SecureRx PDP Generic Standard Formulary (List of Covered Drugs)

Transcription

1 SecureRx PDP Generic Standard SecureRx PDP Option Employer Group Retiree Plan Standard Options 019 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN Formulary ID 1950 v.10 This formulary was updated on 0/0/019. For more recent information or other questions, please contact SecureRx PDP Customer Service at or, for TTY users, 711, Monday through Friday, 8 a.m. to 8 p.m., or visit AV-59 (0/7/19) S8067_19_00_C

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3 Note to existing members: This formulary has changed since last year. Please review this document to make sure that it still contains the drugs you take. When this drug list (formulary) refers to we, us, or our, it means Avalon Insurance Company. When it refers to plan or our plan, it means SecureRx PDP. This document includes a list of the drugs (formulary) for our plan which is current as of April 1, 019. For an updated formulary, please contact us. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. You must generally use network pharmacies to use your prescription drug benefit. Benefits, formulary, pharmacy network, and/or copayments/coinsurance may change on January 1, 00, and from time to time during the year. What is the SecureRx PDP Formulary? A formulary is a list of covered drugs selected by our plan in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Our plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a SecureRx PDP network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Evidence of Coverage. Can the Formulary (drug list) change? Generally, if you are taking a drug on our 019 formulary that was covered at the beginning of the year, we will not discontinue or reduce coverage of the drug during the 019 coverage year except when a new, less expensive generic drug becomes available, when new information about the safety or effectiveness of a drug is released, or the drug is removed from the market. (See bullets below for more information on changes that affect members currently taking the drug.) Other types of formulary changes, such as removing a drug from our formulary, will not affect members who are currently taking the drug. It will remain available at the same cost-sharing for those members taking it for the remainder of the coverage year. Below are changes to the drug list that will also affect members currently taking a drug: New generic drugs. We may immediately remove a brand name drug on our Drug List if we are replacing it with a new generic drug that will appear on the same or lower cost sharing tier and with the same or fewer restrictions. Also, when adding the new generic drug, we may decide to keep the brand name drug on our Drug List, but immediately move it to a different cost-sharing tier or add new restrictions. If you are currently taking that brand name drug, we may not tell you in advance before we make that change, but we will later provide you with information about the specific change(s) we have made. o If we make such a change, you or your prescriber can ask us to make an exception and continue to cover the brand name drug for you. The notice we provide you will also include information on the steps you may take to request an exception, and you can also find information in the section below entitled How do I request an exception to the SecureRx PDP Formulary? Drugs removed from the market. If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug s manufacturer removes the drug from the market, we will immediately remove the drug from our formulary and provide notice to members who take the drug. i

4 Other changes. We may make other changes that affect members currently taking a drug. For instance, we may add a generic drug that is not new to market to replace a brand name drug currently on the formulary or add new restrictions to the brand name drug or move it to a different cost-sharing tier. Or we may make changes based on new clinical guidelines. If we remove drugs from our formulary, or add prior authorization, quantity limits and/or step therapy restrictions on a drug or move a drug to a higher cost-sharing tier, we must notify affected members of the change at least 0 days before the change becomes effective, or at the time the member requests a refill of the drug, at which time the member will receive a 0-day supply of the drug. The enclosed formulary is current as of April 1, 019. To get updated information about the drugs covered by SecureRx PDP, please contact us. Our contact information appears on the front and back cover pages. In the event of a mid-year formulary change, unrelated to a generic becoming available, we will notify you with a written notification of the nonmaintenance formulary change. In addition, the printable formulary will be updated and posted on our website How do I use the Formulary? There are two ways to find your drug within the formulary: Medical Condition The formulary begins on page one. The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, Cardiovascular. If you know what your drug is used for, look for the category name in the list that begins on page one. Then look under the category name for your drug. Alphabetical Listing If you are not sure what category to look under, you should look for your drug in the Index that begins on page 7. The Index provides an alphabetical list of all of the drugs included in this document. Both brand name drugs and generic drugs are listed in the Index. Look in the Index and find your drug. Next to your drug, you will see the page number where you can find coverage information. Turn to the page listed in the Index and find the name of your drug in the first column of the list. What are generic drugs? Our plan covers both brand name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient as the brand name drug. Generally, generic drugs cost less than brand name drugs. Are there any restrictions on my coverage? Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include: Prior Authorization: Our plan requires you or your physician to get prior authorization for certain drugs. This means that you will need to get approval from our plan before you fill your prescriptions. If you don t get approval, we may not cover the drug. Quantity Limits: For certain drugs, our plan limits the amount of the drug that we will cover. For example, our plan provides twelve tablets per prescription for sumatriptan tab 50mg. This may be in addition to a standard one-month or three-month supply. ii

5 Step Therapy: In some cases, our plan requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, our plan may not cover Drug B unless you try Drug A first. If Drug A does not work for you, we will then cover Drug B. You can find out if your drug has any additional requirements or limits by looking in the formulary that begins on page one. You can also get more information about the restrictions applied to specific covered drugs by visiting our Web site. We have posted on line documents that explain our prior authorization and step therapy restrictions. You may also ask us to send you a copy. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. You can ask our plan to make an exception to these restrictions or limits or for a list of other, similar drugs that may treat your health condition. See the section, How do I request an exception to the SecureRx PDP Formulary? below for information about how to request an exception. What if my drug is not on the Formulary? If your drug is not included in this formulary (list of covered drugs), you should first contact Customer Service and ask if your drug is covered. If you learn that our plan does not cover your drug, you have two options: You can ask Customer Service for a list of similar drugs that are covered by our plan. When you receive the list, show it to your doctor and ask him or her to prescribe a similar drug that is covered by our plan. You can ask our plan to make an exception and cover your drug. See below for information about how to request an exception. How do I request an exception to the SecureRx PDP Formulary? You can ask our plan to make an exception to our coverage rules. There are several types of exceptions that you can ask us to make. You can ask us to cover a drug even if it is not on our formulary. If approved, this drug will be covered at a pre-determined cost-sharing level, and you would not be able to ask us to provide the drug at a lower cost-sharing level. You can ask us to cover a formulary drug at a lower cost-sharing level if this drug is not on the specialty tier. If approved this would lower the amount you must pay for your drug. You can ask us to waive coverage restrictions or limits on your drug. For example, for certain drugs, our plan limits the amount of the drug that we will cover. If your drug has a quantity limit, you can ask us to waive the limit and cover a greater amount. Generally, our plan will only approve your request for an exception if the alternative drugs included on the plan s formulary, the lower cost-sharing drug or additional utilization restrictions would not be as effective in treating your condition and/or would cause you to have adverse medical effects. iii

6 You should contact us to ask us for an initial coverage decision for a formulary, or utilization restriction exception. When you request a formulary or utilization restriction exception you should submit a statement from your prescriber or physician supporting your request. Generally, we must make our decision within 7 hours of getting your prescriber s supporting statement. You can request an expedited (fast) exception if you or your doctor believe that your health could be seriously harmed by waiting up to 7 hours for a decision. If your request to expedite is granted, we must give you a decision no later than hours after we get a supporting statement from your doctor or other prescriber. What do I do before I can talk to my doctor about changing my drugs or requesting an exception? As a new or continuing member in our plan you may be taking drugs that are not on our formulary. Or, you may be taking a drug that is on our formulary but your ability to get it is limited. For example, you may need a prior authorization from us before you can fill your prescription. You should talk to your doctor to decide if you should switch to an appropriate drug that we cover or request a formulary exception so that we will cover the drug you take. While you talk to your doctor to determine the right course of action for you, we may cover your drug in certain cases during the first 90 days you are a member of our plan. For each of your drugs that is not on our formulary or if your ability to get your drugs is limited, we will cover a temporary 0-day supply. If your prescription is written for fewer days, we ll allow refills to provide up to a maximum 0 day supply of medication. After your first 0-day supply, we will not pay for these drugs, even if you have been a member of the plan less than 90 days. If you are a resident of a long-term care facility and you need a drug that is not on our formulary or if your ability to get your drugs is limited, but you are past the first 90 days of membership in our plan, we will cover a 1-day emergency supply of that drug while you pursue a formulary exception. Our plan also realizes that other situations may arise where you need access to non-formulary drugs. An example of this situation would include when you are discharged from a hospital. In these cases, members should use the exceptions processes described earlier. For more information For more detailed information about your SecureRx PDP prescription drug coverage, please review your Evidence of Coverage and other plan materials. If you have questions about our plan, please contact us. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. If you have general questions about Medicare prescription drug coverage, please call Medicare at MEDICARE ( ) hours a day/7 days a week. TTY users should call Or, visit SecureRx PDP Formulary The formulary begins on page one provides coverage information about the drugs covered by our plan. If you have trouble finding your drug in the list, turn to the Index that begins on page 7. The first column of the chart lists the drug name. Brand name drugs are capitalized (e.g., ELIQUIS) and generic drugs are listed in lower-case italics (e.g., simvastatin). The information in the Requirements/Limits column tells you if our plan has any special requirements for coverage of your drug. iv

7 019 SECURERX PDP MEDICARE FORMULARY Key Drug Tier Levels: Tier 1 Preferred Generic Tier Generic Tier Preferred Brand (includes preferred brand drugs and some generic drugs) Tier Non-Preferred Drug Tier 5 Specialty The symbol B/D next to a drug name indicates that prior authorization for determination of coverage under Part B vs. Part D may apply. The symbol LA next to a drug name indicates the drug has limited access or distribution. The symbol PA next to a drug name indicates that prior authorization may apply. The symbol QL next to a drug name indicates that quantities dispensed may be limited. The symbol ST next to a drug name indicates that Step Therapy may apply. The symbol NM next to a drug name indicates that the drug is not available through mail service. Note: Drugs that are non-formulary and are not listed in this document are not covered unless approval is provided through the Non-Formulary Exception Process. For employer-sponsored plans, please call Customer Service regarding the type of formulary that is offered. v

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9 ANALGESICS GOUT allopurinol tab (generic of ZYLOPRIM) colchicine w/ probenecid COLCRYS QL (10 tabs / 0 days) MITIGARE QL (60 caps / 0 days) probenecid ULORIC ST NSAIDS celecoxib (generic of CELEBREX) CAPS QL (0 caps / 0 days) 50mg celecoxib (generic of CELEBREX) CAPS QL (10 caps / 0 days) 100mg celecoxib (generic of CELEBREX) CAPS QL (60 caps / 0 days) 00mg celecoxib (generic of CELEBREX) CAPS QL (0 caps / 0 days) 00mg diclofenac potassium QL (10 tabs / 0 days) diclofenac sodium TB; TBEC diflunisal etodolac CAPS etodolac (generic of LODINE) TABS 00mg etodolac TABS 500mg etodolac TB flurbiprofen TABS ibu tab 600mg 1 ibu tab 800mg 1 ibuprofen SUSP ibuprofen TABS 00mg, 600mg, 800mg 1 meloxicam (generic of MOBIC) TABS 1 nabumetone TABS naproxen (generic of NAPROSYN) TABS 1 50mg, 500mg naproxen TABS 75mg 1 naproxen dr (generic of EC-NAPROSYN) 75mg naproxen dr (generic of EC-NAPROXEN) 500mg naproxen sodium TABS 75mg naproxen sodium (generic of ANAPROX DS) TABS 550mg piroxicam (generic of FELDENE) CAPS sulindac TABS 1

10 OPIOID ANALGESICS acetaminophen w/ codeine 00-15mg QL (00 tabs / 0 days) acetaminophen w/ codeine 00-0mg QL (60 tabs / 0 days) (generic of TYLENOL/CODEINE #) acetaminophen w/ codeine 00-60mg QL (180 tabs / 0 days) (generic of TYLENOL/CODEINE #) acetaminophen w/ codeine soln QL (700 ml / 0 days) butorphanol tartrate SOLN 1mg/ml, mg/ml nalbuphine hcl SOLN tramadol hcl tab 50 mg (generic of QL (0 tabs / 0 days) ULTRAM) tramadol-acetaminophen (generic of QL (0 tabs / 0 days) ULTRACET) OPIOID ANALGESICS, CII endocet.5-5mg (generic of PERCOCET) QL (60 tabs / 0 days) endocet 5-5mg (generic of PERCOCET) QL (60 tabs / 0 days) endocet 7.5-5mg (generic of PERCOCET) QL (0 tabs / 0 days) endocet 10-5mg (generic of PERCOCET) QL (180 tabs / 0 days) fentanyl citrate (generic of ACTIQ) LPOP 5 QL (10 lozenges / 0 days), PA fentanyl patch 1 mcg/hr (generic of DURAGESIC) QL (10 patches / 0 days), PA fentanyl patch 5 mcg/hr (generic of DURAGESIC) QL (10 patches / 0 days), PA fentanyl patch 50 mcg/hr (generic of DURAGESIC) QL (10 patches / 0 days), PA fentanyl patch 75 mcg/hr (generic of DURAGESIC) QL (10 patches / 0 days), PA fentanyl patch 100 mcg/hr (generic of DURAGESIC) QL (10 patches / 0 days), PA FENTORA 5 QL (10 tabs / 0 days), PA hydroco/apap tab 5-5mg (generic of QL (0 tabs / 0 days) NORCO) hydroco/apap tab (generic of QL (180 tabs / 0 days) NORCO) hydroco/apap tab 10-5mg (generic of QL (180 tabs / 0 days) NORCO) hydrocodone-acetaminophen QL (700 ml / 0 days) mg/15ml hydrocodone-ibuprofen tab mg QL (150 tabs / 0 days) hydromorphone hcl (generic of DILAUDID) QL (600 ml / 0 days) LIQD

11 hydromorphone hcl SOLN 10mg/ml, 50mg/5ml, 500mg/50ml B/D hydromorphone hcl (generic of DILAUDID) QL (180 tabs / 0 days) TABS HYSINGLA ER QL (0 tabs / 0 days), PA lorcet hd tab 10-5mg (generic of NORCO) QL (180 tabs / 0 days) lorcet plus tab (generic of NORCO) QL (180 tabs / 0 days) lorcet tab 5-5mg (generic of NORCO) QL (0 tabs / 0 days) methadone hcl SOLN 5mg/5ml, 10mg/5ml QL (50 ml / 0 days), PA methadone hcl 5mg (generic of DOLOPHINE) QL (90 tabs / 0 days), PA methadone hcl 10mg (generic of DOLOPHINE) QL (90 tabs / 0 days), PA methadone hcl intensol (generic of METHADOSE) QL (90 ml / 0 days), PA morphine ext-rel tab (generic of MS CONTIN) 15mg, 0mg, 60mg, 100mg QL (90 tabs / 0 days), PA morphine ext-rel tab (generic of MS CONTIN) 00mg QL (60 tabs / 0 days), PA morphine sul inj 1mg/ml B/D MORPHINE SUL INJ MG/ML B/D morphine sul inj 10mg/ml B/D MORPHINE SULFATE SOLN mg/ml, B/D mg/ml, 5mg/ml, 8mg/ml, 10mg/ml, 150mg/0ml morphine sulfate (generic of MORPHINE B/D SULFATE) SOLN mg/ml, 8mg/ml, 10mg/ml morphine sulfate SOLN 8mg/ml B/D morphine sulfate TABS 15mg QL (180 tabs / 0 days) morphine sulfate TABS 0mg QL (90 tabs / 0 days) morphine sulfate oral soln 10mg/5ml QL (900 ml / 0 days) morphine sulfate oral soln 0mg/5ml QL (750 ml / 0 days) morphine sulfate oral soln 100mg/5ml QL (180 ml / 0 days) NUCYNTA ER 50mg, 100mg, 00mg, 50mg QL (60 tabs / 0 days), PA NUCYNTA ER 150mg QL (90 tabs / 0 days), PA oxycodone hcl CAPS QL (180 caps / 0 days) oxycodone hcl CONC QL (180 ml / 0 days) oxycodone hcl SOLN QL (900 ml / 0 days)

12 oxycodone hcl (generic of ROXICODONE) QL (180 tabs / 0 days) TABS 5mg, 15mg, 0mg oxycodone hcl TABS 10mg, 0mg QL (180 tabs / 0 days) oxycodone w/ acetaminophen.5-5mg QL (60 tabs / 0 days) (generic of PERCOCET) oxycodone w/ acetaminophen 5-5mg QL (60 tabs / 0 days) (generic of PERCOCET) oxycodone w/ acetaminophen 7.5-5mg QL (0 tabs / 0 days) (generic of PERCOCET) oxycodone w/ acetaminophen 10-5mg (generic of PERCOCET) QL (180 tabs / 0 days) ANESTHETICS LOCAL ANESTHETICS lidocaine hcl (local anesth.) (generic of B/D XYLOCAINE) % lidocaine hcl (local anesth.) (generic of XYLOCAINE-MPF).5%, 1% B/D lidocaine inj 0.5% (generic of XYLOCAINE) B/D lidocaine inj 1% (generic of XYLOCAINE) B/D lidocaine inj 1.5% preservative free (pf) B/D (generic of XYLOCAINE-MPF) ANTI-INFECTIVES ANTI-BACTERIALS - MISCELLANEOUS amikacin sulfate SOLN gentamicin in saline gentamicin sulfate SOLN neomycin sulfate TABS paromomycin sulfate CAPS streptomycin sulfate SOLR 5 SULFADIAZINE TABS tobramycin (generic of KITABIS PAK) 5 NM, PA NEBU tobramycin inj 1. gm/0ml tobramycin inj 1.gm 5 tobramycin inj 10mg/ml tobramycin inj 0mg/ml tobramycin inj 80mg/ml ANTI-INFECTIVES - MISCELLANEOUS albendazole (generic of ALBENZA) TABS 5 ALBENZA 5 ALINIA 5 atovaquone (generic of MEPRON) SUSP 5 AZACTAM IN ISO-OSMOTIC DE AZACTAM/DEX INJ

13 aztreonam (generic of AZACTAM) BILTRICIDE CAYSTON 5 NM, LA, PA clindamycin cap 75mg (generic of CLEOCIN) clindamycin cap 00 mg (generic of CLEOCIN) clindamycin hcl cap 150 mg (generic of CLEOCIN) clindamycin phosphate in d5w CLINDAMYCIN PHOSPHATE IN NACL clindamycin phosphate inj (generic of CLEOCIN PHOSPHATE) clindamycin soln 75mg/5ml (generic of CLEOCIN PEDIATRIC GRANULE) colistimethate sodium (generic of COLY- MYCIN M) SOLR dapsone TABS DAPTOMYCIN 50mg 5 daptomycin (generic of CUBICIN) 500mg 5 EMVERM 5 ertapenem sodium (generic of INVANZ) imipenem-cilastatin imipenem-cilastatin (generic of PRIMAXIN IV) INVANZ ivermectin (generic of STROMECTOL) TABS linezolid in sodium chloride linezolid inj (generic of ZYVOX) linezolid susp (generic of ZYVOX) 5 linezolid tab 600mg (generic of ZYVOX) 5 meropenem (generic of MERREM) methenamine hippurate (generic of HIPREX) metronidazole (generic of FLAGYL) TABS metronidazole in nacl NEBUPENT B/D nitrofurantoin macrocrystal (generic of MACRODANTIN) 50mg, 100mg PA; PA applies if 70 years and older after a 90 day supply in a calendar year 5

14 nitrofurantoin monohyd macro (generic of MACROBID) PA; PA applies if 70 years and older after a 90 day supply in a calendar year PENTAM 00 praziquantel (generic of BILTRICIDE) TABS SIVEXTRO 5 sulfamethoxazole-trimethop ds (generic of 1 BACTRIM DS) sulfamethoxazole-trimethoprim inj sulfamethoxazole-trimethoprim susp sulfamethoxazole-trimethoprim tab mg (generic of BACTRIM) SYNERCID 5 tigecycline (generic of TYGACIL) 5 trimethoprim TABS vancomycin hcl (generic of VANCOCIN HCL) CAPS 15mg vancomycin hcl (generic of VANCOCIN 5 HCL) CAPS 50mg vancomycin hcl SOLR 1gm, 5gm, 10gm, 500mg, 750mg VANCOMYCIN IN NACL ANTIFUNGALS ABELCET 5 B/D AMBISOME 5 B/D amphotericin b SOLR B/D caspofungin acetate (generic of CANCIDAS) 5 fluconazole (generic of DIFLUCAN) SUSR fluconazole (generic of DIFLUCAN) TABS fluconazole in dextrose fluconazole inj nacl 00 fluconazole inj nacl 00 flucytosine (generic of ANCOBON) CAPS 5 griseofulvin microsize SUSP griseofulvin microsize TABS griseofulvin ultramicrosize itraconazole (generic of SPORANOX) PA CAPS ketoconazole TABS PA MYCAMINE 5 NOXAFIL SUSP 5 QL (60 ml / 0 days) NOXAFIL TBEC 5 QL (9 tabs / 0 days) 6

15 nystatin TABS terbinafine hcl (generic of LAMISIL) TABS QL (90 tabs / year) voriconazole (generic of VFEND IV) SOLR voriconazole (generic of VFEND) SUSR; 5 TABS ANTIMALARIALS atovaquone-proguanil hcl (generic of MALARONE) chloroquine phosphate TABS COARTEM mefloquine hcl PRIMAQUINE PHOSPHATE quinine sulfate (generic of QUALAQUIN) PA CAPS ANTIRETROVIRAL AGENTS abacavir sulfate (generic of ZIAGEN) NM SOLN abacavir sulfate (generic of ZIAGEN) NM TABS APTIVUS 5 NM atazanavir sulfate (generic of REYATAZ) 5 NM CRIXIVAN NM didanosine (generic of VIDEX EC) NM EDURANT 5 NM efavirenz (generic of SUSTIVA) CAPS NM 50mg efavirenz (generic of SUSTIVA) CAPS 5 NM 00mg efavirenz (generic of SUSTIVA) TABS 5 NM EMTRIVA NM fosamprenavir tab 700 mg (generic of 5 NM LEXIVA) FUZEON 5 NM INTELENCE 5mg NM INTELENCE 100mg, 00mg 5 NM INVIRASE 5 NM ISENTRESS CHEW 5mg NM ISENTRESS CHEW 100mg 5 NM ISENTRESS PACK NM ISENTRESS TABS 5 NM ISENTRESS HD 5 NM lamivudine (generic of EPIVIR) NM LEXIVA SUSP NM 7

16 nevirapine susp 50 mg/5ml (generic of NM VIRAMUNE) nevirapine tab 100mg er NM nevirapine tab 00mg (generic of NM VIRAMUNE) nevirapine tab 00mg er (generic of NM VIRAMUNE XR) NORVIR PACK NM NORVIR SOLN NM PIFELTRO 5 NM PREZISTA SUSP 5 QL (00 ml / 0 days), NM PREZISTA TABS 75mg QL (80 tabs / 0 days), NM PREZISTA TABS 150mg 5 QL (0 tabs / 0 days), NM PREZISTA TABS 600mg 5 QL (60 tabs / 0 days), NM PREZISTA TABS 800mg 5 QL (0 tabs / 0 days), NM RESCRIPTOR NM REYATAZ PACK 5 NM ritonavir (generic of NORVIR) NM SELZENTRY SOLN 5 NM SELZENTRY TABS 5mg NM SELZENTRY TABS 75mg, 150mg, 00mg 5 NM stavudine 15mg NM stavudine (generic of ZERIT) 0mg, NM 0mg, 0mg tenofovir disoproxil fumarate (generic of 5 NM VIREAD) TIVICAY 10mg NM TIVICAY 5mg, 50mg 5 NM TROGARZO 5 NM, LA TYBOST NM VIDEX EC 15mg NM VIDEX PEDIATRIC NM VIRACEPT 5 NM VIRAMUNE SUSP NM VIREAD POWD 5 NM VIREAD TABS 150mg, 00mg, 50mg 5 NM zidovudine cap 100mg (generic of NM RETROVIR) zidovudine syp 50mg/5ml (generic of RETROVIR) NM 8

17 zidovudine tab 00mg NM ANTIRETROVIRAL COMBINATION AGENTS abacavir sulfate-lamivudine (generic of NM EPZICOM) abacavir sulfate-lamivudine-zidovudine 5 NM (generic of TRIZIVIR) ATRIPLA 5 NM BIKTARVY 5 NM CIMDUO 5 NM COMPLERA 5 NM DELSTRIGO 5 NM DESCOVY 5 NM EVOTAZ 5 NM GENVOYA 5 NM JULUCA 5 NM KALETRA TAB 100-5MG NM KALETRA TAB 00-50MG 5 NM lamivudine-zidovudine (generic of NM COMBIVIR) lopinavir-ritonavir (generic of KALETRA) NM ODEFSEY 5 NM PREZCOBIX 5 NM STRIBILD 5 NM SYMFI 5 NM SYMFI LO 5 NM SYMTUZA 5 NM TRIUMEQ 5 NM TRUVADA TAB QL (60 tabs / 0 days), NM TRUVADA TAB QL (0 tabs / 0 days), NM TRUVADA TAB QL (0 tabs / 0 days), NM TRUVADA TAB QL (0 tabs / 0 days), NM ANTITUBERCULAR AGENTS cycloserine CAPS 5 ethambutol hcl (generic of MYAMBUTOL) TABS isoniazid TABS 1 isoniazid syp 50mg/5ml PASER D/R PRIFTIN pyrazinamide TABS 9

18 rifabutin (generic of MYCOBUTIN) rifampin (generic of RIFADIN) CAPS rifampin (generic of RIFADIN) SOLR RIFATER SIRTURO 5 LA, PA TRECATOR ANTIVIRALS acyclovir (generic of ZOVIRAX) CAPS; TABS acyclovir (generic of ZOVIRAX) SUSP acyclovir sodium B/D adefovir dipivoxil (generic of HEPSERA) 5 NM BARACLUDE SOLN 5 NM entecavir (generic of BARACLUDE) 5 NM EPCLUSA 5 NM, PA EPIVIR HBV SOLN NM famciclovir ganciclovir sodium (generic of CYTOVENE) B/D HARVONI 5 NM, PA lamivudine (hbv) (generic of EPIVIR HBV) NM MAVYRET 5 NM, PA oseltamivir phosphate (generic of QL (168 caps / year) TAMIFLU) CAPS 0mg oseltamivir phosphate (generic of QL (8 caps / year) TAMIFLU) CAPS 5mg, 75mg oseltamivir phosphate (generic of QL (1080 ml / year) TAMIFLU) SUSR PEGASYS 5 NM, PA PEGASYS PROCLICK 5 NM, PA REBETOL SOLN 5 NM RELENZA DISKHALER QL (6 inhalers / year) ribasphere CAPS NM ribasphere TABS 00mg NM RIBASPHERE TABS 00mg 5 NM ribasphere TABS 600mg 5 NM ribavirin cap 00mg NM ribavirin tab 00mg NM rimantadine hydrochloride (generic of FLUMADINE) valacyclovir hcl (generic of VALTREX) TABS valganciclovir hcl (generic of VALCYTE) 5 VEMLIDY 5 NM VOSEVI 5 NM, PA 10

