Beta-Adrenergic Blocking Agents - Alameda Alliance for Health
Beta-Adrenergic Blocking Agents - Alameda Alliance for Health
Beta-Adrenergic Blocking Agents - Alameda Alliance for Health
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AAH01<br />
ALAMEDA ALLIANCE FOR HEALTH<br />
DRUG FORMULARY<br />
July 2012<br />
INTRODUCTION<br />
Foreword<br />
This document provides physicians and pharmacists with a method to begin to evaluate the<br />
various drug products available. The medical treatment of patients is frequently relative to the<br />
practical application of drug therapy. Due to the vast availability of medication therapy and<br />
treatment modalities, a reasonable program of drug product selection and drug usage must be<br />
developed. The goal of the Drug Formulary is to enhance the physician and pharmacist’s<br />
abilities to provide optimal cost effective drug therapy <strong>for</strong> patients.<br />
The development, maintenance, and improvement of this process are evolutionary and require<br />
constant attention. The Formulary is a continually reviewed and revised list of drugs, which<br />
mirror the prevailing clinical opinion of the P & T and Formulary Committees. Un<strong>for</strong>tunately, this<br />
dynamic process does not allow this document to be completely accurate at all times. To<br />
accommodate the necessary changes of this document, updates are sent regularly.<br />
How to Use the Drug Formulary<br />
The Drug Formulary is a list of covered and preferred drug agents <strong>for</strong> members. All drugs are<br />
listed by their generic names and most common proprietary (branded) name. The Drug<br />
Formulary may be accessed by using either the generic or proprietary name (in small capital<br />
letters) and by therapeutic drug category. The brand names listed are <strong>for</strong> reference use only,<br />
and do not denote coverage, unless specifically noted. Any drug not found in this Formulary<br />
listing shall be considered a Non-Formulary drug.<br />
All drugs are listed in each category in alphabetical order by generic name. Where an FDA<br />
approved generic is available <strong>for</strong> the listed generic name, the generic name is bolded.<br />
For certain agents within the Drug Formulary, a recommended prescribing guideline may apply.<br />
These are denoted throughout the document using the following symbols:<br />
Age Edit<br />
Coverage may depend on patient age<br />
AGE<br />
G Gender Edit Coverage may depend on patient gender<br />
MD Physician Specialty Edit Coverage may depend on prescribing physician’s specialty or board certification<br />
PA Prior Authorization Requires specific physician request process<br />
QL Quantity Limit Coverage may be limited to specific quantities per prescription and/or time period<br />
ST Step Therapy Coverage may depend on previous use of another drug<br />
F Formulary
Benefit Coverage and Limitations<br />
This printed Formulary does not provide in<strong>for</strong>mation regarding the specific coverage and<br />
limitations an individual member may have. Many members have specific benefit inclusions,<br />
exclusions, copays, or a lack of coverage, which are not reflected in the Drug Formulary.<br />
The Drug Formulary applies only to outpatient drugs provided to members, and does not apply<br />
to medications used in inpatient settings. If a member has any specific questions regarding<br />
their coverage, they should contact their Plan Sponsor or MedImpact at (800) 788-2949.<br />
ALLERGY<br />
2nd Gen Antihistamine & Decongestant Combinations<br />
QL loratadine/pseudoephedrine CLARITIN-D 12 HOUR TAB ER 12H 5<br />
MG-120MG<br />
QL loratadine/pseudoephedrine CLARITIN-D 12 HOUR TAB ER 24H<br />
10MG-240MG<br />
Antihistamines<br />
tripelennamine hcl TRIPELENNAMINE HCL TABLET<br />
50MG<br />
Antihistamines - 1st Generation<br />
carbinoxamine maleate PALGIC LIQUID 4<br />
MG/5 ML<br />
chlorpheniramine maleate CHLOR-TRIMETON CAPSULE SA<br />
12MG<br />
chlorpheniramine maleate CHLOR-TRIMETON SYRUP 2<br />
MG/5 ML<br />
chlorpheniramine maleate CHLOR-TRIMETON TABLET 4<br />
MG<br />
clemastine fumarate TAVIST-1 TABLET 1.34<br />
MG<br />
clemastine fumarate TAVIST-1 SYRUP<br />
0.67MG/5ML<br />
cyproheptadine hcl CYPROHEPTADINE HCL SYRUP 2<br />
MG/5 ML<br />
cyproheptadine hcl CYPROHEPTADINE HCL TABLET 4<br />
MG<br />
diphenhydramine hcl BENADRYL TABLET 25<br />
MG<br />
diphenhydramine hcl BENADRYL CAPSULE 25<br />
MG<br />
diphenhydramine hcl BENADRYL CAPSULE 50<br />
MG
diphenhydramine hcl BENADRYL LIQUID<br />
12.5MG/5ML<br />
diphenhydramine hcl BENADRYL TAB CHEW<br />
12.5 MG<br />
diphenhydramine hcl BENADRYL SYRUP<br />
12.5MG/5ML<br />
diphenhydramine hcl BENADRYL TABLET 25<br />
MG<br />
diphenhydramine hcl BENADRYL TABLET 50<br />
MG<br />
diphenhydramine hcl BENADRYL LIQUID<br />
12.5MG/5ML<br />
hydroxyzine hcl HYZINE SYRUP 10<br />
MG/5 ML<br />
hydroxyzine hcl HYZINE TABLET 10<br />
MG<br />
hydroxyzine hcl HYZINE TABLET 25<br />
MG<br />
hydroxyzine hcl HYZINE TABLET 50<br />
MG<br />
hydroxyzine pamoate VISTARIL CAPSULE 100<br />
MG<br />
hydroxyzine pamoate VISTARIL CAPSULE 25<br />
MG<br />
hydroxyzine pamoate VISTARIL CAPSULE 50<br />
MG<br />
promethazine hcl PHENERGAN SYRUP<br />
6.25MG/5ML<br />
promethazine hcl PHENERGAN TABLET 12.5<br />
MG<br />
promethazine hcl PHENERGAN TABLET 25<br />
MG<br />
promethazine hcl PHENERGAN TABLET 50<br />
MG<br />
Antihistamines - 2nd Generation<br />
QL cetirizine hcl CHILDREN'S ZYRTEC SOLUTION 1<br />
MG/ML<br />
QL cetirizine hcl CHILDREN'S ZYRTEC TABLET 10<br />
MG<br />
QL cetirizine hcl CHILDREN'S ZYRTEC TABLET 5<br />
MG<br />
PA fexofenadine hcl ALLEGRA TABLET 30<br />
MG<br />
PA fexofenadine hcl ALLEGRA TABLET 60<br />
MG<br />
PA fexofenadine hcl ALLEGRA TABLET 180
MG<br />
QL loratadine CLARITIN TAB RAPDIS<br />
10 MG<br />
QL loratadine CLARITIN SOLUTION 5<br />
MG/5 ML<br />
QL loratadine CLARITIN TABLET 10<br />
MG<br />
Nasal Anti-Inflammatory Steroids<br />
flunisolide NASAREL SPRAY<br />
29MCG<br />
flunisolide NASAREL SPRAY 25<br />
MCG<br />
fluticasone propionate FLONASE SPRAY SUSP<br />
AGE+<br />
QL<br />
50 MCG<br />
mometasone furoate NASONEX SPRAY/PUMP<br />
50 MCG<br />
Nasal Mast Cell Stabilizers <strong>Agents</strong><br />
cromolyn sodium NASALCROM SPRAY/PUMP<br />
5.2 MG<br />
ANTIEMESIS/ANTIVERTIGO<br />
Antiemetic/Antivertigo <strong>Agents</strong><br />
dimenhydrinate DRAMAMINE TABLET<br />
50MG<br />
meclizine hcl ANTIVERT TABLET 12.5<br />
MG<br />
meclizine hcl ANTIVERT TABLET 25<br />
MG<br />
PA meclizine hcl ANTIVERT TABLET 50<br />
MG<br />
meclizine hcl ANTIVERT TAB CHEW<br />
25 MG<br />
QL ondansetron ZOFRAN ODT TAB RAPDIS<br />
4 MG<br />
QL ondansetron ZOFRAN ODT TAB RAPDIS<br />
8 MG<br />
QL ondansetron hcl ZOFRAN TABLET 4<br />
MG<br />
QL ondansetron hcl ZOFRAN TABLET 8<br />
QL+<br />
ST<br />
MG<br />
ondansetron hcl ZOFRAN TABLET 24<br />
MG<br />
prochlorperazine edisylate COMPAZINE SYRUP 5<br />
MG/5 ML<br />
prochlorperazine maleate COMPAZINE SUPP.RECT
25 MG<br />
prochlorperazine maleate COMPAZINE TABLET 10<br />
MG<br />
prochlorperazine maleate COMPAZINE TABLET 5<br />
MG<br />
promethazine hcl PHENERGAN SUPP.RECT<br />
25 MG<br />
promethazine hcl PHENERGAN SUPP.RECT<br />
50 MG<br />
promethazine hcl PHENERGAN SUPP.RECT<br />
12.5 MG<br />
trimethobenzamide hcl/b-caine TEBAMIDE SUPP.RECT<br />
100MG-2%<br />
trimethobenzamide hcl/b-caine TEBAMIDE SUPP.RECT<br />
200 MG-2 %<br />
ASTHMA<br />
<strong>Adrenergic</strong> <strong>Agents</strong>,Catecholamines<br />
isoetharine hcl ISOETHARINE HCL SOLUTION<br />
10MG/ML<br />
isoproterenol hcl ISUPREL AMPUL 0.2<br />
MG/ML<br />
<strong>Beta</strong>-<strong>Adrenergic</strong> <strong>Agents</strong><br />
albuterol sulfate VOSPIRE ER VIAL-NEB<br />
0.63MG/3ML<br />
albuterol sulfate VOSPIRE ER VIAL-NEB<br />
1.25MG/3ML<br />
albuterol sulfate VOSPIRE ER TABLET 2<br />
MG<br />
albuterol sulfate VOSPIRE ER TABLET 4<br />
MG<br />
albuterol sulfate VOSPIRE ER SYRUP 2<br />
QL+<br />
ST<br />
MG/5 ML<br />
HFA AER AD<br />
90 MCG<br />
albuterol sulfate<br />
PROAIR HFA<br />
VENTOLIN HFA<br />
albuterol sulfate VOSPIRE ER VIAL-NEB 2.5<br />
MG/0.5<br />
albuterol sulfate VOSPIRE ER VIAL-NEB 2.5<br />
MG/3ML<br />
<strong>for</strong>moterol fumarate FORADIL CAP W/DEV<br />
12 MCG<br />
metaproterenol sulfate ALUPENT SYRUP 10<br />
MG/5 ML<br />
metaproterenol sulfate ALUPENT TABLET 10<br />
MG
metaproterenol sulfate ALUPENT TABLET<br />
20MG<br />
ST salmeterol xinafoate SEREVENT DISKUS DISK W/DEV<br />
50 MCG<br />
terbutaline sulfate BRETHINE TABLET 5<br />
MG<br />
terbutaline sulfate BRETHINE TABLET 2.5<br />
MG<br />
<strong>Beta</strong>-<strong>Adrenergic</strong> And Anticholinergic Combinations<br />
ipratropium/albuterol sulfate DUONEB AMPUL-NEB<br />
0.5-3MG/3<br />
ipratropium/albuterol sulfate COMBIVENT AER W/ADAP<br />
18-103MCG<br />
<strong>Beta</strong>-<strong>Adrenergic</strong> And Glucocorticoid Combinations<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
fluticasone/salmeterol ADVAIR DISKUS DISK W/DEV<br />
100-50 MCG<br />
fluticasone/salmeterol ADVAIR DISKUS DISK W/DEV<br />
250-50 MCG<br />
fluticasone/salmeterol ADVAIR DISKUS DISK W/DEV<br />
500-50 MCG<br />
fluticasone/salmeterol ADVAIR HFA HFA AER AD<br />
45-21MCG<br />
fluticasone/salmeterol ADVAIR HFA HFA AER AD<br />
115-21MCG<br />
fluticasone/salmeterol ADVAIR HFA HFA AER AD<br />
230-21MCG<br />
General Bronchodilator <strong>Agents</strong><br />
QL epinephrine PRIMATENE MIST AER W/ADAP<br />
0.22MG<br />
ipratropium bromide ATROVENT HFA HFA AER AD<br />
17MCG<br />
ipratropium bromide IPRATROPIUM BROMIDE SOLUTION<br />
0.2 MG/ML<br />
ST tiotropium bromide SPIRIVA CAP W/DEV<br />
18 MCG<br />
Glucocorticoids, Orally Inhaled<br />
beclomethasone dipropionate QVAR AER W/ADAP<br />
40 MCG<br />
beclomethasone dipropionate QVAR AER W/ADAP<br />
80 MCG<br />
AGE budesonide PULMICORT AMPUL-NEB<br />
0.25MG/2ML<br />
AGE budesonide PULMICORT AMPUL-NEB<br />
0.5 MG/2ML
AGE+ fluticasone propionate FLOVENT DISKUS DISK W/DEV<br />
ST<br />
100 MCG<br />
AGE+ fluticasone propionate FLOVENT DISKUS DISK W/DEV<br />
ST<br />
50 MCG<br />
AGE+ fluticasone propionate FLOVENT HFA AER W/ADAP<br />
ST<br />
110MCG<br />
AGE+ fluticasone propionate FLOVENT HFA AER W/ADAP<br />
ST<br />
44MCG<br />
AGE+ fluticasone propionate FLOVENT HFA AER W/ADAP<br />
ST<br />
220 MCG<br />
PA mometasone furoate ASMANEX AER POW BA<br />
220MCG(14)<br />
PA mometasone furoate ASMANEX AER POW BA<br />
220MCG(30)<br />
PA mometasone furoate ASMANEX AER POW BA<br />
220MCG(60)<br />
Leukotriene Receptor Antagonists<br />
AGE+ montelukast sodium SINGULAIR GRAN PACK<br />
QL+<br />
4 MG<br />
ST<br />
AGE+ montelukast sodium SINGULAIR TAB CHEW 4<br />
QL+<br />
MG<br />
ST<br />
AGE+ montelukast sodium SINGULAIR TAB CHEW 5<br />
QL+<br />
MG<br />
ST<br />
AGE+ montelukast sodium SINGULAIR TABLET 10<br />
QL+<br />
ST<br />
MG<br />
Mast Cell Stabilizers<br />
cromolyn sodium GASTROCROM AMPUL-NEB<br />
20 MG/2 ML<br />
Monoclonal Antibodies To Immunoglobulin E(ige)<br />
AGE omalizumab XOLAIR VIAL 150 MG<br />
Respiratory Aids,Devices,Equipment<br />
QL compressor, <strong>for</strong> nebulizer DEVILBISS COMPACT<br />
DEVILBISS PULMO-AIDE<br />
MISTERNEB COMPRESSOR<br />
PULMO-AIDE<br />
SUNRISE COMPRESSOR-NEBULIZER<br />
QL compressor, <strong>for</strong> nebulizer DEVILBISS COMPACT<br />
DEVILBISS PULMO-AIDE<br />
MISTERNEB COMPRESSOR<br />
PULMO-AIDE<br />
EACH<br />
EACH
SUNRISE COMPRESSOR-NEBULIZER<br />
QL inhaler, assist devices EASIVENT<br />
MICROCHAMBER<br />
QL peak flow meter ASSESS<br />
PEAK-AIR<br />
PERSONAL BEST<br />
POCKET PEAK<br />
TRUZONE PEAK FLOW METER<br />
SPACER<br />
EACH<br />
Xanthines<br />
theophylline anhydrous THEO-24 CAP ER 24H<br />
400 MG<br />
theophylline anhydrous THEO-24 CAP ER 24H<br />
100 MG<br />
theophylline anhydrous THEO-24 CAP ER 24H<br />
200 MG<br />
theophylline anhydrous THEO-24 CAP ER 24H<br />
300 MG<br />
theophylline anhydrous UNIPHYL ELIXIR 80<br />
MG/15ML<br />
theophylline anhydrous UNIPHYL TAB ER 12H<br />
100 MG<br />
theophylline anhydrous UNIPHYL TAB ER 12H<br />
200 MG<br />
theophylline anhydrous UNIPHYL TAB ER 12H<br />
300 MG<br />
theophylline anhydrous UNIPHYL TABLET ER<br />
400 MG<br />
theophylline anhydrous UNIPHYL TAB ER 12H<br />
450 MG<br />
theophylline anhydrous UNIPHYL TABLET ER<br />
400 MG<br />
theophylline anhydrous UNIPHYL TABLET ER<br />
600 MG<br />
theophylline anhydrous UNIPHYL SOLUTION 80<br />
MG/15ML<br />
AUTONOMIC NERVOUS SYSTEM<br />
DISORDERS<br />
Cholinesterase Inhibitors<br />
pyridostigmine bromide MESTINON SYRUP 60<br />
MG/5 ML<br />
pyridostigmine bromide MESTINON TABLET 60<br />
MG
BEHAVIORAL HEALTH - ANTIDEPRESSANTS<br />
Alpha-2 Receptor Antagonist Antidepressants<br />
mirtazapine REMERON TAB RAPDIS<br />
15 MG<br />
mirtazapine REMERON TAB RAPDIS<br />
30 MG<br />
mirtazapine REMERON TAB RAPDIS<br />
45 MG<br />
mirtazapine REMERON TABLET 15<br />
MG<br />
mirtazapine REMERON TABLET<br />
30MG<br />
mirtazapine REMERON TABLET 45<br />
MG<br />
Norepinephrine And Dopamine Reuptake Inhib (ndris)<br />
bupropion hcl WELLBUTRIN SR TABLET 75<br />
MG<br />
bupropion hcl WELLBUTRIN SR TABLET 100<br />
MG<br />
bupropion hcl WELLBUTRIN SR TABLET ER<br />
150 MG<br />
bupropion hcl WELLBUTRIN SR TABLET ER<br />
100 MG<br />
bupropion hcl WELLBUTRIN SR TABLET ER<br />
200 MG<br />
ST bupropion hcl WELLBUTRIN SR TAB ER 24H<br />
150 MG<br />
ST bupropion hcl WELLBUTRIN SR TAB ER 24H<br />
300 MG<br />
Selective Serotonin Reuptake Inhibitor (ssris)<br />
QL citalopram hydrobromide CELEXA TABLET 20<br />
MG<br />
citalopram hydrobromide CELEXA TABLET 40<br />
MG<br />
citalopram hydrobromide CELEXA SOLUTION 10<br />
MG/5 ML<br />
QL citalopram hydrobromide CELEXA TABLET 10<br />
MG<br />
PA escitalopram oxalate LEXAPRO TABLET 10<br />
MG<br />
PA escitalopram oxalate LEXAPRO TABLET 20<br />
MG<br />
PA escitalopram oxalate LEXAPRO TABLET 5<br />
MG
fluoxetine hcl RAPIFLUX CAPSULE 10<br />
MG<br />
fluoxetine hcl RAPIFLUX CAPSULE 20<br />
MG<br />
QL fluoxetine hcl RAPIFLUX SOLUTION 20<br />
MG/5 ML<br />
fluvoxamine maleate FLUVOXAMINE MALEATE TABLET 25<br />
MG<br />
fluvoxamine maleate FLUVOXAMINE MALEATE TABLET 50<br />
MG<br />
fluvoxamine maleate FLUVOXAMINE MALEATE TABLET 100<br />
MG<br />
paroxetine hcl PAXIL TABLET 10<br />
MG<br />
paroxetine hcl PAXIL TABLET 20<br />
MG<br />
paroxetine hcl PAXIL TABLET 30<br />
MG<br />
paroxetine hcl PAXIL TABLET 40<br />
MG<br />
AGE paroxetine hcl PAXIL ORAL SUSP<br />
10 MG/5 ML<br />
PA paroxetine hcl PAXIL TAB ER 24H<br />
25 MG<br />
PA paroxetine hcl PAXIL TAB ER 24H<br />
37.5 MG<br />
PA paroxetine mesylate PEXEVA TABLET 10<br />
MG<br />
PA paroxetine mesylate PEXEVA TABLET 20<br />
MG<br />
PA paroxetine mesylate PEXEVA TABLET 30<br />
MG<br />
PA paroxetine mesylate PEXEVA TABLET 40<br />
MG<br />
QL sertraline hcl ZOLOFT CONC TABLET 25<br />
MG<br />
QL sertraline hcl ZOLOFT CONC TABLET 50<br />
MG<br />
QL sertraline hcl ZOLOFT CONC TABLET 100<br />
MG<br />
sertraline hcl ZOLOFT CONC ORAL CONC<br />
20 MG/ML<br />
Serotonin-2 Antagonist/Reuptake Inhibitors (saris)<br />
trazodone hcl DESYREL 300MG TABLET 50<br />
MG<br />
trazodone hcl DESYREL 300MG TABLET 100
MG<br />
trazodone hcl DESYREL 300MG TABLET 150<br />
MG<br />
Serotonin-Norepinephrine Reuptake-Inhib (snris)<br />
PA desvenlafaxine succinate PRISTIQ ER TAB ER 24H<br />
50 MG<br />
PA desvenlafaxine succinate PRISTIQ ER TAB ER 24H<br />
100 MG<br />
PA duloxetine hcl CYMBALTA CAPSULE DR<br />
20 MG<br />
PA duloxetine hcl CYMBALTA CAPSULE DR<br />
30 MG<br />
PA duloxetine hcl CYMBALTA CAPSULE DR<br />
60 MG<br />
PA venlafaxine hcl EFFEXOR 25MG TAB ER 24<br />
37.5 MG<br />
PA venlafaxine hcl EFFEXOR 25MG TAB ER 24 75<br />
MG<br />
PA venlafaxine hcl EFFEXOR 25MG TAB ER 24<br />
150 MG<br />
PA venlafaxine hcl VENLAFAXINE HCL ER TAB ER 24<br />
225 MG<br />
venlafaxine hcl EFFEXOR 25MG TABLET 25<br />
MG<br />
venlafaxine hcl EFFEXOR 25MG TABLET 37.5<br />
MG<br />
venlafaxine hcl EFFEXOR 25MG TABLET 50<br />
MG<br />
venlafaxine hcl EFFEXOR 25MG TABLET 75<br />
MG<br />
venlafaxine hcl EFFEXOR 25MG TABLET 100<br />
MG<br />
venlafaxine hcl EFFEXOR 25MG CAP ER 24H<br />
37.5 MG<br />
venlafaxine hcl EFFEXOR 25MG CAP ER 24H<br />
75 MG<br />
venlafaxine hcl EFFEXOR 25MG CAP ER 24H<br />
150 MG<br />
Tricyclic Antidepressant/Phenothiazine Combinatns<br />
perphenazine/amitriptyline hcl PERPHENAZINE/AMITRIPTYLINE HCL TABLET 2<br />
MG-10 MG<br />
perphenazine/amitriptyline hcl PERPHENAZINE/AMITRIPTYLINE HCL TABLET<br />
4MG-10MG<br />
perphenazine/amitriptyline hcl PERPHENAZINE/AMITRIPTYLINE HCL TABLET 2<br />
MG-25 MG
perphenazine/amitriptyline hcl PERPHENAZINE/AMITRIPTYLINE HCL TABLET 4<br />
MG-25 MG<br />
perphenazine/amitriptyline hcl PERPHENAZINE/AMITRIPTYLINE HCL TABLET<br />
4MG-50MG<br />
Tricyclic Antidepressants & Rel. Non-Sel. Ru-Inhib<br />
amitriptyline hcl AMITRIPTYLINE HCL TABLET 10<br />
MG<br />
amitriptyline hcl AMITRIPTYLINE HCL TABLET 100<br />
MG<br />
amitriptyline hcl AMITRIPTYLINE HCL TABLET 150<br />
MG<br />
amitriptyline hcl AMITRIPTYLINE HCL TABLET 25<br />
MG<br />
amitriptyline hcl AMITRIPTYLINE HCL TABLET 50<br />
MG<br />
amitriptyline hcl AMITRIPTYLINE HCL TABLET 75<br />
MG<br />
clomipramine hcl ANAFRANIL CAPSULE 25<br />
MG<br />
clomipramine hcl ANAFRANIL CAPSULE 50<br />
MG<br />
clomipramine hcl ANAFRANIL CAPSULE 75<br />
MG<br />
desipramine hcl NORPRAMIN TABLET 10<br />
MG<br />
desipramine hcl NORPRAMIN TABLET 100<br />
MG<br />
desipramine hcl NORPRAMIN TABLET 150<br />
MG<br />
desipramine hcl NORPRAMIN TABLET 25<br />
MG<br />
desipramine hcl NORPRAMIN TABLET 50<br />
MG<br />
desipramine hcl NORPRAMIN TABLET 75<br />
MG<br />
doxepin hcl DOXEPIN HCL CAPSULE 10<br />
MG<br />
doxepin hcl DOXEPIN HCL CAPSULE 100<br />
MG<br />
doxepin hcl DOXEPIN HCL CAPSULE 150<br />
MG<br />
doxepin hcl DOXEPIN HCL CAPSULE 25<br />
MG<br />
doxepin hcl DOXEPIN HCL CAPSULE 50<br />
MG<br />
doxepin hcl DOXEPIN HCL CAPSULE 75
MG<br />
doxepin hcl DOXEPIN HCL ORAL CONC<br />
10 MG/ML<br />
imipramine hcl TOFRANIL TABLET 10<br />
MG<br />
imipramine hcl TOFRANIL TABLET 25<br />
MG<br />
imipramine hcl TOFRANIL TABLET 50<br />
MG<br />
nortriptyline hcl AVENTYL SOL CAPSULE 10<br />
MG<br />
