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Whirlpool Corporation

PDL—Medication Categories Guide Effective August 2014

You can make the most of your pharmacy benefit plan and control your prescription medication costs by using this

Preferred Drug List. Be sure to share this list with your doctor to select cost-effective medications that are

clinically appropriate to treat your condition or maintain your health.

This Preferred Drug List (PDL) was developed by Whirlpool’s Formulary Review Committee, under the direction of a committee of doctors and pharmacists.

Understanding Your Tiered Copays Your pharmacy benefit plan offers five categories— or tiers—of medications that determine your costs (copays):

Tier 0: Value-Based Medications. Select value-based medications for controlling cholesterol, blood pressure, diabetes, asthma, chronic obstructive pulmonary disease and coronary artery disease are included in Tier 0. The co-insurance is 0%, which means they are available at no cost to you.

Tier 1: Generics. Most generic medications are included in Tier 1. Generics contain the same active ingredient as their brand-name equivalents and offer the same effectiveness and safety. These drugs are clinically proven and typically available at a lower cost. The co-insurance is 10%.

Tier 2: Preferred. Clinically proven and cost-effective preferred-brand medications and some generic medications are included in Tier 2. They have higher copays than generics but are less costly than nonpreferred medications on the third tier. The co-insurance is 20%.

Tier 3: Nonpreferred. Mostly non-preferred-brand medications are included in Tier 3. These drugs are not as clinically or cost-effective compared to other drugs available. Because a generic version or a second-tier alternative is available, the co-insurance is 50%. Tier 4: Brand and generic drugs considered to have minimal or no clinical and cost-effective value are in Tier 4. The co-insurance is 100%.

How to Use This Guide Whenever possible, you and your doctor should consult this guide for the lowest cost brand name and generic medications available for your therapy. Some tips to keep in mind when using this guide:

Therapeutic categories are listed alphabetically in all UPPERCASE letters in black boxes. Therapeutic classes in each category are printed in all UPPERCASE letters in bold.

Generic medications are listed in lowercase letters below the word GENERIC. Brand-name generic medications have the first letter in Uppercase.

Some medications treat more than one condition. Check different categories for your medication.

All medications on the PDL have been approved by the FDA. Additional Information Not all medications are listed in this PDL. Medication coverage and copays may vary from plan to plan. For more information specific to your plan, log on to healthscopebenefits.com and click on the Walgreens tab. For additional assistance, please call 877-WHIRL50 (877-944-7550). Please note: The PDL is subject to change without notice.

Drug names are the property of their respective o wners. ©2014 Catamaran Inc. All rights reserved. Catamaran is a registered trademark of C atamaran Inc.

Table of Contents

ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

PENICILLINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

CEPHALOSPORIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FIRST GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

SECOND GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

THIRD GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FOURTH GENERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MACROLIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

TETRACYCLINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

QUINOLONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

AMINOGLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

SULFONAMIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

ANTIMYCOBACTERIAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

ANTIFUNGALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

ANTIVIRALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTIMALARIALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

AMEBICIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTHELMINTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

MISC. ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

ANTINEOPLASTICS, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ALKYLATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ANTIBIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ANTINEOPLASTIC ENZYMES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ANTIMETABOLITES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ANGIOGENESIS INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ANTIBODIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

HORMONAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

MITOTIC INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

ENZYME INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

TOPOISOMERASE I INHIBITOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

RADIOPHARMACEUTICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CELLULAR IMMUNOTHERAPY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

ANTINEOPLASTICS MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CHEMOTHERAPY RESCUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CHEMOTHERAPY ADJUNCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

ANTINEOPLASTIC COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CARDIOVASCULAR DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

PHOSPHODIESTERASE INHBTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

CARDIAC GLYCOSIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

ANTIANGINAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

BETA BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

CALCIUM CHANNEL BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANTIARRHYTHMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ACE INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

ANGIOTENSIN RCPTR BLOCKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

DIRECT RENIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ANTIHYPERTENSIVES MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ANTIHYPERTENSIVE COMBO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

DIURETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

VASOPRESSORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

ANTIHYPERLIPIDEMICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

CARDIOVASCULAR - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

DERMATOLOGICALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ACNE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ROSACEA AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ANTIBIOTICS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ANTIFUNGALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ANTIVIRALS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTI-INFLAMMATORY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTIPRURITICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTIPSORIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

ANTISEBORRHEIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

CORTICOSTEROIDS - TOPICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

IMMUNOMODULATING AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

DERMATOLOGICALS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

ENDOCRINE AND METABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

CORTICOSTEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

ANDROGENS-ANABOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

ESTROGENS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

CONTRACEPTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

PROGESTINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

ANTIDIABETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

INSULIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

AMYLIN ANALOGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

INCRETIN MIMETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

SULFONYLUREAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

BIGUANIDES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

MEGLITINIDE ANALOGUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

DIABETIC OTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

ALPHA-GLUCOSIDASE INHIBIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

DPP-4 INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

INSULIN SENSITIZING AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

ANTIDIABETIC COMBINATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

BISPHOSPHONATES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

CALCITONINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

PARATHYROID HORMONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

RANK LIGAND INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

CALCIUM REGULATORS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

HORMONE RECEPTOR MDLTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

FERTILITY REGULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

LHRH/GNRH AGONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

GNRH/LHRH ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

GROWTH HORMONES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

GHRH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

SOMATOMEDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

SOMATOSTATIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

GH RECEPTOR ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

POSTERIOR PITUITARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

CORTICOTROPIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

PROLACTIN INHIBITORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

VASOPRESSIN ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

PROGESTERONE ANTAGONISTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

METABOLIC MODIFIERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

THYROID AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

GASTROINTESTINAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

LAXATIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

ANTIDIARRHEALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

ANTACIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

ULCER DRUGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

ANTIEMETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

DIGESTIVE AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

GASTROINTESTINAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

GENITOURINARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

URINARY ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

URINARY ANTISPASMODICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

VAGINAL PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

GENITOURINARY - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

HEMATOLOGICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

HEMATOPOIETIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

ANTICOAGULANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

HEMOSTATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

HEMATOLOGICAL - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

MOUTH/THROAT/DENTAL AGENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

NEUROLOGY, CNS, PSYCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

ANTIANXIETY AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

ANTIDEPRESSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

ANTIPSYCHOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

HYPNOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

ADHD, NARCOLEPSY, ETC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

ANTICONVULSANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

ANTIPARKINSON AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

NEUROLOGY, PSYCH - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

NEUROMUSCULAR AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

MUSCULOSKELETAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

ANTIMYASTHENIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

OPHTHALMOLOGY AND OTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

ANTI-INFECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

ARTIFICIAL TEAR/LUBRICANT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

BETA-BLOCKERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

OPHTHALMIC STEROIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

PROSTAGLANDINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

CYCLOPLEGIC MYDRIATICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

DECONGESTANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

MIOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

ADRENERGIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

IMMUNOMODULATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

LOCAL ANESTHETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

OPHTHALMICS - MISC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

OTIC AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

OXYTOCICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

PAIN MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

ANALGESICS - NONNARCOTIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

ANALGESICS - OPIOID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

ANTI-INFLAMMATORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

MIGRAINE PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

GOUT AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

LOCAL ANESTHETICS-INJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

RESPIRATORY, ALLERGY, ETC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

ANTIHISTAMINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

NASAL AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

COUGH/COLD/ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

ANTIASTHMATIC/COPD AGENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

RESPIRATORY AGENTS - MISC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

TOXOIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

VACCINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

VITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

MULTIVITAMINS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

MEDICAL DEVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

DIABETIC SUPPLIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

MISCELLANEOUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Cefaclor ER

Cefotetan

Cefotetan/Dextrose

Cefuroxime/Dextrose

August 2014

TIER 03 NON PREFERRED

Cefoxitin Sodium

ANTI-INFECTIVES

Ceftin

Cefuroxime Sodium

PENICILLINS

Mefoxin

TIER 01 GENERIC

Zinacef

amoxicillin

Zinacef IN Iso-osmotic Dextrose

amoxicillin/clavulanate potassium

Zinacef IN Iso-osmotic Diluent

amoxicillin/clavulanate potassium ER

THIRD GENERATION

ampicillin

TIER 01 GENERIC

ampicillin sodium

cefdinir

ampicillin-sulbactam

cefotaxime sodium

dicloxacillin sodium

cefpodoxime proxetil

nafcillin sodium

ceftazidime

oxacillin sodium

ceftriaxone sodium

penicillin v potassium

Cefditoren Pivoxil

penicillin G potassium

Ceftazidime/Dextrose

piperacillin sodium/ tazobactam sodium

Ceftriaxone IN Iso-osmotic Dextrose

piperacillin sodium/tazobactam sodium

Ceftriaxone/Dextrose

piperacillin/tazobactam


Amoxicillin

Cedax

Ampicillin

Ceftazidime

Ampicillin Sodium

Ceftibuten

Penicillin G Potassium IN Iso-osmotic Dextrose

Claforan

Penicillin G Sodium

Claforan/D5W

Pfizerpen-G

Fortaz


Rocephin

Amoxicillin ER

Spectracef

Ampicillin-sulbactam

Suprax

Augmentin

Tazicef

Augmentin ES-600

FOURTH GENERATION

Augmentin XR

TIER 01 GENERIC

Bactocill IN Dextrose

cefepime

Bicillin C-R


Bicillin L-a

Cefepime

Moxatag

Maxipime

Nafcillin Sodium

Nallpen Iso-osmotic IN Dextrose

MACROLIDES

Nallpen/Dextrose

TIER 01 GENERIC

Penicillin G Procaine

azithromycin

Timentin

clarithromycin

Unasyn

clarithromycin ER

Unasyn Bulk Pack

erythromycin

Zosyn

Azithromycin

E.e.s. 400

CEPHALOSPORIN

Erythrocin Stearate

FIRST GENERATION

Erythromycin Base

TIER 01 GENERIC

Erythromycin Ethylsuccinate

cefadroxil


cefazolin sodium

Biaxin

cephalexin

Biaxin XL

Cefazolin Sodium

Biaxin XL PAC

Cephalexin

Dificid


E.e.s. Granules

Ancef

Ery-TAB

Cefazolin Sodium/Dextrose

Eryped 200

Keflex

Eryped 400

SECOND GENERATION

Erythrocin Lactobionate

TIER 01 GENERIC

PCE

cefaclor

Zithromax

cefoxitin sodium

Zithromax Tri-PAK

cefprozil

Zithromax Z-PAK

cefuroxime axetil

Zmax

cefuroxime sodium

Cefaclor

Effective August 2014

PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits (higher quantity may require a PA) 1

TETRACYCLINES

PREFERRED

tobramycinPA

TIER 01 GENERIC

Tobi Podhaler

demeclocycline HCL


doxycycline

BethkisPA

doxycycline hyclate

Gentamicin Sulfate/0.9% Sodium Chloride

doxycycline monohydrate

Streptomycin Sulfate

minocycline HCL

TobiPA

Morgidox 1X100MG

Tobramycin Sulfate/Sodium Chloride

Morgidox 2X100MG

Tetracycline HCL

SULFONAMIDES


Acticlate

TIER 01 GENERIC

Adoxa

Sulfadiazine

Adoxa PAK 1/100

Adoxa PAK 1/150

ANTIMYCOBACTERIAL AGENTS

Adoxa PAK 2/100

TIER 01 GENERIC

Alodox Convenience Kit

ethambutol HCL

Avidoxy DK

isoniazid

Dynacin

pyrazinamide

Minocin

rifampin

Minocin Kit

Cycloserine

Monodox

Isoniazid

Nutridox

TIER 02 PREFERRED

Ocudox

rifabutin

Oraxyl


Vibramycin

Capastat Sulfate

TIER 04 100% COPAY

Myambutol

doxycycline hyclate DR

Mycobutin

minocycline HCL ER

Paser

Doryx

Priftin

Nicazeldoxy 30 Kit

Rifadin

Nicazeldoxy 60 Kit

Rifamate

Solodyn

Rifater

Seromycin

QUINOLONES

Sirturo

TIER 01 GENERIC

Trecator

ciprofloxacin

ciprofloxacin ER

ANTIFUNGALS

ciprofloxacin HCL

TIER 01 GENERIC

ciprofloxacin I.V.-IN D5W

fluconazole

levofloxacin

fluconazole IN dextrose

levofloxacin IN D5W

fluconazole IN NACL

moxifloxacin HCL

griseofulvin microsize

ofloxacin

griseofulvin ultramicrosize

TIER 02 PREFERRED

itraconazole

Noroxin

ketoconazole


nystatin

Avelox

terbinafine HCL

Avelox Abc Pack

voriconazole

Cipro

Amphotericin B

Cipro I.V.-IN D5W

Fluconazole IN NACL

Cipro XR

TIER 02 PREFERRED

Factive

flucytosine

Levaquin

Noxafil

Ofloxacin


Abelcet

AMINOGLYCOSIDES

Ambisome

TIER 01 GENERIC

Amphotec

amikacin sulfate

Ancobon

gentamicin sulfate

Cancidas

gentamicin sulfate pediatric

Diflucan

gentamicin sulfate/sodium chloride

Eraxis

gentamicin sulfate/0.9% sodium chloride

Grifulvin V

isotonic gentamicin

Gris-peg

neomycin sulfate

Lamisil

paromomycin sulfate

Mycamine

tobramycin sulfate

Onmel

Isotonic Gentamicin

Sporanox

TIER 02

Sporanox Pulsepak



Terbinex

Famvir

Vfend

Flumadine

Vfend IV

Foscavir

HepseraPA

ANTIVIRALS

IncivekPA

InfergenPA

TIER 01 GENERIC

Moderiba

abacavir

Moderiba 1200 Dose Pack

abacavir sulfate/lamivudine/zidovudine

Moderiba 800 Dose Pack

acyclovir

OlysioPA

acyclovir sodium

Rebetol

cidofovir

Retrovir

didanosine

Retrovir IV Infusion

famciclovir

Ribatab

ganciclovir

Rimantalist

lamivudine/zidovudine

Sitavig

nevirapine

SovaldiPA

nevirapine ER

Stribild

ribavirin

Trizivir

rimantadine HCL

TyzekaPA

stavudine

Valtrex

valacyclovir HCL

VictrelisPA

zidovudine

Videx EC

Acyclovir Sodium

Viramune

Foscarnet Sodium

Viramune XR

Nevirapine

Virazole

Ribasphere

Vistide

Ribasphere Ribapak

Zerit

TIER 02 PREFERRED

Ziagen

adefovir dipivoxilPA

Zovirax

lamivudine

Aptivus

ANTIMALARIALS

Atripla

BaracludePA

TIER 01 GENERIC

Complera

atovaquone/proguanil HCL

Crixivan

chloroquine phosphate

Emtriva

hydroxychloroquine sulfate

Epzicom

mefloquine HCL

FuzeonPA

quinine sulfate

Intelence

TIER 02 PREFERRED

Invirase

Daraprim

Isentress

Primaquine Phosphate

Kaletra


Lexiva

Aralen

Norvir

Coartem

Peg-intronPA

Malarone

Peg-intron RedipenPA

Plaquenil

Peg-intron Redipen PAK 4PA

Qualaquin

PegasysPA

Pegasys ProclickPA

AMEBICIDES

Prezista

TIER 02 PREFERRED

Relenza Diskhaler

Yodoxin

Rescriptor

Reyataz

ANTHELMINTICS

SelzentryPA

TIER 02 PREFERRED

Sustiva

Albenza

Tamiflu

Biltricide

Tivicay

Stromectol

TruvadaPA

Valcyte

MISC. ANTI-INFECTIVES

Videx Pediatric

TIER 01 GENERIC

Viracept

aztreonam

Viread

bacitracin


clindamycin palmitate HCL

Combivir

clindamycin phosphate

Copegus

clindamycin phosphate add-vantage

Cytovene

clindamycin phosphate pharmacy bulk package

Edurant

clindamycin phosphate IN D5W

Epivir

clindamycin HCL

Epivir HBV

colistimethate sodium



imipenem/cilastatin

Cisplatin

meropenem

Cyclophosphamide

metronidazole

Ifosfamide

metronidazole IN NACL 0.79%

TIER 02 PREFERRED

polymyxin b sulfate

Alkeran

sulfamethoxazole/trimethoprim

Hexalen

sulfamethoxazole/trimethoprim DS

Leukeran

tinidazole

Lomustine

trimethoprim

MyleranPA

vancomycin HCL

Treanda

Chloramphenicol Sodium Succinate

ValchlorPA

Dapsone


Metro IV

Bicnu

Sulfamethoxazole/Trimethoprim

Busulfex

Vancomycin HCL

Ceenu

TIER 02 PREFERRED

Eloxatin

atovaquone

Gliadel Wafer

Alinia

Ifex

Nebupent

Mustargen

Zyvox

TemodarPA


Zanosar

Azactam

Azactam IN Iso-osmotic Dextrose

ANTIBIOTICS

Bacitracin

TIER 01 GENERIC

Bactrim

bleomycin sulfate

Bactrim DS

daunorubicin HCL

CaystonPA

doxorubicin HCL

Cleocin

doxorubicin HCL liposome

Cleocin IN D5W

epirubicin HCL

Cleocin Pediatric Granules

idarubicin HCL

Cleocin Phosphate

mitomycin

Clindamycin Phosphate

mitoxantrone HCLPA

Coly-mycin M

Adriamycin

Cubicin

Epirubicin HCL

Dalvance


Doribax

Cosmegen

First-vancomycin 25

Daunoxome

First-vancomycin 50

Doxil

Flagyl

Ellence

Flagyl ER

Idamycin PFS

Invanz

Ketek

ANTINEOPLASTIC ENZYMES

Lincocin


Mepron

Elspar

Merrem

ErwinazePA

Neutrexin

Oncaspar

Pentam 300

Primaxin IV

ANTIMETABOLITES

Primaxin IV Add-vantage

TIER 01 GENERIC

Primsol

azacitidinePA

Sivextro

cladribine

Synercid

cytarabine

Tindamax

cytarabine aqueous

Tygacil

decitabinePA

Vancocin HCL

floxuridine

Vancomycin HCL IN Dextrose

fludarabine phosphate

Vibativ

fluorouracil

Xifaxan

gemcitabine HCL

mercaptopurine

ANTINEOPLASTICS, ETC

methotrexate

ALKYLATING AGENTS

methotrexate sodium

TIER 01 GENERIC

Cytarabine

carboplatin

Fludarabine Phosphate

cisplatin

Gemcitabine

ifosfamide

TIER 02 PREFERRED

melphalan hydrochloride

capecitabinePA

oxaliplatin

Folotyn

temozolomidePA

Trexall

Carboplatin

TIER 03



NON PREFERRED

Trelstar MixjectPA

Alimta

ZytigaPA

Arranon

Clolar

IMMUNOMODULATORS

DacogenPA

TIER 01 GENERIC

Fludara

azathioprine

Gemzar

cyclosporine

Purinethol

cyclosporine modified

Purixan

mycophenolate mofetil

Tabloid

mycophenolic acid DR

VidazaPA

sirolimus

XelodaPA

tacrolimus

Cyclosporine Modified

ANGIOGENESIS INHIBITORS

TIER 02 PREFERRED

TIER 02 PREFERRED

Atgam

Avastin

Azasan

CyramzaPA

Neoral

ZaltrapPA

PomalystPA

Rapamune

ANTIBODIES

RevlimidPA

Sandimmune

TIER 02 PREFERRED

ThalomidPA

Erbitux

Thymoglobulin

GazyvaPA


HerceptinPA

Astagraf XL

KadcylaPA

Cellcept

RituxanPA

Cellcept Intravenous


Imuran

AdcetrisPA

Myfortic

ArzerraPA

NulojixPA

Bexxar

Prograf

PerjetaPA

Simulect

Vectibix

ZortressPA

YervoyPA

Zevalin Y-90

MITOTIC INHIBITORS

HORMONAL AGENTS

TIER 01 GENERIC

etoposide

TIER 01 GENERIC

paclitaxel

anastrozole

vincristine sulfate

bicalutamide

vinorelbine tartrate

exemestane

Etoposide

flutamide

Paclitaxel

letrozole

Vinblastine Sulfate

leuprolide acetatePA

TIER 02 PREFERRED

megestrol acetate

Ixempra Kit

tamoxifen citrate

JevtanaPA

TIER 02 PREFERRED


Depo-provera

Abraxane

Emcyt

Docefrez

FirmagonPA

Docetaxel

Lupron DepotPA

Etopophos

Lysodren

HalavenPA

VantasPA

Marqibo

XtandiPA

Navelbine

ZoladexPA

Taxotere


Teniposide

Arimidex

Vumon

Aromasin

Casodex

ENZYME INHIBITORS

EligardPA

Fareston

TIER 02 PREFERRED

Faslodex

AfinitorPA

Femara

Afinitor DisperzPA

Megace Oral

BosulifPA

Nilandron

GleevecPA

Soltamox

JakafiPA

Trelstar DepotPA

MekinistPA

Trelstar Depot MixjectPA

NexavarPA

Trelstar LAPA

SprycelPA

Trelstar LA MixjectPA

SutentPA



TafinlarPA

GENERIC

TarcevaPA

amifostine

TasignaPA

dexrazoxane

Torisel

leucovorin calcium

TykerbPA

mesna

VelcadePA

Calcium Folinate

VotrientPA

Leucovorin Calcium

XalkoriPA


ZelborafPA

Ethyol


Fusilev

Beleodaq

Mesnex

CaprelsaPA

Totect

CometriqPA

Zinecard

GilotrifPA

TIER 04 100% COPAY

IclusigPA

Voraxaze

IstodaxPA

KyprolisPA

CHEMOTHERAPY ADJUNCTS

StivargaPA

TIER 02 PREFERRED

ZolinzaPA

Kepivance

Zydelig


ZykadiaPA

Elitek

TOPOISOMERASE I INHIBITOR

ANTINEOPLASTIC COMBO

TIER 01 GENERIC

TIER 01 GENERIC

irinotecan

Ifosfamide/Mesna

topotecan HCL

Topotecan HCL

CARDIOVASCULAR DRUGS


PHOSPHODIESTERASE INHBTR

Camptosar

TIER 01 GENERIC

Hycamtin

milrinone lactate

Irinotecan

milrinone IN dextrose

RADIOPHARMACEUTICALS

CARDIAC GLYCOSIDES


TIER 01 GENERIC

Bexxar 131 Iodine

digoxin

Metastron

Digoxin

Quadramet


TIER 04 100% COPAY

Lanoxin

Xofigo

Lanoxin Pediatric

CELLULAR IMMUNOTHERAPY

ANTIANGINAL AGENTS


TIER 00 VALUE BASED BENEFIT

Provenge

Nitrostat

TIER 01 GENERIC

ANTINEOPLASTICS MISC.

isosorbide dinitrate

TIER 01 GENERIC

isosorbide dinitrate ER

dacarbazine

isosorbide mononitrate

hydroxyurea

isosorbide mononitrate ER

tretinoin

nitroglycerin

Dacarbazine

nitroglycerin lingual

TIER 02 PREFERRED

nitroglycerin transdermal

Actimmune

nitroglycerin IN dextrose 5%

Intron-aPA

nitroglycerin IN 5% dextrose

Intron-a W/DiluentPA

Isosorbide Dinitrate

Matulane

Nitroglycerin

Proleukin

Nitroglycerin IN Dextrose 5%

SynriboPA

Nitroglycerin Lingual


TIER 02 PREFERRED

Alferon N

Dilatrate SR

Hydrea

RanexaPA

Nipent


Photofrin

Imdur

SylatronPA

Isordil Titradose

TargretinPA

Nitro-bid

Trisenox

Nitro-dur

Uvadex

Nitrolingual Pumpspray

Nitromist

CHEMOTHERAPY RESCUE

Nitronal

TIER 01



BETA BLOCKERS

Calan

Calan SR


Cardene I.v.

carvedilol

Cardene IV

TIER 01 GENERIC

Cardene SR

acebutolol HCL

Cardizem

atenolol

Cardizem CD

betaxolol HCL

Cleviprex

bisoprolol fumarate

Dilacor XR

esmolol HCL

Hypertenipine-2.5

labetalol HCL

Isoptin SR

metoprolol succinate ER

Norvasc

metoprolol tartrate

Nymalize

nadolol

Procardia

pindolol

Procardia XL

propranolol HCL

Sular

propranolol HCL ER

Tiazac

sotalol HCL

Verelan

sotalol HCL (AF)

Verelan PM

Propranolol HCL

Timolol Maleate

ANTIARRHYTHMICS

TIER 02 PREFERRED

Coreg CR

TIER 01 GENERIC


adenosine

Betapace

amiodarone HCL

Betapace AF

disopyramide phosphate

Brevibloc

flecainide acetate

Bystolic

ibutilide fumarate

Coreg

lidocaine HCL

Corgard

lidocaine HCL IN D5W

Hemangeol

lidocaine HCL/dextrose

Hypertenevide-12.5

mexiletine HCL

Inderal LA

propafenone HCL

Inderal XL

propafenone HCL ER

Innopran XL

quinidine gluconate CR

Kerlone

quinidine gluconate ER

Levatol

quinidine sulfate

Lopressor

Amiodarone HCL

Sectral

Lidocaine HCL

Sotalol Hydrochloride

Procainamide HCL

Tenormin

Quinidine Sulfate ER

Toprol XL

TIER 02 PREFERRED

Trandate

Tikosyn

Zebeta


Adenocard

CALCIUM CHANNEL BLOCKERS

Cordarone

Corvert


Multaq

amlodipine besylate

Nexterone

diltiazem HCL

Norpace

verapamil HCL

Norpace CR

TIER 01 GENERIC

Quinidine Gluconate

diltiazem CD

Quinidine Sulfate

diltiazem HCL ER

Rythmol

felodipine ER

Rythmol SR

nicardipine HCL

Tambocor

nifedipine

Xylocaine

nifedipine ER

nimodipine

ACE INHIBITORS

nisoldipine

verapamil HCL ER


verapamil HCL SR

benazepril HCL

Diltiazem HCL

captopril

Isradipine

enalapril maleate

Nisoldipine

fosinopril sodium

Nisoldipine ER

lisinopril

Verapamil HCL

moexipril HCL

TIER 02 PREFERRED

perindopril erbumine

Cardizem LA

quinapril HCL


ramipril

Adalat CC

trandolapril



TIER 01 GENERIC

ANTIHYPERTENSIVE COMBO

enalaprilat



benazepril HCL/hydrochlorothiazide

Accupril

enalapril maleate/hydrochlorothiazide

Aceon

lisinopril/hydrochlorothiazide

Altace

losartan potassium/hydrochlorothiazide

Epaned

Captopril/Hydrochlorothiazide

Lotensin

TIER 01 GENERIC

Mavik

amlodipine besylate/benazepril hydrochloride

Prinivil

amlodipine besylate/benazepril HCL

Univasc

atenolol/chlorthalidone

Vasotec

bisoprolol fumarate/hydrochlorothiazide

Zestril

candesartan cilexetil/hydrochlorothiazide

fosinopril sodium/hydrochlorothiazide

ANGIOTENSIN RCPTR BLOCKER

irbesartan/hydrochlorothiazide


metoprolol/hydrochlorothiazide

losartan potassium

moexipril/hydrochlorothiazide

TIER 01 GENERIC

nadolol/bendroflumethiazide

candesartan cilexetil

quinapril/hydrochlorothiazide

eprosartan mesylate

telmisartan/amlodipine

irbesartan

telmisartan/hydrochloroth

telmisartan

telmisartan/hydrochlorothiazide

valsartan

valsartan/hydrochlorothiazide


Clorpres

AtacandST

Methyldopa/Hydrochlorothiazide

AvaproST

Propranolol/Hydrochlorothiazide

BenicarST


CozaarST

Accuretic

DiovanST

Atacand HCTST

Edarbi

AvalideST

MicardisST

AzorST

TevetenST

Benicar HCTST

Corzide

DIRECT RENIN INHIBITORS

Diovan HCTST

Dutoprol


ExforgeST

TekturnaST

Exforge HCTST

Hypertensolol

ANTIHYPERTENSIVES MISC.

