACEPHEN SUP 325MG
Generic51672211602 FEVERALL SUP 325MG
Generic51672211604 FEVERALL SUP 325MG
Acetaminophen Suppos 650 MG
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NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Acetaminophen Suppos 650 MG
Generic00713016501 ACEPHEN SUP 650MG
Generic00713016512 ACEPHEN SUP 650MG
Generic00713016550 ACEPHEN SUP 650MG
Generic45802073030 ACETAMIN SUP 650MG
Generic45802073032 ACETAMIN SUP 650MG
Generic45802073033 ACETAMIN SUP 650MG
Generic51672211704 FEVERALL SUP 650MG
Acetaminophen Suppos 80 MG
Brand51672211402 FEVERALL INF SUP 80MG
Brand51672211404 FEVERALL INF SUP 80MG
Acetaminophen Susp 160 MG/5ML
Generic00113010526 PAIN RELIEF SUS 160/5ML
Generic00113021226 PAIN & FEVER SUS 160/5ML
Generic00113059010 PAIN & FEVER SUS 160/5ML
Generic00113060826 PAIN & FEVER SUS 160/5ML
Generic00121178105 ACETAMINOPHN SUS 160/5ML
Generic00536360696 PAIN & FEVER SUS 160/5ML
Generic00603084154 Q-PAP CHILD SUS 160/5ML
Generic00603084254 Q-PAP CHILD SUS 160/5ML
Generic00603084354 Q-PAP CHILD SUS 160/5ML
Generic00904630820 MAPAP CHILD SUS 160/5ML
Generic24385013026 PAIN RELIEF SUS 160/5ML
Generic36800010526 PAIN RELIEF SUS 160/5ML
Generic36800013026 PAIN RELIEF SUS 160/5ML
Generic36800017526 PAIN RELIEF SUS 160/5ML
Generic36800020226 PAIN & FEVER SUS 160/5ML
Generic36800039726 PAIN & FEVER SUS 160/5ML
Generic36800059016 PAIN & FEVER SUS 160/5ML
Generic36800075926 PAIN & FEVER SUS 160/5ML
Generic36800076616 PAIN & FEVER SUS 160/5ML
Generic36800095926 PAIN & FEVER SUS 160/5ML
Generic37205057516 PAIN & FEVER SUS 160/5ML
Generic37205057616 PAIN & FEVER SUS 160/5ML
Generic37205057716 PAIN & FEVER SUS 160/5ML
Generic45802020126 ACETAMINOPHN SUS 160/5ML
Generic45802020326 ACETAMINOPHN SUS 160/5ML
Generic46122004203 PAIN & FEVER SUS 160/5ML
Generic46122005603 PAIN & FEVER SUS 160/5ML
Generic46122010526 PAIN & FEVER SUS 160/5ML
Generic46122010626 PAIN RELIEF SUS 160/5ML
Generic46122020926 PAIN & FEVER SUS 160/5ML
Generic46122021026 PAIN & FEVER SUS 160/5ML
Generic46122021126 PAIN & FEVER SUS 160/5ML
Generic46122021226 PAIN & FEVER SUS 160/5ML
Generic46122021426 PAIN & FEVER SUS 160/5ML
Generic49348008130 PAIN & FEVER SUS 160/5ML
Generic49348009334 PAIN & FEVER SUS 160/5ML
Generic49348011934 PAIN & FEVER SUS 160/5ML
Generic49348012334 PAIN & FEVER SUS 160/5ML
Generic49348032534 PAIN & FEVER SUS 160/5ML
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NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Acetaminophen Susp 160 MG/5ML
Generic49348043030 PAIN & FEVER SUS 160/5ML
Generic62011000101 PAIN & FEVER SUS 160/5ML
Generic62011000201 PAIN & FEVER SUS 160/5ML
Generic62011018301 PAIN & FEVER SUS 160/5ML
Generic62011024701 PAIN & FEVER SUS 160/5ML
Generic63868017526 NON-ASPIRIN SUS 160/5ML
Generic63868017626 NON-ASPIRIN SUS 160/5ML
Generic63868083560 PAIN RELIEF SUS 160/5ML
Generic68094058658 ACETAMINOPHN SUS 160/5ML
Generic68094058758 ACETAMINOPHN SUS 160/5ML
Generic68094058759 ACETAMINOPHN SUS 160/5ML
Generic68094058761 ACETAMINOPHN SUS 160/5ML
Generic68094058762 ACETAMINOPHN SUS 160/5ML
Generic68094058859 ACETAMINOPHN SUS 325MG
Generic68094058862 ACETAMINOPHN SUS 325MG
Acetaminophen Tab 325 MG
Generic00536322201 PAIN & FEVER TAB 325MG
Generic00536322210 PAIN & FEVER TAB 325MG
Generic00603026329 Q-PAP TAB 325MG
Generic00603026332 Q-PAP TAB 325MG
Generic00904198251 MAPAP TAB 325MG
Generic00904198259 MAPAP TAB 325MG
Generic00904198260 MAPAP TAB 325MG
Generic00904198261 MAPAP TAB 325MG
Generic00904198280 MAPAP TAB 325MG
Generic16103035307 PHARBETOL TAB 325MG
Generic16103035308 PHARBETOL TAB 325MG
Generic16103035311 PHARBETOL TAB 325MG
Generic24385040378 PAIN RELIEF TAB 325MG
Generic36800040378 PAIN RELIEF TAB 325MG
Generic46122024778 PAIN RELIEF TAB 325MG
Generic49348097310 PAIN RELIEVE TAB 325MG
Generic62011003201 PAIN RELIEVE TAB 325MG
Generic62107005201 TACTINAL TAB 325MG
Generic62107005210 TACTINAL TAB 325MG
Generic63739044001 ACETAMIN TAB 325MG
Generic63868008210 PAIN RELIEF TAB 325MG
Generic68016024600 NON-ASPIRIN TAB 325MG
Acetaminophen Tab 500 MG
Generic00113022771 PAIN RELIEF TAB 500MG
Generic00113048462 PAIN RELIEF TAB 500MG
Generic00113048471 PAIN RELIEF TAB 500MG
Generic00113048478 PAIN RELIEF TAB 500MG
Generic00113048490 PAIN RELIEF TAB 500MG
Generic00536321801 PAIN & FEVER TAB 500MG
Generic00536321810 PAIN & FEVER TAB 500MG
Generic00536323101 PAIN & FEVER TAB 500MG
Generic00536323110 PAIN & FEVER TAB 500MG
Generic00603026829 Q-PAP TAB 500MG
Generic00603026832 Q-PAP TAB 500MG
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NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Acetaminophen Tab 500 MG
Generic00904198324 MAPAP TAB 500MG
Generic00904198340 MAPAP TAB 500MG
Generic00904198351 MAPAP TAB 500MG
Generic00904198359 MAPAP TAB 500MG
Generic00904198380 MAPAP TAB 500MG
Generic00904198394 MAPAP TAB 500MG
Generic00904198859 MAPAP TAB 500MG
Generic00904198860 MAPAP TAB 500MG
Generic00904198861 MAPAP TAB 500MG
Generic00904198880 MAPAP TAB 500MG
Generic00904581660 MAPAP TAB 500MG/RR
Generic16103037606 PHARBETOL TAB 500MG
Generic16103037608 PHARBETOL TAB 500MG
Generic16103037611 PHARBETOL TAB 500MG
Generic24385014571 PAIN RELIEF TAB 500MG
Generic24385048447 PAIN RELIEF TAB 500MG
Generic24385048471 PAIN RELIEF TAB 500MG
Generic24385048478 PAIN RELIEF TAB 500MG
Generic24385048490 PAIN RELIEF TAB 500MG
Generic36800001071 PAIN RELIEF TAB 500MG
Generic36800001078 PAIN RELIEF TAB 500MG
Generic36800004662 PAIN RELIEVE TAB 500MG
Generic36800004671 PAIN RELIEVE TAB 500MG
Generic36800004678 PAIN RELIEVE TAB 500MG
Generic36800004683 PAIN RELIEVE TAB 500MG
Generic36800022771 PAIN RELIEF TAB 500MG
Generic36800022778 PAIN RELIEF TAB 500MG
Generic36800040572 PAIN RELIEF TAB 500MG
Generic36800040578 PAIN RELIEF TAB 500MG
Generic36800048447 PAIN RELIEF TAB 500MG
Generic36800048462 PAIN RELIEF TAB 500MG
Generic36800048471 PAIN RELIEF TAB 500MG
Generic36800048478 PAIN RELIEF TAB 500MG
Generic36800048490 PAIN RELIEF TAB 500MG
Generic37205059371 PAIN RELIEVE TAB 500MG
Generic37205059378 PAIN RELIEVE TAB 500MG
Generic37205059471 PAIN RELIEVE TAB 500MG
Generic37205059478 PAIN RELIEVE TAB 500MG
Generic37205059490 PAIN RELIEVE TAB 500MG
Generic37205098071 PAIN RELIEVE TAB 500MG/RR
Generic37205098078 PAIN RELIEVE TAB 500MG/RR
Generic49348004209 PAIN RELIEVE TAB 500MG
Generic49348004210 PAIN RELIEVE TAB 500MG
Generic49348004214 PAIN RELIEVE TAB 500MG
Generic49348073009 PAIN RELIEVE TAB 500MG
Generic49348073010 PAIN RELIEVE TAB 500MG
Generic49348099810 PAIN RELIEVE TAB 500MG
Generic62011002301 PAIN RELIEF TAB 500MG
Generic62011002302 PAIN RELIEF TAB 500MG
Generic62011002303 PAIN RELIEF TAB 500MG
Generic62011002701 PAIN RELIEF TAB 500MG
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NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Acetaminophen Tab 500 MG
Generic62011004901 PAIN RELIEF TAB 500MG
Generic62107005001 TACTINAL TAB 500MG
Generic62107005010 TACTINAL TAB 500MG
Generic62107005101 TACTINAL TAB 500MG
Generic62107005110 TACTINAL TAB 500MG
Generic63868050350 NON-ASPIRIN TAB 500MG
Generic63868050701 NON-ASPIRIN TAB 500MG
Generic63868098710 NON-ASPIRIN TAB 500MG/RR
Generic63868098750 NON-ASPIRIN TAB 500MG/RR
Acetaminophen Tab CR 650 MG
Generic00113021771 8 HOUR PAIN TAB 650MG
Generic00113054462 PAIN RELIEF TAB 650MG
Generic00113054471 PAIN RELIEF TAB 650MG
Generic00904576960 ARTHRTS PAIN TAB 650MG
Generic24385062971 ARTHRTS PAIN TAB 650MG
Generic24385062978 ARTHRTS PAIN TAB 650MG
Generic36800021778 8 HOUR PAIN TAB 650MG
Generic36800054462 ARTHRTS PAIN TAB 650MG
Generic36800054471 ARTHRTS PAIN TAB 650MG
Generic36800054478 ARTHRTS PAIN TAB 650MG
Generic36800096647 ARTHRTS PAIN TAB 650MG
Generic46122006271 8 HOUR PAIN TAB 650MG
Generic46122006278 8 HOUR PAIN TAB 650MG
Generic46122017081 ARTHRTS PAIN TAB 650MG
Generic49348092109 ARTHRTS PAIN TAB 650MG
Generic49348092110 ARTHRTS PAIN TAB 650MG
Generic49348092410 8 HOUR PAIN TAB 650MG
Generic51660033301 ARTHRTS PAIN TAB 650MG
Generic51660033350 ARTHRTS PAIN TAB 650MG
Generic62011002601 ARTHRTS PAIN TAB 650MG
Generic63868008901 ARTHRTS PAIN TAB 650MG
Generic63868008950 ARTHRTS PAIN TAB 650MG
Generic68084077725 PA REQUIREDACETAMIN TAB 650MG
Generic68084077795 ACETAMIN TAB 650MG
Aspirin Buffered (Ca Carb-Mg Carb-Mg Ox) Tab 325 MG
Generic00904201559 TRI-BUFF ASA TAB 325MG
Aspirin Chew Tab 81 MG
Generic00113027468 ASPIRIN CHW 81MG
Generic00113046768 ASPIRIN CHW 81MG
Generic00536100836 ASPIRIN CHW 81MG
Generic00536100862 ASPIRIN CHW 81MG
Generic00603002436 ASPIRIN CHLD CHW 81MG
Generic00904404073 ASPIRIN CHW 81MG
Generic00904628889 ASPIRIN CHW 81MG
Generic16103036605 ASPIRIN CHW 81MG
Generic16103036611 ASPIRIN CHW 81MG
Generic24385002868 GNP ASPIRIN CHW 81MG
Generic24385027868 GNP ASPIRIN CHW 81MG
Generic24385036468 GNP ASPIRIN CHW 81MG
Generic36800025968 ASPIRIN CHW 81MG
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NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Aspirin Chew Tab 81 MG
Generic36800027468 ASPIRIN LOW CHW 81MG
Generic36800046768 ASPIRIN LOW CHW 81MG
Generic37205046768 CHILD ASA CHW 81MG
Generic37205070868 CHILD ASA CHW 81MG
Generic49348019107 SM CHILD ASA CHW 81MG
Generic49348049807 SM ASPIRIN CHW 81MG
Generic49348075707 SM CHILD ASA CHW 81MG
Generic49483033463 ASPIRIN LOW CHW 81MG
Generic62011002101 HM ASPIRIN CHW 81MG
Generic62011002801 HM ASPIRIN CHW 81MG
Generic62011021201 HM ASPIRIN CHW 81MG
Generic62107002636 CHILD ASA LS CHW 81MG
Generic63739043401 ASPIRIN CHW 81MG
Aspirin Tab 325 MG
Generic00113041678 ASPIRIN TAB 325MG
Generic00113041687 ASPIRIN TAB 325MG
Generic00113041690 ASPIRIN TAB 325MG
Generic00536105301 ASPIRIN TAB 325MG
Generic00536105305 ASPIRIN TAB 325MG
Generic00536105429 ASPIRIN TAB 325MG
Generic00536330501 ASPIRIN TAB 325MG
Generic00536330510 ASPIRIN TAB 325MG
Generic16103036508 ASPIRIN TAB 325MG
Generic16103036511 ASPIRIN TAB 325MG
Generic37205066887 ASPIRIN TAB 325MG
Generic46122029278 GNP ASPIRIN TAB 325MG