nortriptyline hcl AVENTYL SOL CAPSULE 25<br />
MG<br />
nortriptyline hcl AVENTYL SOL CAPSULE 50<br />
MG<br />
nortriptyline hcl AVENTYL SOL CAPSULE 75<br />
MG<br />
nortriptyline hcl AVENTYL SOL SOLUTION 10<br />
MG/5 ML<br />
BEHAVIORAL HEALTH - OTHER<br />
<strong>Adrenergic</strong>s, Aromatic, Non-Catecholamine<br />
AGE+ amphet asp/amphet/d-amphet ADDERALL CAP ER 24H<br />
QL<br />
10 MG<br />
AGE+ amphet asp/amphet/d-amphet ADDERALL CAP ER 24H<br />
QL<br />
20 MG<br />
AGE+ amphet asp/amphet/d-amphet ADDERALL CAP ER 24H<br />
QL<br />
30 MG<br />
AGE+ amphet asp/amphet/d-amphet ADDERALL CAP ER 24H 5<br />
QL<br />
MG<br />
AGE+ amphet asp/amphet/d-amphet ADDERALL CAP ER 24H<br />
QL<br />
15 MG<br />
AGE+ amphet asp/amphet/d-amphet ADDERALL CAP ER 24H<br />
QL<br />
25 MG<br />
QL amphet asp/amphet/d-amphet ADDERALL TABLET 7.5<br />
MG<br />
QL amphet asp/amphet/d-amphet ADDERALL TABLET 12.5<br />
MG<br />
QL amphet asp/amphet/d-amphet ADDERALL TABLET 15<br />
MG<br />
QL amphet asp/amphet/d-amphet ADDERALL TABLET 5<br />
MG<br />
QL amphet asp/amphet/d-amphet ADDERALL TABLET 10<br />
MG<br />
QL amphet asp/amphet/d-amphet ADDERALL TABLET 30<br />
MG
QL amphet asp/amphet/d-amphet ADDERALL TABLET 20<br />
MG<br />
dextroamphetamine sulfate DEXEDRINE CAPSULE ER<br />
10 MG<br />
dextroamphetamine sulfate DEXEDRINE CAPSULE ER<br />
15 MG<br />
dextroamphetamine sulfate DEXEDRINE CAPSULE ER<br />
5 MG<br />
dextroamphetamine sulfate DEXEDRINE TABLET 10<br />
MG<br />
dextroamphetamine sulfate DEXEDRINE TABLET 5<br />
MG<br />
ST lisdexamfetamine dimesylate VYVANSE CAPSULE 30<br />
MG<br />
ST lisdexamfetamine dimesylate VYVANSE CAPSULE 50<br />
MG<br />
ST lisdexamfetamine dimesylate VYVANSE CAPSULE 70<br />
MG<br />
ST lisdexamfetamine dimesylate VYVANSE CAPSULE 20<br />
MG<br />
ST lisdexamfetamine dimesylate VYVANSE CAPSULE 40<br />
MG<br />
ST lisdexamfetamine dimesylate VYVANSE CAPSULE 60<br />
MG<br />
Anti-Alcoholic Preparations<br />
disulfiram ANTABUSE TABLET 250<br />
MG<br />
disulfiram ANTABUSE TABLET 500<br />
MG<br />
Anti-Anxiety Drugs<br />
alprazolam NIRAVAM TABLET 0.25<br />
MG<br />
alprazolam NIRAVAM TABLET 0.5<br />
MG<br />
alprazolam NIRAVAM TABLET 1<br />
MG<br />
alprazolam NIRAVAM TABLET 2<br />
MG<br />
alprazolam ALPRAZOLAM INTENSOL ORAL CONC<br />
1 MG/ML<br />
buspirone hcl VANSPAR TABLET 5<br />
MG<br />
buspirone hcl VANSPAR TABLET 10<br />
MG<br />
buspirone hcl VANSPAR TABLET 15
MG<br />
PA buspirone hcl VANSPAR TABLET 30<br />
MG<br />
chlordiazepoxide LIBRITABS TABLET<br />
25MG<br />
chlordiazepoxide hcl LIBRIUM CAPSULE 10<br />
MG<br />
chlordiazepoxide hcl LIBRIUM CAPSULE 25<br />
MG<br />
chlordiazepoxide hcl LIBRIUM CAPSULE 5<br />
MG<br />
QL diazepam VALIUM TABLET 10<br />
MG<br />
QL diazepam VALIUM TABLET 2<br />
MG<br />
QL diazepam VALIUM TABLET 5<br />
MG<br />
lorazepam ATIVAN TABLET 0.5<br />
MG<br />
lorazepam ATIVAN TABLET 1<br />
MG<br />
lorazepam ATIVAN TABLET 2<br />
MG<br />
lorazepam ATIVAN ORAL CONC<br />
2 MG/ML<br />
PA oxazepam SERAX CAPSULE 10<br />
MG<br />
PA oxazepam SERAX CAPSULE 15<br />
MG<br />
PA oxazepam SERAX CAPSULE 30<br />
MG<br />
Barbiturates<br />
phenobarbital PHENOBARBITAL ELIXIR<br />
20MG/5ML<br />
phenobarbital PHENOBARBITAL TABLET 15<br />
MG<br />
phenobarbital PHENOBARBITAL TABLET 60<br />
MG<br />
phenobarbital PHENOBARBITAL TABLET 30<br />
MG<br />
phenobarbital PHENOBARBITAL TABLET 100<br />
MG<br />
phenobarbital PHENOBARBITAL TABLET 16.2<br />
MG<br />
Sedative-Hypnotics,Non-Barbiturate
diphenhydramine hcl DIPHENHYDRAMINE HCL TABLET 50<br />
MG<br />
diphenhydramine hcl DIPHENHYDRAMINE HCL TABLET 25<br />
MG<br />
diphenhydramine hcl DIPHENHYDRAMINE HCL CAPSULE 50<br />
MG<br />
diphenhydramine hcl ZZZQUIL CAPSULE 25<br />
MG<br />
AGE flurazepam hcl DALMANE CAPSULE 15<br />
MG<br />
AGE flurazepam hcl DALMANE CAPSULE 30<br />
MG<br />
lorazepam ATIVAN VIAL 2<br />
MG/ML<br />
temazepam RESTORIL CAPSULE 15<br />
MG<br />
temazepam RESTORIL CAPSULE 30<br />
MG<br />
PA temazepam RESTORIL CAPSULE 7.5<br />
MG<br />
PA temazepam RESTORIL CAPSULE<br />
22.5 MG<br />
triazolam HALCION TABLET 0.25<br />
MG<br />
triazolam HALCION TABLET 0.125<br />
MG<br />
ST zaleplon SONATA CAPSULE 5<br />
MG<br />
ST zaleplon SONATA CAPSULE 10<br />
MG<br />
QL zolpidem tartrate AMBIEN CR TABLET 5<br />
MG<br />
QL zolpidem tartrate AMBIEN CR TABLET 10<br />
MG<br />
ST zolpidem tartrate AMBIEN CR TAB MPHASE<br />
6.25 MG<br />
ST zolpidem tartrate AMBIEN CR TAB MPHASE<br />
12.5 MG<br />
Tx For Attention Deficit-Hyperact(adhd)/Narcolepsy<br />
QL dexmethylphenidate hcl FOCALIN TABLET 5<br />
MG<br />
QL dexmethylphenidate hcl FOCALIN TABLET 10<br />
MG<br />
ST methylphenidate DAYTRANA PATCH TD24<br />
10MG/9HR<br />
ST methylphenidate DAYTRANA PATCH TD24
15MG/9HR<br />
ST methylphenidate DAYTRANA PATCH TD24<br />
20 MG/9 HR<br />
ST methylphenidate DAYTRANA PATCH TD24<br />
30MG/9HR<br />
AGE+ methylphenidate hcl RITALIN TAB ER 24 54<br />
ST<br />
MG<br />
AGE+ methylphenidate hcl RITALIN TAB ER 24 18<br />
ST<br />
MG<br />
AGE+ methylphenidate hcl<br />
QL+<br />
RITALIN TAB ER 24 36<br />
MG<br />
ST<br />
ST+<br />
AGE<br />
methylphenidate hcl METADATE CD CPMP 30-70<br />
20 MG<br />
methylphenidate hcl RITALIN TABLET 10<br />
MG<br />
methylphenidate hcl RITALIN TABLET 5<br />
MG<br />
methylphenidate hcl RITALIN TABLET 20<br />
MG<br />
QL methylphenidate hcl RITALIN TABLET ER<br />
20 MG<br />
AGE+ methylphenidate hcl RITALIN TAB ER 24 27<br />
ST<br />
MG<br />
ST+<br />
AGE<br />
methylphenidate hcl METADATE CD CPMP 30-70<br />
30 MG<br />
ST+<br />
AGE<br />
methylphenidate hcl METADATE CD CPMP 30-70<br />
10 MG<br />
ST methylphenidate hcl RITALIN CPMP 50-50<br />
20 MG<br />
ST methylphenidate hcl RITALIN LA CPMP 50-50<br />
10 MG<br />
ST+<br />
AGE<br />
ST+<br />
AGE<br />
ST+<br />
AGE<br />
methylphenidate hcl METADATE CD CPMP 30-70<br />
40 MG<br />
methylphenidate hcl METADATE CD CPMP 30-70<br />
50 MG<br />
methylphenidate hcl METADATE CD CPMP 30-70<br />
60 MG<br />
QL methylphenidate hcl RITALIN TABLET ER<br />
10 MG<br />
CARDIOVASCULAR DISEASE -<br />
ARRHYTHMIA<br />
Antiarrhythmics<br />
amiodarone hcl CORDARONE TABLET 200
MG<br />
mexiletine hcl MEXITIL CAPSULE 150<br />
MG<br />
mexiletine hcl MEXITIL CAPSULE 200<br />
MG<br />
mexiletine hcl MEXITIL CAPSULE 250<br />
MG<br />
procainamide hcl PRONESTYL CAPSULE 375<br />
MG<br />
procainamide hcl PROCAINAMIDE HCL CAPSULE<br />
500MG<br />
procainamide hcl PROCAINAMIDE HCL TABLET SA<br />
250MG<br />
procainamide hcl PROCAINAMIDE HCL TABLET SA<br />
500MG<br />
propafenone hcl RYTHMOL SR TABLET 150<br />
MG<br />
propafenone hcl RYTHMOL SR TABLET 300<br />
MG<br />
propafenone hcl RYTHMOL SR TABLET 225<br />
MG<br />
quinidine gluconate QUINIDINE GLUCONATE TABLET ER<br />
324 MG<br />
quinidine sulfate QUINIDEX TABLET 200<br />
MG<br />
quinidine sulfate QUINIDEX TABLET 300<br />
MG<br />
quinidine sulfate QUINIDEX TABLET ER<br />
300 MG<br />
CARDIOVASCULAR DISEASE - CARDIAC<br />
STIMULANT<br />
Digitalis Glycosides<br />
digoxin DIGOXIN SOLUTION 50<br />
MCG/ML<br />
digoxin LANOXIN TABLET 125<br />
MCG<br />
digoxin LANOXIN TABLET 250<br />
MCG<br />
CARDIOVASCULAR DISEASE -<br />
HYPERTENSION<br />
Ace Inhibitor/Calcium Channel Blocker Combination
PA amlodipine besylate/benazepril LOTREL CAPSULE<br />
10MG-20MG<br />
PA amlodipine besylate/benazepril LOTREL CAPSULE<br />
5MG-40MG<br />
PA amlodipine besylate/benazepril LOTREL CAPSULE<br />
10MG-40MG<br />
PA amlodipine besylate/benazepril LOTREL CAPSULE<br />
5MG-20MG<br />
PA amlodipine besylate/benazepril LOTREL CAPSULE 5<br />
MG-10 MG<br />
PA amlodipine besylate/benazepril LOTREL CAPSULE<br />
2.5MG-10MG<br />
Ace Inhibitor/Thiazide & Thiazide-Like Diuretic<br />
benazepril/hydrochlorothiazide LOTENSIN HCT TABLET 5-<br />
6.25MG<br />
benazepril/hydrochlorothiazide LOTENSIN HCT TABLET 10-<br />
12.5MG<br />
benazepril/hydrochlorothiazide LOTENSIN HCT TABLET 20-<br />
12.5 MG<br />
benazepril/hydrochlorothiazide LOTENSIN HCT TABLET 20-<br />
25MG<br />
enalapril/hydrochlorothiazide VASERETIC TABLET<br />
10MG-25MG<br />
enalapril/hydrochlorothiazide VASERETIC TABLET<br />
5MG-12.5MG<br />
lisinopril/hydrochlorothiazide ZESTORETIC TABLET 20-<br />
12.5 MG<br />
lisinopril/hydrochlorothiazide ZESTORETIC TABLET 20-<br />
25MG<br />
lisinopril/hydrochlorothiazide ZESTORETIC TABLET 10-<br />
12.5MG<br />
Alpha-<strong>Adrenergic</strong> <strong>Blocking</strong> <strong>Agents</strong><br />
doxazosin mesylate CARDURA TABLET 1<br />
MG<br />
doxazosin mesylate CARDURA TABLET 2<br />
MG<br />
doxazosin mesylate CARDURA TABLET 4<br />
MG<br />
doxazosin mesylate CARDURA TABLET 8<br />
MG<br />
prazosin hcl MINIPRESS CAPSULE 1<br />
MG<br />
terazosin hcl HYTRIN CAPSULE 1<br />
MG<br />
terazosin hcl HYTRIN CAPSULE 2
MG<br />
terazosin hcl HYTRIN CAPSULE 5<br />
MG<br />
terazosin hcl HYTRIN CAPSULE 10<br />
MG<br />
Alpha/<strong>Beta</strong>-<strong>Adrenergic</strong> <strong>Blocking</strong> <strong>Agents</strong><br />
carvedilol COREG TABLET 25<br />
MG<br />
carvedilol COREG TABLET 12.5<br />
MG<br />
carvedilol COREG TABLET 3.125<br />
MG<br />
carvedilol COREG TABLET 6.25<br />
MG<br />
PA carvedilol phosphate COREG CR CPMP 24HR<br />
10 MG<br />
PA carvedilol phosphate COREG CR CPMP 24HR<br />
20 MG<br />
PA carvedilol phosphate COREG CR CPMP 24HR<br />
40 MG<br />
PA carvedilol phosphate COREG CR CPMP 24HR<br />
80 MG<br />
labetalol hcl TRANDATE TABLET 300<br />
MG<br />
labetalol hcl TRANDATE TABLET 200<br />
MG<br />
labetalol hcl TRANDATE TABLET 100<br />
MG<br />
Angiotensin Receptor Antag./Thiazide Diuretic Comb<br />
QL losartan/hydrochlorothiazide HYZAAR TABLET 50-<br />
12.5 MG<br />
QL losartan/hydrochlorothiazide HYZAAR TABLET<br />
100MG-25MG<br />
QL losartan/hydrochlorothiazide HYZAAR TABLET 100-<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
12.5MG<br />
valsartan/hydrochlorothiazide DIOVAN HCT TABLET 80-<br />
12.5MG<br />
valsartan/hydrochlorothiazide DIOVAN HCT TABLET 160-<br />
12.5MG<br />
valsartan/hydrochlorothiazide DIOVAN HCT TABLET 160-<br />
25MG<br />
valsartan/hydrochlorothiazide DIOVAN HCT TABLET<br />
320MG-25MG<br />
valsartan/hydrochlorothiazide DIOVAN HCT TABLET 320-<br />
12.5MG
Antihypertensives, Ace Inhibitors<br />
benazepril hcl LOTENSIN TABLET 5<br />
MG<br />
benazepril hcl LOTENSIN TABLET 10<br />
MG<br />
benazepril hcl LOTENSIN TABLET 20<br />
MG<br />
benazepril hcl LOTENSIN TABLET 40<br />
MG<br />
captopril CAPOTEN TABLET 100<br />
MG<br />
captopril CAPOTEN TABLET 25<br />
MG<br />
captopril CAPOTEN TABLET 50<br />
MG<br />
captopril CAPOTEN TABLET 12.5<br />
MG<br />
enalapril maleate VASOTEC TABLET 5<br />
MG<br />
enalapril maleate VASOTEC TABLET 10<br />
MG<br />
enalapril maleate VASOTEC TABLET 20<br />
MG<br />
enalapril maleate VASOTEC TABLET 2.5<br />
MG<br />
lisinopril PRINIVIL TABLET 5<br />
MG<br />
lisinopril PRINIVIL TABLET 10<br />
MG<br />
lisinopril PRINIVIL TABLET 20<br />
MG<br />
lisinopril PRINIVIL TABLET 40<br />
MG<br />
lisinopril PRINIVIL TABLET 2.5<br />
MG<br />
lisinopril PRINIVIL TABLET 30<br />
MG<br />
QL ramipril ALTACE CAPSULE<br />
1.25 MG<br />
QL ramipril ALTACE CAPSULE 2.5<br />
MG<br />
QL ramipril ALTACE CAPSULE 5<br />
MG<br />
ramipril ALTACE CAPSULE 10<br />
MG
Antihypertensives, Angiotensin Receptor Antagonist<br />
QL losartan potassium COZAAR TABLET 25<br />
MG<br />
QL losartan potassium COZAAR TABLET 50<br />
MG<br />
QL losartan potassium COZAAR TABLET 100<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
MG<br />
valsartan DIOVAN TABLET 320<br />
MG<br />
valsartan DIOVAN TABLET 160<br />
MG<br />
valsartan DIOVAN TABLET 80<br />
MG<br />
valsartan DIOVAN TABLET 40<br />
MG<br />
Antihypertensives, Sympatholytic<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
clonidine CATAPRES PATCH<br />
TDWK<br />
0.1MG/24HR<br />
clonidine CATAPRES PATCH<br />
TDWK<br />
0.2MG/24HR<br />
clonidine CATAPRES PATCH<br />
TDWK<br />
0.3MG/24HR<br />
clonidine hcl CATAPRES TABLET 0.1<br />
MG<br />
clonidine hcl CATAPRES TABLET 0.2<br />
MG<br />
clonidine hcl CATAPRES TABLET 0.3<br />
MG<br />
guanfacine hcl TENEX TABLET 1<br />
MG<br />
guanfacine hcl TENEX TABLET 2<br />
MG<br />
methyldopa ALDOMET TABLET 125<br />
MG<br />
methyldopa ALDOMET TABLET 250<br />
MG<br />
methyldopa ALDOMET TABLET 500<br />
MG<br />
methyldopa/hydrochlorothiazide METHYLDOPA/HYDROCHLOROTHIAZIDE TABLET<br />
250MG-15MG<br />
methyldopa/hydrochlorothiazide METHYLDOPA/HYDROCHLOROTHIAZIDE TABLET<br />
250MG-25MG
methyldopa/hydrochlorothiazide ALDORIL-D50 TABLET<br />
500MG-50MG<br />
reserpine RESERPINE TABLET 0.25<br />
MG<br />
reserpine/hydrochlorothiazide RESERPINE/HYDROCHLOROTHIAZIDE TABLET<br />
0.125-25MG<br />
reserpine/hydrochlorothiazide RESERPINE/HYDROCHLOROTHIAZIDE TABLET<br />
0.125-50MG<br />
Antihypertensives, Vasodilators<br />
hydralazine hcl APRESOLINE TABLET 10<br />
MG<br />
hydralazine hcl APRESOLINE TABLET 100<br />
MG<br />
hydralazine hcl APRESOLINE TABLET 25<br />
MG<br />
hydralazine hcl APRESOLINE TABLET 50<br />
MG<br />
minoxidil MINOXIDIL TABLET 10<br />
MG<br />
minoxidil MINOXIDIL TABLET 2.5<br />
MG<br />
<strong>Beta</strong>-<strong>Adrenergic</strong> <strong>Blocking</strong> <strong>Agents</strong><br />
atenolol TENORMIN TABLET 100<br />
MG<br />
atenolol TENORMIN TABLET 50<br />
MG<br />
atenolol TENORMIN TABLET 25<br />
MG<br />
ST metoprolol succinate TOPROL XL TAB ER 24H<br />
25 MG<br />
ST metoprolol succinate TOPROL XL TAB ER 24H<br />
50 MG<br />
ST metoprolol succinate TOPROL XL TAB ER 24H<br />
100 MG<br />
ST metoprolol succinate TOPROL XL TAB ER 24H<br />
200 MG<br />
metoprolol tartrate LOPRESSOR TABLET 25<br />
MG<br />
metoprolol tartrate LOPRESSOR TABLET 100<br />
MG<br />
metoprolol tartrate LOPRESSOR TABLET 50<br />
MG<br />
nadolol CORGARD TABLET 40<br />
MG<br />
nadolol CORGARD TABLET 80
MG<br />
nadolol CORGARD TABLET 20<br />
MG<br />
PA nebivolol hcl BYSTOLIC TABLET 5<br />
MG<br />
PA nebivolol hcl BYSTOLIC TABLET 20<br />
MG<br />
PA nebivolol hcl BYSTOLIC TABLET 2.5<br />
MG<br />
PA nebivolol hcl BYSTOLIC TABLET 10<br />
MG<br />
pindolol PINDOLOL TABLET 10<br />
MG<br />
pindolol PINDOLOL TABLET 5<br />
MG<br />
QL+ propranolol hcl INDERAL LA CAP SA 24H<br />
ST<br />
80 MG<br />
QL+ propranolol hcl INDERAL LA CAP SA 24H<br />
ST<br />
120 MG<br />
QL+ propranolol hcl INDERAL LA CAP SA 24H<br />
ST<br />
QL+<br />
ST<br />
160 MG<br />
propranolol hcl INDERAL LA CAP SA 24H<br />
60 MG<br />
propranolol hcl INDERAL LA TABLET 10<br />
MG<br />
propranolol hcl INDERAL LA TABLET 20<br />
MG<br />
propranolol hcl INDERAL LA TABLET 40<br />
MG<br />
propranolol hcl INDERAL LA TABLET 60<br />
MG<br />
propranolol hcl INDERAL LA TABLET 80<br />
MG<br />
propranolol hcl INDERAL LA SOLUTION 20<br />
MG/5 ML<br />
propranolol hcl INDERAL LA SOLUTION<br />
40MG/5ML<br />
QL sotalol hcl BETAPACE TABLET 160<br />
MG<br />
QL sotalol hcl BETAPACE TABLET 80<br />
MG<br />
QL sotalol hcl BETAPACE TABLET 240<br />
MG<br />
QL sotalol hcl BETAPACE TABLET 120<br />
MG<br />
<strong>Beta</strong>-<strong>Adrenergic</strong> <strong>Blocking</strong> <strong>Agents</strong>/Thiazide & Related
atenolol/chlorthalidone TENORETIC 50 TABLET 50<br />
MG-25MG<br />
atenolol/chlorthalidone TENORETIC 50 TABLET<br />
100MG-25MG<br />
bisoprolol fumarate/hctz ZIAC TABLET 2.5-<br />
6.25MG<br />
bisoprolol fumarate/hctz ZIAC TABLET 5-<br />
6.25MG<br />
bisoprolol fumarate/hctz ZIAC TABLET 10-<br />
6.25MG<br />
propranolol/hydrochlorothiazid INDERIDE-40/25 TABLET 40<br />
MG-25MG<br />
propranolol/hydrochlorothiazid INDERIDE-40/25 TABLET 80<br />
MG-25MG<br />
Calcium Channel <strong>Blocking</strong> <strong>Agents</strong><br />
QL amlodipine besylate NORVASC TABLET 2.5<br />
MG<br />
amlodipine besylate NORVASC TABLET 10<br />
MG<br />
QL amlodipine besylate NORVASC TABLET 5<br />
MG<br />
QL diltiazem hcl CARDIZEM CD CAP ER 12H<br />
90 MG<br />
QL diltiazem hcl CARDIZEM CD CAP ER 12H<br />
120 MG<br />
QL diltiazem hcl CARDIZEM CD CAP ER 12H<br />
60 MG<br />
QL diltiazem hcl CARDIZEM CD CAP ER 24H<br />
180 MG<br />
QL diltiazem hcl CARDIZEM CD CAP ER 24H<br />
240 MG<br />
QL diltiazem hcl CARDIZEM CD CAP ER 24H<br />
300 MG<br />
QL diltiazem hcl CARDIZEM CD CAP ER 24H<br />
120 MG<br />
QL diltiazem hcl CARDIZEM CD CAPSULE ER<br />
360 MG<br />
diltiazem hcl CARDIZEM CD CAPSULE ER<br />
300 MG<br />
diltiazem hcl CARDIZEM CD TABLET 30<br />
MG<br />
diltiazem hcl CARDIZEM CD TABLET 60<br />
MG<br />
diltiazem hcl CARDIZEM CD TABLET 90<br />
MG<br />
diltiazem hcl CARDIZEM CD TABLET 120
MG<br />
QL diltiazem hcl CARDIZEM CD CAP ER DEG<br />
180 MG<br />
QL diltiazem hcl CARDIZEM CD CAP ER DEG<br />
240 MG<br />
QL diltiazem hcl CARDIZEM CD CAP ER DEG<br />
120 MG<br />
PA felodipine PLENDIL TAB ER 24H<br />
2.5 MG<br />
PA felodipine PLENDIL TAB ER 24H 5<br />
MG<br />
PA felodipine PLENDIL TAB ER 24H<br />
10 MG<br />
nicardipine hcl CARDENE I.V. CAPSULE 20<br />
MG<br />
nicardipine hcl CARDENE I.V. CAPSULE 30<br />
MG<br />
QL nifedipine ADALAT CC TAB ER 24 30<br />
MG<br />
QL nifedipine ADALAT CC TAB ER 24 60<br />
MG<br />
QL nifedipine ADALAT CC TAB ER 24 90<br />
MG<br />
QL nifedipine ADALAT CC TABLET ER<br />
90 MG<br />
QL nifedipine ADALAT CC TABLET ER<br />
60 MG<br />
QL nifedipine ADALAT CC TABLET ER<br />
30 MG<br />
QL nifedipine ADALAT CC CAPSULE 10<br />
MG<br />
QL nifedipine ADALAT CC CAPSULE 20<br />
MG<br />
verapamil hcl VERELAN TABLET 120<br />
MG<br />
verapamil hcl VERELAN TABLET 80<br />
MG<br />
QL verapamil hcl VERELAN CAP24H PEL<br />
180 MG<br />
verapamil hcl VERELAN CAP24H PEL<br />
240 MG<br />
QL verapamil hcl VERELAN CAP24H PEL<br />
120 MG<br />
QL verapamil hcl VERELAN CAP24H PEL<br />
360 MG<br />
verapamil hcl VERELAN TABLET ER
240 MG<br />
QL verapamil hcl VERELAN TABLET ER<br />
180 MG<br />
QL verapamil hcl VERELAN TABLET ER<br />
120 MG<br />
verapamil hcl VERELAN TABLET 40<br />
MG<br />
Loop Diuretics<br />
bumetanide BUMEX TABLET 0.5<br />
MG<br />
bumetanide BUMEX TABLET 1<br />
MG<br />
bumetanide BUMEX TABLET 2<br />
MG<br />
furosemide LASIX SOLUTION 10<br />
MG/ML<br />
furosemide LASIX TABLET 20<br />
MG<br />
furosemide LASIX TABLET 40<br />
MG<br />
furosemide LASIX TABLET 80<br />
MG<br />
Potassium Sparing Diuretics<br />
spironolactone ALDACTONE TABLET 100<br />
MG<br />
spironolactone ALDACTONE TABLET 25<br />
