docOHP Formulary
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OHP Formulary
Oregon Health Plan (OHP) Medicaid Formulary Effective 7/1/2016 Key Medications that are new to the market are not included within your pharmacy benefit until reviewed by the Pharmacy and Therapeutics Committee. Please contact PA - Prior authorization requirement Moda Health Customer Service if you are taking a medication that is new to the market. Please note that this list is subject to change at any time. Step - Step therapy requirement Questions? Call Pharmacy Customer Service at 888-474-8539. QLL - Quantity level limit Age - Age restriction General Therapeutic Category ALLERGY Brand Name Generic Name ALAVERT ALL DAY ALLERGY LORATADINE CETIRIZINE HCL ALL DAY ALLERGY RELIEF ALLER-CHLOR CETIRIZINE HCL CHLORPHENIRAMINE MALEATE ALLERCLEAR ALLER-G-TIME ALLERGY LORATADINE DIPHENHYDRAMINE HCL CETIRIZINE HCL CHLORPHENIRAMINE MALEATE DIPHENHYDRAMINE HCL ALLERGY 4-HOUR ALLERGY MEDICATION LORATADINE CHLORPHENIRAMINE MALEATE DIPHENHYDRAMINE HCL ALLERGY MEDICINE DIPHENHYDRAMINE HCL ALLERGY RELIEF CETIRIZINE HCL CHLORPHENIRAMINE MALEATE DIPHENHYDRAMINE HCL LORATADINE ALLERGY-TIME ALLER-TEC ANTIHIST ANTIHISTAMINE CHLORPHENIRAMINE MALEATE CETIRIZINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL Dose TAB RAPDIS SOLUTION TABLET TABLET SYRUP TABLET TABLET TABLET TABLET TABLET CAPSULE LIQUID TABLET TABLET TABLET CAPSULE LIQUID TABLET CAPSULE LIQUID TABLET SOLUTION TABLET TABLET CAPSULE LIQUID TABLET SOLUTION TAB RAPDIS TABLET TABLET TABLET ELIXIR CAPSULE TABLET PA Step QLL Age General Therapeutic Category Brand Name ARBINOXA Generic Name CARBINOXAMINE MALEATE BANOPHEN DIPHENHYDRAMINE HCL BENADRYL ALLERGY CARBINOXAMINE MALEATE DIPHENHYDRAMINE HCL CARBINOXAMINE MALEATE CETIRIZINE HCL CETIRIZINE HCL CHILDREN'S ALL DAY ALLERGY CHILDREN'S ALLERGY CETIRIZINE HCL CETIRIZINE HCL DIPHENHYDRAMINE HCL CHILDREN'S ALLERGY COMPLETE CHILDREN'S ALLERGY RELIEF CETIRIZINE HCL CETIRIZINE HCL DIPHENHYDRAMINE HCL CHILDREN'S ALLER-TEC CHILDREN'S CETIRIZINE HCL CHILDREN'S COMPLETE ALLERGY CHILDREN'S LORATADINE CHILDREN'S WAL-DRYL ALLERGY LORATADINE CETIRIZINE HCL CETIRIZINE HCL DIPHENHYDRAMINE HCL LORATADINE DIPHENHYDRAMINE HCL CHILDREN'S WAL-ZYR CHLORPHENIRAMINE MALEATE CHLORTABS CLARITIN CLEMASTINE FUMARATE CETIRIZINE HCL CHLORPHENIRAMINE MALEATE CHLORPHENIRAMINE MALEATE LORATADINE CLEMASTINE FUMARATE COMPLETE ALLERGY DIPHENHYDRAMINE HCL CYPROHEPTADINE HCL CYPROHEPTADINE HCL DESLORATADINE DIPHEDRYL DESLORATADINE DIPHENHYDRAMINE HCL DIPHEDRYL ALLERGY DIPHENHIST DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL Dose LIQUID TABLET CAPSULE LIQUID TABLET TABLET LIQUID TABLET SOLUTION TABLET SOLUTION SOLUTION ELIXIR LIQUID TAB RAPDIS SOLUTION SOLUTION LIQUID TAB RAPDIS SOLUTION SOLUTION SOLUTION TAB RAPDIS SOLUTION LIQUID TAB RAPDIS SOLUTION TABLET TABLET TABLET SYRUP TABLET CAPSULE LIQUID TABLET SYRUP TABLET TABLET CAPSULE LIQUID TABLET LIQUID CAPSULE LIQUID TABLET CAPSULE ELIXIR LIQUID PA Step QLL Age General Therapeutic Category Brand Name Generic Name ED CHLORPED JR ED-CHLORTAN FEXOFENADINE HCL FLUTICASONE PROPIONATE GERI-DRYL CHLORPHENIRAMINE MALEATE CHLORPHENIRAMINE MALEATE FEXOFENADINE HCL FLUTICASONE PROPIONATE DIPHENHYDRAMINE HCL HYDROXYZINE HCL HYDROXYZINE HCL HYDROXYZINE PAMOATE LEVOCETIRIZINE DIHYDROCHLORIDE LORADAMED LORATADINE HYDROXYZINE PAMOATE LEVOCETIRIZINE DIHYDROCHLORIDE LORATADINE LORATADINE LORATADINE ALLERGY LORATADINE HIVES RELIEF MEDI-PHEDRYL LORATADINE LORATADINE DIPHENHYDRAMINE HCL NIGHTTIME ALLERGY RELIEF NON-DROWSY ALLERGY PHARBECHLOR PHARBEDRYL PROMETHAZINE HCL DIPHENHYDRAMINE HCL LORATADINE CHLORPHENIRAMINE MALEATE DIPHENHYDRAMINE HCL PROMETHAZINE HCL Q-DRYL DIPHENHYDRAMINE HCL QUENALIN SILADRYL SILPHEN TOTAL ALLERGY VALU-DRYL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL VALU-DRYL ALLERGY MEDICINE VICKS QLEARQUIL ALLERGY VICKS QLEARQUIL NIGHTTIME WAL-DRYL DIPHENHYDRAMINE HCL LORATADINE DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL WAL-DRYL ALLERGY DIPHENHYDRAMINE HCL WAL-FINATE WAL-ITIN CHLORPHENIRAMINE MALEATE LORATADINE WAL-ZYR CETIRIZINE HCL TAVIST ND LORATADINE Dose SYRUP TABLET SYRUP TABLET TABLET SPRAY SUSP CAPSULE TABLET SOLUTION TABLET CAPSULE SOLUTION TABLET SOLUTION TAB RAPDIS TABLET SOLUTION SOLUTION CAPSULE LIQUID TABLET TABLET TABLET CAPSULE SYRUP TABLET CAPSULE LIQUID SYRUP LIQUID SYRUP TABLET ELIXIR TAB CHEW TABLET TABLET TABLET CAPSULE TABLET LIQUID TABLET TABLET SOLUTION TAB RAPDIS TABLET SOLUTION TABLET TABLET PA Step QLL X X X Age General Therapeutic Category ANTIEMESIS/ANTIVERTIGO ASTHMA AND COPD Brand Name ED-CHLOR-TAN ED CHLORPED PALGIC BROMSPIRO DOXYTEX CHILDREN'S ALLERGY RAPID MELTS ALER-TAB DIPHEN Generic Name CHLORPHENIRAMINE TANNATE CHLORPHENIRAMINE TANNATE CARBINOXAMINE MALEATE BROMPHENIRAMINE MALEATE DOXYLAMINE SUCCINATE DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DEXCHLORPHENIRAMINE MALEATE RESPA-BR LOHIST 12HR CHLORHIST ALER-CAPS ANZEMET CESAMET COMPRO DRONABINOL EMEND DEXCHLORPHENIRAMINE MALEATE BROMPHENIRAMINE MALEATE BROMPHENIRAMINE MALEATE CHLORPHENIRAMINE MALEATE DIPHENHYDRAMINE HCL DOLASETRON MESYLATE NABILONE PROCHLORPERAZINE DRONABINOL APREPITANT GRANISETRON HCL GRANISETRON HCL MECLIZINE HCL ONDANSETRON HCL GRANISETRON HCL/PF MECLIZINE HCL ONDANSETRON HCL ONDANSETRON ODT PHENADOZ PROCHLORPERAZINE PROCHLORPERAZINE MALEATE PROMETHAZINE HCL PROMETHEGAN TRANSDERM-SCOP TRIMETHOBENZAMIDE HCL ANTIVERT GRANISOL ADVAIR DISKUS ADVAIR HFA ALBUTEROL SULFATE ONDANSETRON HCL/PF ONDANSETRON PROMETHAZINE HCL PROCHLORPERAZINE PROCHLORPERAZINE MALEATE PROMETHAZINE HCL PROMETHAZINE HCL SCOPOLAMINE TRIMETHOBENZAMIDE HCL MECLIZINE HCL GRANISETRON HCL FLUTICASONE/SALMETEROL FLUTICASONE/SALMETEROL ALBUTEROL SULFATE ARNUITY ELLIPTA ATROVENT HFA BUDESONIDE FLUTICASONE FUROATE IPRATROPIUM BROMIDE BUDESONIDE Dose TABLET DROPS LIQUID LIQUID LIQUID TAB CHEW TABLET CAPSULE TABLET SYRUP TAB ER 12H TAB ER 12H TABLET CAPSULE TABLET CAPSULE SUPP.RECT CAPSULE CAP DS PK CAPSULE TABLET VIAL VIAL TABLET SOLUTION TABLET VIAL VIAL TAB RAPDIS SUPP.RECT SUPP.RECT TABLET SUPP.RECT SUPP.RECT PATCH TD 3 CAPSULE TABLET SOLUTION BLST W/DEV HFA AER AD SOLUTION SYRUP TAB ER 12H TABLET VIAL-NEB BLST W/DEV HFA AER AD AMPUL-NEB PA Step X QLL Age X X X X X X X X X X X X X X X X X X X X X General Therapeutic Category AUTONOMIC NERVOUS SYSTEM DISORDERS Brand Name CAFFEINE CITRATE COMBIVENT RESPIMAT CROMOLYN SODIUM DULERA ELIXOPHYLLIN FLOVENT DISKUS FLOVENT HFA INCRUSE ELLIPTA IPRATROPIUM BROMIDE IPRATROPIUM-ALBUTEROL LEVALBUTEROL CONCENTRATE LEVALBUTEROL HCL METAPROTERENOL SULFATE MONTELUKAST SODIUM Generic Name CAFFEINE CITRATED IPRATROPIUM/ALBUTEROL SULFATE CROMOLYN SODIUM MOMETASONE/FORMOTEROL THEOPHYLLINE ANHYDROUS FLUTICASONE PROPIONATE FLUTICASONE PROPIONATE UMECLIDINIUM BROMIDE IPRATROPIUM BROMIDE IPRATROPIUM/ALBUTEROL SULFATE LEVALBUTEROL HCL LEVALBUTEROL HCL METAPROTERENOL SULFATE MONTELUKAST SODIUM PULMICORT FLEXHALER QVAR SEREVENT DISKUS SPIRIVA SPIRIVA RESPIMAT SYMBICORT TERBUTALINE SULFATE THEO-24 THEOCHRON THEOPHYLLINE BUDESONIDE BECLOMETHASONE DIPROPIONATE SALMETEROL XINAFOATE TIOTROPIUM BROMIDE TIOTROPIUM BROMIDE BUDESONIDE/FORMOTEROL FUMARATE TERBUTALINE SULFATE THEOPHYLLINE ANHYDROUS THEOPHYLLINE ANHYDROUS THEOPHYLLINE ANHYDROUS THEOPHYLLINE ANHYDROUS TUDORZA PRESSAIR VENTOLIN HFA XOLAIR XOPENEX HFA LUFYLLIN AMINOPHYLLINE COMBIVENT COPD DIFIL-G 400 MAXAIR AUTOHALER DILEX-G 200 DYPHYLLINE GG THEOPHYLLINE ANHYDROUS ACLIDINIUM BROMIDE ALBUTEROL SULFATE OMALIZUMAB LEVALBUTEROL TARTRATE DYPHYLLINE AMINOPHYLLINE IPRATROPIUM/ALBUTEROL SULFATE GUAIFENESIN/DYPHYLLINE GUAIFENESIN/DYPHYLLINE PIRBUTEROL ACETATE GUAIFENESIN/DYPHYLLINE GUAIFENESIN/DYPHYLLINE DY-G LIQUID JAY-PHYL NUCALA SEEBRI NEOHALER UTIBRON NEOHALER DONEPEZIL HCL DONEPEZIL HCL ODT GUAIFENESIN/DYPHYLLINE GUAIFENESIN/DYPHYLLINE MEPOLIZUMAB GLYCOPYRROLATE INDACATEROL/GLYCOPYRROLATE DONEPEZIL HCL DONEPEZIL HCL Dose SOLUTION MIST INHAL AMPUL-NEB HFA AER AD ELIXIR BLST W/DEV AER W/ADAP BLST W/DEV SOLUTION AMPUL-NEB VIAL-NEB VIAL-NEB SYRUP GRAN PACK TAB CHEW TABLET AER POW BA AER W/ADAP BLST W/DEV CAP W/DEV MIST INHAL HFA AER AD TABLET CAP ER 24H TAB ER 12H SOLUTION TABLET ER TAB ER 12H AER POW BA HFA AER AD VIAL HFA AER AD TABLET TABLET AER W/ADAP TABLET TABLET AER BR.ACT SYRUP ELIXIR TABLET LIQUID SYRUP VIAL CAP W/DEV CAP W/DEV TABLET TAB RAPDIS PA Step QLL X X X X X X X X X X X X X X X X X X X X X X X X X Age General Therapeutic Category BEHAVIORAL HEALTH - OTHER Brand Name Generic Name GALANTAMINE HBR GALANTAMINE HBR GALANTAMINE HYDROBROMIDE PYRIDOSTIGMINE BROMIDE PYRIDOSTIGMINE BROMIDE ER RIVASTIGMINE MYTELASE EXELON PROSTIGMIN MEMANTINE HCL ALKA-SELTZER PLUS ALLERGY COMPOZ DEXMETHYLPHENIDATE HCL DEXTROAMPHETAMINE SULFATE GALANTAMINE HBR PYRIDOSTIGMINE BROMIDE PYRIDOSTIGMINE BROMIDE RIVASTIGMINE RIVASTIGMINE TARTRATE AMBENONIUM CHLORIDE RIVASTIGMINE TARTRATE NEOSTIGMINE BROMIDE MEMANTINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DEXMETHYLPHENIDATE HCL DEXTROAMPHETAMINE SULFATE DEXTROAMPHETAMINE SULFATE ER DEXTROAMPHETAMINE-AMPHET ER DIPHENHYDRAMINE HCL DISULFIRAM EZ NITE SLEEP MELATIN MELATONIN DEXTROAMPHETAMINE SULFATE DEXTROAMPHETAMINE/AMPHETAMINE DIPHENHYDRAMINE HCL DISULFIRAM DIPHENHYDRAMINE HCL MELATONIN MELATONIN METADATE ER METHYLPHENIDATE ER MELATONIN/CHAMOMILE FLOWER MELATONIN/PYRIDOXINE HCL (B6) METHYLPHENIDATE HCL METHYLPHENIDATE HCL METHYLPHENIDATE HCL METHYLPHENIDATE HCL METHYLPHENIDATE HCL CD METHYLPHENIDATE LA NALOXONE HCL METHYLPHENIDATE HCL METHYLPHENIDATE HCL NALOXONE HCL NIGHTTIME SLEEP AID DIPHENHYDRAMINE HCL NIGHTTIME SLEEP GEL NYTOL QUICKCAPS NYT-TIME SLEEP ORMIR PHENOBARBITAL QUILLIVANT XR REST SIMPLY RESTFULLY SLEEP RITALIN LA DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL PHENOBARBITAL METHYLPHENIDATE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL METHYLPHENIDATE HCL Dose CAP24H PEL TABLET SOLUTION TABLET TABLET ER PATCH TD24 CAPSULE TABLET SOLUTION TABLET SOLUTION TABLET TABLET TABLET SOLUTION TABLET CAPSULE ER CAP ER 24H TABLET TABLET CAPSULE TABLET TAB RAPDIS TABLET TABLET TABLET TABLET ER CPBP 50-50 TAB ER 24 TABLET ER SOLUTION TAB CHEW TABLET CPBP 30-70 CPBP 50-50 SYRINGE VIAL CAPSULE TABLET CAPSULE TABLET TABLET CAPSULE TABLET SU ER RC24 TABLET TABLET CPBP 50-50 PA X X X Step QLL Age X X X X X X X X X X X X X X X X X X X General Therapeutic Category CARDIOVASCULAR DISEASE - ARRHYTHMIA CARDIOVASCULAR DISEASE - CARDIAC STIMULANT Brand Name SIMPLY SLEEP SLEEP AID Generic Name DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL SLEEP II SLEEP TABLET SLEEP TABS SLEEP-AID SLEEPGELS SLEEPING TEMAZEPAM UNISOM VIVITROL VYVANSE WAL-SLEEP Z DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL TEMAZEPAM DIPHENHYDRAMINE HCL NALTREXONE MICROSPHERES LISDEXAMFETAMINE DIMESYLATE DIPHENHYDRAMINE HCL WAL-SOM DIPHENHYDRAMINE HCL XYREM ZALEPLON ZOLPIDEM ZOLPIDEM TARTRATE ZOLPIDEM TARTRATE ER Z-SLEEP SOMINEX SOMINEX MAX STRENGTH DEXTROAMPHETAMINE-AMPHETAMINE SLEEP-EZE 3 METHYLPHENIDATE SR NYTOL QUILLICHEW ER NARCAN AMIODARONE HCL DISOPYRAMIDE PHOSPHATE FLECAINIDE ACETATE MEXILETINE HCL NORPACE CR PACERONE PROPAFENONE HCL PROPAFENONE HCL ER QUINIDINE GLUCONATE QUINIDINE SULFATE SODIUM OXYBATE ZALEPLON ZOLPIDEM TARTRATE ZOLPIDEM TARTRATE ZOLPIDEM TARTRATE DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DIPHENHYDRAMINE HCL DEXTROAMPHETAMINE/AMPHETAMINE DIPHENHYDRAMINE HCL METHYLPHENIDATE HCL DIPHENHYDRAMINE HCL METHYLPHENIDATE HCL NALOXONE HCL AMIODARONE HCL DISOPYRAMIDE PHOSPHATE FLECAINIDE ACETATE MEXILETINE HCL DISOPYRAMIDE PHOSPHATE AMIODARONE HCL PROPAFENONE HCL PROPAFENONE HCL QUINIDINE GLUCONATE QUINIDINE SULFATE DOFETILIDE DIGITEK DIGOX DIGOXIN DOFETILIDE DIGOXIN DIGOXIN DIGOXIN LANOXIN DIGOXIN Dose TABLET CAPSULE TABLET TABLET TABLET TABLET CAPSULE CAPSULE CAPSULE CAPSULE CAPSULE SUS ER REC CAPSULE CAPSULE TAB RAPDIS CAPSULE TAB RAPDIS SOLUTION CAPSULE TABLET TABLET TAB MPHASE CAPSULE TABLET TABLET TABLET TABLET TABLET ER TABLET TAB CBP24H SPRAY TABLET CAPSULE TABLET CAPSULE CAPSULE ER TABLET TABLET CAP ER 12H TABLET ER TABLET TABLET ER CAPSULE TABLET TABLET SOLUTION TABLET TABLET PA Step X X QLL Age X X X X X X X X X X X General Therapeutic Category CARDIOVASCULAR DISEASE - HYPERTENSION Brand Name ACEBUTOLOL HCL AFEDITAB CR AMILORIDE HCL AMILORIDE-HYDROCHLOROTHIAZIDE AMLODIPINE BESYLATE AMLODIPINE BESYLATE-BENAZEPRIL ATENOLOL ATENOLOL-CHLORTHALIDONE BENAZEPRIL HCL BENAZEPRIL-HYDROCHLOROTHIAZIDE BETAXOLOL HCL BISOPROLOL FUMARATE BISOPROLOL-HYDROCHLOROTHIAZIDE BUMETANIDE BYSTOLIC CANDESARTAN CILEXETIL CANDESARTAN-HYDROCHLOROTHIAZID CAPTOPRIL CAPTOPRIL-HYDROCHLOROTHIAZIDE CARDENE SR CARDURA XL CARTIA XT CARVEDILOL CHLOROTHIAZIDE CHLORTHALIDONE CLONIDINE CLONIDINE HCL CLORPRES DEMSER DILTIAZEM 12HR ER DILTIAZEM 24HR CD DILTIAZEM 24HR ER DILTIAZEM ER Generic Name ACEBUTOLOL HCL NIFEDIPINE AMILORIDE HCL AMILORIDE/HYDROCHLOROTHIAZIDE AMLODIPINE BESYLATE AMLODIPINE BESYLATE/BENAZEPRIL ATENOLOL ATENOLOL/CHLORTHALIDONE BENAZEPRIL HCL BENAZEPRIL/HYDROCHLOROTHIAZIDE BETAXOLOL HCL BISOPROLOL FUMARATE BISOPROLOL FUMARATE/HCTZ BUMETANIDE NEBIVOLOL HCL CANDESARTAN CILEXETIL CANDESARTAN/HYDROCHLOROTHIAZID CAPTOPRIL CAPTOPRIL/HYDROCHLOROTHIAZIDE NICARDIPINE HCL DOXAZOSIN MESYLATE DILTIAZEM HCL CARVEDILOL CHLOROTHIAZIDE CHLORTHALIDONE CLONIDINE CLONIDINE HCL CLONIDINE HCL/CHLORTHALIDONE METYROSINE DILTIAZEM HCL DILTIAZEM HCL DILTIAZEM HCL DILTIAZEM HCL DILTIAZEM HCL DILT-XR DIURIL DOXAZOSIN MESYLATE DYRENIUM EDECRIN ENALAPRIL MALEATE ENALAPRIL-HYDROCHLOROTHIAZIDE EPLERENONE EPROSARTAN MESYLATE FELODIPINE ER FOSINOPRIL SODIUM FOSINOPRIL-HYDROCHLOROTHIAZIDE DILTIAZEM HCL DILTIAZEM HCL CHLOROTHIAZIDE DOXAZOSIN MESYLATE TRIAMTERENE ETHACRYNIC ACID ENALAPRIL MALEATE ENALAPRIL/HYDROCHLOROTHIAZIDE EPLERENONE EPROSARTAN MESYLATE FELODIPINE FOSINOPRIL SODIUM FOSINOPRIL/HYDROCHLOROTHIAZIDE Dose CAPSULE TABLET ER TABLET TABLET TABLET CAPSULE TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET CAPSULE ER TAB ER 24 CAP ER 24H TABLET TABLET TABLET PATCH TDWK TABLET TABLET CAPSULE CAP ER 12H CAP ER 24H CAP ER 24H CAP ER DEG CAPSULE ER TAB ER 24H TABLET CAP ER DEG ORAL SUSP TABLET CAPSULE TABLET TABLET TABLET TABLET TABLET TAB ER 24H TABLET TABLET PA Step QLL X X X X X X Age General Therapeutic Category Brand Name Generic Name FUROSEMIDE FUROSEMIDE GUANFACINE HCL HYDRALAZINE HCL HYDROCHLOROTHIAZIDE GUANFACINE HCL HYDRALAZINE HCL HYDROCHLOROTHIAZIDE INDAPAMIDE INNOPRAN XL IRBESARTAN IRBESARTAN-HYDROCHLOROTHIAZIDE ISRADIPINE LABETALOL HCL LETAIRIS LEVATOL LISINOPRIL LISINOPRIL-HYDROCHLOROTHIAZIDE LOSARTAN POTASSIUM LOSARTAN-HYDROCHLOROTHIAZIDE MATZIM LA METHYCLOTHIAZIDE METHYLDOPA METHYLDOPA-HYDROCHLOROTHIAZIDE METOLAZONE METOPROLOL SUCCINATE METOPROLOL TARTRATE METOPROLOL-HYDROCHLOROTHIAZIDE MINOXIDIL MOEXIPRIL HCL MOEXIPRIL-HYDROCHLOROTHIAZIDE NADOLOL NADOLOL-BENDROFLUMETHIAZIDE NICARDIPINE HCL NIFEDICAL XL NIFEDIPINE NIFEDIPINE ER INDAPAMIDE PROPRANOLOL HCL IRBESARTAN IRBESARTAN/HYDROCHLOROTHIAZIDE ISRADIPINE LABETALOL HCL AMBRISENTAN PENBUTOLOL SULFATE LISINOPRIL LISINOPRIL/HYDROCHLOROTHIAZIDE LOSARTAN POTASSIUM LOSARTAN/HYDROCHLOROTHIAZIDE DILTIAZEM HCL METHYCLOTHIAZIDE METHYLDOPA METHYLDOPA/HYDROCHLOROTHIAZIDE METOLAZONE METOPROLOL SUCCINATE METOPROLOL TARTRATE METOPROLOL/HYDROCHLOROTHIAZIDE MINOXIDIL MOEXIPRIL HCL MOEXIPRIL/HYDROCHLOROTHIAZIDE NADOLOL NADOLOL/BENDROFLUMETHIAZIDE NICARDIPINE HCL NIFEDIPINE NIFEDIPINE NIFEDIPINE NIMODIPINE NISOLDIPINE OPSUMIT ORENITRAM ER PINDOLOL PRAZOSIN HCL PROPRANOLOL HCL NIMODIPINE NISOLDIPINE MACITENTAN TREPROSTINIL DIOLAMINE PINDOLOL PRAZOSIN HCL PROPRANOLOL HCL PROPRANOLOL HCL ER PROPRANOLOL-HYDROCHLOROTHIAZID QUINAPRIL HCL QUINAPRIL-HYDROCHLOROTHIAZIDE PROPRANOLOL HCL PROPRANOLOL/HYDROCHLOROTHIAZID QUINAPRIL HCL QUINAPRIL/HYDROCHLOROTHIAZIDE Dose SOLUTION TABLET TABLET TABLET CAPSULE TABLET TABLET CAP ER 24H TABLET TABLET CAPSULE TABLET TABLET TABLET TABLET TABLET TABLET TABLET TAB ER 24H TABLET TABLET TABLET TABLET TAB ER 24H TABLET TABLET TABLET TABLET TABLET TABLET TABLET CAPSULE TAB ER 24 CAPSULE TAB ER 24 TABLET ER CAPSULE TAB ER 24H TABLET TABLET ER TABLET CAPSULE SOLUTION TABLET CAP SA 24H TABLET TABLET TABLET PA Step QLL X X X Age General Therapeutic Category CARDIOVASCULAR DISEASE - LIPID IRREGULARITY Brand Name RAMIPRIL REMODULIN RESERPINE SORINE SOTALOL SOTALOL AF SPIRONOLACTONE SPIRONOLACTONE-HCTZ TAZTIA XT TERAZOSIN HCL TIMOLOL MALEATE TORSEMIDE TRACLEER TRANDOLAPRIL TRANDOLAPRIL-VERAPAMIL ER TRIAMTERENE-HYDROCHLOROTHIAZID Generic Name RAMIPRIL TREPROSTINIL SODIUM RESERPINE SOTALOL HCL SOTALOL HCL SOTALOL HCL SPIRONOLACTONE SPIRONOLACT/HYDROCHLOROTHIAZID DILTIAZEM HCL TERAZOSIN HCL TIMOLOL MALEATE TORSEMIDE BOSENTAN TRANDOLAPRIL TRANDOLAPRIL/VERAPAMIL HCL TRIAMTERENE/HYDROCHLOROTHIAZID VALSARTAN VALSARTAN-HYDROCHLOROTHIAZIDE VENTAVIS VERAPAMIL ER VALSARTAN VALSARTAN/HYDROCHLOROTHIAZIDE ILOPROST TROMETHAMINE VERAPAMIL HCL VERAPAMIL ER PM VERAPAMIL HCL VERAPAMIL HCL VERAPAMIL HCL VERAPAMIL SR COVERA-HS NIFEDIAC CC GUANABENZ ACETATE DYNACIRC CR DILT-CD DILTZAC ER THALITONE DILTIA XT ALGAL OMEGA-3 DHA ATORVASTATIN CALCIUM CHOLESTYRAMINE VERAPAMIL HCL VERAPAMIL HCL NIFEDIPINE GUANABENZ ACETATE ISRADIPINE DILTIAZEM HCL DILTIAZEM HCL CHLORTHALIDONE DILTIAZEM HCL DOCOSAHEXANOIC ACID ATORVASTATIN CALCIUM CHOLESTYRAMINE (WITH SUGAR) CHOLESTYRAMINE LIGHT CHOLESTYRAMINE/ASPARTAME COLESTIPOL HCL COLESTIPOL HCL ENDUR-ACIN FENOFIBRATE NIACIN FENOFIBRATE FENOFIBRATE NANOCRYSTALLIZED FENOFIBRATE,MICRONIZED Dose CAPSULE VIAL TABLET TABLET TABLET TABLET TABLET TABLET CAPSULE ER CAPSULE TABLET TABLET TABLET TABLET TAB BP 24H CAPSULE TABLET TABLET TABLET AMPUL-NEB