Zing Choice IL (HMO) 2020 Formulary (List of Covered Drugs)...2019/09/01 · medically necessary,...

Zing Choice IL (HMO)

2020 Formulary

(List of Covered Drugs)

PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN

HPMS Approved Formulary File Submission ID 00020325, Version Number 06

This formulary was updated on 09/01/2019. For more recent information or other questions, please contact Zing Choice IL (HMO) Customer Service, at 1-866-946-4458 or, for TTY users, 711. Hours of Operation are 8 a.m. to 8 p.m., 7 days a week (except Thanksgiving and Christmas Day) from October 1 – March 31, and 8 a.m. to 8 p.m., Monday – Friday (other technologies such as voicemail are used after hours, weekends, and on Federal Holidays) from April 1 – September 30, or visit www.myzinghealth.com.

Note to existing members: This formulary has changed since last year. Please review this document to make sure that it still contains the drugs you take.

When this drug list (formulary) refers to “we,” “us”, or “our,” it means Zing Health. When it refers to “plan” or “our plan,” it means Zing Choice IL (HMO).

This document includes a list of the drugs (formulary) for our plan which is current as of 09/01/2019. For an updated formulary, please contact us. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages.

You must generally use network pharmacies to use your prescription drug benefit. Benefits, formulary, pharmacy network, and/or copayments/coinsurance may change on January 1, 2021, and from time to time during the year.

H7330_2020CDFORM_C

iii2020 Formulary - Zing Choice IL (HMO)

What is the Zing Choice IL (HMO) Formulary?

A formulary is a list of covered drugs selected by Zing Choice IL (HMO) in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Our plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a Zing Choice IL (HMO) network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Evidence of Coverage.

Can the Formulary (drug list) change?

Most changes in drug coverage happen on January 1, but we may add or remove drugs on the Drug List during the year, move them to different cost-sharing tiers, or add new restrictions. We must follow Medicare rules in making these changes.

Changes that can affect you this year: In the below cases, you will be affected by coverage changes during the year:

New generic drugs. We may immediately remove a brand name drug on our Drug List if we arereplacing it with a new generic drug that will appear on the same or lower cost sharing tier and withthe same or fewer restrictions. Also, when adding the new generic drug, we may decide to keep thebrand name drug on our Drug List, but immediately move it to a different cost-sharing tier or addnew restrictions. If you are currently taking that brand name drug, we may not tell you in advancebefore we make that change, but we will later provide you with information about the specificchange(s) we have made.

o If we make such a change, you or your prescriber can ask us to make an exception andcontinue to cover the brand name drug for you. The notice we provide you will also includeinformation on how to request an exception, and you can also find information in the sectionbelow entitled “How do I request an exception to the Zing Choice IL (HMO) Formulary?”

Drugs removed from the market. If the Food and Drug Administration deems a drug on ourformulary to be unsafe or the drug’s manufacturer removes the drug from the market, we willimmediately remove the drug from our formulary and provide notice to members who take the drug.

Other changes. We may make other changes that affect members currently taking a drug. Forinstance, we may add a generic drug that is not new to market to replace a brand name drug currentlyon the formulary or add new restrictions to the brand name drug or move it to a different cost-sharingtier. Or we may make changes based on new clinical guidelines. If we remove drugs from ourformulary, add prior authorization, quantity limits and/or step therapy restrictions on a drug, or movea drug to a higher cost-sharing tier, we must notify affected members of the change at least 30 daysbefore the change becomes effective, or at the time the member requests a refill of the drug, at whichtime the member will receive a 30-day supply of the drug.

o If we make these other changes, you or your prescriber can ask us to make an exception andcontinue to cover the brand name drug for you. The notice we provide you will also includeinformation on how to request an exception, and you can also find information in the sectionbelow entitled “How do I request an exception to the Zing Choice IL (HMO) Formulary?”

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iv 2020 Formulary - Zing Choice IL (HMO)

Changes that will not affect you if you are currently taking the drug. Generally, if you are taking a drug on our 2020 formulary that was covered at the beginning of the year, we will not discontinue or reduce coverage of the drug during the 2020 coverage year except as described above. This means these drugs will remain available at the same cost-sharing and with no new restrictions for those members taking them for the remainder of the coverage year.

The enclosed formulary is current as of 09/01/2019. To get updated information about the drugs covered by Zing Choice IL (HMO), please contact us. Our contact information appears on the front and back cover pages. In the event of CMS-approved mid-year non-maintenance formulary changes (e.g., remove drugs from our formulary, add prior authorization, quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier), we will update our formulary and post it on our website. You may obtain the updated formulary from our website or by calling us. Our contact information appears on the front and back cover pages.

How do I use the Formulary?

There are two ways to find your drug within the formulary:

Medical ConditionThe formulary begins on page 1. The drugs in this formulary are grouped into categories depending onthe type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, “Cardiovascular Agents”. If you know what your drug is used for, look for the category name in the list that begins on page 1. Then look under the category name foryour drug.

Alphabetical ListingIf you are not sure what category to look under, you should look for your drug in the Index that beginson page 136. The Index provides an alphabetical list of all the drugs included in this document. Both brand name drugs and generic drugs are listed in the Index. Look in the Index and find your drug. Next to your drug, you will see the page number where you can find coverage information. Turn to the page listed in the Index and find the name of your drug in the first column of the list.

What are generic drugs?

Zing Choice IL (HMO) covers both brand name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient as the brand name drug. Generally, generic drugs cost less than brand name drugs.

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v2020 Formulary - Zing Choice IL (HMO)

Are there any restrictions on my coverage?

Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include:

Prior Authorization: Zing Choice IL (HMO) requires you or your physician to get priorauthorization for certain drugs. This means that you will need to get approval from Zing Choice IL(HMO) before you fill your prescriptions. If you don’t get approval, Zing Choice IL (HMO) may notcover the drug.

Quantity Limits: For certain drugs, Zing Choice IL (HMO) limits the amount of the drug that ourplan will cover. For example, Zing Choice IL (HMO) provides up to 60 capsules per prescription forcelecoxib 100mg. This may be in addition to a standard one-month or three-month supply.

Step Therapy: In some cases, Zing Choice IL (HMO) requires you to first try certain drugs to treatyour medical condition before we will cover another drug for that condition. For example, if Drug Aand Drug B both treat your medical condition, our plan may not cover Drug B unless you try Drug Afirst. If Drug A does not work for you, Zing Choice IL (HMO) will then cover Drug B.

You can find out if your drug has any additional requirements or limits by looking in the formulary thatbegins on page 1. You can also get more information about the restrictions applied to specific covereddrugs by visiting our Web site. We have posted online documents that explain our prior authorization and step therapy restrictions. You may also ask us to send you a copy. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages.

You can ask Zing Choice IL (HMO) to make an exception to these restrictions or limits or for a list of other, similar drugs that may treat your health condition. See the section, “How do I request an exception to the Zing Choice IL (HMO) formulary?” on page v for information about how to request an exception.

What if my drug is not on the Formulary?

If your drug is not included in this formulary (list of covered drugs), you should first contact Customer Service and ask if your drug is covered.

If you learn that Zing Choice IL (HMO) does not cover your drug, you have two options:

You can ask Customer Service for a list of similar drugs that are covered by Zing Choice IL (HMO).When you receive the list, show it to your doctor and ask him or her to prescribe a similar drug that iscovered by our plan.

You can ask Zing Choice IL (HMO) to make an exception and cover your drug. See below forinformation about how to request an exception.

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vi 2020 Formulary - Zing Choice IL (HMO)

How do I request an exception to the Zing Choice IL (HMO) Formulary?

You can ask Zing Choice IL (HMO) to make an exception to our coverage rules. There are several types of exceptions that you can ask us to make.

You can ask us to cover a drug even if it is not on our formulary. If approved, this drug will becovered at a pre-determined cost-sharing level, and you would not be able to ask us to provide thedrug at a lower cost-sharing level.

You can ask us to cover a formulary drug at a lower cost-sharing level if this drug is not on thespecialty tier. If approved this would lower the amount you must pay for your drug.

You can ask us to waive coverage restrictions or limits on your drug. For example, for certain drugs,Zing Choice IL (HMO) limits the amount of the drug that we will cover. If your drug has a quantitylimit, you can ask us to waive the limit and cover a greater amount.

Generally, Zing Choice IL (HMO) will only approve your request for an exception if the alternative drugs included on the plan’s formulary, the lower cost-sharing drug or additional utilization restrictions would not be as effective in treating your condition and/or would cause you to have adverse medical effects.

You should contact us to ask us for an initial coverage decision for a formulary, tiering, or utilization restriction exception. When you request a formulary, tiering, or utilization restriction exception you should submit a statement from your prescriber or physician supporting your request. Generally, we must make our decision within 72 hours of getting your prescriber’s supporting statement. You can request an expedited (fast) exception if you or your doctor believe that your health could be seriously harmed by waiting up to 72 hours for a decision. If your request to expedite is granted, we must give you a decision no later than 24 hours after we get a supporting statement from your doctor or other prescriber.

What do I do before I can talk to my doctor about changing my drugs or requesting an exception?

As a new or continuing member in our plan you may be taking drugs that are not on our formulary. Or, you may be taking a drug that is on our formulary but your ability to get it is limited. For example, you may need a prior authorization from us before you can fill your prescription. You should talk to your doctor to decide if you should switch to an appropriate drug that we cover or request a formulary exception so that we will cover the drug you take. While you talk to your doctor to determine the right course of action for you, we may cover your drug in certain cases during the first 90 days you are a member of our plan.

For each of your drugs that is not on our formulary or if your ability to get your drugs is limited, we will cover a temporary 30-day supply. If your prescription is written for fewer days, we’ll allow refills to provide up to a maximum 30-day supply of medication. After your first 30-day supply, we will not pay for these drugs, even if you have been a member of the plan less than 90 days.

If you are a resident of a long-term care facility and you need a drug that is not on our formulary or if your ability to get your drugs is limited, but you are past the first 90 days of membership in our plan, we will cover a 31-day emergency supply of that drug while you pursue a formulary exception.

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vii2020 Formulary - Zing Choice IL (HMO)

If you have a change in your medications due to a change in treatment setting (i.e., a level of care change)and you need a drug that is not on our formulary, we will provide up to a maximum 30-day supply ofmedication. A level of care change may include:

Members who enter Long Term Care (LTC) facilities from hospitals Members who are discharged from a hospital to a home Members who end their skilled nursing facility Medicare Part A stay (where payments include all

pharmacy charges) and revert to their Part D benefit Members who give up hospice status to revert to standard Medicare Part A and B benefits Members who end an LTC facility stay and return to the community Members who are discharged from psychiatric hospitals with drug regimens that are highly

individualized

For more information

For more detailed information about your Zing Choice IL (HMO) prescription drug coverage, please review your Evidence of Coverage and other plan materials.

If you have questions about Zing Choice IL (HMO), please contact us. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages.

If you have general questions about Medicare prescription drug coverage, please call Medicare at 1-800-MEDICARE (1-800-633-4227) 24 hours a day/7 days a week. TTY users should call 1-877-486-2048. Or, visit http://www.medicare.gov.

Zing Choice IL (HMO) Formulary

The formulary below provides coverage information about the drugs covered by Zing Choice IL (HMO). Ifyou have trouble finding your drug in the list, turn to the Index that begins on page 136.

The first column of the chart lists the drug name. Brand name drugs are capitalized (e.g., BYETTA) and generic drugs are listed in lower-case italics (e.g., prednisone).

The information in the Requirements/Limits column tells you if Zing Choice IL (HMO) has any special requirements for coverage of your drug.

o Limited Distribution (LD): This prescription may be available only at certain pharmacies. For moreinformation consult your Pharmacy Directory or call Customer Service at 1-866-946-4458. Hours ofOperation are 8 a.m. to 8 p.m., 7 days a week (except Thanksgiving and Christmas Day) fromOctober 1 – March 31, and 8 a.m. to 8 p.m., Monday – Friday (other technologies such as voicemailare used after hours, weekends, and on Federal Holidays) from April 1 – September 30. TTY usersshould call 711.

o Non-Extended Day Supply (NDS): You may be able to receive greater than a 1-month supply ofmost of the drugs on your Formulary via mail order at a reduced cost share. Drugs noted with “NDS”are limited to a 1-month supply for both Retail and Mail Order.

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viii 2020 Formulary - Zing Choice IL (HMO)

o Prior Authorization (PA): Zing Choice IL (HMO) requires you or your physician to get priorauthorization for certain drugs. This means that you will need to get approval from Zing Choice IL(HMO) before you fill your prescriptions. If you don’t get approval, Zing Choice IL (HMO) may notcover the drug.

o Prior Authorization Restriction for Part B vs. Part D Determination (PA_BvD): This drug maybe eligible for payment under Medicare Part B or Part D. You, or your physician, are required to getprior authorization from our plan to determine if this drug is covered under Medicare Part D beforeyou fill your prescription for the drug. Without prior approval, Zing Choice IL (HMO) may notcover this drug.

o Prior Authorization Restriction for New Starts Only (PA_NSO): If this drug is new to themember, you or your physician are required to get prior authorization from our plan before you fillyour prescription for this drug. Without prior approval, Zing Choice IL (HMO) will not cover thisdrug.

o Quantity Limits (QL): For certain drugs, Zing Choice IL (HMO) limits the amount of the drug thatour plan will cover. This could include a per-prescription fill, daily, monthly, or yearly limitation.This limitation may be in addition to a standard one-month or three-month supply.

o Step Therapy (ST): In some cases, Zing Choice IL (HMO) requires you to first try certain drugs totreat your medical condition before we will cover another drug for that condition. For example, ifDrug A and Drug B both treat your medical condition, our plan may not cover Drug B unless you tryDrug A first. If Drug A does not work for you, Zing Choice IL (HMO) will then cover Drug B.

o Step Therapy for New Starts Only (ST_NSO): If this drug is new to the member, you are requiredto first try certain drugs to treat your medical condition before we will cover another drug for thatcondition.

Every drug on the Zing Choice IL (HMO) is in one of six cost-sharing tiers. In general, the higher the cost-sharing tier number, the higher your cost for the drug:

Tier 1 - Preferred Generic: Generic drugs that are available at the lowest cost share for the plan Tier 2 - Generic: Generic or brand drugs that the plan offers at a higher cost to you than Tier 1

Preferred Generic drugs Tier 3 - Preferred Brand: Generic or brand drugs that the plan offers at a lower cost to you than Tier 4

Non-Preferred Brand drugs Tier 4 - Non-Preferred Brand: Generic or brand drugs that the plan offers at a higher cost to you than

Tier 3 Preferred Brand drugs Tier 5 - Specialty Tier: Some injectables and other high-cost drugs Tier 6 - Select Care Drug: Generic drugs that the plan offers at no cost during the initial coverage

phase only.

To find out which cost-sharing tier your drug is in, you may look it up in the list below. If you need help or have any questions about your drug costs, please review your Evidence of Coverage or call Zing Choice IL (HMO) Customer Service. Our contact information is on the front and back cover.

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12020 Formulary - Zing Choice IL (HMO)

DRUG NAME DRUG TIER REQUIREMENTS/LIMITS

You can find information on what the symbols and abbreviations on this table mean by going to thebeginning of this table.

1

ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREXIANTSAMPHETAMINES

ADDERALL 10MG XR CAP 4ADDERALL 15MG XR CAP 4ADDERALL 20MG TAB 4ADDERALL 20MG XR CAP 4ADDERALL 25MG XR CAP 4ADDERALL 30MG XR CAP 4ADDERALL 5MG TAB 4ADDERALL 5MG XR CAP 4ADDERALL 7.5MG TAB 4amphetamine 10mg er cap 2amphetamine 10mg tab 2amphetamine 12.5mg tab 2amphetamine 15mg er cap 2amphetamine 15mg tab 2amphetamine 20mg er cap 2amphetamine 20mg tab 2amphetamine 25mg er cap 2amphetamine 30mg er cap 2amphetamine 30mg tab 2amphetamine 5mg er cap 2amphetamine 5mg tab 2amphetamine 7.5mg tab 2DEXEDRINE 10MG ER CAP 4DEXEDRINE 15MG ER CAP 4DEXEDRINE 5MG ER CAP 4dextroamphetamine sulfate 10mg er cap 2dextroamphetamine sulfate 10mg tab 2dextroamphetamine sulfate 15mg er cap 2dextroamphetamine sulfate 5mg er cap 2dextroamphetamine sulfate 5mg tab 2PROCENTRA 5MG/5ML ORAL SOLN 4

ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD) AGENTSatomoxetine 100mg cap 2 QL=60 EA/30 Daysatomoxetine 10mg cap 2 QL=60 EA/30 Daysatomoxetine 18mg cap 2 QL=60 EA/30 Daysatomoxetine 25mg cap 2 QL=60 EA/30 Daysatomoxetine 40mg cap 2 QL=60 EA/30 Daysatomoxetine 60mg cap 2 QL=60 EA/30 Daysatomoxetine 80mg cap 2 QL=60 EA/30 Daysguanfacine 1mg er tab 1

2 2020 Formulary - Zing Choice IL (HMO)



2

guanfacine 2mg er tab 1guanfacine 3mg er tab 1guanfacine 4mg er tab 1INTUNIV 1MG ER TAB 4INTUNIV 2MG ER TAB 4INTUNIV 3MG ER TAB 4INTUNIV 4MG ER TAB 4STRATTERA 100MG CAP 4 QL=60 EA/30 DaysSTRATTERA 10MG CAP 4 QL=60 EA/30 DaysSTRATTERA 18MG CAP 4 QL=60 EA/30 DaysSTRATTERA 25MG CAP 4 QL=60 EA/30 DaysSTRATTERA 40MG CAP 4 QL=60 EA/30 DaysSTRATTERA 60MG CAP 4 QL=60 EA/30 DaysSTRATTERA 80MG CAP 4 QL=60 EA/30 Days

STIMULANTS - MISC.armodafinil 150mg tab 2 PA QL=30 EA/30 Daysarmodafinil 200mg tab 2 PA QL=30 EA/30 Daysarmodafinil 250mg tab 2 PA QL=30 EA/30 Daysarmodafinil 50mg tab 2 PA QL=30 EA/30 DaysBX RATING - METHYLPHENIDATE 18MG SR TAB 3BX RATING - METHYLPHENIDATE 27MG SR TAB 3BX RATING - METHYLPHENIDATE 36MG SR TAB 3BX RATING - METHYLPHENIDATE 54MG SR TAB 3CONCERTA 18MG ER TAB 4CONCERTA 27MG ER TAB 4CONCERTA 36MG ER TAB 4CONCERTA 54MG ER TAB 4dexmethylphenidate 10mg er cap 2dexmethylphenidate 10mg tab 2dexmethylphenidate 15mg er cap 2dexmethylphenidate 2.5mg tab 2dexmethylphenidate 20mg er cap 2dexmethylphenidate 25mg er cap 2dexmethylphenidate 30mg er cap 2dexmethylphenidate 35mg er cap 2dexmethylphenidate 40mg er cap 2dexmethylphenidate 5mg er cap 2dexmethylphenidate 5mg tab 2FOCALIN 10MG TAB 4FOCALIN 10MG XR CAP 4FOCALIN 15MG XR CAP 4FOCALIN 2.5MG TAB 4




3

FOCALIN 20MG XR CAP 4FOCALIN 25MG XR CAP 4FOCALIN 30MG XR CAP 4FOCALIN 35MG XR CAP 4FOCALIN 40MG XR CAP 4FOCALIN 5MG TAB 4FOCALIN 5MG XR CAP 4metadate 20mg er tab 2METHYLIN 10MG/5ML ORAL SOLN 4METHYLIN 5MG/5ML ORAL SOLN 4methylphenidate 10mg chew tab 2methylphenidate 10mg cr cap 2methylphenidate 10mg er tab 2methylphenidate 10mg la cap 2methylphenidate 10mg tab 2methylphenidate 18mg sr tab 2methylphenidate 1mg/ml oral soln 2methylphenidate 2.5mg chew tab 2methylphenidate 20mg cr cap 2methylphenidate 20mg er tab 2methylphenidate 20mg la cap 2methylphenidate 20mg tab 2methylphenidate 27mg sr tab 2methylphenidate 2mg/ml oral soln 2methylphenidate 30mg cr cap 2methylphenidate 30mg la cap 2methylphenidate 36mg sr tab 2methylphenidate 40mg cr cap 2methylphenidate 40mg la cap 2methylphenidate 50mg cr cap 2methylphenidate 54mg sr tab 2methylphenidate 5mg chew tab 2methylphenidate 5mg tab 2methylphenidate 60mg cr cap 2METHYLPHENIDATE 60MG LA CAP 4modafinil 100mg tab 2 PA QL=60 EA/30 Daysmodafinil 200mg tab 2 PA QL=60 EA/30 DaysNUVIGIL 150MG TAB 4 PANUVIGIL 200MG TAB 4 PA QL=30 EA/30 DaysNUVIGIL 250MG TAB 4 PANUVIGIL 50MG TAB 4 PAPROVIGIL 100MG TAB 4 PA QL=60 EA/30 Days




4

PROVIGIL 200MG TAB 4 PA QL=60 EA/30 DaysRITALIN 10MG LA CAP 4RITALIN 10MG TAB 4RITALIN 20MG LA CAP 4RITALIN 20MG TAB 4RITALIN 30MG LA CAP 4RITALIN 40MG LA CAP 4RITALIN 5MG TAB 4

AMEBICIDESAMEBICIDES

SOLOSEC 2GM GRANULE PACKET 4 PAAMINOGLYCOSIDESAMINOGLYCOSIDES

amikacin 250mg/ml inj 2ARIKAYCE 70.3MG/ML INH SOLN 5 NDS PA QL=252 ML/30 DaysGENTAMICIN SULFATE 0.8MG/ML INJ 2gentamicin sulfate 1.2mg/ml inj 2GENTAMICIN SULFATE 1.6MG/ML INJ 2GENTAMICIN SULFATE 1MG/ML INJ 2gentamicin sulfate 40mg/ml inj 2neomycin sulfate 500mg tab 1paromomycin 250mg cap 2STREPTOMYCIN 100MG INJ 4TOBI PODHALER KIT 28MG PACK 5 NDS PATOBRAMYCIN 10MG/ML INJ 2tobramycin 40mg/ml inj 2tobramycin 60mg/ml inh soln 5 NDS PA

ANALGESICS - ANTI-INFLAMMATORYANTI-TNF-ALPHA - MONOCLONAL ANTIBODIES

HUMIRA 10MG/0.1ML SYRINGE 5 NDS PAHUMIRA 10MG/0.2ML SYRINGE 5 NDS PAHUMIRA 20MG/0.2ML SYRINGE 5 NDS PAHUMIRA 20MG/0.4ML SYRINGE 5 NDS PAHUMIRA 40MG/0.4ML PEN INJECTOR 5 NDS PAHUMIRA 40MG/0.4ML SYRINGE 5 NDS PAHUMIRA 40MG/0.8ML AUTO-INJECTOR 5 NDS PAHUMIRA 40MG/0.8ML SYRINGE 5 NDS PAHUMIRA PEDIATRIC CROHN'S STARTER PACK (3)40MG/0.8ML INJ

5 NDS PA

HUMIRA PEDIATRIC CROHN'S STARTER PACK (3)80MG/0.8ML INJ

5 NDS PA




5

HUMIRA PEDIATRIC CROHN'S STARTER PACK (6)40MG/0.8ML INJ

5 NDS PA

HUMIRA PEDIATRIC CROHN'S STARTER PACKSYRINGE (2) 40MG/0.4ML 80MG/0.8ML

5 NDS PA

HUMIRA PEN - CROHN'S STARTER PACK40MG/0.8ML INJ

5 NDS PA

HUMIRA PEN - CROHN'S STARTER PACK80MG/0.8ML INJ

5 NDS PA

HUMIRA PEN - PSORIASIS STARTER PACK40MG/0.8ML INJ

5 NDS PA

HUMIRA PEN - PSORIASIS STARTER PACK80MG/0.8ML INJ

5 NDS PA

SIMPONI 100MG/ML AUTO-INJECTOR 5 NDS PASIMPONI 100MG/ML INJ 5 NDS PASIMPONI 50MG/0.5ML AUTO-INJECTOR 5 NDS PASIMPONI 50MG/0.5ML SYRINGE 5 NDS PA

ANTIRHEUMATIC - ENZYME INHIBITORSOLUMIANT 2MG TAB 3 PAXELJANZ 10MG TAB 5 NDS PAXELJANZ 5MG TAB 5 NDS PA

GOLD COMPOUNDSRIDAURA 3MG CAP 3

INTERLEUKIN-1 BLOCKERSARCALYST 220MG INJ 5 NDS PA

INTERLEUKIN-6 RECEPTOR INHIBITORSACTEMRA 162MG/0.9ML AUTO-INJECTOR 5 NDS PAACTEMRA 162MG/0.9ML SYRINGE 5 NDS PAKEVZARA 150MG/1.14ML PF INJ 5 NDS PAKEVZARA 200MG/1.14ML PF INJ 5 NDS PA

NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDS)ARTHROTEC 50-0.2MG TAB 4ARTHROTEC 75-0.2MG TAB 4CELEBREX 100MG CAP 4 QL=60 EA/30 DaysCELEBREX 200MG CAP 4 QL=60 EA/30 DaysCELEBREX 400MG CAP 4 QL=60 EA/30 DaysCELEBREX 50MG CAP 4 QL=60 EA/30 Dayscelecoxib 100mg cap 1 QL=60 EA/30 Dayscelecoxib 200mg cap 1 QL=60 EA/30 Dayscelecoxib 400mg cap 1 QL=60 EA/30 Dayscelecoxib 50mg cap 1 QL=60 EA/30 DaysDAYPRO 600MG TAB 4diclofenac potassium 50mg tab 2




6

diclofenac sodium 100mg er tab 2diclofenac sodium 25mg dr tab 2diclofenac sodium 50mg dr tab 2diclofenac sodium 50mg/misoprostol 0.2mg tab 2diclofenac sodium 75mg dr tab 2diclofenac sodium 75mg/misoprostol 0.2mg tab 2etodolac 200mg cap 2etodolac 300mg cap 2etodolac 400mg er tab 2etodolac 400mg tab 2etodolac 500mg er tab 2etodolac 500mg tab 2etodolac 600mg er tab 2FELDENE 10MG CAP 4FELDENE 20MG CAP 4flurbiprofen 100mg tab 1flurbiprofen 50mg tab 1ibu 600mg tab 1ibu 800mg tab 1ibuprofen 20mg/ml susp 2ibuprofen 400mg tab 1ibuprofen 600mg tab 1ibuprofen 800mg tab 1KETOPROFEN 200MG ER CAP 4KETOPROFEN 25MG CAP 1ketorolac tromethamine 10mg tab 1 QL=20 EA/5 DaysLODINE 400MG TAB 4meloxicam 15mg tab 1meloxicam 7.5mg tab 1MOBIC 15MG TAB 4MOBIC 7.5MG TAB 4nabumetone 500mg tab 2nabumetone 750mg tab 2naproxen 250mg tab 1naproxen 375mg dr tab 1naproxen 375mg tab 1naproxen 500mg dr tab 1naproxen 500mg tab 1naproxen sodium 275mg tab 2naproxen sodium 550mg tab 2oxaprozin 600mg tab 2piroxicam 10mg cap 2




7

piroxicam 20mg cap 2sulindac 150mg tab 1sulindac 200mg tab 1TOLMETIN 400MG CAP 4TOLMETIN 600MG TAB 4

PHOSPHODIESTERASE 4 (PDE4) INHIBITORSOTEZLA 28-DAY STARTER PACK 5 NDS PAOTEZLA 30MG TAB 5 NDS PA

PYRIMIDINE SYNTHESIS INHIBITORSARAVA 10MG TAB 4ARAVA 20MG TAB 4leflunomide 10mg tab 2leflunomide 20mg tab 2

SOLUBLE TUMOR NECROSIS FACTOR RECEPTOR AGENTSENBREL 25MG INJ 5 NDS PAENBREL 25MG/0.5ML SYRINGE 5 NDS PAENBREL 50MG/ML SURECLICK INJ 5 NDS PAENBREL 50MG/ML SYRINGE 5 NDS PA

ANALGESICS - NONNARCOTICSALICYLATES

diflunisal 500mg tab 2ANALGESICS - OPIOID

OPIOID AGONISTSABSTRAL 100MCG SL TAB 4 PA QL=120 EA/30 DaysABSTRAL 200MCG SL TAB 4 PA QL=120 EA/30 DaysABSTRAL 300MCG SL TAB 4 PA QL=120 EA/30 DaysABSTRAL 400MCG SL TAB 4 PA QL=120 EA/30 DaysABSTRAL 600MCG SL TAB 4 PA QL=120 EA/30 DaysABSTRAL 800MCG SL TAB 4 PA QL=120 EA/30 DaysACTIQ 1200MCG LOZENGE 4 PA QL=120 EA/30 DaysACTIQ 1600MCG LOZENGE 4 PA QL=120 EA/30 DaysACTIQ 200MCG LOZENGE 4 PA QL=120 EA/30 DaysACTIQ 400MCG LOZENGE 4 PA QL=120 EA/30 DaysACTIQ 600MCG LOZENGE 4 PA QL=120 EA/30 DaysACTIQ 800MCG LOZENGE 4 PA QL=120 EA/30 Dayscodeine sulfate 30mg tab 2 QL=240 EA/30 Dayscodeine sulfate 60mg tab 2 QL=180 EA/30 DaysDILAUDID 1MG/ML ORAL SOLN 4 QL=2400 ML/30 DaysDILAUDID 2MG TAB 4 QL=450 EA/30 DaysDILAUDID 4MG TAB 4 QL=240 EA/30 DaysDILAUDID 8MG TAB 4 QL=120 EA/30 DaysDOLOPHINE 10MG TAB 4 QL=360 EA/30 Days




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DOLOPHINE 5MG TAB 4 QL=360 EA/30 DaysDURAGESIC 100MCG/HR PATCH 4 QL=10 EA/30 DaysDURAGESIC 12MCG/HR PATCH 4 QL=10 EA/30 DaysDURAGESIC 25MCG/HR PATCH 4 QL=10 EA/30 DaysDURAGESIC 50MCG/HR PATCH 4 QL=10 EA/30 DaysDURAGESIC 75MCG/HR PATCH 4 QL=10 EA/30 Daysduramorph 0.5mg/ml inj 2 PA BvDduramorph 1mg/ml inj 2 PA BvDfentanyl 0.012mg/hr patch 2 QL=10 EA/30 Daysfentanyl 0.025mg/hr patch 2 QL=10 EA/30 Daysfentanyl 0.05mg/hr patch 2 QL=10 EA/30 Daysfentanyl 0.075mg/hr patch 2 QL=10 EA/30 DaysFENTANYL 0.1MG BUCCAL TAB 4 PA QL=120 EA/30 Daysfentanyl 0.1mg/hr patch 2 QL=10 EA/30 DaysFENTANYL 0.2MG BUCCAL TAB 4 PA QL=120 EA/30 Daysfentanyl 0.2mg lozenge 2 PA QL=120 EA/30 DaysFENTANYL 0.4MG BUCCAL TAB 4 PA QL=120 EA/30 Daysfentanyl 0.4mg lozenge 2 PA QL=120 EA/30 DaysFENTANYL 0.6MG BUCCAL TAB 4 PA QL=120 EA/30 Daysfentanyl 0.6mg lozenge 2 PA QL=120 EA/30 DaysFENTANYL 0.8MG BUCCAL TAB 4 PA QL=120 EA/30 Daysfentanyl 0.8mg lozenge 2 PA QL=120 EA/30 Daysfentanyl 1.2mg lozenge 2 PA QL=120 EA/30 Daysfentanyl 1.6mg lozenge 2 PA QL=120 EA/30 DaysFENTORA 100MCG BUCCAL TAB 4 PA QL=120 EA/30 DaysFENTORA 200MCG BUCCAL TAB 4 PA QL=120 EA/30 DaysFENTORA 400MCG BUCCAL TAB 4 PA QL=120 EA/30 DaysFENTORA 600MCG BUCCAL TAB 4 PA QL=120 EA/30 DaysFENTORA 800MCG BUCCAL TAB 4 PA QL=120 EA/30 Dayshydromorphone 10mg/ml (1ml) inj 2hydromorphone 10mg/ml (5ml) inj 2hydromorphone 1mg/ml oral soln 2 QL=2400 ML/30 Dayshydromorphone 2mg tab 2 QL=450 EA/30 Dayshydromorphone 2mg/ml syringe 2hydromorphone 4mg tab 2 QL=240 EA/30 Dayshydromorphone 8mg tab 2 QL=120 EA/30 DaysHYSINGLA 100MG ER TAB 3 QL=30 EA/30 DaysHYSINGLA 120MG ER TAB 3 QL=30 EA/30 DaysHYSINGLA 20MG ER TAB 3 QL=30 EA/30 DaysHYSINGLA 30MG ER TAB 3 QL=30 EA/30 DaysHYSINGLA 40MG ER TAB 3 QL=30 EA/30 DaysHYSINGLA 60MG ER TAB 3 QL=30 EA/30 Days




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HYSINGLA 80MG ER TAB 3 QL=30 EA/30 DaysLAZANDA 100MCG/ACT NASAL SPRAY 4 PA QL=30 EA/30 DaysLAZANDA 300MCG/ACT NASAL SPRAY 4 PA QL=30 EA/30 DaysLAZANDA 400MCG/ACT NASAL SPRAY 4 PA QL=30 EA/30 Daysmethadone 10mg tab 2 QL=360 EA/30 DaysMETHADONE 1MG/ML ORAL SOLN 2 QL=3600 ML/30 DaysMETHADONE 2MG/ML ORAL SOLN 2 QL=1800 ML/30 Daysmethadone 5mg tab 2 QL=360 EA/30 Daysmorphine sulfate 100mg er tab 2 QL=120 EA/30 DaysMORPHINE SULFATE 10MG/ML SYRINGE 4morphine sulfate 15mg er tab 2 QL=120 EA/30 Daysmorphine sulfate 15mg tab 2 QL=180 EA/30 Daysmorphine sulfate 200mg er tab 2 QL=120 EA/30 Daysmorphine sulfate 20mg/ml oral soln 2 QL=180 ML/30 Daysmorphine sulfate 2mg/ml oral soln 2 QL=1800 ML/30 DaysMORPHINE SULFATE 2MG/ML SYRINGE 4morphine sulfate 30mg er tab 2 QL=120 EA/30 Daysmorphine sulfate 30mg tab 2 QL=180 EA/30 Daysmorphine sulfate 4mg/ml oral soln 2 QL=900 ML/30 DaysMORPHINE SULFATE 4MG/ML SYRINGE 4MORPHINE SULFATE 5MG/ML SYRINGE 4morphine sulfate 60mg er tab 2 QL=120 EA/30 DaysMORPHINE SULFATE 8MG/ML SYRINGE 4MS CONTIN 100MG TAB 4 QL=120 EA/30 DaysMS CONTIN 15MG TAB 4 QL=120 EA/30 DaysMS CONTIN 200MG TAB 4 QL=120 EA/30 DaysMS CONTIN 30MG TAB 4 QL=120 EA/30 DaysMS CONTIN 60MG TAB 4 QL=120 EA/30 DaysNUCYNTA 100MG ER TAB 3 QL=60 EA/30 DaysNUCYNTA 150MG ER TAB 3 QL=60 EA/30 DaysNUCYNTA 200MG ER TAB 3 QL=60 EA/30 DaysNUCYNTA 250MG ER TAB 3 QL=60 EA/30 DaysNUCYNTA 50MG ER TAB 3 QL=60 EA/30 DaysOPANA 10MG TAB 4 QL=360 EA/30 DaysOPANA 5MG TAB 4 QL=360 EA/30 Daysoxycodone 10mg tab 2 QL=180 EA/30 Daysoxycodone 15mg tab 2 QL=180 EA/30 Daysoxycodone 1mg/ml oral soln 2 QL=5400 ML/30 Daysoxycodone 20mg tab 2 QL=180 EA/30 Daysoxycodone 20mg/ml oral soln 2 QL=270 ML/30 Daysoxycodone 30mg tab 2 QL=180 EA/30 Daysoxycodone 5mg cap 2 QL=360 EA/30 Days




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oxycodone 5mg tab 2 QL=360 EA/30 Daysoxymorphone 10mg tab 2 QL=360 EA/30 Daysoxymorphone 5mg tab 2 QL=360 EA/30 DaysROXICODONE 15MG TAB 4 QL=180 EA/30 DaysROXICODONE 30MG TAB 4 QL=180 EA/30 DaysROXICODONE 5MG TAB 4 QL=360 EA/30 Daystramadol 100mg er tab 2 QL=60 EA/30 Daystramadol 100mg er tab (matrix delivery) 2 QL=60 EA/30 Daystramadol 200mg er tab 2 QL=60 EA/30 Daystramadol 200mg er tab (matrix delivery) 2 QL=60 EA/30 Daystramadol 300mg er tab 2 QL=60 EA/30 Daystramadol 300mg er tab (matrix delivery) 2 QL=60 EA/30 Daystramadol 50mg tab 2 QL=240 EA/30 DaysULTRAM 50MG TAB 4 QL=240 EA/30 DaysXTAMPZA 13.5MG ER CAP 3 QL=120 EA/30 DaysXTAMPZA 18MG ER CAP 3 QL=120 EA/30 DaysXTAMPZA 27MG ER CAP 3 QL=120 EA/30 DaysXTAMPZA 36MG ER CAP 3 QL=120 EA/30 DaysXTAMPZA 9MG ER CAP 3 QL=120 EA/30 Days

OPIOID COMBINATIONSacetaminophen 21.7mg/ml/hydrocodone bitartrate0.5mg/ml oral soln

2 QL=5400 ML/30 Days

acetaminophen 24mg/ml/codeine phosphate 2.4mg/mloral soln

2 QL=4980 ML/30 Days

acetaminophen 300mg/codeine phosphate 15mg tab 2 QL=390 EA/30 Daysacetaminophen 300mg/codeine phosphate 30mg tab 2 QL=390 EA/30 Daysacetaminophen 300mg/codeine phosphate 60mg tab 2 QL=390 EA/30 Daysacetaminophen 300mg/hydrocodone bitartrate 10mg tab 2 QL=390 EA/30 Daysacetaminophen 300mg/hydrocodone bitartrate 5mg tab 2 QL=390 EA/30 Daysacetaminophen 300mg/hydrocodone bitartrate 7.5mg tab 2 QL=390 EA/30 Daysacetaminophen 325mg/hydrocodone bitartrate 10mg tab 2 QL=360 EA/30 Daysacetaminophen 325mg/hydrocodone bitartrate 5mg tab 2 QL=360 EA/30 Daysacetaminophen 325mg/hydrocodone bitartrate 7.5mg tab 2 QL=360 EA/30 Daysacetaminophen 325mg/oxycodone 10mg tab 2 QL=360 EA/30 Daysacetaminophen 325mg/oxycodone 2.5mg tab 2 QL=360 EA/30 Daysacetaminophen 325mg/oxycodone 5mg tab 2 QL=360 EA/30 Daysacetaminophen 325mg/oxycodone 7.5mg tab 2 QL=360 EA/30 Daysacetaminophen 325mg/tramadol 37.5mg tab 2 QL=360 EA/30 Daysaspirin 325mg/oxycodone 4.84mg tab 2 QL=360 EA/30 Daysendocet 10-325mg tab 2 QL=360 EA/30 Daysendocet 5-325mg tab 2 QL=360 EA/30 Daysendocet 7.5-325mg tab 2 QL=360 EA/30 Days




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hydrocodone 10mg/ibuprofen 200mg tab 2 QL=480 EA/30 Dayshydrocodone 5mg/ibuprofen 200mg tab 2 QL=480 EA/30 Dayshydrocodone bitartrate 7.5mg/ibuprofen 200mg tab 2 QL=480 EA/30 DaysIBUPROFEN 400MG/OXYCODONE 5MG TAB 2 QL=240 EA/30 Dayslorcet 10-325mg tab 2 QL=360 EA/30 Dayslorcet 5-325mg tab 2 QL=360 EA/30 Dayslorcet 7.5-325mg tab 2 QL=360 EA/30 DaysNORCO 10-325MG TAB 4 QL=360 EA/30 DaysNORCO 5-325MG TAB 4 QL=360 EA/30 DaysNORCO 7.5-325MG TAB 4 QL=360 EA/30 DaysPERCOCET 10-325MG TAB 4 QL=360 EA/30 DaysPERCOCET 2.5-325MG TAB 4 QL=360 EA/30 DaysPERCOCET 5-325MG TAB 4 QL=360 EA/30 DaysPERCOCET 7.5-325MG TAB 4 QL=360 EA/30 DaysTYLENOL WITH CODEINE 300-30MG TAB 4 QL=390 EA/30 DaysTYLENOL WITH CODEINE 300-60MG TAB 4 QL=390 EA/30 DaysULTRACET 37.5-325MG TAB 4 QL=360 EA/30 Daysvicodin 10-300mg tab 2 QL=390 EA/30 Daysvicodin 5-300mg tab 2 QL=390 EA/30 Daysvicodin 7.5-300mg tab 2 QL=390 EA/30 Days

OPIOID PARTIAL AGONISTSbuprenorphine 10mcg/hr weekly patch 2 QL=4 EA/28 Daysbuprenorphine 15mcg/hr weekly patch 2 QL=4 EA/28 Daysbuprenorphine 20mcg/hr weekly patch 2 QL=4 EA/28 Daysbuprenorphine 2mg sl tab 2buprenorphine 2mg/naloxone 0.5mg sl tab 2buprenorphine 5mcg/hr weekly patch 2 QL=4 EA/28 DaysBUPRENORPHINE 7.5MCG/HR WEEKLY PATCH 2 QL=4 EA/28 Daysbuprenorphine 8mg sl tab 2buprenorphine 8mg/naloxone 2mg sl tab 2buprenorphine/naloxone 12-3mg strip 2buprenorphine/naloxone 2-0.5mg strip 2buprenorphine/naloxone 4-1mg strip 2buprenorphine/naloxone 8-2mg strip 2butorphanol tartrate 10mg/ml nasal spray 2 QL=10 ML/30 DaysZUBSOLV 11.4-2.9MG SL TAB 3 QL=60 EA/30 DaysZUBSOLV 1.4-0.36MG SL TAB 3 QL=90 EA/30 DaysZUBSOLV 2.9-0.71MG SL TAB 3 QL=90 EA/30 DaysZUBSOLV 5.7-1.4MG SL TAB 3 QL=90 EA/30 DaysZUBSOLV 8.6-2.1MG SL TAB 3 QL=60 EA/30 Days

ANDROGENS-ANABOLICANABOLIC STEROIDS




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ANADROL-50 50MG TAB 4oxandrolone 10mg tab 2oxandrolone 2.5mg tab 2

ANDROGENSANDRODERM 2MG/24HR PATCH 3 PA QL=60 EA/30 DaysANDRODERM 4MG/24HR PATCH 3 PA QL=30 EA/30 DaysANDROGEL 1% (25MG) GEL 4 PA QL=300 GM/30 DaysANDROGEL 1% (50MG) GEL 4 PA QL=300 GM/30 DaysANDROGEL 1.62% (1.25GM) GEL 4 PA QL=75 GM/30 DaysANDROGEL 1.62% (2.5GM) GEL 4 PA QL=150 GM/30 DaysANDROGEL 1.62% GEL 4 PA QL=150 GM/30 Daysdanazol 100mg cap 2danazol 200mg cap 2danazol 50mg cap 2DEPO-TESTOSTERONE 100MG/ML INJ 4DEPO-TESTOSTERONE 200MG/ML INJ 4METHITEST 10MG TAB 4 PAMETHYLTESTOSTERONE 10MG CAP 2 PATESTIM 1% GEL 4 PA QL=300 GM/30 Daystestosterone 1% (25mg) gel 2 PA QL=300 GM/30 Daystestosterone 1% (50mg) gel 2 PA QL=300 GM/30 DaysTESTOSTERONE 1% GEL PUMP 2 PA QL=300 GM/30 Daystestosterone 1.62% (1.25gm) gel 2 PA QL=75 GM/30 Daystestosterone 1.62% (2.5gm) gel 2 PA QL=150 GM/30 Daystestosterone 1.62% gel pump 2 PA QL=150 GM/30 Daystestosterone cypionate (1ml) 200mg/ml inj 2testosterone cypionate 100mg/ml inj 2testosterone cypionate 200mg/ml inj 2testosterone enanthate 200mg/ml inj 2VOGELXO 1% (50MG) GEL 4 PA QL=300 GM/30 DaysVOGELXO 1% GEL PUMP 4 PA QL=300 GM/30 Days

ANORECTAL AGENTSINTRARECTAL STEROIDS

colocort 100mg/60ml enema 2hydrocortisone 1.67mg/ml enema 2UCERIS 2MG/ACT FOAM 4 PA

RECTAL COMBINATIONShydrocortisone/pramoxine 1-1% rectal cream 2

RECTAL STEROIDSANUSOL HC 2.5% RECTAL CREAM 4procto-med 2.5% cream 2procto-pak 1% rectal cream 2




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proctosol 2.5% cream 2proctozone hc 2.5% cream 2

VASODILATING AGENTSRECTIV 0.4% RECTAL OINTMENT 4 QL=30 GM/30 Days

ANTHELMINTICSANTHELMINTICS

albendazole 200mg tab 5 NDSALBENZA 200MG TAB 5 NDSBENZNIDAZOLE 100MG TAB 3 PABENZNIDAZOLE 12.5MG TAB 3 PABILTRICIDE 600MG TAB 4ivermectin 3mg tab 2praziquantel 600mg tab 2STROMECTOL 3MG TAB 4

ANTI-INFECTIVE AGENTS - MISC.ANTI-INFECTIVE AGENTS - MISC.

FLAGYL 250MG TAB 4FLAGYL 375MG CAP 4FLAGYL 500MG TAB 4metronidazole 250mg tab 1metronidazole 375mg cap 2metronidazole 500mg tab 1metronidazole 5mg/ml inj 2NEBUPENT 300MG INH SOLN 3 PA BvDPENTAM 300MG INJ 3tinidazole 250mg tab 2tinidazole 500mg tab 2trimethoprim 100mg tab 1XIFAXAN 200MG TAB 4 QL=9 EA/3 DaysXIFAXAN 550MG TAB 4 PA QL=60 EA/30 Days

ANTI-INFECTIVE MISC. - COMBINATIONSBACTRIM 400-80MG TAB 4BACTRIM 800-160MG TAB 4sulfamethoxazole 400mg/trimethoprim 80mg tab 1sulfamethoxazole 40mg/ml/trimethoprim 8mg/ml susp 2sulfamethoxazole 800mg/trimethoprim 160mg tab 1

ANTIPROTOZOAL AGENTSALINIA 100MG/5ML SUSP 3 PA QL=150 ML/3 DaysALINIA 500MG TAB 3 PA QL=6 EA/3 Daysatovaquone 150mg/ml susp 2MEPRON 750MG/5ML SUSP 4

CARBAPENEMS




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cilastatin 2.5mg/ml/imipenem 2.5mg/ml inj 2cilastatin 5mg/ml/imipenem 5mg/ml inj 2ertapenem 1gm inj 2INVANZ 1GM INJ 4meropenem 1gm inj 2meropenem 500mg inj 2MERREM 500MG INJ 4PRIMAXIN 500MG INJ 4

CYCLIC LIPOPEPTIDESCUBICIN 500MG INJ 5 NDSDAPTOMYCIN 350MG INJ 5 NDSdaptomycin 500mg inj 5 NDS

GLYCOPEPTIDESDALVANCE 500MG INJ 5 NDSFIRVANQ 25MG/ML ORAL SOLN 2FIRVANQ 50MG/ML ORAL SOLN 2VANCOCIN 125MG CAP 4 QL=120 EA/30 DaysVANCOCIN 250MG CAP 4 QL=120 EA/30 Daysvancomycin 100mg/ml inj 2vancomycin 125mg cap 2 QL=120 EA/30 Daysvancomycin 250mg cap 2 QL=120 EA/30 DaysVANCOMYCIN 250MG INJ 2vancomycin 50mg/ml inj 2vancomycin 5mg/ml inj 2vancomycin 750mg inj 2

LEPROSTATICSdapsone 100mg tab 2dapsone 25mg tab 2

LINCOSAMIDESCLEOCIN 150MG CAP 4CLEOCIN 150MG/ML INJ 4CLEOCIN 300MG CAP 4CLEOCIN 300MG/50ML INJ 4CLEOCIN 600MG/50ML INJ 4CLEOCIN 75MG CAP 4CLEOCIN 75MG/5ML ORAL SOLN 4CLEOCIN 900MG/50ML INJ 4clindamycin 12mg/ml inj 2clindamycin 150mg cap 1clindamycin 150mg/ml (2ml) inj 2clindamycin 150mg/ml (4ml) inj 2clindamycin 150mg/ml (6ml) inj 2




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clindamycin 15mg/ml oral soln 2clindamycin 18mg/ml inj 2clindamycin 300mg cap 1clindamycin 6mg/ml inj 2clindamycin 75mg cap 1

MONOBACTAMSaztreonam 333mg/ml inj 2CAYSTON 75MG INH SOLN 5 NDS PA

OXAZOLIDINONESlinezolid 20mg/ml susp 2linezolid 2mg/ml inj 5 NDSlinezolid 600mg tab 2SIVEXTRO 200MG INJ 5 NDS PA QL=6 EA/6 DaysSIVEXTRO 200MG TAB 5 NDS PA QL=6 EA/6 DaysZYVOX 100MG/5ML SUSP 5 NDSZYVOX 2MG/ML INJ 5 NDSZYVOX 600MG TAB 5 NDS

POLYMYXINScolistin 75mg/ml inj 2polymyxin b 250000unit/ml inj 2

ANTIANGINAL AGENTSANTIANGINALS-OTHER

RANEXA 1000MG ER TAB 4RANEXA 500MG ER TAB 4ranolazine 1000mg er tab 2ranolazine 500mg er tab 2

NITRATESISORDIL 40MG TAB 4ISORDIL 5MG TAB 4isosorbide dinitrate 10mg tab 1isosorbide dinitrate 20mg tab 1ISOSORBIDE DINITRATE 30MG TAB 1ISOSORBIDE DINITRATE 40MG ER TAB 3isosorbide dinitrate 5mg tab 1isosorbide mononitrate 10mg tab 1isosorbide mononitrate 120mg er tab 1isosorbide mononitrate 20mg tab 1isosorbide mononitrate 30mg er tab 1isosorbide mononitrate 60mg er tab 1minitran 0.1mg/hr patch 1minitran 0.2mg/hr patch 1minitran 0.4mg/hr patch 1




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minitran 0.6mg/hr patch 1NITRO-BID 2% OINTMENT 3NITRO-DUR 0.1MG/HR PATCH 4NITRO-DUR 0.2MG/HR PATCH 4NITRO-DUR 0.3MG/HR PATCH 4NITRO-DUR 0.4MG/HR PATCH 4NITRO-DUR 0.6MG/HR PATCH 4NITRO-DUR 0.8MG/HR PATCH 4nitroglycerin 0.1mg/hr patch 1nitroglycerin 0.2mg/hr patch 1nitroglycerin 0.3mg sl tab 1nitroglycerin 0.4mg sl tab 1nitroglycerin 0.4mg/act spray 2nitroglycerin 0.4mg/hr patch 1nitroglycerin 0.6mg sl tab 1nitroglycerin 0.6mg/hr patch 1NITROSTAT 0.3MG SL TAB 4NITROSTAT 0.4MG SL TAB 4NITROSTAT 0.6MG SL TAB 4

ANTIANXIETY AGENTSANTIANXIETY AGENTS - MISC.

buspirone 10mg tab 1buspirone 15mg tab 1buspirone 30mg tab 2buspirone 5mg tab 1buspirone 7.5mg tab 2hydroxyzine 10mg tab 1hydroxyzine 25mg tab 1hydroxyzine 2mg/ml oral soln 2hydroxyzine 50mg tab 1HYDROXYZINE PAMOATE 100MG CAP 2hydroxyzine pamoate 25mg cap 1hydroxyzine pamoate 50mg cap 1VISTARIL 25MG CAP 4VISTARIL 50MG CAP 4

BENZODIAZEPINESalprazolam 0.25mg odt 2alprazolam 0.25mg tab 1alprazolam 0.5mg er tab 2alprazolam 0.5mg odt 2alprazolam 0.5mg tab 1alprazolam 1mg er tab 2




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alprazolam 1mg odt 2alprazolam 1mg tab 1ALPRAZOLAM 1MG/ML ORAL SOLN 4alprazolam 2mg er tab 2alprazolam 2mg odt 2alprazolam 2mg tab 1alprazolam 3mg er tab 2ATIVAN 0.5MG TAB 4ATIVAN 1MG TAB 4ATIVAN 2MG TAB 4chlordiazepoxide 10mg cap 1chlordiazepoxide 25mg cap 1chlordiazepoxide 5mg cap 1clorazepate dipotassium 15mg tab 2clorazepate dipotassium 3.75mg tab 2clorazepate dipotassium 7.5mg tab 2diazepam 10mg tab 1DIAZEPAM 1MG/ML ORAL SOLN 2diazepam 2mg tab 1diazepam 5mg tab 1diazepam 5mg/ml oral soln 2lorazepam 0.5mg tab 1lorazepam 1mg tab 1lorazepam 2mg tab 1lorazepam 2mg/ml conc 2OXAZEPAM 10MG CAP 2oxazepam 15mg cap 2OXAZEPAM 30MG CAP 2TRANXENE 7.5MG TAB 4VALIUM 10MG TAB 4VALIUM 2MG TAB 4VALIUM 5MG TAB 4XANAX 0.25MG TAB 4XANAX 0.5MG TAB 4XANAX 0.5MG XR TAB 4XANAX 1MG TAB 4XANAX 1MG XR TAB 4XANAX 2MG TAB 4XANAX 2MG XR TAB 4XANAX 3MG XR TAB 4

ANTIARRHYTHMICSANTIARRHYTHMICS TYPE I-A




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disopyramide 100mg cap 2 PAdisopyramide 150mg cap 2 PANORPACE 100MG CAP 4 PANORPACE 100MG ER CAP 3 PANORPACE 150MG CAP 4 PANORPACE 150MG ER CAP 3 PAquinidine gluconate 324mg er tab 2QUINIDINE SULFATE 200MG TAB 2QUINIDINE SULFATE 300MG TAB 2

ANTIARRHYTHMICS TYPE I-BMEXILETINE 150MG CAP 4MEXILETINE 200MG CAP 4MEXILETINE 250MG CAP 4

ANTIARRHYTHMICS TYPE I-Cflecainide acetate 100mg tab 2flecainide acetate 150mg tab 2flecainide acetate 50mg tab 2propafenone 150mg tab 2propafenone 225mg er cap 2propafenone 225mg tab 2propafenone 300mg tab 2propafenone 325mg er cap 2propafenone 425mg sr cap 2RYTHMOL 225MG SR CAP 4RYTHMOL 325MG SR CAP 4RYTHMOL 425MG SR CAP 4

ANTIARRHYTHMICS TYPE IIIamiodarone 200mg tab 1amiodarone 400mg tab 2amiodarone hydrochloride 100mg tab 2dofetilide 125mcg cap 2dofetilide 250mcg cap 2dofetilide 500mcg cap 2MULTAQ 400MG TAB 3pacerone 100mg tab 2pacerone 200mg tab 1pacerone 400mg tab 2TIKOSYN 125MCG CAP 4TIKOSYN 250MCG CAP 4TIKOSYN 500MCG CAP 4

ANTIASTHMATIC AND BRONCHODILATOR AGENTSANTI-INFLAMMATORY AGENTS




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cromolyn sodium 10mg/ml inh soln 2 PA BvDANTIASTHMATIC - MONOCLONAL ANTIBODIES

DUPIXENT 200MG/ML PF SYRINGE 5 NDS PAFASENRA 30MG/ML SYRINGE 5 PANUCALA 100MG INJ 5 NDS PAXOLAIR 150MG INJ 5 NDS PAXOLAIR 150MG/ML PF INJ 5 NDS PAXOLAIR 75MG/0.5ML PF INJ 5 NDS PA

BRONCHODILATORS - ANTICHOLINERGICSATROVENT 17MCG INH 3INCRUSE 62.5MCG INH 3ipratropium bromide 0.02% inh soln 2 PA BvDLONHALA 0.0025% INH SOLN 3 STSPIRIVA 1.25MCG RESPIMAT INH 3 ST QL=4 GM/30 Days

LEUKOTRIENE MODULATORSACCOLATE 10MG TAB 4ACCOLATE 20MG TAB 4montelukast 10mg tab 1montelukast 4mg chew tab 1montelukast 4mg granules 2montelukast 5mg chew tab 1SINGULAIR 10MG TAB 4SINGULAIR 4MG CHEW TAB 4SINGULAIR 4MG GRANULES 4SINGULAIR 5MG CHEW TAB 4zafirlukast 10mg tab 2zafirlukast 20mg tab 2

SELECTIVE PHOSPHODIESTERASE 4 (PDE4) INHIBITORSDALIRESP 250MCG TAB 4DALIRESP 500MCG TAB 4

STEROID INHALANTSARNUITY 100MCG INH 2 QL=30 EA/30 DaysARNUITY 200MCG INH 2 QL=30 EA/30 DaysARNUITY 50MCG INH 2 QL=30 EA/30 DaysASMANEX 100MCG (120ACT) HFA INH 2 QL=13 GM/30 DaysASMANEX 110MCG (30ACT) INH 2 QL=1 EA/30 DaysASMANEX 200MCG (120ACT) HFA INH 2 QL=13 GM/30 DaysASMANEX 220MCG (120ACT) INH 2 QL=1 EA/30 DaysASMANEX 220MCG (30ACT) INH 2 QL=1 EA/30 DaysASMANEX 220MCG (60ACT) INH 2 QL=1 EA/30 Daysbudesonide 0.125mg/ml inh soln 2 PA BvD QL=120 ML/30 Daysbudesonide 0.25mg/ml inh soln 2 PA BvD QL=120 ML/30 Days




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budesonide 0.5mg/ml inh soln 2 PA BvD QL=120 ML/30 DaysFLOVENT 100MCG DISKUS 2 QL=60 EA/30 DaysFLOVENT 110MCG HFA INH 2 QL=24 GM/30 DaysFLOVENT 220MCG HFA INH 2 QL=24 GM/30 DaysFLOVENT 250MCG DISKUS 2 QL=60 EA/30 DaysFLOVENT 44MCG HFA INH 2 QL=21.20 GM/30 DaysFLOVENT 50MCG DISKUS 2 QL=60 EA/30 DaysPULMICORT 0.25MG/2ML INH SOLN 4 PA BvD QL=120 ML/30 DaysPULMICORT 0.5MG/2ML INH SOLN 4 PA BvD QL=120 ML/30 DaysPULMICORT 1MG/2ML INH SOLN 4 PA BvD QL=120 ML/30 Days

SYMPATHOMIMETICSADVAIR 115-21MCG HFA INH 3 QL=12 GM/30 DaysADVAIR 230-21MCG HFA INH 3 QL=12 GM/30 DaysADVAIR 45-21MCG HFA INH 3 QL=12 GM/30 Daysalbuterol 0.21mg/ml (0.63mg/3ml) inh soln 1 PA BvDalbuterol 0.417mg/ml (1.25mg/3ml) inh soln 1 PA BvDalbuterol 0.4mg/ml (2mg/5ml) oral oral soln 2albuterol 0.83mg/ml (0.083%) inh soln 2 PA BvDalbuterol 1mg/ml (0.5%) inh soln 2 PA BvDalbuterol 2mg tab 2ALBUTEROL 4MG ER TAB 2albuterol 4mg tab 2ALBUTEROL 8MG ER TAB 2ANORO 62.5-25MCG ELLIPTA INH 3 QL=60 EA/30 DaysBREO 100-25MCG ELLIPTA INH 3 QL=60 EA/30 DaysBREO 200-25MCG ELLIPTA INH 3 QL=60 EA/30 DaysBROVANA 15MCG/2ML INH SOLN 4 PA BvDCOMBIVENT RESPIMAT 20-100MCG INH 3DULERA 100-5MCG INH 3 QL=13 GM/30 DaysDULERA 200-5MCG INH 3 QL=13 GM/30 Daysfluticasone propionate/salmeterol 100-50mcg/act drypowder inh

2 QL=60 EA/30 Days

fluticasone propionate/salmeterol 250-50mcg/act drypowder inh

2 QL=60 EA/30 Days

fluticasone propionate/salmeterol 500-50mcg/act drypowder inh

2 QL=60 EA/30 Days

FLUTICASONE PROPIONATE/SALMETEROLXINAFOATE 113-14MCG/ACT POWDER INH

2 QL=1 EA/30 Days


2 QL=1 EA/30 Days


2 QL=1 EA/30 Days




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ipratropium/albuterol 0.5-2.5mg/3ml inh soln 2 PA BvDlevalbuterol 0.31mg inh soln 2 PA BvDlevalbuterol 0.63mg inh soln 2 PA BvDlevalbuterol 1.25mg inh soln 2 PA BvDlevalbuterol 2.5mg inh soln 2 PA BvDLEVALBUTEROL 45MCG INH 4 ST QL=30 GM/30 DaysMETAPROTERENOL SULFATE 10MG TAB 3METAPROTERENOL SULFATE 20MG TAB 3METAPROTERENOL SULFATE 2MG/ML ORALSOLN

3

PERFOROMIST 20MCG/2ML INH SOLN 4 PA BvDSEREVENT 50MCG/DOSE INH 3STIOLTO 2.5-2.5MCG INH 3 QL=4 GM/30 Daysterbutaline sulfate 2.5mg tab 2terbutaline sulfate 5mg tab 2TRELEGY 62.5-25MCG ELLIPTA INH 3 QL=60 EA/30 DaysVENTOLIN 108MCG INH 3 QL=36 GM/30 Dayswixela 100-50mcg inh 2 QL=60 EA/30 Dayswixela 250-50mcg inh 2 QL=60 EA/30 Dayswixela 500-50mcg inh 2 QL=60 EA/30 DaysXOPENEX 0.31MG INH SOLN 4 PA BvDXOPENEX 0.63MG INH SOLN 4 PA BvDXOPENEX 1.25MG INH SOLN 4 PA BvDXOPENEX 2.5MG INH SOLN 4 PA BvDXOPENEX 45MCG INH 4 ST QL=30 GM/30 Days

XANTHINESTHEO-24 200MG ER CAP 4THEO-24 300MG ER CAP 4THEO-24 400MG ER CAP 4THEO-24 ER CAP 4theophylline 100mg er tab 1theophylline 200mg er tab 1theophylline 300mg er tab 1theophylline 400mg er tab 1theophylline 5.33mg/ml oral soln 2theophylline 600mg er tab 1