MG<br />
spironolactone ALDACTONE TABLET 50<br />
MG<br />
Potassium Sparing Diuretics In Combination<br />
spironolact/hydrochlorothiazid ALDACTAZIDE TABLET 25-<br />
25MG<br />
spironolact/hydrochlorothiazid ALDACTAZIDE TABLET 50<br />
MG-50MG<br />
triamterene/hydrochlorothiazid MAXZIDE CAPSULE<br />
37.5-25MG<br />
triamterene/hydrochlorothiazid MAXZIDE TABLET 75<br />
MG-50MG<br />
triamterene/hydrochlorothiazid MAXZIDE TABLET 37.5-<br />
25MG<br />
Pulm.anti-Htn,Sel.c-Gmp Phosphodiesterase T5 Inhib<br />
AGE tadalafil ADCIRCA TABLET 20<br />
MG<br />
Pulmonary Anti-Htn, Endothelin Receptor Antagonist
AGE bosentan TRACLEER TABLET 125<br />
MG<br />
AGE bosentan TRACLEER TABLET 62.5<br />
MG<br />
Renin Inhibitor, Direct<br />
PA aliskiren hemifumarate TEKTURNA TABLET 300<br />
MG<br />
PA aliskiren hemifumarate TEKTURNA TABLET 150<br />
MG<br />
Renin Inhibitor,Direct & Angiotensin Recept Antag.<br />
PA aliskiren/valsartan VALTURNA TABLET 150-<br />
160MG<br />
PA aliskiren/valsartan VALTURNA TABLET 300-<br />
320MG<br />
Thiazide And Related Diuretics<br />
chlorthalidone CHLORTHALIDONE TABLET 25<br />
MG<br />
chlorthalidone CHLORTHALIDONE TABLET 50<br />
MG<br />
hydrochlorothiazide MICROZIDE CAPSULE<br />
12.5 MG<br />
hydrochlorothiazide MICROZIDE TABLET 25<br />
MG<br />
hydrochlorothiazide MICROZIDE TABLET 50<br />
MG<br />
indapamide LOZOL TABLET 2.5<br />
MG<br />
indapamide LOZOL TABLET 1.25<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
MG<br />
metolazone ZAROXOLYN TABLET 10<br />
MG<br />
metolazone ZAROXOLYN TABLET 2.5<br />
MG<br />
metolazone ZAROXOLYN TABLET 5<br />
MG<br />
CARDIOVASCULAR DISEASE - LIPID<br />
IRREGULARITY<br />
Antihyperlipidemic - Hmg Coa Reductase Inhibitors<br />
AGE+ atorvastatin calcium LIPITOR TABLET 10<br />
QL<br />
MG<br />
AGE+ atorvastatin calcium LIPITOR TABLET 20<br />
QL<br />
MG
AGE+ atorvastatin calcium LIPITOR TABLET 40<br />
QL<br />
MG<br />
AGE+ atorvastatin calcium LIPITOR TABLET 80<br />
QL<br />
MG<br />
pravastatin sodium PRAVACHOL TABLET 80<br />
MG<br />
pravastatin sodium PRAVACHOL TABLET 10<br />
MG<br />
pravastatin sodium PRAVACHOL TABLET 20<br />
MG<br />
pravastatin sodium PRAVACHOL TABLET 40<br />
MG<br />
simvastatin ZOCOR TABLET 5<br />
MG<br />
simvastatin ZOCOR TABLET 10<br />
MG<br />
simvastatin ZOCOR TABLET 20<br />
MG<br />
simvastatin ZOCOR TABLET 40<br />
MG<br />
Bile Salt Sequestrants<br />
cholestyramine (with sugar) QUESTRAN POWDER 4 G<br />
QL cholestyramine/aspartame QUESTRAN LIGHT POWDER 4 G<br />
QL cholestyramine/aspartame QUESTRAN LIGHT PACKET 4 G<br />
colestipol hcl COLESTID PACKET 5 G<br />
colestipol hcl COLESTID PACKET 7.5G<br />
colestipol hcl COLESTID TABLET 1 G<br />
colestipol hcl COLESTID GRANULES 5<br />
G<br />
Lipotropics<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
fenofibrate nanocrystallized TRICOR TABLET 48<br />
MG<br />
fenofibrate nanocrystallized TRICOR TABLET<br />
145MG<br />
gemfibrozil LOPID TABLET 600<br />
MG<br />
PA omega-3 acid ethyl esters LOVAZA CAPSULE 1 G<br />
QL omega-3 fatty acids/fish oil FISH OIL OMEGA-3 CAPSULE<br />
300-1000MG<br />
QL omega-3 fatty acids/fish oil OMEGA-3 FATTY ACIDS/FISH OIL CAPSULE<br />
340-1000MG<br />
QL omega-3 fatty acids/fish oil FISH OIL OMEGA-3 CAPSULE<br />
340-1000MG<br />
QL omega-3 fatty acids/fish oil FISH OIL OMEGA-3 CAPSULE<br />
396-1200MG
QL omega-3 fatty acids/vitamin e OMEGA-3 FATTY ACIDS/VITAMIN E CAPSULE<br />
1000 MG<br />
Niacin Preparations<br />
niacin SLO-NIACIN CAPSULE ER<br />
400 MG<br />
niacin SLO-NIACIN CAPSULE ER<br />
500 MG<br />
niacin SLO-NIACIN CAPSULE ER<br />
250 MG<br />
niacin SLO-NIACIN CAPSULE ER<br />
125 MG<br />
niacin SLO-NIACIN TABLET 500<br />
MG<br />
niacin SLO-NIACIN TABLET<br />
100MG<br />
niacin SLO-NIACIN TABLET 250<br />
MG<br />
niacin SLO-NIACIN TABLET<br />
50MG<br />
niacin SLO-NIACIN TABLET ER<br />
250 MG<br />
niacin SLO-NIACIN TABLET ER<br />
500 MG<br />
niacin SLO-NIACIN TABLET ER<br />
750 MG<br />
niacin SLO-NIACIN TABLET ER<br />
1000 MG<br />
CARDIOVASCULAR DISEASE -<br />
VASODILATION<br />
Vasodilators,Coronary<br />
isosorbide dinitrate ISORDIL TITRADOSE TABLET 10<br />
MG<br />
isosorbide dinitrate ISORDIL TITRADOSE TABLET 20<br />
MG<br />
isosorbide dinitrate ISORDIL TITRADOSE TABLET 5<br />
MG<br />
isosorbide dinitrate ISORDIL TITRADOSE TAB SUBL 5<br />
MG<br />
isosorbide dinitrate ISORDIL TITRADOSE TAB SUBL 2.5<br />
MG<br />
isosorbide mononitrate MONOKET TABLET 20<br />
MG<br />
isosorbide mononitrate MONOKET TABLET 10
MG<br />
isosorbide mononitrate MONOKET TAB ER 24H<br />
60 MG<br />
isosorbide mononitrate MONOKET TAB ER 24H<br />
120 MG<br />
isosorbide mononitrate MONOKET TAB ER 24H<br />
30 MG<br />
nitroglycerin NITRO-DUR CAPSULE ER<br />
2.5 MG<br />
nitroglycerin NITRO-DUR CAPSULE ER<br />
6.5 MG<br />
nitroglycerin NITRO-DUR CAPSULE ER<br />
9 MG<br />
nitroglycerin NITRO-BID OINT. (G) 2 %<br />
nitroglycerin NITRO-DUR PATCH TD24<br />
0.4MG/HR<br />
nitroglycerin NITRO-DUR PATCH TD24<br />
0.2MG/HR<br />
nitroglycerin NITRO-DUR PATCH TD24<br />
0.3 MG/HR<br />
nitroglycerin NITRO-DUR PATCH TD24<br />
0.8MG/HR<br />
nitroglycerin NITROSTAT TAB SUBL 0.3<br />
MG<br />
nitroglycerin NITROSTAT TAB SUBL 0.4<br />
MG<br />
nitroglycerin NITROSTAT TAB SUBL 0.6<br />
MG<br />
Vasodilators,Peripheral<br />
ergoloid mesylates ERGOLOID MESYLATES TAB SUBL<br />
1MG<br />
CONTRACEPTION/OXYTOCICS<br />
Contraceptives, Intravaginal, Systemic<br />
etonogestrel/ethinyl estradiol NUVARING VAG RING<br />
0.12-0.015<br />
Contraceptives,Injectable<br />
QL medroxyprogesterone acetate DEPO-PROVERA VIAL 150<br />
MG/ML<br />
QL medroxyprogesterone acetate DEPO-PROVERA DISP SYRIN<br />
150 MG/ML<br />
Contraceptives,Intravaginal<br />
nonoxynol 9 DELFEN FOAM/APPL<br />
12.5%
nonoxynol 9 GYNOL II JELLY/APPL<br />
2 %<br />
nonoxynol 9 GYNOL II JELLY/APPL<br />
3 %<br />
nonoxynol 9 SHUR-SEAL PACKET 2 %<br />
Contraceptives,Oral<br />
GEN desogestrel-ethinyl estradiol DESOGEN TABLET 0.15-<br />
0.03<br />
PA+<br />
GEN<br />
ethinyl estradiol/drospirenone ETHINYL ESTRADIOL/DROSPIRENONE<br />
YASMIN 28<br />
TABLET 0.03-<br />
3MG<br />
PA+<br />
GEN<br />
ethinyl estradiol/drospirenone ETHINYL ESTRADIOL/DROSPIRENONE<br />
YAZ<br />
TABLET 0.02-<br />
3(24)<br />
GEN ethynodiol d-ethinyl estradiol DEMULEN 1-50-21 TABLET 1<br />
MG-35MCG<br />
GEN ethynodiol d-ethinyl estradiol DEMULEN 1-50-21 TABLET 1<br />
MG-50MCG<br />
GEN levonorgestrel PLAN B ONE-STEP TABLET 1.5<br />
MG<br />
GEN levonorgestrel PLAN B TABLET 0.75<br />
MG<br />
GEN levonorgestrel-eth estradiol SEASONALE TABLET 0.15-<br />
0.03<br />
GEN levonorgestrel-eth estradiol SEASONALE TABLET 6-5-<br />
10<br />
GEN levonorgestrel-eth estradiol SEASONALE TABLET 0.1-<br />
0.02<br />
GEN noreth a-et estra/fe fumarate LOESTRIN FE TABLET 1.5-<br />
0.03MG<br />
GEN noreth a-et estra/fe fumarate LOESTRIN FE TABLET<br />
1MG-20MCG<br />
GEN noreth a-et estra/fe fumarate LOESTRIN FE TABLET 5-7-<br />
9-7<br />
GEN norethindrone MICRONOR TABLET 0.35<br />
MG<br />
GEN norethindrone a-e estradiol LOESTRIN TABLET 1.5-<br />
0.03MG<br />
GEN norethindrone a-e estradiol LOESTRIN TABLET<br />
1MG-20MCG<br />
GEN norethindrone-ethinyl estrad ORTHO-NOVUM TABLET 0.4-<br />
0.035<br />
GEN norethindrone-ethinyl estrad ORTHO-NOVUM TABLET 0.5-<br />
0.035<br />
GEN norethindrone-ethinyl estrad ORTHO-NOVUM TABLET 1<br />
MG-35MCG<br />
GEN norethindrone-ethinyl estrad OVCON-50 TABLET 1<br />
MG-50MCG
GEN norethindrone-ethinyl estrad ORTHO-NOVUM TABLET 10-<br />
11<br />
GEN norethindrone-ethinyl estrad ORTHO-NOVUM TABLET 7<br />
DAYS X 3<br />
GEN norethindrone-ethinyl estrad ORTHO-NOVUM TABLET 7-9-5<br />
GEN norethindrone-mestranol NORINYL 1+50 TABLET 1<br />
MG-50MCG<br />
GEN norgestimate-ethinyl estradiol ORTHO-CYCLEN TABLET 0.25-<br />
0.035<br />
GEN norgestimate-ethinyl estradiol ORTHO-CYCLEN TABLET<br />
7DAYSX3 28<br />
GEN norgestimate-ethinyl estradiol ORTHO TRI-CYCLEN LO TABLET<br />
7DAYSX3 LO<br />
GEN norgestrel-ethinyl estradiol LO-OVRAL-28 TABLET 0.3-<br />
0.03MG<br />
GEN norgestrel-ethinyl estradiol LO-OVRAL-28 TABLET 0.5-<br />
0.05MG<br />
Contraceptives,Transdermal<br />
PA norelgestromin/ethin.estradiol ORTHO EVRA PATCH<br />
TDWK 150-<br />
20/24H<br />
Diaphragms/Cervical Cap<br />
diaphragm fitting set,arcsprng<br />
ORTHO ALL-FLEX<br />
WIDE SEAL DIAPHRAGM<br />
EACH<br />
Oxytocics<br />
methylergonovine maleate METHERGINE TABLET 0.2<br />
MG<br />
COUGH AND COLD<br />
1st Gen Antihistamine & Decongestant Combinations<br />
p-ephed hcl/triprolidine hcl ZYMINE-D SYRUP 30-<br />
1.25/5<br />
p-ephed hcl/triprolidine hcl ZYMINE-D TABLET 60-<br />
2.5MG<br />
phenylephrine hcl/prometh hcl PROMETHAZINE-PHENYLEPHRINE SYRUP 5-<br />
6.25MG/5<br />
phenylephrine/chlorpheniramine DALLERGY LIQUID 10-<br />
4MG/5ML<br />
pseudoephed/chlorpheniramine TRIAMINIC COLD & ALLERGY SYRUP 15-<br />
1MG/5ML<br />
pseudoephed/chlorpheniramine TRIAMINIC COLD & ALLERGY LIQUID 30-<br />
2MG/5ML<br />
pseudoephed/chlorpheniramine TRIAMINIC COLD & ALLERGY TABLET 60<br />
MG-4 MG
pseudoephed/chlorpheniramine TRIAMINIC COLD & ALLERGY TABLET 60<br />
MG-4 MG<br />
pseudoephed/diphenhydramine BENADRYL-D TABLET 60-<br />
25MG<br />
pseudoephedrine/brompheniramin BROVEX PSB LIQUID 15-<br />
1MG/5ML<br />
1st Gen Antihistamine-Decongestant-Analgesic Comb<br />
p-ephed hcl/acetaminophn/cp ACTIFED COLD & SINUS TABLET 30-<br />
500-2MG<br />
Antitussives,Non-Narcotic<br />
dextromethorphan hbr SCOT-TUSSIN LIQUID 10<br />
MG/5 ML<br />
dextromethorphan hbr SCOT-TUSSIN LIQUID 15<br />
MG/5 ML<br />
dextromethorphan hbr SCOT-TUSSIN SYRUP 10<br />
MG/5 ML<br />
dextromethorphan hbr SCOT-TUSSIN SYRUP 5<br />
MG/5 ML<br />
dextromethorphan hbr SCOT-TUSSIN SYRUP 15<br />
MG/5 ML<br />
dextromethorphan hbr SCOT-TUSSIN SYRUP 7.5<br />
MG/5ML<br />
Cough And/Or Cold Preparations<br />
dm hb/p-ephed hcl/apap/doxylam DM HB/P-EPHED HCL/APAP/DOXYLAM LIQUID<br />
Decongestant-Expectorant Combinations<br />
guaifenesin/p-ephed hcl POLY-VENT IR SYRUP 50-<br />
15MG/5<br />
guaifenesin/p-ephed hcl TUSNEL PEDIATRIC DROPS 50-<br />
7.5MG/1<br />
guaifenesin/p-ephed hcl POLY-VENT IR SYRUP 100-<br />
30MG/5<br />
guaifenesin/phenylephrine hcl LIQUIBID PD-R LIQUID 100-5<br />
MG/5<br />
guaifenesin/phenylephrine hcl NUMONYL LIQUID 225-<br />
10MG/5<br />
guaifenesin/phenylephrine hcl NUMONYL PEDIATRIC DROPS 45-<br />
2MG/ML<br />
Expectorants<br />
guaifenesin MUCINEX SYRUP 100<br />
MG/5ML<br />
guaifenesin MUCINEX LIQUID 100<br />
MG/5ML<br />
guaifenesin MUCINEX LIQUID 100<br />
MG/5ML
guaifenesin MUCINEX TABLET 400<br />
MG<br />
Narcotic Antituss-1st Gen. Antihistamine-Decongest<br />
phenylephrine hcl/cod/prometh PHENYLEPHRINE HCL/COD/PROMETH SYRUP 5-10-<br />
6.25<br />
Narcotic Antitussive-1st Generation Antihistamine<br />
codeine/promethazine hcl CODEINE/PROMETHAZINE HCL SYRUP 10-<br />
6.25/5<br />
Narcotic Antitussive-Anticholinergic Comb.<br />
AGE hydrocodone bit/homatropine HYCODAN SYRUP 5-<br />
1.5MG/5<br />
Narcotic Antitussive-Expectorant Combination<br />
guaifenesin/codeine phosphate PRO-CLEAR CAPS LIQUID 100-<br />
10MG/5<br />
guaifenesin/codeine phosphate PRO-CLEAR CAPS LIQUID 100-<br />
10MG/5<br />
Non-Narc Antitus-1st Gen Antihist-Decon-Analges Cb<br />
dm/p-ephed/acetaminoph/doxylam VICKS NYQUIL LIQUID 15-<br />
500/15<br />
Non-Narc Antituss-1st Gen. Antihistamine-Decongest<br />
d-methorphan hb/p-epd hcl/bpm DIMETANE-DX ELIXIR 5-15-<br />
1MG/5<br />
d-methorphan hb/p-ephed hcl/cp VICKS CHILDREN'S NYQUIL SYRUP 15-15-<br />
2/5<br />
d-methorphan hb/p-ephed hcl/cp VICKS CHILDREN'S NYQUIL LIQUID 5-10-<br />
0.7/5<br />
d-methorphan hb/p-ephed hcl/cp RESCON-DM LIQUID 10-30-<br />
2/5<br />
d-methorphan hb/p-ephed hcl/cp VICKS CHILDREN'S NYQUIL SYRUP 15-30-<br />
2/15<br />
d-methorphan hb/p-ephed hcl/cp VICKS CHILDREN'S NYQUIL LIQUID 5-15-<br />
1MG/5<br />
dm hb/p-ephed hcl/carbinox DM HB/P-EPHED HCL/CARBINOX SYRUP 15-60-<br />
4/5<br />
dm/phenyleph/chlorpheniramine ACCUHIST PDX SYRUP 15-10-<br />
2/5<br />
dm/phenyleph/chlorpheniramine ACCUHIST PDX LIQUID 15-10-<br />
4/5<br />
dm/phenyleph/chlorpheniramine ACCUHIST PDX LIQUID 15-5-<br />
2MG/5<br />
Non-Narc Antitussive-1st Gen Antihistamine Comb.<br />
d-methorphan hb/prometh hcl PROMETHAZINE-DM SYRUP 15-<br />
6.25/5
dextromethorphan hbr/chlor-mal CORICIDIN HBP LIQUID 15-<br />
2MG/5ML<br />
Non-Narcotic Antituss-Decongestant-Expectorant Cmb<br />
guaifen/d-methorphan hb/pe BRONTUSS SF SYRUP 100-<br />
10-5<br />
guaifen/dm hb/p-ephedrine POLY-VENT DM LIQUID 67-10<br />
guaifenesin/dm/pseudoephedrine POLY-VENT DM SYRUP 100-<br />
10-30<br />
guaifenesin/dm/pseudoephedrine RU-TUSS DM LIQUID 100-<br />
15-45<br />
Non-Narcotic Antitussive And Expectorant Comb.<br />
guaifenesin/d-methorphan hb MUCINEX COUGH SYRUP 100-<br />
10MG/5<br />
guaifenesin/dextromethorphan MUCINEX COUGH SYRUP 200-<br />
10MG/5<br />
guaifenesin/dextromethorphan MUCINEX COUGH LIQUID 200-<br />
10MG/5<br />
guaifenesin/dextromethorphan MUCINEX COUGH SYRUP 100-<br />
15MG/5<br />
guaifenesin/dextromethorphan MUCINEX COUGH LIQUID 100-<br />
10MG/5<br />
guaifenesin/dextromethorphan MUCINEX COUGH LIQUID 200-<br />
30MG/5<br />
guaifenesin/dextromethorphan VICKS 44E COUGH & CHEST ELIXIR 66.7-<br />
6.7/5<br />
guaifenesin/dextromethorphan MUCINEX COUGH LIQUID 100-5<br />
MG/5<br />
guaifenesin/dextromethorphan MUCINEX COUGH LIQUID 100-<br />
15MG/5<br />
guaifenesin/dextromethorphan SCOT-TUSSIN SENIOR LIQUID 200-<br />
15MG/5<br />
Non-Narcotic Antitussive-Decongestant Combinations<br />
d-methorphan hb/p-ephed hcl PEDIACARE LIQUID 15-<br />
30MG/5<br />
dextromethorphan/pseudoephed VICKS 44D COUGH & HEAD ELIXIR 10-<br />
20MG/5<br />
dextromethorphan/pseudoephed PEDIACARE DROPS 2.5-<br />
7.5/.8<br />
dextromethorphan/pseudoephed PEDIACARE SYRUP 7.5-<br />
15MG/5<br />
Non-Narcotic Antitussive-Decongestant-Analgesic Cb<br />
dm/pseudoephed/acetaminophen TYLENOL INFANTS PLUS COLD-COUG DROPS 5-15-<br />
160MG<br />
Nose Preparations, Vasoconstrictors (rx)
QL epinephrine hcl ADRENALIN CHLORIDE SOLUTION<br />
1:1000<br />
Sympathomimetic <strong>Agents</strong><br />
ephedrine sulfate EPHEDRINE SULFATE CAPSULE 25<br />
MG<br />
phenylpropanolamine hcl PHENYLPROPANOLAMINE HCL TABLET<br />
50MG<br />
pseudoephedrine hcl SUDAFED DROPS<br />
9.4MG/ML<br />
pseudoephedrine hcl SUDAFED LIQUID 15<br />
MG/5 ML<br />
pseudoephedrine hcl SUDAFED LIQUID 30<br />
MG/5 ML<br />
pseudoephedrine hcl PSEUDOEPHEDRINE HCL TABLET 30<br />
MG<br />
pseudoephedrine hcl SUDAFED TABLET<br />
60MG<br />
pseudoephedrine hcl SUDAFED TABLET ER<br />
120 MG<br />
DERMATOLOGY - ACNE<br />
Acne <strong>Agents</strong>,Topical<br />
ST clindamycin phos/benzoyl perox BENZACLIN GEL (GRAM)<br />
1 %-5 %<br />
Astringents<br />
aluminum acetate ALUMINUM ACETATE SOLUTION<br />
Rosacea <strong>Agents</strong>, Topical<br />
metronidazole METROLOTION GEL (GRAM)<br />
0.75 %<br />
metronidazole METROLOTION CREAM (G)<br />
0.75 %<br />
Topical Preparations,Antibacterials<br />
chlorhexidine gluconate HIBICLENS LIQUID 4 %<br />
chlorhexidine gluconate HIBICLENS LIQUID 4 %<br />
chloroxylenol PERIGIENE LIQUID 0.5 %<br />
chloroxylenol PERIGIENE CLEANSER<br />
0.43%<br />
Vitamin A Derivatives<br />
AGE+ tretinoin RETIN-A GEL (GRAM)<br />
QL<br />
0.01 %<br />
AGE+ tretinoin RETIN-A GEL (GRAM)<br />
QL<br />
0.025 %<br />
AGE tretinoin RETIN-A CREAM (G)
0.05 %<br />
AGE+ tretinoin RETIN-A CREAM (G)<br />
QL<br />
0.1 %<br />
AGE+ tretinoin RETIN-A CREAM (G)<br />
QL<br />
0.025 %<br />
AGE+ tretinoin microspheres<br />
RETIN-A MICRO<br />
GEL (GRAM)<br />
QL<br />
RETIN-A MICRO PUMP<br />
0.04%<br />
AGE+ tretinoin microspheres<br />
RETIN-A MICRO<br />
GEL (GRAM)<br />
QL<br />
RETIN-A MICRO PUMP<br />
0.1 %<br />
DERMATOLOGY - ANTIINFECTIVE<br />
Topical Antibiotics<br />
bacitracin BACITRACIN PACKET 500<br />
UNIT/G<br />
bacitracin BACITRACIN OINT. (G) 500<br />
UNIT/G<br />
bacitracin zinc BACITRACIN ZINC OINT. (G) 500<br />
UNIT/G<br />
bacitracin zinc BACITRACIN ZINC PACKET 500<br />
UNIT/G<br />
bacitracin zinc/polymyx b sulf BACITRACIN ZINC/POLYMYX B SULF OINT. (G) 500-<br />
10K/G<br />
bacitracin/polymyxin b sulfate POLYSPORIN OINT. (G) 500-<br />
10K/G<br />
bacitracin/polymyxin b sulfate POLYSPORIN PACKET<br />
bacitracin/polymyxin b sulfate POLYSPORIN OINT. (G) 500-<br />
10K/G<br />
clindamycin phosphate EVOCLIN SOLUTION 1<br />
%<br />
clindamycin phosphate EVOCLIN LOTION 1 %<br />
clindamycin phosphate EVOCLIN MED. SWAB 1<br />
%<br />
erythromycin base AKNE-MYCIN OINT. (G) 2 %<br />
erythromycin base/ethanol ERYGEL GEL (GRAM)<br />
2 %<br />
erythromycin base/ethanol ERYGEL MED. SWAB 2<br />
%<br />
erythromycin base/ethanol ERYGEL SOLUTION 2<br />
%<br />
ST erythromycin/benzoyl peroxide BENZAMYCINPAK GEL (EA) 3 %-<br />
5 %<br />
ST erythromycin/benzoyl peroxide BENZAMYCIN GEL (GRAM)<br />
3 %-5 %<br />
gentamicin sulfate GENTAMICIN SULFATE CREAM (G)<br />
0.1 %<br />
gentamicin sulfate GENTAMICIN SULFATE OINT. (G) 0.1
Topical Antifungals<br />
chloroxylenol SWEEN PREP MED. PAD 0.5<br />
%<br />
ciclopirox olamine LOPROX SUSPENSION<br />
0.77%<br />
clotrimazole MYCELEX CREAM (G) 1<br />
%<br />
clotrimazole MYCELEX SOLUTION 1<br />
%<br />
ketoconazole NIZORAL A-D SHAMPOO 1<br />
%<br />
ketoconazole NIZORAL SHAMPOO 2<br />
%<br />
ketoconazole NIZORAL CREAM (G) 2<br />
%<br />
miconazole nitrate FUNGOID TINCTURE CREAM (G) 2<br />
%<br />
miconazole nitrate FUNGOID TINCTURE POWDER 2 %<br />
nystatin MYCOSTATIN CREAM (G)<br />
100000/G<br />
nystatin MYCOSTATIN OINT. (G)<br />
100000/G<br />
nystatin/triamcin MYCOGEN II CREAM (G)<br />
100000-0.1<br />
nystatin/triamcin MYCOGEN II OINT. (G)<br />
100000-0.1<br />
tolnaftate TINACTIN CREAM (G) 1<br />
%<br />
tolnaftate TINACTIN PACKET 1 %<br />
tolnaftate TINACTIN SOLUTION 1<br />
%<br />
Topical Antiparasitics<br />
crotamiton EURAX CREAM (G)<br />
10 %<br />
permethrin NIX CREAM (G) 5<br />
%<br />
permethrin NIX LIQUID 1 %<br />
permethrin RID LIQUID 1 %<br />
piperonyl butoxide/pyrethrins RID LIQUID 4%-<br />
0.33%<br />
piperonyl butoxide/pyrethrins RID SHAMPOO<br />
4%-0.33%<br />
piperonyl butoxide/pyrethrins RID SHAMPOO<br />
4%-0.33%<br />
%
piperonyl butoxide/pyrethrins RID LIQUID<br />
Topical Sulfonamides<br />
silver sulfadiazine SILVADENE CREAM (G) 1<br />
%<br />
sulfacetamide sodium/sulfur SUMADAN LOTION 10-<br />
5%(W/W)<br />
DERMATOLOGY - ANTIINFLAMMATORY<br />
