Dynamic Therapeutic Formulary (DTF) Prescription Drug

Transcription

Dynamic Therapeutic Formulary (DTF)
Prescription Drug Listing for Plan Members
Your drug plan provides coverage based on two lists of eligible drugs.
Tier 1 - Dynamic Therapeutic Formulary (DTF)
Tier 2 - Base Plan (a formulary of drugs selected by your employer)
*Note: Some benefit plans only have the DTF.
The drugs listed in this document is intended as a guide to help you and your physician
determine if a drug is covered under the DTF. When a drug is prescribed from the DTF
list, you will be reimbursed at a higher percentage compared to a drug from your base
plan list. Your base plan drugs are not listed in this document.
The DTF is a GENERIC formulary, so where there is a GENERIC that is considered
interchangeable with the BRAND, only the cost of the GENERIC will be reimbursed.
• BRAND drugs appear in BLACK
• GENERIC drugs appear in GREEN
HOW TO SEARCH
To help you determine the coverage of a particular drug. Click on the corresponding link
listed below, then you can search the listing by using these quick steps:
1) Click Ctrl+F on the keyboard OR Go to Edit –> Find
2)
A Find box will open. Here you can enter either the DIN # or the Drug Name. Press
enter when finished.
Click the links to find:
• DIN listing of DTF drugs
• Drugs NOT covered on the DTF
• Drugs that require Prior Authorization
This list is subject to change upon review of new products or information.
®
www.esi-canada.com
1
05/2012
DRUGS COVERED ON DTF
Therapy Class
040000
DIN
Drug Name
ANTIHISTAMINE DRUGS
Chemical Name
Strength
Dosage
040000
040000
040000
040000
040000
040000
040000
040000
040000
040000
040000
040000
040000
040000
040000
040000
040000
02239669
02221330
02344572
02316609
02230730
02176084
02218305
01926306
00025771
01926292
00025798
02315963
02231680
02231679
01900978
02172585
00577308
APO‐ASTEMIZOLE 10MG TAB
APO‐KETOTIFEN 1MG/5ML O/L
DOM‐CETIRIZINE 20MG TAB
NOVO‐CETIRIZINE 20MG TAB
NOVO‐KETOTIFEN 1MG TAB
NOVO‐KETOTIFEN 1MG/5ML
NU‐KETOTIFEN 1MG/5ML
PANECTYL 2.5MG TAB
PANECTYL 3.13MG
PANECTYL 5 MG TAB
PANECTYL 6.25MG
PMS‐CETIRIZINE 20MG TAB
PMS‐KETOTIFEN 1MG TAB
PMS‐KETOTIFEN 1MG/5ML SYRUP
REACTINE 20MG TAB
ZADITEN 1MG/ML ORAL DROPS
ZADITEN TAB 1MG
ASTEMIZOLE
KETOTIFEN FUMARATE
CETIRIZINE HCL
CETIRIZINE HCL
KETOTIFEN FUMARATE
KETOTIFEN FUMARATE
KETOTIFEN FUMARATE
TRIMEPRAZINE TARTRATE
CETIRIZINE HCL
KETOTIFEN FUMARATE
KETOTIFEN FUMARATE
CETIRIZINE HCL
KETOTIFEN FUMARATE
KETOTIFEN FUMARATE
10MG
1MG/5ML
20MG
20MG
1MG
1MG/5ML
1MG/5ML
2.5MG
3.13MG
5MG
5MG
20MG
1MG
1MG/5ML
20MG
1MG/ML
1MG
TAB
O/L
TAB
TAB
TAB
O/L
O/L
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
O/L
TAB
*Prior Authorization (PA) approval required for these drugs.
"PA (N)" ‐ PA required for all provinces.
"PA (P)" ‐ PA required for specific provinces only.
Please refer to "Drugs That Require Prior Authorization" page for full listing.
2
*PA
05/2012
Therapy Class
080800
DIN
Drug Name
ANTHELMINTICS
Chemical Name
Strength
Dosage
080800
080800
080800
080800
02230897
02169967
00556734
00333395
BILTRICIDE 600MG TAB
HETRAZAN TAB 50MG
VERMOX 100MG CHEWABLE TAB
VERMOX 100MG TAB
PRAZIQUANTEL
DIETHYLCARBAMAZINE CITRATE
MEBENDAZOLE
MEBENDAZOLE
600MG
50MG
100MG
100MG
TAB
TAB
TAB
TAB
3
*PA
05/2012
Therapy Class
081202
DIN
Drug Name
AMINOGLYCOSIDES
Chemical Name
Strength
Dosage
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
081202
02384930
02242971
02225123
00832812
02082136
02268531
02082144
02242652
02082152
01913565
01913530
01913093
01913549
02243660
02239630
02365154
00533688
02285150
02230639
02241209
02230640
02241210
02382814
AJ‐TOBRAMYCIN 40MG/ML INJ
AMIKACIN SULFATE 250MG/ML INJ
CIDOMYCIN 10MG/ML INJ
GARAMYCIN INJ 1.6MG/ML
GENTAMICIN 100MG/100ML INJ
GENTAMICIN 10MG/ML INJ
GENTAMICIN 40MG/ML INJ
GENTAMICIN SULF IN .9% SOD.CHL
GENTAMICIN SULF/NACL 0.9% INJ
GENTAMICINE SULF/NACL 0.9% INJ
GENTAMICINE SULF/NACL 0.9% INJ
STREPTOMYCIN FOR INJECTION
TOBI 300MG/5ML INH SOL
TOBI PODHALER 28MG CAP
TOBRAMYCIN 1.2G/VIAL INJ
TOBRAMYCIN 1.2GM/VIAL INJEC
TOBRAMYCIN 10MG/ML INJ
TOBRAMYCIN
AMIKACIN SULFATE
GENTAMICIN SULFATE
GENTAMICIN SULFATE
GENTAMICIN SULFATE
GENTAMICIN SULFATE
GENTAMICIN SULFATE
GENTAMICIN SULFATE
GENTAMICIN SULFATE
GENTAMICIN SULF, SODIUM CHLORI
GENTAMICIN SULFATE
GENTAMICIN SULFATE
GENTAMICIN SULFATE
STREPTOMYCIN SULFATE
TOBRAMYCIN SULFATE
TOBRAMYCIN
TOBRAMYCIN SULFATE
TOBRAMYCIN SULFATE
TOBRAMYCIN SULFATE
TOBRAMYCIN SULFATE
TOBRAMYCIN SULFATE
TOBRAMYCIN SULFATE
TOBRAMYCIN
40MG/ML
250MG/ML
10MG/ML
1.6MG/ML
1MG/ML
10MG/ML
1.2MG/ML
40MG/ML
1.6MG/ML
1MG,9MG/ML
1.4MG/ML
1.2MG/ML
0.8MG/ML
1G/VIAL
300MG/5ML
28MG
1.2G/VIAL
1.2GM/VIAL
10MG/ML
10MG/ML
40MG/ML
40MG/ML
40MG/ML
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INH SOL
CAP
INJ
INJ
INJ
INJ
INJ
INJ
INJ
4
*PA
05/2012
Therapy Class
081206
DIN
Drug Name
CEPHALOSPORINS
Chemical Name
Strength
Dosage
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
00319112
02237502
02240774
02293943
09857360
02292998
02293951
09857361
02293005
02244393
02244394
00768723
00768715
02340917
02340925
02347261
02347245
02347288
02347253
02344823
02344831
02362864
02362848
02362872
02362856
02373882
02373890
00465208
00465216
00832804
00465186
00465194
02165465
02165473
02237382
02238790
02238791
02237380
02238792
02237383
02238793
02237384
02237381
02297213
02308967
02237140
02297205
02237139
02318830
02237141
02237136
02297191
02237138
02237137
02233855
02097192
02097206
02097184
02261510
02261529
02261502
02352168
02352176
02352184
02334887
02324172
02332035
02334909
02332027
02334895
09857366
02324180
02332043
02334917
00886955
00886963
00886971
02212307
02212277
02212285
ANCEF 1G INJ
APO‐CEFACLOR 375MG/5ML O/L
APO‐CEFADROXIL 500MG CAP
APO‐CEFPROZIL 125MG/5ML O/L
APO‐CEFPROZIL 250MG TAB
APO‐CEFPROZIL 500MG TAB
APO‐CEFUROXIME 250MG TAB
APO‐CEFUROXIME 500MG TAB
APO‐CEPHALEX 250MG TAB
APO‐CEPHALEX 500MG TAB
APX‐CEPHALEX 250MG TAB
APX‐CEPHALEX 500MG TAB
AURO‐CEFPROZIL 125MG/5ML O/L
AURO‐CEFPROZIL 250MG TAB
AURO‐CEFPROZIL 250MG/5ML O/L
AURO‐CEFPROZIL 500MG TAB
AURO‐CEFUROXIME 250MG TAB
AURO‐CEFUROXIME 500MG TAB
AVA‐CEFPROZIL 125MG/5ML O/L
AVA‐CEFPROZIL 250MG TAB
AVA‐CEFPROZIL 250MG/5ML O/L
AVA‐CEFPROZIL 500MG TAB
AVA‐CEPHALEXIN 250MG TAB
AVA‐CEPHALEXIN 500MG TAB
CECLOR 125MG/5ML SUSP
CECLOR 250MG/5ML SUSP
CECLOR BID PWR 375MG/5ML
CECLOR PULVULE 250MG CAP
CECLOR PULVULES 500MG CAP
CEDAX 200MG CAP
CEDAX 400MG CAP
CEFACLOR 125/5ML SUS
CEFACLOR 125MG/5ML O/L
CEFACLOR 250MG CAP
CEFACLOR 250MG/5ML S
CEFACLOR 375MG/5ML S
CEFACLOR 500MG CAP
CEFAZOLIN 10G/VIAL INJ
CEFAZOLIN 10GM/VIAL INJ
CEFAZOLIN 1GM/VIAL FOR INJ
CEFAZOLIN 20GM/VIAL INJ
CEFAZOLIN 500MG/VIAL INJ
CEFAZOLIN 500MG/VIAL INJ
CEFAZOLIN FOR INJ 1GM/VIAL
CEFAZOLIN FOR INJ 500MG/VIAL
CEFAZOLIN SODIUM 10G
CEFOTAXIME 1G/VIAL INJ
CEFOTAXIME 2G/VIAL INJ
CEFOTAXIME 500MG/VIAL INJ
CEFOTAXIME SOD 1G/VIAL IM INJ
CEFOTAXIME SOD 2G/VIAL IM INJ
CEFOTAXIME SOD 500MG/VIAL INJ
CEFOTAXIME SODIUM 0.5G/VL INJ
CEFOTAXIME SODIUM 1G/VL INJ
CEFOTAXIME SODIUM 2G/VL INJ
CEFPROZIL 125MG/5ML O/L
CEFPROZIL 250MG TAB
CEFPROZIL 250MG TAB
CEFPROZIL 250MG TAB
CEFPROZIL 500MG TAB
CEFPROZIL 500MG TAB
CEFPROZIL 500MG TAB
CEFTAZIDIME 2G/VIAL INJ
CEFTAZIDIME 6G/VIAL INJ
CEFTAZIDIME INJ 1GM/VIAL
CEFTIN 125MG/5ML O/L
CEFTIN 250MG TAB
CEFTIN 500MG TAB
CEFAZOLIN SODIUM
CEFACLOR
CEFADROXIL
CEFPROZIL
CEFPROZIL
CEFPROZIL MONOHYDRATE
CEFPROZIL
CEFPROZIL
CEFUROXIME AXETIL
CEFUROXIME AXETIL
CEPHALEXIN MONOHYDRATE
CEPHALEXIN
CEPHALEXIN
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFUROXIME
CEFUROXIME
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEPHALEXIN
CEPHALEXIN
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFTIBUTEN DIHYDRATE
CEFTIBUTEN DIHYDRATE
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFTAZIDIME
CEFTAZIDIME
CEFTAZIDIME
CEFUROXIME AXETIL
CEFUROXIME AXETIL
CEFUROXIME AXETIL
1G
375MG/5ML
500MG
125MG/5ML
125MG/5ML
250MG
250MG/5ML
250MG/5ML
500MG
250MG
500MG
250MG
500MG
250MG
500MG
125MG/5ML
250MG
250MG/5ML
500MG
250MG
500MG
125MG/5ML
250MG
250MG/5ML
500MG
250MG
500MG
125MG/5ML
250MG/5ML
375MG/5ML
250MG
500MG
200MG
400MG
125MG/5ML
125MG/5ML
187MG/5ML
250MG
250MG/5ML
250MG/5ML
375MG/5ML
375MG/5ML
500MG
10G/VIAL
10G/VIAL
10GM/VIAL
1G/VIAL
1GM/VIAL
20G/VIAL
20GM/VIAL
500MG/VIAL
500MG/VIAL
1GM/VIAL
500MG/VIAL
10GM
1G
2G
500MG
1G/VIAL
2G/VIAL
500MG/VIAL
0.5G/VL
1G/VL
2G/VL
125MG/5ML
250MG
250MG
250MG
250MG/5ML
250MG/5ML
250MG/5ML
500MG
500MG
500MG
2G/VL INJ
6G/VL INJ
1GM/VIAL
125MG/5ML
250MG
500MG
INJ
O/L
CAP
O/L
O/L
TAB
O/L
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
O/L
TAB
TAB
TAB
O/L
TAB
O/L
TAB
TAB
TAB
O/L
O/L
O/L
CAP
CAP
CAP
CAP
O/L
O/L
O/L
CAP
O/L
O/L
O/L
O/L
CAP
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
O/L
TAB
TAB
TAB
O/L
O/L
O/L
TAB
TAB
TAB
INJ
INJ
INJ
O/L
TAB
TAB
5
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
02289679
02289687
02292904
02289717
02292874
02289695
02292866
02292882
02289709
02292297
02292270
02292289
02292262
02287625
02325632
02287668
02325616
02287633
02325594
02325624
02287641
02325608
02250276
02250284
02250292
02250306
02292815
02241639
02241640
02241638
02163675
09857358
02163659
02163683
09857359
02163667
02060051
00321435
00321432
02225093
02225107
02225085
02225115
00839256
02259427
02259435
02259389
02259397
02259400
02259419
02307901
02307928
02177633
02177641
02177862
02177846
02177870
02177854
00674826
02212218
02212226
02212196
02212234
02355469
02355485
02355477
02355493
02241637
02241641
02241642
00752533
02128918
02128926
02128977
02128985
02128993
02317303
02317389
02317311
01970429
01970410
CEFTRIAXONE 0.25GM/VIAL INJ
CEFTRIAXONE 0.5GM/VIAL INJ
CEFTRIAXONE 10G/VIAL INJ
CEFTRIAXONE 10GM/VIAL INJ
CEFTRIAXONE 250MG/VIAL INJ
CEFTRIAXONE FOR INJ 10G/VIAL
CEFTRIAXONE INJ 0.25GM/VIAL
CEFTRIAXONE SODIUM 0.25GM/VIAL
CEFTRIAXONE SODIUM 10G/VIAL
CEFTRIAXONE SODIUM 10GM/VIAL
CEFTRIAXONE SODIUM 1G/VIA INJ
CEFTRIAXONE SODIUM 250MG/VIAL
CEFTRIAXONE SODIUM 2G/VIA INJ
CEFTRIAXONE SODIUM 500MG/VIAL
CEFTRIAXONE SODIUM FOR INJ
CEFTRIAXONE SODIUM INJ
CEFUROXIME FOR INJ 1.5GM/VIAL
CEFUROXIME FOR INJ 7.5GM/VIAL
CEFUROXIME FOR INJ 750MG/VIAL
CEFZIL 125MG/5ML SUSP
CEFZIL 250MG TAB
CEFZIL 500MG TAB
CEPHALOTHIN 1G INJ
CEPOREX 125MG/5ML O/L
CEPOREX GRAN 25MG
CLAFORAN 1G/VIAL INJ
CLAFORAN 2G/VIAL INJ
CLAFORAN 500MG/ML INJ
CLAFORAN INJ
CLAFORAN INJ 2GM/ADD‐VANTAGE
CO CEFACLOR 250MG CAP
CO CEFACLOR 500MG CAP
CO CEFACLOR SUSP 125MG/5ML
CO‐CEFTRIAXONE 1G/VIAL IV INJ
CO‐CEFTRIAXONE 2G/VIAL IM INJ
DOM‐CEFACLOR 250MG CAP
DOM‐CEFACLOR 500MG CAP
DOM‐CEPHALEXIN 125MG/5ML SUSP
DOM‐CEPHALEXIN 250MG TAB
DOM‐CEPHALEXIN 250MG/5ML SUSP
DOM‐CEPHALEXIN 500MG TAB
DURICEF
FORTAZ INJ 1GM/VIAL
FORTAZ INJ 2GM/VIAL
FORTAZ INJ 500MG/VIAL
FORTAZ PWS 6GM/VIAL INJ
GD‐CEFPROZIL 125MG/5ML O/L
GD‐CEFPROZIL 250MG TAB
GD‐CEFPROZIL 250MG/5ML O/L
GD‐CEFPROZIL 500MG TAB
GEN‐CEFACLOR 125MG/5ML O/L
KEFLIN ADD‐VANTAGE INJ 2GM/VIA
KENRAL‐CEFACLOR
KENRAL‐CEFACLOR
KENRAL‐CEFACLOR
KENRAL‐CEFACLOR
KENRAL‐CEFACLOR
MINT‐CEFPROZIL 250MG TAB
MINT‐CEFPROZIL 250MG/5ML SUSP
MINT‐CEFPROZIL 500MG TAB
MONOCID 1GM/VIAL INJ
MONOCID 500MG/VIAL INJ
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE
CEFTRIAXONE SODIUM
CEFTRIAXONE
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFUROXIME SODIUM
CEFUROXIME SODIUM
CEFUROXIME SODIUM
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEPHALOTHIN SODIUM
CEPHALEXIN
CEPHALEXIN
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME SODIUM
CEFOTAXIME
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFACLOR
CEFACLOR
CEFADROXIL
CEFTAZIDIME
CEFTAZIDIME
CEFTAZIDIME
CEFTAZIDIME
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFACLOR
CEFACLOR
CEFACLOR
CEPHALOTHIN SODIUM
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFONICID SODIUM
CEFONICID SODIUM
.25GM/VIAL
0.5GM/VIAL
10G/VIAL
10GM/VIAL
1G/VIAL
1GM/VIAL
250MG/VIAL
2G/VIAL
2GM/VIAL
10G/VIAL
1G/VIAL
2G/VIAL
.25GM/VIAL
0.25GM
10G/VIAL
10GM/VIAL
