BMC Formularies by drug class 11.1.12.xlsx - BMC HealthNet Plan

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ANUSOL‐HC CRE 2.5% ANTI‐INFLAMMATORY AGENTS (SKIN & MUCOUS) Brand‐O PA TIER 2 ANUSOL‐HC SUP 25MG ANTI‐INFLAMMATORY AGENTS (SKIN & MUCOUS) Brand‐O PA TIER 99 ANZEMET INJ 20MG/ML 5‐HT3 RECEPTOR ANTAGONISTS BRAND Covered TIER 3 ANZEMET TAB 100MG 5‐HT3 RECEPTOR ANTAGONISTS BRAND Covered TIER 2 QL ANZEMET TAB 50MG 5‐HT3 RECEPTOR ANTAGONISTS BRAND Covered TIER 2 QL APAP/CAFF/DI TAB HYDROCOD OPIATE AGONISTS GENERIC Covered TIER 1 APAP/CODEINE SOL 120‐12/5 OPIATE AGONISTS GENERIC Covered TIER 1 APAP/CODEINE TAB 300‐15MG OPIATE AGONISTS GENERIC Covered TIER 1 APAP/CODEINE TAB 300‐30MG OPIATE AGONISTS GENERIC Covered TIER 1 APAP/CODEINE TAB 300‐60MG OPIATE AGONISTS GENERIC Covered TIER 1 APEXICON OIN 0.05% ANTI‐INFLAMMATORY AGENTS (SKIN & MUCOUS) GENERIC Covered TIER 1 APEXICON E CRE 0.05% ANTI‐INFLAMMATORY AGENTS (SKIN & MUCOUS) GENERIC Covered TIER 1 APHTHASOL PST 5% EENT DRUGS, MISCELLANEOUS BRAND Covered TIER 3 APIDRA INJ SOLOSTAR INSULINS BRAND Covered TIER 2 APIDRA INJ U‐100 INSULINS BRAND Covered TIER 2 APLENZIN TAB 174MG ANTIDEPRESSANTS, MISCELLANEOUS BRAND Covered TIER 3 QL APLENZIN TAB 348MG ANTIDEPRESSANTS, MISCELLANEOUS BRAND Covered TIER 3 QL APLENZIN TAB 522MG ANTIDEPRESSANTS, MISCELLANEOUS BRAND Covered TIER 3 QL OTHER MISCELLANEOUS APLIGRAF MIS THERAPEUTIC AGENTS BRAND Excluded TIER 99 APLISOL INJ 5/0.1ML TUBERCULOSIS BRAND Covered TIER 3 APOKYN INJ NONERGOT‐DERIV.DOPAMINE RECEPTOR AGONIST BRAND Covered TIER 2 Key: Brand‐O = Brand with AB‐rated generic equivalent. Coverage Detail: PA=Prior Authorization Required, SP= Restricted to specialty pharmacy, QL= Quantity Limit, MO= Mail order eligible after one prescription fill at retail 28
APOKYN INJ 10MG/ML NONERGOT‐DERIV.DOPAMINE RECEPTOR AGONIST BRAND Covered TIER 2 APPBUTAMONE PAK ANTIDEPRESSANTS, MISCELLANEOUS BRAND Covered TIER 3 APPBUTAMONE PAK ‐D ANTIDEPRESSANTS, MISCELLANEOUS BRAND Covered TIER 3 APPFORMIN PAK BIGUANIDES BRAND Covered TIER 3 APPFORMIN‐D PAK BIGUANIDES BRAND Covered TIER 3 APPLE FLAVOR LIQ PHARMACEUTICAL AIDS GENERIC Excluded TIER 99 APPTRIM CAP CALORIC AGENTS BRAND Excluded TIER 99 APPTRIM LIFE CAP BARIATRC CALORIC AGENTS BRAND Excluded TIER 99 APPTRIM LIFE