2010 MEDICARE PART D QUANTITY LIMITS
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- Bathsheba Byrd
- 5 years ago
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1 2010 MEDICARE PART D S The quantity limit indicates the unit values such as number of tablets, capsules, grams or cc s, etc for the drug for each filled prescription. The days supply is the quantity limit day amount for the medication. For example: Four Actonel 35mg tablets are to be dispensed for a twenty eight day supply. MEDICATION NAME ABILIFY 1 MG/ML SOLUTION ABILIFY 10 MG TABLET ABILIFY 15 MG TABLET ABILIFY 20 MG TABLET ABILIFY 30 MG TABLET ABILIFY 5 MG TABLET ACCOLATE 10 MG TABLET ACCOLATE 20 MG TABLET ACCUNEB 0.63 MG/3 ML INH SOLN ACCUNEB 1.25 MG/3 ML INH SOLN ACCUPRIL 10 MG TABLET 60 30
2 ACCUPRIL 20 MG TABLET ACCUPRIL 40 MG TABLET ACCUPRIL 5 MG TABLET ACCURETIC MG TABLET ACCURETIC MG TABLET ACCURETIC MG TABLET ACETAMINOPHEN-CODEINE ELIXIR ACIPHEX 20 MG TABLET EC ACLOVATE 0.05% CREAM ACLOVATE 0.05% OINTMENT ACTONEL 150 MG TABLET 1 28 ACTONEL 30 MG TABLET ACTONEL 35 MG TABLET 4 28 ACTONEL 5 MG TABLET ACTONEL 75 MG TABLET 2 28
3 ACTONEL WITH CALCIUM TABLET ACTOPLUS MET 15 MG-500 MG TAB ACTOPLUS MET 15 MG-850 MG TAB ACTOS 15 MG TABLET ACTOS 30 MG TABLET ACTOS 45 MG TABLET ACULAR 0.5% EYE DROPS ACULAR LS 0.4% OPHTH SOL ADALAT CC 30 MG TABLET ADALAT CC 60 MG TABLET ADALAT CC 90 MG TABLET ADVAIR HFA MCG INHALER ADVICOR 1,000 MG-20 MG TABLET ADVICOR 1,000 MG-40 MG TABLET ADVICOR 500 MG-20 MG TABLET 60 30
4 ADVICOR 750 MG-20 MG TABLET AFEDITAB CR 30 MG TABLET AFEDITAB CR 60 MG TABLET AKNE-MYCIN 2% OINTMENT ALAMAST 0.1% DROPS ALBUTEROL 0.083% INHAL SOLN ALBUTEROL 5 MG/ML SOLUTION ALBUTEROL SUL 0.63 MG/3 ML SOL ALBUTEROL SUL 1.25 MG/3 ML SOL ALCAINE 0.5% EYE DROPS ALDARA 5% CREAM ALENDRONATE SODIUM 10 MG TAB ALENDRONATE SODIUM 35 MG TAB 4 28 ALENDRONATE SODIUM 40 MG TAB ALENDRONATE SODIUM 5 MG TABLET 30 30
5 ALENDRONATE SODIUM 70 MG TAB 4 28 ALINIA 500 MG TABLET 6 30 ALLEGRA 180 MG TABLET ALLEGRA 30 MG/5 ML SUSPENSION ALLEGRA 60 MG TABLET ALLEGRA-D 12 HOUR TABLET ALOCRIL 2% EYE DROPS ALOMIDE 0.1% EYE DROPS ALORA MG PATCH 8 28 ALORA 0.05 MG PATCH 8 28 ALORA MG PATCH 8 28 ALORA 0.1 MG PATCH 8 28 ALOXI 0.25 MG/5 ML VIAL ALPHAGAN P 0.1% DROPS ALPHAGAN P 0.15% EYE DROPS 10 30
6 ALREX 0.2% EYE DROPS ALTABAX 1% OINTMENT ALTOPREV 20 MG TABLET ALTOPREV 40 MG TABLET ALTOPREV 60 MG TABLET AMBIEN 10 MG TABLET AMBIEN 5 MG TABLET AMBIEN CR 12.5 MG TABLET AMBIEN CR 6.25 MG TABLET AMERGE 1 MG TABLET AMERGE 2.5 MG TABLET AMLODIPINE BESYLATE 10 MG TAB AMLODIPINE BESYLATE 2.5 MG TAB AMLODIPINE BESYLATE 5 MG TAB AMLODIPINE-BENAZEPRIL MG 60 30
7 AMLODIPINE-BENAZEPRIL AMLODIPINE-BENAZEPRIL 5-10 MG AMLODIPINE-BENAZEPRIL 5-20 MG AMOXIL 400 MG/5 ML SUSPENSION ANDROGEL 1%(5G) GEL PACKET ANESTACON 2% JEL ANZEMET 100 MG TABLET 5 30 ANZEMET 50 MG TABLET 5 30 APRACLONIDINE HCL 0.5% DROPS 5 30 APRI 28 DAY TABLET ARANELLE 28 TABLET ARANESP 100 MCG/0.5 ML SYRINGE 2 28 ARANESP 100 MCG/ML VIAL 4 28 ARANESP 150 MCG/0.3 ML SYRINGE ARANESP 200 MCG/0.4 ML SYRINGE
8 ARANESP 200 MCG/ML VIAL 4 28 ARANESP 25 MCG/0.42 ML SYRING ARANESP 25 MCG/ML VIAL 4 28 ARANESP 300 MCG/0.6 ML SYRINGE ARANESP 300 MCG/ML VIAL 1 14 ARANESP 40 MCG/0.4 ML SYRINGE ARANESP 40 MCG/ML VIAL 4 28 ARANESP 500 MCG/1 ML SYRINGE 1 14 ARANESP 60 MCG/0.3 ML SYRINGE ARANESP 60 MCG/ML VIAL 4 28 ARAVA 10 MG TABLET ARAVA 20 MG TABLET AREDIA 30 MG VIAL 3 7 AREDIA 90 MG VIAL 1 1 ARICEPT 10 MG TABLET 30 30