ANTICOAGULANTSCOUMARIN ANTICOAGULANTS

COUMADIN 10MG TAB 4COUMADIN 1MG TAB 4COUMADIN 2.5MG TAB 4COUMADIN 2MG TAB 4




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COUMADIN 3MG TAB 4COUMADIN 4MG TAB 4COUMADIN 5MG TAB 4COUMADIN 6MG TAB 4COUMADIN 7.5MG TAB 4jantoven 10mg tab 1jantoven 1mg tab 1jantoven 2.5mg tab 1jantoven 2mg tab 1jantoven 3mg tab 1jantoven 4mg tab 1jantoven 5mg tab 1jantoven 6mg tab 1jantoven 7.5mg tab 1warfarin sodium 10mg tab 1warfarin sodium 1mg tab 1warfarin sodium 2.5mg tab 1warfarin sodium 2mg tab 1warfarin sodium 3mg tab 1warfarin sodium 4mg tab 1warfarin sodium 5mg tab 1warfarin sodium 6mg tab 1warfarin sodium 7.5mg tab 1

DIRECT FACTOR XA INHIBITORSELIQUIS 2.5MG TAB 3ELIQUIS 30-DAY STARTER PACK 3ELIQUIS 5MG TAB 3XARELTO 10MG TAB 3XARELTO 15MG TAB 3XARELTO 2.5MG TAB 3XARELTO 20MG TAB 3XARELTO STARTER PACK 3

HEPARINS AND HEPARINOID-LIKE AGENTSARIXTRA 10MG/0.8ML SYRINGE 4 PAARIXTRA 2.5MG/0.5ML SYRINGE 4 PAARIXTRA 5MG/0.4ML SYRINGE 4 PAARIXTRA 7.5MG/0.6ML SYRINGE 4 PAenoxaparin sodium 100mg/1ml syringe 2 QL=60 ML/30 Daysenoxaparin sodium 120mg/0.8ml syringe 2 QL=48 ML/30 Daysenoxaparin sodium 150mg/1ml syringe 2 QL=60 ML/30 Daysenoxaparin sodium 30mg/0.3ml syringe 2 QL=18 ML/30 Daysenoxaparin sodium 40mg/0.4ml syringe 2 QL=24 ML/30 Days




23

enoxaparin sodium 60mg/0.6ml syringe 2 QL=36 ML/30 Daysenoxaparin sodium 80mg/0.8ml syringe 2 QL=48 ML/30 Daysfondaparinux sodium 12.5mg/ml (0.4ml) syringe 2 PAfondaparinux sodium 12.5mg/ml (0.6ml) syringe 2 PAfondaparinux sodium 12.5mg/ml (0.8ml) syringe 2 PAfondaparinux sodium 5mg/ml syringe 2 PAFRAGMIN 10000UNIT/ML SYRINGE 4FRAGMIN 12500UNIT/0.5ML SYRINGE 4FRAGMIN 15000UNIT/0.6ML SYRINGE 4FRAGMIN 18000UNIT/0.72ML SYRINGE 4FRAGMIN 2500UNIT/0.2ML SYRINGE 4FRAGMIN 5000UNIT/0.2ML SYRINGE 4FRAGMIN 7500UNIT/0.3ML SYRINGE 4FRAGMIN 95000UNIT/3.8ML INJ 4heparin sodium porcine 10000unit/ml inj 2 PA BvDheparin sodium porcine 1000unit/ml inj 2 PA BvDheparin sodium porcine 20000unit/ml inj 2 PA BvDheparin sodium porcine 5000unit/ml inj 2 PA BvDLOVENOX 100MG/ML SYRINGE 4 QL=60 ML/30 DaysLOVENOX 120MG/0.8ML SYRINGE 4 QL=48 ML/30 DaysLOVENOX 150MG/ML SYRINGE 4 QL=60 ML/30 DaysLOVENOX 30MG/0.3ML SYRINGE 4 QL=18 ML/30 DaysLOVENOX 40MG/0.4ML SYRINGE 4 QL=24 ML/30 DaysLOVENOX 60MG/0.6ML SYRINGE 4 QL=36 ML/30 DaysLOVENOX 80MG/0.8ML SYRINGE 4 QL=48 ML/30 Days

THROMBIN INHIBITORSPRADAXA 110MG CAP 3PRADAXA 150MG CAP 3PRADAXA 75MG CAP 3

ANTICONVULSANTSAMPA GLUTAMATE RECEPTOR ANTAGONISTS

FYCOMPA 0.5MG/ML SUSP 4 PA NSOFYCOMPA 10MG TAB 4 PA NSOFYCOMPA 12MG TAB 4 PA NSOFYCOMPA 2MG TAB 4 PA NSOFYCOMPA 4MG TAB 4 PA NSOFYCOMPA 6MG TAB 4 PA NSOFYCOMPA 8MG TAB 4 PA NSO

ANTICONVULSANTS - BENZODIAZEPINESclobazam 10mg tab 2clobazam 2.5mg/ml susp 2clobazam 20mg tab 2




24

clonazepam 0.125mg odt 2clonazepam 0.25mg odt 2clonazepam 0.5mg odt 2clonazepam 0.5mg tab 1clonazepam 1mg odt 2clonazepam 1mg tab 1clonazepam 2mg odt 2clonazepam 2mg tab 1DIASTAT 10MG APPLICATOR 4DIASTAT 2.5MG APPLICATOR 4DIASTAT 20MG APPLICATOR 4KLONOPIN 0.5MG TAB 4KLONOPIN 1MG TAB 4KLONOPIN 2MG TAB 4ONFI 10MG TAB 4ONFI 2.5MG/ML SUSP 4ONFI 20MG TAB 4SYMPAZAN 10MG STRIP 4 ST_NSOSYMPAZAN 20MG STRIP 4 ST_NSOSYMPAZAN 5MG STRIP 4 ST_NSO

ANTICONVULSANTS - MISC.APTIOM 200MG TAB 4 PA NSOAPTIOM 400MG TAB 4 PA NSOAPTIOM 600MG TAB 4 PA NSOAPTIOM 800MG TAB 4 PA NSOBANZEL 200MG TAB 3BANZEL 400MG TAB 3BANZEL 40MG/ML SUSP 3BRIVIACT 100MG TAB 4 PA NSO QL=60 EA/30 DaysBRIVIACT 10MG TAB 4 PA NSO QL=60 EA/30 DaysBRIVIACT 10MG/ML ORAL SOLN 4 PA NSOBRIVIACT 25MG TAB 4 PA NSO QL=60 EA/30 DaysBRIVIACT 50MG TAB 4 PA NSO QL=60 EA/30 DaysBRIVIACT 75MG TAB 4 PA NSO QL=60 EA/30 Dayscarbamazepine 100mg chew tab 2carbamazepine 100mg er cap 2carbamazepine 100mg er tab 2carbamazepine 200mg er cap 2carbamazepine 200mg er tab 2carbamazepine 200mg tab 2carbamazepine 20mg/ml susp 2carbamazepine 300mg er cap 2




25

carbamazepine 400mg er tab 2CARBATROL 100MG ER CAP 4CARBATROL 200MG ER CAP 4CARBATROL 300MG ER CAP 4EPIDIOLEX 100MG/ML ORAL SOLN 4 PA NSOepitol 200mg tab 2gabapentin 100mg cap 1gabapentin 300mg cap 1gabapentin 400mg cap 1gabapentin 50mg/ml oral soln 2gabapentin 600mg tab 1gabapentin 800mg tab 1KEPPRA 1000MG TAB 4KEPPRA 100MG/ML ORAL SOLN 4KEPPRA 250MG TAB 4KEPPRA 500MG TAB 4KEPPRA 500MG XR TAB 4KEPPRA 750MG TAB 4KEPPRA 750MG XR TAB 4LAMICTAL 100MG ODT 4LAMICTAL 100MG TAB 4LAMICTAL 100MG XR TAB 4LAMICTAL 150MG TAB 4LAMICTAL 200MG ODT 4LAMICTAL 200MG TAB 4LAMICTAL 200MG XR TAB 4LAMICTAL 250MG XR TAB 4LAMICTAL 25MG CHEW TAB 4LAMICTAL 25MG ODT 4LAMICTAL 25MG TAB 4LAMICTAL 25MG XR TAB 4LAMICTAL 300MG XR TAB 4LAMICTAL 50MG ODT 4LAMICTAL 50MG XR TAB 4LAMICTAL 5MG CHEW TAB 4LAMICTAL BLUE KIT 4LAMICTAL GREEN KIT 4LAMICTAL ORANGE KIT 4LAMICTAL XR BLUE KIT 4LAMICTAL XR GREEN KIT 4LAMICTAL XR ORANGE KIT 4lamotrigine 100mg er tab 2




26

lamotrigine 100mg odt 2lamotrigine 100mg tab 1lamotrigine 150mg tab 1lamotrigine 200mg er tab 2lamotrigine 200mg odt 2lamotrigine 200mg tab 1lamotrigine 250mg er tab 2lamotrigine 25mg (35) tab starter pack 2lamotrigine 25mg chew tab 2lamotrigine 25mg er tab 2lamotrigine 25mg odt 2lamotrigine 25mg tab 1lamotrigine 300mg er tab 2lamotrigine 50mg er tab 2lamotrigine 50mg odt 2lamotrigine 5mg chew tab 2lamotrigine tab 25mg (42)/100mg (7) starter pack 2lamotrigine tab 25mg (84)/100mg (14) starter pack 2levetiracetam 1000mg tab 1levetiracetam 100mg/ml oral soln 1levetiracetam 250mg tab 1levetiracetam 500mg er tab 1levetiracetam 500mg tab 1levetiracetam 750mg er tab 1levetiracetam 750mg tab 2LYRICA 100MG CAP 3LYRICA 150MG CAP 3LYRICA 200MG CAP 3LYRICA 20MG/ML ORAL SOLN 3LYRICA 225MG CAP 3LYRICA 25MG CAP 3LYRICA 300MG CAP 3LYRICA 50MG CAP 3LYRICA 75MG CAP 3MYSOLINE 250MG TAB 4MYSOLINE 50MG TAB 4NEURONTIN 100MG CAP 4NEURONTIN 250MG/5ML ORAL SOLN 4NEURONTIN 300MG CAP 4NEURONTIN 400MG CAP 4NEURONTIN 600MG TAB 4NEURONTIN 800MG TAB 4




27

oxcarbazepine 150mg tab 1oxcarbazepine 300mg tab 1oxcarbazepine 600mg tab 1oxcarbazepine 60mg/ml susp 2OXTELLAR 150MG XR TAB 4OXTELLAR 300MG XR TAB 4OXTELLAR 600MG XR TAB 4primidone 250mg tab 1primidone 50mg tab 1QUDEXY 100MG XR CAP 4 PA NSOQUDEXY 150MG XR CAP 4 PA NSOQUDEXY 200MG XR CAP 4 PA NSOQUDEXY 25MG XR CAP 4 PA NSOQUDEXY 50MG XR CAP 4 PA NSOroweepra 1000mg tab 2roweepra 500mg er tab 1roweepra 500mg tab 1roweepra 750mg er tab 1roweepra 750mg tab 2SPRITAM 1000MG ODT 4 PA NSOSPRITAM 250MG ODT 4 PA NSOSPRITAM 500MG ODT 4 PA NSOSPRITAM 750MG ODT 4 PA NSOTEGRETOL 100MG XR TAB 4TEGRETOL 100MG/5ML SUSP 4TEGRETOL 200MG TAB 4TEGRETOL 200MG XR TAB 4TEGRETOL 400MG XR TAB 4TOPAMAX 100MG TAB 4TOPAMAX 15MG CAP 4TOPAMAX 200MG TAB 4TOPAMAX 25MG CAP 4TOPAMAX 25MG TAB 4TOPAMAX 50MG TAB 4TOPIRAMATE 100MG ER CAP 4 PA NSOtopiramate 100mg tab 1TOPIRAMATE 150MG ER CAP 4 PA NSOtopiramate 15mg cap 2TOPIRAMATE 200MG ER CAP 4 PA NSOtopiramate 200mg tab 1topiramate 25mg cap 2TOPIRAMATE 25MG ER CAP 4 PA NSO




28

topiramate 25mg tab 1TOPIRAMATE 50MG ER CAP 4 PA NSOtopiramate 50mg tab 1TRILEPTAL 150MG TAB 4TRILEPTAL 300MG TAB 4TRILEPTAL 300MG/5ML SUSP 4TRILEPTAL 600MG TAB 4TROKENDI 100MG XR CAP 4 PA NSOTROKENDI 200MG XR CAP 4 PA NSOTROKENDI 25MG XR CAP 4 PA NSOTROKENDI 50MG XR CAP 4 PA NSOVIMPAT 100MG TAB 3 QL=60 EA/30 DaysVIMPAT 10MG/ML ORAL SOLN 3VIMPAT 150MG TAB 3 QL=60 EA/30 DaysVIMPAT 200MG TAB 3 QL=60 EA/30 DaysVIMPAT 50MG TAB 3 QL=60 EA/30 DaysZONEGRAN 100MG CAP 4ZONEGRAN 25MG CAP 4zonisamide 100mg cap 1zonisamide 25mg cap 1zonisamide 50mg cap 1

CARBAMATESfelbamate 120mg/ml susp 2 NDSfelbamate 400mg tab 2felbamate 600mg tab 2FELBATOL 400MG TAB 4FELBATOL 600MG TAB 4FELBATOL 600MG/5ML SUSP 4

GABA MODULATORSGABITRIL 12MG TAB 4GABITRIL 16MG TAB 4GABITRIL 2MG TAB 4GABITRIL 4MG TAB 4tiagabine 12mg tab 2tiagabine 16mg tab 2tiagabine 2mg tab 2tiagabine 4mg tab 2vigabatrin 500mg tab 5 NDS PA NSOvigabatrin 50mg/ml oral soln 5 NDS PA NSOvigadrone 500mg oral soln 5 NDS PA NSO

HYDANTOINSDILANTIN 100MG ER CAP 4




29

DILANTIN 125MG/5ML SUSP 4DILANTIN 30MG ER CAP 3DILANTIN 50MG CHEW TAB 4PEGANONE 250MG TAB 3PHENYTEK 200MG ER CAP 4PHENYTEK 300MG ER CAP 4phenytoin 25mg/ml susp 2phenytoin 50mg chew tab 2phenytoin sodium 100mg er cap 1phenytoin sodium 200mg er cap 2phenytoin sodium 300mg er cap 2

SUCCINIMIDESCELONTIN 300MG CAP 3ethosuximide 250mg cap 2ethosuximide 50mg/ml oral soln 2ZARONTIN 250MG CAP 4ZARONTIN 250MG/5ML ORAL SOLN 4

VALPROIC ACIDDEPAKENE 250MG CAP 4DEPAKOTE 125MG DR CAP 4DEPAKOTE 125MG DR TAB 4DEPAKOTE 250MG DR TAB 4DEPAKOTE 250MG ER TAB 4DEPAKOTE 500MG DR TAB 4DEPAKOTE 500MG ER TAB 4divalproex sodium 125mg dr cap 2divalproex sodium 125mg dr tab 1divalproex sodium 250mg dr tab 1divalproex sodium 250mg er tab 2divalproex sodium 500mg dr tab 1divalproex sodium 500mg er tab 2valproic acid 250mg cap 2valproic acid 50mg/ml oral soln 2

ANTIDEPRESSANTSALPHA-2 RECEPTOR ANTAGONISTS (TETRACYCLICS)

mirtazapine 15mg odt 2mirtazapine 15mg tab 1mirtazapine 30mg odt 2mirtazapine 30mg tab 1mirtazapine 45mg odt 2mirtazapine 45mg tab 1mirtazapine 7.5mg tab 2




30

REMERON 15MG ODT 4REMERON 15MG TAB 4REMERON 30MG ODT 4REMERON 30MG TAB 4REMERON 45MG ODT 4

ANTIDEPRESSANTS - MISC.APLENZIN 174MG ER TAB 4 ST_NSOAPLENZIN 348MG ER TAB 4 ST_NSOAPLENZIN 522MG ER TAB 4 ST_NSObupropion 100mg sr tab 1bupropion 100mg tab 1bupropion 150mg sr (12 hr) tab 1bupropion 150mg xl (24 hr) tab 1bupropion 200mg sr tab 1bupropion 300mg xl tab 1bupropion 75mg tab 1MAPROTILINE 25MG TAB 2MAPROTILINE 50MG TAB 2MAPROTILINE 75MG TAB 2WELLBUTRIN 100MG SR TAB 4WELLBUTRIN 150MG SR (12 HR) TAB 4WELLBUTRIN 150MG XL (24 HR) TAB 4WELLBUTRIN 200MG SR TAB 4WELLBUTRIN 300MG XL TAB 4

MONOAMINE OXIDASE INHIBITORS (MAOIS)EMSAM 12MG/24HR PATCH 4EMSAM 6MG/24HR PATCH 4EMSAM 9MG/24HR PATCH 4MARPLAN 10MG TAB 3NARDIL 15MG TAB 4PARNATE 10MG TAB 4phenelzine 15mg tab 2tranylcypromine 10mg tab 2

SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS)CELEXA 10MG TAB 4CELEXA 20MG TAB 4CELEXA 40MG TAB 4citalopram 10mg tab 1citalopram 20mg tab 1citalopram 2mg/ml oral soln 2citalopram 40mg tab 1escitalopram 10mg tab 1




31

escitalopram 1mg/ml oral soln 2escitalopram 20mg tab 1escitalopram 5mg tab 1fluoxetine 10mg cap 1fluoxetine 10mg tab 2fluoxetine 20mg cap 1fluoxetine 20mg tab 2fluoxetine 40mg cap 1fluoxetine 4mg/ml oral soln 1fluvoxamine maleate 100mg er cap 2 ST_NSOfluvoxamine maleate 100mg tab 1fluvoxamine maleate 150mg er cap 2 ST_NSOfluvoxamine maleate 25mg tab 1fluvoxamine maleate 50mg tab 1LEXAPRO 10MG TAB 4LEXAPRO 20MG TAB 4LEXAPRO 5MG TAB 4paroxetine 10mg tab 1 PA NSOparoxetine 12.5mg er tab 2 PA NSOparoxetine 20mg tab 1 PA NSOparoxetine 25mg er tab 2 PA NSOparoxetine 30mg tab 1 PA NSOparoxetine 37.5mg er tab 2 PA NSOparoxetine 40mg tab 1 PA NSOPAXIL 10MG TAB 4 PA NSOPAXIL 10MG/5ML SUSP 4 PA NSOPAXIL 12.5MG ER TAB 4 PA NSOPAXIL 20MG TAB 4 PA NSOPAXIL 25MG ER TAB 4 PA NSOPAXIL 30MG TAB 4 PA NSOPAXIL 37.5MG ER TAB 4 PA NSOPAXIL 40MG TAB 4 PA NSOPEXEVA 10MG TAB 4 PA NSOPEXEVA 20MG TAB 4 PA NSOPEXEVA 30MG TAB 4 PA NSOPEXEVA 40MG TAB 4 PA NSOPROZAC 10MG CAP 4PROZAC 20MG CAP 4PROZAC 40MG CAP 4sertraline 100mg tab 1sertraline 20mg/ml oral soln 2sertraline 25mg tab 1




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sertraline 50mg tab 1ZOLOFT 100MG TAB 4ZOLOFT 25MG TAB 4ZOLOFT 50MG TAB 4

SEROTONIN MODULATORSNEFAZODONE 100MG TAB 4NEFAZODONE 150MG TAB 4NEFAZODONE 200MG TAB 4NEFAZODONE 250MG TAB 2NEFAZODONE 50MG TAB 2trazodone 100mg tab 1trazodone 150mg tab 1trazodone 300mg tab 2trazodone 50mg tab 1TRINTELLIX 10MG TAB 4 ST_NSO QL=30 EA/30 DaysTRINTELLIX 20MG TAB 4 ST_NSO QL=30 EA/30 DaysTRINTELLIX 5MG TAB 4 ST_NSO QL=30 EA/30 DaysVIIBRYD 10/20MG STARTER PACK 4 ST_NSO QL=30 EA/30 DaysVIIBRYD 10MG TAB 4 ST_NSO QL=30 EA/30 DaysVIIBRYD 20MG TAB 4 ST_NSO QL=30 EA/30 DaysVIIBRYD 40MG TAB 4 ST_NSO QL=30 EA/30 Days

SEROTONIN-NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIS)CYMBALTA 20MG DR CAP 4CYMBALTA 30MG DR CAP 4CYMBALTA 60MG DR CAP 4desvenlafaxine succinate 100mg er tab 2desvenlafaxine succinate 25mg er tab 2desvenlafaxine succinate 50mg er tab 2duloxetine 20mg dr cap 1duloxetine 30mg dr cap 1duloxetine 40mg dr cap 2 ST_NSO QL=30 EA/30 Daysduloxetine 60mg dr cap 1EFFEXOR 150MG XR CAP 4EFFEXOR 37.5MG XR CAP 4EFFEXOR 75MG XR CAP 4FETZIMA 120MG ER CAP 4 ST_NSO QL=30 EA/30 DaysFETZIMA 20MG ER CAP 4 ST_NSO QL=30 EA/30 DaysFETZIMA 40MG ER CAP 4 ST_NSO QL=30 EA/30 DaysFETZIMA 80MG ER CAP 4 ST_NSO QL=30 EA/30 DaysFETZIMA PACK 4 ST_NSO QL=30 EA/30 DaysPRISTIQ 100MG ER TAB 4 ST_NSOPRISTIQ 25MG ER TAB 4 ST_NSO




33

PRISTIQ 50MG ER TAB 4 ST_NSOvenlafaxine 100mg tab 1venlafaxine 150mg er cap 1venlafaxine 25mg tab 1venlafaxine 37.5mg er cap 1venlafaxine 37.5mg tab 1venlafaxine 50mg tab 1venlafaxine 75mg er cap 1venlafaxine 75mg tab 1

TRICYCLIC AGENTSamitriptyline 100mg tab 1 PA NSOamitriptyline 10mg tab 1 PA NSOamitriptyline 150mg tab 1 PA NSOamitriptyline 25mg tab 1 PA NSOamitriptyline 50mg tab 1 PA NSOamitriptyline 75mg tab 1 PA NSOAMOXAPINE 100MG TAB 3 PA NSOAMOXAPINE 150MG TAB 3 PA NSOAMOXAPINE 25MG TAB 3 PA NSOAMOXAPINE 50MG TAB 3 PA NSOANAFRANIL 25MG CAP 4 PA NSOANAFRANIL 50MG CAP 4 PA NSOANAFRANIL 75MG CAP 4 PA NSOclomipramine 25mg cap 2 PA NSOclomipramine 50mg cap 2 PA NSOclomipramine 75mg cap 2 PA NSOdesipramine 100mg tab 2 PA NSOdesipramine 10mg tab 2 PA NSOdesipramine 150mg tab 2 PA NSOdesipramine 25mg tab 2 PA NSOdesipramine 50mg tab 2 PA NSOdesipramine 75mg tab 2 PA NSOdoxepin 100mg cap 2 PA NSOdoxepin 10mg cap 2 PA NSOdoxepin 10mg/ml oral soln 2 PA NSOdoxepin 150mg cap 2 PA NSOdoxepin 25mg cap 2 PA NSOdoxepin 50mg cap 2 PA NSOdoxepin 75mg cap 2 PA NSOimipramine 10mg tab 1 PA NSOimipramine 25mg tab 1 PA NSOimipramine 50mg tab 1 PA NSO




34

imipramine pamoate 100mg cap 2 PA NSOimipramine pamoate 125mg cap 2 PA NSOimipramine pamoate 150mg cap 2 PA NSOimipramine pamoate 75mg cap 2 PA NSONORPRAMIN 10MG TAB 4 PA NSONORPRAMIN 25MG TAB 4 PA NSOnortriptyline 10mg cap 1nortriptyline 25mg cap 1NORTRIPTYLINE 2MG/ML ORAL SOLN 3nortriptyline 50mg cap 1nortriptyline 75mg cap 1PAMELOR 10MG CAP 4PAMELOR 25MG CAP 4PAMELOR 50MG CAP 4PAMELOR 75MG CAP 4protriptyline 10mg tab 2 PA NSOprotriptyline 5mg tab 2 PA NSOSURMONTIL 100MG CAP 4 PA NSOSURMONTIL 25MG CAP 4 PA NSOSURMONTIL 50MG CAP 4 PA NSOTOFRANIL 10MG TAB 4 PA NSOTOFRANIL 25MG TAB 4 PA NSOTOFRANIL 50MG TAB 4 PA NSOtrimipramine 100mg cap 2 PA NSOtrimipramine 25mg cap 2 PA NSOtrimipramine 50mg cap 2 PA NSO

ANTIDIABETICSALPHA-GLUCOSIDASE INHIBITORS

acarbose 100mg tab 6 NDSacarbose 25mg tab 6acarbose 50mg tab 6 NDSGLYSET 100MG TAB 4GLYSET 25MG TAB 4GLYSET 50MG TAB 4miglitol 100mg tab 6miglitol 25mg tab 6miglitol 50mg tab 6PRECOSE 100MG TAB 4PRECOSE 25MG TAB 4PRECOSE 50MG TAB 4

ANTIDIABETIC COMBINATIONSglipizide 2.5mg/metformin 250mg tab 6




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glipizide 2.5mg/metformin 500mg tab 6glipizide 5mg/metformin 500mg tab 6glyburide 1.25mg/metformin 250mg tab 6glyburide 2.5mg/metformin 500mg tab 6glyburide 5mg/metformin 500mg tab 6GLYXAMBI 10-5MG TAB 3 QL=30 EA/30 DaysGLYXAMBI 25-5MG TAB 3 QL=30 EA/30 DaysJANUMET 100-1000MG XR TAB 3 QL=30 EA/30 DaysJANUMET 50-1000MG TAB 3 QL=60 EA/30 DaysJANUMET 50-1000MG XR TAB 3 QL=60 EA/30 DaysJANUMET 50-500MG TAB 3 QL=60 EA/30 DaysJANUMET 50-500MG XR TAB 3 QL=60 EA/30 DaysJENTADUETO 2.5-1000MG TAB 3 QL=60 EA/30 DaysJENTADUETO 2.5-1000MG XR TAB 3 QL=30 EA/30 DaysJENTADUETO 2.5-500MG TAB 3 QL=60 EA/30 DaysJENTADUETO 2.5-850MG TAB 3 QL=60 EA/30 DaysJENTADUETO 5-1000MG XR TAB 3 QL=30 EA/30 DaysMETFORMIN 500MG/REPAGLINIDE 1MG TAB 4METFORMIN 500MG/REPAGLINIDE 2MG TAB 4SYNJARDY 12.5-1000MG TAB 3 QL=60 EA/30 DaysSYNJARDY 12.5-500MG TAB 3 QL=60 EA/30 DaysSYNJARDY 5-1000MG TAB 3 QL=60 EA/30 DaysSYNJARDY 5-500MG TAB 3 QL=60 EA/30 DaysSYNJARDY XR 10-1000MG TAB 3 QL=30 EA/30 DaysSYNJARDY XR 12.5-1000MG TAB 3 QL=60 EA/30 DaysSYNJARDY XR 25-1000MG TAB 3 QL=30 EA/30 DaysSYNJARDY XR 5-1000MG TAB 3 QL=60 EA/30 DaysXIGDUO 10-1000MG XR TAB 3 QL=30 EA/30 DaysXIGDUO 10-500MG XR TAB 3 QL=30 EA/30 DaysXIGDUO 2.5-1000MG XR TAB 3 QL=60 EA/30 DaysXIGDUO 5-1000MG XR TAB 3 QL=60 EA/30 DaysXIGDUO 5-500MG XR TAB 3 QL=30 EA/30 DaysXULTOPHY 100UNIT-3.6MG/ML PEN INJ 3 PA QL=15 ML/30 Days

BIGUANIDESGLUCOPHAGE 1000MG TAB 4GLUCOPHAGE 500MG TAB 4GLUCOPHAGE 500MG XR TAB 4GLUCOPHAGE 750MG XR TAB 4GLUCOPHAGE 850MG TAB 4metformin 1000mg tab 6metformin 500mg er tab 6metformin 500mg tab 6




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metformin 750mg er tab 6metformin 850mg tab 6RIOMET 500MG/5ML ORAL SOLN 4

DIABETIC OTHERGLUCAGEN 1MG INJ 3 QL=2 EA/7 DaysGLUCAGON 1MG INJ 3 QL=2 EA/7 DaysKORLYM 300MG TAB 5 NDS PAPROGLYCEM 50MG/ML SUSP 4

DIPEPTIDYL PEPTIDASE-4 (DPP-4) INHIBITORSJANUVIA 100MG TAB 3 QL=30 EA/30 DaysJANUVIA 25MG TAB 3 QL=30 EA/30 DaysJANUVIA 50MG TAB 3 QL=30 EA/30 DaysTRADJENTA 5MG TAB 3 QL=30 EA/30 Days

DOPAMINE RECEPTOR AGONISTS - ANTIDIABETICCYCLOSET 0.8MG TAB 4

INCRETIN MIMETIC AGENTS (GLP-1 RECEPTOR AGONISTS)BYDUREON 2.35MG/ML AUTO-INJECTOR 3 QL=3.40 ML/28 DaysBYDUREON 2MG PEN INJ 3 QL=4 EA/28 DaysBYETTA 10MCG/0.04ML PEN INJ 4 QL=2.40 ML/30 DaysBYETTA 5MCG/0.02ML PEN INJ 4 QL=1.20 ML/30 DaysOZEMPIC 2MG/1.5ML PEN INJ 3 QL=1.50 ML/28 DaysOZEMPIC 2MG/1.5ML PEN INJ (1MG DOSE) 3 QL=3 ML/28 DaysTRULICITY 0.75MG/0.5ML AUTO-INJECTOR 4 QL=2 ML/28 DaysTRULICITY 1.5MG/0.5ML AUTO-INJECTOR 4 QL=2 ML/28 DaysVICTOZA 18MG/3ML PEN INJ 3 QL=9 ML/30 Days

INSULINFIASP 100UNIT/ML INJ 3 PA BvDFIASP 100UNIT/ML PEN INJ 3HUMULIN R 500UNIT/ML INJ 3 PA BvDHUMULIN R 500UNIT/ML PEN INJ 3LANTUS 100UNIT/ML INJ 3LANTUS 100UNIT/ML SOLOSTAR 3LEVEMIR 100UNIT/ML FLEXTOUCH 3LEVEMIR 100UNIT/ML INJ 3NOVOLIN 100UNIT/ML INJ 3NOVOLIN N 100UNIT/ML INJ 3NOVOLIN R 100UNIT/ML INJ 3NOVOLOG 100UNIT/ML FLEXPEN 3NOVOLOG 100UNIT/ML INJ 3 PA BvDNOVOLOG 100UNIT/ML PENFILL 3NOVOLOG MIX 100UNIT/ML FLEXPEN 3NOVOLOG MIX 100UNIT/ML INJ 3




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TOUJEO 300UNIT/ML PEN INJ 3TOUJEO MAX 300UNIT/ML PEN INJ (3ML) 3TRESIBA 100UNIT/ML INJ 3TRESIBA 100UNIT/ML PEN INJ 3TRESIBA 200UNIT/ML PEN INJ 3

INSULIN SENSITIZING AGENTSACTOS 15MG TAB 4ACTOS 30MG TAB 4ACTOS 45MG TAB 4AVANDIA 2MG TAB 3AVANDIA 4MG TAB 3pioglitazone 15mg tab 6pioglitazone 30mg tab 6pioglitazone 45mg tab 6

MEGLITINIDE ANALOGUESnateglinide 120mg tab 6nateglinide 60mg tab 6PRANDIN 1MG TAB 4PRANDIN 2MG TAB 4repaglinide 0.5mg tab 6repaglinide 1mg tab 6repaglinide 2mg tab 6STARLIX 120MG TAB 4STARLIX 60MG TAB 4

SODIUM-GLUCOSE CO-TRANSPORTER 2 (SGLT2) INHIBITORSFARXIGA 10MG TAB 3 QL=30 EA/30 DaysFARXIGA 5MG TAB 3 QL=30 EA/30 DaysJARDIANCE 10MG TAB 3 QL=30 EA/30 DaysJARDIANCE 25MG TAB 3 QL=30 EA/30 Days

SULFONYLUREASAMARYL 1MG TAB 4AMARYL 2MG TAB 4AMARYL 4MG TAB 4glimepiride 1mg tab 6glimepiride 2mg tab 6glimepiride 4mg tab 6glipizide 10mg er tab 6glipizide 10mg tab 6glipizide 2.5mg er tab 6glipizide 5mg er tab 6glipizide 5mg tab 6GLUCOTROL 10MG TAB 4




38

GLUCOTROL 10MG XL TAB 4GLUCOTROL 2.5MG XL TAB 4GLUCOTROL 5MG TAB 4GLUCOTROL 5MG XL TAB 4tolazamide 250mg tab 6tolazamide 500mg tab 6TOLBUTAMIDE 500MG TAB 3

ANTIDIARRHEAL/PROBIOTIC AGENTSANTIPERISTALTIC AGENTS

atropine sulfate 0.005mg/ml/diphenoxylate 0.5mg/mloral soln

2

atropine sulfate 0.025mg/diphenoxylate 2.5mg tab 2LOMOTIL 2.5-0.025MG TAB 4loperamide 2mg cap 1

ANTIDOTESANTIDOTES - CHELATING AGENTS

CHEMET 100MG CAP 3FERRIPROX 100MG/ML ORAL SOLN 5 NDS PAJADENU 180MG TAB 5 NDSJADENU 90MG TAB 5 NDS

ANTIDOTES AND SPECIFIC ANTAGONISTSANTIDOTES - CHELATING AGENTS

deferasirox 125mg tab for oral susp 5 NDSdeferasirox 250mg tab for oral susp 5 NDSdeferasirox 500mg tab for oral susp 5 NDSFERRIPROX 500MG TAB 5 NDS PAJADENU 180MG GRANULE PACKET 5 NDSJADENU 360MG GRANULE PACKET 5 NDSJADENU 360MG TAB 5 NDSJADENU 90MG GRANULE PACKET 5 NDS

OPIOID ANTAGONISTSNALOXONE 0.4MG/ML CARTRIDGE 2 QL=2 ML/2 Daysnaloxone 0.4mg/ml inj 2 QL=2 ML/2 DaysNALOXONE 1MG/ML SYRINGE 2 QL=4 ML/2 Daysnaltrexone 50mg tab 1NARCAN 4MG/0.1ML NASAL SPRAY 2 QL=2 EA/2 Days

ANTIEMETICS5-HT3 RECEPTOR ANTAGONISTS

granisetron 1mg tab 2 PA BvD QL=60 EA/30 Daysondansetron 0.8mg/ml oral soln 2 PA BvDondansetron 24mg tab 2 PA BvDondansetron 4mg odt 1 PA BvD




39

ondansetron 4mg tab 1 PA BvDondansetron 8mg odt 1 PA BvDondansetron 8mg tab 1 PA BvDSANCUSO 3.1MG/24HR PATCH 4 QL=2 EA/14 DaysZOFRAN 8MG TAB 4 PA BvD

ANTIEMETICS - ANTICHOLINERGICmeclizine 12.5mg tab 1meclizine 25mg tab 1scopolamine 0.0139mg/hr patch 2TIGAN 300MG CAP 4TRANSDERM SCOP 1MG/3DAYS PATCH 4trimethobenzamide 300mg cap 2

ANTIEMETICS - MISCELLANEOUSCESAMET 1MG CAP 4 PAdronabinol 10mg cap 2 PAdronabinol 2.5mg cap 2 PAdronabinol 5mg cap 2 PAMARINOL 10MG CAP 4 PAMARINOL 2.5MG CAP 4 PAMARINOL 5MG CAP 4 PA

SUBSTANCE P/NEUROKININ 1 (NK1) RECEPTOR ANTAGONISTSaprepitant 125mg cap 2 PA BvD QL=3 EA/2 Daysaprepitant 125mg/80mg pack 2 PA BvD QL=6 EA/4 Daysaprepitant 40mg cap 2 PA BvD QL=3 EA/2 Daysaprepitant 80mg cap 2 PA BvD QL=6 EA/4 DaysEMEND 125MG CAP 4 PA BvD QL=3 EA/2 DaysEMEND 40MG CAP 4 PA BvD QL=3 EA/2 DaysEMEND 80MG CAP 4 PA BvD QL=6 EA/4 DaysEMEND TRI-FOLD PACK 4 PA BvD QL=6 EA/4 DaysVARUBI 90MG TAB 3 PA BvD QL=4 EA/28 Days

ANTIFUNGALSANTIFUNGAL - GLUCAN SYNTHESIS INHIBITORS (ECHINOCANDINS)

CANCIDAS 50MG INJ 5 NDSCANCIDAS 70MG INJ 5 NDSCASPOFUNGIN ACETATE 50MG INJ 5 NDSCASPOFUNGIN ACETATE 70MG INJ 5 NDSERAXIS 100MG INJ 3ERAXIS 50MG INJ 3MYCAMINE 100MG INJ 4MYCAMINE 50MG INJ 4

ANTIFUNGALSABELCET 5MG/ML INJ 4 PA BvD




40

AMBISOME 50MG INJ 4 PA BvDAMPHOTERICIN B 50MG INJ 4 PA BvDANCOBON 250MG CAP 4ANCOBON 500MG CAP 4flucytosine 250mg cap 2flucytosine 500mg cap 2griseofulvin 125mg tab 2griseofulvin 250mg tab 2griseofulvin 25mg/ml susp 2griseofulvin 500mg tab 2nystatin 500000unit tab 2terbinafine 250mg tab 1

IMIDAZOLE-RELATED ANTIFUNGALSDIFLUCAN 100MG TAB 4DIFLUCAN 10MG/ML SUSP 4DIFLUCAN 150MG TAB 4DIFLUCAN 200MG TAB 4DIFLUCAN 40MG/ML SUSP 4DIFLUCAN 50MG TAB 4fluconazole 100mg tab 2fluconazole 10mg/ml susp 2fluconazole 150mg tab 1fluconazole 200mg tab 2fluconazole 2mg/ml (100ml) inj 2fluconazole 2mg/ml inj 2fluconazole 40mg/ml susp 2fluconazole 50mg tab 2itraconazole 100mg cap 2 PAitraconazole 10mg/ml oral soln 2 PAketoconazole 200mg tab 1NOXAFIL 100MG DR TAB 5 NDS PANOXAFIL 40MG/ML SUSP 3 PASPORANOX 100MG CAP 4 PASPORANOX 10MG/ML ORAL SOLN 4 PAVFEND 200MG INJ 4 PAVFEND 200MG TAB 5 NDS PAVFEND 40MG/ML SUSP 5 NDS PAVFEND 50MG TAB 5 NDS PAvoriconazole 200mg inj 2 PAvoriconazole 200mg tab 2 PAvoriconazole 40mg/ml susp 2 PAvoriconazole 50mg tab 2 PA




41

ANTIHISTAMINESANTIHISTAMINES - NON-SEDATING

cetirizine 1mg/ml oral soln 2CLARINEX 0.5MG/ML ORAL SOLN 4CLARINEX 5MG TAB 4desloratadine 5mg tab 2levocetirizine 0.5mg/ml oral soln 2levocetirizine 5mg tab 1

ANTIHISTAMINES - PHENOTHIAZINESphenadoz 12.5mg rectal supp 2promethazine 1.25mg/ml oral soln 2promethazine 12.5mg rectal supp 2promethazine 12.5mg tab 1promethazine 25mg rectal supp 2promethazine 25mg tab 1promethazine 50mg rectal supp 2promethazine 50mg tab 1promethegan 25mg rectal supp 2promethegan 50mg rectal supp 2

ANTIHYPERLIPIDEMICSANTIHYPERLIPIDEMICS - COMBINATIONS

ezetimibe/simvastatin 10-10mg tab 2 QL=30 EA/30 Daysezetimibe/simvastatin 10-20mg tab 2 QL=30 EA/30 Daysezetimibe/simvastatin 10-40mg tab 2 QL=30 EA/30 Daysezetimibe/simvastatin 10-80mg tab 2 QL=30 EA/30 DaysVYTORIN 10-10MG TAB 4 QL=30 EA/30 DaysVYTORIN 10-20MG TAB 4 QL=30 EA/30 DaysVYTORIN 10-40MG TAB 4 QL=30 EA/30 DaysVYTORIN 10-80MG TAB 4 QL=30 EA/30 Days

ANTIHYPERLIPIDEMICS - MISC.LOVAZA 1GM CAP 4omega-3 acid ethyl esters (usp) 1000mg cap 2VASCEPA 1GM CAP 4 PA QL=120 EA/30 DaysVASCEPA 500MG CAP 4 PA QL=120 EA/30 Days

BILE ACID SEQUESTRANTScholestyramine resin 4gm sf powder for oral susp 2cholestyramine resin 66.7mg/ml susp 2colesevelam hcl 3.75gm packet 2colesevelam hcl 625mg tab 2COLESTID 1GM TAB 4COLESTID 5GM GRANULES 4colestipol 1000mg tab 2




42

colestipol 5000mg granules 2prevalite 4gm/dose susp 2QUESTRAN 4GM SF POWDER FOR ORAL SUSP 4QUESTRAN 4GM SUSP 4WELCHOL 3.75GM SUSP 4WELCHOL 625MG TAB 4

FIBRIC ACID DERIVATIVESANTARA 30MG CAP 4ANTARA 90MG CAP 4fenofibrate 134mg cap 2fenofibrate 145mg tab 2FENOFIBRATE 150MG CAP 4fenofibrate 160mg tab 2fenofibrate 200mg cap 2fenofibrate 48mg tab 2FENOFIBRATE 50MG CAP 4fenofibrate 54mg tab 2fenofibrate 67mg cap 2FENOFIBRIC ACID 105MG TAB 4fenofibric acid 135mg dr cap 2FENOFIBRIC ACID 35MG TAB 4fenofibric acid 45mg dr cap 2FIBRICOR 105MG TAB 4FIBRICOR 35MG TAB 4gemfibrozil 600mg tab 1LIPOFEN 150MG CAP 4LIPOFEN 50MG CAP 4LOPID 600MG TAB 4TRICOR 145MG TAB 4TRICOR 48MG TAB 4TRIGLIDE 160MG TAB 4TRILIPIX 135MG DR CAP 4TRILIPIX 45MG DR CAP 4

HMG COA REDUCTASE INHIBITORSatorvastatin 10mg tab 6atorvastatin 20mg tab 6atorvastatin 40mg tab 6atorvastatin 80mg tab 6CRESTOR 10MG TAB 4 STCRESTOR 20MG TAB 4 STCRESTOR 40MG TAB 4 STCRESTOR 5MG TAB 4 ST




43

fluvastatin 20mg cap 2fluvastatin 40mg cap 2fluvastatin 80mg er tab 2LESCOL 80MG XL TAB 4 STLIPITOR 10MG TAB 4 STLIPITOR 20MG TAB 4 STLIPITOR 40MG TAB 4 STLIPITOR 80MG TAB 4 STLIVALO 1MG TAB 4 STLIVALO 2MG TAB 4 STLIVALO 4MG TAB 4 STlovastatin 10mg tab 6lovastatin 20mg tab 6lovastatin 40mg tab 6PRAVACHOL 20MG TAB 4 STPRAVACHOL 40MG TAB 4 STPRAVACHOL 80MG TAB 4 STpravastatin sodium 10mg tab 6pravastatin sodium 20mg tab 6pravastatin sodium 40mg tab 6pravastatin sodium 80mg tab 6rosuvastatin 10mg tab 6rosuvastatin 20mg tab 6rosuvastatin 40mg tab 6rosuvastatin 5mg tab 6simvastatin 10mg tab 6simvastatin 20mg tab 6simvastatin 40mg tab 6simvastatin 5mg tab 6simvastatin 80mg tab 6ZOCOR 10MG TAB 4 STZOCOR 20MG TAB 4 STZOCOR 40MG TAB 4 STZOCOR 80MG TAB 4 ST

INTESTINAL CHOLESTEROL ABSORPTION INHIBITORSezetimibe 10mg tab 2 QL=30 EA/30 DaysZETIA 10MG TAB 4 QL=30 EA/30 Days

MICROSOMAL TRIGLYCERIDE TRANSFER PROTEIN (MTP) INHIBITORSJUXTAPID 10MG CAP 5 NDS PAJUXTAPID 20MG CAP 5 NDS PAJUXTAPID 30MG CAP 5 NDS PAJUXTAPID 40MG CAP 5 NDS PA




44

JUXTAPID 5MG CAP 5 NDS PAJUXTAPID 60MG CAP 5 NDS PA

NICOTINIC ACID DERIVATIVESniacin 1000mg er tab 2niacin 500mg er tab 2niacin 750mg er tab 2NIASPAN 1000MG ER TAB 4NIASPAN 500MG ER TAB 4NIASPAN 750MG ER TAB 4

PROPROTEIN CONVERTASE SUBTILISIN/KEXIN TYPE 9 INHIBITORSPRALUENT 150MG/ML AUTO-INJECTOR 3 PA QL=2 ML/28 DaysPRALUENT 75MG/ML AUTO-INJECTOR 3 PA QL=2 ML/28 DaysREPATHA 120MG/ML CARTRIDGE 3 PA QL=3.50 ML/28 DaysREPATHA 140MG/ML AUTO-INJECTOR 3 PA QL=2 ML/28 DaysREPATHA 140MG/ML SYRINGE 3 PA QL=2 ML/28 Days

ANTIHYPERTENSIVESACE INHIBITORS

ACCUPRIL 10MG TAB 4ACCUPRIL 20MG TAB 4ACCUPRIL 40MG TAB 4ACCUPRIL 5MG TAB 4ALTACE 1.25MG CAP 4ALTACE 10MG CAP 4ALTACE 2.5MG CAP 4ALTACE 5MG CAP 4benazepril 10mg tab 6benazepril 20mg tab 6benazepril 40mg tab 6benazepril 5mg tab 6captopril 100mg tab 2captopril 12.5mg tab 2captopril 25mg tab 2captopril 50mg tab 2enalapril maleate 10mg tab 6enalapril maleate 2.5mg tab 6enalapril maleate 20mg tab 1enalapril maleate 5mg tab 6fosinopril sodium 10mg tab 6fosinopril sodium 20mg tab 6fosinopril sodium 40mg tab 6lisinopril 10mg tab 6lisinopril 2.5mg tab 6




45

lisinopril 20mg tab 6lisinopril 30mg tab 6lisinopril 40mg tab 6lisinopril 5mg tab 6LOTENSIN 10MG TAB 4LOTENSIN 20MG TAB 4LOTENSIN 40MG TAB 4moexipril 15mg tab 2moexipril 7.5mg tab 2perindopril erbumine 2mg tab 2perindopril erbumine 4mg tab 2perindopril erbumine 8mg tab 2PRINIVIL 10MG TAB 4PRINIVIL 20MG TAB 4PRINIVIL 5MG TAB 4QBRELIS 1MG/ML ORAL SOLN 4 PAquinapril 10mg tab 6quinapril 20mg tab 6quinapril 40mg tab 6quinapril 5mg tab 6ramipril 1.25mg cap 6ramipril 10mg cap 6ramipril 2.5mg cap 6ramipril 5mg cap 6trandolapril 1mg tab 1trandolapril 2mg tab 1trandolapril 4mg tab 1VASOTEC 10MG TAB 4VASOTEC 2.5MG TAB 4VASOTEC 20MG TAB 4VASOTEC 5MG TAB 4ZESTRIL 10MG TAB 4ZESTRIL 2.5MG TAB 4ZESTRIL 20MG TAB 4ZESTRIL 30MG TAB 4ZESTRIL 40MG TAB 4ZESTRIL 5MG TAB 4

AGENTS FOR PHEOCHROMOCYTOMADEMSER 250MG CAP 5 NDSDIBENZYLINE 10MG CAP 4phenoxybenzamine 10mg cap 2

ANGIOTENSIN II RECEPTOR ANTAGONISTS




46

AVAPRO 150MG TAB 4AVAPRO 300MG TAB 4AVAPRO 75MG TAB 4BENICAR 20MG TAB 4BENICAR 40MG TAB 4BENICAR 5MG TAB 4COZAAR 100MG TAB 4COZAAR 25MG TAB 4COZAAR 50MG TAB 4DIOVAN 160MG TAB 4DIOVAN 320MG TAB 4DIOVAN 40MG TAB 4DIOVAN 80MG TAB 4irbesartan 150mg tab 6irbesartan 300mg tab 6irbesartan 75mg tab 6losartan potassium 100mg tab 6losartan potassium 25mg tab 6losartan potassium 50mg tab 6MICARDIS 20MG TAB 4MICARDIS 40MG TAB 4MICARDIS 80MG TAB 4olmesartan medoxomil 20mg tab 6olmesartan medoxomil 40mg tab 6olmesartan medoxomil 5mg tab 6telmisartan 20mg tab 2telmisartan 40mg tab 2telmisartan 80mg tab 2valsartan 160mg tab 6valsartan 320mg tab 1valsartan 40mg tab 6valsartan 80mg tab 6

ANTIADRENERGIC ANTIHYPERTENSIVESCARDURA 1MG TAB 4CARDURA 2MG TAB 4CARDURA 4MG TAB 4CARDURA 8MG TAB 4CATAPRES 0.1MG TAB 4CATAPRES 0.2MG TAB 4CATAPRES 0.3MG TAB 4CATAPRES-TTS-1 0.1MG/24HR PATCH 4CATAPRES-TTS-2 0.2MG/24HR PATCH 4




47

CATAPRES-TTS-3 0.3MG/24HR PATCH 4clonidine 0.00417mg/hr patch 2clonidine 0.00833mg/hr patch 2clonidine 0.0125mg/hr patch 2clonidine 0.1mg tab 1clonidine 0.2mg tab 1clonidine 0.3mg tab 1doxazosin 1mg tab 1doxazosin 2mg tab 1doxazosin 4mg tab 1doxazosin 8mg tab 1MINIPRESS 1MG CAP 4MINIPRESS 2MG CAP 4MINIPRESS 5MG CAP 4prazosin 1mg cap 1prazosin 2mg cap 1prazosin 5mg cap 1terazosin 10mg cap 1terazosin 1mg cap 1terazosin 2mg cap 1terazosin 5mg cap 1

ANTIHYPERTENSIVE COMBINATIONSACCURETIC 10-12.5MG TAB 4ACCURETIC 20-12.5MG TAB 4ACCURETIC 20-25MG TAB 4amlodipine 10mg/benazepril 20mg cap 2amlodipine 10mg/benazepril 40mg cap 2amlodipine 10mg/hydrochlorothiazide 12.5mg/valsartan160mg tab

2

amlodipine 10mg/hydrochlorothiazide 25mg/valsartan160mg tab

2


2

amlodipine 10mg/olmesartan medoxomil 20mg tab 2amlodipine 10mg/olmesartan medoxomil 40mg tab 2amlodipine 10mg/telmisartan 40mg tab 2amlodipine 10mg/telmisartan 80mg tab 2amlodipine 10mg/valsartan 160mg tab 2amlodipine 10mg/valsartan 320mg tab 2amlodipine 2.5mg/benazepril 10mg cap 2amlodipine 5mg/benazepril 10mg cap 2amlodipine 5mg/benazepril 20mg cap 2




48

amlodipine 5mg/benazepril 40mg cap 2amlodipine 5mg/hydrochlorothiazide 12.5mg/valsartan160mg tab

2


2

amlodipine 5mg/olmesartan medoxomil 20mg tab 2amlodipine 5mg/olmesartan medoxomil 40mg tab 2amlodipine 5mg/telmisartan 40mg tab 2amlodipine 5mg/telmisartan 80mg tab 2amlodipine 5mg/valsartan 160mg tab 2amlodipine 5mg/valsartan 320mg tab 2atenolol 100mg/chlorthalidone 25mg tab 2atenolol 50mg/chlorthalidone 25mg tab 2AVALIDE 150-12.5MG TAB 4AVALIDE 300-12.5MG TAB 4AZOR 10-20MG TAB 4AZOR 10-40MG TAB 4AZOR 5-20MG TAB 4AZOR 5-40MG TAB 4benazepril 10mg/hydrochlorothiazide 12.5mg tab 2benazepril 20mg/hydrochlorothiazide 12.5mg tab 2benazepril 20mg/hydrochlorothiazide 25mg tab 2benazepril 5mg/hydrochlorothiazide 6.25mg tab 2BENICAR HCT 20-12.5MG TAB 4BENICAR HCT 40-12.5MG TAB 4BENICAR HCT 40-25MG TAB 4bisoprolol fumarate 10mg/hydrochlorothiazide 6.25mgtab

1

bisoprolol fumarate 2.5mg/hydrochlorothiazide 6.25mgtab

1

bisoprolol fumarate 5mg/hydrochlorothiazide 6.25mgtab

1

captopril 25mg/hydrochlorothiazide 15mg tab 2CAPTOPRIL 25MG/HYDROCHLOROTHIAZIDE25MG TAB

2

captopril 50mg/hydrochlorothiazide 15mg tab 2CAPTOPRIL 50MG/HYDROCHLOROTHIAZIDE25MG TAB

2

DIOVAN HCT 160-12.5MG TAB 4DIOVAN HCT 160-25MG TAB 4DIOVAN HCT 320-12.5MG TAB 4DIOVAN HCT 320-25MG TAB 4




49

DIOVAN HCT 80-12.5MG TAB 4enalapril maleate 10mg/hydrochlorothiazide 25mg tab 1enalapril maleate 5mg/hydrochlorothiazide 12.5mg tab 1EXFORGE 10-160MG TAB 4EXFORGE 10-320MG TAB 4EXFORGE 5-160MG TAB 4EXFORGE 5-320MG TAB 4EXFORGE HCT 10-160-12.5MG TAB 4EXFORGE HCT 10-160-25MG TAB 4EXFORGE HCT 10-320-25MG TAB 4EXFORGE HCT 5-160-12.5MG TAB 4EXFORGE HCT 5-160-25MG TAB 4fosinopril sodium 10mg/hydrochlorothiazide 12.5mg tab 2fosinopril sodium 20mg/hydrochlorothiazide 12.5mg tab 2hydrochlorothiazide 12.5mg/irbesartan 150mg tab 2hydrochlorothiazide 12.5mg/irbesartan 300mg tab 2hydrochlorothiazide 12.5mg/lisinopril 10mg tab 1hydrochlorothiazide 12.5mg/lisinopril 20mg tab 1hydrochlorothiazide 12.5mg/losartan potassium 100mgtab

2

hydrochlorothiazide 12.5mg/losartan potassium 50mgtab

2

hydrochlorothiazide 12.5mg/olmesartan medoxomil20mg tab

1

hydrochlorothiazide 12.5mg/olmesartan medoxomil40mg tab

1

hydrochlorothiazide 12.5mg/quinapril 10mg tab 2hydrochlorothiazide 12.5mg/quinapril 20mg tab 2hydrochlorothiazide 12.5mg/telmisartan 40mg tab 2hydrochlorothiazide 12.5mg/telmisartan 80mg tab 2hydrochlorothiazide 12.5mg/valsartan 160mg tab 2hydrochlorothiazide 12.5mg/valsartan 320mg tab 2hydrochlorothiazide 12.5mg/valsartan 80mg tab 2hydrochlorothiazide 25mg/lisinopril 20mg tab 1hydrochlorothiazide 25mg/losartan potassium 100mg tab 2hydrochlorothiazide 25mg/metoprolol tartrate 100mg tab 2hydrochlorothiazide 25mg/metoprolol tartrate 50mg tab 2hydrochlorothiazide 25mg/olmesartan medoxomil 40mgtab

1

hydrochlorothiazide 25mg/propranolol 40mg tab 2hydrochlorothiazide 25mg/propranolol 80mg tab 2hydrochlorothiazide 25mg/quinapril 20mg tab 2




50

hydrochlorothiazide 25mg/telmisartan 80mg tab 2hydrochlorothiazide 25mg/valsartan 160mg tab 2hydrochlorothiazide 25mg/valsartan 320mg tab 2hydrochlorothiazide 50mg/metoprolol tartrate 100mg tab 2HYZAAR 100-12.5MG TAB 4HYZAAR 100-25MG TAB 4HYZAAR 50-12.5MG TAB 4LOPRESSOR HCT 50-25MG TAB 4LOTREL 10-20MG CAP 4LOTREL 10-40MG CAP 4LOTREL 5-10MG CAP 4LOTREL 5-20MG CAP 4MICARDIS-HCT 40-12.5MG TAB 4MICARDIS-HCT 80-12.5MG TAB 4MICARDIS-HCT 80-25MG TAB 4TARKA 2-180MG ER TAB 4TARKA 2-240MG ER TAB 4TARKA 4-240MG ER TAB 4TEKTURNA HCT 150-12.5MG TAB 4TEKTURNA HCT 150-25MG TAB 4TEKTURNA HCT 300-12.5MG TAB 4TEKTURNA HCT 300-25MG TAB 4TENORETIC 100-25MG TAB 4TENORETIC 50-25MG TAB 4TRANDOLAPRIL 1MG/VERAPAMIL 240MG ERTAB

2

trandolapril 2mg/verapamil 180mg er tab 2trandolapril 2mg/verapamil 240mg er tab 2trandolapril 4mg/verapamil 240mg er tab 2TWYNSTA 40-10MG TAB 4TWYNSTA 40-5MG TAB 4TWYNSTA 80-5MG TAB 4VASERETIC 10-25MG TAB 4ZESTORETIC 10-12.5MG TAB 4ZESTORETIC 20-12.5MG TAB 4ZESTORETIC 20-25MG TAB 4ZIAC 10-6.25MG TAB 4ZIAC 2.5-6.25MG TAB 4ZIAC 5-6.25MG TAB 4

DIRECT RENIN INHIBITORSaliskiren 150mg tab 2aliskiren 300mg tab 2




51

TEKTURNA 150MG TAB 4TEKTURNA 300MG TAB 4

SELECTIVE ALDOSTERONE RECEPTOR ANTAGONISTS (SARAS)eplerenone 25mg tab 2eplerenone 50mg tab 2INSPRA 25MG TAB 4INSPRA 50MG TAB 4

VASODILATORShydralazine 100mg tab 2hydralazine 10mg tab 2hydralazine 25mg tab 2hydralazine 50mg tab 2minoxidil 10mg tab 1minoxidil 2.5mg tab 1

ANTIMALARIALSANTIMALARIAL COMBINATIONS

atovaquone 250mg/proguanil 100mg tab 2atovaquone 62.5mg/proguanil 25mg tab 2COARTEM 20-120MG TAB 3MALARONE 250-100MG TAB 4MALARONE 62.5-25MG TAB 4

ANTIMALARIALSCHLOROQUINE PHOSPHATE 250MG TAB 2chloroquine phosphate 500mg tab 2DARAPRIM 25MG TAB 5 NDS QL=90 EA/30 Dayshydroxychloroquine sulfate 200mg tab 2MEFLOQUINE 250MG TAB 3PLAQUENIL 200MG TAB 4PRIMAQUINE PHOSPHATE 26.3MG TAB 2QUALAQUIN 324MG CAP 4quinine sulfate 324mg cap 2

ANTIMYASTHENIC/CHOLINERGIC AGENTSANTIMYASTHENIC/CHOLINERGIC AGENTS

GUANIDINE 125MG TAB 3MESTINON 180MG ER TAB 4MESTINON 60MG TAB 4pyridostigmine bromide 12mg/ml soln 2pyridostigmine bromide 180mg er tab 2pyridostigmine bromide 60mg tab 2

ANTIMYCOBACTERIAL AGENTSANTI TB COMBINATIONS

RIFAMATE 150-300MG CAP 4




52

RIFATER 50-120-300MG TAB 4ANTIMYCOBACTERIAL AGENTS

ethambutol 100mg tab 2ethambutol 400mg tab 2isoniazid 100mg tab 1ISONIAZID 10MG/ML ORAL SOLN 4isoniazid 300mg tab 1MYAMBUTOL 400MG TAB 4MYCOBUTIN 150MG CAP 4PASER D/R 4GM GRANULES 3PRIFTIN 150MG TAB 4pyrazinamide 500mg tab 2rifabutin 150mg cap 2RIFADIN 150MG CAP 4rifampin 150mg cap 2rifampin 300mg cap 2rifampin 60mg/ml inj 2SIRTURO 100MG TAB 5 NDS PATRECATOR 250MG TAB 4

ANTINEOPLASTICS AND ADJUNCTIVE THERAPIESALKYLATING AGENTS

CYCLOPHOSPHAMIDE 25MG CAP 3 PA BvDCYCLOPHOSPHAMIDE 50MG CAP 3 PA BvDGLEOSTINE 100MG CAP 3GLEOSTINE 10MG CAP 3GLEOSTINE 40MG CAP 3LEUKERAN 2MG TAB 3

ANTIMETABOLITESmercaptopurine 50mg tab 2methotrexate 2.5mg tab 1methotrexate 250mg/10ml inj 1methotrexate 50mg/2ml inj 1PURIXAN 2000MG/100ML SUSP 4TABLOID 40MG TAB 3TREXALL 10MG TAB 3TREXALL 15MG TAB 3TREXALL 5MG TAB 3TREXALL 7.5MG TAB 3XATMEP 2.5MG/ML ORAL SOLN 4 PA

ANTINEOPLASTIC - BCL-2 INHIBITORSVENCLEXTA 10/100/50MG STARTING PACK 5 NDS PA NSOVENCLEXTA 100MG TAB 5 NDS PA NSO




53

VENCLEXTA 10MG TAB 4 PA NSOVENCLEXTA 50MG TAB 4 PA NSO

ANTINEOPLASTIC - HEDGEHOG PATHWAY INHIBITORSDAURISMO 100MG TAB 5 NDS PA NSODAURISMO 25MG TAB 5 NDS PA NSOERIVEDGE 150MG CAP 5 NDS PA NSOODOMZO 200MG CAP 5 NDS PA NSO

ANTINEOPLASTIC - HORMONAL AND RELATED AGENTSabiraterone 250mg tab 5 NDS PA NSO QL=120 EA/30 Daysanastrozole 1mg tab 1ARIMIDEX 1MG TAB 4AROMASIN 25MG TAB 4bicalutamide 50mg tab 1CASODEX 50MG TAB 4DEPO-PROVERA 400MG/ML INJ 4ELIGARD 22.5MG SYRINGE 4ELIGARD 30MG SYRINGE 4ELIGARD 45MG SYRINGE 4ELIGARD 7.5MG SYRINGE 4EMCYT 140MG CAP 3ERLEADA 60MG TAB 5 NDS PA NSO QL=120 EA/30 Daysexemestane 25mg tab 2FARESTON 60MG TAB 4FEMARA 2.5MG TAB 4FIRMAGON 120MG INJ 3 PA NSOFIRMAGON 80MG INJ 3 PA NSOflutamide 125mg cap 2letrozole 2.5mg tab 1leuprolide acetate 5mg/ml inj 2LUPRON 11.25MG (1.5ML) SYRINGE 5LUPRON 22.5MG SYRINGE 5LUPRON 3.75MG SYRINGE 5LUPRON 30MG SYRINGE 5LUPRON 45MG SYRINGE 5LUPRON 7.5MG SYRINGE 5LYSODREN 500MG TAB 3megestrol acetate 20mg tab 2 PA NSOmegestrol acetate 40mg tab 2 PA NSOmegestrol acetate 40mg/ml susp 2 PANILANDRON 150MG TAB 4nilutamide 150mg tab 2SOLTAMOX 10MG/5ML ORAL SOLN 4 PA NSO