CAP OBESITY CALORIC AGENTS BRAND Excluded TIER 99 APPTRIM‐D CAP CALORIC AGENTS BRAND Excluded TIER 99 APRACLONIDIN SOL 0.5% OP EENT DRUGS, MISCELLANEOUS GENERIC Covered TIER 1 APRI TAB CONTRACEPTIVES GENERIC Covered TIER 1 APRICOT LIQ FLAVOR PHARMACEUTICAL AIDS GENERIC Excluded TIER 99 APRISO CAP 0.375GM ANTI‐INFLAMMATORY AGENTS (GI DRUGS) BRAND Covered TIER 2 APTIVUS CAP 250MG HIV PROTEASE INHIBITORS BRAND Covered TIER 2 APTIVUS SOL HIV PROTEASE INHIBITORS BRAND Covered TIER 2 AP‐ZEL TAB MULTIVITAMIN PREPARATIONS BRAND Covered TIER 3 AQUA GLYC HC KIT SCLP/BDY ANTI‐INFLAMMATORY AGENTS (SKIN & MUCOUS) BRAND Covered TIER 3 AQUAFLO MIS 3" SKIN AND MUCOUS MEMBRANE AGENTS, MISC. BRAND Covered TIER 3 AQUAFLO MIS 4.75" SKIN AND MUCOUS MEMBRANE AGENTS, MISC. BRAND Covered TIER 3 AQUA‐SEAL MIS UNIT DEVICES BRAND Excluded TIER 99 AQUASOL A INJ 50000/ML VITAMIN A BRAND Covered TIER 3 AQUORAL AER EENT DRUGS, MISCELLANEOUS GENERIC Covered TIER 1 Key: Brand‐O = Brand with AB‐rated generic equivalent. Coverage Detail: PA=Prior Authorization Required, SP= Restricted to specialty pharmacy, QL= Quantity Limit, MO= Mail order eligible after one prescription fill at retail 29
Page 1 and 2: BMC HealthNet Plan Drug List - Empl
Page 3 and 4: ACCURETIC TAB 20‐25MG ANGIOTENSIN
Page 5 and 6: ACTIQ LOZ 400MCG OPIATE AGONISTS Br
Page 7 and 8: ADDERALL XR CAP 5MG AMPHETAMINES Br
Page 9 and 10: AERCHMBR PLS MIS LRG MASK DEVICES B
Page 11 and 12: ALA CORT CRE 1% ANTI‐INFLAMMATORY
Page 13 and 14: ALCORTIN A GEL LOCAL ANTI‐INFECTI
Page 15 and 16: ALOQUIN GEL 1.25‐1% ANTIFULGALS(S
Page 17 and 18: ALTACAINE SOL 0.5% OP LOCAL ANESTHE
Page 19 and 20: AMERGE TAB 2.5MG SELECTIVE SEROTONI
Page 21 and 22: AMITRIPTYLIN TAB 100MG TRYCYCLICS &
Page 23 and 24: AMOXICILLIN CAP 500MG AMINOPENICILL
Page 25 and 26: ANABAR TAB ANALGESICS AND ANTIPYRET
Page 27: ANGELIQ TAB 0.5‐1MG ESTROGENS BRA
Page 31 and 32: ARGATROBAN INJ 100MG/ML DIRECT THRO
Page 33 and 34: ASMALPRED SOL 15MG/5ML ADRENALS GEN
Page 35 and 36: ATIVAN TAB 2MG ATOPICLAIR CRE BENZO
Page 37 and 38: AUG BETAMET CRE 0.05% ANTI‐INFLAM
Page 39 and 40: AVC CRE 15% LOCAL ANTI‐INFECTIVES
Page 41 and 42: AZITHROMYCIN TAB 250MG OTHER MACROL
Page 43 and 44: BARD URETHR MIS CATH 16" DEVICES BR
Page 45 and 46: BENEFIX INJ 3000UNIT HEMOSTATICS BR
