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Page 1: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits
Page 2: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Formulary

(01/01/2019)

INTRODUCTION We are pleased to provide the 2019 University of Maryland Health Partners (UMHP) Formulary as a useful reference and informational tool. This document can assist medical providers in selecting clinically-appropriate and cost-effective products for their patients.

The document is reflective of current medical practice as of the date on which UMHP completed its standard review.

The information contained in this document and its appendices is provided solely for the convenience of medical providers. We do not warrant or assure accuracy of such information nor is it intended to be comprehensive in nature. This document is not intended to be a substitute for the knowledge, expertise, skill and judgment of the medical provider in his or her choice of prescription drugs. All the information in the document is provided as a reference for drug therapy selection. Specific drug selection for an individual patient rests solely with the prescriber.

The document is subject to state-specific regulations and rules, including, but not limited to, those regarding generic substitution, controlled substance schedules, preference for brands and mandatory generics whenever applicable.

We assume no responsibility for the actions or omissions of any medical provider based upon reliance, in whole or in part, on the information contained herein. The medical provider should consult the drug manufacturer's product literature or standard references for more detailed information.

PREFACE The document is organized by sections. Each section is divided by therapeutic drug class primarily defined by mechanism of action. Drugs represented in this document may have varying cost to the plan member based on the plan's benefit structure. Generic medications typically are available at the lower cost, brand-name medications on the document will generally cost more than generics. Generics should be considered the first line of prescribing subject to applicable rules.

PHARMACY AND THERAPEUTICS (P&T) COMMITTEE The services of an independent National Pharmacy and Therapeutics Committee ("P&T Committee") are utilized to determine the safety and clinical effectiveness of drug therapies. The P&T Committee is an external advisory body of clinical professionals from across the United States. Voting members of the P&T Committee must disclose any financial relationship or conflicts of interest with any pharmaceutical manufacturers.

GENERIC SUBSTITUTION Generic substitution is a pharmacy action whereby a generic version is dispensed rather than a prescribed brand-name product. Lower case type indicates generic availability. In most instances, a brand-name drug for which a generic product becomes available will become non-formulary, with the generic product covered in its place, upon release of the generic product to the market. However, the document is subject to state specific regulations and rules regarding generic substitution and mandatory generic rules apply where appropriate.

Generic drugs are usually priced lower than their brand-name equivalents. Prescription generic drugs are:

• Approved by the U.S. Food and Drug Administration for safety and effectiveness, and are manufactured under the same strict standards that apply to brand-name drugs.

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Page 3: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

• Tested in humans to assure the generic is absorbed into the bloodstream in a similar rate and extent compared to the brand-name drug (bioequivalence). Generics may be different from the brand in size, color and inactive ingredients, but this does not alter their effectiveness or ability to be absorbed just like the brand-name drug.

• Manufactured in the same strength and dosage form as the brand-name drugs.

When a generic drug is substituted for a brand-name drug, you can expect the generic to produce the same clinical effect and safety profile as the brand-name drug (therapeutic equivalence).

SPECIALTY PLAN DESIGN Specialty Guideline Management (SGM)

SGM is our utilization management program that helps ensure appropriate utilization for specialty medication based on currently accepted evidence-based medicine guidelines. The utilization management program is available for all therapeutic areas dispensed by our specialty pharmacies. SGM is designed to help ensure safety and efficacy while preventing off-guideline utilization. Medications which may be included in the SGM program are identified in the document as “SP” for your reference.

PLAN DESIGN The document represents a closed formulary plan design. The medications listed on the document are covered by the plan as represented. Certain medications on the list are covered if utilization management criteria are met (i.e., Step Therapy, Prior Authorization, Quantity Limits, etc.); requests for use of such medications outside of their listed criteria will be reviewed for medical necessity. If a medication is not listed on the document, a formulary exception may be requested for coverage. Medical necessity or formulary exception requests will be reviewed based on drug-specific prior authorization criteria or standard non- formulary prescription request criteria. Log in to www.umhealthpartners.com to check coverage.

AUTHORIZATIONS Authorization requests for both FORMULARY and NON-FORMULARY products requiring either a PA (Prior Authorization), QL (Quantity Limit), ST (Step Therapy) or medical necessity review - contact CVS Caremark® at: 1-877-418-4133.

Authorization requests for specific MENTAL HEALTH/HIV products - contact MDH - Maryland Department of Health at: 1-800- 932-3918 (Anti-Psychotic Peer Review Line for children 0-9 years old: 1-855-283-0876).

OPIOIDS The quantity of opioid products prescribed (including those that are combined with acetaminophen, aspirin or ibuprofen) will be limited to up to 90 morphine milligram equivalents (MME) per day based on a 30-day supply. Prescriptions that exceed 90 MME daily limits will be subject to UM criteria, such as prior authorization. Members who are opioid-naïve may be subject to additional step therapy requirements (use of an immediate-release (IR) formulation will be required before moving to an extended-release (ER) formulation) and quantity limit restrictions (first fill will be limited to seven days).

NOTICE The information contained in this document is proprietary. The information may not be copied in whole or in part without written permission. ©2018. All rights reserved. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers. Plan member privacy is important to us. Our employees are trained regarding the appropriate way to handle members' private health information.

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Page 4: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 3 AGE - Age Limit GNDR - Gender Edit

5-HT3 RECEPTOR ANTAGONISTS 5-HT3 RECEPTOR ANTAGONISTS

granisetron hcl tab 1 mg QL (6 tabs / 15 days)

ondansetron hcl oral soln 4 mg/5ml QL (100 mL / 15 days)

ondansetron hcl tab 4 mg QL (12 each / 15 days)

ondansetron hcl tab 4 mg QL (12 tabs / 15 days)

ondansetron hcl tab 8 mg QL (12 each / 15 days)

ondansetron hcl tab 8 mg QL (12 tabs / 15 days)

ondansetron hcl tab 24 mg QL (1 tab / 15 days) ondansetron orally disintegrating tab 4 mg QL (12 each / 15 days) ondansetron orally disintegrating tab 4 mg QL (12 tabs / 15 days) ondansetron orally disintegrating tab 8 mg QL (12 each / 15 days) ondansetron orally disintegrating tab 8 mg QL (12 tabs / 15 days)

ACE INHIBITORS ACE INHIBITORS

benazepril hcl tab 5 mg benazepril hcl tab 10 mg benazepril hcl tab 20 mg benazepril hcl tab 40 mg captopril tab 12.5 mg captopril tab 25 mg captopril tab 50 mg captopril tab 100 mg

enalapril maleate tab 2.5 mg enalapril maleate tab 5 mg enalapril maleate tab 10 mg enalapril maleate tab 20 mg fosinopril sodium tab 10 mg fosinopril sodium tab 20 mg fosinopril sodium tab 40 mg lisinopril tab 2.5 mg lisinopril tab 5 mg

lisinopril tab 10 mg lisinopril tab 20 mg lisinopril tab 30 mg lisinopril tab 40 mg quinapril hcl tab 5 mg quinapril hcl tab 10 mg quinapril hcl tab 20 mg quinapril hcl tab 40 mg ramipril cap 1.25 mg ramipril cap 2.5 mg ramipril cap 5 mg ramipril cap 10 mg

Page 5: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 4 AGE - Age Limit GNDR - Gender Edit

trandolapril tab 1 mg

trandolapril tab 2 mg trandolapril tab 4 mg

ACNE PRODUCTS ACNE ANTIBIOTICS

clindamycin phosphate gel 1% clindamycin phosphate lotion 1% clindamycin phosphate soln 1% erythromycin gel 2% erythromycin soln 2%

sulfacetamide sodium lotion 10% (acne)

ACNE PRODUCTS acne control cre clns 10% OTC acne foaming liq wash 10% OTC

acne max str cre 10% OTC

acne medicat gel 5% OTC

acne medicat gel 10% OTC

acne treat cre 10% OTC

acne treatme cre 10% OTC

acne treatmn gel 10% OTC

acne-clear gel 10% OTC

amnesteem cap 10mg PA

amnesteem cap 20mg PA

amnesteem cap 40mg PA

avita cre 0.025% PA

avita gel 0.025% PA

benzepro liq creamy

benziq wash liq 5.25% BENZOYL PER GEL 2.5% OTC benzoyl per liq 5% wash OTC

benzoyl per liq 10% wash OTC

benzoyl peroxide gel 5% OTC

benzoyl peroxide gel 10% OTC

bp gel gel 5% OTC

bp gel gel 10% OTC

bp wash liq 2.5%

bp wash liq 5% OTC

bp wash liq 7%

bp wash liq 10% OTC

claravis cap 10mg PA

3-in-1 clean liq 5% OTC

clean&clear cre 10% OTC

clearasil cre acne OTC

clearskin cre 10% OTC

Page 6: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 5 AGE - Age Limit GNDR - Gender Edit

creamy face liq wash 4% OTC

Page 7: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 5 AGE - Age Limit GNDR - Gender Edit

cvs acne cre 10% OTC

foaming face liq wsh 10% OTC

myorisan cap 10mg PA

myorisan cap 20mg PA

myorisan cap 30mg PA

myorisan cap 40mg PA

persa-gel gel 10% OTC

pr benzoyl liq 7% wash

ra acne cre 10% OTC

ra renewal gel 10% OTC

tretinoin cream 0.1% PA

tretinoin cream 0.05% PA

tretinoin cream 0.025% PA

tretinoin gel 0.01% PA

tretinoin gel 0.025% PA

zenatane cap 10mg PA

zenatane cap 20mg PA

zenatane cap 30mg PA

zenatane cap 40mg PA

ALKALINIZERS CITRATES

potassium citrate tab er 5 meq (540 mg) potassium citrate tab er 10 meq (1080 mg) potassium citrate tab er 15 meq (1620 mg)

ALKYLATING AGENTS

ALKYLATING AGENTS MYLERAN TAB 2MG

IMIDAZOTETRAZINES temozolomide cap 5 mg SP, PA temozolomide cap 20 mg SP, PA

temozolomide cap 100 mg SP, PA

temozolomide cap 140 mg SP, PA

temozolomide cap 180 mg SP, PA

temozolomide cap 250 mg SP, PA

NITROGEN MUSTARDS LEUKERAN TAB 2MG melphalan tab 2 mg

NITROSOUREAS GLEOSTINE CAP 10MG GLEOSTINE CAP 40MG GLEOSTINE CAP 100MG

ALPHA-BETA BLOCKERS ALPHA-BETA BLOCKERS

carvedilol tab 3.125 mg

Page 8: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 6 AGE - Age Limit GNDR - Gender Edit

carvedilol tab 6.25 mg

carvedilol tab 12.5 mg carvedilol tab 25 mg labetalol hcl tab 100 mg labetalol hcl tab 200 mg labetalol hcl tab 300 mg

ALPHA-GLUCOSIDASE INHIBITORS ALPHA-GLUCOSIDASE INHIBITORS

acarbose tab 25 mg acarbose tab 50 mg acarbose tab 100 mg

ALS AGENTS

BENZATHIAZOLES riluzole tab 50 mg

ALTERNATIVE MEDICINE - M'S ALTERNATIVE MEDICINE - ME'S

cvs quality cap sleep OTC kp melatonin tab 3mg OTC

MELADOX TAB 3MG CR OTC

melatonin cap 10mg OTC

melatonin chew tab 2.5 mg OTC

melatonin chw 10mg OTC

melatonin chw quik dis OTC

MELATONIN LIQ 1MG/4ML OTC

MELATONIN LIQ 2.5MG OTC

melatonin liq 5mg/15ml OTC

melatonin liquid 1 mg/ml OTC

MELATONIN LOZ 5MG OTC

melatonin sl tab 10 mg OTC

melatonin sub 5mg OTC

melatonin sub quik dis OTC

melatonin tab 1 mg OTC

melatonin tab 3mg OTC

MELATONIN TAB 3MG CR OTC

melatonin tab 5mg OTC

melatonin tab 10 mg OTC

melatonin tab 10mg cr OTC

MELATONIN TAB 200MCG OTC

melatonin tab 300 mcg OTC

MELATONIN TAB 500MCG OTC

melatonin tab max st OTC

melatonin tablet disintegrating 3 mg OTC

melatonin tablet disintegrating 5 mg OTC

melatonin tablet disintegrating 10 mg OTC

Page 9: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 7 AGE - Age Limit GNDR - Gender Edit

pa melatonin tab 5mg OTC

RA MELATONIN SUB 1MG OTC

ra melatonin tab 3mg OTC

ra melatonin tab 5mg OTC

ra melatonin tab 10mg OTC

SLEEP SOUNDL LIQ 3.5/2ML OTC

sm melatonin tab 3mg OTC

sm melatonin tab 5mg OTC

vitajoy gumm chw 2.5mg OTC

ALTERNATIVE MEDICINES ALTERNATIVE MEDICINE - M'S

melatonin chew tab 2.5 mg OTC mm melatonin tab 10mg tr OTC

sv melatonin tab 3mg OTC

sv melatonin tab 5mg OTC

AMINOGLYCOSIDES AMINOGLYCOSIDES

AMIKACIN POW SULFATE BETHKIS NEB 300/4ML SP, QL (8 each / 1 day), PA

neomycin sulfate tab 500 mg

STREPTOMYCIN POW SULFATE

tobramycin nebu soln 300 mg/5ml SP, QL (10 each / 1 day),

PA tobramycin nebu soln 300 mg/5ml SP, QL (10 mL / 1 day), PA

TOBRAMYCIN POW SULFATE

AMINOPENICILLINS AMINOPENICILLINS

amoxicillin (trihydrate) cap 250 mg amoxicillin (trihydrate) cap 500 mg amoxicillin (trihydrate) chew tab 125 mg amoxicillin (trihydrate) chew tab 250 mg amoxicillin (trihydrate) for susp 125 mg/5ml amoxicillin (trihydrate) for susp 200 mg/5ml amoxicillin (trihydrate) for susp 250 mg/5ml amoxicillin (trihydrate) for susp 400 mg/5ml amoxicillin (trihydrate) tab 500 mg amoxicillin (trihydrate) tab 875 mg AMOXICILLIN POW TRIHYDRA ampicillin cap 500 mg

ANALGESIC COMBINATIONS ANALGESICS-SEDATIVES

BUT/ASA/CAF TAB QL (60 tabs / 25 days) butalbital-acetaminophen-caffeine cap 50-325-40 QL (60 caps / 25 days)

mg

Page 10: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 8 AGE - Age Limit GNDR - Gender Edit

butalbital-acetaminophen-caffeine tab 50-325-40 QL (60 tabs / 25 days) mg butalbital-aspirin-caffeine cap 50-325-40 mg QL (60 caps / 25 days)

esgic cap QL (60 caps / 25 days)

zebutal cap QL (60 caps / 25 days)

ANALGESICS - ANTI-INFLAMMATORY ANTI-TNF-ALPHA - MONOCLONAL ANTIBODIES

HUMIRA INJ 10MG/0.2 SP, QL (2.4 injections / 30 days), PA

HUMIRA PEDIA INJ CROHNS SP, QL (6.6 injections / 30

days), PA HUMIRA PEN INJ 40MG/0.8 SP, QL (4.5 pens / 30 days),

PA HUMIRA PEN INJ CD/UC/HS SP, QL (6.6 pens / 30 days),

PA HUMIRA PEN INJ PS/UV SP, QL (4.5 pens / 30 days),

PA HUMIRA PEN KIT CD/UC/HS SP, QL (3.3 pens / 30 days),

PA HUMIRA PEN KIT PS/UV SP, QL (3.3 pens / 30 days),

PA

ANTIRHEUMATIC - ENZYME INHIBITORS XELJANZ TAB 5MG SP, QL (2 tabs / 1 day), ST XELJANZ TAB 10MG SP, QL (2 tabs / 1 day), ST

XELJANZ XR TAB 11MG SP, QL (1 tab / 1 day), ST

ANTIRHEUMATIC ANTIMETABOLITES RASUVO INJ 7.5MG SP, QL (30 pens / 30 days),

PA RASUVO INJ 10MG SP, QL (22.5 pens / 30

days), PA RASUVO INJ 12.5MG SP, QL (18 pens / 30 days),

PA RASUVO INJ 15MG SP, QL (15 pens / 30 days),

PA RASUVO INJ 17.5MG SP, QL (12.857 pens / 30

days), PA RASUVO INJ 20MG SP, QL (11.25 pens / 30

days), PA RASUVO INJ 22.5MG SP, QL (10 pens / 30 days),

PA RASUVO INJ 25MG SP, QL (9 pens / 30 days),

PA RASUVO INJ 30MG SP, QL (7.5 pens / 30 days),

PA

Page 11: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 9 AGE - Age Limit GNDR - Gender Edit

INTERLEUKIN-6 RECEPTOR INHIBITORS KEVZARA INJ 150/1.14 SP, QL (2.368 syringes / 30

days), PA KEVZARA INJ 200/1.14 SP, QL (2.368 syringes / 30

days), PA

NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDS) ibuprofen ch sus 100/5ml OTC ibuprofen sus 100/5ml OTC

ibuprofen susp 100 mg/5ml

ibuprofen susp 100 mg/5ml OTC

ibuprofn 100 chw jr 100mg OTC

medi-profen cap 200mg OTC

pain relief tab 200mg OTC

px profen ib sus 100/5ml OTC

wal-profen tab 200mg OTC

SOLUBLE TUMOR NECROSIS FACTOR RECEPTOR AGENTS ENBREL INJ 25/0.5ML SP, QL (17.059 syringes /

30 days), PA ENBREL INJ 25MG SP, QL (8.7 syringes / 30

days), PA ENBREL INJ 50MG/ML SP, QL (8.878 syringes / 30

days), PA ENBREL MINI INJ 50MG/ML SP, QL (8.878 injections /

30 days), PA ENBREL SRCLK INJ 50MG/ML SP, QL (8.7 syringes / 30

days), PA

ANALGESICS - NONNARCOTIC ANALGESICS OTHER

acetaminophen chew tab 160 mg OTC acetaminophen elixir 160 mg/5ml OTC

acetaminophen tab 325 mg OTC

acetaminophen tab 500 mg OTC

gnp acetamin cap 500mg OTC

gnp acetamin tab 325mg OTC

8hr pain er tab 650mg OTC

little remed liq 160/5ml OTC

midol tab 650mg OTC

pain & fever chw 160mg OTC

pain relief chw 160mg OTC

pain relievr chw 80mg OTC

pediacare sus 160/5ml OTC

SALICYLATES low dose asa tab 81mg OTC norwich asa tab 325mg OTC

Page 12: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 10 AGE - Age Limit GNDR - Gender Edit

ANALGESICS - OPIOID OPIOID AGONISTS

fentanyl td patch 72hr 25 mcg/hr QL (10 patches / 25 days), PA

morphine sulfate oral soln 100 mg/5ml (20 mg/ml)QL (180 mL / 25 days), PA

oxycodone hcl cap 5 mg QL (180 caps / 25 days), PA

oxycodone hcl tab 30 mg QL (180 tabs / 25 days), PA

OPIOID COMBINATIONS acetaminophen w/ codeine soln 120-12 mg/5ml QL (5000 mL / 25 days), PA endocet tab 5-325mg QL (375 tabs / 25 days), PA hydrocodone-acetaminophen tab 5-325 mg QL (375 each / 25 days), PA hydrocodone-acetaminophen tab 5-325 mg QL (375 tabs / 25 days), PA hydrocodone-acetaminophen tab 7.5-325 mg QL (375 each / 25 days), PA hydrocodone-acetaminophen tab 7.5-325 mg QL (375 tabs / 25 days), PA hydrocodone-acetaminophen tab 10-325 mg QL (375 each / 25 days), PA hydrocodone-acetaminophen tab 10-325 mg QL (375 tabs / 25 days), PA lorcet tab 5-325mg QL (375 tabs / 25 days), PA oxycodone w/ acetaminophen tab 2.5-325 mg QL (375 tabs / 25 days), PA oxycodone w/ acetaminophen tab 5-325 mg QL (375 each / 25 days), PA oxycodone w/ acetaminophen tab 5-325 mg QL (375 tabs / 25 days), PA oxycodone w/ acetaminophen tab 7.5-325 mg QL (375 each / 25 days), PA oxycodone w/ acetaminophen tab 7.5-325 mg QL (375 tabs / 25 days), PA oxycodone w/ acetaminophen tab 10-325 mg QL (375 each / 25 days), PA oxycodone w/ acetaminophen tab 10-325 mg QL (375 tabs / 25 days), PA

ANALGESICS OTHER ANALGESICS OTHER

acephen sup 120mg OTC

acephen sup 325mg OTC

acephen sup 650mg OTC

acetamin liq 500/15ml OTC

acetamin tab 500mg OTC

acetaminophe chw 160mg OTC

acetaminophe tab 160mg OTC

acetaminophen liquid 160 mg/5ml OTC

acetaminophen soln 160 mg/5ml OTC

acetaminophen suppos 120 mg OTC

acetaminophen suppos 650 mg OTC

acetaminophen tab 325 mg OTC

acetaminophen tab er 650 mg OTC

acetaminophn sus 160/5ml OTC

acetaminophn tab 325mg OTC

acetaminophn tab 500mg OTC

aminofen tab 325mg OTC

aminofen tab 500mg OTC

apap melt tab 80mg OTC

Page 13: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 11 AGE - Age Limit GNDR - Gender Edit

apap melts tab 160mg OTC

apap rapid tab tab 80mg OTC

apra elx 160/5ml OTC

arthrts pain tab 650mg OTC

asa free chw 160mg jr OTC

aspirin free tab 325mg OTC

betatemp sus 160/5ml OTC

child apap tab 80mg OTC

childrens chw apap OTC

chld asafree elx 80/2.5ml OTC

chld meditab chw 80mg OTC

chld non-asa chw 80mg grp OTC

chld non-asa tab 80mg qm OTC

chld pain rl tab 80mg OTC

chld silapap liq 160/5ml OTC

chloraseptic liq sore thr OTC

cvs childs chw 80mg OTC

easy-melts tab 80mg OTC

ed-apap liq 80mg/2.5 OTC

eq acetamin tab 80mg OTC

eq acetamin tab 160mg OTC

eq acetamin tab 500mg OTC

eql acetamin tab 160mg OTC

eql acetamin tab 325mg OTC

eql acetamin tab 500mg OTC

eql arthrts tab 650mg OTC

fever reduce sup 120mg OTC

fever/pain sus 160/5ml OTC

FEVERALL INF SUP 80MG OTC

feverall sup 120mg OTC

feverall sup 325mg OTC

feverall sup 650mg OTC

fevr reducng sup 120mg OTC

hm arthrts tab 650mg OTC

hm pain rlf tab 650mg OTC

hm rpd melt tab 160mg OTC

8 hour pain tab 650mg OTC

little remed liq 160/5ml OTC

mapap apap liq 500/15ml OTC

mapap cap 500mg OTC

mapap child tab 80mg rt OTC

mapap childr sus 160/5ml OTC

mapap chw 160mg OTC

mapap liq 160/5ml OTC

Page 14: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 12 AGE - Age Limit GNDR - Gender Edit

mapap tab 325mg OTC

Page 15: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 13 AGE - Age Limit GNDR - Gender Edit

mapap tab 500mg OTC

mapap tab 500mg/rr OTC

medi-tabs elx 80/2.5ml OTC

medi-tabs jr chw 160mg OTC

medi-tabs tab 500mg OTC

non-asa jr tab 160mg OTC

non-asa jr tab 160mg qm OTC

non-aspirin chw 80mg OTC

non-aspirin chw 160mg jr OTC

non-aspirin sus 160/5ml OTC

non-aspirin tab 325mg OTC

non-aspirin tab 500mg OTC

non-aspirin tab 500mg/rr OTC

non-aspirin tab 650mg OTC

nortemp sus 160/5ml OTC

nortemp sus infants OTC

pain & fever sol 160/5ml OTC

pain & fever sus 160/5ml OTC

pain & fever tab 325mg OTC

pain & fever tab 500mg OTC

pain relief liq 160/5ml OTC

pain relief liq 500/15ml OTC

pain relief sus 160/5ml OTC

pain relief tab 325mg OTC

pain relief tab 500mg OTC

pain relief tab 500mg/rr OTC

pain relief tab 650mg OTC

pain relieve chw 160mg jr OTC

pain relieve sus 160/5ml OTC

pain relieve tab 325mg OTC

pain relieve tab 500mg OTC

pain relieve tab 500mg/rr OTC

pain relievr chw 80mg OTC

pain relievr liq 500/15ml OTC

pain relievr tab 160mg OTC

pain relievr tab 325mg OTC

pain relievr tab 500mg OTC

pain/fever sup 120mg OTC

pain/fever sus 160/5ml OTC

pediacare sus 160/5ml OTC

pharbetol tab 325mg OTC

pharbetol tab 500mg OTC

qc apap 8 hr tab 650mg OTC

ra acetamin tab 325mg OTC

Page 16: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 14 AGE - Age Limit GNDR - Gender Edit

sb non-asa chw 80mg frt OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 13 AGE - Age Limit GNDR - Gender Edit

sb non-asa chw 80mg grp OTC

sb non-asa chw 160mg OTC

shake ache tab 500mg OTC

sm pain rel cap 500mg OTC

sm pain rlvr tab 650mg OTC

sm rpd melt tab 160mg OTC

tactinal chw children OTC

tactinal tab 325mg OTC

tactinal tab 500mg OTC

tgt acetamin tab 500mg OTC

ANDROGENS ANDROGENS

danazol cap 50 mg danazol cap 100 mg danazol cap 200 mg

testosterone td gel 10mg/act (2%) PA

testosterone td gel 25 mg/2.5gm (1%) PA

ANDROGENS-ANABOLIC ANDROGENS

testosterone cypionate im inj in oil 100 mg/ml PA testosterone cypionate im inj in oil 200 mg/ml PA testosterone enanthate im inj in oil 200 mg/ml PA

ANESTHETICS TOPICAL ORAL ANESTHETICS TOPICAL ORAL

lidocaine hcl viscous soln 2%

ANGIOTENSIN II RECEPTOR ANTAGONISTS ANGIOTENSIN II RECEPTOR ANTAGONISTS

irbesartan tab 75 mg irbesartan tab 150 mg irbesartan tab 300 mg losartan potassium tab 25 mg losartan potassium tab 50 mg

losartan potassium tab 100 mg valsartan tab 40 mg valsartan tab 80 mg valsartan tab 160 mg valsartan tab 320 mg

ANTACID COMBINATIONS ANTACID & SIMETHICONE

advanced sus antacid OTC

almacone chw OTC

almacone dbl sus strength OTC

almacone sus OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 14 AGE - Age Limit GNDR - Gender Edit

alum & mag hydroxide-simethicone susp OTC 200-200-20 mg/5ml antacid adv sus max st OTC

antacid fast sus acting OTC

antacid fast sus relief OTC

antacid i sus OTC

antacid iii sus OTC

antacid liq sus OTC

antacid m sus OTC

antacid plus sus anti-gas OTC

antacid plus sus gas rel OTC

antacid sus OTC

antacid sus advanced OTC

antacid sus anti-gas OTC

antacid sus ex st OTC

antacid sus max st OTC

antacid sus mint crm OTC

antacid sus reg OTC

antacid sus reg st OTC

antacid/gas sus rel max OTC

antacid/sime sus ds OTC

comfort gel sus OTC

comfort gel sus antacid OTC

comfort gel sus anti-gas OTC

cvs antacid sus anti-gas OTC

cvs antacid sus antigas OTC

cvs antacid/ sus anti-gas OTC

DI-GEL SUS OTC

eq antacid sus anti-gas OTC

eq antacid sus max st OTC

eql antacid sus anti-gas OTC

geri-lanta sus OTC

geri-mox sus OTC

gnp antacid sus anti-gas OTC

gnp antacid sus cherry OTC

gnp masanti sus max st OTC

gnp masanti sus reg st OTC

hm antacid sus OTC

hm antacid sus anti-gas OTC

maalox max sus cherry OTC

maalox max sus lemon OTC

maalox max sus wild bry OTC

maalox multi sus symp max OTC

mag-al plus liq OTC

mag-al plus liq xs OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 15 AGE - Age Limit GNDR - Gender Edit

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 15 AGE - Age Limit GNDR - Gender Edit

meijer sus antacid OTC

mi-acid sus OTC

mi-acid sus max st OTC

milantex sus ex st OTC

milantex sus original OTC

mintox plus chw OTC

mintox sus OTC

mintox sus max st OTC

mylanta sus max st OTC

px antacid sus max st OTC

px antacid sus reg st OTC

qc antacid sus OTC

qc antacid sus anti-gas OTC

ra antacid sus anti-gas OTC

ra antacid sus antigas OTC

ra liquid sus antacid OTC

rulox sus OTC

sb antacid sus anti-gas OTC

sm antacid sus advanced OTC

sm antacid sus anti-gas OTC

sm antacid sus max st OTC

sm antacid/ sus antigas OTC

tgt antacid sus anti-gas OTC

ANTACID COMBINATIONS acid gone chw OTC acid gone sus OTC

antacid chw 550-110 OTC

cvs antacid sus supreme OTC

eq antacid chw 160-105 OTC

foam antacid chw 80-20mg OTC

foam antacid sus OTC

GAVISCON CHW OTC

geri-lanta sus supreme OTC

gnp antacid chw 160-105 OTC

gnp antacid chw 550-110 OTC

heartbrn ant chw 160-105 OTC

heartbrn rlf chw 160-105 OTC

heartburn chw ex st OTC

heartburn sus relief OTC

MAG-AL LIQ OTC

MI-ACID CHW OTC

rolaids chw 550-110 OTC

ANTACIDS ANTACID COMBINATIONS

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 16 AGE - Age Limit GNDR - Gender Edit

antacid/sime sus ds OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 17 AGE - Age Limit GNDR - Gender Edit

comfort gel sus anti-gas OTC

eq antacid sus OTC

gavis-care sus OTC

gnp antacid sus coolmint OTC

gnp antacid sus original OTC

gnp antacid sus reg st OTC

mylanta sus max st OTC

ANTACIDS - CALCIUM SALTS antacid flav chw 750mg OTC ANTACID SOFT CHW 1177MG OTC

child soothe chw 400mg OTC

ANTACIDS - CALCIUM SALTS ANTACIDS - CALCIUM SALTS

antacid chw 500mg OTC antacid chw 750mg OTC

antacid chw 1000mg OTC

ANTACID CHW 1177MG OTC

antacid extr chw 750mg OTC

antacid kids chw 750mg OTC

antacid max chw 1000mg OTC

cal antacid chw 750mg OTC

cal antacid chw 1000mg OTC

cal-gest chw 500mg OTC

calc antacid chw 500mg OTC

calc antacid chw 750mg OTC

calc antacid chw 1000mg OTC

calcium anta chw 500mg OTC

calcium anta chw 750mg OTC

calcium carb tab 648mg OTC

calcium carbonate (antacid) chew tab 500 mg OTC calcium carbonate (antacid) chew tab 750 mg OTC child soothe chw 400mg OTC childrens chw pepto OTC childrens chw soothe OTC

eq antacid chw 750mg OTC

eq antacid chw 1000mg OTC

eql antacid chw 750mg OTC

eql antacid chw 1000mg OTC

eql antacid chw fruit OTC

eql antacid chw pepprmnt OTC

flavor chews chw 750mg OTC

gnp antacid chw 1000mg OTC

maalox child chw OTC

MAALOX CHW 600MG OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 18 AGE - Age Limit GNDR - Gender Edit

px antacid chw 1000mg OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 17 AGE - Age Limit GNDR - Gender Edit

qc antacid chw 500mg OTC

ra antacid chw 500mg OTC

ra antacid chw 1000mg OTC

sm antacid chw 1000mg OTC

smooth antac chw 750mg OTC

stomach rlf chw 400mg OTC

tame flame chw 500mg OTC

tgt antacid chw 1000mg OTC

titralac chw 420mg OTC

TUMS CHW DEL CHW 1177MG OTC

tums smoothi chw 750mg OTC

ANTHELMINTICS ANTHELMINTICS

cvs pinworm sus 50mg/ml OTC EMVERM CHW 100MG QL (12 tabs / year)

ivermectin tab 3 mg

MEBENDAZOLE POW

pinworm med sus 144mg/ml OTC

PINWORM TAB MEDICINE OTC

PIPERAZINE POW REESES MED SUS PINWORM OTC

THIABENDAZOL POW

ANTI-CATAPLECTIC AGENTS ANTI-CATAPLECTIC AGENTS

XYREM SOL 500MG/ML SP, PA

ANTI-INFECTIVE AGENTS - MISC. ANTI-INFECTIVE AGENTS - MISC.

FIRST-VANC SOL 25MG/ML FIRST-VANC SOL 50MG/ML metronidazole cap 375 mg metronidazole tab 250 mg metronidazole tab 500 mg TRIMETHOPRIM POW trimethoprim tab 100 mg

vancomycin hcl cap 125 mg (base equivalent) ST

vancomycin hcl cap 250 mg (base equivalent) ST XIFAXAN TAB 550MG ST

GLYCOPEPTIDES FIRST-VANC SOL 25MG/ML FIRST-VANC SOL 50MG/ML

OXAZOLIDINONES linezolid in sodium chloride iv soln 600 PA mg/300ml-0.9% linezolid iv soln 600 mg/300ml (2 mg/ml) PA

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 18 AGE - Age Limit GNDR - Gender Edit

ZYVOX SOL 2MG/ML PA

POLYMYXINS POLYMYXIN B POW SULFATE

ANTI-INFECTIVE MISC. - COMBINATIONS ANTI-INFECTIVE MISC. - COMBINATIONS

sulfamethoxazole-trimethoprim susp 200-40 mg/5ml sulfamethoxazole-trimethoprim tab 400-80 mg

sulfamethoxazole-trimethoprim tab 800-160 mg sulfatrim pd sus 200-40/5

ANTI-INFECTIVES - THROAT ANTI-INFECTIVES - THROAT

AMPHOTERICIN POW B clotrimazole troche 10 mg

nystatin susp 100000 unit/ml ANTI-INFLAMMATORY AGENTS

ANTI-INFLAMMATORY AGENTS cromolyn sodium soln nebu 20 mg/2ml

ANTI-INFLAMMATORY AGENTS - TOPICAL ANTI-INFLAMMATORY AGENTS - TOPICAL

diclofenac sodium gel 1% QL (500 gm / 25 days)

ANTI-TNF-ALPHA - MONOCLONAL ANTIBODIES ANTI-TNF-ALPHA - MONOCLONAL ANTIBODIES

HUMIRA KIT 20MG/0.4 SP, QL (2.4 injections / 30 days), PA

HUMIRA KIT 40MG/0.8 SP, QL (4.5 injections / 30

days), PA

ANTIADRENERGIC ANTIHYPERTENSIVES ANTIADRENERGICS - CENTRALLY ACTING

clonidine hcl tab 0.1 mg clonidine hcl tab 0.2 mg clonidine hcl tab 0.3 mg clonidine td patch weekly 0.1 mg/24hr

clonidine td patch weekly 0.2 mg/24hr clonidine td patch weekly 0.3 mg/24hr guanfacine hcl tab 1 mg guanfacine hcl tab 2 mg

methyldopa tab 250 mg methyldopa tab 500 mg

ANTIADRENERGICS - PERIPHERALLY ACTING doxazosin mesylate tab 1 mg doxazosin mesylate tab 2 mg doxazosin mesylate tab 4 mg

doxazosin mesylate tab 8 mg

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 19 AGE - Age Limit GNDR - Gender Edit

prazosin hcl cap 1 mg

prazosin hcl cap 2 mg prazosin hcl cap 5 mg terazosin hcl cap 1 mg (base equivalent)

terazosin hcl cap 2 mg (base equivalent) terazosin hcl cap 5 mg (base equivalent) terazosin hcl cap 10 mg (base equivalent)

ANTIARRHYTHMICS ANTIARRHYTHMICS TYPE I-C

propafenone hcl cap er 12hr 425 mg

ANTIARRHYTHMICS TYPE I-A ANTIARRHYTHMICS TYPE I-A

disopyramide phosphate cap 100 mg disopyramide phosphate cap 150 mg NORPACE CAP 100MG CR NORPACE CAP 150MG CR

ANTIARRHYTHMICS TYPE I-C ANTIARRHYTHMICS TYPE I-C

flecainide acetate tab 50 mg flecainide acetate tab 100 mg flecainide acetate tab 150 mg propafenone hcl cap er 12hr 225 mg propafenone hcl cap er 12hr 325 mg propafenone hcl cap er 12hr 425 mg propafenone hcl tab 150 mg propafenone hcl tab 225 mg propafenone hcl tab 300 mg

ANTIARRHYTHMICS TYPE III ANTIARRHYTHMICS TYPE III

amiodarone hcl tab 200 mg dofetilide cap 125 mcg (0.125 mg) SP, PA

dofetilide cap 250 mcg (0.25 mg) SP, PA

dofetilide cap 500 mcg (0.5 mg) SP, PA

pacerone tab 200mg

ANTIASTHMATIC AND BRONCHODILATOR AGENTS ANTIASTHMATIC - MONOCLONAL ANTIBODIES

XOLAIR SOL 150MG SP, QL (6.6 vials / 30 days), PA

STEROID INHALANTS ARNUITY ELPT INH 100MCG QL (1 blister / 1 day) ARNUITY ELPT INH 200MCG QL (1 blister / 1 day)

FLOVENT DISK AER 50MCG QL (2 inhalations / 1 day)

FLOVENT DISK AER 100MCG QL (2 inhalations / 1 day)

FLOVENT DISK AER 250MCG QL (2 inhalations / 1 day)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 20 AGE - Age Limit GNDR - Gender Edit

FLOVENT HFA AER 44MCG QL (1 inhaler / 30 days)

FLOVENT HFA AER 110MCG QL (1 inhaler / 30 days)

FLOVENT HFA AER 220MCG QL (1 inhaler / 30 days)

QVAR REDIHA AER 80MCG QL (10.599 gm / 30 days)

QVAR REDIHAL AER 40MCG QL (10.599 gm / 30 days)

SYMPATHOMIMETICS albuterol sulfate tab er 12hr 4 mg albuterol sulfate tab er 12hr 8 mg ANORO ELLIPT AER 62.5-25 QL (60 blisters / 25 days)

fluticasone-salmeterol aer powder ba 113-14 QL (1.2 inhalers / 30 days) mcg/act fluticasone-salmeterol aer powder ba 232-14 QL (1.2 inhalers / 30 days) mcg/act

ANTIBIOTICS - TOPICAL ANTIBIOTIC MIXTURES TOPICAL

antibiotic oin OTC cvs triple oin antibiot OTC

double antib oin OTC

eq triple oin antibiot OTC

eql firstaid oin antibiot OTC

first aid oin antibiot OTC

gnp triple oin antibiot OTC

hm triple oin antibiot OTC

lanabiotic oin OTC

poly bacitra oin OTC

px triple oin OTC

ra triple oin antibiot OTC

sb triple oin antibiot OTC

sm triple oin antibiot OTC

triple antib oin OTC

wal-sporin oin OTC

ANTIBIOTICS - TOPICAL bacitracin oin 500/gm OTC bacitracin oint 500 unit/gm OTC

BACITRACIN POW BACITRACIN POW ZINC USP

bacitraycin oin 500/gm OTC

CENTANY OIN 2%

GENTAMICIN POW SULFATE gentamicin sulfate cream 0.1%

gentamicin sulfate oint 0.1% mupirocin calcium cream 2% mupirocin oint 2% NEOMYCIN POW SULFATE

TETRACYCLINE POW

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 21 AGE - Age Limit GNDR - Gender Edit

ANTICOAGULANTS DIRECT FACTOR XA INHIBITORS

ELIQUIS ST P TAB 5MG ELIQUIS TAB 2.5MG ELIQUIS TAB 5MG

HEPARINS AND HEPARINOID-LIKE AGENTS enoxaparin sodium inj 30 mg/0.3ml enoxaparin sodium inj 40 mg/0.4ml enoxaparin sodium inj 60 mg/0.6ml enoxaparin sodium inj 80 mg/0.8ml enoxaparin sodium inj 100 mg/ml enoxaparin sodium inj 120 mg/0.8ml enoxaparin sodium inj 150 mg/ml enoxaparin sodium inj 300 mg/3ml fondaparinux sodium subcutaneous inj 2.5 mg/0.5ml fondaparinux sodium subcutaneous inj 5 mg/0.4ml

fondaparinux sodium subcutaneous inj 7.5 mg/0.6ml fondaparinux sodium subcutaneous inj 10

mg/0.8ml

ANTICONVULSANTS - MISC. ANTICONVULSANTS - MISC.

primidone tab 50 mg primidone tab 250 mg

ANTIDEMENTIA AGENTS CHOLINOMIMETICS - ACHE INHIBITORS

donepezil hydrochloride orally disintegrating tab 5 mg donepezil hydrochloride orally disintegrating tab 10

mg donepezil hydrochloride tab 5 mg

donepezil hydrochloride tab 10 mg donepezil hydrochloride tab 23 mg galantamine hydrobromide cap er 24hr 8 mg galantamine hydrobromide cap er 24hr 16 mg galantamine hydrobromide cap er 24hr 24 mg galantamine hydrobromide oral soln 4 mg/ml galantamine hydrobromide tab 4 mg galantamine hydrobromide tab 8 mg galantamine hydrobromide tab 12 mg rivastigmine tartrate cap 1.5 mg (base equivalent) PA

rivastigmine tartrate cap 3 mg (base equivalent) PA rivastigmine tartrate cap 4.5 mg (base equivalent) PA

rivastigmine tartrate cap 6 mg (base equivalent) PA

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 22 AGE - Age Limit GNDR - Gender Edit

rivastigmine td patch 24hr 4.6 mg/24hr PA

rivastigmine td patch 24hr 9.5 mg/24hr PA

rivastigmine td patch 24hr 13.3 mg/24hr PA

N-METHYL-D-ASPARTATE (NMDA) RECEPTOR ANTAGONISTS memantine hcl oral solution 2 mg/ml memantine hcl tab 5 mg memantine hcl tab 5 mg (28) & 10 mg (21) titration pak memantine hcl tab 10 mg

ANTIDIABETIC COMBINATIONS DIPEPTIDYL PEPTIDASE-4 INHIBITOR-BIGUANIDE COMBINATIONS

JANUMET TAB 50-500MG ST JANUMET TAB 50-1000 ST

JANUMET XR TAB 50-500MG ST

JANUMET XR TAB 50-1000 ST

JANUMET XR TAB 100-1000 ST

SODIUM-GLUCOSE CO-TRANSPORTER 2 INHIBITOR-BIGUANIDE COMB

INVOKAMET TAB 50-500MG ST INVOKAMET TAB 50-1000 ST

INVOKAMET TAB 150-500 ST

INVOKAMET TAB 150-1000 ST

SULFONYLUREA-BIGUANIDE COMBINATIONS glipizide-metformin hcl tab 2.5-250 mg glipizide-metformin hcl tab 2.5-500 mg glipizide-metformin hcl tab 5-500 mg glyburide-metformin tab 1.25-250 mg glyburide-metformin tab 2.5-500 mg glyburide-metformin tab 5-500 mg

SULFONYLUREA-THIAZOLIDINEDIONE COMBINATIONS pioglitazone hcl-glimepiride tab 30-2 mg pioglitazone hcl-glimepiride tab 30-4 mg

THIAZOLIDINEDIONE-BIGUANIDE COMBINATIONS pioglitazone hcl-metformin hcl tab 15-500 mg pioglitazone hcl-metformin hcl tab 15-850 mg

ANTIDIABETICS

ANTIDIABETIC COMBINATIONS INVOKAMET XR TAB 50-500MG ST INVOKAMET XR TAB 50-1000 ST

INVOKAMET XR TAB 150-500 ST

INVOKAMET XR TAB 150-1000 ST

DIABETIC OTHER GLUCAGEN INJ HYPOKIT GLUCAGON KIT 1MG QL (2 kits / 30 days)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 23 AGE - Age Limit GNDR - Gender Edit

INCRETIN MIMETIC AGENTS (GLP-1 RECEPTOR AGONISTS) OZEMPIC INJ 2/1.5ML ST TRULICITY INJ 0.75/0.5 ST

TRULICITY INJ 1.5/0.5 ST

VICTOZA INJ 18MG/3ML ST

INSULIN ADMELOG INJ 100U/ML ADMELOG SOLO INJ 100U/ML BASAGLAR INJ 100UNIT HUMALOG MIX INJ 50/50 HUMALOG MIX INJ 50/50KWP HUMALOG MIX INJ 75/25KWP HUMALOG MIX SUS 75/25 HUMULIN INJ 70/30 OTC

HUMULIN INJ 70/30KWP OTC

HUMULIN N INJ U-100 OTC

HUMULIN N INJ U-100KWP OTC

HUMULIN R INJ U-100 OTC

HUMULIN R INJ U-500

NOVOLIN70/30 INJ RELION OTC

NOVOLIN INJ 70/30 OTC

NOVOLIN INJ FLEXPEN OTC

NOVOLIN N INJ RELION OTC

NOVOLIN N INJ U-100 OTC

NOVOLIN R INJ RELION OTC

NOVOLIN R INJ U-100 OTC

NOVOLOG MIX INJ 70/30

NOVOLOG MIX INJ FLEXPEN TRESIBA FLEX INJ 100UNIT TRESIBA FLEX INJ 200UNIT

SULFONYLUREAS glipizide xl tab 5mg glipizide xl tab 10mg

ANTIDIARRHEAL AGENTS - MISC. ANTIDIARRHEAL AGENTS - MISC.

abatinex cap 680mg OTC ACIDOPH/PROB TAB FORMULA OTC

acidophilus cap 10mg OTC

acidophilus cap 100mg OTC

acidophilus cap ex st OTC

acidophilus tab probiotc OTC

ACIDOPHILUS/ WAF BIFIDUS OTC

anti-diarrhl sus 262/15ml OTC

BIOGAIA CHW 100M CEL OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 24 AGE - Age Limit GNDR - Gender Edit

BIOGAIA CHW GASTRUS OTC

BIOGAIA DRO PROBIOTI OTC

BIOGAIA MIS PROBIOTI OTC

BIOGAIA PROT DRO BABY OTC

biotinex cap OTC

bismatrol chw 262mg OTC

bismatrol sus 262/15ml OTC

bismatrol sus 525/15ml OTC

bismuth subsalicylate chew tab 262 mg OTC

CULTURELLE CHW KIDS OTC

CULTURELLE PAK KIDS OTC

cvs bismuth chw 262mg OTC

cvs bismuth sus max str OTC

cvs bismuth tab 262mg OTC

diarrhea rel sus 262/15ml OTC

diarrhea sus 262/15ml OTC

digestive cap health OTC

digestive cap probioti OTC

dofus cap OTC

eq stomach chw 262mg OTC

eql stomach chw 262mg OTC

flora assist pak OTC

FLORAJEN CAP ACIDOPHI OTC

floranex gra OTC

floranex tab OTC

GERBR SOOTHE DRO COLIC OTC

geri-pectate sus 262/15ml OTC

gnp k-pec sus 262/15ml OTC

hm probiotic cap OTC

hm stomach sus 262/15ml OTC

intestinex cap OTC

kao-tin sus 262/15ml OTC

kaopectate sus 262/15ml OTC

kaopectate sus ex st OTC

kaopectate tab 262mg OTC

lactinex chw OTC

LACTO-BIFIDU CAP -600 OTC

lacto-key- cap 100 OTC

lacto-key- cap 600 OTC

lactobacillu cap OTC

lactobacillus cap OTC

lactobacillus tab OTC

medi-bismuth chw 262mg OTC

MORE-DOPHILU POW ACIDOPHI OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 25 AGE - Age Limit GNDR - Gender Edit

PEDIA-LAX CHW YUMS OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 25 AGE - Age Limit GNDR - Gender Edit

peptic relf chw 262mg OTC

pink bismuth chw 262mg OTC

pink bismuth sus 262/15ml OTC

pink bismuth sus max str OTC

pink bismuth tab 262mg OTC

probiata tab OTC

probiotic cap OTC

PROBIOTIC CAP OTC

probiotic cap acidophi OTC

probiotic cap formula OTC

probiotic cap gold OTC

PROBIOTIC CAP GOLD OTC

probiotic chw children OTC

PROBIOTIC DRO COLIC OTC

probiotic pak children OTC

px stomach chw 262mg OTC

px stomach sus 262/15ml OTC

px stomach sus 525/15ml OTC

ra acidophil cap 300mg OTC

ra k-pec sus 262/15ml OTC

ra pink bism chw 262mg OTC

ra pink bism tab 262mg OTC

REPHRESH CAP PRO-B OTC

sb bismuth tab 262mg OTC

sm stomach sus 262/15ml OTC

sm stomach sus 525/30ml OTC

soothe chw 262mg OTC

soothe sus 262/15ml OTC

soothe sus 525/15ml OTC

soothe tab 262mg OTC

stom relief tab 262mg OTC

stomach relf chw 262mg OTC

stomach relf sus OTC

stomach relf sus 262/15ml OTC

stomach relf sus 524/30ml OTC

stomach relf sus 525/15ml OTC

stomach relf sus 525/30ml OTC

stomach relf sus 527/30ml OTC

stomach relf sus plus OTC

stomach relf tab 262mg OTC

stomach rlf tab 262mg OTC

ANTIDIARRHEAL COMBINATIONS DIARRHEA COMBINATIONS - OPIATES

IMODIUM MS TAB RELIEF OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 26 AGE - Age Limit GNDR - Gender Edit

ANTIDIARRHEAL/PROBIOTIC AGENTS ANTIDIARRHEAL/PROBIOTIC AGENTS - MISC.

acidoph/prob tab formula OTC acidophilus tab probiotc OTC

acidophilus waf OTC

CULTURELLE PAK KIDS OTC

digestive cap probioti OTC

FLORAJEN CAP ACIDOPHI OTC

floranex gra OTC

GERBR SOOTHE DRO COLIC OTC

LACTO-BIFIDU CAP -600 OTC

lactobacillus cap OTC

medi-bismuth chw 262mg OTC

MOMMYS BLISS POW PROBIOTI OTC

probiotic cap OTC

PROBIOTIC CAP OTC

ANTIPERISTALTIC AGENTS anti-diarrhe cap 2mg OTC diphenoxylate w/ atropine tab 2.5-0.025 mg

loperamide cap 2mg OTC

ANTIDIARRHEALS ANTIDIARRHEAL AGENTS - MISC.

lactobacillus - packet OTC lactobacillus tab OTC

MOMMYS BLISS POW PROBIOTI OTC

primadophilu cap OTC

PROBIOTIC LIQ 15 DAY OTC

PROBIOTIC LIQ NEWBORN OTC

ANTIDOTES AND SPECIFIC ANTAGONISTS ANTIDOTES AND SPECIFIC ANTAGONISTS

VISTOGARD PAK 10GM SP

ANTIEMETICS ANTIEMETICS - ANTICHOLINERGIC

dramamine tab 25mg OTC motion relf tab 25mg OTC

motion sick tab 25mg OTC

travel-ease tab 25mg OTC

wal-dram ii tab 25mg OTC

ANTIEMETICS - ANTICHOLINERGIC ANTIEMETICS - ANTICHOLINERGIC

dramamine tab 25mg OTC eql motion tab sickness OTC

meclizine hcl chew tab 25 mg OTC

Page 35: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 27 AGE - Age Limit GNDR - Gender Edit

meclizine hcl tab 12.5 mg

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 27 AGE - Age Limit GNDR - Gender Edit

meclizine hcl tab 12.5 mg OTC

meclizine hcl tab 25 mg

meclizine hcl tab 25 mg OTC

motion relf tab 25mg OTC

motion sick chw 25mg OTC

motion sick tab 25mg OTC

motion-time chw 25mg OTC

travel sick chw 25mg OTC

trimethobenzamide hcl cap 300 mg

wal-dram ii tab 25mg OTC

ANTIEMETICS - MISCELLANEOUS ANTIEMETICS - MISCELLANEOUS

dronabinol cap 2.5 mg QL (60 caps / 25 days) dronabinol cap 5 mg QL (60 caps / 25 days)

dronabinol cap 10 mg QL (60 caps / 25 days)

ANTIFLATULENTS ANTIFLATULENTS

anti-gas cap 180mg OTC cvs gas relf chw 80mg OTC

cvs gas relf chw 125mg OTC

cvs gas relf dro ex st OTC

eql gas gone chw 125mg OTC

eql gas rlf cap 180mg OTC

gas relief cap 125mg OTC

gas relief cap 180mg OTC

gas relief chw 80mg OTC

gas relief chw 125mg OTC

gas relief dro 20/0.3ml OTC

gas relief dro 40/0.6ml OTC

gas relief dro infants OTC

gas relief liq infants OTC

gas-x cap 125mg OTC

gas-x cap 180mg OTC

GAS-X CHILD MIS 40MG OTC

GAS-X EX-STR MIS 62.5MG OTC

gas-x infant dro OTC

gnp gas relf chw 80mg OTC

gnp gas relf chw 125mg OTC

hm gas relf chw 80mg OTC

hm gas relf chw 125mg OTC

little remed sus 20/.03ml OTC

little tummy dro 20/0.3ml OTC

mi-acid gas chw 80mg OTC

phazyme chw 125mg OTC

Page 37: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 28 AGE - Age Limit GNDR - Gender Edit

qc gas relf chw 80mg OTC

Page 38: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 29 AGE - Age Limit GNDR - Gender Edit

qc gas relf chw 125mg OTC

ra gas relf chw 80mg OTC

ra gas relf chw 125mg OTC

sb gas relf chw 125mg OTC

simeped dro 40/0.6ml OTC

simethicone cap 125 mg OTC

simethicone cap 180 mg OTC

simethicone chew tab 80 mg OTC

simethicone chew tab 125 mg OTC

simethicone dro 20/0.3ml OTC

SIMETHICONE LIQ SIMETHICONE LIQ OTC

simethicone susp 40 mg/0.6ml OTC

sm gas rel chw 125mg OTC

sm gas relf chw 80mg OTC

sm gas relie chw 80mg OTC

ANTIFUNGALS ANTIFUNGALS

bio-statin pow griseofulvin microsize susp 125 mg/5ml

griseofulvin ultramicrosize tab 125 mg griseofulvin ultramicrosize tab 250 mg nystatin tab 500000 unit terbinafine hcl tab 250 mg QL (90 tabs / year)

IMIDAZOLE-RELATED ANTIFUNGALS MICONAZOLE POW

ANTIFUNGALS - TOPICAL ANTIFUNGALS - TOPICAL

af spry powd aer 1% OTC anti-fungal cre 1% OTC

anti-fungal sol 1% OTC

antifung pow aer 1% OTC

antifungal cre 1% OTC

athlete foot aer 1% OTC

athlete foot cre 1% OTC

blis-to-sol liq 1% OTC

ciclopirox gel 0.77%

ciclopirox olamine cream 0.77% (base equiv)

ciclopirox olamine susp 0.77% (base equiv) CICLOPIROX POW OLAMINE ciclopirox shampoo 1%

CLIOQUINOL POW

CLIOQUINOL POW OTC

dr gs clear sol nail 1% OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 30 AGE - Age Limit GNDR - Gender Edit

foot&sneaker aer 1% OTC

formula 3 sol OTC

fungi-guard cre 1% OTC

fungoid-d cre 1% OTC

GENTIAN VIOL POW

jck itch pow aer 1% OTC

jock itch aer 1% OTC

lamisil af aer 1% OTC

mycocide ns sol 1% OTC

nyamyc pow 100000

nystatin cream 100000 unit/gm

nystatin oint 100000 unit/gm nystatin topical powder 100000 unit/gm nystop pow 100000 odor control aer powd 1% OTC odor eaters aer 1% OTC

sm antifungl cre 1% OTC

tgt antifung cre 1% OTC

tinaspore sol 1% OTC

tolnaftate aerosol pow 1% OTC

tolnaftate cre 1% OTC

IMIDAZOLE-RELATED ANTIFUNGALS - TOPICAL antifungal cre 1% OTC antifungal cre 2% OTC

antifungal pow 2% OTC

athlete foot cre 1% OTC

athlete foot pow 2% OTC

clotrimazole cre 1% OTC

clotrimazole cre grx 1% OTC

clotrimazole cream 1%

CLOTRIMAZOLE CRY CLOTRIMAZOLE POW clotrimazole soln 1% clotrimazole soln 1% OTC

cvs itch rel cre 1% OTC

dermafungal oin 2% OTC

desenex cre 1% OTC

fungicure spr intens OTC

jock itch cre 1% OTC

ketoconazole cream 2%

ketoconazole shampoo 2%

lotrimin af pow 2% OTC

micaderm cre 2% OTC

miconazole cre 2% OTC

MICONAZOLE POW NITRATE

Page 40: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 31 AGE - Age Limit GNDR - Gender Edit

miconazorb pow af 2% OTC

podactin cre 2% OTC

pro-ex antif cre 1% OTC

remedy cre antifung OTC

remedy oin af 2% OTC

remedy pow antifung OTC

ringworm cre 1% OTC

sm antifungl cre 2% OTC

soothe&cool cre inzo 2% OTC

tetterine oin 2% OTC

tineacide cre OTC

triple paste oin af 2% OTC

ANTIHISTAMINE HYPNOTICS ANTIHISTAMINE HYPNOTICS

compoz cap 50mg OTC

compoz tab 50mg OTC

diphenhydramine hcl (sleep) tab 50 mg OTC

eq sleep aid cap 50mg OTC

eql sleep tab aid OTC

hm nighttime tab 25mg OTC

hm sleep aid tab 25mg OTC

night time tab 25mg OTC

nighttime tab 25mg OTC

nytol tab 25mg OTC

qc sleep aid cap 50mg OTC

ra nighttime cap 50mg OTC

ra nighttime tab 25mg OTC

ra sleep aid cap 50mg OTC

ra sleep aid tab 25mg OTC

rest simply tab 25mg OTC

sb sleep tab 25mg OTC

simply sleep tab 25mg OTC

sleep aid cap 50mg OTC

sleep aid tab 25mg OTC

sleep aid tab 50mg OTC

sleep ii tab 25mg OTC

sleep tab 25mg OTC

sleep-aid tab 25mg OTC

sleep-tabs tab 25mg OTC

sm nighttime tab 25mg OTC

sm sleep aid cap 50mg OTC

sm sleep aid tab 25mg OTC

ultra sleep tab 25mg OTC

wal-som cap 50mg OTC

Page 41: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 32 AGE - Age Limit GNDR - Gender Edit

wal-som tab 25mg OTC

Page 42: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 33 AGE - Age Limit GNDR - Gender Edit

ANTIHISTAMINES ANTIHISTAMINES - ALKYLAMINES

ra allergy tab 4mg OTC

ANTIHISTAMINES - ETHANOLAMINES a-s pls alrg tab 25mg OTC cvs allergy cap 25mg OTC

cvs allergy chw 12.5mg OTC

diphenhydramine hcl cap 50 mg OTC

geri-dryl liq 12.5/5ml OTC

gnp allergy chw 12.5mg OTC

ANTIHISTAMINES - NON-SEDATING all day allg sol 1mg/ml OTC all day allg sol 5mg/5ml OTC

aller-ease tab 180mg OTC

allergy chld sol 1mg/ml OTC

allergy relf sol 5mg/5ml OTC

allergy relf tab 180mg OTC

ALLERGY RLF CHW 5MG OTC

cetirizine chw 5mg OTC

cetirizine chw 10mg OTC

cetirizine sol 1mg/ml OTC

cetirizine sol 5mg/5ml OTC

child allrgy sol 5mg/5ml OTC

claritin sol 5mg/5ml OTC

fexofenadine hcl tab 60 mg OTC

fexofenadine hcl tab 180 mg OTC

fexofenadine tab 60mg OTC

fexofenadine tab 180mg OTC

gnp allergy tab 180mg OTC

24hr allergy tab 180mg OTC

loratadine chw 5mg OTC

loratadine sol 10/10ml OTC

wal-fex tab 180mg OTC

ANTIHISTAMINES - ALKYLAMINES ANTIHISTAMINES - ALKYLAMINES

aller-chlor tab 4mg OTC allergy relf tab 4mg OTC

allergy relf tab 12mg cr OTC

allergy tab 4mg OTC

allergy tab 12mg cr OTC

allergy-time tab 4mg OTC

chlor-phenir tab 4mg OTC

chlorhist tab 4mg OTC

chlorphen sr tab 12mg OTC

Page 43: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 32 AGE - Age Limit GNDR - Gender Edit

chlorpheniramine maleate tab 4 mg OTC

chlorpheniramine maleate tab er 12 mg OTC

cvs allergy tab 4mg OTC

diabet tuss syp allergy OTC

ed chlorped syp jr OTC

eq chlortabs tab 4mg OTC

eql allergy tab 4mg OTC

gnp allergy tab 4mg OTC

hm allergy tab 4mg OTC

pharbechlor tab 4mg OTC

ra chlorphen tab 4mg OTC

sm allergy tab 4mg OTC

wal-finate tab 4mg OTC

ANTIHISTAMINES - ETHANOLAMINES ANTIHISTAMINES - ETHANOLAMINES

a-s pls alrg tab 25mg OTC aler-cap cap 25mg OTC

ALER-DRYL TAB 50MG OTC

alertab tab 25mg OTC

allergy cap 25mg OTC

allergy chld liq 12.5/5ml OTC

allergy liq 12.5/5ml OTC

allergy med cap 25mg OTC

allergy med liq 12.5/5ml OTC

allergy med tab 25mg OTC

allergy rel cap 25mg OTC

allergy rel elx 12.5/5ml OTC

allergy rel tab 25mg OTC

allergy relf cap 25mg OTC

allergy relf liq 12.5/5ml OTC

allergy relf liq 50/20ml OTC

allergy relf tab 1.34mg OTC

allergy relf tab 25mg OTC

allergy tab 25mg OTC

allrgy melts tab 12.5mg OTC

allrgy relf tab 12.5mg OTC

anti-hist tab 25mg OTC

antihistamin cap 25mg OTC

banophen cap 25mg OTC

banophen cap 50mg OTC

banophen liq 12.5/5ml OTC

banophen tab 25mg OTC

chld allergy liq 12.5/5ml OTC

clemastine fumarate tab 2.68 mg

Page 44: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 33 AGE - Age Limit GNDR - Gender Edit

comp allergy cap 25mg OTC

Page 45: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 34 AGE - Age Limit GNDR - Gender Edit

comp allergy tab 25mg OTC

comp allergy tab 25mg med OTC

cvs allergy liq 25/10ml OTC

cvs allergy tab 25mg OTC

cvs allergy tab chldrn OTC

dayhist alrg tab 12 hour OTC

diphedryl liq 12.5/5ml OTC

diphen tab 25mg OTC

diphenhist cap 25mg OTC

diphenhist liq 12.5/5ml OTC

diphenhist tab 25mg OTC

diphenhydramine hcl cap 25 mg OTC

diphenhydramine hcl cap 50 mg OTC diphenhydramine hcl elixir 12.5 mg/5ml diphenhydramine hcl tab 25 mg OTC

eq allergy cap 25mg OTC

eq dayhist tab 1.34mg OTC

eql allergy tab 25mg OTC

eql allergy tab chldrn OTC

genahist cap 25mg OTC

geri-dryl cap 25mg OTC

geri-dryl tab 25mg OTC

gnp allergy cap 25mg OTC

gnp allergy tab 25mg OTC

gnp dayhist tab 1.34mg OTC

hm allergy cap 25mg OTC

hm allergy tab 25mg OTC

kls allergy tab 25mg OTC

medi-phedryl cap 25mg OTC

naramin liq OTC

ormir cap 50mg OTC

pediacare al liq 12.5/5ml OTC

pharbedryl cap 25mg OTC

pharbedryl cap 50mg

pharbedryl cap 50mg OTC

px allergy cap 25mg OTC

px allergy tab 25mg OTC

px dayhist tab 1.34mg OTC

ra allergy tab 25mg OTC

sb allergy tab 25mg med OTC

siladryl alr liq 12.5/5ml OTC

sm allergy cap relief OTC

sm allergy tab 25mg OTC

sm allergy tab 25mg rlf OTC

Page 46: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 35 AGE - Age Limit GNDR - Gender Edit

total allerg liq 12.5/5ml OTC

Page 47: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 36 AGE - Age Limit GNDR - Gender Edit

total allerg tab 25mg OTC

wal-dryl alr tab 12.5mg OTC

wal-dryl cap 25mg OTC

wal-dryl liq 12.5/5ml OTC

wal-dryl tab 25mg OTC

ANTIHISTAMINES - NON-SEDATING ANTIHISTAMINES - NON-SEDATING

alavert tab 10mg OTC all day allg cap 10mg OTC

all day allg sol 1mg/ml OTC

all day allg sol 5mg/5ml OTC

all day allg tab 10mg OTC

all-day allg sol 5mg/5ml OTC

ALLEGRA ALRG TAB 30MG OTC

aller-ease tab 60mg OTC

aller-ease tab 180mg OTC

aller-fex tab 180mg OTC

aller-tec sol 1mg/ml OTC

aller-tec tab 10mg OTC

allerclear tab 10mg OTC

allergy 24hr tab 10mg OTC

allergy chld sol 1mg/ml OTC

allergy chld syp 5mg/5ml OTC

allergy rel sol 1mg/ml OTC

allergy rel tab 10mg OTC

allergy relf cap 10mg OTC

allergy relf chw 10mg OTC

allergy relf sol 5mg/5ml OTC

allergy relf syp 5mg/5ml OTC

allergy relf tab 10mg OTC

allergy relf tab 60mg OTC

allergy relf tab 180mg OTC

allergy rlf sus 30/5ml OTC

allergy rlf tab 10mg OTC

allergy tab 10mg OTC

allergy tab 180mg OTC

cetirizine hcl oral soln 1 mg/ml (5 mg/5ml)

cetirizine hcl tab 10 mg OTC

cetirizine sol 1mg/ml OTC

cetirizine sol 5mg/5ml OTC

cetirizine tab 5mg OTC

CLARITIN RDT TAB 5MG OTC

claritin sol 5mg/5ml OTC

cvs allergy tab 10mg OTC

Page 48: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 37 AGE - Age Limit GNDR - Gender Edit

cvs allergy tab 180mg OTC

Page 49: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 35 AGE - Age Limit GNDR - Gender Edit

eql all day tab allergy OTC

fexofenadine hcl tab 180 mg OTC

fexofenadine tab 60mg OTC

gnp all day tab allergy OTC

gnp allergy tab 180mg OTC

kp loratadin tab 10mg OTC

loradamed tab 10mg OTC

loratadine cap 10 mg OTC

loratadine sol 5mg/5ml OTC

loratadine syp 5mg/5ml OTC

loratadine tab 10 mg OTC

loratadine tab 10mg OTC

mucinex allr tab 180mg OTC

qc allergy tab 10mg OTC

ra cetirizin tab 10mg OTC

sb allergy tab 10mg OTC

sm all day tab 10mg OTC

sm all day tab allergy OTC

triaminic tab 10mg OTC

wal-fex allr tab 180mg OTC

wal-fex alrg tab 60mg 12h OTC

wal-itin chl sol 5mg/5ml OTC

wal-itin syp 5mg/5ml OTC

wal-itin tab 10mg OTC

wal-vert tab 10mg OTC

wal-zyr cap 10mg OTC

wal-zyr chld sol 5mg/5ml OTC

wal-zyr chw 5mg OTC

wal-zyr chw 10mg OTC

wal-zyr sol 1mg/ml OTC

wal-zyr sol 5mg/5ml OTC

wal-zyr tab 10mg OTC

ZYRTEC ALLGY TAB 10MG OTC

ZYRTEC CHILD TAB 10MG OTC

NTIHISTAMINES - PHENOTHIAZINES ANTIHISTAMINES - PHENOTHIAZINES

phenadoz sup 12.5mg phenadoz sup 25mg promethazine hcl suppos 12.5 mg promethazine hcl suppos 25 mg promethazine hcl suppos 50 mg promethazine hcl syrup 6.25 mg/5ml promethazine hcl tab 12.5 mg promethazine hcl tab 25 mg

A

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 36 AGE - Age Limit GNDR - Gender Edit

promethazine hcl tab 50 mg

Page 51: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 37 AGE - Age Limit GNDR - Gender Edit

promethegan sup 12.5mg

promethegan sup 25mg promethegan sup 50mg

ANTIHISTAMINES - PIPERIDINES ANTIHISTAMINES - PIPERIDINES

cyproheptadine hcl syrup 2 mg/5ml cyproheptadine hcl tab 4 mg

ANTIHYPERLIPIDEMICS FIBRIC ACID DERIVATIVES

fenofibrate tab 160 mg

INTESTINAL CHOLESTEROL ABSORPTION INHIBITORS ezetimibe tab 10 mg

NICOTINIC ACID DERIVATIVES niacin tab er 500 mg (antihyperlipidemic)

PROPROTEIN CONVERTASE SUBTILISIN/KEXIN TYPE 9 INHIBITORS PRALUENT INJ 75MG/ML SP, QL (2.16 injections / 30

days), PA PRALUENT INJ 150MG/ML SP, QL (2.16 injections / 30

days), PA

ANTIHYPERTENSIVE COMBINATIONS ACE INHIBITOR & CALCIUM CHANNEL BLOCKER COMBINATIONS

amlodipine besylate-benazepril hcl cap 2.5-10 mg amlodipine besylate-benazepril hcl cap 5-10 mg amlodipine besylate-benazepril hcl cap 5-20 mg amlodipine besylate-benazepril hcl cap 5-40 mg amlodipine besylate-benazepril hcl cap 10-20 mg amlodipine besylate-benazepril hcl cap 10-40 mg

ACE INHIBITORS & THIAZIDE/THIAZIDE-LIKE benazepril & hydrochlorothiazide tab 5-6.25 mg benazepril & hydrochlorothiazide tab 10-12.5 mg benazepril & hydrochlorothiazide tab 20-12.5 mg benazepril & hydrochlorothiazide tab 20-25 mg captopril & hydrochlorothiazide tab 25-15 mg captopril & hydrochlorothiazide tab 25-25 mg captopril & hydrochlorothiazide tab 50-15 mg captopril & hydrochlorothiazide tab 50-25 mg enalapril maleate & hydrochlorothiazide tab 5-12.5 mg enalapril maleate & hydrochlorothiazide tab 10-25

mg fosinopril sodium & hydrochlorothiazide tab

10-12.5 mg fosinopril sodium & hydrochlorothiazide tab

20-12.5 mg

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 38 AGE - Age Limit GNDR - Gender Edit

lisinopril & hydrochlorothiazide tab 10-12.5 mg

lisinopril & hydrochlorothiazide tab 20-12.5 mg lisinopril & hydrochlorothiazide tab 20-25 mg quinapril-hydrochlorothiazide tab 10-12.5 mg quinapril-hydrochlorothiazide tab 20-12.5 mg quinapril-hydrochlorothiazide tab 20-25 mg

ANGIOTENSIN II RECEPTOR ANTAG & THIAZIDE/THIAZIDE-LIKE irbesartan-hydrochlorothiazide tab 150-12.5 mg irbesartan-hydrochlorothiazide tab 300-12.5 mg losartan potassium & hydrochlorothiazide tab 50-12.5 mg losartan potassium & hydrochlorothiazide tab

100-12.5 mg losartan potassium & hydrochlorothiazide tab

100-25 mg valsartan-hydrochlorothiazide tab 80-12.5 mg

valsartan-hydrochlorothiazide tab 160-12.5 mg valsartan-hydrochlorothiazide tab 160-25 mg valsartan-hydrochlorothiazide tab 320-12.5 mg valsartan-hydrochlorothiazide tab 320-25 mg

BETA BLOCKER & DIURETIC COMBINATIONS atenolol & chlorthalidone tab 50-25 mg atenolol & chlorthalidone tab 100-25 mg bisoprolol & hydrochlorothiazide tab 2.5-6.25 mg bisoprolol & hydrochlorothiazide tab 5-6.25 mg bisoprolol & hydrochlorothiazide tab 10-6.25 mg metoprolol & hydrochlorothiazide tab 50-25 mg metoprolol & hydrochlorothiazide tab 100-25 mg metoprolol & hydrochlorothiazide tab 100-50 mg TENORETIC TAB 50

ANTIMALARIAL COMBINATIONS ANTIMALARIAL COMBINATIONS

atovaquone-proguanil hcl tab 62.5-25 mg QL (23 tabs / 180 days) atovaquone-proguanil hcl tab 250-100 mg QL (23 tabs / 180 days)

ANTIMALARIALS ANTIMALARIALS

chloroquine phosphate tab 250 mg QL (8 tabs / 180 days) chloroquine phosphate tab 500 mg QL (8 tabs / 180 days)

CHLOROQUINE POW PHOSPHAT DARAPRIM TAB 25MG hydroxychloroquine sulfate tab 200 mg

mefloquine hcl tab 250 mg QL (8 each / 180 days)

mefloquine hcl tab 250 mg QL (8 tabs / 180 days)

QUININE POW SULFATE QUININE SULF POW DIHYDRAT

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 39 AGE - Age Limit GNDR - Gender Edit

ANTIMETABOLITES ANTIMETABOLITES

mercaptopurine tab 50 mg methotrexate sodium tab 2.5 mg (base equiv)

TREXALL TAB 5MG

TREXALL TAB 7.5MG TREXALL TAB 10MG TREXALL TAB 15MG

ANTIMICROBIAL AGENTS

ANTIMICROBIAL AGENTS BENZYL ALC LIQ BENZYL ALC LIQ OTC

ANTIMYASTHENIC/CHOLINERGIC AGENTS ANTIMYASTHENIC/CHOLINERGIC AGENTS

MESTINON SYP 60MG/5ML pyridostigmine bromide tab 60 mg

pyridostigmine bromide tab er 180 mg ANTIMYCOBACTERIAL AGENTS

ANTIMYCOBACTERIAL AGENTS AMINOSAL ACD POW -4 ethambutol hcl tab 100 mg

ethambutol hcl tab 400 mg ETHAMBUTOL POW HCL ISONIAZID POW isoniazid syrup 50 mg/5ml isoniazid tab 100 mg isoniazid tab 300 mg pyrazinamide tab 500 mg rifabutin cap 150 mg rifampin cap 150 mg rifampin cap 300 mg

ANTINEOPLASTIC - BCL-2 INHIBITORS ANTINEOPLASTIC - BCL-2 INHIBITORS

VENCLEXTA TAB 10MG SP, PA VENCLEXTA TAB 50MG SP, PA

VENCLEXTA TAB 100MG SP, PA

VENCLEXTA TAB START PK SP, PA

ANTINEOPLASTIC - HEDGEHOG PATHWAY INHIBITORS ANTINEOPLASTIC - HEDGEHOG PATHWAY INHIBITORS

ERIVEDGE CAP 150MG SP, QL (1 cap / 1 day), PA

ANTINEOPLASTIC - HORMONAL AND RELATED AGENTS ANTIADRENALS

LYSODREN TAB 500MG

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QL - Quantity Limits ST - Step Therapy SP - Specialty 40 AGE - Age Limit GNDR - Gender Edit

ANTIANDROGENS bicalutamide tab 50 mg flutamide cap 125 mg

ANTIESTROGENS FARESTON TAB 60MG tamoxifen citrate tab 10 mg (base equivalent)

tamoxifen citrate tab 20 mg (base equivalent)

AROMATASE INHIBITORS anastrozole tab 1 mg exemestane tab 25 mg letrozole tab 2.5 mg

PROGESTINS-ANTINEOPLASTIC megestrol acetate susp 40 mg/ml megestrol acetate tab 20 mg megestrol acetate tab 40 mg

ANTINEOPLASTIC ENZYME INHIBITORS ANTINEOPLASTIC - BRAF KINASE INHIBITORS

TAFINLAR CAP 50MG SP, QL (4 caps / 1 day), PA TAFINLAR CAP 75MG SP, QL (4 caps / 1 day), PA

ZELBORAF TAB 240MG SP, QL (8 tabs / 1 day), PA

ANTINEOPLASTIC - HISTONE DEACETYLASE INHIBITORS FARYDAK CAP 10MG SP, PA FARYDAK CAP 15MG SP, PA

FARYDAK CAP 20MG SP, PA

ZOLINZA CAP 100MG SP, QL (4 caps / 1 day), PA

ANTINEOPLASTIC - MEK INHIBITORS MEKINIST TAB 0.5MG SP, QL (3 tabs / 1 day), PA MEKINIST TAB 2MG SP, QL (1 tab / 1 day), PA

ANTINEOPLASTIC - MTOR KINASE INHIBITORS AFINITOR TAB 2.5MG SP, QL (1 tab / 1 day), PA AFINITOR TAB 10MG SP, QL (1 tab / 1 day), PA

ANTINEOPLASTIC - MULTIKINASE INHIBITORS NEXAVAR TAB 200MG SP, QL (4 tabs / 1 day), PA STIVARGA TAB 40MG SP, QL (3 tabs / 1 day), PA

SUTENT CAP 12.5MG SP, QL (1 cap / 1 day), PA

SUTENT CAP 25MG SP, QL (1 cap / 1 day), PA

SUTENT CAP 37.5MG SP, QL (1 cap / 1 day), PA

SUTENT CAP 50MG SP, QL (1 cap / 1 day), PA

ANTINEOPLASTIC - TYROSINE KINASE INHIBITORS CAPRELSA TAB 100MG SP, QL (2 tabs / 1 day), PA COMETRIQ KIT 60MG SP, QL (3 caps / 1 day), PA

COMETRIQ KIT 100MG SP, QL (2 caps / 1 day), PA

COMETRIQ KIT 140MG SP, QL (4 caps / 1 day), PA

GILOTRIF TAB 20MG SP, QL (1 tab / 1 day), PA

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QL - Quantity Limits ST - Step Therapy SP - Specialty 41 AGE - Age Limit GNDR - Gender Edit

GILOTRIF TAB 30MG SP, QL (1 tab / 1 day), PA

GILOTRIF TAB 40MG SP, QL (1 tab / 1 day), PA

IMBRUVICA CAP 140MG SP, QL (3 caps / 1 day), PA

INLYTA TAB 1MG SP, QL (6 tabs / 1 day), PA

INLYTA TAB 5MG SP, QL (4 tabs / 1 day), PA

LENVIMA CAP 8 MG SP, QL (2 caps / 1 day), PA

LENVIMA CAP 8 MG SP, QL (2 ea / 1 day), PA

LENVIMA CAP 10 MG SP, QL (1 cap / 1 day), PA

LENVIMA CAP 10 MG SP, QL (1 ea / 1 day), PA

LENVIMA CAP 14 MG SP, QL (2 caps / 1 day), PA

LENVIMA CAP 14 MG SP, QL (2 ea / 1 day), PA

LENVIMA CAP 18 MG SP, QL (3 caps / 1 day), PA

LENVIMA CAP 18 MG SP, QL (3 ea / 1 day), PA

LENVIMA CAP 20 MG SP, QL (2 caps / 1 day), PA

LENVIMA CAP 20 MG SP, QL (2 ea / 1 day), PA

LENVIMA CAP 24 MG SP, QL (3 caps / 1 day), PA

LENVIMA CAP 24 MG SP, QL (3 ea / 1 day), PA

TARCEVA TAB 25MG SP, QL (2 tabs / 1 day), PA

TARCEVA TAB 100MG SP, QL (1 tab / 1 day), PA

TARCEVA TAB 150MG SP, QL (1 tab / 1 day), PA

TYKERB TAB 250MG SP, QL (6 tabs / 1 day), PA

VOTRIENT TAB 200MG SP, QL (4 tabs / 1 day), PA

ZYKADIA CAP 150MG SP, QL (3 caps / 1 day), PA

CYCLIN-DEPENDENT KINASES (CDK) INHIBITORS IBRANCE CAP 75MG SP, QL (1 cap / 1 day), PA

IBRANCE CAP 100MG SP, QL (1 cap / 1 day), PA

IBRANCE CAP 125MG SP, QL (1 cap / 1 day), PA

JANUS ASSOCIATED KINASE (JAK) INHIBITORS JAKAFI TAB 5MG SP, QL (2 tabs / 1 day), PA

JAKAFI TAB 10MG SP, QL (2 tabs / 1 day), PA

JAKAFI TAB 15MG SP, QL (2 tabs / 1 day), PA

JAKAFI TAB 20MG SP, QL (2 tabs / 1 day), PA

JAKAFI TAB 25MG SP, QL (2 tabs / 1 day), PA

PHOSPHATIDYLINOSITOL 3-KINASE (PI3K) INHIBITORS ZYDELIG TAB 100MG SP, QL (2 tabs / 1 day), PA

ZYDELIG TAB 150MG SP, QL (2 tabs / 1 day), PA

ANTINEOPLASTIC OR PREMALIGNANT LESION AGENTS - TOPICAL ANTINEOPLASTIC ANTIMETABOLITES - TOPICAL

fluorouracil cream 5%

ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES ALKYLATING AGENTS

cyclophosphamide cap 25 mg

cyclophosphamide cap 50 mg

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QL - Quantity Limits ST - Step Therapy SP - Specialty 42 AGE - Age Limit GNDR - Gender Edit

ANTIMETABOLITES capecitabine tab 150 mg SP, QL (4 tabs / 1 day), PA capecitabine tab 500 mg SP, QL (10 each / 1 day),

PA capecitabine tab 500 mg SP, QL (10 tabs / 1 day), PA

ANTINEOPLASTIC - HORMONAL AND RELATED AGENTS abiraterone acetate tab 250 mg SP, QL (4 tabs / 1 day), PA ELIGARD INJ 7.5MG SP, PA

ELIGARD INJ 22.5MG SP, PA

ELIGARD INJ 30MG SP, PA

ELIGARD INJ 45MG SP, PA

FASLODEX INJ 250/5ML

leuprolide acetate inj kit 5 mg/ml SP, PA

ZYTIGA TAB 500MG SP, QL (2 tabs / 1 day), PA

ANTINEOPLASTIC ENZYME INHIBITORS AFINITOR TAB 5MG SP, QL (1 tab / 1 day), PA AFINITOR TAB 7.5MG SP, QL (1 tab / 1 day), PA

CABOMETYX TAB 20MG SP, QL (30 tabs / 25 days),

PA CABOMETYX TAB 40MG SP, QL (30 tabs / 25 days),

PA CABOMETYX TAB 60MG SP, QL (30 tabs / 25 days),

PA CAPRELSA TAB 300MG SP, QL (1 tab / 1 day), PA

imatinib mesylate tab 100 mg (base equivalent) SP, QL (3 each / 1 day), PA

imatinib mesylate tab 100 mg (base equivalent) SP, QL (3 tabs / 1 day), PA imatinib mesylate tab 400 mg (base equivalent) SP, QL (2 each / 1 day), PA imatinib mesylate tab 400 mg (base equivalent) SP, QL (2 tabs / 1 day), PA ISTODAX OVR INJ 10MG SP, PA LENVIMA CAP 4MG SP, QL (1 cap / 1 day), PA

LENVIMA CAP 4MG SP, QL (1 ea / 1 day), PA

LENVIMA CAP 12MG SP, QL (3 caps / 1 day), PA

LENVIMA CAP 12MG SP, QL (3 ea / 1 day), PA

ROMIDEPSIN INJ 10MG SP, PA

RUBRACA TAB 200MG SP, QL (4 tabs / 1 day), PA

RUBRACA TAB 250MG SP, QL (4 tabs / 1 day), PA

RUBRACA TAB 300MG SP, QL (4 tabs / 1 day), PA

RYDAPT CAP 25MG SP, QL (8 caps / 1 day), PA

ZEJULA CAP 100MG SP, QL (3 caps / 1 day), PA

ANTINEOPLASTICS MISC. INTRON A INJ 10MU SP, PA INTRON A INJ 18MU SP, PA

INTRON A INJ 25MU SP, PA

INTRON A INJ 50MU SP, PA

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QL - Quantity Limits ST - Step Therapy SP - Specialty 43 AGE - Age Limit GNDR - Gender Edit

ANTINEOPLASTICS MISC. ANTINEOPLASTICS MISC.

hydroxyurea cap 500 mg MATULANE CAP 50MG

RETINOIDS tretinoin cap 10 mg

SELECTIVE RETINOID X RECEPTOR AGONISTS bexarotene cap 75 mg SP, PA

ANTIPARKINSON COMT INHIBITORS PERIPHERAL COMT INHIBITORS

entacapone tab 200 mg

ANTIPARKINSON DOPAMINERGICS ANTIPARKINSON DOPAMINERGICS

amantadine hcl cap 100 mg amantadine hcl syrup 50 mg/5ml amantadine hcl tab 100 mg bromocriptine mesylate cap 5 mg (base equivalent) bromocriptine mesylate tab 2.5 mg (base equivalent)

LEVODOPA COMBINATIONS carbidopa & levodopa orally disintegrating tab 10-100 mg carbidopa & levodopa orally disintegrating tab

25-100 mg carbidopa & levodopa orally disintegrating tab

25-250 mg carbidopa & levodopa tab 10-100 mg

carbidopa & levodopa tab 25-100 mg carbidopa & levodopa tab 25-250 mg carbidopa & levodopa tab er 25-100 mg carbidopa & levodopa tab er 50-200 mg carbidopa-levodopa-entacapone tabs 12.5-50-200

mg carbidopa-levodopa-entacapone tabs

18.75-75-200 mg carbidopa-levodopa-entacapone tabs 25-100-200

mg carbidopa-levodopa-entacapone tabs

31.25-125-200 mg carbidopa-levodopa-entacapone tabs

37.5-150-200 mg carbidopa-levodopa-entacapone tabs 50-200-200

mg

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 44 AGE - Age Limit GNDR - Gender Edit

NONERGOLINE DOPAMINE RECEPTOR AGONISTS pramipexole dihydrochloride tab 0.5 mg pramipexole dihydrochloride tab 0.25 mg pramipexole dihydrochloride tab 0.75 mg pramipexole dihydrochloride tab 0.125 mg pramipexole dihydrochloride tab 1 mg pramipexole dihydrochloride tab 1.5 mg ropinirole hydrochloride tab 0.5 mg ropinirole hydrochloride tab 0.25 mg ropinirole hydrochloride tab 1 mg ropinirole hydrochloride tab 2 mg ropinirole hydrochloride tab 3 mg ropinirole hydrochloride tab 4 mg ropinirole hydrochloride tab 5 mg

ANTIPARKINSON MONOAMINE OXIDASE INHIBITORS ANTIPARKINSON MONOAMINE OXIDASE INHIBITORS

selegiline hcl cap 5 mg selegiline hcl tab 5 mg

ANTIPERISTALTIC AGENTS ANTIPERISTALTIC AGENTS

anti-diarrhe cap 2mg OTC

anti-diarrhe liq 1mg/5ml OTC

anti-diarrhe tab 2mg OTC

diamode tab 2mg OTC

diphenoxylate w/ atropine liq 2.5-0.025 mg/5ml diphenoxylate w/ atropine tab 2.5-0.025 mg kls anti-dia tab 2mg OTC

loperamide cap 2mg OTC

loperamide hcl cap 2 mg

loperamide hcl liq 1 mg/5ml (0.2 mg/ml) OTC

loperamide tab 2mg OTC

sm anti-diar tab 2mg OTC

ANTIPROTOZOAL AGENTS ANTIPROTOZOAL AGENTS

atovaquone susp 750 mg/5ml

ANTIPSORIATICS ANTIPSORIATICS

calcipotriene oint 0.005%

calcipotriene soln 0.005% (50 mcg/ml)

calcitrene oin 0.005%

ANTISEBORRHEIC PRODUCTS ANTISEBORRHEIC PRODUCTS

anti-dandruf sha 1% OTC

dandruff sha 1% OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 45 AGE - Age Limit GNDR - Gender Edit

ra dandruff sha 1% OTC

selenium sulfide lotion 2.5%

ANTISEPTIC COMBINATIONS ANTISEPTIC COMBINATIONS

IV PREP WIPE PAD OTC MICROCLENS PAD WIPES OTC

UNI-SOLVE PAD WIPES OTC

ANTISEPTICS & DISINFECTANTS ANTISEPTIC COMBINATIONS

IV PREP WIPE PAD OTC

CHLORINE ANTISEPTICS dyna-hex 4 sol 4% OTC TEGADERM CHG MIS DRESSING OTC

IODINE ANTISEPTICS povidone/iod sol 10% OTC

ANTISEPTICS - MOUTH/THROAT ANTISEPTICS - MOUTH/THROAT

chlorhexidine gluconate soln 0.12% paroex sol 0.12%

ANTISPASMODICS ANTICHOLINERGIC COMBINATIONS

chlordiazepoxide hcl-clidinium bromide cap 5-2.5 mg

ANTISPASMODICS dicyclomine hcl cap 10 mg dicyclomine hcl oral soln 10 mg/5ml dicyclomine hcl tab 20 mg

BELLADONNA ALKALOIDS

ed-spaz tab 0.125mg hyoscyamine sulfate elixir 0.125 mg/5ml

hyoscyamine sulfate sl tab 0.125 mg hyoscyamine sulfate soln 0.125 mg/ml hyoscyamine sulfate tab 0.125 mg hyoscyamine sulfate tab disint 0.125 mg hyoscyamine sulfate tab er 12hr 0.375 mg nulev tab 0.125mg oscimin sr tab 0.375mg

oscimin sub 0.125mg oscimin tab 0.125mg SYMAX DUOTAB TAB symax-sr tab 0.375mg

QUATERNARY ANTICHOLINERGICS CUVPOSA SOL 1MG/5ML

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 45 AGE - Age Limit GNDR - Gender Edit

glycopyrrolate tab 1 mg

glycopyrrolate tab 2 mg ANTITHYROID AGENTS

ANTITHYROID AGENTS methimazole tab 5 mg methimazole tab 10 mg propylthiouracil tab 50 mg

ANTITUSSIVES

ANTITUSSIVE - NONNARCOTIC benzonatate cap 100 mg benzonatate cap 200 mg

ANTITUSSIVE - OPIOID

hydrocodone w/ homatropine syrup 5-1.5 mg/5ml hydrocodone w/ homatropine tab 5-1.5 mg hydromet syp 5-1.5/5

ANTIVIRALS HEPATITIS AGENTS

ledipasvir-sofosbuvir tab 90-400 mg SP, QL (1 tab / 1 day), PA PEGASYS INJ SP, QL (9 syringes / 30

days), PA PEGASYS INJ 180MCG/M SP, QL (4.5 vials / 30 days),

PA PEGASYS INJ PROCLICK SP, QL (9 syringes / 30

days), PA ZEPATIER TAB 50-100MG SP, QL (1 tab / 1 day), PA

INFLUENZA AGENTS oseltamivir phosphate for susp 6 mg/ml (base QL (180 mL / 180 days) equiv)

ANTIVIRALS - TOPICAL ANTIVIRALS - TOPICAL

ABREVA CRE 10% OTC

ARTIFICIAL TEARS AND LUBRICANTS ARTIFICIAL TEAR AND LUBRICANT COMBINATIONS

artifi tears dro 1-0.3% OTC artificial dro tears OTC

artificial sol tears OTC

clear eyes dro 0.5-0.6% OTC

cvs dry eye dro relief OTC

eq lubricant dro eye drop OTC

eye drops dro 0.5-0.9% OTC

eye lubrican oin op OTC

for sty reli oin OTC

genteal tear oin nt-time OTC

hm dry eye sol relief OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 46 AGE - Age Limit GNDR - Gender Edit