CAP24H PEL TABLET ER CAP24H PCT CAP24H PEL TABLET CAP24H PEL TAB ER 24 TABLET ER TABLET TAB ER 24 CAP ER 24H CAPSULE ER TABLET CAP ER DEG CAPSULE TABLET POWD PACK POWDER POWD PACK POWDER GRANULES PACKET TABLET TABLET ER CAPSULE TABLET TABLET CAPSULE PA X X Step QLL Age General Therapeutic Category Brand Name FENOFIBRIC ACID FISH OIL FISH OIL OMEGA-3 GEMFIBROZIL KYNAMRO LOVASTATIN MAXEPA NIACIN NIACOR PRAVASTATIN SODIUM PRENATAL DHA PREVALITE OMEGA-3 FATTY ACIDS/FISH OIL OMEGA-3/DHA/EPA/FISH OIL SALMON OIL/OMEGA-3 FATTY ACIDS OMEGA-3 FATTY ACIDS OMEGA-3 FATTY ACIDS/FISH OIL OMEGA-3 FATTY ACIDS/FISH OIL GEMFIBROZIL MIPOMERSEN SODIUM LOVASTATIN OMEGA-3 FATTY ACIDS NIACIN NIACIN PRAVASTATIN SODIUM DOCOSAHEXANOIC ACID CHOLESTYRAMINE/ASPARTAME SALMON OIL-1000 SEA-OMEGA 30 SEA-OMEGA 50 SIMVASTATIN DHA COMPLETE FISH OIL ULTRA DHA PRENATAL OMEGA 3 PRALUENT PEN PRALUENT SYRINGE REPATHA SYRINGE REPATHA SURECLICK JUVISYNC ENTRESTO ISORDIL ISOSORBIDE DINITRATE SALMON OIL/OMEGA-3 FATTY ACIDS OMEGA-3 FATTY ACIDS/FISH OIL OMEGA-3/DHA/EPA/FISH OIL SIMVASTATIN DOCOSAHEXANOIC ACID OMEGA-3/DHA/EPA/FISH OIL DOCOSAHEXANOIC ACID OMEGA-3/DHA/EPA/FISH OIL ALIROCUMAB ALIROCUMAB EVOLOCUMAB EVOLOCUMAB SITAGLIPTIN/SIMVASTATIN SACUBITRIL/VALSARTAN ISOSORBIDE DINITRATE ISOSORBIDE DINITRATE ISOSORBIDE MONONITRATE ISOSORBIDE MONONITRATE ER MINITRAN NITRO-BID NITROGLYCERIN NITROGLYCERIN PATCH NITROSTAT AMYL NITRITE ISODITRATE ALTAVERA ALYACEN ISOSORBIDE MONONITRATE ISOSORBIDE MONONITRATE NITROGLYCERIN NITROGLYCERIN NITROGLYCERIN NITROGLYCERIN NITROGLYCERIN AMYL NITRITE ISOSORBIDE DINITRATE LEVONORGESTREL-ETHIN ESTRADIOL NORETHINDRONE-ETHINYL ESTRAD FISH OIL CONCENTRATE CARDIOVASCULAR DISEASE - MISCELLANEOUS AGENTS CARDIOVASCULAR DISEASE - VASODILATION CONTRACEPTION/OXYTOCICS Generic Name FENOFIBRIC ACID OMEGA-3 FATTY ACIDS Dose TABLET CAPSULE CAPSULE DR CAPSULE CAPSULE CAPSULE CAPSULE CAPSULE CAPSULE TABLET SYRINGE TABLET CAPSULE TABLET ER TABLET TABLET CAPSULE POWD PACK POWDER CAPSULE CAPSULE CAPSULE TABLET CAPSULE CAPSULE CAPSULE CAPSULE PEN INJCTR SYRINGE SYRINGE PEN INJCTR TABLET TABLET TABLET TAB SUBL TABLET TABLET ER TABLET TAB ER 24H PATCH TD24 OINT. (G) CAPSULE ER PATCH TD24 TAB SUBL AMPUL TABLET ER TABLET TABLET PA Step QLL X X X X X X X Age General Therapeutic Category Brand Name AMETHIA AMETHIA LO APRI ARANELLE ASHLYNA AUBRA AVIANE AZURETTE BALZIVA BREVICON BRIELLYN CAMILA CAMRESE CAMRESE LO CAYA CONTOURED CAZIANT CHATEAL CRYSELLE CYCLAFEM CYRED DASETTA DAYSEE DEBLITANE DELYLA DEPO-SUBQ PROVERA 104 DESOGESTREL-ETHINYL ESTRADIOL DESOGESTR-ETH ESTRAD ETH ESTRA DROSPIRENONE-ETHINYL ESTRADIOL ECONTRA EZ ELINEST ELLA EMOQUETTE ENPRESSE ENSKYCE ERRIN ESTARYLLA FALLBACK SOLO FALMINA FEMCAP GIANVI GILDAGIA GILDESS GILDESS 24 FE GILDESS FE HEATHER INTROVALE JENCYCLA JOLESSA Generic Name L-NORGEST/E.ESTRADIOL-E.ESTRAD L-NORGEST/E.ESTRADIOL-E.ESTRAD DESOGESTREL-ETHINYL ESTRADIOL NORETHINDRONE-ETHINYL ESTRAD L-NORGEST/E.ESTRADIOL-E.ESTRAD LEVONORGESTREL-ETHIN ESTRADIOL LEVONORGESTREL-ETHIN ESTRADIOL DESOG-E.ESTRADIOL/E.ESTRADIOL NORETHINDRONE-ETHINYL ESTRAD NORETHINDRONE-ETHINYL ESTRAD NORETHINDRONE-ETHINYL ESTRAD NORETHINDRONE L-NORGEST/E.ESTRADIOL-E.ESTRAD L-NORGEST/E.ESTRADIOL-E.ESTRAD DIAPHRAGMS, CONTOURED DESOGESTREL-ETHINYL ESTRADIOL LEVONORGESTREL-ETHIN ESTRADIOL NORGESTREL-ETHINYL ESTRADIOL NORETHINDRONE-ETHINYL ESTRAD DESOGESTREL-ETHINYL ESTRADIOL NORETHINDRONE-ETHINYL ESTRAD L-NORGEST/E.ESTRADIOL-E.ESTRAD NORETHINDRONE LEVONORGESTREL-ETHIN ESTRADIOL MEDROXYPROGESTERONE ACETATE DESOGESTREL-ETHINYL ESTRADIOL DESOG-E.ESTRADIOL/E.ESTRADIOL ETHINYL ESTRADIOL/DROSPIRENONE LEVONORGESTREL NORGESTREL-ETHINYL ESTRADIOL ULIPRISTAL ACETATE DESOGESTREL-ETHINYL ESTRADIOL LEVONORGESTREL-ETHIN ESTRADIOL DESOGESTREL-ETHINYL ESTRADIOL NORETHINDRONE NORGESTIMATE-ETHINYL ESTRADIOL LEVONORGESTREL LEVONORGESTREL-ETHIN ESTRADIOL CERVICAL CAP ETHINYL ESTRADIOL/DROSPIRENONE NORETHINDRONE-ETHINYL ESTRAD NORETHINDRONE AC-ETH ESTRADIOL NORETHINDRONE-E.ESTRADIOL-IRON NORETHINDRONE-E.ESTRADIOL-IRON NORETHINDRONE LEVONORGESTREL-ETHIN ESTRADIOL NORETHINDRONE LEVONORGESTREL-ETHIN ESTRADIOL Dose TBDSPK 3MO TBDSPK 3MO TABLET TABLET TBDSPK 3MO TABLET TABLET TABLET TABLET TABLET TABLET TABLET TBDSPK 3MO TBDSPK 3MO DIAPHRAGM TABLET TABLET TABLET TABLET TABLET TABLET TBDSPK 3MO TABLET TABLET SYRINGE TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET EACH TABLET TABLET TABLET TABLET TABLET TABLET TBDSPK 3MO TABLET TBDSPK 3MO PA Step QLL X X X Age General Therapeutic Category Brand Name JOLIVETTE JUNEL JUNEL FE JUNEL FE 24 KARIVA KELNOR 1-35 KIMIDESS KURVELO LARIN LARIN 24 FE LARIN FE LEENA LESSINA LEVONEST LEVONORGESTREL LEVONORGESTREL-ETH ESTRADIOL Generic Name NORETHINDRONE NORETHINDRONE AC-ETH ESTRADIOL NORETHINDRONE-E.ESTRADIOL-IRON NORETHINDRONE-E.ESTRADIOL-IRON DESOG-E.ESTRADIOL/E.ESTRADIOL ETHYNODIOL D-ETHINYL ESTRADIOL DESOG-E.ESTRADIOL/E.ESTRADIOL LEVONORGESTREL-ETHIN ESTRADIOL NORETHINDRONE AC-ETH ESTRADIOL NORETHINDRONE-E.ESTRADIOL-IRON NORETHINDRONE-E.ESTRADIOL-IRON NORETHINDRONE-ETHINYL ESTRAD LEVONORGESTREL-ETHIN ESTRADIOL LEVONORGESTREL-ETHIN ESTRADIOL LEVONORGESTREL LEVONORGESTREL-ETHIN ESTRADIOL LEVONORG-ETH ESTRAD ETH ESTRAD LEVORA-28 LOMEDIA 24 FE LORYNA LOW-OGESTREL LUTERA LYZA MARLISSA MEDROXYPROGESTERONE ACETATE L-NORGEST/E.ESTRADIOL-E.ESTRAD LEVONORGESTREL-ETHIN ESTRADIOL NORETHINDRONE-E.ESTRADIOL-IRON ETHINYL ESTRADIOL/DROSPIRENONE NORGESTREL-ETHINYL ESTRADIOL LEVONORGESTREL-ETHIN ESTRADIOL NORETHINDRONE LEVONORGESTREL-ETHIN ESTRADIOL MEDROXYPROGESTERONE ACETATE MICROGESTIN MICROGESTIN FE MONO-LINYAH MONONESSA MY WAY MYZILRA NECON NORETHINDRONE AC-ETH ESTRADIOL NORETHINDRONE-E.ESTRADIOL-IRON NORGESTIMATE-ETHINYL ESTRADIOL NORGESTIMATE-ETHINYL ESTRADIOL LEVONORGESTREL LEVONORGESTREL-ETHIN ESTRADIOL NORETHINDRONE-ETHINYL ESTRAD NORETHINDRONE-MESTRANOL ETONOGESTREL LEVONORGESTREL ETHINYL ESTRADIOL/DROSPIRENONE NORETHINDRONE NORETHINDRONE NORETHINDRONE AC-ETH ESTRADIOL NORGESTIMATE-ETHINYL ESTRADIOL NORETHINDRONE-ETHINYL ESTRAD NORETHINDRONE NORETHINDRONE-ETHINYL ESTRAD ETONOGESTREL/ETHINYL ESTRADIOL ETHINYL ESTRADIOL/DROSPIRENONE NORGESTREL-ETHINYL ESTRADIOL NEXPLANON NEXT CHOICE ONE DOSE NIKKI NORA-BE NORETHINDRONE NORETHINDRON-ETHINYL ESTRADIOL NORGESTIMATE-ETHINYL ESTRADIOL NORINYL 1+35 NORLYROC NORTREL NUVARING OCELLA OGESTREL Dose TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TBDSPK 3MO TBDSPK 3MO TABLET TABLET TABLET TABLET TABLET TABLET TABLET SYRINGE VIAL TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET IMPLANT TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET VAG RING TABLET TABLET PA Step QLL X X X X X Age General Therapeutic Category Brand Name OPCICON ONE-STEP ORSYTHIA PHILITH PIMTREA PIRMELLA PORTIA PREVIFEM QUASENSE RECLIPSEN SHAROBEL SPRINTEC SRONYX SYEDA TARINA FE TILIA FE TRI-ESTARYLLA TRI-LEGEST FE TRI-LINYAH TRINESSA TRI-PREVIFEM TRI-SPRINTEC TRIVORA-28 VELIVET VESTURA VIORELE VYFEMLA WERA WIDE SEAL DIAPHRAGM XULANE ZARAH ZENCHENT ZOVIA 1-35E ZOVIA 1-50E ORTHO ALL-FLEX SETLAKIN JULEBER NORGESTREL-ETHINY ESTRA NEXT CHOICE SOLIA IMPLANON TRI-LO-SPRINTEC TRI-LO-ESTARYLLA VIENVA TRINESSA LO TRI-LO-MARZIA BLISOVI 24 FE BLISOVI FE Generic Name LEVONORGESTREL LEVONORGESTREL-ETHIN ESTRADIOL NORETHINDRONE-ETHINYL ESTRAD DESOG-E.ESTRADIOL/E.ESTRADIOL NORETHINDRONE-ETHINYL ESTRAD LEVONORGESTREL-ETHIN ESTRADIOL NORGESTIMATE-ETHINYL ESTRADIOL LEVONORGESTREL-ETHIN ESTRADIOL DESOGESTREL-ETHINYL ESTRADIOL NORETHINDRONE NORGESTIMATE-ETHINYL ESTRADIOL LEVONORGESTREL-ETHIN ESTRADIOL ETHINYL ESTRADIOL/DROSPIRENONE NORETHINDRONE-E.ESTRADIOL-IRON NORETHINDRONE-E.ESTRADIOL-IRON NORGESTIMATE-ETHINYL ESTRADIOL NORETHINDRONE-E.ESTRADIOL-IRON NORGESTIMATE-ETHINYL ESTRADIOL NORGESTIMATE-ETHINYL ESTRADIOL NORGESTIMATE-ETHINYL ESTRADIOL NORGESTIMATE-ETHINYL ESTRADIOL LEVONORGESTREL-ETHIN ESTRADIOL DESOGESTREL-ETHINYL ESTRADIOL ETHINYL ESTRADIOL/DROSPIRENONE DESOG-E.ESTRADIOL/E.ESTRADIOL NORETHINDRONE-ETHINYL ESTRAD NORETHINDRONE-ETHINYL ESTRAD DIAPHRAGMS, WIDE SEAL NORELGESTROMIN/ETHIN.ESTRADIOL ETHINYL ESTRADIOL/DROSPIRENONE NORETHINDRONE-ETHINYL ESTRAD ETHYNODIOL D-ETHINYL ESTRADIOL ETHYNODIOL D-ETHINYL ESTRADIOL DIAPHRAGMS, ARC-SPRING DIAPHRAGM FITTING SET,ARCSPRNG LEVONORGESTREL-ETHIN ESTRADIOL DESOGESTREL-ETHINYL ESTRADIOL NORGESTREL-ETHINYL ESTRADIOL LEVONORGESTREL DESOGESTREL-ETHINYL ESTRADIOL ETONOGESTREL NORGESTIMATE-ETHINYL ESTRADIOL NORGESTIMATE-ETHINYL ESTRADIOL LEVONORGESTREL-ETHIN ESTRADIOL NORGESTIMATE-ETHINYL ESTRADIOL NORGESTIMATE-ETHINYL ESTRADIOL NORETHINDRONE-E.ESTRADIOL-IRON NORETHINDRONE-E.ESTRADIOL-IRON Dose TABLET TABLET TABLET TABLET TABLET TABLET TABLET TBDSPK 3MO TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET DIAPHRAGM PATCH TDWK TABLET TABLET TABLET TABLET KIT EACH TBDSPK 3MO TABLET TABLET TABLET TABLET IMPLANT TABLET TABLET TABLET TABLET TABLET TABLET TABLET PA X Step QLL Age General Therapeutic Category COUGH AND COLD Brand Name BEKYREE NORETHIN-ETH ESTRA-FERROUS FUM REACT 12 HOUR COLD RELIEF 12 HOUR DECONGESTANT ACETADRYL ACETAMINOPHEN PM ACETAMINOPHEN PM XTRA STRENGTH ACETAMINOPHEN-DIPHENHYDRAMINE ADULT ROBITUSSIN PEAK COLD ADULT TUSSIN DM ADULT WAL-TUSSIN DM ANTITUSSIVE DM BENZONATATE COUGH COUGH CONTROL DM Generic Name DESOG-E.ESTRADIOL/E.ESTRADIOL NORETHINDRONE-E.ESTRADIOL-IRON LEVONORGESTREL PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN BENZONATATE GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN COUGH SYRUP DM EXPECTORANT DM EXTRA ACTION COUGH GERI-TUSSIN DM GUAIFENESIN-DEXTROMETHORPHAN HEADACHE PM HEADACHE PM FORMULA LONG ACTING NASAL DECONGESTANT MAPAP PM MEDI-PHEDRINE GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE PSEUDOEPHEDRINE HCL ACETAMINOPHEN/DIPHENHYDRAMINE PSEUDOEPHEDRINE HCL MEDI-TABS MEDI-TABS PM MEDI-TUSSIN DM NASAL & SINUS DECONGESTANT NASAL DECON (PSEUDOEPHEDRINE) NASAL DECONGESTANT ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE GUAIFENESIN/DEXTROMETHORPHAN PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL NIGHT TIME PAIN MEDICINE NON-ASPIRIN PM NON-ASPIRIN PM EX-STRENGTH NON-ASPIRIN SLEEP AID PAIN & SLEEP PAIN RELIEF PM PAIN RELIEVER PM PSEUDOEPHEDRINE ER PSEUDOEPHEDRINE HCL ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE ACETAMINOPHEN/DIPHENHYDRAMINE PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL Q-TUSSIN DM RI-TUSSIN DM ROBAFEN-DM GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN Dose TABLET TABLET TABLET TABLET ER TABLET ER TABLET TABLET TABLET TABLET LIQUID SYRUP SYRUP SYRUP CAPSULE SYRUP LIQUID SYRUP SYRUP SYRUP SYRUP SYRUP SYRUP TABLET TABLET TABLET ER TABLET TABLET TABLET ER TABLET TABLET SYRUP TABLET LIQUID TABLET TABLET ER TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET ER LIQUID TABLET SYRUP SYRUP SYRUP PA Step QLL Age General Therapeutic Category Brand Name SILTUSSIN DM SINUS & ALLERGY SINUS 12-HOUR SUDAFED 12-HOUR SUDOGEST Generic Name GUAIFENESIN/DEXTROMETHORPHAN PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL SUPHEDRIN PSEUDOEPHEDRINE HCL SUPHEDRIN 12-HOUR SUPHEDRINE SUPHEDRINE 12-HOUR SUPHEDRINE SINUS CONGESTION TUSSIN DM PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL GUAIFENESIN/DEXTROMETHORPHAN TUSSIN DM CLEAR GUAIFENESIN/DEXTROMETHORPHAN TUSSIN DM COUGH TUSSIN DM COUGH & CHEST TUSSIN DM COUGH-CHEST CONGEST GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN ULTRA TUSS WAL-NADOL PM WAL-PHED WAL-PHED 12 HOUR WAL-TUSSIN DM ZEPHREX-D WAL-PHED D SUDAFED ROBAFEN-DM CLEAR EAZZZE THE PAIN SINUS 12 HOUR COUGH FORMULA DM TYLENOL PM EXTRA STRENGTH IOPHEN DM-NR ROBAFEN DM COUGH-CHEST CONGEST ROBAFEN DM COUGH BRONCOTRON ULTRA DM FREE & CLEAR TUSSIN COUGH NEO-TUSS CHERACOL D TUSSIN COUGH DM TUSSIN DM MAX TUSSIN COUGH-CHEST CONGESTION BIOCOTRON MEDI-TUSSIN DM DIABETIC G-TRON SORBUGEN NR GUAIFENESIN/DEXTROMETHORPHAN ACETAMINOPHEN/DIPHENHYDRAMINE PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL GUAIFENESIN/DEXTROMETHORPHAN PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL PSEUDOEPHEDRINE HCL GUAIFENESIN/DEXTROMETHORPHAN ACETAMINOPHEN/DIPHENHYDRAMINE PSEUDOEPHEDRINE HCL GUAIFENESIN/DEXTROMETHORPHAN ACETAMINOPHEN/DIPHENHYDRAMINE GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN Dose SYRUP TABLET ER TABLET ER TABLET ER TABLET TABLET ER LIQUID TABLET TABLET ER TABLET TABLET ER TABLET LIQUID SYRUP LIQUID SYRUP SYRUP SYRUP LIQUID SYRUP SYRUP TABLET TABLET TABLET ER SYRUP TABLET TABLET ER TABLET SYRUP TABLET TABLET ER SYRUP TABLET LIQUID SYRUP LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID PA Step QLL Age General Therapeutic Category DERMATOLOGY - ANTIINFECTIVE Brand Name ADULT TUSSIN COUGH CONGEST DM SAFETUSSIN DM GUAIFENESIN DM NR SILTUSSIN DM DAS COUGH FORMULA DIABETIC SILTUSSIN-DM TUSNEL DIABETIC GUAIASORB DM GANI-TUSS-DM NR DIABETIC TUSSIN DM ACYCLOVIR ALTABAX ANTIBIOTIC ANTIFUNGAL CREAM ANTI-FUNGAL CREAM ATHLETE'S FOOT CREAM BACITRACIN BACITRACIN ZINC BACITRAYCIN PLUS BAZA ANTIFUNGAL CICLOPIROX Generic Name GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN GUAIFENESIN/DEXTROMETHORPHAN ACYCLOVIR RETAPAMULIN BACITRACIN ZINC NEOMYCIN SU/BACITRAC ZN/POLY MICONAZOLE NITRATE TOLNAFTATE MICONAZOLE NITRATE TOLNAFTATE BACITRACIN BACITRACIN ZINC BACITRACIN MICONAZOLE NITRATE CICLOPIROX CICLOPIROX OLAMINE CLINDAMYCIN PHOSPHATE CICLOPIROX/VITE/NAIL LACQ REMO CLINDAMYCIN PHOSPHATE CLOTRIMAZOLE CLOTRIMAZOLE CLOTRIMAZOLE-BETAMETHASONE CLOTRIMAZOLE/BETAMETHASONE DIP ECONAZOLE NITRATE ERY ERYTHROMYCIN ECONAZOLE NITRATE ERYTHROMYCIN BASE/ETHANOL ERYTHROMYCIN BASE/ETHANOL EURAX EXODERM FUNGOID-D GENTAMICIN SULFATE CROTAMITON SODIUM THIOSULFATE/SAL ACID TOLNAFTATE GENTAMICIN SULFATE INZO ANTIFUNGAL KETOCONAZOLE MICONAZOLE NITRATE KETOCONAZOLE LICE CREAM RINSE PERMETHRIN Dose LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID OINT. (G) OINT. (G) OINT. (G) OINT. (G) CREAM (G) CREAM (G) CREAM (G) CREAM (G) OINT. (G) OINT. (G) OINT. (G) CREAM (G) GEL (GRAM) SOLUTION CREAM (G) SUSPENSION KIT GEL (GRAM) LOTION MED. SWAB SOLUTION CREAM (G) SOLUTION CREAM (G) LOTION CREAM (G) MED. SWAB GEL (GRAM) MED. SWAB SOLUTION CREAM (G) LOTION CREAM (G) CREAM (G) OINT. (G) CREAM (G) CREAM (G) SHAMPOO LIQUID PA Step QLL Age General Therapeutic Category DERMATOLOGY - ANTIINFLAMMATORY Brand Name Generic Name LICE KILLING LICE TREATMENT LINDANE PERMETHRIN PERMETHRIN LINDANE MALATHION MICATIN MICONAZOLE NITRATE MUPIROCIN NEOSPORIN NYAMYC NYSTATIN MALATHION MICONAZOLE NITRATE MICONAZOLE NITRATE MUPIROCIN MUPIROCIN CALCIUM NEOMYCIN SU/BACITRAC ZN/POLY NYSTATIN NYSTATIN NYSTATIN-TRIAMCINOLONE NYSTATIN/TRIAMCIN NYSTOP PERMETHRIN NYSTATIN PERMETHRIN REMEDY ANTIFUNGAL SECURA ANTIFUNGAL SILVER SULFADIAZINE SPINOSAD SSD TOLNAFTATE TRIPLE ANTIBIOTIC MICONAZOLE NITRATE MICONAZOLE NITRATE SILVER SULFADIAZINE SPINOSAD SILVER SULFADIAZINE TOLNAFTATE NEOMYCIN SU/BACITRAC ZN/POLY TRIPLE ANTIBIOTIC PLUS TRIPLE DYE VEREGEN LAMISIL AF DEFENSE MIRANEL AF CLINDA-DERM PEDI-DRI ATHLETE'S FOOT SSD AF MAFENIDE ACETATE FUNGI-GUARD MICADERM VERSICLEAR FIRST AID ANTIBIOTIC ALA-CORT ALA-SCALP ALCLOMETASONE DIPROPIONATE NEOMYCN/BACI ZN/PMYX BS/PRAMOX GENTIAN VIOL/BRLNT GRN/PROFLAV SINECATECHINS TOLNAFTATE MICONAZOLE NITRATE CLINDAMYCIN PHOSPHATE NYSTATIN TOLNAFTATE SILVER SULFADIAZINE MAFENIDE ACETATE TOLNAFTATE MICONAZOLE NITRATE SODIUM THIOSULFATE/SAL ACID NEOMYCIN SU/BACITRAC ZN/POLY HYDROCORTISONE HYDROCORTISONE ALCLOMETASONE DIPROPIONATE AMCINONIDE AMCINONIDE Dose LIQUID LIQUID LOTION SHAMPOO LOTION CREAM (G) CREAM (G) OINT. (G) CREAM (G) OINT. (G) POWDER CREAM (G) OINT. (G) POWDER CREAM (G) OINT. (G) POWDER CREAM (G) LIQUID CREAM(ML) CREAM (G) CREAM (G) SUSPENSION CREAM (G) CREAM (G) OINT PACK OINT. (G) OINT. (G) MED. SWAB OINT. (G) CREAM (G) CREAM (G) SOLUTION POWDER CREAM (G) CREAM (G) PACKET CREAM (G) CREAM (G) LOTION OINT. (G) CREAM (G) LOTION CREAM (G) OINT. (G) CREAM (G) LOTION OINT. (G) PA Step QLL X Age General Therapeutic Category Brand Name ANTI-ITCH BETAMETHASONE DIPROPIONATE Generic Name HYDROCORTISONE BETAMETHASONE DIPROPIONATE BETAMETHASONE/PROPYLENE GLYC BETAMETHASONE VALERATE BETAMETHASONE VALERATE CAPEX SHAMPOO CLOBETASOL EMOLLIENT FLUOCINOLONE ACETONIDE CLOBETASOL PROPIONATE/EMOLL CLOBETASOL PROPIONATE CLOBETASOL PROPIONATE CLOCORTOLONE PIVALATE CORDRAN CLOCORTOLONE PIVALATE FLURANDRENOLIDE CORMAX CLOBETASOL PROPIONATE CORTAID CORTISONE CORTISPORIN CORTIZONE-10 CORTIZONE-10 PLUS DESONATE DESONIDE HYDROCORTISONE HYDROCORTISONE NEOMYCIN/BACITRA/POLYMYXIN/HC NEOMYCIN/POLYMYXIN B SULF/HC HYDROCORTISONE HYDROCORTISONE DESONIDE DESONIDE DESOXIMETASONE DESOXIMETASONE DICLOFENAC SODIUM DIFLORASONE DIACETATE DICLOFENAC SODIUM DIFLORASONE DIACETATE ECZEMA ANTI-ITCH FLUOCINOLONE ACETONIDE HYDROCORTISONE FLUOCINOLONE ACETONIDE Dose CREAM (G) CREAM (G) GEL (GRAM) LOTION OINT. (G) CREAM (G) LOTION OINT. (G) CREAM (G) LOTION OINT. (G) SHAMPOO CREAM (G) FOAM CREAM (G) FOAM GEL (GRAM) LOTION OINT. (G) SHAMPOO SOLUTION SPRAY CREAM (G) LOTION MED. TAPE OINT. (G) OINT. (G) SOLUTION CREAM (G) CREAM (G) OINT. (G) CREAM (G) CREAM (G) CREAM (G) GEL (GRAM) CREAM (G) LOTION OINT. (G) CREAM (G) GEL (GRAM) OINT. (G) GEL (GRAM) CREAM (G) OINT. (G) CREAM (G) CREAM (G) OINT. (G) SOLUTION PA Step X QLL Age General Therapeutic Category Brand Name Generic Name FLUOCINONIDE FLUOCINONIDE FLUOCINONIDE-E FLUTICASONE PROPIONATE FLUOCINONIDE/EMOLLIENT BASE FLUTICASONE PROPIONATE HALOBETASOL PROPIONATE HALOBETASOL PROPIONATE HALOG HALCINONIDE HYDROCORTISONE HC/MINERAL OIL/PETROLAT,WHT HYDROCORTISONE HYDROCORTISONE BUTYRATE HYDROCORTISONE BUTYRATE HYDROCORTISONE VALERATE HYDROCORTISONE BUTYRATE/EMOLL HYDROCORTISONE VALERATE HYDROCREAM HYDROSKIN LOCOID MOMETASONE FUROATE HYDROCORTISONE HYDROCORTISONE HYDROCORTISONE