19 ZEPATIER 5 NM, PA CEPHALOSPORINS cefaclor CAPS cefaclor SUSR CEFACLOR ER TAB 500MG cefadroxil CAPS cefadroxil SUSR cefadroxil TABS CEFAZOLIN IN DEXTROSE GM/100ML-% cefazolin inj cefazolin sodium SOLR 1gm, 0gm CEFAZOLIN SODIUM 1 GM/50ML cefdinir CAPS cefdinir SUSR cefepime for inj (generic of MAXIPIME) cefixime (generic of SUPRAX) cefotaxime sodium cefoxitin for inj cefpodoxime proxetil SUSR cefpodoxime proxetil TABS cefprozil ceftazidime SOLR CEFTAZIDIME/DEXTROSE ceftriaxone sodium SOLR 1gm, gm, 10gm, 50mg, 500mg cefuroxime axetil cefuroxime sodium cephalexin (generic of KEFLEX) CAPS 1 50mg, 500mg cephalexin SUSR SUPRAX CAPS SUPRAX CHEW SUPRAX SUSR 500mg/5ml tazicef SOLR TEFLARO 5 ERYTHROMYCINS/MACROLIDES azithromycin PACK azithromycin (generic of ZITHROMAX) SOLR; SUSR azithromycin (generic of ZITHROMAX) 1 TABS clarithromycin TABS clarithromycin er (generic of BIAXIN XL) clarithromycin for susp 11

20 DIFICID 5 e.e.s. 00 ery-tab ERYTHROCIN LACTOBIONATE erythrocin stearate erythromycin base erythromycin cap 50mg ec erythromycin ethylsuccinate TABS FLUOROQUINOLONES ciprofloxacin SUSR 50mg/5ml ciprofloxacin (generic of CIPRO) SUSR 500mg/5ml ciprofloxacin hcl tab 100mg ciprofloxacin hcl tab (generic of CIPRO) 1 50mg, 500mg ciprofloxacin hcl tab 750mg 1 ciprofloxacin in d5w levofloxacin (generic of LEVAQUIN) TABS 1 levofloxacin in d5w levofloxacin inj 5mg/ml levofloxacin oral soln 5 mg/ml PENICILLINS amoxicillin CAPS; SUSR; TABS 1 amoxicillin CHEW amoxicillin & pot clavulanate CHEW amoxicillin & pot clavulanate SUSR amoxicillin & pot clavulanate (generic of AUGMENTIN) SUSR amoxicillin & pot clavulanate TABS amoxicillin & pot clavulanate (generic of AUGMENTIN) TABS amoxicillin & pot clavulanate (generic of AUGMENTIN XR) TB1 ampicillin & sulbactam sodium ampicillin & sulbactam sodium (generic of UNASYN) ampicillin & sulbactam sodium (generic of UNASYN BULK PACK) ampicillin cap 500mg ampicillin inj ampicillin sodium BICILLIN L-A dicloxacillin sodium nafcillin sodium for inj 1gm, gm 1

21 nafcillin sodium for inj 10gm 5 NAFCILLIN SODIUM FOR INJ 10GM oxacillin sodium 1gm, gm oxacillin sodium 10gm 5 PENICILLIN G POT IN DEXTROSE MU PENICILLIN G POT IN DEXTROSE MU PENICILLIN G PROCAINE penicillin g sodium penicillin v potassium SOLR penicillin v potassium TABS 1 penicilln gk inj 5mu penicilln gk inj 0mu pfizerpen-g inj 5mu pfizerpen-g inj 0mu piper/tazoba inj -0.5gm (generic of ZOSYN) piper/tazoba inj -0.75gm (generic of ZOSYN) piper/tazoba inj -0.5gm (generic of ZOSYN) PIPER/TAZOBA INJ 1-1.5GM piper/tazoba inj 6-.5gm (generic of ZOSYN) TETRACYCLINES doxy 100 doxycycline (monohydrate) CAPS 50mg, 100mg doxycycline (monohydrate) TABS doxycycline hyclate CAPS 50mg doxycycline hyclate (generic of VIBRAMYCIN) CAPS 100mg doxycycline hyclate SOLR doxycycline hyclate 0 mg doxycycline hyclate 100 mg minocycline hcl (generic of MINOCIN) CAPS 50mg, 100mg minocycline hcl CAPS 75mg mondoxyne nl cap 100mg morgidox cap 1x50mg tetracycline hcl CAPS ANTINEOPLASTIC AGENTS ALKYLATING AGENTS BENDEKA 5 B/D, NM 1

22 cyclophosphamide (generic of B/D CYCLOPHOSPHAMIDE) CAPS cyclophosphamide SOLR 5 B/D dacarbazine 100mg B/D EMCYT GLEOSTINE IFEX INJ GM B/D ifosfamide inj 1gm/0ml B/D IFOSFAMIDE INJ GM B/D ifosfamide inj gm/60ml B/D LEUKERAN 5 ANTHRACYCLINES adriamycin B/D doxorubicin hcl B/D doxorubicin hcl liposomal (generic of 5 B/D DOXIL) epirubicin hcl (generic of ELLENCE) B/D ANTIBIOTICS bleomycin sulfate B/D mitomycin SOLR 5 B/D ANTIMETABOLITES adrucil B/D adrucil inj B/D ALIMTA 5 B/D azacitidine (generic of VIDAZA) 5 B/D, NM cytarabine 0mg/ml B/D fluorouracil SOLN B/D gemcitabine inj soln B/D gemcitabine inj solr B/D mercaptopurine TABS methotrexate sodium inj B/D PURIXAN 5 NM TABLOID ANTIMITOTIC, TAXOIDS ABRAXANE 5 B/D docetaxel (generic of TAXOTERE) CONC 5 B/D 0mg/ml, 80mg/ml DOCETAXEL CONC 80mg/ml, 160mg/8ml, 00mg/10ml 5 B/D DOCETAXEL SOLN 0mg/ml, 80mg/8ml, 5 B/D 160mg/16ml docetaxel (generic of DOCETAXEL) SOLN 5 B/D 0mg/ml, 80mg/8ml, 160mg/16ml paclitaxel B/D 1

23 TAXOTERE 80mg/ml 5 B/D ANTIMITOTIC, VINCA ALKALOIDS vinblastine sulfate B/D vincasar pfs B/D vincristine sulfate B/D vinorelbine tartrate (generic of B/D NAVELBINE) BIOLOGIC RESPONSE MODIFIERS AVASTIN 5 NM, LA, PA BORTEZOMIB 5 NM, PA DAURISMO 5 NM, LA, PA ERIVEDGE 5 NM, LA, PA FARYDAK 5 NM, LA, PA HERCEPTIN 5 NM, PA IBRANCE 5 NM, LA, PA IDHIFA 5 NM, LA, PA KADCYLA 5 B/D, NM KEYTRUDA 5 NM, PA KISQALI 5 NM, PA KISQALI FEMARA 00 DOSE 5 NM, PA KISQALI FEMARA 00 DOSE 5 NM, PA KISQALI FEMARA 600 DOSE 5 NM, PA LYNPARZA 5 NM, LA, PA MYLOTARG 5 NM, LA, PA NINLARO 5 NM, PA ODOMZO 5 NM, LA, PA RITUXAN 5 NM, LA, PA RITUXAN HYCELA 5 NM, LA, PA RUBRACA 5 NM, LA, PA TALZENNA 5 NM, LA, PA TECENTRIQ 100mg/0ml 5 NM, LA, PA TIBSOVO 5 NM, LA, PA VELCADE 5 NM, PA VENCLEXTA 10mg, 50mg NM, LA, PA VENCLEXTA 100mg 5 NM, LA, PA VENCLEXTA STARTING PACK 5 NM, LA, PA VERZENIO 5 NM, LA, PA ZEJULA 5 NM, LA, PA ZOLINZA 5 NM, PA HORMONAL ANTINEOPLASTIC AGENTS abiraterone acetate (generic of ZYTIGA) 5 NM, PA anastrozole (generic of ARIMIDEX) TABS bicalutamide (generic of CASODEX) 15

24 DEPO-PROVERA INJ 00/ML B/D ERLEADA 5 NM, LA, PA exemestane (generic of AROMASIN) FARESTON 5 FASLODEX 5 B/D flutamide letrozole (generic of FEMARA) TABS leuprolide inj 1mg/0. NM, PA LUPRON DEPOT (1-MONTH).75mg 5 NM, PA LUPRON DEPOT INJ 11.5MG (-MONTH) 5 NM, PA LYSODREN megestrol ac sus 0mg/ml megestrol ac tab 0mg megestrol ac tab 0mg megestrol sus 65mg/5ml (generic of PA MEGACE ES) nilutamide (generic of NILANDRON) 5 SOLTAMOX 5 tamoxifen citrate TABS 1 toremifene citrate (generic of FARESTON) 5 TRELSTAR DEP INJ.75MG 5 NM, PA TRELSTAR LA INJ 11.5MG 5 NM, PA XTANDI 5 NM, LA, PA ZYTIGA 5 NM, LA, PA IMMUNOMODULATORS POMALYST 5 NM, LA, PA REVLIMID 5 QL (8 caps / 8 days), NM, LA, PA THALOMID 50mg, 100mg 5 QL (0 caps / 0 days), NM, PA THALOMID 150mg, 00mg 5 QL (60 caps / 0 days), NM, PA KINASE INHIBITORS AFINITOR 5 QL (0 tabs / 0 days), NM, PA AFINITOR DISPERZ mg 5 QL (150 tabs / 0 days), NM, PA AFINITOR DISPERZ mg 5 QL (90 tabs / 0 days), NM, PA AFINITOR DISPERZ 5mg 5 QL (60 tabs / 0 days), NM, PA ALECENSA 5 NM, LA, PA ALUNBRIG 5 NM, LA, PA BOSULIF 5 NM, PA 16

25 BRAFTOVI 5 NM, LA, PA CABOMETYX 5 QL (0 tabs / 0 days), NM, LA, PA CALQUENCE 5 NM, LA, PA CAPRELSA 5 NM, LA, PA COMETRIQ 5 NM, LA, PA COPIKTRA 5 NM, LA, PA COTELLIC 5 NM, LA, PA GILOTRIF TAB 0MG 5 NM, LA, PA GILOTRIF TAB 0MG 5 NM, LA, PA GILOTRIF TAB 0MG 5 NM, LA, PA ICLUSIG 5 NM, LA, PA imatinib mesylate (generic of GLEEVEC) 100mg 5 QL (90 tabs / 0 days), NM, PA imatinib mesylate (generic of GLEEVEC) 00mg 5 QL (60 tabs / 0 days), NM, PA IMBRUVICA 5 NM, LA, PA INLYTA 1mg 5 QL (180 tabs / 0 days), NM, LA, PA INLYTA 5mg 5 QL (10 tabs / 0 days), NM, LA, PA IRESSA 5 NM, LA, PA JAKAFI 5 QL (60 tabs / 0 days), NM, LA, PA LENVIMA MG DAILY DOSE 5 NM, LA, PA LENVIMA 8 MG DAILY DOSE 5 NM, LA, PA LENVIMA 10 MG DAILY DOSE 5 NM, LA, PA LENVIMA 1MG DAILY DOSE 5 NM, LA, PA LENVIMA 1 MG DAILY DOSE 5 NM, LA, PA LENVIMA 18 MG DAILY DOSE 5 NM, LA, PA LENVIMA 0 MG DAILY DOSE 5 NM, LA, PA LENVIMA MG DAILY DOSE 5 NM, LA, PA LORBRENA 5 NM, LA, PA MEKINIST 5 NM, LA, PA MEKTOVI 5 NM, LA, PA NERLYNX 5 NM, LA, PA NEXAVAR 5 NM, LA, PA RYDAPT 5 NM, PA SPRYCEL 5 NM, PA STIVARGA 5 NM, LA, PA SUTENT 5 NM, PA TAFINLAR 5 NM, LA, PA TAGRISSO 5 NM, LA, PA 17

26 TARCEVA 5mg 5 QL (90 tabs / 0 days), NM, LA, PA TARCEVA 100mg, 150mg 5 QL (0 tabs / 0 days), NM, LA, PA TASIGNA 5 NM, PA TYKERB 5 NM, LA, PA VITRAKVI 5 NM, LA, PA VIZIMPRO 5 NM, LA, PA VOTRIENT 5 NM, LA, PA XALKORI 5 NM, LA, PA XOSPATA 5 NM, LA, PA ZELBORAF 5 NM, LA, PA ZYDELIG 5 NM, LA, PA ZYKADIA 5 NM, LA, PA MISCELLANEOUS bexarotene (generic of TARGRETIN) 5 NM, PA hydroxyurea (generic of HYDREA) CAPS LONSURF 5 NM, PA MATULANE 5 LA SYLATRON KIT 00MCG 5 NM, PA SYLATRON KIT 00MCG 5 NM, PA SYLATRON KIT 600MCG 5 NM, PA SYNRIBO 5 NM, PA tretinoin (chemotherapy) 5 PLATINUM-BASED AGENTS carboplatin B/D cisplatin B/D oxaliplatin inj 50mg 5 B/D oxaliplatin inj 50mg/10ml B/D oxaliplatin inj 100mg 5 B/D oxaliplatin inj 100mg/0ml B/D PROTECTIVE AGENTS dexrazoxane (generic of ZINECARD) 5 B/D 500mg leucovorin calcium SOLR B/D leucovorin calcium TABS MESNEX TABS 5 TOPOISOMERASE INHIBITORS etoposide SOLN B/D irinotecan hcl (generic of CAMPTOSAR) B/D 0mg/ml, 100mg/5ml irinotecan hcl 500mg/5ml B/D toposar B/D 18

27 topotecan hcl (generic of TOPOTECAN HCL) 5 B/D SOLN topotecan hcl (generic of HYCAMTIN) 5 B/D SOLR TOPOTECAN INJ MG/ML 5 B/D CARDIOVASCULAR ACE INHIBITOR COMBINATIONS amlodipine besylate-benazepril hcl cap mg amlodipine besylate-benazepril hcl cap mg (generic of LOTREL) amlodipine besylate-benazepril hcl cap mg (generic of LOTREL) amlodipine besylate-benazepril hcl cap mg amlodipine besylate-benazepril hcl cap mg (generic of LOTREL) amlodipine besylate-benazepril hcl cap mg (generic of LOTREL) benazepril & hydrochlorothiazide 1 benazepril & hydrochlorothiazide (generic 1 of LOTENSIN HCT) captopril & hydrochlorothiazide 1 enalapril maleate & hydrochlorothiazide 1 enalapril maleate & hydrochlorothiazide 1 (generic of VASERETIC) fosinopril sodium & hydrochlorothiazide 1 lisinopril & hydrochlorothiazide (generic of 1 ZESTORETIC) moexipril-hydrochlorothiazide 1 quinapril-hydrochlorothiazide (generic of 1 ACCURETIC) ACE INHIBITORS benazepril hcl TABS 5mg 1 benazepril hcl (generic of LOTENSIN) 1 TABS 10mg, 0mg, 0mg captopril TABS 1 enalapril maleate (generic of VASOTEC) 1 TABS fosinopril sodium 1 lisinopril (generic of ZESTRIL) TABS 1.5mg, 0mg, 0mg lisinopril (generic of PRINIVIL) TABS 5mg, 1 10mg, 0mg moexipril hcl 1 19

28 perindopril erbumine 1 quinapril hcl (generic of ACCUPRIL) 1 ramipril (generic of ALTACE) 1 trandolapril 1mg, mg 1 trandolapril (generic of MAVIK) mg 1 ALDOSTERONE RECEPTOR ANTAGONISTS eplerenone (generic of INSPRA) spironolactone (generic of ALDACTONE) 1 TABS ALPHA BLOCKERS doxazosin mesylate (generic of CARDURA) TABS prazosin hcl (generic of MINIPRESS) terazosin hcl 1 ANGIOTENSIN II RECEPTOR ANTAGONIST COMBINATIONS amlodipine besylate-olmesartan medoxomil 1 (generic of AZOR) amlodipine besylate-valsartan tab (generic 1 of EXFORGE) amlodipine-valsartan-hydrochlorothiazide 1 tab (generic of EXFORGE HCT) ENTRESTO irbesartan-hydrochlorothiazide (generic of 1 AVALIDE) losartan-hydrochlorothiazide (generic of 1 HYZAAR) olmesartan medoxomil-amlodipinehydrochlorothiazide (generic of 1 TRIBENZOR) olmesartan medoxomil-hydrochlorothiazide 1 (generic of BENICAR HCT) valsartan-hydrochlorothiazide (generic of 1 DIOVAN HCT) ANGIOTENSIN II RECEPTOR ANTAGONISTS irbesartan (generic of AVAPRO) 1 losartan potassium (generic of COZAAR) 1 olmesartan medoxomil (generic of 1 BENICAR) TABS telmisartan (generic of MICARDIS) 1 valsartan (generic of DIOVAN) 1 ANTIARRHYTHMICS amiodarone hcl soln amiodarone tab 100mg amiodarone tab 00mg 1 0

29 amiodarone tab 00mg disopyramide phosphate (generic of NORPACE) dofetilide (generic of TIKOSYN) NM flecainide acetate mexiletine hcl MULTAQ NORPACE CR pacerone 100mg, 00mg pacerone 00mg 1 propafenone hcl propafenone hcl 1hr (generic of RYTHMOL SR) quinidine gluconate quinidine sulfate sorine (generic of BETAPACE) 80mg, 10mg, 160mg sorine 0mg sotalol hcl (generic of BETAPACE) 80mg, 10mg, 160mg sotalol hcl 0mg sotalol hcl (afib/afl) (generic of BETAPACE AF) 80mg, 10mg, 160mg sotalol hcl (afib/afl) 10mg ANTILIPEMICS, HMG-CoA REDUCTASE INHIBITORS atorvastatin calcium (generic of LIPITOR) 1 TABS lovastatin 1 pravastatin sodium 10mg 1 pravastatin sodium (generic of 1 PRAVACHOL) 0mg, 0mg, 80mg rosuvastatin calcium (generic of CRESTOR) 1 QL (0 tabs / 0 days) simvastatin (generic of ZOCOR) TABS 1 5mg, 10mg, 0mg, 0mg simvastatin (generic of ZOCOR) TABS 1 QL (0 tabs / 0 days) 80mg ANTILIPEMICS, MISCELLANEOUS cholestyramine (generic of QUESTRAN) cholestyramine light PACK cholestyramine light (generic of QUESTRAN LIGHT) POWD colesevelam hcl (generic of WELCHOL) colestipol hcl gran (generic of COLESTID) colestipol hcl pack (generic of COLESTID) 1

30 colestipol hcl tabs (generic of COLESTID) ezetimibe (generic of ZETIA) fenofibrate (generic of TRICOR) TABS 8mg, 15mg fenofibrate TABS 5mg, 160mg fenofibrate micronized 67mg, 1mg, 00mg gemfibrozil (generic of LOPID) TABS JUXTAPID 5 NM, LA, PA KYNAMRO 5 PA niacin er (antihyperlipidemic) (generic of QL (90 tabs / 0 days) NIASPAN) 500mg niacin er (antihyperlipidemic) (generic of NIASPAN) 750mg, 1000mg niacor PRALUENT 5 PA prevalite PACK prevalite (generic of QUESTRAN LIGHT) POWD VASCEPA WELCHOL PAK BETA-BLOCKER/DIURETIC COMBINATIONS atenolol & chlorthalidone (generic of TENORETIC 50) atenolol & chlorthalidone (generic of TENORETIC 100) bisoprolol & hydrochlorothiazide (generic of 1 ZIAC) metoprolol & hydrochlorothiazide metoprolol & hydrochlorothiazide (generic of LOPRESSOR HCT) propranolol & hydrochlorothiazide BETA-BLOCKERS acebutolol hcl CAPS atenolol (generic of TENORMIN) TABS 1 bisoprolol fumarate BYSTOLIC.5mg, 5mg, 10mg QL (0 tabs / 0 days) BYSTOLIC 0mg QL (60 tabs / 0 days) carvedilol (generic of COREG) 1 labetalol hcl TABS metoprolol succinate (generic of TOPROL XL) metoprolol tartrate SOCT metoprolol tartrate SOLN

31 metoprolol tartrate TABS 5mg 1 metoprolol tartrate (generic of 1 LOPRESSOR) TABS 50mg, 100mg nadolol (generic of CORGARD) TABS pindolol propranolol cap er (generic of INDERAL LA) propranolol hcl TABS propranolol oral sol timolol maleate TABS CALCIUM CHANNEL BLOCKERS amlodipine besylate (generic of NORVASC) 1 TABS cartia xt (generic of CARDIZEM CD) dilt-xr cap diltiazem cap 10mg cd (generic of CARDIZEM CD) diltiazem cap 180mg cd (generic of CARDIZEM CD) diltiazem cap 0mg cd (generic of CARDIZEM CD) diltiazem cap 60mg cd (generic of CARDIZEM CD) diltiazem cap er/1hr diltiazem hcl (generic of CARDIZEM) TABS 0mg, 60mg, 10mg diltiazem hcl TABS 90mg diltiazem hcl cap sr hr diltiazem hcl coated beads cap sr hr (generic of CARDIZEM CD) diltiazem hcl extended release beads cap sr (generic of TIAZAC) 10mg, 180mg, 0mg, 00mg, 60mg, 0mg diltiazem hcl extended release beads cap sr (generic of CARDIZEM CD) 180mg diltiazem inj felodipine isradipine nicardipine hcl CAPS nifedipine (generic of PROCARDIA XL) TB nifedipine er (generic of ADALAT CC) nimodipine CAPS 5 NYMALIZE 5 taztia xt (generic of TIAZAC)

32 verapamil cap er (generic of VERELAN PM) 100mg, 00mg, 00mg verapamil cap er (generic of VERELAN) 10mg, 180mg, 0mg verapamil cap er 60mg verapamil hcl SOLN verapamil hcl TABS 0mg, 80mg 1 verapamil hcl (generic of CALAN) TABS 1 10mg verapamil hcl (generic of CALAN SR) TBCR verapamil tab er 180mg verapamil tab er (generic of CALAN SR) 0mg DIGITALIS GLYCOSIDES digitek (generic of LANOXIN).5mg PA; PA if 70 years and older digitek (generic of LANOXIN).15mg QL (0 tabs / 0 days) digox (generic of LANOXIN) 15mcg QL (0 tabs / 0 days) digox (generic of LANOXIN) 50mcg PA; PA if 70 years and older digoxin (generic of LANOXIN) TABS QL (0 tabs / 0 days) 15mcg digoxin (generic of LANOXIN) TABS 50mcg PA; PA if 70 years and older digoxin inj (generic of LANOXIN) digoxin sol 50mcg/ml PA; PA if 70 years and older DIRECT RENIN INHIBITORS/COMBINATIONS TEKTURNA TEKTURNA HCT DIURETICS acetazolamide CP1 acetazolamide TABS amiloride & hydrochlorothiazide amiloride hcl TABS bumetanide inj 0.5/ml bumetanide tab (generic of BUMEX) chlorothiazide tabs chlorthalidone furosemide SOLN furosemide (generic of LASIX) TABS 1 furosemide inj hydrochlorothiazide CAPS; TABS 1

33 indapamide methazolamide TABS methyclothiazide metolazone spironolactone & hydrochlorothiazide (generic of ALDACTAZIDE) torsemide tabs 5mg, 0mg, 100mg torsemide tabs (generic of DEMADEX) 10mg triamterene & hydrochlorothiazide cap mg (generic of DYAZIDE) triamterene & hydrochlorothiazide tabs 1 (generic of MAXZIDE) triamterene & hydrochlorothiazide tabs 1 (generic of MAXZIDE-5) MISCELLANEOUS clonidine hcl (generic of CATAPRES) TABS 1 clonidine hcl ptwk (generic of CATAPRES- TTS-1).1mg/hr clonidine hcl ptwk (generic of CATAPRES- TTS-).mg/hr clonidine hcl ptwk (generic of CATAPRES- TTS-).mg/hr CORLANOR DEMSER 5 PA hydralazine hcl SOLN hydralazine hcl TABS midodrine hcl minoxidil TABS NORTHERA 5 NM, LA, PA RANEXA NITRATES isosorb mononitrate tab isosorbide dinitrate (generic of ISORDIL TITRADOSE) 5mg isosorbide dinitrate 10mg, 0mg, 0mg isosorbide dinitrate er isosorbide mononitrate er minitran (generic of NITRO-DUR) NITRO-BID NITRO-DUR DIS 0.MG/HR NITRO-DUR DIS 0.8MG/HR nitroglycerin (generic of NITROSTAT) SUBL 5

34 nitroglycerin td patch.1mg/hr nitroglycerin td patch (generic of NITRO- DUR).mg/hr,.mg/hr,.6mg/hr PULMONARY ARTERIAL HYPERTENSION ADEMPAS 5 QL (90 tabs / 0 days), NM, LA, PA LETAIRIS 5 QL (0 tabs / 0 days), NM, LA, PA OPSUMIT 5 QL (0 tabs / 0 days), NM, LA, PA REMODULIN 5 NM, LA, PA sildenafil citrate tab 0 mg (pulmonary hypertension) (generic of REVATIO) QL (90 tabs / 0 days), NM, PA TRACLEER TABS 6.5mg 5 QL (10 tabs / 0 days), NM, LA, PA TRACLEER TABS 15mg 5 QL (60 tabs / 0 days), NM, LA, PA VENTAVIS 5 NM, PA CENTRAL NERVOUS SYSTEM ANTIANXIETY alprazolam tab 0.5mg (generic of XANAX) QL (150 tabs / 0 days) alprazolam tab 0.5mg (generic of XANAX) QL (150 tabs / 0 days) alprazolam tab 1mg (generic of XANAX) QL (150 tabs / 0 days) alprazolam tab mg (generic of XANAX) QL (150 tabs / 0 days) buspirone hcl TABS 5mg, 7.5mg, 10mg, 15mg buspirone hcl TABS 0mg fluvoxamine maleate TABS lorazepam (generic of ATIVAN) SOLN lorazepam (generic of ATIVAN) TABS QL (150 tabs / 0 days) lorazepam intensol QL (150 ml / 0 days) ANTICONVULSANTS APTIOM 00mg 5 QL (180 tabs / 0 days) APTIOM 00mg 5 QL (90 tabs / 0 days) APTIOM 600mg, 800mg 5 QL (60 tabs / 0 days) BANZEL SUS 0MG/ML 5 PA BANZEL TAB 00MG 5 PA BANZEL TAB 00MG 5 PA BRIVIACT INJ 50MG/5ML PA BRIVIACT SOL 10MG/ML 5 PA BRIVIACT TAB 10MG 5 PA BRIVIACT TAB 5MG 5 PA BRIVIACT TAB 50MG 5 PA BRIVIACT TAB 75MG 5 PA 6

