WELL SENSE HEALTH PLAN DRUG LIST (Effective ) 12/12/2013/media/8b75065b9ad34abcbaae8df68549b… ·...

WELL SENSE HEALTH PLAN DRUG LIST (Effective )12/12/2013

Below is a list of prescription drugs covered by Well Sense Health Plan (Plan). Covered devices are listed on the OTC formulary (drug list) at wellsense.org. The list is subject to change. If a drug is not on the list, it may still be available. All newly approved drugs require prior approval from Well Sense before they can be covered, and members may be required to try the generic version of a drug before the brand drug will be covered. Excluded drugs are outlined in the Member Handbook.

Questions? Please contact Well Sense Health Plan at: 1-877-957-1300

Group Drug Name Brand/ Generic Tier PDL Status ST QL QL Amt/Day PA Specialty MO

ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants

ZENZEDI TAB 2.5MG Brand 2

ZENZEDI TAB 5MG generic 1 PREF QL 90/30 PA

DEXTROAMPHET TAB 5MG generic 1 PREF QL 90/30 PA

ZENZEDI TAB 7.5MG Brand 2

ZENZEDI TAB 10MG generic 1 PREF QL 180/30 PA

DEXTROAMPHET TAB 10MG generic 1 PREF QL 180/30 PA

PROCENTRA SOL 5MG/5ML generic 1

DEXTROAMPHET SOL 5MG/5ML generic 1

DEXTROAMPHET CAP 5MG ER generic 1 PREF QL 60/30 PA

DEXEDRINE CAP 5MG CR Brand 2 NON-PREF ST QL 60/30





VYVANSE CAP 20MG Brand 2 PREF QL 30/30 PA






METHAMPHETAM TAB 5MG generic 1 PREF PA

DESOXYN TAB 5MG Brand 2 NON-PREF ST

AMPHETAMINE TAB 5MG generic 1 PREF QL 90/30 PA

of 294KEY: GR=Generic Use required; PA=Prior Authorization required; ST=Step Therapy required; SP=Restricted to Orchard specialty pharmacy: 1-877-437-9012; MO= 90days supply allowed at Retail-90 pharmacies or Orchard Mail Order Pharmacy: 1-866-909-5170.


