Restricted Durg and Enteral Products' Billing Units Tool ... · 00013265802 genotropin miniquick 2 mg somatropin 7 each 00023114501 botox 100 units vial onabotulinumtoxina 1 each

Restricted Durg and Enteral Products' Billing Units Tool

Product

Number Product Number Description Generic Name

Package

Size

Medi-Cal

Billing Unit

00002733501 HUMATROPE 5 MG VIAL SOMATROPIN 1 EACH



00002808901 HUMATROPE 6 MG CARTRIDGE SOMATROPIN 1 EACH






00005422361 GEVRAL PROTEIN POWDER PROTEIN SUPPLEMENT 227 GRAMS

00013260694 GENOTROPIN 1.5 MG CARTRIDGE SOMATROPIN 5 EACH



00013262681 GENOTROPIN 5 MG CARTRIDGE SOMATROPIN 1 EACH


00013264681 GENOTROPIN 12 MG CARTRIDGE SOMATROPIN 1 EACH

00013264902 GENOTROPIN MINIQUICK 0.2 MG SOMATROPIN 7 EACH




00013265302 GENOTROPIN MINIQUICK 1 MG SOMATROPIN 7 EACH





00013265802 GENOTROPIN MINIQUICK 2 MG SOMATROPIN 7 EACH

00023114501 BOTOX 100 UNITS VIAL ONABOTULINUMTOXINA 1 EACH

00023392102 BOTOX 200 UNITS VIAL ONABOTULINUMTOXINA 1 EACH

00023923201 BOTOX COSMETIC 100 UNITS VIAL ONABOTULINUMTOXINA 1 EACH

00023923250 BOTOX COSMETIC 50 UNITS VIAL ONABOTULINUMTOXINA 1 EACH

00024022205 ELIGARD 22.5 MG SYRINGE LEUPROLIDE ACETATE 1 EACH

00024060545 ELIGARD 45 MG SYRINGE LEUPROLIDE ACETATE 1 EACH

00024061030 ELIGARD 30 MG SYRINGE LEUPROLIDE ACETATE 1 EACH

00024079375 ELIGARD 7.5 MG SYRINGE LEUPROLIDE ACETATE 1 EACH

00024079379 ELIGARD 7.5MG SYRINGE LEUPROLIDE ACETATE 1 EACH

00026037220 KOGENATE FS 250 UNIT VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT


00026037250 KOGENATE FS 1,000 UNITS VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00026037920 KOGENATE FS 250 UNITS VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00026037930 KOGENATE FS 500 UNITS VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT


00026063504 GAMASTAN S/D VIAL IMMUNE GLOBULIN,GAMMA (IGG) 2 MILLILITERS

00026064512 GAMUNEX 10% VIAL IMMUNE GLOB,GAM CAPRYLATE(IGG) 10 MILLILITERS



Page 1 of 49 January 2011


Product


Package

Size

Medi-Cal

Billing Unit



00026064612 GAMIMUNE N 5% VIAL IMMUNE GLOBULIN,GAMMA (IGG) 10 MILLILITERS










00026378660 KOGENATE FS 2,000 UNIT VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT





00026379660 KOGENATE FS 2,000 UNIT VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT


00053748605 GAMMAR-P I.V. 5 GM VIAL IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00053748610 GAMMAR-P I.V. 10 GM VIAL IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00053759601 VIVAGLOBIN 16% VIAL IMMUNE GLOBULIN,GAMMA (IGG) 3 MILLILITERS






00053761505 HUMATE-P 600 UNIT VWF:RCO AHF,HUMAN/VWF,HUMAN 1 EACH UNIT

00053761510 HUMATE-P 1,200 UNIT VWF:RCO AHF,HUMAN/VWF,HUMAN 1 EACH UNIT

00053761520 HUMATE-P 2,400 UNIT VWF:RCO AHF,HUMAN/VWF,HUMAN 1 EACH UNIT

00053762005 HUMATE-P 500 UNITS KIT AHF,HUMAN/VWF,HUMAN 1 EACH UNIT

00053762010 HUMATE-P 1,000 UNITS KIT AHF,HUMAN/VWF,HUMAN 1 EACH UNIT


00053765601 MONOCLATE-P 250 UNIT KIT ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00053765602 MONOCLATE-P 500AHFU KIT ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00053765604 MONOCLATE-P 1,000 UNITS KIT ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00053765605 MONOCLATE-P 1,500 UNITS KIT ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00053766802 MONONINE 500 UNITS VIAL FACTOR IX 1 EACH UNIT

00053766804 MONONINE 1,000 UNITS VIAL FACTOR IX 1 EACH UNIT

00053813001 HELIXATE FS 250 UNIT VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT



Product


Package

Size

Medi-Cal

Billing Unit


00053813004 HELIXATE FS 1,000 UNIT VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT






00053813502 HELIXATE FS 3,000 UNITS VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00065900191 TRAVASORB HN POWDER LACTOSE-FREE FOOD 83.3 GRAMS

