Premium-Value Formulary Reference Guide

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

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

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

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

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

ANTIMETABOLITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

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

ANTINEOPLASTIC COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

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

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

IMMUNOMODULATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

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

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

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

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

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

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

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

HEMATOLOGICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

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

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

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

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

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

BETA-BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

ANTIHISTAMINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

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

cefuroxime sodium

PREFERRED

Cefaclor

NON PREFERRED

January 2016 Cefaclor ER

Cefotetan

ANTI-INFECTIVES Cefotetan/Dextrose

Cefoxitin Sodium

PENICILLINS

Ceftin

GENERIC

Cefuroxime Sodium

amoxicillin

Cefuroxime/Dextrose

amoxicillin/clavulanate potassium

Mefoxin

amoxicillin/clavulanate potassium ER

Zinacef

ampicillin

THIRD GENERATION

ampicillin sodium

GENERIC

ampicillin-sulbactam

cefdinir

dicloxacillin sodium

cefixime

nafcillin sodium

cefotaxime sodium

oxacillin sodium

cefpodoxime proxetil

penicillin v potassium

ceftazidime

penicillin G potassium

ceftriaxone sodium

piperacillin sodium/ tazobactam sodium

NON PREFERRED

piperacillin sodium/tazobactam sodium

Cedax

piperacillin/tazobactam

Cefditoren Pivoxil

PREFERRED

Ceftazidime/Dextrose

Amoxicillin

Ceftibuten

Ampicillin

Ceftriaxone IN Iso-osmotic Dextrose

NON PREFERRED

Ceftriaxone Sodium

Amoxicillin ER

Ceftriaxone/Dextrose

Ampicillin Sodium

Claforan

Ampicillin-sulbactam

Claforan/D5W

Augmentin

Fortaz

Augmentin ES-600

Rocephin

Augmentin XR

Spectracef

Bactocill IN Dextrose

Suprax

Bicillin C-R

Tazicef

Bicillin L-a

FOURTH GENERATION

Moxatag

GENERIC

Nafcillin Sodium

cefepime

Nallpen Iso-osmotic IN Dextrose

NON PREFERRED

Nallpen/Dextrose

Cefepime

Penicillin G Potassium IN Iso-osmotic Dextrose

Maxipime

Penicillin G Procaine

Penicillin G Sodium

MACROLIDES

Pfizerpen-G

GENERIC

Timentin

azithromycin

Unasyn

clarithromycin

Unasyn Bulk Pack

clarithromycin ER

Zosyn

erythromycin

PREFERRED

CEPHALOSPORIN

E.e.s. 400

FIRST GENERATION

Erythromycin Base

GENERIC

Erythromycin Ethylsuccinate

cefadroxil

NON PREFERRED

cefazolin sodium

Azithromycin

cephalexin

Biaxin

PREFERRED

Biaxin XL

Cephalexin

Biaxin XL PAC

NON PREFERRED

Dificid

Ancef

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

cefprozil

Zithromax Tri-PAK

cefuroxime axetil

Zithromax Z-PAK

Effective January 1, 2016 v.1 All Optum

TM

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

Zmax PREFERRED

Bethkis

TETRACYCLINES NON PREFERRED

Gentamicin Sulfate/0.9% Sodium Chloride

GENERIC

Isotonic Gentamicin

demeclocycline HCL

Streptomycin Sulfate

doxycycline

Tobramycin Sulfate/Sodium Chloride

doxycycline hyclate

doxycycline hyclate DR

SULFONAMIDES

doxycycline monohydrate

minocycline HCL PREFERRED

minocycline HCL ER Sulfadiazine

Tetracycline HCL

NON PREFERRED ANTIMYCOBACTERIAL AGENTS

Acticlate

GENERIC

Adoxa

ethambutol HCL

Adoxa PAK 1/100

isoniazid

Adoxa PAK 1/150

pyrazinamide

Adoxa PAK 2/100

rifabutin

Alodox Convenience Kit

rifampin

Avidoxy DK

NON PREFERRED

Doryx

Capastat Sulfate

Minocin

Cycloserine

Minocin Kit

Isoniazid

Monodox

Myambutol

Morgidox 1X100MG

Mycobutin

Morgidox 2X100MG

Paser

Nicazeldoxy 30 Kit

Priftin

Nicazeldoxy 60 Kit

Rifadin

Nutridox

Rifamate

Ocudox

Rifater

Solodyn

Sirturo

Targadox

Trecator

Vibramycin

ANTIFUNGALS

QUINOLONES

GENERIC

GENERIC

fluconazole

ciprofloxacin

fluconazole IN dextrose

ciprofloxacin ER

fluconazole IN NACL

ciprofloxacin HCL

flucytosine

ciprofloxacin I.V.-IN D5W

griseofulvin microsize

levofloxacin

griseofulvin ultramicrosize

levofloxacin IN D5W

itraconazole

moxifloxacin HCL

ketoconazole

ofloxacin

nystatin

Ciprofloxacin HCL

terbinafine HCL

Ofloxacin

voriconazole

NON PREFERRED

NON PREFERRED

Avelox

Abelcet

Avelox Abc Pack

Ambisome

Cipro

Amphotec

Cipro I.V.-IN D5W

Amphotericin B

Cipro XR

Ancobon

Factive

Cancidas

Levaquin

Cresemba

Moxifloxacin HCL

Diflucan

Noroxin

Eraxis

Fluconazole IN NACL

AMINOGLYCOSIDES

Grifulvin V

GENERIC Gris-peg

amikacin sulfate Lamisil

gentamicin sulfate Mycamine

gentamicin sulfate pediatric Noxafil

gentamicin sulfate/0.9% sodium chloride Onmel

isotonic gentamicin Sporanox

neomycin sulfate Sporanox Pulsepak

paromomycin sulfate Terbinex

tobramycin Vfend

tobramycin sulfate Vfend IV

Effective January 1, 2016

2

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

Epivir

MISC. ANTI-INFECTIVES

Epivir HBV

GENERIC

Famvir

atovaquone


3

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

ALKYLATING AGENTS

clindamycin HCL

GENERIC

colistimethate sodium

carboplatin

imipenem/cilastatin

cisplatin

linezolid

cyclophosphamide

meropenem

ifosfamide

metronidazole

melphalan hydrochloride

metronidazole IN NACL 0.79%

oxaliplatin

polymyxin b sulfate

temozolomide

sulfamethoxazole/trimethoprim

Lomustine

sulfamethoxazole/trimethoprim DS

PREFERRED

tinidazole

Alkeran

trimethoprim

Bicnu

vancomycin HCL

Busulfex

Dapsone

Hexalen

PREFERRED

Leukeran

Alinia

Mustargen

Nebupent

Myleran

NON PREFERRED

Treanda

Avycaz

Zanosar

Azactam

NON PREFERRED

Azactam IN Iso-osmotic Dextrose

Cisplatin

Bacitracin

Cyclophosphamide

Bactrim

Eloxatin

Bactrim DS

Gleostine

Cayston

Gliadel Wafer

Chloramphenicol Sodium Succinate

Ifex

Cleocin

Ifosfamide

Cleocin IN D5W

Temodar

Cleocin Pediatric Granules

Thiotepa

Cleocin Phosphate

Valchlor

Clin Single Use Kit

Clindamycin Phosphate

ANTIBIOTICS

Coly-mycin M

GENERIC

Cubicin

bleomycin sulfate

Dalvance

daunorubicin HCL

Doribax

doxorubicin HCL

First-vancomycin 25

doxorubicin HCL liposome

First-vancomycin 50

epirubicin HCL

Flagyl

idarubicin HCL

Flagyl ER

mitomycin

Invanz

mitoxantrone HCL

Ketek

Doxorubicin HCL

Lincocin

Mitomycin

Lincomycin/Lidocaine

PREFERRED

Mepron

Daunoxome

Meropenem/Sodium Chloride

NON PREFERRED

Merrem

Adriamycin

Metro IV

Cosmegen

Neutrexin

Doxil

Orbactiv

Ellence

Pentam 300

Epirubicin HCL

Primaxin IV

Idamycin PFS

Primaxin IV Add-vantage

Primsol

ANTINEOPLASTIC ENZYMES

Sivextro

PREFERRED

Sulfamethoxazole/Trimethoprim

Oncaspar

Synercid

NON PREFERRED

Tindamax

Erwinaze

Tygacil

Vancocin HCL

ANTIMETABOLITES

Vancomycin HCL

GENERIC

Vancomycin HCL + Syrspendsf PH4

azacitidine

Vancomycin HCL IN Dextrose


4

capecitabine PREFERRED

cladribine Eligard

cytarabine Emcyt

cytarabine aqueous Fareston

decitabine Faslodex

floxuridine Lupron Depot

fludarabine phosphate Lysodren

fluorouracil Nilandron

gemcitabine HCL Zoladex

mercaptopurine NON PREFERRED

methotrexate Arimidex

methotrexate sodium Aromasin

Floxuridine Casodex

PREFERRED Depo-provera

Alimta Femara

Arranon Firmagon

Clolar Megace Oral

Folotyn Soltamox

Tabloid Trelstar

NON PREFERRED Trelstar Mixject

Cytarabine Vantas

Dacogen Xtandi

Fludara Zytiga

Fludarabine Phosphate

Gemcitabine IMMUNOMODULATORS

Gemzar

GENERIC

Purinethol

azathioprine

Purixan

cyclosporine

Trexall

cyclosporine modified

Vidaza

mycophenolate mofetil

Xeloda

mycophenolic acid DR

sirolimus

ANGIOGENESIS INHIBITORS

tacrolimus

PREFERRED PREFERRED

Avastin Atgam

Zaltrap Cellcept Intravenous

NON PREFERRED Cyclosporine Modified

Cyramza Thalomid

NON PREFERRED

ANTIBODIES Astagraf XL

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

Rituxan

Vectibix

MITOTIC INHIBITORS

Zevalin Y-90

GENERIC

HORMONAL AGENTS docetaxel

etoposide

GENERIC

paclitaxel

anastrozole

vincristine sulfate

bicalutamide

vinorelbine tartrate

exemestane

Docetaxel

flutamide

PREFERRED

letrozole

Abraxane

leuprolide acetate

Etoposide

megestrol acetate

Halaven

tamoxifen citrate

Ixempra Kit


5

Jevtana NON PREFERRED

NON PREFERRED Metastron

Docefrez 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

mesna

Lenvima 10MG Daily Dose

Levoleucovorin Calcium


PREFERRED


Leucovorin Calcium


NON PREFERRED

Lynparza

Calcium Folinate

Sprycel

Ethyol

Stivarga

Fusilev

Sutent

Mesnex

Tarceva

Totect

Votrient

Voraxaze

Zelboraf

Zinecard

Zydelig

Zykadia

CHEMOTHERAPY ADJUNCTS

PREFERRED

TOPOISOMERASE I INHIBITOR

Kepivance

GENERIC

NON PREFERRED

irinotecan

Elitek

topotecan HCL

NON PREFERRED

ANTINEOPLASTIC COMBO

Camptosar

NON PREFERRED

Hycamtin

Lonsurf

Irinotecan

Topotecan HCL

CARDIOVASCULAR DRUGS

PHOSPHODIESTERASE INHBTR

RADIOPHARMACEUTICALS

GENERIC

PREFERRED

milrinone lactate

Bexxar 131 Iodine

milrinone IN dextrose

Xofigo


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

Verapamil HCL

NON PREFERRED

NON PREFERRED

Imdur

Adalat CC

Isordil Titradose

Calan

Nitroglycerin

Calan SR

Nitroglycerin IN Dextrose 5%

Cardene I.v.

Nitrolingual Pumpspray

Cardene IV

Nitromist

Cardene SR

Nitronal

Cardizem

Cardizem CD

BETA BLOCKERS

Cardizem LA

GENERIC

Cleviprex

acebutolol HCL

Dilacor XR

atenolol

Diltiazem HCL

betaxolol HCL

Hypertenipine-2.5

bisoprolol fumarate

Nisoldipine

carvedilol

Nisoldipine ER

esmolol HCL

Norvasc

labetalol HCL

Nymalize

metoprolol succinate ER

Procardia

metoprolol tartrate

Procardia XL

nadolol

Sular

pindolol

Tiazac

propranolol HCL

Verelan

propranolol HCL ER

Verelan PM

sotalol HCL

sotalol HCL (AF)

ANTIARRHYTHMICS

PREFERRED

GENERIC

Bystolic

adenosine

Propranolol HCL

amiodarone HCL

Timolol Maleate

disopyramide phosphate

NON PREFERRED

flecainide acetate

Betapace

ibutilide fumarate

Betapace AF

lidocaine HCL

Brevibloc

lidocaine HCL IN D5W

Coreg

lidocaine HCL/dextrose

Coreg CR

mexiletine HCL

Corgard

propafenone HCL

Hemangeol

propafenone HCL ER

Hypertenevide-12.5

quinidine gluconate CR

Inderal LA

quinidine gluconate ER

Inderal XL


7

quinidine sulfate ANTIHYPERTENSIVES MISC.

Quinidine Sulfate

GENERIC

PREFERRED

clonidine HCL

Norpace CR

doxazosin

Quinidine Sulfate ER

doxazosin mesylate

NON PREFERRED

eplerenone

Adenocard

fenoldopam mesylate

Amiodarone HCL

guanfacine HCL

Cordarone

hydralazine HCL

Corvert

methyldopa

Lidocaine HCL

minoxidil

Multaq

phenoxybenzamine hydrochloride

Nexterone

prazosin HCL

Norpace

terazosin HCL

Procainamide HCL

PREFERRED

Quinidine Gluconate

Reserpine

Rythmol

NON PREFERRED

Rythmol SR

Cardura

Tikosyn

Catapres

Xylocaine

Catapres-tts-1

Catapres-tts-2

ACE INHIBITORS

Catapres-tts-3

GENERIC Corlopam

benazepril HCL Demser

captopril Dibenzyline

enalapril maleate Inspra

enalaprilat Methyldopate HCL

fosinopril sodium Minipress

lisinopril Nitropress

moexipril HCL Phentolamine Mesylate

perindopril erbumine Tenex

quinapril HCL Vecamyl

ramipril

trandolapril ANTIHYPERTENSIVE COMBO

NON PREFERRED

GENERIC

Accupril

amlodipine besylate/benazepril hydrochloride

Aceon

amlodipine besylate/benazepril HCL

Altace

amlodipine besylate/valsartan

Epaned

amlodipine/valsartan/hctz

Lotensin

atenolol/chlorthalidone

Mavik

benazepril HCL/hydrochlorothiazide

Prinivil

bisoprolol fumarate/hydrochlorothiazide

Univasc

candesartan cilexetil/hydrochlorothiazide

Vasotec

enalapril maleate/hydrochlorothiazide

Zestril

fosinopril sodium/hydrochlorothiazide

irbesartan/hydrochlorothiazide

ANGIOTENSIN RCPTR BLOCKER

lisinopril/hydrochlorothiazide

GENERIC losartan potassium/hydrochlorothiazide

candesartan cilexetil metoprolol/hydrochlorothiazide

irbesartan moexipril/hydrochlorothiazide

losartan potassium nadolol/bendroflumethiazide

telmisartan quinapril/hydrochlorothiazide

valsartan telmisartan/amlodipine

Eprosartan Mesylate telmisartan/hydrochloroth

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


8

Amturnide Maxzide-25

Atacand HCT Microzide

Avalide Neptazane

Clorpres Sodium Diuril

Corzide Sodium Edecrin

Diovan HCT Torsemide

Edarbyclor Zaroxolyn

Exforge

Exforge HCT VASOPRESSORS

Hypertensolol

GENERIC

Hyzaar

dobutamine HCL

Lopressor HCT

dobutamine HCL/D5W

Lotensin HCT

dobutamine/dextrose 5%

Lotrel

dopamine HCL

Lytensopril Kit

dopamine HCL-dextrose 5%

Lytensopril-90

dopamine HCL/dextrose 5%

Lytensopril-90 Kit

dopamine/D5W

Micardis HCT

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

Demadex

Fibricor

Diamox

Lipofen

Diuril

Niacor

Dyazide

Simcor

Dyrenium

Vascepa

Edecrin

Welchol

Ethacrynate Sodium

NON PREFERRED

Keveyis

Advicor

Lasix

Antara

Maxzide

Colestid


9

Colestid Flavored tretinoin microsphere

Fenofibrate tretinoin microsphere P.M.

Fenoglide PREFERRED

Juxtapid Benzamycinpak

Kynamro Clindagel

Lescol XL Retinoic Acid

Lofibra Retinoic Acid-all Trans

Lopid Tretinoin

Lovaza Tretinoin (all-trans Retinoic Acid)

Niaspan NON PREFERRED

Omega-3/D-3 Wellness Pack Absorica

Questran Acanya

Questran Light Aczone

Tricor Adapalene

Triglide Akne-mycin

Trilipix Atralin

Zetia Avar

Avar LS

CARDIOVASCULAR - MISC. Avar LS Cleanser

Avar-e LS

GENERIC

Azelex

amlodipine besylate/atorvastatin calcium

Benzac Ac Wash

epoprostenol sodium

Benzac W Wash

papaverine HCL

Benzaclin

sildenafil

Benzaclin With P.M.

sildenafil citrate

Benzamycin

PREFERRED

Benzefoam

Adempas

Benzefoamultra

Cialis

Benziq

Isoxsuprine HCL

Benziq LS

Letairis

Clarifoam EF

Opsumit

Cleocin-t

Remodulin

Clindacin Etz

Stendra

Clindacin PAC

Tracleer

Clindap-t

Veletri

Clinoin

NON PREFERRED

Dermapak Plus

Adcirca

Differin

Bidil

Duac

Caduet

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

clindamycin phosphate

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

sodium sulfacetamide/sulfur wash

Sumadan Wash

sulfacetamide sodium

Sumadan XLT

sulfacetamide sodium/sulfur cleanser

Sumaxin

tretinoin

Sumaxin CP Kit


10

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 Naftin

Nizoral

GENERIC

Oxistat

metronidazole

Pediaderm AF Complete Kit

Doxycycline

Pedipirox-4 Nail

PREFERRED

Penlac Nail Lacquer

Finacea

Vusion

NON PREFERRED

Xolegel

Metrocream

Xolegel Corepak

Metrogel

Xolegel Duo/Head & Shoulders

Metrolotion

Xolegel Duo/Xolex

Mirvaso

Noritate

ANTIVIRALS - TOPICAL

Oracea

Rosadan Kit GENERIC

Soolantra acyclovir

NON PREFERRED

ANALGESICS - TOPICAL Denavir

Lidovir

NON PREFERRED

Xerese

A.a.g.c. Kit IN Teroderm

Zovirax

Baclofen

Equipto-baclofen

ANTIHISTAMINES-TOPICAL

ANTIBIOTICS - TOPICAL NON PREFERRED

Allo-pax

GENERIC

Nazirex

mupirocin

mupirocin calcium

ANTI-INFLAMMATORY AGENTS

PREFERRED

Gentamicin Sulfate GENERIC

NON PREFERRED diclofenac sodium

Altabax PREFERRED

Bactroban Voltaren

Centany AT NON PREFERRED

Cortisporin Dermacinrx Lexitral Pharmapak

Neo-synalar Dipentocaine

Neo-synalar Kit Emvoren

Equipto-naproxen

ANTIFUNGALS - TOPICAL Extardol

Flector

GENERIC

Innoprax-5

ciclopirox

K.b.g.l. IN Teroderm Cream

ciclopirox nail lacquer

Ketorolac 2% Gel

ciclopirox olamine

Lidoprofen

clotrimazole

Novoclair

clotrimazole/betamethasone dipropionate

Nuvya

econazole nitrate

Pennsaid

ketoconazole

Vopac

naftifine HCL

Vopac GB

nystatin

Vopac Kt

nystatin/triamcinolone

Zyvodol

PREFERRED

Exoderm

ANTIPRURITICS

NON PREFERRED

Ciclodan Cream Kit NON PREFERRED

Ciclodan Solution Kit Prudoxin

Ciclopirox Topical Solution Kit Zonalon

Cnl8 Nail Kit

Ecoza ANTIPSORIATICS

Ertaczo

GENERIC

Exelderm

acitretin

Extina

calcipotriene


11

methoxsalen Triamcinolone Acetonide

Calcitriol NON PREFERRED

PREFERRED Aclovate

Anthralin Advanced Allergy Collection Kit

Dritho-creme HP Ala Scalp

Stelara Capex

Vectical Carmol-HC

NON PREFERRED Clobex

Cosentyx Clocortolone Pivalate

Cosentyx Sensoready Pen Clocortolone Pivalate P.M.

Dovonex Clodan Kit

Oxsoralen Ultra Cloderm

Soriatane Cloderm P.M.

Sorilux Cordran

Tazorac Cordran Tape

Zithranol Cortalo

Zithranol-rr Cutivate

8-mop Derma Silkrx Sds PAK

Derma-smoothe/FS Body

ANTISEBORRHEIC AGENTS Derma-smoothe/FS Scalp

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

Synalar

desonide

Synalar Cream Kit

desoximetasone

Synalar Ointment Kit

fluocinolone acetonide

Synalar Ts

fluocinonide

Taclonex

fluocinonide-e

Temovate

fluticasone propionate

Temovate E

halobetasol propionate

Texacort

hydrocortisone

Topicort

hydrocortisone acetate/aloe

Triamsil Combipak

hydrocortisone butyrate

Trianex

hydrocortisone butyrate (lipid)

Triderma Forte

hydrocortisone butyrate (lipophilic)

Ultravate

hydrocortisone valerate

Ultravate PAC

hydrocortisone IN absorbase

Ultravate X

mometasone furoate

Validerm

prednicarbate

Vanos

triamcinolone acetonide

Verdeso

Amcinonide

Westcort

Desoximetasone

Diflorasone Diacetate

IMMUNOMODULATING AGENTS

PREFERRED

Pramosone


12

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

Hylira

GENERIC

HPR

ammonium lactate

HPR Plus

episone CRE

HPR Plus Hydrogel Kit

lactic acid

HPR Plus/Mb Hydrogel

lactic acid e

Kerafoam

lactic acid w/vitamin e

Kerafoam 42

lidocaine

Keralac

lidocaine HCL

Keralyt

lidocaine HCL jelly

Keralyt Scalp

lidocaine/prilocaine

Lac-hydrin

lindane

Latrix XM

malathion

Ldo Plus

permethrin

Lidocaine And Tetracaine Cream

podofilox

Lidocaine HCL

salicylic acid

Lidoderm

salicylic acid cream

Lidothol

salicylic acid lotion

Lycelle

sodium hyaluronate

Mb Hydrogel

urea

Medi-derm/L-RX

urea topical

Megrix

urea IN zinc undecylenate/lactic acid vehicle

Natroba

urea 40% nail film

Neosalus

PREFERRED

Neosalus CP

Drysol

Neuvaxin

Eurax

Nivatopic Plus

NON PREFERRED

Nuvail

Acuicyn Daily Eyelid & Eyelash Cleanser

Ovide

Alevicyn Antipruritic SG

Oxsoralen

Aluvea

Pharmacist Choice Tsx Patch

Anacaine

Pliaglis

Arnica Flower

Pr Cream

Atopiclair

Presera

Aurstat Anti-itch Hydrogel

Pruclair

Aurstat Anti-itch Hydrogel Kit

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

Elimite

Solaice

Emla

Soothee

Emulsion SB

Spinosad

Epiceram

Sulfurated Lime

Ethyl Chloride

Supracil

Ethyl Chloride/Fine Pinpoint

Synera

Ethyl Chloride/Fine Stream

Tetrix

Ethyl Chloride/Medium Jet Stream

Tropazone


13

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 oxandrolone

prednisone testosterone

Dexamethasone Sodium Phosphate testosterone cypionate

PREFERRED testosterone enanthate

Cortisone Acetate Testosterone

Dexamethasone PREFERRED

Medrol Androderm

Millipred Androgel P.M.