Generic49348000110 SM ASPIRIN TAB 325MG
Generic49348000114 SM ASPIRIN TAB 325MG
Generic49348000123 SM ASPIRIN TAB 325MG
Generic49483001110 ASPIRIN TAB 325MG
Generic62011002001 HM ASPIRIN TAB 325MG
Generic62011002003 HM ASPIRIN TAB 325MG
Generic63868035203 QC ASPIRIN TAB 325MG
Generic63868035210 QC ASPIRIN TAB 325MG
Aspirin Tab Delayed Release 325 MG
Generic00536331301 ASPIRIN TAB 325MG EC
Generic00536331310 ASPIRIN TAB 325MG EC
Generic00603016821 ASPIRIN TAB 325MG EC
Generic00603016921 ASPIRIN TAB 325MG EC
Generic00603016932 ASPIRIN TAB 325MG EC
Generic00904201159 ASPIRIN TAB 325MG EC
Generic00904201360 ASPIRIN TAB 325MG EC
Generic00904201372 ASPIRIN TAB 325MG EC
Generic00904201380 ASPIRIN TAB 325MG EC
Generic16103035708 ASPIRIN TAB 325MG EC
Generic16103035711 ASPIRIN TAB 325MG EC
Generic24385042902 GNP ASPIRIN TAB 325MG EC
Generic24385042990 GNP ASPIRIN TAB 325MG EC
Generic36800042902 ASPIRIN TAB 325MG EC
Generic49348093782 SM ASPIRIN TAB 325MG EC
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NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Aspirin Tab Delayed Release 325 MG
Generic49483033101 ASPIRIN TAB 325MG EC
Generic49483033110 ASPIRIN TAB 325MG EC
Generic50844022712 EQ ASPIRIN TAB 325MG EC
Generic62011004001 ASPIRIN TAB 325MG EC
Generic62107002801 ECPIRIN TAB 325MG EC
Generic62107002832 ECPIRIN TAB 325MG EC
Generic63739052301 ASPIRIN TAB 325MG EC
Generic68084084825 ASPIRIN TAB 325MG
Generic68084084895 ASPIRIN TAB 325MG
Aspirin Tab Delayed Release 81 MG
Generic00536100410 ASPIRIN TAB 81MG EC
Generic00536100441 ASPIRIN TAB 81MG EC
Generic00603002622 ASPIRIN LOW TAB 81MG EC
Generic00603002632 ASPIRIN LOW TAB 81MG EC
Generic00904770418 ASPIR-LOW TAB 81MG EC
Generic00904770470 ASPIR-LOW TAB 81MG EC
Generic00904770480 ASPIR-LOW TAB 81MG EC
Generic16103035609 ASPIRIN TAB 81MG EC
Generic16103035611 ASPIRIN TAB 81MG EC
Generic36800002712 ASPIRIN LOW TAB 81MG EC
Generic36800027748 ASPIRIN LOW TAB 81MG EC
Generic46122018076 ASPIRIN LOW TAB 81MG EC
Generic46122018087 ASPIRIN LOW TAB 81MG EC
Generic49348098015 SM ASPIRIN TAB 81MG EC
Generic49348098023 SM ASPIRIN TAB 81MG EC
Generic49348098053 SM ASPIRIN TAB 81MG EC
Generic49348098115 SM ASPIRIN TAB 81MG EC
Generic49483038710 ASPIRIN LOW TAB 81MG EC
Generic49483038712 ASPIRIN LOW TAB 81MG EC
Generic62011000301 ASPIRIN LOW TAB 81MG EC
Generic62011001901 ASPIRIN LOW TAB 81MG EC
Generic62107002726 ASPIR-81 TAB 81MG EC
Generic62107002732 ASPIR-81 TAB 81MG EC
Generic63739052201 ASPIRIN TAB 81MG EC
Generic63739052210 ASPIRIN TAB 81MG EC
Aspirin-Acetaminophen-Caffeine Tab 250-250-65 MG
Brand00067200020 EXCEDRIN TAB EX ST
Brand00067200050 EXCEDRIN TAB EX ST
Brand00067810324 EXCEDRIN TAB MIGRAINE
Brand00067810333 EXCEDRIN TAB MIGRAINE
Brand00067810391 EXCEDRIN TAB MIGRAINE
Brand00067810392 EXCEDRIN TAB MIGRAINE
Brand00067810424 EXCEDRIN TAB EX ST
Brand00067810433 EXCEDRIN TAB EX ST
Brand00067810491 EXCEDRIN TAB EX ST
Brand00067810492 EXCEDRIN TAB EX ST
Generic00113037462 MIGRAINE TAB FORMULA
Generic00113037478 MIGRAINE TAB FORMULA
Generic00904513559 PAIN RELIEVR TAB PLUS
Generic24385036571 GNP MIGRAINE TAB RELIEF
Page 7 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Aspirin-Acetaminophen-Caffeine Tab 250-250-65 MG
Generic24385036578 GNP MIGRAINE TAB RELIEF
Generic36800037462 MIGRAINE TAB FORMULA
Generic36800037478 MIGRAINE TAB FORMULA
Generic36800043078 HEADACHE FOR TAB ADDED ST
Generic37205028062 MIGRAINE TAB FORMULA
Generic37205028078 MIGRAINE TAB FORMULA
Generic46122010478 GNP HEADACHE TAB RELIEF
Generic49348050610 SM MIGRAINE TAB RELIEF
Generic63868048501 QC HEADACHE TAB RELIEF
Cromolyn Sodium Nasal Aerosol Soln 5.2 MG/ACT (4%)
Generic57782039726 CROMOLYN SOD SPR 5.2/ACT
Meclizine HCl Chew Tab 25 MG
Generic00536101801 TRAVEL SICK CHW 25MG
Generic00536101810 TRAVEL SICK CHW 25MG
Generic49483033301 MOTION-TIME CHW 25MG
Generic49483033310 MOTION-TIME CHW 25MG
Generic51645099401 MECLIZINE CHW 25MG
Generic51645099410 MECLIZINE CHW 25MG
Meclizine HCl Tab 12.5 MG
Generic00536101701 MECLIZINE TAB 12.5MG
Generic00536101710 MECLIZINE TAB 12.5MG
Meclizine HCl Tab 25 MG
Generic24385038851 MOTION SICK TAB 25MG
Generic49348036367 MOTION SICK TAB 25MG
Generic62011003501 MOTION RELF TAB 25MG
Cetirizine HCl Oral Soln 1 MG/ML (5 MG/5ML)
Generic00113097426 ALL DAY ALLG SOL 5MG/5ML
Generic00904637220 ALL DAY ALLG SOL 1MG/ML
Generic24385018826 ALL DAY ALLG SOL 1MG/ML
Generic36800097426 ALL DAY ALLG SOL 5MG/5ML
Generic37205059126 ALLERGY RELF SOL 5MG/5ML
Generic37205085526 ALL DAY ALLG SOL 5MG/5ML
Generic45802097426 CETIRIZINE SYP 1MG/ML
Generic46122002026 ALL DAY ALLG SYP 1MG/ML
Generic46122010126 ALL DAY ALLG SOL 5MG/5ML
Generic49348007834 ALL DAY ALLG SOL 5MG/5ML
Generic49348032634 ALL DAY ALLG SOL 5MG/5ML
Generic49348093434 ALL DAY ALLG SOL 5MG/5ML
Generic51672208808 CETIRIZINE SYP 1MG/ML
Generic51672210208 CETIRIZINE SOL 5MG/5ML
Generic54838055240 CETIRIZINE SOL 5MG/5ML
Generic62011005401 ALLERGY COMP SOL 1MG/ML
Generic62011009301 CETIRIZINE SOL 5MG/5ML
Generic68094072059 CETIRIZINE SOL 5MG/5ML
Generic68094072062 CETIRIZINE SOL 5MG/5ML
Cetirizine HCl Tab 10 MG
Generic00113945839 ALL DAY ALLG TAB 10MG
Generic00113945866 ALL DAY ALLG TAB 10MG
Generic00378363701 CETIRIZINE TAB 10MG
Generic00378363705 CETIRIZINE TAB 10MG
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NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Cetirizine HCl Tab 10 MG
Generic00536104105 CETIRIZINE TAB 10MG
Generic00536408807 CETIRIZINE TAB 10MG
Generic00536408811 CETIRIZINE TAB 10MG
Generic00536408888 CETIRIZINE TAB 10MG
Generic00781168401 CETIRIZINE TAB 10MG
Generic00904585241 ALL DAY ALLG TAB 10MG
Generic00904585243 ALL DAY ALLG TAB 10MG
Generic00904585246 ALL DAY ALLG TAB 10MG
Generic00904585260 ALL DAY ALLG TAB 10MG
Generic00904585261 CETIRIZINE TAB 10MG
Generic00904585289 ALL DAY ALLG TAB 10MG
Generic16571040210 CETIRIZINE TAB 10MG
Generic16571040250 CETIRIZINE TAB 10MG
Generic16714027102 CETIRIZINE TAB 10MG
Generic16714027103 CETIRIZINE TAB 10MG
Generic24385099865 GNP ALL DAY TAB ALLERGY
Generic24385099874 GNP ALL DAY TAB ALLERGY
Generic24385099875 GNP ALL DAY TAB ALLERGY
Generic36800045813 ALL DAY ALLG TAB 10MG
Generic36800045839 ALL DAY ALLG TAB 10MG
Generic36800045847 ALL DAY ALLG TAB 10MG
Generic36800045866 ALL DAY ALLG TAB 10MG
Generic36800045872 ALL DAY ALLG TAB 10MG
Generic36800045887 ALL DAY ALLG TAB 10MG
Generic36800045895 ALL DAY ALLG TAB 10MG
Generic45802091939 CETIRIZINE TAB 10MG
Generic45802091987 CETIRIZINE TAB 10MG
Generic49348093912 SM ALL DAY TAB ALLERGY
Generic49348093944 SM ALL DAY TAB ALLERGY
Generic49348098446 SM ALL DAY TAB ALLERGY
Generic51079059701 CETIRIZINE TAB 10MG
Generic51079059720 CETIRIZINE TAB 10MG
Generic51660093930 CETIRIZINE TAB 10MG
Generic51660093954 CETIRIZINE TAB 10MG
Generic51660093990 CETIRIZINE TAB 10MG
Generic55111069990 CETIRIZINE TAB 10MG
Generic60505263301 CETIRIZINE TAB 10MG
Generic60505263308 CETIRIZINE TAB 10MG
Generic60687016501 CETIRIZINE TAB 10MG
Generic60687016511 CETIRIZINE TAB 10MG
Generic62011005201 ALL DAY ALLG TAB 10MG
Generic62011020502 ALL DAY ALLG TAB 10MG
Generic63868013214 QC ALLERGY TAB 10MG
Generic63868013230 QC ALLERGY TAB 10MG
Generic63868013290 QC ALLERGY TAB 10MG
Cetirizine HCl Tab 5 MG
Generic00378363501 CETIRIZINE TAB 5MG
Generic00781168301 CETIRIZINE TAB 5MG
Generic16571040110 CETIRIZINE TAB 5MG
Generic60505263201 CETIRIZINE TAB 5MG
Page 9 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Fexofenadine HCl Tab 180 MG
Generic00113057139 PA REQUIREDALLER-EASE TAB 180MG
Generic00378078205 PA REQUIREDFEXOFENADINE TAB 180MG
Generic00378078293 PA REQUIREDFEXOFENADINE TAB 180MG
Generic00536106615 PA REQUIREDFEXOFENADINE TAB 180MG
Generic00904621418 PA REQUIREDFEXOFENADINE TAB 180MG
Generic00904621446 PA REQUIREDFEXOFENADINE TAB 180MG
Generic00904621448 PA REQUIREDFEXOFENADINE TAB 180MG
Generic00904621452 PA REQUIREDFEXOFENADINE TAB 180MG
Generic00904621489 PA REQUIREDFEXOFENADINE TAB 180MG
Generic36800057113 PA REQUIREDFEXOFENADINE TAB 180MG
Generic36800057122 PA REQUIREDFEXOFENADINE TAB 180MG
Generic36800057139 PA REQUIREDFEXOFENADINE TAB 180MG
Generic36800057175 PA REQUIREDFEXOFENADINE TAB 180MG
Generic36800057195 PA REQUIREDFEXOFENADINE TAB 180MG
Generic37205065065 PA REQUIREDALLER-EASE TAB 180MG
Generic37205065088 PA REQUIREDALLER-EASE TAB 180MG
Generic45802057178 PA REQUIREDFEXOFENADINE TAB 180MG
Generic46122004022 PA REQUIREDGNP ALLERGY TAB 180MG
Generic46122004061 PA REQUIREDGNP ALLERGY TAB 180MG
Generic46122004065 PA REQUIREDGNP ALLERGY TAB 180MG
Generic46122004075 PA REQUIREDGNP ALLERGY TAB 180MG
Generic49348096844 PA REQUIREDFEXOFENADINE TAB 180MG
Generic49348096856 PA REQUIREDFEXOFENADINE TAB 180MG
Generic51079054801 PA REQUIREDFEXOFENADINE TAB 180MG
Generic51079054820 PA REQUIREDFEXOFENADINE TAB 180MG
Generic55111078430 PA REQUIREDFEXOFENADINE TAB 180MG
Generic62011006702 PA REQUIREDFEXOFENADINE TAB 180MG
Generic62011023301 PA REQUIREDFEXOFENADINE TAB 180MG
Generic63824092605 PA REQUIREDMUCINEX ALLR TAB 180MG
Generic63824092610 PA REQUIREDMUCINEX ALLR TAB 180MG
Generic63824092630 PA REQUIREDMUCINEX ALLR TAB 180MG
Generic63824092640 PA REQUIREDMUCINEX ALLR TAB 180MG
Fexofenadine HCl Tab 60 MG
Generic00113042553 PA REQUIREDALLER-EASE TAB 60MG
Generic00378078105 PA REQUIREDFEXOFENADINE TAB 60MG
Generic00378078191 PA REQUIREDFEXOFENADINE TAB 60MG
Generic36800042553 PA REQUIREDFEXOFENADINE TAB 60MG
Generic45802042578 PA REQUIREDFEXOFENADINE TAB 60MG
Generic51079054701 PA REQUIREDFEXOFENADINE TAB 60MG
Generic51079054720 PA REQUIREDFEXOFENADINE TAB 60MG
Loratadine Rapidly-Disintegrating Tab 10 MG
Generic24385016152 PA REQUIREDALLERGY RELF TAB 10MG
Generic24385054053 PA REQUIREDALLERGY RELF TAB 10MG
Generic51660052731 PA REQUIREDALLERGY RELF TAB 10MG
Loratadine Tab 10 MG
Generic00113061239 ALLERGY RELF TAB 10MG
Generic00113061246 ALLERGY RELF TAB 10MG
Generic00113061260 ALLERGY RELF TAB 10MG