Topical Anti-Inflammatory Steroidal<br />
betamethasone dipropionate DIPROSONE CREAM (G)<br />
0.05 %<br />
betamethasone dipropionate DIPROSONE OINT. (G) 0.05<br />
%<br />
betamethasone dipropionate DIPROSONE LOTION 0.05<br />
%<br />
betamethasone valerate VALISONE CREAM (G)<br />
0.1 %<br />
betamethasone valerate VALISONE OINT. (G) 0.1<br />
%<br />
betamethasone valerate VALISONE LOTION 0.1 %<br />
clobetasol propionate OLUX SOLUTION<br />
0.05 %<br />
clobetasol propionate OLUX OINT. (G) 0.05<br />
%<br />
clobetasol propionate OLUX CREAM (G)<br />
0.05 %<br />
desonide TRIDESILON CREAM (G)<br />
0.05 %<br />
desonide TRIDESILON OINT. (G) 0.05<br />
%<br />
fluocinolone acetonide DERMA-SMOOTHE-FS CREAM (G)<br />
0.01 %<br />
fluocinolone acetonide DERMA-SMOOTHE-FS CREAM (G)<br />
0.025 %<br />
fluocinolone acetonide DERMA-SMOOTHE-FS OINT. (G)<br />
0.025 %<br />
fluocinolone acetonide DERMA-SMOOTHE-FS SOLUTION<br />
0.01 %<br />
fluocinonide LIDEX GEL (GRAM)<br />
0.05 %<br />
fluocinonide LIDEX CREAM (G)<br />
0.05 %<br />
fluocinonide LIDEX OINT. (G) 0.05<br />
%<br />
fluocinonide LIDEX SOLUTION
0.05 %<br />
fluocinonide/emollient LIDEX-E CREAM (G)<br />
0.05 %<br />
fluticasone propionate CUTIVATE CREAM (G)<br />
0.05 %<br />
fluticasone propionate CUTIVATE OINT. (G)<br />
0.005 %<br />
hc/mineral oil/petrolat,wht HC/MINERAL OIL/PETROLAT,WHT OINT. (G) 1 %<br />
hydrocortisone CORTIZONE-10 SOLUTION 1<br />
%<br />
hydrocortisone CORTIZONE-10 LOTION 2 %<br />
hydrocortisone CORTIZONE-10 SPRAY 1 %<br />
hydrocortisone CORTIZONE-10 CREAM (G)<br />
0.5 %<br />
hydrocortisone CORTIZONE-10 CREAM (G) 1<br />
%<br />
QL hydrocortisone CORTIZONE-10 CREAM (G)<br />
2.5 %<br />
hydrocortisone CORTIZONE-10 OINT. (G) 0.5<br />
%<br />
hydrocortisone CORTIZONE-10 OINT. (G) 1 %<br />
hydrocortisone CORTIZONE-10 OINT. (G) 2.5<br />
%<br />
hydrocortisone CORTIZONE-10 LOTION 1 %<br />
hydrocortisone CORTIZONE-10 LOTION 2.5 %<br />
QL hydrocortisone acetate CORTAID CREAM (G) 1<br />
%<br />
QL hydrocortisone acetate CORTAID CREAM (G)<br />
0.5 %<br />
QL hydrocortisone acetate CORTAID OINT. (G) 1 %<br />
hydrocortisone acetate/alo ver NUZON OINT.(GM)<br />
0.5%<br />
hydrocortisone acetate/aloe v NUZON CREAM (G)<br />
0.5 %<br />
triamcinolone acetonide KENALOG CREAM (G)<br />
0.025 %<br />
triamcinolone acetonide KENALOG CREAM (G)<br />
0.1 %<br />
triamcinolone acetonide KENALOG CREAM (G)<br />
0.5 %<br />
triamcinolone acetonide KENALOG OINT. (G)<br />
0.025 %<br />
triamcinolone acetonide KENALOG OINT. (G) 0.1<br />
%<br />
triamcinolone acetonide KENALOG OINT. (G) 0.05<br />
%
triamcinolone acetonide KENALOG CREAM 1%<br />
triamcinolone acetonide KENALOG LOTION 0.025<br />
%<br />
triamcinolone acetonide KENALOG LOTION 0.1 %<br />
DERMATOLOGY - ANTIPRURITIC DRUGS<br />
Antipruritics,Topical<br />
diphenhydramine hcl BENADRYL CREAM (G) 2<br />
%<br />
diphenhydramine hcl BENADRYL SPRAY 2%<br />
diphenhydramine hcl BENADRYL SPRAY 1%<br />
diphenhydramine hcl DERMA-PAX LOTION 0.5 %<br />
diphenhydramine hcl BENADRYL GEL (ML) 2 %<br />
diphenhydramine hcl/zinc acet BENADRYL CREAM (G) 2<br />
%-0.1 %<br />
DERMATOLOGY - MISCELLANEOUS<br />
Antiseborrheic <strong>Agents</strong><br />
selenium sulfide SELSUN RX SUSPENSION<br />
2.5 %<br />
Antiseptics,General<br />
alcohol antiseptic pads<br />
ALCOHOL PREP PADS<br />
ALCOHOL SWABS<br />
SINGLE USE SWAB<br />
SURE COMFORT ALCOHOL<br />
SURE-PREP ALCOHOL PREP PADS<br />
MED. PAD<br />
Emollients<br />
ammonium lactate LAC-HYDRIN LOTION 12%<br />
Irrigants<br />
sod chloride/b-6/zinc acet/ca WOUND CLEANSER SPRAY<br />
QL sodium chloride irrig solution SODIUM CHLORIDE IRRIG SOLUTION IRRIG SOLN<br />
0.9 %<br />
Irritants/Counter-Irritants<br />
coal tar CUTAR L.C.D. EMULSION<br />
7.5 %<br />
coal tar DHS TAR CREAM (G) 2<br />
%<br />
Keratolytics<br />
benzoyl peroxide BENZAC AC GEL (GRAM)<br />
10 %<br />
benzoyl peroxide BENZAC AC GEL (GRAM)<br />
5 %<br />
benzoyl peroxide BENZAC AC GEL (GRAM)
2.5 %<br />
benzoyl peroxide BENZAC AC CLEANSER 5<br />
%<br />
benzoyl peroxide BP WASH CLEANSER<br />
2.5 %<br />
benzoyl peroxide BENZAC AC LOTION 10 %<br />
benzoyl peroxide BENZAC AC LOTION 5 %<br />
benzoyl peroxide BENZAC AC CREAM (G)<br />
2.5 %<br />
podofilox CONDYLOX GEL (GRAM)<br />
0.5 %<br />
podofilox CONDYLOX SOLUTION<br />
0.5 %<br />
salicylic acid VIRASAL LIQUID 3 %<br />
Protectives<br />
calamine CALAMINE LOTION<br />
zinc oxide BOUDREAUXS OINT. (G) 20<br />
%<br />
Topical Antineoplastic & Premalignant Lesion Agnts<br />
fluorouracil CARAC CREAM (G)<br />
0.5 %<br />
fluorouracil FLUOROPLEX CREAM (G) 1<br />
%<br />
fluorouracil EFUDEX CREAM (G) 5<br />
%<br />
fluorouracil EFUDEX SOLUTION 2<br />
%<br />
fluorouracil EFUDEX SOLUTION 5<br />
%<br />
Topical Local Anesthetics<br />
lidocaine LIDAMANTLE OINT. (G) 5 %<br />
Topical Preparations,Miscellaneous<br />
calcium acetate/aluminum sulf DOMEBORO PACKET<br />
DERMATOLOGY - PSORIASIS/ECZEMA<br />
Antipsoriatics <strong>Agents</strong><br />
calcipotriene DOVONEX OINT. (G)<br />
0.005 %<br />
calcipotriene DOVONEX CREAM<br />
0.005%<br />
calcipotriene DOVONEX SOLUTION<br />
0.005 %<br />
Topical Immunosuppressive <strong>Agents</strong>
AGE+ pimecrolimus ELIDEL CREAM (G) 1<br />
ST<br />
%<br />
AGE+ tacrolimus PROTOPIC OINT. (G) 0.03<br />
QL+<br />
%<br />
ST<br />
AGE+ tacrolimus PROTOPIC OINT. (G) 0.1<br />
QL+<br />
ST<br />
%<br />
DIABETES<br />
Antihypergly, (dpp-4) Inhibitor & Biguanide Comb.<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
sitagliptin phos/met<strong>for</strong>min hcl JANUMET TABLET<br />
50MG-500MG<br />
sitagliptin phos/met<strong>for</strong>min hcl JANUMET TABLET 50-<br />
1000 MG<br />
Antihyperglycemic, Alpha-Glucosidase Inhib (n-S)<br />
ST acarbose PRECOSE TABLET 100<br />
MG<br />
ST acarbose PRECOSE TABLET 50<br />
MG<br />
ST acarbose PRECOSE TABLET 25<br />
MG<br />
Antihyperglycemic, Dpp-4 Inhibitors<br />
PA linagliptin TRADJENTA TABLET 5<br />
MG<br />
PA saxagliptin hcl ONGLYZA TABLET 2.5<br />
MG<br />
PA saxagliptin hcl ONGLYZA TABLET 5<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
MG<br />
sitagliptin phosphate JANUVIA TABLET 25<br />
MG<br />
sitagliptin phosphate JANUVIA TABLET 50<br />
MG<br />
sitagliptin phosphate JANUVIA TABLET 100<br />
MG<br />
Antihyperglycemic, Insulin-Release Stimulant Type<br />
chlorpropamide DIABINESE TABLET 100<br />
MG<br />
chlorpropamide DIABINESE TABLET 250<br />
MG<br />
glimepiride AMARYL TABLET 1<br />
MG<br />
glimepiride AMARYL TABLET 2<br />
MG
glimepiride AMARYL TABLET 4<br />
MG<br />
glipizide GLUCOTROL XL TABLET 5<br />
MG<br />
glipizide GLUCOTROL XL TABLET 10<br />
MG<br />
glipizide GLUCOTROL XL TAB ER 24 10<br />
MG<br />
glipizide GLUCOTROL XL TAB ER 24 5<br />
MG<br />
glipizide GLUCOTROL XL TAB ER 24 2.5<br />
MG<br />
glyburide MICRONASE TABLET 1.25<br />
MG<br />
glyburide MICRONASE TABLET 2.5<br />
MG<br />
glyburide MICRONASE TABLET 5<br />
MG<br />
glyburide,micronized GLYNASE TABLET 1.5<br />
MG<br />
glyburide,micronized GLYNASE TABLET 3<br />
MG<br />
glyburide,micronized GLYNASE TABLET 6<br />
MG<br />
tolazamide TOLAZAMIDE TABLET 250<br />
MG<br />
tolazamide TOLAZAMIDE TABLET 500<br />
MG<br />
tolbutamide TOLBUTAMIDE TABLET 500<br />
MG<br />
Antihyperglycemic, Insulin-Response Enhancer (n-S)<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
pioglitazone hcl ACTOS TABLET 15<br />
MG<br />
pioglitazone hcl ACTOS TABLET 30<br />
MG<br />
pioglitazone hcl ACTOS TABLET 45<br />
MG<br />
rosiglitazone maleate AVANDIA TABLET 2<br />
MG<br />
rosiglitazone maleate AVANDIA TABLET 4<br />
MG<br />
rosiglitazone maleate AVANDIA TABLET 8<br />
MG<br />
Antihyperglycemic,Biguanide Type(non-Sulfonylurea)<br />
met<strong>for</strong>min hcl GLUCOPHAGE TABLET 500
MG<br />
met<strong>for</strong>min hcl GLUCOPHAGE TABLET 850<br />
MG<br />
met<strong>for</strong>min hcl GLUCOPHAGE TABLET 1000<br />
MG<br />
QL met<strong>for</strong>min hcl GLUCOPHAGE TAB ER 24H<br />
750 MG<br />
QL met<strong>for</strong>min hcl GLUCOPHAGE TAB ER 24H<br />
500 MG<br />
Antihyperglycemic,Insulin-Rel Stim.& Biguanide Cmb<br />
QL glyburide/met<strong>for</strong>min hcl GLUCOVANCE TABLET 1.25-<br />
250MG<br />
glyburide/met<strong>for</strong>min hcl GLUCOVANCE TABLET 5<br />
MG-500MG<br />
QL glyburide/met<strong>for</strong>min hcl GLUCOVANCE TABLET 2.5-<br />
500 MG<br />
Antihyperglycm,Insul-Resp.enhancer & Biguanide Cmb<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
pioglitazone hcl/met<strong>for</strong>min hcl ACTOPLUS MET TABLET<br />
15MG-500MG<br />
pioglitazone hcl/met<strong>for</strong>min hcl ACTOPLUS MET TABLET<br />
15MG-850MG<br />
rosiglitazone/met<strong>for</strong>min hcl AVANDAMET TABLET 2-<br />
1000MG<br />
rosiglitazone/met<strong>for</strong>min hcl AVANDAMET TABLET 4-<br />
1000MG<br />
rosiglitazone/met<strong>for</strong>min hcl AVANDAMET TABLET 2<br />
MG-500MG<br />
rosiglitazone/met<strong>for</strong>min hcl AVANDAMET TABLET 4-<br />
500MG<br />
Blood Sugar Diagnostics<br />
PA+<br />
QL<br />
blood sugar diagnostic<br />
ACCU-CHEK AVIVA PLUS<br />
CONTOUR<br />
FREESTYLE LITE STRIPS<br />
ONE TOUCH ULTRA TEST STRIPS<br />
TRUETRACK TEST STRIP<br />
Diabetic Supplies<br />
QL blood-glucose meter TRUETRACK SMART SYSTEM KIT<br />
diabetic supplies,miscell NEEDLE FREE INSULIN SYR KIT KIT<br />
Hyperglycemics<br />
QL glucagon,human recombinant GLUCAGEN<br />
GLUCAGON EMERGENCY KIT<br />
STRIP<br />
KIT 1 MG<br />
Insulins<br />
QL hum insulin nph/reg insulin hm HUMULIN 70-30 VIAL 70-
NOVOLIN 70-30<br />
30/ML<br />
QL insulin aspart NOVOLOG VIAL 100/ML<br />
PA insulin detemir LEVEMIR INSULN PEN<br />
100/ML (3)<br />
QL+ insulin detemir LEVEMIR VIAL 100/ML<br />
ST<br />
QL insulin glargine,hum.rec.anlog LANTUS VIAL 100/ML<br />
QL insulin lispro HUMALOG VIAL 100/ML<br />
QL insulin npl/insulin lispro HUMALOG MIX 75-25 VIAL 75-<br />
25/ML<br />
QL insulin npl/insulin lispro HUMALOG MIX 50-50 VIAL 50-<br />
50/ML<br />
QL insulin regular, human HUMULIN R VIAL 500/ML<br />
QL insulin regular, human HUMULIN R<br />
VIAL 100/ML<br />
NOVOLIN R<br />
QL insuln asp prt/insulin aspart NOVOLOG MIX 70-30 VIAL 70-<br />
30/ML<br />
QL nph, human insulin isophane HUMULIN N<br />
NOVOLIN N<br />
VIAL 100/ML<br />
Urine Glucose Test Aids<br />
urine glucose test,strip<br />
DIASCREEN 1G REAGENT<br />
DIASTIX REAGENT<br />
STRIP<br />
EAR - GENERAL DISORDERS<br />
Ear Preparations, Misc. Anti-Infectives<br />
acetic acid ACETIC ACID SOLUTION 2<br />
%<br />
acetic acid/aluminum acetate DOMEBORO DROPS 2 %<br />
acetic acid/hydrocortisone VOSOL HC DROPS 2 %-1<br />
%<br />
Ear Preparations,Antibiotics<br />
neomycin/polymyxin b sulf/hc CORTISPORIN SOLUTION<br />
3.5-10K-1<br />
neomycin/polymyxin b sulf/hc CORTISPORIN DROPS SUSP<br />
3.5-10K-1<br />
ofloxacin FLOXIN DROPS 0.3 %<br />
Ear Preparations,Local Anesthetics<br />
antipyrine/benzocaine/glycerin OTRA NR DROPS 5.4 %-<br />
1.4%<br />
ELECTROLYTE REGULATION<br />
Electrolyte Depleters<br />
calcium acetate PHOSLO TABLET 667<br />
MG
calcium acetate PHOSLO CAPSULE 667<br />
MG<br />
calcium acetate PHOSLO TABLET 667<br />
MG<br />
Electrolyte Maintenance<br />
electrolyte,oral PEDIALYTE SOLUTION<br />
Potassium Replacement<br />
potassium bicarbonate QUIC-K TABLET EFF<br />
6.5MEQ<br />
potassium chloride MICRO-K CAPSULE ER<br />
8 MEQ<br />
potassium chloride MICRO-K CAPSULE ER<br />
10 MEQ<br />
potassium chloride MICRO-K PACKET 20<br />
MEQ<br />
potassium chloride MICRO-K PACKET 25<br />
MEQ<br />
potassium chloride MICRO-K LIQUID<br />
40MEQ/15ML<br />
potassium chloride MICRO-K LIQUID<br />
20MEQ/15ML<br />
potassium chloride MICRO-K TABLET SA<br />
10MEQ<br />
potassium chloride MICRO-K TAB ER PRT<br />
10 MEQ<br />
potassium chloride MICRO-K TAB ER PRT<br />
20 MEQ<br />
potassium chloride MICRO-K TABLET ER 8<br />
MEQ<br />
ENDOCRINE DISORDER - OTHER<br />
Antidiuretic And Vasopressor Hormones<br />
ST desmopressin (nonrefrigerated) DDAVP SPRAY/PUMP<br />
10/SPRAY<br />
ST desmopressin acetate DDAVP SOLUTION<br />
0.1 MG/ML<br />
ST desmopressin acetate DDAVP TABLET 0.1<br />
MG<br />
ST desmopressin acetate DDAVP TABLET 0.2<br />
MG<br />
Bone Resorption Inhibitors<br />
QL alendronate sodium FOSAMAX TABLET 35<br />
MG<br />
QL alendronate sodium FOSAMAX TABLET 10
MG<br />
QL alendronate sodium FOSAMAX TABLET 40<br />
MG<br />
QL alendronate sodium FOSAMAX TABLET 5<br />
MG<br />
QL alendronate sodium FOSAMAX TABLET 70<br />
MG<br />
PA calcitonin,salmon,synthetic CALCITONIN,SALMON,SYNTHETIC<br />
MIACALCIN<br />
FORTICAL<br />
SPRAY/PUMP<br />
200/DOSE<br />
PA raloxifene hcl EVISTA TABLET 60<br />
MG<br />
ENDOCRINE DISORDER - THYROID<br />
Antithyroid Preparations<br />
methimazole TAPAZOLE TABLET 20<br />
MG<br />
methimazole TAPAZOLE TABLET 10<br />
MG<br />
methimazole TAPAZOLE TABLET 5<br />
MG<br />
propylthiouracil PROPYLTHIOURACIL TABLET 50<br />
MG<br />
Iodine Containing <strong>Agents</strong><br />
potassium iodide POTASSIUM IODIDE SOLUTION<br />
1G/ML<br />
Thyroid Hormones<br />
levothyroxine sodium<br />
levothyroxine sodium<br />
levothyroxine sodium<br />
levothyroxine sodium<br />
levothyroxine sodium<br />
levothyroxine sodium<br />
LEVOTHROID<br />
LEVOXYL<br />
SYNTHROID<br />
LEVOTHROID<br />
LEVOXYL<br />
SYNTHROID<br />
LEVOTHROID<br />
LEVOXYL<br />
SYNTHROID<br />
LEVOTHROID<br />
LEVOXYL<br />
SYNTHROID<br />
LEVOTHROID<br />
LEVOXYL<br />
SYNTHROID<br />
LEVOTHROID<br />
LEVOXYL<br />
SYNTHROID<br />
TABLET 112<br />
MCG<br />
TABLET 25<br />
MCG<br />
TABLET 50<br />
MCG<br />
TABLET 100<br />
MCG<br />
TABLET 75<br />
MCG<br />
TABLET 200<br />
MCG
levothyroxine sodium LEVOTHROID<br />
LEVOXYL<br />
SYNTHROID<br />
levothyroxine sodium<br />
LEVOTHROID<br />
LEVOXYL<br />
SYNTHROID<br />
levothyroxine sodium<br />
LEVOTHROID<br />
LEVOXYL<br />
SYNTHROID<br />
levothyroxine sodium<br />
LEVOTHROID<br />
SYNTHROID<br />
UNITHROID<br />
levothyroxine sodium<br />
LEVOTHROID<br />
LEVOXYL<br />
SYNTHROID<br />
levothyroxine sodium<br />
LEVOTHROID<br />
LEVOXYL<br />
TABLET 125<br />
MCG<br />
TABLET 150<br />
MCG<br />
TABLET<br />
175MCG<br />
TABLET 300<br />
MCG<br />
TABLET 88<br />
MCG<br />
TABLET 137<br />
MCG<br />
SYNTHROID<br />
liothyronine sodium CYTOMEL TABLET 25<br />
MCG<br />
liothyronine sodium CYTOMEL TABLET 5<br />
MCG<br />
liothyronine sodium CYTOMEL TABLET 50<br />
MCG<br />
thyroid,pork ARMOUR THYROID TABLET 120<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 30<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 300<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 60<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 15<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 90<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 180<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 240<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 195<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 16.25<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 32.5<br />
MG
thyroid,pork ARMOUR THYROID TABLET 65<br />
MG<br />
thyroid,pork ARMOUR THYROID TABLET 130<br />
MG<br />
EYE - GENERAL DISORDERS<br />
Eye Antibiotic-Corticoid Combinations<br />
gentamicin/prednisol ac PRED-G DROPS SUSP<br />
0.3%-1%<br />
gentamicin/prednisol ac PRED-G OINT. (G) 0.3-<br />
0.6%<br />
neo/polymyx b sulf/dexameth MAXITROL OINT. (G) 3.5-<br />
10K-.1<br />
neo/polymyx b sulf/dexameth MAXITROL DROPS SUSP<br />
0.1 %<br />
neomy sulf/bacitrac zn/poly/hc TRIPLE ANTIBIOTIC HC OINT. (G) 3.5-<br />
10K-1<br />
neomycin sulfate/dex na ph NEOMYCIN SULFATE/DEX NA PH DROPS 0.35-<br />
0.1%<br />
tobramycin sulf/dexamethasone TOBRADEX OINT. (G) 0.3<br />
%-0.1%<br />
Eye Antihistamines<br />
QL ketotifen fumarate ZADITOR DROPS 0.025<br />
%<br />
Eye Antiinflammatory <strong>Agents</strong><br />
PA dexamethasone MAXIDEX DROPS SUSP<br />
0.1 %<br />
dexamethasone sod phosphate DECADRON OINT. (G) 0.05<br />
%<br />
dexamethasone sod phosphate DEXASOL DROPS 0.1 %<br />
ST diclofenac sodium VOLTAREN DROPS 0.1 %<br />
fluorometholone FLUOROMETHOLONE DROPS SUSP<br />
0.1 %<br />
flurbiprofen sodium OCUFEN DROPS 0.03 %<br />
ST ketorolac tromethamine ACULAR LS DROPS 0.4 %<br />
ST ketorolac tromethamine ACULAR LS DROPS 0.5 %<br />
prednisolone acetate PRED MILD DROPS SUSP<br />
0.12 %<br />
prednisolone acetate PRED FORTE DROPS SUSP<br />
1 %<br />
prednisolone sod phosphate PREDNISOL DROPS 1 %<br />
Eye Antivirals<br />
trifluridine VIROPTIC DROPS 1 %<br />
Eye Local Anesthetics
proparacaine hcl OPHTHETIC DROPS 0.5 %<br />
tetracaine hcl TETRAVISC DROPS 0.5 %<br />
Eye Sulfonamides<br />
na sulfacetm/prednis sp NA SULFACETM/PREDNIS SP DROPS 10-<br />
0.25%<br />
sulfacetamide sodium SULFAC OINT. (G) 10<br />
%<br />
sulfacetamide sodium SULFAC DROPS 10 %<br />
sulfacetm na/prednisol ac BLEPHAMIDE S.O.P. OINT. (G) 10<br />
%-0.2 %<br />
PA sulfacetm na/prednisol ac BLEPHAMIDE DROPS SUSP<br />
10 %-0.2 %<br />
Eye Vasoconstrictors (otc Only)<br />
naphazoline hcl NAPHCON DROPS 0.012<br />
%<br />
naphazoline hcl/pheniramine OPCON-A DROPS .0268-<br />
.315<br />
naphazoline hcl/pheniramine OPCON-A DROPS .0268-<br />
.315<br />
Eye Vasoconstrictors (rx Only)<br />
naphazoline hcl ALBALON DROPS 0.1 %<br />
phenylephrine hcl MYDFRIN DROPS 10 %<br />
phenylephrine hcl MYDFRIN DROPS 2.5 %<br />
Ophthalmic Antibiotics<br />
bacitracin BACITRACIN OINT. (G) 500<br />
UNIT/G<br />
bacitracin/polymyxin b sulfate POLYSPORIN OINT. (G) 500-<br />
10K/G<br />
bacitracin/polymyxin b sulfate POLYSPORIN OINT. (G) 500-<br />
10K/G<br />
ST ciprofloxacin hcl CILOXAN OINT. (G) 0.3<br />
%<br />
QL ciprofloxacin hcl CILOXAN DROPS 0.3 %<br />
erythromycin base ILOTYCIN OINT. (G)<br />
5MG/G<br />
gentamicin sulfate GARAMYCIN OINT. (G) 0.3<br />
%<br />
gentamicin sulfate GARAMYCIN DROPS 0.3 %<br />
neomy sulf/bacitra/polymyxin b NEOSPORIN OINT. (G)<br />
neomycin/polymyxn b/gramicidin<br />
3.5MG-400<br />
NEOMYCIN/POLYMYXN B/GRAMICIDIN DROPS<br />
1.75MG-10K<br />
QL ofloxacin OCUFLOX DROPS 0.3 %<br />
polymyxin b sulfate/tmp POLYTRIM DROPS
10K/ML-0.1<br />
tobramycin sulfate TOBREX DROPS 0.3 %<br />
Ophthalmic Mast Cell Stabilizers<br />
cromolyn sodium CROMOLYN SODIUM DROPS 4 %<br />
Ophthalmic Preparations, Miscellaneous<br />
sodium chloride SODIUM CHLORIDE OINT. (G) 5 %<br />
sodium chloride SODIUM CHLORIDE DROPS 5 %<br />
EYE - GLAUCOMA<br />