Prednisone Androxy

Prednisone Intensol NON PREFERRED

NON PREFERRED Anadrol-50

Aristospan Intra-articular Androgel

Aristospan Intralesional Android

Beta Inject Kit Aveed

Betalido Depo-testosterone

Betamethasone SP First-testosterone

Celestone-soluspan First-testosterone Mc Compounding Kit

Cortef Natesto

Depo-medrol Oxandrin

Dexamethasone Intensol Striant

Dexlido Testone Cik

Dexlido-m Testopel

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

Dyural-80

estropipate

Entocort EC

norethindrone acetate/ethinyl estradiol

FLO-pred

PREFERRED

Interarticular Joint Kit

Alora

Kenalog-10

Climara Pro

Kenalog-40

Duavee

K10-lido

Estropipate

K40-lido

Menest


14

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

Novolin R

Falessa

Toujeo Solostar

Femcon FE

NON PREFERRED

Generess FE

Afrezza

Loestrin FE 1.5/30

AMYLIN ANALOGS

Loestrin FE 1/20

NON PREFERRED

Loestrin 1.5/30-21

Symlinpen 120

Loestrin 1/20-21

Symlinpen 60

Loseasonique

INCRETIN MIMETIC AGENTS

LO Loestrin FE

PREFERRED

LO Minastrin FE

Bydureon

Minastrin 24 FE

Byetta

Mircette

Victoza

Modicon

SULFONYLUREAS

Nor-QD

GENERIC

Norinyl 1+35

glimepiride

Ortho Evra

glipizide

glipizide ER


15

glyburide Appformin

glyburide micronized Appformin-d

tolazamide Avandamet

Glyburide Avandaryl

PREFERRED Duetact

Chlorpropamide Glucovance

Diabeta Glyxambi

Tolazamide Prandimet

Tolbutamide Xigduo XR

NON PREFERRED

Amaryl BISPHOSPHONATES

Glucotrol

GENERIC

Glucotrol XL

alendronate sodium

Glynase

ibandronate sodium

BIGUANIDES

pamidronate disodium

GENERIC

risedronate sodium

metformin HCL

risedronate sodium DR

metformin HCL ER

zoledronic acid

NON PREFERRED

PREFERRED

Fortamet

Alendronate Sodium

Glucophage

NON PREFERRED

Glucophage XR

Actonel

Glumetza

Atelvia

Riomet

Binosto

MEGLITINIDE ANALOGUES

Boniva

GENERIC

Etidronate Disodium

nateglinide

Fosamax

repaglinide

Fosamax Plus D

NON PREFERRED

Pamidronate Disodium

Prandin

Reclast

Starlix

Zoledronic Acid

DIABETIC OTHER

Zometa

PREFERRED

Glucagen Hypokit

CALCITONINS

Glucagon Emergency Kit

GENERIC

Invokana

calcitonin salmon

Jardiance

calcitonin-salmon

Proglycem

NON PREFERRED

NON PREFERRED

Fortical

Korlym

Miacalcin

ALPHA-GLUCOSIDASE INHIBIT

GENERIC

PARATHYROID HORMONE

acarbose

PREFERRED

NON PREFERRED

Forteo

Glyset

Precose

RANK LIGAND INHIBITORS

DPP-4 INHIBITORS

PREFERRED

PREFERRED

Prolia

Januvia

Xgeva

Onglyza

INSULIN SENSITIZING AGENT

CALCIUM REGULATORS - MISC

GENERIC

NON PREFERRED

pioglitazone HCL

Ganite

NON PREFERRED

Actos

HORMONE RECEPTOR MDLTR

Avandia

GENERIC

ANTIDIABETIC COMBINATIONS

raloxifene hydrochloride

GENERIC

NON PREFERRED

glipizide/metformin HCL

Evista

glyburide/metformin HCL

Osphena

pioglitazone HCL-glimepiride

pioglitazone HCL/metformin HCL

FERTILITY REGULATORS

PREFERRED

GENERIC

Invokamet

chorionic gonadotropin

Janumet

clomiphene citrate

Janumet XR

PREFERRED

Kombiglyze XR

Follistim AQ

NON PREFERRED

Gonal-f

Actoplus Met

Gonal-f RFF

Actoplus Met XR


16

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

Nutropin AQ Nuspin 10

PREFERRED


Aldurazyme


Carbaglu

Nutropin AQ Pen

Elaprase

Saizen

Fabrazyme

Saizen Click.easy

Kuvan

Serostim

Lumizyme

NON PREFERRED

Myozyme

Zorbtive

Naglazyme

NON PREFERRED

GHRH

Ammonul

NON PREFERRED Buphenyl

Egrifta Carnitor

Carnitor SF

SOMATOMEDINS Cystadane

Hectorol

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

GENERIC

Nature-throid

desmopressin acetate

Nature-throid Nt-2.5

vasopressin

Synthroid

NON PREFERRED

Tapazole

Ddavp

Thyrolar-1

Pitressin Synthetic

Thyrolar-1/2

Stimate

Thyrolar-1/4

Vasostrict

Thyrolar-2

Thyrolar-3

CORTICOTROPIN

Tirosint

Triostat


17

Westhroid omeprazole/sodium bicarbonate

Wp Thyroid pantoprazole sodium

rabeprazole sodium

GASTROINTESTINAL ranitidine HCL

sucralfate

LAXATIVES

Esomeprazole Sodium

GENERIC

Famotidine

lactulose

PREFERRED

peg 3350/electrolytes

Carafate

peg-3350/electrolytes

Dexilant

peg-3350/NACL/NA bicarbonate/KCL

Nexium

polyethylene glycol 3350

Nexium 24HR

NON PREFERRED

Omeclamox-PAK

Cascara Sagrada

Propantheline Bromide

Colyte-flavor Packs

Pylera

Golytely

Symax Duotab

Kristalose

NON PREFERRED

Mineral Oil Heavy

Aciphex

Moviprep

Aciphex Sprinkle

Nulytely/Flavor Packs

Anaspaz

Osmoprep

Atropen

Pcp 100

Atropine Sulfate

Prepopik

Axid

Suclear

Belladonna & Opium

Suprep Bowel Prep

Belladonna Alkaloids & Opium

Bentyl

ANTIDIARRHEALS

Cantil

GENERIC

Cuvposa

diphenoxylate/atropine

Cytotec

loperamide HCL

Deprizine Fusepaq

opium

Esomeprazole Strontium

opium tincture

Famotidine Premixed

PREFERRED

First-lansoprazole

Diphenoxylate/Atropine

First-omeprazole

Opium Tincture (paregoric)

Gabitidine

NON PREFERRED

Gastrinex NF

Fulyzaq

Glycate

Lomotil

Helidac

Motofen

Levbid

Restora RX

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

famotidine

glycopyrrolate

ANTIEMETICS

hyoscyamine sulfate

GENERIC

hyoscyamine sulfate odt

dronabinol

hyoscyamine sulfate ER

granisetron HCL

hyoscyamine sulfate SR

meclizine HCL

lansoprazole

ondansetron odt

lansoprazole/amoxicillin/clarithromycin

ondansetron HCL

methscopolamine bromide

trimethobenzamide HCL

misoprostol

PREFERRED

nizatidine

Aloxi

omeprazole


18

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 Metozolv Odt

Transderm-scop Movantik

Zofran Pentasa

Zofran Odt Phoslo

Zuplenz Phoslyra

Procort

DIGESTIVE AIDS Proctocort

Rectiv

PREFERRED

Reglan

Creon

Renagel

Pancrelipase

Rowasa

Zenpep

Uceris

NON PREFERRED

Urso Forte

Sucraid

Urso 250

Velphoro

GASTROINTESTINAL - MISC.

GENERIC

GENITOURINARY

alosetron hydrochloride

balsalazide disodium URINARY ANTI-INFECTIVES

calcium acetate

GENERIC

cromolyn sodium

methenamine hippurate

hydrocort ene 100MG

methenamine mandelate

hydrocortisone

nitrofurantoin

hydrocortisone acetate/lidocaine HCL

nitrofurantoin macrocrystals

hydrocortisone acetate/pramoxine

nitrofurantoin monohydrate

lactulose

nitrofurantoin monohydrate/macrocrystals

lidocaine HCL/hydrocortisone acetate

PREFERRED

mesalamine

Methenamine Mandelate

metoclopramide odt

NON PREFERRED

metoclopramide HCL

Furadantin

sulfasalazine

Hiprex

ursodiol

Macrobid

PREFERRED

Macrodantin

Amitiza

Monurol

Canasa

Prosed/DS

Cimzia

Uretron D/S

Cimzia Starter Kit

Urimar-t

Lialda

Urogesic-blue

Linzess

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

Analpram-HC

trospium chloride

Analpram-HC Singles

trospium chloride ER

Anusol-HC

PREFERRED

Apriso

Gelnique

Auryxia

Vesicare

Azulfidine

NON PREFERRED

Azulfidine EN-TABS

Detrol

Chenodal

Detrol LA

Colazal

Ditropan XL

Cortenema

Enablex

Cortifoam

Myrbetriq

Dexpanthenol

Oxytrol


19

Sanctura Urocit-k 5

Sanctura XR Uroxatral

Toviaz

Urecholine HEMATOLOGICAL

HEMATOPOIETIC AGENTS

VAGINAL PRODUCTS

GENERIC

GENERIC

cyanocobalamin

clindamycin phosphate

folic acid

metronidazole vaginal

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

terconazole

sodium ferric gluconate complex/sucrose

PREFERRED

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

Premarin

NON PREFERRED PREFERRED

Avc Cerezyme

Cleocin Folitab 500

Clindesse Mozobil

Crinone Neumega

Endometrin Nplate

Estrace NON PREFERRED

Estring Abaneu-SL

Fem PH Albafort

Femring Animi-3

First-progesterone VGS 100 Compounding Kit Animi-3/Vitamin D

First-progesterone VGS 200 Compounding Kit Aranesp Albumin Free

First-progesterone VGS 25 Compounding Kit B-6 Folic Acid

First-progesterone VGS 400 Compounding Kit Biferarx

First-progesterone VGS 50 Compounding Kit Cenfol

Gynazole-1 Centratex

Metrogel-vaginal Cerdelga

Nuvessa Ciferex

Relagard Corvite 150

Terazol 3 Divista

Terazol 7 Droxia

Vagifem Ed Cyte F

Elelyso

GENITOURINARY - MISC. Feraheme

Feriva

GENERIC

Feriva 21/7

alfuzosin HCL ER

Ferivafa

citric acid/sodium citrate

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

Avodart

Fusion Plus

Cytra-3

Granix

Elmiron

Hematogen Fa

Jalyn

Hematron-AF

Rapaflo

Hemocyte Plus

NON PREFERRED

Hemocyte-f

Cardura XL

Hydroxocobalamin

Cystagon

Icar-c Plus

Flomax

Infed

K-phos NO 2

Injectafer

Lithostat

Integra F

Oracit

Integra Plus

Procysbi

Irospan 24/6

Proscar

Is 24/6

Pyridium

Leukine

Shohls Solution Modified

Maxaron Forte

Thiola

Maxfe

Urocit-k 10

Mircera

Urocit-k 15


20

Multigen NON PREFERRED

Multigen Folic Amicar

Multigen Plus Aminocaproic Acid

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

Artiss

Astringyn

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

Cyklokapron

Evicel

Nascobal

Evithrom

Natalvirt Flt

Lysteda

Nephron Fa

Recothrom

Neulasta

Recothrom Spray Kit

Neulasta Delivery Kit

Thrombin-jmi Diluent

Neupogen

Thrombin-jmi Epistaxis

Novaferrum

Thrombin-jmi Syringe Spray Kit

Omontys

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

Pre-folic

Thrombogen

Procrit

Tisseel

Proferrin-forte

Tisseel VH

Promacta

Protectiron

HEMATOLOGICAL - MISC.

Tandem F

GENERIC

Tandem Plus

anagrelide hydrochloride

Triferic

cilostazol

Venofer

clopidogrel

Vpriv

dipyridamole

Zavesca

hetastarch 6%/NACL

pentoxifylline ER

ANTICOAGULANTS

ticlopidine HCL

GENERIC

Aspirin/Dipyridamole

argatroban

PREFERRED

bivalirudin

Advate

enoxaparin sodium

Alphanate/Von Willebrand Factor Complex/Human

fondaparinux sodium

Alphanine SD

heparin lock

Bebulin

heparin lock flush

Benefix

heparin lock flush for flushing vascular access devices

Berinert

heparin lock flush/NACL for flushing vascular access devices

Cinryze

Corifact

heparin sodium

Effient

heparin sodium dcu

Feiba

heparin sodium lock flush

Feiba NF

heparin sodium/sodium chloride 0.9% premix

Firazyr

heparin sodium/D5W

Hemofil M

heparin sodium/NACL 0.9%

Humate-p

warfarin sodium

Koate-dvi

PREFERRED

Monoclate-p

Pradaxa

Mononine

Xarelto

Novoseven Rt

Xarelto Starter Pack

Profilnine

NON PREFERRED

Profilnine SD

Angiomax

Recombinate

Argatroban

Riastap

Arixtra

Soliris

Coumadin

Ticlopidine HCL

Eliquis

Wilate

Fragmin

NON PREFERRED

Heparin Lock Flush

Activase

Heparin Sodium

Aggrastat

Heparin Sodium/D5W

Aggrenox

Heparin Sodium/NACL 0.45%

Agrylin

Heparin Sodium/Sodium Chloride 0.9%

Brilinta

Iprivask

Cathflo Activase

Lovenox

Durlaza

Savaysa

Helixate FS

Hespan

HEMOSTATICS

Hextend

GENERIC

Integrilin

aminocaproic acid

Ixinity

tranexamic acid

Kalbitor


21

Kengreal diazepam

Kinlytic droperidol

Kogenate FS gene-xene TAB 15MG

Kogenate FS Bio-set gene-xene TAB 3.75MG

LMD 10% Dextrose 5% gene-xene TAB 7.5MG

LMD 10% Sodium Chloride 0.9% hydroxyzine pamoate

Novoeight 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

Valium

GENERIC

Vistaril

cevimeline HCL

Xanax

chlorhexidine gluconate

Xanax XR

chlorhexidine gluconate oral rinse

clotrimazole

ANTIDEPRESSANTS

lidocaine viscous

GENERIC

lidocaine HCL

amitriptyline HCL

lidocaine HCL viscous

bupropion HCL

nystatin

bupropion HCL ER

pilocarpine hydrochloride

bupropion HCL SR

pilocarpine HCL

bupropion HCL XL

stannous fluoride oral rinse

citalopram hydrobromide


clomipramine HCL

triamcinolone IN orabase

desipramine HCL

NON PREFERRED

doxepin HCL

Aquoral

duloxetine HCL

Caphosol

escitalopram oxalate

Debacterol

fluoxetine DR

Evoxac

fluoxetine HCL

First-bxn Mouthwash

fluvoxamine maleate

First-dukes Mouthwash

fluvoxamine maleate ER

First-marys Mouthwash

imipramine pamoate

First-mouthwash Blm

imipramine HCL

Gel-kam Oral Care Rinse

mirtazapine

Gelclair

mirtazapine odt

Lta 360 Kit

nefazodone HCL

Nafrinse Daily/Acidulated

nortriptyline HCL

Nafrinse Daily/Neutral

paroxetine HCL

Nafrinse Weekly

paroxetine HCL ER

Neutrasal

phenelzine sulfate

Numoisyn

protriptyline HCL

Orafate

sertraline HCL

Oravig

tranylcypromine sulfate

Peridex

trazodone HCL

Prevident

venlafaxine HCL

Prothelial

venlafaxine HCL ER

Salagen

Amoxapine

Doxepin HCL

NEUROLOGY, CNS, PSYCH

Nefazodone HCL

ANTIANXIETY AGENTS

Nortriptyline HCL

GENERIC

Venlafaxine HCL ER

alprazolam

PREFERRED

alprazolam odt

Fluoxetine HCL

alprazolam ER

Forfivo XL

buspirone HCL

Maprotiline HCL

chlordiazepoxide HCL

Paxil

clorazepate dipotassium


22

Pristiq quetiapine fumarate

NON PREFERRED risperidone

Anafranil risperidone odt

Aplenzin thioridazine HCL

Appbutamone thiothixene

Appbutamone-d trifluoperazine HCL

Brintellix ziprasidone HCL

Celexa Clozapine Odt

Cymbalta PREFERRED

Desvenlafaxine ER Abilify Discmelt

Duloxetine HCL Fluphenazine HCL

Effexor XR Saphris

Emsam Seroquel XR

Fetzima NON PREFERRED

Fetzima Titration Pack Abilify

Gaboxetine Abilify Maintena

Irenka Adasuve

Khedezla Chlorpromazine HCL

Lexapro Clozaril

Luvox CR Compazine

Marplan Equetro

Nardil Fanapt

Norpramin Fanapt Titration Pack

Oleptro Fazaclo

Pamelor Geodon

Parnate Haldol

Paxil CR Haldol Decanoate 100

Pexeva Haldol Decanoate 50

Prozac Invega

Prozac Weekly Invega Sustenna

Remeron Invega Trinza

Remeron Soltab Latuda

Sentraflox AM-10 Lithium

Sentralopram AM-10 Lithium Carbonate

Sentravil PM-25 Lithobid

Sentroxatine Loxitane

Surmontil Risperdal

Tofranil Risperdal Consta

Tofranil-PM Risperdal M-TAB

Trazamine Seroquel

Viibryd Versacloz

Viibryd Starter Pack Zyprexa

Vivactil Zyprexa Relprevv

Wellbutrin Zyprexa Zydis

Wellbutrin SR

Wellbutrin XL HYPNOTICS

Zoloft

GENERIC

dexmedetomidine HCL

ANTIPSYCHOTICS

estazolam

GENERIC eszopiclone

aripiprazole flurazepam HCL

chlorpromazine HCL phenobarbital

clozapine temazepam

fluphenazine decanoate triazolam

fluphenazine HCL zaleplon

haloperidol zolpidem tartrate

haloperidol decanoate zolpidem tartrate ER

haloperidol lactate Flurazepam HCL

lithium carbonate Phenobarbital

lithium carbonate ER NON PREFERRED

loxapine Ambien

loxapine succinate Ambien CR

olanzapine Amytal Sodium

olanzapine odt Belsomra

paliperidone ER Butisol Sodium

perphenazine Doral

prochlorperazine Edluar

prochlorperazine edisylate Gabazolpidem-5

prochlorperazine maleate Halcion


23

Hetlioz GENERIC

Intermezzo carbamazepine

Lunesta carbamazepine ER

Nembutal Sodium clonazepam

Phenobarbital Sodium clonazepam odt

Precedex divalproex sodium

Quazepam divalproex sodium DR

Restoril divalproex sodium ER

Rozerem ethosuximide

Seconal felbamate

Sentrazolpidem PM-5 fosphenytoin sodium

Silenor gabapentin

Sonata lamotrigine

Strazepam lamotrigine odt

Zolpimist lamotrigine ER

levetiracetam

ADHD, NARCOLEPSY, ETC. levetiracetam ER

oxcarbazepine

GENERIC

phenytoin

amphetamine/dextroamphetamine

phenytoin sodium

caffeine citrate

phenytoin sodium extended

clonidine HCL ER

primidone

dexmethylphenidate HCL

tiagabine hydrochloride

dexmethylphenidate HCL ER

topiramate

dextroamphetamine sulfate

valproate sodium

dextroamphetamine sulfate ER

valproic acid

doxapram HCL

zonisamide

guanfacine ER

PREFERRED

methamphetamine HCL

Diastat Acudial

methylphenidate hydrochloride

Diastat Pediatric

methylphenidate HCL

Diazepam

methylphenidate HCL CD

Lamictal

methylphenidate HCL ER

Lamictal Chewable Dispersible

methylphenidate HCL SR

Lamictal Starter/Not Taking Carbamazepine

modafinil

Lamictal Starter/Taking Carbamazepine/Not Taking Valproate

Methylphenidate HCL ER

PREFERRED

Lamictal Starter/Taking Valproate

Strattera

Lyrica

Vyvanse

Phenytek

NON PREFERRED

NON PREFERRED

Adderall

Aptiom

Adderall XR

Banzel

Aptensio XR

Carbatrol

Cafcit

Celontin

Caffeine/Sodium Benzoate

Cerebyx

Concerta

Depacon

Daytrana

Depakene

Desoxyn

Depakote

Dexedrine

Depakote ER

Dopram

Depakote Sprinkles

Evekeo

Dilantin

Focalin

Dilantin Infatabs

Focalin XR

Dilantin-125

Intuniv

Fanatrex Fusepaq

Kapvay

Felbatol

Kapvay Dose Pack

Fycompa

Metadate CD

Gabitril

Methylin

Keppra

Nuvigil

Keppra XR

Procentra

Klonopin

Provigil

Lamictal Odt

Quillivant XR

Lamictal XR

Ritalin

Levetiracetam

Ritalin LA

Mysoline

Ritalin SR

Neurontin

Sentramodafin AM-100

Onfi

Zenzedi

Oxtellar XR

Peganone

ANTICONVULSANTS

Potiga

Qudexy XR

Sabril


24

Stavzor memantine HCL

Tegretol memantine HCL titration PAK

Tegretol-XR olanzapine/fluoxetine

Therapentin-60 pimozide

Therapentin-90 rivastigmine tartrate

Topamax rivastigmine transdermal system

Topamax Sprinkle tetrabenazine

Topiramate ER Galantamine Hydrobromide

Trileptal PREFERRED

Trokendi XR Ampyra

Vimpat Avonex

Zarontin Chlordiazepoxide/Amitriptyline

Zonegran Copaxone

Namenda

ANTIPARKINSON AGENTS Namenda XR

Namenda XR Titration Pack

GENERIC

Perphenazine/Amitriptyline

amantadine HCL

Plegridy

benztropine mesylate

Plegridy Starter Pack

bromocriptine mesylate

Tecfidera

carbidopa

Tecfidera Starter Pack

carbidopa/levodopa

NON PREFERRED

carbidopa/levodopa odt

Addyi

carbidopa/levodopa ER

Antabuse

entacapone

Aricept

pramipexole dihydrochloride

Aricept Odt

pramipexole dihydrochloride ER

Aubagio

ropinirole ER

Avonex Pen

ropinirole HCL

Brisdelle

selegiline HCL

Campral

tolcapone

Exelon

trihexyphenidyl HCL

Gilenya

Carbidopa/Levodopa/Entacapone

Gralise

PREFERRED

Gralise Starter

Apokyn

Horizant

NON PREFERRED

Lemtrada

Amantadine HCL

Namenda Titration PAK

Azilect

Nuedexta

Cogentin

Orap

Comtan

Razadyne

Duopa

Razadyne ER

Eldepryl

Sarafem

Lodosyn

Savella

Mirapex

Savella Titration Pack

Mirapex ER

Symbyax

Neupro

Tysabri

Parcopa

Xenazine

Parlodel

Xyrem

Requip

Requip XL

NEUROMUSCULAR AGENTS

Rytary

Sinemet GENERIC

Sinemet CR atracurium besylate

Stalevo 100 cisatracurium besylate

Stalevo 125 pancuronium bromide

Stalevo 150 riluzole

Stalevo 200 rocuronium bromide

Stalevo 50 vecuronium bromide

Stalevo 75 PREFERRED

Tasmar Botox

Zelapar NON PREFERRED

Anectine

NEUROLOGY, PSYCH - MISC. Dysport

Myobloc

GENERIC

Nimbex

acamprosate calcium DR

Quelicin

disulfiram

Quelicin 1000

donepezil HCL

Rilutek

ergoloid mesylates

Xeomin

fluoxetine

Zemuron

galantamine hydrobromide


25

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

Supartz

Supartz Fx

BETA-BLOCKERS

Tabradol Fusepaq

GENERIC

Therabenzaprine-60

betaxolol HCL

Therabenzaprine-90

carteolol HCL

Therabenzaprine-90-5

dorzolamide HCL/timolol maleate

Tizanidine Comfort PAC

levobunolol HCL

Zanaflex

timolol maleate

timolol maleate ophthalmic gel forming

ANTIMYASTHENIC AGENTS

Metipranolol

GENERIC

PREFERRED

neostigmine methylsulfate

Betoptic-s

pyridostigmine bromide

Combigan

PREFERRED

Levobunolol HCL

Guanidine HCL

Timoptic Ocudose

NON PREFERRED

NON PREFERRED

Bloxiverz

Betagan

Enlon

Betimol

Enlon-plus

Cosopt

Mestinon

Cosopt PF

Mestinon Timespan

Istalol

Neostigmine Methylsulfate

Timoptic

Prostigmin

Timoptic-xe

Regonol


26

OPHTHALMIC STEROIDS GENERIC

pilocarpine HCL

GENERIC

PREFERRED

dexamethasone sodium phosphate

Isopto Carbachol

fluorometholone

Phospholine Iodide

neomycin/polymyxin/bacitracin/hydrocortisone

NON PREFERRED

neomycin/polymyxin/dexamethasone

Isopto Carpine

prednisolone acetate

sulfacetamide sodium/prednisolone sodium phosphate

ADRENERGIC AGENTS

tobramycin/dexamethasone

PREFERRED GENERIC

FML apraclonidine

FML Forte brimonidine tartrate

Pred Mild PREFERRED

Prednisolone Sodium Phosphate Alphagan P

NON PREFERRED NON PREFERRED

Alrex Iopidine

Blephamide Simbrinza

Blephamide S.o.p.

Durezol IMMUNOMODULATORS

Flarex

NON PREFERRED

FML Liquifilm

Restasis

Lotemax

Maxidex

LOCAL ANESTHETICS

Maxitrol

GENERIC

Neomycin/Polymyxin/Hydrocortisone

proparacaine HCL

Omnipred

tetracaine HCL

Pred Forte

NON PREFERRED

Pred-G

Akten

Pred-G S.o.p.

Alcaine

Tobradex

Tobradex ST

OPHTHALMICS - MISC.