BUTYRATE MOMETASONE FUROATE NEOSPORIN NOBLE FORMULA HC PANDEL PREDNICARBATE HYDROCORTISONE HYDROCORTISONE HYDROCORTISONE PROBUTATE PREDNICARBATE PREPARATION H RECORT PLUS SOOTHING CARE TEXACORT TRIAMCINOLONE ACETONIDE HYDROCORTISONE HYDROCORTISONE HYDROCORTISONE HYDROCORTISONE TRIAMCINOLONE ACETONIDE TRIANEX TRIDERM U-CORT VERDESO FLUOCINONIDE EMOLLIENT DESOWEN TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE HYDROCORTISONE ACETATE/UREA DESONIDE FLUOCINONIDE/EMOLLIENT BASE DESONIDE DESONIDE/EMOLLIENT COMBO.NO 28 Dose CREAM (G) GEL (GRAM) OINT. (G) SOLUTION CREAM (G) CREAM (G) LOTION OINT. (G) CREAM (G) OINT. (G) CREAM (G) OINT. (G) OINT. (G) CREAM (G) LOTION OINT. (G) CREAM (G) OINT. (G) SOLUTION CREAM (G) CREAM (G) OINT. (G) CREAM (G) CREAM (G) LOTION CREAM (G) OINT. (G) SOLUTION CREAM (G) CREAM (G) CREAM (G) CREAM (G) OINT. (G) CREAM (G) CREAM (G) CREAM (G) SOLUTION AEROSOL CREAM (G) LOTION OINT. (G) OINT. (G) CREAM (G) CREAM (G) FOAM CREAM (G) OINT. (G) KT LOTN CE PA Step QLL Age General Therapeutic Category DERMATOLOGY - MISCELLANEOUS DERMATOLOGY - PSORIASIS/ECZEMA Brand Name Generic Name DESONIDE/EMOLLIENT COMBO.NO 30 HYDROCORTISONE PLUS 12 HYDROCORTISONE PLUS HYDROCORTISONE ACETATE FIRST-HYDROCORTISONE AMMONIUM LACTATE ANACAINE ANALPRAM HC CAPSAICIN CAPZASIN-P CETACAINE ANESTHETIC COCAINE HCL EPIFOAM FLUOROPLEX FLUOROURACIL HYDROCORTISONE HYDROCORTISONE HYDROCORTISONE ACETATE/ALOE V HYDROCORTISONE AMMONIUM LACTATE BENZOCAINE HYDROCORTISONE/PRAMOXINE CAPSAICIN CAPSAICIN TETRACAINE/BENZOCAINE/BUTAMBEN COCAINE HCL HYDROCORTISONE/PRAMOXINE FLUOROURACIL FLUOROURACIL GERI-HYDROLAC LIDOCAINE-HYDROCORTISONE LIDOCAINE-PRILOCAINE AMMONIUM LACTATE LIDOCAINE/HYDROCORTISONE AC LIDOCAINE/PRILOCAINE PAIN EASE PANRETIN PRAMOSONE NORFLURANE/PENTAFLUOROPROPANE ALITRETINOIN HYDROCORTISONE/PRAMOXINE SPRAY AND STRETCH SYNERA TARGRETIN NORFLURANE/PENTAFLUOROPROPANE LIDOCAINE/TETRACAINE BEXAROTENE TRIXAICIN VALCHLOR ZINC OXIDE ZOSTRIX AMLACTIN AMERICAINE 8-MOP ACITRETIN CALCIPOTRIENE CAPSAICIN MECHLORETHAMINE HCL ZINC OXIDE CAPSAICIN AMMONIUM LACTATE BENZOCAINE METHOXSALEN ACITRETIN CALCIPOTRIENE CALCITRENE DRITHOCREME HP METHOXSALEN TAZORAC CALCIPOTRIENE ANTHRALIN METHOXSALEN, RAPID TAZAROTENE DRITHO-SCALP AMEVIVE TALTZ AUTOINJECTOR ANTHRALIN ALEFACEPT IXEKIZUMAB Dose KT CRM LE KT OINT LE CREAM (G) CREAM (G) GEL (GRAM) GEL (GRAM) CREAM (G) OINT. (G) LOTION CREAM (G) CREAM (G) LIQUID SOLUTION FOAM CREAM (G) CREAM (G) SOLUTION CREAM (G) CREAM (G) CREAM (G) KIT SPRAY GEL (GRAM) LOTION OINT. (G) SPRAY M.HT PATCH GEL (GRAM) CREAM (G) GEL (GRAM) OINT. (G) CREAM (G) CREAM (G) LUBRICANT CAPSULE CAPSULE CREAM (G) OINT. (G) SOLUTION OINT. (G) CREAM (G) CAPSULE CREAM (G) GEL (GRAM) CREAM/APPL VIAL AUTO INJCT PA X X X X X X Step QLL Age General Therapeutic Category DIABETES Brand Name TALTZ AUTOINJECTOR (3 PACK) TALTZ AUTOINJECTOR (2 PACK) TALTZ SYRINGE TALTZ SYRINGE (3 PACK) TALTZ SYRINGE (2 PACK) ACARBOSE ACCU-CHEK ACCU-CHEK FASTCLIX ACCU-CHEK SOFTCLIX ACTOPLUS MET XR ADJUSTABLE LANCING DEVICE ADVANCED LANCING DEVICE ADVOCATE RAPID-SAFE ALTERNATE SITE LANCING DEVICE APIDRA APIDRA SOLOSTAR AQUA LANCE LANCING DEVICE AUTOJECT 2 AUTO-LANCET MINI AUTOLET IMPRESSION AUTOLET LANCING DEVICE AUTOPEN CAREONE CHLORPROPAMIDE DEX4 GLUCOSE DROPLET LANCING DEVICE EASY CLICK EASY TOUCH EASY TOUCH LANCING DEVICE FORA LANCING DEVICE FREESTYLE FREEDOM LITE FREESTYLE INSULINX FREESTYLE INSULINX TEST STRIPS FREESTYLE LITE METER FREESTYLE LITE STRIPS FREESTYLE TEST STRIPS GLIMEPIRIDE GLIPIZIDE GLIPIZIDE ER GLIPIZIDE XL GLIPIZIDE-METFORMIN GLUCAGON EMERGENCY KIT GLUCO BURST GLUCOLET 2 Generic Name IXEKIZUMAB IXEKIZUMAB IXEKIZUMAB IXEKIZUMAB IXEKIZUMAB ACARBOSE LANCING DEVICE/LANCETS BLOOD-GLUCOSE CALIB. CONTROL BLOOD GLUCOSE CONTROL HIGH&LOW LANCING DEVICE/LANCETS LANCING DEVICE/LANCETS PIOGLITAZONE HCL/METFORMIN HCL LANCING DEVICE LANCING DEVICE/LANCETS LANCING DEVICE LANCING DEVICE INSULIN GLULISINE INSULIN GLULISINE LANCING DEVICE INSULIN ADMIN. SUPPLIES LANCING DEVICE LANCING DEVICE/LANCETS LANCING DEVICE INSULIN ADMIN. SUPPLIES LANCING DEVICE CHLORPROPAMIDE DEXTROSE LANCING DEVICE LANCING DEVICE BLOOD GLUCOSE CONTROL HIGH&LOW LANCING DEVICE LANCING DEVICE BLOOD-GLUCOSE METER BLOOD SUGAR DIAGNOSTIC BLOOD-GLUCOSE METER BLOOD SUGAR DIAGNOSTIC BLOOD-GLUCOSE METER BLOOD SUGAR DIAGNOSTIC BLOOD SUGAR DIAGNOSTIC GLIMEPIRIDE GLIPIZIDE GLIPIZIDE GLIPIZIDE GLIPIZIDE/METFORMIN HCL GLUCAGON,HUMAN RECOMBINANT DEXTROSE LANCING DEVICE LANCING DEVICE/LANCETS Dose AUTO INJCT AUTO INJCT SYRINGE SYRINGE SYRINGE TABLET KIT COMBO. PKG EACH KIT KIT TBMP 24HR EACH KIT EACH EACH VIAL INSULN PEN EACH INSULN PEN EACH KIT EACH INSULN PEN EACH TABLET GEL (GRAM) EACH EACH EACH EACH EACH KIT STRIP EACH STRIP KIT STRIP STRIP TABLET TABLET TAB ER 24 TAB ER 24 TABLET KIT GEL (GRAM) EACH KIT PA Step QLL X X X X X X X X X X X X X X X Age General Therapeutic Category Brand Name GLUCOSE GEL GLUCOSOURCE GLUTOSE 15 GLUTOSE 45 GLYBURIDE GLYBURIDE MICRONIZED GLYBURIDE-METFORMIN HCL GMATE LANCING DEVICE HEALTHY ACCENTS AUTOLET HUMALOG Generic Name DEXTROSE LANCING DEVICE DEXTROSE DEXTROSE GLYBURIDE GLYBURIDE,MICRONIZED GLYBURIDE/METFORMIN HCL LANCING DEVICE LANCING DEVICE INSULIN LISPRO HUMALOG MIX 50-50 HUMALOG MIX 50-50 KWIKPEN HUMALOG MIX 75-25 HUMALOG MIX 75-25 KWIKPEN HUMAPEN LUXURA HD HUMULIN 70/30 KWIKPEN HUMULIN 70-30 INSULIN LISPRO PROTAMIN/LISPRO INSULIN LISPRO PROTAMIN/LISPRO INSULIN LISPRO PROTAMIN/LISPRO INSULIN LISPRO PROTAMIN/LISPRO INSULIN ADMIN. SUPPLIES INSULIN NPH HUM/REG INSULIN HM INSULIN NPH HUM/REG INSULIN HM HUMULIN N INSULIN NPH HUMAN ISOPHANE HUMULIN N KWIKPEN HUMULIN R HUMULIN R U-500 HYPOLANCE INCONTROL LANCING DEVICE INSTA-GLUCOSE JANUMET JANUMET XR JANUVIA KOMBIGLYZE XR KORLYM LANCET DEVICE LANCING DEVICE LANCING SYSTEM LANTUS LANTUS SOLOSTAR LEVEMIR LEVEMIR FLEXTOUCH LITE TOUCH METFORMIN HCL METFORMIN HCL ER INSULIN NPH HUMAN ISOPHANE INSULIN REGULAR, HUMAN INSULIN REGULAR, HUMAN LANCING DEVICE/LANCETS LANCING DEVICE DEXTROSE/DEXTRIN/MALTOSE SITAGLIPTIN PHOS/METFORMIN HCL SITAGLIPTIN PHOS/METFORMIN HCL SITAGLIPTIN PHOSPHATE SAXAGLIPTIN HCL/METFORMIN HCL MIFEPRISTONE LANCING DEVICE LANCING DEVICE LANCING DEVICE/LANCETS LANCING DEVICE INSULIN GLARGINE,HUM.REC.ANLOG INSULIN GLARGINE,HUM.REC.ANLOG INSULIN DETEMIR INSULIN DETEMIR LANCING DEVICE METFORMIN HCL METFORMIN HCL MICROLET 2 MINI LANCING DEVICE NATEGLINIDE NOVOLIN 70-30 LANCING DEVICE/LANCETS LANCING DEVICE NATEGLINIDE INSULIN NPH HUM/REG INSULIN HM Dose GEL (GRAM) EACH GEL (GRAM) GEL (GRAM) TABLET TABLET TABLET EACH EACH CARTRIDGE VIAL VIAL INSULN PEN VIAL INSULN PEN INSULN PEN INSULN PEN INSULN PEN VIAL INSULN PEN VIAL INSULN PEN VIAL VIAL KIT EACH GEL (GRAM) TABLET TBMP 24HR TABLET TBMP 24HR TABLET EACH EACH KIT EACH VIAL INSULN PEN VIAL INSULN PEN EACH TABLET TAB ER 24 TAB ER 24H KIT EACH TABLET VIAL PA Step X QLL X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Age General Therapeutic Category Brand Name NOVOLIN N NOVOLIN R NOVOLOG NOVOLOG FLEXPEN NOVOLOG MIX 70-30 NOVOLOG MIX 70-30 FLEXPEN NOVOPEN ECHO ON CALL LANCING DEVICE ON CALL PLUS LANCING DEVICE ONETOUCH DELICA ONETOUCH SURESOFT PENLET PLUS BLOOD SAMPLER PIOGLITAZONE HCL PIOGLITAZONE-GLIMEPIRIDE PIOGLITAZONE-METFORMIN PRECISION XTRA PRODIGY LANCING DEVICE PROGLYCEM RELIAMED MINI LANCING DEVICE REPAGLINIDE RIGHTEST GD500 SMARTDIABETES VANTAGE SOFTCLIX SOLUS V2 LANCING DEVICE SURE COMFORT LANCING PEN SUREFLEX SURE-PEN SYMLINPEN 120 SYMLINPEN 60 TANZEUM TOLAZAMIDE TOLBUTAMIDE TRADJENTA TRUEDRAW ULTI-LANCE UNISTIK 2 UNISTIK 2 EXTRA UNISTIK 2 NORMAL UNISTIK 3 UNISTIK 3 COMFORT UNISTIK 3 NEONATAL VICTOZA 2-PAK VICTOZA 3-PAK HUMALOG KWIKPEN U-200 Generic Name INSULIN NPH HUMAN ISOPHANE INSULIN REGULAR, HUMAN INSULIN ASPART INSULIN ASPART INSULIN ASPART PROTAM & ASPART INSULIN ASPART PROTAM & ASPART INSULIN ADMIN. SUPPLIES LANCING DEVICE LANCING DEVICE LANCING DEVICE/LANCETS LANCING DEVICE/LANCETS LANCING DEVICE/LANCETS PIOGLITAZONE HCL PIOGLITAZONE HCL/GLIMEPIRIDE PIOGLITAZONE HCL/METFORMIN HCL BLOOD SUGAR DIAGNOSTIC BLOOD-GLUCOSE METER LANCING DEVICE DIAZOXIDE LANCING DEVICE REPAGLINIDE LANCING DEVICE LANCING DEVICE LANCING DEVICE LANCING DEVICE/LANCETS LANCING DEVICE LANCING DEVICE LANCING DEVICE/LANCETS LANCING DEVICE PRAMLINTIDE ACETATE PRAMLINTIDE ACETATE ALBIGLUTIDE TOLAZAMIDE TOLBUTAMIDE LINAGLIPTIN LANCING DEVICE LANCING DEVICE LANCING DEVICE/LANCETS LANCING DEVICE/LANCETS LANCING DEVICE/LANCETS LANCING DEVICE/LANCETS LANCING DEVICE/LANCETS LANCING DEVICE/LANCETS LANCING DEVICE/LANCETS LIRAGLUTIDE LIRAGLUTIDE INSULIN LISPRO Dose VIAL VIAL CARTRIDGE VIAL INSULN PEN VIAL INSULN PEN INSULN PEN EACH EACH KIT KIT KIT TABLET TABLET TABLET STRIP EACH EACH ORAL SUSP EACH TABLET EACH EACH EACH KIT EACH EACH KIT EACH PEN INJCTR PEN INJCTR PEN INJCTR TABLET TABLET TABLET EACH EACH KIT KIT KIT KIT KIT KIT KIT PEN INJCTR PEN INJCTR INSULN PEN PA Step QLL X X X X X X X X X X X X X X X X X X X X X X X X X X X X Age General Therapeutic Category Brand Name HUMALOG KWIKPEN U-100 LEVEMIR FLEXPEN BREEZE 2 CONTOUR CONTOUR NEXT CONTROL SOLUTION AUTOLET MINI AUTOLET LITE CLINISAFE UNISTIK AUTOLET MKII CLINISAFE ADVANCE INTUITION ASSURE DOSE ASSURE PRISM GLUCOCARD SHINE ASSURE 4 GLUCOCARD EXPRESSION MULTI-LANCET DEVICE GLUCOCARD 01 CONTROL GLUCOCARD X-METER CONTROL EVENCARE G2 EVENCARE EVENCARE G3 CONTROL SOLUTION INFINITY CONTROL SOLUTION ACURA CONTROL SOLUTION NORMAL ACURA CONTROL SOLUTION ACURA CONTROL SOLUTION LOW EASYGLUCO PLUS CONTROL NORMAL PRODIGY CONTROL SOLUTION HEALTHPRO GLUCOSE CONTROL SOLN ECLIPSE ECLIPSE CONTROL SOLUTION ENVISION EVOLUTION CONTROL SOLUTION ELEMENT CONTROL SOLUTION Generic Name INSULIN LISPRO INSULIN DETEMIR BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW LANCING DEVICE/LANCETS LANCING DEVICE LANCING DEVICE/LANCETS LANCING DEVICE BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD GLUCOSE CNTL HI & NORMAL BLOOD GLUCOSE CNTL HI & NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CALIB. CONTROL BLOOD-GLUCOSE CONTROL, NORMAL LANCING DEVICE BLOOD-GLUCOSE CONTROL, NORMAL BLOOD GLUCOSE CNTL HI & NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL Dose INSULN PEN INSULN PEN EACH EACH EACH EACH EACH EACH EACH EACH KIT EACH KIT EACH EACH EACH EACH EACH EACH COMBO. PKG EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH PA X X Step QLL X X Age General Therapeutic Category Brand Name XPRES ELEMENT PLUS CONTROL SOLUTION ELEMENT COMPACT CONTROL SOLN GLUCOLAB CONTROL SMARTEST GLUCOCOM CONTROL SOLUTION GLUCOSE CONTROL SOLUTION GLUCOSE CONTROL BLOOD-GLUCOSE CONTROL RIGHTEST CONTROL SOLUTION RIGHTEST GC250S CONTROL SOLN GE100 CONTROL SOLUTION NORMAL NOVA MAX GLUCOSE CONTROL SOLN NOVAMAX PLUS GLU-KET WAVESENSE CONTROL SOLUTION AGAMATRIX CONTROL LIBERTY CONTROL SOLUTION ULTRATRAK ULTRATRAK ULTIMATE SOLUS V2 CONTROL SOLUTION CARESENS FORA CONTROL SOLUTION TRUE METRIX REFUAH PLUS GLUCOSE CONTROL RENEW ADVANCED LANCING SYSTEM SMS GLUCOSE CONTROL SURECHEK GLUCOSE CONTROL SURE EDGE GLUCOSE CONTROL SOLN VOCALPOINT GLUCOSE CONTROL VOCAL POINT GLUCOSE CONTROL Generic Name BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE & KETONE CTL NML BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD GLUCOSE CNTL HI & NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD GLUCOSE CNTL HI & NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, HIGH LANCING DEVICE/LANCETS BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH Dose EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH KIT EACH EACH EACH EACH EACH EACH EACH PA Step QLL Age General Therapeutic Category Brand Name EASYMAX EASYMAX 15 FORTISCARE TD GOLD LEVEL 1 CONTROL SOL TD GOLD LEVEL 2 CONTROL SOL TD GOLD LEVEL 3 CONTROL SOL MYGLUCOHEALTH CONTROL SOLUTION MICRODOT METER-CHECK EZ SMART ONETOUCH ULTRA CONTROL SOLN ONE TOUCH DELICA ONE TOUCH VERIO ONE TOUCH GLUCOSE CONTROL SOLN ONETOUCH VERIO SURESTEP CONTROL SOLUTION SURESTEP PRO TRUETRACK TRUECONTROL TRUETEST GLUCOSE CONTROL LIBERTY LEV 1 GLUCOSE CONTROL LIBERTY LEV 2 GLUCOSE CONTROL MEDISENSE GLUCOSE KETONE MEDISENSE GLUCOSE KETONE CONTR MEDISENSE 2TEK TELCARE CONTROL SOLUTION SURE-TEST EASYPLUS MINI ACCUTREND GLUCOSE ACCU-CHEK COMPACT BLUE CONTROL Generic Name BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD GLUCOSE CTL HIGH,NML&LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL LANCING DEVICE/LANCETS BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CALIB. CONTROL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CALIB. CONTROL BLOOD GLUCOSE CNTL HI & NORMAL BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD GLUCOSE CNTL HI & NORMAL Dose EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH KIT EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH COMBO. PKG EACH EACH COMBO. PKG EACH EACH EACH EACH EACH PA Step QLL Age General Therapeutic Category Brand Name ACCU-CHEK COMPACT PLUS CONTROL ACCU-CHEK SMARTVIEW REPAGLINIDE-METFORMIN HCL ON CALL PLUS CONTROL OPTUMRX ON CALL VIVID CONTROL ON CALL EXPRESS CONTROL SOLN GMATE CONTROL SOLUTION CHOICEDM CLARUS CONTROL SOLN BLOOD GLUCOSE CONTROL EASY STEP EASY TRAK EASY TALK EASY PLUS II UNISTRIP DIATRUE MEDISENSE CONTROL PRECISION GLUCOSE CONTROL PRECISION EMBRACE EMBRACE GLUCOSE CONTROL SOLN VICTORY EMBRACE EVO EMBRACE PRO ADVOCATE CONTROL SOLUTION ADVOCATE LANCING DEVICE ADVOCATE REDI-CODE+ CTRL SOLN CLEVER CHOICE CONTROL SOLUTION FORACARE GDH FREESTYLE CONTROL SOLUTION Generic Name BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD-GLUCOSE CONTROL, NORMAL REPAGLINIDE/METFORMIN HCL BLOOD GLUCOSE CNTL HI & NORMAL BLOOD GLUCOSE CNTL HI & NORMAL BLOOD GLUCOSE CNTL HI & NORMAL BLOOD GLUCOSE CTL HIGH,NML&LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD GLUCOSE CNTL HI & NORMAL BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CALIB. CONTROL BLOOD-GLUCOSE CALIB. CONTROL BLOOD-GLUCOSE CALIB. CONTROL BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, LOW BLOOD GLUCOSE CONTROL HIGH&LOW BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD GLUCOSE CNTL HI & NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH LANCING DEVICE BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, LOW BLOOD-GLUCOSE CONTROL, HIGH BLOOD-GLUCOSE CONTROL, NORMAL BLOOD GLUCOSE CONTROL HIGH&LOW Dose EACH EACH TABLET EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH COMBO. PKG COMBO. PKG COMBO. PKG EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH PA Step X QLL Age General Therapeutic Category EAR - GENERAL DISORDERS ELECTROLYTE REGULATION Brand Name HUMULIN R U-500 KWIKPEN AUTOLET PLUS COOL CONTROL SOLUTION GLUCOSE MIGLITOL EVENCARE MINI GLUCOSE CONTROL ACETASOL HC ACETIC ACID ACETIC ACID-ALUMINUM AURO CARBAMOXIDE CIPRO HC CIPRODEX CIPROFLOXACIN HCL DEBROX EAR DROPS EAR SYSTEM EAR WAX REMOVAL EARWAX TREATMENT HYDROCORTISONE-ACETIC ACID MURINE EAR WAX REMOVAL SYSTEM NEOMYCIN-POLYMYXIN-HC NEOMYCIN-POLYMYXIN-HYDROCORT OFLOXACIN AURODEX CRESYLATE AURAPHENE-B OTOMAX-HC EXOTIC-HC TREAGAN OTIC ANTIPYRINE-BENZOCAINE ZINOTIC AUROGUARD PRAMOXINE-HC PINNACAINE OTICIN MURINE EAR DROPS CALCIUM ACETATE Generic Name INSULIN REGULAR, HUMAN LANCING DEVICE BLOOD-GLUCOSE CONTROL, NORMAL BLOOD-GLUCOSE CONTROL, HIGH DEXTROSE MIGLITOL BLOOD-GLUCOSE CONTROL, NORMAL ACETIC ACID/HYDROCORTISONE ACETIC ACID ACETIC ACID/ALUMINUM ACETATE CARBAMIDE PEROXIDE CARBAMIDE PEROXIDE CIPROFLOXACIN/HYDROCORTISONE CIPROFLOXACIN HCL/DEXAMETH CIPROFLOXACIN HCL CARBAMIDE PEROXIDE CARBAMIDE PEROXIDE CARBAMIDE PEROXIDE CARBAMIDE PEROXIDE CARBAMIDE PEROXIDE ACETIC ACID/HYDROCORTISONE CARBAMIDE PEROXIDE NEOMYCIN/POLYMYXIN B SULF/HC NEOMYCIN/POLYMYXIN B SULF/HC OFLOXACIN ANTIPYRINE/BENZOCAINE CRESYL ACETATE CARBAMIDE PEROXIDE HC/PRAMOXINE HCL/CHLOROXYLENOL HC/PRAMOXINE HCL/CHLOROXYLENOL AA/ANTIPYRN/BCAINE/POLICO#1/AL ANTIPYRINE/BENZOCAINE CHLOROXYLENOL/GLYC/PRAMOX/ZINC ANTIPYRINE/BENZOCAINE HC/PRAMOXINE HCL/CHLOROXYLENOL BENZOCAINE CHLOROXYLENOL/PRAMOXINE HCL CARBAMIDE PEROXIDE CALCIUM ACETATE EFFER-K ELIPHOS FOSRENOL POTASSIUM BICARBONATE/CIT AC CALCIUM ACETATE LANTHANUM CARBONATE K EFFERVESCENT KIONEX POTASSIUM BICARBONATE/CIT AC SODIUM POLYSTYRENE SULFONATE KLOR-CON POTASSIUM CHLORIDE Dose INSULN PEN EACH EACH EACH TAB CHEW TABLET EACH DROPS SOLUTION DROPS DROPS DROPS DROPS SUSP DROPS SUSP DROPERETTE DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS SUSP SOLUTION DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS CAPSULE TABLET TABLET EFF TABLET POWD PACK TAB CHEW TABLET EFF ORAL SUSP POWDER PACKET PA Step X QLL X X X Age General Therapeutic Category ENDOCRINE DISORDER - OTHER Brand Name KLOR-CON M10 KLOR-CON M15 KLOR-CON M20 KLOR-CON SPRINKLE ORALYTE PEDIATRIC ELECTROLYTE PEDIATRIC FREEZER POPS POTASSIUM BICARBONATE POTASSIUM CHLORIDE Generic Name POTASSIUM CHLORIDE POTASSIUM CHLORIDE POTASSIUM CHLORIDE POTASSIUM CHLORIDE ELECTROLYTES ELECTROLYTES ELECTROLYTES POTASSIUM BICARBONATE/CIT AC POT CHLORIDE/POT BICARB/CIT AC POTASSIUM CHLORIDE RENAGEL SODIUM POLYSTYRENE SULFONATE SEVELAMER HCL SODIUM POLYSTYRENE SULFONATE SPS VELPHORO KAOCHLOR-EFF ENFALYTE SEVELAMER CARBONATE EPIKLOR VELTASSA ALENDRONATE SODIUM SODIUM POLYSTYRENE SULFONATE SUCROFERRIC OXYHYDROXIDE POTASSIUM CHLORIDE/POT BICARB ELECTROLYTES SEVELAMER CARBONATE POTASSIUM CHLORIDE PATIROMER CALCIUM SORBITEX ALENDRONATE SODIUM CABERGOLINE CALCITONIN-SALMON DANAZOL DESMOPRESSIN ACETATE CABERGOLINE CALCITONIN,SALMON,SYNTHETIC DANAZOL DESMOPRESSIN (NONREFRIGERATED) DESMOPRESSIN ACETATE ETIDRONATE DISODIUM FORTEO GENOTROPIN ETIDRONATE DISODIUM TERIPARATIDE SOMATROPIN H.P. ACTHAR HUMATROPE CORTICOTROPIN SOMATROPIN INCRELEX LEUPROLIDE ACETATE MECASERMIN LEUPROLIDE ACETATE LUPRON DEPOT LUPRON DEPOT-PED