Carbonic Anhydrase Inhibitors<br />
acetazolamide DIAMOX SEQUELS CAPSULE ER<br />
500 MG<br />
acetazolamide DIAMOX SEQUELS TABLET 125<br />
MG<br />
acetazolamide DIAMOX SEQUELS TABLET 250<br />
MG<br />
methazolamide NEPTAZANE TABLET 50<br />
MG<br />
methazolamide NEPTAZANE TABLET 25<br />
MG<br />
Miotics/Other Intraoc. Pressure Reducers<br />
PA apraclonidine hcl IOPIDINE DROPERETTE<br />
1 %<br />
brimonidine tartrate ALPHAGAN P DROPS 0.2 %<br />
PA brinzolamide AZOPT DROPS SUSP<br />
1 %<br />
PA carbachol ISOPTO CARBACHOL DROPS 1.5 %<br />
carbachol ISOPTO CARBACHOL DROPS 3 %<br />
dorzolamide hcl TRUSOPT DROPS 2 %<br />
dorzolamide hcl/timolol maleat COSOPT DROPS 2%-<br />
0.5%<br />
echothiophate iodide PHOSPHOLINE IODIDE DROPS 0.125<br />
%<br />
latanoprost XALATAN DROPS 0.005<br />
%<br />
levobunolol hcl BETAGAN DROPS 0.5 %<br />
levobunolol hcl BETAGAN DROPS 0.25 %<br />
metipranolol OPTIPRANOLOL DROPS 0.3 %<br />
pilocarpine hcl ISOPTO CARPINE DROPS 1 %<br />
pilocarpine hcl ISOPTO CARPINE DROPS 2%<br />
pilocarpine hcl ISOPTO CARPINE DROPS 4%<br />
pilocarpine hcl ISOPTO CARPINE DROPS 8 %<br />
timolol maleate TIMOPTIC-XE DROPS 0.25 %<br />
timolol maleate TIMOPTIC-XE DROPS 0.5 %
PA timolol maleate/pf TIMOPTIC OCUDOSE DROPERETTE<br />
0.25 %<br />
PA timolol maleate/pf TIMOPTIC OCUDOSE DROPERETTE<br />
0.5 %<br />
Mydriatics<br />
atropine sulfate ISOPTO ATROPINE OINT. (G) 1 %<br />
atropine sulfate ISOPTO ATROPINE DROPS 1 %<br />
cyclopentolate hcl CYCLOGYL DROPS 0.5 %<br />
cyclopentolate hcl CYCLOGYL DROPS 1 %<br />
cyclopentolate hcl CYCLOGYL DROPS 2 %<br />
homatropine hbr ISOPTO HOMATROPINE DROPS 2 %<br />
homatropine hbr ISOPTO HOMATROPINE DROPS 5 %<br />
scopolamine hydrobromide ISOPTO HYOSCINE DROPS 0.25 %<br />
tropicamide MYDRIACYL DROPS 0.5 %<br />
tropicamide MYDRIACYL DROPS 1 %<br />
EYE - MISCELLANEOUS<br />
Artificial Tears<br />
glycerin/propylene glycol HYPOTEARS DROPS 0.3%-<br />
1%<br />
Contact Lens Preparations<br />
sodium chloride SODIUM CHLORIDE SPRAY 0.9 %<br />
Eye Preparations, Miscellaneous (otc)<br />
tyloxapol ENUCLENE DROPS 0.25 %<br />
GOUT AND RELATED DISEASES<br />
Colchicine<br />
colchicine COLCHICINE TABLET<br />
0.6MG<br />
colchicine/probenecid COLCHICINE/PROBENECID TABLET 0.5-<br />
500MG<br />
Hyperuricemia Tx - Purine Inhibitors<br />
allopurinol ZYLOPRIM TABLET 100<br />
MG<br />
allopurinol ZYLOPRIM TABLET 300<br />
MG<br />
Uricosuric <strong>Agents</strong><br />
probenecid PROBENECID TABLET 500<br />
MG<br />
HEMATOLOGICAL DISORDERS<br />
Anticoagulants,Coumarin Type
warfarin sodium COUMADIN TABLET 10<br />
MG<br />
warfarin sodium COUMADIN TABLET 2<br />
MG<br />
warfarin sodium COUMADIN TABLET 1<br />
MG<br />
warfarin sodium COUMADIN TABLET 5<br />
MG<br />
warfarin sodium COUMADIN TABLET 2.5<br />
MG<br />
warfarin sodium COUMADIN TABLET 7.5<br />
MG<br />
warfarin sodium COUMADIN TABLET 3<br />
MG<br />
warfarin sodium COUMADIN TABLET 4<br />
MG<br />
warfarin sodium COUMADIN TABLET 6<br />
MG<br />
Hemorrheologic <strong>Agents</strong><br />
pentoxifylline TRENTAL TABLET ER<br />
400 MG<br />
Heparin And Related Preparations<br />
QL enoxaparin sodium LOVENOX DISP SYRIN<br />
30MG/0.3ML<br />
QL enoxaparin sodium LOVENOX DISP SYRIN<br />
150 MG/ML<br />
QL enoxaparin sodium LOVENOX DISP SYRIN<br />
120MG/.8ML<br />
QL enoxaparin sodium LOVENOX DISP SYRIN<br />
60MG/0.6ML<br />
QL enoxaparin sodium LOVENOX DISP SYRIN<br />
80MG/0.8ML<br />
QL enoxaparin sodium LOVENOX DISP SYRIN<br />
100 MG/ML<br />
QL enoxaparin sodium LOVENOX DISP SYRIN<br />
40MG/0.4ML<br />
heparin sodium,porcine HEP-LOCK DISP SYRIN<br />
10 UNIT/ML<br />
heparin sodium,porcine HEP-LOCK VIAL<br />
5000/ML<br />
Platelet Aggregation Inhibitors<br />
clopidogrel bisulfate PLAVIX TABLET 75<br />
MG<br />
dipyridamole PERSANTINE TABLET 25<br />
MG
dipyridamole PERSANTINE TABLET 50<br />
MG<br />
dipyridamole PERSANTINE TABLET 75<br />
MG<br />
PA prasugrel hcl EFFIENT TABLET 10<br />
MG<br />
Sickle Cell Anemia <strong>Agents</strong><br />
hydroxyurea DROXIA CAPSULE 200<br />
MG<br />
hydroxyurea DROXIA CAPSULE 300<br />
MG<br />
hydroxyurea DROXIA CAPSULE 400<br />
MG<br />
Thrombin Inhibitors,Selective,Direct, & Reversible<br />
PA dabigatran etexilate mesylate PRADAXA CAPSULE 150<br />
MG<br />
PA dabigatran etexilate mesylate PRADAXA CAPSULE 75<br />
MG<br />
Vitamin K Preparations<br />
phytonadione MEPHYTON TABLET 5<br />
MG<br />
HORMONAL DEFICIENCY<br />
Androgenic <strong>Agents</strong><br />
fluoxymesterone FLUOXYMESTERONE TABLET 10<br />
MG<br />
methyltestosterone METHITEST TABLET 10<br />
MG<br />
PA testosterone TESTOPEL PELLET(EA)<br />
75 MG<br />
PA testosterone STRIANT MUC ER 12H<br />
30 MG<br />
PA testosterone ANDROGEL GEL MD PMP<br />
1.25G (1%)<br />
PA testosterone ANDRODERM PATCH TD24<br />
4 MG/24 HR<br />
PA testosterone ANDROGEL GEL MD PMP<br />
20.25/1.25<br />
PA testosterone ANDROGEL GEL PACKET<br />
25MG(1%)<br />
PA testosterone ANDROGEL<br />
TESTIM<br />
GEL PACKET<br />
50 MG (1%)<br />
AGE+ testosterone cypionate DEPO-TESTOSTERONE VIAL 200<br />
QL<br />
MG/ML
Estrogen/Androgen Combinations<br />
estrogen,ester/me-testosterone ESTRATEST TABLET<br />
0.625-1.25<br />
estrogen,ester/me-testosterone ESTRATEST TABLET 1.25-<br />
2.5MG<br />
Estrogenic <strong>Agents</strong><br />
estradiol CLIMARA TABLET 1<br />
MG<br />
estradiol CLIMARA TABLET 2<br />
MG<br />
estradiol CLIMARA TABLET 0.5<br />
MG<br />
PA estradiol DIVIGEL GEL PACKET<br />
0.5MG(0.1)<br />
PA estradiol ALORA<br />
VIVELLE-DOT<br />
PATCH TDSW<br />
0.05MG/24H<br />
PA estradiol ALORA<br />
VIVELLE-DOT<br />
PATCH TDSW<br />
0.1MG/24HR<br />
PA estradiol ALORA<br />
VIVELLE-DOT<br />
PATCH TDSW<br />
.025MG/24H<br />
PA estradiol CLIMARA PATCH<br />
TDWK<br />
0.1MG/24HR<br />
PA estradiol VIVELLE-DOT PATCH TDSW<br />
.0375MG/24<br />
estrogen,con/m-progest acet PREMPRO TABLET 0.45-<br />
1.5MG<br />
estrogen,con/m-progest acet PREMPRO TABLET 0.3-<br />
1.5MG<br />
estrogen,con/m-progest acet PREMPRO TABLET<br />
0.625-5MG<br />
estrogen,con/m-progest acet PREMPRO TABLET<br />
0.625-2.5<br />
estrogen,con/m-progest acet PREMPHASE TABLET 0.625<br />
(14)<br />
estrogens, conjugated PREMARIN TABLET 0.625<br />
MG<br />
estrogens, conjugated PREMARIN TABLET 0.3<br />
MG<br />
estrogens, conjugated PREMARIN TABLET 0.9<br />
MG<br />
estrogens, conjugated PREMARIN TABLET 1.25<br />
MG<br />
estrogens, conjugated PREMARIN TABLET<br />
0.45MG
estrogens,esterified MENEST TABLET 0.3<br />
MG<br />
estrogens,esterified MENEST TABLET 0.625<br />
MG<br />
estrogens,esterified MENEST TABLET 1.25<br />
MG<br />
estrogens,esterified MENEST TABLET 2.5<br />
MG<br />
norethind ac/ethinyl estradiol FEMHRT TABLET<br />
1MG-5MCG<br />
Progestational <strong>Agents</strong><br />
medroxyprogesterone acet PROVERA TABLET<br />
10MG<br />
medroxyprogesterone acetate PROVERA TABLET 2.5<br />
MG<br />
medroxyprogesterone acetate PROVERA TABLET 5<br />
MG<br />
norethindrone acetate AYGESTIN TABLET 5<br />
MG<br />
IMMUNIZATION<br />
Gram Positive Cocci Vaccines<br />
QL+ pneumococcal 23-val p-sac vac PNEUMOVAX 23 DISP SYRIN<br />
AGE<br />
25MCG/0.5<br />
QL+ pneumococcal 23-val p-sac vac PNEUMOVAX 23 VIAL<br />
AGE<br />
25MCG/0.5<br />
Influenza Virus Vaccines<br />
AGE+<br />
QL<br />
flu vaccine 2011 (36 mos+)/pf<br />
FLUZONE 2011-2012 (PF)<br />
FLUARIX 2011-2012 (PF)<br />
FLUVIRIN 2011-2012 (PF)<br />
AFLURIA 2011-2012 (PF)<br />
DISP SYRIN<br />
45MCG/.5ML<br />
AGE+ flu vaccine 2011 (36 mos+)/pf FLUZONE 2011-2012 (PF) VIAL<br />
QL<br />
45MCG/.5ML<br />
AGE+ flu vaccine 2011(6-35 mos)/pf FLUZONE 2011-2012 (PF) DISP SYRIN<br />
QL<br />
PED-0.25ML<br />
AGE+ flu vaccine ts 2011-12 (4 yr+) FLUVIRIN 2011-2012<br />
VIAL<br />
QL<br />
45MCG/.5ML<br />
FLULAVAL 2011-2012<br />
FLUZONE 2011-2012<br />
AFLURIA 2011-2012<br />
AGE+ influenza tvs 11-12 vaccine/pf FLUZONE INTRADERMAL DISP SYRIN<br />
QL<br />
27MCG/.1ML<br />
AGE+ influenza tvs 11-12 vaccine/pf FLUZONE HIGH-DOSE 2011-12 (PF) DISP SYRIN<br />
QL<br />
180MCG/0.5<br />
AGE+ influenza vacc,tri 2011 (live) FLUMIST SPRAY<br />
QL<br />
10E6.5-7.5
Viral/Tumorigenic Vaccines<br />
QL+<br />
AGE<br />
varicella vacc/pf ZOSTAVAX VIAL 19400 U<br />
IMMUNOSUPPRESSION/MODULATION<br />
Immunomodulators<br />
imiquimod ALDARA CREAM<br />
PACK 5 %<br />
Immunosuppressives<br />
AGE azathioprine AZASAN TABLET 75<br />
MG<br />
AGE azathioprine AZASAN TABLET 100<br />
MG<br />
AGE azathioprine IMURAN TABLET 50<br />
MG<br />
AGE cyclosporine SANDIMMUNE CAPSULE 100<br />
MG<br />
AGE cyclosporine SANDIMMUNE CAPSULE 25<br />
MG<br />
AGE cyclosporine, modified NEORAL CAPSULE 50<br />
MG<br />
AGE cyclosporine, modified NEORAL SOLUTION<br />
100 MG/ML<br />
AGE cyclosporine, modified NEORAL CAPSULE 25<br />
MG<br />
AGE cyclosporine, modified NEORAL CAPSULE 100<br />
MG<br />
AGE mycophenolate mofetil CELLCEPT CAPSULE 250<br />
MG<br />
AGE mycophenolate mofetil CELLCEPT TABLET 500<br />
MG<br />
AGE mycophenolate mofetil CELLCEPT SUSP RECON<br />
200 MG/ML<br />
AGE mycophenolate sodium MYFORTIC TABLET DR<br />
180 MG<br />
AGE mycophenolate sodium MYFORTIC TABLET DR<br />
360 MG<br />
AGE sirolimus RAPAMUNE TABLET 1<br />
MG<br />
AGE sirolimus RAPAMUNE TABLET 2<br />
MG<br />
AGE sirolimus RAPAMUNE TABLET 0.5<br />
MG<br />
AGE sirolimus RAPAMUNE SOLUTION 1<br />
MG/ML
AGE tacrolimus PROGRAF CAPSULE 1<br />
MG<br />
AGE tacrolimus PROGRAF CAPSULE 5<br />
MG<br />
AGE tacrolimus PROGRAF CAPSULE 0.5<br />
MG<br />
INFECTIOUS DISEASE - BACTERIAL<br />
Absorbable Sulfonamides<br />
sulfamethoxazole/trimethoprim BACTRIM ORAL SUSP<br />
200-40MG/5<br />
sulfamethoxazole/trimethoprim BACTRIM TABLET<br />
400MG-80MG<br />
sulfamethoxazole/trimethoprim BACTRIM TABLET 800-<br />
160 MG<br />
Cephalosporins - 1st Generation<br />
cefazolin sodium ANCEF VIAL 1 G<br />
cephalexin KEFLEX CAPSULE 250<br />
MG<br />
cephalexin KEFLEX CAPSULE 500<br />
MG<br />
cephalexin KEFLEX SUSP RECON<br />
125 MG/5ML<br />
cephalexin KEFLEX SUSP RECON<br />
250 MG/5ML<br />
cephalexin KEFLEX TABLET 500<br />
MG<br />
cephalexin KEFLEX TABLET 250<br />
MG<br />
Cephalosporins - 2nd Generation<br />
cefaclor CECLOR CAPSULE 250<br />
MG<br />
cefaclor CECLOR CAPSULE 500<br />
MG<br />
Cephalosporins - 3rd Generation<br />
cefdinir OMNICEF SUSP RECON<br />
250 MG/5ML<br />
cefdinir OMNICEF CAPSULE 300<br />
MG<br />
cefdinir OMNICEF SUSP RECON<br />
125 MG/5ML<br />
cefixime SUPRAX TABLET 400<br />
MG<br />
cefixime SUPRAX SUSP RECON
100 MG/5ML<br />
cefixime SUPRAX SUSP RECON<br />
200 MG/5ML<br />
Chemotherapeutics, Antibacterial, Misc.<br />
methenamine mandelate MANDELAMINE TABLET 1 G<br />
methenamine mandelate MANDELAMINE TABLET 500<br />
MG<br />
trimethoprim PROLOPRIM TABLET 100<br />
MG<br />
trimethoprim PRIMSOL SOLUTION 50<br />
MG/5 ML<br />
Macrolides<br />
QL azithromycin ZITHROMAX PACKET 1 G<br />
QL azithromycin ZITHROMAX SUSP RECON<br />
100 MG/5ML<br />
QL azithromycin ZITHROMAX TABLET 250<br />
MG<br />
AGE+ azithromycin ZITHROMAX TABLET 600<br />
QL<br />
MG<br />
QL azithromycin ZITHROMAX TABLET 500<br />
MG<br />
QL azithromycin ZITHROMAX SUSP RECON<br />
200 MG/5ML<br />
clarithromycin BIAXIN XL TABLET 500<br />
MG<br />
clarithromycin BIAXIN XL TABLET 250<br />
MG<br />
ery e-succ/sulfisoxazole PEDIAZOLE SUSP RECON<br />
200-600/5<br />
erythromycin base ERYC CAPSULE DR<br />
250 MG<br />
erythromycin base ERYC TABLET 250<br />
MG<br />
erythromycin base ERYC TABLET 500<br />
MG<br />
erythromycin base ERYC TABLET DR<br />
250 MG<br />
erythromycin base ERY-TAB TABLET DR<br />
333 MG<br />
erythromycin base ERYC TABLET DR<br />
500 MG<br />
erythromycin ethylsuccinate ERYPED SUSP RECON<br />
200 MG/5ML<br />
erythromycin ethylsuccinate ERYPED 400 SUSP RECON<br />
400 MG/5ML
erythromycin ethylsuccinate ERYPED TABLET 400<br />
MG<br />
erythromycin stearate ERYTHROMYCIN STEARATE TABLET 250<br />
MG<br />
Nitrofuran Derivatives<br />
nitrofurantoin FURADANTIN ORAL SUSP<br />
25 MG/5 ML<br />
nitrofurantoin macrocrystal MACRODANTIN CAPSULE 100<br />
MG<br />
nitrofurantoin macrocrystal MACRODANTIN CAPSULE 25<br />
MG<br />
nitrofurantoin macrocrystal MACRODANTIN CAPSULE 50<br />
MG<br />
nitrofurantoin monohyd/m-cryst MACROBID CAPSULE 100<br />
MG<br />
Penicillins<br />
amoxicillin AMOXIL TABLET<br />
875MG<br />
amoxicillin AMOXIL TAB CHEW<br />
125 MG<br />
amoxicillin AMOXIL TAB CHEW<br />
250 MG<br />
amoxicillin AMOXIL CAPSULE 250<br />
MG<br />
amoxicillin AMOXIL CAPSULE 500<br />
MG<br />
amoxicillin AMOXIL SUSP RECON<br />
125 MG/5ML<br />
amoxicillin AMOXIL SUSP RECON<br />
250 MG/5ML<br />
amoxicillin AMOXIL SUSP RECON<br />
400 MG/5ML<br />
amoxicillin AMOXIL SUSP RECON<br />
200 MG/5ML<br />
amoxicillin/potassium clav AUGMENTIN SUSP RECON<br />
600-42.9/5<br />
amoxicillin/potassium clav AUGMENTIN TABLET 250-<br />
125MG<br />
amoxicillin/potassium clav AUGMENTIN TABLET 500-<br />
125 MG<br />
amoxicillin/potassium clav AUGMENTIN TABLET 875-<br />
125 MG<br />
amoxicillin/potassium clav AUGMENTIN TAB CHEW<br />
400-57MG<br />
amoxicillin/potassium clav AUGMENTIN TAB CHEW
200-28.5MG<br />
amoxicillin/potassium clav AUGMENTIN SUSP RECON<br />
125-31.25/<br />
amoxicillin/potassium clav AUGMENTIN SUSP RECON<br />
250-62.5/5<br />
amoxicillin/potassium clav AUGMENTIN SUSP RECON<br />
400-57MG/5<br />
amoxicillin/potassium clav AUGMENTIN SUSP RECON<br />
200-28.5/5<br />
ampicillin trihydrate AMPICILLIN TRIHYDRATE CAPSULE 250<br />
MG<br />
ampicillin trihydrate AMPICILLIN TRIHYDRATE CAPSULE 500<br />
MG<br />
ampicillin trihydrate AMPICILLIN TRIHYDRATE SUSP RECON<br />
125MG/5ML<br />
ampicillin trihydrate AMPICILLIN TRIHYDRATE SUSP RECON<br />
250MG/5ML<br />
dicloxacillin sodium DICLOXACILLIN SODIUM CAPSULE 250<br />
MG<br />
dicloxacillin sodium DICLOXACILLIN SODIUM CAPSULE 500<br />
MG<br />
penicillin v potassium VEETIDS 250 SOLN RECON<br />
125 MG/5ML<br />
penicillin v potassium VEETIDS 250 SOLN RECON<br />
250 MG/5ML<br />
penicillin v potassium VEETIDS 250 TABLET 250<br />
MG<br />
penicillin v potassium VEETIDS 250 TABLET 500<br />
MG<br />
Quinolones<br />
QL ciprofloxacin hcl CIPRO TABLET 250<br />
MG<br />
QL ciprofloxacin hcl CIPRO TABLET 500<br />
MG<br />
QL ciprofloxacin hcl CIPRO TABLET 750<br />
MG<br />
ciprofloxacin hcl CIPRO TABLET 100<br />
MG<br />
levofloxacin LEVAQUIN TABLET 250<br />
MG<br />
levofloxacin LEVAQUIN TABLET 500<br />
MG<br />
levofloxacin LEVAQUIN TABLET<br />
750MG<br />
ofloxacin FLOXIN TABLET 200<br />
MG
ofloxacin FLOXIN TABLET 300<br />
MG<br />
ofloxacin FLOXIN TABLET 400<br />
MG<br />
Tetracyclines<br />
doxycycline hyclate VIBRAMYCIN CAPSULE 100<br />
MG<br />
doxycycline hyclate VIBRAMYCIN CAPSULE<br />
50MG<br />
doxycycline hyclate VIBRAMYCIN TABLET 100<br />
MG<br />
QL+<br />
ST<br />
minocycline hcl SOLODYN CAPSULE 100<br />
MG<br />
tetracycline hcl ALA-TET CAPSULE 250<br />
MG<br />
tetracycline hcl ALA-TET CAPSULE 500<br />
MG<br />
tetracycline hcl ALA-TET ORAL SUSP<br />
125 MG/5ML<br />
INFECTIOUS DISEASE - FUNGAL<br />
Antifungal <strong>Agents</strong><br />
clotrimazole MYCELEX TROCHE 10<br />
MG<br />
fluconazole DIFLUCAN TABLET 100<br />
MG<br />
fluconazole DIFLUCAN TABLET 200<br />
MG<br />
fluconazole DIFLUCAN TABLET 50<br />
MG<br />
fluconazole DIFLUCAN TABLET 150<br />
MG<br />
fluconazole DIFLUCAN SUSP RECON<br />
40 MG/ML<br />
fluconazole DIFLUCAN SUSP RECON<br />
10 MG/ML<br />
itraconazole SPORANOX SOLUTION 10<br />
MG/ML<br />
itraconazole SPORANOX CAPSULE 100<br />
MG<br />
ketoconazole NIZORAL TABLET 200<br />
MG<br />
Antifungal Antibiotics<br />
griseofulvin ultramicrosize GRIS-PEG TABLET 125<br />
MG
griseofulvin ultramicrosize GRIS-PEG TABLET 250<br />
MG<br />
griseofulvin,microsize GRIFULVIN V ORAL SUSP<br />
125 MG/5ML<br />
griseofulvin,microsize FULVICIN U/F TABLET 250<br />
MG<br />
griseofulvin,microsize GRIFULVIN V TABLET 500<br />
MG<br />
nystatin MYCOSTATIN ORAL SUSP<br />
100000/ML<br />
nystatin MYCOSTATIN TABLET 500K<br />
UNIT<br />
INFECTIOUS DISEASE - MISCELLANEOUS<br />
Anti-Mycobacterium <strong>Agents</strong><br />
ethambutol hcl MYAMBUTOL TABLET 100<br />
MG<br />
ethambutol hcl MYAMBUTOL TABLET 400<br />
MG<br />
isoniazid ISONIAZID SYRUP 50<br />
MG/5 ML<br />
isoniazid ISONIAZID TABLET 100<br />
MG<br />
isoniazid ISONIAZID TABLET 300<br />
MG<br />
pyrazinamide PYRAZINAMIDE TABLET 500<br />
MG<br />
rifabutin MYCOBUTIN CAPSULE 150<br />
MG<br />
Antileprotics<br />
dapsone DAPSONE TABLET 100<br />
MG<br />
dapsone DAPSONE TABLET 25<br />
MG<br />
Antitubercular Antibiotics<br />
rifampin RIFADIN CAPSULE 150<br />
MG<br />
rifampin RIFADIN CAPSULE 300<br />
MG<br />
rifampin/isoniazid RIFAMATE CAPSULE<br />
300-150 MG<br />
rifampin/isoniazid/pyrazinamid RIFATER TABLET 120-<br />
50-300<br />
Lincosamides
clindamycin hcl CLEOCIN HCL CAPSULE 150<br />
MG<br />
AGE clindamycin palmitate hcl CLEOCIN PALMITATE SOLN RECON<br />
75 MG/5 ML<br />
INFECTIOUS DISEASE - PARASITIC<br />
Amebacides<br />
iodoquinol YODOXIN TABLET 210<br />
MG<br />
iodoquinol YODOXIN TABLET 650<br />
MG<br />
Anaerobic Antiprotozoal-Antibacterial <strong>Agents</strong><br />
metronidazole FLAGYL TABLET 250<br />
MG<br />
metronidazole FLAGYL TABLET 500<br />
MG<br />
Antimalarial Drugs<br />
chloroquine phosphate ARALEN PHOSPHATE TABLET 250<br />
MG<br />
chloroquine phosphate ARALEN PHOSPHATE TABLET 500<br />
MG<br />
hydroxychloroquine sulfate PLAQUENIL TABLET 200<br />
MG<br />
primaquine phosphate PRIMAQUINE TABLET 26.3<br />
MG<br />
pyrimethamine DARAPRIM TABLET 25<br />
MG<br />
Antiprotozoal Drugs,Miscellaneous<br />
AGE+<br />
QL<br />
atovaquone MEPRON ORAL SUSP<br />
750 MG/5ML<br />
INFECTIOUS DISEASE - VIRAL<br />
Antivirals, General<br />
acyclovir ZOVIRAX TABLET 800<br />
MG<br />
acyclovir ZOVIRAX TABLET 400<br />
MG<br />
acyclovir ZOVIRAX ORAL SUSP<br />
200 MG/5ML<br />
acyclovir ZOVIRAX CAPSULE 200<br />
MG<br />
QL oseltamivir phosphate TAMIFLU CAPSULE 75<br />
MG<br />
QL oseltamivir phosphate TAMIFLU CAPSULE 30
MG<br />
QL oseltamivir phosphate TAMIFLU CAPSULE 45<br />
MG<br />
zanamivir RELENZA DISK W/DEV<br />
5 MG<br />
Antivirals, Hiv-Specific, Nucleoside Analog, Rti<br />
didanosine VIDEX SOLN RECON<br />
FNL10MG/ML<br />
didanosine VIDEX EC CAPSULE DR<br />
250 MG<br />
didanosine VIDEX EC CAPSULE DR<br />
400 MG<br />
didanosine VIDEX EC CAPSULE DR<br />
125 MG<br />
didanosine VIDEX EC CAPSULE DR<br />
200 MG<br />