Vexol

GENERIC

Zylet

azelastine HCL

bromfenac

PROSTAGLANDINS

cromolyn sodium

GENERIC

diclofenac sodium

latanoprost

dorzolamide HCL

Bimatoprost

epinastine HCL

PREFERRED

flurbiprofen sodium

Lumigan

ketorolac tromethamine

Travatan Z

PREFERRED

Travoprost

Azopt

NON PREFERRED

Pataday

Xalatan

Patanol

NON PREFERRED

CYCLOPLEGIC MYDRIATICS

Acular

GENERIC

Acular LS

atropine sulfate

Acuvail

cyclopentolate HCL

Alocril

homatropine HBR

Alomide

PREFERRED

Bepreve

Atropine Sulfate

Cystaran

Cyclogyl

Elestat

Isopto Homatropine

Emadine

NON PREFERRED

Ilevro

Cyclomydril

Lastacaft

Isopto Atropine

Nevanac

Isopto Hyoscine

Ocufen

Optivar

DECONGESTANTS

Pazeo

GENERIC Prolensa

phenylephrine HCL Trusopt

PREFERRED

Naphazoline HCL OTIC AGENTS

NON PREFERRED

GENERIC

Mydfrin

acetic acid

antipyrine/benzocaine

MIOTICS

fluocinolone acetonide

fluocinolone acetonide ear drops


27

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

Pitocin

tramadol hydrochloride/acetaminophen

Prepidil

tramadol HCL

Prostin E2

tramadol HCL ER

Aspirin-caffeine-dihydrocodeine

PAIN MANAGEMENT

Fentanyl

ANALGESICS - NONNARCOTIC

Hydrocodone Bitartrate/Acetaminophen

GENERIC

Hydrocodone/Acetaminophen

butalbital/acetaminophen

Hydromorphone HCL/Sodium Chloride

butalbital/acetaminophen/caffeine

Morphine Sulfate ER

butalbital/apap/caffeine

Oxycodone HCL ER

butalbital/aspirin/caffeine

PREFERRED

choline magnesium trisalicylate

Hydromorphone HCL

diflunisal

Morphine Sulfate

salsalate

Suboxone

PREFERRED

NON PREFERRED

Choline Magnesium Trisalicylate

Acetaminophen/Caffeine/Dihydrocodeine Bitartrate

Dologesic

Actiq

Prialt

Alfenta

Tencon

Avinza

NON PREFERRED

Bunavail

Bupap

Buprenex

Disalcid

Butrans

Dolgic Plus

Capital/Codeine

Equagesic

Codeine Sulfate

Esgic

Conzip

Fioricet

Demerol

Fiorinal

Dilaudid

Levacet

Dilaudid-HP

Ofirmev

Dolophine

Phrenilin Forte

Dolophine HCL

Rhinoflex-650

Duragesic

Staflex

Exalgo

Vanatol LQ

Fentanyl Citrate/Sodium Chloride

Fioricet/Codeine

ANALGESICS - OPIOID

Fiorinal/Codeine #3

GENERIC

Hycet

acetaminophen/caffeine/dihydrocodeine

Hydromorphone HCL ER

acetaminophen/codeine

Hysingla ER


28

Ibudone indomethacin ER

Infumorph 200 ketoprofen

Infumorph 500 ketorolac tromethamine

Ionsys leflunomide

Levorphanol Tartrate mefenamic acid

Liquicet meloxicam

Lortab nabumetone

Magnacet naproxen

Maxidone naproxen sodium

Meperidine HCL naproxen sodium CR

Methadone HCL naproxen sodium ER

Methadose oxaprozin

Methadose Sugar-free piroxicam

Morphine Sulfate Add-vantage sulindac

Morphine Sulfate/Sodium Chloride tolmetin sodium

MS Contin Meclofenamate Sodium

Norco Tolmetin Sodium

Nucynta PREFERRED

Opana Fenoprofen Calcium

Opana ER (crush Resistant) Humira

Oxaydo Humira Pediatric Crohns Disease Starter Pack

Oxecta Humira Pen

Oxycodone HCL Humira Pen-crohns Diseasestarter

Oxycontin Humira Pen-psoriasis Starter

Percocet Ilaris

Percodan Ketoprofen ER

Primlev Meloxicam

Reprexain Naproxen

Roxicet Rasuvo

Roxicodone Simponi

Subsys Simponi Aria

Synalgos-dc NON PREFERRED

Synapryn Fusepaq Actemra

Talwin Anaprox

Theracodeine-300 Anaprox DS

Theracodophen-low-90 Arava

Theracodophen-325 Arcalyst

Theracodophen-650 Arthrotec 50

Theracodophen-750 Arthrotec 75

Theratramadol-60 Caldolor

Theratramadol-90 Cataflam

Tramadol HCL ER Celebrex

Trezix Daypro

Tylenol/Codeine #3 Derma Silkrx Anodynexa PAK

Tylenol/Codeine #4 Derma Silkrx Diclopak

Ultiva Dermacinrx Inflammatral PAK

Ultracet Enbrel

Ultram Enbrel Sureclick

Ultram ER EC-naprosyn

Vicoprofen Feldene

Xartemis XR Flanax Pain Relief Kit

Xodol Ibuprofen Comfort PAC

Xolox Indocin

Zamicet Indomethacin

Zubsolv Indomethacin Sodium

Zydone IC 400

IC 800

ANTI-INFLAMMATORY Ketorocaine-l

Ketorocaine-lm

GENERIC

Ketorolac Tromethamine

celecoxib

Kineret

diclofenac potassium

Meloxicam Comfort PAC

diclofenac sodium DR

Mobic

diclofenac sodium ER

Nalfon

diclofenac sodium/misoprostol

Naprelan

etodolac

Naprosyn

etodolac ER

Naproxen Comfort PAC

flurbiprofen

Neoprofen

ibuprofen

Orencia

indomethacin

Otezla


29

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

Voltaren-XR

NON PREFERRED

Xeljanz

Articadent Dental

Zipsor

BD Pudendal/Local Block Tray 1% Lidocaine

Carbocaine

MIGRAINE PRODUCTS

Citanest Forte Dental

GENERIC Citanest Plain Dental

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

dihydroergotamine mesylate

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

naratriptan HCL

rizatriptan benzoate

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

rizatriptan benzoate odt

sumatriptan succinate

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

sumatriptan succinate refill

zolmitriptan

Exparel

zolmitriptan odt

Lidocaine HCL/Dextrose

Dihydroergotamine Mesylate

Marcaine

Sumatriptan Succinate

Marcaine W/O Epi

PREFERRED

Marcaine/Epinephrine

Sumatriptan

Marlido-25

Zomig Nasal Spray

Monoject Bone Marrow Biopsy Prepping Tray

NON PREFERRED

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

Alsuma

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

Axert

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

Cafergot

Cambia

Naropin

D.h.e. 45

Nesacaine

Ergomar

Nesacaine-mpf

Frova

Sensorcaine-mpf/Epinephrine

Imitrex

Turkel Paracentesis Procedure Tray/8french

Imitrex Statdose Refill

Xylocaine

Imitrex Statdose System

Xylocaine-mpf

Maxalt

Xylocaine-mpf/Epinephrine

Maxalt-MLT

Xylocaine/Epinephrine

Migergot

Migral

RESPIRATORY, ALLERGY, ETC

Migranal

ANTIHISTAMINES

Relpax

GENERIC

Sumavel Dosepro

carbinoxamine maleate

Treximet

cetirizine HCL

Zomig

clemastine fumarate

Zomig ZMT

cyproheptadine HCL

desloratadine

GOUT AGENTS

desloratadine odt

GENERIC

diphenhydramine HCL

allopurinol

levocetirizine dihydrochloride

probenecid

promethazine HCL

probenecid/colchicine

promethazine HCL plain

PREFERRED

Clemastine Fumarate

Colcrys

PREFERRED

Uloric

Allegra Allergy Childrens


30

Dexchlorpheniramine Maleate Clarinex-d 24 HOUR

NON PREFERRED Codar AR

Brompheniramine Cpb Wc

Brompheniramine Tannate Decon-a

Clarinex Dextromethorphan HBR/Chlorpheniramine/Phenylephrine HCL

Clarinex Reditabs

Exactuss

Dicopanol Fusepaq

Flowtuss

Karbinal ER

Gilphex TR

Palgic

Giltuss

Phenergan

Giltuss PED-c

Respa-BR

Giltuss TR

Xyzal

Hycofenix

Hyper-sal

NASAL AGENTS

Hypersal

GENERIC

Nebusal

azelastine HCL

Neotuss Plus

budesonide

Obredon

flunisolide

Panatuss Dxp

fluticasone propionate

Pediatex TD

ipratropium bromide

Pediatex TDM

olopatadine HCL

Relhist


Rescon-JR

PREFERRED

Rescon-MX

Nasonex

Rezira

Veramyst

Semprex-d

NON PREFERRED

Suttar-SF

Adrenalin

Suttar-2

Astelin

Tessalon Perles

Astepro

Tussicaps

Atrovent

Tussionex Pennkinetic Extended Release

Bactroban Nasal

Tuzistra XR

Beconase AQ

Vituz

Dymista

Zonatuss

Flonase

Zutripro

Omnaris

Patanase

ANTIASTHMATIC/COPD AGENTS

Qnasl

GENERIC

Qnasl Childrens

albuterol sulfate

Rhinocort Aqua

albuterol sulfate ER

Tyzine

albuterol TAB 4MG

Tyzine Pediatric Nasal Drops

aminophylline

Zetonna

budesonide

epinephrine HCL

COUGH/COLD/ALLERGY

ipratropium bromide

GENERIC

ipratropium bromide/albuterol sulfate

acetylcysteine

levalbuterol

benzonatate

levalbuterol HCL

bromphen/pseudoephedrine HCL/dextromethorphan HBR

montelukast sodium

hydrocodone bitartrate/chlorpheniramine maleate/PSE

terbutaline sulfate

hydrocodone bitartrate/homatropine methylbromide

theophylline

hydrocodone polistirex/chlorpheniramine polistirex

theophylline CR

hydrocodone/homatropine

theophylline ER

phenylephrine/guaifenesin

zafirlukast

promethazine-DM

Cromolyn Sodium

promethazine/codeine

PREFERRED

promethazine/dextromethorphan

Advair Diskus

promethazine/phenylephrine

Advair HFA

promethazine/phenylephrine/codeine

Breo Ellipta

sodium chloride

Combivent Respimat

PREFERRED

Elixophyllin

Dallergy

Flovent Diskus

J-max

Flovent HFA

Mucinex D

Foradil Aerolizer

Mucinex Maximum Strength

Incruse Ellipta

Promethazine/Phenylephrine

Metaproterenol Sulfate

NON PREFERRED

Proair HFA

Carbaphen 12

Proair Respiclick

Carbaphen 12 PED

Pulmicort Flexhaler

Clarinex-d 12 HOUR


31

Serevent Diskus Afluria PF 2012-2013

Spiriva Handihaler Afluria PF 2013-2014

Spiriva Respimat Afluria PF 2014-2015

Symbicort Afluria PF 2015-2016

Ventolin HFA Afluria 2012-2013

Xolair Afluria 2013-2014

NON PREFERRED Afluria 2014-2015

Accolate Afluria 2015-2016

Aerospan Bcg Vaccine

Anoro Ellipta Bexsero

Arcapta Neohaler Biothrax

Atrovent HFA Cervarix

Brovana Comvax

Daliresp Engerix-b

Duoneb Fluarix Quadrivalent 2013-2014

Isuprel Fluarix Quadrivalent 2014-2015

Lufyllin Fluarix Quadrivalent 2015-2016

Maxair Autohaler Fluarix 2013-2014

Perforomist Fluarix 2014-2015

Pulmicort Flublok 2013-2014

Pulmophylline Flublok 2014-2015

Senophylline Flublok 2015-2016

Singulair Flucelvax 2013-2014

Striverdi Respimat Flucelvax 2014-2015

Theo-24 Flucelvax 2015-2016

Theophylline/D5W Flulaval Quadrivalent 2013-2014

Vospire ER Flulaval Quadrivalent 2014-2015

Xopenex Flulaval Quadrivalent 2015-2016

Xopenex Concentrate Flulaval 2013-2014

Zyflo Flulaval 2014-2015

Zyflo CR Flumist Quadrivalent

Fluvirin PF 2013-2014

RESPIRATORY AGENTS - MISC Fluvirin PF 2014-2015

Fluvirin 2013-2014

PREFERRED

Fluvirin 2014-2015

Pulmozyme

Fluvirin 2015-2016

NON PREFERRED

Fluzone High-dose PF 2013-2014

Aralast NP


Curosurf


Esbriet

Fluzone Pediatric PF 2013-2014

Glassia

Fluzone PF 2013-2014

Infasurf

Fluzone PF 2014-2015

Kalydeco

Fluzone Quadrivalent 2013-2014

Ofev


Prolastin-c


Surfaxin

Fluzone Split 2013-2014

Survanta Intratracheal


Zemaira


Gardasil

TOXOIDS

Gardasil 9

Havrix

NON PREFERRED

Hiberix

Adacel

Imovax Rabies (h.d.c.v.)

Boostrix

Ipol Inactivated IPV

Daptacel

Ixiaro

Diphtheria/Tetanus Toxoids Adsorbed Pediatric

M-m-r II

Infanrix

Medical Provider EZ Flu Shot 2014-2015

Kinrix

Menactra

Pediarix

Menhibrix

Pentacel

Menomune-a/C/Y/W-135

Quadracel

Menveo

Tenivac

Pedvax HIB

Tetanus Toxoid Adsorbed

Pneumovax 23

Tetanus/Diphtheria Toxoids-adsorbed

Pneumovax 23/1 Dose

Tetanus/Diphtheria Toxoids-adsorbed Adult

Pneumovax 23/5 Dose

Prevnar 13

VACCINES

Proquad

Rabavert

NON PREFERRED

Recombivax HB

Acthib

Rotarix


32

Rotateq O-CAL Fa

Trumenba O-CAL Prenatal

Twinrix Obstetrix DHA

Typhim VI Obtrex

Vaqta Obtrex DHA

Varivax One A Day Womens Prenatal/DHA

Vivotif Berna One A Day Womens Prenatal1

Yf-vax One-a-day Womens Prenatal

Zostavax OB Complete

OB Complete One

VITAMINS OB Complete Petite

OB Complete Premier

VITAMINS

OB Complete 400

GENERIC

OB Complete/DHA

ascorbic acid

Poly-VI-flor

ergocalciferol

Poly-VI-flor FS

phytonadione

Poly-VI-flor/Iron

thiamine HCL

Prefera OB

vitamin c 222MG

Prefera OB + DHA

vitamin d

Prenata

vitamin k1

Prenatal Vitamin

PREFERRED

Prenatal Vitamins

Mephyton

Prenate AM

Vitamin A

Prenate Elite

NON PREFERRED

Prenate Essential

Aquasol A Parenteral

Prenate Star

Drisdol

Provida OB

Pyridoxine HCL

Right Step Prenatal

Vitamin K1

Select-OB

Wheat Germ

Stuart Prenatal

Taron-bc

MULTIVITAMINS

Taron-c DHA

GENERIC

Theranatal Core Nutrition

b-complex 100

Tri-VI-flor

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

Tricare Prenatal Compleat

PREFERRED

Tricare Prenatal DHA One

Atabex EC

Vinacal B

Atabex Prenatal

Vinate AZ Extra

Bal-care DHA

Vinate Calcium

Bal-care DHA Essential

Vinate DHA

Citranatal B-calm

Vinate DHA RF

Citranatal RX

Vita-pren

Clinical Nutrients Prenatal Formula

Vitafol-nano

Concept DHA

Vitafol-pn

Concept OB

Vitamedmd Redichew RX

Duet DHA Balanced

Vitamedmd Redichew RX/Quatrefolic

Duet DHA 400

Vitapearl

Duet DHA 400EC

Viva DHA

Duet DHA 430

Your Life Multi Prenatal

Duet DHA 430EC

Zatean-pn

Enbrace HR

Zatean-pn Plus

Escavite

NON PREFERRED

Escavite D

Adrenal C Formula

Folcaps Omega 3

Albafort

Folivane-OB

Bacmin

Healthy Mama Be Well Rounded

Citranatal Assure

Marnatal-f

Citranatal DHA

Mission Prenatal

Citranatal Harmony

Moms Choice RX

Citranatal 90 DHA

Mykidz Iron Fl

Cod Liver Oil

Mynatal

Corvite

Natachew

Crnatal

Natafort

Dialyvite Supreme D

Natalvit

Dialyvite 3000

Natelle One

Dialyvite 5000

Neevo DHA

Dialyvite/Zinc

Nestabs

Diatx ZN

Nestabs DHA

Floriva

Newgen

Focalgin CA

Niva-plus

Focalgin 90 DHA


33

Folet DHA DIABETIC SUPPLIES

Folet One

PREFERRED

Folgard OS

Accu-chek Multiclix Lancets

Folivane-prx DHA NF

Accu-chek Safe-t-pro Lancets

Fortavit

Accu-chek Safe-t-pro Pluslancets

Gesticare DHA

Accu-chek Soft Touch Lancets

M.v.i. Adult

Accu-chek Softclix Lancets

M.v.i. Pediatric

Advocate Insulin Pen Needles 29GX12.7MM

M.v.i.-12 Without Vitamin K

Advocate Insulin Pen Needles 31GX5MM

Natalvirt CA

Advocate Insulin Pen Needles 31GX8MM

Natalvirt 90 DHA

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

Nephplex RX


Nephro-vite RX


Nephrocaps


Nephrocaps QT


Nestabs Abc


Nexa Plus

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

Nicadan


Nicazel


Nicazel Forte

Advocate Lancets

Nicomide

Advocate Lancets 30G

Nutricap

Advocate Safety Lancets

Nutrivit

Advocate Safety Lancets 26G

Ocuvel

Agamatrix Ultra-thin Lancets 33G

Paire OB

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

Preferaob +dha

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

Preferaob One

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

Prefol-DHA

Assure Haemolance Plus High Flow 18G

Prenate

Assure Haemolance Plus Low Flow 25G

Prenate DHA

Assure Haemolance Plus Micro Flow 28G

Prenate Enhance

Assure Haemolance Plus Normal Flow 21G

Prenate Mini

Assure Haemolance Plus Pediatric Blade

Prenate Pixie

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

Prenate Restore

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

Preque 10

Assure Lance Lancets

Protect Plus

Assure Lance Lancets 21G

Provida DHA

Assure Lance Plus Safety Lancets 25G

R-natal OB

Assure Lance Plus Safety Lancets 30G

Renatabs

Assure Lancets

Renatabs With Iron

Aurora Lancet Super Thin 30G

Req 49+

Aurora Lancet Thin 23G

Select-ob+dha

Aurora Pen Needles 29GX12MM

Siderol

Aurora Pen Needles 31G X 6MM

Strovite Forte

Aurora Pen Needles 31G X 8MM

Strovite One

Autolet Platforms

Supervite

AF Lancets Super Thin

Supervite EC

AT Last Lancets

Support-500

Bayer Microlet Lancets

Synagex

Bullseye Safety Lancets

Synatek

BD Autoshield Duo 30G X 3/16"

Texavite LQ

BD Autoshield 29G X 3/16"

Triveen-duo DHA

BD Autoshield 29G X 5/16"

Triveen-prx RNF

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

TL G-FOL OS

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

Udamin SP

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

Vemavite-prx 2

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

Vitafol

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

Vitafol Fe+

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

Vitafol Ultra

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

Vitafol-ob+dha

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

Vitafol-one

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

Vital-d RX

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

Vitamedmd One RX/Quatrefolic

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

Vitamedmd Plus RX/Quatre Folic

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

Vitaroca Plus

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

Zatean-pn DHA

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

Zatean-CH

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

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

MEDICAL DEVICES

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


34

BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2" Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G 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"





BD Insulin Syringe Ultrafine/U-100/1ML/31G X 5/16" Clever Choice Comfort EZ Pen Needles 29GX12MM

BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2" Clever Choice Comfort EZ Pen Needles 31GX5MM




BD Insulin Syringe Ultrafine/1ML/30G X 1/2" Clever Choice Comfort EZ Pen Needles 32GX8MM

BD Insulin Syringe Ultrafine/1ML/31G X 5/16" Clever Choice Comfort EZ Pen Needles 33GX4MM

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

Clever Choice Comfort EZ Pen Needles 33GX5MM


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


Coaguchek Lancets

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

Comfort Assist Insulin Syringe 0.3ML/29G 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"


BD Lancet Ultrafine 30G

Comfort Lancets

BD Lancet Ultrafine 33G

Diastar Easy Test II Lancets 30G

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

Diastar Easy Test Lancets30G

Droplet Lancets Ultra Thin 30G

BD Microtainer Lancets

Drug Mart On-the-go Lancets Gentle 30G

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

Drug Mart Unilet Lancets Super Thin 30G

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

Drug Mart Unilet Lancets Ultra Thin 28G

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

Duane Reade Unifine Pentips 29G X 12MM

BD Pen Needle/Ultrafine/29G X 12.7MM

Duane Reade Unifine Pentips 31G X 6MM Ultra SHORT

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

Duane Reade Unifine Pentips 31G X 8MM SHORT

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

E-z Ject Lancets

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

E-z Ject Lancets Color

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

E-z Ject Lancets Super Thin

BD Safetyglide Insulin Sysyringe/0.5ML/30G X 5/16" E-z Ject Lancets Super Thin 30G

BD-insul SYR Mis LO Dose E-z Ject Lancets Thin 26G

Carefine Pen Needle 32GX4MM E-z Ject Lancets 21G

Carefine Pen Needles 29GX1/2" E-ZJECT Lancets Micro-thin 33G

Carefine Pen Needles 30GX5/16" Easy Touch Insulin Syringe/Safety/U-100/0.5ML/29G X 1/2"

Carefine Pen Needles 31GX6MM

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

Carefine Pen Needles 31GX8MM

Careone Lancet Thin

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

Careone Lancet Ultra Thin

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

Cleanlet Lancets 28G

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

Clever Chek Lancets Ultrathin


Clever Chek Lancets Ultrathin 30G


Clever Choice Comfort EZ Insulin Pen Needles 31GX8MM


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


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








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






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


Easy Touch Lancets 21G/Pressure Activated



35

Easy Touch Lancets 26G/Pressure Activated Freestyle Precision Insulin Syringes/U-100/1ML/30G X 5/16"

Easy Touch Lancets 26G/Pull-top

Freestyle Unistick II Lancets

Easy Touch Lancets 26G/Twist

Gentle-let GP Lancets


Gentle-let Lancets General Purpose Style/Fine Point


Gentle-let Lancets General Purpose Style/Medium Point


Gentle-let Lancets Safety Style/Fine Point

Easy Touch Lancets 30G/Button-activated

Gentle-let Lancets Safety Style/Medium Point


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"








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

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

Easy Touch Safety Lancets21G/Pressure Activated




Easy Touch Safety Lancets26G/Button Activated

Glucosource Lancets


Gmate Lancets 30G

Easy Touch Safety Lancets28G/Button Activated

H&h Thinlet Lancets 26G


H&h Thinlet Super Thin Lancets 30G

Easy Twist & CAP Lancets

H-e-b Incontrol Pen Needles 29GX12MM

Easytest II Lancets

H-e-b IN Control Pen Needles 31GX6MM

Easytest Lancets

H-e-b IN Control Pen Needles 31GX8MM

Embrace Lancets Ultra Thin 30G

Haemolance

Eql SHORT Pen Needles 31G X 8MM

Haemolance Low Flow Lancets

Eql Ultra SHORT Pen Needles 31G X 6MM

Haemolance Plus

Excel Comfort Point Insulin Pen Needles 31G X 4MM

Haemolance Plus High Flow

Exel Comfort Point Insulin Pen Needles 29G X 12MM

Haemolance Plus Low Flow


Haemolance Plus Max Flow


Haemolance Plus Pediatric Flow

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

Healthwise Mini Pen Needles 31GX6MM


Healthwise Pen Needles 29GX12MM


Healthwise SHORT Pen Needles 31GX8MM


Hy-vee Lancets


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

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





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

EZ Smart Blood Glucose Lancets


EZ-lets Lancets 21G


EZ-lets Lancets 23G


EZ-lets Lancets 26G Super-soft

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

EZ-lets Lancets 28G Ultra-soft

Insulin Syringe/0.3ML/29G X 1"

EZ-lets Lancets 30G


Fasttake Compact Monitoring System


Fasttake Test Strips


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


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


Fifty50 Safety Seal Lancets 30G


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"

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


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


Fine 30


Fingerstix Lancets

Insupen Sensitive 32GX8MM

Fora Lancets

Insupen Ultrafin 29GX12MM

Freestyle Lancets


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



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

IN Touch Sterile Lancets 30G

Lancet Transporter Case

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

Lancets

Lancets Bullseye Safety

Lancets Safety Seal 21G


36

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


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


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


Monolet Opd Lancets

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

Monolettor Safety Lancets

Litetouch Lancets Micro Thin 33G

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

Litetouch Pen Needles 29GX12.7MM

Litetouch Pen Needles 31G X 6MM

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

Litetouch Pen Needles 31GX8MM SHORT

Live Better Lancet Super Thin 30G

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

Live Better Lancet Ultra Thin 28G

Live Better Pen Needles 29G X 12MM

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

Live Better Pen Needles 31G X 12MM

Live Better Pen Needles 31G X 6MM Myglucohealth Mgh Softlance Lancets 30G

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

Magellan Insulin Safety Syringe/U-100/0.3ML/30G X 5/16" Nova Safety Lancets 23G

Magellan Insulin Safety Syringe/U-100/0.5ML/29G X 1/2" Nova Safety Lancets 28G

Magellan Insulin Safety Syringe/U-100/0.5ML/30G X 5/16" Nova Sureflex Lancets

Magellan Insulin Safety Syringe/U-100/1ML/29G X 1/2" Novofine Plus 32GX4MM

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

Maxi-comfort Insulin Syringe/U-100/0.5ML/28GX1/2" On Call Plus Lancets

Maxi-comfort Insulin Syringe/U-100/1ML/28GX1/2" Onetouch Basic System

Medisense Thin Lancets Onetouch Basic/Profile Test Strips

Medlance Plus Extra Lancets 21G Onetouch Club Lancets Fine Point

Medlance Plus Lancets Onetouch Combo Pack

Medlance Plus Lancets Lite 25G Onetouch Delica Lancets Extra Fine 33G

Medlance Plus Lite Lancets 25G Onetouch Delica Lancets Fine 30G

Medlance Plus Special Lancets 0.8MM Onetouch Finepoint Lancets

Medlance Plus Superlite 30G Onetouch Lancets

Medlance Plus Superlite 30G/Comfort Max Onetouch Profile System

Medlance Plus Universal Lancets 21G Onetouch Suresoft Lancing Device/18G

Medlance Plus/Lite 25G Onetouch Suresoft Lancing Device/21G

Medlance/Extra Onetouch Suresoft Lancing Device/28G

Medlance/Lite Onetouch Ultra Blue

Medlance/Universal Onetouch Ultra Mini

Meijer Super Thin Lancets Onetouch Ultra System Kit

Microlet Lancets Onetouch Ultra 2

Microtainer Safety Flow Lancet/Sterile/Single-use Onetouch Ultralink System (hex)

Monoject Insulin Syringe Regular LUER Tip/Softpack/1ML Onetouch Ultralink System (DEC)

Monoject Insulin Syringe/Detach Needle/1ML/25G X 5/8" Onetouch Ultrasmart

Monoject Insulin Syringe/Detach Needle/1ML/27G X 1/2" Onetouch Ultrasoft Lancets


37

Onetouch Verio Relion Insulin Syringe/U-100/1ML/30G X 5/16"

Onetouch Verio IQ Blood Glucose Monitoring System Relion Insulin Syringe/U-100/1ML/31G X 5/16"

Onetouch Verio Sync Bloodglucose Monitoring System Relion Lancets Micro-thin33G

Onetouch Verio Test Strips Relion Lancets Standard 21G

Pen Needles 29G X 12MM Relion Lancets Thin 26G

Pen Needles 29GX1/2" Relion Lancets Ultra-thin30G

Pen Needles 30GX5/16" Relion Mini Pen Needles 31GX6MM

Pen Needles 31G X 1/4" SHORT Relion Pen Needles 29GX12MM

Pen Needles 31G X 3/16" Relion Pen Needles 31GX8MM

Pen Needles 31G X 6MM Relion Pen Needles 32GX4MM

Pen Needles 31GX5/16" Relion SHORT Pen Needles 31GX8MM

Penlet II Replacement CAPS Relion Thin Lancets

Penlet II Replacement CAPS-deep Relion Ultra Thin Lancets

Penlet II Replacement CAPS-regular Relion Ultra Thin Lancets30G

Pentips 31GX5MM Relion Ultra Thin Plus Lancets 32G

Pentips 31GX8MM Relion Ultra Thin Plus Lancets 33G

Pentips 32GX4MM Renew Advanced Lancing Cartridge Refills

Perfect Lancets 30G Rexall Lancets Ultra Thin

Perfect Pressure Activated Safety Lancets 28G Rightest Gl300 Lancets

Pharmacist Choice Ultra Thin Lancets Rightest GD-L500 Alternate Site Adapter

Pharmacist Choice Ultra Thin Lancets 28G Safe-t-lance Low Flow 25G

Pharmacist Choice Ultra Thin Lancets 30G Safe-t-lance Normal Flow 21G

Pharmacist Choice Ultra Thin Lancets 31G Safe-t-lance Plus Safety Lancet High Flow

Pharmacist Choice Ultra Thin Lancets 33G Safe-t-lance Plus Safety Lancet Low Flow

Pharmacy Counter Lancets Safe-t-lance Plus Safety Lancet Normal Flow

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



Precision Sure-dose Insulin Syringe/0.5ML/30G X 3/8" Safesnap Insulin Syringe/1ML/28G X 1/2"

Precision Sure-dose Insulin Syringe/1ML/28G X 1/2" Safesnap Insulin Syringe/1ML/29G X 1/2"

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

Safety Lancet 21G/Pressure Activated

Safety Lancet 28G/Pressure Activated

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

Safety Lancets

Precision Thin Lancets

Safety Lancets 21G

Precision Thins GP Lancet

Safety Lancets 28G

Precision Ultra Lancet

Safety Let Lancets

Preferred Plus Unifine Pentips 29G X 12MM

Safety Seal Lancets 28G

Preferred Plus Unifine Pentips 31G X 6MM Ultra SHORT

Safety Seal Lancets 30G

Preferred Plus Unifine Pentips 31G X 8MM SHORT

Safety-glide Insulin Syringe/0.3ML/29G X 1/2"