HYPOTEARS SOL 1-1% OTC

lubr/dry eye dro 0.5-0.9% OTC

lubric tears sol 0.4-0.3% OTC

lubricant dro 0.4-0.3% OTC

lubricant dro eye OTC

lubricat/eye dro 0.5-0.9% OTC

lubricating sol 0.4-0.3% OTC

lubricnt eye dro OTC

lubricnt eye dro 0.4-0.3% OTC

lubricnt eye oin fast act OTC

lubricnt eye oin nighttim OTC

lubricnt gel dro 0.25-0.3 OTC

murine tears dro dry eyes OTC

puralube oin OTC

ra lubricant dro 0.4-0.3% OTC

REFRESH OPT SOL MEGA-3 OTC

REFRESH OPTI DRO 0.5-0.9% OTC

REFRESH SOL OPTIVE OTC

retaine pm oin OTC

sm dry eye sol relief OTC

sm lubricant dro 0.4-0.3% OTC

systane oin OTC

tgt lubricnt dro eye OTC

tgt lubricnt oin eye nite OTC

ARTIFICIAL TEAR OINTMENTS akwa tears oin op OTC altalube oin OTC

eye lubrican oin op OTC

hypotears oin op OTC

lubricant oin eye OTC

refresh lacr oin op OTC

refresh p.m. oin op OTC

soothe night oin time OTC

tears again oin op OTC

ultra fresh oin pm OTC

ARTIFICIAL TEAR SOLUTIONS artificial sol tears OTC cvs natural sol tears OTC

genteal tear sol mild OTC

genteal tear sol moderate OTC

just tears sol eye drop OTC

lubricnt eye dro OTC

natural bal sol tears OTC

natures sol tears OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 47 AGE - Age Limit GNDR - Gender Edit

sm artificia sol tears OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 47 AGE - Age Limit GNDR - Gender Edit

soothe dro hydratio OTC

soothe xp dro OTC

soothe xp dro 1%-4.5% OTC

systane dro contacts OTC

tears again sol adv eye OTC

tears again sol op OTC

tears natura sol free op OTC

tears pure sol OTC

ARTIFICIAL TEARS AND LUBRICANTS artifi tears sol 1.4% op OTC artificial sol tears op OTC

biolle gel 1% OTC

biolle tears dro 0.5% op OTC

cvs lubricnt dro 0.5% op OTC

eq gentle dro 0.3% OTC

eq revive pl dro 0.5% op OTC

GENTEAL GEL 0.3% OTC

GENTEAL MILD DRO 0.2% OTC

liquitears sol OTC

lubricant dro eye 0.6% OTC

lubricating dro 0.5% OTC

lubricnt eye dro 0.5% op OTC

lubricnt eye dro 0.6% OTC

lubricnt gel dro 1% OTC

polyvinyl alcohol ophth soln 1.4% OTC

pure & gentl dro 0.3% OTC

restore plus dro 0.5% op OTC

restore tear dro 0.5% op OTC

retaine cmc sol 0.5% op OTC

SYSTANE GEL 0.3% OTC

ultra fresh dro 0.5% op OTC

AZITHROMYCIN AZITHROMYCIN

azithromycin for susp 100 mg/5ml azithromycin for susp 200 mg/5ml azithromycin powd pack for susp 1 gm azithromycin tab 250 mg azithromycin tab 500 mg

azithromycin tab 600 mg

B-COMPLEX VITAMINS B-COMPLEX VITAMINS

APETEX ELX OTC APETIGEN ELX OTC

b-complex 50 tab OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 48 AGE - Age Limit GNDR - Gender Edit

b-complex tab OTC

b-complex tab 50 tr OTC

b-complex vitamin cap OTC

b-complex vitamin sublingual liquid OTC

b-complex vitamin tab OTC

pa b-complex tab w/b-12 OTC

ra b-complex tab OTC

ra b-complex tab w/b-12 OTC

BREWERS YEAST BREWERS YEAS POW OTC brewers yeast tab OTC

B-COMPLEX W/ C B-COMPLEX W/ C

allbee plus tab vit c OTC b complex tab plus c OTC

b-complex w/ c cap OTC

b-complex w/ c tab OTC

balanced b tab complex OTC

better b tab complex OTC

cvs super b tab complx/c OTC

ra b-complex tab vit c tr OTC

super b comp tab vit c OTC

super b w/c cap OTC

superplex-t tab OTC

total b/c tab OTC

vt b complex cap OTC

B-COMPLEX W/ C & CALCIUM b-complex tab /vit c OTC b-complex w/ c & calcium tab OTC

B-COMPLEX W/ C & E PRONUTRIENTS TAB SUPER B OTC

B-COMPLEX W/ C & E + ZN bec/zinc tab OTC cvs stress tab form/zn OTC

stress b com tab vit c/zn OTC

stress b/ tab zinc OTC

stress form tab /zinc OTC

stress form/ tab zinc OTC

stress formu tab /zinc OTC

stress plus tab zinc OTC

zinc-vites tab OTC

B-COMPLEX W/ FOLIC ACID B-COMPLEX W/ C & FOLIC ACID

B COMPLEX +C TAB TR OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 49 AGE - Age Limit GNDR - Gender Edit

b complex tab vit c OTC

b-complex tab balanced OTC

b-complex w/ c & folic acid tab OTC

BIOTIN FORTE TAB OTC

dialyvite tab 800 OTC

FULL SPECT TAB B/ VIT C OTC

hm b complex tab with c OTC

kp b complex tab /c OTC

mynephrocaps cap

mynephron cap rena-vite tab OTC renal cap

renal tab multivit OTC

renal vitamn tab OTC

renal-vite tab OTC

reno cap

sm b super tab vita com OTC

SM B-COMPLEX TAB /VIT C OTC

stress form tab OTC

super b comp tab /vit c OTC

super b comp tab vit c OTC

super b-comp tab /fa/vitc OTC

super b-comp tab vit c/fa OTC

triphrocaps cap

virt-caps cap vit b complx tab /vit c OTC vita-bee/c tab OTC

B-COMPLEX W/ C-BIOTIN-E & FOLIC ACID B-COMPLEX TAB C/FA/BIO OTC

B-COMPLEX W/ C-BIOTIN-FE & FOLIC ACID DIALYVITE TAB 800/IRON OTC

B-COMPLEX W/ C-ZN & FOLIC ACID BIOTIN FORTE TAB /ZINC OTC DIALYVIT 800 TAB ZINC 15 OTC

DIALYVITE TAB 800/ZINC OTC

B-COMPLEX W/ FOLIC ACID b complex tab form 1 OTC b complex tab plus OTC

b-50 tr tab OTC

b-complex w/ folic acid cap OTC

b-complex w/ folic acid tab OTC

balance b-50 tab tr OTC

benfotiamine cap multi-b OTC

big 100 tab OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 50 AGE - Age Limit GNDR - Gender Edit

gnp b-100 tab OTC

Page 67: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 51 AGE - Age Limit GNDR - Gender Edit

kobee tab OTC

m2 b125 tab tr OTC

sm balanced tab b-50 OTC

sm balanced tab b-100 OTC

super b comp tab maxi OTC

B-COMPLEX W/ LYSINE-ZN & FOLIC ACID BIOTALAN LIQ CLEAR OTC

B-COMPLEX W/BIOTIN & FOLIC ACID b50 complex tab tr OTC b complete tab OTC

b-50 complex tab OTC

b-100 complx tab OTC

b-100 tab complex OTC

b-100 tr tab OTC

b-compleet- tab 50 OTC

b-compleet- tab 100 OTC

B-COMPLEX CAP OTC

b-complex tab 100 tr OTC

b-complex w/biotin & folic acid tab OTC

balanc b-100 tab tr OTC

balance b-50 tab OTC

balanced b tab complex OTC

balanced tab b-50 OTC

balanced tab b-100 OTC

balanced tab b-100 tr OTC

big 100 tab OTC

complex b-50 tab OTC

eql b complx tab 50 OTC

eql b-100 tab complex OTC

extress tab OTC

EXTRESS-30 CAP OTC

extress- tab super OTC

gnp b-50 tab balanced OTC

gnp b-50 tab complex OTC

gnp b-100 tab complex OTC

MULTI-B CAP COMPLEX OTC

poten b-150 tab tr OTC

quin b stron tab b-25 OTC

ra balanced tab b-50 OTC

ra balanced tab b-50 tr OTC

ra balanced tab b-100 OTC

ra balnaced tab b-100 tr OTC

sm b100 tab complex OTC

sm b-complex tab OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 52 AGE - Age Limit GNDR - Gender Edit

SUPER B-50 CAP B-COMP OTC

Page 69: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 51 AGE - Age Limit GNDR - Gender Edit

SUPER B-50 CAP COMPLEX OTC

super b-50 tab OTC

super b-100 tab OTC

SUPER B- CAP COMPLEX OTC

super b- tab complex OTC

super dec tab b-100 OTC

super quints tab OTC

super-b tab complex OTC

vitamin b50 tab complex OTC

vitamin b100 tab complex OTC

yl balanced tab b-100 OTC

B-COMPLEX W/ IRON B-COMPLEX W/ IRON

APETIGEN-PLS SOL OTC b-complex w/ iron tab OTC

super b-comp tab iron/c OTC

SUPLEVIT LIQ OTC

B-COMPLEX W/ MINERALS B-COMPLEX W/ MINERALS

APETIGEN TAB PLUS OTC geriaton liq OTC

GERIATRIC LIQ VITAMIN OTC

GLYCO-TECH TAB OTC

rabano liq yodado OTC

VITONIC LIQ OTC

BANDAGES-DRESSINGS-TAPE ADHESIVE BANDAGES

ACT BRIGHTS MIS BANDAGES OTC ACT SPORT FM MIS 1-1/8"X3 OTC

ACT SPORT FM MIS ASSORTED OTC

ACT SPORT FM MIS KNEE/ELB OTC

ADH BANDAGE MIS ANTIBACT OTC

ADH BANDAGE MIS CLEAR OTC

ADH BANDAGE MIS FLEXIBLE OTC

ADH BANDAGE MIS FOAM OTC

ADH BANDAGE MIS FOAM TOE OTC

ADH BANDAGE MIS HEALTH OTC

ADH BANDAGE MIS HYPO-ALL OTC

ADH BANDAGE MIS PLASTIC OTC

ADH BANDAGE MIS RETENTIO OTC

ADH BANDAGE MIS SHEER OTC

ADH BANDAGE MIS STRONG OTC

ADH BANDAGE MIS WTR SHLD OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 52 AGE - Age Limit GNDR - Gender Edit

ADHESIVE KNT MIS 3"X5" OTC

Page 71: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 53 AGE - Age Limit GNDR - Gender Edit

ADHESIVE PAD 2"X3" OTC

ADHESIVE PAD 3"X4" OTC

ADHESIVE PAD 4"X4" OTC

ADHESIVE PAD 6"X6" OTC

ADHESIVE PAD MIS LARGE OTC

ADHESIVE PAD MIS MEDIUM OTC

ADHESIVE PAD PAD 2.25"X3" OTC

ADHESIVE PAD PAD ANTIBACT OTC

ADV HEALING MIS BANDAGES OTC

ADVANC CURAD MIS AQUA-PRO OTC

ADVANC CURAD MIS BLISTER OTC

ADVANC CURAD MIS COOL-WRP OTC

ADVANC CURAD MIS SOF-GEL OTC

ANIMAL PRINT MIS STRIPS OTC

ANTIBAC BNDG MIS 7/8" OTC

ANTIBAC FABR MIS STRIPS OTC

ANTIBACTERAI MIS BANDAGES OTC

ANTIBACTERIA MIS BANDAGES OTC

BAND AID MED MIS BUTTRFLY OTC

BAND AID MIS 1" OTC

BAND AID MIS MICKEY OTC

BAND-AID CLR MIS 7/8"SPOT OTC

BAND-AID CLR MIS STRIPS OTC

BAND-AID FLX MIS OTC

BAND-AID FLX MIS 1" X 3" OTC

BAND-AID FLX MIS 1"X3" OTC

BAND-AID FLX MIS 3/4"X3" OTC

BAND-AID FLX MIS ASSORTED OTC

BAND-AID FLX MIS EXTRA LG OTC

BAND-AID FLX MIS FABRIC OTC

BAND-AID FLX MIS FINGRTIP OTC

BAND-AID FLX MIS KNUCKLE OTC

BAND-AID LG MIS BUTTRFLY OTC

BAND-AID MIS OTC

BAND-AID MIS 3/4"X3" OTC

BAND-AID MIS FROZEN OTC

BAND-AID MIS GLOW-DRK OTC

BAND-AID MIS HL KITTY OTC

BAND-AID MIS HOT COLR OTC

BAND-AID MIS MEDICATE OTC

BAND-AID MIS PRINCESS OTC

BAND-AID MIS SHEER OTC

BAND-AID MIS SHEER CF OTC

BAND-AID MIS SPORT EX OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 54 AGE - Age Limit GNDR - Gender Edit

BAND-AID MIS STAR WAR OTC

Page 73: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 55 AGE - Age Limit GNDR - Gender Edit

BAND-AID MIS TOUGH OTC

BAND-AID MIS TOUGH WP OTC

BAND-AID MIS TOUGH XL OTC

BAND-AID MIS TOUGH-ST OTC

BAND-AID MIS VARIETY OTC

BAND-AID MIS WTER BLK OTC

BAND-AID MIS X-LG OTC

BAND-AID PAD 2"X3" OTC

BAND-AID PAD 3"X4" OTC

BAND-AID PAD ADHESIVE OTC

BAND-AID PAD LARGE OTC

BAND-AID PAW MIS PATROL OTC

BANDAGE FABR MIS EX-LONG OTC

BANDAGE FABR MIS KNUC/FIN OTC

BANDAGES CLR MIS ASSORTED OTC

BANDAGES FAB MIS 3/4" OTC

BANDAGES FAB MIS ASSORTED OTC

BLISTER REL MIS BANDAGE OTC

BUTTERFLY MIS CLOSURES OTC

CARPALAID MIS EMPLOYEE OTC

CARPALAID MIS LARGE OTC

CARPALAID MIS PRA LG OTC

CARPALAID MIS PRAC SM OTC

CARPALAID MIS SMALL OTC

CLEAR BANDAG MIS 3/4" OTC

CLEAR SPOT MIS 7/8" OTC

CLEAR STRIPS MIS 3/4" OTC

COMFORT FAB MIS 3/4"X3" OTC

COMFORT FAB MIS ASSORTED OTC

COMFORT FAB MIS KNEE/ELB OTC

CRAYON STRIP MIS BANDAGE OTC

CURAD 7/8" MIS ACTIFLEX OTC

CURAD ASSORT MIS ACTIFLEX OTC

CURAD FAMILY MIS FLX ASST OTC

CURAD FLEX MIS ASSORTED OTC

CURAD KID SZ MIS DINOSAUR OTC

CURAD MIS GODZILLA OTC

CURAD MIS JURASSIC OTC

CURAD PAD 3"X4" OTC

CURAD SENSIT MIS 3/4" OTC

CURAD SENSIT MIS ASSORTED OTC

CURAD SENSIT MIS EX LARGE OTC

CURAD SENSIT MIS SPOTS OTC

CURAD WILD MIS DESIGNIT OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 56 AGE - Age Limit GNDR - Gender Edit

CURAD WILD MIS TATTOO-U OTC

Page 75: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 57 AGE - Age Limit GNDR - Gender Edit

CURITY CURAD MIS 3/4 FABR OTC

CURITY CURAD MIS 3/4 PLAS OTC

CURITY CURAD MIS 3/4 SHEE OTC

CURITY CURAD MIS ASST FAB OTC

CURITY CURAD MIS PLASTIC OTC

CURITY CURAD MIS SHEER OTC

CVS SPOT BAN MIS SHEER OTC

EASY RELEASE PAD NONSTICK OTC

EQ STRONG MIS STRIPS OTC

EQL BUTTERFL MIS CLOSURE OTC

EQL FIRST MIS AID BAND OTC

EQL FLEXIBLE MIS FABRIC OTC

EQL FLEXIBLE MIS FOAM OTC

EQL GENTLE MIS STRIPS OTC

EQL HVY DUTY MIS STRIPS OTC

EQL PLASTIC MIS STRIPS OTC

EQL SHEER MIS SPOTS OTC

EQL SHEER MIS STRIPS OTC

EQL STRIPS MIS OTC

FABRIC BANDG MIS ASSORTED OTC

FABRIC BANDG MIS FLEXIBLE OTC

FIRST AID MIS ANTIBACT OTC

FIRST AID MIS FLEX FAB OTC

FIRST AID MIS SHEER OTC

FIRST AID NO PAD STICK OTC

FLEX BANDAGE MIS OTC

GNP ADHESIVE PAD 3" X 4" OTC

GNP PLASTIC MIS 3/4" OTC

GNP SHEER MIS STRIPS OTC

GNP SHEER ST MIS ASSORTED OTC

GNP SUPER MIS STRIP OTC

GNTL ADHESVE MIS BNDG XL OTC

HEAVY DUTY MIS BANDAGES OTC

HEAVY DUTY MIS CLR&TGH OTC

HEAVY DUTY MIS FAB BAND OTC

HM BUTTERFLY MIS CLOSURES OTC

HYPO-ALLERG MIS BANDAGE OTC

J & J ADHES PAD LARGE OTC

LEUKOSTRIP MIS 1/2"X4" OTC

LEUKOSTRIP MIS 1/4"X3" OTC

LEUKOSTRIP MIS 1/4"X4" OTC

LEUKOSTRIP MIS 1/8X1.5" OTC

MOLESKIN PAD FOAM OTC

NEON STRIPS MIS 3/4 ASST OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 58 AGE - Age Limit GNDR - Gender Edit

NEXCARE TATT MIS BANDAGES OTC

Page 77: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 59 AGE - Age Limit GNDR - Gender Edit

NEXCARE WATR MIS PRF BAND OTC

PEANUTS MIS BANDAGES OTC

PLASTC BANDG MIS 3/4" OTC

PLASTIC MIS BANDAGES OTC

PROXI-STRIP MIS 1/4"X4" OTC

PROXI-STRIPS MIS 1/2"X4" OTC

QUIKSTIK ADH MIS BANDAGES OTC

RA ADH BANDG MIS EX-LARGE OTC

RA ADH PADS MIS 3"X4" OTC

RA ADHESIVE MIS 2-1/4X3" OTC

RA ADHESIVE MIS BANDAGES OTC

RA BANDAGES MIS 1"X3" OTC

ra bandages mis 3/4" OTC

RA BANDAGES MIS 3/4"X3" OTC

RA BANDAGES MIS ASSORTED OTC

RA BANDAGES MIS CLEAR OTC

RA BANDAGES MIS EX-LRG OTC

RA BUTTERFLY MIS BANDAGES OTC

RA SHEER ADH PAD LARGE OTC

SHEER BANDGE MIS 1" OTC

SHEER BANDGE MIS ASSORTED OTC

sheer bandge mis ex-large OTC

SHR BANDAGES MIS OTC

SHR BANDAGES MIS 3/4" OTC

SHR BANDAGES MIS ASSORTED OTC

SHR BANDAGES MIS EX-LARGE OTC

2ND SKIN CUT MIS CLOSURE OTC

2ND SKIN PAD MIS BLISTER OTC

SM ADHESIVE PAD 2"X3" OTC

SM ADHESIVE PAD 3"X4" OTC

SM BANDAGES MIS ANTIBACT OTC

SM BANDAGES MIS CLEAR OTC

SM BANDAGES MIS CLR SPOT OTC

SM BANDAGES MIS FAB 3/4" OTC

SM BANDAGES MIS FAB XL OTC

SM BANDAGES MIS FLEXIBLE OTC

SM BANDAGES MIS FOAM OTC

SM BANDAGES MIS FOAM XL OTC

SM BANDAGES MIS PLASTIC OTC

SM BANDAGES MIS SHEER OTC

SM BANDAGES MIS SHEER XL OTC

SM BANDAGES MIS STRNG ST OTC

SM BANDAGES MIS WTRSHELD OTC

SM KNUCKLE/ MIS FINGERTP OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 60 AGE - Age Limit GNDR - Gender Edit

SM STRONG MIS STRIPS OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 56 AGE - Age Limit GNDR - Gender Edit

SM STURDY MIS STRIP OTC

SOF-SET ADH PAD PATCH OTC

SOFT 'N FLEX MIS OTC

SORESPOT MIS BANDAGES OTC

STERI-STRIP MIS OTC

STERI-STRIP MIS 1" X 5" OTC

STERI-STRIP MIS 1/2"X2" OTC

STERI-STRIP MIS 1/2"X4" OTC

STERI-STRIP MIS 1/4"X1.5 OTC

STERI-STRIP MIS 1/4"X3" OTC

STERI-STRIP MIS 1/4"X4" OTC

STERI-STRIP MIS 1/8"X3" OTC

STRONG STRIP MIS BANDAGES OTC

STRONG STRIP MIS WATERPRF OTC

SUPER STRIP MIS 1"X3" OTC

SUPERSTRIP MIS 1" X 3" OTC

SURESEAL MIS EX LARGE OTC

SURESEAL MIS K OTC

SURESEAL MIS LARGE OTC

VARIETY PACK MIS BANDAGES OTC

WATERPROOF MIS BANDAGES OTC

WATERPROOF PAD 3"X4" OTC

WATERSHIELD MIS BANDAGES OTC

BARBITURATE HYPNOTICS BARBITURATE HYPNOTICS

phenobarbital elixir 20 mg/5ml phenobarbital tab 15 mg phenobarbital tab 16.2 mg phenobarbital tab 30 mg phenobarbital tab 32.4 mg phenobarbital tab 60 mg phenobarbital tab 64.8 mg phenobarbital tab 97.2 mg phenobarbital tab 100 mg

BETA BLOCKERS BETA BLOCKERS NON-SELECTIVE

sotalol hcl tab 120 mg

BETA BLOCKERS CARDIO-SELECTIVE BETA BLOCKERS CARDIO-SELECTIVE

atenolol tab 25 mg atenolol tab 50 mg atenolol tab 100 mg

bisoprolol fumarate tab 5 mg

bisoprolol fumarate tab 10 mg

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 57 AGE - Age Limit GNDR - Gender Edit

metoprolol succinate tab er 24hr 25 mg (tartrate equiv)

metoprolol succinate tab er 24hr 50 mg (tartrate equiv)

metoprolol succinate tab er 24hr 100 mg (tartrate equiv)

metoprolol succinate tab er 24hr 200 mg (tartrate equiv)

metoprolol tartrate tab 25 mg metoprolol tartrate tab 50 mg metoprolol tartrate tab 100 mg

BETA BLOCKERS NON-SELECTIVE BETA BLOCKERS NON-SELECTIVE

nadolol tab 20 mg nadolol tab 40 mg nadolol tab 80 mg pindolol tab 5 mg pindolol tab 10 mg

propranolol hcl cap er 24hr 60 mg propranolol hcl cap er 24hr 80 mg propranolol hcl cap er 24hr 120 mg propranolol hcl cap er 24hr 160 mg propranolol hcl oral soln 20 mg/5ml propranolol hcl oral soln 40 mg/5ml propranolol hcl tab 10 mg propranolol hcl tab 20 mg propranolol hcl tab 40 mg propranolol hcl tab 60 mg propranolol hcl tab 80 mg

sorine tab 80mg sorine tab 120mg sorine tab 160mg sorine tab 240mg

sotalol hcl (afib/afl) tab 80 mg sotalol hcl (afib/afl) tab 120 mg sotalol hcl (afib/afl) tab 160 mg sotalol hcl tab 80 mg

sotalol hcl tab 120 mg sotalol hcl tab 160 mg sotalol hcl tab 240 mg timolol maleate tab 5 mg timolol maleate tab 10 mg

timolol maleate tab 20 mg

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 58 AGE - Age Limit GNDR - Gender Edit

BETA-BLOCKERS - OPHTHALMIC BETA-BLOCKERS - OPHTHALMIC

betaxolol hcl ophth soln 0.5% levobunolol hcl ophth soln 0.5% metipranolol ophth soln 0.3% timolol maleate ophth gel forming soln 0.5%

timolol maleate ophth gel forming soln 0.25% timolol maleate ophth soln 0.5% timolol maleate ophth soln 0.25%

BETA-BLOCKERS - OPHTHALMIC COMBINATIONS dorzolamide hcl-timolol maleate ophth soln 22.3-6.8 mg/ml

BIGUANIDES BIGUANIDES

metformin hcl tab 500 mg metformin hcl tab 850 mg metformin hcl tab 1000 mg metformin hcl tab er 24hr 500 mg metformin hcl tab er 24hr 750 mg

BILE ACID SEQUESTRANTS BILE ACID SEQUESTRANTS

cholestyramine light powder 4 gm/dose cholestyramine light powder packets 4 gm cholestyramine powder 4 gm/dose cholestyramine powder packets 4 gm colestipol hcl granule packets 5 gm colestipol hcl granules 5 gm colestipol hcl tab 1 gm

prevalite pow 4gm prevalite pow 4gm pk

BIOFLAVONOID PRODUCTS BIOFLAVONOID PRODUCTS

ACTITROM CAP OTC ADVANCED C TAB PLUS OTC

anti-allergy tab OTC

ASCOCID-500 TAB OTC

ASCOCID-1000 TAB OTC

BIOFLAVONOID POW CITRUS OTC

bioflavonoid products cap OTC

bioflavonoid products tab OTC

bioflavonoid products tab er OTC

bioflex tab OTC

c1000 tr/rh tab bioflav OTC

c1500 tr/rh tab bioflav OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 59 AGE - Age Limit GNDR - Gender Edit

c1500/rh tab bioflav OTC

c 1000/biofl cap /r hips OTC

c complex tab 500mg OTC

c complex tab 1000mg OTC

C-PLEX CAP OTC

CEMILL PLUS TAB OTC

cemill/biofl tab OTC

DAFLONEX-XL TAB OTC

easy-c tab 500mg OTC

ester-c tab OTC

ester-c tab 500mg OTC

ester-c tab 1000mg OTC

flexgen tab OTC

FRUIT C CHW 200MG OTC

hi c-500 tab OTC

LIQUID C LIQ OTC

M2 C CAP OTC

pan-c 500 tab bioflavo OTC

ra vitamin c tab 1000mg OTC

span c tab OTC

super c-500 tab OTC

SUPER C-500 TAB COMPLEX OTC

super c-1000 tab OTC

tri super tab flavons OTC

TROMBONEX CAP OTC

trombonex-d cap OTC

VASOFLEX CAP OTC

vasoflex cap forte OTC

vasoflex hd tab OTC

vasoflex tab OTC

vita c/biofl tab rose hip OTC

VITAMIN C CHW 500MG OTC

vitamin c tab plus OTC

BONE DENSITY REGULATORS BISPHOSPHONATES

alendronate sodium tab 5 mg alendronate sodium tab 10 mg alendronate sodium tab 35 mg alendronate sodium tab 40 mg alendronate sodium tab 70 mg

CALCITONINS calcitonin (salmon) nasal soln 200 unit/act

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 60 AGE - Age Limit GNDR - Gender Edit

BRONCHODILATORS - ANTICHOLINERGICS BRONCHODILATORS - ANTICHOLINERGICS

INCRUSE ELPT INH 62.5MCG ipratropium bromide inhal soln 0.02% QL (375.6 vials / 75 days)

ipratropium bromide inhal soln 0.02% QL (939 mL / 75 days)

BURN PRODUCTS BURN PRODUCTS

silver sulfadiazine cream 1% ssd cre 1%

CALCIUM CALCIUM

CALCI-CHEW CHW 1250MG OTC calcitrate tab 950mg OTC

calcium 600 tab OTC

calcium carb tab 1250mg OTC

calcium carbonate (antacid) susp 1250 mg/5ml OTC calcium carbonate tab 600 mg OTC calcium carbonate tab 1250 mg (500 mg OTC

elemental ca) calcium carbonate tab 1500 mg (600 mg OTC elemental ca) calcium citrate tab 950 mg (200 mg elemental ca) OTC

calcium tab 600 mg OTC

calcium tab 600mg OTC

caltrate 600 tab OTC

oysco 500 tab 500mg OTC

oyster shell calcium tab 500 mg OTC

oystercal tab 500mg OTC

ra calcium tab 500mg OTC

ra calcium tab 600mg OTC

ra calcium tab hi-cal OTC

ra calcium tab high pot OTC

ra hi-cal tab 500mg OTC

super calciu tab 600mg OTC

CALCIUM COMBINATIONS ca citrate + tab OTC ca citrate tab + d OTC

ca citrate tab plus d OTC

CA HI-CAL/D TAB 250MG OTC

CA HI-CAL/D TAB 500MG OTC

CAL CIT MAL/ TAB VITAMIND OTC

cal cit+d3 tab maximum OTC

cal soft chw chw mlk choc OTC

cal-mag aspa tab 333-167 OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 61 AGE - Age Limit GNDR - Gender Edit

cal-mag tab 500-250 OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 62 AGE - Age Limit GNDR - Gender Edit

calc 600+d3 cap 600-500 OTC

calc 600+d tab 600-800 OTC

calc 600/d3 tab 600-800 OTC

calc cit+d3 tab 200-250 OTC

calc cit+d3 tab 250-200 OTC

calc citr+d3 tab 200-250 OTC

calc citr+d3 tab 315-250 OTC

calc citr+d tab 315-250 OTC

calc citr/d3 tab 200-250 OTC

calc citra+d tab 315-250 OTC

calc citrate tab +d OTC

calcitrate tab OTC

calcitrate tab plus d OTC

calcium 500 tab +d OTC

calcium 500 tab /vit d OTC

calcium 600 chw w/vit d OTC

calcium 600 tab + d OTC

calcium 600 tab +d OTC

calcium 600 tab +d3 OTC

calcium 600 tab -d OTC

calcium 600/ tab vit d OTC

calcium + d tab OTC

calcium + d tab 600-200 OTC

calcium + d tab 600mg OTC

calcium +d3 tab maximum OTC

calcium +d tab maximum OTC

calcium carbonate-cholecalciferol tab 250 mg-125 OTC unit calcium carbonate-cholecalciferol tab 500 mg-125 OTC unit calcium carbonate-cholecalciferol tab 500 mg-200 OTC unit calcium carbonate-cholecalciferol tab 500 mg-400 OTC unit calcium carbonate-cholecalciferol tab 600 mg-200 OTC unit calcium carbonate-cholecalciferol tab 600 mg-400 OTC unit calcium carbonate-vitamin d cap 600 mg-200 unit OTC calcium carbonate-vitamin d tab 500 mg-125 unit OTC calcium carbonate-vitamin d tab 500 mg-200 unit OTC calcium carbonate-vitamin d tab 500 mg-400 unit OTC calcium carbonate-vitamin d tab 600 mg-125 unit OTC calcium carbonate-vitamin d tab 600 mg-200 unit OTC calcium carbonate-vitamin d tab 600 mg-400 unit OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 63 AGE - Age Limit GNDR - Gender Edit

calcium citr tab +d OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 62 AGE - Age Limit GNDR - Gender Edit

calcium citr tab plus d-3 OTC

calcium citr tab w/vit d3 OTC

calcium citrate-vitamin d tab 200 mg-250 unit OTC (elemental ca) calcium citrate-vitamin d tab 315 mg-200 unit OTC (elemental ca) calcium citrate-vitamin d tab 315 mg-250 unit OTC (elemental ca) calcium for chw women OTC

calcium plus cap d3 OTC

calcium soft chw caramel OTC

calcium soft chw chocolat OTC

calcium soft chw mlk choc OTC

calcium tab 500+d OTC

calcium tab 500/d OTC

CALCIUM TAB 600MG OTC

calcium tab vit d OTC

calcium w/ magnesium tab 250-125 mg OTC

calcium w/ magnesium tab 500-250 mg OTC

calcium+d3 tab 315-250 OTC

calcium+d3 tab 600-400 OTC

calcium+d3 tab 600-800 OTC

calcium+d tab 600-400 OTC

calcium+d tab 600-800 OTC

calcium-magnesium-zinc tab 333-133-5 mg OTC

calcium-magnesium-zinc tab 333-133-8.3 mg OTC calcium/d3 cap 600-500 OTC calcium/d3 tab OTC calcium/d3 tab 200-250 OTC

calcium/d3 tab 500-600 OTC

calcium/d3 tab 600-800 OTC

calcium/d chw 500-400 OTC

calcium/d tab 500-200 OTC

calcium/d tab 500-400 OTC

calcium/d tab 500/200 OTC

calcium/d tab 500mg OTC

calcium/d tab 600-200 OTC

calcium/d tab 600-800 OTC

calcium/magn tab /zinc OTC

calcium/vita tab d3 OTC

calcium/vitd cap 600-500 OTC

chew calcium chw OTC

cit calc/d tab 315-250 OTC

coral calciu cap plus OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 63 AGE - Age Limit GNDR - Gender Edit

creamies chw 600-400 OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 64 AGE - Age Limit GNDR - Gender Edit

cvs ca/mg/zn tab OTC

eq calcium tab citr+d OTC

eql calcium tab citr/d3 OTC

eql calcium tab w/vit d OTC

gnp ca/mg/zn tab OTC

gnp calcium tab 500/d OTC

gnp calcium tab 600/d OTC

gnp calcium tab cit +d3 OTC

hm ca/vit d3 tab 600-400 OTC

hm calcium tab citr+d OTC

kp ca/mg/zn tab OTC

kp calcium cap 600+d OTC

kp calcium tab 600+d OTC

kp calcium tab +d OTC

liq ca/vit d cap 600mg OTC

os calcium tab /vit d OTC

os-cal + d3 tab 500-200 OTC

os-cal chw OTC

os-cal chw 500-600 OTC

os-cal extra tab d3 OTC

oscal 500/ tab 200 d-3 OTC

oys shell ca tab 500 + d OTC

oys shell ca tab /d3 OTC

oys shell+d chw 500-400 OTC

oys shell+d tab 250-125 OTC

oysco 500+d chw OTC

oysco 500+d tab OTC

oyst ca/d3 tab 500-200 OTC

oyst cal/d tab 250mg OTC

oyst cal/d tab 500mg OTC

oyst shell/d tab 250mg OTC

oyst shell/d tab 500-125 OTC

oyst shell/d tab 500-200 OTC

oyst shell/d tab 500-400 OTC

oyst shell/d tab 500mg OTC

oystercal-d tab 500mg OTC

pa calcium tab vit d OTC

pa oyster sh tab 500mg OTC

PARVA-CAL TAB 500MG OTC

px calcium&d tab 600-400 OTC

ra ca/mg/zn tab OTC

ra ca/vit d3 tab 600-400 OTC

ra calcium chw caramel OTC

ra calcium chw mlk choc OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 65 AGE - Age Limit GNDR - Gender Edit

ra calcium tab vit d OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 64 AGE - Age Limit GNDR - Gender Edit

ra calcium+d tab 600mg OTC

ra hi cal tab 500-200 OTC

ra hi-cal/d tab 500mg OTC

RA OYS SHL/D TAB 250MG OTC

RA OYS SHL/D TAB 500MG OTC

RISACAL-D TAB OTC

sm ca/mg/zn tab OTC

sm ca/vit d3 tab 600-400 OTC

sm calcium chw OTC

sm calcium tab /vit d3 OTC

sm calcium/d tab 500-200 OTC

sm calcium/d tab 600-400 OTC

super ca 600 tab + d3 OTC

super ca 600 tab + d3 400 OTC

super ca 600 tab + d 400 OTC

super cal/ tab mag OTC

tgt calcium chw suppleme OTC

CALCIUM CHANNEL BLOCKERS CALCIUM CHANNEL BLOCKERS

amlodipine besylate tab 2.5 mg (base equivalent) amlodipine besylate tab 5 mg (base equivalent) amlodipine besylate tab 10 mg (base equivalent) cartia xt cap 120/24hr cartia xt cap 180/24hr

cartia xt cap 240/24hr cartia xt cap 300/24hr dilt-xr cap 120mg dilt-xr cap 180mg

dilt-xr cap 240mg diltiazem hcl cap er 12hr 60 mg

diltiazem hcl cap er 12hr 90 mg diltiazem hcl cap er 12hr 120 mg diltiazem hcl cap er 24hr 120 mg diltiazem hcl cap er 24hr 180 mg diltiazem hcl cap er 24hr 240 mg diltiazem hcl coated beads cap er 24hr 120 mg

diltiazem hcl coated beads cap er 24hr 180 mg diltiazem hcl coated beads cap er 24hr 240 mg diltiazem hcl coated beads cap er 24hr 300 mg diltiazem hcl coated beads cap er 24hr 360 mg diltiazem hcl coated beads tab er 24hr 180 mg diltiazem hcl coated beads tab er 24hr 240 mg diltiazem hcl coated beads tab er 24hr 300 mg diltiazem hcl coated beads tab er 24hr 360 mg

diltiazem hcl coated beads tab er 24hr 420 mg

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 65 AGE - Age Limit GNDR - Gender Edit

diltiazem hcl extended release beads cap er 24hr 120 mg

diltiazem hcl extended release beads cap er 24hr 180 mg

diltiazem hcl extended release beads cap er 24hr 240 mg

diltiazem hcl extended release beads cap er 24hr 300 mg

diltiazem hcl extended release beads cap er 24hr 360 mg

diltiazem hcl extended release beads cap er 24hr 420 mg

diltiazem hcl tab 30 mg diltiazem hcl tab 60 mg diltiazem hcl tab 90 mg diltiazem hcl tab 120 mg felodipine tab er 24hr 2.5 mg felodipine tab er 24hr 5 mg felodipine tab er 24hr 10 mg matzim la tab 180mg/24 matzim la tab 240mg/24 matzim la tab 300mg/24 matzim la tab 360mg/24 matzim la tab 420mg/24 nifedipine tab er 24hr 30 mg nifedipine tab er 24hr 60 mg nifedipine tab er 24hr 90 mg

nifedipine tab er 24hr osmotic release 30 mg nifedipine tab er 24hr osmotic release 60 mg nifedipine tab er 24hr osmotic release 90 mg taztia xt cap 120mg/24 taztia xt cap 180mg/24 taztia xt cap 240mg/24 taztia xt cap 300mg/24 taztia xt cap 360mg/24 verapamil hcl cap er 24hr 100 mg verapamil hcl cap er 24hr 200 mg verapamil hcl cap er 24hr 300 mg verapamil hcl tab er 120 mg verapamil hcl tab er 180 mg verapamil hcl tab er 240 mg

CARBONIC ANHYDRASE INHIBITORS CARBONIC ANHYDRASE INHIBITORS

acetazolamide cap er 12hr 500 mg acetazolamide tab 125 mg

acetazolamide tab 250 mg

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 66 AGE - Age Limit GNDR - Gender Edit

methazolamide tab 25 mg

methazolamide tab 50 mg CARDIAC GLYCOSIDES

CARDIAC GLYCOSIDES digitek tab 0.25mg digitek tab 0.125mg digox tab 0.25mg digox tab 0.125mg digoxin oral soln 0.05 mg/ml

digoxin tab 125 mcg (0.125 mg) digoxin tab 250 mcg (0.25 mg) LANOXIN TAB 0.0625MG LANOXIN TAB 0.1875MG

CARDIOVASCULAR AGENTS - MISC. PROSTAGLANDIN VASODILATORS

epoprostenol sodium for inj 0.5 mg SP, PA epoprostenol sodium for inj 1.5 mg SP, PA

ORENITRAM TAB 0.25MG SP, PA

ORENITRAM TAB 0.125MG SP, PA

ORENITRAM TAB 1MG SP, PA

ORENITRAM TAB 2.5MG SP, PA

ORENITRAM TAB 5MG SP, PA

REMODULIN INJ 1MG/ML SP, PA

REMODULIN INJ 2.5MG/ML SP, PA

REMODULIN INJ 5MG/ML SP, PA

REMODULIN INJ 10MG/ML SP, PA

VELETRI INJ 0.5MG SP, PA

VELETRI INJ 1.5MG SP, PA

PULMONARY HYPERTENSION - ENDOTHELIN RECEPTOR ANTAGONISTS

OPSUMIT TAB 10MG SP, QL (1 tab / 1 day), PA

PULMONARY HYPERTENSION - PHOSPHODIESTERASE INHIBITORS sildenafil citrate tab 20 mg SP, QL (3 tabs / 1 day), PA

CARDIOVASCULAR AGENTS MISC. - COMBINATIONS NEPRILYSIN INHIB (ARNI)-ANGIOTENSIN II RECEPT ANTAG COMB

ENTRESTO TAB 24-26MG ENTRESTO TAB 49-51MG ENTRESTO TAB 97-103MG

CENTRAL MUSCLE RELAXANTS

CENTRAL MUSCLE RELAXANTS baclofen tab 10 mg baclofen tab 20 mg carisoprodol tab 250 mg QL (120 tabs / 25 days) carisoprodol tab 350 mg QL (120 tabs / 25 days)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 67 AGE - Age Limit GNDR - Gender Edit

chlorzoxazone tab 500 mg

cyclobenzaprine hcl tab 5 mg cyclobenzaprine hcl tab 10 mg methocarbamol tab 500 mg methocarbamol tab 750 mg orphenadrine citrate tab er 12hr 100 mg tizanidine hcl tab 2 mg (base equivalent) tizanidine hcl tab 4 mg (base equivalent)

CEPHALOSPORINS CEPHALOSPORIN COMBINATIONS

ZERBAXA INJ 1.5GM PA

CEPHALOSPORINS - 3RD GENERATION ceftriaxone sodium for inj 1 gm ceftriaxone sodium for inj 2 gm ceftriaxone sodium for inj 250 mg ceftriaxone sodium for inj 500 mg

CEPHALOSPORINS - 1ST GENERATION CEPHALOSPORINS - 1ST GENERATION

cefadroxil cap 500 mg cefadroxil for susp 250 mg/5ml cefadroxil for susp 500 mg/5ml cefadroxil tab 1 gm cephalexin cap 250 mg cephalexin cap 500 mg cephalexin cap 750 mg cephalexin for susp 125 mg/5ml cephalexin for susp 250 mg/5ml cephalexin tab 250 mg cephalexin tab 500 mg

CEPHALOSPORINS - 2ND GENERATION CEPHALOSPORINS - 2ND GENERATION

cefprozil for susp 125 mg/5ml cefprozil for susp 250 mg/5ml cefprozil tab 250 mg cefprozil tab 500 mg

cefuroxime axetil tab 250 mg cefuroxime axetil tab 500 mg

CEPHALOSPORINS - 3RD GENERATION CEPHALOSPORINS - 3RD GENERATION

cefdinir cap 300 mg cefdinir for susp 125 mg/5ml

cefdinir for susp 250 mg/5ml

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 68 AGE - Age Limit GNDR - Gender Edit

CHEMICALS LIQUIDS

ALMOND OIL ALMOND OIL SWEET ALMOND OIL SWEET OTC

BASE G ALMON OIL SWEET

OIL-ALMOND OIL SWEET OTC

OLIVE OIL OLIVE OIL OTC QC SWEET OIL OTC

SM SWEET OIL OTC

SWEET OIL OTC

CHEMOTHERAPY RESCUE/ANTIDOTE AGENTS FOLIC ACID ANTAGONISTS RESCUE AGENTS

leucovorin calcium tab 5 mg leucovorin calcium tab 10 mg leucovorin calcium tab 15 mg leucovorin calcium tab 25 mg

CHLORINE ANTISEPTICS CHLORINE ANTISEPTICS

antiseptic sol clnsr 4% OTC antiseptic sol skin cln OTC

betasept liq 4% OTC

BIOPATCH MIS 1"/4MM OTC

BIOPATCH MIS 1"/7MM OTC

BIOPATCH MIS 3/4"/1.5 OTC

BIOPATCH PRO MIS DISK/CHG OTC

CHLOR GLUC LIQ 2% OTC

CHLORHEX GLU PAD 2% OTC

chlorhexidine gluconate liquid 4% OTC

dyna-hex 2 sol 2% OTC

hand wash sol 2% OTC

skin cleansr sol 4% OTC

TEGADERM CHG MIS DRESSING OTC

CLARITHROMYCIN CLARITHROMYCIN

clarithromycin tab 250 mg clarithromycin tab 500 mg clarithromycin tab er 24hr 500 mg

CMV AGENTS

CMV AGENTS valganciclovir hcl for soln 50 mg/ml (base equiv)

valganciclovir hcl tab 450 mg (base equivalent)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 69 AGE - Age Limit GNDR - Gender Edit

COMBINATION CONTRACEPTIVES - ORAL BIPHASIC CONTRACEPTIVES - ORAL

azurette tab 28 day QL (1 tab / 1 day) desogest-eth estrad & eth estrad tab QL (1 tab / 1 day) 0.15-0.02/0.01 mg(21/5) kariva tab 28 day QL (1 tab / 1 day)

pimtrea tab QL (1 tab / 1 day)

viorele tab QL (1 tab / 1 day)

COMBINATION CONTRACEPTIVES - ORAL altavera tab QL (1 tab / 1 day) alyacen tab 1/35 QL (1 tab / 1 day)

apri tab QL (1 tab / 1 day)

aviane tab QL (1 tab / 1 day)

balziva tab QL (1 tab / 1 day)

blisovi fe tab 1.5/30 QL (1 tab / 1 day)

blisovi fe tab 1/20 QL (1 tab / 1 day)

briellyn tab QL (1 tab / 1 day)

cryselle-28 tab 28 tabs QL (1 tab / 1 day)

cyclafem tab 1/35 QL (1 tab / 1 day)

cyred tab QL (1 tab / 1 day)

dasetta tab 1/35 QL (1 tab / 1 day)

delyla tab 0.1-0.02 QL (1 tab / 1 day)

desogestrel & ethinyl estradiol tab 0.15 mg-30 QL (1 tab / 1 day) mcg drospirenone-ethinyl estradiol tab 3-0.02 mg QL (1 tab / 1 day)

elinest tab QL (1 tab / 1 day)

emoquette tab QL (1 tab / 1 day)

estarylla tab 0.25-35 QL (1 tab / 1 day)

ethynodiol diacetate & ethinyl estradiol tab 1 QL (1 tab / 1 day) mg-50 mcg falmina tab QL (1 tab / 1 day)

femynor tab 0.25-35 QL (1 tab / 1 day)

gianvi tab 3-0.02mg QL (1 tab / 1 day)

juleber tab QL (1 tab / 1 day)

junel 1.5/30 tab QL (1 tab / 1 day)

junel 1/20 tab QL (1 tab / 1 day)

junel fe tab 1.5/30 QL (1 tab / 1 day)

junel fe tab 1/20 QL (1 tab / 1 day)

kelnor tab 1/35 QL (1 tab / 1 day)

kurvelo tab 0.15/30 QL (1 tab / 1 day)

larin fe tab 1.5/30 QL (1 tab / 1 day)

larin fe tab 1/20 QL (1 tab / 1 day)

larin tab 1.5/30 QL (1 tab / 1 day)

larin tab 1/20 QL (1 tab / 1 day)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 70 AGE - Age Limit GNDR - Gender Edit

larissia tab QL (1 tab / 1 day)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 71 AGE - Age Limit GNDR - Gender Edit

lessina tab QL (1 tab / 1 day)

levonorgestrel & ethinyl estradiol tab 0.1 mg-20 QL (1 tab / 1 day) mcg levonorgestrel & ethinyl estradiol tab 0.15 mg-30 QL (1 tab / 1 day) mcg levora-28 tab 0.15/30 QL (1 tab / 1 day)

loryna tab 3-0.02mg QL (1 tab / 1 day)

low-ogestrel tab QL (1 tab / 1 day)

lutera tab QL (1 tab / 1 day)

marlissa tab 0.15/30 QL (1 tab / 1 day)

microgestin tab 1.5/30 QL (1 tab / 1 day)

microgestin tab fe1.5/30 QL (1 tab / 1 day)

microgestin tab fe 1/20 QL (1 tab / 1 day)

mono-linyah tab 0.25-35 QL (1 tab / 1 day)

mononessa tab QL (1 tab / 1 day)

necon tab 0.5/35 QL (1 tab / 1 day)

nikki tab 3-0.02mg QL (1 tab / 1 day)

norethindrone ace & ethinyl estradiol-fe tab 1 QL (1 tab / 1 day) mg-20 mcg norgestimate & ethinyl estradiol tab 0.25 mg-35 QL (1 tab / 1 day) mcg nortrel tab 0.5/35 QL (1 tab / 1 day)

nortrel tab 1/35 QL (1 tab / 1 day)

ocella tab 3-0.03mg QL (1 tab / 1 day)

ogestrel tab QL (1 tab / 1 day)

orsythia tab QL (1 tab / 1 day)

philith tab 0.4-35 QL (1 tab / 1 day)

pirmella tab 1/35 QL (1 tab / 1 day)

portia-28 tab QL (1 tab / 1 day)

previfem tab QL (1 tab / 1 day)

reclipsen tab QL (1 tab / 1 day)

sprintec 28 tab 28 day QL (1 tab / 1 day)

syeda tab 3-0.03mg QL (1 tab / 1 day)

tarina fe tab 1/20 QL (1 tab / 1 day)

vyfemla tab 0.4-35 QL (1 tab / 1 day)

wera tab 0.5/35 QL (1 tab / 1 day)

zarah tab 3-0.03mg QL (1 tab / 1 day)

zovia 1/35e tab QL (1 tab / 1 day)

TRIPHASIC CONTRACEPTIVES - ORAL alyacen tab 7/7/7 QL (1 tab / 1 day) aranelle tab QL (1 tab / 1 day)

cyclafem tab 7/7/7 QL (1 tab / 1 day)

dasetta tab 7/7/7 QL (1 tab / 1 day)

enpresse-28 tab QL (1 tab / 1 day)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 72 AGE - Age Limit GNDR - Gender Edit

levonest tab QL (1 tab / 1 day)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 71 AGE - Age Limit GNDR - Gender Edit

levonorgestrel-eth estra tab QL (1 tab / 1 day) 0.05-30/0.075-40/0.125-30mg-mcg myzilra tab QL (1 tab / 1 day)

norgestimate-eth estrad tab QL (1 tab / 1 day) 0.18-25/0.215-25/0.25-25 mg-mcg norgestimate-eth estrad tab QL (1 tab / 1 day) 0.18-35/0.215-35/0.25-35 mg-mcg nortrel tab 7/7/7 QL (1 tab / 1 day)

pirmella tab 7/7/7 QL (1 tab / 1 day)

tri femynor tab QL (1 tab / 1 day)

tri-estaryll tab QL (1 tab / 1 day)

tri-linyah tab QL (1 tab / 1 day)

tri-lo tab estaryll QL (1 tab / 1 day)

tri-lo- tab marzia QL (1 tab / 1 day)

tri-lo- tab sprintec QL (1 tab / 1 day)

tri-sprintec tab QL (1 tab / 1 day)

velivet pak QL (1 tab / 1 day)

COMBINATION CONTRACEPTIVES - TRANSDERMAL COMBINATION CONTRACEPTIVES - TRANSDERMAL

xulane dis 150-35 QL (39 patches / 364 days)

COMBINATION CONTRACEPTIVES - VAGINAL COMBINATION CONTRACEPTIVES - VAGINAL

NUVARING MIS QL (13 rings / 364 days)

CONTRACEPTIVES COMBINATION CONTRACEPTIVES - ORAL

amethia tab QL (1 tab / 1 day) ashlyna tab QL (1 tab / 1 day)

aubra eq tab 0.1-0.02 QL (1 tab / 1 day)

aubra tab 0.1-0.02 QL (1 tab / 1 day)

bekyree tab QL (1 tab / 1 day)

camrese tab QL (1 tab / 1 day)

caziant pak QL (1 tab / 1 day)

chateal eq tab 0.15/30 QL (1 tab / 1 day)

chateal tab 0.15/30 QL (1 tab / 1 day)

cyred eq tab QL (1 tab / 1 day)

daysee tab QL (1 tab / 1 day)

drospirenone-ethinyl estradiol tab 3-0.02 mg QL (1 tab / 1 day)

drospirenone-ethinyl estradiol tab 3-0.03 mg QL (1 tab / 1 day) enskyce tab QL (1 tab / 1 day) ethynodiol diacetate & ethinyl estradiol tab 1 QL (1 tab / 1 day)

mg-35 mcg isibloom tab QL (1 tab / 1 day)

kelnor 1/50 tab QL (1 tab / 1 day)

leena tab QL (1 tab / 1 day)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 72 AGE - Age Limit GNDR - Gender Edit

levonorg-eth est tab 0.15-0.03mg(84) & eth est QL (1 tab / 1 day) tab 0.01mg(7) lillow tab 0.15/30 QL (1 tab / 1 day)

microgestin tab 1/20 QL (1 tab / 1 day)

mili tab 0.25/35 QL (1 tab / 1 day)

norethindrone ace & ethinyl estradiol tab 1 mg-20 QL (1 tab / 1 day) mcg sronyx tab QL (1 tab / 1 day)

tarina fe tab 1/20 eq QL (1 tab / 1 day)

tri-mili tab QL (1 tab / 1 day)

tri-previfem tab QL (1 tab / 1 day)

tri-vylibra tab QL (1 tab / 1 day)

trivora-28 tab QL (1 tab / 1 day)

vienva tab 0.1-20 QL (1 tab / 1 day)

vylibra tab 0.25-35 QL (1 tab / 1 day)

CONDOMS - MALE AIMSCO MIS LUBRICAT OTC, QL (12 12 boxeacesh / 1 day) COLOR CONDOM MIS + LUBE OTC, QL (12 12 boxeacesh / 1 day) CONDOMS MIS OTC, QL (12 12 boxeacesh / 1 day) CONDOMS MIS LUBRICAT OTC, QL (12 12 eac boxesh / 1 day) DUREX EXTRA MIS SENSITIV OTC, QL (12 each / 1 day) FANTASY LUBR MIS COLORS OTC, QL (12 12 eac boxesh / 1 day) FANTASY LUBR MIS SPERMICI OTC, QL (12 12 eac boxhes / 1 day) FANTASY MIS LUBRICAT OTC, QL (12 12 eac boxesh / 1 day) KAMELEON LUB MIS COLORS OTC, QL (12 12 boxeacesh / 1 day) KAMELEON MIS TRI-COLR OTC, QL (12 12 boxeacesh / 1 day) KIMONO COLOR MIS OTC, QL (12 each / 1 day) KIMONO MICRO MIS THIN OTC, QL (1212 eacboxhes / 1 day) KIMONO MICRO MIS THIN + OTC, QL (1212 eacboxhes / 1 day) KIMONO MICRO MIS THIN PLS OTC, QL (12 each / 1 day) KIMONO MIS LUBRICAT OTC, QL (1212 eacboxhes / 1 day) KIMONO PLUS MIS LUBRICAT OTC, QL (1212 eacboxhes / 1 day) KIMONO PLUS MIS SPERMICI OTC, QL (1212 eacboxhes / 1 day) KIMONO PS MIS LUBRICAT OTC, QL (12 each / 1 day) KIMONO PS MIS PLUS OTC, QL (12 each / 1 day)

KIMONO SPEC MIS OTC, QL (12 each / 1 day)

LIFESTYLES MIS EXT STR OTC, QL (1212 eacboxhes / 1 day) LIFESTYLES MIS FORM FIT OTC, QL (1212 eacboxhes / 1 day) LIFESTYLES MIS LUBRICAT OTC, QL (1212 eacboxhes / 1 day) LIFESTYLES MIS RIBBED OTC, QL (1212 eacboxhes / 1 day) LIFESTYLES MIS SKYN OTC, QL (1212 eacboxhes / 1 day) LIFESTYLES MIS STUDDED OTC, QL (1212 eacboxhes / 1 day) LIFESTYLES MIS VIBRA-RI OTC, QL (1212 eacboxhes / 1 day) LIFESTYLES MIS XPLEASUR OTC, QL (1212 eacboxhes / 1 day) MAXX MIS LUBRICAT OTC, QL (1212 eacboxhes / 1 day)

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QL - Quantity Limits ST - Step Therapy SP - Specialty 73 AGE - Age Limit GNDR - Gender Edit

NATURAL COND MIS + LUBE OTC, QL (1212 eacboxhes / 1 day) REALITY MIS LUBRICAT OTC, QL (1212 eacboxhes / 1 day) REALITY ULTR MIS TEXTURED OTC, QL (12 each / 1 day) REALITY ULTR MIS THIN OTC, QL (12 each / 1 day)

TRUSTEX LUBR MIS ASSORTED OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS BANANA OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS CHOC OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS COLA OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS COLORS OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS EX LARGE OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS EX STR OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS GRAPE OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS MINT OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS RIB/STUD OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS SPERMICI OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS STRWBRY OTC, QL (1212 eacboxhes / 1 day) TRUSTEX LUBR MIS VANILLA OTC, QL (1212 eacboxhes / 1 day) TRUSTEX MIS BANANA OTC, QL (1212 eacboxhes / 1 day) TRUSTEX MIS CHOCOLAT OTC, QL (1212 eacboxhes / 1 day) TRUSTEX MIS FLAVORS OTC, QL (1212 eacboxhes / 1 day) TRUSTEX MIS MINT OTC, QL (1212 eacboxhes / 1 day) TRUSTEX MIS STRWBRY OTC, QL (12 12 eac boxhes / 1 day) TRUSTEX MIS VANILLA OTC, QL (12 12 eac boxhes / 1 day) TRUSTEX/RIA MIS LUBRICAT OTC, QL (12 12 eac boxhes / 1 day) TRUSTEX/RIA MIS NON-LUB OTC, QL (12 12 eac boxesh / 1 day) TRUSTEX/RIA MIS SPERMICI OTC, QL (12 12 boxeacesh / 1 day) TRUSTX NON-9 MIS RIB/STUD OTC, QL (12 12 boxeacesh / 1 day)

COPPER CONTRACEPTIVES - IUD PARAGARD IUD T380A QL (1 IUD in lifetime)

DIAPHRAGMS OMNIFLEX DPR QL (1 each / year)

EMERGENCY CONTRACEPTIVES econtra ez tab 1.5mg OTC, QL (1 tab / 30 days) econtra os tab 1.5mg OTC, QL (1 tab / 30 days)

my choice tab 1.5mg OTC, QL (1 tab / 30 days)

new day tab 1.5mg OTC, QL (1 tab / 30 days)

PROGESTIN CONTRACEPTIVES - INJECTABLE medroxyprogesterone acetate im susp 150 mg/ml QL (5 injections / 364 days) medroxyprogesterone acetate im susp prefilled syr QL (5 injections / 364 days) 150 mg/ml

PROGESTIN CONTRACEPTIVES - ORAL camila tab 0.35mg QL (1 tab / 1 day) errin tab 0.35mg QL (1 tab / 1 day)

incassia tab 0.35mg QL (1 tab / 1 day)

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 74 AGE - Age Limit GNDR - Gender Edit

lyza tab 0.35mg QL (1 tab / 1 day)

tulana tab 0.35mg QL (1 tab / 1 day)

CORTICOSTEROIDS GLUCOCORTICOSTEROIDS

budesonide delayed release particles cap 3 mg decadron elx 0.5/5ml decadron tab 0.5mg decadron tab 0.75mg decadron tab 4mg decadron tab 6mg

CORTICOSTEROIDS - TOPICAL

CORTICOSTEROIDS - TOPICAL ala-cort cre 1% ala-cort cre 2.5%

alclometasone dipropionate cream 0.05% QL (120 gm / 25 days)

alclometasone dipropionate oint 0.05% QL (120 gm / 25 days) anti-itch cre 1% OTC anti-itch cre 1%pls 10 OTC anti-itch cre /aloe/e OTC

anti-itch cre /oatmeal OTC

anti-itch lot 1% OTC

anti-itch oin 1% OTC

aquanil hc lot 1% OTC

aveeno cre 1% OTC

beta hc lot 1% OTC

betamethasone dipropionate augmented cream QL (120 gm / 25 days) 0.05% betamethasone dipropionate augmented gel QL (120 gm / 25 days) 0.05% betamethasone dipropionate cream 0.05% QL (120 gm / 25 days)

betamethasone dipropionate lotion 0.05% QL (120 mL / 25 days) betamethasone dipropionate oint 0.05% QL (120 gm / 25 days) betamethasone valerate lotion 0.1% (base QL (120 mL / 25 days)

equivalent) betamethasone valerate oint 0.1% (base QL (120 gm / 25 days) equivalent) cort intense cre heal 1% OTC

cortaid cre 1% OTC

cortisone cre 1% OTC

cortizone-10 gel 1% OTC

cortizone-10 lot diab/1% OTC

cortizone-10 lot eczema OTC

cortizone-10 lot hydraten OTC

cortizone-10 oin 1% OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 75 AGE - Age Limit GNDR - Gender Edit

dermarest lot 1% OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 76 AGE - Age Limit GNDR - Gender Edit

desonide lotion 0.05% QL (120 mL / 25 days)

desoximetasone cream 0.05% QL (120 gm / 25 days)

desoximetasone gel 0.05% QL (120 gm / 25 days)

desoximetasone oint 0.25% QL (120 gm / 25 days)

diflorasone diacetate oint 0.05% QL (120 gm / 25 days)

eq hydrocort cre 1% OTC

fluocinolone acetonide cream 0.025% QL (120 gm / 25 days) fluocinolone acetonide oint 0.025% QL (120 gm / 25 days) fluocinolone acetonide soln 0.01% fluocinonide cream 0.05% QL (120 gm / 25 days)

fluocinonide soln 0.05%

fluticasone propionate cream 0.05% QL (120 gm / 25 days)

fluticasone propionate oint 0.005% QL (120 gm / 25 days)

gnp hydrocor cre 1% plus OTC

gynecort 10 cre 1% OTC

halobetasol propionate cream 0.05% QL (120 gm / 25 days)

hydrocort cre 1% OTC

hydrocort cre 1% plus OTC

hydrocort cre plus 1% OTC

hydrocort oin 1% OTC

hydrocortisone butyrate cream 0.1% QL (120 gm / 25 days) hydrocortisone butyrate oint 0.1% QL (120 gm / 25 days) hydrocortisone butyrate soln 0.1% hydrocortisone cream 0.5% OTC

hydrocortisone cream 1%

hydrocortisone cream 1% OTC

hydrocortisone cream 2.5%

hydrocortisone lotion 1% OTC

hydrocortisone lotion 2.5%

hydrocortisone oint 0.5% OTC

hydrocortisone oint 1%

hydrocortisone oint 2.5%

hydrocortisone valerate cream 0.2% QL (120 gm / 25 days)

hydrocortisone valerate oint 0.2% QL (120 gm / 25 days)

hydrocream cre 1% OTC

hydroskin lot 1% OTC

instacort 5 cre 0.5% OTC

kericort 10 cre 1% OTC

lanacort 10 cre 1% OTC

mg217 gel 1% OTC

mometasone furoate cream 0.1% QL (120 gm / 25 days)

mometasone furoate oint 0.1% QL (120 gm / 25 days)

mometasone furoate solution 0.1% (lotion)

noble formul cre hc 1% OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 77 AGE - Age Limit GNDR - Gender Edit

noble formul spr 1% OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 76 AGE - Age Limit GNDR - Gender Edit

prep h hc cre 1% OTC

PSORCON CRE 0.05% QL (120 gm / 25 days)

qc hydrocort cre 1% OTC

ra anti-itch cre 1% OTC

ra anti-itch oin 1% OTC

ra anti-itch spr 1% OTC

ra hydrocort cre 1% OTC

ra hydrocort cre 1%pls 12 OTC

recort plus cre 1% OTC

sarnol-hc lot 1% OTC

sb hydrocort cre 1% OTC

sb hydrocort oin 1% OTC

scalp relief sol 1% OTC

scalpicin sol 1% OTC

sm hydrocort cre 1% OTC

sm hydrocort oin 1% OTC

triamcinolone acetonide cream 0.1%

triamcinolone acetonide cream 0.5% triamcinolone acetonide cream 0.025% triamcinolone acetonide lotion 0.1% triamcinolone acetonide lotion 0.025% triamcinolone acetonide oint 0.1% triamcinolone acetonide oint 0.5% triamcinolone acetonide oint 0.025% triderm cre 0.1%

TOPICAL STEROID COMBINATIONS anti-itch/ cre aloe OTC cortizone-10 cre /aloe 1% OTC

cortizone-10 cre healing OTC

cortizone-10 cre plus OTC

hm hydrocort cre 1% plus OTC

hydrocort/ cre aloe 1% OTC

kls hydrocrt cre pls 1% OTC

ra hydrocort cre 1% OTC

sm hydrocort cre 1% plus OTC

OUGH/COLD/ALLERGY COUGH/COLD/ALLERGY COMBINATIONS

allerclear d tab 10-240mg OTC allergy relf tab 5-120mg OTC

allrgy relf tab 5-120mg OTC

cgh cong dm liq 5-100/5 OTC

cough/chest liq 20-400 OTC

cough/chest liq dm child OTC

cough/chest syp dm OTC

C

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 77 AGE - Age Limit GNDR - Gender Edit

diabetic tus liq children OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 78 AGE - Age Limit GNDR - Gender Edit

giltuss cgh liq & chest OTC

guaifenesin-codeine soln 100-10 mg/5ml OTC

medi-tuss dm liq dbl str OTC

muc/cgh relf liq 5-100mg OTC

mucus relief tab 30-600er OTC

mucus relief tab 60-600mg OTC

mucus rlf dm tab 30-600er OTC

promethazine w/ codeine syrup 6.25-10 mg/5ml robafen ac sol 100-10/5 OTC robafen dm liq cough OTC tussin dm cg liq 20-400 OTC

tussin dm liq 10-100/5 OTC

tussin dm liq 10-100mg OTC

tussin dm liq 10-200mg OTC

EXPECTORANTS chest conges liq 100/5ml OTC cvs mucus tab 1200 er OTC

gnp mucus er tab 600mg OTC

gnp mucus er tab 1200mg OTC

mucus relief liq 400/20ml OTC

mucus relief tab 600mg OTC

mucus relief tab 600mg er OTC

mucus relief tab 1200mg OTC

mucus+chst liq 200/10ml OTC

pharbinex tab 400mg OTC

robafen liq 200/10ml OTC

COUGH/COLD/ALLERGY COMBINATIONS ANTITUSSIVE-EXPECTORANT

altarussn dm syp 100-10/5 OTC biocotron liq 100-10/5 OTC

cheratussin syp ac OTC

childrens liq 5-100mg OTC

CODITUSSIN LIQ AC OTC

cong/cough liq 5-100/5 OTC

cough child liq 5-100/5 OTC

cough cont liq dm max OTC

delsym cough liq congs dm OTC

dextromethorphan-guaifenesin syrup 10-100 OTC mg/5ml diabetic tus liq children OTC

diabetic tus liq dm OTC

diabetic tus liq max st OTC

dm max adult liq 20-400 OTC

eq tussin dm liq max OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 79 AGE - Age Limit GNDR - Gender Edit

eq tussin dm syp cgh/chst OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 80 AGE - Age Limit GNDR - Gender Edit

eql mucus-dm tab 30-600cr OTC

eql mucus-dm tab 60-1200 OTC

eql tussin liq 10-200 OTC

eql tussin syp dm OTC

extra action syp 100-10/5 OTC

g tussin ac liq 100-10/5 OTC

geri-tussin syp dm OTC

gnp mucus liq rlf dm OTC

gnp tussin liq dm OTC

gnp tussin liq dm cough OTC

gnp tussin liq dm max OTC

guaiasorb dm liq 100-10/5 OTC

guaiatussin syp 100-10/5 OTC

guaicon dms syp 100-10/5 OTC

guaifenesin syp 100-10/5 OTC

guaifenesin-codeine soln 100-10 mg/5ml OTC hm tussin liq adlt dm OTC hm tussin liq dm max OTC intense coug liq reliever OTC

m-clear wc liq 100-6.3 OTC

medi-tuss dm liq dbl str OTC

medi-tussin syp dm OTC

MUCINEX CGH GRA 5-100MG OTC

mucinex cgh liq 5-100mg OTC

mucinex dm liq 20-400 OTC

mucus rel dm liq 5-100/5 OTC

mucus relief liq 5-100mg OTC

mucus relief tab 60-1200 OTC

mucus rlf dm liq 5-100/5 OTC

mucus-dm max tab 60-1200 OTC

mucus-dm tab 30-600mg OTC

neotuss liq OTC

ped formula liq 100-10/5 OTC

px tussin dm liq 100-10/5 OTC

ra tussin dm liq 100-10/5 OTC

ra tussin liq dm max OTC

recofen "d" liq 5-100mg OTC

robafen dm liq 10-100/5 OTC

robafen dm syp 100-10/5 OTC

robitussin liq OTC

robitussin liq 20-400 OTC

robitussin liq cgh/cong OTC

robitussin liq to go dm OTC

safe tussin liq 10-100/5 OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 81 AGE - Age Limit GNDR - Gender Edit

sb cgh contr liq dm OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 82 AGE - Age Limit GNDR - Gender Edit

siltussin dm liq das OTC

siltussin-dm liq diabetic OTC

siltussin-dm liq max st OTC

siltussin-dm syp alc free OTC

sm tussin dm liq max OTC

sm tussin dm syp 100-10/5 OTC

sm tussin syp dm OTC

sorbugen nr liq OTC

tgt cough liq form dm OTC

tusnel diabt liq 10-100/5 OTC

tussin adult liq cgh/cong OTC

tussin cough liq 10-100/5 OTC

tussin dm liq OTC

tussin dm liq 100-10/5 OTC

tussin dm liq max OTC

tussin dm mx liq 10-200/5 OTC

tussin dm syp 100-10/5 OTC

vcks dayquil liq mucus dm OTC

virtussin ac sol 100-10/5 OTC

wal-tussin liq 10-100/5 OTC

wal-tussin liq dm OTC

wal-tussin liq dm max OTC

wal-tussin syp dm OTC

ANTITUSSIVE-EXPECTORANTS-DECONGESTANT sm tussin cf liq OTC TUSNEL C SYP OTC

virtussin sol dac OTC

wal-tussin liq cf OTC

DECONGESTANT & ANTIHISTAMINE alavert alrg tab /sinus OTC all day alrg tab 5-120mg OTC

aller-tec d tab 5-120mg OTC

aller/conges tab 10-240mg OTC

allerclear d tab 5-120mg OTC

allergy d tab 5-120mg OTC

allergy d tab 60-120mg OTC

allergy rel/ tab deconges OTC

allergy relf tab 5-120mg OTC

allergy relf tab /nsl dec OTC

allergy relf tab d OTC

allergy relf tab d12 OTC

allergy relf tab d 24 hr OTC

allergy relf tab d-24 OTC

allergy relf tab deconges OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 83 AGE - Age Limit GNDR - Gender Edit

allergy+ con tab 5-120mg OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 80 AGE - Age Limit GNDR - Gender Edit

allergy+cong tab relief-d OTC

allergy-d tab 5-120mg OTC

allergy-d tab 12 hour OTC

allergy-d tab 60-120mg OTC

allergy/cong tab 5-120mg OTC

allgy comp-d tab 5-120mg OTC

allrgy rel d tab 10-240mg OTC

allrgy rlf-d tab 5-120mg OTC

allrgy rlf-d tab 10-240mg OTC

cetirizine-pseudoephedrine tab er 12hr 5-120 mg OTC cold/allergy elx children OTC ENTRE-HIST LIQ 0.938-10 OTC

eql allergy tab 10-240mg OTC

fexofenadine-pseudoephedrine tab er 12hr 60-120

mg fexofenadine-pseudoephedrine tab er 12hr 60-120 OTC

mg fexofenadine-pseudoephedrine tab er 24hr OTC

180-240 mg lorata-dine tab d 24hr OTC

loratadine d tab 5-120mg OTC

loratadine-d tab 5-120mg OTC

loratadine-d tab 10-240mg OTC

promethazine & phenylephrine syrup 6.25-5

mg/5ml ra cetiri-d tab 5-120mg OTC

ra lorata-d tab 24 hour OTC

rynex pse liq OTC

tgt allergy/ tab congest OTC

wal-fex d tab 12 hour OTC

wal-fex d tab 24 hour OTC

wal-itin d tab 5-120mg OTC

wal-itin d tab 10-240mg OTC

wal-itin d tab 24 hour OTC

wal-tap elx cld/alle OTC

wal-zyr d tab 5-120mg OTC

DECONGESTANT W/ EXPECTORANT altarussin syp -pe OTC cvs mucus d tab 60-600mg OTC

gnp mucus d tab 12hr OTC

mucus d tab 60-600mg OTC

mucus d tab 120/1200 OTC

mucus relf d tab 60-600mg OTC

mucus rlf d tab 60-600mg OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 81 AGE - Age Limit GNDR - Gender Edit

mucus rlf d tab 120-1200 OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 82 AGE - Age Limit GNDR - Gender Edit

pseudoephedrine-guaifenesin tab er 12hr 60-600 OTC mg

NON-NARC ANTITUSSIVE-ANTIHISTAMINE promethazine-dm syrup 6.25-15 mg/5ml

NON-NARC ANTITUSSIVE-DECONGESTANT-ANTIHISTAMINE bromfed dm syp BROTAPP DM LIQ 15-1-5/5 OTC

pseudoephed-bromphen-dm syrup 30-2-10

mg/5ml

OPIOID ANTITUSSIVE-ANTIHISTAMINE promethazine w/ codeine syrup 6.25-10 mg/5ml

OPIOID ANTITUSSIVE-DECONGESTANT-ANTIHISTAMINE promethazine-phenylephrine-codeine syrup 6.25-5-10 mg/5ml

COUMARIN ANTICOAGULANTS COUMARIN ANTICOAGULANTS

jantoven tab 1mg jantoven tab 2.5mg jantoven tab 2mg jantoven tab 3mg jantoven tab 4mg jantoven tab 5mg jantoven tab 6mg jantoven tab 7.5mg jantoven tab 10mg warfarin sodium tab 1 mg warfarin sodium tab 2 mg warfarin sodium tab 2.5 mg

warfarin sodium tab 3 mg warfarin sodium tab 4 mg warfarin sodium tab 5 mg warfarin sodium tab 6 mg warfarin sodium tab 7.5 mg warfarin sodium tab 10 mg

CYSTIC FIBROSIS AGENTS CFTR POTENTIATORS

KALYDECO PAK 50MG SP, QL (2 packets / 1 day), PA

KALYDECO PAK 75MG SP, QL (2 packets / 1 day),

PA KALYDECO TAB 150MG SP, QL (2 tabs / 1 day), PA

CYSTIC FIBROSIS AGENT - COMBINATIONS ORKAMBI TAB 100-125 SP, QL (4 tabs / 1 day), PA ORKAMBI TAB 200-125 SP, QL (4 tabs / 1 day), PA

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 82 AGE - Age Limit GNDR - Gender Edit

HYDROLYTIC ENZYMES PULMOZYME SOL 1MG/ML SP, QL (5 mL / 1 day), PA

DENTAL PRODUCTS FLUORIDE DENTAL PRODUCTS

cavarest gel 1.1% clinpro 5000 pst 1.1%

denta 5000 cre plus denta 5000 cre plus 2pk dentagel gel 1.1% fluoridex pst 1.1%

prevident sol 0.2%

sf 5000 plus cre 1.1%

sf gel 1.1%

sod fluoride sol 0.2%

DERMATOLOGICALS ACNE PRODUCTS

claravis cap 20mg PA claravis cap 30mg PA

claravis cap 40mg PA

isotretinoin cap 10 mg PA

isotretinoin cap 20 mg PA

isotretinoin cap 30 mg PA

isotretinoin cap 40 mg PA

ANTIBIOTICS - TOPICAL BACITRACIN POW curad triple oin antibiot OTC

double oin antibiot OTC

GENTAMICIN POW SULFATE

NEOMYCIN POW SULFATE TETRACYCLINE POW triple antib oin frst aid OTC

ANTIFUNGALS - TOPICAL anti-fungal pow 2% OTC antifungal cre 1% OTC

antifungal cre foot OTC

athlete foot cre 1% OTC

blis-to-sol liq 1% OTC

cavilon cre 2% OTC

CICLOPIROX POW OLAMINE

CLIOQUINOL POW CLIOQUINOL POW OTC

clotrimazole cre 1% OTC

clotrimazole cream 1% OTC

CLOTRIMAZOLE CRY

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 83 AGE - Age Limit GNDR - Gender Edit

CLOTRIMAZOLE POW

clotrimazole soln 1% OTC

dr gs clear sol nail 1% OTC

jock itch cre 1% OTC

MICONAZOLE POW NITRATE

ANTIPSORIATICS COSENTYX INJ 150MG/ML SP, QL (1.2 syringes / 30

days), ST COSENTYX INJ 300DOSE SP, QL (2.4 syringes / 30

days), ST COSENTYX PEN INJ 150MG/ML SP, QL (1.2 pens / 30 days),

ST COSENTYX PEN INJ 300DOSE SP, QL (2.4 pens / 30 days),

ST SILIQ INJ 210/1.5 SP, QL (2.2 syringes / 30

days), PA

CORTICOSTEROIDS - TOPICAL anti-itch cre 1% OTC anti-itch oin 1% OTC

betamethasone dipropionate augmented lotion QL (120 mL / 25 days) 0.05% betamethasone dipropionate augmented oint QL (120 gm / 25 days) 0.05% betamethasone valerate cream 0.1% (base QL (120 gm / 25 days) equivalent) cortisone gel 1% OTC

cortisone lot 1% OTC

cortisone oin 1% OTC

cortizone-10 lot hydraten OTC

cortizone-10 oin 1% OTC

curad hydro cre 1% OTC

desonide cream 0.05% QL (120 gm / 25 days)

desonide lotion 0.05% QL (120 mL / 25 days)

desonide oint 0.05% QL (120 gm / 25 days)

desoximetasone cream 0.25% QL (120 gm / 25 days)

diflorasone diacetate cream 0.05% QL (120 gm / 25 days)

eq 1% hydroc cre OTC

fluocinonide gel 0.05% QL (120 gm / 25 days)

fluocinonide oint 0.05% QL (120 gm / 25 days)

gnp hydrocor cre 1% plus OTC

halobetasol propionate oint 0.05% QL (120 gm / 25 days)

hm hydrocort cre 1% plus OTC

hydrocort cre 1% OTC

hydrocort oin 1% OTC

hydrocort/ cre aloe 1% OTC

hydrocortisone cream 1% OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 84 AGE - Age Limit GNDR - Gender Edit

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 84 AGE - Age Limit GNDR - Gender Edit

hydrocortisone oint 1% OTC

hydrocortisone-aloe vera cream 1% OTC

kls hydrocrt cre pls 1% OTC

lanacort 10 cre 1% OTC

qc hydrocort cre 1% OTC

sm hydrocort cre 1% OTC

sm hydrocort cre 1% plus OTC

sm hydrocort oin 1% OTC

triderm cre 0.5%

DIAPER RASH PRODUCTS A+D DIAPER CRE RASH OTC BENSONS CRE BOTTOM OTC

HINEY HEALER CRE OTC

paladin oin OTC

pinxav oin OTC

RASH AWAY AER OTC

EMOLLIENT/KERATOLYTIC AGENTS gordons urea cre 40% OTC uremez-40 cre 40%

EMOLLIENTS al12 lot 12% OTC lactic acid (ammonium lactate) cream 12% OTC

lactic acid (ammonium lactate) lotion 12% OTC

SCABICIDES & PEDICULICIDES bedding spra aer 0.5% OTC lice bedding aer 0.5% OTC

sm bedding aer lice OTC

DIABETIC SUPPLIES GLUCOSE MONITORING TEST SUPPLIES

ACCU-CHEK MIS MLTICLIX OTC ACTI-LANCE MIS 28G OTC

ACTI-LANCE MIS LITE 28G OTC

ACTI-LANCE MIS SPEC 17G OTC

ACTI-LANCE MIS UNIV 23G OTC

ADV TRAVEL MIS LANC 28G OTC

ADVCATE SAFE MIS LANC 26G OTC

ADVOCATE MIS LANC 30G OTC

ADVOCATE MIS LANCETS OTC

AGAMATRIX MIS 33G OTC

AQUALANCE MIS 30G OTC

ASSURE CMFRT MIS 28G OTC

ASSURE LANCE MIS 21G OTC

ASSURE LANCE MIS LOW FLOW OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 85 AGE - Age Limit GNDR - Gender Edit

ASSURE LANCE MIS MICRO OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 86 AGE - Age Limit GNDR - Gender Edit

ASSURE LANCE MIS SAFE 25G OTC

ASSURE LANCE MIS SAFE 30G OTC

ASSURE MIS LANCETS OTC

ASSURE PLUS MIS HIGH 18G OTC

ASSURE PLUS MIS LOW 25G OTC

ASSURE PLUS MIS MCRO 28G OTC

ASSURE PLUS MIS NORM 21G OTC

ASSURE PLUS MIS PEDIATRI OTC

AURORA LANCE MIS 30G OTC

AURORA LANCE MIS THIN 23G OTC

AUTO LANCET MIS OTC

BAYER MICRLT MIS LANCETS OTC

BD LANCET UF MIS 30G OTC

BD LANCET UF MIS 33G OTC

BD MICROTAIN MIS LANCETS OTC

BULLSEYE MIS LANCETS OTC

BULLSEYE MIS MINI LNC OTC

CAREONE LANC MIS 28G OTC

CAREONE LANC MIS THIN 23G OTC

CARETOUCH MIS TWIST 28 OTC

CARETOUCH MIS TWIST 30 OTC

CLEANLET 28G MIS LANCETS OTC

CLEVER CHECK MIS OTC

CLEVER CHECK MIS 30G OTC

COAGUCHEK MIS LANCETS OTC

COMFORT ASSU MIS LANC 28G OTC

COMFORT ASSU MIS LANC 33G OTC

COMFORT MIS LANCETS OTC

COMFORTOUCH MIS LANCET OTC

CVS LANCETS MIS 21G OTC

CVS LANCETS MIS 30G OTC

CVS LANCETS MIS 33G OTC

CVS LANCETS MIS ORIGINAL OTC

CVS LANCETS MIS THIN 26G OTC

CVS LANCETS MIS THIN 30G OTC

CVS LANCETS MIS THIN 33G OTC

DROPLET LANC MIS 30G OTC

E-Z JECT MIS 21G OTC

E-Z JECT MIS 21G COLR OTC

E-Z JECT MIS 30G OTC

E-Z JECT MIS 32G COLR OTC

E-Z JECT MIS LANC 21G OTC

E-Z JECT MIS THIN 26G OTC

E-ZJECT LANC MIS 33G OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 87 AGE - Age Limit GNDR - Gender Edit

EASY COMFORT MIS 30G OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 88 AGE - Age Limit GNDR - Gender Edit

EASY COMFORT MIS LANC/30G OTC

EASY TOUCH MIS LANC/21G OTC

EASY TOUCH MIS LANC/23G OTC

EASY TOUCH MIS LANC/26G OTC

EASY TOUCH MIS LANC/28G OTC

EASY TOUCH MIS LANC/30G OTC

EASY TOUCH MIS LANC/32G OTC

EASY TOUCH MIS LANC/33G OTC

EMBRACE LANC MIS THIN 30G OTC

EQL LANCETS MIS 21G COLR OTC

EQL LANCETS MIS 33G COLR OTC

EQL LANCETS MIS THIN 26G OTC

EQL LANCETS MIS THIN 30G OTC

EZ SMART MIS LANCETS OTC

EZ-LETS 21G MIS LANCETS OTC

EZ-LETS 23G MIS LANCETS OTC

EZ-LETS 26G MIS LANCETS OTC

EZ-LETS 28G MIS LANCETS OTC

EZ-LETS 30G MIS LANCETS OTC

FASTCLIX MIS LANCETS OTC

FIFTY50 SAFE MIS LANCETS OTC

FINE 30 MIS OTC

FINGERSTIX MIS LANCETS OTC

FORA LANCETS MIS 30G OTC

FORA MIS LANCETS OTC

FREESTYLE MIS LANCETS OTC

FREESTYLE MIS UNISTICK OTC

GENTLE-LET MIS 26G OTC

GENTLE-LET MIS 28G OTC

GENTLE-LET MIS LANCETS OTC

GLOBAL 28G MIS LANCETS OTC

GLOBAL 30G MIS LANCETS OTC

GLUCOCOM MIS 28G OTC

GLUCOCOM MIS 30G OTC

GLUCOCOM MIS 33G OTC

GNP LANCETS MIS OTC

GNP LANCETS MIS 21G OTC

GNP LANCETS MIS MICRO OTC

GNP LANCETS MIS SUP THIN OTC

GNP LANCETS MIS THIN OTC

GNP LANCETS MIS THIN 26G OTC

GOODSENSE MIS LANC 30G OTC

HAEMOLANCE MIS HIGH FLO OTC

HAEMOLANCE MIS LOW FLOW OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 89 AGE - Age Limit GNDR - Gender Edit

HAEMOLANCE MIS PLUS OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 90 AGE - Age Limit GNDR - Gender Edit

HAEMOLANCE MIS PLUS LOW OTC

HAEMOLANCE MIS PLUS MAX OTC

HAEMOLANCE MIS PLUS PED OTC

HAEMOLANCE MIS RETRACT OTC

HLTHY ACCNTS MIS LANC 30G OTC

IN TOUCH LAN MIS 30G OTC

INCONTROL MIS LANC 28G OTC

INCONTROL MIS LANC 30G OTC

INCONTROL MIS LANC 33G OTC

KINNEY MIS LANCETS OTC

KINNEY THIN MIS LANCETS OTC

KROGER LANCE MIS OTC

KROGER LANCE MIS THIN OTC

KROGER LANCE MIS THIN 30G OTC

LANCET MICRO MIS THIN 33G OTC

LANCET STAND MIS 21G OTC

LANCET SUPER MIS THIN 30G OTC

LANCET ULTRA MIS 28G OTC

LANCET ULTRA MIS FINE OTC

LANCET ULTRA MIS THIN 30G OTC

LANCETS MICR MIS THIN 33G OTC

LANCETS MIS OTC

LANCETS MIS 21G OTC

LANCETS MIS 21G COLR OTC

LANCETS MIS 26G OTC

LANCETS MIS 28G OTC

LANCETS MIS 30G OTC

LANCETS MIS 31G OTC

LANCETS MIS 33G OTC

LANCETS MIS ORANGE OTC

LANCETS MIS ORIGINAL OTC

LANCETS MIS THIN OTC

LANCETS MIS THIN 26G OTC

LANCETS MIS THIN 30G OTC

LANCETS SUPR MIS THIN 28G OTC

LANCETS THIN MIS OTC

LANCETS THIN MIS 26G OTC

LANCETS ULTR MIS THIN OTC

LB LANCET MIS 28G OTC

LIFESCAN MIS UNISTIK2 OTC

LITE TOUCH MIS LANCETS OTC

LITETOUCH MIS LANCETS OTC

LONGS LANCET MIS STANDARD OTC

LONGS LANCET MIS THIN OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 91 AGE - Age Limit GNDR - Gender Edit

LONGS LANCET MIS ULTRA TH OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 92 AGE - Age Limit GNDR - Gender Edit

MEDICHOICE MIS LANCET OTC

MEDLANCE MIS 30G PLUS OTC

MEDLANCE MIS EXTR 21G OTC

MEDLANCE MIS LITE 25G OTC

MEDLANCE MIS PLUS OTC

MEDLANCE MIS PLUS 30G OTC

MEDLANCE MIS UNV 21G OTC

MEDLANCE PLS MIS 0.8MM OTC

MEDLANCE PLS MIS EXTR 21G OTC

MEDLANCE PLS MIS LITE 25G OTC

MEDLANCE PLS MIS UNIV 21G OTC

MEIJER LANCE MIS COLOR OTC

MEIJER LANCE MIS UNIV 21G OTC

MEIJER LANCE MIS UNIV 30G OTC

MEIJER LANCE MIS UNIVERSA OTC

MEIJER MIS LANCETS OTC

MICRO THIN MIS LANC 33G OTC

MICROLET MIS LANCETS OTC

MICROTAINER MIS LANCET OTC

MONOLET MIS LANCETS OTC

MONOLET OPD MIS LANCETS OTC

MONOLETTOR MIS LANCETS OTC

MYGLUCOHEALT MIS LANC 30G OTC

NOVA SAFETY MIS LANC 23G OTC

NOVA SAFETY MIS LANC 28G OTC

NOVA SURE MIS LANCETS OTC

ON CALL MIS LANCETS OTC

ON CALL PLUS MIS LANCETS OTC

ON-THE-GO MIS LANC 30G OTC

ONETOUCH FP MIS LANCETS OTC

ONETOUCH KIT ULT MINI OTC

ONETOUCH KIT ULTRA 2 OTC

ONETOUCH KIT VERIO OTC

ONETOUCH KIT VERIO FL OTC

ONETOUCH KIT VERIO IQ OTC

ONETOUCH MIS 30G OTC

ONETOUCH MIS COMBO OTC

ONETOUCH MIS LANCETS OTC

ONETOUCH US MIS LANCETS OTC

ONETOUCH VER KIT SYNC OTC

PC LANCETS MIS 30G OTC

PERFECT 28G MIS LANCETS OTC

PERFECT 30G MIS LANCETS OTC

PHARMACY COU MIS LANCETS OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 93 AGE - Age Limit GNDR - Gender Edit

PRESSURE ACT MIS LANCET OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 94 AGE - Age Limit GNDR - Gender Edit

PRESSURE ACT MIS LANCETS OTC

PRO COMFORT MIS 31G OTC

PRO COMFORT MIS LANCETS OTC

PRODIGY MIS 26G OTC

PRODIGY MIS 28G OTC

PSS SAFE LAN MIS OTC

PSS SEL LANC MIS OTC

PX LANCETS MIS 28G OTC

QC LANCETS MIS 28G OTC

QC LANCETS MIS 30G OTC

RA E-ZJECT MIS 28G OTC

RA E-ZJECT MIS 33G OTC

RA E-ZJECT MIS THIN 26G OTC

RA E-ZJECT MIS THIN 28G OTC

RA E-ZJECT MIS ULT THIN OTC

READYLANCE MIS 30G OTC

REALITY MIS LANCETS OTC

REALITY TRIG MIS LANCETS OTC

RELION LANCE MIS STND 21G OTC

RELION LANCE MIS THIN 26G OTC

RELION LANCE MIS THIN 30G OTC

RELION MICRO MIS THIN 33G OTC

RELION ULTRA MIS THIN 32G OTC

RELION ULTRA MIS THIN PLS OTC

RIGHTEST MIS GL300 OTC

SAFE-T-LANCE MIS 21G OTC

SAFE-T-LANCE MIS 25G OTC

SAFE-T-LANCE MIS HI FLOW OTC

SAFE-T-LANCE MIS LOW FLOW OTC

SAFE-T-LANCE MIS NOR FLOW OTC

SAFE-T-PRO MIS LANCETS OTC

SAFE-T-PRO MIS PLUS OTC

SAFETY 21G MIS LANCETS OTC

SAFETY 28G MIS LANCETS OTC

SAFETY LET MIS LANCETS OTC

SAFETY MIS LANCETS OTC

SAFETY SEAL MIS 28G OTC

SAFETY SEAL MIS 30G OTC

SAPS HEALTH MIS TWIST OTC

SAPSCARE MIS TWIST OTC

SB LANCETS MIS THIN OTC

SB LANCETS MIS ULTR THN OTC

SIDE BUTTON MIS SAFETY OTC

SINGLE-LET MIS 23G OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 95 AGE - Age Limit GNDR - Gender Edit