35 BRIVIACT TAB 100MG 5 PA carbamazepine CHEW carbamazepine (generic of CARBATROL) CP1 carbamazepine (generic of TEGRETOL) SUSP carbamazepine (generic of TEGRETOL) TABS carbamazepine (generic of TEGRETOL-XR) TB1 CELONTIN clobazam (generic of ONFI) PA clonazepam (generic of KLONOPIN) TABS QL (00 tabs / 0 days) mg clonazepam (generic of KLONOPIN) QL (90 tabs / 0 days) TABS.5mg, 1mg clonazepam TBDP mg QL (00 tabs / 0 days) clonazepam TBDP.15mg,.5mg,.5mg, QL (90 tabs / 0 days) 1mg clorazepate dipotassium QL (180 tabs / 0 days), PA; PA if 65 years and older DIASTAT ACUDIAL DIASTAT PEDIATRIC diazepam (generic of VALIUM) TABS QL (10 tabs / 0 days), PA; PA if 65 years and older diazepam gel diazepam inj diazepam intensol QL (0 ml / 0 days), PA; PA if 65 years and older diazepam oral soln 1 mg/ml QL (100 ml / 0 days), PA; PA if 65 years and older DILANTIN CAP 0MG DILANTIN CAP 100MG DILANTIN CHEW TAB 50MG DILANTIN-15 SUSP divalproex sodium (generic of DEPAKOTE SPRINKLES) CSDR divalproex sodium (generic of DEPAKOTE ER) TB divalproex sodium (generic of DEPAKOTE) TBEC 7

36 EPIDIOLEX 5 QL (600 ml / 0 days), NM, LA, PA epitol (generic of TEGRETOL) ethosuximide (generic of ZARONTIN) CAPS; SOLN felbamate (generic of FELBATOL) SUSP 5 felbamate (generic of FELBATOL) TABS FYCOMPA SUSP 5 QL (70 ml / 0 days), PA FYCOMPA TABS mg QL (60 tabs / 0 days), PA FYCOMPA TABS mg, 6mg 5 QL (60 tabs / 0 days), PA FYCOMPA TABS 8mg, 10mg, 1mg 5 QL (0 tabs / 0 days), PA gabapentin (generic of NEURONTIN) CAPS 100mg QL (1080 caps / 0 days) gabapentin (generic of NEURONTIN) QL (60 caps / 0 days) CAPS 00mg gabapentin (generic of NEURONTIN) QL (70 caps / 0 days) CAPS 00mg gabapentin (generic of NEURONTIN) QL (160 ml / 0 days) SOLN gabapentin (generic of NEURONTIN) QL (180 tabs / 0 days) TABS 600mg gabapentin (generic of NEURONTIN) QL (10 tabs / 0 days) TABS 800mg lamotrigine (generic of LAMICTAL CHEWABLE DISPERS) CHEW lamotrigine (generic of LAMICTAL) TABS lamotrigine (generic of LAMICTAL XR) TB levetiracetam (generic of KEPPRA) SOLN levetiracetam (generic of KEPPRA) TABS levetiracetam (generic of KEPPRA XR) TB levetiracetam in sodium chloride (generic of LEVETIRACETAM) levetiracetam oral soln 100 mg/ml (generic of KEPPRA) LYRICA CAPS 5mg, 50mg, 75mg, QL (10 caps / 0 days) 100mg, 150mg LYRICA CAPS 00mg QL (90 caps / 0 days) LYRICA CAPS 5mg, 00mg QL (60 caps / 0 days) LYRICA SOLN QL (96 ml / 0 days) ONFI 5 PA 8

37 oxcarbazepine (generic of TRILEPTAL) SUSP oxcarbazepine (generic of TRILEPTAL) TABS PEGANONE phenobarbital ELIX PA; PA if 70 years and older phenobarbital TABS PA; PA if 70 years and older PHENOBARBITAL SODIUM SOLN 65mg/ml PA; PA if 70 years and older phenobarbital sodium SOLN 10mg/ml PA; PA if 70 years and older PHENYTEK phenytoin (generic of DILANTIN INFATABS) CHEW phenytoin (generic of DILANTIN-15) SUSP phenytoin sodium extended (generic of DILANTIN) 100mg phenytoin sodium extended (generic of PHENYTEK) 00mg, 00mg phenytoin sodium inj 50mg/ml primidone (generic of MYSOLINE) TABS roweepra (generic of KEPPRA) roweepra xr (generic of KEPPRA XR) SABRIL TABS 5 QL (180 tabs / 0 days), NM, LA, PA SPRITAM subvenite tab (generic of LAMICTAL) SYMPAZAN 5mg PA SYMPAZAN 10mg, 0mg 5 PA tiagabine hcl (generic of GABITRIL) topiramate (generic of TOPAMAX SPRINKLE) CPSP topiramate (generic of TOPAMAX) TABS valproate sodium (generic of DEPACON) SOLN valproate sodium oral soln (generic of DEPAKENE) valproic acid (generic of DEPAKENE) CAPS vigabatrin powd pack 500mg (generic of SABRIL) 5 QL (180 packets / 0 days), NM, LA, PA vigabatrin tab 500mg (generic of SABRIL) 5 QL (180 tabs / 0 days), NM, LA, PA 9

38 VIMPAT 50mg QL (10 tabs / 0 days) VIMPAT 100mg, 150mg, 00mg 5 QL (60 tabs / 0 days) VIMPAT INJ 00MG/0ML 5 VIMPAT SOL 10MG/ML 5 QL (100 ml / 0 days) zonisamide (generic of ZONEGRAN) CAPS 5mg, 100mg zonisamide CAPS 50mg ANTIDEMENTIA donepezil hydrochloride (generic of QL (0 tabs / 0 days) ARICEPT) TABS 5mg donepezil hydrochloride (generic of ARICEPT) TABS 10mg donepezil hydrochloride TBDP 5mg QL (0 tabs / 0 days) donepezil hydrochloride TBDP 10mg galantamine hydrobromide SOLN galantamine hydrobromide (generic of QL (60 tabs / 0 days) RAZADYNE) TABS galantamine hydrobromide er (generic of RAZADYNE ER) QL (0 caps / 0 days) memantine hcl cp (generic of NAMENDA PA; PA if < 0 yrs XR) memantine soln PA; PA if < 0 yrs memantine tabs (generic of NAMENDA) PA; PA if < 0 yrs NAMZARIC rivastigmine tartrate 1.5mg, mg QL (90 caps / 0 days) rivastigmine tartrate.5mg, 6mg QL (60 caps / 0 days) rivastigmine td patch hr.6 mg/hr (generic of EXELON) QL (0 patches / 0 days) rivastigmine td patch hr 9.5 mg/hr (generic of EXELON) QL (0 patches / 0 days) rivastigmine td patch hr 1. mg/hr (generic of EXELON) ANTIDEPRESSANTS amitriptyline hcl TABS amoxapine bupropion hcl TABS bupropion hcl (generic of WELLBUTRIN SR) TB1 bupropion hcl (generic of WELLBUTRIN XL) TB 150mg, 00mg citalopram hydrobromide SOLN citalopram hydrobromide (generic of 1 CELEXA) TABS clomipramine hcl (generic of ANAFRANIL) CAPS PA QL (0 patches / 0 days) 0

39 desipramine hcl (generic of NORPRAMIN) TABS 10mg, 5mg desipramine hcl TABS 50mg, 75mg, 100mg, 150mg desvenlafaxine succinate (generic of PRISTIQ) QL (0 tabs / 0 days), PA doxepin hcl CAPS; CONC duloxetine hcl (generic of CYMBALTA) QL (180 caps / 0 days) CPEP 0mg duloxetine hcl (generic of CYMBALTA) QL (10 caps / 0 days) CPEP 0mg duloxetine hcl (generic of CYMBALTA) QL (60 caps / 0 days) CPEP 60mg EMSAM 5 QL (0 patches / 0 days), PA escitalopram oxalate SOLN escitalopram oxalate (generic of LEXAPRO) 1 TABS FETZIMA 0mg QL (180 caps / 0 days), PA FETZIMA 0mg QL (90 caps / 0 days), PA FETZIMA 80mg, 10mg QL (0 caps / 0 days), PA FETZIMA TITRATION PACK PA fluoxetine cap 10mg (generic of PROZAC) 1 fluoxetine cap 0mg (generic of PROZAC) 1 fluoxetine cap 0mg (generic of PROZAC) 1 fluoxetine hcl SOLN imipramine hcl (generic of TOFRANIL) TABS maprotiline hcl MARPLAN TAB 10MG QL (180 tabs / 0 days) mirtazapine TABS 7.5mg, 5mg mirtazapine (generic of REMERON) TABS 15mg, 0mg mirtazapine (generic of REMERON SOLTAB) TBDP nefazodone hcl nortriptyline hcl (generic of PAMELOR) CAPS nortriptyline hcl SOLN paroxetine hcl tabs (generic of PAXIL) PAXIL SUSP QL (900 ml / 0 days) 1

40 phenelzine sulfate (generic of NARDIL) TABS protriptyline hcl sertraline hcl CONC sertraline hcl (generic of ZOLOFT) TABS 1 tranylcypromine sulfate (generic of PARNATE) trazodone hcl TABS 50mg, 100mg, 1 150mg trimipramine maleate (generic of QL (0 caps / 0 days) SURMONTIL) CAPS 5mg trimipramine maleate (generic of QL (10 caps / 0 days) SURMONTIL) CAPS 50mg trimipramine maleate (generic of QL (60 caps / 0 days) SURMONTIL) CAPS 100mg TRINTELLIX 5mg QL (10 tabs / 0 days) TRINTELLIX 10mg QL (60 tabs / 0 days) TRINTELLIX 0mg QL (0 tabs / 0 days) venlafaxine hcl (generic of EFFEXOR XR) CP venlafaxine hcl TABS VIIBRYD STARTER PACK VIIBRYD TAB QL (0 tabs / 0 days) ANTIPARKINSONIAN AGENTS amantadine hcl CAPS QL (10 caps / 0 days) amantadine hcl SYRP amantadine hcl TABS APOKYN 5 QL (0 cartridges / 0 days), NM, LA, PA benztropine mesylate inj (generic of COGENTIN) benztropine mesylate tab 0.5mg PA; PA if 70 years and older benztropine mesylate tab 1mg PA; PA if 70 years and older benztropine mesylate tab mg PA; PA if 70 years and older bromocriptine mesylate (generic of PARLODEL) CAPS; TABS carbidopa-levodopa (generic of SINEMET) TABS carbidopa-levodopa (generic of SINEMET CR) TBCR carbidopa-levodopa TBDP

41 carbidopa/levodopa/entacapone (generic of STALEVO 50) carbidopa/levodopa/entacapone (generic of STALEVO 75) carbidopa/levodopa/entacapone (generic of STALEVO 100) carbidopa/levodopa/entacapone (generic of STALEVO 15) carbidopa/levodopa/entacapone (generic of STALEVO 150) carbidopa/levodopa/entacapone (generic of STALEVO 00) entacapone (generic of COMTAN) NEUPRO pramipexole tab 0.5mg (generic of MIRAPEX) pramipexole tab 0.5mg (generic of MIRAPEX) pramipexole tab 0.75mg (generic of MIRAPEX) pramipexole tab 0.15mg (generic of MIRAPEX) pramipexole tab 1.5mg (generic of MIRAPEX) pramipexole tab 1mg (generic of MIRAPEX) rasagiline mesylate (generic of AZILECT) TABS ropinirole tab 0.5mg (generic of REQUIP) ropinirole tab 0.5mg ropinirole tab 1mg ropinirole tab mg ropinirole tab mg ropinirole tab mg ropinirole tab 5mg (generic of REQUIP) selegiline hcl CAPS; TABS trihexyphenidyl hcl PA; PA if 70 years and older ANTIPSYCHOTICS ABILIFY MAINTENA 5 QL (1 injection / 8 days) aripiprazole odt 5 QL (60 tabs / 0 days) aripiprazole oral solution 1 mg/ml 5 QL (900 ml / 0 days) aripiprazole tab (generic of ABILIFY) QL (0 tabs / 0 days) ARISTADA 1mg/1.6ml, 66mg/.ml, 88mg/.ml 5 QL (1 injection / 8 days)

42 ARISTADA 106mg/.9ml 5 QL (1 injection / 56 days) ARISTADA INITIO 5 chlorpromazine hcl TABS CHLORPROMAZINE INJ clozapine odt (generic of FAZACLO) PA 1.5mg, 5mg clozapine odt (generic of FAZACLO) 100mg QL (70 tabs / 0 days), PA clozapine odt (generic of FAZACLO) 150mg QL (180 tabs / 0 days), PA clozapine odt (generic of FAZACLO) 00mg 5 QL (15 tabs / 0 days), PA clozapine tab 5mg (generic of CLOZARIL) clozapine tab 50mg clozapine tab 100mg (generic of QL (70 tabs / 0 days) CLOZARIL) clozapine tab 00mg QL (15 tabs / 0 days) FANAPT QL (60 tabs / 0 days) FANAPT TITRATION PACK fluphenazine decanoate SOLN fluphenazine hcl GEODON SOLR QL (6 ml / days) haloperidol TABS haloperidol conc mg/ml haloperidol decanoate (generic of HALDOL DECANOATE 50) SOLN 50mg/ml haloperidol decanoate (generic of HALDOL DECANOATE 100) SOLN 100mg/ml haloperidol lactate inj 5mg/ml (generic of HALDOL) INVEGA SUST INJ 9 MG/0.5 ML QL (1 injection / 8 days) INVEGA SUST INJ 78 MG/0.5 ML 5 QL (1 injection / 8 days) INVEGA SUST INJ 117 MG/0.75 ML 5 QL (1 injection / 8 days) INVEGA SUST INJ 156MG/ML 5 QL (1 injection / 8 days) INVEGA SUST INJ MG/1.5 ML 5 QL (1 injection / 8 days) INVEGA TRINZA 5 QL (1 injection / 90 days) LATUDA 0mg, 60mg, 80mg QL (60 tabs / 0 days) LATUDA 0mg, 10mg QL (0 tabs / 0 days)

43 loxapine succinate molindone hcl NUPLAZID CAPS 5 QL (0 caps / 0 days), NM, LA, PA NUPLAZID TABS 10MG 5 QL (0 tabs / 0 days), NM, LA, PA NUPLAZID TABS 17MG 5 QL (60 tabs / 0 days), NM, LA, PA olanzapine (generic of ZYPREXA) SOLR QL ( vials / 1 day) olanzapine (generic of ZYPREXA) TABS QL (0 tabs / 0 days).5mg olanzapine (generic of ZYPREXA) TABS QL (10 tabs / 0 days) 5mg olanzapine (generic of ZYPREXA) TABS QL (0 tabs / 0 days) 7.5mg, 15mg, 0mg olanzapine (generic of ZYPREXA) TABS QL (60 tabs / 0 days) 10mg olanzapine (generic of ZYPREXA ZYDIS) QL (0 tabs / 0 days) TBDP 5mg, 15mg, 0mg olanzapine (generic of ZYPREXA ZYDIS) TBDP 10mg QL (60 tabs / 0 days) paliperidone (generic of INVEGA) 1.5mg, 5 QL (0 tabs / 0 days) mg, 9mg paliperidone (generic of INVEGA) 6mg 5 QL (60 tabs / 0 days) perphenazine TABS pimozide quetiapine fumarate (generic of SEROQUEL) TABS quetiapine fumarate (generic of SEROQUEL QL (60 tabs / 0 days) XR) TB 50mg, 00mg, 00mg quetiapine fumarate (generic of SEROQUEL QL (0 tabs / 0 days) XR) TB 150mg, 00mg REXULTI 1mg 5 QL (90 tabs / 0 days) REXULTI mg 5 QL (60 tabs / 0 days) REXULTI mg, mg 5 QL (0 tabs / 0 days) REXULTI.5mg 5 QL (180 tabs / 0 days) REXULTI.5mg 5 QL (60 tabs / 0 days) RISPERDAL INJ 1.5MG QL ( injections / 8 days) RISPERDAL INJ 5MG QL ( injections / 8 days) RISPERDAL INJ 7.5MG 5 QL ( injections / 8 days) RISPERDAL INJ 50MG 5 QL ( injections / 8 days) 5

44 risperidone (generic of RISPERDAL) SOLN QL (0 ml / 0 days) risperidone (generic of RISPERDAL) TABS risperidone TBDP.5mg QL (90 tabs / 0 days) risperidone TBDP.5mg, 1mg, mg, QL (60 tabs / 0 days) mg, mg SAPHRIS.5mg QL (0 tabs / 0 days) SAPHRIS 5mg QL (10 tabs / 0 days) SAPHRIS 10mg QL (60 tabs / 0 days) thioridazine hcl TABS thiothixene trifluoperazine hcl VERSACLOZ 5 QL (600 ml / 0 days), PA VRAYLAR 1.5mg 5 QL (60 caps / 0 days), PA VRAYLAR mg,.5mg, 6mg 5 QL (0 caps / 0 days), PA VRAYLAR THERAPY PACK PA ziprasidone hcl (generic of GEODON) QL (60 caps / 0 days) ZYPREXA RELPREVV 00mg 5 QL ( vials / 8 days), PA ZYPREXA RELPREVV 05mg 5 QL (1 vial / 8 days), PA ZYPREXA RELPREVV INJ 10MG QL ( vials / 8 days), PA ATTENTION DEFICIT HYPERACTIVITY DISORDER amphetamine-dextroamphetamine cap sr QL (90 caps / 0 days) hr 5 mg (generic of ADDERALL XR) amphetamine-dextroamphetamine cap sr QL (90 caps / 0 days) hr 10 mg (generic of ADDERALL XR) amphetamine-dextroamphetamine cap sr QL (0 caps / 0 days) hr 15 mg (generic of ADDERALL XR) amphetamine-dextroamphetamine cap sr QL (0 caps / 0 days) hr 0 mg (generic of ADDERALL XR) amphetamine-dextroamphetamine cap sr QL (0 caps / 0 days) hr 5 mg (generic of ADDERALL XR) amphetamine-dextroamphetamine cap sr QL (0 caps / 0 days) hr 0 mg (generic of ADDERALL XR) amphetamine-dextroamphetamine tab 5 mg (generic of ADDERALL) QL (60 tabs / 0 days) amphetamine-dextroamphetamine tab 7.5 QL (0 tabs / 0 days) mg (generic of ADDERALL) amphetamine-dextroamphetamine tab 10 QL (180 tabs / 0 days) mg (generic of ADDERALL) amphetamine-dextroamphetamine tab 1.5 mg (generic of ADDERALL) QL (90 tabs / 0 days) 6

45 amphetamine-dextroamphetamine tab 15 QL (10 tabs / 0 days) mg (generic of ADDERALL) amphetamine-dextroamphetamine tab 0 QL (90 tabs / 0 days) mg (generic of ADDERALL) amphetamine-dextroamphetamine tab 0 QL (60 tabs / 0 days) mg (generic of ADDERALL) atomoxetine hcl (generic of STRATTERA) QL (10 caps / 0 days) 10mg, 18mg, 5mg atomoxetine hcl (generic of STRATTERA) QL (60 caps / 0 days) 0mg atomoxetine hcl (generic of STRATTERA) QL (0 caps / 0 days) 60mg, 80mg, 100mg dexmethylphenidate hcl (generic of QL (10 tabs / 0 days) FOCALIN) TABS.5mg, 5mg dexmethylphenidate hcl (generic of FOCALIN) TABS 10mg QL (60 tabs / 0 days) guanfacine er (adhd) (generic of INTUNIV) PA; PA if 70 years and older metadate er tab 0mg QL (90 tabs / 0 days) methylphenidate hcl (generic of RITALIN) QL (180 tabs / 0 days) TABS 5mg, 10mg methylphenidate hcl (generic of RITALIN) QL (90 tabs / 0 days) TABS 0mg methylphenidate hcl oral soln (generic of QL (1800 ml / 0 days) METHYLIN) 5mg/5ml methylphenidate hcl oral soln (generic of QL (900 ml / 0 days) METHYLIN) 10mg/5ml methylphenidate tab 10mg er QL (90 tabs / 0 days) methylphenidate tab 0mg er QL (90 tabs / 0 days) HYPNOTICS HETLIOZ 5 NM, LA, PA SILENOR mg QL (60 tabs / 0 days) SILENOR 6mg QL (0 tabs / 0 days) temazepam (generic of RESTORIL) 7.5mg QL (0 caps / 0 days), PA; PA applies if 65 years and older after a 90 day supply in a calendar year temazepam (generic of RESTORIL) 15mg QL (60 caps / 0 days), PA; PA applies if 65 years and older after a 90 day supply in a calendar year 7

46 zolpidem tartrate (generic of AMBIEN) TABS QL (0 tabs / 0 days), PA; PA applies if 70 years and older after a 90 day supply in a calendar year MIGRAINE dihydroergotamine mesylate inj 1 mg/ml 5 (generic of D.H.E. 5) dihydroergotamine mesylate nasal 5 QL (8 ml / 0 days) eletriptan hydrobromide (generic of QL (1 tabs / 0 days) RELPAX) ergotamine w/ caffeine (generic of CAFERGOT) TABS naratriptan hcl (generic of AMERGE) QL (1 tabs / 0 days) rizatriptan benzoate 5mg QL (18 tabs / 0 days) rizatriptan benzoate (generic of MAXALT) QL (18 tabs / 0 days) 10mg rizatriptan benzoate odt (generic of QL (18 tabs / 0 days) MAXALT-MLT) sumatriptan (generic of IMITREX) SOLN 5mg/act QL ( inhalers / 0 days) sumatriptan (generic of IMITREX) SOLN 0mg/act QL (1 inhalers / 0 days) sumatriptan inj mg/0.5ml (generic of IMITREX STATDOSE SYSTEM) SOAJ QL (18 injections / 0 days) sumatriptan inj mg/0.5ml (generic of IMITREX STATDOSE REFILL) SOCT QL (18 injections / 0 days) sumatriptan inj 6mg/0.5ml (generic of IMITREX STATDOSE SYSTEM) SOAJ QL (1 injections / 0 days) sumatriptan inj 6mg/0.5ml (generic of IMITREX STATDOSE REFILL) SOCT QL (1 injections / 0 days) sumatriptan inj 6mg/0.5ml (generic of IMITREX) SOLN QL (1 injections / 0 days) sumatriptan inj 6mg/0.5ml SOSY QL (1 injections / 0 days) sumatriptan succinate (generic of QL (1 tabs / 0 days) IMITREX) TABS zolmitriptan (generic of ZOMIG) TABS QL (1 tabs / 0 days) zolmitriptan odt (generic of ZOMIG ZMT) QL (1 tabs / 0 days) MISCELLANEOUS AUSTEDO 6mg 5 QL (60 tabs / 0 days), NM, LA, PA AUSTEDO 9mg, 1mg 5 QL (10 tabs / 0 days), NM, LA, PA lithium carbonate CAPS 1 8

47 lithium carbonate TABS lithium carbonate er (generic of LITHOBID) 00mg lithium carbonate er 50mg LITHIUM SOLN 8MEQ/5ML LYRICA CR 8.5mg, 165mg QL (90 tabs / 0 days), PA LYRICA CR 0mg QL (60 tabs / 0 days), PA NUEDEXTA QL (60 caps / 0 days), PA pyridostigmine tab 60mg (generic of MESTINON) riluzole (generic of RILUTEK) tetrabenazine (generic of XENAZINE) 1.5mg 5 QL (0 tabs / 0 days), NM, PA tetrabenazine (generic of XENAZINE) 5mg 5 QL (10 tabs / 0 days), NM, PA MULTIPLE SCLEROSIS AGENTS AMPYRA 5 NM, LA, PA BETASERON 5 QL (1 syringes / 8 days), NM, PA dalfampridine (generic of AMPYRA) 5 NM, PA GILENYA 5 QL (8 caps / 8 days), NM, PA glatiramer acetate 0mg/ml (generic of COPAXONE) 5 QL (0 syringes / 0 days), NM, PA glatiramer acetate 0mg/ml (generic of COPAXONE) 5 QL (1 syringes / 8 days), NM, PA glatopa (generic of COPAXONE) 0mg/ml 5 QL (0 syringes / 0 days), NM, PA glatopa (generic of COPAXONE) 0mg/ml 5 QL (1 syringes / 8 days), NM, PA MUSCULOSKELETAL THERAPY AGENTS baclofen TABS 10mg, 0mg cyclobenzaprine hcl TABS 5mg, 10mg PA; PA if 70 years and older dantrolene sodium (generic of DANTRIUM) CAPS 5mg, 50mg dantrolene sodium CAPS 100mg tizanidine hcl TABS mg tizanidine hcl (generic of ZANAFLEX) TABS mg 9

48 NARCOLEPSY/CATAPLEXY armodafinil (generic of NUVIGIL) 50mg QL (90 tabs / 0 days), PA armodafinil (generic of NUVIGIL) 150mg, QL (0 tabs / 0 days), 00mg, 50mg PA XYREM 5 QL (50 ml / 0 days), NM, LA, PA PSYCHOTHERAPEUTIC-MISC acamprosate calcium buprenorphine hcl SUBL QL (90 tabs / 0 days), PA buprenorphine hcl-naloxone hcl sl QL (90 tabs / 0 days) bupropion hcl (smoking deterrent) (generic of ZYBAN) CHANTIX PA CHANTIX CONTINUING MONTH PA CHANTIX STARTER PACK PA disulfiram (generic of ANTABUSE) TABS naloxone inj 0.mg/ml naloxone inj 1mg/ml naltrexone hcl TABS NARCAN NICOTROL INHALER NICOTROL NS SUBOXONE MIS -0.5MG QL (90 films / 0 days) SUBOXONE MIS -1MG QL (90 films / 0 days) SUBOXONE MIS 8-MG QL (90 films / 0 days) SUBOXONE MIS 1-MG QL (60 films / 0 days) VIVITROL 5 ENDOCRINE AND METABOLIC ANDROGENS ANADROL-50 5 PA ANDRODERM QL (0 patches / 0 days), PA oxandrolone tab.5mg PA oxandrolone tab 10mg (generic of PA OXANDRIN) testosterone GEL 1% QL (00 grams / 0 days), PA testosterone (generic of ANDROGEL) GEL QL (00 grams / 0 5mg/.5gm, 50mg/5gm days), PA testosterone cypionate (generic of DEPO- TESTOSTERONE) SOLN 100mg/ml, 00mg/ml PA 0