ADDERALL TAB 5MG Brand 2 NON-PREF ST QL 90/30

ADDERALL TAB 7.5MG Brand 2 NON-PREF ST QL 90/30

AMPHETAMINE TAB 7.5MG generic 1 PREF QL 90/30 PA



AMPHETAMINE TAB 12.5MG generic 1 PREF QL 90/30 PA

ADDERALL TAB 12.5MG Brand 2 NON-PREF ST QL 90/30







AMPHETAMINE CAP 5MG ER generic 1 NON-PREF ST QL 60/30

ADDERALL XR CAP 5MG Brand 2 PREF QL 60/30 PA











BENZPHETAMIN TAB 50MG generic 1 PA

DIDREX TAB 50MG Brand 2 GR

DIETHYLPROP TAB 25MG generic 1 PA

DIETHYLPROP TAB 75MG ER generic 1 PA

PHENDIMETRAZ TAB 35MG generic 1 PA

BONTRIL PDM TAB 35MG Brand 2 GR

PHENDIMETRAZ CAP 105MG ER generic 1 PA



PHENTERMINE CAP 15MG generic 1 PA

PHENTERMINE CAP 30MG generic 1 PA

PHENTERMINE CAP 37.5MG generic 1 PA

ADIPEX-P CAP 37.5MG Brand 2 GR

PHENTERMINE TAB 37.5MG generic 1 PA

ADIPEX-P TAB 37.5MG Brand 2 GR

XENICAL CAP 120MG Brand 2 PA

CAFFEINE CIT INJ 60MG/3ML generic 1

CAFCIT INJ 60MG/3ML Brand 2 GR

CAFFEINE CIT SOL 20MG/ML generic 1

CAFFEINE CIT SOL 60MG/3ML generic 1

CAFCIT SOL 60MG/3ML Brand 2 GR

CAFFEINE/SOD INJ BENZOATE Brand 2

DOXAPRAM HCL INJ 20MG/ML generic 1

DOPRAM INJ 20MG/ML Brand 2 GR

KAPVAY MIS 0.1&0.2 Brand 2

CLONIDINE TAB 0.1MG ER generic 1

KAPVAY TAB 0.1 MG Brand 2 GR

INTUNIV TAB 1MG Brand 2 NON-PREF ST QL 30/30




STRATTERA CAP 10MG Brand 2 NON-PREF ST QL 60/30







NUVIGIL TAB 50MG Brand 2 QL 60/30 PA





FOCALIN TAB 2.5MG Brand 2 NON-PREF ST QL 60/30

DEXMETHYLPH TAB 2.5MG generic 1 PREF QL 60/30 PA

DEXMETHYLPH TAB 5MG generic 1

FOCALIN TAB 5MG Brand 2 NON-PREF ST QL 60/30

DEXMETHYLPH TAB 10MG generic 1

FOCALIN TAB 10MG Brand 2

FOCALIN XR CAP 5MG Brand 2

FOCALIN XR CAP 10MG Brand 2 PREF QL 30/30 PA







DAYTRANA DIS 10MG/9HR Brand 2 NON-PREF ST QL 30/30




METADATE CD CAP 10MG Brand 2 NON-PREF ST QL 60/30

METHYLPHENID CAP 10MG generic 1 NON-PREF ST QL 60/30











RITALIN TAB 5MG Brand 2 NON-PREF ST QL 90/30

METHYLPHENID TAB 5MG generic 1 PREF QL 90/30 PA







METHYLPHENID TAB 10MG ER generic 1 PREF QL 60/30 PA

METADATE TAB 20MG ER generic 1 PREF QL 60/30 PA

RITALIN TAB 20MG SR Brand 2 NON-PREF ST QL 60/30

METHYLPHENID TAB 18MG ER generic 1 PREF QL 30/30

CONCERTA TAB 18MG Brand 2 GR







METHYLIN CHW 2.5MG generic 1 PREF QL 90/30 PA

METHYLIN CHW 5MG generic 1 PREF QL 90/30 PA

METHYLIN CHW 10MG generic 1 PREF QL 180/30 PA

QUILLIVANT SUS XR Brand 2 NON-PREF ST QL 240/30

METHYLIN SOL 5MG/5ML Brand 2 GR

METHYLIN SOL 10MG/5ML Brand 2 GR

RITALIN LA CAP 10MG Brand 2

METHYLPHENID CAP 20MG ER generic 1 NON-PREF ST QL 60/30

RITALIN LA CAP 20MG Brand 2 NON-PREF ST QL 30/30





MODAFINIL TAB 100MG generic 1 QL 30/30 PA

PROVIGIL TAB 100MG Brand 2 GR

MODAFINIL TAB 200MG generic 1 QL 30/30 PA

PROVIGIL TAB 200MG Brand 2 GR



Alternative Medicines

QUINZYME TAB 90MG Brand 2

Amebicides

YODOXIN TAB 210MG Brand 2

YODOXIN TAB 650MG Brand 2

Aminoglycosides

AMIKACIN INJ 500/2ML generic 1

AMIKACIN INJ 1GM/4ML generic 1

GENTAMICIN INJ 10MG/ML generic 1



GENTAM/NACL INJ 80MG PB generic 1

GENTAM/NACL INJ 80MG generic 1

GENTAM/NACL INJ 0.9MG/ML generic 1




GENTAM/NACL INJ 60MG PB generic 1

GENTAM/NACL INJ 1.4MG/ML generic 1


GENTAM/NACL INJ 100MG PB Brand 2

NEOMYCIN TAB 500MG generic 1

NEO-FRADIN SOL 125/5ML Brand 2

PAROMOMYCIN CAP 250MG generic 1

STREPTOMYCIN INJ 1GM generic 1

TOBI PODHALR CAP 28MG Brand 2

TOBI NEB 300/5ML Brand 2

BETHKIS NEB 300/4ML Brand 2 PA

TOBRAMYCIN INJ 10MG/ML generic 1

TOBRAMYCIN INJ 80MG/2ML generic 1




TOBRAMYCIN INJ 1.2/30ML generic 1



TOBRAMYCIN INJ 1.2GM generic 1

TOBRA/NACL INJ 80/0.9 generic 1

TOBRA/NACL INJ 60/0.9 generic 1

Analgesics – Anti-inflammatory

ZORVOLEX CAP 18MG Brand 2

ZORVOLEX CAP 35MG Brand 2

ZIPSOR CAP 25MG Brand 2 QL 120/30 PA

CATAFLAM TAB 50MG Brand 2 GR

DICLOFEN POT TAB 50MG generic 1

DICLOFENAC TAB 25MG DR generic 1



DICLOFENAC TAB 100MG ER generic 1

DICLOFENAC TAB 100MG XR generic 1

VOLTAREN-XR TAB 100MG Brand 2 GR

ETODOLAC CAP 200MG generic 1

ETODOLAC CAP 300MG generic 1

ETODOLAC TAB 400MG generic 1

ETODOLAC TAB 500MG generic 1

ETODOLAC ER TAB 400MG generic 1



NALFON CAP 400MG Brand 2

FENOPROFEN TAB 600MG generic 1

FLURBIPROFEN TAB 50MG generic 1

FLURBIPROFEN TAB 100MG generic 1

IBUPROFEN TAB 400MG generic 1





IBUPROFEN SUS 100/5ML generic 1

CALDOLOR INJ 400/4ML Brand 2

CALDOLOR INJ 800/8ML Brand 2

NEOPROFEN SOL 10MG/ML Brand 2

INDOMETHACIN CAP 25MG generic 1

INDOMETHACIN CAP 50MG generic 1

INDOMETHACIN CAP 75MG ER generic 1

INDOCIN SUS 25MG/5ML Brand 2

INDOCIN SUP 50MG Brand 2

INDOMETHACIN INJ 1MG generic 1

INDOCIN IV INJ 1MG Brand 2 GR

KETOPROFEN CAP 50MG generic 1

KETOPROFEN CAP 75MG generic 1

KETOPROFEN CAP 200MG ER generic 1

KETOROLAC TAB 10MG generic 1

KETOROLAC INJ 15MG/ML generic 1


KETOROLAC INJ 60MG/2ML generic 1

KETOROLAC INJ 30MG/ML Brand 2


KETOROLAC INJ 60MG/2ML generic 1

SPRIX SPR 15.75MG Brand 2 QL 5/90 PA

MECLOFEN SOD CAP 50MG generic 1

MECLOFEN SOD CAP 100MG generic 1

PONSTEL CAP 250MG Brand 2 GR

MEFENAM ACID CAP 250MG generic 1 PA MO

MOBIC TAB 7.5MG Brand 2 NON-PREF ST MO

MELOXICAM TAB 7.5MG generic 1 PREF MO

MOBIC TAB 15MG Brand 2 NON-PREF ST MO

MELOXICAM TAB 15MG generic 1 PREF MO

MELOXICAM SUS 7.5/5ML generic 1 PREF MO



MOBIC SUS 7.5/5ML Brand 2

NABUMETONE TAB 500MG generic 1

NABUMETONE TAB 750MG generic 1

NAPROXEN TAB 250MG generic 1

NAPROSYN TAB 250MG Brand 2 GR





EC-NAPROSYN TAB 375MG Brand 2 GR

NAPROXEN DR TAB 375MG generic 1

NAPROXEN DR TAB 500MG generic 1

EC-NAPROSYN TAB 500MG Brand 2 GR

NAPROXEN SUS 125/5ML generic 1

NAPROSYN SUS 125/5ML Brand 2 GR

NAPROXEN SOD TAB 275MG generic 1

ANAPROX TAB 275MG Brand 2 GR

NAPROXEN SOD TAB 550MG generic 1

ANAPROX DS TAB 550MG Brand 2 GR

NAPRELAN TAB 375MG CR Brand 2



DAYPRO TAB 600MG Brand 2 GR

OXAPROZIN TAB 600MG generic 1

PIROXICAM CAP 10MG generic 1

FELDENE CAP 10MG Brand 2 GR

PIROXICAM CAP 20MG generic 1

FELDENE CAP 20MG Brand 2 GR

SULINDAC TAB 150MG generic 1

SULINDAC TAB 200MG generic 1

CLINORIL TAB 200MG Brand 2 GR

TOLMETIN SOD CAP 400MG generic 1



TOLMETIN SOD TAB 200MG generic 1

TOLMETIN SOD TAB 600MG generic 1

CELEBREX CAP 50MG Brand 2 PREF QL 60/30 PA MO




ARTHROTEC 50 TAB Brand 2 GR

DICLO/MISOPR TAB 50-0.2MG generic 1

DICLO/MISOPR TAB 75-0.2MG generic 1

ARTHROTEC 75 TAB Brand 2 GR

DUEXIS TAB 800-26.6 Brand 2

VIMOVO TAB 375-20MG Brand 2 NON-PREF ST QL 60/30 MO

VIMOVO TAB 500-20MG Brand 2 NON-PREF ST QL 60/30 MO

RIDAURA CAP 3MG Brand 2

RHEUMATREX TAB 2.5MG Brand 2

KINERET INJ Brand 2 NON-PREF ST QL 20.1/30 PA SP

HUMIRA KIT 20MG/0.4 Brand 2 PREF QL 2/28 PA SP

HUMIRA PEN KIT 40MG/0.8 Brand 2 PREF QL 2/28 PA SP

SIMPONI ARIA SOL 50MG/4ML Brand 2 PA

SIMPONI INJ 50MG Brand 2 NON-PREF ST QL 0.5/30 PA SP

SIMPONI INJ 100MG/ML Brand 2

ARAVA TAB 10MG Brand 2 GR

LEFLUNOMIDE TAB 10MG generic 1

LEFLUNOMIDE TAB 20MG generic 1

ARAVA TAB 20MG Brand 2 GR

ENBREL INJ 50MG/ML Brand 2 PREF QL 4/28 PA SP

ENBREL SRCLK INJ 50MG/ML Brand 2 PREF QL 4/28 PA SP

ENBREL INJ 25/0.5ML Brand 2 PREF QL 4/28 PA SP

ENBREL INJ 25MG Brand 2 PREF QL 1/28 PA SP

ORENCIA INJ 125MG/ML Brand 2 NON-PREF ST QL 4/28 PA SP

ORENCIA INJ 250MG Brand 2 NON-PREF ST PA SP

ARCALYST INJ 220MG Brand 2 QL / PA SP



ILARIS INJ 180MG Brand 2 QL 1/56 PA SP

ACTEMRA INJ 80MG/4ML Brand 2 NON-PREF ST PA SP

ACTEMRA INJ 200/10ML Brand 2 NON-PREF ST PA SP

ACTEMRA INJ 400/20ML Brand 2 NON-PREF ST PA SP

ACTEMRA INJ 162/0.9 Brand 2

XELJANZ TAB 5MG Brand 2 NON-PREF ST QL 60/30 PA SP

THERAPROFEN PAK -90 Brand 2

THERAPROFEN PAK -60 Brand 2

TREPOXICAM PAK 7.5MG Brand 2

TREPOXEN PAK 250MG Brand 2

THERAPROXEN PAK -60 Brand 2

THERAPROXEN PAK -90 Brand 2

THERAFELDAMI PAK Brand 2

Analgesics – Nonnarcotic

DIFLUNISAL TAB 500MG generic 1

MST 600 TAB Brand 2

SALSALATE TAB 500MG generic 1

SALSALATE TAB 750MG generic 1

CHO MAG TRIS TAB 500MG generic 1

CHO MAG TRIS TAB 1000MG generic 1

CHO MAG TRIS LIQ 500/5ML generic 1

PRIALT INJ 25MCG/ML Brand 2

PRIALT INJ 100MCG Brand 2

PRIALT INJ 500MCG Brand 2

OFIRMEV INJ 10MG/ML Brand 2

CLONIDINE INJ generic 1

DURACLON INJ Brand 2 GR

CLONIDINE INJ generic 1

DURACLON INJ Brand 2 GR

DURAXIN CAP generic 1

ED-FLEX CAP generic 1



LEVACET TAB Brand 2

PHRENILIN CAP FORTE Brand 2

BUPAP TAB 50-300MG Brand 2

MARTEN-TAB TAB 50-325MG generic 1

BUTAL/APAP TAB 50-325MG generic 1

TENCON TAB 50-650MG Brand 2

EQUAGESIC TAB 200-325 Brand 2

BIOGESIC TAB 30-500MG generic 1

DOLOGESIC TAB 30-500MG generic 1

DOLOREX TAB 50-500MG generic 1

ALI-FLEX TAB 50-500MG generic 1

BIOREGESIC TAB 50-650MG Brand 2

RELAGESIC TAB 50-650MG Brand 2

RHINOFLEX TAB 50-650MG generic 1

ALPAIN TAB Brand 2

ZFLEX TAB generic 1

STAFLEX TAB 55-500MG Brand 2 GR

ZGESIC TAB 66-600MG Brand 2

DOLOGESIC LIQ 30-500MG Brand 2

BUT/APAP/CAF CAP generic 1

FIORICET CAP Brand 2 GR

CAPACET CAP generic 1

MARGESIC CAP generic 1

BUT/APAP/CAF CAP generic 1

ESGIC CAP Brand 2 GR

ZEBUTAL CAP generic 1

ESGIC-PLUS CAP Brand 2 GR

REPAN TAB generic 1

BUT/APAP/CAF TAB generic 1

ESGIC TAB Brand 2 GR

BUT/APAP/CAF TAB generic 1

ESGIC-PLUS TAB Brand 2 GR



DOLGIC PLUS TAB Brand 2

ALAGESIC LQ SOL Brand 2

BUT/ASA/CAFF CAP generic 1

FIORINAL CAP Brand 2 GR

BUT/ASA/CAFF TAB generic 1

Analgesics – Opioids

ALFENTANIL INJ 500/ML generic 1

ALFENTA INJ 500/ML Brand 2 GR

CODEINE PHOS INJ 30MG/2ML Brand 2

CODEINE PHOS INJ 60MG/2ML Brand 2

CODEINE SULF TAB 15MG Brand 2

CODEINE SULF TAB 30MG generic 1

CODEINE SULF TAB 60MG Brand 2

CODEINE SULF SOL 30MG/5ML Brand 2

SUBSYS SPR 100MCG Brand 2 QL 120/30 PA







FENTANYL DIS 12MCG/HR generic 1 PREF QL 20/30

DURAGESIC DIS 12MCG/HR Brand 2 NON-PREF ST QL 20/30







FENTANYL DIS 100MCG/H generic 1 PREF QL 20/30

DURAGESIC DIS 100MCG/H Brand 2 NON-PREF ST QL 20/30



FENTORA TAB 100MCG Brand 2 QL 28/30 PA





ABSTRAL SUB 100MCG Brand 2 QL 120/30 PA






FENTANYL CIT INJ 0.05MG/1 generic 1

SUBLIMAZE INJ 0.05MG/1 Brand 2 GR

FENTANYL CIT INJ 2500MCG generic 1




LAZANDA SPR 100MCG Brand 2 QL 35/28 PA

LAZANDA SPR 400MCG Brand 2 QL 35/28 PA

ONSOLIS MIS 200MCG Brand 2 QL 120/30 PA SP





FENTANYL OT LOZ 200MCG generic 1 QL 15/30 PA


ACTIQ LOZ 400MCG Brand 2 GR











HYDROMORPHON TAB 2MG generic 1

DILAUDID TAB 2MG Brand 2 GR





DILAUDID-5 LIQ 1MG/ML Brand 2 GR

HYDROMORPHON LIQ 1MG/ML generic 1

HYDROMORPHON INJ 1MG/ML generic 1

DILAUDID INJ 1MG/ML Brand 2 GR







DILAUDID-HP INJ 10MG/ML Brand 2 GR

HYDROMORPHON INJ 500/50ML generic 1

HYDROMORPHON INJ 50MG/5ML generic 1

DILAUDID-HP INJ 250MG Brand 2

HYDROMORPHON SUP 3MG Brand 2

EXALGO TAB 8MG Brand 2 NON-PREF ST QL 30/30




LEVORPHANOL TAB 2MG Brand 2

MEPERIDINE TAB 50MG generic 1

MEPERITAB TAB 50MG generic 1

DEMEROL TAB 50MG Brand 2 GR



MEPERIDINE TAB 100MG generic 1

MEPERITAB TAB 100MG generic 1

DEMEROL TAB 100MG Brand 2 GR

MEPERIDINE INJ 10MG/ML generic 1

DEMEROL INJ 25MG/ML Brand 2 GR


DEMEROL INJ 25MG/0.5 Brand 2



DEMEROL INJ 75MG/1.5 Brand 2

DEMEROL INJ 100/2ML Brand 2

DEMEROL INJ 75MG/ML Brand 2



MEPERIDINE SOL 50MG/5ML generic 1

DOLOPHINE TAB 5MG Brand 2 GR

METHADONE TAB 5MG generic 1


METHADOSE TAB 10MG generic 1

DOLOPHINE TAB 10MG Brand 2 GR

METHADOSE CON 10MG/ML generic 1

METHADOSE SF CON 10MG/ML generic 1

METHADONE CON 10MG/ML generic 1

METHADONE INJ 10MG/ML Brand 2

METHADONE SOL 5MG/5ML generic 1

METHADONE SOL 10MG/5ML generic 1


METHADOSE TAB 40MG generic 1

MORPHINE SUL TAB 15MG generic 1

MORPHINE SUL TAB 30MG generic 1

MORPHINE SUL TAB 15MG ER generic 1 PREF

MS CONTIN TAB 15MG CR Brand 2 NON-PREF ST











MORPHINE SUL INJ 1MG/ML generic 1



MORPHINE SUL INJ 5MG/ML Brand 2

MORPHINE SUL INJ 150/30ML Brand 2






ASTRAMORPH INJ 1MG/2ML generic 1

DURAMORPH INJ 0.5MG/ML generic 1

MORPHINE SUL INJ 0.5MG/ML generic 1


ASTRAMORPH INJ 10/10ML generic 1

ASTRAMORPH INJ 2MG/2ML generic 1

DURAMORPH INJ 1MG/ML generic 1






MORPHINE SUL SOL 10MG/5ML generic 1

MORPHINE SUL SOL 20MG/5ML generic 1



MORPHINE SUL SOL 20MG/ML generic 1

MORPHINE SUL SOL 100/5ML generic 1

MORPHINE SUL SUP 5MG Brand 2



MORPHINE SUL SUP 30MG generic 1

MORPHINE SUL INJ 10/0.7ML Brand 2

MORPHINE SUL CAP 10MG ER generic 1

KADIAN CAP 10MG CR Brand 2 GR

MORPHINE SUL CAP 20MG ER generic 1 NON-PREF ST QL 120/30

KADIAN CAP 20MG CR Brand 2 PREF QL 120/30
















AVINZA CAP 30MG Brand 2 NON-PREF ST QL 30/30








INFUMORPH INJ 10MG/ML Brand 2

INFUMORPH INJ 25MG/ML Brand 2

DEPODUR INJ 10MG/ML Brand 2

DEPODUR INJ 15/1.5ML Brand 2

OXYCODONE CAP 5MG generic 1

OXYCODONE TAB 5MG generic 1

ROXICODONE TAB 5MG Brand 2 GR







OXYCODONE CON 100/5ML generic 1

OXYCODONE CON 20MG/ML generic 1

OXYCODONE SOL 5MG/5ML generic 1

OXECTA TAB 5MG Brand 2 PA

OXECTA TAB 7.5MG Brand 2 PA

OXYCONTIN TAB 10MG CR Brand 2 NON-PREF ST QL 90/30 PA







OXYMORPHONE TAB HCL 5MG generic 1 PA

OPANA TAB 5MG Brand 2 GR

OXYMORPHONE TAB HCL 10MG generic 1 PA

OPANA TAB 10MG Brand 2 GR

OPANA INJ 1MG/ML Brand 2

OXYMORPHONE TAB 5MG ER generic 1 NON-PREF ST QL 90/30

OXYMORPHONE TAB 7.5MG ER generic 1 NON-PREF ST QL 90/30








OPANA ER TAB 5MG Brand 2 NON-PREF ST QL 90/30

OPANA ER TAB 7.5MG Brand 2 NON-PREF ST QL 90/30






ULTIVA INJ 1MG Brand 2



SUFENTA INJ 50MCG/ML Brand 2 GR

SUFENTANIL INJ 50MCG/ML generic 1

SUFENTANIL INJ 100/2ML generic 1


SUFENTANIL INJ 250/5ML generic 1


NUCYNTA TAB 50MG Brand 2 NON-PREF ST QL 180/30



NUCYNTA ER TAB 50MG Brand 2 NON-PREF ST QL 60/30





ULTRAM TAB 50MG Brand 2 NON-PREF ST

TRAMADOL HCL TAB 50MG generic 1 PREF

CONZIP CAP 100MG Brand 2 NON-PREF ST QL 30/30



TRAMADOL HCL CAP 150MG ER Brand 2



TRAMADOL HCL TAB 100MG ER generic 1 NON-PREF ST QL 30/30

ULTRAM ER TAB 100MG Brand 2 NON-PREF ST QL 30/30





TRAMADOL HCL TAB 100MG ER generic 1



BUTRANS DIS 5MCG/HR Brand 2 NON-PREF ST QL 4/28


BUTRANS DIS 15MCG/HR Brand 2


BUPRENORPHIN SUB 2MG generic 1 QL 90/30 PA

BUPRENORPHIN SUB 8MG generic 1 QL 90/30 PA

BUPRENORPHIN INJ 0.3MG/ML generic 1

BUPRENEX INJ 0.3MG/ML Brand 2 GR

ZUBSOLV SUB 1.4-0.36 Brand 2 QL 60/30 PA

BUPREN/NALOX SUB 2-0.5MG generic 1

ZUBSOLV SUB 5.7-1.4 Brand 2 QL 60/30 PA

BUPREN/NALOX SUB 8-2MG generic 1

SUBOXONE MIS 2-0.5MG Brand 2 QL 90/30 PA

SUBOXONE MIS 4-1MG Brand 2 QL 90/30 PA



BUTORPHANOL INJ 1MG/ML generic 1

BUTORPHANOL INJ 2MG/ML generic 1

BUTORPHANOL SOL 10MG/ML generic 1 QL 5/30

NALBUPHINE INJ 10MG/ML generic 1



NALBUPHINE INJ 20MG/ML generic 1

TALWIN INJ 30MG/ML Brand 2

PENTAZ/NALOX TAB 50-0.5MG generic 1

OXYCOD/APAP CAP 5-500MG generic 1 QL 240/30

OXYCOD/APAP TAB 2.5-325 generic 1 QL 360/30

PERCOCET TAB 2.5-325 Brand 2 GR

PRIMLEV TAB 5-300MG Brand 2 QL 390/30

ENDOCET TAB 5-325MG generic 1 QL 360/30

ROXICET TAB 5-325MG generic 1 QL 360/30

PERCOCET TAB 5-325MG Brand 2 GR

OXYCOD/APAP TAB 5-325MG generic 1 QL 360/30

MAGNACET TAB 5-400MG Brand 2 QL 300/30

PRIMLEV TAB 7.5-300 Brand 2 QL 390/30


ENDOCET TAB 7.5-325 generic 1 QL 360/30


MAGNACET TAB 7.5-400 Brand 2 QL 300/30

ENDOCET TAB 7.5-500M generic 1 QL 240/30



PRIMLEV TAB 10-300MG Brand 2 QL 390/30




MAGNACET TAB 10-400MG Brand 2 QL 300/30

XOLOX TAB 10-500MG Brand 2 QL 240/30




ROXICET SOL 5-325/5 generic 1

PERCODAN TAB Brand 2 GR

ENDODAN TAB generic 1 QL 360/30



OXYCOD/ASA TAB generic 1 QL 360/30

OXYCOD/IBU TAB 5-400MG generic 1 QL 240/30

APAP/CODEINE TAB 300-15MG generic 1

TYLENOL/COD TAB #3 Brand 2 GR



TYLENOL/COD TAB #4 Brand 2 GR

CAPITAL/COD SUS 120-12/5 Brand 2

APAP/CODEINE SOL 120-12/5 generic 1

BUT/APAP/CAF CAP CODEINE generic 1

FIORICET CAP CODEINE Brand 2 GR

BUT/APAP/CAF CAP CODEINE generic 1

BUT/ASA/CAF/ CAP COD 30MG generic 1

ASCOMP/COD CAP 30MG generic 1

FIORINAL/COD CAP 30MG Brand 2 GR

TREZIX CAP Brand 2

APAP/CAFF/DI TAB HYDROCOD generic 1

DIHYDROCOD/ CAP ASA/CAFF generic 1

SYNALGOS-DC CAP Brand 2 GR

HYDROGESIC CAP 5-500MG generic 1

STAGESIC CAP 5-500MG generic 1

HYDROCO/APAP TAB 2.5-325 generic 1

NORCO TAB 10-325MG Brand 2 GR

HYDROCO/APAP TAB 10-325MG generic 1


XODOL TAB 5-300MG Brand 2 GR


VICODIN TAB 5-300MG generic 1


LORTAB TAB 5-500MG Brand 2 GR

XODOL TAB 7.5-300 Brand 2 GR

VICODIN ES TAB 7.5-300 generic 1





LORTAB TAB 7.5-500 Brand 2 GR


LORTAB TAB 10-500MG Brand 2 GR


LORCET PLUS TAB 7.5-650 Brand 2 GR


LORCET TAB 10-650MG Brand 2 GR




MAXIDONE TAB 10-750MG Brand 2 GR

NORCO TAB 5-325MG Brand 2 GR



NORCO TAB 7.5-325 Brand 2 GR

ZYDONE TAB 5-400MG Brand 2

ZYDONE TAB 7.5-400 Brand 2

ZYDONE TAB 10-400MG Brand 2


XODOL TAB 10-300MG Brand 2 GR

VICODIN HP TAB 10-300MG generic 1

HYDROCO/APAP SOL 5-217/10 generic 1

HYDROCO/APAP SOL generic 1

HYCET SOL 7.5-325 Brand 2 GR

HYDROCO/APAP SOL 7.5-325 generic 1

HYDROCO/APAP SOL 7.5-500 generic 1

LORTAB ELX 10-300MG generic 1

ZAMICET SOL 10-325MG Brand 2

LIQUICET SOL 10-500MG Brand 2

HYDROCOD/IBU TAB 2.5-200 generic 1



REPREXAIN TAB 2.5-200 Brand 2 GR

REPREXAIN TAB 5-200MG Brand 2 GR

IBUDONE TAB 5-200MG generic 1

HYDROCOD/IBU TAB 5-200MG generic 1

HYDROCOD/IBU TAB 7.5-200 generic 1

VICOPROFEN TAB 7.5-200 Brand 2 GR

HYDROCOD/IBU TAB 10-200MG generic 1

REPREXAIN TAB 10-200MG generic 1

IBUDONE TAB 10-200MG Brand 2 GR

PENTA/APAP TAB 25-650MG generic 1

TRAMADL/APAP TAB 37.5-325 generic 1 PREF

ULTRACET TAB 37.5-325 Brand 2 NON-PREF ST

Androgen-Anabolic

DANAZOL CAP 50MG generic 1



ANDROXY TAB 10MG Brand 2

TESTRED CAP 10MG Brand 2

ANDROID CAP 10MG Brand 2

METHITEST TAB 10MG Brand 2

AXIRON SOL 30MG/ACT Brand 2 NON-PREF ST

ANDROGEL GEL 1%(25MG) Brand 2 PREF

ANDROGEL GEL 1%(50MG) Brand 2 PREF

ANDROGEL GEL PUMP 1% Brand 2 PREF

ANDROGEL GEL 1.62% Brand 2

ANDROGEL GEL 1.62% Brand 2

ANDROGEL GEL 1.62% Brand 2 PREF

FORTESTA GEL 10MG/ACT Brand 2 NON-PREF ST

STRIANT MIS 30MG Brand 2

ANDRODERM DIS 2MG/24HR Brand 2 PREF

ANDRODERM DIS 4MG/24HR Brand 2 PREF



TESTOPEL MIS PELLETS Brand 2

TESTOST CYP INJ 100MG/ML generic 1

DEPO-TESTOST INJ 100MG/ML Brand 2 GR

DEPO-TESTOST INJ 200MG/ML Brand 2 GR

TESTOST CYP INJ 200MG/ML generic 1

DELATESTRYL INJ 200MG/ML Brand 2 GR

TESTOST ENAN INJ 200MG/ML generic 1

FIRST-TESTOS CRE MC 2% Brand 2

FIRST-TESTOS OIN 2% Brand 2

OXANDRIN TAB 2.5MG Brand 2 GR

OXANDROLONE TAB 2.5MG generic 1 PA

OXANDROLONE TAB 10MG generic 1 PA

OXANDRIN TAB 10MG Brand 2 GR

ANADROL-50 TAB 50MG Brand 2 PA

Anorectal Agents

PROCTOCORT CRE 1% Brand 2 GR

PROCTO-PAK CRE 1% generic 1

PROCTOSOL HC CRE 2.5% generic 1

PROCTOZONE CRE -HC 2.5% generic 1

ANUSOL-HC CRE 2.5% Brand 2 GR

HYDROCORT ENE 100MG generic 1

COLOCORT ENE 100MG generic 1

CORTENEMA ENE 100MG Brand 2 GR

CORTIFOAM AER 90MG Brand 2

RECTIV OIN 0.4% Brand 2 QL 30/30 PA

LIDOCAINE/HC CRE 3%-0.5% generic 1

LIDAZONE CRE generic 1

LIDO-HYDRO GEL 2.8-0.55 Brand 2

LIDOCAINE/HC KIT 2-2% Brand 2

LIDOCAINE/HC KIT 3%-0.5% generic 1

LIDOCAINE/HC KIT 3%-1% generic 1



LIDOCAINE/HC KIT 3-2.5% generic 1

PROCTOFOAM AER HC 1% Brand 2

ANALPRAM-HC LOT 2.5% Brand 2

ANALPRAM KIT ADVANCED Brand 2

Anthelmintics

ALBENZA TAB 200MG Brand 2

STROMECTOL TAB 3MG Brand 2

BILTRICIDE TAB 600MG Brand 2

Antianginal Agents

DILATRATE SR CAP 40MG Brand 2

ISOSORB DIN TAB 5MG generic 1

ISORDIL TAB 5MG Brand 2 GR




ISORDIL TAB 40MG Brand 2

ISODITRATE TAB 40MG ER generic 1

ISOSORB DIN TAB 40MG ER generic 1

ISOSORB DIN SUB 2.5MG generic 1

ISOSORB MONO TAB 10MG generic 1

ISOSORB MONO TAB 20MG generic 1

ISOSORB MONO TAB 30MG ER generic 1

IMDUR TAB 30MG ER Brand 2 GR





NITROSTAT SUB 0.3MG Brand 2



NITROGLYCER INJ 5MG/ML generic 1



NITROGLYCRN SPR 0.4MG generic 1

NITROGLYCRN SPR LINGUAL generic 1

NITROLINGUAL SPR PUMPSPRA Brand 2 GR

NITROMIST AER 400MCG Brand 2

NITROGLYCER AER 400MCG Brand 2

NITRO-BID OIN 2% Brand 2

NITRO-DUR DIS 0.1MG/HR Brand 2 GR

MINITRAN DIS 0.1MG/HR generic 1

NITROGLYCER DIS 0.1MG/HR generic 1




NITRO-DUR DIS 0.3MG/HR Brand 2






NITROGLYCERI DIS 0.6MG/HR generic 1


NITRO-DUR DIS 0.8MG/HR Brand 2

RANEXA TAB 500MG Brand 2 PA MO

RANEXA TAB 1000MG Brand 2 PA MO

Antianxiety Agents

ALPRAZOLAM TAB 0.25MG generic 1 PREF

XANAX TAB 0.25MG Brand 2 NON-PREF ST

ALPRAZOLAM TAB 0.5MG generic 1 PREF

XANAX TAB 0.5MG Brand 2 NON-PREF ST

ALPRAZOLAM TAB 1MG generic 1 PREF

XANAX TAB 1MG Brand 2 NON-PREF ST

XANAX TAB 2MG Brand 2 NON-PREF ST



ALPRAZOLAM TAB 2MG generic 1 PREF

ALPRAZOLAM CON 1 MG/ML Brand 2 PREF

NIRAVAM TAB 0.25MG Brand 2 NON-PREF ST

ALPRAZOLAM TAB 0.25 ODT generic 1 PREF

ALPRAZOLAM TAB 0.5MG OD generic 1 PREF

NIRAVAM TAB 0.5MG Brand 2 NON-PREF ST

ALPRAZOLAM TAB 1MG ODT generic 1 PREF

NIRAVAM TAB 1MG Brand 2 NON-PREF ST

NIRAVAM TAB 2MG Brand 2 NON-PREF ST

ALPRAZOLAM TAB 2MG ODT generic 1 PREF

XANAX XR TAB 0.5MG Brand 2 NON-PREF ST

ALPRAZOLAM TAB 0.5MG ER generic 1 NON-PREF ST

ALPRAZOLAM TAB 0.5MG XR generic 1 NON-PREF ST

ALPRAZOLAM TAB 1MG ER generic 1 NON-PREF ST

ALPRAZOLAM TAB 1MG XR generic 1 NON-PREF ST

XANAX XR TAB 1MG Brand 2 NON-PREF ST







CHLORDIAZEP CAP 5MG generic 1 PREF



CLORAZ DIPOT TAB 3.75MG generic 1 PREF

TRANXENE T TAB 3.75MG Brand 2 NON-PREF ST

CLORAZ DIPOT TAB 7.5MG generic 1 PREF

TRANXENE T TAB 7.5MG Brand 2 NON-PREF ST

CLORAZ DIPOT TAB 15MG generic 1 PREF

TRANXENE T TAB 15MG Brand 2 NON-PREF ST

DIAZEPAM TAB 2MG generic 1 PREF



VALIUM TAB 2MG Brand 2 GR





DIAZEPAM CON 5MG/ML Brand 2 PREF

DIAZEPAM SOL 1MG/ML Brand 2 PREF

DIAZEPAM INJ 5MG/ML generic 1

DIAZEPAM INJ 10MG/2ML Brand 2

LORAZEPAM TAB 0.5MG generic 1 PREF

ATIVAN TAB 0.5MG Brand 2 NON-PREF ST

ATIVAN TAB 1MG Brand 2 NON-PREF ST

LORAZEPAM TAB 1MG generic 1 PREF

LORAZEPAM TAB 2MG generic 1 PREF

ATIVAN TAB 2MG Brand 2 NON-PREF ST

LORAZEPAM CON 2MG/ML generic 1 PREF

LORAZEPAM INJ 2MG/ML generic 1

ATIVAN INJ 2MG/ML Brand 2 GR

LORAZEPAM INJ 4MG/ML generic 1

ATIVAN INJ 4MG/ML Brand 2 GR

OXAZEPAM CAP 10MG generic 1 PREF



BUSPIRONE TAB 5MG generic 1 PREF

BUSPIRONE TAB 7.5MG generic 1 PREF




DROPERIDOL INJ 2.5MG/ML generic 1

HYDROXYZ HCL TAB 10MG generic 1





HYDROXYZ HCL SYP 10MG/5ML generic 1

HYDROXYZ HCL SOL 10MG/5ML generic 1

HYDROXYZ HCL INJ 25MG/ML generic 1

HYDROXYZ HCL INJ 50MG/ML generic 1

VISTARIL CAP 25MG Brand 2 GR

HYDROXYZ PAM CAP 25MG generic 1

VISTARIL CAP 50MG Brand 2 GR



MEPROBAMATE TAB 200MG generic 1

MEPROBAMATE TAB 400MG generic 1

Antiarrhythmics

DISOPYRAMIDE CAP 100MG generic 1

NORPACE CAP 100MG Brand 2 GR

NORPACE CAP 150MG Brand 2 GR

DISOPYRAMIDE CAP 150MG generic 1

NORPACE CAP 100MG CR Brand 2

NORPACE CAP 150MG CR Brand 2

PROCAINAMIDE INJ 100MG/ML generic 1

PROCAINAMIDE INJ 500MG/ML generic 1

QUINIDINE GL TAB 324MG CR generic 1

QUINIDINE GL TAB 324MG ER generic 1

QUINIDINE GL INJ 80MG/ML Brand 2

QUINIDINE SU TAB 200MG generic 1

QUINIDINE SU TAB 300MG generic 1

QUINIDINE SU TAB 300MG ER generic 1

LIDOCAINE INJ 10MG/ML generic 1

LIDOCAINE INJ 20MG/ML generic 1

XYLOCAINE INJ 2% Brand 2 GR

MEXILETINE CAP 150MG generic 1





FLECAINIDE TAB 50MG generic 1



PROPAFENONE TAB 150MG generic 1

RYTHMOL TAB 150MG Brand 2 GR


RYTHMOL TAB 225MG Brand 2 GR


RYTHMOL SR CAP 225MG Brand 2 GR

PROPAFENONE CAP 225MG ER generic 1

PROPAFENONE CAP 325MG ER generic 1


PROPAFENONE CAP 425MG SR generic 1


AMIODARONE TAB 100MG generic 1

PACERONE TAB 100MG generic 1



CORDARONE TAB 200MG Brand 2 GR



AMIODARONE INJ 150MG/3M generic 1

AMIODARONE INJ 50MG/ML generic 1



NEXTERONE INJ Brand 2

NEXTERONE INJ Brand 2

TIKOSYN CAP 125MCG Brand 2



MULTAQ TAB 400MG Brand 2



IBUTILIDE INJ 1MG/10ML generic 1

CORVERT INJ 1MG/10ML Brand 2 GR

ADENOCARD INJ 6MG/2ML Brand 2 GR

ADENOSINE INJ 6MG/2ML generic 1

ADENOSINE INJ 3MG/ML generic 1

ADENOCARD INJ 3MG/ML Brand 2 GR

ADENOCARD INJ 12MG/4ML Brand 2 GR

ADENOSINE INJ 12MG/4ML generic 1

Antiasthmatic and Bronchodilator Agents

TUDORZA PRES AER 400/ACT Brand 2 QL 1/30 MO

IPRATROPIUM SOL 0.02%INH generic 1

ATROVENT HFA AER 17MCG Brand 2 QL 25.8/30 MO

SPIRIVA CAP HANDIHLR Brand 2 QL 30/30 MO

CROMOLYN SOD NEB 20MG/2ML generic 1

ALBUTEROL TAB 2MG generic 1

ALBUTEROL TAB 4MG generic 1

ALBUTEROL SYP 2MG/5ML generic 1

ALBUTEROL NEB 0.083% generic 1 PREF QL 360/30 MO

ALBUTEROL NEB 0.5% generic 1 PREF QL 120/30 MO

ALBUTEROL NEB 0.63MG/3 generic 1 PREF QL 360/30 MO

ACCUNEB NEB 0.63MG/3 Brand 2 NON-PREF ST QL 360/30 MO

ALBUTEROL NEB 1.25MG/3 generic 1 PREF QL 360/30 MO

ACCUNEB NEB 1.25MG/3 Brand 2 NON-PREF ST QL 360/30 MO

VOSPIRE ER TAB 4MG Brand 2 GR

ALBUTEROL TAB 4MG ER generic 1

ALBUTEROL TAB 8MG ER generic 1

VOSPIRE ER TAB 8MG Brand 2 GR

BROVANA NEB 15MCG Brand 2 NON-PREF ST MO

FORADIL CAP AEROLIZE Brand 2 PREF QL 60/30 MO

PERFOROMIST NEB 20MCG Brand 2 NON-PREF ST MO

ISUPREL INJ 0.2MG/ML Brand 2



ARCAPTA CAP 75MCG Brand 2 NON-PREF ST QL 30/30 MO

LEVALBUTEROL NEB 0.31MG generic 1

XOPENEX NEB 0.31MG Brand 2 NON-PREF ST QL 288/30 MO

XOPENEX NEB 0.63MG Brand 2 NON-PREF ST QL 288/30 MO


XOPENEX NEB 1.25/3ML Brand 2 NON-PREF ST QL 288/30 MO


XOPENEX CONC NEB 1.25/0.5 Brand 2 NON-PREF ST QL 288/30 MO

LEVALBUTEROL NEB 1.25/0.5 generic 1 NON-PREF ST QL 288/30 MO

XOPENEX HFA AER Brand 2 NON-PREF ST QL 30/30 MO

METAPROTEREN TAB 10MG generic 1

METAPROTEREN TAB 20MG generic 1

METAPROTEREN SYP 10MG/5ML generic 1

MAXAIR AUTOH AER 200MCG Brand 2 PREF QL 28/30 MO

SEREVENT DIS AER 50MCG Brand 2 PREF QL 60/30 MO

TERBUTALINE TAB 2.5MG generic 1

TERBUTALINE TAB 5MG generic 1

TERBUTALINE INJ 1MG/ML generic 1

EPINEPHRINE INJ 0.1MG/ML generic 1

EPINEPHRINE INJ 1MG/ML generic 1

IPRATROPIUM/ SOL ALBUTER generic 1 NON-PREF ST QL 540/30 MO

DUONEB SOL Brand 2 NON-PREF ST QL 540/30 MO

COMBIVENT AER Brand 2 QL 29.4/30 MO

COMBIVENT AER RESPIMAT Brand 2

SYMBICORT AER 80-4.5 Brand 2 PREF QL 10.2/30 MO

SYMBICORT AER 160-4.5 Brand 2 PREF QL 10.2/30 MO

ADVAIR HFA AER 45/21 Brand 2 PREF QL 12/30 MO



ADVAIR DISKU AER 100/50 Brand 2 PREF QL 60/30 MO





BREO ELLIPTA INH 100-25 Brand 2

DULERA AER 100-5MCG Brand 2 PREF QL 13/30 MO

DULERA AER 200-5MCG Brand 2 PREF QL 13/30 MO

AMINOPHYLLIN INJ 25MG/ML generic 1

LUFYLLIN TAB 200MG Brand 2

LUFYLLIN TAB 400MG Brand 2

ELIXOPHYLLIN ELX 80/15ML Brand 2

THEOPHYLLINE SOL 80/15ML generic 1

THEO-24 CAP 100MG CR Brand 2



THEO-24 CAP 400MG ER Brand 2

THEOCHRON TAB 100MG CR generic 1

THEOPHYLLINE TAB 100MG ER generic 1

THEOPHYLLINE TAB 100MG CR generic 1

THEOPHYLLINE TAB 200MG CR generic 1






THEOPHYLLINE TAB 400MG generic 1



QVAR AER 40MCG Brand 2 PREF QL 17.4/30 MO

QVAR AER 80MCG Brand 2 PREF QL 17.4/30 MO

BUDESONIDE SUS 0.25MG/2 generic 1 NON-PREF ST QL 120/30 MO

PULMICORT SUS 0.25MG/2 Brand 2 NON-PREF ST QL 120/30 MO

BUDESONIDE SUS 0.5MG/2 generic 1 NON-PREF ST QL 120/30 MO

PULMICORT SUS 0.5MG/2 Brand 2 NON-PREF ST QL 120/30 MO

PULMICORT SUS 1MG/2ML Brand 2

PULMICORT INH 90MCG Brand 2 NON-PREF ST QL 2/30 MO



PULMICORT INH 180MCG Brand 2 NON-PREF ST QL 2/30 MO

ALVESCO AER 80MCG Brand 2 NON-PREF ST QL 6.1/30 MO

ALVESCO AER 160MCG Brand 2 NON-PREF ST QL 6.1/30 MO

FLOVENT DISK AER 50MCG Brand 2 PREF QL 60/30 MO



FLOVENT HFA AER 44MCG Brand 2 PREF QL 10.6/30 MO



ASMANEX 7 AER 110MCG Brand 2 PREF QL 1/30 MO






DALIRESP TAB 500MCG Brand 2 PA MO

ZYFLO TAB 600MG Brand 2 NON-PREF ST MO

ZYFLO CR TAB 600MG Brand 2 NON-PREF ST MO

SINGULAIR TAB 10MG Brand 2 NON-PREF ST MO

MONTELUKAST TAB 10MG generic 1 PREF MO

SINGULAIR CHW 4MG Brand 2 NON-PREF ST MO

MONTELUKAST CHW 4MG generic 1 PREF MO

MONTELUKAST CHW 5MG generic 1 PREF MO

SINGULAIR CHW 5MG Brand 2 NON-PREF ST MO

MONTELUKAST GRA 4MG generic 1 PREF MO

SINGULAIR GRA 4MG Brand 2 NON-PREF ST MO

ZAFIRLUKAST TAB 10MG generic 1 PREF MO

ACCOLATE TAB 10MG Brand 2 NON-PREF ST MO

ZAFIRLUKAST TAB 20MG generic 1 PREF MO

ACCOLATE TAB 20MG Brand 2 NON-PREF ST MO

XOLAIR SOL 150MG Brand 2 PA SP

DIFIL-G FORT LIQ 100-100 generic 1



Anticoagulants

HEPARIN SOD INJ 1000/ML generic 1




HEPARIN SOD INJ 5000/0.5 generic 1




HEP SOD/NACL INJ 1000UNIT generic 1

HEP SOD/NACL INJ 2UNIT/ML generic 1

HEP SOD/NACL INJ 2000UNIT Brand 2 GR

HEP SOD/NACL INJ 12500UNT generic 1



HEPARIN LOCK INJ 1UNIT/ML generic 1

HEPARIN LOCK INJ 2UNIT/ML Brand 2

HEPARIN LOCK INJ 10UNT/ML generic 1

HEP FLUSH-10 INJ 10UNT/ML generic 1

HEPARIN LOCK INJ 100/ML generic 1

HEPARIN LOCK KIT 10UNT/ML generic 1

SASH KIT 10UNT/ML generic 1

HEPARIN LOCK KIT 100/ML generic 1

SASH KIT 100/ML generic 1

FRAGMIN INJ 10000/ML Brand 2 PREF SP

FRAGMIN INJ 2500/0.2 Brand 2 PREF SP



FRAGMIN INJ 12500UNT Brand 2 PREF SP





FRAGMIN INJ 25000/ML Brand 2 PREF SP

LOVENOX INJ 30/0.3ML Brand 2 PREF SP

ENOXAPARIN INJ 30/0.3ML generic 1 NON-PREF ST SP







ENOXAPARIN INJ 100MG/ML generic 1 NON-PREF ST SP

LOVENOX INJ 100MG/ML Brand 2 PREF SP

ENOXAPARIN INJ 120/0.8 generic 1 NON-PREF ST SP

LOVENOX INJ 120/0.8 Brand 2 PREF SP

LOVENOX INJ 150MG/ML Brand 2 PREF SP

ENOXAPARIN INJ 150MG/ML generic 1 NON-PREF ST SP

ENOXAPARIN INJ 300/3ML generic 1 NON-PREF ST SP

LOVENOX INJ 300/3ML Brand 2 PREF SP

FONDAPARINUX SOL 2.5/0.5 generic 1 NON-PREF ST SP

ARIXTRA SOL 2.5/0.5 Brand 2 NON-PREF ST SP





ARIXTRA SOL 10/0.8 Brand 2 NON-PREF ST SP

FONDAPARINUX SOL 10/0.8 generic 1 NON-PREF ST SP

WARFARIN TAB 1MG generic 1 PREF

JANTOVEN TAB 1MG generic 1 PREF

COUMADIN TAB 1MG Brand 2 NON-PREF ST




COUMADIN TAB 2.5MG Brand 2 NON-PREF ST



WARFARIN TAB 2.5MG generic 1 PREF

JANTOVEN TAB 2.5MG generic 1 PREF













WARFARIN TAB 7.5MG generic 1 PREF

JANTOVEN TAB 7.5MG generic 1 PREF

COUMADIN TAB 7.5MG Brand 2 NON-PREF ST




COUMADIN INJ 5 MG Brand 2

ANGIOMAX INJ 250MG Brand 2

IPRIVASK INJ 15MG Brand 2 PA SP

ARGATROBAN INJ 100MG/ML generic 1

ARGATROBAN INJ 50MG/50M Brand 2

ARGATROBAN INJ 125/125 Brand 2

PRADAXA CAP 75MG Brand 2 PREF QL 60/30

PRADAXA CAP 150MG Brand 2 PREF QL 60/30

ELIQUIS TAB 2.5MG Brand 2 NON-PREF ST QL 60/30

ELIQUIS TAB 5MG Brand 2 NON-PREF ST QL 60/30

XARELTO TAB 10MG Brand 2 PREF QL 35/365





Anticonvulsants

ONFI TAB 5MG Brand 2 PA MO



ONFI SUS 2.5MG/ML Brand 2 PA

KLONOPIN TAB 0.5MG Brand 2 GR

CLONAZEPAM TAB 0.5MG generic 1 PREF

CLONAZEPAM TAB 1MG generic 1 PREF

KLONOPIN TAB 1MG Brand 2 GR

CLONAZEPAM TAB 2MG generic 1 PREF

KLONOPIN TAB 2MG Brand 2 GR

CLONAZEP ODT TAB 0.125MG generic 1 PREF



CLONAZEP ODT TAB 1MG generic 1 PREF

CLONAZEP ODT TAB 2MG generic 1

DIASTAT PED GEL 2.5M GEL Brand 2 PREF

DIAZEPAM GEL 2.5MG generic 1 NON-PREF ST

DIASTAT ACDL GEL 5-10MG Brand 2 PREF

DIAZEPAM GEL 10MG generic 1 NON-PREF ST

DIASTAT ACDL GEL 12.5-20 Brand 2 PREF

DIAZEPAM GEL 20MG generic 1 NON-PREF ST

FELBATOL TAB 400MG Brand 2 PREF MO

FELBAMATE TAB 400MG generic 1 NON-PREF ST MO

FELBATOL TAB 600MG Brand 2 PREF MO

FELBAMATE TAB 600MG generic 1 NON-PREF ST MO

FELBAMATE SUS 600/5ML generic 1 NON-PREF ST MO

FELBATOL SUS 600/5ML Brand 2 PREF MO

GABITRIL TAB 2MG Brand 2 PREF MO

TIAGABINE TAB 2MG generic 1 NON-PREF ST MO



TIAGABINE TAB 4MG generic 1 NON-PREF ST MO




SABRIL TAB 500MG Brand 2 NON-PREF ST QL 180/30 SP

SABRIL POW 500MG Brand 2 NON-PREF ST QL 100/30 SP

PEGANONE TAB 250MG Brand 2

FOSPHENYTOIN INJ 100/2ML generic 1

CEREBYX INJ 100/2ML Brand 2 GR

FOSPHENYTOIN INJ 500/10ML generic 1

CEREBYX INJ 500/10ML Brand 2 GR

PHENYTOIN CHW 50MG generic 1 NON-PREF ST MO

DILANTIN CHW 50MG Brand 2 PREF MO

PHENYTOIN SUS 125/5ML generic 1 PREF MO

DILANTIN-125 SUS 125/5ML Brand 2 NON-PREF ST MO

PHENYTOIN INJ 50MG/ML generic 1

DILANTIN CAP 30MG Brand 2

PHENYTOIN EX CAP 100MG generic 1 PREF MO

DILANTIN CAP 100MG Brand 2 NON-PREF ST MO

PHENYTOIN EX CAP 200MG generic 1 NON-PREF ST MO

PHENYTEK CAP 200MG Brand 2 NON-PREF ST MO

PHENYTOIN EX CAP 300MG generic 1 NON-PREF ST MO

PHENYTEK CAP 300MG Brand 2 NON-PREF ST MO

ZARONTIN CAP 250MG Brand 2 NON-PREF ST MO

ETHOSUXIMIDE CAP 250MG generic 1 PREF MO

ETHOSUXIMIDE SOL 250/5ML generic 1 PREF MO

ZARONTIN SOL 250/5ML Brand 2 NON-PREF ST MO

CELONTIN CAP 300MG Brand 2 PREF MO

DIVALPROEX TAB 125MG DR generic 1 PREF MO

DEPAKOTE TAB 125MG DR Brand 2 NON-PREF ST MO







DEPAKOTE SPR CAP 125MG Brand 2 PREF MO

DIVALPROEX CAP 125MG generic 1 PREF MO

DIVALPROEX TAB 250MG ER generic 1 PREF MO

DEPAKOTE ER TAB 250MG Brand 2 NON-PREF ST MO

DIVALPROEX TAB 500MG ER generic 1 PREF MO

DEPAKOTE ER TAB 500MG Brand 2 NON-PREF ST MO

DEPAKENE SYP 250/5ML Brand 2 NON-PREF ST MO

VALPROIC ACD SOL 250/5ML generic 1 PREF MO

VALPROIC ACD SYP 250/5ML generic 1 PREF MO

VALPROATE INJ 500/5ML generic 1

DEPACON INJ 100MG/ML Brand 2 GR

VALPROATE INJ 100MG/ML generic 1

VALPROIC ACD CAP 250MG generic 1 PREF MO

DEPAKENE CAP 250MG Brand 2 NON-PREF ST MO

STAVZOR CAP 125MG Brand 2 NON-PREF ST MO



CARBAMAZEPIN TAB 200MG generic 1 PREF MO

EPITOL TAB 200MG generic 1 PREF MO

TEGRETOL TAB 200MG Brand 2 NON-PREF ST MO

CARBAMAZEPIN CHW 100MG generic 1 PREF MO

CARBAMAZEPIN SUS 100/5ML generic 1 PREF MO

TEGRETOL SUS 100/5ML Brand 2 NON-PREF ST MO

CARBAMAZEPIN CAP 100MG ER generic 1 NON-PREF ST MO

CARBATROL CAP 100MG Brand 2 PREF MO





TEGRETOL-XR TAB 100MG Brand 2



TEGRETOL-XR TAB 200MG Brand 2 NON-PREF ST MO

CARBAMAZEPIN TAB 200MG ER generic 1 PREF MO

CARBAMAZEPIN TAB 400MG ER generic 1 PREF MO

TEGRETOL-XR TAB 400MG Brand 2 NON-PREF ST MO

