Preferred Drug List - Envolve Health · 2020-06-19 · acidophilus super probiotic caps 1 acidophilus/goat milk caps 1 advanced probiotic 10 caps 1 advanced probiotic caps 1 align

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Preferred Drug List The Premium Hybrid Formulary includes a list of generic drugs covered by your prescription benefit. Preferred Drug List Medication Locator Instructions: 1. With the PDF open, click on the Edit menu, then click Find 2. In the Find box type the name of the medication you want to locate 3. Click the Next button until you find the medication(s) you are looking for

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Drug Name Drug Tier

Requirements/ Limits

ADHD/ANTI-NARCOLEPSY/ANTI- OBESITY/ANOREXIANTS - Drugs to Treat ADHD, Sleep and Eating Disorders

Anorexiants Non-Amphetamine

ADIPEX-P TABS (Use Phentermine HCl) 1

BONTRIL PDM TABS (Use Phendimetrazine Tartrate) 1

phendimetrazine tartrate tabs 1

phentermine hcl tabs 1

ALTERNATIVE MEDICINES

Alternative Medicine - A's

ALPHA LIPOIC ACID CAPS 1

alpha-lipoic acid (thioctic acid) caps 1

Alternative Medicine - B's

black cohosh (cimicifuga racemosa) caps 1

Alternative Medicine - C's

coenzyme q10 (ubidecarenone) caps 1

COLOSTRUM CAPS 1

Alternative Medicine - F's

BIO-FLAX CAPS (Use Flaxseed (Linseed)) 1

flaxseed (linseed) caps 1

Alternative Medicine - G's

glucosamine sulfate caps 1

Alternative Medicine - M's

melatonin caps or 10 mg 1

melatonin subl sl 10 mg 1

MELATONIN SUBL SL 10 MG (Use Melatonin) 1

MELATONIN SUBL SL 3 MG 1

3

Drug Name Drug Tier


melatonin tabs or 3 mg, 1 mg, 5 mg 1

Alternative Medicine Combinations

AZO CRANBERRY TABS 1

FLAX + DHA CAPS 1

flaxseed oil-fish oil-borage oil caps 1

glucosamine-chondroitin-vit c-manganese caps 1

GNP TRIPLE OMEGA COMPLEX CPDR 1

HM OMEGA-3-6-9 FATTY ACIDS CAPS 1

melatonin-pyridoxine tabs 1

melatonin-pyridoxine tbcr 1

OMEGA 3-6-9 COMPLEX CAPS 1

OMEGA-3 & OMEGA-6 FISH OIL CAPS 1

OMEGA-3-6-9 CAPS 1

RA OMEGA 3-6-9 CAPS 1

SM OMEGA-3 CAPS 1

SM OMEGA-3-6-9 FATTY ACIDS CAPS 1

SUPER OMEGA-3 CAPS 1

TRIPLE OMEGA COMPLEX CPDR 1

TRIPLE OMEGA-3-6-9 CAPS 1

ANALGESICS - ANTI-INFLAMMATORY - Drugs to Treat Pain, Swelling, Muscle and Joint Conditions

Nonsteroidal Anti-inflammatory Agents (NSAIDs)

ADVIL CAPS (Use Ibuprofen) 1

ADVIL MIGRAINE CAPS (Use Ibuprofen) 1

4

Drug Name Drug Tier


ADVIL TABS (Use Ibuprofen)

1

ALEVE ARTHRITIS TABS (Use Naproxen Sodium)

1

ALEVE TABS (Use Naproxen Sodium)

1

diclofenac sodium tbec 1

EC-NAPROSYN TBEC (Use Naproxen)

1

flurbiprofen tabs 1

ibuprofen caps 1

ibuprofen tabs 1

indomethacin caps 1

meloxicam tabs 15 mg 1 QL(1 ea per fill retail)

meloxicam tabs 7.5 mg 1 QL(2 ea per fill retail)

MOBIC TABS 15 MG (Use Meloxicam)

1 QL(1 ea per fill retail)

MOBIC TABS 7.5 MG (Use Meloxicam)


nabumetone tabs 500 mg 1 QL(4 ea per fill retail)

nabumetone tabs 750 mg 1 QL(3 ea per fill retail)

NAPROSYN TABS (Use Naproxen)

1

naproxen sodium tabs 1

naproxen tabs 1

naproxen tbec 1

sulindac tabs 1

ANALGESICS - NonNarcotic - Drugs to Treat Pain, Muscle and Joint Conditions

Analgesic Combinations

DOLOGESIC TABS 1

DOLOREX TABS 1

Drug Name Drug Tier


RELAGESIC TABS 1

Analgesics Other

acetaminophen tabs 1

acetaminophen tbcr 1

TYLENOL 8 HOUR ARTHRITISPAIN TBCR (Use Acetaminophen)

1

TYLENOL 8 HOUR TBCR (Use Acetaminophen)

1

TYLENOL EXTRA STRENGTH TABS (Use Acetaminophen)

1

TYLENOL TABS (Use Acetaminophen)

1

Salicylates

aspirin chew 1

aspirin tabs 1

aspirin tbec 1

ECOTRIN REGULAR STRENGTH TBEC (Use Aspirin)

1

ANALGESICS - OPIOID - Drugs to Treat Pain, Muscle and Joint Conditions

Opioid Agonists

tramadol hcl tabs 1 QL(8 ea per fill retail)

ULTRAM TABS (Use Tramadol HCl)


Opioid Combinations

acetaminophen w/ codeine soln

1

acetaminophen w/ codeine tabs

1

hydrocodone- acetaminophen tabs


NORCO TABS (Use Hydrocodone- Acetaminophen)


oxycodone w/ acetaminophen tabs

1

5

Drug Name Drug Tier


PERCOCET TABS (Use Oxycodone w/ Acetaminophen)

1

tramadol-acetaminophen tabs 1

TYLENOL/CODEINE #3 TABS (Use Acetaminophen w/ Codeine)

1

TYLENOL/CODEINE #4 TABS (Use Acetaminophen w/ Codeine)

1

ULTRACET TABS (Use Tramadol-Acetaminophen) 1

ANORECTAL AGENTS - Rectal Drugs to Treat Pain, Swelling and Itching

Rectal Local Anesthetics

dibucaine (rectal) oint 1

NUPERCAINAL OINT (Use Dibucaine (Rectal)) 1

ANTACIDS - Ulcer and Stomach Acid Drugs

Antacids - Bicarbonate

sodium bicarbonate (antacid) tabs 1

Antacids - Calcium Salts

calcium carbonate (antacid) chew 1

TUMS CHEW (Use Calcium Carbonate (Antacid))

1

TUMS CHEWY BITES CHEW (Use Calcium Carbonate (Antacid))

1

TUMS E-X 750 CHEW (Use Calcium Carbonate (Antacid))

1

TUMS EXTRA STRENGTH 750 CHEW (Use Calcium Carbonate (Antacid))

1

TUMS KIDS CHEW (Use Calcium Carbonate (Antacid))

1

TUMS LASTING EFFECTS CHEW (Use Calcium Carbonate (Antacid))

1

Drug Name Drug Tier


TUMS SMOOTHIES CHEW (Use Calcium Carbonate (Antacid))

1

Antacids - Magnesium Salts

magnesium oxide tabs 1

ANTHELMINTICS - Drugs to Treat Worm Infections

Anthelmintics

pyrantel pamoate susp 1

ANTI-INFECTIVE AGENTS - MISC. - Drugs to Treat Bacterial Infections

Anti-infective Agents - Misc.

FLAGYL TABS (Use Metronidazole) 1

metronidazole tabs 1

Anti-infective Misc. - Combinations

BACTRIM DS TABS (Use Sulfamethoxazole- Trimethoprim)

1

BACTRIM TABS (Use Sulfamethoxazole- Trimethoprim)

1

sulfamethoxazole- trimethoprim susp 1

sulfamethoxazole- trimethoprim tabs 1

Lincosamides

CLEOCIN CAPS (Use Clindamycin HCl) 1

clindamycin hcl caps 1

ANTIANGINAL AGENTS - Drugs to Treat Chest Pain

Nitrates

isosorbide mononitrate tb24 1

ANTIANXIETY AGENTS - Drugs to Treat Anxiety

Antianxiety Agents - Misc.

buspirone hcl tabs 1

6

Drug Name Drug Tier


hydroxyzine hcl syrp 1

hydroxyzine hcl tabs 1

hydroxyzine pamoate caps 1

VISTARIL CAPS (Use Hydroxyzine Pamoate) 1

Benzodiazepines

alprazolam tabs 1

ATIVAN TABS (Use Lorazepam) 1

chlordiazepoxide hcl caps 1

diazepam tabs 1

lorazepam tabs 1

VALIUM TABS (Use Diazepam) 1

XANAX TABS (Use Alprazolam) 1

ANTIARRHYTHMICS - Drugs to treat abnormal heart rhythms

Antiarrhythmics Type I-C

propafenone hcl tabs 1 QL(6 ea daily)

RYTHMOL TABS (Use Propafenone HCl) 1 QL(6 ea daily)

Antiarrhythmics Type III

amiodarone hcl tabs 1

CORDARONE TABS (Use Amiodarone HCl) 1

ANTIASTHMATIC AND BRONCHODILATOR AGENTS - Drugs to Treat Lung Conditions

Bronchodilators - Anticholinergics

ipratropium bromide soln 1

Leukotriene Modulators

montelukast sodium chew 1 QL(1 ea daily)

montelukast sodium tabs 1 QL(1 ea daily)

Drug Name Drug Tier


SINGULAIR CHEW (Use Montelukast Sodium) 1 QL(1 ea daily)

SINGULAIR TABS (Use Montelukast Sodium) 1 QL(1 ea daily)

Sympathomimetics

albuterol sulfate nebu 1

albuterol sulfate syrp 1

ipratropium-albuterol soln 1

ANTICOAGULANTS - Blood Thinners

Coumarin Anticoagulants

COUMADIN TABS (Use Warfarin Sodium) 1

warfarin sodium tabs 1

ANTICONVULSANTS - Drugs to Treat Seizures

Anticonvulsants - Benzodiazepines

clonazepam tabs 1

KLONOPIN TABS (Use Clonazepam) 1

Anticonvulsants - Misc.

gabapentin caps 1

gabapentin tabs 1

KEPPRA SOLN (Use Levetiracetam) 1

KEPPRA TABS (Use Levetiracetam) 1

LAMICTAL CHEWABLE DISPERSIBLE CHEW (Use Lamotrigine)

1

LAMICTAL TABS (Use Lamotrigine) 1

lamotrigine chew 1

lamotrigine tabs 1

levetiracetam soln 1

levetiracetam tabs 1

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Drug Name Drug Tier


MYSOLINE TABS (Use Primidone) 1

NEURONTIN CAPS (Use Gabapentin) 1

NEURONTIN TABS (Use Gabapentin) 1

oxcarbazepine tabs 1

primidone tabs 1

TOPAMAX TABS (Use Topiramate) 1

topiramate tabs 1

TRILEPTAL TABS (Use Oxcarbazepine) 1

Hydantoins

DILANTIN CAPS (Use Phenytoin Sodium Extended)

1

phenytoin sodium extended caps 1

Valproic Acid

DEPAKENE CAPS (Use Valproic Acid) 1

DEPAKOTE TBEC (Use Divalproex Sodium) 1

divalproex sodium tbec 1

valproic acid caps 1

ANTIDEPRESSANTS - Drugs to Treat Depression

Alpha-2 Receptor Antagonists (Tetracyclics)

mirtazapine tabs 1

REMERON TABS (Use Mirtazapine) 1

Antidepressants - Misc.

bupropion hcl tb12 1

WELLBUTRIN SR TB12 (Use Bupropion HCl) 1

Selective Serotonin Reuptake Inhibitors (SSRIs)

Drug Name Drug Tier


CELEXA TABS 10 MG (Use Citalopram Hydrobromide)






citalopram hydrobromide tabs 10 mg 1

QL(4 ea per fill retail)





escitalopram oxalate tabs 1

fluoxetine hcl caps 1

fluvoxamine maleate tabs 1

LEXAPRO TABS (Use Escitalopram Oxalate) 1

paroxetine hcl tabs 1

PAXIL TABS (Use Paroxetine HCl) 1

PROZAC CAPS (Use Fluoxetine HCl) 1

sertraline hcl tabs 1

ZOLOFT TABS (Use Sertraline HCl) 1

Serotonin Modulators

trazodone hcl tabs 1

Serotonin-Norepinephrine Reuptake Inhibitors

EFFEXOR XR CP24 150 MG (Use Venlafaxine HCl) 1


EFFEXOR XR CP24 37.5 MG, 75 MG (Use Venlafaxine HCl)


venlafaxine hcl cp24 150 mg


venlafaxine hcl cp24 75 mg, 37.5 mg


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Drug Name Drug Tier


venlafaxine hcl tabs 75 mg 1

Tricyclic Agents

amitriptyline hcl tabs 1

ELAVIL TABS (Use Amitriptyline HCl) 1

imipramine hcl tabs 1

nortriptyline hcl caps 1

PAMELOR CAPS (Use Nortriptyline HCl) 1

TOFRANIL TABS (Use Imipramine HCl) 1

ANTIDIABETICS - Drugs to Regulate Blood Sugar

Antidiabetic Combinations

GLUCOVANCE TABS (Use Glyburide-Metformin) 1

glyburide-metformin tabs 1

Biguanides

GLUCOPHAGE TABS (Use Metformin HCl) 1

GLUCOPHAGE XR TB24 (Use Metformin HCl) 1

metformin hcl tabs 1

metformin hcl tb24 1

Insulin Sensitizing Agents

ACTOS TABS (Use Pioglitazone HCl) 1

pioglitazone hcl tabs 1

Sulfonylureas

AMARYL TABS (Use Glimepiride) 1

DIABETA TABS 1

glimepiride tabs 1

glipizide tabs 1

Drug Name Drug Tier


glipizide tb24 1

GLUCOTROL TABS (Use Glipizide) 1

GLUCOTROL XL TB24 (Use Glipizide) 1

glyburide micronized tabs 1

glyburide tabs 1

GLYNASE TABS (Use Glyburide Micronized) 1

ANTIDIARRHEALS - Drugs to Treat Diarrhea

Antidiarrheal Agents - Misc.