54

tamoxifen 10mg tab 1tamoxifen 20mg tab 1toremifene 60mg tab 2TRELSTAR 11.25MG INJ 5TRELSTAR 22.5MG INJ 5TRELSTAR 3.75MG INJ 5XTANDI 40MG CAP 5 NDS PA NSO QL=120 EA/30 Days

ANTINEOPLASTIC - IMMUNOMODULATORSPOMALYST 1MG CAP 5 NDS PA NSOPOMALYST 2MG CAP 5 NDS PA NSOPOMALYST 3MG CAP 5 NDS PA NSOPOMALYST 4MG CAP 5 NDS PA NSO

ANTINEOPLASTIC COMBINATIONSKISQALI/FEMARA TAB CO-PACK 200MG 5 NDS PA NSO QL=49 EA/28 DaysKISQALI/FEMARA TAB CO-PACK 400MG 5 NDS PA NSO QL=70 EA/28 DaysKISQALI/FEMARA TAB CO-PACK 600MG 5 NDS PA NSO QL=91 EA/28 DaysLONSURF 15-6.14MG TAB 5 NDS PA NSOLONSURF 20-8.19MG TAB 5 NDS PA NSO

ANTINEOPLASTIC ENZYME INHIBITORSAFINITOR 10MG TAB 5 NDS PA NSO QL=30 EA/30 DaysAFINITOR 2.5MG TAB 5 NDS PA NSO QL=30 EA/30 DaysAFINITOR 2MG SUSP 5 NDS PA NSOAFINITOR 3MG SUSP 5 NDS PA NSOAFINITOR 5MG SUSP 5 NDS PA NSOAFINITOR 5MG TAB 5 NDS PA NSO QL=30 EA/30 DaysAFINITOR 7.5MG TAB 5 NDS PA NSO QL=30 EA/30 DaysALECENSA 150MG CAP 5 NDS PA NSO QL=240 EA/30 DaysALUNBRIG 180MG TAB 5 NDS PA NSO QL=30 EA/30 DaysALUNBRIG 30MG TAB 5 NDS PA NSO QL=120 EA/30 DaysALUNBRIG 90MG TAB 5 NDS PA NSO QL=30 EA/30 DaysALUNBRIG TAB STARTER PACK 5 NDS PA NSO QL=30 EA/30 DaysBALVERSA 3MG TAB 5 NDS PA NSO QL=60 EA/30 DaysBALVERSA 4MG TAB 5 NDS PA NSO QL=60 EA/30 DaysBALVERSA 5MG TAB 5 NDS PA NSO QL=30 EA/30 DaysBOSULIF 100MG TAB 5 NDS PA NSOBOSULIF 400MG TAB 5 NDS PA NSOBOSULIF 500MG TAB 5 NDS PA NSOBRAFTOVI 75MG CAP 5 NDS PA NSO QL=180 EA/30 DaysCABOMETYX 20MG TAB 5 NDS PA NSOCABOMETYX 40MG TAB 5 NDS PA NSOCABOMETYX 60MG TAB 5 NDS PA NSOCALQUENCE 100MG CAP 5 NDS PA NSO QL=60 EA/30 Days




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CAPRELSA 100MG TAB 5 NDS PA NSO QL=60 EA/30 DaysCAPRELSA 300MG TAB 5 NDS PA NSO QL=30 EA/30 DaysCOMETRIQ 100MG DAILY DOSE CARTON PACK 5 NDS PA NSOCOMETRIQ 140MG DAILY DOSE CARTON PACK 5 NDS PA NSOCOMETRIQ 60MG DAILY DOSE CARTON PACK 5 NDS PA NSOCOPIKTRA 15MG CAP 5 NDS PA NSO QL=60 EA/30 DaysCOPIKTRA 25MG CAP 5 NDS PA NSO QL=60 EA/30 DaysCOTELLIC 20MG TAB 5 NDS PA NSO QL=63 EA/28 Dayserlotinib 100mg tab 5 NDS PA NSOerlotinib 150mg tab 5 NDS PA NSOerlotinib 25mg tab 5 NDS PA NSOFARYDAK 10MG CAP 5 NDS PA NSOFARYDAK 15MG CAP 5 NDS PA NSOFARYDAK 20MG CAP 5 NDS PA NSOGILOTRIF 20MG TAB 5 NDS PA NSO QL=30 EA/30 DaysGILOTRIF 30MG TAB 5 NDS PA NSO QL=30 EA/30 DaysGILOTRIF 40MG TAB 5 NDS PA NSO QL=30 EA/30 DaysIBRANCE 100MG CAP 5 NDS PA NSO QL=21 EA/28 DaysIBRANCE 125MG CAP 5 NDS PA NSO QL=21 EA/28 DaysIBRANCE 75MG CAP 5 NDS PA NSO QL=21 EA/28 DaysICLUSIG 15MG TAB 5 NDS PA NSO QL=60 EA/30 DaysICLUSIG 45MG TAB 5 NDS PA NSO QL=30 EA/30 DaysIDHIFA 100MG TAB 5 NDS PA NSO QL=30 EA/30 DaysIDHIFA 50MG TAB 5 NDS PA NSO QL=30 EA/30 Daysimatinib 100mg tab 2 PA NSOimatinib 400mg tab 2 PA NSOIMBRUVICA 140MG CAP 5 NDS PA NSO QL=90 EA/30 DaysIMBRUVICA 140MG TAB 5 NDS PA NSO QL=30 EA/30 DaysIMBRUVICA 280MG TAB 5 NDS PA NSO QL=30 EA/30 DaysIMBRUVICA 420MG TAB 5 NDS PA NSO QL=30 EA/30 DaysIMBRUVICA 560MG TAB 5 NDS PA NSO QL=30 EA/30 DaysIMBRUVICA 70MG CAP 5 NDS PA NSO QL=30 EA/30 DaysINLYTA 1MG TAB 5 NDS PA NSOINLYTA 5MG TAB 5 NDS PA NSOIRESSA 250MG TAB 5 NDS PA NSOJAKAFI 10MG TAB 5 NDS PA NSO QL=60 EA/30 DaysJAKAFI 15MG TAB 5 NDS PA NSO QL=60 EA/30 DaysJAKAFI 20MG TAB 5 NDS PA NSO QL=60 EA/30 DaysJAKAFI 25MG TAB 5 NDS PA NSO QL=60 EA/30 DaysJAKAFI 5MG TAB 5 NDS PA NSO QL=60 EA/30 DaysKISQALI 200MG DAILY DOSE PACK 5 NDS PA NSO QL=21 EA/28 DaysKISQALI 400MG DAILY DOSE PACK 5 NDS PA NSO QL=42 EA/28 Days




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KISQALI 600MG DAILY DOSE PACK 5 NDS PA NSO QL=63 EA/28 DaysLENVIMA (10) 10MG PACK 5 NDS PA NSOLENVIMA (12) 4MG PACK 5 NDS PA NSOLENVIMA (14) PACK 5 NDS PA NSOLENVIMA (18) PACK 5 NDS PA NSOLENVIMA (20) 10MG PACK 5 NDS PA NSOLENVIMA (24) PACK 5 NDS PA NSOLENVIMA (4) 4MG PACK 5 NDS PA NSOLENVIMA (8) 4MG PACK 5 NDS PA NSOLORBRENA 100MG TAB 5 NDS PA NSO QL=30 EA/30 DaysLORBRENA 25MG TAB 5 NDS PA NSO QL=90 EA/30 DaysLYNPARZA 100MG CAP 5 NDS PA NSO QL=120 EA/30 DaysLYNPARZA 150MG CAP 5 NDS PA NSO QL=120 EA/30 DaysMEKINIST 0.5MG TAB 5 NDS PA NSO QL=90 EA/30 DaysMEKINIST 2MG TAB 5 NDS PA NSO QL=30 EA/30 DaysMEKTOVI 15MG TAB 5 NDS PA NSO QL=180 EA/30 DaysNERLYNX 40MG TAB 5 NDS PA NSONEXAVAR 200MG TAB 5 NDS PA NSONINLARO 2.3MG CAP 5 NDS PA NSONINLARO 3MG CAP 5 NDS PA NSONINLARO 4MG CAP 5 NDS PA NSOPIQRAY 200MG DAILY DOSE PACK 5 NDS PA NSO QL=30 EA/30 DaysPIQRAY 250MG DAILY DOSE PACK 5 NDS PA NSO QL=60 EA/30 DaysPIQRAY 300MG DAILY DOSE 150MG PACK 5 NDS PA NSO QL=60 EA/30 DaysRUBRACA 200MG TAB 5 NDS PA NSO QL=120 EA/30 DaysRUBRACA 250MG TAB 5 NDS PA NSO QL=120 EA/30 DaysRUBRACA 300MG TAB 5 NDS PA NSO QL=120 EA/30 DaysRYDAPT 25MG CAP 5 NDS PA NSOSPRYCEL 100MG TAB 5 NDS PA NSOSPRYCEL 140MG TAB 5 NDS PA NSOSPRYCEL 20MG TAB 5 NDS PA NSOSPRYCEL 50MG TAB 5 NDS PA NSOSPRYCEL 70MG TAB 5 NDS PA NSOSPRYCEL 80MG TAB 5 NDS PA NSOSTIVARGA 40MG TAB 5 NDS PA NSO QL=120 EA/30 DaysSUTENT 12.5MG CAP 5 NDS PA NSOSUTENT 25MG CAP 5 NDS PA NSOSUTENT 37.5MG CAP 5 NDS PA NSOSUTENT 50MG CAP 5 NDS PA NSOTAFINLAR 50MG CAP 5 NDS PA NSO QL=120 EA/30 DaysTAFINLAR 75MG CAP 5 NDS PA NSO QL=120 EA/30 DaysTAGRISSO 40MG TAB 5 NDS PA NSO




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TAGRISSO 80MG TAB 5 NDS PA NSOTALZENNA 0.25MG CAP 5 NDS PA NSO QL=90 EA/30 DaysTALZENNA 1MG CAP 5 NDS PA NSO QL=30 EA/30 DaysTARCEVA 100MG TAB 5 NDS PA NSOTARCEVA 150MG TAB 5 NDS PA NSOTARCEVA 25MG TAB 5 NDS PA NSOTASIGNA 150MG CAP 5 NDS PA NSOTASIGNA 200MG CAP 5 NDS PA NSOTASIGNA 50MG CAP 5 NDS PA NSOTIBSOVO 250MG TAB 5 NDS PA NSO QL=60 EA/30 DaysTYKERB 250MG TAB 5 NDS PA NSOVERZENIO 100MG TAB 5 NDS PA NSO QL=56 EA/28 DaysVERZENIO 150MG TAB 5 NDS PA NSO QL=56 EA/28 DaysVERZENIO 200MG TAB 5 NDS PA NSO QL=56 EA/28 DaysVERZENIO 50MG TAB 5 NDS PA NSO QL=56 EA/28 DaysVITRAKVI 100MG CAP 5 NDS PA NSOVITRAKVI 20MG/ML ORAL SOLN 5 NDS PA NSOVITRAKVI 25MG CAP 5 NDS PA NSOVIZIMPRO 15MG TAB 5 NDS PA NSO QL=30 EA/30 DaysVIZIMPRO 30MG TAB 5 NDS PA NSO QL=30 EA/30 DaysVIZIMPRO 45MG TAB 5 NDS PA NSO QL=30 EA/30 DaysVOTRIENT 200MG TAB 5 NDS PA NSOXALKORI 200MG CAP 5 NDS PA NSO QL=60 EA/30 DaysXALKORI 250MG CAP 5 NDS PA NSO QL=60 EA/30 DaysXOSPATA 40MG TAB 5 NDS PA NSOZEJULA 100MG CAP 5 NDS PA NSO QL=90 EA/30 DaysZELBORAF 240MG TAB 5 NDS PA NSO QL=240 EA/30 DaysZOLINZA 100MG CAP 5 NDS PA NSOZYDELIG 100MG TAB 5 NDS PA NSO QL=60 EA/30 DaysZYDELIG 150MG TAB 5 NDS PA NSO QL=60 EA/30 DaysZYKADIA 150MG CAP 5 NDS PA NSO QL=90 EA/30 DaysZYKADIA 150MG TAB 5 NDS PA NSO QL=150 EA/30 Days

ANTINEOPLASTICS MISC.ACTIMMUNE 2000000UNIT/0.5ML INJ 5 NDS PA NSObexarotene 75mg cap 5 NDS PA NSOHYDREA 500MG CAP 4hydroxyurea 500mg cap 2INTRON A 10MU INJ 3INTRON A 18MU INJ 5 NDSINTRON A 25MU INJ 3INTRON A 50MU INJ 5 NDSINTRON A 6000000UNIT/ML INJ 3




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MATULANE 50MG CAP 5 NDSSYLATRON 200MCG INJ 5 NDS PA NSOSYLATRON 300MCG INJ 5 NDS PA NSOSYLATRON 600MCG INJ 5 NDS PA NSOSYNRIBO 3.5MG INJ 5 NDSTARGRETIN 75MG CAP 5 NDS PA NSOtretinoin 10mg cap 2

CHEMOTHERAPY RESCUE/ANTIDOTE AGENTSLEUCOVORIN 10MG TAB 2LEUCOVORIN 15MG TAB 2leucovorin 25mg tab 2leucovorin 5mg tab 2MESNEX 400MG TAB 3

ANTIPARKINSON AGENTSANTIPARKINSON DOPAMINERGICS

amantadine 100mg cap 2amantadine 10mg/ml oral soln 2bromocriptine 2.5mg tab 2bromocriptine 5mg cap 2carbidopa 10mg/levodopa 100mg odt 2carbidopa 10mg/levodopa 100mg tab 1CARBIDOPA 12.5MG/ENTACAPONE 200MG/LEVODOPA 50MG TAB

2

CARBIDOPA 18.75MG/ENTACAPONE 200MG/LEVODOPA 75MG TAB

2

CARBIDOPA 25MG/ENTACAPONE 200MG/LEVODOPA 100MG TAB

2

carbidopa 25mg/levodopa 100mg er tab 1carbidopa 25mg/levodopa 100mg odt 2carbidopa 25mg/levodopa 100mg tab 1carbidopa 25mg/levodopa 250mg odt 2CARBIDOPA 31.25MG/ENTACAPONE 200MG/LEVODOPA 125MG TAB

2

CARBIDOPA 37.5MG/ENTACAPONE 200MG/LEVODOPA 150MG TAB

2

CARBIDOPA 50MG/ENTACAPONE 200MG/LEVODOPA 200MG TAB

2

carbidopa 50mg/levodopa 200mg er tab 1MIRAPEX 0.125MG TAB 4MIRAPEX 0.25MG TAB 4MIRAPEX 0.375MG ER TAB 4MIRAPEX 0.5MG TAB 4




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MIRAPEX 0.75MG ER TAB 4MIRAPEX 0.75MG TAB 4MIRAPEX 1.5MG ER TAB 4MIRAPEX 1.5MG TAB 4MIRAPEX 1MG TAB 4MIRAPEX 2.25MG ER TAB 4MIRAPEX 3.75MG ER TAB 4MIRAPEX 3MG ER TAB 4MIRAPEX 4.5MG ER TAB 4NEUPRO 1MG/24HR PATCH 4NEUPRO 2MG/24HR PATCH 4NEUPRO 3MG/24HR PATCH 4NEUPRO 4MG/24HR PATCH 4NEUPRO 6MG/24HR PATCH 4NEUPRO 8MG/24HR PATCH 4pramipexole 0.125mg tab 1pramipexole 0.25mg tab 1pramipexole 0.375mg er tab 2pramipexole 0.5mg tab 1pramipexole 0.75mg er tab 2pramipexole 0.75mg tab 1pramipexole 1.5mg er tab 2pramipexole 1.5mg tab 1pramipexole 1mg tab 1pramipexole 2.25mg er tab 2pramipexole 3.75mg er tab 2pramipexole 3mg er tab 2pramipexole 4.5mg er tab 2REQUIP 4MG XL TAB 4REQUIP 8MG XL TAB 4ropinirole 0.25mg tab 1ropinirole 0.5mg tab 1ropinirole 12mg er tab 2ropinirole 2mg er tab 2ropinirole 3mg tab 1ropinirole 4mg er tab 2ropinirole 4mg tab 1ropinirole 5mg tab 1ropinirole 6mg er tab 2ropinirole 8mg er tab 2SINEMET 10-100MG TAB 4SINEMET 25-100MG ER TAB 4




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SINEMET 25-100MG TAB 4SINEMET 25-250MG TAB 4SINEMET 50-200MG ER TAB 4STALEVO 12.5-50-200MG TAB 4STALEVO 18.75-75-200MG TAB 4STALEVO 25-100-200MG TAB 4STALEVO 31.25-125-200MG TAB 4STALEVO 37.5-150-200MG TAB 4STALEVO 50-200-200MG TAB 4

ANTIPARKINSON MONOAMINE OXIDASE INHIBITORSselegiline 5mg cap 2

ANTIPARKINSON AND RELATED THERAPY AGENTSANTIPARKINSON ADJUVANTS

carbidopa 25mg tab 2LODOSYN 25MG TAB 4

ANTIPARKINSON ANTICHOLINERGICSbenztropine mesylate 0.5mg tab 1benztropine mesylate 1mg tab 1benztropine mesylate 2mg tab 1trihexyphenidyl 0.4mg/ml oral soln 2trihexyphenidyl 2mg tab 1trihexyphenidyl 5mg tab 1

ANTIPARKINSON COMT INHIBITORSCOMTAN 200MG TAB 4entacapone 200mg tab 2TASMAR 100MG TAB 4tolcapone 100mg tab 2

ANTIPARKINSON DOPAMINERGICSamantadine 100mg tab 2APOKYN 10MG/ML CARTRIDGE 5 NDScarbidopa 25mg/levodopa 250mg tab 1PARLODEL 2.5MG TAB 4PARLODEL 5MG CAP 4REQUIP 12MG ER TAB 4REQUIP 6MG ER TAB 4ropinirole 1mg tab 1ropinirole 2mg tab 1

ANTIPARKINSON MONOAMINE OXIDASE INHIBITORSAZILECT 0.5MG TAB 4AZILECT 1MG TAB 4rasagiline 0.5mg tab 2rasagiline 1mg tab 2




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selegiline 5mg tab 2ZELAPAR 1.25MG ODT 4

ANTIPSYCHOTICS/ANTIMANIC AGENTSANTIMANIC AGENTS

lithium carbonate 150mg cap 1lithium carbonate 300mg cap 1lithium carbonate 300mg er tab 1lithium carbonate 300mg tab 1lithium carbonate 450mg er tab 1lithium carbonate 600mg cap 1lithium citrate 60mg/ml oral soln 1LITHOBID 300MG ER TAB 4

ANTIPSYCHOTICS - MISC.EQUETRO 100MG ER CAP 4EQUETRO 200MG ER CAP 4EQUETRO 300MG ER CAP 4GEODON 20MG CAP 4GEODON 20MG INJ 4GEODON 40MG CAP 4GEODON 60MG CAP 4GEODON 80MG CAP 4LATUDA 120MG TAB 3 ST_NSO QL=30 EA/30 DaysLATUDA 20MG TAB 3 ST_NSO QL=30 EA/30 DaysLATUDA 40MG TAB 3 ST_NSO QL=30 EA/30 DaysLATUDA 60MG TAB 3 ST_NSO QL=30 EA/30 DaysLATUDA 80MG TAB 3 ST_NSO QL=30 EA/30 DaysNUPLAZID 10MG TAB 4 PA NSO QL=30 EA/30 DaysNUPLAZID 34MG CAP 4 PA NSO QL=30 EA/30 DaysVRAYLAR 1.5/3MG MIXED PACK 4 PA NSO QL=30 EA/30 DaysVRAYLAR 1.5MG CAP 4 PA NSO QL=30 EA/30 DaysVRAYLAR 3MG CAP 4 PA NSO QL=30 EA/30 DaysVRAYLAR 4.5MG CAP 4 PA NSO QL=30 EA/30 DaysVRAYLAR 6MG CAP 4 PA NSO QL=30 EA/30 Daysziprasidone 20mg cap 1ziprasidone 40mg cap 1ziprasidone 60mg cap 1ziprasidone 80mg cap 1

BENZISOXAZOLESFANAPT 10MG TAB 4 PA NSO QL=60 EA/30 DaysFANAPT 12MG TAB 4 PA NSO QL=60 EA/30 DaysFANAPT 1MG TAB 4 PA NSO QL=60 EA/30 DaysFANAPT 2MG TAB 4 PA NSO QL=60 EA/30 Days




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FANAPT 4MG TAB 4 PA NSO QL=60 EA/30 DaysFANAPT 6MG TAB 4 PA NSO QL=60 EA/30 DaysFANAPT 8MG TAB 4 PA NSO QL=60 EA/30 DaysFANAPT TITRATION PACK 4 PA NSO QL=60 EA/30 DaysINVEGA 1.5MG ER TAB 4 PA NSO QL=30 EA/30 DaysINVEGA 117MG/0.75ML SYRINGE 4INVEGA 156MG/ML SYRINGE 4INVEGA 234MG/1.5ML SYRINGE 4INVEGA 273MG/0.875ML SYRINGE 4INVEGA 39MG/0.25ML SYRINGE 4INVEGA 3MG ER TAB 4 PA NSO QL=30 EA/30 DaysINVEGA 410MG/1.315ML SYRINGE 4INVEGA 546MG/1.75ML SYRINGE 4INVEGA 6MG ER TAB 4 PA NSO QL=60 EA/30 DaysINVEGA 78MG/0.5ML SYRINGE 4INVEGA 819MG/2.625ML SYRINGE 4INVEGA 9MG ER TAB 4 PA NSO QL=30 EA/30 Dayspaliperidone 1.5mg er tab 2 PA NSO QL=30 EA/30 Dayspaliperidone 3mg er tab 2 PA NSO QL=30 EA/30 Dayspaliperidone 6mg er tab 2 PA NSO QL=60 EA/30 Dayspaliperidone 9mg er tab 2 PA NSO QL=30 EA/30 DaysPERSERIS 120MG SYRINGE 5 NDSPERSERIS 90MG SYRINGE 5 NDSRISPERDAL 0.25MG TAB 4RISPERDAL 0.5MG TAB 4RISPERDAL 12.5MG INJ 4RISPERDAL 1MG TAB 4RISPERDAL 1MG/ML ORAL SOLN 4RISPERDAL 25MG INJ 4RISPERDAL 2MG TAB 4RISPERDAL 37.5MG INJ 4RISPERDAL 3MG TAB 4RISPERDAL 4MG TAB 4RISPERDAL 50MG INJ 4risperidone 0.25mg odt 2risperidone 0.25mg tab 1risperidone 0.5mg odt 2risperidone 0.5mg tab 1risperidone 1mg odt 2risperidone 1mg tab 1risperidone 1mg/ml oral soln 2risperidone 2mg odt 2




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risperidone 2mg tab 1risperidone 3mg odt 2risperidone 3mg tab 1risperidone 4mg odt 2risperidone 4mg tab 1

BUTYROPHENONESHALDOL 100MG/ML INJ 4HALDOL 50MG/ML INJ 4HALDOL 5MG/ML INJ 4haloperidol 0.5mg tab 1haloperidol 10mg tab 1haloperidol 1mg tab 1haloperidol 20mg tab 1haloperidol 2mg tab 1haloperidol 2mg/ml oral soln 1haloperidol 5mg tab 1haloperidol 5mg/ml inj 2haloperidol decanoate 100mg/ml inj 2haloperidol decanoate 500mg/5ml inj 2haloperidol decanoate 50mg/ml inj 2

DIBENZAPINESclozapine 100mg odt 2clozapine 100mg tab 2clozapine 12.5mg odt 2CLOZAPINE 150MG ODT 4CLOZAPINE 200MG ODT 4clozapine 200mg tab 2clozapine 25mg odt 2clozapine 25mg tab 2clozapine 50mg tab 2CLOZARIL 100MG TAB 4CLOZARIL 25MG TAB 4FAZACLO 100MG ODT 4FAZACLO 12.5MG ODT 4FAZACLO 150MG ODT 4FAZACLO 200MG ODT 4FAZACLO 25MG ODT 4loxapine 10mg cap 2loxapine 25mg cap 2loxapine 50mg cap 2loxapine 5mg cap 2olanzapine 10mg inj 2




64

olanzapine 10mg odt 2olanzapine 10mg tab 1olanzapine 15mg odt 2olanzapine 15mg tab 1olanzapine 2.5mg tab 1olanzapine 20mg odt 2olanzapine 20mg tab 1olanzapine 5mg odt 2olanzapine 5mg tab 1olanzapine 7.5mg tab 1quetiapine 100mg tab 1quetiapine 150mg xr tab 2quetiapine 200mg tab 1quetiapine 200mg xr tab 2quetiapine 25mg tab 1quetiapine 300mg tab 1quetiapine 300mg xr tab 2quetiapine 400mg tab 1quetiapine 400mg xr tab 2quetiapine 50mg tab 1quetiapine 50mg xr tab 2SAPHRIS 10MG SL TAB 4 PA NSO QL=60 EA/30 DaysSAPHRIS 2.5MG SL TAB 4 PA NSO QL=60 EA/30 DaysSAPHRIS 5MG SL TAB 4 PA NSO QL=60 EA/30 DaysSEROQUEL 100MG TAB 4SEROQUEL 150MG XR TAB 4SEROQUEL 200MG TAB 4SEROQUEL 200MG XR TAB 4SEROQUEL 25MG TAB 4SEROQUEL 300MG TAB 4SEROQUEL 300MG XR TAB 4SEROQUEL 400MG TAB 4SEROQUEL 400MG XR TAB 4SEROQUEL 50MG TAB 4SEROQUEL 50MG XR TAB 4VERSACLOZ 50MG/ML SUSP 4ZYPREXA 10MG INJ 4ZYPREXA 10MG ODT 4ZYPREXA 10MG TAB 4ZYPREXA 15MG ODT 4ZYPREXA 15MG TAB 4ZYPREXA 2.5MG TAB 4




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ZYPREXA 20MG ODT 4ZYPREXA 20MG TAB 4ZYPREXA 210MG INJ 4ZYPREXA 5MG ODT 4ZYPREXA 5MG TAB 4ZYPREXA 7.5MG TAB 4

DIHYDROINDOLONESMOLINDONE 10MG TAB 3MOLINDONE 25MG TAB 3MOLINDONE 5MG TAB 3

PHENOTHIAZINESchlorpromazine 100mg tab 2chlorpromazine 10mg tab 2chlorpromazine 200mg tab 2chlorpromazine 25mg tab 2chlorpromazine 50mg tab 2compro 25mg rectal supp 2FLUPHENAZINE 0.5MG/ML ORAL SOLN 2fluphenazine 10mg tab 1fluphenazine 1mg tab 1fluphenazine 2.5mg tab 1FLUPHENAZINE 2.5MG/ML INJ 3fluphenazine 5mg tab 1FLUPHENAZINE 5MG/ML ORAL SOLN 2fluphenazine decanoate 25mg/ml inj 2perphenazine 16mg tab 2perphenazine 2mg tab 2perphenazine 4mg tab 2perphenazine 8mg tab 2prochlorperazine 10mg tab 1prochlorperazine 25mg rectal supp 2prochlorperazine 5mg tab 1thioridazine 100mg tab 2thioridazine 10mg tab 2thioridazine 25mg tab 2thioridazine 50mg tab 2trifluoperazine 10mg tab 2trifluoperazine 1mg tab 2trifluoperazine 2mg tab 2trifluoperazine 5mg tab 2

QUINOLINONE DERIVATIVESABILIFY 10MG TAB 4




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ABILIFY 15MG TAB 4ABILIFY 20MG TAB 4ABILIFY 2MG TAB 4ABILIFY 300MG MAINTENA INJ 5 NDSABILIFY 300MG MAINTENA PF SYRINGE 5 NDSABILIFY 30MG TAB 4ABILIFY 400MG MAINTENA INJ 5 NDSABILIFY 400MG MAINTENA PF SYRINGE 5 NDSABILIFY 5MG TAB 4aripiprazole 10mg odt 2 PA NSO QL=60 EA/30 Daysaripiprazole 10mg tab 1aripiprazole 15mg odt 2 PA NSO QL=60 EA/30 Daysaripiprazole 15mg tab 1aripiprazole 1mg/ml oral soln 2 PA NSOaripiprazole 20mg tab 1aripiprazole 2mg tab 1aripiprazole 30mg tab 1aripiprazole 5mg tab 1ARISTADA 273MG/ML SYRINGE 5ARISTADA 441MG/1.6ML SYRINGE 5 NDSARISTADA 662MG/2.4ML SYRINGE 5 NDSARISTADA 675MG/2.4ML SYRINGE 5 NDSARISTADA 882MG/3.2ML SYRINGE 5REXULTI 0.25MG TAB 4 PA NSO QL=30 EA/30 DaysREXULTI 0.5MG TAB 4 PA NSO QL=30 EA/30 DaysREXULTI 1MG TAB 4 PA NSO QL=30 EA/30 DaysREXULTI 2MG TAB 4 PA NSO QL=30 EA/30 DaysREXULTI 3MG TAB 4 PA NSO QL=30 EA/30 DaysREXULTI 4MG TAB 4 PA NSO QL=30 EA/30 Days

THIOXANTHENESthiothixene 10mg cap 2thiothixene 1mg cap 2thiothixene 2mg cap 2thiothixene 5mg cap 2

ANTIVIRALSANTIRETROVIRALS

abacavir 20mg/ml oral soln 2abacavir 300mg tab 2abacavir 300mg/lamivudine 150mg/zidovudine 300mgtab

2

abacavir 600mg/lamivudine 300mg tab 2APTIVUS 100MG/ML ORAL SOLN 5 NDS




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APTIVUS 250MG CAP 5 NDSatazanavir 150mg cap 2atazanavir 200mg cap 2atazanavir 300mg cap 2ATRIPLA 600-200-300MG TAB 5 NDSBIKTARVY 50-200-25MG TAB 5 NDSCIMDUO 300-300MG TAB 5 NDSCOMBIVIR 150-300MG TAB 5 NDSCOMPLERA 200-25-300MG TAB 5 NDSCRIXIVAN 200MG CAP 3CRIXIVAN 400MG CAP 3DELSTRIGO 100-300-300MG TAB 5 NDSDESCOVY 200-25MG TAB 5 NDSdidanosine 200mg dr cap 2didanosine 250mg dr cap 2didanosine 400mg dr cap 2DOVATO 50-300MG TAB 5 NDSEDURANT 25MG TAB 5 NDSefavirenz 200mg cap 2efavirenz 50mg cap 2efavirenz 600mg cap 2EMTRIVA 10MG/ML ORAL SOLN 3EMTRIVA 200MG CAP 3EPIVIR 10MG/ML ORAL SOLN 4EPIVIR 150MG TAB 4EPIVIR 300MG TAB 4EPZICOM 600-300MG TAB 5 NDSEVOTAZ 300-150MG TAB 5 NDSfosamprenavir 700mg tab 5 NDSFUZEON 90MG INJ 5 NDSGENVOYA 150-150-200-10MG TAB 5 NDSINTELENCE 100MG TAB 5 NDSINTELENCE 200MG TAB 5 NDSINTELENCE 25MG TAB 4INVIRASE 500MG TAB 5 NDSISENTRESS 100MG CHEW TAB 3 NDSISENTRESS 100MG SUSP 3ISENTRESS 25MG CHEW TAB 3ISENTRESS 400MG TAB 3ISENTRESS 600MG TAB 3 NDSJULUCA 50-25MG TAB 5 NDSKALETRA 100-25MG TAB 3




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KALETRA 200-50MG TAB 5 NDSKALETRA 400-100MG/5ML ORAL SOLN 5 NDSlamivudine 10mg/ml oral soln 2lamivudine 150mg tab 2lamivudine 150mg/zidovudine 300mg tab 2lamivudine 300mg tab 2LEXIVA 50MG/ML SUSP 3LEXIVA 700MG TAB 5 NDSlopinavir 80mg/ml/ritonavir 20mg/ml oral solution 5 NDSnevirapine 100mg er tab 2nevirapine 10mg/ml oral susp 2nevirapine 200mg tab 1nevirapine 400mg er tab 2NORVIR 100MG POWDER PACKET 3NORVIR 100MG TAB 4NORVIR 80MG/ML ORAL SOLN 3ODEFSEY 200-25-25MG TAB 5 NDSPIFELTRO 100MG TAB 5 NDSPREZCOBIX 800-150MG TAB 5 NDSPREZISTA 100MG/ML SUSP 3PREZISTA 150MG TAB 3PREZISTA 600MG TAB 5 NDSPREZISTA 75MG TAB 3PREZISTA 800MG TAB 5 NDSRESCRIPTOR 200MG TAB 3RETROVIR 100MG CAP 4RETROVIR 50MG/5ML ORAL SOLN 4REYATAZ 150MG CAP 5 NDSREYATAZ 200MG CAP 5 NDSREYATAZ 300MG CAP 5 NDSREYATAZ 50MG ORAL POWDER 5 NDSritonavir 100mg tab 2SELZENTRY 150MG TAB 5 NDSSELZENTRY 20MG/ML ORAL SOLN 5 NDSSELZENTRY 25MG TAB 4SELZENTRY 300MG TAB 5 NDSSELZENTRY 75MG TAB 5 NDSstavudine 15mg cap 2stavudine 20mg cap 2stavudine 30mg cap 2stavudine 40mg cap 2STRIBILD 150-150-200-300MG TAB 5 NDS




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SUSTIVA 200MG CAP 4SUSTIVA 50MG CAP 4SUSTIVA 600MG TAB 4SYMFI 600-300-300MG TAB 3SYMFI LO 400-300-300MG TAB 3SYMTUZA 800-150-200-10MG TAB 5 NDStenofovir disoproxil fumarate 300mg tab 2TIVICAY 10MG TAB 4TIVICAY 25MG TAB 4TIVICAY 50MG TAB 5 NDSTRIUMEQ 600-50-300MG TAB 5 NDSTRIZIVIR 300-150-300MG TAB 4TRUVADA 100-150MG TAB 5 NDSTRUVADA 133-200MG TAB 5 NDSTRUVADA 167-250MG TAB 5 NDSTRUVADA 200-300MG TAB 5 NDSTYBOST 150MG TAB 3VIDEX 125MG DR CAP 4VIDEX 2GM ORAL SOLN 3VIDEX EC 200MG DR CAP 4VIDEX EC 250MG DR CAP 4VIDEX EC 400MG DR CAP 4VIRACEPT 250MG TAB 5 NDSVIRACEPT 625MG TAB 5 NDSVIRAMUNE 200MG TAB 4VIRAMUNE 400MG XR TAB 4VIRAMUNE 50MG/5ML SUSP 4VIREAD 150MG TAB 5 NDSVIREAD 200MG TAB 5 NDSVIREAD 250MG TAB 5 NDSVIREAD 300MG TAB 5 NDSVIREAD 40MG/GM ORAL POWDER 3ZIAGEN 20MG/ML ORAL SOLN 4ZIAGEN 300MG TAB 4zidovudine 100mg cap 2zidovudine 10mg/ml oral soln 2zidovudine 300mg tab 2

CMV AGENTSPREVYMIS 240MG TAB 5 NDS PA QL=30 EA/30 DaysPREVYMIS 480MG TAB 5 NDS PA QL=30 EA/30 DaysVALCYTE 450MG TAB 5 NDSVALCYTE 50MG/ML ORAL SOLN 5 NDS




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valganciclovir 450mg tab 5 NDSvalganciclovir 50mg/ml oral soln 5 NDS

HEPATITIS AGENTSadefovir dipivoxil 10mg tab 2BARACLUDE 0.5MG TAB 4BARACLUDE 1MG TAB 4entecavir 0.5mg tab 2entecavir 1mg tab 2EPIVIR HBV 100MG TAB 4EPIVIR HBV 5MG/ML ORAL SOLN 3HEPSERA 10MG TAB 4lamivudine 100mg tab 2MAVYRET 100-40MG TAB 5 NDS PA QL=90 EA/30 DaysPEGASYS 180MCG/0.5ML AUTO-INJECTOR 5 NDSPEGASYS 180MCG/0.5ML SYRINGE 5 NDSPEGASYS 180MCG/ML INJ 5 NDSREBETOL 40MG/ML ORAL SOLN 5 NDSribasphere 200mg cap 2ribasphere 600mg tab 5 NDSRIBASPHERE RIBAPAK 1000/DAY 5 NDSribasphere ribapak 1200/day 5 NDSribavirin 200mg cap 2ribavirin 200mg tab 2SOFOSBUVIR/VELPATASVIR 400-100MG TAB 5 NDS PA QL=30 EA/30 DaysVEMLIDY 25MG TAB 5 NDSVOSEVI 400-100-100MG TAB 5 NDS PA QL=30 EA/30 Days

HERPES AGENTSacyclovir 200mg cap 1acyclovir 400mg tab 1acyclovir 40mg/ml susp 2acyclovir 50mg/ml inj 2 PA BvDacyclovir 800mg tab 1famciclovir 125mg tab 2famciclovir 250mg tab 2famciclovir 500mg tab 2valacyclovir 1000mg tab 1valacyclovir 500mg tab 1VALTREX 1GM TAB 4VALTREX 500MG TAB 4ZOVIRAX 200MG CAP 4ZOVIRAX 200MG/5ML SUSP 4ZOVIRAX 800MG TAB 4




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INFLUENZA AGENTSFLUMADINE 100MG TAB 4oseltamivir 30mg cap 2 QL=84 EA/180 Daysoseltamivir 45mg cap 2 QL=42 EA/180 Daysoseltamivir 6mg/ml oral susp 2 QL=540 ML/180 Daysoseltamivir 75mg cap 2 QL=42 EA/180 DaysRELENZA 5MG/BLISTER INH 3 QL=120 EA/30 Daysrimantadine 100mg tab 2TAMIFLU 30MG CAP 4 QL=84 EA/180 DaysTAMIFLU 45MG CAP 4 QL=42 EA/180 DaysTAMIFLU 6MG/ML SUSP 4 QL=540 ML/180 DaysTAMIFLU 75MG CAP 4 QL=42 EA/180 Days

ASSORTED CLASSESIMMUNOSUPPRESSIVE AGENTS

AZASAN 100MG TAB 4 PA BvDAZASAN 75MG TAB 4 PA BvDazathioprine 50mg tab 2 PA BvDCELLCEPT 200MG/ML SUSP 4 PA BvDCELLCEPT 250MG CAP 4 PA BvDCELLCEPT 500MG TAB 4 PA BvDcyclosporine 100mg cap 2 PA BvDcyclosporine 25mg cap 2 PA BvDcyclosporine modified 100mg cap 2 PA BvDcyclosporine modified 25mg cap 2 PA BvDgengraf 100mg cap 2 PA BvDgengraf 100mg/ml oral soln 2 PA BvDgengraf 25mg cap 2 PA BvDmycophenolate mofetil 200mg/ml susp 2 PA BvDmycophenolate mofetil 250mg cap 2 PA BvDmycophenolate mofetil 500mg tab 2 PA BvDmycophenolic acid 180mg dr tab 2 PA BvDmycophenolic acid 360mg dr tab 2 PA BvDMYFORTIC 180MG DR TAB 4 PA BvDMYFORTIC 360MG DR TAB 4 PA BvDNEORAL 100MG CAP 4 PA BvDNEORAL 100MG/ML ORAL SOLN 4 PA BvDNEORAL 25MG CAP 4 PA BvDPROGRAF 0.5MG CAP 4 PA BvDPROGRAF 5MG CAP 4 PA BvDRAPAMUNE 0.5MG TAB 4 PA BvDRAPAMUNE 1MG TAB 4 PA BvDRAPAMUNE 2MG TAB 4 PA BvD




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SANDIMMUNE 100MG CAP 4 PA BvDSANDIMMUNE 100MG/ML ORAL SOLN 4 PA BvDSANDIMMUNE 25MG CAP 4 PA BvDsirolimus 0.5mg tab 2 PA BvDsirolimus 1mg tab 2 PA BvDsirolimus 2mg tab 2 PA BvDtacrolimus 0.5mg cap 1 PA BvDtacrolimus 1mg cap 1 PA BvDtacrolimus 5mg cap 1 PA BvD

POTASSIUM REMOVING RESINSkionex 250mg/ml susp 2sodium polystyrene sulfonate 15gm oral susp 2sodium polystyrene sulfonate 250mg/ml susp 2sps 250mg/ml oral susp 2

BETA BLOCKERSALPHA-BETA BLOCKERS

carvedilol 12.5mg tab 1carvedilol 25mg tab 1carvedilol 3.125mg tab 1carvedilol 6.25mg tab 1 NDScarvedilol 80mg er cap 2carvedilol phosphate 10mg er cap 2carvedilol phosphate 20mg er cap 2carvedilol phosphate 40mg er cap 2COREG 10MG ER CAP 4COREG 12.5MG TAB 4COREG 20MG ER CAP 4COREG 25MG TAB 4COREG 3.125MG TAB 4COREG 40MG ER CAP 4COREG 6.25MG TAB 4COREG 80MG ER CAP 4labetalol 100mg tab 2labetalol 200mg tab 2labetalol 300mg tab 2

BETA BLOCKERS CARDIO-SELECTIVEacebutolol 200mg cap 1acebutolol 400mg cap 1atenolol 100mg tab 1atenolol 25mg tab 1atenolol 50mg tab 1betaxolol 10mg tab 1




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betaxolol 20mg tab 1bisoprolol fumarate 10mg tab 1bisoprolol fumarate 5mg tab 1BYSTOLIC 10MG TAB 3BYSTOLIC 2.5MG TAB 3BYSTOLIC 20MG TAB 3BYSTOLIC 5MG TAB 3LOPRESSOR 100MG TAB 4metoprolol succinate 100mg er tab 1metoprolol succinate 200mg er tab 1metoprolol succinate 25mg er tab 1metoprolol succinate 50mg er tab 1metoprolol tartrate 100mg tab 1metoprolol tartrate 25mg tab 1metoprolol tartrate 50mg tab 1TENORMIN 100MG TAB 4TENORMIN 25MG TAB 4TENORMIN 50MG TAB 4TOPROL 100MG XL TAB 4TOPROL 200MG XL TAB 4TOPROL 25MG XL TAB 4TOPROL 50MG XL TAB 4

BETA BLOCKERS NON-SELECTIVEBETAPACE 120MG TAB 4BETAPACE 160MG TAB 4BETAPACE 80MG TAB 4CORGARD 20MG TAB 4CORGARD 40MG TAB 4CORGARD 80MG TAB 4INDERAL 120MG ER CAP 4INDERAL 160MG ER CAP 4INDERAL 60MG ER CAP 4INDERAL 80MG ER CAP 4INNOPRAN 120MG XL CAP 4INNOPRAN 80MG XL CAP 4nadolol 20mg tab 2nadolol 40mg tab 2nadolol 80mg tab 2pindolol 10mg tab 2pindolol 5mg tab 2propranolol 10mg tab 1propranolol 120mg er cap 2




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propranolol 160mg er cap 2propranolol 20mg tab 1propranolol 40mg tab 1PROPRANOLOL 4MG/ML ORAL SOLN 2propranolol 60mg er cap 2propranolol 60mg tab 1propranolol 80mg er cap 2propranolol 80mg tab 1PROPRANOLOL 8MG/ML ORAL SOLN 2sorine 120mg tab 1sorine 160mg tab 1sorine 240mg tab 1sorine 80mg tab 1sotalol 120mg tab 1sotalol 160mg tab 1sotalol 240mg tab 1sotalol 80mg tab 1sotalol af 120mg tab 1timolol 10mg tab 2timolol 20mg tab 2timolol 5mg tab 2

CALCIUM CHANNEL BLOCKERSCALCIUM CHANNEL BLOCKERS

ADALAT 30MG ER TAB 4ADALAT 60MG ER TAB 4ADALAT 90MG ER TAB 4amlodipine 10mg tab 1amlodipine 2.5mg tab 1amlodipine 5mg tab 1CALAN 120MG SR TAB 4CALAN 120MG TAB 4CALAN 240MG SR TAB 4CARDIZEM 120MG ER CAP 4CARDIZEM 120MG ER TAB 4CARDIZEM 120MG TAB 4CARDIZEM 180MG ER CAP 4CARDIZEM 180MG ER TAB 4CARDIZEM 240MG ER CAP 4CARDIZEM 240MG ER TAB 4CARDIZEM 300MG ER CAP 4CARDIZEM 300MG ER TAB 4CARDIZEM 30MG TAB 4




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CARDIZEM 360MG ER CAP 4CARDIZEM 360MG ER TAB 4CARDIZEM 420MG ER TAB 4CARDIZEM 60MG TAB 4cartia 120mg er cap 2cartia 180mg er cap 2cartia 240mg er cap 2cartia 300mg er cap 2dilt 120mg xr cap 2dilt 180mg xr cap 2dilt 240mg xr cap 2diltiazem 120mg er (12 hr) cap 2diltiazem 120mg er (24 hr) cap 2diltiazem 120mg tab 1diltiazem 180mg er cap 2diltiazem 240mg er cap 2diltiazem 300mg er cap 2diltiazem 30mg tab 1diltiazem 360mg er cap 2diltiazem 420mg er cap 2diltiazem 60mg er cap 2diltiazem 60mg tab 1diltiazem 90mg er cap 2diltiazem 90mg tab 1felodipine 10mg er tab 2felodipine 2.5mg er tab 2felodipine 5mg er tab 2isradipine 2.5mg cap 2isradipine 5mg cap 2matzim 180mg er tab 2matzim 240mg er tab 2matzim 300mg er tab 2matzim 360mg er tab 2matzim 420mg er tab 2nicardipine 20mg cap 2nicardipine 30mg cap 2nifedipine 30mg er tab 2nifedipine 30mg osmotic er tab 2nifedipine 60mg er tab 2nifedipine 60mg osmotic er tab 2nifedipine 90mg er tab 2nifedipine 90mg osmotic er tab 2




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nimodipine 30mg cap 2nisoldipine 17mg er tab 2nisoldipine 20mg er tab 2NISOLDIPINE 25.5MG ER TAB 4nisoldipine 30mg er tab 2nisoldipine 34mg er tab 2nisoldipine 40mg er tab 2nisoldipine 8.5mg er tab 2NORVASC 10MG TAB 4NORVASC 2.5MG TAB 4NORVASC 5MG TAB 4PROCARDIA 30MG XL TAB 4PROCARDIA 60MG XL TAB 4PROCARDIA 90MG XL TAB 4SULAR 17MG ER TAB 4SULAR 34MG ER TAB 4SULAR 8.5MG ER TAB 4taztia 120mg er cap 2taztia 180mg er cap 2taztia 240mg er cap 2taztia 300mg er cap 2taztia 360mg er cap 2TIAZAC 120MG ER CAP 4TIAZAC 180MG ER CAP 4TIAZAC 240MG ER CAP 4TIAZAC 300MG ER CAP 4TIAZAC 360MG ER CAP 4TIAZAC 420MG ER CAP 4verapamil 100mg er cap 2verapamil 120mg er cap 2verapamil 120mg er tab 2verapamil 120mg tab 1verapamil 180mg er cap 2verapamil 180mg er tab 2verapamil 200mg er cap 2verapamil 240mg er cap 2verapamil 240mg er tab 2verapamil 300mg er cap 2VERAPAMIL 360MG SR CAP 2verapamil 40mg tab 1verapamil 80mg tab 1VERELAN 100MG ER CAP 4




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VERELAN 120MG SR CAP 4VERELAN 180MG SR CAP 4VERELAN 200MG ER CAP 4VERELAN 240MG SR CAP 4VERELAN 300MG ER CAP 4VERELAN 360MG SR CAP 4

CARDIOTONICSCARDIAC GLYCOSIDES

digitek 0.125mg tab 2digitek 0.25mg tab 2digox 0.125mg tab 2digox 0.25mg tab 2digoxin 0.05mg/ml oral soln 2digoxin 0.125mg tab 2digoxin 0.25mg tab 2LANOXIN 125MCG TAB 4LANOXIN 250MCG TAB 4

CARDIOVASCULAR AGENTS - MISC.CARDIOVASCULAR AGENTS MISC. - COMBINATIONS

amlodipine 10mg/atorvastatin 10mg tab 2amlodipine 10mg/atorvastatin 20mg tab 2amlodipine 10mg/atorvastatin 40mg tab 2amlodipine 10mg/atorvastatin 80mg tab 2amlodipine 2.5mg/atorvastatin 10mg tab 2amlodipine 2.5mg/atorvastatin 20mg tab 2amlodipine 2.5mg/atorvastatin 40mg tab 2amlodipine 5mg/atorvastatin 10mg tab 2amlodipine 5mg/atorvastatin 20mg tab 2amlodipine 5mg/atorvastatin 40mg tab 2amlodipine 5mg/atorvastatin 80mg tab 2BIDIL 20-37.5MG TAB 3CADUET 10-10MG TAB 4CADUET 10-20MG TAB 4CADUET 10-40MG TAB 4CADUET 10-80MG TAB 4CADUET 5-10MG TAB 4CADUET 5-20MG TAB 4CADUET 5-40MG TAB 4CADUET 5-80MG TAB 4ENTRESTO 24-26MG TAB 3 QL=60 EA/30 DaysENTRESTO 49-51MG TAB 3 QL=60 EA/30 DaysENTRESTO 97-103MG TAB 3 QL=60 EA/30 Days




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PROSTAGLANDIN VASODILATORSORENITRAM 0.125MG ER TAB 4 PAORENITRAM 0.25MG ER TAB 5 NDS PAORENITRAM 1MG ER TAB 5 NDS PAORENITRAM 2.5MG ER TAB 5 NDS PAORENITRAM 5MG ER TAB 5 NDS PAVENTAVIS 10MCG/ML INH SOLN 5 NDS PAVENTAVIS 20MCG/ML INH SOLN 5 NDS PA

PULMONARY HYPERTENSION - ENDOTHELIN RECEPTOR ANTAGONISTSambrisentan 10mg tab 5 NDS PA QL=30 EA/30 Daysambrisentan 5mg tab 5 NDS PA QL=30 EA/30 Daysbosentan 125mg tab 5 NDS PA QL=60 EA/30 Daysbosentan 62.5mg tab 5 NDS PA QL=60 EA/30 DaysOPSUMIT 10MG TAB 5 NDS PA QL=30 EA/30 DaysTRACLEER 125MG TAB 5 NDS PA QL=60 EA/30 DaysTRACLEER 32MG TAB FOR ORAL SUSP 5 NDS PA QL=120 EA/30 DaysTRACLEER 62.5MG TAB 5 NDS PA QL=60 EA/30 Days

PULMONARY HYPERTENSION - PHOSPHODIESTERASE INHIBITORSADCIRCA 20MG TAB 5 NDS PAalyq 20mg tab 2 PAREVATIO 20MG TAB 5 NDS PAsildenafil 20mg tab 2 PAtadalafil 20mg tab(PAH) 2 PA

PULMONARY HYPERTENSION - PROSTACYCLIN RECEPTOR AGONISTUPTRAVI 1000MCG TAB 5 NDS PAUPTRAVI 1200MCG TAB 5 NDS PAUPTRAVI 1400MCG TAB 5 NDS PAUPTRAVI 1600MCG TAB 5 NDS PAUPTRAVI 200MCG TAB 5 NDS PAUPTRAVI 400MCG TAB 5 NDS PAUPTRAVI 600MCG TAB 5 NDS PAUPTRAVI 800MCG TAB 5 NDS PAUPTRAVI TITRATION PACK 5 NDS PA QL=200 EA/28 Days

PULMONARY HYPERTENSION - SOL GUANYLATE CYCLASE STIMULATORADEMPAS 0.5MG TAB 5 NDS PAADEMPAS 1.5MG TAB 5 NDS PAADEMPAS 1MG TAB 5 NDS PAADEMPAS 2.5MG TAB 5 NDS PAADEMPAS 2MG TAB 5 NDS PA

SINUS NODE INHIBITORSCORLANOR 5MG TAB 4 PACORLANOR 7.5MG TAB 4 PA




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CEPHALOSPORINSCEPHALOSPORIN COMBINATIONS

AVYCAZ 2-0.5GM INJ 5 NDSZERBAXA 1.5GM INJ 5 NDS

CEPHALOSPORINS - 1ST GENERATIONcefadroxil 1000mg tab 2cefadroxil 100mg/ml susp 2cefadroxil 500mg cap 1cefadroxil 50mg/ml susp 2cefazolin 1gm inj 2cefazolin 200mg/ml inj 2cefazolin 500mg inj 2cephalexin 250mg cap 1cephalexin 25mg/ml susp 1cephalexin 500mg cap 1cephalexin 50mg/ml susp 1

CEPHALOSPORINS - 2ND GENERATIONcefaclor 250mg cap 2CEFACLOR 25MG/ML SUSP 2cefaclor 500mg cap 2CEFACLOR 500MG ER TAB 4CEFACLOR 50MG/ML SUSP 2CEFACLOR 75MG/ML SUSP 2cefotetan 1000mg inj 2cefotetan 2000mg inj 2cefoxitin 1000mg inj 2cefoxitin 2000mg inj 2cefoxitin 200mg/ml inj 2cefprozil 250mg tab 1cefprozil 25mg/ml susp 1cefprozil 500mg tab 1cefprozil 50mg/ml susp 1cefuroxime 1.5gm inj 2cefuroxime 250mg tab 2cefuroxime 500mg tab 2cefuroxime 750mg inj 2cefuroxime 95mg/ml inj 2

CEPHALOSPORINS - 3RD GENERATIONcefdinir 25mg/ml susp 1cefdinir 300mg cap 1cefdinir 50mg/ml susp 1cefixime 20mg/ml susp 2




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cefixime 40mg/ml susp 2cefpodoxime 100mg tab 2cefpodoxime 10mg/ml susp 2cefpodoxime 200mg tab 2cefpodoxime 20mg/ml susp 2ceftazidime 1000mg inj 2ceftazidime 2000mg inj 2ceftazidime 200mg/ml inj 2ceftriaxone 1000mg inj 2ceftriaxone 100mg/ml inj 2ceftriaxone 2000mg inj 2ceftriaxone 250mg inj 2ceftriaxone 500mg inj 2SUPRAX 100MG CHEW TAB 4SUPRAX 100MG/5ML SUSP 4SUPRAX 200MG CHEW TAB 4SUPRAX 200MG/5ML SUSP 4SUPRAX 400MG CAP 4SUPRAX 500MG/5ML SUSP 4tazicef 1gm inj 2tazicef 2gm inj 2tazicef 6gm inj 2

CEPHALOSPORINS - 4TH GENERATIONcefepime 1gm inj 2cefepime 2gm inj 2MAXIPIME 1GM INJ 4MAXIPIME 2GM INJ 4

CEPHALOSPORINS - 5TH GENERATIONTEFLARO 400MG INJ 5 NDSTEFLARO 600MG INJ 5 NDS

CONTRACEPTIVESCOMBINATION CONTRACEPTIVES - ORAL

altavera 28 day pack 2alyacen 1/35 28 day pack 2amethia 91 day pack 2amethia lo 91 day pack 2apri 28 day pack 2aranelle 28 pack 2ashlyna 91 day pack 2aubra 28 day pack 2aviane 28 pack 2balziva 28 day pack 2




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blisovi 21 fe 1.5/30 28 day 2blisovi 24 fe 1/20 28 day pack 2briellyn 28 day pack 2camrese lo 91 day pack 2caziant 28 day pack 2cryselle 28 pack 2cyclafem 1/35 28 day pack 2cyclafem 7/7/7 28 day pack 2cyred 28 day pack 2delyla 28 day pack 2desogestrel/ethinyl estradiol 28 day pack 2desogestrel/ethinyl estradiol pack 2drospirenone 3mg/ethinyl estradiol 0.02mg/inert 1 mgpack

2

drospirenone 3mg/ethinyl estradiol 0.03mg/inertingredients 1mg pack

2

emoquette pack 2enpresse 28 day pack 2enskyce 28 day pack 2estarylla 28 day pack 2ethinyl estradiol 0.01mg/ethinyl estradiol 0.02mg/levonorgestrel 0.1mg 91 day pack

2

ethinyl estradiol 0.01mg/ethinyl estradiol 0.03mg/levonorgestrel 0.15mg pack

2

ethinyl estradiol 0.025mg/ferrous fumarate 75mg/norethindrone 0.8mg pack

2

ethinyl estradiol 0.025mg/inert/norgestimate0.18mg/0.215mg/0.25mg pack

2

ethinyl estradiol 0.02mg/ferrous fumarate 75mg/norethindrone acetate 1mg pack

2

ethinyl estradiol 0.02mg/inert ingredients 1mg/levonorgestrel 0.1mg pack

2

ethinyl estradiol 0.02mg/levonorgestrel 0.09mg pack 2ethinyl estradiol 0.02mg/norethindrone 1mg 21 day pack 2ethinyl estradiol 0.02mg/norethindrone acetate 1mg/ferrous fumarate 75mg chewable 28 day pack

2

ethinyl estradiol 0.035mg/ethynodiol 1mg 28 day pack 2ethinyl estradiol 0.035mg/ferrous fumarate 75mg/norethindrone 0.4mg pack

2

ethinyl estradiol 0.035mg/inert/norgestimate0.18mg/0.215mg/0.25mg pack

2

ethinyl estradiol 0.035mg/norgestimate 0.25mg pack 2




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ethinyl estradiol 0.03mg/0.04mg /inert/levonorgestrel0.05mg/ 0.075mg pack

2

ethinyl estradiol 0.03mg/inert ingredients 1mg/levonorgestrel 0.15mg pack

2

ethinyl estradiol 0.03mg/levonorgestrel 0.15mg tab 28day pack

2

ethinyl estradiol 0.05mg/ethynodiol 1mg/inertingredients 1mg 28 day pack

2

ethinyl estradiol/levonorgestrel 91 day pack 2falmina 28 day pack 2fayosim 91 day pack 2femynor 28 day pack 2GENERESS FE 28 PACK 4gianvi 28-day pack 2hailey 24 fe 28 day pack 2introvale 91 day pack 2isibloom 28 day pack 2jasmiel 28 day pack 2juleber 28 day pack 2junel 1.5/30 21 day pack 2junel 1/20 21 day pack 2junel fe 1.5/30 28 day pack 2junel fe 1/20 28 day pack 2junel fe 24 1/20 28 day pack 2kaitlib fe 28 day pack 2kariva 28 day pack 2kelnor 1/35 28 day pack 2kelnor 1/50 28 day pack 2kurvelo 28 day pack 2larin 1.5/30 pack 2larin 1/20 pack 2larin fe 1.5/30 pack 2larin fe 1/20 pack 2larissia 28 day pack 2layolis fe 28 pack 2leena 28 day pack 2lessina 28 day pack 2levonest 28 day pack 2levora 0.15/30 28 day pack 2LO LOESTRIN FE 28 DAY PACK 4LOESTRIN 1.5/30 21 DAY PACK 4LOESTRIN 1/20 21 DAY PACK 4




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LOESTRIN FE 1.5/30 28 DAY PACK 4LOESTRIN FE 1/20 28 DAY PACK 4loryna 28 day pack 2LOSEASONIQUE PACK 4low-ogestrel 28 day pack 2lutera 28 day pack 2marlissa 28 day pack 2melodetta 24 fe chewable 28 day pack 2mibelas 24 fe chewable 28 day pack 2microgestin 1.5/30 21 day pack 2microgestin 1/20 21 day pack 2microgestin fe 1.5/30 28 day pack 2microgestin fe 1/20 28 day pack 2mili 28 day pack 2MINASTRIN 24 FE CHEWABLE 28 DAY PACK 4mononessa 28 day pack 2NATAZIA 28 DAY PACK 4necon 0.5/35 28 day pack 2nikki 28 day pack 2nortrel 0.5/35 28 day pack 2nortrel 1/35 21 day pack 2nortrel 1/35 28 day pack 2nortrel 7/7/7 28 day pack 2ocella 28 day pack 2OGESTREL 28 DAY PACK 4orsythia 28 day pack 2ORTHO TRI-CYCLEN LO 28 DAY PACK 4ORTHO-NOVUM 1/35 28 DAY PACK 4ORTHO-NOVUM 7/7/7 28 DAY PACK 4pimtrea pack 2pirmella 1/35 28 day pack 2portia 28 day pack 2previfem 28 day pack 2QUARTETTE 91 DAY PACK 4reclipsen 28 day pack 2rivelsa 91 day pack 2SAFYRAL 28 DAY PACK 4SEASONIQUE PACK 4setlakin 91 day pack 2sprintec 28 day pack 2sronyx 28 day pack 2syeda 28 day pack 2




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tarina 24 fe 1/20 28 day pack 2tarina fe 1/20 28 day pack 2tri-estarylla 28 day pack 2tri-legest 28 day pack 2tri-lo-estarylla 28 day pack 2tri-lo-sprintec 28 day pack 2tri-mili 28 day pack 2tri-previfem 28 day pack 2tri-sprintec 28 day pack 2tri-vylibra 28 day pack 2tri-vylibra lo 28 day pack 2trivora 28 day pack 2tydemy 28 day pack 2velivet 28 day pack 2vienva 28 day pack 2vyfemla 28 day pack 2vylibra 28 day pack 2wymzya fe 28 day pack 2YASMIN 28 DAY PACK 4YAZ 28 DAY PACK 4zarah 3-0.03mg pack 2zovia 1/35e 28 day pack 2

COMBINATION CONTRACEPTIVES - TRANSDERMALXULANE 150-35MCG PATCH 3

COMBINATION CONTRACEPTIVES - VAGINALNUVARING VAGINAL RING 3

PROGESTIN CONTRACEPTIVES - INJECTABLEDEPO-PROVERA 150MG/ML INJ 4medroxyprogesterone acetate 150mg/ml inj 2medroxyprogesterone acetate 150mg/ml syringe 2

PROGESTIN CONTRACEPTIVES - ORALcamila 28 day 0.35mg pack 2deblitane 28 day 0.35mg pack 2errin 28 day 0.35mg pack 2incassia 28 day 0.35mg pack 2jolivette 28 day 0.35mg pack 2lyza 0.35mg pack 2nora-be 28 day 0.35mg pack 2norethindrone 0.35mg pack 2norlyroc 28 day 0.35mg pack 2ORTHO MICRONOR 28 DAY 0.35MG PACK 4sharobel 28 day 0.35mg pack 2