1G/VIAL
1GM/VIAL
250MG/VIAL
2G/VIAL
2GM/VIAL
500MG/VIAL
250MG/VIAL
500MG/VIAL
1G/VIAL
2G/VIAL
10G
1.5GM
7.5GM
750MG
125MG/5ML
125MG/5ML
250MG
250MG/5ML
250MG/5ML
500MG
1G
125MG/5ML
25MG
1G/VIAL
2G/VIAL
500MG/ML
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
O/L
O/L
TAB
O/L
O/L
TAB
INJ
O/L
PDR
INJ
INJ
INJ
INJ
INJ
CAP
CAP
O/L
O/L
O/L
O/L
INJ
INJ
CAP
CAP
O/L
TAB
O/L
TAB
O/L
INJ
INJ
INJ
INJ
O/L
TAB
O/L
TAB
O/L
O/L
O/L
INJ
CAP
CAP
O/L
O/L
O/L
TAB
O/L
TAB
INJ
INJ
6
2 G
250MG
500MG
125MG/5ML
187MG/5ML
250MG/5ML
375MG/5ML
1G/VIAL
2G/VIAL
250MG
500MG
125MG/5ML
250MG
250MG/5ML
500MG
50MG
1G/VIAL
2G/VIAL
500MG/VIAL
6G/VIAL
125MG/5ML
250MG
250MG/5ML
500MG
125MG/5ML
250MG/5ML
375MG/5ML
2 G
250MG
500MG
125MG/5ML
250MG/5ML
375MG/5ML
250MG
250MG/5ML
500MG
1GM/VIAL
500MG/VIAL
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
081206
02235134
02108135
02108127
02108119
02230126
02230127
00342106
00342084
00342114
00342092
00583413
00583421
02238049
02231432
02238050
02238051
02231433
02240600
02336340
02336103
02336359
02336111
02336448
02336456
00865877
00865885
02239560
02239563
02323117
02323125
02179725
02226847
00828858
00828866
02177781
02177803
02311062
02311445
02311453
02329204
09857356
02293528
02293579
09857365
02293536
02242656
02242657
00657417
00657387
02303426
09857363
02302179
02303434
09857364
02302187
02257866
02257874
02308959
02308932
02237729
02237730
02155818
02155753
02155796
02155788
02155761
00868965
02170760
00868981
02028476
NOVO‐CEFADROXIL 500MG CAP
NOVO‐CEFAZOLIN SOD 10G/VIAL
NOVO‐CEFAZOLIN SOD 1G/VIAL
NOVO‐CEFAZOLIN SOD 500MG/VIAL
NOVO‐CEFUROXIME 250MG TAB
NOVO‐CEFUROXIME 500MG TAB
NOVO‐LEXIN 125MG/5ML SUSP
NOVOLEXIN CAP 250MG
NOVO‐LEXIN CAP 500MG
NOVO‐LEXIN SUSP 250MG/5ML
NOVO‐LEXIN TAB 250MG
NOVO‐LEXIN TAB 500MG
NU‐CEFACLOR 125MG/5ML LIQ
NU‐CEFACLOR 250MG CAP
NU‐CEFACLOR 500MG CAP
NU‐CEFADROXIL 500MG CAP
NU‐CEFPROZIL 125MG/5ML O/L
NU‐CEFPROZIL 250MG TAB
NU‐CEFPROZIL 250MG/5ML O/L
NU‐CEFPROZIL 500MG TAB
NU‐CEFUROXIME 250MG TAB
NU‐CEFUROXIME 500MG TAB
NU‐CEPHALEX TAB 250MG
NU‐CEPHALEX TAB 500MG
OMNICEF 125MG/5ML ORAL SUSP
OMNICEF 300MG CAPSULE
ORB‐CEFUROXIME 250MG TAB
ORB‐CEFUROXIME 500MG TAB
ORELOX 100MG TAB
ORELOX 100MG TAB
PDL‐CEPHALEXIN TAB 250MG
PDL‐CEPHALEXIN TAB 500MG
PMS‐CEPHALEXIN 250MG TAB
PMS‐CEPHALEXIN 500MG TAB
PRO‐CEFADROXIL 500MG CAP
PRO‐CEFUROXIME 250MG TAB
PRO‐CEFUROXIME 500MG TAB
RAN‐CEFPROZIL 125MG/5ML O/L
RAN‐CEFPROZIL 250MG TAB
RAN‐CEFPROZIL 500MG TAB
RATIO‐CEFUROXIME 250MG TAB
RATIO‐CEFUROXIME 500MG TAB
ROCEPHIN PWS 1GM/VIAL
ROCEPHIN PWS INJ 0.25GM/VIAL
SANDOZ CEFPROZIL 125MG/5ML O/L
SANDOZ CEFPROZIL 250MG TAB
SANDOZ CEFPROZIL 500MG TAB
SANDOZ CEFTRIAXONE 1GM/VIAL
SANDOZ CEFTRIAXONE 2GM/VIAL
SANDOZ‐CEFAZOLIN 1G/VIAL INJ
SANDOZ‐CEFAZOLIN 500MG/VIA INJ
SCHEIN‐CEFACLOR 250MG CAP
SCHEIN‐CEFACLOR 500MG CAP
STCC‐CEFACLOR 125MG/5ML
STCC‐CEFACLOR 250MG
STCC‐CEFACLOR 500MG
SUPRAX PWS 100MG/5ML
SUPRAX TAB 200MG
SUPRAX TAB 400MG
TARO‐CEPHALEXIN 250MG
CEFADROXIL
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFUROXIME AXETIL
CEFUROXIME AXETIL
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFADROXIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFUROXIME
CEFUROXIME
CEFDINIR
CEFDINIR
CEFUROXIME AXETIL
CEFUROXIME AXETIL
CEFPODOXIME PROXETIL
CEFPODOXIME PROXETIL
CEPHALEXIN
CEPHALEXIN
CEFADROXIL
CEFUROXIME AXETIL
CEFUROXIME AXETIL
CEFPROZIL
CEFPROZIL
CEFUROXIME AXETIL
CEFUROXIME AXETIL
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFPROZIL
CEFTRIAXONE SODIUM
CEFTRIAXONE SODIUM
CEFAZOLIN SODIUM
CEFAZOLIN SODIUM
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFACLOR
CEFIXIME
CEFIXIME
CEFIXIME
500MG
10G/VIAL
1 G/VIAL
500 MG
250MG
500MG
125MG/5ML
250MG
500MG
250MG/5ML
250MG
500MG
125MG/5ML
250MG
250MG/5ML
375MG/5ML
500MG
500MG
125MG/5ML
250MG
250MG/5ML
500MG
250MG
500MG
250MG
500MG
125MG/5ML
300MG
250MG
500MG
100MG
100MG
250MG
500MG
250 MG
500 MG
500MG
250MG
500MG
125MG/5ML
125MG/5ML
250MG
250MG/5ML
250MG/5ML
500MG
250MG
500MG
1G
0.25G
125MG/5ML
125MG/5ML
250MG
250MG/5ML
250MG/5ML
500MG
1GM/VIAL
2GM/VIAL
1G/VIAL
500MG/VIAL
250MG
500MG
125MG/5ML
250MG
250MG/5ML
375MG/5ML
500MG
100MG/5ML
200MG
400MG
250MG
CAP
INJ
INJ
INJ
TAB
TAB
O/L
CAP
CAP
O/L
TAB
TAB
O/L
CAP
O/L
O/L
CAP
CAP
O/L
TAB
O/L
TAB
TAB
TAB
TAB
TAB
O/L
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
O/L
O/L
TAB
O/L
O/L
TAB
TAB
TAB
INJ
INJ
O/L
O/L
TAB
O/L
O/L
TAB
INJ
INJ
INJ
INJ
CAP
CAP
O/L
CAP
O/L
O/L
CAP
O/L
TAB
TAB
TAB
7
*PA
05/2012
Therapy Class
081207
DIN
Drug Name
MISCELLANEOUS ΒETA-LACTAM
Chemical Name
Strength
Dosage
081207
081207
081207
081207
02329840
02247437
00717274
00717282
CAYSTON 75MG/VIAL INH
INVANZ 1G/VIAL INJ
PRIMAXIN 250 IV INJ
PRIMAXIN 500 IV INJ
AZTREONAM
ERTAPENEM SODIUM
IMIPENEM/CILASTATIN SODIUM
IMIPENEM/CILASTATIN SODIUM
75MG/VIAL
1G/VIAL
250 MG
500 MG
INH
INJ
INJ
INJ
8
*PA
05/2012
Therapy Class
081212
DIN
Drug Name
MACROLIDES
Chemical Name
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
02247423
02274744
02274752
00726672
01925938
00637416
00682020
00545678
00688568
02363372
02363380
02363364
02366371
02366398
02330881
02334070
02342030
02343347
02330911
02342049
02343355
02368846
02146908
02244641
01984853
02126710
02244756
02245063
02245065
02245064
02245066
02335182
02335190
02255340
02256088
02282429
02282437
02278499
02278502
02351005
00583782
00436666
00607142
00873454
02084767
00704385
99100614
02274566
02274574
02274531
02274558
02278367
02249871
02249898
02278359
02248856
02248857
02315157
02315165
02267845
00605859
00652318
00021172
00262595
02051850
00769991
00704393
00704377
00563854
00583405
02282380
02282410
02278588
02278596
02274388
02274396
09857316
02261634
02261642
02247573
APO‐AZITHROMYCIN 250MG TAB
APO‐CLARITHROMYCIN 250MG TAB
APO‐CLARITHROMYCIN 500MG TAB
APO‐ERYTHRO E‐C CAP 250MG
APO‐ERYTHRO E‐C CAP 333MG
APO‐ERYTHRO ES 600MG TAB
APO‐ERYTHRO‐BASE 250MG TAB
APO‐ERYTHRO‐S 250MG TAB
APO‐ERYTHRO‐S 500MG TAB
AVA‐AZITHROMYCIN 100MG/5ML O/L
AVA‐AZITHROMYCIN 200MG/5ML O/L
AVA‐AZITHROMYCIN 250MG TAB
AVA‐CLARITHROMYCIN 250MG TAB
AVA‐CLARITHROMYCIN 500MG TAB
AZITHROMYCIN 250MG TAB
AZITHROMYCIN FOR INJ 500MG
BIAXIN 125 MG/5ML PWD FOR SUSP
BIAXIN 250MG/5ML PWD FOR SUSP
BIAXIN BID 250MG TAB
BIAXIN BID 500MG TAB
BIAXIN XL 500MG TAB
CLARICID 125MG/5ML
CLARICID 250MG TAB
CLARICID 250MG/5ML
CLARICID 500MG TAB
CLARITHROMYCIN 250MG TAB
CLARITHROMYCIN 500MG TAB
CO AZITHROMYCIN 250MG TAB
CO AZITHROMYCIN 600MG TAB
DOM‐AZITHROMYCIN 100MG/5ML O/L
DOM‐AZITHROMYCIN 200MG/5ML O/L
DOM‐AZITHROMYCIN 250MG TAB
DOM‐AZITHROMYCIN 600MG TAB
DOM‐CLARITHROMYCIN 500MG TAB
EES 600 TAB 600MG
EMCINKA POWDER
ERYC ECC 250MG
ERYC ECC 333MG
ERYTHRO EC 333MG CAP
ERYTHRO‐BASE TAB 250MG USP
ERYTHROMYCIN 333MG EC CAP(PQ)
GD‐AZITHROMYCIN 100MG/5ML O/L
GD‐AZITHROMYCIN 200MG/5ML O/L
GD‐AZITHROMYCIN 250MG TAB
GD‐AZITHROMYCIN 600MG TAB
GEN‐ AZITHROMYCIN 600MG TAB
GEN‐CLARITHROMYCIN 250MG TAB
GEN‐CLARITHROMYCIN 500MG TAB
MYLAN‐AZITHROMYCIN 250MG TAB
MYLAN‐CLARITHROMYCIN 250MG TAB
MYLAN‐CLARITHROMYCIN 500MG TAB
NOVO‐AZITHROMYCIN 100MG/5ML OL
NOVO‐AZITHROMYCIN 200MG/5ML OL
NOVO‐AZITHROMYCIN 250MG TAB
NOVO‐RYTHRO EES 200MG/5ML SUSP
NOVO‐RYTHRO EES 400MG/5ML SUSP
NOVO‐RYTHRO ESTOLATE SUSP 125M
NOVO‐RYTHRO ESTOLATE SUSP 250M
NU‐ERYTHROMYCIN‐S TAB 250MG
PCE TAB 333MG
PDL‐ERYTHRO‐500 TAB 500MG USP
PDL‐ERYTHRO‐ES TAB 600MG USP
PDL‐ERYTHROMYCIN 250MG TAB
PEDIAZOLE SUSP
PHL‐AZITHROMYCIN 100MG/5ML O/L
PHL‐AZITHROMYCIN 200MG/5ML O/L
PHL‐AZITHROMYCIN 250MG TAB
PHL‐AZITHROMYCIN 600MG TAB
PMS‐AZITHROMYCIN 100MG/5ML O/L
PMS‐AZITHROMYCIN 250MG TAB
PMS‐AZITHROMYCIN 600MG TAB
PMS‐CLARITHROMYCIN 250MG TAB
AZITHROMYCIN ISOPROPANOLATE MH 250MG
CLARITHROMYCIN
250MG
CLARITHROMYCIN
500MG
ERYTHROMYCIN BASE
250MG
ERYTHROMYCIN BASE
333MG
ERYTHROMYCIN ETHYLSUCCINATE
600MG
ERYTHROMYCIN BASE
250MG
ERYTHROMYCIN STEARATE
250MG
500MG
100MG/5ML
AZITHROMYCIN MONOHYDRATE
200MG/5ML
250MG
CLARITHROMYCIN
250MG
CLARITHROMYCIN
500MG
250MG
AZITHROMYCIN MONOHYD HEM
250MG
250MG
250MG
600MG
600MG
600MG
AZITHROMYCIN
500MG
CLARITHROMYCIN
125MG/5ML
CLARITHROMYCIN
250MG/5ML
CLARITHROMYCIN
250MG
CLARITHROMYCIN
500MG
CLARITHROMYCIN
500MG
CLARITHROMYCIN
125MG/5ML
CLARITHROMYCIN
250MG
CLARITHROMYCIN
250MG/5ML
CLARITHROMYCIN
500MG
CLARITHROMYCIN
250MG
CLARITHROMYCIN
500MG
250MG
600MG
100MG/5ML
200MG/5ML
250MG
600MG
CLARITHROMYCIN
500MG
600MG
ERYTHROMYCIN
ERYTHROMYCIN BASE
250MG
ERYTHROMYCIN BASE
333MG
ERYTHROMYCIN
333MG
ERYTHROMYCIN BASE
250MG
ERYTHROMYCIN BASE
333MG
AZITHROMYCIN
100MG/5ML
AZITHROMYCIN
200MG/5ML
AZITHROMYCIN
250MG
AZITHROMYCIN
600MG
600MG
CLARITHROMYCIN
250MG
CLARITHROMYCIN
500MG
250MG
CLARITHROMYCIN
250MG
CLARITHROMYCIN
500MG
AZITHROMYCIN MONOHYDRATE HEMIE 100MG/5ML
AZITHROMYCIN MH HEMIETHANOLATE 250MG
200MG/5ML
400MG/5ML
ERYTHROMYCIN ESTOLATE
125MG
ERYTHROMYCIN ESTOLATE
250MG
250MG
ERYTHROMYCIN
333MG
ERYTHROMYCIN
500MG
ERYTHROMYCIN
600MG
ERYTHROMYCIN
250MG
ERYTHROMYCIN/ACETYLSULFISOXAZO 200MG
250MG
600MG
AZITHROMYCIN
200MG/5ML
CLARITHROMYCIN
250MG
9
Strength
Dosage
*PA
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
O/L
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
O/L
O/L
TAB
TAB
TAB LA
O/L
TAB
O/L
TAB
TAB
TAB
TAB
TAB
O/L
O/L
TAB
TAB
TAB
TAB
PDR
CAP
CAP
CAP
TAB
CAP LA
O/L
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
O/L
TAB
O/L
O/L
O/L
O/L
TAB
TAB
TAB
TAB
TAB
O/L
O/L
O/L
TAB
TAB
O/L
O/L
O/L
TAB
TAB
TAB
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
081212
02247574
02310600
02310619
02324482
02324490
02339137
02339145
02361426
02361434
02275287
02275295
02247818
02247819
02275309
02275317
02346524
02346532
00568422
01927825
00568430
01927817
09857351
02332388
02332396
02265826
02270358
02266539
02266547
02346923
02346931
02248804
02248805
02223716
02229971
02223724
09857315
02212021
02247748
02231143
PMS‐CLARITHROMYCIN 500MG TAB
PRO‐AZITHROMYCINE 250MG TAB
PRO‐AZITHROMYCINE 600MG TAB
PRO‐CLARITHROMYCIN 250MG TAB
PRO‐CLARITHROMYCIN 500MG TAB
Q‐CLARITHROMYCIN 250MG TAB
Q‐CLARITHROMYCIN 500MG TAB
RAN‐CLARITHROMYCIN 250MG TAB
RAN‐CLARITHROMYCIN 500MG TAB
RATIO‐AZITHROMYCIN 250MG TAB
RATIO‐AZITHROMYCIN 600MG TAB
RATIO‐CLARITHROMYCIN 250MG TAB
RATIO‐CLARITHROMYCIN 500MG TAB
RIVA‐AZITHROMYCIN 250MG TAB
RIVA‐AZITHROMYCIN 600MG TAB
RIVA‐CLARITHROMYCIN 250MG TAB
RIVA‐CLARITHROMYCIN 500MG TAB
ROVAMYCINE 250 CAP 750000UNIT
ROVAMYCINE 250MG CAP
ROVAMYCINE 500 CAP 1500000UNIT
ROVAMYCINE 500MG CAP
SANDOZ AZITHROMYCIN 200MG/5ML
SANDOZ‐AZITHROMYCIN 100MG/5ML
SANDOZ‐AZITHROMYCIN 200MG/5ML
SANDOZ‐AZITHROMYCIN 250MG TAB
SANDOZ‐AZITHROMYCIN 500MG TAB
SANDOZ‐CLARITHROMYCIN 250MGTAB
SANDOZ‐CLARITHROMYCIN 500MGTAB
SIG‐AZITHROMYCIN 250MG TAB
SIG‐AZITHROMYCIN 600MG TAB
TEVA‐CLARITHROMYCIN 250MG TAB
TEVA‐CLARITHROMYCIN 500MG TAB
ZITHROMAX 100MG/5ML
ZITHROMAX 1G UNIPAK
ZITHROMAX 200MG/5ML
ZITHROMAX 200MG/5ML O/L
ZITHROMAX 250MG TAB
ZITHROMAX 500MG TAB
ZITHROMAX 600MG TAB
CLARITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
AZITHROMYCIN MH HEMIETHANOLATE
AZITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
SPIRAMYCIN
SPIRAMYCIN
SPIRAMYCIN
SPIRAMYCIN
AZITHROMYCIN
AZITHROMYCIN
AZITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
CLARITHROMYCIN
AZITHROMYCIN DIHYDRATE
AZITHROMYCIN
500MG
250MG
600MG
250MG
500MG
250MG
500MG
250MG
500MG
250MG
600MG
250MG
500MG
250MG
600MG
250MG
500MG
250MG
250MG
500MG
500MG
200MG/5ML
100MG/5ML
200MG/5ML
250MG
500MG
250MG
500MG
250MG
600MG
250MG
500MG
100MG/5ML
1G
200MG/5ML
200MG/5ML
250MG
500MG
600MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
O/L
O/L
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
PDR
O/L
O/L
TAB
TAB
TAB
10
*PA
05/2012
Therapy Class
081216
DIN
Drug Name
PENICILLINS
Chemical Name
Strength
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
02184613
02243224
02352745
02352761
02352737
02241826
02319594
02352710
02243225
02352753
02352788
02241827
02319608
02352729
02326507
02326515
02326523
02227029
02227010
02068540
02003511
02003481
00628131
00628115
00628158
02230880