SM LANCETS MIS 33G OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 96 AGE - Age Limit GNDR - Gender Edit

SMART SENSE MIS LANC 21G OTC

SMART SENSE MIS LANC 26G OTC

SMART SENSE MIS LANC 30G OTC

SMART SENSE MIS LANC 33G OTC

SMARTEST MIS LANCETS OTC

SOFT TOUCH MIS LANCETS OTC

SOFTCLIX MIS LANCETS OTC

SOLUS V2 MIS LANC 28G OTC

SOLUS V2 MIS LANC 30G OTC

STERILANCE MIS TL 28G OTC

STERILANCE MIS TL 30G OTC

STERILANCE MIS TL 32G OTC

SUPER THIN MIS LANC 28G OTC

SUPER THIN MIS LANCETS OTC

SURE COMFORT MIS LANC 18G OTC

SURE COMFORT MIS LANC 21G OTC

SURE COMFORT MIS LANC 23G OTC

SURE COMFORT MIS LANC 30G OTC

SURE COMFORT MIS LANCETS OTC

SURE-LANCE MIS 26G OTC

SURE-LANCE MIS LANCETS OTC

SURE-TOUCH MIS UNV LANC OTC

SUREFLEX MIS LANCETS OTC

SURELITE MIS LANCETS OTC

TECHLITE AST MIS LANCETS OTC

TECHLITE MIS LANC 30G OTC

TECHLITE MIS LANCETS OTC

TGT LANCET MIS 26G OTC

TGT LANCET MIS 30G OTC

TGT LANCET MIS 33G OTC

THIN LANCETS MIS OTC

THIN LANCETS MIS 26G OTC

THIN LANCETS MIS 30G OTC

THINLETS GP MIS 26G OTC

TOPCARE MIS LANC 33G OTC

TRAVEL LANCE MIS 30G OTC

TRAVEL LANCE MIS ADV 28G OTC

TRUPLUS LANC MIS 26G OTC

TRUPLUS LANC MIS 28G OTC

TRUPLUS LANC MIS 30G OTC

TRUPLUS LANC MIS 33G OTC

ULTILET MIS 26G OTC

ULTILET MIS 28G OTC

ULTILET MIS 30G OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 97 AGE - Age Limit GNDR - Gender Edit

ULTILET MIS 33G OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 98 AGE - Age Limit GNDR - Gender Edit

ULTILET MIS LANCETS OTC

ULTILET MIS SAFETY OTC

ULTILET SAFE MIS 21G OTC

ULTRA THIN MIS 28G OTC

ULTRA THIN MIS 30G OTC

ULTRA THIN MIS 31G OTC

ULTRA THIN MIS 33G OTC

ULTRA THIN MIS LANC 26G OTC

ULTRA THIN MIS LANC 28G OTC

ULTRA THIN MIS LANC 30G OTC

ULTRA THIN MIS LANCETS OTC

UNILET CMFR MIS TCH 28G OTC

UNILET CMFR MIS TCH 30G OTC

UNILET EX II MIS 28G OTC

UNILET EXCEL MIS 23G OTC

UNILET G.P MIS SUPR 23G OTC

UNILET G.P. MIS 21G OTC

UNILET GP 28 MIS ULT THIN OTC

UNILET LANC MIS 33G OTC

UNILET LANCE MIS 21G OTC

UNILET LANCE MIS 28G OTC

UNILET LANCE MIS 33G OTC

UNILET LANCT MIS 28G OTC

UNILET LANCT MIS 30G OTC

UNILET LANCT MIS 33G OTC

UNILET MIS 21G OTC

UNILET SUPER MIS 23G OTC

UNILET SUPER MIS G.P. 23G OTC

UNISTIK 3 MIS GENT 30G OTC

UNISTIK II MIS LANCETS OTC

UNISTIK SAFE MIS LANC 28G OTC

UNISTIK SAFE MIS LANC 30G OTC

UNISTIK TOUC MIS LANC 21G OTC

UNISTIK TOUC MIS LANC 23G OTC

UNISTIK TOUC MIS LANC 28G OTC

UNISTIK TOUC MIS LANC 30G OTC

UNIVERSAL 1 MIS 33G OTC

UNIVERSAL 1 MIS LANC 26G OTC

UNIVERSAL 1 MIS LANC 30G OTC

VITALET PRO MIS OTC

VITALET PRO MIS PLUS OTC

DIAGNOSTIC PRODUCTS DIAGNOSTIC TESTS

CHEMSTRIP 2 TES GP OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 99 AGE - Age Limit GNDR - Gender Edit

CHEMSTRIP 9 TES STRIPS OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 92 AGE - Age Limit GNDR - Gender Edit

CHEMSTRIP 10 TES MD OTC

CHEMSTRIP TES -10 SG OTC

CHEMSTRIP TES UGK OTC

KETO-DIASTIX TES OTC

ONETOUCH TES ULTRA BL OTC, QL (200 strips / 25

days) ONETOUCH TES VERIO OTC, QL (200 strips / 25

days)

DIAGNOSTIC TESTS DIAGNOSTIC TESTS

ONETOUCH TES ULTRA BL OTC, QL (200 strips / 25 days)

MULTIPLE URINE TESTS CHEMSTRIP 2 TES GP OTC CHEMSTRIP 5 TES OB OTC

CHEMSTRIP 7 TES OTC

CHEMSTRIP 9 TES STRIPS OTC

CHEMSTRIP 10 TES MD OTC

CHEMSTRIP TES -10 SG OTC

CHEMSTRIP TES UGK OTC

CVS KETONE TES CARE OTC

KETO-DIASTIX TES OTC

DIAPER RASH PRODUCTS DIAPER RASH PRODUCTS

A+D DIAPER CRE RASH OTC a+d prevent oin OTC

BENSONS CRE BOTTOM OTC

HINEY HEALER CRE OTC

medi-paste oin OTC

paladin oin OTC

pediatric oin OTC

pinxav oin OTC

RASH AWAY AER OTC

skin protect oin all-purp OTC

DIETARY MANAGEMENT PRODUCTS DIETARY MANAGEMENT PRODUCT COMBINATIONS

av-vite fb tab 2.5-25-2 folbic tab niva-fol tab

DIGESTIVE AIDS DIGESTIVE ENZYMES

ZENPEP CAP 3000UNIT ZENPEP CAP 5000UNIT

ZENPEP CAP 15000UNT

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QL - Quantity Limits ST - Step Therapy SP - Specialty 93 AGE - Age Limit GNDR - Gender Edit

ZENPEP CAP 20000UNT

ZENPEP CAP 25000 ZENPEP CAP 40000

DIGESTIVE ENZYMES DIGESTIVE ENZYMES

CREON CAP 3000UNIT CREON CAP 6000UNIT CREON CAP 12000UNT CREON CAP 24000UNT CREON CAP 36000UNT VIOKACE TAB 10440 VIOKACE TAB 20880

DIPEPTIDYL PEPTIDASE-4 (DPP-4) INHIBITORS DIPEPTIDYL PEPTIDASE-4 (DPP-4) INHIBITORS

JANUVIA TAB 25MG ST JANUVIA TAB 50MG ST

JANUVIA TAB 100MG ST

DIRECT FACTOR XA INHIBITORS DIRECT FACTOR XA INHIBITORS

XARELTO STAR TAB 15/20MG XARELTO TAB 10MG XARELTO TAB 15MG XARELTO TAB 20MG

DIRECT MUSCLE RELAXANTS DIRECT MUSCLE RELAXANTS

dantrolene sodium cap 25 mg dantrolene sodium cap 50 mg dantrolene sodium cap 100 mg

DIURETIC COMBINATIONS DIURETIC COMBINATIONS

ALDACTAZIDE TAB 50/50 amiloride & hydrochlorothiazide tab 5-50 mg

spironolactone & hydrochlorothiazide tab 25-25 mg triamterene & hydrochlorothiazide cap 37.5-25 mg triamterene & hydrochlorothiazide tab 37.5-25 mg triamterene & hydrochlorothiazide tab 75-50 mg

ELECTROLYTE MIXTURES ELECTROLYTES ORAL

ceralyte 70 sol OTC cvs electrol sol OTC

gnp pediatri sol electrol OTC

oral electro sol cherry OTC

oral electro sol h-e-b OTC

oral electrolyte solution OTC

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oralyte sol OTC

oralyte sol freeze OTC

ped elctrlyt sol OTC

ped elctrlyt sol /zinc OTC

ped elctrlyt sol freeze OTC

ped elctrlyt sol freezer OTC

ped elctrlyt sol freezpop OTC

ped elctrlyt sol grape OTC

pedia vance sol apple OTC

pedia vance sol grape OTC

ra pediatric sol electrol OTC

rehydralyte sol OTC

EMERGENCY CONTRACEPTIVES EMERGENCY CONTRACEPTIVES

aftera tab 1.5mg OTC, QL (1 tab / 30 days) ELLA TAB 30MG QL (2 tabs / year)

levonorgestrel tab 1.5 mg OTC, QL (1 tab / 30 days)

my way tab 1.5mg OTC, QL (1 tab / 30 days)

opcicon tab 1.5mg OTC, QL (1 tab / 30 days)

option 2 tab 1.5mg OTC, QL (1 tab / 30 days)

react tab 1.5mg OTC, QL (1 tab / 30 days)

take action tab 1.5mg OTC, QL (1 tab / 30 days)

EMOLLIENT/KERATOLYTIC AGENTS EMOLLIENT/KERATOLYTIC AGENTS

urea cream 40%

EMOLLIENTS EMOLLIENTS

al12 lot 12% OTC amlactin lot 12% OTC

geri-hydrola cre 12% OTC

geri-hydrola lot 12% OTC

lactic acid (ammonium lactate) cream 12%

lactic acid (ammonium lactate) cream 12% OTC

lactic acid (ammonium lactate) lotion 12%

lactic acid (ammonium lactate) lotion 12% OTC

skin trtment lot 12% OTC

ENDOCRINE AND METABOLIC AGENTS - MISC. BONE DENSITY REGULATORS

PROLIA SOL 60MG/ML SP, QL (.3 injections / 30 days), PA

TYMLOS INJ SP, QL (1.154 pens / 30

days), PA

CORTICOTROPIN H.P. ACTHAR INJ 80UNIT SP, QL (50.1 mL / 30 days)

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GROWTH HORMONES NORDITROPIN INJ 5/1.5ML SP, ST NORDITROPIN INJ 10/1.5ML SP, ST

NORDITROPIN INJ 15/1.5ML SP, ST

NORDITROPIN INJ 30/3ML SP, ST

SEROSTIM INJ 4MG SP, PA

SEROSTIM INJ 5MG SP, PA

SEROSTIM INJ 6MG SP, PA

ZORBTIVE INJ 8.8MG SP, PA

METABOLIC MODIFIERS calcitriol inj 1 mcg/ml

SOMATOSTATIC AGENTS octreotide acetate inj 50 mcg/ml (0.05 mg/ml) SP, QL (3 mL / 1 day), PA octreotide acetate inj 50 mcg/ml (0.05 mg/ml) SP, QL (3 vials / 1 day), PA octreotide acetate inj 100 mcg/ml (0.1 mg/ml) SP, QL (3 mL / 1 day), PA octreotide acetate inj 100 mcg/ml (0.1 mg/ml) SP, QL (3 vials / 1 day), PA octreotide acetate inj 200 mcg/ml (0.2 mg/ml) SP, QL (45 vials / 30 days),

PA octreotide acetate inj 500 mcg/ml (0.5 mg/ml) SP, QL (3 mL / 1 day), PA

octreotide acetate inj 500 mcg/ml (0.5 mg/ml) SP, QL (3 vials / 1 day), PA octreotide acetate inj 1000 mcg/ml (1 mg/ml) SP, QL (9 vials / 30 days),

PA SOMATULINE INJ 60/0.2ML SP, QL (1.5 syringes / 30

days), PA SOMATULINE INJ 90/0.3ML SP, QL (1.1 syringes / 30

days), PA SOMATULINE INJ 120/.5ML SP, QL (1.2 syringes / 30

days), PA

ENZYMES - TOPICAL ENZYMES - TOPICAL

SANTYL OIN 250/GM PA

ERYTHROMYCINS ERYTHROMYCINS

e.e.s. 400 tab 400mg erythrocin tab 250mg erythromycin ethylsuccinate for susp 200 mg/5ml erythromycin ethylsuccinate tab 400 mg ERYTHROMYCIN POW ERYTHROMYCIN POW ETHYLSUC

erythromycin tab 250 mg

erythromycin tab 500 mg erythromycin w/ delayed release particles cap 250

mg

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ESTROGEN COMBINATIONS ESTROGEN & PROGESTIN

amabelz tab 0.5-0.1 amabelz tab 1-0.5mg COMBIPATCH DIS .05/.14 COMBIPATCH DIS .05/.25

estradiol & norethindrone acetate tab 0.5-0.1 mg estradiol & norethindrone acetate tab 1-0.5 mg fyavolv tab 0.5-2.5 fyavolv tab 1-5 jevantique l tab 0.5-2.5 jinteli tab 1mg-5mcg lopreeza tab 0.5-0.1 lopreeza tab 1-0.5mg mimvey lo tab 0.5-0.1 mimvey tab 1-0.5mg

norethindrone acetate-ethinyl estradiol tab 0.5 mg-2.5 mcg

norethindrone acetate-ethinyl estradiol tab 1 mg-5 mcg

ESTROGENS ESTROGENS

estradiol tab 0.5 mg estradiol tab 1 mg estradiol tab 2 mg estradiol td patch weekly 0.1 mg/24hr estradiol td patch weekly 0.05 mg/24hr estradiol td patch weekly 0.06 mg/24hr estradiol td patch weekly 0.025 mg/24hr estradiol td patch weekly 0.075 mg/24hr

estradiol td patch weekly 0.0375 mg/24hr (37.5 mcg/24hr)

EXPECTORANTS EXPECTORANTS

altarussin syp 100/5ml OTC

bidex tab 400mg OTC

buckleys liq chest OTC

chest conges liq childrns OTC

chest conges tab 400mg OTC

cough syp OTC

cough syp 100/5ml OTC

coughtab tab 200mg OTC

cvs mucus er tab 600mg OTC

diabetic tus liq 100/5ml OTC

diabtc tussn syp 100/5ml OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 97 AGE - Age Limit GNDR - Gender Edit

eq mucus er tab 600mg OTC

eql mucus-er tab 1200mg OTC

fenesin ir tab 400mg OTC

g-fen ex tab 400mg OTC

geri-tussin syp 100/5ml OTC

guaifenesin liquid 100 mg/5ml OTC

guaifenesin tab 200 mg OTC

guaifenesin tab 400 mg OTC

guaifenesin tab er 12hr 1200 mg OTC

hm mucus er tab 1200mg OTC

liquibid tab 400mg OTC

medifin 400 tab 400mg OTC

mucinex chld liq 100/5ml OTC

MUCINEX TAB 600MG ER OTC

MUCINEX/KIDS GRA 100MG OTC

mucosa tab 400mg OTC

mucus er tab 1200mg OTC

mucus relief liq 100/5ml OTC

mucus relief liq 400/20ml OTC

mucus relief tab 200mg OTC

mucus relief tab 400mg OTC

mucus relief tab 600mg er OTC

mucus relief tab 1200 er OTC

mucus+chst liq 100/5ml OTC

pa mucus rel tab 600mg OTC

px tussin sol 100/5ml OTC

qc medifin liq mucus rl OTC

ra tussin liq 100/5ml OTC

ra tussin syp 100/5ml OTC

refenesen tab 200mg OTC

refenesen tab 400mg OTC

robafen syp 100/5ml OTC

sb cgh contr syp 100/5ml OTC

sb coughtab tab 200mg OTC

scot-tussin liq expct sf OTC

siltuss das liq 100/5ml OTC

siltussin sa syp 100/5ml OTC

tab tussin tab 400mg OTC

tussin adult liq 100/5ml OTC

tussin chest syp 100/5ml OTC

tussin mucus liq 100/5ml OTC

tussin mucus liq 200/10ml OTC

tussin syp 100/5ml OTC

wal-tussin liq 100/5ml OTC

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wal-tussin syp 100/5ml OTC

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xpect tab 400mg OTC

FIBRIC ACID DERIVATIVES FIBRIC ACID DERIVATIVES

fenofibrate micronized cap 67 mg fenofibrate micronized cap 134 mg fenofibrate micronized cap 200 mg fenofibrate tab 48 mg fenofibrate tab 54 mg

fenofibrate tab 145 mg fenofibrate tab 160 mg gemfibrozil tab 600 mg

FIBROMYALGIA AGENTS

FIBROMYALGIA AGENT - SNRIS SAVELLA MIS TITR PAK PA SAVELLA TAB 12.5MG PA

SAVELLA TAB 25MG PA

SAVELLA TAB 50MG PA

SAVELLA TAB 100MG PA

FLUORIDE FLUORIDE

fluoritab chw 0.5mg f fluoritab chw 0.25mg f fluoritab chw 1mg f fluoritab chw 2.2mg fluoritab dro 0.125mg flura-drops dro 0.25mg f ludent chw 0.5mg f ludent chw 0.25mg f ludent chw 1mg f nafrinse chw 1mg f nafrinse dro 0.125mg sodium fluoride chew tab 0.5 mg f (from 1.1 mg

naf) sodium fluoride chew tab 0.25 mg f (from 0.55 mg

naf) sodium fluoride chew tab 1 mg f (from 2.2 mg naf)

sodium fluoride soln 0.5 mg/ml f (from 1.1 mg/ml naf) sodium fluoride tab 0.5 mg f (from 1.1 mg naf)

sodium fluoride tab 1 mg f (from 2.2 mg naf)

FLUOROQUINOLONES FLUOROQUINOLONES

ciprofloxacin hcl tab 100 mg (base equiv) ciprofloxacin hcl tab 250 mg (base equiv)

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ciprofloxacin hcl tab 500 mg (base equiv)

ciprofloxacin hcl tab 750 mg (base equiv) ciprofloxacin-ciprofloxacin hcl tab er 24hr 500 mg (base eq) ciprofloxacin-ciprofloxacin hcl tab er 24hr 1000 mg(base eq) levofloxacin oral soln 25 mg/ml

levofloxacin tab 250 mg levofloxacin tab 500 mg levofloxacin tab 750 mg

FOLIC ACID/FOLATES FOLIC ACID/FOLATES

fa-8 tab 0.8mg OTC folic acid tab 1 mg

folic acid tab 400 mcg OTC

folic acid tab 800mcg OTC

folic acid tab 1000mcg OTC

sm folic acd tab 400mcg OTC

yl folic aci tab 400mcg OTC

GALLSTONE SOLUBILIZING AGENTS GALLSTONE SOLUBILIZING AGENTS

ursodiol cap 300 mg ursodiol tab 250 mg ursodiol tab 500 mg

GASTROINTESTINAL AGENTS - MISC. AGENTS FOR CHRONIC IDIOPATHIC CONSTIPATION (CIC)

TRULANCE TAB 3MG

ANTIFLATULENTS eql gas gone chw 125mg OTC little tummy dro 20/0.3ml OTC

simethicone cap 125 mg OTC

SIMETHICONE LIQ OTC

INTESTINAL ACIDIFIERS lactulose (encephalopathy) solution 10 gm/15ml

IRRITABLE BOWEL SYNDROME (IBS) AGENTS LINZESS CAP 72MCG

PHOSPHATE BINDER AGENTS sevelamer carbonate packet 0.8 gm ST sevelamer carbonate packet 2.4 gm ST

sevelamer carbonate tab 800 mg ST

GASTROINTESTINAL STIMULANTS GASTROINTESTINAL STIMULANTS

metoclopramide hcl soln 5 mg/5ml (10 mg/10ml) (base equiv)

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metoclopramide hcl tab 5 mg (base equivalent)

metoclopramide hcl tab 10 mg (base equivalent) GLUCOCORTICOSTEROIDS

GLUCOCORTICOSTEROIDS budesonide delayed release particles cap 3 mg deltasone tab 20mg dexamethasone elixir 0.5 mg/5ml dexamethasone soln 0.5 mg/5ml dexamethasone tab 0.5 mg dexamethasone tab 0.75 mg dexamethasone tab 1 mg dexamethasone tab 1.5 mg dexamethasone tab 2 mg dexamethasone tab 4 mg dexamethasone tab 6 mg hydrocortisone tab 5 mg hydrocortisone tab 10 mg hydrocortisone tab 20 mg MEDROL TAB 2MG methylprednisolone tab 4 mg

methylprednisolone tab 8 mg methylprednisolone tab 16 mg methylprednisolone tab 32 mg methylprednisolone tab therapy pack 4 mg (21) prednisolone sod phos orally disintegr tab 10 mg (base eq) prednisolone sod phos orally disintegr tab 15 mg (base eq) prednisolone sod phos orally disintegr tab 30 mg (base eq) prednisolone sod phosph oral soln 6.7 mg/5ml (5

mg/5ml base) prednisolone sod phosphate oral soln 15 mg/5ml

(base equiv) prednisolone sodium phosphate oral soln 25

mg/5ml (base eq) prednisolone syrup 15 mg/5ml (usp solution

equivalent) prednisone oral soln 5 mg/5ml

prednisone tab 1 mg prednisone tab 2.5 mg prednisone tab 5 mg prednisone tab 10 mg prednisone tab 20 mg prednisone tab 50 mg

prednisone tab therapy pack 5 mg (21)

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prednisone tab therapy pack 5 mg (48)

prednisone tab therapy pack 10 mg (21) prednisone tab therapy pack 10 mg (48)

GOUT AGENTS GOUT AGENTS

allopurinol tab 100 mg allopurinol tab 300 mg colchicine tab 0.6 mg QL (30 tabs / 25 days)

H-2 ANTAGONISTS H-2 ANTAGONISTS

acid control tab 10mg OTC acid control tab 20mg OTC

acid control tab 150mg OTC

acid reducer tab 10mg OTC

acid reducer tab 20mg OTC

acid reducer tab 75mg OTC

acid reducer tab 150mg OTC

acid reducer tab 200mg OTC

cimetidine hcl soln 300 mg/5ml

cimetidine tab 200 mg cimetidine tab 200mg OTC

cimetidine tab 300 mg

cimetidine tab 400 mg cimetidine tab 800 mg eq heartburn tab relief OTC

eql heartbrn tab 10mg OTC

eql heartbur tab 150mg OTC

famotidine for susp 40 mg/5ml

famotidine tab 10 mg OTC

famotidine tab 20 mg

famotidine tab 20mg OTC

famotidine tab 40 mg

heartbrn rel tab 200mg OTC

heartburn tab 20mg OTC

heartburn tab 150mg OTC

heartburn tab 200mg OTC

heartburn tab relief OTC

nizatidine cap 150 mg

nizatidine cap 300 mg nizatidine oral soln 15 mg/ml ranitidine hcl cap 150 mg ranitidine hcl cap 300 mg ranitidine hcl syrup 15 mg/ml (75 mg/5ml)

ranitidine hcl tab 150 mg

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ranitidine hcl tab 150 mg OTC

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ranitidine hcl tab 300 mg

ranitidine tab 75mg OTC

sm acid redu tab 200mg OTC

wal-zan 75 tab OTC

wal-zan tab 75mg OTC

wal-zan tab 150mg OTC

HEMATOLOGICAL AGENTS - MISC. ANTIHEMOPHILIC PRODUCTS

JIVI INJ 500 UNIT SP, PA JIVI INJ 1000UNIT SP, PA

JIVI INJ 2000UNIT SP, PA

JIVI INJ 3000UNIT SP, PA

COMPLEMENT INHIBITORS CINRYZE SOL 500 UNIT SP, PA RUCONEST INJ 2100UNIT SP, PA

SOLIRIS INJ 10MG/ML SP, PA

PLATELET AGGREGATION INHIBITORS prasugrel hcl tab 5 mg (base equiv) prasugrel hcl tab 10 mg (base equiv)

HEMATOPOIETIC AGENTS AGENTS FOR GAUCHER DISEASE

CERDELGA CAP 84MG SP, QL (2 caps / 1 day), PA CEREZYME INJ 400UNIT SP, QL (32.16 vials / 30

days), PA

COBALAMINS cyanocobalamin inj 1000 mcg/ml

HEMATOPOIETIC GROWTH FACTORS ARANESP INJ 25MCG SP, PA ARANESP INJ 40MCG SP, PA

ARANESP INJ 60MCG SP, PA

ARANESP INJ 100MCG SP, PA

ARANESP INJ 150MCG SP, PA

ARANESP INJ 200MCG SP, PA

ARANESP INJ 300MCG SP, PA

ARANESP INJ 500MCG SP, PA

ZARXIO INJ 300/0.5 SP, PA

ZARXIO INJ 480/0.8 SP, PA

IRON ferosul tab 325mg OTC FERROUS SULF TAB 324MG EC OTC

ferrous sulfate tab 325 mg (65 mg elemental fe) OTC

iron suppmnt elx 220/5ml OTC

nat-rul iron tab 325mg OTC

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HEMATOPOIETIC GROWTH FACTORS THROMBOPOIETIN (TPO) RECEPTOR AGONISTS

PROMACTA TAB 12.5MG SP, QL (1 tab / 1 day), PA PROMACTA TAB 25MG SP, QL (1 tab / 1 day), PA

PROMACTA TAB 50MG SP, QL (2 tabs / 1 day), PA

PROMACTA TAB 75MG SP, QL (2 tabs / 1 day), PA

HEMATOPOIETIC MIXTURES FOLIC ACID/FOLATE COMBINATIONS

airavite tab fabb tab 2.2-25-1

folbee tab folic acid-vitamin b6-vitamin b12 tab 2.2-25-0.5 mg folplex 2.2 tab

nufol tab tl gard rx tab virt-gard tab 2.2-25-1

HEPATITIS AGENTS HEPATITIS B AGENTS

adefovir dipivoxil tab 10 mg BARACLUDE SOL .05MG/ML

entecavir tab 0.5 mg

entecavir tab 1 mg EPIVIR HBV SOL 5MG/ML lamivudine tab 100 mg (hbv) VEMLIDY TAB 25MG

HEPATITIS C AGENT - COMBINATIONS HARVONI TAB 90-400MG SP, QL (1 tab / 1 day), PA VIEKIRA PAK TAB SP, QL (4 tabs / 1 day), PA

HEPATITIS C AGENTS moderiba tab 200mg SP, PA REBETOL SOL 40MG/ML SP, PA

ribasphere cap 200mg SP, PA

ribasphere tab 200mg SP, PA

ribasphere tab 400mg SP, PA

ribasphere tab 600mg SP, PA

ribavirin cap 200 mg SP, PA

ribavirin tab 200 mg SP, PA

SOVALDI TAB 400MG SP, QL (1 tab / 1 day), PA

HERPES AGENTS HERPES AGENTS - PURINE ANALOGUES

acyclovir cap 200 mg acyclovir susp 200 mg/5ml

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acyclovir tab 400 mg

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acyclovir tab 800 mg

valacyclovir hcl tab 1 gm valacyclovir hcl tab 500 mg

HERPES AGENTS - THYMIDINE ANALOGUES famciclovir tab 125 mg famciclovir tab 250 mg famciclovir tab 500 mg

HMG COA REDUCTASE INHIBITORS

HMG COA REDUCTASE INHIBITORS atorvastatin calcium tab 10 mg (base equivalent) atorvastatin calcium tab 20 mg (base equivalent) atorvastatin calcium tab 40 mg (base equivalent) atorvastatin calcium tab 80 mg (base equivalent) lovastatin tab 10 mg lovastatin tab 20 mg

lovastatin tab 40 mg pravastatin sodium tab 10 mg pravastatin sodium tab 20 mg pravastatin sodium tab 40 mg pravastatin sodium tab 80 mg simvastatin tab 5 mg simvastatin tab 10 mg simvastatin tab 20 mg simvastatin tab 40 mg simvastatin tab 80 mg

HORMONE RECEPTOR MODULATORS SELECTIVE ESTROGEN RECEPTOR MODULATORS (SERMS)

OSPHENA TAB 60MG PA raloxifene hcl tab 60 mg

HYDANTOINS HYDANTOINS

DILANTIN CAP 30MG phenytoin chew tab 50 mg

phenytoin sodium extended cap 100 mg

phenytoin sodium extended cap 200 mg phenytoin sodium extended cap 300 mg phenytoin susp 125 mg/5ml

HYPNOTICS/SEDATIVES/SLEEP DISORDER AGENTS

ANTIHISTAMINE HYPNOTICS diphenhydramine hcl (sleep) tab 50 mg OTC qc sleep aid cap 50mg OTC

sleep aid cap 50mg OTC

sleep-aid tab 25mg OTC

sleep-tabs tab 25mg OTC

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sm sleep aid cap 50mg OTC

IMIDAZOLE-RELATED ANTIFUNGALS IMIDAZOLES

MICONAZOLE POW

TRIAZOLES fluconazole for susp 10 mg/ml fluconazole for susp 40 mg/ml fluconazole tab 50 mg fluconazole tab 100 mg fluconazole tab 150 mg fluconazole tab 200 mg itraconazole cap 100 mg QL (4 caps / 1 day), PA

voriconazole for susp 40 mg/ml PA

voriconazole tab 50 mg PA

voriconazole tab 200 mg PA

IMMUNOMODULATING AGENTS - TOPICAL IMMUNOMODULATORS IMIDAZOQUINOLINAMINES - TOPICAL

imiquimod cream 5%

IMMUNOMODULATORS IMMUNOMODULATORS FOR MYELODYSPLASTIC SYNDROMES

REVLIMID CAP 2.5MG SP, QL (1 cap / 1 day), PA REVLIMID CAP 5MG SP, QL (1 cap / 1 day), PA

REVLIMID CAP 10MG SP, QL (1 cap / 1 day), PA

REVLIMID CAP 15MG SP, QL (1 cap / 1 day), PA

REVLIMID CAP 20MG SP, QL (1 cap / 1 day), PA

REVLIMID CAP 25MG SP, QL (1 cap / 1 day), PA

IMMUNOSUPPRESSIVE AGENTS CYCLOSPORINE ANALOGS

cyclosporine cap 25 mg cyclosporine cap 100 mg cyclosporine modified cap 25 mg cyclosporine modified cap 50 mg cyclosporine modified cap 100 mg cyclosporine modified oral soln 100 mg/ml

gengraf cap 25mg gengraf cap 100mg gengraf sol 100mg/ml SANDIMMUNE SOL 100MG/ML

INOSINE MONOPHOSPHATE DEHYDROGENASE INHIBITORS mycophenolate mofetil cap 250 mg mycophenolate mofetil for oral susp 200 mg/ml mycophenolate mofetil tab 500 mg

MACROLIDE IMMUNOSUPPRESSANTS RAPAMUNE SOL 1MG/ML

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QL - Quantity Limits ST - Step Therapy SP - Specialty 106 AGE - Age Limit GNDR - Gender Edit

sirolimus tab 0.5 mg

sirolimus tab 1 mg sirolimus tab 2 mg tacrolimus cap 0.5 mg tacrolimus cap 1 mg tacrolimus cap 5 mg

PURINE ANALOGS AZASAN TAB 75 MG AZASAN TAB 100MG azathioprine tab 50 mg

INFLAMMATORY BOWEL AGENTS INFLAMMATORY BOWEL AGENTS

APRISO CAP 0.375GM balsalazide disodium cap 750 mg

mesalamine enema 4 gm mesalamine rectal enema 4 gm & cleanser wipe kit PENTASA CAP 250MG CR PA

PENTASA CAP 500MG CR PA

sulfasalazine tab 500 mg

sulfasalazine tab delayed release 500 mg

INFLUENZA AGENTS NEURAMINIDASE INHIBITORS

oseltamivir phosphate cap 30 mg (base equiv) QL (28 caps / 180 days) oseltamivir phosphate cap 45 mg (base equiv) QL (14 caps / 180 days) oseltamivir phosphate cap 75 mg (base equiv) QL (14 caps / 180 days)

INSULIN SENSITIZING AGENTS

THIAZOLIDINEDIONES pioglitazone hcl tab 15 mg (base equiv) pioglitazone hcl tab 30 mg (base equiv) pioglitazone hcl tab 45 mg (base equiv)

INTESTINAL ACIDIFIERS INTESTINAL ACIDIFIERS

enulose sol 10gm/15 generlac sol 10gm/15 lactulose (encephalopathy) solution 10 gm/15ml

INTRARECTAL STEROIDS INTRARECTAL STEROIDS

colocort ene 100mg hydrocortisone enema 100 mg/60ml

IODINE ANTISEPTICS IODINE ANTISEPTICS

ap povid-iod sol 10% OTC first aid sol 10% OTC

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hm povid-iod sol 10% OTC

povidone iod oin 10% OTC

povidone-iod sol 7.5% OTC

povidone-iod sol 10% OTC

povidone-iodine oint 10% OTC

povidone-iodine soln 10% OTC

pvp prep sol 10% OTC

ra antisepti sol 10% OTC

sm povid-iod sol 10% OTC

IRON IRON

cvs iron tab 27mg OTC cvs iron tab 325mg OTC

fe tabs tab 325mg ec OTC

ferate tab 27mg OTC

fergon tab 27mg OTC

ferosul elx 220/5ml OTC

FERRETTS TAB 325MG OTC

ferrocite tab 324mg OTC

ferrotabs tab OTC

ferrous fumarate tab 324 mg (106 mg elemental OTC fe) ferrous gluc tab 324mg OTC

ferrous gluconate tab 240 mg (27 mg elemental OTC fe) ferrous gluconate tab 324 mg (37.5 mg elemental OTC iron) ferrous sulf tab 325mg OTC ferrous sulfate elixir 220 mg/5ml (44 mg/5ml OTC elemental fe) ferrous sulfate soln 75 mg/ml (15 mg/ml OTC elemental fe) ferrous sulfate tab 27 mg (elemental fe) OTC

ferrous sulfate tab 325 mg (65 mg elemental fe) OTC

ferrous sulfate tab ec 325 mg (65 mg fe OTC equivalent) ferrous sulfate tab er 142 mg (45 mg fe OTC equivalent) ferrousul tab 325mg OTC gnp iron tab 45mg OTC

gnp iron tab 65mg OTC

gnp iron tab 325mg OTC

high potency tab fe 27mg OTC

hm iron tab 45mg OTC

hm iron tab 65mg OTC

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iron slow tab 45mg OTC

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iron supplem tab 325mg OTC

iron supplem tab therapy OTC

iron supplmt dro 15mg/ml OTC

pedia iron dro 15mg/ml OTC

px iron tab 27mg OTC

px iron tab 200mg OTC

ra iron tab 27mg OTC

ra iron tab 65mg OTC

ra iron tab 325mg OTC

slow fe tab 45mg OTC

slow iron tab 160mg cr OTC

slow rel fe tab 160mg cr OTC

slow release tab 45mg OTC

slow release tab 47.5mg OTC

slow release tab iron 45 OTC

slow-release tab fe 45mg OTC

sm iron slow tab 160mg cr OTC

sm iron tab 45mg OTC

sm iron tab 325mg OTC

IRON W/ VITAMINS IRON W/ VITAMINS

s.s.s. tonic liq OTC s.s.s. tonic tab OTC

IRRITABLE BOWEL SYNDROME (IBS) AGENTS IBS AGENT - GUANYLATE CYCLASE-C (GC-C) AGONISTS

LINZESS CAP 145MCG LINZESS CAP 290MCG

KERATOLYTIC/ANTIMITOTIC AGENTS KERATOLYTIC/ANTIMITOTIC AGENTS

podofilox soln 0.5%

LAXATIVE COMBINATIONS BOWEL EVACUANT COMBINATIONS

gavilyte-c sol gavilyte-g sol gavilyte-n sol flav pk GOLYTELY SOL peg 3350-kcl-na bicarb-nacl-na sulfate for soln

236 gm peg 3350-kcl-sod bicarb-nacl for soln 420 gm

SUPREP BOWEL SOL PREP KIT

trilyte sol

LAXATIVES & DSS colace 2in1 tab 8.6-50mg OTC dok plus tab 8.6-50mg OTC

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easy-lax pls tab 8.6-50mg OTC

eq senna-s tab 8.6-50mg OTC

eql stool tab softener OTC

hm senna-s tab 8.6-50mg OTC

lax/stl soft tab 8.6-50mg OTC

laxacin tab 8.6-50mg OTC

laxative pls tab 8.6-50mg OTC

medi-natural tab 8.6-50mg OTC

ra p col-rit tab 8.6-50mg OTC

sb docusate tab 8.6-50mg OTC

senexon-s tab 8.6-50mg OTC

senna plus tab 8.6-50mg OTC

senna s tab 8.6-50mg OTC

senna tab 8.6-50mg OTC

senna-s tab 8.6-50mg OTC

senna-time s tab 8.6-50mg OTC

sennosides-docusate sodium tab 8.6-50 mg OTC sm senna-s tab 8.6-50mg OTC sm stool tab softener OTC

stool softnr tab 8.6-50mg OTC

LAXATIVES LAXATIVES - MISCELLANEOUS

eql clearlax pow OTC gnp clearlax pak 3350 nf OTC

KRISTALOSE PAK 10GM lactulose oral crystal packet 10 gm laxaclear pow OTC

polyeth glyc pow 3350 nf OTC

polyethylene glycol 3350 oral packet OTC

polyethylene glycol 3350 oral powder OTC

smooth lax pow OTC

smooth lax pow 3350 OTC

STIMULANT LAXATIVES CORRECTOL MIS HERBAL OTC cvs c-lax tab 5mg OTC

evac-u-gen tab 8.6mg OTC

gnp senna tab 8.6mg OTC

SURFACTANT LAXATIVES docusate sodium cap 100 mg OTC dulcolax pnk cap 100mg OTC

LAXATIVES - MISCELLANEOUS LAXATIVES - MISCELLANEOUS

clearlax pow OTC constulose sol 10gm/15

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cvs purelax pak OTC

cvs purelax pow OTC

cvs purelax pow 3350 OTC

eq clearlax pow OTC

eql clearlax pow OTC

gavilax pow OTC

gentlelax pow OTC

glycolax pow 3350 nf OTC

gnp clearlax pow OTC

hm clearlax pow OTC

KRISTALOSE PAK 20GM lactulose solution 10 gm/15ml laxaclear pow OTC

natura-lax pow 3350 nf OTC

polyethylene glycol 3350 oral packet OTC

polyethylene glycol 3350 oral powder OTC

powderlax pow OTC

ra laxative pow OTC

sm clearlax pow OTC

smooth lax pow OTC

smooth lax pow 3350 nf OTC

LEPROSTATICS LEPROSTATICS

dapsone tab 25 mg dapsone tab 100 mg

LEUKOTRIENE MODULATORS

LEUKOTRIENE RECEPTOR ANTAGONISTS montelukast sodium chew tab 4 mg (base equiv) montelukast sodium chew tab 5 mg (base equiv) montelukast sodium oral granules packet 4 mg (base equiv) montelukast sodium tab 10 mg (base equiv)

LHRH/GNRH AGONIST ANALOG PITUITARY SUPPRESSANTS LHRH/GNRH AGONIST ANALOG PITUITARY SUPPRESSANTS

SYNAREL SOL 2MG/ML

LINCOSAMIDES LINCOSAMIDES

clindamycin hcl cap 150 mg clindamycin hcl cap 300 mg clindamycin palmitate hcl for soln 75 mg/5ml (base equiv)

LIQUIDS FIXED OILS

ALMOND OIL

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ALMOND OIL SWEET

ALMOND OIL SWEET OTC

BASE G ALMON OIL SWEET

CASTOR OIL CASTOR OIL OTC HM CASTOR OIL OTC

LINSEED OIL RAW

OIL-ALMOND OIL SWEET OTC

OLIVE OIL OLIVE OIL OTC

QC CASTOR OIL OTC

QC SWEET OIL OTC

SM SWEET OIL OTC

SWEET OIL OTC

LOCAL ANESTHETICS - TOPICAL LOCAL ANESTHETICS - TOPICAL

lidocaine hcl soln 4% lidocaine patch 5% PA

TOPICAL ANESTHETIC COMBINATIONS lidocaine-prilocaine cream 2.5-2.5% QL (1 gm / 1 day)

LOOP DIURETICS LOOP DIURETICS

bumetanide tab 0.5 mg bumetanide tab 1 mg bumetanide tab 2 mg furosemide oral soln 8 mg/ml furosemide oral soln 10 mg/ml furosemide tab 20 mg furosemide tab 40 mg furosemide tab 80 mg torsemide tab 5 mg torsemide tab 10 mg

torsemide tab 20 mg torsemide tab 100 mg

MACROLIDES CLARITHROMYCIN

clarithromycin for susp 125 mg/5ml clarithromycin for susp 250 mg/5ml

ERYTHROMYCINS ERYTHROMYCIN POW ERYTHROMYCIN POW ETHYLSUC

MEDICAL DEVICES AND SUPPLIES BANDAGES-DRESSINGS-TAPE

ADH BANDAGE MIS ANTIBACT OTC

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ADH BANDAGE MIS CLEAR OTC

ADH BANDAGE MIS FLEXIBLE OTC

ADH BANDAGE MIS FOAM OTC

ADH BANDAGE MIS PLASTIC OTC

ADH BANDAGE MIS SHEER OTC

ADH BANDAGE MIS STRONG OTC

ADH BANDAGE MIS WTR SHLD OTC

ADHESIVE KNT MIS 3"X5" OTC

ADHESIVE PAD 2"X3" OTC

ADHESIVE PAD 3"X4" OTC

ADHESIVE PAD PAD ANTIBACT OTC

ADV HEALING MIS BANDAGES OTC

ANTI-BACTRIA MIS CHILD OTC

ANTIBACTERIA MIS CLEAR OTC

BAND-AID FLX MIS FABRIC OTC

BAND-AID HYD MIS ALL-PURP OTC

BAND-AID HYD MIS BLS CUSH OTC

BAND-AID HYD MIS FINGERS OTC

BAND-AID HYD MIS LARGE OTC

BAND-AID HYD MIS X-LARGE OTC

BAND-AID MIS OTC

BAND-AID MIS 3/4"X3" OTC

BAND-AID MIS INCRED 2 OTC

BAND-AID MIS JUS LEAG OTC

BAND-AID MIS POKEMON OTC

BAND-AID MIS SHEER OTC

BAND-AID MIS SHEER CF OTC

BAND-AID MIS TOUGH OTC

BAND-AID MIS TOUGH WP OTC

BAND-AID MIS VARIETY OTC

BAND-AID MIS WON WOM OTC

BAND-AID MIS WTER BLK OTC

BAND-AID PAD ADHESIVE OTC

CARPALAID MIS EMPLOYEE OTC

CARPALAID MIS LARGE OTC

CARPALAID MIS SMALL OTC

COVERLET MIS STRIPS OTC

CURAD COMFOR MIS .75X3" OTC

CURITY CURAD MIS 3/4 PLAS OTC

CURITY CURAD MIS 3/4 SHEE OTC

CVS PLASTIC MIS BANDAGE OTC

EQL FLEXIBLE MIS FABRIC OTC

EQL HVY DUTY MIS STRIPS OTC

EQL PLASTIC MIS STRIPS OTC

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EQL SHEER MIS STRIPS OTC

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EQL STRIPS MIS OTC

FABRIC BANDG MIS ASSORTED OTC

FABRIC BANDG MIS FLEXIBLE OTC

FLEX BANDAGE MIS OTC

HEAVY DUTY MIS CLR&TGH OTC

HEAVY DUTY MIS FAB BAND OTC

HYPO-ALLERG MIS BANDAGE OTC

NEXCARE TATT MIS BANDAGES OTC

NEXCARE WATR MIS PRF BAND OTC

PEANUTS MIS BANDAGES OTC

QUIKSTIK ADH MIS BANDAGES OTC

RA ADHESIVE MIS BANDAGES OTC

RA BANDAGES MIS CLEAR OTC

RA BANDAGES MIS EX-LRG OTC

SHEER BANDGE MIS OTC

sheer bandge mis ex-large OTC

SHR BANDAGES MIS OTC

SHR BANDAGES MIS ASSORTED OTC

2ND SKIN CUT MIS CLOSURE OTC

2ND SKIN PAD MIS BLISTER OTC

SM ADHESIVE PAD 2"X3" OTC

SM ADHESIVE PAD 3"X4" OTC

SM BANDAGES MIS ANTIBACT OTC

SM BANDAGES MIS CLEAR OTC

SM BANDAGES MIS CLR SPOT OTC

SM BANDAGES MIS FAB 3/4" OTC

SM BANDAGES MIS FAB XL OTC

SM BANDAGES MIS FLEXIBLE OTC

SM BANDAGES MIS FOAM OTC

SM BANDAGES MIS FOAM XL OTC

SM BANDAGES MIS PLASTIC OTC

SM BANDAGES MIS SHEER OTC

SM BANDAGES MIS SHEER XL OTC

SM BANDAGES MIS STRNG ST OTC

SM BANDAGES MIS WTRSHELD OTC

SM KNUCKLE/ MIS FINGERTP OTC

SM STRONG MIS STRIPS OTC

STERI-STRIP MIS OTC

STRONG STRIP MIS BANDAGES OTC

SUPER STRIP MIS 1"X3" OTC

WATERPROOF MIS BANDAGES OTC

CONTRACEPTIVES COLOR CONDOM MIS + LUBE OTC, QL (1212 eacboxhes / 1 day) DUREX EXTRA MIS SENSITIV OTC, QL (12 each / 1 day)

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DUREX MIS REALFEEL OTC, QL (12 each / 1 day)

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FANTASY LUBR MIS OTC, QL (12 12 eac boxesh / 1 day) FANTASY LUBR MIS COLORS OTC, QL (12 12 boxeacesh / 1 day) FANTASY LUBR MIS SPERMICI OTC, QL (12 12 eac boxesh / 1 day) FC2 FEMALE MIS CONDOM OTC, QL (12 12 eac boxesh / 1 day) FC FEMALE MIS CONDOM OTC, QL (12 12 eac boxesh / 1 day) KIMONO COLOR MIS OTC, QL (12 each / 1 day) KIMONO MICRO MIS THIN OTC, QL (1212 eacboxhes / 1 day) KIMONO MICRO MIS THIN OTC, QL (12 each / 1 day) KIMONO MICRO MIS THIN + OTC, QL (1212 eacboxhes / 1 day) KIMONO MIS LUBRICAT OTC, QL (12 12 eacboxhes / 1 day) KIMONO MIS LUBRICAT OTC, QL (12 each / 1 day) KIMONO MIS SENSATIO OTC, QL (12 12 eacboxhes / 1 day) KIMONO MIS SENSATIO OTC, QL (12 each / 1 day) KIMONO PLUS MIS LUBRICAT OTC, QL (12 each / 1 day)

KIMONO SENSA MIS PLUS OTC, QL (1212 eacboxhes / 1 day) KIMONO SENSA MIS PLUS OTC, QL (12 each / 1 day) KIMONO SPEC MIS OTC, QL (12 each / 1 day)

LIFESTYLES MIS COLORS OTC, QL (12 12 eac boxesh / 1 day) LIFESTYLES MIS EXT STR OTC, QL (12 12 eac boxesh / 1 day) LIFESTYLES MIS LUBRICAT OTC, QL (12 12 eac boxhes / 1 day) LIFESTYLES MIS SPERM/LU OTC, QL (12 12 eac boxesh / 1 day) LIFESTYLES MIS STUDDED OTC, QL (12 12 eac boxesh / 1 day) LIFESTYLES MIS ULT/SENS OTC, QL (12 12 boxeacesh / 1 day) LIFESTYLES MIS VIBRA-RI OTC, QL (12 12 boxeacesh / 1 day) LIFESTYLES MIS XPLEASUR OTC, QL (12 12 eac boxesh / 1 day) MAXX MIS LUBRICAT OTC, QL (12 each / 1 day) MAXX PLUS MIS SPERMICI OTC, QL (1212 eacboxhes / 1 day) MAXX PLUS MIS SPERMICI OTC, QL (12 each / 1 day) NATURAL COND MIS + LUBE OTC, QL (12 12 eac boxhes / 1 day) TRUSTEX LUBR MIS COLORS OTC, QL (12 12 eac boxhes / 1 day) TRUSTEX LUBR MIS EX LARGE OTC, QL (12 12 eac boxesh / 1 day) TRUSTEX LUBR MIS EX STR OTC, QL (12 12 boxeacesh / 1 day) TRUSTEX LUBR MIS RIB/STUD OTC, QL (12 12 eac boxhes / 1 day) TRUSTEX LUBR MIS SPERMICI OTC, QL (12 12 eac boxhes / 1 day) TRUSTEX/RIA MIS LUBRICAT OTC, QL (12 12 eac boxesh / 1 day) TRUSTEX/RIA MIS NON-LUB OTC, QL (12 12 boxeacesh / 1 day) TRUSTEX/RIA MIS SPERMICI OTC, QL (12 12 boxeacesh / 1 day)

DIABETIC SUPPLIES ACCU-CHEK MIS MLTICLIX OTC ACTI-LANCE MIS LITE 28G OTC

ACTI-LANCE MIS SPEC 17G OTC

ACTI-LANCE MIS UNIV 23G OTC

ADVOCATE MIS LANCETS OTC

ASSURE LANCE MIS 21G OTC

ASSURE LANCE MIS LOW FLOW OTC

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ASSURE LANCE MIS MICRO OTC

ASSURE LANCE MIS SAFE 25G OTC

ASSURE LANCE MIS SAFE 30G OTC

ASSURE PLUS MIS HIGH 18G OTC

ASSURE PLUS MIS LOW 25G OTC

ASSURE PLUS MIS MCRO 28G OTC

ASSURE PLUS MIS NORM 21G OTC

ASSURE PLUS MIS PEDIATRI OTC

BD LANCET UF MIS 30G OTC

BD LANCET UF MIS 33G OTC

BD MICROTAIN MIS LANCETS OTC

BULLSEYE MIS LANCETS OTC

BULLSEYE MIS MINI LNC OTC

CARETOUCH MIS TWIST 33 OTC

CLEANLET 28G MIS LANCETS OTC

COAGUCHEK MIS LANCETS OTC

COMFORT ASSU MIS LANC 28G OTC

COMFORT EZ MIS 21G OTC

COMFORT EZ MIS 23G OTC

COMFORT EZ MIS 28G OTC

COMFORTOUCH MIS LANCET OTC

CVS LANCETS MIS 30G OTC

CVS LANCETS MIS THIN 26G OTC

CVS LANCETS MIS THIN 30G OTC

CVS LANCETS MIS THIN 33G OTC

E-Z JECT MIS 21G COLR OTC

E-Z JECT MIS THIN 26G OTC

E-ZJECT LANC MIS 33G OTC

EASY COMFORT MIS LANC/30G OTC

EASY COMFORT MIS TWIST OTC

EASY TOUCH MIS LANC/21G OTC

EASY TOUCH MIS LANC/23G OTC

EASY TOUCH MIS LANC/26G OTC

EASY TOUCH MIS LANC/28G OTC

EASY TOUCH MIS LANC/30G OTC

EASY TOUCH MIS LANC/32G OTC

EQL LANCETS MIS THIN 26G OTC

EQL LANCETS MIS THIN 30G OTC

FIFTY50 SAFE MIS LANCETS OTC

FINE 30 MIS OTC

FREESTYLE MIS LANCETS OTC

GENTEEL MIS LANCETS OTC

GENTLE-LET MIS 26G OTC

GENTLE-LET MIS 28G OTC

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GENTLE-LET MIS LANCETS OTC

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GNP LANCETS MIS OTC

GNP LANCETS MIS 21G OTC

GNP LANCETS MIS THIN 26G OTC

GOODSENSE MIS LANC 26G OTC

GOODSENSE MIS LANC 30G OTC

GOODSENSE MIS LANC 33G OTC

HAEMOLANCE MIS HIGH FLO OTC

HAEMOLANCE MIS LOW FLOW OTC

HAEMOLANCE MIS PLUS OTC

HAEMOLANCE MIS PLUS LOW OTC

HAEMOLANCE MIS PLUS MAX OTC

HAEMOLANCE MIS PLUS PED OTC

HAEMOLANCE MIS RETRACT OTC

KROGER LANCE MIS THIN OTC

LANCET MICRO MIS THIN 33G OTC

LANCET STAND MIS 21G OTC

LANCET SUPER MIS THIN 30G OTC

LANCET ULTRA MIS THIN 30G OTC

LANCETS MICR MIS THIN 33G OTC

LANCETS MIS OTC

LANCETS MIS 21G OTC

LANCETS MIS 21G COLR OTC

LANCETS MIS 26G OTC

LANCETS MIS 28G OTC

LANCETS MIS 30G OTC

LANCETS MIS 33G OTC

LANCETS SUPR MIS THIN 28G OTC

LANCETS THIN MIS OTC

LANCETS THIN MIS 26G OTC

LANCETS ULTR MIS THIN OTC

LITE TOUCH MIS LANCETS OTC

LONGS LANCET MIS ULTRA TH OTC

MEDICHOICE MIS LANCET OTC

MEDLANCE MIS EXTR 21G OTC

MEDLANCE MIS LITE 25G OTC

MEDLANCE MIS PLUS 30G OTC

MEDLANCE MIS UNV 21G OTC

MEDLANCE PLS MIS 0.8MM OTC

MEDLANCE PLS MIS EXTR 21G OTC

MEDLANCE PLS MIS LITE 25G OTC

MEDLANCE PLS MIS UNIV 21G OTC

MEIJER MIS LANCETS OTC

MICROTAINER MIS LANCET OTC

MM TWIST MIS LANCETS OTC

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MOBILE LANCE MIS 30G OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 121 AGE - Age Limit GNDR - Gender Edit

MONOLET MIS LANCETS OTC

MPD SFTY LAN MIS 21G OTC

MPD SFTY LAN MIS 23G OTC

MPD SFTY LAN MIS 28G OTC

MPD SFTY LAN MIS 30G OTC

ON-THE-GO MIS LANC 30G OTC

ONETOUCH KIT ULT MINI OTC

ONETOUCH MIS LANCETS OTC

PRODIGY MIS 28G OTC

PX LANCETS MIS 28G OTC

PX LANCETS MIS ULT THIN OTC

READYLANCE MIS 21G OTC

READYLANCE MIS 23G OTC

READYLANCE MIS 26G OTC

READYLANCE MIS 28G OTC

RELION LANCE MIS THIN 26G OTC

RELION LANCE MIS THIN 30G OTC

RELION ULTRA MIS THIN PLS OTC

SAFE-T-LANCE MIS 21G OTC

SAFE-T-LANCE MIS 25G OTC

SAFE-T-PRO MIS LANCETS OTC

SAFE-T-PRO MIS PLUS OTC

SAFETY 21G MIS LANCETS OTC

SAFETY 28G MIS LANCETS OTC

SAFETY MIS LANCETS OTC

SB LANCETS MIS THIN OTC

SB LANCETS MIS ULTR THN OTC

SIDE BUTTON MIS SAFETY OTC

SMART SENSE MIS LANC 26G OTC

SOFT TOUCH MIS LANCETS OTC

SOFTCLIX MIS LANCETS OTC

SUPER THIN MIS LANC 28G OTC

SUPER THIN MIS LANCETS OTC

SURE COMFORT MIS LANCETS OTC

SURE-LANCE MIS 26G OTC

SURE-LANCE MIS LANCETS OTC

SURE-TOUCH MIS UNV LANC OTC

SURELITE MIS LANCETS OTC

TECHLITE AST MIS LANCETS OTC

TECHLITE MIS LANC 30G OTC

TECHLITE MIS LANCETS OTC

THIN LANCETS MIS OTC

THIN LANCETS MIS 26G OTC

TRUE COMFORT MIS LANC 30G OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 122 AGE - Age Limit GNDR - Gender Edit

TRUPLUS LANC MIS 28G OTC

Page 172: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 123 AGE - Age Limit GNDR - Gender Edit

TRUPLUS LANC MIS 30G OTC

ULTILET MIS 28G OTC

ULTILET MIS 30G OTC

ULTILET MIS 33G OTC

ULTILET MIS LANCETS OTC

ULTILET SAFE MIS 21G OTC

ULTRA THIN MIS LAN 31G OTC

ULTRA THIN MIS LANC 28G OTC

ULTRA THIN MIS LANCETS OTC

UNILET EX II MIS 28G OTC

UNILET EXCEL MIS 23G OTC

UNILET G.P MIS SUPR 23G OTC

UNILET G.P. MIS 21G OTC

UNILET GP 28 MIS ULT THIN OTC

UNILET LANCT MIS 28G OTC

UNILET LANCT MIS 30G OTC

UNILET LANCT MIS 33G OTC

UNILET MICRO MIS 33G OTC

UNILET SUPER MIS 23G OTC

UNILET SUPER MIS G.P. 23G OTC

UNISTIK 3 MIS GENT 30G OTC

UNISTIK PRO MIS LANC 21G OTC

UNISTIK PRO MIS LANC 28G OTC

UNISTIK TOUC MIS LANC 21G OTC

UNISTIK TOUC MIS LANC 23G OTC

UNITSTIK PRO MIS LANC 25G OTC

VITALET PRO MIS OTC

VITALET PRO MIS PLUS OTC

MISC. DEVICES ALCOHOL SWAB PAD OTC

APLICARE ALC PAD SWABSTIC OTC

HM STERILE PAD ALCHOL OTC

PARENTERAL THERAPY SUPPLIES ASSURE ID MIS 31GX3/16 OTC

BD PEN NEEDL MIS 29GX12.7 OTC

BD PEN NEEDL MIS 31GX5MM OTC

BD PEN NEEDL MIS 31GX8MM OTC BD PEN NEEDL MIS 32GX4MM BD PEN NEEDL MIS 32GX4MM OTC

BD PEN NEEDL MIS 32GX6MM OTC BD U-500 MIS 31GX6MM CAREFINE MIS 31GX8MM OTC

CAREFINE MIS 32GX4MM OTC

CAREFINE MIS 32GX6MM OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 124 AGE - Age Limit GNDR - Gender Edit

CARETOUCH MIS 31GX5MM OTC

Page 174: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 125 AGE - Age Limit GNDR - Gender Edit

CARETOUCH MIS 31GX8MM OTC

CARETOUCH MIS 32GX4MM OTC

CLICKFINE MIS 31GX5/16 OTC

CLICKFINE MIS 32GX5/32 OTC

COMFORT EZ MIS 31GX5MM OTC

COMFORT EZ MIS 31GX8MM OTC

COMFORT EZ MIS 32GX4MM OTC

COMFORT EZ MIS 32GX6MM OTC

EASY COMFORT MIS 31GX3/16 OTC

EASY COMFORT MIS 31GX5/16 OTC

EASY COMFORT MIS 32GX5/32 OTC

EASY TOUCH MIS 31GX3/16 OTC

EASY TOUCH MIS 31GX5/16 OTC

EASY TOUCH MIS 32GX1/4" OTC

EASY TOUCH MIS 32GX5/32 OTC

EASY TOUCH MIS 32GX6MM OTC

FIFTY50 MIS 31GX3/16 OTC

FIFTY50 MIS 31GX5/16 OTC

FIFTY50 MIS 31GX5MM OTC

FIFTY50 PEN MIS 31GX8MM OTC

FIFTY50 PEN MIS 32GX4MM OTC

FIFTY50 PEN MIS 32GX6MM OTC

HM ULTICARE MIS 31GX8MM OTC

IN CONTROL MIS 31GX5MM OTC

IN CONTROL MIS 31GX8MM OTC

INSULIN PEN MIS 31GX8MM OTC

INSULIN SYRG MIS 0.3/31G OTC

INSULIN SYRG MIS 0.5/30G OTC

INSULIN SYRG MIS 0.5/31G OTC

INSULIN SYRG MIS 1ML/31G OTC

INSUPEN MIS 31GX5MM OTC

INSUPEN MIS 31GX8MM OTC

INSUPEN MIS 32GX4MM OTC

INSUPEN SENS MIS 32GX6MM OTC

INSUPEN ULTR MIS 31GX8MM OTC

LITETOUCH MIS 29GX12.7 OTC

LITETOUCH MIS 31GX8MM OTC MM PENTIPS MIS 31GX5MM MM PENTIPS MIS 31GX8MM MM PENTIPS MIS 32GX4MM NOVOFINE MIS 32GX6MM OTC

NOVOFINE PLS MIS 32GX4MM OTC

PEN NEEDLE MIS 29GX1/2" OTC

PEN NEEDLE MIS 32GX4MM OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 126 AGE - Age Limit GNDR - Gender Edit

PEN NEEDLES MIS 29GX12.7

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 120 AGE - Age Limit GNDR - Gender Edit

PEN NEEDLES MIS 29GX12.7 OTC

PEN NEEDLES MIS 31GX3/16 OTC

PEN NEEDLES MIS 31GX5/16 OTC PEN NEEDLES MIS 31GX5MM PEN NEEDLES MIS 31GX5MM OTC PEN NEEDLES MIS 31GX8MM PEN NEEDLES MIS 31GX8MM OTC

PEN NEEDLES MIS 32GX1/4 OTC

PEN NEEDLES MIS 32GX1/4" OTC PEN NEEDLES MIS 32GX4MM PEN NEEDLES MIS 32GX4MM OTC

PEN NEEDLES MIS 32GX5/32 OTC

PEN NEEDLES MIS 32GX6MM OTC PENTIPS MIS 31GX5MM PENTIPS MIS 31GX5MM OTC PENTIPS MIS 31GX8MM PENTIPS MIS 31GX8MM OTC PENTIPS MIS 32GX4MM PENTIPS MIS 32GX4MM OTC PRO COMFORT MIS 31GX8MM PRO COMFORT MIS 32GX4MM

PRO COMFORT MIS 32GX6MM OTC

RA PEN NEEDL MIS 31GX3/16 OTC

RELION PEN MIS 31GX8MM OTC

RELION PEN MIS 32GX4MM OTC

SURE COMFORT MIS 29GX1/2" OTC

SURE COMFORT MIS 31GX3/16 OTC

SURE COMFORT MIS 31GX5/16 OTC

SURE COMFORT MIS 32GX5/32 OTC

SURE COMFORT MIS 32GX6MM OTC

SURE-FINE MIS 29GX1/2" OTC

SURE-FINE MIS 31GX3/16 OTC

SURE-FINE MIS 31GX5/16 OTC

1ST TIER UNI MIS 31GX5MM OTC

1ST TIER UNI MIS 31GX8MM OTC

1ST TIER UNI MIS 32GX4MM OTC

TIER UNI PLS MIS 31GX8MM OTC

ULTICARE MIC MIS 32GX4MM OTC

ULTICARE PEN MIS 31GX5MM OTC

ULTICARE PEN MIS 31GX8MM OTC

ULTILET PEN MIS 29GX12.7 OTC

ULTILET PEN MIS 31GX5MM OTC

ULTILET PEN MIS 31GX8MM OTC

ULTILET PEN MIS 32GX4MM OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 121 AGE - Age Limit GNDR - Gender Edit

UNFINE PNTP MIS 32GX4MM OTC

Page 178: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 121 AGE - Age Limit GNDR - Gender Edit

COMPRESSOR MIS NEBULIZR OTC

EFLOW SCF MIS NEBULIZR ERAPID MIS NEBULIZE

FLYP NEBULZR MIS HOMENEB MIS SIDESTRE OTC

ALTERA MIS NEBULIZE ALTERA NEB MIS HANDSET

UNIFINE PNTP MIS 31GX3/16 OTC

UNIFINE PNTP MIS 31GX5/16 OTC

UNIFINE PNTP MIS 31GX5MM OTC

UNIFINE PNTP MIS 31GX8MM OTC

UNIFINE PNTP MIS 32GX4MM OTC

UNIFINE PNTP MIS 32GX5/32 OTC

UNIFINE PNTP MIS 32GX6MM OTC

RESPIRATORY AIDS FACE MASK MIS EARLOOP OTC

MASK PEDIATR MIS SIZE 1" OTC

MASK PEDIATR MIS SIZE 3" OTC

SHIELD-SECUR MIS OTC

RESPIRATORY THERAPY SUPPLIES ADULT MASK MIS

AERCHMBR PLS MIS LRG MASK AERCHMBR PLS MIS SM MASK AERCHMBR Z- MIS STAT PLS AEROCHAMBER MIS PLUS

AEROSOL MASK MIS ADULT OTC AEROVENT MIS PLUS

AIRIAL MIS COMPACT AIRIAL PEDIA MIS PANDA

BREATHE EASE MIS LG MASK

BREATHE EASE MIS MED MASK BREATHE EASE MIS SM MASK BREATHERITE MIS BREATHERITE MIS LG MASK BREATHERITE MIS MED MASK BREATHERITE MIS SM MASK BREATHERITE MIS SPACER BREATHERITE MIS W/MASK

BUBBLES PEDI MIS MASK OTC COMP AIR MIS ELITE

EASIVENT MIS

EASY NEB MIS OTC

ERAPID NEB MIS HANDSET

FILTER AIR MIS PP

FLEXICHAMBER MIS MASK SM QL (2 boxes / year)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 122 AGE - Age Limit GNDR - Gender Edit

MINIELITE MIS COMP/NEB NEBULIZER MIS CMPRESSR NEBULIZER MIS ULTRASON

OPTIONHOME MIS NEBULIZR

PARI LC D MIS NEBULIZR

PARI LC PLUS MIS NEBULIZR

INNOSPIRE EL MIS NEBULIZE INNOSPIRE ES MIS NEBULIZE INNOSPIRE MIS DEL NEBU OTC INNOSPIRE MIS MINI NEB

MABIS COSMO MIS NEBULIZR

PROCARE COMP MIS NEBULIZE OTC PRONEB ULTRA MIS II/LCD PRONEB ULTRA MIS II/PED PRONEB ULTRA MIS LC PLUS PRONEB ULTRA MIS LC SPRNT

INSPIRATION MIS ELITE

LITETOUCH MIS MASK LG LITETOUCH MIS MASK MD LITETOUCH MIS MASK SM

MASK VORTEX/ MIS BABY DUC OTC, QL (2 each / year)

MASK VORTEX/ MIS DUCK OTC, QL (2 each / year)

MASK VORTEX/ MIS FROG OTC, QL (2 each / year)

MASK VORTEX/ MIS LADY BUG OTC, QL (2 each / year)

MINI-MIST MIS PORTABLE OTC

OPTICHAMBER MIS DIA LG

OPTICHAMBER MIS DIA MD OPTICHAMBER MIS DIAMOND

OPTICHAMBER MIS FACE MAS OTC OPTIHALER MIS

PANDA MASK MIS LARGE OTC, QL (0.2 packs / year)

PANDA MASK MIS MEDIUM OTC, QL (0.2 packs / year)

PANDA MASK MIS PEDIATRI OTC, QL (0.2 packs / year)

PANDA MASK MIS SMALL OTC, QL (0.2 packs / year) PARI BABY MIS SIZE 1

PARI LC MIS SPRINT

PARI LC PLUS MIS VIOS PRO PARI PRONEB MIS ULTRA II PARI SINUS MIS AERO SYS PARI TREK S MIS

PILLOW MASK MIS ADULT PILLOW MASK MIS CHILD PILLOW MASK MIS PEDIATRI POCKET CHAMB MIS POCKET SPACE MIS

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 123 AGE - Age Limit GNDR - Gender Edit

SIDESTREAM MIS NEBULIZR

PRONEB ULTRA MIS LC STAR REPLACEMENT MIS FILTER REPLACEMENT MIS FILTERS OTC SIDESTREAM MIS MASK

SIDESTREAM MIS PED MASK

SIDESTREAM MIS PED MASK OTC SILICONE MSK MIS ADULT SILICONE MSK MIS INFANT SILICONE MSK MIS PED SOOTHENEB MIS NBL 100 OTC

SPACER CHAMB MIS ADULT OTC

SPACER CHAMB MIS CHILD OTC

VAPORIZER MIS 1 GALLON OTC

VAPORIZER MIS 1.2 GAL OTC

VAPORIZER MIS 1.7 GAL OTC

VAPORIZER MIS 2 GALLON OTC

VAPORIZER MIS PORTABLE OTC VIOS LC MIS SPRINT VIOS LC PLUS MIS

VIOS LC PLUS MIS DELUXE VIOS LC PLUS MIS PEDIATRC VIOS MIS SYSTEM VIOS PRO LC MIS SPRINT VORTEX VALVE MIS CHAMBER WILLIS THE MIS WHALE OTC

WING TIP MIS TUBING OTC

MEGLITINIDE ANALOGUES MEGLITINIDE ANALOGUES

nateglinide tab 60 mg nateglinide tab 120 mg repaglinide tab 0.5 mg repaglinide tab 1 mg repaglinide tab 2 mg

METABOLIC MODIFIERS HYPERPARATHYROID TREATMENT - VITAMIN D ANALOGS

calcitriol cap 0.5 mcg calcitriol cap 0.25 mcg calcitriol oral soln 1 mcg/ml doxercalciferol cap 0.5 mcg doxercalciferol cap 1 mcg doxercalciferol cap 2.5 mcg paricalcitol cap 1 mcg paricalcitol cap 2 mcg

paricalcitol cap 4 mcg

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 124 AGE - Age Limit GNDR - Gender Edit

PHENYLKETONURIA TREATMENT - AGENTS KUVAN POW 100MG SP, PA KUVAN TAB 100MG SP, PA

MIGRAINE COMBINATIONS ERGOT COMBINATIONS

ergotamine w/ caffeine tab 1-100 mg

MIGRAINE PRODUCTS SEROTONIN AGONISTS

sumatriptan succinate inj 6 mg/0.5ml QL (8 injections / 25 days) sumatriptan succinate solution auto-injector 4 QL (8 injections / 25 days) mg/0.5ml sumatriptan succinate solution auto-injector 6 QL (8 injections / 25 days) mg/0.5ml sumatriptan succinate solution cartridge 4 QL (8 injections / 25 days) mg/0.5ml sumatriptan succinate solution cartridge 6 QL (8 injections / 25 days) mg/0.5ml sumatriptan succinate solution prefilled syringe 6 QL (8 injections / 25 days) mg/0.5ml

MINERALOCORTICOIDS MINERALOCORTICOIDS

fludrocortisone acetate tab 0.1 mg

MINERALS & ELECTROLYTES CALCIUM

CA HI-CAL/D TAB 500MG OTC calc 600+d tab 600-800 OTC

calcium +d3 tab maximum OTC

calcium carbonate-cholecalciferol tab 500 mg-400 OTC unit calcium carbonate-vitamin d tab 250 mg-125 unit OTC

calcium w/ magnesium tab 500-250 mg OTC

calcium+d3 tab 600-400 OTC

calcium-magnesium-zinc tab 333-133-8.3 mg OTC calcium/d3 tab 500-600 OTC calcium/d tab 600-800 OTC calcium/vita tab d3 OTC

coral calciu cap plus OTC

cvs calcium tab 600mg OTC

eq calcium tab citr+d OTC

eql calcium tab w/vit d OTC

hm ca/vit d3 tab 600-400 OTC

hm ca/vit d3 tab 600-800 OTC

nat-rul cal tab /d 500mg OTC

ra hi-cal tab 500mg OTC

sm calcium/d tab 500-200 OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 125 AGE - Age Limit GNDR - Gender Edit

ELECTROLYTE MIXTURES oral electro sol freezer OTC oral electrolyte solution OTC

ped elctrlyt sol apple OTC

ped elctrlyt sol pineappl OTC

FLUORIDE fluoritab chw 0.25mg f

IODINE PRODUCTS SSKI SOL 1GM/ML

POTASSIUM effer-k tab 25meq ef potassium chloride microencapsulated crys er tab

20 meq

MISC. ANTI-ULCER MISC. ANTI-ULCER

CARAFATE SUS 1GM/10ML sucralfate tab 1 gm

MISC. DEVICES APPLICATORS,COTTON BALLS,ETC

ALCOH-GLOVE PAD CONTOURE ALCOH-WIPE MIS 12"X12" ALCOHOL PAD OTC

ALCOHOL PAD 70% OTC

ALCOHOL PAD PREP OTC

ALCOHOL PAD SWABSTIC OTC

ALCOHOL PREP PAD OTC

ALCOHOL PREP PAD 70% OTC

ALCOHOL PREP PAD MED 70% OTC

ALCOHOL PREP PAD PADS 70% OTC

ALCOHOL SWAB PAD 70% OTC

ALCOHOL SWAB PAD EX-THICK OTC

ALCOHOL WIPE PAD OTC

BD SWAB BFLY PAD SNGL USE OTC

BD SWAB REG PAD SNGL USE OTC

CARETOUCH PAD ALCOHOL OTC

CURITY PREP PAD ALCOHOL OTC

CURITY SWABS PAD ALCOHOL OTC

FIFTY50 PREP PAD PADS OTC

GLOBAL PREP PAD PADS OTC

GNP ALCOHOL PAD SWABS OTC

INCONTROL PAD ALCOHOL OTC

PREP PADS PAD OTC

PRO COMFORT PAD ALCOHOL OTC

Page 183: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 126 AGE - Age Limit GNDR - Gender Edit

QC ALCOHOL PAD SWABS OTC

Page 184: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 127 AGE - Age Limit GNDR - Gender Edit

RA ALCOHOL PAD SWABS OTC

REALITY SWAB PAD OTC

SAPS CARE PAD ALCOHOL OTC

SAPS HEALTH PAD ALCOHOL OTC

SB ALCOHOL PAD PREP OTC

SM ALCOHOL PAD PREP OTC

ULTICARE PAD ALCOHOL OTC

ULTILET PAD ALCOHOL OTC

WEBCOL PREP PAD LARGE OTC

WEBCOL PREP PAD MEDIUM OTC

MISC. NUTRITIONAL SUBSTANCES MISC. NUTRITIONAL SUBSTANCES

cvs fish oil cap 1000mg OTC cvs fish oil cap 1200mg OTC

emulsified liq omega-3 OTC

eql fish oil cap 1000mg OTC

eql fish oil cap 1200mg OTC

eskimo-3 cap 500mg OTC

eskimo-3 liq OTC

finest fish liq oil OTC

finest fish liq oil/kids OTC

fish oil cap 300mg OTC

fish oil cap 435mg OTC

FISH OIL CAP 1000MG OTC

fish oil cap 1200mg OTC

FISH OIL CAP 1360MG OTC

FISH OIL CAP 1400MG OTC

fish oil chw gummies OTC

fish oil con cap 300mg OTC

fish oil con cap 1000mg OTC

gnp fish oil cap OTC

gnp fish oil cap 1000mg OTC

healthy kids chw gummies OTC

hm fish oil cap 1000mg OTC

hm fish oil cap 1200mg OTC

kp fish oil cap 1200mg OTC

maxepa cap 1000mg OTC

maximum epa cap 1000mg OTC

omega 3 500 cap 500mg OTC

omega 3 cap 1000mg OTC

omega essent liq basic OTC

omega iii cap epa+dha OTC

OMEGA-3 CAP 1400MG OTC

omega-3 cf cap 1000mg OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 128 AGE - Age Limit GNDR - Gender Edit

omega-3 fatty acids cap 300 mg OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 127 AGE - Age Limit GNDR - Gender Edit

omega-3 fatty acids cap 435 mg OTC

omega-3 fatty acids cap 500 mg OTC

omega-3 fatty acids cap 1000 mg OTC

omega-3 fatty acids cap 1200 mg OTC

omega-3 fish cap 1000 mg OTC

omega-3 fish cap 1200mg OTC

omega-3 fish chw 113.5mg OTC

omega-3 plus cap 1000mg OTC

omera cap 1000mg OTC

ovega-3 cap 500mg OTC

pa fish oil cap 1000mg OTC

purefa cap 1000mg OTC

px fish oil cap 1000mg OTC

ra fish oil cap 1000mg OTC

salmon oil cap 1000mg OTC

sam-e.p.a. cap 500mg OTC

sea-omega 30 cap 1200mg OTC

sea-omega 50 cap 1000mg OTC

sm fish oil cap 1000mg OTC

sm fish oil cap 1200mg OTC

super dha cap gems OTC

super omega cap 500mg OTC

super omega cap -3 OTC

supr omega 3 cap epa/dha OTC

theromega cap 1000mg OTC

ULTRA OMEGA3 CAP 1400MG OTC

very finest liq fish oil OTC

MISC. RESPIRATORY INHALANTS MISC. RESPIRATORY INHALANTS

nebusal neb 3% pulmosal neb 7%

simply salin aer baby OTC

sodium chloride aero soln 0.9% OTC

sodium chloride soln nebu 0.9%

sodium chloride soln nebu 3% sodium chloride soln nebu 7% sodium chloride soln nebu 10%

MISC. TOPICAL ASTRINGENTS

CALAMINE LOT OTC SM CALAMINE LOT OTC

MISCELLANEOUS VAGINAL PRODUCTS MISCELLANEOUS VAGINAL PRODUCTS

acetic acid vaginal solution OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 128 AGE - Age Limit GNDR - Gender Edit

ex cleansing sol OTC

feminine car sol douche OTC

massengill sol vin&watr OTC

summers eve sol ex clean OTC

MITOTIC INHIBITORS MITOTIC INHIBITORS

etoposide cap 50 mg

MOUTH/THROAT/DENTAL AGENTS ANTI-INFECTIVES - THROAT

AMPHOTERICIN POW B

ANTISEPTICS - MOUTH/THROAT paroex sol 0.12%

MULTIPLE SCLEROSIS AGENTS MS AGENTS - PYRIMIDINE SYNTHESIS INHIBITORS

AUBAGIO TAB 7MG SP, QL (1 tab / 1 day), PA AUBAGIO TAB 14MG SP, QL (1 tab / 1 day), PA

MULTIPLE SCLEROSIS AGENTS - NRF2 PATHWAY ACTIVATORS TECFIDERA CAP 120MG SP, QL (2 caps / 1 day), PA TECFIDERA CAP 240MG SP, QL (2 caps / 1 day), PA

TECFIDERA MIS STARTER SP, QL (0.033 kits / 1 day),

PA

SPHINGOSINE 1-PHOSPHATE (S1P) RECEPTOR MODULATORS GILENYA CAP 0.5MG SP, QL (1 cap / 1 day), PA

MULTIPLE VITAMINS W/ CALCIUM MULTIPLE VITAMINS W/ CALCIUM

daily multiv tab womens OTC essent one tab daily OTC

hm one daily tab essentia OTC

HM ONE DAILY TAB ESSENTIA OTC

hm vita-mini tab multi OTC

multi-day tab /ca/iron OTC

one daily tab womens OTC

SM ONE DAILY TAB ESSENTIA OTC

MULTIPLE VITAMINS W/ IRON MULTIPLE VITAMINS W/ IRON

CHLORELLA CAP OTC daily multi tab vit/iron OTC

daily vit tab +iron OTC

daily vit tab iron OTC

daily vite tab iron OTC

daily-vitamn tab OTC

daily-vite/ tab iron OTC

hm one daily tab /iron OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 129 AGE - Age Limit GNDR - Gender Edit

multi vitami tab w/iron OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 130 AGE - Age Limit GNDR - Gender Edit

multi-day tab /iron OTC

multi-vit/fe tab OTC

multiple vitamins w/ iron tab OTC

once daily tab iron OTC

one daily mv tab /iron OTC

one daily tab pls iron OTC

one-daily tab /iron OTC

ra one daily tab +iron OTC

sm multiple tab vit/iron OTC

stress b com tab w/iron OTC

stress form tab /iron OTC

stress formu tab w/iron OTC

tab-a-vite tab /iron OTC

MULTIPLE VITAMINS W/ MINERALS MULTIPLE VITAMINS W/ MINERALS

a thru z adv tab adult OTC a thru z chw select OTC

a thru z sel tab 50+ adva OTC

a thru z sel tab 50+ mens OTC

a thru z sel tab advanced OTC

a thru z tab advanced OTC

a thru z tab high pot OTC

a thru z tab select OTC

a thru z tab ultimate OTC

a thru z ult tab mens OTC

abc plus tab OTC

abc plus tab senior OTC

actical cap OTC

ACTIVE 55 LIQ PLUS OTC

adlt multivi chw gummies OTC

ADLT ONE DLY CHW GUMMIES OTC

ADULT 50+ CAP OCUVITE OTC

50+ adult cap eye hlth OTC

adult gummy chw OTC

ADV DIABETIC TAB MULTIVIT OTC

advanced chw multi ea OTC

advanced eye cap health OTC

advanced tab formula OTC

airborne chw OTC

airborne chw gummies OTC

airborne chw immune OTC

AIRBORNE LOZ OTC

AIRSHIELD CHW IMMUNITY OTC

ALIVE 50+ TAB WOMENS OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 131 AGE - Age Limit GNDR - Gender Edit

ALIVE DAILY TAB WOMENS OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 130 AGE - Age Limit GNDR - Gender Edit

ALIVE ENERGY TAB MENS OTC

ALIVE ENERGY TAB WOMENS OTC

ALIVE WOMENS CHW GUMMY OTC

amoryn mood cap booster OTC

anti-oxidant cap formula OTC

antiox form/ cap minerals OTC

antioxidant cap OTC

antioxidant tab OTC

ANTIOXIDANT TAB FORTE OTC

antioxidant tab protecti OTC

antioxidant tab vitamins OTC

antioxin cap 4000 OTC

AQUADEKS CHW OTC

b-redi/rd hr tab ts/rd ro OTC

BARIATRIC CHW FUSION OTC

BASIC AM TAB OTC

BASIC PM TAB OTC

bdy/hair/skn cap nails OTC

BIO-35 GLUTE CAP FREE OTC

BIO-35 IRON CAP FREE OTC

BIOCAL CAP OTC

BIOSUPP LIQ OTC

BIOTECT PLUS CAP OTC

BIOTECT PLUS LIQ OTC

biotin plus/ tab cal/vitd OTC

BIOVOL SYP OTC

bprotected liq multi-vi OTC

C-BUFF POW OTC

CAL-DAY 1000 TAB OTC

carravite tab OTC

CELLULAR CAP SECURITY OTC

CENT MATURE TAB ADLT 50+ OTC

centamin liq OTC

centavite az tab minerals OTC

centavite liq OTC

central-vite tab mens mat OTC

CENTRAL-VITE TAB UNDER 50 OTC

central-vite tab wmns mat OTC

centravites tab OTC

centravites tab 50 plus OTC

CENTRAVITES TAB 50 PLUS OTC

CENTRAVITES TAB ADULTS OTC

CENTRUM CHW OTC

CENTRUM CHW FLAV BST OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 131 AGE - Age Limit GNDR - Gender Edit

CENTRUM CHW MEN OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 132 AGE - Age Limit GNDR - Gender Edit

CENTRUM CHW MULTI OTC

CENTRUM CHW SILVER OTC

CENTRUM CHW VITAMINT OTC

CENTRUM CHW WOMEN OTC

CENTRUM KIDS CHW FLAV BST OTC

CENTRUM POW DRINK OTC

CENTRUM SPEC TAB HEART OTC

CENTRUM SPEC TAB IMMUNE OTC

CENTRUM SPEC TAB VISION OTC

CENTRUM TAB CARDIO OTC

CENTRUM TAB MEN OTC

CENTRUM TAB SILVER OTC

CENTRUM TAB ULTRA OTC

century tab OTC

century tab mature OTC

cerovite tab advanced OTC

cerovite tab senior OTC

certa plus tab OTC

certagen tab OTC

CERTAVITE TAB SENIOR OTC

certavite/ tab antioxid OTC

CHOICEFUL CAP MULTIVIT OTC

CHOICEFUL CHW MULTIVIT OTC

comp daily tab w/lutein OTC

comp energy tab OTC

comp multivi liq mineral OTC

companion tab OTC

compete tab OTC

comple multi tab adlt 50+ OTC

complere tab OTC

COMPLETE 50+ TAB MENS OTC

COMPLETE 50+ TAB WOMENS OTC

complete tab OTC

complete tab senior OTC

complete tab womens OTC

CONCEPTIONXR MIS MOTILITY OTC

coral calciu cap plus OTC

cvs daily chw gummies OTC

daily betic tab OTC

daily combo tab OTC

daily diet tab support OTC

DAILY ENERGY POW ENFUSION OTC

DAILY HEART PAK SUPPORT OTC

daily mens tab health OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 133 AGE - Age Limit GNDR - Gender Edit

daily multi tab OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 134 AGE - Age Limit GNDR - Gender Edit

daily multi tab 50+ OTC

daily multi tab men OTC

daily multi tab minerals OTC

daily multi tab vit/mens OTC

daily multi tab vit/min OTC

daily multi tab women OTC

daily multi tab womn 50+ OTC

DAILY PAK MIS MULTIVIT OTC

daily vit tab +mineral OTC

daily vitamn cap plus OTC

daily womens tab health OTC

daily-vitamn tab maximum OTC

DECUBI-VITE CAP OTC

DEKAS PLUS CAP OTC

DEKAS PLUS CHW OTC

DERMAVITE TAB OTC

DIABET HLTH PAK SUPPORT OTC

DIABETES PAK HEALTH OTC

DIABETES PAK SUPPORT OTC

diabetic sup tab formula OTC

diabets hlth tab formula OTC

dialyvite tab 800/d OTC

drs choice tab men OTC

dry eye cap formula OTC

ELDERTONIC ELX OTC

EMERGEN-C CHW IMMUNE/D OTC

EMERGEN-C CHW VITA C OTC

EMERGEN-C PAK BLUE OTC

EMERGEN-C PAK FIVE OTC

EMERGEN-C PAK HEART OTC

EMERGEN-C PAK IMMUNE OTC

EMERGEN-C PAK JOINT OTC

EMERGEN-C PAK KIDZ OTC

EMERGEN-C PAK MSM LITE OTC

EMERGEN-C PAK PINK OTC

EMERGEN-C PAK SUPER FR OTC

EMERGEN-C PAK VIT D/CA OTC

EMERGEN-C PAK VITA C OTC

ENERGY POW BOOSTER OTC

enviro-stres tab OTC

EQ COMPLETE TAB ADULT OTC

EQ ONE DAILY TAB MENS OTC

eq one daily tab womens OTC

EQ ONE DAILY TAB WOMENS OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 135 AGE - Age Limit GNDR - Gender Edit

eql century tab OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 136 AGE - Age Limit GNDR - Gender Edit

eql century tab mature OTC

EQL CENTURY TAB MENS OTC

EQL CENTURY TAB WOMENS OTC

eql vision tab formula OTC

essentia tab OTC

essential tab balance OTC

EYE HEALTH CAP OTC

eye vitamins cap OTC

eye-vites tab OTC

eyeprotect tab OTC

FITNESS TABS TAB MEN OTC

FITNESS TABS TAB WOMEN OTC

FORTAVIT LIQ OTC

FREEDAVITE TAB OTC

GERI-FREEDA TAB SENIOR OTC

gerivite tab complete OTC

glucoten cap OTC

gnp century tab OTC

gnp century tab adult OTC

gnp century tab cardio OTC

gnp century tab mature OTC

gnp century tab senior OTC

gnp century tab ultimate OTC

gnp healthy tab eyes OTC

gnp one dail tab maximum OTC

gnp opti-vit tab OTC

hair formula tab ex stren OTC

hair formula tab ultr man OTC

hair skin tab nails OTC

hair vitamin tab OTC

hair/skin cap nails OTC

hair/skin/ tab nails OTC

healthy eyes cap supervis OTC

healthy eyes tab OTC

healthy eyes tab lutein OTC

hi-kovite tab 2-part OTC

hi-potency tab multivit OTC

hm complete tab OTC

HM COMPLETE TAB OTC

hm complete tab 50+ OTC

hm complete tab women OTC

HM HAIR/SKIN TAB /NAILS OTC

hm multivit chw gummy OTC

HM ONE DAILY TAB MENS OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 137 AGE - Age Limit GNDR - Gender Edit

HYALEX TAB OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 138 AGE - Age Limit GNDR - Gender Edit

i-vite prote tab OTC

i-vite tab OTC

icaps areds cap 2 OTC

ICAPS AREDS TAB FORMULA OTC

icaps cap OTC

icaps lutein cap /omega-3 OTC

icaps mv tab OTC

ICAPS PLUS TAB OTC

IMMUNE CHW SUPPORT OTC

IMMUNE SUPP POW VIT C OTC

K-PAX CAP DOUBLE OTC

K-PAX CAP SINGLE OTC

K-PAX TAB PROF ST OTC

kp adult 50+ tab daily OTC

kp adults tab daily OTC

kp mens 50+ tab daily OTC

KP MENS MIS DAILY PK OTC

kp mens tab daily OTC

kp vision tab for/ltn OTC

kp vision tab formula OTC

kp women 50+ tab daily OTC

KP WOMENS PAK DAILY OTC

kp womens tab daily OTC

LIFE PACK MIS MENS OTC

LIFE PACK MIS WOMENS OTC

life pack tab mens OTC

life pack tab womens OTC

lysiplex liq plus OTC

M2 B-60 TAB TR OTC

macular hlth cap formula OTC

MACULAR VIT TAB BENEFIT OTC

macuvite tab OTC

macuvite tab eye care OTC

macuvite tab lutein OTC

magnum-75 tab OTC

max daily tab green OTC

MAXIMIN PAK OTC

maximum tab blue lab OTC

maximum tab green lb OTC

maximum tab red labl OTC

mediplex tab plus OTC

mega multi tab men OTC

mega multi tab women OTC

MEGA MULTIVI POW OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 139 AGE - Age Limit GNDR - Gender Edit

MEGA MULTIVI TAB MEN OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 140 AGE - Age Limit GNDR - Gender Edit