Page 47 and 48: BENZONATATE CAP 200MG ANTITUSSIVES
Page 49 and 50: BETAPACE TAB 160MG BETA‐ADRENERGI
Page 51 and 52: BIONECT GEL 0.2% SKIN AND MUCOUS ME
Page 53 and 54: BONE MARROW KIT BIOPSY LOCAL ANESTH
Page 55 and 56: BREATHERITE MIS W/MASK DEVICES BRAN
Page 57 and 58: BUMETANIDE INJ 0.25/ML LOOP DIURETI
Page 59 and 60: BUSPIRONE TAB 7.5MG ANXIOLYTICS, SE
Page 61 and 62: CAFCIT SOL 60MG/3ML CAFERGOT TAB 1
Page 63 and 64: CALDOLOR INJ 800/8ML OTHER NONSTERO
Page 65 and 66: CAPTOPRIL TAB 50MG ANGIOTENSIN‐CO
Page 67 and 68: CARBOGEL GEL 940 PHARMACEUTICAL AID
Page 69 and 70: CARDURA XL TAB 8MG ALPHA‐ADRENERG
Page 71 and 72: CATAPRES‐TTS DIS 0.1/24HR CENTRAL
Page 73 and 74: CEFAZOL/DEX SOL 1GM CEFAZOL/DEX SOL
Page 75 and 76: CEFPROZIL SUS 250/5ML CEFPROZIL TAB
Page 77 and 78: CEFUROXIME SUS 125/5ML SECOND GENER
Page 79 and 80:
CEPROTIN INJ 500 UNIT ANTICOAGULANT
Page 81 and 82:
CHLORAL HYDR SYP 500/5ML ANXIOLYTIC
Page 83 and 84:
CIALIS TAB 10MG CIALIS TAB 2.5MG CI
Page 85 and 86:
CIPROFLOXACN TAB 500MG QUINOLONES G
Page 87 and 88:
CLARITHROMYC SUS 125/5ML OTHER MACR
Page 89 and 90:
CLINDAMYCIN CAP 75MG LINCOMYCINS GE
Page 91 and 92:
CLOBETASOL LOT 0.05% ANTI‐INFLAMM
Page 93 and 94:
CLORAZ DIPOT TAB 15MG BENZODIAZEPIN
Page 95 and 96:
COLAZAL CAP 750MG ANTI‐INFLAMMATO
Page 97 and 98:
CONCERTA TAB 18MG ANOREX.,RESPIR.,C
Page 99 and 100:
COREG CR CAP 80MG BETA‐ADRENERGIC
Page 101 and 102:
COSOPT PF SOL CARBONIC ANHYDRASE IN
Page 103 and 104:
CROMOLYN SOD SOL 4% OP ANTIALLERGIC
Page 105 and 106:
CURI‐STRIP MIS 1/2"X4" DEVICES BR
Page 107 and 108:
CYCLOPHOSPH INJ 2GM ANTINEOPLASTIC
Page 109 and 110:
D10W/NACL INJ 0.9% REPLACEMENT PREP
Page 111 and 112:
DAYTRANA DIS 10MG/9HR ANOREX.,RESPI
Page 113 and 114:
DENAVIR CRE 1% ANTIVIRALS (SKIN & M
Page 115 and 116:
DERMATOP OIN 0.1% ANTI‐INFLAMMATO
Page 117 and 118:
DESOXIMETAS OIN 0.05% ANTI‐INFLAM
Page 119 and 120:
DEXTROSE INJ 2.5% CALORIC AGENTS GE
Page 121 and 122:
DIBENZYLINE CAP 10MG DICLOFEN POT T
Page 123 and 124:
DIFLUCAN TAB 150MG AZOLES Brand‐O
Page 125 and 126:
DILTIAZEM CAP 180MG/24 DILTIAZEM CA
Page 127 and 128:
DIOVAN TAB 160MG ANGIOTENSIN II REC
Page 129 and 130:
DIURIL SUS 250/5ML THIAZIDE DIURETI
Page 131 and 132:
DONEPEZIL TAB 5MG PARASYMPATHOMIMET
Page 133 and 134:
DOXEPIN HCL CAP 25MG TRYCYCLICS & O