00628123
02243986
02243987
02243350
02288559
02243351
02245623
02230879
00603287
00642223
00642215
00642231
02341301
02341328
02341271
02341336
02341344
02341298
02291924
01916882
02238831
01916874
02238830
01916858
02238829
01912429
02069679
02069660
02188767
02188740
02188775
02188759
02230617
02230615
02230618
02230616
00486817
02042126
02042142
02238173
02238174
00328235
00785873
00885886
00885894
00885908
00885916
02239763
02239761
02239764
02239762
02238171
02238172
02036355
AMOXICILLIN 100MG TAB
AMOXICILLIN 125MG/5ML O/L
AMOXICILLIN 250 TAB CHEW
AMOXICILLIN 250MG CAP
AMOXI‐CLAV 250MG/125MG TAB
AMPICILLIN 250MG/VIAL INJ
AMPICILLIN 500/VIAL INJ
AMPICILLIN SOD 250MG INJ
AMPICILLIN SODIUM 500MG INJ
AMPICILLIN SODIUM 6M
APO‐AMOXI 125MG/5ML O/L
APO‐AMOXI 250MG CAP
APO‐AMOXI 250MG/5ML O/L
APO‐AMOXI 250MG/5ML SUGAR FREE
APO‐AMOXI 500MG CAP
APO‐AMOXI CLAV 125/31.25 SUSP
APO‐AMOXI CLAV 250/62.5 SUSP
APO‐AMOXI CLAV 250MG/125MG TAB
APO‐AMOXI CLAV 400MG/57MG O/L
APO‐AMOXI CLAV 500MG/125MG TAB
APO‐AMOXI CLAV 875/125MG TAB
APO‐AMOXI SUGAR‐FREE 125MG/5ML
APO‐AMPI LIQ 250MG/5ML
APO‐PEN VK 125MG/5ML SUSP
APO‐PEN VK 300MG TAB
APO‐PEN VK 300MG/5ML SUSP
APX‐AMOXI 125MG/5ML O/L
APX‐AMOXI 125MG/5ML SUGAR FREE
APX‐AMOXI 250MG CAP
APX‐AMOXI 250MG/5ML O/L
APX‐AMOXI 250MG/5ML SUGAR FREE
APX‐AMOXI 500MG CAP
BICILLIN L‐A INJECTION
CLAVULIN 125MG SUSP
CLAVULIN 200/28.5MG/5ML O/L
CLAVULIN 250 SUSP
CLAVULIN 400MG/57MG/5ML O/L
CLAVULIN 500MG TAB
CLAVULIN 875MG/125MG TAB
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM 5
CLOXACILLINE‐250 MG
DOM‐AMCLAV 125/31.25MG/5ML O/L
DOM‐AMCLAV 250/125MG TAB
DOM‐AMCLAV 250/62.5MG/5ML O/L
DOM‐AMCLAV 500/125MG TAB
DOM‐AMOXICILLIN 125MG/5ML O/L
DOM‐AMOXICILLIN 250MG CAP
DOM‐AMOXICILLIN 250MG/5ML O/L
DOM‐AMOXICILLIN 500MG CAP
FLUCLOX 125 O/L
FLUCLOX 250 O/L
FLUCLOX 250MG/5ML SUSP
GEN‐AMOXICILLIN 125MG/5ML O/L
GEN‐AMOXICILLIN 250MG/5ML O/L
GEOPEN TAB
JAA AMP TAB 125MG
JAA‐AMOX CAP 250MG
JAA‐AMOX CAP 500MG
JAA‐AMOX S SUSP 125MG
JAA‐AMOX S SUSP 250MG
MED‐AMOXICILLIN 125MG/ML O/L
MED‐AMOXICILLIN 250MG CAP
MED‐AMOXICILLIN 250MG/ML O/L
MED‐AMOXICILLIN 500MG CAP
MYLAN‐AMOXICILLIN 250MG CAP
MYLAN‐AMOXICILLIN 500MG CAP
NOVAMOXIN 250MG CHEW
AMOXICILLIN
AMOXICILLIN TRIHYDRATE
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN/POTASSIUM CLAV
AMPICILLIN SODIUM
AMPICILLIN
AMPICILLIN
AMPICILLIN
AMPICILLIN SODIUM
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN/CLAVULANIC ACID
AMOXICILLIN /CLAVULANIC ACID
AMOXICILLIN
AMPICILLIN
PENICILLIN V POTASSIUM
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
PENCILLIN G BENZATHINE
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM
SODIUM FLUCLOXACILLIN
AMOXICILLIN
AMOXICILLIN
CARBENICILLIN INDANYL SODIUM
AMPICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
100MG
125MG/5ML
125MG/5ML
125MG/5ML
250MG
250MG
250MG
250MG
250MG/5ML
250MG/5ML
250MG/5ML
500MG
500MG
500MG
250/125MG
500/125MG
875/125MG
250MG
500MG
250MG
500MG
11
Dosage
*PA
TAB
O/L
O/L
O/L
TAB
CAP
CAP
CAP
O/L
O/L
O/L
CAP
CAP
CAP
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
125MG/5ML O/L
250MG
CAP
250MG/5ML O/L
250MG/5ML O/L
500MG
CAP
O/L
125‐31.25
O/L
250/125MG
TAB
400MG/57MG O/L
500/125MG
TAB
875/125MG
TAB
125MG/ML
O/L
250MG/5ML O/L
125MG/5ML O/L
300MG
TAB
300MG/5ML O/L
125MG/5ML O/L
125MG/5ML O/L
250MG
CAP
250MG/5ML O/L
250MG/5ML O/L
500MG
CAP
1200000UNI
INJ
125MG
O/L
200/28.5MG O/L
250MG
O/L
400/57MG
O/L
500MG
TAB
875/125MG
TAB
500 MG
INJ
500MG
CAP
250MG
CAP
125/31.25M
O/L
250/125MG
TAB
250/62.5MG O/L
500/125MG
TAB
125MG/5ML O/L
250MG
CAP
250MG/5ML O/L
500MG
CAP
25MG/ML
O/L
50MG/ML
O/L
250MG/5ML O/L
125MG/5ML O/L
250MG/5ML O/L
500MG
TAB
125MG
TAB
250MG
CAP
500MG
CAP
125MG
O/L
250MG
O/L
125MG/ML
O/L
250MG
CAP
250MG/ML
O/L
500MG
CAP
250MG
CAP
500MG
CAP
250MG
TAB
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
00406724
00406716
02036347
01934171
01934163
00452130
00452149
00020877
00020885
00231207
01933345
00872644
01933353
00872652
02248138
02245206
02245207
01975447
00337765
00337773
01912410
00337757
00391603
00021202
00773727
02345544
02348012
02345501
02345536
02345552
02348020
02345528
00865567
00865575
00865540
00865559
00717495
00717649
00717584
00717592
00717630
00717568
02042940
02042959
00644323
00644331
00644307
00644315
00468029
02043181
02043165
02043203
00210714
02229582
02229583
02229584
02233017
02262886
02351153
02262851
02351188
02262894
02351161
02262878
02351196
02370158
02370166
02370174
02246640
02246641
02246642
02248939
02248940
02265567
02248941
02299623
02299631
02299658
02305993
02362627
02362635
NOVAMOXIN CAP 250MG
NOVAMOXIN CAP 500MG
NOVAMOXIN CHEW TAB 125MG
NOVAMOXIN SUGAR RED 125MG/5ML
NOVAMOXIN SUGAR RED 250 MG/5ML
NOVAMOXIN SUSP 250MG/5ML
NOVAMOXIN SUSP 25MG/ML
NOVO‐AMPICILLIN CAP 250MG
NOVO‐AMPICILLIN CAP 500MG
NOVO‐AMPICILLIN PWS 500MG/5ML
NOVO‐AMPICILLIN SODIUM 1G INJ
NOVO‐AMPICILLIN SODIUM 250MG/M
NOVO‐AMPICILLIN SODIUM 2G INJ
NOVO‐AMPICILLIN SODIUM 500MG/M
NOVO‐CLAVAMOXIN 875 TAB
NOVO‐CLAVAMOXIN SUSP 125MG/5ML
NOVO‐CLAVAMOXIN SUSP 250MG/5ML
NOVO‐CLOXACILLIN INJ 1G
NOVO‐CLOXIN CAP 250MG
NOVO‐CLOXIN CAP 500MG
NOVOCLOXIN INJ 2 GM
NOVO‐CLOXIN SUSP 125MG/5ML
NOVO‐PEN VK 300MG/5ML SUSP
NOVO‐PEN VK 500 TAB
NOVO‐PENICILLIN G POT INJ
NTP‐AMOXICILLIN 125MG/5ML O/L
NTP‐AMOXICILLIN 250MG CAP
NTP‐AMOXICILLIN 250MG TAB
NTP‐AMOXICILLIN 500MG CAP
NU‐AMOXI CAP 250MG
NU‐AMOXI CAP 500MG
NU‐AMOXI SUSP 125MG/5ML
NU‐AMOXI SUSP 250MG/5ML
NU‐AMPI SUSP 125MG/5ML
NU‐AMPI SUSP 250MG/5ML
NU‐CLOXI CAPSULES 250MG
NU‐CLOXI CAPSULES 500MG
NU‐CLOXI SUSP 125MG/5ML
NU‐PEN‐VK TABLETS 300MG
ORBENIN 250MG INJ
ORBENIN 500MG INJ
PDL‐AMOX 125MG/5ML SUSP
PDL‐AMOX 250MG/5ML SUSP
PDL‐AMOX‐250 CAP 250MG
PDL‐AMOX‐500 CAP 500MG
PDL‐PENICILLINE V 300 TAB
PENBRITIN 2GM INJ
PENBRITIN 500MG INJ
PENBRITIN PWS 250MG/
PENICILLIN V POT TAB 300MG
PENTA‐AMOXICILLIN 12
PENTA‐AMOXICILLIN 500MG CAP
PHL‐AMOXICILLIN 125MG/5ML O/L
PHL‐AMOXICILLIN 250MG CAP
PIPERACIL/TAZOBAC 2G/250MG INJ
PIPERACILLIN 2GM/VIAL INJ
PIPERACILLIN FOR INJ 2GM/VIAL
PIPERACILLIN FOR INJ 40G/VIAL
PIPERACILLIN SODIUM/TAZOBACTAM
PIPERACILLIN/TAZOBACTAM
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMPICILLIN
AMPICILLIN
AMPICILLIN
AMPICILLIN SODIUM
AMPICILLIN SODIUM
AMPICILLIN SODIUM
AMPICILLIN SODIUM
AMOXICILLIN/CLAVULANATE
AMOXICILLIN/CLAVULANATE
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM
PENICILLIN V (POTASSIUM)
PENICILLIN G POTASSIUM
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMPICILLIN
AMPICILLIN
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM
CLOXACILLIN SODIUM
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
PHENOXYMETHYLPENICILLIN
AMPICILLIN
AMPICILLIN
AMPICILLIN
AMOXICILLIN
AMOXICILLIN
AMOXICILLIN
PIPERACILLIN SODIUM
PIPERACILLIN SODIUM
PIPERACILLIN SODIUM
PIPERACILLIN SODIUM
PIPERACILLIN SODIUM
PIPERACILLIN SODIUM
PIPERACILLIN SODIUM
PENICILLIN
250MG
500MG
125MG
125MG/5ML
250MG/5ML
250MG/5ML
125MG/5ML
250MG
500MG
100MG/ML
1 G
250 MG
2 G
500 MG
875/125MG
125MG/5ML
250MG/5ML
1G/VIAL
250MG
500MG
2G/VIAL
125MG/5ML
300MG/5ML
500000IU
10,000IU
125MG/5ML
125MG/5ML
250MG
250MG
250MG/5ML
250MG/5ML
500MG
250MG
500MG
125MG/5ML
250MG/5ML
125MG/5ML
250MG/5ML
250MG
500MG
125MG/5ML
300MG
250MG
500MG
125MG/5ML
250MG/5ML
250MG
500MG
300MG
2GM
500MG
50MG/ML
300MG
125MG/5ML
250MG/5ML
250MG
500MG
125MG/5ML
125MG/5ML
250MG
250MG
250MG/5ML
250MG/5ML
500MG
500MG
2G/250MG
3G/375MG
4G/500MG
2GM/VIAL
3GM/VIAL
4GM/VIAL
2GM
3GM
40G/VIAL
4GM
2G/0.25G
3G/0.375G
4G/0.5G
2G/0.25G
3/0.375G
4/0.5G
CAP
CAP
TAB
O/L
O/L
O/L
O/L
CAP
CAP
O/L
INJ
INJ
INJ
INJ
TAB
O/L
O/L
INJ
CAP
CAP
INJ
O/L
O/L
TAB
INJ
O/L
O/L
CAP
TAB
O/L
O/L
CAP
CAP
CAP
O/L
O/L
O/L
O/L
CAP
CAP
O/L
TAB
INJ
INJ
O/L
O/L
CAP
CAP
TAB
INJ
INJ
O/L
TAB
O/L
O/L
CAP
CAP
O/L
O/L
CAP
CAP
O/L
O/L
CAP
CAP
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
12
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
081216
02377748
02308444
02305593
02305623
02362619
02305607
02305631
02308452
02305615
02305658
02308460
02330547
02188813
02241001
02188821
02188791
02241000
02188805
02240999
02230243
02230245
02230244
02230246
02157179
02157152
02157187
02157160
02247021
02244646
02244647
02243771
02003503
02003538
02001152
02003531
02226995
02227002
00657212
02170817
02170795
02170809
01916890
01916904
02247880
01916939
00247367
02241990
02241988
02241991
02241989
PIPERACILLIN/TAZOBACTAM 12/1.5
PIPERACILLIN/TAZOBACTAM 2/.25G
PIPERACILLIN/TAZOBACTAM 3/.375
PIPERACILLIN/TAZOBACTAM 4/0.5G
PIPERACILLIN/TAZOBACTAM INJ
PMS‐AMCLAV 125MG SUS
PMS‐AMCLAV 200MG/28.5/5ML O/L
PMS‐AMCLAV 250MG SUS
PMS‐AMCLAV 250MG TAB
PMS‐AMCLAV 400MG/57MG/5ML O/L
PMS‐AMCLAV 500MG TAB
PMS‐AMCLAV 875MG/125MG TAB
PMS‐AMOXICILLIN 250MG CAP
PMS‐AMOXICILLIN 25MG/ML O/L
PMS‐AMOXICILLIN 500MG CAP
PMS‐AMOXICILLIN 50MG/ML O/L
POLYMOX 125MG/5ML SUSP
POLYMOX 250MG CAP
POLYMOX 250MG/5ML SUSP
POLYMOX 500MG CAP
RATIO‐ACLAVULANATE 875MG/125MG
RATIO‐ACLAVULANATE‐125F SUSP
RATIO‐ACLAVULANATE‐250F SUSP
RATIO‐ACLAVULANATE500/125MGTAB
SCHEIN AMPICILLIN 1G INJ
SCHEIN‐AMPICILLIN INJ
SCHEIN‐AMPICILLIN SO
SCHEIN‐AMPICILLIN SO
SCHEIN‐AMPICILLIN SODIUM INJ
SCHEIN‐AMPICILLIN SODIUM INJ
SELEXID TAB 185MG
TAZOCIN 2G/250MG IV
TAZOCIN 3G/375MG IV
TAZOCIN 4G/500MG IV
TICAR 20G IV INJ
TICAR 6G IV INJ
TIMENTIN 30G/VIAL
TIMENTIN IV INJ 13ML
UNIPEN INJ 500MG
ZIMAMOX 125MG/5ML O/L
ZIMAMOX 250MG CAP
ZIMAMOX 250MG/5ML O/L
ZIMAMOX 500MG CAP
AMPICILLIN
AMPICILLIN SODIUM
AMPICILLIN SODIUM
AMPICILLIN SODIUM
AMPICILLIN SODIUM
AMPICILLIN SODIUM
PIVMECILLINAM HCL
PIPERACILLIN SODIUM/TAZOBACTUM
PIPERACILLIN SODIUM/TAZOBACTUM
TICARCILLIN DISODIUM/CLAV K
TICARCILLIN DISODIUM/CLAVULANA
NAFCILLIN SODIUM
12/1.5G
2/.25G/VIA
2/0.25G
2/0.25G
2/0.25G
3/0.375G
3/0.375G
3/.375G/VI
4/0.5G
4/0.5G
4/.5G/VIAL
12G/1.5G
125/31.25M
200/28.5MG
250/62.5MG
250/125MG
400/57MG
500/125MG
875/125MG
250MG
25MG/ML
500MG
50MG/ML
125MG/5ML
250MG
250MG/5ML
500MG
875/125MG
125/31.25
250/62.5
500/125MG
1G
250MG/ML
125MG/ML
500MG/ML
2G/VIAL
1G/VIAL
200MG
2G/250MG
3G/375MG
4G/500MG
20 G
6 G
30G/VIAL
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
O/L
O/L
O/L
TAB
O/L
TAB
TAB
CAP
O/L
CAP
O/L
O/L
CAP
O/L
CAP
TAB
O/L
O/L
TAB
INJ
INJ
INJ
INJ
INJ
INJ
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
O/L
CAP
O/L
CAP
13
250MG
125MG/5ML
250MG
250MG/5ML
500MG
*PA
05/2012
Therapy Class
081218
DIN
Drug Name
QUINOLONES
Chemical Name
Strength
Dosage
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
02378183
02378183
02378191
02378191
02378205
02378205
02218399
02229520
02229521
02229522
02229523
02284707
02284715
02325942
02229524
02341700
02341719
02341727
02341735
02381907
02381923
02381931
02361027
02361035
02366304
02242965
02155958
02155966
02155974
02237514
02237513
02251787
02247916
02285983
02247200
02239098
02285991
02332132
02335352
02345161
02349612
02353318
02247201
02286009
02332140
02335360
02345188
02349620
02247202
02353326
02239096
02286017
02332159
02335379
02345196
02349639
02247203
02353334
02239100
02256789
02251744
02251752
02251760
02251779
02247339
02247340
02247341
02315424
02315432
02315440
02269627
02251264
02251272
02251280
02251299
02286920
02286939
02306735
02245646
02252961
ACCEL‐CIPROFLOXACIN 250MG TAB
ALTI‐NORFLOXACIN 400MG TAB
APO‐CIPROFLOX 100MG TAB
APO‐LEVOFLOXACIN 250MG TAB
APO‐NORFLOX 400MG TAB
APX‐CIPROFLOX 100MG TAB
AURO‐CIPROFLOXACIN 250MG TAB
AVA‐LEVOFLOXACIN 250MG TAB
AVA‐LEVOFLOXACIN 500MG TAB
AVA‐NORFLOXACIN 400MG TAB
AVELOX 400MG TAB
CIPRO 250MG TAB
CIPRO 500MG TAB
CIPRO 750MG TAB
CIPRO ORAL 10GM/100ML
CIPRO ORAL 5GM/100ML
CIPRO XL 1000MG TAB
CIPRO XL 500MG TAB
CIPROFLOXACIN 100MG TAB
CIPROFLOXACIN 100MG TAB USP
CIPROFLOXACIN 10MG/100ML SUSP
CIPROFLOXACIN 500MGTAB
CIPROFLOXACIN 5MG/100ML SUSP
CIPROFLOXACIN 750MGTAB
CIPROFLOXACIN I.V. MINIBAG
CIPROFLOXACIN INJ USP 10MG/ML
CIPROFLOXACIN‐100MG TAB
CO CIPROFLOXACIN 250MG TAB
CO‐LEVOFLOXACIN 250MG TAB
CO‐NORFLOXACIN 400MG TAB
DOM‐CIPROFLOXACIN 100MG TAB
DOM‐LEVOFLOXACIN 250MG TAB
GEN‐CIPROFLOXACIN 100MG TAB