zidovudine RETROVIR SYRUP 10<br />
MG/ML<br />
zidovudine RETROVIR CAPSULE 100<br />
MG<br />
zidovudine RETROVIR TABLET 300<br />
MG<br />
Antivirals, Hiv-Specific, Nucleotide Analog, Rti<br />
PA tenofovir disoproxil fumarate VIREAD TABLET 300<br />
MG<br />
Hepatitis B Treatment <strong>Agents</strong><br />
ST adefovir dipivoxil HEPSERA TABLET 10<br />
MG<br />
PA entecavir BARACLUDE SOLUTION<br />
0.05MG/ML<br />
PA entecavir BARACLUDE TABLET 0.5<br />
MG<br />
PA entecavir BARACLUDE TABLET 1<br />
MG<br />
INFLAMMATORY DISEASE<br />
Anti-Arthritic And Chelating <strong>Agents</strong><br />
penicillamine CUPRIMINE CAPSULE 250<br />
MG<br />
penicillamine DEPEN TABLET 250<br />
MG<br />
Anti-Arthritic, Folate Antagonist <strong>Agents</strong><br />
methotrexate sodium RHEUMATREX TAB DS PK<br />
2.5MG
Glucocorticoids<br />
dexamethasone DEXPAK TAB DS PK<br />
1.5MG (51)<br />
dexamethasone DEXAMETHASONE ELIXIR 0.5<br />
MG/5ML<br />
dexamethasone DEXAMETHASONE SOLUTION<br />
0.5 MG/5ML<br />
dexamethasone DEXAMETHASONE TABLET 0.5<br />
MG<br />
dexamethasone DEXAMETHASONE TABLET 1<br />
MG<br />
dexamethasone DEXAMETHASONE TABLET 0.75<br />
MG<br />
dexamethasone DEXAMETHASONE TABLET 2<br />
MG<br />
dexamethasone DEXAMETHASONE TABLET 1.5<br />
MG<br />
dexamethasone DEXAMETHASONE TABLET 4<br />
MG<br />
dexamethasone DEXAMETHASONE TABLET 6<br />
MG<br />
hydrocortisone CORTEF TABLET 10<br />
MG<br />
hydrocortisone CORTEF TABLET 20<br />
MG<br />
hydrocortisone CORTEF TABLET 5<br />
MG<br />
methylprednisolone MEDROL TABLET 16<br />
MG<br />
methylprednisolone MEDROL TABLET 2<br />
MG<br />
methylprednisolone MEDROL TABLET 32<br />
MG<br />
methylprednisolone MEDROL TABLET 4<br />
MG<br />
methylprednisolone MEDROL TABLET 8<br />
MG<br />
methylprednisolone MEDROL TAB DS PK 4<br />
MG<br />
prednisolone PRELONE SOLUTION 15<br />
MG/5 ML<br />
prednisolone MILLIPRED DP TABLET 5<br />
MG<br />
prednisolone sod phosphate ORAPRED SOLUTION 5<br />
MG/5 ML<br />
prednisolone sod phosphate ORAPRED SOLUTION 15
MG/5 ML<br />
prednisone STERAPRED DS SOLUTION 5<br />
MG/5 ML<br />
prednisone PREDNISONE INTENSOL ORAL CONC<br />
5 MG/ML<br />
prednisone STERAPRED DS TABLET 1<br />
MG<br />
prednisone STERAPRED DS TABLET 10<br />
MG<br />
prednisone STERAPRED DS TABLET 2.5<br />
MG<br />
prednisone STERAPRED DS TABLET 20<br />
MG<br />
prednisone STERAPRED DS TABLET 5<br />
MG<br />
prednisone STERAPRED DS TABLET 50<br />
MG<br />
prednisone STERAPRED DS TAB DS PK 5<br />
MG<br />
prednisone STERAPRED DS TAB DS PK 10<br />
MG<br />
Gold Salts<br />
auranofin RIDAURA CAPSULE 3<br />
MG<br />
Mineralocorticoids<br />
fludrocortisone acetate FLORINEF ACETATE TABLET 0.1<br />
MG<br />
Nsaids, Cyclooxygenase 2 Inhibitor - Type<br />
AGE celecoxib CELEBREX CAPSULE 100<br />
MG<br />
AGE celecoxib CELEBREX CAPSULE 200<br />
MG<br />
Nsaids, Cyclooxygenase Inhibitor-Type<br />
AGE celecoxib CELEBREX CAPSULE 400<br />
MG<br />
AGE celecoxib CELEBREX CAPSULE 50<br />
MG<br />
diclofenac sodium VOLTAREN-XR TABLET DR<br />
25MG<br />
diclofenac sodium VOLTAREN-XR TABLET DR<br />
50 MG<br />
diclofenac sodium VOLTAREN-XR TABLET DR<br />
75 MG<br />
etodolac ETODOLAC CAPSULE 200
MG<br />
etodolac ETODOLAC CAPSULE 300<br />
MG<br />
etodolac ETODOLAC TABLET 400<br />
MG<br />
etodolac ETODOLAC TABLET 500<br />
MG<br />
ibuprofen CHILDREN'S MOTRIN CAPSULE 200<br />
MG<br />
ibuprofen CHILDREN'S MOTRIN TABLET 400<br />
MG<br />
ibuprofen CHILDREN'S MOTRIN TABLET 600<br />
MG<br />
QL ibuprofen CHILDREN'S MOTRIN TABLET 200<br />
MG<br />
ibuprofen CHILDREN'S MOTRIN TABLET 800<br />
MG<br />
ibuprofen CHILDREN'S MOTRIN TABLET 100<br />
MG<br />
ibuprofen CHILDREN'S MOTRIN TAB CHEW<br />
100 MG<br />
ibuprofen CHILDREN'S MOTRIN ORAL SUSP<br />
100 MG/5ML<br />
ibuprofen CHILDREN'S MOTRIN DROPS SUSP<br />
50 MG/1.25<br />
indomethacin INDOCIN SR CAPSULE 25<br />
MG<br />
indomethacin INDOCIN SR CAPSULE 50<br />
MG<br />
ketoprofen ORUDIS KT CAPSULE 75<br />
MG<br />
QL ketorolac tromethamine TORADOL TABLET 10<br />
MG<br />
meloxicam MOBIC TABLET 7.5<br />
MG<br />
meloxicam MOBIC TABLET 15<br />
MG<br />
nabumetone RELAFEN TABLET 500<br />
MG<br />
nabumetone RELAFEN TABLET 750<br />
MG<br />
naproxen EC-NAPROSYN TABLET 250<br />
MG<br />
naproxen EC-NAPROSYN TABLET 375<br />
MG<br />
naproxen EC-NAPROSYN TABLET 500
MG<br />
piroxicam FELDENE CAPSULE 10<br />
MG<br />
piroxicam FELDENE CAPSULE 20<br />
MG<br />
sulindac CLINORIL TABLET 150<br />
MG<br />
sulindac CLINORIL TABLET 200<br />
MG<br />
LOCAL ANESTHESIA<br />
Local Anesthetics<br />
lidocaine hcl XYLOCAINE JEL (ML) 2 %<br />
lidocaine hcl XYLOCAINE SOLUTION 20<br />
MG/ML<br />
lidocaine hcl XYLOCAINE SOLUTION 40<br />
MG/ML<br />
QL phenol PHENOL SPRAY 1.4 %<br />
LOWER GASTROINTESTINAL DISORDERS -<br />
BOWEL INFLAMMAT<br />
Bowel Antiinflamatory <strong>Agents</strong><br />
sulfasalazine AZULFIDINE TABLET 500<br />
MG<br />
sulfasalazine AZULFIDINE TABLET DR<br />
500 MG<br />
Drug Tx-Chronic Inflam. Colon Dx,5-Aminosalicylat<br />
AGE mesalamine ASACOL TABLET DR<br />
400 MG<br />
Hemorrhoidal Prep, Anti-Infam Steroid/Local Anesth<br />
PA hydrocortisone/pramoxine PROCTOFOAM-HC FOAM 1 %-1<br />
%<br />
Rectal Preparations<br />
QL hydrocortisone ANUSOL-HC CREAM (G)<br />
2.5 %<br />
hydrocortisone ANUSOL-HC CREAM (G) 1<br />
%<br />
hydrocortisone acetate PROCTOCORT SUPP.RECT<br />
25 MG<br />
PA hydrocortisone acetate PROCTOCORT SUPP.RECT<br />
30 MG<br />
QL hydrocortisone acetate PROCTOCORT OINT. (G) 1 %
Rectal/Lower Bowel Prep.,Glucocort. (non-Hemorr)<br />
hydrocortisone CORTENEMA ENEMA<br />
100MG/60ML<br />
LOWER GASTROINTESTINAL DISORDERS -<br />
OTHER<br />
Ammonia Inhibitors<br />
lactulose LACTULOSE SOLUTION 10<br />
G/15 ML<br />
lactulose LACTULOSE SOLUTION<br />
10G/15ML<br />
Antidiarrheals<br />
bismuth subsalicylate PEPTO-BISMOL TAB CHEW<br />
262 MG<br />
bismuth subsalicylate PEPTO-BISMOL TABLET 262<br />
MG<br />
bismuth subsalicylate PEPTO-BISMOL ORAL SUSP<br />
262MG/15ML<br />
bismuth subsalicylate PEPTO-BISMOL ORAL SUSP<br />
525MG/15ML<br />
diphenoxylate hcl/atropine LOMOTIL LIQUID 2.5-<br />
.025/5<br />
diphenoxylate hcl/atropine LOMOTIL TABLET 2.5-<br />
.025MG<br />
Bile Salts<br />
ursodiol ACTIGALL CAPSULE 300<br />
MG<br />
Laxatives And Cathartics<br />
bisacodyl DULCOLAX TABLET DR 5<br />
MG<br />
calcium polycarbophil FIBERCON TABLET 625<br />
MG<br />
casanthranol/docusate sodium CASANTHRANOL/DOCUSATE SODIUM CAPSULE 30-<br />
100MG<br />
casanthranol/docusate sodium CASANTHRANOL/DOCUSATE SODIUM TABLET 30-<br />
100MG<br />
cascara sagrada CASCARA SAGRADA CAPSULE<br />
500MG<br />
cascara sagrada CASCARA SAGRADA FL EXTRACT<br />
325MG/5ML<br />
cascara sagrada CASCARA SAGRADA TABLET<br />
325MG<br />
docusate sodium COLACE CAPSULE 100
MG<br />
docusate sodium COLACE CAPSULE 250<br />
MG<br />
docusate sodium COLACE CAPSULE 50<br />
MG<br />
docusate sodium COLACE LIQUID 50<br />
MG/5 ML<br />
docusate sodium COLACE SYRUP 60<br />
MG/15ML<br />
docusate sodium COLACE SYRUP<br />
50MG/15ML<br />
docusate sodium COLACE TABLET 100<br />
MG<br />
lactulose LACTULOSE SOLUTION 10<br />
G/15 ML<br />
lactulose LACTULOSE SOLUTION 10<br />
G/15 ML<br />
magnesium citrate MAGNESIUM CITRATE SOLUTION<br />
magnesium hydroxide PHILLIPS' MILK OF MAGNESIA ORAL SUSP<br />
400 MG/5ML<br />
mineral oil MINERAL OIL OIL<br />
QL peg 3350/na sulf,bicarb,cl/kcl COLYTE WITH FLAVOR PACKETS SOLN RECON<br />
240-22.72G<br />
QL peg 3350/na sulf,bicarb,cl/kcl COLYTE WITH FLAVOR PACKETS SOLN RECON<br />
236-22.74G<br />
QL polyethylene glycol 3350 GAVILAX<br />
MIRALAX<br />
POWDER<br />
17G/DOSE<br />
psyllium husk METAMUCIL CAPSULE<br />
0.52G<br />
psyllium husk (with sugar) WAL-MUCIL POWDER 3.4<br />
G/7 G<br />
psyllium husk/ca carbonate FIBER PLUS CALCIUM CAPSULE 1G-<br />
60MG<br />
psyllium seed METAMUCIL PACKET<br />
psyllium seed (with dextrose) KONSYL-D PACKET<br />
psyllium seed (with sugar) METAMUCIL WAFER<br />
psyllium seed (with sugar) METAMUCIL PACKET<br />
psyllium seed (with sugar) METAMUCIL POWDER 3.4<br />
G/12 G<br />
psyllium seed/sod bicarb PSYLLIUM SEED/SOD BICARB PACKET<br />
sennosides EX-LAX TABLET 8.6<br />
MG<br />
sennosides EX-LAX SYRUP<br />
8.8MG/5ML<br />
sodium chloride/nahco3/kcl/peg NULYTELY WITH FLAVOR PACKS SOLN RECON<br />
420G
Laxatives, Local/Rectal<br />
bisacodyl DULCOLAX SUPP.RECT<br />
10 MG<br />
docusate sodium DOCUSATE SODIUM ENEMA 283<br />
MG<br />
docusate sodium COLACE ENEMA 200<br />
MG/5ML<br />
glycerin GLYCERIN SUPP.RECT<br />
ADULT<br />
glycerin GLYCERIN SUPP.RECT<br />
PEDIATRIC<br />
na phos,m-b/na phos,di-ba PEDIA-LAX ENEMA ENEMA 19G-<br />
7G/118<br />
MEDICAL SUPPLIES<br />
Durable Medical Equipment,Misc<br />
container,empty<br />
PILL DIVIDER WITH PILL BOX<br />
CUT N CRUSH<br />
PILL SPLITTER<br />
TABLET CUTTER<br />
QL nebulizer accessories AIRS ADULT AEROSOL MASK<br />
BUBBLES THE FISH II<br />
PARI LC PLUS NEBULIZER<br />
REUSABLE NEBULIZER KIT<br />
SIDESTREAM MASK<br />
QL nebulizer accessories AIRS ADULT AEROSOL MASK<br />
BUBBLES THE FISH II<br />
PARI LC PLUS NEBULIZER<br />
REUSABLE NEBULIZER KIT<br />
SIDESTREAM MASK<br />
Durable Medical Equipment,Misc(group 1)<br />
lancets<br />
LANCETS<br />
SURE-LANCE<br />
TECHLITE<br />
THIN LANCETS<br />
EACH<br />
KIT<br />
EACH<br />
EACH<br />
Incontinence Supplies<br />
QL incontinence alarms WET-STOP 3 KIT N/A<br />
incontinence pants, reusable SLEEP PANTS EACH<br />
Syringes And Accessories<br />
syr,ndl,ins,safe,disp un, 1 ml<br />
MAGELLAN INSULIN SAFETY SYRNG<br />
SAFESNAP INSULIN SYRINGE<br />
DISP SYRIN<br />
28GX1/2"<br />
syring w-ndl,disp,insul,0.5ml GLUCOPRO DISP SYRIN<br />
31GX5/16"
MISCELLANEOUS AGENTS<br />
Anaphylaxis Therapy <strong>Agents</strong><br />
QL epinephrine EPIPEN JR PEN INJCTR<br />
0.15MG/0.3<br />
QL epinephrine EPIPEN PEN INJCTR<br />
0.3MG/0.3<br />
Parasympathetic <strong>Agents</strong><br />
bethanechol chloride URECHOLINE TABLET 10<br />
MG<br />
bethanechol chloride URECHOLINE TABLET 25<br />
MG<br />
bethanechol chloride URECHOLINE TABLET 5<br />
MG<br />
bethanechol chloride URECHOLINE TABLET 50<br />
MG<br />
NEOPLASTIC DISEASE<br />
Alkylating <strong>Agents</strong><br />
bendamustine hcl TREANDA VIAL 25 MG<br />
bendamustine hcl TREANDA VIAL 100 MG<br />
busulfan MYLERAN TABLET 2<br />
MG<br />
busulfan BUSULFEX AMPUL 60<br />
MG/10ML<br />
busulfan BUSULFEX VIAL 60<br />
MG/10ML<br />
carmustine in polifeprosan 20 GLIADEL WAFER 7.7-<br />
192.3<br />
AGE chlorambucil LEUKERAN TABLET 2<br />
MG<br />
AGE cyclophosphamide CYTOXAN TABLET 25<br />
MG<br />
AGE cyclophosphamide CYTOXAN TABLET 50<br />
MG<br />
AGE hydroxyurea HYDREA CAPSULE 500<br />
MG<br />
ifosfamide IFEX VIAL 1 G/20<br />
ML<br />
ifosfamide IFEX VIAL<br />
3G/60ML<br />
lomustine CEENU CAPSULE 40<br />
MG<br />
melphalan hcl ALKERAN VIAL 50 MG<br />
oxaliplatin OXALIPLATIN VIAL 50 MG
oxaliplatin OXALIPLATIN VIAL 100 MG<br />
oxaliplatin ELOXATIN VIAL<br />
200MG/40ML<br />
AGE temozolomide TEMODAR VIAL 100 MG<br />
AGE temozolomide TEMODAR CAPSULE 5<br />
MG<br />
AGE temozolomide TEMODAR CAPSULE 180<br />
MG<br />
Anti-Cd20 (b Lymphocyte) Monoclonal Antibody<br />
ofatumumab ARZERRA VIAL 1000<br />
MG/50<br />
Antiandrogenic <strong>Agents</strong><br />
bicalutamide CASODEX TABLET 50<br />
MG<br />
flutamide FLUTAMIDE CAPSULE 125<br />
MG<br />
nilutamide NILANDRON TABLET 150<br />
MG<br />
Antibiotic Antineoplastics<br />
epirubicin hcl ELLENCE VIAL<br />
200MG/0.1L<br />
plicamycin MITHRACIN VIAL<br />
2500MCG<br />
streptozocin ZANOSAR VIAL 1 G<br />
valrubicin VALSTAR VIAL 40<br />
MG/ML<br />
Antimetabolites<br />
clofarabine CLOLAR VIAL 20<br />
MG/20ML<br />
fluorouracil FLUOROURACIL VIAL<br />
500MG/10ML<br />
fluorouracil FLUOROURACIL VIAL 1 G/20<br />
ML<br />
fluorouracil FLUOROURACIL VIAL 2.5<br />
G/50ML<br />
fluorouracil FLUOROURACIL VIAL 5 G/100<br />
ML<br />
gemcitabine hcl GEMZAR VIAL 2 G<br />
gemcitabine hcl GEMZAR VIAL 1<br />
G/26.3ML<br />
gemcitabine hcl GEMZAR VIAL 2<br />
G/52.6ML<br />
gemcitabine hcl GEMZAR VIAL<br />
200MG/5.26
mercaptopurine PURINETHOL TABLET 50<br />
MG<br />
methotrexate sodium TREXALL TABLET 10<br />
MG<br />
methotrexate sodium TREXALL TABLET 5<br />
MG<br />
methotrexate sodium TREXALL TABLET 15<br />
MG<br />
methotrexate sodium TREXALL TABLET 7.5<br />
MG<br />
methotrexate sodium METHOTREXATE SODIUM TABLET 2.5<br />
MG<br />
nelarabine ARRANON VIAL<br />
250MG/50ML<br />
pemetrexed disodium ALIMTA VIAL 100 MG<br />
pralatrexate FOLOTYN VIAL<br />
20MG/ML(1)<br />
pralatrexate FOLOTYN VIAL<br />
40MG/2ML<br />
thioguanine TABLOID TABLET 40<br />
MG<br />
Antineoplast Egf Receptor Blocker Rcmb Mc Antibody<br />
pertuzumab PERJETA VIAL<br />
420MG/14ML<br />
Antineoplastic Aromatase Inhibitors<br />
anastrozole ARIMIDEX TABLET 1<br />
MG<br />
exemestane AROMASIN TABLET 25<br />
MG<br />
letrozole FEMARA TABLET 2.5<br />
MG<br />
Antineoplastic - Epothilones And Analogs<br />
ixabepilone IXEMPRA VIAL 15 MG<br />
ixabepilone IXEMPRA VIAL 45 MG<br />
Antineoplastic - Halichondrin B Analogs<br />
eribulin mesylate HALAVEN VIAL 1 MG/2<br />
ML<br />
Antineoplastic - Hedgehog Pathway Inhibitor<br />
vismodegib ERIVEDGE CAPSULE 150<br />
MG<br />
Antineoplastic - Immunotherapy, Therapeutic Vac<br />
sipuleucel-t/lactated ringers PROVENGE PLAST. BAG<br />
50 MM/250
Antineoplastic - Janus Kinase (jak) Inhibitors<br />
ruxolitinib phosphate JAKAFI TABLET 5<br />
MG<br />
ruxolitinib phosphate JAKAFI TABLET 10<br />
MG<br />
ruxolitinib phosphate JAKAFI TABLET 15<br />
MG<br />
ruxolitinib phosphate JAKAFI TABLET 20<br />
MG<br />
ruxolitinib phosphate JAKAFI TABLET 25<br />
MG<br />
Antineoplastic - Mtor Kinase Inhibitors<br />
everolimus AFINITOR TABLET 5<br />
MG<br />
everolimus AFINITOR TABLET 10<br />
MG<br />
everolimus AFINITOR TABLET 2.5<br />
MG<br />
everolimus AFINITOR TABLET 7.5<br />
MG<br />
temsirolimus TORISEL VIAL FNL<br />
30MG/3<br />
Antineoplastic - Topoisomerase I Inhibitors<br />
irinotecan hcl CAMPTOSAR VIAL<br />
40MG/2ML<br />
irinotecan hcl CAMPTOSAR VIAL 100<br />
MG/5ML<br />
irinotecan hcl CAMPTOSAR VIAL<br />
500MG/25ML<br />
irinotecan hcl CAMPTOSAR VIAL<br />
300MG/15ML<br />
topotecan hcl HYCAMTIN CAPSULE<br />
0.25 MG<br />
topotecan hcl HYCAMTIN VIAL 4 MG/4<br />
ML<br />
Antineoplastic Antibody/Radioactive-Drug Complexes<br />
tositumomab iodine-131/maltose BEXXAR VIAL<br />
5.6MCI/ML<br />
Antineoplastic Immunomodulator <strong>Agents</strong><br />
lenalidomide REVLIMID CAPSULE 2.5<br />
MG<br />
peginterferon alfa-2b<br />
SYLATRON<br />
KIT 296 MCG<br />
SYLATRON 4-PACK<br />
peginterferon alfa-2b SYLATRON KIT 888 MCG
peginterferon alfa-2b<br />
SYLATRON 4-PACK<br />
SYLATRON<br />
SYLATRON 4-PACK<br />
KIT 444 MCG<br />
Antineoplastic Lhrh(gnrh) Antagonist,Pituit.supprs<br />
degarelix acetate FIRMAGON VIAL 80 MG<br />
degarelix acetate FIRMAGON VIAL 120 MG<br />
Antineoplastic Systemic Enzyme Inhibitors<br />
axitinib INLYTA TABLET 1<br />
MG<br />
axitinib INLYTA TABLET 5<br />
MG<br />
crizotinib XALKORI CAPSULE 250<br />
MG<br />
crizotinib XALKORI CAPSULE 200<br />
MG<br />
dasatinib SPRYCEL TABLET 20<br />
MG<br />
dasatinib SPRYCEL TABLET 50<br />
MG<br />
dasatinib SPRYCEL TABLET 70<br />
MG<br />
dasatinib SPRYCEL TABLET 80<br />
MG<br />
dasatinib SPRYCEL TABLET 140<br />
MG<br />
AGE dasatinib SPRYCEL TABLET 100<br />
MG<br />
AGE erlotinib hcl TARCEVA TABLET 100<br />
MG<br />
AGE erlotinib hcl TARCEVA TABLET 25<br />
MG<br />
AGE nilotinib hcl TASIGNA CAPSULE 150<br />
MG<br />
nilotinib hcl TASIGNA CAPSULE 200<br />
MG<br />
pazopanib hcl VOTRIENT TABLET 200<br />
MG<br />
AGE vandetanib CAPRELSA TABLET 100<br />
MG<br />
AGE vandetanib CAPRELSA TABLET 300<br />
MG<br />
vemurafenib ZELBORAF TABLET 240<br />
MG<br />
Antineoplastic,Histone Deacetylase Inhibitors,Hdis<br />
romidepsin ISTODAX VIAL 10 MG/2
ML<br />
vorinostat ZOLINZA CAPSULE 100<br />
MG<br />
Antineoplastics Antibody/Antibody-Drug Complexes<br />
brentuximab vedotin ADCETRIS VIAL 50 MG<br />
kit <strong>for</strong> y-90/ibritumomab/album ZEVALIN KIT<br />
3.2MG/2ML<br />
kit i-111/ibritumomab tiuxetan ZEVALIN KIT<br />
3.2MG/2ML<br />
Antineoplastics,Miscellaneous<br />
asparaginase (erwinia chrysan) ERWINAZE VIAL 10000<br />
UNIT<br />
cabazitaxel JEVTANA VIAL<br />
FNL10MG/ML<br />
docetaxel TAXOTERE VIAL<br />
20MG/ML(1)<br />
docetaxel TAXOTERE VIAL 80 MG/4<br />
ML<br />
docetaxel TAXOTERE VIAL 80 MG/8<br />
ML<br />
docetaxel TAXOTERE VIAL 20 MG/2<br />
ML<br />
docetaxel TAXOTERE VIAL<br />
160MG/16ML<br />
docetaxel DOCEFREZ VIAL 80 MG<br />
docetaxel DOCEFREZ VIAL 20 MG<br />
etoposide VEPESID CAPSULE 50<br />
MG<br />
mitotane LYSODREN TABLET 500<br />
MG<br />
Chemotherapy Rescue/Antidote <strong>Agents</strong><br />
glucarpidase VORAXAZE VIAL 1000<br />
UNIT<br />
AGE leucovorin calcium LEUCOVORIN CALCIUM TABLET 10<br />
MG<br />
leucovorin calcium LEUCOVORIN CALCIUM TABLET<br />
15MG<br />
leucovorin calcium LEUCOVORIN CALCIUM TABLET 25<br />
MG<br />
AGE leucovorin calcium LEUCOVORIN CALCIUM TABLET 5<br />
MG<br />
levoleucovorin calcium FUSILEV VIAL 50 MG<br />
AGE mesna MESNEX TABLET 400<br />
MG
Cytotoxic T-Lymphocyte Antigen(ctla-4)rmc Antibody<br />
ipilimumab YERVOY VIAL 50<br />
MG/10ML<br />
ipilimumab YERVOY VIAL<br />
200MG/40ML<br />
Intrapleural Sclerosing <strong>Agents</strong>, Antineoplast. Adj.<br />
talc SCLEROSOL AERO POWD<br />
4 G<br />
talc TALC VIAL 5 G<br />
Photoactivated, Antineoplastic <strong>Agents</strong> (systemic)<br />
methoxsalen UVADEX VIAL 20<br />
MCG/ML<br />
Photoactivated, Antineopls. & Premalignant Lesions<br />
aminolevulinic acid hcl LEVULAN SOL W/APPL<br />
20 %<br />
methyl aminolevulinate hcl METVIXIA CREAM (G)<br />
168 MG/G<br />
Selective Estrogen Receptor Modulators (serm)<br />
tamoxifen citrate NOLVADEX TABLET 10<br />
MG<br />
tamoxifen citrate NOLVADEX TABLET 20<br />
MG<br />
Selective Retinoid X Receptor Agonists (rxr)<br />
bexarotene TARGRETIN CAPSULE 75<br />
MG<br />
Steroid Antineoplastics<br />
estramustine phosphate sodium EMCYT CAPSULE 140<br />
MG<br />
megestrol acetate MEGESTROL ACETATE TABLET 20<br />
MG<br />
megestrol acetate MEGESTROL ACETATE TABLET 40<br />
MG<br />
Vinca Alkaloids<br />
vincristine sulfate VINCRISTINE SULFATE VIAL 2 MG/2<br />
ML<br />
OTHER DRUGS<br />
Appetite Stim. For Anorexia,Cachexia,Wasting Synd.<br />
megestrol acetate MEGACE ORAL SUSP<br />