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CORTICOSTEROIDSGLUCOCORTICOSTEROIDS

budesonide 3mg dr cap 2budesonide 9mg er tab 2 PA QL=30 EA/30 DaysCORTEF 10MG TAB 4CORTEF 20MG TAB 4CORTEF 5MG TAB 4CORTISONE ACETATE 25MG TAB 4dexamethasone 0.1mg/ml oral soln 2dexamethasone 0.5mg tab 1dexamethasone 0.75mg tab 1dexamethasone 1.5mg tab 1DEXAMETHASONE 1MG TAB 2DEXAMETHASONE 1MG/ML ORAL SOLN 2DEXAMETHASONE 2MG TAB 2dexamethasone 4mg tab 1dexamethasone 6mg tab 1ENTOCORT 3MG DR CAP 4hydrocortisone 10mg tab 1hydrocortisone 20mg tab 1hydrocortisone 5mg tab 1MEDROL 16MG TAB 4 PA BvDMEDROL 2MG TAB 3 PA BvDMEDROL 32MG TAB 4 PA BvDMEDROL 4MG TAB 4 PA BvDMEDROL 8MG TAB 4 PA BvDMEDROL DOSEPAK 4MG PACK 4methylprednisolone 16mg tab 2 PA BvDmethylprednisolone 32mg tab 2 PA BvDmethylprednisolone 4mg pack 2methylprednisolone 4mg tab 2 PA BvDmethylprednisolone 8mg tab 2 PA BvDMILLIPRED 5MG TAB 4 PA BvDORAPRED 10MG ODT 4 PA BvDORAPRED 15MG ODT 4 PA BvDORAPRED 30MG ODT 4 PA BvDprednisolone 10mg odt 2 PA BvDprednisolone 15mg odt 2 PA BvDprednisolone 1mg/ml oral soln 2 PA BvDprednisolone 2mg/ml oral soln 2 PA BvDprednisolone 30mg odt 2 PA BvDPREDNISOLONE 3MG/ML ORAL SOLN 2 PA BvD




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prednisolone 4mg/ml oral soln 2 PA BvDPREDNISOLONE 5MG/ML ORAL SOLN 4 PA BvDprednisone 10mg tab 1 PA BvDprednisone 1mg tab 1 PA BvDPREDNISONE 1MG/ML ORAL SOLN 2 PA BvDprednisone 2.5mg tab 1 PA BvDprednisone 20mg tab 1 PA BvDPREDNISONE 50MG TAB 1 PA BvDprednisone 5mg tab 1 PA BvDPREDNISONE 5MG/ML ORAL SOLN 3 PA BvDUCERIS 9MG ER TAB 4 PA QL=30 EA/30 Days

MINERALOCORTICOIDSfludrocortisone 0.1mg tab 2

COUGH/COLD/ALLERGYCOUGH/COLD/ALLERGY COMBINATIONS

CLARINEX-D 2.5-120MG ER TAB 4PHENYLEPHRINE 1MG/ML/PROMETHAZINE1.25MG/ML ORAL SOLN

2

MUCOLYTICSacetylcysteine 10% inh soln 2 PA BvDacetylcysteine 20% inh soln 2 PA BvD

DERMATOLOGICALSACNE PRODUCTS

ACANYA 1.2-2.5% GEL 4adapalene 0.1% cream 2 PAadapalene 0.1% gel 2 PAadapalene 0.3% gel 2 PAadapalene/benzoyl peroxide 0.1-2.5% gel 2 PAamnesteem 10mg cap 2amnesteem 20mg cap 2amnesteem 40mg cap 2ATRALIN 0.05% GEL 4 PAavita 0.025% cream 2 PAavita 0.025% gel 2 PAAZELEX 20% CREAM 4 PABENZACLIN 1-5% GEL 4BENZAMYCIN 5-3% GEL 4benzoyl peroxide 5%/clindamycin phosphate 1.2%topical gel

2

claravis 10mg cap 2claravis 20mg cap 2claravis 30mg cap 2




87

claravis 40mg cap 2CLEOCIN-T 1% GEL 4CLEOCIN-T 1% LOTION 4CLEOCIN-T 1% PAD 4clindacin 1% pad 2clindamycin 1% foam 2clindamycin 1% gel 2clindamycin 1% lotion 2clindamycin 1% pad 2clindamycin 1% topical soln 2 QL=300 ML/30 Daysclindamycin phosphate 1.2%/tretinoin 0.025% topicalgel

2

clindamycin/benzoyl peroxide 1-5% gel 2clindamycin/benzoyl peroxide 1.2-2.5% gel 2DIFFERIN 0.1% CREAM 4 PADIFFERIN 0.1% GEL 4 PADIFFERIN 0.1% LOTION 4 PADIFFERIN 0.3% GEL 4 PADUAC 1.2-5% GEL 4EPIDUO 0.1-2.5% GEL 4 PAEPIDUO 0.3-2.5% GEL 4 PAery 2% pad 2ERYGEL 2% GEL 4erythromycin 2% gel 2erythromycin 2% topical soln 2erythromycin/benzoyl peroxide 5-3% gel 2EVOCLIN 1% FOAM 4isotretinoin 10mg cap 2isotretinoin 20mg cap 2isotretinoin 30mg cap 2isotretinoin 40mg cap 2KLARON 10% LOTION 4myorisan 10mg cap 2myorisan 20mg cap 2myorisan 30mg cap 2myorisan 40mg cap 2neuac 1.2-5% gel 2ONEXTON 1.2-3.75% GEL 4RETIN-A 0.01% GEL 4 PARETIN-A 0.025% CREAM 4 PARETIN-A 0.025% GEL 4 PARETIN-A 0.04% GEL 4 PA




88

RETIN-A 0.05% CREAM 4 PARETIN-A 0.1% CREAM 4 PARETIN-A 0.1% GEL 4 PAsulfacetamide sodium 10% lotion 2tretinoin 0.01% gel 2 PAtretinoin 0.025% cream 2 PAtretinoin 0.025% gel 2 PAtretinoin 0.04% gel 2 PAtretinoin 0.05% cream 2 PAtretinoin 0.05% gel 2 PAtretinoin 0.1% cream 2 PAtretinoin 0.1% gel 2 PAzenatane 10mg cap 2zenatane 20mg cap 2zenatane 30mg cap 2zenatane 40mg cap 2ZIANA 1.2-0.025% GEL 4

ANTI-INFLAMMATORY AGENTS - TOPICALDICLOFENAC EPOLAMINE 1.3% PATCH 4 PA QL=60 EA/30 Daysdiclofenac sodium 1% gel 2 QL=1000 GM/30 DaysFLECTOR 1.3% PATCH 4 PA QL=60 EA/30 DaysVOLTAREN 1% GEL 4 QL=1000 GM/30 Days

ANTIBIOTICS - TOPICALCORTISPORIN 0.5% CREAM 4CORTISPORIN 1% OINTMENT 4gentamicin sulfate 0.1% cream 2gentamicin sulfate 0.1% ointment 2mupirocin 2% ointment 1 QL=220 GM/30 Days

ANTIFUNGALS - TOPICALbetamethasone/clotrimazole 1-0.05% cream 2betamethasone/clotrimazole 1-0.05% lotion 2ciclopirox 0.77% cream 2ciclopirox 0.77% gel 2ciclopirox 0.77% lotion 2ciclopirox 1% shampoo 2ciclopirox 8% topical soln 2clotrimazole 1% cream 2clotrimazole 1% topical soln 2econazole nitrate 1% cream 2ERTACZO 2% CREAM 4EXELDERM 1% CREAM 4EXELDERM 1% TOPICAL SOLN 4




89

EXTINA 2% FOAM 4ketoconazole 2% cream 2ketoconazole 2% shampoo 1ketoconazole 20mg/ml foam 2LOPROX 0.77% CREAM 4LOPROX 1% SHAMPOO 4LOTRISONE 1-0.05% CREAM 4MENTAX 1% CREAM 4naftifine 1% cream 2naftifine 2% cream 2NAFTIN 1% GEL 4NAFTIN 2% CREAM 4NAFTIN 2% GEL 4NIZORAL 2% SHAMPOO 4nyamyc 100000unit/gm powder 2nystatin 100000unit/ml cream 2nystatin 100unit/mg ointment 2nystatin 100unit/mg powder 2nystop 100000unit/gm powder 2oxiconazole 1% cream 2 QL=270 GM/30 DaysOXISTAT 1% CREAM 4 QL=270 GM/30 DaysOXISTAT 1% LOTION 4

ANTINEOPLASTIC OR PREMALIGNANT LESION AGENTS - TOPICALCARAC 0.5% CREAM 4diclofenac sodium 3% gel 2 PA QL=300 GM/30 DaysEFUDEX 5% CREAM 4FLUOROURACIL 0.5% CREAM 3FLUOROURACIL 2% TOPICAL SOLN 3fluorouracil 5% cream 1FLUOROURACIL 5% TOPICAL SOLN 3PANRETIN 0.1% GEL 5 NDSPICATO 0.015% GEL 5 NDS QL=3 EA/10 DaysPICATO 0.05% GEL 5 NDS QL=2 EA/10 DaysTARGRETIN 1% GEL 5 NDS PA NSOTOLAK 4% CREAM 4VALCHLOR 0.016% GEL 5 NDS PA NSO QL=240 GM/30 Days

ANTIPSORIATICSacitretin 10mg cap 2acitretin 17.5mg cap 2acitretin 25mg cap 2calcipotriene 0.005% cream 2 QL=240 GM/30 Dayscalcipotriene 0.005% ointment 2 QL=240 GM/30 Days




90

calcipotriene 0.005% topical soln 2CALCITRIOL 3MCG/GM OINTMENT 4COSENTYX 150MG/ML AUTO-INJECTOR 5 NDS PACOSENTYX 150MG/ML SYRINGE 5 NDS PADOVONEX 0.005% CREAM 4 QL=240 GM/30 Daysmethoxsalen 10mg cap 2OXSORALEN-ULTRA 10MG CAP 4SKYRIZI SYRINGE 150MG DOSE PACK 5 NDS PASORIATANE 10MG CAP 4SORIATANE 25MG CAP 4SORILUX 0.005% FOAM 4STELARA 45MG/0.5ML INJ 5 PASTELARA 45MG/0.5ML SYRINGE 5 PASTELARA 90MG/ML SYRINGE 5 PAtazarotene 1% cream 2TAZORAC 0.05% CREAM 4TAZORAC 0.05% GEL 4TAZORAC 0.1% CREAM 4TAZORAC 0.1% GEL 4

ANTISEBORRHEIC PRODUCTSselenium sulfide 2.5% lotion/shampoo 1

ANTIVIRALS - TOPICALacyclovir 5% cream 2acyclovir 5% ointment 2DENAVIR 1% CREAM 4XERESE 5-1% CREAM 4ZOVIRAX 5% CREAM 4ZOVIRAX 5% OINTMENT 4

BURN PRODUCTSmafenide 5% topical soln 2SILVADENE 1% CREAM 4silver sulfadiazine 1% cream 2ssd 1% cream 2SULFAMYLON 5% TOPICAL SOLN 4SULFAMYLON 85MG/GM CREAM 3

CORTICOSTEROIDS - TOPICALala-cort 1% cream 2ala-cort 2.5% cream 2alclometasone dipropionate 0.05% cream 2alclometasone dipropionate 0.05% ointment 2AMCINONIDE 0.1% CREAM 4 PAAMCINONIDE 0.1% LOTION 4




91

AMCINONIDE 0.1% OINTMENT 4 PAAPEXICON 0.05% CREAM 4 PAbeser 0.05% lotion 2 PAbetamethasone 0.05% aug cream 2BETAMETHASONE 0.05% AUG GEL 2betamethasone 0.05% aug lotion 2betamethasone 0.05% aug ointment 2betamethasone 0.05% cream 2betamethasone 0.05% lotion 2betamethasone 0.05% ointment 2betamethasone 0.1% cream 2betamethasone 0.1% lotion 2betamethasone 0.1% ointment 2betamethasone valerate 0.12% foam 2 PAcalcipotriene/betamethasone 0.005-0.064% ointment 2 QL=420 GM/30 DaysCAPEX 0.01% SHAMPOO 4clobetasol propionate 0.05% cream 2clobetasol propionate 0.05% e cream 2clobetasol propionate 0.05% e foam 2 PAclobetasol propionate 0.05% foam 2 PAclobetasol propionate 0.05% gel 2clobetasol propionate 0.05% lotion 2 PAclobetasol propionate 0.05% ointment 2clobetasol propionate 0.05% shampoo 2 PAclobetasol propionate 0.05% spray 2 PAclobetasol propionate 0.05% topical soln 1 QL=450 ML/30 DaysCLOBEX 0.05% LOTION 4 PACLOBEX 0.05% SHAMPOO 4 PACLOBEX 0.05% SPRAY 4 PAclodan 0.05% shampoo 2 PACORDRAN 4MCG/SQCM TAPE 4CUTIVATE 0.05% LOTION 4 PADESONATE 0.05% GEL 4 PAdesonide 0.05% cream 2 PAdesonide 0.05% lotion 2 PAdesonide 0.05% ointment 2DESOWEN 0.05% CREAM 4 PADESOWEN 0.05% LOTION 4 PAdesoximetasone 0.05% cream 2desoximetasone 0.05% gel 2desoximetasone 0.05% ointment 2desoximetasone 0.25% cream 2




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desoximetasone 0.25% ointment 2DIPROLENE 0.05% AUG OINTMENT 4ELOCON 0.1% CREAM 4ELOCON 0.1% OINTMENT 4fluocinolone acetonide 0.01% cream 2fluocinolone acetonide 0.01% topical soln 2fluocinolone acetonide 0.025% cream 2fluocinolone acetonide 0.025% ointment 2fluocinolone acetonide 0.1mg/ml oil 2fluocinonide 0.05% e cream 2fluocinonide 0.05% gel 2fluocinonide 0.05% ointment 2fluocinonide 0.05% topical soln 2flurandrenolide 0.05% cream 2flurandrenolide 0.05% lotion 2fluticasone propionate 0.005% ointment 2fluticasone propionate 0.05% cream 2fluticasone propionate 0.05% lotion 2 PAhalobetasol propionate 0.05% cream 2halobetasol propionate 0.05% ointment 2hydrocortisone 1% cream 2hydrocortisone 2.5% cream 2hydrocortisone 2.5% lotion 2hydrocortisone 2.5% ointment 2hydrocortisone valerate 0.2% cream 2hydrocortisone valerate 0.2% ointment 2KENALOG 0.147MG/GM SPRAY 4mometasone furoate 0.1% cream 2mometasone furoate 0.1% lotion 2mometasone furoate 0.1% ointment 2nolix 0.05% cream 2nolix 0.05% topical lotion 2OLUX 0.05% E FOAM 4 PAOLUX 0.05% FOAM 4 PAPANDEL 0.1% CREAM 4 PAPREDNICARBATE 0.1% CREAM 3PREDNICARBATE 0.1% OINTMENT 3TACLONEX 0.005-0.064% LOTION 4 QL=420 GM/30 DaysTACLONEX 0.005-0.064% OINTMENT 4 QL=420 GM/30 DaysTOPICORT 0.05% CREAM 4TOPICORT 0.05% GEL 4 PATOPICORT 0.05% OINTMENT 4 PA




93

TOPICORT 0.25% CREAM 4TOPICORT 0.25% OINTMENT 4 PAtriamcinolone acetonide 0.025% cream 2triamcinolone acetonide 0.025% lotion 2triamcinolone acetonide 0.025% ointment 2triamcinolone acetonide 0.1% cream 2triamcinolone acetonide 0.1% lotion 2triamcinolone acetonide 0.1% ointment 2triamcinolone acetonide 0.147mg/ml spray 2triamcinolone acetonide 0.5% cream 2triamcinolone acetonide 0.5% ointment 2triderm 0.1% cream 2TRIDESILON 0.05% CREAM 4 PAULTRAVATE 0.05% CREAM 4ULTRAVATE 0.05% OINTMENT 4

ECZEMA AGENTSDUPIXENT 300MG/2ML PF SYRINGE 5 NDS PA

EMOLLIENTSammonium lactate 12% cream 2ammonium lactate 12% lotion 2

ENZYMES - TOPICALSANTYL 250UNIT/GM OINTMENT 3 QL=90 GM/30 Days

IMMUNOMODULATING AGENTS - TOPICALALDARA 5% CREAM 4IMIQUIMOD 3.75% CREAM 4imiquimod 5% cream 2ZYCLARA 2.5% CREAM 4ZYCLARA 3.75% CREAM 4

IMMUNOSUPPRESSIVE AGENTS - TOPICALELIDEL 1% CREAM 4pimecrolimus 1% cream 2PROTOPIC 0.03% OINTMENT 4 QL=100 GM/30 DaysPROTOPIC 0.1% OINTMENT 4 QL=100 GM/30 Daystacrolimus 0.03% ointment 2 QL=100 GM/30 Daystacrolimus 0.1% ointment 2 QL=100 GM/30 Days

KERATOLYTIC/ANTIMITOTIC AGENTSCONDYLOX 0.5% GEL 4podofilox 0.5% topical soln 2

LOCAL ANESTHETICS - TOPICALlidocaine 2% gel 2lidocaine 4% topical soln 2lidocaine 5% ointment 2 PA QL=107 GM/30 Days




94

lidocaine 5% patch 2 PA QL=90 EA/30 Dayslidocaine/prilocaine 2.5-2.5% cream 2 QL=60 GM/30 DaysLIDODERM 5% PATCH 4 PA QL=90 EA/30 Days

ROSACEA AGENTSazelaic acid 15% gel 2FINACEA 15% FOAM 3FINACEA 15% GEL 4METROCREAM 0.75% CREAM 4METROGEL 1% GEL 4METROLOTION 0.75% LOTION 4metronidazole 0.75% cream 2metronidazole 0.75% gel 2metronidazole 0.75% lotion 2metronidazole 1% gel 2

SCABICIDES & PEDICULICIDESELIMITE 5% CREAM 4EURAX 10% CREAM 4EURAX 10% LOTION 4lindane 1% shampoo 2malathion 0.5% lotion 2OVIDE 0.5% LOTION 4permethrin 5% cream 2SKLICE 0.5% LOTION 4 QL=117 GM/15 Days

WOUND CARE PRODUCTSREGRANEX 0.01% GEL 5 NDS QL=30 GM/15 Days

DIGESTIVE AIDSDIGESTIVE ENZYMES

CREON 12000-38000-60000UNIT DR CAP 3CREON 24000-76000-120000UNIT DR CAP 3CREON 3000-9500-15000UNIT DR CAP 3CREON 36000-114000-180000UNIT DR CAP 3CREON 6000-19000-30000UNIT DR CAP 3SUCRAID 8500UNIT/ML ORAL SOLN 5 NDS PAZENPEP 10000-32000-42000UNIT DR CAP 4 STZENPEP 15000-47000-63000UNIT DR CAP 4 STZENPEP 20000-63000-84000UNIT DR CAP 4 STZENPEP 25000-79000-105000UNIT DR CAP 4 STZENPEP 3000-10000-14000UNIT DR CAP 4 STZENPEP 40000-126000-168000UNIT DR CAP 4 STZENPEP 5000-17000-24000UNIT DR CAP 4 ST

DIURETICSCARBONIC ANHYDRASE INHIBITORS




95

acetazolamide 125mg tab 2acetazolamide 250mg tab 2acetazolamide 500mg er cap 2methazolamide 25mg tab 2methazolamide 50mg tab 2

DIURETIC COMBINATIONSALDACTAZIDE 25-25MG TAB 4ALDACTAZIDE 50-50MG TAB 4amiloride 5mg/hydrochlorothiazide 50mg tab 1DYAZIDE 37.5-25MG CAP 4hydrochlorothiazide 25mg/spironolactone 25mg tab 2hydrochlorothiazide 25mg/triamterene 37.5mg cap 1hydrochlorothiazide 25mg/triamterene 37.5mg tab 1hydrochlorothiazide 50mg/triamterene 75mg tab 1MAXZIDE 37.5-25MG TAB 4MAXZIDE 75-50MG TAB 4

LOOP DIURETICSbumetanide 0.25mg/ml inj 2bumetanide 0.5mg tab 2bumetanide 1mg tab 2bumetanide 2mg tab 2EDECRIN 25MG TAB 4ethacrynic acid 25mg tab 2furosemide 10mg/ml inj 2furosemide 10mg/ml oral soln 2furosemide 10mg/ml syringe 2furosemide 20mg tab 1furosemide 40mg tab 1furosemide 80mg tab 1FUROSEMIDE 8MG/ML ORAL SOLN 2LASIX 20MG TAB 4LASIX 40MG TAB 4LASIX 80MG TAB 4torsemide 100mg tab 1torsemide 10mg tab 1torsemide 20mg tab 1torsemide 5mg tab 1

POTASSIUM SPARING DIURETICSALDACTONE 100MG TAB 4ALDACTONE 25MG TAB 4ALDACTONE 50MG TAB 4amiloride 5mg tab 1




96

DYRENIUM 100MG CAP 3DYRENIUM 50MG CAP 3spironolactone 100mg tab 1spironolactone 25mg tab 1spironolactone 50mg tab 1

THIAZIDES AND THIAZIDE-LIKE DIURETICSCHLOROTHIAZIDE 250MG TAB 2chlorothiazide 500mg tab 2chlorthalidone 25mg tab 2chlorthalidone 50mg tab 2DIURIL 250MG/5ML SUSP 3hydrochlorothiazide 12.5mg cap 1hydrochlorothiazide 12.5mg tab 1hydrochlorothiazide 25mg tab 1hydrochlorothiazide 50mg tab 1indapamide 1.25mg tab 1indapamide 2.5mg tab 1METHYCLOTHIAZIDE 5MG TAB 3metolazone 10mg tab 2metolazone 2.5mg tab 2metolazone 5mg tab 2

ENDOCRINE AND METABOLIC AGENTS - MISC.BONE DENSITY REGULATORS

ACTONEL 150MG TAB 4ACTONEL 35 4-WEEK 35MG PACK 4ACTONEL 5MG TAB 4ALENDRONATE 0.933MG/ML ORAL SOLN 4alendronate 10mg tab 1alendronate 35mg tab 1ALENDRONATE 40MG TAB 3alendronate 5mg tab 1alendronate 70mg tab 1BONIVA 150MG TAB 4 QL=1 EA/30 DaysFORTEO 600MCG/2.4ML PEN INJ 5 NDSFOSAMAX 70MG TAB 4ibandronate 150mg tab 1 QL=1 EA/30 DaysNATPARA 100MCG CARTRIDGE 5 NDS PANATPARA 25MCG CARTRIDGE 5 NDS PANATPARA 50MCG CARTRIDGE 5 NDS PANATPARA 75MCG CARTRIDGE 5 NDS PAPROLIA 60MG/ML SYRINGE 4 PArisedronate sodium 150mg tab 2




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risedronate sodium 30mg tab 2risedronate sodium 35mg (12) pack 2risedronate sodium 35mg (4) pack 2risedronate sodium 35mg tab 2risedronate sodium 5mg tab 2salmon calcitonin 200unit/act nasal spray 2TYMLOS 2MG/ML PEN INJECTOR 5 NDSXGEVA 120MG/1.7ML INJ 5 NDS PA

GNRH/LHRH ANTAGONISTSORILISSA 150MG TAB 3 PA QL=30 EA/30 DaysORILISSA 200MG TAB 3 PA QL=60 EA/30 Days

GROWTH HORMONE RECEPTOR ANTAGONISTSSOMAVERT 10MG INJ 5 NDS PASOMAVERT 15MG INJ 5 NDS PASOMAVERT 20MG INJ 5 NDS PASOMAVERT 25MG INJ 5 NDS PASOMAVERT 30MG INJ 5 NDS PA

GROWTH HORMONESGENOTROPIN 0.2MG SYRINGE 5 NDS PAGENOTROPIN 0.4MG SYRINGE 5 NDS PAGENOTROPIN 0.6MG SYRINGE 5 NDS PAGENOTROPIN 0.8MG SYRINGE 5 NDS PAGENOTROPIN 1.2MG SYRINGE 5 NDS PAGENOTROPIN 1.4MG SYRINGE 5 NDS PAGENOTROPIN 1.6MG SYRINGE 5 NDS PAGENOTROPIN 1.8MG SYRINGE 5 NDS PAGENOTROPIN 12MG CARTRIDGE 5 NDS PAGENOTROPIN 1MG SYRINGE 5 NDS PAGENOTROPIN 2MG SYRINGE 5 NDS PAGENOTROPIN 5MG CARTRIDGE 5 NDS PA

HORMONE RECEPTOR MODULATORSEVISTA 60MG TAB 4OSPHENA 60MG TAB 4 PAraloxifene 60mg tab 2

INSULIN-LIKE GROWTH FACTORS (SOMATOMEDINS)INCRELEX 40MG/4ML INJ 5 NDS PA

LHRH/GNRH AGONIST ANALOG PITUITARY SUPPRESSANTSLUPANETA PACK 1-MONTH PACK 5 NDSLUPANETA PACK 3-MONTH PACK 5SYNAREL 2MG/ML NASAL SPRAY 5 NDS

METABOLIC MODIFIERSBUPHENYL 0.94MG/MG ORAL POWDER 5 NDS




98

calcitriol 0.00025mg cap 2 PA BvDcalcitriol 0.0005mg cap 2 PA BvDcalcitriol 0.001mg/ml oral soln 2 PA BvDCARBAGLU 200MG SUSP 4 PACARNITOR 1GM/10ML ORAL SOLN 4 PA BvDCARNITOR 330MG TAB 4 PA BvDcinacalcet 30mg tab 2 PA BvDcinacalcet 60mg tab 2 PA BvDcinacalcet 90mg tab 2 PA BvDdoxercalciferol 0.0005mg cap 2 PA BvDdoxercalciferol 0.001mg cap 2 PA BvDdoxercalciferol 0.0025mg cap 2 PA BvDGALAFOLD 123MG CAP 5 NDS PA QL=15 EA/30 DaysKUVAN 100MG POWDER FOR ORAL SOLN 5 NDS PAKUVAN 100MG TAB 5 NDS PAKUVAN 500MG POWDER FOR ORAL SOLN 5 NDS PAlevocarnitine 100mg/ml oral soln 2 PA BvDlevocarnitine 330mg tab 2 PA BvDORFADIN 10MG CAP 5 NDS PAORFADIN 20MG CAP 5 NDS PAORFADIN 2MG CAP 5 NDS PAORFADIN 4MG/ML SUSP 5 NDS PAORFADIN 5MG CAP 5 NDS PAPALYNZIQ 10MG/0.5ML SYRINGE 5 NDS PAPALYNZIQ 2.5MG/0.5ML SYRINGE 5 NDS PAPALYNZIQ 20MG/ML SYRINGE 5 NDS PAparicalcitol 0.001mg cap 2 PA BvDparicalcitol 0.002mg cap 2 PA BvDparicalcitol 0.004mg cap 2 PA BvDRAVICTI 1.1GM/ML ORAL SOLN 5 NDS PAROCALTROL 0.25MCG CAP 4 PA BvDROCALTROL 0.5MCG CAP 4 PA BvDROCALTROL 1MCG/ML ORAL SOLN 4 PA BvDSENSIPAR 30MG TAB 3 PA BvDSENSIPAR 60MG TAB 3 PA BvDSENSIPAR 90MG TAB 3 PA BvDsodium phenylbutyrate 0.94mg/mg oral powder 2ZEMPLAR 1MCG CAP 4 PA BvDZEMPLAR 2MCG CAP 4 PA BvD

POSTERIOR PITUITARY HORMONESDDAVP 0.01% NASAL SOLN 4DDAVP 0.01% NASAL SPRAY 4




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DDAVP 0.1MG TAB 4DDAVP 0.2MG TAB 4desmopressin acetate 0.01% nasal spray 2desmopressin acetate 0.1mg tab 2desmopressin acetate 0.2mg tab 2STIMATE 1.5MG/ML NASAL SPRAY 4

PROLACTIN INHIBITORScabergoline 0.5mg tab 2

SOMATOSTATIC AGENTSoctreotide 0.05mg/ml inj 2octreotide 0.1mg/ml inj 2octreotide 0.2mg/ml inj 2octreotide 0.5mg/ml inj 2octreotide 1mg/ml inj 2SANDOSTATIN 100MCG/ML INJ 5 NDSSANDOSTATIN 500MCG/ML INJ 5 NDSSANDOSTATIN 50MCG/ML INJ 4SIGNIFOR 0.3MG/ML INJ 5 NDS PA QL=60 ML/30 DaysSIGNIFOR 0.6MG/ML INJ 5 NDS PA QL=60 ML/30 DaysSIGNIFOR 0.9MG/ML INJ 5 NDS PA QL=60 ML/30 DaysSOMATULINE 120MG/0.5ML SYRINGE 5 NDSSOMATULINE 60MG/0.2ML SYRINGE 5 NDSSOMATULINE 90MG/0.3ML SYRINGE 5 NDS

VASOPRESSIN RECEPTOR ANTAGONISTSJYNARQUE 15MG TAB 5 NDS PA QL=120 EA/30 DaysJYNARQUE 30MG TAB 5 NDS PA QL=120 EA/30 DaysJYNARQUE 45/15 THERAPY PACK 5 NDS PA QL=60 EA/30 DaysJYNARQUE 60/30 THERAPY PACK 5 NDS PA QL=60 EA/30 DaysJYNARQUE 90/30 THERAPY PACK 5 NDS PA QL=60 EA/30 Days

ESTROGENSESTROGEN COMBINATIONS

ACTIVELLA 1/0.5MG 28 DAY PACK 4amabelz 0.5/0.1mg 28 day pack 2amabelz 1/0.5mg 28 day pack 2ANGELIQ 0.25/0.5MG 28 DAY PACK 4ANGELIQ 0.5/1MG 28 DAY PACK 4CLIMARA PRO 0.045-0.015MG PATCH 4COMBIPATCH 0.05-0.14MG PATCH 4COMBIPATCH 0.05-0.25MG PATCH 4estradiol 0.5mg/norethindrone acetate 0.1mg pack 2estradiol 1mg/norethindrone acetate 0.5mg pack 2




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ethinyl estradiol 0.0025mg/norethindrone acetate 0.5mgtab

2

ethinyl estradiol 0.005mg/norethindrone acetate 1mg tab 2FEMHRT 0.5/2.5MG 28 DAY PACK 4fyavolv 0.5mg-2.5mcg tab 2fyavolv 1mg-5mcg tab 2jinteli tab 2lopreeza 1/0.5mg 28 day pack 2mimvey lo 28 day pack 2mimvey pack 2PREFEST 30 DAY PACK 4PREMPHASE 28 DAY PACK 3PREMPRO 0.3/1.5MG 28 DAY PACK 3PREMPRO 0.45/1.5 28 DAY PACK 3PREMPRO 0.625/2.5MG 28 DAY PACK 3PREMPRO 0.625/5MG 28 DAY PACK 3

ESTROGENSALORA 0.025MG/24HR PATCH 4ALORA 0.05MG/24HR PATCH 4ALORA 0.075MG/24HR PATCH 4ALORA 0.1MG/24HR PATCH 4CLIMARA 0.025MG/24HR PATCH 4CLIMARA 0.05MG/24HR PATCH 4CLIMARA 0.06MG/24HR PATCH 4CLIMARA 0.075MG/24HR PATCH 4CLIMARA 0.1MG/24HR PATCH 4CLIMARA 37.5MCG/24HR PATCH 4DELESTROGEN 10MG/ML INJ 4DELESTROGEN 20MG/ML INJ 4DELESTROGEN 40MG/ML INJ 4DEPO-ESTRADIOL 5MG/ML INJ 4dotti 0.025mg/24hr patch 2dotti 0.0375mg/24hr patch 2dotti 0.05mg/24hr patch 2dotti 0.075mg/24hr patch 2dotti 0.1mg/24hr patch 2ESTRACE 0.5MG TAB 4ESTRACE 1MG TAB 4ESTRACE 2MG TAB 4estradiol 0.00104mg/hr twice weekly patch 2estradiol 0.00104mg/hr weekly patch 2estradiol 0.00156mg/hr twice weekly patch 2




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estradiol 0.00156mg/hr weekly patch 2estradiol 0.00208mg/hr twice weekly patch 2estradiol 0.00208mg/hr weekly patch 2estradiol 0.0025mg/hr weekly patch 2estradiol 0.00312mg/hr weekly patch 2estradiol 0.00313mg/hr twice weekly patch 2estradiol 0.00417mg/hr twice weekly patch 2estradiol 0.00417mg/hr weekly patch 2estradiol 0.5mg tab 1estradiol 1mg tab 1estradiol 20mg/ml inj 2estradiol 2mg tab 1estradiol 40mg/ml inj 2EVAMIST 1.53MG/SPRAY SPRAY 4MENEST 0.3MG TAB 4MENEST 0.625MG TAB 4MENEST 1.25MG TAB 4MENOSTAR 14MCG/24HR PATCH 4MINIVELLE 0.025MG/24HR PATCH 4MINIVELLE 0.0375MG/24HR PATCH 4MINIVELLE 0.05MG/24HR PATCH 4MINIVELLE 0.075MG/24HR PATCH 4MINIVELLE 0.1MG/24HR PATCH 4PREMARIN 0.3MG TAB 3PREMARIN 0.45MG TAB 3PREMARIN 0.625MG TAB 3PREMARIN 0.9MG TAB 3PREMARIN 1.25MG TAB 3VIVELLE 0.025MG/24HR PATCH 4VIVELLE 0.0375MG/24HR PATCH 4VIVELLE 0.05MG/24HR PATCH 4VIVELLE 0.075MG/24HR PATCH 4VIVELLE 0.1MG/24HR PATCH 4

FLUOROQUINOLONESFLUOROQUINOLONES

AVELOX 400MG TAB 4BAXDELA 400MG TAB 3 PA QL=60 EA/30 DaysCIPRO (10%) 500MG/5ML SUSP 4CIPRO (5%) 5GM/100ML SUSP 4CIPRO 250MG TAB 4CIPRO 500MG TAB 4ciprofloxacin 100mg/ml susp 2




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ciprofloxacin 250mg tab 1ciprofloxacin 2mg/ml inj 2ciprofloxacin 500mg tab 1ciprofloxacin 750mg tab 1levofloxacin 250mg tab 1levofloxacin 25mg/ml inj 2levofloxacin 25mg/ml oral soln 2levofloxacin 500mg tab 1levofloxacin 5mg/ml (150ml) inj 2levofloxacin 5mg/ml inj 2levofloxacin 750mg tab 1moxifloxacin 1.6mg/ml inj 2moxifloxacin 400mg tab 2ofloxacin 400mg tab 2

GASTROINTESTINAL AGENTS - MISC.BILE ACID SYNTHESIS DISORDER AGENTS

CHOLBAM 250MG CAP 5 NDS PACHOLBAM 50MG CAP 5 NDS PA

FARNESOID X RECEPTOR (FXR) AGONISTSOCALIVA 10MG TAB 5 NDS PA QL=30 EA/30 DaysOCALIVA 5MG TAB 5 NDS PA QL=30 EA/30 Days

GALLSTONE SOLUBILIZING AGENTSACTIGALL 300MG CAP 4CHENODAL 250MG TAB 5 NDSURSO 250MG TAB 4URSO FORTE 500MG TAB 4ursodiol 250mg tab 1ursodiol 300mg cap 2ursodiol 500mg tab 1

GASTROINTESTINAL ANTIALLERGY AGENTScromolyn sodium 20mg/ml oral soln 2GASTROCROM 100MG/5ML ORAL SOLN 4

GASTROINTESTINAL STIMULANTSmetoclopramide 10mg tab 1metoclopramide 1mg/ml oral soln 2metoclopramide 5mg tab 1REGLAN 10MG TAB 4REGLAN 5MG TAB 4

INFLAMMATORY BOWEL AGENTSAPRISO 0.375GM ER CAP 3AZULFIDINE 500MG DR TAB 4AZULFIDINE 500MG TAB 4




103

balsalazide disodium 750mg cap 2CANASA 1000MG RECTAL SUPP 4CIMZIA 200MG INJ 5 NDS PACIMZIA 200MG/ML SYRINGE 5 NDS PACOLAZAL 750MG CAP 4DIPENTUM 250MG CAP 4mesalamine 1.2gm tab 2mesalamine 1000mg rectal supp 2mesalamine 400mg dr cap 2mesalamine 66.7mg/ml enema 2mesalamine 800mg dr tab 2sulfasalazine 500mg dr tab 1sulfasalazine 500mg tab 1

INTESTINAL ACIDIFIERSenulose 10gm/15ml oral soln 1generlac 10gm/15ml oral soln 1

IRRITABLE BOWEL SYNDROME (IBS) AGENTSalosetron 0.5mg tab 2alosetron 1mg tab 2LINZESS 145MCG CAP 3 PALINZESS 290MCG CAP 3 PALINZESS 72MCG CAP 3 PALOTRONEX 0.5MG TAB 4LOTRONEX 1MG TAB 4

PERIPHERAL OPIOID RECEPTOR ANTAGONISTSMOVANTIK 12.5MG TAB 3 PAMOVANTIK 25MG TAB 3 PARELISTOR 12MG/0.6ML INJ 4 PARELISTOR 12MG/0.6ML SYRINGE 4 PARELISTOR 8MG/0.4ML SYRINGE 4 PASYMPROIC 0.2MG TAB 3 PA

PHOSPHATE BINDER AGENTSAURYXIA 210MG TAB 4 PAcalcium acetate 667mg cap 2calcium acetate 667mg tab 2FOSRENOL 1000MG ORAL POWDER 3FOSRENOL 750MG ORAL POWDER 3lanthanum carbonate 1000mg chew tab 2lanthanum carbonate 500mg chew tab 2lanthanum carbonate 750mg chew tab 2PHOSLYRA 667MG/5ML ORAL SOLN 3RENAGEL 800MG TAB 4




104

RENVELA 0.8GM SUSP 4RENVELA 2.4GM SUSP 4RENVELA 800MG TAB 4SEVELAMER 400MG TAB 2sevelamer 800mg tab 2sevelamer carbonate 2400mg oral susp 2sevelamer carbonate 800mg oral susp 2sevelamer carbonate 800mg tab 2VELPHORO 500MG CHEW TAB 4

SHORT BOWEL SYNDROME (SBS) AGENTSGATTEX 5MG INJ 5 NDS PA

GENITOURINARY AGENTS - MISCELLANEOUSALKALINIZERS

potassium citrate 10meq er tab 2potassium citrate 15 meq er tab 2potassium citrate 5 meq er tab 2UROCIT-K 1080MG ER TAB 4UROCIT-K 15MEQ ER TAB 4UROCIT-K 540MG ER TAB 4

CYSTINOSIS AGENTSCYSTAGON 150MG CAP 3CYSTAGON 50MG CAP 3

GENITOURINARY IRRIGANTSsodium chloride 0.9% soln 2

INTERSTITIAL CYSTITIS AGENTSELMIRON 100MG CAP 3

PROSTATIC HYPERTROPHY AGENTSalfuzosin 10mg er tab 1AVODART 0.5MG CAP 4CARDURA 4MG XL TAB 4CARDURA 8MG XL TAB 4dutasteride 0.5mg cap 1dutasteride 0.5mg/tamsulosin 0.4mg cap 2finasteride 5mg tab 1FLOMAX 0.4MG CAP 4JALYN 0.5-0.4MG CAP 4PROSCAR 5MG TAB 4RAPAFLO 4MG CAP 4RAPAFLO 8MG CAP 4silodosin 4mg cap 2silodosin 8mg cap 2tamsulosin 0.4mg cap 1




105

UROXATRAL 10MG ER TAB 4URINARY STONE AGENTS

LITHOSTAT 250MG TAB 4THIOLA 100MG TAB 4

GOUT AGENTSGOUT AGENT COMBINATIONS

colchicine 0.5mg/probenecid 500mg tab 2GOUT AGENTS

allopurinol 100mg tab 1allopurinol 300mg tab 1COLCHICINE 0.6MG TAB 4 PAMITIGARE 0.6MG CAP 3ULORIC 40MG TAB 3 STULORIC 80MG TAB 3 STZYLOPRIM 100MG TAB 4ZYLOPRIM 300MG TAB 4

URICOSURICSprobenecid 500mg tab 2

HEMATOLOGICAL AGENTS - MISC.BRADYKININ B2 RECEPTOR ANTAGONISTS

FIRAZYR 30MG/3ML SYRINGE 5 NDS PACOMPLEMENT INHIBITORS

BERINERT 500UNIT INJ 5 NDS PACINRYZE 500UNIT INJ 5 NDS PAHAEGARDA 2000UNT INJ 5 NDS PAHAEGARDA 3000UNT INJ 5 NDS PARUCONEST 2100UNIT INJ 5 NDS PA

HEMATAOLOGIC - TYROSINE KINASE INHIBITORSTAVALISSE 100MG TAB 5 NDS PA QL=60 EA/30 DaysTAVALISSE 150MG TAB 5 NDS PA QL=60 EA/30 Days

HEMATORHEOLOGIC AGENTSpentoxifylline 400mg er tab 1

PLASMA KALLIKREIN INHIBITORSTAKHZYRO 300MG/2ML INJ 5 NDS PA QL=4 ML/28 Days

PLATELET AGGREGATION INHIBITORSAGGRENOX 25-200MG CAP 4AGRYLIN 0.5MG CAP 4anagrelide 0.5mg cap 2anagrelide 1mg cap 2aspirin 25mg/dipyridamole 200mg cap 2BRILINTA 60MG TAB 4BRILINTA 90MG TAB 4




106

cilostazol 100mg tab 1cilostazol 50mg tab 1clopidogrel 75mg tab 1EFFIENT 10MG TAB 4EFFIENT 5MG TAB 4PLAVIX 75MG TAB 4prasugrel 10mg tab 1prasugrel 5mg tab 1ZONTIVITY 2.08MG TAB 4 PA

HEMATOPOIETIC AGENTSAGENTS FOR GAUCHER DISEASE

CERDELGA 84MG CAP 5 NDS PA QL=60 EA/30 Daysmiglustat 100mg cap 5 NDS PA

AGENTS FOR SICKLE CELL ANEMIADROXIA 200MG CAP 3DROXIA 300MG CAP 3DROXIA 400MG CAP 3ENDARI 5000MG POWDER FOR ORAL SOLN 5 NDS PA QL=180 EA/30 Days

HEMATOPOIETIC GROWTH FACTORSARANESP 100MCG/0.5ML SYRINGE 4 PA BvD STARANESP 100MCG/ML INJ 4 PA BvD STARANESP 10MCG/0.4ML SYRINGE 4 PA BvD STARANESP 150MCG/0.3ML SYRINGE 4 PA BvD STARANESP 200MCG/0.4ML SYRINGE 4 PA BvD STARANESP 200MCG/ML INJ 4 PA BvD STARANESP 25MCG/0.42ML SYRINGE 4 PA BvD STARANESP 25MCG/ML INJ 4 PA BvD STARANESP 300MCG/0.6ML SYRINGE 4 PA BvD STARANESP 300MCG/ML INJ 4 PA BvD STARANESP 40MCG/0.4ML SYRINGE 4 PA BvD STARANESP 40MCG/ML INJ 4 PA BvD STARANESP 500MCG/ML SYRINGE 4 PA BvD STARANESP 60MCG/0.3ML SYRINGE 4 PA BvD STARANESP 60MCG/ML INJ 4 PA BvD STFULPHILA 6/0.6ML SYRINGE 5 NDSLEUKINE 250MCG INJ 5 NDS PAMULPLETA 3MG TAB 5 NDS PA QL=7 EA/7 DaysNIVESTYM 300MCG/0.5ML PF INJ 5 NDSNIVESTYM 300MCG/1ML INJ 5 NDSNIVESTYM 480MCG/0.8ML PF INJ 5 NDSNIVESTYM 480MCG/1.6ML INJ 5 NDSPROMACTA 12.5MG POWDER FOR ORAL SUSP 5 NDS PA




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PROMACTA 12.5MG TAB 5 NDS PAPROMACTA 25MG TAB 5 NDS PAPROMACTA 50MG TAB 5 NDS PAPROMACTA 75MG TAB 5 NDS PARETACRIT 10000UNIT/ML INJ 3 PA BvDRETACRIT 2000UNIT/ML INJ 3 PA BvDRETACRIT 3000UNIT/ML INJ 3 PA BvDRETACRIT 40000UNIT/ML INJ 3 PA BvDRETACRIT 4000UNIT/ML INJ 3 PA BvDUDENYCA 6MG/0.6ML SYRINGE 5 NDSZARXIO 300MCG/0.5ML SYRINGE 5 NDSZARXIO 480MCG/0.8ML SYRINGE 5 NDS

HEMOSTATICSHEMOSTATICS - SYSTEMIC

LYSTEDA 650MG TAB 4tranexamic acid 650mg tab 2

HYPNOTICS/SEDATIVES/SLEEP DISORDER AGENTSBARBITURATE HYPNOTICS

phenobarbital 100mg tab 2phenobarbital 15mg tab 2phenobarbital 16.2mg tab 2phenobarbital 30mg tab 2phenobarbital 32.4mg tab 2phenobarbital 4mg/ml oral soln 2phenobarbital 60mg tab 2phenobarbital 64.8mg tab 2phenobarbital 97.2mg tab 2

NON-BARBITURATE HYPNOTICSAMBIEN 10MG TAB 4 QL=30 EA/30 DaysAMBIEN 5MG TAB 4 QL=60 EA/30 Daysestazolam 1mg tab 2estazolam 2mg tab 2eszopiclone 1mg tab 1 QL=30 EA/30 Dayseszopiclone 2mg tab 1 QL=30 EA/30 Dayseszopiclone 3mg tab 1 QL=30 EA/30 DaysFLURAZEPAM 15MG CAP 3FLURAZEPAM 30MG CAP 3HALCION 0.25MG TAB 4LUNESTA 1MG TAB 4 QL=30 EA/30 DaysLUNESTA 2MG TAB 4 QL=30 EA/30 DaysLUNESTA 3MG TAB 4 QL=30 EA/30 DaysRESTORIL 15MG CAP 4




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RESTORIL 22.5MG CAP 4RESTORIL 30MG CAP 4RESTORIL 7.5MG CAP 4temazepam 15mg cap 1temazepam 22.5mg cap 2temazepam 30mg cap 1temazepam 7.5mg cap 2triazolam 0.125mg tab 2triazolam 0.25mg tab 2zaleplon 10mg cap 1 QL=30 EA/30 Dayszaleplon 5mg cap 1 QL=30 EA/30 Dayszolpidem tartrate 10mg tab 1 QL=30 EA/30 Dayszolpidem tartrate 5mg tab 1 QL=60 EA/30 Days

SELECTIVE MELATONIN RECEPTOR AGONISTSHETLIOZ 20MG CAP 5 NDS PA QL=30 EA/30 DaysROZEREM 8MG TAB 4 QL=30 EA/30 Days

LAXATIVESLAXATIVE COMBINATIONS

CLENPIQ POWDER 3COLYTE ORAL SOLN 4gavilyte-c oral soln 1gavilyte-g oral soln 1gavilyte-n powder for oral soln 1GOLYTELY 236GM ORAL SOLN 4peg 3350/electrolyte oral soln 1peg 3350/kcl/sodium bicarbonate/sodium chloridepowder for oral soln

1

polyethylene glycol 3350/kcl/sodium bicarbonate/sodiumchloride/sodium sulfate powder for oral solut

1

trilyte powder for oral soln 1LAXATIVES - MISCELLANEOUS

constulose 10gm/15ml oral soln 1KRISTALOSE 10GM ORAL SOLN 4KRISTALOSE 20GM ORAL SOLN 4lactulose 667mg/ml oral soln 1

MACROLIDESAZITHROMYCIN

AZITHROMYCIN 16.7MG/ML SUSP 4azithromycin 20mg/ml susp 1azithromycin 250mg pack 1azithromycin 250mg tab 1azithromycin 2mg/ml inj 2




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azithromycin 40mg/ml susp 1azithromycin 500mg (3) tab pack 1azithromycin 500mg tab 1azithromycin 600mg tab 2TRI-PAK 500MG PACK 4Z-PAK 250MG PACK 4ZITHROMAX 100MG/5ML SUSP 4ZITHROMAX 1GM SUSP 4ZITHROMAX 200MG/5ML SUSP 4ZITHROMAX 250MG TAB 4ZITHROMAX 500MG INJ 4ZITHROMAX 500MG TAB 4

CLARITHROMYCINclarithromycin 250mg tab 1CLARITHROMYCIN 25MG/ML SUSP 2clarithromycin 500mg er tab 2clarithromycin 500mg tab 1CLARITHROMYCIN 50MG/ML SUSP 2

ERYTHROMYCINSE.E.S. 200MG/5ML SUSP 4ERY-TAB 250MG DR TAB 4ERY-TAB 333MG DR TAB 4ERY-TAB 500MG DR TAB 4ERYPED 200MG/5ML SUSP 4ERYTHROCIN LACTOBIONATE 500MG INJ 4erythromycin 250mg dr cap 2erythromycin 250mg tab 2erythromycin 500mg tab 2erythromycin ethylsuccinate 40mg/ml susp 2erythromycin ethylsuccinate 80mg/ml oral susp 2

FIDAXOMICINDIFICID 200MG TAB 5 NDS ST QL=20 EA/10 Days

MEDICAL DEVICESPARENTERAL THERAPY SUPPLIES

INSULIN SYRINGE (DISP) U-100 1/2ML 2MEDICAL DEVICES AND SUPPLIES

BANDAGES-DRESSINGS-TAPEGAUZE PAD 2

MISC. DEVICESISOPROPYL ALCOHOL 0.7ML/ML PAD 2

PARENTERAL THERAPY SUPPLIESINSULIN PEN NEEDLE 2




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INSULIN SYRINGE (DISP) U-100 0.3ML 2INSULIN SYRINGE (DISP) U-100 1ML 2INSULIN SYRINGE MIS 1ML/29G 2

MIGRAINE PRODUCTSMIGRAINE PRODUCTS

DIHYDROERGOTAMINE MESYLATE 0.5MG/ACTNASAL SPRAY

4 QL=16 ML/30 Days

MIGRAINE PRODUCTS - MONOCLONAL ANTIBODIESAIMOVIG 140MG/ML AUTO-INJECTOR 3 PAAIMOVIG 70MG/ML AUTO-INJECTOR 3 PAEMGALITY 100MG/ML SYRINGE 3 PAEMGALITY 120MG/ML AUTO-INJECTOR 3 PAEMGALITY 120MG/ML SYRINGE 3 PA

SEROTONIN AGONISTSAMERGE 1MG TAB 4 QL=18 EA/30 DaysAMERGE 2.5MG TAB 4 QL=18 EA/30 DaysIMITREX 100MG TAB 4 QL=18 EA/30 DaysIMITREX 20MG/ACT NASAL SPRAY 4 QL=12 EA/30 DaysIMITREX 25MG TAB 4 QL=18 EA/30 DaysIMITREX 50MG TAB 4 QL=18 EA/30 DaysIMITREX 5MG/ACT NASAL SPRAY 4 QL=12 EA/30 DaysIMITREX 6MG/0.5ML CARTRIDGE 4 QL=5 ML/30 DaysIMITREX 6MG/0.5ML INJ 4 QL=5 ML/30 DaysMAXALT 10MG ODT 4 QL=36 EA/60 DaysMAXALT 10MG TAB 4 QL=36 EA/60 DaysMAXALT 5MG ODT 4 QL=36 EA/60 Daysnaratriptan 1mg tab 2 QL=18 EA/30 Daysnaratriptan 2.5mg tab 2 QL=18 EA/30 Daysrizatriptan 10mg odt 2 QL=36 EA/60 Daysrizatriptan 10mg tab 2 QL=36 EA/60 Daysrizatriptan 5mg odt 2 QL=36 EA/60 Daysrizatriptan 5mg tab 2 QL=36 EA/60 Dayssumatriptan 100mg tab 1 QL=18 EA/30 Dayssumatriptan 12mg/ml auto-injector 2 QL=5 ML/30 Dayssumatriptan 12mg/ml inj 2 QL=5 ML/30 DaysSUMATRIPTAN 12MG/ML SYRINGE 3 QL=5 ML/30 Dayssumatriptan 20mg/act nasal spray 2 QL=12 EA/30 Dayssumatriptan 25mg tab 1 QL=18 EA/30 Dayssumatriptan 4mg cartridge 2 QL=5 ML/30 Dayssumatriptan 50mg tab 1 QL=18 EA/30 Dayssumatriptan 5mg/act nasal spray 2 QL=12 EA/30 Dayssumatriptan 6mg cartridge 2 QL=5 ML/30 Days




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sumatriptan 8mg/ml auto-injector 2 QL=5 ML/30 Dayszolmitriptan 2.5mg odt 2 QL=18 EA/30 Dayszolmitriptan 2.5mg tab 2 QL=18 EA/30 Dayszolmitriptan 5mg odt 2 QL=18 EA/30 Dayszolmitriptan 5mg tab 2 QL=18 EA/30 DaysZOMIG 2.5MG NASAL SPRAY 4 QL=16 EA/30 DaysZOMIG 2.5MG ODT 4 QL=18 EA/30 DaysZOMIG 2.5MG TAB 4 QL=18 EA/30 DaysZOMIG 5MG NASAL SPRAY 4 QL=12 EA/30 DaysZOMIG 5MG ODT 4 QL=18 EA/30 DaysZOMIG 5MG TAB 4 QL=18 EA/30 Days

MINERALS & ELECTROLYTESBICARBONATES

sodium lactate 5 meq/ml inj 2ELECTROLYTE MIXTURES

GLUCOSE 100MG/ML/SODIUM CHLORIDE 0.0342MEQ/ML INJ

3 PA BvD


3 PA BvD


2

glucose 50 mg/ml/potassium chloride 0.04meq/ml/sodium chloride 4.5mg/ml inj

2

glucose 50mg/ml/potassium chloride 0.01 meq/ml/sodium chloride 0.0769 meq/ml inj

2

glucose 50mg/ml/potassium chloride 0.02 meq/ml inj 2glucose 50mg/ml/potassium chloride 0.02 meq/ml/sodium chloride 0.0342 meq/ml inj

2

GLUCOSE 50MG/ML/POTASSIUM CHLORIDE 0.02MEQ/ML/SODIUM CHLORIDE 0.056 MEQ/ML INJ

2


2

glucose 50mg/ml/potassium chloride 0.02meq/ml/sodiumchloride 4.5mg/ml inj

2


2

GLUCOSE 50MG/ML/POTASSIUM CHLORIDE 0.04MEQ/ML INJ

2

GLUCOSE 50MG/ML/POTASSIUM CHLORIDE 0.04MEQ/ML/SODIUM CHLORIDE 0.154 MEQ/ML INJ

3

glucose 50mg/ml/sodium chloride 0.0342 meq/ml inj 2GLUCOSE 50MG/ML/SODIUM CHLORIDE 0.0385MEQ/ML INJ

2




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glucose 50mg/ml/sodium chloride 0.0564 meq/ml inj 2glucose 50mg/ml/sodium chloride 4.5mg/ml inj 2glucose 50mg/ml/sodium chloride 9mg/ml inj 2IONOSOL-MB INJ 3ISOLYTE P INJ 3ISOLYTE S INJ 3KCL/D5W/LR INJ 0.15% 3NORMOSOL-M INJ 2NORMOSOL-R IN 5% DEXTROSE INJ 3NORMOSOL-R INJ 3PLASMA-LYTE 148 INJ 3PLASMALYTE A INJ 3potassium chloride 0.02 meq/ml/sodium chloride 0.0769meq/ml inj

2

potassium chloride 0.02 meq/ml/sodium chloride 0.154meq/ml inj

2

potassium chloride 0.04 meq/ml/sodium chloride 0.154meq/ml inj

2

TPN ELECTROLYTES INJ 2 PA BvDMAGNESIUM

magnesium sulfate 50% inj 2magnesium sulfate 50% syringe 2

POTASSIUMK-TAB 10MEQ ER TAB 4K-TAB 20MEQ ER TAB 2K-TAB 8MEQ ER TAB 2klor-con 10meq er micro tab 1klor-con 10meq er tab 1KLOR-CON 15MEQ ER TAB 2klor-con 20meq er micro tab 1klor-con 20meq powder 2klor-con 8meq er cap 1klor-con 8meq er tab 1potassium chloride 0.1 meq/ml inj 2potassium chloride 0.2meq/ml inj 2potassium chloride 0.4meq/ml inj 2potassium chloride 10% oral soln 2potassium chloride 10meq er cap 1potassium chloride 10meq er micro tab 1potassium chloride 10meq er tab 1potassium chloride 20% oral soln 2potassium chloride 20meq er micro tab 1




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POTASSIUM CHLORIDE 20MEQ ER TAB 2potassium chloride 20meq powder for oral soln 2potassium chloride 2meq/ml inj 2potassium chloride 40meq/20ml inj 2potassium chloride 8 meq er cap 1potassium chloride 8 meq er tab 1

SODIUMsodium chloride 0.45% inj 2sodium chloride 0.9% inj 2sodium chloride 3% inj 2sodium chloride 5% inj 2

MISCELLANEOUS THERAPEUTIC CLASSESCHELATING AGENTS

DEPEN 250MG TAB 3SYPRINE 250MG CAP 4 PAtrientine 250mg tab 2 PA

IMMUNOMODULATORSREVLIMID 10MG CAP 5 NDS PA NSO QL=30 EA/30 DaysREVLIMID 15MG CAP 5 NDS PA NSO QL=30 EA/30 DaysREVLIMID 2.5MG CAP 5 NDS PA NSO QL=30 EA/30 DaysREVLIMID 20MG CAP 5 NDS PA NSO QL=30 EA/30 DaysREVLIMID 25MG CAP 5 NDS PA NSO QL=30 EA/30 DaysREVLIMID 5MG CAP 5 NDS PA NSO QL=30 EA/30 DaysTHALOMID 100MG CAP 5 NDS PA NSOTHALOMID 150MG CAP 5 NDS PA NSOTHALOMID 200MG CAP 5 NDS PA NSOTHALOMID 50MG CAP 5 NDS PA NSO

IMMUNOSUPPRESSIVE AGENTSASTAGRAF 0.5MG XL CAP 4 PA BvDASTAGRAF 1MG XL CAP 4 PA BvDASTAGRAF 5MG XL CAP 4 PA BvDcyclosporine modified 100mg/ml oral soln 2 PA BvDCYCLOSPORINE MODIFIED 50MG CAP 2 PA BvDENVARSUS 0.75MG ER TAB 4 PA BvDENVARSUS 1MG ER TAB 4 PA BvDENVARSUS 4MG ER TAB 4 PA BvDIMURAN 50MG TAB 4 PA BvDPROGRAF 0.2MG GRANULES PACKET 4 PA BvDPROGRAF 1MG CAP 4 PA BvDPROGRAF 1MG GRANULES PACKET 4 PA BvDRAPAMUNE 1MG/ML ORAL SOLN 4 PA BvDsirolimus 1mg/ml oral soln 2 PA BvD




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ZORTRESS 0.25MG TAB 4 PA BvDZORTRESS 0.5MG TAB 4 PA BvDZORTRESS 0.75MG TAB 4 PA BvDZORTRESS 1MG TAB 4 PA BvD

POTASSIUM REMOVING AGENTSLOKELMA 10GM PACKET 3 PALOKELMA 5GM PACKET 3 PAVELTASSA 16.8GM POWDER FOR ORAL SUSP 3 PAVELTASSA 25.2GM POWDER FOR ORAL SUSP 3 PAVELTASSA 8.4GM POWDER FOR ORAL SUSP 3 PA

SYSTEMIC LUPUS ERYTHEMATOSUS AGENTSBENLYSTA 200MG/ML AUTO-INJECTOR 5 NDS PA QL=4 ML/28 DaysBENLYSTA 200MG/ML SYRINGE 5 NDS PA QL=4 ML/28 Days

MOUTH/THROAT/DENTAL AGENTSANESTHETICS TOPICAL ORAL

lidocaine 2% topical soln 2ANTI-INFECTIVES - THROAT

clotrimazole 10mg lozenge 2nystatin 100000unit/ml susp 2ORAVIG 50MG BUCCAL TAB 4

ANTISEPTICS - MOUTH/THROATchlorhexidine gluconate 0.12% mouthwash 1

STEROIDS - MOUTH/THROATtriamcinolone acetonide 0.1% paste 2

THROAT PRODUCTS - MISC.cevimeline 30mg cap 2EVOXAC 30MG CAP 4pilocarpine 5mg tab 2pilocarpine 7.5mg tab 2SALAGEN 5MG TAB 4SALAGEN 7.5MG TAB 4

MUSCULOSKELETAL THERAPY AGENTSCENTRAL MUSCLE RELAXANTS

baclofen 10mg tab 1baclofen 20mg tab 1carisoprodol 350mg tab 2CHLORZOXAZONE 500MG TAB 1cyclobenzaprine 10mg tab 1cyclobenzaprine 5mg tab 1cyclobenzaprine 7.5mg tab 2FEXMID 7.5MG TAB 4metaxall 800mg tab 2




115

METAXALONE 400MG TAB 4metaxalone 800mg tab 2methocarbamol 500mg tab 1methocarbamol 750mg tab 1orphenadrine citrate 100mg er tab 2SKELAXIN 800MG TAB 4SOMA 350MG TAB 4tizanidine 2mg cap 2tizanidine 2mg tab 2tizanidine 4mg cap 2tizanidine 4mg tab 2tizanidine 6mg cap 2ZANAFLEX 2MG CAP 4ZANAFLEX 4MG CAP 4ZANAFLEX 4MG TAB 4ZANAFLEX 6MG CAP 4

DIRECT MUSCLE RELAXANTSDANTRIUM 25MG CAP 4DANTRIUM 50MG CAP 4dantrolene sodium 100mg cap 2dantrolene sodium 25mg cap 2dantrolene sodium 50mg cap 2

NASAL AGENTS - SYSTEMIC AND TOPICALNASAL ANTI-INFECTIVES

BACTROBAN 2% NASAL OINTMENT 4NASAL ANTIALLERGY

ASTEPRO 0.15% NASAL INHALER 4azelastine 0.1% (137mcg) nasal inhaler 1azelastine 0.15% (205.5mcg) nasal inhaler 2olopatadine 0.6% nasal inhaler 2PATANASE 0.6% NASAL INHALER 4

NASAL ANTICHOLINERGICSipratropium bromide 0.03% nasal inhaler 2ipratropium bromide 0.06% nasal inhaler 2

NASAL STEROIDSFLUNISOLIDE 25MCG NASAL INHALER 2 QL=50 ML/30 Daysfluticasone propionate 50mcg nasal inhaler 1 QL=32 GM/30 Days

NEUROMUSCULAR AGENTSALS AGENTS

RILUTEK 50MG TAB 5 NDSriluzole 50mg tab 2

NUTRIENTS




116

CARBOHYDRATESglucose 10% inj 2 PA BvDglucose 100mg/ml inj 2

LIPIDSintralipid 200mg/ml inj 2 PA BvDINTRALIPID 30% INJ 4 PA BvDnutrilipid 20% iv soln 2 PA BvD