HyzaarST

TIER 01 GENERIC

Lopressor HCT

clonidine HCL

Lotensin HCT

doxazosin mesylate

Lotrel

eplerenone

Lytensopril Kit

fenoldopam mesylate

Lytensopril-90

guanfacine HCL

Lytensopril-90 Kit

hydralazine HCL

Micardis HCTST

methyldopa

Tarka

minoxidil

Tekturna HCTST

prazosin HCL

Tenoretic 100

terazosin HCL

Tenoretic 50

Methyldopate HCL

Teveten HCTST

Nitropress

Twynsta

Phentolamine Mesylate

Uniretic

Reserpine

Vaseretic

TIER 02 PREFERRED

Zestoretic

Demser

Ziac

Dibenzyline

TIER 04 100% COPAY


Amturnide

Cardura

Edarbyclor

Catapres

Tekamlo

Catapres-tts-1

Tribenzor

Catapres-tts-2

Catapres-tts-3

DIURETICS

Corlopam


Inspra

hydrochlorothiazide

Minipress

Chlorthalidone

Tenex

TIER 01 GENERIC

Vecamyl

acetazolamide

acetazolamide sodium



acetazolamide ER

VALUE BASED BENEFIT

amiloride HCL

atorvastatin calcium

amiloride/hydrochlorothiazide

lovastatin

bumetanide

pravastatin sodium

chlorothiazide

simvastatin

chlorothiazide sodium

TIER 01 GENERIC

furosemide

cholestyramine

indapamide

cholestyramine light

mannitol

colestipol HCL

methazolamide

colestipol HCL for oral suspension

metolazone

fenofibrate

spironolactone

fenofibrate micronized

spironolactone/hydrochlorothiazide

fluvastatin

torsemide

gemfibrozil

triamterene/hydrochlorothiazide

niacin ER

Acetazolamide

Fenofibric AcidST

Furosemide

TIER 02 PREFERRED

Methyclothiazide

omega-3-acid ethyl esters

Torsemide

JuxtapidPA


KynamroPA

Aldactazide

Welchol

Aldactone

Zetia

Chlorothiazide


Demadex

Advicor

Diamox

AltoprevST

Diuril

Colestid

Dyazide

Colestid Flavored

Dyrenium

CrestorST

Edecrin

Fenofibrate

Introl

FibricorST

Lasix

Lescol

Maxzide

Lescol XLST

Maxzide-25

Lipitor

Microzide

LivaloST

Neptazane

Lopid

Sodium Diuril

Lovaza

Sodium Edecrin

Mevacor

Triamterene/Hydrochlorothiazide

Niacor

Zaroxolyn

Niaspan

Pravachol

VASOPRESSORS

Questran

Questran Light

TIER 01 GENERIC

Simcor

dobutamine HCL

Zocor

dobutamine HCL/D5W

TIER 04 100% COPAY

dobutamine/dextrose 5%

fenofibric acid DR

dopamine HCL

AntaraST

dopamine HCL-dextrose 5%

FenoglideST

dopamine HCL/dextrose 5%

Lipofen

dopamine/D5W

Lofibra

ephedrine sulfate

Tricor

midodrine HCL

TriglideST

norepinephrine bitartrate

Trilipix

phenylephrine HCL

Vytorin

Adrenaclick

Auvi-q

CARDIOVASCULAR - MISC.

Dopamine HCL

Epinephrine

TIER 01 GENERIC

Epipen 2-PAK

amlodipine besylate/atorvastatin calcium

Epipen-JR 2-PAK

epoprostenol sodium


papaverine HCL

Adrenalin

VeletriPA

Dobutamine/Dextrose 5%

TIER 02 PREFERRED

Levophed

sildenafilPA

Neo-synephrine

sildenafil citratePA

Northera

AdempasPA

Phenylephrine HCL

Bidil

Cialis

ANTIHYPERLIPIDEMICS

FlolanPA

LetairisPA

TIER 00



Muse

Nuox

RemodulinPA

Plexion

RevatioPA

Plexion Cleanser

TracleerPA

Plexion Cleansing Cloths

VentavisPA

Retin-aPA

Viagra

Retin-a MicroPA


Retin-a Micro P.M.PA

AdcircaPA

Rosanil

Caduet

Sulfoam

Levitra

Sumadan Wash

Natrecor

Sumadan XLT

OrenitramPA

Sumaxin

Staxyn

Sumaxin CP Kit

Stendra

Sumaxin Ts

TyvasoPA

Sumaxin Wash

Tyvaso RefillPA

Tretin-xPA

Tyvaso StarterPA

VeltinPA

TIER 04 100% COPAY

ZianaPA

OpsumitPA

TIER 04 100% COPAY

Benzaclin With P.M.

DERMATOLOGICALS

EpiduoPA

Sumadan Kit

ACNE PRODUCTS

TIER 01 GENERIC

ROSACEA AGENTS

adapalenePA

TIER 01 GENERIC


metronidazole

clindamycin/benzoyl peroxide

TIER 02 PREFERRED

erythromycin

Finacea

erythromycin/benzoyl peroxide

Oracea

sodium sulfacetamide


sodium sulfacetamide/sulfur

Metrocream

sodium sulfacetamide/sulfur cleanser

Metrogel

sodium sulfacetamide/sulfur cleansing cloths

Metrolotion

sodium sulfacetamide/sulfur green

Noritate

sodium sulfacetamide/sulfur wash

Rosadan Kit

sulfacetamide sodium

sulfacetamide sodium/sulfur cleanser

ANTIBIOTICS - TOPICAL

tretinoinPA

TIER 01 GENERIC

tretinoin microspherePA

mupirocin

tretinoin microsphere P.M.PA

mupirocin calcium

Claravis

Gentamicin Sulfate

Clindacin PAC


Sodium Sulfacetamide/Sulfur

Altabax

Sodium Sulfacetamide/Sulfur Cleanser IN Urea

Bactroban

Sodium Sulfacetamide/Sulfur IN Urea

Centany


Centany AT

Absorica

Cortisporin

Acanya

Neo-synalar

Aczone

Neo-synalar Kit

Akne-mycin

AtralinPA

ANTIFUNGALS - TOPICAL

Avar

Avar LS

TIER 01 GENERIC

Avar LS Cleanser

ciclopirox

Avar-e LS

ciclopirox nail lacquer

Azelex

ciclopirox olamine

Benzaclin

clotrimazole

Benzamycin

clotrimazole/betamethasone dipropionate

Benzamycinpak

econazole nitrate

Clarifoam EF

ketoconazole

Cleocin-t

nystatin

Clindacin Etz

nystatin/triamcinolone

Clindagel

Ciclodan Solution Kit

DifferinPA

Ciclopirox Topical Solution Kit

Duac

TIER 02 PREFERRED

Erygel

Ertaczo

Evoclin

Mentax

Fabior


Klaron

Cnl8 Nail Kit

Neuac Kit

Exelderm



Extina

8-mop

Halotin

TIER 04 100% COPAY

Jublia

Sorilux

Lamisil Spray

Loprox

ANTISEBORRHEIC AGENTS

Loprox Shampoo

TIER 01 GENERIC

Lotrisone

selenium sulfide

Luzu


Naftin

sodium sulfacetamide wash

Nizoral

Seb-prev

Oxistat

Selenium Sulfide

Pediaderm AF Complete Kit

Sodium Sulfacetamide/Urea

Pedipirox-4 Nail


Penlac Nail Lacquer

Glycolic Acid

Vusion

Glycolic Acid 70% High Purity

Xolegel

Ovace Plus

Xolegel Corepak

Ovace Plus Wash

Xolegel Duo/Head & Shoulders

Ovace Wash

Xolegel Duo/Xolex

Promiseb

TIER 04 100% COPAY

Selrx

Ciclodan Cream Kit

Selsun Shampoo

Ecoza

Tersi Foam

Ketodan Kit

TL Triseb

TIER 04 100% COPAY

ANTIVIRALS - TOPICAL

Promiseb Complete

TIER 02 PREFERRED

acyclovir

CORTICOSTEROIDS - TOPICAL


TIER 01 GENERIC

Denavir

alclometasone dipropionate

Xerese

amcinonide

Zovirax

augmented betamethasone dipropionate

TIER 04 100% COPAY

betamethasone dipropionate

Lidovir

betamethasone valerate

clobetasol propionate

ANTI-INFLAMMATORY AGENTS

clobetasol propionate emollient

TIER 01 GENERIC

desonide

diclofenac sodium

desoximetasone


diflorasone diacetate

Flector

fluocinolone acetonide

Lidoprofen

fluocinonide

Pennsaid

fluocinonide emollient base

Voltaren

fluocinonide-e

Vopac

fluticasone propionate

Vopac GB

halobetasol propionate

Vopac Kt

hydrocortisone

hydrocortisone acetate/aloe

ANTIPRURITICS

hydrocortisone butyrate

hydrocortisone valerate

TIER 01 GENERIC

hydrocortisone IN absorbase

Prudoxin

mometasone furoate


prednicarbate

Zonalon

triamcinolone acetonide

Amcinonide

ANTIPSORIATICS

Apexicon E

TIER 01 GENERIC

Desoximetasone

calcipotriene

Diflorasone Diacetate

Calcitriol

Triamcinolone Acetonide

TIER 02 PREFERRED

Trianex

acitretin

U-cort

methoxsalen

TIER 02 PREFERRED

StelaraPA

hydrocortisone butyrate (lipid)


hydrocortisone butyrate (lipophilic)

Dovonex

Capex

Dritho-creme HP

Cordran Tape

Oxsoralen Ultra


Soriatane

Aclovate

Tazorac

Ala Scalp

Vectical

Carmol-HC

Zithranol

Clobex

Zithranol-rr



Clodan Kit

lactic acid e

Cordran

lactic acid w/vitamin e

Cutivate

lidocaine

Derma-smoothe/FS Body

lidocaine HCL

Derma-smoothe/FS Body Oil

lidocaine HCL jelly

Derma-smoothe/FS Scalp

lidocaine/prilocaine

Derma-smoothe/FS Scalp Oil

lindane

Dermasorb HC

malathion

Dermasorb Ta

permethrin

Dermatop

podofilox

Desonate

salicylic acid

Desowen

sodium hyaluronate

Desowen Cream/Cetaphil Lotion

urea

Desowen Lotion/Cetaphil Cream

urea topical

Desowen Ointment/Cetaphil Lotion

urea IN zinc undecylenate/lactic acid vehicle

Diprolene

urea 40% nail film

Diprolene AF

Aluminum Acetate

Elocon

Benzoin Compound Tincture

Epifoam

Cocaine HCL

First-hydrocortisone

Ethyl Chloride/Fine Pinpoint

Halog

Ethyl Chloride/Fine Stream

Halonate

Ethyl Chloride/Medium Jet Stream

Kenalog

Ethyl Chloride/Medium Stream

Locoid

Ethyl Chloride/Mist

Locoid Lipocream

Hylira

Luxiq

Latrix XM

Nucort

Lidocaine HCL

Nuzon

Lidocaine/Prilocaine

Olux

Mb Hydrogel

Olux-e

Pr Cream

Pandel

Pruclair

Pediaderm HC

Prumyx

Pediaderm Ta

Salicylic Acid

Pramosone

Salicylic Acid IN Ammonium Lactate Vehicle

Scalacort DK

TL-cermide

Synalar

TIER 02 PREFERRED

Temovate

Condylox

Temovate E

Eurax

Texacort

Oxsoralen

Topicort


Ultravate

Aluvea

Ultravate PAC

Anacaine

Vanos

Arnica Flower

Verdeso

Atopiclair

Westcort

Aurstat

TIER 04 100% COPAY

Aurstat Anti-itch Hydrogel

calcipotriene/betamethasone dipropionate

Aurstat Anti-itch Hydrogel Kit

Synalar Cream Kit

Benzoin Tincture

Synalar Ointment Kit

Boric Acid

Synalar Ts

Cem-urea

Taclonex

Coal TAR

Ultravate X

Dermasorb XM

Drysol

IMMUNOMODULATING AGENTS

Elenzapatch

Eletone

TIER 01 GENERIC

Eletone Twinpack

imiquimod

Elimite

TIER 02 PREFERRED

Emla

ElidelPA

Emulsion SB

ProtopicPA

Epiceram


Ethyl Chloride

Aldara

Gebauers Pain Ease

Zyclara

Gebauers Spray And Stretch

Zyclara P.M.

Genadur

Gordofilm

DERMATOLOGICALS - MISC.

Gordons Urea

TIER 01 GENERIC

Hydro 35

ammonium lactate

Hydro 40 Foam

episone CRE

Kerafoam

lactic acid

Kerafoam 42



Keralac


Lac-hydrin

A-hydrocort

Lidoderm

Aristospan Intra-articular

Lycelle

Aristospan Intralesional

Natroba

Celestone

Neosalus

Celestone-soluspan

Neosalus CP

Cortef

Nivatopic Plus

Depo-medrol

Ovide

Dexamethasone Sodium Phosphate

Pliaglis

Dexpak 10 Day

Presera

Dexpak 13 Day

Pyrogallic Acid

Dexpak 6 Day

Qutenza

Entocort EC

Radigel

FLO-pred

Salkera

Interarticular Joint Kit

Salvax Duo Plus

Kenalog-10

Sklice

Kenalog-40

Spinosad

Medrol

Sulfurated Lime

Medrol Dosepak

Synera

Millipred

Tetrix

Millipred DP

Tropazone

Orapred

Ulesfia

Orapred Odt

Umecta

Pediapred

Umecta Nail Film

Prelone

Umecta PD

Rayos

Uramaxin

Solu-cortef

Uramaxin GT

Solu-medrol

Uramaxin GT Kit

Uceris

Utopic

Veripred 20

Veregen

Vexa

ANDROGENS-ANABOLIC

Witch Hazel

TIER 01 GENERIC

Xclair

danazol

Xerac Ac

oxandrolonePA

Xylocaine

testosterone cypionatePA

TIER 04 100% COPAY

testosterone enanthatePA

Hylatopic

AndroxyPA

Hylatopic Plus

TIER 02 PREFERRED

HPR

AndrodermPA

HPR Plus

AndrogelPA

HPR Plus/Mb Hydrogel

Androgel P.M.PA

Nuvail


Ultrasal-ER

Anadrol-50PA

Virasal

AndroidPA

Aveed

ENDOCRINE AND METABOLIC

AxironPA

Depo-testosteronePA

CORTICOSTEROIDS

First-testosterone

TIER 01 GENERIC

First-testosterone Mc Compounding KitPA

betamethasone sodium phosphate/betamethasone acetate

FortestaPA

budesonide

OxandrinPA

dexamethasone

StriantPA

dexamethasone sodium phosphate

TestimPA

fludrocortisone acetate

Testopel

hydrocortisone

TestosteronePA

methylprednisolone

Testosterone P.M.PA

methylprednisolone acetate

TestredPA

methylprednisolone dose pack

VogelxoPA

methylprednisolone sodiumsuccinate

Vogelxo P.M.PA

prednisolone

prednisolone sodium phosphate

ESTROGENS

prednisone

TIER 01 GENERIC

Cortisone Acetate

estradiol

Dexamethasone

estradiol valerate

Dexamethasone Intensol

estradiol/norethindrone acetate

Prednisolone Sodium Phosphate

estropipate

Prednisone

Estropipate

Prednisone Intensol

Jinteli



TIER 02 PREFERRED

Nordette-28

Cenestin

Norinyl 1+50

Climara

Ortho Micronor

Combipatch

Ortho Tri-cyclen

Divigel

Ortho-cept

Enjuvia

Ortho-cyclen

Evamist

Ortho-novum 1/35

Premphase

Ovcon-35

Prempro

Plan B

Vivelle-dot

Plan B One-step


Quartette

Activella

Tri-norinyl 28

Alora

Yasmin 28

Angeliq

Yaz

Climara Pro

TIER 04 100% COPAY

Delestrogen

Cyclessa

Depo-estradiol

Femcon FE

Duavee

Loestrin FE 1.5/30

Elestrin

Loestrin FE 1/20

Estrace

Loestrin 24 FE

Estrasorb

Minastrin 24 FE

Estrogel

Seasonique

Femhrt Low Dose

Menest

PROGESTINS

Menostar

TIER 00 GENERIC

Minivelle

medroxyprogesterone acetate

Prefest

TIER 01 GENERIC

Premarin

norethindrone acetate

progesterone

CONTRACEPTIVES


TIER 00 GENERIC

Aygestin

drospirenone/ethinyl estradiol

MakenaPA

levonorgestrel and ethinyl estradiol

Megace ES

levonorgestrel/ethinyl estradiol

Prometrium

norethindrone

Provera

norgestimate/ethinyl estradiol

Amethyst

ANTIDIABETIC AGENTS

Beyaz

INSULIN

Generess FE


Loseasonique

Humalog

Natazia

Humalog Mix 50/50

Necon 1/50-28

Humalog Mix 75/25

Necon 10/11-28

Humulin R U-500 (concentrated)