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

Shopko On-the-go Comfort Lancets 30G

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

Shopko Unifine Pentips Pen Needles/Micro/32GX4MM

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

Shopko Unifine Pentips Pen Needles/Mini/31GX5MM

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

Shopko Unifine Pentips Pen Needles/Original/29GX12MM

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

Shopko Unifine Pentips Pen Needles/SHORT/31GX8MM

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

Shopko Unilet Lancets Super Thin 30G

Prodigy Pressure Activated Safety Lancets

Shopko Unilet Lancets Ultra Thin 28G

Prodigy Twist Top Lancets

Single-let

Pss Select GP Lancets

Smart Diabetes Vantage Universal Lancets 30G

Pss Select Platforms

Smart Sense Color Lancets Universal 33G

Pss Select Safety Lancets

Smart Sense Standard Lancets Universal 21G

Px Lancets Ultra Thin

Smart Sense Super Thin Lancets Universal 30G

PC Unifine Pentips 29G X 1/2"

Smart Sense Thin Lancets Universal 26G

PC Unifine Pentips 31G X 6MM Ultra SHORT

Smartest Lancets 28G

PC Unifine Pentips 31G X 8MM SHORT

Solus V2 Pressure Activated Safety Lancets 28G

Qc Lancets Super Thin

Solus V2 Twist Lancets 30G

Qc Lancets Ultra Thin

Sterilance PA

Qc Pen Needles 29G X 12MM

Sterilance TL


Sure-fine Pen Needles 29GX1/2" 12.7MM


Sure-fine Pen Needles 31GX3/16" 5MM

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

Sure-fine Pen Needles 31GX5/16" 8MM

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

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

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


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











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





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


38

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

Sure-lance Flat Lancets Ulticare Insulin Syringe/U-100/0.3ML/29G X 1/2"

Sure-lance Lancets 26G Ulticare Insulin Syringe/U-100/0.3ML/30G X 1/2"

Sure-lance Thin Lancets 28G Ulticare Insulin Syringe/U-100/0.3ML/30G X 5/16"

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

Sure-touch Lancets Universal Ulticare Insulin Syringe/U-100/0.5ML/29G X 1/2"

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

Surestep Pro Test Strips 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

Thinpro Insulin Syringe/0.5ML/28G X 1/2" Ulticare SHORT Pen Needles 31GX8MM

Thinpro Insulin Syringe/0.5ML/29G X 1/2" Ulticare SHORT Pen Needles/31G X 8MM

Thinpro Insulin Syringe/0.5ML/30G X 3/8" Ulticare Thin Lancets 30G

Thinpro Insulin Syringe/0.5ML/31G X 3/8" Ultiguard Insulin Syringe/U-100/0.3ML/29G X 1/2"

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



Thinpro Insulin Syringe/1ML/31G X 3/8" Ultiguard Insulin Syringe/U-100/1ML/29G X 1/2"

Trueplus Insulin Syringe/U-100/0.3ML/29G X 1/2" Ultiguard Insulin Syringe/U-100/1ML/30G X 5/16"

Trueplus Insulin Syringe/U-100/0.3ML/30G X 5/16" Ultilet Classic Lancets

Trueplus Insulin Syringe/U-100/0.3ML/31G X 5/16" Ultilet Insulin Syringe/SHORT/0.3ML/30G X 5/16"




Trueplus Insulin Syringe/U-100/0.5ML/31G X 5/16" Ultilet Insulin Syringe/SHORT/1ML/30G X 5/16"

Trueplus Insulin Syringe/U-100/1ML/28G X 1/2" Ultilet Insulin Syringe/SHORT/1ML/31G X 5/16"

Trueplus Insulin Syringe/U-100/1ML/29G X 1/2" Ultilet Lancets

Trueplus Insulin Syringe/U-100/1ML/30G X 5/16" Ultilet Lancets 33G

Trueplus Insulin Syringe/U-100/1ML/31G X 5/16" Ultilet Pen Needle 32GX4MM/SHORT

Trueplus Lancets 26G Ultilet Safety Lancets 23G

Trueplus Lancets 28G Ultilet SHORT Pen Needles 31GX5/16"

Trueplus Lancets 28G Super Thin Ultilet SHORT Pen Needles31GX3/16"

Trueplus Lancets 30G Ultra-thin II Auto Lancet

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

Trueplus Lancets 33G

Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/31GX5/16"

Trueplus Lancets 33G Micro Thin

Trueplus Safety Lancets 28G


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

Ulticare Insulin Safety Syringe/1ML/29G X 1/2"


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

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

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

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

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

Ulticare Insulin Syringe 1CC/28G U-100 1/2"

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

Ulticare Insulin Syringe/SHORT/0.3ML/30G X 5/16"

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


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


Ultra-thin II Lancets 28G


Ultra-thin II Lancets 30G

Ulticare Insulin Syringe/SHORT/1ML/30G X 5/16"

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


39

Ultra-thin II Pen Needles 29GX1/2" Walgreens Ultra Thin Lancets

Ultra-thin II Pen Needles/SHORT/31GX5/16" 1ST Choice Lancets Super Thin

Ultra-thin II Safety Autolancets 26G 1ST Choice Lancets Thin

Ultralance 1ST Choice Lancets Ultra Thin

Unifine Pentips Plus 29GX12MM 1ST Tier Unifine Pentips 29GX12MM



Unifine Pentips Plus 31GX8MM

Unifine Pentips 29GX12MM MEDICAL DEVICES - MISC

Unifine Pentips 31G X 3/16"

PREFERRED

Unifine Pentips 31G X 6MM

Aerochamber Mini Aerosol Chamber

Unifine Pentips 31G X 8MM

Aerochamber MV

Unifine Pentips 31GX5MM

Aerochamber Plus Flow VU


Aerochamber Plus Flow-VU


Aerochamber Plus Flow-VU/Large Mask


Aerochamber Plus Flow-VU/Mask

Unilet Comfortouch Lancet

Aerochamber Plus Flow-VU/Medium Mask

Unilet Excelite

Aerochamber Plus Flow-VU/Small Mask

Unilet Excelite II

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

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

Breatherite Collapsible Small Child Spacer W/Mask

Unistik 1

Breatherite Collapsible Spacer W/ Neonate Mask

Unistik 2

Breatherite Rigid Spacer W/Mask

Unistik 2 Comfort

Breatherite W/Large Mask

Unistik 2 Extra

Breatherite W/Medium Mask

Unistik 2 Neonatal

Breatherite W/Small Mask

Unistik 2 Normal

E-z Spacer

Unistik 2 Super

E-z Spacer The Body Guards Pack

Unistik 3

Easivent

Unistik 3 Comfort

Easivent/Mask-large

Unistik 3 Extra

Easivent/Mask-medium

Unistik 3 Gentle

Easivent/Mask-small

Unistik 3 Neonatal

Flexichamber

Unistik 3 Normal

Inspirachamber/Anti-static Valved/Mouthpiece

Universal 1 Lancets Thin 26G

Inspirachamber/Soothermask/Inspiramask/Medium

Universal 1 Lancets Ultra Thin 30G

Inspirachamber/Soothermask/Inspiramask/Small

V-r Monoject Insulin Syringe/U-100/0.3ML/29G X 1/2"

Inspirease Bags


Inspirease Drug Delivery System


Inspirease Mouthpiece

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

Inspirease Reservoir Bags

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

Liteaire

Valumark Lancet Super Thin 30G

Mask Vortex/Baby Whirl Duckling

Valumark Lancet Ultra Thin 28G

Mask Vortex/Child/Frog

Valumark Pen Needles 29GX12MM

Mask Vortex/Spinner The Duck

Valumark Pen Needles 31G X 6MM

Mask Vortex/Toddler/Lady Bug

Valumark Pen Needles 31G X 8MM

Microchamber

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

Microspacer

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

Nessi Spacer/Large Mask

Vida Mia Unifine Pentips Mini 31GX6MM

Nessi Spacer/Mouthpiece

Vida Mia Unifine Pentips Original 29GX12MM

Nessi Spacer/Small/MED Mask

Vida Mia Unifine Pentips 32GX4MM

Optichamber Advantage

Vida Mia Unilet Lancets Super Thin 30G

Optichamber Diamond

Vida Mia Unilet Lancets Ultra Thin 28G

Optichamber Diamond/Largeface Mask

Vida Mia Unipfine Pentipsshort 31GX8MM

Optichamber Diamond/Medium Face Mask

Vitalet Pro Lancets

Optichamber Diamond/Smallface Mask

Vitalet Pro Plus Lancets

Optihaler

W&f Lancets Colored 21G

Optihaler MDI Drug Delivery System

W&f Lancets 26G

Panda Mask Large

Walgreens Lancets

Walgreens Thin Lancets


40

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.1 All Optum

TM

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

Adacel, 32 Aerochamber Z-stat Plus Valved Holding Chamber W/Flow VU, 40

Adalat CC, 7

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

adapalene, 10 Aerochamber Z-stat Plus/Flowsignal, 40

abacavir, 3

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

abacavir sulfate/lamivudine/zidovudine, 3

Adasuve, 23 Aerochamber Z-stat Plus/Medium Mask, 40

Abaneu-SL, 20

Adcetris, 5

Abelcet, 2

Adcirca, 10 Aerochamber Z-stat Plus/Small Mask, 40

Abilify, 23

Adderall, 24 Aerochamber/Flowsignal, 40

Abilify Discmelt, 23

Adderall XR, 24 Aerospan, 32

Abilify Maintena, 23

Addyi, 25 Aerovent Plus Holding Chamber/Collapsible, 40

Abraxane, 5

adefovir dipivoxil, 3

Absorica, 10

Adempas, 10 AF Lancets Super Thin, 34

acamprosate calcium DR, 25

Adenocard, 8 Afinitor, 6

Acanya, 10

adenosine, 7 Afinitor Disperz, 6

acarbose, 16

Adoxa, 2 Afluria 2012-2013, 32

Accolate, 32

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

Accu-chek Multiclix Lancets, 34


Accu-chek Safe-t-pro Lancets, 34


Accu-chek Safe-t-pro Pluslancets, 34

Adrenal C Formula, 33 Afluria PF 2012-2013, 32

Accu-chek Soft Touch Lancets, 34

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

Accu-chek Softclix Lancets, 34

Adriamycin, 4 Afluria PF 2014-2015, 32

Accupril, 8

Advair Diskus, 31 Afluria PF 2015-2016, 32

Accuretic, 8

Advair HFA, 31 Afrezza, 15

acebutolol HCL, 7

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

Aceon, 8

Advate, 21 Aggrastat, 21

acetaminophen/caffeine/dihydrocodeine, 28

Advicor, 9 Aggrenox, 21

Advocate Insulin Pen Needles 29GX12.7MM, 34

Agrylin, 21

Acetaminophen/Caffeine/Dihydrocodeine Bitartrate, 28

Akne-mycin, 10

Advocate Insulin Pen Needles 31GX5MM, 34

Akten, 27

acetaminophen/codeine, 28

Akynzeo, 19

acetaminophen/codeine #2, 28

Advocate Insulin Pen Needles 31GX8MM, 34

Ala Scalp, 12


Albafort, 20, 33


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

Albenza, 3

acetaminophen/codeine phosphate, 28

albuterol sulfate, 31

acetazolamide, 9


albuterol sulfate ER, 31

Acetazolamide, 9

albuterol TAB 4MG, 31

acetazolamide ER, 9


Alcaine, 27

acetazolamide sodium, 9

alclometasone dipropionate, 12

acetic acid, 27


Aldactazide, 9

Acetic Acid/Aluminum Acetate, 28

Aldactone, 9

acetylcysteine, 31


Aldara, 13

Aciphex, 18

Aldurazyme, 17

Aciphex Sprinkle, 18


alendronate sodium, 16

acitretin, 11

Alendronate Sodium, 16

Aclovate, 12

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

Alevicyn Antipruritic SG, 13

Actemra, 29

Alfenta, 28

Acthib, 32


alfentanil, 28

Acticlate, 2

Alferon N, 6

Actigall, 19


alfuzosin HCL ER, 20

Actimmune, 6

Alimta, 5

Actiq, 28

Advocate Lancets, 34 Alinia, 4

Activase, 21

Advocate Lancets 30G, 34 Alkeran, 4

Activella, 15

Advocate Safety Lancets, 34 Allegra Allergy Childrens, 30

Actonel, 16

Advocate Safety Lancets 26G, 34 Allo-pax, 11

Actoplus Met, 16

Aerochamber Mini Aerosol Chamber, 40 allopurinol, 30

Actoplus Met XR, 16

Aerochamber MV, 40 almotriptan malate, 30

Actos, 16

Aerochamber Plus Flow VU, 40 Alocril, 27

Acuicyn Daily Eyelid & Eyelash Cleanser, 13

Aerochamber Plus Flow-VU, 40 Alodox Convenience Kit, 2

Aerochamber Plus Flow-VU/Large Mask, 40

Alomide, 27

Acular, 27

Aloprim, 30

Acular LS, 27

Aerochamber Plus Flow-VU/Mask, 40 Alora, 14

Acuvail, 27

Aerochamber Plus Flow-VU/Medium Mask, 40

alosetron hydrochloride, 19

acyclovir, 3, 11

Aloxi, 18

acyclovir sodium, 3

Aerochamber Plus Flow-VU/Small Mask, 40

Alphagan P, 27

Acyclovir Sodium, 3

Alphanate/Von Willebrand Factor

Aczone, 10

Complex/Human, 21

Anaprox DS, 29 Aspirin-caffeine-dihydrocodeine, 28

Alphanine SD, 21

Anaspaz, 18 Aspirin/Dipyridamole, 21

alprazolam, 22

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

alprazolam ER, 22

Ancef, 1

Alprazolam Intensol, 22

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

alprazolam odt, 22

Androderm, 14

Alrex, 27

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

Alsuma, 30

Androgel P.M., 14

Altabax, 11

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

Altace, 8

Androxy, 14

Aluvea, 13

Anectine, 25 Assure Haemolance Plus Pediatric Blade, 34

amantadine HCL, 25

Angeliq, 15

Amantadine HCL, 25

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

Amaryl, 16

Animi-3, 20

Ambien, 23

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

Ambien CR, 23

Anoro Ellipta, 32

Ambisome, 2

Antabuse, 25 Assure Lance Lancets, 34

Amcinonide, 12

Antara, 9 Assure Lance Lancets 21G, 34

Amerge, 30

Anthralin, 12 Assure Lance Plus Safety Lancets 25G, 34

Amicar, 21

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

amifostine, 6

Assure Lance Plus Safety Lancets 30G, 34

amikacin sulfate, 2

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

amiloride HCL, 9

Assure Lancets, 34

amiloride/hydrochlorothiazide, 9

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

Astagraf XL, 5

aminocaproic acid, 21

Astelin, 31

Aminocaproic Acid, 21

antipyrine/benzocaine, 27 Astepro, 31

aminophylline, 31

Antipyrine/Benzocaine, 28 Astringyn, 21

amiodarone HCL, 7

Anusol-HC, 19 AT Last Lancets, 34

Amiodarone HCL, 8

Anzemet, 19 Atabex EC, 33

Amitiza, 19

Aplenzin, 23 Atabex Prenatal, 33

amitriptyline HCL, 22

Apokyn, 25 Atacand, 8

amlodipine besylate, 7

Appbutamone, 23 Atacand HCT, 9

amlodipine besylate/atorvastatin calcium, 10

Appbutamone-d, 23 Atelvia, 16

Appformin, 16 atenolol, 7

amlodipine besylate/benazepril HCL, 8

Appformin-d, 16 atenolol/chlorthalidone, 8

amlodipine besylate/benazepril hydrochloride, 8

apraclonidine, 27 Atgam, 5

Apriso, 19 Ativan, 22

amlodipine besylate/valsartan, 8

Aptensio XR, 24 Atopiclair, 13

amlodipine/valsartan/hctz, 8

Aptiom, 24 atorvastatin calcium, 9

ammonium lactate, 13

Aptivus, 3 atovaquone, 3

Ammonul, 17

Aquasol A Parenteral, 33 atovaquone/proguanil HCL, 3

Amoxapine, 22

Aquoral, 22 atracurium besylate, 25

amoxicillin, 1

Aralast NP, 32 Atralin, 10

Amoxicillin, 1

Aralen, 3 Atripla, 3

Amoxicillin ER, 1

Aranesp Albumin Free, 20 Atropen, 18

amoxicillin/clavulanate potassium, 1

Arava, 29 atropine sulfate, 18, 27

amoxicillin/clavulanate potassium ER, 1

Arcalyst, 29 Atropine Sulfate, 18, 27

amphetamine/dextroamphetamine, 24

Arcapta Neohaler, 32 Atrovent, 31

Amphotec, 2

argatroban, 21 Atrovent HFA, 32

Amphotericin B, 2

Argatroban, 21 Aubagio, 25

ampicillin, 1

Arial Chamber, 40 augmented betamethasone dipropionate, 12

Ampicillin, 1

Aricept, 25

ampicillin sodium, 1

Aricept Odt, 25 Augmentin, 1

Ampicillin Sodium, 1

Arimidex, 5 Augmentin ES-600, 1

ampicillin-sulbactam, 1

aripiprazole, 23 Augmentin XR, 1

Ampicillin-sulbactam, 1

Aristospan Intra-articular, 14 Auralgan, 28

Ampyra, 25

Aristospan Intralesional, 14 Aurora Lancet Super Thin 30G, 34

Amrix, 26

Arixtra, 21 Aurora Lancet Thin 23G, 34

Amturnide, 9

Armour Thyroid, 17 Aurora Pen Needles 29GX12MM, 34

Amytal Sodium, 23

Arnica Flower, 13 Aurora Pen Needles 31G X 6MM, 34

Anacaine, 13

Aromasin, 5 Aurora Pen Needles 31G X 8MM, 34

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, 34

Analpram-HC, 19

Artiss, 21 Avalide, 9

Analpram-HC Singles, 19

Arzerra, 5 Avandamet, 16

Anaprox, 29

ascorbic acid, 33 Avandaryl, 16

Avandia, 16

BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2", 34

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

Avapro, 8

Avar, 10

BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2", 34

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

Avar LS, 10

Avar LS Cleanser, 10

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


Avar-e LS, 10

Avastin, 5

BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8", 34

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

Avc, 20

Aveed, 14

BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2", 34


Avelox, 2

Avelox Abc Pack, 2

BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2", 34

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

Avidoxy DK, 2

Avinza, 28

BD Insulin Syringe Safetyglide/1ML/29G X 1/2", 34

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

Avodart, 20

Avonex, 25

BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 5/16", 34

BD Lancet Ultrafine 30G, 35

Avonex Pen, 25

BD Lancet Ultrafine 33G, 35

Avycaz, 4

BD Insulin Syringe Slip Tip/U-100/1ML, 34

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

Axert, 30

Axid, 18

BD Insulin Syringe U-40/1ML/25G X 5/8", 34

BD Microtainer Lancets, 35

Aygestin, 15

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

azacitidine, 4

BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16", 34

Azactam, 4

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

Azactam IN Iso-osmotic Dextrose, 4

BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X 5/16", 34

Azasan, 5

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

Azasite, 26

BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16", 34

azathioprine, 5

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

azelastine HCL, 27, 31

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

Azelex, 10

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

Azilect, 25


azithromycin, 1

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

Azithromycin, 1


Azopt, 27

BD Pudendal/Local Block Tray 1% Lidocaine, 30

Azor, 8


aztreonam, 4

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

Azulfidine, 19

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

Azulfidine EN-TABS, 19

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

B

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

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

B-6 Folic Acid, 20

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

b-complex 100, 33

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, 33

Belsomra, 23

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

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

Benzaclin, 10

Baraclude, 3

Benzaclin With P.M., 10

Bayer Microlet Lancets, 34


Benzamycin, 10

Bcg Vaccine, 32

Benzamycinpak, 10

BD Autoshield 29G X 3/16", 34


Benzefoam, 10

BD Autoshield 29G X 5/16", 34

Benzefoamultra, 10

BD Autoshield Duo 30G X 3/16", 34


Benziq, 10

BD Insulin Syringe LUER-LOK/U-100/1ML, 34

Benziq LS, 10

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

Benzoin Compound Tincture, 13

BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2", 34

Benzoin Tincture, 13

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

benzonatate, 31

BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2", 34

benzoyl peroxide, 10

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

benzoyl peroxide SHORT contact, 10

BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8", 34

benztropine mesylate, 25

Bepreve, 27

Breatherite W/Small Mask, 40 Canasa, 19

Berinert, 21

Breo Ellipta, 31 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, 21

Betagan, 26

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, 28

betamethasone valerate, 12

Caprelsa, 6

Betapace, 7

Brompheniramine, 31 Capsiderm, 13

Betapace AF, 7

Brompheniramine Tannate, 31 captopril, 8

betaxolol HCL, 7, 26

Brovana, 32 Captopril/Hydrochlorothiazide, 8

bethanechol chloride, 19

budesonide, 14, 31(2) Carafate, 18

Bethkis, 2

Bullseye Safety Lancets, 34 Carbaglu, 17

Betimol, 26

bumetanide, 9 carbamazepine, 24

Betoptic-s, 26

Bunavail, 28 carbamazepine ER, 24

bexarotene, 6

Bupap, 28 Carbaphen 12, 31

Bexsero, 32

Buphenyl, 17 Carbaphen 12 PED, 31

Bexxar, 5

bupivacaine HCL, 30 Carbatrol, 24

Bexxar 131 Iodine, 6

bupivacaine/epinephrine, 30 carbidopa, 25

Beyaz, 15

Buprenex, 28 carbidopa/levodopa, 25

Biaxin, 1

buprenorphine HCL, 28 carbidopa/levodopa ER, 25

Biaxin XL, 1

buprenorphine HCL/naloxone HCL, 28 carbidopa/levodopa odt, 25

Biaxin XL PAC, 1

bupropion HCL, 22 Carbidopa/Levodopa/Entacapone, 25

bicalutamide, 5

bupropion HCL ER, 22 carbinoxamine maleate, 30

Bicillin C-R, 1

bupropion HCL SR, 22 Carbocaine, 30

Bicillin L-a, 1

bupropion HCL XL, 22 carboplatin, 4

Bicnu, 4

buspirone HCL, 22 Cardene I.v., 7

Bidil, 10

Busulfex, 4 Cardene IV, 7

Biest/Progesterone, 15

butalbital/acetaminophen, 28 Cardene SR, 7

Biferarx, 20

butalbital/acetaminophen/caffeine, 28 Cardizem, 7

Biltricide, 3

butalbital/acetaminophen/caffeine/codeine, 28

Cardizem CD, 7

Bimatoprost, 27

Cardizem LA, 7

Binosto, 16

butalbital/apap/caffeine, 28 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, 23 Carefine Pen Needles 29GX1/2", 35