GMD‐CIPROFLOXACIN 100MG TAB
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
NORFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
LEVOFLOXACIN HEMIHYDRATE
NORFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
LEVOFLOXACIN
LEVOFLOXACIN
NORFLOXACIN
MOXIFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
NORFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
250MG
250MG
500MG
500MG
750MG
750MG
400MG
100MG
250MG
500MG
750MG
250MG
500MG
750MG
400MG
100MG
250MG
500MG
750MG
250MG
500MG
750MG
250MG
500MG
400MG
400MG
250MG
500MG
750MG
10GM/100ML
5GM/100ML
1000MG
500MG
100MG
100MG
10MG/100ML
250MG
250MG
250MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
O/L
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
SOL
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
14
250MG
250MG
250MG
500MG
500MG
500MG
500MG
500MG
500MG
500MG
5MG/100ML
750MG
750MG
750MG
750MG
750MG
750MG
750MG
2MG/ML
10MG/ML
100MG
250MG
500MG
750MG
250MG
500MG
750MG
250MG
500MG
750MG
400MG
100MG
250MG
500MG
750MG
250MG
500MG
750MG
100MG
100MG
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
02252988
02252996
02253003
02378671
02378698
02378701
02345099
02380358
02380366
02380374
02236841
02236842
02246804
02307200
02336871
02343940
02307219
02336898
02343959
02297825
02307227
02336901
02343967
02380587
02380595
02380609
02379686
02379686
02379694
02379694
02379708
02379708
02317427
02317435
02317443
02245647
02245648
02245649
02313979
02313987
02246937
02344882
02161737
02161745
02161753
02248262
02248263
02285649
02237682
02243475
02243476
02358654
02358662
02358670
02364298
02249626
02249634
02249642
02249650
02231529
02231531
02231532
02239670
02238205
02238206
02238207
02251302
02251310
02251329
02251337
02286947
02286955
02306891
02248436
02248437
02248438
02248439
02284677
02284685
02305585
02246596
IPG‐CIPROFLOXACIN 250MG TAB
IZILOX 400MG TAB
JAMP‐CIPROFLOXACIN 250MG TAB
LEVAQUIN 250MG TAB
LEVAQUIN 500MG TAB
LEVAQUIN 750MG TAB
LEVOFLOXACIN 250MG TAB
LEVOFLOXACIN 5MG/ML INJ
MANDA‐CIPROFLOXACIN 250MG TAB
MAR‐CIPROFLOXACIN 250MG TAB
MINT‐CIPROFLOXACIN 250MG TAB
MYLAN‐CIPROFLOXACIN 250MG TAB
MYLAN‐LEVOFLOXACIN 250MG TAB
MYLAN‐LEVOFLOXACIN 500MG TAB
NORFLOXACIN 400MG TAB
NORFLOXACIN 400MG TAB
NOVO‐CIPROFLOXACIN 250MG TAB
NOVO‐LEVOFLOXACIN 250MG TAB
NOVO‐NORFLOXACIN 400MG TAB
NOVO‐OFLOXACIN 300MG TAB
NOVO‐OFLOXACIN 400MG TAB
NTP‐LEVOFLOXACIN 250MG TAB
NTP‐NORFLOXACIN 400MG TAB
NU‐CIPROFLOXACIN 100MG TAB
OFLOXACIN 200MG TAB
OFLOXACIN 300MG TAB
OFLOXACIN 400MG TAB
PDL‐NORFLOXACINE 400MG TAB
PDL‐OFLOXACINE 200MG
PHL‐CIPROFLOXACIN 100MG TAB
PHL‐LEVOFLOXACIN 250MG TAB
PMS‐CIPROFLOXACIN 100MG TAB
PMS‐LEVOFLOXACIN 250MG TAB
PMS‐NORFLOXACIN 400MG TAB
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HYDROCHLORIDE
MOXIFLOXACIN HCL
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
LEVOFLOXACIN
LEVOFLOXACIN
LEVOFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
NORFLOXACIN
NORFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
LEVOFLOXACIN
LEVOFLOXACIN
NORFLOXACIN
OFLOXACIN
OFLOXACIN
LEVOFLOXACIN
LEVOFLOXACIN
LEVOFLOXACIN
NORFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
OFLOXACIN
OFLOXACIN
OFLOXACIN
NORFLOXACIN
OFLOXACIN
OFLOXACIN
OFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
NORFLOXACIN
250MG
500MG
750MG
250MG
500MG
750MG
400MG
250MG
500MG
750MG
250MG
500MG
750MG
250MG
250MG
250MG
500MG
500MG
500MG
5MG/ML
750MG
750MG
750MG
250MG
500MG
750MG
250MG
250MG
500MG
500MG
750MG
750MG
250MG
500MG
750MG
250MG
500MG
750MG
250MG
500MG
400MG
400MG
250MG
500MG
750MG
250MG
500MG
750MG
400MG
300MG
400MG
250MG
500MG
750MG
400MG
100MG
250MG
500MG
750MG
200MG
300MG
400MG
400MG
200MG
300MG
400MG
100MG
250MG
500MG
750MG
250MG
500MG
750MG
100MG
250MG
500MG
750MG
250MG
500MG
750MG
400MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
15
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
081218
02249960
02249979
02249987
02317796
02317818
02317826
02372592
02372606
02372614
02303728
02303736
02303744
02267934
02267942
02267950
02246824
02246825
02246826
02246827
02251213
02251221
02251248
02251256
02241483
02301504
02298635
02298643
02298651
02248756
02248757
02248758
02204347
02204355
02204371
02379627
02379627
02379635
02379635
02379643
02379643
02331853
02331861
02331888
02347423
02347431
02347458
02347466
02266962
02266970
02266989
PREM‐CIPROFLOXACIN 250MG TAB
PRO‐CIPROFLOXACIN 250MG TAB
Q‐CIPROFLOXACIN 250MG TAB
RAN‐CIPROFLOX 250MG TAB
RAN‐CIPROFLOXACIN 250MG TAB
RATIO‐CIPROFLOXACIN 100MG TAB
RIVA‐CIPROFLOXACIN 100MG TAB
RIVA‐NORFLOXACIN 400MG TAB
RIVA‐NORFLOXACIN 400MG TAB
SANDOZ LEVOFLOXACIN 250MG TAB
SANDOZ‐CIPROFLOXACIN 250MG TAB
SCHEIN‐CIPROFLOX 100MG
SEPTA‐CIPROFLOXACIN 250MG TAB
SIG‐CIPROFLOXACIN 250MG TAB
SIG‐LEVOFLOXACIN 250MG TAB
SIG‐NORFLOXACIN 400MG TAB
TARO‐CIPROFLOXACIN 250MG TAB
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
NORFLOXACIN
NORFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
NORFLOXACIN
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
CIPROFLOXACIN HCL
250MG
500MG
750MG
250MG
500MG
750MG
250MG
500MG
750MG
250MG
500MG
750MG
250MG
500MG
750MG
100MG
250MG
500MG
750MG
100MG
250MG
500MG
750MG
400MG
400MG
250MG
500MG
750MG
250MG
500MG
750MG
100MG
250MG
750MG
250MG
250MG
500MG
500MG
750MG
750MG
250MG
500MG
750MG
250MG
500MG
750MG
400MG
250MG
500MG
750MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
16
*PA
05/2012
Therapy Class
081220
DIN
Drug Name
SULFONAMIDES
Chemical Name
Strength
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
081220
00421480
00445282
00445266
00445274
00134198
00272477
00510645
00726540
00510637
00865710
00865729
02129051
00598461
00598488
00512524
02064480
02064472
02004690
02067986
01999567
00274429
00812846
00885932
00885940
00885924
00047503
00047511
APO‐SULFAMETHOXAZOLE 500MG TAB
APO‐SULFATRIM DS TAB
APO‐SULFATRIM PEDIATRIC TAB
APO‐SULFATRIM TAB
AVC DIENESTROL CREAM
BACTRIM PED SUSP
NOVO‐TRIMEL DS TAB
NOVO‐TRIMEL ORAL SUSP
NOVO‐TRIMEL TAB
NU‐COTRIMOX TAB 400/80MG
NU‐COTRIMOX‐DS TAB 800/160MG
PMS‐SULFASALAZINE
PMS‐SULFASALAZINE 500MG TAB
PMS‐SULFASALAZINE‐E.C. TAB 500
PROTRIN DF TAB
SALAZOPYRIN 500MG TAB
SALAZOPYRIN EN TAB 500MG
SALAZOPYRIN EN‐TABS
SALAZOPYRIN ORAL SUS
SALAZOPYRIN ORAL SUSP
SEPTRA PED
SULFACETAMIDE
TRISULFA DS TAB
TRISULFA S SUSP
TRISULFA TAB
TRISULFAMINIC
TRISULFAMINIC
SULFAMETHOXAZOLE
SULFAMETHOXAZOLE/TRIMETHOPRIM
SULFANILAMIDE/ALLANTOIN/AM
TRIMETHOPRIN/SULFAMETHOXAZOLE
SULFASALAZINE
SULFASALAZINE
SULFASALAZINE
TRIMETHOPRIM/SULFAMETHOXAZOLE
SULFASALAZINE
SULFASALAZINE
SULFASALAZINE
SULFASALAZINE
SULFASALAZINE
SULFAMETHAXAZOLE/TRIMETHOPRIM
SULFACETAMIDE
TRISULFAMINIC
TRISULFAMINIC
500MG
800/160MG
100/20MG
400/80MG
17
Dosage
*PA
TAB
TAB
TAB
TAB
CR VAG
O/L
800/160MG
TAB
40MG/ML
O/L
400MG/80MG TAB
400/80MG
TAB
800/160MG
TAB
50MG/ML
O/L
500MG
TAB
500MG
TAB
160/800MG
TAB
500MG
TAB
500MG
TAB
500MG
TAB LA
50MG/ML
O/L
250MG
O/L
O/L
PDR
800/160MG
TAB
40MG/8MG
O/L
400/80MG
TAB
TAB
TAB
05/2012
Therapy Class
081224
DIN
Drug Name
TETRACYCLINES
Chemical Name
Strength
Dosage
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
081224
00740713
00874256
02084104
02084090
00580929
02363593
02363585
02259478
02099721
02099713
02289598
02289547
02239668
02239667
00817120
00860751
02351234
02351242
02231037
02231039
02248209
02248208
02237876
02237875
02173506
02230945
02287234
02230944
02287226
02238607
02230736
02230735
02158574
00725250
02108151
02108143
00021806
02347687
02347679
02044668
02044676
02335336
02335328
00717606
00742562
00887064
02154366
02153394
00156744
02289431
02289458
02294141
02294133
02239239
02294427
02239238
02294419
02372789
02372770
01914146
01914138
02242081
02242080
02237314
02237313
02239982
00024368
00578452
APO‐DOXY 100MG CAP
APO‐DOXY TABS 100MG
APO‐MINOCYCLINE 100MG CAP
APO‐MINOCYCLINE 50MG CAP
APO‐TETRA 250MG CAP
AVA‐MINOCYCLINE 100MG CAP
AVA‐MINOCYCLINE 50MG CAP
CO MINOCYCLINE 100MG CAP
DERMYCIN 100 MG CAP
DERMYCIN 100 MGTAB
DOM‐DOXYCYCLINE 100MG CAP
DOM‐DOXYCYCLINE 100MG TAB
DOM‐MINOCYCLINE 100MG CAP
DOM‐MINOCYCLINE 50MG CAP
DOXYCIN CAP 100MG
DOXYCIN TAB 100MG
DOXYCYCLINE 100MG CAP
DOXYCYCLINE 100MG TAB
DOXYCYCLINE M‐RATIOP
DOXYCYCLINE M‐RATIOP
ENCA 100MG CAP
ENCA 50MG CAP
MED‐MINOCYCLINE 100MG CAP
MED‐MINOCYCLINE 50MG CAP
MINOCIN CAP 100MG
MINOCYCLINE 100MG CAP
MINOCYCLINE‐RATIOPHARM 100MG
MYLAN‐MINOCYCLINE 100MG CAP
MYLAN‐MINOCYCLINE 50MG CAP
NOVO‐DOXYLIN 100MG TAB
NOVO‐DOXYLIN CAP 100MG
NOVO‐MINOCYCLINE 100MG
NOVO‐MINOCYCLINE 50MG
NOVOTETRA 250MG
NTP‐DOXYCYCLINE 100MG CAP
NTP‐DOXYCYCLINE 100MG TAB
NU‐DOXYCYCLINE 100 MG CAP
NU‐DOXYCYCLINE 100MG TAB
NU‐MINOCYCLINE 100MG CAP
NU‐MINOCYCLINE 50MG CAP
NU‐TETRA CAP 250MG
PDL‐DOXYCYCLINE CAP 100MG USP
PDL‐DOXYTAB 100MG
PDL‐MINOCYCLINE 100M
PDL‐MINOCYCLINE 50MG
PDL‐TETRACYCLINE CAP 250MG
PHL‐DOXYCYCLINE 100MG CAP
PHL‐DOXYCYCLINE 100MG TAB
PHL‐MINOCYCLINE 100MG CAP
PHL‐MINOCYCLINE 50MG CAP
PMS‐MINOCYCLINE 100MG CAP
Q‐MINOCYCLINE 100MG CAP
Q‐MINOCYCLINE 50MG CAP
RATIO‐MINOCYCLINE 100MG CAP
RATIO‐MINOCYCLINE 50MG CAP
RIVA‐MINOCYCLINE 100MG CAP
RIVA‐MINOCYCLINE 50MG CAP
SANDOZ‐MINOCYCLINE 100MG CAP
SANDOZ‐MINOCYCLINE 50MG CAP
SCHEIN‐MINOCYCLINE 100MG CAP
VIBRAMYCIN CAP 100MG
VIBRA‐TABS 100MG
DOXYCYCLINE
DOXYCYCLINE
MINOCYCLINE HCL
MINOCYCLINE HCL
TETRACYCLINE
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE HCL
DOXYCYCLINE
DOXYCYCLINE
DOXYCYCLINE HYCLATE
DOXYCYCLINE HYCLATE
MINOCYCLINE
MINOCYCLINE
DOXYCYCLINE
DOXYCYCLINE
DOXYCYCLINE HYCLATE
DOXYCYCLINE HYCLATE
DOXYCYCLINE MONOHYDRATE
DOXYCYCLINE MONOHYDRATE
MINOCYCLINE HCL
MINOCYCLINE HYDROCHLORIDE
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE
MINOCYCLINE HCL
MINOCYCLINE
MINOCYCLINE HCL
MINOCYCLINE
MINOCYCLINE HCL
MINOCYCLINE HCL
DOXYCYCLINE
DOXYCYCLINE
MINOCYCLINE HCL
MINOCYCLINE HCL
TETRACYCLINE
DOXYCYCLINE HYCLATE
DOXYCYCLINE HYCLATE
DOXYCYCLINE
DOXYCYCLINE
MINOCYCLINE HCL
MINOCYCLINE HCL
TETRACYCLINE
DOXYCYCLINE
DOXYCYCLINE
MINOCYCLINE
MINOCYCLINE
TETRACYCLINE
DOXYCYCLINE HYCLATE
DOXYCYCLINE HYCLATE
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE
MINOCYCLINE
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE HCL
MINOCYCLINE HCL
DOXYCYCLINE
DOXYCYCLINE
100MG
100MG
100MG
50MG
250MG
100MG
50MG
100MG
100MG
100 MG
100MG
100MG
100MG
50MG
100MG
100MG
100MG
100MG
100MG
200MG
100MG
50MG
100MG
50MG
100MG
100MG
100MG
50MG
50MG
100MG
100MG
50MG
100MG
100MG
100MG
50MG
250MG
J01AA02
100MG
100MG
100MG
100MG
50MG
250MG
100MG
100MG
100MG
50MG
250MG
100MG
100MG
100MG
50MG
100MG
100MG
50MG
50MG
100MG
50MG
100MG
50MG
100MG
50MG
100MG
50MG
100MG
100MG
100MG
CAP
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
CAP
TAB
CAP
CAP
CAP
TAB
CAP
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
CAP
CAP
CAP
TAB
CAP
TAB
CAP
TAB
CAP
CAP
CAP
CAP
TAB
CAP
CAP
CAP
CAP
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
18
*PA
05/2012
Therapy Class
081228
DIN
Drug Name
MISCELLANEOUS ANTIBACTERIALS
Chemical Name
Strength
Dosage
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
081228
02131595
02130025
02245232
02245233
02364719
02364727
02248525
02248526
02230535
02139286
02230540
00000147
02244849
00030570
02182866
00225851
00260436
02229863
00506028
02380846
02380854
02247520
00030732
02258331
02258358
02215683
02336235
02336243
02241821
02241820
02339218
02339226
02242409
02293382
02242410
02293390
02241807
02378345
02378337
02241709
02241710
02342863
02342855
02015110
00800430
00788716
00722146
00015423
02230192
02380544
02380552
02230191
02377470
02377489
02139383
02139375
02139243
02243686
02243683
02243684
ALTI‐CLINDAMYCIN 150MG/ML INJ
ALTI‐CLINDAMYCIN 75MG
APO‐CLINDAMYCIN 150MG CAP
APO‐CLINDAMYCIN 300MG CAP
AVA‐CLINDAMYCIN 150MG CAP
AVA‐CLINDAMYCIN 300MG CAP
CLINDAMYCIN ‐ 150MG CAP
CLINDAMYCIN ‐ 300MG CAP
CLINDAMYCIN 150MG/ML
CLINDAMYCIN 150MG/ML INJ
CLINDAMYCIN 150MG/ML INJ
CLINDAMYCIN POWDER
COLISTIMETHATE
DALACIN C 150 MG CAP
DALACIN C 300MG CAP
DALACIN C PALMITATE 75MG/5ML S
DALACIN C PHOSPHATE INJ 150MG/