Norinyl 1+35

Lantus

Ogestrel

Levemir

Ortho Tri-cyclen LO

Novolog

Ortho-novum 7/7/7

Novolog Mix 70/30

Safyral

TIER 02 PREFERRED

Zovia 1/50e

Apidra

TIER 01 GENERIC

Apidra Solostar

desogestrel/ethinyl estradiol

Humalog Kwikpen

levonorgestrel

Humalog Mix 50/50 Kwikpen

norethindrone acetate/ethinyl estradiol

Humalog Mix 75/25 Kwikpen

norethindrone acetate/ethinyl estradiol/ferrous fumarate

Lantus Solostar

Brevicon-28

Levemir Flexpen

TIER 02 PREFERRED

Novolog Flexpen

Desogen

Novolog Mix 70/30 Prefilled Flexpen


Novolog Penfill

Ella


Estrostep FE

Levemir Flextouch

Falessa

AMYLIN ANALOGS

Loestrin 1.5/30-21

TIER 02 PREFERRED

Loestrin 1/20-21

Symlinpen 120PA

Lomedia 24 FE

Symlinpen 60PA

LO Loestrin FE

INCRETIN MIMETIC AGENTS

LO Minastrin FE

TIER 02 PREFERRED

Mircette

ByettaPA

Modicon


Nor-QD

Bydureon

Tanzeum



VictozaPA

TIER 01 GENERIC

SULFONYLUREAS

glipizide/metformin HCL


pioglitazone HCL/metformin HCL

glimepiride

TIER 02 PREFERRED

glipizide

pioglitazone HCL-glimepiride

glipizide ER


glyburide

Actoplus Met

glyburide micronized

Actoplus Met XR

Glyburide

Appformin

TIER 01 GENERIC

Appformin-d

tolazamide

Duetact

Chlorpropamide

Glucovance

Tolazamide

Invokamet

Tolbutamide

Janumet


Janumet XR

Amaryl

Juvisync

Diabeta

Kombiglyze XR

Glucotrol

Prandimet

Glucotrol XL

TIER 04 100% COPAY

Glynase

Avandamet

BIGUANIDES

Avandaryl


Kazano

metformin HCL

Oseni

metformin HCL ER


BISPHOSPHONATES

Fortamet

TIER 01 GENERIC

Glucophage

alendronate sodiumQL

Glucophage XR

pamidronate disodium

Glumetza

risedronate sodiumQL

Riomet

Alendronate SodiumQL

MEGLITINIDE ANALOGUES

Etidronate Disodium

TIER 01 GENERIC

TIER 02 PREFERRED

nateglinide

ActonelQL,ST

TIER 02 PREFERRED

Zoledronic AcidPA

repaglinide



ibandronate sodiumQL

Prandin

zoledronic acidPA

Starlix

Didronel

DIABETIC OTHER

FosamaxQL

TIER 02 PREFERRED

Pamidronate Disodium

Glucagon Emergency Kit

ReclastPA

Korlym

ZometaPA


TIER 04 100% COPAY

Farxiga

BinostoQL

Glucagen

BonivaQL

Glucagen Hypokit

InvokanaPA

CALCITONINS

Jardiance

TIER 01 GENERIC

Proglycem

calcitonin salmon

ALPHA-GLUCOSIDASE INHIBIT

calcitonin-salmon

TIER 01 GENERIC


acarbose

Fortical


Miacalcin

Glyset

Precose

PARATHYROID HORMONE

DPP-4 INHIBITORS

TIER 02 PREFERRED


Forteo

Januvia

Nesina

RANK LIGAND INHIBITORS

Onglyza


Tradjenta

ProliaPA

INSULIN SENSITIZING AGENT

XgevaPA

TIER 01 GENERIC

pioglitazone HCL

CALCIUM REGULATORS - MISC



Actos

Ganite

Avandia

ANTIDIABETIC COMBINATIONS

HORMONE RECEPTOR MDLTR


TIER 02

glyburide/metformin HCL



PREFERRED

TIER 02 PREFERRED

raloxifene hydrochloride

Sandostatin Lar DepotPA


Somatuline DepotPA

Evista


Osphena

SandostatinPA

SigniforPA

FERTILITY REGULATORS

GH RECEPTOR ANTAGONISTS

TIER 01 GENERIC

chorionic gonadotropin

TIER 02 PREFERRED

clomiphene citrate

SomavertPA

TIER 02 PREFERRED

Bravelle

POSTERIOR PITUITARY

Gonal-f

TIER 01 GENERIC

Gonal-f RFF

desmopressin acetate

Gonal-f RFF Pen

vasopressin

Ovidrel

TIER 02 PREFERRED

Repronex

Stimate



Follistim AQ

Ddavp

Gonal-f RFF Rediject

Pitressin Synthetic

Menopur

CORTICOTROPIN

LHRH/GNRH AGONIST


TIER 02 PREFERRED

Acthar HPPA

Lupron Depot-PEDPA

Supprelin LAPA

PROLACTIN INHIBITORS

Synarel

TIER 01 GENERIC


cabergoline

Lupaneta PackPA

VASOPRESSIN ANTAGONISTS

GNRH/LHRH ANTAGONISTS


TIER 02 PREFERRED

Samsca

Cetrotide

Vaprisol


Ganirelix Acetate

PROGESTERONE ANTAGONISTS


GROWTH HORMONES

Mifeprex

TIER 02 PREFERRED

GenotropinPA

METABOLIC MODIFIERS

Genotropin MiniquickPA

TIER 01 GENERIC

HumatropePA

calcitriol

Humatrope Combo PackPA

levocarnitine


TIER 02 PREFERRED

Norditropin CartridgePA

doxercalciferol

Norditropin FlexproPA

paricalcitol

Norditropin Nordiflex PenPA

sodium phenylbutyrate

NutropinPA

AldurazymePA

Nutropin AQ Nuspin 10PA

Cystadane


ElaprasePA


FabrazymePA

Nutropin AQ PenPA

KuvanPA

OmnitropePA

MyaleptPA

SaizenPA

NaglazymePA

Saizen Click.easyPA

Orfadin

SerostimPA

RavictiPA

Tev-tropinPA

Sensipar

ZorbtivePA


Ammonul

GHRH

Buphenyl


CarbagluPA

EgriftaPA

Carnitor

Carnitor SF

SOMATOMEDINS

Hectorol


LumizymePA

IncrelexPA

MyozymePA

Rocaltrol

SOMATOSTATIC AGENTS

VimizimPA

TIER 01 GENERIC

Zemplar

octreotide acetatePA



THYROID AGENTS

ULCER DRUGS

TIER 01 GENERIC

TIER 01 GENERIC

levothyroxine sodium

atropine sulfate

liothyronine sodium

cimetidine

methimazole

cimetidine HCL

propylthiouracil

dicyclomine HCL

Levothyroxine Sodium

famotidine


glycopyrrolate

Armour Thyroid

hyoscyamine sulfate

Cytomel

hyoscyamine sulfate odt

Nature-throid

hyoscyamine sulfate ER

Nature-throid Nt-2.5

hyoscyamine sulfate SR

Synthroid

methscopolamine bromide

Tapazole

misoprostol

Thyrolar-1

nizatidine

Thyrolar-1/2

ranitidine HCL

Thyrolar-1/4

sucralfate

Thyrolar-2

Anaspaz

Thyrolar-3

Belladonna & Opium

Tirosint

Belladonna Alkaloids & Opium

Triostat

Dicyclomine HCL

Westhroid

Famotidine Premixed

Westhroid-p

Propantheline Bromide

Wp Thyroid

Scopolamine Hydrobromide

TIER 02 PREFERRED

GASTROINTESTINAL

Pylera


LAXATIVES

Atropen

TIER 01 GENERIC

Atropine Sulfate

lactulose

Axid

peg 3350/electrolytes

Bentyl

peg-3350/electrolytes

Cantil

peg-3350/NACL/NA bicarbonate/KCL

Carafate

polyethylene glycol 3350

Cuvposa


Cytotec

Cascara Sagrada

Digex NF

Colyte-flavor Packs

Famotidine

Golytely

Gabitidine

Halflytely Bowel Prep/Flavor Packs

Gastrinex NF

Kristalose

Glycate

Mineral Oil Heavy

Helidac

Moviprep

Levbid

Nulytely/Flavor Packs

Levsin

Osmoprep

Levsin/SL

Prepopik

Pamine

Senna Leaves

Pamine Forte

Suclear

Pamine FQ

Suprep Bowel Prep

Pepcid

Robinul

ANTIDIARRHEALS

Robinul Forte

TIER 01 GENERIC

Sentradine

diphenoxylate/atropine

Symax Duotab

loperamide HCL

Zantac

opium

opium tincture

ANTIEMETICS

Diphenoxylate/Atropine

TIER 01 GENERIC

Opium Tincture (paregoric)

dronabinol

TIER 02 PREFERRED

granisetron HCLQL

Motofen

meclizine HCL


ondansetron odtQL

FulyzaqPA

ondansetron HCLQL

Lomotil

trimethobenzamide HCL

Restora RX

Dimenhydrinate

Rezyst IM

GranisolQL

Rezyst SB

TIER 02 PREFERRED

Vsl#3 DS

AnzemetQL

DiclegisPA

ANTACIDS

EmendQL


Transderm-scop

Sodium Bicarbonate




Dipentum

Aloxi

Entereg

Cesamet

Gastrocrom

Marinol

GattexPA

SancusoQL

Giazo

Tigan

Lialda

ZofranQL

Lidocaine HCL-hydrocortisone Acetate With Aloe

Zofran OdtQL

Linzess

TIER 04 100% COPAY

Metozolv Odt

ZuplenzQL

Phoslo

Phoslyra

DIGESTIVE AIDS

Procort

Proctocort

TIER 02 PREFERRED

Reglan

Creon

Renvela

Pancreaze

Rowasa

Pancrelipase

Sevelamer Carbonate

Zenpep

Sfrowasa


Urso Forte

Pertzye

Urso 250

Sucraid

Velphoro

Ultresa

Viokace

GENITOURINARY

GASTROINTESTINAL - MISC.

URINARY ANTI-INFECTIVES

TIER 01 GENERIC

TIER 01 GENERIC

balsalazide disodium

methenamine hippurate

calcium acetate

methenamine mandelate

cromolyn sodium

nitrofurantoin

hydrocort ene 100MG

nitrofurantoin macrocrystals

hydrocortisone

nitrofurantoin monohydrate

hydrocortisone acetate/lidocaine HCL

nitrofurantoin monohydrate/macrocrystals

hydrocortisone acetate/pramoxine

Methenamine Mandelate

lactulose

Uretron D/S

lidocaine HCL/hydrocortisone acetate

Urex

mesalamine

Urogesic-blue

metoclopramide HCL


sulfasalazine

Furadantin

ursodiol

Hiprex

Dexpanthenol

Macrobid

Eliphos

Macrodantin

TIER 02 PREFERRED

Monurol

Amitiza

Prosed/DS

Anusol-HC

Urelle

Apriso

Uribel

Asacol

Urimar-t

Asacol HD

Uroqid #2

Canasa

CimziaPA

URINARY ANTISPASMODICS

Cimzia Starter KitPA

TIER 01 GENERIC

Cortifoam

bethanechol chloride

Delzicol

flavoxate HCL

EntyvioPA

oxybutynin chloride

Fosrenol

oxybutynin chloride ER

Lotronex

tolterodine tartrate

Pentasa

tolterodine tartrate ER

Proctofoam HC

trospium chloride

RelistorPA

trospium chloride ER

RemicadePA


Renagel

Detrol


Detrol LA

Actigall

Ditropan XL

Analpram Advanced

Enablex

Analpram-HC

Gelnique

Analpram-HC Singles

Myrbetriq

Azulfidine

Oxytrol

Azulfidine EN-TABS

Sanctura

Chenodal

Sanctura XR

Colazal

Toviaz

Cortenema

Urecholine



Vesicare

HEMATOPOIETIC AGENTS

TIER 01 GENERIC

VAGINAL PRODUCTS

cyanocobalamin

TIER 01 GENERIC

folic acid


folic acid/vitamin b-6/vitamin b-12

metronidazole vaginal

sodium ferric gluconate complex/sucrose

terconazole

Animi-3

Relagard

Centratex

TIER 02 PREFERRED

Ferrex 150 Forte Plus

Avc

Ferrex 28

Estring

Folic Acid

Premarin

Folivane-f

Vagifem

Folivane-plus


Hematogen Fa

Cleocin

Hydroxocobalamin

Clindesse

Icar-c Plus

CrinonePA

Multigen

Endometrin

Multigen Folic

Estrace

Multigen Plus

Fem PH

TIER 02 PREFERRED

Femring

Aranesp Albumin FreePA

First-progesterone VGS 100 Compounding Kit

Droxia


ElelysoPA


Foltrate


LeukinePA


MozobilPA

Gynazole-1

NeulastaPA

Metrogel-vaginal

NeumegaPA

Terazol 3

NeupogenPA

Terazol 7

NplatePA

ProcritPA

GENITOURINARY - MISC.

PromactaPA


TIER 01 GENERIC

Albafort

alfuzosin HCL ER

Animi-3/Vitamin D

citric acid/sodium citrate

B-6 Folic Acid

finasteride

Biferarx

hydrochloric acid

Cenfol

phenazopyridine HCL

CerezymePA

potassium citrate-citric acid crystals

Corvite 150

tamsulosin HCL

Divista

Cytra-3

Ed Cyte F

Potassium Citrate

EpogenPA

Tricitrates

Feraheme

TIER 02 PREFERRED

Feriva

Cystagon

Ferivafa

Elmiron

Ferralet 90


Ferrlecit

Avodart

Ferro-plex Hematinic

Cardura XL

Ferrotrin

Citrolith

Folgard RX

Flomax

Fusion Plus

K-phos NO 2

GranixPA

Lithostat

Hematron-AF

Oracit

Hemocyte Plus

Potassium Citrate ER

Hemocyte-f

ProcysbiPA

Injectafer

Proscar

Integra F

Pyridium

Integra Plus

Shohls Solution Modified

Iron

Thiola

Iron Asp Gly/ Polysacch Compl/Ascorb CAL/B12/Fa/C Threon/Suc

Urocit-k 10

Urocit-k 15

Irospan 24/6

Urocit-k 5

Is 24/6

Uroxatral

Maxaron Forte

TIER 04 100% COPAY

Maxfe

Jalyn

MV FE Asparto Gly/FE Fum/Succ Acid/Vit C/Threonic Acd/B12/Fa

Rapaflo

MV FE Asparto Gly/Vit C/Vit B12/CA Threonate/Succ Acd/Stomac

HEMATOLOGICAL



Nascobal

Recothrom Spray Kit

Natalvirt Flt

Thrombogen

Nephron Fa

Tisseel

Novaferrum

Trasylol

OmontysPA

Pre-folic

HEMATOLOGICAL - MISC.

Proferrin-forte


Protectiron

clopidogrel

Tandem F

TIER 01 GENERIC

Tandem Plus

anagrelide hydrochloride

Venofer

cilostazol

VprivPA

dipyridamole

ZavescaPA

hetastarch 6%/NACL

pentoxifylline ER

ANTICOAGULANTS

ticlopidine HCL


LMD 10% Dextrose 5%

warfarin sodium

LMD 10% Sodium Chloride 0.9%

TIER 01 GENERIC

Protamine Sulfate

enoxaparin sodium

Voluven

fondaparinux sodium

TIER 02 PREFERRED

heparin lock

Aggrenox

heparin lock flush

Effient

heparin lock flush for flushing vascular access devices

SolirisPA

heparin lock flush/NACL for flushing vascular access devices


Activase

heparin sodium

Aggrastat

heparin sodium dcu

Agrylin

heparin sodium lock flush

Brilinta

heparin sodium/sodium chloride 0.9% premix

Cathflo Activase

heparin sodium/D5W

Firazyr

heparin sodium/NACL 0.9%

Hespan

Heparin Sodium/D5W

Hextend

Heparin Sodium/NACL 0.45%

Integrilin

Heparin Sodium/Sodium Chloride 0.9%

Kalbitor

TIER 02 PREFERRED

Kinlytic

Fragmin

Persantine


Plavix

argatroban

Pletal

Angiomax

Reopro

Argatroban

Retavase

Arixtra

Retavase Half-kit

Coumadin

Tnkase

Eliquis

Trental

Heparin Lock Flush

Zontivity

Heparin Sodium

Iprivask

MOUTH/THROAT/DENTAL AGENT

Lovenox

Pradaxa

TIER 01 GENERIC

Xarelto

chlorhexidine gluconate

chlorhexidine gluconate oral rinse

HEMOSTATICS

clotrimazole

TIER 01 GENERIC

lidocaine viscous

aminocaproic acid

lidocaine HCL

Thrombin-jmi Diluent

nystatin

Thrombin-jmi Epistaxis

pilocarpine hydrochloride

Thrombin-jmi Syringe Spray Kit

pilocarpine HCL

Thrombin-jmi W/Dil Spray P.M. Actuator

stannous fluoride oral rinse

TIER 02 PREFERRED


tranexamic acid

triamcinolone IN orabase

Aminocaproic Acid

Nafrinse Daily/Acidulated


Nafrinse Daily/Neutral

Amicar

Nafrinse Weekly

Artiss

TIER 02 PREFERRED

Astringyn

cevimeline HCL

Cyklokapron


Evicel

Aquoral

Evithrom

Caphosol

Lysteda

Debacterol

Recothrom

Evoxac



First-bxn Mouthwash

imipramine pamoate

First-dukes Mouthwash

imipramine HCL

First-marys Mouthwash

mirtazapine

First-mouthwash Blm

mirtazapine odt

Gel-kam Oral Care Rinse

nefazodone HCL

Gelclair

nortriptyline HCL

Lta 360 Kit

paroxetine HCLQL

Neutrasal

paroxetine HCL ERQL

Numoisyn

phenelzine sulfate

Peridex

protriptyline HCL

Prevident

sertraline HCLQL

Salagen

tranylcypromine sulfate

TIER 04 100% COPAY

trazodone HCL

Oravig

trimipramine maleate

venlafaxine HCLQL

NEUROLOGY, CNS, PSYCH

venlafaxine HCL ERQL

Amoxapine

ANTIANXIETY AGENTS

Doxepin HCL

TIER 01 GENERIC

Maprotiline HCL

alprazolam

Nefazodone HCL

alprazolam odt

Nortriptyline HCL

alprazolam ER

Venlafaxine HCL ERQL

buspirone HCL

TIER 02 PREFERRED

chlordiazepoxide HCL

duloxetine HCLQL

clorazepate dipotassium

PristiqQL

diazepam


droperidol

Anafranil

gene-xene TAB 15MG

AplenzinQL

gene-xene TAB 3.75MG

Appbutamone

gene-xene TAB 7.5MG

Appbutamone-d

hydroxyzine pamoate

CelexaQL

hydroxyzine HCL

CymbaltaQL

lorazepam

Desvenlafaxine ERST

meprobamate

Effexor XRQL

oxazepam

Emsam

Diazepam

Fluoxetine HCL

Diazepam Intensol

Gaboxetine

Hydroxyzine HCL

KhedezlaST

Hydroxyzine Pamoate

LexaproQL

Lorazepam Intensol

Luvox CRQL,ST


Marplan

Alprazolam Intensol

Nardil

Ativan

Norpramin

Gabavale-5

Oleptro

Gabazolamine

Pamelor

Gabazolamine-0.5

Parnate

Niravam

PaxilQL

Sentrazolam AM 0.25

Paxil CRQL

Tranxene T

PexevaQL,ST

Valium

ProzacQL

Vistaril

Prozac WeeklyQL

Xanax

Remeron

Xanax XR

Remeron Soltab

Sentraflox AM-10

ANTIDEPRESSANTS

Sentralopram AM-10

TIER 01 GENERIC

Sentravil PM-25

amitriptyline HCL

Sentroxatine

bupropion HCL

Surmontil

bupropion HCL ERQL

Tofranil

bupropion HCL SRQL

Tofranil-PM

bupropion HCL XLQL

Trazamine

citalopram hydrobromideQL

ViibrydQL,ST

clomipramine HCL

Vivactil

desipramine HCL

Wellbutrin

doxepin HCL

Wellbutrin SRQL

escitalopram oxalateQL

Wellbutrin XLQL

fluoxetine DRQL

ZoloftQL

fluoxetine HCLQL

TIER 04 100% COPAY

fluvoxamine maleateQL

BrintellixST

fluvoxamine maleate ERQL

FetzimaST



Fetzima Titration PackST

estazolam

Forfivo XLQL

eszopiclone

flurazepam HCL

ANTIPSYCHOTICS

phenobarbital

temazepam

TIER 01 GENERIC

triazolam

chlorpromazine HCL

zaleplon

clozapine

zolpidem tartrate

fluphenazine decanoate

zolpidem tartrate ER

fluphenazine HCL

Phenobarbital Sodium

haloperidol


haloperidol decanoate

Ambien

haloperidol lactate

Ambien CR

lithium carbonate

Amytal Sodium

lithium carbonate ER

Butisol Sodium

loxapine

Doral

loxapine succinate

Gabazolpidem-5

olanzapine

Halcion

olanzapine odt

HetliozPA

perphenazine

Lunesta

prochlorperazine

Nembutal Sodium

prochlorperazine edisylate

Phenobarbital

prochlorperazine maleate

Precedex

quetiapine fumarate

Quazepam

risperidone

Restoril

risperidone odt

RozeremST

thioridazine HCL

Seconal

thiothixene

Sentrazolpidem PM-5

trifluoperazine HCL

Sonata

ziprasidone HCL

Strazepam

Chlorpromazine HCL

TIER 04 100% COPAY

Clozapine Odt

EdluarST

Fluphenazine HCL

IntermezzoST

Lithium Carbonate

Silenor

Lithium Citrate

ZolpimistST

TIER 02 PREFERRED

Seroquel XR

ADHD, NARCOLEPSY, ETC.


Abilify

TIER 01 GENERIC

Abilify Discmelt

amphetamine/dextroamphetamineQL

Abilify Maintena

caffeine citrate

Adasuve

clonidine HCL ER

Clozaril

dexmethylphenidate HCLQL

Compazine

dexmethylphenidate HCL ERQL

Equetro

dextroamphetamine sulfateQL

Fanapt

dextroamphetamine sulfate ERQL

Fanapt Titration Pack

doxapram HCL

Fazaclo

methamphetamine HCLQL

Geodon

methylphenidate hydrochloride

Haldol

methylphenidate HCLQL

Haldol Decanoate 100

methylphenidate HCL CDQL

Haldol Decanoate 50

methylphenidate HCL ERQL

Invega

methylphenidate HCL SRQL

Invega Sustenna

modafinilPA

Latuda

Caffeine/Sodium Benzoate

Lithobid

Methylphenidate HCL ERQL

Loxitane

TIER 02 PREFERRED

Risperdal

DaytranaQL

Risperdal Consta

StratteraQL,ST

Risperdal M-TAB

VyvanseQL

Saphris


Seroquel

AdderallQL

Versacloz

Adderall XRQL

Zyprexa

Cafcit

Zyprexa Relprevv

ConcertaQL

Zyprexa Zydis

DesoxynQL

DexedrineQL

HYPNOTICS

Dopram

FocalinQL

TIER 01 GENERIC

Focalin XRQL

dexmedetomidine HCL



Intuniv

Felbatol

Kapvay

Keppra

Kapvay Dose Pack

Keppra XR

Metadate CDQL

Klonopin

Methylin

Lamictal

NuvigilPA,QL

Lamictal Chewable Dispersible

ProcentraQL

Lamictal Odt

ProvigilPA

Lamictal Starter/Taking Valproate

Quillivant XRQL

Lamictal XR

RitalinQL

Mysoline

Ritalin LAQL

Neurontin

Ritalin SRQL

Oxtellar XR

Sentramodafin AM-100

Phenytek

Qudexy XR

ANTICONVULSANTS

SabrilPA

Stavzor

TIER 01 GENERIC

Tegretol

carbamazepine

Therapentin-60

carbamazepine ER

Therapentin-90

clonazepam

Topamax

clonazepam odt

Topamax Sprinkle

divalproex sodium

Topiramate ER

divalproex sodium DR

Trileptal

divalproex sodium ER

Trokendi XR

ethosuximide

Vimpat

felbamate

Zarontin

fosphenytoin sodium

Zonegran

gabapentin

lamotrigine

ANTIPARKINSON AGENTS

lamotrigine ER

levetiracetam

TIER 01 GENERIC

levetiracetam ER

amantadine HCL

oxcarbazepine

benztropine mesylate

phenytoin sodium

bromocriptine mesylate

phenytoin sodium extended

carbidopa/levodopa

primidone

carbidopa/levodopa odt

topiramate

carbidopa/levodopa ER

valproate sodium

entacapone

valproic acid

pramipexole dihydrochloride

zonisamide

ropinirole HCL

Diazepam

selegiline HCL

Levetiracetam

trihexyphenidyl HCL

TIER 02 PREFERRED

Amantadine HCL

phenytoin

TIER 02 PREFERRED

tiagabine hydrochloride

carbidopa

Banzel

ropinirole ER

Celontin

ApokynPA

Dilantin Infatabs

Azilect

Fycompa

Carbidopa/Levodopa/Entacapone

Gabitril


Lamictal Starter/Not Taking Carbamazepine

Cogentin

Lamictal Starter/Taking Carbamazepine/Not Taking Valproate

Comtan

Eldepryl

Lyrica

Lodosyn

Onfi

Mirapex

Peganone

Mirapex ER

Potiga

Neupro

Tegretol-XR

Parcopa


Parlodel

Aptiom

Requip

Carbatrol

Requip XL

Cerebyx

Sinemet

Depacon

Sinemet CR

Depakene

Stalevo 100

Depakote

Stalevo 125

Depakote ER

Stalevo 150

Depakote Sprinkles

Stalevo 200

Diastat Acudial

Stalevo 50

Diastat Pediatric

Stalevo 75

Dilantin

Tasmar



Zelapar


cisatracurium besylate

NEUROLOGY, PSYCH - MISC.

BotoxPA

DysportPA

TIER 01 GENERIC

Nimbex

acamprosate calcium DR

Rilutek

disulfiram

XeominPA

donepezil HCL

Zemuron

fluoxetineQL

galantamine

MUSCULOSKELETAL AGENTS

galantamine hydrobromide

olanzapine/fluoxetine

TIER 01 GENERIC

rivastigmine tartrate

baclofen

Chlordiazepoxide/Amitriptyline

carisoprodol

Ergoloid Mesylates

carisoprodol/aspirin

Perphenazine/Amitriptyline

carisoprodol/aspirin/codeine

TIER 02 PREFERRED

chlorzoxazone

AvonexPA

cyclobenzaprine HCL

Avonex PenPA

dantrolene sodium

BetaseronPA

metaxalone

CopaxonePA

methocarbamol

Orap

orphenadrine citrate

RebifPA

orphenadrine citrate ER

Rebif Titration PackPA

orphenadrine/asa/caffeine

XenazinePA

tizanidine HCL

XyremPA

Carisoprodol



AmpyraPA

Amrix

Antabuse

Cyclobenzaprine Comfort PAC

Aricept

Dantrium

Aricept Odt

Dantrium IV

AubagioPA

Dantrolene Sodium

Brisdelle

Fexmid

Campral

Flexeril

Exelon

Lorzone

ExtaviaPA

Norflex

GilenyaPA

Parafon Forte DSC

Gralise Starter

Prazolamine

Namenda

Robaxin

Namenda Titration PAK

Robaxin-750

Nuedexta

Ryanodex

Razadyne

Skelaxin

Razadyne ER

Soma

Rebif RebidosePA

Therabenzaprine-60

Rebif Rebidose Titration PackPA

Therabenzaprine-90

SarafemQL

Therabenzaprine-90-5

Savella

Tizanidine Comfort PAC

Savella Titration Pack

Zanaflex

Symbyax

TecfideraPA

ANTIMYASTHENIC AGENTS

Tecfidera Starter PackPA

TIER 01 GENERIC

TysabriPA

neostigmine methylsulfate

TIER 04 100% COPAY

pyridostigmine bromide

Gralise

Enlon

Horizant

Guanidine HCL

Namenda XR

TIER 02 PREFERRED

Namenda XR Titration Pack

Mestinon Timespan

Prostigmin

NEUROMUSCULAR AGENTS


TIER 01 GENERIC

Bloxiverz

atracurium besylate

Enlon-plus

pancuronium bromide

Mestinon

riluzole

Regonol

rocuronium bromide

vecuronium bromide

OPHTHALMOLOGY AND OTIC

Anectine

ANTI-INFECTIVES

Quelicin

TIER 01 GENERIC

Quelicin 1000

bacitracin/polymyxin b

TIER 02 PREFERRED

ciprofloxacin HCL

MyoblocPA

erythromycin



gatifloxacin

sulfacetamide sodium/prednisolone sodium phosphate

gentamicin sulfate

tobramycin/dexamethasone

levofloxacin

Neomycin/Polymyxin/Hydrocortisone

neomycin/bacitracin/polymyxin

Prednisolone Sodium Phosphate

neomycin/polymyxin/bacitracin zinc

TIER 02 PREFERRED

neomycin/polymyxin/gramicidin

Alrex

ofloxacin

Blephamide S.o.p.

polymyxin b sulfate/trimethoprim sulfate

Lotemax


Pred Mild

sulfacetamide sodium

Zylet

tobramycin sulfate


trifluridine

Blephamide

trimethoprim sulfate/polymyxin b sulfate

Durezol

TIER 02 PREFERRED

Flarex

Ciloxan

FML

Natacyn

FML Forte

Vigamox

FML Liquifilm


Maxidex

Azasite

Maxitrol

Bacitracin

Omnipred

Besivance

Pred Forte

Betadine Ophthalmic Prep

Pred-G

Bleph-10

Pred-G S.o.p.