9 ARICEPT 5 MG TABLET ARICEPT ODT 10 MG TABLET ARICEPT ODT 5 MG TABLET ARIMIDEX 1 MG TABLET ARIXTRA 10 MG SYRINGE ARIXTRA 2.5 MG SYRINGE 7 7 ARIXTRA 5 MG SYRINGE ARIXTRA 7.5 MG SYRINGE ASTELIN 137 MCG NASAL SPRAY ASTEPRO 137 MCG NASAL SPRAY ASTEPRO 0.15 % NASAL SPRAY ATACAND 16 MG TABLET ATACAND 32 MG TABLET ATACAND 4 MG TABLET ATACAND 8 MG TABLET 60 30
10 ATACAND HCT MG TAB ATACAND HCT MG TAB ATROVENT 0.03% SPRAY ATROVENT 0.06% SPRAY AUGMENTIN MG/5 ML AUGMENTIN ES-600 SUSPENSION AUGMENTIN XR 1, TAB AVALIDE MG TABLET AVALIDE MG TABLET AVALIDE MG TABLET AVANDIA 2 MG TABLET AVANDIA 4 MG TABLET AVANDIA 8 MG TABLET AVAPRO 150 MG TABLET AVAPRO 300 MG TABLET 30 30
11 AVAPRO 75 MG TABLET AVELOX 400 MG TABLET AVELOX ABC PACK 400 MG TAB AVIANE-28 TABLET AVITA 0.025% CREAM AVITA 0.025% GEL AVODART 0.5 MG SOFTGEL AVONEX ADMIN PACK 30 MCG VL 4 28 AVONEX PREFILLED SYR 30 MCG 4 28 AXERT 12.5 MG TABLET AXERT 6.25 MG TABLET AXID 15 MG/ML ORAL SOLUTION AZASITE 1% EYE DROPS 5 30 AZITHROMYCIN 100 MG/5 ML SUSP AZITHROMYCIN 200 MG/5 ML SUSP 45 15
12 AZOPT 1% EYE DROPS BACTROBAN 2% OINTMENT BALZIVA 28 TABLET BARACLUDE 0.05 MG/ML SOLUTION BD UF INS SYR 0.3 ML 31GX5/16" BD UF INS SYR 1 ML 31GX5/16" BD UF ORIG PEN NEEDLE 29GX1/2" BECONASE AQ 0.042% SPRAY BENICAR 20 MG TABLET BENICAR 40 MG TABLET BENICAR 5 MG TABLET BENICAR HCT MG TABLET BENICAR HCT MG TABLET BENICAR HCT MG TABLET BENTYL 10 MG/5 ML SYRUP
13 BENZAMYCIN GEL BEPREVE 1.5% EYE DROPS BESIVANCE 0.6% SUSP BETAGAN 0.25% EYE DROPS BETAGAN 0.5% EYE DROPS BETASERON 0.3 MG KIT BETAXOLOL HCL 0.5% EYE DROP 5 10 BIAXIN 125 MG/5 ML SUSPENSION BIAXIN 250 MG/5 ML SUSPENSION BLEPH-10 10% EYE DROPS BLEPHAMIDE EYE DROPS BONIVA 150 MG TABLET 1 30 BONIVA 2.5 MG TABLET BOTOX 100 UNITS VIAL 1 30 BREVICON 28 TABLET 28 28
14 BRIMONIDINE 0.2% EYE DROP 5 15 BUDEPRION XL 150 MG TABLET BUDEPRION XL 300 MG TABLET BUTORPHANOL 10 MG/ML SPRAY 5 1 BYETTA 10 MCG DOSE PEN INJ BYETTA 5 MCG DOSE PEN INJ CABERGOLINE 0.5 MG TABLET CAFERGOT TABLET CALCIPOTRIENE 0.005% SOLUTION CALCITONIN-SALMON 200 UNITS SP CAMILA TABLET CAPITAL WITH CODEINE SUSP CARAFATE 1 GM/10 ML SUSP CARDIZEM CD 120 MG CAPSULE CARDIZEM CD 180 MG CAPSULE 60 30
15 CARDIZEM CD 240 MG CAPSULE CARDIZEM CD 300 MG CAPSULE CARDIZEM CD 360 MG CAPSULE CARMOL HC 1% CREAM CARTEOLOL HCL 1% EYE DROPS CARTIA XT 120 MG CAPSULE CARTIA XT 180 MG CAPSULE CARTIA XT 240 MG CAPSULE CARTIA XT 300 MG CAPSULE CEFTIN 250 MG TABLET CEFTIN 500 MG TABLET CELEBREX 100 MG CAPSULE CELEBREX 200 MG CAPSULE CELEBREX 400 MG CAPSULE CELEBREX 50 MG CAPSULE 60 30
16 CELEXA 10 MG/5 ML SOLUTION CERUBIDINE 20 MG VIAL 15 7 CESIA 28 DAY TABLET CETIRIZINE HCL 1 MG/ML SYRUP CHANTIX 0.5 MG TABLET CHANTIX 1 MG TABLET CHANTIX STARTING MONTH PAK CHLORHEXIDINE 0.12% RINSE CICLOPIROX 8% SOLUTION CILOXAN 0.3% EYE DROPS CILOXAN 0.3% OINTMENT 7 30 CIPRODEX OTIC SUSPENSION CITALOPRAM 10 MG/5 ML SOLUTION CLAFORAN 10 GM VIAL 6 14 CLAFORAN 2 GM VIAL 60 14
17 CLAFORAN 500 MG VIAL CLARINEX 0.5 MG/ML SYRUP CLARINEX 5 MG TABLET CLARINEX-D 12 HOUR TABLET CLARINEX-D 24 HOUR TABLET CLARITHROMYCIN 125 MG/5 ML SUS CLEOCIN 2% VAGINAL CREAM CLEOCIN T 1% GEL CLEOCIN T 1% LOTION CLEOCIN T 1% SOLUTION CLIMARA MG/DAY PATCH 4 28 CLIMARA MG/DAY PATCH 4 28 CLIMARA 0.05 MG/DAY PATCH 4 28 CLIMARA 0.06/MG DAY PATCH 4 28 CLIMARA MG/DAY PATCH 4 28
18 CLIMARA 0.1 MG/DAY PATCH 4 28 CLIMARA PRO PATCH 4 28 CLINDAGEL 1% GEL CLINDESSE 2% VAGINAL CREAM CLOBEX 0.05% SHAMPOO CLOBEX 0.05% SPRAY CLOBEX 0.05% TOPICAL LOTION CLODERM 0.1% CREAM COLYTE SOLUTION COMBIGAN EYE DROPS 5 15 COMBIPATCH MG PTCH 8 28 COMBIPATCH MG PTCH 8 28 COMBIVENT INHALER COMBUNOX TABLET CONCERTA ER 18 MG TABLET 30 30