49 testosterone enanthate SOLN PA ANTIDIABETICS, INJECTABLE ALCOHOL SWABS BASAGLAR KWIKPEN BD ULTRAFINE INSULIN SYRINGE BD ULTRAFINE/NANO PEN NEEDLES BYDUREON BCISE QL ( pens / 8 days) BYDUREON INJ QL ( vials / 8 days) BYDUREON PEN QL ( pens / 8 days) BYETTA QL (1 pen / 0 days) FIASP FIASP FLEXTOUCH GAUZE PADS " X " HUMULIN R INJ U B/D HUMULIN R U-500 KWIKPEN 5 INSULIN PEN NEEDLE INSULIN SAFETY NEEDLES INSULIN SYRINGE LEVEMIR LEVEMIR FLEXTOUCH NOVOLIN 70/0 (brand RELION not covered) NOVOLIN 70/0 FLEXPEN (brand RELION not covered) NOVOLIN N (brand RELION not covered) NOVOLIN R (brand RELION not covered) NOVOLOG NOVOLOG 70/0 FLEXPEN NOVOLOG FLEXPEN NOVOLOG MIX 70/0 NOVOLOG PENFILL OZEMPIC INJ 0.5 OR 0.5MG/DOSE QL (1 pen / 8 days) OZEMPIC INJ 1MG/DOSE QL ( pens / 8 days) SOLIQUA 100/ QL (10 pens / 0 days) TRESIBA FLEXTOUCH TRESIBA INJ TRULICITY QL ( pens / 8 days) VICTOZA QL ( pens / 0 days) XULTOPHY 100/.6 QL (5 pens / 0 days) ANTIDIABETICS, ORAL acarbose (generic of PRECOSE) FARXIGA 5mg QL (60 tabs / 0 days) 1

50 FARXIGA 10mg QL (0 tabs / 0 days) glimepiride (generic of AMARYL) 1mg 1 QL (0 tabs / 0 days) glimepiride (generic of AMARYL) mg 1 QL (10 tabs / 0 days) glimepiride (generic of AMARYL) mg 1 QL (60 tabs / 0 days) glip/metform tab.5-50mg 1 QL (0 tabs / 0 days) glip/metform tab.5-500mg 1 QL (10 tabs / 0 days) glip/metform tab 5-500mg 1 QL (10 tabs / 0 days) glipizide (generic of GLUCOTROL) TABS 1 QL (0 tabs / 0 days) 5mg glipizide (generic of GLUCOTROL) TABS 1 QL (10 tabs / 0 days) 10mg glipizide (generic of GLUCOTROL XL) 1 QL (0 tabs / 0 days) TB.5mg glipizide (generic of GLUCOTROL XL) 1 QL (10 tabs / 0 days) TB 5mg glipizide (generic of GLUCOTROL XL) 1 QL (60 tabs / 0 days) TB 10mg glipizide xl (generic of GLUCOTROL XL) 1 QL (0 tabs / 0 days).5mg glipizide xl (generic of GLUCOTROL XL) 1 QL (10 tabs / 0 days) 5mg glipizide xl (generic of GLUCOTROL XL) 1 QL (60 tabs / 0 days) 10mg JANUMET QL (60 tabs / 0 days) JANUMET XR TAB MG QL (60 tabs / 0 days) JANUMET XR TAB QL (60 tabs / 0 days) JANUMET XR TAB QL (0 tabs / 0 days) JANUVIA QL (0 tabs / 0 days) JARDIANCE 10mg QL (60 tabs / 0 days) JARDIANCE 5mg QL (0 tabs / 0 days) JENTADUETO QL (60 tabs / 0 days) JENTADUETO TAB XR MG QL (60 tabs / 0 days) JENTADUETO TAB XR MG QL (0 tabs / 0 days) metformin er (generic of GLUCOPHAGE XR) 500mg metformin er (generic of GLUCOPHAGE XR) 750mg metformin hcl (generic of GLUCOPHAGE) TABS 500mg metformin hcl (generic of GLUCOPHAGE) TABS 850mg metformin hcl (generic of GLUCOPHAGE) TABS 1000mg 1 QL (10 tabs / 0 days); (generic of GLUCOPHAGE XR) 1 QL (60 tabs / 0 days); (generic of GLUCOPHAGE XR) 1 QL (150 tabs / 0 days) 1 QL (90 tabs / 0 days) 1 QL (75 tabs / 0 days)

51 nateglinide (generic of STARLIX) 1 QL (90 tabs / 0 days) pioglitazone hcl (generic of ACTOS) 1 QL (0 tabs / 0 days) repaglinide (generic of PRANDIN) 1mg 1 QL (10 tabs / 0 days) repaglinide (generic of PRANDIN) mg 1 QL (0 tabs / 0 days) repaglinide.5mg 1 QL (10 tabs / 0 days) SYNJARDY TAB 5-500MG QL (10 tabs / 0 days) SYNJARDY TAB MG QL (60 tabs / 0 days) SYNJARDY TAB MG QL (60 tabs / 0 days) SYNJARDY TAB MG QL (60 tabs / 0 days) SYNJARDY XR TAB MG QL (60 tabs / 0 days) SYNJARDY XR TAB MG QL (60 tabs / 0 days) SYNJARDY XR TAB MG QL (60 tabs / 0 days) SYNJARDY XR TAB MG QL (0 tabs / 0 days) TRADJENTA QL (0 tabs / 0 days) XIGDUO XR TAB MG QL (60 tabs / 0 days) XIGDUO XR TAB 5-500MG QL (60 tabs / 0 days) XIGDUO XR TAB MG QL (60 tabs / 0 days) XIGDUO XR TAB MG QL (0 tabs / 0 days) XIGDUO XR TAB MG QL (0 tabs / 0 days) BISPHOSPHONATES alendronate sodium TABS 5mg, 10mg, 5mg, 0mg 1 alendronate sodium (generic of FOSAMAX) 1 TABS 70mg ibandronate sodium (generic of BONIVA) B/D TABS PAMIDRONATE DISODIUM 6mg/ml B/D pamidronate disodium 0mg/10ml, B/D 90mg/10ml pamidronate inj 0mg B/D pamidronate inj 90mg B/D zoledronic acid inj 5mg/100ml (generic of B/D, NM RECLAST) zoledronic inj mg/5ml B/D, NM CALCIUM RECEPTOR AGONISTS cinacalcet hcl 0mg, 90mg 5 B/D, QL (10 tabs / 0 days), NM cinacalcet hcl 60mg 5 B/D, QL (60 tabs / 0 days), NM SENSIPAR 0mg, 90mg 5 B/D, QL (10 tabs / 0 days), NM SENSIPAR 60mg 5 B/D, QL (60 tabs / 0 days), NM

52 CHELATING AGENTS CHEMET DEPEN TITRATABS 5 JADENU 5 NM, LA, PA JADENU SPRINKLE 5 NM, LA, PA kionex sus 15gm/60ml sodium polystyrene sulfonate powder sodium polystyrene sulfonate susp sps susp 15gm/60ml trientine hcl (generic of SYPRINE) 5 PA CONTRACEPTIVES altavera tab alyacen 1/5 (generic of ORTHO-NOVUM 1/5) apri aranelle (generic of TRI-NORINYL 8) aubra aviane balziva bekyree (generic of MIRCETTE) blisovi fe 1.5/0 (generic of LOESTRIN FE 1.5/0) blisovi fe 1/0 (generic of LOESTRIN FE 1/0) briellyn camila caziant pak cryselle-8 cyclafem 1/5 (generic of ORTHO-NOVUM 1/5) cyclafem 7/7/7 (generic of ORTHO-NOVUM 7/7/7) cyred tab dasetta 1/5 (generic of ORTHO-NOVUM 1/5) dasetta 7/7/7 (generic of ORTHO-NOVUM 7/7/7) deblitane delyla desogestrel & ethinyl estradiol desogestrel-ethinyl estradiol (biphasic) (generic of MIRCETTE) drospirenone-ethinyl estradiol (generic of YASMIN 8)

53 drospirenone-ethinyl estradiol (generic of YAZ) ELLA emoquette enpresse-8 enskyce errin (generic of ORTHO MICRONOR) estarylla tab (generic of ORTHO- CYCLEN) ethynodiol diacet & eth estrad ethynodiol tab 1-50 falmina femynor (generic of ORTHO-CYCLEN) gianvi tab -0.0mg (generic of YAZ) heather incassia introvale isibloom jolessa tab mg jolivette (generic of ORTHO MICRONOR) juleber junel 1.5/0 (generic of LOESTRIN 1.5/0-1) junel 1/0 (generic of LOESTRIN 1/0-1) junel fe 1.5/0 (generic of LOESTRIN FE 1.5/0) junel fe 1/0 (generic of LOESTRIN FE 1/0) kariva (generic of MIRCETTE) kelnor 1/5 kelnor 1/50 kurvelo larin 1.5/0 (generic of LOESTRIN 1.5/0-1) larin 1/0 (generic of LOESTRIN 1/0-1) larin fe 1.5/0 (generic of LOESTRIN FE 1.5/0) larin fe 1/0 (generic of LOESTRIN FE 1/0) larissia tab leena tab (generic of TRI-NORINYL 8) lessina levonest levonor/ethi tab 5

54 levonorgestrel & eth estradiol levonorgestrel-ethinyl estradiol (91-day) levora 0.15/0-8 loryna (generic of YAZ) low-ogestrel lutera lyza (generic of ORTHO MICRONOR) marlissa medroxyprogesterone acetate (contraceptive) (generic of DEPO-PROVERA CONTRACEPTIV) microgestin 1.5/0 (generic of LOESTRIN 1.5/0-1) microgestin 1/0 (generic of LOESTRIN 1/0-1) microgestin fe 1.5/0 (generic of LOESTRIN FE 1.5/0) microgestin fe 1/0 (generic of LOESTRIN FE 1/0) mili (generic of ORTHO-CYCLEN) mono-linyah tab (generic of ORTHO-CYCLEN) mononessa (generic of ORTHO-CYCLEN) myzilra necon 0.5/5-8 necon 1/50-8 necon 7/7/7 (generic of ORTHO-NOVUM 7/7/7) nikki (generic of YAZ) nora-be tab 0.5mg norethindrone (contraceptive) (generic of ORTHO MICRONOR) norethindrone acet & eth estra (generic of LOESTRIN 1/0-1) norgest/ethi tab 0.5/5 (generic of ORTHO-CYCLEN) norgestimate-ethinyl estradiol (triphasic) /0.15-5/0.5-5 mg-mcg (generic of ORTHO TRI-CYCLEN LO) norgestimate-ethinyl estradiol (triphasic) /0.15-5/0.5-5 mg-mcg (generic of ORTHO TRI-CYCLEN) norlyroc nortrel 0.5/5 (8) 6

55 nortrel 1/5 (generic of ORTHO-NOVUM 1/5) nortrel 7/7/7 (generic of ORTHO-NOVUM 7/7/7) NUVARING ocella tab -0.0mg (generic of YASMIN 8) orsythia philith pimtrea (generic of MIRCETTE) pirmella 1/5 (generic of ORTHO-NOVUM 1/5) portia-8 previfem (generic of ORTHO-CYCLEN) quasense reclipsen setlakin tab sharobel (generic of ORTHO MICRONOR) sprintec 8 (generic of ORTHO-CYCLEN) sronyx syeda (generic of YASMIN 8) tarina fe 1/0 (generic of LOESTRIN FE 1/0) tilia fe (generic of ESTROSTEP FE) tri-estarylla (generic of ORTHO TRI- CYCLEN) tri-legest fe (generic of ESTROSTEP FE) tri-linyah (generic of ORTHO TRI-CYCLEN) tri-lo marzia (generic of ORTHO TRI- CYCLEN LO) tri-lo-estarylla (generic of ORTHO TRI- CYCLEN LO) tri-lo-sprintec (generic of ORTHO TRI- CYCLEN LO) tri-mili (generic of ORTHO TRI-CYCLEN) tri-previfem (generic of ORTHO TRI- CYCLEN) tri-sprintec (generic of ORTHO TRI- CYCLEN) tri-vylibra (generic of ORTHO TRI-CYCLEN) tri-vylibra lo (generic of ORTHO TRI- CYCLEN LO) trinessa (generic of ORTHO TRI-CYCLEN) trinessa lo (generic of ORTHO TRI-CYCLEN LO) 7

56 trivora-8 tulana velivet vienva viorele (generic of MIRCETTE) vyfemla vylibra (generic of ORTHO-CYCLEN) xulane dis zarah (generic of YASMIN 8) zovia 1/5e zovia 1/50e ENDOMETRIOSIS danazol CAPS SYNAREL 5 ENZYME REPLACEMENTS ADAGEN 5 NM, LA, PA ALDURAZYME 5 NM, LA, PA CARBAGLU 5 NM, LA, PA CERDELGA 5 NM, PA CEREZYME 5 NM, LA, PA CYSTADANE 5 NM, LA CYSTAGON NM, LA, PA FABRAZYME 5 NM, LA, PA KUVAN 5 NM, LA, PA levocarnitine (metabolic modifiers) B/D (generic of CARNITOR) LUMIZYME 5 NM, LA, PA miglustat (generic of ZAVESCA) 5 NM, PA NAGLAZYME 5 NM, LA, PA NITYR 5 NM, LA, PA ORFADIN 5 NM, LA, PA sodium phenylbutyrate (generic of 5 NM, PA BUPHENYL) ESTROGENS DELESTROGEN 10mg/ml estradiol (generic of CLIMARA) PTWK estradiol (generic of ESTRACE) TABS estradiol vaginal cream (generic of ESTRACE) estradiol vaginal tab (generic of VAGIFEM) estradiol valerate inj (generic of DELESTROGEN) fyavolv fyavolv (generic of FEMHRT LOW DOSE) 8

57 jinteli norethindrone acetate-ethinyl estradiol norethindrone acetate-ethinyl estradiol (generic of FEMHRT LOW DOSE) yuvafem vaginal tablet 10mcg (generic of VAGIFEM) GLUCOCORTICOIDS cortisone acetate TABS DEXAMETHASONE CONC dexamethasone ELIX; SOLN dexamethasone TABS dexamethasone sodium phosphate mg/ml, 10mg/ml, 0mg/5ml, 100mg/10ml, 10mg/0ml dexamethasone sodium phosphate (generic of DEXAMETHASONE SODIUM PHOS) 10mg/ml fludrocortisone acetate TABS hydrocortisone (generic of CORTEF) TABS methylpr ss inj (generic of SOLU-MEDROL) B/D methylpred pak mg (generic of MEDROL DOSEPAK) methylpred tab mg (generic of MEDROL) B/D methylpred tab 8mg (generic of MEDROL) B/D methylpred tab 16mg (generic of MEDROL) B/D methylpred tab mg (generic of MEDROL) B/D methylprednisolone acetate (generic of B/D DEPO-MEDROL) pred sod pho sol 5mg/5ml B/D prednisolone sodium phosphate SOLN B/D 15mg/5ml prednisolone sol 15mg/5ml B/D prednisolone sol 5mg/5ml B/D PREDNISONE CON 5MG/ML B/D prednisone pak 5mg prednisone pak 10mg prednisone sol 5mg/5ml B/D prednisone tab 1mg 1 B/D prednisone tab.5mg 1 B/D prednisone tab 5mg 1 B/D prednisone tab 10mg 1 B/D prednisone tab 0mg 1 B/D prednisone tab 50mg 1 B/D SOLU-CORTEF 9

58 GLUCOSE ELEVATING AGENTS GLUCAGEN HYPOKIT GLUCAGON EMERGENCY KIT PROGLYCEM SUS 50MG/ML MISCELLANEOUS cabergoline calcitonin (salmon) (generic of MIACALCIN) B/D FORTEO 5 NM, PA GENOTROPIN 5 NM, PA GENOTROPIN MINIQUICK.mg NM, PA GENOTROPIN 5 NM, PA MINIQUICK.mg,.6mg,.8mg, 1mg, 1.mg, 1.mg, 1.6mg, 1.8mg, mg INCRELEX 5 NM, LA, PA KORLYM 5 NM, LA, PA LUPRON DEP-PED INJ 7.5MG 5 NM, PA LUPRON DEP-PED INJ 11.5MG (-MONTH)5 NM, PA LUPRON DEPOT-PED (1-MONTH 5 NM, PA LUPRON DEPOT-PED (-MONTH 5 NM, PA NATPARA 5 NM, PA octreotide acetate (generic of NM, PA SANDOSTATIN) 50mcg/ml, 100mcg/ml octreotide acetate 00mcg/ml NM, PA octreotide acetate (generic of 5 NM, PA SANDOSTATIN) 500mcg/ml octreotide acetate 1000mcg/ml 5 NM, PA PROLIA QL (1 injection / 180 days), NM raloxifene tab 60mg (generic of EVISTA) SIGNIFOR 5 NM, LA, PA SOMATULINE DEPOT 5 NM, PA SOMAVERT 5 NM, LA, PA TYMLOS 5 NM, PA XGEVA 5 NM, PA PHOSPHATE BINDER AGENTS AURYXIA 5 QL (60 tabs / 0 days), PA calcium acetate (phosphate binder) (generic of PHOSLO) CAPS QL (60 caps / 0 days) calcium acetate (phosphate binder) TABS QL (60 tabs / 0 days) sevelamer carbonate (generic of RENVELA) 5 QL (180 packets / 0 PACK.gm days) sevelamer carbonate (generic of RENVELA) PACK.8gm 5 QL (50 packets / 0 days) 50

59 sevelamer carbonate (generic of RENVELA) QL (50 tabs / 0 days) TABS PROGESTINS medroxyprogesterone acetate tab (generic 1 of PROVERA) norethindrone acetate (generic of AYGESTIN) TABS THYROID AGENTS levo-t (generic of SYNTHROID) levothyroxine sodium (generic of SYNTHROID) TABS levoxyl (generic of SYNTHROID) liothyronine sodium (generic of CYTOMEL) TABS methimazole (generic of TAPAZOLE) TABS propylthiouracil TABS SYNTHROID unithroid (generic of SYNTHROID) VASOPRESSINS desmopressin acetate spray (generic of DDAVP) desmopressin acetate spray refrigerated desmopressin acetate tabs (generic of DDAVP) desmopressin inj mcg/ml (generic of DDAVP) STIMATE 5 NM GASTROINTESTINAL ANTIEMETICS aprepitant (generic of EMEND) B/D aprepitant pak 80mg & 15mg B/D compro supp dronabinol (generic of MARINOL) B/D, QL (60 caps / 0 days) EMEND SUSR B/D granisetron hcl SOLN granisetron hcl TABS B/D meclizine hcl TABS metoclopramide hcl SOLN metoclopramide hcl (generic of REGLAN) 1 TABS metoclopramide hcl inj ondansetron hcl (generic of ZOFRAN) TABS mg, 8mg B/D 51

60 ondansetron hcl TABS mg B/D ondansetron hcl inj ondansetron hcl oral soln B/D ondansetron odt B/D prochlorperazine inj prochlorperazine maleate TABS prochlorperazine supp promethazine hcl SYRP; TABS PA; PA if 70 years and older promethazine hcl inj (generic of PHENERGAN) PA; PA if 70 years and older scopolamine patch QL (10 patches / 0 days), PA; PA if 70 years and older TRANSDERM-SCOP QL (10 patches / 0 days), PA; PA if 70 years and older ANTISPASMODICS dicyclomine hcl cap 10mg dicyclomine hcl soln 10mg/5ml dicyclomine hcl tab 0mg glycopyrrolate tab 1mg glycopyrrolate tab mg H-RECEPTOR ANTAGONISTS famotidine SUSR famotidine (generic of PEPCID) TABS 1 0mg, 0mg famotidine in nacl famotidine inj ranitidine hcl (generic of ZANTAC) TABS 1 150mg, 00mg ranitidine hcl inj (generic of ZANTAC) ranitidine inj (generic of ZANTAC) ranitidine syrup INFLAMMATORY BOWEL DISEASE APRISO QL (10 caps / 0 days) balsalazide disodium (generic of COLAZAL) budesonide ec (generic of ENTOCORT EC) 5 CANASA colocort (generic of CORTENEMA) DELZICOL hydrocortisone (enema) (generic of CORTENEMA) mesalamine ENEM 5

61 mesalamine (generic of CANASA) SUPP mesalamine (generic of ASACOL HD) TBEC 800mg mesalamine w/ cleanser (generic of ROWASA) sulfasalazine (generic of AZULFIDINE) TABS sulfasalazine ec (generic of AZULFIDINE EN-TABS) LAXATIVES constulose enulose gavilyte-c (generic of COLYTE-FLAVOR PACKS) gavilyte-g (generic of GOLYTELY) gavilyte-n/flavor pack (generic of NULYTELY/FLAVOR PACKS) generlac GOLYTELY lactulose SOLN lactulose (encephalopathy) MOVIPREP NULYTELY/FLAVOR PACKS peg 50-kcl-sod bicarb-sod chloride-sod sulfate (generic of GOLYTELY) peg 50-potassium chloride-sod bicarbonate-sod chloride (generic of NULYTELY/FLAVOR PACKS) peg 50/electrolytes SUPREP BOWEL PREP KIT trilyte (generic of NULYTELY/FLAVOR PACKS) MISCELLANEOUS alosetron hcl (generic of LOTRONEX) 5 PA AMITIZA CAP 8MCG QL (180 caps / 0 days) AMITIZA CAP MCG QL (60 caps / 0 days) cromolyn sodium (mastocytosis) (generic 5 of GASTROCROM) diphenoxylate w/ atropine LIQD diphenoxylate w/ atropine (generic of LOMOTIL) TABS GATTEX 5 NM, LA, PA LINZESS QL (0 caps / 0 days) loperamide hcl CAPS misoprostol (generic of CYTOTEC) TABS 5

62 MOVANTIK 1.5mg QL (60 tabs / 0 days) MOVANTIK 5mg QL (0 tabs / 0 days) RELISTOR SOLN 5 PA sucralfate (generic of CARAFATE) TABS SYMPROIC ursodiol (generic of ACTIGALL) CAPS ursodiol (generic of URSO 50) TABS 50mg ursodiol (generic of URSO FORTE) TABS 500mg XIFAXAN 550mg 5 PA PANCREATIC ENZYMES CREON ZENPEP PROTON PUMP INHIBITORS DEXILANT QL (0 caps / 0 days) esomeprazole magnesium (generic of QL (0 caps / 0 days) NEXIUM) esomeprazole sodium inj 0mg esomeprazole sodium inj (generic of NEXIUM I.V.) 0mg lansoprazole (generic of PREVACID) CPDR QL (0 caps / 0 days) omeprazole cap 10mg 1 omeprazole cap 0mg 1 omeprazole cap 0mg 1 pantoprazole sodium (generic of PROTONIX) SOLR pantoprazole sodium tbec (generic of PROTONIX) GENITOURINARY BENIGN PROSTATIC HYPERPLASIA alfuzosin hcl (generic of UROXATRAL) QL (0 tabs / 0 days) dutasteride (generic of AVODART) CAPS QL (0 caps / 0 days) dutasteride-tamsulosin hcl (generic of QL (0 caps / 0 days) JALYN) finasteride (generic of PROSCAR) TABS 5mg tamsulosin hcl (generic of FLOMAX) MISCELLANEOUS bethanechol chloride (generic of URECHOLINE) TABS potassium citrate (alkalinizer) er tabs (generic of UROCIT-K 15) 15meq 5

63 potassium citrate (alkalinizer) er tabs (generic of UROCIT-K 5) 50mg potassium citrate (alkalinizer) er tabs (generic of UROCIT-K 10) 1080mg URINARY ANTISPASMODICS MYRBETRIQ 5mg QL (60 tabs / 0 days) MYRBETRIQ 50mg QL (0 tabs / 0 days) oxybutynin chloride SYRP oxybutynin chloride TABS oxybutynin chloride (generic of DITROPAN QL (0 tabs / 0 days) XL) TB 5mg oxybutynin chloride (generic of DITROPAN QL (60 tabs / 0 days) XL) TB 10mg oxybutynin chloride TB 15mg QL (60 tabs / 0 days) tolterodine tartrate (generic of DETROL LA) QL (0 caps / 0 days), CP ST tolterodine tartrate (generic of DETROL) ST TABS TOVIAZ QL (0 tabs / 0 days) trospium chloride TABS QL (60 tabs / 0 days) VESICARE QL (0 tabs / 0 days) VAGINAL ANTI-INFECTIVES clindamycin phosphate vaginal (generic of CLEOCIN) metronidazole vaginal (generic of METROGEL-VAGINAL) terconazole vaginal (generic of TERAZOL 7) CREA.% terconazole vaginal CREA.8% terconazole vaginal SUPP vandazole HEMATOLOGIC ANTICOAGULANTS COUMADIN ELIQUIS ELIQUIS STARTER PACK enoxaparin sodium (generic of LOVENOX) fondaparinux sodium (generic of ARIXTRA).5mg/0.5ml fondaparinux sodium (generic of ARIXTRA) 5 5mg/0.ml, 7.5mg/0.6ml, 10mg/0.8ml heparin sod (porcine) in d5w heparin sod inj 1000/ml B/D heparin sod inj 5000/ml B/D 55

64 heparin sod inj 10000/ml B/D heparin sod inj 0000/ml B/D HEPARIN SODIUM/NACL 0.5% jantoven (generic of COUMADIN) 1 PRADAXA warfarin sodium (generic of COUMADIN) 1 XARELTO XARELTO STARTER PACK HEMATOPOIETIC GROWTH FACTORS GRANIX 5 NM, PA NEUPOGEN 5 NM, PA PROCRIT 000unit/ml, 000unit/ml, NM, PA 000unit/ml, 10000unit/ml PROCRIT 0000unit/ml, 0000unit/ml 5 NM, PA MISCELLANEOUS anagrelide hcl 1mg anagrelide hcl (generic of AGRYLIN).5mg BERINERT 5 QL ( boxes / 0 days), NM, LA, PA cilostazol DROXIA ENDARI 5 NM, LA, PA FIRAZYR 5 QL (9 syringes / 0 days), NM, PA HAEGARDA 000unit 5 QL (0 vials / 0 days), NM, LA, PA HAEGARDA 000unit 5 QL (0 vials / 0 days), NM, LA, PA pentoxifylline TBCR PROMACTA PACK 5 QL (60 packets / 0 days), NM, LA, PA PROMACTA TABS 1.5mg 5 QL (60 tabs / 0 days), NM, LA, PA PROMACTA TABS 5mg 5 QL (180 tabs / 0 days), NM, LA, PA PROMACTA TABS 50mg 5 QL (90 tabs / 0 days), NM, LA, PA PROMACTA TABS 75mg 5 QL (60 tabs / 0 days), NM, LA, PA tranexamic acid (generic of CYKLOKAPRON) SOLN tranexamic acid (generic of LYSTEDA) TABS 56