00065901370 RENALCAL LIQUID NUT.TX.IMP.RENAL FXN,LAC-FREE 250 MILLILITERS

00065901470 PEPTAMEN LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

00065901572 PEPTAMEN JUNIOR ULTRAPK LIQ NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

00065902270 REPLETE LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

00065902370 REPLETE W/FIBER LIQUID NUTRITIONAL SUPPLEMENT/FIBER 250 MILLILITERS

00065902470 NUTREN 1.0 LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

00065902570 NUTREN 1.0 W/FIBER LIQUID NUTRITIONAL SUPPLEMENT/FIBER 250 MILLILITERS


00065903170 NUTREN 1.0 W/FIBER LIQUID NUTRITIONAL SUPPLEMENT/FIBER 250 MILLILITERS


00065903570 NUTREN 1.5 FIBER LIQUID FOS/INULIN/NUTRIT SUPP/FIBER 250 MILLILITERS






00065904170 NUBASICS 2.0 LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

00065904270 VHC 2.25 LIQUID CALORIC SUPPLEMENT 250 MILLILITERS

00065904370 NUTREN JUNIOR LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

00065904570 NUTREN JUNIOR/FIBER LIQUID NUTRITIONAL SUPPLEMENT/FIBER 250 MILLILITERS

00065905070 CARNATION INSTANT BREAKFAST NUTRITIONAL SUPPLEMENT 250 MILLILITERS








00065906072 ENTRITION 0.5 CAL/ML LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

00065906272 ENTRITION HN 1.0 CAL/ML LIQ NUTRITIONAL SUPPLEMENT 1000 MILLILITERS




00065906870 PEPTAMEN JUNIOR-PREBIO1 LIQUID NUTRITIONAL SUPPLEMENT/FIBER 250 MILLILITERS

00065906871 PEPTAMEN JUNIOR FIBER LIQUID LACTOSE-FREE FOOD/FIBER 250 MILLILITERS

00065906872 PEPTAMEN VHP LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS




Product


Package

Size

Medi-Cal

Billing Unit

00065906970 PEPTAMEN JUNIOR LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS







00065907670 PEPTAMEN-PREBIO1 LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS



00065907870 NUTRIHEP LIQUID NUT.TX.IMPAIRED HEPATIC FXN 250 MILLILITERS

00065908070 NUTRIVENT 1.5 LIQUID NUT.TX.PULM.DISORD.REG,LAC-FR 250 MILLILITERS

00065908491 MODULEN IBD POWDER NUT.TX.IMPAIRED DIGEST FXN,SOY 400 GRAMS

00065908570 GLYTROL LIQUID NUT.TX.GLUC.INTOLER,LAC-FR,SOY 250 MILLILITERS

00065908672 GLYTROL ULTRAPAK LIQUID NUT.TX.GLUC.INTOLER,LAC-FR,SOY 1000 MILLILITERS

00065908673 GLYTROL ULTRAPAK LIQUID NUT.TX.GLUC.INTOLER,LAC-FR,SOY 1500 MILLILITERS

00065908770 PEPTAMEN 1.5 LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS



00065909270 F-A-A FREE AMINO ACID LIQ NUT.TX.IMPAIRED DIGEST FXN,SOY 250 MILLILITERS

00065909271 PEPTAMEN AF LIQUID NS COMB1/FOS/INULIN 250 MILLILITERS


00065912470 CRUCIAL LIQUID NUT.TX.COMP. IMMUNE SYSTM,SOY 250 MILLILITERS

00065912872 CRUCIAL ULTRAPAK LIQUID NUT.TX.COMP. IMMUNE SYSTM,SOY 1000 MILLILITERS

00065914072 NUTRIVENT LIQUID NUT.TX.PULM.DISORD.REG,LAC-FR 1000 MILLILITERS

00065914170 NUTREN PULMONARY LIQUID NUT.TX.PULM.DISORD.REG,LAC-FR 250 MILLILITERS


00065914270 NUTREN RENAL LIQUID NUT.TX.IMP.RENAL FXN,LAC-FREE 250 MILLILITERS



00065915272 NUTREN 1.0 WITH FIBER LIQUID NUTRITIONAL SUPPLEMENT/FIBER 1000 MILLILITERS

00065915273 NUTREN 1.0 WITH FIBER LIQUID NUTRITIONAL SUPPLEMENT/FIBER 1500 MILLILITERS







00065916270 PROBALANCE LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

00065916672 PROBALANCE ULTRAPAK LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

00065916673 PROBALANCE ULTRAPAK LIQUID NUTRITIONAL SUPPLEMENT 1500 MILLILITERS

00065916970 PEPTAMEN JUNIOR POWDER NUT.TX.IMPAIRED DIGEST FXN 400 GRAMS

00065920070 NUBASICS DRINK LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

00065920270 NUBASICS DRINK LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

00065921670 NUBASICS VHP DRINK LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

00065923081 NUBASICS BAR NUTRITIONAL SUPPLEMENT 1 EACH


00065924074 NUBASICS JUICE DRINK NUTRITIONAL SUPPLEMENT 163 MILLILITERS

00065924174 NUBASICS JUICE DRINK NUTRITIONAL SUPPLEMENT 163 MILLILITERS

00065925070 NUBASICS PLUS DRINK LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS




00065925870 NUTRIRENAL LIQUID NUT.TX.IMP.RENAL FXN,LAC-FREE 250 MILLILITERS



Product


Package

Size

Medi-Cal

Billing Unit

00065925970 NUTRIHEAL LIQUID LACTOSE-FREE FOOD 250 MILLILITERS

00065927091 ADDITIONS FOOD ENHANCER PWD PROTEIN SUPPLEMENT 947 GRAMS

00069033801 REVATIO 10 MG/12.5 ML VIAL SILDENAFIL CITRATE 12.5 MILLILITERS

00069419068 REVATIO 20 MG TABLET SILDENAFIL CITRATE 90 EACH

00074210803 LUPRON DEPOT-PED 7.5 MG KIT LEUPROLIDE ACETATE 1 EACH


00074244003 LUPRON DEPOT-PED 15 MG KIT LEUPROLIDE ACETATE 1 EACH

00074334603 LUPRON DEPOT 22.5 MG 3MO KIT LEUPROLIDE ACETATE 1 EACH

00074364103 LUPRON DEPOT 3.75 MG KIT LEUPROLIDE ACETATE 1 EACH



00074368303 LUPRON DEPOT-4 MONTH KIT LEUPROLIDE ACETATE 1 EACH

00084107901 BEE POLLEN TABLET POLLEN EXTRACTS 100 EACH

00084113401 ROYAL JELLY CAPSULE DIETARY SUPPLEMENT 100 EACH

00087001904 ENFAMIL ENFACARE LIPIL-PWDR INFANT FORMULA W-IRON 363 GRAMS

00087001942 ENFAMIL 22 POWDER INFANT FORMULA,REGULAR 397 GRAMS



00087004042 MAGNACAL RENAL LIQUID NUT.TX.IMPAIRED RENAL FXN,SOY 237 MILLILITERS

00087007447 PHENYL-FREE POWDER 1 NUT. TX FOR PKU WITH IRON #10 454 GRAMS

00087007841 LMD POWDER NUT TX FOR ISOVALERIC ACIDEMIA 454 GRAMS

00087007941 PFD 2 POWDER NUT.TX. METABOLIC DISORDER,SOY 454 GRAMS

00087008041 PHENYL-FREE 2 POWDER NUT. TX FOR PKU WITH IRON #9 454 GRAMS

00087008141 PHENYL-FREE 2HP POWDER NUT. TX FOR PKU WITH IRON #11 454 GRAMS

00087008241 TYROS 2 POWDER NUTRITIONAL TX FOR TYROSINEMIA 454 GRAMS

00087008341 BCAD2 POWDER NUTRIT.THERAPY, MSUD WITH IRON 454 GRAMS

00087008541 OA 1 POWDER INFANT FORM,PROPIONIC ACIDEMIA 454 GRAMS

00087008842 PROTAIN XL LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS


00087008942 COMPLY LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS


00087009241 WND 1 POWDER INFANT FORMULA, UREA CYCLE DIS 454 GRAMS

00087009341 WND 2 POWDER NUT.TX., UREA CYCLE DISORDER 454 GRAMS

00087009501 HCY 1 POWDER INFANT FORMULA, METABOLIC,IRON 454 GRAMS

00087009541 HCY 1 POWDER INFANT FORM, METAB, METHION-FR 454 GRAMS

00087019141 OA2 POWDER NUT. TX FOR PROPIONIC ACIDEMIA 454 GRAMS

00087019441 TYROS 1 POWDER INF FORM FOR TYROSINEMIA, IRON 454 GRAMS

00087019841 GA POWDER NUT. TX, GLUTARIC ACIDURIA I 454 GRAMS

00087019941 HCY 2 POWDER NUT.TX,METABOLIC DIS,METHIO-FR 454 GRAMS

00087026306 NUTRAMIGEN LIPIL NURSETTE INF FORMULA,SP.MET,LAC FR,IRON 177 MILLILITERS


00087026704 ENFAMIL PREMATURE LIPIL LIQ INFANT FORMULA W-IRON 89 MILLILITERS


00087033343 PREGESTIMIL LIQUID INFANT FORMULA W-IRON 89 MILLILITERS

00087033801 NUTRAMIGEN LIPIL POWDER INF FORMULA,SP.MET,LAC FR,IRON 454 GRAMS

00087034042 LOFENALAC POWDER INFANT FORMULA, METABOLIC,IRON 454 GRAMS

00087035042 SUSTACAL LIQUID LACTOSE-FREE FOOD 1 MILLILITERS

00087035101 BOOST HIGH PROTEIN LIQUID LACTOSE-FREE FOOD 355 MILLILITERS

00087035142 SUSTACAL LIQUID LACTOSE-FREE FOOD 240 MILLILITERS

00087035544 ISOCAL LIQUID LACTOSE-FREE FOOD 946 MILLILITERS

00087035546 ISOCAL LIQ KANG REDI-FEED LACTOSE-FREE FOOD 1000 MILLILITERS



00087036503 MCT OIL MEDIUM CHAIN TRIGLYCERIDES 960 MILLILITERS



Product


Package

Size

Medi-Cal

Billing Unit

00087036701 PREGESTIMIL POWDER INFANT FORMULA W-IRON 454 GRAMS

00087036842 PHENYL-FREE POWDER INFANT FORMULA,SPEC. METABOLIC 454 GRAMS

00087037943 PREGESTIMIL LIQUID INFANT FORMULA W-IRON 89 MILLILITERS

00087038701 PORTAGEN POWDER LACTOSE-FREE FOOD 454 GRAMS

00087039040 CASEC POWDER CASEIN 283 GRAMS


00087040600 BCAD 1 POWDER NUT.TX. METABOLIC DISORDER,SOY 454 GRAMS

00087041842 MSUD DIET POWDER INFANT FORMULA,SPEC. METABOLIC 454 GRAMS

00087042042 PRODUCT 80056 POWDER INFANT FORMULA,SPEC. METABOLIC 454 GRAMS

00087042441 PRODUCT 3200 AB POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS

00087042541 PRODUCT 3232A POWDER INFANT FORM,FE,LAC-FR,HYPOALR1 454 GRAMS

00087044643 ISOCAL HN LIQUID LACTOSE-FREE FOOD 946 MILLILITERS



00087046244 DELIVER 2.0 LIQUID LACTOSE-FREE FOOD 237 MILLILITERS

00087046444 TRAUMACAL LIQUID LACTOSE-FREE FOOD 237 MILLILITERS

00087047142 LIPISORB LIQUID NUTRITIONAL SUPPLEMENT/MCT 237 MILLILITERS

00087048041 MODUCAL POWDER GLUCOSE POLYMERS 368 GRAMS

00087049801 NUTRAMIGEN LIPIL LIQ CONC INF FORMULA,SP.MET,LAC FR,IRON 384 MILLILITERS

00087049901 NUTRAMIGEN LIPIL LIQUID INF FORMULA,SP.MET,LAC FR,IRON 946 MILLILITERS

00087056341 CRITICARE HN LIQUID LACTOSE-FREE FOOD 237 MILLILITERS

00087063212 NUTRAMENT LIQUID NUTRITIONAL SUPPLEMENT 355 MILLILITERS






00087064413 RESPALOR LIQUID NUT.TX.PULM.DISORD.SOY,LAC-FR 237 MILLILITERS

00087064541 BOOST NUTRITION ENERGY BAR NUTRITIONAL SUPPLEMENT 1 EACH

00087064545 BOOST NUTRITION ENERGY BAR NUTRITIONAL SUPPLEMENT 4 EACH

00087065145 RESPALOR ADV FORMULA LIQ NUT.TX.PULM.DISORD.SOY,LAC-FR 1000 MILLILITERS

00087065243 ISOCAL HN PLUS LIQUID NUTRITIONAL SUPPLEMENT 240 MILLILITERS



00087065345 CHOICE DM LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS



00087067044 BOOST ENERGY DRINK LACTOSE-FREE FOOD 237 MILLILITERS




00087067405 BOOST ENERGY DRINK NUTRITIONAL SUPPLEMENT 1 MILLILITERS











Product


Package

Size

Medi-Cal

Billing Unit
















00087087342 SUBDUE LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS





00087093145 BOOST PLUS ENERGY DRINK LACTOSE-FREE FOOD 237 MILLILITERS





















00087094343 BOOST HIGH PROTEIN POWDER LACTOSE-FREE FOOD 454 GRAMS





00087094543 BOOST PUDDING MILK BASED FORMULA 142 GRAMS



00087095144 BOOST WITH BENEFIBER LIQUID LACTOSE-FREE FOOD/FIBER 237 MILLILITERS







Product


Package

Size

Medi-Cal

Billing Unit


00087099401 PFD 1 POWDER INFANT FORMULA, METABOLIC,IRON 454 GRAMS

00087099441 PFD 1 POWDER INFANT FORMULA, METABOLIC,IRON 454 GRAMS

00087100742 SUBDUE PLUS LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS

00087123941 NUTRAMIGEN ENFLORA-LGG POWDER INF FORM,SP.MET,IRON/LACT RHAM 357 GRAMS

00087128941 ENFAPORT LIPIL RTU LIQUID INFANT FORMULA, METABOLIC,IRON 237 MILLILITERS

00087129041 NUTRAMIGEN AA LIPIL POWDER INFANT FORMULA, METABOLIC,IRON 400 GRAMS

00087129049 NUTRAMIGEN AA LIPIL POWDER INF FORM,SP.MET,LF,IRON/AA 400 GRAMS

00087139141 ENFAMIL PREMATURE LIPIL NURSET INFANT FORMULA W-IRON 59 MILLILITERS

00087139441 ENFAMIL PREMATURE LIPIL NURSET INFANT FORMULA W-IRON 59 MILLILITERS




00087201448 ENFAMIL POWDER PACKET INFANT FORMULA W-IRON 100 EACH

00087270242 BOOST BREEZE ENERGY DRINK LACTOSE-FREE FOOD 237 MILLILITERS




00087405541 PKU 1 POWDER INFANT FORMULA,SPEC. METABOLIC 500 GRAMS

00087405641 PKU 2 POWDER NUT. TX FOR PKU WITH IRON #21 500 GRAMS


00087406041 MSUD 1 POWDER INFANT FORMULA,SPEC. METABOLIC 500 GRAMS

00087406042 BCAD 1 POWDER INFANT FORMULA,SPEC.METAB MSUD 454 GRAMS

00087406141 MSUD 2 POWDER NUTRITIONAL SUPPLEMENT 500 GRAMS

00087406541 HOM 1 POWDER INFANT FORMULA,SPEC. METABOLIC 500 GRAMS

00087406641 HOM 2 POWDER NUTRITIONAL SUPPLEMENT 500 GRAMS

00087407041 UCD 1 POWDER INFANT FORMULA,SPEC. METABOLIC 500 GRAMS

00087407141 UCD 2 POWDER NUTRITIONAL SUPPLEMENT 500 GRAMS

00087407541 LYS 1 POWDER INFANT FORMULA,SPEC. METABOLIC 500 GRAMS

00087407641 LYS 2 POWDER NUTRITIONAL SUPPLEMENT 500 GRAMS

00087408041 HIST 1 POWDER INFANT FORMULA,SPEC. METABOLIC 500 GRAMS

00087408141 HIST 2 POWDER NUTRITIONAL SUPPLEMENT 500 GRAMS

00087408541 TYR 1 POWDER INFANT FORMULA,SPEC. METABOLIC 500 GRAMS

00087408641 TYR 2 POWDER NUTRITIONAL SUPPLEMENT 500 GRAMS

00087409041 OS 1 POWDER INFANT FORMULA,SPEC. METABOLIC 500 GRAMS

00087409141 OS 2 POWDER NUT. TX FOR PROPIONIC ACIDEMIA 500 GRAMS


00087435942 ULTRACAL LIQUID NUTRITIONAL SUPPLEMENT/FIBER 946 MILLILITERS


00087435946 ULTRACAL LIQ READY-TO-HANG LACTOSE-FREE FOOD 1000 MILLILITERS

00087436143 ULTRACAL HN PLUS LIQUID NUTRITIONAL SUPPLEMENT/FIBER 240 MILLILITERS



00087436241 INTENSICAL LIQUID NUT.TX. METABOLIC DISORDER,REG 1000 MILLILITERS



Product


Package

Size

Medi-Cal

Billing Unit


00165008860 DIASENSE CHROMIUM CAPSULE CHROMIUM POLYNICOTIN/ALIP ACID 60 EACH

00169701001 NOVOSEVEN RT 1,000 MCG VIAL COAGULATION FACTOR VIIA RECOMB 1 EACH MCG




00169706001 NOVOSEVEN 1,200 MCG VIAL COAGULATION FACTOR VIIA RECOMB 1 EACH MCG



00169770311 NORDITROPIN NORDIFLEX 30 MG/3 SOMATROPIN 3 MILLILITERS

00169770411 NORDITROPIN NORDIFLEX 5 MG/1.5 SOMATROPIN 1.5 MILLILITERS

00169770421 NORDITROPIN FLEXPRO 5 MG/1.5 SOMATROPIN 1.5 MILLILITERS

00169770511 NORDITROPIN NORDIFLX 10 MG/1.5 SOMATROPIN 1.5 MILLILITERS


00169770811 NORDITROPIN NORDIFLX 15 MG/1.5 SOMATROPIN 1.5 MILLILITERS


00169776811 NORDITROPIN 5 MG/1.5 ML CRTG SOMATROPIN 1.5 MILLILITERS


00169777411 NORDITROPIN 4 MG VIAL SOMATROPIN 1 EACH

00169777812 NORDITROPIN 8 MG VIAL SOMATROPIN 1 EACH

00182315499 LEUPROLIDE 1 MG/0.2 ML KIT LEUPROLIDE ACETATE 1 EACH

00185740085 LEUPROLIDE 2WK 1 MG/0.2 ML KT LEUPROLIDE ACETATE 1 EACH

00187015206 NITEBITE BAR PROTEIN SUPPLEMENT/STARCH/SUC 6 EACH




00212024101 NUTRISOURCE LIPID MCT LIQ DIETARY SUPPLEMENT 250 MILLILITERS

00212024201 NUTRISOURCE LIPID LCT LIQ DIETARY SUPPLEMENT 250 MILLILITERS


00212140151 COMPLEAT MODIFIED LIQUID LACTOSE-FREE FOOD 250 MILLILITERS



00212142451 COMPLEAT PEDIATRIC FORMULA MILK BASED FORMULA 250 MILLILITERS

00212144217 IMPACT RECOVER PACKET NUT.TX.COMP. IMMUNE SYSTM,REG 30 EACH



00212161142 SANDOSOURCE PEPTIDE LIQUID LACTOSE-FREE FOOD 1000 MILLILITERS



00212162142 IMPACT GLUTAMINE LIQUID NUT.TX.COMP.IMMUNE SYS/SOY FIB 1000 MILLILITERS


00212175562 RESOURCE SUPPORT LIQUID NUT.TX.COMP. IMMUNE SYSTM,REG 237 MILLILITERS




Product


Package

Size

Medi-Cal

Billing Unit


00212180162 RESOURCE 2.0 LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS

00212181551 ISOSOURCE 1.5 CAL LIQUID LACTOSE-FREE FOOD/FIBER 250 MILLILITERS



00212182551 ISOSOURCE LIQUID LACTOSE-FREE FOOD 250 MILLILITERS



00212183551 FIBERSOURCE LIQUID NUTRITIONAL SUPPLEMENT/FIBER 250 MILLILITERS

00212184551 ISOSOURCE HN LIQUID LACTOSE-FREE FOOD 250 MILLILITERS



00212185551 FIBERSOURCE HN LIQUID NUTRITIONAL SUPPLEMENT/FIBER 250 MILLILITERS

00212186062 RESOURCE BREEZE LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS




00212188542 NOVASOURCE PULMONARY LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS



00212195001 NUTRISOURCE PROTEIN POWDER PROTEIN SUPPLEMENT 20 GRAMS

00212195562 IMPACT ADVANCED RECOVERY LIQ NUT.TX.COMP. IMMUNE SYSTM,REG 237 MILLILITERS


00212196301 NUTRISOURCE MINERAL/PROTEIN PROTEIN SUPPLEMENT/MINERALS 24 GRAMS

00212196401 NUTRISOURCE MINERAL/PROT ER PROTEIN SUPPLEMENT/MINERALS 24 GRAMS

00212196662 RESOURCE ARGINAID EXTRA PK NUTRITIONAL SUPPLEMENT 237 MILLILITERS

00212196762 RESOURCE ARGINAID EXTRA LIQ NUTRITIONAL SUPPLEMENT 237 MILLILITERS

00212282580 RESOURCE BENECALORIE LIQUID CALORIC SUPPLEMENT 41.3 GRAMS

00212283378 RESOURCE GLUTASOLVE PACKET NUT.TX.IMPAIRED DIGEST FXN 14 EACH

00212284107 RESOURCE BENEPROTEIN POWDER PROTEIN SUPPLEMENT 227 GRAMS

00212284371

RESOURCE BENEPROTEIN INST

POWD PROTEIN SUPPLEMENT 75 EACH

00212331162 RESOURCE JUST FOR KIDS LIQ NUTRITIONAL SUPPLEMENT 237 MILLILITERS



00212331462 RESOURCE WITH FIBER LIQUID LACTOSE-FREE FOOD/FIBER 237 MILLILITERS


00212332062 RESOURCE JUST FOR KIDS LIQ NUTRITIONAL SUPPLEMENT/FIBER 237 MILLILITERS

00212337162 RESOURCE LIQUID LACTOSE-FREE FOOD 237 MILLILITERS



00212338162 RESOURCE PLUS LIQUID LACTOSE-FREE FOOD 237 MILLILITERS



00212351142 NOVASOURCE RENAL LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS


00212355142 RESOURCE DIABETIC TF LIQUID NUT.TX.GLUCOSE INTOLERANCE,SOY 1000 MILLILITERS

00212355244 RESOURCE DIABETIC TF LIQUID NUT.TX.GLUCOSE INTOLERANCE,SOY 1500 MILLILITERS

00212358134 IMPACT LIQUID LACTOSE-FREE FOOD 250 MILLILITERS

00212358142 IMPACT LIQUID NUT.TX.COMP. IMMUNE SYSTM,REG 1000 MILLILITERS

00212358151 IMPACT LIQUID NUT.TX.COMP. IMMUNE SYSTM,REG 250 MILLILITERS

00212358742 IMPACT WITH FIBER LIQUID NUT.TX.COMP.IMMUNE SYS/SOY FIB 1000 MILLILITERS



Product


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Size

Medi-Cal

Billing Unit


00212358951 IMPACT 1.5 LIQUID NUT.TX.COMP. IMMUNE SYSTM,REG 250 MILLILITERS

00212360162 BOOST DIABETIC LIQUID NUT.TX.GLUCOSE INTOLERANCE,SOY 237 MILLILITERS



00212362542 VIVONEX RTF LIQUID NUT.TX.IMPAIRED DIGEST FXN,SOY 1000 MILLILITERS



00212365051 DIABETISOURCE AC LIQUID NUT.TX.GLUCOSE INTOL,SOY/FIBER 250 MILLILITERS



00212370142 PEPTINEX DT LIQUID NUT.TX.IMPAIRED DIGEST FXN,SOY 1000 MILLILITERS



00212371162 PEPTINEX LIQUID NUT.TX.IMPAIRED DIGEST FXN,SOY 237 MILLILITERS

00212375151 PEDIATRIC PEPTINEX DT LIQ NUT.TX.IMPAIRED DIGEST FXN,SOY 250 MILLILITERS

00212375251 PEDIATRIC PEPTINEX DT LIQ NUT TX IMP.DIGEST FXN,SOY&FIB2 250 MILLILITERS

00212375751 PEPTINEX DT LIQUID NUT TX IMP.DIGEST FXN,SOY&FIB1 250 MILLILITERS

00212458072 TOLEREX PACKET LACTOSE-FREE FOOD 60 EACH

00212598375 RESOURCE ARGINAID PACKET NUTRITIONAL SUPPLEMENT 14 EACH





00212713176 VIVONEX PEDIATRIC PACKET LACTOSE-FREE FOOD 6 EACH

00212727873 VIVONEX T.E.N. POWDER PKT LACTOSE-FREE FOOD 60 EACH

00212729818 VIVONEX PLUS PACKET LACTOSE-FREE FOOD 36 EACH




00212941313 BOOST HIGH PROTEIN ENERGY DRNK LACTOSE-FREE FOOD 237 MILLILITERS

00221110001 FIBRE COOKIES NUTRITIONAL SUPPLEMENT/FIBER 12 EACH

00221111005 NUTRA/SHAKE CITRUS LIQUID LACTOSE-FREE FOOD 118 MILLILITERS

00221111006 NUTRA/SHAKE CITRUS LIQ LACTOSE-FREE FOOD 118 MILLILITERS





00221180001 PROTEIN FORTIFIED COOKIE NUTRITIONAL SUPPLEMENT 1 EACH



00221180005 CALCIUM FORTIFIED COOKIE NUTRITIONAL SUPPLEMENT 1 EACH

00221201003 NU/TASTE LACTOSE FREE LIQ LACTOSE-FREE FOOD 236 MILLILITERS

00221301001 PRO/VIDE LIQUID LACTOSE-FREE FOOD 118 MILLILITERS






00221501003 JUICE PLUS FIBRE LIQUID NUTRITIONAL SUPPLEMENT/FIBER 295 MILLILITERS



Product


Package

Size

Medi-Cal

Billing Unit

00221501004 JUICE PLUS FIBRE LIQUID NUTRITIONAL SUPPLEMENT/FIBER 295 MILLILITERS

00221501006 ORANGE JUICE ORANGE JUICE 240 MILLILITERS

00221501007 APPLE JUICE APPLE JUICE 240 MILLILITERS

00221501008 GRAPE JUICE GRAPE JUICE 240 MILLILITERS

00221501009 ORANGE/PINEAPPLE JUICE ORANGE JUICE/PINEAPPLE JUICE 240 MILLILITERS

00221703101 LACTA/CARE LIQUID NUTRITIONAL SUPPLEMENT 118 MILLILITERS



00221804003 VANILLA NUTRA/SHAKE LIQUID NUTRITIONAL SUPPLEMENT 118 MILLILITERS

00221804004 CHOCOLATE NUTRA/SHAKE LIQ NUTRITIONAL SUPPLEMENT 118 MILLILITERS

00221804005 STRAWBERRY NUTRA/SHAKE LIQ NUTRITIONAL SUPPLEMENT 118 MILLILITERS

00221804006 LEMON NUTRA/SHAKE LIQUID NUTRITIONAL SUPPLEMENT 118 MILLILITERS

00221804104 VANILLA NUTRA/SHAKE LIQUID NUTRITIONAL SUPPLEMENT 118 MILLILITERS

00221804105 DECAF COFFEE NUTRA/SHAKE LQ NUTRITIONAL SUPPLEMENT 118 MILLILITERS

00221804106 CHOCOLATE NUTRA/SHAKE LIQ NUTRITIONAL SUPPLEMENT 118 MILLILITERS


00221901001 VANILLA LOW LACTOSE POWDER NUTRITIONAL SUPPLEMENT 413 GRAMS

00221902001 NONFAT DRY MILK POWDER NUTRITIONAL SUPPLEMENT 50 EACH

00221902002 NONFAT DRY MILK POWDER NUTRITIONAL SUPPLEMENT 16 EACH

00221911002 EGG/PRO POWDER PACKETS ALBUMEN (ALBUMIN) 6 EACH

00264303024 IMMUN-AID POWDER NUT.TX.COMP. IMMUNE SYSTM,REG 123 GRAMS

00264601524 IMMUN-AID POWDER NUTRITIONAL SUPPLEMENT 129 GRAMS

00264610048 AMIN-AID INSTANT DRINK NUTRITIONAL SUPPLEMENT 1 GRAMS



00264620324 TRAUM-AID HBC DIET NUTRITIONAL SUPPLEMENT 135 GRAMS



00264640124 NUTRI-AID LIQUID LACTOSE-FREE FOOD 240 MILLILITERS



00264650124 HEPATIC-AID DRINK NUTRITIONAL SUPPLEMENT 135 GRAMS




00264652224 HEPATIC-AID II DRINK NUTRITIONAL SUPPLEMENT 93 GRAMS

00264928821 HEPATIC-AID II DRINK NUT.TX. METABOLIC DISORDER,SOY 90 GRAMS





00300244001 LUPRON DEPOT-PED 15 MG KIT LEUPROLIDE ACETATE 1 EACH


00300361224 LUPRON 1 MG/0.2 ML VIAL LEUPROLIDE ACETATE 2.8 MILLILITERS

00300361228 LUPRON 2-WK 1 MG/0.2 ML KIT LEUPROLIDE ACETATE 1 EACH




00300368301 LUPRON DEPOT-4 MONTH KIT LEUPROLIDE ACETATE 1 EACH

00338900891 TRAVASORB HEPATIC POWDER NUTRITIONAL SUPPLEMENT 1 GRAMS

00338900991 TRAVASORB HEPATIC POWDER NUTRITIONAL SUPPLEMENT 1 GRAMS

00338917391 SYMPT-X PLUS POWDER GLUTAMINE/VIT A,C & E/SELENIUM 650 GRAMS

00338917991 SYMPT-X PLUS PACKET GLUTAMINE/VIT A,C & E/SELENIUM 60 EACH

00338918091 SYST-AMUNE PACKET A-CYSTEINE/GLUT/VIT A,C & E/SE 60 EACH



Product


Package

Size

Medi-Cal

Billing Unit

00338918291 SYST-AMUNE POWDER A-CYSTEINE/GLUT/VIT A,C & E/SE 650 GRAMS

00338919091 PREVENT-X PACKET A-CYSTEINE/GLUT/VIT A,C & E/SE 60 EACH

00338919291 RESTORE-X PACKETS A-CYSTEINE/ARG ZN/GLUT/MV-MN 60 EACH

00364723816 PROTEIN PLUS POWDER PROTEIN SUPPLEMENT 454 GRAMS

00406805003 LEUPROLIDE ACETATE POWDER LEUPROLIDE ACETATE 0.005 GRAMS



00536193807 COENZYME Q-10 100 MG SOFTGEL UBIDECARENONE 30 EACH

00536203007 COENZYME Q10 200 MG CAPS UBIDECARENONE/VITAMIN E MIXED 30 EACH


00703402419 LEUPROLIDE 1 MG/0.2 ML VIAL LEUPROLIDE ACETATE 2.8 MILLILITERS

00781300107 OMNITROPE 5 MG/1.5 ML CRTG SOMATROPIN 1.5 MILLILITERS






00781400436 OMNITROPE 5.8 MG VIAL SOMATROPIN 1 EACH

00781401471 OMNITROPE 5.8 MG VIAL SOMATROPIN 1 EACH

00847035501 PHENYLADE PHEBLOC TABLET NUTRITIONAL TX FOR PKU #33 550 EACH

00847059000 COMPLEX MSD AMINO ACID POWDER NUTRIT. TX, MSUD WITHOUT IRON 454 GRAMS

00847059722 COMPLEX MSD ESSENTIAL POWDER NUTRIT.THERAPY, MSUD WITH IRON 454 GRAMS

00847059822 COMPLEX MSUD DRINK MIX PWDR NUTRIT.THERAPY, MSUD WITH IRON 454 GRAMS

00847095000 PHENYLADE AMINO ACID POWDER NUTRITIONAL TX FOR PKU #31 454 GRAMS

00847095004 PHENYLADE AMINO ACID POWDER NUTRITIONAL TX FOR PKU #31 30 EACH

00847095012 PHENYLADE ESSENTIAL DRINK POWD NUT. TX FOR PKU WITH IRON #35 454 GRAMS

00847095014 PHENYLADE ESSENTIAL POWDER NUT. TX FOR PKU WITH IRON #35 16 EACH







00847095112 PHENYLADE DRINK MIX POWDER NUT. TX FOR PKU WITH IRON #27 454 GRAMS



00847095404 PHENYLADE40 DRINK MIX PWDER NUT. TX FOR PKU WITH IRON #27 20 EACH

00847095414 PHENYLADE40 DRINK MIX PWDER NUT. TX FOR PKU WITH IRON #27 20 EACH


00847095501 PHENYLADE PHEBLOC TABLET NUTRITIONAL TX FOR PKU #33 550 EACH

00847095602 PHENYLADE60 DRINK MIX POWDER NUT. TX FOR PKU WITH IRON #27 454 GRAMS

00847095604 PHENYLADE60 POWDER PACKET NUT. TX FOR PKU WITH IRON #27 30 EACH

00847095622 PHENYLADE60 DRINK MIX POWDER NUT. TX FOR PKU WITH IRON #27 454 GRAMS

00847095624 PHENYLADE60 POWDER PACKET NUT. TX FOR PKU WITH IRON #27 30 EACH

00847095706 PHENYLADE AMINO ACID BAR NUTRITIONAL TX FOR PKU #31 1 EACH





Product


Package

Size

Medi-Cal

Billing Unit

00847095960 PHENYLADE MTE AMINO ACID POWD NUTRITIONAL TX FOR PKU #31 454 GRAMS

00847095964 PHENYLADE MTE AMINO ACID POWD NUTRITIONAL TX FOR PKU #31 30 EACH

00847590000 COMPLEX MSD AMINO ACID POWDER NUTRIT. TX, MSUD WITHOUT IRON 454 GRAMS

00847598060 COMPLEX MSUD AMINO ACID BAR NUTRIT. TX, MSUD WITHOUT IRON 12 EACH

00904315560 BEE POLLEN 500 MG TABLET BEE POLLEN 100 EACH

00904404360 FISH OIL 1,000 MG CAPSULE OMEGA-3 FATTY ACIDS/FISH OIL 100 EACH

00904424616 PROTEIN POWDER PROTEIN SUPPLEMENT 454 GRAMS

00904501546 COENZYME Q10 30 MG SOFTGEL UBIDECARENONE 30 EACH

00904527152 DHEA TABLET PRASTERONE (DHEA)/CAL PHOS 60 EACH

00904547160 CASCARA SAGRADA 450 MG CAP CASCARA SAGRADA 100 EACH

00904547352 GLUCOSAMINE-MSM COMPLEX TAB GLUCOSAM/MSM/VIT C/MANG/HRB#21 60 EACH

00904549473 PROSIGHT W/LUTEIN CAPSULE VIT C/VIT E AC/LUT/MINERAL 1 36 EACH

00904552046 SOY ISOFLAVONES 102-40 MG TB CALCIUM CARBONATE/SOY ISOFLAV 30 EACH

00904559589 APPLE CIDER VINEGAR TABLET PECT/B-6/MIN COMBO NO.4/CIDER 90 EACH

00904560413 FISH OIL 500 MG SOFTGEL SALMON OIL/OMEGA-3 FATTY ACIDS 130 EACH


00904561646 CO-ENZYME Q-10 50 MG SOFTGEL UBIDECARENONE 30 EACH

00904561746 COENZYME Q-10 75MG SOFTGEL UBIDECARENONE 30 EACH

00904562252 V-MAX FOR HIM TABLET ARGNIN/CA CARB/SAW PAL/HRB73 60 EACH

00904566752 V-MAX FOR HER TABLET ARGNIN/CA CARBONATE/HRB72 60 EACH

00904576052 PRO-ESTRO D CAPSULE CAFFEINE/PRAST (DHEA)/B6/HC132 60 EACH

00904576189 RELAFORM CAPSULE PRAST (DHEA)/VIT BCOMP&C/HC134 90 EACH

00904576297 LEPTOFORM-SD CAPSULE CAFFEINE/NIA/VIT B6/HRB CB133 95 EACH




00904590689 CHOLESTEROL MANAGEMENT TABLET C/NIAC/CHROM POLYNICOTIN/OAT/P 90 EACH

00904604089 CALCIUM PYRUVATE 750 MG CAP CALCIUM PYRUVATE 90 EACH

00944047169 POLYGAM S-D 0.5 GM VL-DILUENT IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00944047172 POLYGAM S-D 2.5 GM VL-DILUENT IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00944047175 POLYGAM S-D 5 GM VIAL-DILUENT IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00944047180 POLYGAM S-D 10 GM VIAL-DILUENT IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00944058101 PROPLEX T 300-1,200 UNITS VIAL FACTOR IX COMPLEX HUMAN 1 EACH UNIT