19 CONCERTA ER 27 MG TABLET CONCERTA ER 36 MG TABLET CONCERTA ER 54 MG TABLET CONDYLOX 0.5% TOPICAL SOLN 7 15 CORDRAN 4 MCG/SQ CM TAPE 2 30 CORDRAN SP 0.05% CREAM CORTISPORIN CREAM CORTISPORIN EAR SOLUTION CORTISPORIN OINTMENT COSOPT EYE DROPS CRESTOR 10 MG TABLET CRESTOR 20 MG TABLET CRESTOR 40 MG TABLET CRESTOR 5 MG TABLET CROLOM 4% EYE DROPS 20 30
20 CRYSELLE-28 TABLET CUTIVATE 0.005% OINTMENT CUTIVATE 0.05% CREAM CYCLESSA 28 DAY TABLET CYMBALTA 20 MG CAPSULE CYMBALTA 30 MG CAPSULE CYMBALTA 60 MG CAPSULE CYTOXAN 500 MG VIAL 1 1 D.H.E.45 1 MG/ML AMPUL 6 7 DDAVP 0.01% SOLUTION 5 30 DDAVP 4 MCG/ML AMPUL 1 1 DELESTROGEN 20 MG/ML VIAL 1 1 DELESTROGEN 40 MG/ML VIAL 1 1 DEMEROL 50 MG/ML VIAL 30 1 DENAVIR 1% CREAM 3 30
21 DEPO-PROVERA 150 MG/ML VIAL 1 90 DEPO-SUBQ PROVERA 104 SYRINGE DERMATOP 0.1% CREAM DERMATOP 0.1% OINTMENT DESMOPRESSIN 0.1 MG/ML SOL 5 1 DESMOPRESSIN 0.1 MG/ML SPRAY DESOGEN 28 DAY TABLET DESONATE 0.05% GEL DESOWEN 0.05% CREAM KIT DESOWEN 0.05% LOTION KIT DETROL 1 MG TABLET DETROL 2 MG TABLET DETROL LA 2 MG CAPSULE DETROL LA 4 MG CAPSULE DICLOFENAC 0.1% EYE DROPS 10 30
22 DIFLUCAN 10 MG/ML SUSPENSION 70 5 DIFLUCAN 150 MG TABLET 1 30 DIFLUCAN 40 MG/ML SUSPENSION 70 5 DILACOR XR 120 MG CAPSULE DILACOR XR 180 MG CAPSULE DILACOR XR 240 MG CAPSULE DILAUDID-5 1 MG/ML LIQUID DILT XR 180 MG CAPSULE DILT XR 240 MG CAPSULE DILT-CD 120 MG CAPSULE DILT-CD 180 MG CAPSULE DILT-CD ER 300 MG CAPSULE DILTIAZEM 24HR ER 120 MG CAP DILTIAZEM 24HR ER 240 MG CAP DILTIAZEM 24HR ER 300 MG CAP 60 30
23 DILTIAZEM HCL ER 360 MG CAP DILTIAZEM HCL ER 420 MG CAP DILTZAC ER 120 MG CAPSULE DILTZAC ER 180 MG CAPSULE DILTZAC ER 240 MG CAPSULE DILTZAC ER 300 MG CAPSULE DILTZAC ER 360 MG CAPSULE DIOVAN 160 MG TABLET DIOVAN 320 MG TABLET DIOVAN 40 MG TABLET DIOVAN 80 MG TABLET DIOVAN HCT MG TAB DIOVAN HCT MG TABLET DIOVAN HCT MG TAB DIOVAN HCT MG TABLET 30 30
24 DIOVAN HCT MG TABLET DIPROLENE 0.05% LOTION DIPROLENE 0.05% OINTMENT DIPROLENE AF 0.05% CREAM DITROPAN XL 10MG TABLET DITROPAN XL 15MG TABLET DITROPAN XL 5MG TABLET DORZOLAMIDE HCL 2% EYE DROPS DORZOLAMIDE-TIMOLOL EYE DROPS DOVONEX 0.005% CREAM DOVONEX 0.005% SOLUTION DOXYCYCLINE HYC 100 MG VIAL 2 1 DUONEB MG/3 ML SOLN DUREZOL 0.05% EYE DROPS E.E.S. 200 MG/5 ML GRANULES
25 EFUDEX 5% CREAM ELESTAT 0.05% EYE DROPS ELIDEL 1% CREAM EE 5% CREAM ELOCON 0.1% CREAM ELOCON 0.1% LOTION ELOCON 0.1% OINTMENT EMADINE 0.05% EYE DROPS ENBREL 25 MG KIT ENBREL 25 MG/0.5 ML SYRINGE ENBREL 50 MG/ML SYRINGE ENPRESSE-28 TABLET EPIDUO GEL EPIPEN 0.3 MG AUTO-INJECTOR 1 30 EPIPEN JR 0.15 MG AUTO-INJCT 1 30
26 EPOGEN 2,000 UNITS/ML VIAL 1 1 EPOGEN 20,000 UNITS/2 ML VIAL 1 1 EPOGEN 20,000 UNITS/ML VIAL 4 30 EPOGEN 3,000 UNITS/ML VIAL 1 1 EPOGEN 4,000 UNITS/ML VIAL 1 1 EPOGEN 40,000 UNITS/ML VIAL 1 1 ERGOTAMINE-CAFFEINE TABLET ERRIN 0.35 MG TABLET ERTACZO 2% CREAM ESTRADERM 0.05 MG PATCH 8 28 ESTRADERM 0.1 MG PATCH 8 28 ESTRADIOL 0.05 MG/DAY PATCH 4 28 ESTRADIOL 0.1 MG/DAY PATCH 4 28 ESTRADIOL TDS MG/DAY 4 28 ESTRADIOL TDS MG/DAY 4 28
27 ESTRADIOL TDS 0.06 MG/DAY 4 28 ESTRADIOL TDS MG/DAY 4 28 ESTRING 2 MG VAGINAL RING 1 90 ESTROSTEP FE-28 TABLET ETHYOL 500 MG VIAL EVISTA 60 MG TABLET EVOCLIN 1% FOAM EXELON 2 MG/ML ORAL SOLUTION FACTIVE 320 MG TABLET 5 15 FASLODEX 125 MG/2.5 ML SYRNGE 5 30 FASLODEX 250 MG/5 ML SYRINGE 5 30 FELODIPINE ER 10 MG TABLET FELODIPINE ER 2.5 MG TABLET FELODIPINE ER 5 MG TABLET FEMARA 2.5 MG TABLET 30 30
