Premium-Value Formulary Reference Guide · Premium-Value Formulary Reference Guide *Formulary Disclaimer: Coverage for some drugs may be limited to specific dosage forms and/or strengths.

Premium-Value Formulary Reference Guide

Your formulary utilizes a Pharmacy and Therapeutics Committee (P & T Committee),

made up of practicing physicians, pharmacists, and nurses to help ensure that our

formulary is medically sound and that it supports patient health. This committee reviews

and evaluates medications on the formulary based on safety and efficacy to help

maintain clinical integrity in all therapeutic categories.

FORMULARY DESIGN

The Optum Premium-Value Formulary is a partially-closed formulary. The Premium-

Value Formulary is considered partially-closed because it excludes coverage of some

brand-name drugs that do not offer a clear clinical advantage over other less costly

brand or generic alternatives. Most other prescription drugs are on the formulary

including specialty medications. Some medications may be subject to utilization

management programs to ensure appropriate clinical use and cost efficiency. The

formulary structure features medications generics (with the lowest copayments),

preferred and non-preferred brand-name drugs.

• Generic drugs: Most generic drugs are listed under “GENERIC”. Drugs listed

under “GENERIC” have the same active ingredient as the brand-name versions

but at a lower cost.

• Preferred drugs: Drugs listed under “PREFERRED” include preferred brand

name drugs that will generally have lower co-payments than non-preferred

brand name drugs.

• Non-preferred drugs: Drugs listed under “NON PREFERRED” generally have

higher co-payments than preferred brand name drugs.

USING THIS FORMULARY REFERENCE GUIDE TO HELP

CONTAIN COSTS

Many health plans use the formulary to help manage the overall cost of providing

prescription drug benefits. This formulary offers a wide range of medications from which

to choose. We realize that this formulary reference guide may not include every drug

from every manufacturer. However, choosing a generic or preferred drug when it is

Premium-Value Formulary Reference Guide

*Formulary Disclaimer: Coverage for some drugs may be limited to specific dosage forms and/or strengths. The benefit design determines what is

covered and the applicable co-payment. The medications listed on this formulary are subject to change pursuant to the formulary management

activities of Optum. The presence of a medication on this formulary list does not guarantee coverage. To determine the most up-to-date formulary

status of your medication, please visit your member website or call member services at the number listed on your ID card.

appropriate can provide access to the necessary medications to stay healthy, at a

cost that is more affordable.

SAVING ON OUT-OF-POCKET COSTS

Your health plan sets the co-payments for each formulary drug status which include

generic, preferred brand-name, and non-preferred brand-name medications. Health

plans often design prescription drug plans to encourage the use of generic and

preferred brand-name drugs. Choosing non-preferred drugs may mean paying higher

out-of-pocket expenses (such as coinsurance, co-payments, and deductible amounts)

or not receiving coverage at all. Patients may also pay less for generic drugs, or they

may be asked to pay the cost difference between brand-name drugs and their generic

alternatives.

PLEASE NOTE: Brand-name drugs may move to non-preferred status if a generic

version becomes available.

CONSULTING THE PRESCRIBER’S OFFICE WHEN

APPROPRIATE

When employers and other health plans design their prescription drug plans, they may

choose to provide coverage only for certain medications, time periods, doses,

quantities, or for a specific indications (e.g. they may exclude coverage for medications

for unapproved, unproven, or cosmetic indications). When coverage for medications is

provided based on use or quantity, your pharmacy benefit may contact your prescriber’s

office for additional information to determine whether coverage is available under your

plan. Patients who are unsure whether these coverage rules apply for a particular

medication can consult their prescription drug benefit manual or contact a Member

Services representative to determine specific coverage requirements.

KNOWING HOW THE FORMULARY INFORMATION IS

ORGANIZED

The following formulary reference guide is designed so that generic products are listed

first in each drug category. The preferred brand name products are listed next, and non-

preferred brand products are listed last.

OptumRx specializes in the delivery, clinical management and affordability of prescription medications and consumer

health products. We are an OptumTM company — a leading provider of integrated health services. Learn more at

optum.com.

All OptumTM

trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or

registered marks of their respective owners. © 2015 Optum, Inc. All rights reserved.

Table of Contents

ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

PENICILLINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

CEPHALOSPORIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FIRST GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

SECOND GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

THIRD GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FOURTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MACROLIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

TETRACYCLINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

QUINOLONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

AMINOGLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

SULFONAMIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

ANTIMYCOBACTERIAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

ANTIFUNGALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

ANTIVIRALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTIMALARIALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

AMEBICIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTHELMINTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

MISC. ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ANTINEOPLASTICS, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ALKYLATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ANTIBIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ANTINEOPLASTIC ENZYMES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ANTIMETABOLITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ANGIOGENESIS INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ANTIBODIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

HORMONAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

MITOTIC INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ENZYME INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

TOPOISOMERASE I INHIBITOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

RADIOPHARMACEUTICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CELLULAR IMMUNOTHERAPY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

ANTINEOPLASTICS MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CHEMOTHERAPY RESCUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CHEMOTHERAPY ADJUNCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CARDIOVASCULAR DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

PHOSPHODIESTERASE INHBTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CARDIAC GLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANTIANGINAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

BETA BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

CALCIUM CHANNEL BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANTIARRHYTHMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ACE INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ANGIOTENSIN RCPTR BLOCKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

DIRECT RENIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ANTIHYPERTENSIVES MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ANTIHYPERTENSIVE COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

DIURETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

VASOPRESSORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

ANTIHYPERLIPIDEMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

CARDIOVASCULAR - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

DERMATOLOGICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ACNE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ROSACEA AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANALGESICS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTIBIOTICS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTIFUNGALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTIVIRALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTIHISTAMINES-TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTI-INFLAMMATORY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTIPRURITICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTIPSORIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

ANTISEBORRHEIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

CORTICOSTEROIDS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

IMMUNOMODULATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

DERMATOLOGICALS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

ENDOCRINE AND METABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

CORTICOSTEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

ANDROGENS-ANABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

ESTROGENS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

CONTRACEPTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

PROGESTINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

ANTIDIABETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

INSULIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

AMYLIN ANALOGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

INCRETIN MIMETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

SULFONYLUREAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

BIGUANIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

MEGLITINIDE ANALOGUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

DIABETIC OTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

ALPHA-GLUCOSIDASE INHIBIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

DPP-4 INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

INSULIN SENSITIZING AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

ANTIDIABETIC COMBINATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

BISPHOSPHONATES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

CALCITONINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

PARATHYROID HORMONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

RANK LIGAND INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

CALCIUM REGULATORS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

HORMONE RECEPTOR MDLTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

FERTILITY REGULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

LHRH/GNRH AGONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

GNRH/LHRH ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

GROWTH HORMONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

GHRH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

SOMATOMEDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

SOMATOSTATIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

GH RECEPTOR ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

POSTERIOR PITUITARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

CORTICOTROPIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

PROLACTIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

VASOPRESSIN ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

PROGESTERONE ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

METABOLIC MODIFIERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

THYROID AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

GASTROINTESTINAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

LAXATIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ANTIDIARRHEALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ANTACIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ULCER DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ANTIEMETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

DIGESTIVE AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

GASTROINTESTINAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

GENITOURINARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

URINARY ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

URINARY ANTISPASMODICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

VAGINAL PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

GENITOURINARY - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

HEMATOLOGAICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

HEMATOPOIETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

ANTICOAGULANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

HEMOSTATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

HEMATOLOGICAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

MOUTH/THROAT/DENTAL AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

NEUROLOGY, CNS, PSYCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

ANTIANXIETY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

ANTIDEPRESSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

ANTIPSYCHOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

HYPNOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

ADHD, NARCOLEPSY, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

ANTICONVULSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

ANTIPARKINSON AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

NEUROLOGY, PSYCH - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

NEUROMUSCULAR AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

MUSCULOSKELETAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

ANTIMYASTHENIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

OPHTHALMOLOGY AND OTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

ARTIFICIAL TEAR/LUBRICANT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

BETA-BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

OPHTHALMIC STEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

PROSTAGLANDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

CYCLOPLEGIC MYDRIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

DECONGESTANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

MIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

ADRENERGIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

LOCAL ANESTHETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

OPHTHALMICS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

OTIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

OXYTOCICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

PAIN MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

ANALGESICS - NONNARCOTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

ANALGESICS - OPIOID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

ANTI-INFLAMMATORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

MIGRAINE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

GOUT AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

LOCAL ANESTHETICS-INJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

RESPIRATORY, ALLERGY, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

ANTIHISTAMINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

NASAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

COUGH/COLD/ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

ANTIASTHMATIC/COPD AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

RESPIRATORY AGENTS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

TOXOIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

VACCINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

MULTIVITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

MEDICAL DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

DIABETIC SUPPLIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

MEDICAL DEVICES - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

MISCELLANEOUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

cefprozil

cefuroxime axetil

cefuroxime sodium

PREFERRED

January 2016 Cefaclor

NON PREFERRED

ANTI-INFECTIVES Cefaclor ER

Cefotetan

PENICILLINS

Cefotetan/Dextrose

GENERIC

Cefoxitin Sodium

amoxicillin

Ceftin

amoxicillin/clavulanate potassium

Cefuroxime Sodium

amoxicillin/clavulanate potassium ER

Cefuroxime/Dextrose

ampicillin

Mefoxin

ampicillin sodium

Zinacef

ampicillin-sulbactam

THIRD GENERATION

dicloxacillin sodium

GENERIC

nafcillin sodium

cefdinir

oxacillin sodium

cefixime

penicillin v potassium

cefotaxime sodium

penicillin G potassium

cefpodoxime proxetil

piperacillin sodium/ tazobactam sodium

ceftazidime

piperacillin sodium/tazobactam sodium

ceftriaxone sodium

piperacillin/tazobactam

NON PREFERRED

Amoxicillin/Clavulanate Potassium

Cedax

PREFERRED

Cefditoren Pivoxil

Amoxicillin

Ceftazidime/Dextrose

Ampicillin

Ceftibuten

NON PREFERRED

Ceftriaxone IN Iso-osmotic Dextrose

Amoxicillin ER

Ceftriaxone Sodium

Ampicillin Sodium

Ceftriaxone/Dextrose

Ampicillin-sulbactam

Claforan

Augmentin

Claforan/D5W

Augmentin ES-600

Fortaz

Augmentin XR

Rocephin

Bactocill IN Dextrose

Spectracef

Bicillin C-R

Suprax

Bicillin L-a

Tazicef

Moxatag

FOURTH GENERATION

Nafcillin Sodium

GENERIC

Nallpen Iso-osmotic IN Dextrose

cefepime

Nallpen/Dextrose

NON PREFERRED

Penicillin G Potassium IN Iso-osmotic Dextrose

Cefepime

Penicillin G Procaine

Maxipime

Penicillin G Sodium

Pfizerpen-G

MACROLIDES

Timentin

GENERIC

Unasyn

azithromycin

Unasyn Bulk Pack

clarithromycin

Zosyn

clarithromycin ER

erythromycin

CEPHALOSPORIN

PREFERRED

FIRST GENERATION

E.e.s. 400

GENERIC

Erythromycin Base

cefadroxil

Erythromycin Ethylsuccinate

cefazolin sodium

NON PREFERRED

cephalexin

Azithromycin

PREFERRED

Biaxin

Cephalexin

Biaxin XL

NON PREFERRED

Biaxin XL PAC

Ancef

Dificid

Cefazolin

E.e.s. Granules

Cefazolin Sodium

Ery-TAB

Cefazolin Sodium/Dextrose

Eryped 200

Keflex

Eryped 400

SECOND GENERATION

Erythrocin Lactobionate

GENERIC

Erythrocin Stearate

cefaclor

PCE

cefoxitin sodium

Zithromax

Effective January 1, 2016 v.3 All OptumTM trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners. © 2015 Optum, Inc. All rights reserved.

1

Zithromax Tri-PAK paromomycin sulfate

Zithromax Z-PAK tobramycin

Zmax tobramycin sulfate

PREFERRED

TETRACYCLINES Bethkis

NON PREFERRED

GENERIC

Gentamicin Sulfate/0.9% Sodium Chloride

demeclocycline HCL

Isotonic Gentamicin

doxycycline

Streptomycin Sulfate

doxycycline hyclate

Tobramycin Sulfate/Sodium Chloride

doxycycline hyclate DR

doxycycline monohydrate

SULFONAMIDES

minocycline HCL

minocycline HCL ER PREFERRED

Tetracycline HCL Sulfadiazine

NON PREFERRED

Acticlate ANTIMYCOBACTERIAL AGENTS

Adoxa

GENERIC

Adoxa PAK 1/100

ethambutol HCL

Adoxa PAK 1/150

isoniazid

Adoxa PAK 2/100

pyrazinamide

Alodox Convenience Kit

rifabutin

Avidoxy DK

rifampin

Benzodox 30 Kit

NON PREFERRED

Benzodox 60 Kit

Capastat Sulfate

Doryx

Cycloserine

Minocin

Isoniazid

Minocin Kit

Myambutol

Monodox

Mycobutin

Morgidox 1X100MG

Paser

Morgidox 2X100MG

Priftin

Nicazeldoxy 30 Kit

Rifadin

Nicazeldoxy 60 Kit

Rifamate

Nutridox

Rifater

Ocudox

Sirturo

Solodyn

Trecator

Targadox

Vibramycin

ANTIFUNGALS

GENERIC

QUINOLONES

fluconazole

GENERIC

fluconazole IN dextrose

ciprofloxacin

fluconazole IN NACL

ciprofloxacin ER

flucytosine

ciprofloxacin HCL

griseofulvin microsize

ciprofloxacin I.V.-IN D5W

griseofulvin ultramicrosize

levofloxacin

itraconazole

levofloxacin IN D5W

ketoconazole

moxifloxacin HCL

nystatin

ofloxacin

terbinafine HCL

Ciprofloxacin HCL

voriconazole

Ofloxacin

NON PREFERRED

NON PREFERRED

Abelcet

Avelox

Ambisome

Avelox Abc Pack

Amphotec

Cipro

Amphotericin B

Cipro I.V.-IN D5W

Ancobon

Cipro XR

Cancidas

Factive

Cresemba

Levaquin

Diflucan

Moxifloxacin HCL

Eraxis

Noroxin

Fluconazole IN NACL

Grifulvin V

AMINOGLYCOSIDES

Gris-peg

GENERIC Lamisil

amikacin sulfate Mycamine

gentamicin sulfate Noxafil

gentamicin sulfate pediatric Onmel

gentamicin sulfate/0.9% sodium chloride Sporanox

isotonic gentamicin Sporanox Pulsepak

neomycin sulfate Terbinex

Effective January 1, 2016

2

Vfend Epivir

Vfend IV Epivir HBV

Famvir

ANTIVIRALS Flumadine

Foscavir

GENERIC

Hepsera

abacavir

Infergen

abacavir sulfate/lamivudine/zidovudine

Moderiba

acyclovir

Moderiba 1200 Dose Pack

acyclovir sodium

Moderiba 800 Dose Pack

adefovir dipivoxil

Olysio

cidofovir

Peg-intron

didanosine

Peg-intron Redipen

entecavir

Peg-intron Redipen PAK 4

famciclovir

Pegintron

ganciclovir

Rapivab

lamivudine

Rebetol

lamivudine/zidovudine

Relenza Diskhaler

nevirapine

Retrovir

nevirapine ER

Ribasphere

ribavirin

Ribasphere Ribapak

rimantadine HCL

Rimantalist

stavudine

Sitavig

valacyclovir HCL

Tamiflu

valganciclovir

Trizivir

zidovudine

Tyzeka

PREFERRED

Valcyte

Aptivus

Valtrex

Atripla

Victrelis

Complera

Videx EC

Crixivan

Viekira PAK

Edurant

Viramune

Emtriva

Viramune XR

Epzicom

Virazole

Evotaz

Vistide

Fuzeon

Zerit

Harvoni

Ziagen

Intelence

Zovirax

Invirase

Isentress

ANTIMALARIALS

Kaletra

Lexiva GENERIC

Nevirapine atovaquone/proguanil HCL

Norvir chloroquine phosphate

Pegasys hydroxychloroquine sulfate

Pegasys Proclick mefloquine HCL

Prezcobix quinine sulfate

Prezista Primaquine Phosphate

Rescriptor PREFERRED

Retrovir IV Infusion Daraprim

Reyataz NON PREFERRED

Ribatab Aralen

Selzentry Coartem

Sovaldi Malarone

Stribild Plaquenil

Sustiva Qualaquin

Tivicay

Triumeq AMEBICIDES

Truvada

PREFERRED

Tybost

Yodoxin

Videx Pediatric

Viracept

ANTHELMINTICS

Viread

GENERIC

Vitekta

ivermectin

NON PREFERRED

PREFERRED

Acyclovir Sodium

Biltricide

Baraclude

NON PREFERRED

Combivir

Albenza

Copegus

Stromectol

Cytovene


3

MISC. ANTI-INFECTIVES Vancocin HCL

Vancomycin HCL

GENERIC

Vancomycin HCL + Syrspendsf PH4

atovaquone

Vancomycin HCL IN Dextrose

aztreonam

Vibativ

bacitracin

Xifaxan

clindamycin palmitate HCL

Zerbaxa

clindamycin phosphate

Zyvox

clindamycin phosphate add-vantage

clindamycin phosphate pharmacy bulk package

ANTINEOPLASTICS, ETC

clindamycin phosphate IN D5W

clindamycin HCL

ALKYLATING AGENTS

colistimethate sodium

GENERIC

imipenem/cilastatin

carboplatin

linezolid

cisplatin

meropenem

cyclophosphamide

metronidazole

ifosfamide

metronidazole IN NACL 0.79%

melphalan hydrochloride

polymyxin b sulfate

oxaliplatin

sulfamethoxazole/trimethoprim

temozolomide

sulfamethoxazole/trimethoprim DS

Lomustine

tinidazole

PREFERRED

trimethoprim

Alkeran

vancomycin HCL

Bicnu

Dapsone

Busulfex

PREFERRED

Hexalen

Alinia

Leukeran

Nebupent

Mustargen

NON PREFERRED

Myleran

Avycaz

Treanda

Azactam

Zanosar

Azactam IN Iso-osmotic Dextrose

NON PREFERRED

Bacitracin

Cisplatin

Bactrim

Cyclophosphamide

Bactrim DS

Eloxatin

Cayston

Gleostine

Chloramphenicol Sodium Succinate

Gliadel Wafer

Cleocin

Ifex

Cleocin IN D5W

Ifosfamide

Cleocin Pediatric Granules

Temodar

Cleocin Phosphate

Thiotepa

Clin Single Use Kit

Valchlor

Clindamycin Phosphate

Coly-mycin M

ANTIBIOTICS

Cubicin

GENERIC

Dalvance

bleomycin sulfate

Doribax

daunorubicin HCL

First-vancomycin 25

doxorubicin HCL

First-vancomycin 50

doxorubicin HCL liposome

Flagyl

epirubicin HCL

Flagyl ER

idarubicin HCL

Invanz

mitomycin

Ketek

mitoxantrone HCL

Lincocin

Doxorubicin HCL

Lincomycin/Lidocaine

Mitomycin

Mepron

PREFERRED

Meropenem/Sodium Chloride

Daunoxome

Merrem

NON PREFERRED

Metro IV

Adriamycin

Neutrexin

Cosmegen

Orbactiv

Doxil

Pentam 300

Ellence

Primaxin IV

Epirubicin HCL

Primaxin IV Add-vantage

Idamycin PFS

Primsol

Sivextro

ANTINEOPLASTIC ENZYMES

Sulfamethoxazole/Trimethoprim

PREFERRED

Synercid

Oncaspar

Tindamax

NON PREFERRED

Tygacil

Erwinaze


4

ANTIMETABOLITES leuprolide acetate

megestrol acetate

GENERIC

tamoxifen citrate

azacitidine

PREFERRED

capecitabine

Eligard

cladribine

Emcyt

cytarabine

Fareston

cytarabine aqueous

Faslodex

decitabine

Lupron Depot

floxuridine

Lysodren

fludarabine phosphate

Nilandron

fluorouracil

Zoladex

gemcitabine HCL

NON PREFERRED

mercaptopurine

Arimidex

methotrexate

Aromasin

methotrexate sodium

Casodex

Floxuridine

Depo-provera

PREFERRED

Femara

Alimta

Firmagon

Arranon

Megace Oral

Clolar

Soltamox

Folotyn

Trelstar

Tabloid

Trelstar Mixject

NON PREFERRED

Vantas

Cytarabine

Xtandi

Dacogen

Zytiga

Fludara

Fludarabine Phosphate

IMMUNOMODULATORS

Gemcitabine

Gemzar GENERIC

Purinethol azathioprine

Purixan cyclosporine

Trexall cyclosporine modified

Vidaza mycophenolate mofetil

Xeloda mycophenolic acid DR

sirolimus

ANGIOGENESIS INHIBITORS tacrolimus

PREFERRED

PREFERRED

Atgam

Avastin

Cellcept Intravenous

Zaltrap

Cyclosporine Modified

NON PREFERRED

Thalomid

Cyramza

NON PREFERRED

Astagraf XL

ANTIBODIES

Azasan

PREFERRED

Cellcept

Adcetris

Envarsus XR

Arzerra

Imuran

Bexxar

Myfortic

Erbitux

Neoral

Herceptin

Nulojix

Perjeta

Pomalyst

Yervoy

Prograf

NON PREFERRED

Rapamune

Blincyto

Revlimid

Gazyva

Sandimmune

Kadcyla

Simulect

Keytruda

Thymoglobulin

Opdivo

Zortress

Portrazza

Rituxan

MITOTIC INHIBITORS

Vectibix

GENERIC

Zevalin Y-90

docetaxel

etoposide

HORMONAL AGENTS

paclitaxel

GENERIC

vincristine sulfate

anastrozole

vinorelbine tartrate

bicalutamide

PREFERRED

exemestane

Abraxane

flutamide

Etoposide

letrozole


5

Halaven PREFERRED

Ixempra Kit Bexxar 131 Iodine

Jevtana Xofigo

NON PREFERRED NON PREFERRED

Docefrez Metastron

Docetaxel Quadramet

Etopophos

Marqibo CELLULAR IMMUNOTHERAPY

Navelbine

PREFERRED

Paclitaxel

Provenge

Taxotere

Teniposide

ANTINEOPLASTICS MISC.

Vinblastine Sulfate

GENERIC

bexarotene

ENZYME INHIBITORS

dacarbazine

PREFERRED

hydroxyurea

Afinitor

tretinoin

Caprelsa

PREFERRED

Gleevec

Actimmune

Istodax

Alferon N

Jakafi

Matulane

Kyprolis

Proleukin

Mekinist

Theracys

Nexavar

Tice Bcg

Tafinlar

Trisenox

Tasigna

NON PREFERRED

Torisel

Dacarbazine

Tykerb

Hydrea

Velcade

Intron A

Xalkori

Intron A W/Diluent

Zolinza

Nipent

NON PREFERRED

Photofrin

Afinitor Disperz

Sylatron

Beleodaq

Synribo

Bosulif

Targretin

Cometriq

Uvadex

Farydak

Gilotrif

CHEMOTHERAPY RESCUE

Ibrance

GENERIC

Iclusig

amifostine

Imbruvica

dexrazoxane

Inlyta

leucovorin calcium

Iressa

levoleucovorin

Lenvima 10MG Daily Dose

levoleucovorin calcium


mesna


PREFERRED


Leucovorin Calcium

Lynparza

NON PREFERRED

Sprycel

Calcium Folinate

Stivarga

Ethyol

Sutent

Fusilev

Tarceva

Levoleucovorin

Votrient

Mesnex

Zelboraf

Totect

Zydelig

Voraxaze

Zykadia

Zinecard

TOPOISOMERASE I INHIBITOR

CHEMOTHERAPY ADJUNCTS

GENERIC

PREFERRED

irinotecan

Kepivance

topotecan HCL

NON PREFERRED

NON PREFERRED

Elitek

Camptosar

Hycamtin

CARDIOVASCULAR DRUGS

Irinotecan

PHOSPHODIESTERASE INHBTR

Topotecan HCL

GENERIC

milrinone lactate

RADIOPHARMACEUTICALS

milrinone IN dextrose


6

CARDIAC GLYCOSIDES Innopran XL

Kerlone

GENERIC

Levatol

digoxin

Lopressor

PREFERRED

Sectral

Lanoxin

Sotalol Hydrochloride

NON PREFERRED

Sotylize

Digoxin

Tenormin

Lanoxin Pediatric

Toprol XL

Trandate

ANTIANGINAL AGENTS

Zebeta

GENERIC

isosorbide dinitrate

CALCIUM CHANNEL BLOCKERS

isosorbide mononitrate

GENERIC

isosorbide mononitrate ER

amlodipine besylate

nitroglycerin lingual

diltiazem CD

nitroglycerin transdermal

diltiazem HCL

nitroglycerin ER

diltiazem HCL ER

nitroglycerin IN dextrose 5%

felodipine ER

nitroglycerin IN 5% dextrose

isradipine

Isosorbide Dinitrate

nicardipine HCL

Nitroglycerin Lingual

nifedipine

PREFERRED

nifedipine ER

Dilatrate SR

nimodipine

Isosorbide Dinitrate ER

nisoldipine

Nitro-bid

verapamil HCL

Nitro-dur

verapamil HCL ER

Nitrostat

verapamil HCL SR

Ranexa

NON PREFERRED

NON PREFERRED

Adalat CC

Imdur

Calan

Isordil Titradose

Calan SR

Nitroglycerin

Cardene I.v.

Nitroglycerin IN Dextrose 5%

Cardene IV

Nitrolingual Pumpspray

Cardene SR

Nitromist

Cardizem

Nitronal

Cardizem CD

Cardizem LA

BETA BLOCKERS

Cleviprex

GENERIC

Dilacor XR

acebutolol HCL

Diltiazem HCL

atenolol

Hypertenipine-2.5

betaxolol HCL

Nisoldipine

bisoprolol fumarate

Nisoldipine ER

carvedilol

Norvasc

esmolol HCL

Nymalize

labetalol HCL

Procardia

metoprolol succinate ER

Procardia XL

metoprolol tartrate

Sular

nadolol

Tiazac

pindolol

Verelan

propranolol HCL

Verelan PM

propranolol HCL ER

sotalol HCL

ANTIARRHYTHMICS

sotalol HCL (AF)

GENERIC

PREFERRED

adenosine

Bystolic

amiodarone HCL

Propranolol HCL

disopyramide phosphate

Timolol Maleate

flecainide acetate

NON PREFERRED

ibutilide fumarate

Betapace

lidocaine HCL

Betapace AF

lidocaine HCL IN D5W

Brevibloc

lidocaine HCL/dextrose

Coreg

mexiletine HCL

Coreg CR

propafenone HCL

Corgard

propafenone HCL ER

Hemangeol

quinidine gluconate CR

Hypertenevide-12.5

quinidine gluconate ER

Inderal LA

quinidine sulfate

Inderal XL


7

PREFERRED ANTIHYPERTENSIVES MISC.

Norpace CR

GENERIC

Quinidine Sulfate

clonidine HCL

Quinidine Sulfate ER

doxazosin

NON PREFERRED

doxazosin mesylate

Adenocard

eplerenone

Amiodarone HCL

fenoldopam mesylate

Cordarone

guanfacine HCL

Corvert

hydralazine HCL

Lidocaine HCL

methyldopa

Multaq

minoxidil

Nexterone

phenoxybenzamine hydrochloride

Norpace

prazosin HCL

Procainamide HCL

terazosin HCL

Quinidine Gluconate

PREFERRED

Rythmol

Reserpine

Rythmol SR

NON PREFERRED

Tikosyn

Cardura

Xylocaine

Catapres

Catapres-tts-1

ACE INHIBITORS

Catapres-tts-2

GENERIC Catapres-tts-3

benazepril HCL Corlopam

captopril Demser

enalapril maleate Dibenzyline

enalaprilat Inspra

fosinopril sodium Methyldopate HCL

lisinopril Minipress

moexipril HCL Nitropress

perindopril erbumine Phentolamine Mesylate

quinapril HCL Tenex

ramipril Vecamyl

trandolapril

NON PREFERRED ANTIHYPERTENSIVE COMBO

Accupril

GENERIC

Aceon

amlodipine besylate/benazepril hydrochloride

Altace

amlodipine besylate/benazepril HCL

Epaned

amlodipine besylate/valsartan

Lotensin

amlodipine/valsartan/hctz

Mavik

atenolol/chlorthalidone

Prinivil

benazepril HCL/hydrochlorothiazide

Univasc

bisoprolol fumarate/hydrochlorothiazide

Vasotec

candesartan cilexetil/hydrochlorothiazide

Zestril

enalapril maleate/hydrochlorothiazide

fosinopril sodium/hydrochlorothiazide

ANGIOTENSIN RCPTR BLOCKER

irbesartan/hydrochlorothiazide

GENERIC lisinopril/hydrochlorothiazide

candesartan cilexetil losartan potassium/hydrochlorothiazide

irbesartan metoprolol/hydrochlorothiazide

losartan potassium moexipril/hydrochlorothiazide

telmisartan nadolol/bendroflumethiazide

valsartan quinapril/hydrochlorothiazide

Eprosartan Mesylate telmisartan/amlodipine

PREFERRED telmisartan/hydrochlorothiazide

Benicar trandolapril/verapamil HCL

NON PREFERRED trandolapril/verapamil HCL ER

Atacand valsartan/hydrochlorothiazide

Avapro PREFERRED

Cozaar Azor

Diovan Benicar HCT

Edarbi Captopril/Hydrochlorothiazide

Micardis Dutoprol

Teveten Methyldopa/Hydrochlorothiazide

Propranolol/Hydrochlorothiazide

DIRECT RENIN INHIBITORS Tekturna HCT

Tribenzor

PREFERRED

NON PREFERRED

Tekturna

Accuretic

Amturnide


8

Atacand HCT Maxzide-25

Avalide Microzide

Clorpres Neptazane

Corzide Sodium Diuril

Diovan HCT Sodium Edecrin

Edarbyclor Torsemide

Exforge Zaroxolyn

Exforge HCT

Hypertensolol VASOPRESSORS

Hyzaar

GENERIC

Lopressor HCT

dobutamine HCL

Lotensin HCT

dobutamine HCL/D5W

Lotrel

dobutamine/dextrose 5%

Lytensopril Kit

dopamine HCL

Lytensopril-90

dopamine HCL-dextrose 5%

Lytensopril-90 Kit

dopamine HCL/dextrose 5%

Micardis HCT

dopamine/D5W

Prestalia

ephedrine sulfate

Tarka

midodrine HCL

Tekamlo

norepinephrine bitartrate

Tenoretic 100

phenylephrine HCL

Tenoretic 50

PREFERRED

Teveten HCT

Epipen 2-PAK

Twynsta

Epipen-JR 2-PAK

Uniretic

NON PREFERRED

Vaseretic

Adrenalin

Zestoretic

Dobutamine/Dextrose 5%

Ziac

Dopamine HCL

Ephedrine Sulfate/Sodium Chloride

DIURETICS

Epinephrine

GENERIC Epinephrine HCL

acetazolamide Episnap

acetazolamide sodium Levophed

acetazolamide ER Northera

amiloride HCL Phenylephrine HCL

amiloride/hydrochlorothiazide Phenylephrine HCL/Sodium Chloride

bumetanide Vazculep

chlorothiazide

chlorothiazide sodium ANTIHYPERLIPIDEMICS

furosemide

GENERIC

hydrochlorothiazide

atorvastatin calcium

indapamide

cholestyramine

mannitol

cholestyramine light

methazolamide

colestipol HCL

metolazone

colestipol HCL for oral suspension

spironolactone

fenofibrate

spironolactone/hydrochlorothiazide

fenofibrate micronized

torsemide

fenofibric acid DR

triamterene/hydrochlorothiazide

fluvastatin

Acetazolamide

fluvastatin sodium ER

Chlorothiazide

gemfibrozil

Chlorthalidone

lovastatin

Triamterene/Hydrochlorothiazide

niacin ER

PREFERRED

omega-3-acid ethyl esters

Furosemide

pravastatin sodium

Methyclothiazide

simvastatin

NON PREFERRED

Fenofibric Acid

Aldactazide

PREFERRED

Aldactone

Crestor

Bumex

Fibricor

Demadex

Lipofen

Diamox

Niacor

Diuril

Praluent

Dyazide

Simcor

Dyrenium

Vascepa

Edecrin

Welchol

Ethacrynate Sodium

NON PREFERRED

Lasix

Advicor

Maxzide

Antara


9

Colestid sodium sulfacetamide/sulfur wash

Colestid Flavored sulfacetamide sodium

Fenofibrate sulfacetamide sodium/sulfur cleanser

Fenoglide tretinoin

Juxtapid tretinoin microsphere

Kynamro tretinoin microsphere P.M.

Lescol XL PREFERRED

Lofibra Benzamycinpak

Lopid Clindagel

Lovaza Retinoic Acid

Niaspan Retinoic Acid-all Trans

Omega-3/D-3 Wellness Pack Tretinoin

Questran Tretinoin (all-trans Retinoic Acid)

Questran Light NON PREFERRED

Repatha Absorica

Repatha Sureclick Acanya

Tricor Aczone

Triglide Adapalene

Trilipix Akne-mycin

Zetia Atralin

Avar

CARDIOVASCULAR - MISC. Avar LS

Avar LS Cleanser

GENERIC

Avar-e LS

amlodipine besylate/atorvastatin calcium

Azelex

epoprostenol sodium

Benzac Ac Wash

papaverine HCL

Benzac W Wash

sildenafil

Benzaclin

sildenafil citrate

Benzaclin With P.M.