DYNABAC 250MG EC TAB
FUCIDIN LEO ECT 250MG
GD‐LINEZOLID 3G O/L
GD‐LINEZOLID 600MG TAB
KETEK 400MG TAB
LINCOCIN 300MG/ML INJ
MYLAN‐CLINDAMYCIN 150MG CAP
MYLAN‐CLINDAMYCIN 300MG CAP
NOVO‐CLINDAMYCIN 150MG/ML INJ
NU‐CLINDAMYCIN 150MG CAP
NU‐CLINDAMYCIN 300MG CAP
PMS‐VANCOMYCIN 1G/VIAL INJ
PMS‐VANCOMYCIN 500MG/VIAL INJ
Q‐CLINDAMYCIN 150MG CAP
Q‐CLINDAMYCIN 300MG CAP
RIVA‐CLINDAMYCIN 150MG CAP
STERILE VANCOMYCIN HCL 10G/V
STERILE VANCOMYCIN HCL 10G/VL
STERILE VANCOMYCIN HCL 5G/VL
TEVA‐CLINDAMYCIN 150MG CAP
TEVA‐CLINDAMYCIN 300MG CAP
VAL‐VANCO 1000MG/VIAL INJ
VAL‐VANCO 500MG/VIAL INJ
VANCOCIN 10G/ML INJ
VANCOCIN CAP 125MG
VANCOCIN CAP 250MG
VANCOCIN CP INJ 1GM/VIAL
VANCOCIN CP IV 500MG INJ
VANCOMYCIN 1000MG/VIAL INJ
VANCOMYCIN 125MG CAP
VANCOMYCIN 250MG CAP
VANCOMYCIN 500MG/VIAL INJ
VANCOMYCIN HCL 125MG CAP
VANCOMYCIN HCL 250MG CAP
VANCOMYCIN STERILE 1G/VIAL
VANCOMYCIN STERILE 500MG/VIAL
VANCOMYCIN STERILE 5G/VIAL INJ
ZYVOXAM 3GM/BOTTLE O/L
ZYVOXAM 400MG TAB
ZYVOXAM 600MG TAB
CLINDAMYCIN PHOSPHATE
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN
COLISTIMETHATE SODIUM
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN 2‐PALMITATE HCL
DIRITHROMYCIN
SODIUM FUSIDATE
LINEZOLID
LINEZOLID
TELITHROMYCIN
LINCOMYCIN
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
CLINDAMYCIN HCL
CLINDAMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
VANCOMYCIN HCL
LINEZOLID
LINEZOLID
LINEZOLID
150MG/ML
75MG/5ML
150MG
300MG
150MG
300MG
150MG
300MG
150MG/ML
150MG/ML
150MG/ML
INJ
O/L
CAP
CAP
CAP
CAP
CAP
CAP
INJ
INJ
INJ
PDR
INJ
CAP
CAP
O/L
INJ
TAB
TAB
O/L
TAB
TAB
INJ
CAP
CAP
INJ
CAP
CAP
INJ
INJ
CAP
CAP
CAP
CAP
CAP
CAP
INJ
INJ
INJ
CAP
CAP
INJ
INJ
INJ
CAP
CAP
INJ
INJ
INJ
CAP
CAP
INJ
CAP
CAP
INJ
INJ
INJ
O/L
TAB
TAB
19
150MG
300MG
75MG/5ML
150MG/ML
250MG
250MG
3G
600MG
400MG
300MG/ML
150MG
300MG
150MG/ML
150MG
300MG
1G/VIAL
500MG/VIAL
150MG
300MG
150MG
150MG
300MG
300MG
10G/VIAL
10G/VL
5G/VL
150MG
300MG
1000MG/VIA
500MG/VIAL
10 G
125MG
250MG
1 G
500MG
1000MG
125MG
250MG
500MG
125MG
250MG
1G
500MG
5GM
3GM/BOTTLE
400MG
600MG
*PA
05/2012
Therapy Class
081404
DIN
Drug Name
ALLYLAMINES
Chemical Name
Strength
Dosage
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
081404
02239893
02320126
02320134
02363836
02254727
02299275
02352796
02352818
02357070
02031108
02031116
02242503
02248845
02297973
02240807
02294273
02372762
02262924
02262177
02332612
02286580
02343452
02353121
02341190
02242735
02240345
02240346
APO‐TERBINAFINE 250MG TAB
AURO‐TERBINAFINE 125MG TAB
AURO‐TERBINAFINE 250MG TAB
AVA‐TERBINAFINE 250MG TAB
CO TERBINAFINE 250MG TAB
DOM‐TERBINAFINE 250MG TAB
GD‐TERBINAFINE 125MG TAB
GD‐TERBINAFINE 250MG TAB
JAMP‐TERBINAFINE 250MG TAB
LAMISIL 125MG TAB
LAMISIL 250MG TAB
MYLAN‐TERBINAFINE 250MG TAB
NU‐TERBINAFINE 250MG TAB
PHL‐TERBINAFINE 250MG TAB
PMS‐TERBINAFINE 250MG TAB
PMS‐TERBINAFINE 250MG TAB
Q‐TERBINAFINE 250MG TAB
RIVA‐TERBINAFINE 250MG TAB
SANDOZ‐TERBINAFINE 250MG TAB
SIG‐TERBINAFINE 250MG TAB
TERBINAFINE 250MG TAB
TERBINAFINE HCL 250MG TAB
TERBINAFINE‐250 TAB
TEVA‐TERBINAFINE 125MG TAB
TEVA‐TERBINAFINE 250MG TAB
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE HCL
250MG
125MG
250MG
250MG
250MG
250MG
125MG
250MG
250MG
125MG
250MG
250MG
250MG
250MG
250MG
250MG
250MG
250MG
250MG
250MG
250MG
250MG
250MG
250MG
250MG
125MG
250MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
20
*PA
05/2012
Therapy Class
081408
DIN
Drug Name
AZOLES
Chemical Name
Strength
Dosage
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
081408
02237371
02237372
02237370
02237235
02281279
02281260
00891835
02024152
00891800
02246109
02246108
02287250
02301946
02340801
02352133
02340828
02247922
02248731
02261472
02287242
02301938
02340798
02248443
02247749
02273640
02273632
02380994
02381001
02380986
02245293
02245294
02245292
02236979
02236978
02231061
02091372
02091380
02091216
02122197
02237882
02294036
02245644
02245643
02293404
02310686
02312686
02271516
02047454
02243343
02231347
02249308
02249316
02249294
02256479
02256460
02279991
APO‐FLUCONAZOLE 100MG TAB
APO‐KETOCONAZOLE 200MG TAB
CO FLUCONAZOLE 100MG TAB
CO FLUCONAZOLE 50MG TAB
DIFLUCAN 2MG/ML INJ
DIFLUCAN 50MG/5ML LIQ
DIFLUCAN TAB 50MG
DOM‐FLUCONAZOLE 100MG TAB
DOM‐FLUCONAZOLE 50MG TAB
FLUCONAZOLE 100MG TAB
FLUCONAZOLE 150MG CAP
FLUCONAZOLE 2MG/ML INJ
FLUCONAZOLE 2MG/ML INJ
FLUCONAZOLE 2MG/ML IV SOL
FLUCONAZOLE INJECTION 2MG/ML
FLUCONAZOLE OMEGA 2MG/ML INJ
GD‐FLUCONAZOLE 100MG TAB
GD‐FLUCONAZOLE 50MG TAB
GD‐VORICONAZOLE 200MG TAB
GD‐VORICONAZOLE 3G O/L
GD‐VORICONAZOLE 50MG TAB
MYLAN‐FLUCONAZOLE 100MG TAB
NOVO‐FLUCONAZOLE 100MG TAB
NOVO‐FLUCONAZOLE 50MG TAB
NOVO‐KETOCONAZOLE 200MG TAB
NU‐FLUCON 100MG TAB
NU‐KETOCON 200MG TAB
PDL‐KETOCONAZOLE 200
PHL‐FLUCONAZOLE 100MG TAB
PMS‐FLUCONAZOLE 100MG TAB
PMS‐FLUCONAZOLE 50MG TAB
POSANOL 40MG/ML SUSPENSION O/L
PRO‐FLUCONAZOLE 100MG TAB
PRO‐FLUCONAZOLE 100MG TAB
RIVA‐FLUCONAZOLE 100MG TAB
SPORANOX 100MG CAP
SPORANOX 10MG/ML INJ
SPORANOX 10MG/ML ORAL SOL
TARO‐FLUCONAZOLE 100MG TAB
VFEND 200MG TAB
VFEND 50MG TAB
VFEND O/L
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
KETOCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
VORICONAZOLE
VORICONAZOLE
VORICONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
KETOCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
KETOCONAZOLE
KETOCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
POSACONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
ITRACONAZOLE
ITRACONAZOLE
ITRACONAZOLE
FLUCONAZOLE
FLUCONAZOLE
FLUCONAZOLE
VORICONAZOLE
VORICONAZOLE
VORICONAZOLE
100MG
200MG
50MG
200MG
100MG
50MG
2MG/ML
50MG/5ML
50MG
100MG
50MG
100MG
100MG
100MG
150MG
200MG
2MG/ML
2MG/ML
2MG/ML
50MG
50MG
50MG
2MG/ML
2MG/ML
100MG
50MG
200MG
3G
50MG
100MG
200MG
50MG
100MG
50MG
200MG
100MG
200MG
50MG
200MG
200MG
100MG
100MG
50MG
40MG/ML
100MG
100MG
100MG
100MG
10MG/ML
10MG/ML
100MG
200MG
50MG
200MG
50MG
3GM/BOTTLE
TAB
TAB
TAB
TAB
TAB
TAB
INJ
O/L
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
INJ
INJ
INJ
TAB
TAB
TAB
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
CAP
INJ
O/L
TAB
TAB
TAB
TAB
TAB
O/L
21
*PA
05/2012
Therapy Class
081428
DIN
Drug Name
POLYENES
Chemical Name
Strength
Dosage
081428
081428
081428
081428
02125145
00792667
02194198
02194201
DOM‐NYSTATIN 100,000U/ML O/L
PMS‐NYSTATIN 100 000U/ML SUSP
RATIO NYSTATIN 500000U TAB
RATIO‐NYSTATIN 100000U/ML O/L
NYSTATIN
NYSTATIN
NYSTATIN
NYSTATIN
100000U/ML
100,000/ML
500000U
100000U/ML
O/L
O/L
TAB
O/L
22
*PA
05/2012
Therapy Class
081492
DIN
Drug Name
MISCELLANEOUS ANTIFUNGALS
081492
081492
00513229 FULVICIN PG TAB 165MG
00028266 FULVICIN U/F TAB 125MG
23
Chemical Name
Strength
Dosage
GRISEOFULVIN
GRISEOFULVIN
165MG
125MG
TAB
TAB
*PA
05/2012
Therapy Class
081604
DIN
Drug Name
ANTITUBERCULOSIS AGENTS
Chemical Name
Strength
Dosage
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
081604
00247960
00247979
00261270
00272655
00265500
02170051
02009331
02063786
00577790
00577804
00577812
00618810
02091887
02092808
02024853
02148625
00210463
00393444
00343617
00283991
ETIBI TAB 100MG
ETIBI TAB 400MG
ISOTAMINE 100MG TAB
ISOTAMINE 300MG TAB
ISOTAMINE SYR PEDIATRIC 50MG/5
MYAMBUTOL TAB 100MG
MYCOBUTIN 150 MG
MYCOBUTIN 150MG CAP
PMS‐ISONIAZID 100MG TAB
PMS‐ISONIAZID 300MG TAB
PMS‐ISONIAZID SYRUP 50MG/5ML
PMS‐PYRAZINAMIDE TAB USP 500MG
RIFADIN 150MG CAP
RIFADIN 300MG CAP
RIFADIN CAP 150MG
RIFATER TAB
RIMACTANE 300MG CAP
ROFACT CAP 150MG
ROFACT CAP 300MG
TEBRAZID TAB 500MG
ETHAMBUTOL HCL
ETHAMBUTOL HCL
ISONIAZID
ISONIAZID
ISONIAZID
ETHAMBUTOL HCL
RIFABUTIN
RIFABUTIN
ISONIAZID
ISONIAZID
ISONIAZID
PYRAZINAMIDE
RIFAMPIN
RIFAMPIN
RIFAMPIN
RIFAMPIN/ISONIAZID/PYRAZINAMID
RIFAMPIN
RIFAMPIN
RIFAMPIN
PYRAZINAMIDE
100MG
400MG
100MG
300MG
50 MG
100MG
150MG
150MG
100MG
300MG
50MG/5ML
500MG
150MG
300MG
150MG
TAB
TAB
TAB
TAB
O/L
TAB
CAP
CAP
TAB
TAB
O/L
TAB
CAP
CAP
CAP
TAB
CAP
CAP
CAP
TAB
24
300MG
150MG
300MG
500MG
*PA
05/2012
Therapy Class
081692
DIN
Drug Name
MISCELLANEOUS ANTIMYCOBACTERIALS
081692
02041510 DAPSONE 100MG TAB
25
Chemical Name
Strength
Dosage
DAPSONE
100MG
TAB
*PA
05/2012
Therapy Class
081804
DIN
Drug Name
ADAMANTANES
Chemical Name
Strength
Dosage
081804
081804
081804
081804
081804
081804
081804
081804
02343398
02130963
02130971
02139200
02238306
02262649
02022826
01990403
AMANTADINE 100MG CAP
DOM‐AMANTADINE 100MG CAP
DOM‐AMANTADINE 10MG/ML O/L
MYLAN‐AMANTADINE 100MG TAB
PHL‐AMANTADINE 100MG CAP
PHL‐AMANTADINE SYRUP 10MG/ML
PMS‐AMANTADINE 10MG/ML SYRUP
PMS‐AMANTADINE CAP 100MG
AMANTADINE HCL
AMANTADINE HCL
AMANTADINE HCL
AMANTADINE HCL
AMANTADINE HCL
AMANTADINE HCL
AMANTADINE HCL
AMANTADINE HCL
100MG
100MG
10MG/ML
100MG
100MG
10MG/ML
10MG/ML
100MG
CAP
CAP
O/L
CAP
CAP
O/L
O/L
CAP
26
*PA
05/2012
Therapy Class
081808
DIN
Drug Name
ANTIRETROVIRALS
Chemical Name
Strength
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
081808
02192691
02192683
02247825
02231003
02375540
02369052
02369060
01946323
02273322
02350513
02300699
02318601
02299844
02299852
02239213
02374129
02229153
02229161
02229188
02229196
02370603
02272091
02247725
02239193
02239194
02306778
02375931
02216965
02279320
02301881
02312301
02285533
02243644
02243643
02269341
02357593
02229145
02241480
02369753
02324016
02324024
02338432
02238348
01902660
01902652
01902644
02248609
02248610
02248611
02294176
02288389
02239888
02246044
02239886
02246045
02261553
02261545
02352893
02244757
02274906
02244596
02244597
02244598
02244599
02238617
02238618
02248761
02238748
02367289
02247128
02216086
02237009
02216094
02216108
02216116
02216078
02247915
02247912
02247913
02247914
3TC (LAMIVUDINE) 10MG/ML
3TC (LAMIVUDINE) 150MG
3TC 300MG TAB
ALTI‐ZIDOVUDINE 10MG/ML INJ
APO‐LAMIVUD.‐ZIDOVUD. 150/300
APO‐LAMIVUDINE 150MG TAB
APO‐LAMIVUDINE 300MG TAB
APO‐ZIDOVUDINE 100MG CAP
APTIVUS 250MG CAP
APX‐ZIDOVUDINE 100MG CAP
ATRIPLA 600/300/200MG TAB
AURO‐NEVIRAPINE 200MG TAB
CELSENTRI 150MG TAB
CELSENTRI 300MG TAB
COMBIVIR TAB
COMPLERA 25/200/300MG TAB
CRIXIVAN 100MG CAP
CRIXIVAN 200MG CAP
CRIXIVAN 300MG CAP
CRIXIVAN 400MG CAP
EDURANT 25MG TAB
EMTRIVA 200MG CAP
FUZEON 108MG/VIAL INJ
HEPTOVIR 100MG TAB
HEPTOVIR 5MG ORAL SOLUTION
INTELENCE 100MG TAB
INTELENCE 200MG TAB
INVIRASE 200MG CAP
INVIRASE 500MG TAB
ISENTRESS 400MG TAB
KALETRA 100MG/25MG TAB
KALETRA 200MG/50MG TAB
KALETRA 80MG/20MG/ML ORAL SOL
KALETRA SOFT GEL CAPS
KIVEXA 600MG/300MG TAB
NORVIR 100MG TAB
NORVIR 80MG/ML SOL
NORVIR SEC 100MG CAP
PREZISTA 150MG TAB
PREZISTA 400MG TAB
PREZISTA 600MG TAB
PREZISTA 75MG TAB
RESCRIPTOR 100MG TAB
RETROVIR 100MG CAP
RETROVIR 50MG/5ML SYR
RETROVIR IV 10MG/ML INJ
REYATAZ 100MG CAP
REYATAZ 150MG CAP
REYATAZ 200MG CAP
REYATAZ 300MG CAP
SEBIVO 600MG TAB
SUSTIVA 200MG CAP
SUSTIVA 300MG TAB
SUSTIVA 50MG CAP
SUSTIVA 600MG TAB
TELZIR 50MG/ML SUSP
TELZIR 700MG TAB
TEVA‐NEVIRAPINE 200MG TAB
TRIZIVIR TAB
TRUVADA 200MG/300MG TAB
VIDEX 125MG EC BEADLETS CAP
VIRACEPT 250MG TAB
VIRACEPT 50MG/G ORL PWS
VIRACEPT 625MG TAB
VIRAMUNE 200MG TAB
VIRAMUNE XR 400MG TAB
VIREAD 300MG TAB
ZERIT 15MG CAP
ZERIT 1MG/ML PWS FOR O/L
ZERIT 20MG CAP
ZERIT 30MG CAP
ZERIT 40MG CAP
ZERIT 5MG CAP
ZERIT XR 100MG CAP
ZERIT XR 37.5MG CAP
ZERIT XR 50MG CAP
ZERIT XR 75MG CAP
LAMIVUDINE
LAMIVUDINE
LAMIVUDINE
ZIDOVUDINE
LAMIVUDINE/ZIDOVUDINE
LAMIVUDINE
LAMIVUDINE
ZIDOVUDINE
TIPRANAVIR
ZIDOVUDINE
EFAVIRENZ/TENOFOVIR/EMTRICITAB
NEVIRAPINE
MARAVIROC
MARAVIROC
LAMIVUDINE/ZIDOVUDINE
RILPIVIRINE/EMTRICITABINE/TENO
INDINAVIR SULFATE
INDINAVIR SULFATE
INDINAVIR SULFATE
INDINAVIR SULFATE
RILPIVIRINE HYDROCHLORIDE
EMTRICITABINE
ENFUVIRTIDE
LAMIVUDINE
LAMIVUDINE
ETRAVIRINE
ETRAVIRINE
SAQUINAVIR MESYLATE
SAQUINAVIR MESYLATE
RALTEGRAVIR POTASSIUM
LOPINAVIR/RITONAVIR
LOPINAVIR/RITONAVIR
LOPINAVIR/RITONAVIR
LOPINAVIR/RITONAVIR
ABACAVIR/LAMIVUDINE
RITONAVIR
RITONAVIR
RITONAVIR
DARUNAVIR ETHANOLATE
DELAVIRDINE
ZIDOVUDINE
ZIDOVUDINE
ZIDOVUDINE
ATAZANAVIR SULFATE
ATAZANAVIR SULFATE
ATAZANAVIR SULFATE
ATAZANAVIR SULFATE
TELBIVUDINE
EFAVIRENZ
EFAVIRENZ
EFAVIRENZ
EFAVIRENZ
FOSAMPRENAVIR CALCIUM