28 FEXOFENADINE HCL 180 MG TABLET FEXOFENADINE HCL 30 MG TABLET FEXOFENADINE HCL 60 MG TABLET FINASTERIDE 5 MG TABLET FLAREX 0.1% EYE DROPS FLOMAX 0.4 MG CAPSULE FLONASE 0.05% NASAL SPRAY FLOXIN 0.3% EAR DROPS FLUCONAZOLE 150 MG TABLET 1 14 FLUNISOLIDE 0.025% SPRAY FLUOR-OP 0.1% EYE DROPS FLUOXETINE 20 MG/5 ML SOLUTION FLURBIPROFEN 0.03% EYE DROP 5 30 FLUTICASONE PROP 50 MCG SPRAY FML LIQUIFILM 0.1% EYE DROP 20 30
29 FORTEO 600 MCG/2.4 ML PEN INJ FORTICAL 200 UNITS NASAL SPRAY FOSAMAX 10 MG TABLET FOSAMAX 35 MG TABLET 4 28 FOSAMAX 40 MG TABLET FOSAMAX 5 MG TABLET FOSAMAX 70 MG ORAL SOLUTION FOSAMAX 70 MG TABLET 4 28 FOSAMAX PLUS D 70 MG-2,800 IU 4 28 FOSAMAX PLUS D 70 MG-5,600 IU 4 28 FOSCAVIR 24 MG/ML INFUS BOTTLE FOSINOPRIL SODIUM 10 MG TAB FOSINOPRIL SODIUM 20 MG TAB FOSINOPRIL SODIUM 40 MG TAB FOSINOPRIL-HCTZ MG TAB
30 FOSINOPRIL-HCTZ MG TAB FRAGMIN 10,000 UNITS SYRINGE FRAGMIN 2,500 UNITS SYRINGE FRAGMIN 25,000 UNITS/ML VIAL FRAGMIN 5,000 UNITS SYRINGE FRAGMIN 7,500 UNITS SYRINGE FROVA 2.5 MG TABLET GALANTAMINE 4 MG/ML ORAL SOLN GAVILYTE-C SOLUTION GAVILYTE-G SOLUTION GAVILYTE-N SOLUTION GLUCAGEN 1 MG HYPOKIT 4 30 GLUCAGON 1 MG EMERGENCY KIT 2 30 GLUCOPHAGE XR 750 MG TAB GOLYTELY SOLUTION
31 GRANISETRON HCL 0.1 MG/ML VIAL 5 14 GRANISETRON HCL 1 MG TABLET 4 2 GRANISETRON HCL 1 MG/ML VIAL 5 14 GRANISOL 2 MG/10 ML SOLUTION 30 5 HALOG 0.1% CREAM HALOG 0.1% OINTMENT HUMATROPE 5 MG VIAL 1 30 HUMIRA 20 MG/0.4 ML SYRINGE 8 28 HUMIRA 40 MG/0.8 ML SYRINGE 8 28 HUMIRA CROHN'S STARTER PACK 6 28 HYCET SOLUTION HYDROCODONE-APAP MG/ HYDROCODONE-APAP SOLUTION IDAMYCIN PFS 1 MG/ML VIAL 60 3 IMITREX 100 MG TABLET 18 30
32 IMITREX 20 MG NASAL SPRAY 6 30 IMITREX 25 MG TABLET IMITREX 4 MG/0.5 ML KIT REFILL 4 30 IMITREX 5 MG NASAL SPRAY IMITREX 50 MG TABLET IMITREX 6 MG/0.5 ML KIT REFILL 4 30 IMITREX 6 MG/0.5 ML VIAL 4 30 INFERGEN 9 MCG/0.3 ML VIAL INNOHEP 20,000 UNIT/ML VIAL 14 7 INTRON A 3MM UNITS INJECT PEN 1 1 IOPIDINE 0.5% EYE DROPS 5 30 IPRATR-ALBUTEROL MG/3 ML IPRATROPIUM 0.03% SPRAY IPRATROPIUM 0.06% SPRAY IPRATROPIUM BR 0.02% SOLN
33 IQUIX 1.5% EYE DROPS ISTALOL 0.5% EYE DROPS JOLIVETTE TABLET JUNEL TABLET JUNEL 1-20 TABLET JUNEL FE TABLET JUNEL FE 1-20 TABLET KAPIDEX DR 30 MG CAPSULE KAPIDEX DR 60 MG CAPSULE KARIVA 28 DAY TABLET KELNOR TABLET KETOROLAC 10 MG TABLET 20 5 KETOROLAC 15 MG/ML VIAL 2 1 KETOROLAC 30 MG/ML VIAL 2 1 KINERET 100 MG/0.67 ML SYR 19 28
34 KLARON 10% LOTION KYTRIL 0.1 MG/ML VIAL 10 7 KYTRIL 1 MG TABLET 4 2 KYTRIL 1 MG/ML VIAL 5 14 LAC-HYDRIN 12% CREAM LAC-HYDRIN 12% LOTION LAMISIL 1% SOLUTION LAMISIL 125 MG GRANULES PACKET LAMISIL MG GRANULES PACK LAMISIL 250 MG TABLET LANSOPRAZOLE DR 15 MG CAPSULE LANSOPRAZOLE DR 30 MG CAPSULE LEENA 28 TABLET LEFLUNOMIDE 10 MG TABLET LEFLUNOMIDE 20 MG TABLET 30 30
35 LESCOL 20 MG CAPSULE LESCOL 40 MG CAPSULE LESCOL XL 80 MG TABLET LESSINA-28 TABLET LEUSTATIN 10 MG/10 ML VIAL 20 1 LEVOBUNOLOL 0.25% EYE DROPS 5 15 LEVOBUNOLOL 0.5% EYE DROPS 5 15 LEVORA-28 TABLET LEXAPRO 5 MG/5 ML SOLUTION LIDOCAINE-PRILOCAINE CREAM LIDODERM 5% PATCH LINDANE 1% LOTION LINDANE 1% SHAMPOO LIPITOR 10 MG TABLET LIPITOR 20 MG TABLET 30 30
36 LIPITOR 40 MG TABLET LIPITOR 80 MG TABLET LISINOPRIL 2.5 MG TABLET LISINOPRIL 20 MG TABLET LISINOPRIL 30 MG TABLET LISINOPRIL 40 MG TABLET LISINOPRIL 5 MG TABLET LISINOPRIL-HCTZ MG TAB LISINOPRIL-HCTZ MG TAB LISINOPRIL-HCTZ MG TAB LOCOID 0.1% OINTMENT LOCOID 0.1% SOLUTION LOESTRIN /30 TABLET LOESTRIN 21 1/20 TABLET LOESTRIN 24 FE TABLET 28 28