Generic00113061265 ALLERGY RELF TAB 10MG
Generic00781507701 LORATADINE TAB 10MG
Page 10 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Loratadine Tab 10 MG
Generic00904572887 ALLERGY TAB 10MG
Generic00904572889 ALLERGY TAB 10MG
Generic00904607489 ALLERGY TAB 10MG
Generic16714048201 LORATADINE TAB 10MG
Generic16714048202 LORATADINE TAB 10MG
Generic16714048203 LORATADINE TAB 10MG
Generic24385047152 LORATADINE TAB 10MG
Generic24385047178 LORATADINE TAB 10MG
Generic24385047199 LORATADINE TAB 10MG
Generic36800061246 ALLERGY RELF TAB 10MG
Generic36800061265 ALLERGY RELF TAB 10MG
Generic36800061272 ALLERGY RELF TAB 10MG
Generic36800061276 ALLERGY RELF TAB 10MG
Generic36800061287 ALLERGY RELF TAB 10MG
Generic45802065065 LORATADINE TAB 10MG
Generic45802065078 LORATADINE TAB 10MG
Generic45802065087 LORATADINE TAB 10MG
Generic46122015865 LORATADINE TAB 10MG
Generic49348081801 ALLERGY RELF TAB 10MG
Generic49348081813 ALLERGY RELF TAB 10MG
Generic49348081844 ALLERGY RELF TAB 10MG
Generic49348081856 ALLERGY RELF TAB 10MG
Generic51079024601 LORATADINE TAB 10MG
Generic51079024620 LORATADINE TAB 10MG
Generic51660052601 ALLERGY RELF TAB 10MG
Generic51660052605 ALLERGY RELF TAB 10MG
Generic51660052631 ALLERGY RELF TAB 10MG
Generic60505014701 LORATADINE TAB 10MG
Generic60505014708 LORATADINE TAB 10MG
Generic62011024802 LORATADINE TAB 10MG
Generic63868015101 LORATADINE TAB 10MG
Generic63868015110 LORATADINE TAB 10MG
Generic63868015130 LORATADINE TAB 10MG
Generic68084024801 LORATADINE TAB 10MG
Generic68084024811 LORATADINE TAB 10MG
Chlorpheniramine Maleate Syrup 2 MG/5ML
Generic00485009804 ED CHLORPED SYP JR
Generic00485009816 ED CHLORPED SYP JR
Generic00536102547 ALLER-CHLOR SYP 2MG/5ML
Chlorpheniramine Maleate Tab 4 MG
Generic00536100601 ALLER-CHLOR TAB 4MG
Generic00536100610 ALLER-CHLOR TAB 4MG
Generic00536100635 ALLER-CHLOR TAB 4MG
Generic00904001224 ALLERGY TAB 4MG
Generic00904001259 ALLERGY TAB 4MG
Generic00904001261 ALLERGY TAB 4MG
Generic00904001280 ALLERGY TAB 4MG
Generic24385046362 GNP ALLERGY TAB 4MG
Generic24385046378 GNP ALLERGY TAB 4MG
Generic36800046362 ALLERGY TAB 4MG
Page 11 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Chlorpheniramine Maleate Tab 4 MG
Generic37205021562 ALLERGY TAB 4MG
Generic37205021578 ALLERGY TAB 4MG
Generic49348002504 SM ALLERGY TAB 4MG
Generic49483024201 ALLERGY-TIME TAB 4MG
Generic49483024210 ALLERGY-TIME TAB 4MG
Generic62011005901 HM ALLERGY TAB 4MG
Diphenhydramine HCl Cap 25 MG
Generic00113046262 ALLERGY RELF CAP 25MG
Generic00185064801 DIPHENHYDRAM CAP 25MG
Generic00185064810 DIPHENHYDRAM CAP 25MG
Generic00536101001 DIPHENHIST CAP 25MG
Generic00603024118 Q-DRYL CAP 25MG
Generic00603333921 DIPHENHYDRAM CAP 25MG
Generic00603333932 DIPHENHYDRAM CAP 25MG
Generic00904203524 BANOPHEN CAP 25MG
Generic00904530660 DIPHENHYDRAM CAP 25MG
Generic00904530661 DIPHENHYDRAM CAP 25MG
Generic00904530680 DIPHENHYDRAM CAP 25MG
Generic16103034803 PHARBEDRYL CAP 25MG
Generic16103034808 PHARBEDRYL CAP 25MG
Generic16103034811 PHARBEDRYL CAP 25MG
Generic24385046262 GNP ALLERGY CAP 25MG
Generic24385046278 GNP ALLERGY CAP 25MG
Generic36800046262 ALLERGY CAP 25MG
Generic36800046267 ALLERGY CAP 25MG
Generic36800046278 ALLERGY CAP 25MG
Generic49348097110 ALLERGY RELF CAP 25MG
Generic62011005601 ALLERGY CAP 25MG
Generic62011005603 ALLERGY CAP 25MG
Generic63868008701 COMP ALLERGY CAP 25MG
Generic63868008724 COMP ALLERGY CAP 25MG
Generic66424002001 DIPHENHYDRAM CAP 25MG
Generic66424002010 DIPHENHYDRAM CAP 25MG
Generic69618002401 DIPHENHYDRAM CAP 25MG
Diphenhydramine HCl Cap 50 MG
Generic00185064901 DIPHENHYDRAM CAP 50MG
Generic00185064910 DIPHENHYDRAM CAP 50MG
Generic00603334021 DIPHENHYDRAM CAP 50MG
Generic00603334032 DIPHENHYDRAM CAP 50MG
Generic00904205661 DIPHENHYDRAM CAP 50MG
Generic00904530760 BANOPHEN CAP 50MG
Generic00904530780 BANOPHEN CAP 50MG
Generic16103034711 PHARBEDRYL CAP 50MG
Generic66424002101 DIPHENHYDRAM CAP 50MG
Generic66424002110 DIPHENHYDRAM CAP 50MG
Diphenhydramine HCl Liquid 12.5 MG/5ML
Generic00113037926 ALLERGY RELF LIQ 12.5/5ML
Generic00536077085 DIPHENHIST LIQ 12.5/5ML
Generic00536077097 DIPHENHIST LIQ 12.5/5ML
Generic00603082354 Q-DRYL LIQ 12.5/5ML
Page 12 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Diphenhydramine HCl Liquid 12.5 MG/5ML
Generic00603082358 Q-DRYL LIQ 12.5/5ML
Generic00603082381 Q-DRYL LIQ 12.5/5ML
Generic00603082394 Q-DRYL LIQ 12.5/5ML
Generic00904122800 BANOPHEN LIQ 12.5/5ML
Generic00904517416 BANOPHEN LIQ 12.5/5ML
Generic24385037926 CHLD ALLERGY LIQ 12.5/5ML
Generic36800037926 CHLD ALLERGY LIQ 12.5/5ML
Generic36800037934 CHLD ALLERGY LIQ 12.5/5ML
Generic37205056526 ALLERGY LIQ 12.5/5ML
Generic37205056534 ALLERGY LIQ 12.5/5ML
Generic49348004534 ALLERGY RELF LIQ 12.5/5ML
Generic49348004537 ALLERGY RELF LIQ 12.5/5ML
Generic54838013540 SILADRYL ALR LIQ 12.5/5ML
Generic54838013570 SILADRYL ALR LIQ 12.5/5ML
Generic54838013580 SILADRYL ALR LIQ 12.5/5ML
Generic63868082354 CHLD ALLERGY LIQ 12.5/5ML
Diphenhydramine HCl Syrup 12.5 MG/5ML
Generic00603086054 QUENALIN SYP 12.5/5ML
Diphenhydramine HCl Tab 25 MG
Generic00113047962 ALLERGY RELF TAB 25MG
Generic00113047978 ALLERGY RELF TAB 25MG
Generic00536101601 DIPHENHIST TAB 25MG
Generic00904555124 BANOPHEN TAB 25MG
Generic00904555159 BANOPHEN TAB 25MG
Generic24385047962 GNP ALLERGY TAB 25MG
Generic24385047978 GNP ALLERGY TAB 25MG
Generic36800047962 ALLERGY TAB 25MG
Generic36800047967 ALLERGY TAB 25MG
Generic36800047978 ALLERGY TAB 25MG
Generic36800047979 ALLERGY TAB 25MG
Generic37205074378 ALLERGY TAB 25MG
Generic49348098310 SM ALLERGY TAB 25MG RLF
Generic49483006101 DIPHENHYDRAM TAB 25MG
Generic49483006110 DIPHENHYDRAM TAB 25MG
Generic62011005801 HM ALLERGY TAB 25MG
Loratadine Syrup 5 MG/5ML
Generic00904623420 LORATADINE SOL 5MG/5ML
Generic24385053126 LORATADINE SYP 5MG/5ML
Generic46122016426 LORATADINE SYP 5MG/5ML
Generic49348033334 LORATADINE SYP 5MG/5ML
Generic49348063634 LORATADINE SYP 5MG/5ML
Generic51672207308 LORATADINE SYP 5MG/5ML
Generic51672208508 LORATADINE SYP 5MG/5ML
Generic51672209208 LORATADINE SOL 5MG/5ML
Generic54838055440 LORATADINE SOL 5MG/5ML
Generic54838055840 LORATADINE SOL 5MG/5ML
Generic62011018101 LORATADINE SYP 5MG/5ML
Dextromethorphan-Guaifenesin Syrup 10-100 MG/5ML
Generic00113035926 TUSSIN DM SYP 100-10/5
Generic00113035934 TUSSIN DM SYP 100-10/5
Page 13 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Dextromethorphan-Guaifenesin Syrup 10-100 MG/5ML
Generic00121063805 GUAIFENESIN SYP DM
Generic00121063810 GUAIFENESIN SYP DM
Generic00536097085 EXTRA ACTION SYP 100-10/5
Generic00536097097 EXTRA ACTION SYP 100-10/5
Generic00603085558 Q-TUSSIN DM SYP 100-10/5
Generic00603085581 Q-TUSSIN DM SYP 100-10/5
Generic00603085594 Q-TUSSIN DM SYP 100-10/5
Generic00904005300 ROBAFEN DM SYP 100-10/5
Generic00904005309 ROBAFEN DM SYP 100-10/5
Generic00904005316 ROBAFEN DM SYP 100-10/5
Generic00904630620 ROBAFEN DM SYP 100-10/5
Generic37205097026 TUSSIN DM SYP 100-10/5
Generic37205097034 TUSSIN DM SYP 100-10/5
Generic49348001734 SM TUSSIN DM SYP 100-10/5
Generic49348001737 SM TUSSIN DM SYP 100-10/5
Generic49348001739 SM TUSSIN DM SYP 100-10/5
Generic49348086134 SM TUSSIN SYP DM
Generic49348086137 SM TUSSIN SYP DM
Generic54838020940 SILTUSSIN-DM SYP ALC FREE
Generic54838020970 SILTUSSIN-DM SYP ALC FREE
Generic54838020980 SILTUSSIN-DM SYP ALC FREE
Guaifenesin Syrup 100 MG/5ML
Generic00113006126 TUSSIN CHEST SYP 100/5ML
Generic00113006134 TUSSIN CHEST SYP 100/5ML
Generic00536082585 COUGH SYP 100/5ML
Generic00904006100 ROBAFEN SYP 100/5ML
Generic00904006116 ROBAFEN SYP 100/5ML
Generic24385031034 GNP TUSSIN SYP 100/5ML
Generic36800031026 TUSSIN CHEST SYP 100/5ML
Generic54838011740 SILTUSSIN SA SYP 100/5ML
Generic54838011770 SILTUSSIN SA SYP 100/5ML
Generic54838011780 SILTUSSIN SA SYP 100/5ML
Pseudoephedrine HCl Liq 30 MG/5ML
Brand00536185097 PA REQUIREDNASAL DECONG LIQ 30MG/5ML
Pseudoephedrine HCl Syrup 30 MG/5ML
Brand00536185085 NASAL DECON SYP 30MG/5ML
Pseudoephedrine HCl Tab 30 MG
Generic00113043262 NASAL DECONG TAB 30MG
Generic00113243262 NASAL DECONG TAB 30MG
Generic00113243267 NASAL DECONG TAB 30MG
Generic00113243280 NASAL DECONG TAB 30MG
Generic00536360735 NASAL DECONG TAB 30MG
Generic00904505324 SUDOGEST TAB 30MG
Generic00904505359 SUDOGEST TAB 30MG
Generic00904633860 SUDOGEST TAB 30MG
Generic24385043262 NASAL DECONG TAB 30MG
Generic24385043280 NASAL DECONG TAB 30MG
Generic36800043262 NASAL DECONG TAB 30MG
Generic36800043267 NASAL DECONG TAB 30MG
Generic37205044580 PSEUDOEPHEDR TAB 30MG
Page 14 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Pseudoephedrine HCl Tab 30 MG
Generic45802043262 PSEUDOEPHEDR TAB 30MG
Generic49348002404 SM NASAL DEC TAB 30MG
Generic49348002408 SM NASAL DEC TAB 30MG
Generic49348002434 SM NASAL DEC TAB 30MG
Generic62011007801 NASAL DECONG TAB 30MG
Generic62011007802 NASAL DECONG TAB 30MG
Pseudoephedrine HCl Tab 60 MG
Generic00904512546 SUDOGEST TAB 60MG
Generic00904512559 SUDOGEST TAB 60MG
Carbamide Peroxide 6.5% Otic Soln
Generic00536101294 EARWAX TRMNT DRO 6.5% OT
Generic00904322035 EAR DROPS SOL 6.5% OT
Generic24385050305 GNP EAR SYS SOL 6.5% OT
Generic37205045705 EAR WAX REMV DRO 6.5% OT
Generic37205045803 EAR WAX REMV SOL 6.5% OT
Generic49348096029 SM EAR DRO 6.5% OT
Generic62011016701 EARWAX REMV SOL 6.5% OT
Generic62011016901 EARWAX REMV SOL 6.5% OT
Polyethylene Glycol 3350 Oral Powder
Generic00536105224 PA REQUIREDPEG3350 POW
Generic00536105227 PA REQUIREDPEG3350 POW
Generic00536105284 PA REQUIREDPEG3350 POW
Generic00904602576 PA REQUIREDPEG 3350 POW
Generic36800018104 PA REQUIREDCLEARLAX POW
Generic36800030601 PA REQUIREDCLEARLAX POW
Generic36800030602 PA REQUIREDCLEARLAX POW
Generic36800030603 PA REQUIREDCLEARLAX POW
Generic37205061271 PA REQUIREDCLEARLAX POW
Generic37205061272 PA REQUIREDCLEARLAX POW
Generic37205061273 PA REQUIREDCLEARLAX POW
Generic43386031208 PA REQUIREDGAVILAX POW
Generic43386031214 PA REQUIREDGAVILAX POW
Generic45802086801 PA REQUIREDPOLYETH GLYC POW 3350 NF