MEGA MULTIVI TAB WOMEN OTC

mega vm-80 tab OTC

mega-maratho tab 100 tr OTC

MEGAVITE TAB FRT/VEG OTC

MEGAVITE TAB GOLD 55+ OTC

mens 50+ adv tab one daly OTC

MENS 50+ CAP ADVANCED OTC

mens daily cap lycopene OTC

mens daily chw gummies OTC

mens daily tab formula OTC

MENS MULTI TAB VIT/MIN OTC

MENS PAK OTC

MH MACULAR MIS HEALTH OTC

milltrium sr tab OTC

milltrium tab advanced OTC

milltrium tab cardio OTC

mult vitamin tab no iron OTC

mult vitamin tab womens OTC

multi 50+ cap for her OTC

multi 50+ tab for her OTC

multi 50+ tab for him OTC

MULTI ADULT CHW EXTRA C OTC

multi adult chw gummies OTC

multi cap complete OTC

multi cap for her OTC

multi cap for him OTC

multi complt tab /iron OTC

MULTI FOR POW HER OTC

MULTI FOR POW HIM OTC

multi gummie chw mens OTC

multi gummie chw womens OTC

multi tab for her OTC

multi tab for him OTC

MULTI VITAMN TAB MINERALS OTC

multi+omega3 chw adult OTC

MULTI-BETIC TAB DIABETES OTC

multi-day tab minerals OTC

multi-day tab wght trm OTC

multi-lean tab OTC

multi-vit/ tab minerals OTC

multi-vitami chw gummies OTC

multi-vitami tab menopaus OTC

MULTI-VITAMI TAB MONOCAPS OTC

multi-vite tab OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 141 AGE - Age Limit GNDR - Gender Edit

multi-vite tab 50&over OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 142 AGE - Age Limit GNDR - Gender Edit

multilex tab OTC

multilex-t&m tab OTC

multimineral tab plus OTC

multiple vitamins w/ minerals tab OTC

multiv women tab 50+ OTC

multivi adlt chw gummies OTC

multivitamin cap daily OTC

MULTIVITAMIN CHW ADLT GUM OTC

MULTIVITAMIN CHW ADULT OTC

multivitamin chw vita d3 OTC

multivitamin liq OTC

multivitamin liq mineral OTC

multivitamin tab adlt 50+ OTC

multivitamin tab adt 50+ OTC

MULTIVITAMIN TAB ADULT OTC

multivitamin tab adults OTC

MULTIVITAMIN TAB ADULTS OTC

MULTIVITAMIN TAB MEN OTC

multivitamin tab men 50+ OTC

multivitamin tab mens OTC

multivitamin tab mineral OTC

multivitamin tab women OTC

multivitamin tab womens OTC

MVW COMPLETE CAP D3000 OTC

MVW COMPLETE CAP D5000 OTC

MVW COMPLETE CHW GRAPE OTC

my-vitalife cap OTC

myamulti tab OTC

natrul-100 tab super OTC

NATRUL-VITES TAB OTC

NUTRIENT 45+ TAB WOMEN OTC

NUTRIENT 50+ TAB MEN OTC

NUTRIENTS CAP ANTIOXID OTC

NUTRIENTS TAB MEN OTC

NUTRIENTS TAB TEENS OTC

NUTRIENTS TAB WOMEN OTC

ocutabs tab OTC

ocutabs tab lutein OTC

OCUVITE CAP ADULT OTC

ocuvite eye cap health OTC

ocuvite eye chw heatlh OTC

ocuvite eye tab + multi OTC

OCUVITE LUTE CAP OTC

ocuvite tab lutein OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 143 AGE - Age Limit GNDR - Gender Edit

ocuvite xtra tab OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 144 AGE - Age Limit GNDR - Gender Edit

ONCOVITE TAB OTC

ONE DAILY CHW ADLT GUM OTC

one daily chw gummy OTC

ONE DAILY MN TAB W/O IRON OTC

one daily tab 50 plus OTC

one daily tab 50+ OTC

one daily tab 50+ adv OTC

one daily tab /mineral OTC

one daily tab complete OTC

one daily tab fe/ca OTC

one daily tab healthy OTC

one daily tab iron-fre OTC

one daily tab maximum OTC

one daily tab men OTC

one daily tab men 50+ OTC

one daily tab mens OTC

ONE DAILY TAB MENS OTC

one daily tab mens 50+ OTC

ONE DAILY TAB MENS 50+ OTC

one daily tab multivit OTC

one daily tab plus iro OTC

ONE DAILY TAB WMNS 50+ OTC

one daily tab wom 50+ OTC

ONE DAILY TAB WOMANS OTC

one daily tab women OTC

one daily tab women 50 OTC

one daily tab womens OTC

one daily wm tab pro-actv OTC

one daily/ tab minerals OTC

one dly hlth tab wght adv OTC

ONE-A-DAY CHW IMMUNITY OTC

ONE-A-DAY CHW VITACRAV OTC

ONE-A-DAY TAB 50+ ADV OTC

ONE-A-DAY TAB ENERGY OTC

ONE-A-DAY TAB MENOPAUS OTC

ONE-A-DAY TAB MENS OTC

ONE-A-DAY TAB PROEDGE OTC

one-a-day tab teen/her OTC

ONE-A-DAY TAB TEEN/HIM OTC

optic-vites tab OTC

optic-vites tab lutein OTC

OPTIMUM CHW AIRVITES OTC

optimum pms tab OTC

OPTISOURCE CHW BARIATRC OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 145 AGE - Age Limit GNDR - Gender Edit

OPURITY CHW BYPASS OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 146 AGE - Age Limit GNDR - Gender Edit

OPURITY TAB OTC

osteoprime tab ultra OTC

PA MENS 50 PAK VITAPAK OTC

PA MENS PAK VITAPAK OTC

PA WOMENS 50 PAK VITAPAK OTC

PA WOMENS PAK VITAPAK OTC

PARVLEX TAB OTC

PHLEXY-VITS POW OTC

PHYTOMULTI TAB OTC

pms support cap complex OTC

PREMIUM MIS PACKETS OTC

PRESCRIPTIVE PAK FORM MEN OTC

PRESCRIPTIVE PAK FORM WMN OTC

PRESERVISION CAP AREDS OTC

PRESERVISION CAP AREDS 2 OTC

PRESERVISION CAP LUTEIN OTC

PRESERVISION TAB AREDS OTC

prevent cap OTC

PRO-CAL TAB OTC

PROCERV HP TAB OTC

PRORENAL +D TAB OTC

PRORENAL+D CAP OMEGA-3 OTC

PRORENAL+D TAB OTC

prosight cap w/lutein OTC

prosight tab OTC

PROTECT CAP CARDIO OTC

PROTECT CAP PLUS SO OTC

PROTECT PLUS LIQ NF OTC

px advanced tab multivit OTC

px complete tab senior OTC

px mens mult tab vitamins OTC

qc therin-m tab OTC

QUENCH TAB OTC

QUIN B TAB STRONG OTC

quintabs-m tab OTC

QUINTABS-M TAB OTC

ra central tab -vite OTC

ra central tab energy OTC

ra central tab vite sel OTC

ra central tab vite sen OTC

RA ESSENCE-C POW LMN-LIME OTC

RA ESSENCE-C POW ORANGE OTC

RA ESSENCE-C POW RASPBRY OTC

RA ESSENCE-C POW TNGERINE OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 147 AGE - Age Limit GNDR - Gender Edit

ra hair/skin tab /nails OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 148 AGE - Age Limit GNDR - Gender Edit

ra mature wm tab diet sup OTC

ra one daily pak mens 50+ OTC

ra one daily tab energy OTC

ra one daily tab maximum OTC

ra one daily tab mens OTC

ra one daily tab mens 50+ OTC

ra one daily tab mens/d3 OTC

ra one daily tab womens OTC

ra therapeut tab m/beta OTC

ra vision tab vite/zn OTC

renaplex tab OTC

RENAPLEX-D TAB OTC

REPLACE CAP OTC

SAVISION CAP OTC

savision tab OTC

sclerex tab OTC

senior tabs tab OTC

sentry adult tab under 50 OTC

SENTRY SENIO TAB LUTEIN OTC

sentry tab OTC

SENTRY TAB OTC

sentry tab senior OTC

SKIN BEAUTY/ PAK WELLNESS OTC

sm complete tab OTC

sm complete tab 50+ OTC

sm complete tab 50+ mens OTC

sm complete tab 50+ wmn OTC

sm complete tab adv form OTC

sm complete tab senior OTC

sm hair/skin tab /nails OTC

SM ONE DAILY TAB MENS OTC

SM ONE DAILY TAB WOMENS OTC

sm opti-vita tab OTC

SOLO TAB OTC

spectr women tab hlth sen OTC

spectra ultr tab hlth men OTC

SPECTRAVITE CHW ADLT 50+ OTC

SPECTRAVITE TAB ADLT 50+ OTC

spectravite tab advanced OTC

SPECTRAVITE TAB MEN 50+ OTC

spectravite tab senior OTC

SPECTRAVITE TAB SENIOR OTC

SPECTRAVITE TAB ULT MEN OTC

SPECTRAVITE TAB ULT WMN OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 149 AGE - Age Limit GNDR - Gender Edit

stress b-com tab /c/zinc OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 140 AGE - Age Limit GNDR - Gender Edit

stress form tab /iron OTC

stress form/ tab zinc OTC

stress formu tab advanced OTC

stress formu tab energy OTC

stress tab formula OTC

stresstabs tab advanced OTC

sunvite actv tab adult OTC

sunvite tab advanced OTC

super 28 tab formula OTC

SUPER ANTIOX CAP OTC

super antiox cap protect OTC

super antiox tab a/c/e/se OTC

super liq nu-thera OTC

super multip cap OTC

super multip tab OTC

SUPER POW NU-THERA OTC

super tab nu-thera OTC

super thera tab vite m OTC

super vikaps tab OTC

superior 35 tab OTC

supr aytinal tab OTC

supr aytinal tab 50 plus OTC

supr vitamin tab OTC

T-VITES TAB OTC

thera form/ tab hematin OTC

THERA M PLUS TAB OTC

thera tab vital-m OTC

thera vital tab m OTC

thera-m tab OTC

THERA-M TAB OTC

thera-mill m tab OTC

THERA-TABS M TAB OTC

therabasic-m tab OTC

THERABETIC TAB MULTIVIT OTC

theradex m tab OTC

theradex m/ tab beta car OTC

THERAGRAN-M TAB OTC

THERAGRAN-M TAB 50 PLUS OTC

THERAGRAN-M TAB ADVANCED OTC

THERAGRAN-M TAB PREMIER OTC

theramill cap plus OTC

THERANATAL CAP LACTATIO OTC

THERANATAL MIS LACTATIO OTC

therapeutic tab OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 141 AGE - Age Limit GNDR - Gender Edit

therapeutic tab -m OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 142 AGE - Age Limit GNDR - Gender Edit

therapeutic- tab m OTC

therapeutic- tab m/lutein OTC

theratrum co tab 50 plus OTC

theratrum tab complete OTC

theravim -m tab OTC

THEREMS-H TAB OTC

THEREMS-M TAB OTC

thrive for tab women OTC

total formul tab OTC

total formul tab 2 OTC

total formul tab 3 OTC

totalday mul tab tr OTC

tropical liq nutritio OTC

trueplus tab diabetic OTC

ultra antiox tab formula OTC

ultra freeda tab OTC

ultra freeda tab /iron OTC

ULTRA MEGA G TAB 75MG CR OTC

ULTRA MEGA G TAB 100MG OTC

ULTRA MEGA TAB 75MG CR OTC

ULTRA MEGA TAB TWO OTC

ULTRA MENS MIS PACK OTC

ultra multi cap /iron OTC

ultra vita-t tab OTC

ULTRA WOMENS MIS PACK OTC

ultra-mega tab cr OTC

ultrachoice tab advanced OTC

UNICOMPLEX-M TAB OTC

vision form cap eye hlth OTC

vision form tab 2 OTC

vision form/ tab lutein OTC

vision formu cap 50+ OTC

vision plus cap OTC

vision tab vitamins OTC

visivites tab OTC

visivites tab /lutein OTC

vita hair tab OTC

vita-min cap OTC

vitabasic tab complete OTC

vitabasic tab senior OTC

VITABEX CAP OTC

VITACRAVES CHW IMMUNITY OTC

VITACRAVES CHW MENS OTC

VITACRAVES CHW SOUR GUM OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 143 AGE - Age Limit GNDR - Gender Edit

VITACRAVES CHW WOMENS OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 144 AGE - Age Limit GNDR - Gender Edit

VITALINE TAB FORMULA2 OTC

VITALINE TAB FORMULA3 OTC

VITAMENT PAK OTC

VITAMIN C PAK BLEND OTC

VITAMIN C POW ELECTROL OTC

VITAMIN D3 TAB COMPLETE OTC

VITAMINS TO MIS GO MAX OTC

VITAMINS TO MIS GO MEN OTC

VITAMINS TO MIS GO WOMEN OTC

VITASANA TAB OTC

vitatrum chw OTC

VITATRUM TAB OTC

vitatrum tab complete OTC

viteyes ared cap advanced OTC

viteyes ared cap formula OTC

viteyes cap /lutein OTC

viteyes cap complete OTC

viteyes smkr cap advanced OTC

viteyes smkr cap w/lutein OTC

viteyes tab lycopene OTC

vitrum tab senior OTC

VITRUM TAB SENIOR OTC

WHOLE FOOD TAB MULTIVIT OTC

whole source tab dietary OTC

whole source tab for men OTC

whole source tab mature OTC

whole source tab women OTC

womens 50+ cap advanced OTC

womens 50+ tab advanced OTC

WOMENS BIO- TAB MULTIPLE OTC

womens cap multi OTC

womens daily chw gummies OTC

womens daily tab fa/ca/fe OTC

womens daily tab formula OTC

womens mult tab OTC

WOMENS MULTI TAB VIT/MIN OTC

womens one tab daily OTC

WOMENS PAK OTC

womns active tab daily OTC

YELETS TEEN TAB FORMULA OTC

YOUR LIFE CHW GUMMIES OTC

YOUR LIFE CHW MULTIVIT OTC

your life tab mens 50+ OTC

your life tab wmns 50+ OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 145 AGE - Age Limit GNDR - Gender Edit

ZINC LOZ OTC

Page 217: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 143 AGE - Age Limit GNDR - Gender Edit

MULTIPLE VITAMINS W/ MINERALS & FOLIC ACID ACTIVITE EC TAB OTC

MULTIVITAMINS B-COMPLEX VITAMINS

APETIGEN ELX OTC b-complex vitamin cap OTC

b-complex vitamin sublingual liquid OTC

b-complex vitamin tab OTC

cvs balanced tab b100 OTC

ra b-complex tab w/b-12 OTC

B-COMPLEX W/ C b-complex w/ c & calcium tab OTC b-complex w/ c tab OTC

cvs super b tab complx/c OTC

stress b com tab vit c/zn OTC

stress form/ tab zinc OTC

super b comp tab vit c OTC

super b w/c cap OTC

vt b complex cap OTC

B-COMPLEX W/ FOLIC ACID b complex tab form 1 OTC b-50 complex tab OTC

b-100 complx tab OTC

b-100 tab b-100 OTC

b-100 tr tab OTC

b-complex tab 100 tr OTC

b-complex w/ c & folic acid tab OTC

b-complex w/ folic acid cap OTC

b-complex w/biotin & folic acid tab OTC

b-complex/fa tab /vit c OTC

balance b-50 tab OTC

endur-b tab OTC

EXTRESS-30 CAP OTC

FULL SPECT TAB B/ VIT C OTC

gnp b-50 tab balanced OTC

gnp b-100 tab OTC

kobee tab OTC

nephro tab vitamins OTC

quin b stron tab b-25 OTC

ra balanced tab b-50 tr OTC

rena-vite rx tab OTC

reno cap OTC

sm balanced tab b-50 OTC

sm balanced tab b-100 OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 144 AGE - Age Limit GNDR - Gender Edit

super b comp tab maxi OTC

super b- tab complex OTC

super b-comp tab vit c/fa OTC

super dec tab b-100 OTC

super quints tab OTC

B-COMPLEX W/ IRON APETIGEN-PLS SOL OTC

B-COMPLEX W/ MINERALS senor tonic liq OTC

BIOFLAVONOID PRODUCTS BIOFLAVONOID POW CITRUS OTC c 1000/biofl cap /r hips OTC

ester-c tab 500mg OTC

ester-c tab 1000mg OTC

pan-c 500 tab bioflavo OTC

span c tab OTC

tri super tab flavons OTC

vasoflex tab OTC

vitamin c tab plus OTC

IRON W/ VITAMINS s.s.s. tonic liq OTC s.s.s. tonic tab OTC

MULTIPLE VITAMINS W/ CALCIUM essent one tab daily OTC one daily tab womens OTC

signacal tab OTC

SM ONE DAILY TAB ESSENTIA OTC

MULTIPLE VITAMINS W/ IRON daily multi tab vit/iron OTC daily vit tab +iron OTC

daily vit tab iron OTC

daily vite tab iron OTC

daily-vite/ tab iron OTC

multi-day tab /iron OTC

multiple vitamins w/ iron tab OTC

nat-rul dail tab vit/iron OTC

once daily tab iron OTC

one daily mv tab /iron OTC

one daily tab pls iron OTC

one-daily tab /iron OTC

ra one daily tab +iron OTC

sm multiple tab vit/iron OTC

stress form tab /iron OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 145 AGE - Age Limit GNDR - Gender Edit

MULTIPLE VITAMINS W/ MINERALS a thru z sel tab advanced OTC a thru z tab advanced OTC

a thru z tab high pot OTC

a thru z tab select OTC

abc plus tab senior OTC

ABDEK CAP OTC

ACTIVESSENT PAK OTC

ACTIVNUTRIEN CAP OTC

adlt multivi chw gummies OTC

ADULT 50+ CAP OCUVITE OTC

advanced tab formula OTC

airborne chw OTC

ALIVE 50+ TAB ENERGY OTC

ALIVE 50+ TAB WOMENS OTC

ALIVE ENERGY TAB MENS OTC

ALIVE WOMENS CHW GUMMY OTC

antioxidant cap OTC

antioxidant tab vitamins OTC

b-redi/rd hr tab ts/rd ro OTC

BARIATRIC CAP MULTIVIT OTC

CELEBRATE CAP 18 OTC

CELEBRATE CAP 36 OTC

CELEBRATE CAP 45 OTC

CELEBRATE CAP 60 OTC

CELEBRATE CHW 18 OTC

CELEBRATE CHW 36 OTC

CELEBRATE CHW 45 OTC

CELEBRATE CHW 60 OTC

centavite az tab minerals OTC

CENTRAL-VITE TAB OTC

CENTRAL-VITE TAB UNDER 50 OTC

centravites tab OTC

CENTRAVITES TAB 50 PLUS OTC

CENTRAVITES TAB ADULTS OTC

CENTRUM CHW OTC

CENTRUM CHW FLAV BST OTC

CENTRUM CHW MEN OTC

CENTRUM CHW MULTI OTC

CENTRUM CHW VITAMINT OTC

CENTRUM CHW WOMEN OTC

CENTRUM KIDS CHW FLAV BST OTC

CENTRUM SPEC TAB HEART OTC

CENTRUM SPEC TAB VISION OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 146 AGE - Age Limit GNDR - Gender Edit

CENTRUM TAB CARDIO OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 147 AGE - Age Limit GNDR - Gender Edit

CENTRUM TAB SILVER OTC

CENTRUM TAB ULTRA OTC

century tab OTC

century tab mature OTC

certa plus tab OTC

CERTAVITE TAB SENIOR OTC

certavite/ tab antioxid OTC

CHOICEFUL CAP MULTIVIT OTC

CHOICEFUL CHW MULTIVIT OTC

comple multi tab adlt 50+ OTC

cvs daily chw gummies OTC

daily diet tab support OTC

daily multi tab men OTC

daily multi tab vit/mens OTC

daily multi tab vit/min OTC

daily multi tab women OTC

daily multi tab womn 50+ OTC

daily vit tab +mineral OTC

DEKAS CHW BARIATRI OTC

DIABET HLTH PAK SUPPORT OTC

diabets hlth tab formula OTC

EMERGEN-C CHW IMMUNE/D OTC

EMERGEN-C PAK FIVE OTC

EMERGEN-C PAK IMMUNE OTC

EMERGEN-C PAK KIDZ OTC

EMERGEN-C PAK SUPER FR OTC

EMERGEN-C PAK VITA C OTC

ENDUR-VM TAB OTC

ENDUR-VM TAB IRON OTC

ENERGY POW BOOSTER OTC

enviro-stres tab OTC

EQ ONE DAILY TAB MENS OTC

eql century tab mature OTC

essential tab balance OTC

EVOLUTION60 POW OTC

eye health & tab lutein OTC

eye-vites tab OTC

FREEDAVITE TAB OTC

GERI-FREEDA TAB SENIOR OTC

gnp century tab OTC

gnp century tab cardio OTC

gnp century tab mature OTC

gnp century tab senior OTC

gnp century tab ultimate OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 148 AGE - Age Limit GNDR - Gender Edit

gnp healthy tab eyes OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 149 AGE - Age Limit GNDR - Gender Edit

gnp one dail tab maximum OTC

hair/skin cap nails OTC

hair/skin/ cap nails OTC

hair/skin/ tab nails OTC

healthy eyes cap supervis OTC

healthy eyes tab OTC

healthy eyes tab lutein OTC

hi-kovite tab 2-part OTC

hm complete tab 50+ OTC

HM HAIR/SKIN TAB /NAILS OTC

icaps cap OTC

ICAPS CHW AREDS 2 OTC

icaps mv tab OTC

ICAPS PLUS TAB OTC

K-PAX TAB PROF ST OTC

kp adult 50+ tab daily OTC

kp adults tab daily OTC

kp mens 50+ tab daily OTC

kp women 50+ tab daily OTC

kp womens tab daily OTC

LIFE PACK MIS MENS OTC

LIFE PACK MIS WOMENS OTC

life pack tab mens OTC

life pack tab womens OTC

lysiplex liq plus OTC

macuvite tab eye care OTC

mega multi tab men OTC

mega multi tab women OTC

MEGA MULTI TAB WOMEN OTC

MEGA MULTIVI POW OTC

MEGA MULTIVI TAB MEN OTC

MEGA MULTIVI TAB WOMEN OTC

mens daily chw gummies OTC

MENS MULTI TAB VIT/MIN OTC

milltrium sr tab OTC

milltrium tab advanced OTC

multi 50+ cap for her OTC

multi cap for her OTC

multi gummie chw mens OTC

multi gummie chw womens OTC

multi-vit/ tab minerals OTC

MULTI-VITAMI TAB MONOCAPS OTC

multi-vite tab OTC

multi-vite tab 50&over OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 150 AGE - Age Limit GNDR - Gender Edit

multiple vitamins w/ minerals tab OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 151 AGE - Age Limit GNDR - Gender Edit

multiv women tab 50+ OTC

multivi adlt chw gummies OTC

multivitamin liq mineral OTC

multivitamin tab adlt 50+ OTC

MULTIVITAMIN TAB ADULTS OTC

MULTIVITAMIN TAB MEN OTC

multivitamin tab men 50+ OTC

multivitamin tab mens OTC

multivitamin tab mineral OTC

multivitamin tab women OTC

multivitamin tab womens OTC

MVW COMPLETE CAP FORMULAT OTC

MVW COMPLETE CAP MINIS OTC

my-vitalife cap OTC

myamulti tab OTC

NAT-RUL THER TAB M OTC

NUTRIENTS TAB TEENS OTC

OCULAR TAB VITAMINS OTC

ocutabs tab OTC

ONE DAILY CHW ADLT GUM OTC

one daily tab 50+ OTC

one daily tab 50+ adv OTC

one daily tab /mineral OTC

one daily tab complete OTC

one daily tab essentl OTC

one daily tab fe/ca OTC

one daily tab healthy OTC

one daily tab maximum OTC

one daily tab men OTC

one daily tab men 50+ OTC

one daily tab mens OTC

one daily tab mens 50+ OTC

ONE DAILY TAB MENS 50+ OTC

one daily tab plus iro OTC

one daily tab wom 50+ OTC

one daily tab women OTC

one daily tab womens OTC

ONE DAILY TAB WOMENS OTC

one daily/ tab minerals OTC

ONE-A-DAY CHW VITACRAV OTC

ONE-A-DAY TAB 50+ ADV OTC

ONE-A-DAY TAB 65+ OTC

ONE-A-DAY TAB ENERGY OTC

optic-vites tab OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 152 AGE - Age Limit GNDR - Gender Edit

OPTIMUM CHW AIRVITES OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 153 AGE - Age Limit GNDR - Gender Edit

OPTISOURCE CHW BARIATRC OTC

OSTEOPRIME TAB PLUS OTC

PARVLEX TAB OTC

PORENAL+D CAP OMEGA 3 OTC

PREMIUM MIS PACKETS OTC

PRESERVISION CHW AREDS 2 OTC

PRO-CAL TAB OTC

prosight tab OTC

PROTEGRA CAP OTC

PROVIT TAB OTC

qc therin-m tab OTC

QUIN B TAB STRONG OTC

quintabs-m tab OTC

QUINTABS-M TAB OTC

ra central tab -vite OTC

ra central tab vite sel OTC

ra central tab vite sen OTC

REPLACE CAP OTC

sentry tab OTC

sentry tab senior OTC

SENTRY TAB SENIOR OTC

sm complete tab OTC

sm complete tab 50+ OTC

sm complete tab adv form OTC

sm complete tab senior OTC

sm opti-vita tab OTC

spectr women tab hlth sen OTC

spectra ultr tab hlth men OTC

SPECTRAVITE CHW ADLT 50+ OTC

SPECTRAVITE TAB OTC

SPECTRAVITE TAB ADLT 50+ OTC

spectravite tab advanced OTC

SPECTRAVITE TAB MEN 50+ OTC

spectravite tab senior OTC

SPECTRAVITE TAB SENIOR OTC

SPECTRAVITE TAB ULT WMN OTC

stress tab formula OTC

SUPER ANTIOX CAP OTC

super multip tab OTC

super thera tab vite m OTC

super vikaps tab OTC

supr aytinal tab OTC

supr aytinal tab 50 plus OTC

T-VITES TAB OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 154 AGE - Age Limit GNDR - Gender Edit

thera form/ tab hematin OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 150 AGE - Age Limit GNDR - Gender Edit

thera vital tab m OTC

thera-m tab OTC

THERA-M TAB OTC

THERA-TABS M TAB OTC

theradex m tab OTC

THERAGRAN-M TAB 50 PLUS OTC

THERAGRAN-M TAB PREMIER OTC

therapeutic tab OTC

therapeutic tab -m OTC

therapeutic- tab m OTC

theratrum co tab 50 plus OTC

theratrum tab complete OTC

THEREMS-M TAB OTC

total formul tab OTC

total formul tab 2 OTC

total formul tab 3 OTC

tropical liq nutritio OTC

trueplus tab diabetic OTC

ultra antiox tab formula OTC

ultra freeda tab OTC

ultra freeda tab /iron OTC

ULTRA MEGA G TAB 100MG OTC

ULTRA MEGA TAB TWO OTC

ultrachoice tab advanced OTC

vision plus cap OTC

vision tab vitamins OTC

vita-min cap OTC

VITABEX PLUS CAP OTC

VITACRAVES CHW MENS OTC

VITACRAVES CHW WOMENS OTC

VITAMIN C PAK BLEND OTC

VITAMIN LIQ MINERAL OTC

VITASANA TAB OTC

vitatrum tab complete OTC

WAL-BORN CHW VIT C OTC

whole source tab for men OTC

womens daily chw gummies OTC

WOMENS MULTI TAB VIT/MIN OTC

womens one tab daily OTC

womns active tab daily OTC

YELETS TEEN TAB FORMULA OTC

ZINC LOZ OTC

MULTIVITAMINS anti-oxidant tab OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 151 AGE - Age Limit GNDR - Gender Edit

antioxidant cap formula OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 152 AGE - Age Limit GNDR - Gender Edit

CHEW-12 CHW OTC

chlorocaps cap OTC

daily multi tab vitamins OTC

daily tab vitamin OTC

daily value tab multivit OTC

daily vit tab OTC

daily vite tab OTC

daily-vitamn tab OTC

daily-vite tab OTC

DEKAS CAP ESSENTIA OTC

DEKAS LIQ ESSENTIA OTC

essentl one tab daily OTC

ESTROFACTORS TAB OTC

healthy hair tab skn/nail OTC

MIL-A-MULSIO EMU OTC

mult vitamin tab daily OTC

mult vitamin tab essent OTC

mult vitamin tab mens OTC

multi vitami tab OTC

multi vitami tab d-3 OTC

multi-day tab OTC

multi-vitamn tab OTC

multiple vitamin cap OTC

multiple vitamin tab OTC

multivitamin cap OTC

MULTIVITAMIN DRO ORGANIC OTC

MULTIVITAMIN LIQ OTC

multivitamin tab daily OTC

multivitamin tab iron-fre OTC

mv-one cap OTC

NEOMULTIVITE TAB OTC

OMNICAP TAB OTC

once daily tab OTC

one daily tab OTC

one daily tab essentl OTC

one daily tab multivit OTC

ONE-A-DAY CHW VITACRAV OTC

one-daily tab mult vit OTC

qc essential tab OTC

QUINTABS TAB OTC

ra one daily tab essentia OTC

ra one daily tab multivit OTC

renal/zinc tab multivit OTC

sigtab tab OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 153 AGE - Age Limit GNDR - Gender Edit

sm multiple tab vitamins OTC

Page 233: UMHP Comprehensive Formulary 2019 1 - UM Health Partners...clearskin cre 10% OTC . Drug Name Requirements/Limits PA - Prior Authorization OTC - Over the counter QL - Quantity Limits

Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 152 AGE - Age Limit GNDR - Gender Edit

stress form tab OTC

stress formu tab OTC

stresstabs tab OTC

stresstabs tab energy OTC

tab-a-vite tab OTC

tab-a-vite tab beta car OTC

thera tab OTC

THERA TAB OTC

thera-mill tab OTC

thera-tabs tab OTC

therapeutic tab OTC

therems tab OTC

vitalee tab OTC

PED MULTI VITAMINS W/FL & FE multivit/fl/ dro fe 0.25

PED MULTIPLE VITAMINS W/ MINERALS centrum kids chw complete OTC chewable chw children OTC

CHILDRENS CHW COMPLETE OTC

compl multiv chw childrns OTC

eq multivita chw gummies OTC

flintstones chw complete OTC

gnp zoochews chw gummies OTC

gummy dinos chw chldrn OTC

multivitamin chw child OTC

multivitamin chw children OTC

mvw complete chw d3000 OTC

mvw complete chw orange OTC

qc childrens chw complete OTC

sm animal sh chw complete OTC

vitachew chw OTC

VITALETS CHW OTC

VITALETS CHW CHILD OTC

VITAMAX CHW OTC

zoo friends chw OTC

ZOO FRIENDS CHW COMPLETE OTC

zoo friends chw gummies OTC

PED MV W/ FLUORIDE FLORIVA DRO PLUS multi vit/fl chw 0.25mg

multivit/fl sol 0.5mg/ml pediatric vitamins acd w/ fluoride soln 0.5 mg/ml

PED MV W/ IRON ANIMAL SHAPE CHW IRON OTC

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DINO-LIFE CHW IRON-ZIN OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 153 AGE - Age Limit GNDR - Gender Edit

HONEY BEARS CHW IRON-ZIN OTC

MULTI-DELYN LIQ /IRON OTC

PEDIATRIC MULTIPLE VITAMINS child chew/ chw extra c OTC childrens chw vitamin OTC

dino-life chw extra c OTC

gnp animal chw plus c OTC

qc childrens chw extra c OTC

zoo friends chw extra c OTC

PEDIATRIC VITAMINS MULTIVITAMIN CHW CHILD OTC

PRENATAL VITAMINS CITRANATAL MIS CITRANATAL TAB BLOOM pnv-dha cap

pnv-select tab

SPECIALTY VITAMINS PRODUCTS a thru z tab advantag OTC ALLERWELL TAB ALLERGY OTC

central-vite tab performa OTC

CENTRUM SPEC TAB ENERGY OTC

CENTRUM TAB PERFORMA OTC

GERM DEFENSE TAB ORANGE OTC

GERM DEFENSE TAB PM OTC

GLYCOTROL CAP OTC

GLYCOTROL CAP COMPLETE OTC

GNP CENTURY TAB ENERGY OTC

HAIR NOURISH TAB SUPPLEMN OTC

hair/skin/ tab nails OTC

MIL ADREGEN TAB OTC

MM BIOTIN CAP KERATIN OTC

RA EFFERVESC TAB FORMULA OTC

THYMUS TAB 140MG OTC

vit for hair tab OTC

WAL-BORN TAB OTC

VITAMIN MIXTURES cod liver oil cap OTC DOSOQUIN TAB OTC

ra cod liver cap OTC

VITA-MAG TAB OTC

VITAMINS W/ LIPOTROPICS b-50 tab OTC b-100 comp tab tr OTC

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b-100 tab OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 155 AGE - Age Limit GNDR - Gender Edit

b-100 tab td OTC

b-complex tab form 1 OTC

balance b100 tab OTC

cvs balanced tab b50 OTC

ear health tab formula OTC

ear health tab plus OTC

mega multi tab w/che mi OTC

multi-vit hp cap /mineral OTC

ultra b-100 tab complex OTC

MUSCULOSKELETAL THERAPY AGENTS CENTRAL MUSCLE RELAXANTS

chlorzoxazone tab 250 mg

VISCOSUPPLEMENTS GEL-ONE INJ 30MG/3ML SP, PA SYNVISC INJ 8MG/ML SP, PA

SYNVISC ONE INJ 8MG/ML SP, PA

VISCO-3 INJ 25/2.5ML SP, PA

NASAL AGENTS - MISC. NASAL AGENTS - MISC.

afrin saline spr 0.65% OTC altamist spr 0.65% OTC

AYR NASAL DRO 0.65% OTC

ayr spr 0.65% OTC

baby ayr spr 0.65% OTC

CVS NASAL SPR MIST OTC

deep sea spr 0.65% OTC

hm saline spr 0.65% OTC

little noses dro stuf nos OTC

little noses spr 0.65% OTC

nasal moist spr 0.65% OTC

nasal saline spr 0.65% OTC

ocean kids spr 0.65% OTC

RA STERILE SOL NASAL OTC

RHINARIS SPR 0.2% OTC

saline mist spr 0.65% OTC

saline nasal spray 0.65% OTC

saline nose spr 0.65% OTC

sb saline spr 0.65% OTC

SIMPLY SALIN AER 0.9% OTC

tgt nasal spr 0.65% OTC

NASAL AGENTS - SYSTEMIC AND TOPICAL NASAL AGENTS - MISC.

afrin saline spr 0.65% OTC

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nasal moist spr 0.65% OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 155 AGE - Age Limit GNDR - Gender Edit

NASAL STEROIDS budesonide nasal susp 32 mcg/act OTC, QL (1 bottle / 30 days) clarispray spr 50mcg OTC, QL (1.013 bottles / 25

days) fluticasone propionate nasal susp 50 mcg/act OTC, QL (1.013 bottles / 25

days) nasal allgy spr 55mcg/ac OTC, QL (1.006 bottles / 25

days)

SYMPATHOMIMETIC DECONGESTANTS gnp deconge tab 30mg OTC wal-phed d tab 120mg OTC, QL (60 tabs / 30 days)

NASAL ANTIALLERGY NASAL ANTIHISTAMINES

azelastine hcl nasal spray 0.1% (137 mcg/spray) QL (2 bottles / 25 days)

NASAL MAST CELL STABILIZERS cromolyn sodium nasal aerosol soln 5.2 mg/act OTC (4%)

NASAL ANTICHOLINERGICS NASAL ANTICHOLINERGICS

ipratropium bromide nasal soln 0.03% (21 mcg/spray) ipratropium bromide nasal soln 0.06% (42

mcg/spray)

NASAL STEROIDS NASAL STEROIDS

aller-flo spr 50mcg OTC, QL (1.013 bottles / 25 days)

allergy nasa spr 24hr OTC, QL (1.006 bottles / 25

days) allergy nasa spr 50mcg OTC, QL (1.013 bottles / 25

days) allergy nasa spr 50mcg OTC, QL (1.616 bottles / 25

days) allergy relf spr 50mcg OTC, QL (1.013 bottles / 25

days) allergy relf spr 50mcg OTC, QL (1.616 bottles / 25

days) budesonide sus 32mcg OTC, QL (1 bottle / 30 days)

budesonide sus nasal OTC, QL (1 bottle / 30 days)

clarispray spr 50mcg OTC, QL (1.616 bottles / 25

days) flunisolide nasal soln 25 mcg/act (0.025%) QL (2 bottles / 25 days)

fluticasone propionate nasal susp 50 mcg/act QL (1 bottle / 25 days) fluticasone spr 50mcg OTC, QL (1.013 bottles / 25

days)

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fluticasone spr 50mcg OTC, QL (1.616 bottles / 25

days) 24 hr nasal spr allergy OTC, QL (1.006 bottles / 25

days) nasal allerg spr 55mcg OTC, QL (1.006 bottles / 25

days) nasal allgy spr 55mcg/ac OTC, QL (1.006 bottles / 25

days) nasal allrgy spr 55mcg/ac OTC, QL (1.006 bottles / 25

days) ra nasal spr allergy OTC, QL (1.006 bottles / 25

days) rhinocort sus allergy OTC, QL (1 bottle / 30 days)

rhinocort sus allergy OTC, QL (1.686 bottles / 30

days) triamcinolone acetonide nasal aerosol suspension OTC, QL (1.006 bottles / 25

55 mcg/act days) NATURAL PENICILLINS

NATURAL PENICILLINS penicillin v potassium for soln 125 mg/5ml penicillin v potassium for soln 250 mg/5ml penicillin v potassium tab 250 mg penicillin v potassium tab 500 mg

NICOTINIC ACID DERIVATIVES NICOTINIC ACID DERIVATIVES

niacin tab er 500 mg (antihyperlipidemic) niacin tab er 750 mg (antihyperlipidemic) niacin tab er 1000 mg (antihyperlipidemic)

NITRATES

NITRATES ISORDIL TAB 40MG isosorbide dinitrate tab 5 mg

isosorbide dinitrate tab 10 mg isosorbide dinitrate tab 20 mg isosorbide dinitrate tab 30 mg isosorbide dinitrate tab er 40 mg isosorbide mononitrate tab 10 mg isosorbide mononitrate tab 20 mg isosorbide mononitrate tab er 24hr 30 mg

isosorbide mononitrate tab er 24hr 60 mg isosorbide mononitrate tab er 24hr 120 mg minitran dis 0.1mg/hr minitran dis 0.2mg/hr minitran dis 0.4mg/hr minitran dis 0.6mg/hr

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NITRO-BID OIN 2%

NITRO-DUR DIS 0.3MG/HR

NITRO-DUR DIS 0.8MG/HR nitro-time cap 2.5mg cr

nitro-time cap 6.5mg cr nitro-time cap 9mg cr nitroglycerin cap er 2.5 mg nitroglycerin cap er 6.5 mg nitroglycerin cap er 9 mg nitroglycerin sl tab 0.3 mg nitroglycerin sl tab 0.4 mg nitroglycerin sl tab 0.6 mg nitroglycerin td patch 24hr 0.1 mg/hr

nitroglycerin td patch 24hr 0.2 mg/hr nitroglycerin td patch 24hr 0.4 mg/hr nitroglycerin td patch 24hr 0.6 mg/hr

NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDS) CYCLOOXYGENASE 2 (COX-2) INHIBITORS

celecoxib cap 50 mg PA celecoxib cap 100 mg PA

celecoxib cap 200 mg PA

celecoxib cap 400 mg PA

NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDS) addaprin tab 200mg OTC advil jr st tab 100mg OTC

advil jr str chw 100mg OTC

all day pain tab 220mg OTC

all day relf tab 220mg OTC

chld ibuprfn dro 40mg/ml OTC

cvs ibuprof dro 50/1.25 OTC

diclofenac potassium tab 50 mg

diclofenac sodium tab delayed release 25 mg

diclofenac sodium tab delayed release 50 mg diclofenac sodium tab delayed release 75 mg diclofenac sodium tab er 24hr 100 mg dyspel tab 200mg OTC

eq ibuprofen tab 200mg OTC

eql ibuprofn tab 200mg OTC

eql naproxen cap 220mg OTC

etodolac cap 200 mg

etodolac cap 300 mg etodolac tab 400 mg etodolac tab 500 mg etodolac tab er 24hr 400 mg

etodolac tab er 24hr 500 mg

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etodolac tab er 24hr 600 mg

flanax pain tab 220mg OTC

flurbiprofen tab 50 mg flurbiprofen tab 100 mg genpril tab 200mg OTC

hm ibuprofen chw 100mg OTC

hm ibuprofen tab 200mg OTC

hyvee ibupro sus 100mg/5m OTC

ibu tab 400mg ibu tab 600mg ibu tab 800mg

ibu-200 tab 200mg OTC

ibu-drops dro 50/1.25 OTC

ibuprfn liqd cap 200mg OTC

ibuprofen cap 200mg OTC

ibuprofen dro 50/1.25 OTC

ibuprofen ib chw 100mg OTC

ibuprofen jr chw 100mg OTC

ibuprofen js chw 100mg OTC

ibuprofen sus 100/5ml OTC

ibuprofen susp 100 mg/5ml

ibuprofen tab 200 mg OTC

ibuprofen tab 200mg OTC

ibuprofen tab 400 mg ibuprofen tab 600 mg ibuprofen tab 800 mg ketorolac tromethamine tab 10 mg QL (20 tabs / 25 days)

kls ibuprofn tab 200mg OTC

kls naproxen tab 220mg OTC

ks ibuprofen cap 200mg OTC

medi-profen cap 200mg OTC

medi-profen sus 40mg/ml OTC

medi-profen sus 100/5ml OTC

medi-profen tab 200mg OTC

mediproxen tab 220mg OTC

meloxicam tab 7.5 mg meloxicam tab 15 mg motrin ib tab 200mg OTC

nabumetone tab 500 mg nabumetone tab 750 mg naproxen dr tab 375mg naproxen dr tab 500mg naproxen sod tab 220mg OTC

naproxen sodium cap 220 mg OTC

naproxen sodium tab 275 mg

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naproxen sodium tab 550 mg

naproxen tab 250 mg naproxen tab 375 mg naproxen tab 500 mg oxaprozin tab 600 mg pamprin tab 220mg OTC

provil tab 200mg OTC

px ibuprofen tab 200mg OTC

px profen ib dro 50/1.25 OTC

px profen ib sus 100/5ml OTC

qc ibuprofen tab 200mg OTC

ra ibuprofen cap 200mg OTC

ra ibuprofen tab 200mg OTC

sb ibuprofen tab 200mg OTC

sm ibuprofen cap 200mg OTC

sm ibuprofen tab 100mg jr OTC

sm ibuprofen tab 200mg OTC

sulindac tab 150 mg

sulindac tab 200 mg wal-profen cap 200mg OTC wal-profen tab 200mg OTC

NUTRIENTS MISC. NUTRITIONAL SUBSTANCES

eskimo-3 cap 500mg OTC finest fish liq oil/kids OTC

fish oil cap 435mg OTC

fish oil cap 500mg OTC

fish oil cap 1200mg OTC

FISH OIL CAP 1360MG OTC

FISH OIL CAP 1400MG OTC

gnp fish oil cap OTC

hm fish oil cap 1200mg OTC

omega-3 fatty acids cap 500 mg OTC

omega-3 fatty acids cap 1200 mg OTC

omega-3 fish cap 1200mg OTC

omega-3 fish chw 113.5mg OTC

ovega-3 cap 500mg OTC

sm fish oil cap 1200mg OTC

PROTEINS levocarnitine (dietary) oral soln 1 gm/10ml OTC levocarnitine tab 500 mg OTC

OIL SOLUBLE VITAMINS VITAMIN D

calcidol dro 8000/ml OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 160 AGE - Age Limit GNDR - Gender Edit

calciferol dro 8000/ml OTC

cholecalciferol cap 1000 unit OTC

cholecalciferol cap 2000 unit OTC

cholecalciferol cap 5000 unit OTC

cholecalciferol cap 10000 unit OTC

cholecalciferol cap 50000 unit OTC

cholecalciferol chew tab 400 unit OTC

cholecalciferol oral liquid 400 unit/ml OTC

cholecalciferol tab 400 unit OTC

cholecalciferol tab 1000 unit OTC

cholecalciferol tab 2000 unit OTC

cholecalciferol tab 5000 unit OTC

cvd d3 chw 1000unit OTC

cvs d3 cap 1000unit OTC

cvs d3 cap 2000unit OTC

cvs d3 cap 5000unit OTC

cvs d3 chw 1000 unt OTC

d3 adult chw 1000unit OTC

d3 cap 1000unit OTC

d3 cap 2000unit OTC

d3 kids chw 400unit OTC

d3 maximum cap 5000unit OTC

d3 super str cap 2000unit OTC

d3 tab 400unit OTC

d3-50 cap 50000unt OTC

d3-1000 cap 1000unit OTC

d 400 chw 400unit OTC

d 400 tab 400unit OTC

d 1000 cap 1000unit OTC

d-3 gummy chw 400unit OTC

decara cap 50000unt OTC

delta d3 tab 400unit OTC

dialyvite d cap 5000unit OTC

eql vitamin cap d3 OTC

ergocalciferol cap 50000 unit

ergocalciferol soln 8000 unit/ml OTC

gnp d cap 1000unit OTC

gnp d chw 2000unit OTC

gnp vit d3 tab 1000unit OTC

gnp vit d tab 1000unit OTC

gnp vit d tab 5000unit OTC

hm vit d3 cap 2000unit OTC

hm vitamin d tab 1000unit OTC

just d liq 400unit OTC

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optimal-d cap 50000unt OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 162 AGE - Age Limit GNDR - Gender Edit

pa vitamin cap 2000unit OTC

pedia d-vite dro 400unit OTC

ra vitamin cap 2000unit OTC

sm vitamin d tab 400unit OTC

thera-d tab 2000unit OTC

vit d3 gumm chw 1000unit OTC

vit d child chw 1000unit OTC

vitajoy daly chw d 1000iu OTC

VITAMIN D2 TAB 400UNIT OTC

VITAMIN D2 TAB 2000UNIT OTC

vitamin d3 cap 1000unit OTC

vitamin d3 cap 2000unit OTC

vitamin d3 cap 10000unt OTC

vitamin d3 chw 1000unit OTC

vitamin d cap 1000unit OTC

vitamin d chw 400unit OTC

vitamin d chw 1000unit OTC

vitamin d tab 1000unit OTC

vitamin d tab 5000iu OTC

vitamin d-3 cap 2000unit OTC

vitamin d-3 tab 1000unit OTC

vitamin d-3 tab 5000unit OTC

OPHTHALMIC ADRENERGIC AGENTS OPHTHALMIC SELECTIVE ALPHA ADRENERGIC AGONISTS

brimonidine tartrate ophth soln 0.2% brimonidine tartrate ophth soln 0.15%

OPHTHALMIC AGENTS ARTIFICIAL TEARS AND LUBRICANTS

artifi tears oin op OTC artificial sol tears OTC

clear eyes dro 0.5-0.6% OTC

cvs lubricnt dro 0.5% op OTC

dry eye relf oin night OTC

eq restore oin pm OTC

eye drops dro 0.25% OTC

gnp eye drop dro 0.4-0.3% OTC

gnp eye drop sol 0.5% op OTC

lubricnt eye dro 0.5% op OTC

murine tears dro dry eyes OTC

refresh cell gel 1% op OTC

REFRESH DRO OP OTC

REFRESH SOL OPTIVE OTC

RETAINE HPMC SOL 0.3% OTC

soothe night oin op OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 163 AGE - Age Limit GNDR - Gender Edit

stye oin OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 164 AGE - Age Limit GNDR - Gender Edit

THERATEARS SOL OP OTC

BETA-BLOCKERS - OPHTHALMIC dorzolamide hcl-timolol maleate ophth soln 22.3-6.8 mg/ml

OPHTHALMIC ANTI-INFECTIVES ak-poly-bac oin op neomycin-bacitrac zn-polymyx

5(3.5)mg-400unt-10000unt op oin

OPHTHALMIC INTEGRIN ANTAGONISTS XIIDRA DRO 5% PA

OPHTHALMIC STEROIDS PREDNISOLONE SUS 1%

OPHTHALMICS - MISC. DORZOLAMIDE SOL 2% eye itch rel dro 0.025% OTC

PROSTAGLANDINS - OPHTHALMIC latanoprost ophth soln 0.005%

OPHTHALMIC ANTI-INFECTIVES OPHTHALMIC ANTI-INFECTIVE COMBINATIONS

bacitracin-polymyxin b ophth oint neo-polycin oin op neomycin-bacitrac zn-polymyx

5(3.5)mg-400unt-10000unt op oin neomycin-polymy-gramicid op sol 1.75-10000-0.025mg-unt-mg/ml polycin oin op polymyxin b-trimethoprim ophth soln 10000

unit/ml-0.1%

OPHTHALMIC ANTIBIOTICS bacitracin ophth oint 500 unit/gm ciprofloxacin hcl ophth soln 0.3% erythromycin ophth oint 5 mg/gm gentak oin 0.3% op gentamicin sulfate ophth soln 0.3%

levofloxacin ophth soln 0.5% ofloxacin ophth soln 0.3% tobramycin ophth soln 0.3%

OPHTHALMIC ANTIFUNGAL NATACYN SUS 5% OP

OPHTHALMIC ANTIVIRALS trifluridine ophth soln 1%

OPHTHALMIC SULFONAMIDES sulfacetamide sodium ophth soln 10%

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OPHTHALMIC STEROIDS OPHTHALMIC STEROID COMBINATIONS

bacitracin-polymyxin-neomycin-hc ophth oint 1% neo-polycin oin hc 1%op neomycin-polymyxin-dexamethasone ophth oint 0.1% neomycin-polymyxin-dexamethasone ophth susp

0.1% neomycin-polymyxin-hc ophth susp

sulfacetamide sodium-prednisolone ophth soln 10-0.23(0.25)% tobramycin-dexamethasone ophth susp 0.3-0.1%

OPHTHALMIC STEROIDS dexamethasone sodium phosphate ophth soln 0.1% fluorometholone ophth susp 0.1%

PRED SOD PHO SOL 1% OP

prednisolone acetate ophth susp 1%

OPHTHALMICS - MISC. OPHTHALMIC ANTIALLERGIC

alaway child dro 0.025%op OTC alaway dro 0.025%op OTC

allergy eye dro 0.025%op OTC

antihistamin dro 0.025%op OTC

azelastine hcl ophth soln 0.05%

claritin eye dro 0.025%op OTC

cromolyn sodium ophth soln 4%

cvs allergy dro 0.025%op OTC

eye itch rel dro 0.025%op OTC

eye itch sol relief OTC

itchy eye dro 0.025%op OTC

itchy eye sol 0.025% OTC

ketotif fum dro 0.025%op OTC

OPHTHALMIC CARBONIC ANHYDRASE INHIBITORS dorzolamide hcl ophth soln 2%

OPHTHALMIC NONSTEROIDAL ANTI-INFLAMMATORY AGENTS diclofenac sodium ophth soln 0.1% ketorolac tromethamine ophth soln 0.4% ketorolac tromethamine ophth soln 0.5%

OPIOID AGONISTS OPIOID AGONISTS

fentanyl td patch 72hr 12 mcg/hr QL (10 patches / 25 days), PA

fentanyl td patch 72hr 50 mcg/hr QL (10 patches / 25 days),

PA

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fentanyl td patch 72hr 75 mcg/hr QL (10 patches / 25 days), PA

fentanyl td patch 72hr 100 mcg/hr QL (10 patches / 25 days), PA

hydromorphone hcl tab 2 mg QL (180 tabs / 25 days), PA

hydromorphone hcl tab 4 mg QL (180 tabs / 25 days), PA

hydromorphone hcl tab 8 mg QL (180 tabs / 25 days), PA

methadone hcl tab 5 mg QL (120 each / 25 days), PA

methadone hcl tab 5 mg QL (120 tabs / 25 days), PA

methadone hcl tab 10 mg QL (120 each / 25 days), PA

methadone hcl tab 10 mg QL (120 tabs / 25 days), PA morphine sulfate oral soln 10 mg/5ml QL (900 mL / 25 days), PA morphine sulfate oral soln 20 mg/5ml QL (900 mL / 25 days), PA morphine sulfate oral soln 100 mg/5ml (20 mg/ml)QL (180 mL / 25 days), PA morphine sulfate suppos 5 mg QL (180 supp / 25 days), PA

morphine sulfate suppos 10 mg QL (180 supp / 25 days), PA

morphine sulfate suppos 20 mg QL (180 supp / 25 days), PA

morphine sulfate tab 15 mg QL (180 tabs / 25 days), PA

morphine sulfate tab 30 mg QL (180 tabs / 25 days), PA

morphine sulfate tab er 15 mg QL (90 ea / 25 days), PA

morphine sulfate tab er 15 mg QL (90 tabs / 25 days), PA

morphine sulfate tab er 30 mg QL (90 ea / 25 days), PA

morphine sulfate tab er 30 mg QL (90 tabs / 25 days), PA

morphine sulfate tab er 60 mg QL (90 ea / 25 days), PA

morphine sulfate tab er 60 mg QL (90 tabs / 25 days), PA

morphine sulfate tab er 100 mg QL (90 ea / 25 days), PA

morphine sulfate tab er 100 mg QL (90 tabs / 25 days), PA

morphine sulfate tab er 200 mg QL (60 tabs / 25 days), PA

oxycodone hcl cap 5 mg QL (180 caps / 25 days), PA oxycodone hcl conc 100 mg/5ml (20 mg/ml) QL (180 mL / 25 days), PA oxycodone hcl soln 5 mg/5ml QL (180 mL / 25 days), PA

oxycodone hcl tab 5 mg QL (180 each / 25 days), PA

oxycodone hcl tab 5 mg QL (180 tabs / 25 days), PA

oxycodone hcl tab 10 mg QL (180 tabs / 25 days), PA

oxycodone hcl tab 15 mg QL (180 tabs / 25 days), PA

oxycodone hcl tab 20 mg QL (180 tabs / 25 days), PA

oxycodone hcl tab 30 mg QL (180 tabs / 25 days), PA

tramadol hcl tab 50 mg QL (240 each / 25 days), PA

tramadol hcl tab 50 mg QL (240 tabs / 25 days), PA

tramadol hcl tab er 24hr 100 mg QL (30 tabs / 25 days), PA

tramadol hcl tab er 24hr 200 mg QL (30 tabs / 25 days), PA

tramadol hcl tab er 24hr 300 mg QL (30 tabs / 25 days), PA

OPIOID COMBINATIONS CODEINE COMBINATIONS

acetaminophen w/ codeine tab 300-15 mg QL (300 tabs / 25 days), PA

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QL - Quantity Limits ST - Step Therapy SP - Specialty 167 AGE - Age Limit GNDR - Gender Edit

acetaminophen w/ codeine tab 300-30 mg QL (300 each / 25 days), PA

acetaminophen w/ codeine tab 300-30 mg QL (300 tabs / 25 days), PA acetaminophen w/ codeine tab 300-60 mg QL (300 tabs / 25 days), PA

HYDROCODONE COMBINATIONS hydrocodone-acetaminophen soln 7.5-325 QL (2700 mL / 25 days), PA mg/15ml lorcet hd tab 10-325mg QL (375 tabs / 25 days), PA

lorcet plus tab 7.5-325 QL (375 tabs / 25 days), PA

OPIOID COMBINATIONS endocet tab 2.5-325 QL (375 tabs / 25 days), PA endocet tab 7.5-325 QL (375 tabs / 25 days), PA

endocet tab 10-325mg QL (375 tabs / 25 days), PA

oxycodone-aspirin tab 4.8355-325 mg QL (308 tabs / 25 days), PA

TRAMADOL COMBINATIONS tramadol-acetaminophen tab 37.5-325 mg QL (40 tabs / 25 days), PA

OTIC AGENTS OTIC AGENTS - MISCELLANEOUS

earwax remov dro kit OTC earwax remov dro system OTC

earwax remov sol 6.5% OTC

OTIC AGENTS - MISCELLANEOUS OTIC AGENTS - MISCELLANEOUS

acetic acid otic soln 2% auraphene-b sol 6.5% ot OTC

ear drops dro 6.5% OTC

ear drops sol 6.5% ot OTC

ear wax kit sol 6.5% ot OTC

ear wax remv dro 6.5% ot OTC

ear wax remv sol 6.5% ot OTC

ear wax sol 6.5% OTC

earwax remv sol 6.5% ot OTC

earwax sol removal OTC

eq ear wax sol removal OTC

gnp ear dro 6.5% ot OTC

gnp ear drop sol 6.5% ot OTC

gnp ear sys sol 6.5% ot OTC

murine ear dro 6.5% ot OTC

murine ear sol 6.5% ot OTC

otix sol 6.5% ot OTC

ra ear dro 6.5% ot OTC

sm ear dro 6.5% ot OTC

OTIC ANTI-INFECTIVES OTIC ANTI-INFECTIVES

ofloxacin otic soln 0.3%

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QL - Quantity Limits ST - Step Therapy SP - Specialty 168 AGE - Age Limit GNDR - Gender Edit

OTIC COMBINATIONS OTIC STEROID-ANTI-INFECTIVE COMBINATIONS

CIPRODEX SUS 0.3-0.1% neomycin-polymyxin-hc otic soln 1%

neomycin-polymyxin-hc otic susp 3.5 mg/ml-10000 unit/ml-1%

OXAZOLIDINONES OXAZOLIDINONES

linezolid for susp 100 mg/5ml PA linezolid tab 600 mg PA

PARENTERAL THERAPY SUPPLIES NEEDLES & SYRINGES

BD PEN NEEDL MIS 29GX12.7 OTC BD PEN NEEDL MIS 31GX5MM OTC

BD PEN NEEDL MIS 31GX8MM OTC

BD PEN NEEDL MIS 32GX4MM OTC

INSULIN SYRG MIS 0.3/30G OTC

INSULIN SYRG MIS 0.3/31G INSULIN SYRG MIS 0.3/31G OTC INSULIN SYRG MIS 0.5/30G OTC

INSULIN SYRG MIS 0.5/31G OTC

INSULIN SYRG MIS 1ML/30G OTC

INSULIN SYRG MIS 1ML/31G OTC

PASSIVE IMMUNIZING AND TREATMENT AGENTS MONOCLONAL ANTIBODIES

SYNAGIS INJ 50MG SP, PA SYNAGIS INJ 100MG/ML SP, PA

PED MULTI VITAMINS W/FL & FE PED MULTI VITAMINS W/FL & FE

ESCAVITE CHW multi-vit/fe dro /fl 0.25

multi-vit/fl dro /fe 0.25 TL-FLUORIVIT CHW

PED MULTIPLE VITAMINS W/ MINERALS PED MULTIPLE VITAMINS W/ MINERALS

DEKAS PLUS LIQ OTC NANOVM POW 1-3 YRS OTC

NANOVM POW 4-8YEARS OTC

NANOVM POW 9-18 YRS OTC

NANOVM T/F LIQ OTC

NANOVM T/F POW OTC

UPSPRINGBABY DRO MV/IRON OTC

PED MULTIPLE VITAMINS W/ MINERALS & C abdek chw OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 169 AGE - Age Limit GNDR - Gender Edit

abdek pediat dro OTC

alive gummie chw children OTC

alive multi chw childrns OTC

animal shape chw complete OTC

aquadeks dro OTC

centrum kids chw complete OTC

cerovite jr chw OTC

child vitami chw OTC

childrens chw complete OTC

CHILDRENS CHW COMPLETE OTC

childrens chw gummies OTC

chld mltivit chw /mineral OTC

compl multiv chw childrns OTC

complete chw multi-vi OTC

cvs children chw complete OTC

disney cars chw gummies OTC

eq multivita chw gummies OTC

flintstones chw bone bld OTC

flintstones chw complete OTC

FLINTSTONES CHW TODDLER OTC

gnp zoochews chw gummies OTC

gummi bear chw multivit OTC

gummies chw OTC

gummy dinos chw OTC

gummy multiv chw kids OTC

gummy vit/ chw minerals OTC

HEALTHY KIDS CHW GUMMIES OTC

healthy kids chw overall OTC

hm animal chw shapes OTC

multivitamin chw child OTC

multivitamin chw children OTC

mvw complete chw bubblgum OTC

NF FORMULAS CHW CHILDREN OTC

polyvitamin chw /iron OTC

princess chw gummies OTC

qc childrens chw complete OTC

sea buddies chw dly mult OTC

sm animal sh chw complete OTC

spider-man chw OTC

ultra choice chw kids OTC

vitachew chw OTC

VITALETS CHW OTC

VITALETS CHW CHILD OTC

VITAMAX CHW OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 170 AGE - Age Limit GNDR - Gender Edit

zoo friends chw OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 171 AGE - Age Limit GNDR - Gender Edit

ZOO FRIENDS CHW COMPLETE OTC

zoo friends chw extra d OTC

zoo friends chw gummies OTC

PED MV W/ FLUORIDE PED MV W/ FLUORIDE

multi vit/fl dro 0.5mg/ml multi-vit/fl dro 0.5mg/ml multivit/fl chw 0.5mg multivit/fl chw 0.25mg multivit/fl chw 1mg multivit/fl dro 0.25mg mvc-fluoride chw 0.5mg mvc-fluoride chw 0.25mg mvc-fluoride chw 1mg QUFLORA PED CHW 0.5MG

QUFLORA PED CHW 0.25MG QUFLORA PED CHW 1MG QUFLORA PED DRO 0.5MG/ML QUFLORA PED DRO 0.25MG

PED VITAMINS ACD W/ FLUORIDE tri-vit/fluo dro 0.5mg tri-vit/fluo dro 0.25mg vit a/c/d/fl dro 0.25mg

PED MV W/ IRON

PED MV W/ IRON animal shape chw /iron OTC animal shape chw iron OTC

bite-a-mins chw /iron OTC

child chew chw iron OTC

child multiv chw iron OTC

childrens chw /iron OTC

chld vitamin chw iron OTC

DINO-LIFE CHW IRON-ZIN OTC

flnston plus chw iron OTC

fruity chews chw /iron OTC

HONEY BEARS CHW IRON-ZIN OTC

land bfr tim chw vit/iron OTC

little anima chw plus fe OTC

MULTI-DELYN LIQ /IRON OTC

MULTIVITAMIN CHW IRON OTC

poly-vite sol /iron OTC

qc childrens chw iron OTC

ra child vit chw /iron OTC

SCOOBY-DOO CHW OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 172 AGE - Age Limit GNDR - Gender Edit

vite/iron chw children OTC

zoo friends chw pls iron OTC

PEDIATRIC MULTIPLE VITAMINS PEDIATRIC MULTIPLE VITAMINS

multi-delyn liq OTC pediavit liq OTC

PEDIATRIC MULTIPLE VITAMINS W/ C poly-vite dro OTC

PEDIATRIC MULTIPLE VITAMINS W/ C & FA animal chews chw OTC animal shape chw OTC

bite-a-mins chw OTC

bounty bears chw /c OTC

chewabl vite chw childrns OTC

child chew chw vitamins OTC

children vit chw OTC

childrens chw multivit OTC

childrens chw vitamins OTC

dino-life chw OTC

flintstones chw my first OTC

flintstones chw omega-3 OTC

flintstones chw pls calc OTC

fruity chews chw OTC

gnp animal chw shapes OTC

gnp little chw ones OTC

little chw animals OTC

multivitamin chw children OTC

poly vitamin chw OTC

sm animal chw shapes OTC

zoo friends chw gummies OTC

PEDIATRIC MULTIPLE VITAMINS W/ EXTRA C & FA child chew/ chw extra c OTC dino-life chw extra c OTC

flintstones chw extra c OTC

gnp animal chw plus c OTC

land bfr tim chw vit/c OTC

qc childrens chw extra c OTC

zoo friends chw extra c OTC

zoo friends chw plus c OTC

PEDIATRIC VITAMINS PEDIATRIC VITAMINS

HONEY BEARS CHW OTC

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QL - Quantity Limits ST - Step Therapy SP - Specialty 170 AGE - Age Limit GNDR - Gender Edit

PENICILLIN COMBINATIONS PENICILLIN COMBINATIONS

amoxicillin & k clavulanate chew tab 200-28.5 mg amoxicillin & k clavulanate chew tab 400-57 mg amoxicillin & k clavulanate for susp 200-28.5 mg/5ml amoxicillin & k clavulanate for susp 250-62.5

mg/5ml amoxicillin & k clavulanate for susp 400-57

mg/5ml amoxicillin & k clavulanate for susp 600-42.9

mg/5ml amoxicillin & k clavulanate tab 250-125 mg

amoxicillin & k clavulanate tab 500-125 mg amoxicillin & k clavulanate tab 875-125 mg AUGMENTIN SUS 125/5ML

PENICILLINASE-RESISTANT PENICILLINS

PENICILLINASE-RESISTANT PENICILLINS dicloxacillin sodium cap 250 mg dicloxacillin sodium cap 500 mg

PENICILLINS AMINOPENICILLINS

AMOXICILLIN POW TRIHYDRA

NATURAL PENICILLINS BICILLIN L-A INJ 600000 BICILLIN L-A INJ 1200000 BICILLIN L-A INJ 2400000

PERIPHERAL OPIOID RECEPTOR ANTAGONISTS

PERIPHERAL OPIOID RECEPTOR ANTAGONISTS MOVANTIK TAB 12.5MG MOVANTIK TAB 25MG

PHARMACEUTICAL ADJUVANTS ANTIMICROBIAL AGENTS

BENZYL ALC LIQ BENZYL ALC LIQ OTC

LIQUID VEHICLES BACTER WATER INJ PARABENS glycine diluent for injection

NACL/BACT INJ 0.9%BENZ

saline injection bacteriostatic

SALINE/PHENO SOL

water for inject, bacteriostatic benzyl alcohol

water for injection water for iv injection

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QL - Quantity Limits ST - Step Therapy SP - Specialty 171 AGE - Age Limit GNDR - Gender Edit

PHENOTHIAZINES PHENOTHIAZINES

compro sup 25mg prochlorperazine maleate tab 5 mg (base

equivalent) prochlorperazine maleate tab 10 mg (base

equivalent) prochlorperazine suppos 25 mg

PHOSPHATE PHOSPHATE

K-PHOS TAB

PHOSPHATE BINDER AGENTS PHOSPHATE BINDER AGENTS

calcium acetate (phosphate binder) cap 667 mg (169 mg ca)

PLATELET AGGREGATION INHIBITORS DIRECT-ACTING P2Y12 INHIBITORS

BRILINTA TAB 60MG BRILINTA TAB 90MG

PHOSPHODIESTERASE III INHIBITORS cilostazol tab 50 mg cilostazol tab 100 mg

PLATELET AGGREGATION INHIBITORS

dipyridamole tab 25 mg dipyridamole tab 50 mg dipyridamole tab 75 mg

PROTEASE-ACTIVATED RECEPTOR-1 (PAR-1) ANTAGONISTS

ZONTIVITY TAB 2.08MG

QUINAZOLINE AGENTS anagrelide hcl cap 0.5 mg anagrelide hcl cap 1 mg

THIENOPYRIDINE DERIVATIVES clopidogrel bisulfate tab 75 mg (base equiv) clopidogrel bisulfate tab 300 mg (base equiv)

POLYMYXINS POLYMYXINS

POLYMYXIN B POW SULFATE

POSTERIOR PITUITARY HORMONES VASOPRESSIN

desmopressin acetate nasal spray soln 0.01% PA desmopressin acetate nasal spray soln 0.01% PA

(refrigerated) desmopressin acetate tab 0.1 mg PA

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QL - Quantity Limits ST - Step Therapy SP - Specialty 172 AGE - Age Limit GNDR - Gender Edit

desmopressin acetate tab 0.2 mg PA

POTASSIUM POTASSIUM

effer-k tab 25meq ef k-effervesce tab 25meq ef

k-prime tab 25meq ef k-vescent tab 25meq ef klor-con 8 tab 8meq er klor-con 10 tab 10meq er klor-con m10 tab 10meq er klor-con m20 tab 20meq er klor-con spr cap 8meq klor-con spr cap 10meq klor-con/ef tab 25meq fr potassium bicarbonate effer tab 25 meq

potassium chloride cap er 8 meq potassium chloride cap er 10 meq potassium chloride microencapsulated crys er tab 10 meq potassium chloride microencapsulated crys er tab

20 meq potassium chloride oral soln 10% (20 meq/15ml)

potassium chloride oral soln 20% (40 meq/15ml) potassium chloride tab er 8 meq (600 mg) potassium chloride tab er 10 meq potassium chloride tab er 20 meq (1500 mg)

POTASSIUM REMOVING AGENTS POTASSIUM REMOVING AGENTS

kionex sus 15gm/60 sodium polystyrene sulfonate oral susp 15

gm/60ml sodium polystyrene sulfonate rectal susp 30

gm/120ml sps sus 15gm/60

POTASSIUM SPARING DIURETICS POTASSIUM SPARING DIURETICS

amiloride hcl tab 5 mg spironolactone tab 25 mg spironolactone tab 50 mg spironolactone tab 100 mg

PRENATAL VITAMINS PRENATAL MV & MIN W/FE-FA

CITRANATAL MIS B-CALM CITRANATAL TAB RX

elite-ob tab

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QL - Quantity Limits ST - Step Therapy SP - Specialty 173 AGE - Age Limit GNDR - Gender Edit

inatal gt tab

prenatabs rx tab prenatal 19 chw tab prenatal 19 tab trinate tab

PRENATAL MV & MIN W/FE-FA-DHA CITRANATAL CAP HARMONY CITRANATAL MIS 90 DHA CITRANATAL PAK ASSURE CITRANATAL PAK DHA

PROGESTIN CONTRACEPTIVES - IMPLANTS PROGESTIN CONTRACEPTIVES - IMPLANTS

NEXPLANON IMP 68MG SP, QL (1 implant in lifetime)

PROGESTIN CONTRACEPTIVES - IUD PROGESTIN CONTRACEPTIVES - IUD

KYLEENA IUD 19.5MG SP, QL (1 IUD in lifetime) LILETTA IUD 52MG SP, QL (1 IUD in lifetime)

MIRENA IUD SYSTEM SP, QL (1 IUD in lifetime)

SKYLA IUD 13.5MG SP, QL (1 IUD in lifetime)

PROGESTIN CONTRACEPTIVES - ORAL PROGESTIN CONTRACEPTIVES - ORAL

deblitane tab 0.35mg QL (1 tab / 1 day) heather tab 0.35mg QL (1 tab / 1 day)

jencycla tab 0.35mg QL (1 tab / 1 day)

jolivette tab 0.35mg QL (1 tab / 1 day)

nora-be tab 0.35mg QL (1 tab / 1 day)

norethindrone tab 0.35 mg QL (1 tab / 1 day)

norlyda tab 0.35mg QL (1 tab / 1 day)

norlyroc tab 0.35mg QL (1 tab / 1 day)

sharobel tab 0.35mg QL (1 tab / 1 day)

PROGESTINS PROGESTINS

MAKENA INJ 275MG SP, PA medroxyprogesterone acetate tab 2.5 mg

medroxyprogesterone acetate tab 5 mg medroxyprogesterone acetate tab 10 mg norethindrone acetate tab 5 mg progesterone micronized cap 100 mg progesterone micronized cap 200 mg

PROLACTIN INHIBITORS DOPAMINE RECEPTOR AGONISTS

cabergoline tab 0.5 mg

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QL - Quantity Limits ST - Step Therapy SP - Specialty 174 AGE - Age Limit GNDR - Gender Edit

PROSTAGLANDIN VASODILATORS PROSTAGLANDIN VASODILATORS

TYVASO REFIL SOL 0.6MG/ML SP, QL (87 mL / 30 days), PA

TYVASO SOL 0.6MG/ML SP, QL (87 mL / 30 days),

PA TYVASO START SOL 0.6MG/ML SP, QL (87 mL / 30 days),

PA

PROSTAGLANDINS - OPHTHALMIC PROSTAGLANDINS - OPHTHALMIC

latanoprost ophth soln 0.005%

PROSTATIC HYPERTROPHY AGENTS 5-ALPHA REDUCTASE INHIBITORS

finasteride tab 5 mg

ALPHA 1-ADRENOCEPTOR ANTAGONISTS alfuzosin hcl tab er 24hr 10 mg tamsulosin hcl cap 0.4 mg

PROTEINS

AMINO ACIDS-SINGLE g-levocarnit sol 1gm/10ml OTC L-CARNITINE CAP 500MG OTC

L-CARNITINE TAB 250MG OTC

LEVOCARNITIN TAB 330MG OTC

levocarnitine cap 250 mg OTC

levocarnitine tab 500 mg OTC

PROTON PUMP INHIBITORS PROTON PUMP INHIBITORS

heartburn tr cap 15mg OTC lansoprazole cap 15mg dr OTC

lansoprazole cap delayed release 15 mg

omeprazole cap delayed release 10 mg QL (90 caps / year)

omeprazole cap delayed release 20 mg QL (90 caps / year) omeprazole cap delayed release 20 mg QL (90 each / year) omeprazole cap delayed release 40 mg QL (90 caps / year) omeprazole magnesium cap dr 20.6 mg (20 mg OTC

base equiv) OMEPRAZOLE TAB 20MG OTC

pantoprazole sodium ec tab 20 mg (base equiv) QL (90 tabs / year)

pantoprazole sodium ec tab 40 mg (base equiv) QL (90 each / year) pantoprazole sodium ec tab 40 mg (base equiv) QL (90 tabs / year) PRILOSEC OTC TAB 20MG OTC

PSEUDOBULBAR AFFECT (PBA) AGENTS

PSEUDOBULBAR AFFECT AGENT COMBINATIONS NUEDEXTA CAP 20-10MG PA

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QL - Quantity Limits ST - Step Therapy SP - Specialty 175 AGE - Age Limit GNDR - Gender Edit

PSYCHOTHERAPEUTIC AND NEUROLOGICAL AGENTS - MISC. ANTIDEMENTIA AGENTS

donepezil hydrochloride orally disintegrating tab 5 mg donepezil hydrochloride orally disintegrating tab 10

mg donepezil hydrochloride tab 5 mg

donepezil hydrochloride tab 10 mg memantine hcl oral solution 2 mg/ml

MULTIPLE SCLEROSIS AGENTS AVONEX KIT 30MCG SP, QL (4.5 injections / 30

days), PA AVONEX PEN KIT 30MCG SP, QL (1.2 injections / 30

days), PA AVONEX PREFL KIT 30MCG SP, QL (1.2 injections / 30

days), PA glatiramer acetate soln prefilled syringe 20 mg/ml SP, QL (1 injection / 1 day),

PA glatiramer acetate soln prefilled syringe 40 mg/ml SP, QL (12.9 injections / 30

days), PA glatopa inj 20mg/ml SP, QL (1 injection / 1 day),

PA glatopa inj 40mg/ml SP, QL (12.9 injections / 30

days), PA OCREVUS INJ 300/10ML SP, QL (0.36 vials / 30

days), PA

PULMONARY FIBROSIS AGENTS PULMONARY FIBROSIS AGENTS - KINASE INHIBITORS

OFEV CAP 100MG SP, QL (2 caps / 1 day), PA OFEV CAP 150MG SP, QL (2 caps / 1 day), PA

PULMONARY HYPERTENSION - ENDOTHELIN RECEPTOR ANTAGONISTS

PULMONARY HYPERTENSION - ENDOTHELIN RECEPTOR ANTAGONISTS

LETAIRIS TAB 5MG SP, QL (1 tab / 1 day), PA LETAIRIS TAB 10MG SP, QL (1 tab / 1 day), PA

TRACLEER TAB 62.5MG SP, QL (2 tabs / 1 day), PA

TRACLEER TAB 125MG SP, QL (2 tabs / 1 day), PA

PULMONARY HYPERTENSION - PHOSPHODIESTERASE INHIBITORS PULMONARY HYPERTENSION - PHOSPHODIESTERASE INHIBITORS

REVATIO SUS 10MG/ML SP, QL (225 mL / 30 days), PA

PULMONARY HYPERTENSION - PROSTACYCLIN RECEPTOR AGONIST PULMONARY HYPERTENSION - PROSTACYCLIN RECEPTOR AGONIST

UPTRAVI TAB 200/800 SP, PA

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QL - Quantity Limits ST - Step Therapy SP - Specialty 176 AGE - Age Limit GNDR - Gender Edit

UPTRAVI TAB 200MCG SP, PA

UPTRAVI TAB 400MCG SP, PA

UPTRAVI TAB 600MCG SP, PA

UPTRAVI TAB 800MCG SP, PA

UPTRAVI TAB 1000MCG SP, PA

UPTRAVI TAB 1200MCG SP, PA

UPTRAVI TAB 1400MCG SP, PA

UPTRAVI TAB 1600MCG SP, PA

PYRIMIDINE SYNTHESIS INHIBITORS PYRIMIDINE SYNTHESIS INHIBITORS

leflunomide tab 10 mg leflunomide tab 20 mg

RECTAL STEROIDS RECTAL STEROIDS

hydrocortisone rectal cream 1% hydrocortisone rectal cream 2.5% procto-med cre hc 2.5% procto-pak cre 1% proctosol hc cre 2.5% proctozone cre -hc 2.5%

RESPIRATORY AGENTS - MISC.

ALPHA-PROTEINASE INHIBITOR (HUMAN) GLASSIA INJ SP, PA PROLASTIN-C INJ 1000MG SP, PA

CYSTIC FIBROSIS AGENTS ORKAMBI GRA 100-125 SP, QL (2 packets / 1 day),

PA ORKAMBI GRA 150-188 SP, QL (2 packets / 1 day),

PA

RESPIRATORY AIDS MASKS

ALL PURPOSE MIS MASK OTC EAR-LOOP MIS MASK SM OTC

EARLOOP MIS MASK OTC

FACE MASK MIS EARLOOP

FACE MASK MIS EARLOOP OTC

FACE MASK MIS N-100 FACE MASK MIS R95 PART J&J GERM FIL MIS MASK OTC

LIGHT SHIELD MIS OTC

LIGHT SHIELD MIS SLP MASK OTC

MASK PEDIATR MIS SIZE 1" OTC

MASK PEDIATR MIS SIZE 3" OTC

MAXI-MASK MIS OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 177 AGE - Age Limit GNDR - Gender Edit

NEBULIZERS AEROECLIPSE MIS II NEB AERONEB GO MIS AERONEB GO MIS COMPLETE AERONEB GO MIS HAND/CBL AERONEB GO MIS HANDSET AIRIAL COMP MIS COMPRESS AIRIAL MIS COMPACT AIRIAL MIS VOYAGER AIRIAL PEDIA MIS BUILDING AIRIAL PEDIA MIS DUCK AIRIAL PEDIA MIS FIRE ENG AIRIAL PEDIA MIS PANDA AIRIAL PEDIA MIS PENGUIN AIRS DISPOSA MIS NEBULIZR OTC ALL-IN-ONE MIS NEBULIZR OTC ALTERA MIS NEBULIZE CLEVER CHOIC MIS NEBULIZR COMP AIR MIS COMP/NEB COMP AIR MIS ELITE COMPMIST MIS NEBULIZE OTC COMPRESSOR MIS NEBULIZE COMPRESSOR MIS NEBULIZR OTC EASY AIR COM MIS NEBULIZE OTC EFLOW SCF MIS NEBULIZR ELITE COMPRS MIS NEBULIZR OTC ELITE SYSTEM MIS NEBULIZR ERAPID MIS NEBULIZE HOMENEB MIS SIDESTRE OTC INNOSPIRE EL MIS NEBULIZE INNOSPIRE ES MIS NEBULIZE INNOSPIRE MIS DEL NEBU OTC INNOSPIRE MIS MINI NEB INSPIRATION MIS ELITE INSPIRATION MIS NEBULIZR LUMINEB II MIS NEBULIZR MABIS COMPXP MIS COMP/NEB OTC

MICROSHIELD MIS CPR OTC

PEDIATRIC MD MIS MASK OTC

PEDIATRIC SM MIS MASK OTC

PROCEDURAL MIS MASK OTC

RA EAR-LOOP MIS MASK OTC

SIESTA MASK MIS OTC

SIESTA MASK MIS ONE SIZE OTC

RESPIRATORY THERAPY SUPPLIES

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QL - Quantity Limits ST - Step Therapy SP - Specialty 178 AGE - Age Limit GNDR - Gender Edit

Drug Name Requirements/Limits MARGO MOO MIS NEBULIZE OTC MICRO AIR MIS NEBULIZR MICRO PLUS MIS NEBULIZR MICROELITE MIS COMP/NEB MICROELITE MIS COMP/NEB OTC MINI COMPRES MIS NEBULIZR MINI PLUS MIS NEBULIZR MINI-MIST MIS PORTABLE OTC MINIBREEZE MIS NEBULIZE OTC MINIELITE MIS COMP/NEB MISTERNEB MIS NEBULIZE MY MDI PORTA MIS NEBULISE NEBULIZER MIS OTC NEBULIZER MIS CMPRESSR NEBULIZER MIS ULTRASON OPTIONHOME MIS NEBULIZR PARI BABY MIS SIZE 0 PARI BABY MIS SIZE 1 PARI BABY MIS SIZE 2 PARI LC D MIS NEBULIZR PARI LC MIS SPRINT PARI LC PLUS MIS PARI LC PLUS MIS NEBULIZR PARI LC PLUS MIS VIOS PRO PARI LC STAR MIS PARI LC STAR MIS NEBULIZR PARI PRONEB MIS ULTRA II PARI SINUS MIS AERO SYS PARI TREK S MIS PORT COMPRES MIS NEBULIZR OTC PRONEB ULTRA MIS II/LCD PRONEB ULTRA MIS II/PED PRONEB ULTRA MIS LC PLUS PRONEB ULTRA MIS LC SPRNT PRONEB ULTRA MIS LC STAR SIDESTREAM MIS NEBULIZR SIDESTREAM MIS PLUS SOOTHE NEB MIS NEBULIZE SOOTHENEB MIS COMP NEB VIOS LC MIS SPRINT VIOS LC PLUS MIS VIOS LC PLUS MIS DELUXE VIOS LC PLUS MIS PEDIATRC VIOS MIS SYSTEM VIOS PRO LC MIS SPRINT

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QL - Quantity Limits ST - Step Therapy SP - Specialty 179 AGE - Age Limit GNDR - Gender Edit

Drug Name Requirements/Limits VIOS PRO LC+ MIS SYSTEM WHISPER AIRE MIS PED NEBU

RESPIRATORY THERAPY SUPPLIES ACE AERO CLD MIS ENHANCER ACTIVITY PCH MIS

ADULT MASK MIS ADULT MASK MIS LARGE AEROSOL MASK MIS ADULT

AEROSOL MASK MIS ADULT OTC AEROTRC PLUS MIS

AIR TUBE MIS /PLUGS

AIRS PEDIATR MIS MASK OTC ALTERA NEB MIS HANDSET BUBBLES PEDI MIS MASK OTC CO MONITOR MIS T PIECES CONVERSION MIS BABY SZ1 CONVERSION MIS BABY SZ2 CONVERSION MIS BABY SZ3 EBASE CONTRO MIS KIT EFLOW SCF MIS AEROSOL ELITE DC AUT MIS ADAPTER ERAPID NEB MIS HANDSET FILTER AIR MIS PP FULL KIT NEB MIS SET LITETOUCH MIS MASK LG LITETOUCH MIS MASK MD LITETOUCH MIS MASK SM

MICROELITE MIS BATTERY OTC

MICROELITE MIS FILTERS OTC MINIELITE MIS BATTERY MINIELITE MIS FILTERS OTC

NOSE CLIP MIS OTC

PARI EXPIRAT MIS FILTER PARI MASK MIS SIZE 3 PARI PLASTIC MIS MASK

PARI PLASTIC MIS MASK PED PEDIATRIC MIS MASK

PEDIATRIC MIS MOUTHPIE OTC PFLEX MIS

PFT FILTER MIS 1000 PILLOW MASK MIS ADULT PILLOW MASK MIS CHILD PILLOW MASK MIS PEDIATRI REPLACEMENT MIS FILTER

REPLACEMENT MIS FILTERS OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 180 AGE - Age Limit GNDR - Gender Edit

SIDESTREAM MIS MASK

SIDESTREAM MIS MASK OTC SIDESTREAM MIS PED MASK

SIDESTREAM MIS PED MASK OTC

SIDESTRM PLS MIS FACE MSK OTC SILICONE MSK MIS ADULT SILICONE MSK MIS INFANT SILICONE MSK MIS PED SOOTHENEB MIS MED CUP OTC

SOOTHENEB MIS MESH CAP OTC

SOOTHENEB MIS NBL 100 OTC THRESHOLD MIS IMT WINDMILL MIS TRAINER

WING TIP MIS TUBING OTC

SPACER/AEROSOL-HOLDING CHAMBERS & SUPPLIES AERCHMBR PLS MIS FLOW-VU AERCHMBR PLS MIS LRG MASK AERCHMBR PLS MIS MED MASK AERCHMBR PLS MIS SM MASK AERCHMBR Z- MIS STAT PLS AEROCHAMBER MIS CHAMBER AEROCHAMBER MIS FLOSIGNA AEROCHAMBER MIS MV AEROCHAMBER MIS PLUS AEROVENT MIS PLUS

ARIAL MIS CHAMBER OTC

BREATHERITE MIS BREATHERITE MIS LG MASK BREATHERITE MIS MED MASK BREATHERITE MIS SM MASK BREATHERITE MIS SPACER BREATHERITE MIS W/MASK COMPACT SPAC MIS CHAMBER COMPACT SPAC MIS LG MASK COMPACT SPAC MIS MD MASK COMPACT SPAC MIS SM MASK EASIVENT MIS

EASIVENT MIS MASK LG EASIVENT MIS MASK MED EASIVENT MIS MASK SM FLEXICHAMBER MIS

FLEXICHAMBER MIS MASK LRG QL (2 boxes / year)

FLEXICHAMBER MIS MASK SM QL (2 boxes / year) HOLD CHAMBER MIS ADLT LG

HOLD CHAMBER MIS MEDIUM

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 181 AGE - Age Limit GNDR - Gender Edit

HOLD CHAMBER MIS SMALL INSPIRACHAMB MIS LARGE INSPIRACHAMB MIS MEDIUM INSPIRACHAMB MIS MOUTHPCE INSPIRACHAMB MIS SMALL INSPIREASE MIS DD SYST LITEAIRE MIS

MASK VORTEX/ MIS BABY DUC OTC, QL (2 each / year)

MASK VORTEX/ MIS DUCK OTC, QL (2 each / year)

MASK VORTEX/ MIS FROG OTC, QL (2 each / year)

MASK VORTEX/ MIS LADY BUG OTC, QL (2 each / year) MICROCHAMBER MIS MICROSPACER MIS OPTICHAMBER MIS ADV LRG OPTICHAMBER MIS ADV MED OPTICHAMBER MIS ADV SM OPTICHAMBER MIS DIA LG OPTICHAMBER MIS DIA MD OPTICHAMBER MIS DIA SM OPTICHAMBER MIS DIAMOND

OPTICHAMBER MIS FACE MAS OTC OPTIHALER MIS

PANDA MASK MIS LARGE OTC, QL (2 packs / year)

PANDA MASK MIS MEDIUM OTC, QL (2 packs / year)

PANDA MASK MIS PEDIATRI OTC, QL (2 packs / year)

PANDA MASK MIS SMALL OTC, QL (2 packs / year) POCKET CHAMB MIS POCKET SPACE MIS RITEFLO MIS VALVD HOLDNG MIS CHAMBER VORTEX VALVE MIS CHAMBER WATCHHALER MIS

VAPORIZERS KAZ VAPORIZR MIS 1 GALLON OTC

KAZ VAPORIZR MIS 1.5 GAL OTC

KAZ VAPORIZR MIS 2.2 GAL OTC

SUNBEAM VAP MIS 1 GAL OTC

SUNBEAM VAP MIS 1.5 GAL OTC

SUNBEAM VAP MIS 2 GAL OTC

VAPORIZER MIS 1 GALLON OTC

VAPORIZER MIS 1.2 GAL OTC

VAPORIZER MIS 1.5 GAL OTC

VAPORIZER MIS 1.7 GAL OTC

VAPORIZER MIS 1.9 GAL OTC

VAPORIZER MIS 2 GALLON OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 182 AGE - Age Limit GNDR - Gender Edit

VAPORIZER MIS 2.5 GAL OTC

VAPORIZER MIS 3 GALLON OTC

VAPORIZER MIS PORTABLE OTC

VAPORIZER MIS WATERLES OTC

ROSACEA AGENTS ROSACEA AGENTS

metronidazole cream 0.75%

metronidazole gel 0.75%

metronidazole gel 1% ST

metronidazole lotion 0.75%

rosadan cre 0.75%

rosadan gel 0.75%

SALICYLATES SALICYLATES

aspir-81 tab 81mg ec OTC

aspir-low tab 81mg ec OTC

aspirin adlt tab 81mg OTC

aspirin chld chw 81mg OTC

aspirin chw 81mg OTC

aspirin low chw 81mg OTC

aspirin low tab 81mg ec OTC

aspirin sup 300mg OTC

aspirin sup 600mg OTC

aspirin tab 81mg ec OTC

aspirin tab 325 mg OTC

aspirin tab 325mg ec OTC

aspirin tab delayed release 81 mg OTC

aspirin tab delayed release 325 mg OTC

aspirin-81 chw 81mg OTC

aspirtab m/s tab 500mg OTC

aspirtab tab 324mg ec OTC

bayer adv tab 325mg OTC

bayer adv tab 500mg OTC

bayer asa tab 325mg OTC

bayer asa tab 500mg OTC

bayer low chw 81mg OTC

bayer low tab 81mg ec OTC

child asa chw 81mg OTC

child asa ls chw 81mg OTC

cvs aspirin tab 81mg ec OTC

cvs aspirin tab 325mg OTC

cvs aspirin tab 325mg ec OTC

diflunisal tab 500 mg

ecotrin low tab 81mg ec OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 183 AGE - Age Limit GNDR - Gender Edit

ecotrin tab 325mg OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 183 AGE - Age Limit GNDR - Gender Edit

ecpirin tab 325mg ec OTC

enteric asa tab 325mg OTC

eq aspirin tab 325mg OTC

eq aspirin tab 325mg ec OTC

eq aspirin tab 500mg ec OTC

eq child asa chw 81mg OTC

eql aspirin chw 81mg OTC

eql aspirin tab 325mg OTC

eql aspirin tab 325mg ec OTC

gnp aspirin chw 81mg OTC

gnp aspirin tab 81mg ec OTC

gnp aspirin tab 325mg OTC

gnp aspirin tab 325mg ec OTC

hm aspirin chw 81mg OTC

hm aspirin tab 325mg OTC

kls aspirin tab 81mg ec OTC

kls aspirin tab 325mg ec OTC

kp aspirin tab 81mg ec OTC

miniprin low tab 81mg ec OTC

mm aspirin tab 325mg OTC

norwich asa tab 325mg OTC

px aspirin chw 81mg OTC

px aspirin tab 81mg ec OTC

px aspirin tab 325mg OTC

px aspirin tab 325mg ec OTC

qc aspirin tab 325mg OTC

qc aspirin tab 325mg ec OTC

qc child asa chw 81mg OTC

ra aspirin chw 81mg OTC

ra aspirin tab 81mg ec OTC

ra aspirin tab 325mg OTC

ra aspirin tab 325mg ec OTC

ra aspirin tab 500mg OTC

ra child asa chw 81mg OTC

sb aspirin tab 325mg OTC

sb aspirin tab 325mg ec OTC

sb child asa chw 81mg OTC

sm aspirin chw 81mg OTC

sm aspirin tab 81mg ec OTC

sm aspirin tab 325mg OTC

sm aspirin tab 325mg ec OTC

sm child asa chw 81mg OTC

st joseph chw low 81mg OTC

tgt aspirin chw 81mg OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 184 AGE - Age Limit GNDR - Gender Edit

tgt aspirin chw child OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 185 AGE - Age Limit GNDR - Gender Edit

tgt aspirin tab 81mg OTC

tgt aspirin tab 81mg ec OTC

tgt aspirin tab 325mg OTC

SCABICIDES & PEDICULICIDES SCABICIDE COMBINATIONS

lice killing sha OTC lice killing sha 0.33-4% OTC

lice treatmt sha 0.33-4% OTC

licide sha 0.33-4% OTC

rid lice kil sha 0.33-4% OTC

stop lice ms sha 0.33-4% OTC

SCABICIDES & PEDICULICIDES bedding spra aer 0.5% OTC lice bedding aer OTC

lice bedding aer 0.5% OTC

lice treatmt lot 1% OTC

lice trtmnt liq 1% OTC

licide aer 0.5% OTC

malathion lotion 0.5% ST

permethrin cream 5%

ra lice lot 1% OTC

sm bedding aer lice OTC

spinosad susp 0.9% ST

stop lice 3 spr 0.5% OTC

stop lice spr 0.5% OTC

SELECTIVE ALDOSTERONE RECEPTOR ANTAGONISTS (SARAS) SELECTIVE ALDOSTERONE RECEPTOR ANTAGONISTS (SARAS)

eplerenone tab 25 mg eplerenone tab 50 mg

SEROTONIN AGONISTS SELECTIVE SEROTONIN AGONISTS 5-HT(1)

naratriptan hcl tab 1 mg (base equiv) QL (8 tabs / 25 days), ST naratriptan hcl tab 2.5 mg (base equiv) QL (8 each / 25 days), ST naratriptan hcl tab 2.5 mg (base equiv) QL (8 tabs / 25 days), ST rizatriptan benzoate oral disintegrating tab 5 mg QL (12 tabs / 25 days), ST