37 LOESTRIN FE TABLET LOESTRIN FE 1-20 TABLET LOMOTIL LIQUID LO-OVRAL-28 TABLET LOPROX 0.77% GEL LORTAB ELIXIR LOTEMAX 0.5% EYE DROPS LOTREL MG CAPSULE LOTREL MG CAPSULE LOTREL MG CAPSULE LOTREL 5-10 MG CAPSULE LOTREL 5-20 MG CAPSULE LOTREL 5-40 MG CAPSULE LOTRISONE CREAM LOTRISONE LOTION 60 30
38 LOTRONEX 0.5 MG TABLET LOTRONEX 1 MG TABLET LOVASTATIN 10 MG TABLET LOVASTATIN 20 MG TABLET LOVASTATIN 40 MG TABLET LOVENOX 100 MG PREFILLED SYR 14 7 LOVENOX 120 MG PREFILLED SYR LOVENOX 150 MG PREFILLED SYR 14 7 LOVENOX 30 MG PREFILLED SYRN LOVENOX 300 MG VIAL 6 30 LOVENOX 40 MG PREFILLED SYRN LOVENOX 60 MG PREFILLED SYRN LOVENOX 80 MG PREFILLED SYRN LOW-OGESTREL-28 TABLET LUMIGAN 0.03% EYE DROPS
39 LUNESTA 1 MG TABLET LUNESTA 2 MG TABLET LUNESTA 3 MG TABLET LUPRON 2-WK 1 MG/0.2 ML KIT 1 1 LUTERA-28 TABLET LUVOX CR 100 MG CAPSULE LUVOX CR 150 MG CAPSULE LYBREL TABLET MALATHION 0.5% LOTION MAXALT 10 MG TABLET MAXALT 5 MG TABLET MAXALT MLT 10 MG TABLET MAXALT MLT 5 MG TABLET MAXITROL EYE DROPS MAXITROL EYE OINTMENT 7 30
40 MEDROXYPROGESTERONE 150 MG/ML 1 90 MEGACE 40 MG/ML ORAL SUSP MELOXICAM 15 MG TABLET MELOXICAM 7.5 MG TABLET MELOXICAM 7.5 MG/5 ML SUSP MENOSTAR 14 MCG/DAY PATCH 4 28 MEPERIDINE 50 MG/5 ML SOLUTION MEPRON 750 MG/5 ML SUSPENSION METFORMIN HCL ER 750 MG TABLET METHADONE 10 MG/5 ML SOLUTION METHADONE 10 MG/ML ORAL CONC METHADONE 5 MG/5 ML SOLUTION METHYLIN 10 MG/5 ML SOLUTION METHYLIN 5 MG/5 ML SOLUTION METROCREAM 0.75% CREAM 90 30
41 METROGEL-VAGINAL 0.75% GEL METROLOTION TOPICAL 0.75% MEVACOR 10 MG TABLET MEVACOR 20 MG TABLET MEVACOR 40 MG TABLET MIACALCIN 200 UNIT NASAL SPRAY MICARDIS 20 MG TABLET MICARDIS 40 MG TABLET MICARDIS 80 MG TABLET MICARDIS HCT MG TABLET MICARDIS HCT MG TABLET MICARDIS HCT MG TABLET MICROGESTIN TAB MICROGESTIN TABLET MICROGESTIN FE TAB 28 28
42 MICROGESTIN FE 1-20 TABLET MIGRANAL NASAL SPRAY 8 30 MINITRAN 0.1 MG/HR PATCH MINITRAN 0.2 MG/HR PATCH MINITRAN 0.4 MG/HR PATCH MINITRAN 0.6 MG/HR PATCH MOBIC 15 MG TABLET MOBIC 7.5 MG TABLET MOBIC 7.5 MG/5 ML SUSPENSION MODICON 28 TABLET MONONESSA 28 TABLET MONOPRIL 10 MG TABLET MONOPRIL 20 MG TABLET MONOPRIL 40 MG TABLET MONOPRIL HCT MG TABLET
43 MONOPRIL HCT MG TABLET MYCOSTATIN 100,000 UNITS/GM PW MYDRIACYL 1% EYE DROPS NAFTIN 1% GEL NAMENDA 10 MG/5 ML SOLUTION NAPROSYN 125 MG/5 ML SUSPEN NASACORT AQ NASAL SPRAY NASAREL 29 MCG-0.025% SPRAY NASONEX 50 MCG NASAL SPRAY NECON TABLET NECON TABLET NECON TABLET NECON TABLET NECON TABLET NEOSPORIN EYE DROPS 20 30
44 NEULASTA 6 MG/0.6 ML SYRINGE NEUMEGA 5 MG VIAL NEUPOGEN 300 MCG/0.5 ML SYR NEUPOGEN 480 MCG/0.8 ML SYR NEUPOGEN 480 MCG/1.6 ML VIAL NEVANAC 0.1% DROPTAINER 6 30 NEXIUM 10 MG PACKET NEXIUM 20 MG CAPSULE NEXIUM 20 MG PACKET NEXIUM 40 MG CAPSULE NEXIUM 40 MG PACKET NEXIUM I.V. 20 MG VIAL NIASPAN ER 1,000 MG TABLET NIASPAN ER 500 MG TABLET NIASPAN ER 750 MG TABLET 60 30
45 NICOTROL NS 10 MG/ML SPRAY NIFEDIAC CC 30 MG TABLET NIFEDIAC CC 60 MG TABLET NIFEDIAC CC 90 MG TABLET NIFEDICAL XL 30 MG TABLET NIFEDICAL XL 60 MG TABLET NIFEDIPINE ER 30 MG TABLET NIFEDIPINE ER 60 MG TABLET NIFEDIPINE ER 90 MG TABLET NIPENT 10 MG VIAL 1 1 NITRO-DUR 0.1 MG/HR PATCH NITRO-DUR 0.2 MG/HR PATCH NITRO-DUR 0.3 MG/HR PATCH NITRO-DUR 0.4 MG/HR PATCH NITRO-DUR 0.6 MG/HR PATCH 30 30
46 NITRO-DUR 0.8 MG/HR PATCH NITROGLYCERIN 0.2 MG/HR PATCH NITROGLYCERIN 0.4 MG/HR PATCH NITROGLYCERIN 0.6 MG/HR PTCH NIZORAL 2% SHAMPOO NORA-BE TABLET NORDETTE-28 TABLET NORINYL TABLET NOR-Q-D TABLET NORTREL 0.5/35 TABLET NORTREL 1/35 TABLET NORTREL 1-35 TABLET NORTREL TABLET NORVASC 10 MG TABLET NORVASC 2.5 MG TABLET 30 30