LEUPROLIDE ACETATE LEUPROLIDE ACETATE Dose TAB ER PRT TAB ER PRT TAB ER PRT CAPSULE ER SOLUTION SOLUTION SOLUTION TABLET EFF TABLET EFF CAPSULE ER LIQUID PACKET TAB ER PRT TABLET ER TABLET ENEMA ORAL SUSP POWDER ORAL SUSP TAB CHEW TABLET EFF SOLUTION TABLET PACKET POWD PACK SOLUTION TABLET TABLET SPRAY/PUMP CAPSULE SPRAY/PUMP AMPUL SOLUTION SPRAY/PUMP TABLET VIAL TABLET PEN INJCTR CARTRIDGE SYRINGE VIAL CARTRIDGE VIAL VIAL KIT VIAL SYRINGEKIT KIT PA Step QLL X X X X X X X X X X X X X X X X X X Age General Therapeutic Category ENDOCRINE DISORDER - THYROID EYE - GENERAL DISORDERS Brand Name NATPARA NORDITROPIN FLEXPRO NUTROPIN AQ Generic Name PARATHYROID HORMONE SOMATROPIN SOMATROPIN NUTROPIN AQ NUSPIN OMNITROPE SOMATROPIN SOMATROPIN PARICALCITOL RALOXIFENE HCL SAIZEN PARICALCITOL RALOXIFENE HCL SOMATROPIN SEROSTIM SOMAVERT STIMATE SUPPRELIN LA SOMATROPIN PEGVISOMANT DESMOPRESSIN ACETATE HISTRELIN AC Dose CARTRIDGE PEN INJCTR CARTRIDGE VIAL PEN INJCTR CARTRIDGE VIAL CAPSULE TABLET CARTRIDGE VIAL VIAL VIAL SPRAY/PUMP KIT SYNAREL NAFARELIN ACETATE SPRAY X THYROGEN VANTAS THYROTROPIN ALFA HISTRELIN AC VIAL KIT X X ZOLADEX ZOMACTON ZORBTIVE NORDITROPIN NORDIFLEX NUTROPIN TEV-TROPIN LEVOTHYROXINE SODIUM LIOTHYRONINE SODIUM METHIMAZOLE PROPYLTHIOURACIL SSKI STRONG IODINE THYROLAR-1 THYROLAR-1/2 THYROLAR-1/4 THYROLAR-2 THYROLAR-3 AK-POLY-BAC ALREX ALTACHLORE GOSERELIN ACETATE SOMATROPIN SOMATROPIN SOMATROPIN SOMATROPIN SOMATROPIN LEVOTHYROXINE SODIUM LIOTHYRONINE SODIUM METHIMAZOLE PROPYLTHIOURACIL POTASSIUM IODIDE POTASSIUM IODIDE/IODINE LIOTRIX LIOTRIX LIOTRIX LIOTRIX LIOTRIX BACITRACIN/POLYMYXIN B SULFATE LOTEPREDNOL ETABONATE SODIUM CHLORIDE X X X X X X AZASITE AZELASTINE HCL BACITRACIN BACITRACIN-POLYMYXIN BLEPH-10 BLEPHAMIDE AZITHROMYCIN AZELASTINE HCL BACITRACIN BACITRACIN/POLYMYXIN B SULFATE SULFACETAMIDE SODIUM SULFACETM NA/PREDNISOL AC IMPLANT VIAL VIAL PEN INJCTR VIAL VIAL TABLET TABLET TABLET TABLET SOLUTION SOLUTION TABLET TABLET TABLET TABLET TABLET OINT. (G) DROPS SUSP DROPS OINT. (G) DROPS DROPS OINT. (G) OINT. (G) DROPS DROPS SUSP PA X X X X X X X X X X X X X X Step QLL X Age General Therapeutic Category Brand Name BLEPHAMIDE S.O.P. CILOXAN CIPROFLOXACIN HCL DEXAMETHASONE SODIUM PHOSPHATE DICLOFENAC SODIUM DUREZOL ERYTHROMYCIN FLAREX FLUOROMETHOLONE FLURBIPROFEN SODIUM FML FORTE FML S.O.P. GATIFLOXACIN GENTAK GENTAMICIN SULFATE Generic Name SULFACETM NA/PREDNISOL AC CIPROFLOXACIN HCL CIPROFLOXACIN HCL DEXAMETHASONE SOD PHOSPHATE DICLOFENAC SODIUM DIFLUPREDNATE ERYTHROMYCIN BASE FLUOROMETHOLONE ACETATE FLUOROMETHOLONE FLURBIPROFEN SODIUM FLUOROMETHOLONE FLUOROMETHOLONE GATIFLOXACIN GENTAMICIN SULFATE GENTAMICIN SULFATE KETOROLAC TROMETHAMINE LEVOFLOXACIN LOTEMAX KETOROLAC TROMETHAMINE LEVOFLOXACIN LOTEPREDNOL ETABONATE MAXIDEX MOXEZA MURO-128 DEXAMETHASONE MOXIFLOXACIN HCL SODIUM CHLORIDE NAPHAZOLINE HCL NATACYN NEOMYCIN-BACITRACIN-POLY-HC NEOMYCIN-BACITRACIN-POLYMYXIN NEOMYCIN-POLYMYXIN-DEXAMETH NAPHAZOLINE HCL NATAMYCIN NEOMYCIN SU/BACI ZN/POLY/HC NEOMYCIN SU/BACITRA/POLYMYXIN NEO/POLYMYX B SULF/DEXAMETH NEOMYCIN-POLYMYXIN-GRAMICIDIN NEOMYCIN-POLYMYXIN-HC NEO-POLYCIN NEO-POLYCIN HC NEVANAC OFLOXACIN PHENYLEPHRINE HCL POLYCIN POLYMYXIN B SUL-TRIMETHOPRIM PRED MILD PRED-G NEOMYCIN/POLYMYXN B/GRAMICIDIN NEOMYCIN/POLYMYXIN B SULF/HC NEOMYCIN SU/BACITRA/POLYMYXIN NEOMYCIN SU/BACI ZN/POLY/HC NEPAFENAC OFLOXACIN PHENYLEPHRINE HCL BACITRACIN/POLYMYXIN B SULFATE POLYMYXIN B SULF/TRIMETHOPRIM PREDNISOLONE ACETATE GENTAMICIN/PREDNISOL AC PREDNISOLONE ACETATE PREDNISOLONE SODIUM PHOSPHATE SOCHLOR PREDNISOLONE ACETATE PREDNISOLONE SOD PHOSPHATE SODIUM CHLORIDE SODIUM CHLORIDE SODIUM CHLORIDE Dose OINT. (G) OINT. (G) DROPS DROPS DROPS DROPS OINT. (G) DROPS SUSP DROPS SUSP DROPS DROPS SUSP OINT. (G) DROPS OINT. (G) DROPS OINT. (G) DROPS DROPS DROPS GEL DROPS SUSP DROPS SUSP DROPS VISC DROPS OINT. (G) DROPS DROPS SUSP OINT. (G) OINT. (G) DROPS SUSP OINT. (G) DROPS DROPS SUSP OINT. (G) OINT. (G) DROPS SUSP DROPS DROPS OINT. (G) DROPS DROPS SUSP DROPS SUSP OINT. (G) DROPS SUSP DROPS DROPS OINT. (G) DROPS OINT. (G) PA Step QLL Age General Therapeutic Category EYE - GLAUCOMA Brand Name SULFACETAMIDE SODIUM Generic Name SULFACETAMIDE SODIUM SULFACETAMIDE-PREDNISOLONE TOBRADEX TOBRAMYCIN TOBRAMYCIN-DEXAMETHASONE TOBREX TRIFLURIDINE VEXOL VIGAMOX ZYLET POLY-PRED SULFAMIDE TOBRASOL NEOFRIN ROMYCIN ALTAFRIN IQUIX VITRASERT ACETAZOLAMIDE SULFACETAMIDE/PREDNISOLONE SP TOBRAMYCIN/DEXAMETHASONE TOBRAMYCIN TOBRAMYCIN/DEXAMETHASONE TOBRAMYCIN TRIFLURIDINE RIMEXOLONE MOXIFLOXACIN HCL TOBRAMYCIN/LOTEPRED ETAB NEOMYCIN SU/PLYMX B SU/PRED SULFACETAMIDE SODIUM TOBRAMYCIN PHENYLEPHRINE HCL ERYTHROMYCIN BASE PHENYLEPHRINE HCL LEVOFLOXACIN GANCICLOVIR ACETAZOLAMIDE ALPHAGAN P APRACLONIDINE HCL ATROPINE SULFATE BRIMONIDINE TARTRATE APRACLONIDINE HCL ATROPINE SULFATE AZOPT BETAXOLOL HCL BETIMOL BETOPTIC S BIMATOPROST BRIMONIDINE TARTRATE CARTEOLOL HCL COMBIGAN CYCLOMYDRIL CYCLOPENTOLATE HCL DORZOLAMIDE HCL DORZOLAMIDE-TIMOLOL HOMATROPAIRE HOMATROPINE HYDROBROMIDE IOPIDINE ISTALOL LATANOPROST LEVOBUNOLOL HCL LUMIGAN METHAZOLAMIDE METIPRANOLOL PAREMYD ATROPINE SULFATE/PF BRINZOLAMIDE BETAXOLOL HCL TIMOLOL BETAXOLOL HCL BIMATOPROST BRIMONIDINE TARTRATE CARTEOLOL HCL BRIMONIDINE TARTRATE/TIMOLOL CYCLOPENTOLATE/PHENYLEPHRINE CYCLOPENTOLATE HCL DORZOLAMIDE HCL DORZOLAMIDE HCL/TIMOLOL MALEAT HOMATROPINE HBR HOMATROPINE HBR APRACLONIDINE HCL TIMOLOL MALEATE LATANOPROST LEVOBUNOLOL HCL BIMATOPROST METHAZOLAMIDE METIPRANOLOL HYDROXYAMPHETAMINE/TROPICAMIDE Dose DROPS OINT. (G) DROPS OINT. (G) DROPS DROPS SUSP OINT. (G) DROPS DROPS SUSP DROPS DROPS SUSP DROPS SUSP DROPS DROPS DROPS OINT. (G) DROPS DROPS IMPLANT CAPSULE ER TABLET DROPS DROPS DROPS OINT. (G) DROPS DROPS SUSP DROPS DROPS DROPS SUSP DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPERETTE DROP DAILY DROPS DROPS DROPS TABLET DROPS DROPS PA X Step QLL Age General Therapeutic Category Brand Name PHOSPHOLINE IODIDE PILOCARPINE HCL TIMOLOL MALEATE EYE - MISCELLANEOUS TIMOPTIC OCUDOSE TRAVOPROST TROPICAMIDE PILOPINE HS ISOPTO CARBACHOL ISOPTO HOMATROPINE ISOPTO HYOSCINE AK-PENTOLATE ATROPINE CARE AKWA TEARS ARTIFICIAL TEARS POLYVINYL ALCOHOL REFRESH CLASSIC REFRESH LACRI-LUBE REFRESH LIQUIGEL TEARS AGAIN TEARS PURE VISUDYNE AKWA TEARS RENEWED TEARS AGAIN MC NATURAL BALANCE TEARS GENTEAL TEARS ALLOPURINOL COLCHICINE TIMOLOL MALEATE/PF TRAVOPROST (BENZALKONIUM) TROPICAMIDE PILOCARPINE HCL CARBACHOL HOMATROPINE HBR SCOPOLAMINE HYDROBROMIDE CYCLOPENTOLATE HCL ATROPINE SULFATE POLYVINYL ALCOHOL DEXTRAN 70/HYPROMELLOSE GLYCERIN/PROPYLENE GLYCOL POLYVINYL ALCOHOL POLYVINYL ALCOHOL/POVIDONE CYSTEAMINE HCL POLYVINYL ALCOHOL POLYVINYL ALCOHOL RANIBIZUMAB PEGAPTANIB SODIUM DEXTRAN 70/HYPROMELLOSE HYPROMELLOSE POLYVINYL ALCOHOL POLYVINYL ALCOHOL/POVIDONE/PF MINERAL OIL/PETROLATUM,WHITE CARBOXYMETHYLCELLULOSE SODIUM POLYVINYL ALCOHOL DEXTRAN 70/HYPROMELLOSE VERTEPORFIN DEXTRAN 70/HYPROMELLOSE DEXTRAN 70/HYPROMELLOSE DEXTRAN 70/HYPROMELLOSE DEXTRAN 70/HYPROMELLOSE ALLOPURINOL COLCHICINE ELITEK PROBENECID PROBENECID-COLCHICINE ADVATE ADVATE H ADVATE L ADVATE M ADVATE SH AMICAR RASBURICASE PROBENECID COLCHICINE/PROBENECID ANTIHEMOPH.FVIII,FULL LENGTH ANTIHEMOPH.FVIII,FULL LENGTH ANTIHEMOPH.FVIII,FULL LENGTH ANTIHEMOPH.FVIII,FULL LENGTH ANTIHEMOPH.FVIII,FULL LENGTH AMINOCAPROIC ACID CYSTARAN LIQUITEARS LUBRICANT EYE LUCENTIS MACUGEN NATURE'S TEARS GOUT AND RELATED DISEASES HEMATOLOGICAL DISORDERS Generic Name ECHOTHIOPHATE IODIDE PILOCARPINE HCL TIMOLOL MALEATE Dose DROPS DROPS DROPS SOL-GEL DROPERETTE DROPS DROPS GEL (GRAM) DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS DROPS VIAL SYRINGE DROPS DROPS DROPS DROPERETTE OINT. (G) DRP LQ GEL DROPS DROPS VIAL DROPS DROPS DROPS DROPS TABLET CAPSULE TABLET VIAL TABLET TABLET VIAL VIAL VIAL VIAL VIAL SOLUTION PA Step X X X X X X X X X X QLL Age General Therapeutic Category Brand Name AMINOCAPROIC ACID Dose Generic Name AMINOCAPROIC ACID ARANESP DARBEPOETIN ALFA IN POLYSORBAT ASPIRIN-DIPYRIDAMOLE ER CILOSTAZOL CLOPIDOGREL DIPYRIDAMOLE DROXIA ELIQUIS ENOXAPARIN SODIUM ASPIRIN/DIPYRIDAMOLE CILOSTAZOL CLOPIDOGREL BISULFATE DIPYRIDAMOLE HYDROXYUREA APIXABAN ENOXAPARIN SODIUM PA TABLET X SOLUTION X TABLET X VIAL SYRINGE X X VIAL CPMP 12HR TABLET TABLET TABLET CAPSULE TABLET SYRINGE VIAL X Step QLL X EPOGEN FEIBA NF FONDAPARINUX SODIUM HELIXATE FS JANTOVEN KOGENATE FS LEUKINE MEPHYTON MIRCERA EPOETIN ALFA ANTI-INHIBITOR COAGULANT COMP. FONDAPARINUX SODIUM ANTIHEMOPH.FVIII,FULL LENGTH WARFARIN SODIUM ANTIHEMOPH.FVIII,FULL LENGTH SARGRAMOSTIM PHYTONADIONE METHOXY PEG-EPOETIN BETA VIAL VIAL SYRINGE VIAL TABLET VIAL VIAL TABLET SYRINGE X X NEULASTA PEGFILGRASTIM SYR W/ INJ X NEUPOGEN FILGRASTIM X X X PENTOXIFYLLINE PRADAXA PROCRIT RECOMBINATE SAVAYSA SOLIRIS THROMBATE III TICLOPIDINE HCL TRANEXAMIC ACID WARFARIN SODIUM XARELTO PENTOXIFYLLINE DABIGATRAN ETEXILATE MESYLATE EPOETIN ALFA ANTIHEMOPHILIC FACTOR, HUM REC EDOXABAN TOSYLATE ECULIZUMAB ANTITHROMBIN III (HUM PLAS) TICLOPIDINE HCL TRANEXAMIC ACID WARFARIN SODIUM RIVAROXABAN ZARXIO ZONTIVITY FILGRASTIM-SNDZ VORAPAXAR SULFATE SYRINGE SYRINGE VIAL TABLET ER CAPSULE VIAL VIAL TABLET VIAL VIAL TABLET TABLET TABLET TAB DS PK TABLET SYRINGE TABLET X X X X X X X X X X X X Age General Therapeutic Category HORMONAL DEFICIENCY Brand Name NEUMEGA FEIBA VH IMMUNO ADYNOVATE WILATE KOVALTRY NUWIQ IDELVION ANADROL-50 ANDROXY CLIMARA PRO COMBIPATCH CRINONE DEPO-PROVERA DIVIGEL ELESTRIN ENJUVIA ESTRADIOL Generic Name OPRELVEKIN ANTI-INHIBITOR COAGULANT COMP. ANTIHEMO.FVIII,FULL LENGTH PEG ANTIHEMOPHILIC FACTOR/VWF ANTIHEMOPH.FVIII,FULL LENGTH ANTIHEMOPH.FVIII,HEK B-DELETE FACTOR IX RECOM,ALBUMIN FUSION OXYMETHOLONE FLUOXYMESTERONE ESTRADIOL/LEVONORGESTREL ESTRADIOL/NORETHINDRONE ACET PROGESTERONE,MICRONIZED MEDROXYPROGESTERONE ACETATE ESTRADIOL ESTRADIOL ESTROGENS,CONJ.,SYNTHETIC B ESTRADIOL ESTRADIOL-NORETHINDRONE ACETAT ESTROGEL ESTROPIPATE EVAMIST JINTELI LOPREEZA LUPANETA PACK MEDROXYPROGESTERONE ACETATE MENEST MENOSTAR METHITEST MIMVEY MIMVEY LO NORETHINDRONE ACETATE NORETHINDRON-ETHINYL ESTRADIOL OXANDROLONE PREFEST PREMARIN PREMPHASE PREMPRO PROGESTERONE TESTOSTERONE CYPIONATE TESTOSTERONE ENANTHATE METHYLTESTOSTERONE FEMTRACE ESTRASORB CENESTIN FYAVOLV HYDROXYPROGESTERONE CAPROATE ESTRADIOL/NORETHINDRONE ACET ESTRADIOL ESTROPIPATE ESTRADIOL NORETHINDRONE AC-ETH ESTRADIOL ESTRADIOL/NORETHINDRONE ACET LEUPROLIDE/NORETHINDRONE ACET MEDROXYPROGESTERONE ACETATE ESTROGENS,ESTERIFIED ESTRADIOL METHYLTESTOSTERONE ESTRADIOL/NORETHINDRONE ACET ESTRADIOL/NORETHINDRONE ACET NORETHINDRONE ACETATE NORETHINDRONE AC-ETH ESTRADIOL OXANDROLONE ESTRADIOL/NORGESTIMATE ESTROGENS, CONJUGATED ESTROGEN,CON/M-PROGEST ACET ESTROGEN,CON/M-PROGEST ACET PROGESTERONE,MICRONIZED TESTOSTERONE CYPIONATE TESTOSTERONE ENANTHATE METHYLTESTOSTERONE ESTRADIOL ACETATE ESTRADIOL ESTROGENS,CONJ.,SYNTHETIC A NORETHINDRONE AC-ETH ESTRADIOL HYDROXYPROGESTERONE CAPROATE Dose VIAL VIAL VIAL VIAL VIAL VIAL VIAL TABLET TABLET PATCH TDWK PATCH TDSW GEL/PF APP VIAL GEL PACKET GEL MD PMP TABLET PATCH TDSW PATCH TDWK TABLET TABLET GEL MD PMP TABLET SPRAY TABLET TABLET KT SYR TAB TABLET TABLET PATCH TDWK TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET CAPSULE VIAL VIAL CAPSULE TABLET EMUL PACKT TABLET TABLET VIAL PA Step QLL X X X X X X X X X X X X X X X X Age General Therapeutic Category IMMUNIZATION Brand Name Generic Name ADACEL TDAP DIPH,PERTUSS(ACELL),TET VAC/PF AFLURIA 2015-2016 ATGAM BEXSERO BIVIGAM BOOSTRIX TDAP FLU VACCINE TS2015-16(5YR+)/PF FLU VACCINE TS2015-16(5 YR UP) LYMPHOCYTE IG, ANTITHYMOCYTE MENINGOCOCCAL B VACC,4-COMP/PF IMMUN GLOB G (IGG)/GLY/IGA 50+ DIPHTH,PERTUSS(ACELL),TET VAC CERVARIX HUMAN PAPILLOMAV VACC BIVAL/PF DIPHTHERIA-TETANUS TOXOIDS-PED ENGERIX-B ADULT TETANUS,DIPHTHERIA TOXD PED/PF HEPATITIS B VIRUS VACCINE/PF ENGERIX-B PEDIATRIC-ADOLESCENT HEPATITIS B VIRUS VACCINE/PF FLUARIX QUAD 2015-2016 FLUBLOK 2015-2016 FLUCELVAX 2015-2016 FLULAVAL QUAD 2015-2016 FLUMIST QUAD 2015-2016 FLUVIRIN 2015-2016 FLUZONE 2015-2016 FLUZONE HIGH-DOSE 2015-2016 FLUZONE INTRADERM QUAD 2015-16 FLUZONE QUAD 2015-2016 FLU VACC QS 2015-16(36MOS+)/PF FLU VAC TV 2015(18 YR+)RCM/PF FLU VACC TS 15-16 (18+)CELL/PF FLU VACCINE QS 2015-16(36MOS+) FLU VACC QV LIVE 2015(2-49YRS) FLU VACCINE TS 2015-2016(4YR+) FLU VACCINE TS2015-16(4YR+)/PF FLU VACCINE TS 2015-16(6 MOS+) FLU VACC TS 2015-16 (65YR+)/PF FLU VACC QS 2015 (18-64YRS)/PF FLU VACC QS 2015-16(36MOS+)/PF FLUZONE QUAD PEDI 2015-2016 GAMASTAN S-D GARDASIL FLU VACCINE QS 2015-16 (6MOS+) FLU VACC QS 2015 (6-35MOS)/PF IMMUNE GLOBUL G (IGG)/GLYCINE HUMAN PAPILOMVIRUS VAC,QVAL/PF GARDASIL 9 HPV VACCINE 9-VALENT/PF HAVRIX HEPATITIS A VIRUS VACCINE/PF IPOL POLIOMYELITIS VACCINE, KILLED MENACTRA MENOMUNE-A-C-Y-W-135 MENING VAC A,C,Y,W-135 DIP/PF MENINGOCOC VAC A,C,Y,W-135/PF MENINGOCOCCAL VAC A,C,Y,W-135 MENING VAC A,C,Y,W-135 DIP/PF MEASLES,MUMPS&RUBELLA VACC/PF DIPH,PERTUS(ACEL),TET,POLIO/PF PNEUMOCOCCAL 23-VAL P-SAC VAC MENVEO A-C-Y-W-135-DIP M-M-R II VACCINE PENTACEL DTAP-IPV COMPONENT PNEUMOVAX 23 Dose SYRINGE VIAL SYRINGE VIAL AMPUL SYRINGE VIAL SYRINGE VIAL SYRINGE VIAL VIAL SYRINGE VIAL SYRINGE VIAL SYRINGE VIAL SYRINGE VIAL NAS SP SYR VIAL SYRINGE VIAL SYRINGE SYRINGE SYRINGE VIAL VIAL SYRINGE VIAL SYRINGE VIAL SYRINGE VIAL SYRINGE VIAL SYRINGE VIAL VIAL VIAL VIAL KIT VIAL VIAL SYRINGE VIAL PA Step QLL Age X X X X X X X X X General Therapeutic Category IMMUNOSUPPRESSION/MODULATION INFECTIOUS DISEASE - BACTERIAL Brand Name PREVNAR 13 PROQUAD QUADRACEL DTAP-IPV RECOMBIVAX HB Generic Name PNEUMOC 13-VAL CONJ-DIP CRM/PF MEASLES,MUMPS,RUB,VARICELLA/PF DIPH,PERTUS(ACEL),TET,POLIO/PF HEPATITIS B VIRUS VACCINE/PF TENIVAC TETANUS AND DIPHTHERIA TOX/PF TETANUS DIPHTHERIA TOXOIDS TRUMENBA TWINRIX TETANUS, DIPHTHERIA TOX,ADULT N.MENINGITIDIS B,LIPID FHBP RC HEPATITIS A & B VACCINE/PF VAQTA HEPATITIS A VIRUS VACCINE/PF VARIVAX VACCINE ZOSTAVAX TETANUS-DIPHTERIA-DECAVAC DECAVAC FLUZONE QUAD PEDI 2013-2014 EZ FLU 2015-2016 (FLUVIRIN) EZ FLU 2015-2016 (FLUCELVAX) FLUAD 2015-2016 ACTIMMUNE ALFERON N AZASAN AZATHIOPRINE CYCLOSPORINE CYCLOSPORINE MODIFIED GENGRAF VARICELLA VACCINE LIVE/PF ZOSTER VACCINE LIVE/PF TETANUS AND DIPHTHERIA TOX/PF TETANUS AND DIPHTHERIA TOX/PF FLU VACCINE 2013(6-35MOS)/PF FLU VACCINE TS2015-16(4YR+)/PF FLU VACC TS 15-16 (18+)CELL/PF FLU VACC TS 2015(65+)/MF59C/PF INTERFERON GAMMA-1B,RECOMB. INTERFERON ALFA-N3 AZATHIOPRINE AZATHIOPRINE CYCLOSPORINE CYCLOSPORINE, MODIFIED CYCLOSPORINE, MODIFIED CYCLOSPORINE, MODIFIED IMIQUIMOD INTRON A MYCOPHENOLATE MOFETIL IMIQUIMOD INTERFERON ALFA-2B,RECOMB. MYCOPHENOLATE MOFETIL MYCOPHENOLIC ACID PROLEUKIN RAPAMUNE SIMULECT SIROLIMUS TACROLIMUS ORTHOCLONE OKT-3 AMOX TR-POTASSIUM CLAVULANATE AMOXICILLIN MYCOPHENOLATE SODIUM ALDESLEUKIN SIROLIMUS BASILIXIMAB SIROLIMUS TACROLIMUS MUROMONAB-CD3 AMOXICILLIN/POTASSIUM CLAV AMOXICILLIN AMOXICILLIN ER AMOXICILLIN Dose SYRINGE VIAL VIAL SYRINGE VIAL SYRINGE VIAL VIAL SYRINGE SYRINGE VIAL SYRINGE VIAL VIAL VIAL SYRINGE VIAL SYRINGE SYRINGEKIT SYRINGEKIT SYRINGE VIAL VIAL TABLET TABLET CAPSULE SOLUTION CAPSULE CAPSULE SOLUTION CREAM PACK VIAL CAPSULE SUSP RECON TABLET TABLET DR VIAL SOLUTION VIAL TABLET CAPSULE AMPUL TABLET CAPSULE SUSP RECON TAB CHEW TABLET TBMP 24HR PA Step QLL Age X X X X X X X X X General Therapeutic Category Brand Name AMPICILLIN TRIHYDRATE Generic Name AMPICILLIN TRIHYDRATE AUGMENTIN AZITHROMYCIN AMOXICILLIN/POTASSIUM CLAV AZITHROMYCIN CEFACLOR CEFACLOR CEFACLOR ER CEFADROXIL CEFACLOR CEFADROXIL CEFDINIR CEFDINIR CEFDITOREN PIVOXIL CEFIXIME CEFPODOXIME PROXETIL CEFDITOREN PIVOXIL CEFIXIME CEFPODOXIME PROXETIL CEFPROZIL CEFPROZIL CEFTIBUTEN CEFTIBUTEN CEFTIN CEFUROXIME CEPHALEXIN CEFUROXIME AXETIL CEFUROXIME AXETIL CEPHALEXIN CIPROFLOXACIN CIPROFLOXACIN ER CIPROFLOXACIN HCL CLARITHROMYCIN CIPROFLOXACIN CIPROFLOXACIN/CIPROFLOXA HCL CIPROFLOXACIN HCL CLARITHROMYCIN CLARITHROMYCIN ER DEMECLOCYCLINE HCL DICLOXACILLIN SODIUM DOXYCYCLINE MONOHYDRATE CLARITHROMYCIN DEMECLOCYCLINE HCL DICLOXACILLIN SODIUM DOXYCYCLINE MONOHYDRATE E.E.S. 200 E.E.S. 400 ERYPED 400 ERY-TAB ERYTHROCIN STEARATE ERYTHROMYCIN ERYTHROMYCIN ETHYLSUCCINATE ERYTHROMYCIN ETHYLSUCCINATE ERYTHROMYCIN ETHYLSUCCINATE ERYTHROMYCIN BASE ERYTHROMYCIN STEARATE ERYTHROMYCIN BASE ERYTHROMYCIN ETHYLSUCCINATE FACTIVE KETEK ERYTHROMYCIN ETHYLSUCCINATE GEMIFLOXACIN MESYLATE TELITHROMYCIN Dose CAPSULE SUSP RECON SUSP RECON PACKET SUSP RECON TABLET CAPSULE SUSP RECON TAB ER 12H CAPSULE SUSP RECON TABLET CAPSULE SUSP RECON TABLET SUSP RECON SUSP RECON TABLET SUSP RECON TABLET CAPSULE SUSP RECON SUSP RECON TABLET CAPSULE SUSP RECON TABLET SUS MC REC TBMP 24HR TABLET SUSP RECON TABLET TAB ER 24H TABLET CAPSULE CAPSULE SUSP RECON TABLET SUSP RECON TABLET SUSP RECON TABLET DR TABLET CAPSULE DR TABLET TABLET TABLET TABLET PA Step QLL X Age General Therapeutic Category INFECTIOUS DISEASE - FUNGAL INFECTIOUS DISEASE - MISCELLANEOUS Brand Name Generic Name LEVOFLOXACIN LEVOFLOXACIN MINOCYCLINE HCL MINOCYCLINE HCL MINOCYCLINE HCL ER MOXIFLOXACIN HCL NITROFURANTOIN NITROFURANTOIN MONO-MACRO OFLOXACIN PCE PENICILLIN V POTASSIUM MINOCYCLINE HCL MOXIFLOXACIN HCL NITROFURANTOIN NITROFURANTOIN MACROCRYSTAL NITROFURANTOIN MONOHYD/M-CRYST OFLOXACIN ERYTHROMYCIN BASE PENICILLIN V POTASSIUM SUPRAX CEFIXIME TETRACYCLINE HCL VIBRAMYCIN ZMAX NOROXIN AMOXICILLIN-CLAVULANATE POTASS TETRACYCLINE HCL DOXYCYCLINE CALCIUM AZITHROMYCIN NORFLOXACIN AMOXICILLIN/POTASSIUM CLAV AMOXICILLIN-CLAVULANATE POT ER ERYTHROMYCIN-SULFISOXAZOLE CEDAX CLOTRIMAZOLE CRESEMBA FLUCONAZOLE AMOXICILLIN/POTASSIUM CLAV ERY E-SUCC/SULFISOXAZOLE CEFTIBUTEN CLOTRIMAZOLE ISAVUCONAZONIUM SULFATE