PREFERRED

Benzamycin

Adempas

Benzefoam

Cialis

Benzefoamultra

Isoxsuprine HCL

Benziq

Letairis

Benziq LS

Opsumit

Clarifoam EF

Remodulin

Cleocin-t

Stendra

Clindacin Etz

Tracleer

Clindacin PAC

Veletri

Clindap-t

NON PREFERRED

Clinoin

Adcirca

Dermapak Plus

Bidil

Differin

Caduet

Duac

Corlanor

Epiduo

Flolan

Epiduo Forte

Muse

Erygel

Natrecor

Evoclin

Orenitram

Fabior

Revatio

Inova

Tyvaso

Inova 4/1 Acne Control Therapy

Tyvaso Refill

Inova 8/2 Acne Control Therapy

Tyvaso Starter

Klaron

Ventavis

Neuac Kit

Nuox

DERMATOLOGICALS

Onexton

ACNE PRODUCTS

Plexion

GENERIC

Plexion Cleanser

adapalene

Plexion Cleansing Cloths

benzoyl peroxide

Prascion Ra With Sunscreens

benzoyl peroxide SHORT contact

Retin-a


Retin-a Micro

clindamycin/benzoyl peroxide

Retin-a Micro P.M.

erythromycin

Riax

erythromycin/benzoyl peroxide

Rosanil

sodium sulfacetamide

Rosula

sodium sulfacetamide/sulfur

Sodium Sulfacetamide/Sulfur

sodium sulfacetamide/sulfur cleanser

Sodium Sulfacetamide/Sulfur Cleanser IN Urea

sodium sulfacetamide/sulfur cleansing cloths

Sodium Sulfacetamide/Sulfur IN Urea

sodium sulfacetamide/sulfur green

Sulfoam

sodium sulfacetamide/sulfur w/sunscreen

Sumadan Kit


10

Sumadan Wash Ecoza

Sumadan XLT Ertaczo

Sumaxin Exelderm

Sumaxin CP Kit Extina

Sumaxin Ts Halotin

Sumaxin Wash Jublia

Tretin-x Kerydin

Triseon Ketodan Kit

Vanoxide-HC Lamisil Spray

Veltin Loprox

Zacare 4% Kit Loprox Shampoo

Zacare 8% Kit Lotrisone

Ziana Luzu

Mentax

ROSACEA AGENTS Naftifine HCL

Naftin

GENERIC

Nizoral

metronidazole

Oxistat

Doxycycline

Pediaderm AF Complete Kit

PREFERRED

Pedipirox-4 Nail

Finacea

Penlac Nail Lacquer

NON PREFERRED

Recura

Metrocream

Vusion

Metrogel

Xolegel

Metrolotion

Xolegel Corepak

Mirvaso

Xolegel Duo/Head & Shoulders

Noritate

Xolegel Duo/Xolex

Oracea

Rosadan Kit

ANTIVIRALS - TOPICAL

Soolantra

GENERIC

ANALGESICS - TOPICAL acyclovir

NON PREFERRED

NON PREFERRED

Denavir

A.a.g.c. Kit IN Teroderm

Lidovir

Baclofen

Xerese

Equipto-baclofen

Zovirax

ANTIBIOTICS - TOPICAL

ANTIHISTAMINES-TOPICAL

GENERIC

NON PREFERRED

mupirocin

Allo-pax

mupirocin calcium

Nazirex

PREFERRED

Gentamicin Sulfate

ANTI-INFLAMMATORY AGENTS

NON PREFERRED

Altabax GENERIC

Bactroban diclofenac sodium

Centany AT PREFERRED

Cortisporin Voltaren

Neo-synalar NON PREFERRED

Neo-synalar Kit Dermacinrx Lexitral Pharmapak

Dipentocaine

ANTIFUNGALS - TOPICAL Dsg PAK

Emvoren

GENERIC

Equipto-naproxen

ciclopirox

Extardol

ciclopirox nail lacquer

Flector

ciclopirox olamine

Innoprax-5

clotrimazole

K.b.g.l. IN Teroderm Cream

clotrimazole/betamethasone dipropionate

Ketorolac 2% Gel

econazole nitrate

Lidoprofen

ketoconazole

Novoclair

nystatin

Nuvya

nystatin/triamcinolone

Pennsaid

PREFERRED

Vopac

Ala-quin

Vopac GB

Exoderm

Vopac Kt

NON PREFERRED

Zyvodol

Ciclodan Cream Kit

Ciclodan Solution Kit

ANTIPRURITICS

Ciclopirox Topical Solution Kit

Cnl8 Nail Kit


11

NON PREFERRED mometasone furoate

Prudoxin prednicarbate

Zonalon triamcinolone acetonide

Amcinonide

ANTIPSORIATICS Desoximetasone

Diflorasone Diacetate

GENERIC

PREFERRED

acitretin

Pramosone

calcipotriene

Triamcinolone Acetonide

methoxsalen

NON PREFERRED

Calcitriol

Aclovate

PREFERRED

Advanced Allergy Collection Kit

Anthralin

Ala Scalp

Dritho-creme HP

Capex

Stelara

Carmol-HC

Vectical

Clobex

NON PREFERRED

Clocortolone Pivalate

Cosentyx

Clocortolone Pivalate P.M.

Cosentyx Sensoready Pen

Clodan Kit

Dovonex

Cloderm

Oxsoralen Ultra

Cloderm P.M.

Soriatane

Cordran

Sorilux

Cordran Tape

Tazorac

Cortalo

Zithranol

Cutivate

Zithranol-rr

Derma Silkrx Sds PAK

8-mop

Derma-smoothe/FS Body

Derma-smoothe/FS Scalp

ANTISEBORRHEIC AGENTS

Dermasorb HC

GENERIC

Dermasorb Ta

selenium sulfide

Dermatop


Desonate

sodium sulfacetamide wash

Desowen

PREFERRED

Desowen Cream/Cetaphil Lotion

Seb-prev

Desowen Lotion/Cetaphil Cream

NON PREFERRED

Desowen Ointment/Cetaphil Lotion

Glycolic Acid

Diprolene

Glycolic Acid 70% High Purity

Diprolene AF

Ovace Plus

Elocon

Ovace Plus Wash

Epifoam

Ovace Wash

First-hydrocortisone

Promiseb

Halog

Promiseb Complete

Halonate

Selrx

Kenalog

Tersi Foam

Locoid

TL Triseb

Locoid Lipocream

Luxiq

CORTICOSTEROIDS - TOPICAL

Nucort

GENERIC

Nuzon

alclometasone dipropionate

Olux

augmented betamethasone dipropionate

Olux-e

betamethasone dipropionate

Pandel

betamethasone valerate

Pediaderm HC

calcipotriene/betamethasone dipropionate

Pediaderm Ta

clobetasol propionate

Scalacort DK

clobetasol propionate emollient

Silazone Pharmapak

desonide

Synalar

desoximetasone

Synalar Cream Kit

fluocinolone acetonide

Synalar Ointment Kit

fluocinonide

Synalar Ts

fluocinonide-e

Taclonex

fluticasone propionate

Temovate

halobetasol propionate

Temovate E

hydrocortisone

Texacort

hydrocortisone acetate/aloe

Topicort

hydrocortisone butyrate

Triamsil Combipak

hydrocortisone butyrate (lipid)

Trianex

hydrocortisone butyrate (lipophilic)

Triderma Forte

hydrocortisone valerate

Ultravate

hydrocortisone IN absorbase

Ultravate PAC


12

Ultravate X Elimite

Validerm Emla

Vanos Emulsion SB

Verdeso Epiceram

Westcort Ethyl Chloride

Ethyl Chloride/Fine Pinpoint

IMMUNOMODULATING AGENTS Ethyl Chloride/Fine Stream

Ethyl Chloride/Medium Jet Stream

GENERIC

Ethyl Chloride/Medium Stream

imiquimod

Ethyl Chloride/Mist

tacrolimus

Gebauers Pain Ease

PREFERRED

Gebauers Spray And Stretch

Elidel

Genadur

NON PREFERRED

Genadur Kit

Aldara

Gordofilm

Protopic

Gordons Urea

Zyclara

Hydro 35

Zyclara P.M.

Hydro 40 Foam

Hylatopic

DERMATOLOGICALS - MISC.

Hylatopic Plus

GENERIC

Hylira

ammonium lactate

HPR

episone CRE

HPR Plus

lactic acid

HPR Plus Hydrogel Kit

lactic acid e

HPR Plus/Mb Hydrogel

lactic acid w/vitamin e

Kerafoam

lidocaine

Kerafoam 42

lidocaine HCL

Keralac

lidocaine HCL jelly

Keralyt

lidocaine/prilocaine

Keralyt Scalp

lindane

Lac-hydrin

malathion

Latrix XM

permethrin

Ldo Plus

podofilox

Lidocaine And Tetracaine Cream

salicylic acid

Lidocaine HCL

salicylic acid cream

Lidoderm

salicylic acid lotion

Lidothol

sodium hyaluronate

Lycelle

urea

Mb Hydrogel

urea topical

Medi-derm/L-RX

urea IN zinc undecylenate/lactic acid vehicle

Megrix

urea 40% nail film

Natroba

PREFERRED

Neosalus

Drysol

Neosalus CP

Eurax

Neuvaxin

NON PREFERRED

Nivatopic Plus

Acuicyn Daily Eyelid & Eyelash Cleanser

Nuvail

Alevicyn Antipruritic SG

Ovide

Aluvea

Oxsoralen

Anacaine

Pharmacist Choice Tsx Patch

Arnica Flower

Pliaglis

Atopiclair

Pr Cream

Aurstat Anti-itch Hydrogel

Presera

Aurstat Anti-itch Hydrogel Kit

Pruclair

Avenova

Prumyx

Benzoin Compound Tincture

Pyrogallic Acid

Benzoin Tincture

Qutenza

Boric Acid

Relyyks

Capsiderm

Relyyt

Clever Choice Comfort EZ Patch

Salex

Coal TAR

Salex Cream

Cocaine HCL

Salex Lotion

Condylox

Salicylic Acid

Copasil

Salicylic Acid IN Ammonium Lactate Vehicle

Dermacinrx Duopatch Pharmapak

Salkera

Dermacinrx Neurotral Pharmapak

Salvax

Dermacinrx Surgical Pharmapak

Salvax Duo Plus

Dermasorb XM

Scar Patch

Eletone

Sinelee

Eletone Twinpack

Sklice


13

Solaice Dyural-80

Soothee Entocort EC

Spinosad FLO-pred

Sulfurated Lime Interarticular Joint Kit

Supracil Kenalog-10

Synera Kenalog-40

Tetrix K10-lido

Tropazone K40-lido

Ulesfia LT Injection Kit

Ultrasal-ER Marbeta-l

Umecta Marbeta-25

Umecta Nail Film Mardex-25

Umecta PD Medrol Dosepak

Uramaxin Methylprednisolone

Uramaxin GT Methylprednisolone PF

Uramaxin GT Kit Methylprednisolone/Lidocaine

Utopic Millipred DP

Veregen Mlk F4 Kit

Verrunex Orapred

Vexa Orapred Odt

Virasal Pediapred

Xerac Ac Prednisolone Sodium Phosphate

Xylocaine Pro-c-dure 1 Kit

Pro-c-dure 2 Kit

ENDOCRINE AND METABOLIC Pro-c-dure 3 Kit

Pro-c-dure 4 Kit

CORTICOSTEROIDS

Pro-c-dure 5 Kit

GENERIC

Pro-c-dure 6 Kit

betamethasone sodium phosphate/betamethasone acetate

Rayos

Solu-cortef

budesonide

Solu-medrol

dexamethasone

Triamcinolone

dexamethasone sodium phosphate

Triamcinolone PF

fludrocortisone acetate

Triamcinolone/Lidocaine

hydrocortisone

Uceris

methylprednisolone

Veripred 20

methylprednisolone acetate

methylprednisolone dose pack

ANDROGENS-ANABOLIC

methylprednisolone sodiumsuccinate

prednisolone GENERIC

prednisolone sodium phosphate danazol

prednisolone sodium phosphate odt methyltestosterone

prednisone oxandrolone

Dexamethasone Sodium Phosphate testosterone cypionate

PREFERRED testosterone enanthate

Cortisone Acetate PREFERRED

Dexamethasone Androderm

Medrol Androgel

Millipred Androgel P.M.

Prednisone Androxy

Prednisone Intensol NON PREFERRED

NON PREFERRED Anadrol-50

Aristospan Intra-articular Android

Aristospan Intralesional Aveed

Beta Inject Kit Depo-testosterone

Betalido First-testosterone

Betamethasone SP First-testosterone Mc Compounding Kit

Celestone-soluspan Natesto

Cortef Oxandrin

Depo-medrol Striant

Dexamethasone Intensol Testone Cik

Dexlido Testopel

Dexlido-m Testosterone

Dexpak 10 Day Testred

Dexpak 13 Day

Dexpak 6 Day ESTROGENS

Doubledex

GENERIC

Dyural-l

estradiol

Dyural-lm

estradiol valerate

Dyural-40

estradiol/norethindrone acetate


14

estropipate LO Loestrin FE

norethindrone acetate/ethinyl estradiol LO Minastrin FE

PREFERRED Minastrin 24 FE

Alora Mircette

Climara Pro Modicon

Duavee Nor-QD

Estropipate Norinyl 1+35

Menest Ortho Evra

Premphase Ortho Micronor

Prempro Ortho Tri-cyclen

NON PREFERRED Ortho Tri-cyclen LO

Activella Ortho-cept

Angeliq Ortho-cyclen

Biest/Progesterone Ortho-novum 1/35

Cenestin Ortho-novum 7/7/7

Climara Ovcon-35

Combipatch Plan B

Delestrogen Plan B One-step

Depo-estradiol Quartette

Divigel Safyral

Elestrin Seasonique

Enjuvia Tri-norinyl 28

Estrace Yasmin 28

Estradiol Yaz

Estrasorb

Estrogel PROGESTINS

Evamist

GENERIC

Femhrt Low Dose

medroxyprogesterone acetate

Menostar

megestrol acetate

Minivelle

norethindrone acetate

Prefest

progesterone

Premarin

PREFERRED

Vivelle-dot

Makena

NON PREFERRED

CONTRACEPTIVES

Aygestin

GENERIC Medroxyprogesterone/Lidocaine

desogestrel/ethinyl estradiol Megace ES

drospirenone/ethinyl estradiol Progesterone 10% Kit

levonorgestrel Prometrium

levonorgestrel and ethinyl estradiol Provera

levonorgestrel/ethinyl estradiol

norethindrone ANTIDIABETIC AGENTS

norethindrone & ethinyl estradiol ferrous fumarate

INSULIN

norethindrone acetate/ethinyl estradiol

PREFERRED

norethindrone acetate/ethinyl estradiol/ferrous fumarate

Humalog

norgestimate/ethinyl estradiol

Humalog Kwikpen

Levonorgestrel

Humalog Mix 50/50

PREFERRED

Humalog Mix 50/50 Kwikpen

Natazia

Humalog Mix 75/25

Necon 1/50-28

Humalog Mix 75/25 Kwikpen

Necon 10/11-28

Humulin N

Norinyl 1+50

Humulin N Kwikpen

Nuvaring

Humulin N U-100 Pen

Zovia 1/50e

Humulin R

NON PREFERRED

Humulin R U-500 (concentrated)

Beyaz

Humulin 70/30

Brevicon-28

Humulin 70/30 Kwikpen

Cyclessa

Humulin 70/30 Pen

Desogen

Lantus

Ella

Lantus Solostar

Estrostep FE

Toujeo Solostar

Falessa

NON PREFERRED

Femcon FE

Afrezza

Generess FE

AMYLIN ANALOGS

Loestrin FE 1.5/30

NON PREFERRED

Loestrin FE 1/20

Symlinpen 120

Loestrin 1.5/30-21

Symlinpen 60

Loestrin 1/20-21

INCRETIN MIMETIC AGENTS

Loseasonique

PREFERRED

Bydureon


15

Byetta PREFERRED

Victoza Invokamet

SULFONYLUREAS Janumet

GENERIC Janumet XR

glimepiride Kombiglyze XR

glipizide NON PREFERRED

glipizide ER Actoplus Met

glyburide Actoplus Met XR

glyburide micronized Appformin

tolazamide Appformin-d

Glyburide Avandamet

PREFERRED Avandaryl

Chlorpropamide Duetact

Diabeta Glucovance

Tolazamide Glyxambi

Tolbutamide Prandimet

NON PREFERRED Xigduo XR

Amaryl

Glucotrol BISPHOSPHONATES

Glucotrol XL

GENERIC

Glynase

alendronate sodium

BIGUANIDES

ibandronate sodium

GENERIC

pamidronate disodium

metformin HCL

risedronate sodium

metformin HCL ER

risedronate sodium DR

NON PREFERRED

zoledronic acid

Fortamet

PREFERRED

Glucophage

Alendronate Sodium

Glucophage XR

NON PREFERRED

Glumetza

Actonel

Riomet

Atelvia

MEGLITINIDE ANALOGUES

Binosto

GENERIC

Boniva

nateglinide

Etidronate Disodium

repaglinide

Fosamax

NON PREFERRED

Fosamax Plus D

Prandin

Pamidronate Disodium

Starlix

Reclast

DIABETIC OTHER

Zoledronic Acid

PREFERRED

Zometa

Glucagen Hypokit

Glucagon Emergency Kit

CALCITONINS

Invokana

GENERIC

Jardiance

calcitonin salmon

Proglycem

calcitonin-salmon

NON PREFERRED

NON PREFERRED

Korlym

Fortical

ALPHA-GLUCOSIDASE INHIBIT

Miacalcin

GENERIC

acarbose

PARATHYROID HORMONE

NON PREFERRED

PREFERRED

Glyset

Forteo

Precose

NON PREFERRED

DPP-4 INHIBITORS

Natpara

PREFERRED

Januvia

RANK LIGAND INHIBITORS

Onglyza

PREFERRED

INSULIN SENSITIZING AGENT

Prolia

GENERIC

Xgeva

pioglitazone HCL

NON PREFERRED

CALCIUM REGULATORS - MISC

Actos

NON PREFERRED

Avandia

Ganite

ANTIDIABETIC COMBINATIONS

GENERIC

HORMONE RECEPTOR MDLTR

glipizide/metformin HCL

GENERIC

glyburide/metformin HCL

raloxifene hydrochloride

pioglitazone HCL-glimepiride

NON PREFERRED

pioglitazone HCL/metformin HCL

Evista

repaglinide/metformin hydrochloride


16

Osphena GENERIC

desmopressin acetate

FERTILITY REGULATORS vasopressin

NON PREFERRED

GENERIC

Ddavp

chorionic gonadotropin

Pitressin Synthetic

clomiphene citrate

Stimate

PREFERRED

Vasostrict

Follistim AQ

Gonal-f

CORTICOTROPIN

Gonal-f RFF

Gonal-f RFF Pen NON PREFERRED

Gonal-f RFF Rediject H.p. Acthar

NON PREFERRED

Bravelle PROLACTIN INHIBITORS

Menopur

GENERIC

Ovidrel

cabergoline

Repronex

VASOPRESSIN ANTAGONISTS

LHRH/GNRH AGONIST

PREFERRED

PREFERRED

Samsca

Lupron Depot-PED

NON PREFERRED

Supprelin LA

Vaprisol

Synarel

NON PREFERRED

PROGESTERONE ANTAGONISTS

Lupaneta Pack

NON PREFERRED

Mifeprex

GNRH/LHRH ANTAGONISTS

PREFERRED

METABOLIC MODIFIERS

Cetrotide

GENERIC

NON PREFERRED

calcitriol

Ganirelix Acetate

doxercalciferol

levocarnitine

GROWTH HORMONES

paricalcitol

PREFERRED

sodium phenylbutyrate

Norditropin Cartridge

PREFERRED

Nutropin AQ Nuspin 10

Aldurazyme


Carbaglu


Elaprase

Nutropin AQ Pen

Fabrazyme

Saizen

Kuvan

Saizen Click.easy

Lumizyme

Serostim

Myozyme

NON PREFERRED

Naglazyme

Zorbtive

NON PREFERRED

Ammonul

GHRH

Buphenyl

NON PREFERRED Carnitor

Egrifta Carnitor SF

Cystadane

SOMATOMEDINS Hectorol

Kanuma

PREFERRED

Myalept

Increlex

Orfadin

Ravicti

SOMATOSTATIC AGENTS

Rocaltrol

GENERIC

Sensipar

octreotide acetate

Vimizim

NON PREFERRED

Zemplar

Sandostatin

Sandostatin Lar Depot

THYROID AGENTS

Signifor

GENERIC

Signifor Lar

levothyroxine sodium

Somatuline Depot

liothyronine sodium

methimazole

GH RECEPTOR ANTAGONISTS

propylthiouracil

NON PREFERRED

NON PREFERRED

Somavert

Armour Thyroid

Cytomel

POSTERIOR PITUITARY

Levothyroxine Sodium


17

Nature-throid famotidine

Nature-throid Nt-2.5 glycopyrrolate

Synthroid hyoscyamine sulfate

Tapazole hyoscyamine sulfate odt

Thyrolar-1 hyoscyamine sulfate ER

Thyrolar-1/2 hyoscyamine sulfate SR

Thyrolar-1/4 lansoprazole

Thyrolar-2 lansoprazole/amoxicillin/clarithromycin

Thyrolar-3 methscopolamine bromide

Tirosint misoprostol

Triostat nizatidine

Westhroid omeprazole

Wp Thyroid omeprazole/sodium bicarbonate

pantoprazole sodium

GASTROINTESTINAL rabeprazole sodium

ranitidine HCL

LAXATIVES

sucralfate

GENERIC

Esomeprazole Sodium

lactulose

Famotidine

peg 3350/electrolytes

PREFERRED

peg-3350/electrolytes

Carafate

peg-3350/NACL/NA bicarbonate/KCL

Dexilant

polyethylene glycol 3350

Nexium

NON PREFERRED

Nexium 24HR

Cascara Sagrada

Omeclamox-PAK

Colyte-flavor Packs

Propantheline Bromide

Golytely

Pylera

Kristalose

Symax Duotab

Mineral Oil Heavy

NON PREFERRED

Moviprep

Aciphex

Nulytely/Flavor Packs

Aciphex Sprinkle

Osmoprep

Anaspaz

Pcp 100

Atropen

Prepopik

Atropine Sulfate

Suclear

Axid

Suprep Bowel Prep

Belladonna & Opium

Belladonna Alkaloids & Opium

ANTIDIARRHEALS

Bentyl

GENERIC

Cantil

diphenoxylate/atropine

Cuvposa

loperamide HCL

Cytotec

opium

Deprizine Fusepaq

opium tincture

Esomeprazole Strontium

PREFERRED

Famotidine Premixed

Diphenoxylate/Atropine

First-lansoprazole

Opium Tincture (paregoric)

First-omeprazole

NON PREFERRED

Gabitidine

Fulyzaq

Gastrinex NF

Lomotil

Glycate

Motofen

Helidac

Restora RX

Levbid

Restora Sprinkles

Levsin

Rezyst IM

Levsin/SL

Rezyst SB

Nexium I.v.

Vsl#3 DS

Omeprazole + Syrspend SF Alka

Pamine

ANTACIDS

Pamine Forte

PREFERRED

Pamine FQ

Calcium Carbonate

Pepcid

NON PREFERRED

Prevacid

Sodium Bicarbonate

Prevacid Solutab

Prevpac

ULCER DRUGS

Prilosec

GENERIC

Protonix

atropine sulfate

Robinul

cimetidine

Robinul Forte

cimetidine HCL

Scopolamine Hydrobromide

dicyclomine HCL

Sentradine

esomeprazole magnesium

Zantac

esomeprazole sodium

Zegerid


18

Analpram-HC

ANTIEMETICS Analpram-HC Singles

Anusol-HC

GENERIC

Auryxia

dronabinol

Azulfidine

granisetron HCL

Azulfidine EN-TABS

meclizine HCL

Chenodal

ondansetron odt

Cholbam

ondansetron HCL

Colazal

trimethobenzamide HCL

Cortenema

PREFERRED

Cortifoam

Aloxi

Dexpanthenol

NON PREFERRED

Dipentum

Akynzeo

Eliphos

Anzemet

Entereg

Cesamet

Entyvio

Diclegis

Fosrenol

Dimenhydrinate

Gastrocrom

Emend

Gattex

Granisol

Giazo

Marinol

Lidocaine HCL-hydrocortisone Acetate With Aloe

Sancuso

Lotronex

Tigan

Metoclopramide Odt

Transderm-scop

Metozolv Odt

Zofran

Pentasa

Zofran Odt

Phoslo

Zuplenz

Phoslyra

Procort

DIGESTIVE AIDS

Proctocort

PREFERRED

Rectiv

Creon

Reglan

Pancrelipase

Renagel

Zenpep

Rowasa

NON PREFERRED

Uceris

Sucraid

Urso Forte

Urso 250

GASTROINTESTINAL - MISC.

Velphoro

GENERIC

alosetron hydrochloride

GENITOURINARY

balsalazide disodium

URINARY ANTI-INFECTIVES

calcium acetate

cromolyn sodium GENERIC

hydrocort ene 100MG methenamine hippurate

hydrocortisone methenamine mandelate

hydrocortisone acetate/lidocaine HCL nitrofurantoin

hydrocortisone acetate/pramoxine nitrofurantoin macrocrystals

lactulose nitrofurantoin monohydrate

lidocaine HCL/hydrocortisone acetate nitrofurantoin monohydrate/macrocrystals

mesalamine PREFERRED

metoclopramide odt Methenamine Mandelate

metoclopramide HCL NON PREFERRED

sulfasalazine Furadantin

ursodiol Hiprex

PREFERRED Macrobid

Amitiza Macrodantin

Canasa Monurol

Cimzia Prosed/DS

Cimzia Starter Kit Uretron D/S

Lialda Urimar-t

Linzess Urogesic-blue

Movantik Uroqid #2

Proctofoam HC

Relistor URINARY ANTISPASMODICS

Remicade

GENERIC

Renvela

bethanechol chloride

Sevelamer Carbonate

flavoxate HCL

Sfrowasa

oxybutynin chloride

NON PREFERRED

oxybutynin chloride ER

Actigall

tolterodine tartrate

Analpram Advanced

tolterodine tartrate ER


19

trospium chloride Cardura XL

trospium chloride ER Cystagon

PREFERRED Flomax

Gelnique Jalyn

Vesicare K-phos NO 2

NON PREFERRED Lithostat

Detrol Oracit

Detrol LA Procysbi

Ditropan XL Proscar

Enablex Pyridium

Myrbetriq Shohls Solution Modified

Oxytrol Thiola

Sanctura Urocit-k 10

Sanctura XR Urocit-k 15

Toviaz Urocit-k 5

Urecholine Uroxatral

VAGINAL PRODUCTS HEMATOLOGAICAL

GENERIC

HEMATOPOIETIC AGENTS


GENERIC

metronidazole vaginal

cyanocobalamin

terconazole

folic acid

PREFERRED

folic acid/vitamin b-6/vitamin b-12

Premarin

sodium ferric gluconate complex/sucrose

NON PREFERRED

Iron Asp Gly/ Polysacch Compl/Ascorb CAL/B12/Fa/C Threon/Suc

Avc

Cleocin PREFERRED

Clindesse Cerezyme

Crinone Folitab 500

Endometrin Mozobil

Estrace Neumega

Estring Nplate

Fem PH NON PREFERRED

Femring Abaneu-SL

First-progesterone VGS 100 Compounding Kit Albafort

First-progesterone VGS 200 Compounding Kit Animi-3

First-progesterone VGS 25 Compounding Kit Animi-3/Vitamin D

First-progesterone VGS 400 Compounding Kit B-6 Folic Acid

First-progesterone VGS 50 Compounding Kit Biferarx

Gynazole-1 Cenfol

Metrogel-vaginal Centratex

Nuvessa Cerdelga

Relagard Ciferex

Terazol 3 Corvite 150

Terazol 7 Dermacinrx Purefolix

Vagifem Divista

Droxia

GENITOURINARY - MISC. Ed Cyte F

Elelyso

GENERIC

Feraheme

alfuzosin HCL ER

Feriva

citric acid/sodium citrate

Feriva 21/7

dutasteride

Ferivafa

dutasteride/tamsulosin hydrochloride

Ferralet 90

finasteride

Ferrex 150 Forte Plus

hydrochloric acid

Ferrex 28

phenazopyridine HCL

Ferrlecit

potassium citrate ER

Ferro-plex Hematinic

potassium citrate-citric acid crystals

Ferrotrin

potassium citrate/citric acid

Focalgin Dss

potassium citrate/sodium citrate/citric acid

Folgard RX

sodium citrate/citric acid

Folic Acid

tamsulosin HCL

Folivane-f

tricitrates

Folivane-plus

PREFERRED

Foltrate

Cytra-3

Fusion Plus

Elmiron

Fusion Sprinkles

Rapaflo

Granix

NON PREFERRED

Hematogen Fa

Avodart


20

Hematron-AF Fragmin

Hemocyte Plus Heparin Lock Flush

Hemocyte-f Heparin Sodium

Hydroxocobalamin Heparin Sodium/D5W

Icar-c Plus Heparin Sodium/NACL 0.45%

Infed Heparin Sodium/Sodium Chloride 0.9%

Injectafer Iprivask

Integra F Lovenox

Integra Plus Savaysa

Irospan 24/6

Is 24/6 HEMOSTATICS

Leukine

GENERIC

Maxaron Forte

aminocaproic acid

Maxfe

tranexamic acid

Mircera

NON PREFERRED

Multigen

Amicar

Multigen Folic

Aminocaproic Acid

Multigen Plus

Artiss

MV FE Asparto Gly/FE Fum/Succ Acid/Vit C/Threonic Acd/B12/Fa

Astringyn

Cyklokapron

MV FE Asparto Gly/Vit C/Vit B12/CA Threonate/Succ Acd/Stomac

Evicel

Evithrom

Nascobal

Lysteda

Natalvirt Flt

Recothrom

Nephron Fa

Recothrom Spray Kit

Neulasta

Thrombin-jmi Diluent

Neulasta Delivery Kit

Thrombin-jmi Epistaxis

Neupogen

Thrombin-jmi Syringe Spray Kit

Novaferrum

Thrombin-jmi W/Dil Spray P.M. Actuator

Omontys

Thrombogen

Pre-folic

Tisseel

Procrit

Tisseel VH

Proferrin-forte

Promacta

HEMATOLOGICAL - MISC.

Protectiron

GENERIC

Tandem F

anagrelide hydrochloride

Tandem Plus

cilostazol

Triferic

clopidogrel

Venofer

dipyridamole

Vpriv

hetastarch 6%/NACL

Zavesca

pentoxifylline ER

ticlopidine HCL

ANTICOAGULANTS

Aspirin/Dipyridamole

GENERIC

PREFERRED

argatroban

Advate

bivalirudin

Alphanate/Von Willebrand Factor Complex/Human

enoxaparin sodium

Alphanine SD

fondaparinux sodium

Bebulin

heparin lock

Benefix

heparin lock flush

Berinert

heparin lock flush for flushing vascular access devices

Cinryze

heparin lock flush/NACL for flushing vascular access devices

Corifact

Effient

heparin sodium

Feiba

heparin sodium dcu

Feiba NF

heparin sodium lock flush

Firazyr

heparin sodium/sodium chloride 0.9% premix

Hemofil M

heparin sodium/D5W

Humate-p

heparin sodium/NACL 0.9%

Koate-dvi

warfarin sodium

Monoclate-p

PREFERRED

Mononine

Pradaxa

Novoseven Rt

Xarelto

Profilnine

Xarelto Starter Pack

Profilnine SD

NON PREFERRED

Recombinate

Angiomax

Riastap

Argatroban

Soliris

Arixtra

Ticlopidine HCL

Coumadin

Wilate

Eliquis


21

NON PREFERRED Oravig

Activase Peridex

Aggrastat Prevident

Aggrenox Prothelial

Agrylin Salagen

Brilinta

Cathflo Activase NEUROLOGY, CNS, PSYCH

Durlaza

ANTIANXIETY AGENTS

Helixate FS

GENERIC

Hespan

alprazolam

Hextend

alprazolam odt

Integrilin

alprazolam ER

Ixinity

buspirone HCL

Kalbitor

chlordiazepoxide HCL

Kengreal

clorazepate dipotassium

Kinlytic

diazepam

Kogenate FS

droperidol

Kogenate FS Bio-set

gene-xene TAB 15MG

LMD 10% Dextrose 5%

gene-xene TAB 3.75MG

LMD 10% Sodium Chloride 0.9%

gene-xene TAB 7.5MG

Novoeight

hydroxyzine pamoate

Nuwiq

hydroxyzine HCL

Persantine

lorazepam

Plavix

meprobamate

Pletal

oxazepam

Protamine Sulfate

Hydroxyzine Pamoate

Reopro

NON PREFERRED

Retavase

Alprazolam Intensol

Retavase Half-kit

Ativan

Tnkase

Diazepam

Voluven

Gabavale-5

Xyntha

Gabazolamine

Xyntha Solofuse

Gabazolamine-0.5

Zontivity

Hydroxyzine HCL

Niravam

MOUTH/THROAT/DENTAL AGENT

Sentrazolam AM 0.25

Tranxene T

GENERIC

Valium

cevimeline HCL

Vistaril

chlorhexidine gluconate

Xanax

chlorhexidine gluconate oral rinse

Xanax XR

clotrimazole

lidocaine viscous

ANTIDEPRESSANTS

lidocaine HCL

GENERIC

lidocaine HCL viscous

amitriptyline HCL

nystatin

bupropion HCL

pilocarpine hydrochloride

bupropion HCL ER

pilocarpine HCL

bupropion HCL SR

stannous fluoride oral rinse

bupropion HCL XL

triamcinolone acetonide

citalopram hydrobromide

triamcinolone IN orabase

clomipramine HCL

NON PREFERRED

desipramine HCL

Aquoral

doxepin HCL

Caphosol

duloxetine HCL

Debacterol

escitalopram oxalate

Evoxac

fluoxetine DR

First-bxn Mouthwash

fluoxetine HCL

First-dukes Mouthwash

fluvoxamine maleate

First-marys Mouthwash

fluvoxamine maleate ER

First-mouthwash Blm

imipramine pamoate

Gel-kam Oral Care Rinse

imipramine HCL

Gelclair

mirtazapine

Lta 360 Kit

mirtazapine odt

Nafrinse Daily/Acidulated

nefazodone HCL

Nafrinse Daily/Neutral

nortriptyline HCL

Nafrinse Weekly

paroxetine HCL

Neutrasal

paroxetine HCL ER

Numoisyn

phenelzine sulfate

Orafate

protriptyline HCL


22

sertraline HCL clozapine odt

tranylcypromine sulfate fluphenazine decanoate

trazodone HCL fluphenazine HCL

trimipramine maleate haloperidol

venlafaxine HCL haloperidol decanoate

venlafaxine HCL ER haloperidol lactate

Amoxapine lithium carbonate

Doxepin HCL lithium carbonate ER

Nefazodone HCL loxapine

Nortriptyline HCL loxapine succinate

Venlafaxine HCL ER olanzapine

PREFERRED olanzapine odt

Fluoxetine HCL paliperidone ER

Forfivo XL perphenazine

Maprotiline HCL prochlorperazine

Paxil prochlorperazine edisylate

Pristiq prochlorperazine maleate

NON PREFERRED quetiapine fumarate

Anafranil risperidone

Aplenzin risperidone odt

Appbutamone thioridazine HCL

Appbutamone-d thiothixene

Brintellix trifluoperazine HCL

Celexa ziprasidone HCL

Cymbalta Aripiprazole Odt

Desvenlafaxine ER Clozapine Odt

Duloxetine HCL PREFERRED

Effexor XR Abilify Discmelt

Emsam Fluphenazine HCL

Fetzima Saphris

Fetzima Titration Pack Seroquel XR

Gaboxetine NON PREFERRED

Irenka Abilify

Khedezla Abilify Maintena

Lexapro Adasuve

Luvox CR Chlorpromazine HCL

Marplan Clozaril

Nardil Compazine

Norpramin Equetro

Oleptro Fanapt

Pamelor Fanapt Titration Pack

Parnate Fazaclo

Paxil CR Geodon

Pexeva Haldol

Prozac Haldol Decanoate 100

Prozac Weekly Haldol Decanoate 50

Remeron Invega

Remeron Soltab Invega Sustenna

Sentraflox AM-10 Invega Trinza

Sentralopram AM-10 Latuda

Sentravil PM-25 Lithium

Sentroxatine Lithium Carbonate

Surmontil Lithobid

Tofranil Loxitane

Tofranil-PM Molindone Hydrochloride

Trazamine Rexulti

Viibryd Risperdal

Viibryd Starter Pack Risperdal Consta

Vivactil Risperdal M-TAB

Wellbutrin Seroquel

Wellbutrin SR Versacloz

Wellbutrin XL Zyprexa

Zoloft Zyprexa Relprevv

Zyprexa Zydis

ANTIPSYCHOTICS

HYPNOTICS

GENERIC

aripiprazole GENERIC

chlorpromazine HCL dexmedetomidine HCL

clozapine estazolam


23

eszopiclone Evekeo

flurazepam HCL Focalin

phenobarbital Focalin XR

temazepam Intuniv

triazolam Kapvay

zaleplon Kapvay Dose Pack

zolpidem tartrate Metadate CD

zolpidem tartrate ER Methylin

Flurazepam HCL Nuvigil

Phenobarbital Procentra

NON PREFERRED Provigil

Ambien Quillivant XR

Ambien CR Ritalin

Amytal Sodium Ritalin LA

Belsomra Ritalin SR

Butisol Sodium Sentramodafin AM-100

Doral Zenzedi

Edluar

Gabazolpidem-5 ANTICONVULSANTS

Halcion

GENERIC

Hetlioz

carbamazepine

Intermezzo

carbamazepine ER

Lunesta

clonazepam

Nembutal Sodium

clonazepam odt

Phenobarbital Sodium

divalproex sodium

Precedex

divalproex sodium DR

Quazepam

divalproex sodium ER

Restoril

ethosuximide

Rozerem

felbamate

Seconal

fosphenytoin sodium

Sentrazolpidem PM-5

gabapentin

Silenor

lamotrigine

Sonata

lamotrigine odt

Strazepam

lamotrigine titration

Zolpimist

lamotrigine ER

levetiracetam

ADHD, NARCOLEPSY, ETC.

levetiracetam ER

GENERIC oxcarbazepine

amphetamine/dextroamphetamine phenytoin

caffeine citrate phenytoin sodium

clonidine HCL ER phenytoin sodium extended

dexmethylphenidate HCL primidone

dexmethylphenidate HCL ER tiagabine hydrochloride

dextroamphetamine sulfate topiramate

dextroamphetamine sulfate ER valproate sodium

doxapram HCL valproic acid

guanfacine ER zonisamide

methamphetamine HCL PREFERRED

methylphenidate hydrochloride Diastat Acudial

methylphenidate HCL Diastat Pediatric

methylphenidate HCL CD Diazepam

methylphenidate HCL ER Lamictal

methylphenidate HCL SR Lamictal Chewable Dispersible

modafinil Lamictal Starter/Not Taking Carbamazepine

Methylphenidate HCL ER Lamictal Starter/Taking Carbamazepine/Not Taking Valproate

PREFERRED

Lamictal Starter/Taking Valproate

Strattera

Lyrica

Vyvanse

NON PREFERRED

NON PREFERRED

Aptiom

Adderall

Banzel

Adderall XR

Carbatrol

Aptensio XR

Celontin

Cafcit

Cerebyx

Caffeine/Sodium Benzoate

Depacon

Concerta

Depakene

Daytrana

Depakote

Desoxyn

Depakote ER

Dexedrine

Depakote Sprinkles

Dopram


24

Dilantin Requip

Dilantin Infatabs Requip XL

Dilantin-125 Rytary

Fanatrex Fusepaq Sinemet

Felbatol Sinemet CR

Fycompa Stalevo 100

Gabitril Stalevo 125

Keppra Stalevo 150

Keppra XR Stalevo 200

Klonopin Stalevo 50

Lamictal Odt Stalevo 75

Lamictal XR Tasmar

Levetiracetam Zelapar

Mysoline

Neurontin NEUROLOGY, PSYCH - MISC.