FOSAMPRENAVIR CALCIUM
NEVIRAPINE
ABACAVIR/LAMIVUDINE/ZIDOVUDINE
EMTRICITABINE/TENOFOVIR
DIDANOSINE
DIDANOSINE
DIDANOSINE
DIDANOSINE
NELFINAVIR MESYLATE
NELFINAVIR MESYLATE
NELFINAVIR MESYLATE
NEVIRAPINE
NEVIRAPINE
TENOFOVIR DISOPROXIL FUMARATE
STAVUDINE (D4T)
STAVUDINE
STAVUDINE (D4T)
STAVUDINE (D4T)
STAVUDINE (D4T)
STAVUDINE (D4T)
STAVUDINE
STAVUDINE
STAVUDINE
STAVUDINE
10MG/ML
150MG
300MG
10MG/ML
150/300
150MG
300MG
100MG
250MG
100MG
27
Dosage
*PA
O/L
TAB
TAB
INJ
TAB
TAB
TAB
CAP
CAP
CAP
TAB
200MG
TAB
150MG
TAB
300MG
TAB
150/300MG
TAB
25/200/300
TAB
100MG
CAP
200MG
CAP
300MG
CAP
400MG
CAP
25MG
TAB
200MG
CAP
108MG/VIAL INJ
100MG
TAB
5MG
O/L
100MG
TAB
200MG
TAB
200MG
CAP
500MG
TAB
400MG
TAB
100MG/25MG TAB
200MG/50MG TAB
80MG/20MG O/L
CAP
600/300MG
TAB
100MG
TAB
80MG/ML
O/L
100MG
CAP
150MG
TAB
400MG
TAB
600MG
TAB
75MG
TAB
100MG
TAB
100MG
CAP
50MG/5ML
O/L
10MG/ML
INJ
100MG
CAP
150MG
CAP
200MG
CAP
300MG
CAP
600MG
TAB
200MG
CAP
300MG
TAB
50MG
CAP
600MG
TAB
50MG/ML
O/L
700MG
TAB
200MG
TAB
TAB
200/300MG
TAB
125MG
CAP
200MG
CAP
250MG
CAP
400MG
CAP
250MG
TAB
50MG/G
PDR
625MG
TAB
200MG
TAB
400MG
TAB LA
300MG
TAB
15MG
CAP
1MG/ML
O/L
20MG
CAP
30MG
CAP
40MG
CAP
5MG
CAP
100MG
CAP LA
37.5MG
CAP LA
50MG
CAP LA
75MG
CAP LA
05/2012
Therapy Class
DIN
Drug Name
081808
081808
02240358 ZIAGEN 20MG/ML O/L
02240357 ZIAGEN 300MG TAB
28
Chemical Name
Strength
Dosage
ABACAVIR SULFATE
ABACAVIR SULFATE
20MG/ML
300MG
O/L
TAB
*PA
05/2012
Therapy Class
081820
DIN
Drug Name
INTERFERONS
Chemical Name
Strength
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
081820
02248077
02248078
09991140
02253429
02253410
02246028
02246029
02246030
02246026
02246027
02254603
02254638
02254646
02254573
02254581
02239729
02248982
02242967
02248983
02248984
02242968
02248985
02242969
02248981
02242966
PEGASYS 180MCG/0.5ML INJ
PEGASYS 180MCG/ML INJ
PEGASYS RBV (196) INJ
PEGASYS RBV 180MCG/0.5ML+200MG
PEGASYS RBV 180MCG/ML+200MG
PEGETRON(100MCG/0.5ML+200MG)
PEGETRON‐REDIPEN 100MCG KIT
REBETRON KIT (CAP+INJ)
UNITRON PEG 108MCG/CARTRIDGE
UNITRON PEG 118.4MCG/VIAL INJ
UNITRON PEG 177.6MCG/VIAL INJ
UNITRON PEG 202.5MCG/CARTRIDGE
UNITRON PEG 222MCG/VIAL INJ
UNITRON PEG 67.5MCG/CARTRIDGE
UNITRON PEG 74MCG/VIAL INJ
PEGINTERFERON ALFA‐2A
PEGINTERFERON ALFA‐2A
PEGINTERFERON ALFA‐2A/RIBAVIR
PEGINTERFERON ALFA‐2B/RIBAVIRI
PEGINTER ALFA‐2BPWD/RIBAVIRIN
PEGINTER ALFA‐2B/RIBAVIRIN
RIBAVIRIN, INTERFERON ALFA‐2B
PEGINTERFERON ALFA‐2B
180MCG/0.5
180MCG/ML
180MCG
180MCG
180MCG/ML
29
Dosage
*PA
INJ
INJ
KIT
KIT
KIT
KIT
KIT
KIT
KIT
KIT
100MCG
KIT
120MCG
KIT
150MCG
KIT
50MCG
KIT
80MCG
KIT
3000000IU
KIT
108MCG/CAR INJ
118.4MCG/V INJ
135MCG/CAR INJ
162MCG/CAR INJ
177.6MCG/V INJ
202.5MCG/C INJ
222MCG/V
INJ
67.5MCG/CA INJ
74MCG/VIAL INJ
05/2012
Therapy Class
081828
DIN
Drug Name
NEURAMINIDASE INHIBITORS
Chemical Name
Strength
Dosage
081828
081828
081828
081828
02240863
02381842
02241472
02245549
RELENZA PWD FOR INHALATION 5MG
TAMIFLU 6MG/ML O/L
TAMIFLU 75MG CAP
TAMIFLU PEDIATRIC
ZANAMIVIR
OSELTAMIVIR PHOSPHATE
5MG/DS
6MG/ML
75MG
12MG/ML
PDR
O/L
CAP
O/L
30
*PA
05/2012
Therapy Class
081832
DIN
Drug Name
NUCLEOSIDES AND NUCLEOTIDES
Chemical Name
Strength
Dosage
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
02286556
02286564
02286572
02236916
02239743
02236926
02207621
02207648
02207656
02292025
02292041
02292068
02354705
02295822
02340739
02340747
02340755
02366827
02366835
02366843
02282232
02282224
02305682
02305690
02305704
02162695
02281910
02281929
02281937
02307936
02344777
02344785
02344793
02229110
02229129
02177102
02247823
02242784
02242463
02242464
02351560
02351579
02283921
02283948
02283956
02357542
02357534
02367513
02367521
02367548
02197405
02197413
02197421
02237541
02237542
02237543
02281953
02281961
02281988
02307944
02278081
02278103
02278111
02381230
02381230
02298457
02315173
02078627
02078635
02078651
02316447
02278634
02278642
02278650
02347105
02347091
02345455
02345463
02345471
02285959
ACYCLOVIR 200MG TAB
ACYCLOVIR 400MG TAB
ACYCLOVIR 800MG TAB
ACYCLOVIR SODIUM 25MG/ML INJ
APO‐ACYCLOVIR 200MG TAB
APO‐FAMCICLOVIR 125MG TAB
APO‐VALACYCLOVIR 1000MG TAB
APO‐VALACYCLOVIR 500MG TAB
APX‐ACYCLOVIR 200MG TAB
AVA‐FAMCICLOVIR 125MG TAB
BARACLUDE 0.05MG/ML
BARACLUDE 0.5MG TAB
CO FAMCICLOVIR 125MG TAB
CYTOVENE INJ 500MG/V
DOM‐FAMCICLOVIR 125MG TAB
DOM‐VALACYCLOVIR 500MG TAB
FAMCICLOVIR 125MG TAB
FAMVIR 125MG TAB
FAMVIR 250MG TAB
FAMVIR 500MG TAB
HEPSERA 10MG TAB
MYLAN‐ACYCLOVIR 200MG TAB
MYLAN‐VALACYCLOVIR 1000MG TAB
MYLAN‐VALACYCLOVIR 500MG TAB
NOVO‐FAMCICLOVIR 125MG TAB
NOVO‐VALACYCLOVIR 1000MG TAB
NOVO‐VALACYCLOVIR 500MG TAB
NTP‐ACYCLOVIR 200MG TAB
NU‐ACYCLOVIR 200MG TAB
PDL‐ACYCLOVIR 200MG
PHL‐FAMCICLOVIR 125MG TAB
PHL‐VALACYCLOVIR 500MG TAB
PMS‐FAMCICLOVIR 125MG TAB
PMS‐VALACYCLOVIR 1000MG TAB
PRO‐VALACYCLOVIR 500MG TAB
RATIO‐ACYCLOVIR 200MG TAB
RATIO‐ACYCLOVIR 400 MG TAB
RATIO‐ACYCLOVIR 800 MG TAB
RIVA‐VALACYCLOVIR 500MG TAB
SANDOZ FAMCICLOVIR 125MG TAB
SANDOZ VALACYCLOVIR 1000MG TAB
SANDOZ VALACYCLOVIR 500MG TAB
SIG‐FAMCICLOVIR 125MG TAB
TEVA‐ACYCLOVIR 200MG TAB
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR SODIUM
ACYCLOVIR SODIUM
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
VALACYCLOVIR HCL
VALACYCLOVIR HCL
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
ENTECAVIR
ENTECAVIR
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
GANCICLOVIR SODIUM
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
VALACYCLOVIR HCL
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
ADEFOVIR DIPIVOXIL
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
VALACYCLOVIR HCL
VALACYCLOVIR HCL
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
VALACYCLOVIR HCL
VALACYCLOVIR HCL
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
VALACYCLOVIR HCL
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
VALACYCLOVIR HYDROCHLORIDE
VALACYCLOVIR HCL
VALACYCLOVIR HCL
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
VALACYCLOVIR HCL
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
VALACYCLOVIR HCL
VALACYCLOVIR HCL
FAMCICLOVIR
FAMCICLOVIR
FAMCICLOVIR
ACYCLOVIR
200MG
400MG
800MG
25MG/ML
25MG/ML
50MG/ML
200MG
400MG
800MG
125MG
250MG
500MG
1000MG
500MG
200MG
400MG
800MG
125MG
250MG
500MG
0.05MG/ML
0.5MG
125MG
250MG
500MG
500MG/VIAL
125MG
250MG
500MG
500MG
125MG
250MG
500MG
125MG
250MG
500MG
10MG
200MG
400MG
800MG
1000MG
500MG
125MG
250MG
500MG
1000MG
500MG
200MG
400MG
800MG
200MG
400MG
800MG
200MG
400MG
800MG
125MG
250MG
500MG
500MG
125MG
250MG
500MG
1000MG
1000MG
500MG
500MG
200MG
400MG
800MG
500MG
125MG
250MG
500MG
1000MG
500MG
125MG
250MG
500MG
200MG
TAB
TAB
TAB
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
31
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
081832
02285967
02285975
02320916
02245777
02306085
02246559
02239130
02219492
02170140
02240509
00886157
00634506
01911627
01911635
VALACYCLOVIR 500MG TAB
VALCYTE 450MG TAB
VALCYTE 50MG/ML O/L
VALTREX 1G TAB
VALTREX 250MG TAB
VALTREX 500MG TAB
VIRAZOLE
VISTIDE 75MG/ML INJ
ZOVIRAX 200MG/5ML SUSP
ZOVIRAX TAB 200MG
ZOVIRAX TAB 400MG
ZOVIRAX TAB 800MG
ACYCLOVIR
ACYCLOVIR
VALACYCLOVIR HCL
VALGANCICLOVIR HCL
VALGANCICLOVIR HCL
VALACYCLOVIR HCL
VALACYCLOVIR HCL
RIBAVIRIN
CIDOFOVIR
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
ACYCLOVIR
400MG
800MG
500MG
450MG
50MG/ML
1000MG
250MG
500MG
6G/VIAL
75MG/ML
200MG/5ML
200MG
400MG
800MG
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
INH SOL
INJ
O/L
TAB
TAB
TAB
32
*PA
05/2012
Therapy Class
081892
DIN
Drug Name
MISCELLANEOUS ANTIVIRALS
Chemical Name
Strength
Dosage
081892
081892
081892
081892
081892
081892
081892
02240713
02371553
02370816
02371456
02371464
02371472
02371448
IMUNOVIR 500MG TAB
INCIVEK 375MG TAB
VICTRELIS 200MG CAP
VICTRELIS TRIPLE 200/100/200
INOSIPLEX
TELAPREVIR
BOCEPREVIR
BOCEPREVIR/PEGINTERFERON/RIBAV
500MG
375MG
200MG
TAB
TAB
CAP
KIT
KIT
KIT
KIT
33
200/80/200
*PA
05/2012
Therapy Class
083004
DIN
Drug Name
AMEBICIDES
083004
083004
083004
01997769 DIODOQUIN TAB 210MG
01997750 DIODOQUIN TAB 650MG
02078759 HUMATIN 250 MG CAP
34
Chemical Name
Strength
Dosage
IODOQUINOL
IODOQUINOL
PAROMOMYCIN SULFATE
210MG
650MG
250MG
TAB
TAB
CAP
*PA
05/2012
Therapy Class
083008
DIN
Drug Name
ANTIMALARIALS
Chemical Name
Strength
Dosage
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
083008
02349183
02246691
02254514
02254522
02363860
00004774
02018055
02238151
02264935
02244366
02252600
00021261
00021008
00021016
02335816
01928287
02017709
00033669
01928414
02017776
00494909
02311011
00695440
00695459
02380927
02380927
AA‐MEFLOQUINE 250MG TAB
APO‐HYDROXYQUINE 200MG TAB
APO‐QUININE 200MG CAP
APO‐QUININE 300MG CAP
AVA‐HYDROXYCHLOROQUINE 200MG
DARAPRIM 25MG TAB
LARIAM TAB 250 MG
MALARONE 250MG/85.6MG TAB
MALARONE PEDIATRIC TAB
MEFLOQUINE 250MG TAB
MYLAN‐HYDROXYCHLOROQUINE 200MG
NOVO‐CHLOROQUINE TAB 250MG
NOVO‐QUININE 200MG CAP
NOVO‐QUININE 300MG CAP
NU‐HYDROXYQUINE 200MG TAB
PLAQUENIL 200MG TAB
PLAQUENIL 200MG TAB
PLAQUENIL SULFATE 200MG TAB
PRIMAQUINE 15MG TAB
PRIMAQUINE 15MG TAB
PRIMAQUINE PHOSPHATE 15MG TAB
PRO‐HYDROXYQUINE 200MG TAB
QUININE SULFATE 200MG CAP
QUININE SULFATE 300MG CAP
TEVA‐ATOVAQUONE PROGUANIL
TEVA‐ATOVAQUONE PROGUANIL
MEFLOQUINE HCL
HYDROXYCHLOROQUINE SULFATE
QUININE SULFATE
QUININE SULFATE
PYRIMETHAMINE
MEFLOQUINE HCL
ATOVAQUONE/PROGUANIL
ATOVAQUONE/PROGUANIL HCL
MEFLOQUINE HCL
CHLOROQUINE PHOSPHATE
QUININE SULFATE
QUININE SULFATE
PRIMAQUINE PHOSPHATE
QUININE SULFATE
QUININE SULFATE
250MG
200MG
200MG
300MG
200MG
25MG
250MG
250/85.6MG
62.5‐25MG
250MG
200MG
250MG
200MG
300MG
200MG
200MG
200MG
200MG
15MG
15MG
15MG
200MG
200MG
300MG
250/100MG
250/100MG
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
35
*PA
05/2012
Therapy Class
083092
DIN
Drug Name
MISCELLANEOUS ANTIPROTOZOALS
Chemical Name
Strength
Dosage
083092
083092
083092
083092
083092
083092
083092
083092
083092
083092
083092
00545066
02248562
01926853
02244405
02217422
00870420
00649074
00420409
02183072
02183080
00783137
APO‐METRONIDAZOLE 250MG TAB
APO‐METRONIDAZOLE 500MG CAP
FLAGYL 500MG CAP
FLORAZOLE ER 750MG TAB
MEPRON 750MG/5ML ORAL SUSP
METRONIDAZOLE 5MG/ML INJ
METRONIDAZOLE INJ USP 5MG/ML
PDL‐METRONIDAZOLE TAB 250MG
PENTAMIDINE ISETHION
PENTAMIDINE ISETHIONATE INJ
PMS‐METRONIDAZOLE 500MG CAP
METRONIDAZOLE
METRONIDAZOLE
METRONIDAZOLE
METRONIDAZOLE
ATOVAQUONE
METRONIDAZOLE
METRONIDAZOLE
METRONIDAZOLE
PENTAMIDINE ISETHIONATE
PENTAMIDINE ISETHIONATE
METRONIDAZOLE
250MG
500MG
500MG
750MG
750MG/5ML
5MG/ML
5MG/ML
250MG
200MG
200MG/VIAL
500MG
TAB
CAP
CAP
TAB
O/L
INJ
INJ
TAB
INJ
INJ
CAP
36
*PA
05/2012
Therapy Class
083600
DIN
Drug Name
URINARY ANTI-INFECTIVES
Chemical Name
Strength
Dosage
083600
083600
083600
083600
083600
083600
083600
083600
083600
083600
083600
083600
083600
02238891
02238892
00312738
00319511
02063662
01997637
02240335
02239927
00092800
02231016
02231015
02243116
02243117
ALTI‐TRIMETHOPRIM 100MG TAB
ALTI‐TRIMETHOPRIM 200MG TAB
APO‐NITROFURANTOIN 100MG TAB
APO‐NITROFURANTOIN 50MG TAB
MACROBID CAP 100MG
MACRODANTIN CAP 50MG
MONUROL 3GM/PK ORAL PWD
MONUROL PDR
NITROFURANTOIN
TEVA‐FURANTOIN 100MG
TEVA‐FURANTOIN 50MG
TRIMETHOPRIM 100MG TAB
TRIMETHOPRIM 200MG TAB
TRIMETHOPRIM
TRIMETHOPRIM
NITROFURANTOIN
NITROFURANTOIN
NITROFURANTOIN
NITROFURANTOIN
FOSFOMYCIN TROMETHAMINE
FOSFOMYCIN TROMETHAMINE
NITROFURANTOIN
NITROFURANTOIN
NITROFURANTOIN
TRIMETHOPRIM
TRIMETHOPRIM
100MG
200MG
100MG
50MG
100MG
50MG
3GM
3GM/PK
50MG
100MG
50MG
100MG
200MG
TAB
TAB
TAB
TAB
CAP
CAP
PDR
PDR
TAB
CAP
CAP
TAB
TAB
37
*PA
05/2012
Therapy Class
100000
DIN
Drug Name
ANTINEOPLASTIC AGENTS
Chemical Name
Strength
Dosage
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
02349221
02349213
02339528
02369257
02339501
02374412
02374439
00004715
02087286
00839361
02238894
02238895
02241376
02221861
00704431
00704423
02296063
02245898
02238560
02247937
02358514
02195925
02195917
02283697
02182963
00812404
00812390
02224135
02242705
02360993
02270994
02325233
02325985
02360098
02382423