ACIDOPHILUS CAPS 1

ACIDOPHILUS HIGH- POTENCY CAPS 1

ACIDOPHILUS PEARLS CAPS 1

ACIDOPHILUS PROBIOTIC BLEND CAPS 1

ACIDOPHILUS SUPER PROBIOTIC CAPS 1

ACIDOPHILUS/GOAT MILK CAPS 1

ADVANCED PROBIOTIC 10 CAPS 1

ADVANCED PROBIOTIC CAPS 1

ALIGN CAPS 1

bismuth subsalicylate chew 1

bismuth subsalicylate tabs 1

CHILDRENS PROBIOTIC PEARLS CAPS 1

CULTURELLE ADVANCED IMMUNE DEFENSE CAPS

1

CULTURELLE PRO-WELL CAPS 1

CVS ADULT 50+ PROBIOTIC CAPS 1

9

Drug Name Drug Tier


CVS ADULT PROBIOTIC CAPS 1

CVS DIGESTIVE PROBIOTIC CAPS 1

CVS PROBIOTIC CAPS 1

CVS PROBIOTIC MAXIMUM STRENGTH CAPS

1

CVS PROBIOTIC PEARLS EXTRA STRENGTH CAPS 1

CVS SENIOR PROBIOTIC CAPS 1

DAILY PROBIOTIC CAPS 1

DIFF-STAT CAPS 1

DIGESTIVE ADVANTAGE CAPS 1

DIGESTIVE ADVANTAGE LACTOSE DEFENSE FORMULA CAPS

1

EQ PROBIOTIC DIGESTIVE SYSTEM SUPPORT CAPS

1

EQL ACIDOPHILUS EXTRA STRENGTH CAPS 1

EQL DAILY PROBIOTIC CAPS 1

EQL PROBIOTIC COLON SUPPORT CAPS 1

FLORA VANCE CAPS 1

FLORA-Q 2 CAPS 1

FLORA-Q CAPS 1

FLORAJEN ACIDOPHILUS CAPS 1

FLORAJEN BIFIDOBLEND CAPS 1

FLORAJEN3 CAPS 1

FLORAJEN4KIDS CAPS 1

FORTIFY DAILY PROBIOTIC CAPS 1

Drug Name Drug Tier


GNP ACIDOPHILUS HIGH POTENCY CAPS 1

GNP PROBIOTIC COLON SUPPORT CAPS 1

HM ACIDOPHILUS CAPS 1

LACTO-PECTIN CAPS 1

lactobacillus caps 1

MEGA PROBIOTIC CAPS 1

META BIOTIC/BIO- ACTIVE 12 CAPS 1

NATRUL PROBIOTIC CAPS 1

PEARLS IC CAPS 1

PEPTO BISMOL TABS (Use Bismuth Subsalicylate)

1

PEPTO-BISMOL CHEW (Use Bismuth Subsalicylate)

1

PEPTO-BISMOL INSTACOOL CHEW (Use Bismuth Subsalicylate)

1

PEPTO-BISMOL TO-GO CHEW (Use Bismuth Subsalicylate)

1

PHILLIPS COLON HEALTH CAPS 1

PREORBOTIC CAPS 1

PRO-BIOTIC BLEND CAPS 1

PRO-FLORA IMMUNE CAPS 1

PROBIOMAX DAILY DF CAPS 1

PROBIOTIC & ACIDOPHILUS FORMULA EXTRA STRENGTH CAPS

1

PROBIOTIC + OMEGA-3 CAPS 1

10

Drug Name Drug Tier


PROBIOTIC ACIDOPHILUS BEADS CAPS

1

PROBIOTIC ACIDOPHILUS CAPS 1

PROBIOTIC ADVANCED ULTRAPOTENCY CAPS 1

PROBIOTIC CAPS 1

PROBIOTIC COLON SUPPORT CAPS 1

PROBIOTIC COMPLEX/ACIDOPHILUS CAPS

1

PROBIOTIC DAILY CAPS 1

PROBIOTIC GOLD EXTRA STRENGTH CAPS 1

PROBIOTIC MATURE ADULT CAPS 1

PROBIOTIC PEARLS ADVANTAGE CAPS 1

PROBIOTIC PEARLS CAPS 1

PROBIOTIC-10 CAPS 1

PROBIOTIC-10 ULTIMATE CAPS 1

RA PROBIOTIC COLON CARE CAPS 1

RA PROBIOTIC COMPLEX CAPS 1

REPHRESH PRO-B CAPS 1

RESTORA CAPS 1

RISAQUAD CAPS 1

RISAQUAD-2 CAPS 1

SM ACIDOPHILUS PEARLS CAPS 1

SUPER PROBIOTIC CAPS 1

SUPER PROBIOTIC DIGESTIVE SUPPORT CAPS

1

Drug Name Drug Tier


TRUBIOTICS CAPS 1

TRUNATURE DIGESTIVE PROBIOTIC CAPS

1

ULTRAFLORA IMMUNE HEALTH CAPS

1

VISBIOME PROBIOTIC HIGH POTENCY CAPS

1

VSL#3 CAPS 1

Antiperistaltic Agents

IMODIUM A-D TABS (Use Loperamide HCl) 1

loperamide hcl tabs 1

ANTIEMETICS - Drugs to Treat Nausea and Vomiting

5-HT3 Receptor Antagonists

ondansetron hcl soln ij 40 mg/20ml, 4 mg/2ml

1

ondansetron hcl tabs or 4 mg


ZOFRAN TABS (Use Ondansetron HCl)


Antiemetics - Anticholinergic

dimenhydrinate tabs 1

DRAMAMINE TABS (Use Dimenhydrinate)

1

meclizine hcl chew 25 mg 1

meclizine hcl tabs 25 mg, 12.5 mg

1 RX/OTC

ANTIFUNGALS - Drugs to Treat Fungal Infections

Antifungals

LAMISIL TABS (Use Terbinafine HCl)

1 QL(365 ea per 90 days retail)

terbinafine hcl tabs 1 QL(365 ea per 90 days retail)

ANTIHISTAMINES - Drugs to Treat Allergies

Antihistamines - Alkylamines

11

Drug Name Drug Tier


CHLOR-TRIMETON TABS (Use Chlorpheniramine Maleate)

1

chlorpheniramine maleate tabs

1

Antihistamines - Ethanolamines

BENADRYL ALLERGY CAPS (Use Diphenhydramine HCl)

1

BENADRYL ALLERGY CHILDRENS LIQD (Use Diphenhydramine HCl)

1

BENADRYL ALLERGY TABS (Use Diphenhydramine HCl)

1

diphenhydramine hcl caps 25 mg

1

diphenhydramine hcl caps 50 mg

1 RX/OTC

diphenhydramine hcl liqd 50 mg/20ml, 12.5 mg/5ml, 25 mg/10ml

1

diphenhydramine hcl tabs 25 mg

1

Antihistamines - Non-Sedating

ALLEGRA ALLERGY TABS (Use Fexofenadine HCl)

1

cetirizine hcl soln 5 mg/5ml, 1 mg/ml

1 RX/OTC

cetirizine hcl syrp 1 mg/ml, 5 mg/5ml

1 RX/OTC

cetirizine hcl tabs 10 mg, 5 mg

1

CLARITIN REDITABS TBDP (Use Loratadine)

1

CLARITIN SYRP (Use Loratadine)

1

CLARITIN TABS (Use Loratadine)

1

fexofenadine hcl tabs 1

levocetirizine dihydrochloride tabs

1 QL(1 ea daily); RX/OTC

loratadine soln 1

Drug Name Drug Tier


loratadine syrp 1

loratadine tabs 1

loratadine tbdp 1

XYZAL ALLERGY 24HR TABS (Use Levocetirizine Dihydrochloride)


XYZAL TABS (Use Levocetirizine Dihydrochloride)


ZYRTEC ALLERGY TABS (Use Cetirizine HCl)

1

ZYRTEC CHILDRENS ALLERGY SYRP (Use Cetirizine HCl)

1 RX/OTC

Antihistamines - Phenothiazines

promethazine hcl soln 1

promethazine hcl syrp 1

promethazine hcl tabs 1

ANTIHYPERLIPIDEMICS - Drugs to Treat High Cholesterol

Fibric Acid Derivatives

gemfibrozil tabs 1

LOPID TABS (Use Gemfibrozil)

1

HMG CoA Reductase Inhibitors

atorvastatin calcium tabs 1 QL(1 ea daily)

CRESTOR TABS (Use Rosuvastatin Calcium)

1 QL(1 ea daily)

LIPITOR TABS (Use Atorvastatin Calcium)

1 QL(1 ea daily)

lovastatin tabs 1

MEVACOR TABS (Use Lovastatin)

1

rosuvastatin calcium tabs 1 QL(1 ea daily)

simvastatin tabs 1 QL(1 ea daily)

10

Drug Name Drug Tier


ZOCOR TABS (Use Simvastatin)

1 QL(1 ea daily)

ANTIHYPERTENSIVES - Drugs to Treat High Blood Pressure

ACE Inhibitors

ACCUPRIL TABS (Use Quinapril HCl)

1

ALTACE CAPS (Use Ramipril)

1 QL(2 ea daily)

benazepril hcl tabs 1

enalapril maleate tabs 1 QL(2 ea daily)

fosinopril sodium tabs 1

lisinopril tabs 1

LOTENSIN TABS (Use Benazepril HCl)

1

MAVIK TABS (Use Trandolapril)

1

PRINIVIL TABS (Use Lisinopril)

1

quinapril hcl tabs 1

ramipril caps 1 QL(2 ea daily)

trandolapril tabs 1

VASOTEC TABS (Use Enalapril Maleate)

1 QL(2 ea daily)

ZESTRIL TABS (Use Lisinopril)

1

Angiotensin II Receptor Antagonists

AVAPRO TABS (Use Irbesartan)

1

COZAAR TABS (Use Losartan Potassium)

1

irbesartan tabs 1

losartan potassium tabs 1

Antiadrenergic Antihypertensives

CATAPRES TABS (Use Clonidine HCl)

1

Drug Name Drug Tier


clonidine hcl tabs 1

methyldopa tabs 1

terazosin hcl caps 1

Antihypertensive Combinations

bisoprolol & hydrochlorothiazide tabs

1

DIOVAN HCT TABS (Use Valsartan- Hydrochlorothiazide)

1

enalapril maleate & hydrochlorothiazide tabs

1

HYZAAR TABS (Use Losartan Potassium & Hydrochlorothiazide)

1

lisinopril & hydrochlorothiazide tabs

1

losartan potassium & hydrochlorothiazide tabs

1

valsartan- hydrochlorothiazide tabs

1

VASERETIC TABS (Use Enalapril Maleate & Hydrochlorothiazide)

1

ZESTORETIC TABS (Use Lisinopril & Hydrochlorothiazide)

1

ZIAC TABS (Use Bisoprolol & Hydrochlorothiazide)

1

Vasodilators

hydralazine hcl tabs 1

ANTIMYCOBACTERIAL AGENTS - Drugs to Treat Tuberculosis (Bacterial Infections)