00944130110 MONARC-M 220-400 UNITS VIAL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00944130210 MONARC-M 401-800 UNITS VIAL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00944130310 MONARC-M 801-1,700 UNITS VIAL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00944130410 MONARC-M 1,701-2,000 UNITS VL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00944262001 GAMMAGARD S-D 0.5 GM VL W-ST IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00944262002 GAMMAGARD S-D 2.5 GM VL W/ST IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00944262003 GAMMAGARD S-D 5 GM VL W/SET IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00944262004 GAMMAGARD S-D 10 GM VL W/ST IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00944265503 GAMMAGARD S-D 5 G (IGA<1) SOLN IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00944265504 GAMMAGARD S-D 10 G (IGA<1) SOL IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

00944270002 GAMMAGARD LIQUID 10% VIAL IMMUNE GLOBULIN,GAMMA (IGG) 10 MILLILITERS






Product


Package

Size

Medi-Cal

Billing Unit


00944283110 RECOMBINATE 220-400 UNIT VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00944283210 RECOMBINATE 401-800 UNIT VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00944283310 RECOMBINATE 801-1,240 UNIT VL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00944283410 RECOMBINATE 1,241-1,800 UNIT V ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00944283510 RECOMBINATE 1,801-2,400 UNIT V ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00944293001 HEMOFIL M 220-400 UNITS VIAL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT


00944293201 HEMOFIL M 801-1,700 UNITS VIAL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00944293301 HEMOFIL M 1,701-2,000 UNITS VL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT



00944293503 HEMOFIL M 801-1,700 UNITS VIAL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00944293504 HEMOFIL M 1,701-2,000 UNITS VL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

00944293801 RECOMBINATE 220-400 UNIT VL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00944293802 RECOMBINATE 401-800 UNIT VL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00944293803 RECOMBINATE 801-1,240 UNITS VL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT

00944294001 ADVATE 250 UNITS VIAL ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH UNIT

00944294002 ADVATE 500 UNITS VIAL ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH UNIT

00944294003 ADVATE 1,000 UNITS VIAL ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH UNIT

00944294004 ADVATE 1,500 UNITS VIAL ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH UNIT

00944294010 ADVATE 1,800-2,200 UNITS VIAL ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH UNIT

00944294110 ADVATE 200-400 UNITS VIAL ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH UNIT

00944294210 ADVATE 401-800 UNITS VIAL ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH UNIT

00944294310 ADVATE 801-1,200 UNITS VIAL ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH UNIT




01769083036 CARDIA SALT ALTERNATIVE PKT SOD CHLORIDE/POT CHLORIDE/MAG 50 EACH

01769099588 DIACHROME CAPSULE BIOTIN/CHROMIUM PICOLINATE 60 EACH

04795035001 CAMINO PRO 15 PKU BETTER MILK NUT. TX FOR PKU WITH IRON #41 1 EACH

07249091101 EGG-PRO POWDER ALBUMEN (ALBUMIN) 283 GRAMS

07249091104 NUTRA-PRO HIGH PROTEIN POWDER NUTRITIONAL SUPPLEMENT 26 GRAMS

07249091105 NUTRA-PRO HIGH PROTEIN POWDER NUTRITIONAL SUPPLEMENT 26 GRAMS

07249404010 RE-GEN LIQUID NUTRITIONAL SUPPLEMENT 200 MILLILITERS






08187570011 RESURGEX SUSPENSION NUT.TX.COMP. IMMUNE SYSTM,REG 240 MILLILITERS

08187570012 RESURGEX SUSPENSION NUT.TX.COMP. IMMUNE SYSTM,REG 240 MILLILITERS

08187570013 PROSURGEX SUSPENSION NUT.TX.COMP. IMMUNE SYSTM,REG 240 MILLILITERS



Product


Package

Size

Medi-Cal

Billing Unit

08187570021 RESURGEX POWDER PACKET NUT.TX.COMP. IMMUNE SYSTM,REG 15 EACH



08187570031 RESURGEX PLUS POWDER PACKET NUT.TX.COMP. IMMUNE SYSTM,REG 15 EACH



08187570041 RESURGEX SELECT POWDER PACKET NUT.TX.COMP. IMMUNE SYSTM,REG 15 EACH



08884301500 PRE-ATTAIN LIQUID NUTRITIONAL SUPPLEMENT 1 MILLILITERS





08884307508 K.D.S. PRE-ATTAIN LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

08884308506 K.D.S. VITANEED LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

08884309512 K.D.S. COMPLY UNFLAV LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

08884310800 MAGNACAL LIQUID NUTRITIONAL SUPPLEMENT 1 MILLILITERS




08884381818 VITANEED LIQUID NUTRITIONAL SUPPLEMENT 1 MILLILITERS

08884390600 PROPAC PROTEIN POWDER PROTEIN SUPPLEMENT 1 GRAMS

10135020201 SHARK FIN CARTILAGE CAPSULE SHARK CARTILAGE 100 EACH




10454071010 MYOBLOC 2,500 UNIT/0.5 ML VIAL RIMABOTULINUMTOXINB 0.5 MILLILITERS

10454071110 MYOBLOC 5,000 UNITS/1 ML VIAL RIMABOTULINUMTOXINB 1 MILLILITERS


10939003722 CO Q-10 10 MG SOFTGEL UBIDECARENONE 60 EACH

10939015344 SM ESTRO VITAL NUTRIENTS CPLT VIT B COMP/VIT E/FA/HB#156 28 EACH

10939032433 SM ESTROPLUS CAPLET VIT B COMP/E/MINERAL 3/ISOFL 1 30 EACH

10939048722 V-R MEMORY COMPLEX CAPLET VIT C/VIT E ACETATE/SE/GNK 60 EACH

10939048922 V-R IMMUNE SUPP COMPLEX CPL VIT C/ZN/K.GIN/ROSE HIPS/HRB62 60 EACH

10939075133 SM COENZYME Q-10 100 MG SFTGL UBIDECARENONE 30 EACH

10939080022 V-R COENZYME Q-10 50 MG SFGL UBIDECARENONE 30 EACH

10939085833 SM ESTRO VITAL NUTRIENTS CPLT VIT B COMP/VIT E AC/FA/HC 104 56 EACH

11694085101 SALMON OIL-1,000 CAPSULE SALMON OIL/OMEGA-3 FATTY ACIDS 100 EACH

11694085105 SALMON OIL-1,000 CAPSULE SALMON OIL/OMEGA-3 FATTY ACIDS 650 EACH

11694088805 ALGA-K CAPSULE VITAMIN A/KELP 1000 EACH

11822002380 RA BEE POLLEN 500 MG TAB CHEW BEE POLLEN 100 EACH

11822006540 RA BALANCED NUTRITION DRINK LACTOSE-FREE FOOD 237 MILLILITERS

11822009310 RA CHROMIUM PICOLINATE TABLET CHROMIUM PICOLINATE/VITAMIN D3 100 EACH

11822014650 RA FISH OIL 1,000 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH

11822119580 RA COENZYME Q-10 100 MG SOFTGL UBIDECARENONE 30 EACH

11822300530 RA BALANCED NUTRIT PLUS DRINK LACTOSE-FREE FOOD 237 MILLILITERS





Product


Package

Size

Medi-Cal

Billing Unit

11822302380 RA BEE POLLEN 500 MG TABLET BEE POLLEN 100 EACH

11822334120 RA BEE POLLEN 500 MG TABLET BEE POLLEN 100 EACH

11822358530 METABODS CAPLET VIT E AC/MIN/BOV CPLX/HRB37 90 EACH







11822449580 RA COENZYME Q-10 100 MG SOFTGL UBIDECARENONE 30 EACH


11822575670 CLA 100 MG CAPSULE LINOLEIC ACID, CONJUGATED 60 EACH

11822576090 RA MSM 1,000 MG CAPSULE METHYLSULFONYLMETHANE 120 EACH

11822880180 RA BEE POLLEN 500 MG TB CHEW BEE POLLEN 100 EACH

11822880570 RA COENZYME Q-10 30 MG CAP UBIDECARENONE 50 EACH



11822881100 RA SAW PALMETTO COMPLEX ZN GLUC/PUMP SEED OIL/SAW PAL 40 EACH

11822985480 RA SAW PALMETTO COMPLEX ZN GLUC/PUMP SEED OIL/SAW PAL 30 EACH


11822990790 RA NATURAL CO-Q10 10 MG TAB UBIDECARENONE 100 EACH

11822990920 RA MELATONIN W/VIT B-6 TAB MELATONIN/PYRIDOXINE 120 EACH

11845012230 FISH OIL 1,000 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 200 EACH


11845012622 MSM 1,000 MG CAPSULE METHYLSULFONYLMETHANE 120 EACH





11845013435 BLOOD SUGAR BALANCE TABLET ALIP ACID/BIOTIN/MIN 16/HRB91 60 EACH

11845013498 VEINERECT CAPSULE CALCIUM CARB/ARGININE/MACA 80 EACH

11845013515 LIVER-KIDNEY CLEANSER CAP CA PHOS/CRANB EXT/MILK THISTLE 60 EACH

11845013608 CHITOSAN-PLUS TABLET CHROMIUM PICOLINATE/CHITOSAN 80 EACH

11845013749 METABO-EPHEDRA FREE CAPLET VIT E AC/MIN/BOV CPLX/HRB38 90 EACH

11845013805 CARBO GRABBER TABLET GUARANA/CR/VANAD/S.GINSG/HRB40 60 EACH

11845013831 THE ELIMINATOR CAPSULE LECITH/PYRIDOX HCL/I2/CIDER 100 EACH

11845013848 THE TRAPPER TABLET CHROMIUM PICOLINATE/CHITOSAN 80 EACH

11845013855 BURN CALORIES TABLET GUARANA/CHRM/GR T/YRB MAT/HB39 60 EACH

11845013951 APPLE CIDER VINEGR 500 MG TB CIDER VINEGAR 100 EACH

11845014015 IMMUNE TRIO CAPLET COLOSTRUM/SE/GR TEA/MUSH CMB1 60 EACH

11845014062 MSM 500 MG CAPSULE METHYLSULFONYLMETHANE 120 EACH


11845014115 CO Q-10-VIT E-FISH OIL SFGL UBIDECARENONE/OMEGA-3/VIT E 60 EACH

11845014165 APPLE CIDER VINEGAR PLUS TB CHRM/CIDER/DR BT-ORG PEEL/GR T 60 EACH

11845014275 DIABETES TRIO CAPLET ALIP ACID/CAL PHOS/CR/FENUGR 60 EACH

11845014288 BLACK COHOSH-FLAXSEED-SOY CPLT CA CARB/SOYB XT/FLAX/BLK COH 30 EACH

11845014349 LIQUITHIN SOFTGEL LECITH/PYRIDOX HCL/I2/CIDER 50 EACH

11845014355 GREEN TEA SLIM TABLET CHRM/CIDER/DR BT-ORG PEEL/GR T 60 EACH

11845014358 GREEN TEA SLIM TABLET CHRM/CIDER/DR BT-ORG PEEL/GR T 30 EACH

11845014375 4 SURE SLIM CAPSULE CR NICOTIN/GLUCO/BN/CHIT/H102 60 EACH



Product


Package

Size

Medi-Cal

Billing Unit

11845014385 MEN'S POTENT SUPREME CAPLET GUARA/M-18/YHBK/K.GINSG/MACA 60 EACH

11845014435 PROSTATE THERAPY SOFTGEL M-17/NETTLE/PUMPK/SAW PALMET 60 EACH

11845014518 FOREVER YOUNG TRIO SOFTGEL LYCOPENE/LUT XT/FRUIT EXTRACTS 30 EACH

11845014562 COLLAGEN PLUS VIT C CAPSULE ASCORBIC ACID/COLLAGEN HYDR 120 EACH

11845014578 CO Q-10 200 MG CAPSULE UBIDECARENONE 30 EACH

11845014608 CO Q-10 50 MG SOFTGEL UBIDECARENONE/VITAMIN E 30 EACH


11845014868 FRUIT & VEGETABLE DAILY SFTGEL LYCOPENE/LUT XT/FRUIT EXTRACTS 30 EACH

11845014882 SALMON OIL 1,000 MG SOFTGEL SALMON OIL/OMEGA-3 FATTY ACIDS 120 EACH

11845014895 RED WINE EXTRACT PLUS CAPSULE VIT C/DIETARY COMBO NO.18 60 EACH

11845014905 SOUTH AFRICAN HOODIA PLUS CAP HOODIA/B COMP/HERBAL COMP. 152 60 EACH


11845014951 FISH OIL 1,000 MG SOFTGEL DR OMEGA-3 FATTY ACIDS/FISH OIL 100 EACH

11845014965 DIETER'S DETOX CAPSULE CR NICOTIN/GLUCO/BN/CHIT/H102 60 EACH

11845015009 TART CHERRY CAPSULE VIT C/CHERRY & CELERY EX/GRP E 90 EACH

11845015035 OMEGA 3-6-9 1,200 MG SOFTGEL FISH OIL/FAT NO.8/HRB COMB.137 60 EACH

11845015189 CLA 1,000 MG SOFTGEL SAFFLOWER OIL/LINOLEIC ACID,CO 50 EACH

11845015209 CO Q-10 RED YEAST RICE SOFTGEL UBIDECARENONE/RED YEAST RICE 50 EACH

11845015235 KIDS OMEGA-3 WITH DHA GUMMMIES OMEGA-3/DHA/EPA/TUNA OIL 60 EACH

11845015375 CALCIUM-D3-GLUCOSAM-CHOND TAB CA CARB/D3/GLUC/CHNDR/SY IS/BR 60 EACH

11845015405 MINUS WEIGHT PLUS ENERGY CAP VIT C/B6/B5/MAGNESIUM/HERB#173 60 EACH

11845015845 CHIA OIL 1,000 MG SOFTGEL CHIA SEED/ALA/LINOLEIC/OLEIC 60 EACH

11845015995 BRAIN MIGHT-DHA-CO Q10 TABLET VIT B CMPLX & C#11/CA/DHA/Q10 60 EACH

11845067901 BEE POLLEN 500 MG TABLET CHW BEE POLLEN 100 EACH

11845068013 PROTEIN POWDER PROTEIN SUPPLEMENT 480 GRAMS

11845074120 BEE POLLEN GRANULES BEE POLLEN 300 GRAMS

11845077201 S.O.D. 2,000 UNITS TABLET SUPER OXIDE DISMUTASE 100 EACH

11845079501 BEE POLLEN 1,000 MG TAB CHEW BEE POLLEN 100 EACH

11845079805 ROYAL JELLY 200 MG CAPSULE ROYAL JELLY 60 EACH

11845092805 Q-10 CO-ENZYME 10 MG SOFTGEL UBIDECARENONE 60 EACH




11845109008 PYCNOGENOL 25 MG TABLET PROCYANIDOLIC OLIGOMERS 30 EACH


11845111405 MELATONIN TABLET MELATONIN/PYRIDOXINE 60 EACH

11845111505 MELATONIN SUBLINGUAL TABLET MELATONIN/PYRIDOXINE 60 EACH

11845114705 GUARANA 1,000 MG CAPSULE GUARANA/CALCIUM/PHOSPHORUS 60 EACH

11845115405 CITRIMAX 250 TABLET CALCIUM PHOSPHATE/BRIND BERRY 60 EACH

11845118505 CITRIMAX 500 PLUS TABLET CAL PHOS/CHROMIUM/BRIND BERRY 60 EACH

11845121505 KOREAN GINSENG COMPLEX CAP ROYAL JELLY/BEE POLLEN/K.GINSG 60 EACH


11845125808 CHONDROITIN SULF 400 MG CAP CHONDROITIN SUL A NA 30 EACH


11917004670 ESTRONATURAL CAPLET VIT B COMP/E AC SUCC/FA/HC 105 30 EACH

11917005207 FISH OIL CONCENTRATE SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH

11917005895 FISH OIL CONCENTRATE SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 120 EACH



Product


Package

Size

Medi-Cal

Billing Unit

11917005896 FLAX, FISH & BORAGE OIL SOFGEL FISH OIL/VIT E/FAT NO.5/HC137 60 EACH

11917005934 ESTRONATURAL TABLET VIT B COMP/E/FA/SOYBEAN/HB 143 56 EACH



11917006550 FLAX, FISH & BORAGE OIL SOFGEL FISH OIL/VIT E/FAT NO.5/HC137 120 EACH

11917007157 FISH OIL CONC 1,000 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 100 EACH

11917007158 FISH OIL SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH

11917007388 THERAGRAN-M 1,200 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 200 EACH

11917007694 FISH OIL CONC 1,000 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 200 EACH






11917008863 OMEGA 3 FISH OIL SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH

11917009212 CO Q-10 200 MG TAB CHEW UBIDECARENONE 60 EACH

11917009899 5-HTP 100 MG CAPSULE 5-HYDROXYTRYPTOPHAN 30 EACH

11917010168 CHOLESTEROL RELIEF SOFTGEL PHYTOSTEROL/VIT D3/ FISH OIL 120 EACH

12539086560 CARDIOVID PLUS SOFTGEL FISH OIL/OM-3/DL-E/FA/B6-B12 60 EACH

12843053936 HEART HEALTH ADVANTAGE CAPLET PHYTOSTEROL 40 EACH

12843053937 HEART HEALTH ADVANTAGE CAPLET PHYTOSTEROL 80 EACH

13486726201 DIACHROME CAPSULE BIOTIN/CHROMIUM PICOLINATE 60 EACH

13533060320 THROMBATE III 500 UNITS VIAL ANTITHROMBIN III (HUM PLAS) 1 EACH UNIT

13533060330 THROMBATE III 1,000 UNITS VIAL ANTITHROMBIN III (HUM PLAS) 1 EACH UNIT

13533063503 GAMASTAN S/D SYRINGE IMMUNE GLOBULIN,GAMMA (IGG) 2 MILLILITERS

13533063504 GAMASTAN S-D VIAL IMMUNE GLOBULIN,GAMMA (IGG) 2 MILLILITERS

13533063512 GAMASTAN S-D VIAL IMMUNE GLOBULIN,GAMMA (IGG) 10 MILLILITERS






13533066520 KOATE-DVI 250 UNIT KIT ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

13533066530 KOATE-DVI 500 UNITS KIT ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

13533066550 KOATE-DVI 1,000 UNITS KIT ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

13533080012 GAMUNEX-C 1 GRAM/10 ML VIAL IMMUNE GLOB,GAM CAPRYLATE(IGG) 10 MILLILITERS

13533080015 GAMUNEX-C 2.5 GRAM/25 ML VIAL IMMUNE GLOB,GAM CAPRYLATE(IGG) 25 MILLILITERS




13613010160 HELIOCARE CAPSULE

POLYPODIUM LEUCOTOMOS

EXTRACT 60 EACH



Product


Package

Size

Medi-Cal

Billing Unit

14362011502 IMMUNE GLOBULIN VIAL IMMU GLOBULIN,GAMMA (IGG) 2 MILLILITERS

14600037010 VEINTAIN CAPLET CAL/VIT A/C/HORSE C-NUT/GRP 60 EACH

14654010105 CARNI Q-GEL FORTE SOFTSULE UBIDECAR/L-CARN FUM/VIT C/E 60 EACH



14654011957 LIQ-10 SYRUP UBIDECARENONE/VITAMIN E 500 MILLILITERS

14654025205 Q-GEL MEGA 100 MG SOFTGEL UBIDECARENONE/VIT E ACETATE 60 EACH



14654029557 Q-UP LIQUID UBIDECARENONE/VITAMIN E 500 MILLILITERS

14654034105 CHEW Q 100 MG CHEWABLE TAB UBIDECARENONE 60 EACH


14654034505 CHEW Q 30 MG TABLET CHEWABLE UBIDECARENONE 60 EACH


14654037405 CHEW Q 100 MG CHEWABLE TABLET UBIDECARENONE 60 EACH


14654038105 CHEW Q 600 MG WAFER UBIDECARENONE 60 EACH


14654042268 LIQSORB LIQUID UBIDECARENONE 170 MILLILITERS

14654045705 H2Q 100 MG CAPSULE UBIDECARENONE 60 EACH

14654068805 Q-GEL 15 MG SOFTSULE UBIDECARENONE/VIT E ACETATE 60 EACH

14654077105 Q-GEL FORTE SOFTSULE UBIDECARENONE/VIT E ACETATE 60 EACH

14654079902 ACTIVE-Q 200 MG SOFTGEL UBIQUINOL 30 EACH



14654095414 Q-GEL ULTRA SOFTSULE UBIDECARENONE/VIT E ACETATE 180 EACH



14654099105 Q-GEL 30 MG SOFTSULE A LIPOIC ACID/UBIDECAR/DL-E 60 EACH

15054050001 DYSPORT 500 UNITS VIAL ABOBOTULINUMTOXINA 1 EACH

15054053006 DYSPORT 300 UNIT VIAL ABOBOTULINUMTOXINA 1 EACH

15821050190 TOZAL SOFTGEL MV, MIN CMB#22/LUT/OM3/DHA/EPA 90 EACH

16110012233 LIVERITE TABLET LECITH/INOSI/CHOL/B12/LIVER 60 EACH



16500008290 ONE-A-DAY TENSION&MOOD TAB LECITH/FA/VIT BCOMP&C/HERB10 30 EACH



16963055169 COENZYME Q-10 30 MG CAPSULE UBIDECARENONE 60 EACH

16963094553 MALIC ACID PLUS CAPSULE UBIDECAR/POT ASPART/MAG/MALIC 90 EACH

17204044595 COENZYME Q10 LIQUID UBIDECARENONE 480 MILLILITERS

17204044620 COENZYME Q10 10 MG CAPSULE UBIDECARENONE 60 EACH



17204045036 CO-ENZYME Q-10 100 MG CAP UBIDECARENONE 30 EACH

17204046320 COQ10 SG 100 SOFTGEL UBIDECARENONE/VITAMIN E MIXED 60 EACH

17204058336 COQ10 SG 100 SOFTGEL UBIDECARENONE/VITAMIN E MIXED 30 EACH

17317040400 PEANUT OIL PEANUT OIL 30 MILLILITERS







Product


Package

Size

Medi-Cal

Billing Unit


















20525012703 SHARK CARTILAGE 740 MG CAP SHARK CARTILAGE 50 EACH

20525012704 SHARK CARTILAGE 740MG CAP SHARK CARTILAGE 100 EACH

20525012705 PYCNOGENOL 30MG CAPSULE PROCYANIDOLIC OLIGOMERS 30 EACH

20525012728 COQ10 30MG CAPSULE UBIDECARENONE 30 EACH

23594040010 BONISARA TABLET STRONTIUM GLUCONATE/B6-B12-FA 60 EACH

24359035001 CAMINO PRO 15 PKU BETTER MILK NUT. TX FOR PKU WITH IRON #41 1 EACH


24385021572 PROSTATE HEALTH FORMULA SFTGEL ZINC MTH/COPPER/SAW PALM/GNSG 60 EACH





24385059165 COQ-10 & FISH OIL SOFTGEL UBIDECARENONE/OMEGA-3/VIT E 30 EACH

24839033401 CARDIOTEK TABLET VIT C/E/B6/FA/B12/ARGIN/PEP XT 100 EACH

26974041007 PRO-STAT 64 LIQUID AMINO ACIDS/PROTEIN HYDROLYS 887 MILLILITERS




26974041012 PRO-STAT PROFILE LIQUID AMINO ACIDS/PROTEIN HYDROLYS 887 MILLILITERS


26974041016 POR-STAT 150 LIQUID AMINO ACIDS/PROTEIN HYDROLYS 30 MILLILITERS





26974041021 PRO-STAT PROFILE LIQUID AMINO ACIDS/PROTEIN HYDROLYS 30 MILLILITERS

26974041030 PRO-STAT AWC LIQUID AMINO ACIDS/PROTEIN HYDROLYS 887 MILLILITERS

26974041031 PRO-STAT AWC LIQUID AMINO ACIDS/PROTEIN HYDROLYS 30 MILLILITERS









Product


Package

Size

Medi-Cal

Billing Unit


26974041060 PRO-STAT RC LIQUID NUT.TX.IMP.RENAL FXN,LAC-FREE 887 MILLILITERS



27434000211 NAC 600 MG CAPSULE ACETYLCYSTEINE 60 EACH

27434000657 MAXILIFE RICE 50 MG CAPSULE VIT E/TOCOTRIENOL GAM,ALPH,DEL 60 EACH

28770004003 PRONUTRA PROTEIN POWDER PROTEIN SUPPLEMENT 37 GRAMS

30610000327 GLYCOTROL CAPSULE VIT B12/FA/PYRIDOXINE HCL/AA15 90 EACH

30610000328 GLYCOTROL CAPSULE VIT B12/FA/PYRIDOXINE HCL/AA15 180 EACH

30768000826 Q-SORB COQ-10 50 MG SOFTGEL UBIDECARENONE/VITAMIN E 30 EACH

30768001054 Q-SORB CO Q-10 75 MG SOFTGEL UBIDECARENONE 30 EACH

30768001189 CASCARA SAGRADA 450 MG CAPSULE CASCARA SAGRADA 100 EACH

30768001473 Q-SORB CO Q-10 150 MG SOFTGEL UBIDECARENONE/VITAMIN E 30 EACH



30768031155 Q-SORB CO Q-10 30 MG SOFTGEL UBIDECARENONE 30 EACH

30768045941 PYCNOGENOL COMPLEX TABLET PROCYAN OLIG/UBI/VIT A/HB#155 45 EACH

31604001091 SAM-E 200 MG TABLET S-ADENOSYLMETHIONINE SUL TOSYL 24 EACH



31604001252 REKINDLE TABLET ARG HCL/CA CARB/GNK/DAM/K.GIN 90 EACH

31604001286 CHOLEST OFF 450 MG TABLET PLANT STANOL ESTER 60 EACH

31604001302 CHOLEST OFF 450 MG CAPLET PLANT STANOL ESTER 120 EACH

31604001318 FIBER CLEAR POWDER MALTODEXTRIN 388 GRAMS

31604001321 COQ10 200 MG SOFTGEL UBIDECARENONE 30 EACH



31604001701 CO Q10 30 MG SOFTGEL UBIDECARENONE 30 EACH

31604001769 ADVANCED ESTER C TABLET VIT C/RUT/HESPER/BIOFLAV/HC122 50 EACH

31604001770 ADVANCED HIGH GAMMA E SOFTGEL VIT E/VIT E MIX/TOCOTR/HC122 50 EACH

31604001771 ADVANCED CALCIUM TABLET CA CARB/CA CIT/MG-ZN/D3/HC122 100 EACH

31604009614 OLAY ULTRA COQ10 150 MG SFTGEL UBIDECARENONE/VITAMIN E 30 EACH

31604009620 OLAY ESSENTIAL SOY TABLET CYANOCOBALAMIN/FA/VIT B6/SOYB 30 EACH



36643028785 URINOZINC PROSTATE FORMULA CAP MULTIVITS-MIN/HRB CB121 120 EACH




36643028803 SUPER URINOZINC PROSTATE SFTGL MULTIVITS-MIN/HRB CB120 30 EACH




Product


Package

Size

Medi-Cal

Billing Unit


36643028807 SUGAR METABOLIC-HELP CAPSULE A LIPOIC ACID/MAG OXIDE/CR/GYM 60 EACH

36652012719 STRESSTABS PMS TABLET CA CARBONATE/MAG OXIDE/CHASTE 60 EACH

36652012819 STRESSTABS MENOPAUSE TABLET MAG OXIDE/ST.JHNWT/BLK COH 60 EACH

37205028931 ESTRO SUPPORT ES CAPLET MV,CA,MIN/FA/HERBAL NO.176 56 EACH

37205035365 CO Q-10 50MG SOFTGEL UBIDECARENONE 30 EACH

37205035472 FISH OIL 300 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH


37205040672 FISH OIL EXTRA STRENGTH SFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH


37205047265 SUPER OMEGA-3 SOFTGEL FISH OIL/VIT E/FAT NO.5/HC137 60 EACH

37205050631 ESTROPLUS CAPLET VIT B COMP/E/FA/SOY ISO/HB 143 56 EACH

37205051352 LEADER GERM DEFENSE TABLET GLUT/LYSINE HC/C/MV-MN/HC124 10 EACH

37205051452 GERM DEFENSE TABLET GLUT/LYSINE HC/C/MV-MN/HC124 10 EACH


37205098376 EYE HEALTH FORMULA SOFTGEL DOCOSAHEXANOIC ACID/VIT C/LUT 120 EACH

38779230503 SOMATROPIN POWDER SOMATROPIN 5 GRAMS

38779230506 SOMATROPIN POWDER SOMATROPIN 1 GRAMS


40985021800 CO Q10 60 MG CAPSULE UBIDECARENONE 50 EACH


40985022687 CO Q10 200 MG CAPSULE UBIDECARENONE 30 EACH

40985022848 APPLE CIDER VINEGAR 300 MG TAB CIDER VINEGAR 250 EACH

40985022881 BIOTIN 800 MCG TABLET BIOTIN/CALCIUM CARBONATE 100 EACH

40986001760 PV APPLE CIDER VINEGAR 300 MG CIDER VINEGAR 200 EACH

40986001794 PV COQ-10 100 MG SOFTGEL UBIDECARENONE/VIT E ACETATE 30 EACH

40986001795 PV CO Q-10 30 MG SOFTGEL UBIDECARENONE 30 EACH


40986001833 PV MSM 1,000 MG TABLET METHYLSULFONYLMETHANE 120 EACH

40986001982 PV AIRSHIELD EFFERVESCENT TAB VIT A,C,& E/DIETARY SUPP NO.12 10 EACH

40986002059 PV FISH OIL 1,000 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 180 EACH

40986002082 PV COQ-10 MG SOFTGEL UBIDECARENONE 60 EACH

40986002083 PV COQ-10 200 MG SOFTGEL UBIDECARENONE 30 EACH


40986002127 PV SHARK CARTILAGE 500 MG SHARK CARTILAGE 100 EACH