PROTEINSAMINOSYN II 10% INJ 4 PA BvDAMINOSYN II 15% INJ 4 PA BvDAMINOSYN-PF 10% SULFITE-FREE INJ 4 PA BvDAMINOSYN-PF 7% INJ 4 PA BvDCLINIMIX 4.25/10 INJ 3 PA BvDCLINIMIX 4.25/5 INJ 3 PA BvDCLINIMIX 5/15 INJ 3 PA BvDCLINIMIX 5/20 INJ 3 PA BvDCLINIMIX E 2.75/5 INJ 3 PA BvDCLINIMIX E 4.25/10 INJ 3 PA BvDCLINIMIX E 4.25/5 INJ 3 PA BvDCLINIMIX E 5/15 INJ 3 PA BvDCLINIMIX E 5/20 INJ 3 PA BvDclinisol 15% inj 2 PA BvDFREAMINE 6.9% INJ 4 PA BvDHEPATAMINE 8% INJ 2 PA BvDNEPHRAMINE 5.4% INJ 4 PA BvDplenamine 15% inj 2 PA BvDPREMASOL 10% INJ 4 PA BvDpremasol 6% inj 2 PA BvDPROCALAMINE 3% INJ 4 PA BvDPROSOL 20% INJ 4 PA BvDTRAVASOL 10% INJ 4 PA BvDTROPHAMINE 10% INJ 4 PA BvDTROPHAMINE 6% INJ 4 PA BvD

OPHTHALMIC AGENTSARTIFICIAL TEARS AND LUBRICANTS

LACRISERT 5MG IMPLANT 3BETA-BLOCKERS - OPHTHALMIC

betaxolol 0.5% ophth soln 2BETIMOL 0.25% OPHTH SOLN 4BETIMOL 0.5% OPHTH SOLN 3BETOPTIC S 0.25% OPHTH SUSP 4CARTEOLOL 1% OPHTH SOLN 2




117

COMBIGAN 0.2-0.5% OPHTH SOLN 3COSOPT 22.3-6.8MG/ML OPHTH SOLN 4COSOPT 22.3-6.8MG/ML OPHTH SOLN(PRESERVATIVE-FREE)

4

dorzolamide 20mg/ml/timolol 5mg/ml ophth soln 1dorzolamide/timolol 22.3-6.8mg/ml ophth soln(preservative-free)

2

ISTALOL 0.5% OPHTH SOLN 4levobunolol 0.5% ophth soln 2TIMOLOL 0.25% OPHTH GEL 3timolol 0.25% ophth soln 1TIMOLOL 0.5% OPHTH GEL 3timolol 0.5% ophth soln 1timolol 5mg/ml ophth 24hr ophth soln 2TIMOPTIC 0.25% OPHTH SOLN 4TIMOPTIC 0.5% OPHTH SOLN 4TIMOPTIC-XE 0.25% OPHTH GEL 3TIMOPTIC-XE 0.5% OPHTH GEL 3

CYCLOPLEGIC MYDRIATICSATROPINE SULFATE 1% OPHTH SOLN 2

MIOTICSISOPTOCARPINE 1% OPHTH SOLN 4ISOPTOCARPINE 2% OPHTH SOLN 4ISOPTOCARPINE 4% OPHTH SOLN 4PHOSPHOLINE IODIDE 0.125% OPHTH SOLN 3pilocarpine 1% ophth soln 2pilocarpine 2% ophth soln 2pilocarpine 4% ophth soln 2

OPHTHALMIC ADRENERGIC AGENTSALPHAGAN P 0.1% OPHTH SOLN 4ALPHAGAN P 0.15% OPHTH SOLN 4apraclonidine 0.5% ophth soln 2brimonidine tartrate 0.15% ophth soln 2brimonidine tartrate 0.2% ophth soln 2IOPIDINE 1% OPHTH SOLN 4SIMBRINZA 1-0.2% OPHTH SUSP 3

OPHTHALMIC ANTI-INFECTIVESAZASITE 1% OPHTH SOLN 3BACITRACIN 0.5UNIT/MG OPHTH OINTMENT 2bacitracin 0.5unit/mg/polymyxin b 10unit/mg ophthointment

2

BLEPH-10 10% OPHTH SOLN 4




118

CILOXAN 0.3% OPHTH OINTMENT 4CILOXAN 0.3% OPHTH SOLN 4ciprofloxacin 0.3% ophth soln 2erythromycin 0.005mg/mg ophth ointment 2gatifloxacin 0.5% ophth soln 2GENTAK 0.3% OPHTH OINTMENT 2gentamicin sulfate 0.3% ophth soln 2GRAMICIDIN 0.025MG/ML/NEOMYCIN 1.75MG/ML/POLYMYXIN B 10000UNIT/ML OPHTH SOLN

2

levofloxacin 0.5% ophth soln 1moxifloxacin 0.5% ophth soln 1NATACYN 5% OPHTH SUSP 3neomycin/bacitracin/polymyxin ophth ointment5(3.5)mg-400unit-10000unit

2

OCUFLOX 0.3% OPHTH SOLN 4ofloxacin 0.3% ophth soln 2polymyxin b 10000unit/ml/trimethoprim 1mg/ml ophthsoln

1

POLYTRIM 10000UNIT/ML-0.1% OPHTH SOLN 4SULFACETAMIDE SODIUM 10% OPHTHOINTMENT

2

sulfacetamide sodium 10% ophth soln 2tobramycin 0.3% ophth soln 2TOBREX 0.3% OPHTH OINTMENT 4TOBREX 0.3% OPHTH SOLN 4TRIFLURIDINE 1% SOLN 2VIGAMOX 0.5% OPHTH SOLN 4ZIRGAN 0.15% OPHTH GEL 3ZYMAXID 0.5% OPHTH SOLN 4

OPHTHALMIC IMMUNOMODULATORSRESTASIS 0.05% OPHTH SUSP 3

OPHTHALMIC LOCAL ANESTHETICSproparacaine 0.5% ophth soln 2

OPHTHALMIC STEROIDSALREX 0.2% OPHTH SUSP 3BLEPHAMIDE 10-0.2% OPHTH OINTMENT 4BLEPHAMIDE 10-0.2% OPHTH SUSP 4DEXAMETHASONE 0.1% OPHTH SOLN 2dexamethasone/neomycin/polymyxin b 0.1% ophthointment

2

dexamethasone/neomycin/polymyxin b 0.1% ophth susp 2dexamethasone/tobramycin 0.3-0.1% ophth susp 2




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DUREZOL 0.05% OPHTH SUSP 3FLAREX 0.1% OPHTH SUSP 4fluorometholone 0.1% ophth susp 2FML 0.1% OPHTH OINTMENT 4FML 0.1% OPHTH SUSP 4FML FORTE LIQUIFILM 0.25% OPHTH SUSP 4hydrocortisone 10mg/ml/neomycin 3.5mg/ml/polymyxinb 10000unit/ml ophth susp

2

LOTEMAX 0.5% OPHTH GEL 3LOTEMAX 0.5% OPHTH OINTMENT 3LOTEMAX 0.5% OPHTH SUSP 3loteprednol etabonate 0.5% ophth susp 2MAXIDEX 0.1% OPHTH SUSP 3MAXITROL 0.1% OPHTH OINTMENT 4MAXITROL 0.1% OPHTH SUSP 4neomycin/polymyxin/bacitracin/hydrocortisone ophthointmentment 1%

2

OMNIPRED 1% OPHTH SUSP 4PRED FORTE 1% OPHTH SUSP 4PRED MILD 0.12% OPHTH SUSP 3PRED-G 0.3-0.6% OPHTH OINTMENT 4PRED-G 0.3-1% OPHTH SUSP 3PREDNISOLONE 1% OPHTH SOLN 2PREDNISOLONE ACETATE 1% OPHTH SUSP 2PREDNISOLONE SODIUM PHOSPHATE 2.5MG/ML/SULFACETAMIDE SODIUM 100MG/ML OPHTHSOLN

2

TOBRADEX 0.3-0.05% OPHTH SUSP 4TOBRADEX 0.3-0.1% OPHTH OINTMENT 3TOBRADEX 0.3-0.1% OPHTH SUSP 4ZYLET 0.5-0.3% OPHTH SUSP 3

OPHTHALMICS - MISC.ACULAR 0.4% OPHTH SOLN 4ACULAR 0.5% OPHTH SOLN 4ACUVAIL 0.45% OPHTH SOLN 4ALOCRIL 2% OPHTH SOLN 3ALOMIDE 0.1% OPHTH SOLN 3azelastine 0.05% ophth soln 2AZOPT 1% OPHTH SUSP 3BEPREVE 1.5% OPHTH SOLN 4BROMFENAC 0.09% OPHTH SOLN 3cromolyn sodium 4% ophth soln 2




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CYSTARAN 0.44% OPHTH SOLN 5 NDS PA QL=60 ML/30 Daysdiclofenac sodium 0.1% ophth soln 1dorzolamide 2% ophth soln 1epinastine 0.05% ophth soln 2flurbiprofen sodium 0.03% ophth soln 1ILEVRO 0.3% OPHTH SUSP 3ketorolac tromethamine 0.4% ophth soln 2ketorolac tromethamine 0.5% ophth soln 1LASTACAFT 0.25% OPHTH SOLN 4NEVANAC 0.1% OPHTH SUSP 3olopatadine 1mg/ml ophth soln 2olopatadine 2% ophth soln 2PATADAY 0.2% OPHTH SOLN 4PATANOL 0.1% OPHTH SOLN 4PROLENSA 0.07% OPHTH SOLN 4TRUSOPT 2% OPHTH SOLN 4

PROSTAGLANDINS - OPHTHALMICbimatoprost 0.03% ophth soln 2 QL=5 ML/30 Dayslatanoprost 0.005% ophth soln 1 QL=5 ML/30 DaysLUMIGAN 0.01% OPHTH SOLN 3 QL=5 ML/30 DaysTRAVATAN Z 0.004% OPHTH SOLN 3 QL=5 ML/30 DaysXALATAN 0.005% OPHTH SOLN 4 QL=5 ML/30 DaysZIOPTAN 0.0015% OPHTH SOLN 4 ST QL=30 EA/30 Days

OTIC AGENTSOTIC AGENTS - MISCELLANEOUS

acetic acid 2% otic soln 2OTIC ANTI-INFECTIVES

CETRAXAL 0.2% OTIC SOLN 3CIPROFLOXACIN 0.2% OTIC SOLN 3ofloxacin 0.3% otic soln 2

OTIC COMBINATIONSCIPRO HC 0.2-1% OTIC SUSP 4CIPRODEX 0.3-0.1% OTIC SUSP 3hydrocortisone 10mg/ml/neomycin 3.5mg/ml/polymyxinb 10000unit/ml otic soln

2

hydrocortisone 10mg/ml/neomycin 3.5mg/ml/polymyxinb 10000unit/ml otic susp

2

OTIC STEROIDSacetic acid/hydrocortisone 1-2% otic soln 2fluocinolone acetonide 0.01% otic oil 2fluocinolone acetonide 0.01% otic soln 2

PASSIVE IMMUNIZING AND TREATMENT AGENTS




121

IMMUNE SERUMSBIVIGAM 10% INJ 5 NDS PAFLEBOGAMMA 10% INJ 5 NDS PAGAMMAGARD 10GM INJ 5 NDS PAGAMMAGARD 2.5GM/25ML INJ 5 NDS PAGAMMAGARD 5GM INJ 5 NDS PAGAMMAKED 1GM/10ML INJ 5 NDS PAGAMMAPLEX 10GM/100ML INJ 5 NDS PAGAMMAPLEX 10GM/200ML INJ 5 NDS PAGAMMAPLEX 20GM/200ML INJ 5 NDS PAGAMMAPLEX 5GM/50ML INJ 5 NDS PAGAMUNEX 1GM/10ML INJ 5 NDS PAOCTAGAM 25GM/500ML INJ 5 NDS PAOCTAGAM 2GM/20ML INJ 5 NDS PAPANZYGA 10GM/100ML IV SOLN 5 NDS PAPANZYGA 1GM/10ML IV SOLN 5 NDS PAPANZYGA 2.5GM/25ML IV SOLN 5 NDS PAPANZYGA 20GM/200ML IV SOLN 5 NDS PAPANZYGA 30GM/300ML IV SOLN 5 NDS PAPANZYGA 5GM/50ML IV SOLN 5 NDS PAPRIVIGEN 20GM/200ML INJ 5 NDS PAVARIZIG 124.8/1.2ML INJ 5 NDS

PENICILLINSAMINOPENICILLINS

amoxicillin 125mg chew tab 1amoxicillin 250mg cap 1AMOXICILLIN 250MG CHEW TAB 2amoxicillin 25mg/ml susp 1 NDSamoxicillin 40mg/ml susp 1 NDSamoxicillin 500mg cap 1amoxicillin 500mg tab 1amoxicillin 50mg/ml susp 1amoxicillin 80mg/ml susp 1amoxicillin 875mg tab 1ampicillin 100mg/ml inj 2AMPICILLIN 125MG/ML INJ 3ampicillin 250mg/ml inj 2AMPICILLIN 500MG CAP 1

NATURAL PENICILLINSBICILLIN L-A 1200000UNIT/2ML SYRINGE 3BICILLIN L-A 2400000UNIT/4ML SYRINGE 3BICILLIN L-A 600000UNIT/ML SYRINGE 3




122

penicillin g potassium 1000000unit/ml inj 2PENICILLIN G POTASSIUM 40000UNIT/ML INJ 2PENICILLIN G POTASSIUM 60000UNIT/ML INJ 2PENICILLIN G PROCAINE 600000UNIT/MLSYRINGE

3

PENICILLIN G SODIUM 100000UNIT/ML INJ 3penicillin v potassium 250mg tab 1PENICILLIN V POTASSIUM 25MG/ML ORAL SOLN 1penicillin v potassium 500mg tab 1PENICILLIN V POTASSIUM 50MG/ML ORAL SOLN 1

PENICILLIN COMBINATIONSamoxicillin 120mg/ml/clavulanate 8.58mg/ml susp 2AMOXICILLIN 200MG/CLAVULANATE 28.5MGCHEW TAB

3

amoxicillin 250mg/clavulanate 125mg tab 2AMOXICILLIN 400MG/CLAVULANATE 57MGCHEW TAB

3

amoxicillin 40mg/ml/clavulanate 5.7mg/ml susp 2amoxicillin 500mg/clavulanate 125mg tab 1amoxicillin 50mg/ml/clavulanate 12.5mg/ml susp 2amoxicillin 80mg/ml/clavulanate 11.4mg/ml susp 2amoxicillin 875mg/clavulanate 125mg tab 1ampicillin 100mg/ml/sulbactam 50mg/ml inj 2ampicillin 20mg/ml/sulbactam 10mg/ml inj 2ampicillin 250mg/ml/sulbactam 125mg/ml inj 2AUGMENTIN 125-31.25MG/5ML SUSP 4BICILLIN 300000-300000UNIT/ML SYRINGE 3BICILLIN 450000-150000UNIT/ML SYRINGE 3piperacillin 2000mg/tazobactam 250mg inj 2piperacillin 200mg/ml/tazobactam 25mg/ml inj 2piperacillin 3000mg/tazobactam 375mg inj 2piperacillin 4000mg/tazobactam 500mg inj 2UNASYN 10-5GM INJ 4UNASYN 2-1GM INJ 4ZOSYN 200-25MG/ML INJ 4ZOSYN 40-5MG/ML INJ 4ZOSYN 60-7.5MG/ML INJ 4

PENICILLINASE-RESISTANT PENICILLINSdicloxacillin 250mg cap 2dicloxacillin 500mg cap 2nafcillin 100mg/ml inj 2nafcillin 1gm inj 2




123

nafcillin 2gm inj 2oxacillin 100mg/ml inj 2oxacillin 1gm inj 2oxacillin 2000mg inj 2OXACILLIN 20MG/ML INJ 3OXACILLIN 40MG/ML INJ 3

PROGESTINSPROGESTINS

AYGESTIN 5MG TAB 4medroxyprogesterone acetate 10mg tab 1medroxyprogesterone acetate 2.5mg tab 1medroxyprogesterone acetate 5mg tab 1megestrol acetate 125mg/ml susp 2 PAnorethindrone acetate 5mg tab 2progesterone 100mg cap 2progesterone 200mg cap 2PROMETRIUM 100MG CAP 4PROMETRIUM 200MG CAP 4PROVERA 10MG TAB 4PROVERA 2.5MG TAB 4PROVERA 5MG TAB 4

PSYCHOTHERAPEUTIC AND NEUROLOGICAL AGENTS - MISC.AGENTS FOR CHEMICAL DEPENDENCY

acamprosate calcium 333mg dr tab 2ANTABUSE 250MG TAB 4ANTABUSE 500MG TAB 4disulfiram 250mg tab 2disulfiram 500mg tab 2LUCEMYRA 0.18MG TAB 4 PA QL=168 EA/14 Days

ANTI-CATAPLECTIC AGENTSXYREM 500MG/ML ORAL SOLN 5 NDS PA QL=540 ML/30 Days

ANTIDEMENTIA AGENTSARICEPT 10MG TAB 4ARICEPT 23MG TAB 4 QL=30 EA/30 DaysARICEPT 5MG TAB 4donepezil 10mg odt 2 QL=30 EA/30 Daysdonepezil 10mg tab 1donepezil 23mg tab 2 QL=30 EA/30 Daysdonepezil 5mg odt 2 QL=30 EA/30 Daysdonepezil 5mg tab 1EXELON 13.3MG/24HR PATCH 4EXELON 4.6MG/24HR PATCH 4




124

EXELON 9.5MG/24HR PATCH 4galantamine 12mg tab 2galantamine 4mg tab 2galantamine 8mg tab 2galantamine hydrobromide 16mg er cap 2galantamine hydrobromide 24mg er cap 2GALANTAMINE HYDROBROMIDE 4MG/ML ORALSOLN

4

galantamine hydrobromide 8mg er cap 2memantine 10mg tab 1memantine 10mg/memantine 5mg pack 1memantine 14mg er cap 2memantine 21mg er cap 2memantine 28mg er cap 2memantine 2mg/ml oral soln 2memantine 5mg tab 1memantine 7mg er cap 2NAMENDA 10MG TAB 4NAMENDA 14MG XR CAP 4NAMENDA 21MG XR CAP 4NAMENDA 28 TITRATION PACK 4NAMENDA 28MG XR CAP 4NAMENDA 49 TITRATION PACK 4NAMENDA 5MG TAB 4NAMENDA 7MG XR CAP 4RAZADYNE 12MG TAB 4RAZADYNE 16MG ER CAP 4RAZADYNE 24MG ER CAP 4RAZADYNE 4MG TAB 4RAZADYNE 8MG ER CAP 4RAZADYNE 8MG TAB 4rivastigmine 1.5mg cap 2rivastigmine 13.3mg/24hr patch 2rivastigmine 3mg cap 2rivastigmine 4.5mg cap 2rivastigmine 4.6mg/24hr patch 2rivastigmine 6mg cap 2rivastigmine 9.5mg/24hr patch 2

COMBINATION PSYCHOTHERAPEUTICSAMITRIPTYLINE 10MG/PERPHENAZINE 2MG TAB 2AMITRIPTYLINE 10MG/PERPHENAZINE 4MG TAB 2amitriptyline 12.5mg/chlordiazepoxide 5mg tab 2




125

amitriptyline 25mg/chlordiazepoxide 10mg tab 2AMITRIPTYLINE 25MG/PERPHENAZINE 2MG TAB 2AMITRIPTYLINE 25MG/PERPHENAZINE 4MG TAB 2AMITRIPTYLINE 50MG/PERPHENAZINE 4MG TAB 2fluoxetine 25mg/olanzapine 12mg cap 2fluoxetine 25mg/olanzapine 3mg cap 2fluoxetine 25mg/olanzapine 6mg cap 2fluoxetine 50mg/olanzapine 12mg cap 2fluoxetine 50mg/olanzapine 6mg cap 2SYMBYAX 12-50MG CAP 4SYMBYAX 3-25MG CAP 4SYMBYAX 6-25MG CAP 4SYMBYAX 6-50MG CAP 4

FIBROMYALGIA AGENTSSAVELLA 100MG TAB 3 QL=60 EA/30 DaysSAVELLA 12.5MG TAB 3 QL=60 EA/30 DaysSAVELLA 25MG TAB 3 QL=60 EA/30 DaysSAVELLA 4-WEEK TITRATION PACK 3SAVELLA 50MG TAB 3 QL=60 EA/30 Days

MOVEMENT DISORDER DRUG THERAPYAUSTEDO 12MG TAB 5 NDS PAAUSTEDO 6MG TAB 5 NDS PAAUSTEDO 9MG TAB 5 NDS PAINGREZZA 40MG CAP 5 NDS PAINGREZZA 80MG CAP 5 NDS PAtetrabenazine 12.5mg tab 5 NDS PAtetrabenazine 25mg tab 5 NDS PA

MULTIPLE SCLEROSIS AGENTSAUBAGIO 14MG TAB 5 NDSAUBAGIO 7MG TAB 5 NDSAVONEX 30MCG/0.5ML AUTO-INJECTOR 5 NDSAVONEX 30MCG/0.5ML SYRINGE 5 NDSAVONEX 30MCG/VIAL INJ 5 NDSCOPAXONE 20MG/ML SYRINGE 5 NDSCOPAXONE 40MG/ML SYRINGE 5 NDSdalfampridine 10mg er tab 2 PA QL=60 EA/30 DaysEXTAVIA 0.3MG INJ 5 NDSGILENYA 0.5MG CAP 5 NDSglatiramer 20mg/ml syringe 5 NDSglatiramer 40mg/ml syringe 5 NDSglatopa 20mg/ml syringe 5 NDSglatopa 40mg/ml syringe 5 NDS




126

PLEGRIDY 125MCG/0.5ML AUTO-INJECTOR 5 NDSPLEGRIDY 125MCG/0.5ML SYRINGE 5 NDSPLEGRIDY PEN STARTER PACK 5 NDSPLEGRIDY STARTER PACK 5 NDSREBIF 22MCG/0.5ML AUTO-INJECTOR 5 NDSREBIF 22MCG/0.5ML SYRINGE 5 NDSREBIF 44MCG/0.5ML AUTO-INJECTOR 5 NDSREBIF 44MCG/0.5ML SYRINGE 5 NDSREBIF REBIDOSE PACK 5 NDSREBIF TITRATION PACK 5 NDSTECFIDERA 120MG DR CAP 5 NDSTECFIDERA 240MG DR CAP 5 NDSTECFIDERA 30-DAY STARTER PACK 5 NDS

PSEUDOBULBAR AFFECT (PBA) AGENTSNUEDEXTA 20-10MG CAP 3 PA QL=60 EA/30 Days

PSYCHOTHERAPEUTIC AND NEUROLOGICAL AGENTS - MISC.ERGOLOID MESYLATES 1MG TAB 4PIMOZIDE 1MG TAB 3PIMOZIDE 2MG TAB 3

SMOKING DETERRENTSbupropion 150mg sr tab 1CHANTIX 0.5MG TAB 3CHANTIX 1MG TAB 3CHANTIX CONTINUING MONTHS OF THERAPY1MG PACK

3

CHANTIX FIRST MONTH OF THERAPY PACK 3NICOTROL 10MG INHALER 3NICOTROL 10MG/ML NASAL INHALER 3ZYBAN 150MG SR TAB 4

RESPIRATORY AGENTS - MISC.ALPHA-PROTEINASE INHIBITOR (HUMAN)

ARALAST 500MG INJ 5 NDSGLASSIA 1000MG/50ML INJ 5 NDSPROLASTIN 1000MG INJ 5 NDSZEMAIRA 1000MG INJ 5 NDS

CYSTIC FIBROSIS AGENTSKALYDECO 150MG TAB 5 NDS PA QL=60 EA/30 DaysKALYDECO 25MG GRANULES 5 NDS PA QL=60 EA/30 DaysKALYDECO 50MG GRANULES PACKET 5 NDS PA QL=60 EA/30 DaysKALYDECO 75MG GRANULES PACKET 5 NDS PA QL=60 EA/30 DaysORKAMBI 100-125MG GRANULES PACKET 5 NDS PA QL=60 EA/30 DaysORKAMBI 100-125MG TAB 5 NDS PA QL=120 EA/30 Days




127

ORKAMBI 188-150MG GRANULES PACKET 5 NDS PA QL=60 EA/30 DaysORKAMBI 200-125MG TAB 5 NDS PA QL=120 EA/30 DaysPULMOZYME 1MG/ML INH SOLN 5 NDS PA BvDSYMDEKO TAB 4-WEEK PACK 5 NDS PA QL=60 EA/30 Days

PULMONARY FIBROSIS AGENTSESBRIET 267MG CAP 5 NDS PAESBRIET 267MG TAB 5 NDS PAESBRIET 801MG TAB 5 NDS PAOFEV 100MG CAP 5 NDS PAOFEV 150MG CAP 5 NDS PA

SULFONAMIDESSULFONAMIDES

SULFADIAZINE 500MG TAB 2TETRACYCLINES

GLYCYLCYCLINESTIGECYCLINE 50MG INJ 5 NDSTYGACIL 50MG INJ 5 NDS

TETRACYCLINESdemeclocycline 150mg tab 2demeclocycline 300mg tab 2doxy 100mg inj 2doxycycline hyclate 100mg cap 1doxycycline hyclate 100mg tab 1doxycycline hyclate 20mg tab 1doxycycline hyclate 50mg cap 1doxycycline monohydrate 100mg cap 1doxycycline monohydrate 100mg tab 1doxycycline monohydrate 50mg cap 1doxycycline monohydrate 50mg tab 1doxycycline monohydrate 5mg/ml susp 2doxycycline monohydrate 75mg tab 1MINOCIN 50MG CAP 4minocycline 100mg cap 1minocycline 100mg tab 2minocycline 50mg cap 1minocycline 50mg tab 2minocycline 75mg cap 1minocycline 75mg tab 2mondoxyne 100mg cap 1morgidox 50mg cap 1tetracycline 250mg cap 4tetracycline 500mg cap 4




128

VIBRAMYCIN 100MG CAP 4VIBRAMYCIN 25MG/5ML SUSP 4VIBRAMYCIN 50MG/5ML SUSP 4

THYROID AGENTSANTITHYROID AGENTS

methimazole 10mg tab 1methimazole 5mg tab 1propylthiouracil 50mg tab 2TAPAZOLE 10MG TAB 4TAPAZOLE 5MG TAB 4

THYROID HORMONESCYTOMEL 25MCG TAB 4CYTOMEL 50MCG TAB 4CYTOMEL 5MCG TAB 4levo-t 100mcg tab 2levo-t 112mcg tab 2levo-t 125mcg tab 2levo-t 137mcg tab 2levo-t 150mcg tab 2levo-t 175mcg tab 2levo-t 200mcg tab 2levo-t 25mcg tab 2levo-t 300mcg tab 2levo-t 50mcg tab 2levo-t 75mcg tab 2levo-t 88mcg tab 2levothyroxine sodium 100mcg tab 2levothyroxine sodium 112mcg tab 2levothyroxine sodium 125mcg tab 2levothyroxine sodium 137mcg tab 2levothyroxine sodium 150mcg tab 2levothyroxine sodium 175mcg tab 2levothyroxine sodium 200mcg tab 2levothyroxine sodium 25mcg tab 2levothyroxine sodium 300mcg tab 2levothyroxine sodium 50mcg tab 2levothyroxine sodium 75mcg tab 2levothyroxine sodium 88mcg tab 2levoxyl 100mcg tab 2levoxyl 112mcg tab 2levoxyl 125mcg tab 2levoxyl 137mcg tab 2




129

levoxyl 150mcg tab 2levoxyl 175mcg tab 2levoxyl 200mcg tab 2levoxyl 25mcg tab 2levoxyl 50mcg tab 2levoxyl 75mcg tab 2levoxyl 88mcg tab 2liothyronine sodium 0.005mg tab 2liothyronine sodium 0.025mg tab 2liothyronine sodium 0.05mg tab 2SYNTHROID 100MCG TAB 4SYNTHROID 112MCG TAB 4SYNTHROID 125MCG TAB 4SYNTHROID 137MCG TAB 4SYNTHROID 150MCG TAB 4SYNTHROID 175MCG TAB 4SYNTHROID 200MCG TAB 4SYNTHROID 25MCG TAB 4SYNTHROID 300MCG TAB 4SYNTHROID 50MCG TAB 4SYNTHROID 75MCG TAB 4SYNTHROID 88MCG TAB 4THYROLAR 120MG TAB 3THYROLAR 15MG TAB 3THYROLAR 180MG TAB 3THYROLAR 30MG TAB 3THYROLAR 60MG TAB 3unithroid 100mcg tab 2unithroid 112mcg tab 2unithroid 125mcg tab 2unithroid 150mcg tab 2unithroid 175mcg tab 2unithroid 200mcg tab 2unithroid 25mcg tab 2unithroid 300mcg tab 2unithroid 50mcg tab 2unithroid 75mcg tab 2unithroid 88mcg tab 2

TOXOIDSTOXOID COMBINATIONS

ADACEL INJ 3ADACEL SYRINGE 3




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BOOSTRIX INJ 3BOOSTRIX SYRINGE 3DAPTACEL INJ 3DIPHTHERIA/TETANUS TOXOID INJ 3 PA BvDINFANRIX INJ 3KINRIX INJ 3KINRIX PF INJ 3PEDIARIX INJ 3QUADRACEL INJ 3TENIVAC SYRINGE 3 PA BvDTETANUS/DIPHTHERIA TOXOID INJ 3 PA BvD

ULCER DRUGSH-2 ANTAGONISTS

cimetidine 200mg tab 2cimetidine 300mg tab 2cimetidine 400mg tab 2cimetidine 800mg tab 2famotidine 20mg tab 1famotidine 40mg tab 1famotidine 8mg/ml susp 2nizatidine 150mg cap 2nizatidine 300mg cap 2PEPCID 20MG TAB 4ranitidine 150mg cap 1ranitidine 15mg/ml oral soln 1ranitidine 300mg cap 1

MISC. ANTI-ULCERCARAFATE 1GM TAB 4CARAFATE 1GM/10ML SUSP 3sucralfate 1000mg tab 1

PROTON PUMP INHIBITORSACIPHEX 20MG DR TAB 4esomeprazole 20mg dr cap 2lansoprazole 15mg dr cap 2lansoprazole 30mg dr cap 2NEXIUM 20MG DR CAP 4omeprazole 10mg dr cap 1omeprazole 20mg dr cap 1pantoprazole 20mg dr tab 1pantoprazole 40mg dr tab 1PREVACID 15MG DR CAP 4PREVACID 30MG DR CAP 4




131

PROTONIX 20MG DR TAB 4PROTONIX 40MG DR TAB 4rabeprazole sodium 20mg dr tab 2

ULCER DRUGS - PROSTAGLANDINSCYTOTEC 100MCG TAB 4CYTOTEC 200MCG TAB 4misoprostol 0.1mg tab 2misoprostol 0.2mg tab 2

ULCER DRUGS/ANTISPASMODICS/ANTICHOLINERGICSANTISPASMODICS

CUVPOSA 1MG/5ML ORAL SOLN 4dicyclomine 10mg cap 1dicyclomine 20mg tab 1dicyclomine 2mg/ml oral soln 2glycopyrrolate 1mg tab 2glycopyrrolate 2mg tab 2methscopolamine 2.5mg tab 2methscopolamine 5mg tab 2

H-2 ANTAGONISTSCIMETIDINE 60MG/ML ORAL SOLN 2NIZATIDINE 15MG/ML ORAL SOLN 4PEPCIC 40MG TAB 4ranitidine 150mg tab 1ranitidine 300mg tab 1

PROTON PUMP INHIBITORSesomeprazole 40mg dr cap 2lansoprazole 15mg odt 2lansoprazole 30mg odt 2NEXIUM 40MG DR CAP 4omeprazole 40mg dr cap 1

ULCER THERAPY COMBINATIONSamoxicillin 500mg/clarithromycin 500mg/lansoprazole30mg pack

2

PYLERA 140-125-125MG CAP 4URINARY ANTI-INFECTIVESURINARY ANTI-INFECTIVES

FURADANTIN 25MG/5ML SUSP 4HIPREX 1GM TAB 4MACROBID 100MG CAP 4MACRODANTIN 100MG CAP 4MACRODANTIN 25MG CAP 4MACRODANTIN 50MG CAP 4




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methenamine hippurate 1000mg tab 2MONUROL 3000MG ORAL SOLN 4nitrofurantoin 5mg/ml susp 2nitrofurantoin macro 100mg cap 2nitrofurantoin macro 25mg cap 2nitrofurantoin macro 25mg/nitrofurantoin mono 75mgcap

2

nitrofurantoin macro 50mg cap 2URINARY ANTISPASMODICS

URINARY ANTISPASMODIC - ANTIMUSCARINICS (ANTICHOLINERGIC)darifenacin 15mg er tab 2darifenacin 7.5mg er tab 2DETROL 1MG TAB 4DETROL 2MG ER CAP 4DETROL 2MG TAB 4DETROL 4MG ER CAP 4DITROPAN 10MG XL TAB 4DITROPAN 5MG XL TAB 4ENABLEX 15MG ER TAB 4ENABLEX 7.5MG ER TAB 4oxybutynin chloride 10mg er tab 1oxybutynin chloride 15mg er tab 1oxybutynin chloride 1mg/ml oral soln 1oxybutynin chloride 5mg er tab 1oxybutynin chloride 5mg tab 1solifenacin succinate 10mg tab 2solifenacin succinate 5mg tab 2tolterodine tartrate 1mg tab 2tolterodine tartrate 2mg er cap 2tolterodine tartrate 2mg tab 2tolterodine tartrate 4mg er cap 2trospium chloride 20mg tab 2trospium chloride 60mg er cap 2

URINARY ANTISPASMODICS - BETA-3 ADRENERGIC AGONISTSMYRBETRIQ 25MG ER TAB 3MYRBETRIQ 50MG ER TAB 3

URINARY ANTISPASMODICS - CHOLINERGIC AGONISTSbethanechol chloride 10mg tab 1bethanechol chloride 25mg tab 1bethanechol chloride 50mg tab 1bethanechol chloride 5mg tab 1URECHOLINE 10MG TAB 4




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URECHOLINE 25MG TAB 4URECHOLINE 50MG TAB 4URECHOLINE 5MG TAB 4

URINARY ANTISPASMODICS - DIRECT MUSCLE RELAXANTSflavoxate 100mg tab 2

VACCINESBACTERIAL VACCINES

ACTHIB INJ 3BCG LIVE TICE STRAIN 50MG/ML INJ 3BEXSERO SYRINGE 3HIBERIX INJ 3MENACTRA INJ 3MENVEO INJ 3PEDVAXHIB 7.5MCG/0.5ML INJ 3TRUMENBA SYRINGE 3TYPHIM VI 25MCG/0.5ML INJ 3TYPHIM VI 25MCG/0.5ML SYRINGE 3

VIRAL VACCINESENGERIX-B 10MCG/0.5ML SYRINGE 3 PA BvDENGERIX-B 20MCG/ML SYRINGE 3 PA BvDGARDASIL 9 INJ 3GARDASIL 9 SYRINGE 3HAVRIX 1440UNIT INJ 3HAVRIX 1440UNIT SYRINGE 3HAVRIX 720UNIT INJ 3HAVRIX 720UNIT SYRINGE 3IMOVAX 2.5UNIT/ML INJ 3 PA BvDIPOL INJ 3IXIARO SYRINGE 3M-M-R II INJ 3PROQUAD INJ 3RABAVERT 2.5UNIT/ML INJ 3 PA BvDRECOMBIVAX 10MCG/ML SYRINGE 3 PA BvDRECOMBIVAX 40MCG/ML INJ 3 PA BvDRECOMBIVAX 5MCG/0.5ML SYRINGE 3 PA BvDRECOMBIVAX HB 10MCG/ML INJ 3 PA BvDROTARIX SUSP 3ROTATEQ SUSP 3SHINGRIX INJ 3TWINRIX 720UNIT SYRINGE 3VAQTA 25UNIT/0.5ML SYRINGE 3VAQTA 50UNIT/0.5ML INJ 3




134

VAQTA 50UNIT/1ML INJ 3VAQTA 50UNIT/ML SYRINGE 3VARIVAX 1350PFU/0.5ML INJ 3YF-VAX 4000UNIT/ML INJ 3ZOSTAVAX 19400UNIT/0.65ML INJ 3

VAGINAL PRODUCTSVAGINAL ANTI-INFECTIVES

AVC BRAND OF SULFANILAMIDE 15% VAGINALCREAM

3

CLEOCIN 100MG VAGINAL SUPP 4CLEOCIN 2% VAGINAL CREAM 4clindamycin 2% vaginal cream 2CLINDESSE 2% APPLICATOR 4METROGEL 0.75% VAGINAL GEL 4metronidazole 0.75% vaginal gel 2MICONAZOLE NITRATE 200MG VAGINAL SUPP 4terconazole 0.4% vaginal cream 2TERCONAZOLE 0.8% VAGINAL CREAM 2terconazole 80mg vaginal supp 2vandazole 0.75% vaginal gel 2

VAGINAL ESTROGENSESTRACE 0.1MG/GM VAGINAL CREAM 4estradiol 0.1mg/ml vaginal cream 2estradiol 10mcg vaginal tab 2ESTRING 2MG VAGINAL RING 4 STFEMRING 0.05MG/24HR VAGINAL RING 4 STFEMRING 0.1MG/24HR VAGINAL RING 4 STPREMARIN 0.625MG/GM VAGINAL CREAM 3VAGIFEM 10MCG VAGINAL TAB 4yuvafem 0.01mg vaginal tab 2

VAGINAL PROGESTINSCRINONE 4% VAGINAL GEL 3 PACRINONE 8% VAGINAL GEL 3 PA

VASOPRESSORSANAPHYLAXIS THERAPY AGENTS

EPINEPHRINE 0.15MG/0.3ML AUTO-INJECTOR 3 QL=2 EA/15 Daysepinephrine 0.3mg/0.3ml auto-injector 3 QL=2 EA/15 Days

NEUROGENIC ORTHOSTATIC HYPOTENSION (NOH) - AGENTSNORTHERA 100MG CAP 5 NDS PANORTHERA 200MG CAP 5 NDS PANORTHERA 300MG CAP 5 NDS PA

VASOPRESSORS




135

midodrine 10mg tab 2midodrine 2.5mg tab 2midodrine 5mg tab 2IDX_136


ALPHABETICAL LISTING OF DRUGS


136

Aabacavir 20mg/ml oral soln 66abacavir 300mg/lamivudine

150mg/zidovudine 300mgtab 66

abacavir 300mg tab 66abacavir 600mg/lamivudine

300mg tab 66ABELCET 5MG/ML INJ 39ABILIFY 10MG TAB 65ABILIFY 15MG TAB 66ABILIFY 20MG TAB 66ABILIFY 2MG TAB 66ABILIFY 300MG

MAINTENA INJ 66ABILIFY 300MG

MAINTENA PFSYRINGE 66

ABILIFY 30MG TAB 66ABILIFY 400MG

MAINTENA INJ 66ABILIFY 400MG

MAINTENA PFSYRINGE 66

ABILIFY 5MG TAB 66abiraterone 250mg tab 53ABSTRAL 100MCG SL TAB 7ABSTRAL 200MCG SL TAB 7ABSTRAL 300MCG SL TAB 7ABSTRAL 400MCG SL TAB 7ABSTRAL 600MCG SL TAB 7ABSTRAL 800MCG SL TAB 7acamprosate calcium 333mg

dr tab 123ACANYA 1.2-2.5% GEL 86acarbose 100mg tab 34acarbose 25mg tab 34acarbose 50mg tab 34ACCOLATE 10MG TAB 19ACCOLATE 20MG TAB 19ACCUPRIL 10MG TAB 44ACCUPRIL 20MG TAB 44ACCUPRIL 40MG TAB 44

ACCUPRIL 5MG TAB 44ACCURETIC 10-12.5MG

TAB 47ACCURETIC 20-12.5MG

TAB 47ACCURETIC 20-25MG TAB 47acebutolol 200mg cap 72acebutolol 400mg cap 72acetaminophen

21.7mg/ml/hydrocodonebitartrate 0.5mg/ml oralsoln 10

acetaminophen24mg/ml/codeinephosphate 2.4mg/ml oralsoln 10

acetaminophen300mg/codeine phosphate15mg tab 10



acetaminophen300mg/hydrocodonebitartrate 10mg tab 10


acetaminophen300mg/hydrocodonebitartrate 7.5mg tab 10



acetaminophen325mg/hydrocodonebitartrate 7.5mg tab 10

acetaminophen325mg/oxycodone 10mgtab 10

acetaminophen325mg/oxycodone 2.5mgtab 10

acetaminophen325mg/oxycodone 5mg tab 10

acetaminophen325mg/oxycodone 7.5mgtab 10

acetaminophen325mg/tramadol 37.5mgtab 10

acetazolamide 125mg tab 95acetazolamide 250mg tab 95acetazolamide 500mg er cap 95acetic acid/hydrocortisone

1-2% otic soln 120acetic acid 2% otic soln 120acetylcysteine 10% inh soln 86acetylcysteine 20% inh soln 86ACIPHEX 20MG DR TAB 130acitretin 10mg cap 89acitretin 17.5mg cap 89acitretin 25mg cap 89ACTEMRA 162MG/0.9ML

AUTO-INJECTOR 5ACTEMRA 162MG/0.9ML

SYRINGE 5ACTHIB INJ 133ACTIGALL 300MG CAP 102ACTIMMUNE

2000000UNIT/0.5ML INJ 57ACTIQ 1200MCG LOZENGE 7ACTIQ 1600MCG LOZENGE 7ACTIQ 200MCG LOZENGE 7ACTIQ 400MCG LOZENGE 7ACTIQ 600MCG LOZENGE 7ACTIQ 800MCG LOZENGE 7ACTIVELLA 1/0.5MG 28

DAY PACK 99ACTONEL 150MG TAB 96




137

ACTONEL 35 4-WEEK35MG PACK 96

ACTONEL 5MG TAB 96ACTOS 15MG TAB 37ACTOS 30MG TAB 37ACTOS 45MG TAB 37ACULAR 0.4% OPHTH

SOLN 119ACULAR 0.5% OPHTH

SOLN 119ACUVAIL 0.45% OPHTH

SOLN 119acyclovir 200mg cap 70acyclovir 400mg tab 70acyclovir 40mg/ml susp 70acyclovir 5% cream 90acyclovir 5% ointment 90acyclovir 50mg/ml inj 70acyclovir 800mg tab 70ADACEL INJ 129ADACEL SYRINGE 129ADALAT 30MG ER TAB 74ADALAT 60MG ER TAB 74ADALAT 90MG ER TAB 74adapalene/benzoyl peroxide

0.1-2.5% gel 86adapalene 0.1% cream 86adapalene 0.1% gel 86adapalene 0.3% gel 86ADCIRCA 20MG TAB 78ADDERALL 10MG XR CAP 1ADDERALL 15MG XR CAP 1ADDERALL 20MG TAB 1ADDERALL 20MG XR CAP 1ADDERALL 25MG XR CAP 1ADDERALL 30MG XR CAP 1ADDERALL 5MG TAB 1ADDERALL 5MG XR CAP 1ADDERALL 7.5MG TAB 1adefovir dipivoxil 10mg tab 70ADEMPAS 0.5MG TAB 78ADEMPAS 1.5MG TAB 78ADEMPAS 1MG TAB 78ADEMPAS 2.5MG TAB 78

ADEMPAS 2MG TAB 78ADVAIR 115-21MCG HFA

INH 20ADVAIR 230-21MCG HFA

INH 20ADVAIR 45-21MCG HFA

INH 20AFINITOR 10MG TAB 54AFINITOR 2.5MG TAB 54AFINITOR 2MG SUSP 54AFINITOR 3MG SUSP 54AFINITOR 5MG SUSP 54AFINITOR 5MG TAB 54AFINITOR 7.5MG TAB 54AGGRENOX 25-200MG

CAP 105AGRYLIN 0.5MG CAP 105AIMOVIG 140MG/ML

AUTO-INJECTOR 110AIMOVIG 70MG/ML

AUTO-INJECTOR 110ala-cort 1% cream 90ala-cort 2.5% cream 90albendazole 200mg tab 13ALBENZA 200MG TAB 13albuterol 0.21mg/ml

(0.63mg/3ml) inh soln 20albuterol 0.417mg/ml

(1.25mg/3ml) inh soln 20albuterol 0.4mg/ml (2mg/5ml)

oral oral soln 20albuterol 0.83mg/ml (0.083%)

inh soln 20albuterol 1mg/ml (0.5%) inh

soln 20albuterol 2mg tab 20ALBUTEROL 4MG ER TAB 20albuterol 4mg tab 20ALBUTEROL 8MG ER TAB 20alclometasone dipropionate

0.05% cream 90alclometasone dipropionate

0.05% ointment 90

ALDACTAZIDE 25-25MGTAB 95

ALDACTAZIDE 50-50MGTAB 95

ALDACTONE 100MG TAB 95ALDACTONE 25MG TAB 95ALDACTONE 50MG TAB 95ALDARA 5% CREAM 93ALECENSA 150MG CAP 54ALENDRONATE

0.933MG/ML ORALSOLN 96

alendronate 10mg tab 96alendronate 35mg tab 96ALENDRONATE 40MG TAB96alendronate 5mg tab 96alendronate 70mg tab 96alfuzosin 10mg er tab 104ALINIA 100MG/5ML SUSP 13ALINIA 500MG TAB 13aliskiren 150mg tab 50aliskiren 300mg tab 50allopurinol 100mg tab 105allopurinol 300mg tab 105ALOCRIL 2% OPHTH

SOLN 119ALOMIDE 0.1% OPHTH

SOLN 119ALORA 0.025MG/24HR

PATCH 100ALORA 0.05MG/24HR



PATCH 100alosetron 0.5mg tab 103alosetron 1mg tab 103ALPHAGAN P 0.1%

OPHTH SOLN 117ALPHAGAN P 0.15%

OPHTH SOLN 117alprazolam 0.25mg odt 16alprazolam 0.25mg tab 16




138

alprazolam 0.5mg er tab 16alprazolam 0.5mg odt 16alprazolam 0.5mg tab 16ALPRAZOLAM 1MG/ML

ORAL SOLN 17alprazolam 1mg er tab 16alprazolam 1mg odt 17alprazolam 1mg tab 17alprazolam 2mg er tab 17alprazolam 2mg odt 17alprazolam 2mg tab 17alprazolam 3mg er tab 17ALREX 0.2% OPHTH

SUSP 118ALTACE 1.25MG CAP 44ALTACE 10MG CAP 44ALTACE 2.5MG CAP 44ALTACE 5MG CAP 44altavera 28 day pack 80ALUNBRIG 180MG TAB 54ALUNBRIG 30MG TAB 54ALUNBRIG 90MG TAB 54ALUNBRIG TAB STARTER

PACK 54alyacen 1/35 28 day pack 80alyq 20mg tab 78amabelz 0.5/0.1mg 28 day

pack 99amabelz 1/0.5mg 28 day pack 99amantadine 100mg cap 58amantadine 100mg tab 60amantadine 10mg/ml oral

soln 58AMARYL 1MG TAB 37AMARYL 2MG TAB 37AMARYL 4MG TAB 37AMBIEN 10MG TAB 107AMBIEN 5MG TAB 107AMBISOME 50MG INJ 40ambrisentan 10mg tab 78ambrisentan 5mg tab 78AMCINONIDE 0.1%

CREAM 90

AMCINONIDE 0.1%LOTION 90

AMCINONIDE 0.1%OINTMENT 91

AMERGE 1MG TAB 110AMERGE 2.5MG TAB 110amethia 91 day pack 80amethia lo 91 day pack 80amikacin 250mg/ml inj 4amiloride

5mg/hydrochlorothiazide50mg tab 95

amiloride 5mg tab 95AMINOSYN II 10% INJ 116AMINOSYN II 15% INJ 116AMINOSYN-PF 10%

SULFITE-FREE INJ 116AMINOSYN-PF 7% INJ 116amiodarone 200mg tab 18amiodarone 400mg tab 18amiodarone hydrochloride

100mg tab 18amitriptyline 100mg tab 33AMITRIPTYLINE

10MG/PERPHENAZINE2MG TAB 124

AMITRIPTYLINE10MG/PERPHENAZINE4MG TAB 124

amitriptyline 10mg tab 33amitriptyline

12.5mg/chlordiazepoxide5mg tab 124

amitriptyline 150mg tab 33amitriptyline

25mg/chlordiazepoxide10mg tab 125



amitriptyline 25mg tab 33


amitriptyline 50mg tab 33amitriptyline 75mg tab 33amlodipine 10mg/atorvastatin

10mg tab 77amlodipine 10mg/atorvastatin



80mg tab 77amlodipine 10mg/benazepril

20mg cap 47amlodipine 10mg/benazepril

40mg cap 47amlodipine

10mg/hydrochlorothiazide12.5mg/valsartan 160mgtab 47

amlodipine10mg/hydrochlorothiazide25mg/valsartan 160mg tab 47


amlodipine 10mg/olmesartanmedoxomil 20mg tab 47


amlodipine 10mg/telmisartan40mg tab 47


amlodipine 10mg/valsartan160mg tab 47


amlodipine 10mg tab 74amlodipine

2.5mg/atorvastatin 10mgtab 77




139

amlodipine2.5mg/atorvastatin 20mgtab 77

amlodipine2.5mg/atorvastatin 40mgtab 77

amlodipine 2.5mg/benazepril10mg cap 47

amlodipine 2.5mg tab 74amlodipine 5mg/atorvastatin




80mg tab 77amlodipine 5mg/benazepril



40mg cap 48amlodipine

5mg/hydrochlorothiazide12.5mg/valsartan 160mgtab 48








amlodipine 5mg tab 74ammonium lactate 12% cream93

ammonium lactate 12% lotion 93amnesteem 10mg cap 86amnesteem 20mg cap 86amnesteem 40mg cap 86AMOXAPINE 100MG TAB 33AMOXAPINE 150MG TAB 33AMOXAPINE 25MG TAB 33AMOXAPINE 50MG TAB 33amoxicillin

120mg/ml/clavulanate8.58mg/ml susp 122

amoxicillin 125mg chew tab 121AMOXICILLIN

200MG/CLAVULANATE28.5MG CHEW TAB 122

amoxicillin250mg/clavulanate 125mgtab 122

amoxicillin 250mg cap 121AMOXICILLIN 250MG

CHEW TAB 121amoxicillin 25mg/ml susp 121AMOXICILLIN

400MG/CLAVULANATE57MG CHEW TAB 122

amoxicillin40mg/ml/clavulanate5.7mg/ml susp 122

amoxicillin 40mg/ml susp 121amoxicillin

500mg/clarithromycin500mg/lansoprazole 30mgpack 131

amoxicillin500mg/clavulanate 125mgtab 122

amoxicillin 500mg cap 121amoxicillin 500mg tab 121amoxicillin

50mg/ml/clavulanate12.5mg/ml susp 122

amoxicillin 50mg/ml susp 121

amoxicillin80mg/ml/clavulanate11.4mg/ml susp 122

amoxicillin 80mg/ml susp 121amoxicillin

875mg/clavulanate 125mgtab 122

amoxicillin 875mg tab 121amphetamine 10mg er cap 1amphetamine 10mg tab 1amphetamine 12.5mg tab 1amphetamine 15mg er cap 1amphetamine 15mg tab 1amphetamine 20mg er cap 1amphetamine 20mg tab 1amphetamine 25mg er cap 1amphetamine 30mg er cap 1amphetamine 30mg tab 1amphetamine 5mg er cap 1amphetamine 5mg tab 1amphetamine 7.5mg tab 1AMPHOTERICIN B 50MG

INJ 40ampicillin

100mg/ml/sulbactam50mg/ml inj 122

ampicillin 100mg/ml inj 121AMPICILLIN 125MG/ML

INJ 121ampicillin

20mg/ml/sulbactam10mg/ml inj 122

ampicillin250mg/ml/sulbactam125mg/ml inj 122

ampicillin 250mg/ml inj 121AMPICILLIN 500MG CAP 121ANADROL-50 50MG TAB 12ANAFRANIL 25MG CAP 33ANAFRANIL 50MG CAP 33ANAFRANIL 75MG CAP 33anagrelide 0.5mg cap 105anagrelide 1mg cap 105anastrozole 1mg tab 53




140

ANCOBON 250MG CAP 40ANCOBON 500MG CAP 40ANDRODERM 2MG/24HR

PATCH 12ANDRODERM 4MG/24HR

PATCH 12ANDROGEL 1.62%

(1.25GM) GEL 12ANDROGEL 1.62% (2.5GM)

GEL 12ANDROGEL 1.62% GEL 12ANDROGEL 1% (25MG)

GEL 12ANDROGEL 1% (50MG)

GEL 12ANGELIQ 0.25/0.5MG 28

DAY PACK 99ANGELIQ 0.5/1MG 28 DAY

PACK 99ANORO 62.5-25MCG

ELLIPTA INH 20ANTABUSE 250MG TAB 123ANTABUSE 500MG TAB 123ANTARA 30MG CAP 42ANTARA 90MG CAP 42ANUSOL HC 2.5% RECTAL

CREAM 12APEXICON 0.05% CREAM 91APLENZIN 174MG ER TAB 30APLENZIN 348MG ER TAB 30APLENZIN 522MG ER TAB 30APOKYN 10MG/ML

CARTRIDGE 60apraclonidine 0.5% ophth

soln 117aprepitant 125mg/80mg pack 39aprepitant 125mg cap 39aprepitant 40mg cap 39aprepitant 80mg cap 39apri 28 day pack 80APRISO 0.375GM ER CAP 102APTIOM 200MG TAB 24APTIOM 400MG TAB 24APTIOM 600MG TAB 24

APTIOM 800MG TAB 24APTIVUS 100MG/ML

ORAL SOLN 66APTIVUS 250MG CAP 67ARALAST 500MG INJ 126aranelle 28 pack 80ARANESP 100MCG/0.5ML

SYRINGE 106ARANESP 100MCG/ML

INJ 106ARANESP 10MCG/0.4ML

SYRINGE 106ARANESP 150MCG/0.3ML




SYRINGE 106ARANESP 25MCG/ML INJ 106ARANESP 300MCG/0.6ML



SYRINGE 106ARANESP 40MCG/ML INJ 106ARANESP 500MCG/ML


SYRINGE 106ARANESP 60MCG/ML INJ 106ARAVA 10MG TAB 7ARAVA 20MG TAB 7ARCALYST 220MG INJ 5ARICEPT 10MG TAB 123ARICEPT 23MG TAB 123ARICEPT 5MG TAB 123ARIKAYCE 70.3MG/ML

INH SOLN 4ARIMIDEX 1MG TAB 53aripiprazole 10mg odt 66aripiprazole 10mg tab 66

aripiprazole 15mg odt 66aripiprazole 15mg tab 66aripiprazole 1mg/ml oral soln 66aripiprazole 20mg tab 66aripiprazole 2mg tab 66aripiprazole 30mg tab 66aripiprazole 5mg tab 66ARISTADA 273MG/ML

SYRINGE 66ARISTADA 441MG/1.6ML




SYRINGE 66ARIXTRA 10MG/0.8ML

SYRINGE 22ARIXTRA 2.5MG/0.5ML

SYRINGE 22ARIXTRA 5MG/0.4ML

SYRINGE 22ARIXTRA 7.5MG/0.6ML

SYRINGE 22armodafinil 150mg tab 2armodafinil 200mg tab 2armodafinil 250mg tab 2armodafinil 50mg tab 2ARNUITY 100MCG INH 19ARNUITY 200MCG INH 19ARNUITY 50MCG INH 19AROMASIN 25MG TAB 53ARTHROTEC 50-0.2MG TAB 5ARTHROTEC 75-0.2MG TAB 5ashlyna 91 day pack 80ASMANEX 100MCG

(120ACT) HFA INH 19ASMANEX 110MCG

(30ACT) INH 19ASMANEX 200MCG

(120ACT) HFA INH 19ASMANEX 220MCG

(120ACT) INH 19




141

ASMANEX 220MCG(30ACT) INH 19

ASMANEX 220MCG(60ACT) INH 19

aspirin 25mg/dipyridamole200mg cap 105

aspirin 325mg/oxycodone4.84mg tab 10

ASTAGRAF 0.5MG XLCAP 113

ASTAGRAF 1MG XL CAP 113ASTAGRAF 5MG XL CAP 113ASTEPRO 0.15% NASAL

INHALER 115atazanavir 150mg cap 67atazanavir 200mg cap 67atazanavir 300mg cap 67atenolol

100mg/chlorthalidone25mg tab 48

atenolol 100mg tab 72atenolol 25mg tab 72atenolol 50mg/chlorthalidone

25mg tab 48atenolol 50mg tab 72ATIVAN 0.5MG TAB 17ATIVAN 1MG TAB 17ATIVAN 2MG TAB 17atomoxetine 100mg cap 1atomoxetine 10mg cap 1atomoxetine 18mg cap 1atomoxetine 25mg cap 1atomoxetine 40mg cap 1atomoxetine 60mg cap 1atomoxetine 80mg cap 1atorvastatin 10mg tab 42atorvastatin 20mg tab 42atorvastatin 40mg tab 42atorvastatin 80mg tab 42atovaquone 150mg/ml susp 13atovaquone 250mg/proguanil

100mg tab 51atovaquone 62.5mg/proguanil

25mg tab 51

ATRALIN 0.05% GEL 86ATRIPLA 600-200-300MG

TAB 67atropine sulfate

0.005mg/ml/diphenoxylate0.5mg/ml oral soln 38

atropine sulfate0.025mg/diphenoxylate2.5mg tab 38

ATROPINE SULFATE 1%OPHTH SOLN 117

ATROVENT 17MCG INH 19AUBAGIO 14MG TAB 125AUBAGIO 7MG TAB 125aubra 28 day pack 80AUGMENTIN

125-31.25MG/5ML SUSP122AURYXIA 210MG TAB 103AUSTEDO 12MG TAB 125AUSTEDO 6MG TAB 125AUSTEDO 9MG TAB 125AVALIDE 150-12.5MG TAB 48AVALIDE 300-12.5MG TAB 48AVANDIA 2MG TAB 37AVANDIA 4MG TAB 37AVAPRO 150MG TAB 46AVAPRO 300MG TAB 46AVAPRO 75MG TAB 46AVC BRAND OF

SULFANILAMIDE 15%VAGINAL CREAM 134

AVELOX 400MG TAB 101aviane 28 pack 80avita 0.025% cream 86avita 0.025% gel 86AVODART 0.5MG CAP 104AVONEX 30MCG/0.5ML

AUTO-INJECTOR 125AVONEX 30MCG/0.5ML

SYRINGE 125AVONEX 30MCG/VIAL

INJ 125AVYCAZ 2-0.5GM INJ 79AYGESTIN 5MG TAB 123

AZASAN 100MG TAB 71AZASAN 75MG TAB 71AZASITE 1% OPHTH

SOLN 117azathioprine 50mg tab 71azelaic acid 15% gel 94azelastine 0.05% ophth soln 119azelastine 0.1% (137mcg)

nasal inhaler 115azelastine 0.15% (205.5mcg)

nasal inhaler 115AZELEX 20% CREAM 86AZILECT 0.5MG TAB 60AZILECT 1MG TAB 60AZITHROMYCIN

16.7MG/ML SUSP 108azithromycin 20mg/ml susp 108azithromycin 250mg pack 108azithromycin 250mg tab 108azithromycin 2mg/ml inj 108azithromycin 40mg/ml susp 109azithromycin 500mg (3) tab

pack 109azithromycin 500mg tab 109azithromycin 600mg tab 109AZOPT 1% OPHTH SUSP 119AZOR 10-20MG TAB 48AZOR 10-40MG TAB 48AZOR 5-20MG TAB 48AZOR 5-40MG TAB 48aztreonam 333mg/ml inj 15AZULFIDINE 500MG DR

TAB 102AZULFIDINE 500MG TAB 102

Bbacitracin

0.5unit/mg/polymyxin b10unit/mg ophth ointment 117

BACITRACIN 0.5UNIT/MGOPHTH OINTMENT 117

baclofen 10mg tab 114baclofen 20mg tab 114BACTRIM 400-80MG TAB 13




142

BACTRIM 800-160MG TAB 13BACTROBAN 2% NASAL

OINTMENT 115balsalazide disodium 750mg

cap 103BALVERSA 3MG TAB 54BALVERSA 4MG TAB 54BALVERSA 5MG TAB 54balziva 28 day pack 80BANZEL 200MG TAB 24BANZEL 400MG TAB 24BANZEL 40MG/ML SUSP 24BARACLUDE 0.5MG TAB 70BARACLUDE 1MG TAB 70BAXDELA 400MG TAB 101BCG LIVE TICE STRAIN

50MG/ML INJ 133benazepril

10mg/hydrochlorothiazide12.5mg tab 48

benazepril 10mg tab 44benazepril


benazepril20mg/hydrochlorothiazide25mg tab 48

benazepril 20mg tab 44benazepril 40mg tab 44benazepril


benazepril 5mg tab 44BENICAR 20MG TAB 46BENICAR 40MG TAB 46BENICAR 5MG TAB 46BENICAR HCT 20-12.5MG

TAB 48BENICAR HCT 40-12.5MG

TAB 48BENICAR HCT 40-25MG

TAB 48BENLYSTA 200MG/ML

AUTO-INJECTOR 114

BENLYSTA 200MG/MLSYRINGE 114

BENZACLIN 1-5% GEL 86BENZAMYCIN 5-3% GEL 86BENZNIDAZOLE 100MG

TAB 13BENZNIDAZOLE 12.5MG

TAB 13benzoyl peroxide

5%/clindamycin phosphate1.2% topical gel 86

benztropine mesylate 0.5mgtab 60

benztropine mesylate 1mg tab 60benztropine mesylate 2mg tab 60BEPREVE 1.5% OPHTH

SOLN 119BERINERT 500UNIT INJ 105beser 0.05% lotion 91betamethasone/clotrimazole

1-0.05% cream 88betamethasone/clotrimazole

1-0.05% lotion 88betamethasone 0.05% aug

cream 91BETAMETHASONE 0.05%

AUG GEL 91betamethasone 0.05% aug

lotion 91betamethasone 0.05% aug

ointment 91betamethasone 0.05% cream 91betamethasone 0.05% lotion 91betamethasone 0.05%

ointment 91betamethasone 0.1% cream 91betamethasone 0.1% lotion 91betamethasone 0.1% ointment 91betamethasone valerate

0.12% foam 91BETAPACE 120MG TAB 73BETAPACE 160MG TAB 73BETAPACE 80MG TAB 73betaxolol 0.5% ophth soln 116

betaxolol 10mg tab 72betaxolol 20mg tab 73bethanechol chloride 10mg

tab 132bethanechol chloride 25mg



tab 132BETIMOL 0.25% OPHTH

SOLN 116BETIMOL 0.5% OPHTH

SOLN 116BETOPTIC S 0.25% OPHTH

SUSP 116bexarotene 75mg cap 57BEXSERO SYRINGE 133bicalutamide 50mg tab 53BICILLIN