(base eq) rizatriptan benzoate oral disintegrating tab 10 mg QL (12 tabs / 25 days), ST (base eq) rizatriptan benzoate tab 5 mg (base equivalent) QL (12 tabs / 25 days), ST

rizatriptan benzoate tab 10 mg (base equivalent) QL (12 tabs / 25 days), ST sumatriptan nasal spray 5 mg/act QL (8 inhalers / 25 days) sumatriptan nasal spray 20 mg/act QL (8 inhalers / 25 days)

sumatriptan succinate tab 25 mg QL (8 tabs / 25 days)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 186 AGE - Age Limit GNDR - Gender Edit

sumatriptan succinate tab 50 mg QL (8 tabs / 25 days)

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 187 AGE - Age Limit GNDR - Gender Edit

sumatriptan succinate tab 100 mg QL (8 tabs / 25 days)

zolmitriptan orally disintegrating tab 2.5 mg QL (8 each / 25 days), ST zolmitriptan orally disintegrating tab 2.5 mg QL (8 tabs / 25 days), ST zolmitriptan orally disintegrating tab 5 mg QL (8 each / 25 days), ST zolmitriptan orally disintegrating tab 5 mg QL (8 tabs / 25 days), ST zolmitriptan tab 2.5 mg QL (8 tabs / 25 days), ST zolmitriptan tab 5 mg QL (8 tabs / 25 days), ST

SINUS NODE INHIBITORS SINUS NODE INHIBITORS

CORLANOR TAB 5MG CORLANOR TAB 7.5MG

SODIUM-GLUCOSE CO-TRANSPORTER 2 (SGLT2) INHIBITORS

SODIUM-GLUCOSE CO-TRANSPORTER 2 (SGLT2) INHIBITORS INVOKANA TAB 100MG ST INVOKANA TAB 300MG ST

SPECIALTY VITAMINS PRODUCTS SPECIALTY VITAMINS PRODUCTS

a thru z tab advantag OTC ADRENAL TAB CALM OTC

ADRENOID CAP OTC

ADV COLLAGEN TAB OTC

ALLERWELL TAB ALLERGY OTC

BILBERRY CAP PLUS OTC

BIOTIN PLUS TAB KERATIN OTC

BRAIN MIGHT TAB OTC

BRAIN TAB 355MG OTC

CA-PLUS TAB 280MG OTC

CAL-CO3Y CAP OTC

CARDIO TONE TAB OTC

CARDIOPRESS CAP OTC

CAROZYME CAP OTC

central-vite tab cardio OTC

central-vite tab performa OTC

CENTRUM SPEC TAB ENERGY OTC

CENTRUM TAB PERFORMA OTC

CHOLASE CAP CONTROL OTC

COLLAGEN CAP ULTRA OTC

CU-PLUS TAB 2MG OTC

CVS HAIR/SKN TAB NAILS OTC

ELON MATRIX TAB 5000 OTC

ELON MATRIX TAB 5000 COM OTC

ELON MATRIX TAB COMPLETE OTC

ELON MATRIX TAB PLUS OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 188 AGE - Age Limit GNDR - Gender Edit

ELON R3 TAB OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 189 AGE - Age Limit GNDR - Gender Edit

GERM DEFENSE TAB LEM-LIME OTC

GERM DEFENSE TAB ORANGE OTC

GERM DEFENSE TAB PM OTC

GLUCO COR CAP OTC

GLYCOTROL CAP OTC

GLYCOTROL CAP COMPLETE OTC

GREEN SOURCE TAB OTC

HAIR FARE TAB OTC

HAIR NOURISH TAB SUPPLEMN OTC

hair/skin/ tab nails OTC

HEALTHY TAB HEART OTC

HEART SAVIOR CAP OTC

HEART TAB 140MG OTC

HM ESTROPLUS TAB OTC

immunicare cap OTC

INULOSE BLD CAP SUGAR OTC

KIDNEY TAB 280MG OTC

LIPIDSHIELD TAB PLUS OTC

LIPOTRIAD CAP VIS PLUS OTC

LIPOTRIAD CAP VISION OTC

LIPOTRIAD CAP VISIONAR OTC

LONGEVITY CAP OTC

LONGEVITY CAP PLUS OTC

LUNG TAB 180MG OTC

LYMPH TAB 150MG OTC

M2 CALCIUM TAB 280MG OTC

M2 CHROMIUM TAB 500MCG OTC

MAMMARY TAB 150MG OTC

MENOPAUSE MIS AM/PM OTC

menopause tab support OTC

MG-PLUS TAB PROTEIN OTC

MIL ADREGEN TAB OTC

MILADRE FORT TAB 160MG OTC

milltrium tab stamina OTC

MILPAN TAB 325 MG OTC

MPS CAP OTC

MULTI-GLAN TAB 455 MG OTC

NEW LIFE TAB HAIR OTC

ORCHIC TAB 150MG OTC

OVARY TAB 125 MG OTC

PARATHYROID TAB 10MG OTC

PITUITARY TAB 35 MG OTC

PROSTATE TAB 130MG OTC

RA EAR CARE TAB OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 190 AGE - Age Limit GNDR - Gender Edit

RA EFFERVESC TAB FORMULA OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 191 AGE - Age Limit GNDR - Gender Edit

ra menopause tab support OTC

RETAINE CAP VISION OTC

SPLEEN TAB 250MG OTC

STOMACH TAB 300MG OTC

SYNERTROPIN CAP OTC

THERABETIC TAB EYE HLTH OTC

THYMUS TAB 140MG OTC

ultimate fat tab burner OTC

ULTRA MAN TAB OTC

ULTRA WOMAN TAB OTC

UTERUS TAB 150MG OTC

varisan tab vitality OTC

vigor cap OTC

vit for hair tab OTC

VITAMINS FOR TAB THE HAIR OTC

WAL-BORN TAB OTC

weight loss tab multi OTC

WOMENS MENOP MIS VITA PAK OTC

WOMENS VITA MIS PAK OTC

ZN-PLUS TAB 15MG OTC

SPERMICIDES SPERMICIDES

ENCARE SUP 100MG OTC GYNOL II GEL 3% OTC

SHUR-SEAL GEL 2% OTC

VCF VAGINAL AER CONTRACP OTC

vcf vaginal gel contrace OTC

VCF VAGINAL MIS CONTRACP OTC

STEROID INHALANTS STEROID INHALANTS

budesonide inhalation susp 0.5 mg/2ml QL (120 mL / 25 days) budesonide inhalation susp 0.25 mg/2ml QL (120 mL / 25 days) budesonide inhalation susp 1 mg/2ml QL (60 mL / 25 days)

STEROIDS - MOUTH/THROAT STEROIDS - MOUTH/THROAT

oralone dent pst 0.1% triamcinolone acetonide dental paste 0.1%

STIMULANT LAXATIVES STIMULANT LAXATIVES

AGORAL LIQ MAX ST OTC alophen tab 5mg ec OTC

bisac-evac sup 10mg OTC

bisacodyl sup 10mg OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 192 AGE - Age Limit GNDR - Gender Edit

bisacodyl tab 5mg ec OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 193 AGE - Age Limit GNDR - Gender Edit

biscolax sup 10mg OTC

BLK DRAUGHT CHW 10MG OTC

choc laxativ chw 15mg OTC

correct tab 5mg ec OTC

CORRECTOL MIS HERBAL OTC

correctol tab 5mg ec OTC

cvs laxative chw 15mg OTC

cvs laxative tab 25mg OTC

cvs senna tab 8.6mg OTC

dr edwards tab 8.6mg OTC

ducodyl tab 5mg ec OTC

eq laxative chw 15mg OTC

eq laxative tab 8.6mg OTC

eq laxative tab 25mg OTC

eql gentle tab laxative OTC

eql laxative chw 15mg OTC

eql laxative tab 5mg ec OTC

eql laxative tab 25mg OTC

EVAC-U-GEN CHW 10MG OTC

evac-u-gen tab 8.6mg OTC

ex-lax ultra tab 5mg ec OTC

fast relief sup 10mg OTC

feenamint tab 5mg ec OTC

gentle laxat sup 10mg OTC

gentle laxat tab 5mg ec OTC

geri-kot tab 8.6mg OTC

gnp bisa-lax tab 5mg ec OTC

gnp laxative sup 10mg OTC

gnp laxative tab 5mg ec OTC

gnp laxative tab 25mg OTC

hm laxative sup 10mg OTC

hm laxative tab 5mg OTC

hm laxative tab 5mg ec OTC

hm senna tab 8.6mg OTC

kp bisacodyl tab 5mg ec OTC

kp senna tab 8.6mg OTC

laxative chw 15mg OTC

laxative sup 10mg OTC

laxative tab 5mg ec OTC

laxative tab 15mg OTC

laxative tab 25mg OTC

laxative tab max-str OTC

laxative tab w/senna OTC

LITTLE TUMMY DRO LAXATIVE OTC

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PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 194 AGE - Age Limit GNDR - Gender Edit

magic bullet sup 10mg OTC

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Drug Name Requirements/Limits

PA - Prior Authorization OTC - Over the counter

QL - Quantity Limits ST - Step Therapy SP - Specialty 195 AGE - Age Limit GNDR - Gender Edit

medi-lax tab 15mg OTC

medi-natural tab 8.6mg OTC

nat veg lax tab 8.6mg OTC

natural lax tab 8.6mg OTC

px laxative tab 8.6mg OTC

qc laxative sup 10mg OTC

qc laxative tab 5mg ec OTC

qc senna tab 8.6mg OTC

ra laxative chw 15mg OTC

ra laxative sup 10mg OTC

ra laxative tab 5mg ec OTC

ra laxative tab 25mg OTC

ra laxative tab ex st OTC

ra senna cap 8.6mg OTC

ra senna tab 8.6mg OTC

sb bisacodyl tab 5mg ec OTC

sb laxative sup 10mg OTC

sb senna-lax tab 8.6mg OTC

senexon tab 8.6mg OTC

senna lax tab 8.6mg OTC

senna laxati tab 8.6mg OTC

SENNA LEAVES MIS OTC

senna smooth tab 15mg OTC

SENNA SYP OTC

senna-extra tab 17.2mg OTC

senna-grx syp 8.8mg/5 OTC

senna-lax tab 8.6mg OTC

senna-tabs tab 8.6mg OTC

senna-time tab 8.6mg OTC

sennazon syp 8.8mg/5 OTC

senno tab 8.6mg OTC

sennosides cap 8.6 mg OTC

sennosides syrup 8.8 mg/5ml OTC

sennosides tab 8.6 mg OTC

senokot extr tab 17.2mg OTC

sm gentle tab laxative OTC

sm laxative sup 10mg OTC

sm laxative tab 5mg ec OTC

sm laxative tab 25mg OTC

sm senna lax tab 8.6mg OTC

sm senna lax tab max str OTC

stim laxat tab 5mg ec OTC

tgt natural tab laxative OTC

tgt senna tab 8.6mg OTC

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vercolate tab 5mg ec OTC

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womans laxat tab 5mg ec OTC

womens laxat tab 5mg ec OTC

SUBSTANCE P/NEUROKININ 1 (NK1) RECEPTOR ANTAGONISTS SUBSTANCE P/NEUROKININ 1 (NK1) RECEPTOR ANTAGONISTS

aprepitant capsule 40 mg PA aprepitant capsule 80 mg PA

aprepitant capsule 125 mg PA

aprepitant capsule therapy pack 80 & 125 mg PA EMEND SUS 125MG PA

SUCCINIMIDES SUCCINIMIDES

ethosuximide cap 250 mg ethosuximide soln 250 mg/5ml

SULFONAMIDES SULFONAMIDES

SULFADIAZINE POW SULFADIAZINE POW SODIUM SULFADIAZINE TAB 500MG SULFAMETHOX POW SULFAMETHOX POW MICRO SULFAPYRIDIN POW SULFATHIAZOL POW SULFISOXIZOL CRY

SULFONYLUREAS SULFONYLUREAS

glimepiride tab 1 mg glimepiride tab 2 mg glimepiride tab 4 mg glipizide tab 5 mg glipizide tab 10 mg glipizide tab er 24hr 2.5 mg

glipizide tab er 24hr 5 mg glipizide tab er 24hr 10 mg glipizide xl tab 2.5mg glipizide xl tab 5mg glipizide xl tab 10mg glyburide micronized tab 1.5 mg

glyburide micronized tab 3 mg glyburide micronized tab 6 mg glyburide tab 1.25 mg glyburide tab 2.5 mg

glyburide tab 5 mg

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SURFACTANT LAXATIVES SURFACTANT LAXATIVES

correctol cap 100mg OTC diocto liq 50mg/5ml OTC

diocto syp 60/15ml OTC

docu liq 50mg/5ml OTC

docu soft cap 100mg OTC

docuprene tab 100mg OTC

docusate calcium cap 240 mg OTC

docusate sod liq 50mg/5ml OTC

docusate sodium cap 100 mg OTC

docusate sodium cap 250 mg OTC

docusate sodium liquid 150 mg/15ml OTC

docusate sodium syrup 60 mg/15ml OTC

docusate sodium tab 100 mg OTC

docusil cap 100mg OTC

dok cap 100mg OTC

dok cap 250mg OTC

dok tab 100mg OTC

dulcolax ss cap 100mg OTC

easy-lax cap 100mg OTC

eq stool cap softener OTC

kao-tin cap 240mg OTC

laxa basic cap 100mg OTC

move along tab 100mg OTC

PEDIA-LAX LIQ 50MG OTC

phillips cap 100mg OTC

promolaxin tab 100mg OTC

ra col-rite cap 50mg OTC

ra col-rite cap 100mg OTC

ra col-rite cap 250mg OTC

silace liq 10mg/ml OTC

silace syp 60/15ml OTC

stool soften cap 100mg OTC

stool soften cap 250mg OTC

stool softnr cap 50mg OTC

stool softnr cap 100mg OTC

stool softnr cap 240mg OTC

stool softnr cap 250mg OTC

stool softnr syp 60/15ml OTC

stool softnr tab 100mg OTC

surfak cap 240mg OTC

SYMPATHOMIMETIC DECONGESTANTS SYSTEMIC DECONGESTANTS

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child silfed liq 15mg/5ml OTC

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decongestant tab 30mg OTC

decongestant tab 120mg er OTC, QL (60 tabs / 30 days)

eq suphedrin tab 30mg OTC

genaphed tab 30mg OTC

gnp suphedrn liq 15mg/5ml OTC

12hr deconge tab 120mg cr OTC, QL (60 tabs / 30 days)

NASAL DECON SYP 30MG/5ML OTC

NASAL DECONG LIQ 30MG/5ML OTC

nasal decong tab 30mg OTC

nasal decong tab 120mg er OTC, QL (60 tabs / 30 days)

pseudoephedr tab 30mg OTC

pseudoephedr tab 60mg OTC

pseudoephedr tab 120mg er OTC, QL (60 tabs / 30 days)

qc suphedrin tab 120mg sr OTC, QL (60 tabs / 30 days)

ra suphedrin tab 30mg OTC

ra suphedrin tab 120mg cr OTC, QL (60 tabs / 30 days)

sm nasal dec tab 30mg OTC

sudafed 12hr tab 120mg cr OTC, QL (60 tabs / 30 days)

SUDAFED 24HR TAB 240MG OTC, QL (30 tabs / 30 days)

sudogest tab 30mg OTC

sudogest tab 60mg OTC

sudogest tab 120mg er OTC, QL (60 tabs / 30 days)

suphedrine tab 30mg OTC

tgt sinus tab 120mg OTC, QL (60 tabs / 30 days)

wal-phed tab 30mg OTC

wal-phed tab 120mg er OTC, QL (60 tabs / 30 days)

SYMPATHOMIMETICS ADRENERGIC COMBINATIONS

ADVAIR DISKU AER 100/50 QL (60 inhalations / 25 days), ST

COMBIVENT AER 20-100 QL (2 inhalers / 25 days)

DULERA AER 100-5MCG QL (1 inhaler / 25 days), ST

DULERA AER 100-5MCG QL (1.477 inhalers / 25

days), ST DULERA AER 200-5MCG QL (1 inhaler / 25 days), ST

DULERA AER 200-5MCG QL (1.477 inhalers / 25

days), ST ipratropium-albuterol nebu soln 0.5-2.5(3) mg/3mlQL (1620 mL / 75 days)

SYMBICORT AER 80-4.5 ST SYMBICORT AER 160-4.5 ST

BETA ADRENERGICS albuterol sulfate soln nebu 0.5% (5 mg/ml) QL (180 each / 75 days) albuterol sulfate soln nebu 0.5% (5 mg/ml) QL (180 mL / 75 days)

albuterol sulfate soln nebu 0.63 mg/3ml (base QL (1125 each / 75 days)

equiv)

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albuterol sulfate soln nebu 0.083% (2.5 mg/3ml) QL (1125 each / 75 days)

albuterol sulfate soln nebu 1.25 mg/3ml (base QL (1125 each / 75 days) equiv) albuterol sulfate syrup 2 mg/5ml albuterol sulfate tab 2 mg albuterol sulfate tab 4 mg STRIVERDI AER 2.5MCG QL (1 inhaler / 25 days) terbutaline sulfate tab 2.5 mg

terbutaline sulfate tab 5 mg VENTOLIN HFA AER QL (6 inhalers / 75 days)

TETRACYCLINES TETRACYCLINES

doxycycline hyclate cap 50 mg doxycycline hyclate cap 100 mg doxycycline hyclate tab 20 mg doxycycline hyclate tab 100 mg doxycycline monohydrate for susp 25 mg/5ml

DOXYCYCLINE POW HYCLATE

minocycline hcl cap 50 mg

minocycline hcl cap 75 mg minocycline hcl cap 100 mg MINOCYCLINE POW morgidox cap 1x50mg

morgidox cap 1x100mg morgidox cap 2x100mg OXYTETRACYC POW HCL tetracycline hcl cap 250 mg

tetracycline hcl cap 500 mg

THIAZIDES AND THIAZIDE-LIKE DIURETICS THIAZIDES AND THIAZIDE-LIKE DIURETICS

chlorthalidone tab 25 mg chlorthalidone tab 50 mg hydrochlorothiazide cap 12.5 mg hydrochlorothiazide tab 12.5 mg hydrochlorothiazide tab 25 mg hydrochlorothiazide tab 50 mg indapamide tab 1.25 mg indapamide tab 2.5 mg metolazone tab 2.5 mg metolazone tab 5 mg metolazone tab 10 mg

THROAT PRODUCTS - MISC. SALIVA STIMULANTS

pilocarpine hcl tab 5 mg pilocarpine hcl tab 7.5 mg

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THYROID AGENTS THYROID HORMONES

euthyrox tab 25mcg euthyrox tab 50mcg euthyrox tab 75mcg euthyrox tab 88mcg euthyrox tab 100mcg euthyrox tab 112mcg euthyrox tab 125mcg euthyrox tab 137mcg euthyrox tab 150mcg euthyrox tab 175mcg euthyrox tab 200mcg

THYROID HORMONES THYROID HORMONES

levo-t tab 25mcg levo-t tab 50mcg levo-t tab 75mcg levo-t tab 88mcg levo-t tab 100mcg levo-t tab 112mcg levo-t tab 125mcg levo-t tab 137mcg levo-t tab 150mcg levo-t tab 175mcg levo-t tab 200 mcg levo-t tab 300 mcg

levothyroxine sodium tab 25 mcg levothyroxine sodium tab 50 mcg levothyroxine sodium tab 75 mcg levothyroxine sodium tab 88 mcg levothyroxine sodium tab 100 mcg levothyroxine sodium tab 112 mcg levothyroxine sodium tab 125 mcg levothyroxine sodium tab 137 mcg levothyroxine sodium tab 150 mcg levothyroxine sodium tab 175 mcg levothyroxine sodium tab 200 mcg levothyroxine sodium tab 300 mcg levoxyl tab 25mcg

levoxyl tab 50mcg levoxyl tab 75mcg levoxyl tab 88mcg levoxyl tab 100mcg

levoxyl tab 112mcg

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levoxyl tab 125mcg

levoxyl tab 137mcg levoxyl tab 150mcg levoxyl tab 175mcg levoxyl tab 200mcg liothyronine sodium tab 5 mcg

liothyronine sodium tab 25 mcg liothyronine sodium tab 50 mcg unith direct tab 25mcg unith direct tab 50mcg

unith direct tab 75mcg unith direct tab 88mcg unith direct tab 100mcg unith direct tab 112mcg unith direct tab 125mcg unith direct tab 150mcg unith direct tab 175mcg unith direct tab 200mcg unith direct tab 300mcg unithroid tab 25mcg unithroid tab 50mcg unithroid tab 75mcg unithroid tab 88mcg unithroid tab 100mcg unithroid tab 112mcg unithroid tab 125mcg unithroid tab 137mcg unithroid tab 150mcg unithroid tab 175mcg unithroid tab 200mcg unithroid tab 300mcg

TOXOIDS TOXOID COMBINATIONS

BOOSTRIX INJ

ULCER DRUGS PROTON PUMP INHIBITORS

acid reducer cap 20.6mgdr OTC esomepra mag cap 20mg dr OTC, QL (30 caps / 25 days)

heartburn tr cap 24h 20mg OTC, QL (30 caps / 25 days)

NEXIUM 24HR TAB 20MG OTC, QL (90 tabs / year)

NEXIUM GRA 2.5MG DR QL (90 packets / year)

NEXIUM GRA 5MG DR QL (90 packets / year)

NEXIUM GRA 10MG DR QL (90 packets / year)

omeprazole cap delayed release 20 mg OTC, QL (90 caps / year)

pantoprazole sodium ec tab 20 mg (base equiv) QL (90 tabs / year)

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pantoprazole sodium ec tab 40 mg (base equiv) QL (90 tabs / year)

ULCER DRUGS - PROSTAGLANDINS ULCER DRUGS - PROSTAGLANDINS

misoprostol tab 100 mcg misoprostol tab 200 mcg

ULCER DRUGS/ANTISPASMODICS/ANTICHOLINERGICS H-2 ANTAGONISTS

acid control tab 20mg OTC acid control tab 150mg OTC

acid reducer tab 20mg OTC

acid reducer tab 150mg OTC

acid reducer tab 200mg OTC

cimetidine tab 200 mg OTC

cimetidine tab 200mg OTC

famotidine tab 20mg OTC

heartburn tab 20mg OTC

heartburn tab 150mg OTC

heartburn tab 200mg OTC

heartburn tab relief OTC

ranitidine hcl tab 150 mg OTC

sm acid redu tab 200mg OTC

PROTON PUMP INHIBITORS heartburn tr cap 15mg OTC lansoprazole cap 15mg dr OTC

lansoprazole cap delayed release 15 mg OTC

omeprazole cap 20.6mgdr OTC

omeprazole magnesium cap dr 20.6 mg (20 mg OTC base equiv)

ULCER THERAPY COMBINATIONS PROTON PUMP INHIBITOR-ANTACID COMBINATIONS

omeprazole-sodium bicarbonate cap 20-1100 mg OTC, QL (90 caps / year)

URICOSURICS URICOSURICS

probenecid tab 500 mg

URINARY ANALGESICS URINARY ANALGESICS

phenazo tab 200mg phenazopyridine hcl tab 100 mg phenazopyridine hcl tab 200 mg

URINARY ANTI-INFECTIVES URINARY ANTI-INFECTIVES

NALIDIXIC POW ACID NITROFURAN POW ANHYDROU

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nitrofurantoin macrocrystalline cap 25 mg

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QL - Quantity Limits ST - Step Therapy SP - Specialty 197 AGE - Age Limit GNDR - Gender Edit

nitrofurantoin macrocrystalline cap 50 mg

nitrofurantoin macrocrystalline cap 100 mg nitrofurantoin monohydrate macrocrystalline cap 100 mg nitrofurantoin susp 25 mg/5ml

URINARY ANTISPASMODIC - ANTIMUSCARINICS (ANTICHOLINERGIC)

URINARY ANTISPASMODIC - ANTIMUSCARINIC (ANTICHOLINERGIC)

oxybutynin chloride syrup 5 mg/5ml oxybutynin chloride tab 5 mg

oxybutynin chloride tab er 24hr 5 mg oxybutynin chloride tab er 24hr 10 mg oxybutynin chloride tab er 24hr 15 mg OXYTROL/WOMN DIS 3.9MG/24 OTC, GNDR

trospium chloride tab 20 mg

URINARY ANTISPASMODICS URINARY ANTISPASMODIC - ANTIMUSCARINICS (ANTICHOLINERGIC)

OXYTROL/WOMN DIS 3.9MG/24 OTC, GNDR

URINARY ANTISPASMODICS - CHOLINERGIC AGONISTS URINARY ANTISPASMODICS - CHOLINERGIC AGONISTS

bethanechol chloride tab 5 mg bethanechol chloride tab 10 mg bethanechol chloride tab 25 mg bethanechol chloride tab 50 mg

VAGINAL ANTI-INFECTIVES

IMIDAZOLE-RELATED ANTIFUNGALS clotrimazole cre 1% vag OTC clotrimazole cre 2% OTC

clotrimazole cre 3 day OTC

clotrimazole vaginal cream 1% OTC

cvs 3-day cre OTC

cvs miconazo cre 7 OTC

3 day vaginl cre 2% OTC

3 day vagnal cre 4% OTC

miconazole 1 kit OTC

miconazole 1 kit 1200-2% OTC

miconazole 1 kit 1200mg2% OTC

MICONAZOLE 1 KIT COMBO OTC

miconazole 3 cre 4% OTC

miconazole 3 kit combinat OTC

miconazole 3 kit combo OTC

miconazole 3 kit combo pk OTC

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miconazole 3 sup 200mg

miconazole 7 cre OTC

miconazole 7 cre 2% OTC

miconazole 7 cre tube/kit OTC

miconazole 7 sup 100mg OTC

miconazole nitrate vaginal cream 2% OTC

miconazole nitrate vaginal suppos 100 mg OTC MONISTAT 3 KIT COMBO PK OTC MONISTAT 7 KIT COMBO PK OTC MONISTAT 7 KIT COMPLETE OTC

ra clotrimaz cre 3 OTC

sm micon 7 sup 100mg OTC

terconazole vaginal cream 0.4%

terconazole vaginal suppos 80 mg VAGINAL ANTI-INFECTIVES

clindamycin phosphate vaginal cream 2% metronidazole vaginal gel 0.75% vandazole gel 0.75%

VAGINAL ESTROGENS VAGINAL ESTROGENS

estradiol vaginal tab 10 mcg yuvafem tab 10mcg

VAGINAL PRODUCTS

MISCELLANEOUS VAGINAL PRODUCTS acetic acid vaginal solution OTC massengill sol vin&watr OTC

summers eve sol ex clean OTC

VAGINAL ANTI-INFECTIVES terconazole vaginal cream 0.8%

VASODILATORS VASODILATORS

hydralazine hcl tab 10 mg hydralazine hcl tab 25 mg hydralazine hcl tab 50 mg hydralazine hcl tab 100 mg

VASOPRESSIN RECEPTOR ANTAGONISTS

SELECTIVE VASOPRESSIN V2-RECEPTOR ANTAGONISTS SAMSCA TAB 15MG SP, PA SAMSCA TAB 30MG SP, PA

VASOPRESSORS ANAPHYLAXIS THERAPY AGENTS

epinephrine solution auto-injector 0.3 mg/0.3ml QL (8 pens / year) (1:1000)

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epinephrine solution auto-injector 0.15 mg/0.15ml QL (4 pens / year)

(1:1000) EPIPEN-JR INJ 2-PAK QL (8 pens / year)

VASOPRESSORS midodrine hcl tab 2.5 mg midodrine hcl tab 5 mg midodrine hcl tab 10 mg

VITAMIN MIXTURES NIACIN W/ INOSITOL

niacin cap 400-100 OTC niacin cap 400mg OTC

VITAMIN C, VITAMIN D & ZINC D3/VITAMIN C TAB /ZINC OTC

VITAMIN D & K D3 + K2 DOTS TAB OTC K2 PLUS D3 TAB OTC

VITAMIN MIXTURES e-400 cap selenium OTC ecee plus tab OTC

VITA-MAG TAB OTC

VITAMIN C LIQ OTC

VITAMIN E CAP COMPLETE OTC

vitamin mixture cap OTC

VITAMINS A & D cod liver cap norwegia OTC cod liver cap oil OTC

cod liver cap oil/a&d OTC

COD LIVER OIL OTC

cod liver oil cap OTC

COD LIVER OIL FOR KIDS OTC

COD LIVER OIL NORWEGIA OTC

COD LIVER OIL OIL OTC

COD LIVER OIL USP/NF OTC

d 400 cap OTC

d-natural-5 cap OTC

ra cod liver cap OTC

RA COD LIVER OIL OTC

vitamin a&d cap OTC

vitamins a & d cap OTC

vitamins a & d tab OTC

yl vitamin cap a & d OTC

VITAMINS A & D W/ C cod liver chw /vit d OTC

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cod liver chw w/vit OTC

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VITAMINS A & D W/ MINERALS SUPER D3 CAP COMPLEX OTC

VITAMINS ACE & ZN AZEC CAP OTC

VITAMINS C & E c & e cap 500-400 OTC cranberry cap urin com OTC

vitamins c & e cap OTC

VITAMINS OIL SOLUBLE VITAMINS

BABY DDROPS LIQ 400UNIT OTC baby super dro daily d3 OTC

baby vit d dro 400/.028 OTC

cholecalciferol cap 5000 unit OTC

cholecalciferol cap 10000 unit OTC

d3 vitamin liq 400unit OTC

DDROPS LIQ 2000UNIT OTC

decara cap 10000unt OTC

ergocalciferol cap 50000 unit

kids vit d3 chw 1000unit OTC

optimal-d cap 50000unt OTC

phytonadione tab 5 mg

vit d3 drops liq 400unit OTC

VITAMIN D2 TAB 2000UNIT OTC

VITAMIN D CAP 2000UNIT OTC

WATER SOLUBLE VITAMINS b-1 hi potcy tab 100mg OTC cvs b1 tab 100mg OTC

cvs b-1 tab 100mg OTC

pyridoxine hcl tab 25 mg OTC

thiamine hcl tab 50 mg OTC

thiamine hcl tab 100 mg OTC

VITAMINS W/ LIPOTROPICS VITAMINS W/ LIPOTROPICS

ACTIFLOVIT TAB EAR HEAL OTC b-50 tab OTC

b-100 comp tab tr OTC

b-100 complx tab OTC

b-100 tab OTC

b-100 tab td OTC

b-100 tab tr OTC

b-complex tab form 1 OTC

b-stress cap OTC

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balanc b-50 tab OTC

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balanc b-100 tab tr OTC

balance b100 tab OTC

balance b-50 cap complex OTC

balance b-50 tab complex OTC

cvs inner tab ear plus OTC

ear health tab formula OTC

ear health tab plus OTC

GERAVINE ELX OTC

lipo-key tab OTC

lipocomplex tab OTC

lipoflavon tab OTC

lipoflavovit tab OTC

mega multi tab w/che mi OTC

methacholine cap /liver OTC

multi-vit hp cap /mineral OTC

nat-rul tab b-50 OTC

px b-50 tab OTC

risanoid tab plus OTC

super stress tab b-complx OTC

ultra b-100 tab complex OTC

vitamins w/ lipotropics tab OTC

WATER SOLUBLE VITAMINS VITAMIN B-6

neuro-k-50 tab OTC pyridoxine hcl tab 50 mg OTC

ra vit b-6 tab 50mg OTC

VITAMIN C c-500 tab non-acid OTC calcium ascorbate tab 500 mg OTC

XANTHINES XANTHINES

ELIXOPHYLLIN ELX 80/15ML THEO-24 CAP 100MG CR THEO-24 CAP 200MG CR THEO-24 CAP 300MG CR THEO-24 CAP 400MG ER theochron tab 100mg cr

theochron tab 200mg cr theochron tab 300mg cr theophylline soln 80 mg/15ml theophylline tab er 12hr 100 mg theophylline tab er 12hr 200 mg theophylline tab er 12hr 300 mg theophylline tab er 12hr 450 mg

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theophylline tab er 24hr 400 mg

theophylline tab er 24hr 600 mg

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Index 1 12hr deconge tab 120mg cr ............. 192 1ST TIER UNI MIS 31GX5MM ........... 120 1ST TIER UNI MIS 31GX8MM ........... 120 1ST TIER UNI MIS 32GX4MM ........... 120 2 24 hr nasal spr allergy .................... 156 24hr allergy tab 180mg .................... 31 2ND SKIN CUT MIS CLOSURE ..... 55, 113 2ND SKIN PAD MIS BLISTER ...... 55, 113 3 3 day vaginl cre 2% ....................... 197 3 day vagnal cre 4% ...................... 197 3-in-1 clean liq 5% ........................... 4 5 50+ adult cap eye hlth.................... 129 8 8 hour pain tab 650mg ..................... 11 8hr pain er tab 650mg ....................... 9 A a thru z adv tab adult ..................... 129 a thru z chw select ......................... 129 a thru z sel tab 50+ adva ................ 129 a thru z sel tab 50+ mens ............... 129 a thru z sel tab advanced ......... 129, 145 a thru z tab advanced.............. 129, 145 a thru z tab advantag .............. 153, 185 a thru z tab high pot ............... 129, 145 a thru z tab select ................... 129, 145 a thru z tab ultimate ....................... 129 a thru z ult tab mens ...................... 129 A+D DIAPER CRE RASH ............... 84, 92 a+d prevent oin ............................... 92 abatinex cap 680mg ......................... 23 abc plus tab .................................. 129 abc plus tab senior .................. 129, 145 ABDEK CAP ................................... 145 abdek chw .................................... 166 abdek pediat dro ............................ 167 abiraterone acetate tab 250 mg ......... 41 ABREVA CRE 10% ............................ 45 acarbose tab 100 mg ......................... 6 acarbose tab 25 mg ........................... 6 acarbose tab 50 mg ........................... 6 ACCU-CHEK MIS MLTICLIX......... 84, 114 ACE AERO CLD MIS ENHANCER ........ 179

acephen sup 120mg ......................... 10 acephen sup 325mg ......................... 10 acephen sup 650mg ......................... 10 acetamin liq 500/15ml ...................... 10 acetamin tab 500mg ........................ 10 acetaminophe chw 160mg ................ 10 acetaminophe tab 160mg ................. 10 acetaminophen chew tab 160 mg ......... 9 acetaminophen elixir 160 mg/5ml ........ 9 acetaminophen liquid 160 mg/5ml ..... 10 acetaminophen soln 160 mg/5ml ....... 10 acetaminophen suppos 120 mg ......... 10 acetaminophen suppos 650 mg ......... 10 acetaminophen tab 325 mg ........... 9, 10 acetaminophen tab 500 mg ................. 9 acetaminophen tab er 650 mg ........... 10 acetaminophen w/ codeine soln 120-12 mg/5ml .......................................... 10 acetaminophen w/ codeine tab 300-15 mg .............................................. 164 acetaminophen w/ codeine tab 300-30 mg .............................................. 165 acetaminophen w/ codeine tab 300-60 mg .............................................. 165 acetaminophn sus 160/5ml ............... 10 acetaminophn tab 325mg ................. 10 acetaminophn tab 500mg ................. 10 acetazolamide cap er 12hr 500 mg ..... 65 acetazolamide tab 125 mg ................ 65 acetazolamide tab 250 mg ................ 65 acetic acid otic soln 2% .................. 165 acetic acid vaginal solution ....... 127, 198 acid control tab 10mg .................... 101 acid control tab 150mg ............ 101, 196 acid control tab 20mg .............. 101, 196 acid gone chw ................................. 15 acid gone sus .................................. 15 acid reducer cap 20.6mgdr.............. 195 acid reducer tab 10mg ................... 101 acid reducer tab 150mg ........... 101, 196 acid reducer tab 200mg ........... 101, 196 acid reducer tab 20mg ............. 101, 196 acid reducer tab 75mg ................... 101 acidoph/prob tab formula .................. 26 ACIDOPH/PROB TAB FORMULA .......... 23 acidophilus cap 100mg ..................... 23

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acidophilus cap 10mg ....................... 23 acidophilus cap ex st ........................ 23 acidophilus tab probiotc ............... 23, 26 acidophilus waf ................................ 26 ACIDOPHILUS/ WAF BIFIDUS ............ 23 acne control cre clns 10% .................. 4 acne foaming liq wash 10% ................ 4 acne max str cre 10% ....................... 4 acne medicat gel 10% ....................... 4 acne medicat gel 5% ......................... 4 acne treat cre 10% ........................... 4 acne treatme cre 10% ....................... 4 acne treatmn gel 10% ....................... 4 acne-clear gel 10% ........................... 4 ACT BRIGHTS MIS BANDAGES ........... 51 ACT SPORT FM MIS 1-1/8 ................. 51 ACT SPORT FM MIS ASSORTED .......... 51 ACT SPORT FM MIS KNEE/ELB ........... 51 actical cap .................................... 129 ACTIFLOVIT TAB EAR HEAL ............. 200 ACTI-LANCE MIS 28G ....................... 84 ACTI-LANCE MIS LITE 28G......... 84, 114 ACTI-LANCE MIS SPEC 17G........ 84, 114 ACTI-LANCE MIS UNIV 23G........ 84, 114 ACTITROM CAP ................................ 58 ACTIVE 55 LIQ PLUS ...................... 129 ACTIVESSENT PAK ......................... 145 ACTIVITE EC TAB ........................... 143 ACTIVITY PCH MIS ......................... 179 ACTIVNUTRIEN CAP ....................... 145 acyclovir cap 200 mg ...................... 103 acyclovir susp 200 mg/5ml .............. 103 acyclovir tab 400 mg ...................... 103 acyclovir tab 800 mg ...................... 104 addaprin tab 200mg ....................... 157 adefovir dipivoxil tab 10 mg ............ 103 ADH BANDAGE MIS ANTIBACT.... 51, 111 ADH BANDAGE MIS CLEAR ......... 51, 112 ADH BANDAGE MIS FLEXIBLE..... 51, 112 ADH BANDAGE MIS FOAM .......... 51, 112 ADH BANDAGE MIS FOAM TOE ........... 51 ADH BANDAGE MIS HEALTH .............. 51 ADH BANDAGE MIS HYPO-ALL ........... 51 ADH BANDAGE MIS PLASTIC ...... 51, 112 ADH BANDAGE MIS RETENTIO ........... 51 ADH BANDAGE MIS SHEER ........ 51, 112 ADH BANDAGE MIS STRONG ...... 51, 112

ADH BANDAGE MIS WTR SHLD ... 51, 112 ADHESIVE KNT MIS 3 ................ 51, 112 ADHESIVE PAD 2 ...................... 52, 112 ADHESIVE PAD 3 ...................... 52, 112 ADHESIVE PAD 4 ............................. 52 ADHESIVE PAD 6 ............................. 52 ADHESIVE PAD MIS LARGE ............... 52 ADHESIVE PAD MIS MEDIUM ............. 52 ADHESIVE PAD PAD 2.25 .................. 52 ADHESIVE PAD PAD ANTIBACT ... 52, 112 adlt multivi chw gummies......... 129, 145 ADLT ONE DLY CHW GUMMIES ........ 129 ADMELOG INJ 100U/ML .................... 23 ADMELOG SOLO INJ 100U/ML ........... 23 ADRENAL TAB CALM ....................... 185 ADRENOID CAP ............................. 185 ADULT 50+ CAP OCUVITE ........ 129, 145 adult gummy chw .......................... 129 ADULT MASK MIS.................... 121, 179 ADULT MASK MIS LARGE ................ 179 ADV COLLAGEN TAB ...................... 185 ADV DIABETIC TAB MULTIVIT .......... 129 ADV HEALING MIS BANDAGES .... 52, 112 ADV TRAVEL MIS LANC 28G .............. 84 ADVAIR DISKU AER 100/50 ............ 192 ADVANC CURAD MIS AQUA-PRO ........ 52 ADVANC CURAD MIS BLISTER ........... 52 ADVANC CURAD MIS COOL-WRP ........ 52 ADVANC CURAD MIS SOF-GEL ........... 52 ADVANCED C TAB PLUS .................... 58 advanced chw multi ea ................... 129 advanced eye cap health ................ 129 advanced sus antacid ....................... 13 advanced tab formula .............. 129, 145 ADVCATE SAFE MIS LANC 26G .......... 84 advil jr st tab 100mg ...................... 157 advil jr str chw 100mg .................... 157 ADVOCATE MIS LANC 30G ................ 84 ADVOCATE MIS LANCETS ........... 84, 114 AERCHMBR PLS MIS FLOW-VU ......... 180 AERCHMBR PLS MIS LRG MASK. 121, 180 AERCHMBR PLS MIS MED MASK ....... 180 AERCHMBR PLS MIS SM MASK .. 121, 180 AERCHMBR Z- MIS STAT PLS .... 121, 180 AEROCHAMBER MIS CHAMBER ........ 180 AEROCHAMBER MIS FLOSIGNA ........ 180 AEROCHAMBER MIS MV .................. 180

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AEROCHAMBER MIS PLUS ........ 121, 180 AEROECLIPSE MIS II NEB ................ 177 AERONEB GO MIS .......................... 177 AERONEB GO MIS COMPLETE ........... 177 AERONEB GO MIS HAND/CBL ........... 177 AERONEB GO MIS HANDSET ............ 177 AEROSOL MASK MIS ADULT ..... 121, 179 AEROTRC PLUS MIS ........................ 179 AEROVENT MIS PLUS .............. 121, 180 af spry powd aer 1% ........................ 28 AFINITOR TAB 10MG ........................ 39 AFINITOR TAB 2.5MG ....................... 39 AFINITOR TAB 5MG .......................... 41 AFINITOR TAB 7.5MG ....................... 41 afrin saline spr 0.65% ..................... 154 aftera tab 1.5mg .............................. 94 AGAMATRIX MIS 33G........................ 84 AGORAL LIQ MAX ST ...................... 187 AIMSCO MIS LUBRICAT ..................... 72 AIR TUBE MIS /PLUGS .................... 179 airavite tab ................................... 103 airborne chw .......................... 129, 145 airborne chw gummies .................... 129 airborne chw immune ..................... 129 AIRBORNE LOZ .............................. 129 AIRIAL COMP MIS COMPRESS .......... 177 AIRIAL MIS COMPACT.............. 121, 177 AIRIAL MIS VOYAGER ..................... 177 AIRIAL PEDIA MIS BUILDING ........... 177 AIRIAL PEDIA MIS DUCK ................. 177 AIRIAL PEDIA MIS FIRE ENG ............ 177 AIRIAL PEDIA MIS PANDA ........ 121, 177 AIRIAL PEDIA MIS PENGUIN ............ 177 AIRS DISPOSA MIS NEBULIZR ......... 177 AIRS PEDIATR MIS MASK ................ 179 AIRSHIELD CHW IMMUNITY ............. 129 ak-poly-bac oin op ......................... 162 akwa tears oin op ............................. 46 al12 lot 12% .............................. 84, 94 ala-cort cre 1% ................................ 74 ala-cort cre 2.5% ............................. 74 alavert alrg tab /sinus ....................... 79 alavert tab 10mg ............................. 34 alaway child dro 0.025%op ............. 163 alaway dro 0.025%op ..................... 163 albuterol sulfate soln nebu 0.083% (2.5 mg/3ml) ....................................... 193

albuterol sulfate soln nebu 0.5% (5 mg/ml) ........................................ 192 albuterol sulfate soln nebu 0.63 mg/3ml (base equiv) ................................. 192 albuterol sulfate soln nebu 1.25 mg/3ml (base equiv) ................................. 193 albuterol sulfate syrup 2 mg/5ml ..... 193 albuterol sulfate tab 2 mg ............... 193 albuterol sulfate tab 4 mg ............... 193 albuterol sulfate tab er 12hr 4 mg ...... 20 albuterol sulfate tab er 12hr 8 mg ...... 20 alclometasone dipropionate cream 0.05% ...................................................... 74 alclometasone dipropionate oint 0.05% ...................................................... 74 ALCOH-GLOVE PAD CONTOURE ....... 125 ALCOHOL PAD ............................... 125 ALCOHOL PAD 70% ....................... 125 ALCOHOL PAD PREP ....................... 125 ALCOHOL PAD SWABSTIC ............... 125 ALCOHOL PREP PAD ....................... 125 ALCOHOL PREP PAD 70%................ 125 ALCOHOL PREP PAD MED 70% ........ 125 ALCOHOL PREP PAD PADS 70% ....... 125 ALCOHOL SWAB PAD ..................... 118 ALCOHOL SWAB PAD 70% .............. 125 ALCOHOL SWAB PAD EX-THICK ....... 125 ALCOHOL WIPE PAD ....................... 125 ALCOH-WIPE MIS 12 ...................... 125 ALDACTAZIDE TAB 50/50 ................. 93 alendronate sodium tab 10 mg .......... 59 alendronate sodium tab 35 mg .......... 59 alendronate sodium tab 40 mg .......... 59 alendronate sodium tab 5 mg ............ 59 alendronate sodium tab 70 mg .......... 59 aler-cap cap 25mg ........................... 32 ALER-DRYL TAB 50MG ...................... 32 alertab tab 25mg ............................. 32 alfuzosin hcl tab er 24hr 10 mg ........ 174 ALIVE 50+ TAB ENERGY ................. 145 ALIVE 50+ TAB WOMENS ......... 129, 145 ALIVE DAILY TAB WOMENS ............. 129 ALIVE ENERGY TAB MENS ........ 130, 145 ALIVE ENERGY TAB WOMENS .......... 130 alive gummie chw children .............. 167 alive multi chw childrns .................. 167 ALIVE WOMENS CHW GUMMY ... 130, 145

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all day allg cap 10mg ....................... 34 all day allg sol 1mg/ml ................ 31, 34 all day allg sol 5mg/5ml............... 31, 34 all day allg tab 10mg ........................ 34 all day alrg tab 5-120mg ................... 79 all day pain tab 220mg ................... 157 all day relf tab 220mg .................... 157 ALL PURPOSE MIS MASK ................. 176 allbee plus tab vit c .......................... 48 all-day allg sol 5mg/5ml ................... 34 ALLEGRA ALRG TAB 30MG ................. 34 aller/conges tab 10-240mg ............... 79 aller-chlor tab 4mg........................... 31 allerclear d tab 10-240mg ................. 76 allerclear d tab 5-120mg ................... 79 allerclear tab 10mg .......................... 34 aller-ease tab 180mg .................. 31, 34 aller-ease tab 60mg ......................... 34 aller-fex tab 180mg ......................... 34 aller-flo spr 50mcg ......................... 155 allergy 24hr tab 10mg ...................... 34 allergy cap 25mg ............................. 32 allergy chld liq 12.5/5ml ................... 32 allergy chld sol 1mg/ml ............... 31, 34 allergy chld syp 5mg/5ml .................. 34 allergy d tab 5-120mg ...................... 79 allergy d tab 60-120mg .................... 79 allergy eye dro 0.025%op ............... 163 allergy liq 12.5/5ml .......................... 32 allergy med cap 25mg ...................... 32 allergy med liq 12.5/5ml ................... 32 allergy med tab 25mg ...................... 32 allergy nasa spr 24hr ...................... 155 allergy nasa spr 50mcg ................... 155 allergy rel cap 25mg ......................... 32 allergy rel elx 12.5/5ml ..................... 32 allergy rel sol 1mg/ml ....................... 34 allergy rel tab 10mg ......................... 34 allergy rel tab 25mg ......................... 32 allergy rel/ tab deconges ................... 79 allergy relf cap 10mg ........................ 34 allergy relf cap 25mg ........................ 32 allergy relf chw 10mg ....................... 34 allergy relf liq 12.5/5ml .................... 32 allergy relf liq 50/20ml ..................... 32 allergy relf sol 5mg/5ml............... 31, 34 allergy relf spr 50mcg ..................... 155

allergy relf syp 5mg/5ml ................... 34 allergy relf tab /nsl dec ..................... 79 allergy relf tab 1.34mg ..................... 32 allergy relf tab 10mg ........................ 34 allergy relf tab 12mg cr .................... 31 allergy relf tab 180mg .................31, 34 allergy relf tab 25mg ........................ 32 allergy relf tab 4mg ......................... 31 allergy relf tab 5-120mg ..............76, 79 allergy relf tab 60mg ........................ 34 allergy relf tab d .............................. 79 allergy relf tab d 24 hr ...................... 79 allergy relf tab d12 .......................... 79 allergy relf tab d-24 ......................... 79 allergy relf tab deconges ................... 79 ALLERGY RLF CHW 5MG .................... 31 allergy rlf sus 30/5ml ....................... 34 allergy rlf tab 10mg ......................... 34 allergy tab 10mg ............................. 34 allergy tab 12mg cr .......................... 31 allergy tab 180mg ........................... 34 allergy tab 25mg ............................. 32 allergy tab 4mg ............................... 31 allergy/cong tab 5-120mg ................. 80 allergy+ con tab 5-120mg ................ 79 allergy+cong tab relief-d .................. 80 allergy-d tab 12 hour ....................... 80 allergy-d tab 5-120mg ..................... 80 allergy-d tab 60-120mg .................... 80 allergy-time tab 4mg ........................ 31 aller-tec d tab 5-120mg .................... 79 aller-tec sol 1mg/ml ......................... 34 aller-tec tab 10mg ........................... 34 ALLERWELL TAB ALLERGY ........ 153, 185 allgy comp-d tab 5-120mg ................ 80 ALL-IN-ONE MIS NEBULIZR ............. 177 allopurinol tab 100 mg ................... 101 allopurinol tab 300 mg ................... 101 allrgy melts tab 12.5mg .................... 32 allrgy rel d tab 10-240mg ................. 80 allrgy relf tab 12.5mg ....................... 32 allrgy relf tab 5-120mg ..................... 76 allrgy rlf-d tab 10-240mg .................. 80 allrgy rlf-d tab 5-120mg ................... 80 almacone chw ................................. 13 almacone dbl sus strength ................ 13 almacone sus .................................. 13

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ALMOND OIL ............................ 68, 110 ALMOND OIL SWEET ................. 68, 111 alophen tab 5mg ec ........................ 187 altalube oin ..................................... 46 altamist spr 0.65% ......................... 154 altarussin syp 100/5ml ..................... 96 altarussin syp -pe ............................ 80 altarussn dm syp 100-10/5 ................ 77 altavera tab .................................... 69 ALTERA MIS NEBULIZE ............ 121, 177 ALTERA NEB MIS HANDSET...... 121, 179 alum & mag hydroxide-simethicone susp 200-200-20 mg/5ml ......................... 14 alyacen tab 1/35 .............................. 69 alyacen tab 7/7/7 ............................. 70 amabelz tab 0.5-0.1 ......................... 96 amabelz tab 1-0.5mg ....................... 96 amantadine hcl cap 100 mg ............... 42 amantadine hcl syrup 50 mg/5ml ....... 42 amantadine hcl tab 100 mg ............... 42 amethia tab .................................... 71 AMIKACIN POW SULFATE ................... 7 amiloride & hydrochlorothiazide tab 5-50 mg ................................................. 93 amiloride hcl tab 5 mg .................... 172 aminofen tab 325mg ........................ 10 aminofen tab 500mg ........................ 10 AMINOSAL ACD POW -4 .................... 38 amiodarone hcl tab 200 mg ............... 19 amlactin lot 12% .............................. 94 amlodipine besylate tab 10 mg (base equivalent) ..................................... 64 amlodipine besylate tab 2.5 mg (base equivalent) ..................................... 64 amlodipine besylate tab 5 mg (base equivalent) ..................................... 64 amlodipine besylate-benazepril hcl cap 10-20 mg ....................................... 36 amlodipine besylate-benazepril hcl cap 10-40 mg ....................................... 36 amlodipine besylate-benazepril hcl cap 2.5-10 mg ...................................... 36 amlodipine besylate-benazepril hcl cap 5-10 mg ......................................... 36 amlodipine besylate-benazepril hcl cap 5-20 mg ......................................... 36 amlodipine besylate-benazepril hcl cap

5-40 mg ......................................... 36 amnesteem cap 10mg ........................ 4 amnesteem cap 20mg ........................ 4 amnesteem cap 40mg ........................ 4 amoryn mood cap booster .............. 130 amoxicillin & k clavulanate chew tab 200-28.5 mg................................. 170 amoxicillin & k clavulanate chew tab 400-57 mg ................................... 170 amoxicillin & k clavulanate for susp 200-28.5 mg/5ml .......................... 170 amoxicillin & k clavulanate for susp 250-62.5 mg/5ml .......................... 170 amoxicillin & k clavulanate for susp 400-57 mg/5ml ............................. 170 amoxicillin & k clavulanate for susp 600-42.9 mg/5ml .......................... 170 amoxicillin & k clavulanate tab 250-125 mg .............................................. 170 amoxicillin & k clavulanate tab 500-125 mg .............................................. 170 amoxicillin & k clavulanate tab 875-125 mg .............................................. 170 amoxicillin (trihydrate) cap 250 mg ...... 7 amoxicillin (trihydrate) cap 500 mg ...... 7 amoxicillin (trihydrate) chew tab 125 mg ........................................................ 7 amoxicillin (trihydrate) chew tab 250 mg ........................................................ 7 amoxicillin (trihydrate) for susp 125 mg/5ml ............................................ 7 amoxicillin (trihydrate) for susp 200 mg/5ml ............................................ 7 amoxicillin (trihydrate) for susp 250 mg/5ml ............................................ 7 amoxicillin (trihydrate) for susp 400 mg/5ml ............................................ 7 amoxicillin (trihydrate) tab 500 mg ...... 7 amoxicillin (trihydrate) tab 875 mg ...... 7 AMOXICILLIN POW TRIHYDRA ......7, 170 AMPHOTERICIN POW B .............. 18, 128 ampicillin cap 500 mg ........................ 7 anagrelide hcl cap 0.5 mg ............... 171 anagrelide hcl cap 1 mg .................. 171 anastrozole tab 1 mg ....................... 39 animal chews chw .......................... 169 ANIMAL PRINT MIS STRIPS ............... 52

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animal shape chw .......................... 169 animal shape chw /iron ................... 168 animal shape chw complete ............. 167 animal shape chw iron .................... 168 ANIMAL SHAPE CHW IRON .............. 152 ANORO ELLIPT AER 62.5-25 .............. 20 antacid adv sus max st ..................... 14 antacid chw 1000mg ........................ 16 ANTACID CHW 1177MG .................... 16 antacid chw 500mg .......................... 16 antacid chw 550-110 ........................ 15 antacid chw 750mg .......................... 16 antacid extr chw 750mg .................... 16 antacid fast sus acting ...................... 14 antacid fast sus relief ........................ 14 antacid flav chw 750mg .................... 16 antacid i sus .................................... 14 antacid iii sus .................................. 14 antacid kids chw 750mg .................... 16 antacid liq sus ................................. 14 antacid m sus .................................. 14 antacid max chw 1000mg .................. 16 antacid plus sus anti-gas ................... 14 antacid plus sus gas rel ..................... 14 ANTACID SOFT CHW 1177MG ............ 16 antacid sus ..................................... 14 antacid sus advanced ....................... 14 antacid sus anti-gas ......................... 14 antacid sus ex st .............................. 14 antacid sus max st ........................... 14 antacid sus mint crm ........................ 14 antacid sus reg ................................ 14 antacid sus reg st ............................. 14 antacid/gas sus rel max .................... 14 antacid/sime sus ds .................... 14, 15 anti-allergy tab ................................ 58 ANTIBAC BNDG MIS 7/8 .................... 52 ANTIBAC FABR MIS STRIPS ............... 52 ANTIBACTERAI MIS BANDAGES .......... 52 ANTIBACTERIA MIS BANDAGES .......... 52 ANTIBACTERIA MIS CLEAR .............. 112 ANTI-BACTRIA MIS CHILD ............... 112 antibiotic oin ................................... 20 anti-dandruf sha 1% ......................... 43 anti-diarrhe cap 2mg................... 26, 43 anti-diarrhe liq 1mg/5ml ................... 43 anti-diarrhe tab 2mg ........................ 43

anti-diarrhl sus 262/15ml ................. 23 antifung pow aer 1% ........................ 28 antifungal cre 1%.................. 28, 29, 82 anti-fungal cre 1% ........................... 28 antifungal cre 2% ............................ 29 antifungal cre foot ........................... 82 antifungal pow 2% ........................... 29 anti-fungal pow 2% ......................... 82 anti-fungal sol 1% ........................... 28 anti-gas cap 180mg ......................... 27 anti-hist tab 25mg ........................... 32 antihistamin cap 25mg ..................... 32 antihistamin dro 0.025%op ............. 163 anti-itch cre /aloe/e ......................... 74 anti-itch cre /oatmeal ....................... 74 anti-itch cre 1% ..........................74, 83 anti-itch cre 1%pls 10 ...................... 74 anti-itch lot 1% ............................... 74 anti-itch oin 1% ..........................74, 83 anti-itch/ cre aloe ............................ 76 antiox form/ cap minerals ............... 130 antioxidant cap ....................... 130, 145 antioxidant cap formula .................. 150 anti-oxidant cap formula ................. 130 antioxidant tab .............................. 130 anti-oxidant tab ............................ 150 ANTIOXIDANT TAB FORTE ............... 130 antioxidant tab protecti .................. 130 antioxidant tab vitamins........... 130, 145 antioxin cap 4000 .......................... 130 antiseptic sol clnsr 4% ..................... 68 antiseptic sol skin cln ....................... 68 ap povid-iod sol 10% ..................... 106 apap melt tab 80mg ......................... 10 apap melts tab 160mg ...................... 11 apap rapid tab tab 80mg .................. 11 APETEX ELX .................................... 47 APETIGEN ELX .......................... 47, 143 APETIGEN TAB PLUS ........................ 51 APETIGEN-PLS SOL ................... 51, 144 APLICARE ALC PAD SWABSTIC ........ 118 apra elx 160/5ml ............................. 11 aprepitant capsule 125 mg .............. 190 aprepitant capsule 40 mg ............... 190 aprepitant capsule 80 mg ............... 190 aprepitant capsule therapy pack 80 & 125 mg ........................................ 190

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apri tab .......................................... 69 APRISO CAP 0.375GM ..................... 106 AQUADEKS CHW ............................ 130 aquadeks dro ................................ 167 AQUALANCE MIS 30G ....................... 84 aquanil hc lot 1% ............................. 74 aranelle tab ..................................... 70 ARANESP INJ 100MCG .................... 102 ARANESP INJ 150MCG .................... 102 ARANESP INJ 200MCG .................... 102 ARANESP INJ 25MCG ...................... 102 ARANESP INJ 300MCG .................... 102 ARANESP INJ 40MCG ...................... 102 ARANESP INJ 500MCG .................... 102 ARANESP INJ 60MCG ...................... 102 ARIAL MIS CHAMBER ...................... 180 ARNUITY ELPT INH 100MCG .............. 19 ARNUITY ELPT INH 200MCG .............. 19 arthrts pain tab 650mg ..................... 11 artifi tears dro 1-0.3% ...................... 45 artifi tears oin op ........................... 161 artifi tears sol 1.4% op ..................... 47 artificial dro tears ............................. 45 artificial sol tears .................45, 46, 161 artificial sol tears op ......................... 47 a-s pls alrg tab 25mg .................. 31, 32 asa free chw 160mg jr ...................... 11 ASCOCID-1000 TAB ......................... 58 ASCOCID-500 TAB ........................... 58 ashlyna tab ..................................... 71 aspir-81 tab 81mg ec ..................... 182 aspirin adlt tab 81mg ...................... 182 aspirin chld chw 81mg .................... 182 aspirin chw 81mg ........................... 182 aspirin free tab 325mg ...................... 11 aspirin low chw 81mg ..................... 182 aspirin low tab 81mg ec .................. 182 aspirin sup 300mg ......................... 182 aspirin sup 600mg ......................... 182 aspirin tab 325 mg ......................... 182 aspirin tab 325mg ec ...................... 182 aspirin tab 81mg ec ........................ 182 aspirin tab delayed release 325 mg ... 182 aspirin tab delayed release 81 mg .... 182 aspirin-81 chw 81mg ...................... 182 aspir-low tab 81mg ec .................... 182 aspirtab m/s tab 500mg .................. 182

aspirtab tab 324mg ec ................... 182 ASSURE CMFRT MIS 28G .................. 84 ASSURE ID MIS 31GX3/16 .............. 118 ASSURE LANCE MIS 21G ............ 84, 114 ASSURE LANCE MIS LOW FLOW .. 84, 114 ASSURE LANCE MIS MICRO ........ 84, 115 ASSURE LANCE MIS SAFE 25G.... 85, 115 ASSURE LANCE MIS SAFE 30G.... 85, 115 ASSURE MIS LANCETS ..................... 85 ASSURE PLUS MIS HIGH 18G ..... 85, 115 ASSURE PLUS MIS LOW 25G ...... 85, 115 ASSURE PLUS MIS MCRO 28G..... 85, 115 ASSURE PLUS MIS NORM 21G .... 85, 115 ASSURE PLUS MIS PEDIATRI ...... 85, 115 atenolol & chlorthalidone tab 100-25 mg ...................................................... 37 atenolol & chlorthalidone tab 50-25 mg ...................................................... 37 atenolol tab 100 mg ......................... 56 atenolol tab 25 mg ........................... 56 atenolol tab 50 mg ........................... 56 athlete foot aer 1% .......................... 28 athlete foot cre 1% ............... 28, 29, 82 athlete foot pow 2% ......................... 29 atorvastatin calcium tab 10 mg (base equivalent) ................................... 104 atorvastatin calcium tab 20 mg (base equivalent) ................................... 104 atorvastatin calcium tab 40 mg (base equivalent) ................................... 104 atorvastatin calcium tab 80 mg (base equivalent) ................................... 104 atovaquone susp 750 mg/5ml ........... 43 atovaquone-proguanil hcl tab 250-100 mg ................................................ 37 atovaquone-proguanil hcl tab 62.5-25 mg ................................................ 37 AUBAGIO TAB 14MG ...................... 128 AUBAGIO TAB 7MG ........................ 128 aubra eq tab 0.1-0.02 ...................... 71 aubra tab 0.1-0.02 .......................... 71 AUGMENTIN SUS 125/5ML .............. 170 auraphene-b sol 6.5% ot ................ 165 AURORA LANCE MIS 30G .................. 85 AURORA LANCE MIS THIN 23G .......... 85 AUTO LANCET MIS ........................... 85 aveeno cre 1% ................................ 74

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aviane tab ....................................... 69 avita cre 0.025% .............................. 4 avita gel 0.025% .............................. 4 AVONEX KIT 30MCG ....................... 175 AVONEX PEN KIT 30MCG ................. 175 AVONEX PREFL KIT 30MCG .............. 175 av-vite fb tab 2.5-25-2 ..................... 92 AYR NASAL DRO 0.65% .................. 154 ayr spr 0.65% ............................... 154 AZASAN TAB 100MG ....................... 106 AZASAN TAB 75 MG ....................... 106 azathioprine tab 50 mg ................... 106 AZEC CAP ..................................... 200 azelastine hcl nasal spray 0.1% (137 mcg/spray) ................................... 155 azelastine hcl ophth soln 0.05% ....... 163 azithromycin for susp 100 mg/5ml ...... 47 azithromycin for susp 200 mg/5ml ...... 47 azithromycin powd pack for susp 1 gm 47 azithromycin tab 250 mg ................... 47 azithromycin tab 500 mg ................... 47 azithromycin tab 600 mg ................... 47 azurette tab 28 day .......................... 69 B b complete tab ................................ 50 B COMPLEX +C TAB TR ..................... 48 b complex tab form 1 ................ 49, 143 b complex tab plus ........................... 49 b complex tab plus c ......................... 48 b complex tab vit c ........................... 49 b-1 hi potcy tab 100mg ................... 200 b-100 comp tab tr................... 153, 200 b-100 complx tab .............. 50, 143, 200 b-100 tab .............................. 153, 200 b-100 tab b-100 ............................ 143 b-100 tab complex ........................... 50 b-100 tab td........................... 154, 200 b-100 tab tr .................................. 200 b-100 tr tab ............................. 50, 143 b-50 complex tab...................... 50, 143 b50 complex tab tr ........................... 50 b-50 tab ................................ 153, 200 b-50 tr tab ...................................... 49 baby ayr spr 0.65% ........................ 154 BABY DDROPS LIQ 400UNIT ............ 200 baby super dro daily d3 .................. 200 baby vit d dro 400/.028 .................. 200

bacitracin oin 500/gm ...................... 20 bacitracin oint 500 unit/gm ............... 20 bacitracin ophth oint 500 unit/gm .... 162 BACITRACIN POW .......................20, 82 BACITRACIN POW ZINC USP ............. 20 bacitracin-polymyxin b ophth oint .... 162 bacitracin-polymyxin-neomycin-hc ophth oint 1% ........................................ 163 bacitraycin oin 500/gm ..................... 20 baclofen tab 10 mg .......................... 66 baclofen tab 20 mg .......................... 66 BACTER WATER INJ PARABENS ........ 170 balanc b-100 tab tr ................... 50, 201 balanc b-50 tab ............................. 200 balance b100 tab .................... 154, 201 balance b-50 cap complex ............... 201 balance b-50 tab ....................... 50, 143 balance b-50 tab complex ............... 201 balance b-50 tab tr .......................... 49 balanced b tab complex ...............48, 50 balanced tab b-100 .......................... 50 balanced tab b-100 tr ....................... 50 balanced tab b-50 ............................ 50 balsalazide disodium cap 750 mg ..... 106 balziva tab ...................................... 69 BAND AID MED MIS BUTTRFLY .......... 52 BAND AID MIS 1 .............................. 52 BAND AID MIS MICKEY ..................... 52 BANDAGE FABR MIS EX-LONG ........... 53 BANDAGE FABR MIS KNUC/FIN .......... 53 BANDAGES CLR MIS ASSORTED ........ 53 BANDAGES FAB MIS 3/4 ................... 53 BANDAGES FAB MIS ASSORTED ........ 53 BAND-AID CLR MIS 7/8 .................... 52 BAND-AID CLR MIS STRIPS ............... 52 BAND-AID FLX MIS .......................... 52 BAND-AID FLX MIS 1 ....................... 52 BAND-AID FLX MIS 3/4 .................... 52 BAND-AID FLX MIS ASSORTED .......... 52 BAND-AID FLX MIS EXTRA LG............ 52 BAND-AID FLX MIS FABRIC ........ 52, 112 BAND-AID FLX MIS FINGRTIP ............ 52 BAND-AID FLX MIS KNUCKLE ............ 52 BAND-AID HYD MIS ALL-PURP ......... 112 BAND-AID HYD MIS BLS CUSH ........ 112 BAND-AID HYD MIS FINGERS .......... 112 BAND-AID HYD MIS LARGE ............. 112

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BAND-AID HYD MIS X-LARGE .......... 112 BAND-AID LG MIS BUTTRFLY ............. 52 BAND-AID MIS ......................... 52, 112 BAND-AID MIS 3/4.................... 52, 112 BAND-AID MIS FROZEN .................... 52 BAND-AID MIS GLOW-DRK ................ 52 BAND-AID MIS HL KITTY ................... 52 BAND-AID MIS HOT COLR ................. 52 BAND-AID MIS INCRED 2 ................ 112 BAND-AID MIS JUS LEAG ................ 112 BAND-AID MIS MEDICATE ................. 52 BAND-AID MIS POKEMON ................ 112 BAND-AID MIS PRINCESS ................. 52 BAND-AID MIS SHEER ............... 52, 112 BAND-AID MIS SHEER CF .......... 52, 112 BAND-AID MIS SPORT EX .................. 52 BAND-AID MIS STAR WAR ................. 52 BAND-AID MIS TOUGH .............. 53, 112 BAND-AID MIS TOUGH WP......... 53, 112 BAND-AID MIS TOUGH XL ................. 53 BAND-AID MIS TOUGH-ST ................. 53 BAND-AID MIS VARIETY ............ 53, 112 BAND-AID MIS WON WOM .............. 112 BAND-AID MIS WTER BLK.......... 53, 112 BAND-AID MIS X-LG ......................... 53 BAND-AID PAD 2 ............................. 53 BAND-AID PAD 3 ............................. 53 BAND-AID PAD ADHESIVE ......... 53, 112 BAND-AID PAD LARGE ...................... 53 BAND-AID PAW MIS PATROL .............. 53 banophen cap 25mg ......................... 32 banophen cap 50mg ......................... 32 banophen liq 12.5/5ml ...................... 32 banophen tab 25mg ......................... 32 BARACLUDE SOL .05MG/ML ............. 103 BARIATRIC CAP MULTIVIT ............... 145 BARIATRIC CHW FUSION ................ 130 BASAGLAR INJ 100UNIT .................... 23 BASE G ALMON OIL SWEET ........ 68, 111 BASIC AM TAB ............................... 130 BASIC PM TAB ............................... 130 bayer adv tab 325mg ..................... 182 bayer adv tab 500mg ..................... 182 bayer asa tab 325mg ...................... 182 bayer asa tab 500mg ...................... 182 bayer low chw 81mg....................... 182 bayer low tab 81mg ec ................... 182

BAYER MICRLT MIS LANCETS ............ 85 b-compleet- tab 100 ........................ 50 b-compleet- tab 50 .......................... 50 b-complex 50 tab ............................ 47 B-COMPLEX CAP .............................. 50 b-complex tab ................................. 48 b-complex tab /vit c ......................... 48 b-complex tab 100 tr ................. 50, 143 b-complex tab 50 tr ......................... 48 b-complex tab balanced ................... 49 B-COMPLEX TAB C/FA/BIO ................ 49 b-complex tab form 1 .............. 154, 200 b-complex vitamin cap............... 48, 143 b-complex vitamin sublingual liquid 48, 143 b-complex vitamin tab ............... 48, 143 b-complex w/ c & calcium tab ..... 48, 143 b-complex w/ c & folic acid tab ... 49, 143 b-complex w/ c cap .......................... 48 b-complex w/ c tab ................... 48, 143 b-complex w/ folic acid cap ........ 49, 143 b-complex w/ folic acid tab ............... 49 b-complex w/ iron tab ...................... 51 b-complex w/biotin & folic acid tab 50, 143 b-complex/fa tab /vit c ................... 143 BD LANCET UF MIS 30G ............. 85, 115 BD LANCET UF MIS 33G ............. 85, 115 BD MICROTAIN MIS LANCETS ..... 85, 115 BD PEN NEEDL MIS 29GX12.7 .. 118, 166 BD PEN NEEDL MIS 31GX5MM .. 118, 166 BD PEN NEEDL MIS 31GX8MM .. 118, 166 BD PEN NEEDL MIS 32GX4MM .. 118, 166 BD PEN NEEDL MIS 32GX6MM ......... 118 BD SWAB BFLY PAD SNGL USE ........ 125 BD SWAB REG PAD SNGL USE ......... 125 BD U-500 MIS 31GX6MM ................ 118 bdy/hair/skn cap nails .................... 130 bec/zinc tab .................................... 48 bedding spra aer 0.5% .............. 84, 184 bekyree tab .................................... 71 benazepril & hydrochlorothiazide tab 10-12.5 mg .................................... 36 benazepril & hydrochlorothiazide tab 20-12.5 mg .................................... 36 benazepril & hydrochlorothiazide tab 20-25 mg ....................................... 36

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benazepril & hydrochlorothiazide tab 5-6.25 mg ...................................... 36 benazepril hcl tab 10 mg .................... 3 benazepril hcl tab 20 mg .................... 3 benazepril hcl tab 40 mg .................... 3 benazepril hcl tab 5 mg ..................... 3 benfotiamine cap multi-b .................. 49 BENSONS CRE BOTTOM............... 84, 92 benzepro liq creamy .......................... 4 benziq wash liq 5.25% ....................... 4 benzonatate cap 100 mg ................... 45 benzonatate cap 200 mg ................... 45 BENZOYL PER GEL 2.5% .................... 4 benzoyl per liq 10% wash ................... 4 benzoyl per liq 5% wash .................... 4 benzoyl peroxide gel 10% .................. 4 benzoyl peroxide gel 5% .................... 4 BENZYL ALC LIQ ....................... 38, 170 beta hc lot 1% ................................. 74 betamethasone dipropionate augmented cream 0.05% .................................. 74 betamethasone dipropionate augmented gel 0.05% ....................................... 74 betamethasone dipropionate augmented lotion 0.05% ................................... 83 betamethasone dipropionate augmented oint 0.05% ...................................... 83 betamethasone dipropionate cream 0.05% ............................................ 74 betamethasone dipropionate lotion 0.05% ............................................ 74 betamethasone dipropionate oint 0.05% ......................................................74 betamethasone valerate cream 0.1% (base equivalent) ............................. 83 betamethasone valerate lotion 0.1% (base equivalent) ............................. 74 betamethasone valerate oint 0.1% (base equivalent) ..................................... 74 betasept liq 4% ............................... 68 betatemp sus 160/5ml ...................... 11 betaxolol hcl ophth soln 0.5% ............ 58 bethanechol chloride tab 10 mg ....... 197 bethanechol chloride tab 25 mg ....... 197 bethanechol chloride tab 5 mg ......... 197 bethanechol chloride tab 50 mg ....... 197 BETHKIS NEB 300/4ML ...................... 7

better b tab complex ........................ 48 bexarotene cap 75 mg ...................... 42 bicalutamide tab 50 mg .................... 39 BICILLIN L-A INJ 1200000 .............. 170 BICILLIN L-A INJ 2400000 .............. 170 BICILLIN L-A INJ 600000 ................ 170 bidex tab 400mg ............................. 96 big 100 tab.................................49, 50 BILBERRY CAP PLUS ....................... 185 BIO-35 GLUTE CAP FREE ................ 130 BIO-35 IRON CAP FREE .................. 130 BIOCAL CAP .................................. 130 biocotron liq 100-10/5 ...................... 77 BIOFLAVONOID POW CITRUS ..... 58, 144 bioflavonoid products cap ................. 58 bioflavonoid products tab .................. 58 bioflavonoid products tab er .............. 58 bioflex tab ...................................... 58 BIOGAIA CHW 100M CEL .................. 23 BIOGAIA CHW GASTRUS .................. 24 BIOGAIA DRO PROBIOTI ................... 24 BIOGAIA MIS PROBIOTI ................... 24 BIOGAIA PROT DRO BABY ................. 24 biolle gel 1% ................................... 47 biolle tears dro 0.5% op ................... 47 BIOPATCH MIS 1 ............................. 68 BIOPATCH MIS 3/4 .......................... 68 BIOPATCH PRO MIS DISK/CHG .......... 68 bio-statin pow ................................. 28 BIOSUPP LIQ ................................ 130 BIOTALAN LIQ CLEAR ....................... 50 BIOTECT PLUS CAP ........................ 130 BIOTECT PLUS LIQ ......................... 130 BIOTIN FORTE TAB .......................... 49 BIOTIN FORTE TAB /ZINC ................. 49 BIOTIN PLUS TAB KERATIN ............. 185 biotin plus/ tab cal/vitd ................... 130 biotinex cap .................................... 24 BIOVOL SYP .................................. 130 bisac-evac sup 10mg ..................... 187 bisacodyl sup 10mg ....................... 187 bisacodyl tab 5mg ec...................... 187 biscolax sup 10mg ......................... 188 bismatrol chw 262mg ....................... 24 bismatrol sus 262/15ml .................... 24 bismatrol sus 525/15ml .................... 24 bismuth subsalicylate chew tab 262 mg

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......................................................24 bisoprolol & hydrochlorothiazide tab 10-6.25 mg ..................................... 37 bisoprolol & hydrochlorothiazide tab 2.5-6.25 mg .................................... 37 bisoprolol & hydrochlorothiazide tab 5-6.25 mg ...................................... 37 bisoprolol fumarate tab 10 mg ........... 56 bisoprolol fumarate tab 5 mg ............. 56 bite-a-mins chw ............................. 169 bite-a-mins chw /iron ..................... 168 blisovi fe tab 1.5/30 ......................... 69 blisovi fe tab 1/20 ............................ 69 BLISTER REL MIS BANDAGE .............. 53 blis-to-sol liq 1% ........................ 28, 82 BLK DRAUGHT CHW 10MG ............... 188 BOOSTRIX INJ ............................... 195 bounty bears chw /c ....................... 169 bp gel gel 10% ................................. 4 bp gel gel 5% ................................... 4 bp wash liq 10% ............................... 4 bp wash liq 2.5% .............................. 4 bp wash liq 5% ................................. 4 bp wash liq 7% ................................. 4 bprotected liq multi-vi ..................... 130 BRAIN MIGHT TAB ......................... 185 BRAIN TAB 355MG ......................... 185 BREATHE EASE MIS LG MASK .......... 121 BREATHE EASE MIS MED MASK ........ 121 BREATHE EASE MIS SM MASK .......... 121 BREATHERITE MIS .................. 121, 180 BREATHERITE MIS LG MASK .... 121, 180 BREATHERITE MIS MED MASK .. 121, 180 BREATHERITE MIS SM MASK .... 121, 180 BREATHERITE MIS SPACER ...... 121, 180 BREATHERITE MIS W/MASK ..... 121, 180 b-r edi/rd hr tab ts/rd ro ........... 130, 145 BREWERS YEAS POW ........................ 48 brewers yeast tab ............................ 48 briellyn tab ...................................... 69 BRILINTA TAB 60MG ....................... 171 BRILINTA TAB 90MG ....................... 171 brimonidine tartrate ophth soln 0.15% .................................................... 161 brimonidine tartrate ophth soln 0.2% 161 bromfed dm syp .............................. 81 bromocriptine mesylate cap 5 mg (base

equivalent) ..................................... 42 bromocriptine mesylate tab 2.5 mg (base equivalent) ..................................... 42 BROTAPP DM LIQ 15-1-5/5 ............... 81 b-s tress cap .................................. 200 BUBBLES PEDI MIS MASK ........ 121, 179 buckleys liq chest ............................ 96 budesonide delayed release particles cap 3 mg ....................................... 74, 100 budesonide inhalation susp 0.25 mg/2ml .................................................... 187 budesonide inhalation susp 0.5 mg/2ml .................................................... 187 budesonide inhalation susp 1 mg/2ml 187 budesonide nasal susp 32 mcg/act ... 155 budesonide sus 32mcg ................... 155 budesonide sus nasal ..................... 155 BULLSEYE MIS LANCETS ............ 85, 115 BULLSEYE MIS MINI LNC............ 85, 115 bumetanide tab 0.5 mg .................. 111 bumetanide tab 1 mg ..................... 111 bumetanide tab 2 mg ..................... 111 BUT/ASA/CAF TAB ............................. 7 butalbital-acetaminophen-caffeine cap 50-325-40 mg................................... 7 butalbital-acetaminophen-caffeine tab 50-325-40 mg................................... 8 butalbital-aspirin-caffeine cap 50-325-40 mg .................................................. 8 BUTTERFLY MIS CLOSURES ............... 53 C c & e cap 500-400 ......................... 200 c 1000/biofl cap /r hips .............. 59, 144 c complex tab 1000mg ..................... 59 c complex tab 500mg ....................... 59 c1000 tr/rh tab bioflav ..................... 58 c1500 tr/rh tab bioflav ..................... 58 c1500/rh tab bioflav ......................... 59 c-500 tab non-acid ........................ 201 ca citrate + tab ............................... 60 ca citrate tab + d ............................. 60 ca citrate tab plus d ......................... 60 CA HI-CAL/D TAB 250MG .................. 60 CA HI-CAL/D TAB 500MG ........... 60, 124 cabergoline tab 0.5 mg ................... 173 CABOMETYX TAB 20MG .................... 41 CABOMETYX TAB 40MG .................... 41

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CABOMETYX TAB 60MG .................... 41 cal antacid chw 1000mg .................... 16 cal antacid chw 750mg ..................... 16 CAL CIT MAL/ TAB VITAMIND ............ 60 cal cit+d3 tab maximum ................... 60 cal soft chw chw mlk choc ................. 60 CALAMINE LOT .............................. 127 calc 600/d3 tab 600-800 ................... 61 calc 600+d tab 600-800 ............ 61, 124 calc 600+d3 cap 600-500 .................. 61 calc antacid chw 1000mg .................. 16 calc antacid chw 500mg .................... 16 calc antacid chw 750mg .................... 16 calc cit+d3 tab 200-250 .................... 61 calc cit+d3 tab 250-200 .................... 61 calc citr/d3 tab 200-250 .................... 61 calc citr+d tab 315-250 .................... 61 calc citr+d3 tab 200-250 ................... 61 calc citr+d3 tab 315-250 ................... 61 calc citra+d tab 315-250 ................... 61 calc citrate tab +d ............................ 61 CALCI-CHEW CHW 1250MG ............... 60 calcidol dro 8000/ml ....................... 159 calciferol dro 8000/ml ..................... 160 calcipotriene oint 0.005% .................. 43 calcipotriene soln 0.005% (50 mcg/ml) ......................................................43 calcitonin (salmon) nasal soln 200 unit/act .......................................... 59 calcitrate tab ................................... 61 calcitrate tab 950mg ........................ 60 calcitrate tab plus d .......................... 61 calcitrene oin 0.005% ....................... 43 calcitriol cap 0.25 mcg .................... 123 calcitriol cap 0.5 mcg ...................... 123 calcitriol inj 1 mcg/ml ....................... 95 calcitriol oral soln 1 mcg/ml ............. 123 calcium + d tab ............................... 61 calcium + d tab 600-200 ................... 61 calcium + d tab 600mg ..................... 61 calcium +d tab maximum .................. 61 calcium +d3 tab maximum ........ 61, 124 calcium 500 tab /vit d ....................... 61 calcium 500 tab +d .......................... 61 calcium 600 chw w/vit d .................... 61 calcium 600 tab ............................... 60 calcium 600 tab + d ......................... 61

calcium 600 tab +d .......................... 61 calcium 600 tab +d3 ........................ 61 calcium 600 tab -d ........................... 61 calcium 600/ tab vit d ...................... 61 calcium acetate (phosphate binder) cap 667 mg (169 mg ca) ...................... 171 calcium anta chw 500mg .................. 16 calcium anta chw 750mg .................. 16 calcium ascorbate tab 500 mg ......... 201 calcium carb tab 1250mg .................. 60 calcium carb tab 648mg ................... 16 calcium carbonate (antacid) chew tab 500 mg .......................................... 16 calcium carbonate (antacid) chew tab 750 mg .......................................... 16 calcium carbonate (antacid) susp 1250 mg/5ml .......................................... 60 calcium carbonate tab 1250 mg (500 mg elemental ca) .................................. 60 calcium carbonate tab 1500 mg (600 mg elemental ca) .................................. 60 calcium carbonate tab 600 mg ........... 60 calcium carbonate-cholecalciferol tab 250 mg-125 unit ................................... 61 calcium carbonate-cholecalciferol tab 500 mg-125 unit ................................... 61 calcium carbonate-cholecalciferol tab 500 mg-200 unit ................................... 61 calcium carbonate-cholecalciferol tab 500 mg-400 unit ............................. 61, 124 calcium carbonate-cholecalciferol tab 600 mg-200 unit ................................... 61 calcium carbonate-cholecalciferol tab 600 mg-400 unit ................................... 61 calcium carbonate-vitamin d cap 600 mg-200 unit ................................... 61 calcium carbonate-vitamin d tab 250 mg-125 unit ................................. 124 calcium carbonate-vitamin d tab 500 mg-125 unit ................................... 61 calcium carbonate-vitamin d tab 500 mg-200 unit ................................... 61 calcium carbonate-vitamin d tab 500 mg-400 unit ................................... 61 calcium carbonate-vitamin d tab 600 mg-125 unit ................................... 61 calcium carbonate-vitamin d tab 600

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mg-200 unit .................................... 61 calcium carbonate-vitamin d tab 600 mg-400 unit .................................... 61 calcium citr tab +d ........................... 61 calcium citr tab plus d-3 ................... 62 calcium citr tab w/vit d3 ................... 62 calcium citrate tab 950 mg (200 mg elemental ca) .................................. 60 calcium citrate-vitamin d tab 200 mg-250 unit (elemental ca) ............... 62 calcium citrate-vitamin d tab 315 mg-200 unit (elemental ca) ............... 62 calcium citrate-vitamin d tab 315 mg-250 unit (elemental ca) ............... 62 calcium for chw women .................... 62 calcium plus cap d3 .......................... 62 calcium soft chw caramel .................. 62 calcium soft chw chocolat .................. 62 calcium soft chw mlk choc ................. 62 calcium tab 500/d ............................ 62 calcium tab 500+d ........................... 62 calcium tab 600 mg .......................... 60 calcium tab 600mg ........................... 60 CALCIUM TAB 600MG ....................... 62 calcium tab vit d .............................. 62 calcium w/ magnesium tab 250-125 mg ......................................................62 calcium w/ magnesium tab 500-250 mg .............................................. 62, 124 calcium/d chw 500-400 .................... 62 calcium/d tab 500/200 ..................... 62 calcium/d tab 500-200 ..................... 62 calcium/d tab 500-400 ..................... 62 calcium/d tab 500mg ........................ 62 calcium/d tab 600-200 ..................... 62 calcium/d tab 600-800 .............. 62, 124 calcium/d3 cap 600-500 ................... 62 calcium/d3 tab ................................ 62 calcium/d3 tab 200-250 .................... 62 calcium/d3 tab 500-600............. 62, 124 calcium/d3 tab 600-800 .................... 62 calcium/magn tab /zinc .................... 62 calcium/vita tab d3 ................... 62, 124 calcium/vitd cap 600-500 .................. 62 calcium+d tab 600-400 .................... 62 calcium+d tab 600-800 .................... 62 calcium+d3 tab 315-250 ................... 62

calcium+d3 tab 600-400 ............ 62, 124 calcium+d3 tab 600-800 .................. 62 calcium-magnesium-zinc tab 333-133-5 mg ................................................ 62 calcium-magnesium-zinc tab 333-133-8.3 mg ....................... 62, 124 CAL-CO3Y CAP .............................. 185 CAL-DAY 1000 TAB ........................ 130 cal-gest chw 500mg ......................... 16 cal-mag aspa tab 333-167 ................ 60 cal-mag tab 500-250 ....................... 60 caltrate 600 tab .............................. 60 camila tab 0.35mg ........................... 73 camrese tab .................................... 71 capecitabine tab 150 mg ................... 41 capecitabine tab 500 mg ................... 41 CA-PLUS TAB 280MG ..................... 185 CAPRELSA TAB 100MG ..................... 39 CAPRELSA TAB 300MG ..................... 41 captopril & hydrochlorothiazide tab 25-15 mg ................................................ 36 captopril & hydrochlorothiazide tab 25-25 mg ................................................ 36 captopril & hydrochlorothiazide tab 50-15 mg ................................................ 36 captopril & hydrochlorothiazide tab 50-25 mg ................................................ 36 captopril tab 100 mg .......................... 3 captopril tab 12.5 mg ......................... 3 captopril tab 25 mg ............................ 3 captopril tab 50 mg ........................... 3 CARAFATE SUS 1GM/10ML .............. 125 carbidopa & levodopa orally disintegrating tab 10-100 mg ............ 42 carbidopa & levodopa orally disintegrating tab 25-100 mg ............ 42 carbidopa & levodopa orally disintegrating tab 25-250 mg ............ 42 carbidopa & levodopa tab 10-100 mg . 42 carbidopa & levodopa tab 25-100 mg . 42 carbidopa & levodopa tab 25-250 mg . 42 carbidopa & levodopa tab er 25-100 mg ...................................................... 42 carbidopa & levodopa tab er 50-200 mg ...................................................... 42 carbidopa-levodopa-entacapone tabs 12.5-50-200 mg .............................. 42

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carbidopa-levodopa-entacapone tabs 18.75-75-200 mg ............................ 42 carbidopa-levodopa-entacapone tabs 25-100-200 mg ............................... 42 carbidopa-levodopa-entacapone tabs 31.25-125-200 mg ........................... 42 carbidopa-levodopa-entacapone tabs 37.5-150-200 mg ............................ 42 carbidopa-levodopa-entacapone tabs 50-200-200 mg ............................... 42 CARDIO TONE TAB ......................... 185 CARDIOPRESS CAP ........................ 185 CAREFINE MIS 31GX8MM ................ 118 CAREFINE MIS 32GX4MM ................ 118 CAREFINE MIS 32GX6MM ................ 118 CAREONE LANC MIS 28G ................... 85 CAREONE LANC MIS THIN 23G ........... 85 CARETOUCH MIS 31GX5MM ............. 118 CARETOUCH MIS 31GX8MM ............. 119 CARETOUCH MIS 32GX4MM ............. 119 CARETOUCH MIS TWIST 28 ............... 85 CARETOUCH MIS TWIST 30 ............... 85 CARETOUCH MIS TWIST 33 ............. 115 CARETOUCH PAD ALCOHOL ............. 125 carisoprodol tab 250 mg ................... 66 carisoprodol tab 350 mg ................... 66 CAROZYME CAP ............................. 185 CARPALAID MIS EMPLOYEE ........ 53, 112 CARPALAID MIS LARGE ............. 53, 112 CARPALAID MIS PRA LG .................... 53 CARPALAID MIS PRAC SM ................. 53 CARPALAID MIS SMALL ............. 53, 112 carravite tab ................................. 130 cartia xt cap 120/24hr ...................... 64 cartia xt cap 180/24hr ...................... 64 cartia xt cap 240/24hr ...................... 64 cartia xt cap 300/24hr ...................... 64 carvedilol tab 12.5 mg ....................... 6 carvedilol tab 25 mg .......................... 6 carvedilol tab 3.125 mg ..................... 5 carvedilol tab 6.25 mg ....................... 6 CASTOR OIL .................................. 111 cavarest gel 1.1% ............................ 82 cavilon cre 2% ................................. 82 caziant pak ..................................... 71 C-BUFF POW ................................. 130 cefadroxil cap 500 mg....................... 67

cefadroxil for susp 250 mg/5ml ......... 67 cefadroxil for susp 500 mg/5ml ......... 67 cefadroxil tab 1 gm .......................... 67 cefdinir cap 300 mg ......................... 67 cefdinir for susp 125 mg/5ml ............ 67 cefdinir for susp 250 mg/5ml ............ 67 cefprozil for susp 125 mg/5ml ........... 67 cefprozil for susp 250 mg/5ml ........... 67 cefprozil tab 250 mg ........................ 67 cefprozil tab 500 mg ........................ 67 ceftriaxone sodium for inj 1 gm ......... 67 ceftriaxone sodium for inj 2 gm ......... 67 ceftriaxone sodium for inj 250 mg ...... 67 ceftriaxone sodium for inj 500 mg ...... 67 cefuroxime axetil tab 250 mg ............ 67 cefuroxime axetil tab 500 mg ............ 67 CELEBRATE CAP 18 ........................ 145 CELEBRATE CAP 36 ........................ 145 CELEBRATE CAP 45 ........................ 145 CELEBRATE CAP 60 ........................ 145 CELEBRATE CHW 18 ...................... 145 CELEBRATE CHW 36 ...................... 145 CELEBRATE CHW 45 ...................... 145 CELEBRATE CHW 60 ...................... 145 celecoxib cap 100 mg ..................... 157 celecoxib cap 200 mg ..................... 157 celecoxib cap 400 mg ..................... 157 celecoxib cap 50 mg ...................... 157 CELLULAR CAP SECURITY ............... 130 CEMILL PLUS TAB ............................ 59 cemill/biofl tab ................................ 59 CENT MATURE TAB ADLT 50+ ......... 130 centamin liq .................................. 130 CENTANY OIN 2% ............................ 20 centavite az tab minerals ......... 130, 145 centavite liq .................................. 130 CENTRAL-VITE TAB ........................ 145 central-vite tab cardio .................... 185 central-vite tab mens mat ............... 130 central-vite tab performa ......... 153, 185 CENTRAL-VITE TAB UNDER 50 .. 130, 145 central-vite tab wmns mat .............. 130 centravites tab........................ 130, 145 centravites tab 50 plus ................... 130 CENTRAVITES TAB 50 PLUS...... 130, 145 CENTRAVITES TAB ADULTS ...... 130, 145 CENTRUM CHW ....................... 130, 145