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

bivalirudin, 21

Butrans, 28 Carefine Pen Needles 31GX6MM, 35

bleomycin sulfate, 4

Bydureon, 15 Carefine Pen Needles 31GX8MM, 35

Bleph-10, 26

Byetta, 15 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

Botox, 25

carteolol HCL, 26

Calan, 7

Bravelle, 17

carvedilol, 7

Calan SR, 7

Breatherite, 40

Cascara Sagrada, 18

calcipotriene, 11

Breatherite Collapsible Adult Spacer W/Mask, 40

Casodex, 5

calcipotriene/betamethasone dipropionate, 12

Cataflam, 29

Breatherite Collapsible Child Spacer W/Mask, 40

Catapres, 8

calcitonin salmon, 16

Catapres-tts-1, 8

calcitonin-salmon, 16

Breatherite Collapsible Infant Spacer W/Mask, 40

Catapres-tts-2, 8

Calcitriol, 12

Catapres-tts-3, 8

calcitriol, 17

Breatherite Collapsible Small Child Spacer W/Mask, 40

Cathflo Activase, 21

calcium acetate, 19

Cayston, 4

Calcium Carbonate, 18

Breatherite Collapsible Spacer W/ Neonate Mask, 40

Cedax, 1

Calcium Folinate, 6

cefaclor, 1

Caldolor, 29

Breatherite Rigid Spacer W/Mask, 40

Cefaclor, 1

Cambia, 30

Breatherite W/Large Mask, 40

Cefaclor ER, 1

Campral, 25

Breatherite W/Medium Mask, 40

cefadroxil, 1

Camptosar, 6

cefazolin sodium, 1

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

Cefazolin Sodium, 1

choline magnesium trisalicylate, 28

Cefazolin Sodium/Dextrose, 1

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

cefdinir, 1

chorionic gonadotropin, 16

Cefditoren Pivoxil, 1

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

cefepime, 1

Ciclodan Cream Kit, 11

Cefepime, 1

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

cefixime, 1

ciclopirox, 11

cefotaxime sodium, 1

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

Cefotetan, 1

ciclopirox olamine, 11

Cefotetan/Dextrose, 1

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

cefoxitin sodium, 1

cidofovir, 3

Cefoxitin Sodium, 1

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

cefpodoxime proxetil, 1

cilostazol, 21

cefprozil, 1

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

ceftazidime, 1

cimetidine, 18

Ceftazidime/Dextrose, 1

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

Ceftibuten, 1

Cimzia, 19

Ceftin, 1

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

Ceftriaxone IN Iso-osmotic Dextrose, 1

Cinryze, 21

ceftriaxone sodium, 1

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

Ceftriaxone Sodium, 1

Cipro HC, 28

Ceftriaxone/Dextrose, 1

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

cefuroxime axetil, 1

Cipro XR, 2

cefuroxime sodium, 1

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

Cefuroxime Sodium, 1

ciprofloxacin, 2

Cefuroxime/Dextrose, 1

Ciprofloxacin, 28 Clever Choice Comfort EZ Patch, 13

Celebrex, 29

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

celecoxib, 29

ciprofloxacin HCL, 2, 26

Celestone-soluspan, 14

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

Celexa, 23

ciprofloxacin I.V.-IN D5W, 2

Cellcept, 5

cisatracurium besylate, 25 Clever Choice Comfort EZ Pen Needles 31GX6MM, 35

Cellcept Intravenous, 5

cisplatin, 4

Celontin, 24

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

Cenestin, 15

citalopram hydrobromide, 22

Cenfol, 20

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

Centany AT, 11

Citanest Plain Dental, 30

Centratex, 20

Citranatal 90 DHA, 33 Clever Choice Comfort EZ Pen Needles 32GX8MM, 35

cephalexin, 1

Citranatal Assure, 33

Cephalexin, 1

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

Cerdelga, 20

Citranatal DHA, 33

Cerebyx, 24

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

Cerezyme, 20

Citranatal RX, 33

Cervarix, 32

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

Cervidil, 28

cladribine, 5

Cesamet, 19

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

cetirizine HCL, 30

Claforan/D5W, 1

Cetraxal, 28

Clarifoam EF, 10 Cleviprex, 7

Cetrotide, 17

Clarinex, 31 Climara, 15

cevimeline HCL, 22

Clarinex Reditabs, 31 Climara Pro, 14

Chemet, 41

Clarinex-d 12 HOUR, 31 Clin Single Use Kit, 4

Chenodal, 19

Clarinex-d 24 HOUR, 31 Clindacin Etz, 10

Chloramphenicol Sodium Succinate, 4

clarithromycin, 1 Clindacin PAC, 10

chlordiazepoxide HCL, 22

clarithromycin ER, 1 Clindagel, 10

Chlordiazepoxide/Amitriptyline, 25

Cleanlet Lancets 28G, 35 clindamycin HCL, 4

chlorhexidine gluconate, 22

clemastine fumarate, 30 clindamycin palmitate HCL, 4

chlorhexidine gluconate oral rinse, 22

Clemastine Fumarate, 30 clindamycin phosphate, 4, 10, 20

chloroprocaine HCL, 30

Cleocin, 4, 20 Clindamycin Phosphate, 4

chloroquine phosphate, 3

Cleocin IN D5W, 4 clindamycin phosphate add-vantage, 4

chlorothiazide, 9

Cleocin Pediatric Granules, 4 clindamycin phosphate IN D5W, 4

Chlorothiazide, 9

Cleocin Phosphate, 4 clindamycin phosphate pharmacy bulk package, 4

chlorothiazide sodium, 9

Cleocin-t, 10

chlorpromazine HCL, 23

Clever Chek Lancets Ultrathin, 35 clindamycin/benzoyl peroxide, 10

Chlorpromazine HCL, 23

Clever Chek Lancets Ultrathin 30G, 35 Clindap-t, 10

Chlorpropamide, 16

Clever Choice Comfort EZ Insulin Pen Needles 31GX8MM, 35

Clindesse, 20

Chlorthalidone, 9

Clinical Nutrients Prenatal Formula, 33

chlorzoxazone, 26

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

Clinoin, 10

cholestyramine, 9

clobetasol propionate, 12

clobetasol propionate emollient, 12

Compazine, 23 Cyramza, 5

Clobex, 12

Complera, 3 Cystadane, 17

Clocortolone Pivalate, 12

Comtan, 25 Cystagon, 20

Clocortolone Pivalate P.M., 12

Comvax, 32 Cystaran, 27

Clodan Kit, 12

Concept DHA, 33 cytarabine, 5

Cloderm, 12

Concept OB, 33 Cytarabine, 5

Cloderm P.M., 12

Concerta, 24 cytarabine aqueous, 5

Clolar, 5

Condylox, 13 Cytomel, 17

clomiphene citrate, 16

Conzip, 28 Cytotec, 18

clomipramine HCL, 22

Copasil, 13 Cytovene, 3

clonazepam, 24

Copaxone, 25 Cytra-3, 20

clonazepam odt, 24

Copegus, 3 D

clonidine HCL, 8

Cordarone, 8

D.h.e. 45, 30

clonidine HCL ER, 24

Cordran, 12

dacarbazine, 6

clopidogrel, 21

Cordran Tape, 12

Dacarbazine, 6

clorazepate dipotassium, 22

Coreg, 7

Dacogen, 5

Clorpres, 9

Coreg CR, 7

Daliresp, 32

clotrimazole, 11, 22

Corgard, 7

Dallergy, 31

clotrimazole/betamethasone dipropionate, 11

Corifact, 21

Dalvance, 4

Corlopam, 8

danazol, 14

clozapine, 23

Cortalo, 12

Dantrium, 26

Clozapine Odt, 23

Cortef, 14

Dantrium IV, 26

Clozaril, 23

Cortenema, 19

dantrolene sodium, 26

Cnl8 Nail Kit, 11

Cortifoam, 19

Dantrolene Sodium, 26

Coaguchek Lancets, 35

Cortisone Acetate, 14

Dapsone, 4

Coal TAR, 13

Cortisporin, 11, 28

Daptacel, 32

Coartem, 3

Cortisporin-tc, 28

Daraprim, 3

Cocaine HCL, 13

Corvert, 8

daunorubicin HCL, 4

Cod Liver Oil, 33

Corvite, 33

Daunoxome, 4

Codar AR, 31

Corvite 150, 20

Daypro, 29

codeine sulfate, 28

Corzide, 9

Daytrana, 24

Codeine Sulfate, 28

Cosentyx, 12

Ddavp, 17

Cogentin, 25

Cosentyx Sensoready Pen, 12

Debacterol, 22

Colazal, 19

Cosmegen, 4

decitabine, 5

Colchicine, 30

Cosopt, 26

Decon-a, 31

Colcrys, 30

Cosopt PF, 26

Delestrogen, 15

Colestid, 9

Coumadin, 21

Demadex, 9

Colestid Flavored, 10

Cozaar, 8

demeclocycline HCL, 2

colestipol HCL, 9

Cpb Wc, 31

Demerol, 28

colestipol HCL for oral suspension, 9

Creon, 19

Demser, 8

colistimethate sodium, 4

Cresemba, 2

Denavir, 11

Coly-mycin M, 4

Crestor, 9

Depacon, 24

Coly-mycin S, 28

Cresylate, 28

Depakene, 24

Colyte-flavor Packs, 18

Crinone, 20

Depakote, 24

Combigan, 26

Crixivan, 3

Depakote ER, 24

Combipatch, 15

Crnatal, 33

Depakote Sprinkles, 24

Combivent Respimat, 31

cromolyn sodium, 19, 27

Depo-estradiol, 15

Combivir, 3

Cromolyn Sodium, 31

Depo-medrol, 14

Cometriq, 6

Cubicin, 4

Depo-provera, 5

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

Curosurf, 32

Depo-testosterone, 14

Cutivate, 12

Deprizine Fusepaq, 18

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

Cuvposa, 18

Derma Silkrx Anodynexa PAK, 29

cyanocobalamin, 20

Derma Silkrx Diclopak, 29


Cyclessa, 15

Derma Silkrx Sds PAK, 12

Cyclobenzaprine Comfort PAC, 26

Derma-smoothe/FS Body, 12


cyclobenzaprine HCL, 26

Derma-smoothe/FS Scalp, 12

Cyclogyl, 27

Dermacinrx Duopatch Pharmapak, 13


Cyclomydril, 27

Dermacinrx Inflammatral PAK, 29

cyclopentolate HCL, 27

Dermacinrx Lexitral Pharmapak, 11


cyclophosphamide, 4

Dermacinrx Neurotral Pharmapak, 13

Cyclophosphamide, 4

Dermacinrx Surgical Pharmapak, 13

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

Cycloserine, 2

Dermapak Plus, 10

cyclosporine, 5

Dermasorb HC, 12


cyclosporine modified, 5

Dermasorb Ta, 12

Cyclosporine Modified, 5

Dermasorb XM, 13


Cyklokapron, 21

Dermatop, 12

Cymbalta, 23

Dermotic, 28

Comfort Lancets, 35

cyproheptadine HCL, 30

desipramine HCL, 22

desloratadine, 30

Diflucan, 2 doxepin HCL, 22

desloratadine odt, 30

diflunisal, 28 Doxepin HCL, 22

desmopressin acetate, 17

digoxin, 7 doxercalciferol, 17

Desogen, 15

Digoxin, 7 Doxil, 4

desogestrel/ethinyl estradiol, 15

dihydroergotamine mesylate, 30 doxorubicin HCL, 4

Desonate, 12

Dihydroergotamine Mesylate, 30 Doxorubicin HCL, 4

desonide, 12

Dilacor XR, 7 doxorubicin HCL liposome, 4

Desowen, 12

Dilantin, 24 doxycycline, 2

Desowen Cream/Cetaphil Lotion, 12

Dilantin Infatabs, 24 Doxycycline, 11

Desowen Lotion/Cetaphil Cream, 12

Dilantin-125, 24 doxycycline hyclate, 2

Desowen Ointment/Cetaphil Lotion, 12

Dilatrate SR, 7 doxycycline hyclate DR, 2

desoximetasone, 12

Dilaudid, 28 doxycycline monohydrate, 2

Desoximetasone, 12

Dilaudid-HP, 28 Drisdol, 33

Desoxyn, 24

diltiazem CD, 7 Dritho-creme HP, 12

Desvenlafaxine ER, 23

diltiazem HCL, 7 dronabinol, 18

Detrol, 19

Diltiazem HCL, 7 droperidol, 22

Detrol LA, 19

diltiazem HCL ER, 7 Droplet Lancets Ultra Thin 30G, 35

dexamethasone, 14

Dimenhydrinate, 19 drospirenone/ethinyl estradiol, 15

Dexamethasone, 14

Diovan, 8 Droxia, 20

Dexamethasone Intensol, 14

Diovan HCT, 9 Drug Mart On-the-go Lancets Gentle 30G, 35

dexamethasone sodium phosphate, 14, 27

Dipentocaine, 11

Dipentum, 19 Drug Mart Unilet Lancets Super Thin 30G, 35

Dexamethasone Sodium Phosphate, 14

diphenhydramine HCL, 30

Dexchlorpheniramine Maleate, 31

diphenoxylate/atropine, 18 Drug Mart Unilet Lancets Ultra Thin 28G, 35

Dexedrine, 24

Diphenoxylate/Atropine, 18

Dexilant, 18

Diphtheria/Tetanus Toxoids Adsorbed Pediatric, 32

Drysol, 13

Dexlido, 14

Duac, 10

Dexlido-m, 14

Diprolene, 12 Duane Reade Unifine Pentips 29G X 12MM, 35

dexmedetomidine HCL, 23

Diprolene AF, 12

dexmethylphenidate HCL, 24

dipyridamole, 21 Duane Reade Unifine Pentips 31G X 6MM Ultra SHORT, 35

dexmethylphenidate HCL ER, 24

Disalcid, 28

Dexpak 10 Day, 14

disopyramide phosphate, 7 Duane Reade Unifine Pentips 31G X 8MM SHORT, 35

Dexpak 13 Day, 14

disulfiram, 25

Dexpak 6 Day, 14

Ditropan XL, 19 Duavee, 14

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, 33

Dobutamine/Dextrose 5%, 9 Duopa, 25

Dialyvite 5000, 33

Docefrez, 6 Duragesic, 28

Dialyvite Supreme D, 33

docetaxel, 5 Durasafe Spinal/Epidural Tray/1% Xylocaine/19GX36"close CATH, 30

Dialyvite/Zinc, 33

Docetaxel, 5

Diamox, 9

Dolgic Plus, 28 Durasafe Spinal/Epidural Tray/1% Xylocaine/19GX36"open CATH, 30

Diastar Easy Test II Lancets 30G, 35

Dologesic, 28

Diastar Easy Test Lancets30G, 35

Dolophine, 28 Durasafe Spinal/Epidural Tray/1% Xylocaine/20GX36"close CATH, 30

Diastat Acudial, 24

Dolophine HCL, 28

Diastat Pediatric, 24

donepezil HCL, 25 Durasafe Spinal/Epidural Tray/1% Xylocaine/20GX36"open CATH, 30

Diatx ZN, 33

dopamine HCL, 9

diazepam, 22

Dopamine HCL, 9 Durezol, 27

Diazepam, 22, 24

dopamine HCL-dextrose 5%, 9 Durlaza, 21

Dibenzyline, 8

dopamine HCL/dextrose 5%, 9 Dutoprol, 8

Diclegis, 19

dopamine/D5W, 9 Dyazide, 9

diclofenac potassium, 29

Dopram, 24 Dymista, 31

diclofenac sodium, 11, 27

Doral, 23 Dyrenium, 9

diclofenac sodium DR, 29

Doribax, 4 Dysport, 25

diclofenac sodium ER, 29

Doryx, 2 Dyural-40, 14

diclofenac sodium/misoprostol, 29

dorzolamide HCL, 27 Dyural-80, 14

dicloxacillin sodium, 1

dorzolamide HCL/timolol maleate, 26 Dyural-l, 14

Dicopanol Fusepaq, 31

Doubledex, 14 Dyural-lm, 14

dicyclomine HCL, 18

Dovonex, 12 E

didanosine, 3

doxapram HCL, 24

Differin, 10

E-z Ject Lancets, 35

doxazosin, 8

Dificid, 1

E-z Ject Lancets 21G, 35

doxazosin mesylate, 8

Diflorasone Diacetate, 12

E-z Ject Lancets Color, 35

E-z Ject Lancets Super Thin, 35

Easy Touch Lancets 32G/Pressure Activated, 36

enalapril maleate/hydrochlorothiazide, 8

E-z Ject Lancets Super Thin 30G, 35

enalaprilat, 8

E-z Ject Lancets Thin 26G, 35

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

E-z Spacer, 40

Easy Touch Lancets 32G/Twist, 36 Enbrel, 29

E-z Spacer The Body Guards Pack, 40

Easy Touch Lancets 33G/Twist, 36 Enbrel Sureclick, 29

E-ZJECT Lancets Micro-thin 33G, 35

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

E.e.s. 400, 1

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

E.e.s. Granules, 1

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

Easivent, 40

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

Easivent/Mask-large, 40

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

Enlon-plus, 26

Easivent/Mask-medium, 40

enoxaparin sodium, 21

Easivent/Mask-small, 40

Easy Touch Safety Lancets21G/Pressure Activated, 36

entacapone, 25

Easy Touch Insulin Syringe/0.3ML/30G X 5/16", 35

entecavir, 3


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

Easy Touch Insulin Syringe/1ML/30G X 5/16", 35

Epiceram, 13


Epiduo, 10

Easy Touch Insulin Syringe/Safety/U-100/0.5ML/29G X 1/2", 35

Epiduo Forte, 10

Easy Twist & CAP Lancets, 36 Epifoam, 12

Easy Touch Insulin Syringe/Safety/U-100/0.5ML/30G X 5/16", 35

Easytest II Lancets, 36 epinastine HCL, 27

Easytest Lancets, 36 Epinephrine, 9

Easy Touch Insulin Syringe/Safety/U-100/1ML/29G X 1/2", 35

EC-naprosyn, 29 Epinephrine HCL, 9

econazole nitrate, 11 epinephrine HCL, 31

Easy Touch Insulin Syringe/Safety/U-100/1ML/30G X 1/2", 35

Ecoza, 11 Epipen 2-PAK, 9

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

Easy Touch Insulin Syringe/U-100/0.3ML/30G X 1/2", 35

Edarbi, 8 epirubicin HCL, 4

Edarbyclor, 9 Epirubicin HCL, 4


Edecrin, 9 Episnap, 9

Edluar, 23 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

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

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

Elestat, 27


Elestrin, 15 Eql Ultra SHORT Pen Needles 31G X 6MM, 36

Eletone, 13


Eletone Twinpack, 13 Equagesic, 28

Elidel, 13 Equetro, 23


Eligard, 5 Equipto-baclofen, 11

Elimite, 13 Equipto-naproxen, 11


Eliphos, 19 Eraxis, 2

Eliquis, 21 Erbitux, 5


Elitek, 6 ergocalciferol, 33

Elixophyllin, 31 ergoloid mesylates, 25


Ella, 15 Ergomar, 30

Ellence, 4 Ertaczo, 11


Elmiron, 20 Erwinaze, 4

Elocon, 12 Ery-TAB, 1

Easy Touch Lancets 26G/Pull-top, 36

Eloxatin, 4 Erygel, 10

Easy Touch Lancets 26G/Twist, 36

Emadine, 27 Eryped 200, 1


Embrace Lancets Ultra Thin 30G, 36 Eryped 400, 1

Emcyt, 5 Erythrocin Lactobionate, 1


Emend, 19 Erythrocin Stearate, 1


Emla, 13 erythromycin, 1, 10, 26

Easy Touch Lancets 30G/Button-activated, 36

Emsam, 23 Erythromycin Base, 1

Emtriva, 3 Erythromycin Ethylsuccinate, 1


Emulsion SB, 13 erythromycin/benzoyl peroxide, 10

Emvoren, 11 Esbriet, 32


Enablex, 19 Escavite, 33


enalapril maleate, 8 Escavite D, 33

escitalopram oxalate, 22

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

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, 14

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

Estropipate, 14

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, 23

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, 28

Famotidine, 18

Ethyl Chloride/Mist, 13

Fiorinal, 28

Famotidine Premixed, 18

Ethyol, 6

Fiorinal/Codeine #3, 28

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, 24

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

Evista, 16


Feiba NF, 21

Evithrom, 21

felbamate, 24

Evoclin, 10


Felbatol, 24

Evotaz, 3

Feldene, 29

Evoxac, 22


felodipine ER, 7

Exactuss, 31

Fem PH, 20

Exalgo, 28


Femara, 5

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

Femcon FE, 15

First-testosterone, 14

Femhrt Low Dose, 15

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

First-testosterone Mc Compounding Kit, 14

Femring, 20

fenofibrate, 9


First-vancomycin 25, 4

Fenofibrate, 10

First-vancomycin 50, 4

fenofibrate micronized, 9


Flagyl, 4

Fenofibric Acid, 9

Flagyl ER, 4

fenofibric acid DR, 9

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

Flanax Pain Relief Kit, 29

Fenoglide, 10

Flarex, 27

fenoldopam mesylate, 8


flavoxate HCL, 19

Fenoprofen Calcium, 29

flecainide acetate, 7

fentanyl, 28


Flector, 11

Fentanyl, 28

Flexepax, 26

fentanyl citrate oral transmucosal, 28


Flexichamber, 40

Fentanyl Citrate/Sodium Chloride, 28

FLO-pred, 14

Feraheme, 20


Flolan, 10

Feriva, 20

Flomax, 20

Feriva 21/7, 20


Flonase, 31

Ferivafa, 20

Floriva, 33

Ferralet 90, 20

Flovent Diskus, 31

Fluzone Quadrivalent 2014-2015, 32 Gabazolamine, 22

Flovent HFA, 31

Fluzone Quadrivalent 2015-2016, 32 Gabazolamine-0.5, 22

Flowtuss, 31

Fluzone Split 2013-2014, 32 Gabazolpidem-5, 23

floxuridine, 5

Fluzone Split 2014-2015, 32 Gabitidine, 18

Floxuridine, 5

Fluzone Split 2015-2016, 32 Gabitril, 24

Fluarix 2013-2014, 32

FML, 27 Gablofen, 26

Fluarix 2014-2015, 32

FML Forte, 27 Gaboxetine, 23

Fluarix Quadrivalent 2013-2014, 32

FML Liquifilm, 27 galantamine hydrobromide, 25


Focalgin 90 DHA, 33 Galantamine Hydrobromide, 25


Focalgin CA, 33 ganciclovir, 3

Flublok 2013-2014, 32

Focalgin Dss, 20 Ganirelix Acetate, 17

Flublok 2014-2015, 32

Focalin, 24 Ganite, 16

Flublok 2015-2016, 32

Focalin XR, 24 Garamycin, 26

Flucelvax 2013-2014, 32

Folcaps Omega 3, 33 Gardasil, 32

Flucelvax 2014-2015, 32

Folet DHA, 34 Gardasil 9, 32

Flucelvax 2015-2016, 32

Folet One, 34 Gastrinex NF, 18

fluconazole, 2

Folgard OS, 34 Gastrocrom, 19

fluconazole IN dextrose, 2

Folgard RX, 20 gatifloxacin, 26

fluconazole IN NACL, 2

folic acid, 20 Gattex, 19

Fluconazole IN NACL, 2

Folic Acid, 20 Gazyva, 5

flucytosine, 2

folic acid/vitamin b-6/vitamin b-12, 20 Gebauers Pain Ease, 13

Fludara, 5

Folitab 500, 20 Gebauers Spray And Stretch, 13

fludarabine phosphate, 5

Folivane-f, 20 Gel-kam Oral Care Rinse, 22

Fludarabine Phosphate, 5

Folivane-OB, 33 Gel-one, 26

fludrocortisone acetate, 14

Folivane-plus, 20 Gelclair, 22

Flulaval 2013-2014, 32

Folivane-prx DHA NF, 34 Gelnique, 19

Flulaval 2014-2015, 32

Follistim AQ, 16 Gemcitabine, 5

Flulaval Quadrivalent 2013-2014, 32

Folotyn, 5 gemcitabine HCL, 5


Foltrate, 20 gemfibrozil, 9


fondaparinux sodium, 21 Gemzar, 5

Flumadine, 3

Fora Lancets, 36 Genadur, 13

Flumist Quadrivalent, 32

Foradil Aerolizer, 31 Genadur Kit, 13

flunisolide, 31

Forfivo XL, 22 gene-xene TAB 15MG, 22

fluocinolone acetonide, 12, 27

Fortamet, 16 gene-xene TAB 3.75MG, 22

fluocinolone acetonide ear drops, 27

Fortavit, 34 gene-xene TAB 7.5MG, 22

fluocinonide, 12

Fortaz, 1 Generess FE, 15

fluocinonide-e, 12

Forteo, 16 gentamicin sulfate, 2, 26

fluorometholone, 27

Fortical, 16 Gentamicin Sulfate, 11

fluorouracil, 5

Fosamax, 16 gentamicin sulfate pediatric, 2

fluoxetine, 25

Fosamax Plus D, 16 gentamicin sulfate/0.9% sodium chloride, 2

fluoxetine DR, 22

Foscavir, 3

fluoxetine HCL, 22

fosinopril sodium, 8 Gentamicin Sulfate/0.9% Sodium Chloride, 2

Fluoxetine HCL, 22

fosinopril sodium/hydrochlorothiazide, 8

fluphenazine decanoate, 23

fosphenytoin sodium, 24 Gentle-let GP Lancets, 36

fluphenazine HCL, 23

Fosrenol, 19 Gentle-let Lancets General Purpose Style/Fine Point, 36

Fluphenazine HCL, 23

Fragmin, 21

flurazepam HCL, 23

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

Flurazepam HCL, 23

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

flurbiprofen, 29

Gentle-let Lancets Safety Style/Fine Point, 36

flurbiprofen sodium, 27

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

flutamide, 5

Gentle-let Lancets Safety Style/Medium Point, 36

fluticasone propionate, 12, 31

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

fluvastatin, 9

Gentle-let Platforms 2.4MM, 36

fluvastatin sodium ER, 9

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

Gentle-let Platforms 3.0MM, 36

Fluvirin 2013-2014, 32

Geodon, 23

Fluvirin 2014-2015, 32

Freestyle Unistick II Lancets, 36 Gesticare DHA, 34

Fluvirin 2015-2016, 32

Frova, 30 Giazo, 19

Fluvirin PF 2013-2014, 32

Fulyzaq, 18 Gilenya, 25

Fluvirin PF 2014-2015, 32

Furadantin, 19 Gilotrif, 6

fluvoxamine maleate, 22

furosemide, 9 Gilphex TR, 31

fluvoxamine maleate ER, 22

Furosemide, 9 Giltuss, 31

Fluzone High-dose PF 2013-2014, 32

Fusilev, 6 Giltuss PED-c, 31


Fusion Plus, 20 Giltuss TR, 31


Fuzeon, 3 Glassia, 32

Fluzone Pediatric PF 2013-2014, 32

Fycompa, 24 Gleevec, 6

Fluzone PF 2013-2014, 32

G Gleostine, 4

Fluzone PF 2014-2015, 32

Gliadel Wafer, 4

gabapentin, 24

Fluzone Quadrivalent 2013-2014, 32

glimepiride, 15

Gabavale-5, 22

glipizide, 15

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

Hexalen, 4

glipizide ER, 15

Hextend, 21

glipizide/metformin HCL, 16

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

Hiberix, 32

Glucagen Hypokit, 16

Hiprex, 19

Glucagon Emergency Kit, 16

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

homatropine HBR, 27

Glucocom Lancets 28G, 36

Horizant, 25


H.p. Acthar, 17 HPR, 13


Haemolance, 36 HPR Plus, 13

Glucophage, 16

Haemolance Low Flow Lancets, 36 HPR Plus Hydrogel Kit, 13

Glucophage XR, 16

Haemolance Plus, 36 HPR Plus/Mb Hydrogel, 13

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

Haemolance Plus High Flow, 36 Humalog, 15

Haemolance Plus Low Flow, 36 Humalog Kwikpen, 15


Haemolance Plus Max Flow, 36 Humalog Mix 50/50, 15

Haemolance Plus Pediatric Flow, 36 Humalog Mix 50/50 Kwikpen, 15


Halaven, 5 Humalog Mix 75/25, 15

Halcion, 23 Humalog Mix 75/25 Kwikpen, 15


Haldol, 23 Humate-p, 21

Haldol Decanoate 100, 23 Humira, 29


Haldol Decanoate 50, 23 Humira Pediatric Crohns Disease Starter Pack, 29

halobetasol propionate, 12


Halog, 12 Humira Pen, 29

Halonate, 12 Humira Pen-crohns Diseasestarter, 29

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

haloperidol, 23 Humira Pen-psoriasis Starter, 29

haloperidol decanoate, 23 Humulin 70/30, 15


haloperidol lactate, 23 Humulin 70/30 Kwikpen, 15

Halotin, 11 Humulin 70/30 Pen, 15


Harvoni, 3 Humulin N, 15

Havrix, 32 Humulin N Kwikpen, 15

Glucosource Lancets, 36

Healthwise Mini Pen Needles 31GX6MM, 36

Humulin N U-100 Pen, 15

Glucotrol, 16

Humulin R, 15

Glucotrol XL, 16

Healthwise Pen Needles 29GX12MM, 36 Humulin R U-500 (concentrated), 15

Glucovance, 16

Healthwise SHORT Pen Needles 31GX8MM, 36

Hy-vee Lancets, 36

Glumetza, 16

Hyalgan, 26

glyburide, 16

Healthy Mama Be Well Rounded, 33 Hycamtin, 6

Glyburide, 16

Hectorol, 17 Hycet, 28

glyburide micronized, 16

Helidac, 18 Hycofenix, 31

glyburide/metformin HCL, 16

Helixate FS, 21 hydralazine HCL, 8

Glycate, 18

Hemabate, 28 Hydrea, 6

Glycolic Acid, 12

Hemangeol, 7 Hydro 35, 13

Glycolic Acid 70% High Purity, 12

Hematogen Fa, 20 Hydro 40 Foam, 13

glycopyrrolate, 18

Hematron-AF, 20 hydrochloric acid, 20

Glynase, 16

Hemocyte Plus, 20 hydrochlorothiazide, 9

Glyset, 16

Hemocyte-f, 20 hydrocodone bitartrate/acetaminophen, 28

Glyxambi, 16

Hemofil M, 21

Gmate Lancets 30G, 36

heparin lock, 21 Hydrocodone Bitartrate/Acetaminophen, 28

Golytely, 18

heparin lock flush, 21

Gonal-f, 16

Heparin Lock Flush, 21 hydrocodone bitartrate/chlorpheniramine maleate/PSE, 31

Gonal-f RFF, 16

heparin lock flush for flushing vascular access devices, 21

Gonal-f RFF Pen, 17

hydrocodone bitartrate/homatropine methylbromide, 31

Gonal-f RFF Rediject, 17

heparin lock flush/NACL for flushing vascular access devices, 21

Gordofilm, 13

hydrocodone polistirex/chlorpheniramine polistirex, 31

Gordons Urea, 13

heparin sodium, 21

Gralise, 25

Heparin Sodium, 21 hydrocodone/acetaminophen, 28

Gralise Starter, 25

heparin sodium dcu, 21 Hydrocodone/Acetaminophen, 28

granisetron HCL, 18

heparin sodium lock flush, 21 hydrocodone/homatropine, 31

Granisol, 19

heparin sodium/D5W, 21 hydrocodone/ibuprofen, 28

Granix, 20

Heparin Sodium/D5W, 21 hydrocort ene 100MG, 19

Grifulvin V, 2

Heparin Sodium/NACL 0.45%, 21 hydrocortisone, 12, 14, 19

Gris-peg, 2

heparin sodium/NACL 0.9%, 21 hydrocortisone acetate/aloe, 12

griseofulvin microsize, 2

Heparin Sodium/Sodium Chloride 0.9%, 21

hydrocortisone acetate/lidocaine HCL, 19

griseofulvin ultramicrosize, 2

hydrocortisone acetate/pramoxine, 19

guanfacine ER, 24

heparin sodium/sodium chloride 0.9% premix, 21

hydrocortisone butyrate, 12

guanfacine HCL, 8

hydrocortisone butyrate (lipid), 12

Guanidine HCL, 26

Hepsera, 3 hydrocortisone butyrate (lipophilic), 12

Gynazole-1, 20

Herceptin, 5 hydrocortisone IN absorbase, 12

H

Hespan, 21 hydrocortisone valerate, 12

hetastarch 6%/NACL, 21 hydrocortisone/acetic acid, 28

H&h Thinlet Lancets 26G, 36

Hetlioz, 24 hydromorphone HCL, 28

H&h Thinlet Super Thin Lancets 30G, 36

Hydromorphone HCL, 28

Infasurf, 32 Invega Trinza, 23

hydromorphone HCL dosette, 28

Infed, 20 Invirase, 3

hydromorphone HCL ER, 28

Infergen, 3 Invokamet, 16

Hydromorphone HCL ER, 28

Infumorph 200, 29 Invokana, 16

Hydromorphone HCL/Sodium Chloride, 28

Infumorph 500, 29 Ionsys, 29

Injectafer, 20 Iopidine, 27

Hydroxocobalamin, 20

Inlyta, 6 Ipol Inactivated IPV, 32

hydroxychloroquine sulfate, 3

Innopran XL, 7 ipratropium bromide, 31(2)