Antimycobacterial Agents

isoniazid tabs 1

ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES - Drugs to Treat Cancer

Antimetabolites

fluorouracil soln 1

Antineoplastic - Hormonal and Related Agents

11

Drug Name Drug Tier


FEMARA TABS (Use Letrozole)

1

letrozole tabs 1

MEGACE ORAL SUSP (Use Megestrol Acetate)

1

megestrol acetate susp 1

megestrol acetate tabs 1

ANTIPARKINSON AGENTS - Drugs to Treat Parkinson's Disease

Antiparkinson Anticholinergics

benztropine mesylate tabs 1

trihexyphenidyl hcl tabs 1

Antiparkinson Dopaminergics

carbidopa-levodopa tabs 1

carbidopa-levodopa tbcr 1

MIRAPEX TABS (Use Pramipexole Dihydrochloride)

1

pramipexole dihydrochloride tabs

1

REQUIP TABS (Use Ropinirole Hydrochloride)

1

ropinirole hydrochloride tabs

1

SINEMET CR TBCR (Use Carbidopa-Levodopa)

1

SINEMET TABS (Use Carbidopa-Levodopa)

1

ANTIPSYCHOTICS/ANTIMANIC AGENTS - Drugs to Treat Mood Disorders

Antimanic Agents

LITHIUM CARBONATE CAPS 600 MG, 150 MG (Use Lithium Carbonate)

1

lithium carbonate caps 600 mg, 300 mg, 150 mg

1

lithium carbonate tabs 300 mg

1

Drug Name Drug Tier


lithium carbonate tbcr 450 mg

1

Benzisoxazoles

RISPERDAL TABS (Use Risperidone)

1

risperidone tabs 1

Butyrophenones

haloperidol tabs 1

Dibenzapines

olanzapine tabs 1

quetiapine fumarate tabs 1

SEROQUEL TABS (Use Quetiapine Fumarate)

1

ZYPREXA TABS (Use Olanzapine)

1

Phenothiazines

prochlorperazine maleate tabs

1

thioridazine hcl tabs 1

ANTISEPTICS & DISINFECTANTS - Drugs to Prevent Bacterial Skin Infections

Antiseptic Combinations

BUCALSEP LIQD 1

ANTIVIRALS - Drugs to Treat Viral Infections

Herpes Agents

acyclovir caps 1

acyclovir tabs 1

ZOVIRAX CAPS (Use Acyclovir)

1

ZOVIRAX TABS (Use Acyclovir)

1

BETA BLOCKERS - Drugs to Treat High Blood Pressure

Alpha-Beta Blockers

carvedilol tabs 3.125 mg 1 QL(2 ea daily)

12

CEPHALOSPORINS - Drugs to Treat Bacterial Infections

Drug Name Drug Tier


carvedilol tabs 6.25 mg, 25 mg, 12.5 mg

1

COREG TABS 25 MG, 12.5 MG, 6.25 MG (Use Carvedilol)

1

COREG TABS 3.125 MG (Use Carvedilol)

1 QL(2 ea daily)

labetalol hcl tabs 1

Beta Blockers Cardio-Selective

atenolol tabs 1

LOPRESSOR TABS (Use Metoprolol Tartrate)

1

metoprolol tartrate tabs 1

TENORMIN TABS (Use Atenolol)

1

Beta Blockers Non-Selective

BETAPACE AF TABS (Use Sotalol HCl (AFIB/AFL))

1

BETAPACE TABS (Use Sotalol HCl)

1

propranolol hcl tabs 1

sotalol hcl (afib/afl) tabs 1

sotalol hcl tabs 1

CALCIUM CHANNEL BLOCKERS - Drugs to Treat High Blood Pressure

Calcium Channel Blockers

amlodipine besylate tabs 1 QL(2 ea daily)

CALAN TABS (Use Verapamil HCl)

1

CARDIZEM TABS (Use Diltiazem HCl)

1

diltiazem hcl tabs 1

NORVASC TABS (Use Amlodipine Besylate)

1 QL(2 ea daily)

verapamil hcl tabs 1

Drug Name Drug Tier


Cephalosporins - 1st Generation

cefadroxil caps 1

cephalexin caps 1

KEFLEX CAPS (Use Cephalexin)

1

CHEMICALS

Bulk Chemicals - T's

TEA TREE OIL OIL 1 RX/OTC

CORTICOSTEROIDS - Steroid Hormone Drugs to Treat Systemic Swelling Conditions

Glucocorticosteroids

CORTEF TABS (Use Hydrocortisone)

1

dexamethasone elix 0.5 mg/5ml

1

DEXAMETHASONE SOLN 0.5 MG/5ML

1

dexamethasone tabs 0.5 mg, 0.75 mg, 4 mg

1

hydrocortisone tabs 1

prednisolone sodium phosphate soln

1

prednisolone soln 1

prednisolone syrp 1

prednisone tabs 1 mg, 10 mg, 5 mg, 2.5 mg, 20 mg

1

PREDNISONE TABS 50 MG

1

COUGH/COLD/ALLERGY - Drugs to Treat Cough, Cold and Allergy Symptoms

Antitussives

benzonatate caps 1

TESSALON PERLES CAPS (Use Benzonatate)

1

Cough/Cold/Allergy Combinations

ACTICON SOLN 1

13

Drug Name Drug Tier


ACTICON TABS 1

ACTIDOGESIC TABS 1

ACTINEL LIQD 1

BIONEL LIQD 1

CONEX COLD/ALLERGY SOLN

1

CONEX COLD/ALLERGY TABS

1

DECON-A ELIX 1

DESPEC-TAB TABS 1

dextromethorphan- guaifenesin syrp

1

diphenhydramine- acetaminophen tabs

1

DOLOGEN TABS 1

DOLOGESIC TABS 1

DOLOGESIC-DF TABS 1

DOMETUSS- DA/CHILDREN LIQD

1

EXACTUSS LIQD (Use Phenylephrine w/ DM-GG)

1 RX/OTC

G-DOLOGEN TABS 1

G-TUSICOF LIQD 1

G-ZYNCOF SYRP 1

GILTUSS LIQD (Use Phenylephrine w/ DM-GG)

1 RX/OTC

PECGEN DMX LIQD 1

PERCOGESIC TABS (Use Diphenhydramine- Acetaminophen)

1

Drug Name Drug Tier


phenylephrine w/ dm-gg liqd 10mg/5ml-10mg/5ml- 100mg/5ml-100mg/5ml- 5mg/5ml-5mg/5ml, 10mg/5ml-100mg/5ml- 5mg/5ml, 10mg/5ml- 200mg/5ml-5mg/5ml

1

phenylephrine w/ dm-gg liqd 28mg/5ml-388mg/5ml- 10mg/5ml, 5mg/ml- 50mg/ml-2.5mg/ml, 7.5mg/ml-88mg/ml- 2.5mg/ml

1

RX/OTC

promethazine w/codeine syrp

1

pseudoephedrine w/ dm-gg liqd

1

pseudoephedrine w/ dm-gg tabs

1

pseudoephedrine- dexchlorpheniramine- chlophedianol liqd

1

ROBITUSSIN DM SYRP (Use Dextromethorphan- Guaifenesin)

1

ROBITUSSIN PEAK COLD DM SYRP (Use Dextromethorphan- Guaifenesin)

1

ROBITUSSIN PEAK COLD MULTI-SYMPTOM COLD LIQD (Use Phenylephrine w/ DM-GG)

1

ROBITUSSIN TO GO COUGH &COLD CF LIQD (Use Phenylephrine w/ DM- GG)

1

SORBUTUSS NR LIQD 1

TRISPEC DMX LIQD 1

TRISPEC DMX PEDIATRIC LIQD

1

TUSICOF LIQD 1

TUSNEL C SYRP 1

TUSNEL LIQD 1

14

Drug Name Drug Tier


ZYNCOF SYRP 1

Expectorants

guaifenesin tabs 1

Misc. Respiratory Inhalants

HYPERSAL NEBU 1

NEBUSAL NEBU 1

sodium chloride (inhalant) nebu

1

DERMATOLOGICALS - Drugs to Treat Skin Conditions

Acne Products

benzoyl peroxide gel 1 RX/OTC

Antibiotics - Topical

BACIGUENT OINT (Use Bacitracin (Topical))

1

bacitracin (topical) oint 1

bacitracin zinc oint 1

gentamicin sulfate (topical) crea

1

neomycin-bacitracin- polymyxin oint

1

neomycin-polymyxin w/ pramoxine crea

1

NEOSPORIN ORIGINAL OINT (Use Neomycin- Bacitracin-Polymyxin)

1

NEOSPORIN PLUS PAIN RELIEF MAXIMUM STRENGTH CREA (Use Neomycin-Polymyxin w/ Pramoxine)

1

Antifungals - Topical

ciclopirox olamine crea 1

clotrimazole (topical) crea 1 RX/OTC

FUNGI-NAIL SOLN 1

Drug Name Drug Tier


G-MYCO NAIL SOLN 1

GORDOCHOM SOLN 1

LAMISIL AT CREA (Use Terbinafine HCl (Topical))

1

LAMISIL AT JOCK ITCH CREA (Use Terbinafine HCl (Topical))

1

LOPROX CREA (Use Ciclopirox Olamine)

1

LOTRIMIN AF CREA (Use Clotrimazole (Topical))

1 RX/OTC

LOTRIMIN AF FOR HER CREA (Use Clotrimazole (Topical))

1 RX/OTC

LOTRIMIN AF JOCK ITCH CREA (Use Clotrimazole (Topical))

1 RX/OTC

MICATIN CREA (Use Miconazole Nitrate (Topical))

1

miconazole nitrate (topical) crea

1

MYCO NAIL A SOLN 1

MYCO NAIL SOLN 1

MYCO-NAIL SOLN 1

RA ANTI-FUNGAL FOOT CARE SOLN

1

terbinafine hcl (topical) crea 1

TINACTIN CREA (Use Tolnaftate)

1

TINACTIN JOCK ITCH CREA (Use Tolnaftate)

1

TINACTIN POWD (Use Tolnaftate)

1

tolnaftate crea 1

tolnaftate powd 1

Antihistamines-Topical

15

Drug Name Drug Tier


BENADRYL EXTRA STRENGTH CREA (Use Diphenhydramine-Zinc Acetate)

1

BENADRYL ITCH STOPPING CREA (Use Diphenhydramine-Zinc Acetate)

1

diphenhydramine-zinc acetate crea

1

Burn Products

SILVADENE CREA (Use Silver Sulfadiazine)

1

silver sulfadiazine crea 1

Corticosteroids - Topical

betamethasone dipropionate augmented crea

1

DIPROLENE AF CREA (Use Betamethasone Dipropionate Augmented)

1

ELOCON CREA (Use Mometasone Furoate)

1

ELOCON LOTN (Use Mometasone Furoate)

1

fluocinonide crea 1

hydrocortisone (topical) crea 0.5 %, 2.5 %

1

hydrocortisone (topical) crea 1%, 1 %

1 RX/OTC

hydrocortisone (topical) oint 1 %

1 RX/OTC

hydrocortisone (topical) oint 2.5 %

1

hydrocortisone-aloe vera crea

1

mometasone furoate crea 1

mometasone furoate soln 1

MONISTAT SOOTHING CARE ITCH RELIEF CREA (Use Hydrocortisone (Topical))

1

RX/OTC

Drug Name Drug Tier


triamcinolone acetonide (topical) crea

1

triamcinolone acetonide (topical) oint

1

Diaper Rash Products

diaper rash products oint 1

Emollient/Keratolytic Agents

ATRAC-TAIN CREA (Use Urea)

1

CARMOL 20 CREA (Use Urea)

1

urea crea 1

Liniments

ASPERCREME/ALOE CREA (Use Trolamine Salicylate)

1

MOBISYL CREA (Use Trolamine Salicylate)

1

MYOFLEX CREA (Use Trolamine Salicylate)

1

SPORTSCREME CREA (Use Trolamine Salicylate)

1

trolamine salicylate crea 1

Local Anesthetics - Topical

capsaicin crea 1

lidocaine hcl gel 2 % 1 RX/OTC

lidocaine hcl soln 4 % 1

XYLOCAINE SOLN (Use Lidocaine HCl)

1

ZOSTRIX ARTHRITIS PAIN RELIEF CREA (Use Capsaicin)