65 PLATELET AGGREGATION INHIBITORS aspirin-dipyridamole (generic of AGGRENOX) BRILINTA clopidogrel tab 75mg (generic of PLAVIX) 1 prasugrel hcl (generic of EFFIENT) ZONTIVITY IMMUNOLOGIC AGENTS DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS (DMARDS) HUMIRA 10mg/0.1ml, 0mg/0.ml 5 QL ( injections / 8 days), NM, PA HUMIRA 0mg/0.ml 5 QL (6 injections / 8 days), NM, PA HUMIRA INJ 10MG/0.ML 5 QL ( syringes / 8 days), NM, PA HUMIRA KIT 0MG/0.ML 5 QL ( syringes / 8 days), NM, PA HUMIRA KIT 0MG/0.8ML 5 QL (6 syringes / 8 days), NM, PA HUMIRA PEDIATRIC CROHNS DISEASE 5 NM, PA HUMIRA PEN 5 QL (6 pens / 8 days), NM, PA HUMIRA PEN CD/UC/HS STARTER 5 NM, PA HUMIRA PEN INJ CD/UC/HS STARTER 5 NM, PA HUMIRA PEN INJ PS/UV STARTER 5 NM, PA HUMIRA PEN-PS/UV STARTER 5 NM, PA hydroxychloroquine sulfate (generic of PLAQUENIL) leflunomide (generic of ARAVA) TABS methotrexate sodium tabs REMICADE 5 NM, PA XATMEP B/D XELJANZ 5 QL (60 tabs / 0 days), NM, PA XELJANZ XR 5 QL (0 tabs / 0 days), NM, PA IMMUNOGLOBULINS BIVIGAM 5 NM, PA CARIMUNE NANOFILTERED 5 NM, PA FLEBOGAMMA DIF 5 NM, PA GAMASTAN S/D B/D, NM GAMMAGARD LIQUID 5 NM, PA GAMMAGARD S/D 5 NM, PA GAMMAKED 5 NM, PA 57

66 GAMMAPLEX 5 NM, PA GAMMAPLEX 10GM/100ML 5 NM, PA GAMUNEX-C 5 NM, PA OCTAGAM 5 NM, PA PANZYGA 5 NM, PA PRIVIGEN 5 NM, PA IMMUNOMODULATORS ACTIMMUNE 5 NM, LA, PA ARCALYST 5 NM, PA INTRON-A INJ 10MU 5 B/D, NM INTRON-A INJ 18MU 5 B/D, NM INTRON-A INJ 5MU 5 B/D, NM INTRON-A INJ 50MU 5 B/D, NM IMMUNOSUPPRESSANTS azathioprine (generic of IMURAN) TABS B/D BENLYSTA 5 NM, PA cyclosporine (generic of SANDIMMUNE) CAPS; SOLN B/D, NM cyclosporine modified (for microemulsion) B/D, NM (generic of NEORAL) CAPS 5mg, 100mg cyclosporine modified (for microemulsion) B/D, NM CAPS 50mg cyclosporine modified (for microemulsion) B/D, NM (generic of NEORAL) SOLN gengraf (generic of NEORAL) B/D, NM mycophenolate mofetil (generic of B/D, NM CELLCEPT) CAPS; TABS mycophenolate mofetil (generic of 5 B/D, NM CELLCEPT) SUSR mycophenolate sodium tbec (generic of B/D, NM MYFORTIC) NULOJIX 5 B/D, NM RAPAMUNE SOLN 5 B/D, NM SANDIMMUNE SOLN 100mg/ml B/D, NM sirolimus (generic of RAPAMUNE) SOLN 5 B/D, NM sirolimus (generic of RAPAMUNE) TABS 5 B/D, NM mg sirolimus (generic of RAPAMUNE) B/D, NM TABS.5mg, 1mg tacrolimus (generic of PROGRAF) CAPS B/D, NM ZORTRESS TAB 0.5MG 5 B/D, NM ZORTRESS TAB 0.5MG 5 B/D, NM ZORTRESS TAB 0.75MG 5 B/D, NM ZORTRESS TAB 1MG 5 B/D, NM 58

67 VACCINES ACTHIB ADACEL BCG VACCINE BEXSERO BOOSTRIX DAPTACEL DIPHTHERIA/TETANUS TOXOID B/D ENGERIX-B SUSP B/D GARDASIL 9 HAVRIX HIBERIX IMOVAX RABIES (H.D.C.V.) B/D INFANRIX IPOL INACTIVATED IPV IXIARO KINRIX M-M-R II MENACTRA MENVEO PEDIARIX PEDVAX HIB PENTACEL PROQUAD QUADRACEL RABAVERT B/D RECOMBIVAX HB B/D ROTARIX ROTATEQ SHINGRIX QL ( vials per lifetime) TDVAX B/D TENIVAC B/D TRUMENBA TWINRIX INJ TYPHIM VI VAQTA VARIVAX YF-VAX ZOSTAVAX QL (1 vial per lifetime) NUTRITIONAL/SUPPLEMENTS ELECTROLYTES klor-con 8 klor-con 10 59

68 klor-con m10 klor-con m15 klor-con m0 klor-con pak 0meq klor-con spr cap 8meq klor-con spr cap 10meq MAGNESIUM SULFATE SOLN gm/50ml, gm/100ml, gm/50ml, 0gm/500ml, 0gm/1000ml magnesium sulfate (generic of MAGNESIUM SULFATE) SOLN gm/50ml, gm/100ml, gm/50ml, 0gm/500ml, 0gm/1000ml magnesium sulfate SOLN 50% MAGNESIUM SULFATE IN D5W magnesium sulfate in dextrose (generic of MAGNESIUM SULFATE IN D5W) magnesium sulfate inj 50% potassium chloride CPCR potassium chloride PACK potassium chloride SOLN 10%, 0% potassium chloride TBCR 8meq, 10meq potassium chloride (generic of K-TAB) TBCR 0meq potassium chloride microencapsulated crystals er potassium chloride tab cr 10 meq sodium chloride SOLN.5meq/ml sodium fluoride chew; tab; 1.1 (0.5 f) mg/ml soln tpn electrolytes B/D IV NUTRITION AMINOSYN B/D AMINOSYN 7%/ELECTROLYTES B/D aminosyn 8.5%/electrolyte B/D aminosyn ii 8.5%/electrol B/D AMINOSYN II INJ 8.5% B/D AMINOSYN II INJ 10% B/D AMINOSYN M B/D AMINOSYN-HBC B/D AMINOSYN-PF 7% B/D AMINOSYN-PF INJ 10% B/D AMINOSYN-RF B/D CLINIMIX.5%/DEXTROSE 5% B/D 60

69 CLINIMIX.5%/DEXTROSE 5% B/D CLINIMIX 5%/DEXTROSE 15% B/D CLINIMIX 5%/DEXTROSE 0% B/D CLINIMIX 5%/DEXTROSE 5% B/D CLINIMIX INJ.5/D10 B/D FREAMINE HBC 6.9% B/D FREAMINE III B/D hepatamine B/D INTRALIPID 0% B/D intralipid inj 0% B/D NEPHRAMINE B/D nutrilipid inj 0% B/D premasol 6% B/D PREMASOL 10% B/D PROCALAMINE B/D PROSOL B/D TRAVASOL B/D TROPHAMINE INJ 10% B/D IV REPLACEMENT SOLUTIONS dextrose.5%/nacl 0.5% dextrose 5% DEXTROSE 5% /ELECTROLYTE dextrose 5%/nacl 0.% DEXTROSE 5%/NACL 0.% dextrose 5%/nacl 0.9% dextrose 5%/nacl 0.% dextrose 5%/nacl 0.5% dextrose 5%/nacl 0.5% dextrose 5%/potassium chl dextrose 10% flex contain DEXTROSE 10%/NACL 0.% dextrose 10%/nacl 0.5% dextrose 50% dextrose in lactated ringers dextrose inj 70% IONOSOL-MB/DEXTROSE 5% ISOLYTE P ISOLYTE S kcl0.15%/d5w/nacl0.% KCL 0.%/D5W/NACL 0.9% kcl 0.%/d5w/nacl 0.5% kcl 0.15%/d5w/nacl 0.9% KCL 0.15%/D5W/NACL 0.5% 61

70 kcl 0.075%/d5w/nacl 0.5% kcl/d5w inj 0.% kcl/d5w/nacl inj 0.%/0.5% kcl/d5w/nacl inj.15/.% kcl/d5w/nacl inj.15/.5% kcl/nacl inj kcl/nacl inj 0.15%-0.9% lactated ringer's NORMOSOL-M IN D5W NORMOSOL-R NORMOSOL-R IN D5W PLASMA-LYTE A PLASMA-LYTE-18 pot chloride inj meq/ml potassium chloride SOLN.meq/ml, meq/ml, 10meq/100ml, 10meq/50ml, 0meq/100ml, 0meq/100ml potassium chloride in nacl sodium chloride SOLN %, 5% sodium chloride 0.5% sodium chloride inj 0.9% VITAMINS calcitriol (generic of ROCALTROL) CAPS B/D calcitriol inj B/D calcitriol oral soln 1 mcg/ml (generic of B/D ROCALTROL) M-NATAL PLUS NIVA-PLUS O-CAL FA paricalcitol CAPS 1mcg, mcg B/D paricalcitol (generic of ZEMPLAR) CAPS B/D mcg PNV FOLIC ACID + IRON MUL PNV PRENATAL PLUS PNV PRENATAL TAB PLUS PRENATAL PRENATAL PLUS PRENATAL PLUS LOW IRON PREPLUS RAYALDEE 5 TRICARE VOL-PLUS 6

71 OPHTHALMIC ANTI-INFECTIVE/ANTI-INFLAMMATORY bacitracin-poly-neomycin-hc BLEPHAMIDE OINT neomycin-polymy-dexameth (generic of MAXITROL) neomycin-polymyxin-hc (ophth) sulfacetamide sod-prednisolone TOBRADEX OINT TOBRADEX ST tobramycin-dexamethasone (generic of TOBRADEX) ZYLET ANTI-INFECTIVES AZASITE bacitracin (ophthalmic) bacitracin-polymyxin b (ophth) BESIVANCE CILOXAN OINT ciprofloxacin hcl (ophth) (generic of CILOXAN) erythromycin (ophth) gatifloxacin (ophth) (generic of ZYMAXID) gentak gentamicin sulfate soln (ophth) MOXEZA moxifloxacin hcl (ophth) (generic of VIGAMOX) NATACYN neomycin-bacitracin zn-polymyxin neomycin-polymyxin-gramicidin ofloxacin (ophth) (generic of OCUFLOX) polymyxin b-trimethoprim (generic of POLYTRIM) sulfacetamide sodium (ophth) OINT sulfacetamide sodium (ophth) (generic of BLEPH-10) SOLN tobramycin (ophth) (generic of TOBREX) trifluridine (generic of VIROPTIC) ZIRGAN ANTI-INFLAMMATORIES ALREX bromfenac sodium (ophth) BROMSITE 6

72 dexamethasone sodium phosphate (ophth) diclofenac sodium (ophth) DUREZOL fluorometholone flurbiprofen sodium ILEVRO ketorolac tromethamine (ophth) (generic of ACULAR LS).% ketorolac tromethamine (ophth) (generic of ACULAR).5% LOTEMAX prednisolone acetate (ophth) (generic of OMNIPRED) PREDNISOLONE SODIUM PHOSPHATE (OPHTH) PROLENSA ANTIALLERGICS azelastine drop 0.05% BEPREVE cromolyn sodium (ophth) 1 LASTACAFT olopatadine hcl 0.% (generic of PATADAY) PAZEO ANTIGLAUCOMA ALPHAGAN P SOL 0.1% AZOPT betaxolol hcl (ophth) BETOPTIC-S brimonidine sol 0.% brimonidine sol 0.15% (generic of ALPHAGAN P) carteolol hcl (ophth) COMBIGAN dorzolamide hcl (generic of TRUSOPT) dorzolamide hcl-timolol maleate (generic of COSOPT) latanoprost (generic of XALATAN) SOLN levobunolol hcl LUMIGAN PHOSPHOLINE IODIDE pilocarpine hcl (generic of ISOPTO CARPINE) SOLN SIMBRINZA 6

73 timolol maleate (ophth) soln (generic of 1 TIMOPTIC) timolol maleate gel (generic of TIMOPTIC- XE) timolol maleate ophth soln 0.5% (oncedaily) (generic of ISTALOL) TRAVATAN Z MISCELLANEOUS CYSTARAN 5 NM, LA, PA proparacaine hcl (generic of ALCAINE) SOLN RESTASIS QL (60 single use vials / 0 days) RESTASIS MULTIDOSE QL (1 bottle / 0 days) RESPIRATORY ANTICHOLINERGIC/BETA AGONIST COMBINATIONS ANORO ELLIPTA QL (60 blisters / 0 days) BEVESPI AEROSPHERE QL (1 inhaler / 0 days) COMBIVENT RESPIMAT QL ( inhalers / 0 days) ipratropium-albuterol nebu B/D TRELEGY ELLIPTA QL (60 blisters / 0 days) ANTICHOLINERGICS ATROVENT HFA QL ( inhalers / 0 days) INCRUSE ELLIPTA QL (0 blisters / 0 days) ipratropium bromide SOLN B/D ipratropium bromide (nasal) ANTIHISTAMINES azelastine spr 0.1% azelastine spr 0.15% (generic of ASTEPRO) cetirizine syrup cyproheptadine hcl SYRP; TABS PA; PA if 70 years and older diphenhydramine hcl inj 50mg/ml hydroxyzine hcl SYRP PA; PA if 70 years and older hydroxyzine hcl TABS PA; PA if 70 years and older hydroxyzine hcl inj PA; PA if 70 years and older 65

74 hydroxyzine pamoate (generic of VISTARIL) CAPS 5mg, 50mg PA; PA if 70 years and older levocetirizine dihydrochloride SOLN levocetirizine dihydrochloride TABS BETA AGONISTS albuterol sulfate AERS 108mcg/act QL ( inhalers / 0 days); (generic of Proair HFA) albuterol sulfate AERS 108mcg/act QL ( inhalers / 0 days); (generic of Ventolin HFA) albuterol sulfate NEBU B/D albuterol sulfate SYRP albuterol sulfate TABS albuterol sulfate TB1 levalbuterol hcl (generic of XOPENEX) B/D NEBU 1.5mg/ml levalbuterol hcl soln nebu conc 1.5 B/D mg/0.5ml (generic of XOPENEX CONCENTRATE) levalbuterol tartrate hfa QL ( inhalers / 0 days) SEREVENT DISKUS QL (60 inhalations / 0 days) terbutaline sulfate TABS VENTOLIN HFA QL ( inhalers / 0 days) LEUKOTRIENE MODULATORS montelukast sodium (generic of SINGULAIR) CHEW; TABS montelukast sodium (generic of SINGULAIR) PACK zafirlukast (generic of ACCOLATE) MAST CELL STABILIZERS cromolyn sod neb 0mg/ml B/D MISCELLANEOUS acetylcysteine SOLN 10%, 0% B/D ARALAST NP 5 NM, LA, PA DALIRESP epinephrine (generic of Adrenaclick) (anaphylaxis).15mg/0.15ml,.mg/0.ml ESBRIET 5 NM, PA KALYDECO 5 NM, PA OFEV 5 NM, PA 66

75 ORKAMBI 5 NM, PA PROLASTIN-C 5 NM, LA, PA PULMOZYME 5 NM, PA SYMDEKO 5 NM, LA, PA THEO- theophylline SOLN theophylline TB1; TB XOLAIR 5 NM, LA, PA ZEMAIRA 5 NM, LA, PA NASAL STEROIDS flunisolide (nasal) QL ( bottles / 0 days) fluticasone propionate (nasal) QL (1 bottle / 0 days) STEROID INHALANTS ARNUITY ELLIPTA QL (0 inhalations / 0 days) budesonide (inhalation) (generic of B/D PULMICORT).5mg/ml,.5mg/ml FLOVENT DISKUS 50mcg/blist, 100mcg/blist QL (10 inhalations / 0 days) FLOVENT DISKUS 50mcg/blist QL (0 inhalations / 0 days) FLOVENT HFA QL ( inhalers / 0 days) PULMICORT FLEXHALER QL ( inhalers / 0 days) STEROID/BETA-AGONIST COMBINATIONS ADVAIR DISKUS QL (60 inhalations / 0 days) ADVAIR HFA QL (1 inhaler / 0 days) BREO ELLIPTA QL (60 blisters / 0 days) SYMBICORT QL (1 inhaler / 0 days) TOPICAL DERMATOLOGY, ACNE amnesteem PA avita (generic of RETIN-A) CREA PA avita GEL PA benzoyl peroxide-erythromycin (generic of BENZAMYCIN) claravis PA clindacin-p (generic of CLEOCIN-T) clindamycin phosphate (topical) (generic of CLEOCIN-T) GEL; LOTN 67

76 clindamycin phosphate (topical) (generic of CLEOCIN-T) SOLN; SWAB ery pad % erythromycin (acne aid) (generic of ERYGEL) GEL erythromycin (acne aid) SOLN isotretinoin CAPS PA myorisan PA sulfacetamide sodium (acne) (generic of KLARON) tretinoin (generic of RETIN-A) CREA PA tretinoin (generic of RETIN-A) PA GEL.01%,.05% zenatane PA DERMATOLOGY, ANTIBIOTICS gentamicin sulfate (topical) mupirocin OINT silver sulfadiazine (generic of SILVADENE) CREA ssd (generic of SILVADENE) SULFAMYLON CREA DERMATOLOGY, ANTIFUNGALS ciclopirox (generic of LOPROX) CREA; SUSP ciclopirox GEL ciclopirox shampoo 1% (generic of LOPROX SHAMPOO) clotrimazole (topical) clotrimazole w/ betamethasone (generic of LOTRISONE) CREA ketoconazole cream nyamyc nystatin (topical) nystop DERMATOLOGY, ANTIPSORIATICS acitretin (generic of SORIATANE) 10mg, 5 PA 5mg acitretin 17.5mg 5 PA calcipotriene (generic of DOVONEX) CREA QL (10 gm / 0 days), PA calcipotriene OINT QL (10 gm / 0 days), PA calcipotriene SOLN QL (10 ml / 0 days), PA 68

77 calcitrene QL (10 gm / 0 days), PA tazarotene (generic of TAZORAC) CREA PA TAZORAC CREA.05% PA DERMATOLOGY, ANTISEBORRHEICS ketoconazole shampoo (generic of NIZORAL) selenium sulfide LOTN DERMATOLOGY, CORTICOSTEROIDS ala-cort 1% 1 ala-cort.5% alclometasone dipropionate betamethasone dipropionate (topical) CREA; LOTN betamethasone dipropionate (topical) OINT betamethasone dipropionate augmented (generic of DIPROLENE AF) CREA betamethasone dipropionate augmented GEL; LOTN betamethasone dipropionate augmented (generic of DIPROLENE) OINT betamethasone valerate CREA; LOTN; OINT ENSTILAR PA fluocinolone acetonide CREA fluocinolone acetonide (generic of DERMA- SMOOTHE/FS BODY) OIL fluocinolone acetonide (generic of SYNALAR) OINT; SOLN fluocinolone acetonide oil body (generic of DERMA-SMOOTHE/FS SCALP) fluocinonide CREA.05% fluocinonide GEL fluocinonide SOLN fluocinonide emulsified base fluticasone propionate CREA; OINT halobetasol propionate (generic of ULTRAVATE) CREA; OINT hydrocortisone (topical) CREA 1% 1 hydrocortisone (topical) CREA.5% hydrocortisone (topical) LOTN hydrocortisone (topical) OINT.5% hydrocortisone butyrate cream 0.1% (generic of LOCOID) 69

78 hydrocortisone butyrate oint 0.1% hydrocortisone valerate mometasone furoate (generic of ELOCON) CREA mometasone furoate (generic of ELOCON) OINT mometasone furoate SOLN TEXACORT SOLN.5% triamcinolone acetonide (topical) CREA; OINT triamcinolone acetonide (topical) LOTN DERMATOLOGY, LOCAL ANESTHETICS glydo QL (0 ml / 0 days), PA lidocaine (generic of LIDODERM) PTCH QL ( patches / 1 day), PA lidocaine hcl GEL QL (0 ml / 0 days), PA lidocaine hcl SOLN % QL (50 ml / 0 days), PA lidocaine oint 5% QL (50 grams / 0 days), PA lidocaine-prilocaine QL (0 grams / 0 days), PA DERMATOLOGY, MISCELLANEOUS SKIN AND MUCOUS MEMBRANE ammonium lactate CREA; LOTN diclofenac sodium (topical) 1% gel (generic PA of VOLTAREN) fluorouracil (topical) (generic of EFUDEX) CREA 5% fluorouracil (topical) SOLN imiquimod (generic of ALDARA) CREA 5% metronidazole (topical) (generic of METROCREAM) CREA metronidazole (topical) (generic of METROLOTION) LOTN metronidazole gel 0.75% PANRETIN 5 PICATO.05% QL ( tubes / 0 days) PICATO.015% QL ( tubes / 0 days) podofilox SOLN procto-med hc (generic of ANUSOL-HC) procto-pak (generic of PROCTOCORT) proctosol hc cre.5% (generic of ANUSOL- HC) 70

79 proctozone-hc (generic of ANUSOL-HC) rosadan cre 0.75% (generic of METROCREAM) tacrolimus (topical) (generic of PROTOPIC) TARGRETIN GEL 5 NM, PA VALCHLOR 5 NM, LA, PA DERMATOLOGY, SCABICIDES AND PEDICULIDES malathion (generic of OVIDE) permethrin cre 5% (generic of ELIMITE) DERMATOLOGY, WOUND CARE AGENTS acetic acid.5% REGRANEX 5 PA SANTYL sodium chlor sol 0.9% irr water for irrigation, sterile MOUTH/THROAT/DENTAL AGENTS cevimeline hcl (generic of EVOXAC) chlorhexidine gluconate (mouth-throat) 1 (generic of PERIDEX) clotrimazole LOZG lidocaine hcl (mouth-throat) nystatin (mouth-throat) paroex sol 0.1% (generic of PERIDEX) 1 periogard (generic of PERIDEX) 1 pilocarpine hcl (oral) (generic of SALAGEN) triamcinolone acetonide (mouth) OTIC acetic acid (otic) CIPRODEX flac (generic of DERMOTIC) fluocinolone acetonide (otic) (generic of DERMOTIC) neomycin-polymyxin-hc (otic) ofloxacin (otic) (generic of FLOXIN OTIC) 71

80 Index A abacavir sulfate...7 abacavir sulfate-lamivudine...9 abacavir sulfate-lamivudine-zidovudine.9 ABELCET...6 ABILIFY see aripiprazole tab... ABILIFY MAINTENA... abiraterone acetate...15 ABRAXANE...1 acamprosate calcium...0 acarbose...1 ACCOLATE see zafirlukast...66 ACCUPRIL see quinapril hcl...0 ACCURETIC see quinapril-hydrochlorothiazide...19 acebutolol hcl... acetaminophen w/ codeine 00-15mg... acetaminophen w/ codeine 00-0mg... acetaminophen w/ codeine 00-60mg... acetaminophen w/ codeine soln... acetazolamide... acetic acid...71 acetic acid (otic)...71 acetylcysteine...66 acitretin...68 ACTHIB...59 ACTIGALL see ursodiol...5 ACTIMMUNE...58 ACTIQ see fentanyl citrate... ACTOS see pioglitazone hcl... ACULAR see ketorolac tromethamine (ophth).6 ACULAR LS see ketorolac tromethamine (ophth).6 acyclovir...10 acyclovir sodium...10 ADACEL...59 ADAGEN...8 ADALAT CC see nifedipine er... ADDERALL see amphetamine-dextroamphetamine tab 10 mg...6 see amphetamine-dextroamphetamine tab 1.5 mg...6 see amphetamine-dextroamphetamine tab 15 mg...7 see amphetamine-dextroamphetamine tab 0 mg...7 see amphetamine-dextroamphetamine tab 0 mg...7 see amphetamine-dextroamphetamine tab 5 mg...6 see amphetamine-dextroamphetamine tab 7.5 mg...6 ADDERALL XR see amphetamine-dextroamphetamine cap sr hr 10 mg...6 see amphetamine-dextroamphetamine cap sr hr 15 mg...6 see amphetamine-dextroamphetamine cap sr hr 0 mg...6 see amphetamine-dextroamphetamine cap sr hr 5 mg...6 see amphetamine-dextroamphetamine cap sr hr 0 mg...6 see amphetamine-dextroamphetamine cap sr hr 5 mg...6 adefovir dipivoxil...10 ADEMPAS...6 adriamycin...1 adrucil...1 adrucil inj...1 ADVAIR DISKUS...67 ADVAIR HFA...67 AFINITOR...16 AFINITOR DISPERZ...16 AGGRENOX see aspirin-dipyridamole...57 AGRYLIN see anagrelide hcl...56 ala-cort

81 albendazole... ALBENZA... see albendazole... albuterol sulfate...66 ALCAINE see proparacaine hcl...65 alclometasone dipropionate...69 ALCOHOL SWABS...1 ALDACTAZIDE see spironolactone & hydrochlorothiazide...5 ALDACTONE see spironolactone...0 ALDARA see imiquimod...70 ALDURAZYME...8 ALECENSA...16 alendronate sodium... alfuzosin hcl...5 ALIMTA...1 ALINIA... allopurinol tab...1 alosetron hcl...5 ALPHAGAN P see brimonidine sol 0.15%...6 ALPHAGAN P SOL 0.1%...6 alprazolam tab 0.5mg...6 alprazolam tab 0.5mg...6 alprazolam tab 1mg...6 alprazolam tab mg...6 ALREX...6 ALTACE see ramipril...0 altavera tab... ALUNBRIG...16 alyacen 1/5... amantadine hcl... AMARYL see glimepiride... AMBIEN see zolpidem tartrate...8 AMBISOME...6 AMERGE see naratriptan hcl...8 amikacin sulfate... amiloride & hydrochlorothiazide... amiloride hcl... AMINOSYN...60 AMINOSYN-HBC...60 AMINOSYN-PF 7%...60 AMINOSYN-PF INJ 10%...60 AMINOSYN-RF...60 AMINOSYN 7%/ELECTROLYTES...60 aminosyn 8.5%/electrolyte...60 aminosyn ii 8.5%/electrol...60 AMINOSYN II INJ 10%...60 AMINOSYN II INJ 8.5%...60 AMINOSYN M...60 amiodarone hcl soln...0 amiodarone tab 100mg...0 amiodarone tab 00mg...0 amiodarone tab 00mg...1 AMITIZA CAP MCG...5 AMITIZA CAP 8MCG...5 amitriptyline hcl...0 amlodipine-valsartan-hydrochlorothiazide tab...0 amlodipine besylate... amlodipine besylate-benazepril hcl cap 10-0 mg...19 amlodipine besylate-benazepril hcl cap 10-0 mg...19 amlodipine besylate-benazepril hcl cap.5-10 mg...19 amlodipine besylate-benazepril hcl cap 5-10 mg...19 amlodipine besylate-benazepril hcl cap 5-0 mg...19 amlodipine besylate-benazepril hcl cap 5-0 mg...19 amlodipine besylate-olmesartan medoxomil...0 amlodipine besylate-valsartan tab...0 ammonium lactate...70 amnesteem...67 amoxapine...0 amoxicillin...1 amoxicillin & pot clavulanate...1 amphetamine-dextroamphetamine cap sr hr 10 mg...6 amphetamine-dextroamphetamine cap sr hr 15 mg...6 7