Garamycin

Tobradex

Mitosol

Tobradex ST

Moxeza

Vexol

Neosporin

Ocuflox

PROSTAGLANDINS

Polytrim

TIER 01 GENERIC

Sulfacetamide Sodium

latanoprost

Tobrex

TIER 02 PREFERRED

Viroptic

Travatan Z

Zirgan

Travoprost

Zymaxid


Lumigan

ARTIFICIAL TEAR/LUBRICANT

Rescula

TIER 02 PREFERRED

Xalatan

Lacrisert

Zioptan

BETA-BLOCKERS

CYCLOPLEGIC MYDRIATICS

TIER 01 GENERIC

TIER 01 GENERIC

betaxolol HCL

atropine sulfate

carteolol HCL

homatropine HBR

dorzolamide HCL/timolol maleate

Atropine Sulfate

levobunolol HCL

TIER 02 PREFERRED

timolol maleate

cyclopentolate HCL

timolol maleate ophthalmic gel forming


Levobunolol HCL

Cyclogyl

TIER 02 PREFERRED

Cyclomydril

Betimol

Isopto Atropine

Betoptic-s

Isopto Homatropine


Isopto Hyoscine

Betagan

Combigan

DECONGESTANTS

Cosopt

TIER 01 GENERIC

Cosopt PF

phenylephrine HCL

Istalol

Mydfrin

Metipranolol

Naphazoline HCL

Timoptic

Timoptic Ocudose

MIOTICS

Timoptic-xe

TIER 01 GENERIC

pilocarpine HCL

OPHTHALMIC STEROIDS

TIER 02 PREFERRED

TIER 01 GENERIC

Isopto Carbachol

dexamethasone sodium phosphate

Phospholine Iodide

fluorometholone

Pilopine HS

neomycin/polymyxin/bacitracin/hydrocortisone


neomycin/polymyxin/dexamethasone

Isopto Carpine

prednisolone acetate



ADRENERGIC AGENTS

Otozin

TIER 02 PREFERRED

TIER 01 GENERIC

Cipro HC

apraclonidine

Ciprodex

brimonidine tartrate



Cetraxal

Alphagan P

Coly-mycin S

Iopidine

Cortisporin

Simbrinza

Cortisporin-tc

Cresylate

IMMUNOMODULATORS

Dermotic

TIER 02 PREFERRED

Pramotic

RestasisPA

Vosol HC

TIER 04 100% COPAY

LOCAL ANESTHETICS

Auralgan

TIER 01 GENERIC

proparacaine HCL

OXYTOCICS

tetracaine HCL


TIER 01 GENERIC

Akten

methylergonovine maleate

Alcaine

oxytocin


OPHTHALMICS - MISC.

Cervidil

TIER 01 GENERIC

Hemabate

azelastine HCL

Pitocin

bromfenac

Prepidil

cromolyn sodium

Prostin E2

diclofenac sodium

dorzolamide HCL

PAIN MANAGEMENT

epinastine HCL

flurbiprofen sodium

ANALGESICS - NONNARCOTIC

ketorolac tromethamine

TIER 01 GENERIC

Bromfenac

butal/asa/caff

TIER 02 PREFERRED

butalbital/acetaminophen

Azopt

butalbital/acetaminophen/caffeine

CystaranPA

butalbital/apap/caffeine

Pataday

butalbital/asa/caffeine

Patanol

choline magnesium trisalicylate


diflunisal

Acular

salsalate

Acular LS

Alagesic LQ

Acuvail

Butalbital/Aspirin/Caffeine

Alocril

Mst 600

Alomide

Rhinoflex-650

Bepreve

Tencon

Bromday

TIER 02 PREFERRED

Elestat

Ofirmev

Emadine

Phrenilin Forte

Ilevro


Lastacaft

Bupap

Nevanac

Dolgic Plus

Ocufen

Dologesic

Optivar

Equagesic

Prolensa

Esgic

Trusopt

Esgic-plus

Fioricet

OTIC AGENTS

Fiorinal

TIER 01 GENERIC

Levacet

acetic acid

Orbivan

antipyrine/benzocaine

Staflex

fluocinolone acetonide

TIER 04 100% COPAY

fluocinolone acetonide ear drops

Orbivan CF

hydrocortisone/acetic acid

neomycin/polymyxin/hydrocortisone

ANALGESICS - OPIOID

neomycin/polymyxin/HC

TIER 01 GENERIC

ofloxacin

acetaminophen/codeine

Acetic Acid/Aluminum Acetate

acetaminophen/codeine #2

Antipyrine/Benzocaine


Ciprofloxacin


Myoxin

acetaminophen/codeine phosphate



alfentanil

Infumorph 500

buprenorphine HCL

Kadian

butalbital/acetaminophen/caffeine/codeine

Liquicet

butalbital/aspirin/caffeine/codeine

Lorcet Plus

butorphanol tartrateQL

Lorcet 10/650

fentanylQL

Lortab

fentanyl citrate oral transmucosalQL

Magnacet

hydrocodone bitartrate/acetaminophen

Morphine Sulfate Add-vantage

hydrocodone/acetaminophen

MS Contin

hydrocodone/ibuprofen

Norco

hydromorphone HCL

Nucynta

hydromorphone HCL ER

Nucynta ER

meperidine HCL

Opana

methadone HCL

Opana ER (crush Resistant)

morphine sulfate

Percocet

nalbuphine HCL

Percodan

oxycodone HCL

Primlev

oxycodone/acetaminophen

Reprexain

oxycodone/aspirin

Roxicet

oxycodone/ibuprofen

Roxicodone

oxymorphone hydrochloride

Rybix Odt

oxymorphone hydrochloride ER

Suboxone

pentazocine/acetaminophen

Subsys

pentazocine/naloxone HCL

Synalgos-dc

tramadol hydrochloride/acetaminophen

Talwin

tramadol HCL

Theracodeine-300

tramadol HCL ER

Theracodophen-low-90

Acetaminophen/Caffeine/Dihydrocodeine Bitartrate

Theracodophen-325

Codeine Sulfate

Theracodophen-650

Hydrocodone Bitartrate/Acetaminophen

Theracodophen-750

Hydrocodone/Acetaminophen

Theratramadol-60

Hydromorphone HCL

Theratramadol-90

Hydromorphone HCL Dosette

Tylenol/Codeine #3

Levorphanol Tartrate

Tylenol/Codeine #4

Maxidone

Ultiva

Meperidine HCL

Ultracet

Methadone HCL

Ultram

Methadose

Ultram ER

Methadose Sugar-free

Vicoprofen

Morphine Sulfate

Xartemis XR

Oxycodone HCL

Xodol

Tramadol HCL ER

Zohydro ER

Trezix

Zolvit

Xolox

Zydone

TIER 02 PREFERRED

TIER 04 100% COPAY

buprenorphine HCL/naloxone HCL

Butrans

morphine sulfate ER

Conzip

OxycontinQL

Lazanda


AbstralQL

ANTI-INFLAMMATORY

ActiqQL

TIER 01 GENERIC

Alfenta

diclofenac potassium

Aspirin-caffeine-dihydrocodeine

diclofenac sodium DR

Avinza

diclofenac sodium ER

Buprenex

diclofenac sodium/misoprostol

Capital/Codeine

etodolac

Demerol

etodolac ER

Dilaudid

flurbiprofen

Dilaudid-HP

ibuprofen

Dolophine

indomethacin

Dolophine HCL

indomethacin sodium

DuragesicQL

indomethacin ER

Exalgo

ketoprofen

FentoraQL

ketorolac tromethamine

Fioricet/Codeine

leflunomide

Fiorinal/Codeine #3

mefenamic acid

Hycet

meloxicam

Hydromorphone HCL ER

nabumetone

Ibudone

naproxen

Infumorph 200



naproxen sodium

100% COPAY

oxaprozin

Ketorolac Tromethamine

piroxicam

Sprix

sulindac

tolmetin sodium

MIGRAINE PRODUCTS

Fenoprofen Calcium

TIER 01 GENERIC

Indomethacin

dihydroergotamine mesylatePA

Ketoprofen ER

naratriptan HCLQL

Meclofenamate Sodium

rizatriptan benzoatePA

Meloxicam

rizatriptan benzoate odtPA

Tolmetin Sodium

sumatriptan succinateQL

TIER 02 PREFERRED

sumatriptan succinate refill

ArcalystPA

zolmitriptanPA

CelebrexST

zolmitriptan odtPA

EnbrelPA

Migergot

Enbrel SureclickPA

SumatriptanPA

HumiraPA

TIER 02 PREFERRED

Humira PenPA

Ergomar

Humira Pen-crohns DiseasestarterPA

RelpaxQL

Humira Pen-psoriasis StarterPA


OrenciaPA

Alsuma

Ridaura

AmergePA


AxertPA

ActemraPA

Cafergot

Anaprox

D.h.e. 45PA

Anaprox DS

Dihydroergotamine MesylatePA

Arava

FrovaPA

Arthrotec 50

ImitrexPA

Arthrotec 75

Imitrex Statdose Refill

Caldolor

Imitrex Statdose System

Cataflam

MaxaltPA

Daypro

Maxalt-MLTPA

Duexis

Migral

EC-naprosyn

MigranalPA

Feldene

Sumatriptan SuccinatePA

Ibuprofen Comfort PAC

Sumavel Dosepro

IlarisPA

TreximetPA

Indocin

ZomigPA

Indocin IV

Zomig Nasal SprayPA

IC 400

Zomig ZMTPA

IC 800

TIER 04 100% COPAY

KineretPA

Cambia

Meloxicam Comfort PAC

Mobic

GOUT AGENTS

Nalfon

TIER 01 GENERIC

Naprelan

allopurinol

Naprosyn

probenecid

Naproxen Comfort PAC

probenecid/colchicine

Neoprofen


OtezlaPA

Aloprim

Ponstel

Colcrys

Rasuvo

KrystexxaPA

Rheumatrex

Uloric

SimponiPA

Zyloprim

Simponi AriaPA

Therafeldamine

LOCAL ANESTHETICS-INJ

Theraprofen-60

TIER 01 GENERIC

Theraprofen-800

bupivacaine HCL

Theraprofen-90

chloroprocaine HCL

Theraproxen-500

lidocaine HCL

Theraproxen-60

lidocaine/epinephrine

Theraproxen-90

ropivacaine HCL

Trepadiclofen-25

Carbocaine

Trepoxen-250

Marcaine

Trepoxicam-7.5

Marcaine W/O Epi

Vimovo

Marcaine/Epinephrine

Voltaren-XR

Mepivacaine HCL

XeljanzPA


Zipsor

bupivacaine/epinephrine

TIER 04



BD Pudendal/Local Block Tray 1% Lidocaine

Astelin

Duocaine

Astepro

Durasafe Spinal/Epidural Tray/1% Xylocaine/19GX36"close CATH

Atrovent

Bactroban Nasal

Durasafe Spinal/Epidural Tray/1% Xylocaine/19GX36"open CATH

Patanase

Qnasl

Durasafe Spinal/Epidural Tray/1% Xylocaine/20GX36"close CATH

Tyzine

Tyzine Pediatric Nasal Drops

Durasafe Spinal/Epidural Tray/1% Xylocaine/20GX36"open CATH

TIER 04 100% COPAY

Beconase AQ

Exparel

Dymista

Lidocaine HCL/Dextrose

Flonase

Monoject Bone Marrow Biopsy Prepping Tray

Nasacort AQ

Monoject Bone Marrow Biopsy Tray/Biop Aspir Needle 11GX4"

Nasonex

Monoject Bone Marrow Biopsy Tray/Biop Aspir Needle 8GX4"

Omnaris

Rhinocort Aqua

Monoject Bone Marrow Biopsy Tray/Sternal-iliac Needle 16G

Veramyst

Zetonna

Naropin

Nesacaine

COUGH/COLD/ALLERGY

Nesacaine-mpf

TIER 01 GENERIC

Sensorcaine-mpf/Epinephrine

acetylcysteine

Tetracaine HCL

benzonatate

Turkel Paracentesis Procedure Tray/8french

bromphen/pseudoephedrine HCL/dextromethorphan HBR

Xylocaine

hydrocodone bitartrate/chlorpheniramine maleate/PSE

Xylocaine-mpf

hydrocodone bitartrate/homatropine methylbromide

Xylocaine-mpf/Epinephrine

hydrocodone/homatropine

Xylocaine/Epinephrine

phenylephrine/guaifenesin

promethazine-DM

RESPIRATORY, ALLERGY, ETC

promethazine/codeine

ANTIHISTAMINES

promethazine/dextromethorphan

TIER 01 GENERIC

sodium chloride

carbinoxamine maleate

Dextromethorphan HBR/Chlorpheniramine/Phenylephrine HCL

clemastine fumarate

cyproheptadine HCL

Pediatex TD

desloratadine odt

Relhist

diphenhydramine HCL

Suttar-SF

promethazine HCL

Suttar-2

promethazine HCL plain

TIER 02 PREFERRED

Brompheniramine Tannate

hydrocodone polistirex/chlorpheniramine polistirex

Clemastine Fumarate

Tussicaps

Dexchlorpheniramine Maleate


Doxytex

Alahist Ac

Ed-chlor-tan

Alahist DHC


Allfen CD

Karbinal ER

Allfen CDX

Palgic

Ambifed CD

Phenergan

Ambifed CDX

Respa-BR

Ambifed-G CD

TIER 04 100% COPAY

Ambifed-G CDX

cetirizine HCL

Carbaphen 12

desloratadine

Carbaphen 12 PED

levocetirizine dihydrochloride

Cotab A

Clarinex

Cotab AX

Clarinex Reditabs

Cotabflu

Xyzal

Cpb Wc

Decon-a

NASAL AGENTS

Donatuss Dc

Exactuss

TIER 01 GENERIC

Gilphex TR

budesonide

Giltuss

flunisolide

Giltuss PED-c

fluticasone propionate

Giltuss TR

ipratropium bromide

Hyper-sal

Flunisolide

Hypersal

TIER 02 PREFERRED

J-cof DHC

azelastine HCL

J-max DHC


Maxifed CD


Maxifed CDX

Adrenalin



Maxifed-G CD

Perforomist

Maxifed-G CDX

Serevent Diskus

Maxiflu CD

Spiriva Handihaler

Maxiflu CDX

Xopenex HFA

Maxiphen CD


Maxiphen CDX

Accolate

Nebusal

Accuneb

Neotuss Plus

Adrenalin

Panatuss Dxp

Aerospan

Pediatex TDM

Alvesco

Phenflu CD

Anoro Ellipta

Phenflu CDX

Arcapta Neohaler

Poly-tussin DHC

Breo Ellipta

Rescon-JR

Brondil

Rescon-MX

Brovana

Rezira

Daliresp

Tessalon Perles

Duoneb

Tussionex Pennkinetic Extended Release

Isuprel

Vituz

Lufyllin

Zonatuss

Proventil HFA

Zutripro

Pulmicort

TIER 04 100% COPAY

Pulmophylline

Clarinex-d 12 HOUR

Senophylline

Clarinex-d 24 HOUR

Singulair

Semprex-d

Striverdi Respimat

Theo-24

ANTIASTHMATIC/COPD AGENTS

Tudorza Pressair

Ventolin HFA


Vospire ER

budesonide

XolairPA

Advair Diskus

Xopenex

Advair HFA

Xopenex Concentrate

Asmanex 120 Metered Doses

Zyflo


Zyflo CR


TIER 04 100% COPAY


Combivent Respimat


Dulera

RESPIRATORY AGENTS - MISC

Flovent Diskus

Flovent HFA

TIER 02 PREFERRED

Proair HFA

PulmozymePA

Pulmicort Flexhaler


Qvar

Aralast NPPA

Symbicort

Curosurf

TIER 01 GENERIC

GlassiaPA

albuterol sulfate

Infasurf

albuterol sulfate ER

KalydecoPA

albuterol TAB 4MG

Prolastin-cPA

aminophylline

Surfaxin

cromolyn sodium

Survanta Intratracheal

epinephrine HCL

ZemairaPA

ipratropium bromide

ipratropium bromide/albuterol sulfate

TOXOIDS

montelukast sodium

terbutaline sulfate

TIER 01 GENERIC

theophylline

Adacel

theophylline CR

TIER 02 PREFERRED

theophylline ER

Boostrix

theophylline/D5W

Daptacel

zafirlukast

Infanrix

Metaproterenol Sulfate

Tenivac

Theophylline/D5W

Tetanus/Diphtheria Toxoids-adsorbed Adult

TIER 02 PREFERRED


levalbuterol

Diphtheria/Tetanus Toxoids Adsorbed Pediatric

levalbuterol HCL

Kinrix

Atrovent HFA

Pediarix

Combivent

Pentacel

Elixophyllin

Tetanus Toxoid Adsorbed

Foradil Aerolizer

Maxair Autohaler

VACCINES



Prevnar 13

TIER 02 PREFERRED

Proquad

Acthib

Rabavert

Comvax

Recombivax HB

Hiberix

Rotarix

Imovax Rabies (h.d.c.v.)

Rotateq

Ipol Inactivated IPV

Twinrix

M-m-r II W/Diluent 10 Dose

Vaqta

Menomune-a/C/Y/W-135

Vivotif Berna

Pedvax HIB

Zostavax

Pneumovax 23

Pneumovax 23/1 Dose

VITAMINS

Pneumovax 23/5 Dose

VITAMINS

Typhim VI

TIER 01 GENERIC

Varivax

ascorbic acid

Yf-vax

ergocalciferol


phytonadione

Afluria PF 2012-2013

thiamine HCL


vitamin c 222MG


vitamin d

Afluria 2012-2013

vitamin k1

Afluria 2013-2014

Pyridoxine HCL

Afluria 2014-2015

Vitamin K1

Bcg Vaccine

Wheat Germ

Biothrax

TIER 02 PREFERRED

Cervarix

Mephyton

Engerix-b


Fluarix Quadrivalent 2013-2014

Aquasol A Parenteral

Fluarix Quadrivalent 2014-2015

Decara

Fluarix 2012-2013

Drisdol

Fluarix 2013-2014

Flublok 2013-2014

MULTIVITAMINS

Flucelvax 2012-2013

TIER 01 GENERIC

Flucelvax 2013-2014

b-complex

Flucelvax 2014-2015

b-complex 100

Flulaval Quadrivalent 2013-2014

niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper

Flulaval Quadrivalent 2014-2015

Albafort

Flulaval 2012-2013

Cavan-alpha Kit

Flulaval 2013-2014

Cod Liver Oil

Flulaval 2014-2015

Crnatal

Flumist Nasal Vaccine 2012-2013

CO-natal Fa

Flumist Quadrivalent

Elite-OB

Fluvirin PF 2012-2013

Folbecal


Folcaps Omega 3


Folivane-prx DHA NF

Fluvirin 2012-2013

Folivane-OB

Fluvirin 2013-2014

Inatal Advance

Fluvirin 2014-2015

Inatal GT

Fluzone High-dose PF 2012-2013

Inatal Ultra


M.v.i. Adult


Macnatal CN DHA

Fluzone Pediatric PF 2012-2013

Mynatal


Mynatal Advance


Mynatal Ultracaplet

Fluzone PF 2012-2013

Natalvit

Fluzone PF 2013-2014

OB-natal One

Fluzone Quadrivalent 2013-2014

Pr Natal 400

Fluzone Quadrivalent 2014-2015

Pr Natal 400 EC

Fluzone Split 2012-2013

Pr Natal 430


Pr Natal 430 EC


Prenatabs RX

Gardasil

Prenatal Ad

Havrix

Strovite

Influenza A (h1n1) Monovalent 2009

Taron-bc

Ixiaro

Taron-c DHA

Medical Provider EZ Flu Shot 2014-2015

Taron-duo EC

Menactra

Taron-prex

Menhibrix

Tricare

Menveo

Trinate



Triveen-duo DHA

Natelle One

Triveen-prx RNF

Neevo DHA

Triveen-ten

Nephplex RX

Triveen-u

Nephro-vite RX

TL G-FOL OS

Nephrocaps

Vemavite-prx 2

Nephrocaps QT

Vinacal

Nestabs

Vinate AZ Extra

Nestabs Abc

Vinate C

Nestabs DHA

Vinate Calcium

Newgen

Vinate Care

Nexa Plus

Vinate GT

Nexa Select

Vinate IC

Nicadan

Vinate II

Nicazel

Vinate M

Nicazel Forte

Vinate One

Nicomide

Vinate Pn Care

Nutricap

Vitaroca Plus

Nutrivit

Zatean-pn

O-CAL Fa

Zatean-pn DHA

O-CAL Prenatal

Zatean-pn Plus

Obstetrix DHA

Zatean-CH

Obstetrix EC

TIER 02 PREFERRED

OB Complete

Bal-care DHA

OB Complete One


OB Complete Petite

Adrenal C Formula

OB Complete Premier

Atabex EC

OB Complete 400

Atabex Prenatal

OB Complete/DHA

B-nexa

Paire OB

Bacmin

Poly-VI-flor

Bal-care DHA Essential

Poly-VI-flor/Iron

Citranatal Assure

Prefera OB

Citranatal B-calm

Prefera OB + DHA

Citranatal DHA

Preferaob One

Citranatal Harmony

Prefol-DHA

Citranatal RX

Prenata

Citranatal 90 DHA

Prenatal-u

Concept DHA

Prenate

Concept OB

Prenate AM

Corvite

Prenate DHA

Dialyvite Supreme D

Prenate Elite

Dialyvite 3000

Prenate Enhance

Dialyvite 5000

Prenate Essential

Dialyvite/Zinc

Prenate Mini

Diatx ZN

Prenate Pixie

Duet DHA

Prenate Restore

Duet DHA Balanced

Prenate Star

Duet DHA EC

Prenexa

Duet DHA 400

Preque 10

Duet DHA 400EC

Protect Plus

Duet DHA 430

Protectbone

Duet DHA 430EC

Protectnatal

Escavite

Provida OB

Escavite D

Quflora Pediatric

Folet DHA

R-natal OB

Folet One

Renatabs

Folgard OS

Renatabs With Iron

Fortavit

Renax

Gesticare DHA

Req 49+

M.v.i. Pediatric

Select-ob+dha

M.v.i.-12 Without Vitamin K

Select-OB

M-vit

Siderol

Marnatal-f

Strovite Forte

Maxinate

Strovite One

Moms Choice RX

Supervite

Mykidz Iron Fl

Supervite EC

Natachew

Support-500

Natafort

Synagex

Natalvirt CA

Synatek

Natalvirt 90 DHA

Tri-VI-flor



Tricare Prenatal Compleat

Tricare Prenatal DHA One

Udamin

Udamin SP

Vinacal B

Vinate DHA

Vinate DHA RF

Vita-pren

Vitafol

Vitafol Ultra

Vitafol-nano

Vitafol-ob+dha

Vitafol-one

Vitafol-plus

Vitafol-pn

Vitafol-OB

Vital-d RX

Vitamedmd One RX/Quatrefolic

Vitamedmd Plus RX/Quatre Folic

Vitamedmd Redichew RX

Vitamedmd Redichew RX/Quatrefolic

Vitapearl

Viva CT Prenatal

Viva DHA

MEDICAL DEVICES

DIABETIC SUPPLIES


Insulin Syringe/0.5ML/30G X 5/16"

Relion Insulin Syringe/U-100/0.5ML/29G X 1/2"