FLUCONAZOLE FLUCYTOSINE GRISEOFULVIN ITRACONAZOLE KETOCONAZOLE LAMISIL NOXAFIL FLUCYTOSINE GRISEOFULVIN, MICROSIZE ITRACONAZOLE KETOCONAZOLE TERBINAFINE HCL POSACONAZOLE NYSTATIN NYSTATIN SPORANOX TERBINAFINE HCL VORICONAZOLE ITRACONAZOLE TERBINAFINE HCL VORICONAZOLE BETHKIS TOBRAMYCIN Dose SOLUTION TABLET CAPSULE TAB ER 24H TABLET TAB ER 24H TABLET ORAL SUSP CAPSULE CAPSULE TABLET TAB PART SOLN RECON TABLET CAPSULE SUSP RECON TAB CHEW TABLET CAPSULE SYRUP SUS ER REC TABLET SUSP RECON TAB CHEW TABLET TAB ER 12H SUSP RECON SUSP RECON TROCHE CAPSULE SUSP RECON TABLET CAPSULE ORAL SUSP CAPSULE TABLET GRAN PACK ORAL SUSP TABLET DR ORAL SUSP POWDER(EA) TABLET SOLUTION TABLET SUSP RECON TABLET AMPUL-NEB PA Step QLL Age X X X X X X X X X X General Therapeutic Category Brand Name CLINDAMYCIN HCL CLINDAMYCIN PALMITATE HCL CLINDAMYCIN PEDIATRIC CYCLOSERINE DAPSONE ETHAMBUTOL HCL ISONIAZID Generic Name CLINDAMYCIN HCL CLINDAMYCIN PALMITATE HCL CLINDAMYCIN PALMITATE HCL CYCLOSERINE DAPSONE ETHAMBUTOL HCL ISONIAZID NEOMYCIN SULFATE AMINOSALICYLIC ACID RIFAPENTINE PYRAZINAMIDE RIFABUTIN RIFAMPIN RIFAMP/ISONIAZID/PYRAZINAMIDE THALIDOMIDE Dose CAPSULE SOLN RECON SOLN RECON CAPSULE TABLET TABLET SOLUTION TABLET TABLET GRANPKT DR TABLET TABLET CAPSULE CAPSULE TABLET CAPSULE NEOMYCIN SULFATE PASER PRIFTIN PYRAZINAMIDE RIFABUTIN RIFAMPIN RIFATER THALOMID X TOBI PODHALER TOBRAMYCIN CAP W/DEV X CAPSULE X TOBRAMYCIN IN 0.225% NACL AMPUL-NEB X TOBRAMYCIN/NEBULIZER AMPUL-NEB X TRECATOR VANCOMYCIN HCL ETHIONAMIDE VANCOMYCIN HCL XIFAXAN ISONARIF KITABIS PAK RIFAXIMIN RIFAMPIN/ISONIAZID TOBRAMYCIN/NEBULIZER TABLET CAPSULE VIAL VIAL PORT TABLET CAPSULE AMPUL-NEB ALBENZA ATOVAQUONE ATOVAQUONE-PROGUANIL HCL BILTRICIDE CHLOROQUINE PHOSPHATE DARAPRIM FLAGYL ER HYDROXYCHLOROQUINE SULFATE IVERMECTIN MEFLOQUINE HCL METRONIDAZOLE ALBENDAZOLE ATOVAQUONE ATOVAQUONE/PROGUANIL HCL PRAZIQUANTEL CHLOROQUINE PHOSPHATE PYRIMETHAMINE METRONIDAZOLE HYDROXYCHLOROQUINE SULFATE IVERMECTIN MEFLOQUINE HCL METRONIDAZOLE NEBUPENT PAROMOMYCIN SULFATE PRIMAQUINE PENTAMIDINE ISETHIONATE PAROMOMYCIN SULFATE PRIMAQUINE PHOSPHATE TOBRAMYCIN INFECTIOUS DISEASE - PARASITIC TABLET ORAL SUSP TABLET TABLET TABLET TABLET TABLET ER TABLET TABLET TABLET CAPSULE TABLET VIAL-NEB CAPSULE TABLET PA Step QLL X X X X X X X X X X X X X Age General Therapeutic Category INFECTIOUS DISEASE - VIRAL Brand Name QUININE SULFATE TINIDAZOLE MEBENDAZOLE YODOXIN ABACAVIR ABACAVIR-LAMIVUDINE-ZIDOVUDINE ACYCLOVIR Generic Name QUININE SULFATE TINIDAZOLE MEBENDAZOLE IODOQUINOL ABACAVIR SULFATE ABACAVIR/LAMIVUDINE/ZIDOVUDINE ACYCLOVIR ADEFOVIR DIPIVOXIL Dose CAPSULE TABLET TAB CHEW TABLET TABLET TABLET CAPSULE ORAL SUSP TABLET TABLET ADEFOVIR DIPIVOXIL X APTIVUS ATRIPLA BARACLUDE TIPRANAVIR TIPRANAVIR/VITAMIN E TPGS EFAVIRENZ/EMTRICITAB/TENOFOVIR ENTECAVIR CAPSULE SOLUTION TABLET SOLUTION X COMPLERA CRIXIVAN DIDANOSINE EDURANT EMTRIVA EMTRICITAB/RILPIVIRINE/TENOFOV INDINAVIR SULFATE DIDANOSINE RILPIVIRINE HCL EMTRICITABINE ENTECAVIR ENTECAVIR TABLET CAPSULE CAPSULE DR TABLET CAPSULE SOLUTION TABLET X EPIVIR HBV LAMIVUDINE SOLUTION X EPZICOM EVOTAZ FAMCICLOVIR HARVONI INTELENCE INVIRASE ABACAVIR SULFATE/LAMIVUDINE ATAZANAVIR SULFATE/COBICISTAT FAMCICLOVIR LEDIPASVIR/SOFOSBUVIR ETRAVIRINE SAQUINAVIR MESYLATE ISENTRESS RALTEGRAVIR POTASSIUM KALETRA LOPINAVIR/RITONAVIR LAMIVUDINE LAMIVUDINE TABLET TABLET TABLET TABLET TABLET CAPSULE TABLET POWD PACK TAB CHEW TABLET SOLUTION TABLET SOLUTION TABLET LAMIVUDINE HBV LAMIVUDINE TABLET LAMIVUDINE-ZIDOVUDINE LEXIVA LAMIVUDINE/ZIDOVUDINE FOSAMPRENAVIR CALCIUM NEVIRAPINE NEVIRAPINE TABLET ORAL SUSP TABLET ORAL SUSP TABLET PA Step QLL X X X X X Age General Therapeutic Category Brand Name Generic Name NEVIRAPINE ER NORVIR NEVIRAPINE RITONAVIR OLYSIO PEGASYS SIMEPREVIR SODIUM PEGINTERFERON ALFA-2A Dose TAB ER 24H CAPSULE SOLUTION TABLET CAPSULE KIT X SYRINGE X VIAL X KIT PEN IJ KIT TABLET ORAL SUSP TABLET X X X PA Step QLL X X PEGINTRON PEGINTRON REDIPEN PREZCOBIX PREZISTA PEGINTERFERON ALFA-2B PEGINTERFERON ALFA-2B DARUNAVIR/COBICISTAT DARUNAVIR ETHANOLATE X REBETOL RIBAVIRIN SOLUTION RELENZA RESCRIPTOR ZANAMIVIR DELAVIRDINE MESYLATE REYATAZ ATAZANAVIR SULFATE RIBASPHERE RIBAVIRIN BLST W/DEV TAB DISPER TABLET CAPSULE POWD PACK CAPSULE X TABLET X X RIBASPHERE RIBAPAK RIBAVIRIN TAB DS PK X RIBAVIRIN RIBAVIRIN CAPSULE X TABLET X RIMANTADINE HCL SELZENTRY SOVALDI STAVUDINE RIMANTADINE HCL MARAVIROC SOFOSBUVIR STAVUDINE STRIBILD SUSTIVA ELVITEGR/COBICIST/EMTRIC/TENOF EFAVIRENZ SYNAGIS TAMIFLU PALIVIZUMAB OSELTAMIVIR PHOSPHATE TIVICAY TRIUMEQ TRUVADA DOLUTEGRAVIR SODIUM ABACAVIR/DOLUTEGRAVIR/LAMIVUDI EMTRICITABINE/TENOFOVIR TABLET TABLET TABLET CAPSULE SOLN RECON TABLET CAPSULE TABLET VIAL CAPSULE SUSP RECON TABLET TABLET TABLET X X X X X X Age General Therapeutic Category INFLAMMATORY DISEASE Brand Name Dose TABLET TABLET TABLET TABLET SOLN RECON POWDER TABLET VIAL-NEB X BOCEPREVIR POWDER TABLET TABLET SOLUTION CAPSULE SYRUP TABLET CAPSULE X RIBAPAK INCIVEK RIBAVIRIN TELAPREVIR TAB DS PK TABLET X X INFERGEN GENVOYA DAKLINZA INTERFERON ALFACON-1 ELVITEG/COBI/EMTRIC/TENOFO ALA DACLATASVIR DIHYDROCHLORIDE VIAL TABLET TABLET X ZEPATIER DESCOVY ODEFSEY ALEVE ALL DAY PAIN RELIEF ALL DAY RELIEF ARCALYST BUDESONIDE EC CELECOXIB CHILD IBUPROFEN CHILDREN'S IBUPROFEN CHILDREN'S MEDI-PROFEN CHILDREN'S PROFEN IB CHILDREN'S PROFENIB CORTISONE ACETATE DELTASONE DEPEN DEXAMETHASONE ELBASVIR/GRAZOPREVIR EMTRICITABINE/TENOFOV ALAFENAM EMTRICITAB/RILPIVIRI/TENOF ALA NAPROXEN SODIUM NAPROXEN SODIUM NAPROXEN SODIUM RILONACEPT BUDESONIDE CELECOXIB IBUPROFEN IBUPROFEN IBUPROFEN IBUPROFEN IBUPROFEN CORTISONE ACETATE PREDNISONE PENICILLAMINE DEXAMETHASONE X DEXAMETHASONE INTENSOL DICLOFENAC POTASSIUM DICLOFENAC SODIUM DEXAMETHASONE DICLOFENAC POTASSIUM DICLOFENAC SODIUM TABLET TABLET TABLET TABLET TABLET TABLET VIAL CAPDR - ER CAPSULE ORAL SUSP ORAL SUSP ORAL SUSP ORAL SUSP ORAL SUSP TABLET TABLET TABLET ELIXIR SOLUTION TABLET DROPS TABLET TABLET DR Generic Name TYBOST TYZEKA VALACYCLOVIR VALGANCICLOVIR HCL VIDEX VIRACEPT COBICISTAT TELBIVUDINE VALACYCLOVIR HCL VALGANCICLOVIR HCL DIDANOSINE NELFINAVIR MESYLATE VIRAZOLE RIBAVIRIN VIREAD TENOFOVIR DISOPROXIL FUMARATE VITEKTA ZIAGEN ZIDOVUDINE ELVITEGRAVIR ABACAVIR SULFATE ZIDOVUDINE VICTRELIS PA X Step QLL X X X X X Age General Therapeutic Category Brand Name DICLOFENAC SODIUM ER ENBREL DICLOFENAC SODIUM ETANERCEPT ETODOLAC ETODOLAC ETODOLAC ER FENOPROFEN CALCIUM ETODOLAC FENOPROFEN CALCIUM FLANAX FLUDROCORTISONE ACETATE FLURBIPROFEN HUMIRA NAPROXEN SODIUM FLUDROCORTISONE ACETATE FLURBIPROFEN ADALIMUMAB HUMIRA PEDIATRIC CROHN'S HYALGAN HYDROCORTISONE IBUPROFEN ADALIMUMAB HYALURONATE SODIUM HYDROCORTISONE IBUPROFEN IBUPROFEN IB INDOCIN IBUPROFEN INDOMETHACIN INDOMETHACIN INDOMETHACIN I-PRIN KETOPROFEN IBUPROFEN KETOPROFEN KETOROLAC TROMETHAMINE KINERET LEFLUNOMIDE MECLOFENAMATE SODIUM MEDI-PROFEN MEDIPROXEN MEDROL MEFENAMIC ACID MELOXICAM KETOROLAC TROMETHAMINE ANAKINRA LEFLUNOMIDE MECLOFENAMATE SODIUM IBUPROFEN NAPROXEN SODIUM METHYLPREDNISOLONE MEFENAMIC ACID MELOXICAM METHYLPREDNISOLONE METHYLPREDNISOLONE MILLIPRED MILLIPRED DP NABUMETONE NAPRELAN NAPROXEN PREDNISOLONE PREDNISOLONE SOD PHOSPHATE PREDNISOLONE NABUMETONE NAPROXEN SODIUM NAPROXEN NAPROXEN SODIUM NAPROXEN SODIUM Generic Name Dose TAB ER 24H PEN INJCTR SYRINGE VIAL CAPSULE TABLET TAB ER 24H CAPSULE TABLET TABLET TABLET TABLET SYRINGEKIT SYRINGEKIT VIAL TABLET ORAL SUSP TABLET TABLET ORAL SUSP SUPP.RECT CAPSULE CAPSULE ER TABLET CAP24H PEL CAPSULE TABLET SYRINGE TABLET CAPSULE TABLET TABLET TABLET CAPSULE ORAL SUSP TABLET TAB DS PK TABLET TABLET SOLUTION TAB DS PK TABLET TBMP 24HR ORAL SUSP TABLET TABLET DR TABLET PA Step QLL X X X X X X X X X X X X Age General Therapeutic Category Brand Name Generic Name ORENCIA OTEZLA ABATACEPT/MALTOSE APREMILAST OXAPROZIN PIROXICAM PREDNISOLONE PREDNISOLONE SODIUM PHOSPHATE PREDNISONE OXAPROZIN PIROXICAM PREDNISOLONE PREDNISOLONE SOD PHOSPHATE PREDNISONE PREDNISONE INTENSOL PROVIL RIDAURA SIMPONI PREDNISONE IBUPROFEN AURANOFIN GOLIMUMAB Dose VIAL TAB DS PK TABLET TABLET CAPSULE SOLUTION SOLUTION SOLUTION TAB DS PK TABLET ORAL CONC TABLET CAPSULE PEN INJCTR SYRINGE PA Step QLL X X X X X X X X LOCAL ANESTHESIA LOWER GASTROINTESTINAL DISORDERS - BOWEL INFLAMMAT STELARA SULINDAC TOLMETIN SODIUM USTEKINUMAB SULINDAC TOLMETIN SODIUM VERIPRED 20 WAL-PROFEN WAL-PROXEN XELJANZ PREDNISOLONE SOD PHOSPHATE IBUPROFEN NAPROXEN SODIUM TOFACITINIB CITRATE CELESTONE PREDNISOLONE SODIUM PHOS ODT PRELONE HUMIRA PEN HUMIRA PEN CROHN'S-UC-HS HUMIRA PEN PSORIASIS XELJANZ XR LIDOCAINE HCL BETAMETHASONE PREDNISOLONE SOD PHOSPHATE PREDNISOLONE ADALIMUMAB ADALIMUMAB ADALIMUMAB TOFACITINIB CITRATE LIDOCAINE HCL ANUCORT-HC APRISO ASACOL HD BALSALAZIDE DISODIUM CANASA CIMZIA COLOCORT CORTIFOAM DELZICOL DIPENTUM GRX HICORT 25 HYDROCORTISONE HYDROCORTISONE ACETATE MESALAMINE MESALAMINE BALSALAZIDE DISODIUM MESALAMINE CERTOLIZUMAB PEGOL HYDROCORTISONE HYDROCORTISONE ACETATE MESALAMINE OLSALAZINE SODIUM HYDROCORTISONE ACETATE HYDROCORTISONE SYRINGE TABLET CAPSULE TABLET SOLUTION TABLET TABLET TABLET SOLUTION TAB RAPDIS SOLUTION PEN IJ KIT PEN IJ KIT PEN IJ KIT TAB ER 24H SOLUTION JEL (ML) SUPP.RECT CAP ER 24H TABLET DR CAPSULE SUPP.RECT KIT ENEMA FOAM/APPL CAPSULE DR CAPSULE SUPP.RECT CREAM (G) X X X X X X X X X X X X Age General Therapeutic Category Brand Name Generic Name LIALDA LINZESS MESALAMINE PENTASA PROCTOFOAM-HC PROCTO-PAK PROCTOSOL-HC PROCTOZONE-HC REMICADE MESALAMINE LINACLOTIDE MESALAMINE MESALAMINE HYDROCORTISONE/PRAMOXINE HYDROCORTISONE HYDROCORTISONE HYDROCORTISONE INFLIXIMAB SULFADIAZINE SULFAMETHOXAZOLE-TRIMETHOPRIM SULFADIAZINE SULFAMETHOXAZOLE/TRIMETHOPRIM SULFASALAZINE SULFASALAZINE DR SULFATRIM ASACOL HYDROCORTISONE ACETATE VIBERZI PROCTO-MED HC ALOPHEN PILLS ALOSETRON HCL AMITIZA ANTI-DIARRHEAL BISAC-EVAC BISACODYL SULFASALAZINE SULFASALAZINE SULFAMETHOXAZOLE/TRIMETHOPRIM MESALAMINE HYDROCORTISONE ACETATE ELUXADOLINE HYDROCORTISONE BISACODYL ALOSETRON HCL LUBIPROSTONE BISMUTH SUBSALICYLATE LOPERAMIDE HCL BISACODYL BISACODYL BISA-LAX BISCOLAX BISMATROL BISACODYL BISACODYL BISMUTH SUBSALICYLATE BISMUTH BISMUTH SUBSALICYLATE BUPHENYL SODIUM PHENYLBUTYRATE CHILD SUPPOSITORY CHOLBAM CITRATE OF MAGNESIA CITROMA COL-RITE CONSTULOSE DIARRHEA RELIEF DIOCTO GLYCERIN CHOLIC ACID MAGNESIUM CITRATE MAGNESIUM CITRATE DOCUSATE SODIUM LACTULOSE BISMUTH SUBSALICYLATE DOCUSATE SODIUM DIOCTYL DOCUSATE SODIUM Dose CREAM/APPL ENEMA TABLET DR CAPSULE ENEMA CAPSULE ER FOAM CREAM (G) CREAM/APPL CREAM/APPL VIAL PA Step QLL X X X LOWER GASTROINTESTINAL DISORDERS - OTHER TABLET ORAL SUSP TABLET TABLET TABLET DR ORAL SUSP TABLET DR SUPP.RECT TABLET CREAM/APPL TABLET DR TABLET CAPSULE ORAL SUSP LIQUID SUPP.RECT SUPP.RECT TABLET DR TABLET DR SUPP.RECT ORAL SUSP TAB CHEW ORAL SUSP TAB CHEW TABLET SUPP.RECT CAPSULE SOLUTION SOLUTION CAPSULE SOLUTION ORAL SUSP LIQUID SYRUP SYRUP X X Age General Therapeutic Category Brand Name DIOTAME DIPHENOXYLATE-ATROPINE Generic Name BISMUTH SUBSALICYLATE DIPHENOXYLATE HCL/ATROPINE DOC-Q-LACE DOCUSATE SODIUM DOC-Q-LAX DOCU LIQUID DOCUSATE CALCIUM DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM DOCUSATE SODIUM DOCUSATE CALCIUM DOCUSATE SODIUM DOCUSATE SODIUM-SENNA DOCUSIL DOK DOK PLUS DUCODYL DULCOLAX STOOL SOFTENER ENEMA ENEMA DISPOSABLE ENULOSE EVAC-U-GEN FAST RELIEF LAXATIVE FIBER SENNOSIDES/DOCUSATE SODIUM DOCUSATE SODIUM DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM BISACODYL DOCUSATE SODIUM NA PHOS,M-B/NA PHOS,DI-BA NA PHOS,M-B/NA PHOS,DI-BA LACTULOSE SENNOSIDES BISACODYL CALCIUM POLYCARBOPHIL PSYLLIUM HUSK PSYLLIUM HUSK (WITH SUGAR) PSYLLIUM HUSK/ASPARTAME CALCIUM POLYCARBOPHIL CALCIUM POLYCARBOPHIL PSYLLIUM HUSK PSYLLIUM SEED PSYLLIUM SEED (WITH SUGAR) PSYLLIUM SEED PSYLLIUM SEED (WITH SUGAR) CALCIUM POLYCARBOPHIL CALCIUM POLYCARBOPHIL PSYLLIUM HUSK PSYLLIUM HUSK (WITH SUGAR) PSYLLIUM SEED PSYLLIUM SEED (WITH SUGAR) CALCIUM POLYCARBOPHIL CALCIUM POLYCARBOPHIL CROFELEMER PEG 3350/NA SULF,BICARB,CL/KCL PEG 3350/NA SULF,BICARB,CL/KCL SODIUM CHLORIDE/NAHCO3/KCL/PEG LACTULOSE BISACODYL FIBER LAX FIBER LAXATIVE FIBER SMOOTH FIBER TABS FIBER THERAPY FIBER-LAX FIBER-TABS FULYZAQ GAVILYTE-C GAVILYTE-G GAVILYTE-N GENERLAC GENTLE LAXATIVE Dose TAB CHEW LIQUID TABLET CAPSULE LIQUID SYRUP TABLET LIQUID CAPSULE CAPSULE LIQUID SYRUP TABLET CAPSULE CAPSULE TABLET TABLET DR CAPSULE ENEMA ENEMA SOLUTION TABLET SUPP.RECT TABLET CAPSULE POWDER POWDER TABLET TABLET CAPSULE POWDER POWDER POWDER POWDER TABLET TABLET CAPSULE POWDER POWDER POWDER TABLET TABLET TABLET DR SOLN RECON SOLN RECON SOLN RECON SOLUTION SUPP.RECT PA X Step QLL X Age General Therapeutic Category Brand Name GERI-KOT GERI-PECTATE GLYCERIN GOLYTELY HYDROCIL INSTANT KAOPECTATE KAO-TIN KONSYL KONSYL FIBER K-PEC KRISTALOSE LACTULOSE LAX STOOL SOFTENER WITH SENNA LAXACIN LAXATIVE LAXATIVE SUPPOSITORY LITHOSTAT LOPERAMIDE MAGIC BULLET MAGNESIUM CITRATE MEDI-BISMUTH MEDI-LAXX MEDI-MUCIL MEDI-NATURAL MEDI-NATURAL SENNA STOOL SOFT MILK OF MAGNESIA MOTOFEN MOVIPREP NATURAL FIBER NATURAL FIBER POWDER NATURAL SENNA LAXATIVE NATURAL VEGETABLE LAXATIVE NATURAL VEGETABLE POWDER OPIUM TINCTURE OSMOPREP PAREGORIC P-COL RITE PEDIA-LAX PEDIATRIC ENEMA Generic Name SENNOSIDES BISMUTH SUBSALICYLATE GLYCERIN PEG 3350/NA SULF,BICARB,CL/KCL PSYLLIUM SEED BISMUTH SUBSALICYLATE BISMUTH SUBSALICYLATE DOCUSATE CALCIUM PSYLLIUM HUSK PSYLLIUM HUSK (WITH SUGAR) CALCIUM POLYCARBOPHIL BISMUTH SUBSALICYLATE LACTULOSE LACTULOSE SENNOSIDES/DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM BISACODYL BISACODYL GLYCERIN ACETOHYDROXAMIC ACID LOPERAMIDE HCL BISACODYL MAGNESIUM CITRATE BISMUTH SUBSALICYLATE SENNOSIDES/DOCUSATE SODIUM PSYLLIUM HUSK SENNOSIDES SENNOSIDES/DOCUSATE SODIUM MAGNESIUM HYDROXIDE DIFENOXIN HCL/ATROPINE SULFATE PEG3350/SOD SUL/NACL/ASB/C/KCL PSYLLIUM HUSK PSYLLIUM SEED (WITH SUGAR) PSYLLIUM SEED (WITH SUGAR) SENNOSIDES SENNOSIDES PSYLLIUM HUSK (WITH SUGAR) PSYLLIUM SEED PSYLLIUM SEED (WITH SUGAR) OPIUM TINCTURE NAPHOS M-B M-H/NA PHOS,DI-BA PAREGORIC SENNOSIDES/DOCUSATE SODIUM GLYCERIN NA PHOS,M-B/NA PHOS,DI-BA Dose TABLET DR TABLET ORAL SUSP SUPP.RECT POWD PACK POWDER ORAL SUSP ORAL SUSP CAPSULE CAPSULE POWDER POWDER TABLET ORAL SUSP PACKET SOLUTION TABLET TABLET TABLET DR SUPP.RECT SUPP.RECT TABLET CAPSULE LIQUID SUPP.RECT SOLUTION TAB CHEW TABLET CAPSULE TABLET TABLET ORAL SUSP TABLET POWD PACK CAPSULE POWDER POWDER TABLET TABLET POWDER POWDER POWDER TINCTURE TABLET LIQUID TABLET SUPP.RECT ENEMA PA Step QLL Age General Therapeutic Category Brand Name PEG 3350-ELECTROLYTE PEG-3350 AND ELECTROLYTES PEG-3350 WITH FLAVOR PACKS PEPTIC RELIEF Generic Name PEG 3350/NA SULF,BICARB,CL/KCL SODIUM CHLORIDE/NAHCO3/KCL/PEG PEG 3350/NA SULF,BICARB,CL/KCL SODIUM CHLORIDE/NAHCO3/KCL/PEG BISMUTH SUBSALICYLATE PEP-T-MED PERI-COLACE PHILLIPS' LAXATIVE PHOSPHATE ENEMA PINK BISMUTH BISMUTH SUBSALICYLATE SENNOSIDES/DOCUSATE SODIUM DOCUSATE SODIUM NA PHOS,M-B/NA PHOS,DI-BA BISMUTH SUBSALICYLATE POLYETHYLENE GLYCOL 3350 POLYETHYLENE GLYCOL 3350 PSYLLIUM FIBER PURE & GENTLE SALINE ENEMA REGULOID SENNA PLUS SENNA S SENNALAX-S SENNA-S SENNA-TIME S SENNO SENNOSIDES-DOCUSATE SODIUM SENOKOT-S SEN-O-TAB SILACE PSYLLIUM HUSK NA PHOS,M-B/NA PHOS,DI-BA PSYLLIUM HUSK PSYLLIUM SEED PSYLLIUM SEED (WITH SUGAR) NA PHOS,M-B/NA PHOS,DI-BA GLYCERIN SENNOSIDES SENNOSIDES/DOCUSATE SODIUM SENNOSIDES SENNOSIDES SENNOSIDES SENNOSIDES/DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM SENNOSIDES SENNOSIDES/DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM SENNOSIDES DOCUSATE SODIUM SOOTHE BISMUTH SUBSALICYLATE STIMULANT LAXATIVE PLUS STOMACH RELIEF SENNOSIDES/DOCUSATE SODIUM BISMUTH SUBSALICYLATE STOMACH RELIEF ORIGINAL STOOL SOFTENER BISMUTH SUBSALICYLATE DOCUSATE CALCIUM DOCUSATE SODIUM SALINE ENEMA SANI-SUPP SENEXON SENEXON-S SENNA SENNA LAX SENNA LAXATIVE Dose SOLN RECON SOLN RECON SOLN RECON SOLN RECON ORAL SUSP TAB CHEW TAB CHEW TABLET CAPSULE ENEMA ORAL SUSP TAB CHEW POWD PACK POWDER CAPSULE ENEMA CAPSULE POWDER POWDER ENEMA SUPP.RECT TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET LIQUID SYRUP ORAL SUSP TAB CHEW TABLET ORAL SUSP TAB CHEW ORAL SUSP CAPSULE CAPSULE LIQUID SYRUP PA Step QLL Age General Therapeutic Category Brand Name STOOL SOFTENER-LAXATIVE STOOL SOFTENER-STIMULANT LAX TRILYTE WITH FLAVOR PACKETS URSODIOL VEGETABLE LAXATIVE WAL-MUCIL WOMAN'S LAXATIVE WOMEN'S GENTLE LAXATIVE WOMEN'S LAXATIVE WOMENS STOOL SOFTENER EX-LAX MILK OF MAGNESIA PERDIEM OCL SENNA-GEN FIBERTAB DOCUSOFT S DOCU SOFT FIBER SUPPLEMENT CALCIUM STOOL SOFTENER INFANT GLYCERIN SENNA-DOCUSATE SODIUM METAMUCIL DSS NATURAL FIBER LAXATIVE NATURAL DAILY FIBER DISPOSABLE ENEMA NATURAL FIBER SUPPLEMENT CURAD ENEMA GERI-MUCIL METAFIBER NATURAL PSYLLIUM FIBER DAILY FIBER CALCIUM POLYCARBOPHIL DIGESTIVE RELIEF MEDICAL SUPPLIES ACCU-CHEK ACCU-CHEK FASTCLIX ACCU-CHEK SOFTCLIX ADVOCATE SYRINGES ASSURE ID INSULIN SAFETY Generic Name SENNOSIDES/DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM SENNOSIDES/DOCUSATE SODIUM SODIUM CHLORIDE/NAHCO3/KCL/PEG URSODIOL PSYLLIUM SEED SENNOSIDES PSYLLIUM HUSK PSYLLIUM HUSK/ASPARTAME BISACODYL BISACODYL BISACODYL DOCUSATE SODIUM MAGNESIUM HYDROXIDE CALCIUM POLYCARBOPHIL SOD SULF/SODIUM/NAHCO3/KCL/PEG SENNOSIDES CALCIUM POLYCARBOPHIL DOCUSATE SODIUM DOCUSATE SODIUM PSYLLIUM SEED (WITH SUGAR) DOCUSATE CALCIUM GLYCERIN SENNOSIDES/DOCUSATE SODIUM PSYLLIUM HUSK/ASPARTAME DOCUSATE SODIUM PSYLLIUM HUSK/ASPARTAME PSYLLIUM HUSK/ASPARTAME NA PHOS,M-B/NA PHOS,DI-BA PSYLLIUM HUSK/ASPARTAME NA PHOS,M-B/NA PHOS,DI-BA PSYLLIUM HUSK/ASPARTAME PSYLLIUM SEED PSYLLIUM SEED (WITH SUGAR) PSYLLIUM HUSK/ASPARTAME