1

Misc. Topical

AVEENO BABY SOOTHING RELIEF DIAPER RASH CREA

1

DRYSOL SOLN 1

XERAC AC SOLN 1

16

Drug Name Drug Tier


zinc oxide (topical) crea 1

zinc oxide (topical) oint 1

Wound Care Products

DUODERM HYDROACTIVE GEL GEL

1

DIETARY PRODUCTS/DIETARY MANAGEMENT PRODUCTS

Nutritional Supplements

ACAI WEIGHT CONTROL CAPS

1 RX/OTC

APP SLIM RMS CAPS 1 RX/OTC

CARB INTERCEPT/PHASE 2 CAPS

1 RX/OTC

DEXATRIM MAX COMPLEX 7 CAPS

1 RX/OTC

DIETERS DETOX CAPS 1 RX/OTC

DIETEX FORTE CAPS 1 RX/OTC

MINUS WEIGHT PLUS ENERGY CAPS

1 RX/OTC

ULTRA DIET AID CAPS 1 RX/OTC

DIGESTIVE AIDS - Drugs to Treat Low Digestive Enzymes

Digestive Enzymes

ABATRACE CAPS 1

DIGAZ CAPS 1

DIGEST II CAPS 1

DIGEST III CAPS 1

digestive enzymes caps 1

DIGESTIVE SUPPORT CAPS

1

GASTRACE DIGESTIVE SUPPORT CAPS

1

LACTAID FAST ACT CHEW (Use Lactase)

1

Drug Name Drug Tier


LACTAID FAST ACT TABS (Use Lactase)

1

lactase chew 1

lactase tabs 1

LIPASE CONCENTRATE- HP CAPS

1

TYLER SIMILASE JR CAPS

1

DIURETICS - Drugs to Treat Heart, Circulation Conditions and Blood Pressure

Diuretic Combinations

DYAZIDE CAPS (Use Triamterene & Hydrochlorothiazide)

1

MAXZIDE TABS (Use Triamterene & Hydrochlorothiazide)

1

MAXZIDE-25 TABS (Use Triamterene & Hydrochlorothiazide)

1

triamterene & hydrochlorothiazide caps

1

triamterene & hydrochlorothiazide tabs

1

Loop Diuretics

bumetanide tabs 1

BUMEX TABS (Use Bumetanide)

1

furosemide tabs 1

LASIX TABS (Use Furosemide)

1

Potassium Sparing Diuretics

ALDACTONE TABS (Use Spironolactone)

1

spironolactone tabs 1

Thiazides and Thiazide-Like Diuretics

hydrochlorothiazide caps 1

hydrochlorothiazide tabs 1

17

HEMATOPOIETIC AGENTS - Drugs to Treat Blood Disorders

Drug Name Drug Tier


MICROZIDE CAPS (Use Hydrochlorothiazide)

1

ESTROGENS - Hormone Replacement/Modifying Drugs

Estrogens

ESTRACE TABS (Use Estradiol)

1

estradiol tabs 1

FLUOROQUINOLONES - Drugs to Treat Bacterial Infections

Fluoroquinolones

CIPRO TABS (Use Ciprofloxacin HCl)

1

ciprofloxacin hcl tabs 1

LEVAQUIN TABS (Use Levofloxacin)


levofloxacin tabs 1 QL(14 ea per fill retail)

GASTROINTESTINAL AGENTS - MISC. - Miscellaneous Gastrointestinal Drugs

Antiflatulents

BICARSIM TABS 1

GAS-X CHEW (Use Simethicone)

1

GAS-X EXTRA STRENGTH CHEW (Use Simethicone)

1

MYLICON INFANTS GAS RELIEF SUSP (Use Simethicone)

1

MYLICON SUSP (Use Simethicone)

1

PHAZYME CAPS (Use Simethicone)

1

PHAZYME MAXIMUM STRENGTH CAPS

1

PHAZYME ULTRA STRENGTH CAPS (Use Simethicone)

1

simethicone caps 1

Drug Name Drug Tier


simethicone chew 1

simethicone liqd 1

simethicone susp 1

Gastrointestinal Stimulants

metoclopramide hcl soln 1

metoclopramide hcl tabs 1

REGLAN TABS (Use Metoclopramide HCl)

1

Inflammatory Bowel Agents

AZULFIDINE EN-TABS TBEC (Use Sulfasalazine)

1

AZULFIDINE TABS (Use Sulfasalazine)

1

sulfasalazine tabs 1

sulfasalazine tbec 1

GOUT AGENTS - Drugs to Treat Gout

Gout Agents

allopurinol tabs 1

ZYLOPRIM TABS (Use Allopurinol)

1

HEMATOLOGICAL AGENTS - MISC. - Drugs to Treat Blood Disorders

Hematorheologic Agents

pentoxifylline tbcr 1

Platelet Aggregation Inhibitors

cilostazol tabs 1 QL(2 ea per fill retail)

clopidogrel bisulfate tabs 1 QL(2 ea daily)

PLAVIX TABS (Use Clopidogrel Bisulfate)

1 QL(2 ea daily)

PLETAL TABS (Use Cilostazol)


18

Drug Name Drug Tier


Cobalamins

B-12 LOZG 1

B-12 TABS 1

cyanocobalamin subl 1

cyanocobalamin tabs 1

cyanocobalamin tbcr 1

methylcobalamin subl 1

VITAMIN B 12 LOZG 1

Folic Acid/Folates

folic acid tabs 1 mg 1 RX/OTC

folic acid tabs 400 mcg, 800 mcg

1

Hematopoietic Mixtures

ABANEU-SL SUBL 1

ABATREX TABS 1

B-12 1000 SUBL 1

B-12 SUBL 1

ferrous fumarate-fa-b complex-c-zn-mg-mn-cu tabs

1

ferrous fumarate-folic acid tabs

1

FOLGARD TABS 1

FOLIC + B12 TABS 1 RX/OTC

FOLINIC-PLUS TABS 1

FOLTRATE TABS 1 RX/OTC

HEMATRON-AF TABS (Use Iron-Docusate-B12- Folic Acid-Vit C-Vit E- Copper-Biotin)

1

RX/OTC

Drug Name Drug Tier


iron polysaccharide complex-vit b12-folic acid caps

1

iron-docusate-b12-folic acid-vit c-vit e-copper-biotin tabs

1 RX/OTC

MTX SUPPORT TABS 1 RX/OTC

NEURIN-SL SUBL 1

OPURITY B12/FOLIC ACID TABS

1 RX/OTC

VITAMIN B12/FOLIC ACID TABS

1 RX/OTC

Iron

FEOSOL TABS (Use Ferrous Sulfate Dried)

1

ferrous fumarate tabs 1

ferrous gluconate tabs 1

FERROUS GLUCONATE TABS

1

ferrous sulfate dried tabs 1

ferrous sulfate dried tbcr 1

ferrous sulfate elix 220 mg/5ml

1

ferrous sulfate tabs 65 mg, 325 mg

1

ferrous sulfate tbcr 50 mg 1

FERROUS SULFATE TBEC 324 MG

1

HEMOCYTE TABS (Use Ferrous Fumarate)

1

IRON TABS 1

polysaccharide iron complex caps

1

HYPNOTICS/SEDATIVES/SLEEP DISORDER AGENTS

Antihistamine Hypnotics

diphenhydramine- acetaminophen (sleep) tabs

1

19

Drug Name Drug Tier


doxylamine succinate (sleep) tabs

1

TYLENOL PM EXTRA STRENGTH TABS (Use Diphenhydramine- Acetaminophen (sleep))

1

UNISOM TABS (Use Doxylamine Succinate (Sleep))

1

Non-Barbiturate Hypnotics

AMBIEN TABS (Use Zolpidem Tartrate)


estazolam tabs 1

RESTORIL CAPS (Use Temazepam)

1

SONATA CAPS (Use Zaleplon)


temazepam caps 1

zaleplon caps 1 QL(1 ea per fill retail)

zolpidem tartrate tabs 1 QL(1 ea per fill retail)

LAXATIVES - Bowel Treatment Drugs

Bulk Laxatives

calcium polycarbophil tabs 1

FIBERCON TABS (Use Calcium Polycarbophil)

1

Laxative Combinations

sennosides-docusate sodium tabs

1

SENOKOT S TABS (Use Sennosides-Docusate Sodium)

1

Stimulant Laxatives

bisacodyl tbec 1

AL; At least 50 yrs old - Up to 74 yrs old

DULCOLAX TBEC (Use Bisacodyl)

1 AL; At least 50 yrs old - Up to 74 yrs old

sennosides tabs 1

Drug Name Drug Tier


SENOKOT TABS (Use Sennosides)

1

Surfactant Laxatives

COLACE CAPS (Use Docusate Sodium)

1

docusate calcium caps 1

docusate sodium caps 1

MEDICAL DEVICES AND SUPPLIES

Parenteral Therapy Supplies

3ML LUER LOCK SAFETY SYRINGES/3ML/21G X 1 1/2" MISC

1 RX/OTC

3ML LUER-LOK SYRINGE21G X 1-1/2" MISC

1 RX/OTC

3ML SYRINGE/21G X 1- 1/2"/LUER LOCK TIP MISC

1 RX/OTC

BD 3ML LUER-LOK SYRINGE/21G X 1-1/2" MISC

1 RX/OTC

BD INTEGRA 3ML SYRINGE W/RETRACTING NEEDLE/21G X 1-1/2" MISC

1

RX/OTC

EASY TOUCH FLIPLOCK SAFETY SYRINGES 3ML/21GX1-1/2" MISC

1 RX/OTC

EASY TOUCH SHEATHLOCK SAFETY SYRINGE 3ML/21GX1-1/2" MISC

1

RX/OTC

INSULIN SYRINGES-MISC 1

MONOJECT 3ML SYRINGE/STANDARD HYPODERMIC NEEDLE/21GX1-1/2" MISC

1

RX/OTC

MONOJECT MAGELLAN SYRINGE/SAFETY NEEDLE/3ML/21G X 1-1/2" MISC

1

RX/OTC

20

Drug Name Drug Tier


MONOJECT SAFETY SYRINGE/SHIELD/NEEDL E/3ML/21G X 1-1/2" MISC

1 RX/OTC

MONOJECT SYRINGE/LUER- LOCK/3ML/21G X 1-1/2" MISC

1

RX/OTC

PENTIPS/PEN NEEDLES MISC

1

SAFESNAP SYRINGE/NEEDLE/3ML/2 1G X 1-1/2" MISC

1 RX/OTC

SAFETY SYRINGES/NEEDLE 3ML/21GX1-1/2" MISC

1 RX/OTC

SAFETY-LOK SYRINGE/NEEDLE3ML LUER-LOK 21GX1-1/2" MISC

1

RX/OTC

SYRINGE/LUER LOCK/3ML/21G X 1-1/2" MISC

1 RX/OTC

SYRINGE/LUER LOCK/3ML/21GX1-1/2" MISC

1 RX/OTC

VANISHPOINT SAFETY SYRINGE/3ML/21GX1-1/2" MISC

1 RX/OTC

VANISHPOINT SYRINGE/3ML/21G X 1- 1/2" MISC

1 RX/OTC

MINERALS & ELECTROLYTES

Calcium

calcium carbonate tabs 1

calcium carbonate- cholecalciferol tabs

1

calcium carbonate-vitamin d tabs

1

calcium carbonate-vitamin d w/ minerals chew

1

calcium carbonate-vitamin d w/ minerals tabs

1

calcium citrate-vitamin d tabs

1

Drug Name Drug Tier


calcium-magnesium w/ vitamin d tb24

1

CALTRATE 600+D PLUS MINERALS CHEW (Use Calcium Carbonate-Vitamin D w/ Minerals)

1

CALTRATE 600+D PLUS MINERALS TABS (Use Calcium Carbonate-Vitamin D w/ Minerals)

1

CALTRATE 600+D TABS (Use Calcium Carbonate- Cholecalciferol)

1

CALTRATE 600+D3 SOFT CHEWS CHEW

1

CITRACAL + D3 MAXIMUM TABS (Use Calcium Citrate-Vitamin D)

1

CITRACAL CALCIUM+D SLOW RELEASE TB24 (Use Calcium-Magnesium w/ Vitamin D)

1

CITRACAL MAXIMUM TABS (Use Calcium Citrate-Vitamin D)

1

CORAL CALCIUM PLUS CAPS

1

Magnesium

magnesium oxide (mg supplement) tabs

1

MAGOX 400 TABS (Use Magnesium Oxide (Mg Supplement))

1

Potassium

K-TAB TBCR (Use Potassium Chloride)