82 amphetamine-dextroamphetamine cap sr hr 0 mg...6 amphetamine-dextroamphetamine cap sr hr 5 mg...6 amphetamine-dextroamphetamine cap sr hr 0 mg...6 amphetamine-dextroamphetamine cap sr hr 5 mg...6 amphetamine-dextroamphetamine tab 10 mg...6 amphetamine-dextroamphetamine tab 1.5 mg...6 amphetamine-dextroamphetamine tab 15 mg...7 amphetamine-dextroamphetamine tab 0 mg...7 amphetamine-dextroamphetamine tab 0 mg...7 amphetamine-dextroamphetamine tab 5 mg...6 amphetamine-dextroamphetamine tab 7.5 mg...6 amphotericin b...6 ampicillin & sulbactam sodium...1 ampicillin cap 500mg...1 ampicillin inj...1 ampicillin sodium...1 AMPYRA...9 see dalfampridine...9 ANADROL ANAFRANIL see clomipramine hcl...0 anagrelide hcl...56 ANAPROX DS see naproxen sodium...1 anastrozole...15 ANCOBON see flucytosine...6 ANDRODERM...0 ANDROGEL see testosterone...0 ANORO ELLIPTA...65 ANTABUSE see disulfiram...0 ANUSOL-HC see procto-med hc...70 see proctosol hc cre.5%...70 see proctozone-hc...71 APOKYN... aprepitant...51 aprepitant pak 80mg & 15mg...51 apri... APRISO...5 APTIOM...6 APTIVUS...7 ARALAST NP...66 aranelle... ARAVA see leflunomide...57 ARCALYST...58 ARICEPT see donepezil hydrochloride...0 ARIMIDEX see anastrozole...15 aripiprazole odt... aripiprazole oral solution 1 mg/ml... aripiprazole tab... ARISTADA..., ARISTADA INITIO... ARIXTRA see fondaparinux sodium...55 armodafinil...0 ARNUITY ELLIPTA...67 AROMASIN see exemestane...16 ASACOL HD see mesalamine...5 aspirin-dipyridamole...57 ASTEPRO see azelastine spr 0.15%...65 atazanavir sulfate...7 atenolol... atenolol & chlorthalidone... ATIVAN see lorazepam...6 atomoxetine hcl...7 atorvastatin calcium...1 atovaquone... atovaquone-proguanil hcl...7 ATRIPLA...9 ATROVENT HFA...65 aubra... 7

83 AUGMENTIN see amoxicillin & pot clavulanate...1 AUGMENTIN XR see amoxicillin & pot clavulanate...1 AURYXIA...50 AUSTEDO...8 AVALIDE see irbesartan-hydrochlorothiazide...0 AVAPRO see irbesartan...0 AVASTIN...15 aviane... avita...67 AVODART see dutasteride...5 AYGESTIN see norethindrone acetate...51 azacitidine...1 AZACTAM see aztreonam...5 AZACTAM/DEX INJ... AZACTAM IN ISO-OSMOTIC DE... AZASITE...6 azathioprine...58 azelastine drop 0.05%...6 azelastine spr 0.1%...65 azelastine spr 0.15%...65 AZILECT see rasagiline mesylate... azithromycin...11 AZOPT...6 AZOR see amlodipine besylate-olmesartan medoxomil...0 aztreonam...5 AZULFIDINE see sulfasalazine...5 AZULFIDINE EN-TABS see sulfasalazine ec...5 B bacitracin-poly-neomycin-hc...6 bacitracin-polymyxin b (ophth)...6 bacitracin (ophthalmic)...6 baclofen...9 BACTRIM see sulfamethoxazole-trimethoprim tab 00-80mg...6 BACTRIM DS see sulfamethoxazole-trimethop ds...6 balsalazide disodium...5 balziva... BANZEL SUS 0MG/ML...6 BANZEL TAB 00MG...6 BANZEL TAB 00MG...6 BARACLUDE...10 see entecavir...10 BASAGLAR KWIKPEN...1 BCG VACCINE...59 BD ULTRAFINE/NANO PEN NEEDLES...1 BD ULTRAFINE INSULIN SYRINGE...1 bekyree... benazepril & hydrochlorothiazide...19 benazepril hcl...19 BENDEKA...1 BENICAR see olmesartan medoxomil...0 BENICAR HCT see olmesartan medoxomilhydrochlorothiazide...0 BENLYSTA...58 BENZAMYCIN see benzoyl peroxide-erythromycin..67 benzoyl peroxide-erythromycin...67 benztropine mesylate inj... benztropine mesylate tab 0.5mg... benztropine mesylate tab 1mg... benztropine mesylate tab mg... BEPREVE...6 BERINERT...56 BESIVANCE...6 betamethasone dipropionate (topical)..69 betamethasone dipropionate augmented...69 betamethasone valerate...69 BETAPACE see sorine...1 see sotalol hcl...1 BETAPACE AF see sotalol hcl (afib/afl)...1 BETASERON...9 betaxolol hcl (ophth)...6 bethanechol chloride

84 BETOPTIC-S...6 BEVESPI AEROSPHERE...65 bexarotene...18 BEXSERO...59 BIAXIN XL see clarithromycin er...11 bicalutamide...15 BICILLIN L-A...1 BIKTARVY...9 BILTRICIDE...5 see praziquantel...6 bisoprolol & hydrochlorothiazide... bisoprolol fumarate... BIVIGAM...57 bleomycin sulfate...1 BLEPH-10 see sulfacetamide sodium (ophth)...6 BLEPHAMIDE...6 blisovi fe 1/0... blisovi fe 1.5/0... BONIVA see ibandronate sodium... BOOSTRIX...59 BORTEZOMIB...15 BOSULIF...16 BRAFTOVI...17 BREO ELLIPTA...67 briellyn... BRILINTA...57 brimonidine sol 0.15%...6 brimonidine sol 0.%...6 BRIVIACT INJ 50MG/5ML...6 BRIVIACT SOL 10MG/ML...6 BRIVIACT TAB 100MG...7 BRIVIACT TAB 10MG...6 BRIVIACT TAB 5MG...6 BRIVIACT TAB 50MG...6 BRIVIACT TAB 75MG...6 bromfenac sodium (ophth)...6 bromocriptine mesylate... BROMSITE...6 budesonide (inhalation)...67 budesonide ec...5 bumetanide inj 0.5/ml... bumetanide tab... BUMEX see bumetanide tab... BUPHENYL see sodium phenylbutyrate...8 buprenorphine hcl...0 buprenorphine hcl-naloxone hcl sl...0 bupropion hcl...0 bupropion hcl (smoking deterrent)...0 buspirone hcl...6 butorphanol tartrate... BYDUREON BCISE...1 BYDUREON INJ...1 BYDUREON PEN...1 BYETTA...1 BYSTOLIC... C cabergoline...50 CABOMETYX...17 CAFERGOT see ergotamine w/ caffeine...8 CALAN see verapamil hcl... CALAN SR see verapamil hcl... see verapamil tab er... calcipotriene...68 calcitonin (salmon)...50 calcitrene...69 calcitriol...6 calcitriol inj...6 calcitriol oral soln 1 mcg/ml...6 calcium acetate (phosphate binder)...50 CALQUENCE...17 camila... CAMPTOSAR see irinotecan hcl...18 CANASA...5 see mesalamine...5 CANCIDAS see caspofungin acetate...6 CAPRELSA...17 captopril...19 captopril & hydrochlorothiazide...19 CARAFATE see sucralfate...5 CARBAGLU...8 carbamazepine

85 CARBATROL see carbamazepine...7 carbidopa-levodopa... carbidopa/levodopa/entacapone... carboplatin...18 CARDIZEM see diltiazem hcl... CARDIZEM CD see cartia xt... see diltiazem cap 10mg cd... see diltiazem cap 180mg cd... see diltiazem cap 0mg cd... see diltiazem cap 60mg cd... see diltiazem hcl coated beads cap sr hr... see diltiazem hcl extended release beads cap sr... CARDURA see doxazosin mesylate...0 CARIMUNE NANOFILTERED...57 CARNITOR see levocarnitine (metabolic modifiers)...8 carteolol hcl (ophth)...6 cartia xt... carvedilol... CASODEX see bicalutamide...15 caspofungin acetate...6 CATAPRES see clonidine hcl...5 CATAPRES-TTS-1 see clonidine hcl ptwk...5 CATAPRES-TTS- see clonidine hcl ptwk...5 CATAPRES-TTS- see clonidine hcl ptwk...5 CAYSTON...5 caziant pak... cefaclor...11 CEFACLOR ER TAB 500MG...11 cefadroxil...11 CEFAZOLIN IN DEXTROSE GM/100ML- %...11 cefazolin inj...11 cefazolin sodium...11 CEFAZOLIN SODIUM 1 GM/50ML...11 cefdinir...11 cefepime for inj...11 cefixime...11 cefotaxime sodium...11 cefoxitin for inj...11 cefpodoxime proxetil...11 cefprozil...11 ceftazidime...11 CEFTAZIDIME/DEXTROSE...11 ceftriaxone sodium...11 cefuroxime axetil...11 cefuroxime sodium...11 CELEBREX see celecoxib...1 celecoxib...1 CELEXA see citalopram hydrobromide...0 CELLCEPT see mycophenolate mofetil...58 CELONTIN...7 cephalexin...11 CERDELGA...8 CEREZYME...8 cetirizine syrup...65 cevimeline hcl...71 CHANTIX...0 CHANTIX CONTINUING MONTH...0 CHANTIX STARTER PACK...0 CHEMET... chlorhexidine gluconate (mouth-throat)...71 chloroquine phosphate...7 chlorothiazide tabs... chlorpromazine hcl... CHLORPROMAZINE INJ... chlorthalidone... cholestyramine...1 cholestyramine light...1 ciclopirox...68 ciclopirox shampoo 1%...68 cilostazol...56 CILOXAN...6 see ciprofloxacin hcl (ophth)...6 CIMDUO...9 cinacalcet hcl... 77

86 CIPRO see ciprofloxacin...1 see ciprofloxacin hcl tab...1 CIPRODEX...71 ciprofloxacin...1 ciprofloxacin hcl (ophth)...6 ciprofloxacin hcl tab...1 ciprofloxacin in d5w...1 cisplatin...18 citalopram hydrobromide...0 claravis...67 clarithromycin...11 clarithromycin er...11 clarithromycin for susp...11 CLEOCIN see clindamycin cap 00 mg...5 see clindamycin cap 75mg...5 see clindamycin hcl cap 150 mg...5 see clindamycin phosphate vaginal...55 CLEOCIN-T see clindacin-p...67 see clindamycin phosphate (topical)67, 68 CLEOCIN PEDIATRIC GRANULE see clindamycin soln 75mg/5ml...5 CLEOCIN PHOSPHATE see clindamycin phosphate inj...5 CLIMARA see estradiol...8 clindacin-p...67 clindamycin cap 00 mg...5 clindamycin cap 75mg...5 clindamycin hcl cap 150 mg...5 clindamycin phosphate (topical)...67, 68 clindamycin phosphate in d5w...5 clindamycin phosphate inj...5 CLINDAMYCIN PHOSPHATE IN NACL...5 clindamycin phosphate vaginal...55 clindamycin soln 75mg/5ml...5 CLINIMIX.5%/DEXTROSE 5%...61 CLINIMIX.5%/DEXTROSE 5%...60 CLINIMIX 5%/DEXTROSE 15%...61 CLINIMIX 5%/DEXTROSE 0%...61 CLINIMIX 5%/DEXTROSE 5%...61 CLINIMIX INJ.5/D clobazam...7 clomipramine hcl...0 clonazepam...7 clonidine hcl...5 clonidine hcl ptwk...5 clopidogrel tab 75mg...57 clorazepate dipotassium...7 clotrimazole...71 clotrimazole (topical)...68 clotrimazole w/ betamethasone...68 clozapine odt... clozapine tab 100mg... clozapine tab 00mg... clozapine tab 5mg... clozapine tab 50mg... CLOZARIL see clozapine tab 100mg... see clozapine tab 5mg... COARTEM...7 COGENTIN see benztropine mesylate inj... COLAZAL see balsalazide disodium...5 colchicine w/ probenecid...1 COLCRYS...1 colesevelam hcl...1 COLESTID see colestipol hcl gran...1 see colestipol hcl pack...1 see colestipol hcl tabs... colestipol hcl gran...1 colestipol hcl pack...1 colestipol hcl tabs... colistimethate sodium...5 colocort...5 COLY-MYCIN M see colistimethate sodium...5 COLYTE-FLAVOR PACKS see gavilyte-c...5 COMBIGAN...6 COMBIVENT RESPIMAT...65 COMBIVIR see lamivudine-zidovudine...9 COMETRIQ...17 COMPLERA...9 compro supp...51 COMTAN 78

87 see entacapone... constulose...5 COPAXONE see glatiramer acetate 0mg/ml...9 see glatiramer acetate 0mg/ml...9 see glatopa...9 COPIKTRA...17 COREG see carvedilol... CORGARD see nadolol... CORLANOR...5 CORTEF see hydrocortisone...9 CORTENEMA see colocort...5 see hydrocortisone (enema)...5 cortisone acetate...9 COSOPT see dorzolamide hcl-timolol maleate.6 COTELLIC...17 COUMADIN...55 see jantoven...56 see warfarin sodium...56 COZAAR see losartan potassium...0 CREON...5 CRESTOR see rosuvastatin calcium...1 CRIXIVAN...7 cromolyn sodium (mastocytosis)...5 cromolyn sodium (ophth)...6 cromolyn sod neb 0mg/ml...66 cryselle-8... CUBICIN see daptomycin...5 cyclafem 1/5... cyclafem 7/7/7... cyclobenzaprine hcl...9 cyclophosphamide...1 CYCLOPHOSPHAMIDE see cyclophosphamide...1 cycloserine...9 cyclosporine...58 cyclosporine modified (for microemulsion)...58 CYKLOKAPRON see tranexamic acid...56 CYMBALTA see duloxetine hcl...1 cyproheptadine hcl...65 cyred tab... CYSTADANE...8 CYSTAGON...8 CYSTARAN...65 cytarabine...1 CYTOMEL see liothyronine sodium...51 CYTOTEC see misoprostol...5 CYTOVENE see ganciclovir sodium...10 D D.H.E. 5 see dihydroergotamine mesylate inj 1 mg/ml...8 dacarbazine...1 dalfampridine...9 DALIRESP...66 danazol...8 DANTRIUM see dantrolene sodium...9 dantrolene sodium...9 dapsone...5 DAPTACEL...59 daptomycin...5 DAPTOMYCIN...5 dasetta 1/5... dasetta 7/7/7... DAURISMO...15 DDAVP see desmopressin acetate spray...51 see desmopressin acetate tabs...51 see desmopressin inj mcg/ml...51 deblitane... DELESTROGEN...8 see estradiol valerate inj...8 DELSTRIGO...9 delyla... DELZICOL...5 DEMADEX see torsemide tabs

88 DEMSER...5 DEPACON see valproate sodium...9 DEPAKENE see valproate sodium oral soln...9 see valproic acid...9 DEPAKOTE see divalproex sodium...7 DEPAKOTE ER see divalproex sodium...7 DEPAKOTE SPRINKLES see divalproex sodium...7 DEPEN TITRATABS... DEPO-MEDROL see methylprednisolone acetate...9 DEPO-PROVERA CONTRACEPTIV see medroxyprogesterone acetate (contraceptive)...6 DEPO-PROVERA INJ 00/ML...16 DEPO-TESTOSTERONE see testosterone cypionate...0 DERMA-SMOOTHE/FS BODY see fluocinolone acetonide...69 DERMA-SMOOTHE/FS SCALP see fluocinolone acetonide oil body...69 DERMOTIC see flac...71 see fluocinolone acetonide (otic)...71 DESCOVY...9 desipramine hcl...1 desmopressin acetate spray...51 desmopressin acetate spray refrigerated...51 desmopressin acetate tabs...51 desmopressin inj mcg/ml...51 desogestrel-ethinyl estradiol (biphasic) desogestrel & ethinyl estradiol... desvenlafaxine succinate...1 DETROL see tolterodine tartrate...55 DETROL LA see tolterodine tartrate...55 dexamethasone...9 DEXAMETHASONE...9 DEXAMETHASONE SODIUM PHOS see dexamethasone sodium phosphate...9 dexamethasone sodium phosphate...9 dexamethasone sodium phosphate (ophth)...6 DEXILANT...5 dexmethylphenidate hcl...7 dexrazoxane...18 DEXTROSE 10%/NACL 0.%...61 dextrose 10%/nacl 0.5%...61 dextrose 10% flex contain...61 dextrose.5%/nacl 0.5%...61 dextrose 5%...61 DEXTROSE 5% /ELECTROLYTE...61 dextrose 5%/nacl 0.%...61 dextrose 5%/nacl 0.5%...61 DEXTROSE 5%/NACL 0.%...61 dextrose 5%/nacl 0.%...61 dextrose 5%/nacl 0.5%...61 dextrose 5%/nacl 0.9%...61 dextrose 5%/potassium chl...61 dextrose 50%...61 dextrose inj 70%...61 dextrose in lactated ringers...61 DIASTAT ACUDIAL...7 DIASTAT PEDIATRIC...7 diazepam...7 diazepam gel...7 diazepam inj...7 diazepam intensol...7 diazepam oral soln 1 mg/ml...7 diclofenac potassium...1 diclofenac sodium...1 diclofenac sodium (ophth)...6 diclofenac sodium (topical) 1% gel...70 dicloxacillin sodium...1 dicyclomine hcl cap 10mg...5 dicyclomine hcl soln 10mg/5ml...5 dicyclomine hcl tab 0mg...5 didanosine...7 DIFICID...1 DIFLUCAN see fluconazole...6 diflunisal...1 digitek... digox... digoxin... 80

89 digoxin inj... digoxin sol 50mcg/ml... dihydroergotamine mesylate inj 1 mg/ml...8 dihydroergotamine mesylate nasal...8 DILANTIN see phenytoin sodium extended...9 DILANTIN-15 see phenytoin...9 DILANTIN-15 SUSP...7 DILANTIN CAP 100MG...7 DILANTIN CAP 0MG...7 DILANTIN CHEW TAB 50MG...7 DILANTIN INFATABS see phenytoin...9 DILAUDID see hydromorphone hcl..., dilt-xr cap... diltiazem cap 10mg cd... diltiazem cap 180mg cd... diltiazem cap 0mg cd... diltiazem cap 60mg cd... diltiazem cap er/1hr... diltiazem hcl... diltiazem hcl cap sr hr... diltiazem hcl coated beads cap sr hr diltiazem hcl extended release beads cap sr... diltiazem inj... DIOVAN see valsartan...0 DIOVAN HCT see valsartan-hydrochlorothiazide...0 diphenhydramine hcl inj 50mg/ml...65 diphenoxylate w/ atropine...5 DIPHTHERIA/TETANUS TOXOID...59 DIPROLENE see betamethasone dipropionate augmented...69 DIPROLENE AF see betamethasone dipropionate augmented...69 disopyramide phosphate...1 disulfiram...0 DITROPAN XL see oxybutynin chloride...55 divalproex sodium...7 docetaxel...1 DOCETAXEL...1 see docetaxel...1 dofetilide...1 DOLOPHINE see methadone hcl 10mg... see methadone hcl 5mg... donepezil hydrochloride...0 dorzolamide hcl...6 dorzolamide hcl-timolol maleate...6 DOVONEX see calcipotriene...68 doxazosin mesylate...0 doxepin hcl...1 DOXIL see doxorubicin hcl liposomal...1 doxorubicin hcl...1 doxorubicin hcl liposomal...1 doxy doxycycline (monohydrate)...1 doxycycline hyclate...1 doxycycline hyclate 100 mg...1 doxycycline hyclate 0 mg...1 dronabinol...51 drospirenone-ethinyl estradiol..., 5 DROXIA...56 duloxetine hcl...1 DURAGESIC see fentanyl patch 100 mcg/hr... see fentanyl patch 1 mcg/hr... see fentanyl patch 5 mcg/hr... see fentanyl patch 50 mcg/hr... see fentanyl patch 75 mcg/hr... DUREZOL...6 dutasteride...5 dutasteride-tamsulosin hcl...5 DYAZIDE see triamterene & hydrochlorothiazide cap mg...5 E e.e.s EC-NAPROSYN see naproxen dr...1 EC-NAPROXEN see naproxen dr

90 EDURANT...7 efavirenz...7 EFFEXOR XR see venlafaxine hcl... EFFIENT see prasugrel hcl...57 EFUDEX see fluorouracil (topical)...70 eletriptan hydrobromide...8 ELIMITE see permethrin cre 5%...71 ELIQUIS...55 ELIQUIS STARTER PACK...55 ELLA...5 ELLENCE see epirubicin hcl...1 ELOCON see mometasone furoate...70 EMCYT...1 EMEND...51 see aprepitant...51 emoquette...5 EMSAM...1 EMTRIVA...7 EMVERM...5 enalapril maleate...19 enalapril maleate & hydrochlorothiazide...19 ENDARI...56 endocet 10-5mg... endocet.5-5mg... endocet 5-5mg... endocet 7.5-5mg... ENGERIX-B...59 enoxaparin sodium...55 enpresse enskyce...5 ENSTILAR...69 entacapone... entecavir...10 ENTOCORT EC see budesonide ec...5 ENTRESTO...0 enulose...5 EPCLUSA...10 EPIDIOLEX...8 epinephrine (anaphylaxis)...66 epirubicin hcl...1 epitol...8 EPIVIR see lamivudine...7 EPIVIR HBV...10 see lamivudine (hbv)...10 eplerenone...0 EPZICOM see abacavir sulfate-lamivudine...9 ergotamine w/ caffeine...8 ERIVEDGE...15 ERLEADA...16 errin...5 ertapenem sodium...5 ery-tab...1 ERYGEL see erythromycin (acne aid)...68 ery pad %...68 ERYTHROCIN LACTOBIONATE...1 erythrocin stearate...1 erythromycin (acne aid)...68 erythromycin (ophth)...6 erythromycin base...1 erythromycin cap 50mg ec...1 erythromycin ethylsuccinate...1 ESBRIET...66 escitalopram oxalate...1 esomeprazole magnesium...5 esomeprazole sodium inj...5 estarylla tab ESTRACE see estradiol...8 see estradiol vaginal cream...8 estradiol...8 estradiol vaginal cream...8 estradiol vaginal tab...8 estradiol valerate inj...8 ESTROSTEP FE see tilia fe...7 see tri-legest fe...7 ethambutol hcl...9 ethosuximide...8 ethynodiol diacet & eth estrad...5 ethynodiol tab etodolac...1 8

91 etoposide...18 EVISTA see raloxifene tab 60mg...50 EVOTAZ...9 EVOXAC see cevimeline hcl...71 EXELON see rivastigmine td patch hr 1. mg/hr...0 see rivastigmine td patch hr.6 mg/hr...0 see rivastigmine td patch hr 9.5 mg/hr...0 exemestane...16 EXFORGE see amlodipine besylate-valsartan tab...0 EXFORGE HCT see amlodipine-valsartanhydrochlorothiazide tab...0 ezetimibe... F FABRAZYME...8 falmina...5 famciclovir...10 famotidine...5 famotidine inj...5 famotidine in nacl...5 FANAPT... FANAPT TITRATION PACK... FARESTON...16 see toremifene citrate...16 FARXIGA...1, FARYDAK...15 FASLODEX...16 FAZACLO see clozapine odt... felbamate...8 FELBATOL see felbamate...8 FELDENE see piroxicam...1 felodipine... FEMARA see letrozole...16 FEMHRT LOW DOSE see fyavolv...8 see norethindrone acetate-ethinyl estradiol...9 femynor...5 fenofibrate... fenofibrate micronized... fentanyl citrate... fentanyl patch 100 mcg/hr... fentanyl patch 1 mcg/hr... fentanyl patch 5 mcg/hr... fentanyl patch 50 mcg/hr... fentanyl patch 75 mcg/hr... FENTORA... FETZIMA...1 FETZIMA TITRATION PACK...1 FIASP...1 FIASP FLEXTOUCH...1 finasteride...5 FIRAZYR...56 flac...71 FLAGYL see metronidazole...5 FLEBOGAMMA DIF...57 flecainide acetate...1 FLOMAX see tamsulosin hcl...5 FLOVENT DISKUS...67 FLOVENT HFA...67 FLOXIN OTIC see ofloxacin (otic)...71 fluconazole...6 fluconazole in dextrose...6 fluconazole inj nacl fluconazole inj nacl flucytosine...6 fludrocortisone acetate...9 FLUMADINE see rimantadine hydrochloride...10 flunisolide (nasal)...67 fluocinolone acetonide...69 fluocinolone acetonide (otic)...71 fluocinolone acetonide oil body...69 fluocinonide...69 fluocinonide emulsified base...69 fluorometholone...6 fluorouracil...1 8

92 fluorouracil (topical)...70 fluoxetine cap 10mg...1 fluoxetine cap 0mg...1 fluoxetine cap 0mg...1 fluoxetine hcl...1 fluphenazine decanoate... fluphenazine hcl... flurbiprofen...1 flurbiprofen sodium...6 flutamide...16 fluticasone propionate...69 fluticasone propionate (nasal)...67 fluvoxamine maleate...6 FOCALIN see dexmethylphenidate hcl...7 fondaparinux sodium...55 FORTEO...50 FOSAMAX see alendronate sodium... fosamprenavir tab 700 mg...7 fosinopril sodium...19 fosinopril sodium & hydrochlorothiazide...19 FREAMINE HBC 6.9%...61 FREAMINE III...61 furosemide... furosemide inj... FUZEON...7 fyavolv...8 FYCOMPA...8 G gabapentin...8 GABITRIL see tiagabine hcl...9 galantamine hydrobromide...0 galantamine hydrobromide er...0 GAMASTAN S/D...57 GAMMAGARD LIQUID...57 GAMMAGARD S/D...57 GAMMAKED...57 GAMMAPLEX...58 GAMMAPLEX 10GM/100ML...58 GAMUNEX-C...58 ganciclovir sodium...10 GARDASIL GASTROCROM see cromolyn sodium (mastocytosis) 5 gatifloxacin (ophth)...6 GATTEX...5 GAUZE PADS...1 gavilyte-c...5 gavilyte-g...5 gavilyte-n/flavor pack...5 gemcitabine inj soln...1 gemcitabine inj solr...1 gemfibrozil... generlac...5 gengraf...58 GENOTROPIN...50 GENOTROPIN MINIQUICK...50 gentak...6 gentamicin in saline... gentamicin sulfate... gentamicin sulfate (topical)...68 gentamicin sulfate soln (ophth)...6 GENVOYA...9 GEODON... see ziprasidone hcl...6 gianvi tab -0.0mg...5 GILENYA...9 GILOTRIF TAB 0MG...17 GILOTRIF TAB 0MG...17 GILOTRIF TAB 0MG...17 glatiramer acetate 0mg/ml...9 glatiramer acetate 0mg/ml...9 glatopa...9 GLEEVEC see imatinib mesylate...17 GLEOSTINE...1 glimepiride... glip/metform tab.5-50mg... glip/metform tab.5-500mg... glip/metform tab 5-500mg... glipizide... glipizide xl... GLUCAGEN HYPOKIT...50 GLUCAGON EMERGENCY KIT...50 GLUCOPHAGE see metformin hcl... GLUCOPHAGE XR see metformin er... GLUCOTROL 8