POTIGA TAB 50MG Brand 2 NON-PREF ST QL 270/30 MO




GABAPENTIN CAP 100MG generic 1 PREF

NEURONTIN CAP 100MG Brand 2 NON-PREF ST





NEURONTIN TAB 600MG Brand 2 NON-PREF ST

GABAPENTIN TAB 600MG generic 1 PREF

GABAPENTIN TAB 800MG generic 1 PREF

NEURONTIN TAB 800MG Brand 2 NON-PREF ST

GABAPENTIN SOL 250/5ML generic 1 PREF

NEURONTIN SOL 250/5ML Brand 2 NON-PREF ST

VIMPAT TAB 50MG Brand 2 NON-PREF ST QL 90/30 MO




VIMPAT INJ 200MG/20 Brand 2

VIMPAT SOL 10MG/ML Brand 2 NON-PREF ST QL 1395/30 MO

LAMICTAL TAB 25MG Brand 2 NON-PREF ST QL 180/30 MO

LAMOTRIGINE TAB 25MG generic 1 PREF QL 180/30 MO









LAMOTRIGINE CHW 5MG generic 1 PREF MO

LAMICTAL CHW 5MG Brand 2 NON-PREF ST MO

LAMICTAL CHW 25MG Brand 2 NON-PREF ST QL 180/30 MO

LAMOTRIGINE CHW 25MG generic 1 PREF QL 180/30 MO

LAMICTAL KIT START 35 Brand 2 NON-PREF ST MO



LAMICTAL ODT KIT Brand 2 NON-PREF ST MO



LAMICTAL XR KIT Brand 2 NON-PREF ST MO



LAMICTAL ODT TAB 25MG Brand 2 NON-PREF ST QL 180/30 MO




LAMOTRIGINE TAB 25MG ER generic 1 NON-PREF ST QL 30/30 MO

LAMICTAL XR TAB 25MG Brand 2 NON-PREF ST QL 30/30 MO











LEVETIRACETA TAB 250MG generic 1 PREF MO



KEPPRA TAB 250MG Brand 2 NON-PREF ST MO







LEVETIRACETA SOL 100MG/ML generic 1 PREF MO

KEPPRA SOL 100MG/ML Brand 2 NON-PREF ST MO

LEVETIRACETA SOL 500/5ML generic 1 PREF MO

KEPPRA INJ 500/5ML Brand 2 GR

LEVETIRACETM INJ 500/5ML generic 1

KEPPRA XR TAB 500MG Brand 2 NON-PREF ST QL 180/30 MO

LEVETIRACETA TAB 500MG ER generic 1

KEPPRA XR TAB 750MG Brand 2 NON-PREF ST QL 120/30 MO

LEVETIRACETA TAB 750MG ER generic 1

LEVETIRACETA INJ 5MG/ML Brand 2



OXCARBAZEPIN TAB 150MG generic 1 PREF MO

TRILEPTAL TAB 150MG Brand 2 NON-PREF ST MO





TRILEPTAL SUS 300MG/5M Brand 2 NON-PREF ST MO

OXCARBAZEPIN SUS 300MG/5M generic 1 PREF MO

OXTELLAR XR TAB 150MG Brand 2 NON-PREF ST QL 60/30 MO



LYRICA CAP 25MG Brand 2 NON-PREF ST QL 90/30 PA










LYRICA SOL 20MG/ML Brand 2 NON-PREF ST QL 900/30 PA

PRIMIDONE TAB 50MG generic 1 PREF MO

MYSOLINE TAB 50MG Brand 2 GR

PRIMIDONE TAB 250MG generic 1 PREF MO

MYSOLINE TAB 250MG Brand 2 GR

BANZEL TAB 200MG Brand 2 NON-PREF ST QL 60/30 MO

BANZEL TAB 400MG Brand 2 NON-PREF ST QL 240/30 MO

BANZEL SUS 40MG/ML Brand 2 NON-PREF ST QL 2760/30 MO

TOPIRAGEN TAB 25MG generic 1 PREF MO

TOPIRAMATE TAB 25MG generic 1 PREF MO

TOPAMAX TAB 25MG Brand 2 NON-PREF ST MO










TOPIRAMATE CAP 15MG generic 1 PREF MO

TOPAMAX SPR CAP 15MG Brand 2 NON-PREF ST MO

TOPIRAMATE CAP 25MG generic 1 PREF MO

TOPAMAX SPR CAP 25MG Brand 2 NON-PREF ST MO

TROKENDI XR CAP 25MG Brand 2 PA






ZONISAMIDE CAP 25MG generic 1 PREF MO

ZONEGRAN CAP 25MG Brand 2 NON-PREF ST MO


ZONEGRAN CAP 100MG Brand 2 NON-PREF ST MO


Antidepressants

MIRTAZAPINE TAB 7.5MG generic 1 PREF QL 30/30 MO

REMERON TAB 15MG Brand 2 NON-PREF ST QL 30/30 MO

MIRTAZAPINE TAB 15MG generic 1 PREF QL 30/30 MO





REMERON SLTB TAB 15MG Brand 2 NON-PREF ST QL 30/30 MO

MIRTAZAPINE TAB 15MG ODT generic 1 PREF QL 30/30 MO





MARPLAN TAB 10MG Brand 2

PHENELZINE TAB 15MG generic 1

NARDIL TAB 15MG Brand 2 GR

EMSAM DIS 6MG/24HR Brand 2 NON-PREF ST MO

EMSAM DIS 9MG/24HR Brand 2 NON-PREF ST MO

EMSAM DIS 12MG/24H Brand 2 NON-PREF ST MO

PARNATE TAB 10MG Brand 2 GR

TRANYLCYPROM TAB 10MG generic 1

NEFAZODONE TAB 50MG generic 1 PREF MO







TRAZODONE TAB 50MG generic 1 PREF MO




VIIBRYD TAB 10MG Brand 2 NON-PREF ST QL 60/30 MO



VIIBRYD KIT Brand 2 NON-PREF ST QL 30/life

BRINTELLIX TAB 5MG Brand 2 PA



CELEXA TAB 10MG Brand 2 NON-PREF ST QL 45/30 MO

CITALOPRAM TAB 10MG generic 1 PREF QL 45/30 MO





CITALOPRAM SOL 10MG/5ML generic 1 PREF MO

LEXAPRO TAB 5MG Brand 2 NON-PREF ST QL 45/30 MO

ESCITALOPRAM TAB 5MG generic 1 PREF QL 45/30 MO





ESCITALOPRAM SOL 5MG/5ML generic 1 PREF MO

LEXAPRO SOL 5MG/5ML Brand 2 NON-PREF ST MO

FLUOXETINE CAP 10MG generic 1 PREF QL 30/30 MO

PROZAC CAP 10MG Brand 2 NON-PREF ST QL 30/30 MO







FLUOXETINE TAB 10MG generic 1 PREF QL 45/30 MO

FLUOXETINE TAB 20MG generic 1 PREF QL 90/30 MO

FLUOXETINE TAB 60MG Brand 2 PREF QL 30/30 MO

FLUOXETINE SOL 20MG/5ML generic 1 PREF MO

PROZAC WEEKL CAP 90MG Brand 2 NON-PREF ST QL 4/28 MO

FLUOXETINE CAP 90MG DR generic 1 NON-PREF ST QL 4/28 MO

FLUVOXAMINE TAB 25MG generic 1 PREF QL 60/30 MO



FLUVOXAMINE CAP 100MG ER generic 1 QL 30/30 PA

LUVOX CR CAP 100MG Brand 2 NON-PREF ST QL 30/30 MO

FLUVOXAMINE CAP 150MG ER generic 1 QL 30/30 PA

LUVOX CR CAP 150MG Brand 2 NON-PREF ST QL 30/30 MO

PAROXETINE TAB 10MG generic 1 PREF QL 30/30 MO

PAXIL TAB 10MG Brand 2 NON-PREF ST QL 30/30 MO







PAXIL SUS 10MG/5ML Brand 2

PAROXETIN ER TAB 12.5MG generic 1 NON-PREF ST QL 30/30 MO

PAXIL CR TAB 12.5MG Brand 2 NON-PREF ST QL 30/30 MO

PAROXETINE TAB 25MG ER generic 1 NON-PREF ST QL 30/30 MO

PAXIL CR TAB 25MG Brand 2 NON-PREF ST QL 30/30 MO

PAROXETIN ER TAB 37.5MG generic 1 NON-PREF ST QL 30/30 MO

PAXIL CR TAB 37.5MG Brand 2 NON-PREF ST QL 30/30 MO

PEXEVA TAB 10MG Brand 2 NON-PREF ST QL 30/30 MO






SERTRALINE TAB 25MG generic 1 PREF QL 45/30 MO

ZOLOFT TAB 25MG Brand 2 NON-PREF ST QL 45/30 MO





ZOLOFT CON 20MG/ML Brand 2 NON-PREF ST MO

SERTRALINE CON 20MG/ML generic 1 PREF MO

KHEDEZLA TAB 50MG ER Brand 2 QL 30/30 PA

DESVENLAFAX TAB 50MG ER Brand 2 QL 30/30 PA

DESVENLAFAX TAB 100MG ER Brand 2 QL 30/30 PA

KHEDEZLA TAB 100MG ER Brand 2 QL 30/30 PA

PRISTIQ TAB 50MG Brand 2 NON-PREF ST QL 30/30 MO

PRISTIQ TAB 100MG Brand 2 NON-PREF ST QL 30/30 MO

CYMBALTA CAP 20MG Brand 2 NON-PREF ST QL 60/30 PA MO



FETZIMA CAP 20MG Brand 2




FETZIMA CAP TITRATIO Brand 2

VENLAFAXINE TAB 25MG generic 1 PREF QL 90/30 MO

VENLAFAXINE TAB 37.5MG generic 1 PREF QL 90/30 MO




EFFEXOR XR CAP 37.5MG Brand 2 NON-PREF ST QL 60/30 MO

VENLAFAXINE CAP 37.5MG generic 1 NON-PREF ST QL 60/30 MO



VENLAFAXINE CAP 75MG ER generic 1 NON-PREF ST QL 60/30 MO

EFFEXOR XR CAP 75MG Brand 2 NON-PREF ST QL 60/30 MO

EFFEXOR XR CAP 150MG Brand 2 NON-PREF ST QL 60/30 MO

VENLAFAXINE CAP 150MG ER generic 1 NON-PREF ST QL 60/30 MO

VENLAFAXINE TAB 37.5 ER generic 1 NON-PREF ST QL 60/30 MO

VENLAFAXINE TAB 75MG ER generic 1 NON-PREF ST QL 60/30 MO



AMITRIPTYLIN TAB 10MG generic 1






AMOXAPINE TAB 25MG generic 1




ANAFRANIL CAP 25MG Brand 2 GR

CLOMIPRAMINE CAP 25MG generic 1





DESIPRAMINE TAB 10MG generic 1

NORPRAMIN TAB 10MG Brand 2 GR













DOXEPIN HCL CAP 10MG generic 1






DOXEPIN HCL CON 10MG/ML generic 1

TOFRANIL TAB 10MG Brand 2 GR

IMIPRAM HCL TAB 10MG generic 1





TOFRANIL-PM CAP 75MG Brand 2 GR

IMIPRAM PAM CAP 75MG generic 1







PAMELOR CAP 10MG Brand 2 GR

NORTRIPTYLIN CAP 10MG generic 1









NORTRIPTYLIN SOL 10MG/5ML Brand 2

VIVACTIL TAB 5MG Brand 2 GR

PROTRIPTYLIN TAB 5MG generic 1

VIVACTIL TAB 10MG Brand 2 GR

PROTRIPTYLIN TAB 10MG generic 1

SURMONTIL CAP 25MG Brand 2



MAPROTILINE TAB 25MG generic 1



WELLBUTRIN TAB 75MG Brand 2

BUPROPION TAB 75MG generic 1 PREF QL 90/30 MO

WELLBUTRIN TAB 100MG Brand 2

BUPROPION TAB 100MG generic 1 PREF QL 90/30 MO

BUPROPION TAB 100MG ER generic 1 PREF QL 60/30 MO

WELLBUTRIN TAB 100MG SR Brand 2

BUPROPION TAB 100MG SR generic 1 PREF QL 60/30 MO


BUDEPRION TAB 150MG SR generic 1 PREF QL 90/30 MO






WELLBUTRIN TAB XL 150MG Brand 2 NON-PREF ST QL 30/30 MO

BUPROPN HCL TAB 150MG XL generic 1 PREF QL 30/30 MO

WELLBUTRIN TAB XL 300MG Brand 2 NON-PREF ST QL 30/30 MO

BUPROPN HCL TAB 300MG XL generic 1 PREF QL 30/30 MO

FORFIVO XL TAB 450MG Brand 2 NON-PREF ST QL 30/30 MO

APLENZIN TAB 174MG Brand 2 NON-PREF ST QL 30/30 MO





Antidiabetics

NOVOLOG INJ 100/ML Brand 2 PREF MO

NOVOLOG INJ PENFILL Brand 2 PREF MO

NOVOLOG INJ FLEXPEN Brand 2 PREF MO

LANTUS INJ 100/ML Brand 2 PREF MO

APIDRA INJ SOLOSTAR Brand 2 NON-PREF ST MO

APIDRA INJ U-100 Brand 2 NON-PREF ST MO

HUMALOG INJ 100/ML Brand 2 NON-PREF ST MO

HUMALOG KWIK INJ 100/ML Brand 2 NON-PREF ST MO

LEVEMIR FLEXPEN 100/ML Brand 2 NON-PREF ST MO

LEVEMIR INJ 100/ML Brand 2 PREF MO

HUMULIN R INJ U-500 Brand 2 NON-PREF ST MO

NOVOLOG MIX INJ FLEXPEN Brand 2 PREF MO

NOVOLOG MIX INJ 70/30 Brand 2 PREF MO

HUMALOG MIX SUS 75/25 Brand 2 NON-PREF ST MO

HUMALOG MIX INJ 75/25KWP Brand 2 NON-PREF ST MO

HUMALOG MIX INJ 50/50 Brand 2 NON-PREF ST MO

HUMALOG MIX INJ 50/50KWP Brand 2 NON-PREF ST MO

SYMLINPEN 60 INJ 1000MCG Brand 2

SYMLNPEN 120 INJ 1000MCG Brand 2

BYDUREON INJ Brand 2 PA MO

BYETTA INJ 5MCG Brand 2 PA MO

BYETTA INJ 10MCG Brand 2 PA MO

VICTOZA INJ 18MG/3ML Brand 2 PA MO

CHLORPROPAM TAB 100MG generic 1

CHLORPROPAM TAB 250MG generic 1

AMARYL TAB 1MG Brand 2 NON-PREF ST MO

GLIMEPIRIDE TAB 1MG generic 1 NON-PREF ST MO







GLIPIZIDE TAB 5MG generic 1 PREF MO

GLUCOTROL TAB 5MG Brand 2 NON-PREF ST MO

GLIPIZIDE TAB 10MG generic 1 PREF MO

GLUCOTROL TAB 10MG Brand 2 NON-PREF ST MO

GLUCOTROL XL TAB 2.5MG Brand 2 NON-PREF ST MO

GLIPIZIDE XL TAB 2.5MG generic 1 PREF MO

GLIPIZIDE ER TAB 2.5MG generic 1 PREF MO

GLIPIZIDE XL TAB 5MG generic 1 PREF MO

GLIPIZIDE ER TAB 5MG generic 1 PREF MO

GLUCOTROL XL TAB 5MG Brand 2 NON-PREF ST MO

GLIPIZIDE ER TAB 10MG generic 1 PREF MO

GLIPIZIDE XL TAB 10MG generic 1 PREF MO

GLUCOTROL XL TAB 10MG Brand 2 NON-PREF ST MO

GLYBURIDE TAB 1.25MG generic 1 PREF MO

DIABETA TAB 1.25MG Brand 2 NON-PREF ST MO

DIABETA TAB 2.5MG Brand 2 NON-PREF ST MO

GLYBURIDE TAB 2.5MG generic 1 PREF MO

GLYBURIDE TAB 5MG generic 1 PREF MO

DIABETA TAB 5MG Brand 2 NON-PREF ST MO

GLYBURID MCR TAB 1.5MG generic 1 PREF MO

GLYNASE TAB 1.5MG Brand 2 NON-PREF ST MO

GLYBURID MCR TAB 3MG generic 1 PREF MO

GLYNASE TAB 3MG Brand 2 NON-PREF ST MO

GLYBURID MCR TAB 6MG generic 1 PREF MO

GLYNASE TAB 6MG Brand 2 NON-PREF ST MO

TOLAZAMIDE TAB 250MG generic 1

TOLAZAMIDE TAB 500MG generic 1

TOLBUTAMIDE TAB 500MG generic 1

METFORMIN TAB 500MG generic 1 PREF MO



GLUCOPHAGE TAB 500MG Brand 2 NON-PREF ST MO





RIOMET SOL Brand 2 NON-PREF ST MO

METFORMIN TAB 500MG ER generic 1 PREF MO

GLUCOPHAGE TAB 500MG XR Brand 2 NON-PREF ST MO

GLUCOPHAGE TAB 750MG XR Brand 2 NON-PREF ST MO

METFORMIN TAB 750MG ER generic 1 PREF MO

METFORMIN TAB 500MG ER generic 1

FORTAMET TAB 500MG Brand 2 NON-PREF ST MO

METFORMIN ER TAB 1000MG generic 1 PREF MO

FORTAMET TAB 1000MG Brand 2 NON-PREF ST MO

GLUMETZA TAB 500MG Brand 2 NON-PREF ST MO

GLUMETZA TAB 1000MG Brand 2 NON-PREF ST MO

NATEGLINIDE TAB 60MG generic 1 PREF MO

STARLIX TAB 60MG Brand 2 NON-PREF ST MO

STARLIX TAB 120MG Brand 2 NON-PREF ST MO

NATEGLINIDE TAB 120MG generic 1 PREF MO

REPAGLINIDE TAB 0.5MG generic 1

PRANDIN TAB 0.5MG Brand 2 GR

REPAGLINIDE TAB 1MG generic 1

PRANDIN TAB 1MG Brand 2 GR

REPAGLINIDE TAB 2MG generic 1

PRANDIN TAB 2MG Brand 2 GR

GLUCAGON KIT 1MG Brand 2

GLUCAGEN INJ HYPOKIT Brand 2

GLUCAGEN INJ 1MG Brand 2

PROGLYCEM SUS 50MG/ML Brand 2

KORLYM TAB 300MG Brand 2 SP

ACARBOSE TAB 25MG generic 1 PREF MO



PRECOSE TAB 25MG Brand 2 NON-PREF ST MO





GLYSET TAB 25MG Brand 2 PREF MO



NESINA TAB 6.25MG Brand 2 PA MO

NESINA TAB 12.5MG Brand 2 PA MO

NESINA TAB 25MG Brand 2 PA MO

TRADJENTA TAB 5MG Brand 2 NON-PREF ST PA MO

ONGLYZA TAB 2.5MG Brand 2 PREF PA MO

ONGLYZA TAB 5MG Brand 2 PREF PA MO

JANUVIA TAB 25MG Brand 2 PREF PA MO



CYCLOSET TAB 0.8MG Brand 2 QL 180/30 PA MO

ACTOS TAB 15MG Brand 2 NON-PREF ST MO

PIOGLITAZONE TAB 15MG generic 1 PREF MO





AVANDIA TAB 2MG Brand 2 NON-PREF ST MO



INVOKANA TAB 100MG Brand 2 PA

INVOKANA TAB 300MG Brand 2 PA

KAZANO 12.5- TAB 500MG Brand 2 PA MO

KAZANO 12.5- TAB 1000MG Brand 2 PA MO

JENTADUETO TAB 2.5-500 Brand 2 NON-PREF ST PA MO





KOMBIGLYZE TAB 2.5-1000 Brand 2 PREF PA MO

KOMBIGLYZE TAB 5-500MG Brand 2 PREF PA MO

KOMBIGLYZE TAB 5-1000MG Brand 2 PREF PA MO

JANUMET TAB 50-500MG Brand 2 PREF PA MO

JANUMET TAB 50-1000 Brand 2 PREF PA MO

JANUMET XR TAB 50-500MG Brand 2 NON-PREF ST PA MO

JANUMET XR TAB 50-1000 Brand 2 NON-PREF ST PA MO

JANUMET XR TAB 100-1000 Brand 2 NON-PREF ST PA MO

OSENI TAB 12.5-15 Brand 2 PA MO



OSENI TAB 25-15MG Brand 2 PA MO



PRANDIMET TAB 1-500MG Brand 2 NON-PREF ST MO

PRANDIMET TAB 2-500MG Brand 2 NON-PREF ST MO

GLIP/METFORM TAB 2.5-250M generic 1 NON-PREF ST MO

METAGLIP TAB 2.5-250M Brand 2 GR

GLIP/METFORM TAB 2.5-500M generic 1 NON-PREF ST MO

GLIP/METFORM TAB 5-500MG generic 1 NON-PREF ST MO

GLYB/METFORM TAB 1.25-250 generic 1 PREF MO

GLUCOVANCE TAB 1.25-250 Brand 2 GR

GLUCOVANCE TAB 2.5-500 Brand 2 NON-PREF ST MO

GLUCOVANCE TAB 5-500MG Brand 2 NON-PREF ST MO

PIOGLIT/GLIM TAB 30-2MG generic 1 NON-PREF ST MO

DUETACT TAB 30-2MG Brand 2 PREF MO

PIOGLIT/GLIM TAB 30-4MG generic 1 NON-PREF ST MO

DUETACT TAB 30-4MG Brand 2 PREF MO

AVANDARYL TAB 4-1MG Brand 2 NON-PREF ST MO







ACTOPLUS MET TAB 15-500MG Brand 2 NON-PREF ST MO

PIOGLITA/MET TAB 15-500MG generic 1 NON-PREF ST MO

PIOGLITA/MET TAB 15-850MG generic 1 NON-PREF ST MO

ACTOPLUS MET TAB 15-850MG Brand 2 NON-PREF ST MO

ACTOPLUS MET TAB XR Brand 2

ACTOPLUS MET TAB XR Brand 2

AVANDAMET TAB 2-500MG Brand 2 NON-PREF ST MO




Antidiarrheals

LOMOTIL TAB 2.5MG Brand 2 GR

LONOX TAB 2.5MG generic 1

DIPHEN/ATROP TAB 2.5MG generic 1

LOFENE TAB 2.5MG generic 1

DIPHEN/ATROP LIQ 2.5/5 generic 1

MOTOFEN TAB Brand 2

LOPERAMIDE CAP 2MG generic 1

OPIUM TIN 1% generic 1

PAREGORIC TIN 2MG/5ML Brand 2

FULYZAQ TAB 125MG Brand 2

Antidotes

ACETYLCYST INJ 200MG/ML generic 1

ACETADOTE INJ 200MG/ML Brand 2 GR

DEFEROXAMINE INJ 500MG generic 1

DESFERAL INJ 500MG Brand 2 GR

DEFEROXAMINE INJ 2GM generic 1

DESFERAL INJ 2GM Brand 2 GR



DIGIFAB INJ 40MG Brand 2

BAL IN OIL INJ 100MG/ML Brand 2

CALCIUM DISO INJ 1GM/5ML Brand 2

FOMEPIZOLE INJ 1GM/ML generic 1

FOMEPIZOLE INJ 1.5GM generic 1

ANTIZOL INJ 1GM/ML Brand 2 GR

CYANOKIT INJ 5GM Brand 2

METHYLENE BL INJ 1% generic 1

PHYSOS SALIC INJ 1MG/ML Brand 2

PROTOPAM CHL INJ 1GM Brand 2

PRALIDOXIME INJ 600/2ML Brand 2

SOD NITRITE INJ 30MG/ML Brand 2

SOD THIOSULF INJ 10% Brand 2

SOD THIOSULF INJ 25% generic 1

EXJADE TAB 125MG Brand 2 PA SP



FERRIPROX TAB 500MG Brand 2 PA SP

CA-DTPA SOL 1000MG Brand 2

ZN-DTPA SOL 1000MG Brand 2

CHEMET CAP 100MG Brand 2

FLUMAZENIL INJ 0.5MG/5 generic 1

FLUMAZENIL INJ 1MG/10ML generic 1

NALOXONE INJ 0.4MG/ML Brand 2

NALOXONE INJ 1MG/ML generic 1

VIVITROL INJ 380MG Brand 2 QL 1/30 PA SP

REVIA TAB 50MG Brand 2 GR

NALTREXONE TAB 50MG generic 1

DUODOTE INJ Brand 2

NITHIODOTE KIT Brand 2

Antiemetics



DIMENHYDRIN INJ 50MG/ML Brand 2

MECLIZINE TAB 12.5MG generic 1

ANTIVERT TAB 12.5MG Brand 2 GR

MECLIZINE TAB 25MG generic 1

MOTION SICK TAB 25MG generic 1

ANTIVERT TAB 25MG Brand 2 GR

UNIVERT TAB 32MG generic 1

TRANSDERM-SC DIS 1.5MG Brand 2

TRIMETHOBENZ CAP 300MG generic 1

TIGAN CAP 300MG Brand 2 GR

TIGAN INJ 100MG/ML Brand 2 GR

TRIMETHOBENZ INJ 100MG/ML generic 1

ANZEMET TAB 50MG Brand 2 NON-PREF ST QL 5/30

ANZEMET TAB 100MG Brand 2 NON-PREF ST QL 5/30

ANZEMET INJ 20MG/ML Brand 2 PA

SANCUSO DIS 3.1MG Brand 2 NON-PREF ST QL 4/30

GRANISETRON TAB 1MG generic 1 PREF QL 10/30

GRANISETRON INJ 0.1MG/ML generic 1 PA

GRANISETRON INJ 1MG/ML generic 1 PA

GRANISETRON INJ 1MG/ML generic 1

GRANISETRON INJ 4MG/4ML generic 1

GRANISOL SOL 2MG/10ML Brand 2

ZOFRAN TAB 4MG ODT Brand 2 NON-PREF ST QL 15/30

ONDANSETRON TAB 4MG ODT generic 1 PREF QL 30/30

ZOFRAN TAB 8MG ODT Brand 2 NON-PREF ST QL 15/30

ONDANSETRON TAB 8MG ODT generic 1 PREF QL 30/30

ZUPLENZ MIS 4MG Brand 2 NON-PREF ST QL 15/30

ZUPLENZ MIS 8MG Brand 2 NON-PREF ST QL 15/30

ZOFRAN TAB 4MG Brand 2 NON-PREF ST QL 30/30

ONDANSETRON TAB 4MG generic 1 PREF QL 30/30

ZOFRAN TAB 8MG Brand 2 NON-PREF ST QL 30/30





ONDANSETRON INJ 4MG/2ML generic 1 PA

ZOFRAN INJ 40/20ML Brand 2 GR

ONDANSETRON INJ 40/20ML generic 1 PA

ZOFRAN SOL 4MG/5ML Brand 2 NON-PREF ST QL 75/30

ONDANSETRON SOL 4MG/5ML generic 1 PREF QL 75/30

ALOXI INJ 0.25MG/5 Brand 2 PA

EMEND CAP 40MG Brand 2 NON-PREF ST QL 1/30



EMEND PAK 80 & 125 Brand 2 NON-PREF ST QL 12/30

EMEND SOL 150MG Brand 2 PA

DRONABINOL CAP 2.5MG generic 1 QL 30/30 PA

MARINOL CAP 2.5MG Brand 2 GR

DRONABINOL CAP 5MG generic 1 QL 30/30 PA

MARINOL CAP 5MG Brand 2 GR

DRONABINOL CAP 10MG generic 1 QL 30/30 PA

MARINOL CAP 10MG Brand 2 GR

CESAMET CAP 1MG Brand 2 PA

DICLEGIS TAB 10-10MG Brand 2

Antifungals

AMPHOTERICIN INJ 50MG generic 1

AMPHOTEC INJ 50MG Brand 2

AMPHOTEC INJ 100MG Brand 2

ABELCET INJ 5MG/ML Brand 2

AMBISOME INJ 50MG Brand 2

ANCOBON CAP 250MG Brand 2 GR

FLUCYTOSINE CAP 250MG generic 1

FLUCYTOSINE CAP 500MG generic 1

ANCOBON CAP 500MG Brand 2 GR

GRISEOFULVIN TAB MICR 500 generic 1



GRIFULVIN V TAB 500MG Brand 2 GR

GRISEOFULVIN SUS 125/5ML generic 1

GRIS-PEG TAB 125MG Brand 2 GR

GRISEOFULVIN TAB ULTR 125 generic 1

GRISEOFULVIN TAB ULTR 250 generic 1

GRIS-PEG TAB 250MG Brand 2 GR

BIO-STATIN CAP 500000 Brand 2

BIO-STATIN CAP 1000000 Brand 2

NYSTATIN TAB 500000 generic 1

TERBINAFINE TAB 250MG generic 1 PREF QL 90/365

LAMISIL TAB 250MG Brand 2 NON-PREF ST QL 90/365

LAMISIL GRA 125MG Brand 2 NON-PREF ST QL 84/365

LAMISIL GRA 187.5MG Brand 2 NON-PREF ST QL 42/365

TERBINEX KIT Brand 2 NON-PREF ST

KETOCONAZOLE TAB 200MG generic 1

FLUCONAZOLE TAB 50MG generic 1

DIFLUCAN TAB 50MG Brand 2 GR







DIFLUCAN SUS 10MG/ML Brand 2 GR

FLUCONAZOLE SUS 10MG/ML generic 1

FLUCONAZOLE SUS 40MG/ML generic 1

DIFLUCAN SUS 40MG/ML Brand 2 GR

FLUCONAZOLE/ INJ NACL 100 Brand 2

FLUCONAZOLE/ INJ NACL 200 generic 1

FLUCONAZOLE/ INJ NACL 400 generic 1

FLUCONAZOLE/ INJ DEX 200 generic 1

FLUCONAZOLE/ INJ DEX 400 generic 1



SPORANOX CAP 100MG Brand 2 NON-PREF ST

SPORANOX CAP PULSEPAK Brand 2 NON-PREF ST

ITRACONAZOLE CAP 100MG generic 1 NON-PREF ST QL 180/365

ONMEL TAB 200MG Brand 2 NON-PREF ST QL 90/365

SPORANOX SOL 10MG/ML Brand 2 NON-PREF ST

NOXAFIL SUS 40MG/ML Brand 2 PA

VORICONAZOLE TAB 50MG generic 1 PA

VFEND TAB 50MG Brand 2 GR

VORICONAZOLE TAB 200MG generic 1 PA

VFEND TAB 200MG Brand 2 GR

VFEND SUS 40MG/ML Brand 2 GR

VORICONAZOLE SUS 40MG/ML generic 1

VFEND IV INJ 200MG Brand 2 GR

VORICONAZOLE INJ 200MG generic 1 PA

ERAXIS INJ 50MG Brand 2

ERAXIS INJ 100MG Brand 2

CANCIDAS INJ 50MG Brand 2

CANCIDAS INJ 70MG Brand 2

MYCAMINE INJ 50MG Brand 2

MYCAMINE INJ 100MG Brand 2

Antihistamines

RESPA-BR TAB 11MG Brand 2

BROMPHENIRAM CHW 12MG generic 1

ED-CHLOR-TAN TAB 8MG Brand 2

AHIST TAB 12MG Brand 2

ED CHLORPED SUS 2MG/ML Brand 2

DEXCHLORPHEN SYP 2MG/5ML generic 1

CARBINOXAMIN TAB 4MG generic 1

ARBINOXA TAB 4MG generic 1

PALGIC TAB 4MG Brand 2 GR

CARBINOXAMIN SOL 4MG/5ML generic 1



PALGIC SOL 4MG/5ML generic 1

ARBINOXA SOL 4MG/5ML generic 1

CLEMASTINE TAB 2.68MG generic 1

CLEMASTINE SYP 0.5/5ML generic 1

DIPHENHYDRAM CAP 50MG generic 1

DIPHENHYDRAM ELX 12.5/5ML generic 1

DIPHENHYDRAM INJ 50MG/ML generic 1

DOXYTEX LIQ Brand 2

PROMETHAZINE TAB 12.5MG generic 1

PROMETHAZINE TAB 25MG generic 1

PROMETHAZINE TAB 50MG generic 1

PROMETHAZINE SYP 6.25/5ML generic 1

PROMETHAZINE SOL 6.25/5ML generic 1

PHENERGAN INJ 25MG/ML Brand 2 GR

PROMETHAZINE INJ 25MG/ML generic 1

PROMETHAZINE INJ 50MG/ML generic 1

PHENERGAN INJ 50MG/ML Brand 2 GR

PROMETHAZINE SUP 12.5MG generic 1

PHENADOZ SUP 12.5MG generic 1

PROMETHEGAN SUP 12.5MG generic 1

PROMETHAZINE SUP 25MG generic 1

PHENADOZ SUP 25MG generic 1

PROMETHEGAN SUP 25MG generic 1

PROMETHEGAN SUP 50MG generic 1

CYPROHEPTAD TAB 4MG generic 1

CYPROHEPTAD SYP 2MG/5ML generic 1

CETIRIZINE SYP 1MG/ML generic 1 PREF

CETIRIZINE SYP 5MG/5ML generic 1 PREF

CLARINEX TAB 5MG Brand 2 NON-PREF ST

DESLORATADIN TAB 5MG generic 1 NON-PREF ST

CLARINEX SYP 0.5MG/ML Brand 2 NON-PREF ST

CLARINEX RDT TAB 2.5MG Brand 2 NON-PREF ST



DESLORATADIN TAB 2.5 ODT generic 1 NON-PREF ST

DESLORATADIN TAB 5MG ODT generic 1 NON-PREF ST

CLARINEX RDT TAB 5MG Brand 2 NON-PREF ST

XYZAL TAB 5MG Brand 2 NON-PREF ST

LEVOCETIRIZI TAB 5MG generic 1 NON-PREF ST

LEVOCETIRIZI SOL 2.5/5ML generic 1 NON-PREF ST

XYZAL SOL Brand 2 NON-PREF ST

Antihyperlipidemics

CHOLESTYRAM POW 4GM generic 1

QUESTRAN POW 4GM Brand 2 GR

WELCHOL TAB 625MG Brand 2

WELCHOL PAK 3.75GM Brand 2

COLESTIPOL TAB 1GM generic 1

COLESTID TAB 1GM Brand 2 GR

COLESTID FLA GRA 5GM Brand 2 GR

COLESTID GRA 5GM Brand 2 GR

COLESTIPOL GRA 5GM generic 1

COLESTIPOL GRA 5GM generic 1

COLESTID POW 5GM Brand 2 GR

COLESTID FLA GRA 5/7.5GM Brand 2 GR

TRILIPIX CAP 45MG Brand 2 GR

FENOFIBRIC CAP 45MG DR generic 1

FENOFIBRIC CAP 135MG DR generic 1

TRILIPIX CAP 135MG Brand 2 GR

FIBRICOR TAB 35MG Brand 2 NON-PREF ST QL 60/30 MO

FENOFIBRIC TAB 35MG Brand 2 NON-PREF ST QL 60/30 MO

FENOFIBRIC TAB 105MG Brand 2 NON-PREF ST QL 30/30 MO

FIBRICOR TAB 105MG Brand 2 NON-PREF ST QL 30/30 MO

LIPOFEN CAP 50MG Brand 2 NON-PREF ST QL 60/30 MO

LIPOFEN CAP 150MG Brand 2 NON-PREF ST QL 30/30 MO

FENOGLIDE TAB 40MG Brand 2 NON-PREF ST QL 60/30 MO



TRICOR TAB 48MG Brand 2 PREF QL 60/30 MO

FENOFIBRATE TAB 48MG generic 1 NON-PREF ST QL 60/30 MO


LOFIBRA TAB 54MG Brand 2 NON-PREF ST QL 60/30 MO

FENOGLIDE TAB 120MG Brand 2 NON-PREF ST QL 30/30 MO

TRICOR TAB 145MG Brand 2 PREF QL 30/30 MO



LOFIBRA TAB 160MG Brand 2 NON-PREF ST QL 30/30 MO

TRIGLIDE TAB 160MG Brand 2 NON-PREF ST QL 30/30 MO

ANTARA CAP 30MG Brand 2

ANTARA CAP 43MG Brand 2 NON-PREF ST QL 60/30 MO

FENOFIBRATE CAP 43MG generic 1

FENOFIBRATE CAP 67MG generic 1 NON-PREF ST QL 30/30 MO

LOFIBRA CAP 67MG Brand 2 NON-PREF ST QL 30/30 MO

ANTARA CAP 90MG Brand 2

ANTARA CAP 130MG Brand 2 NON-PREF ST QL 30/30 MO

FENOFIBRATE CAP 130MG generic 1





GEMFIBROZIL TAB 600MG generic 1 PREF MO

LOPID TAB 600MG Brand 2 NON-PREF ST MO

ZETIA TAB 10MG Brand 2 NON-PREF ST MO

LIPITOR TAB 10MG Brand 2 NON-PREF ST MO

ATORVASTATIN TAB 10MG generic 1 PREF MO









LESCOL CAP 20MG Brand 2 PREF MO

FLUVASTATIN CAP 20MG generic 1 NON-PREF ST MO

FLUVASTATIN CAP 40MG generic 1 NON-PREF ST MO

LESCOL CAP 40MG Brand 2 PREF MO

LESCOL XL TAB 80MG Brand 2

LOVASTATIN TAB 10MG generic 1 PREF MO


MEVACOR TAB 20MG Brand 2 NON-PREF ST MO

MEVACOR TAB 40MG Brand 2 NON-PREF ST MO


ALTOPREV TAB 20MG ER Brand 2 PREF MO



LIVALO TAB 1MG Brand 2 NON-PREF ST MO



CRESTOR TAB 5MG Brand 2 NON-PREF ST MO




PRAVASTATIN TAB 10MG generic 1 PREF MO


PRAVACHOL TAB 20MG Brand 2 NON-PREF ST MO





SIMVASTATIN TAB 5MG generic 1 PREF MO

ZOCOR TAB 5MG Brand 2 NON-PREF ST MO











ADVICOR TAB 500-20MG Brand 2 NON-PREF ST MO

ADVICOR TAB 750-20MG Brand 2 NON-PREF ST MO

ADVICOR TAB 1000-20 Brand 2 NON-PREF ST MO

ADVICOR TAB 1000-40 Brand 2 NON-PREF ST MO

SIMCOR TAB 500-20MG Brand 2 NON-PREF ST MO



SIMCOR TAB 1000-20 Brand 2 NON-PREF ST MO

SIMCOR TAB 1000-40 Brand 2 NON-PREF ST MO

NIACOR TAB 500MG Brand 2

NIACIN ER TAB 500MG generic 1

NIASPAN TAB 500MG ER Brand 2 GR

NIASPAN TAB 750MG ER Brand 2 GR


NIASPAN TAB 1000 ER Brand 2 GR


JUXTAPID CAP 5MG Brand 2



VASCEPA CAP 1GM Brand 2 NON-PREF ST QL 120/30 MO

KYNAMRO INJ 200MG/ML Brand 2

LOVAZA CAP 1GM Brand 2 NON-PREF ST QL 120/30 MO

LIPTRUZET TAB 10-10MG Brand 2 PA






VYTORIN TAB 10-10MG Brand 2 NON-PREF ST MO




Antihypertensives

BENAZEPRIL TAB 5MG generic 1 PREF MO


LOTENSIN TAB 10MG Brand 2 NON-PREF ST MO





CAPTOPRIL TAB 12.5MG generic 1 PREF MO

CAPTOPRIL TAB 25MG generic 1 PREF MO



VASOTEC TAB 2.5MG Brand 2 NON-PREF ST MO

ENALAPRIL TAB 2.5MG generic 1 PREF MO

VASOTEC TAB 5MG Brand 2 NON-PREF ST MO

ENALAPRIL TAB 5MG generic 1 PREF MO





EPANED SOL 1MG/ML Brand 2 PA

ENALAPRILAT INJ 1.25/ML generic 1

FOSINOPRIL TAB 10MG generic 1 NON-PREF ST MO



LISINOPRIL TAB 2.5MG generic 1 PREF MO

ZESTRIL TAB 2.5MG Brand 2 NON-PREF ST MO



LISINOPRIL TAB 5MG generic 1 PREF MO

PRINIVIL TAB 5MG Brand 2 NON-PREF ST MO

ZESTRIL TAB 5MG Brand 2 NON-PREF ST MO











MOEXIPRIL TAB 7.5MG generic 1 NON-PREF ST MO

UNIVASC TAB 7.5MG Brand 2 NON-PREF ST MO

UNIVASC TAB 15MG Brand 2 NON-PREF ST MO

MOEXIPRIL TAB 15MG generic 1 NON-PREF ST MO

PERINDOPRIL TAB 2MG generic 1


ACEON TAB 4MG Brand 2 NON-PREF ST MO

ACEON TAB 8MG Brand 2 NON-PREF ST MO


QUINAPRIL TAB 5MG generic 1 NON-PREF ST MO

ACCUPRIL TAB 5MG Brand 2 NON-PREF ST MO







RAMIPRIL CAP 1.25MG generic 1 NON-PREF ST MO

ALTACE CAP 1.25MG Brand 2 NON-PREF ST MO



ALTACE CAP 2.5MG Brand 2 NON-PREF ST MO

RAMIPRIL CAP 2.5MG generic 1 NON-PREF ST MO

RAMIPRIL CAP 5MG generic 1 NON-PREF ST MO

ALTACE CAP 5MG Brand 2 NON-PREF ST MO

ALTACE CAP 10MG Brand 2 NON-PREF ST MO

RAMIPRIL CAP 10MG generic 1 NON-PREF ST MO

MAVIK TAB 1MG Brand 2 NON-PREF ST MO

TRANDOLAPRIL TAB 1MG generic 1 NON-PREF ST MO





EDARBI TAB 40MG Brand 2 NON-PREF ST MO

EDARBI TAB 80MG Brand 2 NON-PREF ST MO

CANDESARTAN TAB 4MG generic 1

ATACAND TAB 4MG Brand 2 NON-PREF ST MO


ATACAND TAB 8MG Brand 2 GR





EPROSART MES TAB 600MG generic 1 NON-PREF ST MO

TEVETEN TAB 600MG Brand 2 NON-PREF ST MO

IRBESARTAN TAB 75MG generic 1 NON-PREF ST MO

AVAPRO TAB 75MG Brand 2 NON-PREF ST MO





LOSARTAN POT TAB 25MG generic 1 PREF MO

COZAAR TAB 25MG Brand 2 NON-PREF ST MO







BENICAR TAB 5MG Brand 2 NON-PREF ST MO



MICARDIS TAB 20MG Brand 2 NON-PREF ST MO



DIOVAN TAB 40MG Brand 2




TEKTURNA TAB 150MG Brand 2 PA MO

TEKTURNA TAB 300MG Brand 2

CLONIDINE TAB 0.1MG generic 1

CATAPRES TAB 0.1MG Brand 2 GR





CATAPRES-TTS DIS 0.1/24HR Brand 2 GR

CLONIDINE DIS 0.1/24HR generic 1





GUANFACINE TAB 1MG generic 1

TENEX TAB 1MG Brand 2 GR

TENEX TAB 2MG Brand 2 GR

GUANFACINE TAB 2MG generic 1



METHYLDOPA TAB 250MG generic 1

METHYLDOPA TAB 500MG generic 1

METHYLDOPATE INJ 250/5ML generic 1

DOXAZOSIN TAB 1MG generic 1

CARDURA TAB 1MG Brand 2 GR







PRAZOSIN HCL CAP 1MG generic 1

MINIPRESS CAP 1MG Brand 2 GR





TERAZOSIN CAP 1MG generic 1




RESERPINE TAB 0.1MG generic 1

RESERPINE TAB 0.25MG generic 1

INSPRA TAB 25MG Brand 2 GR

EPLERENONE TAB 25MG generic 1

EPLERENONE TAB 50MG generic 1

INSPRA TAB 50MG Brand 2 GR

DIBENZYLINE CAP 10MG Brand 2

DEMSER CAP 250MG Brand 2

HYDRALAZINE TAB 10MG generic 1






HYDRALAZINE INJ 20MG/ML generic 1

MINOXIDIL TAB 2.5MG generic 1

MINOXIDIL TAB 10MG generic 1

NITROPRESS INJ 25MG/ML Brand 2

FENOLDOPAM INJ 10MG/ML generic 1

CORLOPAM INJ 10MG/ML Brand 2 GR

FENOLDOPAM INJ 20MG/2ML generic 1

CORLOPAM INJ 10MG/ML Brand 2 GR

VECAMYL TAB 2.5MG generic 1

AMLOD/BENAZP CAP 2.5-10MG generic 1 PREF MO

LOTREL CAP 2.5-10MG Brand 2 NON-PREF ST MO

LOTREL CAP 5-10MG Brand 2 NON-PREF ST MO

AMLOD/BENAZP CAP 5-10MG generic 1 PREF MO









TARKA TAB 1-240 CR Brand 2 NON-PREF ST MO




BENAZEP/HCTZ TAB 5-6.25 generic 1 PREF MO

BENAZEP/HCTZ TAB 10-12.5 generic 1

LOTENSIN HCT TAB 10-12.5 Brand 2 NON-PREF ST MO

LOTENSIN HCT TAB 20-12.5 Brand 2 NON-PREF ST MO

BENAZEP/HCTZ TAB 20-12.5 generic 1

LOTENSIN HCT TAB 20-25MG Brand 2 NON-PREF ST MO



BENAZEP/HCTZ TAB 20-25MG generic 1

CAPTOPR/HCTZ TAB 25-15MG generic 1 PREF MO

CAPTOPR/HCTZ TAB 25-25MG generic 1



ENALAPR/HCTZ TAB 5-12.5MG generic 1 PREF MO

ENALAPR/HCTZ TAB 10-25MG generic 1

VASERETIC TAB 10-25MG Brand 2 NON-PREF ST MO

FOSINOP/HCTZ TAB 10/12.5 generic 1 NON-PREF ST MO

FOSINOP/HCTZ TAB 20/12.5 generic 1 NON-PREF ST MO

ZESTORETIC TAB 10-12.5 Brand 2 NON-PREF ST MO

LISINOP/HCTZ TAB 10-12.5 generic 1 PREF MO

ZESTORETIC TAB 20-12.5 Brand 2 NON-PREF ST MO

LISINOP/HCTZ TAB 20-12.5 generic 1

ZESTORETIC TAB 20-25MG Brand 2 NON-PREF ST MO

LISINOP/HCTZ TAB 20-25MG generic 1

MOEXIPR/HCTZ TAB 7.5-12.5 generic 1 NON-PREF ST MO

UNIRETIC TAB 7.5-12.5 Brand 2 NON-PREF ST MO

MOEXIPR/HCTZ TAB 15-12.5 generic 1

UNIRETIC TAB 15-12.5 Brand 2 NON-PREF ST MO

UNIRETIC TAB 15-25MG Brand 2 NON-PREF ST MO

MOEXIPR/HCTZ TAB 15-25MG generic 1

QNAPRIL/HCTZ TAB 10-12.5 generic 1 NON-PREF ST MO

ACCURETIC TAB 10-12.5 Brand 2 NON-PREF ST MO

ACCURETIC TAB 20-12.5 Brand 2 NON-PREF ST MO

QNAPRIL/HCTZ TAB 20-12.5 generic 1

QNAPRIL/HCTZ TAB 20-25MG generic 1

ACCURETIC TAB 20-25MG Brand 2 NON-PREF ST MO

ATENOL/CHLOR TAB 50-25MG generic 1 PREF MO

TENORETIC TAB 50 Brand 2 NON-PREF ST MO

ATENOL/CHLOR TAB 100-25MG generic 1

TENORETIC TAB 100 Brand 2 NON-PREF ST MO



ZIAC TAB 2.5/6.25 Brand 2 NON-PREF ST MO

BISOPRL/HCTZ TAB 2.5/6.25 generic 1 PREF MO

ZIAC TAB 5-6.25MG Brand 2 NON-PREF ST MO

BISOPRL/HCTZ TAB 5-6.25MG generic 1

BISOPRL/HCTZ TAB 10/6.25 generic 1

ZIAC TAB 10/6.25 Brand 2 NON-PREF ST MO

LOPRESS HCT TAB 50-25MG Brand 2 NON-PREF ST MO

METOPRL/HCTZ TAB 50-25MG generic 1

LOPRESS HCT TAB 100-25MG Brand 2 NON-PREF ST MO



DUTOPROL TAB 25-12.5 Brand 2 NON-PREF ST MO



NADOLOL/BEND TAB 40-5MG generic 1 PREF MO

CORZIDE TAB 40-5MG Brand 2 NON-PREF ST MO

CORZIDE TAB 80-5MG Brand 2 NON-PREF ST MO

NADOLOL/BEND TAB 80-5MG generic 1

PROPRAN/HCTZ TAB 40/25 generic 1 PREF MO

PROPRAN/HCTZ TAB 80/25 generic 1 PREF MO

AZOR TAB 5-20MG Brand 2 NON-PREF ST MO




EXFORGE TAB 5-160MG Brand 2 NON-PREF ST MO




TWYNSTA TAB 40-5MG Brand 2 NON-PREF ST MO






EDARBYCLOR TAB 40-12.5 Brand 2 NON-PREF ST MO

EDARBYCLOR TAB 40-25MG Brand 2 NON-PREF ST MO

CANDESA/HCTZ TAB 16-12.5 generic 1 NON-PREF ST MO

ATACAND HCT TAB 16-12.5 Brand 2 NON-PREF ST MO

CANDESA/HCTZ TAB 32-12.5 generic 1 NON-PREF ST MO

ATACAND HCT TAB 32-12.5 Brand 2 NON-PREF ST MO

ATACAND HCT TAB 32-25MG Brand 2 NON-PREF ST MO

CANDESA/HCTZ TAB 32-25MG generic 1 NON-PREF ST MO

TEVETEN HCT TAB 600-12.5 Brand 2

TEVETEN HCT TAB 600-25MG Brand 2

AVALIDE TAB 150-12.5 Brand 2 NON-PREF ST MO

IRBESAR/HCTZ TAB 150-12.5 generic 1 NON-PREF ST MO

IRBESAR/HCTZ TAB 300-12.5 generic 1

AVALIDE TAB 300-12.5 Brand 2 NON-PREF ST MO

LOSARTAN/HCT TAB 50-12.5 generic 1 PREF MO

HYZAAR TAB 50-12.5 Brand 2 NON-PREF ST MO

LOSARTAN/HCT TAB 100-12.5 generic 1

HYZAAR TAB 100-12.5 Brand 2 NON-PREF ST MO

HYZAAR TAB 100-25 Brand 2 NON-PREF ST MO

LOSARTAN/HCT TAB 100-25 generic 1

BENICAR HCT TAB 20-12.5 Brand 2 NON-PREF ST MO

BENICAR HCT TAB 40-12.5 Brand 2 NON-PREF ST MO

BENICAR HCT TAB 40-25MG Brand 2 NON-PREF ST MO

MICARDIS HCT TAB 40/12.5 Brand 2 NON-PREF ST MO

MICARDIS HCT TAB 80/12.5 Brand 2 NON-PREF ST MO

MICARDIS HCT TAB 80-25MG Brand 2 NON-PREF ST MO

DIOVAN HCT TAB 80/12.5 Brand 2 PREF MO

VALSART/HCTZ TAB 80-12.5 generic 1 NON-PREF ST MO


DIOVAN HCT TAB 160-12.5 Brand 2 PREF MO

VALSART/HCTZ TAB 160-25MG generic 1 NON-PREF ST MO

DIOVAN HCT TAB 160-25MG Brand 2 PREF MO




DIOVAN HCT TAB 320-12.5 Brand 2 PREF MO

DIOVAN HCT TAB 320-25MG Brand 2 PREF MO

VALSART/HCTZ TAB 320-25MG generic 1 NON-PREF ST MO

EXFORGEH/5- TAB 160-12.5 Brand 2 NON-PREF ST MO

EXFORGEH/5- TAB 160-25 Brand 2 NON-PREF ST MO

EXFORGEH/10- TAB 160-12.5 Brand 2 NON-PREF ST MO



TRIBENZOR20- TAB 5-12.5MG Brand 2 NON-PREF ST MO

TRIBENZOR40- TAB 5-12.5MG Brand 2

TRIBENZOR40- TAB 5-25MG Brand 2

TRIBENZOR40- TAB 10-12.5 Brand 2

TRIBENZOR40- TAB 10-25MG Brand 2

CLORPRES TAB 0.1-15MG Brand 2



METHYLD/HCTZ TAB 250/15 generic 1

METHYLD/HCTZ TAB 250/25 generic 1

TEKTURNA HCT TAB 150-12.5 Brand 2

TEKTURNA HCT TAB 150-25MG Brand 2

TEKTURNA HCT TAB 300-12.5 Brand 2

TEKTURNA HCT TAB 300-25MG Brand 2 PA MO

TEKAMLO TAB 150-5MG Brand 2 NON-PREF ST PA MO




AMTURNIDE150 TAB -5-12.5 Brand 2 NON-PREF ST PA MO

AMTURNIDE300 TAB -5-12.5 Brand 2

AMTURNIDE300 TAB -5-25MG Brand 2

AMTURNIDE300 TAB -10-12.5 Brand 2

AMTURNIDE300 TAB -10-25MG Brand 2



Anti-infectives Agents Misc

AZACTAM INJ 1GM Brand 2 GR

AZTREONAM INJ 1GM generic 1

AZTREONAM INJ 2GM generic 1

AZACTAM INJ 2GM Brand 2 GR

AZACTAM/DEX INJ 1GM Brand 2

AZACTAM/DEX INJ 2GM Brand 2

CAYSTON INH 75MG Brand 2

BACIIM INJ 50000UNT generic 1

BACITRACIN INJ 50000UNT generic 1

COLY-MYCIN M INJ 150MG Brand 2 GR

COLISTIMETH INJ 150MG generic 1

FLAGYL CAP 375MG Brand 2

FLAGYL TAB 250MG Brand 2 GR

METRONIDAZOL TAB 250MG generic 1

METRONIDAZOL TAB 500MG generic 1

FLAGYL TAB 500MG Brand 2 GR

FLAGYL ER TAB 750MG Brand 2

METRO IV INJ 5MG/ML Brand 2

METRON/NACL INJ 500MG generic 1

PENTAM 300 INJ 300MG Brand 2

NEBUPENT INH 300MG Brand 2

XIFAXAN TAB 200MG Brand 2 QL 9/365 PA

XIFAXAN TAB 550MG Brand 2 QL 60/30 PA

VIBATIV INJ 750MG Brand 2

TINIDAZOLE TAB 250MG generic 1

TINDAMAX TAB 250MG Brand 2 GR

TINIDAZOLE TAB 500MG generic 1

TINDAMAX TAB 500MG Brand 2 GR

TRIMETHOPRIM TAB 100MG generic 1

PRIMSOL SOL 50MG/5ML Brand 2



VANCOMYCIN CAP 125MG generic 1

VANCOCIN HCL CAP 125MG Brand 2 GR

VANCOMYCIN CAP 250MG generic 1

VANCOCIN HCL CAP 250MG Brand 2 GR

VANCOMYCIN INJ 500MG generic 1

VANCOMYCIN INJ 750MG Brand 2

VANCOMYCIN INJ 1 GM generic 1

VANCOMYCIN INJ 1000MG generic 1

VANCOMYCIN INJ 5GM generic 1

VANCOMYCIN INJ 10GM generic 1

VANCOMYC/DEX INJ 500MG Brand 2

VANCOMYC/DEX INJ 750MG Brand 2

VANCOMYC/DEX INJ 1GM Brand 2

POLYMYXIN B INJ 500000 generic 1

DORIBAX INJ 250MG Brand 2

DORIBAX INJ 500MG Brand 2

INVANZ INJ 1GM Brand 2

INVANZ INJ 1GM Brand 2

MEROPENEM INJ 500MG generic 1

MERREM INJ 500MG Brand 2 GR

MEROPENEM INJ 1GM generic 1

MERREM INJ 1GM Brand 2 GR

IMIPENEM/CIL INJ 250MG generic 1

PRIMAXIN IV INJ 250MG Brand 2 GR

IMIPENEM/CIL INJ 500MG generic 1

PRIMAXIN IV INJ 500MG Brand 2 GR

CHLORAMPHEN INJ 1GM generic 1

KETEK TAB 300MG Brand 2

KETEK TAB 400MG Brand 2

LINCOCIN INJ 300MG/ML Brand 2

CLINDAMYCIN CAP 75MG generic 1

CLEOCIN CAP 75MG Brand 2 GR