400MG/10ML<br />
Blood Testing Preparations,In-Vitro
QL blood ketone test,strips PRECISION XTRA STRIP<br />
Bulk Chemicals<br />
aromatic cascara fluid extract CASCARA SAGRADA FL EXTRACT<br />
100 %<br />
Condoms<br />
condoms, female<br />
FC CONDOM, FEMALE<br />
REALITY<br />
EACH<br />
Dietary Supplement, Miscellaneous<br />
PA caloric supplement DUOCAL LIQUID<br />
7KCAL/ML<br />
PA fos/inulin/nutrit supp/fiber FOS/INULIN/NUTRIT SUPP/FIBER ORAL SUSP<br />
0.06G-1.5<br />
PA fos/inulin/nutrit supp/fiber FOS/INULIN/NUTRIT SUPP/FIBER ORAL SUSP<br />
0.03G-1/ML<br />
PA lipase/protease/amylase TRI-PASE 8 TABLET 8K-<br />
30K-30K<br />
PA lipase/protease/amylase TRI-PASE 16 TABLET 16-<br />
60-60K<br />
PA milk based <strong>for</strong>mula MILK BASED FORMULA LIQUID<br />
PA ns comb1/fos/inulin PEPTAMEN AF ORAL SUSP<br />
0.0756-1.2<br />
PA nutritional supplement ENFAGROW GENTLEASE LIPIL ORAL SUSP<br />
0.03G-1/ML<br />
General Inhalation <strong>Agents</strong><br />
sodium chloride <strong>for</strong> inhalation SODIUM CHLORIDE VIAL-NEB 0.9<br />
%<br />
Needles/Needleless Devices<br />
needleless access. dev,insulin<br />
MEDI-JECTOR NEEDLE-FREE SYR B<br />
MEDI-JECTOR NEEDLE-FREE SYR C<br />
PEN NEEDLE<br />
PRODIGY PEN NEEDLE<br />
NOVOFINE AUTOCOVER<br />
EACH<br />
Nose Preparations, Miscellaneous (otc)<br />
sodium chloride LITTLE NOSES SPRAY 0.65 %<br />
sodium chloride LITTLE NOSES DROPS 0.65 %<br />
Nut.tx Phenylketonuria (pku) Formulations<br />
PA infant <strong>for</strong>m.<strong>for</strong> pku,iron no.4 PERIFLEX INFANT POWDER<br />
13G-421<br />
PA nut. tx <strong>for</strong> pku with iron #10 NUT. TX FOR PKU WITH IRON #10 POWDER<br />
16.2G-500<br />
PA nut. tx <strong>for</strong> pku with iron #13 EAA POWD PACK<br />
5G-36KCAL<br />
PA nut. tx <strong>for</strong> pku with iron #2 XPHE MAXAMUM LIQUID
0.06G-0.64<br />
PA nut. tx <strong>for</strong> pku with iron #20 PERIFLEX ADVANCE POWDER<br />
35G-385<br />
PA nut. tx <strong>for</strong> pku with iron #20 PERIFLEX ADVANCE POWDER 35<br />
G-369<br />
PA nut. tx <strong>for</strong> pku with iron #27 PHENYLADE60 POWD PACK<br />
10G-49<br />
PA nut. tx <strong>for</strong> pku with iron #27 PHENYLADE60 POWDER<br />
60G-295<br />
PA nut. tx <strong>for</strong> pku with iron #27 PHENYLADE60 POWDER<br />
60G-327<br />
PA nut. tx <strong>for</strong> pku with iron #3 PERIFLEX JUNIOR POWDER 25<br />
G-374<br />
PA nut. tx <strong>for</strong> pku with iron #3 PERIFLEX JUNIOR POWDER 25<br />
G-394<br />
PA nut. tx <strong>for</strong> pku with iron #3 PERIFLEX JUNIOR POWDER 25<br />
G-374<br />
PA nut. tx <strong>for</strong> pku with iron #33 PHENYLENE POWDER<br />
31.1G-422<br />
PA nut. tx <strong>for</strong> pku with iron #34 PHENYLENE 75 POWDER<br />
74.97G-301<br />
PA nut. tx <strong>for</strong> pku with iron #35 PHENYLADE ESSENTIAL POWDER<br />
25G-390<br />
PA nut. tx <strong>for</strong> pku with iron #35 PHENYLADE ESSENTIAL POWD PACK<br />
10G-156/40<br />
PA nut. tx <strong>for</strong> pku with iron #36 ADD-INS POWD PACK<br />
10G-86<br />
PA nut. tx <strong>for</strong> pku with iron #4 NUT. TX FOR PKU WITH IRON #4<br />
PKU COOLER 10<br />
PKU COOLER 15<br />
PKU COOLER 20<br />
ORAL SUSP<br />
0.12G-0.71<br />
PA nut. tx <strong>for</strong> pku with iron #40 PKU LOPHLEX LIQUID PKT<br />
20-116/125<br />
PA nut. tx <strong>for</strong> pku with iron #41 CAMINO PRO 15 PKU POWD PACK<br />
15G-140/49<br />
PA nut. tx <strong>for</strong> pku with iron #42 PKU LOPHLEX LIQUID PKT<br />
20-115/125<br />
PA nut. tx <strong>for</strong> pku with iron #45 PHENYL-FREE 2 POWDER<br />
22G-410<br />
PA nut. tx <strong>for</strong> pku with iron #45 PHENYL-FREE 2HP POWDER<br />
40G-390<br />
PA nut. tx <strong>for</strong> pku with iron #48 PKU TRIO POWDER 30<br />
G-404<br />
PA nut. tx <strong>for</strong> pku with iron, #26 CAMINO PRO 15 ORAL SUSP<br />
0.11G-1.06<br />
PA nut. tx <strong>for</strong> pku, #22 PREKUNIL TABLET 0.4G-
2.2<br />
PA nut. tx <strong>for</strong> pku, #23 NEOPHE TABLET 0.4G-<br />
2.1<br />
PA nut. tx <strong>for</strong> pku, #38 NEOPHE POWDER<br />
60G-315<br />
PA nut. tx <strong>for</strong> pku, #43 PHENYLADE PHEBLOC POWD PACK<br />
2.2G-10/3G<br />
PA nut. tx <strong>for</strong> pku, #46 CAMINO-PRO RESTORE LIQUID 2G-<br />
36/100<br />
Nutritional Therapy, Med Cond Special Formulation<br />
PA nut.tx. metabolic disorder,soy PERATIVE LIQUID<br />
0.067G-1.3<br />
PA nut.tx.comp. immune systm,soy CRUCIAL LIQUID<br />
PA nut.tx.gluc.intoler,lac-fr,reg DIABETISOURCE LIQUID<br />
PA nut.tx.gluc.intoler,lac-fr,soy GLUCERNA HUNGER SMART LIQUID<br />
PA nut.tx.glucose intol,soy/fiber DIABETISOURCE AC<br />
RESOURCE DIABETIC TF<br />
LIQUID<br />
0.06G-1.2<br />
PA nut.tx.imp.renal fxn,lac-free NUT.TX.IMP.RENAL FXN,LAC-FREE<br />
PRO-STAT RC<br />
LIQUID<br />
0.08G-2/ML<br />
PA nut.tx.imp.renal fxn,lac-free NUT.TX.IMP.RENAL FXN,LAC-FREE<br />
NUTREN PULMONARY<br />
LIQUID<br />
0.08G-2/ML<br />
PA nut.tx.impaired digest fxn,soy VIVONEX RTF LIQUID<br />
0.05G-1/ML<br />
PA nut.tx.impaired digest fxn,soy PEPDITE JUNIOR POWD PACK<br />
7.4G-240<br />
PA nut.tx.impaired hepatic fxn NUT.TX.IMPAIRED HEPATIC FXN LIQUID<br />
0.16G-1.5<br />
PA nut.tx.impaired renal fxn,soy NEPRO<br />
NEPRO CARB STEADY<br />
SUPLENA CARB STEADY<br />
LIQUID<br />
0.08G-1.80<br />
PA nut.tx.pulm.disord.soy,lac-fr NUT.TX.PULM.DISORD.SOY,LAC-FR LIQUID<br />
Solvents<br />
isopropyl alcohol INSTACLEAN SOLUTION<br />
mineral oil MINERAL OIL HEAVY OIL<br />
Urine Acetone Test Aids<br />
QL urine acetone test,strips DIASCREEN 1K REAGENT STRIP<br />
Vehicles<br />
sorbitol solution SORBITOL SOLUTION 70<br />
%<br />
PAIN MANAGEMENT - ANALGESICS<br />
Analgesic, Salicylate, Barbiturate,& Xanthine Cmb<br />
butalbital/aspirin/caffeine FIORINAL CAPSULE 50-<br />
325-40
utalbital/aspirin/caffeine FIORINAL TABLET 50-<br />
325-40<br />
Analgesic,Non-Salicylate,Barbiturate,&xanthine Cmb<br />
acetaminophen/caffeine/butalb ESGIC-PLUS TABLET 325-<br />
40-50<br />
Analgesic/Antipyretics, Salicylates<br />
asa/calcium carb/mag/al hydrox ASCRIPTIN TABLET 325<br />
MG<br />
QL aspirin BAYER ASPIRIN TABLET DR<br />
81 MG<br />
QL aspirin BAYER ASPIRIN TABLET<br />
325MG<br />
QL aspirin BAYER ASPIRIN TABLET 500<br />
MG<br />
QL aspirin BAYER ASPIRIN TAB CHEW<br />
81 MG<br />
QL aspirin BAYER ASPIRIN TABLET DR<br />
325 MG<br />
QL aspirin BAYER ASPIRIN TABLET DR<br />
500MG<br />
QL aspirin BAYER ASPIRIN TABLET DR<br />
650 MG<br />
QL aspirin BAYER ASPIRIN TABLET DR<br />
975 MG<br />
aspirin/acetaminophen/caffeine EXCEDRIN EXTRA STRENGTH TABLET<br />
aspirin/mag carb/al aminoacet ASPIRIN/MAG CARB/AL AMINOACET TABLET 325<br />
MG<br />
choline sal/mag salicylate CHOLINE SAL/MAG SALICYLATE LIQUID 500<br />
MG/5ML<br />
salsalate SALFLEX TABLET 500<br />
MG<br />
salsalate SALFLEX TABLET 750<br />
MG<br />
Analgesic/Antipyretics,Non-Salicylate<br />
acetaminophen ACETAMINOPHEN CAPSULE<br />
500MG<br />
acetaminophen ACETAMINOPHEN SUPP.RECT<br />
120 MG<br />
acetaminophen ACETAMINOPHEN SUPP.RECT<br />
325 MG<br />
acetaminophen ACETAMINOPHEN SUPP.RECT<br />
650 MG<br />
acetaminophen FEVERALL SUPP.RECT<br />
80 MG<br />
acetaminophen ACETAMINOPHEN TABLET ER
650 MG<br />
acetaminophen ACETAMINOPHEN ELIXIR<br />
160MG/5ML<br />
acetaminophen ACETAMINOPHEN LIQUID 500<br />
MG/5ML<br />
acetaminophen ACETAMINOPHEN SOLUTION<br />
160 MG/CUP<br />
acetaminophen ACETAMINOPHEN LIQUID<br />
160MG/5ML<br />
acetaminophen ACETAMINOPHEN LIQUID<br />
500MG/15ML<br />
acetaminophen ACETAMINOPHEN DROPS SUSP<br />
80MG/0.8ML<br />
acetaminophen ACETAMINOPHEN TABLET<br />
325MG<br />
acetaminophen ACETAMINOPHEN TABLET 500<br />
MG<br />
acetaminophen ACETAMINOPHEN TABLET 650<br />
MG<br />
acetaminophen ACETAMINOPHEN TAB CHEW<br />
160 MG<br />
acetaminophen ACETAMINOPHEN ORAL SUSP<br />
160 MG/5ML<br />
acetaminophen ACETAMINOPHEN DROPS SUSP<br />
80MG/0.8ML<br />
Analgesics,Narcotics<br />
QL+ fentanyl DURAGESIC PATCH TD72<br />
ST<br />
25MCG/HR<br />
QL+ fentanyl DURAGESIC PATCH TD72<br />
ST<br />
50MCG/HR<br />
QL+ fentanyl DURAGESIC PATCH TD72<br />
ST<br />
75MCG/HR<br />
QL+ fentanyl DURAGESIC PATCH TD72<br />
ST<br />
100 MCG/HR<br />
QL+ fentanyl DURAGESIC PATCH TD72<br />
ST<br />
12 MCG/HR<br />
QL hydrocodone bit/acetaminophen VICODIN TABLET<br />
5MG-325MG<br />
QL hydrocodone bit/acetaminophen VICODIN TABLET 7.5-<br />
325MG<br />
hydrocodone bit/acetaminophen VICODIN CAPSULE 5<br />
MG-500MG<br />
QL hydrocodone bit/acetaminophen VICODIN TABLET<br />
10MG-325MG<br />
QL hydrocodone bit/acetaminophen VICODIN TABLET 5<br />
MG-500MG
QL hydrocodone bit/acetaminophen VICODIN TABLET<br />
10MG-650MG<br />
QL hydrocodone bit/acetaminophen VICODIN TABLET 7.5-<br />
650 MG<br />
QL hydrocodone bit/acetaminophen VICODIN TABLET<br />
10MG-500MG<br />
QL hydrocodone bit/acetaminophen VICODIN TABLET 7.5-<br />
750MG<br />
QL hydrocodone bit/acetaminophen VICODIN TABLET 7.5-<br />
500MG<br />
QL hydrocodone bit/acetaminophen VICODIN SOLUTION<br />
7.5-500/15<br />
QL hydrocodone bit/acetaminophen VICODIN TABLET 10-<br />
660MG<br />
QL hydromorphone hcl DILAUDID-5 SUPP.RECT 3<br />
MG<br />
QL hydromorphone hcl DILAUDID-5 TABLET 2<br />
MG<br />
QL hydromorphone hcl DILAUDID-5 TABLET 4<br />
MG<br />
QL hydromorphone hcl DILAUDID-5 TABLET 8<br />
MG<br />
methadone hcl DOLOPHINE HCL SOLUTION 5<br />
MG/5 ML<br />
methadone hcl DOLOPHINE HCL SOLUTION 10<br />
MG/5 ML<br />
methadone hcl DOLOPHINE HCL TABLET 10<br />
MG<br />
methadone hcl DOLOPHINE HCL TABLET 5<br />
MG<br />
methadone hcl DOLOPHINE HCL TABLET SOL<br />
40 MG<br />
PA morphine sulfate KADIAN CAP ER PEL<br />
30 MG<br />
PA morphine sulfate KADIAN CAP ER PEL<br />
60 MG<br />
PA morphine sulfate KADIAN CAP ER PEL<br />
100 MG<br />
PA morphine sulfate KADIAN CAP ER PEL<br />
50 MG<br />
PA morphine sulfate KADIAN CAP ER PEL<br />
20 MG<br />
morphine sulfate KADIAN SOLUTION 10<br />
MG/5 ML<br />
morphine sulfate KADIAN SOLUTION 20<br />
MG/5 ML
morphine sulfate KADIAN SOLUTION<br />
100 MG/5ML<br />
morphine sulfate KADIAN TABLET 15<br />
MG<br />
morphine sulfate KADIAN TABLET 30<br />
MG<br />
QL morphine sulfate KADIAN TABLET ER<br />
200 MG<br />
PA morphine sulfate AVINZA CPMP 24HR<br />
45 MG<br />
PA morphine sulfate AVINZA CPMP 24HR<br />
75 MG<br />
QL morphine sulfate KADIAN TABLET ER<br />
30 MG<br />
QL morphine sulfate KADIAN TABLET ER<br />
60 MG<br />
QL morphine sulfate KADIAN TABLET ER<br />
100 MG<br />
QL morphine sulfate KADIAN TABLET ER<br />
15 MG<br />
PA morphine sulfate AVINZA CPMP 24HR<br />
120 MG<br />
PA morphine sulfate AVINZA CPMP 24HR<br />
90 MG<br />
PA morphine sulfate AVINZA CPMP 24HR<br />
60 MG<br />
PA morphine sulfate AVINZA CPMP 24HR<br />
30 MG<br />
PA morphine sulfate KADIAN CAP ER PEL<br />
10 MG<br />
PA morphine sulfate KADIAN CAP ER PEL<br />
80 MG<br />
PA morphine sulfate KADIAN CAP ER PEL<br />
200 MG<br />
QL oxycodone hcl/acetaminophen TYLOX TABLET 7.5-<br />
325MG<br />
QL oxycodone hcl/acetaminophen TYLOX TABLET<br />
10MG-325MG<br />
QL oxycodone hcl/acetaminophen TYLOX TABLET 7.5-<br />
500MG<br />
QL oxycodone hcl/acetaminophen TYLOX TABLET<br />
10MG-650MG<br />
oxycodone hcl/acetaminophen TYLOX SOLUTION 5-<br />
325/5ML<br />
QL oxycodone hcl/acetaminophen TYLOX TABLET 5<br />
MG-500MG
QL oxycodone hcl/acetaminophen TYLOX TABLET<br />
5MG-325MG<br />
QL oxycodone hcl/acetaminophen TYLOX CAPSULE 5<br />
MG-500MG<br />
QL oxycodone hcl/aspirin ENDODAN TABLET<br />
4.8355-325<br />
pentazocine hcl/naloxone hcl TALWIN NX TABLET<br />
50MG-0.5MG<br />
QL tramadol hcl ULTRAM TABLET 50<br />
MG<br />
Antimigraine Preparations<br />
QL+ almotriptan malate AXERT TABLET 12.5<br />
ST<br />
MG<br />
QL+ almotriptan malate AXERT TABLET 6.25<br />
ST<br />
MG<br />
QL eletriptan hydrobromide RELPAX TABLET 20<br />
MG<br />
QL eletriptan hydrobromide RELPAX TABLET 40<br />
MG<br />
ergotamine tartrate ERGOMAR TAB SUBL 2<br />
MG<br />
ergotamine tartrate/caffeine CAFERGOT SUPP.RECT 2-<br />
100MG<br />
ergotamine tartrate/caffeine CAFERGOT TABLET<br />
1MG-100MG<br />
QL+<br />
ST<br />
frovatriptan succinate FROVA TABLET 2.5<br />
MG<br />
isomethept/acetaminop/dichlphn MIDRIN CAPSULE 65-<br />
325-100<br />
isometheptene/acetaminoph/caff PRODRIN TABLET 130-<br />
500-20<br />
QL+ rizatriptan benzoate MAXALT TABLET 5<br />
ST<br />
MG<br />
QL+ rizatriptan benzoate MAXALT TABLET 10<br />
ST<br />
MG<br />
QL+ rizatriptan benzoate MAXALT MLT TAB RAPDIS<br />
ST<br />
5 MG<br />
QL+ rizatriptan benzoate MAXALT MLT TAB RAPDIS<br />
ST<br />
10 MG<br />
QL+ sumatriptan IMITREX SPRAY 5 MG<br />
ST<br />
QL+<br />
ST<br />
QL sumatriptan succinate IMITREX TABLET 50<br />
MG<br />
QL sumatriptan succinate IMITREX TABLET 100<br />
sumatriptan IMITREX SPRAY 20 MG
MG<br />
QL sumatriptan succinate IMITREX TABLET 25<br />
MG<br />
QL+<br />
ST<br />
sumatriptan succinate IMITREX PEN INJCTR 6<br />
MG/0.5ML<br />
Narc.& Non-Sal.analgesic,Barbiturate &xanthine Cmb<br />
codeine/butalbit/acetamin/caff FIORICET WITH CODEINE CAPSULE 30-<br />
50-325<br />
Narcotic & Salicylate Analgesics, Barb.& Xanthine<br />
codeine/butalbital/asa/caffein FIORINAL WITH CODEINE #3 CAPSULE 30-<br />
50-325<br />
Narcotic Analgesic & Non-Salicylate Analgesic Comb<br />
QL acetaminophen with codeine TYLENOL-CODEINE NO.4 ELIXIR 120-<br />
12MG/5<br />
acetaminophen with codeine CAPITAL W-CODEINE ORAL SUSP<br />
120-12MG/5<br />
QL acetaminophen with codeine TYLENOL-CODEINE NO.4 TABLET<br />
300MG-15MG<br />
QL acetaminophen with codeine TYLENOL-CODEINE NO.4 TABLET<br />
300MG-30MG<br />
acetaminophen with codeine TYLENOL-CODEINE NO.4 TABLET<br />
650MG-30MG<br />
QL acetaminophen with codeine TYLENOL-CODEINE NO.4 TABLET<br />
300MG-60MG<br />
PARKINSONS DISEASE<br />
Antiparkinsonism Drugs,Other<br />
PA bromocriptine mesylate PARLODEL CAPSULE 5<br />
MG<br />
bromocriptine mesylate PARLODEL TABLET 2.5<br />
MG<br />
carbidopa/levodopa PARCOPA TABLET ER<br />
50MG-200MG<br />
carbidopa/levodopa PARCOPA TABLET ER<br />
25MG-100MG<br />
carbidopa/levodopa PARCOPA TABLET<br />
10MG-100MG<br />
carbidopa/levodopa PARCOPA TABLET<br />
25MG-100MG<br />
carbidopa/levodopa PARCOPA TABLET<br />
25MG-250MG<br />
ST carbidopa/levodopa/entacapone STALEVO 100 TABLET<br />
18.75-75MG<br />
ST carbidopa/levodopa/entacapone STALEVO 100 TABLET
31.25-125<br />
ST carbidopa/levodopa/entacapone STALEVO 100 TABLET 37.5-<br />
150MG<br />
ST carbidopa/levodopa/entacapone STALEVO 100 TABLET 25-<br />
100-200<br />
ST carbidopa/levodopa/entacapone STALEVO 100 TABLET 12.5-<br />
50MG<br />
ST carbidopa/levodopa/entacapone STALEVO 100 TABLET 50-<br />
200-200<br />
ST entacapone COMTAN TABLET 200<br />
MG<br />
pramipexole di-hcl MIRAPEX TABLET 1<br />
MG<br />
pramipexole di-hcl MIRAPEX TABLET 1.5<br />
MG<br />
pramipexole di-hcl MIRAPEX TABLET 0.125<br />
MG<br />
pramipexole di-hcl MIRAPEX TABLET 0.25<br />
MG<br />
pramipexole di-hcl MIRAPEX TABLET 0.5<br />
MG<br />
pramipexole di-hcl MIRAPEX TABLET 0.75<br />
MG<br />
ropinirole hcl REQUIP TABLET 0.25<br />
MG<br />
ropinirole hcl REQUIP TABLET 1<br />
MG<br />
ropinirole hcl REQUIP TABLET 2<br />
MG<br />
ropinirole hcl REQUIP TABLET 5<br />
MG<br />
ropinirole hcl REQUIP TABLET 0.5<br />
MG<br />
ropinirole hcl REQUIP TABLET 4<br />
MG<br />
ropinirole hcl REQUIP TABLET 3<br />
MG<br />
selegiline hcl ELDEPRYL TABLET 5<br />
MG<br />
selegiline hcl ELDEPRYL CAPSULE 5<br />
MG<br />
SEIZURE DISORDER<br />
Anticonvulsants<br />
carbamazepine CARBATROL TABLET 200<br />
MG
carbamazepine CARBATROL TAB CHEW<br />
100 MG<br />
PA carbamazepine TEGRETOL XR TAB ER 12H<br />
100 MG<br />
PA carbamazepine CARBAMAZEPINE<br />
TEGRETOL XR<br />
TAB ER 12H<br />
200 MG<br />
PA carbamazepine CARBAMAZEPINE<br />
TEGRETOL XR<br />
TAB ER 12H<br />
400 MG<br />
carbamazepine CARBATROL ORAL SUSP<br />
100 MG/5ML<br />
clonazepam KLONOPIN TABLET 0.5<br />
MG<br />
clonazepam KLONOPIN TABLET 1<br />
MG<br />
clonazepam KLONOPIN TABLET 2<br />
MG<br />
QL diazepam DIASTAT ACUDIAL KIT 5-7.5-<br />
10MG<br />
QL diazepam DIASTAT ACUDIAL KIT 12.5-15-20<br />
QL diazepam DIASTAT KIT 2.5 MG<br />
QL diazepam DIASTAT KIT 5-7.5-<br />
10MG<br />
QL diazepam DIASTAT KIT 12.5-15-20<br />
divalproex sodium DEPAKOTE TABLET DR<br />
250 MG<br />
divalproex sodium DEPAKOTE TABLET DR<br />
500 MG<br />
divalproex sodium DEPAKOTE TABLET DR<br />
125 MG<br />
divalproex sodium DEPAKOTE CAP SPRINK<br />
125 MG<br />
divalproex sodium DEPAKOTE TAB ER 24H<br />
500 MG<br />
divalproex sodium DEPAKOTE TAB ER 24H<br />
250 MG<br />
ethosuximide ZARONTIN CAPSULE 250<br />
MG<br />
ethosuximide ZARONTIN SYRUP 250<br />
MG/5ML<br />
QL gabapentin NEURONTIN CAPSULE 100<br />
MG<br />
QL gabapentin NEURONTIN CAPSULE 300<br />
MG<br />
QL gabapentin NEURONTIN CAPSULE 400<br />
MG<br />
QL gabapentin NEURONTIN TABLET 800
MG<br />
QL gabapentin NEURONTIN TABLET 600<br />
MG<br />
PA lacosamide VIMPAT TABLET 50<br />
MG<br />
PA lacosamide VIMPAT TABLET 100<br />
MG<br />
PA lacosamide VIMPAT TABLET 150<br />
MG<br />
PA lacosamide VIMPAT TABLET 200<br />
MG<br />
PA lacosamide VIMPAT SOLUTION 10<br />
MG/ML<br />
PA lamotrigine LAMICTAL XR TAB ER 24 25<br />
MG<br />
PA lamotrigine LAMICTAL XR TAB ER 24 50<br />
MG<br />
PA lamotrigine LAMICTAL XR TAB ER 24<br />
100 MG<br />
PA lamotrigine LAMICTAL XR TAB ER 24<br />
200 MG<br />
PA lamotrigine LAMICTAL XR TAB ER 24<br />
300 MG<br />
PA lamotrigine LAMICTAL XR TAB ER 24<br />
250 MG<br />
AGE+ lamotrigine LAMICTAL TABLET 100<br />
QL<br />
MG<br />
AGE+ lamotrigine LAMICTAL TABLET 25<br />
QL<br />
MG<br />
AGE+ lamotrigine LAMICTAL TB CHW DSP<br />
QL<br />
5 MG<br />
AGE+ lamotrigine LAMICTAL TABLET 150<br />
QL<br />
MG<br />
AGE+ lamotrigine LAMICTAL TABLET 200<br />
QL<br />
MG<br />
AGE+ levetiracetam KEPPRA XR TAB ER 24H<br />
QL+<br />
500 MG<br />
ST<br />
AGE+ levetiracetam KEPPRA XR SOLUTION<br />
QL<br />
100 MG/ML<br />
AGE+ levetiracetam KEPPRA XR TAB ER 24H<br />
QL+<br />
750 MG<br />
ST<br />
AGE+ levetiracetam KEPPRA XR TABLET 750<br />
QL<br />
MG<br />
AGE+ levetiracetam KEPPRA XR TABLET 250
QL<br />
MG<br />
AGE+ levetiracetam KEPPRA XR TABLET<br />
QL<br />
500MG<br />
AGE+ levetiracetam KEPPRA XR TABLET 1000<br />
QL<br />
MG<br />
AGE+ oxcarbazepine TRILEPTAL TABLET 300<br />
QL<br />
MG<br />
AGE+ oxcarbazepine TRILEPTAL TABLET 600<br />
QL<br />
MG<br />
AGE+ oxcarbazepine TRILEPTAL TABLET 150<br />