Onfi

GENERIC

Oxtellar XR

acamprosate calcium DR

Peganone

disulfiram

Phenytek

donepezil HCL

Potiga

ergoloid mesylates

Qudexy XR

fluoxetine

Sabril

galantamine hydrobromide

Stavzor

memantine hydrochloride

Tegretol

memantine HCL

Tegretol-XR

memantine HCL titration PAK

Therapentin-60

olanzapine/fluoxetine

Therapentin-90

pimozide

Topamax

rivastigmine tartrate

Topamax Sprinkle

rivastigmine transdermal system

Topiramate ER

tetrabenazine

Trileptal

Ergoloid Mesylates

Trokendi XR

Galantamine Hydrobromide

Vimpat

PREFERRED

Zarontin

Ampyra

Zonegran

Avonex

Avonex Pen

ANTIPARKINSON AGENTS

Chlordiazepoxide/Amitriptyline

GENERIC Copaxone

amantadine HCL Namenda XR

benztropine mesylate Namenda XR Titration Pack

bromocriptine mesylate Perphenazine/Amitriptyline

carbidopa Plegridy

carbidopa/levodopa Plegridy Starter Pack

carbidopa/levodopa odt Tecfidera

carbidopa/levodopa ER Tecfidera Starter Pack

entacapone NON PREFERRED

pramipexole dihydrochloride Antabuse

pramipexole dihydrochloride ER Aricept

ropinirole ER Aricept Odt

ropinirole HCL Aubagio

selegiline HCL Brisdelle

tolcapone Campral

trihexyphenidyl HCL Exelon

Carbidopa/Levodopa/Entacapone Gilenya

PREFERRED Gralise

Apokyn Gralise Starter

NON PREFERRED Horizant

Amantadine HCL Lemtrada

Azilect Namenda

Cogentin Namenda Titration PAK

Comtan Namzaric

Duopa Nuedexta

Eldepryl Orap

Lodosyn Razadyne

Mirapex Razadyne ER

Mirapex ER Sarafem

Neupro Savella

Parcopa Savella Titration Pack

Parlodel Symbyax


25

Tysabri Supartz

Xenazine Supartz Fx

Xyrem Tabradol Fusepaq

Therabenzaprine-60

NEUROMUSCULAR AGENTS Therabenzaprine-90

Therabenzaprine-90-5

GENERIC

Tizanidine Comfort PAC

atracurium besylate

Zanaflex

cisatracurium besylate

pancuronium bromide

ANTIMYASTHENIC AGENTS

riluzole

rocuronium bromide GENERIC

vecuronium bromide neostigmine methylsulfate

PREFERRED pyridostigmine bromide

Botox PREFERRED

NON PREFERRED Guanidine HCL

Anectine NON PREFERRED

Dysport Bloxiverz

Myobloc Enlon

Nimbex Enlon-plus

Quelicin Mestinon

Quelicin 1000 Mestinon Timespan

Rilutek Neostigmine Methylsulfate

Xeomin Prostigmin

Zemuron Regonol

MUSCULOSKELETAL AGENTS OPHTHALMOLOGY AND OTIC

GENERIC

ANTI-INFECTIVES

baclofen

GENERIC

carisoprodol

bacitracin/polymyxin b

carisoprodol/aspirin

ciprofloxacin HCL

carisoprodol/aspirin/codeine

erythromycin

chlorzoxazone

gatifloxacin

cyclobenzaprine HCL

gentamicin sulfate

dantrolene sodium

levofloxacin

metaxalone

neomycin/bacitracin/polymyxin

methocarbamol

neomycin/polymyxin/bacitracin zinc

orphenadrine citrate

neomycin/polymyxin/gramicidin

orphenadrine citrate ER

ofloxacin

orphenadrine/asa/caffeine

polymyxin b sulfate/trimethoprim sulfate

tizanidine HCL


Carisoprodol

sulfacetamide sodium

Dantrolene Sodium

tobramycin sulfate

PREFERRED

trifluridine

Euflexxa

trimethoprim sulfate/polymyxin b sulfate

Gablofen

PREFERRED

Lioresal Intrathecal

Bacitracin

Synvisc

Moxeza

Synvisc One

Natacyn

NON PREFERRED

Sulfacetamide Sodium

Amrix

Vigamox

Cyclobenzaprine Comfort PAC

NON PREFERRED

Dantrium

Azasite

Dantrium IV

Besivance

Fexmid

Betadine Ophthalmic Prep

Flexepax

Bleph-10

Gel-one

Ciloxan

Hyalgan

Garamycin

Lorzone

Mitosol

Metaxalone

Neosporin

Monovisc

Ocuflox

Norflex

Polytrim

Orthovisc

Tobrex

Parafon Forte DSC

Viroptic

Prazolamine

Zirgan

Robaxin

Zymaxid

Robaxin-750

Ryanodex

ARTIFICIAL TEAR/LUBRICANT

Skelaxin

NON PREFERRED

Soma

Lacrisert


26

BETA-BLOCKERS CYCLOPLEGIC MYDRIATICS

GENERIC GENERIC

betaxolol HCL atropine sulfate

carteolol HCL cyclopentolate HCL

dorzolamide HCL/timolol maleate homatropine HBR

levobunolol HCL PREFERRED

timolol maleate Atropine Sulfate

timolol maleate ophthalmic gel forming Cyclogyl

Metipranolol Isopto Homatropine

PREFERRED NON PREFERRED

Betoptic-s Cyclomydril

Combigan Isopto Atropine

Levobunolol HCL Isopto Hyoscine

Timoptic Ocudose

NON PREFERRED DECONGESTANTS

Betagan

GENERIC

Betimol

phenylephrine HCL

Cosopt

PREFERRED

Cosopt PF

Naphazoline HCL

Istalol

NON PREFERRED

Timoptic

Mydfrin

Timoptic-xe

MIOTICS

OPHTHALMIC STEROIDS

GENERIC

GENERIC

pilocarpine HCL

dexamethasone sodium phosphate

PREFERRED

fluorometholone

Isopto Carbachol

neomycin/polymyxin/bacitracin/hydrocortisone

Phospholine Iodide

neomycin/polymyxin/dexamethasone

NON PREFERRED

prednisolone acetate

Isopto Carpine

sulfacetamide sodium/prednisolone sodium phosphate

tobramycin/dexamethasone

ADRENERGIC AGENTS

PREFERRED

GENERIC

Dexamethasone Sodium Phosphate

apraclonidine

FML

brimonidine tartrate

FML Forte

PREFERRED

Pred Mild

Alphagan P

Prednisolone Sodium Phosphate

NON PREFERRED

NON PREFERRED

Iopidine

Alrex

Simbrinza

Blephamide

Blephamide S.o.p.

IMMUNOMODULATORS

Durezol

NON PREFERRED

Flarex

Restasis

FML Liquifilm

Lotemax

LOCAL ANESTHETICS

Maxidex

GENERIC

Maxitrol

proparacaine HCL

Neomycin/Polymyxin/Hydrocortisone

tetracaine HCL

Omnipred

NON PREFERRED

Pred Forte

Akten

Pred-G

Alcaine

Pred-G S.o.p.

Tobradex

OPHTHALMICS - MISC.

Tobradex ST

GENERIC

Vexol

azelastine HCL

Zylet

bromfenac

cromolyn sodium

PROSTAGLANDINS

diclofenac sodium

GENERIC

dorzolamide HCL

latanoprost

epinastine HCL

Bimatoprost

flurbiprofen sodium

PREFERRED

ketorolac tromethamine

Lumigan

olopatadine HCL

Travatan Z

PREFERRED

Travoprost

Azopt

NON PREFERRED

Pataday

Xalatan

NON PREFERRED

Acular


27

Acular LS PREFERRED

Acuvail Choline Magnesium Trisalicylate

Alocril Dologesic

Alomide Prialt

Bepreve Tencon

Cystaran NON PREFERRED

Elestat Bupap

Emadine Disalcid

Ilevro Dolgic Plus

Lastacaft Equagesic

Nevanac Esgic

Ocufen Fioricet

Optivar Fiorinal

Patanol Levacet

Pazeo Ofirmev

Prolensa Phrenilin Forte

Trusopt Rhinoflex-650

Staflex

OTIC AGENTS Vanatol LQ

GENERIC

ANALGESICS - OPIOID

acetic acid

antipyrine/benzocaine GENERIC

fluocinolone acetonide acetaminophen/caffeine/dihydrocodeine

fluocinolone acetonide ear drops acetaminophen/codeine

hydrocortisone/acetic acid acetaminophen/codeine #2

neomycin/polymyxin/hydrocortisone acetaminophen/codeine #3

neomycin/polymyxin/HC acetaminophen/codeine #4

ofloxacin acetaminophen/codeine phosphate

PREFERRED alfentanil

Acetic Acid/Aluminum Acetate buprenorphine HCL

NON PREFERRED buprenorphine HCL/naloxone HCL

Antipyrine/Benzocaine butalbital/acetaminophen/caffeine/codeine

Auralgan butalbital/aspirin/caffeine/codeine

Cetraxal butorphanol tartrate

Cipro HC codeine sulfate

Ciprodex fentanyl

Ciprofloxacin fentanyl citrate oral transmucosal

Coly-mycin S hydrocodone bitartrate/acetaminophen

Cortisporin hydrocodone/acetaminophen

Cortisporin-tc hydrocodone/ibuprofen

Cresylate hydromorphone HCL

Dermotic hydromorphone HCL dosette

Myoxin hydromorphone HCL ER

Otozin meperidine HCL

Pramotic methadone HCL

Vosol HC morphine sulfate

morphine sulfate ER

OXYTOCICS nalbuphine HCL

oxycodone HCL

oxycodone/acetaminophen

GENERIC

oxycodone/aspirin

methylergonovine maleate

oxycodone/ibuprofen

oxytocin

oxymorphone hydrochloride

NON PREFERRED

oxymorphone hydrochloride ER

Cervidil

pentazocine/acetaminophen

Hemabate

pentazocine/naloxone HCL

Oxytocin/Lactated Ringers

tramadol hydrochloride/acetaminophen

Pitocin

tramadol HCL

Prepidil

tramadol HCL ER

Prostin E2

Aspirin-caffeine-dihydrocodeine

Fentanyl

PAIN MANAGEMENT

Hydrocodone Bitartrate/Acetaminophen

ANALGESICS - NONNARCOTIC

Hydrocodone/Acetaminophen

GENERIC

Hydromorphone HCL/Sodium Chloride

butalbital/acetaminophen

Morphine Sulfate ER

butalbital/acetaminophen/caffeine

Oxycodone HCL ER

butalbital/aspirin/caffeine

PREFERRED

choline magnesium trisalicylate

Hydromorphone HCL

diflunisal

Morphine Sulfate

salsalate


28

Oxycontin Ultiva

Suboxone Ultracet

NON PREFERRED Ultram

Acetaminophen/Caffeine/Dihydrocodeine Bitartrate Ultram ER

Actiq Vicoprofen

Alfenta Xartemis XR

Avinza Xodol

Bunavail Xolox

Buprenex Zamicet

Butrans Zubsolv

Capital/Codeine Zydone

Codeine Sulfate

Conzip ANTI-INFLAMMATORY

Demerol

GENERIC

Dilaudid

celecoxib

Dilaudid-HP

diclofenac potassium

Dolophine

diclofenac sodium DR

Duragesic

diclofenac sodium ER

Exalgo

diclofenac sodium/misoprostol

Fentanyl Citrate/Sodium Chloride

etodolac

Fioricet/Codeine

etodolac ER

Fiorinal/Codeine #3

flurbiprofen

Hycet

ibuprofen

Hydromorphone HCL ER

indomethacin

Hydromorphone HCL/NACL

indomethacin ER

Hysingla ER

ketoprofen

Ibudone

ketorolac tromethamine

Infumorph 200

leflunomide

Infumorph 500

mefenamic acid

Ionsys

meloxicam

Levorphanol Tartrate

nabumetone

Liquicet

naproxen

Lortab

naproxen sodium

Magnacet

naproxen sodium CR

Maxidone

naproxen sodium ER

Meperidine HCL

oxaprozin

Methadone HCL

piroxicam

Methadose

sulindac

Methadose Sugar-free

tolmetin sodium

Morphine Sulfate Add-vantage

Meclofenamate Sodium

Morphine Sulfate/Sodium Chloride

Tolmetin Sodium

MS Contin

PREFERRED

Norco

Fenoprofen Calcium

Nucynta

Humira

Opana

Humira Pediatric Crohns Disease Starter Pack

Opana ER (crush Resistant)

Humira Pen

Oxaydo

Humira Pen-crohns Diseasestarter

Oxecta

Humira Pen-psoriasis Starter

Oxycodone HCL

Ilaris

Percocet

Ketoprofen ER

Percodan

Meloxicam

Primlev

Naproxen

Reprexain

Rasuvo

Roxicet

Simponi

Roxicodone

Simponi Aria

Subsys

NON PREFERRED

Synalgos-dc

Actemra

Synapryn Fusepaq

Anaprox

Talwin

Anaprox DS

Theracodeine-300

Arava

Theracodophen-low-90

Arcalyst

Theracodophen-325

Arthrotec 50

Theracodophen-650

Arthrotec 75

Theracodophen-750

Caldolor

Theratramadol-60

Cataflam

Theratramadol-90

Celebrex

Tramadol HCL ER

Daypro

Trezix

Derma Silkrx Anodynexa PAK

Tylenol/Codeine #3

Derma Silkrx Diclopak

Tylenol/Codeine #4


29

Dermacinrx Inflammatral PAK D.h.e. 45

Enbrel Ergomar

Enbrel Sureclick Frova

EC-naprosyn Imitrex

Feldene Imitrex Statdose Refill

Flanax Pain Relief Kit Imitrex Statdose System

Ibuprofen Comfort PAC Maxalt

Indocin Maxalt-MLT

Indomethacin Migergot

Indomethacin Sodium Migral

IC 400 Migranal

IC 800 Relpax

Ketorocaine-l Sumavel Dosepro

Ketorocaine-lm Treximet

Ketorolac Tromethamine Zomig

Kineret Zomig ZMT

Meloxicam Comfort PAC

Mobic GOUT AGENTS

Nalfon

GENERIC

Naprelan

allopurinol

Naprosyn

probenecid

Naproxen Comfort PAC

probenecid/colchicine

Neoprofen

PREFERRED

Orencia

Colcrys

Otezla

Uloric

Otrexup

NON PREFERRED

Ponstel

Aloprim

Prastera

Colchicine

Rheumatrex

Krystexxa

Ridaura

Mitigare

Sprix

Zyloprim

Therafeldamine

Theraprofen-60

LOCAL ANESTHETICS-INJ

Theraprofen-800

GENERIC

Theraprofen-90

bupivacaine HCL

Theraproxen-500

bupivacaine/epinephrine

Theraproxen-60

chloroprocaine HCL

Theraproxen-90

lidocaine HCL

Tivorbex

lidocaine/epinephrine

Trepadiclofen-25

ropivacaine

Trepoxen-250

ropivacaine HCL

Trepoxicam-7.5

Tetracaine HCL

Vivlodex

NON PREFERRED

Voltaren-XR

Articadent Dental

Xeljanz

BD Pudendal/Local Block Tray 1% Lidocaine

Zipsor

Carbocaine

Citanest Forte Dental

MIGRAINE PRODUCTS

Citanest Plain Dental

GENERIC

Durasafe Spinal/Epidural Tray/1% Xylocaine/19GX36"close CATH

almotriptan malate

Durasafe Spinal/Epidural Tray/1% Xylocaine/19GX36"open CATH

dihydroergotamine mesylate

naratriptan HCL

Durasafe Spinal/Epidural Tray/1% Xylocaine/20GX36"close CATH

rizatriptan benzoate

rizatriptan benzoate odt

Durasafe Spinal/Epidural Tray/1% Xylocaine/20GX36"open CATH

sumatriptan succinate

sumatriptan succinate refill

Exparel

zolmitriptan

Lidocaine HCL/Dextrose

zolmitriptan odt

Marcaine

Dihydroergotamine Mesylate

Marcaine W/O Epi

Sumatriptan Succinate

Marcaine/Epinephrine

PREFERRED

Marlido-25

Sumatriptan

Monoject Bone Marrow Biopsy Prepping Tray

Zomig Nasal Spray

Monoject Bone Marrow Biopsy Tray/Biop Aspir Needle 11GX4"

NON PREFERRED

Alsuma

Monoject Bone Marrow Biopsy Tray/Biop Aspir Needle 8GX4"

Amerge

Monoject Bone Marrow Biopsy Tray/Sternal-iliac Needle 16G

Axert

Cafergot

Naropin

Cambia

Nesacaine


30

Nesacaine-mpf COUGH/COLD/ALLERGY

Sensorcaine-mpf/Epinephrine

GENERIC

Turkel Paracentesis Procedure Tray/8french

acetylcysteine

Xylocaine

benzonatate

Xylocaine-mpf

bromphen/pseudoephedrine HCL/dextromethorphan HBR

Xylocaine-mpf/Epinephrine

hydrocodone bitartrate/chlorpheniramine maleate/PSE

Xylocaine/Epinephrine

hydrocodone bitartrate/homatropine methylbromide

hydrocodone polistirex/chlorpheniramine polistirex

RESPIRATORY, ALLERGY, ETC

hydrocodone/homatropine

phenylephrine/guaifenesin

ANTIHISTAMINES

promethazine-DM

GENERIC

promethazine/codeine

carbinoxamine maleate

promethazine/dextromethorphan

cetirizine HCL

promethazine/phenylephrine

clemastine fumarate

promethazine/phenylephrine/codeine

cyproheptadine HCL

sodium chloride

desloratadine

PREFERRED

desloratadine odt

Dallergy

diphenhydramine HCL

J-max

levocetirizine dihydrochloride

Mucinex D

promethazine HCL

Mucinex Maximum Strength

promethazine HCL plain

Promethazine/Phenylephrine

Clemastine Fumarate

NON PREFERRED

PREFERRED

Carbaphen 12

Allegra Allergy Childrens

Carbaphen 12 PED

Dexchlorpheniramine Maleate

Clarinex-d 12 HOUR

NON PREFERRED

Clarinex-d 24 HOUR

Brompheniramine

Codar AR

Brompheniramine Tannate

Cpb Wc

Clarinex

Decon-a

Clarinex Reditabs

Dextromethorphan HBR/Chlorpheniramine/Phenylephrine HCL

Dicopanol Fusepaq

Karbinal ER

Exactuss

Palgic

Flowtuss

Phenergan

Gilphex TR

Respa-BR

Giltuss

Xyzal

Giltuss PED-c

Giltuss TR

NASAL AGENTS

Hycofenix

GENERIC

Hyper-sal

azelastine HCL

Hypersal

budesonide

Nebusal

flunisolide

Neotuss Plus

fluticasone propionate

Obredon

ipratropium bromide

Panatuss Dxp

olopatadine HCL

Pediatex TD

triamcinolone acetonide

Pediatex TDM

PREFERRED

Relhist

Nasonex

Rescon-JR

Veramyst

Rescon-MX

NON PREFERRED

Rezira

Adrenalin

Semprex-d

Astelin

Suttar-SF

Astepro

Suttar-2

Atrovent

Tessalon Perles

Bactroban Nasal

Tussicaps

Beconase AQ

Tussionex Pennkinetic Extended Release

Dermacinrx Azenase PAK

Tuzistra XR

Dermacinrx Ticanase PAK

Vituz

Dymista

Zonatuss

Flonase

Zutripro

Omnaris

Patanase

ANTIASTHMATIC/COPD AGENTS

Qnasl

GENERIC

Qnasl Childrens

albuterol

Rhinocort Aqua

albuterol sulfate

Tyzine

albuterol sulfate ER

Tyzine Pediatric Nasal Drops

albuterol TAB 4MG

Zetonna

aminophylline


31

budesonide Infasurf

epinephrine HCL Kalydeco

ipratropium bromide Ofev

ipratropium bromide/albuterol sulfate Orkambi

levalbuterol Prolastin-c

levalbuterol HCL Surfaxin

montelukast sodium Survanta Intratracheal

terbutaline sulfate Zemaira

theophylline

theophylline CR TOXOIDS

theophylline ER

zafirlukast

NON PREFERRED

Cromolyn Sodium

Adacel

PREFERRED

Boostrix

Advair Diskus

Daptacel

Advair HFA

Diphtheria/Tetanus Toxoids Adsorbed Pediatric

Anoro Ellipta

Infanrix

Breo Ellipta

Kinrix

Combivent Respimat

Pediarix

Elixophyllin

Pentacel

Flovent Diskus

Quadracel

Flovent HFA

Tenivac

Foradil Aerolizer

Tetanus Toxoid Adsorbed

Incruse Ellipta

Tetanus/Diphtheria Toxoids-adsorbed

Metaproterenol Sulfate

Tetanus/Diphtheria Toxoids-adsorbed Adult

Proair HFA

Proair Respiclick

VACCINES

Pulmicort Flexhaler

Serevent Diskus

NON PREFERRED

Spiriva Handihaler

Acthib

Spiriva Respimat

Afluria PF 2012-2013

Symbicort


Ventolin HFA


Xolair


NON PREFERRED

Afluria 2012-2013

Accolate

Afluria 2013-2014

Aerospan

Afluria 2014-2015

Arcapta Neohaler

Afluria 2015-2016

Arnuity Ellipta

Bcg Vaccine

Atrovent HFA

Bexsero

Brovana

Biothrax

Daliresp

Cervarix

Duoneb

Comvax

Isuprel

Engerix-b

Lufyllin

Fluarix Quadrivalent 2013-2014

Maxair Autohaler


Perforomist


Pulmicort

Fluarix 2013-2014

Pulmophylline

Fluarix 2014-2015

Senophylline

Flublok 2013-2014

Singulair

Flublok 2014-2015

Stiolto Respimat

Flublok 2015-2016

Striverdi Respimat

Flucelvax 2013-2014

Theo-24

Flucelvax 2014-2015

Theophylline/D5W

Flucelvax 2015-2016

Vospire ER

Flulaval Quadrivalent 2013-2014

Xopenex


Xopenex Concentrate


Zyflo

Flulaval 2013-2014

Zyflo CR

Flulaval 2014-2015

Flumist Quadrivalent

RESPIRATORY AGENTS - MISC

Fluvirin PF 2013-2014

PREFERRED

Fluvirin PF 2014-2015

Pulmozyme

Fluvirin 2013-2014

NON PREFERRED

Fluvirin 2014-2015

Aralast NP

Fluvirin 2015-2016

Curosurf

Fluzone High-dose PF 2013-2014

Esbriet


Glassia



32

Fluzone Pediatric PF 2013-2014 PREFERRED

Fluzone PF 2013-2014 Atabex EC

Fluzone PF 2014-2015 Atabex Prenatal

Fluzone Quadrivalent 2013-2014 Bal-care DHA

Fluzone Quadrivalent 2014-2015 Bal-care DHA Essential

Fluzone Quadrivalent 2015-2016 Citranatal B-calm

Fluzone Split 2013-2014 Citranatal RX

Fluzone Split 2014-2015 Clinical Nutrients Prenatal Formula

Fluzone Split 2015-2016 Concept DHA

Gardasil Concept OB

Gardasil 9 Duet DHA Balanced

Havrix Duet DHA 400

Hiberix Duet DHA 400EC

Imovax Rabies (h.d.c.v.) Duet DHA 430

Ipol Inactivated IPV Duet DHA 430EC

Ixiaro Enbrace HR

M-m-r II Escavite

Medical Provider EZ Flu Shot 2014-2015 Escavite D

Medical Provider EZ Flu Shot 2015-2016 Folcaps Omega 3

Medical Provider Single Use EZ Flu Shot Folivane-OB

Menactra Healthy Mama Be Well Rounded

Menhibrix Marnatal-f

Menomune-a/C/Y/W-135 Mission Prenatal

Menveo Moms Choice RX

Pedvax HIB Mykidz Iron Fl

Pneumovax 23 Mynatal

Pneumovax 23/1 Dose Natachew

Pneumovax 23/5 Dose Natafort

Prevnar 13 Natalvit

Proquad Natelle One

Rabavert Neevo DHA

Recombivax HB Nestabs

Rotarix Nestabs DHA

Rotateq Newgen

Trumenba Niva-plus

Twinrix O-CAL Fa

Typhim VI O-CAL Prenatal

Vaqta Obstetrix DHA

Varivax Obtrex

Vivotif Obtrex DHA

Vivotif Berna One A Day Womens Prenatal/DHA

Yf-vax One A Day Womens Prenatal1

Zostavax One-a-day Womens Prenatal

OB Complete

VITAMINS OB Complete One

OB Complete Petite

VITAMINS

OB Complete Premier

GENERIC

OB Complete 400

ascorbic acid

OB Complete/DHA

ergocalciferol

Poly-VI-flor

phytonadione

Poly-VI-flor FS

thiamine HCL

Poly-VI-flor/Iron

vitamin c 222MG

Prefera OB

vitamin d

Prefera OB + DHA

vitamin k1

Prenata

PREFERRED

Prenatal Vitamin

Mephyton

Prenatal Vitamins

Vitamin A

Prenate AM

NON PREFERRED

Prenate Elite

Aquasol A Parenteral

Prenate Essential

Drisdol

Prenate Star

Pyridoxine HCL

Provida OB

Vitamin K1

Right Step Prenatal

Wheat Germ

Select-OB

Stuart Prenatal

MULTIVITAMINS

Taron-bc

GENERIC

Taron-c DHA

b-complex 100

Theranatal Core Nutrition

niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper

Tri-VI-flor

Tricare Prenatal Compleat


33

Tricare Prenatal DHA One Protect Plus

Vinacal B Provida DHA

Vinate AZ Extra R-natal OB

Vinate Calcium Renatabs

Vinate DHA Renatabs With Iron

Vinate DHA RF Req 49+

Vita-pren Select-ob+dha

Vitafol-nano Siderol

Vitafol-pn Strovite Forte

Vitamedmd Redichew RX Strovite One

Vitamedmd Redichew RX/Quatrefolic Supervite

Vitapearl Supervite EC

Viva DHA Support-500

Your Life Multi Prenatal Synagex

Zatean-pn Synatek

Zatean-pn Plus Texavite LQ

NON PREFERRED Triveen-duo DHA

Adrenal C Formula Triveen-prx RNF

Albafort TL G-FOL OS

Bacmin Udamin SP

Citranatal Assure Vemavite-prx 2

Citranatal DHA Vitafol

Citranatal Harmony Vitafol Fe+

Citranatal 90 DHA Vitafol Ultra

Cod Liver Oil Vitafol-ob+dha

Corvite Vitafol-one

Crnatal Vital-d RX

Dialyvite Supreme D Vitamedmd One RX/Quatrefolic

Dialyvite 3000 Vitamedmd Plus RX/Quatre Folic

Dialyvite 5000 Vitaroca Plus

Dialyvite/Zinc Vitatrue

Diatx ZN Zatean-pn DHA

Floriva Zatean-CH

Focalgin CA

Focalgin 90 DHA MEDICAL DEVICES

Folet DHA

DIABETIC SUPPLIES

Folet One

PREFERRED

Folgard OS

Accu-chek Safe-t-pro Lancets

Folivane-prx DHA NF

Accu-chek Safe-t-pro Pluslancets

Fortavit

Accu-chek Soft Touch Lancets

Gesticare DHA

Accu-chek Softclix Lancets

M.v.i. Adult

Advocate Insulin Pen Needles 29GX12.7MM

M.v.i. Pediatric

Advocate Insulin Pen Needles 31GX5MM

M.v.i.-12 Without Vitamin K

Advocate Insulin Pen Needles 31GX8MM

Natalvirt CA

Advocate Insulin Syringe/U-100/0.3ML/29GX1/2"

Natalvirt 90 DHA


Nephplex RX


Nephro-vite RX


Nephrocaps


Nephrocaps QT


Nestabs Abc

Advocate Insulin Syringe/U-100/1ML/29GX1/2"

Nexa Plus


Nicadan


Nicazel

Advocate Lancets

Nicazel Forte

Advocate Lancets 30G

Nicomide

Advocate Safety Lancets

Nutricap

Advocate Safety Lancets 26G

Nutrivit

Agamatrix Ultra-thin Lancets 33G

Ocuvel

Anti-stick Insulin Syringe/U-100/0.5ML/28G X 1/2"

Paire OB

Anti-stick Insulin Syringe/U-100/0.5ML/29G X 1/2"

Preferaob +dha

Anti-stick Insulin Syringe/U-100/1ML/29G X 1/2"

Preferaob One

Assure Haemolance Plus High Flow 18G

Prefol-DHA

Assure Haemolance Plus Low Flow 25G

Prenate

Assure Haemolance Plus Micro Flow 28G

Prenate DHA

Assure Haemolance Plus Normal Flow 21G

Prenate Enhance

Assure Haemolance Plus Pediatric Blade

Prenate Mini

Assure ID Insulin Safety Syringe/U-100/0.5ML/29G X 1/2"

Prenate Pixie

Assure ID Insulin Safety Syringe/U-100/1ML/29G X 1/2"

Prenate Restore

Assure Lance Lancets

Preque 10


34

Assure Lance Lancets 21G BD Lancet Ultrafine 30G

Assure Lance Plus Safety Lancets 25G BD Lancet Ultrafine 33G

Assure Lance Plus Safety Lancets 30G BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X 1/2"

Assure Lancets

BD Microtainer Lancets

Aurora Lancet Super Thin 30G

BD Pen Needle/Mini/Ultrafine/31G X 3/16"

Aurora Lancet Thin 23G

BD Pen Needle/Nano/Ultra Fine/32G X 4MM

Aurora Pen Needles 29GX12MM

BD Pen Needle/SHORT/Ultrafine/31G X 5/16"

Aurora Pen Needles 31G X 6MM

BD Pen Needle/Ultrafine/29G X 12.7MM

Aurora Pen Needles 31G X 8MM

BD Pen Needle/Ultrafine/29GX1/2" 12.7MM

Autolet Platforms

BD Pen Needles SHORT/Ultrafine/31G X 5/16"

AF Lancets Super Thin

BD Safety-glide Insulin Syringe/0.5ML/29G X 1/2"

AT Last Lancets

BD Safety-lok Insulin Syringe/Perm Needle/UF/1ML/29G X 1/2"

B-d Insulin Syringe Ultrafine II/0.3ML/31G X 5/16"

B-d Insulin Syringe Ultrafine II/0.5ML/31G X 5/16"

BD Safetyglide Insulin Sysyringe/0.5ML/30G X 5/16"

B-d Insulin Syringe Ultrafine II/1ML/31G X 5/16"

BD-insul SYR Mis LO Dose

B-d Insulin Syringe Ultrafine/0.3ML/30G X 1/2"

Carefine Pen Needle 32GX4MM

B-d Insulin Syringe Ultrafine/0.5ML/30G X 1/2"

Carefine Pen Needles 29GX1/2"

B-d Insulin Syringe Ultrafine/1ML/30G X 1/2"

Carefine Pen Needles 30GX5/16"

Bayer Microlet Lancets

Carefine Pen Needles 31GX6MM

Bullseye Safety Lancets

Carefine Pen Needles 31GX8MM

BD Autoshield Duo 30G X 3/16"

Careone Lancet Thin

BD Autoshield 29G X 3/16"

Careone Lancet Ultra Thin

BD Autoshield 29G X 5/16"

Cleanlet Lancets 28G

BD Insulin Syringe LUER-LOK/U-100/1ML

Clever Chek Lancets Ultrathin

BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2"

Clever Chek Lancets Ultrathin 30G

BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2"

Clever Choice Comfort EZ Insulin Pen Needles 31GX8MM

BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8"

Clever Choice Comfort EZ Insulin Syringe/U-100/1ML/31GX5/16"

BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2"

BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2"

Clever Choice Comfort EZ Insulin Syringe/0.3ML/29G X 1/2"

BD Insulin Syringe Microfine/U-100/0.5ML/28G X 1/2"

BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8"


BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2"

BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 5/16" Clever Choice Comfort EZ Insulin Syringe/0.3ML/30G X 5/16"

BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2"


BD Insulin Syringe Safetyglide/1ML/29G X 1/2"

BD Insulin Syringe Slip Tip/U-100/1ML


BD Insulin Syringe U-40/1ML/25G X 5/8"

BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16"


BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X 5/16"

BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16"


BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2"

BD Insulin Syringe Ultrafine/U-100/0.3ML/30G X 1/2" Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 5/16"








Clever Choice Comfort EZ Insulin Syringe/1ML/28G X 1/2"



BD Insulin Syringe Ultrafine/U-100/1ML/29G X 1/2"




Clever Choice Comfort EZ Pen Needles 29GX12MM



BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2"








BD Insulin Syringe Ultrafine/1ML/30G X 1/2"


BD Insulin Syringe Ultrafine/1ML/31G X 5/16"


BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 1"



BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 5/8"

Coaguchek Lancets

Comfort Assist Insulin Syringe 0.3ML/29G X 1/2"

BD Insulin Syringe/Detachable Needle/U-100/1ML/26G X 1/2"

Comfort Assist Insulin Syringe/0.3ML/30G X 5/16"


BD Insulin Syringe/U-100/0.5ML/30G X 1/2"


BD Insulin Syringe/U-100/1ML/27G X 1/2"




BD Insulin Syringe/U-100/2ML/27.5G X 5/8"

Comfort Assist Insulin Syringe/1ML/29G X 1/2"



BD Integra Insulin Syringe/U-100/1ML/29G X 1/2"


BD Integra Syringe/Retracting Needle/1ML/25G X 1"


35

Comfort Lancets Excel Comfort Point Insulin Pen Needles 31G X 4MM

Diastar Easy Test II Lancets 30G Exel Comfort Point Insulin Pen Needles 29G X 12MM

Diastar Easy Test Lancets30G Exel Comfort Point Insulin Pen Needles 31G X 6MM

Droplet Lancets Ultra Thin 30G Exel Comfort Point Insulin Pen Needles 31G X 8MM

Drug Mart On-the-go Lancets Gentle 30G Exel Comfort Point Insulin Syringe/0.3ML/29G X 1/2"