CLEOCIN PED SOL 75MG/5ML Brand 2 GR

CLINDAMYCIN SOL 75MG/5ML generic 1

CLEOCIN PHOS INJ 300MG Brand 2 GR

CLINDAMYCIN INJ 300MG generic 1

CLINDAMYCIN INJ 300/2ML generic 1

CLINDAMYCIN INJ 150MG/ML generic 1










CLINDAMYCIN INJ 9000/60 generic 1

CLEOCIN PHOS INJ 9GM/60ML Brand 2 GR






CLEOCIN/D5W INJ 300MG Brand 2 GR








ZYVOX TAB 600MG Brand 2 QL 60/30 PA

ZYVOX SUS 100MG/5M Brand 2 QL 900/14 PA

ZYVOX SOL 2MG/ML Brand 2

SYNERCID INJ 500MG Brand 2

CUBICIN SOL 500MG Brand 2

TYGACIL INJ 50MG Brand 2

DAPSONE TAB 25MG generic 1

DAPSONE TAB 100MG generic 1

MEPRON SUS Brand 2

ALINIA TAB 500MG Brand 2

ALINIA SUS 100/5ML Brand 2

NEUTREXIN INJ 25MG Brand 2

E.S.P. SUS 200-600 generic 1

EES/SULFISOX SUS 200-600 generic 1

BACTRIM TAB 400-80MG Brand 2 GR

SMZ-TMP TAB 400-80MG generic 1

BACTRIM DS TAB 800-160 Brand 2 GR

SMZ/TMP DS TAB 800-160 generic 1

SMZ-TMP SUS 200-40/5 generic 1

SULFATRIM PD SUS 200-40/5 generic 1

SMZ-TMP INJ 400-80/5 generic 1

Antimalarials

CHLOROQUINE TAB 250MG generic 1 QL 12/90

CHLOROQUINE TAB 500MG generic 1 QL 12/90

ARALEN TAB 500MG Brand 2 GR

HYDROXYCHLOR TAB 200MG generic 1

PLAQUENIL TAB 200MG Brand 2 GR

MEFLOQUINE TAB 250MG generic 1

PRIMAQUINE TAB 26.3MG Brand 2

DARAPRIM TAB 25MG Brand 2

QUALAQUIN CAP 324MG Brand 2 GR



QUININE SULF CAP 324MG generic 1

COARTEM TAB 20-120MG Brand 2

ATOVAQ/PROGU TAB 62.5-25 generic 1

MALARONE TAB 62.5-25 Brand 2

MALARONE TAB 250-100 Brand 2 GR

ATOVAQ/PROGU TAB 250-100 generic 1

Antimycobacterial Agents

PASER GRA 4GM Brand 2

SIRTURO TAB 100MG Brand 2

CAPASTAT SUL INJ 1GM Brand 2

CYCLOSERINE CAP 250MG generic 1

ETHAMBUTOL TAB 100MG generic 1

MYAMBUTOL TAB 100MG Brand 2 GR

MYAMBUTOL TAB 400MG Brand 2 GR

ETHAMBUTOL TAB 400MG generic 1

TRECATOR TAB 250MG Brand 2

ISONIAZID TAB 100MG generic 1

ISONIAZID TAB 300MG generic 1

ISONIAZID SYP 50MG/5ML generic 1

ISONIAZID INJ 100MG/ML generic 1

PYRAZINAMIDE TAB 500MG generic 1

MYCOBUTIN CAP 150MG Brand 2

RIFADIN CAP 150MG Brand 2 GR

RIFAMPIN CAP 150MG generic 1

RIFADIN CAP 300MG Brand 2 GR

RIFAMPIN CAP 300MG generic 1

RIFADIN INJ 600 MG Brand 2 GR

RIFAMPIN INJ 600 MG generic 1

PRIFTIN TAB 150MG Brand 2

RIFAMATE CAP Brand 2

RIFATER TAB Brand 2



Antimysasthenic Agents

ENLON INJ 150/15ML Brand 2

GUANIDINE TAB 125MG Brand 2

PROSTIGMIN TAB 15MG Brand 2

NEOSTIG METH INJ 0.5MG/ML generic 1

PROSTIGMIN INJ 0.5MG/ML Brand 2 GR

BLOXIVERZ INJ 5MG/10ML Brand 2 Exc

NEOSTIG METH INJ 1MG/ML generic 1

BLOXIVERZ INJ 1MG/ML Brand 2 Exc

MESTINON TAB 60MG Brand 2 GR

PYRIDOSTIGM TAB 60MG generic 1

MESTINON TAB TIMESPAN Brand 2

MESTINON SYP 60MG/5ML Brand 2

REGONOL INJ 5MG/ML Brand 2

ENLON-PLUS INJ 10-0.14 Brand 2

Antineoplastic and Adjunctive Therapies

HEXALEN CAP 50MG Brand 2

TREANDA INJ 25MG Brand 2

TREANDA INJ 100MG Brand 2

MYLERAN TAB 2MG Brand 2

BUSULFEX INJ 6MG/ML Brand 2

CARBOPLATIN INJ 50MG/5ML generic 1

CARBOPLATIN INJ 150/15ML generic 1



CARBOPLATIN INJ 150MG Brand 2

CISPLATIN INJ 50/50ML generic 1

CISPLATIN INJ 100MG generic 1

CISPLATIN INJ 200MG Brand 2

OXALIPLATIN INJ 50MG generic 1

ELOXATIN INJ 50MG Brand 2 GR




ELOXATIN INJ 100MG Brand 2 GR

ELOXATIN INJ 200MG Brand 2



THIOTEPA INJ 15MG generic 1

LEUKERAN TAB 2MG Brand 2

CYCLOPHOSPH TAB 25MG generic 1

CYCLOPHOSPH TAB 50MG generic 1

CYCLOPHOSPH INJ 500MG Brand 2

CYCLOPHOSPH INJ 1GM generic 1

CYCLOPHOSPH INJ 2GM Brand 2

IFOSFAMIDE INJ 1GM/20ML generic 1

IFOSFAMIDE INJ 3GM/60ML generic 1

IFOSFAMIDE INJ 1GM generic 1

IFEX INJ 1GM Brand 2 GR

IFOSFAMIDE INJ 3GM generic 1

IFEX INJ 3GM Brand 2

MUSTARGEN INJ 10MG Brand 2

ALKERAN TAB 2MG Brand 2

MELPHALAN INJ 50MG generic 1

ALKERAN INJ 50MG Brand 2 GR

BICNU INJ 100MG Brand 2

GLIADEL WAF 7.7MG Brand 2

LOMUSTINE CAP 10MG generic 1



ZANOSAR INJ 1GM Brand 2

TEMOZOLOMIDE CAP 5MG generic 1

TEMODAR CAP 5MG Brand 2 GR













TEMODAR INJ 100MG Brand 2

BLEOMYCIN INJ 15UNIT generic 1

BLEOMYCIN INJ 30UNIT generic 1

COSMEGEN INJ 0.5MG Brand 2 GR

DACTINOMYCIN INJ 0.5MG generic 1

DAUNOXOME INJ 2MG/ML Brand 2

CERUBIDINE INJ 20MG Brand 2 GR

DAUNORUBICIN INJ 20MG generic 1

DAUNORUBICIN INJ 5MG/ML generic 1

DOXORUBICIN INJ 10MG generic 1

DOXORUBICIN INJ 2MG/ML generic 1



DOXORUBICIN INJ 200/100 generic 1

DOXORUBICIN INJ 150/75ML generic 1




ADRIAMYCIN INJ 2MG/ML generic 1

DOXORUBICIN INJ 10MG/5ML generic 1


ADRIAMYCIN INJ 10MG generic 1

ADRIAMYCIN INJ 20MG generic 1




ADRIAMYC INJ 50MG generic 1

DOXORUBICIN INJ 2MG/ML generic 1

LIPODOX INJ 2MG/ML generic 1

DOXIL INJ 2MG/ML Brand 2 GR

LIPODOX 50 INJ 2MG/ML generic 1

ELLENCE INJ 2MG/ML Brand 2 GR

EPIRUBICIN INJ 50/25ML generic 1

EPIRUBICIN INJ 200MG generic 1

ELLENCE INJ 2MG/ML Brand 2 GR

EPIRUBICIN INJ 50MG Brand 2

IDARUBICIN INJ 5MG/5ML generic 1

IDAMYCIN PFS INJ 5MG/5ML Brand 2 GR

IDAMYCIN PFS INJ 10/10ML Brand 2 GR

IDARUBICIN INJ 10/10ML generic 1

IDARUBICIN INJ 20/20ML generic 1

IDAMYCIN PFS INJ 20/20ML Brand 2 GR

MITOMYCIN INJ 5MG generic 1





MITOXANTRON INJ 2MG/ML generic 1



VALSTAR SOL 40MG/ML Brand 2

ELSPAR INJ 10000UNT Brand 2

ERWINAZE INJ 10000UNT Brand 2 PA SP

ONCASPAR INJ 750/ML Brand 2

AZACITIDINE INJ 100MG generic 1

VIDAZA INJ 100MG Brand 2 GR

XELODA TAB 150MG Brand 2

XELODA TAB 500MG Brand 2



CLADRIBINE INJ 1MG/ML generic 1

CLOLAR INJ 1MG/ML Brand 2

CYTARABINE INJ 20MG/ML generic 1



CYTARABINE INJ 100MG generic 1

CYTARABINE INJ 500MG generic 1

CYTARABINE INJ 1GM Brand 2

DEPOCYT INJ 50MG/5ML Brand 2

DACOGEN INJ 50MG Brand 2 GR

DECITABINE INJ 50MG generic 1

FLOXURIDINE INJ 0.5GM generic 1

FLUDARABINE INJ 50MG/2ML generic 1

FLUDARABINE INJ 50MG generic 1

FLUDARA INJ 50MG Brand 2 GR

ADRUCIL INJ 500/10ML generic 1

FLUOROURACIL INJ 500/10ML generic 1

FLUOROURACIL INJ 1GM/20ML generic 1

FLUOROURACIL INJ 2.5G/50M generic 1

ADRUCIL INJ 2.5G/50M generic 1

FLUOROURACIL INJ 5GM/100M generic 1

ADRUCIL INJ 5GM/100M generic 1

GEMCITABINE INJ 200MG Brand 2

GEMCITABINE INJ 1GM Brand 2

GEMCITABINE INJ 2GM Brand 2

GEMCITABINE INJ 200MG generic 1

GEMZAR INJ 200MG Brand 2 GR

GEMCITABINE INJ 1GM generic 1

GEMZAR INJ 1GM Brand 2 GR

GEMCITABINE INJ 2GM generic 1

PURINETHOL TAB 50MG Brand 2 GR

MERCAPTOPUR TAB 50MG generic 1



METHOTREXATE TAB 2.5MG generic 1

TREXALL TAB 5MG Brand 2

TREXALL TAB 7.5MG Brand 2



METHOTREXATE INJ 25MG/ML generic 1

METHOTREXATE INJ 250/10ML generic 1

METHOTREXATE INJ 25MG/ML generic 1

METHOTREXATE INJ 1GM/40ML generic 1


METHOTREXATE INJ 50MG/2ML generic 1


METHOTREXATE INJ 1GM generic 1

ARRANON INJ 5MG/ML Brand 2

ALIMTA INJ 100MG Brand 2

ALIMTA INJ 500MG Brand 2

FOLOTYN INJ 20MG/ML Brand 2

FOLOTYN INJ 40MG/2ML Brand 2

TABLOID TAB 40MG Brand 2

ZALTRAP INJ 100/4ML Brand 2 PA SP

ZALTRAP INJ 200/8ML Brand 2 PA SP

AVASTIN INJ Brand 2

AVASTIN INJ Brand 2

ERBITUX INJ 100MG Brand 2

ERBITUX INJ 200MG Brand 2

YERVOY INJ 50MG Brand 2

YERVOY INJ 200MG Brand 2

GAZYVA INJ 25MG/ML Brand 2

ARZERRA CON 100/5ML Brand 2

ARZERRA CON 1000/50 Brand 2

VECTIBIX INJ 100MG Brand 2

VECTIBIX INJ 400MG Brand 2



PERJETA INJ 420/14ML Brand 2

RITUXAN INJ 500MG Brand 2 PA SP

RITUXAN INJ 100MG Brand 2 PA SP

HERCEPTIN INJ 440MG Brand 2

ADCETRIS INJ 50MG Brand 2 PA SP

KADCYLA INJ 100MG Brand 2 PA SP

KADCYLA INJ 160MG Brand 2 PA SP

ZEVALIN KIT Y-90 Brand 2

BEXXAR CON 14MG/ML Brand 2

ERIVEDGE CAP 150MG Brand 2

LYSODREN TAB 500MG Brand 2

BICALUTAMIDE TAB 50MG generic 1

CASODEX TAB 50MG Brand 2 GR

XTANDI CAP 40MG Brand 2

FLUTAMIDE CAP 125MG generic 1

NILANDRON TAB 150MG Brand 2

TAMOXIFEN TAB 10MG generic 1

TAMOXIFEN TAB 20MG generic 1

SOLTAMOX SOL 10MG/5ML Brand 2

FARESTON TAB 60MG Brand 2

ARIMIDEX TAB 1MG Brand 2 GR

ANASTROZOLE TAB 1MG generic 1

AROMASIN TAB 25MG Brand 2 GR

EXEMESTANE TAB 25MG generic 1

FEMARA TAB 2.5MG Brand 2 GR

LETROZOLE TAB 2.5MG generic 1

EMCYT CAP 140MG Brand 2

FASLODEX INJ 250MG Brand 2

DEPO-PROVERA INJ 400/ML Brand 2

MEGESTROL AC TAB 20MG generic 1

MEGESTROL AC TAB 40MG generic 1

MEGESTROL AC SUS 400MG/10 generic 1



MEGESTROL AC SUS 40MG/ML generic 1

MEGACE ORAL SUS 40MG/ML Brand 2 GR

ZOLADEX IMP 3.6MG Brand 2 PA SP

ZOLADEX IMP 10.8MG Brand 2 PA SP

VANTAS KIT 50MG Brand 2 PA SP

LUPRON DEPOT INJ 3.75MG Brand 2 PA SP

LEUPROLIDE INJ 1MG/0.2 generic 1 PA SP

LUPRON DEPOT INJ 7.5MG Brand 2

ELIGARD INJ 7.5MG Brand 2 PA SP



ELIGARD INJ 22.5MG Brand 2 PA SP

LUPRON DEPOT INJ 30MG Brand 2 PA SP

ELIGARD INJ 30MG Brand 2 PA SP

ELIGARD INJ 45MG Brand 2 PA SP

LUPRON DEPOT INJ 45MG Brand 2

TRELSTAR DEP INJ 3.75MG Brand 2 PA SP

TRELSTAR LA INJ 11.25MG Brand 2 PA SP

TRELSTAR MIX INJ 22.5MG Brand 2 PA SP

FIRMAGON INJ 80MG Brand 2 PA SP

FIRMAGON INJ 120MG Brand 2 PA SP

ZYTIGA TAB 250MG Brand 2

POMALYST CAP 1MG Brand 2 PA SP




JEVTANA INJ 60/1.5ML Brand 2

DOCETAXEL INJ 20MG/ML Brand 2

TAXOTERE INJ 20MG/ML Brand 2

DOCETAXEL INJ 80MG/4ML Brand 2

TAXOTERE INJ 80MG/4ML Brand 2

DOCETAXEL INJ 140/7ML Brand 2




DOCETAXEL INJ 20/0.5ML Brand 2





DOCEFREZ INJ 20MG Brand 2

DOCEFREZ INJ 80MG Brand 2

HALAVEN INJ 1MG/2ML Brand 2

ETOPOSIDE CAP 50MG generic 1

TOPOSAR INJ 100/5ML generic 1

ETOPOSIDE INJ 20MG/ML generic 1

ETOPOSIDE INJ 100/5ML generic 1


ETOPOSIDE INJ 500/25ML generic 1

TOPOSAR INJ 500/25ML generic 1

TOPOSAR INJ 20MG/ML generic 1

TOPOSAR INJ 1GM/50ML generic 1

TOPOSAR INJ 20MG/ML generic 1


ETOPOPHOS INJ 100MG Brand 2

IXEMPRA KIT INJ 15MG Brand 2

IXEMPRA KIT INJ 45MG Brand 2

PACLITAXEL INJ 30MG/5ML generic 1

PACLITAXEL INJ 100MG generic 1

PACLITAXEL INJ 150/25ML generic 1

PACLITAXEL INJ 300/50ML generic 1

ABRAXANE INJ 100MG Brand 2

TENIPOSIDE INJ 50MG/5ML Brand 2

VINCRISTINE INJ 1MG/ML generic 1

VINCASAR PFS INJ 1MG/ML generic 1

MARQIBO INJ 5MG/31ML Brand 2 PA



VINBLASTINE INJ 1MG/ML generic 1

VINBLASTINE INJ 10MG generic 1

VINORELBINE INJ 10MG/ML generic 1

NAVELBINE INJ 10MG/ML Brand 2 GR

VINORELBINE INJ 50MG/5ML generic 1

VINORELBINE INJ 10MG/ML generic 1

NAVELBINE INJ 50MG/5ML Brand 2 GR

ISTODAX INJ 10MG Brand 2

ZOLINZA CAP 100MG Brand 2 QL 120/30 SP

TAFINLAR CAP 50MG Brand 2

TAFINLAR CAP 75MG Brand 2

ZELBORAF TAB 240MG Brand 2

AFINITOR TAB 2.5MG Brand 2 QL 60/30

AFINITOR TAB 5MG Brand 2

AFINITOR TAB 7.5MG Brand 2

AFINITOR TAB 10MG Brand 2

AFINITOR DIS TAB 2MG Brand 2



TORISEL SOL 25MG/ML Brand 2

STIVARGA TAB 40MG Brand 2 PA SP

NEXAVAR TAB 200MG Brand 2 QL 120/30 SP

SUTENT CAP 12.5MG Brand 2 QL 30/30 SP

SUTENT CAP 25MG Brand 2 QL 30/30 SP

SUTENT CAP 50MG Brand 2 QL 30/30 SP

MEKINIST TAB 0.5MG Brand 2

MEKINIST TAB 2MG Brand 2

GILOTRIF TAB 20MG Brand 2 PA



INLYTA TAB 1MG Brand 2 PA SP

INLYTA TAB 5MG Brand 2 PA SP



BOSULIF TAB 100MG Brand 2 PA SP

BOSULIF TAB 500MG Brand 2 PA SP

COMETRIQ KIT 60MG Brand 2



XALKORI CAP 200MG Brand 2

XALKORI CAP 250MG Brand 2

SPRYCEL TAB 20MG Brand 2 QL 60/30 SP



SPRYCEL TAB 80MG Brand 2


SPRYCEL TAB 140MG Brand 2

TARCEVA TAB 25MG Brand 2 QL 90/30 SP



IMBRUVICA CAP 140MG Brand 2

GLEEVEC TAB 100MG Brand 2 QL 90/30 SP

GLEEVEC TAB 400MG Brand 2 QL 60/30 SP

TYKERB TAB 250MG Brand 2 QL 180/30 SP

TASIGNA CAP 150MG Brand 2 QL 120/30 SP

TASIGNA CAP 200MG Brand 2 QL 120/30 SP

VOTRIENT TAB 200MG Brand 2 QL 120/30 SP

ICLUSIG TAB 15MG Brand 2 PA SP

ICLUSIG TAB 45MG Brand 2 PA SP

CAPRELSA TAB 100MG Brand 2

CAPRELSA TAB 300MG Brand 2

VELCADE INJ 3.5MG Brand 2

KYPROLIS SOL 60MG Brand 2 PA SP

JAKAFI TAB 5MG Brand 2







IRINOTECAN INJ 40MG/2ML generic 1

CAMPTOSAR INJ 40MG/2ML Brand 2 GR

IRINOTECAN INJ 100/5ML generic 1

CAMPTOSAR INJ 100/5ML Brand 2 GR

CAMPTOSAR INJ 300/15ML Brand 2

IRINOTECAN INJ 500MG/25 generic 1

HYCAMTIN CAP 0.25MG Brand 2

HYCAMTIN CAP 1MG Brand 2

TOPOTECAN INJ 4MG/4ML Brand 2

TOPOTECAN INJ 4MG generic 1

HYCAMTIN INJ 4MG Brand 2 GR

BEXXAR 131 I INJ 0.61/ML Brand 2

BEXXAR 131 I INJ 5.6MCI/M Brand 2

XOFIGO INJ 1000KBQ Brand 2

QUADRAMET INJ Brand 2

METASTRON INJ Brand 2

PROVENGE INJ Brand 2

TRISENOX SOL 10MG/10M Brand 2

TICE BCG INJ Brand 2

THERACYS INJ Brand 2

DACARBAZINE INJ 100MG Brand 2

DACARBAZINE INJ 200MG generic 1

HYDROXYUREA CAP 500MG generic 1

HYDREA CAP 500MG Brand 2 GR

SYNRIBO INJ 3.5MG Brand 2 PA SP

NIPENT INJ 10MG Brand 2 GR

PENTOSTATIN INJ 10MG generic 1

MATULANE CAP 50MG Brand 2

INTRON-A INJ 18MU Brand 2







ALFERON N INJ 5MU/ML Brand 2

ACTIMMUNE INJ 2MU/0.5 Brand 2

SYLATRON KIT 296MCG Brand 2






PROLEUKIN INJ 22MU Brand 2

UVADEX INJ 20MCG/ML Brand 2

PHOTOFRIN INJ 75MG Brand 2

TRETINOIN CAP 10MG generic 1

TARGRETIN CAP 75MG Brand 2

ZINECARD INJ 250MG Brand 2 GR

DEXRAZOXANE INJ 250MG generic 1

TOTECT INJ 500MG Brand 2

ZINECARD INJ 500MG Brand 2 GR

DEXRAZOXANE INJ 500MG generic 1

LEUCOVOR CA TAB 5MG generic 1




LEUCOVOR CA INJ 10MG/ML Brand 2

CALC FOLINAT INJ 300/30ML Brand 2

LEUCOVOR CA INJ 50MG generic 1




LEUCOVORIN INJ CALCIUM generic 1



FUSILEV INJ 50MG Brand 2

VORAXAZE INJ 1000UNIT Brand 2

AMIFOSTINE INJ 500MG generic 1

ETHYOL INJ 500MG Brand 2 GR

MESNEX TAB 400MG Brand 2

MESNA INJ 1GM generic 1

MESNEX INJ 1GM Brand 2 GR

ELITEK INJ 1.5MG Brand 2

ELITEK INJ 7.5MG Brand 2

KEPIVANCE INJ 6.25MG Brand 2

IFOSFAMIDE KIT MESNA Brand 2

Antiparkinson Agents

BENZTROPINE TAB 0.5MG generic 1

BENZTROPINE TAB 1MG generic 1

BENZTROPINE TAB 2MG generic 1

BENZTROPINE INJ 1MG/ML generic 1

COGENTIN INJ 1MG/ML Brand 2 GR

TRIHEXYPHEN TAB 2MG generic 1

TRIHEXYPHEN TAB 5MG generic 1

TRIHEXYPHEN ELX 0.4MG/ML generic 1

TASMAR TAB 100MG Brand 2

ENTACAPONE TAB 200MG generic 1

COMTAN TAB 200MG Brand 2 GR

AMANTADINE CAP 100MG generic 1 PREF MO

AMANTADINE TAB 100MG generic 1 PREF MO

AMANTADINE SYP 50MG/5ML generic 1 PREF MO

PARLODEL CAP 5MG Brand 2 GR

BROMOCRIPTIN CAP 5MG generic 1

BROMOCRIPTIN TAB 2.5MG generic 1

PARLODEL TAB 2.5MG Brand 2 GR

APOKYN INJ 10MG/ML Brand 2



PRAMIPEXOLE TAB 0.125MG generic 1 PREF MO

MIRAPEX TAB 0.125MG Brand 2 NON-PREF ST MO







PRAMIPEXOLE TAB 1MG generic 1 PREF MO

MIRAPEX TAB 1MG Brand 2 NON-PREF ST MO



MIRAPEX ER TAB 0.375MG Brand 2




MIRAPEX ER TAB 3MG Brand 2



ROPINIROLE TAB 0.25MG generic 1 PREF MO

REQUIP TAB 0.25MG Brand 2 NON-PREF ST MO

ROPINIROLE TAB 0.5MG generic 1 PREF MO

REQUIP TAB 0.5MG Brand 2 NON-PREF ST MO

ROPINIROLE TAB 1MG generic 1 PREF MO

REQUIP TAB 1MG Brand 2 NON-PREF ST MO











ROPINIROLE TAB 2MG ER generic 1 NON-PREF ST QL 30/30 MO

REQUIP XL TAB 2MG Brand 2 NON-PREF ST QL 30/30 MO









NEUPRO DIS 1MG/24HR Brand 2 NON-PREF ST QL 30/30 MO

NEUPRO DIS 2MG/24HR Brand 2





SINEMET TAB 10-100MG Brand 2 GR

CARB/LEVO TAB 10-100MG generic 1





SINEMET CR TAB 25-100MG Brand 2 GR

CARB/LEVO SR TAB 25-100MG generic 1

CARB/LEVO ER TAB 25-100MG generic 1

CARB/LEVO ER TAB 50-200MG generic 1

CARB/LEVO SR TAB 50-200MG generic 1

SINEMET CR TAB 50-200MG Brand 2 GR


PARCOPA TAB 10-100MG Brand 2 GR







CARB/LEVO 50 TAB /ENTACAP generic 1

STALEVO 50 TAB Brand 2

CARB/LEVO 75 TAB /ENTACAP generic 1


CARB/LEVO100 TAB /ENTACAP generic 1








AZILECT TAB 0.5MG Brand 2

AZILECT TAB 1MG Brand 2

ELDEPRYL CAP 5MG Brand 2 GR

SELEGILINE CAP 5MG generic 1

SELEGILINE TAB 5MG generic 1

ZELAPAR TAB 1.25MG Brand 2

LODOSYN TAB 25MG Brand 2

Antipsychotics/Antimanic Agents

FANAPT TAB 1MG Brand 2 PREF QL 60/30







FANAPT PAK Brand 2 PREF QL 8/life



INVEGA TAB 1.5MG Brand 2 NON-PREF ST QL 30/30 MO

INVEGA TAB 3MG Brand 2 NON-PREF ST QL 60/30 MO



INVEGA SUST INJ 39/0.25 Brand 2 NON-PREF ST QL 0.25/30

INVEGA SUST INJ 78/0.5ML Brand 2 NON-PREF ST QL 0.5/30


INVEGA SUST INJ 156MG/ML Brand 2 NON-PREF ST QL 1/30


RISPERIDONE TAB 0.25MG generic 1 PREF QL 60/30 MO

RISPERDAL TAB 0.25MG Brand 2 NON-PREF ST QL 60/30 MO

RISPERIDONE TAB 0.5MG generic 1 PREF QL 120/30 MO

RISPERDAL TAB 0.5MG Brand 2 NON-PREF ST QL 120/30 MO

RISPERIDONE TAB 1MG generic 1 PREF QL 60/30 MO

RISPERDAL TAB 1MG Brand 2 NON-PREF ST QL 60/30 MO







RISPERIDONE SOL 1MG/ML generic 1 PREF QL 120/30 MO

RISPERDAL SOL 1MG/ML Brand 2 NON-PREF ST QL 120/30 MO

RISPERIDONE TAB 0.25 ODT generic 1 PREF QL 60/30 MO

RISPERIDONE TAB 0.5MG OD generic 1 PREF QL 120/30 MO

RISPERDAL M TAB 0.5MG Brand 2 NON-PREF ST QL 120/30 MO

RISPERDAL M TAB 1MG Brand 2 NON-PREF ST QL 60/30 MO

RISPERIDONE TAB 1MG ODT generic 1 PREF QL 60/30 MO









RISPERDAL INJ 12.5MG Brand 2 NON-PREF ST QL 2/30

RISPERDAL INJ 25MG Brand 2 NON-PREF ST QL 2/30

RISPERDAL INJ 37.5MG Brand 2 NON-PREF ST QL 2/30

RISPERDAL INJ 50MG Brand 2 NON-PREF ST QL 2/30

HALOPERIDOL TAB 0.5MG generic 1

HALOPERIDOL TAB 1MG generic 1





HALOPERIDOL CON 2MG/ML generic 1

HALOPER LAC INJ 5MG/ML generic 1

HALDOL INJ 5MG/ML Brand 2 GR

HALOPER DEC INJ 50MG/ML generic 1

HALDOL DECAN INJ 50MG/ML Brand 2 GR

HALOPER DEC INJ 100MG/ML generic 1

HALDOL DECAN INJ 100MG/ML Brand 2 GR

CLOZARIL TAB 25MG Brand 0 NON-PREF ST

CLOZAPINE TAB 25MG generic 0 PREF



CLOZARIL TAB 100MG Brand 0 NON-PREF ST


FAZACLO TAB 12.5/ODT Brand 0 PREF

CLOZAPINE TAB 12.5/ODT Brand 0 PREF

CLOZAPINE TAB 25MG ODT Brand 0 PREF

FAZACLO TAB 25MG ODT Brand 0 PREF

FAZACLO TAB 100/ODT Brand 0 PREF

CLOZAPINE TAB 100/ODT Brand 0 PREF

FAZACLO TAB 150MG Brand 0 NON-PREF ST



FAZACLO TAB 200MG Brand 0 NON-PREF ST

QUETIAPINE TAB 25MG generic 1 PREF QL 120/30 MO

SEROQUEL TAB 25MG Brand 2 NON-PREF ST QL 120/30 MO











SEROQUEL XR TAB 50MG Brand 2 PREF QL 60/30 MO





LOXAPINE CAP 5MG generic 1

LOXITANE CAP 5MG Brand 2 GR




SAPHRIS SUB 5MG Brand 2 NON-PREF ST QL 60/30 MO

SAPHRIS SUB 10MG Brand 2 NON-PREF ST QL 60/30 MO

OLANZAPINE TAB 2.5MG generic 1 PREF QL 60/30 MO

ZYPREXA TAB 2.5MG Brand 2 NON-PREF ST QL 60/30 MO

OLANZAPINE TAB 5MG generic 1 PREF QL 60/30 MO

ZYPREXA TAB 5MG Brand 2 NON-PREF ST QL 60/30 MO

ZYPREXA TAB 7.5MG Brand 2 NON-PREF ST QL 60/30 MO

OLANZAPINE TAB 7.5MG generic 1 PREF QL 60/30 MO









OLANZAPINE INJ 10MG generic 1 PREF QL 6/30

ZYPREXA INJ 10MG Brand 2 NON-PREF ST QL 6/30

OLANZAPINE TAB 5MG ODT generic 1 PREF QL 60/30 MO

ZYPREXA ZYDI TAB 5MG Brand 2 NON-PREF ST QL 60/30 MO







ZYPREXA RELP INJ 210MG Brand 2 NON-PREF ST



CHLORPROMAZ TAB 10MG generic 1





CHLORPROMAZ INJ 25MG/ML generic 1

FLUPHENAZINE TAB 1MG generic 1

FLUPHENAZINE TAB 2.5MG generic 1



FLUPHENAZINE ELX 2.5/5ML generic 1

FLUPHENAZINE CON 5MG/ML generic 1

FLUPHENAZINE INJ 2.5MG/ML generic 1

FLUPHENAZ DE INJ 25MG/ML generic 1



PERPHENAZINE TAB 2MG generic 1




COMPRO SUP 25MG generic 1

COMPAZINE SUP 25MG generic 1

PROCHLORPER SUP 25MG generic 1

PROCHLORPER TAB 5MG generic 1

PROCHLORPER TAB 10MG generic 1

PROCHLORPER INJ 5MG/ML Brand 2

THIORIDAZINE TAB 10MG generic 1




TRIFLUOPERAZ TAB 1MG generic 1




ABILIFY TAB 2MG Brand 2 NON-PREF ST QL 30/30 MO






ABILIFY MAIN INJ 300MG Brand 2 QL 30/30 MO

ABILIFY MAIN INJ 400MG Brand 2 QL 1/30 MO

ABILIFY SOL 1MG/ML Brand 2 NON-PREF ST QL 900/30 MO

ABILIFY INJ 9.75MG Brand 2 NON-PREF ST

ABILIFY DISC TAB 10MG Brand 2 NON-PREF ST QL 30/30 MO

ABILIFY DISC TAB 15MG Brand 2 NON-PREF ST QL 30/30 MO

THIOTHIXENE CAP 1MG generic 1






EQUETRO CAP 100MG Brand 2



LATUDA TAB 20MG Brand 2 PREF QL 30/30 MO


LATUDA TAB 60MG Brand 2



ZIPRASIDONE CAP 20MG generic 1 PREF QL 60/30 MO

GEODON CAP 20MG Brand 2 NON-PREF ST QL 60/30 MO







GEODON INJ 20MG Brand 2 NON-PREF ST

LITHIUM CARB CAP 150MG generic 1



LITHIUM CARB TAB 300MG generic 1

LITHIUM CARB TAB 300MG ER generic 1

LITHOBID TAB 300MG CR Brand 2 GR

LITHIUM CARB TAB 450MG ER generic 1

LITHIUM CITR SOL 8MEQ/5ML generic 1

Antiseptics & Disinfectants

FORMA-RAY SOL 20% Brand 2

FORMALDEHYDE SOL 37% Brand 2

GLUTARALDEHY SOL 25% Brand 2



HYDROGEN PER SOL 30% Brand 2

TRIPLE DYE LIQ Brand 2

KERR TRIPLE MIS DYE SWAB Brand 2

BENZALKONIUM SOL NF Brand 2

BENZALKONIUM SOL 50% generic 1

CHLORHEX GLU SOL 20% Brand 2

IODOFLEX PAD PAD Brand 2

IODINE TIN 2% MILD Brand 2

IODINE TIN 2% Brand 2

IODINE TIN STRONG Brand 2

LUGOLS SOL STRONG Brand 2

BUCALSEP SPR Brand 2

BUCALSEP SOL Brand 2

SKIN SCRUB KIT PREP TRY Brand 2

Antivirals

SELZENTRY TAB 150MG Brand 2 PA SP

SELZENTRY TAB 300MG Brand 2 PA SP

FUZEON INJ 90MG Brand 2

TIVICAY TAB 50MG Brand 2

ISENTRESS TAB 400MG Brand 2

ISENTRESS CHW 25MG Brand 2

ISENTRESS CHW 100MG Brand 2

REYATAZ CAP 150MG Brand 2



PREZISTA TAB 75MG Brand 2





PREZISTA SUS 100MG/ML Brand 2



LEXIVA TAB 700MG Brand 2

LEXIVA SUS 50MG/ML Brand 2

CRIXIVAN CAP 200MG Brand 2

CRIXIVAN CAP 400MG Brand 2

VIRACEPT TAB 250MG Brand 2

VIRACEPT TAB 625MG Brand 2

NORVIR CAP 100MG Brand 2

NORVIR TAB 100MG Brand 2

NORVIR SOL 80MG/ML Brand 2

INVIRASE CAP 200MG Brand 2

INVIRASE TAB 500MG Brand 2

APTIVUS CAP 250MG Brand 2

APTIVUS SOL Brand 2

ZIAGEN TAB 300MG Brand 2 GR

ABACAVIR TAB 300MG generic 1

ZIAGEN SOL 20MG/ML Brand 2

VIDEX SOL 2GM Brand 2

VIDEX SOL 4GM Brand 2

DIDANOSINE CAP 125MG generic 1

VIDEX EC CAP 125MG Brand 2 GR







EMTRIVA CAP 200MG Brand 2

EMTRIVA SOL 10MG/ML Brand 2

EPIVIR HBV TAB 100MG Brand 2

EPIVIR TAB 150MG Brand 2 GR

LAMIVUDINE TAB 150MG generic 1

EPIVIR TAB 300MG Brand 2 GR



LAMIVUDINE TAB 300MG generic 1

EPIVIR HBV SOL 5MG/ML Brand 2

EPIVIR SOL 10MG/ML Brand 2

STAVUDINE CAP 15MG generic 1

ZERIT CAP 15MG Brand 2 GR







ZERIT SOL 1MG/ML Brand 2 GR

STAVUDINE SOL 1MG/ML generic 1

RETROVIR CAP 100MG Brand 2 GR

ZIDOVUDINE CAP 100MG generic 1

ZIDOVUDINE TAB 300MG generic 1

RETROVIR SYP 50MG/5ML Brand 2 GR

ZIDOVUDINE SYP 50MG/5ML generic 1

RETROVIR INJ 10MG/ML Brand 2

VIREAD TAB 150MG Brand 2




RESCRIPTOR TAB 100 MG Brand 2

RESCRIPTOR TAB 200MG Brand 2

SUSTIVA CAP 50MG Brand 2

SUSTIVA CAP 200MG Brand 2

SUSTIVA TAB 600MG Brand 2

INTELENCE TAB 25MG Brand 2



NEVIRAPINE TAB 200MG generic 1



VIRAMUNE TAB 200MG Brand 2 GR

NEVIRAPINE SUS 50MG/5ML Brand 2

VIRAMUNE SUS 50MG/5ML Brand 2

VIRAMUNE XR TAB 100MG Brand 2

VIRAMUNE XR TAB 400MG Brand 2

EDURANT TAB 25MG Brand 2

EPZICOM TAB 600-300 Brand 2

TRUVADA TAB 200-300 Brand 2

LAMIVUD/ZIDO TAB 150-300 generic 1

COMBIVIR TAB 150-300 Brand 2 GR

KALETRA TAB 100-25MG Brand 2

KALETRA TAB 200-50MG Brand 2

KALETRA SOL Brand 2

TRIZIVIR TAB Brand 2

ATRIPLA TAB Brand 2

COMPLERA TAB Brand 2

STRIBILD TAB Brand 2 PA SP

VISTIDE INJ 75MG/ML Brand 2 GR

CIDOFOVIR INJ 75MG/ML generic 1

FOSCAVIR INJ 24MG/ML Brand 2

FOSCARNET INJ 24MG/ML generic 1

CYTOVENE INJ 500MG Brand 2 GR

GANCICLOVIR INJ 500MG generic 1

VALCYTE TAB 450MG Brand 2

VALCYTE SOL 50MG/ML Brand 2

ADEFOV DIPIV TAB 10MG generic 1

HEPSERA TAB 10MG Brand 2 GR

BARACLUDE TAB 0.5MG Brand 2

BARACLUDE TAB 1MG Brand 2

BARACLUDE SOL .05MG/ML Brand 2

TYZEKA TAB 600MG Brand 2

VICTRELIS CAP 200MG Brand 2 PREF PA SP



INFERGEN INJ 9MCG Brand 2

INFERGEN INJ 15MCG Brand 2

PEGASYS INJ 180MCG/M Brand 2 PREF PA SP

PEGASYS INJ PROCLICK Brand 2 PREF PA SP

PEGASYS INJ Brand 2 PREF PA SP

PEGASYS INJ PROCLICK Brand 2 PREF PA SP

PEGASYS KIT Brand 2 PREF PA SP

PEG-INTRON KIT 50MCG RP Brand 2 NON-PREF ST PA SP

PEG-INTRON KIT 50MCG Brand 2 NON-PREF ST PA SP


PEG-INTRON KIT 80MCG RP Brand 2 NON-PREF ST PA SP

PEG-INTRON KIT 120 RP Brand 2 NON-PREF ST PA SP


PEG-INTRON KIT 150 RP Brand 2 NON-PREF ST PA SP


RIBAVIRIN CAP 200MG generic 1 PREF PA SP

REBETOL CAP 200MG Brand 2 NON-PREF ST PA SP

RIBAVIRIN TAB 200MG generic 1 PREF PA SP

COPEGUS TAB 200MG Brand 2 NON-PREF ST PA SP

RIBAPAK PAK 800/DAY generic 1 NON-PREF ST PA SP

RIBASPHERE TAB 400MG Brand 2 NON-PREF ST PA SP

RIBATAB TAB 800/DAY Brand 2 NON-PREF ST PA SP

RIBASPHERE TAB 600MG Brand 2 NON-PREF ST PA SP

RIBATAB TAB 1200/DAY Brand 2 NON-PREF ST PA SP


REBETOL SOL 40MG/ML Brand 2 NON-PREF ST PA SP

RIBAPAK MIS 600/DAY Brand 2 NON-PREF ST PA SP


RIBATAB PAK 1000/DAY Brand 2

INCIVEK TAB 375MG Brand 2 PREF PA SP

ACYCLOVIR CAP 200MG generic 1 PREF

ZOVIRAX CAP 200MG Brand 2 NON-PREF ST



ACYCLOVIR TAB 400MG generic 1 PREF

ZOVIRAX TAB 400MG Brand 2 NON-PREF ST

ACYCLOVIR TAB 800MG generic 1 PREF

ZOVIRAX TAB 800MG Brand 2 NON-PREF ST

ACYCLOVIR SUS 200/5ML generic 1 PREF

ZOVIRAX SUS 200/5ML Brand 2 NON-PREF ST

ACYCLOVIR NA INJ 50MG/ML generic 1

ACYCLOVIR NA INJ 500MG generic 1

ACYCLOVIR NA INJ 1000MG generic 1

VALACYCLOVIR TAB 500MG generic 1 PREF

VALTREX TAB 500MG Brand 2 NON-PREF ST

VALTREX TAB 1GM Brand 2 NON-PREF ST

VALACYCLOVIR TAB 1GM generic 1 PREF

FAMCICLOVIR TAB 125MG generic 1 PREF

FAMVIR TAB 125MG Brand 2 NON-PREF ST





FLUMADINE TAB 100MG Brand 2 NON-PREF ST MO

RIMANTADINE TAB 100MG generic 1 PREF

TAMIFLU CAP 30MG Brand 2 PREF QL 20/30



TAMIFLU SUS 6MG/ML Brand 2 PREF QL 75/30

RELENZA MIS DISKHALE Brand 2 PREF QL 20/30

VIRAZOLE INH 6GM Brand 2

Assorted Classes

NEXAVIR INJ Brand 2

AMMONIA AROM INH Brand 2

ENDRATE INJ 150MG/ML Brand 2



SYPRINE CAP 250MG Brand 2

CUPRIMINE CAP 250MG Brand 2

DEPEN TITRA TAB 250MG Brand 2

XIAFLEX INJ 0.9MG Brand 2 PA SP

HYLENEX INJ 150 UNIT Brand 2

VITRASE INJ 200/ML Brand 2

AMPHADASE INJ 150/ML Brand 2

THALOMID CAP 50MG Brand 2 QL 30/30 SP




REVLIMID CAP 2.5MG Brand 2 QL 21/28 SP

REVLIMID CAP 5MG Brand 2 QL 30/30 SP



REVLIMID CAP 20MG Brand 2


SANDIMMUNE CAP 25MG Brand 2

CYCLOSPORINE CAP 25MG generic 1

CYCLOSPORINE CAP 100MG generic 1

SANDIMMUNE CAP 100MG Brand 2

SANDIMMUNE INJ 50MG/ML Brand 2 GR

CYCLOSPORINE INJ 50MG/ML generic 1

SANDIMMUNE SOL 100MG/ML Brand 2

CYCLOSPORINE CAP 25MG MOD generic 1

NEORAL CAP 25MG Brand 2 GR

GENGRAF CAP 25MG generic 1

CYCLOSPORINE CAP 50MG MOD generic 1

CYCLOSPORINE CAP 100MG MD generic 1

GENGRAF CAP 100MG generic 1

NEORAL CAP 100MG Brand 2 GR

CYCLOSPORINE SOL MODIFIED generic 1



GENGRAF SOL 100MG/ML generic 1

NEORAL SOL 100MG/ML Brand 2 GR

ATGAM INJ 250MG Brand 2

THYMOGLOBULN INJ 25MG Brand 2

CELLCEPT CAP 250MG Brand 2 GR

MYCOPHENOLAT CAP 250MG generic 1

MYCOPHENOLAT TAB 500MG generic 1

CELLCEPT TAB 500MG Brand 2 GR

CELLCEPT SUS 200MG/ML Brand 2

CELLCEPT IV INJ 500MG Brand 2

MYFORTIC TAB 180MG Brand 2

MYFORTIC TAB 360MG Brand 2

ZORTRESS TAB 0.25MG Brand 2



RAPAMUNE TAB 0.5MG Brand 2

RAPAMUNE TAB 1MG Brand 2

RAPAMUNE TAB 2MG Brand 2

RAPAMUNE SOL 1MG/ML Brand 2

PROGRAF CAP 0.5MG Brand 2 GR

HECORIA CAP 0.5MG generic 1

TACROLIMUS CAP 0.5MG generic 1

PROGRAF CAP 1MG Brand 2 GR

TACROLIMUS CAP 1MG generic 1

HECORIA CAP 1MG generic 1

PROGRAF CAP 5MG Brand 2 GR

TACROLIMUS CAP 5MG generic 1

HECORIA CAP 5MG generic 1

PROGRAF INJ 5MG/ML Brand 2

ASTAGRAF XL CAP 0.5MG Brand 2

ASTAGRAF XL CAP 1MG Brand 2

ASTAGRAF XL CAP 5MG Brand 2



SIMULECT INJ 10MG Brand 2

SIMULECT INJ 20MG Brand 2

IMURAN TAB 50MG Brand 2 GR

AZATHIOPRINE TAB 50MG generic 1

AZASAN TAB 75 MG Brand 2

AZASAN TAB 100MG Brand 2

AZATHIOPRINE INJ 100MG generic 1

NULOJIX INJ 250MG Brand 2

BENLYSTA INJ 120MG Brand 2 PA SP

BENLYSTA INJ 400MG Brand 2 PA SP

SPS SUS 15GM/60 generic 1

KIONEX SUS 15GM/60 generic 1

SOD POLY SUL SUS 15GM/60 generic 1

SOD POLY SUL SUS 30/120ML generic 1

SOD POLY SUL SUS 50/200ML generic 1

SOTRADECOL INJ 1% Brand 2

SOTRADECOL INJ 3% Brand 2

ETHAMOLIN INJ 5% Brand 2

ASCLERA INJ 0.5% Brand 2

ASCLERA INJ 1% Brand 2

SCLEROMATE INJ 5% generic 1

MORRHUAT SOD INJ 5% generic 1

VIASPAN SOL Brand 2

Beta Blockers

CORGARD TAB 20MG Brand 2 NON-PREF ST MO

NADOLOL TAB 20MG generic 1 PREF MO





LEVATOL TAB 20MG Brand 2 NON-PREF ST MO



PINDOLOL TAB 5MG generic 1 PREF MO

PINDOLOL TAB 10MG generic 1 PREF MO

PROPRANOLOL TAB 10MG generic 1 PREF MO





PROPRANOLOL INJ 1MG/ML generic 1

PROPRANOLOL SOL 20MG/5ML generic 1 PREF MO

PROPRANOLOL SOL 40MG/5ML generic 1 PREF MO

PROPRANOLOL CAP 60MG ER generic 1 PREF MO

INDERAL LA CAP 60MG Brand 2 PREF MO







INNOPRAN XL CAP 80MG Brand 2 NON-PREF ST MO

INNOPRAN XL CAP 120MG Brand 2 NON-PREF ST MO

BETAPACE TAB 80MG Brand 2 NON-PREF ST MO



BETAPACE AF TAB 80MG Brand 2 NON-PREF ST MO

SOTALOL AF TAB 80MG generic 1 PREF MO





TIMOLOL MAL TAB 5MG generic 1 PREF MO





SECTRAL CAP 200MG Brand 2 NON-PREF ST MO

ACEBUTOLOL CAP 200MG generic 1 PREF MO

SECTRAL CAP 400MG Brand 2 NON-PREF ST MO

ACEBUTOLOL CAP 400MG generic 1 PREF MO

ATENOLOL TAB 25MG generic 1 PREF MO

TENORMIN TAB 25MG Brand 2 NON-PREF ST MO





BETAXOLOL TAB 10MG generic 1 PREF MO

KERLONE TAB 10MG Brand 2 NON-PREF ST MO

KERLONE TAB 20MG Brand 2 NON-PREF ST MO

BETAXOLOL TAB 20MG generic 1 PREF MO

ZEBETA TAB 5MG Brand 2 NON-PREF ST MO

BISOPROL FUM TAB 5MG generic 1 PREF MO

ZEBETA TAB 10MG Brand 2 NON-PREF ST MO

BISOPROL FUM TAB 10MG generic 1

BREVIBLOC INJ 10MG/ML Brand 2 GR

ESMOLOL HCL INJ 10MG/ML generic 1

ESMOLOL HCL INJ 100MG/10 generic 1

BREVIBLOC SOL 10MG/ML Brand 2

BREVIBLOC SOL Brand 2

METOPROLOL TAB 25MG ER generic 1 NON-PREF ST MO

TOPROL XL TAB 25MG Brand 2 NON-PREF ST MO







METOPROL TAR TAB 25MG generic 1 PREF MO




LOPRESSOR TAB 50MG Brand 2 NON-PREF ST MO


LOPRESSOR TAB 100MG Brand 2 NON-PREF ST MO

METOPROLOL INJ 5MG/5ML generic 1

METOPROLOL INJ 1MG/ML generic 1

LOPRESSOR INJ 5MG/5ML Brand 2 GR

BYSTOLIC TAB 2.5MG Brand 2 NON-PREF ST MO

BYSTOLIC TAB 5MG Brand 2 NON-PREF ST MO



CARVEDILOL TAB 3.125MG generic 1 PREF MO

COREG TAB 3.125MG Brand 2 NON-PREF ST MO





COREG TAB 25MG Brand 2 NON-PREF ST MO

CARVEDILOL TAB 25MG generic 1 PREF MO

COREG CR CAP 10MG Brand 2




LABETALOL TAB 100MG generic 1 PREF MO

TRANDATE TAB 100MG Brand 2 NON-PREF ST MO





LABETALOL INJ 5MG/ML generic 1

Biologicals Misc



ADAGEN INJ 250/ML Brand 2

STAPHAGE LYS INJ Brand 2

CAT HAIR INJ EXTRACT Brand 2

BEE VENOM INJ 550MCG Brand 2

HONEY BEE INJ 1000MCG Brand 2

BEE VENOM INJ 1300MCG Brand 2

VENOMIL KIT HONEYBEE Brand 2

HONEY BEE KIT 100MCG Brand 2

VENOMIL KIT HONEYBEE Brand 2

VENOMIL MIX INJ VESPID Brand 2

MIXED VESPID INJ 1650MCG Brand 2

MIXED VESPID INJ 3900MCG Brand 2

MIXED VESPID KIT 300MCG Brand 2

MIXED VESPID KIT 3000MCG Brand 2

YELLOW HORN INJ 550MCG Brand 2

YELLOW HORNT SOL 1000MCG Brand 2

VENOMIL KIT YEL HORN Brand 2

YELLOW HORNT KIT 100MCG Brand 2

VENOMIL KIT YEL HORN Brand 2

YELLOW JACK INJ 550MCG Brand 2

YELLOW JACKT SOL 1000MCG Brand 2

YELLOW JACK INJ 1300MCG Brand 2

VENOMIL KIT YEL JACK Brand 2

YELLOW JACKT KIT 100MCG Brand 2

VENOMIL KIT YEL JACK Brand 2

WASP VENOM INJ 550MCG Brand 2



VENOMIL KIT WASP Brand 2

WASP VENOM KIT 100MCG Brand 2

VENOMIL KIT WASP Brand 2

HORNET VENOM INJ 550MCG Brand 2



WHITE HORNET SOL 1000MCG Brand 2

HORNET VENOM INJ 1300MCG Brand 2

VENOMIL KIT WHT HORN Brand 2

WHITE HORNET KIT 100MCG Brand 2

VENOMIL KIT WHT HORN Brand 2

Calcium Channel Blockers

AMLODIPINE TAB 2.5MG generic 1 PREF MO

NORVASC TAB 2.5MG Brand 2 NON-PREF ST MO

NORVASC TAB 5MG Brand 2 NON-PREF ST MO

AMLODIPINE TAB 5MG generic 1 PREF MO

AMLODIPINE TAB 10MG generic 1 PREF MO

NORVASC TAB 10MG Brand 2 NON-PREF ST MO

CLEVIPREX EMU 0.5MG/ML Brand 2

CARDIZEM TAB 30MG Brand 2 NON-PREF ST MO

DILTIAZEM TAB 30MG generic 1 PREF MO






DILTIAZEM INJ 25MG/5ML generic 1

DILTIAZEM INJ 50/10ML generic 1

DILTIAZEM INJ 125/25ML generic 1

DILTIAZEM INJ 100MG generic 1

DILTIAZEM CAP 60MG ER generic 1 PREF MO



DILTIAZEM CAP 120MG ER generic 1

DILT-XR CAP 120MG generic 1


DILT-XR CAP 180MG generic 1 PREF MO




DILACOR XR CAP 240MG/24 Brand 2 NON-PREF ST MO

DILT-XR CAP 240MG generic 1 PREF MO

DILTZAC CAP 120MG/24 generic 1 PREF MO

TAZTIA XT CAP 120MG/24 generic 1 PREF MO

TIAZAC CAP 120MG/24 Brand 2 NON-PREF ST MO

DILTIAZEM CAP 120MG/24 generic 1 PREF MO




















DILT-CD CAP 120MG generic 1 PREF MO

CARTIA XT CAP 120/24HR generic 1 PREF MO

CARDIZEM CD CAP 120MG/24 Brand 2 NON-PREF ST MO

DILTIAZEM CAP 120MG CD generic 1 PREF MO





















CARDIZEM LA TAB 120MG Brand 2

MATZIM LA TAB 180MG/24 generic 1

CARDIZEM LA TAB 180MG Brand 2 NON-PREF ST MO

MATZIM LA TAB 240MG/24 generic 1


CARDIZEM LA TAB 300MG/24 Brand 2 NON-PREF ST MO

MATZIM LA TAB 300MG/24 generic 1 NON-PREF ST MO



CARDIZEM LA TAB 420MG/24 Brand 2 NON-PREF ST MO


FELODIPINE TAB 2.5MG ER generic 1 PREF MO

FELODIPINE TAB 5MG ER generic 1 PREF MO

FELODIPINE TAB 10MG ER generic 1 PREF MO

ISRADIPINE CAP 2.5MG generic 1 PREF MO

ISRADIPINE CAP 5MG generic 1 PREF MO



NICARDIPINE CAP 20MG generic 1 PREF MO

NICARDIPINE CAP 30MG generic 1 PREF MO

NICARDIPINE INJ 25/10ML generic 1

CARDENE I.V. INJ 2.5MG/ML Brand 2 GR

CARDENE SR CAP 30MG Brand 2

CARDENE SR CAP 60MG Brand 2

CARDENE IV SOL 20/200ML Brand 2

CARDENE IV INJ 40/200ML Brand 2

CARDENE IV SOL 20/200ML Brand 2

CARDENE IV INJ 40/200ML Brand 2

NIFEDIPINE CAP 10MG generic 1 PREF MO

PROCARDIA CAP 10MG Brand 2 NON-PREF ST MO

NIFEDIPINE CAP 20MG generic 1 PREF MO

ADALAT CC TAB 30MG ER Brand 2 NON-PREF ST MO

NIFEDIAC CC TAB 30MG ER generic 1 PREF MO

NIFEDIPINE TAB 30MG ER generic 1 PREF MO

AFEDITAB TAB 30MG CR generic 1 PREF MO


AFEDITAB TAB 60MG CR generic 1 PREF MO







NIFEDICAL XL TAB 30MG generic 1 PREF MO

PROCARDIA XL TAB 30MG CR Brand 2 NON-PREF ST MO


NIFEDICAL XL TAB 60MG generic 1 PREF MO






NIMODIPINE CAP 30MG generic 1 NON-PREF ST MO

NYMALIZE SOL 60/20ML Brand 2

NISOLDIPINE TAB 8.5MG ER generic 1 PREF MO

SULAR TAB 8.5MG Brand 2 NON-PREF ST MO

NISOLDIPINE TAB 17MG ER generic 1 PREF MO

SULAR TAB 17MG Brand 2 NON-PREF ST MO