Generic45802086802 PA REQUIREDPOLYETH GLYC POW 3350 NF
Generic45802086803 PA REQUIREDPOLYETH GLYC POW 3350 NF
Generic46122001431 PA REQUIREDGNP CLEARLAX POW
Generic46122001433 PA REQUIREDGNP CLEARLAX POW
Generic46122001438 PA REQUIREDGNP CLEARLAX POW
Generic46122001471 PA REQUIREDGNP CLEARLAX POW
Generic49348089350 PA REQUIREDSM CLEARLAX POW
Generic49348089370 PA REQUIREDSM CLEARLAX POW
Generic62011015304 PA REQUIREDHM CLEARLAX POW
Generic62175019015 PA REQUIREDGLYCOLAX POW 3350 NF
Generic62175019031 PA REQUIREDGLYCOLAX POW 3350 NF
Generic62175019507 PA REQUIREDPOLYETH GLYC POW 3350 NF
Generic62175019515 PA REQUIREDPOLYETH GLYC POW 3350 NF
Generic62175019531 PA REQUIREDPOLYETH GLYC POW 3350 NF
Generic63868000214 PA REQUIREDNATURA-LAX POW 3350 NF
Simethicone Chew Tab 125 MG
Brand00067011718 GAS-X EX-STR CHW 125MG
Page 15 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Simethicone Chew Tab 125 MG
Brand00067011748 GAS-X EX-STR CHW 125MG
Brand00067012918 GAS-X EX-STR CHW 125MG
Generic00536102008 GAS RELIEF CHW 125MG
Generic00603021120 MYTAB GAS CHW 125MG
Generic24385030789 GNP GAS RELF CHW 125MG
Generic49348086348 SM GAS REL CHW 125MG
Generic62011018901 HM GAS RELF CHW 125MG
Simethicone Chew Tab 80 MG
Brand00067011336 GAS-X CHW 80MG
Brand00067011636 GAS-X CHW 80MG
Generic00536101901 GAS RELIEF CHW 80MG
Generic00603021021 MYTAB GAS CHW 80MG
Generic00904506860 MI-ACID GAS CHW 80MG
Generic24385011878 GNP GAS RELF CHW 80MG
Generic37205011278 GAS RELIEF CHW 80MG
Generic49348050907 SM GAS RELF CHW 80MG
Simethicone Susp 40 MG/0.6ML
Generic00113088210 SIMETHICONE DRO 20/0.3ML
Generic00536222075 GAS RELIEF DRO 20/0.3ML
Generic00603089450 SIMETHICONE DRO 40/0.6ML
Generic00904589430 GAS RELIEF DRO 20/0.3ML
Generic36800088210 GAS RELIEF DRO 40/0.6ML
Generic37205011910 SIMETHICONE DRO 40/0.6ML
Generic46122005103 GAS RELIEF DRO 20/0.3ML
Generic49348074027 GAS RELIEF DRO 20/0.3ML
Generic62011018701 GAS RELIEF DRO 20/0.3ML
Aluminum Hydroxide Gel Susp 320 MG/5ML
Generic00536009185 ALUM HYDROX SUS 320/5ML
Bismuth Subsalicylate Chew Tab 262 MG
Generic00536102107 PEPTIC RELF CHW 262MG
Generic00603023516 PINK BISMUTH CHW 262MG
Generic00904131546 BISMATROL CHW 262MG
Generic24385002465 PINK BISMUTH CHW 262MG
Generic36800046965 STOMACH RELF CHW 262MG
Generic37205072065 PINK BISMUTH CHW 262MG
Generic49348095344 STOMACH RELF CHW 262MG
Generic62011014001 STOMACH RELF CHW 262MG
Bismuth Subsalicylate Susp 262 MG/15ML
Generic00113030234 STOMACH RELF SUS 262/15ML
Generic00113030240 STOMACH RELF SUS 262/15ML
Generic00536181059 PEPTIC RELF SUS 262/15ML
Generic00904131309 BISMATROL SUS 262/15ML
Generic00904570909 KAO-TIN SUS 262/15ML
Generic00904570916 KAO-TIN SUS 262/15ML
Generic24385030226 STOMACH RELF SUS 262/15ML
Generic36800030234 STOMACH RELF SUS 262/15ML
Generic36800030240 STOMACH RELF SUS 262/15ML
Generic49348092237 SM STOMACH SUS 262/15ML
Bismuth Subsalicylate Tab 262 MG
Generic24385001758 PINK BISMUTH TAB 262MG
Page 16 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Bismuth Subsalicylate Tab 262 MG
Generic49348051159 STOMACH RELF TAB 262MG
Calcium Carbonate (Antacid) Chew Tab 1000 MG
Generic00113059523 CAL ANTACID CHW 1000MG
Brand00135011814 TUMS ULTRA CHW 1000MG
Brand00135011883 TUMS ULTRA CHW 1000MG
Brand00135018002 TUMS ULTRA CHW 1000MG
Brand00135018014 TUMS ULTRA CHW 1000MG
Brand00135018101 TUMS ULTRA CHW 1000MG
Brand00135018102 TUMS ULTRA CHW 1000MG
Brand00135018105 TUMS ULTRA CHW 1000MG
Brand00135018114 TUMS ULTRA CHW 1000MG
Brand00135022801 TUMS ULTRA CHW 1000MG
Generic36800059523 CALC ANTACID CHW 1000MG
Generic37205033369 CAL ANTACID CHW 1000MG
Generic49348095916 SM ANTACID CHW 1000MG
Calcium Carbonate (Antacid) Chew Tab 500 MG
Generic00113047847 CALC ANTACID CHW 500MG
Generic00113048547 ANTACID CHW 500MG
Brand00135007003 TUMS CHW 500MG
Brand00135007027 TUMS CHW 500MG
Brand00135007048 TUMS CHW 500MG
Brand00135007127 TUMS CHW 500MG
Brand00135007148 TUMS CHW 500MG
Generic00135052203 TUMS FRESHER CHW 500MG
Generic00135054103 TUMS FRESHER CHW 500MG
Generic00536100715 CAL-GEST CHW 500MG
Generic00536104815 ANTACID CHW 500MG
Generic00904641292 CALC ANTACID CHW 500MG
Generic36800047847 ANTACID CHW 500MG
Generic36800048547 CALC ANTACID CHW 500MG
Generic37205020047 ANTACID CHW 500MG
Generic37205021047 ANTACID CHW 500MG
Generic49348095721 CALC ANTACID CHW 500MG
Generic49348095821 CALC ANTACID CHW 500MG
Generic62011013201 CALC ANTACID CHW 500MG
Generic68084098832 ANTACID CHW 500MG
Generic68084098833 ANTACID CHW 500MG
Calcium Carbonate (Antacid) Chew Tab 750 MG
Generic00113017980 CALC ANTACID CHW 750MG
Generic00113046880 ANTACID CHW 750MG
Generic00113048980 ANTACID CHW 750MG
Brand00135007407 TUMS E-X CHW 750MG
Brand00135007422 TUMS E-X CHW 750MG
Brand00135007424 TUMS E-X CHW 750MG
Brand00135007425 TUMS E-X CHW 750MG
Brand00135007446 TUMS E-X CHW 750MG
Brand00135007625 TUMS E-X CHW 750MG
Brand00135014001 TUMS E-X CHW 750MG
Brand00135014003 TUMS E-X CHW 750MG
Brand00135015405 TUMS E-X CHW 750MG
Page 17 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Calcium Carbonate (Antacid) Chew Tab 750 MG
Brand00135017802 TUMS E-X CHW 750MG
Brand00135017803 TUMS E-X CHW 750MG
Brand00135017808 TUMS E-X CHW 750MG
Brand00135017809 TUMS E-X CHW 750MG
Brand00135024302 TUMS SMOOTHI CHW 750MG
Generic00135024502 TUMS SMOOTHI CHW 750MG
Brand00135024601 TUMS SMOOTHI CHW 750MG
Brand00135024602 TUMS SMOOTHI CHW 750MG
Brand00135045603 TUMS SMOOTHI CHW 750MG
Brand00135046901 TUMS KIDS CHW 750MG
Generic00536104922 CALC ANTACID CHW 750MG
Generic00536105022 CALC ANTACID CHW 750MG
Generic24385010680 ANTACID CHW 750MG
Generic36800017980 CALC ANTACID CHW 750MG
Generic36800046880 CALC ANTACID CHW 750MG
Generic36800048980 CALC ANTACID CHW 750MG
Generic37205020580 ANTACID CHW 750MG
Generic37205070680 ANTACID CHW 750MG
Generic62011022901 CALC ANTACID CHW 750MG
Generic68084099432 CALC ANTACID CHW 750MG
Generic68084099433 CALC ANTACID CHW 750MG
Calcium Carbonate Susp 1250 MG/5ML (500 MG/5ML Elemental Ca)
Generic00054311763 CALCIUM CARB SUS 1250/5ML
Generic00121076616 CALCIUM CARB SUS 1250/5ML
Generic00121476605 CALCIUM CARB SUS 1250/5ML
Magnesium Oxide Tab 400 MG
Generic00603020922 MAG OXIDE TAB 400MG
Sodium Bicarbonate Tab 325 MG
Generic00536104610 SODIUM BICAR TAB 325MG
Sodium Bicarbonate Tab 650 MG
Generic00536104710 SODIUM BICAR TAB 650MG
Generic64980018210 SODIUM BICAR TAB 10GR
Loperamide HCl Cap 2 MG
Generic46122020762 ANTI-DIARRHE CAP 2MG
Generic49348075204 ANTI-DIARRHE CAP 2MG
Generic62011015801 LOPERAMIDE CAP 2MG
Loperamide HCl Liq 1 MG/5ML (0.2 MG/ML)
Generic50383061804 LOPERAMIDE LIQ 1MG/5ML
Generic50383061805 LOPERAMIDE LIQ 1MG/5ML
Generic50383061806 LOPERAMIDE LIQ 1MG/5ML
Generic50383061810 LOPERAMIDE LIQ 1MG/5ML
Generic50383061811 LOPERAMIDE LIQ 1MG/5ML
Famotidine Tab 10 MG
Generic00093274865 FAMOTIDINE TAB 10MG
Generic00093274892 FAMOTIDINE TAB 10MG
Generic00093274894 FAMOTIDINE TAB 10MG
Generic00113014165 ACID REDUCER TAB 10MG
Generic00904552952 HEARTBURN TAB RELIEF
Generic00904552987 HEARTBURN TAB RELIEF
Generic24385025572 ACID REDUCER TAB 10MG
Page 18 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Famotidine Tab 10 MG
Generic36800014165 ACID REDUCER TAB 10MG
Generic36800014172 ACID REDUCER TAB 10MG
Generic37205061465 ACID REDUCER TAB 10MG
Generic49348012812 ACID REDUCER TAB 10MG
Generic49348012813 ACID REDUCER TAB 10MG
Generic49348012844 ACID REDUCER TAB 10MG
Generic62011014201 FAMOTIDINE TAB 10MG
Generic63868071430 ACID CONTROL TAB 10MG
Ranitidine HCl Tab 75 MG
Brand00597012213 PA REQUIREDZANTAC TAB 75MG
Brand00597012254 ZANTAC TAB 75MG
Generic00904634946 RANITIDINE TAB 75MG
Generic00904634952 RANITIDINE TAB 75MG
Generic36800027139 HEARTBRN REL TAB 75MG
Generic36800027172 HEARTBRN REL TAB 75MG
Generic46122022365 ACID REDUCER TAB 75MG
Generic46122022372 ACID REDUCER TAB 75MG
Generic51660035230 ACID REDUCER TAB 75MG
Generic51660035260 ACID REDUCER TAB 75MG
*Sodium Phosphates - Enema***
Brand00132020140 FLEET ENE
Brand00132020142 FLEET ENE
Brand00132020145 FLEET ENE
Brand00132020220 FLEET ENE PED
Generic00536741551 ENEMA READY- ENE -TO-USE
Generic00904632078 ENEMA READY- ENE -TO-USE
Generic24385003936 GNP ENEMA ENE
Generic36800000202 ENEMA ENE SINGLE
Generic36800000236 ENEMA ENE SINGLE
Generic46122016128 GNP ENEMA ENE
Generic46122016136 GNP ENEMA ENE
Generic49348052709 SM ENEMA ENE
Generic49348086414 SM ENEMA ENE
Generic49348086420 SM ENEMA ENE
Generic62011015401 HM ENEMA ENE
Generic62011019101 HM ENEMA ENE R-T-U
Generic63868038045 QC ENEMA ENE
Generic63868038090 QC ENEMA ENE
Alum & Mag Hydroxide-Simethicone Susp 200-200-20 MG/5ML
Generic00113035740 ANTACID PLUS SUS GAS REL
Generic00113085140 ANTACID SUS
Generic00121176130 MAG-AL PLUS LIQ
Generic00536002583 ALMACONE SUS
Generic00536194583 RULOX SUS
Generic00904000414 MI-ACID SUS
Generic00904572114 MINTOX SUS
Generic15127088352 SB ANTACID/ SUS ANTIGAS
Generic24385035640 GNP ANTACID SUS ANTI-GAS
Generic24385035740 GNP MASANTI SUS REG ST
Generic36800035740 ANTACID PLUS SUS GAS REL
Page 19 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Alum & Mag Hydroxide-Simethicone Susp 200-200-20 MG/5ML
Generic36800085140 ANTACID FAST SUS RELIEF
Generic37205031440 ANTACID SUS REG ST
Generic37205053040 ANTACID FAST SUS ACTING
Generic49348001939 SM ANTACID/ SUS ANTIGAS
Generic49348002039 SM ANTACID SUS ANTI-GAS
Generic62011014701 HM ANTACID SUS ANTI-GAS
Generic62011014801 HM ANTACID SUS ANTI-GAS
Generic63868069457 QC ANTACID SUS
Generic63868071257 QC ANTACID SUS ANTI-GAS
Alum & Mag Hydroxide-Simethicone Susp 400-400-40 MG/5ML
Generic00113034040 ANTACID PLUS SUS GAS REL
Generic00113058840 ANTACID SUS ANTI-GAS
Generic00121176230 MAG-AL PLUS LIQ XS
Generic00536001583 ALMACONE DBL SUS STRENGTH
Generic00904000514 MI-ACID SUS MAX ST
Generic00904572514 MINTOX SUS MAX ST
Generic24385034040 GNP MASANTI SUS MAX ST
Generic24385036240 GNP ANTACID SUS CHERRY
Generic36800034040 ANTACID PLUS SUS ANTI-GAS