Drug Mart Unilet Lancets Super Thin 30G Exel Comfort Point Insulin Syringe/0.3ML/30G X 5/16"

Drug Mart Unilet Lancets Ultra Thin 28G Exel Comfort Point Insulin Syringe/0.5ML/28G X 1/2"

Duane Reade Unifine Pentips 29G X 12MM Exel Comfort Point Insulin Syringe/0.5ML/29G X 1/2"

Duane Reade Unifine Pentips 31G X 6MM Ultra SHORT Exel Comfort Point Insulin Syringe/0.5ML/30G X 5/16"

Duane Reade Unifine Pentips 31G X 8MM SHORT Exel Comfort Point Insulin Syringe/1ML/28G X 1/2"

E-z Ject Lancets Exel Comfort Point Insulin Syringe/1ML/29G X 1/2"

E-z Ject Lancets Color Exel Comfort Point Insulin Syringe/1ML/30G X 5/16"

E-z Ject Lancets Super Thin EZ Smart Blood Glucose Lancets

E-z Ject Lancets Super Thin 30G EZ-lets Lancets 21G

E-z Ject Lancets Thin 26G EZ-lets Lancets 23G

E-z Ject Lancets 21G EZ-lets Lancets 26G Super-soft

E-ZJECT Lancets Micro-thin 33G EZ-lets Lancets 28G Ultra-soft

Easy Touch Insulin Syringe/Safety/U-100/0.5ML/29G X 1/2"

EZ-lets Lancets 30G

Fasttake Compact Monitoring System

Easy Touch Insulin Syringe/Safety/U-100/0.5ML/30G X 5/16"

Fasttake Test Strips

Fifty50 Pen Needles 31G X3/16" (5MM)

Easy Touch Insulin Syringe/Safety/U-100/1ML/29G X 1/2"

Fifty50 Pen Needles 31G X5/16" (8MM)

Easy Touch Insulin Syringe/Safety/U-100/1ML/30G X 1/2"

Fifty50 Safety Seal Lancets 30G

Easy Touch Insulin Syringe/U-100/0.3ML/30G X 1/2"

Fifty50 Safety Seal Lancets 32G


Fifty50 Superior Comfort Insulin Syringe/0.3ML/31G X 5/16"



Fifty50 Superior Comfort Insulin Syringe/0.5ML/31G X 5/16"


Easy Touch Insulin Syringe/U-100/1ML/27G X 1/2" Fifty50 Superior Comfort Insulin Syringe/1ML/31G X 5/16"

Easy Touch Insulin Syringe/U-100/1ML/28G X 1/2" Fine 30

Easy Touch Insulin Syringe/U-100/1ML/29G X 1/2" Fingerstix Lancets

Easy Touch Insulin Syringe/U-100/1ML/30G X 1/2" Fora Lancets

Easy Touch Insulin Syringe/U-100/1ML/31G X 5/16" Freestyle Lancets

Easy Touch Insulin Syringe/0.3ML/30G X 5/16" Freestyle Precision Insulin Syringe/U-100/0.5ML/30G X 5/16"

Easy Touch Insulin Syringe/0.3ML/31G X 5/16"

Freestyle Precision Insulin Syringe/U-100/0.5ML/31G X 5/16"



Freestyle Precision Insulin Syringe/U-100/1ML/31G X 5/16"

Easy Touch Insulin Syringe/1ML/30G X 5/16"

Easy Touch Lancets 21G/Pressure Activated

Freestyle Precision Insulin Syringes/U-100/1ML/30G X 5/16"



Freestyle Unistick II Lancets

Easy Touch Lancets 26G/Pull-top

Gentle-let GP Lancets

Easy Touch Lancets 26G/Twist

Gentle-let Lancets General Purpose Style/Fine Point


Gentle-let Lancets General Purpose Style/Medium Point


Gentle-let Lancets Safety Style/Fine Point


Gentle-let Lancets Safety Style/Medium Point

Easy Touch Lancets 30G/Button-activated

Gentle-let Platforms 2.4MM


Gentle-let Platforms 3.0MM


Glucocom Lancets 28G






Glucopro Insulin Syringe/U-100/0.3ML/30G X 1/2"





Easy Touch Pen Needles 29GX1/2"







Glucopro Insulin Syringe/U-100/1ML/30G X 1/2"

Easy Touch Pen Needles/31G X 3/16"


Easy Touch Safety Lancets21G/Pressure Activated



Glucosource Lancets

Easy Touch Safety Lancets26G/Button Activated

Gmate Lancets 30G


H&h Thinlet Lancets 26G

Easy Touch Safety Lancets28G/Button Activated

H&h Thinlet Super Thin Lancets 30G


H-e-b Incontrol Pen Needles 29GX12MM

Easy Twist & CAP Lancets

H-e-b IN Control Pen Needles 31GX6MM

Easytest II Lancets

H-e-b IN Control Pen Needles 31GX8MM

Easytest Lancets

Haemolance

Embrace Lancets Ultra Thin 30G

Haemolance Low Flow Lancets

Eql SHORT Pen Needles 31G X 8MM

Haemolance Plus

Eql Ultra SHORT Pen Needles 31G X 6MM

Haemolance Plus High Flow


36

Haemolance Plus Low Flow Litetouch Insulin Syringe/0.5ML/31G X 5/16"

Haemolance Plus Max Flow Litetouch Insulin Syringe/1ML/30G X 5/16"

Haemolance Plus Pediatric Flow Litetouch Lancets Micro Thin 33G

Healthwise Mini Pen Needles 31GX6MM Litetouch Pen Needles 29GX12.7MM

Healthwise Pen Needles 29GX12MM Litetouch Pen Needles 31G X 6MM

Healthwise SHORT Pen Needles 31GX8MM Litetouch Pen Needles 31GX8MM SHORT

Hy-vee Lancets Live Better Lancet Super Thin 30G

Insulin Syringe/U-100/0.3ML/29G X 1/2" Live Better Lancet Ultra Thin 28G

Insulin Syringe/U-100/0.5ML/28G X 1/2" Live Better Pen Needles 29G X 12MM

Insulin Syringe/U-100/0.5ML/29G X 1/2" Live Better Pen Needles 31G X 12MM

Insulin Syringe/U-100/1ML/28G X 1/2" Live Better Pen Needles 31G X 6MM

Insulin Syringe/U-100/1ML/29G X 1/2" Magellan Insulin Safety Syringe/U-100/0.3ML/29G X 1/2"



Insulin Syringe/0.3ML/29G X 1/2" Magellan Insulin Safety Syringe/U-100/0.5ML/30G X 5/16"

Insulin Syringe/0.3ML/29G X 1" Magellan Insulin Safety Syringe/U-100/1ML/29G X 1/2"

Insulin Syringe/0.3ML/30G X 5/16" Magellan Insulin Safety Syringe/U-100/1ML/30G X 5/16"

Insulin Syringe/0.3ML/31G X 5/16" Maxi-comfort Insulin Syringe/U-100/0.5ML/28GX1/2"

Insulin Syringe/0.5ML/27G X 1/2" Maxi-comfort Insulin Syringe/U-100/1ML/28GX1/2"

Insulin Syringe/0.5ML/28G X 1/2" Medisense Thin Lancets

Insulin Syringe/0.5ML/29G X 1/2" Medlance Plus Extra Lancets 21G

Insulin Syringe/0.5ML/30G X 1/2" Medlance Plus Lancets

Insulin Syringe/0.5ML/30G X 5/16" Medlance Plus Lancets Lite 25G

Insulin Syringe/0.5ML/31G X 5/16" Medlance Plus Lite Lancets 25G

Insulin Syringe/1ML/28G X 1/2" Medlance Plus Special Lancets 0.8MM

Insulin Syringe/1ML/29G X 1/2" Medlance Plus Superlite 30G

Insulin Syringe/1ML/30G X 5/16" Medlance Plus Superlite 30G/Comfort Max

Insulin Syringe/1ML/31G X 5/16" Medlance Plus Universal Lancets 21G

Insupen Sensitive 32GX8MM Medlance Plus/Lite 25G

Insupen Ultrafin 29GX12MM Medlance/Extra

Insupen Ultrafin 30GX8MM Medlance/Lite

Insupen Ultrafin 31GX6MM Medlance/Universal

Insupen Ultrafin 31GX8MM Meijer Super Thin Lancets

IN Touch Sterile Lancets 30G Microlet Lancets

Lancet Transporter Case Microtainer Safety Flow Lancet/Sterile/Single-use

Lancets Monoject Insulin Syringe Regular LUER Tip/Softpack/1ML

Lancets Bullseye Safety Monoject Insulin Syringe/Detach Needle/1ML/25G X 5/8"

Lancets Safety Seal 21G Monoject Insulin Syringe/Detach Needle/1ML/27G X 1/2"

Lancets Safety Seal 26G Monoject Insulin Syringe/Perm Needle/U-100/0.5ML/28G X 1/2"

Lancets Safety Seal 28G

Monoject Insulin Syringe/Perm Needle/1ML/28G X 1/2"

Lancets Safety Seal 30G

Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29G X 1/2"

Lancets Thin

Lancets Twist Top

Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29GX1/2"

Lancets Ultra Fine

Lancets Ultra Thin

Monoject Insulin Syringe/Safety/Perm Needle/0.5ML/29G X 1/2"

Lancets 26G Twist Top

Lancets 28G

Monoject Insulin Syringe/Safety/Perm Needle/1ML/29G X 1/2"

Lancets 30G

Lancets 30G Twist Top Monoject Insulin Syringe/Softpack/U-100/0.5ML/28G X 1/2"

Lancets 30G/Twist Top

Monoject Insulin Syringe/Softpack/1ML/27G X 1/2"

Lancets 31G Twist Top

Monoject Insulin Syringe/U-100/0.3ML/30G X 5/16"

Lancets 33G Universal Design


Leader Unifine Pentips Plus/Mini/31GX3/16"


Leader Unifine Pentips Plus/SHORT/31GX5/16"

Monoject Insulin Syringe/U-100/1ML/28G X 1/2"

Leader Unifine Pentips/Mini/31GX3/16"

Monoject Insulin Syringe/U-100/1ML/30G X 5/16"

Leader Unifine Pentips/Nano/32GX5/32"

Monoject Insulin Syringe/1ML

Leader Unifine Pentips/Plus/32GX5/32"

Monoject Insulin Syringe/1ML/31G X 5/16"

Liberty Medical Lancets 30G

Monoject Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2"

Lifescan Unistik II Lancets


Lifescan Unistik 2 Deep Penetration


Lite Touch Pen Needles/31G X 3/16"


Litetouch Insulin Syringe/U-100/0.5ML/28G X 1/2"


Litetouch Insulin Syringe/U-100/0.5ML/29G X 1/2"


Litetouch Insulin Syringe/U-100/1ML/28G X 1/2"



Monoject Ultra Comfort Insulin Syringe/1ML/28G X 1/2"



Litetouch Insulin Syringe/0.3ML/29G X 1/2"



Monojector End CAPS


Monojector Opd End CAPS


Monolet Lancets


37

Monolet Opd Lancets Precision Thin Lancets

Monolettor Safety Lancets Precision Thins GP Lancet

Moore MED Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2"

Precision Ultra Lancet

Preferred Plus Unifine Pentips 29G X 12MM

Moore MED Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2"

Preferred Plus Unifine Pentips 31G X 6MM Ultra SHORT

Preferred Plus Unifine Pentips 31G X 8MM SHORT

Moore MED Monoject Insulin Syringe/U-100/1ML/28G X 1/2"

Prodigy Insulin Mini Pen Needles/31G X 3/16"

Prodigy Insulin Pen Needles/29G X 1/2"

Moore MED Monoject Insulin Syringe/U-100/1ML/29G X 1/2"

Prodigy Insulin Syring/U-100/0.3ML/31G X 5/16"

Prodigy Insulin Syringe/1/2ML/31G X 5/16"

Myglucohealth Mgh Softlance Lancets 30G

Prodigy Insulin Syringe/1ML/28G X 1/2"

Netgroup Lancets

Prodigy Insulin SHORT Penneedles/31G X 5/16"

Nova Safety Lancets 23G

Prodigy Pressure Activated Safety Lancets

Nova Safety Lancets 28G

Prodigy Safety Lancets

Nova Sureflex Lancets

Prodigy Twist Top Lancets

Novofine Plus 32GX4MM

Pss Select GP Lancets

On Call Lancets

Pss Select Platforms

On Call Plus Lancets

Pss Select Safety Lancets

Onetouch Basic System

Px Lancets Ultra Thin

Onetouch Basic/Profile Test Strips

PC Unifine Pentips 29G X 1/2"

Onetouch Club Lancets Fine Point

PC Unifine Pentips 31G X 6MM Ultra SHORT

Onetouch Combo Pack

PC Unifine Pentips 31G X 8MM SHORT

Onetouch Delica Lancets Extra Fine 33G

Qc Lancets Super Thin

Onetouch Delica Lancets Fine 30G

Qc Lancets Ultra Thin

Onetouch Finepoint Lancets

Qc Pen Needles 29G X 12MM

Onetouch Lancets


Onetouch Profile System


Onetouch Suresoft Lancing Device/18G

Relion Insulin Syringe/U -100/0.5ML/29G


Relion Insulin Syringe/U-00/1ML/29G X 1/2"


Relion Insulin Syringe/U-100/0.3ML/29G

Onetouch Ultra Blue

Relion Insulin Syringe/U-100/0.3ML/29G X 1/2"

Onetouch Ultra Mini


Onetouch Ultra System Kit


Onetouch Ultra 2


Onetouch Ultralink System (hex)


Onetouch Ultralink System (DEC)


Onetouch Ultrasmart


Onetouch Ultrasoft Lancets


Onetouch Verio

Relion Insulin Syringe/U-100/1ML/30G

Onetouch Verio IQ Blood Glucose Monitoring System


Onetouch Verio Sync Bloodglucose Monitoring System


Onetouch Verio Test Strips

Relion Lancets Micro-thin33G

Pen Needles 29G X 12MM

Relion Lancets Standard 21G

Pen Needles 29GX1/2"

Relion Lancets Thin 26G


Relion Lancets Ultra-thin30G

Pen Needles 31G X 1/4" SHORT

Relion Mini Pen Needles 31GX6MM

Pen Needles 31G X 3/16"

Relion Pen Needles 29GX12MM

Pen Needles 31G X 6MM




Penlet II Replacement CAPS

Relion SHORT Pen Needles 31GX8MM

Penlet II Replacement CAPS-deep

Relion Thin Lancets

Penlet II Replacement CAPS-regular

Relion Ultra Thin Lancets

Pentips 31GX5MM

Relion Ultra Thin Lancets30G

Pentips 31GX8MM

Relion Ultra Thin Plus Lancets 32G

Pentips 32GX4MM

Relion Ultra Thin Plus Lancets 33G

Perfect Lancets 30G

Renew Advanced Lancing Cartridge Refills

Perfect Pressure Activated Safety Lancets 28G

Rexall Lancets Ultra Thin

Pharmacist Choice Ultra Thin Lancets

Rightest Gl300 Lancets

Pharmacist Choice Ultra Thin Lancets 28G

Rightest GD-L500 Alternate Site Adapter


Safe-t-lance Low Flow 25G


Safe-t-lance Normal Flow 21G


Safe-t-lance Plus Safety Lancet High Flow

Pharmacy Counter Lancets

Safe-t-lance Plus Safety Lancet Low Flow

Precision Sure-dose Insulin Syringe/0.3ML/30G X 5/16"

Safe-t-lance Plus Safety Lancet Normal Flow


Safesnap Insulin Syringe/0.3ML/30G X 5/16"





Precision Sure-dose Insulin Syringe/1ML/28G X 1/2"

Safesnap Insulin Syringe/1ML/28G X 1/2"

Precision Sure-dose Plus Insulin Syringe/0.3ML/29G X 1/2"

Safesnap Insulin Syringe/1ML/29G X 1/2"

Precision Sure-dose Plus Insulin Syringe/1ML/29G X 1/2" Safety Lancet 21G/Pressure Activated


38

Safety Lancet 28G/Pressure Activated Thinpro Insulin Syringe/0.5ML/28G X 1/2"

Safety Lancets Thinpro Insulin Syringe/0.5ML/29G X 1/2"

Safety Lancets 21G Thinpro Insulin Syringe/0.5ML/30G X 3/8"

Safety Lancets 28G Thinpro Insulin Syringe/0.5ML/31G X 3/8"

Safety Let Lancets Thinpro Insulin Syringe/1ML/28G X 1/2"

Safety Seal Lancets 28G Thinpro Insulin Syringe/1ML/29G X 1/2"

Safety Seal Lancets 30G Thinpro Insulin Syringe/1ML/30G X 3/8"

Safety-glide Insulin Syringe/0.3ML/29G X 1/2" Thinpro Insulin Syringe/1ML/31G X 3/8"

Shopko On-the-go Comfort Lancets 30G Trueplus Insulin Syringe/U-100/0.3ML/29G X 1/2"

Shopko Unifine Pentips Pen Needles/Micro/32GX4MM Trueplus Insulin Syringe/U-100/0.3ML/30G X 5/16"

Shopko Unifine Pentips Pen Needles/Mini/31GX5MM Trueplus Insulin Syringe/U-100/0.3ML/31G X 5/16"

Shopko Unifine Pentips Pen Needles/Original/29GX12MM Trueplus Insulin Syringe/U-100/0.5ML/28G X 1/2"

Shopko Unifine Pentips Pen Needles/SHORT/31GX8MM Trueplus Insulin Syringe/U-100/0.5ML/29G X 1/2"

Shopko Unilet Lancets Super Thin 30G Trueplus Insulin Syringe/U-100/0.5ML/30G X 5/16"

Shopko Unilet Lancets Ultra Thin 28G Trueplus Insulin Syringe/U-100/0.5ML/31G X 5/16"

Single-let Trueplus Insulin Syringe/U-100/1ML/28G X 1/2"

Smart Diabetes Vantage Universal Lancets 30G Trueplus Insulin Syringe/U-100/1ML/29G X 1/2"

Smart Sense Color Lancets Universal 33G Trueplus Insulin Syringe/U-100/1ML/30G X 5/16"

Smart Sense Standard Lancets Universal 21G Trueplus Insulin Syringe/U-100/1ML/31G X 5/16"

Smart Sense Super Thin Lancets Universal 30G Trueplus Lancets 26G

Smart Sense Thin Lancets Universal 26G Trueplus Lancets 28G

Smartest Lancets 28G Trueplus Lancets 28G Super Thin

Solus V2 Pressure Activated Safety Lancets 28G Trueplus Lancets 30G

Solus V2 Twist Lancets 30G Trueplus Lancets 30G Ultra Thin

Sterilance PA Trueplus Lancets 33G

Sterilance TL Trueplus Lancets 33G Micro Thin

Sure-fine Pen Needles 29GX1/2" 12.7MM Trueplus Safety Lancets 28G

Sure-fine Pen Needles 31GX3/16" 5MM Ulticare Insulin Safety Syringe/0.5ML/29G X 1/2"

Sure-fine Pen Needles 31GX5/16" 8MM Ulticare Insulin Safety Syringe/1ML/29G X 1/2"

Sure-ject Insulin Syringe/U-100/0.3ML/29G X 1/2" Ulticare Insulin Syringe Ultrafine U-100/0.3ML/31G X 5/16"

Sure-ject Insulin Syringe/U-100/0.3ML/30G X 5/16" Ulticare Insulin Syringe Ultrafine U-100/0.5ML/31G X 5/16"

Sure-ject Insulin Syringe/U-100/0.3ML/31G X 5/16" Ulticare Insulin Syringe Ultrafine U-100/1ML/31G X 5/16"

Sure-ject Insulin Syringe/U-100/0.5ML/28G X 1/2" Ulticare Insulin Syringe 1CC/28G U-100 1/2"

Sure-ject Insulin Syringe/U-100/0.5ML/29G X 1/2" Ulticare Insulin Syringe/SHORT/0.3ML/30G X 5/16"



Sure-ject Insulin Syringe/U-100/1ML/28G X 1/2" Ulticare Insulin Syringe/SHORT/0.5ML/31G X 5/16"

Sure-ject Insulin Syringe/U-100/1ML/29G X 1/2" Ulticare Insulin Syringe/SHORT/1ML/30G X 5/16"

Sure-ject Insulin Syringe/U-100/1ML/30G X 5/16" Ulticare Insulin Syringe/SHORT/1ML/31G X 5/16"

Sure-ject Insulin Syringe/U-100/1ML/31G X 5/16" Ulticare Insulin Syringe/U-100/0.3ML/29G X 1/2"

Sure-lance Flat Lancets Ulticare Insulin Syringe/U-100/0.3ML/30G X 1/2"

Sure-lance Lancets 26G Ulticare Insulin Syringe/U-100/0.3ML/30G X 5/16"

Sure-lance Thin Lancets 28G Ulticare Insulin Syringe/U-100/0.3ML/31G X 5/16"

Sure-lance Ultra Thin Lancets Ulticare Insulin Syringe/U-100/0.5ML/29G X 1/2"

Sure-touch Lancets Universal Ulticare Insulin Syringe/U-100/0.5ML/30G X 1/2"

Surelite Lancets Ulticare Insulin Syringe/U-100/0.5ML/30G X 5/16"

Surestep Test Strips Ulticare Insulin Syringe/U-100/0.5ML/31G X 5/16"

Techlite AST Lancets Ulticare Insulin Syringe/U-100/1ML/29G X 1/2"

Techlite Lancets Ulticare Insulin Syringe/U-100/1ML/30G X 1/2"

Techlite Lancets 30G Ulticare Insulin Syringe/U-100/1ML/30G X 5/16"

Terumo Insulin Syringe/U-100/0.3ML/29G X 1/2" Ulticare Insulin Syringe/U-100/1ML/31G X 5/16"

Terumo Insulin Syringe/U-100/0.5ML/27G X 1/2" Ulticare Insulin Syringe/0.3ML/29G X 1/2"

Terumo Insulin Syringe/U-100/0.5ML/28G X 1/2" Ulticare Insulin Syringe/0.3ML/30G X 1/2"

Terumo Insulin Syringe/U-100/1ML/28G X 1/2" Ulticare Insulin Syringe/0.3ML/30G X 5/16"

Terumo Insulin Syringe/0.3ML/30G X 3/8" Ulticare Insulin Syringe/0.5ML/28G X 1/2"



Terumo Insulin Syringe/1ML/27G X 1/2" Ulticare Insulin Syringe/0.5ML/30G X 5/16"

Terumo Insulin Syringe/1ML/29G X 1/2" Ulticare Insulin Syringe/1ML/28G X 1/2"

Terumo Insulin Syringe/1ML/30G X 3/8" Ulticare Insulin Syringe/1ML/29G X 1/2"

Terumo Surguard Insulin Syringe/0.3ML/29G X 1/2" Ulticare Insulin Syringe/1ML/30G X 1/2"

Terumo Surguard Insulin Syringe/0.5ML/28G X 1/2" Ulticare Insulin Syringe/1ML/30G X 5/16"

Terumo Surguard Insulin Syringe/0.5ML/29G X 1/2" Ulticare Micro Pen Needles/32G X 4MM

Terumo Surguard Insulin Syringe/1ML/28G X 1/2" Ulticare Mini Pen Needles Ulti-fine IV

Terumo Surguard Insulin Syringe/1ML/29G X 1/2" Ulticare Mini Pen Needles 31GX6MM

Thinlets GP Lancets Ulticare Mini Pen Needles/31G X 6MM

Thinlets Lancet Ulticare Mini Pen Needles31GX6MM

Thinpro Insulin Syringe/0.3ML/29G X 1/2" Ulticare Original Pen Needles Ulti-fine

Thinpro Insulin Syringe/0.3ML/30G X 3/8" Ulticare Pen Needles/29G X 12.7MM

Thinpro Insulin Syringe/0.3ML/31G X 3/8" Ulticare SHORT Pen Needles Ulti-fine IV


39

Ulticare SHORT Pen Needles 31GX8MM Unistik 2

Ulticare SHORT Pen Needles/31G X 8MM Unistik 2 Comfort

Ulticare Thin Lancets 30G Unistik 2 Extra

Ultiguard Insulin Syringe/U-100/0.3ML/29G X 1/2" Unistik 2 Neonatal

Ultiguard Insulin Syringe/U-100/0.3ML/30G X 5/16" Unistik 2 Normal

Ultiguard Insulin Syringe/U-100/0.5ML/29G X 1/2" Unistik 2 Super

Ultiguard Insulin Syringe/U-100/0.5ML/30G X 5/16" Unistik 3

Ultiguard Insulin Syringe/U-100/1ML/29G X 1/2" Unistik 3 Comfort

Ultiguard Insulin Syringe/U-100/1ML/30G X 5/16" Unistik 3 Extra

Ultilet Classic Lancets Unistik 3 Gentle

Ultilet Insulin Syringe/SHORT/0.3ML/30G X 5/16" Unistik 3 Neonatal

Ultilet Insulin Syringe/SHORT/0.3ML/31G X 5/16" Unistik 3 Normal

Ultilet Insulin Syringe/SHORT/0.5ML/30G X 5/16" Universal 1 Lancets Thin 26G

Ultilet Insulin Syringe/SHORT/0.5ML/31G X 5/16" Universal 1 Lancets Ultra Thin 30G

Ultilet Insulin Syringe/SHORT/1ML/30G X 5/16" V-r Monoject Insulin Syringe/U-100/0.3ML/29G X 1/2"

Ultilet Insulin Syringe/SHORT/1ML/31G X 5/16" V-r Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2"

Ultilet Lancets V-r Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2"

Ultilet Lancets 33G V-r Monoject Insulin Syringe/U-100/1ML/28G X 1/2"

Ultilet Pen Needle 32GX4MM/SHORT V-r Monoject Insulin Syringe/U-100/1ML/29G X 1/2"

Ultilet Safety Lancets 23G Valumark Lancet Super Thin 30G

Ultilet SHORT Pen Needles 31GX5/16" Valumark Lancet Ultra Thin 28G

Ultilet SHORT Pen Needles31GX3/16" Valumark Pen Needles 29GX12MM

Ultra-thin II Auto Lancet Valumark Pen Needles 31G X 6MM

Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/30GX5/16"

Valumark Pen Needles 31G X 8MM

Vanishpoint Insulin Syringe/0.5ML/30G X 1/2"


Vanishpoint Insulin Syringe/1ML/29G X 1/2"

Vida Mia Unifine Pentips Mini 31GX6MM


Vida Mia Unifine Pentips Original 29GX12MM

Vida Mia Unifine Pentips 32GX4MM


Vida Mia Unilet Lancets Super Thin 30G

Vida Mia Unilet Lancets Ultra Thin 28G

Ultra-thin II Insulin Syringe SHORT/U-100/1ML/30GX5/16"

Vida Mia Unipfine Pentipsshort 31GX8MM

Ultra-thin II Insulin Syringe SHORT/U-100/1ML/31GX5/16"

Vitalet Pro Lancets

Ultra-thin II Insulin Syringe/U-100/0.3ML/29GX1/2"

Vitalet Pro Plus Lancets

Ultra-thin II Insulin Syringe/U-100/0.5ML/29GX1/2"

W&f Lancets Colored 21G

Ultra-thin II Insulin Syringe/U-100/1ML/29GX1/2"

W&f Lancets 26G

Ultra-thin II Lancets 28G

Walgreens Lancets

Ultra-thin II Lancets 30G

Walgreens Thin Lancets

Ultra-thin II Mini Pen Neeedles/31GX3/16"

Walgreens Ultra Thin Lancets

Ultra-thin II Pen Needles 29GX1/2"

1ST Choice Lancets Super Thin

Ultra-thin II Pen Needles/SHORT/31GX5/16"

1ST Choice Lancets Thin

Ultra-thin II Safety Autolancets 26G

1ST Choice Lancets Ultra Thin

Ultralance

1ST Tier Unifine Pentips 29GX12MM

Unifine Pentips Plus 29GX12MM






MEDICAL DEVICES - MISC

Unifine Pentips 29GX12MM

PREFERRED

Unifine Pentips 31G X 3/16"

Aerochamber Mini Aerosol Chamber

Unifine Pentips 31G X 6MM

Aerochamber MV

Unifine Pentips 31G X 8MM

Aerochamber Plus Flow VU


Aerochamber Plus Flow-VU


Aerochamber Plus Flow-VU/Large Mask


Aerochamber Plus Flow-VU/Mask


Aerochamber Plus Flow-VU/Medium Mask

Unilet Comfortouch Lancet

Aerochamber Plus Flow-VU/Small Mask

Unilet Excelite

Aerochamber Z-stat Plus Valved Holding Chamber W/Flow VU

Unilet Excelite II

Unilet G.p. Lancet

Aerochamber Z-stat Plus/Flowsignal

Unilet G.p. Superlite Lancet

Aerochamber Z-stat Plus/Large Mask

Unilet GP 28 Ultra Thin

Aerochamber Z-stat Plus/Medium Mask

Unilet Lancet

Aerochamber Z-stat Plus/Small Mask

Unilet Lancets Micro-thin33G

Aerochamber/Flowsignal

Unilet Lancets Super-thin30G

Aerovent Plus Holding Chamber/Collapsible

Unilet Lancets Ultra-thin 28G

Arial Chamber

Unilet Superlite Lancet

Breatherite

Unistik CZT Comfort

Breatherite Collapsible Adult Spacer W/Mask

Unistik CZT Normal

Breatherite Collapsible Child Spacer W/Mask

Unistik Safety Lancets 28G

Breatherite Collapsible Infant Spacer W/Mask

Unistik Safety Lancets 30G

Unistik 1


40

Breatherite Collapsible Small Child Spacer W/Mask

Breatherite Collapsible Spacer W/ Neonate Mask

Breatherite Rigid Spacer W/Mask

Breatherite W/Large Mask

Breatherite W/Medium Mask

Breatherite W/Small Mask

E-z Spacer

E-z Spacer The Body Guards Pack

Easivent

Easivent/Mask-large

Easivent/Mask-medium

Easivent/Mask-small

Flexichamber

Inspirachamber/Anti-static Valved/Mouthpiece

Inspirachamber/Soothermask/Inspiramask/Medium

Inspirachamber/Soothermask/Inspiramask/Small

Inspirease Bags

Inspirease Drug Delivery System

Inspirease Mouthpiece

Inspirease Reservoir Bags

Liteaire

Mask Vortex/Baby Whirl Duckling

Mask Vortex/Child/Frog

Mask Vortex/Spinner The Duck

Mask Vortex/Toddler/Lady Bug

Microchamber

Microspacer

Nessi Spacer/Large Mask

Nessi Spacer/Mouthpiece

Nessi Spacer/Small/MED Mask

Optichamber Advantage

Optichamber Diamond

Optichamber Diamond/Largeface Mask

Optichamber Diamond/Medium Face Mask

Optichamber Diamond/Smallface Mask

Optihaler

Optihaler MDI Drug Delivery System

Panda Mask Large

Panda Mask Medium

Panda Mask Small

Pediatric Panda Mask

Pocket Chamber

Pocket Spacer

Riteflo

Vortex Valved Holding Chamber

Watchhaler

MISCELLANEOUS

NON PREFERRED

Chemet

Exjade

Ferriprox

Jadenu

Pentetate Calcium Trisodium

Pentetate Zinc Trisodium

Effective January 1, 2016 v.3 All OptumTM trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners. © 2015 Optum, Inc. All rights reserved.