00297763
00301032
02265982
02367351
02240602
02126680
02125439
02366053
02320371
02246768
02184478
00360414
00360430
00360422
01926683
02366711
02355183
02126613
02319918
02274337
02352052
00213071
02126656
00386715
00602833
02231420
02241150
02281139
02237872
02230524
02316374
02237598
02237599
02230108
02375710
02248239
02248240
02248999
02268892
02063764
02063794
02324091
02322242
02264927
02303892
AA‐MEGESTROL 160MG TAB
AA‐MEGESTROL 40MG TAB
AFINITOR 10MG TAB
AFINITOR 2.5MG TAB
AFINITOR 5MG TAB
AG‐BICALUTAMIDE 50MG TAB
AG‐LETROZOLE 2.5MG TAB
ALKERAN 2MG TAB
ALKERAN 50MG/VIAL KIT
ALPHA‐TAMOXIFEN TAB 10MG
ALTI‐CHLORAMBUCIL 2MG TAB
ALTI‐MERCAPTOPURINE 50MG TAB
ANANDRON 150MG TAB
ANANDRON 50MG TAB
ANDROCUR 50MG TAB
ANDROCUR DEPOT 100MG/ML INJ
APO‐BICALUTAMIDE 50MG TAB
APO‐CYPROTERONE 50MG TAB
APO‐FLUTAMIDE 250MG TAB
APO‐HYDROXYUREA 500MG CAP
APO‐LETROZOLE 2.5MG TAB
APO‐MEGESTROL 160MG TAB
APO‐MEGESTROL 40MG TAB
APO‐METHOTREXATE 2.5MG TAB
APO‐METHOTREXATE TAB 2.5MG
APO‐TAMOX 10MG TAB
APO‐TAMOX 20MG TAB
ARIMIDEX 1MG TAB
AROMASIN 25MG TAB
AVA‐BICALUTAMIDE 50MG TAB
AVASTIN 25MG/ML IV
BICALUTAMIDE 50MG TAB
BICNU INJ 100MG
BLENOXANE 15UNITS INJ
BLEOMYCIN 15IU/VIAL INJ
BLEOMYCIN 15UNIT/VIAL INJ
BUSULFEX 6MG/ML INJ
CARBOPLAIN 10MG/ML INJ
CARBOPLATIN 10MG/ML INJ
CARBOPLATIN 10MG/ML INJ
CARBOPLATIN 10MG/ML IV INJ
CASODEX 150MG TAB
CASODEX 50MG TAB
CEENU CAP 100MG
CEENU CAP 10MG
CEENU CAP 40MG
CERUBIDINE 20MG/VIAL INJ
CISPLATIN 1MG INJ
CISPLATIN INJECTION BP
CISPLATIN INJECTION LIQ IV
CLADRIBINE 1MG/ML INJ
CO BICALUTAMIDE 50MG TAB
CO LETROZOLE 2.5MG TAB
COSMEGEN 0.5MG/VIAL INJ
CYTARABINE 100MG/ML INJ
CYTOSAR 100MG/5ML INJ
CYTOXAN PWS FOR INJ 1000MG/VIA
DAUNORUBICIN HCL INJ 20MG/VIAL
DEPOCYT LIPOSOME 10MG/ML INJ
DOM‐BICALUTAMIDE 50MG TAB
DOM‐ETOPOSIDE 20MG/ML INJ
DOM‐FLUTAMIDE 250MG TAB
DOM‐LETROZOLE 2.5MG TAB
DOM‐TAMOXIFEN 10MG TAB
DOM‐TAMOXIFEN 20MG TAB
DOXORUBICIN 200MG/100ML INJ
DOXORUBICIN HCL 2MG/ML INJ
ELIGARD 10.2MG INJ
ELIGARD 28.2MG INJ
ELIGARD 30MG INJ
ELIGARD 45MG INJ
EMCYT 140MG CAP
EMCYT 140MG CAP
EPIRUBICIN 2MG/ML INJ
EPIRUBICIN HCL 2MG/ML INJ
EPIRUBICIN HCL 2MG/ML IV INJ
MEGESTROL ACETATE
MEGESTROL ACETATE
EVEROLIMUS
EVEROLIMUS
EVEROLIMUS
BICALUTAMIDE
LETROZOLE
MELPHALAN
MELPHALAN/BUFFER SOLUTION
TAMOXIFEN CITRATE
CHLORAMBUCIL
MERCAPTOPURINE
NILUTAMIDE
NILUTAMIDE
CYPROTERONE ACETATE
CYPROTERONE ACETATE
BICALUTAMIDE
CYPROTERONE ACETATE
FLUTAMIDE
HYDROXYUREA
LETROZOLE
MEGESTROL ACETATE
MEGESTROL ACETATE
METHOTREXATE SODIUM
METHOTREXATE SODIUM
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
ANASTROZOLE
EXEMESTANE
BICALUTAMIDE
BEVACIZUMAB
BICALUTAMIDE
BICALUTAMIDE
BICALUTAMIDE
BICALUTAMIDE
CARMUSTINE (BCNU)
BLEOMYCIN SULFATE
BLEOMYCIN SULFATE
BLEOMYCIN SULFATE
BUSULFAN
CARBOPLATIN
CARBOPLATIN
CARBOPLATIN
CARBOPLATIN
BICALUTAMIDE
BICALUTAMIDE
LOMUSTINE (CCNU)
LOMUSTINE (CCNU)
LOMUSTINE (CCNU)
DAUNORUBICIN HCL
CISPLATIN
CISPLATIN
CISPLATIN DIAMINODICHLORIDE
CLADRIBINE
BICALUTAMIDE
LETROZOLE
DACTINOMYCIN
CYTARABINE
CYTARABINE
CYCLOPHOSPHAMIDE
DAUNORUBICIN HCL
CYTARABINE
BICALUTAMIDE
ETOPOSIDE
FLUTAMIDE
LETROZOLE
TAMOXIFEN
TAMOXIFEN
DOXORUBICIN HCL
DOXORUBICIN HCL
LEUPROLIDE ACETATE
LEUPROLIDE ACETATE
LEUPROLIDE ACETATE
LEUPROLIDE ACETATE
ESTRAMUSTINE PHOS DISODIUM
ESTRAMUSTINE PHOS DISODIUM
EPIRUBICIN HCL
EPIRUBICIN HCL
EPIRUBICIN HCL
EPIRUBICIN HCL
160MG
40MG
10MG
2.5MG
5MG
50MG
2.5MG
2MG
5MG/ML
10MG
2MG
50MG
150MG
50 MG
50MG
100MG/ML
50MG
50MG
250MG
500MG
2.5MG
160MG
40MG
2.5MG
2.5MG
10MG
20MG
1MG
25MG
50MG
25MG/ML
50MG
50MG
50MG
50MG
100MG
15IU
15IU/VIAL
15UNIT/VL
6MG/ML
10MG/ML
10MG/ML
10MG/ML
10MG/ML
150MG
50MG
100MG
10MG
40MG
20 MG
1MG
1MG/ML
1MG/ML
1MG/ML
50MG
2.5MG
0.5MG
100MG/ML
100MG/5ML
1G
20MG/VIAL
10MG/ML
50MG
20MG/ML
250MG
2.5MG
10MG
20MG
2MG/ML
2MG/ML
10.2MG/INJ
28.2MG/INJ
30MG
56.3MG/INJ
140MG
140MG
2MG/ML
2MG/ML
2MG/ML
2MG/ML
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
CAP
CAP
CAP
INJ
INJ
INJ
INJ
INJ
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
TAB
INJ
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
CAP
CAP
INJ
INJ
INJ
INJ
38
*PA
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
02312093
02323001
02301067
02237428
02230986
02237873
02239961
02241182
02380935
02380935
00637726
02239109
02248624
02231384
02337037
02337029
02246226
01989537
02182742
02059673
02239045
02359693
02337010
02373181
02305534
02324210
02305526
02324202
02337002
02373173
02370034
02318741
02298775
02298783
02302101
02302098
02230309
02230308
02219093
00839353
02253275
02253283
02244724
02126230
02231116
00465283
02343096
02068095
02065630
02282496
02337606
02337592
02337584
02241357
02241356
02246565
02246566
02153424
02239832
02240694
02238675
02240693
02231651
02231652
02231653
02240695
02238674
02223406
02370794
02248676
02357216
02373009
00282081
02316935
02338459
02347997
02348896
02348969
02381958
02375273
00004626
EPIRUBICIN HCL 50MG/VIAL INJ
EPOSIN 20MG/ML INJ
ETOPOPHOS 100MG/VIAL INJ
ETOPOSIDE 20MG/ML INJ
EUFLEX TAB 250MG
FARESTON 60MG TAB
FASLODEX 50MG/ML INJ
FEMARA 2.5MG TAB
FIRMAGON 120MG/VIAL INJ
FIRMAGON 80MG/VIAL INJ
FLUDARA 10MG TAB
FLUDARA 50MG/VIAL INJ
FLUOROURACIL INJ 50MG/ML
FLUTAMIDE 250MG TAB
FLUTAMIDE 250MG TAB
GD‐EXEMESTANE 25MG TAB
GEMCITABINE 1000MG/VIAL INJ
GEMCITABINE 1000MG/VL INJ
GEMCITABINE 1G/VIAL INJ
GEMCITABINE 200MG/VL INJ
GEMCITABINE 2G/VIAL IV INJ
GEMCITABINE FOR INJECTION USP
GEMCITABINE FOR INJECTION USP
GEMCITABINE HCL 1G/VIAL INJ
GEMCITABINE HCL 200MG/VIAL INJ
GEMZAR 1000MG/VIAL INJ
GEMZAR 200MG/VIAL INJ
GEN‐ETOPOSIDE 20MG/ML INJ
GEN‐TAMOXIFEN TAB 20MG
GLEEVEC 100MG TAB
GLEEVEC 400MG TAB
GLEEVEC 50MG CAP
HEXALEN 50 MG CAP
HYCAMTIN 4MG/VIAL INJ
HYDREA 500MG CAP
HYDROXYUREA 500MG CAP
IDAMYCIN 10MG/VIAL PWS IV
IDAMYCIN 5MG/VIAL PWS IV
IDAMYCIN PFS 1MG/ML INJ
IDARUBICIN HCL INJ 10MG/10ML
IFEX 1G/VIAL INJ
IFEX 3G/VIAL INJ
IFOSFAMIDE 1GM/VIAL INJ
IFOSFAMIDE 3GM/VIAL INJ
IMMUCYST INJ
INFERGEN 0.03MG/ML INJ
INTRON 25,000,000IU/ML INJ
INTRON A 10X10000000IU/ML INJ
INTRON A 15,000,000IU/ML INJ
INTRON A 18 MEGA IU PWD INJ
INTRON A 30 MILLION IU PWD INJ
INTRON A 50 MILLION IU PWD INJ
INTRON A 50,000,000IU/ML INJ
INTRON A 6X10000000IU/ML INJ
INTRON A INJ 1000000UNIT/VIAL
IPG‐LETROZOLE 2.5MG TAB
IRESSA 250MG TAB
JAMP‐BICALUTAMIDE 50MG TAB
JAMP‐LETROZOLE 2.5MG TAB
LANVIS 40MG TAB
LETROZOLE 2.5MG TAB
LETROZOLE 2.5MG TAB
LETROZOLE 2.5MG TAB
LETROZOLE 2.5MG TAB
LETROZOLE 2.5MG TAB
LETROZOLE 2.5MG TAB
LETROZOLE SUN 2.5MG TAB
LEUKERAN 2MG TAB
EPIRUBICIN HCL
EPIRUBICIN HCL
EPIRUBICIN HCL
ETOPOSIDE
ETOPOSIDE PHOSPHATE
ETOPOSIDE
ETOPOSIDE
ETOPOSIDE
ETOPOSIDE
ETOPOSIDE
FLUTAMIDE
TOREMIFENE CITRATE
FULVESTRANT
LETROZOLE
DEGARELIX ACETATE
DEGARELIX ACETATE
FLUDARABINE PHOSPHATE
FLUDARABINE PHOSPHATE
FLUOROURACIL
FLUTAMIDE
FLUTAMIDE
EXEMESTANE
GEMCITABINE HCL
GEMCITABINE
GEMCITABINE HCL
GEMCITABINE HCL
GEMCITABINE HCL
GEMCITABINE HCL
GEMCITABINE HCL
GEMCITABINE
GEMCITABINE HCL
GEMCITABINE HCL
GEMCITABINE HCL
GEMCITABINE HCL
GEMCITABINE HCL
GEMCITABINE HCL
GEMCITABINE HCL
GEMCITABINE HCL
ETOPOSIDE
TAMOXIFEN CITRATE
IMATINIB MESYLATE
IMATINIB MESYLATE
IMATINIB MESYLATE
ALTRETAMINE
TOPOTECAN HCL
HYDROXYUREA
HYDROXYUREA
IDARUBICIN HCL
IDARUBICIN HCL
IDARUBICIN HCL
IDARUBICIN HCL
IDARUBICIN HCL
IDARUBICIN HCL
IFOSFAMIDE
IFOSFAMIDE
IFOSFAMIDE USP
IFOSFAMIDE USP
BACILLUS CALMETTE‐GUERIN
INTERFERON ALFACON‐1
INTERFERON ALFA‐2B
INTERFERO ALFA‐2B
INTERFERO ALFA‐2B
INTERFERO ALFA‐2B
INTERFERON ALFA 2B
LETROZOLE
GEFITINIB
BICALUTAMIDE
LETROZOLE
THIOGUANINE
LETROZOLE
LETROZOLE
LETROZOLE
LETROZOLE
LETROZOLE
LETROZOLE
LETROZOLE
CHLORAMBUCIL
2MG/ML
2MG/ML
50MG/VIAL
20MG/ML
100MG
20MG/ML
20MG/ML
20MG/ML
20MG/ML
20MG/ML
250MG
60MG
50MG/ML
2.5MG
120MG/VIAL
80MG/VIAL
10MG
50MG
50MG/ML
250MG
250MG
25MG
1000MG/VL
1000MG/VL
1G/VIAL
1G/VIAL
200MG/VIAL
200MG/VIAL
200MG/VL
200MG/VL
2G
2G/VIAL
200MG
1G
1G/VIAL
200MG/VIAL
1000MG
200MG
20MG/ML
20MG
100MG
400MG
50MG
50MG
4MG/VIAL
500MG
500MG
10MG/VIAL
5MG/VIAL
1MG/ML
10MG/10ML
20MG/20ML
5MG/5ML
1G
3G
1GM/VIAL
3GM/VIAL
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
INJ
TAB
INJ
INJ
TAB
INJ
INJ
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
CAP
CAP
INJ
CAP
CAP
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
39
0.03MG
25MU/ML
10000000IU
15MU/VIAL
18 MEGA IU
30 MILL IU
50 MILL IU
50MU/ML
1 MIL IU
2.5MG
250MG
50MG
2.5MG
40MG
2.5MG
2.5MG
2.5MG
2.5MG
2.5MG
2.5MG
2.5MG
2MG
*PA
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
02240264
02022117
02179092
02148730
02239834
02230248
00884502
02239833
02148722
00836273
00727695
00463221
02373424
00012750
02237276
02322315
02084422
02084430
02168979
02182750
02182947
02327236
02333023
02182777
02182955
02182971
02377624
02182939
01907204
02099705
02177110
02170698
02304767
02320037
02320045
09991119
02320053
09991120
02320029
02230451
02230729
02230450
02237745
02244614
02267535
02286300
00016063
02302403
02229723
02242920
02322544
02088428
02089858
00004618
02372169
02091283
02284227
02048485
02270226
02080036
02343657
00851965
00851973
02358557
02336545
02239082
02185423
02185415
02243681
02065703
02281163
02316366
02275589
02237871
02230104
02230875
02309114
02237459
02237460
02311038
02241799
LEUPROLIDE ACETATE 5MG/ML INJ
LEUSTATIN 1MG/ML INJ
LIN‐MEGESTROL 40MG TAB
LUPRON DEPOT 11.25MG/VIAL INJ
LUPRON DEPOT 22.5MG
LUPRON DEPOT 3.75MG INJ KIT
LUPRON DEPOT 30MG/VIAL INJ
LUPRON DEPOT KIT WITH DILUENT
LUPRON INJ 5MG/ML
LYSODREN TAB 500MG
MAR‐LETROZOLE 2.5MG TAB
MATULANE 50MG CAP
MED‐CYPROTERONE 50MG TAB
MED‐LETROZOLE 2.5MG TAB
MED‐TAMOXIFEN 10MG TAB
MED‐TAMOXIFEN 20MG TAB
MEGACE 40MG/5ML SUSP
METHOTREXATE 10MG TAB
METHOTREXATE 20MG/2ML
METHOTREXATE 25MG/ML INJ
METHOTREXATE 25MG/ML INJ
METHOTREXATE INJ 25MG/ML
METHOTREXATE INJ 25MG/ML
METHOTREXATE IV INJ 25MG/ML
METHOTREXATE PF/SA 25MG/ML INJ
METHOTREXATE SOD INJ 2.5MG/ML
METHOTREXATE SODIUM INJ 25.0MG
METHOTREXATE SODIUM INJ 25MG/M
METHOTREXATE TAB 10MG
METHOTREXATE TAB 2.5MG
METOJECT 10MG/ML INJ
METOJECT 10MG/ML INJ
METOJECT 15MG/1.5ML INJ
METOJECT 20MG/2ML INJ
METOJECT 7.5MG/0.75ML INJ
MITOMYCIN 20MG/VIAL
MITOMYCIN 20MG/VIAL INJ
MITOMYCIN 5MG/VIAL
MITOMYCIN 5MG/VIAL INJ
MITOXANTRONE 2MG/ML INJ
MITOXANTRONE 2MG/ML INJ
MITOXANTRONE INJECTION 2MG/ML
MUSTARGEN HCL 10MG INJ
MYLAN‐BICALUTAMIDE 50MG TAB
MYLAN‐CYPROTERONE 50MG TAB
MYLAN‐HYDROXYUREA 500MG CAP
MYLAN‐LETROZOLE 2.5MG TAB
MYLAN‐TAMOXIFEN 10 MG TAB
MYLAN‐TAMOXIFEN 20 MG TAB
MYLERAN 2MG TAB
MYL‐LETROZOLE 2.5MG TAB
NAVELBINE 10MG/ML INJ
NEXAVAR 200MG TAB
NOLVADEX D 20MG TAB
NOVO‐BICALUTAMIDE 50MG TAB
NOVO‐ETOPOSIDE 20MG/ML INJ
NOVO‐LETROZOLE 2.5MG TAB
NOVO‐TAMOXIFEN TAB 10MG
NOVO‐TAMOXIFEN TAB 20MG
NTP‐BICALUTAMIDE 50MG TAB
NU‐BICALUTAMIDE 50MG TAB
NU‐FLUTAMIDE 250MG TAB
NU‐MEGESTROL 160MG TAB
NU‐MEGESTROL 40MG TAB
ORZEL KIT
PHARMORUBICIN PFS 2MG/ML INJ
PHL‐BICALUTAMIDE 50MG TAB
PHL‐LETROZOLE 2.5MG TAB
PMS‐BICALUTAMIDE 50MG TAB
PMS‐ETOPOSIDE 20MG/ML INJ
PMS‐FLUTAMIDE TAB 250MG
PMS‐FLUTAMIDE‐R 250MG TAB
PMS‐LETROZOLE 2.5MG TAB
PMS‐TAMOXIFEN 10MG TAB
PMS‐TAMOXIFEN 20MG TAB
PRO‐BICALUTAMIDE 50MG TAB
PROCYTOX 1000MG/VIAL INJ
LEUPROLIDE ACETATE
CLADRIBINE
MEGESTROL ACETATE
LEUPROLIDE ACETATE
LEUPROLIDE ACETATE F DEPOT SUS
LEUPROLIDE ACETATE
LEUPROLIDE ACETATE
LEUPROLIDE ACETATE F DEPOT SUS
LEUPROLIDE ACETATE
LEUPROLIDE ACETATE
LEUPROLIDE ACETATE
MITOTANE
LETROZOLE
PROCARBAZINE HCL
CYPROTERONE ACETATE
LETROZOLE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
MEGESTROL ACETATE
METHOTREXATE
METHOTREXATE SODIUM
METHOTREXATE
METHOTREXATE
METHOTREXATE SODIUM
METHOTREXATE SODIUM
METHOTREXATE SODIUM
METHOTREXATE
METHOTREXATE SODIUM
METHOTREXATE SODIUM
METHOTREXATE SODIUM
AMETHOPTERIN (METHOTREXATE SOD
METHOTREXATE SODIUM
METHOTREXATE SODIUM
METHOTREXATE SODIUM
METHOTREXATE SODIUM
METHOTREXATE SODIUM
METHOTREXATE SODIUM
METHOTREXATE SODIUM
METHOTREXATE SODIUM
MITOMYCIN
MITOMYCIN
MITOMYCIN
MITOMYCIN
MITOXANTRONE HCL
MITOXANTRONE HCL
MITOXANTRONE HCL
MECHLORETHAMINE HCL
BICALUTAMIDE
CYPROTERONE ACETATE
HYDROXYUREA