41163023534 NATURAL BEE POLLEN 500 MG TB BEE POLLEN 100 EACH

41163023852 EQL COENZYME Q-10 50 MG SOFTGL UBIDECARENONE 30 EACH

41163026627 EQL FISH OIL 1,000 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 100 EACH

41163026628 EQL MSM 1,000 MG TABLET METHYLSULFONYLMETHANE 125 EACH

41163026663 EQL SAM-E 200 MG TABLET S-ADENOSYLMETHIONINE SUL TOSYL 50 EACH

41163026666 EQL SAM-E 200 MG TABLET S-ADENOSYLMETHIONINE SUL TOSYL 20 EACH

41163026672 EQL COENZYME Q-10 100 MG SFTGL UBIDECARENONE 30 EACH

41163041147 EQL FISH OIL 1,000 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH

41163041149 EQL ESTRO VITAL NUTRIENTS CPLT VIT B COMP/E AC SUCC/FA/HC 105 30 EACH

41163041154 EQL COENZYME Q-10 50 MG SOFTGL UBIDECARENONE 60 EACH

41163041178 EQL COENZYME Q-10 150 MG SFTGL UBIDECARENONE 30 EACH

41163041867 EQL ESTRO VITAL NUTRIENTS CPLT VIT B COMP/VIT E AC/FA/HC 104 56 EACH



Product


Package

Size

Medi-Cal

Billing Unit

41167020130 DEXATRIM NATURAL CAPLET GRN TEA LF/GINSENG/CHROMIUM DI 30 EACH


41679004002 MAGNACAL RENAL LIQUID NUT.TX.IMPAIRED RENAL FXN,SOY 237 MILLILITERS








41679033251 BOOST KID ESSENTIALS LIQUID PEDIATRIC NUTRITION, IRON, LF 244 MILLILITERS




41679035506 ISOCAL LIQ KANG REDI-FEED LACTOSE-FREE FOOD 1000 MILLILITERS








41679036513 MCT OIL MEDIUM CHAIN TRIGLYCERIDES 946 MILLILITERS





41679046204 DELIVER 2.0 LIQUID LACTOSE-FREE FOOD 237 MILLILITERS

41679046404 TRAUMACAL LIQUID LACTOSE-FREE FOOD 237 MILLILITERS

41679047102 LIPISORB LIQUID NUTRITIONAL SUPPLEMENT/MCT 237 MILLILITERS

41679048021 MUDUCAL POWDER GLUCOSE POLYMERS 368 GRAMS

41679056341 CRITICARE HN LIQUID LACTOSE-FREE FOOD 237 MILLILITERS















41679069601 CHOICE DM NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

41679069602 CHOICE DM NUTRITIONAL SUPPLEMENT 1500 MILLILITERS








Product


Package

Size

Medi-Cal

Billing Unit














41679094303 BOOST HIGH PROTEIN POWDER LACTOSE-FREE FOOD 454 GRAMS






42192030160 BP VIT 3 CAPSULE OMEGA-3/B12/FA/B-6/PHYTOSTEROL 60 EACH

42192030901 TRI-PASE 8 TABLET LIPASE/PROTEASE/AMYLASE 100 EACH

42192031001 TRI-PASE 16 TABLET LIPASE/PROTEASE/AMYLASE 100 EACH

42485020001 HELIOCARE CAPSULE

POLYPODIUM LEUCOTOMOS

EXTRACT 60 EACH

42783050160 NICAZEL TABLET B3/AZEL AC/ZINC/B6/COPPER/FA 60 EACH

42895000001 ESSENTIAL PROTEIN POWDER PROTEIN SUPPLEMENT 908 GRAMS

42895000002 ESSENTIAL PROPLUS POWDER PROTEIN SUPPLEMENT 908 GRAMS



43292055761 PROTEIN 90% POWDER PROTEIN SUPPLEMENT 454 GRAMS

43292055815 BEE POLLEN-GINSENG 500 MG CP BEE POLLEN/GINSENG 100 EACH




43656021110 GLUTAMINE-ANTIOXIDANT POWDER GLUTAMINE/VIT A,C & E/SELENIUM 500 GRAMS

43656021120 GLUTAMINE-ANTIOXIDANT POWDER GLUTAMINE/VIT A,C & E/SELENIUM 500 GRAMS

43900014180 COMPLEAT SPIKERIGHT 1000ML MILK BASED FORMULA 1000 MILLILITERS

43900014182 COMPLEAT SPIKERIGHT 1500ML MILK BASED FORMULA 1500 MILLILITERS








43900018040 RESOURCE 2.0 LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS

43900018181 ISOSOURCE 1.5 CAL SPIKERIGHT 1 LACTOSE-FREE FOOD/FIBER 1000 MILLILITERS

43900018182 ISOSOURCE ® 1.5 CAL SPIKERIGHT LACTOSE-FREE FOOD/FIBER 1500 MILLILITERS

43900018466 ISOSOURCEHN(1500ML)SPIKERIGHT LACTOSE-FREE FOOD 1500 MILLILITERS

43900018480 ISOSOURCEHN(1000ML)SPIKERIGHT LACTOSE-FREE FOOD 1000 MILLILITERS

43900018556 FIBERSOURCE HN LIQUID NUTRITIONAL SUPPLEMENT/FIBER 250 MILLILITERS





Product


Package

Size

Medi-Cal

Billing Unit


43900028250 RESOURCE BENECALORIE LIQUID CALORIC SUPPLEMENT 41.3 GRAMS

43900028430

RESOURCE BENEPROTEIN INST

POWD PROTEIN SUPPLEMENT 75 EACH

43900033500 BOOST KID ESSENTIALS-FIBER LIQ PEDIATRIC NUTRIT,IRON,LF&FIBER 237 MILLILITERS





43900033588 BOOST® KID ESSENTIALS 1.5 CAL PEDIATRIC NUTRITION, IRON, LF 237 MILLILITERS

43900033590 BOOST® KID ESSENTIALS 1.5 CAL PEDIATRIC NUTRITION, IRON, LF 237 MILLILITERS

43900033794 PEPTAMEN OS LIQUID NUT.TX.IMPAIRED DIGEST FXN,SOY 237 MILLILITERS


43900035818 IMPACT TUBE FEEDING LIQUID LACTOSE-FREE FOOD 1000 MILLILITERS



43900036508 DIABETISOURCE AC SPIKERIGHTTM NUT.TX.GLUCOSE INTOL,SOY/FIBER 1000 MILLILITERS

43900036582 DIABETISOURCE AC SPIKERIGHTTM NUT.TX.GLUCOSE INTOL,SOY/FIBER 1500 MILLILITERS

43900037120 PEPTINEX 1.0 LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS

43900037122 PEPTAMEN OS 1.5 LIQUID NUT.TX.IMPAIRED DIGEST FXN,SOY 237 MILLILITERS

43900037129 PEPTAMEN OS LIQUID NUT.TX.IMPAIRED DIGEST FXN,SOY 237 MILLILITERS



43900037510 PEDIATRIC PEPTINEX DT LIQ NUT.TX.IMPAIRED DIGEST FXN,SOY 250 MILLILITERS

43900037520 PEDIATRIC PEPTINEX DT LIQ NUT TX IMP.DIGEST FXN,SOY&FIB2 250 MILLILITERS

43900037570 PEPTINEX DT LIQUID NUT TX IMP.DIGEST FXN,SOY&FIB1 250 MILLILITERS

43900097234 PEPTAMEN BARIATRIC LIQUID NUT.SOY,LACFREE/FOS/DHA/EPA/IN 250 MILLILITERS

43900097266 PEPTAMEN BARIATRIC LIQUID NUT.SOY,LACFREE/FOS/DHA/EPA/IN 1000 MILLILITERS

44087000401 SEROSTIM 4 MG VIAL SOMATROPIN 1 EACH






44087008804 SEROSTIM 8.8 MG VIAL SOMATROPIN 1 EACH

44087100502 SAIZEN 5 MG VIAL SOMATROPIN 1 EACH

44087108001 SAIZEN 8.8 MG CLICK.EASY CARTG SOMATROPIN 1 EACH

44087108002 SAIZEN 8.8 MG CLICK.EASY CARTG SOMATROPIN 1 EACH

44087108801 SAIZEN 8.8 MG VIAL SOMATROPIN 1 EACH

44087338807 ZORBTIVE 8.8 MG VIAL SOMATROPIN 1 EACH

44206041501 CARIMUNE NF 1 GM VIAL IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

44206041603 CARIMUNE NF 3 GM VIAL IMMU GLOBULIN,GAMMA (IGG) 1 EACH



44206043605 PRIVIGEN 10% VIAL IMMUNE GLOBULIN,GAMMA (IGG) 50 MILLILITERS



44206045101 HIZENTRA 1 GRAM/5 ML VIAL IMMUNE GLOBULIN,GAMMA (IGG) 5 MILLILITERS



44206050551 CARIMUNE 1 GM VIAL IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

44206050862 CARIMUNE 12 GM VIAL IMMU GLOBULIN,GAMMA (IGG) 1 EACH



Product


Package

Size

Medi-Cal

Billing Unit

44411010360 AVAILNEX 750 MG TABLET CHEW CARBOCYSTEINE 60 EACH

45737040660 BIOFLEX TABLET RUTIN/HESP CM/BIOFL/ROSE/HC111 60 EACH

45945015101 GABLOFEN 50 MCG/ML SYRINGE BACLOFEN 1 MILLILITERS

45945015502 GABLOFEN 10,000 MCG/20 ML VIAL BACLOFEN 20 MILLILITERS

45945015702 GABLOFEN 40,000 MCG/20 ML VIAL BACLOFEN 20 MILLILITERS

47046044000 NEWPHASE COMPLETE CAPLET DIETARY SUPP CMB.20/FOLIC ACID 30 EACH

47046130000 PROPALMEX SOFTGEL ZN GLUC/PUMP SEED OIL/SAW PAL 30 EACH

47046400000 MELATONEX TABLET MELATONIN/PYRIDOXINE HCL (B6) 30 EACH

47469000280 COQ-10 30 MG CAPSULE UBIDECARENONE 30 EACH


47469000597 DHEA TABLET PRASTERONE (DHEA)/CALCIUM CARB 90 EACH

47469000870 ENADA NADH TABLET NADH/ASCORBIC ACID/SOD BICARB 10 EACH

47469000884 NATROL 5-HTP 50 MG CAPSULE 5-HYDROXYTRYPTOPHAN 30 EACH

47469003008 HOT FLASHEX CAPLET CA PH TRI/E AC SUCC/HERB23 60 EACH


47469016106 DHEA 50 MG TABLET PRASTERONE (DHEA)/CALCIUM CARB 60 EACH


47469016176 CARB INTERCEPT CAPSULE CHROMIUM CHLORIDE/BEAN POD EXT 60 EACH


48107001565 ENERGEL SOFTGEL CAPSULE GUARANA/I/MEDWSW/S.GINSG/HRB31 120 EACH

48107001575 GINSENG EDGE SOFTGEL GUARANA/SGINRT/AMER GINS/K.GIN 60 EACH



48107002686 CLA CAPSULES LINOLEIC ACID/SUNFLOWER OIL 50 EACH

48107003150 NAC 600 MG CAPSULE ACETYLCYSTEINE 60 EACH

48107003430 MODIFIED CITRUS PECTIN TAB PEC, CITRUS/INOSI/VIT C/SOYB 60 EACH

48107004681 GINKGO VIN 20-120 MG TABLET VINCAMINE/GINKGO BILOBA LEAF 60 EACH

48107004765 MEN'S SAW PALMETTO TABLET ZNOX/PYG/PUMPK/SAW PAL/PROST 120 EACH

48107004766 MEN'S SAW PALMETTO TABLET ZNOX/PYG/PUMPK/SAW PAL/PROST 240 EACH

48107004792 EPHADRENE TABLET AMINO AC/VIT B12/B6/CR/HRB35 120 EACH

48107004802 GINKGO BILOBA PLUS TABLET LECITH/GNKBILLF/S.GINSENG/GOTK 120 EACH


48107004858 PRO CUT CAPSULE TAUR/POT CHLORIDE/MAG/B6/HRB34 60 EACH

48107004930 CHONDROITIN SULF 400 MG CAP CHONDROITIN SUL A NA 60 EACH


48107004967 MELATONIN 3 MG TABLET MELATONIN/PYRIDOXINE 60 EACH

48107004968 MELATONIN 3 MG TABLET MELATONIN/PYRIDOXINE 100 EACH

48107004975 PYCNOGENOL 50 MG CAPSULE PROCYANIDOLIC OLIGOMERS 30 EACH

48107004978 SHARK CARTILAGE 750 MG TAB SHARK CARTILAGE 60 EACH

48107004980 SOY ISOFLAVONE 50 MG CAPSULE SOY ISOFLAVONE 30 EACH

48107005027 MOODPLEX CAPSULE PH-LALAN,DL/ST.JHNWT/GRIFF 60 EACH

48107005028 PRENATAL COMPANION SOFTGEL DHA/CALCIUM CARBONATE 60 EACH

48107005029 Z-PLEX SOFTGEL MELATONIN/KAVA ROOT/GRIFFONIA 30 EACH

48107005031 LIVER PRO SOFTGEL PH-PHAT-CHO/VIT C/MILK THISTLE 60 EACH

48107005033 BONEPLEX TABLET IPRIFLAV/CA CARBONATE/VIT D3 30 EACH

48107005034 MIGRAPLEX TABLET MAG OXIDE/VIT B2/FEVERFEW/GING 60 EACH

48107005037 VARICLEAR CAPSULE E AC SUCC/HERBAL COMPLEX NO.3 60 EACH

48107005040 CARDIOFLOW SOFTGEL UBIDEC/DHA/E,B6-FA(<1MG)/HERB2 60 EACH



Product


Package

Size

Medi-Cal

Billing Unit

48107005046 PROVENTRA 50 MG TABLET IMMU GLOBULIN,GAMMA,WHEY 30 EACH

48107005078 NEUROSYN SOFTGEL PH-P-CHOLINE/DHA/VITAMIN E/GNK 60 EACH

48107005099 RESISTANCE PLUS TABLET ACETYLCYSTEINE/VIT C/MIN/ECHIN 60 EACH

48107005101 ENERGY FORMULA TABLET GUARANA/SGINRT/MA-HUNG/K.GINSG 60 EACH

48107005107 AQUATONE TABLET POT GLUCONATE/MAG/VIT B6/BEARB 60 EACH




48107019384 WOMEN'S WATER BALANCE TAB PSYLL SEED/POT GLUC/B6/HERB29 100 EACH







49348030912 V-R MEMORY COMPLEX CAPLET VIT C/VIT E ACETATE/SE/GNK 60 EACH

49348031112 V-R IMMUNE SUPP COMPLEX CPL VIT C/ZN/K.GIN/ROSE HIPS/HRB62 60 EACH

49348032644 V-R COENZYME Q-10 50 MG SFGL UBIDECARENONE 30 EACH

49348052338 SM ESTROPLUS CAPLET VIT B COMP/E/MINERAL 3/ISOFL 1 30 EACH

49348060544 SM COENZYME Q-10 100 MG SFTGL UBIDECARENONE 30 EACH

49348066526 SM ESTRO VITAL NUTRIENTS CPLT VIT B COMP/VIT E AC/FA/HC 104 56 EACH

49348083678 SM ESTRO VITAL NUTRIENTS CPLT VIT B COMP/VIT E/FA/HB#156 28 EACH

49452182001 CASEIN POWDER CASEIN 500 GRAMS

49452182002 CASEIN POWDER CASEIN 2500 GRAMS




49452908501 BEE POLLEN/ROYAL JLLY TB CHW ROYAL JELLY/BEE POLLEN 100 EACH

49452908502 BEE POLLEN/ROYAL JLLY TB CHW ROYAL JELLY/BEE POLLEN 100 EACH



49614024865 COENZYME Q-10 50MG SOFTGEL UBIDECARENONE 30 EACH




49614042472 FISH OIL EXTRA STRENGTH SOFTGL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH

49614045365 COQ-10 & FISH OIL SOFTGEL UBIDECAR/FISH OIL/OMEGA-3/VITE 30 EACH

49614065865 ESTROPLUS CAPLET VIT B COMP/E/MINERAL 3/ISOFL 1 30 EACH



49669161201 VENOGLOBULIN-S 5% VIAL IMMUNE GLOBULIN,GAMMA (IGG) 50 MILLILITERS




49735001152 POLYCAL POWDER CALORIC SUPPLEMENT 400 GRAMS

49735002301 XPHE MAXAMUM POWDER NUT. TX FOR PKU WITH IRON #6 454 GRAMS


49735002311 XPHE MAXAMUM PACKET NUTRITIONAL SUPPLEMENT 30 EACH

49735002312 XPHE MAXAMUM PACKET NUTRITIONAL SUPPLEMENT 30 EACH

49735002340 MSUD MAXAMUM POWDER NUTRIT.THERAPY, MSUD WITH IRON 454 GRAMS

49735002342 XMTVI MAXAMUM POWDER NUT. TX FOR PROPIONIC ACIDEMIA 454 GRAMS



Product


Package

Size

Medi-Cal

Billing Unit

49735002343 XLEU MAXAMUM POWDER NUT TX FOR ISOVALERIC ACIDEMIA 454 GRAMS

49735002344 XLYS, XTRP MAXAMUM POWDER NUT. TX, GLUTARIC ACIDURIA I 454 GRAMS

49735002357 XPHE MAXAMAID POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS


49735002359 XLYS, XTRP MAXAMAID POWDER NUT. TX, GLUTARIC ACIDURIA I 454 GRAMS

49735002360 MSUD MAXAMAID POWDER NUTRIT.THERAPY, MSUD WITH IRON 454 GRAMS

49735002362 XPHE, XTYR MAXAMAID POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS

49735002364 XLEU MAXAMAID POWDER NUT TX FOR ISOVALERIC ACIDEMIA 454 GRAMS

49735002371 XPHE MAXAMAID POWDER NUT. TX FOR PKU WITH IRON #5 454 GRAMS

49735002595 NEOCATE INFANT POWDER INFANT FORMULA, IRON/DHA/ARA 400 GRAMS

49735009708 MONOGEN POWDER NUTRITIONAL SUPPLEMENT/MCT 400 GRAMS

49735010026 ACERFLEX POWDER NUTRIT.THERAPY, MSUD WITH IRON 454 GRAMS

49735010077 PHLEXY-10 BAR NUT. TX FOR PKU, #8 20 EACH

49735010124 COMPLETE AMINO ACID MIX PWD AMINO ACIDS 200 GRAMS

49735010131 TARVIL PACKET NUT. TX, MOVEMENT DISORDER,SOY 30 EACH

49735010143 MSUD AID POWDER NUTRIT.THERAPY, MSUD WITH IRON 200 GRAMS

49735010242 METHIONAID POWDER NUT.TX,METABOLIC DIS,METHIO-FR 200 GRAMS

49735010280 DUOCAL POWDER CALORIC SUPPLEMENT 400 GRAMS


49735010376 XLYS, XTRP MAXAMAID POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS


49735010501 NEOCATE ONE+ LIQUID NUTRITIONAL SUPPLEMENT 1 MILLILITERS


49735010503 XMTVI MAXAMAID POWDER NUT. TX FOR PROPIONIC ACIDEMIA 454 GRAMS

49735010504 XPHE, XTYR MAXAMAID POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS

49735010505 XMET MAXAMAID POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS

49735010511 MSUD MAXAMUM POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS

49735010535 XPHE, XTRP MAXAMAID POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS


49735010537 XMET MAXAMUM POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS


49735010651 UCD MAXAMAID POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS

49735010679 XPTM MAXAMAID POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS

49735010685 PHLEXY-VITS POWDER NUTRITIONAL SUPPLEMENT 30 EACH

49735010804 NEOCATE POWDER NUT.TX.IMPAIRED DIGEST FXN 400 GRAMS


49735011047 NEOCATE ONE+ POWDER PACKET NUT.TX.IMPAIRED DIGEST FXN 10 EACH

49735011048 NEOCATE ONE+ POWDER PACKET NUT.TX.IMPAIRED DIGEST FXN 15 EACH

49735011050 EO28 SPLASH DRINK NUTRITIONAL SUPPLEMENT 237 MILLILITERS

49735011134 PROTIFAR PROTEIN POWDER PROTEIN SUPPLEMENT 225 GRAMS

49735011152 POLYCAL POWDER CALORIC SUPPLEMENT 400 GRAMS

49735011401 PERIFLEX JUNIOR POWDER NUT. TX FOR PKU WITH IRON #3 454 GRAMS


49735011451 XPHE MAXAMUM POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS

49735011452 XPHE MAXAMUM POWDER NUTRITIONAL SUPPLEMENT 454 GRAMS

49735011467 PHLEXY-10 DRINK MIX POWDER NUT. TX FOR PKU, #8 30 EACH

49735011490 ESSENTIAL AMINO ACID MIX PD NUT TX,UREA CYCLE DIS W-O IRON 200 GRAMS

49735011766 PEPDITE ONE+ POWDER PACKET NUT.TX.IMPAIRED DIGEST FXN,SOY 15 EACH

49735011780 PEPDITE ONE+ POWDER PACKET NUT.TX.IMPAIRED DIGEST FXN,SOY 15 EACH

49735011790 NEOCATE JUNIOR POWDER NUT.TX.IMPAIRED DIGEST FXN 400 GRAMS

49735011809 PHLEXY-10 500 MG CAPSULE NUT. TX FOR PKU, #8 200 EACH

49735011810 PHLEXY-10 ADD-INS NUT. TX FOR PKU, #24 17 EACH

49735011880 PERIFLEX INFANT POWDER INFANT FORM.FOR PKU,IRON NO.4 400 GRAMS



Product


Package

Size

Medi-Cal

Billing Unit

49735011881 XMET ANALOG POWDER INFANT FORM, METAB, METHION-FR 400 GRAMS

49735011882 XLYS, XTRP ANALOG POWDER INF FORM, GLUTARIC ACIDURIA I 400 GRAMS

49735011884 XPTM ANALOG POWDER INF FORM FOR TYROSINEMIA, IRON 400 GRAMS

49735011885 XPHE, XTYR ANALOG POWDER INF FORM FOR TYROSINEMIA, IRON 400 GRAMS

49735011886 MSUD ANALOG POWDER INFANT FORMULA,SPEC.METAB MSUD 400 GRAMS

49735011887 XMTVI ANALOG POWDER INFANT FORM,PROPIONIC ACIDEMIA 400 GRAMS

49735011888 XLEU ANALOG POWDER INF. FORM, ISOVALERIC ACIDEMIA 400 GRAMS

49735011910 PHLEXY-10 DRINK MIX POWDER NUT. TX FOR PKU, #8 30 EACH

49735011951 PHLEXY-10 TABLET NUT. TX FOR PKU, #8 75 EACH


49735012167 LOPHLEX PACKET NUT. TX FOR PKU WITH IRON #7 30 EACH

49735012169 LOPHLEX PACKET NUT. TX FOR PKU WITH IRON #7 30 EACH



49735012311 XPHE MAXAMUM PACKET NUT. TX FOR PKU WITH IRON #6 30 EACH

49735012312 XPHE MAXAMUM PACKET NUT. TX FOR PKU WITH IRON #6 30 EACH

49735012340 MSUD MAXAMUM POWDER NUTRIT.THERAPY, MSUD WITH IRON 454 GRAMS

49735012341 XMET MAXAMUM POWDER NUT.TX,METABOLIC DIS,METHIO-FR 454 GRAMS



49735012344 XLYS, XTRP MAXAMUM POWDER NUT. TX, GLUTARIC ACIDURIA I 454 GRAMS



49735012359 XLYS, XTRP MAXAMAID POWDER NUT. TX, GLUTARIC ACIDURIA I 454 GRAMS



49735012362 XPHE, XTYR MAXAMAID POWDER NUTRITIONAL TX FOR TYROSINEMIA 454 GRAMS

49735012363 XMET MAXAMAID POWDER NUT.TX,METABOLIC DIS,METHIO-FR 454 GRAMS



49735012524 XPHE MAXAMUM DRINK NUT. TX FOR PKU WITH IRON #2 250 MILLILITERS



49735012595 NEOCATE INFANT POWDER INFANT FORMULA, IRON/DHA/ARA 400 GRAMS

49735012641 ADD-INS POWDER NUT. TX FOR PKU WITH IRON #36 60 EACH

49735012643 LANAFLEX POWDER PACKET NUT. TX FOR PKU WITH IRON #25 40 EACH

49735012650 PERIFLEX ADVANCE PKU POWDER NUT. TX FOR PKU WITH IRON #20 454 GRAMS



49735012666 EO28 SPLASH DRINK NUT.TX.IMPAIRED DIGEST FXN 237 MILLILITERS

49735012670 EO28 SPLASH DRINK NUT.TX.IMPAIRED DIGEST FXN 237 MILLILITERS


49735012912 NEOCATE JR WITH PREBIOTICS PWD NUT.TX.IMPAIRED DIGEST/FIBER 400 GRAMS

49735016670 KETOCAL 4:1 POWDER NUTRITIONAL TX, KETOGENIC, SOY 300 GRAMS

49735016672 KETOCAL 3:1 POWDER NUTRITIONAL TX, KETOGENIC, SOY 300 GRAMS

49735017779 XMTVI MAXAMUM (ORANGE) POWDER NUT. TX FOR PROPIONIC ACIDEMIA 454 GRAMS

49735017780 XLYS, XTRP MAXAMAID (ORANGE) P NUT. TX, GLUTARIC ACIDURIA I 454 GRAMS

49735017781 MSUD MAXAMAID (ORANGE) POWDER NUTRIT.THERAPY, MSUD WITH IRON 454 GRAMS

49735017785 XMTVI MAXAMAID (ORANGE) POWDER NUT. TX FOR PROPIONIC ACIDEMIA 454 GRAMS



Product


Package

Size

Medi-Cal

Billing Unit

49735017786 XPHE, XTYR MAXAMAID (ORANGE) P NUTRITIONAL TX FOR TYROSINEMIA 454 GRAMS

49735017787 XMET MAXAMAID POWDER (ORANGE) NUT.TX,METABOLIC DIS,METHIO-FR 454 GRAMS

49735017788 XLYS, XTRP MAXAMUM (ORANGE) PO NUT. TX, GLUTARIC ACIDURIA I 454 GRAMS

49735017789

MSUD MAXAMUM (UNFLAVORED)

POWD NUTRIT.THERAPY, MSUD WITH IRON 454 GRAMS

49735017790 XLEU MAXAMUM (ORANGE) POWDER NUT TX FOR ISOVALERIC ACIDEMIA 454 GRAMS

49735017791 XLEU MAXAMAID (ORANGE) POWDER NUT TX FOR ISOVALERIC ACIDEMIA 454 GRAMS

49735017792 XPHE MAXAMAID (ORANGE) POWDER NUT. TX FOR PKU WITH IRON #5 454 GRAMS

49735017793 XPHE MAXAMAID (UNFLAVORED) POW NUT. TX FOR PKU WITH IRON #5 454 GRAMS

49735017794

XPHE MAXAMAID (STRAWBERRY)

POW NUT. TX FOR PKU WITH IRON #5 454 GRAMS

49735017795 XMET MAXAMUM (ORANGE) POWDER ( NUT.TX,METABOLIC DIS,METHIO-FR 454 GRAMS

49735018262 DUOCAL (UNFLAV) POWD (400GM) CALORIC SUPPLEMENT 400 GRAMS

49735018301 XPHE, XTYR ANALOG (UNFLAVORED) INF FORM FOR TYROSINEMIA, IRON 400 GRAMS

49735018302 MSUD ANALOG (UNFLAVORED) POWD INFANT FORMULA,SPEC.METAB MSUD 400 GRAMS

49735018303 XMTVI ANALOG (UNFLAVORED) POWD INFANT FORM,PROPIONIC ACIDEMIA 400 GRAMS

49735018305 PERIFLEX ADVANCE (UNFLAVORED) NUT. TX FOR PKU WITH IRON #20 454 GRAMS

49735018306 PERIFLEX ADVANCE (CHOCOLATE) ( NUT. TX FOR PKU WITH IRON #20 454 GRAMS

49735018307 PERIFLEX ADVANCE (ORANGE) POWD NUT. TX FOR PKU WITH IRON #20 454 GRAMS

49735018308 PERIFLEX JUNIOR (UNFLAVORED) P NUT. TX FOR PKU WITH IRON #3 454 GRAMS

49735018309 PERIFLEX JUNIOR (CHOCOLATE) PO NUT. TX FOR PKU WITH IRON #3 454 GRAMS


49735018323

XPHE MAXAMUM (UNFLAVORED)

POWD NUT. TX FOR PKU WITH IRON #6 454 GRAMS

49735018324 XPHE MAXAMUM (ORANGE) POWDER ( NUT. TX FOR PKU WITH IRON #6 454 GRAMS

49735018326 PERIFLEX INFANT (UNFLAVORED) F INFANT FORM.FOR PKU,IRON NO.4 400 GRAMS

49735018327

XMET ANALOG (UNFLAVORED)