1

potassium chloride microencapsulated crystals er tbcr

1

potassium chloride tbcr 1

Trace Minerals

chromium picolinate caps 1

Zinc

21

Drug Name Drug Tier


zinc sulfate caps 1

MISCELLANEOUS THERAPEUTIC CLASSES

Homeopathic Products

ARNICARE GEL 1 RX/OTC

BIORX SPONIX NAIL GEL GEL

1 RX/OTC

CALENDULA GEL 1 RX/OTC

COLCIGEL GEL 1 RX/OTC

LICEFREEE GEL GEL 1 RX/OTC

NEURAGEN GEL 1 RX/OTC

PROSACEA GEL 1 RX/OTC

RAPID GEL RX GEL 1 RX/OTC

SPEEDGEL RX GEL 1 RX/OTC

STERYMINE GEL 1 RX/OTC

T-RELIEF PAIN ARNICA + 12 GEL

1 RX/OTC

TECNU EXTREME MEDICATED POISON IVY SCRUB GEL

1 RX/OTC

TRANZGEL GEL 1 RX/OTC

TRAUMEEL GEL 1 RX/OTC

MOUTH/THROAT/DENTAL AGENTS

Anesthetics Topical Oral

ACTISEP SOLN 1

G-BUCAL-C SOLN 1

GUMSOL LIQD 1

lidocaine hcl (mouth-throat) soln

1

ORASEP SOLN 1

Anti-infectives - Throat

Drug Name Drug Tier


nystatin (mouth-throat) susp

1

Antiseptics - Mouth/Throat

CHERACOL SORE THROAT LIQD (Use Phenol (Antiseptic))

1

PAIN-A-LAY LIQD (Use Phenol (Antiseptic))

1

phenol (antiseptic) liqd 1

MULTIVITAMINS

B-Complex Vitamins

b-complex vitamins caps 1

b-complex vitamins tabs 1

B-Complex w/ C

b complex w/ c caps 1

b complex w/ c tabs 1

B-Complex w/ Folic Acid

B-100 COMPLEX TABS 1

b-complex w/ folic acid tabs 1

b-complex w/biotin & folic acid tabs

1

b-complex w/biotin & folic acid tbcr

1

BIOTALAN CLEAR LIQD 1 RX/OTC

SUPERVITE LIQD 1 RX/OTC

B-Complex w/ Iron

APETIGEN-PLUS SOLN 1

SUPLEVIT LIQD 1

Bioflavonoid Products

bioflavonoid caps 1

bioflavonoid tabs 1

Multiple Vitamins w/ Calcium

22

Drug Name Drug Tier


HM ONE DAILY ESSENTIAL TABS

1

multiple vitamins w/ calcium tabs

1

ONE-A-DAY WOMENS FORMULA TABS (Use Multiple Vitamins w/ Calcium)

1

SM ONE DAILY ESSENTIAL TABS

1

Multiple Vitamins w/ Minerals

ACTIVITE EC TABS 1 RX/OTC

CENTRUM MULTIVITAMIN FLAVOR BURST DRINK PACK

1

EMERGEN-C BLUE PACK 1

EMERGEN-C FIVE PACK 1

EMERGEN-C HEART HEALTH PACK

1

EMERGEN-C IMMUNE PACK

1

EMERGEN-C IMMUNE PLUS PACK

1

EMERGEN-C IMMUNE+ WARMERS PACK

1

EMERGEN-C JOINT HEALTH PACK

1

EMERGEN-C KIDZ PACK 1

EMERGEN-C MSM LITE PACK

1

EMERGEN-C PINK PACK 1

EMERGEN-C SUPER FRUIT PACK

1

EMERGEN-C VITAMIN C LITE PACK

1

EMERGEN-C VITAMIN C PACK

1

EMERGEN-C VITAMIN D & CALCIUM PACK

1

ENERGY BOOSTER PACK

1

Drug Name Drug Tier


EQL SUPER ENERGY BOOSTER PACK

1

IMMUNE SUPPORT VITAMIN C PACK

1

MAXIMIN PACK PACK 1

MULTI FOR HER PACK 1

MULTI FOR HIM PACK 1

multivitamin/minerals cap 1

multivitamin/minerals liq 1

multivitamin/minerals tab 1

RA ESSENCE-C PACK 1

SKIN BEAUTY & WELLNESS PACK

1

UDAMIN SP TABS 1 RX/OTC

VITAMENT PACK 1

VITAMIN C EFFERVESCENT BLEND PACK

1

VITAMIN C/ELECTROLYTES PACK

1

Multivitamins

CARDENZ TABS (Use Multiple Vitamin)

1

DEKAS ESSENTIAL CAPS 1

multiple vitamin caps 1

multiple vitamin tabs 1

OMNICAP TABS 1

ONE-A-DAY ESSENTIAL TABS (Use Multiple Vitamin)

1

ONE-A-DAY MENS TABS (Use Multiple Vitamin)

1

QUINTABS TABS 1

23

Drug Name Drug Tier


THERA TABS 1

THERA/BETA-CAROTENE TABS

1

ZE-PLUS CAPS (Use Multiple Vitamin)

1

Prenatal Vitamins

CENTRUM SPECIALIST PRENATAL MISC

1

CLASSIC PRENATAL TABS

1

CVS PRENATAL MULTI+DHA CAPS

1

CVS PRENATAL TABS 1

ENFAMIL EXPECTA MISC 1

EQL PRENATAL FORMULA TABS

1

GNP PRENATAL TABS 1

GOODSENSE PRENATAL VITAMINS TABS

1

HM PRENATAL TABS 1

KP PRENATAL MULTIVITAMINS TABS

1

M-VIT TABS 1 RX/OTC

MULTI PRENATAL TABS 1

NAT-RUL PRENATAL VITAMINS TABS

1

NIVA-PLUS TABS 1 RX/OTC

O-CAL FA TABS 1 RX/OTC

PNV FOLIC ACID + IRON MULTIVITAMIN TABS

1 RX/OTC

PNV PRENATAL PLUS MULTIVITAMIN TABS

1 RX/OTC

PRENATAL FORMULA TABS

1

PRENATAL LOW IRON TABS

1

PRENATAL MULTI + DHA CAPS

1

Drug Name Drug Tier


PRENATAL MULTIVITAMIN + DHA MISC

1

PRENATAL MULTIVITAMIN PLUS DHA CAPS

1

PRENATAL MULTIVITAMIN TABS

1

PRENATAL ONE DAILY TABS

1

PRENATAL PLUS TABS 1 RX/OTC

PRENATAL TABS 22MG- 2MG-25MG-1.84MG- 200MG-27MG-4000UNIT- 20MG-3MG-12MCG- 400UNIT-1MG-10MG- 120MG

1

RX/OTC

PRENATAL TABS 30UNIT- 4000UNIT-25MG-1.8MG- 200MG-28MG-20MG- 1.7MG-8MCG-400UNIT- 0.8MG-2.6MG-120MG, 4000UNIT-30UNIT-25MG- 1.8MG-200MG-28MG- 20MG-1.7MG-8MCG- 400UNIT-800MCG-2.6MG- 120MG, 4000UNIT- 30UNIT-200MG-25MG- 1.8MG-28MG-20MG- 1.7MG-8MCG-400UNIT- 800MCG-2.6MG-120MG, 30UNIT-25MG-1.8MG- 200MG-28MG-20MG- 1.7MG-4000UNIT-8MCG- 400UNIT-800MCG-2.6MG- 120MG, 11UNIT-263MG- 25MG-1.5MG-27MG- 4000UNIT-18MG-1.7MG- 4MCG-400UNIT-0.8MG- 2.6MG-100MG, 30UNIT- 4000UNIT-25MG-1.8MG- 200MG-28MG-20MG- 1.7MG-8MCG-400UNIT- 800MCG-2.6MG-120MG, 160MG-11UNIT-200MG- 25MG-1.84MG-27MG- 4000UNIT-18MG-1.7MG- 4MCG-400UNIT-800MCG- 2.6MG-100MG

1

24

Drug Name Drug Tier


PRENATAL VITAMIN & MINERAL TABS

1

PRENATAL VITAMIN TABS

1

PRENATAL VITAMIN/IRON TABS

1

PRENATAL VITAMINS PLUS LOW IRON TABS

1 RX/OTC

PRENATAL VITAMINS TABS

1

PREPLUS TABS 1 RX/OTC

PX PRENATAL MULTIVITAMINS TABS

1

QC PRENATAL TABS 1

RA PRENATAL FORMULA/FOLICACID TABS

1

RA PRENATAL TABS 1

RIGHT STEP PRENATAL TABS

1

SIMILAC PRENATAL EARLY SHIELD MISC

1

SM PRENATAL VITAMINS TABS

1

THERANATAL CORE NUTRITION TABS

1 RX/OTC

TRICARE TABS 1 RX/OTC

VINATE M TABS 1

VOL-PLUS TABS 1 RX/OTC

Vitamins w/ Lipotropics

ACTIFLOVIT EAR HEALTH TABS

1

LIPOTRIAD TABS (Use Vitamins w/ Lipotropics)

1

vitamins w/ lipotropics tabs 1

MUSCULOSKELETAL THERAPY AGENTS - Drugs to Treat Spasms

Central Muscle Relaxants

Drug Name Drug Tier


baclofen tabs 1

carisoprodol tabs 1

chlorzoxazone tabs 1

cyclobenzaprine hcl tabs 1

methocarbamol tabs 1

PARAFON FORTE DSC TABS (Use Chlorzoxazone)

1

ROBAXIN TABS (Use Methocarbamol)

1

ROBAXIN-750 TABS (Use Methocarbamol)

1

SOMA TABS (Use Carisoprodol)

1

tizanidine hcl tabs 1

ZANAFLEX TABS (Use Tizanidine HCl)

1

NASAL AGENTS - SYSTEMIC AND TOPICAL - Drugs to treat the Nose or Sinus

Nasal Agents - Misc.

OCEAN NASAL SPRAY SOLN (Use Saline)

1

saline soln 1

Sympathomimetic Decongestants

AFRIN 12 HOUR SOLN (Use Oxymetazoline HCl)

1

AFRIN ALL NIGHT NODRIP SOLN (Use Oxymetazoline HCl)

1

AFRIN NASAL SPRAY SOLN (Use Oxymetazoline HCl)

1

AFRIN NODRIP EXTRA MOISTURIZING SOLN (Use Oxymetazoline HCl)

1

AFRIN NODRIP ORIGINAL SOLN (Use Oxymetazoline HCl)

1

AFRIN NODRIP SEVERE CONGESTION SOLN (Use Oxymetazoline HCl)

1

25

Drug Name Drug Tier


AFRIN NODRIP SINUS SOLN (Use Oxymetazoline HCl)

1

AFRIN SINUS SOLN (Use Oxymetazoline HCl)

1

AFRIN SOLN (Use Oxymetazoline HCl)

1

DRISTAN SPRAY SOLN (Use Oxymetazoline HCl)

1

DURATION 12 HOUR SOLN (Use Oxymetazoline HCl)

1

DURATION SPRAY SOLN (Use Oxymetazoline HCl)

1

NASAL DECONGESTANT SYRP

1

NEO-SYNEPHRINE 12 HOUR EXTRA MOISTURIZING SOLN (Use Oxymetazoline HCl)

1

oxymetazoline hcl soln 1

phenylephrine hcl (oral) tabs

1

pseudoephedrine hcl tabs 1

SUDAFED CONGESTION TABS (Use Pseudoephedrine HCl)

1

SUDAFED NASAL DECONGESTANT MAXIMUM STRENGTH TABS (Use Pseudoephedrine HCl)

1

SUDAFED PE CONGESTION TABS (Use Phenylephrine HCl (Oral))

1

VICKS SINEX 12 HOUR DECONGESTANT SOLN (Use Oxymetazoline HCl)

1

VICKS SINEX 12 HOUR DECONGESTANT ULTRA FINE MIST SOLN (Use Oxymetazoline HCl)

1

Drug Name Drug Tier


VICKS SINEX 12 HOUR DECONGESTANT ULTRA FINE MIST/MOISTURIZNG SOLN (Use Oxymetazoline HCl)

1

VICKS SINEX MOISTURIZING SOLN (Use Oxymetazoline HCl)

1

VICKS SINEX SEVERE NASALDECONGESTANT SOLN (Use Oxymetazoline HCl)

1

VICKS SINEX SOLN (Use Oxymetazoline HCl)

1

NUTRIENTS

Lipotropics

lecithin caps 1

Misc. Nutritional Substances

omega-3 fatty acids caps 1

Proteins

amino acids tabs 1

arginine tabs 1

DEQUASINE TABS (Use Amino Acids)

1

PHENYLADE PHEBLOC TABS

1

SUPER-AMINO 1600 TABS

1

TRIAMINO TABS 1

OPHTHALMIC AGENTS - Drugs to Treat the Eye

Artificial Tears and Lubricants

artificial tear solution soln 1

carboxymethylcellulose sodium (ophth) soln

1

GENTEAL TEARS MODERATEPF SOLN

1

polyvinyl alcohol-povidone (ophth) soln

1

26

TETRACYCLINES - Drugs to Treat Bacterial Infections

Drug Name Drug Tier


REFRESH LIQUIGEL SOLN

1

REFRESH SOLN (Use Polyvinyl Alcohol-Povidone (Ophth))

1

REFRESH TEARS SOLN (Use Carboxymethylcellulose Sodium (Ophth))

1

Ophthalmic Decongestants

naphazoline w/ pheniramine soln

1

OPCON-A SOLN (Use Naphazoline w/ Pheniramine)

1

tetrahydrozoline hcl (ophth) soln

1

VISINE EXTRA SOLN (Use Tetrahydrozoline HCl (Ophth))

1

VISINE SOLN (Use Tetrahydrozoline HCl (Ophth))

1

Ophthalmics - Misc.