47 NORVASC 5 MG TABLET NULYTELY WITH FLAVOR PACKS SOL NUTROPIN 10 MG VIAL 4 30 NUTROPIN 5 MG VIAL 4 30 NUTROPIN AQ 20 MG/2ML PEN CART 4 30 NUTROPIN AQ PEN CARTRIDGE 4 30 NYAMYC 100,000 UNITS/GM POWDER OCELLA TABLET OCUFEN 0.03% EYE DROPS 5 30 OCUFLOX 0.3% EYE DROPS OFLOXACIN 0.3% EAR DROPS OFLOXACIN 0.3% EYE DROPS OGESTREL TABLET OLUX-E 0.05% FOAM OMEPRAZOLE DR 10 MG CAPSULE 30 30
48 OMEPRAZOLE DR 20 MG CAPSULE OMEPRAZOLE DR 40 MG CAPSULE OMNARIS 50 MCG NASAL SPRAY OMNICEF 125 MG/5 ML SUSP OMNICEF 250 MG/5 ML SUSPENSION OMNIPRED 1% EYE DROPS ONDANSETRON 4 MG/5 ML SOLUTION ONDANSETRON HCL 24 MG TABLET ONDANSETRON ODT 4 MG TABLET 18 5 ONDANSETRON ODT 8 MG TABLET 18 5 OPTIPRANOLOL 0.3% EYE DROPS 5 15 OPTIVAR 0.05% DROPS ORTHO EVRA PATCH 3 28 ORTHO MICRONOR TABLET ORTHO TRI-CYCLEN LO TABLET 28 28
49 ORTHO-CEPT 28 DAY TABLET ORTHO-CYCLEN 28 TABLET ORTHO-NOVUM TABLET OVCON TABLET OVCON TABLET OXALIPLATIN 100 MG/20 ML 1 1 OXYBUTYNIN CL ER 10 MG TABLET OXYBUTYNIN CL ER 15 MG TABLET OXYBUTYNIN CL ER 5 MG TABLET OXYCODONE-IBUPROFEN TAB PAMELOR 10 MG/5 ML SOLUTION PANDEL 0.1% CREAM PANTOPRAZOLE SOD DR 20 MG TAB PANTOPRAZOLE SOD DR 40 MG TAB PAROXETINE HCL 10 MG/5 ML SUSP
50 PATADAY 0.2% EYE DROPS 5 30 PATANASE 0.6% NASAL SPRAY PATANOL 0.1% EYE DROPS PAXIL 10 MG/5 ML SUSPENSION PEG 3350 ELECTROLYTE SOLN PEGASYS 180 MCG/0.5 ML CONV.PK 2 28 PEGINTRON REDIPEN 120 MCG 4 28 PEGINTRON REDIPEN 120 MCG 4PK 4 28 PEGINTRON REDIPEN 150 MCG 4 28 PEGINTRON REDIPEN 150 MCG 4PK 4 28 PEGINTRON REDIPEN 50 MCG 4 28 PEGINTRON REDIPEN 80 MCG 4 28 PEGINTRON REDIPEN 80 MCG 4PK 4 28 PENLAC 8% SOLUTION PENTAM 300 VIAL 21 21
51 PERFOROMIST 20 MCG/2 ML SOLN PERIDEX 0.12% LIQUID PERIOGARD 0.12% ORAL RINSE PHISOHEX 3% CLEANSER PHYSIOSOL IRRIGATION SOLN PLAVIX 300 MG TABLET 1 1 PLAVIX 75 MG TABLET POLYTRIM EYE DROPS PORTIA-28 TABLET PRAVACHOL 10 MG TABLET PRAVACHOL 20 MG TABLET PRAVACHOL 40 MG TABLET PRAVACHOL 80 MG TABLET PRAVASTATIN SODIUM 10 MG TAB PRAVASTATIN SODIUM 20 MG TAB 30 30
52 PRAVASTATIN SODIUM 40 MG TAB PRAVASTATIN SODIUM 80 MG TAB PRED FORTE 1% EYE DROPS PRED-G 1% EYE DROPS PRED-G S.O.P. EYE OINTMENT 7 30 PRELONE 15 MG/5 ML SYRUP PREVACID 15 MG SOLUTAB PREVACID 30 MG SOLUTAB PREVACID DR 15 MG CAPSULE PREVACID DR 30 MG CAPSULE PREVIFEM TABLET PREVPAC PATIENT PACK PRILOSEC DR 10 MG CAPSULE PRILOSEC DR 20 MG CAPSULE PRILOSEC DR 40 MG CAPSULE 30 30
53 PRINIVIL 10 MG TABLET PRINIVIL 20 MG TABLET PRINIVIL 5 MG TABLET PRINZIDE MG TABLET PRINZIDE MG TABLET PRINZIDE MG TABLET PROAIR HFA 90 MCG INHALER PROCARDIA XL 30 MG TABLET PROCARDIA XL 60 MG TABLET PROCARDIA XL 90 MG TABLET PROCRIT 10,000 UNITS/ML VIAL PROCRIT 2,000 UNITS/ML VIAL PROCRIT 20,000 UNITS/ML VIAL 4 28 PROCRIT 3,000 UNITS/ML VIAL PROCRIT 4,000 UNITS/ML VIAL 12 28
54 PROCRIT 40,000 UNITS/ML VIAL 4 28 PROCTOCORT 1% CREAM PROPINE 0.1% EYE DROPS PROSCAR 5 MG TABLET PROTONIX 40 MG SUSPENSION PROTONIX DR 20 MG TABLET PROTONIX DR 40 MG TABLET PROTOPIC 0.03% OINTMENT PROTOPIC 0.1% OINTMENT PROZAC 20 MG/5 ML SOLUTION PROZAC WEEKLY 90 MG CAPSULE 4 28 PULMICORT 0.25 MG/2 ML RESPUL PULMICORT 0.5 MG/2 ML RESPULE PULMICORT 1 MG/2 ML RESPULE PULMICORT 180 MCG FLEXHALER 1 30
55 PULMICORT 90 MCG FLEXHALER 1 30 QUASENSE MG TABLET QUESTRAN PACKET QUINAPRIL 10 MG TABLET QUINAPRIL 20 MG TABLET QUINAPRIL 40 MG TABLET QUINAPRIL 5 MG TABLET QUINAPRIL-HCTZ MG TAB QUINAPRIL-HCTZ MG TAB QUINAPRIL-HCTZ MG TAB QUINARETIC MG TABLET QUINARETIC MG TABLET QUINARETIC MG TABLET RAZADYNE 4 MG/ML ORAL SOLUTION 60 5 REBIF 22 MCG/0.5 ML SYRINGE 6 28