NISOLDIPINE TAB 20MG generic 1 PREF MO

NISOLDIPINE TAB 25.5MG generic 1 PREF MO


NISOLDIPINE TAB 34MG ER generic 1 PREF MO

SULAR TAB 34MG Brand 2 NON-PREF ST MO


VERAPAMIL TAB 40MG generic 1 PREF MO

CALAN TAB 80MG Brand 2 NON-PREF ST MO


CALAN TAB 120MG Brand 2 NON-PREF ST MO


VERAPAMIL TAB 120MG ER generic 1 PREF MO

ISOPTIN SR TAB 120MG Brand 2 NON-PREF ST MO

CALAN SR TAB 120MG Brand 2 NON-PREF ST MO







VERAPAMIL INJ 2.5MG/ML generic 1

VERELAN PM CAP 100MG Brand 2 NON-PREF ST MO

VERAPAMIL CAP 100MG ER generic 1 MO

VERAPAMIL CAP 120MG ER generic 1 PREF MO

VERAPAMIL CAP 120MG SR generic 1 PREF MO

VERELAN CAP 120MG SR Brand 2 NON-PREF ST MO





VERELAN CAP 180MG Brand 2 NON-PREF ST MO










Cardiotonics

MILRINONE INJ 10/10ML generic 1

MILRINONE INJ 1MG/ML generic 1





MILRINONE/D5 INJ 20/100ML generic 1

MILRINONE/D5 INJ 40/200ML generic 1

LANOXIN TAB 0.125MG Brand 2 GR

DIGOXIN TAB 0.125MG generic 1

LANOXIN TAB 0.25MG Brand 2 GR

DIGOXIN TAB 0.25MG generic 1

LANOXIN PED INJ 0.1MG/ML Brand 2

DIGOXIN INJ 0.25MG/1 generic 1

LANOXIN INJ 0.25MG/1 Brand 2 GR

DIGOXIN SOL 50MCG/ML generic 1

Cardiovascular Agents

ADEMPAS TAB 0.5MG Brand 2 PA



ADEMPAS TAB 1MG Brand 2 PA


ADEMPAS TAB 2MG Brand 2 PA


SILDENAFIL TAB 20MG generic 1 PREF PA SP

REVATIO TAB 20MG Brand 2 NON-PREF ST SP

REVATIO INJ Brand 2 PA SP

ADCIRCA TAB 20MG Brand 2 PREF SP

LETAIRIS TAB 5MG Brand 2 PREF SP

LETAIRIS TAB 10MG Brand 2 PREF SP

TRACLEER TAB 62.5MG Brand 2 PREF SP

TRACLEER TAB 125MG Brand 2 PREF SP

OPSUMIT TAB 10MG Brand 2

EPOPROSTENOL INJ 0.5MG generic 1 PA SP

VELETRI INJ 0.5MG Brand 2 PA SP

FLOLAN INJ 0.5MG Brand 2 GR SP

EPOPROSTENOL INJ 1.5MG generic 1 PA SP

VELETRI INJ 1.5MG Brand 2 PA SP

FLOLAN INJ 1.5MG Brand 2 GR SP

VENTAVIS SOL 10MCG/ML Brand 2 NON-PREF ST SP

VENTAVIS SOL 20MCG/ML Brand 2 NON-PREF ST SP

TYVASO START SOL 0.6MG/ML Brand 2 NON-PREF ST SP

TYVASO REFIL SOL 0.6MG/ML Brand 2 NON-PREF ST SP

TYVASO SOL 0.6MG/ML Brand 2 NON-PREF ST SP

REMODULIN INJ 1MG/ML Brand 2 PA SP

REMODULIN INJ 2.5MG/ML Brand 2 PA SP



NATRECOR INJ 1.5MG Brand 2

CARDIOPLEGIC SOL generic 1

PLEGISOL SOL Brand 2 GR

CIALIS TAB 5MG Brand 2 QL 30/30 PA



CADUET TAB 2.5-10MG Brand 2 GR

AMLOD/ATORVA TAB 2.5-10MG generic 1 NON-PREF ST MO





AMLOD/ATORVA TAB 5-10MG generic 1 NON-PREF ST MO

CADUET TAB 5-10MG Brand 2 GR















BIDIL TAB Brand 2

Cephalosporins

CEFADROXIL CAP 500MG generic 1

CEFADROXIL TAB 1GM generic 1

CEFADROXIL SUS 250/5ML generic 1

CEFADROXIL SUS 500/5ML generic 1

CEFAZOLIN INJ 500MG generic 1

CEFAZOLIN INJ 1GM generic 1

CEFAZOLIN INJ 1GM Brand 2







CEFAZOLIN INJ 1GM/50ML generic 1

CEFAZOL/DEX SOL 1GM generic 1

CEFAZOL/DEX SOL 2GM Brand 2

CEPHALEXIN CAP 250MG generic 1

KEFLEX CAP 250MG Brand 2 GR





CEPHALEXIN TAB 250MG generic 1

CEPHALEXIN TAB 500MG generic 1

CEPHALEXIN SUS 125/5ML generic 1

CEPHALEXIN SUS 250/5ML generic 1

CEFACLOR CAP 250MG generic 1 NON-PREF ST

CEFACLOR CAP 500MG generic 1 NON-PREF ST

CEFACLOR SUS 125/5ML Brand 2 PREF



CEFACLOR ER TAB 500MG generic 1 NON-PREF ST

CEFOTETAN INJ 1GM/10ML generic 1

CEFOTETAN INJ 2GM/20ML generic 1

CEFOTETAN INJ 10G Brand 2

CEFOTET/DEX INJ 1-3.58% Brand 2

CEFOTET/DEX INJ 2-2.08% Brand 2

CEFOXITIN INJ 1GM generic 1



MEFOXIN INJ 1GM/50ML Brand 2



MEFOXIN INJ 2GM/50ML Brand 2



CEFPROZIL TAB 250MG generic 1 PREF

CEFPROZIL TAB 500MG generic 1 PREF

CEFPROZIL SUS 125/5ML generic 1 PREF

CEFPROZIL SUS 250/5ML generic 1 PREF

CEFTIN TAB 250MG Brand 2 NON-PREF ST

CEFUROXIME TAB 250MG generic 1 PREF

CEFTIN TAB 500MG Brand 2 NON-PREF ST

CEFUROXIME TAB 500MG generic 1 PREF

CEFTIN SUS 125/5ML Brand 2 NON-PREF ST

CEFUROXIME SUS 125/5ML generic 1

CEFTIN SUS 250/5ML Brand 2 NON-PREF ST

CEFUROXIME INJ 750MG generic 1

ZINACEF INJ 750MG Brand 2 GR

ZINACEF INJ 750MG Brand 2

ZINACEF INJ 1.5GM Brand 2 GR

CEFUROXIME INJ 1.5GM generic 1





CEFUROXIME INJ 7.5GM Brand 2

CEFUROXIME INJ 75GM Brand 2

CEFUROXIME INJ 225GM Brand 2

ZINACEF/H20 INJ 1.5GM PB Brand 2

CEFUROX/DEXT INJ 750MG generic 1

CEFUROX/DEXT INJ 1.5GM generic 1

CEFDINIR CAP 300MG generic 1 PREF

CEFDINIR SUS 125/5ML generic 1 PREF

CEFDINIR SUS 250/5ML generic 1 PREF



SPECTRACEF TAB 200MG Brand 2 NON-PREF ST

CEFDITOREN TAB 200MG Brand 2 NON-PREF ST

CEFDITOREN TAB 400MG Brand 2 NON-PREF ST

SPECTRACEF TAB 400MG Brand 2 NON-PREF ST

SUPRAX CAP 400MG Brand 2

SUPRAX TAB 400MG Brand 2 PREF

SUPRAX CHW 100MG Brand 2

SUPRAX CHW 200MG Brand 2

SUPRAX SUS 100/5ML Brand 2 PREF

SUPRAX SUS 200/5ML Brand 2 PREF

SUPRAX SUS 500/5ML Brand 2

CEFPODOXIME TAB 100MG generic 1 PREF

CEFPODOXIME TAB 200MG generic 1 PREF

CEFPODO PROX SUS 50MG/5ML generic 1 PREF

CEFPODO PROX SUS 100/5ML generic 1 PREF

CLAFORAN INJ 500MG Brand 2 GR

CEFOTAXIME INJ 500MG generic 1

CLAFORAN INJ 1GM Brand 2 GR

CEFOTAXIME INJ 1GM generic 1

CLAFORAN INJ 1GM Brand 2



CLAFORAN INJ 2GM Brand 2



FORTAZ INJ 500MG Brand 2

TAZICEF INJ 1GM generic 1

CEFTAZIDIME INJ 1GM generic 1

FORTAZ INJ 1GM Brand 2 GR













CEFTAZIDIME INJ 100GM Brand 2

FORTAZ INJ 1GM Brand 2

FORTAZ INJ 2GM Brand 2

TAZICEF INJ 1GM/50ML Brand 2

CEFTIBUTEN CAP 400MG generic 1

CEDAX CAP 400MG Brand 2 GR

CEDAX SUS 90MG/5ML Brand 2 NON-PREF ST

CEFTIBUTEN SUS 180/5ML generic 1

CEDAX SUS 180/5ML Brand 2 GR

CEFTRIAXONE INJ 250MG generic 1

CEFTRIAXONE INJ 500MG generic 1

ROCEPHIN INJ 500MG Brand 2 GR

ROCEPHIN INJ 1GM Brand 2 GR

CEFTRIAXONE INJ 1GM generic 1





CEFTRIAXONE/ INJ DEX 1GM Brand 2

CEFTRIAXONE/ INJ DEX 2GM Brand 2

CEFTRIAX/DEX INJ 1GM generic 1

CEFTRIAX/DEX INJ 2GM generic 1

CEFEPIME INJ 1GM generic 1





MAXIPIME INJ 1GM Brand 2 GR

MAXIPIME INJ 1GM Brand 2

MAXIPIME INJ 2GM Brand 2 GR


MAXIPIME INJ 2GM Brand 2

CEFEPIME INJ 1GM Brand 2

CEFEPIME INJ 2GM Brand 2

TEFLARO INJ 400MG Brand 2

TEFLARO INJ 600MG Brand 2

Chemicals

ACETIC ACID SOL 5% Brand 2

ACETIC ACID SOL GLACIAL generic 1

FUMARIC ACID POW Brand 2

GLYCOLIC ACD GRA Brand 2

GLYCOLIC ACD CRY Brand 2

HYDROCHLORIC LIQ ACID Brand 2

HYDROCHL ACD LIQ 10% Brand 2

HYDROCHL ACD LIQ 37% Brand 2

LACTIC ACID SOL Brand 2

NITRIC ACID LIQ Brand 2

OXALIC ACID CRY Brand 2

OXALIC ACID POW DIHYDRAT Brand 2

PHOSPHOR ACD SOL 85% Brand 2

SULFURIC ACD SOL Brand 2

AMMONIUM SOL HYDROXID Brand 2

POT HYDROXID SOL 5% Brand 2

POTASSIUM SOL HYDROXID Brand 2

POTASSIUM MIS HYDROXID Brand 2

NA HYDROXIDE SOL 10% Brand 2

SODIUM MIS HYDROXID Brand 2

TARTARIC ACD POW Brand 2



BORAX GRA Brand 2

SODIUM BORAT POW DECAHYDR Brand 2

SOD CARBONAT POW ANHYDROU Brand 2

AMMONIUM LAC SOL 70% Brand 2

BENZYL BENZO LIQ Brand 2

CAMPHOR SOL SPIRITS Brand 2

CHLORHEXIDIN SOL GLUCONAT Brand 2

DIMETHYL SOL SULFOXID Brand 2

CRYOSERV SOL Brand 2

GLYCEROL LIQ FORMAL Brand 2

GLYCERIN LIQ Brand 2

GLYCERINE LIQ Brand 2

GLYCERIN SOL SYNTHETC Brand 2

GUAIACOL SOL Brand 2

ISOPROPYL LIQ PALMITAT Brand 2

PINE TAR LIQ Brand 2

POLYSORBATE SOL 20 Brand 2

POLYSORBATE SOL 40 Brand 2

POLYSORBATE LIQ 60 Brand 2

POLYSORBATE LIQ 80 Brand 2

SOD SILICATE SOL 40% Brand 2

UNDECYLENIC LIQ ACID Brand 2

ACETONE SOL Brand 2

ETHYL ALCOHO SOL 95% Brand 2

DENATURED SOL ALCOHOL Brand 2

CHLOROFORM SOL NF Brand 2

ETHER SOL Brand 2

ISOPROPYL SOL ALCOHOL Brand 2

ISOP ALCOHOL SOL 70% Brand 2

ISOPROPANOL SOL 70% Brand 2

ISOP ALCOHOL SOL 99% Brand 2

ISOP ALCOHOL SOL 70% RUB generic 1



OIL-ALMOND OIL SWEET Brand 2

ALMOND OIL SWEET Brand 2

BASE G ALMON OIL SWEET Brand 2

CASTOR OIL Brand 2

OIL-COCONUT OIL Brand 2

COCONUT OIL Brand 2

COTTONSEED OIL Brand 2

LINSEED OIL RAW Brand 2

OLIVE OIL Brand 2

PEANUT OIL NF Brand 2

SAFFLOWER OIL Brand 2

SESAME OIL Brand 2

SOYBEAN OIL Brand 2

GLYCINE SOYA SOL PROTEIN Brand 2

CEDAR LEAF OIL Brand 2

CINNAMON OIL ARTIFIC Brand 2

CITRONELLA OIL Brand 2

CLOVE OIL NF Brand 2

CLOVE OIL Brand 2

EUCALYPTUS OIL Brand 2

EUGENOL SOL Brand 2

JUNIPER TAR OIL Brand 2

LAVENDER OIL NATURAL Brand 2

LAVENDER OIL FRAGRANC Brand 2

ACTIPHYTE OF LIQ LEMONGRA Brand 2

NIAOULI OIL Brand 2

PEPPERMINT OIL Brand 2

PINE OIL Brand 2

ROSE OIL Brand 2

ROSEMARY OIL Brand 2

SASSAFRAS OIL Brand 2

ALUM AMMONIU POW Brand 2



ALUMINUM POT GRA SULFATE Brand 2

ALUMINUM POT POW SULFATE Brand 2

AMMONIUM GRA CHLORIDE Brand 2

AMMONIUM CAR POW Brand 2

AMMONIUM BRO GRA Brand 2

AMMONIUM BRO POW Brand 2

AMMONIUM GRA SULFATE Brand 2

ALUMINUM GRA SULFATE Brand 2

L-ASPARTIC POW Brand 2

BISMUTH SUBC POW Brand 2

BISMUTH POW SUBNITRA Brand 2

BISMUTH POW SUBSALIC Brand 2

BORIC ACID POW Brand 2

BHT POW Brand 2

CALCIUM POW HYDROXID Brand 2

CALC SULFATE POW ANHYDR Brand 2

CALC SULFATE POW HEMIHYDR Brand 2

CARBOXYM SOD GRA MED VISC Brand 2

CARBOXYMETHY POW SODIUM Brand 2

CITRIC ACID GRA ANHYDROU Brand 2

CITRIC ACID POW ANHYDROU Brand 2

CITRIC ACID POW MONOHYD Brand 2

DINITROCHLOR CRY 99% Brand 2

FULLERS POW EARTH Brand 2

GERMANIUM POW Brand 2

GINGER ROOT POW Brand 2

LEAD ACETATE POW TRIHYDRA Brand 2

LICORICE POW ROOT Brand 2

MANNITOL POW Brand 2

MENTHOL CRY Brand 2

POTASH SULFU MIS LUMP Brand 2

POT BITARTRA POW Brand 2



POT BROMIDE GRA Brand 2

POTASSIUM POW BROMIDE Brand 2

POT GLUCONAT POW ANHYDROU Brand 2

POT NITRATE GRA Brand 2

POT NITRATE POW Brand 2

POT PERCHLOR CRY Brand 2

PUMICE POW FLOUR Brand 2

ROSIN LUMP MIS Brand 2

SILICON POW DIOXIDE Brand 2

SILICA GEL Brand 2

SOD BROMIDE GRA Brand 2

CACODYLATE POW SODIUM Brand 2

SOD NITRITE GRA USP Brand 2

SOD NITRITE GRA Brand 2

SOD PERBORAT POW PURIFIED Brand 2

SOD PERBORAT CRY Brand 2

SOD SULFATE POW Brand 2

SOD SULFITE POW ANHYDROU Brand 2

SODIUM BUTYR POW Brand 2

SORBITOL POW Brand 2

CORN STARCH POW Brand 2

STRONTIUM CRY NITRATE Brand 2

SUCROSE POW Brand 2

SULFANILAMID POW Brand 2

TALC POW Brand 2

THEOPHYLLINE POW ANHYDROU Brand 2

THYMOL CRY Brand 2

THYMOL POW IODIDE Brand 2

IODOFORM POW Brand 2

METHENAMINE POW Brand 2

METHENAMINE POW MANDELAT Brand 2

PHENYLMERCUR POW ACETATE Brand 2



PHENYLMERCUR POW NITRATE Brand 2

PILOCARPINE POW HCL Brand 2

PILOCARPINE POW NITRATE Brand 2

DHEA POW Brand 2

DEHYDROEPIAN POW MICRO Brand 2

PREGNENOLONE POW Brand 2

PREGNENOLONE POW MICRONIZ Brand 2

PYROGALLOL CRY Brand 2

QUINIDINE CRY SULFATE Brand 2

RESORCINOL POW Brand 2

RESORCINOL CRY Brand 2

STANNOUS POW FLUORIDE Brand 2

ALLANTOIN POW Brand 2

ALUMINUM POW HYDROXID Brand 2

CAPSICUM LIQ OLEORESI Brand 2

CARBIDOPA POW ANHYDROU Brand 2

CARBIDOPA POW Brand 2

COENZYME Q10 POW Brand 2

DIMENHYDRIN POW USP Brand 2

DMPS POW Brand 2

EDETATE ACID POW Brand 2

EDETATE POW DISODIUM Brand 2

EDETATE POW SODIUM Brand 2

EPINEPHRINE POW Brand 2

FLUORESCEIN POW Brand 2

FLUORESCEIN POW SODIUM Brand 2

HOMATROPINE POW METHYLBR Brand 2

HYDROXYTRYPT POW Brand 2

5-HYDROXY-L- POW TRYPTOPH Brand 2

KETOCONAZOLE POW Brand 2

KOJIC ACID POW Brand 2

MELATONIN POW generic 1



MENADIONE NA CRY BISULFIT Brand 2

METHYLENE POW BLUE Brand 2

MINOXIDIL POW Brand 2

OXYBENZONE POW Brand 2

PYRUVIC ACID LIQ Brand 2

PYRUVIC ACID POW Brand 2

TINIDAZOLE POW Brand 2

DSS/SOD BENZ POW 85-15% Brand 2

NACL/NA BICA POW Brand 2

COAL TAR SOL 20% Brand 2

COAL TAR SOL Brand 2

COAL TAR SOL USP Brand 2

COAL TAR MIS Brand 2

PERUVIAN MIS BALSAM Brand 2

PERUVIAN LIQ BALSAM Brand 2

PERUVIAN POW BALSAM Brand 2

ACEPROMAZINE POW MALEATE Brand 2

ACESULFAME POW POTASSIU Brand 2

ACETAMIN POW Brand 2

ACETAMIN POW USP/NF Brand 2

APAP CRYSTAL CRY 60 MESH Brand 2

ACETARSONE POW Brand 2

ACETAZOLAMID POW Brand 2

HEXAPEPTIDE SOL ACETYL Brand 2

GLUCOSAMINE POW ACETYL-D Brand 2

ACETYL DIPEP SOL CETYL ES Brand 2

ACETYL-L-CAR POW HCL Brand 2

ACETYLCHOLIN POW CHLORIDE Brand 2

ACYCLOVIR POW Brand 2

ADENOSINE POW Brand 2

BLUE AGAVE LIQ ORGANIC Brand 2

ALASKAN RED POW ALGAE Brand 2



ALBENDAZOLE POW Brand 2

BOVINE SERUM POW ALBUMIN Brand 2

ALDOSTERONE POW Brand 2

ACTIPHYTE OF LIQ ALGAE Brand 2

ALGINIC ACID POW Brand 2

ALKYL BENZOA LIQ C12-15 Brand 2

ALLOPURINOL POW Brand 2

ALOE VERA OIL Brand 2

ALOE VERA POW Brand 2

ALOE VERA POW 200:1 Brand 2

ALOE VERA POW LEAF Brand 2

KETOGLUTARIC POW ACID Brand 2

ALPHA LIPOIC POW ACID Brand 2

LIPOIC ACID POW Brand 2

A-LIPOIC POW ACID Brand 2

ALPRAZOLAM POW Brand 2

ALPRAZOLAM POW USP Brand 2

ALTRENOGEST POW Brand 2

ALUMINUM POW ACETATE Brand 2

ALUMINUM POW CHLOROHY Brand 2

AMANTADINE POW HCL Brand 2

AMIKACIN POW Brand 2

AMINOCAPROIC POW ACID Brand 2

6-AMINOCAPRO POW ACID Brand 2

AMINOSALICYL POW SODIUM Brand 2

AMITRIPTYLIN KIT 2% Brand 2

AMLODIPINE POW BESYLATE Brand 2

MAGNASWEET LIQ 110 Brand 2

MAGNASWEET POW 135 Brand 2

AMMONIUM LIQ LAURYL Brand 2

AMMONIUM POW MOLYBDAT Brand 2

ANASTROZOLE POW Brand 2



ANDROSTENEDI POW Brand 2

ANISINDIONE POW Brand 2

ANTIMONY CRY TRICHLOR Brand 2

ANTIMONY POW TRISULF Brand 2

ANTIPYRINE CRY Brand 2

APOMORPHINE POW HCL Brand 2

ARBUTIN POW ALPHA Brand 2

ARGININE HCL POW Brand 2

L-ARGININE POW HCL Brand 2

ARSENIC POW TRIOXIDE Brand 2

ASCORBIC ACD GRA Brand 2

ASCORBIC ACD POW Brand 2

ASCORBIC ACD POW FINE Brand 2

ASCORBIC ACD POW CASSAVE Brand 2

ASCORBYL POW PALMITAT Brand 2

ASHWAGANDHA POW EXT 2.5% Brand 2

ASPARAGINE POW MONOHYDR Brand 2

ASTRAGALUS POW EXTRACT Brand 2

ATTAPULGITE POW Brand 2

AVOCADO OIL REFINED Brand 2

AZELAIC ACID MIS Brand 2

AZITHROMYCIN POW Brand 2

AZITHROMYCIN POW DIHYDRAT Brand 2

BACITRACIN POW MICRONIZ Brand 2

BASIC FUCHSI POW HCL Brand 2

BECLOMETHASO POW DIPROPIO Brand 2

BELLADONNA TIN Brand 2

BELLADONNA POW EXTRACT Brand 2

BENACTYZINE POW HCL Brand 2

BENAZEPRIL POW HCL Brand 2

BENZETHONIUM POW CHLORIDE Brand 2

BENZOIN GUM POW Brand 2



BENZOQUINONE CRY PARA Brand 2

BETA CAROTEN BEA 10% Brand 2

CYCLODEXTRIN POW BETA Brand 2

BETA GLUCAN POW Brand 2

BETAHISTINE POW DIHCL Brand 2

BETAINE POW ANHYDROU Brand 2

BETAINE HCL POW Brand 2

BETAMETH ACE POW Brand 2

BETAMETH ACE POW MICRONIZ Brand 2

BETANAPHTHOL POW 99% Brand 2

BETHANECHOL POW CHLORIDE Brand 2

BISABOLOL LIQ ALPHA-L Brand 2

BISMUTH POW CITRATE Brand 2

BITTER MELON POW EXTRACT Brand 2

BORON CITRAT POW 5% Brand 2

BOSWELLIA POW SERRATA Brand 2

BRILLIANT POW GREEN Brand 2

BUDESONIDE POW Brand 2

BUFLOMEDIL POW HCL Brand 2

BUPRENORPHIN POW HCL Brand 2

BUPROPION POW HCL Brand 2

BUSPIRONE POW HCL Brand 2

BUTALBITAL POW Brand 2

BUTORPHANOL POW TARTRATE Brand 2

BUTYL ALCOHO LIQ Brand 2

HYDROXYANISO POW BUTYLATE Brand 2

BUTYLENE LIQ GLYCOL Brand 2

CALCIPOTRIEN POW Brand 2

CALCITRIOL POW Brand 2

CALCITRIOL OIL ALMOND Brand 2

CALCIUM POW ACETATE Brand 2

CALCIUM POW ALGINATE Brand 2



CA CHLORIDE POW ANHYDR Brand 2

CALCIUM POW CITRATE Brand 2

CALCIUM POW GLUBIONA Brand 2

CALCIUM LEV POW DIHYDRAT Brand 2

CALCIUM POW PYRUVATE Brand 2

THIOGLYCOLAT POW CALCIUM Brand 2

YLANG-YLANG OIL FRAGRANC Brand 2

CAPRYLIC LIQ ACID Brand 2

CAPRYLIC CAP LIQ TRIGLYCE Brand 2

CAPRYLIC/CAP POW TRIGLYCE Brand 2

CAPTOPRIL POW Brand 2

CARBACHOL POW Brand 2

CARBAMIDE POW PEROXIDE Brand 2

CARBAZOCHROM POW Brand 2

ADRENOCHROME POW SEMICARB Brand 2

CARBIMAZOLE POW Brand 2

ETHOXY LIQ DIGLYCOL Brand 2

DIETHYLENE POW MONOETHY Brand 2

CARBOPOL 940 POW Brand 2

CARBOPOL 940 POW NF Brand 2

CARBOMER POW 934P Brand 2

CARBOMER POW 940 Brand 2

CARNAUBA WAX MIS Brand 2

CARNOSINE L POW Brand 2

L-CARNOSINE POW Brand 2

LOCUST BEAN POW GUM Brand 2

CANADIAN LIQ BALSAM Brand 2

CEFTAZIDIME POW SODIUM Brand 2

CEFTRIAXONE POW SODIUM Brand 2

CELECOXIB POW Brand 2

CELLULASE POW Brand 2

AVICEL PH105 POW MICROCRY Brand 2



CELLULOSE POW MICROCRY Brand 2

CELLULOSE CRY MICROCRY Brand 2

CELLULOSE/ POW CMC NA Brand 2

CERESIN WAX MIS Brand 2

CESIUM CHLOR POW Brand 2

CETEARYL ALC POW /CET-20 Brand 2

FREEDOM LIQ ESTERDER Brand 2

CETYL MYRIST OIL OLEATE Brand 2

CETYL MYRIST OIL 40% Brand 2

CETYL MYRIST POW OLEATE Brand 2

CETYL MYRIST POW OLEATE Brand 2

CETYL MYRIST POW 20% Brand 2

CETYL MYRIST MIS OLEATE Brand 2

CETYLPYRIDIN CRY CHLORIDE Brand 2

CHICKEN POW PROTEIN Brand 2

CHLORAMBUCIL POW USP Brand 2

CHLORAMBUCIL POW Brand 2

CHLORAMPHENI POW PALMITAT Brand 2

CHLORHEXIDIN POW DIACETAT Brand 2

CHLOROPHYLLN POW COPPER Brand 2

CHLOROXINE POW Brand 2

CHLOROXYLEN POW Brand 2

VITAMIN D3 LIQ Brand 2

VITAMIN D3 POW Brand 2

VITAMIN D3 POW Brand 2

CHOLESTEROL POW Brand 2

CHOLESTEROL MIS FLAKES Brand 2

CHOLESTYRAMI POW Brand 2

CHOLESTYRAMI POW RESIN Brand 2

CHOLINE POW CHLORIDE Brand 2

CHOLINE MAGN POW TRISALIC Brand 2

CHONDROITIN POW SULFATE Brand 2



CHORIONIC POW GONADOTR Brand 2

CHROMIUM POW CHLORIDE Brand 2

CHROMIC CRY CHLORIDE Brand 2

CHROMIUM POW PICOLINA Brand 2

CHROMIUM POW POLYNICO Brand 2

CHROMIUM K CRY SULF DOD Brand 2

CHRYSIN POW Brand 2

CINNAMON BRK POW CASSIA Brand 2

CIPROFLOXACN POW Brand 2

CIPROFLOXACN POW HCL Brand 2

CISAPRIDE POW MONOHYDR Brand 2

CITRULLINE POW (L) Brand 2

L-CITRULLINE POW Brand 2

CITRUS BIOFL POW 13% Brand 2

CLARITHROMYC POW Brand 2

CLEMIZOLE POW HCL Brand 2

CLIDINIUM POW BROMIDE Brand 2

CLINDAMYCIN POW HCL Brand 2

CLINDAMYCIN POW HCL MONO Brand 2

CLINDAMYCIN POW PHOSPHAT Brand 2

CLOFAZIMINE POW Brand 2

CLONAZEPAM POW Brand 2

CLOMIPRAMINE POW HCL Brand 2

CLORSULON POW Brand 2

COBALT POW GLUCONAT Brand 2

COBAMAMIDE POW Brand 2

COCAMIDE DEA POW Brand 2

COLISTIMETHA POW SODIUM Brand 2

COLLAGEN POW HYDROLYS Brand 2

COPPER POW GLUCONAT Brand 2

COPPER POW PEPTIDE Brand 2

CORAL POW CALCIUM Brand 2



CORN OIL Brand 2

ANDRENOCORTI POW HORMONE Brand 2

CORTICOTROPH POW Brand 2

COUMARIN POW Brand 2

CRANBERRY POW Brand 2

CREATINE POW Brand 2

CREATINE POW MONOHYDR Brand 2

CREATININE POW Brand 2

CRESOL LIQ Brand 2

CROTON OIL Brand 2

ACTIPHYTE OF LIQ CUCUMBER Brand 2

COPPER POW GLYCINAT Brand 2

CUPUACU MIS BUTTER Brand 2

CYCLOMETHICO LIQ Brand 2

CYCLOPENTOLA POW HCL Brand 2

CYCLANDELATE POW Brand 2

CYCLOPHOSPHA POW Brand 2

CYCLOPHOSPHA POW USP Brand 2

CYCLOSERINE POW Brand 2

CYCLOSPORINE POW A Brand 2

CYCLOSPORINE POW Brand 2

CYPROHEPTADI POW Brand 2

CYPROHEPTADI POW USP Brand 2

CYSTEAMINE POW Brand 2

L-CYSTEINE POW Brand 2

L-CYSTEINE POW HCL MONO Brand 2

DANTROLENE POW Brand 2

DAPIPRAZOLE POW HCL Brand 2

DAPSONE POW Brand 2

DEANOL LIQ Brand 2

PCCA DMAE LIQ COMPLEX Brand 2

DMAE POW BITARTRA Brand 2



DOW CORNING LIQ 1501 FL Brand 2

DEMECARIUM POW BROMIDE Brand 2

DEOXYCHOLIC POW ACID Brand 2

2-DEOXY-D POW -GLUCOSE Brand 2

BEEF LIVER POW DESICCAT Brand 2

DESMOPRESSIN POW ACETATE Brand 2

DESOXIMETASN POW Brand 2

DESOXYCORTIC POW ACETATE Brand 2

DEXAMETHASON POW ISONICOT Brand 2

DEXPANTHENOL LIQ Brand 2

DEXPANTHENOL POW Brand 2

DIAMINOPYRID POW Brand 2

GERMALL PLUS LIQ Brand 2

DIAZEPAM POW Brand 2

DIAZOXIDE POW Brand 2

DIBUCAINE POW Brand 2

DICHLOROACET LIQ Brand 2

DICHLORALPHE POW USP Brand 2

DICLAZURIL POW Brand 2

DICLOFENAC POW SODIUM Brand 2

DICUMAROL POW Brand 2

DICYCLOMINE POW Brand 2

DIETHANOLAMI LIQ Brand 2

DIETHYLCARB POW CITRATE Brand 2

DIETHYLPROPI POW HCL Brand 2

DIETHYLSTILB POW Brand 2

DIETHYL TOLU LIQ 98% Brand 2

DIHYROCODEIN POW BITARTRA Brand 2

DIIODO-L- POW THYRONIN Brand 2

DIINDOLYLMET POW Brand 2

DILTIAZEM POW Brand 2

DIMETHYLACET LIQ Brand 2



DIMETHYL POW FUMARATE Brand 2

DIMETHYLGLYC POW HCL Brand 2

PROSTAGLAND POW E2 Brand 2

DIOSGENIN POW Brand 2

DIOSMIN POW Brand 2

DIOXYBENZONE POW Brand 2

SYN-AKE LIQ Brand 2

DIPHENIDOL POW HCL Brand 2

DIPHENYLCYCL POW Brand 2

DIPYRIDAMOLE POW Brand 2

DISOPHENOL POW 97% Brand 2

DISULFIRAM POW Brand 2

D-MANNOSE POW Brand 2

DOCOSANOL POW Brand 2

DOPAMINE HCL POW Brand 2

RIBOSE (D) POW Brand 2

D-RIBOSE POW Brand 2

HYDROXYAPATI POW CALCIUM Brand 2

DYCLONINE POW USP Brand 2

DYCLONINE POW Brand 2

DYPHYLLINE POW Brand 2

ECONAZOLE POW NITRATE Brand 2

EDROPHONIUM POW CHLORIDE Brand 2

EMU OIL Brand 2

ENALAPRIL POW MALEATE Brand 2

ENROFLOXACIN POW Brand 2

EPINEPHRINE POW BITARTRA Brand 2

ERGOLOID POW MESYLATE Brand 2

ERYTHROMYCIN POW ESTOLATE Brand 2

ESTRADIOL POW BENZOATE Brand 2

ESTRADIOL POW CYPIONAT Brand 2

ESTRADIOL POW CYP USP Brand 2



ESTRADIOL POW VALERATE Brand 2

ETHOSUXIMIDE POW Brand 2

ETHYL OLEATE LIQ Brand 2

ETHYLENEDIAM LIQ 99% Brand 2

ETODOLAC POW Brand 2

ETOMIDATE POW Brand 2

ETOPOSIDE POW Brand 2

EUCALYPTOL LIQ Brand 2

FAMOTIDINE POW Brand 2

4 AMINOPYRID POW Brand 2

FENBENDAZOLE POW Brand 2

FERRIC CHLOR MIS HEXAHYDR Brand 2

FERRIC SUBSU SOL Brand 2

FERRIC POW SULFATE Brand 2

FERR BISGLYC POW CHELATE Brand 2

FERROUS POW FUMARATE Brand 2

FERROUS GRA GLUCONAT Brand 2

FERULIC ACID POW Brand 2

FEVERFEW POW Brand 2

FINASTERIDE POW Brand 2

FINASTERIDE CRY Brand 2

FLOXURIDINE POW Brand 2

FLUCONAZOLE POW generic 1

FLUCYTOSINE POW Brand 2

FLUNIXIN POW MEGLUMIN Brand 2

FLUOROURACIL POW Brand 2

FLUOROURACIL POW USP Brand 2

FLUOROURACIL POW USP/NF Brand 2

FLUOXETINE POW HCL Brand 2

FLUOXYMESTER POW Brand 2

FLUPHENAZINE POW DECANOAT Brand 2

FLUTICASONE POW PROPIONA Brand 2



METHYLPYRAZO LIQ Brand 2

FORMOTEROL POW FUMARATE Brand 2

FORSKOLIN POW Brand 2

FURAZOLIDONE POW Brand 2

GALACTOSE POW Brand 2

4-AMINOBUTYR CRY ACID Brand 2

GABAPENTIN POW Brand 2

GARDENIA OIL FRAGRANC Brand 2

GINKGO BILOB POW Brand 2

GINSENG ROOT POW Brand 2

GLUCONOLACTO POW Brand 2

GLUCOSAMINE POW HCL Brand 2

GLUCOSAMINE POW SULFATE Brand 2

GLUCOSAMINE POW SULFATE Brand 2

GLUCOSAMINE POW SUL NACL Brand 2

GLUTARALDEHY LIQ 50% Brand 2

GLUTARALDEHY SOL 25% Brand 2

GLYCEROL POW MONOOLEA Brand 2

GLYCERYL MIS MONOSTEA Brand 2

ARLACEL 165 POW Brand 2

GUANIDINEACE POW ACID Brand 2

GLYCOFUROL LIQ Brand 2

GLYCOSAMINOG LIQ Brand 2

GLYCYRRHIZIC POW ACID Brand 2

GOLD SODIUM POW THIOMALA Brand 2

GRAMICIDIN D POW Brand 2

GRAPESEED OIL Brand 2

GRAPE SEED OIL Brand 2

GREEN SOAP EMU Brand 2

GREEN TEA POW Brand 2

EGCG POW Brand 2

GREEN TEA OIL FRAGRANC Brand 2



GRISEOFULVIN POW MICRONIZ Brand 2

GRISEOFULVIN POW Brand 2

GUANABENZ POW ACETATE Brand 2

GUANETHIDINE POW SULFATE Brand 2

GUAR GUM POW Brand 2

GYMNEMA SYLV POW LEAF Brand 2

HALOPERIDOL POW Brand 2

HALOPERIDOL POW DECANOAT Brand 2

WITCH HAZEL EXT Brand 2

HAWTHORN POW BERRY Brand 2

ACTIPHYTE OF LIQ IVY Brand 2

HEMATOXYLIN POW Brand 2

HEPARIN SOD POW PORCINE Brand 2

HEPES POW Brand 2

HEPTAMINOL POW Brand 2

HISTAMINE CRY DIPHOSPH Brand 2

HISTAMINE CRY PHOSPHAT Brand 2

HONEY ALMOND LIQ FRAGRANC Brand 2

HUPRZN SER A POW 1% Brand 2

HYALURONIC POW ACID Brand 2

HYALURONIDAS POW BOVINE Brand 2

HYALURONATE POW SODIUM Brand 2

HYALURONIC POW SODIUM Brand 2

HYDRAZINE CRY SULFATE Brand 2

HYDROXOCOBAL POW Brand 2

HYDROXYAMPHE POW HBR Brand 2

HYDROXYCHLOR POW SULFATE Brand 2

HYDROXYETHYL POW CELLULOS Brand 2

HYDROXY CELL POW 1500 CPS Brand 2

HYDROXY CELL POW Brand 2

HYDROXYPROPY POW BETA-CYC Brand 2

HYDROXOCOBAL POW HCL Brand 2



HYDROXY METH POW 4000 Brand 2

METHOCEL POW K100M Brand 2

METHOCEL POW K100 Brand 2

METHOCEL E4M POW PREMIUM Brand 2

HYDROXYPROG POW CAPROATE Brand 2

HYDROXYUREA POW Brand 2

HYDROXYZINE POW HCL Brand 2

HYDROFLUORIC LIQ 48% Brand 2

HYDROXYETHYL POW METHACRY Brand 2

IDEBENONE POW Brand 2

IDOXURIDINE POW Brand 2

IMIDUREA POW Brand 2

IMIQUIMOD POW Brand 2

LIPACTIVE IN LIQ INCHI WO Brand 2

INDOCYANINE POW GREEN Brand 2

INDOLE-3- POW CARBINOL Brand 2

INOSITOL POW Brand 2

INOSITOL POW HEXANICO Brand 2

IODINE GRA RESUBLIM Brand 2

LUGOLS SOL Brand 2

IODINE SOL STRONG Brand 2

IOPANOIC POW ACID Brand 2

CERAPHYL SLK LIQ Brand 2

ISOMETHEPTEN POW MUCATE Brand 2

ISOPROPYL SOL MYRISTAT Brand 2

ISOPROTERENO POW HCL Brand 2

ISOSORBIDE POW Brand 2

ISOXSUPRINE POW HCL Brand 2

ITRACONAZOLE POW Brand 2

IVERMECTIN POW Brand 2

JASMINE LIQ FRAGRANC Brand 2

JOJOBA OIL Brand 2



KANAMYCIN POW SULFATE Brand 2

KETAMINE HCL POW Brand 2

KETOROLAC POW TROMETHA Brand 2

7-KETO DHEA POW Brand 2

KETOTIFEN POW FUMARATE Brand 2

KINETIN POW Brand 2

KIWI LIQ FRAGRANC Brand 2

PINENE POW L-ALPHA Brand 2

LABETALOL POW Brand 2

LACTASE 5000 POW Brand 2

ACIDO LACTOB POW 1BU/GM Brand 2

ACIDOPHILUS POW LACTOBAC Brand 2

ACIDO LACTOB POW 10BU/GM Brand 2

LAMOTRIGINE POW Brand 2

LANSOPRAZOLE POW Brand 2

LAURETH-9 LIQ POLIDOCA Brand 2

LAURIC ACID POW Brand 2

LEAD TETROXI POW 99% Brand 2

LEFLUNOMIDE POW Brand 2

LETROZOLE POW Brand 2

LEUCOVORIN POW CALCIUM Brand 2

CALCIUM POW FOLINATE Brand 2

LEUPROLIDE POW ACETATE Brand 2

LEVETIRACETA POW Brand 2

L-CARNITINE POW Brand 2

CARNITINE POW (L) Brand 2

LEVOCARNITIN POW Brand 2

LEVOCETIRIZI POW DHCL Brand 2

LEVOFLOXACIN POW HEMIHYDR Brand 2

LEVOFLOXACIN POW Brand 2

LEVOFLOXACIN POW HEMIHYDR Brand 2

LEVORPHANOL POW TARTRATE Brand 2



L-THYROXINE POW Brand 2

LEVOTHYROXIN POW SODIUM Brand 2

T4 SODIUM POW DILUTION Brand 2

LICORICE POW DEGLYCY Brand 2

LINCOMYCIN POW HCL Brand 2

LIDOCAINE POW Brand 2

LIDOCAINE POW USP Brand 2

LIDOCAINE POW BASE Brand 2

LIDOCAINE CRY Brand 2

LIMONENE LIQ Brand 2

LINOLEIC LIQ ACID Brand 2

LISINOPRIL POW Brand 2

LITHIUM CITR POW TETRAHYD Brand 2

LORATADINE POW Brand 2

LORAZEPAM POW Brand 2

L-SELENOMETH POW Brand 2

LUTEIN POW Brand 2

LUTEIN BEA 5% Brand 2

L-LYSINE HCL POW Brand 2

MAFENIDE POW ACETATE Brand 2

MAGNESIUM POW ALUMINUM Brand 2

MAGNESIUM POW ASCORBAT Brand 2

MAGNSIUM BIS POW DIHYDRAT Brand 2

MAG CITRATE POW TRIBASIC Brand 2

MAG CITRATE POW Brand 2

MAGNESIUM POW GLUCONAT Brand 2

MAGNESIUM POW GLYCINAT Brand 2

MAGNESIUM POW HYDROXID Brand 2

MAGNESIUM POW MALATE Brand 2

MAGNESIUM POW PHOSPHAT Brand 2

MALEIC ACID POW Brand 2

MALIC ACID POW Brand 2



MALTODEXTRIN POW Brand 2

MANDELIC POW ACID Brand 2

MANGANESE POW CHLORIDE Brand 2

MANGANESE POW GLUCONAT Brand 2

MANGANESE POW SULFATE Brand 2

MECAMYLAMINE POW HCL Brand 2

MECHLORETHAM POW HCL Brand 2

MECLOFENOXAT POW HCL Brand 2

MEDROXYPROG POW MICRONIZ Brand 2

MEDROXYPROGE POW ACETATE Brand 2

MEDROXYPROGE POW ACETATE Brand 2

MEGLUMINE POW Brand 2

MELOXICAM POW Brand 2

MENADIONE POW USP Brand 2

MEQUINOL POW Brand 2

MERCAPTOPURI POW USP Brand 2

MERCAPTOPURI POW MONOHYDR Brand 2

MERCAPTOPURI POW Brand 2

METACRESOL LIQ ACETATE Brand 2

METFORMIN POW HCL Brand 2

METHACRYLIC POW COPOLYME Brand 2

METHANESULFO LIQ ACID 99% Brand 2

METHOCARBAM POW Brand 2

2-METHOXYEST POW Brand 2

METHOXYETHAN LIQ Brand 2

METHSCOPOLAM POW BROMIDE Brand 2

METHSCOPOLAM POW NITRATE Brand 2

METHYLCOBALA POW Brand 2

METHYLCOBALA POW PREMIUM Brand 2

5-METHYLTETR POW CALCIUM Brand 2

METHYLPHENID POW HCL Brand 2

METHYSERGIDE POW MALEATE Brand 2



DIMETHYL POW SULFONE Brand 2

METRONIDAZOL POW Brand 2

METRONIDAZOL POW USP Brand 2

MEXILETINE POW HCL Brand 2

MIDAZOLAM POW Brand 2

MILK THISTLE POW Brand 2

MILK THISTLE POW EXTRACT Brand 2

MIRTAZAPINE POW ANHYDROU Brand 2

MISOPROSTOL POW HPMC 1% Brand 2

MITOMYCIN POW Brand 2

MITOMYCIN C POW Brand 2

MITOTANE POW Brand 2

MOLYBDENUM POW Brand 2

MOMETASONE POW Brand 2

MONOETHANOLA LIQ Brand 2

L-GLUTAMIC POW ACID Brand 2

MONTELUKAST POW SODIUM Brand 2

MORANTEL POW TARTRATE Brand 2

MOXISYLYTE POW HCL Brand 2

MUPIROCIN POW Brand 2

NABUMETONE POW Brand 2

NICOTINAMIDE POW ADENINE Brand 2

NALBUPHINE POW HCL Brand 2

NALOXONE HCL POW Brand 2

NALOXONE HCL POW DIHYDRAT Brand 2

NALTREXONE POW HCL Brand 2

NANDROLONE POW DECANOAT Brand 2

NEOSTIGMINE POW METHYLSU Brand 2

NICLOSAMIDE POW Brand 2

NADH DISODIU POW Brand 2

NADH DISODIU POW REDUCED Brand 2

NICOTINE POW POLACRIL Brand 2



NICOTINE POW TARTRATE Brand 2

NIMODIPINE POW Brand 2

NITROFURANTN POW ANHYDR Brand 2

NITROFURANTN POW Brand 2

NORETHINDRON POW Brand 2

TRITON X-100 LIQ Brand 2

OCTINOXATE LIQ Brand 2

OMEPRAZOLE POW Brand 2

ONDANSETRON POW HCL Brand 2

ORIGANUM OIL Brand 2

L-ORNITHINE POW HCL Brand 2

ORNITHINE POW HCL Brand 2

OXANDROLONE POW Brand 2

OXYBUTININ POW CHLORIDE Brand 2

OXYMETAZOLIN POW HCL Brand 2

HYDROXYQUINO POW SULFATE Brand 2

OXYTETRACYCL POW DIHYDRAT Brand 2

OXYTOCIN POW Brand 2

PALMAROSA OIL Brand 2

PALMITOYL GEL PENT-3 Brand 2

PANCREATIN POW Brand 2

PANCURONIUM POW BROMIDE Brand 2

PANTHENOL POW Brand 2

DL-PANTHENOL POW Brand 2

PAPAIN POW Brand 2

PARACHLOROPH POW Brand 2

PAROMOMYCIN POW SULFATE Brand 2

PEG-40 CASTO OIL Brand 2

PEG 400 POW MONOSTEA Brand 2

PEMOLINE POW Brand 2

PENNYROYAL OIL Brand 2

PENTOSAN POW SODIUM Brand 2



PENTOXIFYL POW Brand 2

PENTYLENE LIQ GLYCOL Brand 2

PENTYLENETET CRY Brand 2

PERGOLIDE POW MESYLATE Brand 2

PERMETHRIN LIQ Brand 2

PERPHENAZINE POW Brand 2

PEUCEDANUM SOL OSTRUTHI Brand 2

PHENELZINE POW SULFATE Brand 2

PHENINDIONE POW Brand 2

PHENOXYETHAN LIQ Brand 2

PHENOLSULFON LIQ ACID Brand 2

PHENOXYBENZA POW Brand 2

PHENTERMINE POW HCL Brand 2

PHENYL SALIC CRY Brand 2

PHENYLETHYLA POW HCL Brand 2

PHENYTOIN POW Brand 2

PHOSPHATIDYL POW CHOLINE Brand 2

PHYTIC ACID LIQ 50% Brand 2

PHYTONADIONE LIQ Brand 2

VITAMIN K1 POW Brand 2

PIMOBENDAN POW Brand 2

PINE NEEDLE OIL Brand 2

PINEAPPLE LIQ EXTRACT Brand 2

PIPERINE POW Brand 2

PIRACETAM POW Brand 2

PODOFILOX POW Brand 2

COSMOCIL CQ LIQ Brand 2

POLYHEXAMETH LIQ 20% BIGU Brand 2

BRIJ 35 MIS Brand 2

BRIJ 93 LIQ Brand 2

BRIJ 700 MIS Brand 2

POLYVINYL POW ALCOHOL Brand 2



POMEGRANATE OIL 80% Brand 2

PONAZURIL POW Brand 2

POTASSIUM POW ACETATE Brand 2

POT ACETATE CRY Brand 2

POTASSIUM POW METABISU Brand 2

POTASSIUM POW ASPARTAT Brand 2

POT AZELAOYL LIQ DIGLYCIN Brand 2

POTASSIUM GRA IODIDE Brand 2

POTASSIUM POW IODIDE Brand 2

POTASSIUM CRY IODIDE Brand 2

POT PHOSPHAT POW MONOBAS Brand 2

POT PHOSPHAT CRY MONOBASI Brand 2

POT PHOSPHAT GRA DIBASIC Brand 2

POT PHOSPHAT POW DIBASIC Brand 2

POTASSIUM POW SULFATE Brand 2

POVIDONE POW K-30 Brand 2

POVIDONE POW Brand 2

POVIDONE POW IODINE Brand 2

POWDER SCENT LIQ FRAGRANC Brand 2

PRALIDOXIME POW CHLORIDE Brand 2

PRAZIQUANTEL POW Brand 2

PRIMIDONE POW Brand 2

PROCHLORPERA POW EDISYLAT Brand 2

PROFLAVINE POW HEMISULF Brand 2

PROMAZINE POW HCL Brand 2

PROMETHAZINE POW HCL Brand 2

PROMETHAZINE CRY HCL Brand 2

PROPARACAINE POW HCL Brand 2

PROPYL POW GALLATE Brand 2

PROPYLENE LIQ GLYCOL Brand 2

PROPYLENE GL BEA MONOSTEA Brand 2

PROPYLTHIOUR POW Brand 2



PROTAMINE POW SULFATE Brand 2

PROTIRELIN POW Brand 2

PSYLLIUM POW HUSK Brand 2

PYRANTEL POW PAMOATE Brand 2

PYRIDOSTIGMI POW BROMIDE Brand 2

PYRIDOXAL-5- POW PHOSPHAT Brand 2

PYRIMETHAMIN POW Brand 2

ZINC PYRITHI LIQ Brand 2

QUATERNIUM- POW 15 Brand 2

QUERCETIN POW DIHYDRAT Brand 2

QUININE HCL CRY Brand 2

RACEPINEPHRI POW HCL Brand 2

RANITIDINE POW HCL Brand 2

RAPESEED OIL Brand 2

RAUWOLFIA POW SERPENTI Brand 2

RED YEAST POW RICE Brand 2

RESVERATROL POW Brand 2

RIBAVIRIN POW Brand 2

RIBOFLAVIN POW Brand 2

RIBO-5-PHOSP POW SODIUM Brand 2

RONIDAZOLE POW Brand 2

ROSE BENGAL POW B Brand 2

RUBIDIUM POW CHLORIDE Brand 2

RUTIN POW Brand 2

SACCHARIN CRY CALCIUM Brand 2

AC DERMAPEPT LIQ Brand 2

SAGE LEAF POW Brand 2

SALSALATE POW Brand 2

SAW PALMETTO POW Brand 2

SAW PALMETTO POW BERRY Brand 2

SCARLET RED POW Brand 2

SECRETIN- POW MANNITOL Brand 2



SELENIUM POW SULFIDE Brand 2

SELENIUM POW YEAST Brand 2

SENNA EXT Brand 2

SERMORELIN POW ACETATE Brand 2

SEROTONIN POW HCL Brand 2

SERTRALINE POW Brand 2

SHARK POW CARTLG Brand 2

SHOWER FRESH LIQ FRAGRANC Brand 2

SIB GINSENG POW Brand 2

SILICONE LIQ Brand 2

DOW CORNING LIQ 200 Brand 2

SILICONE GEL BLEND Brand 2

SILICNE BLND PST CUSTOM Brand 2

SILVER SULFA POW Brand 2

SIMVASTATIN POW Brand 2

SINCALIDE IN POW MANNITOL Brand 2

SIROLIMUS POW Brand 2

SOD ACETATE POW TRIHYDRA Brand 2

SOD ALGINATE POW Brand 2

ASCRBYL PHOS POW SOD DIHY Brand 2

SODIUM POW CAPRATE Brand 2

SODIUM POW CAPYRLAT Brand 2

SODIUM POW BICARBON Brand 2

SOD BISULFIT GRA Brand 2

SODIUM MIS CHLORITE Brand 2

SOD CITRATE POW DIHYDRAT Brand 2

NA COCOYL LIQ GLUTAMTE Brand 2

DEHYDROACETA POW SODIUM Brand 2

DEOXYCHOLATE POW SODIUM Brand 2

DEOXYCHOLIC POW ACID Brand 2

SODIUM POW DICHLORO Brand 2

SOD FLUORIDE POW Brand 2



SODIUM POW GLUCONAT Brand 2

SOD IODIDE GRA Brand 2

SOD LACTATE SOL 60% Brand 2

SODIUM LAURE POW SULFATE Brand 2

SOD METABISU GRA Brand 2

SOD METABISU POW Brand 2

SOD FLUORO POW PHOSPHAT Brand 2

SODIUM POW NITRATE Brand 2

SODIUM POW OLEATE Brand 2

PHENYLBUTYRA POW SODIUM Brand 2

SOD PHOSPHAT GRA DIBASIC Brand 2

SOD PHOS DIB POW ANHYDR Brand 2

SOD PHOS DIB POW DRIED Brand 2

SOD PHOS DIB POW HEPTAHYD Brand 2

SOD PHOSPHAT CRY DIBASIC Brand 2

NA PHOS MONO POW ANHYDROU Brand 2

SOD PHOSPHAT CRY TRIBASIC Brand 2

SODIUM LIQ PIDOLATE Brand 2

SOD PROPION POW Brand 2

SODIUM POW SELENITE Brand 2

SOD STEARATE POW Brand 2

SOD STEARYL POW FUMARATE Brand 2

SODIUM POW SUCCINAT Brand 2

SODIUM TARTR POW DIHYDRAT Brand 2

SOD TETR SUL SOL 27% Brand 2

SODIUM TETRA POW SULFATE Brand 2

THIOSALICYLI POW SODIUM Brand 2

SORBITAN LIQ MONOLAUR Brand 2

SORBITAN LIQ MONOOLEA Brand 2

SORBITAN POW MONOPALM Brand 2

SOYABEAN POW CASEIN Brand 2

LECITHIN SOY GRA Brand 2



LECITHIN GRA SOYA Brand 2

LECITHIN GRA Brand 2

LECITHIN SOY POW Brand 2

PHOSPHATIDYL POW 40% Brand 2

CETYL ESTERS MIS Brand 2

SQUALANE LIQ Brand 2

SQUALANE OIL Brand 2

SQUARIC ACID POW Brand 2

DIBUTYL LIQ SQUARATE Brand 2