MISCELLANEOUS

TIER 02 PREFERRED

Chemet

ExjadePA


FerriproxPA

Pentetate Calcium Trisodium

Pentetate Zinc Trisodium



Index

A

Adempas, 9

alprazolam odt, 21

Adenocard, 7

Alrex, 25

A-hydrocort, 13

adenosine, 7

Alsuma, 28

abacavir, 3

Adoxa, 2

Altabax, 10

abacavir sulfate/lamivudine/zidovudine, 3

Adoxa PAK 1/100, 2

Altace, 8

Abelcet, 2

Adoxa PAK 1/150, 2

Altoprev, 9

Abilify, 22

Adoxa PAK 2/100, 2

Aluminum Acetate, 12

Abilify Discmelt, 22

Adrenaclick, 9

Aluvea, 12

Abilify Maintena, 22

Adrenal C Formula, 32

Alvesco, 30

Abraxane, 5

Adrenalin, 9, 29, 30

amantadine HCL, 23

Absorica, 10

Adriamycin, 4

Amantadine HCL, 23

Abstral, 27

Advair Diskus, 30

Amaryl, 15

acamprosate calcium DR, 24

Advair HFA, 30

Ambien, 22

Acanya, 10

Advicor, 9

Ambien CR, 22

acarbose, 15

Aerospan, 30

Ambifed CD, 29

Accolate, 30

Afinitor, 5

Ambifed CDX, 29

Accuneb, 30

Afinitor Disperz, 5

Ambifed-G CD, 29

Accupril, 8

Afluria 2012-2013, 31

Ambifed-G CDX, 29

Accuretic, 8

Afluria 2013-2014, 31

Ambisome, 2

acebutolol HCL, 7

Afluria 2014-2015, 31

amcinonide, 11

Aceon, 8

Afluria PF 2012-2013, 31

Amcinonide, 11

Acetaminophen/Caffeine/Dihydrocodeine Bitartrate, 27

Afluria PF 2013-2014, 31

Amerge, 28

Afluria PF 2014-2015, 31

Amethyst, 14

acetaminophen/codeine, 26

Aggrastat, 20

Amicar, 20

acetaminophen/codeine #2, 26

Aggrenox, 20

amifostine, 6


Agrylin, 20

amikacin sulfate, 2


Akne-mycin, 10

amiloride HCL, 9

acetaminophen/codeine phosphate, 26

Akten, 26

amiloride/hydrochlorothiazide, 9

acetazolamide, 8

Ala Scalp, 11

aminocaproic acid, 20

Acetazolamide, 9

Alagesic LQ, 26

Aminocaproic Acid, 20

acetazolamide ER, 9

Alahist Ac, 29

aminophylline, 30

acetazolamide sodium, 8

Alahist DHC, 29

amiodarone HCL, 7

acetic acid, 26

Albafort, 19, 31

Amiodarone HCL, 7

Acetic Acid/Aluminum Acetate, 26

Albenza, 3

Amitiza, 18

acetylcysteine, 29

albuterol sulfate, 30

amitriptyline HCL, 21

acitretin, 11

albuterol sulfate ER, 30

amlodipine besylate, 7

Aclovate, 11

albuterol TAB 4MG, 30

amlodipine besylate/atorvastatin calcium, 9

Actemra, 28

Alcaine, 26

Acthar HP, 16

alclometasone dipropionate, 11

amlodipine besylate/benazepril HCL, 8

Acthib, 31

Aldactazide, 9

amlodipine besylate/benazepril hydrochloride, 8

Acticlate, 2

Aldactone, 9

Actigall, 18

Aldara, 12

ammonium lactate, 12

Actimmune, 6

Aldurazyme, 16

Ammonul, 16

Actiq, 27

alendronate sodium, 15

Amoxapine, 21

Activase, 20

Alendronate Sodium, 15

amoxicillin, 1

Activella, 14

Alfenta, 27

Amoxicillin, 1

Actonel, 15

alfentanil, 27

Amoxicillin ER, 1

Actoplus Met, 15

Alferon N, 6

amoxicillin/clavulanate potassium, 1

Actoplus Met XR, 15

alfuzosin HCL ER, 19

amoxicillin/clavulanate potassium ER, 1

Actos, 15

Alimta, 5

amphetamine/dextroamphetamine, 22

Acular, 26

Alinia, 4

Amphotec, 2

Acular LS, 26

Alkeran, 4

Amphotericin B, 2

Acuvail, 26

Allfen CD, 29

ampicillin, 1

acyclovir, 3, 11

Allfen CDX, 29

Ampicillin, 1

acyclovir sodium, 3

allopurinol, 28

ampicillin sodium, 1

Acyclovir Sodium, 3

Alocril, 26

Ampicillin Sodium, 1

Aczone, 10

Alodox Convenience Kit, 2

ampicillin-sulbactam, 1

Adacel, 30

Alomide, 26

Ampicillin-sulbactam, 1

Adalat CC, 7

Aloprim, 28

Ampyra, 24

adapalene, 10

Alora, 14

Amrix, 24

Adasuve, 22

Aloxi, 18

Amturnide, 8

Adcetris, 5

Alphagan P, 26

Amytal Sodium, 22

Adcirca, 10

alprazolam, 21

Anacaine, 12

Adderall, 22

alprazolam ER, 21

Anadrol-50, 13

Adderall XR, 22

Alprazolam Intensol, 21

Anafranil, 21

adefovir dipivoxil, 3

anagrelide hydrochloride, 20

Asmanex 14 Metered Doses, 30

azathioprine, 5

Analpram Advanced, 18


azelastine HCL, 26, 29

Analpram-HC, 18


Azelex, 10

Analpram-HC Singles, 18


Azilect, 23

Anaprox, 28

Aspirin-caffeine-dihydrocodeine, 27

azithromycin, 1

Anaprox DS, 28

Astagraf XL, 5

Azithromycin, 1

Anaspaz, 17

Astelin, 29

Azopt, 26

anastrozole, 5

Astepro, 29

Azor, 8

Ancef, 1

Astringyn, 20

aztreonam, 3

Ancobon, 2

Atabex EC, 32

Azulfidine, 18

Androderm, 13

Atabex Prenatal, 32

Azulfidine EN-TABS, 18

Androgel, 13

Atacand, 8

B

Androgel P.M., 13

Atacand HCT, 8

B-6 Folic Acid, 19

Android, 13

atenolol, 7

b-complex, 31

Androxy, 13

atenolol/chlorthalidone, 8

b-complex 100, 31

Anectine, 24

Atgam, 5

B-nexa, 32

Angeliq, 14

Ativan, 21

bacitracin, 3

Angiomax, 20

Atopiclair, 12

Bacitracin, 4, 25

Animi-3, 19

atorvastatin calcium, 9

bacitracin/polymyxin b, 24

Animi-3/Vitamin D, 19

atovaquone, 4

baclofen, 24

Anoro Ellipta, 30

atovaquone/proguanil HCL, 3

Bacmin, 32

Antabuse, 24

atracurium besylate, 24

Bactocill IN Dextrose, 1

Antara, 9

Atralin, 10

Bactrim, 4

antipyrine/benzocaine, 26

Atripla, 3

Bactrim DS, 4

Antipyrine/Benzocaine, 26

Atropen, 17

Bactroban, 10

Anusol-HC, 18

atropine sulfate, 17, 25

Bactroban Nasal, 29

Anzemet, 17

Atropine Sulfate, 17, 25

Bal-care DHA, 32

Apexicon E, 11

Atrovent, 29

Bal-care DHA Essential, 32

Apidra, 14

Atrovent HFA, 30

balsalazide disodium, 18

Apidra Solostar, 14

Aubagio, 24

Banzel, 23

Aplenzin, 21

augmented betamethasone dipropionate, 11

Baraclude, 3

Apokyn, 23

Bcg Vaccine, 31

Appbutamone, 21

Augmentin, 1

BD Pudendal/Local Block Tray 1% Lidocaine, 29

Appbutamone-d, 21

Augmentin ES-600, 1

Appformin, 15

Augmentin XR, 1

Beconase AQ, 29

Appformin-d, 15

Auralgan, 26

Beleodaq, 6

apraclonidine, 26

Aurstat, 12

Belladonna & Opium, 17

Apriso, 18

Aurstat Anti-itch Hydrogel, 12

Belladonna Alkaloids & Opium, 17

Aptiom, 23

Aurstat Anti-itch Hydrogel Kit, 12

benazepril HCL, 7

Aptivus, 3

Auvi-q, 9

benazepril HCL/hydrochlorothiazide, 8

Aquasol A Parenteral, 31

Avalide, 8

Benicar, 8

Aquoral, 20

Avandamet, 15

Benicar HCT, 8

Aralast NP, 30

Avandaryl, 15

Bentyl, 17

Aralen, 3

Avandia, 15

Benzaclin, 10

Aranesp Albumin Free, 19

Avapro, 8

Benzaclin With P.M., 10

Arava, 28

Avar, 10

Benzamycin, 10

Arcalyst, 28

Avar LS, 10

Benzamycinpak, 10

Arcapta Neohaler, 30

Avar LS Cleanser, 10

Benzoin Compound Tincture, 12

argatroban, 20

Avar-e LS, 10

Benzoin Tincture, 12

Argatroban, 20

Avastin, 5

benzonatate, 29

Aricept, 24

Avc, 19

benztropine mesylate, 23

Aricept Odt, 24

Aveed, 13

Bepreve, 26

Arimidex, 5

Avelox, 2

Besivance, 25

Aristospan Intra-articular, 13

Avelox Abc Pack, 2

Betadine Ophthalmic Prep, 25

Aristospan Intralesional, 13

Avidoxy DK, 2

Betagan, 25

Arixtra, 20

Avinza, 27

betamethasone dipropionate, 11

Armour Thyroid, 17

Avodart, 19

betamethasone sodium phosphate/betamethasone acetate, 13

Arnica Flower, 12

Avonex, 24

Aromasin, 5

Avonex Pen, 24

betamethasone valerate, 11

Arranon, 5

Axert, 28

Betapace, 7

Arthrotec 50, 28

Axid, 17

Betapace AF, 7

Arthrotec 75, 28

Axiron, 13

Betaseron, 24

Artiss, 20

Aygestin, 14

betaxolol HCL, 7, 25

Arzerra, 5

azacitidine, 4

bethanechol chloride, 18

Asacol, 18

Azactam, 4

Bethkis, 2

Asacol HD, 18

Azactam IN Iso-osmotic Dextrose, 4

Betimol, 25

ascorbic acid, 31

Azasan, 5

Betoptic-s, 25


Azasite, 25

Bexxar, 5

Bexxar 131 Iodine, 6

Butisol Sodium, 22

carisoprodol/aspirin, 24

Beyaz, 14

butorphanol tartrate, 27

carisoprodol/aspirin/codeine, 24

Biaxin, 1

Butrans, 27

Carmol-HC, 11

Biaxin XL, 1

Bydureon, 14

Carnitor, 16

Biaxin XL PAC, 1

Byetta, 14

Carnitor SF, 16

bicalutamide, 5

Bystolic, 7

carteolol HCL, 25

Bicillin C-R, 1

C

carvedilol, 7

Bicillin L-a, 1

Cascara Sagrada, 17

cabergoline, 16

Bicnu, 4

Casodex, 5

Caduet, 10

Bidil, 9

Cataflam, 28

Cafcit, 22

Biferarx, 19

Catapres, 8

Cafergot, 28

Biltricide, 3

Catapres-tts-1, 8

caffeine citrate, 22

Binosto, 15

Catapres-tts-2, 8

Caffeine/Sodium Benzoate, 22

Biothrax, 31

Catapres-tts-3, 8

Calan, 7

bisoprolol fumarate, 7

Cathflo Activase, 20

Calan SR, 7

bisoprolol fumarate/hydrochlorothiazide, 8

Cavan-alpha Kit, 31

calcipotriene, 11

Cayston, 4

calcipotriene/betamethasone dipropionate, 12

bleomycin sulfate, 4

Cedax, 1

Bleph-10, 25

Ceenu, 4

calcitonin salmon, 15

Blephamide, 25

cefaclor, 1

calcitonin-salmon, 15

Blephamide S.o.p., 25

Cefaclor, 1

Calcitriol, 11

Bloxiverz, 24

Cefaclor ER, 1

calcitriol, 16

Boniva, 15

cefadroxil, 1

calcium acetate, 18

Boostrix, 30

cefazolin sodium, 1

Calcium Folinate, 6

Boric Acid, 12

Cefazolin Sodium, 1

Caldolor, 28

Bosulif, 5

Cefazolin Sodium/Dextrose, 1

Cambia, 28

Botox, 24

cefdinir, 1

Campral, 24

Bravelle, 16

Cefditoren Pivoxil, 1

Camptosar, 6

Breo Ellipta, 30

cefepime, 1

Canasa, 18

Brevibloc, 7

Cefepime, 1

Cancidas, 2

Brevicon-28, 14

cefotaxime sodium, 1

candesartan cilexetil, 8

Brilinta, 20

Cefotetan, 1

candesartan cilexetil/hydrochlorothiazide, 8

brimonidine tartrate, 26

Cefotetan/Dextrose, 1

Brintellix, 21

cefoxitin sodium, 1

Cantil, 17

Brisdelle, 24

Cefoxitin Sodium, 1

Capastat Sulfate, 2

Bromday, 26

cefpodoxime proxetil, 1

capecitabine, 4

bromfenac, 26

cefprozil, 1

Capex, 11

Bromfenac, 26

ceftazidime, 1

Caphosol, 20

bromocriptine mesylate, 23

Ceftazidime, 1

Capital/Codeine, 27

bromphen/pseudoephedrine HCL/dextromethorphan HBR, 29

Ceftazidime/Dextrose, 1

Caprelsa, 6

Ceftibuten, 1

captopril, 7

Brompheniramine Tannate, 29

Ceftin, 1

Captopril/Hydrochlorothiazide, 8

Brondil, 30

Ceftriaxone IN Iso-osmotic Dextrose, 1

Carafate, 17

Brovana, 30

ceftriaxone sodium, 1

Carbaglu, 16

budesonide, 13, 29, 30

Ceftriaxone/Dextrose, 1

carbamazepine, 23

bumetanide, 9

cefuroxime axetil, 1

carbamazepine ER, 23

Bupap, 26

cefuroxime sodium, 1

Carbaphen 12, 29

Buphenyl, 16

Cefuroxime Sodium, 1

Carbaphen 12 PED, 29

bupivacaine HCL, 28

Cefuroxime/Dextrose, 1

Carbatrol, 23

bupivacaine/epinephrine, 28

Celebrex, 28

carbidopa, 23

Buprenex, 27

Celestone, 13

carbidopa/levodopa, 23

buprenorphine HCL, 27

Celestone-soluspan, 13

carbidopa/levodopa ER, 23

buprenorphine HCL/naloxone HCL, 27

Celexa, 21

carbidopa/levodopa odt, 23

bupropion HCL, 21

Cellcept, 5

Carbidopa/Levodopa/Entacapone, 23

bupropion HCL ER, 21

Cellcept Intravenous, 5

carbinoxamine maleate, 29

bupropion HCL SR, 21

Celontin, 23

Carbocaine, 28

bupropion HCL XL, 21

Cem-urea, 12

carboplatin, 4

buspirone HCL, 21

Cenestin, 14

Carboplatin, 4

Busulfex, 4

Cenfol, 19

Cardene I.v., 7

butal/asa/caff, 26

Centany, 10

Cardene IV, 7

butalbital/acetaminophen, 26

Centany AT, 10

Cardene SR, 7

butalbital/acetaminophen/caffeine, 26

Centratex, 19

Cardizem, 7

butalbital/acetaminophen/caffeine/codeine, 27

cephalexin, 1

Cardizem CD, 7

Cephalexin, 1

Cardizem LA, 7

butalbital/apap/caffeine, 26

Cerebyx, 23

Cardura, 8

butalbital/asa/caffeine, 26

Cerezyme, 19

Cardura XL, 19

Butalbital/Aspirin/Caffeine, 26

Cervarix, 31

carisoprodol, 24

butalbital/aspirin/caffeine/codeine, 27

Cervidil, 26

Carisoprodol, 24

Cesamet, 18

Clarinex Reditabs, 29

Combivent, 30

cetirizine HCL, 29

Clarinex-d 12 HOUR, 30

Combivent Respimat, 30

Cetraxal, 26

Clarinex-d 24 HOUR, 30

Combivir, 3

Cetrotide, 16

clarithromycin, 1

Cometriq, 6

cevimeline HCL, 20

clarithromycin ER, 1

Compazine, 22

Chemet, 33

clemastine fumarate, 29

Complera, 3

Chenodal, 18

Clemastine Fumarate, 29

Comtan, 23

Chloramphenicol Sodium Succinate, 4

Cleocin, 4, 19

Comvax, 31

chlordiazepoxide HCL, 21

Cleocin IN D5W, 4

Concept DHA, 32

Chlordiazepoxide/Amitriptyline, 24

Cleocin Pediatric Granules, 4

Concept OB, 32

chlorhexidine gluconate, 20

Cleocin Phosphate, 4

Concerta, 22

chlorhexidine gluconate oral rinse, 20

Cleocin-t, 10

Condylox, 12

chloroprocaine HCL, 28

Cleviprex, 7

Conzip, 27

chloroquine phosphate, 3

Climara, 14

Copaxone, 24

chlorothiazide, 9

Climara Pro, 14

Copegus, 3

Chlorothiazide, 9

Clindacin Etz, 10

Cordarone, 7

chlorothiazide sodium, 9

Clindacin PAC, 10

Cordran, 12

chlorpromazine HCL, 22

Clindagel, 10

Cordran Tape, 11

Chlorpromazine HCL, 22

clindamycin HCL, 3

Coreg, 7

Chlorpropamide, 15

clindamycin palmitate HCL, 3

Coreg CR, 7

Chlorthalidone, 8

clindamycin phosphate, 3, 10, 19

Corgard, 7

chlorzoxazone, 24

Clindamycin Phosphate, 4

Corlopam, 8

cholestyramine, 9

clindamycin phosphate add-vantage, 3

Cortef, 13

cholestyramine light, 9

clindamycin phosphate IN D5W, 3

Cortenema, 18

choline magnesium trisalicylate, 26

clindamycin phosphate pharmacy bulk package, 3

Cortifoam, 18

chorionic gonadotropin, 16

Cortisone Acetate, 13

Cialis, 9

clindamycin/benzoyl peroxide, 10

Cortisporin, 10, 26

Ciclodan Cream Kit, 11

Clindesse, 19

Cortisporin-tc, 26

Ciclodan Solution Kit, 10

clobetasol propionate, 11

Corvert, 7

ciclopirox, 10

clobetasol propionate emollient, 11

Corvite, 32

ciclopirox nail lacquer, 10

Clobex, 11

Corvite 150, 19

ciclopirox olamine, 10

Clodan Kit, 12

Corzide, 8

Ciclopirox Topical Solution Kit, 10

Clolar, 5

Cosmegen, 4

cidofovir, 3

clomiphene citrate, 16

Cosopt, 25

cilostazol, 20

clomipramine HCL, 21

Cosopt PF, 25

Ciloxan, 25

clonazepam, 23

Cotab A, 29

cimetidine, 17

clonazepam odt, 23

Cotab AX, 29

cimetidine HCL, 17

clonidine HCL, 8

Cotabflu, 29

Cimzia, 18

clonidine HCL ER, 22

Coumadin, 20

Cimzia Starter Kit, 18

clopidogrel, 20

Cozaar, 8

Cipro, 2

clorazepate dipotassium, 21

Cpb Wc, 29

Cipro HC, 26

Clorpres, 8

Creon, 18

Cipro I.V.-IN D5W, 2

clotrimazole, 10, 20

Crestor, 9

Cipro XR, 2

clotrimazole/betamethasone dipropionate, 10

Cresylate, 26

Ciprodex, 26

Crinone, 19

ciprofloxacin, 2

clozapine, 22

Crixivan, 3

Ciprofloxacin, 26

Clozapine Odt, 22

Crnatal, 31

ciprofloxacin ER, 2

Clozaril, 22

cromolyn sodium, 18, 26, 30

ciprofloxacin HCL, 2, 24

Cnl8 Nail Kit, 10

Cubicin, 4

ciprofloxacin I.V.-IN D5W, 2

CO-natal Fa, 31

Curosurf, 30

cisatracurium besylate, 24

Coal TAR, 12

Cutivate, 12

cisplatin, 4

Coartem, 3

Cuvposa, 17

Cisplatin, 4

Cocaine HCL, 12

cyanocobalamin, 19

citalopram hydrobromide, 21

Cod Liver Oil, 31

Cyclessa, 14

Citranatal 90 DHA, 32

Codeine Sulfate, 27

Cyclobenzaprine Comfort PAC, 24

Citranatal Assure, 32

Cogentin, 23

cyclobenzaprine HCL, 24

Citranatal B-calm, 32

Colazal, 18

Cyclogyl, 25

Citranatal DHA, 32

Colcrys, 28

Cyclomydril, 25

Citranatal Harmony, 32

Colestid, 9

cyclopentolate HCL, 25

Citranatal RX, 32

Colestid Flavored, 9

Cyclophosphamide, 4

citric acid/sodium citrate, 19

colestipol HCL, 9

Cycloserine, 2

Citrolith, 19

colestipol HCL for oral suspension, 9

cyclosporine, 5

cladribine, 4

colistimethate sodium, 3

cyclosporine modified, 5

Claforan, 1

Coly-mycin M, 4

Cyclosporine Modified, 5

Claforan/D5W, 1

Coly-mycin S, 26

Cyklokapron, 20

Claravis, 10

Colyte-flavor Packs, 17

Cymbalta, 21

Clarifoam EF, 10

Combigan, 25

cyproheptadine HCL, 29

Clarinex, 29

Combipatch, 14

Cyramza, 5

Cystadane, 16

Desowen Cream/Cetaphil Lotion, 12

Dilatrate SR, 6

Cystagon, 19

Desowen Lotion/Cetaphil Cream, 12

Dilaudid, 27

Cystaran, 26

Desowen Ointment/Cetaphil Lotion, 12

Dilaudid-HP, 27

cytarabine, 4

desoximetasone, 11

diltiazem CD, 7

Cytarabine, 4

Desoximetasone, 11

diltiazem HCL, 7

cytarabine aqueous, 4

Desoxyn, 22

Diltiazem HCL, 7

Cytomel, 17

Desvenlafaxine ER, 21

diltiazem HCL ER, 7

Cytotec, 17

Detrol, 18

Dimenhydrinate, 17

Cytovene, 3

Detrol LA, 18

Diovan, 8

Cytra-3, 19

dexamethasone, 13

Diovan HCT, 8

D

Dexamethasone, 13

Dipentum, 18

Dexamethasone Intensol, 13

diphenhydramine HCL, 29

D.h.e. 45, 28

dexamethasone sodium phosphate, 13, 25

diphenoxylate/atropine, 17

dacarbazine, 6

Diphenoxylate/Atropine, 17

Dacarbazine, 6

Dexamethasone Sodium Phosphate, 13

Diphtheria/Tetanus Toxoids Adsorbed Pediatric, 30

Dacogen, 5

Dexchlorpheniramine Maleate, 29

Daliresp, 30

Dexedrine, 22

Diprolene, 12

Dalvance, 4

dexmedetomidine HCL, 22

Diprolene AF, 12

danazol, 13

dexmethylphenidate HCL, 22

dipyridamole, 20

Dantrium, 24

dexmethylphenidate HCL ER, 22

disopyramide phosphate, 7

Dantrium IV, 24

Dexpak 10 Day, 13

disulfiram, 24

dantrolene sodium, 24

Dexpak 13 Day, 13

Ditropan XL, 18

Dantrolene Sodium, 24

Dexpak 6 Day, 13

Diuril, 9

Dapsone, 4

Dexpanthenol, 18

divalproex sodium, 23

Daptacel, 30

dexrazoxane, 6

divalproex sodium DR, 23

Daraprim, 3

dextroamphetamine sulfate, 22

divalproex sodium ER, 23

daunorubicin HCL, 4

dextroamphetamine sulfate ER, 22

Divigel, 14

Daunoxome, 4

Dextromethorphan HBR/Chlorpheniramine/Phenylephrine HCL, 29

Divista, 19

Daypro, 28

dobutamine HCL, 9

Daytrana, 22

dobutamine HCL/D5W, 9

Ddavp, 16

dobutamine/dextrose 5%, 9

Diabeta, 15

Debacterol, 20

Dobutamine/Dextrose 5%, 9

Dialyvite 3000, 32

Decara, 31

Docefrez, 5

Dialyvite 5000, 32

decitabine, 4

Docetaxel, 5

Dialyvite Supreme D, 32

Decon-a, 29

Dolgic Plus, 26

Dialyvite/Zinc, 32

Delestrogen, 14

Dologesic, 26

Diamox, 9

Delzicol, 18

Dolophine, 27

Diastat Acudial, 23

Demadex, 9

Dolophine HCL, 27

Diastat Pediatric, 23

demeclocycline HCL, 2

Donatuss Dc, 29

Diatx ZN, 32

Demerol, 27

donepezil HCL, 24

diazepam, 21

Demser, 8

dopamine HCL, 9

Diazepam, 21, 23

Denavir, 11

Dopamine HCL, 9

Diazepam Intensol, 21