hydroxyurea, 6

Innoprax-5, 11 ipratropium bromide/albuterol sulfate, 31

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, 40

Irenka, 23

Hylatopic, 13

Iressa, 6

Hylatopic Plus, 13

Inspirachamber/Soothermask/Inspiramask/Medium, 40

irinotecan, 6

Hylira, 13

Irinotecan, 6

hyoscyamine sulfate, 18

Inspirachamber/Soothermask/Inspiramask/Small, 40

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

hyoscyamine sulfate ER, 18

hyoscyamine sulfate odt, 18

Inspirease Bags, 40 Irospan 24/6, 20

hyoscyamine sulfate SR, 18

Inspirease Drug Delivery System, 40 Is 24/6, 20

Hyper-sal, 31

Inspirease Mouthpiece, 40 Isentress, 3

Hypersal, 31

Inspirease Reservoir Bags, 40 isoniazid, 2

Hypertenevide-12.5, 7

Inspra, 8 Isoniazid, 2

Hypertenipine-2.5, 7

Insulin Syringe/0.3ML/29G X 1", 36 Isopto Atropine, 27

Hypertensolol, 9

Insulin Syringe/0.3ML/29G X 1/2", 36 Isopto Carbachol, 27

Hysingla ER, 28

Insulin Syringe/0.3ML/30G X 5/16", 36 Isopto Carpine, 27

Hyzaar, 9

Insulin Syringe/0.3ML/31G X 5/16", 36 Isopto Homatropine, 27

I

Insulin Syringe/0.5ML/27G X 1/2", 36 Isopto Hyoscine, 27

Insulin Syringe/0.5ML/28G X 1/2", 36 Isordil Titradose, 7

ibandronate sodium, 16

Insulin Syringe/0.5ML/29G X 1/2", 36 isosorbide dinitrate, 7

Ibrance, 6

Insulin Syringe/0.5ML/30G X 1/2", 36 Isosorbide Dinitrate, 7

Ibudone, 29

Insulin Syringe/0.5ML/30G X 5/16", 36 Isosorbide Dinitrate ER, 7

ibuprofen, 29

Insulin Syringe/0.5ML/31G X 5/16", 36 isosorbide mononitrate, 7

Ibuprofen Comfort PAC, 29

Insulin Syringe/1ML/28G X 1/2", 36 isosorbide mononitrate ER, 7

ibutilide fumarate, 7

Insulin Syringe/1ML/29G X 1/2", 36 isotonic gentamicin, 2

IC 400, 29

Insulin Syringe/1ML/30G X 5/16", 36 Isotonic Gentamicin, 2

IC 800, 29

Insulin Syringe/1ML/31G X 5/16", 36 Isoxsuprine HCL, 10

Icar-c Plus, 20

Insulin Syringe/U-100/0.3ML/29G X 1/2", 36

isradipine, 7

Iclusig, 6

Istalol, 26

Idamycin PFS, 4


Istodax, 6

idarubicin HCL, 4

Isuprel, 32

Ifex, 4


itraconazole, 2

ifosfamide, 4

ivermectin, 3

Ifosfamide, 4

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

Ixempra Kit, 5

Ilaris, 29

Ixiaro, 32

Ilevro, 27


Ixinity, 21

Imbruvica, 6

J

Imdur, 7


imipenem/cilastatin, 4

J-max, 31

imipramine HCL, 22

Jadenu, 41


imipramine pamoate, 22

Jakafi, 6

imiquimod, 13

Jalyn, 20

Insupen Sensitive 32GX8MM, 36

Imitrex, 30

Janumet, 16

Insupen Ultrafin 29GX12MM, 36

Imitrex Statdose Refill, 30

Janumet XR, 16


Imitrex Statdose System, 30

Januvia, 16


Imovax Rabies (h.d.c.v.), 32

Jardiance, 16


Imuran, 5

Jevtana, 6

Integra F, 20

IN Touch Sterile Lancets 30G, 36

Jublia, 11

Integra Plus, 20

Increlex, 17

Juxtapid, 10

Integrilin, 21

Incruse Ellipta, 31

K

Intelence, 3

indapamide, 9

Interarticular Joint Kit, 14

K-phos NO 2, 20

Inderal LA, 7

Intermezzo, 24

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

Inderal XL, 7

Intron A, 6

K10-lido, 14

Indocin, 29

Intron A W/Diluent, 6

K40-lido, 14

indomethacin, 29

Intuniv, 24

Kadcyla, 5

Indomethacin, 29

Invanz, 4

Kalbitor, 21

indomethacin ER, 29

Invega, 23

Kaletra, 3

Indomethacin Sodium, 29

Invega Sustenna, 23

Kalydeco, 32

Infanrix, 32

Kapvay, 24

lamotrigine, 24 Levobunolol HCL, 26

Kapvay Dose Pack, 24

lamotrigine ER, 24 levocarnitine, 17

Karbinal ER, 31

lamotrigine odt, 24 levocetirizine dihydrochloride, 30

Keflex, 1

Lancet Transporter Case, 36 levofloxacin, 2, 26

Kenalog, 12

Lancets, 36 levofloxacin IN D5W, 2

Kenalog-10, 14

Lancets 26G Twist Top, 37 Levoleucovorin Calcium, 6

Kenalog-40, 14

Lancets 28G, 37 levonorgestrel, 15

Kengreal, 22

Lancets 30G, 37 Levonorgestrel, 15

Kepivance, 6

Lancets 30G Twist Top, 37 levonorgestrel and ethinyl estradiol, 15

Keppra, 24

Lancets 30G/Twist Top, 37 levonorgestrel/ethinyl estradiol, 15

Keppra XR, 24

Lancets 31G Twist Top, 37 Levophed, 9

Kerafoam, 13

Lancets 33G Universal Design, 37 Levorphanol Tartrate, 29

Kerafoam 42, 13

Lancets Bullseye Safety, 36 levothyroxine sodium, 17

Keralac, 13

Lancets Safety Seal 21G, 36 Levothyroxine Sodium, 17

Keralyt, 13

Lancets Safety Seal 26G, 37 Levsin, 18

Keralyt Scalp, 13

Lancets Safety Seal 28G, 37 Levsin/SL, 18

Kerlone, 7

Lancets Safety Seal 30G, 37 Lexapro, 23

Kerydin, 11

Lancets Thin, 37 Lexiva, 3

Ketek, 4

Lancets Twist Top, 37 Lialda, 19

ketoconazole, 2, 11

Lancets Ultra Fine, 37 Liberty Medical Lancets 30G, 37

Ketodan Kit, 11

Lancets Ultra Thin, 37 lidocaine, 13

ketoprofen, 29

Lanoxin, 7 Lidocaine And Tetracaine Cream, 13

Ketoprofen ER, 29

Lanoxin Pediatric, 7 lidocaine HCL, 7, 13, 22, 30

Ketorocaine-l, 29

lansoprazole, 18 Lidocaine HCL, 8, 13

Ketorocaine-lm, 29

lansoprazole/amoxicillin/clarithromycin, 18

lidocaine HCL IN D5W, 7

Ketorolac 2% Gel, 11

lidocaine HCL jelly, 13

ketorolac tromethamine, 27, 29

Lantus, 15 lidocaine HCL viscous, 22

Ketorolac Tromethamine, 29

Lantus Solostar, 15 Lidocaine HCL-hydrocortisone Acetate With Aloe, 19

Keveyis, 9

Lasix, 9

Keytruda, 5

Lastacaft, 27 lidocaine HCL/dextrose, 7

Khedezla, 23

latanoprost, 27 Lidocaine HCL/Dextrose, 30

Kineret, 29

Latrix XM, 13 lidocaine HCL/hydrocortisone acetate, 19

Kinlytic, 22

Latuda, 23 lidocaine viscous, 22

Kinrix, 32

Ldo Plus, 13 lidocaine/epinephrine, 30

Klaron, 10

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

lidocaine/prilocaine, 13

Klonopin, 24

Lidoderm, 13

Koate-dvi, 21

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

Lidoprofen, 11

Kogenate FS, 22

Lidothol, 13

Kogenate FS Bio-set, 22

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

Lidovir, 11

Kombiglyze XR, 16

Lifescan Unistik 2 Deep Penetration, 37

Korlym, 16

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

Lifescan Unistik II Lancets, 37

Kristalose, 18

Lincocin, 4

Krystexxa, 30

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

Lincomycin/Lidocaine, 4

Kuvan, 17

lindane, 13

Kynamro, 10

leflunomide, 29 linezolid, 4

Kyprolis, 6

Lemtrada, 25 Linzess, 19

L

Lenvima 10MG Daily Dose, 6 Lioresal Intrathecal, 26

Lenvima 14MG Daily Dose, 6 liothyronine sodium, 17

labetalol HCL, 7

Lenvima 20MG Daily Dose, 6 Lipofen, 9

Lac-hydrin, 13

Lenvima 24MG Daily Dose, 6 Liquicet, 29

Lacrisert, 26

Lescol XL, 10 lisinopril, 8

lactic acid, 13

Letairis, 10 lisinopril/hydrochlorothiazide, 8

lactic acid e, 13

letrozole, 5 Lite Touch Pen Needles/31G X 3/16", 37

lactic acid w/vitamin e, 13

leucovorin calcium, 6 Liteaire, 40

lactulose, 18, 19

Leucovorin Calcium, 6 Litetouch Insulin Syringe/0.3ML/29G X 1/2", 37

Lamictal, 24

Leukeran, 4

Lamictal Chewable Dispersible, 24

Leukine, 20 Litetouch Insulin Syringe/0.3ML/30G X 5/16", 37

Lamictal Odt, 24

leuprolide acetate, 5

Lamictal Starter/Not Taking Carbamazepine, 24

Levacet, 28 Litetouch Insulin Syringe/0.3ML/31G X 5/16", 37

levalbuterol, 31

Lamictal Starter/Taking Carbamazepine/Not Taking Valproate, 24

levalbuterol HCL, 31 Litetouch Insulin Syringe/0.5ML/30G X 5/16", 37

Levaquin, 2

Levatol, 7 Litetouch Insulin Syringe/0.5ML/31G X 5/16", 37

Lamictal Starter/Taking Valproate, 24

Levbid, 18

Lamictal XR, 24

levetiracetam, 24 Litetouch Insulin Syringe/1ML/30G X 5/16", 37

Lamisil, 2

Levetiracetam, 24

Lamisil Spray, 11

levetiracetam ER, 24 Litetouch Insulin Syringe/U-100/0.5ML/28G X 1/2", 37

lamivudine, 3

levobunolol HCL, 26

lamivudine/zidovudine, 3

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

Lufyllin, 32 100/1ML/28GX1/2", 37

Lumigan, 27 Maxidex, 27

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

Lumizyme, 17 Maxidone, 29

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

Litetouch Lancets Micro Thin 33G, 37

Luxiq, 12 meclizine HCL, 18

Litetouch Pen Needles 29GX12.7MM, 37

Luzu, 11 Meclofenamate Sodium, 29

Litetouch Pen Needles 31G X 6MM, 37

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

Litetouch Pen Needles 31GX8MM SHORT, 37

Lynparza, 6 Medical Provider EZ Flu Shot 2014-2015, 32

Lyrica, 24

Lithium, 23

Lysodren, 5 Medisense Thin Lancets, 37

lithium carbonate, 23

Lysteda, 21 Medlance Plus Extra Lancets 21G, 37

Lithium Carbonate, 23

Lytensopril Kit, 9 Medlance Plus Lancets, 37

lithium carbonate ER, 23

Lytensopril-90, 9 Medlance Plus Lancets Lite 25G, 37

Lithobid, 23

Lytensopril-90 Kit, 9 Medlance Plus Lite Lancets 25G, 37

Lithostat, 20

M Medlance Plus Special Lancets 0.8MM, 37

Live Better Lancet Super Thin 30G, 37

M-m-r II, 32

Live Better Lancet Ultra Thin 28G, 37

Medlance Plus Superlite 30G, 37

M.v.i. Adult, 34

Live Better Pen Needles 29G X 12MM, 37

Medlance Plus Superlite 30G/Comfort Max, 37

M.v.i. Pediatric, 34

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


Medlance Plus Universal Lancets 21G, 37

Macrobid, 19

Macrodantin, 19


Medlance Plus/Lite 25G, 37

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

LMD 10% Dextrose 5%, 22

Medlance/Extra, 37

LMD 10% Sodium Chloride 0.9%, 22

Medlance/Lite, 37


LO Loestrin FE, 15

Medlance/Universal, 37

LO Minastrin FE, 15

Medrol, 14


Locoid, 12

Medrol Dosepak, 14

Locoid Lipocream, 12

medroxyprogesterone acetate, 15


Lodosyn, 25

Medroxyprogesterone/Lidocaine, 15

Loestrin 1.5/30-21, 15

mefenamic acid, 29

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

Loestrin 1/20-21, 15

mefloquine HCL, 3

Loestrin FE 1.5/30, 15

Mefoxin, 1

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

Loestrin FE 1/20, 15

Megace ES, 15

Lofibra, 10

Megace Oral, 5

Magnacet, 29

Lomotil, 18

megestrol acetate, 5, 15

Makena, 15

Lomustine, 4

Megrix, 13

Malarone, 3

Lonsurf, 6

Meijer Super Thin Lancets, 37

malathion, 13

loperamide HCL, 18

Mekinist, 6

mannitol, 9

Lopid, 10

meloxicam, 29

Maprotiline HCL, 22

Lopressor, 7

Meloxicam, 29

Marbeta-25, 14

Lopressor HCT, 9

Meloxicam Comfort PAC, 29

Marbeta-l, 14

Loprox, 11

melphalan hydrochloride, 4

Marcaine, 30

Loprox Shampoo, 11

memantine HCL, 25

Marcaine W/O Epi, 30

lorazepam, 22

memantine HCL titration PAK, 25

Marcaine/Epinephrine, 30

Lortab, 29

Menactra, 32

Mardex-25, 14

Lorzone, 26

Menest, 14

Marinol, 19

losartan potassium, 8

Menhibrix, 32

Marlido-25, 30

losartan potassium/hydrochlorothiazide, 8

Menomune-a/C/Y/W-135, 32

Marnatal-f, 33

Menopur, 17

Marplan, 23

Loseasonique, 15

Menostar, 15

Marqibo, 6

Lotemax, 27

Mentax, 11

Mask Vortex/Baby Whirl Duckling, 40

Lotensin, 8

Menveo, 32

Mask Vortex/Child/Frog, 40

Lotensin HCT, 9

meperidine HCL, 28

Mask Vortex/Spinner The Duck, 40

Lotrel, 9

Meperidine HCL, 29

Mask Vortex/Toddler/Lady Bug, 40

Lotrisone, 11

Mephyton, 33

Matulane, 6

Lotronex, 19

meprobamate, 22

Mavik, 8

lovastatin, 9

Mepron, 4

Maxair Autohaler, 32

Lovaza, 10

mercaptopurine, 5

Maxalt, 30

Lovenox, 21

meropenem, 4

Maxalt-MLT, 30

loxapine, 23

Meropenem/Sodium Chloride, 4

Maxaron Forte, 20

loxapine succinate, 23

Merrem, 4

Maxfe, 20

Loxitane, 23

mesalamine, 19

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

LT Injection Kit, 14

mesna, 6

Lta 360 Kit, 22

Mesnex, 6

Maxi-comfort Insulin Syringe/U-

Mestinon, 26

Microzide, 9 Needle/0.3ML/29G X 1/2", 37

Mestinon Timespan, 26

midodrine HCL, 9 Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29GX1/2", 37

Metadate CD, 24

Mifeprex, 17

Metaproterenol Sulfate, 31

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

Metastron, 6

Migral, 30

metaxalone, 26

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

Metaxalone, 26

Millipred, 14

metformin HCL, 16

Millipred DP, 14 Monoject Insulin Syringe/Softpack/1ML/27G X 1/2", 37

metformin HCL ER, 16

milrinone IN dextrose, 6

methadone HCL, 28

milrinone lactate, 6 Monoject Insulin Syringe/Softpack/U-100/0.5ML/28G X 1/2", 37

Methadone HCL, 29

Minastrin 24 FE, 15

Methadose, 29

Mineral Oil Heavy, 18 Monoject Insulin Syringe/U-100/0.3ML/30G X 5/16", 37

Methadose Sugar-free, 29

Minipress, 8

methamphetamine HCL, 24

Minivelle, 15 Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2", 37

methazolamide, 9

Minocin, 2

methenamine hippurate, 19

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

methenamine mandelate, 19

minocycline HCL, 2

Methenamine Mandelate, 19

minocycline HCL ER, 2 Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 37

methimazole, 17

minoxidil, 8

methocarbamol, 26

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

methotrexate, 5

Mirapex ER, 25

methotrexate sodium, 5

Mircera, 20 Monoject Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2", 37

methoxsalen, 12

Mircette, 15

methscopolamine bromide, 18

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

Methyclothiazide, 9

mirtazapine odt, 22

methyldopa, 8

Mirvaso, 11 Monoject Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16", 37

Methyldopa/Hydrochlorothiazide, 8

misoprostol, 18

Methyldopate HCL, 8

Mission Prenatal, 33 Monoject Ultra Comfort Insulin Syringe/0.5ML/28G X 1/2", 37

methylergonovine maleate, 28

Mitigare, 30

Methylin, 24

mitomycin, 4 Monoject Ultra Comfort Insulin Syringe/0.5ML/29G X 1/2", 37

methylphenidate HCL, 24

Mitomycin, 4

methylphenidate HCL CD, 24

Mitosol, 26 Monoject Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16", 37

methylphenidate HCL ER, 24

mitoxantrone HCL, 4

Methylphenidate HCL ER, 24

Mlk F4 Kit, 14 Monoject Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16", 37

methylphenidate HCL SR, 24

Mobic, 29

methylphenidate hydrochloride, 24

modafinil, 24 Monoject Ultra Comfort Insulin Syringe/1ML/28G X 1/2", 37

methylprednisolone, 14

Moderiba, 3

Methylprednisolone, 14

Moderiba 1200 Dose Pack, 3 Monoject Ultra Comfort Insulin Syringe/1ML/29G X 1/2", 37

methylprednisolone acetate, 14

Moderiba 800 Dose Pack, 3

methylprednisolone dose pack, 14

Modicon, 15 Monoject Ultra Comfort Insulin Syringe/1ML/30G X 5/16", 37

Methylprednisolone PF, 14

moexipril HCL, 8

methylprednisolone sodiumsuccinate, 14

moexipril/hydrochlorothiazide, 8 Monojector End CAPS, 37

Methylprednisolone/Lidocaine, 14

mometasone furoate, 12 Monojector Opd End CAPS, 37

Metipranolol, 26

Moms Choice RX, 33 Monolet Lancets, 37

metoclopramide HCL, 19

Monoclate-p, 21 Monolet Opd Lancets, 37

metoclopramide odt, 19

Monodox, 2 Monolettor Safety Lancets, 37

metolazone, 9

Monoject Bone Marrow Biopsy Prepping Tray, 30

Mononine, 21

metoprolol succinate ER, 7

Monovisc, 26

metoprolol tartrate, 7

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

montelukast sodium, 31

metoprolol/hydrochlorothiazide, 8

Monurol, 19

Metozolv Odt, 19

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

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

Metro IV, 4

Metrocream, 11

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

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

Metrogel, 11

Metrogel-vaginal, 20

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

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

Metrolotion, 11

metronidazole, 4, 11

Monoject Insulin Syringe/1ML, 37 Moore MED Monoject Insulin Syringe/U-100/1ML/29G X 1/2", 37

metronidazole IN NACL 0.79%, 4

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

metronidazole vaginal, 20

Morgidox 1X100MG, 2

mexiletine HCL, 7

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

Morgidox 2X100MG, 2

Miacalcin, 16

morphine sulfate, 28

Micardis, 8

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

Morphine Sulfate, 28

Micardis HCT, 9

Morphine Sulfate Add-vantage, 29

Microchamber, 40

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

morphine sulfate ER, 28

Microlet Lancets, 37

Morphine Sulfate ER, 28

Microspacer, 40

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

Morphine Sulfate/Sodium Chloride, 29

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

Motofen, 18

Monoject Insulin Syringe/Safety/Perm Movantik, 19

Moviprep, 18

naratriptan HCL, 30 Neumega, 20

Moxatag, 1

Nardil, 23 Neupogen, 21

Moxeza, 26

Naropin, 30 Neupro, 25

moxifloxacin HCL, 2

Nascobal, 21 Neurontin, 24

Moxifloxacin HCL, 2

Nasonex, 31 Neutrasal, 22

Mozobil, 20

Natachew, 33 Neutrexin, 4

MS Contin, 29

Natacyn, 26 Neuvaxin, 13

Mucinex D, 31

Natafort, 33 Nevanac, 27

Mucinex Maximum Strength, 31

Natalvirt 90 DHA, 34 nevirapine, 3

Multaq, 8

Natalvirt CA, 34 Nevirapine, 3

Multigen, 21

Natalvirt Flt, 21 nevirapine ER, 3

Multigen Folic, 21

Natalvit, 33 Newgen, 33

Multigen Plus, 21

Natazia, 15 Nexa Plus, 34

mupirocin, 11

nateglinide, 16 Nexavar, 6

mupirocin calcium, 11

Natelle One, 33 Nexium, 18

Muse, 10

Natesto, 14 Nexium 24HR, 18

Mustargen, 4

Natrecor, 10 Nexium I.v., 18

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

Natroba, 13 Nexterone, 8

Nature-throid, 17 niacin ER, 9

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

Nature-throid Nt-2.5, 17 niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper, 33