PSYLLIUM HUSK CALCIUM POLYCARBOPHIL BISMUTH SUBSALICYLATE LANCETS LANCETS LANCETS SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE,NEEDLE,INSULN,SAFE,1ML SYRINGE,NEEDLE,INSULN,SF 0.5ML Dose TABLET TABLET TABLET SOLN RECON CAPSULE TABLET POWDER TABLET CAPSULE POWDER TABLET DR TABLET DR TABLET DR CAPSULE ORAL SUSP TABLET SOLUTION TABLET TABLET CAPSULE CAPSULE POWDER CAPSULE SUPP.RECT TABLET POWDER CAPSULE POWDER POWDER ENEMA POWDER ENEMA POWDER POWDER POWDER POWDER CAPSULE TABLET ORAL SUSP TAB CHEW EACH EACH EACH DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN PA Step QLL Age General Therapeutic Category Brand Name CAREONE COMFORT EZ EASY COMFORT INSULIN SYRINGE EASY TOUCH EASY TOUCH INSULIN SAFETY EASY TOUCH INSULIN SYRINGE EASY-TOUCH INSULIN SYRINGE ECLIPSE SYRINGE FREESTYLE PRECISION GLUCOSOURCE INSULIN SYRINGE INTEGRA SYRINGE LITE TOUCH LUER-LOK SYRINGE MAGELLAN INSULIN SAFETY SYRNG MAGELLAN INSULIN SYRINGE MAXI-COMFORT MONOJECT MONOJECT INSULIN SAFETY SYRNG MONOJECT INSULIN SYRINGE ONE-PIECE SHARPS COLLECTORS ONETOUCH DELICA Generic Name LANCETS SYR,NDL,INSULIN,1ML-SHARPS BIN LANCETS SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML LANCETS SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE,NEEDLE,INSULN,SAFE,1ML SYRINGE,NEEDLE,INSULN,SF 0.5ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML LANCETS SYRINGE W-O NEEDL,INSULIN,1 ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRGE-NDL,INS 0.3 ML HALF MARK SYRINGE AND NEEDLE,INSULIN,1ML LANCETS SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE W-O NEEDL,INSULIN,1 ML SYRINGE,NEEDLE,INSULN,SAFE,1ML SYRINGE,NEEDLE,INSULN,SF 0.5ML SYRINGE,NEEDLE,INSULN,SF,0.3ML SYRINGE,NEEDLE,INSULN,SF 0.5ML SYRINGE,NEEDLE,INSULN,SF,0.3ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRINGE W-NDL, DISP., INSULIN SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML CONTAINER,EMPTY LANCETS Dose EACH SYRINGE EACH DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN EACH DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN EACH DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN EACH DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN EACH EACH PA Step QLL Age General Therapeutic Category Brand Name ONETOUCH SURESOFT PRODIGY INSULIN SYRINGE SAFESNAP INSULIN SYRINGE SAFETYGLIDE INSULIN SYRINGE SAFETYGLIDE SYRINGE SHARPS COLLECTOR SHARPS CONTAINER SMARTDIABETES VANTAGE SOFTCLIX SURE COMFORT SURE-JECT INSULIN SYRINGE TERUMO INSULIN SYRINGE THINPRO INSULIN SYRINGE TOPCARE ULTRA COMFORT TRUEPLUS INSULIN SYRINGE ULTICARE ULTILET INSULIN SYRINGE ULTRA COMFORT ULTRA-THIN II Generic Name LANCETS SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYR,NDL 0.3 ML,INS,SAFE,D.UNIT SYR,NDL,INS,SAFE 0.5ML,DISP UN SYR,NDL 1 ML,INS,SAFE,DISP UNT SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE AND NEEDLE,INSULIN,1ML CONTAINER,EMPTY CONTAINER,EMPTY MISCELLANEOUS MEDICAL SUPPLY LANCETS LANCETS SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML LANCETS SYRINGE AND NEEDLE,INSULIN,1ML SYR,NDL,INSULIN,1ML-SHARPS BIN SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRINGE W-NDL, DISP., INSULIN SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML SYRGE-NDL,INS 0.3 ML HALF MARK LANCETS SYRINGE AND NEEDLE,INSULIN,1ML Dose EACH DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN EACH EACH EACH EACH EACH DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN EACH DISP SYRIN SYRINGE DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN DISP SYRIN EACH DISP SYRIN PA Step QLL Age General Therapeutic Category Brand Name UNISTIK 3 VANISHPOINT FINGERSTIX MICROLET SINGLE-LET ULTRA THIN LANCETS MICRO THIN LANCETS SUPER THIN LANCETS E-Z JECT LANCETS MAJOR COMFORT LANCETS KINNEY BRAND LANCETS THIN LANCETS INCONTROL ULTRA THIN LANCETS UNILET LANCETS ADVANCED TRAVEL LANCETS ON-THE-GO UNILET LANCET UNILET GP LANCET ALTERNATE SITE LANCETS UNILET COMFORTOUCH UNILET EXCELITE UNILET EXCELITE II COMFORT LANCETS AURORA SUPER THIN LANCETS INCONTROL SUPER THIN LANCETS HEALTHY ACCENTS UNILET LANCET LANCETS THIN LANCETS ULTRA THIN FINE 30 UNIVERSAL LANCETS MEDLANCE PLUS EXEL INSULIN SYRINGE BD ULTRA-FINE BD ULTRA-FINE II BD MICROTAINER LANCETS MICROTAINER LANCETS HAEMOLANCE, RETRACTABLE TECHLITE LANCETS TECHLITE BLOOD LANCET TECHLITE HAEMOLANCE ASSURE HAEMOLANCE PLUS ASSURE LANCE PLUS ASSURE LANCE Generic Name SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML LANCETS SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS SYRINGE-NEEDLE,INSULIN,0.5 ML LANCETS LANCETS LANCETS BLADE LANCET, SAFETY LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS BLADE LANCET, SAFETY LANCETS LANCETS Dose DISP SYRIN DISP SYRIN EACH DISP SYRIN DISP SYRIN EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH DISP SYRIN EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH PA Step QLL Age General Therapeutic Category Brand Name HAEMOLANCE PLUS ULTILET SAFETY ULTILET CLASSIC ULTILET LANCETS ULTILET BASIC SAFETY LANCETS PRESSURE ACTIVATED LANCETS UNISTIK CZT UNISTIK 3 EXTRA UNISTIK SAFETY ULTRACOMFORT ORSINI INSULIN SYRINGE PRODIGY TWIST TOP LANCET PRODIGY LANCETS MEDLANCE PLUS SPECIAL BLADE ACTI-LANCE DROPLET LANCETS 1ST CHOICE LANCETS 1ST TIER UNILET COMFORTOUCH FIFTY50 SAFETY SEAL LANCETS SMARTEST LANCET GLUCOCOM LANCETS GLUCOCOM RIGHTEST GL300 LANCETS NOVA SUREFLEX NOVA SAFETY LANCETS STERILANCE TL ULTRALANCE SOLUS V2 LANCETS SOLUS V2 CARESENS INVACARE LANCETS MONOLET LANCETS MONOLET THIN LANCETS COLOR LANCETS UNIVERSAL 1 E-ZJECT LANCETS TRUEPLUS LANCETS MEDI-LANCE RELION THIN SMART SENSE LANCETS TOPCARE UNIVERSAL1 THIN LANCET ULTRA THIN PLUS SMART SENSE ULTRA THIN PLUS LANCETS Generic Name LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS SYRINGE AND NEEDLE,INSULIN,1ML SYR,NDL,INSULIN,1ML-SHARPS BIN SYRINGE-NEEDLE,INSULIN,0.5 ML SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML LANCETS LANCETS BLADE LANCET, SAFETY LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS Dose EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH DISP SYRIN SYRINGE DISP SYRIN DISP SYRIN DISP SYRIN EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH PA Step QLL Age General Therapeutic Category MISCELLANEOUS AGENTS Brand Name RENEW ADVANCED MICRO-LANCETS BULLSEYE MINI SAFETY LANCETS SAFETY-LET SAFETY SEAL LANCETS EASY TWIST & CAP LANCETS GLUCOPRO RELIAMED RELIAMED SAFETY SEAL LANCETS MYGLUCOHEALTH LANCETS COAGUCHEK ACCU-CHEK SAFE-T-PRO PLUS SOFT TOUCH ACCU-CHEK SAFE-T-PRO ULTRA THIN II ULTRA-THIN II LANCETS EZ SMART LANCETS ONE TOUCH DELICA ONETOUCH FINEPOINT LANCETS ONETOUCH LANCETS MEDISENSE THIN LANCETS TELCARE SURE-LANCE SURE-TOUCH ON CALL PLUS LANCET ON CALL LANCET SURE COMFORT LANCETS GMATE PUSH BUTTON SAFETY LANCETS INJECT EASE LANCETS EASY COMFORT EASY TOUCH LANCETS ULTRATLC LANCETS EMBRACE ADVOCATE LANCET ADVOCATE LANCETS CLEVER CHEK LANCETS FORACARE LANCETS FREESTYLE LANCETS FREESTYLE UNISTIK 2 FORA LANCETS TOPCARE UNIVERSAL1 LANCET BLOOD LANCETS UNISTIK TOUCH ARALAST NP AUVI-Q BETHANECHOL CHLORIDE Generic Name LANCETS LANCETS LANCETS LANCETS LANCETS SYRINGE AND NEEDLE,INSULIN,1ML SYRINGE-NEEDLE,INSULIN,0.5 ML SYRING-NEEDL,DISP,INSUL,0.3 ML LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS LANCETS ALPHA-1-PROTEINASE INHIBITOR EPINEPHRINE BETHANECHOL CHLORIDE Dose EACH EACH EACH EACH EACH DISP SYRIN DISP SYRIN DISP SYRIN EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH EACH VIAL AUTO INJCT TABLET PA Step QLL X X Age General Therapeutic Category NEOPLASTIC DISEASE CEVIMELINE HCL EPINEPHRINE EPIPEN 2-PAK EPIPEN JR 2-PAK GUANIDINE HCL PILOCARPINE HCL PROLASTIN C ZEMAIRA EPIPEN EPIPEN JR TWINJECT PROLASTIN AFINITOR AFINITOR DISPERZ ALIMTA ALKERAN Brand Name Generic Name CEVIMELINE HCL EPINEPHRINE EPINEPHRINE EPINEPHRINE GUANIDINE HCL PILOCARPINE HCL ALPHA-1-PROTEINASE INHIBITOR ALPHA-1-PROTEINASE INHIBITOR EPINEPHRINE EPINEPHRINE EPINEPHRINE ALPHA-1-PROTEINASE INHIBITOR EVEROLIMUS EVEROLIMUS PEMETREXED DISODIUM MELPHALAN Dose CAPSULE AUTO INJCT AUTO INJCT AUTO INJCT TABLET TABLET VIAL VIAL AUTO INJCT AUTO INJCT COMBO. PKG VIAL TABLET TAB SUSP VIAL TABLET AMIFOSTINE ANASTROZOLE AVASTIN BICALUTAMIDE BOSULIF AMIFOSTINE CRYSTALLINE ANASTROZOLE BEVACIZUMAB BICALUTAMIDE BOSUTINIB VIAL TABLET VIAL TABLET TABLET X CAPECITABINE CAPECITABINE TABLET X CAPRELSA CLADRIBINE CYCLOPHOSPHAMIDE VANDETANIB CLADRIBINE CYCLOPHOSPHAMIDE CYTARABINE DEXRAZOXANE DOCETAXEL EMCYT CYTARABINE CYTARABINE/PF DEXRAZOXANE HCL DOCETAXEL ESTRAMUSTINE PHOSPHATE SODIUM TABLET VIAL CAPSULE TABLET VIAL VIAL VIAL VIAL VIAL CAPSULE EPIRUBICIN HCL ERBITUX ETOPOSIDE EPIRUBICIN HCL CETUXIMAB ETOPOSIDE VIAL VIAL CAPSULE X X X EXEMESTANE FARESTON EXEMESTANE TOREMIFENE CITRATE TABLET TABLET X FARYDAK FASLODEX FLUDARABINE PHOSPHATE FLUTAMIDE GILOTRIF PANOBINOSTAT LACTATE FULVESTRANT FLUDARABINE PHOSPHATE FLUTAMIDE AFATINIB DIMALEATE CAPSULE SYRINGE VIAL CAPSULE TABLET PA Step QLL X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Age General Therapeutic Category GLEOSTINE Brand Name LOMUSTINE Dose CAPSULE X GLIADEL CARMUSTINE IN POLIFEPROSAN 20 WAFER X HERCEPTIN HEXALEN TRASTUZUMAB ALTRETAMINE VIAL CAPSULE X X HYCAMTIN HYDROXYUREA IBRANCE IDARUBICIN HCL IFOSFAMIDE IMBRUVICA INLYTA IRESSA TOPOTECAN HCL HYDROXYUREA PALBOCICLIB IDARUBICIN HCL IFOSFAMIDE IBRUTINIB AXITINIB GEFITINIB CAPSULE CAPSULE CAPSULE VIAL VIAL CAPSULE TABLET TABLET IXEMPRA LENVIMA LETROZOLE LEUCOVORIN CALCIUM LEUKERAN IXABEPILONE LENVATINIB MESYLATE LETROZOLE LEUCOVORIN CALCIUM CHLORAMBUCIL VIAL CAPSULE TABLET TABLET TABLET LEVULAN LIPODOX LIPODOX 50 LYSODREN MATULANE AMINOLEVULINIC ACID HCL DOXORUBICIN HCL PEG-LIPOSOMAL DOXORUBICIN HCL PEG-LIPOSOMAL MITOTANE PROCARBAZINE HCL SOL W/APPL VIAL VIAL TABLET CAPSULE MEGESTROL ACETATE MEKINIST MELPHALAN HCL MEGESTROL ACETATE TRAMETINIB DIMETHYL SULFOXIDE MELPHALAN HCL TABLET TABLET VIAL X MERCAPTOPURINE MESNA MESNEX MERCAPTOPURINE MESNA MESNA TABLET VIAL TABLET X X METHOTREXATE MUSTARGEN MYLERAN METHOTREXATE SODIUM MECHLORETHAMINE HCL BUSULFAN TABLET VIAL TABLET X X NEXAVAR SORAFENIB TOSYLATE TABLET X NILANDRON NILUTAMIDE TABLET X OXALIPLATIN PHOTOFRIN POMALYST OXALIPLATIN PORFIMER SODIUM POMALIDOMIDE VIAL VIAL CAPSULE X X X Generic Name PA X X X Step QLL X X X X X X X X X X Age General Therapeutic Category PURIXAN REVLIMID Brand Name MERCAPTOPURINE LENALIDOMIDE Dose ORAL SUSP CAPSULE RITUXAN SOLTAMOX SPRYCEL RITUXIMAB TAMOXIFEN CITRATE DASATINIB VIAL SOLUTION TABLET X STIVARGA REGORAFENIB TABLET X SUTENT SUNITINIB MALATE CAPSULE X SYLATRON SYNRIBO TABLOID PEGINTERFERON ALFA-2B OMACETAXINE MEPESUCCINATE THIOGUANINE KIT VIAL TABLET X X X TAFINLAR TAMOXIFEN CITRATE TARCEVA DABRAFENIB MESYLATE TAMOXIFEN CITRATE ERLOTINIB HCL CAPSULE TABLET TABLET X TASIGNA NILOTINIB HCL CAPSULE X TEMOZOLOMIDE TEMOZOLOMIDE CAPSULE X THIOTEPA TOPOTECAN HCL TORISEL TRETINOIN TREXALL TYKERB THIOTEPA TOPOTECAN HCL TEMSIROLIMUS TRETINOIN METHOTREXATE SODIUM LAPATINIB DITOSYLATE VIAL VIAL VIAL CAPSULE TABLET TABLET X X X VECTIBIX VELCADE VINBLASTINE SULFATE VINORELBINE TARTRATE XTANDI PANITUMUMAB BORTEZOMIB VINBLASTINE SULFATE VINORELBINE TARTRATE ENZALUTAMIDE VIAL VIAL VIAL VIAL CAPSULE X X X X X ZANOSAR ZOLINZA ZYKADIA STREPTOZOCIN VORINOSTAT CERITINIB VIAL CAPSULE CAPSULE X CEENU LOMUSTINE CAPSULE X VANDETANIB ELOXATIN SYLATRON 4-PACK BUSULFEX ELSPAR IMATINIB MESYLATE VANDETANIB OXALIPLATIN PEGINTERFERON ALFA-2B BUSULFAN ASPARAGINASE IMATINIB MESYLATE TABLET VIAL KIT VIAL VIAL TABLET X X X X X Generic Name PA Step QLL X X X X X X X X X X X X Age General Therapeutic Category Brand Name Dose Generic Name PA LONSURF EVOMELA VENCLEXTA VENCLEXTA STARTING PACK AUBAGIO TRIFLURIDINE/TIPIRACIL HCL MELPHALAN HCL VENETOCLAX VENETOCLAX TERIFLUNOMIDE TABLET VIAL TABLET TAB DS PK TABLET X AVONEX INTERFERON BETA-1A SYRINGE X SYRINGEKIT X X X X NEUROLOGICAL DISEASE - MISCELLANEOUS AVONEX ADMINISTRATION PACK INTERFERON BETA-1A/ALBUMIN KIT X AVONEX PEN INTERFERON BETA-1A PEN IJ KIT X PEN INJCTR X COPAXONE GLATOPA GLATIRAMER ACETATE GLATIRAMER ACETATE SYRINGE SYRINGE X X REBIF REBIF REBIDOSE RILUZOLE INTERFERON BETA-1A/ALBUMIN INTERFERON BETA-1A/ALBUMIN RILUZOLE SYRINGE PEN INJCTR TABLET X X X TECFIDERA DIMETHYL FUMARATE CAPSULE DR X TYSABRI CHLORHEXIDINE GLUCONATE KEPIVANCE ORALONE PAROEX PERIOGARD TRIAMCINOLONE ACETONIDE 1ST TIER UNIFINE PENTIPS 1ST TIER UNIFINE PENTIPS PLUS ADVOCATE PEN NEEDLES ALTAMIST AUTOSHIELD DUO PEN NEEDLE AUTOSHIELD PEN NEEDLE AYR SALINE BD ULTRA-FINE PEN NEEDLE CEREZYME CHILDREN'S SALINE NASAL SPRAY CLICKFINE COMFORT EZ CYSTADANE NATALIZUMAB CHLORHEXIDINE GLUCONATE PALIFERMIN TRIAMCINOLONE ACETONIDE CHLORHEXIDINE GLUCONATE CHLORHEXIDINE GLUCONATE TRIAMCINOLONE ACETONIDE PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC SODIUM CHLORIDE PEN NEEDLE,DUAL SAFETY,DIABETC PEN NEEDLE, DIABETIC, SAFETY SODIUM CHLORIDE PEN NEEDLE, DIABETIC IMIGLUCERASE SODIUM CHLORIDE PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC BETAINE VIAL MOUTHWASH VIAL PASTE (G) MOUTHWASH MOUTHWASH PASTE (G) DIS NEEDLE DIS NEEDLE DIS NEEDLE SPRAY DIS NEEDLE DIS NEEDLE SPRAY DIS NEEDLE VIAL SPRAY DIS NEEDLE DIS NEEDLE POWDER X DEEP SEA SODIUM CHLORIDE SPRAY Step QLL X X X X X X X X X X X X X X X ORAL/PHARYNGEAL DISORDERS OTHER DRUGS X X X X X X X Age General Therapeutic Category Brand Name EASY COMFORT PEN NEEDLES EASY TOUCH PEN NEEDLE ELAPRASE EXJADE PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC IDURSULFASE DEFERASIROX Dose DIS NEEDLE DIS NEEDLE VIAL TAB DISPER VIAL DIS NEEDLE DIS NEEDLE DIS NEEDLE DIS NEEDLE DIS NEEDLE TABLET X INCONTROL PEN NEEDLE INSULIN PEN NEEDLE INSUPEN JADENU AGALSIDASE BETA PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC, SAFETY PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC DEFERASIROX KUVAN SAPROPTERIN DIHYDROCHLORIDE POWD PACK X TABLET SOL X LILETTA LEVOCARNITINE LEVOCARNITINE (WITH SUGAR) LEVONORGESTREL TABLET SOLUTION IUD X LITE TOUCH LITTLE REMEDIES STUFFY NOSE MEGESTROL ACETATE MINI ULTRA-THIN II MIRENA PEN NEEDLE, DIABETIC SODIUM CHLORIDE MEGESTROL ACETATE PEN NEEDLE, DIABETIC LEVONORGESTREL DIS NEEDLE SPRAY ORAL SUSP DIS NEEDLE IUD X NAGLAZYME NASAL MOISTURIZING NASAL SPRAY NEEDLES NOVOFINE NOVOFINE 32 NOVOFINE AUTOCOVER NOVOTWIST OCEAN OCTREOTIDE ACETATE GALSULFASE SODIUM CHLORIDE SODIUM CHLORIDE PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC, SAFETY PEN NEEDLE, DIABETIC SODIUM CHLORIDE OCTREOTIDE ACETATE PARAGARD T 380-A COPPER VIAL SPRAY SPRAY DIS NEEDLE DIS NEEDLE DIS NEEDLE DIS NEEDLE DIS NEEDLE SPRAY AMPUL SYRINGE VIAL IUD PEN NEEDLE PEN NEEDLES PRECISION XTRA RELION PEN NEEDLES SALINE MIST SALINE NASAL SPRAY SALINE NOSE SPRAY PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC BLOOD KETONE TEST,STRIPS PEN NEEDLE, DIABETIC SODIUM CHLORIDE SODIUM CHLORIDE SODIUM CHLORIDE DIS NEEDLE DIS NEEDLE STRIP DIS NEEDLE SPRAY SPRAY SPRAY FABRAZYME HEALTHY ACCENTS UNIFINE PENTIP LEVOCARNITINE Generic Name PA Step QLL X X X X X X X X X Age General Therapeutic Category OTHER RESPIRATORY DISORDERS PAIN MANAGEMENT - ANALGESICS Brand Name Dose Generic Name SEA SOFT SKYLA SODIUM CHLORIDE LEVONORGESTREL SPRAY IUD SODIUM CHLORIDE SOMATULINE DEPOT SURE COMFORT SURE-FINE PEN NEEDLES TOPCARE CLICKFINE ULTILET PEN NEEDLE ULTRA SALINE ULTRA-THIN II UNIFINE PENTIPS UNIFINE PENTIPS PLUS ZAVESCA SODIUM CHLORIDE FOR INHALATION LANREOTIDE ACETATE PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC SODIUM CHLORIDE PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC MIGLUSTAT VIAL-NEB SYRINGE DIS NEEDLE DIS NEEDLE DIS NEEDLE DIS NEEDLE SPRAY DIS NEEDLE DIS NEEDLE DIS NEEDLE CAPSULE FC CONDOM, FEMALE ULTRACOMFORT PRODIGY PEN NEEDLE POLYMYXIN B SULFATE UNDECYLENIC ACID AIMSCO ULTRA THIN II AIMSCO MINI ULTRA-THIN II CEREDASE ULTICARE PEN NEEDLE HAIR, SKIN AND NAILS STRENSIQ ACETYLCYSTEINE ORKAMBI PULMOZYME 8 HOUR 8 HOUR PAIN RELIEF 8 HOUR PAIN RELIEVER ACEPHEN ACETAMINOPHEN CONDOMS, FEMALE PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC, SAFETY POLYMYXIN B SULFATE,MICRONIZED UNDECYLENIC ACID PEN NEEDLE, DIABETIC PEN NEEDLE, DIABETIC ALGLUCERASE PEN NEEDLE, DIABETIC MULTIVITS MIN/IRON/FA/HERB#186 ASFOTASE ALFA ACETYLCYSTEINE LUMACAFTOR/IVACAFTOR DORNASE ALFA ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN 8 HOUR ACETAMINOPHEN ER ACETAMINOPHEN EXTRA STRENGTH ACETAMINOPHEN-CODEINE ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN WITH CODEINE ADDED STRENGTH HEADACHE ASPIRIN/ACETAMINOPHEN/CAFFEINE EACH DIS NEEDLE DIS NEEDLE DIS NEEDLE POWDER(EA) LIQUID DIS NEEDLE DIS NEEDLE VIAL DIS NEEDLE TABLET VIAL VIAL TABLET SOLUTION TABLET ER TABLET ER TABLET ER SUPP.RECT DROPS SUSP ELIXIR LIQUID ORAL SUSP SOLUTION SUPP.RECT TAB CHEW TABLET TABLET ER TABLET ER TABLET SOLUTION TABLET TABLET PA Step QLL X X X X X X X X X Age General Therapeutic Category Brand Name ADDED STRENGTH PAIN RELIEVER ADULT LOW DOSE ASPIRIN EC ARTHRITIS PAIN ARTHRITIS PAIN RELIEF ARTHRITIS PAIN RELIEVER ASCOMP WITH CODEINE ASPIR 81 ASPIRIN Generic Name ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN CODEINE/BUTALBITAL/ASA/CAFFEIN ASPIRIN ASPIRIN ASPIRIN BUFFERED ASPIRIN EC ASPIRIN-CAFFEINE-DIHYDROCODEIN ASPIR-LOW ASPIR-TRIN ATHENOL BAYER MIGRAINE BELLADONNA-OPIUM BETATEMP BUFFERED ASPIRIN BUFFERIN BUNAVAIL BUPRENORPHINE HCL BUPRENORPHINE-NALOXONE BUTALB-ACETAMINOPH-CAFF-CODEIN BUTALB-CAFF-ACETAMINOPH-CODEIN BUTALBITAL COMPOUND-CODEINE BUTALBITAL-ACETAMINOPHEN BUTALBITAL-ACETAMINOPHEN-CAFFE ASPIRIN/CALCIUM CARBONATE/MAG ASPIRIN DIHYDROCODEINE/ASPIRIN/CAFFEIN ASPIRIN ASPIRIN ACETAMINOPHEN ASPIRIN/ACETAMINOPHEN/CAFFEINE OPIUM/BELLADONNA ALKALOIDS ACETAMINOPHEN ASPIRIN/CALCIUM CARBONATE/MAG ASPIRIN/CALCIUM CARBONATE/MAG BUPRENORPHINE HCL/NALOXONE