41

Index

A

Adalat CC, 7 Aerochamber Z-stat Plus/Flowsignal, 40

adapalene, 10 Aerochamber Z-stat Plus/Large Mask, 40

A.a.g.c. Kit IN Teroderm, 11

Adapalene, 10 Aerochamber Z-stat Plus/Medium Mask, 40

abacavir, 3

Adasuve, 23

abacavir sulfate/lamivudine/zidovudine, 3

Adcetris, 5 Aerochamber Z-stat Plus/Small Mask, 40

Abaneu-SL, 20

Adcirca, 10 Aerochamber/Flowsignal, 40

Abelcet, 2

Adderall, 24 Aerospan, 32

Abilify, 23

Adderall XR, 24 Aerovent Plus Holding Chamber/Collapsible, 40

Abilify Discmelt, 23

adefovir dipivoxil, 3

Abilify Maintena, 23

Adempas, 10 AF Lancets Super Thin, 35

Abraxane, 5

Adenocard, 8 Afinitor, 6

Absorica, 10

adenosine, 7 Afinitor Disperz, 6

acamprosate calcium DR, 25

Adoxa, 2 Afluria 2012-2013, 32

Acanya, 10

Adoxa PAK 1/100, 2 Afluria 2013-2014, 32

acarbose, 16


Accolate, 32


Accu-chek Safe-t-pro Lancets, 34

Adrenal C Formula, 34 Afluria PF 2012-2013, 32

Accu-chek Safe-t-pro Pluslancets, 34

Adrenalin, 9, 31 Afluria PF 2013-2014, 32

Accu-chek Soft Touch Lancets, 34

Adriamycin, 4 Afluria PF 2014-2015, 32

Accu-chek Softclix Lancets, 34

Advair Diskus, 32 Afluria PF 2015-2016, 32

Accupril, 8

Advair HFA, 32 Afrezza, 15

Accuretic, 8

Advanced Allergy Collection Kit, 12 Agamatrix Ultra-thin Lancets 33G, 34

acebutolol HCL, 7

Advate, 21 Aggrastat, 22

Aceon, 8

Advicor, 9 Aggrenox, 22

acetaminophen/caffeine/dihydrocodeine, 28

Advocate Insulin Pen Needles 29GX12.7MM, 34

Agrylin, 22

Akne-mycin, 10

Acetaminophen/Caffeine/Dihydrocodeine Bitartrate, 29

Advocate Insulin Pen Needles 31GX5MM, 34

Akten, 27

Akynzeo, 19

acetaminophen/codeine, 28

Advocate Insulin Pen Needles 31GX8MM, 34

Ala Scalp, 12

acetaminophen/codeine #2, 28

Ala-quin, 11


Advocate Insulin Syringe/U-100/0.3ML/29GX1/2", 34

Albafort, 20, 34


Albenza, 3

acetaminophen/codeine phosphate, 28


albuterol, 31

acetazolamide, 9

albuterol sulfate, 31

Acetazolamide, 9


albuterol sulfate ER, 31

acetazolamide ER, 9

albuterol TAB 4MG, 31

acetazolamide sodium, 9


Alcaine, 27

acetic acid, 28

alclometasone dipropionate, 12

Acetic Acid/Aluminum Acetate, 28


Aldactazide, 9

acetylcysteine, 31

Aldactone, 9

Aciphex, 18


Aldara, 13

Aciphex Sprinkle, 18

Aldurazyme, 17

acitretin, 12

Advocate Insulin Syringe/U-100/1ML/29GX1/2", 34

alendronate sodium, 16

Aclovate, 12

Alendronate Sodium, 16

Actemra, 29


Alevicyn Antipruritic SG, 13

Acthib, 32

Alfenta, 29

Acticlate, 2


alfentanil, 28

Actigall, 19

Alferon N, 6

Actimmune, 6

Advocate Lancets, 34 alfuzosin HCL ER, 20

Actiq, 29

Advocate Lancets 30G, 34 Alimta, 5

Activase, 22

Advocate Safety Lancets, 34 Alinia, 4

Activella, 15

Advocate Safety Lancets 26G, 34 Alkeran, 4

Actonel, 16

Aerochamber Mini Aerosol Chamber, 40 Allegra Allergy Childrens, 31

Actoplus Met, 16

Aerochamber MV, 40 Allo-pax, 11

Actoplus Met XR, 16

Aerochamber Plus Flow VU, 40 allopurinol, 30

Actos, 16

Aerochamber Plus Flow-VU, 40 almotriptan malate, 30

Acuicyn Daily Eyelid & Eyelash Cleanser, 13

Aerochamber Plus Flow-VU/Large Mask, 40

Alocril, 28

Alodox Convenience Kit, 2

Acular, 27

Aerochamber Plus Flow-VU/Mask, 40 Alomide, 28

Acular LS, 28

Aerochamber Plus Flow-VU/Medium Mask, 40

Aloprim, 30

Acuvail, 28

Alora, 15

acyclovir, 3, 11

Aerochamber Plus Flow-VU/Small Mask, 40

alosetron hydrochloride, 19

acyclovir sodium, 3

Aloxi, 19

Acyclovir Sodium, 3

Aerochamber Z-stat Plus Valved Holding Chamber W/Flow VU, 40

Alphagan P, 27

Aczone, 10

Alphanate/Von Willebrand Factor

Adacel, 32

Complex/Human, 21

Anaprox, 29 ascorbic acid, 33

Alphanine SD, 21

Anaprox DS, 29 Aspirin-caffeine-dihydrocodeine, 28

alprazolam, 22

Anaspaz, 18 Aspirin/Dipyridamole, 21

alprazolam ER, 22

anastrozole, 5 Assure Haemolance Plus High Flow 18G, 34

Alprazolam Intensol, 22

Ancef, 1

alprazolam odt, 22

Ancobon, 2 Assure Haemolance Plus Low Flow 25G, 34

Alrex, 27

Androderm, 14

Alsuma, 30

Androgel, 14 Assure Haemolance Plus Micro Flow 28G, 34

Altabax, 11

Androgel P.M., 14

Altace, 8

Android, 14 Assure Haemolance Plus Normal Flow 21G, 34

Aluvea, 13

Androxy, 14

amantadine HCL, 25

Anectine, 26 Assure Haemolance Plus Pediatric Blade, 34

Amantadine HCL, 25

Angeliq, 15

Amaryl, 16

Angiomax, 21 Assure ID Insulin Safety Syringe/U-100/0.5ML/29G X 1/2", 34

Ambien, 24

Animi-3, 20

Ambien CR, 24

Animi-3/Vitamin D, 20 Assure ID Insulin Safety Syringe/U-100/1ML/29G X 1/2", 34

Ambisome, 2

Anoro Ellipta, 32

Amcinonide, 12

Antabuse, 25 Assure Lance Lancets, 34

Amerge, 30

Antara, 9 Assure Lance Lancets 21G, 35

Amicar, 21

Anthralin, 12 Assure Lance Plus Safety Lancets 25G, 35

amifostine, 6

Anti-stick Insulin Syringe/U-100/0.5ML/28G X 1/2", 34

amikacin sulfate, 2

Assure Lance Plus Safety Lancets 30G, 35

amiloride HCL, 9

Anti-stick Insulin Syringe/U-100/0.5ML/29G X 1/2", 34

amiloride/hydrochlorothiazide, 9

Assure Lancets, 35

aminocaproic acid, 21

Anti-stick Insulin Syringe/U-100/1ML/29G X 1/2", 34

Astagraf XL, 5

Aminocaproic Acid, 21

Astelin, 31

aminophylline, 31

antipyrine/benzocaine, 28 Astepro, 31

amiodarone HCL, 7

Antipyrine/Benzocaine, 28 Astringyn, 21

Amiodarone HCL, 8

Anusol-HC, 19 AT Last Lancets, 35

Amitiza, 19

Anzemet, 19 Atabex EC, 33

amitriptyline HCL, 22

Aplenzin, 23 Atabex Prenatal, 33

amlodipine besylate, 7

Apokyn, 25 Atacand, 8

amlodipine besylate/atorvastatin calcium, 10

Appbutamone, 23 Atacand HCT, 9

Appbutamone-d, 23 Atelvia, 16

amlodipine besylate/benazepril HCL, 8

Appformin, 16 atenolol, 7

amlodipine besylate/benazepril hydrochloride, 8

Appformin-d, 16 atenolol/chlorthalidone, 8

apraclonidine, 27 Atgam, 5

amlodipine besylate/valsartan, 8

Aptensio XR, 24 Ativan, 22

amlodipine/valsartan/hctz, 8

Aptiom, 24 Atopiclair, 13

ammonium lactate, 13

Aptivus, 3 atorvastatin calcium, 9

Ammonul, 17

Aquasol A Parenteral, 33 atovaquone, 4

Amoxapine, 23

Aquoral, 22 atovaquone/proguanil HCL, 3

amoxicillin, 1

Aralast NP, 32 atracurium besylate, 26

Amoxicillin, 1

Aralen, 3 Atralin, 10

Amoxicillin ER, 1

Arava, 29 Atripla, 3

amoxicillin/clavulanate potassium, 1

Arcalyst, 29 Atropen, 18

Amoxicillin/Clavulanate Potassium, 1

Arcapta Neohaler, 32 atropine sulfate, 18, 27

amoxicillin/clavulanate potassium ER, 1

argatroban, 21 Atropine Sulfate, 18, 27

amphetamine/dextroamphetamine, 24

Argatroban, 21 Atrovent, 31

Amphotec, 2

Arial Chamber, 40 Atrovent HFA, 32

Amphotericin B, 2

Aricept, 25 Aubagio, 25

ampicillin, 1

Aricept Odt, 25 augmented betamethasone dipropionate, 12

Ampicillin, 1

Arimidex, 5

ampicillin sodium, 1

aripiprazole, 23 Augmentin, 1

Ampicillin Sodium, 1

Aripiprazole Odt, 23 Augmentin ES-600, 1

ampicillin-sulbactam, 1

Aristospan Intra-articular, 14 Augmentin XR, 1

Ampicillin-sulbactam, 1

Aristospan Intralesional, 14 Auralgan, 28

Ampyra, 25

Arixtra, 21 Aurora Lancet Super Thin 30G, 35

Amrix, 26

Armour Thyroid, 17 Aurora Lancet Thin 23G, 35

Amturnide, 8

Arnica Flower, 13 Aurora Pen Needles 29GX12MM, 35

Amytal Sodium, 24

Arnuity Ellipta, 32 Aurora Pen Needles 31G X 6MM, 35

Anacaine, 13

Aromasin, 5 Aurora Pen Needles 31G X 8MM, 35

Anadrol-50, 14

Arranon, 5 Aurstat Anti-itch Hydrogel, 13

Anafranil, 23

Arthrotec 50, 29 Aurstat Anti-itch Hydrogel Kit, 13

anagrelide hydrochloride, 21

Arthrotec 75, 29 Auryxia, 19

Analpram Advanced, 19

Articadent Dental, 30 Autolet Platforms, 35

Analpram-HC, 19

Artiss, 21 Avalide, 9

Analpram-HC Singles, 19

Arzerra, 5 Avandamet, 16

Avandaryl, 16

Baraclude, 3 BD Insulin Syringe Ultrafine/U-100/1ML/29G X 1/2", 35

Avandia, 16

Bayer Microlet Lancets, 35

Avapro, 8

Bcg Vaccine, 32 BD Insulin Syringe Ultrafine/U-100/1ML/30G X 1/2", 35

Avar, 10

BD Autoshield 29G X 3/16", 35

Avar LS, 10

BD Autoshield 29G X 5/16", 35 BD Insulin Syringe Ultrafine/U-100/1ML/31G X 15/64", 35

Avar LS Cleanser, 10

BD Autoshield Duo 30G X 3/16", 35

Avar-e LS, 10

BD Insulin Syringe LUER-LOK/U-100/1ML, 35

BD Insulin Syringe Ultrafine/U-100/1ML/31G X 5/16", 35

Avastin, 5

Avc, 20

BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2", 35

BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 1", 35

Aveed, 14

Avelox, 2

BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2", 35

BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 5/8", 35

Avelox Abc Pack, 2

Avenova, 13

BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8", 35

BD Insulin Syringe/Detachable Needle/U-100/1ML/26G X 1/2", 35

Avidoxy DK, 2

Avinza, 29

BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2", 35

BD Insulin Syringe/U-100/0.5ML/30G X 1/2", 35

Avodart, 20

Avonex, 25

BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2", 35

BD Insulin Syringe/U-100/1ML/27G X 1/2", 35

Avonex Pen, 25

Avycaz, 4

BD Insulin Syringe Microfine/U-100/0.5ML/28G X 1/2", 35


Axert, 30

Axid, 18

BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8", 35

BD Insulin Syringe/U-100/2ML/27.5G X 5/8", 35

Aygestin, 15

azacitidine, 5

BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2", 35


Azactam, 4

Azactam IN Iso-osmotic Dextrose, 4

BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2", 35

BD Integra Insulin Syringe/U-100/1ML/29G X 1/2", 35

Azasan, 5

Azasite, 26

BD Insulin Syringe Safetyglide/1ML/29G X 1/2", 35

BD Integra Syringe/Retracting Needle/1ML/25G X 1", 35

azathioprine, 5

azelastine HCL, 27, 31

BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 5/16", 35

BD Lancet Ultrafine 30G, 35

Azelex, 10

BD Lancet Ultrafine 33G, 35

Azilect, 25

BD Insulin Syringe Slip Tip/U-100/1ML, 35

BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X 1/2", 35

azithromycin, 1

Azithromycin, 1

BD Insulin Syringe U-40/1ML/25G X 5/8", 35

BD Microtainer Lancets, 35

Azopt, 27

BD Pen Needle/Mini/Ultrafine/31G X 3/16", 35

Azor, 8

BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16", 35

aztreonam, 4

BD Pen Needle/Nano/Ultra Fine/32G X 4MM, 35

Azulfidine, 19

BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X 5/16", 35

Azulfidine EN-TABS, 19

BD Pen Needle/SHORT/Ultrafine/31G X 5/16", 35

B

BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16", 35

BD Pen Needle/Ultrafine/29G X 12.7MM, 35

B-6 Folic Acid, 20

BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2", 35

b-complex 100, 33

BD Pen Needle/Ultrafine/29GX1/2" 12.7MM, 35

B-d Insulin Syringe Ultrafine II/0.3ML/31G X 5/16", 35


BD Pen Needles SHORT/Ultrafine/31G X 5/16", 35

B-d Insulin Syringe Ultrafine II/0.5ML/31G X 5/16", 35


BD Pudendal/Local Block Tray 1% Lidocaine, 30

B-d Insulin Syringe Ultrafine II/1ML/31G X 5/16", 35


BD Safety-glide Insulin Syringe/0.5ML/29G X 1/2", 35

B-d Insulin Syringe Ultrafine/0.3ML/30G X 1/2", 35

BD Insulin Syringe Ultrafine/1ML/30G X 1/2", 35

BD Safety-lok Insulin Syringe/Perm Needle/UF/1ML/29G X 1/2", 35

B-d Insulin Syringe Ultrafine/0.5ML/30G X 1/2", 35

BD Insulin Syringe Ultrafine/1ML/31G X 5/16", 35

BD Safetyglide Insulin Sysyringe/0.5ML/30G X 5/16", 35

B-d Insulin Syringe Ultrafine/1ML/30G X 1/2", 35

BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2", 35

BD-insul SYR Mis LO Dose, 35

bacitracin, 4


Bebulin, 21

Bacitracin, 4, 26

Beconase AQ, 31

bacitracin/polymyxin b, 26


Beleodaq, 6

Baclofen, 11

Belladonna & Opium, 18

baclofen, 26


Belladonna Alkaloids & Opium, 18

Bacmin, 34

Belsomra, 24

Bactocill IN Dextrose, 1


benazepril HCL, 8

Bactrim, 4

benazepril HCL/hydrochlorothiazide, 8

Bactrim DS, 4


Benefix, 21

Bactroban, 11

Benicar, 8

Bactroban Nasal, 31


Benicar HCT, 8

Bal-care DHA, 33

Bentyl, 18

Bal-care DHA Essential, 33


Benzac Ac Wash, 10

balsalazide disodium, 19

Benzac W Wash, 10

Banzel, 24

Benzaclin, 10

Botox, 26 Calan, 7

Benzaclin With P.M., 10

Bravelle, 17 Calan SR, 7

Benzamycin, 10

Breatherite, 40 calcipotriene, 12

Benzamycinpak, 10

Breatherite Collapsible Adult Spacer W/Mask, 40

calcipotriene/betamethasone dipropionate, 12

Benzefoam, 10

Benzefoamultra, 10

Breatherite Collapsible Child Spacer W/Mask, 40

calcitonin salmon, 16

Benziq, 10

calcitonin-salmon, 16

Benziq LS, 10

Breatherite Collapsible Infant Spacer W/Mask, 40

Calcitriol, 12

Benzodox 30 Kit, 2

calcitriol, 17

Benzodox 60 Kit, 2

Breatherite Collapsible Small Child Spacer W/Mask, 41

calcium acetate, 19

Benzoin Compound Tincture, 13

Calcium Carbonate, 18

Benzoin Tincture, 13

Breatherite Collapsible Spacer W/ Neonate Mask, 41

Calcium Folinate, 6

benzonatate, 31

Caldolor, 29

benzoyl peroxide, 10

Breatherite Rigid Spacer W/Mask, 41 Cambia, 30

benzoyl peroxide SHORT contact, 10

Breatherite W/Large Mask, 41 Campral, 25

benztropine mesylate, 25

Breatherite W/Medium Mask, 41 Camptosar, 6

Bepreve, 28

Breatherite W/Small Mask, 41 Canasa, 19

Berinert, 21

Breo Ellipta, 32 Cancidas, 2

Besivance, 26

Brevibloc, 7 candesartan cilexetil, 8

Beta Inject Kit, 14

Brevicon-28, 15 candesartan cilexetil/hydrochlorothiazide, 8

Betadine Ophthalmic Prep, 26

Brilinta, 22

Betagan, 27

brimonidine tartrate, 27 Cantil, 18

Betalido, 14

Brintellix, 23 Capastat Sulfate, 2

betamethasone dipropionate, 12

Brisdelle, 25 capecitabine, 5

betamethasone sodium phosphate/betamethasone acetate, 14

bromfenac, 27 Capex, 12

bromocriptine mesylate, 25 Caphosol, 22

Betamethasone SP, 14

bromphen/pseudoephedrine HCL/dextromethorphan HBR, 31

Capital/Codeine, 29

betamethasone valerate, 12

Caprelsa, 6

Betapace, 7

Brompheniramine, 31 Capsiderm, 13

Betapace AF, 7

Brompheniramine Tannate, 31 captopril, 8

betaxolol HCL, 7, 27

Brovana, 32 Captopril/Hydrochlorothiazide, 8

bethanechol chloride, 19

budesonide, 14, 31, 32 Carafate, 18

Bethkis, 2

Bullseye Safety Lancets, 35 Carbaglu, 17

Betimol, 27

bumetanide, 9 carbamazepine, 24

Betoptic-s, 27

Bumex, 9 carbamazepine ER, 24

bexarotene, 6

Bunavail, 29 Carbaphen 12, 31

Bexsero, 32

Bupap, 28 Carbaphen 12 PED, 31

Bexxar, 5

Buphenyl, 17 Carbatrol, 24

Bexxar 131 Iodine, 6

bupivacaine HCL, 30 carbidopa, 25

Beyaz, 15

bupivacaine/epinephrine, 30 carbidopa/levodopa, 25

Biaxin, 1

Buprenex, 29 carbidopa/levodopa ER, 25

Biaxin XL, 1

buprenorphine HCL, 28 carbidopa/levodopa odt, 25

Biaxin XL PAC, 1

buprenorphine HCL/naloxone HCL, 28 Carbidopa/Levodopa/Entacapone, 25

bicalutamide, 5

bupropion HCL, 22 carbinoxamine maleate, 31

Bicillin C-R, 1

bupropion HCL ER, 22 Carbocaine, 30

Bicillin L-a, 1

bupropion HCL SR, 22 carboplatin, 4

Bicnu, 4

bupropion HCL XL, 22 Cardene I.v., 7

Bidil, 10

buspirone HCL, 22 Cardene IV, 7

Biest/Progesterone, 15

Busulfex, 4 Cardene SR, 7

Biferarx, 20

butalbital/acetaminophen, 28 Cardizem, 7

Biltricide, 3

butalbital/acetaminophen/caffeine, 28 Cardizem CD, 7

Bimatoprost, 27

butalbital/acetaminophen/caffeine/codeine, 28

Cardizem LA, 7

Binosto, 16

Cardura, 8

Biothrax, 32

butalbital/aspirin/caffeine, 28 Cardura XL, 20

bisoprolol fumarate, 7

butalbital/aspirin/caffeine/codeine, 28 Carefine Pen Needle 32GX4MM, 35

bisoprolol fumarate/hydrochlorothiazide, 8

Butisol Sodium, 24 Carefine Pen Needles 29GX1/2", 35

butorphanol tartrate, 28 Carefine Pen Needles 30GX5/16", 35

bivalirudin, 21

Butrans, 29 Carefine Pen Needles 31GX6MM, 35

bleomycin sulfate, 4

Bydureon, 15 Carefine Pen Needles 31GX8MM, 35

Bleph-10, 26

Byetta, 16 Careone Lancet Thin, 35

Blephamide, 27

Bystolic, 7 Careone Lancet Ultra Thin, 35

Blephamide S.o.p., 27

C carisoprodol, 26

Blincyto, 5

Carisoprodol, 26

cabergoline, 17

Bloxiverz, 26

carisoprodol/aspirin, 26

Caduet, 10

Boniva, 16

carisoprodol/aspirin/codeine, 26

Cafcit, 24

Boostrix, 32

Carmol-HC, 12

Cafergot, 30

Boric Acid, 13

Carnitor, 17

caffeine citrate, 24

Bosulif, 6

Carnitor SF, 17

Caffeine/Sodium Benzoate, 24

carteolol HCL, 27

Chenodal, 19 Clarinex-d 12 HOUR, 31

carvedilol, 7

Chloramphenicol Sodium Succinate, 4 Clarinex-d 24 HOUR, 31

Cascara Sagrada, 18

chlordiazepoxide HCL, 22 clarithromycin, 1

Casodex, 5

Chlordiazepoxide/Amitriptyline, 25 clarithromycin ER, 1

Cataflam, 29

chlorhexidine gluconate, 22 Cleanlet Lancets 28G, 35

Catapres, 8

chlorhexidine gluconate oral rinse, 22 clemastine fumarate, 31

Catapres-tts-1, 8

chloroprocaine HCL, 30 Clemastine Fumarate, 31

Catapres-tts-2, 8

chloroquine phosphate, 3 Cleocin, 4, 20

Catapres-tts-3, 8

chlorothiazide, 9 Cleocin IN D5W, 4

Cathflo Activase, 22

Chlorothiazide, 9 Cleocin Pediatric Granules, 4

Cayston, 4

chlorothiazide sodium, 9 Cleocin Phosphate, 4

Cedax, 1

chlorpromazine HCL, 23 Cleocin-t, 10

cefaclor, 1

Chlorpromazine HCL, 23 Clever Chek Lancets Ultrathin, 35

Cefaclor, 1

Chlorpropamide, 16 Clever Chek Lancets Ultrathin 30G, 35

Cefaclor ER, 1

Chlorthalidone, 9 Clever Choice Comfort EZ Insulin Pen Needles 31GX8MM, 35

cefadroxil, 1

chlorzoxazone, 26

Cefazolin, 1

Cholbam, 19 Clever Choice Comfort EZ Insulin Syringe/0.3ML/29G X 1/2", 35

cefazolin sodium, 1

cholestyramine, 9

Cefazolin Sodium, 1

cholestyramine light, 9 Clever Choice Comfort EZ Insulin Syringe/0.3ML/30G X 1/2", 35

Cefazolin Sodium/Dextrose, 1

choline magnesium trisalicylate, 28

cefdinir, 1

Choline Magnesium Trisalicylate, 28 Clever Choice Comfort EZ Insulin Syringe/0.3ML/30G X 5/16", 35

Cefditoren Pivoxil, 1

chorionic gonadotropin, 17

cefepime, 1

Cialis, 10 Clever Choice Comfort EZ Insulin Syringe/0.3ML/31G X 5/16", 35

Cefepime, 1

Ciclodan Cream Kit, 11

cefixime, 1

Ciclodan Solution Kit, 11 Clever Choice Comfort EZ Insulin Syringe/0.5ML/28G X 1/2", 35

cefotaxime sodium, 1

ciclopirox, 11

Cefotetan, 1

ciclopirox nail lacquer, 11 Clever Choice Comfort EZ Insulin Syringe/0.5ML/29G X 1/2", 35

Cefotetan/Dextrose, 1

ciclopirox olamine, 11

cefoxitin sodium, 1

Ciclopirox Topical Solution Kit, 11 Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 1/2", 35

Cefoxitin Sodium, 1

cidofovir, 3

cefpodoxime proxetil, 1

Ciferex, 20 Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 5/16", 35

cefprozil, 1

cilostazol, 21

ceftazidime, 1

Ciloxan, 26 Clever Choice Comfort EZ Insulin Syringe/0.5ML/31G X 5/16", 35

Ceftazidime/Dextrose, 1

cimetidine, 18

Ceftibuten, 1

cimetidine HCL, 18 Clever Choice Comfort EZ Insulin Syringe/1.0ML/30G X 1/2", 35

Ceftin, 1

Cimzia, 19

Ceftriaxone IN Iso-osmotic Dextrose, 1

Cimzia Starter Kit, 19 Clever Choice Comfort EZ Insulin Syringe/1ML/28G X 1/2", 35

ceftriaxone sodium, 1

Cinryze, 21

Ceftriaxone Sodium, 1

Cipro, 2 Clever Choice Comfort EZ Insulin Syringe/1ML/29G X 1/2", 35

Ceftriaxone/Dextrose, 1

Cipro HC, 28

cefuroxime axetil, 1

Cipro I.V.-IN D5W, 2 Clever Choice Comfort EZ Insulin Syringe/1ML/30G X 5/16", 35