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CENTRUM CHW FLAV BST ........ 130, 145 CENTRUM CHW MEN ............... 130, 145 CENTRUM CHW MULTI ............. 131, 145 CENTRUM CHW SILVER ................... 131 CENTRUM CHW VITAMINT........ 131, 145 CENTRUM CHW WOMEN........... 131, 145 centrum kids chw complete ...... 152, 167 CENTRUM KIDS CHW FLAV BST 131, 145 CENTRUM POW DRINK .................... 131 CENTRUM SPEC TAB ENERGY ... 153, 185 CENTRUM SPEC TAB HEART ..... 131, 145 CENTRUM SPEC TAB IMMUNE .......... 131 CENTRUM SPEC TAB VISION .... 131, 145 CENTRUM TAB CARDIO............ 131, 145 CENTRUM TAB MEN ........................ 131 CENTRUM TAB PERFORMA........ 153, 185 CENTRUM TAB SILVER............. 131, 146 CENTRUM TAB ULTRA.............. 131, 146 century tab ............................ 131, 146 century tab mature ................. 131, 146 cephalexin cap 250 mg ..................... 67 cephalexin cap 500 mg ..................... 67 cephalexin cap 750 mg ..................... 67 cephalexin for susp 125 mg/5ml ......... 67 cephalexin for susp 250 mg/5ml ......... 67 cephalexin tab 250 mg ...................... 67 cephalexin tab 500 mg ...................... 67 ceralyte 70 sol ................................. 93 CERDELGA CAP 84MG ..................... 102 CEREZYME INJ 400UNIT .................. 102 cerovite jr chw ............................... 167 cerovite tab advanced ..................... 131 cerovite tab senior ......................... 131 certa plus tab ......................... 131, 146 certagen tab .................................. 131 CERTAVITE TAB SENIOR .......... 131, 146 certavite/ tab antioxid ............. 131, 146 cetirizine chw 10mg .......................... 31 cetirizine chw 5mg ........................... 31 cetirizine hcl oral soln 1 mg/ml (5 mg/5ml) ......................................... 34 cetirizine hcl tab 10 mg ..................... 34 cetirizine sol 1mg/ml ................... 31, 34 cetirizine sol 5mg/5ml ................. 31, 34 cetirizine tab 5mg ............................ 34 cetirizine-pseudoephedrine tab er 12hr 5-120 mg ....................................... 80

cgh cong dm liq 5-100/5 ................... 76 chateal eq tab 0.15/30 ..................... 71 chateal tab 0.15/30 ......................... 71 CHEMSTRIP 10 TES MD .................... 92 CHEMSTRIP 2 TES GP ..................91, 92 CHEMSTRIP 5 TES OB ...................... 92 CHEMSTRIP 7 TES ........................... 92 CHEMSTRIP 9 TES STRIPS............91, 92 CHEMSTRIP TES -10 SG ................... 92 CHEMSTRIP TES UGK ....................... 92 cheratussin syp ac ........................... 77 chest conges liq 100/5ml .................. 77 chest conges liq childrns ................... 96 chest conges tab 400mg ................... 96 chew calcium chw ............................ 62 CHEW-12 CHW .............................. 151 chewabl vite chw childrns ............... 169 chewable chw children .................... 152 child allrgy sol 5mg/5ml ................... 31 child apap tab 80mg ........................ 11 child asa chw 81mg ....................... 182 child asa ls chw 81mg .................... 182 child chew chw iron ........................ 168 child chew chw vitamins ................. 169 child chew/ chw extra c............ 153, 169 child multiv chw iron ...................... 168 child silfed liq 15mg/5ml ................. 191 child soothe chw 400mg ................... 16 child vitami chw ............................ 167 children vit chw ............................. 169 childrens chw /iron ........................ 168 childrens chw apap .......................... 11 childrens chw complete .................. 167 CHILDRENS CHW COMPLETE .... 152, 167 childrens chw gummies .................. 167 childrens chw multivit ..................... 169 childrens chw pepto ......................... 16 childrens chw soothe ........................ 16 childrens chw vitamin ..................... 153 childrens chw vitamins ................... 169 childrens liq 5-100mg ....................... 77 chld allergy liq 12.5/5ml ................... 32 chld asafree elx 80/2.5ml ................. 11 chld ibuprfn dro 40mg/ml ............... 157 chld meditab chw 80mg .................... 11 chld mltivit chw /mineral ................ 167 chld non-asa chw 80mg grp .............. 11

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chld non-asa tab 80mg qm ................ 11 chld pain rl tab 80mg ........................ 11 chld silapap liq 160/5ml .................... 11 chld vitamin chw iron ...................... 168 CHLOR GLUC LIQ 2% ........................ 68 chloraseptic liq sore thr ..................... 11 chlordiazepoxide hcl-clidinium bromide cap 5-2.5 mg................................... 44 CHLORELLA CAP ............................ 128 CHLORHEX GLU PAD 2% ................... 68 chlorhexidine gluconate liquid 4% ...... 68 chlorhexidine gluconate soln 0.12% .... 44 chlorhist tab 4mg ............................. 31 chlorocaps cap ............................... 151 chloroquine phosphate tab 250 mg ..... 37 chloroquine phosphate tab 500 mg ..... 37 CHLOROQUINE POW PHOSPHAT ......... 37 chlorphen sr tab 12mg ...................... 31 chlor-phenir tab 4mg ........................ 31 chlorpheniramine maleate tab 4 mg .... 32 chlorpheniramine maleate tab er 12 mg ......................................................32 chlorthalidone tab 25 mg ................. 193 chlorthalidone tab 50 mg ................. 193 chlorzoxazone tab 250 mg ............... 154 chlorzoxazone tab 500 mg ................. 67 choc laxativ chw 15mg .................... 188 CHOICEFUL CAP MULTIVIT ....... 131, 146 CHOICEFUL CHW MULTIVIT...... 131, 146 CHOLASE CAP CONTROL ................. 185 cholecalciferol cap 1000 unit ............ 160 cholecalciferol cap 10000 unit... 160, 200 cholecalciferol cap 2000 unit ............ 160 cholecalciferol cap 5000 unit .... 160, 200 cholecalciferol cap 50000 unit .......... 160 cholecalciferol chew tab 400 unit ...... 160 cholecalciferol oral liquid 400 unit/ml 160 cholecalciferol tab 1000 unit ............ 160 cholecalciferol tab 2000 unit ............ 160 cholecalciferol tab 400 unit .............. 160 cholecalciferol tab 5000 unit ............ 160 cholestyramine light powder 4 gm/dose ......................................................58 cholestyramine light powder packets 4 gm ................................................. 58 cholestyramine powder 4 gm/dose ..... 58 cholestyramine powder packets 4 gm .. 58

ciclopirox gel 0.77% ........................ 28 ciclopirox olamine cream 0.77% (base equiv) ............................................ 28 ciclopirox olamine susp 0.77% (base equiv) ............................................ 28 CICLOPIROX POW OLAMINE .........28, 82 ciclopirox shampoo 1% ..................... 28 cilostazol tab 100 mg ..................... 171 cilostazol tab 50 mg ....................... 171 cimetidine hcl soln 300 mg/5ml ....... 101 cimetidine tab 200 mg ............. 101, 196 cimetidine tab 200mg .............. 101, 196 cimetidine tab 300 mg .................... 101 cimetidine tab 400 mg .................... 101 cimetidine tab 800 mg .................... 101 CINRYZE SOL 500 UNIT .................. 102 CIPRODEX SUS 0.3-0.1% ............... 166 ciprofloxacin hcl ophth soln 0.3% ..... 162 ciprofloxacin hcl tab 100 mg (base equiv) ...................................................... 98 ciprofloxacin hcl tab 250 mg (base equiv) ...................................................... 98 ciprofloxacin hcl tab 500 mg (base equiv) ...................................................... 99 ciprofloxacin hcl tab 750 mg (base equiv) ...................................................... 99 ciprofloxacin-ciprofloxacin hcl tab er 24hr 1000 mg(base eq) ........................... 99 ciprofloxacin-ciprofloxacin hcl tab er 24hr 500 mg (base eq) ............................ 99 cit calc/d tab 315-250 ...................... 62 CITRANATAL CAP HARMONY ............ 173 CITRANATAL MIS ........................... 153 CITRANATAL MIS 90 DHA ............... 173 CITRANATAL MIS B-CALM ............... 172 CITRANATAL PAK ASSURE .............. 173 CITRANATAL PAK DHA .................... 173 CITRANATAL TAB BLOOM ................ 153 CITRANATAL TAB RX ...................... 172 claravis cap 10mg .............................. 4 claravis cap 20mg ............................ 82 claravis cap 30mg ............................ 82 claravis cap 40mg ............................ 82 clarispray spr 50mcg ...................... 155 clarithromycin for susp 125 mg/5ml . 111 clarithromycin for susp 250 mg/5ml . 111 clarithromycin tab 250 mg ................ 68

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clarithromycin tab 500 mg ................. 68 clarithromycin tab er 24hr 500 mg ...... 68 claritin eye dro 0.025%op ............... 163 CLARITIN RDT TAB 5MG .................... 34 claritin sol 5mg/5ml .................... 31, 34 clean&clear cre 10% .......................... 4 CLEANLET 28G MIS LANCETS ..... 85, 115 CLEAR BANDAG MIS 3/4 ................... 53 clear eyes dro 0.5-0.6% ............ 45, 161 CLEAR SPOT MIS 7/8 ........................ 53 CLEAR STRIPS MIS 3/4 ..................... 53 clearasil cre acne .............................. 4 clearlax pow .................................. 109 clearskin cre 10% ............................. 4 clemastine fumarate tab 2.68 mg ....... 32 CLEVER CHECK MIS .......................... 85 CLEVER CHECK MIS 30G ................... 85 CLEVER CHOIC MIS NEBULIZR ......... 177 CLICKFINE MIS 31GX5/16 ............... 119 CLICKFINE MIS 32GX5/32 ............... 119 clindamycin hcl cap 150 mg ............. 110 clindamycin hcl cap 300 mg ............. 110 clindamycin palmitate hcl for soln 75 mg/5ml (base equiv) ...................... 110 clindamycin phosphate gel 1% ............ 4 clindamycin phosphate lotion 1% ........ 4 clindamycin phosphate soln 1%........... 4 clindamycin phosphate vaginal cream 2% .................................................... 198 clinpro 5000 pst 1.1% ...................... 82 CLIOQUINOL POW....................... 28, 82 clonidine hcl tab 0.1 mg .................... 18 clonidine hcl tab 0.2 mg .................... 18 clonidine hcl tab 0.3 mg .................... 18 clonidine td patch weekly 0.1 mg/24hr 18 clonidine td patch weekly 0.2 mg/24hr 18 clonidine td patch weekly 0.3 mg/24hr 18 clopidogrel bisulfate tab 300 mg (base equiv) .......................................... 171 clopidogrel bisulfate tab 75 mg (base equiv) .......................................... 171 clotrimazole cre 1% .................... 29, 82 clotrimazole cre 1% vag .................. 197 clotrimazole cre 2% ........................ 197 clotrimazole cre 3 day ..................... 197 clotrimazole cre grx 1% .................... 29 clotrimazole cream 1% ................ 29, 82

CLOTRIMAZOLE CRY ....................29, 82 CLOTRIMAZOLE POW ...................29, 83 clotrimazole soln 1% ...................29, 83 clotrimazole troche 10 mg ................. 18 clotrimazole vaginal cream 1% ........ 197 CO MONITOR MIS T PIECES ............ 179 COAGUCHEK MIS LANCETS ........ 85, 115 cod liver cap norwegia .................... 199 cod liver cap oil ............................. 199 cod liver cap oil/a&d ....................... 199 cod liver chw /vit d ........................ 199 cod liver chw w/vit ......................... 199 COD LIVER OIL ............................. 199 cod liver oil cap....................... 153, 199 COD LIVER OIL FOR KIDS ............... 199 COD LIVER OIL NORWEGIA ............. 199 COD LIVER OIL OIL ........................ 199 COD LIVER OIL USP/NF .................. 199 CODITUSSIN LIQ AC ........................ 77 colace 2in1 tab 8.6-50mg ............... 108 colchicine tab 0.6 mg ..................... 101 cold/allergy elx children .................... 80 colestipol hcl granule packets 5 gm .... 58 colestipol hcl granules 5 gm .............. 58 colestipol hcl tab 1 gm ...................... 58 COLLAGEN CAP ULTRA ................... 185 colocort ene 100mg ....................... 106 COLOR CONDOM MIS + LUBE ..... 72, 113 COMBIPATCH DIS .05/.14 ................. 96 COMBIPATCH DIS .05/.25 ................. 96 COMBIVENT AER 20-100 ................ 192 COMETRIQ KIT 100MG ..................... 39 COMETRIQ KIT 140MG ..................... 39 COMETRIQ KIT 60MG ....................... 39 COMFORT ASSU MIS LANC 28G .. 85, 115 COMFORT ASSU MIS LANC 33G ......... 85 COMFORT EZ MIS 21G.................... 115 COMFORT EZ MIS 23G.................... 115 COMFORT EZ MIS 28G.................... 115 COMFORT EZ MIS 31GX5MM ........... 119 COMFORT EZ MIS 31GX8MM ........... 119 COMFORT EZ MIS 32GX4MM ........... 119 COMFORT EZ MIS 32GX6MM ........... 119 COMFORT FAB MIS 3/4 ..................... 53 COMFORT FAB MIS ASSORTED .......... 53 COMFORT FAB MIS KNEE/ELB ............ 53 comfort gel sus ............................... 14

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COMPRESSOR MIS NEBULIZE .......... 177 COMPRESSOR MIS NEBULIZR... 121, 177

comfort gel sus antacid ..................... 14 comfort gel sus anti-gas .............. 14, 16 COMFORT MIS LANCETS ................... 85 COMFORTOUCH MIS LANCET...... 85, 115 COMP AIR MIS COMP/NEB ............... 177 COMP AIR MIS ELITE ............... 121, 177 comp allergy cap 25mg ..................... 32 comp allergy tab 25mg ..................... 33 comp allergy tab 25mg med .............. 33 comp daily tab w/lutein ................... 131 comp energy tab ............................ 131 comp multivi liq mineral .................. 131 COMPACT SPAC MIS CHAMBER ........ 180 COMPACT SPAC MIS LG MASK .......... 180 COMPACT SPAC MIS MD MASK ......... 180 COMPACT SPAC MIS SM MASK ......... 180 companion tab ............................... 131 compete tab .................................. 131 compl multiv chw childrns ........ 152, 167 comple multi tab adlt 50+........ 131, 146 complere tab ................................. 131 COMPLETE 50+ TAB MENS .............. 131 COMPLETE 50+ TAB WOMENS .......... 131 complete chw multi-vi ..................... 167 complete tab ................................. 131 complete tab senior ........................ 131 complete tab womens ..................... 131 complex b-50 tab ............................. 50 COMPMIST MIS NEBULIZE ............... 177 compoz cap 50mg ............................ 30 compoz tab 50mg ............................ 30

compro sup 25mg .......................... 171 CONCEPTIONXR MIS MOTILITY ........ 131 CONDOMS MIS ................................ 72 CONDOMS MIS LUBRICAT ................. 72 cong/cough liq 5-100/5 ..................... 77 constulose sol 10gm/15 .................. 109 CONVERSION MIS BABY SZ1 ........... 179 CONVERSION MIS BABY SZ2 ........... 179 CONVERSION MIS BABY SZ3 ........... 179 coral calciu cap plus ........... 62, 124, 131 CORLANOR TAB 5MG ...................... 185 CORLANOR TAB 7.5MG ................... 185 correct tab 5mg ec ......................... 188 correctol cap 100mg ....................... 191

CORRECTOL MIS HERBAL ......... 109, 188 correctol tab 5mg ec ...................... 188 cort intense cre heal 1% ................... 74 cortaid cre 1% ................................ 74 cortisone cre 1% ............................. 74 cortisone gel 1% ............................. 83 cortisone lot 1% .............................. 83 cortisone oin 1% ............................. 83 cortizone-10 cre /aloe 1% ................. 76 cortizone-10 cre healing ................... 76 cortizone-10 cre plus ........................ 76 cortizone-10 gel 1% ......................... 74 cortizone-10 lot diab/1% .................. 74 cortizone-10 lot eczema ................... 74 cortizone-10 lot hydraten .............74, 83 cortizone-10 oin 1% ....................74, 83 COSENTYX INJ 150MG/ML ................. 83 COSENTYX INJ 300DOSE .................. 83 COSENTYX PEN INJ 150MG/ML .......... 83 COSENTYX PEN INJ 300DOSE ............ 83 cough child liq 5-100/5 ..................... 77 cough cont liq dm max ..................... 77 cough syp ....................................... 96 cough syp 100/5ml .......................... 96 cough/chest liq 20-400 ..................... 76 cough/chest liq dm child ................... 76 cough/chest syp dm ......................... 76 coughtab tab 200mg ........................ 96 COVERLET MIS STRIPS ................... 112 C-PLEX CAP .................................... 59 cranberry cap urin com ................... 200 CRAYON STRIP MIS BANDAGE ........... 53 creamies chw 600-400 ..................... 62 creamy face liq wash 4% .................... 4 CREON CAP 12000UNT ..................... 93 CREON CAP 24000UNT ..................... 93 CREON CAP 3000UNIT ...................... 93 CREON CAP 36000UNT ..................... 93 CREON CAP 6000UNIT ...................... 93 cromolyn sodium nasal aerosol soln 5.2 mg/act (4%) ................................. 155 cromolyn sodium ophth soln 4% ...... 163 cromolyn sodium soln nebu 20 mg/2ml ...................................................... 18 cryselle-28 tab 28 tabs ..................... 69 CULTURELLE CHW KIDS ................... 24 CULTURELLE PAK KIDS ................24, 26

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CU-PLUS TAB 2MG ......................... 185 CURAD 7/8 ..................................... 53 CURAD ASSORT MIS ACTIFLEX .......... 53 CURAD COMFOR MIS .75X3 ............. 112 CURAD FAMILY MIS FLX ASST ............ 53 CURAD FLEX MIS ASSORTED ............. 53 curad hydro cre 1% .......................... 83 CURAD KID SZ MIS DINOSAUR .......... 53 CURAD MIS GODZILLA ...................... 53 CURAD MIS JURASSIC ...................... 53 CURAD PAD 3 .................................. 53 CURAD SENSIT MIS 3/4 .................... 53 CURAD SENSIT MIS ASSORTED .......... 53 CURAD SENSIT MIS EX LARGE ........... 53 CURAD SENSIT MIS SPOTS ............... 53 curad triple oin antibiot ..................... 82 CURAD WILD MIS DESIGNIT .............. 53 CURAD WILD MIS TATTOO-U ............. 53 CURITY CURAD MIS 3/4 FABR ............ 54 CURITY CURAD MIS 3/4 PLAS..... 54, 112 CURITY CURAD MIS 3/4 SHEE .... 54, 112 CURITY CURAD MIS ASST FAB ........... 54 CURITY CURAD MIS PLASTIC ............. 54 CURITY CURAD MIS SHEER ............... 54 CURITY PREP PAD ALCOHOL ............ 125 CURITY SWABS PAD ALCOHOL ......... 125 CUVPOSA SOL 1MG/5ML ................... 44 cvd d3 chw 1000unit ...................... 160 cvs 3-day cre ................................ 197 cvs acne cre 10% .............................. 5 cvs allergy cap 25mg ........................ 31 cvs allergy chw 12.5mg .................... 31 cvs allergy dro 0.025%op ................ 163 cvs allergy liq 25/10ml ...................... 33 cvs allergy tab 10mg ........................ 34 cvs allergy tab 180mg ...................... 34 cvs allergy tab 25mg ........................ 33 cvs allergy tab 4mg .......................... 32 cvs allergy tab chldrn........................ 33 cvs antacid sus antigas ..................... 14 cvs antacid sus anti-gas .................... 14 cvs antacid sus supreme ................... 15 cvs antacid/ sus anti-gas ................... 14 cvs aspirin tab 325mg..................... 182 cvs aspirin tab 325mg ec................. 182 cvs aspirin tab 81mg ec .................. 182 cvs b1 tab 100mg .......................... 200

cvs b-1 tab 100mg ........................ 200 cvs balanced tab b100 .................... 143 cvs balanced tab b50 ..................... 154 cvs bismuth chw 262mg ................... 24 cvs bismuth sus max str ................... 24 cvs bismuth tab 262mg .................... 24 cvs ca/mg/zn tab ............................. 63 cvs calcium tab 600mg ................... 124 cvs children chw complete .............. 167 cvs childs chw 80mg ........................ 11 cvs c-lax tab 5mg .......................... 109 cvs d3 cap 1000unit ....................... 160 cvs d3 cap 2000unit ....................... 160 cvs d3 cap 5000unit ....................... 160 cvs d3 chw 1000 unt ...................... 160 cvs daily chw gummies ............ 131, 146 cvs dry eye dro relief........................ 45 cvs electrol sol ................................ 93 cvs fish oil cap 1000mg .................. 126 cvs fish oil cap 1200mg .................. 126 cvs gas relf chw 125mg .................... 27 cvs gas relf chw 80mg ...................... 27 cvs gas relf dro ex st ........................ 27 CVS HAIR/SKN TAB NAILS .............. 185 cvs ibuprof dro 50/1.25 .................. 157 cvs inner tab ear plus ..................... 201 cvs iron tab 27mg .......................... 107 cvs iron tab 325mg ........................ 107 cvs itch rel cre 1% ........................... 29 CVS KETONE TES CARE .................... 92 CVS LANCETS MIS 21G .................... 85 CVS LANCETS MIS 30G .............. 85, 115 CVS LANCETS MIS 33G .................... 85 CVS LANCETS MIS ORIGINAL ............ 85 CVS LANCETS MIS THIN 26G ...... 85, 115 CVS LANCETS MIS THIN 30G ...... 85, 115 CVS LANCETS MIS THIN 33G ...... 85, 115 cvs laxative chw 15mg ................... 188 cvs laxative tab 25mg .................... 188 cvs lubricnt dro 0.5% op ............ 47, 161 cvs miconazo cre 7 ........................ 197 cvs mucus d tab 60-600mg ............... 80 cvs mucus er tab 600mg ................... 96 cvs mucus tab 1200 er ..................... 77 CVS NASAL SPR MIST .................... 154 cvs natural sol tears ......................... 46 cvs pinworm sus 50mg/ml ................ 17

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CVS PLASTIC MIS BANDAGE ............ 112 cvs purelax pak ............................. 110 cvs purelax pow ............................. 110 cvs purelax pow 3350 ..................... 110 cvs quality cap sleep ......................... 6 cvs senna tab 8.6mg ...................... 188 CVS SPOT BAN MIS SHEER ................ 54 cvs stress tab form/zn ...................... 48 cvs super b tab complx/c ........... 48, 143 cvs triple oin antibiot ........................ 20 cyanocobalamin inj 1000 mcg/ml ..... 102 cyclafem tab 1/35 ............................ 69 cyclafem tab 7/7/7 ........................... 70 cyclobenzaprine hcl tab 10 mg ........... 67 cyclobenzaprine hcl tab 5 mg ............. 67 cyclophosphamide cap 25 mg ............ 40 cyclophosphamide cap 50 mg ............ 40 cyclosporine cap 100 mg ................. 105 cyclosporine cap 25 mg ................... 105 cyclosporine modified cap 100 mg .... 105 cyclosporine modified cap 25 mg ...... 105 cyclosporine modified cap 50 mg ...... 105 cyclosporine modified oral soln 100 mg/ml .......................................... 105 cyproheptadine hcl syrup 2 mg/5ml .... 36 cyproheptadine hcl tab 4 mg .............. 36 cyred eq tab .................................... 71 cyred tab ........................................ 69 D d 1000 cap 1000unit ...................... 160 d 400 cap ..................................... 199 d 400 chw 400unit ......................... 160 d 400 tab 400unit .......................... 160 D3 + K2 DOTS TAB ........................ 199 d3 adult chw 1000unit .................... 160 d3 cap 1000unit ............................. 160 d3 cap 2000unit ............................. 160 d-3 gummy chw 400unit ................. 160 d3 kids chw 400unit ....................... 160 d3 maximum cap 5000unit .............. 160 d3 super str cap 2000unit ............... 160 d3 tab 400unit ............................... 160 d3 vitamin liq 400unit ..................... 200 D3/VITAMIN C TAB /ZINC ............... 199 d3-1000 cap 1000unit .................... 160 d3-50 cap 50000unt ....................... 160 DAFLONEX-XL TAB ........................... 59

daily betic tab ............................... 131 daily combo tab ............................. 131 daily diet tab support............... 131, 146 DAILY ENERGY POW ENFUSION ....... 131 DAILY HEART PAK SUPPORT ............ 131 daily mens tab health ..................... 131 daily multi tab ............................... 131 daily multi tab 50+ ........................ 132 daily multi tab men ................. 132, 146 daily multi tab minerals .................. 132 daily multi tab vit/iron ............. 128, 144 daily multi tab vit/mens ........... 132, 146 daily multi tab vit/min ............. 132, 146 daily multi tab vitamins .................. 151 daily multi tab women ............. 132, 146 daily multi tab womn 50+ ........ 132, 146 daily multiv tab womens ................. 128 DAILY PAK MIS MULTIVIT ............... 132 daily tab vitamin ............................ 151 daily value tab multivit ................... 151 daily vit tab .................................. 151 daily vit tab +iron ................... 128, 144 daily vit tab +mineral .............. 132, 146 daily vit tab iron...................... 128, 144 daily vitamn cap plus ..................... 132 daily vite tab ................................. 151 daily vite tab iron .................... 128, 144 daily womens tab health ................. 132 daily-vitamn tab...................... 128, 151 daily-vitamn tab maximum ............. 132 daily-vite tab ................................ 151 daily-vite/ tab iron .................. 128, 144 danazol cap 100 mg ......................... 13 danazol cap 200 mg ......................... 13 danazol cap 50 mg ........................... 13 dandruff sha 1%.............................. 43 dantrolene sodium cap 100 mg .......... 93 dantrolene sodium cap 25 mg ............ 93 dantrolene sodium cap 50 mg ............ 93 dapsone tab 100 mg ...................... 110 dapsone tab 25 mg ........................ 110 DARAPRIM TAB 25MG....................... 37 dasetta tab 1/35 .............................. 69 dasetta tab 7/7/7 ............................ 70 dayhist alrg tab 12 hour ................... 33 daysee tab ..................................... 71 DDROPS LIQ 2000UNIT .................. 200

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deblitane tab 0.35mg ..................... 173 decadron elx 0.5/5ml ........................ 74 decadron tab 0.5mg ......................... 74 decadron tab 0.75mg ....................... 74 decadron tab 4mg ............................ 74 decadron tab 6mg ............................ 74 decara cap 10000unt ...................... 200 decara cap 50000unt ...................... 160 decongestant tab 120mg er ............. 192 decongestant tab 30mg .................. 192 DECUBI-VITE CAP .......................... 132 deep sea spr 0.65% ....................... 154 DEKAS CAP ESSENTIA .................... 151 DEKAS CHW BARIATRI .................... 146 DEKAS LIQ ESSENTIA ..................... 151 DEKAS PLUS CAP ........................... 132 DEKAS PLUS CHW .......................... 132 DEKAS PLUS LIQ ............................ 166 delsym cough liq congs dm ................ 77 delta d3 tab 400unit ....................... 160 deltasone tab 20mg ........................ 100 delyla tab 0.1-0.02 ........................... 69 denta 5000 cre plus .......................... 82 denta 5000 cre plus 2pk .................... 82 dentagel gel 1.1% ............................ 82 dermafungal oin 2% ......................... 29 dermarest lot 1% ............................. 74 DERMAVITE TAB ............................ 132 desenex cre 1% ............................... 29 desmopressin acetate nasal spray soln 0.01% .......................................... 171 desmopressin acetate nasal spray soln 0.01% (refrigerated) ...................... 171 desmopressin acetate tab 0.1 mg ..... 171 desmopressin acetate tab 0.2 mg ..... 172 desogest-eth estrad & eth estrad tab 0.15-0.02/0.01 mg(21/5) .................. 69 desogestrel & ethinyl estradiol tab 0.15 mg-30 mcg ..................................... 69 desonide cream 0.05% ..................... 83 desonide lotion 0.05% ................. 75, 83 desonide oint 0.05% ........................ 83 desoximetasone cream 0.05% ........... 75 desoximetasone cream 0.25% ........... 83 desoximetasone gel 0.05% ................ 75 desoximetasone oint 0.25% .............. 75 dexamethasone elixir 0.5 mg/5ml..... 100

dexamethasone sodium phosphate ophth soln 0.1% ..................................... 163 dexamethasone soln 0.5 mg/5ml ..... 100 dexamethasone tab 0.5 mg ............. 100 dexamethasone tab 0.75 mg ........... 100 dexamethasone tab 1 mg ............... 100 dexamethasone tab 1.5 mg ............ 100 dexamethasone tab 2 mg ............... 100 dexamethasone tab 4 mg ............... 100 dexamethasone tab 6 mg ............... 100 dextromethorphan-guaifenesin syrup 10-100 mg/5ml ............................... 77 DIABET HLTH PAK SUPPORT ..... 132, 146 diabet tuss syp allergy ...................... 32 DIABETES PAK HEALTH .................. 132 DIABETES PAK SUPPORT ................ 132 diabetic sup tab formula ................. 132 diabetic tus liq 100/5ml .................... 96 diabetic tus liq children ................76, 77 diabetic tus liq dm ........................... 77 diabetic tus liq max st ...................... 77 diabets hlth tab formula ........... 132, 146 diabtc tussn syp 100/5ml .................. 96 DIALYVIT 800 TAB ZINC 15 ............... 49 dialyvite d cap 5000unit ................. 160 dialyvite tab 800 .............................. 49 dialyvite tab 800/d ......................... 132 DIALYVITE TAB 800/IRON ................. 49 DIALYVITE TAB 800/ZINC ................. 49 diamode tab 2mg ............................ 43 diarrhea rel sus 262/15ml ................. 24 diarrhea sus 262/15ml ..................... 24 diclofenac potassium tab 50 mg ....... 157 diclofenac sodium gel 1% ................. 18 diclofenac sodium ophth soln 0.1% .. 163 diclofenac sodium tab delayed release 25 mg .............................................. 157 diclofenac sodium tab delayed release 50 mg .............................................. 157 diclofenac sodium tab delayed release 75 mg .............................................. 157 diclofenac sodium tab er 24hr 100 mg .................................................... 157 dicloxacillin sodium cap 250 mg ....... 170 dicloxacillin sodium cap 500 mg ....... 170 dicyclomine hcl cap 10 mg ................ 44 dicyclomine hcl oral soln 10 mg/5ml ... 44

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dicyclomine hcl tab 20 mg ................. 44 diflorasone diacetate cream 0.05% ..... 83 diflorasone diacetate oint 0.05% ........ 75 diflunisal tab 500 mg ...................... 182 DI-GEL SUS .................................... 14 digestive cap health .......................... 24 digestive cap probioti .................. 24, 26 digitek tab 0.125mg ......................... 66 digitek tab 0.25mg ........................... 66 digox tab 0.125mg ........................... 66 digox tab 0.25mg ............................. 66 digoxin oral soln 0.05 mg/ml ............. 66 digoxin tab 125 mcg (0.125 mg) ........ 66 digoxin tab 250 mcg (0.25 mg) .......... 66 DILANTIN CAP 30MG ...................... 104 diltiazem hcl cap er 12hr 120 mg ........ 64 diltiazem hcl cap er 12hr 60 mg ......... 64 diltiazem hcl cap er 12hr 90 mg ......... 64 diltiazem hcl cap er 24hr 120 mg ........ 64 diltiazem hcl cap er 24hr 180 mg ........ 64 diltiazem hcl cap er 24hr 240 mg ........ 64 diltiazem hcl coated beads cap er 24hr 120 mg .......................................... 64 diltiazem hcl coated beads cap er 24hr 180 mg .......................................... 64 diltiazem hcl coated beads cap er 24hr 240 mg .......................................... 64 diltiazem hcl coated beads cap er 24hr 300 mg .......................................... 64 diltiazem hcl coated beads cap er 24hr 360 mg .......................................... 64 diltiazem hcl coated beads tab er 24hr 180 mg .......................................... 64 diltiazem hcl coated beads tab er 24hr 240 mg .......................................... 64 diltiazem hcl coated beads tab er 24hr 300 mg .......................................... 64 diltiazem hcl coated beads tab er 24hr 360 mg .......................................... 64 diltiazem hcl coated beads tab er 24hr 420 mg .......................................... 64 diltiazem hcl extended release beads cap er 24hr 120 mg ............................... 65 diltiazem hcl extended release beads cap er 24hr 180 mg ............................... 65 diltiazem hcl extended release beads cap er 24hr 240 mg ............................... 65

diltiazem hcl extended release beads cap er 24hr 300 mg ............................... 65 diltiazem hcl extended release beads cap er 24hr 360 mg ............................... 65 diltiazem hcl extended release beads cap er 24hr 420 mg ............................... 65 diltiazem hcl tab 120 mg ................... 65 diltiazem hcl tab 30 mg .................... 65 diltiazem hcl tab 60 mg .................... 65 diltiazem hcl tab 90 mg .................... 65 dilt-xr cap 120mg ............................ 64 dilt-xr cap 180mg ............................ 64 dilt-xr cap 240mg ............................ 64 dino-life chw ................................. 169 dino-life chw extra c ................ 153, 169 DINO-LIFE CHW IRON-ZIN ....... 152, 168 diocto liq 50mg/5ml ....................... 191 diocto syp 60/15ml ........................ 191 diphedryl liq 12.5/5ml ...................... 33 diphen tab 25mg ............................. 33 diphenhist cap 25mg ........................ 33 diphenhist liq 12.5/5ml .................... 33 diphenhist tab 25mg ........................ 33 diphenhydramine hcl (sleep) tab 50 mg ............................................... 30, 104 diphenhydramine hcl cap 25 mg ........ 33 diphenhydramine hcl cap 50 mg....31, 33 diphenhydramine hcl elixir 12.5 mg/5ml ...................................................... 33 diphenhydramine hcl tab 25 mg ......... 33 diphenoxylate w/ atropine liq 2.5-0.025 mg/5ml .......................................... 43 diphenoxylate w/ atropine tab 2.5-0.025 mg ............................................26, 43 dipyridamole tab 25 mg .................. 171 dipyridamole tab 50 mg .................. 171 dipyridamole tab 75 mg .................. 171 disney cars chw gummies ............... 167 disopyramide phosphate cap 100 mg .. 19 disopyramide phosphate cap 150 mg .. 19 dm max adult liq 20-400 .................. 77 d-natural-5 cap ............................. 199 docu liq 50mg/5ml ......................... 191 docu soft cap 100mg ...................... 191 docuprene tab 100mg .................... 191 docusate calcium cap 240 mg .......... 191 docusate sod liq 50mg/5ml ............. 191

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docusate sodium cap 100 mg ... 109, 191 docusate sodium cap 250 mg ........... 191 docusate sodium liquid 150 mg/15ml 191 docusate sodium syrup 60 mg/15ml . 191 docusate sodium tab 100 mg ........... 191 docusil cap 100mg ......................... 191 dofetilide cap 125 mcg (0.125 mg) ..... 19 dofetilide cap 250 mcg (0.25 mg) ....... 19 dofetilide cap 500 mcg (0.5 mg) ......... 19 dofus cap ........................................ 24 dok cap 100mg .............................. 191 dok cap 250mg .............................. 191 dok plus tab 8.6-50mg .................... 108 dok tab 100mg .............................. 191 donepezil hydrochloride orally disintegrating tab 10 mg............ 21, 175 donepezil hydrochloride orally disintegrating tab 5 mg ............. 21, 175 donepezil hydrochloride tab 10 mg .... 21, 175 donepezil hydrochloride tab 23 mg ..... 21 donepezil hydrochloride tab 5 mg 21, 175 dorzolamide hcl ophth soln 2% ........ 163 dorzolamide hcl-timolol maleate ophth soln 22.3-6.8 mg/ml ................. 58, 162 DORZOLAMIDE SOL 2% .................. 162 DOSOQUIN TAB ............................. 153 double antib oin ............................... 20 double oin antibiot ........................... 82 doxazosin mesylate tab 1 mg ............. 18 doxazosin mesylate tab 2 mg ............. 18 doxazosin mesylate tab 4 mg ............. 18 doxazosin mesylate tab 8 mg ............. 18 doxercalciferol cap 0.5 mcg ............. 123 doxercalciferol cap 1 mcg ................ 123 doxercalciferol cap 2.5 mcg ............. 123 doxycycline hyclate cap 100 mg ....... 193 doxycycline hyclate cap 50 mg ......... 193 doxycycline hyclate tab 100 mg ....... 193 doxycycline hyclate tab 20 mg ......... 193 doxycycline monohydrate for susp 25 mg/5ml ........................................ 193 DOXYCYCLINE POW HYCLATE .......... 193 dr edwards tab 8.6mg..................... 188 dr gs clear sol nail 1% ................. 28, 83 dramamine tab 25mg ....................... 26 dronabinol cap 10 mg ....................... 27

dronabinol cap 2.5 mg ...................... 27 dronabinol cap 5 mg ........................ 27 DROPLET LANC MIS 30G ................... 85 drospirenone-ethinyl estradiol tab 3-0.02 mg ............................................69, 71 drospirenone-ethinyl estradiol tab 3-0.03 mg ................................................ 71 drs choice tab men ........................ 132 dry eye cap formula ....................... 132 dry eye relf oin night ...................... 161 ducodyl tab 5mg ec ........................ 188 dulcolax pnk cap 100mg ................. 109 dulcolax ss cap 100mg ................... 191 DULERA AER 100-5MCG ................. 192 DULERA AER 200-5MCG ................. 192 DUREX EXTRA MIS SENSITIV...... 72, 113 DUREX MIS REALFEEL .................... 113 dyna-hex 2 sol 2%........................... 68 dyna-hex 4 sol 4%........................... 44 dyspel tab 200mg .......................... 157 E e.e.s. 400 tab 400mg ....................... 95 e-400 cap selenium ....................... 199 ear drops dro 6.5% ........................ 165 ear drops sol 6.5% ot ..................... 165 ear health tab formula ............. 154, 201 ear health tab plus .................. 154, 201 ear wax kit sol 6.5% ot .................. 165 ear wax remv dro 6.5% ot .............. 165 ear wax remv sol 6.5% ot ............... 165 ear wax sol 6.5% .......................... 165 EARLOOP MIS MASK ...................... 176 EAR-LOOP MIS MASK SM ................ 176 earwax remov dro kit ..................... 165 earwax remov dro system ............... 165 earwax remov sol 6.5% .................. 165 earwax remv sol 6.5% ot ................ 165 earwax sol removal ........................ 165 EASIVENT MIS ........................ 121, 180 EASIVENT MIS MASK LG ................. 180 EASIVENT MIS MASK MED .............. 180 EASIVENT MIS MASK SM ................ 180 EASY AIR COM MIS NEBULIZE ......... 177 EASY COMFORT MIS 30G .................. 85 EASY COMFORT MIS 31GX3/16 ........ 119 EASY COMFORT MIS 31GX5/16 ........ 119 EASY COMFORT MIS 32GX5/32 ........ 119

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EASY COMFORT MIS LANC/30G .. 86, 115 EASY COMFORT MIS TWIST ............. 115 EASY NEB MIS ............................... 121 EASY RELEASE PAD NONSTICK .......... 54 EASY TOUCH MIS 31GX3/16 ............ 119 EASY TOUCH MIS 31GX5/16 ............ 119 EASY TOUCH MIS 32GX1/4.............. 119 EASY TOUCH MIS 32GX5/32 ............ 119 EASY TOUCH MIS 32GX6MM ............ 119 EASY TOUCH MIS LANC/21G ...... 86, 115 EASY TOUCH MIS LANC/23G ...... 86, 115 EASY TOUCH MIS LANC/26G ...... 86, 115 EASY TOUCH MIS LANC/28G ...... 86, 115 EASY TOUCH MIS LANC/30G ...... 86, 115 EASY TOUCH MIS LANC/32G ...... 86, 115 EASY TOUCH MIS LANC/33G .............. 86 easy-c tab 500mg ............................ 59 easy-lax cap 100mg ....................... 191 easy-lax pls tab 8.6-50mg ............... 109 easy-melts tab 80mg ........................ 11 EBASE CONTRO MIS KIT ................. 179 ecee plus tab ................................. 199 econtra ez tab 1.5mg ....................... 73 econtra os tab 1.5mg ....................... 73 ecotrin low tab 81mg ec .................. 182 ecotrin tab 325mg ......................... 182 ecpirin tab 325mg ec ...................... 183 ed chlorped syp jr ............................ 32 ed-apap liq 80mg/2.5 ....................... 11 ed-spaz tab 0.125mg ........................ 44 effer-k tab 25meq ef ............... 125, 172 EFLOW SCF MIS AEROSOL .............. 179 EFLOW SCF MIS NEBULIZR ...... 121, 177 ELDERTONIC ELX ........................... 132 ELIGARD INJ 22.5MG ........................ 41 ELIGARD INJ 30MG .......................... 41 ELIGARD INJ 45MG .......................... 41 ELIGARD INJ 7.5MG ......................... 41 elinest tab ....................................... 69 ELIQUIS ST P TAB 5MG ..................... 21 ELIQUIS TAB 2.5MG ......................... 21 ELIQUIS TAB 5MG ............................ 21 ELITE COMPRS MIS NEBULIZR ......... 177 ELITE DC AUT MIS ADAPTER ........... 179 ELITE SYSTEM MIS NEBULIZR .......... 177 elite-ob tab ................................... 172 ELIXOPHYLLIN ELX 80/15ML ............ 201

ELLA TAB 30MG ............................... 94 ELON MATRIX TAB 5000 ................. 185 ELON MATRIX TAB 5000 COM .......... 185 ELON MATRIX TAB COMPLETE ......... 185 ELON MATRIX TAB PLUS ................. 185 ELON R3 TAB ................................ 185 EMBRACE LANC MIS THIN 30G .......... 86 EMEND SUS 125MG ....................... 190 EMERGEN-C CHW IMMUNE/D.... 132, 146 EMERGEN-C CHW VITA C ................ 132 EMERGEN-C PAK BLUE ................... 132 EMERGEN-C PAK FIVE.............. 132, 146 EMERGEN-C PAK HEART ................. 132 EMERGEN-C PAK IMMUNE ........ 132, 146 EMERGEN-C PAK JOINT .................. 132 EMERGEN-C PAK KIDZ ............. 132, 146 EMERGEN-C PAK MSM LITE ............. 132 EMERGEN-C PAK PINK .................... 132 EMERGEN-C PAK SUPER FR ...... 132, 146 EMERGEN-C PAK VIT D/CA .............. 132 EMERGEN-C PAK VITA C .......... 132, 146 emoquette tab ................................ 69 emulsified liq omega-3 ................... 126 EMVERM CHW 100MG ...................... 17 enalapril maleate & hydrochlorothiazide tab 10-25 mg .................................. 36 enalapril maleate & hydrochlorothiazide tab 5-12.5 mg ................................. 36 enalapril maleate tab 10 mg ................ 3 enalapril maleate tab 2.5 mg ............... 3 enalapril maleate tab 20 mg ................ 3 enalapril maleate tab 5 mg ................. 3 ENBREL INJ 25/0.5ML ........................ 9 ENBREL INJ 25MG ............................. 9 ENBREL INJ 50MG/ML ........................ 9 ENBREL MINI INJ 50MG/ML ................. 9 ENBREL SRCLK INJ 50MG/ML .............. 9 ENCARE SUP 100MG ...................... 187 endocet tab 10-325mg ................... 165 endocet tab 2.5-325 ...................... 165 endocet tab 5-325mg ....................... 10 endocet tab 7.5-325 ...................... 165 endur-b tab .................................. 143 ENDUR-VM TAB ............................. 146 ENDUR-VM TAB IRON ..................... 146 ENERGY POW BOOSTER ........... 132, 146 enoxaparin sodium inj 100 mg/ml ...... 21

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enoxaparin sodium inj 120 mg/0.8ml ..21 enoxaparin sodium inj 150 mg/ml ...... 21 enoxaparin sodium inj 30 mg/0.3ml .... 21 enoxaparin sodium inj 300 mg/3ml ..... 21 enoxaparin sodium inj 40 mg/0.4ml .... 21 enoxaparin sodium inj 60 mg/0.6ml .... 21 enoxaparin sodium inj 80 mg/0.8ml .... 21 enpresse-28 tab .............................. 70 enskyce tab .................................... 71 entacapone tab 200 mg .................... 42 entecavir tab 0.5 mg ...................... 103 entecavir tab 1 mg ......................... 103 enteric asa tab 325mg .................... 183 ENTRE-HIST LIQ 0.938-10 ................ 80 ENTRESTO TAB 24-26MG .................. 66 ENTRESTO TAB 49-51MG .................. 66 ENTRESTO TAB 97-103MG ................ 66 enulose sol 10gm/15 ...................... 106 enviro-stres tab ...................... 132, 146 epinephrine solution auto-injector 0.15 mg/0.15ml (1:1000) ...................... 199 epinephrine solution auto-injector 0.3 mg/0.3ml (1:1000) ........................ 198 EPIPEN-JR INJ 2-PAK ...................... 199 EPIVIR HBV SOL 5MG/ML ................ 103 eplerenone tab 25 mg ..................... 184 eplerenone tab 50 mg ..................... 184 epoprostenol sodium for inj 0.5 mg ..... 66 epoprostenol sodium for inj 1.5 mg ..... 66 eq 1% hydroc cre ............................. 83 eq acetamin tab 160mg .................... 11 eq acetamin tab 500mg .................... 11 eq acetamin tab 80mg ...................... 11 eq allergy cap 25mg ......................... 33 eq antacid chw 1000mg .................... 16 eq antacid chw 160-105 .................... 15 eq antacid chw 750mg ...................... 16 eq antacid sus ................................. 16 eq antacid sus anti-gas ..................... 14 eq antacid sus max st ....................... 14 eq aspirin tab 325mg ...................... 183 eq aspirin tab 325mg ec .................. 183 eq aspirin tab 500mg ec .................. 183 eq calcium tab citr+d ................ 63, 124 eq child asa chw 81mg .................... 183 eq chlortabs tab 4mg ........................ 32 eq clearlax pow .............................. 110

EQ COMPLETE TAB ADULT .............. 132 eq dayhist tab 1.34mg ..................... 33 eq ear wax sol removal .................. 165 eq gentle dro 0.3% .......................... 47 eq heartburn tab relief ................... 101 eq hydrocort cre 1% ........................ 75 eq ibuprofen tab 200mg ................. 157 eq laxative chw 15mg .................... 188 eq laxative tab 25mg ..................... 188 eq laxative tab 8.6mg .................... 188 eq lubricant dro eye drop .................. 45 eq mucus er tab 600mg .................... 97 eq multivita chw gummies ........ 152, 167 EQ ONE DAILY TAB MENS......... 132, 146 eq one daily tab womens ................ 132 EQ ONE DAILY TAB WOMENS .......... 132 eq restore oin pm .......................... 161 eq revive pl dro 0.5% op .................. 47 eq senna-s tab 8.6-50mg ................ 109 eq sleep aid cap 50mg ...................... 30 eq stomach chw 262mg .................... 24 eq stool cap softener ...................... 191 EQ STRONG MIS STRIPS ................... 54 eq suphedrin tab 30mg .................. 192 eq triple oin antibiot ......................... 20 eq tussin dm liq max ........................ 77 eq tussin dm syp cgh/chst ................ 77 eql acetamin tab 160mg ................... 11 eql acetamin tab 325mg ................... 11 eql acetamin tab 500mg ................... 11 eql all day tab allergy ....................... 35 eql allergy tab 10-240mg ................. 80 eql allergy tab 25mg ........................ 33 eql allergy tab 4mg .......................... 32 eql allergy tab chldrn ....................... 33 eql antacid chw 1000mg ................... 16 eql antacid chw 750mg .................... 16 eql antacid chw fruit ........................ 16 eql antacid chw pepprmnt ................. 16 eql antacid sus anti-gas .................... 14 eql arthrts tab 650mg ...................... 11 eql aspirin chw 81mg ..................... 183 eql aspirin tab 325mg .................... 183 eql aspirin tab 325mg ec ................ 183 eql b complx tab 50 ......................... 50 eql b-100 tab complex ...................... 50 EQL BUTTERFL MIS CLOSURE ............ 54

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eql calcium tab citr/d3 ...................... 63 eql calcium tab w/vit d .............. 63, 124 eql century tab .............................. 132 eql century tab mature ............ 133, 146 EQL CENTURY TAB MENS ................ 133 EQL CENTURY TAB WOMENS ............ 133 eql clearlax pow...................... 109, 110 EQL FIRST MIS AID BAND ................. 54 eql firstaid oin antibiot ...................... 20 eql fish oil cap 1000mg ................... 126 eql fish oil cap 1200mg ................... 126 EQL FLEXIBLE MIS FABRIC......... 54, 112 EQL FLEXIBLE MIS FOAM ................... 54 eql gas gone chw 125mg ............. 27, 99 eql gas rlf cap 180mg ....................... 27 EQL GENTLE MIS STRIPS .................. 54 eql gentle tab laxative .................... 188 eql heartbrn tab 10mg .................... 101 eql heartbur tab 150mg .................. 101 EQL HVY DUTY MIS STRIPS ........ 54, 112 eql ibuprofn tab 200mg ................... 157 EQL LANCETS MIS 21G COLR ............. 86 EQL LANCETS MIS 33G COLR ............. 86 EQL LANCETS MIS THIN 26G...... 86, 115 EQL LANCETS MIS THIN 30G...... 86, 115 eql laxative chw 15mg .................... 188 eql laxative tab 25mg ..................... 188 eql laxative tab 5mg ec ................... 188 eql motion tab sickness ..................... 26 eql mucus-dm tab 30-600cr ............... 78 eql mucus-dm tab 60-1200 ............... 78 eql mucus-er tab 1200mg ................. 97 eql naproxen cap 220mg ................. 157 EQL PLASTIC MIS STRIPS .......... 54, 112 EQL SHEER MIS SPOTS ..................... 54 EQL SHEER MIS STRIPS............. 54, 112 eql sleep tab aid .............................. 30 eql stomach chw 262mg.................... 24 eql stool tab softener ...................... 109 EQL STRIPS MIS ....................... 54, 113 eql tussin liq 10-200 ......................... 78 eql tussin syp dm ............................. 78 eql vision tab formula ..................... 133 eql vitamin cap d3 .......................... 160 ERAPID MIS NEBULIZE ............ 121, 177 ERAPID NEB MIS HANDSET ...... 121, 179 ergocalciferol cap 50000 unit.... 160, 200

ergocalciferol soln 8000 unit/ml ....... 160 ergotamine w/ caffeine tab 1-100 mg 124 ERIVEDGE CAP 150MG ..................... 38 errin tab 0.35mg ............................. 73 erythrocin tab 250mg ....................... 95 erythromycin ethylsuccinate for susp 200 mg/5ml .......................................... 95 erythromycin ethylsuccinate tab 400 mg ...................................................... 95 erythromycin gel 2% .......................... 4 erythromycin ophth oint 5 mg/gm .... 162 ERYTHROMYCIN POW ................ 95, 111 ERYTHROMYCIN POW ETHYLSUC. 95, 111 erythromycin soln 2% ........................ 4 erythromycin tab 250 mg.................. 95 erythromycin tab 500 mg.................. 95 erythromycin w/ delayed release particles cap 250 mg ........................ 95 ESCAVITE CHW ............................. 166 esgic cap .......................................... 8 eskimo-3 cap 500mg ............... 126, 159 eskimo-3 liq .................................. 126 esomepra mag cap 20mg dr ............ 195 essent one tab daily ................ 128, 144 essentia tab .................................. 133 essential tab balance ............... 133, 146 essentl one tab daily ...................... 151 estarylla tab 0.25-35 ........................ 69 ester-c tab ...................................... 59 ester-c tab 1000mg ................... 59, 144 ester-c tab 500mg..................... 59, 144 estradiol & norethindrone acetate tab 0.5-0.1 mg ..................................... 96 estradiol & norethindrone acetate tab 1-0.5 mg ........................................ 96 estradiol tab 0.5 mg ......................... 96 estradiol tab 1 mg ........................... 96 estradiol tab 2 mg ........................... 96 estradiol td patch weekly 0.025 mg/24hr ...................................................... 96 estradiol td patch weekly 0.0375 mg/24hr (37.5 mcg/24hr) ................. 96 estradiol td patch weekly 0.05 mg/24hr ...................................................... 96 estradiol td patch weekly 0.06 mg/24hr ...................................................... 96 estradiol td patch weekly 0.075 mg/24hr

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......................................................96 estradiol td patch weekly 0.1 mg/24hr 96 estradiol vaginal tab 10 mcg ............ 198 ESTROFACTORS TAB ...................... 151 ethambutol hcl tab 100 mg ............... 38 ethambutol hcl tab 400 mg ............... 38 ETHAMBUTOL POW HCL .................... 38 ethosuximide cap 250 mg ............... 190 ethosuximide soln 250 mg/5ml ........ 190 ethynodiol diacetate & ethinyl estradiol tab 1 mg-35 mcg ............................. 71 ethynodiol diacetate & ethinyl estradiol tab 1 mg-50 mcg ............................. 69 etodolac cap 200 mg ...................... 157 etodolac cap 300 mg ...................... 157 etodolac tab 400 mg ...................... 157 etodolac tab 500 mg ...................... 157 etodolac tab er 24hr 400 mg ........... 157 etodolac tab er 24hr 500 mg ........... 157 etodolac tab er 24hr 600 mg ........... 158 etoposide cap 50 mg ...................... 128 euthyrox tab 100mcg ..................... 194 euthyrox tab 112mcg ..................... 194 euthyrox tab 125mcg ..................... 194 euthyrox tab 137mcg ..................... 194 euthyrox tab 150mcg ..................... 194 euthyrox tab 175mcg ..................... 194 euthyrox tab 200mcg ..................... 194 euthyrox tab 25mcg ....................... 194 euthyrox tab 50mcg ....................... 194 euthyrox tab 75mcg ....................... 194 euthyrox tab 88mcg ....................... 194 EVAC-U-GEN CHW 10MG ................. 188 evac-u-gen tab 8.6mg ............. 109, 188 EVOLUTION60 POW ........................ 146 ex cleansing sol ............................. 128 exemestane tab 25 mg ..................... 39 ex-lax ultra tab 5mg ec ................... 188 extra action syp 100-10/5 ................. 78 extress tab ...................................... 50 extress- tab super ............................ 50 EXTRESS-30 CAP ...................... 50, 143 eye drops dro 0.25% ...................... 161 eye drops dro 0.5-0.9% .................... 45 eye health & tab lutein ................... 146 EYE HEALTH CAP ........................... 133 eye itch rel dro 0.025% .................. 162

eye itch rel dro 0.025%op .............. 163 eye itch sol relief ........................... 163 eye lubrican oin op ......................45, 46 eye vitamins cap ........................... 133 eyeprotect tab............................... 133 eye-vites tab .......................... 133, 146 E-Z JECT MIS 21G ........................... 85 E-Z JECT MIS 21G COLR ............ 85, 115 E-Z JECT MIS 30G ........................... 85 E-Z JECT MIS 32G COLR ................... 85 E-Z JECT MIS LANC 21G ................... 85 E-Z JECT MIS THIN 26G ............. 85, 115 EZ SMART MIS LANCETS .................. 86 ezetimibe tab 10 mg ........................ 36 E-ZJECT LANC MIS 33G ............. 85, 115 EZ-LETS 21G MIS LANCETS .............. 86 EZ-LETS 23G MIS LANCETS .............. 86 EZ-LETS 26G MIS LANCETS .............. 86 EZ-LETS 28G MIS LANCETS .............. 86 EZ-LETS 30G MIS LANCETS .............. 86 F fa-8 tab 0.8mg ................................ 99 fabb tab 2.2-25-1 .......................... 103 FABRIC BANDG MIS ASSORTED .. 54, 113 FABRIC BANDG MIS FLEXIBLE .... 54, 113 FACE MASK MIS EARLOOP ........ 121, 176 FACE MASK MIS N-100 ................... 176 FACE MASK MIS R95 PART .............. 176 falmina tab ..................................... 69 famciclovir tab 125 mg ................... 104 famciclovir tab 250 mg ................... 104 famciclovir tab 500 mg ................... 104 famotidine for susp 40 mg/5ml ........ 101 famotidine tab 10 mg ..................... 101 famotidine tab 20 mg ..................... 101 famotidine tab 20mg ............... 101, 196 famotidine tab 40 mg ..................... 101 FANTASY LUBR MIS ....................... 114 FANTASY LUBR MIS COLORS ...... 72, 114 FANTASY LUBR MIS SPERMICI .... 72, 114 FANTASY MIS LUBRICAT ................... 72 FARESTON TAB 60MG ...................... 39 FARYDAK CAP 10MG ........................ 39 FARYDAK CAP 15MG ........................ 39 FARYDAK CAP 20MG ........................ 39 FASLODEX INJ 250/5ML ................... 41 fast relief sup 10mg ....................... 188

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FIRST-VANC SOL 25MG/ML ............... 17 FIRST-VANC SOL 50MG/ML ............... 17

FASTCLIX MIS LANCETS .................... 86 FC FEMALE MIS CONDOM ................ 114 FC2 FEMALE MIS CONDOM .............. 114 fe tabs tab 325mg ec ...................... 107 feenamint tab 5mg ec ..................... 188 felodipine tab er 24hr 10 mg .............. 65 felodipine tab er 24hr 2.5 mg ............. 65 felodipine tab er 24hr 5 mg ............... 65 feminine car sol douche .................. 128 femynor tab 0.25-35 ........................ 69 fenesin ir tab 400mg ........................ 97 fenofibrate micronized cap 134 mg ..... 98 fenofibrate micronized cap 200 mg ..... 98 fenofibrate micronized cap 67 mg ....... 98 fenofibrate tab 145 mg ..................... 98 fenofibrate tab 160 mg ................ 36, 98 fenofibrate tab 48 mg ....................... 98 fenofibrate tab 54 mg ....................... 98 fentanyl td patch 72hr 100 mcg/hr ... 164 fentanyl td patch 72hr 12 mcg/hr ..... 163 fentanyl td patch 72hr 25 mcg/hr ....... 10 fentanyl td patch 72hr 50 mcg/hr ..... 163 fentanyl td patch 72hr 75 mcg/hr ..... 164 ferate tab 27mg ............................. 107 fergon tab 27mg ............................ 107 ferosul elx 220/5ml ........................ 107 ferosul tab 325mg .......................... 102 FERRETTS TAB 325MG .................... 107 ferrocite tab 324mg ........................ 107 ferrotabs tab ................................. 107 ferrous fumarate tab 324 mg (106 mg elemental fe) ................................. 107 ferrous gluc tab 324mg ................... 107 ferrous gluconate tab 240 mg (27 mg elemental fe) ................................. 107 ferrous gluconate tab 324 mg (37.5 mg elemental iron) .............................. 107 FERROUS SULF TAB 324MG EC ........ 102 ferrous sulf tab 325mg .................... 107 ferrous sulfate elixir 220 mg/5ml (44 mg/5ml elemental fe) ..................... 107 ferrous sulfate soln 75 mg/ml (15 mg/ml elemental fe) ................................. 107 ferrous sulfate tab 27 mg (elemental fe) .................................................... 107 ferrous sulfate tab 325 mg (65 mg elemental fe).......................... 102, 107

ferrous sulfate tab ec 325 mg (65 mg fe equivalent) ................................... 107 ferrous sulfate tab er 142 mg (45 mg fe equivalent) ................................... 107 ferrousul tab 325mg ...................... 107 fever reduce sup 120mg ................... 11 fever/pain sus 160/5ml .................... 11 FEVERALL INF SUP 80MG .................. 11 feverall sup 120mg .......................... 11 feverall sup 325mg .......................... 11 feverall sup 650mg .......................... 11 fevr reducng sup 120mg ................... 11 fexofenadine hcl tab 180 mg ........31, 35 fexofenadine hcl tab 60 mg ............... 31 fexofenadine tab 180mg ................... 31 fexofenadine tab 60mg ................31, 35 fexofenadine-pseudoephedrine tab er 12hr 60-120 mg .............................. 80 fexofenadine-pseudoephedrine tab er 24hr 180-240 mg ............................ 80 FIFTY50 MIS 31GX3/16 .................. 119 FIFTY50 MIS 31GX5/16 .................. 119 FIFTY50 MIS 31GX5MM .................. 119 FIFTY50 PEN MIS 31GX8MM ............ 119 FIFTY50 PEN MIS 32GX4MM ............ 119 FIFTY50 PEN MIS 32GX6MM ............ 119 FIFTY50 PREP PAD PADS................. 125 FIFTY50 SAFE MIS LANCETS ....... 86, 115 FILTER AIR MIS PP .................. 121, 179 finasteride tab 5 mg ....................... 174 FINE 30 MIS ............................. 86, 115 finest fish liq oil ............................. 126 finest fish liq oil/kids................ 126, 159 FINGERSTIX MIS LANCETS ................ 86 FIRST AID MIS ANTIBACT ................. 54 FIRST AID MIS FLEX FAB .................. 54 FIRST AID MIS SHEER ...................... 54 FIRST AID NO PAD STICK ................. 54 first aid oin antibiot .......................... 20 first aid sol 10% ............................ 106

FISH OIL CAP 1000MG ................... 126 fish oil cap 1200mg ................. 126, 159 FISH OIL CAP 1360MG ............. 126, 159 FISH OIL CAP 1400MG ............. 126, 159 fish oil cap 300mg ......................... 126

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fish oil cap 435mg................... 126, 159 fish oil cap 500mg .......................... 159 fish oil chw gummies ...................... 126 fish oil con cap 1000mg .................. 126 fish oil con cap 300mg .................... 126 FITNESS TABS TAB MEN ................. 133 FITNESS TABS TAB WOMEN ............. 133 flanax pain tab 220mg .................... 158 flavor chews chw 750mg ................... 16 flecainide acetate tab 100 mg ............ 19 flecainide acetate tab 150 mg ............ 19 flecainide acetate tab 50 mg .............. 19 FLEX BANDAGE MIS .................. 54, 113 flexgen tab ...................................... 59 FLEXICHAMBER MIS ....................... 180 FLEXICHAMBER MIS MASK LRG ........ 180 FLEXICHAMBER MIS MASK SM.. 121, 180 flintstones chw bone bld .................. 167 flintstones chw complete.......... 152, 167 flintstones chw extra c .................... 169 flintstones chw my first ................... 169 flintstones chw omega-3 ................. 169 flintstones chw pls calc ................... 169 FLINTSTONES CHW TODDLER .......... 167 flnston plus chw iron ...................... 168 flora assist pak ................................ 24 FLORAJEN CAP ACIDOPHI ............ 24, 26 floranex gra ............................... 24, 26 floranex tab .................................... 24 FLORIVA DRO PLUS ........................ 152 FLOVENT DISK AER 100MCG.............. 19 FLOVENT DISK AER 250MCG.............. 19 FLOVENT DISK AER 50MCG ............... 19 FLOVENT HFA AER 110MCG ............... 20 FLOVENT HFA AER 220MCG ............... 20 FLOVENT HFA AER 44MCG ................. 20 fluconazole for susp 10 mg/ml ......... 105 fluconazole for susp 40 mg/ml ......... 105 fluconazole tab 100 mg ................... 105 fluconazole tab 150 mg ................... 105 fluconazole tab 200 mg ................... 105 fluconazole tab 50 mg .................... 105 fludrocortisone acetate tab 0.1 mg ... 124 flunisolide nasal soln 25 mcg/act (0.025%)...................................... 155 fluocinolone acetonide cream 0.025% .75 fluocinolone acetonide oint 0.025% .... 75

fluocinolone acetonide soln 0.01% ..... 75 fluocinonide cream 0.05% ................ 75 fluocinonide gel 0.05% ..................... 83 fluocinonide oint 0.05% .................... 83 fluocinonide soln 0.05% ................... 75 fluoridex pst 1.1% ........................... 82 fluoritab chw 0.25mg f ............... 98, 125 fluoritab chw 0.5mg f ....................... 98 fluoritab chw 1mg f .......................... 98 fluoritab chw 2.2mg ......................... 98 fluoritab dro 0.125mg ...................... 98 fluorometholone ophth susp 0.1% .... 163 fluorouracil cream 5% ...................... 40 flura-drops dro 0.25mg f................... 98 flurbiprofen tab 100 mg .................. 158 flurbiprofen tab 50 mg ................... 158 flutamide cap 125 mg ...................... 39 fluticasone propionate cream 0.05% ... 75 fluticasone propionate nasal susp 50 mcg/act ....................................... 155 fluticasone propionate oint 0.005% .... 75 fluticasone spr 50mcg .............. 155, 156 fluticasone-salmeterol aer powder ba 113-14 mcg/act .............................. 20 fluticasone-salmeterol aer powder ba 232-14 mcg/act .............................. 20 FLYP NEBULZR MIS ........................ 121 foam antacid chw 80-20mg ............... 15 foam antacid sus ............................. 15 foaming face liq wsh 10% ................... 5 folbee tab ..................................... 103 folbic tab ........................................ 92 folic acid tab 1 mg ........................... 99 folic acid tab 1000mcg ...................... 99 folic acid tab 400 mcg ...................... 99 folic acid tab 800mcg ....................... 99 folic acid-vitamin b6-vitamin b12 tab 2.2-25-0.5 mg .............................. 103 folplex 2.2 tab............................... 103 fondaparinux sodium subcutaneous inj 10 mg/0.8ml ................................... 21 fondaparinux sodium subcutaneous inj 2.5 mg/0.5ml .................................. 21 fondaparinux sodium subcutaneous inj 5 mg/0.4ml ....................................... 21 fondaparinux sodium subcutaneous inj 7.5 mg/0.6ml ................................. 21

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foot&sneaker aer 1% ........................ 29 for sty reli oin .................................. 45 FORA LANCETS MIS 30G ................... 86 FORA MIS LANCETS ......................... 86 formula 3 sol ................................... 29 FORTAVIT LIQ ............................... 133 fosinopril sodium & hydrochlorothiazide tab 10-12.5 mg ............................... 36 fosinopril sodium & hydrochlorothiazide tab 20-12.5 mg ............................... 36 fosinopril sodium tab 10 mg ............... 3 fosinopril sodium tab 20 mg ............... 3 fosinopril sodium tab 40 mg ............... 3 FREEDAVITE TAB .................... 133, 146 FREESTYLE MIS LANCETS .......... 86, 115 FREESTYLE MIS UNISTICK ................. 86 FRUIT C CHW 200MG ........................ 59 fruity chews chw ............................ 169 fruity chews chw /iron .................... 168 FULL KIT NEB MIS SET .................... 179 FULL SPECT TAB B/ VIT C .......... 49, 143 fungicure spr intens .......................... 29 fungi-guard cre 1% .......................... 29 fungoid-d cre 1% ............................. 29 furosemide oral soln 10 mg/ml ........ 111 furosemide oral soln 8 mg/ml .......... 111 furosemide tab 20 mg .................... 111 furosemide tab 40 mg .................... 111 furosemide tab 80 mg .................... 111 fyavolv tab 0.5-2.5 ........................... 96 fyavolv tab 1-5 ................................ 96 G g tussin ac liq 100-10/5 .................... 78 galantamine hydrobromide cap er 24hr 16 mg ............................................ 21 galantamine hydrobromide cap er 24hr 24 mg ............................................ 21 galantamine hydrobromide cap er 24hr 8 mg ................................................. 21 galantamine hydrobromide oral soln 4 mg/ml ............................................ 21 galantamine hydrobromide tab 12 mg .21 galantamine hydrobromide tab 4 mg ... 21 galantamine hydrobromide tab 8 mg ... 21 gas relief cap 125mg ........................ 27 gas relief cap 180mg ........................ 27 gas relief chw 125mg ........................ 27

gas relief chw 80mg ......................... 27 gas relief dro 20/0.3ml ..................... 27 gas relief dro 40/0.6ml ..................... 27 gas relief dro infants ........................ 27 gas relief liq infants ......................... 27 gas-x cap 125mg ............................. 27 gas-x cap 180mg ............................. 27 GAS-X CHILD MIS 40MG ................... 27 GAS-X EX-STR MIS 62.5MG .............. 27 gas-x infant dro .............................. 27 gavilax pow .................................. 110 gavilyte-c sol ................................ 108 gavilyte-g sol ................................ 108 gavilyte-n sol flav pk ...................... 108 gavis-care sus ................................. 16 GAVISCON CHW .............................. 15 GEL-ONE INJ 30MG/3ML ................. 154 gemfibrozil tab 600 mg ..................... 98 genahist cap 25mg .......................... 33 genaphed tab 30mg ....................... 192 generlac sol 10gm/15 ..................... 106 gengraf cap 100mg ........................ 105 gengraf cap 25mg ......................... 105 gengraf sol 100mg/ml .................... 105 genpril tab 200mg ......................... 158 gentak oin 0.3% op ....................... 162 GENTAMICIN POW SULFATE .........20, 82 gentamicin sulfate cream 0.1% ......... 20 gentamicin sulfate oint 0.1% ............. 20 gentamicin sulfate ophth soln 0.3% .. 162 GENTEAL GEL 0.3% ......................... 47 GENTEAL MILD DRO 0.2% ................ 47 genteal tear oin nt-time .................... 45 genteal tear sol mild ........................ 46 genteal tear sol moderate ................. 46 GENTEEL MIS LANCETS .................. 115 GENTIAN VIOL POW ......................... 29 gentle laxat sup 10mg .................... 188 gentle laxat tab 5mg ec .................. 188 gentlelax pow ............................... 110 GENTLE-LET MIS 26G ................ 86, 115 GENTLE-LET MIS 28G ................ 86, 115 GENTLE-LET MIS LANCETS ......... 86, 115 GERAVINE ELX .............................. 201 GERBR SOOTHE DRO COLIC .........24, 26 geriaton liq ..................................... 51 GERIATRIC LIQ VITAMIN .................. 51

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geri-dryl cap 25mg ........................... 33 geri-dryl liq 12.5/5ml ........................ 31 geri-dryl tab 25mg ........................... 33 GERI-FREEDA TAB SENIOR ...... 133, 146 geri-hydrola cre 12% ........................ 94 geri-hydrola lot 12% ........................ 94 geri-kot tab 8.6mg ......................... 188 geri-lanta sus .................................. 14 geri-lanta sus supreme ..................... 15 geri-mox sus ................................... 14 geri-pectate sus 262/15ml ................ 24 geri-tussin syp 100/5ml .................... 97 geri-tussin syp dm ........................... 78 gerivite tab complete ...................... 133 GERM DEFENSE TAB LEM-LIME ........ 186 GERM DEFENSE TAB ORANGE... 153, 186 GERM DEFENSE TAB PM........... 153, 186 g-fen ex tab 400mg .......................... 97 gianvi tab 3-0.02mg ......................... 69 GILENYA CAP 0.5MG ....................... 128 GILOTRIF TAB 20MG ......................... 39 GILOTRIF TAB 30MG ......................... 40 GILOTRIF TAB 40MG ......................... 40 giltuss cgh liq & chest ....................... 77 GLASSIA INJ ................................. 176 glatiramer acetate soln prefilled syringe 20 mg/ml...................................... 175 glatiramer acetate soln prefilled syringe 40 mg/ml...................................... 175 glatopa inj 20mg/ml ....................... 175 glatopa inj 40mg/ml ....................... 175 GLEOSTINE CAP 100MG ..................... 5 GLEOSTINE CAP 10MG ....................... 5 GLEOSTINE CAP 40MG ....................... 5 g-levocarnit sol 1gm/10ml ............... 174 glimepiride tab 1 mg ...................... 190 glimepiride tab 2 mg ...................... 190 glimepiride tab 4 mg ...................... 190 glipizide tab 10 mg ......................... 190 glipizide tab 5 mg ........................... 190 glipizide tab er 24hr 10 mg .............. 190 glipizide tab er 24hr 2.5 mg ............. 190 glipizide tab er 24hr 5 mg ............... 190 glipizide xl tab 10mg ................. 23, 190 glipizide xl tab 2.5mg ..................... 190 glipizide xl tab 5mg ................... 23, 190 glipizide-metformin hcl tab 2.5-250 mg

...................................................... 22 glipizide-metformin hcl tab 2.5-500 mg ...................................................... 22 glipizide-metformin hcl tab 5-500 mg . 22 GLOBAL 28G MIS LANCETS ............... 86 GLOBAL 30G MIS LANCETS ............... 86 GLOBAL PREP PAD PADS ................. 125 GLUCAGEN INJ HYPOKIT ................... 22 GLUCAGON KIT 1MG ........................ 22 GLUCO COR CAP............................ 186 GLUCOCOM MIS 28G ........................ 86 GLUCOCOM MIS 30G ........................ 86 GLUCOCOM MIS 33G ........................ 86 glucoten cap ................................. 133 glyburide micronized tab 1.5 mg ...... 190 glyburide micronized tab 3 mg ......... 190 glyburide micronized tab 6 mg ......... 190 glyburide tab 1.25 mg .................... 190 glyburide tab 2.5 mg ...................... 190 glyburide tab 5 mg ........................ 190 glyburide-metformin tab 1.25-250 mg 22 glyburide-metformin tab 2.5-500 mg .. 22 glyburide-metformin tab 5-500 mg ..... 22 glycine diluent for injection ............. 170 glycolax pow 3350 nf ..................... 110 glycopyrrolate tab 1 mg .................... 45 glycopyrrolate tab 2 mg .................... 45 GLYCO-TECH TAB ............................ 51 GLYCOTROL CAP ..................... 153, 186 GLYCOTROL CAP COMPLETE ..... 153, 186 gnp acetamin cap 500mg .................... 9 gnp acetamin tab 325mg .................... 9 GNP ADHESIVE PAD 3 ...................... 54 GNP ALCOHOL PAD SWABS ............. 125 gnp all day tab allergy ...................... 35 gnp allergy cap 25mg ....................... 33 gnp allergy chw 12.5mg ................... 31 gnp allergy tab 180mg .................31, 35 gnp allergy tab 25mg ....................... 33 gnp allergy tab 4mg ......................... 32 gnp animal chw plus c ............. 153, 169 gnp animal chw shapes .................. 169 gnp antacid chw 1000mg .................. 16 gnp antacid chw 160-105.................. 15 gnp antacid chw 550-110.................. 15 gnp antacid sus anti-gas ................... 14 gnp antacid sus cherry ..................... 14

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gnp antacid sus coolmint ................... 16 gnp antacid sus original .................... 16 gnp antacid sus reg st ...................... 16 gnp aspirin chw 81mg .................... 183 gnp aspirin tab 325mg .................... 183 gnp aspirin tab 325mg ec ................ 183 gnp aspirin tab 81mg ec ................. 183 gnp b-100 tab .......................... 49, 143 gnp b-100 tab complex ..................... 50 gnp b-50 tab balanced............... 50, 143 gnp b-50 tab complex ...................... 50 gnp bisa-lax tab 5mg ec ................. 188 gnp ca/mg/zn tab ............................ 63 gnp calcium tab 500/d ...................... 63 gnp calcium tab 600/d ...................... 63 gnp calcium tab cit +d3 .................... 63 gnp century tab ...................... 133, 146 gnp century tab adult ..................... 133 gnp century tab cardio............. 133, 146 GNP CENTURY TAB ENERGY ............. 153 gnp century tab mature ........... 133, 146 gnp century tab senior............. 133, 146 gnp century tab ultimate.......... 133, 146 gnp clearlax pak 3350 nf ................. 109 gnp clearlax pow ............................ 110 gnp d cap 1000unit ........................ 160 gnp d chw 2000unit ....................... 160 gnp dayhist tab 1.34mg .................... 33 gnp deconge tab 30mg ................... 155 gnp ear dro 6.5% ot ....................... 165 gnp ear drop sol 6.5% ot ................ 165 gnp ear sys sol 6.5% ot .................. 165 gnp eye drop dro 0.4-0.3% ............. 161 gnp eye drop sol 0.5% op ............... 161 gnp fish oil cap ....................... 126, 159 gnp fish oil cap 1000mg .................. 126 gnp gas relf chw 125mg .................... 27 gnp gas relf chw 80mg ..................... 27 gnp healthy tab eyes ............... 133, 146 gnp hydrocor cre 1% plus ............ 75, 83 gnp iron tab 325mg ........................ 107 gnp iron tab 45mg ......................... 107 gnp iron tab 65mg ......................... 107 gnp k-pec sus 262/15ml ................... 24 GNP LANCETS MIS .................... 86, 116 GNP LANCETS MIS 21G ............. 86, 116 GNP LANCETS MIS MICRO ................. 86

GNP LANCETS MIS SUP THIN ............ 86 GNP LANCETS MIS THIN ................... 86 GNP LANCETS MIS THIN 26G...... 86, 116 gnp laxative sup 10mg ................... 188 gnp laxative tab 25mg ................... 188 gnp laxative tab 5mg ec ................. 188 gnp little chw ones ......................... 169 gnp masanti sus max st .................... 14 gnp masanti sus reg st ..................... 14 gnp mucus d tab 12hr ...................... 80 gnp mucus er tab 1200mg ................ 77 gnp mucus er tab 600mg .................. 77 gnp mucus liq rlf dm ........................ 78 gnp one dail tab maximum ....... 133, 147 gnp opti-vit tab ............................. 133 gnp pediatri sol electrol .................... 93 GNP PLASTIC MIS 3/4 ...................... 54 gnp senna tab 8.6mg ..................... 109 GNP SHEER MIS STRIPS ................... 54 GNP SHEER ST MIS ASSORTED ......... 54 GNP SUPER MIS STRIP ..................... 54 gnp suphedrn liq 15mg/5ml ............ 192 gnp triple oin antibiot ....................... 20 gnp tussin liq dm ............................. 78 gnp tussin liq dm cough .................... 78 gnp tussin liq dm max ...................... 78 gnp vit d tab 1000unit .................... 160 gnp vit d tab 5000unit .................... 160 gnp vit d3 tab 1000unit .................. 160 gnp zoochews chw gummies ..... 152, 167 GNTL ADHESVE MIS BNDG XL ........... 54 GOLYTELY SOL .............................. 108 GOODSENSE MIS LANC 26G ............ 116 GOODSENSE MIS LANC 30G ....... 86, 116 GOODSENSE MIS LANC 33G ............ 116 gordons urea cre 40% ...................... 84 granisetron hcl tab 1 mg ..................... 3 GREEN SOURCE TAB ...................... 186 griseofulvin microsize susp 125 mg/5ml ...................................................... 28 griseofulvin ultramicrosize tab 125 mg 28 griseofulvin ultramicrosize tab 250 mg 28 guaiasorb dm liq 100-10/5 ................ 78 guaiatussin syp 100-10/5 ................. 78 guaicon dms syp 100-10/5 ............... 78 guaifenesin liquid 100 mg/5ml .......... 97 guaifenesin syp 100-10/5 ................. 78

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guaifenesin tab 200 mg .................... 97 guaifenesin tab 400 mg .................... 97 guaifenesin tab er 12hr 1200 mg ....... 97 guaifenesin-codeine soln 100-10 mg/5ml ................................................ 77, 78 guanfacine hcl tab 1 mg .................... 18 guanfacine hcl tab 2 mg .................... 18 gummi bear chw multivit ................ 167 gummies chw ................................ 167 gummy dinos chw .......................... 167 gummy dinos chw chldrn ................. 152 gummy multiv chw kids .................. 167 gummy vit/ chw minerals ................ 167 gynecort 10 cre 1% .......................... 75 GYNOL II GEL 3% .......................... 187 H H.P. ACTHAR INJ 80UNIT .................. 94 HAEMOLANCE MIS HIGH FLO...... 86, 116 HAEMOLANCE MIS LOW FLOW .... 86, 116 HAEMOLANCE MIS PLUS ............ 86, 116 HAEMOLANCE MIS PLUS LOW..... 87, 116 HAEMOLANCE MIS PLUS MAX ..... 87, 116 HAEMOLANCE MIS PLUS PED...... 87, 116 HAEMOLANCE MIS RETRACT ...... 87, 116 HAIR FARE TAB .............................. 186 hair formula tab ex stren ................. 133 hair formula tab ultr man ................ 133 HAIR NOURISH TAB SUPPLEMN 153, 186 hair skin tab nails ........................... 133 hair vitamin tab ............................. 133 hair/skin cap nails ................... 133, 147 hair/skin/ cap nails ......................... 147 hair/skin/ tab nails .... 133, 147, 153, 186 halobetasol propionate cream 0.05% 75 halobetasol propionate oint 0.05% 83 hand wash sol 2% ............................ 68 HARVONI TAB 90-400MG ................ 103 healthy eyes cap supervis ........ 133, 147 healthy eyes tab ..................... 133, 147 healthy eyes tab lutein ............ 133, 147 healthy hair tab skn/nail ................. 151 healthy kids chw gummies ............... 126 HEALTHY KIDS CHW GUMMIES ........ 167 healthy kids chw overall .................. 167 HEALTHY TAB HEART ...................... 186 HEART SAVIOR CAP ........................ 186 HEART TAB 140MG ......................... 186

heartbrn ant chw 160-105 ................ 15 heartbrn rel tab 200mg .................. 101 heartbrn rlf chw 160-105 .................. 15 heartburn chw ex st ......................... 15 heartburn sus relief ......................... 15 heartburn tab 150mg............... 101, 196 heartburn tab 200mg............... 101, 196 heartburn tab 20mg ................ 101, 196 heartburn tab relief ................. 101, 196 heartburn tr cap 15mg............. 174, 196 heartburn tr cap 24h 20mg ............. 195 heather tab 0.35mg ....................... 173 HEAVY DUTY MIS BANDAGES ............ 54 HEAVY DUTY MIS CLR&TGH........ 54, 113 HEAVY DUTY MIS FAB BAND ....... 54, 113 hi c-500 tab .................................... 59 high potency tab fe 27mg ............... 107 hi-kovite tab 2-part ................. 133, 147 HINEY HEALER CRE .....................84, 92 hi-potency tab multivit ................... 133 HLTHY ACCNTS MIS LANC 30G .......... 87 hm allergy cap 25mg ....................... 33 hm allergy tab 25mg ........................ 33 hm allergy tab 4mg .......................... 32 hm animal chw shapes ................... 167 hm antacid sus ................................ 14 hm antacid sus anti-gas .................... 14 hm arthrts tab 650mg ...................... 11 hm aspirin chw 81mg ..................... 183 hm aspirin tab 325mg .................... 183 hm b complex tab with c ................... 49 HM BUTTERFLY MIS CLOSURES ......... 54 hm ca/vit d3 tab 600-400 .......... 63, 124 hm ca/vit d3 tab 600-800 ............... 124 hm calcium tab citr+d ...................... 63 HM CASTOR OIL ............................ 111 hm clearlax pow ............................ 110 hm complete tab ........................... 133 HM COMPLETE TAB ........................ 133 hm complete tab 50+ .............. 133, 147 hm complete tab women ................ 133 hm dry eye sol relief ........................ 45 HM ESTROPLUS TAB ...................... 186 hm fish oil cap 1000mg .................. 126 hm fish oil cap 1200mg............ 126, 159 hm gas relf chw 125mg .................... 27 hm gas relf chw 80mg ...................... 27

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HM HAIR/SKIN TAB /NAILS ...... 133, 147 hm hydrocort cre 1% plus............ 76, 83 hm ibuprofen chw 100mg ................ 158 hm ibuprofen tab 200mg ................. 158 hm iron tab 45mg .......................... 107 hm iron tab 65mg .......................... 107 hm laxative sup 10mg .................... 188 hm laxative tab 5mg ....................... 188 hm laxative tab 5mg ec ................... 188 hm mucus er tab 1200mg ................. 97 hm multivit chw gummy .................. 133 hm nighttime tab 25mg .................... 30 hm one daily tab /iron .................... 128 hm one daily tab essentia ............... 128 HM ONE DAILY TAB ESSENTIA ......... 128 HM ONE DAILY TAB MENS ............... 133 hm pain rlf tab 650mg ...................... 11 hm povid-iod sol 10% ..................... 107 hm probiotic cap .............................. 24 hm rpd melt tab 160mg .................... 11 hm saline spr 0.65% ...................... 154 hm senna tab 8.6mg ...................... 188 hm senna-s tab 8.6-50mg ............... 109 hm sleep aid tab 25mg ..................... 30 HM STERILE PAD ALCHOL ................ 118 hm stomach sus 262/15ml ................ 24 hm triple oin antibiot ........................ 20 hm tussin liq adlt dm ........................ 78 hm tussin liq dm max ....................... 78 HM ULTICARE MIS 31GX8MM ........... 119 hm vit d3 cap 2000unit ................... 160 hm vitamin d tab 1000unit .............. 160 hm vita-mini tab multi .................... 128 HOLD CHAMBER MIS ADLT LG ......... 180 HOLD CHAMBER MIS MEDIUM .......... 180 HOLD CHAMBER MIS SMALL ............ 181 HOMENEB MIS SIDESTRE ........ 121, 177 HONEY BEARS CHW ....................... 169 HONEY BEARS CHW IRON-ZIN . 153, 168 HUMALOG MIX INJ 50/50 .................. 23 HUMALOG MIX INJ 50/50KWP ............ 23 HUMALOG MIX INJ 75/25KWP ............ 23 HUMALOG MIX SUS 75/25 ................. 23 HUMIRA INJ 10MG/0.2 ....................... 8 HUMIRA KIT 20MG/0.4 ..................... 18 HUMIRA KIT 40MG/0.8 ..................... 18 HUMIRA PEDIA INJ CROHNS ............... 8

HUMIRA PEN INJ 40MG/0.8 ................. 8 HUMIRA PEN INJ CD/UC/HS ................ 8 HUMIRA PEN INJ PS/UV ...................... 8 HUMIRA PEN KIT CD/UC/HS ................ 8 HUMIRA PEN KIT PS/UV ..................... 8 HUMULIN INJ 70/30 ......................... 23 HUMULIN INJ 70/30KWP .................. 23 HUMULIN N INJ U-100 ..................... 23 HUMULIN N INJ U-100KWP ............... 23 HUMULIN R INJ U-100 ...................... 23 HUMULIN R INJ U-500 ...................... 23 HYALEX TAB ................................. 133 hydralazine hcl tab 10 mg ............... 198 hydralazine hcl tab 100 mg ............. 198 hydralazine hcl tab 25 mg ............... 198 hydralazine hcl tab 50 mg ............... 198 hydrochlorothiazide cap 12.5 mg ..... 193 hydrochlorothiazide tab 12.5 mg ...... 193 hydrochlorothiazide tab 25 mg ........ 193 hydrochlorothiazide tab 50 mg ........ 193 hydrocodone w/ homatropine syrup 5-1.5 mg/5ml ................................. 45 hydrocodone w/ homatropine tab 5-1.5 mg ................................................ 45 hydrocodone-acetaminophen soln 7.5-325 mg/15ml .......................... 165 hydrocodone-acetaminophen tab 10-325 mg ................................................ 10 hydrocodone-acetaminophen tab 5-325 mg ................................................ 10 hydrocodone-acetaminophen tab 7.5-325 mg ................................................ 10 hydrocort cre 1% ........................75, 83 hydrocort cre 1% plus ...................... 75 hydrocort cre plus 1% ...................... 75 hydrocort oin 1% ........................75, 83 hydrocort/ cre aloe 1% ................76, 83 hydrocortisone butyrate cream 0.1% .. 75 hydrocortisone butyrate oint 0.1% ..... 75 hydrocortisone butyrate soln 0.1% ..... 75 hydrocortisone cream 0.5% .............. 75 hydrocortisone cream 1% ............75, 83 hydrocortisone cream 2.5% .............. 75 hydrocortisone enema 100 mg/60ml 106 hydrocortisone lotion 1% .................. 75 hydrocortisone lotion 2.5% ............... 75 hydrocortisone oint 0.5% .................. 75