93 see glipizide... GLUCOTROL XL see glipizide... see glipizide xl... glycopyrrolate tab 1mg...5 glycopyrrolate tab mg...5 glydo...70 GOLYTELY...5 see gavilyte-g...5 see peg 50-kcl-sod bicarb-sod chloride-sod sulfate...5 granisetron hcl...51 GRANIX...56 griseofulvin microsize...6 griseofulvin ultramicrosize...6 guanfacine er (adhd)...7 H HAEGARDA...56 HALDOL see haloperidol lactate inj 5mg/ml... HALDOL DECANOATE 100 see haloperidol decanoate... HALDOL DECANOATE 50 see haloperidol decanoate... halobetasol propionate...69 haloperidol... haloperidol conc mg/ml... haloperidol decanoate... haloperidol lactate inj 5mg/ml... HARVONI...10 HAVRIX...59 heather...5 heparin sod (porcine) in d5w...55 heparin sod inj 1000/ml...55 heparin sod inj 10000/ml...56 heparin sod inj 0000/ml...56 heparin sod inj 5000/ml...55 HEPARIN SODIUM/NACL 0.5%...56 hepatamine...61 HEPSERA see adefovir dipivoxil...10 HERCEPTIN...15 HETLIOZ...7 HIBERIX...59 HIPREX see methenamine hippurate...5 HUMIRA...57 HUMIRA INJ 10MG/0.ML...57 HUMIRA KIT 0MG/0.ML...57 HUMIRA KIT 0MG/0.8ML...57 HUMIRA PEDIATRIC CROHNS DISEASE57 HUMIRA PEN...57 HUMIRA PEN-PS/UV STARTER...57 HUMIRA PEN CD/UC/HS STARTER...57 HUMIRA PEN INJ CD/UC/HS STARTER.57 HUMIRA PEN INJ PS/UV STARTER...57 HUMULIN R INJ U HUMULIN R U-500 KWIKPEN...1 HYCAMTIN see topotecan hcl...19 hydralazine hcl...5 HYDREA see hydroxyurea...18 hydrochlorothiazide... hydroco/apap tab 10-5mg... hydroco/apap tab 5-5mg... hydroco/apap tab hydrocodone-acetaminophen mg/15ml... hydrocodone-ibuprofen tab mg. hydrocortisone...9 hydrocortisone (enema)...5 hydrocortisone (topical)...69 hydrocortisone butyrate cream 0.1%..69 hydrocortisone butyrate oint 0.1%...70 hydrocortisone valerate...70 hydromorphone hcl..., hydroxychloroquine sulfate...57 hydroxyurea...18 hydroxyzine hcl...65 hydroxyzine hcl inj...65 hydroxyzine pamoate...66 HYSINGLA ER... HYZAAR see losartan-hydrochlorothiazide...0 I ibandronate sodium... IBRANCE...15 ibuprofen...1 ibu tab 600mg...1 ibu tab 800mg...1 ICLUSIG

94 IDHIFA...15 IFEX INJ GM...1 ifosfamide inj 1gm/0ml...1 IFOSFAMIDE INJ GM...1 ifosfamide inj gm/60ml...1 ILEVRO...6 imatinib mesylate...17 IMBRUVICA...17 imipenem-cilastatin...5 imipramine hcl...1 imiquimod...70 IMITREX see sumatriptan...8 see sumatriptan inj 6mg/0.5ml...8 see sumatriptan succinate...8 IMITREX STATDOSE REFILL see sumatriptan inj mg/0.5ml...8 see sumatriptan inj 6mg/0.5ml...8 IMITREX STATDOSE SYSTEM see sumatriptan inj mg/0.5ml...8 see sumatriptan inj 6mg/0.5ml...8 IMOVAX RABIES (H.D.C.V.)...59 IMURAN see azathioprine...58 incassia...5 INCRELEX...50 INCRUSE ELLIPTA...65 indapamide...5 INDERAL LA see propranolol cap er... INFANRIX...59 INLYTA...17 INSPRA see eplerenone...0 INSULIN PEN NEEDLE...1 INSULIN SAFETY NEEDLES...1 INSULIN SYRINGE...1 INTELENCE...7 INTRALIPID 0%...61 intralipid inj 0%...61 INTRON-A INJ 10MU...58 INTRON-A INJ 18MU...58 INTRON-A INJ 5MU...58 INTRON-A INJ 50MU...58 introvale...5 INTUNIV see guanfacine er (adhd)...7 INVANZ...5 see ertapenem sodium...5 INVEGA see paliperidone...5 INVEGA SUST INJ 117 MG/0.75 ML... INVEGA SUST INJ 156MG/ML... INVEGA SUST INJ MG/1.5 ML... INVEGA SUST INJ 9 MG/0.5 ML... INVEGA SUST INJ 78 MG/0.5 ML... INVEGA TRINZA... INVIRASE...7 IONOSOL-MB/DEXTROSE 5%...61 IPOL INACTIVATED IPV...59 ipratropium-albuterol nebu...65 ipratropium bromide...65 ipratropium bromide (nasal)...65 irbesartan...0 irbesartan-hydrochlorothiazide...0 IRESSA...17 irinotecan hcl...18 ISENTRESS...7 ISENTRESS HD...7 isibloom...5 ISOLYTE P...61 ISOLYTE S...61 isoniazid...9 isoniazid syp 50mg/5ml...9 ISOPTO CARPINE see pilocarpine hcl...6 ISORDIL TITRADOSE see isosorbide dinitrate...5 isosorbide dinitrate...5 isosorbide dinitrate er...5 isosorbide mononitrate er...5 isosorb mononitrate tab...5 isotretinoin...68 isradipine... ISTALOL see timolol maleate ophth soln 0.5% (once-daily)...65 itraconazole...6 ivermectin...5 IXIARO...59 J JADENU... 86

95 JADENU SPRINKLE... JAKAFI...17 JALYN see dutasteride-tamsulosin hcl...5 jantoven...56 JANUMET... JANUMET XR TAB JANUMET XR TAB JANUMET XR TAB MG... JANUVIA... JARDIANCE... JENTADUETO... JENTADUETO TAB XR MG... JENTADUETO TAB XR MG... jinteli...9 jolessa tab mg...5 jolivette...5 juleber...5 JULUCA...9 junel 1/0...5 junel 1.5/0...5 junel fe 1/0...5 junel fe 1.5/0...5 JUXTAPID... K K-TAB see potassium chloride...60 KADCYLA...15 KALETRA see lopinavir-ritonavir...9 KALETRA TAB 100-5MG...9 KALETRA TAB 00-50MG...9 KALYDECO...66 kariva...5 kcl/d5w/nacl inj.15/.%...6 kcl/d5w/nacl inj.15/.5%...6 kcl/d5w/nacl inj 0.%/0.5%...6 kcl/d5w inj 0.%...6 kcl/nacl inj 0.15%-0.9%...6 kcl/nacl inj kcl 0.075%/d5w/nacl 0.5%...6 kcl0.15%/d5w/nacl0.%...61 KCL 0.15%/D5W/NACL 0.5%...61 kcl 0.15%/d5w/nacl 0.9%...61 kcl 0.%/d5w/nacl 0.5%...61 KCL 0.%/D5W/NACL 0.9%...61 KEFLEX see cephalexin...11 kelnor 1/5...5 kelnor 1/ KEPPRA see levetiracetam...8 see levetiracetam oral soln 100 mg/ml...8 see roweepra...9 KEPPRA XR see levetiracetam...8 see roweepra xr...9 ketoconazole...6 ketoconazole cream...68 ketoconazole shampoo...69 ketorolac tromethamine (ophth)...6 KEYTRUDA...15 KINRIX...59 kionex sus 15gm/60ml... KISQALI...15 KISQALI FEMARA 00 DOSE...15 KISQALI FEMARA 00 DOSE...15 KISQALI FEMARA 600 DOSE...15 KITABIS PAK see tobramycin... KLARON see sulfacetamide sodium (acne)...68 KLONOPIN see clonazepam...7 klor-con klor-con klor-con m klor-con m klor-con m klor-con pak 0meq...60 klor-con spr cap 10meq...60 klor-con spr cap 8meq...60 KORLYM...50 kurvelo...5 KUVAN...8 KYNAMRO... L labetalol hcl... lactated ringer's...6 lactulose...5 lactulose (encephalopathy)

96 LAMICTAL see lamotrigine...8 see subvenite tab...9 LAMICTAL CHEWABLE DISPERS see lamotrigine...8 LAMICTAL XR see lamotrigine...8 LAMISIL see terbinafine hcl...7 lamivudine...7 lamivudine-zidovudine...9 lamivudine (hbv)...10 lamotrigine...8 LANOXIN see digitek... see digox... see digoxin... see digoxin inj... lansoprazole...5 larin 1/0...5 larin 1.5/0...5 larin fe 1/0...5 larin fe 1.5/0...5 larissia tab...5 LASIX see furosemide... LASTACAFT...6 latanoprost...6 LATUDA... leena tab...5 leflunomide...57 LENVIMA 10 MG DAILY DOSE...17 LENVIMA 1MG DAILY DOSE...17 LENVIMA 1 MG DAILY DOSE...17 LENVIMA 18 MG DAILY DOSE...17 LENVIMA 0 MG DAILY DOSE...17 LENVIMA MG DAILY DOSE...17 LENVIMA MG DAILY DOSE...17 LENVIMA 8 MG DAILY DOSE...17 lessina...5 LETAIRIS...6 letrozole...16 leucovorin calcium...18 LEUKERAN...1 leuprolide inj 1mg/ levalbuterol hcl...66 levalbuterol hcl soln nebu conc 1.5 mg/0.5ml...66 levalbuterol tartrate hfa...66 LEVAQUIN see levofloxacin...1 LEVEMIR...1 LEVEMIR FLEXTOUCH...1 levetiracetam...8 LEVETIRACETAM see levetiracetam in sodium chloride 8 levetiracetam in sodium chloride...8 levetiracetam oral soln 100 mg/ml...8 levo-t...51 levobunolol hcl...6 levocarnitine (metabolic modifiers)...8 levocetirizine dihydrochloride...66 levofloxacin...1 levofloxacin in d5w...1 levofloxacin inj 5mg/ml...1 levofloxacin oral soln 5 mg/ml...1 levonest...5 levonor/ethi tab...5 levonorgestrel-ethinyl estradiol (91-day)...6 levonorgestrel & eth estradiol...6 levora 0.15/ levothyroxine sodium...51 levoxyl...51 LEXAPRO see escitalopram oxalate...1 LEXIVA...7 see fosamprenavir tab 700 mg...7 lidocaine...70 lidocaine-prilocaine...70 lidocaine hcl...70 lidocaine hcl (local anesth.)... lidocaine hcl (mouth-throat)...71 lidocaine inj 0.5%... lidocaine inj 1.5% preservative free (pf) lidocaine inj 1%... lidocaine oint 5%...70 LIDODERM see lidocaine...70 linezolid inj...5 linezolid in sodium chloride...5 linezolid susp

97 linezolid tab 600mg...5 LINZESS...5 liothyronine sodium...51 LIPITOR see atorvastatin calcium...1 lisinopril...19 lisinopril & hydrochlorothiazide...19 lithium carbonate...8, 9 lithium carbonate er...9 LITHIUM SOLN 8MEQ/5ML...9 LITHOBID see lithium carbonate er...9 LOCOID see hydrocortisone butyrate cream 0.1%...69 LODINE see etodolac...1 LOESTRIN 1/0-1 see junel 1/0...5 see larin 1/0...5 see microgestin 1/0...6 see norethindrone acet & eth estra...6 LOESTRIN 1.5/0-1 see junel 1.5/0...5 see larin 1.5/0...5 see microgestin 1.5/0...6 LOESTRIN FE 1/0 see blisovi fe 1/0... see junel fe 1/0...5 see larin fe 1/0...5 see microgestin fe 1/0...6 see tarina fe 1/0...7 LOESTRIN FE 1.5/0 see blisovi fe 1.5/0... see junel fe 1.5/0...5 see larin fe 1.5/0...5 see microgestin fe 1.5/0...6 LOMOTIL see diphenoxylate w/ atropine...5 LONSURF...18 loperamide hcl...5 LOPID see gemfibrozil... lopinavir-ritonavir...9 LOPRESSOR see metoprolol tartrate... LOPRESSOR HCT see metoprolol & hydrochlorothiazide... LOPROX see ciclopirox...68 LOPROX SHAMPOO see ciclopirox shampoo 1%...68 lorazepam...6 lorazepam intensol...6 LORBRENA...17 lorcet hd tab 10-5mg... lorcet plus tab lorcet tab 5-5mg... loryna...6 losartan-hydrochlorothiazide...0 losartan potassium...0 LOTEMAX...6 LOTENSIN see benazepril hcl...19 LOTENSIN HCT see benazepril & hydrochlorothiazide 19 LOTREL see amlodipine besylate-benazepril hcl cap 10-0 mg...19 see amlodipine besylate-benazepril hcl cap 10-0 mg...19 see amlodipine besylate-benazepril hcl cap 5-10 mg...19 see amlodipine besylate-benazepril hcl cap 5-0 mg...19 LOTRISONE see clotrimazole w/ betamethasone..68 LOTRONEX see alosetron hcl...5 lovastatin...1 LOVENOX see enoxaparin sodium...55 low-ogestrel...6 loxapine succinate...5 LUMIGAN...6 LUMIZYME...8 LUPRON DEP-PED INJ 11.5MG (- MONTH)...50 LUPRON DEP-PED INJ 7.5MG...50 LUPRON DEPOT-PED (1-MONTH...50 LUPRON DEPOT-PED (-MONTH

98 LUPRON DEPOT (1-MONTH)...16 LUPRON DEPOT INJ 11.5MG (-MONTH)...16 lutera...6 LYNPARZA...15 LYRICA...8 LYRICA CR...9 LYSODREN...16 LYSTEDA see tranexamic acid...56 lyza...6 M M-M-R II...59 M-NATAL PLUS...6 MACROBID see nitrofurantoin monohyd macro...6 MACRODANTIN see nitrofurantoin macrocrystal...5 magnesium sulfate...60 MAGNESIUM SULFATE...60 see magnesium sulfate...60 MAGNESIUM SULFATE IN D5W...60 see magnesium sulfate in dextrose...60 magnesium sulfate in dextrose...60 magnesium sulfate inj 50%...60 MALARONE see atovaquone-proguanil hcl...7 malathion...71 maprotiline hcl...1 MARINOL see dronabinol...51 marlissa...6 MARPLAN TAB 10MG...1 MATULANE...18 MAVIK see trandolapril...0 MAVYRET...10 MAXALT see rizatriptan benzoate...8 MAXALT-MLT see rizatriptan benzoate odt...8 MAXIPIME see cefepime for inj...11 MAXITROL see neomycin-polymy-dexameth...6 MAXZIDE see triamterene & hydrochlorothiazide tabs...5 MAXZIDE-5 see triamterene & hydrochlorothiazide tabs...5 meclizine hcl...51 MEDROL see methylpred tab 16mg...9 see methylpred tab mg...9 see methylpred tab mg...9 see methylpred tab 8mg...9 MEDROL DOSEPAK see methylpred pak mg...9 medroxyprogesterone acetate (contraceptive)...6 medroxyprogesterone acetate tab...51 mefloquine hcl...7 MEGACE ES see megestrol sus 65mg/5ml...16 megestrol ac sus 0mg/ml...16 megestrol ac tab 0mg...16 megestrol ac tab 0mg...16 megestrol sus 65mg/5ml...16 MEKINIST...17 MEKTOVI...17 meloxicam...1 memantine hcl cp...0 memantine soln...0 memantine tabs...0 MENACTRA...59 MENVEO...59 MEPRON see atovaquone... mercaptopurine...1 meropenem...5 MERREM see meropenem...5 mesalamine...5, 5 mesalamine w/ cleanser...5 MESNEX...18 MESTINON see pyridostigmine tab 60mg...9 metadate er tab 0mg...7 metformin er... metformin hcl... methadone hcl... 90

99 methadone hcl 10mg... methadone hcl 5mg... methadone hcl intensol... METHADOSE see methadone hcl intensol... methazolamide...5 methenamine hippurate...5 methimazole...51 methotrexate sodium inj...1 methotrexate sodium tabs...57 methyclothiazide...5 METHYLIN see methylphenidate hcl oral soln...7 methylphenidate hcl...7 methylphenidate hcl oral soln...7 methylphenidate tab 10mg er...7 methylphenidate tab 0mg er...7 methylprednisolone acetate...9 methylpred pak mg...9 methylpred tab 16mg...9 methylpred tab mg...9 methylpred tab mg...9 methylpred tab 8mg...9 methylpr ss inj...9 metoclopramide hcl...51 metoclopramide hcl inj...51 metolazone...5 metoprolol & hydrochlorothiazide... metoprolol succinate... metoprolol tartrate..., METROCREAM see metronidazole (topical)...70 see rosadan cre 0.75%...71 METROGEL-VAGINAL see metronidazole vaginal...55 METROLOTION see metronidazole (topical)...70 metronidazole...5 metronidazole (topical)...70 metronidazole gel 0.75%...70 metronidazole in nacl...5 metronidazole vaginal...55 mexiletine hcl...1 MIACALCIN see calcitonin (salmon)...50 MICARDIS see telmisartan...0 microgestin 1/0...6 microgestin 1.5/0...6 microgestin fe 1/0...6 microgestin fe 1.5/0...6 midodrine hcl...5 miglustat...8 mili...6 MINIPRESS see prazosin hcl...0 minitran...5 MINOCIN see minocycline hcl...1 minocycline hcl...1 minoxidil...5 MIRAPEX see pramipexole tab 0.15mg... see pramipexole tab 0.5mg... see pramipexole tab 0.5mg... see pramipexole tab 0.75mg... see pramipexole tab 1.5mg... see pramipexole tab 1mg... MIRCETTE see bekyree... see desogestrel-ethinyl estradiol (biphasic)... see kariva...5 see pimtrea...7 see viorele...8 mirtazapine...1 misoprostol...5 MITIGARE...1 mitomycin...1 MOBIC see meloxicam...1 moexipril-hydrochlorothiazide...19 moexipril hcl...19 molindone hcl...5 mometasone furoate...70 mondoxyne nl cap 100mg...1 mono-linyah tab mononessa...6 montelukast sodium...66 morgidox cap 1x50mg...1 morphine ext-rel tab... morphine sulfate... 91

100 MORPHINE SULFATE... see morphine sulfate... morphine sulfate oral soln 100mg/5ml.. morphine sulfate oral soln 10mg/5ml... morphine sulfate oral soln 0mg/5ml... morphine sul inj 10mg/ml... morphine sul inj 1mg/ml... MORPHINE SUL INJ MG/ML... MOVANTIK...5 MOVIPREP...5 MOXEZA...6 moxifloxacin hcl (ophth)...6 MS CONTIN see morphine ext-rel tab... MULTAQ...1 mupirocin...68 MYAMBUTOL see ethambutol hcl...9 MYCAMINE...6 MYCOBUTIN see rifabutin...10 mycophenolate mofetil...58 mycophenolate sodium tbec...58 MYFORTIC see mycophenolate sodium tbec...58 MYLOTARG...15 myorisan...68 MYRBETRIQ...55 MYSOLINE see primidone...9 myzilra...6 N nabumetone...1 nadolol... nafcillin sodium for inj...1, 1 NAFCILLIN SODIUM FOR INJ 10GM...1 NAGLAZYME...8 nalbuphine hcl... naloxone inj 0.mg/ml...0 naloxone inj 1mg/ml...0 naltrexone hcl...0 NAMENDA see memantine tabs...0 NAMENDA XR see memantine hcl cp...0 NAMZARIC...0 NAPROSYN see naproxen...1 naproxen...1 naproxen dr...1 naproxen sodium...1 naratriptan hcl...8 NARCAN...0 NARDIL see phenelzine sulfate... NATACYN...6 nateglinide... NATPARA...50 NAVELBINE see vinorelbine tartrate...15 NEBUPENT...5 necon 0.5/ necon 1/ necon 7/7/7...6 nefazodone hcl...1 neomycin-bacitracin zn-polymyxin...6 neomycin-polymy-dexameth...6 neomycin-polymyxin-gramicidin...6 neomycin-polymyxin-hc (ophth)...6 neomycin-polymyxin-hc (otic)...71 neomycin sulfate... NEORAL see cyclosporine modified (for microemulsion)...58 see gengraf...58 NEPHRAMINE...61 NERLYNX...17 NEUPOGEN...56 NEUPRO... NEURONTIN see gabapentin...8 nevirapine susp 50 mg/5ml...8 nevirapine tab 100mg er...8 nevirapine tab 00mg...8 nevirapine tab 00mg er...8 NEXAVAR...17 NEXIUM see esomeprazole magnesium...5 NEXIUM I.V. see esomeprazole sodium inj...5 niacin er (antihyperlipidemic)... niacor... 9

101 NIASPAN see niacin er (antihyperlipidemic)... nicardipine hcl... NICOTROL INHALER...0 NICOTROL NS...0 nifedipine... nifedipine er... nikki...6 NILANDRON see nilutamide...16 nilutamide...16 nimodipine... NINLARO...15 NITRO-BID...5 NITRO-DUR see minitran...5 see nitroglycerin td patch...6 NITRO-DUR DIS 0.MG/HR...5 NITRO-DUR DIS 0.8MG/HR...5 nitrofurantoin macrocrystal...5 nitrofurantoin monohyd macro...6 nitroglycerin...5 nitroglycerin td patch...6 NITROSTAT see nitroglycerin...5 NITYR...8 NIVA-PLUS...6 NIZORAL see ketoconazole shampoo...69 nora-be tab 0.5mg...6 NORCO see hydroco/apap tab 10-5mg... see hydroco/apap tab 5-5mg... see hydroco/apap tab see lorcet hd tab 10-5mg... see lorcet plus tab see lorcet tab 5-5mg... norethindrone (contraceptive)...6 norethindrone acet & eth estra...6 norethindrone acetate...51 norethindrone acetate-ethinyl estradiol9 norgest/ethi tab 0.5/5...6 norgestimate-ethinyl estradiol (triphasic) /0.15-5/0.5-5 mg-mcg...6 norgestimate-ethinyl estradiol (triphasic) /0.15-5/0.5-5 mg-mcg...6 norlyroc...6 NORMOSOL-M IN D5W...6 NORMOSOL-R...6 NORMOSOL-R IN D5W...6 NORPACE see disopyramide phosphate...1 NORPACE CR...1 NORPRAMIN see desipramine hcl...1 NORTHERA...5 nortrel 0.5/5 (8)...6 nortrel 1/5...7 nortrel 7/7/7...7 nortriptyline hcl...1 NORVASC see amlodipine besylate... NORVIR see ritonavir...8 NORVIR PACK...8 NORVIR SOLN...8 NOVOLIN 70/0...1 NOVOLIN 70/0 FLEXPEN...1 NOVOLIN N...1 NOVOLIN R...1 NOVOLOG...1 NOVOLOG 70/0 FLEXPEN...1 NOVOLOG FLEXPEN...1 NOVOLOG MIX 70/0...1 NOVOLOG PENFILL...1 NOXAFIL...6 NUCYNTA ER... NUEDEXTA...9 NULOJIX...58 NULYTELY/FLAVOR PACKS...5 see gavilyte-n/flavor pack...5 see peg 50-potassium chloride-sod bicarbonate-sod chloride...5 see trilyte...5 NUPLAZID CAPS...5 NUPLAZID TABS 10MG...5 NUPLAZID TABS 17MG...5 nutrilipid inj 0%...61 NUVARING...7 NUVIGIL see armodafinil...0 nyamyc

102 NYMALIZE... nystatin...7 nystatin (mouth-throat)...71 nystatin (topical)...68 nystop...68 O O-CAL FA...6 ocella tab -0.0mg...7 OCTAGAM...58 octreotide acetate...50 OCUFLOX see ofloxacin (ophth)...6 ODEFSEY...9 ODOMZO...15 OFEV...66 ofloxacin (ophth)...6 ofloxacin (otic)...71 olanzapine...5 olmesartan medoxomil...0 olmesartan medoxomil-amlodipinehydrochlorothiazide...0 olmesartan medoxomilhydrochlorothiazide...0 olopatadine hcl 0.%...6 omeprazole cap 10mg...5 omeprazole cap 0mg...5 omeprazole cap 0mg...5 OMNIPRED see prednisolone acetate (ophth)...6 ondansetron hcl...51, 5 ondansetron hcl inj...5 ondansetron hcl oral soln...5 ondansetron odt...5 ONFI...8 see clobazam...7 OPSUMIT...6 ORFADIN...8 ORKAMBI...67 orsythia...7 ORTHO-CYCLEN see estarylla tab see femynor...5 see mili...6 see mono-linyah tab see mononessa...6 see norgest/ethi tab 0.5/5...6 see previfem...7 see sprintec see vylibra...8 ORTHO-NOVUM 1/5 see alyacen 1/5... see cyclafem 1/5... see dasetta 1/5... see nortrel 1/5...7 see pirmella 1/5...7 ORTHO-NOVUM 7/7/7 see cyclafem 7/7/7... see dasetta 7/7/7... see necon 7/7/7...6 see nortrel 7/7/7...7 ORTHO MICRONOR see errin...5 see jolivette...5 see lyza...6 see norethindrone (contraceptive)...6 see sharobel...7 ORTHO TRI-CYCLEN see norgestimate-ethinyl estradiol (triphasic) /0.15-5/0.5-5 mg-mcg...6 see tri-estarylla...7 see tri-linyah...7 see tri-mili...7 see tri-previfem...7 see tri-sprintec...7 see tri-vylibra...7 see trinessa...7 ORTHO TRI-CYCLEN LO see norgestimate-ethinyl estradiol (triphasic) /0.15-5/0.5-5 mg-mcg...6 see tri-lo-estarylla...7 see tri-lo-sprintec...7 see tri-lo marzia...7 see tri-vylibra lo...7 see trinessa lo...7 oseltamivir phosphate...10 OVIDE see malathion...71 oxacillin sodium...1 oxaliplatin inj 100mg...18 oxaliplatin inj 100mg/0ml