cefuroxime sodium, 1

Cipro XR, 2

Cefuroxime Sodium, 1

Ciprodex, 28 Clever Choice Comfort EZ Insulin Syringe/U-100/1ML/31GX5/16", 35

Cefuroxime/Dextrose, 1

ciprofloxacin, 2

Celebrex, 29

Ciprofloxacin, 28 Clever Choice Comfort EZ Patch, 13

celecoxib, 29

ciprofloxacin ER, 2 Clever Choice Comfort EZ Pen Needles 29GX12MM, 35

Celestone-soluspan, 14

ciprofloxacin HCL, 2, 26

Celexa, 23

Ciprofloxacin HCL, 2 Clever Choice Comfort EZ Pen Needles 31GX5MM, 35

Cellcept, 5

ciprofloxacin I.V.-IN D5W, 2

Cellcept Intravenous, 5

cisatracurium besylate, 26 Clever Choice Comfort EZ Pen Needles 31GX6MM, 35

Celontin, 24

cisplatin, 4

Cenestin, 15

Cisplatin, 4 Clever Choice Comfort EZ Pen Needles 31GX8MM, 35

Cenfol, 20

citalopram hydrobromide, 22

Centany AT, 11

Citanest Forte Dental, 30 Clever Choice Comfort EZ Pen Needles 32GX4MM, 35

Centratex, 20

Citanest Plain Dental, 30

cephalexin, 1

Citranatal 90 DHA, 34 Clever Choice Comfort EZ Pen Needles 32GX8MM, 35

Cephalexin, 1

Citranatal Assure, 34

Cerdelga, 20

Citranatal B-calm, 33 Clever Choice Comfort EZ Pen Needles 33GX4MM, 35

Cerebyx, 24

Citranatal DHA, 34

Cerezyme, 20

Citranatal Harmony, 34 Clever Choice Comfort EZ Pen Needles 33GX5MM, 35

Cervarix, 32

Citranatal RX, 33

Cervidil, 28

citric acid/sodium citrate, 20 Clever Choice Comfort EZ Pen Needles 33GX6MM, 35

Cesamet, 19

cladribine, 5

cetirizine HCL, 31

Claforan, 1 Clever Choice Comfort EZ Pen Needles 33GX8MM, 35

Cetraxal, 28

Claforan/D5W, 1

Cetrotide, 17

Clarifoam EF, 10 Cleviprex, 7

cevimeline HCL, 22

Clarinex, 31 Climara, 15

Chemet, 41

Clarinex Reditabs, 31 Climara Pro, 15

Clin Single Use Kit, 4

Comfort Assist Insulin Syringe 0.3ML/29G X 1/2", 35

Cubicin, 4

Clindacin Etz, 10

Curosurf, 32

Clindacin PAC, 10

Comfort Assist Insulin Syringe/0.3ML/30G X 5/16", 35

Cutivate, 12

Clindagel, 10

Cuvposa, 18

clindamycin HCL, 4


cyanocobalamin, 20

clindamycin palmitate HCL, 4

Cyclessa, 15

clindamycin phosphate, 4, 10, 20


Cyclobenzaprine Comfort PAC, 26

Clindamycin Phosphate, 4

cyclobenzaprine HCL, 26

clindamycin phosphate add-vantage, 4


Cyclogyl, 27

clindamycin phosphate IN D5W, 4

Cyclomydril, 27

clindamycin phosphate pharmacy bulk package, 4


cyclopentolate HCL, 27

cyclophosphamide, 4

clindamycin/benzoyl peroxide, 10

Comfort Assist Insulin Syringe/1ML/29G X 1/2", 35

Cyclophosphamide, 4

Clindap-t, 10

Cycloserine, 2

Clindesse, 20


cyclosporine, 5

Clinical Nutrients Prenatal Formula, 33

cyclosporine modified, 5

Clinoin, 10


Cyclosporine Modified, 5

clobetasol propionate, 12

Cyklokapron, 21

clobetasol propionate emollient, 12

Comfort Lancets, 36 Cymbalta, 23

Clobex, 12

Compazine, 23 cyproheptadine HCL, 31

Clocortolone Pivalate, 12

Complera, 3 Cyramza, 5

Clocortolone Pivalate P.M., 12

Comtan, 25 Cystadane, 17

Clodan Kit, 12

Comvax, 32 Cystagon, 20

Cloderm, 12

Concept DHA, 33 Cystaran, 28

Cloderm P.M., 12

Concept OB, 33 cytarabine, 5

Clolar, 5

Concerta, 24 Cytarabine, 5

clomiphene citrate, 17

Condylox, 13 cytarabine aqueous, 5

clomipramine HCL, 22

Conzip, 29 Cytomel, 17

clonazepam, 24

Copasil, 13 Cytotec, 18

clonazepam odt, 24

Copaxone, 25 Cytovene, 3

clonidine HCL, 8

Copegus, 3 Cytra-3, 20

clonidine HCL ER, 24

Cordarone, 8 D

clopidogrel, 21

Cordran, 12

D.h.e. 45, 30

clorazepate dipotassium, 22

Cordran Tape, 12

dacarbazine, 6

Clorpres, 9

Coreg, 7

Dacarbazine, 6

clotrimazole, 11, 22

Coreg CR, 7

Dacogen, 5

clotrimazole/betamethasone dipropionate, 11

Corgard, 7

Daliresp, 32

Corifact, 21

Dallergy, 31

clozapine, 23

Corlanor, 10

Dalvance, 4

clozapine odt, 23

Corlopam, 8

danazol, 14

Clozapine Odt, 23

Cortalo, 12

Dantrium, 26

Clozaril, 23

Cortef, 14

Dantrium IV, 26

Cnl8 Nail Kit, 11

Cortenema, 19

dantrolene sodium, 26

Coaguchek Lancets, 35

Cortifoam, 19

Dantrolene Sodium, 26

Coal TAR, 13

Cortisone Acetate, 14

Dapsone, 4

Coartem, 3

Cortisporin, 11, 28

Daptacel, 32

Cocaine HCL, 13

Cortisporin-tc, 28

Daraprim, 3

Cod Liver Oil, 34

Corvert, 8

daunorubicin HCL, 4

Codar AR, 31

Corvite, 34

Daunoxome, 4

codeine sulfate, 28

Corvite 150, 20

Daypro, 29

Codeine Sulfate, 29

Corzide, 9

Daytrana, 24

Cogentin, 25

Cosentyx, 12

Ddavp, 17

Colazal, 19

Cosentyx Sensoready Pen, 12

Debacterol, 22

Colchicine, 30

Cosmegen, 4

decitabine, 5

Colcrys, 30

Cosopt, 27

Decon-a, 31

Colestid, 10

Cosopt PF, 27

Delestrogen, 15

Colestid Flavored, 10

Coumadin, 21

Demadex, 9

colestipol HCL, 9

Cozaar, 8

demeclocycline HCL, 2

colestipol HCL for oral suspension, 9

Cpb Wc, 31

Demerol, 29

colistimethate sodium, 4

Creon, 19

Demser, 8

Coly-mycin M, 4

Cresemba, 2

Denavir, 11

Coly-mycin S, 28

Crestor, 9

Depacon, 24

Colyte-flavor Packs, 18

Cresylate, 28

Depakene, 24

Combigan, 27

Crinone, 20

Depakote, 24

Combipatch, 15

Crixivan, 3

Depakote ER, 24

Combivent Respimat, 32

Crnatal, 34

Depakote Sprinkles, 24

Combivir, 3

cromolyn sodium, 19, 27

Depo-estradiol, 15

Cometriq, 6

Cromolyn Sodium, 32

Depo-medrol, 14

Depo-provera, 5

Dialyvite Supreme D, 34 Docefrez, 6

Depo-testosterone, 14

Dialyvite/Zinc, 34 docetaxel, 5

Deprizine Fusepaq, 18

Diamox, 9 Docetaxel, 6

Derma Silkrx Anodynexa PAK, 29

Diastar Easy Test II Lancets 30G, 36 Dolgic Plus, 28

Derma Silkrx Diclopak, 29

Diastar Easy Test Lancets30G, 36 Dologesic, 28

Derma Silkrx Sds PAK, 12

Diastat Acudial, 24 Dolophine, 29

Derma-smoothe/FS Body, 12

Diastat Pediatric, 24 donepezil HCL, 25

Derma-smoothe/FS Scalp, 12

Diatx ZN, 34 dopamine HCL, 9

Dermacinrx Azenase PAK, 31

diazepam, 22 Dopamine HCL, 9

Dermacinrx Duopatch Pharmapak, 13

Diazepam, 22, 24 dopamine HCL-dextrose 5%, 9

Dermacinrx Inflammatral PAK, 30

Dibenzyline, 8 dopamine HCL/dextrose 5%, 9

Dermacinrx Lexitral Pharmapak, 11

Diclegis, 19 dopamine/D5W, 9

Dermacinrx Neurotral Pharmapak, 13

diclofenac potassium, 29 Dopram, 24

Dermacinrx Purefolix, 20

diclofenac sodium, 11, 27 Doral, 24

Dermacinrx Surgical Pharmapak, 13

diclofenac sodium DR, 29 Doribax, 4

Dermacinrx Ticanase PAK, 31

diclofenac sodium ER, 29 Doryx, 2

Dermapak Plus, 10

diclofenac sodium/misoprostol, 29 dorzolamide HCL, 27

Dermasorb HC, 12

dicloxacillin sodium, 1 dorzolamide HCL/timolol maleate, 27

Dermasorb Ta, 12

Dicopanol Fusepaq, 31 Doubledex, 14

Dermasorb XM, 13

dicyclomine HCL, 18 Dovonex, 12

Dermatop, 12

didanosine, 3 doxapram HCL, 24

Dermotic, 28

Differin, 10 doxazosin, 8

desipramine HCL, 22

Dificid, 1 doxazosin mesylate, 8

desloratadine, 31

Diflorasone Diacetate, 12 doxepin HCL, 22

desloratadine odt, 31

Diflucan, 2 Doxepin HCL, 23

desmopressin acetate, 17

diflunisal, 28 doxercalciferol, 17

Desogen, 15

digoxin, 7 Doxil, 4

desogestrel/ethinyl estradiol, 15

Digoxin, 7 doxorubicin HCL, 4

Desonate, 12

dihydroergotamine mesylate, 30 Doxorubicin HCL, 4

desonide, 12

Dihydroergotamine Mesylate, 30 doxorubicin HCL liposome, 4

Desowen, 12

Dilacor XR, 7 doxycycline, 2

Desowen Cream/Cetaphil Lotion, 12

Dilantin, 25 Doxycycline, 11

Desowen Lotion/Cetaphil Cream, 12

Dilantin Infatabs, 25 doxycycline hyclate, 2

Desowen Ointment/Cetaphil Lotion, 12

Dilantin-125, 25 doxycycline hyclate DR, 2

desoximetasone, 12

Dilatrate SR, 7 doxycycline monohydrate, 2

Desoximetasone, 12

Dilaudid, 29 Drisdol, 33

Desoxyn, 24

Dilaudid-HP, 29 Dritho-creme HP, 12

Desvenlafaxine ER, 23

diltiazem CD, 7 dronabinol, 19

Detrol, 20

diltiazem HCL, 7 droperidol, 22

Detrol LA, 20

Diltiazem HCL, 7 Droplet Lancets Ultra Thin 30G, 36

dexamethasone, 14

diltiazem HCL ER, 7 drospirenone/ethinyl estradiol, 15

Dexamethasone, 14

Dimenhydrinate, 19 Droxia, 20

Dexamethasone Intensol, 14

Diovan, 8 Drug Mart On-the-go Lancets Gentle 30G, 36

dexamethasone sodium phosphate, 14, 27

Diovan HCT, 9

Dipentocaine, 11 Drug Mart Unilet Lancets Super Thin 30G, 36

Dexamethasone Sodium Phosphate, 14, 27

Dipentum, 19

diphenhydramine HCL, 31 Drug Mart Unilet Lancets Ultra Thin 28G, 36

Dexchlorpheniramine Maleate, 31

diphenoxylate/atropine, 18

Dexedrine, 24

Diphenoxylate/Atropine, 18 Drysol, 13

Dexilant, 18

Diphtheria/Tetanus Toxoids Adsorbed Pediatric, 32

Dsg PAK, 11

Dexlido, 14

Duac, 10

Dexlido-m, 14

Diprolene, 12 Duane Reade Unifine Pentips 29G X 12MM, 36

dexmedetomidine HCL, 23

Diprolene AF, 12

dexmethylphenidate HCL, 24

dipyridamole, 21 Duane Reade Unifine Pentips 31G X 6MM Ultra SHORT, 36

dexmethylphenidate HCL ER, 24

Disalcid, 28

Dexpak 10 Day, 14

disopyramide phosphate, 7 Duane Reade Unifine Pentips 31G X 8MM SHORT, 36

Dexpak 13 Day, 14

disulfiram, 25

Dexpak 6 Day, 14

Ditropan XL, 20 Duavee, 15

Dexpanthenol, 19

Diuril, 9 Duet DHA 400, 33

dexrazoxane, 6

divalproex sodium, 24 Duet DHA 400EC, 33

dextroamphetamine sulfate, 24

divalproex sodium DR, 24 Duet DHA 430, 33

dextroamphetamine sulfate ER, 24

divalproex sodium ER, 24 Duet DHA 430EC, 33

Dextromethorphan HBR/Chlorpheniramine/Phenylephrine HCL, 31

Divigel, 15 Duet DHA Balanced, 33

Divista, 20 Duetact, 16

dobutamine HCL, 9 duloxetine HCL, 22

dobutamine HCL/D5W, 9 Duloxetine HCL, 23

Diabeta, 16

dobutamine/dextrose 5%, 9 Duoneb, 32

Dialyvite 3000, 34

Dobutamine/Dextrose 5%, 9 Duopa, 25

Dialyvite 5000, 34

Duragesic, 29

Easy Touch Insulin Syringe/U-100/1ML/28G X 1/2", 36

Elestrin, 15

Durasafe Spinal/Epidural Tray/1% Xylocaine/19GX36"close CATH, 30

Eletone, 13


Eletone Twinpack, 13

Durasafe Spinal/Epidural Tray/1% Xylocaine/19GX36"open CATH, 30

Elidel, 13


Eligard, 5

Durasafe Spinal/Epidural Tray/1% Xylocaine/20GX36"close CATH, 30

Elimite, 13


Eliphos, 19

Durasafe Spinal/Epidural Tray/1% Xylocaine/20GX36"open CATH, 30

Eliquis, 21

Easy Touch Lancets 21G/Pressure Activated, 36

Elitek, 6

Durezol, 27

Elixophyllin, 32

Durlaza, 22


Ella, 15

dutasteride, 20

Ellence, 4

dutasteride/tamsulosin hydrochloride, 20


Elmiron, 20

Dutoprol, 8

Elocon, 12

Dyazide, 9

Easy Touch Lancets 26G/Pull-top, 36 Eloxatin, 4

Dymista, 31

Easy Touch Lancets 26G/Twist, 36 Emadine, 28

Dyrenium, 9


Embrace Lancets Ultra Thin 30G, 36

Dysport, 26

Emcyt, 5

Dyural-40, 14

Easy Touch Lancets 28G/Pull-top, 36 Emend, 19

Dyural-80, 14

Easy Touch Lancets 28G/Twist, 36 Emla, 13

Dyural-l, 14

Easy Touch Lancets 30G/Button-activated, 36

Emsam, 23

Dyural-lm, 14

Emtriva, 3

E


Emulsion SB, 13

Emvoren, 11

E-z Ject Lancets, 36

Easy Touch Lancets 30G/Pull-top, 36 Enablex, 20

E-z Ject Lancets 21G, 36

Easy Touch Lancets 30G/Twist, 36 enalapril maleate, 8

E-z Ject Lancets Color, 36


enalapril maleate/hydrochlorothiazide, 8

E-z Ject Lancets Super Thin, 36

enalaprilat, 8

E-z Ject Lancets Super Thin 30G, 36

Easy Touch Lancets 32G/Pull-top, 36 Enbrace HR, 33

E-z Ject Lancets Thin 26G, 36

Easy Touch Lancets 32G/Twist, 36 Enbrel, 30

E-z Spacer, 41

Easy Touch Lancets 33G/Twist, 36 Enbrel Sureclick, 30

E-z Spacer The Body Guards Pack, 41

Easy Touch Pen Needles 29GX1/2", 36 Endometrin, 20

E-ZJECT Lancets Micro-thin 33G, 36

Easy Touch Pen Needles 31GX1/4", 36 Engerix-b, 32

E.e.s. 400, 1

Easy Touch Pen Needles 31GX5/16", 36 Enjuvia, 15

E.e.s. Granules, 1

Easy Touch Pen Needles 32GX5/32", 36 Enlon, 26

Easivent, 41

Easy Touch Pen Needles/31G X 3/16", 36

Enlon-plus, 26

Easivent/Mask-large, 41

enoxaparin sodium, 21

Easivent/Mask-medium, 41

Easy Touch Safety Lancets21G/Pressure Activated, 36

entacapone, 25

Easivent/Mask-small, 41

entecavir, 3

Easy Touch Insulin Syringe/0.3ML/30G X 5/16", 36


Entereg, 19

Entocort EC, 14


Easy Touch Safety Lancets26G/Button Activated, 36

Entyvio, 19

Envarsus XR, 5



Epaned, 8

ephedrine sulfate, 9


Easy Touch Safety Lancets28G/Button Activated, 36

Ephedrine Sulfate/Sodium Chloride, 9

Epiceram, 13

Easy Touch Insulin Syringe/1ML/30G X 5/16", 36


Epiduo, 10

Epiduo Forte, 10

Easy Touch Insulin Syringe/Safety/U-100/0.5ML/29G X 1/2", 36

Easy Twist & CAP Lancets, 36 Epifoam, 12

Easytest II Lancets, 36 epinastine HCL, 27

Easy Touch Insulin Syringe/Safety/U-100/0.5ML/30G X 5/16", 36

Easytest Lancets, 36 Epinephrine, 9

EC-naprosyn, 30 Epinephrine HCL, 9

Easy Touch Insulin Syringe/Safety/U-100/1ML/29G X 1/2", 36

econazole nitrate, 11 epinephrine HCL, 32

Ecoza, 11 Epipen 2-PAK, 9

Easy Touch Insulin Syringe/Safety/U-100/1ML/30G X 1/2", 36

Ed Cyte F, 20 Epipen-JR 2-PAK, 9

Edarbi, 8 epirubicin HCL, 4

Easy Touch Insulin Syringe/U-100/0.3ML/30G X 1/2", 36

Edarbyclor, 9 Epirubicin HCL, 4

Edecrin, 9 Episnap, 9


Edluar, 24 episone CRE, 13

Edurant, 3 Epivir, 3


Effexor XR, 23 Epivir HBV, 3

Effient, 21 eplerenone, 8


Egrifta, 17 epoprostenol sodium, 10

Elaprase, 17 Eprosartan Mesylate, 8


Eldepryl, 25 Epzicom, 3

Elelyso, 20 Eql SHORT Pen Needles 31G X 8MM, 36


Elestat, 28

Eql Ultra SHORT Pen Needles 31G X 6MM, 36

Evista, 16 Feiba NF, 21

Evithrom, 21 felbamate, 24

Equagesic, 28

Evoclin, 10 Felbatol, 25

Equetro, 23

Evotaz, 3 Feldene, 30

Equipto-baclofen, 11

Evoxac, 22 felodipine ER, 7

Equipto-naproxen, 11

Exactuss, 31 Fem PH, 20

Eraxis, 2

Exalgo, 29 Femara, 5

Erbitux, 5

Excel Comfort Point Insulin Pen Needles 31G X 4MM, 36

Femcon FE, 15

ergocalciferol, 33

Femhrt Low Dose, 15

ergoloid mesylates, 25

Exel Comfort Point Insulin Pen Needles 29G X 12MM, 36

Femring, 20

Ergoloid Mesylates, 25

fenofibrate, 9

Ergomar, 30


Fenofibrate, 10

Ertaczo, 11

fenofibrate micronized, 9

Erwinaze, 4


Fenofibric Acid, 9

Ery-TAB, 1

fenofibric acid DR, 9

Erygel, 10

Exel Comfort Point Insulin Syringe/0.3ML/29G X 1/2", 36

Fenoglide, 10

Eryped 200, 1

fenoldopam mesylate, 8

Eryped 400, 1


Fenoprofen Calcium, 29

Erythrocin Lactobionate, 1

fentanyl, 28

Erythrocin Stearate, 1


Fentanyl, 28

erythromycin, 1, 10, 26

fentanyl citrate oral transmucosal, 28

Erythromycin Base, 1


Fentanyl Citrate/Sodium Chloride, 29

Erythromycin Ethylsuccinate, 1

Feraheme, 20

erythromycin/benzoyl peroxide, 10


Feriva, 20

Esbriet, 32

Feriva 21/7, 20

Escavite, 33

Exel Comfort Point Insulin Syringe/1ML/28G X 1/2", 36

Ferivafa, 20

Escavite D, 33

Ferralet 90, 20

escitalopram oxalate, 22


Ferrex 150 Forte Plus, 20

Esgic, 28

Ferrex 28, 20

esmolol HCL, 7


Ferriprox, 41

esomeprazole magnesium, 18

Ferrlecit, 20

esomeprazole sodium, 18

Exelderm, 11 Ferro-plex Hematinic, 20

Esomeprazole Sodium, 18

Exelon, 25 Ferrotrin, 20

Esomeprazole Strontium, 18

exemestane, 5 Fetzima, 23

estazolam, 23

Exforge, 9 Fetzima Titration Pack, 23

Estrace, 15, 20

Exforge HCT, 9 Fexmid, 26

estradiol, 14

Exjade, 41 Fibricor, 9

Estradiol, 15

Exoderm, 11 Fifty50 Pen Needles 31G X3/16" (5MM), 36

estradiol valerate, 14

Exparel, 30

estradiol/norethindrone acetate, 14

Extardol, 11 Fifty50 Pen Needles 31G X5/16" (8MM), 36

Estrasorb, 15

Extina, 11

Estring, 20

EZ Smart Blood Glucose Lancets, 36 Fifty50 Safety Seal Lancets 30G, 36

Estrogel, 15

EZ-lets Lancets 21G, 36 Fifty50 Safety Seal Lancets 32G, 36

estropipate, 15

EZ-lets Lancets 23G, 36 Fifty50 Superior Comfort Insulin Syringe/0.3ML/31G X 5/16", 36

Estropipate, 15

EZ-lets Lancets 26G Super-soft, 36

Estrostep FE, 15

EZ-lets Lancets 28G Ultra-soft, 36 Fifty50 Superior Comfort Insulin Syringe/0.5ML/31G X 5/16", 36

eszopiclone, 24

EZ-lets Lancets 30G, 36

Ethacrynate Sodium, 9

F Fifty50 Superior Comfort Insulin Syringe/1ML/31G X 5/16", 36

ethambutol HCL, 2

Fabior, 10

ethosuximide, 24

Finacea, 11

Fabrazyme, 17

Ethyl Chloride, 13

finasteride, 20

Factive, 2

Ethyl Chloride/Fine Pinpoint, 13

Fine 30, 36

Falessa, 15

Ethyl Chloride/Fine Stream, 13

Fingerstix Lancets, 36

famciclovir, 3

Ethyl Chloride/Medium Jet Stream, 13

Fioricet, 28

famotidine, 18

Ethyl Chloride/Medium Stream, 13

Fioricet/Codeine, 29

Famotidine, 18

Ethyl Chloride/Mist, 13

Fiorinal, 28

Famotidine Premixed, 18

Ethyol, 6

Fiorinal/Codeine #3, 29

Famvir, 3

Etidronate Disodium, 16

Firazyr, 21

Fanapt, 23

etodolac, 29

Firmagon, 5

Fanapt Titration Pack, 23

etodolac ER, 29

First-bxn Mouthwash, 22

Fanatrex Fusepaq, 25

Etopophos, 6

First-dukes Mouthwash, 22

Fareston, 5

etoposide, 5

First-hydrocortisone, 12

Farydak, 6

Etoposide, 5

First-lansoprazole, 18

Faslodex, 5

Euflexxa, 26

First-marys Mouthwash, 22

Fasttake Compact Monitoring System, 36

Eurax, 13

First-mouthwash Blm, 22

Evamist, 15

First-omeprazole, 18

Fasttake Test Strips, 36

Evekeo, 24

First-progesterone VGS 100 Compounding Kit, 20

Fazaclo, 23

Evicel, 21

Feiba, 21


fluoxetine HCL, 22 fosinopril sodium, 8

Fluoxetine HCL, 23 fosinopril sodium/hydrochlorothiazide, 8


fluphenazine decanoate, 23 fosphenytoin sodium, 24

fluphenazine HCL, 23 Fosrenol, 19


Fluphenazine HCL, 23 Fragmin, 21

flurazepam HCL, 24 Freestyle Lancets, 36


Flurazepam HCL, 24 Freestyle Precision Insulin Syringe/U-100/0.5ML/30G X 5/16", 36

flurbiprofen, 29

First-testosterone, 14

flurbiprofen sodium, 27 Freestyle Precision Insulin Syringe/U-100/0.5ML/31G X 5/16", 36

First-testosterone Mc Compounding Kit, 14

flutamide, 5

fluticasone propionate, 12, 31 Freestyle Precision Insulin Syringe/U-100/1ML/31G X 5/16", 36

First-vancomycin 25, 4

fluvastatin, 9

First-vancomycin 50, 4

fluvastatin sodium ER, 9 Freestyle Precision Insulin Syringes/U-100/1ML/30G X 5/16", 36

Flagyl, 4

Fluvirin 2013-2014, 32

Flagyl ER, 4

Fluvirin 2014-2015, 32 Freestyle Unistick II Lancets, 36

Flanax Pain Relief Kit, 30

Fluvirin 2015-2016, 32 Frova, 30

Flarex, 27

Fluvirin PF 2013-2014, 32 Fulyzaq, 18

flavoxate HCL, 19

Fluvirin PF 2014-2015, 32 Furadantin, 19

flecainide acetate, 7

fluvoxamine maleate, 22 furosemide, 9

Flector, 11

fluvoxamine maleate ER, 22 Furosemide, 9

Flexepax, 26

Fluzone High-dose PF 2013-2014, 32 Fusilev, 6

Flexichamber, 41

Fluzone High-dose PF 2014-2015, 32 Fusion Plus, 20

FLO-pred, 14

Fluzone High-dose PF 2015-2016, 32 Fusion Sprinkles, 20

Flolan, 10

Fluzone Pediatric PF 2013-2014, 33 Fuzeon, 3

Flomax, 20

Fluzone PF 2013-2014, 33 Fycompa, 25

Flonase, 31

Fluzone PF 2014-2015, 33 G

Floriva, 34

Fluzone Quadrivalent 2013-2014, 33

gabapentin, 24

Flovent Diskus, 32


Gabavale-5, 22

Flovent HFA, 32


Gabazolamine, 22

Flowtuss, 31

Fluzone Split 2013-2014, 33

Gabazolamine-0.5, 22

floxuridine, 5


Gabazolpidem-5, 24

Floxuridine, 5


Gabitidine, 18

Fluarix 2013-2014, 32

FML, 27

Gabitril, 25

Fluarix 2014-2015, 32

FML Forte, 27

Gablofen, 26

Fluarix Quadrivalent 2013-2014, 32

FML Liquifilm, 27

Gaboxetine, 23


Focalgin 90 DHA, 34

galantamine hydrobromide, 25


Focalgin CA, 34

Galantamine Hydrobromide, 25

Flublok 2013-2014, 32

Focalgin Dss, 20

ganciclovir, 3

Flublok 2014-2015, 32

Focalin, 24

Ganirelix Acetate, 17

Flublok 2015-2016, 32

Focalin XR, 24

Ganite, 16

Flucelvax 2013-2014, 32

Folcaps Omega 3, 33

Garamycin, 26

Flucelvax 2014-2015, 32

Folet DHA, 34

Gardasil, 33

Flucelvax 2015-2016, 32

Folet One, 34

Gardasil 9, 33

fluconazole, 2

Folgard OS, 34

Gastrinex NF, 18

fluconazole IN dextrose, 2

Folgard RX, 20

Gastrocrom, 19

fluconazole IN NACL, 2

folic acid, 20

gatifloxacin, 26

Fluconazole IN NACL, 2

Folic Acid, 20

Gattex, 19

flucytosine, 2

folic acid/vitamin b-6/vitamin b-12, 20

Gazyva, 5

Fludara, 5

Folitab 500, 20

Gebauers Pain Ease, 13

fludarabine phosphate, 5

Folivane-f, 20

Gebauers Spray And Stretch, 13

Fludarabine Phosphate, 5

Folivane-OB, 33

Gel-kam Oral Care Rinse, 22

fludrocortisone acetate, 14

Folivane-plus, 20

Gel-one, 26

Flulaval 2013-2014, 32

Folivane-prx DHA NF, 34

Gelclair, 22

Flulaval 2014-2015, 32

Follistim AQ, 17

Gelnique, 20

Flulaval Quadrivalent 2013-2014, 32

Folotyn, 5

Gemcitabine, 5


Foltrate, 20

gemcitabine HCL, 5


fondaparinux sodium, 21

gemfibrozil, 9

Flumadine, 3

Fora Lancets, 36

Gemzar, 5

Flumist Quadrivalent, 32

Foradil Aerolizer, 32

Genadur, 13

flunisolide, 31

Forfivo XL, 23

Genadur Kit, 13

fluocinolone acetonide, 12, 28

Fortamet, 16

gene-xene TAB 15MG, 22

fluocinolone acetonide ear drops, 28

Fortavit, 34

gene-xene TAB 3.75MG, 22

fluocinonide, 12

Fortaz, 1

gene-xene TAB 7.5MG, 22

fluocinonide-e, 12

Forteo, 16

Generess FE, 15

fluorometholone, 27

Fortical, 16

gentamicin sulfate, 2, 26

fluorouracil, 5

Fosamax, 16

Gentamicin Sulfate, 11

fluoxetine, 25

Fosamax Plus D, 16

gentamicin sulfate pediatric, 2

fluoxetine DR, 22

Foscavir, 3

gentamicin sulfate/0.9% sodium chloride,

2

glycopyrrolate, 18 Hematron-AF, 21

Gentamicin Sulfate/0.9% Sodium Chloride, 2

Glynase, 16 Hemocyte Plus, 21

Glyset, 16 Hemocyte-f, 21

Gentle-let GP Lancets, 36

Glyxambi, 16 Hemofil M, 21

Gentle-let Lancets General Purpose Style/Fine Point, 36

Gmate Lancets 30G, 36 heparin lock, 21

Golytely, 18 heparin lock flush, 21

Gentle-let Lancets General Purpose Style/Medium Point, 36

Gonal-f, 17 Heparin Lock Flush, 21

Gonal-f RFF, 17 heparin lock flush for flushing vascular access devices, 21

Gentle-let Lancets Safety Style/Fine Point, 36

Gonal-f RFF Pen, 17

Gonal-f RFF Rediject, 17 heparin lock flush/NACL for flushing vascular access devices, 21

Gentle-let Lancets Safety Style/Medium Point, 36

Gordofilm, 13

Gordons Urea, 13 heparin sodium, 21

Gentle-let Platforms 2.4MM, 36

Gralise, 25 Heparin Sodium, 21

Gentle-let Platforms 3.0MM, 36

Gralise Starter, 25 heparin sodium dcu, 21

Geodon, 23

granisetron HCL, 19 heparin sodium lock flush, 21

Gesticare DHA, 34

Granisol, 19 heparin sodium/D5W, 21

Giazo, 19

Granix, 20 Heparin Sodium/D5W, 21

Gilenya, 25

Grifulvin V, 2 Heparin Sodium/NACL 0.45%, 21

Gilotrif, 6

Gris-peg, 2 heparin sodium/NACL 0.9%, 21

Gilphex TR, 31

griseofulvin microsize, 2 Heparin Sodium/Sodium Chloride 0.9%, 21

Giltuss, 31

griseofulvin ultramicrosize, 2

Giltuss PED-c, 31

guanfacine ER, 24 heparin sodium/sodium chloride 0.9% premix, 21

Giltuss TR, 31

guanfacine HCL, 8

Glassia, 32

Guanidine HCL, 26 Hepsera, 3

Gleevec, 6

Gynazole-1, 20 Herceptin, 5

Gleostine, 4

H Hespan, 22

Gliadel Wafer, 4

hetastarch 6%/NACL, 21

H&h Thinlet Lancets 26G, 36

glimepiride, 16

Hetlioz, 24

H&h Thinlet Super Thin Lancets 30G, 36

glipizide, 16

Hexalen, 4

H-e-b IN Control Pen Needles 31GX6MM, 36

glipizide ER, 16

Hextend, 22

glipizide/metformin HCL, 16

Hiberix, 33

H-e-b IN Control Pen Needles 31GX8MM, 36

Glucagen Hypokit, 16

Hiprex, 19

Glucagon Emergency Kit, 16

homatropine HBR, 27

H-e-b Incontrol Pen Needles 29GX12MM, 36

Glucocom Lancets 28G, 36

Horizant, 25


HPR, 13

H.p. Acthar, 17


HPR Plus, 13

Haemolance, 36

Glucophage, 16

HPR Plus Hydrogel Kit, 13

Haemolance Low Flow Lancets, 36

Glucophage XR, 16

HPR Plus/Mb Hydrogel, 13

Haemolance Plus, 36

Glucopro Insulin Syringe/U-100/0.3ML/30G X 1/2", 36

Humalog, 15

Haemolance Plus High Flow, 36

Humalog Kwikpen, 15

Haemolance Plus Low Flow, 37


Humalog Mix 50/50, 15

Haemolance Plus Max Flow, 37

Humalog Mix 50/50 Kwikpen, 15

Haemolance Plus Pediatric Flow, 37


Humalog Mix 75/25, 15

Halaven, 6

Humalog Mix 75/25 Kwikpen, 15

Halcion, 24


Humate-p, 21

Haldol, 23

Humira, 29

Haldol Decanoate 100, 23


Humira Pediatric Crohns Disease Starter Pack, 29

Haldol Decanoate 50, 23

halobetasol propionate, 12


Humira Pen, 29

Halog, 12

Humira Pen-crohns Diseasestarter, 29

Halonate, 12

Glucopro Insulin Syringe/U-100/1ML/30G X 1/2", 36

Humira Pen-psoriasis Starter, 29

haloperidol, 23

Humulin 70/30, 15

haloperidol decanoate, 23


Humulin 70/30 Kwikpen, 15

haloperidol lactate, 23

Humulin 70/30 Pen, 15

Halotin, 11


Humulin N, 15

Harvoni, 3

Humulin N Kwikpen, 15

Havrix, 33

Glucosource Lancets, 36

Humulin N U-100 Pen, 15

Healthwise Mini Pen Needles 31GX6MM, 37

Glucotrol, 16

Humulin R, 15

Glucotrol XL, 16

Humulin R U-500 (concentrated), 15

Healthwise Pen Needles 29GX12MM, 37

Glucovance, 16

Hy-vee Lancets, 37

Healthwise SHORT Pen Needles 31GX8MM, 37

Glumetza, 16

Hyalgan, 26

glyburide, 16

Hycamtin, 6

Healthy Mama Be Well Rounded, 33

Glyburide, 16

Hycet, 29

Hectorol, 17

glyburide micronized, 16

Hycofenix, 31

Helidac, 18

glyburide/metformin HCL, 16

hydralazine HCL, 8

Helixate FS, 22

Glycate, 18

Hydrea, 6

Hemabate, 28

Glycolic Acid, 12

Hydro 35, 13

Hemangeol, 7

Glycolic Acid 70% High Purity, 12

Hydro 40 Foam, 13

Hematogen Fa, 20

hydrochloric acid, 20

idarubicin HCL, 4 Insulin Syringe/U-100/0.5ML/28G X 1/2", 37

hydrochlorothiazide, 9

Ifex, 4

hydrocodone bitartrate/acetaminophen, 28

ifosfamide, 4 Insulin Syringe/U-100/0.5ML/29G X 1/2", 37

Ifosfamide, 4

Hydrocodone Bitartrate/Acetaminophen, 28

Ilaris, 29 Insulin Syringe/U-100/1ML/28G X 1/2", 37

Ilevro, 28

hydrocodone bitartrate/chlorpheniramine maleate/PSE, 31

Imbruvica, 6 Insulin Syringe/U-100/1ML/29G X 1/2", 37

Imdur, 7

hydrocodone bitartrate/homatropine methylbromide, 31

imipenem/cilastatin, 4 Insulin Syringe/U-100/1ML/30G X 5/16", 37

imipramine HCL, 22

hydrocodone polistirex/chlorpheniramine polistirex, 31

imipramine pamoate, 22 Insulin Syringe/U-100/1ML/31G X 5/16", 37

imiquimod, 13

hydrocodone/acetaminophen, 28

Imitrex, 30 Insupen Sensitive 32GX8MM, 37

Hydrocodone/Acetaminophen, 28

Imitrex Statdose Refill, 30 Insupen Ultrafin 29GX12MM, 37

hydrocodone/homatropine, 31

Imitrex Statdose System, 30 Insupen Ultrafin 30GX8MM, 37

hydrocodone/ibuprofen, 28

Imovax Rabies (h.d.c.v.), 33 Insupen Ultrafin 31GX6MM, 37

hydrocort ene 100MG, 19

Imuran, 5 Insupen Ultrafin 31GX8MM, 37

hydrocortisone, 12, 14, 19

IN Touch Sterile Lancets 30G, 37 Integra F, 21

hydrocortisone acetate/aloe, 12

Increlex, 17 Integra Plus, 21

hydrocortisone acetate/lidocaine HCL, 19

Incruse Ellipta, 32 Integrilin, 22

hydrocortisone acetate/pramoxine, 19

indapamide, 9 Intelence, 3

hydrocortisone butyrate, 12

Inderal LA, 7 Interarticular Joint Kit, 14

hydrocortisone butyrate (lipid), 12

Inderal XL, 7 Intermezzo, 24

hydrocortisone butyrate (lipophilic), 12

Indocin, 30 Intron A, 6

hydrocortisone IN absorbase, 12

indomethacin, 29 Intron A W/Diluent, 6

hydrocortisone valerate, 12

Indomethacin, 30 Intuniv, 24

hydrocortisone/acetic acid, 28

indomethacin ER, 29 Invanz, 4

hydromorphone HCL, 28

Indomethacin Sodium, 30 Invega, 23

Hydromorphone HCL, 28

Infanrix, 32 Invega Sustenna, 23

hydromorphone HCL dosette, 28

Infasurf, 32 Invega Trinza, 23

hydromorphone HCL ER, 28

Infed, 21 Invirase, 3

Hydromorphone HCL ER, 29

Infergen, 3 Invokamet, 16

Hydromorphone HCL/NACL, 29

Infumorph 200, 29 Invokana, 16

Hydromorphone HCL/Sodium Chloride, 28

Infumorph 500, 29 Ionsys, 29

Injectafer, 21 Iopidine, 27

Hydroxocobalamin, 21

Inlyta, 6 Ipol Inactivated IPV, 33

hydroxychloroquine sulfate, 3

Innopran XL, 7 ipratropium bromide, 31, 32

hydroxyurea, 6

Innoprax-5, 11 ipratropium bromide/albuterol sulfate, 32

hydroxyzine HCL, 22

Inova, 10 Iprivask, 21

Hydroxyzine HCL, 22

Inova 4/1 Acne Control Therapy, 10 irbesartan, 8

hydroxyzine pamoate, 22

Inova 8/2 Acne Control Therapy, 10 irbesartan/hydrochlorothiazide, 8

Hydroxyzine Pamoate, 22

Inspirachamber/Anti-static Valved/Mouthpiece, 41

Irenka, 23

Hylatopic, 13

Iressa, 6

Hylatopic Plus, 13

Inspirachamber/Soothermask/Inspiramask/Medium, 41

irinotecan, 6

Hylira, 13

Irinotecan, 6

hyoscyamine sulfate, 18

Inspirachamber/Soothermask/Inspiramask/Small, 41

Iron Asp Gly/ Polysacch Compl/Ascorb CAL/B12/Fa/C Threon/Suc, 20

hyoscyamine sulfate ER, 18

hyoscyamine sulfate odt, 18

Inspirease Bags, 41 Irospan 24/6, 21

hyoscyamine sulfate SR, 18

Inspirease Drug Delivery System, 41 Is 24/6, 21

Hyper-sal, 31

Inspirease Mouthpiece, 41 Isentress, 3

Hypersal, 31

Inspirease Reservoir Bags, 41 isoniazid, 2

Hypertenevide-12.5, 7

Inspra, 8 Isoniazid, 2

Hypertenipine-2.5, 7

Insulin Syringe/0.3ML/29G X 1", 37 Isopto Atropine, 27

Hypertensolol, 9

Insulin Syringe/0.3ML/29G X 1/2", 37 Isopto Carbachol, 27

Hysingla ER, 29

Insulin Syringe/0.3ML/30G X 5/16", 37 Isopto Carpine, 27

Hyzaar, 9

Insulin Syringe/0.3ML/31G X 5/16", 37 Isopto Homatropine, 27

I

Insulin Syringe/0.5ML/27G X 1/2", 37 Isopto Hyoscine, 27

Insulin Syringe/0.5ML/28G X 1/2", 37 Isordil Titradose, 7

ibandronate sodium, 16

Insulin Syringe/0.5ML/29G X 1/2", 37 isosorbide dinitrate, 7

Ibrance, 6

Insulin Syringe/0.5ML/30G X 1/2", 37 Isosorbide Dinitrate, 7

Ibudone, 29

Insulin Syringe/0.5ML/30G X 5/16", 37 Isosorbide Dinitrate ER, 7

ibuprofen, 29

Insulin Syringe/0.5ML/31G X 5/16", 37 isosorbide mononitrate, 7

Ibuprofen Comfort PAC, 30

Insulin Syringe/1ML/28G X 1/2", 37 isosorbide mononitrate ER, 7

ibutilide fumarate, 7

Insulin Syringe/1ML/29G X 1/2", 37 isotonic gentamicin, 2

IC 400, 30

Insulin Syringe/1ML/30G X 5/16", 37 Isotonic Gentamicin, 2

IC 800, 30

Insulin Syringe/1ML/31G X 5/16", 37 Isoxsuprine HCL, 10

Icar-c Plus, 21

Insulin Syringe/U-100/0.3ML/29G X 1/2", 37

isradipine, 7

Iclusig, 6

Istalol, 27

Idamycin PFS, 4

Istodax, 6

Kombiglyze XR, 16 Leader Unifine Pentips/Mini/31GX3/16", 37

Isuprel, 32

Korlym, 16

itraconazole, 2

Kristalose, 18 Leader Unifine Pentips/Nano/32GX5/32", 37

ivermectin, 3

Krystexxa, 30

Ixempra Kit, 6

Kuvan, 17 Leader Unifine Pentips/Plus/32GX5/32", 37

Ixiaro, 33

Kynamro, 10

Ixinity, 22

Kyprolis, 6 leflunomide, 29

J

L Lemtrada, 25

Lenvima 10MG Daily Dose, 6

J-max, 31

labetalol HCL, 7


Jadenu, 41

Lac-hydrin, 13


Jakafi, 6

Lacrisert, 26


Jalyn, 20

lactic acid, 13

Lescol XL, 10

Janumet, 16

lactic acid e, 13

Letairis, 10

Janumet XR, 16

lactic acid w/vitamin e, 13

letrozole, 5

Januvia, 16

lactulose, 18, 19

leucovorin calcium, 6

Jardiance, 16

Lamictal, 24

Leucovorin Calcium, 6

Jevtana, 6

Lamictal Chewable Dispersible, 24

Leukeran, 4

Jublia, 11

Lamictal Odt, 25

Leukine, 21

Juxtapid, 10

Lamictal Starter/Not Taking Carbamazepine, 24

leuprolide acetate, 5

K

Levacet, 28

Lamictal Starter/Taking Carbamazepine/Not Taking Valproate, 24

levalbuterol, 32

K-phos NO 2, 20

levalbuterol HCL, 32

K.b.g.l. IN Teroderm Cream, 11

Levaquin, 2

K10-lido, 14

Lamictal Starter/Taking Valproate, 24

Levatol, 7

K40-lido, 14

Lamictal XR, 25

Levbid, 18

Kadcyla, 5

Lamisil, 2

levetiracetam, 24

Kalbitor, 22

Lamisil Spray, 11

Levetiracetam, 25

Kaletra, 3

lamivudine, 3

levetiracetam ER, 24

Kalydeco, 32

lamivudine/zidovudine, 3

levobunolol HCL, 27

Kanuma, 17

lamotrigine, 24

Levobunolol HCL, 27

Kapvay, 24

lamotrigine ER, 24

levocarnitine, 17

Kapvay Dose Pack, 24

lamotrigine odt, 24

levocetirizine dihydrochloride, 31

Karbinal ER, 31

lamotrigine titration, 24

levofloxacin, 2, 26

Keflex, 1

Lancet Transporter Case, 37

levofloxacin IN D5W, 2

Kenalog, 12

Lancets, 37

levoleucovorin, 6

Kenalog-10, 14

Lancets 26G Twist Top, 37

Levoleucovorin, 6

Kenalog-40, 14

Lancets 28G, 37

levoleucovorin calcium, 6

Kengreal, 22

Lancets 30G, 37

levonorgestrel, 15

Kepivance, 6


Levonorgestrel, 15

Keppra, 25

Lancets 30G/Twist Top, 37

levonorgestrel and ethinyl estradiol, 15

Keppra XR, 25


levonorgestrel/ethinyl estradiol, 15

Kerafoam, 13

Lancets 33G Universal Design, 37

Levophed, 9

Kerafoam 42, 13

Lancets Bullseye Safety, 37

Levorphanol Tartrate, 29

Keralac, 13

Lancets Safety Seal 21G, 37

levothyroxine sodium, 17

Keralyt, 13


Levothyroxine Sodium, 17

Keralyt Scalp, 13


Levsin, 18

Kerlone, 7


Levsin/SL, 18

Kerydin, 11

Lancets Thin, 37

Lexapro, 23

Ketek, 4

Lancets Twist Top, 37

Lexiva, 3

ketoconazole, 2, 11

Lancets Ultra Fine, 37

Lialda, 19

Ketodan Kit, 11

Lancets Ultra Thin, 37

Liberty Medical Lancets 30G, 37

ketoprofen, 29

Lanoxin, 7

lidocaine, 13

Ketoprofen ER, 29

Lanoxin Pediatric, 7

Lidocaine And Tetracaine Cream, 13

Ketorocaine-l, 30

lansoprazole, 18

lidocaine HCL, 7, 13, 22, 30

Ketorocaine-lm, 30

lansoprazole/amoxicillin/clarithromycin, 18

Lidocaine HCL, 8, 13

Ketorolac 2% Gel, 11

lidocaine HCL IN D5W, 7

ketorolac tromethamine, 27, 29

Lantus, 15

lidocaine HCL jelly, 13

Ketorolac Tromethamine, 30

Lantus Solostar, 15

lidocaine HCL viscous, 22

Keytruda, 5

Lasix, 9

Lidocaine HCL-hydrocortisone Acetate With Aloe, 19

Khedezla, 23

Lastacaft, 28

Kineret, 30

latanoprost, 27

lidocaine HCL/dextrose, 7

Kinlytic, 22

Latrix XM, 13

Lidocaine HCL/Dextrose, 30

Kinrix, 32

Latuda, 23

lidocaine HCL/hydrocortisone acetate, 19

Klaron, 10

Ldo Plus, 13

lidocaine viscous, 22

Klonopin, 25

Leader Unifine Pentips Plus/Mini/31GX3/16", 37

lidocaine/epinephrine, 30

Koate-dvi, 21

lidocaine/prilocaine, 13

Kogenate FS, 22

Leader Unifine Pentips Plus/SHORT/31GX5/16", 37

Lidoderm, 13

Kogenate FS Bio-set, 22

Lidoprofen, 11

Loestrin FE 1/20, 15 Magnacet, 29

Lidothol, 13

Lofibra, 10 Makena, 15

Lidovir, 11

Lomotil, 18 Malarone, 3

Lifescan Unistik 2 Deep Penetration, 37

Lomustine, 4 malathion, 13

Lifescan Unistik II Lancets, 37

loperamide HCL, 18 mannitol, 9

Lincocin, 4

Lopid, 10 Maprotiline HCL, 23

Lincomycin/Lidocaine, 4

Lopressor, 7 Marbeta-25, 14

lindane, 13

Lopressor HCT, 9 Marbeta-l, 14

linezolid, 4

Loprox, 11 Marcaine, 30

Linzess, 19

Loprox Shampoo, 11 Marcaine W/O Epi, 30

Lioresal Intrathecal, 26

lorazepam, 22 Marcaine/Epinephrine, 30

liothyronine sodium, 17

Lortab, 29 Mardex-25, 14

Lipofen, 9

Lorzone, 26 Marinol, 19

Liquicet, 29

losartan potassium, 8 Marlido-25, 30

lisinopril, 8

losartan potassium/hydrochlorothiazide, 8

Marnatal-f, 33

lisinopril/hydrochlorothiazide, 8

Marplan, 23

Lite Touch Pen Needles/31G X 3/16", 37

Loseasonique, 15 Marqibo, 6

Liteaire, 41

Lotemax, 27 Mask Vortex/Baby Whirl Duckling, 41

Litetouch Insulin Syringe/0.3ML/29G X 1/2", 37

Lotensin, 8 Mask Vortex/Child/Frog, 41

Lotensin HCT, 9 Mask Vortex/Spinner The Duck, 41


Lotrel, 9 Mask Vortex/Toddler/Lady Bug, 41

Lotrisone, 11 Matulane, 6


Lotronex, 19 Mavik, 8

lovastatin, 9 Maxair Autohaler, 32


Lovaza, 10 Maxalt, 30

Lovenox, 21 Maxalt-MLT, 30


loxapine, 23 Maxaron Forte, 21

loxapine succinate, 23 Maxfe, 21

Litetouch Insulin Syringe/1ML/30G X 5/16", 37

Loxitane, 23 Maxi-comfort Insulin Syringe/U-100/0.5ML/28GX1/2", 37

LT Injection Kit, 14

Litetouch Insulin Syringe/U-100/0.5ML/28G X 1/2", 37

Lta 360 Kit, 22 Maxi-comfort Insulin Syringe/U-100/1ML/28GX1/2", 37

Lufyllin, 32

Litetouch Insulin Syringe/U-100/0.5ML/29G X 1/2", 37

Lumigan, 27 Maxidex, 27

Lumizyme, 17 Maxidone, 29

Litetouch Insulin Syringe/U-100/1ML/28G X 1/2", 37

Lunesta, 24 Maxipime, 1

Lupaneta Pack, 17 Maxitrol, 27


Lupron Depot, 5 Maxzide, 9

Lupron Depot-PED, 17 Maxzide-25, 9


Luvox CR, 23 Mb Hydrogel, 13

Luxiq, 12 meclizine HCL, 19

Litetouch Lancets Micro Thin 33G, 37

Luzu, 11 Meclofenamate Sodium, 29

Litetouch Pen Needles 29GX12.7MM, 37

Lycelle, 13 Medi-derm/L-RX, 13

Litetouch Pen Needles 31G X 6MM, 37

Lynparza, 6 Medical Provider EZ Flu Shot 2014-2015, 33

Litetouch Pen Needles 31GX8MM SHORT, 37

Lyrica, 24

Lysodren, 5 Medical Provider EZ Flu Shot 2015-2016, 33

Lithium, 23

Lysteda, 21

lithium carbonate, 23

Lytensopril Kit, 9 Medical Provider Single Use EZ Flu Shot, 33

Lithium Carbonate, 23

Lytensopril-90, 9

lithium carbonate ER, 23

Lytensopril-90 Kit, 9 Medisense Thin Lancets, 37

Lithobid, 23

M Medlance Plus Extra Lancets 21G, 37

Lithostat, 20

Medlance Plus Lancets, 37

M-m-r II, 33

Live Better Lancet Super Thin 30G, 37

Medlance Plus Lancets Lite 25G, 37

M.v.i. Adult, 34

Live Better Lancet Ultra Thin 28G, 37

Medlance Plus Lite Lancets 25G, 37

M.v.i. Pediatric, 34

Live Better Pen Needles 29G X 12MM, 37

Medlance Plus Special Lancets 0.8MM, 37

M.v.i.-12 Without Vitamin K, 34

Macrobid, 19


Medlance Plus Superlite 30G, 37

Macrodantin, 19

Medlance Plus Superlite 30G/Comfort Max, 37

Magellan Insulin Safety Syringe/U-100/0.3ML/29G X 1/2", 37


LMD 10% Dextrose 5%, 22

Medlance Plus Universal Lancets 21G, 37


LMD 10% Sodium Chloride 0.9%, 22

LO Loestrin FE, 15

Medlance Plus/Lite 25G, 37


LO Minastrin FE, 15

Medlance/Extra, 37

Locoid, 12

Medlance/Lite, 37


Locoid Lipocream, 12

Medlance/Universal, 37

Lodosyn, 25

Medrol, 14

Magellan Insulin Safety Syringe/U-100/1ML/29G X 1/2", 37

Loestrin 1.5/30-21, 15

Medrol Dosepak, 14

Loestrin 1/20-21, 15

medroxyprogesterone acetate, 15

Magellan Insulin Safety Syringe/U-100/1ML/30G X 5/16", 37

Loestrin FE 1.5/30, 15

Medroxyprogesterone/Lidocaine, 15

mefenamic acid, 29

methylphenidate HCL ER, 24 Mitomycin, 4

mefloquine HCL, 3

Methylphenidate HCL ER, 24 Mitosol, 26

Mefoxin, 1

methylphenidate HCL SR, 24 mitoxantrone HCL, 4

Megace ES, 15

methylphenidate hydrochloride, 24 Mlk F4 Kit, 14

Megace Oral, 5

methylprednisolone, 14 Mobic, 30

megestrol acetate, 5, 15

Methylprednisolone, 14 modafinil, 24

Megrix, 13

methylprednisolone acetate, 14 Moderiba, 3

Meijer Super Thin Lancets, 37

methylprednisolone dose pack, 14 Moderiba 1200 Dose Pack, 3

Mekinist, 6

Methylprednisolone PF, 14 Moderiba 800 Dose Pack, 3

meloxicam, 29

methylprednisolone sodiumsuccinate, 14 Modicon, 15

Meloxicam, 29

Methylprednisolone/Lidocaine, 14 moexipril HCL, 8

Meloxicam Comfort PAC, 30

methyltestosterone, 14 moexipril/hydrochlorothiazide, 8

melphalan hydrochloride, 4

Metipranolol, 27 Molindone Hydrochloride, 23

memantine HCL, 25

metoclopramide HCL, 19 mometasone furoate, 12

memantine HCL titration PAK, 25

metoclopramide odt, 19 Moms Choice RX, 33

memantine hydrochloride, 25

Metoclopramide Odt, 19 Monoclate-p, 21

Menactra, 33

metolazone, 9 Monodox, 2

Menest, 15

metoprolol succinate ER, 7 Monoject Bone Marrow Biopsy Prepping Tray, 30

Menhibrix, 33

metoprolol tartrate, 7

Menomune-a/C/Y/W-135, 33

metoprolol/hydrochlorothiazide, 8 Monoject Bone Marrow Biopsy Tray/Biop Aspir Needle 11GX4", 30