HCL BUPRENORPHINE HCL BUPRENORPHINE HCL/NALOXONE HCL BUTALBIT/ACETAMIN/CAFF/CODEINE BUTALBIT/ACETAMIN/CAFF/CODEINE CODEINE/BUTALBITAL/ASA/CAFFEIN BUTALBITAL/ACETAMINOPHEN BUTALB/ACETAMINOPHEN/CAFFEINE BUTALBITAL-ASPIRIN-CAFFEINE BUTALBITAL/ASPIRIN/CAFFEINE CAPACET CAPITAL W-CODEINE CARISOPRODOL COMPOUND-CODEINE CARISOPRODOL-ASPIRIN-CODEINE CHILDREN'S ACETAMINOPHEN BUTALB/ACETAMINOPHEN/CAFFEINE ACETAMINOPHEN WITH CODEINE CODEINE/CARISOPRODOL/ASPIRIN CODEINE/CARISOPRODOL/ASPIRIN ACETAMINOPHEN CHILDREN'S ASPIRIN CHILDREN'S MEDI-TABS CHILDREN'S NON-ASPIRIN ASPIRIN ACETAMINOPHEN ACETAMINOPHEN CHILDREN'S PAIN & FEVER ACETAMINOPHEN Dose TABLET TABLET DR TABLET ER TABLET ER TABLET ER CAPSULE TABLET DR TAB CHEW TABLET TABLET TABLET DR CAPSULE TABLET DR TABLET DR TABLET TABLET SUPP.RECT ORAL SUSP TABLET TABLET FILM TAB SUBL TAB SUBL CAPSULE CAPSULE CAPSULE TABLET CAPSULE TABLET CAPSULE TABLET CAPSULE ORAL SUSP TABLET TABLET ELIXIR ORAL SUSP TAB CHEW TAB CHEW ORAL SUSP DROPS ELIXIR LIQUID ORAL SUSP TAB CHEW ORAL SUSP TAB CHEW PA Step QLL X X X X X X X X Age General Therapeutic Category Brand Name CHILDREN'S PAIN RELIEF ACETAMINOPHEN CHILDREN'S PAIN RELIEVER ACETAMINOPHEN CHILDREN'S Q-PAP CHILDREN'S SILAPAP CHILDREN'S TACTINAL CHOLINE MAG TRISALICYLATE ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN CHOLINE SAL/MAG SALICYLATE CODEINE SULFATE DIFLUNISAL ECOTRIN ECPIRIN ED-APAP ENDOCET ENDODAN EXCEDRIN MIGRAINE EXTRA STRENGTH NON-ASPIRIN FENTANYL FEVER REDUCER & PAIN RELIEVER FEVERALL GOODY'S EXTRA STRENGTH GOODY'S MIGRAINE RELIEF HEADACHE FORMULA HEADACHE PAIN HEADACHE RELIEF HYDROCODONE-ACETAMINOPHEN CODEINE SULFATE DIFLUNISAL ASPIRIN ASPIRIN ACETAMINOPHEN OXYCODONE HCL/ACETAMINOPHEN OXYCODONE HCL/ASPIRIN ASPIRIN/ACETAMINOPHEN/CAFFEINE ACETAMINOPHEN FENTANYL ACETAMINOPHEN ACETAMINOPHEN ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE HYDROCODONE/ACETAMINOPHEN HYDROCODONE-IBUPROFEN HYDROMORPHONE HCL HYDROCODONE/IBUPROFEN HYDROMORPHONE HCL INFANT FEVER-PAIN RELIEVER INFANT PAIN & FEVER INFANT PAIN RELIEF INFANT'S NON-ASPIRIN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN INFANTS' PAIN & FEVER INFANTS' PAIN RELIEF INFANT'S PAIN RELIEF ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN INFANTS PAIN RELIEVER INFANTS' PAIN RELIEVER INFANT'S PAIN RELIEVER ISOMETHEPT-DICHLORALP-ACETAMIN KADIAN LEVACET ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ISOMETHEPT/DICHLPHN/ACETAMINOP MORPHINE SULFATE ASA/SALICYLAM/ACETAMINOPH/CAFF Generic Name Dose LIQUID ORAL SUSP ORAL SUSP TAB CHEW ORAL SUSP LIQUID TAB CHEW LIQUID TABLET TABLET TABLET TABLET DR TABLET DR LIQUID TABLET TABLET TABLET TABLET PATCH TD72 ORAL SUSP SUPP.RECT TABLET TABLET TABLET TABLET TABLET CAPSULE SOLUTION TABLET TABLET LIQUID SUPP.RECT TABLET ORAL SUSP ORAL SUSP ORAL SUSP DROPS DROPS SUSP ORAL SUSP ORAL SUSP DROPS SUSP ORAL SUSP DROPS ORAL SUSP DROPS CAPSULE CAP ER PEL TABLET PA Step QLL X X X X X X Age General Therapeutic Category Brand Name LEVORPHANOL TARTRATE LITE COAT ASPIRIN LITTLE REMEDIES FEVER & PAIN LO-DOSE ASPIRIN EC LORCET LORCET HD LORCET PLUS LOW DOSE ASPIRIN EC MAPAP Generic Name LEVORPHANOL TARTRATE ASPIRIN ACETAMINOPHEN ASPIRIN HYDROCODONE/ACETAMINOPHEN HYDROCODONE/ACETAMINOPHEN HYDROCODONE/ACETAMINOPHEN ASPIRIN ACETAMINOPHEN MAPAP ARTHRITIS PAIN MARGESIC MARTEN-TAB MASOPHEN MEDI-TABS MEDI-TABS EXTRA STRENGTH MEPERIDINE HCL ACETAMINOPHEN BUTALB/ACETAMINOPHEN/CAFFEINE BUTALBITAL/ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN MEPERIDINE HCL METHADONE HCL METHADONE HCL METHADONE INTENSOL METHADOSE MIGERGOT MIGRAGESIC IDA MIGRAINE FORMULA MIGRAINE PAIN-RELIEVER MIGRAINE RELIEF MORPHINE SULFATE METHADONE HCL METHADONE HCL ERGOTAMINE TARTRATE/CAFFEINE ISOMETHEPT/DICHLPHN/ACETAMINOP ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE MORPHINE SULFATE MORPHINE SULFATE ER MORPHINE SULFATE NARATRIPTAN NARATRIPTAN HCL NODOLOR NON-ASPIRIN NARATRIPTAN HCL NARATRIPTAN HCL ISOMETHEPT/DICHLPHN/ACETAMINOP ACETAMINOPHEN NON-ASPIRIN 8 HOUR NON-ASPIRIN EXTRA STRENGTH NON-ASPIRIN PAIN RELIEF ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN Dose TABLET TABLET ORAL SUSP TABLET DR TABLET TABLET TABLET TABLET DR LIQUID ORAL SUSP TAB CHEW TABLET TABLET ER CAPSULE TABLET TABLET TABLET TABLET SOLUTION TABLET ORAL CONC SOLUTION TABLET TABLET SOL ORAL CONC TABLET SOL SUPP.RECT CAPSULE TABLET TABLET TABLET SOLUTION SUPP.RECT TABLET CAP ER PEL CPMP 24HR TABLET ER TABLET TABLET CAPSULE DROPS ELIXIR ORAL SUSP TAB CHEW TABLET TABLET ER TABLET TABLET PA Step QLL X X X X X X Age General Therapeutic Category Brand Name NORTEMP OXYCODONE HCL Generic Name ACETAMINOPHEN OXYCODONE HCL OXYCODONE HCL ER OXYCODONE HCL OXYCODONE HCL-ASPIRIN OXYCODONE HCL-IBUPROFEN OXYCODONE-ACETAMINOPHEN OXYCODONE HCL/ASPIRIN IBUPROFEN/OXYCODONE HCL OXYCODONE HCL/ACETAMINOPHEN OXYCONTIN OXYMORPHONE HCL OXYMORPHONE HCL ER PAIN & FEVER PAIN RELIEF OXYCODONE HCL OXYMORPHONE HCL OXYMORPHONE HCL ACETAMINOPHEN ACETAMINOPHEN PAIN RELIEF EXTRA STRENGTH PAIN RELIEVER PLUS PAIN-OFF PAMPRIN MAX PEDIACARE FEVER REDUCER PENTAZOCINE-NALOXONE HCL PHARBETOL PRIALT ACETAMINOPHEN ASPIRIN/ACETAMINOPHEN/CAFFEINE ACETAMINOPHEN ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE ACETAMINOPHEN PENTAZOCINE HCL/NALOXONE HCL ACETAMINOPHEN ZICONOTIDE ACETATE PRIMLEV Q-PAP OXYCODONE HCL/ACETAMINOPHEN ACETAMINOPHEN Q-PAP EXTRA STRENGTH REPREXAIN RIZATRIPTAN ACETAMINOPHEN HYDROCODONE/IBUPROFEN RIZATRIPTAN BENZOATE SALSALATE SILAPAP ST. JOSEPH ASPIRIN SALSALATE ACETAMINOPHEN ASPIRIN SUBOXONE SUMATRIPTAN SUMATRIPTAN SUCCINATE TACTINAL TENCON BUPRENORPHINE HCL/NALOXONE HCL SUMATRIPTAN SUMATRIPTAN SUCCINATE ACETAMINOPHEN BUTALBITAL/ACETAMINOPHEN PAIN RELIEVER Dose ORAL SUSP CAPSULE ORAL CONC SOLUTION TABLET TAB ER 12H TABLET TABLET CAPSULE SOLUTION TABLET TAB ER 12H TABLET TAB ER 12H TABLET LIQUID TABLET TABLET ER TABLET TABLET TABLET TABLET TABLET TABLET TABLET ORAL SUSP TABLET TABLET VIAL TABLET DROPS LIQUID TABLET TABLET TABLET TAB RAPDIS TABLET TABLET DROPS TAB CHEW TABLET DR FILM SPRAY TABLET TABLET TABLET PA Step QLL X X X X X X X X X X X X X X X X X X X X Age General Therapeutic Category Brand Name Generic Name TRAMADOL HCL TRAMADOL HCL ER TRAMADOL HCL TRAMADOL HCL TRAMADOL HCL-ACETAMINOPHEN TRI-BUFFERED ASPIRIN VICODIN VICODIN ES VICODIN HP XYLON 10 ZEBUTAL ZOLMITRIPTAN ZOLMITRIPTAN ODT CHILD TRIAMINIC FEVER REDUCER ROXICET TRAMADOL HCL/ACETAMINOPHEN ASPIRIN/CALCIUM CARBONATE/MAG HYDROCODONE/ACETAMINOPHEN HYDROCODONE/ACETAMINOPHEN HYDROCODONE/ACETAMINOPHEN HYDROCODONE/IBUPROFEN BUTALB/ACETAMINOPHEN/CAFFEINE ZOLMITRIPTAN ZOLMITRIPTAN ACETAMINOPHEN OXYCODONE HCL/ACETAMINOPHEN INFANT TRIAMINIC FEVER REDUCER BUPAP CO-GESIC ERGOTAMINE-CAFFEINE PHRENILIN FORTE BUTALBITAL COMPOUND ESGIC-PLUS ED-FLEX PENTAZOCINE-ACETAMINOPHEN OXYCODONE-ASPIRIN REPAN INFANTS' MAPAP SHAKE THAT ACHE CHILD'S ACCUDIAL ACETAMINOPHEN MINIPRIN COCET FLEXTRA PLUS ALAGESIC LQ HALFPRIN STAGESIC PROMACET INFANTAIRE DOLGIC PLUS MAGNACET MST 600 ZYDONE ACETAMINOPH-CAFF-DIHYDROCODEIN TREZIX APHEN EXTRAPRIN ASPIRIN-ACETAMINPHEN-CAFFEINE ASA-BUTALB-CAFFEINE-CODEINE CHILDREN'S PAIN-FEVER ACETAMINOPHEN BUTALBITAL/ACETAMINOPHEN HYDROCODONE/ACETAMINOPHEN ERGOTAMINE TARTRATE/CAFFEINE BUTALBITAL/ACETAMINOPHEN BUTALBITAL/ASPIRIN/CAFFEINE BUTALB/ACETAMINOPHEN/CAFFEINE SAL-AMIDE/ACETAMINOPHN/P-TLOX PENTAZOCINE HCL/ACETAMINOPHEN OXYCODONE HCL/OXYCODON TER/ASA BUTALB/ACETAMINOPHEN/CAFFEINE ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ASPIRIN ACETAMINOPHEN WITH CODEINE ACETAMINOPHEN/PHENYLTOLOX/CAFF BUTALB/ACETAMINOPHEN/CAFFEINE ASPIRIN HYDROCODONE/ACETAMINOPHEN BUTALBITAL/ACETAMINOPHEN ACETAMINOPHEN BUTALB/ACETAMINOPHEN/CAFFEINE OXYCODONE HCL/ACETAMINOPHEN MAGNESIUM SALICYLATE HYDROCODONE/ACETAMINOPHEN DHCODEINE BT/ACETAMINOPHN/CAFF DHCODEINE BT/ACETAMINOPHN/CAFF ACETAMINOPHEN ASPIRIN/ACETAMINOPHEN/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE CODEINE/BUTALBITAL/ASA/CAFFEIN ACETAMINOPHEN Dose TABLET TAB ER 24H TABLET TABLET TABLET TABLET TABLET TABLET CAPSULE TABLET TAB RAPDIS LIQUID SOLUTION TABLET LIQUID TABLET TABLET TABLET CAPSULE TABLET CAPSULE CAPSULE TABLET TABLET TABLET ORAL SUSP TABLET ORAL SUSP TABLET DR TABLET CAPSULE SOLUTION TABLET DR CAPSULE TABLET DROPS TABLET TABLET TABLET TABLET TABLET CAPSULE TABLET TABLET TABLET CAPSULE ORAL SUSP PA X Step QLL X X X X X X X X X X X X X X X X X X Age General Therapeutic Category PARKINSONS DISEASE SEIZURE DISORDER Brand Name CHILDREN'S PAIN AND FEVER INFANTS' ACETAMINOPHEN SUPER PAIN RELIEF AMANTADINE Generic Name ACETAMINOPHEN ACETAMINOPHEN ASPIRIN/ACETAMINOPHEN/CAFFEINE AMANTADINE HCL APOKYN AZILECT BENZTROPINE MESYLATE BROMOCRIPTINE MESYLATE APOMORPHINE HCL RASAGILINE MESYLATE BENZTROPINE MESYLATE BROMOCRIPTINE MESYLATE CARBIDOPA CARBIDOPA-LEVODOPA CARBIDOPA CARBIDOPA/LEVODOPA CARBIDOPA-LEVODOPA ER CARBIDOPA-LEVODOPA-ENTACAPONE ENTACAPONE NEUPRO PRAMIPEXOLE DIHYDROCHLORIDE ROPINIROLE HCL SELEGILINE HCL CARBIDOPA/LEVODOPA CARBIDOPA/LEVODOPA/ENTACAPONE ENTACAPONE ROTIGOTINE PRAMIPEXOLE DI-HCL ROPINIROLE HCL SELEGILINE HCL TOLCAPONE TRIHEXYPHENIDYL HCL TOLCAPONE TRIHEXYPHENIDYL HCL ZELAPAR ROPINIROLE ER CARBAMAZEPINE SELEGILINE HCL ROPINIROLE HCL CARBAMAZEPINE CARBAMAZEPINE ER CARBAMAZEPINE CARBAMAZEPINE XR CELONTIN CLONAZEPAM CARBAMAZEPINE METHSUXIMIDE CLONAZEPAM DIAZEPAM DILANTIN EPITOL ETHOSUXIMIDE DIAZEPAM PHENYTOIN SODIUM EXTENDED CARBAMAZEPINE ETHOSUXIMIDE FELBAMATE FELBAMATE GABAPENTIN GABAPENTIN GABITRIL LEVETIRACETAM TIAGABINE HCL LEVETIRACETAM Dose LIQUID ORAL SUSP TABLET CAPSULE SOLUTION TABLET CARTRIDGE TABLET TABLET CAPSULE TABLET TABLET TAB RAPDIS TABLET TABLET ER TABLET TABLET PATCH TD24 TABLET TABLET CAPSULE TABLET TABLET ELIXIR TABLET TAB RAPDIS TAB ER 24H ORAL SUSP TAB CHEW TABLET CPMP 12HR TAB ER 12H TAB ER 12H CAPSULE TAB RAPDIS TABLET KIT CAPSULE TABLET CAPSULE SOLUTION ORAL SUSP TABLET CAPSULE SOLUTION TABLET TABLET SOLUTION PA Step QLL X X Age General Therapeutic Category SKELETAL MUSCLE DISORDER SMOKING CESSATION Brand Name Generic Name LEVETIRACETAM ER LYRICA LEVETIRACETAM PREGABALIN OXCARBAZEPINE OXCARBAZEPINE OXTELLAR XR PEGANONE PHENYTOIN OXCARBAZEPINE ETHOTOIN PHENYTOIN PHENYTOIN SODIUM EXTENDED PRIMIDONE TIAGABINE HCL TOPIRAMATE PHENYTOIN SODIUM EXTENDED PRIMIDONE TIAGABINE HCL TOPIRAMATE ZONISAMIDE TOPIRAGEN BACLOFEN CARISOPRODOL CARISOPRODOL COMPOUND CARISOPRODOL-ASPIRIN CHLORZOXAZONE CYCLOBENZAPRINE HCL DANTROLENE SODIUM METHOCARBAMOL ORPHENADRINE CITRATE TIZANIDINE HCL ORPHENADRINE COMPOUND FORTE BUPROBAN BUPROPION HCL SR CHANTIX ZONISAMIDE TOPIRAMATE BACLOFEN CARISOPRODOL CARISOPRODOL/ASPIRIN CARISOPRODOL/ASPIRIN CHLORZOXAZONE CYCLOBENZAPRINE HCL DANTROLENE SODIUM METHOCARBAMOL ORPHENADRINE CITRATE TIZANIDINE HCL ORPHENADRINE/ASPIRIN/CAFFEINE BUPROPION HCL BUPROPION HCL VARENICLINE TARTRATE NICODERM CQ NICORELIEF NICOTINE NICOTINE POLACRILEX NICORETTE NICOTINE GUM NICOTINE LOZENGE NICOTINE PATCH NTS QUIT 2 NICOTINE POLACRILEX NICOTINE POLACRILEX NICOTINE POLACRILEX NICOTINE NICOTINE NICOTINE POLACRILEX QUIT 4 NICOTINE POLACRILEX STOP SMOKING AID NICOTINE POLACRILEX THRIVE NICOTINE NICOTROL NICOTINE POLACRILEX NICOTINE Dose TABLET TAB ER 24H CAPSULE SOLUTION ORAL SUSP TABLET TAB ER 24H TABLET ORAL SUSP TAB CHEW CAPSULE TABLET TABLET CAP SPRINK TABLET CAPSULE TABLET TABLET TABLET TABLET TABLET TABLET TABLET CAPSULE TABLET TABLET ER TABLET TABLET TABLET ER TABLET ER TAB DS PK TABLET PATCH TD24 GUM LOZENGE GUM GUM LOZENGE PATCH TD24 PATCH TD24 GUM LOZENGE GUM LOZENGE GUM LOZENGE GUM CARTRIDGE PA X X Step QLL X X X X X X X X Age General Therapeutic Category UPPER GASTROINTESTINAL DISORDERS - DIGESTIVE Brand Name NICOTROL NS CREON GAS RELIEF Generic Name NICOTINE LIPASE/PROTEASE/AMYLASE SIMETHICONE GAS RELIEF 80 INFANT GAS RELIEF INFANTS' GAS RELIEF MI-ACID MYTAB GAS MYTAB GAS MAXIMUM STRENGTH PANCRELIPASE 5,000 SIMETHICONE SIMETHICONE SIMETHICONE SIMETHICONE SIMETHICONE SIMETHICONE SIMETHICONE LIPASE/PROTEASE/AMYLASE SIMETHICONE ZENPEP MYLANTA GAS MAXIMUM STRENGTH EQUALIZER GAS RELIEF VIOKASE DICYCLOMINE HCL LIPASE/PROTEASE/AMYLASE SIMETHICONE SIMETHICONE LIPASE/PROTEASE/AMYLASE DICYCLOMINE HCL ED-SPAZ HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE ER HYOSCYAMINE SULFATE SR HYOSYNE HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE METHSCOPOLAMINE BROMIDE OSCIMIN METHSCOPOLAMINE BROMIDE HYOSCYAMINE SULFATE OSCIMIN SL OSCIMIN SR GASTRINEX NF HYOMAX-SL QUADRAPAX ME-PB-HYOS HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE HYOSCYAMINE SULFATE/PHENYLTOLX HYOSCYAMINE SULFATE PHENOBARB/HYOSCY/ATROPINE/SCOP PHENOBARB/HYOSCY/ATROPINE/SCOP SAL-TROPINE DIGEX NF BELLADONNA-PHENOBARBITAL ACID CONTROLLER ACID REDUCER ATROPINE SULFATE HYOSCYAMINE SULFATE/PHENYLTOLX PHENOBARB/HYOSCY/ATROPINE/SCOP FAMOTIDINE FAMOTIDINE RANITIDINE HCL MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH UPPER GASTROINTESTINAL DISORDERS - SPASTIC DISEASE UPPER GASTROINTESTINAL DISORDERS - ULCER DISEASE ADVANCED ANTACID ADVANCED ANTACID-ANTIGAS Dose SPRAY CAPSULE DR DROPS SUSP TAB CHEW TAB CHEW DROPS SUSP DROPS SUSP TAB CHEW TAB CHEW TAB CHEW CAPSULE DR DROPS SUSP TAB CHEW CAPSULE DR TAB CHEW DROPS SUSP TABLET CAPSULE SOLUTION TABLET TAB RAPDIS DROPS ELIXIR TAB RAPDIS TAB SUBL TABLET TAB ER 12H TAB ER 12H DROPS ELIXIR TABLET TAB RAPDIS TABLET TAB SUBL TAB ER 12H CAPSULE TAB SUBL ELIXIR ELIXIR TABLET TABLET CAPSULE TABLET TABLET TABLET TABLET ORAL SUSP ORAL SUSP PA X X Step QLL X Age General Therapeutic Category Brand Name ALMACONE ALMACONE-2 ANTACID ANTACID & ANTIGAS ANTACID & GAS RELIEF ANTACID ANTI-GAS DOUBLE STR ANTACID EXTRA STRENGTH ANTACID II PLUS SIMETHICONE ANTACID M ANTACID MAXIMUM STRENGTH ANTACID PLUS ANTI-GAS ANTACID ULTRA STRENGTH ANTACID WITH SIMETHICONE ANTACID-ANTIGAS BAN-ACID CALCIUM ANTACID CALCIUM CARBONATE CAL-GEST CANTIL CARAFATE CHLORDIAZEPOXIDE-CLIDINIUM CIMETIDINE COMFORT GEL FAMOTIDINE FLANAX FLAVOR CHEWS ANTACID GELUSIL GERI-LANTA GERI-MOX GLYCOPYRROLATE HEARTBURN PREVENTION HEARTBURN RELIEF Generic Name MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH CALCIUM CARBONATE MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH CALCIUM CARBONATE MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH CALCIUM CARBONATE MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH CALCIUM CARBONATE CALCIUM CARBONATE CALCIUM CARBONATE CALCIUM CARBONATE MEPENZOLATE BROMIDE SUCRALFATE CHLORDIAZEPOXIDE/CLIDINIUM BR CIMETIDINE CIMETIDINE HCL MAG HYDROX/AL HYDROX/SIMETH FAMOTIDINE LANSOPRAZOL-AMOXICIL-CLARITHRO LIQUID ANTACID MAALOX ADVANCED MAG-AL PLUS MAG-AL PLUS XS MAGLOX MASANTI METOCLOPRAMIDE HCL MAG HYDROX/AL HYDROX/SIMETH CALCIUM CARBONATE MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH GLYCOPYRROLATE FAMOTIDINE FAMOTIDINE RANITIDINE HCL LANSOPRAZOLE/AMOXICILN/CLARITH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH METOCLOPRAMIDE HCL MI ACID MAG HYDROX/AL HYDROX/SIMETH Dose ORAL SUSP ORAL SUSP TAB CHEW ORAL SUSP ORAL SUSP ORAL SUSP ORAL SUSP TAB CHEW ORAL SUSP ORAL SUSP ORAL SUSP ORAL SUSP ORAL SUSP TAB CHEW ORAL SUSP ORAL SUSP TAB CHEW TAB CHEW TAB CHEW TABLET TAB CHEW TABLET ORAL SUSP CAPSULE TABLET SOLUTION ORAL SUSP ORAL SUSP TABLET ORAL SUSP TAB CHEW ORAL SUSP ORAL SUSP ORAL SUSP TABLET TABLET TABLET TABLET COMBO. PKG ORAL SUSP ORAL SUSP ORAL SUSP ORAL SUSP ORAL SUSP ORAL SUSP SOLUTION TABLET ORAL SUSP PA Step QLL Age General Therapeutic Category URINARY TRACT - FUNCTIONAL DISORDERS Brand Name MI-ACID MINTOX MINTOX MAXIMUM STRENGTH MISOPROSTOL NIZATIDINE Generic Name MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MISOPROSTOL NIZATIDINE OMEPRAZOLE OMEPRAZOLE OMEPRAZOLE MAGNESIUM OMEPRAZOLE-SODIUM BICARBONATE PANTOPRAZOLE SODIUM PRILOSEC PRILOSEC OTC PROPANTHELINE BROMIDE RANITIDINE HCL OMEPRAZOLE MAGNESIUM OMEPRAZOLE/SODIUM BICARBONATE PANTOPRAZOLE SODIUM OMEPRAZOLE MAGNESIUM OMEPRAZOLE MAGNESIUM PROPANTHELINE BROMIDE RANITIDINE HCL RI-GEL RI-GEL II SMOOTH ANTACID SODIUM BICARBONATE SUCRALFATE ULTRA STRENGTH ANTACID WAL-ZAN 75 ZANTAC 75 MAALOX MAXIMUM STRENGTH ZANTAC 25 MYLANTA ACID CONTROL HEARTBURN RELIEF 75 OMEPRAZOLE+SYRSPEND SF ALKA MILANTEX MYLANTEX DOUBLE-STRENGTH SUPREME ANTACID SMOOTH DISSOLVING ANTACID ANTACID CALCIUM ALFUZOSIN HCL ER CYSTAGON CYTRA-2 CYTRA-3 CYTRA-K MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH CALCIUM CARBONATE SODIUM BICARBONATE SUCRALFATE CALCIUM CARBONATE RANITIDINE HCL RANITIDINE HCL MAG HYDROX/AL HYDROX/SIMETH RANITIDINE HCL MAG HYDROX/AL HYDROX/SIMETH RANITIDINE HCL RANITIDINE HCL OMEPRAZOLE MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH CALCIUM CARB/MAGNESIUM HYDROX CALCIUM CARBONATE CALCIUM CARBONATE ALFUZOSIN HCL CYSTEAMINE BITARTRATE CITRIC ACID/SODIUM CITRATE SOD/POT/K CIT/SOD CIT/CIT ACID POTASSIUM CITRATE/CITRIC ACID ELMIRON FINASTERIDE FLAVOXATE HCL K-PHOS NO.2 K-PHOS ORIGINAL PENTOSAN POLYSULFATE SODIUM FINASTERIDE FLAVOXATE HCL NA PHOS,M-B/K PHOS,MONOB POTASSIUM PHOSPHATE,MONOBASIC Dose ORAL SUSP ORAL SUSP ORAL SUSP TABLET CAPSULE SOLUTION CAPSULE DR TABLET DR CAPSULE DR CAPSULE TABLET DR SUSPDR PKT TABLET DR TABLET CAPSULE SYRUP TABLET ORAL SUSP ORAL SUSP TAB CHEW TABLET TABLET TAB CHEW TABLET TABLET ORAL SUSP TABLET EFF ORAL SUSP TABLET TABLET SUSP RECON ORAL SUSP ORAL SUSP ORAL SUSP TAB CHEW TAB CHEW TAB ER 24H CAPSULE SOLUTION SOLUTION PACKET SOLUTION CAPSULE TABLET TABLET TABLET TABLET SOL PA Step QLL Age X X X X X X X X X X X General Therapeutic Category VAGINAL DISORDERS Brand Name ORACIT OXYBUTYNIN CHLORIDE Generic Name CITRIC ACID/SODIUM CITRATE OXYBUTYNIN CHLORIDE OXYBUTYNIN CHLORIDE ER OXYTROL PHENAZOPYRIDINE HCL PHOSPHA 250 NEUTRAL POTASS CIT-SOD CIT-CITRIC ACID POTASSIUM CITRATE ER POTASSIUM CITRATE-CITRIC ACID