Navelbine, 6

Myalept, 17

Nazirex, 11 Niacor, 9

Myambutol, 2

Nebupent, 4 Niaspan, 10

Mycamine, 2

Nebusal, 31 Nicadan, 34

Mycobutin, 2

Necon 1/50-28, 15 nicardipine HCL, 7

mycophenolate mofetil, 5

Necon 10/11-28, 15 Nicazel, 34

mycophenolic acid DR, 5

Neevo DHA, 33 Nicazel Forte, 34

Mydfrin, 27

nefazodone HCL, 22 Nicazeldoxy 30 Kit, 2

Myfortic, 5

Nefazodone HCL, 22 Nicazeldoxy 60 Kit, 2

Myglucohealth Mgh Softlance Lancets 30G, 37

Nembutal Sodium, 24 Nicomide, 34

Neo-synalar, 11 nifedipine, 7

Mykidz Iron Fl, 33

Neo-synalar Kit, 11 nifedipine ER, 7

Myleran, 4

neomycin sulfate, 2 Nilandron, 5

Mynatal, 33

neomycin/bacitracin/polymyxin, 26 Nimbex, 25

Myobloc, 25

neomycin/polymyxin/bacitracin zinc, 26 nimodipine, 7

Myoxin, 28

neomycin/polymyxin/bacitracin/hydrocortisone, 27

Nipent, 6

Myozyme, 17

Niravam, 22

Myrbetriq, 19

neomycin/polymyxin/dexamethasone, 27 nisoldipine, 7

Mysoline, 24

neomycin/polymyxin/gramicidin, 26 Nisoldipine, 7

N

neomycin/polymyxin/HC, 28 Nisoldipine ER, 7

Neomycin/Polymyxin/Hydrocortisone, 27 Nitro-bid, 7

nabumetone, 29

neomycin/polymyxin/hydrocortisone, 28 Nitro-dur, 7

nadolol, 7

Neoprofen, 29 nitrofurantoin, 19

nadolol/bendroflumethiazide, 8

Neoral, 5 nitrofurantoin macrocrystals, 19

nafcillin sodium, 1

Neosalus, 13 nitrofurantoin monohydrate, 19

Nafcillin Sodium, 1

Neosalus CP, 13 nitrofurantoin monohydrate/macrocrystals, 19

Nafrinse Daily/Acidulated, 22

Neosporin, 26

Nafrinse Daily/Neutral, 22

neostigmine methylsulfate, 26 Nitroglycerin, 7

Nafrinse Weekly, 22

Neostigmine Methylsulfate, 26 nitroglycerin ER, 7

naftifine HCL, 11

Neotuss Plus, 31 nitroglycerin IN 5% dextrose, 7

Naftin, 11

Nephplex RX, 34 nitroglycerin IN dextrose 5%, 7

Naglazyme, 17

Nephro-vite RX, 34 Nitroglycerin IN Dextrose 5%, 7

nalbuphine HCL, 28

Nephrocaps, 34 nitroglycerin lingual, 7

Nalfon, 29

Nephrocaps QT, 34 Nitroglycerin Lingual, 7

Nallpen Iso-osmotic IN Dextrose, 1

Nephron Fa, 21 nitroglycerin transdermal, 7

Nallpen/Dextrose, 1

Neptazane, 9 Nitrolingual Pumpspray, 7

Namenda, 25

Nesacaine, 30 Nitromist, 7

Namenda Titration PAK, 25

Nesacaine-mpf, 30 Nitronal, 7

Namenda XR, 25

Nessi Spacer/Large Mask, 40 Nitropress, 8

Namenda XR Titration Pack, 25

Nessi Spacer/Mouthpiece, 40 Nitrostat, 7

Naphazoline HCL, 27

Nessi Spacer/Small/MED Mask, 40 Niva-plus, 33

Naprelan, 29

Nestabs, 33 Nivatopic Plus, 13

Naprosyn, 29

Nestabs Abc, 34 nizatidine, 18

naproxen, 29

Nestabs DHA, 33 Nizoral, 11

Naproxen, 29

Netgroup Lancets, 37 Nor-QD, 15

Naproxen Comfort PAC, 29

Neuac Kit, 10 Norco, 29

naproxen sodium, 29

Neulasta, 21 norepinephrine bitartrate, 9

naproxen sodium CR, 29

Neulasta Delivery Kit, 21 norethindrone, 15

naproxen sodium ER, 29

norethindrone & ethinyl estradiol ferrous fumarate, 15

octreotide acetate, 17 Opana, 29

Ocudox, 2 Opana ER (crush Resistant), 29

norethindrone acetate, 15

Ocufen, 27 Opdivo, 5

norethindrone acetate/ethinyl estradiol, 14, 15

Ocuflox, 26 opium, 18

Ocuvel, 34 opium tincture, 18

norethindrone acetate/ethinyl estradiol/ferrous fumarate, 15

Ofev, 32 Opium Tincture (paregoric), 18

Ofirmev, 28 Opsumit, 10

Norflex, 26

ofloxacin, 2, 26, 28 Optichamber Advantage, 40

norgestimate/ethinyl estradiol, 15

Ofloxacin, 2 Optichamber Diamond, 40

Norinyl 1+35, 15

olanzapine, 23 Optichamber Diamond/Largeface Mask, 40

Norinyl 1+50, 15

olanzapine odt, 23

Noritate, 11

olanzapine/fluoxetine, 25 Optichamber Diamond/Medium Face Mask, 40

Noroxin, 2

Oleptro, 23

Norpace, 8

olopatadine HCL, 31 Optichamber Diamond/Smallface Mask, 40

Norpace CR, 8

Olux, 12

Norpramin, 23

Olux-e, 12 Optihaler, 40

Northera, 9

Olysio, 3 Optihaler MDI Drug Delivery System, 40

nortriptyline HCL, 22

Omeclamox-PAK, 18 Optivar, 27

Nortriptyline HCL, 22

omega-3-acid ethyl esters, 9 Oracea, 11

Norvasc, 7

Omega-3/D-3 Wellness Pack, 10 Oracit, 20

Norvir, 3

omeprazole, 18 Orafate, 22

Nova Safety Lancets 23G, 37

Omeprazole + Syrspend SF Alka, 18 Orap, 25

Nova Safety Lancets 28G, 37

omeprazole/sodium bicarbonate, 18 Orapred, 14

Nova Sureflex Lancets, 37

Omnaris, 31 Orapred Odt, 14

Novaferrum, 21

Omnipred, 27 Oravig, 22

Novoclair, 11

Omontys, 21 Orbactiv, 4

Novoeight, 22

On Call Lancets, 37 Orencia, 29

Novofine Plus 32GX4MM, 37

On Call Plus Lancets, 37 Orenitram, 10

Novolin R, 15

Oncaspar, 4 Orfadin, 17

Novoseven Rt, 21

ondansetron HCL, 18 orphenadrine citrate, 26

Noxafil, 2

ondansetron odt, 18 orphenadrine citrate ER, 26

Nplate, 20

One A Day Womens Prenatal/DHA, 33 orphenadrine/asa/caffeine, 26

Nucort, 12

One A Day Womens Prenatal1, 33 Ortho Evra, 15

Nucynta, 29

One-a-day Womens Prenatal, 33 Ortho Micronor, 15

Nuedexta, 25

Onetouch Basic System, 37 Ortho Tri-cyclen, 15

Nulojix, 5

Onetouch Basic/Profile Test Strips, 37 Ortho Tri-cyclen LO, 15

Nulytely/Flavor Packs, 18

Onetouch Club Lancets Fine Point, 37 Ortho-cept, 15

Numoisyn, 22

Onetouch Combo Pack, 37 Ortho-cyclen, 15

Nuox, 10

Onetouch Delica Lancets Extra Fine 33G, 37

Ortho-novum 1/35, 15

Nutricap, 34

Ortho-novum 7/7/7, 15

Nutridox, 2

Onetouch Delica Lancets Fine 30G, 37 Orthovisc, 26

Nutrivit, 34

Onetouch Finepoint Lancets, 37 Osmoprep, 18

Nutropin AQ Nuspin 10, 17

Onetouch Lancets, 37 Osphena, 16


Onetouch Profile System, 37 Otezla, 29


Onetouch Suresoft Lancing Device/18G, 37

Otozin, 28

Nutropin AQ Pen, 17

Otrexup, 30

Nuvail, 13


Ovace Plus, 12

Nuvaring, 15

Ovace Plus Wash, 12

Nuvessa, 20


Ovace Wash, 12

Nuvigil, 24

Ovcon-35, 15

Nuvya, 11

Onetouch Ultra 2, 37 Ovide, 13

Nuzon, 12

Onetouch Ultra Blue, 37 Ovidrel, 17

Nymalize, 7

Onetouch Ultra Mini, 37 oxacillin sodium, 1

nystatin, 2, 11, 22

Onetouch Ultra System Kit, 37 oxaliplatin, 4

nystatin/triamcinolone, 11

Onetouch Ultralink System (DEC), 37 Oxandrin, 14

O

Onetouch Ultralink System (hex), 37 oxandrolone, 14

Onetouch Ultrasmart, 37 oxaprozin, 29

O-CAL Fa, 33

Onetouch Ultrasoft Lancets, 37 Oxaydo, 29

O-CAL Prenatal, 33

Onetouch Verio, 38 oxazepam, 22

OB Complete, 33

Onetouch Verio IQ Blood Glucose Monitoring System, 38

oxcarbazepine, 24

OB Complete 400, 33

Oxecta, 29

OB Complete One, 33

Onetouch Verio Sync Bloodglucose Monitoring System, 38

Oxistat, 11

OB Complete Petite, 33

Oxsoralen, 13

OB Complete Premier, 33

Onetouch Verio Test Strips, 38 Oxsoralen Ultra, 12

OB Complete/DHA, 33

Onexton, 10 Oxtellar XR, 24

Obredon, 31

Onfi, 24 oxybutynin chloride, 19

Obstetrix DHA, 33

Onglyza, 16 oxybutynin chloride ER, 19

Obtrex, 33

Onmel, 2 oxycodone HCL, 28

Obtrex DHA, 33

Oxycodone HCL, 29

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

Oxycodone HCL ER, 28

Peganone, 24 Phentolamine Mesylate, 8

oxycodone/acetaminophen, 28

Pegasys, 3 phenylephrine HCL, 9, 27

oxycodone/aspirin, 28

Pegasys Proclick, 3 Phenylephrine HCL, 9

oxycodone/ibuprofen, 28

Pegintron, 3 Phenylephrine HCL/Sodium Chloride, 9

Oxycontin, 29

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

oxymorphone hydrochloride, 28

Pen Needles 29GX1/2", 38 Phenytek, 24

oxymorphone hydrochloride ER, 28

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

oxytocin, 28

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

Oxytrol, 19

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, 1

Pancrelipase, 19

Pentam 300, 4

pancuronium bromide, 25

Pentasa, 19 piperacillin sodium/tazobactam sodium, 1

Panda Mask Large, 40

pentazocine/acetaminophen, 28 piperacillin/tazobactam, 1

Panda Mask Medium, 41

pentazocine/naloxone HCL, 28 piroxicam, 29

Panda Mask Small, 41

Pentetate Calcium Trisodium, 41 Pitocin, 28

Pandel, 12

Pentetate Zinc Trisodium, 41 Pitressin Synthetic, 17

pantoprazole sodium, 18

Pentips 31GX5MM, 38 Plan B, 15

papaverine HCL, 10

Pentips 31GX8MM, 38 Plan B One-step, 15

Parafon Forte DSC, 26

Pentips 32GX4MM, 38 Plaquenil, 3

Parcopa, 25

pentoxifylline ER, 21 Plavix, 22

paricalcitol, 17

Pepcid, 18 Plegridy, 25

Parlodel, 25

Percocet, 29 Plegridy Starter Pack, 25

Parnate, 23

Percodan, 29 Pletal, 22

paromomycin sulfate, 2

Perfect Lancets 30G, 38 Plexion, 10

paroxetine HCL, 22

Perfect Pressure Activated Safety Lancets 28G, 38

Plexion Cleanser, 10

paroxetine HCL ER, 22

Plexion Cleansing Cloths, 10

Paser, 2

Perforomist, 32 Pliaglis, 13

Pataday, 27

Peridex, 22 Pneumovax 23, 32

Patanase, 31

perindopril erbumine, 8 Pneumovax 23/1 Dose, 32

Patanol, 27

Perjeta, 5 Pneumovax 23/5 Dose, 32

Paxil, 22

permethrin, 13 Pocket Chamber, 41

Paxil CR, 23

perphenazine, 23 Pocket Spacer, 41

Pazeo, 27

Perphenazine/Amitriptyline, 25 podofilox, 13

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

Persantine, 22 Poly-VI-flor, 33

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

Pexeva, 23 Poly-VI-flor FS, 33

Pfizerpen-G, 1 Poly-VI-flor/Iron, 33

PC Unifine Pentips 31G X 8MM SHORT, 38

Pharmacist Choice Tsx Patch, 13 polyethylene glycol 3350, 18

Pharmacist Choice Ultra Thin Lancets, 38

polymyxin b sulfate, 4

PCE, 1

polymyxin b sulfate/trimethoprim sulfate, 26

Pcp 100, 18

Pharmacist Choice Ultra Thin Lancets 28G, 38

Pediaderm AF Complete Kit, 11

Polytrim, 26

Pediaderm HC, 12


Pomalyst, 5

Pediaderm Ta, 12

Ponstel, 30

Pediapred, 14


potassium citrate ER, 20

Pediarix, 32

potassium citrate-citric acid crystals, 20

Pediatex TD, 31


potassium citrate/citric acid, 20

Pediatex TDM, 31

potassium citrate/sodium citrate/citric acid, 20

Pediatric Panda Mask, 41

Pharmacy Counter Lancets, 38

Pedipirox-4 Nail, 11

phenazopyridine HCL, 20 Potiga, 24

Pedvax HIB, 32

phenelzine sulfate, 22 Pr Cream, 13

peg 3350/electrolytes, 18

Phenergan, 31 Pradaxa, 21

peg-3350/electrolytes, 18

phenobarbital, 23 pramipexole dihydrochloride, 25

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

Phenobarbital, 23 pramipexole dihydrochloride ER, 25

Peg-intron, 3

Phenobarbital Sodium, 24 Pramosone, 12

Peg-intron Redipen, 3

Pramotic, 28

Prenate Star, 33 Prolensa, 27

Prandimet, 16

Prepidil, 28 Proleukin, 6

Prandin, 16

Prepopik, 18 Prolia, 16

Prascion Ra With Sunscreens, 10

Preque 10, 34 Promacta, 21

Prastera, 30

Presera, 13 promethazine HCL, 30

pravastatin sodium, 9

Prevacid, 18 promethazine HCL plain, 30

Prazolamine, 26

Prevacid Solutab, 18 promethazine-DM, 31

prazosin HCL, 8

Prevident, 22 promethazine/codeine, 31

Pre-folic, 21

Prevnar 13, 32 promethazine/dextromethorphan, 31

Precedex, 24

Prevpac, 18 promethazine/phenylephrine, 31

Precision Sure-dose Insulin Syringe/0.3ML/30G X 5/16", 38

Prezcobix, 3 Promethazine/Phenylephrine, 31

Prezista, 3 promethazine/phenylephrine/codeine, 31


Prialt, 28 Prometrium, 15

Priftin, 2 Promiseb, 12


Prilosec, 18 Promiseb Complete, 12

Primaquine Phosphate, 3 propafenone HCL, 7


Primaxin IV, 4 propafenone HCL ER, 7

Primaxin IV Add-vantage, 4 Propantheline Bromide, 18

Precision Sure-dose Insulin Syringe/1ML/28G X 1/2", 38

primidone, 24 proparacaine HCL, 27

Primlev, 29 propranolol HCL, 7

Precision Sure-dose Plus Insulin Syringe/0.3ML/29G X 1/2", 38

Primsol, 4 Propranolol HCL, 7

Prinivil, 8 propranolol HCL ER, 7

Precision Sure-dose Plus Insulin Syringe/1ML/29G X 1/2", 38

Pristiq, 23 Propranolol/Hydrochlorothiazide, 8

Pro-c-dure 1 Kit, 14 propylthiouracil, 17

Precision Thin Lancets, 38

Pro-c-dure 2 Kit, 14 Proquad, 32

Precision Thins GP Lancet, 38

Pro-c-dure 3 Kit, 14 Proscar, 20

Precision Ultra Lancet, 38

Pro-c-dure 4 Kit, 14 Prosed/DS, 19

Precose, 16

Pro-c-dure 5 Kit, 14 Prostigmin, 26

Pred Forte, 27

Pro-c-dure 6 Kit, 14 Prostin E2, 28

Pred Mild, 27

Proair HFA, 31 Protamine Sulfate, 22

Pred-G, 27

Proair Respiclick, 31 Protect Plus, 34

Pred-G S.o.p., 27

probenecid, 30 Protectiron, 21

prednicarbate, 12

probenecid/colchicine, 30 Prothelial, 22

prednisolone, 14

Procainamide HCL, 8 Protonix, 18

prednisolone acetate, 27

Procardia, 7 Protopic, 13

prednisolone sodium phosphate, 14

Procardia XL, 7 protriptyline HCL, 22

Prednisolone Sodium Phosphate, 14, 27

Procentra, 24 Provenge, 6

prednisolone sodium phosphate odt, 14

prochlorperazine, 23 Provera, 15

prednisone, 14

prochlorperazine edisylate, 23 Provida DHA, 34

Prednisone, 14

prochlorperazine maleate, 23 Provida OB, 33

Prednisone Intensol, 14

Procort, 19 Provigil, 24

Prefera OB, 33

Procrit, 21 Prozac, 23

Prefera OB + DHA, 33

Proctocort, 19 Prozac Weekly, 23

Preferaob +dha, 34

Proctofoam HC, 19 Pruclair, 13

Preferaob One, 34

Procysbi, 20 Prudoxin, 11

Preferred Plus Unifine Pentips 29G X 12MM, 38

Prodigy Insulin Mini Pen Needles/31G X 3/16", 38

Prumyx, 13

Pss Select GP Lancets, 38

Preferred Plus Unifine Pentips 31G X 6MM Ultra SHORT, 38

Prodigy Insulin Pen Needles/29G X 1/2", 38

Pss Select Platforms, 38

Pss Select Safety Lancets, 38

Preferred Plus Unifine Pentips 31G X 8MM SHORT, 38

Prodigy Insulin SHORT Penneedles/31G X 5/16", 38

Pulmicort, 32

Pulmicort Flexhaler, 31

Prefest, 15

Prodigy Insulin Syring/U-100/0.3ML/31G X 5/16", 38

Pulmophylline, 32

Prefol-DHA, 34

Pulmozyme, 32

Premarin, 15, 20

Prodigy Insulin Syringe/1/2ML/31G X 5/16", 38

Purinethol, 5

Premphase, 15

Purixan, 5

Prempro, 15

Prodigy Insulin Syringe/1ML/28G X 1/2", 38

Px Lancets Ultra Thin, 38

Prenata, 33

Pylera, 18

Prenatal Vitamin, 33

Prodigy Pressure Activated Safety Lancets, 38

pyrazinamide, 2

Prenatal Vitamins, 33

Pyridium, 20

Prenate, 34

Prodigy Twist Top Lancets, 38 pyridostigmine bromide, 26

Prenate AM, 33

Proferrin-forte, 21 Pyridoxine HCL, 33

Prenate DHA, 34

Profilnine, 21 Pyrogallic Acid, 13

Prenate Elite, 33

Profilnine SD, 21 Q

Prenate Enhance, 34

progesterone, 15

Qc Lancets Super Thin, 38

Prenate Essential, 33

Progesterone 10% Kit, 15

Qc Lancets Ultra Thin, 38

Prenate Mini, 34

Proglycem, 16

Qc Pen Needles 29G X 12MM, 38

Prenate Pixie, 34

Prograf, 5


Prenate Restore, 34

Prolastin-c, 32


Qnasl, 31

Relion Insulin Syringe/U-100/0.5ML/30G, 38

Reyataz, 3

Qnasl Childrens, 31

Rezira, 31

Quadracel, 32

Relion Insulin Syringe/U-100/0.5ML/30G X 5/16", 38

Rezyst IM, 18

Quadramet, 6

Rezyst SB, 18

Qualaquin, 3


Rheumatrex, 30

Quartette, 15

Rhinocort Aqua, 31

Quazepam, 24

Relion Insulin Syringe/U-100/1ML/30G, 38

Rhinoflex-650, 28

Qudexy XR, 24

Riastap, 21

Quelicin, 25

Relion Insulin Syringe/U-100/1ML/30G X 5/16", 38

Riax, 10

Quelicin 1000, 25

Ribasphere, 3

Questran, 10


Ribasphere Ribapak, 3

Questran Light, 10

Ribatab, 3

quetiapine fumarate, 23

Relion Lancets Micro-thin33G, 38 ribavirin, 3

Quillivant XR, 24

Relion Lancets Standard 21G, 38 Ridaura, 30

quinapril HCL, 8

Relion Lancets Thin 26G, 38 rifabutin, 2

quinapril/hydrochlorothiazide, 8

Relion Lancets Ultra-thin30G, 38 Rifadin, 2

Quinidine Gluconate, 8

Relion Mini Pen Needles 31GX6MM, 38 Rifamate, 2

quinidine gluconate CR, 7

Relion Pen Needles 29GX12MM, 38 rifampin, 2

quinidine gluconate ER, 7

Relion Pen Needles 31GX8MM, 38 Rifater, 2

quinidine sulfate, 8

Relion Pen Needles 32GX4MM, 38 Right Step Prenatal, 33

Quinidine Sulfate, 8

Relion SHORT Pen Needles 31GX8MM, 38

Rightest GD-L500 Alternate Site Adapter, 38

Quinidine Sulfate ER, 8

quinine sulfate, 3

Relion Thin Lancets, 38 Rightest Gl300 Lancets, 38

Qutenza, 13

Relion Ultra Thin Lancets, 38 Rilutek, 25

R

Relion Ultra Thin Lancets30G, 38 riluzole, 25

Relion Ultra Thin Plus Lancets 32G, 38 rimantadine HCL, 3

R-natal OB, 34

Relion Ultra Thin Plus Lancets 33G, 38 Rimantalist, 3

Rabavert, 32

Relistor, 19 Riomet, 16

rabeprazole sodium, 18

Relpax, 30 risedronate sodium, 16

raloxifene hydrochloride, 16

Relyyks, 13 risedronate sodium DR, 16

ramipril, 8

Relyyt, 13 Risperdal, 23

Ranexa, 7

Remeron, 23 Risperdal Consta, 23

ranitidine HCL, 18

Remeron Soltab, 23 Risperdal M-TAB, 23

Rapaflo, 20

Remicade, 19 risperidone, 23

Rapamune, 5

Remodulin, 10 risperidone odt, 23

Rapivab, 3

Renagel, 19 Ritalin, 24

Rasuvo, 29

Renatabs, 34 Ritalin LA, 24

Ravicti, 17

Renatabs With Iron, 34 Ritalin SR, 24

Rayos, 14

Renew Advanced Lancing Cartridge Refills, 38

Riteflo, 41

Razadyne, 25

Rituxan, 5

Razadyne ER, 25

Renvela, 19 rivastigmine tartrate, 25

Rebetol, 3

Reopro, 22 rivastigmine transdermal system, 25

Reclast, 16

repaglinide, 16 rizatriptan benzoate, 30

Recombinate, 21

Reprexain, 29 rizatriptan benzoate odt, 30

Recombivax HB, 32

Repronex, 17 Robaxin, 26

Recothrom, 21

Req 49+, 34 Robaxin-750, 26

Recothrom Spray Kit, 21

Requip, 25 Robinul, 18

Rectiv, 19

Requip XL, 25 Robinul Forte, 18

Reglan, 19

Rescon-JR, 31 Rocaltrol, 17

Regonol, 26

Rescon-MX, 31 Rocephin, 1

Relagard, 20

Rescriptor, 3 rocuronium bromide, 25

Relenza Diskhaler, 3

Reserpine, 8 ropinirole ER, 25

Relhist, 31

Respa-BR, 31 ropinirole HCL, 25

Relion Insulin Syringe/U -100/0.5ML/29G, 38

Restasis, 27 ropivacaine, 30

Restora RX, 18 ropivacaine HCL, 30


Restoril, 24 Rosadan Kit, 11

Retavase, 22 Rosanil, 10


Retavase Half-kit, 22 Rosula, 10

Retin-a, 10 Rotarix, 32


Retin-a Micro, 10 Rotateq, 33

Retin-a Micro P.M., 10 Rowasa, 19


Retinoic Acid, 10 Roxicet, 29

Retinoic Acid-all Trans, 10 Roxicodone, 29


Retrovir, 3 Rozerem, 24

Retrovir IV Infusion, 3 Ryanodex, 26


Revatio, 10 Rytary, 25

Revlimid, 5 Rythmol, 8


Rexall Lancets Ultra Thin, 38 Rythmol SR, 8

S

Select-OB, 33 21G, 38

Select-ob+dha, 34 Smart Sense Super Thin Lancets Universal 30G, 38

Sabril, 24

selegiline HCL, 25

Safe-t-lance Low Flow 25G, 38

selenium sulfide, 12 Smart Sense Thin Lancets Universal 26G, 38

Safe-t-lance Normal Flow 21G, 38

Selrx, 12

Safe-t-lance Plus Safety Lancet High Flow, 38

Selzentry, 3 Smartest Lancets 28G, 38

Semprex-d, 31 Sodium Bicarbonate, 18

Safe-t-lance Plus Safety Lancet Low Flow, 38

Senophylline, 32 sodium chloride, 31

Sensipar, 17 sodium citrate/citric acid, 20

Safe-t-lance Plus Safety Lancet Normal Flow, 38

Sensorcaine-mpf/Epinephrine, 30 Sodium Diuril, 9

Sentradine, 18 Sodium Edecrin, 9

Safesnap Insulin Syringe/0.3ML/30G X 5/16", 38

Sentraflox AM-10, 23 sodium ferric gluconate complex/sucrose, 20

Sentralopram AM-10, 23


Sentramodafin AM-100, 24 sodium hyaluronate, 13

Sentravil PM-25, 23 sodium phenylbutyrate, 17


Sentrazolam AM 0.25, 22 sodium sulfacetamide, 10, 12, 26

Sentrazolpidem PM-5, 24 sodium sulfacetamide wash, 12

Safesnap Insulin Syringe/1ML/28G X 1/2", 38

Sentroxatine, 23 sodium sulfacetamide/sulfur, 10

Serevent Diskus, 32 Sodium Sulfacetamide/Sulfur, 10

Safesnap Insulin Syringe/1ML/29G X 1/2", 38

Seroquel, 23 sodium sulfacetamide/sulfur cleanser, 10

Seroquel XR, 23 Sodium Sulfacetamide/Sulfur Cleanser IN Urea, 10

Safety Lancet 21G/Pressure Activated, 38

Serostim, 17

sertraline HCL, 22 sodium sulfacetamide/sulfur cleansing cloths, 10

Safety Lancet 28G/Pressure Activated, 38

Sevelamer Carbonate, 19

Sfrowasa, 19 sodium sulfacetamide/sulfur green, 10

Safety Lancets, 38

Shohls Solution Modified, 20 Sodium Sulfacetamide/Sulfur IN Urea, 10

Safety Lancets 21G, 38

Shopko On-the-go Comfort Lancets 30G, 38

sodium sulfacetamide/sulfur w/sunscreen, 10

Safety Lancets 28G, 38

Safety Let Lancets, 38

Shopko Unifine Pentips Pen Needles/Micro/32GX4MM, 38

sodium sulfacetamide/sulfur wash, 10

Safety Seal Lancets 28G, 38

Solaice, 13

Safety Seal Lancets 30G, 38

Shopko Unifine Pentips Pen Needles/Mini/31GX5MM, 38

Soliris, 21

Safety-glide Insulin Syringe/0.3ML/29G X 1/2", 38

Solodyn, 2

Shopko Unifine Pentips Pen Needles/Original/29GX12MM, 38