QL<br />
MG<br />
phenytoin DILANTIN-125 ORAL SUSP<br />
125 MG/5ML<br />
phenytoin DILANTIN TAB CHEW<br />
50 MG<br />
phenytoin sodium extended DILANTIN CAPSULE 300<br />
MG<br />
phenytoin sodium extended DILANTIN CAPSULE 200<br />
MG<br />
phenytoin sodium extended DILANTIN CAPSULE 100<br />
MG<br />
phenytoin sodium extended DILANTIN CAPSULE 30<br />
MG<br />
primidone MYSOLINE TABLET 250<br />
MG<br />
primidone MYSOLINE TABLET 50<br />
MG<br />
PA rufinamide BANZEL TABLET 200<br />
MG<br />
PA rufinamide BANZEL TABLET 400<br />
MG<br />
PA tiagabine hcl GABITRIL TABLET 4<br />
MG<br />
PA tiagabine hcl GABITRIL TABLET 12<br />
MG<br />
PA tiagabine hcl GABITRIL TABLET 16<br />
MG<br />
PA tiagabine hcl GABITRIL TABLET 2<br />
MG<br />
QL+ topiramate TOPAMAX TABLET 50<br />
AGE<br />
MG<br />
QL+ topiramate TOPAMAX TABLET 100<br />
AGE<br />
MG<br />
QL+ topiramate TOPAMAX TABLET 200<br />
AGE<br />
MG<br />
QL+ topiramate TOPAMAX TABLET 25
AGE<br />
MG<br />
PA topiramate TOPAMAX CAP SPRINK<br />
15 MG<br />
PA topiramate TOPAMAX CAP SPRINK<br />
25 MG<br />
valproate sodium DEPACON SOLUTION<br />
250 MG/5ML<br />
valproic acid DEPAKENE CAPSULE 250<br />
MG<br />
AGE+ zonisamide ZONEGRAN CAPSULE 25<br />
QL<br />
MG<br />
AGE+ zonisamide ZONEGRAN CAPSULE 50<br />
QL<br />
MG<br />
AGE+ zonisamide ZONEGRAN CAPSULE 100<br />
QL<br />
MG<br />
SKELETAL MUSCLE DISORDER<br />
Skeletal Muscle Relaxants<br />
baclofen BACLOFEN TABLET 10<br />
MG<br />
baclofen BACLOFEN TABLET 20<br />
MG<br />
carisoprodol SOMA TABLET 350<br />
MG<br />
cyclobenzaprine hcl FLEXERIL TABLET 10<br />
MG<br />
methocarbamol ROBAXIN-750 TABLET 500<br />
MG<br />
methocarbamol ROBAXIN-750 TABLET 750<br />
MG<br />
SMOKING CESSATION<br />
Smoking Deterrent <strong>Agents</strong> (ganglionic Stim,Others)<br />
QL nicotine NICODERM CQ PATCH TD24<br />
7MG/24HR<br />
QL nicotine NICODERM CQ PATCH TD24<br />
14MG/24HR<br />
QL nicotine NICODERM CQ PATCH TD24<br />
21 MG/24HR<br />
QL nicotine polacrilex NICORETTE GUM 2MG<br />
QL nicotine polacrilex NICORETTE GUM 4 MG<br />
Smoking Deterrents, Other<br />
bupropion hcl ZYBAN TABLET ER<br />
150 MG
UPPER GASTROINTESTINAL DISORDERS -<br />
DIGESTIVE<br />
Antiflatulents<br />
simethicone INFANTS' MYLICON DROPS SUSP<br />
40MG/0.6ML<br />
simethicone INFANTS' MYLICON CAPSULE 125<br />
MG<br />
Pancreatic Enzymes<br />
AGE lipase/protease/amylase ULTRASE MT 20 CAPSULE DR<br />
371 MG<br />
AGE lipase/protease/amylase ULTRASE MT 12 CAPSULE DR<br />
223MG<br />
AGE lipase/protease/amylase VIOKASE TABLET<br />
468MG<br />
AGE lipase/protease/amylase ULTRASE MT 18 CAPSULE DR<br />
333 MG<br />
AGE lipase/protease/amylase VIOKASE TABLET 935<br />
MG<br />
AGE lipase/protease/amylase CREON CAPSULE DR<br />
6K-19K-30K<br />
AGE lipase/protease/amylase CREON CAPSULE DR<br />
12K-38K-60<br />
AGE lipase/protease/amylase CREON CAPSULE DR<br />
24-76-120K<br />
AGE lipase/protease/amylase ZENPEP CAPSULE DR<br />
5K-17K-27K<br />
AGE lipase/protease/amylase ZENPEP CAPSULE DR<br />
10-34-55K<br />
AGE lipase/protease/amylase ZENPEP CAPSULE DR<br />
15-51-82K<br />
AGE lipase/protease/amylase ZENPEP CAPSULE DR<br />
20-68-109K<br />
AGE lipase/protease/amylase PANCREAZE CAPSULE DR<br />
16.8-40-70<br />
AGE lipase/protease/amylase PANCREAZE CAPSULE DR<br />
21-37-61K<br />
AGE lipase/protease/amylase PANCREAZE CAPSULE DR<br />
10.5K-25K<br />
AGE lipase/protease/amylase PANCREAZE CAPSULE DR<br />
4.2K-10K<br />
AGE lipase/protease/amylase CREON CAPSULE DR<br />
3-9.5-15K<br />
AGE lipase/protease/amylase ZENPEP CAPSULE DR
3K-10K-16K<br />
AGE lipase/protease/amylase ZENPEP CAPSULE DR<br />
25-85-136K<br />
AGE lipase/protease/amylase PERTZYE CAPSULE DR<br />
8K-28.75K<br />
AGE lipase/protease/amylase PERTZYE CAPSULE DR<br />
16K-57.5K<br />
AGE lipase/protease/amylase ULTRASE CAPSULE DR<br />
250 MG<br />
AGE pancreatin/potass/sod bicarb KARBOZYME TABLET<br />
UPPER GASTROINTESTINAL DISORDERS -<br />
SPASTIC DISEASE<br />
Anticholinergics/Antispasmodics<br />
dicyclomine hcl BENTYL CAPSULE 10<br />
MG<br />
dicyclomine hcl BENTYL SYRUP 10<br />
MG/5 ML<br />
dicyclomine hcl BENTYL TABLET 20<br />
MG<br />
Belladonna Alkaloids<br />
belladonna alkaloids/phenobarb DONNATAL TABLET<br />
16.2MG<br />
hyoscyamine sulfate SYMAX DUOTAB ELIXIR<br />
125MCG/5ML<br />
hyoscyamine sulfate SYMAX DUOTAB DROPS<br />
0.125MG/ML<br />
hyoscyamine sulfate SYMAX DUOTAB TAB ER 12H<br />
0.375 MG<br />
hyoscyamine sulfate SYMAX DUOTAB TABLET 0.125<br />
MG<br />
hyoscyamine sulfate SYMAX DUOTAB TAB SUBL<br />
0.125 MG<br />
phenobarb/hyoscy/atropine/scop DONNATAL ELIXIR<br />
16.2MG/5ML<br />
UPPER GASTROINTESTINAL DISORDERS -<br />
ULCER DISEASE<br />
Antacids<br />
aluminum hydroxide ALTERNAGEL ORAL SUSP<br />
320MG/5ML<br />
aluminum hydroxide ALTERNAGEL ORAL SUSP<br />
600MG/5ML
calcium carbonate TUMS TAB CHEW<br />
168(420)MG<br />
calcium carbonate TUMS TAB CHEW<br />
200(500)MG<br />
calcium carbonate TUMS TAB CHEW<br />
300MG(750)<br />
calcium carbonate TUMS TAB CHEW<br />
400(1000)<br />
calcium carbonate TUMS TAB CHEW<br />
600 MG<br />
calcium carbonate/simethicone MAALOX ADVANCED TAB CHEW<br />
1000-60MG<br />
mag hydrox/al hydrox/simeth MYLANTA DOUBLE-STRENGTH ORAL SUSP<br />
200-200-20<br />
mag hydrox/al hydrox/simeth MYLANTA DOUBLE-STRENGTH ORAL SUSP<br />
400-400-30<br />
mag hydrox/al hydrox/simeth MYLANTA DOUBLE-STRENGTH ORAL SUSP<br />
400-400-40<br />
mag hydrox/al hydrox/simeth MYLANTA DOUBLE-STRENGTH ORAL SUSP<br />
200-225-25<br />
mag hydrox/al hydrox/simeth MYLANTA DOUBLE-STRENGTH ORAL SUSP<br />
450-500-40<br />
mag hydrox/al hydrox/simeth MYLANTA DOUBLE-STRENGTH TAB CHEW<br />
200-200-20<br />
mag hydrox/al hydrox/simeth MYLANTA DOUBLE-STRENGTH TAB CHEW<br />
200-200-25<br />
mag hydrox/al hydrox/simeth MYLANTA DOUBLE-STRENGTH TAB CHEW<br />
400-400-40<br />
mag hydrox/al hydrox/simeth MYLANTA DOUBLE-STRENGTH ORAL SUSP<br />
200-200-20<br />
magnesium carbonate/al hydrox GAVISCON TAB CHEW<br />
105-160MG<br />
mg trisilicate/alh/nahco3/aa GAVISCON TAB CHEW<br />
20-80MG<br />
sodium bicarbonate SODIUM BICARBONATE TABLET 650<br />
MG<br />
Anti-Ulcer Preparations<br />
misoprostol CYTOTEC TABLET 200<br />
MCG<br />
misoprostol CYTOTEC TABLET 100<br />
MCG<br />
sucralfate CARAFATE ORAL SUSP 1<br />
G/10 ML<br />
sucralfate CARAFATE TABLET 1 G<br />
Anti-Ulcer-H.pylori <strong>Agents</strong>
PA lansoprazole/amoxiciln/clarith PREVPAC COMBO. PKG<br />
30-500-500<br />
Anticholinergics,Quaternary Ammonium<br />
propantheline bromide PROPANTHELINE BROMIDE TABLET 15<br />
MG<br />
propantheline bromide PRO-BANTHINE TABLET 7.5<br />
MG<br />
Histamine H2-Receptor Inhibitors<br />
cimetidine TAGAMET TABLET 200<br />
MG<br />
cimetidine TAGAMET TABLET 300<br />
MG<br />
cimetidine TAGAMET TABLET 400<br />
MG<br />
cimetidine TAGAMET TABLET 800<br />
MG<br />
cimetidine hcl CIMETIDINE HCL SOLUTION<br />
300 MG/5ML<br />
famotidine PEPCID TABLET 20<br />
MG<br />
famotidine PEPCID TABLET 40<br />
MG<br />
famotidine PEPCID TABLET 10<br />
MG<br />
ranitidine ZANTAC TABLET 150<br />
ranitidine hcl ZANTAC TABLET 300<br />
MG<br />
ranitidine hcl ZANTAC SYRUP 15<br />
MG/ML<br />
ranitidine hcl ZANTAC CAPSULE 150<br />
MG<br />
ranitidine hcl ZANTAC CAPSULE 300<br />
MG<br />
Intestinal Motility Stimulants<br />
metoclopramide hcl REGLAN SOLUTION<br />
5MG/5ML<br />
metoclopramide hcl REGLAN TABLET 10<br />
MG<br />
metoclopramide hcl REGLAN TABLET 5<br />
MG<br />
Proton-Pump Inhibitors<br />
lansoprazole PREVACID 24HR CAPSULE DR<br />
15 MG<br />
omeprazole PRILOSEC OTC TABLET DR
20 MG<br />
QL pantoprazole sodium PROTONIX TABLET DR<br />
40 MG<br />
QL pantoprazole sodium PROTONIX TABLET DR<br />
20 MG<br />
URINARY TRACT - FUNCTIONAL<br />
DISORDERS<br />
Benign Prostatic Hypertrophy/Micturition <strong>Agents</strong><br />
ST+<br />
QL<br />
QL+<br />
ST<br />
finasteride PROSCAR TABLET 5<br />
MG<br />
tamsulosin hcl FLOMAX CAP ER 24H<br />
0.4 MG<br />
Urinary Ph Modifiers<br />
QL potassium citrate UROCIT-K TABLET ER 5<br />
MEQ<br />
QL potassium citrate UROCIT-K TABLET ER<br />
10 MEQ<br />
potassium phosphate,monobasic K-PHOS ORIGINAL TABLET SOL<br />
500 MG<br />
Urinary Tract Anesthetic/Analgesic Agnt (azo-Dye)<br />
phenazopyridine hcl AZO STANDARD TABLET 100<br />
MG<br />
phenazopyridine hcl AZO STANDARD TABLET 200<br />
MG<br />
Urinary Tract Antispasmodic/Antiincontinence Agent<br />
oxybutynin chloride DITROPAN XL SYRUP 5<br />
MG/5 ML<br />
oxybutynin chloride DITROPAN XL TABLET 5<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
QL+<br />
ST<br />
MG<br />
oxybutynin chloride DITROPAN XL TAB ER 24 5<br />
MG<br />
oxybutynin chloride DITROPAN XL TAB ER 24 10<br />
MG<br />
oxybutynin chloride DITROPAN XL TAB ER 24 15<br />
MG<br />
VAGINAL DISORDERS<br />
Vaginal Antibiotics<br />
clindamycin phosphate CLEOCIN CREAM/APPL<br />
2 %<br />
metronidazole METROGEL-VAGINAL GEL W/APPL<br />
0.75 %
Vaginal Antifungals<br />
butoconazole nitrate MYCELEX-3 CREAM/APPL<br />
2 %<br />
butoconazole nitrate FEMSTAT 3 CRM/PF APP<br />
2 %<br />
clotrimazole FEMCARE CREAM/APPL<br />
1 %<br />
clotrimazole FEMCARE CREAM/APPL<br />
2 %<br />
clotrimazole FEMCARE TABLET 100<br />
MG<br />
clotrimazole FEMCARE COMBO. PKG<br />
100MG-1%<br />
clotrimazole FEMCARE COMBO. PKG<br />
200 MG-1 %<br />
miconazole nitrate MONISTAT 3 CREAM/APPL<br />
2 %<br />
miconazole nitrate MONISTAT 3 CREAM/APPL<br />
4 %<br />
miconazole nitrate MONISTAT 3 SUPP.VAG<br />
100 MG<br />
miconazole nitrate MONISTAT 3 SUPP.VAG<br />
200 MG<br />
miconazole nitrate MONISTAT 3 COMBO. PKG<br />
200 MG-2 %<br />
miconazole nitrate MONISTAT 3 COMBO. PKG<br />
1200MG-2%<br />
nystatin NYSTATIN TABLET 100K<br />
UNIT<br />
terconazole TERAZOL 3 SUPP.VAG 80<br />
MG<br />
terconazole TERAZOL 3 CREAM/APPL<br />
0.4 %<br />
terconazole TERAZOL 3 CREAM/APPL<br />
0.8 %<br />
tioconazole VAGISTAT-1 OIN/PF APP<br />
6.5 %<br />
Vaginal Estrogen Preparations<br />
estradiol ESTRACE CREAM/APPL<br />
0.01 %<br />
estrogens, conjugated PREMARIN CREAM/APPL<br />
0.625 MG/G<br />
VITAMIN AND/OR MINERAL DEFICIENCY<br />
Bioflavonoids
PA bioflav,lemon/vit bcomp&c BIOFLAV,LEMON/VIT BCOMP&C TABLET 200-<br />
100 MG<br />
Calcium Replacement<br />
calcium CALCIUM TABLET 500<br />
MG<br />
calcium carb&gluc/vitamin d2 OS-CAL 500+D TABLET 500<br />
MG-200<br />
calcium carbonate CALTRATE 600 TABLET<br />
500(1250)<br />
calcium carbonate CALTRATE 600 TABLET 600<br />
MG<br />
calcium carbonate CALTRATE 600 TABLET 600<br />
MG<br />
calcium carbonate CALTRATE 600 TABLET 648<br />
MG<br />
calcium carbonate CALTRATE 600 TAB CHEW<br />
300MG(750)<br />
calcium carbonate CALTRATE 600 TAB CHEW<br />
500(1250)<br />
calcium carbonate CALCIUM CARBONATE ORAL SUSP<br />
500 MG/5ML<br />
calcium carbonate CALCIUM CARBONATE TAB CHEW<br />
500(1250)<br />
calcium carbonate/vitamin d2 OS-CAL 500+D TABLET 250<br />
MG-125<br />
calcium carbonate/vitamin d2 OS-CAL 500+D TABLET 500<br />
MG-125<br />
calcium carbonate/vitamin d3 OS-CAL 500+D TABLET 500<br />
MG-200<br />
calcium carbonate/vitamin d3 OS-CAL 500+D TABLET 250<br />
MG-125<br />
calcium carbonate/vitamin d3 OS-CAL 500+D TABLET 600<br />
MG-200<br />
calcium carbonate/vitamin d3 OS-CAL 500+D TABLET 600<br />
MG-400<br />
calcium carbonate/vitamin d3 CALCIUM WITH VITAMIN D TAB CHEW<br />
500 MG-100<br />
calcium citrate/vitamin d2 CALCIUM CITRATE/VITAMIN D2 TABLET<br />
1500MG-200<br />
calcium citrate/vitamin d3 CITRACAL + D TABLET<br />
250MG-200<br />
calcium citrate/vitamin d3 CITRACAL + D TABLET 315<br />
MG-200<br />
calcium gluconate CALCIUM GLUCONATE TABLET<br />
45(500) MG<br />
calcium gluconate CALCIUM GLUCONATE TABLET
60(648) MG<br />
calcium lactate CALCIUM LACTATE TABLET 84<br />
MG(648)<br />
calcium phosphate/vitamin d3 CALCIUM PHOSPHATE/VITAMIN D3 TABLET 105<br />
MG-120<br />
Fluoride Preparations<br />
sodium fluoride ACT ANTI-CAVITY MOUTH RINSE SOLUTION<br />
sodium fluoride<br />
NAFRINSE DAILY-NEUTRAL<br />
PHOS-FLUR<br />
0.2 %<br />
SOLUTION<br />
0.05 %<br />
sodium fluoride FLUORITAB DROPS<br />
0.125/DROP<br />
sodium fluoride FLURA-DROPS DROPS<br />
0.25MG/DRP<br />
sodium fluoride ACT ANTI-CAVITY MOUTH RINSE DROPS 0.5<br />
MG/ML<br />
sodium fluoride FLUOR-A-DAY DROPS 2.5<br />
MG/ML<br />
sodium fluoride ACT ANTI-CAVITY MOUTH RINSE TAB CHEW<br />
0.25(0.55)<br />
sodium fluoride ACT ANTI-CAVITY MOUTH RINSE TAB CHEW<br />
0.5(1.1)MG<br />
sodium fluoride ACT ANTI-CAVITY MOUTH RINSE TAB CHEW<br />
1MG(2.2MG)<br />
sodium fluoride ACT ANTI-CAVITY MOUTH RINSE TABLET<br />
1MG(2.2MG)<br />
sodium fluoride ACT ANTI-CAVITY MOUTH RINSE TAB CHEW<br />
0.5(1.1)MG<br />
Folic Acid Preparations<br />
folic acid FOLIC ACID TABLET 1<br />
MG<br />
Iron Replacement<br />
QL ferrous sulfate FER-IN-SOL SOLUTION<br />
220(44)/5<br />
QL ferrous sulfate FER-IN-SOL LIQUID 300<br />
MG/5ML<br />
QL ferrous sulfate FER-IN-SOL DROPS 15<br />
MG/ML<br />
QL ferrous sulfate FER-IN-SOL TABLET<br />
325(65) MG<br />
QL ferrous sulfate FER-IN-SOL TABLET DR<br />
325(65) MG<br />
Magnesium Salts Replacement<br />
PA magnesium oxide/mag aa chelate MG-PLUS-PROTEIN TABLET
133MG<br />
Multivitamin Preparations<br />
PA b complex with vitamin c BEROCCA TABLET<br />
beta-carotene(a) w-c & e/min OCUVITE TABLET ER<br />
folic acid/mv,fe,other min/lut FOLIC ACID/MV,FE,OTHER MIN/LUT TABLET 0.4-<br />
18-250<br />
QL multivitamins,ther w-minerals THERAPEUTIC-M TABLET<br />
QL multivitamins,therapeutic MULTIVITAMINS,THERAPEUTIC TABLET<br />
QL multivitamins,therapeutic MULTIVITAMINS,THERAPEUTIC LIQUID<br />
QL multivits w-iron,hematinic CENTRUM TABLET<br />
27MG-0.4MG<br />
QL multivits,th w-fe,other min MULTIVITS,TH W-FE,OTHER MIN TABLET<br />
Pediatric Vitamin Preparations<br />
QL+<br />
AGE<br />
QL+<br />
AGE<br />
QL+<br />
AGE<br />
QL+<br />
AGE<br />
QL+<br />
AGE<br />
QL+<br />
AGE<br />
QL+<br />
AGE<br />
QL+<br />
AGE<br />
QL+<br />
AGE<br />
QL+<br />
AGE<br />
fluoride ion/multivitamins POLY-VI-FLOR DROPS<br />
0.5MG/ML<br />
fluoride/iron/vit a,c&d FLUORIDE/IRON/VIT A,C&D DROPS 0.25<br />
MG/ML<br />
multivitamin POLY-VI-SOL DROPS<br />
multivitamins with fluoride POLY-VI-FLOR DROPS 0.25<br />
MG/ML<br />
multivitamins with fluoride MULTIVITAMINS WITH FLUORIDE DROPS 0.5<br />
MG/ML<br />
multivitamins with iron POLY-VI-SOL WITH IRON DROPS<br />
multivits with iron & fluoride MULTIVITS WITH IRON & FLUORIDE DROPS 0.25<br />
MG/ML<br />
ped mv a,c,d3 #21 w-fluoride FLUORABON BASIC DROPS 0.5<br />
MG/ML<br />
ped mv a,c,d3 #21 w-fluoride FLUORABON BASIC DROPS 0.25<br />
MG/ML<br />
pedi m.vit no.17 with fluoride POLY-VI-FLOR TAB CHEW<br />
0.5 MG<br />
pedi m.vit no.17 with fluoride POLY-VI-FLOR TAB CHEW 1<br />
MG<br />
pedi m.vit no.17 with fluoride POLY-VI-FLOR TAB CHEW<br />
0.25 MG<br />
pedi multivits a,c,&d3 no.21 PEDI MULTIVITS A,C,&D3 NO.21 DROPS 1500-<br />
35/ML<br />
pedi mv a,c,d3 #21 with iron TRI-VI-SOL WITH IRON DROPS 1500-<br />
10/ML<br />
Prenatal Vitamin Preparations<br />
QL+ pnv #14/ferrous fum/folic acid NATACHEW TAB CHEW<br />
GEN+<br />
29 MG-1 MG<br />
AGE
QL+ pnv cmb#95/ferrous fumarate/fa PRENATAL TABLET<br />
GEN+<br />
28MG-0.8MG<br />
AGE<br />
QL+ pnv cmb#95/ferrous fumarate/fa TRICARE TABLET<br />
GEN+<br />
28MG-0.8MG<br />
AGE<br />
QL+ pnv no.4/iron cbn&gluc/fa/doss CITRANATAL RX TABLET 27-1-<br />
GEN+<br />
50MG<br />
AGE<br />
QL+ pnv w-o ca no5/fe fumarate/fa PNV W-O CA NO5/FE FUMARATE/FA CAPSULE<br />
GEN+<br />
106.5-1MG<br />
AGE<br />
QL+ pnv with ca no.36/iron/fa P-D NATAL PLUS CAPSULE<br />
GEN+<br />
13.5-0.4MG<br />
AGE<br />
QL+ pnv with ca,no.71/iron/fa TRICARE TABLET 27<br />
GEN+<br />
MG-1 MG<br />
AGE<br />
QL+ pnv with ca,no.74/iron/fa PNV WITH CA,NO.74/IRON/FA TABLET 27<br />
GEN+<br />
MG-1 MG<br />
AGE<br />
QL+ pnv2/iron b-g suc-p/fa/omega-3 TRUST NATAL DHA COMBO. PKG<br />
GEN+<br />
29-1-250MG<br />
AGE<br />
GEN+ prenatal vit #76/iron,carb/fa NESTABS CBF TABLET 29<br />
AGE+<br />
MG-1 MG<br />
QL<br />
QL+ prenatal vit 15/iron cb/fa/dss PRENATAL VIT 15/IRON CB/FA/DSS TABLET 90-1-<br />
GEN+<br />
50 MG<br />
AGE<br />
QL+ prenatal vit no.73/iron/fa TRICARE TABLET 28<br />
GEN+<br />
MG-1 MG<br />
AGE<br />
QL+ prenatal vit no.78/iron/fa TRICARE TABLET 29<br />
GEN+<br />
MG-1 MG<br />
AGE<br />
QL+ prenatal vit/fe carb-feso4/fa PRENATAL VIT/FE CARB-FESO4/FA TABLET 60-<br />
GEN+<br />
1MG<br />
AGE<br />
QL+ prenatal vit/fe fum/doss/fa PRENATAL VIT/FE FUM/DOSS/FA TABLET ER<br />
GEN+<br />
90-50-1MG<br />
AGE<br />
QL+ prenatal vit/fe fumarate/fa/se MATERNA TABLET 27<br />
GEN+<br />
MG-1 MG<br />
AGE<br />
QL+ prenatal vit/fe gluconate/fa PRENATAL VIT/FE GLUCONATE/FA TABLET 30-
GEN+<br />
0.8MG<br />
AGE<br />
QL+ prenatal vit/iron bisglycin/fa NATELLE TABLET 29<br />
GEN+<br />
MG-1 MG<br />
AGE<br />
QL+ prenatal vit/iron bisglycin/fa NATELLE TABLET 27<br />
GEN+<br />
MG-1 MG<br />
AGE<br />
QL+ prenatal vit/iron fumarate/fa TRICARE TABLET<br />
GEN+<br />
60MG-0.8MG<br />
AGE<br />
QL+ prenatal vit/iron fumarate/fa TRICARE TABLET 65<br />
GEN+<br />
MG-1 MG<br />
AGE<br />
QL+ prenatal vit/iron fumarate/fa TRICARE TABLET 66-<br />
GEN+<br />
1MG<br />
AGE<br />
QL+ prenatal vit/iron fumarate/fa TRICARE TAB CHEW<br />
GEN+<br />
29 MG-1 MG<br />
AGE<br />
QL+ prenatal vit27&calcium/iron/fa TRICARE TABLET 60<br />
GEN+<br />
MG-1 MG<br />
AGE<br />
QL+ pv w-o cal/ferrous fumarate/fa M-VIT TABLET 27<br />
GEN+<br />
AGE<br />
MG-1 MG<br />
Prenatal Vitamins Without Iron<br />
QL+<br />
GEN+<br />
AGE<br />
pnv w-o iron/fa/calcium/b6/b12 PREMESIS RX TBMP 24HR<br />
1-200-75<br />
Vitamin B Preparations<br />
PA fa/vit b complex & c/rice bran ALLBEE C-800 TABLET<br />
400MCG-500<br />
PA vit b cmplx 3/fa/vit c/biotin NEPHROCAPS TABLET<br />
1MG-60MG<br />
Vitamin B1 Preparations<br />
thiamine hcl THIAMINE HCL TABLET 100<br />
MG<br />
Vitamin B6 Preparations<br />
pyridoxine hcl PYRIDOXINE HCL TABLET<br />
100MG<br />
pyridoxine hcl PYRIDOXINE HCL TABLET 500<br />
MG<br />
pyridoxine hcl PYRIDOXINE HCL TABLET 50
MG<br />
pyridoxine hcl PYRIDOXINE HCL TABLET<br />
25MG<br />
Vitamin D Preparations<br />
calcitriol ROCALTROL CAPSULE<br />
0.25 MCG<br />
calcitriol ROCALTROL CAPSULE 0.5<br />
MCG<br />
cholecalciferol VITAMIN D TABLET 1000<br />
UNIT<br />
dihydrotachysterol DHT TABLET<br />
0.2MG<br />
ergocalciferol (vitamin d2) DRISDOL DROPS<br />
8000/ML<br />
ergocalciferol (vitamin d2) DRISDOL CAPSULE<br />
50000 UNIT