300000-300000UNIT/MLSYRINGE 122

BICILLIN450000-150000UNIT/MLSYRINGE 122

BICILLIN L-A1200000UNIT/2MLSYRINGE 121

BICILLIN L-A2400000UNIT/4MLSYRINGE 121

BICILLIN L-A600000UNIT/MLSYRINGE 121

BIDIL 20-37.5MG TAB 77BIKTARVY 50-200-25MG

TAB 67BILTRICIDE 600MG TAB 13bimatoprost 0.03% ophth

soln 120bisoprolol fumarate


bisoprolol fumarate 10mg tab 73




143

bisoprolol fumarate2.5mg/hydrochlorothiazide6.25mg tab 48

bisoprolol fumarate5mg/hydrochlorothiazide6.25mg tab 48

bisoprolol fumarate 5mg tab 73BIVIGAM 10% INJ 121BLEPH-10 10% OPHTH

SOLN 117BLEPHAMIDE 10-0.2%

OPHTH OINTMENT 118BLEPHAMIDE 10-0.2%

OPHTH SUSP 118blisovi 21 fe 1.5/30 28 day 81blisovi 24 fe 1/20 28 day pack 81BONIVA 150MG TAB 96BOOSTRIX INJ 130BOOSTRIX SYRINGE 130bosentan 125mg tab 78bosentan 62.5mg tab 78BOSULIF 100MG TAB 54BOSULIF 400MG TAB 54BOSULIF 500MG TAB 54BRAFTOVI 75MG CAP 54BREO 100-25MCG

ELLIPTA INH 20BREO 200-25MCG

ELLIPTA INH 20briellyn 28 day pack 81BRILINTA 60MG TAB 105BRILINTA 90MG TAB 105brimonidine tartrate 0.15%

ophth soln 117brimonidine tartrate 0.2%

ophth soln 117BRIVIACT 100MG TAB 24BRIVIACT 10MG/ML

ORAL SOLN 24BRIVIACT 10MG TAB 24BRIVIACT 25MG TAB 24BRIVIACT 50MG TAB 24BRIVIACT 75MG TAB 24

BROMFENAC 0.09%OPHTH SOLN 119

bromocriptine 2.5mg tab 58bromocriptine 5mg cap 58BROVANA 15MCG/2ML

INH SOLN 20budesonide 0.125mg/ml inh

soln 19budesonide 0.25mg/ml inh

soln 19budesonide 0.5mg/ml inh soln 20budesonide 3mg dr cap 85budesonide 9mg er tab 85bumetanide 0.25mg/ml inj 95bumetanide 0.5mg tab 95bumetanide 1mg tab 95bumetanide 2mg tab 95BUPHENYL 0.94MG/MG

ORAL POWDER 97buprenorphine/naloxone

12-3mg strip 11buprenorphine/naloxone

2-0.5mg strip 11buprenorphine/naloxone

4-1mg strip 11buprenorphine/naloxone

8-2mg strip 11buprenorphine 10mcg/hr

weekly patch 11buprenorphine 15mcg/hr

weekly patch 11buprenorphine 20mcg/hr

weekly patch 11buprenorphine 2mg/naloxone

0.5mg sl tab 11buprenorphine 2mg sl tab 11buprenorphine 5mcg/hr

weekly patch 11BUPRENORPHINE

7.5MCG/HR WEEKLYPATCH 11

buprenorphine 8mg/naloxone2mg sl tab 11

buprenorphine 8mg sl tab 11

bupropion 100mg sr tab 30bupropion 100mg tab 30bupropion 150mg sr (12 hr)

tab 30bupropion 150mg sr tab 126bupropion 150mg xl (24 hr)

tab 30bupropion 200mg sr tab 30bupropion 300mg xl tab 30bupropion 75mg tab 30buspirone 10mg tab 16buspirone 15mg tab 16buspirone 30mg tab 16buspirone 5mg tab 16buspirone 7.5mg tab 16butorphanol tartrate 10mg/ml

nasal spray 11BX RATING -

METHYLPHENIDATE18MG SR TAB 2

BX RATING -METHYLPHENIDATE27MG SR TAB 2



BYDUREON 2.35MG/MLAUTO-INJECTOR 36

BYDUREON 2MG PEN INJ 36BYETTA 10MCG/0.04ML

PEN INJ 36BYETTA 5MCG/0.02ML

PEN INJ 36BYSTOLIC 10MG TAB 73BYSTOLIC 2.5MG TAB 73BYSTOLIC 20MG TAB 73BYSTOLIC 5MG TAB 73

Ccabergoline 0.5mg tab 99CABOMETYX 20MG TAB 54




144

CABOMETYX 40MG TAB 54CABOMETYX 60MG TAB 54CADUET 10-10MG TAB 77CADUET 10-20MG TAB 77CADUET 10-40MG TAB 77CADUET 10-80MG TAB 77CADUET 5-10MG TAB 77CADUET 5-20MG TAB 77CADUET 5-40MG TAB 77CADUET 5-80MG TAB 77CALAN 120MG SR TAB 74CALAN 120MG TAB 74CALAN 240MG SR TAB 74calcipotriene/betamethasone

0.005-0.064% ointment 91calcipotriene 0.005% cream 89calcipotriene 0.005%

ointment 89calcipotriene 0.005% topical

soln 90calcitriol 0.00025mg cap 98calcitriol 0.0005mg cap 98calcitriol 0.001mg/ml oral

soln 98CALCITRIOL 3MCG/GM

OINTMENT 90calcium acetate 667mg cap 103calcium acetate 667mg tab 103CALQUENCE 100MG CAP 54camila 28 day 0.35mg pack 84camrese lo 91 day pack 81CANASA 1000MG RECTAL

SUPP 103CANCIDAS 50MG INJ 39CANCIDAS 70MG INJ 39CAPEX 0.01% SHAMPOO 91CAPRELSA 100MG TAB 55CAPRELSA 300MG TAB 55captopril 100mg tab 44captopril 12.5mg tab 44captopril


CAPTOPRIL25MG/HYDROCHLOROTHIAZIDE25MG TAB 48

captopril 25mg tab 44captopril


CAPTOPRIL50MG/HYDROCHLOROTHIAZIDE25MG TAB 48

captopril 50mg tab 44CARAC 0.5% CREAM 89CARAFATE 1GM/10ML

SUSP 130CARAFATE 1GM TAB 130CARBAGLU 200MG SUSP 98carbamazepine 100mg chew

tab 24carbamazepine 100mg er cap 24carbamazepine 100mg er tab 24carbamazepine 200mg er cap 24carbamazepine 200mg er tab 24carbamazepine 200mg tab 24carbamazepine 20mg/ml susp 24carbamazepine 300mg er cap 24carbamazepine 400mg er tab 25CARBATROL 100MG ER

CAP 25CARBATROL 200MG ER

CAP 25CARBATROL 300MG ER

CAP 25carbidopa 10mg/levodopa

100mg odt 58carbidopa 10mg/levodopa

100mg tab 58CARBIDOPA

12.5MG/ENTACAPONE200MG/LEVODOPA50MG TAB 58

CARBIDOPA18.75MG/ENTACAPONE

200MG/LEVODOPA75MG TAB 58

CARBIDOPA25MG/ENTACAPONE200MG/LEVODOPA100MG TAB 58

carbidopa 25mg/levodopa100mg er tab 58

carbidopa 25mg/levodopa100mg odt 58

carbidopa 25mg/levodopa100mg tab 58

carbidopa 25mg/levodopa250mg odt 58

carbidopa 25mg/levodopa250mg tab 60

carbidopa 25mg tab 60CARBIDOPA

31.25MG/ENTACAPONE200MG/LEVODOPA125MG TAB 58

CARBIDOPA37.5MG/ENTACAPONE200MG/LEVODOPA150MG TAB 58

CARBIDOPA50MG/ENTACAPONE200MG/LEVODOPA200MG TAB 58

carbidopa 50mg/levodopa200mg er tab 58

CARDIZEM 120MG ERCAP 74

CARDIZEM 120MG ER TAB74CARDIZEM 120MG TAB 74CARDIZEM 180MG ER

CAP 74CARDIZEM 180MG ER TAB74CARDIZEM 240MG ER

CAP 74CARDIZEM 240MG ER TAB74CARDIZEM 300MG ER

CAP 74CARDIZEM 300MG ER TAB74




145

CARDIZEM 30MG TAB 74CARDIZEM 360MG ER

CAP 75CARDIZEM 360MG ER TAB75CARDIZEM 420MG ER TAB75CARDIZEM 60MG TAB 75CARDURA 1MG TAB 46CARDURA 2MG TAB 46CARDURA 4MG TAB 46CARDURA 4MG XL TAB 104CARDURA 8MG TAB 46CARDURA 8MG XL TAB 104carisoprodol 350mg tab 114CARNITOR 1GM/10ML

ORAL SOLN 98CARNITOR 330MG TAB 98CARTEOLOL 1% OPHTH

SOLN 116cartia 120mg er cap 75cartia 180mg er cap 75cartia 240mg er cap 75cartia 300mg er cap 75carvedilol 12.5mg tab 72carvedilol 25mg tab 72carvedilol 3.125mg tab 72carvedilol 6.25mg tab 72carvedilol 80mg er cap 72carvedilol phosphate 10mg er

cap 72carvedilol phosphate 20mg er

cap 72carvedilol phosphate 40mg er

cap 72CASODEX 50MG TAB 53CASPOFUNGIN ACETATE

50MG INJ 39CASPOFUNGIN ACETATE

70MG INJ 39CATAPRES 0.1MG TAB 46CATAPRES 0.2MG TAB 46CATAPRES 0.3MG TAB 46CATAPRES-TTS-1

0.1MG/24HR PATCH 46

CATAPRES-TTS-20.2MG/24HR PATCH 46

CATAPRES-TTS-30.3MG/24HR PATCH 47

CAYSTON 75MG INHSOLN 15

caziant 28 day pack 81cefaclor 250mg cap 79CEFACLOR 25MG/ML

SUSP 79cefaclor 500mg cap 79CEFACLOR 500MG ER TAB 79CEFACLOR 50MG/ML

SUSP 79CEFACLOR 75MG/ML

SUSP 79cefadroxil 1000mg tab 79cefadroxil 100mg/ml susp 79cefadroxil 500mg cap 79cefadroxil 50mg/ml susp 79cefazolin 1gm inj 79cefazolin 200mg/ml inj 79cefazolin 500mg inj 79cefdinir 25mg/ml susp 79cefdinir 300mg cap 79cefdinir 50mg/ml susp 79cefepime 1gm inj 80cefepime 2gm inj 80cefixime 20mg/ml susp 79cefixime 40mg/ml susp 80cefotetan 1000mg inj 79cefotetan 2000mg inj 79cefoxitin 1000mg inj 79cefoxitin 2000mg inj 79cefoxitin 200mg/ml inj 79cefpodoxime 100mg tab 80cefpodoxime 10mg/ml susp 80cefpodoxime 200mg tab 80cefpodoxime 20mg/ml susp 80cefprozil 250mg tab 79cefprozil 25mg/ml susp 79cefprozil 500mg tab 79cefprozil 50mg/ml susp 79ceftazidime 1000mg inj 80

ceftazidime 2000mg inj 80ceftazidime 200mg/ml inj 80ceftriaxone 1000mg inj 80ceftriaxone 100mg/ml inj 80ceftriaxone 2000mg inj 80ceftriaxone 250mg inj 80ceftriaxone 500mg inj 80cefuroxime 1.5gm inj 79cefuroxime 250mg tab 79cefuroxime 500mg tab 79cefuroxime 750mg inj 79cefuroxime 95mg/ml inj 79CELEBREX 100MG CAP 5CELEBREX 200MG CAP 5CELEBREX 400MG CAP 5CELEBREX 50MG CAP 5celecoxib 100mg cap 5celecoxib 200mg cap 5celecoxib 400mg cap 5celecoxib 50mg cap 5CELEXA 10MG TAB 30CELEXA 20MG TAB 30CELEXA 40MG TAB 30CELLCEPT 200MG/ML

SUSP 71CELLCEPT 250MG CAP 71CELLCEPT 500MG TAB 71CELONTIN 300MG CAP 29cephalexin 250mg cap 79cephalexin 25mg/ml susp 79cephalexin 500mg cap 79cephalexin 50mg/ml susp 79CERDELGA 84MG CAP 106CESAMET 1MG CAP 39cetirizine 1mg/ml oral soln 41CETRAXAL 0.2% OTIC

SOLN 120cevimeline 30mg cap 114CHANTIX 0.5MG TAB 126CHANTIX 1MG TAB 126CHANTIX CONTINUING

MONTHS OF THERAPY1MG PACK 126




146

CHANTIX FIRST MONTHOF THERAPY PACK 126

CHEMET 100MG CAP 38CHENODAL 250MG TAB 102chlordiazepoxide 10mg cap 17chlordiazepoxide 25mg cap 17chlordiazepoxide 5mg cap 17chlorhexidine gluconate

0.12% mouthwash 114CHLOROQUINE

PHOSPHATE 250MGTAB 51

chloroquine phosphate 500mgtab 51

CHLOROTHIAZIDE 250MGTAB 96

chlorothiazide 500mg tab 96chlorpromazine 100mg tab 65chlorpromazine 10mg tab 65chlorpromazine 200mg tab 65chlorpromazine 25mg tab 65chlorpromazine 50mg tab 65chlorthalidone 25mg tab 96chlorthalidone 50mg tab 96CHLORZOXAZONE 500MG

TAB 114CHOLBAM 250MG CAP 102CHOLBAM 50MG CAP 102cholestyramine resin 4gm sf

powder for oral susp 41cholestyramine resin

66.7mg/ml susp 41ciclopirox 0.77% cream 88ciclopirox 0.77% gel 88ciclopirox 0.77% lotion 88ciclopirox 1% shampoo 88ciclopirox 8% topical soln 88cilastatin 2.5mg/ml/imipenem

2.5mg/ml inj 14cilastatin 5mg/ml/imipenem

5mg/ml inj 14cilostazol 100mg tab 106cilostazol 50mg tab 106

CILOXAN 0.3% OPHTHOINTMENT 118

CILOXAN 0.3% OPHTHSOLN 118

CIMDUO 300-300MG TAB 67cimetidine 200mg tab 130cimetidine 300mg tab 130cimetidine 400mg tab 130CIMETIDINE 60MG/ML

ORAL SOLN 131cimetidine 800mg tab 130CIMZIA 200MG/ML

SYRINGE 103CIMZIA 200MG INJ 103cinacalcet 30mg tab 98cinacalcet 60mg tab 98cinacalcet 90mg tab 98CINRYZE 500UNIT INJ 105CIPRO (10%) 500MG/5ML

SUSP 101CIPRO (5%) 5GM/100ML

SUSP 101CIPRO 250MG TAB 101CIPRO 500MG TAB 101CIPRODEX 0.3-0.1% OTIC

SUSP 120CIPROFLOXACIN 0.2%

OTIC SOLN 120ciprofloxacin 0.3% ophth

soln 118ciprofloxacin 100mg/ml susp 101ciprofloxacin 250mg tab 102ciprofloxacin 2mg/ml inj 102ciprofloxacin 500mg tab 102ciprofloxacin 750mg tab 102CIPRO HC 0.2-1% OTIC

SUSP 120citalopram 10mg tab 30citalopram 20mg tab 30citalopram 2mg/ml oral soln 30citalopram 40mg tab 30claravis 10mg cap 86claravis 20mg cap 86claravis 30mg cap 86

claravis 40mg cap 87CLARINEX 0.5MG/ML

ORAL SOLN 41CLARINEX 5MG TAB 41CLARINEX-D 2.5-120MG

ER TAB 86clarithromycin 250mg tab 109CLARITHROMYCIN

25MG/ML SUSP 109clarithromycin 500mg er tab 109clarithromycin 500mg tab 109CLARITHROMYCIN

50MG/ML SUSP 109CLENPIQ POWDER 108CLEOCIN 100MG

VAGINAL SUPP 134CLEOCIN 150MG/ML INJ 14CLEOCIN 150MG CAP 14CLEOCIN 2% VAGINAL

CREAM 134CLEOCIN 300MG/50ML INJ14CLEOCIN 300MG CAP 14CLEOCIN 600MG/50ML INJ14CLEOCIN 75MG/5ML

ORAL SOLN 14CLEOCIN 75MG CAP 14CLEOCIN 900MG/50ML INJ14CLEOCIN-T 1% GEL 87CLEOCIN-T 1% LOTION 87CLEOCIN-T 1% PAD 87CLIMARA 0.025MG/24HR

PATCH 100CLIMARA 0.05MG/24HR




PATCH 100CLIMARA 37.5MCG/24HR

PATCH 100CLIMARA PRO

0.045-0.015MG PATCH 99




147

clindacin 1% pad 87clindamycin/benzoyl peroxide

1.2-2.5% gel 87clindamycin/benzoyl peroxide

1-5% gel 87clindamycin 1% foam 87clindamycin 1% gel 87clindamycin 1% lotion 87clindamycin 1% pad 87clindamycin 1% topical soln 87clindamycin 12mg/ml inj 14clindamycin 150mg/ml (2ml)

inj 14clindamycin 150mg/ml (4ml)

inj 14clindamycin 150mg/ml (6ml)

inj 14clindamycin 150mg cap 14clindamycin 15mg/ml oral

soln 15clindamycin 18mg/ml inj 15clindamycin 2% vaginal

cream 134clindamycin 300mg cap 15clindamycin 6mg/ml inj 15clindamycin 75mg cap 15clindamycin phosphate

1.2%/tretinoin 0.025%topical gel 87

CLINDESSE 2%APPLICATOR 134

CLINIMIX 4.25/10 INJ 116CLINIMIX 4.25/5 INJ 116CLINIMIX 5/15 INJ 116CLINIMIX 5/20 INJ 116CLINIMIX E 2.75/5 INJ 116CLINIMIX E 4.25/10 INJ 116CLINIMIX E 4.25/5 INJ 116CLINIMIX E 5/15 INJ 116CLINIMIX E 5/20 INJ 116clinisol 15% inj 116clobazam 10mg tab 23clobazam 2.5mg/ml susp 23clobazam 20mg tab 23

clobetasol propionate 0.05%cream 91

clobetasol propionate 0.05%e cream 91

clobetasol propionate 0.05%e foam 91

clobetasol propionate 0.05%foam 91

clobetasol propionate 0.05%gel 91

clobetasol propionate 0.05%lotion 91

clobetasol propionate 0.05%ointment 91

clobetasol propionate 0.05%shampoo 91

clobetasol propionate 0.05%spray 91

clobetasol propionate 0.05%topical soln 91

CLOBEX 0.05% LOTION 91CLOBEX 0.05% SHAMPOO 91CLOBEX 0.05% SPRAY 91clodan 0.05% shampoo 91clomipramine 25mg cap 33clomipramine 50mg cap 33clomipramine 75mg cap 33clonazepam 0.125mg odt 24clonazepam 0.25mg odt 24clonazepam 0.5mg odt 24clonazepam 0.5mg tab 24clonazepam 1mg odt 24clonazepam 1mg tab 24clonazepam 2mg odt 24clonazepam 2mg tab 24clonidine 0.00417mg/hr patch 47clonidine 0.00833mg/hr patch 47clonidine 0.0125mg/hr patch 47clonidine 0.1mg tab 47clonidine 0.2mg tab 47clonidine 0.3mg tab 47clopidogrel 75mg tab 106clorazepate dipotassium

15mg tab 17

clorazepate dipotassium3.75mg tab 17

clorazepate dipotassium7.5mg tab 17

clotrimazole 1% cream 88clotrimazole 1% topical soln 88clotrimazole 10mg lozenge 114clozapine 100mg odt 63clozapine 100mg tab 63clozapine 12.5mg odt 63CLOZAPINE 150MG ODT 63CLOZAPINE 200MG ODT 63clozapine 200mg tab 63clozapine 25mg odt 63clozapine 25mg tab 63clozapine 50mg tab 63CLOZARIL 100MG TAB 63CLOZARIL 25MG TAB 63COARTEM 20-120MG TAB 51codeine sulfate 30mg tab 7codeine sulfate 60mg tab 7COLAZAL 750MG CAP 103colchicine 0.5mg/probenecid

500mg tab 105COLCHICINE 0.6MG TAB 105colesevelam hcl 3.75gm

packet 41colesevelam hcl 625mg tab 41COLESTID 1GM TAB 41COLESTID 5GM

GRANULES 41colestipol 1000mg tab 41colestipol 5000mg granules 42colistin 75mg/ml inj 15colocort 100mg/60ml enema 12COLYTE ORAL SOLN 108COMBIGAN 0.2-0.5%

OPHTH SOLN 117COMBIPATCH 0.05-0.14MG

PATCH 99COMBIPATCH 0.05-0.25MG

PATCH 99COMBIVENT RESPIMAT

20-100MCG INH 20




148

COMBIVIR 150-300MGTAB 67

COMETRIQ 100MG DAILYDOSE CARTON PACK 55



COMPLERA 200-25-300MGTAB 67

compro 25mg rectal supp 65COMTAN 200MG TAB 60CONCERTA 18MG ER TAB 2CONCERTA 27MG ER TAB 2CONCERTA 36MG ER TAB 2CONCERTA 54MG ER TAB 2CONDYLOX 0.5% GEL 93constulose 10gm/15ml oral

soln 108COPAXONE 20MG/ML

SYRINGE 125COPAXONE 40MG/ML

SYRINGE 125COPIKTRA 15MG CAP 55COPIKTRA 25MG CAP 55CORDRAN 4MCG/SQCM

TAPE 91COREG 10MG ER CAP 72COREG 12.5MG TAB 72COREG 20MG ER CAP 72COREG 25MG TAB 72COREG 3.125MG TAB 72COREG 40MG ER CAP 72COREG 6.25MG TAB 72COREG 80MG ER CAP 72CORGARD 20MG TAB 73CORGARD 40MG TAB 73CORGARD 80MG TAB 73CORLANOR 5MG TAB 78CORLANOR 7.5MG TAB 78CORTEF 10MG TAB 85CORTEF 20MG TAB 85CORTEF 5MG TAB 85

CORTISONE ACETATE25MG TAB 85

CORTISPORIN 0.5%CREAM 88

CORTISPORIN 1%OINTMENT 88

COSENTYX 150MG/MLAUTO-INJECTOR 90

COSENTYX 150MG/MLSYRINGE 90

COSOPT 22.3-6.8MG/MLOPHTH SOLN 117

COSOPT 22.3-6.8MG/MLOPHTH SOLN(PRESERVATIVE-FREE) 117

COTELLIC 20MG TAB 55COUMADIN 10MG TAB 21COUMADIN 1MG TAB 21COUMADIN 2.5MG TAB 21COUMADIN 2MG TAB 21COUMADIN 3MG TAB 22COUMADIN 4MG TAB 22COUMADIN 5MG TAB 22COUMADIN 6MG TAB 22COUMADIN 7.5MG TAB 22COZAAR 100MG TAB 46COZAAR 25MG TAB 46COZAAR 50MG TAB 46CREON

12000-38000-60000UNITDR CAP 94

CREON24000-76000-120000UNITDR CAP 94

CREON3000-9500-15000UNITDR CAP 94

CREON36000-114000-180000UNITDR CAP 94

CREON6000-19000-30000UNITDR CAP 94

CRESTOR 10MG TAB 42

CRESTOR 20MG TAB 42CRESTOR 40MG TAB 42CRESTOR 5MG TAB 42CRINONE 4% VAGINAL

GEL 134CRINONE 8% VAGINAL

GEL 134CRIXIVAN 200MG CAP 67CRIXIVAN 400MG CAP 67cromolyn sodium 10mg/ml

inh soln 19cromolyn sodium 20mg/ml

oral soln 102cromolyn sodium 4% ophth

soln 119cryselle 28 pack 81CUBICIN 500MG INJ 14CUTIVATE 0.05% LOTION 91CUVPOSA 1MG/5ML

ORAL SOLN 131cyclafem 1/35 28 day pack 81cyclafem 7/7/7 28 day pack 81cyclobenzaprine 10mg tab 114cyclobenzaprine 5mg tab 114cyclobenzaprine 7.5mg tab 114CYCLOPHOSPHAMIDE

25MG CAP 52CYCLOPHOSPHAMIDE

50MG CAP 52CYCLOSET 0.8MG TAB 36cyclosporine 100mg cap 71cyclosporine 25mg cap 71cyclosporine modified

100mg/ml oral soln 113cyclosporine modified 100mg

cap 71cyclosporine modified 25mg

cap 71CYCLOSPORINE

MODIFIED 50MG CAP 113CYMBALTA 20MG DR CAP 32CYMBALTA 30MG DR CAP 32CYMBALTA 60MG DR CAP 32cyred 28 day pack 81




149

CYSTAGON 150MG CAP 104CYSTAGON 50MG CAP 104CYSTARAN 0.44% OPHTH

SOLN 120CYTOMEL 25MCG TAB 128CYTOMEL 50MCG TAB 128CYTOMEL 5MCG TAB 128CYTOTEC 100MCG TAB 131CYTOTEC 200MCG TAB 131

Ddalfampridine 10mg er tab 125DALIRESP 250MCG TAB 19DALIRESP 500MCG TAB 19DALVANCE 500MG INJ 14danazol 100mg cap 12danazol 200mg cap 12danazol 50mg cap 12DANTRIUM 25MG CAP 115DANTRIUM 50MG CAP 115dantrolene sodium 100mg

cap 115dantrolene sodium 25mg cap 115dantrolene sodium 50mg cap 115dapsone 100mg tab 14dapsone 25mg tab 14DAPTACEL INJ 130DAPTOMYCIN 350MG INJ 14daptomycin 500mg inj 14DARAPRIM 25MG TAB 51darifenacin 15mg er tab 132darifenacin 7.5mg er tab 132DAURISMO 100MG TAB 53DAURISMO 25MG TAB 53DAYPRO 600MG TAB 5DDAVP 0.01% NASAL

SOLN 98DDAVP 0.01% NASAL

SPRAY 98DDAVP 0.1MG TAB 99DDAVP 0.2MG TAB 99deblitane 28 day 0.35mg pack 84deferasirox 125mg tab for

oral susp 38

deferasirox 250mg tab fororal susp 38

deferasirox 500mg tab fororal susp 38

DELESTROGEN 10MG/MLINJ 100



DELSTRIGO100-300-300MG TAB 67

delyla 28 day pack 81demeclocycline 150mg tab 127demeclocycline 300mg tab 127DEMSER 250MG CAP 45DENAVIR 1% CREAM 90DEPAKENE 250MG CAP 29DEPAKOTE 125MG DR CAP29DEPAKOTE 125MG DR TAB29DEPAKOTE 250MG DR TAB29DEPAKOTE 250MG ER TAB 29DEPAKOTE 500MG DR TAB29DEPAKOTE 500MG ER TAB 29DEPEN 250MG TAB 113DEPO-ESTRADIOL

5MG/ML INJ 100DEPO-PROVERA

150MG/ML INJ 84DEPO-PROVERA

400MG/ML INJ 53DEPO-TESTOSTERONE

100MG/ML INJ 12DEPO-TESTOSTERONE

200MG/ML INJ 12DESCOVY 200-25MG TAB 67desipramine 100mg tab 33desipramine 10mg tab 33desipramine 150mg tab 33desipramine 25mg tab 33desipramine 50mg tab 33desipramine 75mg tab 33desloratadine 5mg tab 41

desmopressin acetate 0.01%nasal spray 99

desmopressin acetate 0.1mgtab 99

desmopressin acetate 0.2mgtab 99

desogestrel/ethinyl estradiol28 day pack 81

desogestrel/ethinyl estradiolpack 81

DESONATE 0.05% GEL 91desonide 0.05% cream 91desonide 0.05% lotion 91desonide 0.05% ointment 91DESOWEN 0.05% CREAM 91DESOWEN 0.05% LOTION 91desoximetasone 0.05% cream 91desoximetasone 0.05% gel 91desoximetasone 0.05%

ointment 91desoximetasone 0.25% cream 91desoximetasone 0.25%

ointment 92desvenlafaxine succinate

100mg er tab 32desvenlafaxine succinate

25mg er tab 32desvenlafaxine succinate

50mg er tab 32DETROL 1MG TAB 132DETROL 2MG ER CAP 132DETROL 2MG TAB 132DETROL 4MG ER CAP 132dexamethasone/neomycin/

polymyxin b 0.1% ophthointment 118

dexamethasone/neomycin/polymyxin b 0.1% ophthsusp 118

dexamethasone/tobramycin0.3-0.1% ophth susp 118

DEXAMETHASONE 0.1%OPHTH SOLN 118




150

dexamethasone 0.1mg/ml oralsoln 85

dexamethasone 0.5mg tab 85dexamethasone 0.75mg tab 85dexamethasone 1.5mg tab 85DEXAMETHASONE

1MG/ML ORAL SOLN 85DEXAMETHASONE 1MG

TAB 85DEXAMETHASONE 2MG

TAB 85dexamethasone 4mg tab 85dexamethasone 6mg tab 85DEXEDRINE 10MG ER CAP 1DEXEDRINE 15MG ER CAP 1DEXEDRINE 5MG ER CAP 1dexmethylphenidate 10mg er

cap 2dexmethylphenidate 10mg tab 2dexmethylphenidate 15mg er

cap 2dexmethylphenidate 2.5mg tab 2dexmethylphenidate 20mg er

cap 2dexmethylphenidate 25mg er




cap 2dexmethylphenidate 5mg er cap2dexmethylphenidate 5mg tab 2dextroamphetamine sulfate

10mg er cap 1dextroamphetamine sulfate

10mg tab 1dextroamphetamine sulfate



5mg tab 1

DIASTAT 10MGAPPLICATOR 24

DIASTAT 2.5MGAPPLICATOR 24

DIASTAT 20MGAPPLICATOR 24

diazepam 10mg tab 17DIAZEPAM 1MG/ML ORAL

SOLN 17diazepam 2mg tab 17diazepam 5mg/ml oral soln 17diazepam 5mg tab 17DIBENZYLINE 10MG CAP 45DICLOFENAC

EPOLAMINE 1.3%PATCH 88

diclofenac potassium 50mg tab 5diclofenac sodium 0.1%

ophth soln 120diclofenac sodium 1% gel 88diclofenac sodium 100mg er

tab 6diclofenac sodium 25mg dr tab 6diclofenac sodium 3% gel 89diclofenac sodium

50mg/misoprostol 0.2mg tab 6diclofenac sodium 50mg dr tab 6diclofenac sodium

75mg/misoprostol 0.2mg tab 6diclofenac sodium 75mg dr tab 6dicloxacillin 250mg cap 122dicloxacillin 500mg cap 122dicyclomine 10mg cap 131dicyclomine 20mg tab 131dicyclomine 2mg/ml oral

soln 131didanosine 200mg dr cap 67didanosine 250mg dr cap 67didanosine 400mg dr cap 67DIFFERIN 0.1% CREAM 87DIFFERIN 0.1% GEL 87DIFFERIN 0.1% LOTION 87DIFFERIN 0.3% GEL 87DIFICID 200MG TAB 109

DIFLUCAN 100MG TAB 40DIFLUCAN 10MG/ML

SUSP 40DIFLUCAN 150MG TAB 40DIFLUCAN 200MG TAB 40DIFLUCAN 40MG/ML

SUSP 40DIFLUCAN 50MG TAB 40diflunisal 500mg tab 7digitek 0.125mg tab 77digitek 0.25mg tab 77digox 0.125mg tab 77digox 0.25mg tab 77digoxin 0.05mg/ml oral soln 77digoxin 0.125mg tab 77digoxin 0.25mg tab 77DIHYDROERGOTAMINE

MESYLATE 0.5MG/ACTNASAL SPRAY 110

DILANTIN 100MG ER CAP 28DILANTIN 125MG/5ML

SUSP 29DILANTIN 30MG ER CAP 29DILANTIN 50MG CHEW

TAB 29DILAUDID 1MG/ML ORAL

SOLN 7DILAUDID 2MG TAB 7DILAUDID 4MG TAB 7DILAUDID 8MG TAB 7dilt 120mg xr cap 75dilt 180mg xr cap 75dilt 240mg xr cap 75diltiazem 120mg er (12 hr)

cap 75diltiazem 120mg er (24 hr)

cap 75diltiazem 120mg tab 75diltiazem 180mg er cap 75diltiazem 240mg er cap 75diltiazem 300mg er cap 75diltiazem 30mg tab 75diltiazem 360mg er cap 75diltiazem 420mg er cap 75




151

diltiazem 60mg er cap 75diltiazem 60mg tab 75diltiazem 90mg er cap 75diltiazem 90mg tab 75DIOVAN 160MG TAB 46DIOVAN 320MG TAB 46DIOVAN 40MG TAB 46DIOVAN 80MG TAB 46DIOVAN HCT 160-12.5MG

TAB 48DIOVAN HCT 160-25MG

TAB 48DIOVAN HCT 320-12.5MG

TAB 48DIOVAN HCT 320-25MG

TAB 48DIOVAN HCT 80-12.5MG

TAB 49DIPENTUM 250MG CAP 103DIPHTHERIA/TETANUS

TOXOID INJ 130DIPROLENE 0.05% AUG

OINTMENT 92disopyramide 100mg cap 18disopyramide 150mg cap 18disulfiram 250mg tab 123disulfiram 500mg tab 123DITROPAN 10MG XL TAB 132DITROPAN 5MG XL TAB 132DIURIL 250MG/5ML SUSP 96divalproex sodium 125mg dr

cap 29divalproex sodium 125mg dr

tab 29divalproex sodium 250mg dr

tab 29divalproex sodium 250mg er

tab 29divalproex sodium 500mg dr

tab 29divalproex sodium 500mg er

tab 29dofetilide 125mcg cap 18dofetilide 250mcg cap 18

dofetilide 500mcg cap 18DOLOPHINE 10MG TAB 7DOLOPHINE 5MG TAB 8donepezil 10mg odt 123donepezil 10mg tab 123donepezil 23mg tab 123donepezil 5mg odt 123donepezil 5mg tab 123dorzolamide/timolol

22.3-6.8mg/ml ophth soln(preservative-free) 117

dorzolamide 2% ophth soln 120dorzolamide 20mg/ml/timolol

5mg/ml ophth soln 117dotti 0.025mg/24hr patch 100dotti 0.0375mg/24hr patch 100dotti 0.05mg/24hr patch 100dotti 0.075mg/24hr patch 100dotti 0.1mg/24hr patch 100DOVATO 50-300MG TAB 67DOVONEX 0.005% CREAM 90doxazosin 1mg tab 47doxazosin 2mg tab 47doxazosin 4mg tab 47doxazosin 8mg tab 47doxepin 100mg cap 33doxepin 10mg/ml oral soln 33doxepin 10mg cap 33doxepin 150mg cap 33doxepin 25mg cap 33doxepin 50mg cap 33doxepin 75mg cap 33doxercalciferol 0.0005mg cap 98doxercalciferol 0.001mg cap 98doxercalciferol 0.0025mg cap 98doxy 100mg inj 127doxycycline hyclate 100mg

cap 127doxycycline hyclate 100mg

tab 127doxycycline hyclate 20mg

tab 127doxycycline hyclate 50mg

cap 127

doxycycline monohydrate100mg cap 127

doxycycline monohydrate100mg tab 127

doxycycline monohydrate50mg cap 127


doxycycline monohydrate5mg/ml susp 127


dronabinol 10mg cap 39dronabinol 2.5mg cap 39dronabinol 5mg cap 39drospirenone 3mg/ethinyl

estradiol 0.02mg/inert 1mg pack 81

drospirenone 3mg/ethinylestradiol 0.03mg/inertingredients 1mg pack 81

DROXIA 200MG CAP 106DROXIA 300MG CAP 106DROXIA 400MG CAP 106DUAC 1.2-5% GEL 87DULERA 100-5MCG INH 20DULERA 200-5MCG INH 20duloxetine 20mg dr cap 32duloxetine 30mg dr cap 32duloxetine 40mg dr cap 32duloxetine 60mg dr cap 32DUPIXENT 200MG/ML PF

SYRINGE 19DUPIXENT 300MG/2ML PF

SYRINGE 93DURAGESIC 100MCG/HR

PATCH 8DURAGESIC 12MCG/HR



PATCH 8




152

DURAGESIC 75MCG/HRPATCH 8

duramorph 0.5mg/ml inj 8duramorph 1mg/ml inj 8DUREZOL 0.05% OPHTH

SUSP 119dutasteride 0.5mg/tamsulosin

0.4mg cap 104dutasteride 0.5mg cap 104DYAZIDE 37.5-25MG CAP 95DYRENIUM 100MG CAP 96DYRENIUM 50MG CAP 96

EE.E.S. 200MG/5ML SUSP 109econazole nitrate 1% cream 88EDECRIN 25MG TAB 95EDURANT 25MG TAB 67efavirenz 200mg cap 67efavirenz 50mg cap 67efavirenz 600mg cap 67EFFEXOR 150MG XR CAP 32EFFEXOR 37.5MG XR CAP 32EFFEXOR 75MG XR CAP 32EFFIENT 10MG TAB 106EFFIENT 5MG TAB 106EFUDEX 5% CREAM 89ELIDEL 1% CREAM 93ELIGARD 22.5MG

SYRINGE 53ELIGARD 30MG SYRINGE 53ELIGARD 45MG SYRINGE 53ELIGARD 7.5MG SYRINGE 53ELIMITE 5% CREAM 94ELIQUIS 2.5MG TAB 22ELIQUIS 30-DAY STARTER

PACK 22ELIQUIS 5MG TAB 22ELMIRON 100MG CAP 104ELOCON 0.1% CREAM 92ELOCON 0.1% OINTMENT 92EMCYT 140MG CAP 53EMEND 125MG CAP 39EMEND 40MG CAP 39

EMEND 80MG CAP 39EMEND TRI-FOLD PACK 39EMGALITY 100MG/ML

SYRINGE 110EMGALITY 120MG/ML

AUTO-INJECTOR 110EMGALITY 120MG/ML

SYRINGE 110emoquette pack 81EMSAM 12MG/24HR

PATCH 30EMSAM 6MG/24HR PATCH 30EMSAM 9MG/24HR PATCH 30EMTRIVA 10MG/ML ORAL

SOLN 67EMTRIVA 200MG CAP 67ENABLEX 15MG ER TAB 132ENABLEX 7.5MG ER TAB 132enalapril maleate


enalapril maleate 10mg tab 44enalapril maleate 2.5mg tab 44enalapril maleate 20mg tab 44enalapril maleate


enalapril maleate 5mg tab 44ENBREL 25MG/0.5ML

SYRINGE 7ENBREL 25MG INJ 7ENBREL 50MG/ML

SURECLICK INJ 7ENBREL 50MG/ML

SYRINGE 7ENDARI 5000MG POWDER

FOR ORAL SOLN 106endocet 10-325mg tab 10endocet 5-325mg tab 10endocet 7.5-325mg tab 10ENGERIX-B 10MCG/0.5ML

SYRINGE 133ENGERIX-B 20MCG/ML

SYRINGE 133

enoxaparin sodium100mg/1ml syringe 22

enoxaparin sodium120mg/0.8ml syringe 22

enoxaparin sodium150mg/1ml syringe 22





enpresse 28 day pack 81enskyce 28 day pack 81entacapone 200mg tab 60entecavir 0.5mg tab 70entecavir 1mg tab 70ENTOCORT 3MG DR CAP 85ENTRESTO 24-26MG TAB 77ENTRESTO 49-51MG TAB 77ENTRESTO 97-103MG TAB 77enulose 10gm/15ml oral soln103ENVARSUS 0.75MG ER

TAB 113ENVARSUS 1MG ER TAB 113ENVARSUS 4MG ER TAB 113EPIDIOLEX 100MG/ML

ORAL SOLN 25EPIDUO 0.1-2.5% GEL 87EPIDUO 0.3-2.5% GEL 87epinastine 0.05% ophth soln 120EPINEPHRINE

0.15MG/0.3MLAUTO-INJECTOR 134

epinephrine 0.3mg/0.3mlauto-injector 134

epitol 200mg tab 25EPIVIR 10MG/ML ORAL

SOLN 67EPIVIR 150MG TAB 67EPIVIR 300MG TAB 67EPIVIR HBV 100MG TAB 70




153

EPIVIR HBV 5MG/MLORAL SOLN 70

eplerenone 25mg tab 51eplerenone 50mg tab 51EPZICOM 600-300MG TAB 67EQUETRO 100MG ER CAP 61EQUETRO 200MG ER CAP 61EQUETRO 300MG ER CAP 61ERAXIS 100MG INJ 39ERAXIS 50MG INJ 39ERGOLOID MESYLATES

1MG TAB 126ERIVEDGE 150MG CAP 53ERLEADA 60MG TAB 53erlotinib 100mg tab 55erlotinib 150mg tab 55erlotinib 25mg tab 55errin 28 day 0.35mg pack 84ERTACZO 2% CREAM 88ertapenem 1gm inj 14ery 2% pad 87ERYGEL 2% GEL 87ERYPED 200MG/5ML

SUSP 109ERY-TAB 250MG DR TAB 109ERY-TAB 333MG DR TAB 109ERY-TAB 500MG DR TAB 109ERYTHROCIN

LACTOBIONATE 500MGINJ 109

erythromycin/benzoylperoxide 5-3% gel 87

erythromycin 0.005mg/mgophth ointment 118

erythromycin 2% gel 87erythromycin 2% topical soln 87erythromycin 250mg dr cap 109erythromycin 250mg tab 109erythromycin 500mg tab 109erythromycin ethylsuccinate

40mg/ml susp 109erythromycin ethylsuccinate

80mg/ml oral susp 109ESBRIET 267MG CAP 127

ESBRIET 267MG TAB 127ESBRIET 801MG TAB 127escitalopram 10mg tab 30escitalopram 1mg/ml oral

soln 31escitalopram 20mg tab 31escitalopram 5mg tab 31esomeprazole 20mg dr cap 130esomeprazole 40mg dr cap 131estarylla 28 day pack 81estazolam 1mg tab 107estazolam 2mg tab 107ESTRACE 0.1MG/GM

VAGINAL CREAM 134ESTRACE 0.5MG TAB 100ESTRACE 1MG TAB 100ESTRACE 2MG TAB 100estradiol 0.00104mg/hr twice

weekly patch 100estradiol 0.00104mg/hr

weekly patch 100estradiol 0.00156mg/hr twice




weekly patch 101estradiol 0.0025mg/hr weekly

patch 101estradiol 0.00312mg/hr




weekly patch 101estradiol 0.1mg/ml vaginal

cream 134estradiol

0.5mg/norethindroneacetate 0.1mg pack 99

estradiol 0.5mg tab 101estradiol 10mcg vaginal tab 134estradiol 1mg/norethindrone

acetate 0.5mg pack 99estradiol 1mg tab 101estradiol 20mg/ml inj 101estradiol 2mg tab 101estradiol 40mg/ml inj 101ESTRING 2MG VAGINAL

RING 134eszopiclone 1mg tab 107eszopiclone 2mg tab 107eszopiclone 3mg tab 107ethacrynic acid 25mg tab 95ethambutol 100mg tab 52ethambutol 400mg tab 52ethinyl

estradiol/levonorgestrel 91day pack 82

ethinyl estradiol0.0025mg/norethindroneacetate 0.5mg tab 100

ethinyl estradiol0.005mg/norethindroneacetate 1mg tab 100

ethinyl estradiol0.01mg/ethinyl estradiol0.02mg/levonorgestrel0.1mg 91 day pack 81

ethinyl estradiol0.01mg/ethinyl estradiol0.03mg/levonorgestrel0.15mg pack 81

ethinyl estradiol0.025mg/ferrous fumarate75mg/norethindrone 0.8mgpack 81

ethinyl estradiol0.025mg/inert/norgestimate0.18mg/0.215mg/0.25mgpack 81

ethinyl estradiol0.02mg/ferrous fumarate




154

75mg/norethindroneacetate 1mg pack 81

ethinyl estradiol 0.02mg/inertingredients1mg/levonorgestrel 0.1mgpack 81

ethinyl estradiol0.02mg/levonorgestrel0.09mg pack 81

ethinyl estradiol0.02mg/norethindrone 1mg21 day pack 81

ethinyl estradiol0.02mg/norethindroneacetate 1mg/ferrousfumarate 75mg chewable28 day pack 81

ethinyl estradiol0.035mg/ethynodiol 1mg28 day pack 81

ethinyl estradiol0.035mg/ferrous fumarate75mg/norethindrone 0.4mgpack 81

ethinyl estradiol0.035mg/inert/norgestimate0.18mg/0.215mg/0.25mgpack 81

ethinyl estradiol0.035mg/norgestimate0.25mg pack 81

ethinyl estradiol0.03mg/0.04mg /inert/levonorgestrel 0.05mg/0.075mg pack 82

ethinyl estradiol 0.03mg/inertingredients1mg/levonorgestrel 0.15mgpack 82

ethinyl estradiol0.03mg/levonorgestrel0.15mg tab 28 day pack 82

ethinyl estradiol0.05mg/ethynodiol1mg/inert ingredients 1mg28 day pack 82

ethosuximide 250mg cap 29ethosuximide 50mg/ml oral

soln 29etodolac 200mg cap 6etodolac 300mg cap 6etodolac 400mg er tab 6etodolac 400mg tab 6etodolac 500mg er tab 6etodolac 500mg tab 6etodolac 600mg er tab 6EURAX 10% CREAM 94EURAX 10% LOTION 94EVAMIST 1.53MG/SPRAY

SPRAY 101EVISTA 60MG TAB 97EVOCLIN 1% FOAM 87EVOTAZ 300-150MG TAB 67EVOXAC 30MG CAP 114EXELDERM 1% CREAM 88EXELDERM 1% TOPICAL

SOLN 88EXELON 13.3MG/24HR

PATCH 123EXELON 4.6MG/24HR

PATCH 123EXELON 9.5MG/24HR

PATCH 124exemestane 25mg tab 53EXFORGE 10-160MG TAB 49EXFORGE 10-320MG TAB 49EXFORGE 5-160MG TAB 49EXFORGE 5-320MG TAB 49EXFORGE HCT

10-160-12.5MG TAB 49EXFORGE HCT

10-160-25MG TAB 49EXFORGE HCT

10-320-25MG TAB 49EXFORGE HCT

5-160-12.5MG TAB 49

EXFORGE HCT5-160-25MG TAB 49

EXTAVIA 0.3MG INJ 125EXTINA 2% FOAM 89ezetimibe/simvastatin

10-10mg tab 41ezetimibe/simvastatin



10-80mg tab 41ezetimibe 10mg tab 43

Ffalmina 28 day pack 82famciclovir 125mg tab 70famciclovir 250mg tab 70famciclovir 500mg tab 70famotidine 20mg tab 130famotidine 40mg tab 130famotidine 8mg/ml susp 130FANAPT 10MG TAB 61FANAPT 12MG TAB 61FANAPT 1MG TAB 61FANAPT 2MG TAB 61FANAPT 4MG TAB 62FANAPT 6MG TAB 62FANAPT 8MG TAB 62FANAPT TITRATION PACK 62FARESTON 60MG TAB 53FARXIGA 10MG TAB 37FARXIGA 5MG TAB 37FARYDAK 10MG CAP 55FARYDAK 15MG CAP 55FARYDAK 20MG CAP 55FASENRA 30MG/ML

SYRINGE 19fayosim 91 day pack 82FAZACLO 100MG ODT 63FAZACLO 12.5MG ODT 63FAZACLO 150MG ODT 63FAZACLO 200MG ODT 63FAZACLO 25MG ODT 63




155

felbamate 120mg/ml susp 28felbamate 400mg tab 28felbamate 600mg tab 28FELBATOL 400MG TAB 28FELBATOL 600MG/5ML

SUSP 28FELBATOL 600MG TAB 28FELDENE 10MG CAP 6FELDENE 20MG CAP 6felodipine 10mg er tab 75felodipine 2.5mg er tab 75felodipine 5mg er tab 75FEMARA 2.5MG TAB 53FEMHRT 0.5/2.5MG 28

DAY PACK 100FEMRING 0.05MG/24HR

VAGINAL RING 134FEMRING 0.1MG/24HR

VAGINAL RING 134femynor 28 day pack 82fenofibrate 134mg cap 42fenofibrate 145mg tab 42FENOFIBRATE 150MG CAP42fenofibrate 160mg tab 42fenofibrate 200mg cap 42fenofibrate 48mg tab 42FENOFIBRATE 50MG CAP 42fenofibrate 54mg tab 42fenofibrate 67mg cap 42FENOFIBRIC ACID 105MG

TAB 42fenofibric acid 135mg dr cap 42FENOFIBRIC ACID 35MG

TAB 42fenofibric acid 45mg dr cap 42fentanyl 0.012mg/hr patch 8fentanyl 0.025mg/hr patch 8fentanyl 0.05mg/hr patch 8fentanyl 0.075mg/hr patch 8fentanyl 0.1mg/hr patch 8FENTANYL 0.1MG

BUCCAL TAB 8FENTANYL 0.2MG

BUCCAL TAB 8

fentanyl 0.2mg lozenge 8FENTANYL 0.4MG

BUCCAL TAB 8fentanyl 0.4mg lozenge 8FENTANYL 0.6MG

BUCCAL TAB 8fentanyl 0.6mg lozenge 8FENTANYL 0.8MG

BUCCAL TAB 8fentanyl 0.8mg lozenge 8fentanyl 1.2mg lozenge 8fentanyl 1.6mg lozenge 8FENTORA 100MCG

BUCCAL TAB 8FENTORA 200MCG




BUCCAL TAB 8FERRIPROX 100MG/ML

ORAL SOLN 38FERRIPROX 500MG TAB 38FETZIMA 120MG ER CAP 32FETZIMA 20MG ER CAP 32FETZIMA 40MG ER CAP 32FETZIMA 80MG ER CAP 32FETZIMA PACK 32FEXMID 7.5MG TAB 114FIASP 100UNIT/ML INJ 36FIASP 100UNIT/ML PEN

INJ 36FIBRICOR 105MG TAB 42FIBRICOR 35MG TAB 42FINACEA 15% FOAM 94FINACEA 15% GEL 94finasteride 5mg tab 104FIRAZYR 30MG/3ML

SYRINGE 105FIRMAGON 120MG INJ 53FIRMAGON 80MG INJ 53

FIRVANQ 25MG/ML ORALSOLN 14

FIRVANQ 50MG/ML ORALSOLN 14

FLAGYL 250MG TAB 13FLAGYL 375MG CAP 13FLAGYL 500MG TAB 13FLAREX 0.1% OPHTH

SUSP 119flavoxate 100mg tab 133FLEBOGAMMA 10% INJ 121flecainide acetate 100mg tab 18flecainide acetate 150mg tab 18flecainide acetate 50mg tab 18FLECTOR 1.3% PATCH 88FLOMAX 0.4MG CAP 104FLOVENT 100MCG

DISKUS 20FLOVENT 110MCG HFA

INH 20FLOVENT 220MCG HFA

INH 20FLOVENT 250MCG

DISKUS 20FLOVENT 44MCG HFA INH20FLOVENT 50MCG DISKUS 20fluconazole 100mg tab 40fluconazole 10mg/ml susp 40fluconazole 150mg tab 40fluconazole 200mg tab 40fluconazole 2mg/ml (100ml)

inj 40fluconazole 2mg/ml inj 40fluconazole 40mg/ml susp 40fluconazole 50mg tab 40flucytosine 250mg cap 40flucytosine 500mg cap 40fludrocortisone 0.1mg tab 86FLUMADINE 100MG TAB 71FLUNISOLIDE 25MCG

NASAL INHALER 115fluocinolone acetonide 0.01%

cream 92




156

fluocinolone acetonide 0.01%otic oil 120

fluocinolone acetonide 0.01%otic soln 120

fluocinolone acetonide 0.01%topical soln 92

fluocinolone acetonide0.025% cream 92

fluocinolone acetonide0.025% ointment 92

fluocinolone acetonide0.1mg/ml oil 92

fluocinonide 0.05% e cream 92fluocinonide 0.05% gel 92fluocinonide 0.05% ointment 92fluocinonide 0.05% topical

soln 92fluorometholone 0.1% ophth

susp 119FLUOROURACIL 0.5%

CREAM 89FLUOROURACIL 2%

TOPICAL SOLN 89fluorouracil 5% cream 89FLUOROURACIL 5%

TOPICAL SOLN 89fluoxetine 10mg cap 31fluoxetine 10mg tab 31fluoxetine 20mg cap 31fluoxetine 20mg tab 31fluoxetine 25mg/olanzapine

12mg cap 125fluoxetine 25mg/olanzapine


6mg cap 125fluoxetine 40mg cap 31fluoxetine 4mg/ml oral soln 31fluoxetine 50mg/olanzapine


6mg cap 125FLUPHENAZINE

0.5MG/ML ORAL SOLN 65

fluphenazine 10mg tab 65fluphenazine 1mg tab 65FLUPHENAZINE

2.5MG/ML INJ 65fluphenazine 2.5mg tab 65FLUPHENAZINE 5MG/ML

ORAL SOLN 65fluphenazine 5mg tab 65fluphenazine decanoate

25mg/ml inj 65flurandrenolide 0.05% cream 92flurandrenolide 0.05% lotion 92FLURAZEPAM 15MG CAP 107FLURAZEPAM 30MG CAP 107flurbiprofen 100mg tab 6flurbiprofen 50mg tab 6flurbiprofen sodium 0.03%

ophth soln 120flutamide 125mg cap 53fluticasone

propionate/salmeterol100-50mcg/act dry powderinh 20

fluticasonepropionate/salmeterol250-50mcg/act dry powderinh 20

fluticasonepropionate/salmeterol500-50mcg/act dry powderinh 20

FLUTICASONEPROPIONATE/SALMETEROLXINAFOATE113-14MCG/ACTPOWDER INH 20



fluticasone propionate0.005% ointment 92

fluticasone propionate 0.05%cream 92

fluticasone propionate 0.05%lotion 92

fluticasone propionate 50mcgnasal inhaler 115

fluvastatin 20mg cap 43fluvastatin 40mg cap 43fluvastatin 80mg er tab 43fluvoxamine maleate 100mg

er cap 31fluvoxamine maleate 100mg

tab 31fluvoxamine maleate 150mg

er cap 31fluvoxamine maleate 25mg

tab 31fluvoxamine maleate 50mg

tab 31FML 0.1% OPHTH

OINTMENT 119FML 0.1% OPHTH SUSP 119FML FORTE LIQUIFILM

0.25% OPHTH SUSP 119FOCALIN 10MG TAB 2FOCALIN 10MG XR CAP 2FOCALIN 15MG XR CAP 2FOCALIN 2.5MG TAB 2FOCALIN 20MG XR CAP 3FOCALIN 25MG XR CAP 3FOCALIN 30MG XR CAP 3FOCALIN 35MG XR CAP 3FOCALIN 40MG XR CAP 3FOCALIN 5MG TAB 3FOCALIN 5MG XR CAP 3




157

fondaparinux sodium12.5mg/ml (0.4ml) syringe 23



fondaparinux sodium 5mg/mlsyringe 23

FORTEO 600MCG/2.4MLPEN INJ 96

FOSAMAX 70MG TAB 96fosamprenavir 700mg tab 67fosinopril sodium


fosinopril sodium 10mg tab 44fosinopril sodium


fosinopril sodium 20mg tab 44fosinopril sodium 40mg tab 44FOSRENOL 1000MG ORAL

POWDER 103FOSRENOL 750MG ORAL

POWDER 103FRAGMIN 10000UNIT/ML

SYRINGE 23FRAGMIN

12500UNIT/0.5MLSYRINGE 23

FRAGMIN15000UNIT/0.6MLSYRINGE 23





FRAGMIN95000UNIT/3.8ML INJ 23

FREAMINE 6.9% INJ 116FULPHILA 6/0.6ML

SYRINGE 106FURADANTIN 25MG/5ML

SUSP 131furosemide 10mg/ml inj 95furosemide 10mg/ml oral soln 95furosemide 10mg/ml syringe 95furosemide 20mg tab 95furosemide 40mg tab 95furosemide 80mg tab 95FUROSEMIDE 8MG/ML

ORAL SOLN 95FUZEON 90MG INJ 67fyavolv 0.5mg-2.5mcg tab 100fyavolv 1mg-5mcg tab 100FYCOMPA 0.5MG/ML SUSP23FYCOMPA 10MG TAB 23FYCOMPA 12MG TAB 23FYCOMPA 2MG TAB 23FYCOMPA 4MG TAB 23FYCOMPA 6MG TAB 23FYCOMPA 8MG TAB 23

Ggabapentin 100mg cap 25gabapentin 300mg cap 25gabapentin 400mg cap 25gabapentin 50mg/ml oral soln 25gabapentin 600mg tab 25gabapentin 800mg tab 25GABITRIL 12MG TAB 28GABITRIL 16MG TAB 28GABITRIL 2MG TAB 28GABITRIL 4MG TAB 28GALAFOLD 123MG CAP 98galantamine 12mg tab 124galantamine 4mg tab 124galantamine 8mg tab 124

galantamine hydrobromide16mg er cap 124


GALANTAMINEHYDROBROMIDE4MG/ML ORAL SOLN 124


GAMMAGARD 10GM INJ 121GAMMAGARD

2.5GM/25ML INJ 121GAMMAGARD 5GM INJ 121GAMMAKED 1GM/10ML

INJ 121GAMMAPLEX

10GM/100ML INJ 121GAMMAPLEX

10GM/200ML INJ 121GAMMAPLEX

20GM/200ML INJ 121GAMMAPLEX 5GM/50ML

INJ 121GAMUNEX 1GM/10ML

INJ 121GARDASIL 9 INJ 133GARDASIL 9 SYRINGE 133GASTROCROM

100MG/5ML ORALSOLN 102

gatifloxacin 0.5% ophth soln 118GATTEX 5MG INJ 104GAUZE PAD 109gavilyte-c oral soln 108gavilyte-g oral soln 108gavilyte-n powder for oral

soln 108gemfibrozil 600mg tab 42GENERESS FE 28 PACK 82generlac 10gm/15ml oral

soln 103gengraf 100mg/ml oral soln 71gengraf 100mg cap 71gengraf 25mg cap 71




158

GENOTROPIN 0.2MGSYRINGE 97








GENOTROPIN 12MGCARTRIDGE 97

GENOTROPIN 1MGSYRINGE 97

GENOTROPIN 2MGSYRINGE 97

GENOTROPIN 5MGCARTRIDGE 97

GENTAK 0.3% OPHTHOINTMENT 118

gentamicin sulfate 0.1%cream 88

gentamicin sulfate 0.1%ointment 88

gentamicin sulfate 0.3%ophth soln 118

GENTAMICIN SULFATE0.8MG/ML INJ 4

gentamicin sulfate 1.2mg/ml inj4GENTAMICIN SULFATE

1.6MG/ML INJ 4GENTAMICIN SULFATE

1MG/ML INJ 4gentamicin sulfate 40mg/ml inj 4GENVOYA

150-150-200-10MG TAB 67GEODON 20MG CAP 61GEODON 20MG INJ 61

GEODON 40MG CAP 61GEODON 60MG CAP 61GEODON 80MG CAP 61gianvi 28-day pack 82GILENYA 0.5MG CAP 125GILOTRIF 20MG TAB 55GILOTRIF 30MG TAB 55GILOTRIF 40MG TAB 55GLASSIA 1000MG/50ML

INJ 126glatiramer 20mg/ml syringe 125glatiramer 40mg/ml syringe 125glatopa 20mg/ml syringe 125glatopa 40mg/ml syringe 125GLEOSTINE 100MG CAP 52GLEOSTINE 10MG CAP 52GLEOSTINE 40MG CAP 52glimepiride 1mg tab 37glimepiride 2mg tab 37glimepiride 4mg tab 37glipizide 10mg er tab 37glipizide 10mg tab 37glipizide 2.5mg/metformin

250mg tab 34glipizide 2.5mg/metformin

500mg tab 35glipizide 2.5mg er tab 37glipizide 5mg/metformin

500mg tab 35glipizide 5mg er tab 37glipizide 5mg tab 37GLUCAGEN 1MG INJ 36GLUCAGON 1MG INJ 36GLUCOPHAGE 1000MG

TAB 35GLUCOPHAGE 500MG TAB35GLUCOPHAGE 500MG XR

TAB 35GLUCOPHAGE 750MG XR

TAB 35GLUCOPHAGE 850MG TAB35glucose 10% inj 116GLUCOSE

100MG/ML/SODIUM

CHLORIDE 0.0342MEQ/ML INJ 111

GLUCOSE100MG/ML/SODIUMCHLORIDE 0.0769MEQ/ML INJ 111

glucose 100mg/ml inj 116GLUCOSE

25MG/ML/SODIUMCHLORIDE 0.0769MEQ/ML INJ 111

glucose 50mg/ml/potassiumchloride 0.01meq/ml/sodium chloride0.0769 meq/ml inj 111


GLUCOSE50MG/ML/POTASSIUMCHLORIDE 0.02MEQ/ML/SODIUMCHLORIDE 0.056MEQ/ML INJ 111


glucose 50mg/ml/potassiumchloride0.02meq/ml/sodiumchloride 4.5mg/ml inj 111

glucose 50mg/ml/potassiumchloride 0.02 meq/ml inj 111


GLUCOSE50MG/ML/POTASSIUMCHLORIDE 0.04MEQ/ML/SODIUM




159

CHLORIDE 0.154MEQ/ML INJ 111

glucose 50 mg/ml/potassiumchloride0.04meq/ml/sodiumchloride 4.5mg/ml inj 111

GLUCOSE50MG/ML/POTASSIUMCHLORIDE 0.04MEQ/ML INJ 111

glucose 50mg/ml/sodiumchloride 0.0342 meq/mlinj 111

GLUCOSE50MG/ML/SODIUMCHLORIDE 0.0385MEQ/ML INJ 111

glucose 50mg/ml/sodiumchloride 0.0564 meq/mlinj 112

glucose 50mg/ml/sodiumchloride 4.5mg/ml inj 112

glucose 50mg/ml/sodiumchloride 9mg/ml inj 112

GLUCOTROL 10MG TAB 37GLUCOTROL 10MG XL

TAB 38GLUCOTROL 2.5MG XL

TAB 38GLUCOTROL 5MG TAB 38GLUCOTROL 5MG XL TAB 38glyburide 1.25mg/metformin

250mg tab 35glyburide 2.5mg/metformin

500mg tab 35glyburide 5mg/metformin

500mg tab 35glycopyrrolate 1mg tab 131glycopyrrolate 2mg tab 131GLYSET 100MG TAB 34GLYSET 25MG TAB 34GLYSET 50MG TAB 34GLYXAMBI 10-5MG TAB 35GLYXAMBI 25-5MG TAB 35

GOLYTELY 236GM ORALSOLN 108

GRAMICIDIN0.025MG/ML/NEOMYCIN1.75MG/ML/POLYMYXIN B10000UNIT/ML OPHTHSOLN 118

granisetron 1mg tab 38griseofulvin 125mg tab 40griseofulvin 250mg tab 40griseofulvin 25mg/ml susp 40griseofulvin 500mg tab 40guanfacine 1mg er tab 1guanfacine 2mg er tab 2guanfacine 3mg er tab 2guanfacine 4mg er tab 2GUANIDINE 125MG TAB 51