EYEAID IRRIGATING SOLUTION SOLN (Use Ophthalmic Irrigation Solution)

1

ophthalmic irrigation solution soln

1

OTIC AGENTS - Drugs to Treat the Ear

Otic Agents - Miscellaneous

carbamide peroxide (otic) soln

1

DEBROX SOLN (Use Carbamide Peroxide (Otic))

1

isopropyl alcohol (otic) liqd 1

SWIM EAR LIQD (Use Isopropyl Alcohol (Otic))

1

PENICILLINS - Drugs to Treat Bacterial Infections

Aminopenicillins

amoxicillin caps 1

Drug Name Drug Tier


amoxicillin tabs 1

ampicillin caps 250 mg, 500 mg

1

AMPICILLIN CAPS 500 MG

1

Natural Penicillins

penicillin v potassium tabs 1

PHARMACEUTICAL ADJUVANTS

Liquid Vehicles

BACTERIOSTATIC WATER FORINJECTION/BENZYL ALCOHOL SOLN

1

Pharmaceutical Excipients

LACTOSE ANHYDROUS POWD

1 RX/OTC

LACTOSE HYDROUS POWD

1 RX/OTC

LACTOSE POWD 1 RX/OTC

Semi Solid Vehicles

white petrolatum gel 1 RX/OTC

PROGESTINS - Hormone Replacement/Modifying Drugs

Progestins

medroxyprogesterone acetate tabs

1

PROVERA TABS (Use Medroxyprogesterone Acetate)

1

PSYCHOTHERAPEUTIC AND NEUROLOGICAL AGENTS - MISC. - Drugs to Treat Mental and Emotional Conditions

Antidementia Agents

ARICEPT TABS (Use Donepezil Hydrochloride)

1

donepezil hydrochloride tabs

1

27

Drug Name Drug Tier


Tetracyclines

doxycycline (monohydrate) caps

1

MINOCIN CAPS (Use Minocycline HCl)

1

minocycline hcl caps 1

THYROID AGENTS - Drugs to Regulate Thyroid Hormones

Antithyroid Agents

methimazole tabs 1

TAPAZOLE TABS (Use Methimazole)

1

Thyroid Hormones

ARMOUR THYROID TABS (Use Thyroid)

1

levothyroxine sodium tabs 1

NATURE-THROID TABS 1

SYNTHROID TABS (Use Levothyroxine Sodium)

1

thyroid tabs 1

WESTHROID TABS 1

WP THYROID TABS 1

ULCER DRUGS - Drugs to Treat Bowel, Intestine and Stomach Conditions

Antispasmodics

ANASPAZ TBDP (Use Hyoscyamine Sulfate)

1

BENTYL CAPS (Use Dicyclomine HCl)

1

BENTYL TABS (Use Dicyclomine HCl)

1

dicyclomine hcl caps 1

dicyclomine hcl soln 1

dicyclomine hcl tabs 1

hyoscyamine sulfate subl 1

Drug Name Drug Tier


hyoscyamine sulfate tabs 1

hyoscyamine sulfate tbdp 1

LEVSIN TABS (Use Hyoscyamine Sulfate)

1

LEVSIN/SL SUBL (Use Hyoscyamine Sulfate)

1

H-2 Antagonists

cimetidine hcl soln 1

cimetidine tabs 1

famotidine tabs 10 mg 1

famotidine tabs 20 mg 1 QL(4 ea daily); RX/OTC

famotidine tabs 40 mg 1 QL(2 ea daily)

PEPCID AC MAXIMUM STRENGTH TABS (Use Famotidine)


PEPCID AC TABS (Use Famotidine)

1

PEPCID TABS 20 MG (Use Famotidine)


PEPCID TABS 40 MG (Use Famotidine)

1 QL(2 ea daily)

ranitidine hcl syrp 15 mg/ml, 150 mg/10ml, 75 mg/5ml

1

ranitidine hcl tabs 150 mg 1 RX/OTC

ranitidine hcl tabs 75 mg, 300 mg

1

ZANTAC 150 MAXIMUM STRENGTH TABS (Use Ranitidine HCl)

1 RX/OTC

ZANTAC 75 TABS (Use Ranitidine HCl)

1

ZANTAC TABS 150 MG (Use Ranitidine HCl)

1 RX/OTC

ZANTAC TABS 300 MG (Use Ranitidine HCl)

1

Misc. Anti-Ulcer

CARAFATE TABS (Use Sucralfate)

1

28

Drug Name Drug Tier


sucralfate tabs 1

Proton Pump Inhibitors

omeprazole cpdr 1

pantoprazole sodium tbec 1

PRILOSEC CPDR (Use Omeprazole)

1

PROTONIX TBEC (Use Pantoprazole Sodium)

1

VAGINAL PRODUCTS - Drugs to Treat Vaginal Infections and Low Hormones

Miscellaneous Vaginal Products

REPLENS VAGINAL MOISTURIZER GEL (Use Vaginal Lubricant)

1

vaginal lubricant gel 1

Vaginal Anti-infectives

clotrimazole vaginal crea 1

GYNE-LOTRIMIN CREA (Use Clotrimazole Vaginal)

1

miconazole nitrate vaginal crea

1

MONISTAT 7 SIMPLY CURE CREA (Use Miconazole Nitrate Vaginal)

1

VITAMINS

Misc. Nutritional Factors

BIOFLONEX TABS (Use Hesperidin-Diosmin)

1

hesperidin-diosmin tabs 1

Oil Soluble Vitamins

cholecalciferol caps 1

cholecalciferol tabs 1

DRISDOL CAPS (Use Ergocalciferol)

1

ergocalciferol caps 1

Drug Name Drug Tier


vitamin a caps 1

VITAMIN D2 TABS 1

VITAMIN D3 TABS 1

vitamin e caps 1

Water Soluble Vitamins

ascorbic acid tabs 1

biotin tabs 1

niacin tabs 1

pyridoxine hcl tabs 1

thiamine hcl tabs 1

Index 1

Index 3ML LUER LOCK SAFETY SYRINGES/3ML/21G X 1 1/2"

ALEVE ARTHRITIS 2

ALIGN 6

BACIGUENT 14 bacitracin (topical) 14

3ML LUER-LOK 19

SYRINGE21G X ALLEGRA ALLERGY 9 bacitracin zinc 14

1-1/2" 19 3ML SYRINGE/21G X 1- 1/2"/LUER LOCK TIP 19 ABANEU-SL 18

ABATRACE 16

ABATREX 18

ACAI WEIGHT CONTROL 16

ACCUPRIL 10

acetaminophen 2

acetaminophen w/ codeine 2

ACIDOPHILUS 6 ACIDOPHILUS HIGH- POTENCY 6 ACIDOPHILUS PEARLS 6 ACIDOPHILUS PROBIOTIC BLEND 6 ACIDOPHILUS SUPER PROBIOTIC 6 ACIDOPHILUS/GOAT MILK 6

ACTICON 12

ACTIDOGESIC 13

ACTIFLOVIT EAR HEALTH 24

ACTINEL 13

ACTISEP 21

ACTIVITE EC 22

ACTOS 6

acyclovir 11

ADIPEX-P 1

ADVANCED PROBIOTIC 6

ADVANCED PROBIOTIC 10 6

ADVIL 1

ADVIL MIGRAINE 1

AFRIN 25

AFRIN 12 HOUR 24

AFRIN ALL NIGHT NODRIP 24

AFRIN NASAL SPRAY 24 AFRIN NODRIP EXTRA MOISTURIZING 24 AFRIN NODRIP ORIGINAL 24 AFRIN NODRIP SEVERE CONGESTION 24 AFRIN NODRIP SINUS 25

AFRIN SINUS 25

albuterol sulfate 4

ALDACTONE 16

ALEVE

2

allopurinol 17

ALPHA LIPOIC ACID 1 alpha-lipoic acid (thioctic acid) 1 alprazolam 4

ALTACE 10

AMARYL 6

AMBIEN 19

amino acids 25

amiodarone hcl 4

amitriptyline hcl 6

amlodipine besylate 12

amoxicillin 26

ampicillin 26

AMPICILLIN 26

ANASPAZ 27

APETIGEN-PLUS 21

APP SLIM RMS 16

arginine 25

ARICEPT 26

ARMOUR THYROID 27

ARNICARE 21

artificial tear solution 25 ascorbic

acid 28

ASPERCREME/ALOE 15

aspirin 2

atenolol 12

ATIVAN 4

atorvastatin calcium 9

ATRAC-TAIN 15

AVAPRO 10 AVEENO BABY SOOTHING RELIEF DIAPER RASH 15 AZO CRANBERRY 1

AZULFIDINE 17

AZULFIDINE EN-TABS 17

b complex w/ c 21 B-

100 COMPLEX 21 B-

12 18 B-

12 1000 18

b-complex vitamins 21 b-

complex w/ folic acid 21 b-complex w/biotin & folic acid 21

Index 2

baclofen 24 BACTERIOSTATIC WATER FORINJECTION/BENZYL ALCOHOL 26 BACTRIM 3

BACTRIM DS 3 BD 3ML LUER-LOK SYRINGE/21G X 1-1/2" 19 BD INTEGRA 3ML SYRINGE W/RETRACTING NEEDLE/21G X 1-1/2" 19 BENADRYL ALLERGY 9 BENADRYL ALLERGY CHILDRENS 9 BENADRYL EXTRA STRENGTH 15 BENADRYL ITCH STOPPING 15 benazepril hcl

10 BENTYL

27

benzonatate

12 benzoyl peroxide

14 benztropine mesylate

11 betamethasone dipropionate augmented 15 BETAPACE

12 BETAPACE AF

12 BICARSIM

17 BIO-FLAX 1

bioflavonoid caps

21 bioflavonoid tabs

21 BIOFLONEX

28 BIONEL

13 BIORX SPONIX NAIL

GEL 21 BIOTALAN CLEAR

21

biotin

28 bisacodyl

19 bismuth subsalicylate

6 bisoprolol & hydrochlorothiazide 10 black cohosh (cimicifuga racemosa) 1 BONTRIL PDM 1

BUCALSEP 11

bumetanide

16 BUMEX

16

bupropion hcl 5

Index 3

buspirone hcl 3

CALAN 12

calcium carbonate 20

calcium carbonate (antacid) 3 calcium carbonate- cholecalciferol 20 calcium carbonate-vitamin d 20 calcium carbonate-vitamin d w/ minerals 20 calcium citrate-vitamin d 20

calcium polycarbophil 19 calcium-magnesium w/ vitamin d 20 CALENDULA 21

CALTRATE 600+D 20 CALTRATE 600+D PLUS MINERALS 20 CALTRATE 600+D3 SOFT CHEWS 20 capsaicin 15 CARAFATE 27 CARB INTERCEPT/PHASE 2 16 carbamide peroxide (otic) 26

carbidopa-levodopa 11 carboxymethylcellulose sodium (ophth) 25 CARDENZ 22

CARDIZEM 12

carisoprodol 24

CARMOL 20 15

carvedilol 11,12

CATAPRES 10

cefadroxil 12

CELEXA 5 CENTRUM MULTIVITAMIN FLAVOR BURST DRINK 22 CENTRUM SPECIALIST PRENATAL 23 cephalexin 12 cetirizine hcl 9 CHERACOL SORE THROAT 21 CHILDRENS PROBIOTIC PEARLS 6 CHLOR-TRIMETON 9

chlordiazepoxide hcl 4

chlorpheniramine maleate 9

chlorzoxazone 24

cholecalciferol 28

chromium picolinate 20

ciclopirox olamine 14

cilostazol 17

cimetidine 27

cimetidine hcl 27

CIPRO 17

ciprofloxacin hcl 17 citalopram hydrobromide 5 CITRACAL + D3 MAXIMUM 20 CITRACAL CALCIUM+D SLOW RELEASE 20 CITRACAL MAXIMUM 20