STANNOUS CRY CHLORIDE Brand 2

STANOZOLOL POW Brand 2

STEVIA POW EXTRACT Brand 2

STEVIOL GLYC POW 95% Brand 2

STEVIOSIDE EXT 15% Brand 2

STEVIOSIDE POW 90% Brand 2

ST JOHNS POW WORT Brand 2

STRONTIUM CRY CHLORIDE Brand 2

DIMERCAPTOSU POW ACID Brand 2

SUCCIMER DMS POW Brand 2

SUCCINIC ACD CRY Brand 2

SUCCINYLCHOL POW CHLORIDE Brand 2

SUCROSE OCTA CRY ACETATE Brand 2

SUFENTANIL POW CITRATE Brand 2

SULFACETAMID POW USP Brand 2

SULFADIMETHO POW Brand 2

SULFAMERAZIN POW Brand 2

SULFOSALICYL POW DIHYDRAT Brand 2

SULFUR POW Brand 2

SULFUR POW PRECIPIT Brand 2

SULFUR POW SUBLIMED Brand 2

SULPIRIDE POW Brand 2

SUMATRIPTAN POW Brand 2



SUMATRIPTAN POW SUCCINAT Brand 2

SUPEROXIDE SOL DISMUTAS Brand 2

SUPEROXIDE POW DISMUTAS Brand 2

TACROLIMUS POW MONOHYD Brand 2

TACROLIMUS POW Brand 2

TAMOXIFEN POW CITRATE Brand 2

TAZAROTENE POW Brand 2

TEA TREE OIL Brand 2

TERBINAFINE POW HCL Brand 2

TESTOSTERONE POW MICRONIZ Brand 2

TESTOSTERONE CRY YAM Brand 2

TESTOSTERONE POW ENANTHAT Brand 2

TETRACAINE POW Brand 2

TETRAHYDROBI POW DIHCL Brand 2

TETRAHYDROZ POW Brand 2

THEANINE POW Brand 2

THEOBROMINE POW Brand 2

THIOGUANINE POW Brand 2

THIORIDAZINE POW HCL Brand 2

THIOTEPA POW Brand 2

THYROID 3X POW PORCINE Brand 2

TITANIUM DIO LIQ 30% Brand 2

TITANIUM POW DIOXIDE Brand 2

TIZANIDINE POW HCL Brand 2

TOBRAMYCIN POW Brand 2

TOLAZOLINE POW HCL Brand 2

TOLUIDINE POW BLUE O Brand 2

TOLTRAZURIL POW Brand 2

TOPIRAMATE POW Brand 2

TRAMADOL HCL POW Brand 2

TRANEXAMIC POW ACID Brand 2

TRANILAST POW Brand 2



RENOVAGE LIQ Brand 2

TRIACETIN LIQ Brand 2

TRIAMCINOLON POW USP Brand 2

TRIAMCINOLON POW Brand 2

TRIAMCINOLON POW HEXACETO Brand 2

TRICHLORMETH POW USP Brand 2

TRICLOSAN POW Brand 2

TEA LAURYL LIQ SULFATE Brand 2

TRIFLURIDINE POW Brand 2

TRILOSTANE POW Brand 2

TRIMEPRAZINE POW TARTRATE Brand 2

TRIMETHOBENZ POW HCL Brand 2

TRIOXSALEN POW Brand 2

TRIPROLIDINE CRY Brand 2

TROMETHAMINE POW Brand 2

TROPOLONE POW Brand 2

TRYPSIN POW Brand 2

TURMERIC POW Brand 2

CURCUMIN POW Brand 2

TYLOSIN POW TARTRATE Brand 2

TYLOXAPOL LIQ Brand 2

UBIQUINOL POW Brand 2

UBIQUINOL POW 30% Brand 2

UREA POW Brand 2

URIDINE POW Brand 2

URSODIOL POW Brand 2

VALACYCLOVIR POW HCL Brand 2

VALERIAN POW ROOT Brand 2

VALPROIC ACI LIQ Brand 2

SOD VALPROAT POW Brand 2

VALPROATE POW SODIUM Brand 2

VANADIUM POW Brand 2



VANADYL CRY SULFATE Brand 2

VIDARABINE POW Brand 2

VINPOCETINE POW Brand 2

RETINOL FILM OIL MOLECULR Brand 2

VITAMIN A BEA ACETATE Brand 2

VITAMIN A LIQ PALMITAT Brand 2

TOCOPHEROL LIQ ALPHA Brand 2

VITAMIN E LIQ ACETATE Brand 2

VITAMIN E POW SUCCINAT Brand 2

TOCOPHERYL POW SUCCINAT Brand 2

VORICONAZOLE POW Brand 2

WHEY PROTEIN POW ISOLATE Brand 2

WHITE KIDNEY POW BEAN EXT Brand 2

SEPICALM VG LIQ Brand 2

XYLAZINE HCL POW Brand 2

XYLITOL POW Brand 2

XYLOMETAZOLI POW HCL Brand 2

YEAST EXTRCT LIQ Brand 2

YOHIMBINE POW Brand 2

ZEAXANTHIN POW Brand 2

ZINC ACETATE POW Brand 2

ZINC CHLORID POW Brand 2

ZINC CITRATE POW Brand 2

ZINC GLUCONA POW Brand 2

MONOMETHIONI POW ZINC Brand 2

ZINC OXIDE POW Brand 2

ZINC PICOLIN POW Brand 2

ZN UNDECYLEN POW USP Brand 2

ZN UNDECYLEN POW Brand 2

ZIRCONIUM POW OXIDE Brand 2

NATAPRES LIQ Brand 2

POLYOX POW WSR-301 Brand 2



Contraceptives

PARAGARD IUD T380A Brand 0

JOLIVETTE TAB 0.35MG generic 0

ERRIN TAB 0.35MG generic 0

NORA-BE TAB 0.35MG generic 0

ORTHO MICRON TAB 0.35MG Brand 0 GR

JENCYCLA TAB 0.35MG generic 0

NOR-QD TAB 0.35MG Brand 0 GR

CAMILA TAB 0.35MG generic 0

NORETHINDRON TAB 0.35MG generic 0

LYZA TAB 0.35MG generic 0

HEATHER TAB 0.35MG generic 0

MEDROXYPR AC INJ 150MG/ML generic 0 QL 1/90

DEPO-PROVERA INJ 150MG/ML Brand 0 GR

DEPO-SQ PROV INJ 104 Brand 0

SKYLA IUD 13.5MG Brand 0 QL 1/365

MIRENA IUD SYSTEM Brand 0

NEXPLANON IMP 68MG Brand 0

IMPLANON IMP 68MG Brand 0

LEVONORGESTR TAB 0.75MG generic 0

PLAN B TAB 0.75MG Brand 0 GR

NEXT CHOICE TAB 1.5MG generic 0

MY WAY TAB 1.5MG generic 0

PLAN B TAB 1.5MG Brand 0 GR

LEVONORGESTR TAB 1.5MG generic 0

ELLA TAB 30MG Brand 0

ORTHO EVRA DIS WEEK Brand 0

NUVARING MIS Brand 0

APRI TAB generic 0

ENSKYCE TAB generic 0

ORTHO-CEPT TAB 28 Brand 0 GR



DESOGEN-28 TAB Brand 0 GR

SOLIA TAB generic 0

RECLIPSEN TAB generic 0

EMOQUETTE TAB generic 0

VESTURA TAB 3-0.02MG generic 0

YAZ TAB 3-0.02MG Brand 0 GR

LORYNA TAB 3-0.02MG generic 0

GIANVI TAB 3-0.02MG generic 0

OCELLA TAB 3-0.03MG generic 0

ZARAH TAB 3-0.03MG generic 0

SYEDA TAB 3-0.03MG generic 0

DROSPIR/ETHI TAB 3-0.03MG generic 0

YASMIN 28 TAB 3-0.03MG Brand 0 GR

KELNOR TAB 1/35 generic 0

ZOVIA 1/35E TAB generic 0

ZOVIA 1/50E TAB Brand 0

LUTERA TAB generic 0

AUBRA TAB 0.1-0.02 generic 0

FALMINA TAB generic 0

ORSYTHIA TAB generic 0

LEVONOR/ETHI TAB 0.1-0.02 generic 0

AVIANE TAB generic 0

LESSINA TAB generic 0

SRONYX TAB generic 0

MARLISSA TAB 0.15/30 generic 0

PORTIA-28 TAB generic 0

LEVORA-28 TAB 0.15/30 generic 0

LEVONOR/ETHI TAB ESTRADIO generic 0

KURVELO TAB 0.15/30 generic 0

ALTAVERA TAB generic 0

CHATEAL TAB 0.15/30 generic 0

OVCON-35 TAB Brand 0 GR



ZENCHENT TAB generic 0

BRIELLYN TAB generic 0

BALZIVA TAB generic 0

PHILITH TAB 0.4-35 generic 0

GILDAGIA TAB 0.4-35 generic 0

BREVICON TAB 0.5/35 Brand 0 GR

MODICON TAB 0.5/35 Brand 0 GR

NORTREL TAB 0.5/35 generic 0

NECON TAB 0.5/35 generic 0

WERA TAB 0.5/35 generic 0

NORINYL TAB 1/35 Brand 0 GR

CYCLAFEM TAB 1/35 generic 0

ALYACEN TAB 1/35 generic 0

DASETTA TAB 1/35 generic 0

PIRMELLA TAB 1/35 generic 0

NORTREL TAB 1/35 generic 0

ORTHO-NOVUM TAB 1/35 Brand 0 GR

NECON TAB 1/35 generic 0

LOESTRIN TAB 1/20-21 Brand 0 GR

GILDESS TAB 1/20 generic 0

JUNEL 1/20 TAB generic 0

MICROGESTIN TAB 1/20 generic 0

LOESTRIN 21 TAB 1.5/30 Brand 0 GR

JUNEL 1.5/30 TAB generic 0

MICROGESTIN TAB 1.5/30 generic 0

GILDESS TAB 1.5/30 generic 0

NECON TAB 1/50-28 Brand 0

NORINYL TAB 1+50-28 Brand 0

LOW-OGESTREL TAB generic 0

ELINEST TAB generic 0

CRYSELLE-28 TAB 28 TABS generic 0

OGESTREL TAB generic 0



MONONESSA TAB generic 0

MONO-LINYAH TAB 0.25-35 generic 0

ESTARYLLA TAB 0.25-35 generic 0

NORGEST/ETHI TAB 0.25/35 generic 0

ORTHO-CYCLEN TAB 0.25/35 Brand 0 GR

PREVIFEM TAB generic 0

SPRINTEC 28 TAB 28 DAY generic 0

BEYAZ TAB Brand 0

SAFYRAL TAB Brand 0

WYMZYA FE CHW 0.4MG-35 generic 0

ZENCHENT FE CHW 0.4MG-35 generic 0

FEMCON FE CHW Brand 0 GR

GENERESS FE CHW Brand 0

LOESTRIN FE TAB 1/20 Brand 0 GR

GILDESS FE TAB 1/20 generic 0

JUNEL FE TAB 1/20 generic 0

MICROGESTIN TAB FE 1/20 generic 0

MICROGESTIN TAB FE1.5/30 generic 0

LOESTRIN FE TAB 1.5/30 Brand 0 GR

JUNEL FE TAB 1.5/30 generic 0

GILDESS FE TAB 1.5/30 generic 0

MINASTRIN 24 CHW FE Brand 0

AZURETTE TAB 28 DAY generic 0

VIORELE TAB generic 0

KARIVA TAB 28 DAY generic 0

MIRCETTE TAB 28 DAY Brand 0 GR

NECON TAB 10/11-28 generic 0

LO LOESTRIN TAB Brand 0

LO MINASTRIN PAK FE Brand 0

CYCLESSA PAK Brand 0 GR

VELIVET PAK generic 0

CAZIANT PAK generic 0



CESIA PAK generic 0

LEVONEST TAB generic 0

MYZILRA TAB generic 0

TRIVORA-28 TAB generic 0

ENPRESSE-28 TAB generic 0

CYCLAFEM TAB 7/7/7 generic 0

NECON TAB 7/7/7 generic 0

NORTREL TAB 7/7/7 generic 0

DASETTA TAB 7/7/7 generic 0

ALYACEN TAB 7/7/7 generic 0

PIRMELLA TAB 7/7/7 generic 0

ORTHO-NOVUM TAB 7/7/7 Brand 0 GR

LEENA TAB generic 0

TRI-NORINYL TAB 28 Brand 0 GR

ARANELLE TAB generic 0

ORTHO TRI- TAB CYCLN LO Brand 0

NORGEST/ETHI TAB ESTRADIO generic 0

TRI-ESTARYLL TAB generic 0

ORTHO TRI- TAB CYCLEN Brand 0 GR

TRINESSA TAB generic 0

TRI-PREVIFEM TAB generic 0

TRI-SPRINTEC TAB generic 0

TRI-LINYAH TAB generic 0

TILIA FE TAB generic 0

TRI-LEGEST TAB FE generic 0

ESTROSTEP FE TAB Brand 0 GR

NATAZIA TAB Brand 0

AMETHIA LO TAB generic 0

LOSEASONIQUE TAB Brand 0 GR

CAMRESE LO TAB generic 0





INTROVALE TAB generic 0

JOLESSA TAB generic 0

QUASENSE TAB generic 0

SEASONIQUE TAB Brand 0 GR

DAYSEE TAB generic 0

CAMRESE TAB generic 0

AMETHIA TAB generic 0

QUARTETTE TAB Brand 0

AMETHYST TAB 90-20MCG generic 0

Corticosteroids

CELESTONE SOL 0.6MG/5 Brand 2

ENTOCORT EC CAP 3MG/24HR Brand 2 GR

BUDESONIDE CAP 3MG/24HR generic 1

UCERIS TAB 9MG Brand 2 QL 90/30

CORTISONE AC TAB 25MG generic 1

DEXAMETHASON TAB 0.5MG generic 1


DEXAMETHASON TAB 1MG generic 1





DEXAMETHASON ELX 0.5/5ML generic 1

BAYCADRON ELX 0.5/5ML generic 1

DEXAMETHASON CON 1MG/ML generic 1

DEXAMETHASON SOL 0.5/5ML generic 1

DEXPAK PAK 6 DAY Brand 2



DEXAMETH PHO INJ 4MG/ML generic 1





CORTEF TAB 5MG Brand 2 GR

HYDROCORT TAB 5MG generic 1





A-HYDROCORT INJ 100MG generic 1

SOLU-CORTEF INJ 100MG Brand 2 GR

SOLU-CORTEF INJ 250MG Brand 2



MEDROL TAB 2MG Brand 2

METHYLPRED TAB 4MG generic 1

MEDROL TAB 4MG Brand 2 GR







METHYLPRED PAK 4MG generic 1

MEDROL PAK 4MG Brand 2 GR

DEPO-MEDROL INJ 20MG/ML Brand 2

METHYLPR ACE INJ 40MG/ML generic 1

DEPO-MEDROL INJ 40MG/ML Brand 2 GR

DEPO-MEDROL INJ 80MG/ML Brand 2 GR

METHYLPR ACE INJ 80MG/ML generic 1

A-METHAPRED INJ 40MG generic 1

SOLU-MEDROL INJ 40MG Brand 2 GR

METHYLPR SS INJ 40MG generic 1

A-METHAPRED INJ 125MG generic 1







SOLU-MEDROL INJ 1GM Brand 2 GR


METHYLPR SS INJ 1GM generic 1

SOLU-MEDROL INJ 2GM Brand 2

MILLIPRED TAB 5MG Brand 2

PREDNISOLONE SOL 15MG/5ML generic 1

PREDNISOLONE SYP 15MG/5ML generic 1

PRELONE SYP 15MG/5ML Brand 2 GR

MILLIPRED DP PAK 5MG Brand 2

FLO-PRED SUS Brand 2 PA

ASMALPRED SOL PLUS generic 1


ORAPRED SOL 15MG/5ML Brand 2 GR


PEDIAPRED SOL 6.7/5ML Brand 2 GR

PRED SOD PHO SOL 5MG/5ML generic 1

MILLIPRED SOL 10MG/5ML Brand 2

VERIPRED 20 SOL 20MG/5ML Brand 2

ORAPRED ODT TAB 10MG Brand 2



PREDNISONE TAB 1MG generic 1

PREDNISONE TAB 2.5MG generic 1





RAYOS TAB 1MG Brand 2 PA





PREDNISONE CON 5MG/ML generic 1

PREDNISONE SOL 5MG/5ML generic 1

PREDNISONE PAK 5MG generic 1

PREDNISONE PAK 10MG generic 1

KENALOG-10 INJ 10MG/ML Brand 2

KENALOG-40 INJ 40MG/ML Brand 2

ARISTOSPAN INJ 5MG/ML Brand 2

ARISTOSPAN INJ 20MG/ML Brand 2

CELESTONE INJ SOLUSPAN Brand 2 GR

BETA-PHOS/AC INJ 3-3MG/ML generic 1

PHYS EZ USE KIT M-PRED Brand 2

JNT/TUNNEL/ KIT TRIGGER Brand 2

FLUDROCORT TAB 0.1MG generic 1

Cough/Cold/Allergy

HYDROCODONE/ TAB HOMATROP generic 1

TUSSIGON TAB 5MG generic 1

HYDROCOD/HOM SYP 5-1.5/5 generic 1

HYDROMET SYP 5-1.5/5 generic 1

BENZONATATE CAP 100MG generic 1

BENZONATATE CAP 200MG generic 1

ACETYLCYST SOL 10% generic 1

ACETYLCYST SOL 20% generic 1

SOD CHLORIDE NEB 0.9% generic 1

NEBUSAL NEB 3% generic 1

SODIUM CHLOR NEB 3% generic 1



CLARINEX-D TAB 2.5-120 Brand 2 NON-PREF ST

CLARINEX-D TAB 5-240MG Brand 2 NON-PREF ST



PROMETH VC SYP PLAIN generic 1

PROMETH/COD SYP 6.25-10 generic 1

HYD POL/CPM LIQ 10-8/5ML generic 1

PROMETHAZINE SYP DM generic 1

TGQ 7.5PEH/4 LIQ BRM/15DM generic 1

DM/CPM/PE DRO generic 1

HDC DM SYP generic 1

BROMFED DM SYP generic 1

TGQ 30/PSE/3 SYP BRM/15DM generic 1

TGQ 50PSE/3 SYP BRM/30DM generic 1

PE/GUAIFENES DRO 1.5-20MG generic 1

GUAIATUSSIN SYP AC generic 1

NORTUSS-EX LIQ 200-20/5 generic 1

BIOTUSS LIQ generic 1

TUSSAFED EX LIQ generic 1

BIOTUSS LIQ PEDIATRC generic 1

NORTUSS-DE DRO generic 1

TGQ 30/ SYP 150/15 generic 1

Dermatologics

ADAPALENE CRE 0.1% generic 1 NON-PREF ST

DIFFERIN CRE 0.1% Brand 2 PREF

ADAPALENE GEL 0.1% generic 1 NON-PREF ST

DIFFERIN GEL 0.1% Brand 2 PREF

DIFFERIN GEL 0.3% Brand 2 PREF

DIFFERIN LOT 0.1% Brand 2 PREF

AZELEX CRE 20% Brand 2

BP WASH LIQ 2.5% generic 1

LAVOCLEN-4 LIQ CREM WSH Brand 2

BENZAC AC LIQ 5% WASH Brand 2 GR

BENZAC W LIQ 5% WASH Brand 2 GR

SE BPO WASH LIQ 7% generic 1



BP WASH LIQ 7% generic 1

PR BENZOYL LIQ 7% WASH generic 1

LAVOCLEN-8 LIQ CREM WSH Brand 2

BENZIQ WASH LIQ 5.25% generic 1

RIAX AER 5.5% Brand 2 PA

RIAX AER 9.5% Brand 2 PA

BP FOAM AER 9.8% generic 1

BENZEFOAM AER 9.8% Brand 2 GR

BENZEPRO SC AER 9.8% generic 1

BENZOYL PERO AER 9.8% generic 1

BENZOYL PER AER 9.8% generic 1

BENZIQ LS GEL 2.75% Brand 2

BENZIQ GEL 5.25% Brand 2

BPO GEL 4% generic 1

BPO GEL 8% Brand 2

CLEARPLEX X GEL 10% generic 1

OSCION CLNSR LOT 6% generic 1

ZACLIR LOT 8% generic 1

BPO CLOTHS MIS 3% Brand 2



BPO CREAMY KIT 8% WASH generic 1

BENZOYL PERO KIT ACNE PCK generic 1

NUOX GEL 6-3% Brand 2 PA

ZENATANE CAP 10MG generic 1

AMNESTEEM CAP 10MG generic 1

CLARAVIS CAP 10MG generic 1

ABSORICA CAP 10MG Brand 2 QL 60/30 PA

MYORISAN CAP 10MG generic 1















SULFOAM SHA 2% Brand 2

FABIOR AER 0.1% Brand 2 PA

AVITA CRE 0.025% generic 1 NON-PREF ST

TRETINOIN CRE 0.025% generic 1 PREF

RETIN-A CRE 0.025% Brand 2 NON-PREF ST

TRETIN-X CRE 0.0375% Brand 2



TRETIN-X CRE 0.075% Brand 2



RETIN-A GEL 0.01% Brand 2 NON-PREF ST

TRETINOIN GEL 0.01% generic 1 PREF

AVITA GEL 0.025% generic 1 NON-PREF ST


RETIN-A GEL 0.025% Brand 2 NON-PREF ST

ATRALIN GEL 0.05% Brand 2 NON-PREF ST


TRETINOIN GEL 0.04%PMP generic 1 PREF

RETIN-A MICR GEL 0.04% Brand 2 GR

RETIN-A MICR GEL 0.04%PMP Brand 2 GR

TRETINOIN GEL 0.1%PUMP generic 1 PREF

RETIN-A MICR GEL 0.1% Brand 2 NON-PREF ST




RETIN-A MICR GEL 0.1%PUMP Brand 2 NON-PREF ST

CLINDAMYCIN SOL 1% generic 1

CLEOCIN-T SOL 1% Brand 2 GR

CLINDAMYCIN AER 1% generic 1

EVOCLIN AER 1% Brand 2 GR

CLINDAMAX GEL 1% generic 1

CLINDAGEL GEL 1% Brand 2 PA

CLINDAMYCIN GEL 1% generic 1

CLEOCIN-T GEL 1% Brand 2 GR

CLEOCIN-T LOT 1% Brand 2 GR

CLINDAMYCIN LOT 1% generic 1

CLINDAMYCIN LOT 10MG/ML generic 1

CLINDAMAX LOT 10MG/ML generic 1

CLEOCIN-T PAD 1% Brand 2 GR

CLINDAMYCIN PAD 1% generic 1

CLINDACIN-P PAD 1% generic 1

CLINDACIN MIS ETZ 1% generic 1

ACZONE GEL 5% Brand 2 PA

ERYTHROMYCIN SOL 2% generic 1

ERYTHROMYCIN GEL 2% generic 1

AKNE-MYCIN OIN 2% Brand 2 PA

ERYTHROMYCIN PAD 2% generic 1

ERY PAD 2% generic 1

SULFACETAMID LOT 10% generic 1

SULFACETAMID SUS 10% generic 1

KLARON LOT 10% Brand 2 GR

EPIDUO GEL 0.1-2.5% Brand 2 NON-PREF ST

BENZAMYCIN GEL PAK Brand 2

ERYTHROMYCIN GEL /BENZOYL generic 1

BENZAMYCIN GEL Brand 2 GR

BENZAMYCIN GEL 5-3% Brand 2 GR



ZACARE KIT KIT 4% Brand 2

ZACARE KIT KIT 8% Brand 2

CLINDAMY/BEN GEL 1-5% generic 1 NON-PREF ST

BENZACLIN GEL 1-5% Brand 2 PREF PA

BENZACLIN GEL 1-5%PUMP Brand 2 PREF PA

ACANYA GEL 1.2-2.5% Brand 2 NON-PREF ST

CLINDAMY/BEN GEL 1.2-5% generic 1 NON-PREF ST

DUAC GEL 1.2-5% Brand 2 GR

VELTIN GEL Brand 2 NON-PREF ST

ZIANA GEL Brand 2 NON-PREF ST

VANOXIDE-HC LOT 5-0.5% Brand 2

ZENCIA LIQ 9-4% generic 1

SUMAXIN WASH LIQ 9-4% Brand 2 GR

SOD SUL/SULF LIQ WASH generic 1

SOD SUL/SULF LIQ 9-4.5% generic 1

SUMADAN WASH LIQ 9-4.5% Brand 2 GR

SOD SUL/SULF LIQ 10-2% generic 1

AVAR LS LIQ 10-2% Brand 2 GR

BP 10-1 EMU generic 1

CERISA WASH EMU 10-1% generic 1

SOD SUL/SULF EMU 10-5% generic 1

PRASCION EMU generic 1

AVAR CLEANSE EMU 10-5% generic 1

ROSANIL EMU CLEANSER generic 1

SUMAXIN TS SUS 8-4% Brand 2 GR

SULFACLEANSE SUS 8-4% generic 1

SOD SUL/SULF SUS 8-4% generic 1

SOD SUL/SULF SUS 10-5% Brand 2

SOD SUL/SULF CRE 10-2% generic 1 PA

AVAR-E LS CRE 10-2% Brand 2 GR

SE 10-5 SS CRE 10-5% generic 1

SSS CRE 10%-5% generic 1



SOD SUL/SULF CRE 10-5% generic 1

VIRTI-SULF CRE 10-5% generic 1

AVAR-E GREEN CRE 10-5% generic 1

AVAR-E EMOLL CRE 10-5% generic 1

SSS 10-4 AER 10-4% Brand 2 PA

SOD SUL/SULF AER 10-5% generic 1

CLARIFOAM EF AER 10-5% Brand 2 GR

SSS 10-5 AER 10-5% generic 1

SOD SUL/SULF LOT 10-5% generic 1

AVAR PAD 9.5-5% Brand 2

AVAR LS PAD 10-2% Brand 2

SOD SUL/SULF PAD 10-4% generic 1

SUMAXIN PAD 10-4% Brand 2 GR

SOD SUL/SULF PAD 10-5% generic 1

PRASCION FC PAD 10-5% generic 1

BP CLEANSING EMU 10-4% generic 1

CLARIS WASH EMU 10-4% generic 1

SOD SUL/SULF EMU 10-5% generic 1

SOD SUL/SULF GEL 10-5% Brand 2

ROSANIL KIT Brand 2

SUMAXIN CP KIT Brand 2

PRASCION RA CRE 10-5% generic 1

FINACEA GEL 15% Brand 2 PA

MIRVASO GEL 0.33% Brand 2 PA

ORACEA CAP 40MG Brand 2 PA

ROSADAN CRE 0.75% generic 1

METRONIDAZOL CRE 0.75% generic 1

METROCREAM CRE 0.75% Brand 2 GR

NORITATE CRE 1% Brand 2 PA

ROSADAN GEL 0.75% generic 1

METRONIDAZOL GEL 0.75% generic 1

METRONIDAZOL GEL 1% generic 1



METROGEL GEL 1% Brand 2 GR

METROLOTION LOT 0.75% Brand 2 GR

METRONIDAZOL LOT 0.75% generic 1

ROSADAN KIT 0.75% Brand 2

ROSADAN KIT 0.75% Brand 2

GENTAMICIN CRE 0.1% generic 1

GENTAMICIN OIN 0.1% generic 1

MUPIROCIN OIN 2% generic 1 PREF

BACTROBAN OIN 2% Brand 2 NON-PREF ST

CENTANY OIN 2% Brand 2 NON-PREF ST

CENTANY AT KIT 2% Brand 2 NON-PREF ST

MUPIROCIN CA CRE 2% generic 1 NON-PREF ST

MUPIROCIN CRE 2% generic 1 NON-PREF ST

BACTROBAN CRE 2% Brand 2 PREF

ALTABAX OIN 1% Brand 2 PREF

CORTISPORIN CRE 0.5% Brand 2

CORTISPORIN OIN 1% Brand 2 PA

MENTAX CRE 1% Brand 2 PA

CICLODAN SOL 8% generic 1 PREF PA

CICLOPIROX SOL 8% generic 1 PREF PA

PENLAC SOL 8% Brand 2 NON-PREF ST

CICLOPIROX GEL 0.77% generic 1 PREF PA

LOPROX GEL 0.77% Brand 2 GR

CICLOPIROX SHA 1% generic 1

LOPROX SHA 1% Brand 2 GR

CICLOPIROX KIT 8% generic 1 PREF PA

CICLODAN SOL KIT 8% Brand 2 PREF PA

CNL8 NAIL KIT Brand 2 NON-PREF ST

CICLOPIROX SUS 0.77% generic 1 PREF PA

CICLOPIROX CRE 0.77% generic 1 PREF PA

CICLODAN CRE 0.77% generic 1 PREF PA

CICLODAN CRE KIT 0.77% Brand 2 PREF PA



CICLOPIROX KIT 8% generic 1 NON-PREF ST PA

HALOTIN CRE 1% Brand 2

NAFTIN CRE 1% Brand 2 PA

NAFTIN CRE 2% Brand 2 PA

NAFTIN GEL 1% Brand 2 PA

NAFTIN GEL 2% Brand 2 PA

NYSTATIN CRE 100000 generic 1

NYSTATIN OIN 100000 generic 1

LAMISIL SPR 1% Brand 2

CLOTRIMAZOLE SOL 1% generic 1

CLOTRIMAZOLE CRE 1% generic 1

ECONAZOLE CRE 1% generic 1

KETOCONAZOLE CRE 2% generic 1

EXTINA AER 2% Brand 2 GR

KETODAN AER 2% generic 1

XOLEGEL GEL 2% Brand 2 PA

KETOCONAZOLE SHA 2% generic 1

NIZORAL SHA 2% Brand 2 GR

OXISTAT CRE 1% Brand 2 PA

OXISTAT LOT 1% Brand 2 PA

ERTACZO CRE 2% Brand 2 PA

EXELDERM SOL 1% Brand 2

EXELDERM CRE 1% Brand 2 PA

CLOTRIM/BETA CRE DIPROP generic 1

CLOTRIM/BETA CRE 1-0.05% generic 1

LOTRISONE CRE Brand 2 GR

CLOTRIM/BETA LOT DIPROP generic 1

XOLEGEL DUO/ KIT XOLEX Brand 2

XOLEGEL DUO/ KIT HEAD&SHD Brand 2

NYSTAT/TRIAM CRE generic 1

NYSTAT/TRIAM OIN generic 1

EXODERM LOT 25-1% generic 1



VERSICLEAR LOT generic 1

XOLEGEL KIT COREPAK Brand 2

VYTONE CRE 1-1.9% Brand 2 PA

VUSION OIN Brand 2

FLECTOR DIS 1.3% Brand 2 QL 60/30 PA

PENNSAID SOL 1.5% Brand 2 QL 300/30 PA

VOLTAREN GEL 1% Brand 2 QL 200/30 PA

NAPRO CRE 15% Brand 2

LIDOPROFEN CRE 5-5-2% Brand 2

PRUDOXIN CRE 5% Brand 2

ZONALON CRE 5% Brand 2

DRITHO-CREME CRE HP 1% Brand 2

ZITHRANOL-RR CRE 1.2% Brand 2

ZITHRANOL SHA 1% Brand 2 PA

CALCIPOTRIEN SOL 0.005% generic 1 PREF

CALCIPOTRIEN CRE 0.005% generic 1 NON-PREF ST

DOVONEX CRE 0.005% Brand 2 PREF

SORILUX AER 0.005% Brand 2 NON-PREF ST PA

CALCITRENE OIN 0.005% generic 1 NON-PREF ST PA

CALCIPOTRIEN OIN 0.005% generic 1 NON-PREF ST PA

CALCITRIOL OIN 3MCG/GM Brand 2 NON-PREF ST

VECTICAL OIN 3MCG/GM Brand 2 NON-PREF ST

TAZORAC CRE 0.05% Brand 2 NON-PREF ST

TAZORAC CRE 0.1% Brand 2 NON-PREF ST

TAZORAC GEL 0.05% Brand 2 NON-PREF ST

TAZORAC GEL 0.1% Brand 2 NON-PREF ST

ACITRETIN CAP 10MG generic 1

SORIATANE CAP 10MG Brand 2 GR

ACITRETIN CAP 17.5MG generic 1

SORIATANE CAP 17.5MG Brand 2 GR

ACITRETIN CAP 25MG generic 1

SORIATANE CAP 25MG Brand 2 GR



8-MOP CAP 10MG Brand 2

OXSORALEN-UL CAP 10MG Brand 2

STELARA INJ 45MG/0.5 Brand 2 NON-PREF ST QL 0.5/30 PA SP

STELARA INJ 90MG/ML Brand 2 NON-PREF ST QL 1/90 PA SP

GLYCOLIC ACD SOL 70% Brand 2

TERSI FOAM AER 2.25% Brand 2

SELENIUM SUL SHA 2.5% generic 1

SELENIUM SUL LOT 2.5% generic 1

SODIUM SULFA LIQ 10% WASH generic 1

MEXAR WASH LIQ 10% generic 1

SEB-PREV LIQ WASH generic 1

OVACE WASH LIQ 10% Brand 2 GR

OVACE PLUS LIQ 10% WASH Brand 2 GR

OVACE PLUS CRE 10% Brand 2

SOD SULFACET GEL 10% generic 1

OVACE PLUS GEL 10% WASH Brand 2 GR

SEB-PREV LOT 10% Brand 2

SOD SULFACET SHA 10% generic 1

OVACE PLUS SHA 10% Brand 2 GR

PROMISEB KIT COMPLETE Brand 2

SODIUM SULFA LIQ 10% WASH Brand 2

SOD SULFACET PAD 10% Brand 2

SELENIUM SUL SHA 2.25% Brand 2

SELRX SHA 2.3% Brand 2

ZOVIRAX CRE 5% Brand 2

ACYCLOVIR OIN 5% generic 1

ZOVIRAX OIN 5% Brand 2 GR

DENAVIR CRE 1% Brand 2

XERESE CRE 5-1% Brand 2

VALCHLOR GEL 0.016% Brand 2

FLUOROURACIL SOL 2% generic 1

FLUOROURACIL DRO 2% generic 1



FLUOROURACIL SOL 5% generic 1

FLUOROURACIL DRO 5% generic 1

CARAC CRE 0.5% Brand 2

FLUOROPLEX CRE 1% Brand 2

EFUDEX CRE 5% Brand 2 GR

FLUOROURACIL CRE 5% generic 1

SOLARAZE GEL 3% W/W Brand 2 QL 100/30 PA

LEVULAN KERA SOL 20% Brand 2

PANRETIN GEL 0.1% Brand 2

TARGRETIN GEL 1% Brand 2

PICATO GEL 0.015% Brand 2 QL 3/60 PA

PICATO GEL 0.05% Brand 2 QL 2/60 PA

MAFENIDE ACE PAK 5% generic 1

SULFAMYLON PAK 5% Brand 2 GR

SULFAMYLON CRE 85MG/GM Brand 2

THERMAZENE CRE 1% generic 1

SILVADENE CRE 1% Brand 2 GR

SSD CRE 1% generic 1

SILVER SULFA CRE 1% generic 1

SILVER NITRA SOL 0.5% Brand 2

SILVER NITRA SOL 10% Brand 2



SILVER NITRA OIN 10% Brand 2

TRI-CHLOR LIQ 80% Brand 2

GRAFCO SILVR MIS NIT APPL generic 1

ARZOL SILVER MIS NITR APP Brand 2 GR

COAL TAR SOL 20% Brand 2

ALCLOMETASON CRE 0.05% generic 1 PREF

ACLOVATE CRE 0.05% Brand 2 GR

ALCLOMETASON OIN 0.05% generic 1 PREF

AMCINONIDE CRE 0.1% generic 1 NON-PREF ST



AMCINONIDE LOT 0.1% generic 1 NON-PREF ST

AMCINONIDE OIN 0.1% generic 1 NON-PREF ST

BETAMETH DIP CRE 0.05% generic 1 PREF

BETAMETH DIP LOT 0.05% generic 1 PREF

BETAMETH DIP OIN 0.05% generic 1 PREF

AUG BETAMET CRE 0.05% generic 1

DIPROLENE AF CRE 0.05% Brand 2 GR

ALPHATREX GEL 0.05% generic 1 PREF

AUG BETAMET GEL 0.05% generic 1 PREF

AUG BETAMET LOT 0.05% generic 1

DIPROLENE LOT 0.05% Brand 2 GR

AUG BETAMET OIN 0.05% generic 1

DIPROLENE OIN 0.05% Brand 2 GR

BETAMETH VAL CRE 0.1% generic 1 PREF

LUXIQ AER 0.12% Brand 2 NON-PREF ST

BETAMETH VAL AER 0.12% generic 1 PREF

BETAMETH VAL LOT 0.1% generic 1 PREF

BETAMETH VAL OIN 0.1% generic 1 PREF

CLOBEX SPR 0.05% Brand 2 NON-PREF ST

CLOBETASOL SOL 0.05% generic 1 NON-PREF ST

CORMAX SCALP SOL 0.05% generic 1 NON-PREF ST

TEMOVATE SOL 0.05% Brand 2 NON-PREF ST

CLOBETASOL CRE 0.05% generic 1 PREF

TEMOVATE CRE 0.05% Brand 2 NON-PREF ST

CLOBETASOL AER 0.05% generic 1 PREF

OLUX AER 0.05% Brand 2 NON-PREF ST

CLOBETASOL GEL 0.05% generic 1 PREF

TEMOVATE GEL 0.05% Brand 2 NON-PREF ST

CLOBETASOL LOT 0.05% generic 1 NON-PREF ST

CLOBEX LOT 0.05% Brand 2 NON-PREF ST

CLOBETASOL OIN 0.05% generic 1 PREF

TEMOVATE OIN 0.05% Brand 2 NON-PREF ST



CLOBETASOL SHA 0.05% generic 1 NON-PREF ST

CLOBEX SHA 0.05% Brand 2 NON-PREF ST

CLOBETASOL E CRE 0.05% generic 1 PREF

TEMOVATE E CRE 0.05%EML Brand 2 NON-PREF ST

CLOBETASOL AER 0.05% generic 1

OLUX-E AER 0.05% Brand 2 NON-PREF ST

CLODERM CRE 0.1% PMP Brand 2

CLODERM CRE 0.1% Brand 2

DESONIDE CRE 0.05% generic 1 PREF

DESOWEN CRE 0.05% Brand 2 GR

VERDESO AER 0.05% Brand 2 NON-PREF ST

DESONATE GEL 0.05% Brand 2 NON-PREF ST

LOKARA LOT 0.05% generic 1 PREF

DESOWEN LOT 0.05% Brand 2 GR

DESONIDE LOT 0.05% generic 1 PREF

DESOWEN OIN 0.05% Brand 2 GR

DESONIDE OIN 0.05% generic 1 PREF

DESOWEN CRM KIT 0.05% Brand 2

DESOWEN OINT KIT 0.05% Brand 2

TOPICORT SPR 0.25% Brand 2

DESOXIMETAS CRE 0.05% generic 1 NON-PREF ST

TOPICORT CRE 0.05% Brand 2

DESOXIMETAS CRE 0.25% generic 1 NON-PREF ST

TOPICORT CRE 0.25% Brand 2 GR

DESOXIMETAS GEL 0.05% generic 1 NON-PREF ST

TOPICORT GEL 0.05% Brand 2 GR

TOPICORT OIN 0.05% Brand 2 NON-PREF ST

DESOXIMETAS OIN 0.05% Brand 2 NON-PREF ST

DESOXIMETAS OIN 0.25% generic 1 NON-PREF ST

TOPICORT OIN 0.25% Brand 2 GR

DIFLORASONE CRE 0.05% generic 1 NON-PREF ST

DIFLORASONE OIN 0.05% generic 1 NON-PREF ST



APEXICON OIN 0.05% generic 1 NON-PREF ST

APEXICON E CRE 0.05% Brand 2 NON-PREF ST

FLUOCIN ACET OIL BODY generic 1 NON-PREF ST

FLUOCIN ACET OIL 0.01% SC generic 1 NON-PREF ST

FLUOCIN ACET OIL SCALP generic 1 NON-PREF ST

DERMA-SMOOTH OIL /FS BODY Brand 2 NON-PREF ST

DERMA-SMOOTH OIL /FS SCLP Brand 2 NON-PREF ST

FLUOCIN ACET SOL 0.01% generic 1 PREF

SYNALAR SOL 0.01% Brand 2 GR

FLUOCIN ACET CRE 0.01% generic 1 PREF

SYNALAR CRE 0.025% Brand 2 GR

FLUOCIN ACET CRE 0.025% generic 1 PREF

SYNALAR OIN 0.025% Brand 2 GR

FLUOCIN ACET OIN 0.025% generic 1 PREF

CAPEX SHA 0.01% Brand 2 NON-PREF ST

FLUOCINONIDE SOL 0.05% generic 1 PREF

FLUOCINONIDE CRE 0.05% generic 1 PREF

VANOS CRE 0.1% Brand 2 NON-PREF ST

FLUOCINONIDE GEL 0.05% generic 1 PREF

FLUOCINONIDE OIN 0.05% generic 1 PREF

FLUOCINONIDE CRE -E 0.05% generic 1 PREF

CORDRAN SP CRE 0.05% Brand 2 PA

CORDRAN LOT 0.05% Brand 2 PA

CORDRAN 24X3 TAP 4MCG/CM Brand 2 NON-PREF ST

CORDRAN 80X3 TAP 4MCG/CM Brand 2 NON-PREF ST

FLUTICASONE CRE 0.05% generic 1 PREF

CUTIVATE CRE 0.05% Brand 2 NON-PREF ST

FLUTICASONE LOT 0.05% generic 1 PREF

CUTIVATE LOT 0.05% Brand 2 NON-PREF ST

FLUTICASONE OIN 0.005% generic 1 PREF

CUTIVATE OIN 0.005% Brand 2 NON-PREF ST

HALOG CRE 0.1% Brand 2 NON-PREF ST



HALOG OIN 0.1% Brand 2 NON-PREF ST

HALOBETASOL CRE 0.05% generic 1 PREF

ULTRAVATE CRE 0.05% Brand 2 NON-PREF ST

HALOBETASOL OIN 0.05% generic 1 PREF

ULTRAVATE OIN 0.05% Brand 2 NON-PREF ST

TEXACORT SOL 2.5% Brand 2

HYDROCORT CRE 1% generic 1 PREF

ALA CORT CRE 1% generic 1 PREF

HYDROCORT CRE 2.5% generic 1 PREF

FRST-HYDRCRT GEL 10% Brand 2 PA

SCALACORT LOT 2% generic 1

ALA SCALP LOT 2% Brand 2 GR

HYDROCORT LOT 2.5% generic 1 PREF

HYDROCORT OIN 1% generic 1 PREF

HYDROCORT/AB OIN 1% generic 1 PREF

HYDROCORT OIN 2.5% generic 1 PREF

NUCORT LOT 2% Brand 2 PA

HC VALERATE CRE 0.2% generic 1 PREF

HC VALERATE OIN 0.2% generic 1 PREF

WESTCORT OIN 0.2% Brand 2 GR

PANDEL CRE 0.1% Brand 2 NON-PREF ST

HC BUTYRATE SOL 0.1% generic 1 PREF

LOCOID SOL 0.1% Brand 2 GR

HC BUTYRATE CRE 0.1% generic 1 PREF

LOCOID CRE 0.1% Brand 2 GR

LOCOID LOT 0.1% Brand 2

LOCOID OIN 0.1% Brand 2 GR

HC BUTYRATE OIN 0.1% generic 1 PREF

HC BUTYRATE CRE 0.1% generic 1

LOCOID LIPO CRE 0.1% Brand 2 GR

PEDIADERM HC KIT Brand 2 NON-PREF ST

MOMETASONE SOL 0.1% generic 1 PREF



ELOCON LOT 0.1% Brand 2 GR

MOMETASONE CRE 0.1% generic 1 PREF

ELOCON CRE 0.1% Brand 2 GR

MOMETASONE OIN 0.1% generic 1 PREF

ELOCON OIN 0.1% Brand 2 GR

PREDNICARBAT CRE 0.1% generic 1 PREF

DERMATOP CRE 0.1% Brand 2 GR

DERMATOP OIN 0.1% Brand 2 GR

PREDNICARBAT OIN 0.1% generic 1 PREF

KENALOG AER SPRAY Brand 2 NON-PREF ST

TRIAMCINOLON CRE 0.025% generic 1 PREF


TRIDERM CRE 0.1% generic 1 PREF


TRIAMCINOLON LOT 0.025% generic 1 PREF

TRIAMCINOLON LOT 0.1% generic 1 PREF

TRIAMCINOLON OIN 0.025% generic 1 PREF

TRIANEX OIN 0.05% Brand 2



PRAMOSONE CRE 1% Brand 2

EPIFOAM AER 1% Brand 2

PRAMOSONE LOT 1% Brand 2

PRAMOSONE LOT 2.5% Brand 2

TACLONEX SUS Brand 2

TACLONEX OIN Brand 2 NON-PREF ST

SYNALAR KIT 0.025% Brand 2

SYNALAR KIT 0.025% Brand 2

ULTRAVATE KIT PAC Brand 2 NON-PREF ST

HALONATE PAC KIT generic 1 NON-PREF ST

HALAC KIT generic 1 NON-PREF ST

ULTRAVATE KIT Brand 2 NON-PREF ST



HALONATE KIT Brand 2 NON-PREF ST

ULTRAVATE X KIT 0.05-10% Brand 2 NON-PREF ST

ULTRAVATE X KIT 0.05-10% Brand 2 NON-PREF ST

HC AC/ALOE GEL 2% generic 1

CORTALO GEL 2% generic 1

NUZON GEL 2% Brand 2 GR

CARMOL-HC CRE 1% Brand 2 GR

U-CORT CRE 1% generic 1

AMMONIUM LAC CRE 12% generic 1

LAC-HYDRIN CRE 12% Brand 2 GR

LACTIC ACID LOT 10% generic 1

AMMONIUM LAC LOT 12% generic 1

LACLOTION LOT 12% generic 1

LAC-HYDRIN LOT 12% Brand 2 GR

UMECTA PD SUS 40-0.3% Brand 2

UREA HYDRATI AER 35% generic 1

SANTYL OIN 250/GM Brand 2

PODOFILOX SOL 0.5% generic 1

CONDYLOX SOL 0.5% Brand 2 GR

CONDYLOX GEL 0.5% Brand 2

PODOCON SOL 25% Brand 2

VIRASAL LIQ 27.5% Brand 2 GR

SALICYLIC AC LIQ 27.5% generic 1

SALICYLIC AC LIQ 26% generic 1

SALICYLIC AC CRE 6% generic 1

SALACYN CRE 6% generic 1

SALICYLIC AER 6% generic 1

SALVAX AER 6% Brand 2 GR

SALICYLIC AC GEL 6% generic 1

KERALYT GEL 6% Brand 2 GR

SALICYLIC AC LOT 6% generic 1

SALACYN LOT 6% generic 1



SALICYLIC AC SHA 6% generic 1

ALICLEN SHA 6% generic 1

SALEX SHA 6% Brand 2 GR

KERALYT KIT SCALP 6% Brand 2

PYROGALL ACD OIN Brand 2

SALICYLIC AC AER 6% Brand 2

SALKERA AER 6% Brand 2

BENSAL HP OIN Brand 2

GORDOFILM SOL Brand 2

SALVAX DUO KIT PLUS Brand 2

VEREGEN OIN 15% Brand 2

ZYCLARA PUMP CRE 2.5% Brand 2 PA

ZYCLARA PUMP CRE 3.75% Brand 2 PA

ZYCLARA CRE 3.75% Brand 2 QL 56/42 PA

IMIQUIMOD CRE 5% generic 1 QL 48/112 PA

ALDARA CRE 5% Brand 2 GR

ELIDEL CRE 1% Brand 2 PREF QL 30/30 PA

PROTOPIC OIN 0.03% Brand 2 NON-PREF ST QL 30/30

PROTOPIC OIN 0.1% Brand 2 NON-PREF ST QL 30/30

ANACAINE OIN Brand 2 PA

QUTENZA KIT 8% 2-PCH Brand 2 QL 4/90 PA SP

QUTENZA KIT 8% 1-PCH Brand 2 QL 4/90 PA SP

COCAINE HCL SOL 4% generic 1

COCAINE HCL SOL 10% generic 1

LIDOCAINE OIN 5% generic 1

LIDOCAINE PAD 5% generic 1

LIDODERM DIS 5% Brand 2 GR

LIDOCAINE SOL 4% generic 1

XYLOCAINE SOL 4% Brand 2 GR

LIDOCAINE CRE 3% generic 1

LIDOCAINE GEL 2% JELLY generic 1

LIDOCAINE GEL 2% generic 1



LIDORX GEL 3% Brand 2

LIDOCAINE LOT 3% Brand 2

PRAMOX GEL 1% generic 1

PONTOCAINE SOL 2% Brand 2

ETHYL CHLOR AER MIST Brand 2

ETHYL CHLOR AER MED JET Brand 2

ETHYL CHLOR AER FINE PIN Brand 2

ETHYL CHLOR AER MED STRM Brand 2

ETHYL CHLOR AER FN STRM Brand 2

GEBAUERS SPR AER /STRETCH Brand 2

PAIN EASE AER MIST Brand 2

PAIN EASE AER MD STRM Brand 2

ALEVEER DIS 0.0375-5 Brand 2

SYNERA DIS 70-70MG Brand 2

ELENZAPATCH DIS 4-1% Brand 2

LIDO/PRILOCN CRE 2.5-2.5% generic 1

EMLA CRE 2.5-2.5% Brand 2 GR

LIDO/PRILOCN KIT 2.5-2.5% Brand 2

BOTOX COSMET INJ 100UNIT Brand 2

ULESFIA LOT 5% Brand 2 PREF

EURAX CRE 10% Brand 2 PREF

EURAX LOT 10% Brand 2 PREF

SKLICE LOT 0.5% Brand 2 NON-PREF ST PA

LINDANE LOT 1% generic 1 NON-PREF ST

LINDANE SHA 1% generic 1 NON-PREF ST

OVIDE LOT 0.5% Brand 2 NON-PREF ST

MALATHION LOT 0.5% generic 1 NON-PREF ST

PERMETHRIN CRE 5% generic 1 PREF

ACTICIN CRE 5% generic 1 PREF

ELIMITE CRE 5% Brand 2 GR

SPINOSAD SUS 0.9% Brand 2 NON-PREF ST

NATROBA SUS 0.9% Brand 2 NON-PREF ST



SULF LIME SOL USP Brand 2

LYCELLE GEL Brand 2

DRYSOL SOL 20% Brand 2 GR

HYPERCARE SOL 20% generic 1

ARNICA TIN FLOWER Brand 2

BORIC ACID GRA Brand 2

ALUMINUM SOL ACETATE Brand 2

XERAC-AC SOL 6.25% Brand 2

BENZOIN TIN NF Brand 2

BENZOIN CMPD TIN Brand 2

GENADUR LIQ Brand 2

TL-CERMIDE EMU Brand 2

EMULSION SB EMU Brand 2

EPICERAM EMU Brand 2

XCLAIR CRE Brand 2

AURSTAT ANTI GEL -ITCH Brand 2

PR CREAM KIT Brand 2

TETRIX KIT Brand 2

AURSTAT KIT HYDROGEL Brand 2

GENADUR KIT Brand 2

Diagnostic Products

CYSVIEW INJ 100MG Brand 2

Digestive Aids

VIOKACE TAB Brand 2 NON-PREF ST

VIOKACE TAB Brand 2 NON-PREF ST

CREON CAP 3000UNIT Brand 2 PREF

ZENPEP CAP 3000UNIT Brand 2 PREF

PANCREAZE CAP 4200UNIT Brand 2 NON-PREF ST

ZENPEP CAP 5000UNIT Brand 2 PREF

PANCRELIPASE CAP 5000UNIT Brand 2 PREF

CREON CAP 6000UNIT Brand 2 PREF



PERTZYE CAP Brand 2 NON-PREF ST

ZENPEP CAP 10000UNT Brand 2 PREF

PANCREAZE CAP 10500UNT Brand 2 NON-PREF ST

CREON CAP 12000UNT Brand 2 PREF

ULTRESA CAP 13800UNT Brand 2 NON-PREF ST


PERTZYE CAP Brand 2






CREON CAP 24000UNT Brand 2 PREF


CREON CAP 36000UNT Brand 2

SUCRAID SOL 8500/ML Brand 2

Diuretics

ACETAZOLAMID TAB 125MG generic 1

ACETAZOLAMID TAB 250MG generic 1

DIAMOX SEQUE CAP 500MG CR Brand 2 GR

ACETAZOLAMID CAP 500MG ER generic 1

ACETAZOLAMID INJ 500MG generic 1

NEPTAZANE TAB 25MG Brand 2 GR

METHAZOLAMID TAB 25MG generic 1

NEPTAZANE TAB 50MG Brand 2 GR

METHAZOLAMID TAB 50MG generic 1

BUMETANIDE TAB 0.5MG generic 1

BUMETANIDE TAB 1MG generic 1

BUMETANIDE TAB 2MG generic 1

BUMETANIDE INJ 0.25/ML generic 1

EDECRIN TAB 25MG Brand 2



SOD EDECRIN INJ 50MG Brand 2

FUROSEMIDE TAB 20MG generic 1

LASIX TAB 20MG Brand 2 GR





FUROSEMIDE INJ 10MG/ML generic 1

FUROSEMIDE SOL 8MG/ML generic 1

FUROSEMIDE SOL 10MG/ML generic 1

TORSEMIDE TAB 5MG generic 1

DEMADEX TAB 5MG Brand 2 GR







TORSEMIDE INJ 20MG/2ML Brand 2

TORSEMIDE INJ 50MG/5ML Brand 2

INTROL SOL 75% Brand 2

MANNITOL INJ 5% generic 1

OSMITROL INJ 5% generic 1





OSMITROL VFX INJ 20% generic 1



AMILORIDE TAB 5MG generic 1

SPIRONOLACT TAB 25MG generic 1



ALDACTONE TAB 25MG Brand 2 GR





DYRENIUM CAP 50MG Brand 2

DYRENIUM CAP 100MG Brand 2

CHLOROTHIAZ TAB 250MG generic 1

CHLOROTHIAZ TAB 500MG generic 1

DIURIL SUS 250/5ML Brand 2

SOD DIURIL INJ 500MG Brand 2 GR

CHLOROTHIAZ INJ 500MG generic 1

CHLORTHALID TAB 25MG generic 1

CHLORTHALID TAB 50MG generic 1

HYDROCHLOROT CAP 12.5MG generic 1

MICROZIDE CAP 12.5MG Brand 2 GR

HYDROCHLOROT TAB 12.5MG generic 1

HYDROCHLOROT TAB 25MG generic 1

HYDROCHLOROT TAB 50MG generic 1

INDAPAMIDE TAB 1.25MG generic 1

INDAPAMIDE TAB 2.5MG generic 1

METHYCLOTHIA TAB 5MG generic 1

METOLAZONE TAB 2.5MG generic 1

ZAROXOLYN TAB 2.5MG Brand 2 GR

METOLAZONE TAB 5MG generic 1

ZAROXOLYN TAB 5MG Brand 2 GR

METOLAZONE TAB 10MG generic 1

AMILOR/HCTZ TAB 5-50 generic 1

SPIRONO/HCTZ TAB 25/25 generic 1

ALDACTAZIDE TAB 25/25 Brand 2 GR

ALDACTAZIDE TAB 50/50 Brand 2

TRIAMT/HCTZ CAP 37.5-25 generic 1



DYAZIDE CAP 37.5-25 Brand 2 GR

TRIAMT/HCTZ CAP 50-25MG Brand 2

TRIAMT/HCTZ TAB 37.5-25 generic 1

MAXZIDE-25 TAB Brand 2 GR

TRIAMT/HCTZ TAB 75-50MG generic 1

MAXZIDE TAB 75-50 Brand 2 GR

Endocrine and Metabolic Agents Misc.