Generic36800058840 ANTACID SUS MAX ST
Generic37205053540 ANTACID SUS MAX ST
Generic37205053640 ANTACID SUS MAX ST
Generic49348030239 SM ANTACID SUS ADVANCED
Generic62011012201 ADVANCED SUS ANTACID
Generic62011014901 HM ANTACID SUS ANTI-GAS
Bisacodyl Suppos 10 MG
Generic00536135501 LAXATIVE SUP 10MG
Generic00536135512 LAXATIVE SUP 10MG
Generic00574705012 BISACODYL SUP 10MG
Generic00574705050 BISACODYL SUP 10MG
Generic00713010901 BISAC-EVAC SUP 10MG
Generic00713010905 BISAC-EVAC SUP 10MG
Generic00713010908 BISAC-EVAC SUP 10MG
Generic00713010910 BISAC-EVAC SUP 10MG
Generic00713010912 BISAC-EVAC SUP 10MG
Generic00713010950 BISAC-EVAC SUP 10MG
Generic00904505812 BISCOLAX SUP 10MG
Generic00904505860 BISCOLAX SUP 10MG
Generic63868032808 QC LAXATIVE SUP 10MG
Bisacodyl Tab Delayed Release 5 MG
Generic00536338101 STIM LAXAT TAB 5MG EC
Generic00536338110 STIM LAXAT TAB 5MG EC
Generic00904640761 BISACODYL TAB 5MG EC
Generic00904792717 BISACODYL TAB 5MG EC
Generic00904792760 BISACODYL TAB 5MG EC
Generic00904792780 BISACODYL TAB 5MG EC
Generic24385019365 GNP LAXATIVE TAB 5MG EC
Generic24385090363 GNP LAXATIVE TAB 5MG EC
Generic24385090378 GNP BISA-LAX TAB 5MG EC
Generic36800008663 LAXATIVE TAB 5MG EC
Page 20 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Bisacodyl Tab Delayed Release 5 MG
Generic36800017465 WOMANS LAXAT TAB 5MG EC
Generic37205012863 BISACODYL TAB 5MG EC
Generic37205029865 FEMININE LAX TAB 5MG EC
Generic49348059905 SM LAXATIVE TAB 5MG EC
Generic49483000301 BISACODYL TAB 5MG EC
Generic49483000310 BISACODYL TAB 5MG EC
Generic62107003001 DUCODYL TAB 5MG EC
Generic62107003010 DUCODYL TAB 5MG EC
Calcium Polycarbophil Tab 625 MG
Generic00113047775 FIBER LAXATV TAB 625MG
Generic00224050080 KONSYL FIBER TAB 625MG
Generic00224050090 KONSYL FIBER TAB 625MG
Generic00536430605 FIBER-LAX TAB 625MG
Generic00536430608 FIBER-LAX TAB 625MG
Generic00536430611 FIBER-LAX TAB 625MG
Generic00904250091 FIBER TAB 625MG
Generic24385012576 FIBER-CAPS TAB 625MG
Generic36800047775 FIBER LAXATV TAB 625MG
Generic36800047792 FIBER LAXATV TAB 625MG
Generic37205021375 FIBER LAXATV TAB 625MG
Generic49348075913 FIBER LAXATV TAB 625MG
Generic68084096032 FIBER-CAPS TAB 625MG
Generic68084096033 FIBER-CAPS TAB 625MG
Docusate Calcium Cap 240 MG
Generic00536106501 STOOL SOFTNR CAP 240MG
Generic00536106505 STOOL SOFTNR CAP 240MG
Generic00536106510 STOOL SOFTNR CAP 240MG
Generic00904645959 KAO-TIN CAP 240MG
Generic24385043578 DOCUSATE CAL CAP 240MG
Generic49348012210 STOOL SOFTNR CAP 240MG
Docusate Sodium Cap 100 MG
Generic00113048672 STOOL SOFTNR CAP 100MG
Generic00536106210 STOOL SOFTNR CAP 100MG
Generic00536106229 STOOL SOFTNR CAP 100MG
Generic00603015021 DOCQLACE CAP 100MG
Generic00603015032 DOCQLACE CAP 100MG
Generic00904645561 DOK CAP 100MG
Generic00904645760 DOK CAP 100MG
Generic00904645780 DOK CAP 100MG
Generic16103038408 DOCUSATE SOD CAP 100MG
Generic16103038411 DOCUSATE SOD CAP 100MG
Generic24385043678 STOOL SOFTNR CAP 100MG
Generic36800023825 STOOL SOFTNR CAP 100MG
Generic36800048672 STOOL SOFTNR CAP 100MG
Generic36800048678 STOOL SOFTNR CAP 100MG
Generic45802048678 DOCUSATE SOD CAP 100MG
Generic46122023172 STOOL SOFTNR CAP 100MG
Generic46122023178 STOOL SOFTNR CAP 100MG
Generic49348012105 STOOL SOFTNR CAP 100MG
Generic49348048310 STOOL SOFTNR CAP 100MG
Page 21 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Docusate Sodium Cap 100 MG
Generic49348048319 STOOL SOFTNR CAP 100MG
Generic49348048390 STOOL SOFTNR CAP 100MG
Generic60687012901 DOCUSATE SOD CAP 100MG
Generic60687012911 DOCUSATE SOD CAP 100MG
Generic62011022401 STOOL SOFTNR CAP 100MG
Generic62107003301 DOCUSIL CAP 100MG
Generic62107003310 DOCUSIL CAP 100MG
Generic63739047801 DOCUSATE SOD CAP 100MG
Generic63739047810 DOCUSATE SOD CAP 100MG
Generic66424003010 STOOL SOFTNR CAP 100MG
Brand67618010110 PA REQUIREDCOLACE CAP 100MG
Brand67618010130 PA REQUIREDCOLACE CAP 100MG
Brand67618010152 PA REQUIREDCOLACE CAP 100MG
Brand67618010160 PA REQUIREDCOLACE CAP 100MG
Docusate Sodium Cap 250 MG
Generic00536106401 STOOL SOFTNR CAP 250MG
Generic00536106410 STOOL SOFTNR CAP 250MG
Generic00904645859 DOK CAP 250MG
Generic46122026378 STOOL SOFTNR CAP 250MG
Generic49348012510 STOOL SOFTNR CAP 250MG
Generic62011024401 STOOL SOFTNR CAP 250MG
Docusate Sodium Enema 283 MG
Brand17433987603 PA REQUIREDENEMEEZ MINI ENE
Brand17433987805 PA REQUIREDDOCUSOL MINI ENE
Docusate Sodium Liquid 150 MG/15ML
Generic00121054410 DOCUSATE SOD LIQ 50MG/5ML
Generic00536059085 DIOCTO LIQ 50MG/5ML
Generic50383077110 DOCU LIQ 50MG/5ML
Generic50383077111 DOCU LIQ 50MG/5ML
Generic50383077116 DOCU LIQ 50MG/5ML
Generic54838011680 SILACE LIQ 10MG/ML
Docusate Sodium Syrup 60 MG/15ML
Generic00536100185 DIOCTO SYP 60/15ML
Generic54838010780 SILACE SYP 60/15ML
Magnesium Citrate Soln
Generic00904630477 MAG CITRATE SOL LEMON
Generic24385067510 MAG CITRATE SOL LEMON
Generic49348050449 MAG CITRATE SOL CHERRY
Generic49348069649 MAG CITRATE SOL LEMON
Generic62011016601 MAG CITRATE SOL LEMON
Generic62011017400 MAG CITRATE SOL CHERRY
Generic63868093510 MAG CITRATE SOL LEMON
Magnesium Hydroxide Susp 400 MG/5ML
Generic00113033240 MILK OF MAGN SUS FRSH MNT
Generic00113039640 MILK OF MAGN SUS
Generic00121043130 MILK OF MAGN SUS
Generic00536247083 MILK OF MAGN SUS
Generic00536247085 MILK OF MAGN SUS
Generic00904078814 MILK OF MAGN SUS 1200/15
Generic00904078816 MILK OF MAGN SUS 1200/15
Page 22 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Magnesium Hydroxide Susp 400 MG/5ML
Generic00904078914 MILK OF MAGN SUS MINT
Generic24385033240 GNP MILK MAG SUS
Generic24385039640 GNP MILK MAG SUS
Generic24385060840 GNP MILK MAG SUS
Generic36800033240 MILK OF MAGN SUS 1200/15
Generic36800039640 MILK OF MAGN SUS
Generic36800094940 MILK OF MAGN SUS CHERRY
Generic37205083340 MILK OF MAGN SUS 400/5ML
Generic37205083440 MILK OF MAGN SUS MINT
Generic49348030539 MILK OF MAGN SUS 1200/15
Generic49348030739 MILK OF MAGN SUS 1200/15
Generic62011012301 MILK OF MAGN SUS 400/5ML
Generic62011012401 MILK OF MAGN SUS 400/5ML
Generic63868031012 MILK OF MAGN SUS 400/5ML
Generic63868078757 MILK OF MAGN SUS 400/5ML
Generic63868078857 MILK OF MAGN SUS 400/5ML
Methylcellulose Powder Laxative
Brand00135008969 CITRUCEL POW ORANGE
Brand00135008971 CITRUCEL POW ORANGE
Brand00135009070 CITRUCEL POW SF ORANG
Brand00135009074 CITRUCEL POW SF ORANG
Brand00135009075 CITRUCEL POW SF ORANG
Generic00904567516 SOLUBLE FIB POW THERAPY
Methylcellulose Tab 500 MG
Brand00135019901 CITRUCEL TAB 500MG
Brand00135019902 CITRUCEL TAB 500MG
Brand00135019907 CITRUCEL TAB 500MG
Generic24385046678 FIBER THERAP TAB 500MG
Generic49348054110 SM FIBER LAX TAB 500MG
Generic62011013401 HM FIBER TAB 500MG
Mineral Oil
Generic00574061816 MINERAL OIL
Generic24385068516 GNP MINERAL OIL HEAVY
Generic63868093816 QC MINERAL OIL HEAVY
Mineral Oil Enema
Brand00132030140 FLEET OIL ENE
Psyllium Cap 0.52 GM
Generic00224184710 KONSYL CAP 520MG
Generic00224184780 KONSYL CAP 520MG
Generic00536150060 REGULOID CAP 0.52GM
Generic37205037278 FIBER LAXTIV CAP 0.52GM
Generic49348063349 SM FIBER LAX CAP 0.52GM
Generic62011005301 HM FIBER CAP 0.52GM
Sennosides Chew Tab 15 MG
Brand00067000512 PA REQUIREDEX-LAX CHW 15MG
Brand00067000524 PA REQUIREDEX-LAX CHW 15MG
Brand00067000548 PA REQUIREDEX-LAX CHW 15MG
Sennosides Syrup 8.8 MG/5ML
Generic00536100059 SENEXON LIQ 8.8MG/5
Generic00904628909 SENNA SYP 8.8MG/5
Page 23 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Sennosides Tab 15 MG
Brand00067000308 PA REQUIREDEX-LAX TAB 15MG
Brand00067000330 PA REQUIREDEX-LAX TAB 15MG
Generic00067602560 PERDIEM OVER TAB 15MG
Sennosides Tab 17.2 MG
Brand67618031512 PA REQUIREDSENOKOT XTRA TAB 17.2MG
Sennosides Tab 25 MG
Brand00067001624 PA REQUIREDEX-LAX TAB MAX ST
Brand00067001648 PA REQUIREDEX-LAX TAB MAX ST
Brand00067001690 PA REQUIREDEX-LAX TAB MAX ST
Generic24385036962 PA REQUIREDGNP LAXATIVE TAB 25MG
Generic37205029462 PA REQUIREDLAXATIVE TAB 25MG
Generic49348022404 PA REQUIREDSM SENNA LAX TAB MAX STR
Sennosides Tab 8.6 MG
Generic00536590401 SENEXON TAB 8.6MG
Generic00536590410 SENEXON TAB 8.6MG
Generic00603028221 SENNA LAX TAB 8.6MG
Generic00603028232 SENNA LAX TAB 8.6MG
Generic00904643459 SENNA TAB 8.6MG
Generic00904643480 SENNA TAB 8.6MG
Generic16103036308 SENNA-TABS TAB 8.6MG
Generic16103036311 SENNA-TABS TAB 8.6MG
Generic24385040478 SENNA-LAX TAB 8.6MG
Generic49483008001 SENNA-TIME TAB 8.6MG
Generic49483008010 SENNA-TIME TAB 8.6MG
Generic51645085199 SENNA TAB 8.6MG
Generic62107003101 SENNO TAB 8.6MG
Generic63868025710 NAT VEG LAX TAB 8.6MG
Brand67618030010 SENOKOT TAB 8.6MG
Brand67618030020 SENOKOT TAB 8.6MG
Brand67618030050 SENOKOT TAB 8.6MG
Sennosides-Docusate Sodium Tab 8.6-50 MG
Generic00536035501 DSS/SENNA TAB 8.6-50MG
Generic00536035510 DSS/SENNA TAB 8.6-50MG
Generic00536408601 SENEXON-S TAB 8.6-50MG
Generic00536408610 SENEXON-S TAB 8.6-50MG
Generic00603014921 DOC-Q-LAX TAB 8.6-50MG
Generic00603014932 DOC-Q-LAX TAB 8.6-50MG
Generic00603028321 SENNALAX-S TAB 8.6-50MG
Generic00603028332 SENNALAX-S TAB 8.6-50MG
Generic00904564360 DOK PLUS TAB 8.6-50MG
Generic00904564361 DOK PLUS TAB 8.6-50MG
Generic00904633961 SENNA PLUS TAB 8.6-50MG
Generic24385049572 STOOL SOFTNR TAB 8.6-50MG
Generic24385049578 STOOL SOFTNR TAB 8.6-50MG
Generic24385050572 SENNA PLUS TAB 8.6-50MG
Generic36800016260 SENNA-S TAB 8.6-50MG
Generic49348053212 LAX/STL SOFT TAB 8.6-50MG
Generic49348054410 STOOL SOFTNR TAB 8.6-50MG
Generic49348054419 STOOL SOFTNR TAB 8.6-50MG
Generic49483008101 SENNA-TIME S TAB 8.6-50MG
Page 24 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Sennosides-Docusate Sodium Tab 8.6-50 MG
Generic49483008110 SENNA-TIME S TAB 8.6-50MG
Generic60258095106 SENNA-S TAB 8.6-50MG
Generic62011018801 STOOL SOFTNR TAB 8.6-50MG
Generic63739043201 SENNA/DSS TAB 8.6-50MG
Generic63739043210 SENNA/DSS TAB 8.6-50MG
Generic67618010610 PERI-COLACE TAB 8.6-50MG
Generic67618010630 PERI-COLACE TAB 8.6-50MG
Generic67618010660 PERI-COLACE TAB 8.6-50MG