CLARITIN 9

CLARITIN REDITABS 9

CLASSIC PRENATAL 23

CLEOCIN 3

clindamycin hcl 3

clonazepam 4

clonidine hcl 10

clopidogrel bisulfate 17

clotrimazole (topical) 14

clotrimazole vaginal 28 coenzyme q10 (ubidecarenone) 1 COLACE 19

COLCIGEL 21

COLOSTRUM 1

CONEX COLD/ALLERGY 13

CORAL CALCIUM PLUS 20

CORDARONE 4

COREG 12

CORTEF 12

COUMADIN 4

COZAAR 10

CRESTOR 9 CULTURELLE ADVANCED IMMUNE DEFENSE 6 CULTURELLE PRO-WELL 6 CVS ADULT 50+ PROBIOTIC 6 CVS ADULT PROBIOTIC 7 CVS DIGESTIVE PROBIOTIC 7 CVS PRENATAL 23 CVS PRENATAL MULTI+DHA 23 CVS PROBIOTIC 7 CVS PROBIOTIC MAXIMUM STRENGTH 7

CVS PROBIOTIC PEARLS EXTRA STRENGTH 7 CVS SENIOR PROBIOTIC 7

cyanocobalamin 18

cyclobenzaprine hcl 24

DAILY PROBIOTIC 7

DEBROX 26

DECON-A 13

DEKAS ESSENTIAL 22

DEPAKENE 5

DEPAKOTE 5

DEQUASINE 25

DESPEC-TAB 13

dexamethasone 12

DEXAMETHASONE 12

dexamethasone 12 DEXATRIM MAX COMPLEX 7 16 dextromethorphan-guaifenesin 13 DIABETA 6

diaper rash products 15

diazepam 4

dibucaine (rectal) 3

diclofenac sodium 2

dicyclomine hcl 27

DIETERS DETOX 16

DIETEX FORTE 16

DIFF-STAT 7

DIGAZ 16

DIGEST II 16

DIGEST III 16

DIGESTIVE ADVANTAGE 7 DIGESTIVE ADVANTAGE LACTOSE DEFENSE FORMULA 7 digestive enzymes 16

DIGESTIVE SUPPORT 16

DILANTIN 5

diltiazem hcl 12

dimenhydrinate 8

DIOVAN HCT 10

diphenhydramine hcl 9 diphenhydramine-acetaminophen 13 diphenhydramine-acetaminophen (sleep) 18 diphenhydramine-zinc acetate 15

Index 4

DIPROLENE AF 15

divalproex sodium 5

docusate calcium 19

docusate sodium 19

DOLOGEN 13

DOLOGESIC 2

DOLOGESIC-DF 13

DOLOREX 2 DOMETUSS-DA/CHILDREN 13 donepezil hydrochloride 26 doxycycline (monohydrate) 27 doxylamine succinate (sleep) 19 DRAMAMINE 8

DRISDOL 28

DRISTAN SPRAY 25

DRYSOL 15

DULCOLAX 19 DUODERM HYDROACTIVE GEL 16 DURATION 12 HOUR 25

DURATION SPRAY 25

DYAZIDE 16 EASY TOUCH FLIPLOCK SAFETY SYRINGES 3ML/21GX1-1/2" 19 EASY TOUCH SHEATHLOCK SAFETY SYRINGE 3ML/21GX1- 1/2" 19 EC-NAPROSYN 2 ECOTRIN REGULAR STRENGTH 2 EFFEXOR XR 5

ELAVIL 6

ELOCON 15

EMERGEN-C BLUE 22

EMERGEN-C FIVE 22 EMERGEN-C HEART HEALTH 22 EMERGEN-C IMMUNE 22 EMERGEN-C IMMUNE PLUS 22 EMERGEN-C IMMUNE+ WARMERS 22 EMERGEN-C JOINT

EMERGEN-C SUPER FRUIT 22 EMERGEN-C VITAMIN C 22 EMERGEN-C VITAMIN C LITE 22 EMERGEN-C VITAMIN D & CALCIUM 22 enalapril maleate 10 enalapril maleate & hydrochlorothiazide 10 ENERGY BOOSTER 22

ENFAMIL EXPECTA 23 EQ PROBIOTIC DIGESTIVE SYSTEM SUPPORT 7 EQL ACIDOPHILUS EXTRA STRENGTH 7 EQL DAILY PROBIOTIC 7 EQL PRENATAL FORMULA 23 EQL PROBIOTIC COLON SUPPORT 7 EQL SUPER ENERGY BOOSTER 22 ergocalciferol 28

escitalopram oxalate 5

estazolam 19

ESTRACE 17

estradiol 17

EXACTUSS 13 EYEAID IRRIGATING SOLUTION 26 famotidine 27

FEMARA 11

FEOSOL 18

ferrous fumarate 18 ferrous fumarate-fa-b complex- c-zn-mg-mn-cu 18 ferrous fumarate-folic acid 18

ferrous gluconate 18

FERROUS GLUCONATE 18

ferrous sulfate 18

FERROUS SULFATE 18

ferrous sulfate dried 18

fexofenadine hcl 9

FIBERCON 19

FLAGYL 3 FLAX + DHA 1

FLORA-Q 7

FLORA-Q 2 7

FLORAJEN ACIDOPHILUS 7

FLORAJEN BIFIDOBLEND 7

FLORAJEN3 7

FLORAJEN4KIDS 7

fluocinonide 15

fluorouracil 10

fluoxetine hcl 5

flurbiprofen 2

fluvoxamine maleate 5

FOLGARD 18

FOLIC + B12 18

folic acid 18

FOLINIC-PLUS 18

FOLTRATE 18

FORTIFY DAILY PROBIOTIC 7

fosinopril sodium 10

FUNGI-NAIL 14

furosemide 16

G-BUCAL-C 21

G-DOLOGEN 13

G-MYCO NAIL 14

G-TUSICOF 13

G-ZYNCOF 13

gabapentin 4

GAS-X 17

GAS-X EXTRA STRENGTH 17 GASTRACE DIGESTIVE SUPPORT 16 gemfibrozil 9

gentamicin sulfate (topical) 14 GENTEAL TEARS MODERATEPF 25 GILTUSS 13

glimepiride 6

glipizide 6

GLUCOPHAGE 6

GLUCOPHAGE XR 6

glucosamine sulfate 1 glucosamine-chondroitin-vit c- manganese 1 GLUCOTROL 6

HEALTH 22 EMERGEN-C KIDZ 22 flaxseed (linseed) 1 flaxseed oil-fish oil-borage

GLUCOTROL XL 6

GLUCOVANCE 6

EMERGEN-C MSM LITE 22 EMERGEN-C PINK 22 oil 1

FLORA VANCE 7

glyburide 6

glyburide micronized 6

Index 5

glyburide-metformin 6

GLYNASE 6 GNP ACIDOPHILUS HIGH POTENCY 7 GNP PRENATAL 23 GNP PROBIOTIC COLON SUPPORT 7 GNP TRIPLE OMEGA COMPLEX 1 GOODSENSE PRENATAL VITAMINS 23 GORDOCHOM 14

guaifenesin 14

GUMSOL 21

GYNE-LOTRIMIN 28

haloperidol 11

HEMATRON-AF 18

HEMOCYTE 18

hesperidin-diosmin 28

HM ACIDOPHILUS 7 HM OMEGA-3-6-9 FATTY ACIDS 1 HM ONE DAILY ESSENTIAL 22 HM PRENATAL 23

hydralazine hcl 10

hydrochlorothiazide 16

hydrocodone-acetaminophen 2

hydrocortisone 12

hydrocortisone (topical) 15

hydrocortisone-aloe vera 15

hydroxyzine hcl 4

hydroxyzine pamoate 4

hyoscyamine sulfate 27

HYPERSAL 14

HYZAAR 10

ibuprofen 2

imipramine hcl 6 IMMUNE SUPPORT VITAMIN C 22 IMODIUM A-D 8

indomethacin 2

INSULIN SYRINGES-MISC 19

ipratropium bromide 4

ipratropium-albuterol 4

irbesartan 10

IRON 18 iron polysaccharide complex-vit b12-folic acid 18

iron-docusate-b12-folic acid-vit c-vit e-copper-biotin 18 isoniazid 10

isopropyl alcohol (otic) 26

isosorbide mononitrate 3 K-

TAB 20

KEFLEX 12

KEPPRA 4

KLONOPIN 4 KP PRENATAL MULTIVITAMINS 23 labetalol hcl 12

LACTAID FAST ACT 16

lactase 16

LACTO-PECTIN 7

lactobacillus 7

LACTOSE 26

LACTOSE ANHYDROUS 26

LACTOSE HYDROUS 26

LAMICTAL 4 LAMICTAL CHEWABLE DISPERSIBLE 4 LAMISIL 8

LAMISIL AT 14

LAMISIL AT JOCK ITCH 14

lamotrigine 4

LASIX 16

lecithin 25

letrozole 11

LEVAQUIN 17

levetiracetam 4 levocetirizine dihydrochloride 9 levofloxacin 17

levothyroxine sodium 27

LEVSIN 27

LEVSIN/SL 27

LEXAPRO 5

LICEFREEE GEL 21

lidocaine hcl 15 lidocaine hcl (mouth- throat) 21 LIPASE CONCENTRATE- HP 16 LIPITOR 9

LIPOTRIAD 24

lisinopril 10 lisinopril & hydrochlorothiazide 10

LITHIUM CARBONATE 11

lithium carbonate 11

loperamide hcl 8

LOPID 9

LOPRESSOR 12

LOPROX 14

loratadine 9

lorazepam 4

losartan potassium 10 losartan potassium & hydrochlorothiazide 10 LOTENSIN 10

LOTRIMIN AF 14

LOTRIMIN AF FOR HER 14

LOTRIMIN AF JOCK ITCH 14

lovastatin 9

M-VIT 23

magnesium oxide 3 magnesium oxide (mg supplement) 20 MAGOX 400 20

MAVIK 10

MAXIMIN PACK 22

MAXZIDE 16

MAXZIDE-25 16

meclizine hcl 8 medroxyprogesterone acetate 26 MEGA PROBIOTIC 7

MEGACE ORAL 11

megestrol acetate 11

melatonin 1

MELATONIN 1

melatonin 1

melatonin-pyridoxine 1

meloxicam 2

META BIOTIC/BIO-ACTIVE 12 7 metformin hcl 6

methimazole 27

methocarbamol 24

methylcobalamin 18

methyldopa 10

metoclopramide hcl 17

metoprolol tartrate 12

metronidazole 3

MEVACOR 9

MICATIN 14

Index 6

miconazole nitrate (topical) 14

miconazole nitrate vaginal 28

MICROZIDE 17

MINOCIN 27

minocycline hcl 27 MINUS WEIGHT PLUS ENERGY 16 MIRAPEX 11

mirtazapine 5

MOBIC 2

MOBISYL 15

mometasone furoate 15 MONISTAT 7 SIMPLY CURE 28 MONISTAT SOOTHING CARE ITCH RELIEF 15 MONOJECT 3ML SYRINGE/STANDARD HYPODERMIC NEEDLE/21GX1- 1/2" 19 MONOJECT MAGELLAN SYRINGE/SAFETY NEEDLE/3ML/21G X 1-1/2" 19 MONOJECT SAFETY SYRINGE/SHIELD/NEEDLE/3ML /21G X 1-1/2" 20 MONOJECT SYRINGE/LUER- LOCK/3ML/21G X 1-1/2" 20 montelukast sodium 4

MTX SUPPORT 18

MULTI FOR HER 22

MULTI FOR HIM 22

MULTI PRENATAL 23 multiple vitamin 22

naproxen sodium 2

NASAL DECONGESTANT 25 NAT-RUL PRENATAL VITAMINS 23 NATRUL PROBIOTIC 7

NATURE-THROID 27

NEBUSAL 14 NEO-SYNEPHRINE 12 HOUR EXTRA MOISTURIZING 25 neomycin-bacitracin-polymyxin 14 neomycin-polymyxin w/ pramoxine 14 NEOSPORIN ORIGINAL 14 NEOSPORIN PLUS PAIN RELIEF MAXIMUM STRENGTH 14 NEURAGEN 21