Depacon, 23

dopamine HCL-dextrose 5%, 9

Dibenzyline, 8

Depakene, 23

dopamine HCL/dextrose 5%, 9

Diclegis, 17

Depakote, 23

dopamine/D5W, 9

diclofenac potassium, 27

Depakote ER, 23

Dopram, 22

diclofenac sodium, 11, 26

Depakote Sprinkles, 23

Doral, 22

diclofenac sodium DR, 27

Depo-estradiol, 14

Doribax, 4

diclofenac sodium ER, 27

Depo-medrol, 13

Doryx, 2

diclofenac sodium/misoprostol, 27

Depo-provera, 5

dorzolamide HCL, 26

dicloxacillin sodium, 1

Depo-testosterone, 13

dorzolamide HCL/timolol maleate, 25

dicyclomine HCL, 17

Derma-smoothe/FS Body, 12

Dovonex, 11

Dicyclomine HCL, 17

Derma-smoothe/FS Body Oil, 12

doxapram HCL, 22

didanosine, 3

Derma-smoothe/FS Scalp, 12

doxazosin mesylate, 8

Didronel, 15

Derma-smoothe/FS Scalp Oil, 12

doxepin HCL, 21

Differin, 10

Dermasorb HC, 12

Doxepin HCL, 21

Dificid, 1

Dermasorb Ta, 12

doxercalciferol, 16

diflorasone diacetate, 11

Dermasorb XM, 12

Doxil, 4

Diflorasone Diacetate, 11

Dermatop, 12

doxorubicin HCL, 4

Diflucan, 2

Dermotic, 26

doxorubicin HCL liposome, 4

diflunisal, 26

desipramine HCL, 21

doxycycline, 2

Digex NF, 17

desloratadine, 29

doxycycline hyclate, 2

digoxin, 6

desloratadine odt, 29

doxycycline hyclate DR, 2

Digoxin, 6

desmopressin acetate, 16

doxycycline monohydrate, 2

dihydroergotamine mesylate, 28

Desogen, 14

Doxytex, 29

Dihydroergotamine Mesylate, 28

desogestrel/ethinyl estradiol, 14

Drisdol, 31

Dilacor XR, 7

Desonate, 12

Dritho-creme HP, 11

Dilantin, 23

desonide, 11

dronabinol, 17

Dilantin Infatabs, 23

Desowen, 12

droperidol, 21

Ellence, 4

Escavite D, 32

drospirenone/ethinyl estradiol, 14

Elmiron, 19

escitalopram oxalate, 21

Droxia, 19

Elocon, 12

Esgic, 26

Drysol, 12

Eloxatin, 4

Esgic-plus, 26

Duac, 10

Elspar, 4

esmolol HCL, 7

Duavee, 14

Emadine, 26

estazolam, 22

Duet DHA, 32

Emcyt, 5

Estrace, 14, 19

Duet DHA 400, 32

Emend, 17

estradiol, 13

Duet DHA 400EC, 32

Emla, 12

estradiol valerate, 13

Duet DHA 430, 32

Emsam, 21

estradiol/norethindrone acetate, 13

Duet DHA 430EC, 32

Emtriva, 3

Estrasorb, 14

Duet DHA Balanced, 32

Emulsion SB, 12

Estring, 19

Duet DHA EC, 32

Enablex, 18

Estrogel, 14

Duetact, 15

enalapril maleate, 7

estropipate, 13

Duexis, 28

enalapril maleate/hydrochlorothiazide, 8

Estropipate, 13

Dulera, 30

enalaprilat, 8

Estrostep FE, 14

duloxetine HCL, 21

Enbrel, 28

eszopiclone, 22

Duocaine, 29

Enbrel Sureclick, 28

ethambutol HCL, 2

Duoneb, 30

Endometrin, 19

ethosuximide, 23

Duragesic, 27

Engerix-b, 31

Ethyl Chloride, 12

Durasafe Spinal/Epidural Tray/1% Xylocaine/19GX36"close CATH, 29

Enjuvia, 14

Ethyl Chloride/Fine Pinpoint, 12

Enlon, 24

Ethyl Chloride/Fine Stream, 12

Durasafe Spinal/Epidural Tray/1% Xylocaine/19GX36"open CATH, 29

Enlon-plus, 24

Ethyl Chloride/Medium Jet Stream, 12

enoxaparin sodium, 20

Ethyl Chloride/Medium Stream, 12

Durasafe Spinal/Epidural Tray/1% Xylocaine/20GX36"close CATH, 29

entacapone, 23

Ethyl Chloride/Mist, 12

Entereg, 18

Ethyol, 6

Durasafe Spinal/Epidural Tray/1% Xylocaine/20GX36"open CATH, 29

Entocort EC, 13

Etidronate Disodium, 15

Entyvio, 18

etodolac, 27

Durezol, 25

Epaned, 8

etodolac ER, 27

Dutoprol, 8

ephedrine sulfate, 9

Etopophos, 5

Dyazide, 9

Epiceram, 12

etoposide, 5

Dymista, 29

Epiduo, 10

Etoposide, 5

Dynacin, 2

Epifoam, 12

Eurax, 12

Dyrenium, 9

epinastine HCL, 26

Evamist, 14

Dysport, 24

Epinephrine, 9

Evicel, 20

E

epinephrine HCL, 30

Evista, 16

Epipen 2-PAK, 9

Evithrom, 20

E.e.s. 400, 1

Epipen-JR 2-PAK, 9

Evoclin, 10

E.e.s. Granules, 1

epirubicin HCL, 4

Evoxac, 20

EC-naprosyn, 28

Epirubicin HCL, 4

Exactuss, 29

econazole nitrate, 10

episone CRE, 12

Exalgo, 27

Ecoza, 11

Epivir, 3

Exelderm, 10

Ed Cyte F, 19

Epivir HBV, 3

Exelon, 24

Ed-chlor-tan, 29

eplerenone, 8

exemestane, 5

Edarbi, 8

Epogen, 19

Exforge, 8

Edarbyclor, 8

epoprostenol sodium, 9

Exforge HCT, 8

Edecrin, 9

eprosartan mesylate, 8

Exjade, 33

Edluar, 22

Epzicom, 3

Exparel, 29

Edurant, 3

Equagesic, 26

Extavia, 24

Effexor XR, 21

Equetro, 22

Extina, 11

Effient, 20

Eraxis, 2

F

Egrifta, 16

Erbitux, 5

Elaprase, 16

Fabior, 10

ergocalciferol, 31

Eldepryl, 23

Fabrazyme, 16

Ergoloid Mesylates, 24

Elelyso, 19

Factive, 2

Ergomar, 28

Elenzapatch, 12

Falessa, 14

Ertaczo, 10

Elestat, 26

famciclovir, 3

Erwinaze, 4

Elestrin, 14

famotidine, 17

Ery-TAB, 1

Eletone, 12

Famotidine, 17

Erygel, 10

Eletone Twinpack, 12

Famotidine Premixed, 17

Eryped 200, 1

Elidel, 12

Famvir, 3

Eryped 400, 1

Eligard, 5

Fanapt, 22

Erythrocin Lactobionate, 1

Elimite, 12

Fanapt Titration Pack, 22

Erythrocin Stearate, 1

Eliphos, 18

Fareston, 5

erythromycin, 1, 10, 24

Eliquis, 20

Farxiga, 15

Erythromycin Base, 1

Elite-OB, 31

Faslodex, 5

Erythromycin Ethylsuccinate, 1

Elitek, 6

Fazaclo, 22

erythromycin/benzoyl peroxide, 10

Elixophyllin, 30

felbamate, 23

Escavite, 32

Ella, 14

Felbatol, 23

Feldene, 28

Flolan, 9

Fluzone PF 2013-2014, 31

felodipine ER, 7

Flomax, 19

Fluzone Quadrivalent 2013-2014, 31

Fem PH, 19

Flonase, 29

Fluzone Quadrivalent 2014-2015, 31

Femara, 5

Flovent Diskus, 30

Fluzone Split 2012-2013, 31

Femcon FE, 14

Flovent HFA, 30


Femhrt Low Dose, 14

floxuridine, 4


Femring, 19

Fluarix 2012-2013, 31

FML, 25

fenofibrate, 9

Fluarix 2013-2014, 31

FML Forte, 25

Fenofibrate, 9

Fluarix Quadrivalent 2013-2014, 31

FML Liquifilm, 25

fenofibrate micronized, 9

Fluarix Quadrivalent 2014-2015, 31

Focalin, 22

Fenofibric Acid, 9

Flublok 2013-2014, 31

Focalin XR, 22

fenofibric acid DR, 9

Flucelvax 2012-2013, 31

Folbecal, 31

Fenoglide, 9

Flucelvax 2013-2014, 31

Folcaps Omega 3, 31

fenoldopam mesylate, 8

Flucelvax 2014-2015, 31

Folet DHA, 32

Fenoprofen Calcium, 28

fluconazole, 2

Folet One, 32

fentanyl, 27

fluconazole IN dextrose, 2

Folgard OS, 32

fentanyl citrate oral transmucosal, 27

fluconazole IN NACL, 2

Folgard RX, 19

Fentora, 27

Fluconazole IN NACL, 2

folic acid, 19

Feraheme, 19

flucytosine, 2

Folic Acid, 19

Feriva, 19

Fludara, 5

folic acid/vitamin b-6/vitamin b-12, 19

Ferivafa, 19

fludarabine phosphate, 4

Folivane-f, 19

Ferralet 90, 19

Fludarabine Phosphate, 4

Folivane-OB, 31

Ferrex 150 Forte Plus, 19

fludrocortisone acetate, 13

Folivane-plus, 19

Ferrex 28, 19

Flulaval 2012-2013, 31

Folivane-prx DHA NF, 31

Ferriprox, 33

Flulaval 2013-2014, 31

Follistim AQ, 16

Ferrlecit, 19

Flulaval 2014-2015, 31

Folotyn, 4

Ferro-plex Hematinic, 19

Flulaval Quadrivalent 2013-2014, 31

Foltrate, 19

Ferrotrin, 19

Flulaval Quadrivalent 2014-2015, 31

fondaparinux sodium, 20

Fetzima, 21

Flumadine, 3

Foradil Aerolizer, 30

Fetzima Titration Pack, 22

Flumist Nasal Vaccine 2012-2013, 31

Forfivo XL, 22

Fexmid, 24

Flumist Quadrivalent, 31

Fortamet, 15

Fibricor, 9

flunisolide, 29

Fortavit, 32

Finacea, 10

Flunisolide, 29

Fortaz, 1

finasteride, 19

fluocinolone acetonide, 11, 26

Forteo, 15

Fioricet, 26

fluocinolone acetonide ear drops, 26

Fortesta, 13

Fioricet/Codeine, 27

fluocinonide, 11

Fortical, 15

Fiorinal, 26

fluocinonide emollient base, 11

Fosamax, 15

Fiorinal/Codeine #3, 27

fluocinonide-e, 11

Foscarnet Sodium, 3

Firazyr, 20

fluorometholone, 25

Foscavir, 3

Firmagon, 5

fluorouracil, 4

fosinopril sodium, 7

First-bxn Mouthwash, 21

fluoxetine, 24

fosinopril sodium/hydrochlorothiazide, 8

First-dukes Mouthwash, 21

fluoxetine DR, 21

fosphenytoin sodium, 23

First-hydrocortisone, 12

fluoxetine HCL, 21

Fosrenol, 18

First-marys Mouthwash, 21

Fluoxetine HCL, 21

Fragmin, 20

First-mouthwash Blm, 21

fluphenazine decanoate, 22

Frova, 28

First-progesterone VGS 100 Compounding Kit, 19

fluphenazine HCL, 22

Fulyzaq, 17

Fluphenazine HCL, 22

Furadantin, 18


flurazepam HCL, 22

furosemide, 9

flurbiprofen, 27

Furosemide, 9


flurbiprofen sodium, 26

Fusilev, 6

flutamide, 5

Fusion Plus, 19


fluticasone propionate, 11, 29

Fuzeon, 3

fluvastatin, 9

Fycompa, 23


Fluvirin 2012-2013, 31

G

Fluvirin 2013-2014, 31

gabapentin, 23

First-testosterone, 13

Fluvirin 2014-2015, 31

Gabavale-5, 21

First-testosterone Mc Compounding Kit, 13

Fluvirin PF 2012-2013, 31

Gabazolamine, 21


Gabazolamine-0.5, 21

First-vancomycin 25, 4


Gabazolpidem-5, 22

First-vancomycin 50, 4

fluvoxamine maleate, 21

Gabitidine, 17

Flagyl, 4

fluvoxamine maleate ER, 21

Gabitril, 23

Flagyl ER, 4

Fluzone High-dose PF 2012-2013, 31

Gaboxetine, 21

Flarex, 25


galantamine, 24

flavoxate HCL, 18


galantamine hydrobromide, 24

flecainide acetate, 7

Fluzone Pediatric PF 2012-2013, 31

ganciclovir, 3

Flector, 11


Ganirelix Acetate, 16

Flexeril, 24


Ganite, 15

FLO-pred, 13

Fluzone PF 2012-2013, 31

Garamycin, 25

Gardasil, 31

Gonal-f RFF Pen, 16

Horizant, 24

Gastrinex NF, 17

Gonal-f RFF Rediject, 16

HPR, 13

Gastrocrom, 18

Gordofilm, 12

HPR Plus, 13

gatifloxacin, 25

Gordons Urea, 12

HPR Plus/Mb Hydrogel, 13

Gattex, 18

Gralise, 24

Humalog, 14

Gazyva, 5

Gralise Starter, 24

Humalog Kwikpen, 14

Gebauers Pain Ease, 12

granisetron HCL, 17

Humalog Mix 50/50, 14

Gebauers Spray And Stretch, 12

Granisol, 17

Humalog Mix 50/50 Kwikpen, 14

Gel-kam Oral Care Rinse, 21

Granix, 19

Humalog Mix 75/25, 14

Gelclair, 21

Grifulvin V, 2

Humalog Mix 75/25 Kwikpen, 14

Gelnique, 18

Gris-peg, 2

Humatrope, 16

Gemcitabine, 4

griseofulvin microsize, 2

Humatrope Combo Pack, 16

gemcitabine HCL, 4

griseofulvin ultramicrosize, 2

Humira, 28

gemfibrozil, 9

guanfacine HCL, 8

Humira Pen, 28

Gemzar, 5

Guanidine HCL, 24

Humira Pen-crohns Diseasestarter, 28

Genadur, 12

Gynazole-1, 19

Humira Pen-psoriasis Starter, 28

gene-xene TAB 15MG, 21

H

Humulin R U-500 (concentrated), 14

gene-xene TAB 3.75MG, 21

Hycamtin, 6

Halaven, 5

gene-xene TAB 7.5MG, 21

Hycet, 27

Halcion, 22

Generess FE, 14

hydralazine HCL, 8

Haldol, 22

Genotropin, 16

Hydrea, 6

Haldol Decanoate 100, 22

Genotropin Miniquick, 16

Hydro 35, 12

Haldol Decanoate 50, 22

gentamicin sulfate, 2, 25

Hydro 40 Foam, 12

Halflytely Bowel Prep/Flavor Packs, 17

Gentamicin Sulfate, 10

hydrochloric acid, 19

halobetasol propionate, 11

gentamicin sulfate pediatric, 2

hydrochlorothiazide, 8

Halog, 12

gentamicin sulfate/0.9% sodium chloride, 2

hydrocodone bitartrate/acetaminophen, 27

Halonate, 12

haloperidol, 22

Gentamicin Sulfate/0.9% Sodium Chloride, 2

Hydrocodone Bitartrate/Acetaminophen, 27

haloperidol decanoate, 22

haloperidol lactate, 22

gentamicin sulfate/sodium chloride, 2

hydrocodone bitartrate/chlorpheniramine maleate/PSE, 29

Halotin, 11

Geodon, 22

Havrix, 31

Gesticare DHA, 32

hydrocodone bitartrate/homatropine methylbromide, 29

Hectorol, 16

Giazo, 18

Helidac, 17

Gilenya, 24

hydrocodone polistirex/chlorpheniramine polistirex, 29

Hemabate, 26

Gilotrif, 6

Hemangeol, 7

Gilphex TR, 29

hydrocodone/acetaminophen, 27

Hematogen Fa, 19

Giltuss, 29

Hydrocodone/Acetaminophen, 27

Hematron-AF, 19

Giltuss PED-c, 29

hydrocodone/homatropine, 29

Hemocyte Plus, 19

Giltuss TR, 29

hydrocodone/ibuprofen, 27

Hemocyte-f, 19

Glassia, 30

hydrocort ene 100MG, 18

heparin lock, 20

Gleevec, 5

hydrocortisone, 11, 13, 18

heparin lock flush, 20

Gliadel Wafer, 4

hydrocortisone acetate/aloe, 11

Heparin Lock Flush, 20

glimepiride, 15

hydrocortisone acetate/lidocaine HCL, 18

heparin lock flush for flushing vascular access devices, 20

glipizide, 15

hydrocortisone acetate/pramoxine, 18

glipizide ER, 15

hydrocortisone butyrate, 11

heparin lock flush/NACL for flushing vascular access devices, 20

glipizide/metformin HCL, 15

hydrocortisone butyrate (lipid), 11

Glucagen, 15

hydrocortisone butyrate (lipophilic), 11

heparin sodium, 20

Glucagen Hypokit, 15

hydrocortisone IN absorbase, 11

Heparin Sodium, 20

Glucagon Emergency Kit, 15

hydrocortisone valerate, 11

heparin sodium dcu, 20

Glucophage, 15

hydrocortisone/acetic acid, 26

heparin sodium lock flush, 20

Glucophage XR, 15

hydromorphone HCL, 27

heparin sodium/D5W, 20

Glucotrol, 15

Hydromorphone HCL, 27

Heparin Sodium/D5W, 20

Glucotrol XL, 15

Hydromorphone HCL Dosette, 27

Heparin Sodium/NACL 0.45%, 20

Glucovance, 15

hydromorphone HCL ER, 27

heparin sodium/NACL 0.9%, 20

Glumetza, 15

Hydromorphone HCL ER, 27

Heparin Sodium/Sodium Chloride 0.9%, 20

glyburide, 15

Hydroxocobalamin, 19

Glyburide, 15

hydroxychloroquine sulfate, 3

heparin sodium/sodium chloride 0.9% premix, 20

glyburide micronized, 15

hydroxyurea, 6

glyburide/metformin HCL, 15

hydroxyzine HCL, 21

Hepsera, 3

Glycate, 17

Hydroxyzine HCL, 21

Herceptin, 5

Glycolic Acid, 11

hydroxyzine pamoate, 21

Hespan, 20

Glycolic Acid 70% High Purity, 11

Hydroxyzine Pamoate, 21

hetastarch 6%/NACL, 20

glycopyrrolate, 17

Hylatopic, 13

Hetlioz, 22

Glynase, 15

Hylatopic Plus, 13

Hexalen, 4

Glyset, 15

Hylira, 12

Hextend, 20

Golytely, 17

hyoscyamine sulfate, 17

Hiberix, 31

Gonal-f, 16

hyoscyamine sulfate ER, 17

Hiprex, 18

Gonal-f RFF, 16

hyoscyamine sulfate odt, 17

homatropine HBR, 25

hyoscyamine sulfate SR, 17

Intuniv, 23

Kapvay Dose Pack, 23

Hyper-sal, 29

Invanz, 4

Karbinal ER, 29

Hypersal, 29

Invega, 22

Kazano, 15

Hypertenevide-12.5, 7

Invega Sustenna, 22

Keflex, 1

Hypertenipine-2.5, 7

Invirase, 3

Kenalog, 12

Hypertensolol, 8

Invokamet, 15

Kenalog-10, 13

Hyzaar, 8

Invokana, 15

Kenalog-40, 13

I

Iopidine, 26

Kepivance, 6

Ipol Inactivated IPV, 31

Keppra, 23

ibandronate sodium, 15

ipratropium bromide, 29, 30

Keppra XR, 23

Ibudone, 27

ipratropium bromide/albuterol sulfate, 30

Kerafoam, 12

ibuprofen, 27

Iprivask, 20

Kerafoam 42, 12

Ibuprofen Comfort PAC, 28

irbesartan, 8

Keralac, 13

ibutilide fumarate, 7

irbesartan/hydrochlorothiazide, 8

Kerlone, 7

IC 400, 28

irinotecan, 6

Ketek, 4

IC 800, 28

Irinotecan, 6

ketoconazole, 2, 10

Icar-c Plus, 19

Iron, 19

Ketodan Kit, 11

Iclusig, 6

Iron Asp Gly/ Polysacch Compl/Ascorb CAL/B12/Fa/C Threon/Suc, 19

ketoprofen, 27

Idamycin PFS, 4

Ketoprofen ER, 28

idarubicin HCL, 4

Irospan 24/6, 19

ketorolac tromethamine, 26, 27

Ifex, 4

Is 24/6, 19

Ketorolac Tromethamine, 28

ifosfamide, 4

Isentress, 3

Khedezla, 21

Ifosfamide, 4

isoniazid, 2

Kineret, 28

Ifosfamide/Mesna, 6

Isoniazid, 2

Kinlytic, 20

Ilaris, 28

Isoptin SR, 7

Kinrix, 30

Ilevro, 26

Isopto Atropine, 25

Klaron, 10

Imdur, 6

Isopto Carbachol, 25

Klonopin, 23

imipenem/cilastatin, 4

Isopto Carpine, 25

Kombiglyze XR, 15

imipramine HCL, 21

Isopto Homatropine, 25

Korlym, 15

imipramine pamoate, 21

Isopto Hyoscine, 25

Kristalose, 17

imiquimod, 12

Isordil Titradose, 6

Krystexxa, 28

Imitrex, 28

isosorbide dinitrate, 6

Kuvan, 16

Imitrex Statdose Refill, 28

Isosorbide Dinitrate, 6

Kynamro, 9

Imitrex Statdose System, 28

isosorbide dinitrate ER, 6

Kyprolis, 6

Imovax Rabies (h.d.c.v.), 31

isosorbide mononitrate, 6

L

Imuran, 5

isosorbide mononitrate ER, 6

Inatal Advance, 31

labetalol HCL, 7

isotonic gentamicin, 2

Inatal GT, 31

Lac-hydrin, 13

Isotonic Gentamicin, 2

Inatal Ultra, 31

Lacrisert, 25

Isradipine, 7

Incivek, 3

lactic acid, 12

Istalol, 25

Increlex, 16

lactic acid e, 12

Istodax, 6

indapamide, 9

lactic acid w/vitamin e, 12

Isuprel, 30

Inderal LA, 7

lactulose, 17, 18

itraconazole, 2

Inderal XL, 7

Lamictal, 23

Ixempra Kit, 5

Indocin, 28

Lamictal Chewable Dispersible, 23

Ixiaro, 31

Indocin IV, 28

Lamictal Odt, 23

J

indomethacin, 27

Lamictal Starter/Not Taking Carbamazepine, 23

Indomethacin, 28

J-cof DHC, 29

indomethacin ER, 27

J-max DHC, 29

Lamictal Starter/Taking Carbamazepine/Not Taking Valproate, 23

indomethacin sodium, 27

Jakafi, 5

Infanrix, 30

Jalyn, 19

Infasurf, 30

Janumet, 15

Lamictal Starter/Taking Valproate, 23

Infergen, 3

Janumet XR, 15

Lamictal XR, 23

Influenza A (h1n1) Monovalent 2009, 31

Januvia, 15

Lamisil, 2

Infumorph 200, 27

Jardiance, 15

Lamisil Spray, 11

Infumorph 500, 27

Jevtana, 5

lamivudine, 3

Injectafer, 19

Jinteli, 13

lamivudine/zidovudine, 3

Innopran XL, 7

Jublia, 11

lamotrigine, 23

Inspra, 8

Juvisync, 15

lamotrigine ER, 23

Insulin Syringe/0.5ML/30G X 5/16", 33

Juxtapid, 9

Lanoxin, 6

Integra F, 19

K

Lanoxin Pediatric, 6

Integra Plus, 19

Lantus, 14

K-phos NO 2, 19

Integrilin, 20

Lantus Solostar, 14

Kadcyla, 5

Intelence, 3

Lasix, 9

Kadian, 27

Interarticular Joint Kit, 13

Lastacaft, 26

Kalbitor, 20

Intermezzo, 22

latanoprost, 25

Kaletra, 3

Introl, 9

Latrix XM, 12

Kalydeco, 30

Intron-a, 6

Latuda, 22

Kapvay, 23

Intron-a W/Diluent, 6

Lazanda, 27

leflunomide, 27

Lithium Carbonate, 22

M

Lescol, 9

lithium carbonate ER, 22

M-m-r II W/Diluent 10 Dose, 31

Lescol XL, 9

Lithium Citrate, 22

M-vit, 32

Letairis, 9

Lithobid, 22

M.v.i. Adult, 31

letrozole, 5

Lithostat, 19

M.v.i. Pediatric, 32

leucovorin calcium, 6

Livalo, 9

M.v.i.-12 Without Vitamin K, 32

Leucovorin Calcium, 6

LMD 10% Dextrose 5%, 20

Macnatal CN DHA, 31

Leukeran, 4

LMD 10% Sodium Chloride 0.9%, 20

Macrobid, 18