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hydrocortisone oint 1% ............... 75, 84 hydrocortisone oint 2.5% .................. 75 hydrocortisone rectal cream 1% ....... 176 hydrocortisone rectal cream 2.5% .... 176 hydrocortisone tab 10 mg ............... 100 hydrocortisone tab 20 mg ............... 100 hydrocortisone tab 5 mg ................. 100 hydrocortisone valerate cream 0.2% ... 75 hydrocortisone valerate oint 0.2% ...... 75 hydrocortisone-aloe vera cream 1% .... 84 hydrocream cre 1% .......................... 75 hydromet syp 5-1.5/5 ....................... 45 hydromorphone hcl tab 2 mg ........... 164 hydromorphone hcl tab 4 mg ........... 164 hydromorphone hcl tab 8 mg ........... 164 hydroskin lot 1% .............................. 75 hydroxychloroquine sulfate tab 200 mg ......................................................37 hydroxyurea cap 500 mg .................. 42 hyoscyamine sulfate elixir 0.125 mg/5ml ......................................................44 hyoscyamine sulfate sl tab 0.125 mg .. 44 hyoscyamine sulfate soln 0.125 mg/ml 44 hyoscyamine sulfate tab 0.125 mg ..... 44 hyoscyamine sulfate tab disint 0.125 mg ......................................................44 hyoscyamine sulfate tab er 12hr 0.375 mg ................................................. 44 HYPO-ALLERG MIS BANDAGE ..... 54, 113 hypotears oin op .............................. 46 HYPOTEARS SOL 1-1% ..................... 46 hyvee ibupro sus 100mg/5m ........... 158 I IBRANCE CAP 100MG ........................ 40 IBRANCE CAP 125MG ........................ 40 IBRANCE CAP 75MG ......................... 40 ibu tab 400mg ............................... 158 ibu tab 600mg ............................... 158 ibu tab 800mg ............................... 158 ibu-200 tab 200mg ........................ 158 ibu-drops dro 50/1.25 ..................... 158 ibuprfn liqd cap 200mg ................... 158 ibuprofen cap 200mg ...................... 158 ibuprofen ch sus 100/5ml ................... 9 ibuprofen dro 50/1.25 ..................... 158 ibuprofen ib chw 100mg .................. 158 ibuprofen jr chw 100mg .................. 158

ibuprofen js chw 100mg ................. 158 ibuprofen sus 100/5ml .................9, 158 ibuprofen susp 100 mg/5ml ..........9, 158 ibuprofen tab 200 mg .................... 158 ibuprofen tab 200mg ..................... 158 ibuprofen tab 400 mg .................... 158 ibuprofen tab 600 mg .................... 158 ibuprofen tab 800 mg .................... 158 ibuprofn 100 chw jr 100mg ................. 9 icaps areds cap 2 ........................... 134 ICAPS AREDS TAB FORMULA ........... 134 icaps cap................................ 134, 147 ICAPS CHW AREDS 2 ..................... 147 icaps lutein cap /omega-3 ............... 134 icaps mv tab........................... 134, 147 ICAPS PLUS TAB ..................... 134, 147 imatinib mesylate tab 100 mg (base equivalent) ..................................... 41 imatinib mesylate tab 400 mg (base equivalent) ..................................... 41 IMBRUVICA CAP 140MG .................... 40 imiquimod cream 5% ..................... 105 IMMUNE CHW SUPPORT.................. 134 IMMUNE SUPP POW VIT C ............... 134 immunicare cap ............................. 186 IMODIUM MS TAB RELIEF ................. 25 IN CONTROL MIS 31GX5MM ............ 119 IN CONTROL MIS 31GX8MM ............ 119 IN TOUCH LAN MIS 30G ................... 87 inatal gt tab .................................. 173 incassia tab 0.35mg ......................... 73 INCONTROL MIS LANC 28G ............... 87 INCONTROL MIS LANC 30G ............... 87 INCONTROL MIS LANC 33G ............... 87 INCONTROL PAD ALCOHOL ............. 125 INCRUSE ELPT INH 62.5MCG ............. 60 indapamide tab 1.25 mg ................. 193 indapamide tab 2.5 mg................... 193 INLYTA TAB 1MG ............................. 40 INLYTA TAB 5MG ............................. 40 INNOSPIRE EL MIS NEBULIZE ... 122, 177 INNOSPIRE ES MIS NEBULIZE .. 122, 177 INNOSPIRE MIS DEL NEBU ....... 122, 177 INNOSPIRE MIS MINI NEB ........ 122, 177 INSPIRACHAMB MIS LARGE ............ 181 INSPIRACHAMB MIS MEDIUM .......... 181 INSPIRACHAMB MIS MOUTHPCE ...... 181

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INSPIRACHAMB MIS SMALL ............. 181 INSPIRATION MIS ELITE .......... 122, 177 INSPIRATION MIS NEBULIZR ........... 177 INSPIREASE MIS DD SYST ............... 181 instacort 5 cre 0.5% ......................... 75 INSULIN PEN MIS 31GX8MM ............ 119 INSULIN SYRG MIS 0.3/30G ............ 166 INSULIN SYRG MIS 0.3/31G..... 119, 166 INSULIN SYRG MIS 0.5/30G..... 119, 166 INSULIN SYRG MIS 0.5/31G..... 119, 166 INSULIN SYRG MIS 1ML/30G ........... 166 INSULIN SYRG MIS 1ML/31G.... 119, 166 INSUPEN MIS 31GX5MM ................. 119 INSUPEN MIS 31GX8MM ................. 119 INSUPEN MIS 32GX4MM ................. 119 INSUPEN SENS MIS 32GX6MM ......... 119 INSUPEN ULTR MIS 31GX8MM ......... 119 intense coug liq reliever .................... 78 intestinex cap .................................. 24 INTRON A INJ 10MU ......................... 41 INTRON A INJ 18MU ......................... 41 INTRON A INJ 25MU ......................... 41 INTRON A INJ 50MU ......................... 41 INULOSE BLD CAP SUGAR ............... 186 INVOKAMET TAB 150-1000 ............... 22 INVOKAMET TAB 150-500 ................. 22 INVOKAMET TAB 50-1000 ................. 22 INVOKAMET TAB 50-500MG ............... 22 INVOKAMET XR TAB 150-1000 ........... 22 INVOKAMET XR TAB 150-500 ............. 22 INVOKAMET XR TAB 50-1000 ............. 22 INVOKAMET XR TAB 50-500MG .......... 22 INVOKANA TAB 100MG ................... 185 INVOKANA TAB 300MG ................... 185 ipratropium bromide inhal soln 0.02% .60 ipratropium bromide nasal soln 0.03% (21 mcg/spray) ............................. 155 ipratropium bromide nasal soln 0.06% (42 mcg/spray) ............................. 155 ipratropium-albuterol nebu soln 0.5-2.5(3) mg/3ml ......................... 192 irbesartan tab 150 mg ...................... 13 irbesartan tab 300 mg ...................... 13 irbesartan tab 75 mg ........................ 13 irbesartan-hydrochlorothiazide tab 150-12.5 mg ................................... 37 irbesartan-hydrochlorothiazide tab

300-12.5 mg .................................. 37 iron slow tab 45mg ........................ 107 iron supplem tab 325mg ................. 108 iron supplem tab therapy ................ 108 iron supplmt dro 15mg/ml .............. 108 iron suppmnt elx 220/5ml ............... 102 isibloom tab .................................... 71 ISONIAZID POW .............................. 38 isoniazid syrup 50 mg/5ml ................ 38 isoniazid tab 100 mg ........................ 38 isoniazid tab 300 mg ........................ 38 ISORDIL TAB 40MG ....................... 156 isosorbide dinitrate tab 10 mg ......... 156 isosorbide dinitrate tab 20 mg ......... 156 isosorbide dinitrate tab 30 mg ......... 156 isosorbide dinitrate tab 5 mg ........... 156 isosorbide dinitrate tab er 40 mg ..... 156 isosorbide mononitrate tab 10 mg .... 156 isosorbide mononitrate tab 20 mg .... 156 isosorbide mononitrate tab er 24hr 120 mg .............................................. 156 isosorbide mononitrate tab er 24hr 30 mg .............................................. 156 isosorbide mononitrate tab er 24hr 60 mg .............................................. 156 isotretinoin cap 10 mg ...................... 82 isotretinoin cap 20 mg ...................... 82 isotretinoin cap 30 mg ...................... 82 isotretinoin cap 40 mg ..................... 82 ISTODAX OVR INJ 10MG ................... 41 itchy eye dro 0.025%op ................. 163 itchy eye sol 0.025% ..................... 163 itraconazole cap 100 mg ................. 105 IV PREP WIPE PAD ........................... 44 ivermectin tab 3 mg ......................... 17 i-vite prote tab .............................. 134 i-vite tab ...................................... 134 J J & J ADHES PAD LARGE ................... 54 J&J GERM FIL MIS MASK ................ 176 JAKAFI TAB 10MG ............................ 40 JAKAFI TAB 15MG ............................ 40 JAKAFI TAB 20MG ............................ 40 JAKAFI TAB 25MG ........................... 40 JAKAFI TAB 5MG ............................. 40 jantoven tab 10mg .......................... 81 jantoven tab 1mg ............................ 81

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jantoven tab 2.5mg .......................... 81 jantoven tab 2mg ............................ 81 jantoven tab 3mg ............................ 81 jantoven tab 4mg ............................ 81 jantoven tab 5mg ............................ 81 jantoven tab 6mg ............................ 81 jantoven tab 7.5mg .......................... 81 JANUMET TAB 50-1000 ..................... 22 JANUMET TAB 50-500MG .................. 22 JANUMET XR TAB 100-1000 ............... 22 JANUMET XR TAB 50-1000 ................ 22 JANUMET XR TAB 50-500MG ............. 22 JANUVIA TAB 100MG ........................ 93 JANUVIA TAB 25MG .......................... 93 JANUVIA TAB 50MG .......................... 93 jck itch pow aer 1% .......................... 29 jencycla tab 0.35mg ....................... 173 jevantique l tab 0.5-2.5 .................... 96 jinteli tab 1mg-5mcg ........................ 96 JIVI INJ 1000UNIT ......................... 102 JIVI INJ 2000UNIT ......................... 102 JIVI INJ 3000UNIT ......................... 102 JIVI INJ 500 UNIT .......................... 102 jock itch aer 1% .............................. 29 jock itch cre 1% ......................... 29, 83 jolivette tab 0.35mg ....................... 173 juleber tab ...................................... 69 junel 1.5/30 tab ............................... 69 junel 1/20 tab ................................. 69 junel fe tab 1.5/30 ........................... 69 junel fe tab 1/20 .............................. 69 just d liq 400unit ........................... 160 just tears sol eye drop ...................... 46 K K2 PLUS D3 TAB ............................ 199 KALYDECO PAK 50MG ....................... 81 KALYDECO PAK 75MG ....................... 81 KALYDECO TAB 150MG ..................... 81 KAMELEON LUB MIS COLORS ............ 72 KAMELEON MIS TRI-COLR ................. 72 kaopectate sus 262/15ml .................. 24 kaopectate sus ex st ......................... 24 kaopectate tab 262mg ...................... 24 kao-tin cap 240mg ......................... 191 kao-tin sus 262/15ml ....................... 24 kariva tab 28 day ............................. 69 KAZ VAPORIZR MIS 1 GALLON ......... 181

KAZ VAPORIZR MIS 1.5 GAL ........... 181 KAZ VAPORIZR MIS 2.2 GAL ........... 181 k-effervesce tab 25meq ef .............. 172 kelnor 1/50 tab ............................... 71 kelnor tab 1/35 ............................... 69 kericort 10 cre 1% ........................... 75 ketoconazole cream 2% .................... 29 ketoconazole shampoo 2% ................ 29 KETO-DIASTIX TES .......................... 92 ketorolac tromethamine ophth soln 0.4% .................................................... 163 ketorolac tromethamine ophth soln 0.5% .................................................... 163 ketorolac tromethamine tab 10 mg ... 158 ketotif fum dro 0.025%op ............... 163 KEVZARA INJ 150/1.14 ....................... 9 KEVZARA INJ 200/1.14 ....................... 9 KIDNEY TAB 280MG ....................... 186 kids vit d3 chw 1000unit ................. 200 KIMONO COLOR MIS ................. 72, 114 KIMONO MICRO MIS THIN.......... 72, 114 KIMONO MICRO MIS THIN + ...... 72, 114 KIMONO MICRO MIS THIN PLS .......... 72 KIMONO MIS LUBRICAT ............. 72, 114 KIMONO MIS SENSATIO ................. 114 KIMONO PLUS MIS LUBRICAT ..... 72, 114 KIMONO PLUS MIS SPERMICI ............ 72 KIMONO PS MIS LUBRICAT ............... 72 KIMONO PS MIS PLUS ...................... 72 KIMONO SENSA MIS PLUS .............. 114 KIMONO SPEC MIS .................... 72, 114 KINNEY MIS LANCETS ...................... 87 KINNEY THIN MIS LANCETS .............. 87 kionex sus 15gm/60 ...................... 172 klor-con 10 tab 10meq er ............... 172 klor-con 8 tab 8meq er ................... 172 klor-con m10 tab 10meq er ............. 172 klor-con m20 tab 20meq er ............. 172 klor-con spr cap 10meq .................. 172 klor-con spr cap 8meq .................... 172 klor-con/ef tab 25meq fr ................. 172 kls allergy tab 25mg ........................ 33 kls anti-dia tab 2mg ......................... 43 kls aspirin tab 325mg ec ................. 183 kls aspirin tab 81mg ec................... 183 kls hydrocrt cre pls 1% ................76, 84 kls ibuprofn tab 200mg ................... 158

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kls naproxen tab 220mg ................. 158 kobee tab ................................ 50, 143 kp adult 50+ tab daily ............. 134, 147 kp adults tab daily .................. 134, 147 kp aspirin tab 81mg ec ................... 183 kp b complex tab /c .......................... 49 kp bisacodyl tab 5mg ec .................. 188 kp ca/mg/zn tab .............................. 63 kp calcium cap 600+d ....................... 63 kp calcium tab +d ............................ 63 kp calcium tab 600+d ....................... 63 kp fish oil cap 1200mg .................... 126 kp loratadin tab 10mg ...................... 35 kp melatonin tab 3mg ........................ 6 kp mens 50+ tab daily ............ 134, 147 KP MENS MIS DAILY PK .................. 134 kp mens tab daily ........................... 134 kp senna tab 8.6mg ....................... 188 kp vision tab for/ltn ........................ 134 kp vision tab formula ...................... 134 kp women 50+ tab daily .......... 134, 147 KP WOMENS PAK DAILY .................. 134 kp womens tab daily ............... 134, 147 K-PAX CAP DOUBLE ........................ 134 K-PAX CAP SINGLE ......................... 134 K-PAX TAB PROF ST ................ 134, 147 K-PHOS TAB .................................. 171 k-prime tab 25meq ef ..................... 172 KRISTALOSE PAK 10GM .................. 109 KRISTALOSE PAK 20GM .................. 110 KROGER LANCE MIS ......................... 87 KROGER LANCE MIS THIN.......... 87, 116 KROGER LANCE MIS THIN 30G ........... 87 ks ibuprofen cap 200mg .................. 158 kurvelo tab 0.15/30 .......................... 69 KUVAN POW 100MG ....................... 124 KUVAN TAB 100MG ........................ 124 k-vescent tab 25meq ef .................. 172 KYLEENA IUD 19.5MG ..................... 173 L labetalol hcl tab 100 mg ..................... 6 labetalol hcl tab 200 mg ..................... 6 labetalol hcl tab 300 mg ..................... 6 lactic acid (ammonium lactate) cream 12%.......................................... 84, 94 lactic acid (ammonium lactate) lotion 12%.......................................... 84, 94

lactinex chw ................................... 24 lactobacillu cap ............................... 24 lactobacillus - packet ....................... 26 lactobacillus cap..........................24, 26 lactobacillus tab ..........................24, 26 LACTO-BIFIDU CAP -600 ..............24, 26 lacto-key- cap 100 ........................... 24 lacto-key- cap 600 ........................... 24 lactulose (encephalopathy) solution 10 gm/15ml .................................. 99, 106 lactulose oral crystal packet 10 gm 109 lactulose solution 10 gm/15ml ......... 110 lamisil af aer 1% ............................. 29 lamivudine tab 100 mg (hbv) .......... 103 lanabiotic oin .................................. 20 lanacort 10 cre 1% ......................75, 84 LANCET MICRO MIS THIN 33G .... 87, 116 LANCET STAND MIS 21G............ 87, 116 LANCET SUPER MIS THIN 30G .... 87, 116 LANCET ULTRA MIS 28G ................... 87 LANCET ULTRA MIS FINE .................. 87 LANCET ULTRA MIS THIN 30G .... 87, 116 LANCETS MICR MIS THIN 33G .... 87, 116 LANCETS MIS ........................... 87, 116 LANCETS MIS 21G..................... 87, 116 LANCETS MIS 21G COLR ............ 87, 116 LANCETS MIS 26G..................... 87, 116 LANCETS MIS 28G..................... 87, 116 LANCETS MIS 30G..................... 87, 116 LANCETS MIS 31G ........................... 87 LANCETS MIS 33G..................... 87, 116 LANCETS MIS ORANGE ..................... 87 LANCETS MIS ORIGINAL ................... 87 LANCETS MIS THIN .......................... 87 LANCETS MIS THIN 26G ................... 87 LANCETS MIS THIN 30G ................... 87 LANCETS SUPR MIS THIN 28G .... 87, 116 LANCETS THIN MIS ................... 87, 116 LANCETS THIN MIS 26G............. 87, 116 LANCETS ULTR MIS THIN ........... 87, 116 land bfr tim chw vit/c ..................... 169 land bfr tim chw vit/iron ................. 168 LANOXIN TAB 0.0625MG .................. 66 LANOXIN TAB 0.1875MG .................. 66 lansoprazole cap 15mg dr ........ 174, 196 lansoprazole cap delayed release 15 mg ............................................. 174, 196

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larin fe tab 1.5/30 ............................ 69 larin fe tab 1/20 .............................. 69 larin tab 1.5/30 ............................... 69 larin tab 1/20 .................................. 69 larissia tab ...................................... 69 latanoprost ophth soln 0.005%. 162, 174 lax/stl soft tab 8.6-50mg ................ 109 laxa basic cap 100mg ..................... 191 laxacin tab 8.6-50mg ..................... 109 laxaclear pow ......................... 109, 110 laxative chw 15mg ......................... 188 laxative pls tab 8.6-50mg ............... 109 laxative sup 10mg ......................... 188 laxative tab 15mg .......................... 188 laxative tab 25mg .......................... 188 laxative tab 5mg ec ........................ 188 laxative tab max-str ....................... 188 laxative tab w/senna ...................... 188 LB LANCET MIS 28G ......................... 87 L-CARNITINE CAP 500MG ................ 174 L-CARNITINE TAB 250MG ................ 174 ledipasvir-sofosbuvir tab 90-400 mg ... 45 leena tab ........................................ 71 leflunomide tab 10 mg .................... 176 leflunomide tab 20 mg .................... 176 LENVIMA CAP 10 MG ........................ 40 LENVIMA CAP 12MG ......................... 41 LENVIMA CAP 14 MG ........................ 40 LENVIMA CAP 18 MG ........................ 40 LENVIMA CAP 20 MG ........................ 40 LENVIMA CAP 24 MG ........................ 40 LENVIMA CAP 4MG ........................... 41 LENVIMA CAP 8 MG .......................... 40 lessina tab ...................................... 70 LETAIRIS TAB 10MG ....................... 175 LETAIRIS TAB 5MG ........................ 175 letrozole tab 2.5 mg ......................... 39 leucovorin calcium tab 10 mg ............ 68 leucovorin calcium tab 15 mg ............ 68 leucovorin calcium tab 25 mg ............ 68 leucovorin calcium tab 5 mg .............. 68 LEUKERAN TAB 2MG .......................... 5 LEUKOSTRIP MIS 1/2 ....................... 54 LEUKOSTRIP MIS 1/4 ....................... 54 LEUKOSTRIP MIS 1/8X1.5 ................. 54 leuprolide acetate inj kit 5 mg/ml ....... 41 levobunolol hcl ophth soln 0.5% ......... 58

LEVOCARNITIN TAB 330MG ............ 174 levocarnitine (dietary) oral soln 1 gm/10ml ...................................... 159 levocarnitine cap 250 mg ................ 174 levocarnitine tab 500 mg.......... 159, 174 levofloxacin ophth soln 0.5% ........... 162 levofloxacin oral soln 25 mg/ml ......... 99 levofloxacin tab 250 mg ................... 99 levofloxacin tab 500 mg ................... 99 levofloxacin tab 750 mg ................... 99 levonest tab .................................... 70 levonorgestrel & ethinyl estradiol tab 0.1 mg-20 mcg ..................................... 70 levonorgestrel & ethinyl estradiol tab 0.15 mg-30 mcg .............................. 70 levonorgestrel tab 1.5 mg ................. 94 levonorgestrel-eth estra tab 0.05-30/0.075-40/0.125-30mg-mcg .. 71 levonorg-eth est tab 0.15-0.03mg(84) & eth est tab 0.01mg(7) ...................... 72 levora-28 tab 0.15/30 ...................... 70 levo-t tab 100mcg ......................... 194 levo-t tab 112mcg ......................... 194 levo-t tab 125mcg ......................... 194 levo-t tab 137mcg ......................... 194 levo-t tab 150mcg ......................... 194 levo-t tab 175mcg ......................... 194 levo-t tab 200 mcg ........................ 194 levo-t tab 25mcg ........................... 194 levo-t tab 300 mcg ........................ 194 levo-t tab 50mcg ........................... 194 levo-t tab 75mcg ........................... 194 levo-t tab 88mcg ........................... 194 levothyroxine sodium tab 100 mcg ... 194 levothyroxine sodium tab 112 mcg ... 194 levothyroxine sodium tab 125 mcg ... 194 levothyroxine sodium tab 137 mcg ... 194 levothyroxine sodium tab 150 mcg ... 194 levothyroxine sodium tab 175 mcg ... 194 levothyroxine sodium tab 200 mcg ... 194 levothyroxine sodium tab 25 mcg ..... 194 levothyroxine sodium tab 300 mcg ... 194 levothyroxine sodium tab 50 mcg ..... 194 levothyroxine sodium tab 75 mcg ..... 194 levothyroxine sodium tab 88 mcg ..... 194 levoxyl tab 100mcg ........................ 194 levoxyl tab 112mcg ........................ 194

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levoxyl tab 125mcg ........................ 195 levoxyl tab 137mcg ........................ 195 levoxyl tab 150mcg ........................ 195 levoxyl tab 175mcg ........................ 195 levoxyl tab 200mcg ........................ 195 levoxyl tab 25mcg .......................... 194 levoxyl tab 50mcg .......................... 194 levoxyl tab 75mcg .......................... 194 levoxyl tab 88mcg .......................... 194 lice bedding aer ............................. 184 lice bedding aer 0.5% ............... 84, 184 lice killing sha ................................ 184 lice killing sha 0.33-4% ................... 184 lice treatmt lot 1% ......................... 184 lice treatmt sha 0.33-4% ................ 184 lice trtmnt liq 1% ........................... 184 licide aer 0.5% .............................. 184 licide sha 0.33-4% ......................... 184 lidocaine hcl soln 4% ..................... 111 lidocaine hcl viscous soln 2% ............. 13 lidocaine patch 5% ......................... 111 lidocaine-prilocaine cream 2.5-2.5% .111 LIFE PACK MIS MENS .............. 134, 147 LIFE PACK MIS WOMENS ......... 134, 147 life pack tab mens................... 134, 147 life pack tab womens............... 134, 147 LIFESCAN MIS UNISTIK2 ................... 87 LIFESTYLES MIS COLORS ................ 114 LIFESTYLES MIS EXT STR .......... 72, 114 LIFESTYLES MIS FORM FIT ................ 72 LIFESTYLES MIS LUBRICAT ........ 72, 114 LIFESTYLES MIS RIBBED ................... 72 LIFESTYLES MIS SKYN ...................... 72 LIFESTYLES MIS SPERM/LU ............. 114 LIFESTYLES MIS STUDDED ........ 72, 114 LIFESTYLES MIS ULT/SENS ............. 114 LIFESTYLES MIS VIBRA-RI ......... 72, 114 LIFESTYLES MIS XPLEASUR........ 72, 114 LIGHT SHIELD MIS ......................... 176 LIGHT SHIELD MIS SLP MASK .......... 176 LILETTA IUD 52MG ......................... 173 lillow tab 0.15/30 ............................. 72 linezolid for susp 100 mg/5ml .......... 166 linezolid in sodium chloride iv soln 600 mg/300ml-0.9% .............................. 17 linezolid iv soln 600 mg/300ml (2 mg/ml) ........................................... 17

linezolid tab 600 mg ....................... 166 LINSEED OIL RAW ......................... 111 LINZESS CAP 145MCG .................... 108 LINZESS CAP 290MCG .................... 108 LINZESS CAP 72MCG ....................... 99 liothyronine sodium tab 25 mcg ....... 195 liothyronine sodium tab 5 mcg ......... 195 liothyronine sodium tab 50 mcg ....... 195 LIPIDSHIELD TAB PLUS .................. 186 lipocomplex tab ............................. 201 lipoflavon tab ................................ 201 lipoflavovit tab .............................. 201 lipo-key tab .................................. 201 LIPOTRIAD CAP VIS PLUS ............... 186 LIPOTRIAD CAP VISION .................. 186 LIPOTRIAD CAP VISIONAR .............. 186 liq ca/vit d cap 600mg ...................... 63 liquibid tab 400mg ........................... 97 LIQUID C LIQ .................................. 59 liquitears sol ................................... 47 lisinopril & hydrochlorothiazide tab 10-12.5 mg .................................... 37 lisinopril & hydrochlorothiazide tab 20-12.5 mg .................................... 37 lisinopril & hydrochlorothiazide tab 20-25 mg ................................................ 37 lisinopril tab 10 mg ............................ 3 lisinopril tab 2.5 mg ........................... 3 lisinopril tab 20 mg ............................ 3 lisinopril tab 30 mg ............................ 3 lisinopril tab 40 mg ............................ 3 lisinopril tab 5 mg .............................. 3 LITE TOUCH MIS LANCETS ......... 87, 116 LITEAIRE MIS ............................... 181 LITETOUCH MIS 29GX12.7 .............. 119 LITETOUCH MIS 31GX8MM .............. 119 LITETOUCH MIS LANCETS ................. 87 LITETOUCH MIS MASK LG ........ 122, 179 LITETOUCH MIS MASK MD ....... 122, 179 LITETOUCH MIS MASK SM........ 122, 179 little anima chw plus fe ................... 168 little chw animals ........................... 169 little noses dro stuf nos .................. 154 little noses spr 0.65% .................... 154 little remed liq 160/5ml ................ 9, 11 little remed sus 20/.03ml .................. 27 little tummy dro 20/0.3ml ............27, 99

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LITTLE TUMMY DRO LAXATIVE ......... 188 LONGEVITY CAP ............................. 186 LONGEVITY CAP PLUS ..................... 186 LONGS LANCET MIS STANDARD ......... 87 LONGS LANCET MIS THIN ................. 87 LONGS LANCET MIS ULTRA TH ... 87, 116 loperamide cap 2mg.................... 26, 43 loperamide hcl cap 2 mg ................... 43 loperamide hcl liq 1 mg/5ml (0.2 mg/ml) ......................................................43 loperamide tab 2mg ......................... 43 lopreeza tab 0.5-0.1 ......................... 96 lopreeza tab 1-0.5mg ....................... 96 loradamed tab 10mg ........................ 35 loratadine cap 10 mg ........................ 35 loratadine chw 5mg .......................... 31 loratadine d tab 5-120mg .................. 80 loratadine sol 10/10ml ...................... 31 loratadine sol 5mg/5ml ..................... 35 loratadine syp 5mg/5ml .................... 35 loratadine tab 10 mg ........................ 35 loratadine tab 10mg ......................... 35 lorata-dine tab d 24hr ....................... 80 loratadine-d tab 10-240mg ................ 80 loratadine-d tab 5-120mg ................. 80 lorcet hd tab 10-325mg .................. 165 lorcet plus tab 7.5-325 ................... 165 lorcet tab 5-325mg .......................... 10 loryna tab 3-0.02mg ......................... 70 losartan potassium & hydrochlorothiazide tab 100-12.5 mg .............................. 37 losartan potassium & hydrochlorothiazide tab 100-25 mg ................................ 37 losartan potassium & hydrochlorothiazide tab 50-12.5 mg ............................... 37 losartan potassium tab 100 mg .......... 13 losartan potassium tab 25 mg ............ 13 losartan potassium tab 50 mg ............ 13 lotrimin af pow 2% ........................... 29 lovastatin tab 10 mg....................... 104 lovastatin tab 20 mg....................... 104 lovastatin tab 40 mg....................... 104 low dose asa tab 81mg ...................... 9 low-ogestrel tab ............................... 70 lubr/dry eye dro 0.5-0.9% ................. 46 lubric tears sol 0.4-0.3% ................... 46 lubricant dro 0.4-0.3% ..................... 46

lubricant dro eye ............................. 46 lubricant dro eye 0.6% ..................... 47 lubricant oin eye .............................. 46 lubricat/eye dro 0.5-0.9% ................ 46 lubricating dro 0.5% ........................ 47 lubricating sol 0.4-0.3% ................... 46 lubricnt eye dro ............................... 46 lubricnt eye dro 0.4-0.3% ................. 46 lubricnt eye dro 0.5% op............ 47, 161 lubricnt eye dro 0.6% ...................... 47 lubricnt eye oin fast act .................... 46 lubricnt eye oin nighttim ................... 46 lubricnt gel dro 0.25-0.3 ................... 46 lubricnt gel dro 1% .......................... 47 ludent chw 0.25mg f ........................ 98 ludent chw 0.5mg f .......................... 98 ludent chw 1mg f ............................ 98 LUMINEB II MIS NEBULIZR ............. 177 LUNG TAB 180MG .......................... 186 lutera tab ....................................... 70 LYMPH TAB 150MG ........................ 186 lysiplex liq plus ....................... 134, 147 LYSODREN TAB 500MG .................... 38 lyza tab 0.35mg .............................. 74 M m2 b125 tab tr ................................ 50 M2 B-60 TAB TR ............................ 134 M2 C CAP ....................................... 59 M2 CALCIUM TAB 280MG ................ 186 M2 CHROMIUM TAB 500MCG ........... 186 maalox child chw ............................. 16 MAALOX CHW 600MG ....................... 16 maalox max sus cherry .................... 14 maalox max sus lemon ..................... 14 maalox max sus wild bry .................. 14 maalox multi sus symp max .............. 14 MABIS COMPXP MIS COMP/NEB ....... 177 MABIS COSMO MIS NEBULIZR ......... 122 macular hlth cap formula ................ 134 MACULAR VIT TAB BENEFIT ............ 134 macuvite tab ................................. 134 macuvite tab eye care ............. 134, 147 macuvite tab lutein ........................ 134 MAG-AL LIQ .................................... 15 mag-al plus liq ................................ 14 mag-al plus liq xs ............................ 14 magic bullet sup 10mg ................... 188

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magnum-75 tab ............................. 134 MAKENA INJ 275MG ....................... 173 malathion lotion 0.5% .................... 184 MAMMARY TAB 150MG .................... 186 mapap apap liq 500/15ml .................. 11 mapap cap 500mg ........................... 11 mapap child tab 80mg rt ................... 11 mapap childr sus 160/5ml ................. 11 mapap chw 160mg ........................... 11 mapap liq 160/5ml ........................... 11 mapap tab 325mg ............................ 11 mapap tab 500mg ............................ 12 mapap tab 500mg/rr ........................ 12 MARGO MOO MIS NEBULIZE ............ 178 marlissa tab 0.15/30 ........................ 70 MASK PEDIATR MIS SIZE 1 ...... 121, 176 MASK PEDIATR MIS SIZE 3 ...... 121, 176 MASK VORTEX/ MIS BABY DUC. 122, 181 MASK VORTEX/ MIS DUCK ....... 122, 181 MASK VORTEX/ MIS FROG ....... 122, 181 MASK VORTEX/ MIS LADY BUG. 122, 181 massengill sol vin&watr ........... 128, 198 MATULANE CAP 50MG ....................... 42 matzim la tab 180mg/24 ................... 65 matzim la tab 240mg/24 ................... 65 matzim la tab 300mg/24 ................... 65 matzim la tab 360mg/24 ................... 65 matzim la tab 420mg/24 ................... 65 max daily tab green ....................... 134 maxepa cap 1000mg ...................... 126 MAXI-MASK MIS ............................ 176 MAXIMIN PAK ................................ 134 maximum epa cap 1000mg ............. 126 maximum tab blue lab .................... 134 maximum tab green lb .................... 134 maximum tab red labl ..................... 134 MAXX MIS LUBRICAT................. 72, 114 MAXX PLUS MIS SPERMICI .............. 114 m-clear wc liq 100-6.3 ...................... 78 MEBENDAZOLE POW ......................... 17 meclizine hcl chew tab 25 mg ............ 26 meclizine hcl tab 12.5 mg ............ 26, 27 meclizine hcl tab 25 mg .................... 27 medi-bismuth chw 262mg............ 24, 26 MEDICHOICE MIS LANCET ......... 88, 116 medifin 400 tab 400mg ..................... 97 medi-lax tab 15mg ......................... 189

medi-natural tab 8.6-50mg ............. 109 medi-natural tab 8.6mg .................. 189 medi-paste oin ................................ 92 medi-phedryl cap 25mg .................... 33 mediplex tab plus .......................... 134 medi-profen cap 200mg ...............9, 158 medi-profen sus 100/5ml ................ 158 medi-profen sus 40mg/ml ............... 158 medi-profen tab 200mg .................. 158 mediproxen tab 220mg .................. 158 medi-tabs elx 80/2.5ml .................... 12 medi-tabs jr chw 160mg ................... 12 medi-tabs tab 500mg ....................... 12 medi-tuss dm liq dbl str ...............77, 78 medi-tussin syp dm ......................... 78 MEDLANCE MIS 30G PLUS ................. 88 MEDLANCE MIS EXTR 21G.......... 88, 116 MEDLANCE MIS LITE 25G ........... 88, 116 MEDLANCE MIS PLUS ....................... 88 MEDLANCE MIS PLUS 30G .......... 88, 116 MEDLANCE MIS UNV 21G ........... 88, 116 MEDLANCE PLS MIS 0.8MM ........ 88, 116 MEDLANCE PLS MIS EXTR 21G.... 88, 116 MEDLANCE PLS MIS LITE 25G..... 88, 116 MEDLANCE PLS MIS UNIV 21G.... 88, 116 MEDROL TAB 2MG ......................... 100 medroxyprogesterone acetate im susp 150 mg/ml ..................................... 73 medroxyprogesterone acetate im susp prefilled syr 150 mg/ml .................... 73 medroxyprogesterone acetate tab 10 mg .................................................... 173 medroxyprogesterone acetate tab 2.5 mg .............................................. 173 medroxyprogesterone acetate tab 5 mg .................................................... 173 mefloquine hcl tab 250 mg ................ 37 mega multi tab men ................ 134, 147 mega multi tab w/che mi ......... 154, 201 mega multi tab women ............ 134, 147 MEGA MULTI TAB WOMEN ............... 147 MEGA MULTIVI POW ................ 134, 147 MEGA MULTIVI TAB MEN .......... 134, 147 MEGA MULTIVI TAB WOMEN ..... 135, 147 mega vm-80 tab ............................ 135 mega-maratho tab 100 tr ............... 135 MEGAVITE TAB FRT/VEG ................. 135

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MEGAVITE TAB GOLD 55+ .............. 135 megestrol acetate susp 40 mg/ml ....... 39 megestrol acetate tab 20 mg ............. 39 megestrol acetate tab 40 mg ............. 39 MEIJER LANCE MIS COLOR ................ 88 MEIJER LANCE MIS UNIV 21G ............ 88 MEIJER LANCE MIS UNIV 30G ............ 88 MEIJER LANCE MIS UNIVERSA ........... 88 MEIJER MIS LANCETS ................ 88, 116 meijer sus antacid ............................ 15 MEKINIST TAB 0.5MG ....................... 39 MEKINIST TAB 2MG ......................... 39 MELADOX TAB 3MG CR ...................... 6 melatonin cap 10mg .......................... 6 melatonin chew tab 2.5 mg ..............6, 7 melatonin chw 10mg ......................... 6 melatonin chw quik dis ...................... 6 MELATONIN LIQ 1MG/4ML .................. 6 MELATONIN LIQ 2.5MG ...................... 6 melatonin liq 5mg/15ml ..................... 6 melatonin liquid 1 mg/ml ................... 6 MELATONIN LOZ 5MG ........................ 6 melatonin sl tab 10 mg ...................... 6 melatonin sub 5mg ........................... 6 melatonin sub quik dis ....................... 6 melatonin tab 1 mg ........................... 6 melatonin tab 10 mg ......................... 6 melatonin tab 10mg cr ...................... 6 MELATONIN TAB 200MCG .................. 6 melatonin tab 300 mcg ...................... 6 melatonin tab 3mg ............................ 6 MELATONIN TAB 3MG CR ................... 6 MELATONIN TAB 500MCG .................. 6 melatonin tab 5mg ............................ 6 melatonin tab max st ........................ 6 melatonin tablet disintegrating 10 mg .. 6 melatonin tablet disintegrating 3 mg .... 6 melatonin tablet disintegrating 5 mg .... 6 meloxicam tab 15 mg ..................... 158 meloxicam tab 7.5 mg .................... 158 melphalan tab 2 mg .......................... 5 memantine hcl oral solution 2 mg/ml .22, 175 memantine hcl tab 10 mg.................. 22 memantine hcl tab 5 mg ................... 22 memantine hcl tab 5 mg (28) & 10 mg (21) titration pak ............................. 22

MENOPAUSE MIS AM/PM ................. 186 menopause tab support .................. 186 mens 50+ adv tab one daly ............. 135 MENS 50+ CAP ADVANCED ............. 135 mens daily cap lycopene ................. 135 mens daily chw gummies ......... 135, 147 mens daily tab formula ................... 135 MENS MULTI TAB VIT/MIN........ 135, 147 MENS PAK .................................... 135 mercaptopurine tab 50 mg ................ 38 mesalamine enema 4 gm ................ 106 mesalamine rectal enema 4 gm & cleanser wipe kit ........................... 106 MESTINON SYP 60MG/5ML ................ 38 metformin hcl tab 1000 mg ............... 58 metformin hcl tab 500 mg ................. 58 metformin hcl tab 850 mg ................. 58 metformin hcl tab er 24hr 500 mg ...... 58 metformin hcl tab er 24hr 750 mg ...... 58 methacholine cap /liver .................. 201 methadone hcl tab 10 mg ............... 164 methadone hcl tab 5 mg ................. 164 methazolamide tab 25 mg ................ 66 methazolamide tab 50 mg ................ 66 methimazole tab 10 mg .................... 45 methimazole tab 5 mg ...................... 45 methocarbamol tab 500 mg .............. 67 methocarbamol tab 750 mg .............. 67 methotrexate sodium tab 2.5 mg (base equiv) ............................................ 38 methyldopa tab 250 mg .................... 18 methyldopa tab 500 mg .................... 18 methylprednisolone tab 16 mg ........ 100 methylprednisolone tab 32 mg ........ 100 methylprednisolone tab 4 mg .......... 100 methylprednisolone tab 8 mg .......... 100 methylprednisolone tab therapy pack 4 mg (21) ....................................... 100 metipranolol ophth soln 0.3% ............ 58 metoclopramide hcl soln 5 mg/5ml (10 mg/10ml) (base equiv) ..................... 99 metoclopramide hcl tab 10 mg (base equivalent) ................................... 100 metoclopramide hcl tab 5 mg (base equivalent) ................................... 100 metolazone tab 10 mg .................... 193 metolazone tab 2.5 mg ................... 193

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metolazone tab 5 mg ...................... 193 metoprolol & hydrochlorothiazide tab 100-25 mg ...................................... 37 metoprolol & hydrochlorothiazide tab 100-50 mg ...................................... 37 metoprolol & hydrochlorothiazide tab 50-25 mg ....................................... 37 metoprolol succinate tab er 24hr 100 mg (tartrate equiv) ................................ 57 metoprolol succinate tab er 24hr 200 mg (tartrate equiv) ................................ 57 metoprolol succinate tab er 24hr 25 mg (tartrate equiv) ................................ 57 metoprolol succinate tab er 24hr 50 mg (tartrate equiv) ................................ 57 metoprolol tartrate tab 100 mg .......... 57 metoprolol tartrate tab 25 mg ............ 57 metoprolol tartrate tab 50 mg ............ 57 metronidazole cap 375 mg ................ 17 metronidazole cream 0.75% ............ 182 metronidazole gel 0.75% ................ 182 metronidazole gel 1% ..................... 182 metronidazole lotion 0.75% ............. 182 metronidazole tab 250 mg ................. 17 metronidazole tab 500 mg ................. 17 metronidazole vaginal gel 0.75% ...... 198 mg217 gel 1% ................................. 75 MG-PLUS TAB PROTEIN ................... 186 MH MACULAR MIS HEALTH .............. 135 MI-ACID CHW .................................. 15 mi-acid gas chw 80mg ...................... 27 mi-acid sus ..................................... 15 mi-acid sus max st ........................... 15 micaderm cre 2% ............................. 29 miconazole 1 kit ............................. 197 miconazole 1 kit 1200-2% ............... 197 miconazole 1 kit 1200mg2% ............ 197 MICONAZOLE 1 KIT COMBO ............. 197 miconazole 3 cre 4% ...................... 197 miconazole 3 kit combinat ............... 197 miconazole 3 kit combo ................... 197 miconazole 3 kit combo pk .............. 197 miconazole 3 sup 200mg ................. 198 miconazole 7 cre ............................ 198 miconazole 7 cre 2% ...................... 198 miconazole 7 cre tube/kit ................ 198 miconazole 7 sup 100mg ................. 198

miconazole cre 2% .......................... 29 miconazole nitrate vaginal cream 2% 198 miconazole nitrate vaginal suppos 100 mg .............................................. 198 MICONAZOLE POW .................... 28, 105 MICONAZOLE POW NITRATE.........29, 83 miconazorb pow af 2% ..................... 30 MICRO AIR MIS NEBULIZR .............. 178 MICRO PLUS MIS NEBULIZR ............ 178 MICRO THIN MIS LANC 33G .............. 88 MICROCHAMBER MIS ..................... 181 MICROCLENS PAD WIPES ................. 44 MICROELITE MIS BATTERY .............. 179 MICROELITE MIS COMP/NEB ........... 178 MICROELITE MIS FILTERS ............... 179 microgestin tab 1.5/30 ..................... 70 microgestin tab 1/20 ........................ 72 microgestin tab fe 1/20 .................... 70 microgestin tab fe1.5/30 .................. 70 MICROLET MIS LANCETS .................. 88 MICROSHIELD MIS CPR .................. 177 MICROSPACER MIS ........................ 181 MICROTAINER MIS LANCET ........ 88, 116 midodrine hcl tab 10 mg ................. 199 midodrine hcl tab 2.5 mg ................ 199 midodrine hcl tab 5 mg ................... 199 midol tab 650mg ............................... 9 MIL ADREGEN TAB .................. 153, 186 MILADRE FORT TAB 160MG ............. 186 MIL-A-MULSIO EMU ....................... 151 milantex sus ex st ............................ 15 milantex sus original ........................ 15 mili tab 0.25/35 .............................. 72 milltrium sr tab ....................... 135, 147 milltrium tab advanced ............ 135, 147 milltrium tab cardio ........................ 135 milltrium tab stamina ..................... 186 MILPAN TAB 325 MG ...................... 186 mimvey lo tab 0.5-0.1 ...................... 96 mimvey tab 1-0.5mg ....................... 96 MINI COMPRES MIS NEBULIZR ........ 178 MINI PLUS MIS NEBULIZR ............... 178 MINIBREEZE MIS NEBULIZE ............ 178 MINIELITE MIS BATTERY ................ 179 MINIELITE MIS COMP/NEB ....... 122, 178 MINIELITE MIS FILTERS ................. 179 MINI-MIST MIS PORTABLE ....... 122, 178

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miniprin low tab 81mg ec ................ 183 minitran dis 0.1mg/hr ..................... 156 minitran dis 0.2mg/hr ..................... 156 minitran dis 0.4mg/hr ..................... 156 minitran dis 0.6mg/hr ..................... 156 minocycline hcl cap 100 mg ............. 193 minocycline hcl cap 50 mg .............. 193 minocycline hcl cap 75 mg .............. 193 MINOCYCLINE POW ........................ 193 mintox plus chw ............................... 15 mintox sus ...................................... 15 mintox sus max st ............................ 15 MIRENA IUD SYSTEM ..................... 173 misoprostol tab 100 mcg ................. 196 misoprostol tab 200 mcg ................. 196 MISTERNEB MIS NEBULIZE ............. 178 mm aspirin tab 325mg .................... 183 MM BIOTIN CAP KERATIN ................ 153 mm melatonin tab 10mg tr................. 7 MM PENTIPS MIS 31GX5MM ............ 119 MM PENTIPS MIS 31GX8MM ............ 119 MM PENTIPS MIS 32GX4MM ............ 119 MM TWIST MIS LANCETS ................ 116 MOBILE LANCE MIS 30G ................. 116 moderiba tab 200mg ...................... 103 MOLESKIN PAD FOAM ....................... 54 mometasone furoate cream 0.1% ....... 75 mometasone furoate oint 0.1% .......... 75 mometasone furoate solution 0.1% (lotion) ........................................... 75 MOMMYS BLISS POW PROBIOTI ......... 26 MONISTAT 3 KIT COMBO PK ............ 198 MONISTAT 7 KIT COMBO PK ............ 198 MONISTAT 7 KIT COMPLETE ............ 198 MONOLET MIS LANCETS ............ 88, 117 MONOLET OPD MIS LANCETS ............. 88 MONOLETTOR MIS LANCETS .............. 88 mono-linyah tab 0.25-35 ................... 70 mononessa tab ................................ 70 montelukast sodium chew tab 4 mg (base equiv) .................................. 110 montelukast sodium chew tab 5 mg (base equiv) .................................. 110 montelukast sodium oral granules packet 4 mg (base equiv) .......................... 110 montelukast sodium tab 10 mg (base equiv) .......................................... 110

MORE-DOPHILU POW ACIDOPHI ........ 24 morgidox cap 1x100mg .................. 193 morgidox cap 1x50mg .................... 193 morgidox cap 2x100mg .................. 193 morphine sulfate oral soln 10 mg/5ml164 morphine sulfate oral soln 100 mg/5ml (20 mg/ml) .............................. 10, 164 morphine sulfate oral soln 20 mg/5ml164 morphine sulfate suppos 10 mg ....... 164 morphine sulfate suppos 20 mg ....... 164 morphine sulfate suppos 5 mg ......... 164 morphine sulfate tab 15 mg ............ 164 morphine sulfate tab 30 mg ............ 164 morphine sulfate tab er 100 mg ....... 164 morphine sulfate tab er 15 mg ......... 164 morphine sulfate tab er 200 mg ....... 164 morphine sulfate tab er 30 mg ......... 164 morphine sulfate tab er 60 mg ......... 164 motion relf tab 25mg ...................26, 27 motion sick chw 25mg ...................... 27 motion sick tab 25mg ..................26, 27 motion-time chw 25mg .................... 27 motrin ib tab 200mg ...................... 158 MOVANTIK TAB 12.5MG .................. 170 MOVANTIK TAB 25MG .................... 170 move along tab 100mg ................... 191 MPD SFTY LAN MIS 21G ................. 117 MPD SFTY LAN MIS 23G ................. 117 MPD SFTY LAN MIS 28G ................. 117 MPD SFTY LAN MIS 30G ................. 117 MPS CAP ...................................... 186 muc/cgh relf liq 5-100mg .................. 77 mucinex allr tab 180mg .................... 35 MUCINEX CGH GRA 5-100MG ............ 78 mucinex cgh liq 5-100mg .................. 78 mucinex chld liq 100/5ml .................. 97 mucinex dm liq 20-400 ..................... 78 MUCINEX TAB 600MG ER .................. 97 MUCINEX/KIDS GRA 100MG .............. 97 mucosa tab 400mg .......................... 97 mucus d tab 120/1200 ..................... 80 mucus d tab 60-600mg .................... 80 mucus er tab 1200mg ...................... 97 mucus rel dm liq 5-100/5 ................. 78 mucus relf d tab 60-600mg ............... 80 mucus relief liq 100/5ml ................... 97 mucus relief liq 400/20ml.............77, 97

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mucus relief liq 5-100mg .................. 78 mucus relief tab 1200 er ................... 97 mucus relief tab 1200mg .................. 77 mucus relief tab 200mg .................... 97 mucus relief tab 30-600er ................. 77 mucus relief tab 400mg .................... 97 mucus relief tab 600mg .................... 77 mucus relief tab 600mg er ........... 77, 97 mucus relief tab 60-1200 .................. 78 mucus relief tab 60-600mg ............... 77 mucus rlf d tab 120-1200 .................. 80 mucus rlf d tab 60-600mg ................. 80 mucus rlf dm liq 5-100/5 .................. 78 mucus rlf dm tab 30-600er ................ 77 mucus+chst liq 100/5ml ................... 97 mucus+chst liq 200/10ml ................. 77 mucus-dm max tab 60-1200 ............. 78 mucus-dm tab 30-600mg.................. 78 mult vitamin tab daily ..................... 151 mult vitamin tab essent .................. 151 mult vitamin tab mens .................... 151 mult vitamin tab no iron ................. 135 mult vitamin tab womens ................ 135 multi 50+ cap for her .............. 135, 147 multi 50+ tab for her ...................... 135 multi 50+ tab for him ..................... 135 MULTI ADULT CHW EXTRA C ........... 135 multi adult chw gummies ................ 135 multi cap complete ......................... 135 multi cap for her ..................... 135, 147 multi cap for him ........................... 135 multi complt tab /iron ..................... 135 MULTI FOR POW HER ..................... 135 MULTI FOR POW HIM ...................... 135 multi gummie chw mens .......... 135, 147 multi gummie chw womens ...... 135, 147 multi tab for her ............................ 135 multi tab for him ............................ 135 multi vit/fl chw 0.25mg ................... 152 multi vit/fl dro 0.5mg/ml ................. 168 multi vitami tab ............................. 151 multi vitami tab d-3 ....................... 151 multi vitami tab w/iron ................... 128 MULTI VITAMN TAB MINERALS ........ 135 multi+omega3 chw adult ................ 135 MULTI-B CAP COMPLEX ..................... 50 MULTI-BETIC TAB DIABETES ........... 135

multi-day tab ................................ 151 multi-day tab /ca/iron .................... 128 multi-day tab /iron .................. 129, 144 multi-day tab minerals ................... 135 multi-day tab wght trm .................. 135 multi-delyn liq ............................... 169 MULTI-DELYN LIQ /IRON.......... 153, 168 MULTI-GLAN TAB 455 MG ............... 186 multi-lean tab ............................... 135 multilex tab .................................. 136 multilex-t&m tab ........................... 136 multimineral tab plus ..................... 136 multiple vitamin cap ....................... 151 multiple vitamin tab ....................... 151 multiple vitamins w/ iron tab .... 129, 144 multiple vitamins w/ minerals tab ... 136, 147 multiv women tab 50+ ............ 136, 148 multivi adlt chw gummies......... 136, 148 multi-vit hp cap /mineral.......... 154, 201 multi-vit/ tab minerals ............. 135, 147 multi-vit/fe dro /fl 0.25 ................... 166 multi-vit/fe tab .............................. 129 multivit/fl chw 0.25mg ................... 168 multivit/fl chw 0.5mg ..................... 168 multivit/fl chw 1mg ........................ 168 multi-vit/fl dro /fe 0.25 ................... 166 multivit/fl dro 0.25mg .................... 168 multi-vit/fl dro 0.5mg/ml ................ 168 multivit/fl sol 0.5mg/ml .................. 152 multivit/fl/ dro fe 0.25 .................... 152 multi-vitami chw gummies .............. 135 multi-vitami tab menopaus ............. 135 MULTI-VITAMI TAB MONOCAPS. 135, 147 multivitamin cap ............................ 151 multivitamin cap daily .................... 136 MULTIVITAMIN CHW ADLT GUM ....... 136 MULTIVITAMIN CHW ADULT ............ 136 multivitamin chw child ............. 152, 167 MULTIVITAMIN CHW CHILD ............ 153 multivitamin chw children.. 152, 167, 169 MULTIVITAMIN CHW IRON .............. 168 multivitamin chw vita d3 ................. 136 MULTIVITAMIN DRO ORGANIC ......... 151 multivitamin liq ............................. 136 MULTIVITAMIN LIQ ........................ 151 multivitamin liq mineral ........... 136, 148

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multivitamin tab adlt 50+ ........ 136, 148 multivitamin tab adt 50+ ................ 136 MULTIVITAMIN TAB ADULT ............. 136 multivitamin tab adults ................... 136 MULTIVITAMIN TAB ADULTS .... 136, 148 multivitamin tab daily ..................... 151 multivitamin tab iron-fre ................. 151 MULTIVITAMIN TAB MEN ......... 136, 148 multivitamin tab men 50+ ....... 136, 148 multivitamin tab mens............. 136, 148 multivitamin tab mineral .......... 136, 148 multivitamin tab women .......... 136, 148 multivitamin tab womens ......... 136, 148 multi-vitamn tab ............................ 151 multi-vite tab ......................... 135, 147 multi-vite tab 50&over............. 135, 147 mupirocin calcium cream 2% ............. 20 mupirocin oint 2% ............................ 20 murine ear dro 6.5% ot .................. 165 murine ear sol 6.5% ot ................... 165 murine tears dro dry eyes .......... 46, 161 mvc-fluoride chw 0.25mg ................ 168 mvc-fluoride chw 0.5mg.................. 168 mvc-fluoride chw 1mg .................... 168 mv-one cap ................................... 151 MVW COMPLETE CAP D3000 ............ 136 MVW COMPLETE CAP D5000 ............ 136 MVW COMPLETE CAP FORMULAT ...... 148 MVW COMPLETE CAP MINIS ............. 148 mvw complete chw bubblgum .......... 167 mvw complete chw d3000 ............... 152 MVW COMPLETE CHW GRAPE ........... 136 mvw complete chw orange .............. 152 my choice tab 1.5mg ........................ 73 MY MDI PORTA MIS NEBULISE ......... 178 my way tab 1.5mg ........................... 94 myamulti tab.......................... 136, 148 mycocide ns sol 1% .......................... 29 mycophenolate mofetil cap 250 mg... 105 mycophenolate mofetil for oral susp 200 mg/ml .......................................... 105 mycophenolate mofetil tab 500 mg ... 105 MYGLUCOHEALT MIS LANC 30G ......... 88 mylanta sus max st ..................... 15, 16 MYLERAN TAB 2MG ........................... 5 mynephrocaps cap ........................... 49 mynephron cap ................................ 49

myorisan cap 10mg ........................... 5 myorisan cap 20mg ........................... 5 myorisan cap 30mg ........................... 5 myorisan cap 40mg ........................... 5 my-vitalife cap ........................ 136, 148 myzilra tab ..................................... 71 N nabumetone tab 500 mg ................ 158 nabumetone tab 750 mg ................ 158 NACL/BACT INJ 0.9%BENZ ............. 170 nadolol tab 20 mg ........................... 57 nadolol tab 40 mg ........................... 57 nadolol tab 80 mg ........................... 57 nafrinse chw 1mg f .......................... 98 nafrinse dro 0.125mg ....................... 98 NALIDIXIC POW ACID .................... 196 NANOVM POW 1-3 YRS ................... 166 NANOVM POW 4-8YEARS ................ 166 NANOVM POW 9-18 YRS ................. 166 NANOVM T/F LIQ ........................... 166 NANOVM T/F POW ......................... 166 naproxen dr tab 375mg .................. 158 naproxen dr tab 500mg .................. 158 naproxen sod tab 220mg ................ 158 naproxen sodium cap 220 mg ......... 158 naproxen sodium tab 275 mg .......... 158 naproxen sodium tab 550 mg .......... 159 naproxen tab 250 mg ..................... 159 naproxen tab 375 mg ..................... 159 naproxen tab 500 mg ..................... 159 naramin liq ..................................... 33 naratriptan hcl tab 1 mg (base equiv) 184 naratriptan hcl tab 2.5 mg (base equiv) .................................................... 184 nasal allerg spr 55mcg ................... 156 nasal allgy spr 55mcg/ac.......... 155, 156 nasal allrgy spr 55mcg/ac ............... 156 NASAL DECON SYP 30MG/5ML ........ 192 NASAL DECONG LIQ 30MG/5ML ....... 192 nasal decong tab 120mg er ............. 192 nasal decong tab 30mg .................. 192 nasal moist spr 0.65% ................... 154 nasal saline spr 0.65% ................... 154 nat veg lax tab 8.6mg .................... 189 NATACYN SUS 5% OP .................... 162 nateglinide tab 120 mg .................. 123 nateglinide tab 60 mg .................... 123

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NEBULIZER MIS ............................. 178 NEBULIZER MIS CMPRESSR ..... 122, 178 NEBULIZER MIS ULTRASON ..... 122, 178

nat-rul cal tab /d 500mg ................. 124 nat-rul dail tab vit/iron ................... 144 nat-rul iron tab 325mg .................... 102 nat-rul tab b-50 ............................. 201 NAT-RUL THER TAB M ..................... 148 natrul-100 tab super ...................... 136 NATRUL-VITES TAB ........................ 136 natural bal sol tears ......................... 46 NATURAL COND MIS + LUBE ...... 73, 114 natural lax tab 8.6mg ..................... 189 natura-lax pow 3350 nf ................... 110 natures sol tears .............................. 46

nebusal neb 3% ............................. 127 necon tab 0.5/35 ............................. 70 NEOMULTIVITE TAB ....................... 151 NEOMYCIN POW SULFATE ............ 20, 82 neomycin sulfate tab 500 mg .............. 7 neomycin-bacitrac zn-polymyx 5(3.5)mg-400unt-10000unt op oin ... 162 neomycin-polymy-gramicid op sol 1.75-10000-0.025mg-unt-mg/ml ..... 162 neomycin-polymyxin-dexamethasone ophth oint 0.1% ............................. 163 neomycin-polymyxin-dexamethasone ophth susp 0.1% ........................... 163 neomycin-polymyxin-hc ophth susp .. 163 neomycin-polymyxin-hc otic soln 1% 166 neomycin-polymyxin-hc otic susp 3.5 mg/ml-10000 unit/ml-1% ............... 166 NEON STRIPS MIS 3/4 ASST .............. 54 neo-polycin oin hc 1%op ................. 163 neo-polycin oin op .......................... 162 neotuss liq ...................................... 78 nephro tab vitamins ....................... 143 neuro-k-50 tab .............................. 201 new day tab 1.5mg .......................... 73 NEW LIFE TAB HAIR ....................... 186 NEXAVAR TAB 200MG ....................... 39 NEXCARE TATT MIS BANDAGES.. 54, 113 NEXCARE WATR MIS PRF BAND .. 55, 113 NEXIUM 24HR TAB 20MG ................ 195 NEXIUM GRA 10MG DR ................... 195 NEXIUM GRA 2.5MG DR .................. 195 NEXIUM GRA 5MG DR ..................... 195

NEXPLANON IMP 68MG .................. 173 NF FORMULAS CHW CHILDREN ........ 167 niacin cap 400-100 ........................ 199 niacin cap 400mg .......................... 199 niacin tab er 1000 mg (antihyperlipidemic) ....................... 156 niacin tab er 500 mg (antihyperlipidemic) ............................................... 36, 156 niacin tab er 750 mg (antihyperlipidemic) .................................................... 156 nifedipine tab er 24hr 30 mg ............. 65 nifedipine tab er 24hr 60 mg ............. 65 nifedipine tab er 24hr 90 mg ............. 65 nifedipine tab er 24hr osmotic release 30 mg ................................................ 65 nifedipine tab er 24hr osmotic release 60 mg ................................................ 65 nifedipine tab er 24hr osmotic release 90 mg ................................................ 65 night time tab 25mg ........................ 30 nighttime tab 25mg ......................... 30 nikki tab 3-0.02mg .......................... 70 NITRO-BID OIN 2% ....................... 157 NITRO-DUR DIS 0.3MG/HR ............. 157 NITRO-DUR DIS 0.8MG/HR ............. 157 NITROFURAN POW ANHYDROU ........ 196 nitrofurantoin macrocrystalline cap 100 mg .............................................. 197 nitrofurantoin macrocrystalline cap 25 mg .............................................. 196 nitrofurantoin macrocrystalline cap 50 mg .............................................. 197 nitrofurantoin monohydrate macrocrystalline cap 100 mg ........... 197 nitrofurantoin susp 25 mg/5ml ........ 197 nitroglycerin cap er 2.5 mg ............. 157 nitroglycerin cap er 6.5 mg ............. 157 nitroglycerin cap er 9 mg ................ 157 nitroglycerin sl tab 0.3 mg .............. 157 nitroglycerin sl tab 0.4 mg .............. 157 nitroglycerin sl tab 0.6 mg .............. 157 nitroglycerin td patch 24hr 0.1 mg/hr 157 nitroglycerin td patch 24hr 0.2 mg/hr 157 nitroglycerin td patch 24hr 0.4 mg/hr 157 nitroglycerin td patch 24hr 0.6 mg/hr 157 nitro-time cap 2.5mg cr .................. 157 nitro-time cap 6.5mg cr .................. 157

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nitro-time cap 9mg cr ..................... 157 niva-fol tab ..................................... 92 nizatidine cap 150 mg ..................... 101 nizatidine cap 300 mg ..................... 101 nizatidine oral soln 15 mg/ml ........... 101 noble formul cre hc 1% ..................... 75 noble formul spr 1% ......................... 75 non-asa jr tab 160mg ....................... 12 non-asa jr tab 160mg qm .................. 12 non-aspirin chw 160mg jr .................. 12 non-aspirin chw 80mg ...................... 12 non-aspirin sus 160/5ml ................... 12 non-aspirin tab 325mg ...................... 12 non-aspirin tab 500mg ...................... 12 non-aspirin tab 500mg/rr .................. 12 non-aspirin tab 650mg ...................... 12 nora-be tab 0.35mg ....................... 173 NORDITROPIN INJ 10/1.5ML .............. 95 NORDITROPIN INJ 15/1.5ML .............. 95 NORDITROPIN INJ 30/3ML ................ 95 NORDITROPIN INJ 5/1.5ML ............... 95 norethindrone ace & ethinyl estradiol tab 1 mg-20 mcg .................................. 72 norethindrone ace & ethinyl estradiol-fe tab 1 mg-20 mcg ............................. 70 norethindrone acetate tab 5 mg ....... 173 norethindrone acetate-ethinyl estradiol tab 0.5 mg-2.5 mcg ......................... 96 norethindrone acetate-ethinyl estradiol tab 1 mg-5 mcg ............................... 96 norethindrone tab 0.35 mg .............. 173 norgestimate & ethinyl estradiol tab 0.25 mg-35 mcg ..................................... 70 norgestimate-eth estrad tab 0.18-25/0.215-25/0.25-25 mg-mcg .... 71 norgestimate-eth estrad tab 0.18-35/0.215-35/0.25-35 mg-mcg .... 71 norlyda tab 0.35mg ........................ 173 norlyroc tab 0.35mg ....................... 173 NORPACE CAP 100MG CR .................. 19 NORPACE CAP 150MG CR .................. 19 nortemp sus 160/5ml ....................... 12 nortemp sus infants .......................... 12 nortrel tab 0.5/35 ............................ 70 nortrel tab 1/35 ............................... 70 nortrel tab 7/7/7 .............................. 71 norwich asa tab 325mg ............... 9, 183

NOSE CLIP MIS ............................. 179 NOVA SAFETY MIS LANC 23G ............ 88 NOVA SAFETY MIS LANC 28G ............ 88 NOVA SURE MIS LANCETS ................ 88 NOVOFINE MIS 32GX6MM ............... 119 NOVOFINE PLS MIS 32GX4MM ......... 119 NOVOLIN INJ 70/30 ......................... 23 NOVOLIN INJ FLEXPEN ..................... 23 NOVOLIN N INJ RELION .................... 23 NOVOLIN N INJ U-100 ...................... 23 NOVOLIN R INJ RELION .................... 23 NOVOLIN R INJ U-100 ...................... 23 NOVOLIN70/30 INJ RELION .............. 23 NOVOLOG MIX INJ 70/30.................. 23 NOVOLOG MIX INJ FLEXPEN .............. 23 NUEDEXTA CAP 20-10MG ............... 174 nufol tab ...................................... 103 nulev tab 0.125mg .......................... 44 NUTRIENT 45+ TAB WOMEN ........... 136 NUTRIENT 50+ TAB MEN ................ 136 NUTRIENTS CAP ANTIOXID ............. 136 NUTRIENTS TAB MEN ..................... 136 NUTRIENTS TAB TEENS ........... 136, 148 NUTRIENTS TAB WOMEN ................ 136 NUVARING MIS ............................... 71 nyamyc pow 100000 ........................ 29 nystatin cream 100000 unit/gm ......... 29 nystatin oint 100000 unit/gm ............ 29 nystatin susp 100000 unit/ml ............ 18 nystatin tab 500000 unit ................... 28 nystatin topical powder 100000 unit/gm ...................................................... 29 nystop pow 100000 ......................... 29 nytol tab 25mg ............................... 30 O ocean kids spr 0.65% .................... 154 ocella tab 3-0.03mg ......................... 70 OCREVUS INJ 300/10ML ................. 175 octreotide acetate inj 100 mcg/ml (0.1 mg/ml) .......................................... 95 octreotide acetate inj 1000 mcg/ml (1 mg/ml) .......................................... 95 octreotide acetate inj 200 mcg/ml (0.2 mg/ml) .......................................... 95 octreotide acetate inj 50 mcg/ml (0.05 mg/ml) .......................................... 95 octreotide acetate inj 500 mcg/ml (0.5

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mg/ml) ........................................... 95 OCULAR TAB VITAMINS .................. 148 ocutabs tab ............................ 136, 148 ocutabs tab lutein .......................... 136 OCUVITE CAP ADULT ...................... 136 ocuvite eye cap health .................... 136 ocuvite eye chw heatlh ................... 136 ocuvite eye tab + multi ................... 136 OCUVITE LUTE CAP ........................ 136 ocuvite tab lutein ........................... 136 ocuvite xtra tab ............................. 136 odor control aer powd 1% ................. 29 odor eaters aer 1% .......................... 29 OFEV CAP 100MG ........................... 175 OFEV CAP 150MG ........................... 175 ofloxacin ophth soln 0.3% ............... 162 ofloxacin otic soln 0.3% .................. 165 ogestrel tab ..................................... 70 OIL-ALMOND OIL SWEET ........... 68, 111 OLIVE OIL ................................ 68, 111 omega 3 500 cap 500mg ................. 126 omega 3 cap 1000mg ..................... 126 omega essent liq basic .................... 126 omega iii cap epa+dha .................... 126 OMEGA-3 CAP 1400MG ................... 126 omega-3 cf cap 1000mg ................. 126 omega-3 fatty acids cap 1000 mg ..... 127 omega-3 fatty acids cap 1200 mg .... 127, 159 omega-3 fatty acids cap 300 mg ...... 126 omega-3 fatty acids cap 435 mg ...... 127 omega-3 fatty acids cap 500 mg 127, 159 omega-3 fish cap 1000 mg .............. 127 omega-3 fish cap 1200mg........ 127, 159 omega-3 fish chw 113.5mg ...... 127, 159 omega-3 plus cap 1000mg .............. 127 omeprazole cap 20.6mgdr ............... 196 omeprazole cap delayed release 10 mg .................................................... 174 omeprazole cap delayed release 20 mg ............................................ 174, 195 omeprazole cap delayed release 40 mg .................................................... 174 omeprazole magnesium cap dr 20.6 mg (20 mg base equiv)................. 174, 196 OMEPRAZOLE TAB 20MG ................. 174 omeprazole-sodium bicarbonate cap

20-1100 mg ................................. 196 omera cap 1000mg ........................ 127 OMNICAP TAB ............................... 151 OMNIFLEX DPR ................................ 73 ON CALL MIS LANCETS ..................... 88 ON CALL PLUS MIS LANCETS ............. 88 once daily tab ............................... 151 once daily tab iron................... 129, 144 ONCOVITE TAB ............................. 137 ondansetron hcl oral soln 4 mg/5ml ...... 3 ondansetron hcl tab 24 mg ................. 3 ondansetron hcl tab 4 mg ................... 3 ondansetron hcl tab 8 mg ................... 3 ondansetron orally disintegrating tab 4 mg .................................................. 3 ondansetron orally disintegrating tab 8 mg .................................................. 3 ONE DAILY CHW ADLT GUM...... 137, 148 one daily chw gummy .................... 137 ONE DAILY MN TAB W/O IRON ........ 137 one daily mv tab /iron ............. 129, 144 one daily tab ................................. 151 one daily tab /mineral.............. 137, 148 one daily tab 50 plus ...................... 137 one daily tab 50+.................... 137, 148 one daily tab 50+ adv.............. 137, 148 one daily tab complete............. 137, 148 one daily tab essentl................ 148, 151 one daily tab fe/ca .................. 137, 148 one daily tab healthy ............... 137, 148 one daily tab iron-fre ..................... 137 one daily tab maximum ........... 137, 148 one daily tab men ................... 137, 148 one daily tab men 50+............. 137, 148 one daily tab mens .................. 137, 148 ONE DAILY TAB MENS .................... 137 one daily tab mens 50+ ........... 137, 148 ONE DAILY TAB MENS 50+....... 137, 148 one daily tab multivit ............... 137, 151 one daily tab pls iron ............... 129, 144 one daily tab plus iro ............... 137, 148 ONE DAILY TAB WMNS 50+ ............ 137 one daily tab wom 50+ ............ 137, 148 ONE DAILY TAB WOMANS ............... 137 one daily tab women ............... 137, 148 one daily tab women 50 ................. 137 one daily tab womens 128, 137, 144, 148

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ONE DAILY TAB WOMENS ............... 148 one daily wm tab pro-actv ............... 137 one daily/ tab minerals ............ 137, 148 one dly hlth tab wght adv ................ 137 ONE-A-DAY CHW IMMUNITY ............ 137 ONE-A-DAY CHW VITACRAV .... 137, 148, 151 ONE-A-DAY TAB 50+ ADV........ 137, 148 ONE-A-DAY TAB 65+ ...................... 148 ONE-A-DAY TAB ENERGY ......... 137, 148 ONE-A-DAY TAB MENOPAUS ............ 137 ONE-A-DAY TAB MENS .................... 137 ONE-A-DAY TAB PROEDGE .............. 137 one-a-day tab teen/her ................... 137 ONE-A-DAY TAB TEEN/HIM .............. 137 one-daily tab /iron .................. 129, 144 one-daily tab mult vit ..................... 151 ONETOUCH FP MIS LANCETS ............. 88 ONETOUCH KIT ULT MINI .......... 88, 117 ONETOUCH KIT ULTRA 2 ................... 88 ONETOUCH KIT VERIO ...................... 88 ONETOUCH KIT VERIO FL .................. 88 ONETOUCH KIT VERIO IQ .................. 88 ONETOUCH MIS 30G ........................ 88 ONETOUCH MIS COMBO .................... 88 ONETOUCH MIS LANCETS .......... 88, 117 ONETOUCH TES ULTRA BL ................. 92 ONETOUCH TES VERIO ..................... 92 ONETOUCH US MIS LANCETS ............. 88 ONETOUCH VER KIT SYNC ................. 88 ON-THE-GO MIS LANC 30G ........ 88, 117 opcicon tab 1.5mg ........................... 94 OPSUMIT TAB 10MG ......................... 66 OPTICHAMBER MIS ADV LRG ........... 181 OPTICHAMBER MIS ADV MED ........... 181 OPTICHAMBER MIS ADV SM ............. 181 OPTICHAMBER MIS DIA LG ...... 122, 181 OPTICHAMBER MIS DIA MD...... 122, 181 OPTICHAMBER MIS DIA SM ............. 181 OPTICHAMBER MIS DIAMOND .. 122, 181 OPTICHAMBER MIS FACE MAS .. 122, 181 optic-vites tab ........................ 137, 148 optic-vites tab lutein ....................... 137 OPTIHALER MIS...................... 122, 181 optimal-d cap 50000unt........... 160, 200 OPTIMUM CHW AIRVITES......... 137, 148 optimum pms tab ........................... 137

option 2 tab 1.5mg .......................... 94 OPTIONHOME MIS NEBULIZR ... 122, 178 OPTISOURCE CHW BARIATRC ... 137, 149 OPURITY CHW BYPASS ................... 137 OPURITY TAB ................................ 138 oral electro sol cherry ....................... 93 oral electro sol freezer .................... 125 oral electro sol h-e-b ........................ 93 oral electrolyte solution.............. 93, 125 oralone dent pst 0.1% .................... 187 oralyte sol ...................................... 94 oralyte sol freeze ............................. 94 ORCHIC TAB 150MG ...................... 186 ORENITRAM TAB 0.125MG ................ 66 ORENITRAM TAB 0.25MG .................. 66 ORENITRAM TAB 1MG ...................... 66 ORENITRAM TAB 2.5MG .................... 66 ORENITRAM TAB 5MG ...................... 66 ORKAMBI GRA 100-125 .................. 176 ORKAMBI GRA 150-188 .................. 176 ORKAMBI TAB 100-125 .................... 81 ORKAMBI TAB 200-125 .................... 81 ormir cap 50mg ............................... 33 orphenadrine citrate tab er 12hr 100 mg ...................................................... 67 orsythia tab .................................... 70 os calcium tab /vit d......................... 63 os-cal + d3 tab 500-200 ................... 63 oscal 500/ tab 200 d-3 ..................... 63 os-cal chw ...................................... 63 os-cal chw 500-600 ......................... 63 os-cal extra tab d3 ........................... 63 oscimin sr tab 0.375mg .................... 44 oscimin sub 0.125mg ....................... 44 oscimin tab 0.125mg ....................... 44 oseltamivir phosphate cap 30 mg (base equiv) .......................................... 106 oseltamivir phosphate cap 45 mg (base equiv) .......................................... 106 oseltamivir phosphate cap 75 mg (base equiv) .......................................... 106 oseltamivir phosphate for susp 6 mg/ml (base equiv) ................................... 45 OSPHENA TAB 60MG ...................... 104 OSTEOPRIME TAB PLUS .................. 149 osteoprime tab ultra ...................... 138 otix sol 6.5% ot ............................. 165

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OVARY TAB 125 MG ....................... 186 ovega-3 cap 500mg ................ 127, 159 oxaprozin tab 600 mg ..................... 159 oxybutynin chloride syrup 5 mg/5ml .197 oxybutynin chloride tab 5 mg ........... 197 oxybutynin chloride tab er 24hr 10 mg .................................................... 197 oxybutynin chloride tab er 24hr 15 mg .................................................... 197 oxybutynin chloride tab er 24hr 5 mg 197 oxycodone hcl cap 5 mg ............ 10, 164 oxycodone hcl conc 100 mg/5ml (20 mg/ml) ......................................... 164 oxycodone hcl soln 5 mg/5ml ........... 164 oxycodone hcl tab 10 mg ................ 164 oxycodone hcl tab 15 mg ................ 164 oxycodone hcl tab 20 mg ................ 164 oxycodone hcl tab 30 mg ........... 10, 164 oxycodone hcl tab 5 mg .................. 164 oxycodone w/ acetaminophen tab 10-325 mg ................................................. 10 oxycodone w/ acetaminophen tab 2.5-325 mg ..................................... 10 oxycodone w/ acetaminophen tab 5-325 mg ................................................. 10 oxycodone w/ acetaminophen tab 7.5-325 mg ..................................... 10 oxycodone-aspirin tab 4.8355-325 mg .................................................... 165 OXYTETRACYC POW HCL ................. 193 OXYTROL/WOMN DIS 3.9MG/24 ....... 197 oys shell ca tab /d3 .......................... 63 oys shell ca tab 500 + d .................... 63 oys shell+d chw 500-400 .................. 63 oys shell+d tab 250-125 ................... 63 oysco 500 tab 500mg ....................... 60 oysco 500+d chw ............................. 63 oysco 500+d tab .............................. 63 oyst ca/d3 tab 500-200 ..................... 63 oyst cal/d tab 250mg ........................ 63 oyst cal/d tab 500mg ........................ 63 oyst shell/d tab 250mg ..................... 63 oyst shell/d tab 500-125 ................... 63 oyst shell/d tab 500-200 ................... 63 oyst shell/d tab 500-400 ................... 63 oyst shell/d tab 500mg ..................... 63 oyster shell calcium tab 500 mg ......... 60

oystercal tab 500mg ........................ 60 oystercal-d tab 500mg ..................... 63 OZEMPIC INJ 2/1.5ML ...................... 23 P pa b-complex tab w/b-12 ................. 48 pa calcium tab vit d ......................... 63 pa fish oil cap 1000mg ................... 127 pa melatonin tab 5mg ........................ 7 PA MENS 50 PAK VITAPAK .............. 138 PA MENS PAK VITAPAK ................... 138 pa mucus rel tab 600mg ................... 97 pa oyster sh tab 500mg ................... 63 pa vitamin cap 2000unit ................. 161 PA WOMENS 50 PAK VITAPAK ......... 138 PA WOMENS PAK VITAPAK .............. 138 pacerone tab 200mg ........................ 19 pain & fever chw 160mg ..................... 9 pain & fever sol 160/5ml .................. 12 pain & fever sus 160/5ml .................. 12 pain & fever tab 325mg .................... 12 pain & fever tab 500mg .................... 12 pain relief chw 160mg ........................ 9 pain relief liq 160/5ml ...................... 12 pain relief liq 500/15ml .................... 12 pain relief sus 160/5ml ..................... 12 pain relief tab 200mg ......................... 9 pain relief tab 325mg ....................... 12 pain relief tab 500mg ....................... 12 pain relief tab 500mg/rr ................... 12 pain relief tab 650mg ....................... 12 pain relieve chw 160mg jr ................ 12 pain relieve sus 160/5ml .................. 12 pain relieve tab 325mg .................... 12 pain relieve tab 500mg .................... 12 pain relieve tab 500mg/rr ................. 12 pain relievr chw 80mg .................. 9, 12 pain relievr liq 500/15ml .................. 12 pain relievr tab 160mg ..................... 12 pain relievr tab 325mg ..................... 12 pain relievr tab 500mg ..................... 12 pain/fever sup 120mg ...................... 12 pain/fever sus 160/5ml .................... 12 paladin oin .................................84, 92 pamprin tab 220mg ....................... 159 pan-c 500 tab bioflavo ............... 59, 144 PANDA MASK MIS LARGE ......... 122, 181 PANDA MASK MIS MEDIUM....... 122, 181

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PANDA MASK MIS PEDIATRI..... 122, 181 PANDA MASK MIS SMALL ......... 122, 181 pantoprazole sodium ec tab 20 mg (base equiv) ................................... 174, 195 pantoprazole sodium ec tab 40 mg (base equiv) ................................... 174, 196 PARAGARD IUD T380A ...................... 73 PARATHYROID TAB 10MG ................ 186 PARI BABY MIS SIZE 0 .................... 178 PARI BABY MIS SIZE 1 ............ 122, 178 PARI BABY MIS SIZE 2 .................... 178 PARI EXPIRAT MIS FILTER ............... 179 PARI LC D MIS NEBULIZR ........ 122, 178 PARI LC MIS SPRINT ............... 122, 178 PARI LC PLUS MIS .......................... 178 PARI LC PLUS MIS NEBULIZR ... 122, 178 PARI LC PLUS MIS VIOS PRO.... 122, 178 PARI LC STAR MIS .......................... 178 PARI LC STAR MIS NEBULIZR .......... 178 PARI MASK MIS SIZE 3 ................... 179 PARI PLASTIC MIS MASK ................. 179 PARI PLASTIC MIS MASK PED .......... 179 PARI PRONEB MIS ULTRA II ..... 122, 178 PARI SINUS MIS AERO SYS...... 122, 178 PARI TREK S MIS .................... 122, 178 paricalcitol cap 1 mcg ..................... 123 paricalcitol cap 2 mcg ..................... 123 paricalcitol cap 4 mcg ..................... 123 paroex sol 0.12% ..................... 44, 128 PARVA-CAL TAB 500MG .................... 63 PARVLEX TAB ......................... 138, 149 PC LANCETS MIS 30G ....................... 88 PEANUTS MIS BANDAGES .......... 55, 113 ped elctrlyt sol ................................. 94 ped elctrlyt sol /zinc ......................... 94 ped elctrlyt sol apple ...................... 125 ped elctrlyt sol freeze ....................... 94 ped elctrlyt sol freezer ...................... 94 ped elctrlyt sol freezpop .................... 94 ped elctrlyt sol grape ........................ 94 ped elctrlyt sol pineappl .................. 125 ped formula liq 100-10/5 .................. 78 pedia d-vite dro 400unit .................. 161 pedia iron dro 15mg/ml .................. 108 pedia vance sol apple ....................... 94 pedia vance sol grape ....................... 94 pediacare al liq 12.5/5ml ................... 33

pediacare sus 160/5ml.................. 9, 12 PEDIA-LAX CHW YUMS ..................... 24 PEDIA-LAX LIQ 50MG ..................... 191 PEDIATRIC MD MIS MASK ............... 177 PEDIATRIC MIS MASK .................... 179 PEDIATRIC MIS MOUTHPIE ............. 179 pediatric oin .................................... 92 PEDIATRIC SM MIS MASK ............... 177 pediatric vitamins acd w/ fluoride soln 0.5 mg/ml .................................... 152 pediavit liq.................................... 169 peg 3350-kcl-na bicarb-nacl-na sulfate for soln 236 gm ............................. 108 peg 3350-kcl-sod bicarb-nacl for soln 420 gm ........................................ 108 PEGASYS INJ .................................. 45 PEGASYS INJ 180MCG/M .................. 45 PEGASYS INJ PROCLICK ................... 45 PEN NEEDLE MIS 29GX1/2 .............. 119 PEN NEEDLE MIS 32GX4MM ............ 119 PEN NEEDLES MIS 29GX12.7 .... 119, 120 PEN NEEDLES MIS 31GX3/16 .......... 120 PEN NEEDLES MIS 31GX5/16 .......... 120 PEN NEEDLES MIS 31GX5MM .......... 120 PEN NEEDLES MIS 31GX8MM .......... 120 PEN NEEDLES MIS 32GX1/4 ............ 120 PEN NEEDLES MIS 32GX4MM .......... 120 PEN NEEDLES MIS 32GX5/32 .......... 120 PEN NEEDLES MIS 32GX6MM .......... 120 penicillin v potassium for soln 125 mg/5ml ........................................ 156 penicillin v potassium for soln 250 mg/5ml ........................................ 156 penicillin v potassium tab 250 mg .... 156 penicillin v potassium tab 500 mg .... 156 PENTASA CAP 250MG CR ................ 106 PENTASA CAP 500MG CR ................ 106 PENTIPS MIS 31GX5MM .................. 120 PENTIPS MIS 31GX8MM .................. 120 PENTIPS MIS 32GX4MM .................. 120 peptic relf chw 262mg ...................... 25 PERFECT 28G MIS LANCETS .............. 88 PERFECT 30G MIS LANCETS .............. 88 permethrin cream 5% .................... 184 persa-gel gel 10% ............................. 5 PFLEX MIS .................................... 179 PFT FILTER MIS 1000 ..................... 179

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pharbechlor tab 4mg ........................ 32 pharbedryl cap 25mg ........................ 33 pharbedryl cap 50mg ........................ 33 pharbetol tab 325mg ........................ 12 pharbetol tab 500mg ........................ 12 pharbinex tab 400mg ....................... 77 PHARMACY COU MIS LANCETS ........... 88 phazyme chw 125mg ........................ 27 phenadoz sup 12.5mg ...................... 35 phenadoz sup 25mg ......................... 35 phenazo tab 200mg ........................ 196 phenazopyridine hcl tab 100 mg ....... 196 phenazopyridine hcl tab 200 mg ....... 196 phenobarbital elixir 20 mg/5ml .......... 56 phenobarbital tab 100 mg ................. 56 phenobarbital tab 15 mg ................... 56 phenobarbital tab 16.2 mg ................ 56 phenobarbital tab 30 mg ................... 56 phenobarbital tab 32.4 mg ................ 56 phenobarbital tab 60 mg ................... 56 phenobarbital tab 64.8 mg ................ 56 phenobarbital tab 97.2 mg ................ 56 phenytoin chew tab 50 mg .............. 104 phenytoin sodium extended cap 100 mg .................................................... 104 phenytoin sodium extended cap 200 mg .................................................... 104 phenytoin sodium extended cap 300 mg .................................................... 104 phenytoin susp 125 mg/5ml ............ 104 philith tab 0.4-35 ............................. 70 phillips cap 100mg ......................... 191 PHLEXY-VITS POW ......................... 138 PHYTOMULTI TAB ........................... 138 phytonadione tab 5 mg ................... 200 PILLOW MASK MIS ADULT........ 122, 179 PILLOW MASK MIS CHILD ........ 122, 179 PILLOW MASK MIS PEDIATRI ... 122, 179 pilocarpine hcl tab 5 mg .................. 193 pilocarpine hcl tab 7.5 mg ............... 193 pimtrea tab ..................................... 69 pindolol tab 10 mg ........................... 57 pindolol tab 5 mg ............................. 57 pink bismuth chw 262mg .................. 25 pink bismuth sus 262/15ml ............... 25 pink bismuth sus max str .................. 25 pink bismuth tab 262mg ................... 25

pinworm med sus 144mg/ml ............. 17 PINWORM TAB MEDICINE ................. 17 pinxav oin ..................................84, 92 pioglitazone hcl tab 15 mg (base equiv) .................................................... 106 pioglitazone hcl tab 30 mg (base equiv) .................................................... 106 pioglitazone hcl tab 45 mg (base equiv) .................................................... 106 pioglitazone hcl-glimepiride tab 30-2 mg ...................................................... 22 pioglitazone hcl-glimepiride tab 30-4 mg ...................................................... 22 pioglitazone hcl-metformin hcl tab 15-500 mg ..................................... 22 pioglitazone hcl-metformin hcl tab 15-850 mg ..................................... 22 PIPERAZINE POW ............................ 17 pirmella tab 1/35 ............................. 70 pirmella tab 7/7/7 ........................... 71 PITUITARY TAB 35 MG .................... 186 PLASTC BANDG MIS 3/4 ................... 55 PLASTIC MIS BANDAGES .................. 55 pms support cap complex ............... 138 pnv-dha cap ................................. 153 pnv-select tab ............................... 153 POCKET CHAMB MIS................ 122, 181 POCKET SPACE MIS................. 122, 181 podactin cre 2% .............................. 30 podofilox soln 0.5% ....................... 108 poly bacitra oin ............................... 20 poly vitamin chw ........................... 169 polycin oin op ............................... 162 polyeth glyc pow 3350 nf ................ 109 polyethylene glycol 3350 oral packet 109, 110 polyethylene glycol 3350 oral powder ............................................. 109, 110 POLYMYXIN B POW SULFATE ...... 18, 171 polymyxin b-trimethoprim ophth soln 10000 unit/ml-0.1% ...................... 162 polyvinyl alcohol ophth soln 1.4% ...... 47 polyvitamin chw /iron ..................... 167 poly-vite dro ................................. 169 poly-vite sol /iron .......................... 168 PORENAL+D CAP OMEGA 3 ............. 149 PORT COMPRES MIS NEBULIZR ....... 178

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portia-28 tab ................................... 70 potassium bicarbonate effer tab 25 meq .................................................... 172 potassium chloride cap er 10 meq .... 172 potassium chloride cap er 8 meq ...... 172 potassium chloride microencapsulated crys er tab 10 meq ......................... 172 potassium chloride microencapsulated crys er tab 20 meq.................. 125, 172 potassium chloride oral soln 10% (20 meq/15ml) ................................... 172 potassium chloride oral soln 20% (40 meq/15ml) ................................... 172 potassium chloride tab er 10 meq ..... 172 potassium chloride tab er 20 meq (1500 mg) ............................................. 172 potassium chloride tab er 8 meq (600 mg) ............................................. 172 potassium citrate tab er 10 meq (1080 mg) ................................................ 5 potassium citrate tab er 15 meq (1620 mg) ................................................ 5 potassium citrate tab er 5 meq (540 mg) ....................................................... 5 poten b-150 tab tr ............................ 50 povidone iod oin 10% ..................... 107 povidone/iod sol 10% ....................... 44 povidone-iod sol 10% ..................... 107 povidone-iod sol 7.5% .................... 107 povidone-iodine oint 10%................ 107 povidone-iodine soln 10% ............... 107 powderlax pow .............................. 110 pr benzoyl liq 7% wash ...................... 5 PRALUENT INJ 150MG/ML ................. 36 PRALUENT INJ 75MG/ML ................... 36 pramipexole dihydrochloride tab 0.125 mg ................................................. 43 pramipexole dihydrochloride tab 0.25 mg ......................................................43 pramipexole dihydrochloride tab 0.5 mg ......................................................43 pramipexole dihydrochloride tab 0.75 mg ......................................................43 pramipexole dihydrochloride tab 1 mg .43 pramipexole dihydrochloride tab 1.5 mg ......................................................43 prasugrel hcl tab 10 mg (base equiv) 102

prasugrel hcl tab 5 mg (base equiv) . 102 pravastatin sodium tab 10 mg ......... 104 pravastatin sodium tab 20 mg ......... 104 pravastatin sodium tab 40 mg ......... 104 pravastatin sodium tab 80 mg ......... 104 prazosin hcl cap 1 mg ...................... 19 prazosin hcl cap 2 mg ...................... 19 prazosin hcl cap 5 mg ...................... 19 PRED SOD PHO SOL 1% OP ............ 163 prednisolone acetate ophth susp 1% 163 prednisolone sod phos orally disintegr tab 10 mg (base eq) ...................... 100 prednisolone sod phos orally disintegr tab 15 mg (base eq) ...................... 100 prednisolone sod phos orally disintegr tab 30 mg (base eq) ...................... 100 prednisolone sod phosph oral soln 6.7 mg/5ml (5 mg/5ml base) ................ 100 prednisolone sod phosphate oral soln 15 mg/5ml (base equiv) ...................... 100 prednisolone sodium phosphate oral soln 25 mg/5ml (base eq) ..................... 100 PREDNISOLONE SUS 1% ................ 162 prednisolone syrup 15 mg/5ml (usp solution equivalent) ....................... 100 prednisone oral soln 5 mg/5ml ........ 100 prednisone tab 1 mg ...................... 100 prednisone tab 10 mg .................... 100 prednisone tab 2.5 mg ................... 100 prednisone tab 20 mg .................... 100 prednisone tab 5 mg ...................... 100 prednisone tab 50 mg .................... 100 prednisone tab therapy pack 10 mg (21) .................................................... 101 prednisone tab therapy pack 10 mg (48) .................................................... 101 prednisone tab therapy pack 5 mg (21) .................................................... 100 prednisone tab therapy pack 5 mg (48) .................................................... 101 PREMIUM MIS PACKETS ........... 138, 149 prenatabs rx tab ............................ 173 prenatal 19 chw tab ....................... 173 prenatal 19 tab ............................. 173 prep h hc cre 1% ............................. 76 PREP PADS PAD ............................ 125 PRESCRIPTIVE PAK FORM MEN ........ 138