HHAEGARDA 2000UNT INJ 105HAEGARDA 3000UNT INJ 105hailey 24 fe 28 day pack 82HALCION 0.25MG TAB 107HALDOL 100MG/ML INJ 63HALDOL 50MG/ML INJ 63HALDOL 5MG/ML INJ 63halobetasol propionate 0.05%

cream 92halobetasol propionate 0.05%

ointment 92haloperidol 0.5mg tab 63haloperidol 10mg tab 63haloperidol 1mg tab 63haloperidol 20mg tab 63haloperidol 2mg/ml oral soln 63haloperidol 2mg tab 63haloperidol 5mg/ml inj 63haloperidol 5mg tab 63haloperidol decanoate

100mg/ml inj 63haloperidol decanoate

500mg/5ml inj 63

haloperidol decanoate50mg/ml inj 63

HAVRIX 1440UNIT INJ 133HAVRIX 1440UNIT

SYRINGE 133HAVRIX 720UNIT INJ 133HAVRIX 720UNIT

SYRINGE 133heparin sodium porcine

10000unit/ml inj 23heparin sodium porcine



5000unit/ml inj 23HEPATAMINE 8% INJ 116HEPSERA 10MG TAB 70HETLIOZ 20MG CAP 108HIBERIX INJ 133HIPREX 1GM TAB 131HUMIRA 10MG/0.1ML

SYRINGE 4HUMIRA 10MG/0.2ML



SYRINGE 4HUMIRA 40MG/0.4ML PEN

INJECTOR 4HUMIRA 40MG/0.4ML


AUTO-INJECTOR 4HUMIRA 40MG/0.8ML

SYRINGE 4HUMIRA PEDIATRIC

CROHN'S STARTERPACK (3) 40MG/0.8ML INJ4

HUMIRA PEDIATRICCROHN'S STARTERPACK (3) 80MG/0.8ML INJ4




160

HUMIRA PEDIATRICCROHN'S STARTERPACK (6) 40MG/0.8ML INJ5

HUMIRA PEDIATRICCROHN'S STARTERPACK SYRINGE (2)40MG/0.4ML 80MG/0.8ML 5

HUMIRA PEN - CROHN'SSTARTER PACK40MG/0.8ML INJ 5

HUMIRA PEN - CROHN'SSTARTER PACK80MG/0.8ML INJ 5

HUMIRA PEN - PSORIASISSTARTER PACK40MG/0.8ML INJ 5

HUMIRA PEN - PSORIASISSTARTER PACK80MG/0.8ML INJ 5

HUMULIN R 500UNIT/MLINJ 36

HUMULIN R 500UNIT/MLPEN INJ 36

hydralazine 100mg tab 51hydralazine 10mg tab 51hydralazine 25mg tab 51hydralazine 50mg tab 51HYDREA 500MG CAP 57hydrochlorothiazide

12.5mg/irbesartan 150mgtab 49

hydrochlorothiazide12.5mg/irbesartan 300mgtab 49

hydrochlorothiazide12.5mg/lisinopril 10mg tab 49

hydrochlorothiazide12.5mg/lisinopril 20mg tab 49

hydrochlorothiazide12.5mg/losartan potassium100mg tab 49

hydrochlorothiazide12.5mg/losartan potassium50mg tab 49

hydrochlorothiazide12.5mg/olmesartanmedoxomil 20mg tab 49

hydrochlorothiazide12.5mg/olmesartanmedoxomil 40mg tab 49

hydrochlorothiazide12.5mg/quinapril 10mg tab 49

hydrochlorothiazide12.5mg/quinapril 20mg tab 49

hydrochlorothiazide12.5mg/telmisartan 40mgtab 49

hydrochlorothiazide12.5mg/telmisartan 80mgtab 49

hydrochlorothiazide12.5mg/valsartan 160mgtab 49

hydrochlorothiazide12.5mg/valsartan 320mgtab 49

hydrochlorothiazide12.5mg/valsartan 80mg tab49

hydrochlorothiazide 12.5mgcap 96

hydrochlorothiazide 12.5mgtab 96

hydrochlorothiazide25mg/lisinopril 20mg tab 49

hydrochlorothiazide25mg/losartan potassium100mg tab 49

hydrochlorothiazide25mg/metoprolol tartrate100mg tab 49

hydrochlorothiazide25mg/metoprolol tartrate50mg tab 49

hydrochlorothiazide25mg/olmesartanmedoxomil 40mg tab 49

hydrochlorothiazide25mg/propranolol 40mgtab 49

hydrochlorothiazide25mg/propranolol 80mgtab 49

hydrochlorothiazide25mg/quinapril 20mg tab 49

hydrochlorothiazide25mg/spironolactone 25mgtab 95

hydrochlorothiazide25mg/telmisartan 80mg tab50

hydrochlorothiazide25mg/triamterene 37.5mgcap 95

hydrochlorothiazide25mg/triamterene 37.5mgtab 95

hydrochlorothiazide25mg/valsartan 160mg tab 50

hydrochlorothiazide25mg/valsartan 320mg tab 50

hydrochlorothiazide 25mg tab 96hydrochlorothiazide

50mg/metoprolol tartrate100mg tab 50

hydrochlorothiazide50mg/triamterene 75mg tab95

hydrochlorothiazide 50mg tab 96hydrocodone 10mg/ibuprofen

200mg tab 11hydrocodone 5mg/ibuprofen

200mg tab 11hydrocodone bitartrate

7.5mg/ibuprofen 200mg tab11hydrocortisone/pramoxine

1-1% rectal cream 12hydrocortisone 1.67mg/ml

enema 12hydrocortisone 1% cream 92hydrocortisone

10mg/ml/neomycin




161

3.5mg/ml/polymyxin b10000unit/ml ophth susp 119

hydrocortisone10mg/ml/neomycin3.5mg/ml/polymyxin b10000unit/ml otic soln 120

hydrocortisone10mg/ml/neomycin3.5mg/ml/polymyxin b10000unit/ml otic susp 120

hydrocortisone 10mg tab 85hydrocortisone 2.5% cream 92hydrocortisone 2.5% lotion 92hydrocortisone 2.5% ointment 92hydrocortisone 20mg tab 85hydrocortisone 5mg tab 85hydrocortisone valerate 0.2%

cream 92hydrocortisone valerate 0.2%

ointment 92hydromorphone 10mg/ml

(1ml) inj 8hydromorphone 10mg/ml

(5ml) inj 8hydromorphone 1mg/ml oral

soln 8hydromorphone 2mg/ml

syringe 8hydromorphone 2mg tab 8hydromorphone 4mg tab 8hydromorphone 8mg tab 8hydroxychloroquine sulfate

200mg tab 51hydroxyurea 500mg cap 57hydroxyzine 10mg tab 16hydroxyzine 25mg tab 16hydroxyzine 2mg/ml oral soln 16hydroxyzine 50mg tab 16HYDROXYZINE PAMOATE

100MG CAP 16hydroxyzine pamoate 25mg

cap 16hydroxyzine pamoate 50mg

cap 16

HYSINGLA 100MG ER TAB 8HYSINGLA 120MG ER TAB 8HYSINGLA 20MG ER TAB 8HYSINGLA 30MG ER TAB 8HYSINGLA 40MG ER TAB 8HYSINGLA 60MG ER TAB 8HYSINGLA 80MG ER TAB 9HYZAAR 100-12.5MG TAB 50HYZAAR 100-25MG TAB 50HYZAAR 50-12.5MG TAB 50

Iibandronate 150mg tab 96IBRANCE 100MG CAP 55IBRANCE 125MG CAP 55IBRANCE 75MG CAP 55ibu 600mg tab 6ibu 800mg tab 6ibuprofen 20mg/ml susp 6IBUPROFEN

400MG/OXYCODONE5MG TAB 11

ibuprofen 400mg tab 6ibuprofen 600mg tab 6ibuprofen 800mg tab 6ICLUSIG 15MG TAB 55ICLUSIG 45MG TAB 55IDHIFA 100MG TAB 55IDHIFA 50MG TAB 55ILEVRO 0.3% OPHTH

SUSP 120imatinib 100mg tab 55imatinib 400mg tab 55IMBRUVICA 140MG CAP 55IMBRUVICA 140MG TAB 55IMBRUVICA 280MG TAB 55IMBRUVICA 420MG TAB 55IMBRUVICA 560MG TAB 55IMBRUVICA 70MG CAP 55imipramine 10mg tab 33imipramine 25mg tab 33imipramine 50mg tab 33imipramine pamoate 100mg

cap 34

imipramine pamoate 125mgcap 34



IMIQUIMOD 3.75%CREAM 93

imiquimod 5% cream 93IMITREX 100MG TAB 110IMITREX 20MG/ACT

NASAL SPRAY 110IMITREX 25MG TAB 110IMITREX 50MG TAB 110IMITREX 5MG/ACT

NASAL SPRAY 110IMITREX 6MG/0.5ML

CARTRIDGE 110IMITREX 6MG/0.5ML INJ 110IMOVAX 2.5UNIT/ML INJ 133IMURAN 50MG TAB 113incassia 28 day 0.35mg pack 84INCRELEX 40MG/4ML INJ 97INCRUSE 62.5MCG INH 19indapamide 1.25mg tab 96indapamide 2.5mg tab 96INDERAL 120MG ER CAP 73INDERAL 160MG ER CAP 73INDERAL 60MG ER CAP 73INDERAL 80MG ER CAP 73INFANRIX INJ 130INGREZZA 40MG CAP 125INGREZZA 80MG CAP 125INLYTA 1MG TAB 55INLYTA 5MG TAB 55INNOPRAN 120MG XL

CAP 73INNOPRAN 80MG XL CAP 73INSPRA 25MG TAB 51INSPRA 50MG TAB 51INSULIN PEN NEEDLE 109INSULIN SYRINGE (DISP)

U-100 0.3ML 110




162

INSULIN SYRINGE (DISP)U-100 1/2ML 109

INSULIN SYRINGE (DISP)U-100 1ML 110

INSULIN SYRINGE MIS1ML/29G 110

INTELENCE 100MG TAB 67INTELENCE 200MG TAB 67INTELENCE 25MG TAB 67intralipid 200mg/ml inj 116INTRALIPID 30% INJ 116INTRON A 10MU INJ 57INTRON A 18MU INJ 57INTRON A 25MU INJ 57INTRON A 50MU INJ 57INTRON A

6000000UNIT/ML INJ 57introvale 91 day pack 82INTUNIV 1MG ER TAB 2INTUNIV 2MG ER TAB 2INTUNIV 3MG ER TAB 2INTUNIV 4MG ER TAB 2INVANZ 1GM INJ 14INVEGA 1.5MG ER TAB 62INVEGA 117MG/0.75ML

SYRINGE 62INVEGA 156MG/ML

SYRINGE 62INVEGA 234MG/1.5ML



SYRINGE 62INVEGA 3MG ER TAB 62INVEGA 410MG/1.315ML


SYRINGE 62INVEGA 6MG ER TAB 62INVEGA 78MG/0.5ML


SYRINGE 62

INVEGA 9MG ER TAB 62INVIRASE 500MG TAB 67IONOSOL-MB INJ 112IOPIDINE 1% OPHTH

SOLN 117IPOL INJ 133ipratropium/albuterol

0.5-2.5mg/3ml inh soln 21ipratropium bromide 0.02%

inh soln 19ipratropium bromide 0.03%

nasal inhaler 115ipratropium bromide 0.06%

nasal inhaler 115irbesartan 150mg tab 46irbesartan 300mg tab 46irbesartan 75mg tab 46IRESSA 250MG TAB 55ISENTRESS 100MG CHEW

TAB 67ISENTRESS 100MG SUSP 67ISENTRESS 25MG CHEW

TAB 67ISENTRESS 400MG TAB 67ISENTRESS 600MG TAB 67isibloom 28 day pack 82ISOLYTE P INJ 112ISOLYTE S INJ 112isoniazid 100mg tab 52ISONIAZID 10MG/ML

ORAL SOLN 52isoniazid 300mg tab 52ISOPROPYL ALCOHOL

0.7ML/ML PAD 109ISOPTOCARPINE 1%

OPHTH SOLN 117ISOPTOCARPINE 2%

OPHTH SOLN 117ISOPTOCARPINE 4%

OPHTH SOLN 117ISORDIL 40MG TAB 15ISORDIL 5MG TAB 15isosorbide dinitrate 10mg tab 15isosorbide dinitrate 20mg tab 15

ISOSORBIDE DINITRATE30MG TAB 15

ISOSORBIDE DINITRATE40MG ER TAB 15

isosorbide dinitrate 5mg tab 15isosorbide mononitrate 10mg

tab 15isosorbide mononitrate

120mg er tab 15isosorbide mononitrate 20mg

tab 15isosorbide mononitrate 30mg

er tab 15isosorbide mononitrate 60mg

er tab 15isotretinoin 10mg cap 87isotretinoin 20mg cap 87isotretinoin 30mg cap 87isotretinoin 40mg cap 87isradipine 2.5mg cap 75isradipine 5mg cap 75ISTALOL 0.5% OPHTH

SOLN 117itraconazole 100mg cap 40itraconazole 10mg/ml oral

soln 40ivermectin 3mg tab 13IXIARO SYRINGE 133

JJADENU 180MG

GRANULE PACKET 38JADENU 180MG TAB 38JADENU 360MG

GRANULE PACKET 38JADENU 360MG TAB 38JADENU 90MG GRANULE

PACKET 38JADENU 90MG TAB 38JAKAFI 10MG TAB 55JAKAFI 15MG TAB 55JAKAFI 20MG TAB 55JAKAFI 25MG TAB 55JAKAFI 5MG TAB 55




163

JALYN 0.5-0.4MG CAP 104jantoven 10mg tab 22jantoven 1mg tab 22jantoven 2.5mg tab 22jantoven 2mg tab 22jantoven 3mg tab 22jantoven 4mg tab 22jantoven 5mg tab 22jantoven 6mg tab 22jantoven 7.5mg tab 22JANUMET 100-1000MG XR

TAB 35JANUMET 50-1000MG TAB 35JANUMET 50-1000MG XR

TAB 35JANUMET 50-500MG TAB 35JANUMET 50-500MG XR

TAB 35JANUVIA 100MG TAB 36JANUVIA 25MG TAB 36JANUVIA 50MG TAB 36JARDIANCE 10MG TAB 37JARDIANCE 25MG TAB 37jasmiel 28 day pack 82JENTADUETO 2.5-1000MG

TAB 35JENTADUETO 2.5-1000MG

XR TAB 35JENTADUETO 2.5-500MG

TAB 35JENTADUETO 2.5-850MG

TAB 35JENTADUETO 5-1000MG

XR TAB 35jinteli tab 100jolivette 28 day 0.35mg pack 84juleber 28 day pack 82JULUCA 50-25MG TAB 67junel 1/20 21 day pack 82junel 1.5/30 21 day pack 82junel fe 1/20 28 day pack 82junel fe 1.5/30 28 day pack 82junel fe 24 1/20 28 day pack 82JUXTAPID 10MG CAP 43

JUXTAPID 20MG CAP 43JUXTAPID 30MG CAP 43JUXTAPID 40MG CAP 43JUXTAPID 5MG CAP 44JUXTAPID 60MG CAP 44JYNARQUE 15MG TAB 99JYNARQUE 30MG TAB 99JYNARQUE 45/15

THERAPY PACK 99JYNARQUE 60/30

THERAPY PACK 99JYNARQUE 90/30

THERAPY PACK 99

Kkaitlib fe 28 day pack 82KALETRA 100-25MG TAB 67KALETRA 200-50MG TAB 68KALETRA 400-100MG/5ML

ORAL SOLN 68KALYDECO 150MG TAB 126KALYDECO 25MG

GRANULES 126KALYDECO 50MG

GRANULES PACKET 126KALYDECO 75MG

GRANULES PACKET 126kariva 28 day pack 82KCL/D5W/LR INJ 0.15% 112kelnor 1/35 28 day pack 82kelnor 1/50 28 day pack 82KENALOG 0.147MG/GM

SPRAY 92KEPPRA 1000MG TAB 25KEPPRA 100MG/ML ORAL

SOLN 25KEPPRA 250MG TAB 25KEPPRA 500MG TAB 25KEPPRA 500MG XR TAB 25KEPPRA 750MG TAB 25KEPPRA 750MG XR TAB 25ketoconazole 2% cream 89ketoconazole 2% shampoo 89ketoconazole 200mg tab 40

ketoconazole 20mg/ml foam 89KETOPROFEN 200MG ER

CAP 6KETOPROFEN 25MG CAP 6ketorolac tromethamine 0.4%

ophth soln 120ketorolac tromethamine 0.5%

ophth soln 120ketorolac tromethamine 10mg

tab 6KEVZARA 150MG/1.14ML

PF INJ 5KEVZARA 200MG/1.14ML

PF INJ 5KINRIX INJ 130KINRIX PF INJ 130kionex 250mg/ml susp 72KISQALI/FEMARA TAB

CO-PACK 200MG 54KISQALI/FEMARA TAB

CO-PACK 400MG 54KISQALI/FEMARA TAB

CO-PACK 600MG 54KISQALI 200MG DAILY

DOSE PACK 55KISQALI 400MG DAILY

DOSE PACK 55KISQALI 600MG DAILY

DOSE PACK 56KLARON 10% LOTION 87KLONOPIN 0.5MG TAB 24KLONOPIN 1MG TAB 24KLONOPIN 2MG TAB 24klor-con 10meq er micro tab 112klor-con 10meq er tab 112KLOR-CON 15MEQ ER

TAB 112klor-con 20meq er micro tab 112klor-con 20meq powder 112klor-con 8meq er cap 112klor-con 8meq er tab 112KORLYM 300MG TAB 36KRISTALOSE 10GM ORAL

SOLN 108




164

KRISTALOSE 20GM ORALSOLN 108

K-TAB 10MEQ ER TAB 112K-TAB 20MEQ ER TAB 112K-TAB 8MEQ ER TAB 112kurvelo 28 day pack 82KUVAN 100MG POWDER

FOR ORAL SOLN 98KUVAN 100MG TAB 98KUVAN 500MG POWDER

FOR ORAL SOLN 98

Llabetalol 100mg tab 72labetalol 200mg tab 72labetalol 300mg tab 72LACRISERT 5MG

IMPLANT 116lactulose 667mg/ml oral soln108LAMICTAL 100MG ODT 25LAMICTAL 100MG TAB 25LAMICTAL 100MG XR TAB25LAMICTAL 150MG TAB 25LAMICTAL 200MG ODT 25LAMICTAL 200MG TAB 25LAMICTAL 200MG XR TAB25LAMICTAL 250MG XR TAB25LAMICTAL 25MG CHEW

TAB 25LAMICTAL 25MG ODT 25LAMICTAL 25MG TAB 25LAMICTAL 25MG XR TAB 25LAMICTAL 300MG XR TAB25LAMICTAL 50MG ODT 25LAMICTAL 50MG XR TAB 25LAMICTAL 5MG CHEW

TAB 25LAMICTAL BLUE KIT 25LAMICTAL GREEN KIT 25LAMICTAL ORANGE KIT 25LAMICTAL XR BLUE KIT 25LAMICTAL XR GREEN KIT25LAMICTAL XR ORANGE

KIT 25

lamivudine 100mg tab 70lamivudine 10mg/ml oral soln 68lamivudine 150mg/zidovudine

300mg tab 68lamivudine 150mg tab 68lamivudine 300mg tab 68lamotrigine 100mg er tab 25lamotrigine 100mg odt 26lamotrigine 100mg tab 26lamotrigine 150mg tab 26lamotrigine 200mg er tab 26lamotrigine 200mg odt 26lamotrigine 200mg tab 26lamotrigine 250mg er tab 26lamotrigine 25mg (35) tab

starter pack 26lamotrigine 25mg chew tab 26lamotrigine 25mg er tab 26lamotrigine 25mg odt 26lamotrigine 25mg tab 26lamotrigine 300mg er tab 26lamotrigine 50mg er tab 26lamotrigine 50mg odt 26lamotrigine 5mg chew tab 26lamotrigine tab 25mg

(42)/100mg (7) starterpack 26

lamotrigine tab 25mg(84)/100mg (14) starterpack 26

LANOXIN 125MCG TAB 77LANOXIN 250MCG TAB 77lansoprazole 15mg dr cap 130lansoprazole 15mg odt 131lansoprazole 30mg dr cap 130lansoprazole 30mg odt 131lanthanum carbonate 1000mg

chew tab 103lanthanum carbonate 500mg

chew tab 103lanthanum carbonate 750mg

chew tab 103LANTUS 100UNIT/ML INJ 36

LANTUS 100UNIT/MLSOLOSTAR 36

larin 1/20 pack 82larin 1.5/30 pack 82larin fe 1/20 pack 82larin fe 1.5/30 pack 82larissia 28 day pack 82LASIX 20MG TAB 95LASIX 40MG TAB 95LASIX 80MG TAB 95LASTACAFT 0.25% OPHTH

SOLN 120latanoprost 0.005% ophth

soln 120LATUDA 120MG TAB 61LATUDA 20MG TAB 61LATUDA 40MG TAB 61LATUDA 60MG TAB 61LATUDA 80MG TAB 61layolis fe 28 pack 82LAZANDA 100MCG/ACT

NASAL SPRAY 9LAZANDA 300MCG/ACT

NASAL SPRAY 9LAZANDA 400MCG/ACT

NASAL SPRAY 9leena 28 day pack 82leflunomide 10mg tab 7leflunomide 20mg tab 7LENVIMA (10) 10MG PACK 56LENVIMA (12) 4MG PACK 56LENVIMA (14) PACK 56LENVIMA (18) PACK 56LENVIMA (20) 10MG PACK 56LENVIMA (24) PACK 56LENVIMA (4) 4MG PACK 56LENVIMA (8) 4MG PACK 56LESCOL 80MG XL TAB 43lessina 28 day pack 82letrozole 2.5mg tab 53LEUCOVORIN 10MG TAB 58LEUCOVORIN 15MG TAB 58leucovorin 25mg tab 58leucovorin 5mg tab 58




165

LEUKERAN 2MG TAB 52LEUKINE 250MCG INJ 106leuprolide acetate 5mg/ml inj 53levalbuterol 0.31mg inh soln 21levalbuterol 0.63mg inh soln 21levalbuterol 1.25mg inh soln 21levalbuterol 2.5mg inh soln 21LEVALBUTEROL 45MCG

INH 21LEVEMIR 100UNIT/ML

FLEXTOUCH 36LEVEMIR 100UNIT/ML INJ 36levetiracetam 1000mg tab 26levetiracetam 100mg/ml oral

soln 26levetiracetam 250mg tab 26levetiracetam 500mg er tab 26levetiracetam 500mg tab 26levetiracetam 750mg er tab 26levetiracetam 750mg tab 26levobunolol 0.5% ophth soln 117levocarnitine 100mg/ml oral

soln 98levocarnitine 330mg tab 98levocetirizine 0.5mg/ml oral

soln 41levocetirizine 5mg tab 41levofloxacin 0.5% ophth soln118levofloxacin 250mg tab 102levofloxacin 25mg/ml inj 102levofloxacin 25mg/ml oral

soln 102levofloxacin 500mg tab 102levofloxacin 5mg/ml (150ml)

inj 102levofloxacin 5mg/ml inj 102levofloxacin 750mg tab 102levonest 28 day pack 82levora 0.15/30 28 day pack 82levo-t 100mcg tab 128levo-t 112mcg tab 128levo-t 125mcg tab 128levo-t 137mcg tab 128levo-t 150mcg tab 128

levo-t 175mcg tab 128levo-t 200mcg tab 128levo-t 25mcg tab 128levo-t 300mcg tab 128levo-t 50mcg tab 128levo-t 75mcg tab 128levo-t 88mcg tab 128levothyroxine sodium 100mcg

tab 128levothyroxine sodium 112mcg











tab 128levoxyl 100mcg tab 128levoxyl 112mcg tab 128levoxyl 125mcg tab 128levoxyl 137mcg tab 128levoxyl 150mcg tab 129levoxyl 175mcg tab 129levoxyl 200mcg tab 129levoxyl 25mcg tab 129levoxyl 50mcg tab 129levoxyl 75mcg tab 129levoxyl 88mcg tab 129LEXAPRO 10MG TAB 31LEXAPRO 20MG TAB 31

LEXAPRO 5MG TAB 31LEXIVA 50MG/ML SUSP 68LEXIVA 700MG TAB 68lidocaine/prilocaine 2.5-2.5%

cream 94lidocaine 2% gel 93lidocaine 2% topical soln 114lidocaine 4% topical soln 93lidocaine 5% ointment 93lidocaine 5% patch 94LIDODERM 5% PATCH 94lindane 1% shampoo 94linezolid 20mg/ml susp 15linezolid 2mg/ml inj 15linezolid 600mg tab 15LINZESS 145MCG CAP 103LINZESS 290MCG CAP 103LINZESS 72MCG CAP 103liothyronine sodium 0.005mg

tab 129liothyronine sodium 0.025mg

tab 129liothyronine sodium 0.05mg

tab 129LIPITOR 10MG TAB 43LIPITOR 20MG TAB 43LIPITOR 40MG TAB 43LIPITOR 80MG TAB 43LIPOFEN 150MG CAP 42LIPOFEN 50MG CAP 42lisinopril 10mg tab 44lisinopril 2.5mg tab 44lisinopril 20mg tab 45lisinopril 30mg tab 45lisinopril 40mg tab 45lisinopril 5mg tab 45lithium carbonate 150mg cap 61lithium carbonate 300mg cap 61lithium carbonate 300mg er

tab 61lithium carbonate 300mg tab 61lithium carbonate 450mg er

tab 61lithium carbonate 600mg cap 61




166

lithium citrate 60mg/ml oralsoln 61

LITHOBID 300MG ER TAB 61LITHOSTAT 250MG TAB 105LIVALO 1MG TAB 43LIVALO 2MG TAB 43LIVALO 4MG TAB 43LODINE 400MG TAB 6LODOSYN 25MG TAB 60LOESTRIN 1/20 21 DAY

PACK 82LOESTRIN 1.5/30 21 DAY

PACK 82LOESTRIN FE 1/20 28 DAY

PACK 83LOESTRIN FE 1.5/30 28

DAY PACK 83LOKELMA 10GM PACKET114LOKELMA 5GM PACKET 114LO LOESTRIN FE 28 DAY

PACK 82LOMOTIL 2.5-0.025MG

TAB 38LONHALA 0.0025% INH

SOLN 19LONSURF 15-6.14MG TAB 54LONSURF 20-8.19MG TAB 54loperamide 2mg cap 38LOPID 600MG TAB 42lopinavir 80mg/ml/ritonavir

20mg/ml oral solution 68lopreeza 1/0.5mg 28 day

pack 100LOPRESSOR 100MG TAB 73LOPRESSOR HCT 50-25MG

TAB 50LOPROX 0.77% CREAM 89LOPROX 1% SHAMPOO 89lorazepam 0.5mg tab 17lorazepam 1mg tab 17lorazepam 2mg/ml conc 17lorazepam 2mg tab 17LORBRENA 100MG TAB 56LORBRENA 25MG TAB 56

lorcet 10-325mg tab 11lorcet 5-325mg tab 11lorcet 7.5-325mg tab 11loryna 28 day pack 83losartan potassium 100mg tab46losartan potassium 25mg tab 46losartan potassium 50mg tab 46LOSEASONIQUE PACK 83LOTEMAX 0.5% OPHTH

GEL 119LOTEMAX 0.5% OPHTH

OINTMENT 119LOTEMAX 0.5% OPHTH

SUSP 119LOTENSIN 10MG TAB 45LOTENSIN 20MG TAB 45LOTENSIN 40MG TAB 45loteprednol etabonate 0.5%

ophth susp 119LOTREL 10-20MG CAP 50LOTREL 10-40MG CAP 50LOTREL 5-10MG CAP 50LOTREL 5-20MG CAP 50LOTRISONE 1-0.05%

CREAM 89LOTRONEX 0.5MG TAB 103LOTRONEX 1MG TAB 103lovastatin 10mg tab 43lovastatin 20mg tab 43lovastatin 40mg tab 43LOVAZA 1GM CAP 41LOVENOX 100MG/ML

SYRINGE 23LOVENOX 120MG/0.8ML

SYRINGE 23LOVENOX 150MG/ML




SYRINGE 23

LOVENOX 80MG/0.8MLSYRINGE 23

low-ogestrel 28 day pack 83loxapine 10mg cap 63loxapine 25mg cap 63loxapine 50mg cap 63loxapine 5mg cap 63LUCEMYRA 0.18MG TAB 123LUMIGAN 0.01% OPHTH

SOLN 120LUNESTA 1MG TAB 107LUNESTA 2MG TAB 107LUNESTA 3MG TAB 107LUPANETA PACK

1-MONTH PACK 97LUPANETA PACK

3-MONTH PACK 97LUPRON 11.25MG (1.5ML)

SYRINGE 53LUPRON 22.5MG SYRINGE 53LUPRON 3.75MG SYRINGE 53LUPRON 30MG SYRINGE 53LUPRON 45MG SYRINGE 53LUPRON 7.5MG SYRINGE 53lutera 28 day pack 83LYNPARZA 100MG CAP 56LYNPARZA 150MG CAP 56LYRICA 100MG CAP 26LYRICA 150MG CAP 26LYRICA 200MG CAP 26LYRICA 20MG/ML ORAL

SOLN 26LYRICA 225MG CAP 26LYRICA 25MG CAP 26LYRICA 300MG CAP 26LYRICA 50MG CAP 26LYRICA 75MG CAP 26LYSODREN 500MG TAB 53LYSTEDA 650MG TAB 107lyza 0.35mg pack 84

MMACROBID 100MG CAP 131




167

MACRODANTIN 100MGCAP 131



mafenide 5% topical soln 90magnesium sulfate 50% inj 112magnesium sulfate 50%

syringe 112MALARONE 250-100MG

TAB 51MALARONE 62.5-25MG

TAB 51malathion 0.5% lotion 94MAPROTILINE 25MG TAB 30MAPROTILINE 50MG TAB 30MAPROTILINE 75MG TAB 30MARINOL 10MG CAP 39MARINOL 2.5MG CAP 39MARINOL 5MG CAP 39marlissa 28 day pack 83MARPLAN 10MG TAB 30MATULANE 50MG CAP 58matzim 180mg er tab 75matzim 240mg er tab 75matzim 300mg er tab 75matzim 360mg er tab 75matzim 420mg er tab 75MAVYRET 100-40MG TAB 70MAXALT 10MG ODT 110MAXALT 10MG TAB 110MAXALT 5MG ODT 110MAXIDEX 0.1% OPHTH

SUSP 119MAXIPIME 1GM INJ 80MAXIPIME 2GM INJ 80MAXITROL 0.1% OPHTH

OINTMENT 119MAXITROL 0.1% OPHTH

SUSP 119MAXZIDE 37.5-25MG TAB 95MAXZIDE 75-50MG TAB 95meclizine 12.5mg tab 39

meclizine 25mg tab 39MEDROL 16MG TAB 85MEDROL 2MG TAB 85MEDROL 32MG TAB 85MEDROL 4MG TAB 85MEDROL 8MG TAB 85MEDROL DOSEPAK 4MG

PACK 85medroxyprogesterone acetate

10mg tab 123medroxyprogesterone acetate

150mg/ml inj 84medroxyprogesterone acetate

150mg/ml syringe 84medroxyprogesterone acetate

2.5mg tab 123medroxyprogesterone acetate

5mg tab 123MEFLOQUINE 250MG TAB 51megestrol acetate 125mg/ml

susp 123megestrol acetate 20mg tab 53megestrol acetate 40mg/ml

susp 53megestrol acetate 40mg tab 53MEKINIST 0.5MG TAB 56MEKINIST 2MG TAB 56MEKTOVI 15MG TAB 56melodetta 24 fe chewable 28

day pack 83meloxicam 15mg tab 6meloxicam 7.5mg tab 6memantine 10mg/memantine

5mg pack 124memantine 10mg tab 124memantine 14mg er cap 124memantine 21mg er cap 124memantine 28mg er cap 124memantine 2mg/ml oral soln 124memantine 5mg tab 124memantine 7mg er cap 124MENACTRA INJ 133MENEST 0.3MG TAB 101MENEST 0.625MG TAB 101

MENEST 1.25MG TAB 101MENOSTAR 14MCG/24HR

PATCH 101MENTAX 1% CREAM 89MENVEO INJ 133MEPRON 750MG/5ML

SUSP 13mercaptopurine 50mg tab 52meropenem 1gm inj 14meropenem 500mg inj 14MERREM 500MG INJ 14mesalamine 1.2gm tab 103mesalamine 1000mg rectal

supp 103mesalamine 400mg dr cap 103mesalamine 66.7mg/ml

enema 103mesalamine 800mg dr tab 103MESNEX 400MG TAB 58MESTINON 180MG ER TAB51MESTINON 60MG TAB 51metadate 20mg er tab 3METAPROTERENOL

SULFATE 10MG TAB 21METAPROTERENOL

SULFATE 20MG TAB 21METAPROTERENOL

SULFATE 2MG/MLORAL SOLN 21

metaxall 800mg tab 114METAXALONE 400MG

TAB 115metaxalone 800mg tab 115metformin 1000mg tab 35METFORMIN

500MG/REPAGLINIDE1MG TAB 35

METFORMIN500MG/REPAGLINIDE2MG TAB 35

metformin 500mg er tab 35metformin 500mg tab 35metformin 750mg er tab 36metformin 850mg tab 36




168

methadone 10mg tab 9METHADONE 1MG/ML

ORAL SOLN 9METHADONE 2MG/ML

ORAL SOLN 9methadone 5mg tab 9methazolamide 25mg tab 95methazolamide 50mg tab 95methenamine hippurate

1000mg tab 132methimazole 10mg tab 128methimazole 5mg tab 128METHITEST 10MG TAB 12methocarbamol 500mg tab 115methocarbamol 750mg tab 115methotrexate 2.5mg tab 52methotrexate 250mg/10ml inj 52methotrexate 50mg/2ml inj 52methoxsalen 10mg cap 90methscopolamine 2.5mg tab 131methscopolamine 5mg tab 131METHYCLOTHIAZIDE

5MG TAB 96METHYLIN 10MG/5ML

ORAL SOLN 3METHYLIN 5MG/5ML

ORAL SOLN 3methylphenidate 10mg chew

tab 3methylphenidate 10mg cr cap 3methylphenidate 10mg er tab 3methylphenidate 10mg la cap 3methylphenidate 10mg tab 3methylphenidate 18mg sr tab 3methylphenidate 1mg/ml oral

soln 3methylphenidate 2.5mg chew

tab 3methylphenidate 20mg cr cap 3methylphenidate 20mg er tab 3methylphenidate 20mg la cap 3methylphenidate 20mg tab 3methylphenidate 27mg sr tab 3

methylphenidate 2mg/ml oralsoln 3

methylphenidate 30mg cr cap 3methylphenidate 30mg la cap 3methylphenidate 36mg sr tab 3methylphenidate 40mg cr cap 3methylphenidate 40mg la cap 3methylphenidate 50mg cr cap 3methylphenidate 54mg sr tab 3methylphenidate 5mg chew tab 3methylphenidate 5mg tab 3methylphenidate 60mg cr cap 3METHYLPHENIDATE

60MG LA CAP 3methylprednisolone 16mg tab 85methylprednisolone 32mg tab 85methylprednisolone 4mg pack 85methylprednisolone 4mg tab 85methylprednisolone 8mg tab 85METHYLTESTOSTERONE

10MG CAP 12metoclopramide 10mg tab 102metoclopramide 1mg/ml oral

soln 102metoclopramide 5mg tab 102metolazone 10mg tab 96metolazone 2.5mg tab 96metolazone 5mg tab 96metoprolol succinate 100mg

er tab 73metoprolol succinate 200mg

er tab 73metoprolol succinate 25mg er

tab 73metoprolol succinate 50mg er

tab 73metoprolol tartrate 100mg tab73metoprolol tartrate 25mg tab 73metoprolol tartrate 50mg tab 73METROCREAM 0.75%

CREAM 94METROGEL 0.75%

VAGINAL GEL 134METROGEL 1% GEL 94

METROLOTION 0.75%LOTION 94

metronidazole 0.75% cream 94metronidazole 0.75% gel 94metronidazole 0.75% lotion 94metronidazole 0.75% vaginal

gel 134metronidazole 1% gel 94metronidazole 250mg tab 13metronidazole 375mg cap 13metronidazole 500mg tab 13metronidazole 5mg/ml inj 13MEXILETINE 150MG CAP 18MEXILETINE 200MG CAP 18MEXILETINE 250MG CAP 18mibelas 24 fe chewable 28

day pack 83MICARDIS 20MG TAB 46MICARDIS 40MG TAB 46MICARDIS 80MG TAB 46MICARDIS-HCT 40-12.5MG

TAB 50MICARDIS-HCT 80-12.5MG

TAB 50MICARDIS-HCT 80-25MG

TAB 50MICONAZOLE NITRATE

200MG VAGINAL SUPP 134microgestin 1/20 21 day pack 83microgestin 1.5/30 21 day

pack 83microgestin fe 1/20 28 day

pack 83microgestin fe 1.5/30 28 day

pack 83midodrine 10mg tab 135midodrine 2.5mg tab 135midodrine 5mg tab 135miglitol 100mg tab 34miglitol 25mg tab 34miglitol 50mg tab 34miglustat 100mg cap 106mili 28 day pack 83MILLIPRED 5MG TAB 85




169

mimvey lo 28 day pack 100mimvey pack 100MINASTRIN 24 FE

CHEWABLE 28 DAYPACK 83

MINIPRESS 1MG CAP 47MINIPRESS 2MG CAP 47MINIPRESS 5MG CAP 47minitran 0.1mg/hr patch 15minitran 0.2mg/hr patch 15minitran 0.4mg/hr patch 15minitran 0.6mg/hr patch 16MINIVELLE

0.025MG/24HR PATCH 101MINIVELLE

0.0375MG/24HR PATCH 101MINIVELLE 0.05MG/24HR

PATCH 101MINIVELLE

0.075MG/24HR PATCH 101MINIVELLE 0.1MG/24HR

PATCH 101MINOCIN 50MG CAP 127minocycline 100mg cap 127minocycline 100mg tab 127minocycline 50mg cap 127minocycline 50mg tab 127minocycline 75mg cap 127minocycline 75mg tab 127minoxidil 10mg tab 51minoxidil 2.5mg tab 51MIRAPEX 0.125MG TAB 58MIRAPEX 0.25MG TAB 58MIRAPEX 0.375MG ER

TAB 58MIRAPEX 0.5MG TAB 58MIRAPEX 0.75MG ER TAB 59MIRAPEX 0.75MG TAB 59MIRAPEX 1.5MG ER TAB 59MIRAPEX 1.5MG TAB 59MIRAPEX 1MG TAB 59MIRAPEX 2.25MG ER TAB 59MIRAPEX 3.75MG ER TAB 59MIRAPEX 3MG ER TAB 59

MIRAPEX 4.5MG ER TAB 59mirtazapine 15mg odt 29mirtazapine 15mg tab 29mirtazapine 30mg odt 29mirtazapine 30mg tab 29mirtazapine 45mg odt 29mirtazapine 45mg tab 29mirtazapine 7.5mg tab 29misoprostol 0.1mg tab 131misoprostol 0.2mg tab 131MITIGARE 0.6MG CAP 105M-M-R II INJ 133MOBIC 15MG TAB 6MOBIC 7.5MG TAB 6modafinil 100mg tab 3modafinil 200mg tab 3moexipril 15mg tab 45moexipril 7.5mg tab 45MOLINDONE 10MG TAB 65MOLINDONE 25MG TAB 65MOLINDONE 5MG TAB 65mometasone furoate 0.1%

cream 92mometasone furoate 0.1%

lotion 92mometasone furoate 0.1%

ointment 92mondoxyne 100mg cap 127mononessa 28 day pack 83montelukast 10mg tab 19montelukast 4mg chew tab 19montelukast 4mg granules 19montelukast 5mg chew tab 19MONUROL 3000MG ORAL

SOLN 132morgidox 50mg cap 127morphine sulfate 100mg er tab 9MORPHINE SULFATE

10MG/ML SYRINGE 9morphine sulfate 15mg er tab 9morphine sulfate 15mg tab 9morphine sulfate 200mg er tab 9morphine sulfate 20mg/ml

oral soln 9

morphine sulfate 2mg/ml oralsoln 9

MORPHINE SULFATE2MG/ML SYRINGE 9

morphine sulfate 30mg er tab 9morphine sulfate 30mg tab 9morphine sulfate 4mg/ml oral

soln 9MORPHINE SULFATE

4MG/ML SYRINGE 9MORPHINE SULFATE

5MG/ML SYRINGE 9morphine sulfate 60mg er tab 9MORPHINE SULFATE

8MG/ML SYRINGE 9MOVANTIK 12.5MG TAB 103MOVANTIK 25MG TAB 103moxifloxacin 0.5% ophth

soln 118moxifloxacin 1.6mg/ml inj 102moxifloxacin 400mg tab 102MS CONTIN 100MG TAB 9MS CONTIN 15MG TAB 9MS CONTIN 200MG TAB 9MS CONTIN 30MG TAB 9MS CONTIN 60MG TAB 9MULPLETA 3MG TAB 106MULTAQ 400MG TAB 18mupirocin 2% ointment 88MYAMBUTOL 400MG TAB 52MYCAMINE 100MG INJ 39MYCAMINE 50MG INJ 39MYCOBUTIN 150MG CAP 52mycophenolate mofetil

200mg/ml susp 71mycophenolate mofetil 250mg

cap 71mycophenolate mofetil 500mg

tab 71mycophenolic acid 180mg dr

tab 71mycophenolic acid 360mg dr

tab 71MYFORTIC 180MG DR TAB71




170

MYFORTIC 360MG DR TAB71myorisan 10mg cap 87myorisan 20mg cap 87myorisan 30mg cap 87myorisan 40mg cap 87MYRBETRIQ 25MG ER

TAB 132MYRBETRIQ 50MG ER

TAB 132MYSOLINE 250MG TAB 26MYSOLINE 50MG TAB 26

Nnabumetone 500mg tab 6nabumetone 750mg tab 6nadolol 20mg tab 73nadolol 40mg tab 73nadolol 80mg tab 73nafcillin 100mg/ml inj 122nafcillin 1gm inj 122nafcillin 2gm inj 123naftifine 1% cream 89naftifine 2% cream 89NAFTIN 1% GEL 89NAFTIN 2% CREAM 89NAFTIN 2% GEL 89NALOXONE 0.4MG/ML

CARTRIDGE 38naloxone 0.4mg/ml inj 38NALOXONE 1MG/ML

SYRINGE 38naltrexone 50mg tab 38NAMENDA 10MG TAB 124NAMENDA 14MG XR CAP124NAMENDA 21MG XR CAP124NAMENDA 28MG XR CAP124NAMENDA 28 TITRATION

PACK 124NAMENDA 49 TITRATION

PACK 124NAMENDA 5MG TAB 124NAMENDA 7MG XR CAP 124naproxen 250mg tab 6naproxen 375mg dr tab 6

naproxen 375mg tab 6naproxen 500mg dr tab 6naproxen 500mg tab 6naproxen sodium 275mg tab 6naproxen sodium 550mg tab 6naratriptan 1mg tab 110naratriptan 2.5mg tab 110NARCAN 4MG/0.1ML

NASAL SPRAY 38NARDIL 15MG TAB 30NATACYN 5% OPHTH

SUSP 118NATAZIA 28 DAY PACK 83nateglinide 120mg tab 37nateglinide 60mg tab 37NATPARA 100MCG

CARTRIDGE 96NATPARA 25MCG



CARTRIDGE 96NEBUPENT 300MG INH

SOLN 13necon 0.5/35 28 day pack 83NEFAZODONE 100MG TAB 32NEFAZODONE 150MG TAB 32NEFAZODONE 200MG TAB 32NEFAZODONE 250MG TAB 32NEFAZODONE 50MG TAB 32neomycin/bacitracin/

polymyxin ophth ointment5(3.5)mg-400unit-10000unit118

neomycin/polymyxin/bacitracin/hydrocortisoneophth ointmentment 1% 119

neomycin sulfate 500mg tab 4NEORAL 100MG/ML

ORAL SOLN 71NEORAL 100MG CAP 71NEORAL 25MG CAP 71NEPHRAMINE 5.4% INJ 116NERLYNX 40MG TAB 56

neuac 1.2-5% gel 87NEUPRO 1MG/24HR PATCH59NEUPRO 2MG/24HR PATCH59NEUPRO 3MG/24HR PATCH59NEUPRO 4MG/24HR PATCH59NEUPRO 6MG/24HR PATCH59NEUPRO 8MG/24HR PATCH59NEURONTIN 100MG CAP 26NEURONTIN 250MG/5ML

ORAL SOLN 26NEURONTIN 300MG CAP 26NEURONTIN 400MG CAP 26NEURONTIN 600MG TAB 26NEURONTIN 800MG TAB 26NEVANAC 0.1% OPHTH

SUSP 120nevirapine 100mg er tab 68nevirapine 10mg/ml oral susp 68nevirapine 200mg tab 68nevirapine 400mg er tab 68NEXAVAR 200MG TAB 56NEXIUM 20MG DR CAP 130NEXIUM 40MG DR CAP 131niacin 1000mg er tab 44niacin 500mg er tab 44niacin 750mg er tab 44NIASPAN 1000MG ER TAB 44NIASPAN 500MG ER TAB 44NIASPAN 750MG ER TAB 44nicardipine 20mg cap 75nicardipine 30mg cap 75NICOTROL 10MG/ML

NASAL INHALER 126NICOTROL 10MG

INHALER 126nifedipine 30mg er tab 75nifedipine 30mg osmotic er

tab 75nifedipine 60mg er tab 75nifedipine 60mg osmotic er

tab 75nifedipine 90mg er tab 75nifedipine 90mg osmotic er

tab 75




171

nikki 28 day pack 83NILANDRON 150MG TAB 53nilutamide 150mg tab 53nimodipine 30mg cap 76NINLARO 2.3MG CAP 56NINLARO 3MG CAP 56NINLARO 4MG CAP 56nisoldipine 17mg er tab 76nisoldipine 20mg er tab 76NISOLDIPINE 25.5MG ER

TAB 76nisoldipine 30mg er tab 76nisoldipine 34mg er tab 76nisoldipine 40mg er tab 76nisoldipine 8.5mg er tab 76NITRO-BID 2% OINTMENT 16NITRO-DUR 0.1MG/HR

PATCH 16NITRO-DUR 0.2MG/HR





PATCH 16nitrofurantoin 5mg/ml susp 132nitrofurantoin macro 100mg

cap 132nitrofurantoin macro

25mg/nitrofurantoin mono75mg cap 132

nitrofurantoin macro 25mgcap 132

nitrofurantoin macro 50mgcap 132

nitroglycerin 0.1mg/hr patch 16nitroglycerin 0.2mg/hr patch 16nitroglycerin 0.3mg sl tab 16nitroglycerin 0.4mg/act spray 16nitroglycerin 0.4mg/hr patch 16nitroglycerin 0.4mg sl tab 16

nitroglycerin 0.6mg/hr patch 16nitroglycerin 0.6mg sl tab 16NITROSTAT 0.3MG SL TAB 16NITROSTAT 0.4MG SL TAB 16NITROSTAT 0.6MG SL TAB 16NIVESTYM

300MCG/0.5ML PF INJ 106NIVESTYM 300MCG/1ML

INJ 106NIVESTYM

480MCG/0.8ML PF INJ 106NIVESTYM

480MCG/1.6ML INJ 106nizatidine 150mg cap 130NIZATIDINE 15MG/ML

ORAL SOLN 131nizatidine 300mg cap 130NIZORAL 2% SHAMPOO 89nolix 0.05% cream 92nolix 0.05% topical lotion 92nora-be 28 day 0.35mg pack 84NORCO 10-325MG TAB 11NORCO 5-325MG TAB 11NORCO 7.5-325MG TAB 11norethindrone 0.35mg pack 84norethindrone acetate 5mg

tab 123norlyroc 28 day 0.35mg pack 84NORMOSOL-M INJ 112NORMOSOL-R IN 5%

DEXTROSE INJ 112NORMOSOL-R INJ 112NORPACE 100MG CAP 18NORPACE 100MG ER CAP 18NORPACE 150MG CAP 18NORPACE 150MG ER CAP 18NORPRAMIN 10MG TAB 34NORPRAMIN 25MG TAB 34NORTHERA 100MG CAP 134NORTHERA 200MG CAP 134NORTHERA 300MG CAP 134nortrel 0.5/35 28 day pack 83nortrel 1/35 21 day pack 83nortrel 1/35 28 day pack 83

nortrel 7/7/7 28 day pack 83nortriptyline 10mg cap 34nortriptyline 25mg cap 34NORTRIPTYLINE 2MG/ML

ORAL SOLN 34nortriptyline 50mg cap 34nortriptyline 75mg cap 34NORVASC 10MG TAB 76NORVASC 2.5MG TAB 76NORVASC 5MG TAB 76NORVIR 100MG POWDER

PACKET 68NORVIR 100MG TAB 68NORVIR 80MG/ML ORAL

SOLN 68NOVOLIN 100UNIT/ML INJ 36NOVOLIN N 100UNIT/ML

INJ 36NOVOLIN R 100UNIT/ML

INJ 36NOVOLOG 100UNIT/ML

FLEXPEN 36NOVOLOG 100UNIT/ML

INJ 36NOVOLOG 100UNIT/ML

PENFILL 36NOVOLOG MIX

100UNIT/ML FLEXPEN 36NOVOLOG MIX

100UNIT/ML INJ 36NOXAFIL 100MG DR TAB 40NOXAFIL 40MG/ML SUSP 40NUCALA 100MG INJ 19NUCYNTA 100MG ER TAB 9NUCYNTA 150MG ER TAB 9NUCYNTA 200MG ER TAB 9NUCYNTA 250MG ER TAB 9NUCYNTA 50MG ER TAB 9NUEDEXTA 20-10MG CAP126NUPLAZID 10MG TAB 61NUPLAZID 34MG CAP 61nutrilipid 20% iv soln 116NUVARING VAGINAL

RING 84




172

NUVIGIL 150MG TAB 3NUVIGIL 200MG TAB 3NUVIGIL 250MG TAB 3NUVIGIL 50MG TAB 3nyamyc 100000unit/gm

powder 89nystatin 100000unit/ml cream 89nystatin 100000unit/ml susp 114nystatin 100unit/mg ointment 89nystatin 100unit/mg powder 89nystatin 500000unit tab 40nystop 100000unit/gm powder89

OOCALIVA 10MG TAB 102OCALIVA 5MG TAB 102ocella 28 day pack 83OCTAGAM 25GM/500ML

INJ 121OCTAGAM 2GM/20ML INJ121octreotide 0.05mg/ml inj 99octreotide 0.1mg/ml inj 99octreotide 0.2mg/ml inj 99octreotide 0.5mg/ml inj 99octreotide 1mg/ml inj 99OCUFLOX 0.3% OPHTH

SOLN 118ODEFSEY 200-25-25MG

TAB 68ODOMZO 200MG CAP 53OFEV 100MG CAP 127OFEV 150MG CAP 127ofloxacin 0.3% ophth soln 118ofloxacin 0.3% otic soln 120ofloxacin 400mg tab 102OGESTREL 28 DAY PACK 83olanzapine 10mg inj 63olanzapine 10mg odt 64olanzapine 10mg tab 64olanzapine 15mg odt 64olanzapine 15mg tab 64olanzapine 2.5mg tab 64olanzapine 20mg odt 64olanzapine 20mg tab 64

olanzapine 5mg odt 64olanzapine 5mg tab 64olanzapine 7.5mg tab 64olmesartan medoxomil 20mg

tab 46olmesartan medoxomil 40mg

tab 46olmesartan medoxomil 5mg

tab 46olopatadine 0.6% nasal

inhaler 115olopatadine 1mg/ml ophth

soln 120olopatadine 2% ophth soln 120OLUMIANT 2MG TAB 5OLUX 0.05% E FOAM 92OLUX 0.05% FOAM 92omega-3 acid ethyl esters

(usp) 1000mg cap 41omeprazole 10mg dr cap 130omeprazole 20mg dr cap 130omeprazole 40mg dr cap 131OMNIPRED 1% OPHTH

SUSP 119ondansetron 0.8mg/ml oral

soln 38ondansetron 24mg tab 38ondansetron 4mg odt 38ondansetron 4mg tab 39ondansetron 8mg odt 39ondansetron 8mg tab 39ONEXTON 1.2-3.75% GEL 87ONFI 10MG TAB 24ONFI 2.5MG/ML SUSP 24ONFI 20MG TAB 24OPANA 10MG TAB 9OPANA 5MG TAB 9OPSUMIT 10MG TAB 78ORAPRED 10MG ODT 85ORAPRED 15MG ODT 85ORAPRED 30MG ODT 85ORAVIG 50MG BUCCAL

TAB 114

ORENITRAM 0.125MG ERTAB 78

ORENITRAM 0.25MG ERTAB 78

ORENITRAM 1MG ER TAB 78ORENITRAM 2.5MG ER

TAB 78ORENITRAM 5MG ER TAB 78ORFADIN 10MG CAP 98ORFADIN 20MG CAP 98ORFADIN 2MG CAP 98ORFADIN 4MG/ML SUSP 98ORFADIN 5MG CAP 98ORILISSA 150MG TAB 97ORILISSA 200MG TAB 97ORKAMBI 100-125MG

GRANULES PACKET 126ORKAMBI 100-125MG

TAB 126ORKAMBI 188-150MG

GRANULES PACKET 127ORKAMBI 200-125MG

TAB 127orphenadrine citrate 100mg

er tab 115orsythia 28 day pack 83ORTHO MICRONOR 28

DAY 0.35MG PACK 84ORTHO-NOVUM 1/35 28

DAY PACK 83ORTHO-NOVUM 7/7/7 28

DAY PACK 83ORTHO TRI-CYCLEN LO

28 DAY PACK 83oseltamivir 30mg cap 71oseltamivir 45mg cap 71oseltamivir 6mg/ml oral susp 71oseltamivir 75mg cap 71OSPHENA 60MG TAB 97OTEZLA 28-DAY STARTER

PACK 7OTEZLA 30MG TAB 7OVIDE 0.5% LOTION 94oxacillin 100mg/ml inj 123




173

oxacillin 1gm inj 123oxacillin 2000mg inj 123OXACILLIN 20MG/ML INJ123OXACILLIN 40MG/ML INJ123oxandrolone 10mg tab 12oxandrolone 2.5mg tab 12oxaprozin 600mg tab 6OXAZEPAM 10MG CAP 17oxazepam 15mg cap 17OXAZEPAM 30MG CAP 17oxcarbazepine 150mg tab 27oxcarbazepine 300mg tab 27oxcarbazepine 600mg tab 27oxcarbazepine 60mg/ml susp 27oxiconazole 1% cream 89OXISTAT 1% CREAM 89OXISTAT 1% LOTION 89OXSORALEN-ULTRA

10MG CAP 90OXTELLAR 150MG XR

TAB 27OXTELLAR 300MG XR

TAB 27OXTELLAR 600MG XR

TAB 27oxybutynin chloride 10mg er

tab 132oxybutynin chloride 15mg er

tab 132oxybutynin chloride 1mg/ml

oral soln 132oxybutynin chloride 5mg er

tab 132oxybutynin chloride 5mg tab 132oxycodone 10mg tab 9oxycodone 15mg tab 9oxycodone 1mg/ml oral soln 9oxycodone 20mg/ml oral soln 9oxycodone 20mg tab 9oxycodone 30mg tab 9oxycodone 5mg cap 9oxycodone 5mg tab 10oxymorphone 10mg tab 10oxymorphone 5mg tab 10

OZEMPIC 2MG/1.5ML PENINJ 36

OZEMPIC 2MG/1.5ML PENINJ (1MG DOSE) 36

Ppacerone 100mg tab 18pacerone 200mg tab 18pacerone 400mg tab 18paliperidone 1.5mg er tab 62paliperidone 3mg er tab 62paliperidone 6mg er tab 62paliperidone 9mg er tab 62PALYNZIQ 10MG/0.5ML

SYRINGE 98PALYNZIQ 2.5MG/0.5ML

SYRINGE 98PALYNZIQ 20MG/ML

SYRINGE 98PAMELOR 10MG CAP 34PAMELOR 25MG CAP 34PAMELOR 50MG CAP 34PAMELOR 75MG CAP 34PANDEL 0.1% CREAM 92PANRETIN 0.1% GEL 89pantoprazole 20mg dr tab 130pantoprazole 40mg dr tab 130PANZYGA 10GM/100ML IV

SOLN 121PANZYGA 1GM/10ML IV

SOLN 121PANZYGA 2.5GM/25ML IV




SOLN 121paricalcitol 0.001mg cap 98paricalcitol 0.002mg cap 98paricalcitol 0.004mg cap 98PARLODEL 2.5MG TAB 60PARLODEL 5MG CAP 60

PARNATE 10MG TAB 30paromomycin 250mg cap 4paroxetine 10mg tab 31paroxetine 12.5mg er tab 31paroxetine 20mg tab 31paroxetine 25mg er tab 31paroxetine 30mg tab 31paroxetine 37.5mg er tab 31paroxetine 40mg tab 31PASER D/R 4GM

GRANULES 52PATADAY 0.2% OPHTH

SOLN 120PATANASE 0.6% NASAL

INHALER 115PATANOL 0.1% OPHTH

SOLN 120PAXIL 10MG/5ML SUSP 31PAXIL 10MG TAB 31PAXIL 12.5MG ER TAB 31PAXIL 20MG TAB 31PAXIL 25MG ER TAB 31PAXIL 30MG TAB 31PAXIL 37.5MG ER TAB 31PAXIL 40MG TAB 31PEDIARIX INJ 130PEDVAXHIB

7.5MCG/0.5ML INJ 133peg 3350/electrolyte oral

soln 108peg 3350/kcl/sodium

bicarbonate/sodiumchloride powder for oralsoln 108

PEGANONE 250MG TAB 29PEGASYS 180MCG/0.5ML

AUTO-INJECTOR 70PEGASYS 180MCG/0.5ML

SYRINGE 70PEGASYS 180MCG/ML INJ 70penicillin g potassium

1000000unit/ml inj 122




174

PENICILLIN GPOTASSIUM40000UNIT/ML INJ 122

PENICILLIN GPOTASSIUM60000UNIT/ML INJ 122

PENICILLIN G PROCAINE600000UNIT/MLSYRINGE 122

PENICILLIN G SODIUM100000UNIT/ML INJ 122

penicillin v potassium 250mgtab 122

PENICILLIN VPOTASSIUM 25MG/MLORAL SOLN 122

penicillin v potassium 500mgtab 122

PENICILLIN VPOTASSIUM 50MG/MLORAL SOLN 122

PENTAM 300MG INJ 13pentoxifylline 400mg er tab 105PEPCIC 40MG TAB 131PEPCID 20MG TAB 130PERCOCET 10-325MG TAB 11PERCOCET 2.5-325MG TAB11PERCOCET 5-325MG TAB 11PERCOCET 7.5-325MG TAB11PERFOROMIST

20MCG/2ML INH SOLN 21perindopril erbumine 2mg tab 45perindopril erbumine 4mg tab 45perindopril erbumine 8mg tab 45permethrin 5% cream 94perphenazine 16mg tab 65perphenazine 2mg tab 65perphenazine 4mg tab 65perphenazine 8mg tab 65PERSERIS 120MG

SYRINGE 62PERSERIS 90MG SYRINGE 62PEXEVA 10MG TAB 31PEXEVA 20MG TAB 31

PEXEVA 30MG TAB 31PEXEVA 40MG TAB 31phenadoz 12.5mg rectal supp 41phenelzine 15mg tab 30phenobarbital 100mg tab 107phenobarbital 15mg tab 107phenobarbital 16.2mg tab 107phenobarbital 30mg tab 107phenobarbital 32.4mg tab 107phenobarbital 4mg/ml oral

soln 107phenobarbital 60mg tab 107phenobarbital 64.8mg tab 107phenobarbital 97.2mg tab 107phenoxybenzamine 10mg cap 45PHENYLEPHRINE

1MG/ML/PROMETHAZINE1.25MG/ML ORAL SOLN 86

PHENYTEK 200MG ERCAP 29

PHENYTEK 300MG ERCAP 29

phenytoin 25mg/ml susp 29phenytoin 50mg chew tab 29phenytoin sodium 100mg er

cap 29phenytoin sodium 200mg er

cap 29phenytoin sodium 300mg er

cap 29PHOSLYRA 667MG/5ML

ORAL SOLN 103PHOSPHOLINE IODIDE

0.125% OPHTH SOLN 117PICATO 0.015% GEL 89PICATO 0.05% GEL 89PIFELTRO 100MG TAB 68pilocarpine 1% ophth soln 117pilocarpine 2% ophth soln 117pilocarpine 4% ophth soln 117pilocarpine 5mg tab 114pilocarpine 7.5mg tab 114pimecrolimus 1% cream 93

PIMOZIDE 1MG TAB 126PIMOZIDE 2MG TAB 126pimtrea pack 83pindolol 10mg tab 73pindolol 5mg tab 73pioglitazone 15mg tab 37pioglitazone 30mg tab 37pioglitazone 45mg tab 37piperacillin

2000mg/tazobactam250mg inj 122

piperacillin200mg/ml/tazobactam25mg/ml inj 122

piperacillin3000mg/tazobactam375mg inj 122

piperacillin4000mg/tazobactam500mg inj 122

PIQRAY 200MG DAILYDOSE PACK 56

PIQRAY 250MG DAILYDOSE PACK 56

PIQRAY 300MG DAILYDOSE 150MG PACK 56

pirmella 1/35 28 day pack 83piroxicam 10mg cap 6piroxicam 20mg cap 7PLAQUENIL 200MG TAB 51PLASMA-LYTE 148 INJ 112PLASMALYTE A INJ 112PLAVIX 75MG TAB 106PLEGRIDY 125MCG/0.5ML