Leukine, 19

LO Loestrin FE, 14

Macrodantin, 18

leuprolide acetate, 5

LO Minastrin FE, 14

Magnacet, 27

Levacet, 26

Locoid, 12

Makena, 14

levalbuterol, 30

Locoid Lipocream, 12

Malarone, 3

levalbuterol HCL, 30

Lodosyn, 23

malathion, 12

Levaquin, 2

Loestrin 1.5/30-21, 14

mannitol, 9

Levatol, 7

Loestrin 1/20-21, 14

Maprotiline HCL, 21

Levbid, 17

Loestrin 24 FE, 14

Marcaine, 28

Levemir, 14

Loestrin FE 1.5/30, 14

Marcaine W/O Epi, 28

Levemir Flexpen, 14

Loestrin FE 1/20, 14

Marcaine/Epinephrine, 28

Levemir Flextouch, 14

Lofibra, 9

Marinol, 18

levetiracetam, 23

Lomedia 24 FE, 14

Marnatal-f, 32

Levetiracetam, 23

Lomotil, 17

Marplan, 21

levetiracetam ER, 23

Lomustine, 4

Marqibo, 5

Levitra, 10

loperamide HCL, 17

Matulane, 6

levobunolol HCL, 25

Lopid, 9

Mavik, 8

Levobunolol HCL, 25

Lopressor, 7

Maxair Autohaler, 30

levocarnitine, 16

Lopressor HCT, 8

Maxalt, 28

levocetirizine dihydrochloride, 29

Loprox, 11

Maxalt-MLT, 28

levofloxacin, 2, 25

Loprox Shampoo, 11

Maxaron Forte, 19

levofloxacin IN D5W, 2

lorazepam, 21

Maxfe, 19

levonorgestrel, 14

Lorazepam Intensol, 21

Maxidex, 25

levonorgestrel and ethinyl estradiol, 14

Lorcet 10/650, 27

Maxidone, 27

levonorgestrel/ethinyl estradiol, 14

Lorcet Plus, 27

Maxifed CD, 29

Levophed, 9

Lortab, 27

Maxifed CDX, 29

Levorphanol Tartrate, 27

Lorzone, 24

Maxifed-G CD, 30

levothyroxine sodium, 17

losartan potassium, 8

Maxifed-G CDX, 30

Levothyroxine Sodium, 17

losartan potassium/hydrochlorothiazide, 8

Maxiflu CD, 30

Levsin, 17

Maxiflu CDX, 30

Levsin/SL, 17

Loseasonique, 14

Maxinate, 32

Lexapro, 21

Lotemax, 25

Maxiphen CD, 30

Lexiva, 3

Lotensin, 8

Maxiphen CDX, 30

Lialda, 18

Lotensin HCT, 8

Maxipime, 1

lidocaine, 12

Lotrel, 8

Maxitrol, 25

lidocaine HCL, 7, 12, 20, 28

Lotrisone, 11

Maxzide, 9

Lidocaine HCL, 7, 12

Lotronex, 18

Maxzide-25, 9

lidocaine HCL IN D5W, 7

lovastatin, 9

Mb Hydrogel, 12

lidocaine HCL jelly, 12

Lovaza, 9

meclizine HCL, 17

Lidocaine HCL-hydrocortisone Acetate With Aloe, 18

Lovenox, 20

Meclofenamate Sodium, 28

loxapine, 22

Medical Provider EZ Flu Shot 2014-2015, 31

lidocaine HCL/dextrose, 7

loxapine succinate, 22

Lidocaine HCL/Dextrose, 29

Loxitane, 22

Medrol, 13

lidocaine HCL/hydrocortisone acetate, 18

Lta 360 Kit, 21

Medrol Dosepak, 13

lidocaine viscous, 20

Lufyllin, 30

medroxyprogesterone acetate, 14

lidocaine/epinephrine, 28

Lumigan, 25

mefenamic acid, 27

lidocaine/prilocaine, 12

Lumizyme, 16

mefloquine HCL, 3

Lidocaine/Prilocaine, 12

Lunesta, 22

Mefoxin, 1

Lidoderm, 13

Lupaneta Pack, 16

Megace ES, 14

Lidoprofen, 11

Lupron Depot, 5

Megace Oral, 5

Lidovir, 11

Lupron Depot-PED, 16

megestrol acetate, 5

Lincocin, 4

Luvox CR, 21

Mekinist, 5

lindane, 12

Luxiq, 12

meloxicam, 27

Linzess, 18

Luzu, 11

Meloxicam, 28

liothyronine sodium, 17

Lycelle, 13

Meloxicam Comfort PAC, 28

Lipitor, 9

Lyrica, 23

melphalan hydrochloride, 4

Lipofen, 9

Lysodren, 5

Menactra, 31

Liquicet, 27

Lysteda, 20

Menest, 14

lisinopril, 7

Lytensopril Kit, 8

Menhibrix, 31

lisinopril/hydrochlorothiazide, 8

Lytensopril-90, 8

Menomune-a/C/Y/W-135, 31

lithium carbonate, 22

Lytensopril-90 Kit, 8

Menopur, 16

Menostar, 14

metronidazole vaginal, 19

Mst 600, 26

Mentax, 10

Mevacor, 9

Multaq, 7

Menveo, 31

mexiletine HCL, 7

Multigen, 19

meperidine HCL, 27

Miacalcin, 15

Multigen Folic, 19

Meperidine HCL, 27

Micardis, 8

Multigen Plus, 19

Mephyton, 31

Micardis HCT, 8

mupirocin, 10

Mepivacaine HCL, 28

Microzide, 9

mupirocin calcium, 10

meprobamate, 21

midodrine HCL, 9

Muse, 10

Mepron, 4

Mifeprex, 16

Mustargen, 4

mercaptopurine, 4

Migergot, 28

MV FE Asparto Gly/FE Fum/Succ Acid/Vit C/Threonic Acd/B12/Fa, 19

meropenem, 4

Migral, 28

Merrem, 4

Migranal, 28

MV FE Asparto Gly/Vit C/Vit B12/CA Threonate/Succ Acd/Stomac, 19

mesalamine, 18

Millipred, 13

mesna, 6

Millipred DP, 13

Myalept, 16

Mesnex, 6

milrinone IN dextrose, 6

Myambutol, 2

Mestinon, 24

milrinone lactate, 6

Mycamine, 2

Mestinon Timespan, 24

Minastrin 24 FE, 14

Mycobutin, 2

Metadate CD, 23

Mineral Oil Heavy, 17

mycophenolate mofetil, 5

Metaproterenol Sulfate, 30

Minipress, 8

mycophenolic acid DR, 5

Metastron, 6

Minivelle, 14

Mydfrin, 25

metaxalone, 24

Minocin, 2

Myfortic, 5

metformin HCL, 15

Minocin Kit, 2

Mykidz Iron Fl, 32

metformin HCL ER, 15

minocycline HCL, 2

Myleran, 4

methadone HCL, 27

minocycline HCL ER, 2

Mynatal, 31

Methadone HCL, 27

minoxidil, 8

Mynatal Advance, 31

Methadose, 27

Mirapex, 23

Mynatal Ultracaplet, 31

Methadose Sugar-free, 27

Mirapex ER, 23

Myobloc, 24

methamphetamine HCL, 22

Mircette, 14

Myoxin, 26

methazolamide, 9

mirtazapine, 21

Myozyme, 16

methenamine hippurate, 18

mirtazapine odt, 21

Myrbetriq, 18

methenamine mandelate, 18

misoprostol, 17

Mysoline, 23

Methenamine Mandelate, 18

mitomycin, 4

N

methimazole, 17

Mitosol, 25

nabumetone, 27

methocarbamol, 24

mitoxantrone HCL, 4

nadolol, 7

methotrexate, 4

Mobic, 28

nadolol/bendroflumethiazide, 8

methotrexate sodium, 4

modafinil, 22

nafcillin sodium, 1

methoxsalen, 11

Moderiba, 3

Nafcillin Sodium, 1

methscopolamine bromide, 17

Moderiba 1200 Dose Pack, 3

Nafrinse Daily/Acidulated, 20

Methyclothiazide, 9

Moderiba 800 Dose Pack, 3

Nafrinse Daily/Neutral, 20

methyldopa, 8

Modicon, 14

Nafrinse Weekly, 20

Methyldopa/Hydrochlorothiazide, 8

moexipril HCL, 7

Naftin, 11

Methyldopate HCL, 8

moexipril/hydrochlorothiazide, 8

Naglazyme, 16

methylergonovine maleate, 26

mometasone furoate, 11

nalbuphine HCL, 27

Methylin, 23

Moms Choice RX, 32

Nalfon, 28

methylphenidate HCL, 22

Monodox, 2

Nallpen Iso-osmotic IN Dextrose, 1

methylphenidate HCL CD, 22

Monoject Bone Marrow Biopsy Prepping Tray, 29

Nallpen/Dextrose, 1

methylphenidate HCL ER, 22

Namenda, 24

Methylphenidate HCL ER, 22

Monoject Bone Marrow Biopsy Tray/Biop Aspir Needle 11GX4", 29

Namenda Titration PAK, 24

methylphenidate HCL SR, 22

Namenda XR, 24

methylphenidate hydrochloride, 22

Monoject Bone Marrow Biopsy Tray/Biop Aspir Needle 8GX4", 29

Namenda XR Titration Pack, 24

methylprednisolone, 13

Naphazoline HCL, 25

methylprednisolone acetate, 13

Monoject Bone Marrow Biopsy Tray/Sternal-iliac Needle 16G, 29

Naprelan, 28

methylprednisolone dose pack, 13

Naprosyn, 28

methylprednisolone sodiumsuccinate, 13

montelukast sodium, 30

naproxen, 27

Metipranolol, 25

Monurol, 18

Naproxen Comfort PAC, 28

metoclopramide HCL, 18

Morgidox 1X100MG, 2

naproxen sodium, 28

metolazone, 9

Morgidox 2X100MG, 2

naratriptan HCL, 28

metoprolol succinate ER, 7

morphine sulfate, 27

Nardil, 21

metoprolol tartrate, 7

Morphine Sulfate, 27

Naropin, 29

metoprolol/hydrochlorothiazide, 8

Morphine Sulfate Add-vantage, 27

Nasacort AQ, 29

Metozolv Odt, 18

morphine sulfate ER, 27

Nascobal, 20

Metro IV, 4

Motofen, 17

Nasonex, 29

Metrocream, 10

Moviprep, 17

Natachew, 32

Metrogel, 10

Moxatag, 1

Natacyn, 25

Metrogel-vaginal, 19

Moxeza, 25

Natafort, 32

Metrolotion, 10

moxifloxacin HCL, 2

Natalvirt 90 DHA, 32

metronidazole, 4, 10

Mozobil, 19

Natalvirt CA, 32

metronidazole IN NACL 0.79%, 4

MS Contin, 27

Natalvirt Flt, 20

Natalvit, 31

ox/copper, 31

Norvasc, 7

Natazia, 14

Niacor, 9

Norvir, 3

nateglinide, 15

Niaspan, 9

Novaferrum, 20

Natelle One, 32

Nicadan, 32

Novolog, 14

Natrecor, 10

nicardipine HCL, 7

Novolog Flexpen, 14

Natroba, 13

Nicazel, 32

Novolog Mix 70/30, 14

Nature-throid, 17

Nicazel Forte, 32

Novolog Mix 70/30 Prefilled Flexpen, 14

Nature-throid Nt-2.5, 17

Nicazeldoxy 30 Kit, 2

Novolog Penfill, 14

Navelbine, 5

Nicazeldoxy 60 Kit, 2

Noxafil, 2

Nebupent, 4

Nicomide, 32

Nplate, 19

Nebusal, 30

nifedipine, 7

Nucort, 12

Necon 1/50-28, 14

nifedipine ER, 7

Nucynta, 27

Necon 10/11-28, 14

Nilandron, 5

Nucynta ER, 27

Neevo DHA, 32

Nimbex, 24

Nuedexta, 24

nefazodone HCL, 21

nimodipine, 7

Nulojix, 5

Nefazodone HCL, 21

Nipent, 6

Nulytely/Flavor Packs, 17

Nembutal Sodium, 22

Niravam, 21

Numoisyn, 21

Neo-synalar, 10

nisoldipine, 7

Nuox, 10

Neo-synalar Kit, 10

Nisoldipine, 7

Nutricap, 32

Neo-synephrine, 9

Nisoldipine ER, 7

Nutridox, 2

neomycin sulfate, 2

Nitro-bid, 6

Nutrivit, 32

neomycin/bacitracin/polymyxin, 25

Nitro-dur, 6

Nutropin, 16

neomycin/polymyxin/bacitracin zinc, 25

nitrofurantoin, 18

Nutropin AQ Nuspin 10, 16

neomycin/polymyxin/bacitracin/hydrocortisone, 25

nitrofurantoin macrocrystals, 18


nitrofurantoin monohydrate, 18


neomycin/polymyxin/dexamethasone, 25

nitrofurantoin monohydrate/macrocrystals, 18

Nutropin AQ Pen, 16

neomycin/polymyxin/gramicidin, 25

Nuvail, 13

neomycin/polymyxin/HC, 26

nitroglycerin, 6

Nuvigil, 23

Neomycin/Polymyxin/Hydrocortisone, 25

Nitroglycerin, 6

Nuzon, 12

neomycin/polymyxin/hydrocortisone, 26

nitroglycerin IN 5% dextrose, 6

Nymalize, 7

Neoprofen, 28

nitroglycerin IN dextrose 5%, 6

nystatin, 2, 10, 20

Neoral, 5

Nitroglycerin IN Dextrose 5%, 6

nystatin/triamcinolone, 10

Neosalus, 13

nitroglycerin lingual, 6

O

Neosalus CP, 13

Nitroglycerin Lingual, 6

O-CAL Fa, 32

Neosporin, 25

nitroglycerin transdermal, 6

O-CAL Prenatal, 32

neostigmine methylsulfate, 24

Nitrolingual Pumpspray, 6

OB Complete, 32

Neotuss Plus, 30

Nitromist, 6

OB Complete 400, 32

Nephplex RX, 32

Nitronal, 6

OB Complete One, 32

Nephro-vite RX, 32

Nitropress, 8

OB Complete Petite, 32

Nephrocaps, 32

Nitrostat, 6

OB Complete Premier, 32

Nephrocaps QT, 32

Nivatopic Plus, 13

OB Complete/DHA, 32

Nephron Fa, 20

nizatidine, 17

OB-natal One, 31

Neptazane, 9

Nizoral, 11

Obstetrix DHA, 32

Nesacaine, 29

Nor-QD, 14

Obstetrix EC, 32

Nesacaine-mpf, 29

Norco, 27

octreotide acetate, 16

Nesina, 15

Nordette-28, 14

Ocudox, 2

Nestabs, 32

Norditropin Cartridge, 16

Ocufen, 26

Nestabs Abc, 32

Norditropin Flexpro, 16

Ocuflox, 25

Nestabs DHA, 32

Norditropin Nordiflex Pen, 16

Ofirmev, 26

Neuac Kit, 10

norepinephrine bitartrate, 9

ofloxacin, 2, 25, 26

Neulasta, 19

norethindrone, 14

Ofloxacin, 2

Neumega, 19

norethindrone acetate, 14

Ogestrel, 14

Neupogen, 19

norethindrone acetate/ethinyl estradiol, 14

olanzapine, 22

Neupro, 23

olanzapine odt, 22

Neurontin, 23

norethindrone acetate/ethinyl estradiol/ferrous fumarate, 14

olanzapine/fluoxetine, 24

Neutrasal, 21

Oleptro, 21

Neutrexin, 4

Norflex, 24

Olux, 12

Nevanac, 26

norgestimate/ethinyl estradiol, 14

Olux-e, 12

nevirapine, 3

Norinyl 1+35, 14

Olysio, 3

Nevirapine, 3

Norinyl 1+50, 14

omega-3-acid ethyl esters, 9

nevirapine ER, 3

Noritate, 10

Omnaris, 29

Newgen, 32

Noroxin, 2

Omnipred, 25

Nexa Plus, 32

Norpace, 7

Omnitrope, 16

Nexa Select, 32

Norpace CR, 7

Omontys, 20

Nexavar, 5

Norpramin, 21

Oncaspar, 4

Nexterone, 7

Northera, 9

ondansetron HCL, 17

niacin ER, 9

nortriptyline HCL, 21

ondansetron odt, 17

niacinamide/azelaic ac/ turmer/fa/b6/zinc

Nortriptyline HCL, 21

Onfi, 23

Onglyza, 15

Paire OB, 32

perindopril erbumine, 7

Onmel, 2

Palgic, 29

Perjeta, 5

Opana, 27

Pamelor, 21

permethrin, 12

Opana ER (crush Resistant), 27

pamidronate disodium, 15

perphenazine, 22

opium, 17

Pamidronate Disodium, 15

Perphenazine/Amitriptyline, 24

opium tincture, 17

Pamine, 17

Persantine, 20

Opium Tincture (paregoric), 17

Pamine Forte, 17

Pertzye, 18

Opsumit, 10

Pamine FQ, 17

Pexeva, 21

Optivar, 26

Panatuss Dxp, 30

Pfizerpen-G, 1

Oracea, 10

Pancreaze, 18

phenazopyridine HCL, 19

Oracit, 19

Pancrelipase, 18

phenelzine sulfate, 21

Orap, 24

pancuronium bromide, 24

Phenergan, 29

Orapred, 13

Pandel, 12

Phenflu CD, 30

Orapred Odt, 13

papaverine HCL, 9

Phenflu CDX, 30

Oravig, 21

Parafon Forte DSC, 24

phenobarbital, 22

Oraxyl, 2

Parcopa, 23

Phenobarbital, 22

Orbivan, 26

paricalcitol, 16

Phenobarbital Sodium, 22

Orbivan CF, 26

Parlodel, 23

Phentolamine Mesylate, 8

Orencia, 28

Parnate, 21

phenylephrine HCL, 9, 25

Orenitram, 10

paromomycin sulfate, 2

Phenylephrine HCL, 9

Orfadin, 16

paroxetine HCL, 21

phenylephrine/guaifenesin, 29

orphenadrine citrate, 24

paroxetine HCL ER, 21

Phenytek, 23

orphenadrine citrate ER, 24

Paser, 2

phenytoin, 23

orphenadrine/asa/caffeine, 24

Pataday, 26

phenytoin sodium, 23

Ortho Micronor, 14

Patanase, 29

phenytoin sodium extended, 23

Ortho Tri-cyclen, 14

Patanol, 26

Phoslo, 18

Ortho Tri-cyclen LO, 14

Paxil, 21

Phoslyra, 18

Ortho-cept, 14

Paxil CR, 21

Phospholine Iodide, 25

Ortho-cyclen, 14

PCE, 1

Photofrin, 6

Ortho-novum 1/35, 14

Pediaderm AF Complete Kit, 11

Phrenilin Forte, 26

Ortho-novum 7/7/7, 14

Pediaderm HC, 12

phytonadione, 31

Oseni, 15

Pediaderm Ta, 12

pilocarpine HCL, 20, 25

Osmoprep, 17

Pediapred, 13

pilocarpine hydrochloride, 20

Osphena, 16

Pediarix, 30

Pilopine HS, 25

Otezla, 28

Pediatex TD, 29

pindolol, 7

Otozin, 26

Pediatex TDM, 30

pioglitazone HCL, 15

Ovace Plus, 11

Pedipirox-4 Nail, 11

pioglitazone HCL-glimepiride, 15

Ovace Plus Wash, 11

Pedvax HIB, 31

pioglitazone HCL/metformin HCL, 15

Ovace Wash, 11

peg 3350/electrolytes, 17

piperacillin sodium/ tazobactam sodium, 1

Ovcon-35, 14

peg-3350/electrolytes, 17

Ovide, 13

peg-3350/NACL/NA bicarbonate/KCL, 17

piperacillin sodium/tazobactam sodium, 1

Ovidrel, 16

Peg-intron, 3

piperacillin/tazobactam, 1

oxacillin sodium, 1

Peg-intron Redipen, 3

piroxicam, 28

oxaliplatin, 4

Peg-intron Redipen PAK 4, 3

Pitocin, 26

Oxandrin, 13

Peganone, 23

Pitressin Synthetic, 16

oxandrolone, 13

Pegasys, 3

Plan B, 14

oxaprozin, 28

Pegasys Proclick, 3

Plan B One-step, 14

oxazepam, 21

penicillin G potassium, 1

Plaquenil, 3

oxcarbazepine, 23

Penicillin G Potassium IN Iso-osmotic Dextrose, 1

Plavix, 20

Oxistat, 11

Pletal, 20

Oxsoralen, 12

Penicillin G Procaine, 1

Plexion, 10

Oxsoralen Ultra, 11

Penicillin G Sodium, 1

Plexion Cleanser, 10

Oxtellar XR, 23

penicillin v potassium, 1

Plexion Cleansing Cloths, 10

oxybutynin chloride, 18

Penlac Nail Lacquer, 11

Pliaglis, 13

oxybutynin chloride ER, 18

Pennsaid, 11

Pneumovax 23, 31

oxycodone HCL, 27

Pentacel, 30

Pneumovax 23/1 Dose, 31

Oxycodone HCL, 27

Pentam 300, 4

Pneumovax 23/5 Dose, 31

oxycodone/acetaminophen, 27

Pentasa, 18

podofilox, 12

oxycodone/aspirin, 27

pentazocine/acetaminophen, 27

Poly-tussin DHC, 30

oxycodone/ibuprofen, 27

pentazocine/naloxone HCL, 27

Poly-VI-flor, 32

Oxycontin, 27

Pentetate Calcium Trisodium, 33

Poly-VI-flor/Iron, 32

oxymorphone hydrochloride, 27

Pentetate Zinc Trisodium, 33

polyethylene glycol 3350, 17

oxymorphone hydrochloride ER, 27

pentoxifylline ER, 20

polymyxin b sulfate, 4

oxytocin, 26

Pepcid, 17

polymyxin b sulfate/trimethoprim sulfate, 25

Oxytrol, 18

Percocet, 27

P

Percodan, 27

Polytrim, 25

Perforomist, 30

Pomalyst, 5

paclitaxel, 5

Peridex, 21

Ponstel, 28

Paclitaxel, 5

Potassium Citrate, 19

Primaxin IV Add-vantage, 4

Prumyx, 12

Potassium Citrate ER, 19

primidone, 23

Pulmicort, 30

potassium citrate-citric acid crystals, 19

Primlev, 27

Pulmicort Flexhaler, 30

Potiga, 23

Primsol, 4

Pulmophylline, 30

Pr Cream, 12

Prinivil, 8

Pulmozyme, 30

Pr Natal 400, 31

Pristiq, 21

Purinethol, 5

Pr Natal 400 EC, 31

Proair HFA, 30

Purixan, 5

Pr Natal 430, 31

probenecid, 28

Pylera, 17

Pr Natal 430 EC, 31

probenecid/colchicine, 28

pyrazinamide, 2

Pradaxa, 20

Procainamide HCL, 7

Pyridium, 19

pramipexole dihydrochloride, 23

Procardia, 7

pyridostigmine bromide, 24

Pramosone, 12

Procardia XL, 7

Pyridoxine HCL, 31

Pramotic, 26

Procentra, 23

Pyrogallic Acid, 13

Prandimet, 15

prochlorperazine, 22

Q

Prandin, 15

prochlorperazine edisylate, 22

Qnasl, 29

Pravachol, 9

prochlorperazine maleate, 22

Quadramet, 6

pravastatin sodium, 9

Procort, 18

Qualaquin, 3

Prazolamine, 24

Procrit, 19

Quartette, 14

prazosin HCL, 8

Proctocort, 18

Quazepam, 22

Pre-folic, 20

Proctofoam HC, 18

Qudexy XR, 23

Precedex, 22

Procysbi, 19

Quelicin, 24

Precose, 15

Proferrin-forte, 20

Quelicin 1000, 24

Pred Forte, 25

progesterone, 14

Questran, 9

Pred Mild, 25

Proglycem, 15

Questran Light, 9

Pred-G, 25

Prograf, 5

quetiapine fumarate, 22

Pred-G S.o.p., 25

Prolastin-c, 30

Quflora Pediatric, 32

prednicarbate, 11

Prolensa, 26

Quillivant XR, 23

prednisolone, 13

Proleukin, 6

quinapril HCL, 7

prednisolone acetate, 25

Prolia, 15

quinapril/hydrochlorothiazide, 8

prednisolone sodium phosphate, 13

Promacta, 19

Quinidine Gluconate, 7

Prednisolone Sodium Phosphate, 13, 25

promethazine HCL, 29

quinidine gluconate CR, 7

prednisone, 13

promethazine HCL plain, 29

quinidine gluconate ER, 7

Prednisone, 13

promethazine-DM, 29

quinidine sulfate, 7

Prednisone Intensol, 13

promethazine/codeine, 29

Quinidine Sulfate, 7

Prefera OB, 32

promethazine/dextromethorphan, 29

Quinidine Sulfate ER, 7

Prefera OB + DHA, 32

Prometrium, 14

quinine sulfate, 3

Preferaob One, 32

Promiseb, 11

Qutenza, 13

Prefest, 14

Promiseb Complete, 11

Qvar, 30

Prefol-DHA, 32