ALENDRONATE TAB 5MG generic 1 PREF MO




FOSAMAX TAB 70MG Brand 2 NON-PREF ST MO


BINOSTO TAB 70MG Brand 2 NON-PREF ST MO

ALENDRONATE SOL 70/75ML Brand 2 PREF MO

FOSAMAX + D TAB 70-2800 Brand 2 PREF MO

FOSAMAX + D TAB 70-5600 Brand 2 PREF MO

ETIDRON DISD TAB 200MG Brand 2

ETIDRON DISD TAB 400MG Brand 2

BONIVA TAB 150MG Brand 2 NON-PREF ST MO

IBANDRONATE TAB 150MG generic 1 NON-PREF ST MO

BONIVA INJ 3MG/3ML Brand 2 QL 3/90 PA SP

PAMIDRONATE INJ 30/10ML generic 1

PAMIDRONATE INJ 6MG/ML generic 1

PAMIDRONATE INJ 90/10ML generic 1

PAMIDRONATE INJ 30MG generic 1

PAMIDRONATE INJ 90MG generic 1

ACTONEL TAB 5MG Brand 2 NON-PREF ST MO






ATELVIA TAB Brand 2 NON-PREF ST MO

SKELID TAB 200MG Brand 2

ZOLEDRONIC INJ 4MG/100 generic 1

ZOMETA INJ 4MG/100 Brand 2

ZOLEDRONIC INJ 5/100ML generic 1

RECLAST INJ 5/100ML Brand 2 GR

ZOLEDRONIC INJ 4MG Brand 2

MIACALCIN INJ 200/ML Brand 2

CALCITONIN SPR 200/ACT generic 1 PREF MO

FORTICAL SPR 200/ACT Brand 2 NON-PREF ST MO

MIACALCIN SPR 200/ACT Brand 2 NON-PREF ST MO

FORTEO SOL 600/2.4 Brand 2 QL 43.2/life PA SP

PROLIA SOL 60MG/ML Brand 2 QL 2/365 PA SP

XGEVA INJ Brand 2 QL 1.7/30 PA SP

GANITE INJ 25MG/ML Brand 2

OSPHENA TAB 60MG Brand 2

EVISTA TAB 60MG Brand 2

PREGNYL INJ 10000UNT Brand 2 GR

CHOR GONADOT INJ 10000UNT generic 1

NOVAREL INJ 10000UNT generic 1

SEROPHENE TAB 50MG generic 1

CLOMID TAB 50MG Brand 2 GR

CLOMIPHENE TAB 50MG generic 1

SUPPRELIN LA KIT 50MG Brand 2 QL 1/365 PA SP

LUPR DEP-PED INJ 7.5MG Brand 2 PA SP

LUPR DEP-PED INJ 11.25MG Brand 2 PA SP

LUPR DEP-PED INJ 15MG Brand 2 PA SP

LUPR DEP-PED INJ 11.25MG Brand 2

LUPR DEP-PED INJ 30MG Brand 2 PA SP

SYNAREL SOL 2MG/ML Brand 2

NUTROPIN AQ INJ NUSPIN 5 Brand 2 NON-PREF ST PA SP

NUTROPIN AQ INJ 10MG/2ML Brand 2 NON-PREF ST PA SP



NORDITROPIN INJ 10/1.5ML Brand 2 PREF PA SP

NORDITROPIN INJ 15/1.5ML Brand 2 PREF PA SP

NUTROPIN AQ INJ 20MG/2ML Brand 2 NON-PREF ST PA SP

NORDITROPIN INJ 30/3ML Brand 2 PREF PA SP

HUMATROPE INJ 5MG Brand 2 NON-PREF ST PA SP

GENOTROPIN INJ 5MG Brand 2 PREF PA SP

OMNITROPE INJ 5.8MG Brand 2 NON-PREF ST PA SP




NUTROPIN INJ 10MG Brand 2 NON-PREF ST PA SP


GENOTROPIN INJ 0.2MG Brand 2 PREF PA SP










SEROSTIM INJ 4MG Brand 2 NON-PREF ST PA SP

SAIZEN INJ 5MG Brand 2 PREF PA SP



SAIZEN INJ 8.8MG Brand 2 PREF PA SP

ZORBTIVE INJ 8.8MG Brand 2 NON-PREF ST PA SP

EGRIFTA SOL 2MG Brand 2 QL 60/30 PA SP

INCRELEX INJ 40MG/4ML Brand 2 PA SP

SOMATULINE INJ 60/0.2ML Brand 2

SOMATULINE INJ 90/0.3ML Brand 2



SOMATULINE INJ 120/.5ML Brand 2

OCTREOTIDE INJ 50MCG/ML generic 1

SANDOSTATIN INJ 50MCG/ML Brand 2 GR

OCTREOTIDE INJ 100MCG generic 1

SANDOSTATIN INJ 100MCG Brand 2 GR








SANDOSTATIN KIT LAR 10MG Brand 2



SIGNIFOR INJ 0.3MG/ML Brand 2



SOMAVERT INJ 10MG Brand 2



DESMOPRESSIN TAB 0.1MG generic 1

DDAVP TAB 0.1MG Brand 2 GR

DESMOPRESSIN TAB 0.2MG generic 1

DDAVP TAB 0.2MG Brand 2 GR

STIMATE SOL 1.5MG/ML Brand 2

DESMOPRESSIN INJ 4MCG/ML generic 1

DDAVP INJ 4MCG/ML Brand 2 GR

DDAVP SOL 0.01% Brand 2 GR

DESMOPRESSIN SOL 0.01% generic 1

DESMOPRESSIN SPR 0.01% generic 1

DESMOPRESSIN SPR 0.01% generic 1



DDAVP SPR 0.01% Brand 2 GR

VASOPRESSIN INJ 20UNT/ML generic 1

VASOPRESSIN INJ 10/0.5ML generic 1

PITRESSIN INJ 20UNT/ML Brand 2 GR

ACTHAR HP INJ 80UNIT Brand 2 PA SP

CABERGOLINE TAB 0.5MG generic 1

VAPRISOL INJ Brand 2

SAMSCA TAB 15MG Brand 2 QL 30/30 PA SP

SAMSCA TAB 30MG Brand 2 QL 60/30 PA SP

MIFEPREX TAB 200MG Brand 2

LEVOCARNITIN TAB 330MG generic 1

CARNITOR TAB 330MG Brand 2 GR

LEVOCARNITIN SOL 1GM/10ML generic 1

CARNITOR SOL 1GM/10ML Brand 2 GR

CARNITOR SF SOL 1GM/10ML Brand 2 GR

LEVOCARNITIN INJ 200MG/ML generic 1

CARNITOR INJ 1GM/5ML Brand 2 GR

FABRAZYME INJ 5MG Brand 2

FABRAZYME INJ 35MG Brand 2

ORFADIN CAP 2MG Brand 2



CYSTADANE POW Brand 2

CALCITRIOL CAP 0.25MCG generic 1

ROCALTROL CAP 0.25MCG Brand 2 GR

CALCITRIOL CAP 0.5MCG generic 1

ROCALTROL CAP 0.5MCG Brand 2 GR

CALCITRIOL INJ 1MCG/ML generic 1

CALCITRIOL SOL 1MCG/ML generic 1

ROCALTROL SOL 1MCG/ML Brand 2 GR

HECTOROL CAP 0.5MCG Brand 2

HECTOROL CAP 1MCG Brand 2



HECTOROL CAP 2.5MCG Brand 2

HECTOROL INJ 4MCG/2ML Brand 2

HECTOROL INJ 2MCG/ML Brand 2

ZEMPLAR CAP 1MCG Brand 2 GR

PARICALCITOL CAP 1 MCG generic 1





ZEMPLAR INJ 2MCG/ML Brand 2

ZEMPLAR INJ 5MCG/ML Brand 2

SENSIPAR TAB 30MG Brand 2



ALDURAZYME INJ 2.9MG/5M Brand 2

ELAPRASE INJ 6MG/3ML Brand 2

NAGLAZYME INJ 1MG/ML Brand 2

LUMIZYME INJ 50MG Brand 2

MYOZYME INJ 50MG Brand 2

RAVICTI LIQ 1.1GM/ML Brand 2

AMMONUL INJ 10% Brand 2

BUPHENYL TAB 500MG Brand 2

PHENYLBUTYRA POW SODIUM generic 1

BUPHENYL POW Brand 2 GR

CARBAGLU TAB 200MG Brand 2 PA SP

KUVAN TAB 100MG Brand 2

Estrogens

PREMARIN TAB 0.3MG Brand 2







PREMARIN INJ 25MG Brand 2

CENESTIN TAB 0.3MG Brand 2




ENJUVIA TAB 0.3MG Brand 2





MENEST TAB 0.3MG Brand 2




ESTRACE TAB 0.5MG Brand 2 GR

ESTRADIOL TAB 0.5MG generic 1

ESTRADIOL TAB 1MG generic 1

ESTRACE TAB 1MG Brand 2 GR

ESTRACE TAB 2MG Brand 2 GR

ESTRADIOL TAB 2MG generic 1

ESTRASORB EMU Brand 2

EVAMIST SPR 1.53MG Brand 2

ELESTRIN GEL 0.06% Brand 2

ESTROGEL GEL Brand 2

DIVIGEL GEL 0.25MG Brand 2

DIVIGEL GEL 0.5MG Brand 2

DIVIGEL GEL 1MG/GM Brand 2

VIVELLE-DOT DIS 0.025MG Brand 2

ALORA DIS 0.025MG Brand 2

MINIVELLE DIS 0.0375MG Brand 2













MENOSTAR DIS 14MCG Brand 2

CLIMARA DIS 0.025MG Brand 2 GR

ESTRADIOL DIS 0.025MG generic 1











DEPO-ESTRADI INJ 5MG/ML Brand 2

ESTRAD VAL INJ 10MG/ML generic 1

DELESTROGEN INJ 10MG/ML Brand 2 GR





ESTRAD VAL INJ 200MG/5 generic 1

ORTHO-EST TAB 0.625 generic 1

ESTROPIPATE TAB 0.75MG generic 1



ORTHO-EST TAB 1.25 generic 1

ESTROPIPATE TAB 1.5MG generic 1

ESTROPIPATE TAB 3MG generic 1

PREMPRO TAB 0.3-1.5 Brand 2

PREMPRO TAB 0.45-1.5 Brand 2

PREMPRO TAB .625-2.5 Brand 2

PREMPRO TAB 0.625-5 Brand 2

PREMPHASE TAB Brand 2

ESTRA/NORETH TAB 0.5-0.1 generic 1

ACTIVELLA TAB 0.5-0.1 Brand 2 GR

ESTRA/NORETH TAB 1-0.5MG generic 1

MIMVEY TAB 1-0.5MG generic 1

ACTIVELLA TAB 1-0.5MG Brand 2 GR

COMBIPATCH DIS .05/.14 Brand 2

COMBIPATCH DIS .05/.25 Brand 2

FEMHRT TAB 0.5-2.5 Brand 2

JINTELI TAB 1MG-5MCG generic 1

ANGELIQ TAB 0.25-0.5 Brand 2

ANGELIQ TAB 0.5-1MG Brand 2

CLIMARA PRO DIS WEEKLY Brand 2

PREFEST TAB Brand 2

Fluoroquinolones

CIPRO (5%) SUS 250MG/5 Brand 2 PREF

CIPRO (10%) SUS 500MG/5 Brand 2 PREF

CIPROFLOXACN INJ 200MG generic 1


CIPROFLOXACN TAB 500MG ER generic 1 NON-PREF ST

CIPRO XR TAB 500MG Brand 2 NON-PREF ST

CIPROFLOXACN TAB 1000MG generic 1 NON-PREF ST

CIPRO XR TAB 1000MG Brand 2 NON-PREF ST

CIPROFLOXACN TAB 100MG generic 1 PREF




CIPRO TAB 250MG Brand 2 NON-PREF ST

CIPRO TAB 500MG Brand 2 NON-PREF ST




CIPRO I.V. INJ 200MG Brand 2 GR

LEVOFLOXACIN TAB 250MG generic 1 PREF

LEVAQUIN TAB 250MG Brand 2 NON-PREF ST





LEVOFLOXACIN INJ 25MG/ML generic 1

LEVOFLOXACIN SOL 25MG/ML generic 1 PREF

LEVAQUIN SOL 25MG/ML Brand 2 NON-PREF ST

AVELOX ABC TAB 400MG Brand 2 PREF

AVELOX TAB 400MG Brand 2 PREF

AVELOX INJ Brand 2

NOROXIN TAB 400MG Brand 2 NON-PREF ST

OFLOXACIN TAB 200MG generic 1 PREF



FACTIVE TAB 320MG Brand 2 NON-PREF ST

Gastrointestinal Agents Misc

CHENODAL TAB 250MG Brand 2

ACTIGALL CAP 300MG Brand 2 GR

URSODIOL CAP 300MG generic 1

URSODIOL TAB 250MG generic 1

URSO 250 TAB 250MG Brand 2 GR

URSODIOL TAB 500MG generic 1



URSO FORTE TAB 500MG Brand 2 GR

CROMOLYN SOD CON 100/5ML generic 1

GASTROCROM CON 100/5ML Brand 2 GR

DEXPANTHENOL INJ 250MG/ML generic 1

METOCLOPRAM TAB 5MG generic 1

METOCLOPRAM TAB 10MG generic 1

METOCLOPRAM INJ 5MG/ML generic 1

METOCLOPRAM INJ 10MG/2ML generic 1

METOCLOPRAM SOL 10/10ML generic 1

METOCLOPRAM SOL 5MG/5ML generic 1

METOZOLV ODT TAB 5MG Brand 2 NON-PREF ST QL 120/30

LACTULOSE SOL 10GM/15 generic 1

GENERLAC SOL 10GM/15 generic 1

ENULOSE SOL 10GM/15 generic 1

AMITIZA CAP 8MCG Brand 2 PA MO

AMITIZA CAP 24MCG Brand 2 PA MO

COLAZAL CAP 750MG Brand 2 NON-PREF ST

BALSALAZIDE CAP 750MG generic 1 PREF

GIAZO TAB 1.1GM Brand 2 NON-PREF ST

PENTASA CAP 250MG CR Brand 2 PREF MO

PENTASA CAP 500MG CR Brand 2 PREF MO

ASACOL HD TAB 800MG Brand 2 NON-PREF ST MO

LIALDA TAB 1.2GM Brand 2 NON-PREF ST

MESALAMINE ENE 4GM generic 1 PREF

SFROWASA ENE 4GM Brand 2 NON-PREF ST

CANASA SUP 1000MG Brand 2 PREF

DELZICOL CAP 400MG Brand 2 NON-PREF ST

APRISO CAP 0.375GM Brand 2 PREF MO

ROWASA KIT 4GM Brand 2 NON-PREF ST

MESALAMINE KIT 4GM generic 1 PREF

DIPENTUM CAP 250MG Brand 2 NON-PREF ST MO

SULFASALAZIN TAB 500MG generic 1 PREF MO



AZULFIDINE TAB 500MG Brand 2 NON-PREF ST MO

SULFAZINE TAB 500MG generic 1 PREF MO

SULFAZINE EC TAB 500MG generic 1 PREF MO

SULFASALAZIN TAB 500MG DR generic 1 PREF MO

AZULFIDINE TAB 500MG EN Brand 2 NON-PREF ST MO

CIMZIA KIT Brand 2 NON-PREF ST QL 2/30 PA SP

CIMZIA PREFL KIT 200MG/ML Brand 2 NON-PREF ST QL 2/30 PA SP

CIMZIA KIT STARTER Brand 2 NON-PREF ST QL 6/30 PA SP

REMICADE INJ 100MG Brand 2 NON-PREF ST PA SP

GATTEX KIT 5MG Brand 2

LOTRONEX TAB 0.5MG Brand 2

LOTRONEX TAB 1MG Brand 2

LINZESS CAP 145MCG Brand 2 PA MO

LINZESS CAP 290MCG Brand 2 PA MO

RELISTOR INJ 8/0.4ML Brand 2 QL 6/30 PA

RELISTOR INJ 12/0.6ML Brand 2 QL 9/30 PA

RELISTOR KIT 12/0.6ML Brand 2 QL 21/30 PA

PHOSLO CAP 667MG Brand 2 NON-PREF ST

CALC ACETATE CAP 667MG generic 1 PREF

ELIPHOS TAB 667MG generic 1 NON-PREF ST

PHOSLYRA SOL Brand 2 NON-PREF ST

FOSRENOL CHW 500MG Brand 2 NON-PREF ST



RENVELA TAB 800MG Brand 2 PREF

RENVELA PAK 0.8GM Brand 2 PREF

RENVELA PAK 2.4GM Brand 2 PREF

RENAGEL TAB 400MG Brand 2 PREF

RENAGEL TAB 800MG Brand 2 PREF

General Anesthetics

COMPOUND 347 LIQ generic 1



ETHRANE INH Brand 2 GR

FORANE SOL Brand 2 GR

TERRELL SOL generic 1

ISOFLURANE SOL generic 1

ULTANE SOL Brand 2 GR

SOJOURN SOL generic 1

SEVOFLURANE SOL generic 1

ETOMIDATE INJ 2MG/ML generic 1

AMIDATE INJ 2MG/ML Brand 2 GR

KETALAR INJ 10MG/ML Brand 2 GR

KETAMINE INJ 10MG/ML generic 1





PROPOVEN INJ 10MG/ML generic 1

DIPRIVAN INJ 10MG/ML Brand 2 GR

PROPOFOL INJ 10MG/ML generic 1

Genitourinary Agents Misc

K-PHOS TAB NO 2 Brand 2

HYDROCHLORIC INJ 1:500 generic 1

SODIUM CITRA GRA Brand 2

UROCIT-K 5 TAB Brand 2

POT CITRATE TAB 540MG generic 1

POT CITRATE TAB 1080MG generic 1



CITRIC ACID/ SOL SOD CITR generic 1

CYTRA-2 SOL generic 1

SHOHLS SOL MODIFIED Brand 2 GR

ORACIT SOL Brand 2



CYTRA-K SOL Brand 2

TARON GRA CRYSTALS generic 1

CYTRA K GRA CRYSTALS generic 1

CITROLITH TAB Brand 2

CYTRA-3 SYP generic 1

TRICITRATES SOL Brand 2

PHENAZOPYRID TAB 100MG generic 1

PYRIDIUM TAB 100MG Brand 2 GR

PYRIDIUM TAB 200MG Brand 2 GR

PHENAZO TAB 200MG generic 1

PHENAZOPYRID TAB 200MG generic 1

CYSTAGON CAP 50MG Brand 2

CYSTAGON CAP 150MG Brand 2

PROCYSBI CAP 25MG Brand 2

PROCYSBI CAP 75MG Brand 2

RIMSO-50 SOL 50% Brand 2

ELMIRON CAP 100MG Brand 2

LITHOSTAT TAB 250MG Brand 2

THIOLA TAB 100MG Brand 2

RENACIDIN SOL IRR Brand 2

ACETIC ACID SOL 0.25%IRR generic 1

AMINOAC ACID SOL 1.5% IRR generic 1

GLYCINE SOL 1.5% IRR generic 1

ARGYL SALINE SOL 0.9% generic 1

CURITY SALIN SOL 0.9% IRR generic 1

SODIUM CHLOR SOL 0.9% IRR generic 1

RESECTISOL SOL 5% Brand 2

SORBITOL SOL 3% IRR Brand 2

SORBITOL SOL 3.3% IRR Brand 2

SORBITOL-MAN SOL Brand 2

NEO/POLY GU SOL 40/ML IR generic 1

NEOSPORIN GU SOL 40/ML IR Brand 2 GR



AVODART CAP 0.5MG Brand 2 NON-PREF ST QL 30/30 MO

PROSCAR TAB 5MG Brand 2 NON-PREF ST MO

FINASTERIDE TAB 5MG generic 1 PREF QL 30/30 MO

UROXATRAL TAB 10MG Brand 2 NON-PREF ST QL 30/30 MO

ALFUZOSIN TAB 10MG generic 1 PREF QL 30/30 MO

CARDURA XL TAB 4MG Brand 2 QL 30/30 PA MO

CARDURA XL TAB 8MG Brand 2 QL 30/30 PA MO

RAPAFLO CAP 4MG Brand 2 NON-PREF ST QL 30/30 MO

RAPAFLO CAP 8MG Brand 2 NON-PREF ST QL 30/30 MO

FLOMAX CAP 0.4MG Brand 2 NON-PREF ST MO

TAMSULOSIN CAP 0.4MG generic 1 PREF MO

JALYN CAP Brand 2 NON-PREF ST QL 30/30 MO

Gout Agents

ZYLOPRIM TAB 100MG Brand 2 GR

ALLOPURINOL TAB 100MG generic 1

ZYLOPRIM TAB 300MG Brand 2 GR

ALLOPURINOL TAB 300MG generic 1

ALOPRIM INJ 500MG Brand 2 GR

ALLOPURINOL INJ 500MG generic 1

COLCRYS TAB 0.6MG Brand 2

ULORIC TAB 40MG Brand 2 PA

ULORIC TAB 80MG Brand 2 PA

KRYSTEXXA INJ 8MG/ML Brand 2 PA SP

PROBENECID TAB 500MG generic 1

PROBEN/COLCH TAB 500-0.5 generic 1

Hematologic Agents Misc

HEMOFIL M INJ 220-400 Brand 2 PA SP

HEMOFIL M INJ 250UNIT Brand 2 PA SP

KOATE-DVI INJ 250UNIT Brand 2 PA SP

HEMOFIL M INJ 401-800 Brand 2 PA SP







HEMOFIL M INJ 1700UNIT Brand 2

HEMOFIL M SOL 801-1500 Brand 2 PA SP

HEMOFIL M SOL 501-2000 Brand 2 PA SP

MONOCLATE-P INJ 250UNIT Brand 2 PA SP




RECOMBINATE INJ 220-400 Brand 2 PA SP



RECOMBINATE INJ Brand 2 PA SP

RECOMBINATE INJ Brand 2 PA SP

HELIXATE FS INJ 250UNIT Brand 2 PA SP

KOGENATE FS INJ 250UNIT Brand 2 PA SP

KOGENATE FS INJ 250/BS Brand 2 PA SP

HELIXATE FS SOL 250UNIT Brand 2 PA SP

















ADVATE INJ 250UNIT Brand 2 PA SP







XYNTHA INJ 250UNIT Brand 2 PA SP

XYNTHA SOLOF KIT 250UNIT Brand 2 PA SP


XYNTHA SOLOF INJ 500UNIT Brand 2 PA SP






HUMATE-P INJ 600UNIT Brand 2 PA SP

WILATE INJ Brand 2 PA SP

HUMATE-P SOL 1200UNIT Brand 2 PA SP

WILATE INJ Brand 2 PA SP

HUMATE-P SOL 2400UNIT Brand 2 PA SP

ALPHANATE INJ VWF/HUM Brand 2 PA SP




FEIBA VH INJ IMMUNO Brand 2 PA SP

FEIBA NF INJ Brand 2 PA SP

NOVOSEVEN RT INJ 1MG Brand 2 PA SP






MONONINE INJ 250UNIT Brand 2 PA SP


ALPHANINE SD INJ 500UNIT Brand 2 PA SP




RIXUBIS INJ 250 UNIT Brand 2 PA SP

BENEFIX INJ 250UNIT Brand 2 PA SP

RIXUBIS INJ 500UNIT Brand 2 PA SP








PROFILNINE INJ 500UNIT Brand 2 PA SP



BEBULIN INJ 200-1200 Brand 2 PA SP

BEBULIN VH INJ 200-1200 Brand 2 PA SP

CORIFACT KIT Brand 2 PA SP

RIASTAP SOL 1GM Brand 2

KCENTRA KIT 500UNIT Brand 2

PERSANTINE TAB 25MG Brand 2 GR

DIPYRIDAMOLE TAB 25MG generic 1





REOPRO INJ 2MG/ML Brand 2

INTEGRILIN INJ 0.75MG/1 Brand 2



INTEGRILIN INJ 2MG/ML Brand 2

AGGRASTAT INJ 25MG/500 Brand 2

PLETAL TAB 50MG Brand 2 GR

CILOSTAZOL TAB 50MG generic 1

PLETAL TAB 100MG Brand 2 GR

CILOSTAZOL TAB 100MG generic 1

ANAGRELIDE CAP 0.5MG generic 1

AGRYLIN CAP 0.5MG Brand 2 GR

ANAGRELIDE CAP 1MG generic 1

CLOPIDOGREL TAB 75MG generic 1

PLAVIX TAB 75MG Brand 2 GR

CLOPIDOGREL TAB 300MG generic 1

PLAVIX TAB 300MG Brand 2 GR

EFFIENT TAB 5MG Brand 2

EFFIENT TAB 10MG Brand 2

TICLOPIDINE TAB 250MG generic 1

BRILINTA TAB 90MG Brand 2

AGGRENOX CAP 25-200MG Brand 2

PENTOXIFYLLI TAB 400MG ER generic 1

PANHEMATIN INJ 313MG Brand 2

HETASTARCH INJ 6%/NACL generic 1

ALBUMIN-ZLB INJ generic 1

ALBUMIN HUM INJ 5% generic 1

ALBUKED 5 INJ 5% generic 1

ALBUTEIN INJ 5% generic 1

ALBUMINAR-5 INJ 5% generic 1

BUMINATE INJ 5% generic 1

ALBURX INJ 5% generic 1

PLASBUMIN-5 INJ 5% generic 1

ALBUMIN-ZLB SOL 25% generic 1

FLEXBUMIN INJ 25% generic 1

PLASBUMIN-25 INJ 25% generic 1



ALBUMIN HUM INJ 25% generic 1

BUMINATE INJ 25% generic 1

ALBUMINAR-25 INJ 25% generic 1

ALBUKED 25 INJ 25% generic 1

ALBUTEIN INJ 25% generic 1

KEDBUMIN INJ 25% generic 1

THROMBAT III INJ 500UNIT Brand 2

THROMBAT III INJ 1000UNIT Brand 2

PLASMANATE INJ 5% Brand 2

OCTAPLAS INJ GROUP B Brand 2

OCTAPLAS INJ GROUP AB Brand 2

OCTAPLAS INJ GROUP O Brand 2

OCTAPLAS INJ GROUP A Brand 2

PROTAMINE SU SOL 10MG/ML Brand 2

CEPROTIN INJ 500 UNIT Brand 2

CEPROTIN INJ 1000UNIT Brand 2

KINLYTIC INJ 250000 Brand 2

CATHFLO ACTI INJ VASE Brand 2

ACTIVASE INJ 50MG Brand 2

ACTIVASE INJ 100MG Brand 2

RETAVASE INJ HALF-KIT Brand 2

RETAVASE INJ Brand 2

TNKASE KIT 50MG Brand 2

SOLIRIS INJ 10MG/ML Brand 2

CINRYZE SOL 500 UNIT Brand 2 QL 16/30 PA SP

BERINERT INJ 500UNIT Brand 2 PA SP

FIRAZYR INJ 30MG/3ML Brand 2 PA SP

KALBITOR INJ 10MG/ML Brand 2 PA SP

Hematopoietics Agents

CYANOCOBALAM INJ 1000MCG generic 1

NASCOBAL SPR 500MCG Brand 2



B-12 COMP KIT 1000MCG Brand 2

HYDROXOCOBAL INJ 1000MCG Brand 2

FOLIC ACID TAB 1MG generic 1

FOLIC ACID INJ 5MG/ML Brand 2

INFED INJ 50MG/ML generic 1

DEXFERRUM INJ 50MG/ML generic 1

VENOFER INJ 20MG/ML Brand 2

INJECTAFER INJ 750/15ML Brand 2 PA

FERAHEME INJ 510/17ML Brand 2

FERRLECIT INJ 12.5MG/M Brand 2 GR

FERRIC GLUCO INJ 12.5MG/M generic 1

ARANESP INJ 25MCG Brand 2




ARANESP INJ 60MCG Brand 2 PREF PA SP










ARANESP INJ 500MCG Brand 2 PREF PA SP

EPOGEN INJ 2000/ML Brand 2 PREF PA SP

PROCRIT INJ 2000/ML Brand 2 PREF PA SP












OMONTYS INJ 10MG/ML Brand 2 PA SP

OMONTYS INJ 20MG/2ML Brand 2 PA SP

NEUPOGEN INJ 300MCG Brand 2

NEUPOGEN INJ 480MCG Brand 2

NEUPOGEN INJ 300/0.5 Brand 2

NEUPOGEN INJ 480/0.8 Brand 2

GRANIX INJ 300/0.5 Brand 2

GRANIX INJ 480/0.8 Brand 2

NEULASTA INJ 6MG/0.6M Brand 2

LEUKINE INJ 500 MCG Brand 2

LEUKINE INJ 250MCG Brand 2

NEUMEGA INJ 5MG Brand 2

PROMACTA TAB 12.5MG Brand 2

PROMACTA TAB 25MG Brand 2 PA SP



NPLATE INJ 250MCG Brand 2 PA SP

NPLATE INJ 500MCG Brand 2 PA SP

MOZOBIL INJ Brand 2 PA SP

CEREZYME INJ 200UNIT Brand 2

CEREZYME INJ 400UNIT Brand 2

ZAVESCA CAP 100MG Brand 2

ELELYSO INJ 200UNIT Brand 2

VPRIV INJ 400UNIT Brand 2

DROXIA CAP 200MG Brand 2





B6 FOLIC ACD CAP Brand 2

FOLTRATE TAB Brand 2

NEURIN-SL SUB Brand 2

PRE-FOLIC TAB 1-100MG Brand 2

FOLPLEX 2.2 TAB generic 1

FA-B6-B12 TAB generic 1

FOLGARD RX TAB Brand 2

FABB TAB generic 1

TL GARD RX TAB generic 1

CENFOL TAB Brand 2

AIRAVITE TAB generic 1

FOLBEE TAB generic 1

NUFOL TAB generic 1

VIRT-VITE TAB generic 1

BP VIT 3 CAP Brand 2

ANIMI-3 CAP Brand 2

ANIMI-3 CAP VIT D Brand 2

HEMATOGEN CAP generic 1

CORVITE FE TAB Brand 2

CORVITE 150 TAB Brand 2

HEMOCYTE-F ELX Brand 2

ED CYTE F TAB Brand 2

ALBAFORT INJ Brand 2

MYFERON 150 CAP FORTE generic 1

POLY-IRON CAP 150 FORT generic 1

IFEREX 150 CAP FORTE generic 1

FERREX 150 CAP FORTE generic 1

POLYSACCHARI CAP IRON generic 1

TL-FOL 500 TAB generic 1

NOVAFERRUM SOL Brand 2

FE C PLUS TAB generic 1

ICAR-C PLUS TAB Brand 2 GR



HEMATOGEN FA CAP Brand 2

TRIGELS-F CAP FORTE generic 1

HEMATOGEN CAP FORTE generic 1

FERROGELS FO CAP FORTE generic 1

FERROTRIN CAP Brand 2

NEPHRON FA TAB Brand 2

TRICON CAP generic 1

FEROTRINSIC CAP generic 1

FEROCON CAP generic 1

TL ICON CAP generic 1

FOLTRIN CAP generic 1

TARON FORTE CAP Brand 2

MAXARON TAB FORTE Brand 2

MULTIGEN TAB Brand 2

MULTIGEN TAB FOLIC Brand 2

FOLIVANE-PLS CAP Brand 2

INTEGRA PLUS CAP Brand 2

CORVITA 150 TAB generic 1

CORVITE 150 TAB Brand 2 GR

PROTECTIRON TAB Brand 2

FERRO-PLEX TAB Brand 2

MULTIGEN PLS TAB Brand 2

FERREX 150 CAP FORTE PL Brand 2

IROSPAN 24/6 MIS Brand 2

FERIVA CAP 75-1MG Brand 2

FUSION PLUS CAP Brand 2

TL-HEM 150 TAB generic 1

HEMATRON-AF TAB Brand 2 GR

SE-TAN PLUS CAP generic 1

PUREVIT DUAL CAP FE PLUS generic 1

TANDEM PLUS CAP Brand 2 GR

HEMOCYTE PLS CAP Brand 2



PUREFE CAP PLUS Brand 2

CENTRATEX CAP Brand 2

HEMOCYTE TAB -PLUS generic 1

HEMATINIC PL TAB VIT/MIN generic 1

FERROCITE TAB PLUS generic 1

HEMATINIC/FA TAB generic 1

HEMOCYTE-F TAB generic 1

PROFERRIN- TAB FORTE Brand 2

TANDEM F CAP Brand 2

INTEGRA F CAP Brand 2

FOLIVANE-F CAP Brand 2

BIFERARX TAB Brand 2

HEMETAB TAB Brand 2

FERRAPLUS 90 TAB Brand 2

FERREX 28 TAB Brand 2

FE 90 PLUS TAB Brand 2

NATALVIRT TAB FLT Brand 2

FERRALET 90 TAB Brand 2

Hemostatics

AMINOCAPR AC TAB 500MG generic 1

AMICAR TAB 500MG Brand 2 GR

AMICAR TAB 1000MG Brand 2

AMINOCAPR AC TAB 1000MG Brand 2

AMICAR SYP 25% Brand 2 GR

AMINOCAPR AC SYP 25% generic 1

AMINOCAPR AC INJ 250MG/ML generic 1

TRASYLOL INJ 10000/ML Brand 2

LYSTEDA TAB 650MG Brand 2 GR

TRANEX ACID TAB 650MG generic 1 QL 30/28 PA

TRANEX ACID INJ 100MG/ML generic 1

CYKLOKAPRON INJ 100MG/ML Brand 2 GR



Hypnotics

AMYTAL SOD INJ 500MG Brand 2

BUTISOL SOD TAB 30MG Brand 2

BUTISOL SOD TAB 50MG Brand 2

BUTISOL SOD ELX 30MG/5ML Brand 2

NEMBUTAL SOD INJ 50MG/ML Brand 2

PHENOBARB TAB 15MG generic 1

PHENOBARB TAB 16.2MG generic 1







PHENOBARB ELX 20MG/5ML generic 1

PHENOBARB SOL 20MG/5ML generic 1

PHENOBARB INJ 65MG/ML Brand 2

LUMINAL INJ 130MG/ML Brand 2 GR

PHENOBARB INJ 130MG/ML generic 1

SECONAL CAP 100MG Brand 2

ESTAZOLAM TAB 1MG generic 1 PREF

ESTAZOLAM TAB 2MG generic 1 PREF

FLURAZEPAM CAP 15MG generic 1 PREF

FLURAZEPAM CAP 30MG generic 1 PREF

MIDAZOLAM SYP 2MG/ML generic 1

MIDAZOLAM INJ 2MG/2ML generic 1


MIDAZOLAM INJ 10/10ML generic 1

MIDAZOLAM INJ 5MG/ML generic 1






MIDAZOLAM INJ 50MG/10 generic 1


QUAZEPAM TAB 15MG generic 1

DORAL TAB 15MG Brand 2

TEMAZEPAM CAP 7.5MG generic 1 PREF

RESTORIL CAP 7.5MG Brand 2 NON-PREF ST

TEMAZEPAM CAP 15MG generic 1 PREF

RESTORIL CAP 15MG Brand 2 NON-PREF ST

TEMAZEPAM CAP 22.5MG generic 1 PREF

RESTORIL CAP 22.5MG Brand 2 NON-PREF ST

TEMAZEPAM CAP 30MG generic 1 PREF

RESTORIL CAP 30MG Brand 2 NON-PREF ST

TRIAZOLAM TAB 0.125MG generic 1 PREF

HALCION TAB 0.25MG Brand 2 NON-PREF ST

TRIAZOLAM TAB 0.25MG generic 1 PREF

LUNESTA TAB 1MG Brand 2 NON-PREF ST QL 30/30



ZALEPLON CAP 5MG generic 1 NON-PREF ST QL 30/30

SONATA CAP 5MG Brand 2 NON-PREF ST

ZALEPLON CAP 10MG generic 1 NON-PREF ST QL 30/30

SONATA CAP 10MG Brand 2 NON-PREF ST

ZOLPIDEM TAB 5MG generic 1 PREF QL 30/30

AMBIEN TAB 5MG Brand 2 NON-PREF ST QL 30/30

ZOLPIDEM TAB 10MG generic 1 PREF QL 30/30

AMBIEN TAB 10MG Brand 2 NON-PREF ST QL 30/30

ZOLPIDEM ER TAB 6.25MG generic 1 NON-PREF ST QL 30/30

AMBIEN CR TAB 6.25MG Brand 2 NON-PREF ST QL 30/30

ZOLPIDEM ER TAB 12.5MG generic 1 NON-PREF ST QL 30/30

AMBIEN CR TAB 12.5MG Brand 2 NON-PREF ST QL 30/30

INTERMEZZO SUB 1.75MG Brand 2 NON-PREF ST QL 30/30



INTERMEZZO SUB 3.5MG Brand 2 NON-PREF ST QL 30/30

EDLUAR SUB 5MG Brand 2 NON-PREF ST QL 30/30

EDLUAR SUB 10MG Brand 2 NON-PREF ST QL 30/30

ZOLPIMIST SPR 5MG Brand 2 NON-PREF ST QL 7.7/30

PRECEDEX INJ 100MCG Brand 2

PRECEDEX INJ 200/50ML Brand 2

PRECEDEX INJ 400/100 Brand 2

ROZEREM TAB 8MG Brand 2 NON-PREF ST QL 30/30

SILENOR TAB 3MG Brand 2 NON-PREF ST QL 30/30

SILENOR TAB 6MG Brand 2 NON-PREF ST QL 30/30

Laxatives

MAGN SULFATE POW HEPTAHYD Brand 2

MAGN SULFATE POW Brand 2

OSMOPREP TAB 1.5GM Brand 2

BISACODYL POW Brand 2

CASCARA EXT SAGRADA Brand 2

SENNA LEAVES MIS Brand 2

MINERAL OIL HEAVY Brand 2

MINERAL OIL Brand 2

MINERAL OIL HEAVY Brand 2

MURI-LUBE OIL Brand 2

MINERAL OIL LIGHT Brand 2



CONSTULOSE SOL 10GM/15 generic 1

KRISTALOSE PAK 10GM Brand 2

KRISTALOSE PAK 20GM Brand 2

PEGYLAX POW generic 1

POLYETH GLYC POW 3350 NF generic 1

PREPOPIK PAK Brand 2

SUPREP BOWEL SOL PREP Brand 2



GAVILYTE-N SOL FLAV PK generic 1

PEG-3350/KCL SOL /SODIUM generic 1

NULYTELY SOL FLAV PKS Brand 2 GR

TRILYTE SOL generic 1

COLYTE/FLAVR SOL PACKS Brand 2

GAVILYTE-G SOL generic 1

PEG-3350 SOL ELECTROL generic 1

GOLYTELY SOL PINEAPPL Brand 2 GR

GOLYTELY SOL Brand 2 GR

COLYTE/FLAVR SOL PACKS Brand 2 GR

GAVILYTE-C SOL generic 1

PEG 3350 SOL ELECTROL generic 1

GOLYTELY SOL Brand 2

MOVIPREP SOL Brand 2

SUCLEAR KIT Brand 2

Local Anesthetics - Parenteral

BUPIVACAINE INJ 0.25% generic 1

SENSORCAINE INJ 0.25% generic 1

MARCAINE INJ 0.25% Brand 2 GR



SENSORCAINE INJ MPF0.25% generic 1


SENSORCAINE INJ 0.5% generic 1



SENSORCAINE INJ MPF 0.5% generic 1



SENSORCAINE INJ MPF0.75% generic 1




BUPIVACAINE INJ SPINAL generic 1

SENSORCAINE INJ MPF SPIN generic 1

MARCAINE INJ SPINAL Brand 2 GR

LIDOCAINE INJ 0.5% generic 1

XYLOCAINE INJ 0.5% Brand 2 GR

XYLOCAINE INJ MPF 0.5% Brand 2 GR


LIDOCAINE INJ 1% generic 1



XYLOCAINE INJ -MPF 1% Brand 2 GR


XYLOCAINE INJ MPF 1.5% Brand 2 GR







CARBOCAINE INJ 1% Brand 2 GR

POLOCAINE INJ 1% generic 1

CARBOCAINE INJ 1% PF Brand 2 GR

POLOCAINE INJ -MPF 1% generic 1

CARBOCAINE INJ 1.5% PF Brand 2 GR

POLOCAINE INJ MPF 1.5% generic 1

POLOCAINE INJ 2% generic 1

CARBOCAINE INJ 2% Brand 2 GR

CARBOCAINE INJ 2% PF Brand 2 GR

POLOCAINE INJ -MPF 2% generic 1

NESACAINE INJ 2% Brand 2 GR

NESACAINE INJ -MPF 2% Brand 2 GR

CHLOROPROC INJ 2% generic 1



CHLOROPROC INJ 3% generic 1

NESACAINE INJ -MPF 3% Brand 2 GR

TETRACAINE INJ 1% generic 1

PONTOCAINE INJ 1% Brand 2 GR

MARCAINE/EPI INJ 0.25% Brand 2 GR

SENSORCAINE/ INJ EPI 0.25 generic 1

BUPIVACAINE/ INJ EPI 0.25 generic 1


BUPIVACAINE/ INJ EPI 0.25 generic 1

SENSORCAINE INJ -MPF/EPI generic 1

BUPIVACAINE/ INJ EPI 0.5% generic 1

SENSORCAINE/ INJ EPI 0.5% generic 1


BUPIVACAINE/ INJ EPI 0.5% generic 1

SENSORCAINE INJ -MPF/EPI generic 1


LIDO/EPI INJ 0.5% generic 1

XYLO/EPI INJ 0.5% Brand 2 GR

LIDO/EPI 1%- INJ 1:100000 generic 1

XYLO/EPI 1%- INJ 1:100000 Brand 2 GR

XYLO-MPF/EPI INJ 1.5% Brand 2 GR

LIDO/EPI INJ 1.5% generic 1

LIDO/EPI INJ 2% generic 1

XYLO-MPF/EPI INJ 2% Brand 2 GR


XYLO/EPI INJ 2% Brand 2 GR


Macrolides

ERYTHROMYCIN TAB 250MG BS generic 1 PREF

ERYTHROMYCIN TAB 500MG BS generic 1 PREF

ERY-TAB TAB 250MG EC Brand 2 PREF



ERY-TAB TAB 333MG EC Brand 2 PREF

ERY-TAB TAB 500MG EC generic 1 PREF

ERYTHROMYCIN CAP 250MG EC generic 1

PCE TAB 333MG EC Brand 2 NON-PREF ST

PCE TAB 500MG EC Brand 2 NON-PREF ST

ERYTHROCIN TAB 250MG generic 1

E.E.S. 400 TAB 400MG generic 1 NON-PREF ST

E.E.S. GRAN SUS 200/5ML Brand 2 NON-PREF ST

ERYPED SUS 200/5ML Brand 2 NON-PREF ST

ERYPED SUS 400/5ML Brand 2 NON-PREF ST

ERYTHROCIN INJ 500MG generic 1

ERYTHROCIN INJ 1000MG generic 1

AZITHROMYCIN TAB 250MG generic 1 PREF

ZITHROMAX TAB Z-PAK Brand 2 NON-PREF ST

ZITHROMAX TAB 250MG Brand 2 NON-PREF ST



ZITHROMAX TAB TRI-PAK Brand 2 NON-PREF ST



AZITHROMYCIN SUS 100/5ML generic 1 PREF

ZITHROMAX SUS 100/5ML Brand 2 NON-PREF ST

AZITHROMYCIN SUS 200/5ML generic 1 PREF

ZITHROMAX SUS 200/5ML Brand 2 NON-PREF ST

ZMAX SUS 2GM Brand 2 NON-PREF ST

AZITHROMYCIN INJ 500MG generic 1

ZITHROMAX INJ 500MG Brand 2 GR

ZITHROMAX POW 1GM PAK Brand 2 NON-PREF ST

AZITHROMYCIN POW 1GM PAK generic 1 PREF

AZITHROMYCIN INJ 2.5GM Brand 2

CLARITHROMYC TAB 250MG generic 1 PREF

BIAXIN TAB 250MG Brand 2 NON-PREF ST



CLARITHROMYC TAB 500MG generic 1 PREF

BIAXIN TAB 500MG Brand 2 NON-PREF ST

CLARITHROMYC SUS 125/5ML generic 1 PREF

CLARITHROMYC SUS 250/5ML generic 1 PREF

BIAXIN SUS 250/5ML Brand 2 NON-PREF ST

CLARITHROMYC TAB 500MG ER generic 1 NON-PREF ST

BIAXIN XL TAB 500MG Brand 2 NON-PREF ST

BIAXIN XL TAB PAC 500 Brand 2 NON-PREF ST

DIFICID TAB 200MG Brand 2 QL 60/30 PA

Medical Devices

INSULIN SYRG MIS 1ML Brand 2

INSULIN SYRG MIS 0.3/29G Brand 2



INSULIN SYRG MIS 1ML/27G Brand 2

INSULIN SYRG MIS 1ML/28G Brand 2

AUTOSHIELD MIS 30GX3/16 Brand 2

OPTICHAMBER MIS DIA LG Brand 2

AERCHMBR PLS MIS FLOW-VU Brand 2

POCKET SPACE MIS Brand 2

POCKET CHAMB MIS Brand 2

RITEFLO MIS Brand 2

E-Z SPACER MIS Brand 2

E-Z SPACER MIS BODY GRD Brand 2

VORTEX VALVE MIS CHAMBER Brand 2

INSPIREASE MIS DD SYST Brand 2

MICROCHAMBER MIS Brand 2

WATCHHALER MIS Brand 2

OPTICHAMBER MIS DIA SM Brand 2

AERCHMBR PLS MIS SM MASK Brand 2

EASIVENT MIS MASK LG Brand 2



EASIVENT MIS MASK MED Brand 2

EASIVENT MIS MASK SM Brand 2

EASIVENT MIS Brand 2

MICROSPACER MIS Brand 2

BREATHERITE MIS SM MASK Brand 2

BREATHERITE MIS MED MASK Brand 2

BREATHERITE MIS LG MASK Brand 2

BREATHERITE MIS W/MASK Brand 2

BREATHERITE MIS SPACER Brand 2

OPTICHAMBER MIS DIA MD Brand 2

AERCHMBR PLS MIS LRG MASK Brand 2

OPTICHAMBER MIS ADV LRG Brand 2

OPTICHAMBER MIS ADV MED Brand 2

OPTICHAMBER MIS ADV SM Brand 2

OPTICHAMBER MIS ADVANTAG Brand 2

AEROCHAMBER MIS MV Brand 2

AEROCHAMBER MIS PLUS Brand 2

AEROCHAMBER MIS FLOSIGNA Brand 2

AERCHMBR PLS MIS MED MASK Brand 2

AERCHMBR Z- MIS STAT PLS Brand 2

AEROCHAMBER MIS PLUS Brand 2

BREATHERITE MIS Brand 2

OPTIHALER MIS Brand 2

VALVD HOLDNG MIS CHAMBER Brand 2

OPTICHAMBER MIS DIAMOND Brand 2

LITEAIRE MIS Brand 2

AEROCHAMBER MIS CHAMBER Brand 2

PARI LC PLUS MIS NEBULIZR Brand 2

PARI LC STAR MIS NEBULIZR Brand 2

PARI LC MIS SPRINT Brand 2

PARI SINUS MIS AERO SYS Brand 2

VIOS LC MIS SPRINT Brand 2



VIOS LC PLUS MIS DELUXE Brand 2

VIOS MIS SYSTEM Brand 2

VIOS LC PLUS MIS Brand 2

VIOS LC PLUS MIS PEDIATRC Brand 2

ALTERA MIS NEBULIZE Brand 2

EFLOW SCF MIS NEBULIZR Brand 2

PARI PRONEB MIS ULTRA II Brand 2

AIRIAL MIS VOYAGER Brand 2

AIRIAL PEDIA MIS PANDA Brand 2

AEROECLIPSE MIS II NEB Brand 2

MINI COMPRES MIS NEBULIZR Brand 2

PRONEB ULTRA MIS LC PLUS Brand 2

PARI TREK S MIS Brand 2

PARI BABY MIS SIZE 0 Brand 2


HEALTHY LIV MIS COMPRESS Brand 2


PULMO-AIDE MIS COMP/NEB Brand 2

PRONEB ULTRA MIS II/LCD Brand 2

PRONEB ULTRA MIS LC SPRNT Brand 2

PRONEB ULTRA MIS LC STAR Brand 2

VIXONE DISP MIS NEBULIZR Brand 2

INSPIRATION MIS NEBULIZR Brand 2

SIDESTREAM MIS NEBULIZR Brand 2

INNOSPIRE EL MIS NEBULIZE Brand 2

MICROELITE MIS COMP/NEB Brand 2

OPTIONHOME MIS NEBULIZR Brand 2

SIDESTREAM MIS PLUS Brand 2

MICRO PLUS MIS NEBULIZR Brand 2

MINI PLUS MIS NEBULIZR Brand 2

INNOSPIRE ES MIS NEBULIZE Brand 2

NEBULIZER MIS ULTRASNC Brand 2



NEBULIZER MIS CMPRESSR Brand 2

NEBULIZER MIS POCKET Brand 2

PARI LC D MIS NEBULIZR Brand 2

DEVILBISS MIS NEBULIZR Brand 2

MINIELITE MIS COMP/NEB Brand 2

AIRIAL PEDIA MIS FIRE ENG Brand 2

NEBULIZER MIS Brand 2

PULMOMATE/ MIS NEBULIZR Brand 2

LUMINEB II MIS NEBULIZR Brand 2

NEBULIZER MIS ULTRASON Brand 2

PARI LC PLUS MIS Brand 2

PARI LC STAR MIS Brand 2

COMP AIR MIS ELITE Brand 2

MICRO AIR MIS NEBULIZR Brand 2

COMP AIR MIS COMP/NEB Brand 2

ELITE SYSTEM MIS NEBULIZR Brand 2

MISTERNEB MIS NEBULIZE Brand 2

ERAPID MIS NEBULIZE Brand 2

NEBULIZER MIS COMPRESS Brand 2

PRONEB ULTRA MIS II/PED Brand 2

AIRIAL PEDIA MIS DUCK Brand 2

AIRIAL COMP MIS COMPRESS Brand 2

AIRIAL PEDIA MIS BUILDING Brand 2

AIRIAL PEDIA MIS PENGUIN Brand 2

AIRIAL MIS COMPACT Brand 2

INSPIRATION MIS ELITE Brand 2

TRUZONE PEAK MIS FLOW MTR Brand 2

ALCOH-WIPE PAD 12"X12" Brand 0

ALCOH-GLOVE PAD CONTOURE Brand 0

Migraine Products

ERGOMAR SUB 2MG Brand 2



DIHYDROERGOT INJ 1MG/ML generic 1

D.H.E. 45 INJ 1MG/ML Brand 2 GR

MIGRANAL SPR 4MG/ML Brand 2 GR

DIHYDROERGOT SPR 4MG/ML generic 1 QL 12/30

MIGRAL TAB 130MG Brand 2

AXERT TAB 6.25MG Brand 2 NON-PREF ST QL 12/30

AXERT TAB 12.5MG Brand 2 NON-PREF ST QL 12/30

RELPAX TAB 20MG Brand 2 NON-PREF ST QL 12/30

RELPAX TAB 40MG Brand 2 NON-PREF ST QL 12/30

FROVA TAB 2.5MG Brand 2 NON-PREF ST QL 12/30

AMERGE TAB 1MG Brand 2 NON-PREF ST QL 12/30

NARATRIPTAN TAB 1MG generic 1 NON-PREF ST QL 12/30

AMERGE TAB 2.5MG Brand 2 NON-PREF ST QL 12/30

NARATRIPTAN TAB 2.5MG generic 1 NON-PREF ST QL 12/30

RIZATRIPTAN TAB 5MG generic 1 NON-PREF ST QL 12/30

MAXALT TAB 5MG Brand 2 NON-PREF ST QL 12/30

RIZATRIPTAN TAB 10MG generic 1 NON-PREF ST QL 12/30

MAXALT TAB 10MG Brand 2 NON-PREF ST QL 12/30

RIZATRIPTAN TAB 5MG ODT generic 1 NON-PREF ST QL 12/30

MAXALT-MLT TAB 5MG Brand 2 PREF QL 12/30

RIZATRIPTAN TAB 10MG ODT generic 1 NON-PREF ST QL 12/30

MAXALT-MLT TAB 10MG Brand 2 PREF QL 12/30

IMITREX SPR 5MG/ACT Brand 2 NON-PREF ST QL 12/30

SUMATRIPTAN SPR 5MG/ACT generic 1 PREF QL 12/30

SUMATRIPTAN SPR 20MG/ACT generic 1 PREF QL 12/30

IMITREX SPR 20MG/ACT Brand 2 NON-PREF ST QL 12/30

SUMATRIPTAN TAB 25MG generic 1 PREF QL 12/30

IMITREX TAB 25MG Brand 2 NON-PREF ST QL 12/30







IMITREX INJ 4MG/0.5 Brand 2 NON-PREF ST QL 6/30

SUMATRIPTAN INJ 4MG/0.5 generic 1 PREF QL 3/30

SUMATRIPTAN INJ 6MG/0.5 generic 1 PREF QL 5/30

IMITREX INJ 6MG/0.5 Brand 2 NON-PREF ST QL 5/30

ALSUMA INJ 6MG/0.5 Brand 2 NON-PREF ST QL 5/30

SUMAVEL DOSE INJ 6MG/0.5 Brand 2 NON-PREF ST QL 6/30

ZOLMITRIPTAN TAB 2.5MG generic 1

ZOMIG TAB 2.5MG Brand 2 GR

ZOLMITRIPTAN TAB 5MG generic 1

ZOMIG TAB 5MG Brand 2 GR

ZOMIG NASAL SPR 5MG Brand 2 NON-PREF ST QL 12/30

ZOLMITRIPTAN TAB 2.5 MG generic 1

ZOMIG ZMT TAB 2.5 MG Brand 2 GR

ZOMIG ZMT TAB 5MG Brand 2 GR

ZOLMITRIPTAN TAB 5MG generic 1

CAMBIA POW 50MG Brand 2 QL 9/30 PA

CAFERGOT TAB 1-100MG Brand 2

MIGERGOT SUP 2/100 generic 1

TREXIMET TAB 85-500MG Brand 2 NON-PREF ST QL 12/30

Mineral & Electrolytes

SOD ACETATE INJ 2MEQ/ML generic 1

SOD ACETATE INJ 4MEQ/ML generic 1

NEUT INJ 4% Brand 2

SOD BICARB INJ 4.2% generic 1



SOD LACTATE INJ 5MEQ/ML Brand 2

SOD LACTATE INJ 1/6M generic 1

THAM INJ 30MEQ Brand 2

CALCIUM CL INJ 10% generic 1

CALCIUM GLUC INJ 10% generic 1



CALCIUM-FA WAF PLUS D generic 1

CALCIFOL WAF Brand 2

AMMONIUM CHL INJ 5MEQ/ML generic 1

SOD FLUORIDE TAB 0.5MG F Brand 2

SOD FLUORIDE TAB 1MG F Brand 2

SOD FLUORIDE CHW 0.25MG F generic 1

FLUORITAB CHW 0.25MG F generic 1

EPIFLUR CHW 0.25MG F generic 1

LURIDE CHW 0.25MG F Brand 2 GR

LUDENT CHW 0.25MG F generic 1

FLUORIDE CHW 0.25MG F generic 1

EPIFLUR CHW 0.5MG F generic 1

FLUORIDE CHW 0.5MG F generic 1

SOD FLUORIDE CHW 0.5MG F generic 1

SOD FLUORIDE CHW 1.1MG generic 1

FLUORITAB CHW 0.5MG F generic 1

LUDENT CHW 0.5MG F generic 1

LURIDE CHW 0.5MG F Brand 2 GR

FLUORIDE CHW 1MG F generic 1

LURIDE CHW 1MG F Brand 2 GR

LUDENT CHW 1MG F generic 1

SOD FLUORIDE CHW 1MG F generic 1

NAFRINSE CHW 1MG F generic 1

SOD FLUORIDE CHW 2.2MG generic 1

EPIFLUR CHW 1MG F generic 1

FLUORITAB CHW 1MG F generic 1

FLUORITAB CHW 2.2MG generic 1

NAFRINSE DRO 0.125MG generic 1

FLURA-DROPS DRO 0.125MG generic 1

FLUORITAB DRO 0.125MG generic 1

KARIDIUM DRO 0.125MG generic 1

FLUOR-A-DAY DRO 0.125MG generic 1



FLURA-DROPS DRO 0.25MG F Brand 2

FLUORABON DRO Brand 2

SOD FLUORIDE DRO 0.5MG/ML generic 1

LURIDE DRO 0.5MG/ML Brand 2 GR

LOZI-FLUR LOZ 1MG F Brand 2

FLUOR-A-DAY CHW 0.25MG F Brand 2

FLUOR-A-DAY CHW 0.5MG F Brand 2

FLUOR-A-DAY CHW 1MG F Brand 2

SSKI SOL 1GM/ML Brand 2

IODOPEN INJ 100MCG Brand 2

IODINE SOL STRONG Brand 2

MAGNESIUM CL INJ 20% generic 1

CHLOROMAG INJ 20% generic 1

MAGNESIUM SU INJ 40MG/ML generic 1

MAGNESIUM SU INJ 80MG/ML generic 1

MAGNESIUM SU INJ 50% generic 1

MAGNEBIND TAB 400 Brand 2

MANGANESE CL INJ 0.1MG/ML Brand 2

MANGANESE SU INJ 0.1MG/ML Brand 2

POT PHOSPHAT INJ 3MM/ML generic 1

K-PHOS TAB Brand 2

GLYCOPHOS SOL 1MM/ML Brand 2

SOD PHOSPHAT INJ 3MM/ML generic 1

PHOSPHA 250 TAB NEUTRAL generic 1

K-PHOS TAB NEUTRAL Brand 2 GR

POT ACETATE INJ 2MEQ/ML generic 1

POT ACETATE INJ 4MEQ/ML generic 1

K-EFFERVESCE TAB 25MEQ EF generic 1

KLOR-CON/EF TAB 25MEQ FR generic 1

POTASSIUM TAB 25MEQ EF generic 1

K-VESCENT TAB 25MEQ EF generic 1

EFFER-K TAB 25MEQ EF generic 1



POT BICARBON TAB 25MEQ EF generic 1

K-PRIME TAB 25MEQ EF generic 1

POT CHLORIDE CAP 8MEQ ER generic 1

MICRO-K CAP 8MEQ CR Brand 2 GR

MICRO-K CAP 10MEQ CR Brand 2 GR

POT CHLORIDE CAP 10MEQ ER generic 1

POT CHLORIDE TAB 8MEQ ER generic 1

POT CHLORIDE TAB 8MEQ SR generic 1

KLOR-CON 8 TAB 8MEQ ER generic 1

POT CHLORIDE TAB 10MEQ ER generic 1

POT CHLORIDE TAB 10MEQ CR generic 1

KLOR-CON 10 TAB 10MEQ ER generic 1

K-TABS TAB 10MEQ CR Brand 2 GR

POT CHLORIDE LIQ 10% SF generic 1

POT CHLORIDE SOL 10% SF generic 1

POT CHLORIDE LIQ 10% generic 1

POT CHLORIDE LIQ 20% generic 1

POT CHLORIDE INJ 2MEQ/ML generic 1

POT CHLORIDE INJ 10MEQ generic 1






POT CL MICRO TAB 10MEQ ER generic 1

POT CL MICRO TAB 10MEQ CR generic 1

KLOR-CON M10 TAB 10MEQ ER generic 1

KLOR-CON M15 TAB generic 1

POT CL MICRO TAB 20MEQ ER generic 1

KLOR-CON M20 TAB 20MEQ ER generic 1

POT/CHLORIDE TAB 25MEQ EF generic 1

POT CHLORIDE TAB 25MEQ EF generic 1



EFFER-K TAB 10MEQ Brand 2

EFFER-K TAB 20MEQ Brand 2

SOD CHLORIDE INJ 0.45% generic 1

FLUSH SYRING INJ 0.9% generic 1



SOD CHLORIDE INJ 3% generic 1

SOD CHLORIDE INJ 5% generic 1


SOD CHLORIDE INJ 4MEQ/ML generic 1

SOD CHLORIDE INJ 2.5/ML generic 1

NORMAL SALIN INJ 0.9% generic 1

NORML SALINE INJ FLUSH generic 1


BD POSIFLUSH INJ 0.9% generic 1

SALINE FLUSH INJ 0.9% generic 1

SALINE FLUSH INJ ZR 0.9% generic 1

SWABFLUSH INJ 0.9% generic 1

NORML SALINE INJ IV FLUSH generic 1

GALZIN CAP 25MG Brand 2

GALZIN CAP 50MG Brand 2

ZINC SULFATE CAP 220MG generic 1

ZINC SULFATE INJ 1MG/ML Brand 2

ZINC SULFATE INJ 5MG/ML Brand 2

ZINC TRACE INJ 1MG/ML Brand 2

MULTITRACE-4 INJ NEONATAL Brand 2

MULTITRACE-4 INJ PED Brand 2

TRACE ELEM 4 INJ PED Brand 2

MULTITRACE-4 INJ Brand 2

MULTITRACE-4 INJ CONC generic 1

MULTITRACE-5 INJ REGULAR Brand 2

MULTITRACE-5 INJ generic 1



MULTITRACE-5 INJ CONC generic 1

PEDITRACE INJ Brand 2

ADDAMEL N INJ Brand 2

Mouth/Throat/Dental Agents

NYSTATIN SUS 100000 generic 1

CLOTRIMAZOLE LOZ 10MG generic 1

CLOTRIMAZOLE TRO 10MG generic 1

ORAVIG TAB 50MG Brand 2

FIRST DUKES SUS MOUTHWSH Brand 2

BXN MOUTHWSH SUS Brand 2

FIRST-MARYS SUS MOUTHWSH Brand 2

CHLORHEX GLU SOL 0.12% generic 1

PERIOGARD SOL 0.12% generic 1

PERIDEX SOL 0.12% Brand 2 GR

DEBACTEROL SOL 30-50% Brand 2

TRIAMCINOLON PST 0.1% generic 1

TRIAMCIN/ORA PST 0.1% generic 1

ORALONE PST 0.1% generic 1

APHTHASOL PST 5% Brand 2

DOBELLS SOL generic 1

TOPEX TOPCAL SPR ANESTHET generic 1

LIDOCAINE SOL 4% generic 1

LTA 360 KIT SOL 4% Brand 2 GR

LIDOCAINE SOL 2% VISC generic 1

FIRST-MOUTHW SUS BLM Brand 2

SOD FLUORIDE SOL 0.2% generic 1

SOD FLUORIDE SOL 0.2%MINT generic 1

CAVIRINSE SOL 0.2% generic 1

PREVIDENT SOL RINSE Brand 2 GR

NAFRINSE DLY SOL /NEUTRAL Brand 2

NAFRINSE WK SOL 0.2% Brand 2



SF 5000 PLUS CRE 1.1% generic 1

PREVIDENT CRE 5000 PLS Brand 2 GR

CONTROLRX CRE 1.1% generic 1

DENTA 5000 CRE PLUS generic 1

DENTA 5000 CRE PLUS 2PK generic 1

FLUORIDEX GEL WHITENIN generic 1

KARIGEL GEL 0.5% generic 1

CAVAREST GEL 1.1% generic 1

PHOS-FLUR GEL 1.1% generic 1

DENTAGEL GEL 1.1% generic 1

KARIGEL-N GEL 1.1% generic 1

NEUTRAGARD GEL 1.1% generic 1

SF GEL 1.1% generic 1

THERA-FLUR-N DRO 1.1% Brand 2 GR

PREVIDENT GEL 1.1% MIN Brand 2 GR

PREVIDENT GEL 1.1% BER Brand 2 GR

PREVIDENT GEL 1.1% CHR Brand 2 GR

FLUORIDEX GEL 1.1% generic 1

PREVIDENT PST 1.1% Brand 2 GR

PREVDNT 5000 PST 1.1% Brand 2 GR

CONTROLRX PST 1.1% generic 1

CLINPRO 5000 PST 1.1% generic 1

PREVIDENT PST 5000 BST Brand 2 GR

STAN FLUORID CON 0.63% generic 1

PERIO MED CON 0.63% generic 1

GEL-KAM CON 0.63% Brand 2 GR

EASYGEL GEL 0.4%CHRY generic 1

EASYGEL GEL 0.4%CITR generic 1

EASYGEL GEL 0.4% generic 1

EASYGEL GEL 0.4%MINT generic 1

NAFRINSE SOL DAILY Brand 2

FLUORIDEX GEL SENSITIV Brand 2



FLUORIDEX DD PST SENSITIV generic 1

PRVDNT 5000 PST ENAML PR Brand 2 GR

PREVIDENT PST 5000 SEN Brand 2 GR

ARESTIN MIS 1MG Brand 2

NUMOISYN LIQ Brand 2

CAPHOSOL SOL Brand 2

AQUORAL AER Brand 2

NUMOISYN LOZ Brand 2 GR

CEVIMELINE CAP 30MG generic 1

EVOXAC CAP 30MG Brand 2 GR

PILOCARPINE TAB 5MG generic 1

SALAGEN TAB 5MG Brand 2 GR

PILOCARPINE TAB 7.5MG generic 1

SALAGEN TAB 7.5MG Brand 2 GR

ORAFATE PST 10% Brand 2

PROTHELIAL PST 10% Brand 2

GELCLAIR GEL Brand 2

SALICEPT SUS Brand 2

ORAMAGICRX SUS Brand 2

MUCOTROL WAF Brand 2

GELX GEL Brand 2

Multivitamins

COD LIVER OIL Brand 2 PA

NICOMIDE TAB Brand 2 PA

VIT B-COMPLX INJ 100 generic 1

B-COMPLEX INJ generic 1

B-COMPLEX INJ 100 generic 1

VITAJECT INJ Brand 2 PA

NEURODEP SOL Brand 2 PA

RENAL CAP SOFTGEL generic 1

RENO CAP generic 1



MYNEPHROCAPS CAP generic 1

RENALPREN CAP generic 1

TRIPHROCAPS CAP generic 1

NEPHROCAPS CAP Brand 2 GR

B-PLEX TAB generic 1

SM B-COMPLEX TAB /VIT C Brand 2 PA

STROVITE TAB Brand 2 GR

NEPHRO-VITE TAB RX Brand 2 GR

DIALYVITE TAB generic 1

VOL-CARE RX TAB generic 1

NEPHRONEX TAB 1MG generic 1

RENA-VITE RX TAB generic 1

FOLBEE PLUS TAB generic 1

VIRT-VITE TAB PLUS generic 1

NEPHROCAPS TAB QT Brand 2 PA

DIALYVITE/ TAB ZINC Brand 2 PA

NEPHPLEX RX TAB Brand 2 PA

SUPERVITE LIQ Brand 2 PA

NUTRIVIT LIQ 800-15-1 Brand 2 PA

RENATABS TAB Brand 2 PA

DIALYVITE TAB 3000 Brand 2 PA

DIALYVITE TAB 5000 Brand 2 PA

RENATABS MIS IRON Brand 2 PA

VITAL-D RX TAB Brand 2 PA

DIATX ZN TAB Brand 2 GR

FOLBEE PLUS TAB CZ generic 1

ALBAFORT INJ Brand 2 PA

ADRENAL C TAB FORMULA Brand 2 PA

M.V.I PEDIAT INJ Brand 2 PA

M.V.I-12 W/O INJ VIT K Brand 2 PA

M.V.I. ADULT INJ Brand 2 PA

INFUVITE INJ PEDIATRI generic 1



INFUVITE INJ generic 1

INFUVITE INJ ADULT generic 1

PROTECT PLUS CAP Brand 2 PA

FORTAVIT CAP Brand 2 PA

VIC-FORTE CAP generic 1

VITA-MIN CAP generic 1

V-C FORTE CAP generic 1

NICAZEL TAB FORTE Brand 2 PA

STROVITE FOR TAB Brand 2 GR

VITAROCA PLU TAB Brand 2 GR

STROVITE ONE TAB Brand 2 PA

STROVITE PLU TAB generic 1

B-PLEX PLUS TAB generic 1

CHOICE-TABS TAB generic 1

BIOCEL TAB generic 1

LYSIPLEX TAB PLUS generic 1

VITACEL TAB generic 1

VITA S FORTE TAB generic 1

REQ 49+ TAB Brand 2 PA

CORVITE FREE TAB generic 1

TRI-ZEL TAB Brand 2 PA

BACMIN TAB Brand 2 PA

SIDEROL TAB Brand 2 PA

AP-ZEL TAB Brand 2 PA

NUTRICAP TAB Brand 2 PA

VP-ZEL TAB Brand 2 PA

NICAZEL TAB Brand 2 PA

NUTRIFAC ZX TAB generic 1

PROTECT PLUS LIQ Brand 2 PA

SUPPORT LIQ Brand 2 PA

SYNATEK CAP Brand 2 PA

SYNAGEX CAP 1.25MG Brand 2 PA



UDAMIN SP TAB Brand 2 PA

CORVITE TAB Brand 2 GR

CORVITA TAB generic 1

UDAMIN TAB Brand 2 PA

RENAX TAB 2.5MG Brand 2 PA

DIALYVITE TAB SUPREM D Brand 2 PA

SUPERVITE EC TAB Brand 2 PA

STROVITE FOR SYP Brand 2 PA

ADVANCED MIS AM/PM Brand 2 PA

FOLGARD OS TAB Brand 2 PA

TL G-FOL OS TAB Brand 2 PA

PROTECTBONE WAF Brand 2 PA

VITAMAX PED DRO generic 1

ACD/FLUORIDE DRO 0.25MG generic 1

TRI-VIT/FL DRO 0.25MG generic 1

TRI-VIT/FLUO DRO 0.25MG generic 1

TRI-VITA/FL DRO 0.25MG generic 1

TRI-VIT/FLUO DRO 0.5MG generic 1

TRI-VIT/FL DRO 0.5MG generic 1

TRI-VI-FLORO SUS 0.25/ML Brand 2 PA

TRI-VI-FLOR SUS 0.25/ML Brand 2 PA

TRI-VI-FLORO SUS 0.5MG/ML Brand 2 PA

TRI-VI-FLOR SUS 0.5MG/ML Brand 2 PA

MULTIVIT/FL CHW 0.25MG generic 1

MULTI-VIT/FL CHW 0.25MG generic 1

MVC-FLUORIDE CHW 0.25MG generic 1

MULTIVIT/FL CHW 0.5MG generic 1

MULT-VIT/FL CHW 0.5MG generic 1

MULTI-VIT/FL CHW 0.5MG generic 1

MVC-FLUORIDE CHW 0.5MG generic 1

MVC-FLUORIDE CHW 1MG generic 1

MULTIVIT/FL CHW 1MG generic 1



MULTI-VIT/FL CHW 1MG generic 1

POLY-VI-FLOR CHW 0.25MG Brand 2 PA