AUTO-INJECTOR 126PLEGRIDY 125MCG/0.5ML

SYRINGE 126PLEGRIDY PEN STARTER

PACK 126PLEGRIDY STARTER

PACK 126plenamine 15% inj 116podofilox 0.5% topical soln 93




175

polyethylene glycol3350/kcl/sodiumbicarbonate/sodiumchloride/sodium sulfatepowder for oral solut 108

polymyxin b10000unit/ml/trimethoprim1mg/ml ophth soln 118

polymyxin b 250000unit/mlinj 15

POLYTRIM10000UNIT/ML-0.1%OPHTH SOLN 118

POMALYST 1MG CAP 54POMALYST 2MG CAP 54POMALYST 3MG CAP 54POMALYST 4MG CAP 54portia 28 day pack 83potassium chloride 0.02

meq/ml/sodium chloride0.0769 meq/ml inj 112

potassium chloride 0.02meq/ml/sodium chloride0.154 meq/ml inj 112

potassium chloride 0.04meq/ml/sodium chloride0.154 meq/ml inj 112

potassium chloride 0.1meq/ml inj 112

potassium chloride 0.2meq/mlinj 112

potassium chloride 0.4meq/mlinj 112

potassium chloride 10% oralsoln 112

potassium chloride 10meq ercap 112

potassium chloride 10meq ermicro tab 112

potassium chloride 10meq ertab 112

potassium chloride 20% oralsoln 112

potassium chloride 20meq ermicro tab 112

POTASSIUM CHLORIDE20MEQ ER TAB 113

potassium chloride 20meqpowder for oral soln 113

potassium chloride 2meq/mlinj 113

potassium chloride40meq/20ml inj 113

potassium chloride 8 meq ercap 113

potassium chloride 8 meq ertab 113

potassium citrate 10meq ertab 104

potassium citrate 15 meq ertab 104

potassium citrate 5 meq ertab 104

PRADAXA 110MG CAP 23PRADAXA 150MG CAP 23PRADAXA 75MG CAP 23PRALUENT 150MG/ML

AUTO-INJECTOR 44PRALUENT 75MG/ML

AUTO-INJECTOR 44pramipexole 0.125mg tab 59pramipexole 0.25mg tab 59pramipexole 0.375mg er tab 59pramipexole 0.5mg tab 59pramipexole 0.75mg er tab 59pramipexole 0.75mg tab 59pramipexole 1.5mg er tab 59pramipexole 1.5mg tab 59pramipexole 1mg tab 59pramipexole 2.25mg er tab 59pramipexole 3.75mg er tab 59pramipexole 3mg er tab 59pramipexole 4.5mg er tab 59PRANDIN 1MG TAB 37PRANDIN 2MG TAB 37prasugrel 10mg tab 106prasugrel 5mg tab 106

PRAVACHOL 20MG TAB 43PRAVACHOL 40MG TAB 43PRAVACHOL 80MG TAB 43pravastatin sodium 10mg tab 43pravastatin sodium 20mg tab 43pravastatin sodium 40mg tab 43pravastatin sodium 80mg tab 43praziquantel 600mg tab 13prazosin 1mg cap 47prazosin 2mg cap 47prazosin 5mg cap 47PRECOSE 100MG TAB 34PRECOSE 25MG TAB 34PRECOSE 50MG TAB 34PRED FORTE 1% OPHTH

SUSP 119PRED-G 0.3-0.6% OPHTH

OINTMENT 119PRED-G 0.3-1% OPHTH

SUSP 119PRED MILD 0.12% OPHTH

SUSP 119PREDNICARBATE 0.1%

CREAM 92PREDNICARBATE 0.1%

OINTMENT 92PREDNISOLONE 1%

OPHTH SOLN 119prednisolone 10mg odt 85prednisolone 15mg odt 85prednisolone 1mg/ml oral

soln 85prednisolone 2mg/ml oral

soln 85prednisolone 30mg odt 85PREDNISOLONE 3MG/ML

ORAL SOLN 85prednisolone 4mg/ml oral

soln 86PREDNISOLONE 5MG/ML

ORAL SOLN 86PREDNISOLONE ACETATE

1% OPHTH SUSP 119




176

PREDNISOLONE SODIUMPHOSPHATE2.5MG/ML/SULFACETAMIDESODIUM 100MG/MLOPHTH SOLN 119

prednisone 10mg tab 86PREDNISONE 1MG/ML

ORAL SOLN 86prednisone 1mg tab 86prednisone 2.5mg tab 86prednisone 20mg tab 86PREDNISONE 50MG TAB 86PREDNISONE 5MG/ML

ORAL SOLN 86prednisone 5mg tab 86PREFEST 30 DAY PACK 100PREMARIN 0.3MG TAB 101PREMARIN 0.45MG TAB 101PREMARIN 0.625MG/GM

VAGINAL CREAM 134PREMARIN 0.625MG TAB 101PREMARIN 0.9MG TAB 101PREMARIN 1.25MG TAB 101PREMASOL 10% INJ 116premasol 6% inj 116PREMPHASE 28 DAY

PACK 100PREMPRO 0.3/1.5MG 28

DAY PACK 100PREMPRO 0.45/1.5 28 DAY

PACK 100PREMPRO 0.625/2.5MG 28

DAY PACK 100PREMPRO 0.625/5MG 28

DAY PACK 100PREVACID 15MG DR CAP 130PREVACID 30MG DR CAP 130prevalite 4gm/dose susp 42previfem 28 day pack 83PREVYMIS 240MG TAB 69PREVYMIS 480MG TAB 69PREZCOBIX 800-150MG

TAB 68

PREZISTA 100MG/MLSUSP 68

PREZISTA 150MG TAB 68PREZISTA 600MG TAB 68PREZISTA 75MG TAB 68PREZISTA 800MG TAB 68PRIFTIN 150MG TAB 52PRIMAQUINE PHOSPHATE

26.3MG TAB 51PRIMAXIN 500MG INJ 14primidone 250mg tab 27primidone 50mg tab 27PRINIVIL 10MG TAB 45PRINIVIL 20MG TAB 45PRINIVIL 5MG TAB 45PRISTIQ 100MG ER TAB 32PRISTIQ 25MG ER TAB 32PRISTIQ 50MG ER TAB 33PRIVIGEN 20GM/200ML

INJ 121probenecid 500mg tab 105PROCALAMINE 3% INJ 116PROCARDIA 30MG XL

TAB 76PROCARDIA 60MG XL

TAB 76PROCARDIA 90MG XL

TAB 76PROCENTRA 5MG/5ML

ORAL SOLN 1prochlorperazine 10mg tab 65prochlorperazine 25mg rectal

supp 65prochlorperazine 5mg tab 65procto-med 2.5% cream 12procto-pak 1% rectal cream 12proctosol 2.5% cream 13proctozone hc 2.5% cream 13progesterone 100mg cap 123progesterone 200mg cap 123PROGLYCEM 50MG/ML

SUSP 36PROGRAF 0.2MG

GRANULES PACKET 113

PROGRAF 0.5MG CAP 71PROGRAF 1MG CAP 113PROGRAF 1MG

GRANULES PACKET 113PROGRAF 5MG CAP 71PROLASTIN 1000MG INJ 126PROLENSA 0.07% OPHTH

SOLN 120PROLIA 60MG/ML

SYRINGE 96PROMACTA 12.5MG

POWDER FOR ORALSUSP 106

PROMACTA 12.5MG TAB 107PROMACTA 25MG TAB 107PROMACTA 50MG TAB 107PROMACTA 75MG TAB 107promethazine 1.25mg/ml oral

soln 41promethazine 12.5mg rectal

supp 41promethazine 12.5mg tab 41promethazine 25mg rectal

supp 41promethazine 25mg tab 41promethazine 50mg rectal

supp 41promethazine 50mg tab 41promethegan 25mg rectal

supp 41promethegan 50mg rectal

supp 41PROMETRIUM 100MG

CAP 123PROMETRIUM 200MG

CAP 123propafenone 150mg tab 18propafenone 225mg er cap 18propafenone 225mg tab 18propafenone 300mg tab 18propafenone 325mg er cap 18propafenone 425mg sr cap 18proparacaine 0.5% ophth

soln 118




177

propranolol 10mg tab 73propranolol 120mg er cap 73propranolol 160mg er cap 74propranolol 20mg tab 74propranolol 40mg tab 74PROPRANOLOL 4MG/ML

ORAL SOLN 74propranolol 60mg er cap 74propranolol 60mg tab 74propranolol 80mg er cap 74propranolol 80mg tab 74PROPRANOLOL 8MG/ML

ORAL SOLN 74propylthiouracil 50mg tab 128PROQUAD INJ 133PROSCAR 5MG TAB 104PROSOL 20% INJ 116PROTONIX 20MG DR TAB 131PROTONIX 40MG DR TAB 131PROTOPIC 0.03%

OINTMENT 93PROTOPIC 0.1%

OINTMENT 93protriptyline 10mg tab 34protriptyline 5mg tab 34PROVERA 10MG TAB 123PROVERA 2.5MG TAB 123PROVERA 5MG TAB 123PROVIGIL 100MG TAB 3PROVIGIL 200MG TAB 4PROZAC 10MG CAP 31PROZAC 20MG CAP 31PROZAC 40MG CAP 31PULMICORT 0.25MG/2ML

INH SOLN 20PULMICORT 0.5MG/2ML

INH SOLN 20PULMICORT 1MG/2ML

INH SOLN 20PULMOZYME 1MG/ML

INH SOLN 127PURIXAN 2000MG/100ML

SUSP 52

PYLERA 140-125-125MGCAP 131

pyrazinamide 500mg tab 52pyridostigmine bromide

12mg/ml soln 51pyridostigmine bromide

180mg er tab 51pyridostigmine bromide 60mg

tab 51

QQBRELIS 1MG/ML ORAL

SOLN 45QUADRACEL INJ 130QUALAQUIN 324MG CAP 51QUARTETTE 91 DAY PACK 83QUDEXY 100MG XR CAP 27QUDEXY 150MG XR CAP 27QUDEXY 200MG XR CAP 27QUDEXY 25MG XR CAP 27QUDEXY 50MG XR CAP 27QUESTRAN 4GM SF


QUESTRAN 4GM SUSP 42quetiapine 100mg tab 64quetiapine 150mg xr tab 64quetiapine 200mg tab 64quetiapine 200mg xr tab 64quetiapine 25mg tab 64quetiapine 300mg tab 64quetiapine 300mg xr tab 64quetiapine 400mg tab 64quetiapine 400mg xr tab 64quetiapine 50mg tab 64quetiapine 50mg xr tab 64quinapril 10mg tab 45quinapril 20mg tab 45quinapril 40mg tab 45quinapril 5mg tab 45quinidine gluconate 324mg er

tab 18QUINIDINE SULFATE

200MG TAB 18

QUINIDINE SULFATE300MG TAB 18

quinine sulfate 324mg cap 51

RRABAVERT 2.5UNIT/ML

INJ 133rabeprazole sodium 20mg dr

tab 131raloxifene 60mg tab 97ramipril 1.25mg cap 45ramipril 10mg cap 45ramipril 2.5mg cap 45ramipril 5mg cap 45RANEXA 1000MG ER TAB 15RANEXA 500MG ER TAB 15ranitidine 150mg cap 130ranitidine 150mg tab 131ranitidine 15mg/ml oral soln 130ranitidine 300mg cap 130ranitidine 300mg tab 131ranolazine 1000mg er tab 15ranolazine 500mg er tab 15RAPAFLO 4MG CAP 104RAPAFLO 8MG CAP 104RAPAMUNE 0.5MG TAB 71RAPAMUNE 1MG/ML

ORAL SOLN 113RAPAMUNE 1MG TAB 71RAPAMUNE 2MG TAB 71rasagiline 0.5mg tab 60rasagiline 1mg tab 60RAVICTI 1.1GM/ML ORAL

SOLN 98RAZADYNE 12MG TAB 124RAZADYNE 16MG ER

CAP 124RAZADYNE 24MG ER

CAP 124RAZADYNE 4MG TAB 124RAZADYNE 8MG ER CAP 124RAZADYNE 8MG TAB 124REBETOL 40MG/ML ORAL

SOLN 70




178

REBIF 22MCG/0.5MLAUTO-INJECTOR 126

REBIF 22MCG/0.5MLSYRINGE 126

REBIF 44MCG/0.5MLAUTO-INJECTOR 126

REBIF 44MCG/0.5MLSYRINGE 126

REBIF REBIDOSE PACK 126REBIF TITRATION PACK 126reclipsen 28 day pack 83RECOMBIVAX 10MCG/ML

SYRINGE 133RECOMBIVAX 40MCG/ML

INJ 133RECOMBIVAX

5MCG/0.5ML SYRINGE 133RECOMBIVAX HB

10MCG/ML INJ 133RECTIV 0.4% RECTAL

OINTMENT 13REGLAN 10MG TAB 102REGLAN 5MG TAB 102REGRANEX 0.01% GEL 94RELENZA 5MG/BLISTER

INH 71RELISTOR 12MG/0.6ML

INJ 103RELISTOR 12MG/0.6ML

SYRINGE 103RELISTOR 8MG/0.4ML

SYRINGE 103REMERON 15MG ODT 30REMERON 15MG TAB 30REMERON 30MG ODT 30REMERON 30MG TAB 30REMERON 45MG ODT 30RENAGEL 800MG TAB 103RENVELA 0.8GM SUSP 104RENVELA 2.4GM SUSP 104RENVELA 800MG TAB 104repaglinide 0.5mg tab 37repaglinide 1mg tab 37repaglinide 2mg tab 37

REPATHA 120MG/MLCARTRIDGE 44

REPATHA 140MG/MLAUTO-INJECTOR 44

REPATHA 140MG/MLSYRINGE 44

REQUIP 12MG ER TAB 60REQUIP 4MG XL TAB 59REQUIP 6MG ER TAB 60REQUIP 8MG XL TAB 59RESCRIPTOR 200MG TAB 68RESTASIS 0.05% OPHTH

SUSP 118RESTORIL 15MG CAP 107RESTORIL 22.5MG CAP 108RESTORIL 30MG CAP 108RESTORIL 7.5MG CAP 108RETACRIT 10000UNIT/ML

INJ 107RETACRIT 2000UNIT/ML




INJ 107RETIN-A 0.01% GEL 87RETIN-A 0.025% CREAM 87RETIN-A 0.025% GEL 87RETIN-A 0.04% GEL 87RETIN-A 0.05% CREAM 88RETIN-A 0.1% CREAM 88RETIN-A 0.1% GEL 88RETROVIR 100MG CAP 68RETROVIR 50MG/5ML

ORAL SOLN 68REVATIO 20MG TAB 78REVLIMID 10MG CAP 113REVLIMID 15MG CAP 113REVLIMID 2.5MG CAP 113REVLIMID 20MG CAP 113REVLIMID 25MG CAP 113REVLIMID 5MG CAP 113

REXULTI 0.25MG TAB 66REXULTI 0.5MG TAB 66REXULTI 1MG TAB 66REXULTI 2MG TAB 66REXULTI 3MG TAB 66REXULTI 4MG TAB 66REYATAZ 150MG CAP 68REYATAZ 200MG CAP 68REYATAZ 300MG CAP 68REYATAZ 50MG ORAL

POWDER 68ribasphere 200mg cap 70ribasphere 600mg tab 70RIBASPHERE RIBAPAK

1000/DAY 70ribasphere ribapak 1200/day 70ribavirin 200mg cap 70ribavirin 200mg tab 70RIDAURA 3MG CAP 5rifabutin 150mg cap 52RIFADIN 150MG CAP 52RIFAMATE 150-300MG CAP51rifampin 150mg cap 52rifampin 300mg cap 52rifampin 60mg/ml inj 52RIFATER 50-120-300MG

TAB 52RILUTEK 50MG TAB 115riluzole 50mg tab 115rimantadine 100mg tab 71RIOMET 500MG/5ML

ORAL SOLN 36risedronate sodium 150mg tab96risedronate sodium 30mg tab 97risedronate sodium 35mg (12)

pack 97risedronate sodium 35mg (4)

pack 97risedronate sodium 35mg tab 97risedronate sodium 5mg tab 97RISPERDAL 0.25MG TAB 62RISPERDAL 0.5MG TAB 62RISPERDAL 12.5MG INJ 62




179

RISPERDAL 1MG/MLORAL SOLN 62

RISPERDAL 1MG TAB 62RISPERDAL 25MG INJ 62RISPERDAL 2MG TAB 62RISPERDAL 37.5MG INJ 62RISPERDAL 3MG TAB 62RISPERDAL 4MG TAB 62RISPERDAL 50MG INJ 62risperidone 0.25mg odt 62risperidone 0.25mg tab 62risperidone 0.5mg odt 62risperidone 0.5mg tab 62risperidone 1mg/ml oral soln 62risperidone 1mg odt 62risperidone 1mg tab 62risperidone 2mg odt 62risperidone 2mg tab 63risperidone 3mg odt 63risperidone 3mg tab 63risperidone 4mg odt 63risperidone 4mg tab 63RITALIN 10MG LA CAP 4RITALIN 10MG TAB 4RITALIN 20MG LA CAP 4RITALIN 20MG TAB 4RITALIN 30MG LA CAP 4RITALIN 40MG LA CAP 4RITALIN 5MG TAB 4ritonavir 100mg tab 68rivastigmine 1.5mg cap 124rivastigmine 13.3mg/24hr

patch 124rivastigmine 3mg cap 124rivastigmine 4.5mg cap 124rivastigmine 4.6mg/24hr

patch 124rivastigmine 6mg cap 124rivastigmine 9.5mg/24hr

patch 124rivelsa 91 day pack 83rizatriptan 10mg odt 110rizatriptan 10mg tab 110rizatriptan 5mg odt 110

rizatriptan 5mg tab 110ROCALTROL 0.25MCG

CAP 98ROCALTROL 0.5MCG CAP 98ROCALTROL 1MCG/ML

ORAL SOLN 98ropinirole 0.25mg tab 59ropinirole 0.5mg tab 59ropinirole 12mg er tab 59ropinirole 1mg tab 60ropinirole 2mg er tab 59ropinirole 2mg tab 60ropinirole 3mg tab 59ropinirole 4mg er tab 59ropinirole 4mg tab 59ropinirole 5mg tab 59ropinirole 6mg er tab 59ropinirole 8mg er tab 59rosuvastatin 10mg tab 43rosuvastatin 20mg tab 43rosuvastatin 40mg tab 43rosuvastatin 5mg tab 43ROTARIX SUSP 133ROTATEQ SUSP 133roweepra 1000mg tab 27roweepra 500mg er tab 27roweepra 500mg tab 27roweepra 750mg er tab 27roweepra 750mg tab 27ROXICODONE 15MG TAB 10ROXICODONE 30MG TAB 10ROXICODONE 5MG TAB 10ROZEREM 8MG TAB 108RUBRACA 200MG TAB 56RUBRACA 250MG TAB 56RUBRACA 300MG TAB 56RUCONEST 2100UNIT INJ 105RYDAPT 25MG CAP 56RYTHMOL 225MG SR CAP 18RYTHMOL 325MG SR CAP 18RYTHMOL 425MG SR CAP 18

SSAFYRAL 28 DAY PACK 83

SALAGEN 5MG TAB 114SALAGEN 7.5MG TAB 114salmon calcitonin 200unit/act

nasal spray 97SANCUSO 3.1MG/24HR

PATCH 39SANDIMMUNE 100MG/ML

ORAL SOLN 72SANDIMMUNE 100MG

CAP 72SANDIMMUNE 25MG CAP 72SANDOSTATIN

100MCG/ML INJ 99SANDOSTATIN

500MCG/ML INJ 99SANDOSTATIN 50MCG/ML

INJ 99SANTYL 250UNIT/GM

OINTMENT 93SAPHRIS 10MG SL TAB 64SAPHRIS 2.5MG SL TAB 64SAPHRIS 5MG SL TAB 64SAVELLA 100MG TAB 125SAVELLA 12.5MG TAB 125SAVELLA 25MG TAB 125SAVELLA 4-WEEK

TITRATION PACK 125SAVELLA 50MG TAB 125scopolamine 0.0139mg/hr

patch 39SEASONIQUE PACK 83selegiline 5mg cap 60selegiline 5mg tab 61selenium sulfide 2.5%

lotion/shampoo 90SELZENTRY 150MG TAB 68SELZENTRY 20MG/ML

ORAL SOLN 68SELZENTRY 25MG TAB 68SELZENTRY 300MG TAB 68SELZENTRY 75MG TAB 68SENSIPAR 30MG TAB 98SENSIPAR 60MG TAB 98SENSIPAR 90MG TAB 98




180

SEREVENT 50MCG/DOSEINH 21

SEROQUEL 100MG TAB 64SEROQUEL 150MG XR

TAB 64SEROQUEL 200MG TAB 64SEROQUEL 200MG XR

TAB 64SEROQUEL 25MG TAB 64SEROQUEL 300MG TAB 64SEROQUEL 300MG XR

TAB 64SEROQUEL 400MG TAB 64SEROQUEL 400MG XR

TAB 64SEROQUEL 50MG TAB 64SEROQUEL 50MG XR TAB 64sertraline 100mg tab 31sertraline 20mg/ml oral soln 31sertraline 25mg tab 31sertraline 50mg tab 32setlakin 91 day pack 83SEVELAMER 400MG TAB 104sevelamer 800mg tab 104sevelamer carbonate 2400mg

oral susp 104sevelamer carbonate 800mg

oral susp 104sevelamer carbonate 800mg

tab 104sharobel 28 day 0.35mg pack 84SHINGRIX INJ 133SIGNIFOR 0.3MG/ML INJ 99SIGNIFOR 0.6MG/ML INJ 99SIGNIFOR 0.9MG/ML INJ 99sildenafil 20mg tab 78silodosin 4mg cap 104silodosin 8mg cap 104SILVADENE 1% CREAM 90silver sulfadiazine 1% cream 90SIMBRINZA 1-0.2%

OPHTH SUSP 117SIMPONI 100MG/ML

AUTO-INJECTOR 5

SIMPONI 100MG/ML INJ 5SIMPONI 50MG/0.5ML

AUTO-INJECTOR 5SIMPONI 50MG/0.5ML

SYRINGE 5simvastatin 10mg tab 43simvastatin 20mg tab 43simvastatin 40mg tab 43simvastatin 5mg tab 43simvastatin 80mg tab 43SINEMET 10-100MG TAB 59SINEMET 25-100MG ER

TAB 59SINEMET 25-100MG TAB 60SINEMET 25-250MG TAB 60SINEMET 50-200MG ER

TAB 60SINGULAIR 10MG TAB 19SINGULAIR 4MG CHEW

TAB 19SINGULAIR 4MG

GRANULES 19SINGULAIR 5MG CHEW

TAB 19sirolimus 0.5mg tab 72sirolimus 1mg/ml oral soln 113sirolimus 1mg tab 72sirolimus 2mg tab 72SIRTURO 100MG TAB 52SIVEXTRO 200MG INJ 15SIVEXTRO 200MG TAB 15SKELAXIN 800MG TAB 115SKLICE 0.5% LOTION 94SKYRIZI SYRINGE 150MG

DOSE PACK 90sodium chloride 0.45% inj 113sodium chloride 0.9% inj 113sodium chloride 0.9% soln 104sodium chloride 3% inj 113sodium chloride 5% inj 113sodium lactate 5 meq/ml inj 111sodium phenylbutyrate

0.94mg/mg oral powder 98

sodium polystyrene sulfonate15gm oral susp 72

sodium polystyrene sulfonate250mg/ml susp 72

SOFOSBUVIR/VELPATASVIR400-100MG TAB 70

solifenacin succinate 10mgtab 132

solifenacin succinate 5mgtab 132

SOLOSEC 2GM GRANULEPACKET 4

SOLTAMOX 10MG/5MLORAL SOLN 53

SOMA 350MG TAB 115SOMATULINE

120MG/0.5ML SYRINGE 99SOMATULINE

60MG/0.2ML SYRINGE 99SOMATULINE

90MG/0.3ML SYRINGE 99SOMAVERT 10MG INJ 97SOMAVERT 15MG INJ 97SOMAVERT 20MG INJ 97SOMAVERT 25MG INJ 97SOMAVERT 30MG INJ 97SORIATANE 10MG CAP 90SORIATANE 25MG CAP 90SORILUX 0.005% FOAM 90sorine 120mg tab 74sorine 160mg tab 74sorine 240mg tab 74sorine 80mg tab 74sotalol 120mg tab 74sotalol 160mg tab 74sotalol 240mg tab 74sotalol 80mg tab 74sotalol af 120mg tab 74SPIRIVA 1.25MCG

RESPIMAT INH 19spironolactone 100mg tab 96spironolactone 25mg tab 96spironolactone 50mg tab 96




181

SPORANOX 100MG CAP 40SPORANOX 10MG/ML

ORAL SOLN 40sprintec 28 day pack 83SPRITAM 1000MG ODT 27SPRITAM 250MG ODT 27SPRITAM 500MG ODT 27SPRITAM 750MG ODT 27SPRYCEL 100MG TAB 56SPRYCEL 140MG TAB 56SPRYCEL 20MG TAB 56SPRYCEL 50MG TAB 56SPRYCEL 70MG TAB 56SPRYCEL 80MG TAB 56sps 250mg/ml oral susp 72sronyx 28 day pack 83ssd 1% cream 90STALEVO 12.5-50-200MG

TAB 60STALEVO 18.75-75-200MG

TAB 60STALEVO 25-100-200MG

TAB 60STALEVO

31.25-125-200MG TAB 60STALEVO 37.5-150-200MG

TAB 60STALEVO 50-200-200MG

TAB 60STARLIX 120MG TAB 37STARLIX 60MG TAB 37stavudine 15mg cap 68stavudine 20mg cap 68stavudine 30mg cap 68stavudine 40mg cap 68STELARA 45MG/0.5ML INJ 90STELARA 45MG/0.5ML

SYRINGE 90STELARA 90MG/ML

SYRINGE 90STIMATE 1.5MG/ML

NASAL SPRAY 99STIOLTO 2.5-2.5MCG INH 21STIVARGA 40MG TAB 56

STRATTERA 100MG CAP 2STRATTERA 10MG CAP 2STRATTERA 18MG CAP 2STRATTERA 25MG CAP 2STRATTERA 40MG CAP 2STRATTERA 60MG CAP 2STRATTERA 80MG CAP 2STREPTOMYCIN 100MG INJ4STRIBILD

150-150-200-300MG TAB 68STROMECTOL 3MG TAB 13SUCRAID 8500UNIT/ML

ORAL SOLN 94sucralfate 1000mg tab 130SULAR 17MG ER TAB 76SULAR 34MG ER TAB 76SULAR 8.5MG ER TAB 76sulfacetamide sodium 10%

lotion 88SULFACETAMIDE

SODIUM 10% OPHTHOINTMENT 118

sulfacetamide sodium 10%ophth soln 118

SULFADIAZINE 500MGTAB 127

sulfamethoxazole400mg/trimethoprim 80mgtab 13

sulfamethoxazole40mg/ml/trimethoprim8mg/ml susp 13

sulfamethoxazole800mg/trimethoprim160mg tab 13

SULFAMYLON 5%TOPICAL SOLN 90

SULFAMYLON 85MG/GMCREAM 90

sulfasalazine 500mg dr tab 103sulfasalazine 500mg tab 103sulindac 150mg tab 7sulindac 200mg tab 7sumatriptan 100mg tab 110

sumatriptan 12mg/mlauto-injector 110

sumatriptan 12mg/ml inj 110SUMATRIPTAN 12MG/ML

SYRINGE 110sumatriptan 20mg/act nasal

spray 110sumatriptan 25mg tab 110sumatriptan 4mg cartridge 110sumatriptan 50mg tab 110sumatriptan 5mg/act nasal

spray 110sumatriptan 6mg cartridge 110sumatriptan 8mg/ml

auto-injector 111SUPRAX 100MG/5ML SUSP80SUPRAX 100MG CHEW

TAB 80SUPRAX 200MG/5ML SUSP80SUPRAX 200MG CHEW

TAB 80SUPRAX 400MG CAP 80SUPRAX 500MG/5ML SUSP80SURMONTIL 100MG CAP 34SURMONTIL 25MG CAP 34SURMONTIL 50MG CAP 34SUSTIVA 200MG CAP 69SUSTIVA 50MG CAP 69SUSTIVA 600MG TAB 69SUTENT 12.5MG CAP 56SUTENT 25MG CAP 56SUTENT 37.5MG CAP 56SUTENT 50MG CAP 56syeda 28 day pack 83SYLATRON 200MCG INJ 58SYLATRON 300MCG INJ 58SYLATRON 600MCG INJ 58SYMBYAX 12-50MG CAP 125SYMBYAX 3-25MG CAP 125SYMBYAX 6-25MG CAP 125SYMBYAX 6-50MG CAP 125SYMDEKO TAB 4-WEEK

PACK 127SYMFI 600-300-300MG TAB69




182

SYMFI LO 400-300-300MGTAB 69

SYMPAZAN 10MG STRIP 24SYMPAZAN 20MG STRIP 24SYMPAZAN 5MG STRIP 24SYMPROIC 0.2MG TAB 103SYMTUZA

800-150-200-10MG TAB 69SYNAREL 2MG/ML

NASAL SPRAY 97SYNJARDY 12.5-1000MG

TAB 35SYNJARDY 12.5-500MG

TAB 35SYNJARDY 5-1000MG TAB 35SYNJARDY 5-500MG TAB 35SYNJARDY XR 10-1000MG

TAB 35SYNJARDY XR

12.5-1000MG TAB 35SYNJARDY XR 25-1000MG

TAB 35SYNJARDY XR 5-1000MG

TAB 35SYNRIBO 3.5MG INJ 58SYNTHROID 100MCG

TAB 129SYNTHROID 112MCG






TAB 129SYNTHROID 25MCG TAB 129SYNTHROID 300MCG

TAB 129SYNTHROID 50MCG TAB 129SYNTHROID 75MCG TAB 129

SYNTHROID 88MCG TAB 129SYPRINE 250MG CAP 113

TTABLOID 40MG TAB 52TACLONEX 0.005-0.064%

LOTION 92TACLONEX 0.005-0.064%

OINTMENT 92tacrolimus 0.03% ointment 93tacrolimus 0.1% ointment 93tacrolimus 0.5mg cap 72tacrolimus 1mg cap 72tacrolimus 5mg cap 72tadalafil 20mg tab(PAH) 78TAFINLAR 50MG CAP 56TAFINLAR 75MG CAP 56TAGRISSO 40MG TAB 56TAGRISSO 80MG TAB 57TAKHZYRO 300MG/2ML

INJ 105TALZENNA 0.25MG CAP 57TALZENNA 1MG CAP 57TAMIFLU 30MG CAP 71TAMIFLU 45MG CAP 71TAMIFLU 6MG/ML SUSP 71TAMIFLU 75MG CAP 71tamoxifen 10mg tab 54tamoxifen 20mg tab 54tamsulosin 0.4mg cap 104TAPAZOLE 10MG TAB 128TAPAZOLE 5MG TAB 128TARCEVA 100MG TAB 57TARCEVA 150MG TAB 57TARCEVA 25MG TAB 57TARGRETIN 1% GEL 89TARGRETIN 75MG CAP 58tarina 24 fe 1/20 28 day pack 84tarina fe 1/20 28 day pack 84TARKA 2-180MG ER TAB 50TARKA 2-240MG ER TAB 50TARKA 4-240MG ER TAB 50TASIGNA 150MG CAP 57TASIGNA 200MG CAP 57

TASIGNA 50MG CAP 57TASMAR 100MG TAB 60TAVALISSE 100MG TAB 105TAVALISSE 150MG TAB 105tazarotene 1% cream 90tazicef 1gm inj 80tazicef 2gm inj 80tazicef 6gm inj 80TAZORAC 0.05% CREAM 90TAZORAC 0.05% GEL 90TAZORAC 0.1% CREAM 90TAZORAC 0.1% GEL 90taztia 120mg er cap 76taztia 180mg er cap 76taztia 240mg er cap 76taztia 300mg er cap 76taztia 360mg er cap 76TECFIDERA 120MG DR

CAP 126TECFIDERA 240MG DR

CAP 126TECFIDERA 30-DAY

STARTER PACK 126TEFLARO 400MG INJ 80TEFLARO 600MG INJ 80TEGRETOL 100MG/5ML

SUSP 27TEGRETOL 100MG XR

TAB 27TEGRETOL 200MG TAB 27TEGRETOL 200MG XR

TAB 27TEGRETOL 400MG XR

TAB 27TEKTURNA 150MG TAB 51TEKTURNA 300MG TAB 51TEKTURNA HCT

150-12.5MG TAB 50TEKTURNA HCT

150-25MG TAB 50TEKTURNA HCT

300-12.5MG TAB 50TEKTURNA HCT

300-25MG TAB 50




183

telmisartan 20mg tab 46telmisartan 40mg tab 46telmisartan 80mg tab 46temazepam 15mg cap 108temazepam 22.5mg cap 108temazepam 30mg cap 108temazepam 7.5mg cap 108TENIVAC SYRINGE 130tenofovir disoproxil fumarate

300mg tab 69TENORETIC 100-25MG

TAB 50TENORETIC 50-25MG TAB 50TENORMIN 100MG TAB 73TENORMIN 25MG TAB 73TENORMIN 50MG TAB 73terazosin 10mg cap 47terazosin 1mg cap 47terazosin 2mg cap 47terazosin 5mg cap 47terbinafine 250mg tab 40terbutaline sulfate 2.5mg tab 21terbutaline sulfate 5mg tab 21terconazole 0.4% vaginal

cream 134TERCONAZOLE 0.8%

VAGINAL CREAM 134terconazole 80mg vaginal

supp 134TESTIM 1% GEL 12testosterone 1.62% (1.25gm)

gel 12testosterone 1.62% (2.5gm)

gel 12testosterone 1.62% gel pump 12testosterone 1% (25mg) gel 12testosterone 1% (50mg) gel 12TESTOSTERONE 1% GEL

PUMP 12testosterone cypionate (1ml)

200mg/ml inj 12testosterone cypionate

100mg/ml inj 12

testosterone cypionate200mg/ml inj 12

testosterone enanthate200mg/ml inj 12

TETANUS/DIPHTHERIATOXOID INJ 130

tetrabenazine 12.5mg tab 125tetrabenazine 25mg tab 125tetracycline 250mg cap 127tetracycline 500mg cap 127THALOMID 100MG CAP 113THALOMID 150MG CAP 113THALOMID 200MG CAP 113THALOMID 50MG CAP 113THEO-24 200MG ER CAP 21THEO-24 300MG ER CAP 21THEO-24 400MG ER CAP 21THEO-24 ER CAP 21theophylline 100mg er tab 21theophylline 200mg er tab 21theophylline 300mg er tab 21theophylline 400mg er tab 21theophylline 5.33mg/ml oral

soln 21theophylline 600mg er tab 21THIOLA 100MG TAB 105thioridazine 100mg tab 65thioridazine 10mg tab 65thioridazine 25mg tab 65thioridazine 50mg tab 65thiothixene 10mg cap 66thiothixene 1mg cap 66thiothixene 2mg cap 66thiothixene 5mg cap 66THYROLAR 120MG TAB 129THYROLAR 15MG TAB 129THYROLAR 180MG TAB 129THYROLAR 30MG TAB 129THYROLAR 60MG TAB 129tiagabine 12mg tab 28tiagabine 16mg tab 28tiagabine 2mg tab 28tiagabine 4mg tab 28TIAZAC 120MG ER CAP 76

TIAZAC 180MG ER CAP 76TIAZAC 240MG ER CAP 76TIAZAC 300MG ER CAP 76TIAZAC 360MG ER CAP 76TIAZAC 420MG ER CAP 76TIBSOVO 250MG TAB 57TIGAN 300MG CAP 39TIGECYCLINE 50MG INJ 127TIKOSYN 125MCG CAP 18TIKOSYN 250MCG CAP 18TIKOSYN 500MCG CAP 18TIMOLOL 0.25% OPHTH

GEL 117timolol 0.25% ophth soln 117TIMOLOL 0.5% OPHTH

GEL 117timolol 0.5% ophth soln 117timolol 10mg tab 74timolol 20mg tab 74timolol 5mg/ml ophth 24hr

ophth soln 117timolol 5mg tab 74TIMOPTIC 0.25% OPHTH

SOLN 117TIMOPTIC 0.5% OPHTH

SOLN 117TIMOPTIC-XE 0.25%

OPHTH GEL 117TIMOPTIC-XE 0.5%

OPHTH GEL 117tinidazole 250mg tab 13tinidazole 500mg tab 13TIVICAY 10MG TAB 69TIVICAY 25MG TAB 69TIVICAY 50MG TAB 69tizanidine 2mg cap 115tizanidine 2mg tab 115tizanidine 4mg cap 115tizanidine 4mg tab 115tizanidine 6mg cap 115TOBI PODHALER KIT

28MG PACK 4TOBRADEX 0.3-0.05%

OPHTH SUSP 119




184

TOBRADEX 0.3-0.1%OPHTH OINTMENT 119

TOBRADEX 0.3-0.1%OPHTH SUSP 119

tobramycin 0.3% ophth soln 118TOBRAMYCIN 10MG/ML

INJ 4tobramycin 40mg/ml inj 4tobramycin 60mg/ml inh soln 4TOBREX 0.3% OPHTH

OINTMENT 118TOBREX 0.3% OPHTH

SOLN 118TOFRANIL 10MG TAB 34TOFRANIL 25MG TAB 34TOFRANIL 50MG TAB 34TOLAK 4% CREAM 89tolazamide 250mg tab 38tolazamide 500mg tab 38TOLBUTAMIDE 500MG

TAB 38tolcapone 100mg tab 60TOLMETIN 400MG CAP 7TOLMETIN 600MG TAB 7tolterodine tartrate 1mg tab 132tolterodine tartrate 2mg er

cap 132tolterodine tartrate 2mg tab 132tolterodine tartrate 4mg er

cap 132TOPAMAX 100MG TAB 27TOPAMAX 15MG CAP 27TOPAMAX 200MG TAB 27TOPAMAX 25MG CAP 27TOPAMAX 25MG TAB 27TOPAMAX 50MG TAB 27TOPICORT 0.05% CREAM 92TOPICORT 0.05% GEL 92TOPICORT 0.05%

OINTMENT 92TOPICORT 0.25% CREAM 93TOPICORT 0.25%

OINTMENT 93

TOPIRAMATE 100MG ERCAP 27

topiramate 100mg tab 27TOPIRAMATE 150MG ER

CAP 27topiramate 15mg cap 27TOPIRAMATE 200MG ER

CAP 27topiramate 200mg tab 27topiramate 25mg cap 27TOPIRAMATE 25MG ER

CAP 27topiramate 25mg tab 28TOPIRAMATE 50MG ER

CAP 28topiramate 50mg tab 28TOPROL 100MG XL TAB 73TOPROL 200MG XL TAB 73TOPROL 25MG XL TAB 73TOPROL 50MG XL TAB 73toremifene 60mg tab 54torsemide 100mg tab 95torsemide 10mg tab 95torsemide 20mg tab 95torsemide 5mg tab 95TOUJEO 300UNIT/ML PEN

INJ 37TOUJEO MAX

300UNIT/ML PEN INJ(3ML) 37

TPN ELECTROLYTES INJ 112TRACLEER 125MG TAB 78TRACLEER 32MG TAB

FOR ORAL SUSP 78TRACLEER 62.5MG TAB 78TRADJENTA 5MG TAB 36tramadol 100mg er tab 10tramadol 100mg er tab

(matrix delivery) 10tramadol 200mg er tab 10tramadol 200mg er tab

(matrix delivery) 10tramadol 300mg er tab 10

tramadol 300mg er tab(matrix delivery) 10

tramadol 50mg tab 10TRANDOLAPRIL

1MG/VERAPAMIL240MG ER TAB 50

trandolapril 1mg tab 45trandolapril 2mg/verapamil

180mg er tab 50trandolapril 2mg/verapamil

240mg er tab 50trandolapril 2mg tab 45trandolapril 4mg/verapamil

240mg er tab 50trandolapril 4mg tab 45tranexamic acid 650mg tab 107TRANSDERM SCOP

1MG/3DAYS PATCH 39TRANXENE 7.5MG TAB 17tranylcypromine 10mg tab 30TRAVASOL 10% INJ 116TRAVATAN Z 0.004%

OPHTH SOLN 120trazodone 100mg tab 32trazodone 150mg tab 32trazodone 300mg tab 32trazodone 50mg tab 32TRECATOR 250MG TAB 52TRELEGY 62.5-25MCG

ELLIPTA INH 21TRELSTAR 11.25MG INJ 54TRELSTAR 22.5MG INJ 54TRELSTAR 3.75MG INJ 54TRESIBA 100UNIT/ML INJ 37TRESIBA 100UNIT/ML

PEN INJ 37TRESIBA 200UNIT/ML

PEN INJ 37tretinoin 0.01% gel 88tretinoin 0.025% cream 88tretinoin 0.025% gel 88tretinoin 0.04% gel 88tretinoin 0.05% cream 88tretinoin 0.05% gel 88




185

tretinoin 0.1% cream 88tretinoin 0.1% gel 88tretinoin 10mg cap 58TREXALL 10MG TAB 52TREXALL 15MG TAB 52TREXALL 5MG TAB 52TREXALL 7.5MG TAB 52triamcinolone acetonide

0.025% cream 93triamcinolone acetonide

0.025% lotion 93triamcinolone acetonide

0.025% ointment 93triamcinolone acetonide 0.1%

cream 93triamcinolone acetonide 0.1%

lotion 93triamcinolone acetonide 0.1%

ointment 93triamcinolone acetonide 0.1%

paste 114triamcinolone acetonide

0.147mg/ml spray 93triamcinolone acetonide 0.5%

cream 93triamcinolone acetonide 0.5%

ointment 93triazolam 0.125mg tab 108triazolam 0.25mg tab 108TRICOR 145MG TAB 42TRICOR 48MG TAB 42triderm 0.1% cream 93TRIDESILON 0.05%

CREAM 93trientine 250mg tab 113tri-estarylla 28 day pack 84trifluoperazine 10mg tab 65trifluoperazine 1mg tab 65trifluoperazine 2mg tab 65trifluoperazine 5mg tab 65TRIFLURIDINE 1% SOLN 118TRIGLIDE 160MG TAB 42trihexyphenidyl 0.4mg/ml

oral soln 60

trihexyphenidyl 2mg tab 60trihexyphenidyl 5mg tab 60tri-legest 28 day pack 84TRILEPTAL 150MG TAB 28TRILEPTAL 300MG/5ML

SUSP 28TRILEPTAL 300MG TAB 28TRILEPTAL 600MG TAB 28TRILIPIX 135MG DR CAP 42TRILIPIX 45MG DR CAP 42tri-lo-estarylla 28 day pack 84tri-lo-sprintec 28 day pack 84trilyte powder for oral soln 108trimethobenzamide 300mg

cap 39trimethoprim 100mg tab 13tri-mili 28 day pack 84trimipramine 100mg cap 34trimipramine 25mg cap 34trimipramine 50mg cap 34TRINTELLIX 10MG TAB 32TRINTELLIX 20MG TAB 32TRINTELLIX 5MG TAB 32TRI-PAK 500MG PACK 109tri-previfem 28 day pack 84tri-sprintec 28 day pack 84TRIUMEQ 600-50-300MG

TAB 69trivora 28 day pack 84tri-vylibra 28 day pack 84tri-vylibra lo 28 day pack 84TRIZIVIR 300-150-300MG

TAB 69TROKENDI 100MG XR CAP28TROKENDI 200MG XR CAP28TROKENDI 25MG XR CAP 28TROKENDI 50MG XR CAP 28TROPHAMINE 10% INJ 116TROPHAMINE 6% INJ 116trospium chloride 20mg tab 132trospium chloride 60mg er

cap 132TRULICITY 0.75MG/0.5ML

AUTO-INJECTOR 36

TRULICITY 1.5MG/0.5MLAUTO-INJECTOR 36

TRUMENBA SYRINGE 133TRUSOPT 2% OPHTH

SOLN 120TRUVADA 100-150MG TAB 69TRUVADA 133-200MG TAB 69TRUVADA 167-250MG TAB 69TRUVADA 200-300MG TAB 69TWINRIX 720UNIT

SYRINGE 133TWYNSTA 40-10MG TAB 50TWYNSTA 40-5MG TAB 50TWYNSTA 80-5MG TAB 50TYBOST 150MG TAB 69tydemy 28 day pack 84TYGACIL 50MG INJ 127TYKERB 250MG TAB 57TYLENOL WITH CODEINE

300-30MG TAB 11TYLENOL WITH CODEINE

300-60MG TAB 11TYMLOS 2MG/ML PEN

INJECTOR 97TYPHIM VI 25MCG/0.5ML

INJ 133TYPHIM VI 25MCG/0.5ML

SYRINGE 133

UUCERIS 2MG/ACT FOAM 12UCERIS 9MG ER TAB 86UDENYCA 6MG/0.6ML

SYRINGE 107ULORIC 40MG TAB 105ULORIC 80MG TAB 105ULTRACET 37.5-325MG

TAB 11ULTRAM 50MG TAB 10ULTRAVATE 0.05% CREAM 93ULTRAVATE 0.05%

OINTMENT 93UNASYN 10-5GM INJ 122UNASYN 2-1GM INJ 122




186

unithroid 100mcg tab 129unithroid 112mcg tab 129unithroid 125mcg tab 129unithroid 150mcg tab 129unithroid 175mcg tab 129unithroid 200mcg tab 129unithroid 25mcg tab 129unithroid 300mcg tab 129unithroid 50mcg tab 129unithroid 75mcg tab 129unithroid 88mcg tab 129UPTRAVI 1000MCG TAB 78UPTRAVI 1200MCG TAB 78UPTRAVI 1400MCG TAB 78UPTRAVI 1600MCG TAB 78UPTRAVI 200MCG TAB 78UPTRAVI 400MCG TAB 78UPTRAVI 600MCG TAB 78UPTRAVI 800MCG TAB 78UPTRAVI TITRATION

PACK 78URECHOLINE 10MG TAB 132URECHOLINE 25MG TAB 133URECHOLINE 50MG TAB 133URECHOLINE 5MG TAB 133UROCIT-K 1080MG ER

TAB 104UROCIT-K 15MEQ ER TAB104UROCIT-K 540MG ER TAB 104UROXATRAL 10MG ER

TAB 105URSO 250MG TAB 102ursodiol 250mg tab 102ursodiol 300mg cap 102ursodiol 500mg tab 102URSO FORTE 500MG TAB 102

VVAGIFEM 10MCG

VAGINAL TAB 134valacyclovir 1000mg tab 70valacyclovir 500mg tab 70VALCHLOR 0.016% GEL 89VALCYTE 450MG TAB 69

VALCYTE 50MG/ML ORALSOLN 69

valganciclovir 450mg tab 70valganciclovir 50mg/ml oral

soln 70VALIUM 10MG TAB 17VALIUM 2MG TAB 17VALIUM 5MG TAB 17valproic acid 250mg cap 29valproic acid 50mg/ml oral

soln 29valsartan 160mg tab 46valsartan 320mg tab 46valsartan 40mg tab 46valsartan 80mg tab 46VALTREX 1GM TAB 70VALTREX 500MG TAB 70VANCOCIN 125MG CAP 14VANCOCIN 250MG CAP 14vancomycin 100mg/ml inj 14vancomycin 125mg cap 14vancomycin 250mg cap 14VANCOMYCIN 250MG INJ 14vancomycin 50mg/ml inj 14vancomycin 5mg/ml inj 14vancomycin 750mg inj 14vandazole 0.75% vaginal gel 134VAQTA 25UNIT/0.5ML

SYRINGE 133VAQTA 50UNIT/0.5ML INJ 133VAQTA 50UNIT/1ML INJ 134VAQTA 50UNIT/ML

SYRINGE 134VARIVAX 1350PFU/0.5ML

INJ 134VARIZIG 124.8/1.2ML INJ 121VARUBI 90MG TAB 39VASCEPA 1GM CAP 41VASCEPA 500MG CAP 41VASERETIC 10-25MG TAB 50VASOTEC 10MG TAB 45VASOTEC 2.5MG TAB 45VASOTEC 20MG TAB 45VASOTEC 5MG TAB 45

velivet 28 day pack 84VELPHORO 500MG CHEW

TAB 104VELTASSA 16.8GM


VELTASSA 25.2GMPOWDER FOR ORALSUSP 114

VELTASSA 8.4GMPOWDER FOR ORALSUSP 114

VEMLIDY 25MG TAB 70VENCLEXTA 10/100/50MG

STARTING PACK 52VENCLEXTA 100MG TAB 52VENCLEXTA 10MG TAB 53VENCLEXTA 50MG TAB 53venlafaxine 100mg tab 33venlafaxine 150mg er cap 33venlafaxine 25mg tab 33venlafaxine 37.5mg er cap 33venlafaxine 37.5mg tab 33venlafaxine 50mg tab 33venlafaxine 75mg er cap 33venlafaxine 75mg tab 33VENTAVIS 10MCG/ML INH

SOLN 78VENTAVIS 20MCG/ML INH

SOLN 78VENTOLIN 108MCG INH 21verapamil 100mg er cap 76verapamil 120mg er cap 76verapamil 120mg er tab 76verapamil 120mg tab 76verapamil 180mg er cap 76verapamil 180mg er tab 76verapamil 200mg er cap 76verapamil 240mg er cap 76verapamil 240mg er tab 76verapamil 300mg er cap 76VERAPAMIL 360MG SR

CAP 76verapamil 40mg tab 76




187

verapamil 80mg tab 76VERELAN 100MG ER CAP 76VERELAN 120MG SR CAP 77VERELAN 180MG SR CAP 77VERELAN 200MG ER CAP 77VERELAN 240MG SR CAP 77VERELAN 300MG ER CAP 77VERELAN 360MG SR CAP 77VERSACLOZ 50MG/ML

SUSP 64VERZENIO 100MG TAB 57VERZENIO 150MG TAB 57VERZENIO 200MG TAB 57VERZENIO 50MG TAB 57VFEND 200MG INJ 40VFEND 200MG TAB 40VFEND 40MG/ML SUSP 40VFEND 50MG TAB 40VIBRAMYCIN 100MG

CAP 128VIBRAMYCIN 25MG/5ML

SUSP 128VIBRAMYCIN 50MG/5ML

SUSP 128vicodin 10-300mg tab 11vicodin 5-300mg tab 11vicodin 7.5-300mg tab 11VICTOZA 18MG/3ML PEN

INJ 36VIDEX 125MG DR CAP 69VIDEX 2GM ORAL SOLN 69VIDEX EC 200MG DR CAP 69VIDEX EC 250MG DR CAP 69VIDEX EC 400MG DR CAP 69vienva 28 day pack 84vigabatrin 500mg tab 28vigabatrin 50mg/ml oral soln 28vigadrone 500mg oral soln 28VIGAMOX 0.5% OPHTH

SOLN 118VIIBRYD 10/20MG

STARTER PACK 32VIIBRYD 10MG TAB 32VIIBRYD 20MG TAB 32

VIIBRYD 40MG TAB 32VIMPAT 100MG TAB 28VIMPAT 10MG/ML ORAL

SOLN 28VIMPAT 150MG TAB 28VIMPAT 200MG TAB 28VIMPAT 50MG TAB 28VIRACEPT 250MG TAB 69VIRACEPT 625MG TAB 69VIRAMUNE 200MG TAB 69VIRAMUNE 400MG XR

TAB 69VIRAMUNE 50MG/5ML

SUSP 69VIREAD 150MG TAB 69VIREAD 200MG TAB 69VIREAD 250MG TAB 69VIREAD 300MG TAB 69VIREAD 40MG/GM ORAL

POWDER 69VISTARIL 25MG CAP 16VISTARIL 50MG CAP 16VITRAKVI 100MG CAP 57VITRAKVI 20MG/ML

ORAL SOLN 57VITRAKVI 25MG CAP 57VIVELLE 0.025MG/24HR

PATCH 101VIVELLE 0.0375MG/24HR




PATCH 101VIZIMPRO 15MG TAB 57VIZIMPRO 30MG TAB 57VIZIMPRO 45MG TAB 57VOGELXO 1% (50MG) GEL 12VOGELXO 1% GEL PUMP 12VOLTAREN 1% GEL 88voriconazole 200mg inj 40voriconazole 200mg tab 40

voriconazole 40mg/ml susp 40voriconazole 50mg tab 40VOSEVI 400-100-100MG

TAB 70VOTRIENT 200MG TAB 57VRAYLAR 1.5/3MG MIXED

PACK 61VRAYLAR 1.5MG CAP 61VRAYLAR 3MG CAP 61VRAYLAR 4.5MG CAP 61VRAYLAR 6MG CAP 61vyfemla 28 day pack 84vylibra 28 day pack 84VYTORIN 10-10MG TAB 41VYTORIN 10-20MG TAB 41VYTORIN 10-40MG TAB 41VYTORIN 10-80MG TAB 41

Wwarfarin sodium 10mg tab 22warfarin sodium 1mg tab 22warfarin sodium 2.5mg tab 22warfarin sodium 2mg tab 22warfarin sodium 3mg tab 22warfarin sodium 4mg tab 22warfarin sodium 5mg tab 22warfarin sodium 6mg tab 22warfarin sodium 7.5mg tab 22WELCHOL 3.75GM SUSP 42WELCHOL 625MG TAB 42WELLBUTRIN 100MG SR

TAB 30WELLBUTRIN 150MG SR

(12 HR) TAB 30WELLBUTRIN 150MG XL

(24 HR) TAB 30WELLBUTRIN 200MG SR

TAB 30WELLBUTRIN 300MG XL

TAB 30wixela 100-50mcg inh 21wixela 250-50mcg inh 21wixela 500-50mcg inh 21wymzya fe 28 day pack 84




188

XXALATAN 0.005% OPHTH

SOLN 120XALKORI 200MG CAP 57XALKORI 250MG CAP 57XANAX 0.25MG TAB 17XANAX 0.5MG TAB 17XANAX 0.5MG XR TAB 17XANAX 1MG TAB 17XANAX 1MG XR TAB 17XANAX 2MG TAB 17XANAX 2MG XR TAB 17XANAX 3MG XR TAB 17XARELTO 10MG TAB 22XARELTO 15MG TAB 22XARELTO 2.5MG TAB 22XARELTO 20MG TAB 22XARELTO STARTER PACK 22XATMEP 2.5MG/ML ORAL

SOLN 52XELJANZ 10MG TAB 5XELJANZ 5MG TAB 5XERESE 5-1% CREAM 90XGEVA 120MG/1.7ML INJ 97XIFAXAN 200MG TAB 13XIFAXAN 550MG TAB 13XIGDUO 10-1000MG XR

TAB 35XIGDUO 10-500MG XR

TAB 35XIGDUO 2.5-1000MG XR

TAB 35XIGDUO 5-1000MG XR

TAB 35XIGDUO 5-500MG XR TAB 35XOLAIR 150MG/ML PF INJ 19XOLAIR 150MG INJ 19XOLAIR 75MG/0.5ML PF

INJ 19XOPENEX 0.31MG INH

SOLN 21XOPENEX 0.63MG INH

SOLN 21

XOPENEX 1.25MG INHSOLN 21

XOPENEX 2.5MG INHSOLN 21

XOPENEX 45MCG INH 21XOSPATA 40MG TAB 57XTAMPZA 13.5MG ER CAP 10XTAMPZA 18MG ER CAP 10XTAMPZA 27MG ER CAP 10XTAMPZA 36MG ER CAP 10XTAMPZA 9MG ER CAP 10XTANDI 40MG CAP 54XULANE 150-35MCG

PATCH 84XULTOPHY

100UNIT-3.6MG/ML PENINJ 35

XYREM 500MG/ML ORALSOLN 123

YYASMIN 28 DAY PACK 84YAZ 28 DAY PACK 84YF-VAX 4000UNIT/ML INJ134yuvafem 0.01mg vaginal tab 134

Zzafirlukast 10mg tab 19zafirlukast 20mg tab 19zaleplon 10mg cap 108zaleplon 5mg cap 108ZANAFLEX 2MG CAP 115ZANAFLEX 4MG CAP 115ZANAFLEX 4MG TAB 115ZANAFLEX 6MG CAP 115zarah 3-0.03mg pack 84ZARONTIN 250MG/5ML

ORAL SOLN 29ZARONTIN 250MG CAP 29ZARXIO 300MCG/0.5ML

SYRINGE 107ZARXIO 480MCG/0.8ML

SYRINGE 107ZEJULA 100MG CAP 57ZELAPAR 1.25MG ODT 61

ZELBORAF 240MG TAB 57ZEMAIRA 1000MG INJ 126ZEMPLAR 1MCG CAP 98ZEMPLAR 2MCG CAP 98zenatane 10mg cap 88zenatane 20mg cap 88zenatane 30mg cap 88zenatane 40mg cap 88ZENPEP

10000-32000-42000UNITDR CAP 94

ZENPEP15000-47000-63000UNITDR CAP 94






ZERBAXA 1.5GM INJ 79ZESTORETIC 10-12.5MG

TAB 50ZESTORETIC 20-12.5MG

TAB 50ZESTORETIC 20-25MG

TAB 50ZESTRIL 10MG TAB 45ZESTRIL 2.5MG TAB 45ZESTRIL 20MG TAB 45ZESTRIL 30MG TAB 45ZESTRIL 40MG TAB 45ZESTRIL 5MG TAB 45ZETIA 10MG TAB 43ZIAC 10-6.25MG TAB 50




189

ZIAC 2.5-6.25MG TAB 50ZIAC 5-6.25MG TAB 50ZIAGEN 20MG/ML ORAL

SOLN 69ZIAGEN 300MG TAB 69ZIANA 1.2-0.025% GEL 88zidovudine 100mg cap 69zidovudine 10mg/ml oral soln 69zidovudine 300mg tab 69ZIOPTAN 0.0015% OPHTH

SOLN 120ziprasidone 20mg cap 61ziprasidone 40mg cap 61ziprasidone 60mg cap 61ziprasidone 80mg cap 61ZIRGAN 0.15% OPHTH

GEL 118ZITHROMAX 100MG/5ML

SUSP 109ZITHROMAX 1GM SUSP 109ZITHROMAX 200MG/5ML

SUSP 109ZITHROMAX 250MG TAB 109ZITHROMAX 500MG INJ 109ZITHROMAX 500MG TAB 109ZOCOR 10MG TAB 43ZOCOR 20MG TAB 43ZOCOR 40MG TAB 43ZOCOR 80MG TAB 43ZOFRAN 8MG TAB 39ZOLINZA 100MG CAP 57zolmitriptan 2.5mg odt 111zolmitriptan 2.5mg tab 111zolmitriptan 5mg odt 111zolmitriptan 5mg tab 111ZOLOFT 100MG TAB 32ZOLOFT 25MG TAB 32ZOLOFT 50MG TAB 32zolpidem tartrate 10mg tab 108zolpidem tartrate 5mg tab 108ZOMIG 2.5MG NASAL

SPRAY 111ZOMIG 2.5MG ODT 111ZOMIG 2.5MG TAB 111

ZOMIG 5MG NASALSPRAY 111

ZOMIG 5MG ODT 111ZOMIG 5MG TAB 111ZONEGRAN 100MG CAP 28ZONEGRAN 25MG CAP 28zonisamide 100mg cap 28zonisamide 25mg cap 28zonisamide 50mg cap 28ZONTIVITY 2.08MG TAB 106ZORTRESS 0.25MG TAB 114ZORTRESS 0.5MG TAB 114ZORTRESS 0.75MG TAB 114ZORTRESS 1MG TAB 114ZOSTAVAX

19400UNIT/0.65ML INJ 134ZOSYN 200-25MG/ML INJ 122ZOSYN 40-5MG/ML INJ 122ZOSYN 60-7.5MG/ML INJ 122zovia 1/35e 28 day pack 84ZOVIRAX 200MG/5ML

SUSP 70ZOVIRAX 200MG CAP 70ZOVIRAX 5% CREAM 90ZOVIRAX 5% OINTMENT 90ZOVIRAX 800MG TAB 70Z-PAK 250MG PACK 109ZUBSOLV 1.4-0.36MG SL

TAB 11ZUBSOLV 11.4-2.9MG SL




TAB 11ZYBAN 150MG SR TAB 126ZYCLARA 2.5% CREAM 93ZYCLARA 3.75% CREAM 93ZYDELIG 100MG TAB 57ZYDELIG 150MG TAB 57ZYKADIA 150MG CAP 57ZYKADIA 150MG TAB 57

ZYLET 0.5-0.3% OPHTHSUSP 119

ZYLOPRIM 100MG TAB 105ZYLOPRIM 300MG TAB 105ZYMAXID 0.5% OPHTH

SOLN 118ZYPREXA 10MG INJ 64ZYPREXA 10MG ODT 64ZYPREXA 10MG TAB 64ZYPREXA 15MG ODT 64ZYPREXA 15MG TAB 64ZYPREXA 2.5MG TAB 64ZYPREXA 20MG ODT 65ZYPREXA 20MG TAB 65ZYPREXA 210MG INJ 65ZYPREXA 5MG ODT 65ZYPREXA 5MG TAB 65ZYPREXA 7.5MG TAB 65ZYVOX 100MG/5ML SUSP 15ZYVOX 2MG/ML INJ 15ZYVOX 600MG TAB 15


Discrimination is Against the Law Zing Choice IL (HMO) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Zing Choice IL (HMO) does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Zing Choice IL (HMO): • Provides free aids and services to people with disabilities to communicate effectively with us, such as: ○ Qualified sign language interpreters

○ Written information in other formats (large print, audio, accessible electronic formats, other formats)

• Provides free language services to people whose primary language is not English, such as: ○ Qualified interpreters ○ Information written in other languages If you need these services, contact a Zing Choice IL (HMO) Civil Rights Coordinator. If you believe that Zing Choice IL (HMO) has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Zing Choice IL (HMO) Grievance Department PO Box 1039, Appleton, WI, 54912-1039 1-866-946-4458, TTY: 711 Fax: 1-844-268-9791 Email: [email protected] You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, a Zing Choice IL (HMO) Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.


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ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-866-946-4458 (телетайп: 711). સુચના: જો તમે ગજુરાતી બોલતા હો, તો િન:�ુ�ક ભાષા સહાય સેવાઓ તમારા માટે ��લ�� છે. ફોન કરો 1-866-946-4458 (TTY: 711).

مدد کی خدمات مفت ميں دستياب ہيں ۔ کال کريںخبردار: اگر آپ اردو بولتے ہيں، تو آپ کو زبان کی 1-866-946-4458 (TTY: 711).

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1- 866-946-4458 (TTY: 711). ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-866-946-4458 (TTY: 711). �यान द�: य�द आप िहंदी बोलते ह� तो आपके िलए म�ुत म� भाषा सहायता सेवाए ंउपल�ध ह�। 1-866-946-4458 (TTY: 711) पर कॉल कर�। ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-866-946-4458 (ATS: 711). ΠΡΟΣΟΧΗ: Αν μιλάτε ελληνικά, στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης, οι οποίες παρέχονται δωρεάν. Καλέστε 1-866-946-4458 (TTY: 711). ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-866-946-4458 (TTY: 711).


This formulary was updated on 09/01/2019. For more recent information or other questions, please contact ZingChoice IL (HMO) Customer Service, at 1-866-946-4458 or, for TTY users, 711. Hours of Operation are 8 a.m. to 8p.m., 7 days a week (except Thanksgiving and Christmas Day) from October 1 – March 31, and 8 a.m. to 8 p.m.,Monday – Friday (other technologies such as voicemail are used after hours, weekends, and on Federal Holidays) fromApril 1 – September 30, or visit www.myzinghealth.com.

Zing Choice IL (HMO) is a HMO plan with a Medicare contract. Enrollment in Zing Choice IL (HMO) depends on contract renewal.

ATTENTION: If you speak a language other than English, language assistance services, free of charge, are availableto you. Call 1-866-946-4458 (TTY: 711).

ATENCIÓN: Si no habla inglés, tiene a su disposición gratis el servicio de asistencia en idiomas. Llame al1-866-946-4458 (TTY: 711).

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Zing Choice IL (HMO) 2020 Formulary (List of Covered Drugs)...2019/09/01 · medically necessary,...

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