Soltamox, 5

Safyral, 15

Solu-cortef, 14

Saizen, 17

Shopko Unifine Pentips Pen Needles/SHORT/31GX8MM, 38

Solu-medrol, 14

Saizen Click.easy, 17

Solus V2 Pressure Activated Safety Lancets 28G, 38

Salagen, 22

Shopko Unilet Lancets Super Thin 30G, 38

Salex, 13

Solus V2 Twist Lancets 30G, 38

Salex Cream, 13

Shopko Unilet Lancets Ultra Thin 28G, 38

Soma, 26

Salex Lotion, 13

Somatuline Depot, 17

salicylic acid, 13

Siderol, 34 Somavert, 17

Salicylic Acid, 13

Signifor, 17 Sonata, 24

salicylic acid cream, 13

Signifor Lar, 17 Soolantra, 11

Salicylic Acid IN Ammonium Lactate Vehicle, 13

sildenafil, 10 Soothee, 13

sildenafil citrate, 10 Soriatane, 12

salicylic acid lotion, 13

Silenor, 24 Sorilux, 12

Salkera, 13

Simbrinza, 27 sotalol HCL, 7

salsalate, 28

Simcor, 9 sotalol HCL (AF), 7

Salvax, 13

Simponi, 29 Sotalol Hydrochloride, 7

Salvax Duo Plus, 13

Simponi Aria, 29 Sotylize, 7

Samsca, 17

Simulect, 5 Sovaldi, 3

Sanctura, 20

simvastatin, 9 Spectracef, 1

Sanctura XR, 20

Sinelee, 13 Spinosad, 13

Sancuso, 19

Sinemet, 25 Spiriva Handihaler, 32

Sandimmune, 5

Sinemet CR, 25 Spiriva Respimat, 32

Sandostatin, 17

Single-let, 38 spironolactone, 9

Sandostatin Lar Depot, 17

Singulair, 32 spironolactone/hydrochlorothiazide, 9

Saphris, 23

sirolimus, 5 Sporanox, 2

Sarafem, 25

Sirturo, 2 Sporanox Pulsepak, 2

Savaysa, 21

Sitavig, 3 Sprix, 30

Savella, 25

Sivextro, 4 Sprycel, 6

Savella Titration Pack, 25

Skelaxin, 26 Staflex, 28

Scalacort DK, 12

Sklice, 13 Stalevo 100, 25

Scar Patch, 13

Smart Diabetes Vantage Universal Lancets 30G, 38

Stalevo 125, 25

Scopolamine Hydrobromide, 18

Stalevo 150, 25

Seasonique, 15

Smart Sense Color Lancets Universal 33G, 38

Stalevo 200, 25

Seb-prev, 12

Stalevo 50, 25

Seconal, 24

Smart Sense Standard Lancets Universal Stalevo 75, 25

Sectral, 7

stannous fluoride oral rinse, 22

Sure-ject Insulin Syringe/U-100/0.3ML/30G X 5/16", 38

Tapazole, 17

Starlix, 16

Tarceva, 6

stavudine, 3


Targadox, 2

Stavzor, 25

Targretin, 6

Stelara, 12


Tarka, 9

Stendra, 10

Taron-bc, 33

Sterilance PA, 38


Taron-c DHA, 33

Sterilance TL, 38

Tasigna, 6

Stimate, 17


Tasmar, 25

Stivarga, 6

Taxotere, 6

Strattera, 24


Tazicef, 1

Strazepam, 24

Tazorac, 12

Streptomycin Sulfate, 2

Sure-ject Insulin Syringe/U-100/1ML/28G X 1/2", 38

Tecfidera, 25

Striant, 14

Tecfidera Starter Pack, 25

Stribild, 3


Techlite AST Lancets, 39

Striverdi Respimat, 32

Techlite Lancets, 39

Stromectol, 3


Techlite Lancets 30G, 39

Strovite Forte, 34

Tegretol, 25

Strovite One, 34


Tegretol-XR, 25

Stuart Prenatal, 33

Tekamlo, 9

Suboxone, 28

Sure-lance Flat Lancets, 39 Tekturna, 8

Subsys, 29

Sure-lance Lancets 26G, 39 Tekturna HCT, 8

Suclear, 18

Sure-lance Thin Lancets 28G, 39 telmisartan, 8

Sucraid, 19

Sure-lance Ultra Thin Lancets, 39 telmisartan/amlodipine, 8

sucralfate, 18

Sure-touch Lancets Universal, 39 telmisartan/hydrochloroth, 8

Sular, 7

Surelite Lancets, 39 telmisartan/hydrochlorothiazide, 8

sulfacetamide sodium, 10, 26

Surestep Pro Test Strips, 39 temazepam, 23

Sulfacetamide Sodium, 26

Surestep Test Strips, 39 Temodar, 4

sulfacetamide sodium/prednisolone sodium phosphate, 27

Surfaxin, 32 Temovate, 12

Surmontil, 23 Temovate E, 12

sulfacetamide sodium/sulfur cleanser, 10

Survanta Intratracheal, 32 temozolomide, 4

Sulfadiazine, 2

Sustiva, 3 Tencon, 28

sulfamethoxazole/trimethoprim, 4

Sutent, 6 Tenex, 8

Sulfamethoxazole/Trimethoprim, 4

Suttar-2, 31 Teniposide, 6

sulfamethoxazole/trimethoprim DS, 4

Suttar-SF, 31 Tenivac, 32

sulfasalazine, 19

Sylatron, 6 Tenoretic 100, 9

Sulfoam, 10

Symax Duotab, 18 Tenoretic 50, 9

Sulfurated Lime, 13

Symbicort, 32 Tenormin, 7

sulindac, 29

Symbyax, 25 Terazol 3, 20

Sumadan Kit, 10

Symlinpen 120, 15 Terazol 7, 20

Sumadan Wash, 10

Symlinpen 60, 15 terazosin HCL, 8

Sumadan XLT, 10

Synagex, 34 terbinafine HCL, 2

Sumatriptan, 30

Synalar, 12 Terbinex, 2

sumatriptan succinate, 30

Synalar Cream Kit, 12 terbutaline sulfate, 31

Sumatriptan Succinate, 30

Synalar Ointment Kit, 12 terconazole, 20

sumatriptan succinate refill, 30

Synalar Ts, 12 Tersi Foam, 12

Sumavel Dosepro, 30

Synalgos-dc, 29 Terumo Insulin Syringe/0.3ML/30G X 3/8", 39

Sumaxin, 10

Synapryn Fusepaq, 29

Sumaxin CP Kit, 10

Synarel, 17 Terumo Insulin Syringe/0.5ML/29G X 1/2", 39

Sumaxin Ts, 11

Synatek, 34

Sumaxin Wash, 11

Synera, 13 Terumo Insulin Syringe/0.5ML/30G X 3/8", 39

Supartz, 26

Synercid, 4

Supartz Fx, 26

Synribo, 6 Terumo Insulin Syringe/1ML/27G X 1/2", 39

Supervite, 34

Synthroid, 17

Supervite EC, 34

Synvisc, 26 Terumo Insulin Syringe/1ML/29G X 1/2", 39

Support-500, 34

Synvisc One, 26

Supprelin LA, 17

T Terumo Insulin Syringe/1ML/30G X 3/8", 39

Supracil, 13

Tabloid, 5

Suprax, 1

Terumo Insulin Syringe/U-100/0.3ML/29G X 1/2", 39

Tabradol Fusepaq, 26

Suprep Bowel Prep, 18

Taclonex, 12

Sure-fine Pen Needles 29GX1/2" 12.7MM, 38


tacrolimus, 5, 13

Tafinlar, 6

Sure-fine Pen Needles 31GX3/16" 5MM, 38


Talwin, 29

Tamiflu, 3

Sure-fine Pen Needles 31GX5/16" 8MM, 38

Terumo Insulin Syringe/U-100/1ML/28G X 1/2", 39

tamoxifen citrate, 5

tamsulosin HCL, 20


Terumo Surguard Insulin Syringe/0.3ML/29G X 1/2", 39

Tandem F, 21

Tandem Plus, 21


Thinpro Insulin Syringe/0.5ML/29G X 1/2", 39

Tolbutamide, 16

tolcapone, 25



tolmetin sodium, 29

Tolmetin Sodium, 29

Terumo Surguard Insulin Syringe/1ML/28G X 1/2", 39


tolterodine tartrate, 19

tolterodine tartrate ER, 19

Terumo Surguard Insulin Syringe/1ML/29G X 1/2", 39

Thinpro Insulin Syringe/1ML/28G X 1/2", 39

Topamax, 25

Topamax Sprinkle, 25

Tessalon Perles, 31


Topicort, 12

Testone Cik, 14

topiramate, 24

Testopel, 14


Topiramate ER, 25

testosterone, 14

topotecan HCL, 6

Testosterone, 14


Topotecan HCL, 6

testosterone cypionate, 14

Toprol XL, 7

testosterone enanthate, 14

Thiola, 20 Torisel, 6

Testred, 14

thioridazine HCL, 23 torsemide, 9

Tetanus Toxoid Adsorbed, 32

Thiotepa, 4 Torsemide, 9

Tetanus/Diphtheria Toxoids-adsorbed, 32

thiothixene, 23 Totect, 6

Thrombin-jmi Diluent, 21 Toujeo Solostar, 15

Tetanus/Diphtheria Toxoids-adsorbed Adult, 32

Thrombin-jmi Epistaxis, 21 Toviaz, 20

Thrombin-jmi Syringe Spray Kit, 21 Tracleer, 10

tetrabenazine, 25

Thrombin-jmi W/Dil Spray P.M. Actuator, 21

tramadol HCL, 28

tetracaine HCL, 27

tramadol HCL ER, 28

Tetracaine HCL, 30

Thrombogen, 21 Tramadol HCL ER, 29

Tetracycline HCL, 2

Thymoglobulin, 5 tramadol hydrochloride/acetaminophen, 28

Tetrix, 13

Thyrolar-1, 17

Teveten, 8

Thyrolar-1/2, 17 Trandate, 7

Teveten HCT, 9

Thyrolar-1/4, 17 trandolapril, 8

Texacort, 12

Thyrolar-2, 17 trandolapril/verapamil HCL, 8

Texavite LQ, 34

Thyrolar-3, 17 trandolapril/verapamil HCL ER, 8

Thalomid, 5

tiagabine hydrochloride, 24 tranexamic acid, 21

Theo-24, 32

Tiazac, 7 Transderm-scop, 19

theophylline, 31

Tice Bcg, 6 Tranxene T, 22

theophylline CR, 31

ticlopidine HCL, 21 tranylcypromine sulfate, 22

theophylline ER, 31

Ticlopidine HCL, 21 Travatan Z, 27

Theophylline/D5W, 32

Tigan, 19 Travoprost, 27

Therabenzaprine-60, 26

Tikosyn, 8 Trazamine, 23

Therabenzaprine-90, 26

Timentin, 1 trazodone HCL, 22

Therabenzaprine-90-5, 26

Timolol Maleate, 7 Treanda, 4

Theracodeine-300, 29

timolol maleate, 26 Trecator, 2

Theracodophen-325, 29

timolol maleate ophthalmic gel forming, 26

Trelstar, 5


Trelstar Mixject, 5


Timoptic, 26 Trepadiclofen-25, 30

Theracodophen-low-90, 29

Timoptic Ocudose, 26 Trepoxen-250, 30

Theracys, 6

Timoptic-xe, 26 Trepoxicam-7.5, 30

Therafeldamine, 30

Tindamax, 4 Tretin-x, 11

Theranatal Core Nutrition, 33

tinidazole, 4 tretinoin, 6, 10

Therapentin-60, 25

Tirosint, 17 Tretinoin, 10

Therapentin-90, 25

Tisseel, 21 Tretinoin (all-trans Retinoic Acid), 10

Theraprofen-60, 30

Tisseel VH, 21 tretinoin microsphere, 10

Theraprofen-800, 30

Tivicay, 3 tretinoin microsphere P.M., 10

Theraprofen-90, 30

Tivorbex, 30 Trexall, 5

Theraproxen-500, 30

Tizanidine Comfort PAC, 26 Treximet, 30

Theraproxen-60, 30

tizanidine HCL, 26 Trezix, 29

Theraproxen-90, 30

TL G-FOL OS, 34 Tri-norinyl 28, 15

Theratramadol-60, 29

TL Triseb, 12 Tri-VI-flor, 33

Theratramadol-90, 29

Tnkase, 22 Triamcinolone, 14

thiamine HCL, 33

Tobradex, 27 triamcinolone acetonide, 12, 22, 31

Thinlets GP Lancets, 39

Tobradex ST, 27 Triamcinolone Acetonide, 12

Thinlets Lancet, 39

tobramycin, 2 triamcinolone IN orabase, 22


tobramycin sulfate, 2, 26 Triamcinolone PF, 14

Tobramycin Sulfate/Sodium Chloride, 2 Triamcinolone/Lidocaine, 14


tobramycin/dexamethasone, 27 Triamsil Combipak, 12

Tobrex, 26 triamterene/hydrochlorothiazide, 9


Tofranil, 23 Triamterene/Hydrochlorothiazide, 9

Tofranil-PM, 23 Trianex, 12


tolazamide, 16 triazolam, 23

Tolazamide, 16 Tribenzor, 8

Tricare Prenatal Compleat, 33

Tybost, 3 Ulticare Insulin Syringe/U-100/0.3ML/30G X 5/16", 39

Tricare Prenatal DHA One, 33

Tygacil, 4

tricitrates, 20

Tykerb, 6 Ulticare Insulin Syringe/U-100/0.3ML/31G X 5/16", 39

Tricor, 10

Tylenol/Codeine #3, 29

Triderma Forte, 12

Tylenol/Codeine #4, 29 Ulticare Insulin Syringe/U-100/0.5ML/29G X 1/2", 39

Triferic, 21

Typhim VI, 33

trifluoperazine HCL, 23

Tysabri, 25 Ulticare Insulin Syringe/U-100/0.5ML/30G X 1/2", 39

trifluridine, 26

Tyvaso, 10

Triglide, 10

Tyvaso Refill, 10 Ulticare Insulin Syringe/U-100/0.5ML/30G X 5/16", 39

trihexyphenidyl HCL, 25

Tyvaso Starter, 10

Trileptal, 25

Tyzeka, 3 Ulticare Insulin Syringe/U-100/0.5ML/31G X 5/16", 39

Trilipix, 10

Tyzine, 31

trimethobenzamide HCL, 18

Tyzine Pediatric Nasal Drops, 31 Ulticare Insulin Syringe/U-100/1ML/29G X 1/2", 39

trimethoprim, 4

U

trimethoprim sulfate/polymyxin b sulfate, 26

Ulticare Insulin Syringe/U-100/1ML/30G X 1/2", 39

Uceris, 14, 19

Udamin SP, 34

Triostat, 17


Ulesfia, 14

Trisenox, 6

Uloric, 30

Triseon, 11


Ulticare Insulin Safety Syringe/0.5ML/29G X 1/2", 39

Triumeq, 3

Triveen-duo DHA, 34

Ulticare Micro Pen Needles/32G X 4MM, 39

Ulticare Insulin Safety Syringe/1ML/29G X 1/2", 39

Triveen-prx RNF, 34

Trizivir, 3

Ulticare Mini Pen Needles 31GX6MM, 39

Ulticare Insulin Syringe 1CC/28G U-100 1/2", 39

Trokendi XR, 25

Ulticare Mini Pen Needles Ulti-fine IV, 39

Tropazone, 13

Ulticare Mini Pen Needles/31G X 6MM, 39

Ulticare Insulin Syringe Ultrafine U-100/0.3ML/31G X 5/16", 39

trospium chloride, 19

trospium chloride ER, 19

Ulticare Mini Pen Needles31GX6MM, 39

Ulticare Insulin Syringe Ultrafine U-100/0.5ML/31G X 5/16", 39

Trueplus Insulin Syringe/U-100/0.3ML/29G X 1/2", 39

Ulticare Original Pen Needles Ulti-fine, 39

Ulticare Insulin Syringe Ultrafine U-100/1ML/31G X 5/16", 39


Ulticare Pen Needles/29G X 12.7MM, 39

Ulticare SHORT Pen Needles 31GX8MM, 39

Ulticare Insulin Syringe/0.3ML/29G X 1/2", 39


Ulticare SHORT Pen Needles Ulti-fine IV, 39



Ulticare SHORT Pen Needles/31G X 8MM, 39



Ulticare Thin Lancets 30G, 39



Ultiguard Insulin Syringe/U-100/0.3ML/29G X 1/2", 39





Trueplus Insulin Syringe/U-100/1ML/28G X 1/2", 39





Ulticare Insulin Syringe/1ML/28G X 1/2", 39


Ultiguard Insulin Syringe/U-100/1ML/29G X 1/2", 39



Ultiguard Insulin Syringe/U-100/1ML/30G X 5/16", 39


Trueplus Lancets 26G, 39

Ultilet Classic Lancets, 39


Ultilet Insulin Syringe/SHORT/0.3ML/30G X 5/16", 39


Trueplus Lancets 28G Super Thin, 39



Ulticare Insulin Syringe/SHORT/0.3ML/30G X 5/16", 39

Trueplus Lancets 30G Ultra Thin, 39




Trueplus Lancets 33G Micro Thin, 39

Trueplus Safety Lancets 28G, 39



Trumenba, 33

Trusopt, 27

Ultilet Insulin Syringe/SHORT/1ML/30G X 5/16", 39


Truvada, 3

Turkel Paracentesis Procedure Tray/8french, 30

Ultilet Insulin Syringe/SHORT/1ML/31G X 5/16", 39

Ulticare Insulin Syringe/SHORT/1ML/30G X 5/16", 39

Tussicaps, 31

Ultilet Lancets, 39

Ulticare Insulin Syringe/SHORT/1ML/31G X 5/16", 39

Tussionex Pennkinetic Extended Release, 31

Ultilet Lancets 33G, 39

Ultilet Pen Needle 32GX4MM/SHORT, 39

Ulticare Insulin Syringe/U-100/0.3ML/29G X 1/2", 39

Tuzistra XR, 31

Twinrix, 33

Ultilet Safety Lancets 23G, 39

Ulticare Insulin Syringe/U-100/0.3ML/30G X 1/2", 39

Twynsta, 9

Ultilet SHORT Pen Needles 31GX5/16",

39

Unistik 1, 40 Valumark Pen Needles 31G X 6MM, 40

Ultilet SHORT Pen Needles31GX3/16", 39

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, 39

Unistik 2 Neonatal, 40 vancomycin HCL, 4

Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/30GX5/16", 39

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, 12

Ultra-thin II Insulin Syringe SHORT/U-100/1ML/30GX5/16", 39

Unistik CZT Comfort, 40 Vanoxide-HC, 11

Unistik CZT Normal, 40 Vantas, 5

Ultra-thin II Insulin Syringe SHORT/U-100/1ML/31GX5/16", 39

Unistik Safety Lancets 28G, 40 Vaprisol, 17

Unistik Safety Lancets 30G, 40 Vaqta, 33

Ultra-thin II Insulin Syringe/U-100/0.3ML/29GX1/2", 39

Univasc, 8 Varivax, 33

Universal 1 Lancets Thin 26G, 40 Vascepa, 9

Ultra-thin II Insulin Syringe/U-100/0.5ML/29GX1/2", 39

Universal 1 Lancets Ultra Thin 30G, 40 Vaseretic, 9

Uramaxin, 14 vasopressin, 17

Ultra-thin II Insulin Syringe/U-100/1ML/29GX1/2", 39

Uramaxin GT, 14 Vasostrict, 17

Uramaxin GT Kit, 14 Vasotec, 8

Ultra-thin II Lancets 28G, 39

urea, 13 Vazculep, 9

Ultra-thin II Lancets 30G, 39

urea 40% nail film, 13 Vecamyl, 8

Ultra-thin II Mini Pen Neeedles/31GX3/16", 39

urea IN zinc undecylenate/lactic acid vehicle, 13

Vectibix, 5

Vectical, 12

Ultra-thin II Pen Needles 29GX1/2", 40

urea topical, 13 vecuronium bromide, 25

Ultra-thin II Pen Needles/SHORT/31GX5/16", 40

Urecholine, 20 Velcade, 6

Uretron D/S, 19 Veletri, 10

Ultra-thin II Safety Autolancets 26G, 40

Urimar-t, 19 Velphoro, 19

Ultracet, 29

Urocit-k 10, 20 Veltin, 11

Ultralance, 40

Urocit-k 15, 20 Vemavite-prx 2, 34

Ultram, 29

Urocit-k 5, 20 venlafaxine HCL, 22

Ultram ER, 29

Urogesic-blue, 19 venlafaxine HCL ER, 22

Ultrasal-ER, 14

Uroqid #2, 19 Venlafaxine HCL ER, 22

Ultravate, 12

Uroxatral, 20 Venofer, 21

Ultravate PAC, 12

Urso 250, 19 Ventavis, 10

Ultravate X, 12

Urso Forte, 19 Ventolin HFA, 32

Umecta, 14

ursodiol, 19 Veramyst, 31

Umecta Nail Film, 14

Utopic, 14 verapamil HCL, 7

Umecta PD, 14

Uvadex, 6 Verapamil HCL, 7

Unasyn, 1

V verapamil HCL ER, 7

Unasyn Bulk Pack, 1

verapamil HCL SR, 7

V-r Monoject Insulin Syringe/U-100/0.3ML/29G X 1/2", 40

Unifine Pentips 29GX12MM, 40

Verdeso, 12

Unifine Pentips 31G X 3/16", 40

Veregen, 14


Unifine Pentips 31G X 6MM, 40

Verelan, 7

Unifine Pentips 31G X 8MM, 40

Verelan PM, 7



Veripred 20, 14


Verrunex, 14

V-r Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 40


Versacloz, 23


Vesicare, 19

V-r Monoject Insulin Syringe/U-100/1ML/29G X 1/2", 40

Unifine Pentips Plus 29GX12MM, 40

Vexa, 14


Vexol, 27

Vagifem, 20


Vfend, 2

valacyclovir HCL, 3


Vfend IV, 2

Valchlor, 4

Unilet Comfortouch Lancet, 40

Vibativ, 4

Valcyte, 3

Unilet Excelite, 40

Vibramycin, 2

valganciclovir, 3

Unilet Excelite II, 40

Vicoprofen, 29

Validerm, 12

Unilet G.p. Lancet, 40

Victoza, 15

Valium, 22

Unilet G.p. Superlite Lancet, 40

Victrelis, 3

valproate sodium, 24

Unilet GP 28 Ultra Thin, 40

Vida Mia Unifine Pentips 32GX4MM, 40

valproic acid, 24

Unilet Lancet, 40

Vida Mia Unifine Pentips Mini 31GX6MM, 40

valsartan, 8

Unilet Lancets Micro-thin33G, 40

valsartan/hydrochlorothiazide, 8

Unilet Lancets Super-thin30G, 40

Vida Mia Unifine Pentips Original 29GX12MM, 40

Valtrex, 3

Unilet Lancets Ultra-thin 28G, 40

Valumark Lancet Super Thin 30G, 40

Unilet Superlite Lancet, 40

Vida Mia Unilet Lancets Super Thin 30G, 40

Valumark Lancet Ultra Thin 28G, 40

Uniretic, 9

Valumark Pen Needles 29GX12MM, 40

Vida Mia Unilet Lancets Ultra Thin 28G, 40

Vospire ER, 32 Z

Votrient, 6

Zacare 4% Kit, 11

Vida Mia Unipfine Pentipsshort 31GX8MM, 40

Vpriv, 21

Zacare 8% Kit, 11

Vsl#3 DS, 18

zafirlukast, 31

Vidaza, 5

Vusion, 11

zaleplon, 23

Videx EC, 3

Vyvanse, 24

Zaltrap, 5

Videx Pediatric, 3

W

Zamicet, 29

Viekira PAK, 3

W&f Lancets 26G, 40 Zanaflex, 26

Vigamox, 26

W&f Lancets Colored 21G, 40 Zanosar, 4

Viibryd, 23

Walgreens Lancets, 40 Zantac, 18

Viibryd Starter Pack, 23

Walgreens Thin Lancets, 40 Zarontin, 25

Vimizim, 17

Walgreens Ultra Thin Lancets, 40 Zaroxolyn, 9

Vimpat, 25

warfarin sodium, 21 Zatean-CH, 34

Vinacal B, 33

Watchhaler, 41 Zatean-pn, 33

Vinate AZ Extra, 33

Welchol, 9 Zatean-pn DHA, 34

Vinate Calcium, 33

Wellbutrin, 23 Zatean-pn Plus, 33

Vinate DHA, 33

Wellbutrin SR, 23 Zavesca, 21

Vinate DHA RF, 33

Wellbutrin XL, 23 Zebeta, 7

Vinblastine Sulfate, 6

Westcort, 12 Zegerid, 18

vincristine sulfate, 5

Westhroid, 18 Zelapar, 25

vinorelbine tartrate, 5

Wheat Germ, 33 Zelboraf, 6

Viracept, 3

Wilate, 21 Zemaira, 32

Viramune, 3

Wp Thyroid, 18 Zemplar, 17

Viramune XR, 3

X Zemuron, 25

Virasal, 14

Zenpep, 19

Virazole, 3

Xalatan, 27

Zenzedi, 24

Viread, 3

Xalkori, 6

Zerbaxa, 4

Viroptic, 26

Xanax, 22

Zerit, 3

Vistaril, 22

Xanax XR, 22

Zestoretic, 9

Vistide, 3

Xarelto, 21

Zestril, 8

Vita-pren, 33

Xarelto Starter Pack, 21

Zetia, 10

Vitafol, 34

Xartemis XR, 29

Zetonna, 31

Vitafol Fe+, 34

Xeljanz, 30

Zevalin Y-90, 5

Vitafol Ultra, 34

Xeloda, 5

Ziac, 9

Vitafol-nano, 33

Xenazine, 25

Ziagen, 3

Vitafol-ob+dha, 34

Xeomin, 25

Ziana, 11

Vitafol-one, 34

Xerac Ac, 14

zidovudine, 3

Vitafol-pn, 33

Xerese, 11

Zinacef, 1

Vital-d RX, 34

Xgeva, 16

Zinecard, 6

Vitalet Pro Lancets, 40

Xifaxan, 4

ziprasidone HCL, 23

Vitalet Pro Plus Lancets, 40

Xigduo XR, 16

Zipsor, 30

Vitamedmd One RX/Quatrefolic, 34

Xodol, 29

Zirgan, 26

Vitamedmd Plus RX/Quatre Folic, 34

Xofigo, 6

Zithranol, 12

Vitamedmd Redichew RX, 33

Xolair, 32

Zithranol-rr, 12

Vitamedmd Redichew RX/Quatrefolic, 33

Xolegel, 11

Zithromax, 1

Vitamin A, 33

Xolegel Corepak, 11

Zithromax Tri-PAK, 1

vitamin c 222MG, 33

Xolegel Duo/Head & Shoulders, 11

Zithromax Z-PAK, 1

vitamin d, 33

Xolegel Duo/Xolex, 11

Zmax, 2

vitamin k1, 33

Xolox, 29

Zofran, 19

Vitamin K1, 33

Xopenex, 32

Zofran Odt, 19

Vitapearl, 33

Xopenex Concentrate, 32

Zoladex, 5

Vitaroca Plus, 34

Xtandi, 5

zoledronic acid, 16

Vitekta, 3

Xylocaine, 8, 14, 30

Zoledronic Acid, 16

Vituz, 31

Xylocaine-mpf, 30

Zolinza, 6

Viva DHA, 33

Xylocaine-mpf/Epinephrine, 30

zolmitriptan, 30

Vivactil, 23

Xylocaine/Epinephrine, 30

zolmitriptan odt, 30

Vivelle-dot, 15

Xyntha, 22

Zoloft, 23

Vivotif Berna, 33

Xyntha Solofuse, 22

zolpidem tartrate, 23

Voltaren, 11

Xyrem, 25

zolpidem tartrate ER, 23

Voltaren-XR, 30

Xyzal, 31

Zolpimist, 24

Voluven, 22

Y

Zometa, 16

Vopac, 11

Zomig, 30

Yasmin 28, 15

Vopac GB, 11

Zomig Nasal Spray, 30

Yaz, 15

Vopac Kt, 11

Zomig ZMT, 30

Yervoy, 5

Voraxaze, 6

Zonalon, 11

Yf-vax, 33

voriconazole, 2

Zonatuss, 31

Yodoxin, 3

Vortex Valved Holding Chamber, 41

Zonegran, 25

Your Life Multi Prenatal, 33

Vosol HC, 28

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

Zydelig, 6

Zydone, 29

Zyflo, 32

Zyflo CR, 32

Zykadia, 6

Zylet, 27

Zyloprim, 30

Zymaxid, 26

Zyprexa, 23

Zyprexa Relprevv, 23

Zyprexa Zydis, 23

Zytiga, 5

Zyvodol, 11

Zyvox, 4

1

1ST Choice Lancets Super Thin, 40

1ST Choice Lancets Thin, 40

1ST Choice Lancets Ultra Thin, 40

1ST Tier Unifine Pentips 29GX12MM, 40



8

8-mop, 12

Premium-Value Formulary Reference Guide

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