56 REBIF 44 MCG/0.5 ML SYRINGE 6 28 REBIF TITRATION PACK 6 28 RECLIPSEN 28 DAY TABLET REGRANEX 0.01% GEL RELENZA 5 MG DISKHALER RELPAX 20 MG TABLET RELPAX 40 MG TABLET RESTASIS 0.05% EYE EMULSION RETIN-A 0.01% GEL RETIN-A 0.025% CREAM RETIN-A 0.025% GEL RETIN-A 0.05% CREAM RETIN-A 0.1% CREAM RETIN-A MICRO 0.04% GEL RETIN-A MICRO 0.1% GEL 90 30
57 RETROVIR 10 MG/ML SYRUP RHINOCORT AQUA NASAL SPRAY RIFADIN IV 600 MG VIAL 1 1 RISPERDAL 1 MG/ML SOLUTION RISPERDAL CONSTA 12.5 MG SYR 4 28 RISPERDAL CONSTA 25 MG SYR 4 28 RISPERDAL CONSTA 37.5 MG SYR 4 28 RISPERDAL CONSTA 50 MG SYR 4 28 RISPERIDONE 1 MG/ML SOLUTION ROCEPHIN 1 GM VIAL 14 7 ROWASA 4 GM/60 ML ENEMA KIT ROXICET ORAL SOLUTION SANTYL OINTMENT SEASONALE MG TAB SEASONIQUE TAB 91 91
58 SELSUN RX 2.5% SHAMPOO SELZENTRY 150 MG TABLET SELZENTRY 300 MG TABLET SEREVENT DISKUS 50 MCG SERTRALINE 20 MG/ML ORAL CONC SILVADENE 1% CREAM SIMCOR 1, MG TABLET SIMCOR MG TABLET SIMCOR MG TABLET SIMPONI 50 MG/0.5 ML SYRINGE SIMVASTATIN 10 MG TABLET SIMVASTATIN 20 MG TABLET SIMVASTATIN 40 MG TABLET SIMVASTATIN 5 MG TABLET SIMVASTATIN 80 MG TABLET 30 30
59 SINGULAIR 10 MG TABLET SINGULAIR 4 MG GRANULES SINGULAIR 4 MG TABLET CHEW SINGULAIR 5 MG TABLET CHEW SOLARAZE 3% GEL SOLIA TABLET SOLU-CORTEF 100 MG ACT-O-VL 1 1 SOLU-MEDROL 125 MG VIAL 3 3 SOLU-MEDROL 40 MG VIAL 1 1 SOMATULINE 120 MG/0.5 ML SYRGE 1 30 SOMATULINE 90 MG/0.3 ML SYRING SOMAVERT 10 MG VIAL 1 1 SOMAVERT 15 MG VIAL 1 1 SOMAVERT 20 MG VIAL 1 1 SONATA 10 MG CAPSULE 60 30
60 SONATA 5 MG CAPSULE SPORANOX 10 MG/ML SOLUTION SPRINTEC 28 DAY TABLET SUBOXONE 2 MG-0.5 MG TABLET SUBOXONE 8 MG-2 MG TABLET SUBUTEX 2 MG TABLET SUBUTEX 8 MG TABLET SUMATRIPTAN 6 MG/0.5 ML VIAL 4 30 SUMATRIPTAN SUCC 100 MG TABLET 9 30 SUMATRIPTAN SUCC 25 MG TABLET 9 30 SUMATRIPTAN SUCC 50 MG TABLET 9 30 SUPRAX 400 MG TABLET SUTENT 50 MG CAPSULE SYMBICORT MCG INHALER SYMBICORT MCG INHALER
61 SYMLIN 0.6 MG/ML VIAL SYMLINPEN 120 PEN INJECTOR SYMLINPEN 60 PEN INJECTOR 6 30 TACLONEX OINTMENT TACLONEX SCALP SUSPENSION TAMIFLU 12 MG/ML SUSPENSION TAMIFLU 30 MG GELCAP TAMIFLU 45 MG GELCAP TAMIFLU 75 MG GELCAP TAMSULOSIN HCL 0.4 MG CAPSULE TARGRETIN 1% GEL TARKA MG TABLET SA TARKA MG TABLET SA TARKA MG TABLET SA TARKA MG TABLET SA 60 30
62 TAZORAC 0.05% CREAM TAZORAC 0.05% GEL TAZORAC 0.1% CREAM TAZORAC 0.1% GEL TAZTIA XT 120 MG CAPSULE TAZTIA XT 180 MG CAPSULE TAZTIA XT 240 MG CAPSULE TAZTIA XT 300 MG CAPSULE TAZTIA XT 360 MG CAPSULE TEMOVATE 0.05% CREAM TEMOVATE 0.05% GEL TEMOVATE 0.05% OINTMENT TEMOVATE 0.05% SOLUTION TERAZOL 3 80 MG SUPPOSITORY 6 30 TERAZOL 3 CREAM 40 30
63 TERAZOL 7 CREAM TERBINAFINE HCL 250 MG TABLET TERCONAZOLE 0.4% CREAM TERCONAZOLE 0.8% CREAM TESTIM 1%(50MG) GEL TEVETEN 400 MG TABLET TEVETEN 600 MG TABLET TEVETEN HCT MG TAB TEVETEN HCT MG TAB TIAZAC ER 120 MG CAPSULE TIAZAC ER 180 MG CAPSULE TIAZAC ER 240 MG CAPSULE TIAZAC ER 300 MG CAPSULE TIAZAC ER 360 MG CAPSULE TIAZAC ER 420 MG CAPSULE 60 30
64 TIGAN 100 MG/ML VIAL 20 1 TIMOLOL 0.25% EYE DROPS TIMOLOL 0.5% EYE DROPS 5 30 TIMOPTIC 0.25% OCUDOSE DROP 5 15 TIMOPTIC 0.5% OCUDOSE DROP 5 15 TIMOPTIC-XE 0.25% EYE SOLN 5 30 TIMOPTIC-XE 0.5% EYE SOLN 5 30 TOBRADEX EYE DROPS TOBRADEX EYE OINTMENT 7 30 TOBRAMYCIN-DEXAMETH OPTH SUSP TOBREX 0.3% EYE DROPS TOPICORT 0.05% GEL TOPICORT 0.25% CREAM TOPICORT 0.25% OINTMENT TOPICORT LP 0.05% CREAM
65 TRACLEER 125 MG TABLET TRACLEER 62.5 MG TABLET TRANSDERM-SCOP 1.5 MG/72HR TRAVATAN Z 0.004% EYE DROP TRETINOIN 0.01% GEL TRETINOIN 0.025% CREAM TRETINOIN 0.025% GEL TRETINOIN 0.05% CREAM TRETINOIN 0.1% CREAM TREXIMET MG TABLET TRILYTE WITH FLAVOR PACKETS TRINESSA 28 DAY TRI-NORINYL 28 TABLET TRI-PREVIFEM 28 DAY TRI-SPRINTEC TABLET 28 28