103 oxaliplatin inj 50mg...18 oxaliplatin inj 50mg/10ml...18 OXANDRIN see oxandrolone tab 10mg...0 oxandrolone tab 10mg...0 oxandrolone tab.5mg...0 oxcarbazepine...9 oxybutynin chloride...55 oxycodone hcl..., oxycodone w/ acetaminophen 10-5mg... oxycodone w/ acetaminophen.5-5mg... oxycodone w/ acetaminophen 5-5mg oxycodone w/ acetaminophen 7.5-5mg... OZEMPIC INJ 0.5 OR 0.5MG/DOSE...1 OZEMPIC INJ 1MG/DOSE...1 P pacerone...1 paclitaxel...1 paliperidone...5 PAMELOR see nortriptyline hcl...1 pamidronate disodium... PAMIDRONATE DISODIUM... pamidronate inj 0mg... pamidronate inj 90mg... PANRETIN...70 pantoprazole sodium...5 pantoprazole sodium tbec...5 PANZYGA...58 paricalcitol...6 PARLODEL see bromocriptine mesylate... PARNATE see tranylcypromine sulfate... paroex sol 0.1%...71 paromomycin sulfate... paroxetine hcl tabs...1 PASER D/R...9 PATADAY see olopatadine hcl 0.%...6 PAXIL...1 see paroxetine hcl tabs...1 PAZEO...6 PEDIARIX...59 PEDVAX HIB...59 peg 50-kcl-sod bicarb-sod chloride-sod sulfate...5 peg 50-potassium chloride-sod bicarbonate-sod chloride...5 peg 50/electrolytes...5 PEGANONE...9 PEGASYS...10 PEGASYS PROCLICK...10 PENICILLIN G POT IN DEXTROSE MU.1 PENICILLIN G POT IN DEXTROSE MU.1 PENICILLIN G PROCAINE...1 penicillin g sodium...1 penicillin v potassium...1 penicilln gk inj 0mu...1 penicilln gk inj 5mu...1 PENTACEL...59 PENTAM pentoxifylline...56 PEPCID see famotidine...5 PERCOCET see endocet 10-5mg... see endocet.5-5mg... see endocet 5-5mg... see endocet 7.5-5mg... see oxycodone w/ acetaminophen 10-5mg... see oxycodone w/ acetaminophen.5-5mg... see oxycodone w/ acetaminophen 5-5mg... see oxycodone w/ acetaminophen 7.5-5mg... PERIDEX see chlorhexidine gluconate (mouththroat)...71 see paroex sol 0.1%...71 see periogard...71 perindopril erbumine...0 periogard...71 permethrin cre 5%...71 perphenazine...5 pfizerpen-g inj 0mu...1 pfizerpen-g inj 5mu

104 phenelzine sulfate... PHENERGAN see promethazine hcl inj...5 phenobarbital...9 phenobarbital sodium...9 PHENOBARBITAL SODIUM...9 PHENYTEK...9 see phenytoin sodium extended...9 phenytoin...9 phenytoin sodium extended...9 phenytoin sodium inj 50mg/ml...9 philith...7 PHOSLO see calcium acetate (phosphate binder)...50 PHOSPHOLINE IODIDE...6 PICATO...70 PIFELTRO...8 pilocarpine hcl...6 pilocarpine hcl (oral)...71 pimozide...5 pimtrea...7 pindolol... pioglitazone hcl... PIPER/TAZOBA INJ 1-1.5GM...1 piper/tazoba inj -0.5gm...1 piper/tazoba inj -0.75gm...1 piper/tazoba inj 6-.5gm...1 piper/tazoba inj -0.5gm...1 pirmella 1/5...7 piroxicam...1 PLAQUENIL see hydroxychloroquine sulfate...57 PLASMA-LYTE PLASMA-LYTE A...6 PLAVIX see clopidogrel tab 75mg...57 PNV FOLIC ACID + IRON MUL...6 PNV PRENATAL PLUS...6 PNV PRENATAL TAB PLUS...6 podofilox...70 polymyxin b-trimethoprim...6 POLYTRIM see polymyxin b-trimethoprim...6 POMALYST...16 portia potassium chloride...60, 6 potassium chloride in nacl...6 potassium chloride microencapsulated crystals er...60 potassium chloride tab cr 10 meq...60 potassium citrate (alkalinizer) er tabs5, 55 pot chloride inj meq/ml...6 PRADAXA...56 PRALUENT... pramipexole tab 0.15mg... pramipexole tab 0.5mg... pramipexole tab 0.5mg... pramipexole tab 0.75mg... pramipexole tab 1.5mg... pramipexole tab 1mg... PRANDIN see repaglinide... prasugrel hcl...57 PRAVACHOL see pravastatin sodium...1 pravastatin sodium...1 praziquantel...6 prazosin hcl...0 PRECOSE see acarbose...1 prednisolone acetate (ophth)...6 prednisolone sodium phosphate...9 PREDNISOLONE SODIUM PHOSPHATE (OPHTH)...6 prednisolone sol 15mg/5ml...9 prednisolone sol 5mg/5ml...9 PREDNISONE CON 5MG/ML...9 prednisone pak 10mg...9 prednisone pak 5mg...9 prednisone sol 5mg/5ml...9 prednisone tab 10mg...9 prednisone tab 1mg...9 prednisone tab.5mg...9 prednisone tab 0mg...9 prednisone tab 50mg...9 prednisone tab 5mg...9 pred sod pho sol 5mg/5ml...9 PREMASOL 10%...61 premasol 6%...61 PRENATAL

105 PRENATAL PLUS...6 PRENATAL PLUS LOW IRON...6 PREPLUS...6 PREVACID see lansoprazole...5 prevalite... previfem...7 PREZCOBIX...9 PREZISTA...8 PRIFTIN...9 PRIMAQUINE PHOSPHATE...7 PRIMAXIN IV see imipenem-cilastatin...5 primidone...9 PRINIVIL see lisinopril...19 PRISTIQ see desvenlafaxine succinate...1 PRIVIGEN...58 probenecid...1 PROCALAMINE...61 PROCARDIA XL see nifedipine... prochlorperazine inj...5 prochlorperazine maleate...5 prochlorperazine supp...5 PROCRIT...56 procto-med hc...70 procto-pak...70 PROCTOCORT see procto-pak...70 proctosol hc cre.5%...70 proctozone-hc...71 PROGLYCEM SUS 50MG/ML...50 PROGRAF see tacrolimus...58 PROLASTIN-C...67 PROLENSA...6 PROLIA...50 PROMACTA...56 promethazine hcl...5 promethazine hcl inj...5 propafenone hcl...1 propafenone hcl 1hr...1 proparacaine hcl...65 propranolol & hydrochlorothiazide... propranolol cap er... propranolol hcl... propranolol oral sol... propylthiouracil...51 PROQUAD...59 PROSCAR see finasteride...5 PROSOL...61 PROTONIX see pantoprazole sodium...5 see pantoprazole sodium tbec...5 PROTOPIC see tacrolimus (topical)...71 protriptyline hcl... PROVERA see medroxyprogesterone acetate tab...51 PROZAC see fluoxetine cap 10mg...1 see fluoxetine cap 0mg...1 see fluoxetine cap 0mg...1 PULMICORT see budesonide (inhalation)...67 PULMICORT FLEXHALER...67 PULMOZYME...67 PURIXAN...1 pyrazinamide...9 pyridostigmine tab 60mg...9 Q QUADRACEL...59 QUALAQUIN see quinine sulfate...7 quasense...7 QUESTRAN see cholestyramine...1 QUESTRAN LIGHT see cholestyramine light...1 see prevalite... quetiapine fumarate...5 quinapril-hydrochlorothiazide...19 quinapril hcl...0 quinidine gluconate...1 quinidine sulfate...1 quinine sulfate...7 R RABAVERT

106 raloxifene tab 60mg...50 ramipril...0 RANEXA...5 ranitidine hcl...5 ranitidine hcl inj...5 ranitidine inj...5 ranitidine syrup...5 RAPAMUNE...58 see sirolimus...58 rasagiline mesylate... RAYALDEE...6 RAZADYNE see galantamine hydrobromide...0 RAZADYNE ER see galantamine hydrobromide er...0 REBETOL SOLN...10 RECLAST see zoledronic acid inj 5mg/100ml... reclipsen...7 RECOMBIVAX HB...59 REGLAN see metoclopramide hcl...51 REGRANEX...71 RELENZA DISKHALER...10 RELISTOR...5 RELPAX see eletriptan hydrobromide...8 REMERON see mirtazapine...1 REMERON SOLTAB see mirtazapine...1 REMICADE...57 REMODULIN...6 RENVELA see sevelamer carbonate...50, 51 repaglinide... REQUIP see ropinirole tab 0.5mg... see ropinirole tab 5mg... RESCRIPTOR...8 RESTASIS...65 RESTASIS MULTIDOSE...65 RESTORIL see temazepam...7 RETIN-A see avita...67 see tretinoin...68 RETROVIR see zidovudine cap 100mg...8 see zidovudine syp 50mg/5ml...8 REVATIO see sildenafil citrate tab 0 mg (pulmonary hypertension)...6 REVLIMID...16 REXULTI...5 REYATAZ...8 see atazanavir sulfate...7 ribasphere...10 RIBASPHERE...10 ribavirin cap 00mg...10 ribavirin tab 00mg...10 rifabutin...10 RIFADIN see rifampin...10 rifampin...10 RIFATER...10 RILUTEK see riluzole...9 riluzole...9 rimantadine hydrochloride...10 RISPERDAL see risperidone...6 RISPERDAL INJ 1.5MG...5 RISPERDAL INJ 5MG...5 RISPERDAL INJ 7.5MG...5 RISPERDAL INJ 50MG...5 risperidone...6 RITALIN see methylphenidate hcl...7 ritonavir...8 RITUXAN...15 RITUXAN HYCELA...15 rivastigmine tartrate...0 rivastigmine td patch hr 1. mg/hr...0 rivastigmine td patch hr.6 mg/hr...0 rivastigmine td patch hr 9.5 mg/hr...0 rizatriptan benzoate...8 rizatriptan benzoate odt...8 ROCALTROL 98

107 see calcitriol...6 see calcitriol oral soln 1 mcg/ml...6 ropinirole tab 0.5mg... ropinirole tab 0.5mg... ropinirole tab 1mg... ropinirole tab mg... ropinirole tab mg... ropinirole tab mg... ropinirole tab 5mg... rosadan cre 0.75%...71 rosuvastatin calcium...1 ROTARIX...59 ROTATEQ...59 ROWASA see mesalamine w/ cleanser...5 roweepra...9 roweepra xr...9 ROXICODONE see oxycodone hcl... RUBRACA...15 RYDAPT...17 RYTHMOL SR see propafenone hcl 1hr...1 S SABRIL...9 see vigabatrin powd pack 500mg...9 see vigabatrin tab 500mg...9 SALAGEN see pilocarpine hcl (oral)...71 SANDIMMUNE...58 see cyclosporine...58 SANDOSTATIN see octreotide acetate...50 SANTYL...71 SAPHRIS...6 scopolamine patch...5 selegiline hcl... selenium sulfide...69 SELZENTRY...8 SENSIPAR... SEREVENT DISKUS...66 SEROQUEL see quetiapine fumarate...5 SEROQUEL XR see quetiapine fumarate...5 sertraline hcl... setlakin tab...7 sevelamer carbonate...50, 51 sharobel...7 SHINGRIX...59 SIGNIFOR...50 sildenafil citrate tab 0 mg (pulmonary hypertension)...6 SILENOR...7 SILVADENE see silver sulfadiazine...68 see ssd...68 silver sulfadiazine...68 SIMBRINZA...6 simvastatin...1 SINEMET see carbidopa-levodopa... SINEMET CR see carbidopa-levodopa... SINGULAIR see montelukast sodium...66 sirolimus...58 SIRTURO...10 SIVEXTRO...6 sodium chloride...60, 6 sodium chloride 0.5%...6 sodium chloride inj 0.9%...6 sodium chlor sol 0.9% irr...71 sodium fluoride chew; tab; 1.1 (0.5 f) mg/ml soln...60 sodium phenylbutyrate...8 sodium polystyrene sulfonate powder.. sodium polystyrene sulfonate susp... SOLIQUA 100/...1 SOLTAMOX...16 SOLU-CORTEF...9 SOLU-MEDROL see methylpr ss inj...9 SOMATULINE DEPOT...50 SOMAVERT...50 SORIATANE see acitretin...68 sorine...1 sotalol hcl...1 sotalol hcl (afib/afl)...1 spironolactone...0 spironolactone & hydrochlorothiazide..5 99

108 SPORANOX see itraconazole...6 sprintec SPRITAM...9 SPRYCEL...17 sps susp 15gm/60ml... sronyx...7 ssd...68 STALEVO 100 see carbidopa/levodopa/entacapone. STALEVO 15 see carbidopa/levodopa/entacapone. STALEVO 150 see carbidopa/levodopa/entacapone. STALEVO 00 see carbidopa/levodopa/entacapone. STALEVO 50 see carbidopa/levodopa/entacapone. STALEVO 75 see carbidopa/levodopa/entacapone. STARLIX see nateglinide... stavudine...8 STIMATE...51 STIVARGA...17 STRATTERA see atomoxetine hcl...7 streptomycin sulfate... STRIBILD...9 STROMECTOL see ivermectin...5 SUBOXONE MIS 1-MG...0 SUBOXONE MIS -0.5MG...0 SUBOXONE MIS -1MG...0 SUBOXONE MIS 8-MG...0 subvenite tab...9 sucralfate...5 sulfacetamide sod-prednisolone...6 sulfacetamide sodium (acne)...68 sulfacetamide sodium (ophth)...6 SULFADIAZINE... sulfamethoxazole-trimethop ds...6 sulfamethoxazole-trimethoprim inj...6 sulfamethoxazole-trimethoprim susp...6 sulfamethoxazole-trimethoprim tab 00-80mg...6 SULFAMYLON...68 sulfasalazine...5 sulfasalazine ec...5 sulindac...1 sumatriptan...8 sumatriptan inj mg/0.5ml...8 sumatriptan inj 6mg/0.5ml...8 sumatriptan succinate...8 SUPRAX...11 see cefixime...11 SUPREP BOWEL PREP KIT...5 SURMONTIL see trimipramine maleate... SUSTIVA see efavirenz...7 SUTENT...17 syeda...7 SYLATRON KIT 00MCG...18 SYLATRON KIT 00MCG...18 SYLATRON KIT 600MCG...18 SYMBICORT...67 SYMDEKO...67 SYMFI...9 SYMFI LO...9 SYMPAZAN...9 SYMPROIC...5 SYMTUZA...9 SYNALAR see fluocinolone acetonide...69 SYNAREL...8 SYNERCID...6 SYNJARDY TAB MG... SYNJARDY TAB MG... SYNJARDY TAB MG... SYNJARDY TAB 5-500MG... SYNJARDY XR TAB MG... SYNJARDY XR TAB MG... SYNJARDY XR TAB MG... SYNJARDY XR TAB MG... SYNRIBO...18 SYNTHROID...51 see levo-t...51 see levothyroxine sodium...51 see levoxyl...51 see unithroid...51 SYPRINE 100

109 see trientine hcl... T TABLOID...1 tacrolimus...58 tacrolimus (topical)...71 TAFINLAR...17 TAGRISSO...17 TALZENNA...15 TAMIFLU see oseltamivir phosphate...10 tamoxifen citrate...16 tamsulosin hcl...5 TAPAZOLE see methimazole...51 TARCEVA...18 TARGRETIN...71 see bexarotene...18 tarina fe 1/0...7 TASIGNA...18 TAXOTERE...15 see docetaxel...1 tazarotene...69 tazicef...11 TAZORAC...69 see tazarotene...69 taztia xt... TDVAX...59 TECENTRIQ...15 TEFLARO...11 TEGRETOL see carbamazepine...7 see epitol...8 TEGRETOL-XR see carbamazepine...7 TEKTURNA... TEKTURNA HCT... telmisartan...0 temazepam...7 TENIVAC...59 tenofovir disoproxil fumarate...8 TENORETIC 100 see atenolol & chlorthalidone... TENORETIC 50 see atenolol & chlorthalidone... TENORMIN see atenolol... TERAZOL 7 see terconazole vaginal...55 terazosin hcl...0 terbinafine hcl...7 terbutaline sulfate...66 terconazole vaginal...55 testosterone...0 testosterone cypionate...0 testosterone enanthate...1 tetrabenazine...9 tetracycline hcl...1 TEXACORT SOLN.5%...70 THALOMID...16 THEO theophylline...67 thioridazine hcl...6 thiothixene...6 tiagabine hcl...9 TIAZAC see diltiazem hcl extended release beads cap sr... see taztia xt... TIBSOVO...15 tigecycline...6 TIKOSYN see dofetilide...1 tilia fe...7 timolol maleate... timolol maleate (ophth) soln...65 timolol maleate gel...65 timolol maleate ophth soln 0.5% (oncedaily)...65 TIMOPTIC see timolol maleate (ophth) soln...65 TIMOPTIC-XE see timolol maleate gel...65 TIVICAY...8 tizanidine hcl...9 TOBRADEX...6 see tobramycin-dexamethasone...6 TOBRADEX ST...6 tobramycin... tobramycin-dexamethasone...6 tobramycin (ophth)...6 tobramycin inj 1.gm... tobramycin inj 1. gm/0ml

110 tobramycin inj 10mg/ml... tobramycin inj 0mg/ml... tobramycin inj 80mg/ml... TOBREX see tobramycin (ophth)...6 TOFRANIL see imipramine hcl...1 tolterodine tartrate...55 TOPAMAX see topiramate...9 TOPAMAX SPRINKLE see topiramate...9 topiramate...9 toposar...18 topotecan hcl...19 TOPOTECAN HCL see topotecan hcl...19 TOPOTECAN INJ MG/ML...19 TOPROL XL see metoprolol succinate... toremifene citrate...16 torsemide tabs...5 TOVIAZ...55 tpn electrolytes...60 TRACLEER...6 TRADJENTA... tramadol-acetaminophen... tramadol hcl tab 50 mg... trandolapril...0 tranexamic acid...56 TRANSDERM-SCOP...5 tranylcypromine sulfate... TRAVASOL...61 TRAVATAN Z...65 trazodone hcl... TRECATOR...10 TRELEGY ELLIPTA...65 TRELSTAR DEP INJ.75MG...16 TRELSTAR LA INJ 11.5MG...16 TRESIBA FLEXTOUCH...1 TRESIBA INJ...1 tretinoin...68 tretinoin (chemotherapy)...18 tri-estarylla...7 tri-legest fe...7 tri-linyah...7 tri-lo-estarylla...7 tri-lo-sprintec...7 tri-lo marzia...7 tri-mili...7 TRI-NORINYL 8 see aranelle... see leena tab...5 tri-previfem...7 tri-sprintec...7 tri-vylibra...7 tri-vylibra lo...7 triamcinolone acetonide (mouth)...71 triamcinolone acetonide (topical)...70 triamterene & hydrochlorothiazide cap mg...5 triamterene & hydrochlorothiazide tabs5 TRIBENZOR see olmesartan medoxomil-amlodipinehydrochlorothiazide...0 TRICARE...6 TRICOR see fenofibrate... trientine hcl... trifluoperazine hcl...6 trifluridine...6 trihexyphenidyl hcl... TRILEPTAL see oxcarbazepine...9 trilyte...5 trimethoprim...6 trimipramine maleate... trinessa...7 trinessa lo...7 TRINTELLIX... TRIUMEQ...9 trivora TRIZIVIR see abacavir sulfate-lamivudinezidovudine...9 TROGARZO...8 TROPHAMINE INJ 10%...61 trospium chloride...55 TRULICITY...1 TRUMENBA...59 TRUSOPT see dorzolamide hcl

111 TRUVADA TAB TRUVADA TAB TRUVADA TAB TRUVADA TAB tulana...8 TWINRIX INJ...59 TYBOST...8 TYGACIL see tigecycline...6 TYKERB...18 TYLENOL/CODEINE # see acetaminophen w/ codeine 00-0mg... TYLENOL/CODEINE # see acetaminophen w/ codeine 00-60mg... TYMLOS...50 TYPHIM VI...59 U ULORIC...1 ULTRACET see tramadol-acetaminophen... ULTRAM see tramadol hcl tab 50 mg... ULTRAVATE see halobetasol propionate...69 UNASYN see ampicillin & sulbactam sodium...1 UNASYN BULK PACK see ampicillin & sulbactam sodium...1 unithroid...51 URECHOLINE see bethanechol chloride...5 UROCIT-K 10 see potassium citrate (alkalinizer) er tabs...55 UROCIT-K 15 see potassium citrate (alkalinizer) er tabs...5 UROCIT-K 5 see potassium citrate (alkalinizer) er tabs...55 UROXATRAL see alfuzosin hcl...5 URSO 50 see ursodiol...5 ursodiol...5 URSO FORTE see ursodiol...5 V VAGIFEM see estradiol vaginal tab...8 see yuvafem vaginal tablet 10mcg...9 valacyclovir hcl...10 VALCHLOR...71 VALCYTE see valganciclovir hcl...10 valganciclovir hcl...10 VALIUM see diazepam...7 valproate sodium...9 valproate sodium oral soln...9 valproic acid...9 valsartan...0 valsartan-hydrochlorothiazide...0 VALTREX see valacyclovir hcl...10 VANCOCIN HCL see vancomycin hcl...6 vancomycin hcl...6 VANCOMYCIN IN NACL...6 vandazole...55 VAQTA...59 VARIVAX...59 VASCEPA... VASERETIC see enalapril maleate & hydrochlorothiazide...19 VASOTEC see enalapril maleate...19 VELCADE...15 velivet...8 VEMLIDY...10 VENCLEXTA...15 VENCLEXTA STARTING PACK...15 venlafaxine hcl... VENTAVIS...6 VENTOLIN HFA...66 verapamil cap er... verapamil hcl... verapamil tab er... VERELAN 10

112 see verapamil cap er... VERELAN PM see verapamil cap er... VERSACLOZ...6 VERZENIO...15 VESICARE...55 VFEND see voriconazole...7 VFEND IV see voriconazole...7 VIBRAMYCIN see doxycycline hyclate...1 VICTOZA...1 VIDAZA see azacitidine...1 VIDEX EC...8 see didanosine...7 VIDEX PEDIATRIC...8 vienva...8 vigabatrin powd pack 500mg...9 vigabatrin tab 500mg...9 VIGAMOX see moxifloxacin hcl (ophth)...6 VIIBRYD STARTER PACK... VIIBRYD TAB... VIMPAT...0 VIMPAT INJ 00MG/0ML...0 VIMPAT SOL 10MG/ML...0 vinblastine sulfate...15 vincasar pfs...15 vincristine sulfate...15 vinorelbine tartrate...15 viorele...8 VIRACEPT...8 VIRAMUNE...8 see nevirapine susp 50 mg/5ml...8 see nevirapine tab 00mg...8 VIRAMUNE XR see nevirapine tab 00mg er...8 VIREAD...8 see tenofovir disoproxil fumarate...8 VIROPTIC see trifluridine...6 VISTARIL see hydroxyzine pamoate...66 VITRAKVI...18 VIVITROL...0 VIZIMPRO...18 VOL-PLUS...6 VOLTAREN see diclofenac sodium (topical) 1% gel...70 voriconazole...7 VOSEVI...10 VOTRIENT...18 VRAYLAR...6 VRAYLAR THERAPY PACK...6 vyfemla...8 vylibra...8 W warfarin sodium...56 water for irrigation, sterile...71 WELCHOL see colesevelam hcl...1 WELCHOL PAK... WELLBUTRIN SR see bupropion hcl...0 WELLBUTRIN XL see bupropion hcl...0 X XALATAN see latanoprost...6 XALKORI...18 XANAX see alprazolam tab 0.5mg...6 see alprazolam tab 0.5mg...6 see alprazolam tab 1mg...6 see alprazolam tab mg...6 XARELTO...56 XARELTO STARTER PACK...56 XATMEP...57 XELJANZ...57 XELJANZ XR...57 XENAZINE see tetrabenazine...9 XGEVA...50 XIFAXAN...5 XIGDUO XR TAB MG... XIGDUO XR TAB MG... XIGDUO XR TAB MG... XIGDUO XR TAB MG... XIGDUO XR TAB 5-500MG... 10

113 XOLAIR...67 XOPENEX see levalbuterol hcl...66 XOPENEX CONCENTRATE see levalbuterol hcl soln nebu conc 1.5 mg/0.5ml...66 XOSPATA...18 XTANDI...16 xulane dis XULTOPHY 100/ XYLOCAINE see lidocaine hcl (local anesth.)... see lidocaine inj 0.5%... see lidocaine inj 1%... XYLOCAINE-MPF see lidocaine hcl (local anesth.)... see lidocaine inj 1.5% preservative free (pf)... XYREM...0 Y YASMIN 8 see drospirenone-ethinyl estradiol... see ocella tab -0.0mg...7 see syeda...7 see zarah...8 YAZ see drospirenone-ethinyl estradiol...5 see gianvi tab -0.0mg...5 see loryna...6 see nikki...6 YF-VAX...59 yuvafem vaginal tablet 10mcg...9 Z zafirlukast...66 ZANAFLEX see tizanidine hcl...9 ZANTAC see ranitidine hcl...5 see ranitidine hcl inj...5 see ranitidine inj...5 zarah...8 ZARONTIN see ethosuximide...8 ZAVESCA see miglustat...8 ZEJULA...15 ZELBORAF...18 ZEMAIRA...67 ZEMPLAR see paricalcitol...6 zenatane...68 ZENPEP...5 ZEPATIER...11 ZERIT see stavudine...8 ZESTORETIC see lisinopril & hydrochlorothiazide...19 ZESTRIL see lisinopril...19 ZETIA see ezetimibe... ZIAC see bisoprolol & hydrochlorothiazide. ZIAGEN see abacavir sulfate...7 zidovudine cap 100mg...8 zidovudine syp 50mg/5ml...8 zidovudine tab 00mg...9 ZINECARD see dexrazoxane...18 ziprasidone hcl...6 ZIRGAN...6 ZITHROMAX see azithromycin...11 ZOCOR see simvastatin...1 ZOFRAN see ondansetron hcl...51 zoledronic acid inj 5mg/100ml... zoledronic inj mg/5ml... ZOLINZA...15 zolmitriptan...8 zolmitriptan odt...8 ZOLOFT see sertraline hcl... zolpidem tartrate...8 ZOMIG see zolmitriptan...8 ZOMIG ZMT see zolmitriptan odt...8 ZONEGRAN see zonisamide

114 zonisamide...0 ZONTIVITY...57 ZORTRESS TAB 0.5MG...58 ZORTRESS TAB 0.5MG...58 ZORTRESS TAB 0.75MG...58 ZORTRESS TAB 1MG...58 ZOSTAVAX...59 ZOSYN see piper/tazoba inj -0.5gm...1 see piper/tazoba inj -0.75gm...1 see piper/tazoba inj 6-.5gm...1 see piper/tazoba inj -0.5gm...1 zovia 1/5e...8 zovia 1/50e...8 ZOVIRAX see acyclovir...10 ZYBAN see bupropion hcl (smoking deterrent)...0 ZYDELIG...18 ZYKADIA...18 ZYLET...6 ZYLOPRIM see allopurinol tab...1 ZYMAXID see gatifloxacin (ophth)...6 ZYPREXA see olanzapine...5 ZYPREXA RELPREVV...6 ZYPREXA RELPREVV INJ 10MG...6 ZYPREXA ZYDIS see olanzapine...5 ZYTIGA...16 see abiraterone acetate...15 ZYVOX see linezolid inj...5 see linezolid susp...5 see linezolid tab 600mg

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