propafenone HCL, 7

R

Prelone, 13

propafenone HCL ER, 7

Premarin, 14, 19

Propantheline Bromide, 17

R-natal OB, 32

Premphase, 14

proparacaine HCL, 26

Rabavert, 31

Prempro, 14

propranolol HCL, 7

Radigel, 13

Prenata, 32

Propranolol HCL, 7

raloxifene hydrochloride, 16

Prenatabs RX, 31

propranolol HCL ER, 7

ramipril, 7

Prenatal Ad, 31

Propranolol/Hydrochlorothiazide, 8

Ranexa, 6

Prenatal-u, 32

propylthiouracil, 17

ranitidine HCL, 17

Prenate, 32

Proquad, 31

Rapaflo, 19

Prenate AM, 32

Proscar, 19

Rapamune, 5

Prenate DHA, 32

Prosed/DS, 18

Rasuvo, 28

Prenate Elite, 32

Prostigmin, 24

Ravicti, 16

Prenate Enhance, 32

Prostin E2, 26

Rayos, 13

Prenate Essential, 32

Protamine Sulfate, 20

Razadyne, 24

Prenate Mini, 32

Protect Plus, 32

Razadyne ER, 24

Prenate Pixie, 32

Protectbone, 32

Rebetol, 3

Prenate Restore, 32

Protectiron, 20

Rebif, 24

Prenate Star, 32

Protectnatal, 32

Rebif Rebidose, 24

Prenexa, 32

Protopic, 12

Rebif Rebidose Titration Pack, 24

Prepidil, 26

protriptyline HCL, 21

Rebif Titration Pack, 24

Prepopik, 17

Provenge, 6

Reclast, 15

Preque 10, 32

Proventil HFA, 30

Recombivax HB, 31

Presera, 13

Provera, 14

Recothrom, 20

Prevident, 21

Provida OB, 32

Recothrom Spray Kit, 20

Prevnar 13, 31

Provigil, 23

Reglan, 18

Prezista, 3

Prozac, 21

Regonol, 24

Priftin, 2

Prozac Weekly, 21

Relagard, 19

Primaquine Phosphate, 3

Pruclair, 12

Relenza Diskhaler, 3

Primaxin IV, 4

Prudoxin, 11

Relhist, 29

Relion Insulin Syringe/U-100/0.5ML/29G X 1/2", 33

Ritalin SR, 23

Sensipar, 16

Rituxan, 5

Sensorcaine-mpf/Epinephrine, 29

Relistor, 18

rivastigmine tartrate, 24

Sentradine, 17

Relpax, 28

rizatriptan benzoate, 28

Sentraflox AM-10, 21

Remeron, 21

rizatriptan benzoate odt, 28

Sentralopram AM-10, 21

Remeron Soltab, 21

Robaxin, 24

Sentramodafin AM-100, 23

Remicade, 18

Robaxin-750, 24

Sentravil PM-25, 21

Remodulin, 10

Robinul, 17

Sentrazolam AM 0.25, 21

Renagel, 18

Robinul Forte, 17

Sentrazolpidem PM-5, 22

Renatabs, 32

Rocaltrol, 16

Sentroxatine, 21

Renatabs With Iron, 32

Rocephin, 1

Serevent Diskus, 30

Renax, 32

rocuronium bromide, 24

Seromycin, 2

Renvela, 18

ropinirole ER, 23

Seroquel, 22

Reopro, 20

ropinirole HCL, 23

Seroquel XR, 22

repaglinide, 15

ropivacaine HCL, 28

Serostim, 16

Reprexain, 27

Rosadan Kit, 10

sertraline HCL, 21

Repronex, 16

Rosanil, 10

Sevelamer Carbonate, 18

Req 49+, 32

Rotarix, 31

Sfrowasa, 18

Requip, 23

Rotateq, 31

Shohls Solution Modified, 19

Requip XL, 23

Rowasa, 18

Siderol, 32

Rescon-JR, 30

Roxicet, 27

Signifor, 16

Rescon-MX, 30

Roxicodone, 27

sildenafil, 9

Rescriptor, 3

Rozerem, 22

sildenafil citrate, 9

Rescula, 25

Ryanodex, 24

Silenor, 22

Reserpine, 8

Rybix Odt, 27

Simbrinza, 26

Respa-BR, 29

Rythmol, 7

Simcor, 9

Restasis, 26

Rythmol SR, 7

Simponi, 28

Restora RX, 17

S

Simponi Aria, 28

Restoril, 22

Simulect, 5

Sabril, 23

Retavase, 20

simvastatin, 9

Safyral, 14

Retavase Half-kit, 20

Sinemet, 23

Saizen, 16

Retin-a, 10

Sinemet CR, 23

Saizen Click.easy, 16

Retin-a Micro, 10

Singulair, 30

Salagen, 21

Retin-a Micro P.M., 10

sirolimus, 5

salicylic acid, 12

Retrovir, 3

Sirturo, 2

Salicylic Acid, 12

Retrovir IV Infusion, 3

Sitavig, 3

Salicylic Acid IN Ammonium Lactate Vehicle, 12

Revatio, 10

Sivextro, 4

Revlimid, 5

Skelaxin, 24

Salkera, 13

Reyataz, 3

Sklice, 13

salsalate, 26

Rezira, 30

Sodium Bicarbonate, 17

Salvax Duo Plus, 13

Rezyst IM, 17

sodium chloride, 29

Samsca, 16

Rezyst SB, 17

Sodium Diuril, 9

Sanctura, 18

Rheumatrex, 28

Sodium Edecrin, 9

Sanctura XR, 18

Rhinocort Aqua, 29

sodium ferric gluconate complex/sucrose, 19

Sancuso, 18

Rhinoflex-650, 26

Sandimmune, 5

Ribasphere, 3

sodium hyaluronate, 12

Sandostatin, 16

Ribasphere Ribapak, 3

sodium phenylbutyrate, 16

Sandostatin Lar Depot, 16

Ribatab, 3

sodium sulfacetamide, 10, 11, 25

Saphris, 22

ribavirin, 3

sodium sulfacetamide wash, 11

Sarafem, 24

Ridaura, 28

sodium sulfacetamide/sulfur, 10

Savella, 24

rifabutin, 2

Sodium Sulfacetamide/Sulfur, 10

Savella Titration Pack, 24

Rifadin, 2

sodium sulfacetamide/sulfur cleanser, 10

Scalacort DK, 12

Rifamate, 2

Sodium Sulfacetamide/Sulfur Cleanser IN Urea, 10

Scopolamine Hydrobromide, 17

rifampin, 2

Seasonique, 14

Rifater, 2

sodium sulfacetamide/sulfur cleansing cloths, 10

Seb-prev, 11

Rilutek, 24

Seconal, 22

riluzole, 24

sodium sulfacetamide/sulfur green, 10

Sectral, 7

rimantadine HCL, 3

Sodium Sulfacetamide/Sulfur IN Urea, 10

Select-OB, 32

Rimantalist, 3

sodium sulfacetamide/sulfur wash, 10

Select-ob+dha, 32

Riomet, 15

Sodium Sulfacetamide/Urea, 11

selegiline HCL, 23

risedronate sodium, 15

Soliris, 20

selenium sulfide, 11

Risperdal, 22

Solodyn, 2

Selenium Sulfide, 11

Risperdal Consta, 22

Soltamox, 5

Selrx, 11

Risperdal M-TAB, 22

Solu-cortef, 13

Selsun Shampoo, 11

risperidone, 22

Solu-medrol, 13

Selzentry, 3

risperidone odt, 22

Soma, 24

Semprex-d, 30

Ritalin, 23

Somatuline Depot, 16

Senna Leaves, 17

Ritalin LA, 23

Somavert, 16

Senophylline, 30

Sonata, 22

Sumavel Dosepro, 28

Tekturna HCT, 8

Soriatane, 11

Sumaxin, 10

telmisartan, 8

Sorilux, 11

Sumaxin CP Kit, 10

telmisartan/amlodipine, 8

sotalol HCL, 7

Sumaxin Ts, 10

telmisartan/hydrochloroth, 8

sotalol HCL (AF), 7

Sumaxin Wash, 10

telmisartan/hydrochlorothiazide, 8

Sotalol Hydrochloride, 7

Supervite, 32

temazepam, 22

Sovaldi, 3

Supervite EC, 32

Temodar, 4

Spectracef, 1

Support-500, 32

Temovate, 12

Spinosad, 13

Supprelin LA, 16

Temovate E, 12

Spiriva Handihaler, 30

Suprax, 1

temozolomide, 4

spironolactone, 9

Suprep Bowel Prep, 17

Tencon, 26

spironolactone/hydrochlorothiazide, 9

Surfaxin, 30

Tenex, 8

Sporanox, 2

Surmontil, 21

Teniposide, 5

Sporanox Pulsepak, 2

Survanta Intratracheal, 30

Tenivac, 30

Sprix, 28

Sustiva, 3

Tenoretic 100, 8

Sprycel, 5

Sutent, 5

Tenoretic 50, 8

Staflex, 26

Suttar-2, 29

Tenormin, 7

Stalevo 100, 23

Suttar-SF, 29

Terazol 3, 19

Stalevo 125, 23

Sylatron, 6

Terazol 7, 19

Stalevo 150, 23

Symax Duotab, 17

terazosin HCL, 8

Stalevo 200, 23

Symbicort, 30

terbinafine HCL, 2

Stalevo 50, 23

Symbyax, 24

Terbinex, 3

Stalevo 75, 23

Symlinpen 120, 14

terbutaline sulfate, 30

stannous fluoride oral rinse, 20

Symlinpen 60, 14

terconazole, 19

Starlix, 15

Synagex, 32

Tersi Foam, 11

stavudine, 3

Synalar, 12

Tessalon Perles, 30

Stavzor, 23

Synalar Cream Kit, 12

Testim, 13

Staxyn, 10

Synalar Ointment Kit, 12

Testopel, 13

Stelara, 11

Synalar Ts, 12

Testosterone, 13

Stendra, 10

Synalgos-dc, 27

testosterone cypionate, 13

Stimate, 16

Synarel, 16

testosterone enanthate, 13

Stivarga, 6

Synatek, 32

Testosterone P.M., 13

Strattera, 22

Synera, 13

Testred, 13

Strazepam, 22

Synercid, 4

Tetanus Toxoid Adsorbed, 30

Streptomycin Sulfate, 2

Synribo, 6

Tetanus/Diphtheria Toxoids-adsorbed Adult, 30

Striant, 13

Synthroid, 17

Stribild, 3

T

tetracaine HCL, 26

Striverdi Respimat, 30

Tetracaine HCL, 29

Tabloid, 5

Stromectol, 3

Tetracycline HCL, 2

Taclonex, 12

Strovite, 31

Tetrix, 13

tacrolimus, 5

Strovite Forte, 32

Tev-tropin, 16

Tafinlar, 6

Strovite One, 32

Teveten, 8

Talwin, 27

Suboxone, 27

Teveten HCT, 8

Tambocor, 7

Subsys, 27

Texacort, 12

Tamiflu, 3

Suclear, 17

Thalomid, 5

tamoxifen citrate, 5

Sucraid, 18

Theo-24, 30

tamsulosin HCL, 19

sucralfate, 17

theophylline, 30

Tandem F, 20

Sular, 7

theophylline CR, 30

Tandem Plus, 20

sulfacetamide sodium, 10, 25

theophylline ER, 30

Tanzeum, 14

Sulfacetamide Sodium, 25

theophylline/D5W, 30

Tapazole, 17

sulfacetamide sodium/prednisolone sodium phosphate, 25

Theophylline/D5W, 30

Tarceva, 6

Therabenzaprine-60, 24

Targretin, 6

sulfacetamide sodium/sulfur cleanser, 10

Therabenzaprine-90, 24

Tarka, 8

Sulfadiazine, 2

Therabenzaprine-90-5, 24

Taron-bc, 31

sulfamethoxazole/trimethoprim, 4

Theracodeine-300, 27

Taron-c DHA, 31

Sulfamethoxazole/Trimethoprim, 4

Theracodophen-325, 27

Taron-duo EC, 31

sulfamethoxazole/trimethoprim DS, 4


Taron-prex, 31

sulfasalazine, 18


Tasigna, 6

Sulfoam, 10

Theracodophen-low-90, 27

Tasmar, 23

Sulfurated Lime, 13

Therafeldamine, 28

Taxotere, 5

sulindac, 28

Therapentin-60, 23

Tazicef, 1

Sumadan Kit, 10

Therapentin-90, 23

Tazorac, 11

Sumadan Wash, 10

Theraprofen-60, 28

Tecfidera, 24

Sumadan XLT, 10

Theraprofen-800, 28

Tecfidera Starter Pack, 24

Sumatriptan, 28

Theraprofen-90, 28

Tegretol, 23

sumatriptan succinate, 28

Theraproxen-500, 28

Tegretol-XR, 23

Sumatriptan Succinate, 28

Theraproxen-60, 28

Tekamlo, 8

sumatriptan succinate refill, 28

Theraproxen-90, 28

Tekturna, 8

Theratramadol-60, 27

Torisel, 6

Triostat, 17

Theratramadol-90, 27

torsemide, 9

Trisenox, 6

thiamine HCL, 31

Torsemide, 9

Triveen-duo DHA, 32

Thiola, 19

Totect, 6

Triveen-prx RNF, 32

thioridazine HCL, 22

Toviaz, 18

Triveen-ten, 32

thiothixene, 22

Tracleer, 10

Triveen-u, 32

Thrombin-jmi Diluent, 20

Tradjenta, 15

Trizivir, 3

Thrombin-jmi Epistaxis, 20

tramadol HCL, 27

Trokendi XR, 23

Thrombin-jmi Syringe Spray Kit, 20

tramadol HCL ER, 27

Tropazone, 13

Thrombin-jmi W/Dil Spray P.M. Actuator, 20

Tramadol HCL ER, 27

trospium chloride, 18

tramadol hydrochloride/acetaminophen, 27

trospium chloride ER, 18

Thrombogen, 20

Trusopt, 26

Thymoglobulin, 5

Trandate, 7

Truvada, 3

Thyrolar-1, 17

trandolapril, 7

Tudorza Pressair, 30

Thyrolar-1/2, 17

tranexamic acid, 20

Turkel Paracentesis Procedure Tray/8french, 29

Thyrolar-1/4, 17

Transderm-scop, 17

Thyrolar-2, 17

Tranxene T, 21

Tussicaps, 29

Thyrolar-3, 17

tranylcypromine sulfate, 21

Tussionex Pennkinetic Extended Release, 30

tiagabine hydrochloride, 23

Trasylol, 20

Tiazac, 7

Travatan Z, 25

Twinrix, 31

ticlopidine HCL, 20

Travoprost, 25

Twynsta, 8

Tigan, 18

Trazamine, 21

Tygacil, 4

Tikosyn, 7

trazodone HCL, 21

Tykerb, 6

Timentin, 1

Treanda, 4

Tylenol/Codeine #3, 27

Timolol Maleate, 7

Trecator, 2

Tylenol/Codeine #4, 27

timolol maleate, 25

Trelstar Depot, 5

Typhim VI, 31

timolol maleate ophthalmic gel forming, 25

Trelstar Depot Mixject, 5

Tysabri, 24

Trelstar LA, 5

Tyvaso, 10

Timoptic, 25

Trelstar LA Mixject, 5

Tyvaso Refill, 10

Timoptic Ocudose, 25

Trelstar Mixject, 5

Tyvaso Starter, 10

Timoptic-xe, 25

Trental, 20

Tyzeka, 3

Tindamax, 4

Trepadiclofen-25, 28

Tyzine, 29

tinidazole, 4

Trepoxen-250, 28

Tyzine Pediatric Nasal Drops, 29

Tirosint, 17

Trepoxicam-7.5, 28

U

Tisseel, 20

Tretin-x, 10

U-cort, 11

Tivicay, 3

tretinoin, 6, 10

Uceris, 13

Tizanidine Comfort PAC, 24

tretinoin microsphere, 10

Udamin, 33

tizanidine HCL, 24

tretinoin microsphere P.M., 10

Udamin SP, 33

TL G-FOL OS, 32

Trexall, 4

Ulesfia, 13

TL Triseb, 11

Treximet, 28

Uloric, 28

TL-cermide, 12

Trezix, 27

Ultiva, 27

Tnkase, 20

Tri-norinyl 28, 14

Ultracet, 27

Tobi, 2

Tri-VI-flor, 32

Ultram, 27

Tobi Podhaler, 2

triamcinolone acetonide, 11, 20, 29

Ultram ER, 27

Tobradex, 25

Triamcinolone Acetonide, 11

Ultrasal-ER, 13

Tobradex ST, 25

triamcinolone IN orabase, 20

Ultravate, 12

tobramycin, 2

triamterene/hydrochlorothiazide, 9

Ultravate PAC, 12

tobramycin sulfate, 2, 25

Triamterene/Hydrochlorothiazide, 9

Ultravate X, 12

Tobramycin Sulfate/Sodium Chloride, 2

Trianex, 11

Ultresa, 18

tobramycin/dexamethasone, 25

triazolam, 22

Umecta, 13

Tobrex, 25

Tribenzor, 8

Umecta Nail Film, 13

Tofranil, 21

Tricare, 31

Umecta PD, 13

Tofranil-PM, 21

Tricare Prenatal Compleat, 33

Unasyn, 1

tolazamide, 15

Tricare Prenatal DHA One, 33

Unasyn Bulk Pack, 1

Tolazamide, 15

Tricitrates, 19

Uniretic, 8

Tolbutamide, 15

Tricor, 9

Univasc, 8

tolmetin sodium, 28

trifluoperazine HCL, 22

Uramaxin, 13

Tolmetin Sodium, 28

trifluridine, 25

Uramaxin GT, 13

tolterodine tartrate, 18

Triglide, 9

Uramaxin GT Kit, 13

tolterodine tartrate ER, 18

trihexyphenidyl HCL, 23

urea, 12

Topamax, 23

Trileptal, 23

urea 40% nail film, 12

Topamax Sprinkle, 23

Trilipix, 9

urea IN zinc undecylenate/lactic acid vehicle, 12

Topicort, 12

trimethobenzamide HCL, 17

topiramate, 23

trimethoprim, 4

urea topical, 12

Topiramate ER, 23

trimethoprim sulfate/polymyxin b sulfate, 25

Urecholine, 18

topotecan HCL, 6

Urelle, 18

Topotecan HCL, 6

trimipramine maleate, 21

Uretron D/S, 18

Toprol XL, 7

Trinate, 31

Urex, 18

Uribel, 18

Vibativ, 4

Voltaren, 11

Urimar-t, 18

Vibramycin, 2

Voltaren-XR, 28

Urocit-k 10, 19

Vicoprofen, 27

Voluven, 20

Urocit-k 15, 19

Victoza, 15

Vopac, 11

Urocit-k 5, 19

Victrelis, 3

Vopac GB, 11

Urogesic-blue, 18

Vidaza, 5

Vopac Kt, 11

Uroqid #2, 18

Videx EC, 3

Voraxaze, 6

Uroxatral, 19

Videx Pediatric, 3

voriconazole, 2

Urso 250, 18

Vigamox, 25

Vosol HC, 26

Urso Forte, 18

Viibryd, 21

Vospire ER, 30

ursodiol, 18

Vimizim, 16

Votrient, 6

Utopic, 13

Vimovo, 28

Vpriv, 20

Uvadex, 6

Vimpat, 23

Vsl#3 DS, 17

V

Vinacal, 32

Vumon, 5

Vinacal B, 33

Vusion, 11

Vagifem, 19

Vinate AZ Extra, 32

Vytorin, 9

valacyclovir HCL, 3

Vinate C, 32

Vyvanse, 22

Valchlor, 4

Vinate Calcium, 32

W

Valcyte, 3

Vinate Care, 32

Valium, 21

warfarin sodium, 20

Vinate DHA, 33

valproate sodium, 23

Welchol, 9

Vinate DHA RF, 33

valproic acid, 23

Wellbutrin, 21

Vinate GT, 32

valsartan, 8

Wellbutrin SR, 21

Vinate IC, 32

valsartan/hydrochlorothiazide, 8

Wellbutrin XL, 21

Vinate II, 32

Valtrex, 3

Westcort, 12

Vinate M, 32

Vancocin HCL, 4

Westhroid, 17

Vinate One, 32

vancomycin HCL, 4

Westhroid-p, 17

Vinate Pn Care, 32

Vancomycin HCL, 4

Wheat Germ, 31

Vinblastine Sulfate, 5

Vancomycin HCL IN Dextrose, 4

Witch Hazel, 13

vincristine sulfate, 5

Vanos, 12

Wp Thyroid, 17

vinorelbine tartrate, 5

Vantas, 5

X

Viokace, 18

Vaprisol, 16

Viracept, 3

Xalatan, 25

Vaqta, 31

Viramune, 3

Xalkori, 6

Varivax, 31

Viramune XR, 3

Xanax, 21

Vaseretic, 8

Virasal, 13

Xanax XR, 21

vasopressin, 16

Virazole, 3

Xarelto, 20

Vasotec, 8

Viread, 3

Xartemis XR, 27

Vecamyl, 8

Viroptic, 25

Xclair, 13

Vectibix, 5

Vistaril, 21

Xeljanz, 28

Vectical, 11

Vistide, 3

Xeloda, 5

vecuronium bromide, 24

Vita-pren, 33

Xenazine, 24

Velcade, 6

Vitafol, 33

Xeomin, 24

Veletri, 9

Vitafol Ultra, 33

Xerac Ac, 13

Velphoro, 18

Vitafol-nano, 33

Xerese, 11

Veltin, 10

Vitafol-OB, 33

Xgeva, 15

Vemavite-prx 2, 32

Vitafol-ob+dha, 33

Xifaxan, 4

venlafaxine HCL, 21

Vitafol-one, 33

Xodol, 27

venlafaxine HCL ER, 21

Vitafol-plus, 33

Xofigo, 6

Venlafaxine HCL ER, 21

Vitafol-pn, 33

Xolair, 30

Venofer, 20

Vital-d RX, 33

Xolegel, 11

Ventavis, 10

Vitamedmd One RX/Quatrefolic, 33

Xolegel Corepak, 11

Ventolin HFA, 30

Vitamedmd Plus RX/Quatre Folic, 33

Xolegel Duo/Head & Shoulders, 11

Veramyst, 29

Vitamedmd Redichew RX, 33

Xolegel Duo/Xolex, 11

verapamil HCL, 7

Vitamedmd Redichew RX/Quatrefolic, 33

Xolox, 27

Verapamil HCL, 7

vitamin c 222MG, 31

Xopenex, 30

verapamil HCL ER, 7

vitamin d, 31

Xopenex Concentrate, 30

verapamil HCL SR, 7

vitamin k1, 31

Xopenex HFA, 30

Verdeso, 12

Vitamin K1, 31

Xtandi, 5

Veregen, 13

Vitapearl, 33

Xylocaine, 7, 13, 29

Verelan, 7

Vitaroca Plus, 32

Xylocaine-mpf, 29

Verelan PM, 7

Vituz, 30

Xylocaine-mpf/Epinephrine, 29

Veripred 20, 13

Viva CT Prenatal, 33

Xylocaine/Epinephrine, 29

Versacloz, 22

Viva DHA, 33

Xyrem, 24

Vesicare, 19

Vivactil, 21

Xyzal, 29

Vexa, 13

Vivelle-dot, 14

Y

Vexol, 25

Vivotif Berna, 31

Vfend, 3

Yasmin 28, 14

Vogelxo, 13

Vfend IV, 3

Yaz, 14

Vogelxo P.M., 13

Viagra, 10

Yervoy, 5

Yf-vax, 31

Zonegran, 23

Yodoxin, 3

zonisamide, 23

Z

Zontivity, 20

Zorbtive, 16

zafirlukast, 30

Zortress, 5

zaleplon, 22

Zostavax, 31

Zaltrap, 5

Zosyn, 1

Zanaflex, 24

Zovia 1/50e, 14

Zanosar, 4

Zovirax, 3, 11

Zantac, 17

Zuplenz, 18

Zarontin, 23

Zutripro, 30

Zaroxolyn, 9

Zyclara, 12

Zatean-CH, 32

Zyclara P.M., 12

Zatean-pn, 32

Zydelig, 6

Zatean-pn DHA, 32

Zydone, 27

Zatean-pn Plus, 32

Zyflo, 30

Zavesca, 20

Zyflo CR, 30

Zebeta, 7

Zykadia, 6

Zelapar, 24

Zylet, 25

Zelboraf, 6

Zyloprim, 28

Zemaira, 30

Zymaxid, 25

Zemplar, 16

Zyprexa, 22

Zemuron, 24

Zyprexa Relprevv, 22

Zenpep, 18

Zyprexa Zydis, 22

Zerit, 3

Zytiga, 5

Zestoretic, 8

Zyvox, 4

Zestril, 8

8

Zetia, 9

Zetonna, 29

8-mop, 11

Zevalin Y-90, 5

Ziac, 8

Ziagen, 3

Ziana, 10

zidovudine, 3

Zinacef, 1

Zinacef IN Iso-osmotic Dextrose, 1

Zinacef IN Iso-osmotic Diluent, 1

Zinecard, 6

Zioptan, 25

ziprasidone HCL, 22

Zipsor, 28

Zirgan, 25

Zithranol, 11

Zithranol-rr, 11

Zithromax, 1

Zithromax Tri-PAK, 1

Zithromax Z-PAK, 1

Zmax, 1

Zocor, 9

Zofran, 18

Zofran Odt, 18

Zohydro ER, 27

Zoladex, 5

Zoledronic Acid, 15

zoledronic acid, 15

Zolinza, 6

zolmitriptan, 28

zolmitriptan odt, 28

Zoloft, 21

zolpidem tartrate, 22

zolpidem tartrate ER, 22

Zolpimist, 22

Zolvit, 27

Zometa, 15

Zomig, 28

Zomig Nasal Spray, 28

Zomig ZMT, 28

Zonalon, 11

Zonatuss, 30

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