Brand67618031001 SENOKOT S TAB 8.6-50MG
Brand67618031030 SENOKOT S TAB 8.6-50MG
Brand67618031060 SENOKOT S TAB 8.6-50MG
Sennosides-Psyllium Cap 9-500 MG
Brand00224186060 PA REQUIREDSENNA PROMPT CAP 9-500MG
Brand00224186081 PA REQUIREDSENNA PROMPT CAP 9-500MG
Calcium Carbonate Tab 1250 MG (500 MG Elemental Ca)
Generic00054412025 CALCIUM CARB TAB 1250MG
Generic00054812025 CALCIUM CARB TAB 1250MG
Polysaccharide Iron Complex Cap 150 MG (Iron Equivalent)
Generic63044020301 PA REQUIREDIFEREX 150 CAP
Generic63044020361 PA REQUIREDIFEREX 150 CAP
Capsicum Oleoresin Cream 0.025%
Brand00603064888 TRIXAICIN CRE 0.025%
Clemastine Fumarate Tab 1.34 MG (1 MG Base Equiv)
Generic00113028273 DAYHIST ALRG TAB 12 HOUR
Generic24385018351 GNP DAYHIST TAB 1.34MG
Generic36800028251 DAYHIST ALRG TAB 12 HOUR
Generic37205022873 ALLERHIST-1 TAB 1.34MG
Generic49348068603 ALLERGY RELF TAB 1.34MG
Coal Tar Shampoo 0.5%
Brand00096073608 DHS TAR GEL SHA 0.5%
Brand00096073704 DHS TAR SHA
Brand00096073708 DHS TAR SHA
Generic00904525944 THERAPEUTIC SHA
Generic49348060247 ANTI-DANDRUF SHA COAL TAR
Diphenhydramine HCl Syrup 12.5 MG/5ML
Brand54838015440 PA REQUIREDSILPHEN COUG SYP 12.5/5ML
Brand54838015470 PA REQUIREDSILPHEN COUG SYP 12.5/5ML
Brand54838015480 PA REQUIREDSILPHEN COUG SYP 12.5/5ML
Diphenhydramine-Acetaminophen Tab 25-500 MG (sleep)
Generic00113035571 HEADACHE TAB 25-500MG
Generic00113075171 PAIN RELF PM TAB 25-500MG
Generic00536101506 APAP/DIPHEN TAB 25-500MG
Generic00904765151 MAPAP PM TAB 25-500MG
Generic36800035571 HEADACHE TAB 25-500MG
Generic36800043771 PAIN RELIEF TAB 25-500MG
Generic36800043778 PAIN RELIEF TAB 25-500MG
Generic36800082927 PAIN RELIEF TAB 25-500MG
Generic36800082949 PAIN RELIEF TAB 25-500MG
Generic36800082960 PAIN RELIEF TAB 25-500MG
Generic37205067771 HEADACHE PM TAB 25-500MG
Page 25 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Diphenhydramine-Acetaminophen Tab 25-500 MG (sleep)
Generic37205075971 PAIN RELIEVE TAB 25-500MG
Generic37205075978 PAIN RELIEVE TAB 25-500MG
Generic46122002658 PAIN RELIEF TAB 25-500MG
Generic46122013471 HEADACHE PM TAB 25-500MG
Generic46122017971 PAIN RELIEF TAB 25-500MG
Generic49348014010 PAIN RELIEVE TAB 25-500
Generic62011025001 PAIN RELIEVE TAB 25-500
Generic62011025601 PAIN RELIEVR TAB 25-500MG
Generic63868032501 PAIN RELIEVE TAB 25-500MG
Generic63868032550 PAIN RELIEVE TAB 25-500MG
Nicotine TD Patch 24HR 14 MG/24HR
Brand00135019502 PA REQUIREDNICODERM CQ DIS 14MG/24H
Brand00135019503 PA REQUIREDNICODERM CQ DIS 14MG/24H
Brand00135019505 PA REQUIREDNICODERM CQ DIS 14MG/24H
Generic00536110788 NICOTINE TD DIS 14MG/24H
Generic00536589588 NICOTINE TD DIS 14MG/24H
Generic43598044770 NICOTINE TD DIS 14MG/24H
Generic43598044774 NICOTINE TD DIS 14MG/24H
Generic49348014546 SM NICOTINE DIS 14MG/24H
Generic62011017201 HM NICOTINE DIS 14MG/24H
Nicotine TD Patch 24HR 21 MG/24HR
Brand00135014502 PA REQUIREDNICODERM CQ DIS 21MG/24H
Brand00135019401 PA REQUIREDNICODERM CQ DIS 21MG/24H
Brand00135019402 PA REQUIREDNICODERM CQ DIS 21MG/24H
Brand00135019403 PA REQUIREDNICODERM CQ DIS 21MG/24H
Brand00135019405 PA REQUIREDNICODERM CQ DIS 21MG/24H
Generic00536110888 NICOTINE TD DIS 21MG/24H
Generic00536589688 NICOTINE TD DIS 21MG/24H
Generic43598044828 NICOTINE TD DIS 21MG/24H
Generic43598044870 NICOTINE TD DIS 21MG/24H
Generic43598044874 NICOTINE TD DIS 21MG/24H
Generic49348014446 SM NICOTINE DIS 21MG/24H
Generic62011017301 HM NICOTINE DIS 21MG/24H
Nicotine TD Patch 24HR 7 MG/24HR
Brand00135019602 PA REQUIREDNICODERM CQ DIS 7MG/24HR
Brand00135019605 PA REQUIREDNICODERM CQ DIS 7MG/24HR
Generic00536110688 NICOTINE TD DIS 7MG/24HR
Generic00536589488 NICOTINE TD DIS 7MG/24HR
Generic43598044670 NICOTINE TD DIS 7MG/24HR
Generic43598044674 NICOTINE TD DIS 7MG/24HR
Generic49348014646 SM NICOTINE DIS 7MG/24HR
Generic62011005001 NICOTINE TD DIS 7MG/24HR
Nicotine Polacrilex Gum 2 MG
Generic00113020625 NICOTINE POL GUM 2MG MINT
Brand00135015707 PA REQUIREDNICORETTE ST GUM 2MG ORIG
Brand00135015710 PA REQUIREDNICORETTE GUM 2MG ORIG
Brand00135015711 PA REQUIREDNICORETTE GUM 2MG ORIG
Brand00135022502 PA REQUIREDNICORETTE ST GUM 2MG MINT
Brand00135022503 PA REQUIREDNICORETTE GUM 2MG MINT
Brand00135022905 PA REQUIREDNICORETTE GUM 2MG MINT
Page 26 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Nicotine Polacrilex Gum 2 MG
Brand00135024102 PA REQUIREDNICORETTE GUM 2MGFRUIT
Brand00135024103 PA REQUIREDNICORETTE GUM 2MGFRUIT
Brand00135024105 PA REQUIREDNICORETTE GUM 2MGFRUIT
Brand00135024106 PA REQUIREDNICORETTE GUM 2MGFRUIT
Brand00135024108 PA REQUIREDNICORETTE GUM 2MGFRUIT
Brand00135046601 PA REQUIREDNICORETTE GUM 2MG CINN
Brand00135046602 PA REQUIREDNICORETTE GUM 2MG CINN
Brand00135046603 PA REQUIREDNICORETTE GUM 2MG CINN
Brand00135046605 PA REQUIREDNICORETTE GUM 2MG CINN
Brand00135047401 PA REQUIREDNICORETTE GUM 2MG MINT
Brand00135047402 PA REQUIREDNICORETTE GUM 2MG MINT
Brand00135047403 PA REQUIREDNICORETTE GUM 2MG MINT
Brand00135047405 PA REQUIREDNICORETTE GUM 2MG MINT
Brand00135047408 PA REQUIREDNICORETTE GUM 2MG MINT
Generic00536136206 NICOTINE POL GUM 2MG
Generic00536136223 NICOTINE POL GUM 2MG
Generic00536136234 NICOTINE POL GUM 2MG
Generic00536302906 NICOTINE POL GUM 2MG ORIG
Generic00536302923 NICOTINE POL GUM 2MG ORIG
Generic00536302934 NICOTINE POL GUM 2MG ORIG
Generic00536311201 NICOTINE POL GUM 2MG MINT
Generic00536311237 NICOTINE POL GUM 2MG MINT
Generic00536338601 NICOTINE POL GUM 2MGFRUIT
Generic00536340401 NICOTINE POL GUM 2MG CINN
Generic00904573411 NICORELIEF GUM 2MG ORIG
Generic00904573451 NICORELIEF GUM 2MG ORIG
Generic00904573611 NICORELIEF GUM 2MG MINT
Generic00904573651 NICORELIEF GUM 2MG MINT
Generic24385017058 GNP NICOTINE GUM 2MG MINT
Generic24385059471 GNP NICOTINE GUM 2MG MINT
Generic36800002925 NICOTINE POL GUM 2MG ORIG
Generic36800020625 NICOTINE POL GUM 2MG MINT
Generic36800035278 NICOTINE POL GUM 2MGFRUIT
Generic36800045660 NICOTINE POL GUM 2MG MINT
Generic36800045678 NICOTINE POL GUM 2MG MINT
Generic37205020371 NICOTINE POL GUM 2MG
Generic37205096758 NICOTINE POL GUM 2MG MINT
Generic37205096778 NICOTINE POL GUM 2MG MINT
Generic45802020625 NICOTINE POL GUM 2MG MINT
Generic46122017125 GNP NICOTINE GUM 2MG MINT
Generic46122017320 GNP NICOTINE GUM 2MG ORIG
Generic49348057308 SM NICOTINE GUM 2MG
Generic49348057336 SM NICOTINE GUM 2MG
Generic49348069136 SM NICOTINE GUM 2MG MINT
Generic49348078710 SM NICOTINE GUM 2MG MINT
Generic62011004702 HM NICOTINE GUM 2MG MINT
Nicotine Polacrilex Gum 4 MG
Generic00113017060 NICOTINE GUM 4MG
Generic00113042225 NICOTINE POL GUM 4MG MINT
Generic00113053278 NICOTINE POL GUM 4MG MINT
Page 27 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Nicotine Polacrilex Gum 4 MG
Brand00135015807 PA REQUIREDNICORETTE ST GUM 4MG ORIG
Brand00135015810 PA REQUIREDNICORETTE GUM 4MG ORIG
Brand00135015811 PA REQUIREDNICORETTE GUM 4MG ORIG
Brand00135022602 PA REQUIREDNICORETTE GUM 4MG MINT
Brand00135022603 PA REQUIREDNICORETTE GUM 4MG MINT
Brand00135023005 PA REQUIREDNICORETTE GUM 4MG MINT
Brand00135024201 PA REQUIREDNICORETTE GUM 4MGFRUIT
Brand00135024202 PA REQUIREDNICORETTE GUM 4MGFRUIT
Brand00135024203 PA REQUIREDNICORETTE GUM 4MGFRUIT
Brand00135024205 PA REQUIREDNICORETTE GUM 4MGFRUIT
Brand00135024206 PA REQUIREDNICORETTE GUM 4MGFRUIT
Brand00135024208 PA REQUIREDNICORETTE GUM 4MGFRUIT
Brand00135046702 PA REQUIREDNICORETTE GUM 4MG CINN
Brand00135046703 PA REQUIREDNICORETTE GUM 4MG CINN
Brand00135046705 PA REQUIREDNICORETTE GUM 4MG CINN
Brand00135047501 PA REQUIREDNICORETTE GUM 4MG MINT
Brand00135047502 PA REQUIREDNICORETTE GUM 4MG MINT
Brand00135047503 PA REQUIREDNICORETTE GUM 4MG MINT
Brand00135047505 PA REQUIREDNICORETTE GUM 4MG MINT
Brand00135047508 PA REQUIREDNICORETTE GUM 4MG MINT
Generic00536137206 NICOTINE POL GUM 4MG MINT
Generic00536137223 NICOTINE POL GUM 4MG MINT
Generic00536137234 NICOTINE POL GUM 4MG MINT
Generic00536303006 NICOTINE POL GUM 4MG ORIG
Generic00536303023 NICOTINE POL GUM 4MG ORIG
Generic00536311301 NICOTINE POL GUM 4MG MINT
Generic00536311337 NICOTINE POL GUM 4MG MINT
Generic00536338701 NICOTINE POL GUM 4MG
Generic00536340501 NICOTINE POL GUM 4MG
Generic00904573511 NICORELIEF GUM 4MG ORIG
Generic00904573551 NICORELIEF GUM 4MG ORIG
Generic00904573711 NICORELIEF GUM 4MG MINT
Generic00904573751 NICORELIEF GUM 4MG MINT
Generic24385059871 GNP NICOTINE GUM 4MG MINT
Generic36800017025 NICOTINE POL GUM 4MG ORIG
Generic36800017071 NICOTINE POL GUM 4MG ORIG
Generic36800042271 NICOTINE POL GUM 4MG MINT
Generic36800053278 NICOTINE POL GUM 4MG MINT
Generic36800085478 NICOTINE POL GUM 4MGFRUIT
Generic37205020471 NICOTINE POL GUM 4MG
Generic37205096878 NICOTINE POL GUM 4MG MINT
Generic45802000125 NICOTINE POL GUM 4MG MINT
Generic46122028660 GNP NICOTINE GUM 4MG MINT
Generic49348057208 SM NICOTINE GUM 4MG
Generic49348057236 SM NICOTINE GUM 4MG
Generic49348069236 SM NICOTINE GUM 4MG MINT
Generic49348078810 SM NICOTINE GUM 4MG MINT
Generic62011017001 HM NICOTINE GUM 4MG MINT
Nicotine Polacrilex Lozenge 2 MG
Generic00113034405 PA REQUIREDNICOTINE POL LOZ 2MG MINT
Page 28 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Nicotine Polacrilex Lozenge 2 MG
Brand00135050802 PA REQUIREDNICORETTE LOZ 2MG MINT
Brand00135050803 PA REQUIREDNICORETTE LOZ 2MG MINT
Brand00135051001 PA REQUIREDNICORETTE LOZ 2MG MINT
Brand00135051002 PA REQUIREDNICORETTE LOZ 2MG MINT
Brand00135051003 PA REQUIREDNICORETTE LOZ 2MG MINT
Brand00135051005 PA REQUIREDNICORETTE LOZ 2MG MINT
Brand00135051006 PA REQUIREDNICORETTE LOZ 2MG MINT
Brand00135051007 PA REQUIREDNICORETTE LOZ 2MG MINT
Brand00135051201 PA REQUIREDNICORETTE LOZ 2MG CHRY
Brand00135051403 PA REQUIREDNICORETTE LOZ 2MG ORIG
Generic36800034405 PA REQUIREDNICOTINE POL LOZ 2MG MINT
Generic37205098769 PA REQUIREDNICOTINE POL LOZ 2MG MINT
Generic45802034405 PA REQUIREDNICOTINE POL LOZ 2MG MINT
Generic46122017608 PA REQUIREDGNP NICOTINE LOZ 2MG MINT
Generic46122025415 PA REQUIREDGNP NICOTINE LOZ MINI 2MG