66 TRIVORA-28 TABLET TRUSOPT 2% EYE DROPS TWINJECT 0.15 MG AUTO-INJECTOR 2 30 TWINJECT 0.3 MG AUTO-INJECTOR 2 30 ULTRAVATE 0.05% CREAM ULTRAVATE 0.05% OINTMENT UNASYN 15 GM VIAL 1 1 UNASYN 3 GM VIAL UROXATRAL 10 MG TABLET VANOS 0.1% CREAM VELIVET 28 DAY TABLET VERAMYST 27.5 MCG NASAL SPRAY VERDESO 0.05% FOAM VEREGEN 15% OINTMENT VEXOL 1% EYE DROPS 40 30
67 VFEND 40 MG/ML SUSPENSION VICTOZA 18 MG/3 ML INJECT PEN VIGAMOX 0.5% EYE DROPS 6 30 VIROPTIC 1% EYE DROPS VIVELLE-DOT MG PATCH 8 28 VIVELLE-DOT MG PATCH 8 28 VIVELLE-DOT 0.05 MG PATCH 8 28 VIVELLE-DOT MG PATCH 8 28 VIVELLE-DOT 0.1 MG PATCH 8 28 VOLTAREN 0.1% EYE DROPS VYTORIN MG TABLET VYTORIN MG TABLET VYTORIN MG TABLET VYTORIN MG TABLET WELLBUTRIN XL 150 MG TABLET 90 30
68 WELLBUTRIN XL 300 MG TABLET WESTCORT 0.2% OINTMENT XALATAN 0.005% EYE DROPS XIBROM 0.09% EYE DROPS XIFAXAN 200 MG TABLET 9 30 XOLEGEL 2% GEL XOPENEX 0.31 MG/3 ML SOLUTION XOPENEX 0.63 MG/3 ML SOLUTION XOPENEX 1.25 MG/3 ML SOLUTION XYLOCAINE 0.5% VIAL 1 1 XYLOCAINE 2% JELLY XYREM 500 MG/ML ORAL SOLUTION XYZAL 2.5 MG/5 ML SOLUTION YASMIN 28 TABLET YAZ 28 TABLET 28 28
69 ZALEPLON 10 MG CAPSULE ZALEPLON 5 MG CAPSULE ZANTAC 15 MG/ML SYRUP ZAZOLE 0.8% VAGINAL CREAM ZAZOLE VAGINAL 0.4% CREAM ZEGERID 20 MG CAPSULE ZEGERID 20 MG PACKET ZEGERID 40 MG CAPSULE ZEGERID 40 MG PACKET ZESTORETIC TABLET ZESTORETIC TABLET ZESTORETIC TABLET ZESTRIL 10 MG TABLET ZESTRIL 2.5 MG TABLET ZESTRIL 20 MG TABLET 60 30
70 ZESTRIL 30 MG TABLET ZESTRIL 40 MG TABLET ZESTRIL 5 MG TABLET ZETIA 10 MG TABLET ZIAC MG TABLET ZIAC MG TABLET ZIAC MG TABLET ZIANA GEL ZITHROMAX 100 MG/5 ML SUSP ZITHROMAX 200 MG/5 ML SUSP ZITHROMAX I.V. 500 MG VIAL 2 2 ZOCOR 10 MG TABLET ZOCOR 20 MG TABLET ZOCOR 40 MG TABLET ZOCOR 5 MG TABLET 30 30
71 ZOCOR 80 MG TABLET ZOFRAN 2 MG/ML VIAL 20 1 ZOFRAN 4 MG TABLET 9 3 ZOFRAN 4 MG/5 ML ORAL SOLN ZOFRAN 8 MG TABLET 9 3 ZOFRAN ODT 4 MG TABLET 18 3 ZOFRAN ODT 8 MG TABLET 18 3 ZOLOFT 20 MG/ML ORAL CONC ZOLPIDEM TARTRATE 10 MG TABLET ZOLPIDEM TARTRATE 5 MG TABLET ZOMIG 2.5 MG TABLET ZOMIG 5 MG NASAL SPRAY 6 30 ZOMIG 5 MG TABLET 6 30 ZOMIG ZMT 2.5 MG TABLET ZOMIG ZMT 5 MG TABLET 6 30
72 ZONALON 5% CREAM ZOSTAVAX VIAL 1 30 ZOVIA 1-35E TABLET ZOVIA 1-50E TABLET ZOVIRAX 200 MG/5 ML SUSP ZOVIRAX 5% CREAM 10 1 ZOVIRAX 5% OINTMENT ZYLET EYE DROPS ZYMAR 0.3% EYE DROPS ZYVOX 600 MG TABLET 28 14
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Quantity Limits Drug List Updated: February 2018 Helpful Tip: To search fo a specific drug, use the find feature (Ctrl + F)
Azithromycin Oral Susp. 100 2 bottles Antibiotics 200 3 bottles Factive 320 mg 7 tabs Antidepressantes- SSRIs, SNRIs, other Zmax Aplenzin Budeprion SR Budeprion XL Bupropion SR/ER Celexa Citalopram Cymbalta
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Updated: October 2018 Helpful Tip: To search fo a specific drug, use the find feature (Ctrl + F) Category Brand Name Drug (Generic) Quantity Limit Azithromycin Oral Susp. 100 2 bottles 200 3 bottles Factive
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ulary ulary Effective ADDS 00472088282 ACETASOL HC 2%; 1% SOLN Pref(1) no 1/29/2009 3/1/2009 68382026101 ACETAZOLAMIDE 500MG CP12 Pref(1) yes 3/24/2009 5/1/2009 00078056651 AFINITOR 5MG TABS Pref (4);
+-Quantity per Dispensing Level Limits/Allowances
An independent licensee of the Blue Cross and Blue Shield Association. +-Quantity per Dispensing Level Limits/Allowances All covered prescription medications are available at a participating pharmacy for