POLY-VI-FLOR CHW 0.5MG Brand 2 PA

POLY-VI-FLOR CHW 1MG Brand 2 PA

POLY-VI-FLOR SUS 0.25/ML Brand 2 PA

MULTI-VIT/FL DRO 0.25MG generic 1

MULTI-VIT/FL DRO 0.5MG/ML generic 1

TL-FLUORIVIT CHW Brand 2 PA

ESCAVITE CHW Brand 2 PA

POLY-VI-FLOR CHW W/IRON Brand 2 PA

POLY-VI-FLOR SUS /IRON Brand 2 PA

ESCAVITE LQ DRO Brand 2 PA

MULTI-VIT/FE DRO /FL 0.25 Brand 2 PA

MULTI-VIT/FL DRO /FE 0.25 Brand 2 PA

MYKIDZ IRON SUS FL Brand 2 PA

TRI-VIT/FE DRO /FL 0.25 generic 1

PRENA1 CHW QUATREFO Brand 0

REDICHEW CHW RX Brand 0

PRENAISSANCE TAB NEXT Brand 0

ZINGIBER TAB Brand 0

VP-GGR-B6 TAB PRENATAL Brand 0

FOCALGIN-B TAB Brand 0

PRENAISSANCE TAB NEXT-B Brand 0

TRIMESIS RX TAB Brand 0

FOLBECAL TAB Brand 0

BP FOLINATAL TAB PLUS B Brand 0

PRENATE AM TAB 1MG Brand 0

PRENATE CHW 0.6-0.4 Brand 0

MYNATAL CAP Brand 0

PRENATABS RX TAB Brand 0

NATAL-V RX TAB 29-1MG Brand 0

PRENATAL TAB PLUS FE Brand 0



VOL-TAB RX TAB Brand 0

PRENATAL+FE TAB 29-1MG Brand 0

ELITE-OB TAB Brand 0

OB COMPLETE TAB Brand 0

ATABEX TAB PRENATAL Brand 0

OB COMPLETE/ CAP DHA Brand 0

OB COMPLETE TAB PREMIER Brand 0

O-CAL TAB PRENATAL Brand 0

PRENAFIRST TAB Brand 0

NATELLE-EZ TAB Brand 0

M-VIT TAB 27-1MG Brand 0

TRICARE TAB PRENATAL Brand 0

PRENAPLUS TAB Brand 0

PNV FOLIC AC TAB + IRON Brand 0

PNV PRENATAL TAB PLUS Brand 0

PRENATAL TAB PLUS Brand 0

VOL-PLUS TAB Brand 0

PRENATAL TAB LOW IRON Brand 0

O-CAL FA TAB Brand 0

PRENATAL VIT TAB PLUS Brand 0

PRENATAL TAB 27-1MG Brand 0

TRINATE TAB Brand 0

VOL-NATE TAB Brand 0

VENATAL-FA TAB Brand 0

CO-NATAL FA TAB 29-1MG Brand 0

PRENATABS FA TAB Brand 0

VINATE ONE TAB Brand 0

SE-NATAL ONE TAB Brand 0

TRINATAL RX TAB 1 Brand 0

MYNATAL PLUS TAB Brand 0

VITAFOL-PN TAB Brand 0

MYNATAL-Z TAB Brand 0



VITAFOL-OB TAB 65-1MG Brand 0

NATALVIT TAB 75-1MG Brand 0

COMPLETENATE CHW Brand 0

SE-NATAL 19 CHW Brand 0

PRENATAL 19 CHW 29-1MG Brand 0

PRENATAL 19 CHW TAB Brand 0

CAVAN ONE CAP OMEGA Brand 0

FOLCAPS CAP OMEGA 3 Brand 0

ULTIMATECARE CAP ONE Brand 0

OB-NATAL ONE CAP 27-1MG generic 0

RELNATE DHA CAP Brand 0

C-NATE DHA CAP 28-1-200 Brand 0

VIVA DHA CAP Brand 0

VP-PNV-DHA CAP Brand 0

SE-PLETE DHA CAP Brand 0

ELITE OB CAP W/DHA Brand 0

PRENATE TAB ELITE Brand 0

VIRT-PN TAB Brand 0

PNV-SELECT TAB Brand 0

ZATEAN-PN TAB Brand 0

SELECT-OB CHW Brand 0

VINATE CAL TAB Brand 0

VINATE AZ TAB Brand 0

GENTEX ADE TAB 28-1MG Brand 0

VINATE II TAB Brand 0

VINATE AZ EX TAB Brand 0

NATACHEW CHW Brand 0

PRENATAL-U CAP Brand 0

TRIVEEN-U CAP Brand 0

BP MULTINATL TAB PLUS Brand 0

SE-CARE TAB CONCEIVE Brand 0

VINATE C TAB Brand 0



VIVA CT CHW 28-1MG Brand 0

PRENATA CHW 29-1MG Brand 0

SE-CARE CHW Brand 0

BP MULTINATL CHW PLUS Brand 0

VINATE CARE CHW Brand 0

TARON-EC CAL TAB 28-1MG Brand 0

CAVAN TAB PRENATAL Brand 0

TRI RX TAB Brand 0

VINACAL TAB Brand 0

CITRANATAL TAB RX Brand 0

VITASPIRE TAB Brand 0

PRENATABS TAB OBN Brand 0

VINATE PN TAB CARE Brand 0

COMPLETE-RF TAB PRENATAL Brand 0

NATAFORT TAB Brand 0

PROVIDA OB CAP Brand 0

FOLIVANE-OB CAP Brand 0

CONCEPT OB CAP Brand 0

VINATE IC CAP Brand 0

PUREFE OB CAP PLUS Brand 0

TANDEM OB CAP Brand 0

ULTIMATECARE MIS ADVANTAG Brand 0

ULTIMATECARE MIS COMBO Brand 0

VINATE M TAB Brand 0

TRIVEEN-ONE CAP Brand 0

NATELLE ONE CAP Brand 0

VIRT-PN PLUS CAP Brand 0

ZATEAN-PN CAP PLUS Brand 0

PNV-OMEGA CAP Brand 0

PRENATE CAP ESSENTIL Brand 0

TARON-BC MIS Brand 0

VITA-PREN TAB Brand 0



OBSTETRIX EC TAB Brand 0

MYNATAL TAB ADVANCE Brand 0

INATAL GT TAB Brand 0

INATAL ULTRA TAB Brand 0

TRIADVANCE TAB Brand 0

PRENATAL AD TAB Brand 0

VINATE GT TAB Brand 0

VINATE ULTRA TAB Brand 0

TRINATAL TAB ULTRA Brand 0

TRINATAL GT TAB Brand 0

ULTRA TABS TAB Brand 0

INATAL ADV TAB Brand 0

MYNATAL TAB Brand 0

ATABEX EC TAB Brand 0

NESTABS TAB Brand 0

NESTABS DHA PAK Brand 0

MARNATAL-F CAP Brand 0

SE-NATAL 19 TAB Brand 0

PRENATAL 19 TAB Brand 0

PRENATAL 19 TAB 29-1MG Brand 0

MYNATE 90 TAB PLUS Brand 0

SE-NATAL 90 TAB Brand 0

VINACAL B MIS Brand 0

CITRANATAL MIS B-CALM Brand 0

OB COMPLETE CAP 400 Brand 0

OB COMPLETE CAP ONE Brand 0

OB COMPLETE CAP PETITE Brand 0

OB COMPLETE CHW Brand 0

NEEVO DHA CAP 27-1.13 Brand 0

PRENATAL MIS COMPLEAT Brand 0

VINATE DHA CAP Brand 0

PROTECTNATAL TAB Brand 0



PREFERA OB MIS + DHA Brand 0

HEMENATAL OB MIS + DHA Brand 0

VP-ERA OB PAK PLUS Brand 0

PREFERA OB TAB Brand 0

HEMENATAL OB TAB 28-6-1MG Brand 0

SE-TAN DHA CAP Brand 0

TANDEM DHA CAP Brand 0

TARON-C DHA CAP Brand 0

CONCEPT DHA CAP Brand 0

OB-NATAL ONE CAP 20-7-1MG Brand 0

ULTIMATECARE CAP ONE NF Brand 0

OBSTETRIX PAK DHA Brand 0

TL-CARE DHA CAP 27-1-500 Brand 0

TRICARE PRE CAP 27-1-500 Brand 0

TRICARE DHA CAP 301 Brand 0

ELITE-OB 400 CAP Brand 0

PNV-TOTAL CAP Brand 0

CAVAN-EC SOD MIS DHA Brand 0

DUET DHA MIS BALANCED Brand 0


DUET DHA 400 MIS 25-1-400 Brand 0




MOMS CHOICE MIS RX Brand 0


VIRT-BAL DHA MIS Brand 0

BAL-CARE DHA MIS ESSNTIAL Brand 0

PRENAISSANCE MIS HARMONY Brand 0

VIRT-BAL DHA MIS PLUS Brand 0

VENATAL COMP MIS DHA Brand 0

BAL-CARE MIS DHA Brand 0



VENA-BAL MIS DHA Brand 0

COMPLETE NAT PAK DHA Brand 0

TRIVEEN-DUO PAK DHA Brand 0

PR NATAL 400 PAK Brand 0

PR NATAL 400 PAK EC Brand 0

SETONET PAK Brand 0

PR NATAL 430 PAK Brand 0

SETON ET-EC PAK Brand 0

PR NATAL 430 PAK EC Brand 0

MARNATAL-F MIS PLUS DUO Brand 0

NESTABS ABC MIS Brand 0

ACTIVE OB CAP Brand 0

R-NATAL OB CAP 20-1-320 Brand 0

TRIVEEN-TEN TAB Brand 0

PREQUE 10 TAB Brand 0

FOLIVANE-EC PAK CA DHA Brand 0

GESTICARE PAK DHA Brand 0

TARON EC PAK CALCIUM Brand 0

VITAFOL-OB PAK +DHA Brand 0

PNV-OB/DHA PAK Brand 0

LEVOMEFOLATE CAP DHA Brand 0

PRENATE MINI CAP Brand 0

VIRT-PN DHA CAP Brand 0

PNV-DHA CAP Brand 0

ZATEAN-PN CAP DHA Brand 0

PRENATE CAP RESTORE Brand 0

PRENATE DHA CAP Brand 0

PRENATE CAP ENHANCE Brand 0

VITAMEDMD CAP ONE RX Brand 0

PRENA1 CAP QUATREFO Brand 0

VITAFOL-PLUS CAP Brand 0

REAPHIRM CAP Brand 0



PNV-FIRST CAP Brand 0

VITAFOL-ONE CAP Brand 0

CHOICE-OB+ PAK DHA Brand 0

SELECT-OB+ PAK DHA Brand 0

ZATEAN-CH CAP Brand 0

MACNATAL CN CAP DHA Brand 0

PRENAISSANCE CAP PLUS Brand 0

CITRANATAL CAP HARMONY Brand 0

INFANATE CAP BALANCE Brand 0

VP-CH PLUS CAP Brand 0

PRENAISSANCE CAP BALANCE Brand 0

VP-CH-PNV CAP Brand 0

TRIVEEN-PRX CAP RNF Brand 0

PREFOL-DHA CAP Brand 0

PNV-DHA CAP DOCUSATE Brand 0

FOLCAL DHA CAP Brand 0

VEMAVITE- CAP PRX 2 Brand 0

TARON-PREX CAP Brand 0

FOLIVANE-PRX CAP DHA NF Brand 0

PRENAISSANCE CAP Brand 0

VIRT-SELECT CAP Brand 0

TL-SELECT CAP Brand 0

NEXA PLUS CAP Brand 0

TL-SELECT CAP DHA Brand 0

EXTRA-VIRT CAP PLUS DHA Brand 0

PRENAISSANCE PAK DHA Brand 0

PNV OB+DHA PAK Brand 0

CITRANATAL PAK DHA Brand 0

PRENAISSANCE PAK PROMISE Brand 0

NATALVIRT CA PAK Brand 0

CITRANATAL PAK ASSURE Brand 0

CITRANATAL MIS 90 DHA Brand 0



PRENAISSANCE PAK 90 DHA Brand 0

NATALVIRT MIS 90 DHA Brand 0

CRNATAL PAK Brand 0

PREFERAOB CAP ONE Brand 0

VP-HEME ONE CAP Brand 0

ULTIMATE OB MIS DHA Brand 0

PAIRE OB MIS Brand 0

VITAFOL CAP ULTRA Brand 0

VITAMEDMD MIS PLUS RX Brand 0

PRENA1 PLUS MIS QUATREFO Brand 0

VITAFOL TAB Brand 2 GR

VITAFOL SYP Brand 2 PA

Musculoskeletal Therapy Agents

BACLOFEN TAB 10MG generic 1 PREF

BACLOFEN TAB 20MG generic 1 PREF

LIORESAL INT INJ 0.05MG/1 Brand 2

GABLOFEN INJ 50MCG/ML Brand 2

GABLOFEN INJ 10000/20 Brand 2

LIORESAL INT INJ 10MG/20 Brand 2


LIORESAL INT INJ 10MG/5ML Brand 2


LIORESAL INT INJ 40MG/20 Brand 2

CARISOPRODOL TAB 250MG generic 1 PREF QL 120/180

SOMA TAB 250MG Brand 2 NON-PREF ST QL 120/180

SOMA TAB 350MG Brand 2 NON-PREF ST QL 120/180

CARISOPRODOL TAB 350MG generic 1 PREF QL 120/180

LORZONE TAB 375MG Brand 2 NON-PREF ST

PARAFON FORT TAB 500MG Brand 2 NON-PREF ST

CHLORZOXAZON TAB 500MG generic 1 PREF

LORZONE TAB 750MG Brand 2 NON-PREF ST



CYCLOBENZAPR TAB 5MG generic 1 PREF

FEXMID TAB 7.5MG Brand 2 NON-PREF ST

CYCLOBENZAPR TAB 7.5MG generic 1

CYCLOBENZAPR TAB 10MG generic 1 PREF

CYCLOBENZAPR CRE 20MG/GM Brand 2

AMRIX CAP 15MG Brand 2 NON-PREF ST

AMRIX CAP 30MG Brand 2 NON-PREF ST

SKELAXIN TAB 800MG Brand 2 GR

METAXALONE TAB 800MG generic 1

METHOCARBAM TAB 500MG generic 1

ROBAXIN TAB 500MG Brand 2 GR

ROBAXIN-750 TAB 750MG Brand 2 GR

METHOCARBAM TAB 750MG generic 1

ROBAXIN INJ 100MG/ML Brand 2

ORPHENADRINE INJ 30MG/ML generic 1

NORFLEX INJ 30MG/ML Brand 2 GR

ORPHENADRINE TAB 100MG ER generic 1

TIZANIDINE CAP 2MG generic 1

ZANAFLEX CAP 2MG Brand 2 GR





TIZANIDINE TAB 2MG generic 1

TIZANIDINE TAB 4MG generic 1

ZANAFLEX TAB 4MG Brand 2 GR

DANTRIUM CAP 25MG Brand 2 GR

DANTROLENE CAP 25MG generic 1







DANTRIUM IV INJ 20MG Brand 2 GR

REVONTO INJ 20MG generic 1

GEL-ONE INJ 30MG/3ML Brand 2 QL 6/180 PA SP

SYNVISC INJ 8MG/ML Brand 2 QL 12/180 PA SP

ORTHOVISC INJ 15MG/ML Brand 2 QL 16/180 PA SP

HYALGAN INJ 20MG/2ML Brand 2 QL 20/180 PA SP

SUPARTZ INJ 25/2.5ML Brand 2 QL 25/180 PA SP

CARISOPR/ASA TAB 200-325 generic 1 QL 240/180

CARISOPRODOL TAB ASA/COD generic 1 QL 240/180

ORPH/ASA/CAF TAB generic 1

TIZANIDINE KIT COMFORT Brand 2

Nasal Agents - Systemic and Topical

ADRENALIN SOL 1:1000 Brand 2

TYZINE PED DRO 0.05% Brand 2

TYZINE SOL 0.1% Brand 2

QNASL AER 80MCG Brand 2 NON-PREF ST

BECONASE AQ SUS 0.042% Brand 2 NON-PREF ST

RHINOCORT SUS AQUA Brand 2 NON-PREF ST

OMNARIS SPR Brand 2 NON-PREF ST

ZETONNA AER 37MCG Brand 2 NON-PREF ST

FLUNISOLIDE SPR 0.025% generic 1 NON-PREF ST

VERAMYST SPR 27.5MCG Brand 2 NON-PREF ST

FLUTICASONE SPR 50MCG generic 1 PREF

FLONASE SPR 0.05% Brand 2 NON-PREF ST

NASONEX SPR 50MCG/AC Brand 2 PREF

NASACORT AQ AER 55MCG/AC Brand 2 NON-PREF ST

TRIAMCINOLON SPR 55MCG/AC generic 1 NON-PREF ST

BACTROBAN OIN NASAL 2% Brand 2 NON-PREF ST

ATROVENT NAS SOL 0.03% Brand 2 GR

IPRATROPIUM SPR 0.03% generic 1

IPRATROPIUM SPR 0.06% generic 1



ATROVENT NAS SOL 0.06% Brand 2 GR

ASTELIN NASA SPR 137MCG Brand 2 PREF

AZELASTINE SPR 0.1% generic 1 NON-PREF ST

ASTEPRO SPR 0.15% Brand 2 PREF

PATANASE SPR 0.6% Brand 2 NON-PREF ST

DYMISTA SPR 137-50 Brand 2 NON-PREF ST

Neuromuscular Agents

ANECTINE INJ 20MG/ML Brand 2 GR

QUELICIN INJ 20MG/ML Brand 2 GR

QUELICIN INJ -1000 Brand 2

ATRACURIUM INJ 50MG/5ML generic 1

ATRACURIUM INJ 10MG/ML generic 1

ATRACURIUM INJ 10MG/ML generic 1

CISATRACURIU INJ 2MG/ML generic 1

NIMBEX INJ 2MG/ML Brand 2 GR





PANCURONIUM INJ 1MG/ML generic 1

PANCURONIUM INJ 2MG/ML generic 1

ROCURONIUM INJ 50MG/5ML generic 1

ROCURONIUM INJ 10MG/ML generic 1

ZEMURON INJ 10MG/ML Brand 2 GR

ROCURONIUM INJ 100MG/10 generic 1

ROCURONIUM INJ 10MG/ML generic 1

ZEMURON INJ 10MG/ML Brand 2 GR

VECURONIUM INJ 10MG generic 1

VECURONIUM INJ 20MG generic 1

DYSPORT INJ 300UNIT Brand 2 PA SP

DYSPORT INJ 500UNIT Brand 2 PA SP



BOTOX INJ 100UNIT Brand 2 PA SP

BOTOX INJ 200UNIT Brand 2 PA SP

MYOBLOC INJ 2500/0.5 Brand 2 PA SP

MYOBLOC INJ 5000/ML Brand 2 PA SP

MYOBLOC INJ 10000/2 Brand 2 PA SP

XEOMIN INJ 50 UNIT Brand 2 PA SP

XEOMIN INJ 100UNIT Brand 2 PA SP

RILUTEK TAB 50MG Brand 2 GR

RILUZOLE TAB 50MG generic 1

Nutrients

ALCOHOL INJ 98% generic 1

DEXTROSE INJ 2.5% generic 1

DEXTROSE INJ 5% generic 1

DEXTROSE INJ 5% PGBK generic 1





INTRALIPID INJ 20% generic 1

LIPOSYN III INJ 30% generic 1

PREMASOL SOL 6% generic 1

AMINOSYN II INJ 15% Brand 2 GR

CLINIMIX INJ 4.25/D10 Brand 2

CYSTEINE HCL INJ 50MG/ML Brand 2 GR

Ophthalmic Agents

AZASITE SOL 1% Brand 2 NON-PREF ST

BACITRACIN OIN OP generic 1

BESIVANCE SUS 0.6% Brand 2 NON-PREF ST

CILOXAN SOL 0.3% OP Brand 2 NON-PREF ST

CIPROFLOXACN SOL 0.3% OP generic 1 PREF

CILOXAN OIN 0.3% OP Brand 2 NON-PREF ST



ERYTHROMYCIN OIN 5MG/GM generic 1

ILOTYCIN OIN OP generic 1

ERYTHROMYCIN OIN OP generic 1

ROMYCIN OIN OP generic 1

GATIFLOXACIN SOL 0.5% generic 1

ZYMAXID SOL 0.5% Brand 2 NON-PREF ST

GARAMYCIN SOL 0.3% OP Brand 2 GR

GENTAMICIN SOL 0.3% OP generic 1

GARAMYCIN OIN 0.3% OP generic 1

GENTAK OIN 0.3% OP generic 1

GENTAMICIN OIN 0.3% OP generic 1

LEVOFLOXACIN SOL 0.5% generic 1 PREF

VIGAMOX DRO 0.5% Brand 2 PREF

MOXEZA SOL 0.5% Brand 2 PREF

OCUFLOX DRO 0.3% OP Brand 2 NON-PREF ST

OFLOXACIN DRO 0.3% OP generic 1 PREF

TOBRAMYCIN SOL 0.3% OP generic 1

TOBREX SOL 0.3% OP Brand 2 GR

TOBREX OIN 0.3% OP Brand 2 PA

MITOSOL KIT 0.2MG Brand 2

BLEPH-10 SOL 10% OP Brand 2 GR

SULFACET SOD SOL 10% OP generic 1

SOD SULFACET SOL 10% OP generic 1

SULFACET SOD OIN 10% OP Brand 2

VITRAVENE INJ 6.6MG/ML Brand 2

ZIRGAN GEL 0.15% Brand 2

TRIFLURIDINE SOL 1% OP generic 1

VIROPTIC SOL 1% OP Brand 2 GR

NATACYN SUS 5% OP Brand 2

BETADINE SOL 5% OP Brand 2

BACIT/POLYMY OIN OP generic 1

AK-POLY-BAC OIN OP generic 1



POLYCIN B OIN OP generic 1

POLYCIN OIN OP generic 1

POLYTRIM SOL OP Brand 2 GR

POLYMYXIN B/ SOL TRIMETHP generic 1

TRIMETHOPRIM SOL POLYMYXN generic 1

NEO-POLYCIN OIN OP generic 1

NEO/BAC/POLY OIN OP generic 1

NEOSPORIN SOL OP Brand 2 GR

NEO/POLY/GRA SOL OP generic 1

LACRISERT MIS 5MG OP Brand 2

BETOPTIC-S SUS 0.25% OP Brand 2

BETAXOLOL SOL 0.5% OP generic 1

CARTEOLOL SOL 1% OP generic 1

METIPRANOLOL SOL 0.3% OPH generic 1

OPTIPRANOLOL SOL 0.3% OP Brand 2 GR

LEVOBUNOLOL SOL 0.25% OP Brand 2

BETAGAN SOL 0.5% OP Brand 2 GR

LEVOBUNOLOL SOL 0.5% OP generic 1

BETIMOL SOL 0.25% Brand 2

BETIMOL SOL 0.5% Brand 2

TIMOPTIC SOL 0.25% OP Brand 2 GR

TIMOLOL MAL SOL 0.25% OP generic 1

TIMOPTIC OCU SOL 0.25% OP Brand 2

TIMOPTIC SOL 0.5% OP Brand 2 GR

TIMOLOL MAL SOL 0.5% OP generic 1

TIMOPTIC OCU SOL 0.5% OP Brand 2

ISTALOL SOL 0.5% OP Brand 2

TIMOPTIC-XE SOL 0.25% OP Brand 2 GR

TIMOLOL GEL SOL 0.25% OP generic 1

TIMOLOL GEL SOL 0.5% OP generic 1

TIMOPTIC-XE SOL 0.5% OP Brand 2 GR

COMBIGAN SOL 0.2/0.5% Brand 2



DORZOL/TIMOL SOL 2-0.5%OP generic 1

COSOPT SOL 2-0.5%OP Brand 2 GR

COSOPT PF SOL Brand 2

MAXIDEX SUS 0.1% OP Brand 2

DEXAMETH PHO SOL 0.1% OP generic 1

DUREZOL EMU 0.05% Brand 2 PA

FLUOROMETHOL SUS 0.1% OP generic 1

FML LIQUIFLM SUS 0.1% OP Brand 2 GR

FML FORTE SUS 0.25% OP Brand 2

FML OIN 0.1% OP Brand 2

FLAREX SUS 0.1% OP Brand 2

ALREX SUS 0.2% Brand 2 NON-PREF ST

LOTEMAX SUS 0.5% Brand 2 PA

LOTEMAX GEL 0.5% Brand 2 PA

LOTEMAX OIN 0.5% Brand 2 PA

PRED MILD SUS 0.12% OP Brand 2

PREDNISOLONE SUS 1% OP generic 1

PRED FORTE SUS 1% OP Brand 2 GR

OMNIPRED SUS 1% OP Brand 2 GR

PRED SOD PHO SOL 1% OP generic 1

VEXOL SUS 1% OP Brand 2

TRIESENCE INJ 40MG/ML Brand 2

PRED-G SUS OP Brand 2

PRED-G S.O.P OIN OP Brand 2

ZYLET SUS 0.5-0.3% Brand 2 PA

BLEPHAMIDE SUS OP Brand 2

SULF/PRED NA SOL OP generic 1

BLEPHAMIDE OIN S.O.P. Brand 2 PA

TOBRADEX ST SUS 0.3-0.05 Brand 2 PA

TOBRADEX SUS 0.3-0.1% Brand 2 GR

TOBRA/DEXAME SUS 0.3-0.1% generic 1

TOBRADEX OIN 0.3-0.1% Brand 2



MAXITROL SUS 0.1% OP Brand 2 GR

NEO/POLY/DEX SUS 0.1% OP generic 1

POLY-DEX OIN 0.1% OP generic 1

NEO/POLY/DEX OIN 0.1% OP generic 1

MAXITROL OIN 0.1% OP Brand 2 GR

NEO/POLY/HC SUS OP generic 1

NEO-POLYCIN OIN HC 1%OP generic 1

NEO/POLY/BAC OIN /HC 1%OP generic 1

LUMIGAN SOL 0.01% Brand 2

LATANOPROST SOL 0.005% generic 1

XALATAN SOL 0.005% Brand 2 GR

ZIOPTAN DRO 0.0015% Brand 2

TRAVOPROST DRO 0.004% generic 1

TRAVATAN Z DRO 0.004% Brand 2

RESCULA SOL 0.15% Brand 2

ATROPIN-CARE SOL 1% OP generic 1

ISO ATROPINE SOL 1% OP Brand 2 GR

ATROPINE SUL SOL 1% OP generic 1

ATROPINE SUL OIN 1% OP generic 1

CYCLOGYL SOL 0.5% OP Brand 2

CYCLOPENTOL SOL 1% OP generic 1

CYCLOGYL SOL 1% OP Brand 2 GR

CYCLOPENTOL SOL 2% OP generic 1

CYCLOGYL SOL 2% OP Brand 2 GR

ISO HOMATROP SOL 2% OP Brand 2

HOMATROPINE SOL 5% OP generic 1

HOMATROPAIRE SOL 5% OP generic 1

ISO HOMATROP SOL 5% OP Brand 2 GR

ISO HYOSCINE SOL 0.25% OP Brand 2

TROPICAMIDE SOL 0.5% OP generic 1

MYDRAL SOL 0.5% OP generic 1

TROPICAMIDE SOL 1% OP generic 1



MYDRAL SOL 1% OP generic 1

MYDRIACYL SOL 1% OP Brand 2 GR

CYCLOMYDRIL SOL OP Brand 2

NAPHAZOLINE SOL 0.1% OP generic 1

PHENYLEPHRIN SOL 2.5% OP generic 1

NEOFRIN SOL 2.5% OP generic 1

ALTAFRIN SOL 2.5% OP generic 1

MYDFRIN SOL 2.5% OP Brand 2 GR

ALTAFRIN SOL 10% OP generic 1

NEOFRIN SOL 10% OP generic 1

PHENYLEPHRIN SOL 10% OP generic 1

MIOCHOL-E SOL 1:100 Brand 2

MIOSTAT INJ 0.01% OP Brand 2

ISO CARBACHO SOL 1.5% OP Brand 2

ISO CARBACHO SOL 3% OP Brand 2

PILOCARPINE SOL 1% OP generic 1

ISOPTO CARP SOL 1% OP Brand 2 GR





PILOPINE HS GEL 4% OP Brand 2

PHOSPHOLINE SOL 0.125%OP Brand 2

APRACLONIDIN SOL 0.5% OP generic 1

IOPIDINE SOL 0.5% OP Brand 2 GR

IOPIDINE SOL 1% OP Brand 2

ALPHAGAN P SOL 0.1% Brand 2

BRIMONIDINE SOL 0.15% generic 1

ALPHAGAN P SOL 0.15% Brand 2 GR

BRIMONIDINE SOL 0.2% OP generic 1

SIMBRINZA SUS 1-0.2% Brand 2

EYLEA INJ 2/0.05ML Brand 2



MACUGEN INJ Brand 2

LUCENTIS SOL 0.3MG Brand 2

LUCENTIS SOL 0.5MG Brand 2

VISUDYNE INJ 15MG Brand 2

RESTASIS EMU 0.05% Brand 2 QL 60/30 PA

PROPARACAINE SOL 0.5% OP generic 1

PARCAINE SOL 0.5% OP generic 1

ALCAINE SOL 0.5% OP Brand 2 GR

TETCAINE SOL 0.5% OP generic 1

ALTACAINE SOL 0.5% OP generic 1

TETRAVISC SOL FORTE generic 1

TETRAVISC SOL 0.5% OP generic 1

TETRACAINE SOL 0.5% OP generic 1

JETREA INJ 2.5MG/ML Brand 2

LASTACAFT SOL 0.25% Brand 2 NON-PREF ST

AZELASTINE DRO 0.05% generic 1 NON-PREF ST

OPTIVAR DRO 0.05% Brand 2 NON-PREF ST

BEPREVE DRO 1.5% Brand 2 NON-PREF ST

CROMOLYN SOD SOL 4% OP generic 1 NON-PREF ST

EMADINE SOL 0.05% OP Brand 2 NON-PREF ST

ELESTAT DRO 0.05% Brand 2 NON-PREF ST

EPINASTINE DRO 0.05% generic 1 NON-PREF ST

ALOMIDE SOL 0.1% OP Brand 2 NON-PREF ST

ALOCRIL SOL 2% Brand 2 NON-PREF ST

PATANOL SOL 0.1% OP Brand 2 NON-PREF ST

PATADAY SOL 0.2% Brand 2 PREF

AZOPT SUS 1% OP Brand 2

DORZOLAMIDE SOL 2% OP generic 1

TRUSOPT SOL 2% OP Brand 2 GR

BAL SALT SOL OP generic 1

AKORN BALANC SOL SALT OP generic 1

BALANCED SAL SOL OP generic 1



BSS PLUS SOL OP Brand 2 GR

BSS SOL OP generic 1

PROLENSA SOL 0.07% Brand 2

BROMFENAC SOL 0.09% generic 1 NON-PREF ST

DICLOFENAC SOL 0.1% OP generic 1 PREF

FLURBIPROFEN SOL 0.03% OP generic 1 PREF

OCUFEN SOL 0.03% OP Brand 2 NON-PREF ST

ACULAR LS SOL 0.4% Brand 2 NON-PREF ST

KETOROLAC SOL 0.4% generic 1 PREF

ACUVAIL SOL 0.45% Brand 2 NON-PREF ST

ACULAR SOL 0.5% OP Brand 2 NON-PREF ST

KETOROLAC SOL 0.5% generic 1 PREF

NEVANAC SUS 0.1% Brand 2 NON-PREF ST

ILEVRO DRO 0.3% OP Brand 2 NON-PREF ST

CYSTARAN SOL 0.44% Brand 2

FUL-GLO TES 0.6MG OP Brand 2

BIO GLO TES 1MG OP generic 1

FUL-GLO TES 1MG OP generic 1

FLUORETS TES 1MG OP generic 1

FLUOR-I-STRI TES 1MG OP generic 1

AK-FLUOR INJ 10% OP generic 1

FLUORESCITE INJ 10% OP Brand 2 GR

AK-FLUOR INJ 25% OP Brand 2

ALTAFLUOR SOL 0.25-0.4 generic 1

FLURESS SOL OP Brand 2 GR

FLUROX SOL OP generic 1

FLUORE-BENOX SOL 0.25-0.4 generic 1

FLUORESCEIN/ SOL PROPARAC generic 1

FLUORACAINE SOL OP Brand 2 GR

FLUCAINE SOL 0.25-0.5 generic 1

PAREMYD SOL 1-0.25% Brand 2

LISSAMINE GR TES 1.5MG Brand 2



ROSE GLO TES 1.5MG Brand 2

Otic Agents

CIPROFLOXACN SOL 0.2% Brand 2

CETRAXAL SOL 0.2% Brand 2

OFLOXACIN DRO 0.3%OTIC generic 1

PINNACAINE DRO 20% OTIC Brand 2

FLUOCIN ACET OIL EAR0.01% generic 1

FLUOCIN ACET OIL 0.01% generic 1

DERMOTIC OIL 0.01% Brand 2 GR

ACETASOL HC SOL OTIC generic 1

VOSOL HC SOL OTIC Brand 2 GR

HC/ACET ACID SOL OTIC generic 1

ACETIC ACID SOL 2% OTIC generic 1

ACE ACD/ALUM SOL 2% OTIC generic 1

CRESYLATE SOL 25% OTIC Brand 2

CIPRODEX SUS 0.3-0.1% Brand 2

CIPRO HC SUS OTIC Brand 2

NEO/POLY/HC SUS 1% OTIC generic 1

NEO/POLY/HC SOL 1% OTIC generic 1

CORTISPORIN SOL 1% OTIC Brand 2 GR

CORTISPORIN SUS -TC OTIC Brand 2

COLY-MYCIN S SUS OTIC Brand 2

AURODEX SOL OTIC generic 1

ANTIPY/BENZO SOL OTIC generic 1

ANTIPY/BENZO SOL OTIC generic 1 PA

AURALGAN SOL 5.5-1.4% Brand 2 GR

OTICIN DRO 1-0.1% generic 1

PRAMOTIC DRO 1-0.1% Brand 2 GR

TREAGAN OTIC DRO Brand 2 GR

OTIC CARE DRO generic 1

MYOXIN SUS OTIC Brand 2



OTOZIN DRO Brand 2

Oxytocics

METHYLERGON TAB 0.2MG generic 1

METHYLERGON INJ 0.2MG/ML generic 1

OXYTOCIN INJ 10UNT/ML generic 1

PITOCIN INJ 10UNT/ML Brand 2 GR

Passive Immunizing Agents

GAMASTAN S/D INJ Brand 2

FLEBOGAMMA INJ DIF 5% Brand 2 PA SP

FLEBOGAMMA INJ 5% Brand 2 PA SP

OCTAGAM INJ 1GM Brand 2 PA SP

OCTAGAM INJ 2.5GM Brand 2 PA SP


GAMMAPLEX INJ 2.5GM Brand 2 PA SP

GAMMAPLEX INJ 5GM Brand 2 PA SP



GAMMAPLEX INJ 10GM Brand 2 PA SP





PRIVIGEN INJ 5 GRAMS Brand 2 PA SP

BIVIGAM INJ 10% Brand 2 PA SP


PRIVIGEN INJ 10GRAMS Brand 2 PA SP

BIVIGAM INJ 10% Brand 2 PA SP


PRIVIGEN INJ 20GRAMS Brand 2 PA SP


PRIVIGEN INJ 40GRAMS Brand 2



GAMMAGARD SD INJ 2.5GM HU Brand 2

CARIMUNE NF INJ 3GM Brand 2

GAMMAGARD SD INJ 5GM HU Brand 2 PA SP

CARIMUNE NF INJ 6GM Brand 2

GAMMAGARD SD INJ 10GM HU Brand 2 PA SP

CARIMUNE NF INJ 12GM Brand 2 PA SP

HIZENTRA INJ 1GM/5ML Brand 2 PA SP



HIZENTRA INJ 10/50ML Brand 2

GAMMAGARD INJ 1GM/10ML Brand 2 PA SP

GAMUNEX-C INJ 1GM/10ML Brand 2 PA SP

GAMMAKED INJ 1GM/10ML Brand 2 PA SP

GAMMAKED INJ 2.5GM/25 Brand 2 PA SP

GAMUNEX-C INJ 2.5GM/25 Brand 2 PA SP

GAMMAGARD INJ 2.5GM/25 Brand 2 PA SP

GAMMAKED INJ 5GM/50ML Brand 2 PA SP

GAMUNEX-C INJ 5GM/50ML Brand 2 PA SP

GAMMAGARD INJ 5GM/50ML Brand 2 PA SP

GAMMAGARD INJ 10GM/100 Brand 2 PA SP

GAMMAKED INJ 10GM/100 Brand 2 PA SP

GAMUNEX-C INJ 10GM/100 Brand 2 PA SP

GAMMAKED INJ 20GM/200 Brand 2 PA SP

GAMUNEX-C INJ 20GM/200 Brand 2 PA SP



SYNAGIS INJ 50MG Brand 2 PA SP

SYNAGIS INJ 100MG/ML Brand 2 PA SP

Penicillins

PFIZERPEN-G INJ 5MU generic 1

PENICILLN GK INJ 5MU generic 1



PENICILLN GK INJ 20MU generic 1

PFIZERPEN-G INJ 20MU Brand 2 GR

PENICILL GK/ INJ DEX 1MU generic 1



PEN G SOD INJ 5000000 generic 1

BICILLIN L-A INJ 600000 Brand 2



PEN G PROC INJ 600000 Brand 2

PENICILLN VK TAB 250MG generic 1

PENICILLN VK TAB 500MG generic 1

PENICILLN VK SOL 125/5ML generic 1

PENICILLN VK SOL 250/5ML generic 1

AMOXICILLIN CAP 250MG generic 1

AMOXICILLIN CAP 500MG generic 1

AMOXICILLIN TAB 500MG generic 1

AMOXICILLIN TAB 875MG generic 1

AMOXICILLIN CHW 125MG generic 1

AMOXICILLIN CHW 250MG generic 1

AMOXICILLIN SUS 125/5ML generic 1




MOXATAG TAB 775MG Brand 2

AMPICILLIN CAP 250MG generic 1

AMPICILLIN CAP 500MG generic 1

AMPICILLIN SUS 125/5ML generic 1

AMPICILLIN SUS 250/5ML generic 1

AMPICILLIN INJ 125MG generic 1





AMPICILLIN INJ 1GM generic 1

AMPICILLIN INJ 1GM Brand 2


AMPICILLIN INJ 2GM Brand 2



DICLOXACILL CAP 250MG generic 1

DICLOXACILL CAP 500MG generic 1

NAFCILLIN INJ 1GM generic 1

NAFCILLIN INJ 1GM Brand 2




NALLPEN/DEX INJ 1GM/50ML Brand 2

NALLPEN/DEX INJ 2GM/100 Brand 2

OXACILLIN INJ 1GM generic 1



BACTOCILL INJ DEX 1GM Brand 2

BACTOCILL INJ DEX 2GM Brand 2

BICILLIN C-R INJ 1200000 Brand 2

BICILLIN C-R INJ 900/300 Brand 2

AMOX/K CLAV TAB 250MG generic 1


AUGMENTIN TAB 500MG Brand 2 GR

AUGMENTIN TAB 875MG Brand 2 GR


AMOX/K CLAV CHW 200MG generic 1

AMOX/K CLAV CHW 400MG generic 1

AUGMENTIN SUS 125/5ML Brand 2

AMOX/K CLAV SUS 200/5ML generic 1

AUGMENTIN SUS 250/5ML Brand 2 GR





AUGMENTIN SUS ES-600 Brand 2 GR


AUGMENTIN XR TAB 12HR Brand 2 GR

AMOX-POT CLA TAB ER generic 1

AMP-SULBACTA INJ 1-0.5GM generic 1

AMP-SULBACTA INJ 1.5GM generic 1

UNASYN INJ 1.5GM Brand 2 GR

AMP-SULBACTA INJ 1.5GM generic 1

UNASYN INJ 3GM Brand 2 GR

AMP-SULBACTA INJ 3GM generic 1

AMP-SULBACTA INJ 2-1GM generic 1



UNASYN INJ 15GM Brand 2 GR



TIMENTIN INJ 3.1GM Brand 2

TIMENTIN INJ 3.1GM Brand 2

TIMENTIN INJ 31GM Brand 2

ZOSYN INJ 2-0.25GM Brand 2 GR

PIPER/TAZOBA INJ 2-0.25GM generic 1

ZOSYN INJ 3-0.375G Brand 2 GR

PIPER/TAZOBA INJ 3-0.375G generic 1





ZOSYN SOL 2-0.25GM Brand 2

ZOSYN SOL 4-0.50GM Brand 2

ZOSYN SOL 3-0.375G Brand 2



Pharmaceutical Adjuvants

LANOLIN MIS ALCOHOL Brand 2

LANOLIN OIL Brand 2

LANOLIN ANHY OIN Brand 2

LANOLIN OIN Brand 2

Progestins

MAKENA INJ 250MG/ML Brand 2 QL 5/30 PA SP

PROVERA TAB 2.5MG Brand 2 GR

MEDROXYPR AC TAB 2.5MG generic 1

MEDROXYPR AC TAB 5MG generic 1

PROVERA TAB 5MG Brand 2 GR

MEDROXYPR AC TAB 10MG generic 1

PROVERA TAB 10MG Brand 2 GR

MEGACE ES SUS 625/5ML Brand 2

AYGESTIN TAB 5MG Brand 2 GR

NORETHIN ACE TAB 5MG generic 1

PROGESTERONE INJ 50MG/ML generic 1

PROGESTERONE CAP 100MG generic 1

PROMETRIUM CAP 100MG Brand 2 GR

PROGESTERONE CAP 200MG generic 1

PROMETRIUM CAP 200MG Brand 2 GR

Psychotherapeutic and Neurological Agents Misc

ERGOLOID MES TAB 1MG ORAL generic 1

ORAP TAB 1MG Brand 2

ORAP TAB 2MG Brand 2

DONEPEZIL TAB 5MG generic 1 PREF MO

ARICEPT TAB 5MG Brand 2 NON-PREF ST MO

DONEPEZIL TAB 10MG generic 1 PREF MO

ARICEPT TAB 10MG Brand 2 NON-PREF ST MO

DONEPEZIL TAB HCL 23MG generic 1

ARICEPT TAB 23MG Brand 2 GR



DONEPEZIL TAB 5MG ODT generic 1 NON-PREF ST MO

ARICEPT ODT TAB 5MG Brand 2 NON-PREF ST MO

ARICEPT ODT TAB 10MG Brand 2 NON-PREF ST MO

DONEPEZIL TAB 10MG ODT generic 1 NON-PREF ST MO

RAZADYNE TAB 4MG Brand 2 NON-PREF ST MO

GALANTAMINE TAB 4MG generic 1 NON-PREF ST MO





RAZADYNE SOL 4MG/ML Brand 2 NON-PREF ST MO

GALANTAMINE SOL 4MG/ML generic 1 NON-PREF ST MO

GALANTAMINE CAP 8MG ER generic 1 NON-PREF ST MO

RAZADYNE ER CAP 8MG Brand 2 NON-PREF ST MO





EXELON DIS 4.6MG/24 Brand 2 NON-PREF ST MO

EXELON DIS 9.5MG/24 Brand 2 NON-PREF ST MO

EXELON DIS 13.3/24 Brand 2 NON-PREF ST MO

EXELON CAP 1.5MG Brand 2 NON-PREF ST MO

RIVASTIGMINE CAP 1.5MG generic 1 PREF MO

RIVASTIGMINE CAP 3MG generic 1 PREF MO

EXELON CAP 3MG Brand 2 NON-PREF ST MO

EXELON CAP 4.5MG Brand 2 NON-PREF ST MO

RIVASTIGMINE CAP 4.5MG generic 1 PREF MO

RIVASTIGMINE CAP 6MG generic 1 PREF MO

EXELON CAP 6MG Brand 2 NON-PREF ST MO

EXELON SOL 2MG/ML Brand 2 NON-PREF ST MO

NAMENDA TAB 5MG Brand 2 NON-PREF ST MO

NAMENDA TAB 10MG Brand 2 NON-PREF ST MO



NAMENDA TAB 5-10MG Brand 2 NON-PREF ST MO

NAMENDA SOL 10MG/5ML Brand 2 NON-PREF ST MO

NAMENDA XR CAP 7MG Brand 2




NAMENDA XR CAP TITRATIO Brand 2

BUPROPION TAB 150MG generic 1 PREF

BUPROBAN TAB 150MG generic 1 PREF

ZYBAN TAB 150MG SR Brand 2 NON-PREF ST

NICOTROL NS SPR 10MG/ML Brand 2 NON-PREF ST

NICOTROL INH Brand 2 NON-PREF ST QL 504/30

CHANTIX TAB 0.5MG Brand 2 NON-PREF ST QL 60/30

CHANTIX TAB 1MG Brand 2 NON-PREF ST QL 60/30

CHANTIX PAK 1MG Brand 2 NON-PREF ST QL 60/30

CHANTIX PAK 0.5& 1MG Brand 2 NON-PREF ST QL 60/30

FLUOXETINE CAP 10MG generic 1

FLUOXETINE CAP 20MG generic 1

SARAFEM TAB 10MG Brand 2 NON-PREF ST QL 30/30 MO

SARAFEM TAB 20MG Brand 2 NON-PREF ST QL 30/30 MO

BRISDELLE CAP 7.5MG Brand 2 QL 30/30 PA

XENAZINE TAB 12.5MG Brand 2

XENAZINE TAB 25MG Brand 2

COPAXONE KIT 20MG/ML Brand 2 PREF SP

REBIF INJ 22/0.5 Brand 2 NON-PREF ST SP

REBIF REBIDO INJ 22/0.5 Brand 2 NON-PREF ST SP

REBIF INJ 44/0.5 Brand 2 NON-PREF ST SP

REBIF REBIDO INJ 44/0.5 Brand 2 NON-PREF ST SP

REBIF TITRTN SOL PACK Brand 2 NON-PREF ST SP

REBIF REBIDO SOL TITRATN Brand 2 NON-PREF ST SP

AVONEX KIT 30MCG Brand 2 PREF SP

AVONEX PEN KIT 30MCG Brand 2 PREF SP



AVONEX PREFL KIT 30MCG Brand 2 PREF SP

BETASERON INJ 0.3MG Brand 2 PREF SP

BETASERON INJ 0.3MG Brand 2

AUBAGIO TAB 7MG Brand 2 QL 30/30 SP

AUBAGIO TAB 14MG Brand 2 QL 30/30 SP

TYSABRI INJ 300/15ML Brand 2

TECFIDERA MIS STARTER Brand 2

TECFIDERA CAP 120MG Brand 2

TECFIDERA CAP 240MG Brand 2

AMPYRA TAB 10MG Brand 2 QL 60/30 PA SP

GILENYA CAP 0.5MG Brand 2 QL 30/30 PA SP

XYREM SOL 500MG/ML Brand 2

SAVELLA TAB 12.5MG Brand 2 QL 60/30 PA MO

SAVELLA TAB 25MG Brand 2 QL 60/30 PA MO



SAVELLA MIS TITR PAK Brand 2 QL 55/365 PA

GRALISE TAB 300MG Brand 2 QL 60/30 PA

GRALISE TAB 600MG Brand 2 QL 90/30 PA

GRALISE STAR MIS 300/600 Brand 2

HORIZANT TAB 600MG Brand 2 QL 30/30 PA

NUEDEXTA CAP 20-10MG Brand 2 QL 60/30 PA MO

ACAMPRO CAL TAB 333MG generic 1

CAMPRAL TAB 333MG Brand 2 GR

DISULFIRAM TAB 250MG generic 1

ANTABUSE TAB 250MG Brand 2 GR

ANTABUSE TAB 500MG Brand 2 GR

DISULFIRAM TAB 500MG generic 1

CDP/AMITRIP TAB 5-12.5MG generic 1

CDP/AMITRIP TAB 10-25MG generic 1

PERPHEN/AMIT TAB 2-10MG generic 1







OLANZA/FLUOX CAP 3-25MG generic 1 NON-PREF ST QL 30/30 MO

SYMBYAX CAP 3-25MG Brand 2 NON-PREF ST QL 30/30 MO






SYMBYAX CAP 12-25MG Brand 2 GR


SYMBYAX CAP 12-50MG Brand 2 GR

Respiratory Agents Misc

SURVANTA INH Brand 2

INFASURF SUS 35MG/ML Brand 2

CUROSURF SUS 80MG/ML Brand 2

GLASSIA INJ Brand 2

ARALAST NP INJ 400MG Brand 2




ZEMAIRA INJ 1000MG Brand 2

PROLASTIN-C INJ 1000MG Brand 2

KALYDECO TAB 150MG Brand 2 SP

PULMOZYME SOL 1MG/ML Brand 2

STERIL TALC SUS 5GM Brand 2

SCLEROSOL AER INTRAPLE Brand 2

Sulfonamides

SULFADIAZINE TAB 500MG generic 1

Tetracyclines



DEMECLOCYCL TAB 150MG generic 1

DEMECLOCYCL TAB 300MG generic 1

DOXYCYC MONO CAP 50MG generic 1

DOXYCYCLINE CAP 75MG generic 1

MONODOX CAP 75MG Brand 2 GR

DOXYCYC MONO CAP 100MG generic 1

MONODOX CAP 100MG Brand 2 GR

DOXYCYCLINE CAP 150MG generic 1

ADOXA CAP 150MG Brand 2 GR

DOXYCYC MONO TAB 50MG generic 1

ADOXA TAB 50MG Brand 2 GR



ADOXA PAK 1/ TAB 100MG Brand 2 GR


AVIDOXY TAB 100MG generic 1





VIBRAMYCIN SUS 25MG/5ML Brand 2 GR

DOXYCYCLINE SUS 25MG/5ML generic 1

DOXYCYCL HYC CAP 50MG generic 1

VIBRAMYCIN CAP 100MG Brand 2 GR


MORGIDOX CAP 2X100MG generic 1

MORGIDOX CAP 1X100MG generic 1

DOXYCYCLINE TAB 20MG generic 1

DOXYCYCL HYC TAB 100MG generic 1

DOXYCYCL HYC TAB 75MG DR generic 1


DORYX TAB 150MG Brand 2 GR




DORYX TAB 200MG Brand 2

DOXY 100 INJ 100MG generic 1

DOXYCYCL HYC INJ 100MG generic 1


VIBRAMYCIN SYP 50MG/5ML Brand 2

MORGIDOX KIT 1X100MG Brand 2

MORGIDOX KIT 2X100MG Brand 2

NUTRIDOX KIT Brand 2

MINOCIN CAP 50MG Brand 2 GR

MINOCYCLINE CAP 50MG generic 1



MINOCIN CAP 100MG Brand 2 GR

MINOCYCLINE TAB 50MG generic 1



MINOCIN INJ 100MG Brand 2

MINOCYCLINE TAB 45MG ER generic 1 PA

SOLODYN TAB 55MG Brand 2 PA







MINOCIN KIT 50MG Brand 2

MINOCIN KIT 100MG Brand 2

TETRACYCLINE CAP 250MG Brand 2

TETRACYCLINE CAP 500MG Brand 2

NICAZELDOXY KIT 60 Brand 2

NICAZELDOXY KIT 30 Brand 2



Thyroid Agents

TIROSINT CAP 13MCG Brand 2










SYNTHROID TAB 25MCG Brand 2

UNITH DIRECT TAB 25MCG generic 1

UNITHROID TAB 25MCG generic 1

LEVOTHYROXIN TAB 25MCG generic 1














































LEVOTHYROXIN INJ 100MCG Brand 2



LIOTHYRONINE TAB 5MCG generic 1

CYTOMEL TAB 5MCG Brand 2 GR







LIOTHYRONINE INJ 10MCG/ML generic 1

TRIOSTAT INJ 10MCG/ML Brand 2 GR

THYROLAR-1/4 TAB 15MG Brand 2

THYROLAR-1/2 TAB 30MG Brand 2

THYROLAR-1 TAB 60MG Brand 2



ARMOUR THYRO TAB 15MG Brand 2

NATURE-THROI TAB 16.25MG generic 1

WESTHROID TAB 16.25MG Brand 2

WP THYROID TAB 16.25MG Brand 2

ARMOUR THYRO TAB 30MG Brand 2 GR

NP THYROID TAB 30MG generic 1

NATURE-THROI TAB 32.5MG Brand 2








NATURE-THROI TAB 65MG Brand 2

WESTHROID TAB 65MG Brand 2

WP THYROID TAB 65MG Brand 2













WP THYROID TAB 130MG Brand 2



NATURE THROI TAB 162.5MG Brand 2













METHIMAZOLE TAB 5MG generic 1

TAPAZOLE TAB 5MG Brand 2 GR

METHIMAZOLE TAB 10MG generic 1

TAPAZOLE TAB 10MG Brand 2 GR

PROPYLTHIOUR TAB 50MG generic 1

Ulcer Drugs

ATROPINE SUL INJ 0.05MG/1 generic 1

ATROPINE SUL INJ 0.1MG/ML generic 1

ATROPINE SUL INJ 0.4MG/ML generic 1



ATROPINE SUL INJ 0.4/0.5 generic 1

ATROPINE SUL INJ 1MG/ML generic 1

ATROPEN INJ 0.25MG Brand 2

ATROPEN INJ 0.5MG Brand 2

ATROPEN INJ 1MG Brand 2

ATROPEN INJ 2MG Brand 2

HYOSCYAMINE TAB 0.125MG generic 1

LEVSIN TAB 0.125MG Brand 2 GR

OSCIMIN TAB 0.125MG generic 1

SYMAX DUOTAB TAB Brand 2

HYOMAX-SL SUB 0.125MG generic 1

SYMAX-SL SUB 0.125MG generic 1

OSCIMIN SUB 0.125MG generic 1

HYOSCYAMINE SUB 0.125MG generic 1

LEVSIN/SL SUB 0.125MG Brand 2 GR

HYOSCYAMINE ELX 0.125/5 generic 1

HYOSYNE ELX 0.125/5 generic 1

LEVSIN INJ 0.5MG/ML Brand 2

HYOSCYAMINE DRO 0.125/ML generic 1

HYOSYNE DRO 0.125/ML generic 1

SYMAX FASTAB TAB 0.125MG generic 1

ED-SPAZ TAB 0.125MG generic 1

NULEV TAB 0.125MG generic 1

ANASPAZ TAB 0.125MG Brand 2 GR

HYOSCYAMINE TAB 0.125MG generic 1

OSCIMIN TAB 0.125MG generic 1

HYOSCYAMINE TAB 0.375 ER generic 1

SYMAX-SR TAB 0.375MG generic 1

OSCIMIN SR TAB 0.375MG generic 1

LEVBID TAB 0.375 ER Brand 2 GR

SCOPOLAMINE INJ 0.4MG/ML Brand 2

GLYCOPYRROL TAB 1MG generic 1



ROBINUL TAB 1MG Brand 2 GR

GLYCATE TAB 1.5MG Brand 2

GLYCOPYRROL TAB 2MG generic 1

ROBINUL FORT TAB 2MG Brand 2 GR

GLYCOPYRROL INJ 0.2MG/ML generic 1

ROBINUL INJ 0.2MG/ML Brand 2 GR

GLYCOPYRROL INJ 0.4/2ML generic 1



ROBINUL INJ 0.4/2ML Brand 2 GR



GLYCOPYRROL INJ 1MG/5ML generic 1

GLYCOPYRROL INJ 4MG/20ML generic 1



CUVPOSA SOL 1MG/5ML Brand 2 PA MO

CANTIL TAB 25MG Brand 2

PAMINE TAB 2.5MG Brand 2 GR

METHSCOPOLAM TAB 2.5MG generic 1

PAMINE FORTE TAB 5MG Brand 2 GR

METHSCOPOLAM TAB 5MG generic 1

PROPANTHELIN TAB 15MG generic 1

BENTYL CAP 10MG Brand 2 GR

DICYCLOMINE CAP 10MG generic 1

BENTYL TAB 20MG Brand 2 GR

DICYCLOMINE TAB 20MG generic 1

BENTYL INJ 10MG/ML Brand 2

DICYCLOMINE SOL 10MG/5ML generic 1

BELLA/OPIUM SUP 16.2-30 Brand 2

BELLA/OPIUM SUP 16.2-60 generic 1

PAMINE FQ KIT Brand 2



GASTRINEX NF CAP generic 1

CIMETIDINE TAB 200MG generic 1




CIMETIDINE SOL 300/5ML generic 1

RANITIDINE CAP 150MG generic 1

RANITIDINE CAP 300MG generic 1

ZANTAC TAB 150MG Brand 2 GR

RANITIDINE TAB 150MG generic 1

ZANTAC TAB 300MG Brand 2 GR

RANITIDINE TAB 300MG generic 1

RANITIDINE SYP 150/10ML generic 1

ZANTAC SYP 15MG/ML Brand 2 GR

RANITIDINE SYP 75MG/5ML generic 1

RANITIDINE SYP 15MG/ML generic 1

RANITIDINE INJ 50MG/2ML generic 1

ZANTAC INJ 25MG/ML Brand 2 GR

RANITIDINE INJ 150/6ML generic 1


RANITIDINE INJ 25MG/ML generic 1


FAMOTIDINE TAB 20MG generic 1

PEPCID TAB 20MG Brand 2 GR

PEPCID TAB 40MG Brand 2 GR

FAMOTIDINE TAB 40MG generic 1

FAMOTIDINE SUS 40MG/5ML generic 1

PEPCID SUS 40MG/5ML Brand 2 GR

FAMOTIDINE INJ 20MG/2ML generic 1

FAMOTIDINE INJ 40MG/4ML generic 1

FAMOTIDINE INJ 200/20ML generic 1

FAMOTIDINE INJ 10MG/ML generic 1



FAMOTIDINE INJ 20MG/50M Brand 2

NIZATIDINE CAP 150MG generic 1

NIZATIDINE CAP 300MG generic 1

AXID CAP 300MG Brand 2 GR

NIZATIDINE SOL 15MG/ML generic 1

AXID SOL 15MG/ML Brand 2 GR

MISOPROSTOL TAB 100MCG generic 1

CYTOTEC TAB 100MCG Brand 2 GR

CYTOTEC TAB 200MCG Brand 2 GR

MISOPROSTOL TAB 200MCG generic 1

DEXILANT CAP 30MG DR Brand 2 NON-PREF ST QL 30/30 PA

DEXILANT CAP 60MG DR Brand 2 NON-PREF ST QL 30/30 PA

NEXIUM GRA 2.5MG DR Brand 2

NEXIUM GRA 5MG DR Brand 2

NEXIUM GRA 10MG DR Brand 2 NON-PREF ST QL 30/30 PA



NEXIUM CAP 20MG Brand 2 NON-PREF ST QL 30/30 PA

NEXIUM CAP 40MG Brand 2 NON-PREF ST QL 30/30 PA

NEXIUM I.V. INJ 20MG Brand 2

NEXIUM I.V. INJ 40MG Brand 2

ESOMEPRAZOLE CAP 24.65MG Brand 2 PA

ESOMEPRAZOLE CAP 49.3MG Brand 2 PA

LANSOPRAZOLE SUS 3MG/ML Brand 2 QL 300/30 MO

LANSOPRAZOLE CAP 15MG DR generic 1 NON-PREF ST QL 30/30 PA

PREVACID CAP 15MG DR Brand 2 NON-PREF ST QL 30/30 PA

PREVACID CAP 30MG DR Brand 2 NON-PREF ST QL 30/30 PA

LANSOPRAZOLE CAP 30MG DR generic 1 NON-PREF ST QL 30/30 PA

PREVACID TAB 15MG STB Brand 2 NON-PREF ST QL 30/30 PA

PREVACID TAB 30MG STB Brand 2 NON-PREF ST QL 30/30 PA

FIRST-OMEPRA SUS 2MG/ML Brand 2 QL 300/30 MO

OMEPRAZOLE + SUS SYRSPEND Brand 2 QL 300/30 MO



PRILOSEC CAP 10MG Brand 2 NON-PREF ST QL 30/30 PA

OMEPRAZOLE CAP 10MG generic 1 PREF QL 30/30 PA





PRILOSEC POW 2.5MG Brand 2

PRILOSEC POW 10MG Brand 2

PANTOPRAZOLE TAB 20MG generic 1 PREF QL 30/30 PA

PROTONIX TAB 20MG Brand 2 NON-PREF ST QL 30/30 PA

PANTOPRAZOLE TAB 40MG generic 1 PREF QL 30/30 PA

PROTONIX TAB 40MG Brand 2 NON-PREF ST QL 30/30 PA

PROTONIX INJ 40MG Brand 2 GR

PANTOPRAZOLE INJ 40MG generic 1

PROTONIX PAK Brand 2

ACIPHEX TAB 20MG Brand 2 GR

RABEPRAZOLE TAB 20MG generic 1

ACIPHEX SPR CAP 5MG Brand 2

ACIPHEX SPR CAP 10MG Brand 2

SUCRALFATE TAB 1GM generic 1

CARAFATE TAB 1GM Brand 2 GR

CARAFATE SUS 1GM/10ML Brand 2

PYLERA CAP Brand 2 PA

HELIDAC MIS Brand 2

LANSOPR/AMOX MIS /CLARITH generic 1

PREVPAC MIS Brand 2 GR

OMECLAMOX- MIS PAK Brand 2 PA

OMEPRA/BICAR CAP 20-1100 generic 1 NON-PREF ST QL 30/30 PA

ZEGERID CAP 20-1100 Brand 2 NON-PREF ST PA

ZEGERID CAP 40-1100 Brand 2 GR

OMEPRA/BICAR CAP 40-1100 generic 1

ZEGERID POW 20-1680 Brand 2



ZEGERID POW 40-1680 Brand 2

Urinary Anti-infectives

MONUROL PAK GRANULES Brand 2

METHENAM MAN TAB 500MG Brand 2

METHENAM MAN TAB 1GM generic 1

METHENAM MAN TAB 1000MG generic 1

UREX TAB 1GM Brand 2 GR

METHENAM HIP TAB 1GM generic 1

HIPREX TAB 1GM Brand 2 GR

NITROFURANTN SUS 25MG/5ML generic 1

FURADANTIN SUS 25MG/5ML Brand 2 GR

MACRODANTIN CAP 25MG Brand 2

NITROFUR MAC CAP 50MG generic 1

MACRODANTIN CAP 50MG Brand 2 GR

NITROFUR MAC CAP 100MG generic 1

MACRODANTIN CAP 100MG Brand 2 GR

NITROFURANTN CAP 100MG generic 1

MACROBID CAP 100MG Brand 2 GR

UROQID #2 TAB Brand 2

URYL TAB generic 1

UROGESIC- TAB BLUE Brand 2 GR

HYOPHEN TAB generic 1

PROSED/DS TAB Brand 2 GR

UTICAP CAP generic 1

USTELL CAP generic 1

UTA CAP 120MG generic 1

URELLE TAB Brand 2

PHOSPHASAL TAB generic 1

UTIRA-C TAB generic 1

UR N-C TAB generic 1

UTRONA-C TAB generic 1



URIN D/S TAB generic 1

URETRON D/S TAB generic 1

URIMAR-T TAB Brand 2

URETRON D/S TAB Brand 2

Urinary Antispasmodics

ENABLEX TAB 7.5MG Brand 2 NON-PREF ST QL 30/30 MO

ENABLEX TAB 15MG Brand 2 NON-PREF ST QL 30/30 MO

TOVIAZ TAB 4MG Brand 2 PREF QL 30/30 MO

TOVIAZ TAB 8MG Brand 2 PREF QL 30/30 MO

GELNIQUE GEL 3% Brand 2

OXYTROL DIS 3.9MG/24 Brand 2 NON-PREF ST QL 8/30 MO

OXYBUTYNIN TAB 5MG generic 1 PREF MO

OXYBUTYNIN SYP 5MG/5ML generic 1 PREF MO

GELNIQUE GEL 10% Brand 2 NON-PREF ST QL 30/30 MO

OXYBUTYNIN TAB 5MG ER generic 1 NON-PREF ST QL 30/30 MO

DITROPAN XL TAB 5MG Brand 2 NON-PREF ST MO





VESICARE TAB 5MG Brand 2 PREF QL 30/30 MO

VESICARE TAB 10MG Brand 2 PREF QL 30/30 MO

TOLTERODINE TAB 1MG generic 1 NON-PREF ST MO

DETROL TAB 1MG Brand 2 NON-PREF ST MO

TOLTERODINE TAB 2MG generic 1 NON-PREF ST MO

DETROL TAB 2MG Brand 2 NON-PREF ST MO

DETROL LA CAP 2MG Brand 2 NON-PREF ST QL 30/30 MO

DETROL LA CAP 4MG Brand 2 NON-PREF ST QL 30/30 MO

TROSPIUM CL TAB 20MG generic 1

SANCTURA TAB 20MG Brand 2 NON-PREF ST MO

TROSPIUM CHL CAP 60MG ER generic 1 NON-PREF ST QL 30/30 MO



SANCTURA XR CAP 60MG Brand 2 NON-PREF ST QL 30/30 MO

MYRBETRIQ TAB 25MG Brand 2 NON-PREF ST QL 30/30 MO

MYRBETRIQ TAB 50MG Brand 2 NON-PREF ST QL 30/30 MO

BETHANECHOL TAB 5MG generic 1

URECHOLINE TAB 5MG Brand 2 GR







FLAVOXATE TAB 100MG generic 1

Vaccines

FLUZONE SPLT INJ 2013-14 Brand 2

AFLURIA INJ 2012-13 Brand 2

AFLURIA INJ 2013-14 Brand 2

FLULAVAL INJ 2013-14 Brand 2

FLUZONE INJ INTRADRM Brand 2

FLUZONE PED/ INJ PF 13-14 Brand 2

AFLURIA INJ PF 13-14 Brand 2

AFLURIA INJ PF 12-13 Brand 2

FLUARIX PF INJ 2013-14 Brand 2

FLUZONE INJ PF 13-14 Brand 2

FLUZONE HD INJ PF 13-14 Brand 2

FLULAVAL QUA INJ 2013-14 Brand 2

FLUZONE QUAD INJ 13-14 Brand 2

FLUARIX QUAD INJ 2013-14 Brand 2

FLUZONE QUAD INJ 13-14 Brand 2

EZ FLU SHOT KIT 13-14 Brand 2

FLUVIRIN INJ 2013-14 Brand 2

EZ USE FLU KIT 2012-13 Brand 2



FLUVIRIN INJ PF 13-14 Brand 2

EZ FLU SHOT KIT PF 13-14 Brand 2

FLUMIST NASA LIQ 2012-13 Brand 2

FLUMIST QUAD SUS 2013-14 Brand 2

INFLUENZA A SPR 09 H1N1 Brand 2

FLUCELVAX INJ 2013-14 Brand 2

FLUBLOK SOL 2013-14 Brand 2

GARDASIL INJ Brand 2 PA

CERVARIX INJ Brand 2 PA

ZOSTAVAX INJ Brand 2 QL 1/Life PA

Vaginal Products

CLEOCIN CRE 2% VAG Brand 2 GR

CLINDAMYCIN CRE 2% VAG generic 1

CLEOCIN SUP 100MG Brand 2

CLINDESSE CRE 2% Brand 2

METRONIDAZOL GEL 0.75%VAG generic 1

VANDAZOLE GEL 0.75% generic 1

METROGEL-VAG GEL 0.75% Brand 2 GR

AVC CRE 15% Brand 2

GYNAZOLE-1 CRE 2% Brand 2

MICONAZOLE 3 SUP 200MG generic 1

MICONAZOLE 3 KIT COMBO PK generic 1

ZAZOLE CRE 0.4% generic 1

TERAZOL 7 CRE 0.4% Brand 2 GR

TERCONAZOLE CRE 0.4% generic 1

ZAZOLE CRE 0.8% generic 1

TERAZOL 3 CRE 0.8% Brand 2 GR

TERCONAZOLE CRE 0.8% generic 1

TERCONAZOLE SUP 80MG generic 1

ZAZOLE SUP 80MG generic 1

TERAZOL 3 SUP 80MG Brand 2 GR



VAGIFEM TAB 10MCG Brand 2

ESTRACE VAG CRE 0.1MG/GM Brand 2

ESTRING MIS 2MG Brand 2

FEMRING MIS 0.05/24H Brand 2

FEMRING MIS 0.1MG/24 Brand 2

PREMARIN VAG CRE 0.625MG Brand 2

CRINONE GEL 4% VAG Brand 2

CRINONE GEL 8% VAG Brand 2

PROGESTERONE SUP VGS 25 Brand 2





ENDOMETRIN SUP 100MG Brand 2

FEM PH GEL Brand 2

RELAGARD GEL Brand 2

Vasopressors

DOBUTAMINE INJ 250MG generic 1

DOBUTAMINE INJ 500MG generic 1

DOPAMINE INJ 40MG/ML generic 1

DOPAMINE INJ 80MG/ML generic 1

DOPAMINE INJ 160MG/ML Brand 2

EPHEDRINE SU INJ 50MG/ML generic 1

MIDODRINE TAB 2.5MG generic 1

MIDODRINE TAB 5MG generic 1

MIDODRINE TAB 10MG generic 1

LEVOPHED INJ 1MG/ML Brand 2 GR

NOREPINEPHR INJ 1MG/ML generic 1

PHENYLEPHRIN INJ 10MG/ML generic 1

ADRENALIN INJ 1MG/ML Brand 2

EPIPEN-JR INJ 2-PAK Brand 2 QL 4/30



EPINEPHRINE INJ 0.15MG generic 1

AUVI-Q INJ 0.15MG Brand 2

ADRENACLICK INJ 0.15MG Brand 2 GR

EPINEPHRINE INJ 0.3MG generic 1

AUVI-Q INJ 0.3MG Brand 2 QL 4/30

EPIPEN 2-PAK INJ 0.3MG Brand 2 QL 4/30

ADRENACLICK INJ 0.3MG Brand 2 GR

Vitamins

THIAMINE HCL INJ 100MG/ML generic 1

PYRIDOXINE INJ 100MG/ML generic 1

ASCOR L 500 INJ 500MG/ML generic 1

MEGA-C/A PLU INJ 500MG/ML generic 1

ASCORBIC ACD INJ 500MG/ML generic 1

ASCOR L NC INJ 500MG/ML generic 1

ORTHO-CS 250 INJ 250MG/ML generic 1

VITAMIN C INJ 222MG/ML generic 1

AQUASOL A INJ 50000/ML Brand 2 PA

DRISDOL CAP 50000UNT Brand 2 GR

ERGOCALCIFER CAP 50000UNT generic 1

VITAMIN D CAP 50000UNT generic 1

DECARA CAP 25000UNT Brand 2 PA

WHEAT GERM OIL Brand 2 PA

MEPHYTON TAB 5MG Brand 2 PA

VITAMIN K1 INJ 1MG/0.5 generic 1

PHYTONADIONE INJ 1MG/0.5 generic 1

VITAMIN K1 INJ 10MG/ML Brand 2 PA


WELL SENSE HEALTH PLAN DRUG LIST (Effective ) 12/12/2013/media/8b75065b9ad34abcbaae8df68549b… ·...

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