Generic49348085216 PA REQUIREDSM NICOTINE LOZ 2MG MINT
Generic62011004801 PA REQUIREDHM NICOTINE LOZ 2MG MINT
Generic62011019901 PA REQUIREDHM NICOTINE LOZ 2MG MINT
Nicotine Polacrilex Lozenge 4 MG
Generic00113087305 PA REQUIREDNICOTINE POL LOZ 4MG MINT
Brand00135050902 PA REQUIREDNICORETTE LOZ 4MG MINT
Brand00135050903 PA REQUIREDNICORETTE LOZ 4MG MINT
Brand00135051101 PA REQUIREDNICORETTE LOZ 4MG MINT
Brand00135051102 PA REQUIREDNICORETTE LOZ 4MG MINT
Brand00135051106 PA REQUIREDNICORETTE LOZ 4MG MINT
Brand00135051107 PA REQUIREDNICORETTE LOZ 4MG MINT
Brand00135051301 PA REQUIREDNICORETTE LOZ 4MG CHRY
Brand00135051503 PA REQUIREDNICORETTE LOZ 4MG ORIG
Generic36800053905 PA REQUIREDNICOTINE POL LOZ 4MG CHRY
Generic36800087305 PA REQUIREDNICOTINE POL LOZ 4MG MINT
Generic37205098869 PA REQUIREDNICOTINE POL LOZ 4MG MINT
Generic45802087305 PA REQUIREDNICOTINE POL LOZ 4MG MINT
Generic46122017708 PA REQUIREDGNP NICOTINE LOZ 4MG MINT
Generic46122025515 PA REQUIREDGNP NICOTINE LOZ 4MG MINT
Generic49348085316 PA REQUIREDSM NICOTINE LOZ 4MG MINT
Generic62011017101 PA REQUIREDHM NICOTINE LOZ 4MG MINT
Generic62011020001 PA REQUIREDHM NICOTINE LOZ 4MG MINT
Ibuprofen Susp 100 MG/5ML
Generic00113016626 IBUPROFEN SUS 100/5ML
Generic00113066026 IBUPROFEN SUS 100/5ML
Generic00113089726 IBUPROFEN SUS 100/5ML
Generic00113089734 IBUPROFEN SUS 100/5ML
Generic00121183605 IBUPROFEN SUS 100/5ML
Generic00121477405 IBUPROFEN SUS 100/5ML
Generic00472125594 IBUPROFEN SUS 100/5ML
Generic00472126194 IBUPROFEN SUS 100/5ML
Generic00472126394 IBUPROFEN SUS 100/5ML
Generic00536108159 IBUPROFEN SUS 100/5ML
Generic00536108197 IBUPROFEN SUS 100/5ML
Generic00904530909 IBUPROFEN SUS 100/5ML
Page 29 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Ibuprofen Susp 100 MG/5ML
Generic00904530920 IBUPROFEN SUS 100/5ML
Generic00904557720 IBUPROFEN SUS 100/5ML
Generic24385000926 IBUPROFEN SUS 100/5ML
Generic24385000934 IBUPROFEN SUS 100/5ML
Generic24385036126 IBUPROFEN SUS 100/5ML
Generic24385036134 IBUPROFEN SUS 100/5ML
Generic24385037226 IBUPROFEN SUS 100/5ML
Generic24385090526 IBUPROFEN SUS 100/5ML
Generic24385090534 IBUPROFEN SUS 100/5ML
Generic36800016626 IBUPROFEN SUS 100/5ML
Generic36800066026 IBUPROFEN SUS 100/5ML
Generic36800068526 IBUPROFEN SUS 100/5ML
Generic36800089726 IBUPROFEN SUS 100/5ML
Generic37205028226 IBUPROFEN SUS 100/5ML
Generic37205028326 IBUPROFEN SUS 100/5ML
Generic37205064326 IBUPROFEN SUS 100/5ML
Generic37205066026 IBUPROFEN SUS 100/5ML
Generic37205084826 IBUPROFEN SUS 100/5ML
Generic45802013326 IBUPROFEN SUS 100/5ML
Generic45802014026 IBUPROFEN SUS 100/5ML
Generic45802089726 IBUPROFEN SUS 100/5ML
Generic45802089734 IBUPROFEN SUS 100/5ML
Generic46122011026 IBUPROFEN SUS 100/5ML
Generic49348022934 IBUPROFEN SUS 100/5ML
Generic49348022937 IBUPROFEN SUS 100/5ML
Generic49348049934 IBUPROFEN SUS 100/5ML
Generic49348050034 IBUPROFEN SUS 100/5ML
Generic49348087634 IBUPROFEN SUS 100/5ML
Generic62011001001 IBUPROFEN SUS 100/5ML
Generic62011001101 IBUPROFEN SUS 100/5ML
Generic62011003001 IBUPROFEN SUS 100/5ML
Generic62011003002 IBUPROFEN SUS 100/5ML
Generic62011021401 IBUPROFEN SUS 100/5ML
Generic63868075618 IBUPROFEN SUS 100/5ML
Generic63868075818 IBUPROFEN SUS 100/5ML
Generic68094049458 IBUPROFEN SUS 100/5ML
Generic68094049459 IBUPROFEN SUS 100/5ML
Generic68094049461 IBUPROFEN SUS 100/5ML
Generic68094049462 IBUPROFEN SUS 100/5ML
Generic68094050359 IBUPROFEN SUS 100/5ML
Generic68094050361 IBUPROFEN SUS 100/5ML
Generic68094050362 IBUPROFEN SUS 100/5ML
Generic68094060059 IBUPROFEN SUS 100/5ML
Generic68094060062 IBUPROFEN SUS 100/5ML
Ibuprofen Tab 200 MG
Generic00113007471 IBUPROFEN TAB 200MG
Generic00113007478 IBUPROFEN TAB 200MG
Generic00113051771 IBUPROFEN TAB 200MG
Generic00113060462 IBUPROFEN TAB 200MG
Generic00113060471 IBUPROFEN TAB 200MG
Page 30 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Ibuprofen Tab 200 MG
Generic00113060478 IBUPROFEN TAB 200MG
Generic00113060490 IBUPROFEN TAB 200MG
Generic00113064762 IBUPROFEN TAB 200MG
Generic00113064771 IBUPROFEN TAB 200MG
Generic00113064778 IBUPROFEN TAB 200MG
Generic00536108801 IBUPROFEN TAB 200MG
Generic00536108802 IBUPROFEN TAB 200MG
Generic00536108805 IBUPROFEN TAB 200MG
Generic00536108806 IBUPROFEN TAB 200MG
Generic00536108901 IBUPROFEN TAB 200MG
Generic00904791251 IBUPROFEN TAB 200MG
Generic00904791259 IBUPROFEN TAB 200MG
Generic00904791451 IBU-200 TAB 200MG
Generic00904791459 IBU-200 TAB 200MG
Generic00904791461 IBU-200 TAB 200MG
Generic00904791524 IBUPROFEN TAB 200MG
Generic00904791540 IBUPROFEN TAB 200MG
Generic00904791551 IBUPROFEN TAB 200MG
Generic00904791559 IBUPROFEN TAB 200MG
Generic00904791570 IBUPROFEN TAB 200MG
Generic00904791580 IBUPROFEN TAB 200MG
Generic16103039306 IBUPROFEN TAB 200MG
Generic16103039308 IBUPROFEN TAB 200MG
Generic24385005878 IBUPROFEN TAB 200MG
Generic24385005882 IBUPROFEN TAB 200MG
Generic24385005978 IBUPROFEN TAB 200MG
Generic24385060471 IBUPROFEN TAB 200MG
Generic24385060478 IBUPROFEN TAB 200MG
Generic24385060485 IBUPROFEN TAB 200MG
Generic24385060490 IBUPROFEN TAB 200MG
Generic24385064771 IBUPROFEN TAB 200MG
Generic24385064778 IBUPROFEN TAB 200MG
Generic36800007471 IBUPROFEN TAB 200MG
Generic36800007478 IBUPROFEN TAB 200MG
Generic36800018383 IBUPROFEN TAB 200MG
Generic36800051771 IBUPROFEN TAB 200MG
Generic36800051778 IBUPROFEN TAB 200MG
Generic36800060462 IBUPROFEN TAB 200MG
Generic36800060471 IBUPROFEN TAB 200MG
Generic36800060478 IBUPROFEN TAB 200MG
Generic36800060485 IBUPROFEN TAB 200MG
Generic36800060490 IBUPROFEN TAB 200MG
Generic36800060493 IBUPROFEN TAB 200MG
Generic36800064762 IBUPROFEN TAB 200MG
Generic36800064771 IBUPROFEN TAB 200MG
Generic36800064778 IBUPROFEN TAB 200MG
Generic36800064790 IBUPROFEN TAB 200MG
Generic37205034171 IBUPROFEN TAB 200MG
Generic37205034178 IBUPROFEN TAB 200MG
Generic37205034571 IBUPROFEN TAB 200MG
Generic37205034578 IBUPROFEN TAB 200MG
Page 31 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Ibuprofen Tab 200 MG
Generic37205035071 IBUPROFEN TAB 200MG
Generic37205060571 IBUPROFEN TAB 200MG
Generic37205067085 IBUPROFEN TAB 200MG
Generic37205067090 IBUPROFEN TAB 200MG
Generic49348019609 IBUPROFEN TAB 200MG
Generic49348019610 IBUPROFEN TAB 200MG
Generic49348019635 IBUPROFEN TAB 200MG
Generic49348070604 IBUPROFEN TAB 200MG
Generic49348070609 IBUPROFEN TAB 200MG
Generic49348070610 IBUPROFEN TAB 200MG
Generic49348070614 IBUPROFEN TAB 200MG
Generic49348072709 SM IBUPROFEN TAB 200MG
Generic49348072710 SM IBUPROFEN TAB 200MG
Generic53746014001 IBUPROFEN TAB 200MG
Generic53746014010 IBUPROFEN TAB 200MG
Generic62011001401 HM IBUPROFEN TAB 200MG
Generic62011001402 HM IBUPROFEN TAB 200MG
Generic62011001403 HM IBUPROFEN TAB 200MG
Generic62011001501 HM IBUPROFEN TAB 200MG
Generic62011001502 HM IBUPROFEN TAB 200MG
Generic62011021301 HM IBUPROFEN TAB 200MG
Generic62011022201 HM IBUPROFEN TAB 200MG
Generic62011022202 HM IBUPROFEN TAB 200MG
Generic62107000201 PROVIL TAB 200MG
Generic62107000250 PROVIL TAB 200MG
Generic63868079050 QC IBUPROFEN TAB 200MG
Generic63868079150 QC IBUPROFEN TAB 200MG
Generic63868098350 QC IBUPROFEN TAB 200MG
Generic66424099610 IBUPROFEN TAB 200MG
Naproxen Sodium Tab 220 MG
Generic00113036862 ALL DAY PAIN TAB 220MG
Generic00113036871 ALL DAY PAIN TAB 220MG
Generic00113036878 ALL DAY PAIN TAB 220MG
Generic00113949062 ALL DAY PAIN TAB 220MG
Generic00113949071 ALL DAY PAIN TAB 220MG
Generic00113949078 ALL DAY PAIN TAB 220MG
Generic00536109301 ALL DAY RELF TAB 220MG
Generic00536109306 ALL DAY RELF TAB 220MG
Generic00536109401 ALL DAY RELF TAB 220MG
Generic00536109406 ALL DAY RELF TAB 220MG
Generic24385036881 ALL DAY PAIN TAB 220MG
Generic24385049071 ALL DAY PAIN TAB 220MG
Generic24385049078 ALL DAY PAIN TAB 220MG
Generic36800036862 ALL DAY PAIN TAB 220MG
Generic36800036871 ALL DAY PAIN TAB 220MG
Generic36800036878 ALL DAY PAIN TAB 220MG
Generic36800036882 ALL DAY PAIN TAB 220MG
Generic36800049062 ALL DAY PAIN TAB 220MG
Generic36800049071 ALL DAY PAIN TAB 220MG
Generic36800049078 ALL DAY PAIN TAB 220MG
Page 32 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Naproxen Sodium Tab 220 MG
Generic45802049071 NAPROXEN SOD TAB 220MG
Generic45802049078 NAPROXEN SOD TAB 220MG
Generic49348030609 NAPROXEN SOD TAB 220MG
Generic62011001701 NAPROXEN SOD TAB 220MG
Generic62011001702 NAPROXEN SOD TAB 220MG
Generic63868046501 NAPROXEN SOD TAB 220MG
Generic63868046550 NAPROXEN SOD TAB 220MG
Ketotifen Fumarate Ophth Soln 0.025% (Base Equiv)
Brand00065401105 PA REQUIREDZADITOR DRO 0.025%OP
Brand00065401106 PA REQUIREDZADITOR DRO 0.025%OP
Generic17478071710 KETOTIF FUM DRO 0.025%OP
Generic24208060105 ALAWAY CHILD DRO 0.025%OP
Generic24208060110 ALAWAY DRO 0.025%OP
Generic49348010717 EYE ITCH REL DRO 0.025%OP
Generic62011023201 EYE ITCH REL DRO 0.025%OP
*Artificial Tear Ophth Ointment***
Generic00023024004 REFRESH P.M. OIN OP
Generic00023031204 REFRESH LACR OIN OP
Generic00023031207 REFRESH LACR OIN OP
Generic17478006235 AKWA TEARS OIN OP
Generic46122020204 LUBRICANT OIN EYE
*Artificial Tear Ophth Solution***
Generic00065041622 TEARS NATURA SOL FREE OP
Generic00065041625 TEARS NATURA SOL FREE OP
Generic00065041636 TEARS NATURA SOL FREE OP
Generic00065041928 BION TEARS SOL OP
Generic00536108794 NATURES SOL TEARS
Generic00904649335 NATURAL BAL SOL TEARS
Carboxymethylcellulose Sodium Ophth Soln 0.5%
Brand00023040330 REFRESH PLUS DRO 0.5% OP
Brand00023040350 REFRESH PLUS DRO 0.5% OP
Brand00023040370 REFRESH PLUS DRO 0.5% OP
Brand00023079801 REFRESH TEAR DRO 0.5% OP
Brand00023079802 REFRESH TEAR DRO 0.5% OP
Brand00023079815 REFRESH TEAR DRO 0.5% OP
Generic00113032365 PA REQUIREDLUBRICATING SOL 0.5%
Generic00904632946 PA REQUIREDLUBRICNT EYE DRO 0.5% OP
Generic00904632951 PA REQUIREDLUBRICNT EYE DRO 0.5% OP
Generic46122019565 PA REQUIREDLUBRICNT EYE DRO 0.5% OP
Generic49348032944 PA REQUIREDLUBRICATING SOL 0.5%
Generic62011020301 PA REQUIREDLUBRICATING SOL 0.5%
Carboxymethylcellulose Sodium Ophth Soln 1%