Menopur, 17

Metozolv Odt, 19

Menostar, 15

Metro IV, 4 Monoject Bone Marrow Biopsy Tray/Biop Aspir Needle 8GX4", 30

Mentax, 11

Metrocream, 11

Menveo, 33

Metrogel, 11 Monoject Bone Marrow Biopsy Tray/Sternal-iliac Needle 16G, 30

meperidine HCL, 28

Metrogel-vaginal, 20

Meperidine HCL, 29

Metrolotion, 11 Monoject Insulin Syringe Regular LUER Tip/Softpack/1ML, 37

Mephyton, 33

metronidazole, 4, 11

meprobamate, 22

metronidazole IN NACL 0.79%, 4 Monoject Insulin Syringe/1ML, 37

Mepron, 4

metronidazole vaginal, 20 Monoject Insulin Syringe/1ML/31G X 5/16", 37

mercaptopurine, 5

mexiletine HCL, 7

meropenem, 4

Miacalcin, 16 Monoject Insulin Syringe/Detach Needle/1ML/25G X 5/8", 37

Meropenem/Sodium Chloride, 4

Micardis, 8

Merrem, 4

Micardis HCT, 9 Monoject Insulin Syringe/Detach Needle/1ML/27G X 1/2", 37

mesalamine, 19

Microchamber, 41

mesna, 6

Microlet Lancets, 37 Monoject Insulin Syringe/Perm Needle/1ML/28G X 1/2", 37

Mesnex, 6

Microspacer, 41

Mestinon, 26

Microtainer Safety Flow Lancet/Sterile/Single-use, 37

Monoject Insulin Syringe/Perm Needle/U-100/0.5ML/28G X 1/2", 37

Mestinon Timespan, 26

Metadate CD, 24

Microzide, 9 Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29G X 1/2", 37

Metaproterenol Sulfate, 32

midodrine HCL, 9

Metastron, 6

Mifeprex, 17 Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29GX1/2", 37

metaxalone, 26

Migergot, 30

Metaxalone, 26

Migral, 30 Monoject Insulin Syringe/Safety/Perm Needle/0.5ML/29G X 1/2", 37

metformin HCL, 16

Migranal, 30

metformin HCL ER, 16

Millipred, 14 Monoject Insulin Syringe/Safety/Perm Needle/1ML/29G X 1/2", 37

methadone HCL, 28

Millipred DP, 14

Methadone HCL, 29

milrinone IN dextrose, 6 Monoject Insulin Syringe/Softpack/1ML/27G X 1/2", 37

Methadose, 29

milrinone lactate, 6

Methadose Sugar-free, 29

Minastrin 24 FE, 15 Monoject Insulin Syringe/Softpack/U-100/0.5ML/28G X 1/2", 37

methamphetamine HCL, 24

Mineral Oil Heavy, 18

methazolamide, 9

Minipress, 8 Monoject Insulin Syringe/U-100/0.3ML/30G X 5/16", 37

methenamine hippurate, 19

Minivelle, 15

methenamine mandelate, 19

Minocin, 2 Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2", 37

Methenamine Mandelate, 19

Minocin Kit, 2

methimazole, 17

minocycline HCL, 2 Monoject Insulin Syringe/U-100/0.5ML/30G X 5/16", 37

methocarbamol, 26

minocycline HCL ER, 2

methotrexate, 5

minoxidil, 8 Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 37

methotrexate sodium, 5

Mirapex, 25

methoxsalen, 12

Mirapex ER, 25 Monoject Insulin Syringe/U-100/1ML/30G X 5/16", 37

methscopolamine bromide, 18

Mircera, 21

Methyclothiazide, 9

Mircette, 15 Monoject Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2", 37

methyldopa, 8

mirtazapine, 22

Methyldopa/Hydrochlorothiazide, 8

mirtazapine odt, 22 Monoject Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16", 37

Methyldopate HCL, 8

Mirvaso, 11

methylergonovine maleate, 28

misoprostol, 18 Monoject Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16", 37

Methylin, 24

Mission Prenatal, 33

methylphenidate HCL, 24

Mitigare, 30 Monoject Ultra Comfort Insulin Syringe/0.5ML/28G X 1/2", 37

methylphenidate HCL CD, 24

mitomycin, 4

Monoject Ultra Comfort Insulin Syringe/0.5ML/29G X 1/2", 37

Myglucohealth Mgh Softlance Lancets 30G, 38

nefazodone HCL, 22

Nefazodone HCL, 23


Mykidz Iron Fl, 33 Nembutal Sodium, 24

Myleran, 4 Neo-synalar, 11


Mynatal, 33 Neo-synalar Kit, 11

Myobloc, 26 neomycin sulfate, 2

Monoject Ultra Comfort Insulin Syringe/1ML/28G X 1/2", 37

Myoxin, 28 neomycin/bacitracin/polymyxin, 26

Myozyme, 17 neomycin/polymyxin/bacitracin zinc, 26


Myrbetriq, 20 neomycin/polymyxin/bacitracin/hydrocortisone, 27

Mysoline, 25


N neomycin/polymyxin/dexamethasone, 27

neomycin/polymyxin/gramicidin, 26

nabumetone, 29

Monojector End CAPS, 37

neomycin/polymyxin/HC, 28

nadolol, 7

Monojector Opd End CAPS, 37

Neomycin/Polymyxin/Hydrocortisone, 27

nadolol/bendroflumethiazide, 8

Monolet Lancets, 37

neomycin/polymyxin/hydrocortisone, 28

nafcillin sodium, 1

Monolet Opd Lancets, 38

Neoprofen, 30

Nafcillin Sodium, 1

Monolettor Safety Lancets, 38

Neoral, 5

Nafrinse Daily/Acidulated, 22

Mononine, 21

Neosalus, 13

Nafrinse Daily/Neutral, 22

Monovisc, 26

Neosalus CP, 13

Nafrinse Weekly, 22

montelukast sodium, 32

Neosporin, 26

Naftifine HCL, 11

Monurol, 19

neostigmine methylsulfate, 26

Naftin, 11

Moore MED Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2", 38

Neostigmine Methylsulfate, 26

Naglazyme, 17

Neotuss Plus, 31

nalbuphine HCL, 28

Moore MED Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2", 38

Nephplex RX, 34

Nalfon, 30

Nephro-vite RX, 34

Nallpen Iso-osmotic IN Dextrose, 1

Moore MED Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 38

Nephrocaps, 34

Nallpen/Dextrose, 1

Nephrocaps QT, 34

Namenda, 25

Moore MED Monoject Insulin Syringe/U-100/1ML/29G X 1/2", 38

Nephron Fa, 21

Namenda Titration PAK, 25

Neptazane, 9

Namenda XR, 25

Morgidox 1X100MG, 2

Nesacaine, 30

Namenda XR Titration Pack, 25

Morgidox 2X100MG, 2

Nesacaine-mpf, 31

Namzaric, 25

morphine sulfate, 28

Nessi Spacer/Large Mask, 41

Naphazoline HCL, 27

Morphine Sulfate, 28

Nessi Spacer/Mouthpiece, 41

Naprelan, 30

Morphine Sulfate Add-vantage, 29

Nessi Spacer/Small/MED Mask, 41

Naprosyn, 30

morphine sulfate ER, 28

Nestabs, 33

naproxen, 29

Morphine Sulfate ER, 28

Nestabs Abc, 34

Naproxen, 29

Morphine Sulfate/Sodium Chloride, 29

Nestabs DHA, 33

Naproxen Comfort PAC, 30

Motofen, 18

Netgroup Lancets, 38

naproxen sodium, 29

Movantik, 19

Neuac Kit, 10

naproxen sodium CR, 29

Moviprep, 18

Neulasta, 21

naproxen sodium ER, 29

Moxatag, 1

Neulasta Delivery Kit, 21

naratriptan HCL, 30

Moxeza, 26

Neumega, 20

Nardil, 23

moxifloxacin HCL, 2

Neupogen, 21

Naropin, 30

Moxifloxacin HCL, 2

Neupro, 25

Nascobal, 21

Mozobil, 20

Neurontin, 25

Nasonex, 31

MS Contin, 29

Neutrasal, 22

Natachew, 33

Mucinex D, 31

Neutrexin, 4

Natacyn, 26

Mucinex Maximum Strength, 31

Neuvaxin, 13

Natafort, 33

Multaq, 8

Nevanac, 28

Natalvirt 90 DHA, 34

Multigen, 21

nevirapine, 3

Natalvirt CA, 34

Multigen Folic, 21

Nevirapine, 3

Natalvirt Flt, 21

Multigen Plus, 21

nevirapine ER, 3

Natalvit, 33

mupirocin, 11

Newgen, 33

Natazia, 15

mupirocin calcium, 11

Nexa Plus, 34

nateglinide, 16

Muse, 10

Nexavar, 6

Natelle One, 33

Mustargen, 4

Nexium, 18

Natesto, 14

MV FE Asparto Gly/FE Fum/Succ Acid/Vit C/Threonic Acd/B12/Fa, 21

Nexium 24HR, 18

Natpara, 16

Nexium I.v., 18

Natrecor, 10

MV FE Asparto Gly/Vit C/Vit B12/CA Threonate/Succ Acd/Stomac, 21

Nexterone, 8

Natroba, 13

niacin ER, 9

Nature-throid, 18

Myalept, 17

niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper, 33

Nature-throid Nt-2.5, 18

Myambutol, 2

Navelbine, 6

Mycamine, 2

Niacor, 9

Nazirex, 11

Mycobutin, 2

Niaspan, 10

Nebupent, 4

mycophenolate mofetil, 5

Nicadan, 34

Nebusal, 31

mycophenolic acid DR, 5

nicardipine HCL, 7

Necon 1/50-28, 15

Mydfrin, 27

Nicazel, 34

Necon 10/11-28, 15

Myfortic, 5

Nicazel Forte, 34

Neevo DHA, 33

Nicazeldoxy 30 Kit, 2

Novoeight, 22 On Call Lancets, 38

Nicazeldoxy 60 Kit, 2

Novofine Plus 32GX4MM, 38 On Call Plus Lancets, 38

Nicomide, 34

Novoseven Rt, 21 Oncaspar, 4

nifedipine, 7

Noxafil, 2 ondansetron HCL, 19

nifedipine ER, 7

Nplate, 20 ondansetron odt, 19

Nilandron, 5

Nucort, 12 One A Day Womens Prenatal/DHA, 33

Nimbex, 26

Nucynta, 29 One A Day Womens Prenatal1, 33

nimodipine, 7

Nuedexta, 25 One-a-day Womens Prenatal, 33

Nipent, 6

Nulojix, 5 Onetouch Basic System, 38

Niravam, 22

Nulytely/Flavor Packs, 18 Onetouch Basic/Profile Test Strips, 38

nisoldipine, 7

Numoisyn, 22 Onetouch Club Lancets Fine Point, 38

Nisoldipine, 7

Nuox, 10 Onetouch Combo Pack, 38

Nisoldipine ER, 7

Nutricap, 34 Onetouch Delica Lancets Extra Fine 33G, 38

Nitro-bid, 7

Nutridox, 2

Nitro-dur, 7

Nutrivit, 34 Onetouch Delica Lancets Fine 30G, 38

nitrofurantoin, 19

Nutropin AQ Nuspin 10, 17 Onetouch Finepoint Lancets, 38

nitrofurantoin macrocrystals, 19

Nutropin AQ Nuspin 20, 17 Onetouch Lancets, 38

nitrofurantoin monohydrate, 19

Nutropin AQ Nuspin 5, 17 Onetouch Profile System, 38

nitrofurantoin monohydrate/macrocrystals, 19

Nutropin AQ Pen, 17 Onetouch Suresoft Lancing Device/18G, 38

Nuvail, 13

Nitroglycerin, 7

Nuvaring, 15 Onetouch Suresoft Lancing Device/21G, 38

nitroglycerin ER, 7

Nuvessa, 20

nitroglycerin IN 5% dextrose, 7

Nuvigil, 24 Onetouch Suresoft Lancing Device/28G, 38

nitroglycerin IN dextrose 5%, 7

Nuvya, 11

Nitroglycerin IN Dextrose 5%, 7

Nuwiq, 22 Onetouch Ultra 2, 38

nitroglycerin lingual, 7

Nuzon, 12 Onetouch Ultra Blue, 38

Nitroglycerin Lingual, 7

Nymalize, 7 Onetouch Ultra Mini, 38

nitroglycerin transdermal, 7

nystatin, 2, 11, 22 Onetouch Ultra System Kit, 38

Nitrolingual Pumpspray, 7

nystatin/triamcinolone, 11 Onetouch Ultralink System (DEC), 38

Nitromist, 7

O Onetouch Ultralink System (hex), 38

Nitronal, 7

Onetouch Ultrasmart, 38

O-CAL Fa, 33

Nitropress, 8

Onetouch Ultrasoft Lancets, 38

O-CAL Prenatal, 33

Nitrostat, 7

Onetouch Verio, 38

OB Complete, 33

Niva-plus, 33

Onetouch Verio IQ Blood Glucose Monitoring System, 38

OB Complete 400, 33

Nivatopic Plus, 13

OB Complete One, 33

nizatidine, 18

Onetouch Verio Sync Bloodglucose Monitoring System, 38

OB Complete Petite, 33

Nizoral, 11

OB Complete Premier, 33

Nor-QD, 15

Onetouch Verio Test Strips, 38

OB Complete/DHA, 33

Norco, 29

Onexton, 10

Obredon, 31

Norditropin Cartridge, 17

Onfi, 25

Obstetrix DHA, 33

norepinephrine bitartrate, 9

Onglyza, 16

Obtrex, 33

norethindrone, 15

Onmel, 2

Obtrex DHA, 33

norethindrone & ethinyl estradiol ferrous fumarate, 15

Opana, 29

octreotide acetate, 17

Opana ER (crush Resistant), 29

Ocudox, 2

norethindrone acetate, 15

Opdivo, 5

Ocufen, 28

norethindrone acetate/ethinyl estradiol, 15(2)