Page 135 and 136:
DUEXIS TAB 800‐26.6 OTHER NONSTER
Page 137 and 138:
E.E.S. 400 TAB 400MG ERYTHROMYCINS
Page 139 and 140:
EEMT TAB ESTROGENS GENERIC Excluded
Page 141 and 142:
ELOCON OIN 0.1% ANTI‐INFLAMMATORY
Page 143 and 144:
ENBREL SRCLK INJ 50MG/ML DISEASE‐
Page 145 and 146:
EPIFLUR CHW 0.5MG F CARIOSTATIC AGE
Page 147 and 148:
EQUAGESIC TAB 200‐325 ANXIOLYTICS
Page 149 and 150:
ESCITALOPRAM TAB 10MG SELECTIVE‐S
Page 151 and 152:
ETHOSUXIMIDE CAP 250MG SUCCINIMIDES
Page 153 and 154:
EVOXAC CAP 30MG PARASYMPATHOMIMETIC
Page 155 and 156:
E‐Z‐CAT DRY PAK ROENTGENOGRAPHY
Page 157 and 158:
FEEDING TUBE MIS 8FR 16" DEVICES BR
Page 159 and 160:
FENTANYL DIS 100MCG/H OPIATE AGONIS
Page 161 and 162:
FINACEA GEL 15% SKIN AND MUCOUS MEM
Page 163 and 164:
FLOLAN INJ 0.5MG VASODILATING AGENT
Page 165 and 166:
FLUOCIN ACET OIN 0.025% ANTI‐INFL
Page 167 and 168:
FLUOXETINE CAP 10MG SELECTIVE‐SER
Page 169 and 170:
FLUVOXAMINE TAB 25MG SELECTIVE‐SE
Page 171 and 172:
FOLEY TRAY KIT 5ML DEVICES BRAND Ex
Page 173 and 174:
FORTICAL SPR 200/ACT PARATHYROID GE
Page 175 and 176:
FUZEON INJ 90MG HIV ENTRY AND FUSIO
Page 177 and 178:
GALANTAMINE TAB 4MG PARASYMPATHOMIM
Page 179 and 180:
GELCLAIR GEL SKIN AND MUCOUS MEMBRA
Page 181 and 182:
GENTAMICIN OIN 0.1% ANTIBACTERIALS
Page 183 and 184:
GLUCOTROL TAB 5MG SULFONYLUREAS Bra
Page 185 and 186:
GRAFIX PRIME MIS 7.5X15CM OTHER MIS
Page 187 and 188:
HALONATE PAC KIT ANTI‐INFLAMMATOR
Page 189 and 190:
HELIXATE FS SOL 250UNIT HEMOSTATICS
Page 191 and 192:
HISTOACRYL LIQ DEVICES BRAND Exclud
Page 193 and 194:
HUMIRA PEN KIT CROHNS DISEASE‐MOD
Page 195 and 196:
HYDROCORT LOT 2.5% ANTI‐INFLAMMAT
Page 197 and 198:
HYDROXYZ HCL TAB 50MG ANXIOLYTICS,
Page 199 and 200:
HYPERTENIPIN PAK 2.5MG DIHYDROPYRID
Page 201 and 202:
IFOSFAMIDE KIT MESNA ANTINEOPLASTIC
Page 203 and 204:
INDIUM IN111 INJ OXYQUINO DIAGNOSTI
Page 205 and 206:
INFUSION SET MIS CATH 23" DEVICES G
Page 207 and 208:
INTERCED TC7 PAD 1.5"X2" SKIN AND M
Page 209 and 210:
IPRATROPIUM SPR 0.03% ANTIMUSCARINI
Page 211 and 212:
ISOPTIN SR TAB 240MG CALCIUM‐CHAN
Page 213 and 214:
JANUMET TAB 50‐1000 DIPEPTIDYL PE
Page 215 and 216:
KADIAN CAP 40MG CR OPIATE AGONISTS
Page 217 and 218:
KANGAROO KIT 18FR/3.5 DEVICES BRAND
Page 219 and 220:
KEPPRA TAB 1000MG ANTICONVULSANTS,