Brand00023455430 REFRESH CELL DRO 1% OP
Brand00023920502 REFRESH LIQU DRO 1% OP
Brand00023920515 REFRESH LIQU DRO 1% OP
Polyvinyl Alcohol Ophth Soln 1.4%
Generic00536108494 ARTIFI TEARS SOL 1.4% OP
Generic00904649235 LIQUITEARS SOL
Generic17478006012 ARTIFI TEARS SOL 1.4% OP
Polyvinyl Alcohol-Povidone Ophth Soln 1.4-0.6%
Page 33 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Polyvinyl Alcohol-Povidone Ophth Soln 1.4-0.6%
Brand00023050601 REFRESH DRO OP
Brand00023050650 REFRESH DRO OP
Naphazoline w/ Pheniramine Ophth Soln 0.025-0.3%
Brand00065008515 NAPHCON-A SOL OP
Brand00065008542 NAPHCON-A SOL OP
Sodium Chloride Hypertonic Ophth Oint 5%
Generic00904648938 SOD CHLORIDE OIN 5% OP
Generic17478062235 SOD CHLORIDE OIN 5% OP
Brand24208038555 MURO 128 OIN 5% OP
Brand24208038556 MURO 128 OIN 5% OP
Sodium Chloride Hypertonic Ophth Soln 5%
Generic00904649035 SOD CHLORIDE SOL 5% OP
Generic17478062312 SOD CHLORIDE SOL 5% OP
Brand24208027715 MURO 128 SOL 5% OP
Brand24208027730 MURO 128 SOL 5% OP
Tetrahydrozoline HCl Ophth Soln 0.05%
Generic00536100294 EYE DROPS SOL 0.05% OP
Generic00904633435 OPTI-CLEAR SOL 0.05%
Generic24385007505 GNP EYE DROP SOL 0.05% OP
Generic37205013905 EYE DROPS SOL 0.05% OP
Generic62011010201 HM EYE DROPS SOL 0.05% OP
Benzoyl Peroxide Gel 10%
Generic00536105656 PA REQUIREDACNE MEDICAT GEL 10%
Generic45802030801 PA REQUIREDBENZOYL PER GEL 10%
Generic45802030896 PA REQUIREDBENZOYL PER GEL 10%
Benzoyl Peroxide Gel 5%
Generic00536105556 PA REQUIREDACNE MEDICAT GEL 5%
Generic45802021601 PA REQUIREDBENZOYL PER GEL 5%
Generic45802021696 PA REQUIREDBENZOYL PER GEL 5%
Benzoyl Peroxide Liq 10%
Generic00145098505 PA REQUIREDPANOXYL WASH LIQ 10%
Generic45802031801 PA REQUIREDBENZOYL PER LIQ 10% WASH
Generic45802031834 PA REQUIREDBENZOYL PER LIQ 10% WASH
Generic67405083005 PA REQUIREDBENZOYL PER LIQ 10% WASH
Generic67405083008 PA REQUIREDBENZOYL PER LIQ 10% WASH
Benzoyl Peroxide Lotion 5%
Brand00536105775 PA REQUIREDACNE MEDICAT LOT 5%
*Neomycin-Bacitracin-Polymyxin Oint***
Generic00113006764 TRIPLE ANTIB OIN
Generic00168001209 BAC/NEO/POLY OIN
Generic00168001231 BAC/NEO/POLY OIN
Generic00168001235 BAC/NEO/POLY OIN
Generic00472017934 TRIPLE ANTIB OIN
Generic00472017956 TRIPLE ANTIB OIN
Generic00713026831 TRIPLE ANTIB OIN
Generic00904073431 TRIPLE ANTIB OIN
Generic00904073436 TRIPLE ANTIB OIN
Generic24385006101 GNP TRIPLE OIN ANTIBIOT
Generic24385006103 GNP TRIPLE OIN ANTIBIOT
Generic37205027310 TRIPLE ANTIB OIN
Page 34 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
*Neomycin-Bacitracin-Polymyxin Oint***
Generic45802014301 TRIPLE ANTIB OIN
Generic45802014303 TRIPLE ANTIB OIN
Generic45802014370 TRIPLE ANTIB OIN
Generic49348002972 SM TRIPLE OIN ANTIBIOT
Generic51672201601 TRIPLE ANTIB OIN
Generic51672201602 TRIPLE ANTIB OIN
Generic62011009801 HM TRIPLE OIN ANTIBIOT
Bacitracin Oint 500 Unit/GM
Generic00713028031 BACITRACIN OIN 500/GM
Generic37205027510 BACITRACIN OIN 500/GM
Generic45802006001 BACITRACIN OIN 500/GM
Generic45802006003 BACITRACIN OIN 500/GM
Generic45802006070 BACITRACIN OIN 500/GM
Generic62011009401 BACITRACIN OIN 500/GM
Clotrimazole Cream 1%
Generic00904782231 CLOTRIMAZOLE CRE 1%
Generic00904782236 CLOTRIMAZOLE CRE 1%
Generic24385020501 ATHLETE FOOT CRE 1%
Generic24385020503 ATHLETE FOOT CRE 1%
Generic45802043401 CLOTRIMAZOLE CRE 1%
Generic45802043411 CLOTRIMAZOLE CRE 1%
Generic49348027972 CLOTRIMAZOLE CRE 1%
Generic51672200201 CLOTRIMAZOLE CRE 1%
Generic51672200202 CLOTRIMAZOLE CRE 1%
Miconazole Nitrate Cream 2%
Generic00472073514 ANTIFUNGAL CRE 2%
Generic00472073542 ANTIFUNGAL CRE 2%
Generic00472073556 ANTIFUNGAL CRE 2%
Generic00603780550 MICONAZOLE CRE 2%
Generic11701004514 BAZA ANTIFUN CRE 2%
Generic11701004522 BAZA ANTIFUN CRE 2%
Generic11701004523 BAZA ANTIFUN CRE 2%
Generic49348068972 SM ANTIFUNGL CRE 2%
Generic50484032800 ANTIFUNGAL CRE 2%
Generic50484032900 ANTIFUNGAL CRE 2%
Generic51672200101 MICONAZOLE CRE 2%
Generic51672200102 MICONAZOLE CRE 2%
Generic53329007964 ANTIFUNGAL CRE 2%
Generic53329008057 SOOTHE&COOL CRE INZO 2%
Generic53329008058 SOOTHE&COOL CRE INZO 2%
Generic53329016204 REMEDY CRE ANTIFUNG
Tolnaftate Aerosol Pow 1%
Generic00067611446 LAMISIL AF AER 1%
Generic00113069590 JOCK ITCH AER 1%
Tolnaftate Cream 1%
Generic00904072236 ANTIFUNGAL CRE 1%
Generic24385003203 TOLNAFTATE CRE 1%
Generic37205019710 ANTIFUNGAL CRE 1%
Generic45802003201 TOLNAFTATE CRE 1%
Generic49348015529 SM ANTIFUNGL CRE 1%
Page 35 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Tolnaftate Cream 1%
Generic51672202001 TOLNAFTATE CRE 1%
Generic51672202002 TOLNAFTATE CRE 1%
Generic63868010446 TOLNAFTATE CRE 1%
Selenium Sulfide Lotion 1%
Generic00536199553 ANTI-DANDRUF SHA 1%
Chlorhexidine Gluconate Liquid 4%
Generic67618020001 BETASEPT LIQ 4%
Generic67618020004 BETASEPT LIQ 4%
Generic67618020008 BETASEPT LIQ 4%
Generic67618020016 BETASEPT LIQ 4%
Generic67618020030 BETASEPT LIQ 4%
Generic67618020032 BETASEPT LIQ 4%
Povidone-Iodine Soln 10%
Generic00904110309 POVIDONE-IOD SOL 10%
Generic24385005355 POVIDONE-IOD SOL 10%
Generic49348062237 SM POVID-IOD SOL 10%
Generic49348062238 SM POVID-IOD SOL 10%
Generic62011011801 HM POVID-IOD SOL 10%
Generic63868023008 POVIDONE/IOD SOL 10%
Brand67618015001 PA REQUIREDBETADINE SOL 10%
Brand67618015003 PA REQUIREDBETADINE SOL 10%
Brand67618015004 PA REQUIREDBETADINE SOL 10%
Brand67618015005 PA REQUIREDBETADINE SOL 10%
Brand67618015008 PA REQUIREDBETADINE SOL 10%
Brand67618015009 PA REQUIREDBETADINE SOL 10%
Brand67618015017 PA REQUIREDBETADINE SOL 10%
Brand67618015032 PA REQUIREDBETADINE SOL 10%
Zinc Oxide Oint 20%
Generic00168006202 ZINC OXIDE OIN 20%
Generic00168006216 ZINC OXIDE OIN 20%
Generic00168006231 ZINC OXIDE OIN 20%
Generic00536570098 ZINC OXIDE OIN 20%
Generic46122011846 ZINC OXIDE OIN 20%
Hydrocortisone Cream 0.5%
Generic00168001431 HYDROCORT CRE 0.5%
Generic24385019003 HYDROCORT CRE 0.5%
Hydrocortisone Cream 1%
Generic00113054164 ANTI-ITCH CRE 1%
Generic00113097364 ANTI-ITCH CRE 1%
Generic00168015408 HYDROCORT CRE 1%
Generic00168015431 HYDROCORT CRE 1%
Generic00472034356 HYDROCORT CRE 1%
Generic00536106995 HYDROSKIN CRE 1%
Generic00603053550 HYDROCORT CRE 1%
Generic00904762331 HYDROCORT CRE 1%
Generic24385002103 GNP HYDROCOR CRE 1% PLUS
Generic37205016210 HYDROCORT CRE 1%
Generic45802043803 HYDROCORT CRE 1%
Generic45802043805 HYDROCORT CRE 1%
Generic49348052172 SM HYDROCORT CRE 1%
Page 36 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Hydrocortisone Cream 1%
Generic51672201301 HYDROCORT CRE 1%
Generic51672201302 HYDROCORT CRE 1%
Generic51672206302 HYDROCORT CRE 1%
Generic51672206902 HYDROCORT CRE 1%
Hydrocortisone Lotion 1%
Generic00536107997 HYDROSKIN LOT 1%
Generic24385028306 HYDRO-LOTION LOT 1%
Hydrocortisone Oint 0.5%
Generic00168001631 HYDROCORT OIN 0.5%
Hydrocortisone Oint 1%
Generic00168018131 HYDROCORT OIN 1%
Generic00472034556 HYDROCORT OIN 1%
Generic24385027603 HYDROCORT OIN 1%
Generic45802027603 HYDROCORT OIN 1%
Generic49348052272 SM HYDROCORT OIN 1%
Generic51672201802 HYDROCORT OIN 1%
Lactic Acid (Ammonium Lactate) Cream 12%
Generic63044040420 AMMONIUM LAC CRE 12%
Lactic Acid (Ammonium Lactate) Lotion 12%
Generic63044048409 AMMONIUM LAC LOT 12%
Capsaicin Cream 0.025%
Generic00536252525 CAPSAICIN CRE 0.025%
Capsaicin Cream 0.075%
Generic00603064988 TRIXAICIN HP CRE 0.075%
Permethrin Creme Rinse 1%
Generic46122010846 LICE TRTMNT LIQ 1%
Generic62011025501 LICE TRTMNT LIQ 1%
Pyrethrins-Piperonyl Butoxide Shampoo 0.33-4%
Generic00113086626 LICE KILLING SHA 0.33-4%
Generic00904252820 LICE KILLING SHA 0.33-4%
Generic24385011603 LICE TREATMT SHA 0.33-4%
Generic36800086634 LICE KILLING SHA
Generic37205016526 LICE KILLING SHA 0.33-4%
Generic49348044334 LICE KILLING SHA 0.33-4%
Generic62011011902 LICE KILLING SHA 0.33-4%
Clotrimazole Vaginal Cream 1%
Generic00472022041 CLOTRIMAZOLE CRE 1%
Generic00472022063 CLOTRIMAZOLE CRE 1%
Generic49348079376 CLOTRIMAZOLE CRE 1% VAG
Generic51672200306 CLOTRIMAZOLE CRE 1% VAG
Clotrimazole Vaginal Cream 2%
Generic24385011009 CLOTRIMAZOLE CRE 3 DAY
Generic49348037954 3 DAY VAGINL CRE 2%
Generic51672206200 3 DAY VAGINL CRE 2%
Miconazole Nitrate Vaginal Cream 2%
Generic00113021429 MICONAZOLE 7 CRE TUBE/KIT
Generic00113082529 MICONAZOLE 7 CRE 2%
Generic00472073041 MICONAZOLE CRE 2%
Generic00472073063 MICONAZOLE CRE 2%
Generic00713025237 MICONAZOLE CRE 2%
Page 37 of 38RT23200
NDC Product Description
Generic Drug Description
Brand /
Generic
DRUG CATEGORY
Labeler Name PA
Required
Miconazole Nitrate Vaginal Cream 2%
Generic00904773445 MICONAZOLE 7 CRE 2%
Generic24385059029 MICONAZOLE 7 CRE 2%
Generic36800082529 MICONAZOLE 7 CRE 2%
Generic49348053077 MICONAZOLE 7 CRE 2%
Generic49348087277 MICONAZOLE 7 CRE 2%
Generic51672203506 MICONAZOLE CRE 2%
Miconazole Nitrate Vaginal Cream 4% (200 MG/5GM)
Generic36800007009 MICONAZOLE 3 CRE 4%
Generic63868019725 3 DAY VAGNAL CRE 4%
Miconazole Nitrate Vaginal Supp 200 MG & 2% Cream 9 GM Kit
Generic00067209103 VAGISTAT-3 KIT COMBO PK
Generic00113008100 MICONAZOLE 3 KIT COMBO PK
Generic00904541501 MICONAZOLE 3 KIT COMBO PK
Generic24385060602 MICONAZOLE 3 KIT COMBO PK
Generic36800008100 MICONAZOLE 3 KIT COMBO PK
Generic49348035543 MICONAZOLE 3 KIT COMBO PK
Miconazole Nitrate Vaginal Suppos 100 MG
Generic00472173607 MICONAZOLE 7 SUP 100MG
Generic00713019757 MICONAZOLE SUP 100MG
Generic49348083361 SM MICON 7 SUP 100MG
Levonorgestrel Tab 1.5 MG
Generic43386062230 MY WAY TAB 1.5MG
Generic50102011101 ECONTRA EZ TAB 1.5MG
Generic50102011112 ECONTRA EZ TAB 1.5MG
Generic51285010088 TAKE ACTION TAB 1.5MG
Generic51285010388 AFTERA TAB 1.5MG
Brand51285014619 PLAN B TAB 1.5MG
Brand51285016288 PLAN B TAB 1.5MG
Generic52544006554 NEXT CHOICE TAB 1.5MG
Generic62756071860 OPCICON TAB 1.5MG
Generic68180085313 FALLBACK TAB 1.5MG
Niacin Cap CR 250 MG
Generic49483001401 NIACIN CAP 250MG SR
Generic49483001410 NIACIN CAP 250MG SR
Niacin Cap CR 500 MG
Generic49483001801 NIACIN CAP 500MG SR
Page 38 of 38RT23200