opium, 18

Ocuflox, 26

opium tincture, 18

Ocuvel, 34

norethindrone acetate/ethinyl estradiol/ferrous fumarate, 15

Opium Tincture (paregoric), 18

Ofev, 32

Opsumit, 10

Ofirmev, 28

Norflex, 26

Optichamber Advantage, 41

ofloxacin, 2, 26, 28

norgestimate/ethinyl estradiol, 15

Optichamber Diamond, 41

Ofloxacin, 2

Norinyl 1+35, 15

Optichamber Diamond/Largeface Mask, 41

olanzapine, 23

Norinyl 1+50, 15

olanzapine odt, 23

Noritate, 11

Optichamber Diamond/Medium Face Mask, 41

olanzapine/fluoxetine, 25

Noroxin, 2

Oleptro, 23

Norpace, 8

Optichamber Diamond/Smallface Mask, 41

olopatadine HCL, 27, 31

Norpace CR, 8

Olux, 12

Norpramin, 23

Optihaler, 41

Olux-e, 12

Northera, 9

Optihaler MDI Drug Delivery System, 41

Olysio, 3

nortriptyline HCL, 22

Optivar, 28

Omeclamox-PAK, 18

Nortriptyline HCL, 23

Oracea, 11

omega-3-acid ethyl esters, 9

Norvasc, 7

Oracit, 20

Omega-3/D-3 Wellness Pack, 10

Norvir, 3

Orafate, 22

omeprazole, 18

Nova Safety Lancets 23G, 38

Orap, 25

Omeprazole + Syrspend SF Alka, 18

Nova Safety Lancets 28G, 38

Orapred, 14

omeprazole/sodium bicarbonate, 18

Nova Sureflex Lancets, 38

Orapred Odt, 14

Omnaris, 31

Novaferrum, 21

Oravig, 22

Omnipred, 27

Novoclair, 11

Orbactiv, 4

Omontys, 21

Orencia, 30

pancuronium bromide, 26 Pentam 300, 4

Orenitram, 10

Panda Mask Large, 41 Pentasa, 19

Orfadin, 17

Panda Mask Medium, 41 pentazocine/acetaminophen, 28

Orkambi, 32

Panda Mask Small, 41 pentazocine/naloxone HCL, 28

orphenadrine citrate, 26

Pandel, 12 Pentetate Calcium Trisodium, 41

orphenadrine citrate ER, 26

pantoprazole sodium, 18 Pentetate Zinc Trisodium, 41

orphenadrine/asa/caffeine, 26

papaverine HCL, 10 Pentips 31GX5MM, 38

Ortho Evra, 15

Parafon Forte DSC, 26 Pentips 31GX8MM, 38

Ortho Micronor, 15

Parcopa, 25 Pentips 32GX4MM, 38

Ortho Tri-cyclen, 15

paricalcitol, 17 pentoxifylline ER, 21

Ortho Tri-cyclen LO, 15

Parlodel, 25 Pepcid, 18

Ortho-cept, 15

Parnate, 23 Percocet, 29

Ortho-cyclen, 15

paromomycin sulfate, 2 Percodan, 29

Ortho-novum 1/35, 15

paroxetine HCL, 22 Perfect Lancets 30G, 38

Ortho-novum 7/7/7, 15

paroxetine HCL ER, 22 Perfect Pressure Activated Safety Lancets 28G, 38

Orthovisc, 26

Paser, 2

Osmoprep, 18

Pataday, 27 Perforomist, 32

Osphena, 17

Patanase, 31 Peridex, 22

Otezla, 30

Patanol, 28 perindopril erbumine, 8

Otozin, 28

Paxil, 23 Perjeta, 5

Otrexup, 30

Paxil CR, 23 permethrin, 13

Ovace Plus, 12

Pazeo, 28 perphenazine, 23

Ovace Plus Wash, 12

PC Unifine Pentips 29G X 1/2", 38 Perphenazine/Amitriptyline, 25

Ovace Wash, 12

PC Unifine Pentips 31G X 6MM Ultra SHORT, 38

Persantine, 22

Ovcon-35, 15

Pexeva, 23

Ovide, 13

PC Unifine Pentips 31G X 8MM SHORT, 38

Pfizerpen-G, 1

Ovidrel, 17

Pharmacist Choice Tsx Patch, 13

oxacillin sodium, 1

PCE, 1 Pharmacist Choice Ultra Thin Lancets, 38

oxaliplatin, 4

Pcp 100, 18

Oxandrin, 14

Pediaderm AF Complete Kit, 11 Pharmacist Choice Ultra Thin Lancets 28G, 38

oxandrolone, 14

Pediaderm HC, 12

oxaprozin, 29

Pediaderm Ta, 12 Pharmacist Choice Ultra Thin Lancets 30G, 38

Oxaydo, 29

Pediapred, 14

oxazepam, 22

Pediarix, 32 Pharmacist Choice Ultra Thin Lancets 31G, 38

oxcarbazepine, 24

Pediatex TD, 31

Oxecta, 29

Pediatex TDM, 31 Pharmacist Choice Ultra Thin Lancets 33G, 38

Oxistat, 11

Pediatric Panda Mask, 41

Oxsoralen, 13

Pedipirox-4 Nail, 11 Pharmacy Counter Lancets, 38

Oxsoralen Ultra, 12

Pedvax HIB, 33 phenazopyridine HCL, 20

Oxtellar XR, 25

peg 3350/electrolytes, 18 phenelzine sulfate, 22

oxybutynin chloride, 19

peg-3350/electrolytes, 18 Phenergan, 31

oxybutynin chloride ER, 19

peg-3350/NACL/NA bicarbonate/KCL, 18 phenobarbital, 24

oxycodone HCL, 28

Peg-intron, 3 Phenobarbital, 24

Oxycodone HCL, 29

Peg-intron Redipen, 3 Phenobarbital Sodium, 24

Oxycodone HCL ER, 28

Peg-intron Redipen PAK 4, 3 phenoxybenzamine hydrochloride, 8

oxycodone/acetaminophen, 28

Peganone, 25 Phentolamine Mesylate, 8

oxycodone/aspirin, 28

Pegasys, 3 phenylephrine HCL, 9, 27

oxycodone/ibuprofen, 28

Pegasys Proclick, 3 Phenylephrine HCL, 9

Oxycontin, 29

Pegintron, 3 Phenylephrine HCL/Sodium Chloride, 9

oxymorphone hydrochloride, 28

Pen Needles 29G X 12MM, 38 phenylephrine/guaifenesin, 31

oxymorphone hydrochloride ER, 28

Pen Needles 29GX1/2", 38 Phenytek, 25

oxytocin, 28

Pen Needles 30GX5/16", 38 phenytoin, 24

Oxytocin/Lactated Ringers, 28

Pen Needles 31G X 1/4" SHORT, 38 phenytoin sodium, 24

Oxytrol, 20

Pen Needles 31G X 3/16", 38 phenytoin sodium extended, 24

P

Pen Needles 31G X 6MM, 38 Phoslo, 19

Pen Needles 31GX5/16", 38 Phoslyra, 19

paclitaxel, 5

penicillin G potassium, 1 Phospholine Iodide, 27

Paclitaxel, 6

Penicillin G Potassium IN Iso-osmotic Dextrose, 1

Photofrin, 6

Paire OB, 34

Phrenilin Forte, 28

Palgic, 31

Penicillin G Procaine, 1 phytonadione, 33

paliperidone ER, 23

Penicillin G Sodium, 1 pilocarpine HCL, 22, 27

Pamelor, 23

penicillin v potassium, 1 pilocarpine hydrochloride, 22

pamidronate disodium, 16

Penlac Nail Lacquer, 11 pimozide, 25

Pamidronate Disodium, 16

Penlet II Replacement CAPS, 38 pindolol, 7

Pamine, 18

Penlet II Replacement CAPS-deep, 38 pioglitazone HCL, 16

Pamine Forte, 18

Penlet II Replacement CAPS-regular, 38 pioglitazone HCL-glimepiride, 16

Pamine FQ, 18

Pennsaid, 11 pioglitazone HCL/metformin HCL, 16

Panatuss Dxp, 31

Pentacel, 32 piperacillin sodium/ tazobactam sodium,

Pancrelipase, 19

1

Precision Sure-dose Plus Insulin Syringe/1ML/29G X 1/2", 38

Prinivil, 8

piperacillin sodium/tazobactam sodium, 1

Pristiq, 23

piperacillin/tazobactam, 1

Precision Thin Lancets, 38 Pro-c-dure 1 Kit, 14

piroxicam, 29

Precision Thins GP Lancet, 38 Pro-c-dure 2 Kit, 14

Pitocin, 28

Precision Ultra Lancet, 38 Pro-c-dure 3 Kit, 14

Pitressin Synthetic, 17

Precose, 16 Pro-c-dure 4 Kit, 14

Plan B, 15

Pred Forte, 27 Pro-c-dure 5 Kit, 14

Plan B One-step, 15

Pred Mild, 27 Pro-c-dure 6 Kit, 14

Plaquenil, 3

Pred-G, 27 Proair HFA, 32

Plavix, 22

Pred-G S.o.p., 27 Proair Respiclick, 32

Plegridy, 25

prednicarbate, 12 probenecid, 30

Plegridy Starter Pack, 25

prednisolone, 14 probenecid/colchicine, 30

Pletal, 22

prednisolone acetate, 27 Procainamide HCL, 8

Plexion, 10

prednisolone sodium phosphate, 14 Procardia, 7

Plexion Cleanser, 10

Prednisolone Sodium Phosphate, 14, 27 Procardia XL, 7

Plexion Cleansing Cloths, 10

prednisolone sodium phosphate odt, 14 Procentra, 24

Pliaglis, 13

prednisone, 14 prochlorperazine, 23

Pneumovax 23, 33

Prednisone, 14 prochlorperazine edisylate, 23

Pneumovax 23/1 Dose, 33

Prednisone Intensol, 14 prochlorperazine maleate, 23

Pneumovax 23/5 Dose, 33

Prefera OB, 33 Procort, 19

Pocket Chamber, 41

Prefera OB + DHA, 33 Procrit, 21

Pocket Spacer, 41

Preferaob +dha, 34 Proctocort, 19

podofilox, 13

Preferaob One, 34 Proctofoam HC, 19

Poly-VI-flor, 33

Preferred Plus Unifine Pentips 29G X 12MM, 38

Procysbi, 20

Poly-VI-flor FS, 33

Prodigy Insulin Mini Pen Needles/31G X 3/16", 38

Poly-VI-flor/Iron, 33

Preferred Plus Unifine Pentips 31G X 6MM Ultra SHORT, 38

polyethylene glycol 3350, 18

Prodigy Insulin Pen Needles/29G X 1/2", 38

polymyxin b sulfate, 4

Preferred Plus Unifine Pentips 31G X 8MM SHORT, 38

polymyxin b sulfate/trimethoprim sulfate, 26

Prodigy Insulin SHORT Penneedles/31G X 5/16", 38

Prefest, 15

Polytrim, 26

Prefol-DHA, 34 Prodigy Insulin Syring/U-100/0.3ML/31G X 5/16", 38

Pomalyst, 5

Premarin, 15, 20

Ponstel, 30

Premphase, 15 Prodigy Insulin Syringe/1/2ML/31G X 5/16", 38

Portrazza, 5

Prempro, 15

potassium citrate ER, 20

Prenata, 33 Prodigy Insulin Syringe/1ML/28G X 1/2", 38

potassium citrate-citric acid crystals, 20

Prenatal Vitamin, 33

potassium citrate/citric acid, 20

Prenatal Vitamins, 33 Prodigy Pressure Activated Safety Lancets, 38

potassium citrate/sodium citrate/citric acid, 20

Prenate, 34

Prenate AM, 33 Prodigy Safety Lancets, 38

Potiga, 25

Prenate DHA, 34 Prodigy Twist Top Lancets, 38

Pr Cream, 13

Prenate Elite, 33 Proferrin-forte, 21

Pradaxa, 21

Prenate Enhance, 34 Profilnine, 21

Praluent, 9

Prenate Essential, 33 Profilnine SD, 21

pramipexole dihydrochloride, 25

Prenate Mini, 34 progesterone, 15

pramipexole dihydrochloride ER, 25

Prenate Pixie, 34 Progesterone 10% Kit, 15

Pramosone, 12

Prenate Restore, 34 Proglycem, 16

Pramotic, 28

Prenate Star, 33 Prograf, 5

Prandimet, 16

Prepidil, 28 Prolastin-c, 32

Prandin, 16

Prepopik, 18 Prolensa, 28

Prascion Ra With Sunscreens, 10

Preque 10, 34 Proleukin, 6

Prastera, 30

Presera, 13 Prolia, 16

pravastatin sodium, 9

Prestalia, 9 Promacta, 21

Prazolamine, 26

Prevacid, 18 promethazine HCL, 31

prazosin HCL, 8

Prevacid Solutab, 18 promethazine HCL plain, 31

Pre-folic, 21

Prevident, 22 promethazine-DM, 31

Precedex, 24

Prevnar 13, 33 promethazine/codeine, 31

Precision Sure-dose Insulin Syringe/0.3ML/30G X 5/16", 38

Prevpac, 18 promethazine/dextromethorphan, 31

Prezcobix, 3 promethazine/phenylephrine, 31


Prezista, 3 Promethazine/Phenylephrine, 31

Prialt, 28 promethazine/phenylephrine/codeine, 31


Priftin, 2 Prometrium, 15

Prilosec, 18 Promiseb, 12


Primaquine Phosphate, 3 Promiseb Complete, 12

Primaxin IV, 4 propafenone HCL, 7

Precision Sure-dose Insulin Syringe/1ML/28G X 1/2", 38

Primaxin IV Add-vantage, 4 propafenone HCL ER, 7

primidone, 24 Propantheline Bromide, 18

Precision Sure-dose Plus Insulin Syringe/0.3ML/29G X 1/2", 38

Primlev, 29 proparacaine HCL, 27

Primsol, 4 propranolol HCL, 7

Propranolol HCL, 7

Quinidine Sulfate, 8 Relion Pen Needles 32GX4MM, 38

propranolol HCL ER, 7

Quinidine Sulfate ER, 8 Relion SHORT Pen Needles 31GX8MM, 38

Propranolol/Hydrochlorothiazide, 8

quinine sulfate, 3

propylthiouracil, 17

Qutenza, 13 Relion Thin Lancets, 38

Proquad, 33

R Relion Ultra Thin Lancets, 38

Proscar, 20

Relion Ultra Thin Lancets30G, 38

R-natal OB, 34

Prosed/DS, 19

Relion Ultra Thin Plus Lancets 32G, 38

Rabavert, 33

Prostigmin, 26

Relion Ultra Thin Plus Lancets 33G, 38

rabeprazole sodium, 18

Prostin E2, 28

Relistor, 19

raloxifene hydrochloride, 16

Protamine Sulfate, 22

Relpax, 30

ramipril, 8

Protect Plus, 34

Relyyks, 13

Ranexa, 7

Protectiron, 21

Relyyt, 13

ranitidine HCL, 18

Prothelial, 22

Remeron, 23

Rapaflo, 20

Protonix, 18

Remeron Soltab, 23

Rapamune, 5

Protopic, 13

Remicade, 19

Rapivab, 3

protriptyline HCL, 22

Remodulin, 10

Rasuvo, 29

Provenge, 6

Renagel, 19

Ravicti, 17

Provera, 15

Renatabs, 34

Rayos, 14

Provida DHA, 34

Renatabs With Iron, 34

Razadyne, 25

Provida OB, 33

Renew Advanced Lancing Cartridge Refills, 38

Razadyne ER, 25

Provigil, 24

Rebetol, 3

Prozac, 23

Renvela, 19

Reclast, 16

Prozac Weekly, 23

Reopro, 22

Recombinate, 21

Pruclair, 13

repaglinide, 16

Recombivax HB, 33

Prudoxin, 12

repaglinide/metformin hydrochloride, 16

Recothrom, 21

Prumyx, 13

Repatha, 10

Recothrom Spray Kit, 21

Pss Select GP Lancets, 38

Repatha Sureclick, 10

Rectiv, 19

Pss Select Platforms, 38

Reprexain, 29

Recura, 11

Pss Select Safety Lancets, 38

Repronex, 17

Reglan, 19

Pulmicort, 32

Req 49+, 34

Regonol, 26

Pulmicort Flexhaler, 32

Requip, 25

Relagard, 20

Pulmophylline, 32

Requip XL, 25

Relenza Diskhaler, 3

Pulmozyme, 32

Rescon-JR, 31

Relhist, 31

Purinethol, 5

Rescon-MX, 31

Relion Insulin Syringe/U -100/0.5ML/29G, 38

Purixan, 5

Rescriptor, 3

Px Lancets Ultra Thin, 38

Reserpine, 8

Relion Insulin Syringe/U-00/1ML/29G X 1/2", 38

Pylera, 18

Respa-BR, 31

pyrazinamide, 2

Restasis, 27

Relion Insulin Syringe/U-100/0.3ML/29G, 38

Pyridium, 20

Restora RX, 18

pyridostigmine bromide, 26

Restora Sprinkles, 18

Relion Insulin Syringe/U-100/0.3ML/29G X 1/2", 38

Pyridoxine HCL, 33

Restoril, 24

Pyrogallic Acid, 13

Retavase, 22


Q

Retavase Half-kit, 22

Retin-a, 10

Qc Lancets Super Thin, 38


Retin-a Micro, 10

Qc Lancets Ultra Thin, 38

Retin-a Micro P.M., 10

Qc Pen Needles 29G X 12MM, 38


Retinoic Acid, 10


Retinoic Acid-all Trans, 10



Retrovir, 3

Qnasl, 31

Retrovir IV Infusion, 3

Qnasl Childrens, 31


Revatio, 10

Quadracel, 32

Revlimid, 5

Quadramet, 6


Rexall Lancets Ultra Thin, 38

Qualaquin, 3

Rexulti, 23

Quartette, 15


Reyataz, 3

Quazepam, 24

Rezira, 31

Qudexy XR, 25

Relion Insulin Syringe/U-100/1ML/30G, 38

Rezyst IM, 18

Quelicin, 26

Rezyst SB, 18

Quelicin 1000, 26


Rheumatrex, 30

Questran, 10

Rhinocort Aqua, 31

Questran Light, 10


Rhinoflex-650, 28

quetiapine fumarate, 23

Riastap, 21

Quillivant XR, 24

Relion Lancets Micro-thin33G, 38

Riax, 10

quinapril HCL, 8

Relion Lancets Standard 21G, 38

Ribasphere, 3

quinapril/hydrochlorothiazide, 8

Relion Lancets Thin 26G, 38

Ribasphere Ribapak, 3

Quinidine Gluconate, 8

Relion Lancets Ultra-thin30G, 38

Ribatab, 3

quinidine gluconate CR, 7

Relion Mini Pen Needles 31GX6MM, 38

ribavirin, 3

quinidine gluconate ER, 7

Relion Pen Needles 29GX12MM, 38

Ridaura, 30

quinidine sulfate, 7

Relion Pen Needles 31GX8MM, 38

rifabutin, 2

Safesnap Insulin Syringe/0.5ML/30G X 5/16", 38

Sentravil PM-25, 23

Rifadin, 2

Sentrazolam AM 0.25, 22

Rifamate, 2

Safesnap Insulin Syringe/1ML/28G X 1/2", 38

Sentrazolpidem PM-5, 24

rifampin, 2

Sentroxatine, 23

Rifater, 2

Safesnap Insulin Syringe/1ML/29G X 1/2", 38

Serevent Diskus, 32

Right Step Prenatal, 33

Seroquel, 23

Rightest GD-L500 Alternate Site Adapter, 38

Safety Lancet 21G/Pressure Activated, 38

Seroquel XR, 23

Serostim, 17

Rightest Gl300 Lancets, 38

Safety Lancet 28G/Pressure Activated, 39

sertraline HCL, 23

Rilutek, 26

Sevelamer Carbonate, 19

riluzole, 26

Safety Lancets, 39 Sfrowasa, 19

rimantadine HCL, 3

Safety Lancets 21G, 39 Shohls Solution Modified, 20

Rimantalist, 3

Safety Lancets 28G, 39 Shopko On-the-go Comfort Lancets 30G, 39

Riomet, 16

Safety Let Lancets, 39

risedronate sodium, 16

Safety Seal Lancets 28G, 39 Shopko Unifine Pentips Pen Needles/Micro/32GX4MM, 39

risedronate sodium DR, 16

Safety Seal Lancets 30G, 39

Risperdal, 23

Safety-glide Insulin Syringe/0.3ML/29G X 1/2", 39

Shopko Unifine Pentips Pen Needles/Mini/31GX5MM, 39

Risperdal Consta, 23

Risperdal M-TAB, 23

Safyral, 15 Shopko Unifine Pentips Pen Needles/Original/29GX12MM, 39

risperidone, 23

Saizen, 17

risperidone odt, 23

Saizen Click.easy, 17 Shopko Unifine Pentips Pen Needles/SHORT/31GX8MM, 39

Ritalin, 24

Salagen, 22

Ritalin LA, 24

Salex, 13 Shopko Unilet Lancets Super Thin 30G, 39

Ritalin SR, 24

Salex Cream, 13

Riteflo, 41

Salex Lotion, 13 Shopko Unilet Lancets Ultra Thin 28G, 39

Rituxan, 5

salicylic acid, 13

rivastigmine tartrate, 25

Salicylic Acid, 13 Siderol, 34

rivastigmine transdermal system, 25

salicylic acid cream, 13 Signifor, 17

rizatriptan benzoate, 30

Salicylic Acid IN Ammonium Lactate Vehicle, 13

Signifor Lar, 17

rizatriptan benzoate odt, 30

Silazone Pharmapak, 12

Robaxin, 26

salicylic acid lotion, 13 sildenafil, 10

Robaxin-750, 26

Salkera, 13 sildenafil citrate, 10

Robinul, 18

salsalate, 28 Silenor, 24

Robinul Forte, 18

Salvax, 13 Simbrinza, 27

Rocaltrol, 17

Salvax Duo Plus, 13 Simcor, 9

Rocephin, 1

Samsca, 17 Simponi, 29

rocuronium bromide, 26

Sanctura, 20 Simponi Aria, 29

ropinirole ER, 25

Sanctura XR, 20 Simulect, 5

ropinirole HCL, 25

Sancuso, 19 simvastatin, 9

ropivacaine, 30

Sandimmune, 5 Sinelee, 13

ropivacaine HCL, 30

Sandostatin, 17 Sinemet, 25

Rosadan Kit, 11

Sandostatin Lar Depot, 17 Sinemet CR, 25

Rosanil, 10

Saphris, 23 Single-let, 39

Rosula, 10

Sarafem, 25 Singulair, 32

Rotarix, 33

Savaysa, 21 sirolimus, 5

Rotateq, 33

Savella, 25 Sirturo, 2

Rowasa, 19

Savella Titration Pack, 25 Sitavig, 3

Roxicet, 29

Scalacort DK, 12 Sivextro, 4

Roxicodone, 29

Scar Patch, 13 Skelaxin, 26

Rozerem, 24

Scopolamine Hydrobromide, 18 Sklice, 13

Ryanodex, 26

Seasonique, 15 Smart Diabetes Vantage Universal Lancets 30G, 39

Rytary, 25

Seb-prev, 12

Rythmol, 8

Seconal, 24 Smart Sense Color Lancets Universal 33G, 39

Rythmol SR, 8

Sectral, 7

S

Select-OB, 33 Smart Sense Standard Lancets Universal 21G, 39

Select-ob+dha, 34

Sabril, 25

selegiline HCL, 25 Smart Sense Super Thin Lancets Universal 30G, 39

Safe-t-lance Low Flow 25G, 38

selenium sulfide, 12

Safe-t-lance Normal Flow 21G, 38

Selrx, 12 Smart Sense Thin Lancets Universal 26G, 39

Safe-t-lance Plus Safety Lancet High Flow, 38

Selzentry, 3

Semprex-d, 31 Smartest Lancets 28G, 39

Safe-t-lance Plus Safety Lancet Low Flow, 38

Senophylline, 32 Sodium Bicarbonate, 18

Sensipar, 17 sodium chloride, 31

Safe-t-lance Plus Safety Lancet Normal Flow, 38

Sensorcaine-mpf/Epinephrine, 31 sodium citrate/citric acid, 20

Sentradine, 18 Sodium Diuril, 9


Sentraflox AM-10, 23 Sodium Edecrin, 9

Sentralopram AM-10, 23 sodium ferric gluconate complex/sucrose, 20


Sentramodafin AM-100, 24

sodium hyaluronate, 13

Streptomycin Sulfate, 2 Sure-ject Insulin Syringe/U-100/1ML/28G X 1/2", 39

sodium phenylbutyrate, 17

Striant, 14

sodium sulfacetamide, 10, 12, 26

Stribild, 3 Sure-ject Insulin Syringe/U-100/1ML/29G X 1/2", 39

sodium sulfacetamide wash, 12

Striverdi Respimat, 32

sodium sulfacetamide/sulfur, 10

Stromectol, 3 Sure-ject Insulin Syringe/U-100/1ML/30G X 5/16", 39

Sodium Sulfacetamide/Sulfur, 10

Strovite Forte, 34

sodium sulfacetamide/sulfur cleanser, 10

Strovite One, 34 Sure-ject Insulin Syringe/U-100/1ML/31G X 5/16", 39

Sodium Sulfacetamide/Sulfur Cleanser IN Urea, 10

Stuart Prenatal, 33

Suboxone, 29 Sure-lance Flat Lancets, 39

sodium sulfacetamide/sulfur cleansing cloths, 10

Subsys, 29 Sure-lance Lancets 26G, 39

Suclear, 18 Sure-lance Thin Lancets 28G, 39

sodium sulfacetamide/sulfur green, 10

Sucraid, 19 Sure-lance Ultra Thin Lancets, 39

Sodium Sulfacetamide/Sulfur IN Urea, 10

sucralfate, 18 Sure-touch Lancets Universal, 39

sodium sulfacetamide/sulfur w/sunscreen, 10

Sular, 7 Surelite Lancets, 39

sulfacetamide sodium, 10, 26 Surestep Test Strips, 39

sodium sulfacetamide/sulfur wash, 10

Sulfacetamide Sodium, 26 Surfaxin, 32

Solaice, 14

sulfacetamide sodium/prednisolone sodium phosphate, 27

Surmontil, 23

Soliris, 21

Survanta Intratracheal, 32

Solodyn, 2

sulfacetamide sodium/sulfur cleanser, 10 Sustiva, 3

Soltamox, 5

Sulfadiazine, 2 Sutent, 6

Solu-cortef, 14

sulfamethoxazole/trimethoprim, 4 Suttar-2, 31

Solu-medrol, 14

Sulfamethoxazole/Trimethoprim, 4 Suttar-SF, 31

Solus V2 Pressure Activated Safety Lancets 28G, 39

sulfamethoxazole/trimethoprim DS, 4 Sylatron, 6

sulfasalazine, 19 Symax Duotab, 18

Solus V2 Twist Lancets 30G, 39

Sulfoam, 10 Symbicort, 32

Soma, 26

Sulfurated Lime, 14 Symbyax, 25

Somatuline Depot, 17

sulindac, 29 Symlinpen 120, 15

Somavert, 17

Sumadan Kit, 10 Symlinpen 60, 15

Sonata, 24

Sumadan Wash, 11 Synagex, 34

Soolantra, 11

Sumadan XLT, 11 Synalar, 12

Soothee, 14

Sumatriptan, 30 Synalar Cream Kit, 12

Soriatane, 12

sumatriptan succinate, 30 Synalar Ointment Kit, 12

Sorilux, 12

Sumatriptan Succinate, 30 Synalar Ts, 12

sotalol HCL, 7

sumatriptan succinate refill, 30 Synalgos-dc, 29

sotalol HCL (AF), 7

Sumavel Dosepro, 30 Synapryn Fusepaq, 29

Sotalol Hydrochloride, 7

Sumaxin, 11 Synarel, 17

Sotylize, 7

Sumaxin CP Kit, 11 Synatek, 34

Sovaldi, 3

Sumaxin Ts, 11 Synera, 14

Spectracef, 1

Sumaxin Wash, 11 Synercid, 4

Spinosad, 14

Supartz, 26 Synribo, 6

Spiriva Handihaler, 32

Supartz Fx, 26 Synthroid, 18

Spiriva Respimat, 32

Supervite, 34 Synvisc, 26

spironolactone, 9

Supervite EC, 34 Synvisc One, 26

spironolactone/hydrochlorothiazide, 9

Support-500, 34 T

Sporanox, 2

Supprelin LA, 17

Tabloid, 5

Sporanox Pulsepak, 2

Supracil, 14

Tabradol Fusepaq, 26

Sprix, 30

Suprax, 1

Taclonex, 12

Sprycel, 6

Suprep Bowel Prep, 18

tacrolimus, 5, 13

Staflex, 28

Sure-fine Pen Needles 29GX1/2" 12.7MM, 39

Tafinlar, 6

Stalevo 100, 25

Talwin, 29

Stalevo 125, 25

Sure-fine Pen Needles 31GX3/16" 5MM, 39

Tamiflu, 3

Stalevo 150, 25

tamoxifen citrate, 5

Stalevo 200, 25

Sure-fine Pen Needles 31GX5/16" 8MM, 39

tamsulosin HCL, 20

Stalevo 50, 25

Tandem F, 21

Stalevo 75, 25

Sure-ject Insulin Syringe/U-100/0.3ML/29G X 1/2", 39

Tandem Plus, 21

stannous fluoride oral rinse, 22

Tapazole, 18

Starlix, 16


Tarceva, 6

stavudine, 3

Targadox, 2

Stavzor, 25


Targretin, 6

Stelara, 12

Tarka, 9

Stendra, 10


Taron-bc, 33

Sterilance PA, 39

Taron-c DHA, 33

Sterilance TL, 39


Tasigna, 6

Stimate, 17

Tasmar, 25

Stiolto Respimat, 32


Taxotere, 6

Stivarga, 6

Tazicef, 1

Strattera, 24


Tazorac, 12

Strazepam, 24

Tecfidera, 25

Tecfidera Starter Pack, 25

Testred, 14 thioridazine HCL, 23

Techlite AST Lancets, 39

Tetanus Toxoid Adsorbed, 32 Thiotepa, 4

Techlite Lancets, 39

Tetanus/Diphtheria Toxoids-adsorbed, 32

thiothixene, 23

Techlite Lancets 30G, 39

Thrombin-jmi Diluent, 21

Tegretol, 25

Tetanus/Diphtheria Toxoids-adsorbed Adult, 32

Thrombin-jmi Epistaxis, 21

Tegretol-XR, 25

Thrombin-jmi Syringe Spray Kit, 21

Tekamlo, 9

tetrabenazine, 25 Thrombin-jmi W/Dil Spray P.M. Actuator, 21

Tekturna, 8

tetracaine HCL, 27

Tekturna HCT, 8

Tetracaine HCL, 30 Thrombogen, 21

telmisartan, 8

Tetracycline HCL, 2 Thymoglobulin, 5

telmisartan/amlodipine, 8

Tetrix, 14 Thyrolar-1, 18

telmisartan/hydrochlorothiazide, 8

Teveten, 8 Thyrolar-1/2, 18

temazepam, 24

Teveten HCT, 9 Thyrolar-1/4, 18

Temodar, 4

Texacort, 12 Thyrolar-2, 18

Temovate, 12

Texavite LQ, 34 Thyrolar-3, 18

Temovate E, 12

Thalomid, 5 tiagabine hydrochloride, 24

temozolomide, 4

Theo-24, 32 Tiazac, 7

Tencon, 28

theophylline, 32 Tice Bcg, 6

Tenex, 8

theophylline CR, 32 ticlopidine HCL, 21

Teniposide, 6

theophylline ER, 32 Ticlopidine HCL, 21

Tenivac, 32

Theophylline/D5W, 32 Tigan, 19

Tenoretic 100, 9

Therabenzaprine-60, 26 Tikosyn, 8

Tenoretic 50, 9

Therabenzaprine-90, 26 Timentin, 1

Tenormin, 7

Therabenzaprine-90-5, 26 Timolol Maleate, 7

Terazol 3, 20

Theracodeine-300, 29 timolol maleate, 27

Terazol 7, 20

Theracodophen-325, 29 timolol maleate ophthalmic gel forming, 27

terazosin HCL, 8

Theracodophen-650, 29

terbinafine HCL, 2

Theracodophen-750, 29 Timoptic, 27

Terbinex, 2

Theracodophen-low-90, 29 Timoptic Ocudose, 27

terbutaline sulfate, 32

Theracys, 6 Timoptic-xe, 27

terconazole, 20

Therafeldamine, 30 Tindamax, 4

Tersi Foam, 12

Theranatal Core Nutrition, 33 tinidazole, 4

Terumo Insulin Syringe/0.3ML/30G X 3/8", 39

Therapentin-60, 25 Tirosint, 18

Therapentin-90, 25 Tisseel, 21


Theraprofen-60, 30 Tisseel VH, 21

Theraprofen-800, 30 Tivicay, 3


Theraprofen-90, 30 Tivorbex, 30

Theraproxen-500, 30 Tizanidine Comfort PAC, 26

Terumo Insulin Syringe/1ML/27G X 1/2", 39

Theraproxen-60, 30 tizanidine HCL, 26

Theraproxen-90, 30 TL G-FOL OS, 34


Theratramadol-60, 29 TL Triseb, 12

Theratramadol-90, 29 Tnkase, 22


thiamine HCL, 33 Tobradex, 27

Thinlets GP Lancets, 39 Tobradex ST, 27

Terumo Insulin Syringe/U-100/0.3ML/29G X 1/2", 39

Thinlets Lancet, 39 tobramycin, 2

Thinpro Insulin Syringe/0.3ML/29G X 1/2", 39

tobramycin sulfate, 2, 26


Tobramycin Sulfate/Sodium Chloride, 2


tobramycin/dexamethasone, 27


Tobrex, 26


Tofranil, 23

Terumo Insulin Syringe/U-100/1ML/28G X 1/2", 39

Tofranil-PM, 23


tolazamide, 16

Terumo Surguard Insulin Syringe/0.3ML/29G X 1/2", 39

Tolazamide, 16


Tolbutamide, 16


tolcapone, 25


tolmetin sodium, 29


Tolmetin Sodium, 29


tolterodine tartrate, 19

Terumo Surguard Insulin Syringe/1ML/28G X 1/2", 39

tolterodine tartrate ER, 19

Thinpro Insulin Syringe/1ML/28G X 1/2", 39

Topamax, 25

Terumo Surguard Insulin Syringe/1ML/29G X 1/2", 39

Topamax Sprinkle, 25


Topicort, 12

Tessalon Perles, 31

topiramate, 24

Testone Cik, 14


Topiramate ER, 25

Testopel, 14

topotecan HCL, 6

Testosterone, 14


Topotecan HCL, 6

testosterone cypionate, 14

Toprol XL, 7

testosterone enanthate, 14

Thiola, 20 Torisel, 6

torsemide, 9

26 U

Torsemide, 9

trimipramine maleate, 23

Uceris, 14, 19

Totect, 6

Triostat, 18

Udamin SP, 34

Toujeo Solostar, 15

Trisenox, 6

Ulesfia, 14

Toviaz, 20

Triseon, 11

Uloric, 30

Tracleer, 10

Triumeq, 3

Ulticare Insulin Safety Syringe/0.5ML/29G X 1/2", 39

tramadol HCL, 28

Triveen-duo DHA, 34

tramadol HCL ER, 28

Triveen-prx RNF, 34

Ulticare Insulin Safety Syringe/1ML/29G X 1/2", 39

Tramadol HCL ER, 29

Trizivir, 3

tramadol hydrochloride/acetaminophen, 28

Trokendi XR, 25

Ulticare Insulin Syringe 1CC/28G U-100 1/2", 39

Tropazone, 14

Trandate, 7

trospium chloride, 20

Ulticare Insulin Syringe Ultrafine U-100/0.3ML/31G X 5/16", 39

trandolapril, 8

trospium chloride ER, 20

trandolapril/verapamil HCL, 8

Trueplus Insulin Syringe/U-100/0.3ML/29G X 1/2", 39

Ulticare Insulin Syringe Ultrafine U-100/0.5ML/31G X 5/16", 39

trandolapril/verapamil HCL ER, 8

tranexamic acid, 21


Ulticare Insulin Syringe Ultrafine U-100/1ML/31G X 5/16", 39

Transderm-scop, 19

Tranxene T, 22


Ulticare Insulin Syringe/0.3ML/29G X 1/2", 39

tranylcypromine sulfate, 23

Travatan Z, 27



Travoprost, 27

Trazamine, 23



trazodone HCL, 23

Treanda, 4



Trecator, 2

Trelstar, 5



Trelstar Mixject, 5

Trepadiclofen-25, 30

Trueplus Insulin Syringe/U-100/1ML/28G X 1/2", 39


Trepoxen-250, 30

Trepoxicam-7.5, 30



Tretin-x, 11

tretinoin, 6, 10


Ulticare Insulin Syringe/1ML/28G X 1/2", 39

Tretinoin, 10

Tretinoin (all-trans Retinoic Acid), 10



tretinoin microsphere, 10

tretinoin microsphere P.M., 10

Trueplus Lancets 26G, 39


Trexall, 5


Treximet, 30

Trueplus Lancets 28G Super Thin, 39


Trezix, 29


Tri-norinyl 28, 15

Trueplus Lancets 30G Ultra Thin, 39

Ulticare Insulin Syringe/SHORT/0.3ML/30G X 5/16", 39

Tri-VI-flor, 33


Triamcinolone, 14

Trueplus Lancets 33G Micro Thin, 39


triamcinolone acetonide, 12, 22, 31

Trueplus Safety Lancets 28G, 39

Triamcinolone Acetonide, 12

Trumenba, 33


triamcinolone IN orabase, 22

Trusopt, 28

Triamcinolone PF, 14

Truvada, 3


Triamcinolone/Lidocaine, 14

Turkel Paracentesis Procedure Tray/8french, 31

Triamsil Combipak, 12

Ulticare Insulin Syringe/SHORT/1ML/30G X 5/16", 39

triamterene/hydrochlorothiazide, 9

Tussicaps, 31

Triamterene/Hydrochlorothiazide, 9

Tussionex Pennkinetic Extended Release, 31

Ulticare Insulin Syringe/SHORT/1ML/31G X 5/16", 39

Trianex, 12

triazolam, 24

Tuzistra XR, 31

Ulticare Insulin Syringe/U-100/0.3ML/29G X 1/2", 39

Tribenzor, 8

Twinrix, 33

Tricare Prenatal Compleat, 33

Twynsta, 9


Tricare Prenatal DHA One, 34

Tybost, 3

tricitrates, 20

Tygacil, 4


Tricor, 10

Tykerb, 6

Triderma Forte, 12

Tylenol/Codeine #3, 29


Triferic, 21

Tylenol/Codeine #4, 29

trifluoperazine HCL, 23

Typhim VI, 33


trifluridine, 26

Tysabri, 26

Triglide, 10

Tyvaso, 10


trihexyphenidyl HCL, 25

Tyvaso Refill, 10

Trileptal, 25

Tyvaso Starter, 10


Trilipix, 10

Tyzeka, 3

trimethobenzamide HCL, 19

Tyzine, 31


trimethoprim, 4

Tyzine Pediatric Nasal Drops, 31

trimethoprim sulfate/polymyxin b sulfate,

Ulticare Insulin Syringe/U-100/1ML/29G X

1/2", 39

Ultra-thin II Insulin Syringe SHORT/U-100/1ML/30GX5/16", 40

Unistik CZT Comfort, 40

Ulticare Insulin Syringe/U-100/1ML/30G X 1/2", 39

Unistik CZT Normal, 40

Ultra-thin II Insulin Syringe SHORT/U-100/1ML/31GX5/16", 40

Unistik Safety Lancets 28G, 40


Unistik Safety Lancets 30G, 40

Ultra-thin II Insulin Syringe/U-100/0.3ML/29GX1/2", 40

Univasc, 8


Universal 1 Lancets Thin 26G, 40

Ultra-thin II Insulin Syringe/U-100/0.5ML/29GX1/2", 40

Universal 1 Lancets Ultra Thin 30G, 40

Ulticare Micro Pen Needles/32G X 4MM, 39

Uramaxin, 14

Ultra-thin II Insulin Syringe/U-100/1ML/29GX1/2", 40

Uramaxin GT, 14

Ulticare Mini Pen Needles 31GX6MM, 39

Uramaxin GT Kit, 14

Ulticare Mini Pen Needles Ulti-fine IV, 39

Ultra-thin II Lancets 28G, 40 urea, 13

Ulticare Mini Pen Needles/31G X 6MM, 39

Ultra-thin II Lancets 30G, 40 urea 40% nail film, 13

Ultra-thin II Mini Pen Neeedles/31GX3/16", 40

urea IN zinc undecylenate/lactic acid vehicle, 13

Ulticare Mini Pen Needles31GX6MM, 39

Ulticare Original Pen Needles Ulti-fine, 39

Ultra-thin II Pen Needles 29GX1/2", 40 urea topical, 13

Ultra-thin II Pen Needles/SHORT/31GX5/16", 40

Urecholine, 20

Ulticare Pen Needles/29G X 12.7MM, 39

Uretron D/S, 19

Ulticare SHORT Pen Needles 31GX8MM, 40

Ultra-thin II Safety Autolancets 26G, 40 Urimar-t, 19

Ultracet, 29 Urocit-k 10, 20

Ulticare SHORT Pen Needles Ulti-fine IV, 39

Ultralance, 40 Urocit-k 15, 20

Ultram, 29 Urocit-k 5, 20

Ulticare SHORT Pen Needles/31G X 8MM, 40

Ultram ER, 29 Urogesic-blue, 19

Ultrasal-ER, 14 Uroqid #2, 19

Ulticare Thin Lancets 30G, 40

Ultravate, 12 Uroxatral, 20

Ultiguard Insulin Syringe/U-100/0.3ML/29G X 1/2", 40

Ultravate PAC, 12 Urso 250, 19

Ultravate X, 13 Urso Forte, 19


Umecta, 14 ursodiol, 19

Umecta Nail Film, 14 Utopic, 14


Umecta PD, 14 Uvadex, 6

Unasyn, 1 V


Unasyn Bulk Pack, 1

V-r Monoject Insulin Syringe/U-100/0.3ML/29G X 1/2", 40

Unifine Pentips 29GX12MM, 40

Ultiguard Insulin Syringe/U-100/1ML/29G X 1/2", 40

Unifine Pentips 31G X 3/16", 40


Unifine Pentips 31G X 6MM, 40

Ultiguard Insulin Syringe/U-100/1ML/30G X 5/16", 40

Unifine Pentips 31G X 8MM, 40



Ultilet Classic Lancets, 40


V-r Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 40

Ultilet Insulin Syringe/SHORT/0.3ML/30G X 5/16", 40



V-r Monoject Insulin Syringe/U-100/1ML/29G X 1/2", 40


Unifine Pentips Plus 29GX12MM, 40


Vagifem, 20



valacyclovir HCL, 3


Valchlor, 4


Unilet Comfortouch Lancet, 40

Valcyte, 3

Unilet Excelite, 40

valganciclovir, 3

Ultilet Insulin Syringe/SHORT/1ML/30G X 5/16", 40

Unilet Excelite II, 40

Validerm, 13

Unilet G.p. Lancet, 40

Valium, 22

Ultilet Insulin Syringe/SHORT/1ML/31G X 5/16", 40

Unilet G.p. Superlite Lancet, 40

valproate sodium, 24

Unilet GP 28 Ultra Thin, 40

valproic acid, 24

Ultilet Lancets, 40

Unilet Lancet, 40

valsartan, 8

Ultilet Lancets 33G, 40

Unilet Lancets Micro-thin33G, 40

valsartan/hydrochlorothiazide, 8

Ultilet Pen Needle 32GX4MM/SHORT, 40

Unilet Lancets Super-thin30G, 40

Valtrex, 3

Unilet Lancets Ultra-thin 28G, 40

Valumark Lancet Super Thin 30G, 40

Ultilet Safety Lancets 23G, 40

Unilet Superlite Lancet, 40

Valumark Lancet Ultra Thin 28G, 40

Ultilet SHORT Pen Needles 31GX5/16", 40

Uniretic, 9

Valumark Pen Needles 29GX12MM, 40

Unistik 1, 40

Valumark Pen Needles 31G X 6MM, 40

Ultilet SHORT Pen Needles31GX3/16", 40

Unistik 2, 40

Valumark Pen Needles 31G X 8MM, 40

Unistik 2 Comfort, 40

Vanatol LQ, 28

Ultiva, 29

Unistik 2 Extra, 40

Vancocin HCL, 4

Ultra-thin II Auto Lancet, 40

Unistik 2 Neonatal, 40

vancomycin HCL, 4

Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/30GX5/16", 40

Unistik 2 Normal, 40

Vancomycin HCL, 4

Unistik 2 Super, 40

Vancomycin HCL + Syrspendsf PH4, 4


Unistik 3, 40

Vancomycin HCL IN Dextrose, 4

Unistik 3 Comfort, 40

Vanishpoint Insulin Syringe/0.5ML/30G X 1/2", 40


Unistik 3 Extra, 40

Unistik 3 Gentle, 40

Vanishpoint Insulin Syringe/1ML/29G X 1/2", 40


Unistik 3 Neonatal, 40

Unistik 3 Normal, 40

Vanos, 13

Vanoxide-HC, 11

Vinate AZ Extra, 34 Walgreens Ultra Thin Lancets, 40

Vantas, 5

Vinate Calcium, 34 warfarin sodium, 21

Vaprisol, 17

Vinate DHA, 34 Watchhaler, 41

Vaqta, 33

Vinate DHA RF, 34 Welchol, 9

Varivax, 33

Vinblastine Sulfate, 6 Wellbutrin, 23

Vascepa, 9

vincristine sulfate, 5 Wellbutrin SR, 23

Vaseretic, 9

vinorelbine tartrate, 5 Wellbutrin XL, 23

vasopressin, 17

Viracept, 3 Westcort, 13

Vasostrict, 17

Viramune, 3 Westhroid, 18

Vasotec, 8

Viramune XR, 3 Wheat Germ, 33

Vazculep, 9

Virasal, 14 Wilate, 21

Vecamyl, 8

Virazole, 3 Wp Thyroid, 18

Vectibix, 5

Viread, 3 X

Vectical, 12

Viroptic, 26

Xalatan, 27

vecuronium bromide, 26

Vistaril, 22

Xalkori, 6

Velcade, 6

Vistide, 3

Xanax, 22

Veletri, 10

Vita-pren, 34

Xanax XR, 22

Velphoro, 19

Vitafol, 34

Xarelto, 21

Veltin, 11

Vitafol Fe+, 34

Xarelto Starter Pack, 21

Vemavite-prx 2, 34

Vitafol Ultra, 34

Xartemis XR, 29

venlafaxine HCL, 23

Vitafol-nano, 34

Xeljanz, 30

venlafaxine HCL ER, 23

Vitafol-ob+dha, 34

Xeloda, 5

Venlafaxine HCL ER, 23

Vitafol-one, 34

Xenazine, 26

Venofer, 21

Vitafol-pn, 34

Xeomin, 26

Ventavis, 10

Vital-d RX, 34

Xerac Ac, 14

Ventolin HFA, 32

Vitalet Pro Lancets, 40

Xerese, 11

Veramyst, 31

Vitalet Pro Plus Lancets, 40

Xgeva, 16

verapamil HCL, 7

Vitamedmd One RX/Quatrefolic, 34

Xifaxan, 4

verapamil HCL ER, 7

Vitamedmd Plus RX/Quatre Folic, 34

Xigduo XR, 16

verapamil HCL SR, 7

Vitamedmd Redichew RX, 34

Xodol, 29

Verdeso, 13

Vitamedmd Redichew RX/Quatrefolic, 34

Xofigo, 6

Veregen, 14

Vitamin A, 33

Xolair, 32

Verelan, 7

vitamin c 222MG, 33

Xolegel, 11

Verelan PM, 7

vitamin d, 33

Xolegel Corepak, 11

Veripred 20, 14

vitamin k1, 33

Xolegel Duo/Head & Shoulders, 11

Verrunex, 14

Vitamin K1, 33

Xolegel Duo/Xolex, 11

Versacloz, 23

Vitapearl, 34

Xolox, 29

Vesicare, 20

Vitaroca Plus, 34

Xopenex, 32

Vexa, 14

Vitatrue, 34

Xopenex Concentrate, 32

Vexol, 27

Vitekta, 3

Xtandi, 5

Vfend, 3

Vituz, 31

Xylocaine, 8, 14, 31

Vfend IV, 3

Viva DHA, 34

Xylocaine-mpf, 31

Vibativ, 4

Vivactil, 23

Xylocaine-mpf/Epinephrine, 31

Vibramycin, 2

Vivelle-dot, 15

Xylocaine/Epinephrine, 31

Vicoprofen, 29

Vivlodex, 30

Xyntha, 22

Victoza, 16

Vivotif, 33

Xyntha Solofuse, 22

Victrelis, 3

Vivotif Berna, 33

Xyrem, 26

Vida Mia Unifine Pentips 32GX4MM, 40

Voltaren, 11

Xyzal, 31

Vida Mia Unifine Pentips Mini 31GX6MM, 40

Voltaren-XR, 30

Y

Voluven, 22

Vida Mia Unifine Pentips Original 29GX12MM, 40

Vopac, 11

Yasmin 28, 15

Vopac GB, 11

Yaz, 15

Vida Mia Unilet Lancets Super Thin 30G, 40

Vopac Kt, 11

Yervoy, 5

Voraxaze, 6

Yf-vax, 33

Vida Mia Unilet Lancets Ultra Thin 28G, 40

voriconazole, 2

Yodoxin, 3

Vortex Valved Holding Chamber, 41

Your Life Multi Prenatal, 34

Vida Mia Unipfine Pentipsshort 31GX8MM, 40

Vosol HC, 28

Z

Vospire ER, 32

Zacare 4% Kit, 11

Vidaza, 5

Votrient, 6

Zacare 8% Kit, 11

Videx EC, 3

Vpriv, 21

zafirlukast, 32

Videx Pediatric, 3

Vsl#3 DS, 18

zaleplon, 24

Viekira PAK, 3

Vusion, 11

Zaltrap, 5

Vigamox, 26

Vyvanse, 24

Zamicet, 29

Viibryd, 23

W

Zanaflex, 26

Viibryd Starter Pack, 23

W&f Lancets 26G, 40

Zanosar, 4

Vimizim, 17

W&f Lancets Colored 21G, 40

Zantac, 18

Vimpat, 25

Walgreens Lancets, 40

Zarontin, 25

Vinacal B, 34

Walgreens Thin Lancets, 40

Zaroxolyn, 9

Zatean-CH, 34

Zydelig, 6

Zatean-pn, 34

Zydone, 29

Zatean-pn DHA, 34

Zyflo, 32

Zatean-pn Plus, 34

Zyflo CR, 32

Zavesca, 21

Zykadia, 6

Zebeta, 7

Zylet, 27

Zegerid, 18

Zyloprim, 30

Zelapar, 25

Zymaxid, 26

Zelboraf, 6

Zyprexa, 23

Zemaira, 32

Zyprexa Relprevv, 23

Zemplar, 17

Zyprexa Zydis, 23

Zemuron, 26

Zytiga, 5

Zenpep, 19

Zyvodol, 11

Zenzedi, 24

Zyvox, 4

Zerbaxa, 4

1

Zerit, 3

1ST Choice Lancets Super Thin, 40

Zestoretic, 9

1ST Choice Lancets Thin, 40

Zestril, 8

1ST Choice Lancets Ultra Thin, 40

Zetia, 10

1ST Tier Unifine Pentips 29GX12MM, 40

Zetonna, 31


Zevalin Y-90, 5


Ziac, 9

8

Ziagen, 3

Ziana, 11

8-mop, 12

zidovudine, 3

Zinacef, 1

Zinecard, 6

ziprasidone HCL, 23

Zipsor, 30

Zirgan, 26

Zithranol, 12

Zithranol-rr, 12

Zithromax, 1

Zithromax Tri-PAK, 2

Zithromax Z-PAK, 2

Zmax, 2

Zofran, 19

Zofran Odt, 19

Zoladex, 5

zoledronic acid, 16

Zoledronic Acid, 16

Zolinza, 6

zolmitriptan, 30

zolmitriptan odt, 30

Zoloft, 23

zolpidem tartrate, 24

zolpidem tartrate ER, 24

Zolpimist, 24

Zometa, 16

Zomig, 30

Zomig Nasal Spray, 30

Zomig ZMT, 30

Zonalon, 12

Zonatuss, 31

Zonegran, 25

zonisamide, 24

Zontivity, 22

Zorbtive, 17

Zortress, 5

Zostavax, 33

Zosyn, 1

Zovia 1/50e, 15

Zovirax, 3, 11

Zubsolv, 29

Zuplenz, 19

Zutripro, 31

Zyclara, 13

Zyclara P.M., 13

Premium-Value Formulary Reference Guide · Premium-Value Formulary Reference Guide *Formulary Disclaimer: Coverage for some drugs may be limited to specific dosage forms and/or strengths.

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