PROCYSBI SHOHL'S MODIFIED SODIUM CITRATE & CITRIC ACID TAMSULOSIN HCL THIOLA TOLTERODINE TARTRATE TRICITRATES TROSPIUM CHLORIDE TROSPIUM CHLORIDE ER UROQID-ACID NO.2 VIRT-PHOS 250 NEUTRAL VIRTRATE-2 VIRTRATE-3 VIRTRATE-K DUTASTERIDE K-PHOS M.F. AVC CLEOCIN CLINDAMYCIN PHOSPHATE CLINDESSE CLOTRIMAZOLE CLOTRIMAZOLE 3 CLOTRIMAZOLE-7 ESTRACE METRONIDAZOLE MICONAZOLE 3 OXYBUTYNIN CHLORIDE OXYBUTYNIN PHENAZOPYRIDINE HCL PHOSPHORUS #1 SOD/POT/K CIT/SOD CIT/CIT ACID POTASSIUM CITRATE POTASSIUM CITRATE/CITRIC ACID CYSTEAMINE BITARTRATE CITRIC ACID/SODIUM CITRATE CITRIC ACID/SODIUM CITRATE TAMSULOSIN HCL TIOPRONIN TOLTERODINE TARTRATE SOD/POT/K CIT/SOD CIT/CIT ACID TROSPIUM CHLORIDE TROSPIUM CHLORIDE METHEN MAND/NAPHOS M-B M-H PHOSPHORUS #1 CITRIC ACID/SODIUM CITRATE SOD/POT/K CIT/SOD CIT/CIT ACID POTASSIUM CITRATE/CITRIC ACID DUTASTERIDE NA PHOS,M-B/K PHOS,MONOB SULFANILAMIDE CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE CLOTRIMAZOLE CLOTRIMAZOLE CLOTRIMAZOLE ESTRADIOL METRONIDAZOLE MICONAZOLE NITRATE MICONAZOLE 7 MICONAZOLE NITRATE MICONAZOLE NITRATE MICONAZOLE NITRATE MONISTAT 7 NYSTATIN TERCONAZOLE MICONAZOLE NITRATE NYSTATIN TERCONAZOLE VAGISTAT-3 MONISTAT 3 MICONAZOLE NITRATE MICONAZOLE NITRATE Dose SOLUTION SYRUP TABLET TAB ER 24 PATCH TDSW TABLET TABLET SOLUTION TABLET ER SOLUTION CAP DR SPR SOLUTION SOLUTION CAP ER 24H TABLET TABLET SOLUTION TABLET CAP ER 24H TABLET TABLET SOLUTION SOLUTION SOLUTION CAPSULE TABLET CREAM/APPL SUPP.VAG CREAM/APPL CRM ER (G) CREAM/APPL CREAM/APPL CREAM/APPL CREAM/APPL GEL W/APPL CMB PF CRM KIT SUPP.VAG CREAM/APPL SUPP.VAG CREAM/APPL SUPP.VAG CREAM/APPL TABLET CREAM/APPL SUPP.VAG KIT CMB PF CRM PA Step QLL X X X X X X Age General Therapeutic Category VITAMIN AND/OR MINERAL DEFICIENCY Brand Name GYNAZOLE-1 ACEROLA C Generic Name ANTIOXIDANT VITAMIN ASCORBIC ACID ASCORBIC ACID WITH RH B-12 B-12 DOTS BEE-ZEE C-500 BUTOCONAZOLE NITRATE ASCORBIC ACID ASCORBIC ACID/ASCORBATE SODIUM MULTIVITAMIN WITH MINERALS ASCORBIC ACID ASCORBIC ACID CYANOCOBALAMIN (VITAMIN B-12) CYANOCOBALAMIN (VITAMIN B-12) MULTIVITAMIN WITH MINERALS ASCORBIC ACID CALCITRIOL CALCIUM CALCIUM CARBONATE CALCIUM CITRATE CALCIUM CITRATE - VITAMIN D CALCIUM CITRATE - VITAMIN D3 CALCIUM CITRATE PLUS CALCIUM CITRATE+D CALCIUM CITRATE-VIT D CALCIUM CITRATE-VITAMIN D CALCIUM CITRATE-VITAMIN D3 CALCIUM WITH VITAMIN D CENTAMIN CENTRAL VITE FOR SENIORS CENTRAVITES 50 PLUS CEROVITE CEROVITE ADVANCED FORMULA CEROVITE SENIOR CERTAVITE-ANTIOXIDANT CHILDREN'S FERROUS SULFATE CHILDREN'S IRON CITRACAL + D MAXIMUM CITRUS CALCIUM + D C-NATE DHA COMPLETE FORMULATION MULTIVIT COMPLETE NATAL DHA COMPLETE SENIOR COMPLETENATE DAILY MULTIPLE VITAMIN DAILY MULTIVITAMIN WITH IRON DAILY VALUE DAILY VITAMIN + IRON DAILY VITAMIN FORMULA DAILY VITAMIN FORMULA-MINERALS DAILY VITE DAILY VITE WITH IRON CALCITRIOL CALCIUM CARBONATE CALCIUM CARBONATE CALCIUM CITRATE CALCIUM CITRATE/VITAMIN D3 CALCIUM CITRATE/VITAMIN D3 CALCIUM CITRATE/VITAMIN D3 CALCIUM CITRATE/VITAMIN D3 CALCIUM CITRATE/VITAMIN D3 CALCIUM CITRATE/VITAMIN D3 CALCIUM CITRATE/VITAMIN D3 CALCIUM CARBONATE/VITAMIN D2 MULTIVIT-MINERALS/FERROUS GLUC MULTIVIT WITH IRON-MINERALS MULTIVIT WITH IRON-MINERALS MULTIVIT-MINERALS/FERROUS GLUC MULTIVITAMIN/IRON/FOLIC ACID MULTIVITAMIN WITH MINERALS/LUT MULTIVIT-MINERALS/FERROUS GLUC FERROUS SULFATE FERROUS SULFATE CALCIUM CITRATE/VITAMIN D3 CALCIUM CITRATE/VITAMIN D3 PNV 11-IRON FUM-FOLIC ACID-OM3 PEDI MULTIVIT #61/VIT D3/VIT K PNV2/IRON B-G SUC-P/FA/OMEGA-3 MULTIVIT WITH IRON-MINERALS PNV #14/FERROUS FUM/FOLIC ACID MULTIVITAMIN MULTIVITAMIN WITH IRON MULTIVITAMIN MULTIVITAMIN WITH IRON MULTIVITAMIN MULTIVITAMIN WITH MINERALS MULTIVITAMIN MULTIVITAMIN WITH IRON Dose KIT CRM ER (G) TAB CHEW WAFER TABLET TABLET TABLET TABLET TABLET TABLET TAB CHEW TABLET CAPSULE TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET LIQUID TABLET TABLET LIQUID TABLET TABLET LIQUID DROPS DROPS TABLET TABLET CAPSULE CAPSULE COMBO. PKG TABLET TAB CHEW TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET PA Step QLL Age General Therapeutic Category Brand Name DENTA 5000 PLUS DENTAGEL ELITE OB DHA FE C PLUS FEOSOL FER-IRON FEROSUL Generic Name SODIUM FLUORIDE SODIUM FLUORIDE PN VIT.W-O CA #7, IRON,FA,DHA IRON,CARBONYL/VIT C/VIT B12/FA FERROUS SULFATE FERROUS SULFATE FERROUS SULFATE FERREX 150 FERRO-TIME FERROUS SULFATE IRON POLYSACCHARIDE COMPLEX FERROUS SULFATE FERROUS SULFATE FERROUSUL FLUORABON FLUOR-A-DAY FLUORIDE FLUORIDEX DAILY DEFENSE FLUORIDEX SENSITIVITY RELIEF FLURA-DROPS FOLBECAL FOLIC ACID FOLINATAL PLUS B FRUIT C-500 HAIR VITAMIN HAIR, SKIN & NAILS HIGH POTENCY CALCIUM ICAPS PLUS ICAR-C PLUS IFEREX 150 INATAL ADVANCE INATAL ULTRA IRON FERROUS SULFATE SODIUM FLUORIDE SODIUM FLUORIDE SODIUM FLUORIDE SODIUM FLUORIDE SODIUM FLUORIDE/POTASSIUM NIT SODIUM FLUORIDE PNV W-O IRON/FA/CALCIUM/B6/B12 FOLIC ACID PNV W-O IRON/FA/CALCIUM/B6/B12 ASCORBIC ACID MULTIVITAMIN WITH IRON MULTIVITAMIN WITH MINERALS CALCIUM CARBONATE MULTIVITAMIN WITH MINERALS IRON,CARBONYL/VIT C/VIT B12/FA IRON POLYSACCHARIDE COMPLEX PRENATAL VIT 15/IRON CB/FA/DSS PRENATAL VIT 18/IRON CB/FA/DSS FERROUS SULFATE IRON SUPPLEMENT I-VITE MAG DELAY MAG64 MAGNESIUM MAGNESIUM OXIDE MAXINATE MEGA MULTI W-CHELATED MINERALS MEGA MULTIVITAMIN WITH MINERAL MEN'S MULTI-VITAMIN MEN'S ONE DAILY MGO MULTI-DAY PLUS IRON MULTIPLE VITAMIN FERROUS SULFATE VIT A,C & E/LUTEIN/MINERALS MAGNESIUM CHLORIDE MAGNESIUM CHLORIDE MAGNESIUM OXIDE MAGNESIUM OXIDE PNV COMB NO.3/IRON FUM&GLUC/FA MULTIVITAMIN WITH MINERALS MULTIVITAMIN WITH MINERALS MULTIVITAMIN MULTIVITAMIN WITH MINERALS MAGNESIUM OXIDE MULTIVITAMIN/IRON/FOLIC ACID MULTIVITAMIN WITH MINERALS Dose CREAM (G) GEL (GRAM) CAPSULE TABLET TABLET DROPS SOLUTION TABLET CAPSULE TABLET DROPS SOLUTION TABLET TABLET DROPS DROPS TAB CHEW GEL (GRAM) GEL (GRAM) DROPS TBMP 24HR TABLET TBMP 24HR TAB CHEW TABLET TABLET TABLET TABLET TABLET CAPSULE TABLET TABLET DROPS TABLET TABLET TABLET TABLET DR TABLET DR TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET PA Step QLL Age General Therapeutic Category Brand Name MULTIPLE VITAMINS MULTIVITAMIN AND FLUORIDE MULTI-VITAMIN DAILY MULTI-VITAMIN W-FLUORIDE MULTI-VITAMIN W-FLUORIDE-IRON MULTIVITAMIN WITH FLUORIDE MULTI-VITAMIN WITH FLUORIDE MULTI-VITAMIN-FLUOR-IRON MULTIVITAMINS MULTIVITAMINS W-FLUORIDE-IRON MULTIVITAMINS WITH FLUORIDE MULTIVITAMINS WITH IRON MULTIVITAMINS WITH MINERALS MULTIVITAMINS-A,B,D,E,K,ZN MVC-FLUORIDE M-VIT MYFERON 150 MYKIDZ IRON FL MYNATAL MYNATAL ADVANCE MYNATAL PLUS MYNATAL-Z MYNATE 90 PLUS NATALVIT NU-IRON 150 OBSTETRIX DHA OBSTETRIX EC O-CAL FA O-CAL PRENATAL ONCE DAILY ONCOVITE ONE DAILY ONE DAILY COMPLETE ONE DAILY ENERGY ONE DAILY ESSENTIAL ONE DAILY MULTIVITAMIN Generic Name MULTIVITAMIN PEDI MULTIVIT NO.2 W-FLUORIDE MULTIVITAMIN PEDI MULTIVIT NO.2 W-FLUORIDE PEDI MV #45/FLUORIDE/IRON PEDI M.VIT NO.17 WITH FLUORIDE PEDI MVI NO.12/SODIUM FLUORIDE PEDI M.VIT NO.17 WITH FLUORIDE PEDI MV #45/FLUORIDE/IRON MULTIVITAMIN PEDI MV #45/FLUORIDE/IRON PEDI MV #75/FLUORIDE/IRON PEDI M.VIT NO.17 WITH FLUORIDE PEDI MULTIVIT NO.2 W-FLUORIDE PEDI MVI NO.16 WITH FLUORIDE PEDI MVI NO.82 WITH FLUORIDE MULTIVITAMIN WITH IRON MULTIVITAMIN WITH MINERALS MULTIVITAMIN NO.44/VIT D3/K PEDI MULTIVIT #22/VIT D3/VIT K PEDI MULTIVIT #65/VIT D3/VIT K PEDI MVI NO.12/SODIUM FLUORIDE PV W-O CAL/FERROUS FUMARATE/FA IRON POLYSACCHARIDE COMPLEX IRON/FLUORIDE/VITS A, C, & D3 PNV/IRON,CARBONYL/DOCUSATE/FA PRENATAL VIT/IRON FUMARATE/FA PRENATAL VIT 15/IRON CB/FA/DSS PRENATAL VIT/IRON FUMARATE/FA PRENATAL VIT/IRON FUMARATE/FA PNV/FERROUS FUMARATE/DOSS/FA PRENATAL VIT/IRON FUMARATE/FA IRON POLYSACCHARIDE COMPLEX PNV NO12/IRON,CARB/FA/DSS/OM-3 PV W-O CAL/FE,CARBONYL/DOSS/FA PRENATAL VIT/IRON FUMARATE/FA PRENATAL VIT NO.127/IRON/FA MULTIVITAMIN MULTIVITAMIN,THERAPEUTIC MULTIVITAMIN MULTIVITAMIN WITH MINERALS MULTIVITAMIN WITH MINERALS FOLIC ACID/MV,FE,MIN MULTIVITAMIN WITH MINERALS MULTIVITAMIN MULTIVITAMIN Dose TABLET DROPS TABLET DROPS DROPS TAB CHEW TAB CHEW TAB CHEW DROPS DROPS TABLET DROPS DROPS TAB CHEW DROPS TAB CHEW DROPS DROPS TABLET TABLET CAPSULE TAB CHEW DROPS TAB CHEW TABLET CAPSULE ORAL SUSP TABLET CAPSULE TABLET TABLET TABLET TABLET ER TABLET CAPSULE CMBPKGDRCP TABLET DR TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET PA Step QLL Age General Therapeutic Category Brand Name SENTRY SE-TAN DHA SF SF 5000 PLUS SODIUM FLUORIDE Generic Name MULTIVITAMIN WITH IRON MULTIVITAMIN WITH IRON MULTIVITAMIN WITH MINERALS MULTIVITAMIN WITH IRON MULTIVITAMIN MULTIVITAMIN WITH MINERALS MULTIVIT-MINERALS/FA/LYCOPENE MULTIVITS,CA,MINERALS/IRON/FA VIT A,C & E/LUTEIN/MINERALS IRON,CARBONYL/FA/MULTIVIT-MIN MULTIVITAMIN PNV W-O CA NO5/FE FUMARATE/FA IRON POLYSACCHARIDE COMPLEX PEDIATRIC MULTIVITAMIN NO.20 PED MULTIVIT #46/IRON SULFATE MULTIVITAMIN PEDIATRIC MULTIVITAMIN NO.20 PED MULTIVIT #46/IRON SULFATE MULTIVITAMIN WITH IRON PNV53/IRON B-G HCL-P/FA/OMEGA3 PNV19/IRON BG HC&SUCC-P/FA/OM3 PNV54/IRON B-G HCL-P/FA/OMEGA3 PNV55/IRON BG HC,SUCC-P/FA/OM3 PRENATAL VIT #76/IRON,CARB/FA PNV WITH CA,NO.72/IRON,CARB/FA PNV WITH CA,NO.72/IRON/FA PNV W-O CA NO5/FE FUMARATE/FA VIT A/VIT C/VIT E/ZINC/COPPER SODIUM FLUORIDE SODIUM FLUORIDE SODIUM FLUORIDE/POTASSIUM NIT SODIUM FLUORIDE/POTASSIUM NIT A/C/E/ZINC/SOD SELENATE/COPPER PYRIDOXINE HCL PNV 11-IRON FUM-FOLIC ACID-OM3 PV W-O CAL/IRON PS CPLX/FA PNV NO.118/IRON FUMARATE/FA PNV119/IRON FUMARATE/FA/DSS MULTIVITAMIN/IRON/FOLIC ACID PNV NO10/IRON FUM&P/FA/OMEGA-3 SODIUM FLUORIDE SODIUM FLUORIDE SODIUM FLUORIDE SOOTHING PUREWAY-C SPECTRAVITE ADULT 50+ ASCORBIC ACID MULTIVIT-MIN/FA/LYCOPEN/LUTEIN ONE DAILY PLUS IRON ONE DAILY PLUS MINERALS ONE DAILY WITH IRON ONE-A-DAY ESSENTIAL ONE-A-DAY MAXIMUM FORMULA ONE-A-DAY MEN'S ONE-A-DAY TEEN ADVANTAGE OPTI-VITAMIN OPURITY MULTIVITAMIN PHARMACIST FAVORITE MULTI-VITE PNV-VP-U POLY-IRON POLY-VITA POLY-VITA WITH IRON POLY-VITAMIN POLYVITAMIN WITH IRON PR NATAL 400 PR NATAL 400 EC PR NATAL 430 PR NATAL 430 EC PRENATABS RX PRENATAL PLUS PRENATAL-U PRESERVISION AREDS PREVIDENT PREVIDENT 5000 PREVIDENT 5000 ENAMEL PROTECT PREVIDENT 5000 SENSITIVE PROSIGHT PYRIDOXINE HCL RELNATE DHA SELECT-OB SE-NATAL 19 Dose TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TAB CHEW TABLET CAPSULE CAPSULE DROPS DROPS DROPS DROPS DROPS DROPS COMBO. PKG CMBPKGDRCP COMBO. PKG CMBPKGDRCP TABLET TABLET TABLET CAPSULE CAPSULE PASTE (ML) GEL (ML) PASTE (ML) PASTE (ML) TABLET TABLET CAPSULE TAB CHEW TAB CHEW TABLET TABLET CAPSULE GEL (GRAM) CREAM (G) DROPS SOLUTION TAB CHEW TABLET TABLET TABLET PA Step QLL Age General Therapeutic Category Brand Name SPECTRAVITE ADVANCED FORMULA SPECTRAVITE SENIOR SUPER B-50 COMPLEX SUPER CALCIUM SUPER MULTIVITAMIN TAB-A-VITE TAB-A-VITE WITH IRON TAB-A-VITE-MINERALS TARON-PREX PRENATAL THERA THERA M PLUS THERADEX M THERA-M THERAPEUTIC M THERA-TABS THERA-TABS M THERATRUM COMPLETE 50 PLUS THEREMS THEREMS-M THRIVITE 19 TRIADVANCE TRINATAL GT TRIPLE-VITAMIN W-FLUORIDE TRIVEEN-DUO DHA TRIVEEN-U TRI-VI-SOL TRI-VIT WITH FLUORIDE-IRON TRI-VITAMIN TRI-VITAMIN WITH FLUORIDE TRUST NATAL DHA ULTIMATECARE ONE ULTIMATECARE ONE NF V-C FORTE VIC-FORTE VINACAL VINATE CARE VINATE GT VINATE II VINATE ONE VINATE PN CARE VINATE ULTRA VINATE-M VIRT-ADVANCE VIRT-CARE ONE VIRT-VITE GT VITAFOL-OB+DHA Generic Name MULTIVITAMIN/IRON/FOLIC ACID MULTIVIT WITH IRON-MINERALS VITAMIN B COMPLEX CALCIUM CARBONATE MULTIVITAMIN MULTIVITAMIN MULTIVITAMIN WITH IRON MULTIVITAMIN WITH MINERALS PNV39/IRON FUMARATE/FA/DSS/DHA MULTIVITAMIN,THERAPEUTIC MULTIVITS,CA,MINERALS/IRON/FA MULTIVIT,TX,IRON/CALCM/FA/MINS MULTIVITS,CA,MINERALS/IRON/FA MULTIVIT,TX,IRON/CALCM/FA/MINS MULTIVIT,TX,IRON/CALCM/FA/MINS MULTIVITAMIN,THERAPEUTIC MULTIVITS,CA,MINERALS/IRON/FA MULTIVITAMIN WITH MINERALS/LUT MULTIVIT WITH IRON-MINERALS MULTIVITAMIN,THERAPEUTIC MULTIVIT,TH IRON,OTHER MIN PNV119/IRON FUMARATE/FA/DSS PRENATAL VIT 15/IRON CB/FA/DSS PRENATAL VIT 16/IRON CB/FA/DSS PED MV A,C,D3 #21 W-FLUORIDE PNV53/IRON B-G HCL-P/FA/OMEGA3 PNV W-O CA NO5/FE FUMARATE/FA VIT A PALMITATE/VIT C/VIT D3 FLUORIDE/IRON/VITAMINS A,C,D PEDI MULTIVITS A,C,&D3 NO.21 PED MV A,C,D3 #21 W-FLUORIDE PNV2/IRON B-G SUC-P/FA/OMEGA-3 PNV W-CA NO.37/IRON/FA/OMEGA-3 PNV,CA,NO.35/IRON/FA/DS/OMEG-3 MULTIVITAMIN-MINERALS NO.7/FA MULTIVITAMIN-MINERALS NO.7/FA PNV NO.22/IRON CBN&GLUC/FA/DSS PRENATAL VIT NO.109/IRON/FA PRENATAL VIT 16/IRON CB/FA/DSS PRENATAL VIT/IRON BISGLYCIN/FA PRENATAL VIT27,CALCIUM/IRON/FA PNV7/FE ASP GLY/DOCUSATE/FA PRENATAL VIT 18/IRON CB/FA/DSS PNV/FERROUS FUMARATE/FA/SE PRENATAL VIT 15/IRON CB/FA/DSS PNV W-CA NO.37/IRON/FA/OMEGA-3 PRENATAL VIT 16/IRON CB/FA/DSS PRENAT VIT COMB.10/IRON/FA/DHA Dose TABLET TABLET CAPSULE TABLET TABLET TABLET TABLET TABLET CAPSULE TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET TABLET DROPS COMBO. PKG CAPSULE DROPS DROPS DROPS DROPS COMBO. PKG CAPSULE CAPSULE CAPSULE CAPSULE TABLET TAB CHEW TABLET TABLET TABLET TABLET TABLET TABLET TABLET CAPSULE TABLET COMBO. PKG PA Step QLL Age General Therapeutic Category Brand Name VITAMIN B COMPLEX VITAMIN B-12 Generic Name VITAMIN B COMPLEX CYANOCOBALAMIN (VITAMIN B-12) VITAMIN B-6 VITAMIN C PYRIDOXINE HCL ASCORBIC ACID VITAMIN C WITH ROSE HIPS VITAMIN D2 VITAMIN E ASCORBIC ACID ERGOCALCIFEROL (VITAMIN D2) VITAMIN E VITAMIN E ACETATE VITAMIN E MIXED PED MV A,C,D3 #21 W-FLUORIDE MULTIVITAMIN PNV 11-IRON FUM-FOLIC ACID-OM3 ZINC SULFATE ZINC SULFATE PNV22/IRON CBN&GLUC/FA/DSS/DHA CALCIUM CARBONATE/VITAMIN D3 PNV W-CA NO.37/IRON/FA/OMEGA-3 ZINC SULFATE VITAMIN B COMP AND VIT C NO.6 MULTIVIT, IRON, MIN #6, FA ERGOCALCIFEROL (VITAMIN D2) MULTIVITAMIN IRON POLYSACCHARIDE COMPLEX PNV/IRON PS CPLX/FOLIC ACID PNV/IRON PS CPLX/FOLIC ACID SODIUM FLUORIDE MULTIVITAMIN CALCIUM CARB/VIT D3/MINERALS IRON POLYSACCHARIDE COMPLEX MULTIVITAMIN WITH MINERALS PNV W-O IRON/FA/CALCIUM/B6/B12 PNV NO.22/IRON CBN&GLUC/FA/DSS PNV19/IRON BG HC&SUCC#2/FA/OM3 PRENATAL VIT 18/IRON CB/FA/DSS PNV W-CA NO.37/IRON/FA/OMEGA-3 PNV54/IRON B-G HCL-P/FA/OMEGA3 PNV55/IRON BISGL,SUCC#2/FA/OM3 PNV/FERROUS FUMARATE/DOSS/FA PRENATAL VIT27,CALCIUM/IRON/FA PV W-O VIT A/FE FUMARATE/FA PV W-O VIT A/FECBN-FEFM/FA PNV WITH CALCIUM,NO.34/IRON/FA PN VIT.W-O CA #7, IRON,FA,DHA PRENAT VIT COMB.10/IRON/FA/DHA VITAMIN E MULTIVITAMIN VITAMINS A,C,D & FLUORIDE VITAMINS FOR HAIR VIVA DHA ZINC SULFATE ZINC-220 CITRANATAL DHA CALCARB 600 WITH VITAMIN D OB-NATAL ONE ZINCATE STROVITE STROVITE PLUS ERGOCALCIFEROL (VITAMIN D2) DAILY VITAMIN POLYSACCHARIDE IRON POLY IRON PN FORTE POLY IRON PN NAFRINSE DAILY-NEUTRAL CENTRAL-VITE HP CALCIUM 600+D PLUS MINERALS FERUS VIGOMAR FORTE TRIMESIS RX TRI RX TARON-DUO EC TRINATAL ULTRA CAVAN ONE OMEGA SETONET SETONET-EC SE-NATAL 90 SE-NATAL ONE SE-CARE SE-CARE CONCEIVE SE-CARE GESTURE SE-PLETE DHA CAVAN-FOLATE DHA FORMULA E ESSENTIAL ONE DAILY Dose CAPSULE TABLET TABLET ER TABLET TAB CHEW TABLET TABLET CAPSULE CAPSULE CAPSULE CAPSULE DROPS TABLET CAPSULE CAPSULE CAPSULE COMBO. PKG TABLET CAPSULE CAPSULE TABLET TABLET CAPSULE TABLET CAPSULE TABLET TABLET SOLUTION TABLET TABLET CAPSULE TABLET TBMP 24HR TABLET CMBPKGDRCP TABLET CAPSULE COMBO. PKG CMBPKGDRCP TABLET ER TABLET TAB CHEW TABLET TBMP 24HR CAPSULE COMBO. PKG CAPSULE TABLET PA Step QLL Age General Therapeutic Category FLUID REPLACEMENT Brand Name ONE DAILY MAXIMUM THERAPEUTIC-M DAILY DIET SUPPORT CALCIUM CITRATE- VITAMIN D MULTINATAL PLUS PNV-OB WITH DHA PRENAISSANCE DHA EPIFLUR TRI-VITAMIN WITH IRON-FLUORIDE POLYVITAMIN WITH IRON-FLUORIDE POLYVITAMINS-FLUORIDE GOLDEN AGE SPECTRAVITE VINATE AZ VINATE CALCIUM VINATE AZ EXTRA VINATE IC OYSTER SHELL CALCIUM W-VIT D STANNOUS FLUORIDE MAG-SR MAG-SR PLUS CALCIUM PRENAFIRST PRENATAL AD INATAL GT ICAR-C PLUS SR OBTREX FOLCAPS OMEGA-3 PREPLUS VP-ERA OB PLUS PRENATAL VITAMIN PLUS LOW IRON VIRT-NATE DHA CALCIUM 600-VIT D3 HAIR, SKIN AND NAILS NU-MAG XURIDEN Generic Name FOLIC ACID/MV,FE,MIN MULTIVIT,TX,IRON/CALCM/FA/MINS MULTIVITAMIN CALCIUM CITRATE/VITAMIN D3 PV W-O VIT A/FE FUMARATE/FA PRENAT VIT COMB.10/IRON/FA/DHA PNV22/IRON CBN&GLUC/FA/DSS/DHA SODIUM FLUORIDE FLUORIDE/IRON/VITAMINS A,C,D MULTIVITS WITH IRON & FLUORIDE MULTIVITAMINS WITH FLUORIDE MULTIVIT WITH IRON-MINERALS MULTIVIT WITH IRON-MINERALS PRENATAL VIT/IRON BISGLYCIN/FA PNV NO.4/IRON CBN&GLUC/FA/DOSS PV W-O CAL/FE BISGLY/FA PRENATAL VITS CMB W-O CA NO.2 CALCIUM CARBONATE/VITAMIN D3 STANNOUS FLUORIDE MAGNESIUM CHLORIDE MAGNESIUM CHLORIDE PRENATAL VIT/IRON FUMARATE/FA PRENATAL VIT 15/IRON CB/FA/DSS PNV/IRON,CARBONYL/DOCUSATE/FA IRON,CARBONYL/VIT C/VIT B12/FA PV W-O CAL/FE,CARBONYL/DOSS/FA PNV W-CA NO.37/IRON/FA/OMEGA-3 PNV WITH CA,NO.72/IRON/FA PNV #8/IRON PS & HEME POLYP/FA PNV WITH CA,NO.72/IRON/FA PNV 11-IRON FUM-FOLIC ACID-OM3 CALCIUM CARBONATE/VITAMIN D3 MULTIVITAMIN WITH MINERALS MAGNESIUM CHLORIDE URIDINE TRIACETATE Dose TABLET TABLET TABLET TABLET TAB CHEW COMBO. PKG COMBO. PKG TAB CHEW DROPS DROPS DROPS LIQUID LIQUID TABLET TABLET TABLET CAPSULE TABLET SOLN(GRAM) TABLET ER TABLET ER TABLET TABLET TABLET CAP MPHASE TABLET CAPSULE TABLET TABLET TABLET CAPSULE TABLET TABLET TABLET DR GRAN PACK PA X Step QLL Age EOCCO nondiscrimination notice EOCCO complies with applicable federal civil rights laws. We do not discriminate on the basis of race, color, national origin, age, disability or sex. EOCCO provides free, timely aids and services to people with disabilities to help them communicate with us effectively. These accommodations include sign language interpreters and written information in other formats. If your primary language is not English, EOCCO also provides free, timely interpretation services and/or materials written in other languages. 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