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PRESCRIPTIVE PAK FORM WMN ....... 138 PRESERVISION CAP AREDS ............. 138 PRESERVISION CAP AREDS 2 .......... 138 PRESERVISION CAP LUTEIN ............ 138 PRESERVISION CHW AREDS 2 ......... 149 PRESERVISION TAB AREDS ............. 138 PRESSURE ACT MIS LANCET .............. 88 PRESSURE ACT MIS LANCETS ............ 89 prevalite pow 4gm ........................... 58 prevalite pow 4gm pk ....................... 58 prevent cap ................................... 138 prevident sol 0.2% ........................... 82 previfem tab ................................... 70 PRILOSEC OTC TAB 20MG ............... 174 primadophilu cap ............................. 26 primidone tab 250 mg ...................... 21 primidone tab 50 mg ........................ 21 princess chw gummies .................... 167 PRO COMFORT MIS 31G .................... 89 PRO COMFORT MIS 31GX8MM .......... 120 PRO COMFORT MIS 32GX4MM .......... 120 PRO COMFORT MIS 32GX6MM ......... 120 PRO COMFORT MIS LANCETS ............. 89 PRO COMFORT PAD ALCOHOL .......... 125 probenecid tab 500 mg ................... 196 probiata tab .................................... 25 probiotic cap .............................. 25, 26 PROBIOTIC CAP .......................... 25, 26 probiotic cap acidophi ....................... 25 probiotic cap formula ........................ 25 probiotic cap gold ............................. 25 PROBIOTIC CAP GOLD ...................... 25 probiotic chw children ....................... 25 PROBIOTIC DRO COLIC ..................... 25 PROBIOTIC LIQ 15 DAY ..................... 26 PROBIOTIC LIQ NEWBORN ................ 26 probiotic pak children ....................... 25 PRO-CAL TAB ......................... 138, 149 PROCARE COMP MIS NEBULIZE ........ 122 PROCEDURAL MIS MASK ................. 177 PROCERV HP TAB ........................... 138 prochlorperazine maleate tab 10 mg (base equivalent) ........................... 171 prochlorperazine maleate tab 5 mg (base equivalent) ................................... 171 prochlorperazine suppos 25 mg ........ 171 procto-med cre hc 2.5% ................. 176

procto-pak cre 1% ......................... 176 proctosol hc cre 2.5% .................... 176 proctozone cre -hc 2.5% ................ 176 PRODIGY MIS 26G ........................... 89 PRODIGY MIS 28G .................... 89, 117 pro-ex antif cre 1% .......................... 30 progesterone micronized cap 100 mg 173 progesterone micronized cap 200 mg 173 PROLASTIN-C INJ 1000MG .............. 176 PROLIA SOL 60MG/ML ...................... 94 PROMACTA TAB 12.5MG ................. 103 PROMACTA TAB 25MG .................... 103 PROMACTA TAB 50MG .................... 103 PROMACTA TAB 75MG .................... 103 promethazine & phenylephrine syrup 6.25-5 mg/5ml ................................ 80 promethazine hcl suppos 12.5 mg ...... 35 promethazine hcl suppos 25 mg ......... 35 promethazine hcl suppos 50 mg ......... 35 promethazine hcl syrup 6.25 mg/5ml . 35 promethazine hcl tab 12.5 mg ........... 35 promethazine hcl tab 25 mg .............. 35 promethazine hcl tab 50 mg .............. 35 promethazine w/ codeine syrup 6.25-10 mg/5ml......................................77, 81 promethazine-dm syrup 6.25-15 mg/5ml ...................................................... 81 promethazine-phenylephrine-codeine syrup 6.25-5-10 mg/5ml .................. 81 promethegan sup 12.5mg ................. 36 promethegan sup 25mg .................... 36 promethegan sup 50mg .................... 36 promolaxin tab 100mg ................... 191 PRONEB ULTRA MIS II/LCD ...... 122, 178 PRONEB ULTRA MIS II/PED ...... 122, 178 PRONEB ULTRA MIS LC PLUS .... 122, 178 PRONEB ULTRA MIS LC SPRNT.. 122, 178 PRONEB ULTRA MIS LC STAR.... 123, 178 PRONUTRIENTS TAB SUPER B ........... 48 propafenone hcl cap er 12hr 225 mg .. 19 propafenone hcl cap er 12hr 325 mg .. 19 propafenone hcl cap er 12hr 425 mg .. 19 propafenone hcl tab 150 mg .............. 19 propafenone hcl tab 225 mg .............. 19 propafenone hcl tab 300 mg .............. 19 propranolol hcl cap er 24hr 120 mg .... 57 propranolol hcl cap er 24hr 160 mg .... 57

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propranolol hcl cap er 24hr 60 mg ...... 57 propranolol hcl cap er 24hr 80 mg ...... 57 propranolol hcl oral soln 20 mg/5ml .... 57 propranolol hcl oral soln 40 mg/5ml .... 57 propranolol hcl tab 10 mg ................. 57 propranolol hcl tab 20 mg ................. 57 propranolol hcl tab 40 mg ................. 57 propranolol hcl tab 60 mg ................. 57 propranolol hcl tab 80 mg ................. 57 propylthiouracil tab 50 mg ................. 45 PRORENAL +D TAB ........................ 138 PRORENAL+D CAP OMEGA-3 ........... 138 PRORENAL+D TAB ......................... 138 prosight cap w/lutein ...................... 138 prosight tab ........................... 138, 149 PROSTATE TAB 130MG ................... 186 PROTECT CAP CARDIO .................... 138 PROTECT CAP PLUS SO ................... 138 PROTECT PLUS LIQ NF .................... 138 PROTEGRA CAP ............................. 149 provil tab 200mg ........................... 159 PROVIT TAB .................................. 149 PROXI-STRIP MIS 1/4 ....................... 55 PROXI-STRIPS MIS 1/2 ..................... 55 pseudoephed-bromphen-dm syrup 30-2-10 mg/5ml .............................. 81 pseudoephedr tab 120mg er ............ 192 pseudoephedr tab 30mg ................. 192 pseudoephedr tab 60mg ................. 192 pseudoephedrine-guaifenesin tab er 12hr 60-600 mg ...................................... 81 PSORCON CRE 0.05% ....................... 76 PSS SAFE LAN MIS ........................... 89 PSS SEL LANC MIS ........................... 89 pulmosal neb 7% ........................... 127 PULMOZYME SOL 1MG/ML ................. 82 puralube oin .................................... 46 pure & gentl dro 0.3% ...................... 47 purefa cap 1000mg ........................ 127 pvp prep sol 10% ........................... 107 px advanced tab multivit ................. 138 px allergy cap 25mg ......................... 33 px allergy tab 25mg ......................... 33 px antacid chw 1000mg .................... 16 px antacid sus max st ....................... 15 px antacid sus reg st ........................ 15 px aspirin chw 81mg ...................... 183

px aspirin tab 325mg ..................... 183 px aspirin tab 325mg ec ................. 183 px aspirin tab 81mg ec ................... 183 px b-50 tab .................................. 201 px calcium&d tab 600-400 ................ 63 px complete tab senior ................... 138 px dayhist tab 1.34mg ..................... 33 px fish oil cap 1000mg ................... 127 px ibuprofen tab 200mg ................. 159 px iron tab 200mg ......................... 108 px iron tab 27mg ........................... 108 PX LANCETS MIS 28G ................ 89, 117 PX LANCETS MIS ULT THIN ............. 117 px laxative tab 8.6mg .................... 189 px mens mult tab vitamins .............. 138 px profen ib dro 50/1.25 ................. 159 px profen ib sus 100/5ml .............9, 159 px stomach chw 262mg .................... 25 px stomach sus 262/15ml ................. 25 px stomach sus 525/15ml ................. 25 px triple oin .................................... 20 px tussin dm liq 100-10/5 ................. 78 px tussin sol 100/5ml ....................... 97 pyrazinamide tab 500 mg ................. 38 pyridostigmine bromide tab 60 mg ..... 38 pyridostigmine bromide tab er 180 mg 38 pyridoxine hcl tab 25 mg ................ 200 pyridoxine hcl tab 50 mg ................ 201 Q QC ALCOHOL PAD SWABS ............... 125 qc allergy tab 10mg ......................... 35 qc antacid chw 500mg ..................... 17 qc antacid sus ................................. 15 qc antacid sus anti-gas ..................... 15 qc apap 8 hr tab 650mg ................... 12 qc aspirin tab 325mg ..................... 183 qc aspirin tab 325mg ec ................. 183 QC CASTOR OIL ............................ 111 qc child asa chw 81mg ................... 183 qc childrens chw complete ........ 152, 167 qc childrens chw extra c ........... 153, 169 qc childrens chw iron ...................... 168 qc essential tab ............................. 151 qc gas relf chw 125mg ..................... 28 qc gas relf chw 80mg ....................... 27 qc hydrocort cre 1% ....................76, 84 qc ibuprofen tab 200mg .................. 159

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QC LANCETS MIS 28G ...................... 89 QC LANCETS MIS 30G ....................... 89 qc laxative sup 10mg ..................... 189 qc laxative tab 5mg ec .................... 189 qc medifin liq mucus rl ...................... 97 qc senna tab 8.6mg ....................... 189 qc sleep aid cap 50mg ............... 30, 104 qc suphedrin tab 120mg sr .............. 192 QC SWEET OIL ......................... 68, 111 qc therin-m tab ...................... 138, 149 QUENCH TAB ................................. 138 QUFLORA PED CHW 0.25MG ............ 168 QUFLORA PED CHW 0.5MG .............. 168 QUFLORA PED CHW 1MG ................ 168 QUFLORA PED DRO 0.25MG ............ 168 QUFLORA PED DRO 0.5MG/ML ......... 168 QUIKSTIK ADH MIS BANDAGES .. 55, 113 quin b stron tab b-25 ................ 50, 143 QUIN B TAB STRONG .............. 138, 149 quinapril hcl tab 10 mg ...................... 3 quinapril hcl tab 20 mg ...................... 3 quinapril hcl tab 40 mg ...................... 3 quinapril hcl tab 5 mg ........................ 3 quinapril-hydrochlorothiazide tab 10-12.5 mg ................................................. 37 quinapril-hydrochlorothiazide tab 20-12.5 mg ................................................. 37 quinapril-hydrochlorothiazide tab 20-25 mg ................................................. 37 QUININE POW SULFATE .................... 37 QUININE SULF POW DIHYDRAT .......... 37 QUINTABS TAB .............................. 151 quintabs-m tab ....................... 138, 149 QUINTABS-M TAB ................... 138, 149 QVAR REDIHA AER 80MCG ................ 20 QVAR REDIHAL AER 40MCG ............... 20 R ra acetamin tab 325mg ..................... 12 ra acidophil cap 300mg ..................... 25 ra acne cre 10% ............................... 5 RA ADH BANDG MIS EX-LARGE .......... 55 RA ADH PADS MIS 3 ......................... 55 RA ADHESIVE MIS 2-1/4X3 ............... 55 RA ADHESIVE MIS BANDAGES.... 55, 113 RA ALCOHOL PAD SWABS ............... 126 ra allergy tab 25mg .......................... 33 ra allergy tab 4mg ............................ 31

ra antacid chw 1000mg .................... 17 ra antacid chw 500mg ...................... 17 ra antacid sus antigas ...................... 15 ra antacid sus anti-gas ..................... 15 ra anti-itch cre 1% ........................... 76 ra anti-itch oin 1% ........................... 76 ra anti-itch spr 1%........................... 76 ra antisepti sol 10% ....................... 107 ra aspirin chw 81mg ...................... 183 ra aspirin tab 325mg ...................... 183 ra aspirin tab 325mg ec .................. 183 ra aspirin tab 500mg ...................... 183 ra aspirin tab 81mg ec ................... 183 ra balanced tab b-100 ...................... 50 ra balanced tab b-50 ........................ 50 ra balanced tab b-50 tr .............. 50, 143 ra balnaced tab b-100 tr ................... 50 RA BANDAGES MIS 1 ....................... 55 ra bandages mis 3/4 ........................ 55 RA BANDAGES MIS 3/4 .................... 55 RA BANDAGES MIS ASSORTED .......... 55 RA BANDAGES MIS CLEAR.......... 55, 113 RA BANDAGES MIS EX-LRG ........ 55, 113 ra b-complex tab ............................. 48 ra b-complex tab vit c tr ................... 48 ra b-complex tab w/b-12............ 48, 143 RA BUTTERFLY MIS BANDAGES ......... 55 ra ca/mg/zn tab .............................. 63 ra ca/vit d3 tab 600-400 ................... 63 ra calcium chw caramel .................... 63 ra calcium chw mlk choc ................... 63 ra calcium tab 500mg ....................... 60 ra calcium tab 600mg ....................... 60 ra calcium tab hi-cal ......................... 60 ra calcium tab high pot ..................... 60 ra calcium tab vit d .......................... 63 ra calcium+d tab 600mg ................... 64 ra central tab energy ...................... 138 ra central tab -vite .................. 138, 149 ra central tab vite sel............... 138, 149 ra central tab vite sen.............. 138, 149 ra cetiri-d tab 5-120mg .................... 80 ra cetirizin tab 10mg ........................ 35 ra child asa chw 81mg .................... 183 ra child vit chw /iron ...................... 168 ra chlorphen tab 4mg ....................... 32 ra clotrimaz cre 3 .......................... 198

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ra cod liver cap....................... 153, 199 RA COD LIVER OIL ......................... 199 ra col-rite cap 100mg ..................... 191 ra col-rite cap 250mg ..................... 191 ra col-rite cap 50mg ....................... 191 ra dandruff sha 1% .......................... 44 RA EAR CARE TAB .......................... 186 ra ear dro 6.5% ot ......................... 165 RA EAR-LOOP MIS MASK ................. 177 RA EFFERVESC TAB FORMULA .. 153, 186 RA ESSENCE-C POW LMN-LIME ........ 138 RA ESSENCE-C POW ORANGE .......... 138 RA ESSENCE-C POW RASPBRY ......... 138 RA ESSENCE-C POW TNGERINE ....... 138 RA E-ZJECT MIS 28G ........................ 89 RA E-ZJECT MIS 33G ........................ 89 RA E-ZJECT MIS THIN 26G ................ 89 RA E-ZJECT MIS THIN 28G ................ 89 RA E-ZJECT MIS ULT THIN ................ 89 ra fish oil cap 1000mg .................... 127 ra gas relf chw 125mg ...................... 28 ra gas relf chw 80mg ........................ 28 ra hair/skin tab /nails ..................... 138 ra hi cal tab 500-200 ........................ 64 ra hi-cal tab 500mg................... 60, 124 ra hi-cal/d tab 500mg ....................... 64 ra hydrocort cre 1% ......................... 76 ra hydrocort cre 1%pls 12 ................. 76 ra ibuprofen cap 200mg .................. 159 ra ibuprofen tab 200mg .................. 159 ra iron tab 27mg ............................ 108 ra iron tab 325mg .......................... 108 ra iron tab 65mg ............................ 108 ra k-pec sus 262/15ml ...................... 25 ra laxative chw 15mg ..................... 189 ra laxative pow .............................. 110 ra laxative sup 10mg ...................... 189 ra laxative tab 25mg ...................... 189 ra laxative tab 5mg ec .................... 189 ra laxative tab ex st ....................... 189 ra lice lot 1% ................................ 184 ra liquid sus antacid ......................... 15 ra lorata-d tab 24 hour ..................... 80 ra lubricant dro 0.4-0.3% ................. 46 ra mature wm tab diet sup .............. 139 RA MELATONIN SUB 1MG ................... 7 ra melatonin tab 10mg ...................... 7

ra melatonin tab 3mg ........................ 7 ra melatonin tab 5mg ......................... 7 ra menopause tab support .............. 187 ra nasal spr allergy ........................ 156 ra nighttime cap 50mg ..................... 30 ra nighttime tab 25mg ...................... 30 ra one daily pak mens 50+ ............. 139 ra one daily tab +iron .............. 129, 144 ra one daily tab energy .................. 139 ra one daily tab essentia ................ 151 ra one daily tab maximum .............. 139 ra one daily tab mens ..................... 139 ra one daily tab mens 50+ .............. 139 ra one daily tab mens/d3 ................ 139 ra one daily tab multivit ................. 151 ra one daily tab womens ................. 139 RA OYS SHL/D TAB 250MG ............... 64 RA OYS SHL/D TAB 500MG ............... 64 ra p col-rit tab 8.6-50mg ................ 109 ra pediatric sol electrol ..................... 94 RA PEN NEEDL MIS 31GX3/16 ......... 120 ra pink bism chw 262mg ................... 25 ra pink bism tab 262mg .................... 25 ra renewal gel 10% ............................ 5 ra senna cap 8.6mg ....................... 189 ra senna tab 8.6mg ....................... 189 RA SHEER ADH PAD LARGE ............... 55 ra sleep aid cap 50mg ...................... 30 ra sleep aid tab 25mg ...................... 30 RA STERILE SOL NASAL ................. 154 ra suphedrin tab 120mg cr .............. 192 ra suphedrin tab 30mg ................... 192 ra therapeut tab m/beta ................. 139 ra triple oin antibiot ......................... 20 ra tussin dm liq 100-10/5 ................. 78 ra tussin liq 100/5ml ........................ 97 ra tussin liq dm max ........................ 78 ra tussin syp 100/5ml ...................... 97 ra vision tab vite/zn ....................... 139 ra vit b-6 tab 50mg ....................... 201 ra vitamin c tab 1000mg ................... 59 ra vitamin cap 2000unit .................. 161 rabano liq yodado ............................ 51 raloxifene hcl tab 60 mg ................. 104 ramipril cap 1.25 mg .......................... 3 ramipril cap 10 mg............................. 3 ramipril cap 2.5 mg............................ 3

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ramipril cap 5 mg .............................. 3 ranitidine hcl cap 150 mg ................ 101 ranitidine hcl cap 300 mg ................ 101 ranitidine hcl syrup 15 mg/ml (75 mg/5ml) ....................................... 101 ranitidine hcl tab 150 mg ......... 101, 196 ranitidine hcl tab 300 mg ................ 102 ranitidine tab 75mg ........................ 102 RAPAMUNE SOL 1MG/ML ................. 105 RASH AWAY AER......................... 84, 92 RASUVO INJ 10MG ............................ 8 RASUVO INJ 12.5MG ......................... 8 RASUVO INJ 15MG ............................ 8 RASUVO INJ 17.5MG ......................... 8 RASUVO INJ 20MG ............................ 8 RASUVO INJ 22.5MG ......................... 8 RASUVO INJ 25MG ............................ 8 RASUVO INJ 30MG ............................ 8 RASUVO INJ 7.5MG ........................... 8 react tab 1.5mg ............................... 94 READYLANCE MIS 21G .................... 117 READYLANCE MIS 23G .................... 117 READYLANCE MIS 26G .................... 117 READYLANCE MIS 28G .................... 117 READYLANCE MIS 30G ...................... 89 REALITY MIS LANCETS ...................... 89 REALITY MIS LUBRICAT .................... 73 REALITY SWAB PAD ........................ 126 REALITY TRIG MIS LANCETS .............. 89 REALITY ULTR MIS TEXTURED ........... 73 REALITY ULTR MIS THIN ................... 73 REBETOL SOL 40MG/ML .................. 103 reclipsen tab ................................... 70 recofen ........................................... 78 recort plus cre 1% ........................... 76 REESES MED SUS PINWORM .............. 17 refenesen tab 200mg ........................ 97 refenesen tab 400mg ........................ 97 refresh cell gel 1% op ..................... 161 REFRESH DRO OP .......................... 161 refresh lacr oin op ............................ 46 REFRESH OPT SOL MEGA-3 ............... 46 REFRESH OPTI DRO 0.5-0.9% ........... 46 refresh p.m. oin op ........................... 46 REFRESH SOL OPTIVE ............... 46, 161 rehydralyte sol ................................ 94 RELION LANCE MIS STND 21G ........... 89

RELION LANCE MIS THIN 26G..... 89, 117 RELION LANCE MIS THIN 30G..... 89, 117 RELION MICRO MIS THIN 33G ........... 89 RELION PEN MIS 31GX8MM ............. 120 RELION PEN MIS 32GX4MM ............. 120 RELION ULTRA MIS THIN 32G ........... 89 RELION ULTRA MIS THIN PLS ..... 89, 117 remedy cre antifung ......................... 30 remedy oin af 2% ............................ 30 remedy pow antifung ....................... 30 REMODULIN INJ 10MG/ML ................ 66 REMODULIN INJ 1MG/ML .................. 66 REMODULIN INJ 2.5MG/ML ............... 66 REMODULIN INJ 5MG/ML .................. 66 renal cap ........................................ 49 renal tab multivit ............................. 49 renal vitamn tab .............................. 49 renal/zinc tab multivit .................... 151 renal-vite tab .................................. 49 renaplex tab ................................. 139 RENAPLEX-D TAB .......................... 139 rena-vite rx tab ............................. 143 rena-vite tab ................................... 49 reno cap .................................. 49, 143 repaglinide tab 0.5 mg ................... 123 repaglinide tab 1 mg ...................... 123 repaglinide tab 2 mg ...................... 123 REPHRESH CAP PRO-B ..................... 25 REPLACE CAP.......................... 139, 149 REPLACEMENT MIS FILTER ....... 123, 179 REPLACEMENT MIS FILTERS ..... 123, 179 rest simply tab 25mg ....................... 30 restore plus dro 0.5% op .................. 47 restore tear dro 0.5% op .................. 47 RETAINE CAP VISION ..................... 187 retaine cmc sol 0.5% op ................... 47 RETAINE HPMC SOL 0.3% .............. 161 retaine pm oin ................................ 46 REVATIO SUS 10MG/ML ................. 175 REVLIMID CAP 10MG ..................... 105 REVLIMID CAP 15MG ..................... 105 REVLIMID CAP 2.5MG .................... 105 REVLIMID CAP 20MG ..................... 105 REVLIMID CAP 25MG ..................... 105 REVLIMID CAP 5MG ....................... 105 RHINARIS SPR 0.2% ...................... 154 rhinocort sus allergy ...................... 156

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ribasphere cap 200mg .................... 103 ribasphere tab 200mg ..................... 103 ribasphere tab 400mg ..................... 103 ribasphere tab 600mg ..................... 103 ribavirin cap 200 mg ....................... 103 ribavirin tab 200 mg ....................... 103 rid lice kil sha 0.33-4% ................... 184 rifabutin cap 150 mg ........................ 38 rifampin cap 150 mg ........................ 38 rifampin cap 300 mg ........................ 38 RIGHTEST MIS GL300 ....................... 89 riluzole tab 50 mg ............................. 6 ringworm cre 1% ............................. 30 RISACAL-D TAB ............................... 64 risanoid tab plus ............................ 201 RITEFLO MIS ................................. 181 rivastigmine tartrate cap 1.5 mg (base equivalent) ..................................... 21 rivastigmine tartrate cap 3 mg (base equivalent) ..................................... 21 rivastigmine tartrate cap 4.5 mg (base equivalent) ..................................... 21 rivastigmine tartrate cap 6 mg (base equivalent) ..................................... 21 rivastigmine td patch 24hr 13.3 mg/24hr ......................................................22 rivastigmine td patch 24hr 4.6 mg/24hr ......................................................22 rivastigmine td patch 24hr 9.5 mg/24hr ......................................................22 rizatriptan benzoate oral disintegrating tab 10 mg (base eq) ....................... 184 rizatriptan benzoate oral disintegrating tab 5 mg (base eq) ........................ 184 rizatriptan benzoate tab 10 mg (base equivalent) ................................... 184 rizatriptan benzoate tab 5 mg (base equivalent) ................................... 184 robafen ac sol 100-10/5 .................... 77 robafen dm liq 10-100/5 ................... 78 robafen dm liq cough ........................ 77 robafen dm syp 100-10/5 .................. 78 robafen liq 200/10ml ........................ 77 robafen syp 100/5ml ........................ 97 robitussin liq ................................... 78 robitussin liq 20-400 ......................... 78 robitussin liq cgh/cong ...................... 78

robitussin liq to go dm...................... 78 rolaids chw 550-110 ........................ 15 ROMIDEPSIN INJ 10MG .................... 41 ropinirole hydrochloride tab 0.25 mg .. 43 ropinirole hydrochloride tab 0.5 mg .... 43 ropinirole hydrochloride tab 1 mg ...... 43 ropinirole hydrochloride tab 2 mg ...... 43 ropinirole hydrochloride tab 3 mg ...... 43 ropinirole hydrochloride tab 4 mg ...... 43 ropinirole hydrochloride tab 5 mg ...... 43 rosadan cre 0.75% ........................ 182 rosadan gel 0.75% ........................ 182 RUBRACA TAB 200MG ...................... 41 RUBRACA TAB 250MG ...................... 41 RUBRACA TAB 300MG ...................... 41 RUCONEST INJ 2100UNIT ............... 102 rulox sus ........................................ 15 RYDAPT CAP 25MG .......................... 41 rynex pse liq ................................... 80 S s.s.s. tonic liq ......................... 108, 144 s.s.s. tonic tab ........................ 108, 144 safe tussin liq 10-100/5 .................... 78 SAFE-T-LANCE MIS 21G............. 89, 117 SAFE-T-LANCE MIS 25G............. 89, 117 SAFE-T-LANCE MIS HI FLOW ............. 89 SAFE-T-LANCE MIS LOW FLOW .......... 89 SAFE-T-LANCE MIS NOR FLOW .......... 89 SAFE-T-PRO MIS LANCETS ......... 89, 117 SAFE-T-PRO MIS PLUS ............... 89, 117 SAFETY 21G MIS LANCETS ......... 89, 117 SAFETY 28G MIS LANCETS ......... 89, 117 SAFETY LET MIS LANCETS ................ 89 SAFETY MIS LANCETS ................ 89, 117 SAFETY SEAL MIS 28G ..................... 89 SAFETY SEAL MIS 30G ..................... 89 saline injection bacteriostatic ........... 170 saline mist spr 0.65% .................... 154 saline nasal spray 0.65% ................ 154 saline nose spr 0.65% .................... 154 SALINE/PHENO SOL ....................... 170 salmon oil cap 1000mg ................... 127 sam-e.p.a. cap 500mg ................... 127 SAMSCA TAB 15MG ........................ 198 SAMSCA TAB 30MG ........................ 198 SANDIMMUNE SOL 100MG/ML ......... 105 SANTYL OIN 250/GM ........................ 95

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SAPS CARE PAD ALCOHOL .............. 126 SAPS HEALTH MIS TWIST ................. 89 SAPS HEALTH PAD ALCOHOL ........... 126 SAPSCARE MIS TWIST ...................... 89 sarnol-hc lot 1% .............................. 76 SAVELLA MIS TITR PAK ..................... 98 SAVELLA TAB 100MG ........................ 98 SAVELLA TAB 12.5MG ....................... 98 SAVELLA TAB 25MG ......................... 98 SAVELLA TAB 50MG ......................... 98 SAVISION CAP .............................. 139 savision tab .................................. 139 SB ALCOHOL PAD PREP .................. 126 sb allergy tab 10mg ......................... 35 sb allergy tab 25mg med .................. 33 sb antacid sus anti-gas ..................... 15 sb aspirin tab 325mg ...................... 183 sb aspirin tab 325mg ec .................. 183 sb bisacodyl tab 5mg ec .................. 189 sb bismuth tab 262mg ...................... 25 sb cgh contr liq dm .......................... 78 sb cgh contr syp 100/5ml .................. 97 sb child asa chw 81mg .................... 183 sb coughtab tab 200mg .................... 97 sb docusate tab 8.6-50mg ............... 109 sb gas relf chw 125mg ...................... 28 sb hydrocort cre 1% ......................... 76 sb hydrocort oin 1% ......................... 76 sb ibuprofen tab 200mg .................. 159 SB LANCETS MIS THIN .............. 89, 117 SB LANCETS MIS ULTR THN ....... 89, 117 sb laxative sup 10mg ..................... 189 sb non-asa chw 160mg ..................... 13 sb non-asa chw 80mg frt .................. 12 sb non-asa chw 80mg grp ................. 13 sb saline spr 0.65% ....................... 154 sb senna-lax tab 8.6mg .................. 189 sb sleep tab 25mg ........................... 30 sb triple oin antibiot ......................... 20 scalp relief sol 1% ............................ 76 scalpicin sol 1% ............................... 76 sclerex tab .................................... 139 SCOOBY-DOO CHW ........................ 168 scot-tussin liq expct sf ...................... 97 sea buddies chw dly mult ................ 167 sea-omega 30 cap 1200mg ............. 127 sea-omega 50 cap 1000mg ............. 127

selegiline hcl cap 5 mg ..................... 43 selegiline hcl tab 5 mg ...................... 43 selenium sulfide lotion 2.5% ............. 44 senexon tab 8.6mg ........................ 189 senexon-s tab 8.6-50mg ................. 109 senior tabs tab .............................. 139 senna lax tab 8.6mg ...................... 189 senna laxati tab 8.6mg ................... 189 SENNA LEAVES MIS ....................... 189 senna plus tab 8.6-50mg ................ 109 senna s tab 8.6-50mg .................... 109 senna smooth tab 15mg ................. 189 SENNA SYP ................................... 189 senna tab 8.6-50mg ....................... 109 senna-extra tab 17.2mg ................. 189 senna-grx syp 8.8mg/5 .................. 189 senna-lax tab 8.6mg ...................... 189 senna-s tab 8.6-50mg .................... 109 senna-tabs tab 8.6mg .................... 189 senna-time s tab 8.6-50mg ............. 109 senna-time tab 8.6mg .................... 189 sennazon syp 8.8mg/5 ................... 189 senno tab 8.6mg ........................... 189 sennosides cap 8.6 mg ................... 189 sennosides syrup 8.8 mg/5ml .......... 189 sennosides tab 8.6 mg ................... 189 sennosides-docusate sodium tab 8.6-50 mg .............................................. 109 senokot extr tab 17.2mg ................ 189 senor tonic liq ............................... 144 sentry adult tab under 50 ............... 139 SENTRY SENIO TAB LUTEIN ............ 139 sentry tab .............................. 139, 149 SENTRY TAB ................................. 139 sentry tab senior ..................... 139, 149 SENTRY TAB SENIOR ..................... 149 SEROSTIM INJ 4MG ......................... 95 SEROSTIM INJ 5MG ......................... 95 SEROSTIM INJ 6MG ......................... 95 sevelamer carbonate packet 0.8 gm ... 99 sevelamer carbonate packet 2.4 gm ... 99 sevelamer carbonate tab 800 mg ....... 99 sf 5000 plus cre 1.1% ...................... 82 sf gel 1.1% ..................................... 82 shake ache tab 500mg ..................... 13 sharobel tab 0.35mg ...................... 173 SHEER BANDGE MIS ...................... 113

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SHEER BANDGE MIS 1 ...................... 55 SHEER BANDGE MIS ASSORTED ......... 55 sheer bandge mis ex-large ......... 55, 113 SHIELD-SECUR MIS ........................ 121 SHR BANDAGES MIS ................. 55, 113 SHR BANDAGES MIS 3/4 ................... 55 SHR BANDAGES MIS ASSORTED . 55, 113 SHR BANDAGES MIS EX-LARGE .......... 55 SHUR-SEAL GEL 2% ....................... 187 SIDE BUTTON MIS SAFETY......... 89, 117 SIDESTREAM MIS MASK .......... 123, 180 SIDESTREAM MIS NEBULIZR .... 123, 178 SIDESTREAM MIS PED MASK.... 123, 180 SIDESTREAM MIS PLUS .................. 178 SIDESTRM PLS MIS FACE MSK ......... 180 SIESTA MASK MIS .......................... 177 SIESTA MASK MIS ONE SIZE ........... 177 signacal tab ................................... 144 sigtab tab ..................................... 151 silace liq 10mg/ml .......................... 191 silace syp 60/15ml ......................... 191 siladryl alr liq 12.5/5ml ..................... 33 sildenafil citrate tab 20 mg ................ 66 SILICONE MSK MIS ADULT....... 123, 180 SILICONE MSK MIS INFANT ..... 123, 180 SILICONE MSK MIS PED .......... 123, 180 SILIQ INJ 210/1.5 ............................ 83 siltuss das liq 100/5ml ...................... 97 siltussin dm liq das ........................... 79 siltussin sa syp 100/5ml .................... 97 siltussin-dm liq diabetic ..................... 79 siltussin-dm liq max st ...................... 79 siltussin-dm syp alc free .................... 79 silver sulfadiazine cream 1% ............. 60 simeped dro 40/0.6ml ...................... 28 simethicone cap 125 mg .............. 28, 99 simethicone cap 180 mg ................... 28 simethicone chew tab 125 mg ............ 28 simethicone chew tab 80 mg .............. 28 simethicone dro 20/0.3ml ................. 28 SIMETHICONE LIQ ...................... 28, 99 simethicone susp 40 mg/0.6ml .......... 28 SIMPLY SALIN AER 0.9% ................. 154 simply salin aer baby ...................... 127 simply sleep tab 25mg ...................... 30 simvastatin tab 10 mg .................... 104 simvastatin tab 20 mg .................... 104

simvastatin tab 40 mg ................... 104 simvastatin tab 5 mg ..................... 104 simvastatin tab 80 mg ................... 104 SINGLE-LET MIS 23G ....................... 89 sirolimus tab 0.5 mg ...................... 106 sirolimus tab 1 mg ......................... 106 sirolimus tab 2 mg ......................... 106 SKIN BEAUTY/ PAK WELLNESS ........ 139 skin cleansr sol 4% .......................... 68 skin protect oin all-purp .................... 92 skin trtment lot 12% ........................ 94 SKYLA IUD 13.5MG ........................ 173 sleep aid cap 50mg ................... 30, 104 sleep aid tab 25mg .......................... 30 sleep aid tab 50mg .......................... 30 sleep ii tab 25mg ............................. 30 SLEEP SOUNDL LIQ 3.5/2ML ............... 7 sleep tab 25mg ............................... 30 sleep-aid tab 25mg ................... 30, 104 sleep-tabs tab 25mg.................. 30, 104 slow fe tab 45mg ........................... 108 slow iron tab 160mg cr ................... 108 slow rel fe tab 160mg cr ................. 108 slow release tab 45mg ................... 108 slow release tab 47.5mg ................. 108 slow release tab iron 45 ................. 108 slow-release tab fe 45mg ............... 108 sm acid redu tab 200mg .......... 102, 196 SM ADHESIVE PAD 2 ................. 55, 113 SM ADHESIVE PAD 3 ................. 55, 113 SM ALCOHOL PAD PREP .................. 126 sm all day tab 10mg ........................ 35 sm all day tab allergy ....................... 35 sm allergy cap relief ......................... 33 sm allergy tab 25mg ........................ 33 sm allergy tab 25mg rlf .................... 33 sm allergy tab 4mg .......................... 32 sm animal chw shapes ................... 169 sm animal sh chw complete ...... 152, 167 sm antacid chw 1000mg ................... 17 sm antacid sus advanced .................. 15 sm antacid sus anti-gas .................... 15 sm antacid sus max st ..................... 15 sm antacid/ sus antigas .................... 15 sm anti-diar tab 2mg ....................... 43 sm antifungl cre 1% ......................... 29 sm antifungl cre 2% ......................... 30

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sm artificia sol tears ......................... 46 sm aspirin chw 81mg ..................... 183 sm aspirin tab 325mg ..................... 183 sm aspirin tab 325mg ec ................. 183 sm aspirin tab 81mg ec .................. 183 sm b super tab vita com .................... 49 sm b100 tab complex ....................... 50 sm balanced tab b-100 .............. 50, 143 sm balanced tab b-50................ 50, 143 SM BANDAGES MIS ANTIBACT.... 55, 113 SM BANDAGES MIS CLEAR ......... 55, 113 SM BANDAGES MIS CLR SPOT .... 55, 113 SM BANDAGES MIS FAB 3/4....... 55, 113 SM BANDAGES MIS FAB XL ........ 55, 113 SM BANDAGES MIS FLEXIBLE..... 55, 113 SM BANDAGES MIS FOAM .......... 55, 113 SM BANDAGES MIS FOAM XL ..... 55, 113 SM BANDAGES MIS PLASTIC ...... 55, 113 SM BANDAGES MIS SHEER ........ 55, 113 SM BANDAGES MIS SHEER XL .... 55, 113 SM BANDAGES MIS STRNG ST.... 55, 113 SM BANDAGES MIS WTRSHELD .. 55, 113 sm b-complex tab ............................ 50 SM B-COMPLEX TAB /VIT C ................ 49 sm bedding aer lice ................... 84, 184 sm ca/mg/zn tab.............................. 64 sm ca/vit d3 tab 600-400 .................. 64 SM CALAMINE LOT ......................... 127 sm calcium chw ............................... 64 sm calcium tab /vit d3 ...................... 64 sm calcium/d tab 500-200 ......... 64, 124 sm calcium/d tab 600-400 ................ 64 sm child asa chw 81mg ................... 183 sm clearlax pow ............................. 110 sm complete tab ..................... 139, 149 sm complete tab 50+ .............. 139, 149 sm complete tab 50+ mens ............. 139 sm complete tab 50+ wmn .............. 139 sm complete tab adv form ....... 139, 149 sm complete tab senior ........... 139, 149 sm dry eye sol relief ......................... 46 sm ear dro 6.5% ot ........................ 165 sm fish oil cap 1000mg ................... 127 sm fish oil cap 1200mg............ 127, 159 sm folic acd tab 400mcg ................... 99 sm gas rel chw 125mg ...................... 28 sm gas relf chw 80mg ....................... 28

sm gas relie chw 80mg ..................... 28 sm gentle tab laxative .................... 189 sm hair/skin tab /nails ................... 139 sm hydrocort cre 1% ...................76, 84 sm hydrocort cre 1% plus ............76, 84 sm hydrocort oin 1% ...................76, 84 sm ibuprofen cap 200mg ................ 159 sm ibuprofen tab 100mg jr .............. 159 sm ibuprofen tab 200mg ................. 159 sm iron slow tab 160mg cr .............. 108 sm iron tab 325mg ........................ 108 sm iron tab 45mg .......................... 108 SM KNUCKLE/ MIS FINGERTP ..... 55, 113 SM LANCETS MIS 33G ...................... 89 sm laxative sup 10mg .................... 189 sm laxative tab 25mg ..................... 189 sm laxative tab 5mg ec .................. 189 sm lubricant dro 0.4-0.3% ................ 46 sm melatonin tab 3mg........................ 7 sm melatonin tab 5mg........................ 7 sm micon 7 sup 100mg .................. 198 sm multiple tab vit/iron............ 129, 144 sm multiple tab vitamins ................. 151 sm nasal dec tab 30mg................... 192 sm nighttime tab 25mg .................... 30 SM ONE DAILY TAB ESSENTIA .. 128, 144 SM ONE DAILY TAB MENS ............... 139 SM ONE DAILY TAB WOMENS .......... 139 sm opti-vita tab ...................... 139, 149 sm pain rel cap 500mg ..................... 13 sm pain rlvr tab 650mg .................... 13 sm povid-iod sol 10% ..................... 107 sm rpd melt tab 160mg .................... 13 sm senna lax tab 8.6mg ................. 189 sm senna lax tab max str ................ 189 sm senna-s tab 8.6-50mg ............... 109 sm sleep aid cap 50mg .............. 30, 105 sm sleep aid tab 25mg ..................... 30 sm stomach sus 262/15ml ................ 25 sm stomach sus 525/30ml ................ 25 sm stool tab softener ..................... 109 SM STRONG MIS STRIPS............ 55, 113 SM STURDY MIS STRIP ..................... 56 SM SWEET OIL.......................... 68, 111 sm triple oin antibiot ........................ 20 sm tussin cf liq ................................ 79 sm tussin dm liq max ....................... 79

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sm tussin dm syp 100-10/5 ............... 79 sm tussin syp dm ............................. 79 sm vitamin d tab 400unit ................ 161 SMART SENSE MIS LANC 21G ............ 90 SMART SENSE MIS LANC 26G..... 90, 117 SMART SENSE MIS LANC 30G ............ 90 SMART SENSE MIS LANC 33G ............ 90 SMARTEST MIS LANCETS .................. 90 smooth antac chw 750mg ................. 17 smooth lax pow ...................... 109, 110 smooth lax pow 3350 ..................... 109 smooth lax pow 3350 nf .................. 110 sod fluoride sol 0.2% ........................ 82 sodium chloride aero soln 0.9% ....... 127 sodium chloride soln nebu 0.9% ....... 127 sodium chloride soln nebu 10% ........ 127 sodium chloride soln nebu 3% ......... 127 sodium chloride soln nebu 7%.......... 127 sodium fluoride chew tab 0.25 mg f (from 0.55 mg naf) .......................... 98 sodium fluoride chew tab 0.5 mg f (from 1.1 mg naf) ..................................... 98 sodium fluoride chew tab 1 mg f (from 2.2 mg naf) ..................................... 98 sodium fluoride soln 0.5 mg/ml f (from 1.1 mg/ml naf) ................................ 98 sodium fluoride tab 0.5 mg f (from 1.1 mg naf) .......................................... 98 sodium fluoride tab 1 mg f (from 2.2 mg naf) ............................................... 98 sodium polystyrene sulfonate oral susp 15 gm/60ml .................................. 172 sodium polystyrene sulfonate rectal susp 30 gm/120ml ................................ 172 SOF-SET ADH PAD PATCH ................. 56 SOFT 'N FLEX MIS ............................ 56 SOFT TOUCH MIS LANCETS........ 90, 117 SOFTCLIX MIS LANCETS ............ 90, 117 SOLIRIS INJ 10MG/ML .................... 102 SOLO TAB ..................................... 139 SOLUS V2 MIS LANC 28G .................. 90 SOLUS V2 MIS LANC 30G .................. 90 SOMATULINE INJ 120/.5ML ............... 95 SOMATULINE INJ 60/0.2ML ............... 95 SOMATULINE INJ 90/0.3ML ............... 95 soothe chw 262mg ........................... 25 soothe dro hydratio .......................... 47

SOOTHE NEB MIS NEBULIZE ........... 178 soothe night oin op ........................ 161 soothe night oin time ....................... 46 soothe sus 262/15ml........................ 25 soothe sus 525/15ml ....................... 25 soothe tab 262mg ........................... 25 soothe xp dro ................................. 47 soothe xp dro 1%-4.5% ................... 47 soothe&cool cre inzo 2% ................... 30 SOOTHENEB MIS COMP NEB ........... 178 SOOTHENEB MIS MED CUP ............. 180 SOOTHENEB MIS MESH CAP ........... 180 SOOTHENEB MIS NBL 100 ........ 123, 180 sorbugen nr liq ................................ 79 SORESPOT MIS BANDAGES ............... 56 sorine tab 120mg ............................ 57 sorine tab 160mg ............................ 57 sorine tab 240mg ............................ 57 sorine tab 80mg .............................. 57 sotalol hcl (afib/afl) tab 120 mg ......... 57 sotalol hcl (afib/afl) tab 160 mg ......... 57 sotalol hcl (afib/afl) tab 80 mg .......... 57 sotalol hcl tab 120 mg .................56, 57 sotalol hcl tab 160 mg ...................... 57 sotalol hcl tab 240 mg ...................... 57 sotalol hcl tab 80 mg ....................... 57 SOVALDI TAB 400MG ..................... 103 SPACER CHAMB MIS ADULT ............ 123 SPACER CHAMB MIS CHILD ............ 123 span c tab ................................ 59, 144 spectr women tab hlth sen ....... 139, 149 spectra ultr tab hlth men.......... 139, 149 SPECTRAVITE CHW ADLT 50+ .. 139, 149 SPECTRAVITE TAB ......................... 149 SPECTRAVITE TAB ADLT 50+.... 139, 149 spectravite tab advanced ......... 139, 149 SPECTRAVITE TAB MEN 50+..... 139, 149 spectravite tab senior .............. 139, 149 SPECTRAVITE TAB SENIOR....... 139, 149 SPECTRAVITE TAB ULT MEN ............ 139 SPECTRAVITE TAB ULT WMN .... 139, 149 spider-man chw............................. 167 spinosad susp 0.9% ....................... 184 spironolactone & hydrochlorothiazide tab 25-25 mg ....................................... 93 spironolactone tab 100 mg .............. 172 spironolactone tab 25 mg ............... 172

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spironolactone tab 50 mg ................ 172 SPLEEN TAB 250MG ....................... 187 sprintec 28 tab 28 day ...................... 70 sps sus 15gm/60 ........................... 172 sronyx tab ...................................... 72 ssd cre 1%...................................... 60 SSKI SOL 1GM/ML ......................... 125 st joseph chw low 81mg .................. 183 STERILANCE MIS TL 28G .................. 90 STERILANCE MIS TL 30G .................. 90 STERILANCE MIS TL 32G .................. 90 STERI-STRIP MIS...................... 56, 113 STERI-STRIP MIS 1 .......................... 56 STERI-STRIP MIS 1/2 ....................... 56 STERI-STRIP MIS 1/4 ....................... 56 STERI-STRIP MIS 1/8 ....................... 56 stim laxat tab 5mg ec ..................... 189 STIVARGA TAB 40MG ....................... 39 stom relief tab 262mg ...................... 25 stomach relf chw 262mg ................... 25 stomach relf sus .............................. 25 stomach relf sus 262/15ml ................ 25 stomach relf sus 524/30ml ................ 25 stomach relf sus 525/15ml ................ 25 stomach relf sus 525/30ml ................ 25 stomach relf sus 527/30ml ................ 25 stomach relf sus plus ........................ 25 stomach relf tab 262mg .................... 25 stomach rlf chw 400mg .................... 17 stomach rlf tab 262mg ..................... 25 STOMACH TAB 300MG .................... 187 stool soften cap 100mg ................... 191 stool soften cap 250mg ................... 191 stool softnr cap 100mg ................... 191 stool softnr cap 240mg ................... 191 stool softnr cap 250mg ................... 191 stool softnr cap 50mg ..................... 191 stool softnr syp 60/15ml ................. 191 stool softnr tab 100mg ................... 191 stool softnr tab 8.6-50mg ............... 109 stop lice 3 spr 0.5% ....................... 184 stop lice ms sha 0.33-4% ................ 184 stop lice spr 0.5% .......................... 184 STREPTOMYCIN POW SULFATE ........... 7 stress b com tab vit c/zn............ 48, 143 stress b com tab w/iron .................. 129 stress b/ tab zinc ............................. 48

stress b-com tab /c/zinc ................. 139 stress form tab ......................... 49, 152 stress form tab /iron......... 129, 140, 144 stress form tab /zinc ........................ 48 stress form/ tab zinc...........48, 140, 143 stress formu tab ............................ 152 stress formu tab /zinc ...................... 48 stress formu tab advanced .............. 140 stress formu tab energy.................. 140 stress formu tab w/iron .................. 129 stress plus tab zinc .......................... 48 stress tab formula ................... 140, 149 stresstabs tab ............................... 152 stresstabs tab advanced ................. 140 stresstabs tab energy ..................... 152 STRIVERDI AER 2.5MCG ................. 193 STRONG STRIP MIS BANDAGES .. 56, 113 STRONG STRIP MIS WATERPRF ......... 56 stye oin ........................................ 161 sucralfate tab 1 gm ........................ 125 sudafed 12hr tab 120mg cr ............. 192 SUDAFED 24HR TAB 240MG ............ 192 sudogest tab 120mg er ................... 192 sudogest tab 30mg ........................ 192 sudogest tab 60mg ........................ 192 sulfacetamide sodium lotion 10% (acne) ........................................................ 4 sulfacetamide sodium ophth soln 10% .................................................... 162 sulfacetamide sodium-prednisolone ophth soln 10-0.23(0.25)% ............. 163 SULFADIAZINE POW ...................... 190 SULFADIAZINE POW SODIUM .......... 190 SULFADIAZINE TAB 500MG ............. 190 SULFAMETHOX POW ...................... 190 SULFAMETHOX POW MICRO ............ 190 sulfamethoxazole-trimethoprim susp 200-40 mg/5ml ............................... 18 sulfamethoxazole-trimethoprim tab 400-80 mg ..................................... 18 sulfamethoxazole-trimethoprim tab 800-160 mg.................................... 18 SULFAPYRIDIN POW ...................... 190 sulfasalazine tab 500 mg ................ 106 sulfasalazine tab delayed release 500 mg .................................................... 106 SULFATHIAZOL POW ...................... 190

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sulfatrim pd sus 200-40/5 ................. 18 SULFISOXIZOL CRY ........................ 190 sulindac tab 150 mg ....................... 159 sulindac tab 200 mg ....................... 159 sumatriptan nasal spray 20 mg/act ... 184 sumatriptan nasal spray 5 mg/act .... 184 sumatriptan succinate inj 6 mg/0.5ml124 sumatriptan succinate solution auto-injector 4 mg/0.5ml ................ 124 sumatriptan succinate solution auto-injector 6 mg/0.5ml ................ 124 sumatriptan succinate solution cartridge 4 mg/0.5ml ................................... 124 sumatriptan succinate solution cartridge 6 mg/0.5ml ................................... 124 sumatriptan succinate solution prefilled syringe 6 mg/0.5ml ........................ 124 sumatriptan succinate tab 100 mg .... 185 sumatriptan succinate tab 25 mg ...... 184 sumatriptan succinate tab 50 mg ...... 184 summers eve sol ex clean ........ 128, 198 SUNBEAM VAP MIS 1 GAL ................ 181 SUNBEAM VAP MIS 1.5 GAL ............. 181 SUNBEAM VAP MIS 2 GAL ................ 181 sunvite actv tab adult ..................... 140 sunvite tab advanced ...................... 140 super 28 tab formula ...................... 140 SUPER ANTIOX CAP ................ 140, 149 super antiox cap protect.................. 140 super antiox tab a/c/e/se ................ 140 SUPER B- CAP COMPLEX ................... 51 super b comp tab /vit c ..................... 49 super b comp tab maxi .............. 50, 144 super b comp tab vit c ..........48, 49, 143 super b- tab complex ................ 51, 144 super b w/c cap ........................ 48, 143 super b-100 tab ............................... 51 SUPER B-50 CAP B-COMP .................. 50 SUPER B-50 CAP COMPLEX ................ 51 super b-50 tab ................................ 51 super b-comp tab /fa/vitc ................. 49 super b-comp tab iron/c ................... 51 super b-comp tab vit c/fa........... 49, 144 super c-1000 tab ............................. 59 super c-500 tab ............................... 59 SUPER C-500 TAB COMPLEX .............. 59 super ca 600 tab + d 400 .................. 64

super ca 600 tab + d3 ...................... 64 super ca 600 tab + d3 400 ............... 64 super cal/ tab mag .......................... 64 super calciu tab 600mg .................... 60 SUPER D3 CAP COMPLEX ................ 200 super dec tab b-100 .................. 51, 144 super dha cap gems ....................... 127 super liq nu-thera .......................... 140 super multip cap ........................... 140 super multip tab ..................... 140, 149 super omega cap -3 ....................... 127 super omega cap 500mg ................ 127 SUPER POW NU-THERA .................. 140 super quints tab ........................ 51, 144 super stress tab b-complx............... 201 SUPER STRIP MIS 1 ................... 56, 113 super tab nu-thera ......................... 140 super thera tab vite m ............. 140, 149 SUPER THIN MIS LANC 28G........ 90, 117 SUPER THIN MIS LANCETS ......... 90, 117 super vikaps tab ..................... 140, 149 super-b tab complex ........................ 51 superior 35 tab ............................. 140 superplex-t tab ............................... 48 SUPERSTRIP MIS 1 .......................... 56 suphedrine tab 30mg ..................... 192 SUPLEVIT LIQ ................................. 51 supr aytinal tab....................... 140, 149 supr aytinal tab 50 plus ........... 140, 149 supr omega 3 cap epa/dha .............. 127 supr vitamin tab ............................ 140 SUPREP BOWEL SOL PREP KIT ......... 108 SURE COMFORT MIS 29GX1/2 ......... 120 SURE COMFORT MIS 31GX3/16 ....... 120 SURE COMFORT MIS 31GX5/16 ....... 120 SURE COMFORT MIS 32GX5/32 ....... 120 SURE COMFORT MIS 32GX6MM ....... 120 SURE COMFORT MIS LANC 18G ......... 90 SURE COMFORT MIS LANC 21G ......... 90 SURE COMFORT MIS LANC 23G ......... 90 SURE COMFORT MIS LANC 30G ......... 90 SURE COMFORT MIS LANCETS.... 90, 117 SURE-FINE MIS 29GX1/2 ................ 120 SURE-FINE MIS 31GX3/16 .............. 120 SURE-FINE MIS 31GX5/16 .............. 120 SUREFLEX MIS LANCETS .................. 90 SURE-LANCE MIS 26G ............... 90, 117

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SURE-LANCE MIS LANCETS ........ 90, 117 SURELITE MIS LANCETS ............ 90, 117 SURESEAL MIS EX LARGE .................. 56 SURESEAL MIS K ............................. 56 SURESEAL MIS LARGE ...................... 56 SURE-TOUCH MIS UNV LANC...... 90, 117 surfak cap 240mg .......................... 191 SUTENT CAP 12.5MG ........................ 39 SUTENT CAP 25MG ........................... 39 SUTENT CAP 37.5MG ........................ 39 SUTENT CAP 50MG ........................... 39 sv melatonin tab 3mg ........................ 7 sv melatonin tab 5mg ........................ 7 SWEET OIL .............................. 68, 111 syeda tab 3-0.03mg ......................... 70 SYMAX DUOTAB TAB ........................ 44 symax-sr tab 0.375mg ...................... 44 SYMBICORT AER 160-4.5 ................ 192 SYMBICORT AER 80-4.5 .................. 192 SYNAGIS INJ 100MG/ML ................. 166 SYNAGIS INJ 50MG ........................ 166 SYNAREL SOL 2MG/ML .................... 110 SYNERTROPIN CAP ......................... 187 SYNVISC INJ 8MG/ML ..................... 154 SYNVISC ONE INJ 8MG/ML .............. 154 systane dro contacts ......................... 47 SYSTANE GEL 0.3% .......................... 47 systane oin ..................................... 46 T tab tussin tab 400mg ........................ 97 tab-a-vite tab ................................ 152 tab-a-vite tab /iron ......................... 129 tab-a-vite tab beta car .................... 152 tacrolimus cap 0.5 mg .................... 106 tacrolimus cap 1 mg ....................... 106 tacrolimus cap 5 mg ....................... 106 tactinal chw children ......................... 13 tactinal tab 325mg ........................... 13 tactinal tab 500mg ........................... 13 TAFINLAR CAP 50MG ........................ 39 TAFINLAR CAP 75MG ........................ 39 take action tab 1.5mg ....................... 94 tame flame chw 500mg .................... 17 tamoxifen citrate tab 10 mg (base equivalent) ..................................... 39 tamoxifen citrate tab 20 mg (base equivalent) ..................................... 39

tamsulosin hcl cap 0.4 mg .............. 174 TARCEVA TAB 100MG ....................... 40 TARCEVA TAB 150MG ....................... 40 TARCEVA TAB 25MG ........................ 40 tarina fe tab 1/20 ............................ 70 tarina fe tab 1/20 eq ........................ 72 taztia xt cap 120mg/24 .................... 65 taztia xt cap 180mg/24 .................... 65 taztia xt cap 240mg/24 .................... 65 taztia xt cap 300mg/24 .................... 65 taztia xt cap 360mg/24 .................... 65 tears again oin op ............................ 46 tears again sol adv eye ..................... 47 tears again sol op ............................ 47 tears natura sol free op .................... 47 tears pure sol ................................. 47 TECFIDERA CAP 120MG .................. 128 TECFIDERA CAP 240MG .................. 128 TECFIDERA MIS STARTER ............... 128 TECHLITE AST MIS LANCETS ...... 90, 117 TECHLITE MIS LANC 30G ........... 90, 117 TECHLITE MIS LANCETS............. 90, 117 TEGADERM CHG MIS DRESSING ...44, 68 temozolomide cap 100 mg .................. 5 temozolomide cap 140 mg .................. 5 temozolomide cap 180 mg .................. 5 temozolomide cap 20 mg .................... 5 temozolomide cap 250 mg .................. 5 temozolomide cap 5 mg ..................... 5 TENORETIC TAB 50 .......................... 37 terazosin hcl cap 1 mg (base equivalent) ...................................................... 19 terazosin hcl cap 10 mg (base equivalent) ..................................... 19 terazosin hcl cap 2 mg (base equivalent) ...................................................... 19 terazosin hcl cap 5 mg (base equivalent) ...................................................... 19 terbinafine hcl tab 250 mg ................ 28 terbutaline sulfate tab 2.5 mg ......... 193 terbutaline sulfate tab 5 mg ............ 193 terconazole vaginal cream 0.4% ...... 198 terconazole vaginal cream 0.8% ...... 198 terconazole vaginal suppos 80 mg .... 198 testosterone cypionate im inj in oil 100 mg/ml ........................................... 13 testosterone cypionate im inj in oil 200

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mg/ml ............................................ 13 testosterone enanthate im inj in oil 200 mg/ml ............................................ 13 testosterone td gel 10mg/act (2%) ..... 13 testosterone td gel 25 mg/2.5gm (1%)13 tetracycline hcl cap 250 mg ............. 193 tetracycline hcl cap 500 mg ............. 193 TETRACYCLINE POW ................... 20, 82 tetterine oin 2% ............................... 30 tgt acetamin tab 500mg .................... 13 tgt allergy/ tab congest ..................... 80 tgt antacid chw 1000mg .................... 17 tgt antacid sus anti-gas ..................... 15 tgt antifung cre 1% .......................... 29 tgt aspirin chw 81mg ...................... 183 tgt aspirin chw child ....................... 183 tgt aspirin tab 325mg ..................... 184 tgt aspirin tab 81mg ....................... 184 tgt aspirin tab 81mg ec ................... 184 tgt calcium chw suppleme ................. 64 tgt cough liq form dm ....................... 79 TGT LANCET MIS 26G ....................... 90 TGT LANCET MIS 30G ....................... 90 TGT LANCET MIS 33G ....................... 90 tgt lubricnt dro eye ........................... 46 tgt lubricnt oin eye nite ..................... 46 tgt nasal spr 0.65% ........................ 154 tgt natural tab laxative ................... 189 tgt senna tab 8.6mg ....................... 189 tgt sinus tab 120mg ....................... 192 THEO-24 CAP 100MG CR ................. 201 THEO-24 CAP 200MG CR ................. 201 THEO-24 CAP 300MG CR ................. 201 THEO-24 CAP 400MG ER ................. 201 theochron tab 100mg cr .................. 201 theochron tab 200mg cr .................. 201 theochron tab 300mg cr .................. 201 theophylline soln 80 mg/15ml .......... 201 theophylline tab er 12hr 100 mg ...... 201 theophylline tab er 12hr 200 mg ...... 201 theophylline tab er 12hr 300 mg ...... 201 theophylline tab er 12hr 450 mg ...... 201 theophylline tab er 24hr 400 mg ...... 202 theophylline tab er 24hr 600 mg ...... 202 thera form/ tab hematin .......... 140, 149 THERA M PLUS TAB ........................ 140 thera tab ...................................... 152

THERA TAB ................................... 152 thera tab vital-m ........................... 140 thera vital tab m ..................... 140, 150 therabasic-m tab ........................... 140 THERABETIC TAB EYE HLTH ............ 187 THERABETIC TAB MULTIVIT ............ 140 thera-d tab 2000unit ...................... 161 theradex m tab ....................... 140, 150 theradex m/ tab beta car ................ 140 THERAGRAN-M TAB ....................... 140 THERAGRAN-M TAB 50 PLUS .... 140, 150 THERAGRAN-M TAB ADVANCED ....... 140 THERAGRAN-M TAB PREMIER ... 140, 150 thera-m tab ............................ 140, 150 THERA-M TAB ......................... 140, 150 theramill cap plus .......................... 140 thera-mill m tab ............................ 140 thera-mill tab ................................ 152 THERANATAL CAP LACTATIO ........... 140 THERANATAL MIS LACTATIO ........... 140 therapeutic tab ................ 140, 150, 152 therapeutic tab -m .................. 140, 150 therapeutic- tab m ......................... 141 therapeutic- tab m ......................... 150 therapeutic- tab m/lutein ................ 141 THERA-TABS M TAB................. 140, 150 thera-tabs tab ............................... 152 THERATEARS SOL OP ..................... 162 theratrum co tab 50 plus.......... 141, 150 theratrum tab complete ........... 141, 150 theravim -m tab ............................ 141 therems tab .................................. 152 THEREMS-H TAB ............................ 141 THEREMS-M TAB ..................... 141, 150 theromega cap 1000mg .................. 127 THIABENDAZOL POW ....................... 17 thiamine hcl tab 100 mg ................. 200 thiamine hcl tab 50 mg ................... 200 THIN LANCETS MIS ................... 90, 117 THIN LANCETS MIS 26G............. 90, 117 THIN LANCETS MIS 30G ................... 90 THINLETS GP MIS 26G ..................... 90 THRESHOLD MIS IMT ..................... 180 thrive for tab women ...................... 141 THYMUS TAB 140MG ............... 153, 187 TIER UNI PLS MIS 31GX8MM ........... 120 timolol maleate ophth gel forming soln

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0.25% .............................................58 timolol maleate ophth gel forming soln 0.5%.............................................. 58 timolol maleate ophth soln 0.25% ...... 58 timolol maleate ophth soln 0.5% ........ 58 timolol maleate tab 10 mg ................. 57 timolol maleate tab 20 mg ................. 57 timolol maleate tab 5 mg .................. 57 tinaspore sol 1% .............................. 29 tineacide cre ................................... 30 titralac chw 420mg ........................... 17 tizanidine hcl tab 2 mg (base equivalent) ......................................................67 tizanidine hcl tab 4 mg (base equivalent) ......................................................67 tl gard rx tab ................................. 103 TL-FLUORIVIT CHW ........................ 166 tobramycin nebu soln 300 mg/5ml ....... 7 tobramycin ophth soln 0.3% ............ 162 TOBRAMYCIN POW SULFATE ............... 7 tobramycin-dexamethasone ophth susp 0.3-0.1% ...................................... 163 tolnaftate aerosol pow 1% ................. 29 tolnaftate cre 1% ............................. 29 TOPCARE MIS LANC 33G ................... 90 torsemide tab 10 mg ...................... 111 torsemide tab 100 mg .................... 111 torsemide tab 20 mg ...................... 111 torsemide tab 5 mg ........................ 111 total allerg liq 12.5/5ml ..................... 33 total allerg tab 25mg ........................ 34 total b/c tab .................................... 48 total formul tab ...................... 141, 150 total formul tab 2.................... 141, 150 total formul tab 3.................... 141, 150 totalday mul tab tr ......................... 141 TRACLEER TAB 125MG .................... 175 TRACLEER TAB 62.5MG ................... 175 tramadol hcl tab 50 mg ................... 164 tramadol hcl tab er 24hr 100 mg ...... 164 tramadol hcl tab er 24hr 200 mg ...... 164 tramadol hcl tab er 24hr 300 mg ...... 164 tramadol-acetaminophen tab 37.5-325 mg ............................................... 165 trandolapril tab 1 mg ......................... 4 trandolapril tab 2 mg ......................... 4 trandolapril tab 4 mg ......................... 4

TRAVEL LANCE MIS 30G ................... 90 TRAVEL LANCE MIS ADV 28G ............ 90 travel sick chw 25mg ....................... 27 travel-ease tab 25mg ....................... 26 TRESIBA FLEX INJ 100UNIT .............. 23 TRESIBA FLEX INJ 200UNIT .............. 23 tretinoin cap 10 mg ......................... 42 tretinoin cream 0.025% ...................... 5 tretinoin cream 0.05% ....................... 5 tretinoin cream 0.1% ......................... 5 tretinoin gel 0.01% ............................ 5 tretinoin gel 0.025% .......................... 5 TREXALL TAB 10MG ......................... 38 TREXALL TAB 15MG ......................... 38 TREXALL TAB 5MG ........................... 38 TREXALL TAB 7.5MG ........................ 38 tri femynor tab ................................ 71 tri super tab flavons .................. 59, 144 triamcinolone acetonide cream 0.025% ...................................................... 76 triamcinolone acetonide cream 0.1% .. 76 triamcinolone acetonide cream 0.5% .. 76 triamcinolone acetonide dental paste 0.1% ........................................... 187 triamcinolone acetonide lotion 0.025% 76 triamcinolone acetonide lotion 0.1% ... 76 triamcinolone acetonide nasal aerosol suspension 55 mcg/act ................... 156 triamcinolone acetonide oint 0.025% .. 76 triamcinolone acetonide oint 0.1% ..... 76 triamcinolone acetonide oint 0.5% ..... 76 triaminic tab 10mg .......................... 35 triamterene & hydrochlorothiazide cap 37.5-25 mg .................................... 93 triamterene & hydrochlorothiazide tab 37.5-25 mg .................................... 93 triamterene & hydrochlorothiazide tab 75-50 mg ....................................... 93 triderm cre 0.1% ............................. 76 triderm cre 0.5% ............................. 84 tri-estaryll tab ................................. 71 trifluridine ophth soln 1% ............... 162 tri-linyah tab ................................... 71 tri-lo tab estaryll ............................. 71 tri-lo- tab marzia ............................. 71 tri-lo- tab sprintec ........................... 71 trilyte sol ...................................... 108

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trimethobenzamide hcl cap 300 mg 27 TRIMETHOPRIM POW ........................ 17 trimethoprim tab 100 mg .................. 17 tri-mili tab ...................................... 72 trinate tab ..................................... 173 triphrocaps cap ................................ 49 triple antib oin ................................. 20 triple antib oin frst aid ...................... 82 triple paste oin af 2% ....................... 30 tri-previfem tab ............................... 72 tri-sprintec tab ................................ 71 tri-vit/fluo dro 0.25mg .................... 168 tri-vit/fluo dro 0.5mg ...................... 168 trivora-28 tab .................................. 72 tri-vylibra tab .................................. 72 TROMBONEX CAP ............................. 59 trombonex-d cap ............................. 59 tropical liq nutritio................... 141, 150 trospium chloride tab 20 mg ............ 197 TRUE COMFORT MIS LANC 30G ........ 117 trueplus tab diabetic ............... 141, 150 TRULANCE TAB 3MG ......................... 99 TRULICITY INJ 0.75/0.5 .................... 23 TRULICITY INJ 1.5/0.5 ...................... 23 TRUPLUS LANC MIS 26G ................... 90 TRUPLUS LANC MIS 28G............ 90, 117 TRUPLUS LANC MIS 30G............ 90, 118 TRUPLUS LANC MIS 33G ................... 90 TRUSTEX LUBR MIS ASSORTED .......... 73 TRUSTEX LUBR MIS BANANA ............. 73 TRUSTEX LUBR MIS CHOC ................. 73 TRUSTEX LUBR MIS COLA ................. 73 TRUSTEX LUBR MIS COLORS ...... 73, 114 TRUSTEX LUBR MIS EX LARGE.... 73, 114 TRUSTEX LUBR MIS EX STR ....... 73, 114 TRUSTEX LUBR MIS GRAPE ................ 73 TRUSTEX LUBR MIS MINT .................. 73 TRUSTEX LUBR MIS RIB/STUD ... 73, 114 TRUSTEX LUBR MIS SPERMICI.... 73, 114 TRUSTEX LUBR MIS STRWBRY ........... 73 TRUSTEX LUBR MIS VANILLA ............. 73 TRUSTEX MIS BANANA ..................... 73 TRUSTEX MIS CHOCOLAT .................. 73 TRUSTEX MIS FLAVORS .................... 73 TRUSTEX MIS MINT .......................... 73 TRUSTEX MIS STRWBRY ................... 73 TRUSTEX MIS VANILLA ..................... 73

TRUSTEX/RIA MIS LUBRICAT ...... 73, 114 TRUSTEX/RIA MIS NON-LUB ....... 73, 114 TRUSTEX/RIA MIS SPERMICI ...... 73, 114 TRUSTX NON-9 MIS RIB/STUD .......... 73 tulana tab 0.35mg ........................... 74 TUMS CHW DEL CHW 1177MG ........... 17 tums smoothi chw 750mg ................. 17 TUSNEL C SYP ................................. 79 tusnel diabt liq 10-100/5 .................. 79 tussin adult liq 100/5ml .................... 97 tussin adult liq cgh/cong ................... 79 tussin chest syp 100/5ml .................. 97 tussin cough liq 10-100/5 ................. 79 tussin dm cg liq 20-400 .................... 77 tussin dm liq ................................... 79 tussin dm liq 100-10/5 ..................... 79 tussin dm liq 10-100/5 ..................... 77 tussin dm liq 10-100mg .................... 77 tussin dm liq 10-200mg .................... 77 tussin dm liq max ............................ 79 tussin dm mx liq 10-200/5 ................ 79 tussin dm syp 100-10/5 .................... 79 tussin mucus liq 100/5ml .................. 97 tussin mucus liq 200/10ml ................ 97 tussin syp 100/5ml .......................... 97 T-VITES TAB........................... 140, 149 TYKERB TAB 250MG ......................... 40 TYMLOS INJ .................................... 94 TYVASO REFIL SOL 0.6MG/ML ......... 174 TYVASO SOL 0.6MG/ML .................. 174 TYVASO START SOL 0.6MG/ML ........ 174 U ULTICARE MIC MIS 32GX4MM ......... 120 ULTICARE PAD ALCOHOL ................ 126 ULTICARE PEN MIS 31GX5MM ......... 120 ULTICARE PEN MIS 31GX8MM ......... 120 ULTILET MIS 26G ............................ 90 ULTILET MIS 28G ...................... 90, 118 ULTILET MIS 30G ...................... 90, 118 ULTILET MIS 33G ...................... 90, 118 ULTILET MIS LANCETS ............... 91, 118 ULTILET MIS SAFETY ........................ 91 ULTILET PAD ALCOHOL ................... 126 ULTILET PEN MIS 29GX12.7 ............ 120 ULTILET PEN MIS 31GX5MM ............ 120 ULTILET PEN MIS 31GX8MM ............ 120 ULTILET PEN MIS 32GX4MM ............ 120

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ULTILET SAFE MIS 21G.............. 91, 118 ultimate fat tab burner .................... 187 ultra antiox tab formula ........... 141, 150 ultra b-100 tab complex .......... 154, 201 ultra choice chw kids ...................... 167 ultra freeda tab ...................... 141, 150 ultra freeda tab /iron ............... 141, 150 ultra fresh dro 0.5% op ..................... 47 ultra fresh oin pm ............................ 46 ULTRA MAN TAB ............................ 187 ULTRA MEGA G TAB 100MG...... 141, 150 ULTRA MEGA G TAB 75MG CR .......... 141 ULTRA MEGA TAB 75MG CR ............. 141 ULTRA MEGA TAB TWO ............ 141, 150 ULTRA MENS MIS PACK ................... 141 ultra multi cap /iron ........................ 141 ULTRA OMEGA3 CAP 1400MG .......... 127 ultra sleep tab 25mg ........................ 30 ULTRA THIN MIS 28G ....................... 91 ULTRA THIN MIS 30G ....................... 91 ULTRA THIN MIS 31G ....................... 91 ULTRA THIN MIS 33G ....................... 91 ULTRA THIN MIS LAN 31G ............... 118 ULTRA THIN MIS LANC 26G ............... 91 ULTRA THIN MIS LANC 28G........ 91, 118 ULTRA THIN MIS LANC 30G ............... 91 ULTRA THIN MIS LANCETS ......... 91, 118 ultra vita-t tab ............................... 141 ULTRA WOMAN TAB ........................ 187 ULTRA WOMENS MIS PACK .............. 141 ultrachoice tab advanced ......... 141, 150 ultra-mega tab cr ........................... 141 UNFINE PNTP MIS 32GX4MM ........... 120 UNICOMPLEX-M TAB ....................... 141 UNIFINE PNTP MIS 31GX3/16 .......... 121 UNIFINE PNTP MIS 31GX5/16 .......... 121 UNIFINE PNTP MIS 31GX5MM .......... 121 UNIFINE PNTP MIS 31GX8MM .......... 121 UNIFINE PNTP MIS 32GX4MM .......... 121 UNIFINE PNTP MIS 32GX5/32 .......... 121 UNIFINE PNTP MIS 32GX6MM .......... 121 UNILET CMFR MIS TCH 28G ............... 91 UNILET CMFR MIS TCH 30G ............... 91 UNILET EX II MIS 28G ............... 91, 118 UNILET EXCEL MIS 23G ............. 91, 118 UNILET G.P MIS SUPR 23G ........ 91, 118 UNILET G.P. MIS 21G ................ 91, 118

UNILET GP 28 MIS ULT THIN ...... 91, 118 UNILET LANC MIS 33G ..................... 91 UNILET LANCE MIS 21G ................... 91 UNILET LANCE MIS 28G ................... 91 UNILET LANCE MIS 33G ................... 91 UNILET LANCT MIS 28G ............. 91, 118 UNILET LANCT MIS 30G ............. 91, 118 UNILET LANCT MIS 33G ............. 91, 118 UNILET MICRO MIS 33G ................. 118 UNILET MIS 21G .............................. 91 UNILET SUPER MIS 23G ............. 91, 118 UNILET SUPER MIS G.P. 23G ...... 91, 118 UNI-SOLVE PAD WIPES .................... 44 UNISTIK 3 MIS GENT 30G .......... 91, 118 UNISTIK II MIS LANCETS .................. 91 UNISTIK PRO MIS LANC 21G ........... 118 UNISTIK PRO MIS LANC 28G ........... 118 UNISTIK SAFE MIS LANC 28G ............ 91 UNISTIK SAFE MIS LANC 30G ............ 91 UNISTIK TOUC MIS LANC 21G .... 91, 118 UNISTIK TOUC MIS LANC 23G .... 91, 118 UNISTIK TOUC MIS LANC 28G ........... 91 UNISTIK TOUC MIS LANC 30G ........... 91 unith direct tab 100mcg ................. 195 unith direct tab 112mcg ................. 195 unith direct tab 125mcg ................. 195 unith direct tab 150mcg ................. 195 unith direct tab 175mcg ................. 195 unith direct tab 200mcg ................. 195 unith direct tab 25mcg ................... 195 unith direct tab 300mcg ................. 195 unith direct tab 50mcg ................... 195 unith direct tab 75mcg ................... 195 unith direct tab 88mcg ................... 195 unithroid tab 100mcg ..................... 195 unithroid tab 112mcg ..................... 195 unithroid tab 125mcg ..................... 195 unithroid tab 137mcg ..................... 195 unithroid tab 150mcg ..................... 195 unithroid tab 175mcg ..................... 195 unithroid tab 200mcg ..................... 195 unithroid tab 25mcg ....................... 195 unithroid tab 300mcg ..................... 195 unithroid tab 50mcg ....................... 195 unithroid tab 75mcg ....................... 195 unithroid tab 88mcg ....................... 195 UNITSTIK PRO MIS LANC 25G ......... 118

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UNIVERSAL 1 MIS 33G ...................... 91 UNIVERSAL 1 MIS LANC 26G ............. 91 UNIVERSAL 1 MIS LANC 30G ............. 91 UPSPRINGBABY DRO MV/IRON ......... 166 UPTRAVI TAB 1000MCG .................. 176 UPTRAVI TAB 1200MCG .................. 176 UPTRAVI TAB 1400MCG .................. 176 UPTRAVI TAB 1600MCG .................. 176 UPTRAVI TAB 200/800 .................... 175 UPTRAVI TAB 200MCG .................... 176 UPTRAVI TAB 400MCG .................... 176 UPTRAVI TAB 600MCG .................... 176 UPTRAVI TAB 800MCG .................... 176 urea cream 40% .............................. 94 uremez-40 cre 40% ......................... 84 ursodiol cap 300 mg ......................... 99 ursodiol tab 250 mg ......................... 99 ursodiol tab 500 mg ......................... 99 UTERUS TAB 150MG ....................... 187 V valacyclovir hcl tab 1 gm ................. 104 valacyclovir hcl tab 500 mg ............. 104 valganciclovir hcl for soln 50 mg/ml (base equiv) .................................... 68 valganciclovir hcl tab 450 mg (base equivalent) ..................................... 68 valsartan tab 160 mg ....................... 13 valsartan tab 320 mg ....................... 13 valsartan tab 40 mg ......................... 13 valsartan tab 80 mg ......................... 13 valsartan-hydrochlorothiazide tab 160-12.5 mg ................................... 37 valsartan-hydrochlorothiazide tab 160-25 mg ................................................. 37 valsartan-hydrochlorothiazide tab 320-12.5 mg ................................... 37 valsartan-hydrochlorothiazide tab 320-25 mg ................................................. 37 valsartan-hydrochlorothiazide tab 80-12.5 mg ..................................... 37 VALVD HOLDNG MIS CHAMBER ........ 181 vancomycin hcl cap 125 mg (base equivalent) ..................................... 17 vancomycin hcl cap 250 mg (base equivalent) ..................................... 17 vandazole gel 0.75% ...................... 198 VAPORIZER MIS 1 GALLON ...... 123, 181

VAPORIZER MIS 1.2 GAL.......... 123, 181 VAPORIZER MIS 1.5 GAL ................ 181 VAPORIZER MIS 1.7 GAL.......... 123, 181 VAPORIZER MIS 1.9 GAL ................ 181 VAPORIZER MIS 2 GALLON....... 123, 181 VAPORIZER MIS 2.5 GAL ................ 182 VAPORIZER MIS 3 GALLON ............. 182 VAPORIZER MIS PORTABLE ...... 123, 182 VAPORIZER MIS WATERLES ............ 182 VARIETY PACK MIS BANDAGES .......... 56 varisan tab vitality ......................... 187 VASOFLEX CAP ................................ 59 vasoflex cap forte ............................ 59 vasoflex hd tab ............................... 59 vasoflex tab.............................. 59, 144 VCF VAGINAL AER CONTRACP ......... 187 vcf vaginal gel contrace .................. 187 VCF VAGINAL MIS CONTRACP ......... 187 vcks dayquil liq mucus dm ................ 79 VELETRI INJ 0.5MG .......................... 66 VELETRI INJ 1.5MG .......................... 66 velivet pak ...................................... 71 VEMLIDY TAB 25MG ....................... 103 VENCLEXTA TAB 100MG ................... 38 VENCLEXTA TAB 10MG ..................... 38 VENCLEXTA TAB 50MG ..................... 38 VENCLEXTA TAB START PK ............... 38 VENTOLIN HFA AER ....................... 193 verapamil hcl cap er 24hr 100 mg ...... 65 verapamil hcl cap er 24hr 200 mg ...... 65 verapamil hcl cap er 24hr 300 mg ...... 65 verapamil hcl tab er 120 mg .............. 65 verapamil hcl tab er 180 mg .............. 65 verapamil hcl tab er 240 mg .............. 65 vercolate tab 5mg ec ..................... 189 very finest liq fish oil ...................... 127 VICTOZA INJ 18MG/3ML ................... 23 VIEKIRA PAK TAB .......................... 103 vienva tab 0.1-20 ............................ 72 vigor cap ...................................... 187 VIOKACE TAB 10440 ........................ 93 VIOKACE TAB 20880 ........................ 93 viorele tab ...................................... 69 VIOS LC MIS SPRINT ............... 123, 178 VIOS LC PLUS MIS .................. 123, 178 VIOS LC PLUS MIS DELUXE ...... 123, 178 VIOS LC PLUS MIS PEDIATRC ... 123, 178

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VIOS MIS SYSTEM .................. 123, 178 VIOS PRO LC MIS SPRINT ........ 123, 178 VIOS PRO LC+ MIS SYSTEM ............ 179 virt-caps cap ................................... 49 virt-gard tab 2.2-25-1 .................... 103 virtussin ac sol 100-10/5 ................... 79 virtussin sol dac ............................... 79 VISCO-3 INJ 25/2.5ML ................... 154 vision form cap eye hlth .................. 141 vision form tab 2 ............................ 141 vision form/ tab lutein .................... 141 vision formu cap 50+ ..................... 141 vision plus cap........................ 141, 150 vision tab vitamins .................. 141, 150 visivites tab .................................. 141 visivites tab /lutein ......................... 141 VISTOGARD PAK 10GM ..................... 26 vit a/c/d/fl dro 0.25mg ................... 168 vit b complx tab /vit c ....................... 49 vit d child chw 1000unit .................. 161 vit d3 drops liq 400unit ................... 200 vit d3 gumm chw 1000unit .............. 161 vit for hair tab ........................ 153, 187 vita c/biofl tab rose hip ..................... 59 vita hair tab .................................. 141 vitabasic tab complete .................... 141 vitabasic tab senior ........................ 141 vita-bee/c tab .................................. 49 VITABEX CAP ................................. 141 VITABEX PLUS CAP ......................... 150 vitachew chw ......................... 152, 167 VITACRAVES CHW IMMUNITY .......... 141 VITACRAVES CHW MENS ......... 141, 150 VITACRAVES CHW SOUR GUM ......... 141 VITACRAVES CHW WOMENS .... 141, 150 vitajoy daly chw d 1000iu ................ 161 vitajoy gumm chw 2.5mg ................... 7 vitalee tab..................................... 152 VITALET PRO MIS ..................... 91, 118 VITALET PRO MIS PLUS ............. 91, 118 VITALETS CHW ....................... 152, 167 VITALETS CHW CHILD ............. 152, 167 VITALINE TAB FORMULA2 ................ 142 VITALINE TAB FORMULA3 ................ 142 VITA-MAG TAB ....................... 153, 199 VITAMAX CHW........................ 152, 167 VITAMENT PAK .............................. 142

vitamin a&d cap ............................ 199 vitamin b100 tab complex ................. 51 vitamin b50 tab complex .................. 51 VITAMIN C CHW 500MG ................... 59 VITAMIN C LIQ .............................. 199 VITAMIN C PAK BLEND ............ 142, 150 VITAMIN C POW ELECTROL ............. 142 vitamin c tab plus...................... 59, 144 vita-min cap ........................... 141, 150 vitamin d cap 1000unit ................... 161 VITAMIN D CAP 2000UNIT .............. 200 vitamin d chw 1000unit .................. 161 vitamin d chw 400unit .................... 161 vitamin d tab 1000unit ................... 161 vitamin d tab 5000iu ...................... 161 VITAMIN D2 TAB 2000UNIT...... 161, 200 VITAMIN D2 TAB 400UNIT .............. 161 vitamin d3 cap 10000unt ................ 161 vitamin d3 cap 1000unit ................. 161 vitamin d3 cap 2000unit ................. 161 vitamin d-3 cap 2000unit ................ 161 vitamin d3 chw 1000unit ................ 161 vitamin d-3 tab 1000unit ................ 161 vitamin d-3 tab 5000unit ................ 161 VITAMIN D3 TAB COMPLETE ............ 142 VITAMIN E CAP COMPLETE .............. 199 VITAMIN LIQ MINERAL ................... 150 vitamin mixture cap ....................... 199 vitamins a & d cap ......................... 199 vitamins a & d tab ......................... 199 vitamins c & e cap ......................... 200 VITAMINS FOR TAB THE HAIR ......... 187 VITAMINS TO MIS GO MAX ............. 142 VITAMINS TO MIS GO MEN ............. 142 VITAMINS TO MIS GO WOMEN ........ 142 vitamins w/ lipotropics tab .............. 201 VITASANA TAB........................ 142, 150 vitatrum chw ................................ 142 VITATRUM TAB .............................. 142 vitatrum tab complete ............. 142, 150 vite/iron chw children ..................... 169 viteyes ared cap advanced .............. 142 viteyes ared cap formula ................. 142 viteyes cap /lutein ......................... 142 viteyes cap complete ...................... 142 viteyes smkr cap advanced ............. 142 viteyes smkr cap w/lutein ............... 142

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viteyes tab lycopene ....................... 142 VITONIC LIQ ................................... 51 vitrum tab senior ........................... 142 VITRUM TAB SENIOR ...................... 142 voriconazole for susp 40 mg/ml ........ 105 voriconazole tab 200 mg ................. 105 voriconazole tab 50 mg ................... 105 VORTEX VALVE MIS CHAMBER.. 123, 181 VOTRIENT TAB 200MG ...................... 40 vt b complex cap ...................... 48, 143 vyfemla tab 0.4-35 ........................... 70 vylibra tab 0.25-35 .......................... 72 W WAL-BORN CHW VIT C .................... 150 WAL-BORN TAB ...................... 153, 187 wal-dram ii tab 25mg .................. 26, 27 wal-dryl alr tab 12.5mg..................... 34 wal-dryl cap 25mg ........................... 34 wal-dryl liq 12.5/5ml ........................ 34 wal-dryl tab 25mg ............................ 34 wal-fex allr tab 180mg ...................... 35 wal-fex alrg tab 60mg 12h ................ 35 wal-fex d tab 12 hour ....................... 80 wal-fex d tab 24 hour ....................... 80 wal-fex tab 180mg ........................... 31 wal-finate tab 4mg ........................... 32 wal-itin chl sol 5mg/5ml .................... 35 wal-itin d tab 10-240mg ................... 80 wal-itin d tab 24 hour ....................... 80 wal-itin d tab 5-120mg ..................... 80 wal-itin syp 5mg/5ml ........................ 35 wal-itin tab 10mg ............................. 35 wal-phed d tab 120mg .................... 155 wal-phed tab 120mg er ................... 192 wal-phed tab 30mg ........................ 192 wal-profen cap 200mg .................... 159 wal-profen tab 200mg ................. 9, 159 wal-som cap 50mg ........................... 30 wal-som tab 25mg ........................... 30 wal-sporin oin .................................. 20 wal-tap elx cld/alle ........................... 80 wal-tussin liq 100/5ml ...................... 97 wal-tussin liq 10-100/5 ..................... 79 wal-tussin liq cf................................ 79 wal-tussin liq dm.............................. 79 wal-tussin liq dm max ....................... 79 wal-tussin syp 100/5ml ..................... 97

wal-tussin syp dm ........................... 79 wal-vert tab 10mg ........................... 35 wal-zan 75 tab .............................. 102 wal-zan tab 150mg ........................ 102 wal-zan tab 75mg .......................... 102 wal-zyr cap 10mg ............................ 35 wal-zyr chld sol 5mg/5ml ................. 35 wal-zyr chw 10mg ........................... 35 wal-zyr chw 5mg ............................. 35 wal-zyr d tab 5-120mg ..................... 80 wal-zyr sol 1mg/ml .......................... 35 wal-zyr sol 5mg/5ml ........................ 35 wal-zyr tab 10mg ............................ 35 warfarin sodium tab 1 mg ................. 81 warfarin sodium tab 10 mg ............... 81 warfarin sodium tab 2 mg ................. 81 warfarin sodium tab 2.5 mg .............. 81 warfarin sodium tab 3 mg ................. 81 warfarin sodium tab 4 mg ................. 81 warfarin sodium tab 5 mg ................. 81 warfarin sodium tab 6 mg ................. 81 warfarin sodium tab 7.5 mg .............. 81 WATCHHALER MIS ......................... 181 water for inject, bacteriostatic benzyl alcohol ......................................... 170 water for injection ......................... 170 water for iv injection ...................... 170 WATERPROOF MIS BANDAGES .... 56, 113 WATERPROOF PAD 3 ........................ 56 WATERSHIELD MIS BANDAGES ......... 56 WEBCOL PREP PAD LARGE .............. 126 WEBCOL PREP PAD MEDIUM ........... 126 weight loss tab multi ...................... 187 wera tab 0.5/35 .............................. 70 WHISPER AIRE MIS PED NEBU ........ 179 WHOLE FOOD TAB MULTIVIT ........... 142 whole source tab dietary ................ 142 whole source tab for men ......... 142, 150 whole source tab mature ................ 142 whole source tab women ................ 142 WILLIS THE MIS WHALE ................. 123 WINDMILL MIS TRAINER ................ 180 WING TIP MIS TUBING ............ 123, 180 womans laxat tab 5mg ec ............... 190 womens 50+ cap advanced ............. 142 womens 50+ tab advanced ............. 142 WOMENS BIO- TAB MULTIPLE ......... 142

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womens cap multi .......................... 142 womens daily chw gummies ..... 142, 150 womens daily tab fa/ca/fe ............... 142 womens daily tab formula ............... 142 womens laxat tab 5mg ec ............... 190 WOMENS MENOP MIS VITA PAK ....... 187 womens mult tab ........................... 142 WOMENS MULTI TAB VIT/MIN .. 142, 150 womens one tab daily.............. 142, 150 WOMENS PAK ................................ 142 WOMENS VITA MIS PAK .................. 187 womns active tab daily ............ 142, 150 X XARELTO STAR TAB 15/20MG ............ 93 XARELTO TAB 10MG ......................... 93 XARELTO TAB 15MG ......................... 93 XARELTO TAB 20MG ......................... 93 XELJANZ TAB 10MG ........................... 8 XELJANZ TAB 5MG ............................ 8 XELJANZ XR TAB 11MG ...................... 8 XIFAXAN TAB 550MG ........................ 17 XIIDRA DRO 5% ............................ 162 XOLAIR SOL 150MG ......................... 19 xpect tab 400mg .............................. 98 xulane dis 150-35 ............................ 71 XYREM SOL 500MG/ML ..................... 17 Y YELETS TEEN TAB FORMULA..... 142, 150 yl balanced tab b-100 ....................... 51 yl folic aci tab 400mcg ...................... 99 yl vitamin cap a & d ....................... 199 YOUR LIFE CHW GUMMIES .............. 142 YOUR LIFE CHW MULTIVIT .............. 142 your life tab mens 50+ ................... 142 your life tab wmns 50+ .................. 142 yuvafem tab 10mcg ....................... 198 Z zarah tab 3-0.03mg .......................... 70 ZARXIO INJ 300/0.5 ....................... 102 ZARXIO INJ 480/0.8 ....................... 102 zebutal cap ...................................... 8

ZEJULA CAP 100MG ......................... 41 ZELBORAF TAB 240MG ..................... 39 zenatane cap 10mg ............................ 5 zenatane cap 20mg ............................ 5 zenatane cap 30mg ............................ 5 zenatane cap 40mg ............................ 5 ZENPEP CAP 15000UNT .................... 92 ZENPEP CAP 20000UNT .................... 93 ZENPEP CAP 25000 .......................... 93 ZENPEP CAP 3000UNIT ..................... 92 ZENPEP CAP 40000 .......................... 93 ZENPEP CAP 5000UNIT ..................... 92 ZEPATIER TAB 50-100MG ................. 45 ZERBAXA INJ 1.5GM ........................ 67 ZINC LOZ............................... 142, 150 zinc-vites tab .................................. 48 ZN-PLUS TAB 15MG ....................... 187 ZOLINZA CAP 100MG ....................... 39 zolmitriptan orally disintegrating tab 2.5 mg .............................................. 185 zolmitriptan orally disintegrating tab 5 mg .............................................. 185 zolmitriptan tab 2.5 mg .................. 185 zolmitriptan tab 5 mg ..................... 185 ZONTIVITY TAB 2.08MG ................. 171 zoo friends chw ....................... 152, 167 ZOO FRIENDS CHW COMPLETE . 152, 168 zoo friends chw extra c ............ 153, 169 zoo friends chw extra d .................. 168 zoo friends chw gummies .. 152, 168, 169 zoo friends chw pls iron .................. 169 zoo friends chw plus c .................... 169 ZORBTIVE INJ 8.8MG ....................... 95 zovia 1/35e tab ............................... 70 ZYDELIG TAB 100MG ....................... 40 ZYDELIG TAB 150MG ....................... 40 ZYKADIA CAP 150MG ....................... 40 ZYRTEC ALLGY TAB 10MG ................. 35 ZYRTEC CHILD TAB 10MG ................. 35 ZYTIGA TAB 500MG ......................... 41 ZYVOX SOL 2MG/ML ........................ 18