POWDE INFANT FORM, METAB, METHION-FR 400 GRAMS

49735018328 XLYS, XTRP ANALOG (UNFLAVORED) INF FORM, GLUTARIC ACIDURIA I 400 GRAMS

49735018361 XLEU ANALOG (UNFLAVORED) POWD INF. FORM, ISOVALERIC ACIDEMIA 400 GRAMS

49735018842 ACERFLEX (PINEAPPLE) POWDER ( NUTRIT.THERAPY, MSUD WITH IRON 454 GRAMS

49735018843 XPTM ANALOG (UNFLAVORED) POWD INF FORM FOR TYROSINEMIA, IRON 400 GRAMS

49735019535 PKU LOPHLEX LQ 20 POUCH NUT. TX FOR PKU WITH IRON #40 125 MILLILITERS

49735019708 MONOGEN POWDER NUTRITIONAL SUPPLEMENT/MCT 400 GRAMS


49735023631 XMET MAXAMAID POWDER NUT.TX,METABOLIC DIS,METHIO-FR 454 GRAMS


49735025314 PERIFLEX POWDER NUT. TX FOR PKU WITH IRON #3 454 GRAMS


49735110508 NEOCATE ONE+ LIQUID NUTRITIONAL SUPPLEMENT 1 MILLILITERS




Product


Package

Size

Medi-Cal

Billing Unit

50242001665 PROTROPIN 10 MG VIAL SOMATREM 1 EACH

50242001821 NUTROPIN 10 MG VIAL SOMATROPIN 1 EACH



50242002220 NUTROPIN AQ 5 MG/ML VIAL SOMATROPIN 2 MILLILITERS

50242003050 PROTROPIN 10 MG VIAL SOMATREM 1 EACH

50242003235 NUTROPIN DEPOT 13.5 MG KIT SOMATROPIN 1 EACH

50242003441 NUTROPIN DEPOT 18 MG KIT SOMATROPIN 1 EACH

50242003654 NUTROPIN DEPOT 22.5 MG KIT SOMATROPIN 1 EACH

50242004314 NUTROPIN AQ PEN CARTRIDGE SOMATROPIN 2 MILLILITERS


50242007301 NUTROPIN AQ 20 MG/2ML PEN CART SOMATROPIN 2 MILLILITERS

50242007401 NUTROPIN AQ NUSPIN 10 PEN CART SOMATROPIN 2 MILLILITERS



50313005113 ROYAGEL CAPSULE VITAMIN E/ROYAL JELLY/BEE POLL 60 EACH

50313006313 GITRON CAPSULE VITAMIN E/ROYAL JELLY/GINSENG 60 EACH

50428122869 CVS COENZYME Q10 50 MG CAP UBIDECARENONE 30 EACH

50428142158 CVS NUTRITION PLUS LIQUID LACTOSE-FREE FOOD 236 MILLILITERS



50428142695 CVS NUTRITION LIQUID LACTOSE-FREE FOOD 236 MILLILITERS



50428145477 CVS BONES & JOINTS POWDER NUTRITIONAL SUPPLEMENT 312 GRAMS

50428145484 CVS MSM 1,000 MG TABLET METHYLSULFONYLMETHANE 60 EACH

50428155185 CVS SAM-E 200 MG TABLET S-ADENOSYLMETHIONINE SUL TOSYL 20 EACH

50428174703 CVS SAM-E 400 MG TABLET S-ADENOSYLMETHIONINE SUL TOSYL 30 EACH

50428184706 CVS MENOPAUSE SUPPORT CPLET B COMP/VIT E AC/MINERAL 3/SOYB 30 EACH

50428184708 CVS COENZYME Q10 100 MG SFTGEL UBIDECARENONE 30 EACH

50428247315 CVS COENZYME Q10 150 MG SOFTGL UBIDECARENONE 30 EACH

50428277287 CVS MENOPAUSE SUPPORT CAPLET B/E AC/FA/MIN CMB NO.26/SOYB 56 EACH

50428277431 CVS SUPER OMEGA-3 SOFTGEL FISH OIL/VIT E/FAT NO.5/HC137 60 EACH


50428318769 CVS CELADRIN JOINT FORMULA SFT SALM OIL/VIT E MIX/SOY/FAT 3 80 EACH

50428416265 CVS COENZYME Q-10 100 MG SFTGL UBIDECARENONE/VIT E ACETATE 60 EACH


50428459962 CVS EAR CARE FORMULA TABLET MVI-MIN-INOSIT/CHOLI/BIOFLAVON 100 EACH

50428716145 CVS WHEY PROTEIN POWDER AMINO AC/WHEY PROT CON & ISOL 454 GRAMS

50428716152 CVS WHEY PROTEIN POWDER AMINO AC/WHEY PROT CON & ISOL 454 GRAMS

50600050236 MCT PRO-CAL POWDER NUT.TX.IMPAIRED DIGEST FXN 1 EACH

50600051318 PKU COOLER 10 LIQ COOLER NUT. TX FOR PKU WITH IRON #4 87 MILLILITERS


50600053206 PKU EXPRESS POWDER NUT. TX FOR PKU WITH IRON #20 25 GRAMS



50600053558 HCU EXPRESS POWDER NUT.TX,METABOLIC DIS,METHIO-FR 30 EACH



Product


Package

Size

Medi-Cal

Billing Unit

50600053848 TYR EXPRESS POWDER NUTRITIONAL TX FOR TYROSINEMIA 1 EACH



50600054654 MSUD EXPRESS COOLER LIQUID NUTRIT.THERAPY, MSUD WITH IRON 3900 MILLILITERS





50600054906 EAA POWDER NUT. TX FOR PKU WITH IRON #13 25 EACH

50600055156 RENA START POWDER SACHET NUT. TX,IMP. RENAL FXN, WHEY 1 EACH


50951000200 CERAXON 500 MG TABLET CITICOLINE SODIUM 60 EACH

50951000201 CERAXON 500 MG TABLET CITICOLINE SODIUM 20 EACH

51049955401 NUTRIVIR POWDER NUTRITIONAL SUPPLEMENT 1 GRAMS

51552117201 SILDENAFIL CITRATE POWDER SILDENAFIL CITRATE 1 GRAMS




51991011006 CO ENZYME Q-10 50 MG CAPSULE UBIDECARENONE 60 EACH


51991011406 CONJ LINOLEIC ACID SOFTGEL LINOLEIC ACID, CONJUGATED 60 EACH

52083033560 VASOFLEX TABLET RUTIN/HESP CM/BIOFL/ROSE/HC111 60 EACH

52083033690 VASOFLEX FORTE CAPSULE HESP METH CHAL/RUS ACU XT/ROSE 90 EACH

52083033890 VASOFLEX HD CAPLET C/HESP METH CHAL/DIOSM/BUTC BR 90 EACH

52083047060 DIETEX FORTE CAPSULE GUAR/CHRM/DR BT-ORG PEEL/HC109 60 EACH

52083052950 VARISAN VITALITY TABLET E AC/RUT/HESPER/BIO/B&C/HC111 50 EACH

52083053308 PRE-PROTEIN LIQUID AMINO ACIDS/PROTEIN HYDROLYS 240 MILLILITERS


52083093308 PRE-PROTEIN LIQUID AMINO ACIDS/PROTEIN HYDROLYS 236.5 MILLILITERS


52083098308 PRE-PROTEIN L-C 1000 LIQUID AMINO ACIDS/PROTEIN HYDROLYS 236.5 MILLILITERS

52083099260 BIO-IMMUNEX CAPSULE H-IMMU COL,BOV/A-CAR/ARA/HC112 60 EACH

52218000200 PROTEOLIN CAPSULE MILK PROT/TURMER/PEPPER/PINEAP 60 EACH

52218000201 PROTEOLIN CAPLET MILK PROT/TURMER/PEPPER/PINEAP 60 EACH

52311053101 ENTRITION 1.0 CAL/ML LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

52311053102 ENTRITION 0.5 CAL/ML LIQ NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

52311053104 ENTRITION 1.0 W/FIBER LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

52311053105 ENTRITION HN 1CAL/ML LIQ NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

52311053108 ENTRITION RDA 1.0 CAL/ML LIQ NUTRITIONAL SUPPLEMENT 1500 MILLILITERS

52472878601 REABILAN LIQUID LACTOSE-FREE FOOD 1 MILLILITERS

52472878701 REABILAN HN LIQUID LACTOSE-FREE FOOD 1 MILLILITERS

52735039714 FP VISION CAPSULE VIT C/VIT E AC/LUT/MINERAL 1 36 EACH

52735066744 FP HI-NUTRITIONAL SUPP PLUS LACTOSE-FREE FOOD 240 MILLILITERS



52735067044 FP HI-NUTRITIONAL SUPP LIQ LACTOSE-FREE FOOD 240 MILLILITERS



52747011060 DIVISTA SOFTGEL CAPSULE CHROMIUM/VIT B #13/FA/DHA/EPA 60 EACH



Product


Package

Size

Medi-Cal

Billing Unit

52769041706 PANGLOBULIN NF 6 GM VIAL IMMU GLOBULIN,GAMMA (IGG) 1 EACH

52769041812 PANGLOBULIN NF 12 GM VIAL IMMU GLOBULIN,GAMMA (IGG) 1 EACH

52769046001 MONARC-M VIAL 250-1,100 UNITS ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

52769047172 POLYGAM S/D 2.5 GM VL W/DIL IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

52769047175 POLYGAM S/D 5 GM VL W/DILUNT IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

52769047180 POLYGAM S/D 10 GM VL W/DILUNT IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

52769057622 IMMUNE GLOBULIN VIAL IMMU GLOBULIN,GAMMA (IGG) 2 MILLILITERS

53110097001 NUTRIVIR POWDER NUTRITIONAL SUPPLEMENT 546 GRAMS

53191003401 G.L.A.-45 SOFTGEL GAMOLENIC ACID 100 EACH

53191003418 G.L.A.-45 SOFTGEL GAMOLENIC ACID 180 EACH

53191006501 MPS CAPSULE DIETARY SUPPLEMENT 100 EACH

53191010501 LITHATE 5 MG CAPSULE LITHIUM ASPARTATE 100 EACH

53191012101 DNZ-2 100 MG CAPSULE DEANOL ACETAMIDOBENZOATE 100 EACH

53191012301 DNZ-2 250 MG CAPSULE DEANOL ACETAMIDOBENZOATE 100 EACH

53191018201 COQ10 30 MG CAPSULE UBIDECARENONE 100 EACH


53191018303 BORAGE SOFTGEL E AC/LINOLEIC/GAMOL AC/BORG 30 EACH


53191044701 LITHATE 20 MG CAPSULE LITHIUM ASPARTATE 100 EACH


53983020025 BIFIDO FACTOR POWDER BIFIDOBACTERIUM BIFIDUM 71.9 GRAMS

53983020045 BIFIDO FACTOR POWDER BIFIDOBACTERIUM BIFIDUM 127.6 GRAMS

54022010821 FREE FORM AMINO ACIDS TABLET LACTALBUMINS, HYDROLYZATES/CYS 250 EACH

54022010823 FREE FORM AMINO ACIDS TABLET LACTALBUMINS, HYDROLYZATES/CYS 1000 EACH

54022030351 SHARPER FOCUS TABLET CHOL/GL/SER/RNA/PHEN/PRG/HB150 60 EACH

54022030601 NEURO-ESSENTIALS CAPLET CH/GL/CAR/PID/TY/DMAE/DHA/H151 120 EACH

54022081001 HERBAL ANTIOXIDANT FORMULA TAB

PYCNOGN/GRPSDXT/GKBLFXT/GRTLF

X 60 EACH

54022081002 HERBAL ANTIOXIDANT FORMULA TAB

PYCNOGN/GRPSDXT/GKBLFXT/GRTLF

X 100 EACH

54022105801 L-GLUTAMINE & CHOLINE TAB INOSITOL/CHOLINE/GLUTAMINE 90 EACH

54022205501 COENZYME Q10 25 MG TABLET UBIDECARENONE 60 EACH








54022208501 COENZYME Q10 60 MG WAFER UBIDECARENONE 30 EACH









54023678102 Q-GEL 15 MG SOFTSULE UBIDECARENONE/VIT E ACETATE 60 EACH

54023694802 Q-GEL 30 MG SOFTSULE A LIPOIC ACID/UBIDECAR/DL-E 60 EACH




Product


Package

Size

Medi-Cal

Billing Unit













54023863907 Q-UP LIQUID UBIDECARENONE/VITAMIN E 500 MILLILITERS





54023913702 CHEW Q 600 MG WAFER UBIDECARENONE 60 EACH


54023915802 CHEW Q 100 MG CHEWABLE TABLET UBIDECARENONE 60 EACH


54023937301 LIQSORB DROPS UBIDECARENONE 30 MILLILITERS

54023937306 LIQSORB LIQUID UBIDECARENONE 170 MILLILITERS

54023982702 H2Q 100 MG CAPSULE UBIDECARENONE 60 EACH

54092063775 SUPPRELIN 200 MCG/ML KIT HISTRELIN AC 1 EACH

54092063875 SUPPRELIN 500 MCG/ML KIT HISTRELIN AC 1 EACH

54092063975 SUPPRELIN 1,000 MCG/ML KIT HISTRELIN AC 1 EACH

54458001202 RX BALANCE B CAPSULE UBIDCAR/B1/B6/C/MAG CH/ZINC CH 30 EACH

54458001207 RX BALANCE STATIN CAPSULE UBIDECARENONE/B-6/B12/B5/MGOX 30 EACH

54458001208 RX BALANCE DPR CAPSULE UBIDECARENONE/RIBOFLAVIN 30 EACH




54458073950 OMEGA 3 1,000 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 50 EACH

54458079790 MALIC ACID 800 MG TABLET MALIC ACID 90 EACH

54629000014 ROYAL JELLY 250 MG SOFTGEL ROYAL JELLY 90 EACH


54629001160 VIRA EXTRA CAPSULE ARGNIN/HIST/E/GNK/K.GIN/HRB50 60 EACH

54629001169 VIRA FEMALE CAPSULE LECITH/TAUR/ARGNIN/KAV/HRB58 60 EACH


54629006991 OMEGA-3 FISH OIL 1,760 MG STGL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH

54629008039 HEALTHY HEART FORMULA SFTGL UBIDECARENONE/L-CARN FUM/VIT E 60 EACH

54629010213 ULTIMATE PROTEIN MIX POWDER PROTEIN SUPPLEMENT 381 GRAMS

54629011520 MAXIMUM DAILY GREEN TABLET FA/MV/BEE POLLEN/HERB CMB 101 120 EACH

54629012039 APPLE CIDER VINGR 600 MG CAP CIDER VINEGAR 90 EACH

54629012169 CHITOSAN 500 MG CAPSULE CHITOSAN 90 EACH


54629026260 ALLERWELL ALLRGY FORMULA TB AA COMB.NO3/B/MV-AO4/MN/MIN AA 60 EACH

54629034001 BEE POLLEN CAPSULE BEE POLLEN 100 EACH

54629035000 ULTRA ENERGY TABLET GUARA XT/AA COMB 2/CA/BEE POLL 60 EACH



Product


Package

Size

Medi-Cal

Billing Unit


54629036120 METABO-STYLE CAPLET VIT E AC/MIN/BOV CPLX/HRB37 90 EACH

54629039336 SLENDER CORTISOL CAPSULE B-SIT/M-19/DR BT-ORG PEEL/GR T 60 EACH




54629066487 BEE POLLEN 580 MG CAPSULE BEE POLLEN 100 EACH

54629066607 LECITHIN KELP-B6 TABLET LECITH/PYRIDOX HCL/I2/CIDER 100 EACH

54629066691 BILBERRY EXTRACT 40 MG CAP RUTIN/QUERCETIN/BIOFLAV/BILBER 60 EACH

54629066693 COLD & FLU FIGHTER CAP C/ECH/ST.JHNWT/ELD/SGIN/HRB30 60 EACH




54629068600 VITAMANIX ULTIMATE CAPSULE BIOFLAV/FA/MV/DIET7/BEE POLL 60 EACH



54629069500 CARDIOVASCULAR SUPPORT CAP INOSITOL/MV COMB 1/SE/BETAINE 60 EACH


54629071126 MUSCLE BUILD UP POWDER NUTRITIONAL SUPPLEMENT 528 GRAMS

54629071128 ISOFLAVONES SOY PROTEIN PWD CALCIUM/FOLIC ACID/MIN/SOYBEAN 297 GRAMS



54629071135 ISOFLAVONES SOY PROTEIN PWD SOY PROTEIN 306 GRAMS

54629071152 SPIRULINA SOY PROTEIN PWDER SOY PROTEIN 1008 GRAMS



54629071361 CREATINE POWDER CREATINE MONOHYDRATE 681 GRAMS

54629073293 CREATINE POWDER CREATINE MONOHYDRATE 1362 GRAMS

54629078400 CHONDROITIN SULF 400 MG CAP CHONDRO SU A/VIT C/MANGANESE 60 EACH

54629078943 80% PROTEIN SUPPLEMENT PWD SOY PROTEIN 1362 GRAMS



54799091705 ZYTAZE CAPSULE ZINC CITRATE/PHYTASE 10 EACH

54859051508 PROTEINEX LIQUID AMINO ACIDS/PROTEIN HYDROLYS 236 MILLILITERS

54859051516 PROTEINEX LIQUID AMINO ACIDS/PROTEIN HYDROLYS 472 MILLILITERS

54859052501 PROTEINEX-18 LIQUID AMINO ACIDS/PROTEIN HYDROLYS 30 MILLILITERS

54859052508 PROTEINEX-18 LIQUID AMINO ACIDS/PROTEIN HYDROLYS 236.5 MILLILITERS



54859053508 PROTEINEX-18 LIQUID AMINO ACIDS/PROTEIN HYDROLYS 236.5 MILLILITERS


54859070860 TROMBONEX CAPSULE VIT C/RUT/HESPER/BIOFL/BUTC BR 60 EACH

55146001109 CHLORELLA CAPS CHLOREL/CHLOROPH/D3/B2/FA/IRON 180 EACH

55571002496 MYOCALM TABLET CAL LAC/MAG CIT/PASS FLW/VALER 180 EACH

55571002497 MYOCALM TABLET CAL LAC/MAG CIT/PASS FLW/VALER 60 EACH

55571091783 EC MATRIXX TABLET VIT B COMPLEX/MIN/HOPS/BERB CL 90 EACH

55571091876 OSTERA TABLET VIT D3 & K/BERBERINE HCL/HOPS 60 EACH

55592050001 VANTAS 50 MG KIT HISTRELIN AC 1 EACH

55970055501 SENIOR MOMENT CAPSULE DHA/PHOSPHOLIPIDS,PORCINE 30 EACH

55970055521 SENIOR MOMENT CAPSULE DHA/PHOSPHOLIPIDS,PORCINE 75 EACH

56643080060 REJOYN VEROMAX CAPSULE AM AC/G-AC/GIN/GNK/SAW P/JUJU 60 EACH



Product


Package

Size

Medi-Cal

Billing Unit



56643085060 REJOYN VEROMAX CAPSULE AA/G-AC/GIN/GNK/KUD RT XT/JUJU 60 EACH



57844071319 TEV-TROPIN 5 MG VIAL SOMATROPIN 1 EACH

57844071341 TEV-TROPIN 5 MG VIAL SOMATROPIN 1 EACH

58281056001 LIORESAL IT 10 MG/20 ML KIT BACLOFEN 20 MILLILITERS



58281056201 LIORESAL IT 0.05 MG/1 ML AMP BACLOFEN 1 MILLILITERS



58394000101 BENEFIX 1,000 UNIT VIAL FACTOR IX HUMAN RECOMBINANT 1 EACH UNIT


58394000201 BENEFIX 500 UNIT VIAL FACTOR IX HUMAN RECOMBINANT 1 EACH UNIT




58394000502 REFACTO 1,000 UNITS VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT


58394000602 REFACTO 500 UNITS VIAL ANTIHEMOPHILIC FACTOR, HUM REC 1 EACH UNIT







58394001201 XYNTHA 250 UNIT KIT ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH

58394001301 XYNTHA 500 UNIT KIT ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH

58394001401 XYNTHA 1,000 UNIT KIT ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH

58394001501 XYNTHA 2,000 UNIT KIT ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH

58394001603 XYNTHA 3,000 UNIT SYRINGE KIT ANTIHEMOPH.FVIII PLAS/ALB FREE 1 EACH UNIT

58487002181 CHOLINE CITRATE 650 MG TABLET CHOLINE DIHYDROGEN CITRATE 100 EACH

58487002331 BETAINE HCL 300 MG TABLET BETAINE HCL 100 EACH

58487002332 BETAINE HCL 300 MG TABLET BETAINE HCL 250 EACH

58487003071 ANTI-ALLERGY FORMULA TABLET ASCORBATE CALCIUM/B5/QUERCETIN 100 EACH

58487003072 ANTI-ALLERGY FORMULA TABLET ASCORBATE CALCIUM/B5/QUERCETIN 250 EACH

58790000360 THERA TEARS NUTRITION CAPSULE OM-3/EPA/DHA/FISH OIL/FLAX/E 90 EACH

58809074790 VANACHOL SOFTGEL CAPSULE DHA/EPA/POLICOS/B6/B12/FA/PHYT 240 EACH

58809747890 VANACHOL SOFTGEL CAPSULE DHA/EPA/POLICOS/VIT B12/FA/B6 90 EACH

58869012101 ELON MATRIX PLUS TABLET BIOTIN/SILICON DIOX/L-CYSTEINE 60 EACH

58869012201 ELON MATRIX COMPLETE TABLET BIOTIN/SILIC/CYSTEIN/LUT/MVMIN 60 EACH

58869012501 ELON MATRIX 5000 TABLET BIOTIN/SILICON DIOX/L-CYSTEINE 60 EACH



Product


Package

Size

Medi-Cal

Billing Unit

58869012601 ELON MATRIX 5000 COMPLETE TAB BIOTIN/SILIC/CYSTEIN/LUT/MVMIN 60 EACH

59075071010 MYOBLOC 2,500 UNIT/0.5 ML VIAL RIMABOTULINUMTOXINB 0.5 MILLILITERS



59630041560 FOSTEUM CAPSULE GENISTEIN/CIT ZN BISGLY/VIT D3 60 EACH

59781020864 JUVEN PACKET ARGININE/GLUTAMINE/CALCIUM HMB 1 EACH






59781071164 JUVEN POWDER NUTRITIONAL SUPPLEMENT 545 GRAMS

60574411101 SYNAGIS 100 MG VIAL PALIVIZUMAB 1 EACH

60574411201 SYNAGIS 50 MG VIAL PALIVIZUMAB 1 EACH

60574411301 SYNAGIS 100 MG/1 ML VIAL PALIVIZUMAB 1 MILLILITERS

60574411401 SYNAGIS 50 MG/0.5 ML VIAL PALIVIZUMAB 0.5 MILLILITERS

61480025505 PSORIZIDE FORTE TABLET NICKEL SU/POT BROMIDE/FUMARIC 90 EACH

61678012416 L-EMENTAL HEPATIC PWDR PKT NUTRITIONAL SUPPLEMENT 24 EACH

61678013607 L-EMENTAL PLUS PACKET LACTOSE-FREE FOOD 36 EACH

61678013615 L-EMENTAL PEDIATRIC PACKET LACTOSE-FREE FOOD 36 EACH

61678016001 L-EMENTAL PACKET LACTOSE-FREE FOOD 60 EACH

61678022402 PRO-PEPTIDE LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

61678022412 PRO-PEPTIDE VHN LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

61678022415 PRO-PEPTIDE LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

61678022421 PRO-PEPTIDE FOR KIDS LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

61941040050 COLDEEZE IMMUNE SUPPORT 10 TAB VIT A,C,E/B6/B12/ZINC/HERB 148 20 EACH



61953000301 FLEBOGAMMA 5% VIAL IMMUNE GLOBULIN,GAMMA (IGG) 10 MILLILITERS




61953000401 FLEBOGAMMA DIF 5% VIAL IMMUNE GLOBULIN,GAMMA (IGG) 10 MILLILITERS












63833061502 HUMATE-P 600 UNITS KIT AHF,HUMAN/VWF,HUMAN 1 EACH UNIT



Product


Package

Size

Medi-Cal

Billing Unit



64193022203 FEIBA VH IMMUNO 400-650 UNITS ANTI-INHIBITOR COAGULANT COMP. 1 EACH UNIT

64193022204 FEIBA VH IMMUNO 651-1,200 UNIT ANTI-INHIBITOR COAGULANT COMP. 1 EACH UNIT

64193022205 FEIBA VH IMMU 1,750-3,250 UNIT ANTI-INHIBITOR COAGULANT COMP. 1 EACH UNIT

64193022302 FEIBA NF 400-650 UNIT VIAL ANTI-INHIBITOR COAGULANT COMP. 1 EACH UNIT

64193022402 FEIBA NF 651-1,200 UNIT VIAL ANTI-INHIBITOR COAGULANT COMP. 1 EACH UNIT

64193022502 FEIBA NF 1,750-3,250 UNIT VIAL ANTI-INHIBITOR COAGULANT COMP. 1 EACH UNIT

64193024402 BEBULIN VH IMMU 200-1,200 UNIT FACTOR IX COMPLEX HUMAN 1 EACH UNIT

64193025050 IVEEGAM EN 5 GM VIAL IMMUNE GLOBULIN,GAMMA (IGG) 1 EACH

64208823401 GAMMAPLEX 5% VIAL IMMUNE GLOBULIN,GAMMA (IGG) 50 MILLILITERS



64769010203 PROSTAT TABLET POLLEN EXTRACTS 60 EACH

64769040002 PROFEMME TABLET POLLEN EXTRACTS 60 EACH

64769070002 PROFEMME TABLET POLLEN EXTRACTS 120 EACH

64769070203 PROSTAT TABLET POLLEN EXTRACTS 120 EACH

64915030560 PANPLEX 2-PHASE TABLET PEP/PANCREAT/GLUT ACID/BETAINE 60 EACH

64915040160 ECHINACEA ACZ CAPSULE VIT A/VIT C/BIOFLAV/ZN/HERB25 60 EACH

64915040950 IMMUPLEX LOZENGE VIT A/VIT C/ZN/HERB15 50 EACH

64915050690 ARTHRO-COMPLEX CAPSULE MSM/HERBAL COMPLEX NO.1 90 EACH

64915053060 SEDAPLEX CAPSULE CA CITRATE/MGOX/NIA/B6/HERB16 60 EACH

64915055012 PARA-GARD CAPSULE BERB SU/HERBAL COMPLEX NO.18 120 EACH

64915055060 PARA-GARD CAPSULE BERB SU/HERBAL COMPLEX NO.18 60 EACH

64915058090 MENO-BALANCE CAPSULE MG CIT/E AC SUCC/HESPER/HERB13 90 EACH

64915064290 HEPATIC COMPLEX CAPSULE ENZYM,PLT/HERBAL COMPLEX NO.12 90 EACH

64915066390 HF COMPLEX CAPSULE ENZYM,PLT/BIO/MAHUG/EYEBR/SABD 90 EACH

64915070860 Q-MAX CAPSULE UBIDECAR/PH-PHAT-CHO/E/BORG 60 EACH

64915071490 HTN COMPLEX CAPSULE POTASS/VIT C/MIN/HERB17 90 EACH

64915071712 LIPIDIN-HP CAPSULE PANTET/GAM ORYZ/GUGGUL/GARLIC 120 EACH

64915075860 NEURO-PLUS CAPSULE DMAE/GKB/GOTK/ASGD/BRAHM/K.GIN 60 EACH

65224058001 FOVEX CAPSULE OMEGA-3/DHA/EPA/LUT/ZEAXANTHIN 90 EACH

65880094212 PSORIACAP SOFTGEL DHA/EPA/FA/VIT A&D/MINERALS 120 EACH

66213054060 ANIMI-3 CAPSULE OMEGA-3/B12/FA/B-6/PHYTOSTEROL 60 EACH

66213054160 ANIMI-3 CAPSULE OMEGA-3/B12/FA/B-6/PHYTOSTEROL 60 EACH

66302046760 ADCIRCA 20 MG TABLET TADALAFIL 60 EACH

66860061212 ALBUMAX POWDER PROTEIN SUPP/AMINO ACIDS/MIN 1000 GRAMS

67043020024 EPULOR LIQUID NUTRITIONAL SUPPLEMENT 45 MILLILITERS

67043030024 EPULOR LIQUID NUTRITIONAL SUPPLEMENT 45 MILLILITERS

67467018101 WILATE 450-450 UNIT KIT AHF,HUMAN/VWF,HUMAN 1 EACH UNIT

67467018102 WILATE 900-900 UNIT KIT AHF,HUMAN/VWF,HUMAN 1 EACH UNIT

67467084301 OCTAGAM 5% VIAL IMMUNE GLOBULIN,G(IGG)/MALTOSE 20 MILLILITERS




Product


Package

Size

Medi-Cal

Billing Unit




67979000201 SUPPRELIN LA 50 MG KIT HISTRELIN AC 1 EACH

67979050001 VANTAS 50 MG KIT HISTRELIN AC 1 EACH

68016001760 PV APPLE CIDER VINEGAR 300 MG CIDER VINEGAR 200 EACH

68016001794 PV COQ-10 100 MG SOFTGEL UBIDECARENONE/VIT E ACETATE 30 EACH



68016001833 PV MSM 1,000 MG TABLET METHYLSULFONYLMETHANE 120 EACH

68016001982 PV AIRSHIELD EFFERVESCENT TAB VIT A,C,& E/DIETARY SUPP NO.12 10 EACH





68016002127 PV SHARK CARTILAGE 500 MG SHARK CARTILAGE 100 EACH


68040060116 LIMBREL 250 MG CAPSULE BAICALIN/CATECHIN 60 EACH

68040060216 LIMBREL 500 MG CAPSULE BAICALIN/CATECHIN 60 EACH

68040060316 FOSTEUM CAPSULE GENISTEIN/CIT ZN BISGLY/VIT D3 60 EACH

68040060516 LIMBREL250 CAPSULE BAICALIN/CATECHIN/CITRATED ZNC 60 EACH

68040060616 LIMBREL500 CAPSULE BAICALIN/CATECHIN/CITRATED ZNC 60 EACH

68040060916 LIMBREL525 525-50 MG CAPSULE BAICALIN/CATECHIN/CITRATED ZNC 60 EACH

68135030002 KUVAN 100 MG TABLET SAPROPTERIN DIHYDROCHLORIDE 120 EACH





68308050260 MI-OMEGA NF CAPSULE OMEGA-3/B12/FA/B-6/PHYTOSTEROL 60 EACH

68405100101 APPTRIM CAPSULE CAF/CHOL BTT/AA COMB.NO7/HC125 120 EACH

68405100202 SENTRA AM CAPSULE AA9/A-CARNITIN/DEX/COCOA/HC127 60 EACH

68405100302 SENTRA PM CAPSULE AA9/A-CARNITIN/DEX/COCOA/HC128 60 EACH

68405100402 GABADONE CAPSULE AA8/A-CARNITIN/GRP/COCOA/HC126 60 EACH

68405100503 PULMONA CAPSULE CAFFEIN/AA COMB13/CINN/HC135 90 EACH

68405100602 VIRILEX CAPSULE CAFFEIN/CHOL/AA COMB12/HC131 60 EACH

68405100702 HYPERTENSA CAPSULE CAFFEIN/CHOL BITART/AA11/HC130 60 EACH

68405100703 HYPERTENSA CAPSULE CAFFEIN/CHOL BITART/AA11/HC130 90 EACH

68405100802 THERAMINE CAPSULE CHOL BITART/AA10/GABA/HC129 60 EACH

68405100803 THERAMINE CAPSULE CHOL BITART/AA10/GABA/HC129 90 EACH

68405100901 APPTRIM-D CAPSULE CHOL BITART/AA COMB.NO7/HC125 120 EACH

68405101002 LISTER-V CAPSULE DIETARY SUPPLEMENT,MISC COMB14 60 EACH






Product


Package

Size

Medi-Cal

Billing Unit




68516320002 PROFILNINE SD 500 UNITS VIAL FACTOR IX COMPLEX HUMAN 1 EACH UNIT

68516320003 PROFILNINE SD 1,000-1,500 UNIT FACTOR IX COMPLEX HUMAN 1 EACH UNIT

68516320004 PROFILNINE SD 1,000 UNITS VIAL FACTOR IX COMPLEX HUMAN 1 EACH UNIT


68516320101 PROFILNINE SD 500 UNITS VIAL FACTOR IX COMPLEX HUMAN 1 EACH UNIT



68516360002 ALPHANINE SD 250-1,500 UNIT VL FACTOR IX 1 EACH UNIT

68516360004 ALPHANINE SD 500 UNITS VIAL FACTOR IX 1 EACH UNIT

68516360005 ALPHANINE SD 1,000 UNITS VIAL FACTOR IX 1 EACH UNIT


68516360102 ALPHANINE SD 500 UNITS VIAL FACTOR IX 1 EACH UNIT



68516460001 ALPHANATE 250-500 UNIT VIAL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

68516460002 ALPHANATE 1,000-1,500 UNITS VL ANTIHEMOPHILIC FACTOR,HUMAN 1 EACH UNIT

68516460101 ALPHANATE 250-100 UNIT VIAL AHF,HUMAN/VWF,HUMAN 1 EACH UNIT

68516460201 ALPHANATE 500-200 UNIT VIAL AHF,HUMAN/VWF,HUMAN 1 EACH UNIT

68516460302 ALPHANATE 1,000-400 UNIT VIAL AHF,HUMAN/VWF,HUMAN 1 EACH UNIT

68516460402 ALPHANATE 1,500-600 UNIT VIAL AHF,HUMAN/VWF,HUMAN 1 EACH UNIT

70074000378 CALCILO XD POWDER INFANT FORMULA W-IRON 400 GRAMS


70074006690 INTROLITE LIQUID LACTOSE-FREE FOOD 1000 MILLILITERS

70074006810 ENSURE PLUS HN LIQUID LACTOSE-FREE FOOD 1000 MILLILITERS

70074006820 JEVITY LIQUID LACTOSE-FREE FOOD 1000 MILLILITERS

70074011107 ENSURE PLUS LIQUID LACTOSE-FREE FOOD 237 MILLILITERS





70074011114 ENSURE WITH FIBER LIQUID LACTOSE-FREE FOOD/FIBER 237 MILLILITERS

70074011116 ENSURE LIGHT LIQUID LACTOSE-FREE FOOD 237 MILLILITERS



70074011119 ENSURE HIGH PROTEIN LIQUID LACTOSE-FREE FOOD 237 MILLILITERS


70074040108 RCF SOY FORMULA W-IRON LIQUID INFANT FORMULA,SOY-FE LAC-FREE 384 MILLILITERS

70074040143 JEVITY 1 CAL LIQUID LACTOSE-FREE FOOD 237 MILLILITERS

70074040373 PEDIASURE LIQUID PEDIATRIC NUTRITION, IRON, LF 237 MILLILITERS

70074040604 FORTA SHAKE POWDER STRAWBER NUTRITIONAL SUPPLEMENT 470 GRAMS

70074040619 FORTA SHAKE POWDER EGGNOG NUTRITIONAL SUPPLEMENT 470 GRAMS


70074040699 PULMOCARE LIQUID NUT.TX.PULM.DISORD.SOY,LAC-FR 240 MILLILITERS

70074040703 ENSURE LIQUID LACTOSE-FREE FOOD 237 MILLILITERS


70074040729 TWOCAL HN LIQUID NUT.SUP,SPEC.FRM,L-FR,IRON/FOS 237 MILLILITERS

70074040735 OSMOLITE 1 CAL LIQUID LACTOSE-FREE FOOD 240 MILLILITERS

70074040766 VITAL HIGH NITROGEN PACKET LACTOSE-FREE FOOD 6 EACH

70074050097 VITAL JR LIQUID NUTRITIONAL SUPPLEMENT 500 MILLILITERS



Product


Package

Size

Medi-Cal

Billing Unit

70074050165 SUPLENA RTU LIQUID NUT.TX.IMPAIRED RENAL FXN,SOY 237 MILLILITERS


70074050241 GLUCERNA LIQUID NUT.TX.GLUC.INTOLER,LAC-FR,SOY 237 MILLILITERS

70074050260 PROVIMIN POWDER MINERALS/PROTEIN SUPPLEMENT 150 GRAMS

70074050261 PROVIMIN POWDER MINERALS/PROTEIN SUPPLEMENT 150 GRAMS

70074050331 JEVITY 1 CAL LIQUID LACTOSE-FREE FOOD 946 MILLILITERS

70074050461 ENSURE IMMUNE HEALTH LIQUID LACTOSE-FREE FOOD 237 MILLILITERS




70074050541 ALIMENTUM LIQUID INFANT FORMULA W-IRON 237 MILLILITERS

70074050588 SIMILAC SPEC CARE/IRON LIQ INFANT FORMULA W-IRON 118 MILLILITERS

70074050629 PERATIVE LIQUID NUTRITION NUT.TX. METABOLIC DISORDER,SOY 240 MILLILITERS

70074050631 ALITRAQ W-GLUTAMINE PKT VAN NUTRITIONAL SUPPLEMENT 6 EACH

70074050633 NEPRO LIQUID NUT.TX.IMPAIRED RENAL FXN,SOY 237 MILLILITERS




70074050775 PROMOTE LIQUID VANILLA LACTOSE-FREE FOOD 237 MILLILITERS

70074050903 GLUCERNA 1.2 CAL LIQUID NUT.TX.GLUC.INTOLER,LAC-FR,SOY 1500 MILLILITERS



70074051016 SIMILAC EXPERT CARE LIQUID INFANT FORMULA W-IRON 59 MILLILITERS

70074051113 KETONEX-1 POWDER INFANT FORMULA,SPEC.METAB MSUD 400 GRAMS

70074051115 KETONEX-2 POWDER NUTRIT.THERAPY, MSUD WITH IRON 400 GRAMS

70074051117 HOMINEX-1 POWDER INFANT FORM, METAB, METHION-FR 400 GRAMS

70074051119 HOMINEX-2 POWDER NUT.TX,METABOLIC DIS,METHIO-FR 400 GRAMS

70074051121 PHENEX-1 POWDER INFANT FORM. FOR PKU,IRON, #2 400 GRAMS

70074051123 PHENEX-2 POWDER NUT. TX FOR PKU WITH IRON #1 400 GRAMS

70074051127 TYREX-2 POWDER NUTRITIONAL TX FOR TYROSINEMIA 400 GRAMS

70074051129 TYREX-1 POWDER INF FORM FOR TYROSINEMIA, IRON 400 GRAMS

70074051133 PROPIMEX-1 POWDER INFANT FORM,PROPIONIC ACIDEMIA 400 GRAMS

70074051135 PROPIMEX-2 POWDER NUT. TX FOR PROPIONIC ACIDEMIA 400 GRAMS

70074051137 I-VALEX-1 POWDER INF. FORM, ISOVALERIC ACIDEMIA 400 GRAMS

70074051139 I-VALEX-2 POWDER NUT TX FOR ISOVALERIC ACIDEMIA 400 GRAMS

70074051141 GLUTAREX-1 POWDER INF FORM, GLUTARIC ACIDURIA I 400 GRAMS

70074051143 GLUTAREX-2 POWDER NUT. TX, GLUTARIC ACIDURIA I 400 GRAMS

70074051145 CYCLINEX-1 POWDER INFANT FORMULA, UREA CYCLE DIS 400 GRAMS

70074051147 CYCLINEX-2 NUT.TX., UREA CYCLE DISORDER 400 GRAMS

70074051149 PRO-PHREE POWDER INFANT FORMULA W-IRON 400 GRAMS




70074051305 ADVERA LIQUID NUT.TX.COMP. IMMUNE SYSTM,SOY 240 MILLILITERS

70074051617 PROMOTE LIQUID LACTOSE-FREE FOOD 1000 MILLILITERS







70074051807 PEDIASURE WITH FIBER LIQUID PEDIATRIC NUTRIT,IRON,LF&FIBER 237 MILLILITERS




Product


Package

Size

Medi-Cal

Billing Unit



70074051849 NEOSURE ADVANCE LIQUID INFANT FORMULA W-IRON 118 MILLILITERS

70074051873 PROMOTE WITH FIBER LIQUID LACTOSE-FREE FOOD/FIBER 237 MILLILITERS

70074051875 PROMOTE LIQUID LACTOSE-FREE FOOD/FIBER 1000 MILLILITERS










70074052453 ADVERA LIQUID NUT.TX.COMP. IMMUNE SYSTM,SOY 240 MILLILITERS





70074053115 JEVITY PLUS LIQUID LACTOSE-FREE FOOD/FIBER 1500 MILLILITERS

70074053117 OSMOLITE HN PLUS LIQUID LACTOSE-FREE FOOD 1500 MILLILITERS

70074053119 JEVITY 1.2 CAL LIQUID LACTOSE-FREE FOOD/FIBER 237 MILLILITERS

70074053121 OSMOLITE 1.2 CAL LIQUID LACTOSE-FREE FOOD 237 MILLILITERS

70074053123 OSMOLITE HN PLUS LIQUID LACTOSE-FREE FOOD 1000 MILLILITERS

70074053125 JEVITY PLUS LIQUID LACTOSE-FREE FOOD/FIBER 1000 MILLILITERS


70074053463 ENLIVE LIQUID NUT.TX.IMPAIRED DIGEST FXN 240 MILLILITERS