Page 221 and 222:
KETOROLAC INJ 15MG/ML OTHER NONSTER
Page 223 and 224:
K‐PHOS TAB MF ACIDIFYING AGENTS B
Page 225 and 226:
LAMICTAL ODT TAB 100MG ANTICONVULSA
Page 227 and 228:
LANTUS INJ SOLOSTAR INSULINS BRAND
Page 229 and 230:
LEUCOVOR CA TAB 25MG ANTIDOTES GENE
Page 231 and 232:
LEVITRA TAB 20MG PHOSPHODIESTERASE
Page 233 and 234:
LEVOTHYROXIN TAB 300MCG THYROID AGE
Page 235 and 236:
LIDOCAIN/D5W INJ 4MG/ML CLASS IB AN
Page 237 and 238:
LIORESAL INT INJ 0.05MG/1 GABA‐DE
Page 239 and 240:
LITEAIRE MIS DEVICES BRAND Excluded
Page 241 and 242:
LOHIST‐12 TAB 12 HOUR PROPYLAMINE
Page 243 and 244:
LOTEMAX OIN 0.5% CORTICOSTEROIDS (E
Page 245 and 246:
LTA 360 KIT SOL 4% LOCAL ANESTHETIC
Page 247 and 248:
L‐VALINE CRY CALORIC AGENTS GENER
Page 249 and 250:
MALARONE TAB 250‐100 ANTIMALARIAL
Page 251 and 252:
MAVIK TAB 4MG ANGIOTENSIN‐CONVERT
Page 253 and 254:
MEFOXIN INJ 2GM/50ML CEPHAMYCINS BR
Page 255 and 256:
MERREM INJ 500MG CARBAPENEMS Brand
Page 257 and 258:
METHADOSE TAB 10MG OPIATE AGONISTS
Page 259 and 260:
METHYLIN TAB 20MG METHYLIN TAB 20MG
Page 261 and 262:
METIPRANOLOL SOL 0.3% BETA‐ADRENE
Page 263 and 264:
METRONIDAZOL LOT 0.75% ANTIBACTERIA
Page 265 and 266:
MIDAZOLAM INJ 1MG/ML BENZODIAZEPINE
Page 267 and 268:
MINOCYCLINE CAP 50MG TETRACYCLINES
Page 269 and 270:
MIRTAZAPINE TAB 45MG ODT ANTIDEPRES
Page 271 and 272:
MONODOX CAP 100MG TETRACYCLINES Bra
Page 273 and 274:
MORPHINE SUL TAB 200MG ER OPIATE AG
Page 275 and 276:
MUSE SUP 1000MCG VASODILATING AGENT
Page 277 and 278:
MYSOLINE TAB 50MG BARBITURATES (ANT
Page 279 and 280:
NAMENDA TAB 5MG NAPRELAN PAK NAPREL
Page 281 and 282:
NASOTUSS LIQ ANTITUSSIVES BRAND Exc
Page 283 and 284:
NEFAZODONE TAB 250MG SEROTONIN MODU
Page 285 and 286:
NEPHRONEX TAB 1MG MULTIVITAMIN PREP
Page 287 and 288:
NEVIRAPINE TAB 200MG NONNUCLEOSIDE
Page 289 and 290:
NIRAVAM TAB 0.5MG BENZODIAZEPINES (
Page 291 and 292:
NOHIST DMX TAB ANTITUSSIVES GENERIC
Page 293 and 294:
NORTRIPTYLIN CAP 25MG TRYCYCLICS &
Page 295 and 296:
NUOX GEL 6‐3% SKIN AND MUCOUS MEM
Page 297 and 298:
NYSTATIN POW 1BU POLYENES GENERIC E
Page 299 and 300:
OFFICE SAFET KIT 3.2QT DEVICES BRAN
Page 301 and 302:
OMNITROPE 5 MIS DEVICE DEVICES BRAN
Page 303 and 304:
OPTIRAY 160 INJ 34% ROENTGENOGRAPHY
Page 305 and 306:
ORTHO COIL DPR KIT 50 CONTRACEPTIVE