NEURIN-SL 18

NEURONTIN 5

niacin 28

NIVA-PLUS 23

NORCO 2

nortriptyline hcl 6

NORVASC 12

NUPERCAINAL 3

nystatin (mouth-throat) 21 O-

CAL FA 23

OCEAN NASAL SPRAY 24

olanzapine 11

OMEGA 3-6-9 COMPLEX 1 OMEGA-3 & OMEGA-6 FISH

oxymetazoline hcl 25

PAIN-A-LAY 21

PAMELOR 6

pantoprazole sodium 28

PARAFON FORTE DSC 24

paroxetine hcl 5

PAXIL 5

PEARLS IC 7

PECGEN DMX 13

penicillin v potassium 26 PENTIPS/PEN NEEDLES MISC 20 pentoxifylline 17

PEPCID 27

PEPCID AC 27 PEPCID AC MAXIMUM STRENGTH 27 PEPTO BISMOL 7 PEPTO-BISMOL 7 PEPTO-BISMOL INSTACOOL 7 PEPTO-BISMOL TO-GO 7

PERCOCET 3

PERCOGESIC 13

PHAZYME 17 PHAZYME MAXIMUM STRENGTH 17 PHAZYME ULTRA STRENGTH 17 phendimetrazine tartrate 1

phenol (antiseptic) 21 phentermine hcl 1

multiple vitamins w/ calcium 22 OIL 1 omega-3 fatty acids 25 PHENYLADE PHEBLOC 25

multivitamin/minerals cap 22

multivitamin/minerals liq 22

multivitamin/minerals tab 22

MYCO NAIL 14

MYCO NAIL A 14

MYCO-NAIL 14

MYLICON 17 MYLICON INFANTS GAS RELIEF 17 MYOFLEX 15

MYSOLINE 5

nabumetone 2

naphazoline w/ pheniramine 26

NAPROSYN 2

naproxen 2

OMEGA-3-6-9 1

omeprazole 28

OMNICAP 22

ondansetron hcl 8

ONE-A-DAY ESSENTIAL 22

ONE-A-DAY MENS 22 ONE-A-DAY WOMENS FORMULA 22 OPCON-A 26 ophthalmic irrigation solution 26 OPURITY B12/FOLIC ACID 18 ORASEP 21

oxcarbazepine 5

Index 7

oxycodone w/ acetaminophen 2

phenylephrine hcl (oral) 25

phenylephrine w/ dm-gg 13

phenytoin sodium

extended 5 PHILLIPS

COLON HEALTH 7

pioglitazone hcl

6 PLAVIX

17 PLETAL

17 PNV FOLIC ACID + IRON MULTIVITAMIN 23 PNV PRENATAL PLUS MULTIVITAMIN 23 polysaccharide iron complex 18 polyvinyl alcohol-povidone (ophth) 25 potassium chloride 20

Index 8

potassium chloride microencapsulated crystals er 20 pramipexole dihydrochloride 11

prednisolone 12 prednisolone sodium phosphate 12 prednisone 12

PREDNISONE 12

PRENATAL 23

PRENATAL FORMULA 23

PRENATAL LOW IRON 23

PRENATAL MULTI + DHA 23

PRENATAL MULTIVITAMIN 23 PRENATAL MULTIVITAMIN + DHA 23 PRENATAL MULTIVITAMIN 23

PROBIOTIC MATURE ADULT 8 PROBIOTIC PEARLS 8 PROBIOTIC PEARLS ADVANTAGE 8 PROBIOTIC-10 8

PROBIOTIC-10 ULTIMATE 8

prochlorperazine maleate 11

promethazine hcl 9

promethazine w/codeine 13

propafenone hcl 4

propranolol hcl 12

PROSACEA 21

PROTONIX 28

PROVERA 26

PROZAC 5 pseudoephedrine hcl 25

REPLENS VAGINAL MOISTURIZER 28 REQUIP 11

RESTORA 8

RESTORIL 19

RIGHT STEP PRENATAL 24

RISAQUAD 8

RISAQUAD-2 8

RISPERDAL 11

risperidone 11

ROBAXIN 24

ROBAXIN-750 24

ROBITUSSIN DM 13 ROBITUSSIN PEAK COLD DM 13 ROBITUSSIN PEAK COLD MULTI-SYMPTOM COLD 13

PLUS DHA ONE DAILY 23 pseudoephedrine w/ dm- ROBITUSSIN TO GO COUGH

PRENATAL

PRENATAL PLUS 23

PRENATAL VITAMIN 24 PRENATAL VITAMIN & MINERAL 24 PRENATAL VITAMIN/IRON 24

PRENATAL VITAMINS 24 PRENATAL VITAMINS PLUS LOW IRON 24 PREORBOTIC 7

PREPLUS 24

PRILOSEC 28

primidone 5

PRINIVIL 10

PRO-BIOTIC BLEND 7

PRO-FLORA IMMUNE 7

PROBIOMAX DAILY DF 7

PROBIOTIC 8 PROBIOTIC & ACIDOPHILUS FORMULA EXTRA STRENGTH 7 PROBIOTIC + OMEGA-3 7

PROBIOTIC ACIDOPHILUS 8 PROBIOTIC ACIDOPHILUS BEADS 8 PROBIOTIC ADVANCED ULTRAPOTENCY 8 PROBIOTIC COLON SUPPORT 8 PROBIOTIC COMPLEX/ACIDOPHILUS 8 PROBIOTIC DAILY 8

PROBIOTIC GOLD EXTRA STRENGTH 8

gg 13 pseudoephedrine- dexchlorpheniramine- chlophedianol 13 PX PRENATAL MULTIVITAMINS 24 pyrantel pamoate 3

pyridoxine hcl 28

QC PRENATAL 24

quetiapine fumarate 11

quinapril hcl 10

QUINTABS 22 RA ANTI-FUNGAL FOOT CARE 14 RA ESSENCE-C 22

RA OMEGA 3-6-9 1

RA PRENATAL 24 RA PRENATAL FORMULA/FOLICACID 24 RA PROBIOTIC COLON CARE 8 RA PROBIOTIC COMPLEX 8

ramipril 10

ranitidine hcl 27

RAPID GEL RX 21

REFRESH 26

REFRESH LIQUIGEL 26

REFRESH TEARS 26

REGLAN 17

RELAGESIC 2

Index 9

REMERON 5

REPHRESH PRO-B 8

&COLD CF 13 ropinirole hydrochloride 11

rosuvastatin calcium

9 RYTHMOL

4 SAFESNAP SYRINGE/NEEDLE/3ML/21G X 1-1/2" 20 SAFETY SYRINGES/NEEDLE 3ML/21GX1-1/2" 20 SAFETY-LOK SYRINGE/NEEDLE3ML LUER- LOK 21GX1-1/2" 20 saline 24 sennosides 19 sennosides-docusate sodium 19 SENOKOT

19 SENOKOT S

19 SEROQUEL

11

sertraline hcl

5 SILVADENE

15

silver sulfadiazine

15 simethicone

17 SIMILAC PRENATAL EARLY SHIELD 24 simvastatin

9

SINEMET 11

SINEMET CR 11

SINGULAIR 4 SKIN BEAUTY & WELLNESS 22 SM ACIDOPHILUS PEARLS 8

SM OMEGA-3 1

Index 10

SM OMEGA-3-6-9 FATTY ACIDS 1 SM ONE DAILY ESSENTIAL22

SM PRENATAL VITAMINS 24 sodium bicarbonate (antacid) 3

TESSALON PERLES 12 tetrahydrozoline hcl (ophth) 26 THERA 23 THERA/BETA-CAROTENE

TUSICOF 13

TUSNEL 13

TUSNEL C 13

TYLENOL 2

TYLENOL 8 HOUR 2

sodium chloride (inhalant) 14 23 THERANATAL CORE TYLENOL 8 HOUR

SOMA 24

SONATA 19

SORBUTUSS NR 13

sotalol hcl 12

sotalol hcl (afib/afl) 12

SPEEDGEL RX 21

spironolactone 16

SPORTSCREME 15

STERYMINE 21

sucralfate 28

SUDAFED CONGESTION 25 SUDAFED NASAL DECONGESTANT MAXIMUM STRENGTH 25 SUDAFED PE CONGESTION 25 sulfamethoxazole- trimethoprim 3 sulfasalazine 17

sulindac 2

NUTRITION 24 thiamine hcl 28

thioridazine hcl 11

thyroid 27

TINACTIN 14

TINACTIN JOCK ITCH 14

tizanidine hcl 24

TOFRANIL 6

tolnaftate 14

TOPAMAX 5

topiramate 5

tramadol hcl 2

tramadol-acetaminophen 3

trandolapril 10

TRANZGEL 21

TRAUMEEL 21

trazodone hcl 5 triamcinolone acetonide (topical) 15

ARTHRITISPAIN 2 TYLENOL EXTRA STRENGTH 2 TYLENOL PM EXTRA STRENGTH 19 TYLENOL/CODEINE #3 3

TYLENOL/CODEINE #4 3

TYLER SIMILASE JR 16

UDAMIN SP 22

ULTRA DIET AID 16

ULTRACET 3 ULTRAFLORA IMMUNE HEALTH 8 ULTRAM 2

UNISOM 19

urea 15

vaginal lubricant 28

VALIUM 4

valproic acid 5 valsartan-hydrochlorothiazide

SUPER OMEGA-3 1 TRIAMINO 25 10 VANISHPOINT SAFETY

SUPER PROBIOTIC 8 SUPER PROBIOTIC DIGESTIVE SUPPORT 8 SUPER-AMINO 1600 25

SUPERVITE 21

SUPLEVIT 21

SWIM EAR 26

SYNTHROID 27 SYRINGE/LUER LOCK/3ML/21G X 1-1/2" 20 SYRINGE/LUER LOCK/3ML/21GX1-1/2" 20 T-RELIEF PAIN ARNICA + 12 21 TAPAZOLE 27

TEA TREE OIL 12 TECNU EXTREME MEDICATED POISON IVY SCRUB 21 temazepam 19

TENORMIN 12

terazosin hcl 10

terbinafine hcl 8

terbinafine hcl (topical)

14

triamterene & hydrochlorothiazide 16 TRICARE 24

trihexyphenidyl hcl 11 TRILEPTAL 5 TRIPLE OMEGA COMPLEX 1 TRIPLE OMEGA-3-6-9 1 TRISPEC DMX 13 TRISPEC DMX PEDIATRIC 13 trolamine salicylate 15

TRUBIOTICS 8 TRUNATURE DIGESTIVE PROBIOTIC 8 TUMS 3

TUMS CHEWY BITES 3 TUMS E-

X 750 3 TUMS EXTRA STRENGTH 750 3 TUMS KIDS 3

TUMS LASTING EFFECTS 3

TUMS SMOOTHIES 3

Index 11

SYRINGE/3ML/21GX1-1/2" 20 VANISHPOINT SYRINGE/3ML/21G X 1-1/2" 20 VASERETIC 10

VASOTEC 10

venlafaxine hcl

5,

6 verapamil hcl

1

2 VICKS SINEX

2

5 VICKS SINEX 12 HOUR DECONGESTANT 25 VICKS SINEX 12 HOUR DECONGESTANT ULTRA FINE MIST 25 VICKS SINEX 12 HOUR DECONGESTANT ULTRA FINE MIST/MOISTURIZNG 25 VICKS SINEX MOISTURIZING 25 VICKS SINEX SEVERE NASALDECONGESTANT 25 VINATE M 24 VISBIOME PROBIOTIC HIGH POTENCY 8 VISINE 26

Index 12

VISINE EXTRA 26

VISTARIL 4

VITAMENT 22

vitamin a 28

VITAMIN B 12 18

VITAMIN B12/FOLIC ACID 18 VITAMIN C EFFERVESCENT BLEND 22 VITAMIN C/ELECTROLYTES 22 VITAMIN D2 28

VITAMIN D3 28

vitamin e 28

vitamins w/ lipotropics 24 VOL-

PLUS 24

VSL#3 8

warfarin sodium 4

WELLBUTRIN SR 5

WESTHROID 27

white petrolatum 26

WP THYROID 27

XANAX 4

XERAC AC 15

XYLOCAINE 15

XYZAL 9

XYZAL ALLERGY 24HR 9

zaleplon 19

ZANAFLEX 24

ZANTAC 27 ZANTAC 150 MAXIMUM STRENGTH 27 ZANTAC 75 27

ZE-PLUS 23

ZESTORETIC 10

ZESTRIL 10

ZIAC 10

zinc oxide (topical) 16

zinc sulfate 21

ZOCOR 10

ZOFRAN 8

ZOLOFT 5

zolpidem tartrate 19 ZOSTRIX ARTHRITIS PAIN RELIEF 15 ZOVIRAX 11

ZYLOPRIM 17

ZYNCOF 14

ZYPREXA 11

ZYRTEC ALLERGY 9 ZYRTEC CHILDRENS ALLERGY 9

Preferred Drug List - Envolve Health · 2020-06-19 · acidophilus super probiotic caps 1 acidophilus/goat milk caps 1 advanced probiotic 10 caps 1 advanced probiotic caps 1 align

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