70074053638 SUPLENA CARB STEADY LIQUID NUT.TX.IMPAIRED RENAL FXN,SOY 237 MILLILITERS




70074054387 OXEPA LIQUID NUT.TX.PULM.DISORD.REG,LAC-FR 237 MILLILITERS

70074054568 SIMILAC ALIMENTUM POWDER INFANT FORMULA W-IRON 454 GRAMS

70074054599 SIMILAC MILK FORTIFIER PCKT INFANT FORMULA,REGULAR 1 EACH

70074054639 OPTIMENTAL LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS

70074054666 ELECARE AMINO ACID POWDER AMINO ACIDS 400 GRAMS

70074054777 ENSURE ENLIVE LIQUID NUT.TX.IMPAIRED DIGEST FXN 240 MILLILITERS

70074054780 ENSURE ENLIVE LIQUID LACTOSE-FREE FOOD 240 MILLILITERS

70074054823 ENSURE HIGH CALCIUM LIQUID LACTOSE-FREE FOOD 237 MILLILITERS


70074054944 HEALTH SOURCE PROTEIN PWDR SOY PROTEIN 306 GRAMS



70074055306 HI-CAL LIQUID NUTRITIONAL SUPPLEMENT 946 MILLILITERS


70074055427 RE/NEPH HP/HC LIQUID NUT.TX.IMP.RENAL FXN,LAC-FREE 118 MILLILITERS






Product


Package

Size

Medi-Cal

Billing Unit

70074055431 RE/NEPH LP/HC LIQUID NUT.TX.IMP.RENAL FXN,LAC-FREE 118 MILLILITERS

70074055433 RE/NEPH LP/HC LIQUID NUT.TX.IMP.RENAL FXN,LAC-FREE 118 MILLILITERS

70074055434 RE/NEPH LIQUID NUT.TX.IMP.RENAL FXN,LAC-FREE 118 MILLILITERS

70074055435 RE/NEPH LIQUID NUT.TX.IMP.RENAL FXN,LAC-FREE 118 MILLILITERS

70074055436 RE/NEPH REDUCED SUGAR LIQ NUT.TX.IMP.RENAL FXN,LAC-FREE 118 MILLILITERS

70074055756 PHENEX-2 POWDER NUT. TX FOR PKU WITH IRON #1 400 GRAMS

70074055775 PROSURE LIQUID CALORIC SUPPLEMENT 237 MILLILITERS




70074055859 NUTRIFOCUS LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS

70074055861 NUTRIFOCUS LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS


70074056003 ENSURE BAR NUTRITIONAL SUPPLEMENT 12 EACH




70074056278 VITAL 1.0 CAL LIQUID NUT.TX.IMPAIRED DIGEST/FIBER 237 MILLILITERS




70074056295 SIMILAC SPECIAL CARE LIQUID INFANT FORMULA, IRON/DHA/ARA 59 MILLILITERS




70074056410 PEDIASURE 1.5 CAL(VAN 8OZ CAN) PEDIATRIC NUTRITION, IRON, LF 237 MILLILITERS

70074056412 PEDIASURE 1.5CALW/FIBER PEDIATRIC NUTRIT,IRON,LF&FIBER 237 MILLILITERS

70074056471 ENSURE BONE HEALTH LIQUID LACTOSE-FREE FOOD 237 MILLILITERS

70074056474 ENSURE BONE HEALTH LIQUID LACTOSE-FREE FOOD 237 MILLILITERS

70074056477 ENSURE MUSCLE HEALTH LIQUID LACTOSE-FREE FOOD 237 MILLILITERS




70074056489 ENSURE CLINICAL STRENGTH LIQ LACTOSE-FREE FOOD 237 MILLILITERS



70074056543 VITAL AF 1.2 CAL LIQUID NUT.TX.IMPAIRED DIGEST/FIBER 237 MILLILITERS

70074056545 VITAL AF 1.2 CAL LIQUID NUT.TX.IMPAIRED DIGEST/FIBER 1000 MILLILITERS







70074057044 OXEPA LIQUID NUT.TX.PULM.DISORD.REG,LAC-FR 1000 MILLILITERS

70074057046 OPTIMENTAL LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS






70074057431 SIMILAC EXPERT CARE NEOSURE PW INFANT FORMULA, IRON/DHA/ARA 371 GRAMS



Product


Package

Size

Medi-Cal

Billing Unit

70074057456 SIMILAC EXPERT CARE NEOSURE LQ INFANT FORMULA W-IRON 946 MILLILITERS

70074057470 OSMOLITE 1.5 CAL LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS

70074057472 OSMOLITE 1.5 CAL LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

70074057507 SIMILAC ALIMENTUM ADVANCE LIQD INF FORM FE LF/DHA/ARACHID AC 118 MILLILITERS

70074057509 SIMILAC ALIMENTUM ADVANCE LIQ INF FORM FE LF/DHA/ARACHID AC 237 MILLILITERS

70074057512 SIMILAC ALIMENTUM LIQUID INF FORM FE LF/DHA/ARACHID AC 946 MILLILITERS

70074057513 SIMILAC ALIMENTUM LIQUID INF FORM FE LF/DHA/ARACHID AC 946 MILLILITERS

70074057632 PROMOTE LIQUID LACTOSE-FREE FOOD 1500 MILLILITERS

70074057634 PROMOTE WITH FIBER LIQUID LACTOSE-FREE FOOD/FIBER 1500 MILLILITERS


70074057664 SIMILAC ALIMENTUM ADV POWD INFANT FORMULA W-IRON 454 GRAMS

70074057702 GLUCERNA SELECT LIQUID NUT.TX.GLUC.INTOLER,LAC-FR,SOY 237 MILLILITERS




70074057949 SIMILAC NEOSURE ADVANCE LIQUID INFANT FORMULA W-IRON 118 MILLILITERS

70074058014 PIVOT 1.5 CAL LIQUID NUTRITIONAL SUPPLEMENT 237 MILLILITERS

70074058016 PIVOT 1.5 CAL LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

70074058209 PHENEX CHEWS TABLET NUT. TX FOR PKU WITH IRON #1 350 EACH

70074058211 PHENEX CHEWS TABLET NUT. TX FOR PKU WITH IRON #1 350 EACH

70074058221 PEDIASURE WITH FIBER LIQUID PEDIATRIC NUTRIT,IRON,LF&FIBER 237 MILLILITERS

70074059406 ELECARE AMINO ACID POWDER AMINO ACIDS 400 GRAMS

70074059439 SIMILAC SPECIAL CARE-IRON LIQ INFANT FORMULA W-IRON 59 MILLILITERS

70074059583 SIMILAC SPECIAL CARE FORMULA INFANT FORMULA W-IRON 59 MILLILITERS

70074059646 SIMILAC NEOSURE INFANT FORMULA INFANT FORMULA W-IRON 59 MILLILITERS



70074059665 SUPLENA CARB STEADY LIQUID NUT.TX.IMPAIRED RENAL FXN,SOY 237 MILLILITERS



70074059722 PROMOD LIQUID PROTEIN PROTEIN SUPPLEMENT 946 MILLILITERS



70074060237 ALIMENTUM LIQUID INFANT FORMULA W-IRON 946 MILLILITERS




70074060738 OSMOLITE LIQUID LACTOSE-FREE FOOD 960 MILLILITERS


70074060746 POLYCOSE POWDER GLUCOSE POLYMERS 349 GRAMS

70074060750 ENSURE POWDER LACTOSE-FREE FOOD 397 GRAMS

70074060775 PROMOD POWDER PROTEIN SUPPLEMENT 275 GRAMS

70074060850 SIMILAC PM 60-40 POWDER INFANT FORMULA,REGULAR 400 GRAMS

70074080214 SIMILAC SPEC CARE/IRON LIQ INFANT FORMULA W-IRON 120 MILLILITERS

70074080431 POLYCOSE LIQUID GLUCOSE POLYMERS 126 MILLILITERS

70074080668 OSMOLITE HN LIQUID LACTOSE-FREE FOOD 1000 MILLILITERS

70074080669 INTROLITE LIQUID LACTOSE-FREE FOOD 1000 MILLILITERS



70074401080 RCF LIQUID INFANT FORMULA,SOY-FE LAC-FREE 390 MILLILITERS

71791000038 VITALINE COQ10 60 MG TABLET UBIDECARENONE 800 EACH



Product


Package

Size

Medi-Cal

Billing Unit

74013000012 MOOD SUPPORT FORMULA SOFTGEL FA/OMEGA-3/DHA/EPA/ST.JOHN 90 EACH




74312013440 HYALURONIC ACID CAPSULE HYALURONATE SODIUM 30 EACH

74312013731 L-CARNIT-ALPHA LIPOIC ACID CAP ALPHA LIPOIC ACID/ACETYLCARN 30 EACH

74312051241 APPLE CIDER VINEGAR DIET TAB CIDER/AP PECTIN/GYM LF/B6/MC32 90 EACH

74970004395 YL COENZYME Q10 30 MG SFTGEL UBIDECARENONE 50 EACH

77273072516 AMINO ACID POWDER AMINO ACIDS 454 GRAMS

79854000014 ROYAL JELLY 250 MG SOFTGEL ROYAL JELLY 90 EACH

79854000035 ULTRA ENERGY TABLET GUARA XT/AA COMB 2/CA/BEE POLL 60 EACH


79854000686 VITAMANIX ULTIMATE CAPSULE BIOFLAV/FA/MV/DIET7/BEE POLL 60 EACH



79854000695 CARDIOVASCULAR SUPPORT CAP INOSITOL/MV COMB 1/SE/BETAINE 60 EACH

79854000784 CHONDROITIN SULF 400 MG CAP CHONDRO SU A/VIT C/MANGANESE 60 EACH



79854001150 MAXIMUM DAILY GREEN TABLET FA/MV/BEE POLLEN/HERB CMB 101 120 EACH

79854001160 VIRA EXTRA CAPSULE ARGNIN/HIST/E/GNK/K.GIN/HRB50 60 EACH

79854001169 VIRA FEMALE CAPSULE LECITH/TAUR/ARGNIN/KAV/HRB58 60 EACH

79854001203 APPLE CIDER VINGR 600 MG CAP CIDER VINEGAR 90 EACH

79854001216 CHITOSAN 500 MG CAPSULE CHITOSAN 90 EACH

79854001262 ALLERWELL ALLRGY FORMULA TB AA COMB.NO3/B/MV-AO4/MN/MIN AA 60 EACH


79854003612 METABO-STYLE CAPLET VIT E AC/MIN/BOV CPLX/HRB37 90 EACH

79854003933 SLENDER CORTISOL CAPSULE B-SIT/M-19/DR BT-ORG PEEL/GR T 60 EACH




79854008039 HEALTHY HEART FORMULA SFTGL UBIDECARENONE/L-CARN FUM/VIT E 60 EACH




79854020925 LECITHIN KELP-B6 TABLET LECITH/PYRIDOX HCL/I2/CIDER 100 EACH

79854020950 BEE POLLEN 580 MG CAPSULE BEE POLLEN 100 EACH


79854060085 PROTEIN POWDER 80% PROTEIN SUPPLEMENT 454 GRAMS

79854061002 BEE POLLEN CAPSULE BEE POLLEN 100 EACH





79854071135 ISOFLAVONES SOY PROTEIN PWD SOY PROTEIN 306 GRAMS



81361093450 PKU 1 POWDER INFANT FORM. FOR PKU, IRON #3 500 GRAMS





Product


Package

Size

Medi-Cal

Billing Unit

81361093480 OS 1 POWDER INFANT FORMULA,SP. METAB.-IRON 500 GRAMS

81361093490 OS 2 POWDER NUT. TX FOR PROPIONIC ACIDEMIA 500 GRAMS

81361093500 MSUD 1 POWDER INFANT FORMULA,SPEC.METAB MSUD 500 GRAMS

81361093510 MSUD 2 POWDER NUTRIT.THERAPY, MSUD WITH IRON 500 GRAMS

81361093520 TYR 1 POWDER INFANT FORMULA,SP. METAB.-IRON 500 GRAMS

81361093530 TYR 2 POWDER NUTRITIONAL TX FOR TYROSINEMIA 500 GRAMS

81361093560 HOM 1 POWDER INFANT FORMULA,SP. METAB.-IRON 500 GRAMS

81361093570 HOM 2 POWDER NUT.TX,METABOLIC DIS,METHIO-FR 500 GRAMS

81361093600 UCD 1 POWDER INFANT FORMULA,SPEC. METABOLIC 500 GRAMS

81361093610 UCD 2 POWDER NUT.TX., UREA CYCLE DISORDER 500 GRAMS

81361908701 PKU 2 TOMATO POWDER NUT. TX FOR PKU WITH IRON #37 30 EACH

82028000080 PROCEL PROTEIN POWDER PROTEIN SUPPLEMENT 285 GRAMS

82028000680 PROCEL PROTEIN POWDER PROTEIN SUPPLEMENT 285 GRAMS

82028006100 PROCEL 100 PROTEIN POWDER PROTEIN SUPPLEMENT 750 GRAMS

82028010081 PROCEL SINGLES POWDER PROTEIN SUPPLEMENT 1 EACH

82468061442 FP VISION CAPSULE VIT C/VIT E AC/LUT/MINERAL 1 36 EACH

83744040103 BRIGHT BEGINNINGS LIQUID LACTOSE-FREE FOOD 237 MILLILITERS



83744040403 BRIGHT BEGINNINGS-FIBER LIQ LACTOSE-FREE FOOD/FIBER 237 MILLILITERS

87651060467 AZO CONFIDENCE TABLET HYOSCYAMINE/CHASTE/AMER GINS 60 EACH

87701000814 GNP FISH OIL 1,000 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH


87701039987 GNP FISH OIL SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH

87701039996 GNP COQ-10 & FISH OIL SOFTGEL UBIDECARENONE/OMEGA-3/VIT E 30 EACH


87701040491 GNP PROSTATE HEALTH FML SFTGEL ZINC MTH/COPPER/SAW PALM/GNSG 60 EACH

87701057497 BL NUTRITIONAL SUPLMNT PLUS LACTOSE-FREE FOOD 237 MILLILITERS

87701057710 BL NUTRITIONAL SUPLMNT PLUS LACTOSE-FREE FOOD 237 MILLILITERS

87701057975 BL NUTRITIONAL SUPPLEMENT LACTOSE-FREE FOOD 237 MILLILITERS

87701058167 BL NUTRITIONAL SUPPLEMENT LACTOSE-FREE FOOD 237 MILLILITERS

87701071320 BL BEE POLLEN 500 MG TABLET BEE POLLEN 100 EACH

87701086732 GNP COENZYME Q-10 100 MG SFTG UBIDECARENONE 30 EACH

87701086735 GNP FISH OIL SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH

90962069332 LPS SF LIQUID AMINO ACIDS/PROTEIN HYDROLYS 960 MILLILITERS

90962069532 LPS 15-30 LIQUID AMINO ACIDS/PROTEIN/FRUCTOSE 960 MILLILITERS

90962069732 LPS CC LIQUID AA/PROT/FRUC/C/ZN/COPPER/ARGIN 960 MILLILITERS





91899042472 FISH OIL EXTRA STRENGTH SOFTGL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH

91899045365 COQ-10 & FISH OIL SOFTGEL UBIDECAR/FISH OIL/OMEGA-3/VITE 30 EACH



92961001333

ESTROVEN REGULAR STRENGTH

CPLT MV,CA,MIN/FA/HERBAL NO.159 30 EACH

92961001633 ESTROVEN ENERGY CAPSULE MV,CA,MIN/FA/HERBAL NO.158 40 EACH

92961001643 ESTROVEN PMS CAPLET MV,CA,MIN/FA/HERBAL NO.160 24 EACH



Product


Package

Size

Medi-Cal

Billing Unit

92961001864 ESTROVEN PM CAPLET MULTIVIT,CA,MIN/D3/HERBAL #161 24 EACH

92961001947 ESTROVEN MAX STRENGTH CAPLET MV,CA,MIN/FA/HERBAL NO.157 28 EACH

93190007097 PROSTATONIN SOFTGEL PYGEUM AFRICANUM/NETTLE 28 EACH

93190007098 PROSTATONIN SOFTGEL PYGEUM AFRICANUM/NETTLE 56 EACH

94688001180 RENAMENT PACKETS NUT. TX,IMP. RENAL FXN, WHEY 1 EACH

94688001184 RENAMENT PACKETS NUT. TX,IMP. RENAL FXN, WHEY 1 EACH

94688001245 ARGITEIN PACKETS WHEY/ARGNIN/VIT C/E/MALIC/CA 1 EACH

94688001340 VITAMENT PACKETS A-CYST/AA COMB.NO5/FA/MV-MN 1 EACH

94688001535 PROSOURCE NO CARB PROTEIN LIQ AMINO ACIDS/PROTEIN HYDROLYS 946 MILLILITERS

94688001545 PROSOURCE NO CARB PROTEIN LIQ AMINO ACIDS/PROTEIN HYDROLYS 946 MILLILITERS

94688001555 PROSOURCE ZAC PROTEIN LIQUID AMINO ACID/PROTEIN/VIT C/ZINC 946 MILLILITERS

94688001651 PROSOURCE PLUS PROTEIN LIQUID AMINO ACIDS/PROTEIN HYDROLYS 946 MILLILITERS



94688011162 PROSOURCE PROTEIN POWDER PROTEIN SUPPLEMENT 275 GRAMS

94688011432 PROSOURCE PROTEIN LIQUID AMINO ACIDS/PROTEIN HYDROLYS 946 MILLILITERS

94688011454 PROSOURCE LIQUID AMINO ACIDS/PROTEIN HYDROLYS 30 MILLILITERS


96295011204 CO Q-10 50MG SOFTGEL UBIDECARENONE 30 EACH

96295011205 FISH OIL 300 MG SOFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH


96295011249 FISH OIL EXTRA STRENGTH SFTGEL OMEGA-3 FATTY ACIDS/FISH OIL 60 EACH




96295011352 LEADER GERM DEFENSE TABLET GLUT/LYSINE HC/C/MV-MN/HC124 10 EACH

96295011353 GERM DEFENSE TABLET GLUT/LYSINE HC/C/MV-MN/HC124 10 EACH



96295011843 ESTRO SUPPORT ES CAPLET MV,CA,MIN/FA/HERBAL NO.176 56 EACH

96502057171 METAFORM PACKET NUTRITIONAL SUPPLEMENT 20 EACH



98152000141 FLEX OMEGA BENEFITS SOFTGEL OM-3/DHA/EPA/FISH OIL/VIT D3 180 EACH

98716007363 PEPTAMEN JUNIOR 1.5 LIQUID NUTRITIONAL SUPPLEMENT 250 MILLILITERS

98716008543 PEPTAMEN JUNIOR 1.5 LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS


98716012804 PEPTAMEN W-PREBIO 1 LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS


98716016283 CRUCIAL ULTRAPAK LIQUID NUT.TX.COMP. IMMUNE SYSTM,SOY 1000 MILLILITERS


98716016356 NUTREN REPLETE LIQUID NUTRITIONAL SUPPLEMENT 1000 MILLILITERS

98716016358 REPLETE WITH FIBER LIQUID NUTRITIONAL SUPPLEMENT/FIBER 1000 MILLILITERS

98716016359 REPLETE WITH FIBER LIQUID NUTRITIONAL SUPPLEMENT/FIBER 1500 MILLILITERS













Product


Package

Size

Medi-Cal

Billing Unit


98716060210 PEPTAMEN JUNIOR FIBER LIQUID LACTOSE-FREE FOOD/FIBER 250 MILLILITERS





003382L6113 TRAVASORB STD PEPTIDE DIET LACTOSE-FREE FOOD 83 GRAMS

003382L6313 TRAVASORB WHOLE PROTEIN LIQ LACTOSE-FREE FOOD 240 MILLILITERS



10106E39707 CASEIN POWDER CASEIN 500 GRAMS


Restricted Durg and Enteral Products' Billing Units Tool ... · 00013265802 genotropin miniquick 2 mg somatropin 7 each 00023114501 botox 100 units vial onabotulinumtoxina 1 each

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