Page 307 and 308:
OTIC CARE DRO LOCAL ANESTHETICS (EE
Page 309 and 310:
OXYBUTYNIN TAB 15MG ER GENITOURINAR
Page 311 and 312:
PACNEX MX LIQ 4.25% LOCAL ANTI‐IN
Page 313 and 314:
PARAFON FORT TAB DSC CENTRALLY ACTI
Page 315 and 316:
PATROL PUMP MIS 40MM CAP DEVICES BR
Page 317 and 318:
PEDIPIROX‐4 KIT NAIL HYDROXYPYRID
Page 319 and 320:
PENTOTHAL INJ 500MG BARBITURATES (G
Page 321 and 322:
PEXEVA TAB 30MG SELECTIVE‐SEROTON
Page 323 and 324:
PHENOBARB TAB 100MG PHENOBARB TAB 1
Page 325 and 326:
PHYSOS SALIC INJ 1MG/ML PARASYMPATH
Page 327 and 328:
PLASMANATE INJ 5% BLOOD DERIVATIVES
Page 329 and 330:
POLYETHYLENE LIQ GLYCOL CATHARTICS
Page 331 and 332:
POT CITRATE TAB 540MG ALKALINIZING
Page 333 and 334:
PRAMOSONE OIN 1% ANTI‐INFLAMMATOR
Page 335 and 336:
PREDNISOLONE SUS 1% OP CORTICOSTERO
Page 337 and 338:
PRENATE MINI CAP MULTIVITAMIN PREPA
Page 339 and 340:
PRIMLEV TAB 7.5‐300 OPIATE AGONIS
Page 341 and 342:
PROCTOCREAM CRE HC 2.5% ANTI‐INFL
Page 343 and 344:
PROMETHAZINE TAB 25MG PHENOTHIAZINE
Page 345 and 346:
PROQUAD INJ VACCINES BRAND Covered
Page 347 and 348:
PROZAC CAP 40MG SELECTIVE‐SEROTON
Page 349 and 350:
PYRIDOSTIGM TAB 60MG PARASYMPATHOMI
Page 351 and 352:
QUINIDINE SU TAB 300MG ER CLASS IA
Page 353 and 354:
RAPID‐D INF MIS 43"/8MM DEVICES B
Page 355 and 356:
REGENECARE GEL ANTIPRURITICS AND LO
Page 357 and 358:
RENACIDIN SOL IRR IRRIGATING SOLUTI
Page 359 and 360:
RESCRIPTOR TAB 100 MG NONNUCLEOSIDE
Page 361 and 362:
RETISERT IMP 0.59MG CORTICOSTEROIDS
Page 363 and 364:
RIFAMPIN INJ 600 MG ANTITUBERCULOSI
Page 365 and 366:
RITUXAN INJ 500MG ANTINEOPLASTIC AG
Page 367 and 368:
ROPINIROLE TAB 6MG ER NONERGOT‐DE
Page 369 and 370:
SAFETY PEG MIS KIT 20FR DEVICES BRA
Page 371 and 372:
SALVAX DUO KIT PLUS KERATOLYTIC AGE
Page 373 and 374:
SCOPOLAMINE INJ 0.4MG/ML ANTIMUSCAR
Page 375 and 376:
SENILEZOL ELX IRON PREPARATIONS GEN
Page 377 and 378:
SEROQUEL TAB 50MG ATYPICAL ANTIPSYC
Page 379 and 380:
SILICONE MSK MIS PED DEVICES GENERI
Page 381 and 382:
SINGULAIR TAB 10MG LEUKOTRIENE MODI
Page 383 and 384:
SOD POLY SUL SUS 15GM/60 POTASSIUM
Page 385 and 386:
SOLODYN TAB 90MG SKIN AND MUCOUS ME
Page 387 and 388:
SOTALOL AF TAB 80MG BETA‐ADRENERG
Page 389 and 390:
SPRYCEL TAB 100MG ANTINEOPLASTIC AG
Page 391 and 392:
STOPCOCK MIS 1‐WAY DEVICES BRAND
Page 393 and 394:
SUDATEX‐DM TAB ANTITUSSIVES GENER
Page 395 and 396:
SUPPORT‐500 CAP MULTIVITAMIN PREP
Page 397 and 398:
SURGIFOAM MIS 12‐7MM HEMOSTATICS
Page 399 and 400:
SYMBYAX CAP 6‐25MG SELECTIVE‐SE
Page 401 and 402:
T.E.D. MIS XSM/LONG DEVICES BRAND E
Page 403 and 404:
TASMAR TAB 100MG CATECHOL‐O‐ ME
Page 405 and 406:
TEGRETOL XR TAB 200MG ANTICONVULSAN
Page 407 and 408:
TEQUILA SUNR LIQ FLAVOR PHARMACEUTI
Page 409 and 410:
TEV‐TROPIN INJ 5MG SOMATOTROPIN A
Page 411 and 412:
THERABENZAPR PAK ‐90‐5 CENTRALL
Page 413 and 414:
THORA‐SEAL MIS III UNIT DEVICES B
Page 415 and 416:
TIMOLOL GEL SOL 0.25% OP TIMOLOL GE
Page 417 and 418:
TIZANIDINE TAB 2MG CENTRALLY ACTING
Page 419 and 420:
TOLMETIN SOD TAB 200MG OTHER NONSTE
Page 421 and 422:
TOPIRAMATE TAB 25MG ANTICONVULSANTS
Page 423 and 424:
TRANDO/VERAP TAB 4‐240 CR CALCIUM
Page 425 and 426:
TRETINOIN GEL 0.01% CELL STIMULANTS
Page 427 and 428:
TRIAZ PAD 9% LOCAL ANTI‐INFECTIVE
Page 429 and 430:
TRILIPIX CAP 135MG FIBRIC ACID DERI
Page 431 and 432:
TROCHE MOLD MIS 30 CAVIT DEVICES BR
Page 433 and 434:
TYLOX CAP 5‐500MG OPIATE AGONISTS
Page 435 and 436:
ULTRAVATE KIT PAC ANTI‐INFLAMMATO
Page 437 and 438:
UNITHROID TAB 50MCG THYROID AGENTS
Page 439 and 440:
UROGESIC‐ TAB BLUE URINARY ANTI
Page 441 and 442:
VALTURNA TAB 300‐320 RENIN INHIBI
Page 443 and 444:
VAYACOG CAP OTHER MISCELLANEOUS THE
Page 445 and 446:
VENOMIL KIT HONEYBEE OTHER MISCELLA
Page 447 and 448:
VERDESO AER 0.05% ANTI‐INFLAMMATO
Page 449 and 450:
VIBATIV INJ 250MG GLYCOPEPTIDES BRA
Page 451 and 452:
VINATE ONE TAB MULTIVITAMIN PREPARA
Page 453 and 454:
VITACIRC‐B TAB VITAMIN B COMPLEX
Page 455 and 456:
VORTEX/MASK MIS TODDLER DEVICES BRA
Page 457 and 458:
WELLBUTRIN TAB 100MG SR ANTIDEPRESS
Page 459 and 460:
WINRHO SDF INJ 5000UNIT SERUMS BRAN
Page 461 and 462:
XIGRIS INJ 5MG OTHER MISCELLANEOUS
Page 463 and 464:
XYLO‐MPF/EPI INJ 1.5% LOCAL ANEST
Page 465 and 466:
ZANAFLEX CAP 4MG CENTRALLY ACTING S
Page 467 and 468:
ZENCHENT TAB CONTRACEPTIVES GENERIC
Page 469 and 470:
ZIANA GEL SKIN AND MUCOUS MEMBRANE
Page 471 and 472:
ZOCOR TAB 5MG HMG‐COA REDUCTASE I
Page 473 and 474:
ZOSYN INJ 3‐0.375G EXTENDED‐SPE
Page 475 and 476:
ZYPREXA TAB 15MG ATYPICAL ANTIPSYCH
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