LETROZOLE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
BUSULFAN
LETROZOLE
VINORELBINE TARTRATE
SORAFENIB
TAMOXIFEN CITRATE
BICALUTAMIDE
ETOPOSIDE
LETROZOLE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
BICALUTAMIDE
BICALUTAMIDE
FLUTAMIDE
MEGESTROL ACETATE
MEGESTROL ACETATE
TEGAFUR/URACIL&LEUCOVORIN CALC
EPIRUBICIN HCL
BICALUTAMIDE
LETROZOLE
BICALUTAMIDE
ETOPOSIDE
FLUTAMIDE
FLUTAMIDE
LETROZOLE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
BICALUTAMIDE
CYCLOPHOSPHAMIDE
5MG/ML
1MG/ML
40MG
11.25MG
11.25MG
22.5MG
3.75MG
30MG
7.5MG/VIAL
7.5 MG
5MG/ML
500MG
2.5MG
50MG
50MG
2.5MG
10MG
20MG
40MG/5ML
10MG
10MG/ML
25MG/ML
25MG/ML
25MG/ML
25MG/ML
25MG/ML
25MG/ML
2.5MG/ML
25MG/ML
25MG/ML
10MG
2.5MG
10MG/ML
10MG/ML
15MG/1.5ML
20MG/2ML
25MG/2.5ML
25MG/2.5ML
7.5MG/.75M
20MG/VIAL
20MG/VIAL
5MG/VIAL
5MG/VIAL
2MG/ML
2MG/ML
2MG/ML
10MG
50MG
50MG
500MG
2.5MG
10MG
20MG
2MG
2.5MG
10MG/ML
200MG
20MG
50MG
20MG/ML
2.5MG
10MG
20MG
50MG
50MG
250MG
160MG
40MG
INJ
INJ
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
CAP
TAB
TAB
TAB
TAB
O/L
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
KIT
INJ
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
INJ
40
2MG/ML
50MG
2.5MG
50MG
20MG/ML
250MG
250MG
2.5MG
10MG
20MG
50MG
1000MG/VIA
*PA
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
02241800
02241797
02241795
02241798
02241796
00004723
02371324
02372282
02277700
02244798
02304902
02317699
02317710
02304899
02241927
02276089
02344815
02320193
02360829
02293129
02293137
02293145
02360810
02131692
02228955
02240749
02225166
02225158
02280795
02280809
02328607
02280817
01926624
01926632
00657360
00657379
02163778
02220652
02220660
02230042
02237596
02230043
02237597
02296721
02269015
02269023
02269007
02368250
02315874
02241095
02312794
02312816
02241094
02241096
02241093
02230089
02355205
02355213
02355221
02355191
02229566
02333880
02379422
02379422
02344009
02346656
02243856
02240000
02326442
02308487
02308495
02308509
00616192
02145839
02336707
02183064
02183056
02183013
02324148
02333198
02183021
PROCYTOX 25MG TAB
PROCYTOX 50MG TAB
PURINETHOL 50MG TAB
RAN‐BICALUTAMIDE 50MG TAB
RAN‐LETROZOLE 2.5MG TAB
RATIO‐BICALUTAMIDE 50MG TAB
RATIO‐METHOTREXATE 2.5MG TAB
REVLIMID 10MG CAP
REVLIMID 15MG CAP
REVLIMID 25MG CAP
REVLIMID 5MG CAP
RITUXAN 10MG/ML LIQ
SANDOZ BICALUTAMIDE 50MG TAB
SANDOZ LETROZOLE 2.5MG TAB
SPRYCEL 100MG TAB
SPRYCEL 140MG TAB
SPRYCEL 20MG TAB
SPRYCEL 50MG TAB
SPRYCEL 70MG TAB
SPRYCEL 80MG TAB
STERILE BLEOMYCIN SULFATE USP
SUPREFACT DEPOT 2 MONTHS IMPL
SUPREFACT DEPOT 3MON 9.45MG
SUPREFACT INJ 1MG/ML
SUPREFACT NASAL SOL 1MG/ML
SUTENT 12.5MG CAP
SUTENT 25MG CAP
SUTENT 37.5MG CAP
SUTENT 50MG CAP
TAMOFEN 10MG TAB
TAMOFEN 20MG TAB
TAMOFEN TAB 10MG
TAMOFEN TAB 20MG
TAMONE 10MG TAB
TAMOPLEX 10MG TAB
TAMOPLEX 20MG TAB
TAMOXIFEN 10MG TAB
TAMOXIFEN 10MG TAB
TAMOXIFEN 20MG TAB
TAMOXIFEN 20MG TAB
TAMOXIFENE 10MG TAB
TARCEVA 100MG TAB
TARCEVA 150MG TAB
TARCEVA 25MG TAB
TASIGNA 150MG CAP
TASIGNA 200MG CAP
TEMODAL 100MG CAP
TEMODAL 140MG CAP
TEMODAL 180MG CAP
TEMODAL 20MG CAP
TEMODAL 250MG CAP
TEMODAL 5MG CAP
TEVA‐FLUTAMIDE TAB 250MG
THALOMID 100MG CAP
THALOMID 150MG CAP
THALOMID 200MG CAP
THALOMID 50MG CAP
TOMUDEX 2MG VIAL INJ
TOPOTECAN 4MG/VIAL INJ
TOPOTECAN HCL 1MG/ML INJ
TOPOTECAN HCL 1MG/ML INJ
TOPOTECAN HCL 4MG/VIAL INJ
TOPOTECAN HCL 4MG/VIAL INJ
TRELSTAR 11.25MG/VIAL INJ
TRELSTAR 3.75MG/VIAL INJ
TYKERB 250MG TAB
VECTIBIX 100MG/5ML IV INJ
VEPESID CAP 50MG
VESANOID 10MG CAP
VIDAZA 100MG/VIAL INJ
VINBLASTINE SULFATE 10MG/VIAL
VINBLASTINE SULFATE 1MG/ML INJ
VINCRISTINE SULFATE 1MG/ML INJ
VINCRISTINE SULFATE 1MG/VIAL
CYCLOPHOSPHAMIDE
CYCLOPHOSPHAMIDE
CYCLOPHOSPHAMIDE
CYCLOPHOSPHAMIDE
CYCLOPHOSPHAMIDE
MERCAPTOPURINE
BICALUTAMIDE
LETROZOLE
BICALUTAMIDE
METHOTREXATE SODIUM
LENALIDOMIDE
LENALIDOMIDE
LENALIDOMIDE
LENALIDOMIDE
RITUXIMAB
BICALUTAMIDE
LETROZOLE
DASATINIB MONOHYDRATE
BLEOMYCIN SULFATE
BUSERELIN ACETATE
BUSERELIN ACETATE
BUSERELIN ACETATE
BUSERELIN ACETATE
SUNITINIB MALATE
SUNITINIB MALATE
SUNITINIB MALATE
SUNITINIB MALATE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
TAMOXIFEN CITRATE
TAMOXIFENE CITRATE
ERLOTINIB HCL
ERLOTINIB HCL
ERLOTINIB HCL
NILOTINIB HCL
NILOTINIB HCL
TEMOZOLOMIDE
TEMOZOLOMIDE
TEMOZOLOMIDE
TEMOZOLOMIDE
TEMOZOLOMIDE
TEMOZOLOMIDE
FLUTAMIDE
THALIDOMIDE
THALIDOMIDE
THALIDOMIDE
THALIDOMIDE
RALTITREXED
TOPOTECAN HCL
TOPOTECAN HCL
TOPOTECAN HCL
TOPOTECAN HCL
TOPOTECAN HCL
TRIPTORELIN PAMOATE
TRIPTORELIN PAMOATE
LAPATINIB DITOSYLATE MONOHYDRA
PANITUMUMAB
PANITUMUMAB
PANITUMUMAB
ETOPOSIDE
TRETINOIN
AZACITIDINE
VINBLASTINE SULPHATE
VINBLASTINE SULPHATE
VINCRISTINE SULFATE
VINCRISTINE SULFATE
VINCRISTINE SULFATE
VINCRISTINE SULPHATE
2000MG/VIA
200MG/VIAL
25MG
500MG/VIAL
50MG
50MG
50MG
2.5MG
50MG
2.5MG
10MG
15MG
25MG
5MG
10MG/ML
50MG
2.5MG
100MG
140MG
20MG
50MG
70MG
80MG
15IU/VIAL
6.3MG
9.45MG
1MG/ML
1MG/ML
12.5MG
25MG
37.5MG
50MG
10MG
20MG
10MG
20MG
10MG
10 MG
20 MG
10MG
10MG
20MG
20MG
10MG
100MG
150MG
25MG
150MG
200MG
100MG
140MG
180MG
20MG
250MG
5MG
250MG
100MG
150MG
200MG
50MG
2MG
4MG/VIAL
1MG/ML
1MG/ML
4MG/VIAL
4MG/VIAL
11.25MG/VL
3.75MG/VL
250MG
100MG/5ML
200MG/10ML
400MG/20ML
50MG
10 MG
100MG/VIAL
10MG/VIAL
1MG/ML
1MG/ML
1MG/ML
1MG/ML
1MG/VIAL
INJ
INJ
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
IMPLANT
IMPLANT
INJ
NAS SOL
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
CAP
CAP
CAP
CAP
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
INJ
INJ
INJ
CAP
CAP
INJ
INJ
INJ
INJ
INJ
INJ
INJ
41
*PA
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
100000
02183048
02182785
02143305
02265990
02257777
02271214
02327643
02352303
02352311
00588989
02161176
02238453
02238454
00622141
02380242
02378213
02049325
02225905
02327619
02371065
VINCRISTINE SULFATE INJ 1MG/ML
VINORELBINE 10MG/ML INJ
VINORELBINE TARTRATE 10MG/ML
VOTRIENT 200MG TAB
VOTRIENT 400MG TAB
VUMON INJ 10MG/ML
WELLFERON 5 MEGA UNITS/ML INJ
XELODA 150MG TAB
XELODA 500MG TAB
ZANOSAR 1G/VIAL INJ
ZELBORAF 240MG TAB
ZINDA‐LETROZOLE 2.5MG TAB
ZOLADEX INJ DEPOT 3.6MG
ZOLADEX LA 10.8MG INJ
ZOLINZA 100MG CAP
ZYTIGA 250MG TAB
VINCRISTINE SULFATE
PAZOPANIB HCL
PAZOPANIB HCL
TENIPOSIDE
INTERFERON
CAPECITABINE
CAPECITABINE
STREPTOZOCIN
VEMURAFENIB
LETROZOLE
GOSERELIN ACETATE
GOSERELIN ACETATE
VORINOSTAT
ABIRATERONE ACETATE
2MG/VIAL
5MG/VIAL
1 MG/ML
10MG/ML
10MG/ML
10MG/ML
10MG/ML
200MG
400MG
10MG/ML
5MEGA U/ML
150MG
500MG
1G
240MG
2.5MG
3.6MG
10.8MG
100MG
250MG
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
INJ
INJ
TAB
TAB
INJ
TAB
TAB
INJ
INJ
CAP
TAB
42
*PA
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
120400
DIN
Drug Name
PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS
Chemical Name
Strength
Dosage
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
02293056
02293021
02293048
02336715
02336723
02336731
02336758
02232044
02232043
02269465
02269457
02237047
02237048
02237049
02095157
00885568
02060043
02295245
02295229
02295237
02307685
02307693
02307707
02307715
01947958
01947931
01947923
02242115
02302853
02242116
02242117
02302845
02242118
02245240
00869961
00869953
02339447
02339455
02339439
02332809
02333280
02332817
02332825
02332833
00874957
01915436
02230592
02305984
02305992
02306018
02306026
02316951
02316978
02316943
02308169
02308177
02308185
02308193
02333392
02333376
02333384
02306034
02306042
02306050
02306069
00115436
00869945
02270803
02270773
02270781
02311283
02311291
02311305
02311313
02244300
02244298
02244302
02244299
02266725
02266733
APO‐GALANTAMINE 12MG TAB
APO‐RIVASTIGMINE 1.5MG TAB
APO‐RIVASTIGMINE 3MG TAB
APO‐RIVASTIGMINE 4.5MG TAB
APO‐RIVASTIGMINE 6MG TAB
ARICEPT 10MG TAB
ARICEPT 5MG TAB
ARICEPT RDT 10MG TAB
ARICEPT RDT 5MG TAB
BETHANECHOL CHLORIDE 10MG TAB
CARBACHOL 0.25MG/ML INJ
CARBACHOL 2MG TAB
CARBACHOL 2MG TAB
CO‐GALANTAMINE 12MG TAB
DOM‐RIVASTIGMINE 1.5MG CAP
DOM‐RIVASTIGMINE 3MG CAP
DOM‐RIVASTIGMINE 4.5MG CAP
DOM‐RIVASTIGMINE 6MG CAP
DUVOID 10MG TAB
DUVOID 25 MG TAB
DUVOID 50 MG TAB
EXELON 1.5MG CAP
EXELON 10 PATCH 18MG
EXELON 3MG CAP
EXELON 4.5MG CAP
EXELON 5 PATCH 9MG
EXELON 6MG CAP
EXELON ORAL SOLUTION
MESTINON TAB 60MG
MESTINON‐SR TAB 180MG
MYLAN‐GALANTAMINE ER 16MG TAB
MYLAN‐RIVASTIGMINE 1.5MG CAP
MYLAN‐RIVASTIGMINE 3MG CAP
MYLAN‐RIVASTIGMINE 6MG CAP
NEOSTIGMINE METHYLSULFATE INJ
NEOSTIGMINE METHYLSULFATE INJ
NEOSTIGMINE OMEGA 1MG/ML INJ
NOVO‐RIVASTIGMINE 1.5MG CAP
NOVO‐RIVASTIGMINE 3MG CAP
NOVO‐RIVASTIGMINE 4.5MG CAP
NOVO‐RIVASTIGMINE 6MG CAP
PAT‐GALANTAMINE ER 16MG CAP
PHL‐RIVASTIGMINE 1.5MG CAP
PHL‐RIVASTIGMINE 3MG CAP
PHL‐RIVASTIGMINE 4.5MG CAP
PHL‐RIVASTIGMINE 6MG CAP
PMS‐GALANTAMINE 12MG TAB
PMS‐RIVASTIGMINE 1.5MG CAP
PMS‐RIVASTIGMINE 3MG CAP
PMS‐RIVASTIGMINE 4.5MG CAP
PMS‐RIVASTIGMINE 6MG CAP
PROSTIGMIN 1MG INJ
PROSTIGMIN TAB 15MG USP
RATIO‐GALANTAMINE 12MG TAB
RATIO‐RIVASTIGMINE 1.5MG CAP
RATIO‐RIVASTIGMINE 3MG CAP
RATIO‐RIVASTIGMINE 4.5MG CAP
RATIO‐RIVASTIGMINE 6MG CAP
REMINYL 12MG TAB
REMINYL 4MG TAB
REMINYL 4MG/ML O/L
REMINYL 8MG TAB
REMINYL ER 16MG CAP
REMINYL ER 24MG CAP
GALANTAMINE HBR
GALANTAMINE HBR
GALANTAMINE HBR
RIVASTIGMINE HYDROGEN TARTRATE
DONEPEZIL HCL
DONEPEZIL HCL
DONEPEZIL HCL
DONEPEZIL HCL
BETHANECHOL CHLORIDE
CARBAMYLCHOLINE CHLORIDE
CARBACHOL
CARBAMYLCHOLINE CHLORIDE
GALANTAMINE HYDROBROMIDE
RIVASTIGMINE
RIVASTIGMINE
RIVASTIGMINE
RIVASTIGMINE
RIVASTIGMINE
RIVASTIGMINE
PYRIDOSTIGMINE BROMIDE
PYRIDOSTIGMINE BROMIDE
RIVASTIGMINE
NEOSTIGMINE METHYLSULFATE
NEOSTIGMINE
NEOSTIGMINE METHYLSULFATE
NEOSTIGMINE
NEOSTIGMINE BROMIDE
GALANTAMINE HBR
GALANTAMINE HBR
GALANTAMINE HBR
GALANTAMINE HBR
GALANTAMINE HBR
12MG
4MG
8MG
1.5MG
3MG
4.5MG
6MG
10MG
5MG
10MG
5MG
10MG
25MG
50MG
0.25MG/ML
2MG
2MG
12MG
4MG
8MG
1.5MG
3MG
4.5MG
6MG
10MG
25MG
50MG
1.5MG
18MG
3MG
4.5MG
9MG
6MG
2MG/ML
60MG
180MG
16MG
24MG
8MG
1.5MG
1.5MG
3MG
4.5MG
6MG
0.5 MG/ML
2.5 MG/ML
1MG/ML
1.5MG
3MG
4.5MG
6MG
16MG
24MG
8MG
1.5MG
3MG
4.5MG
6MG
12MG
4MG
8MG
1.5MG
3MG
4.5MG
6MG
1MG
15MG
8MG
4MG
8MG
1.5MG
3MG
4.5MG
6MG
12MG
4MG
4MG/ML
8MG
16MG
24MG
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
CAP
PATCH
CAP
CAP
PATCH
CAP
O/L
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
INJ
INJ
INJ
CAP
CAP
CAP
CAP
CAP LA
CAP LA
CAP LA
CAP
CAP
CAP
CAP
TAB
TAB
TAB
CAP
CAP
CAP
CAP
INJ
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
O/L
TAB
CAP LA
CAP LA
43
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
120400
02266717
02312492
02375729
02312506
02375737
02312514
02375745
02312522
02375753
02216345
02324563
02324571
02324598
02324601
02377969
02377977
02377950
02308622
02308630
02308649
02308657
REMINYL ER 8MG CAP
RIVASTIGMINE 1.5MG CAP
RIVASTIGMINE 3MG CAP
SALAGEN 5MG TAB
SANDOZ RIVASTIGMINE 1.5MG CAP
SANDOZ RIVASTIGMINE 3MG CAP
SANDOZ RIVASTIGMINE 4.5MG CAP
SANDOZ RIVASTIGMINE 6MG CAP
TEVA‐GALANTAMINE ER 16MG CAP
ZYM‐RIVASTIGMINE 1.5MG CAP
ZYM‐RIVASTIGMINE 3MG CAP
ZYM‐RIVASTIGMINE 4.5MG CAP
ZYM‐RIVASTIGMINE 6MG CAP
GALANTAMINE HBR
PILOCARPINE HCL
8MG
1.5MG
1.5MG
3MG
3MG
4.5MG
4.5MG
6MG
6MG
5MG
1.5MG
3MG
4.5MG
6MG
16MG
24MG
8MG
1.5MG
3MG
4.5MG
6MG
CAP LA
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
CAP
CAP
CAP
CAP
CAP LA
CAP LA
CAP LA
CAP
CAP
CAP
CAP
44
*PA
05/2012
Therapy Class
120808
DIN
Drug Name
ANTIMUSCARINICS/ANTISPASMODIC
Chemical Name
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
120808
02349027
02349035
02094959
00618454
02126222
02246083
02246084
02247686
02163705
02163713
00921122
02276348
02231675
02230684
01950592
00465240
00157066
02241606
02241605
02241604
02241607
02240508
02244498
02264609
02240474
02153408
02237189
00115630
02241119
02241120
00803499
02020200
02272695
02239131
02216221
02210479
02228238
02231785
01901869
00451606
01927774
02239074
02236934
02259842
02236935
02259850
02259869
02259877
02237134
02237135
02239627
02231135
02231136
02231245
02231244
00636223
02097168
02097141
02097176
02246793
00280828
02245663
02245664
AA‐TRIMEBUTINE 100MG TAB
AA‐TRIMEBUTINE 200MG TAB
ALTI‐IPRATROPIUM 20MCG INH
APO‐CHLORAX CAP
APO‐IPRAVENT 250MCG INH SOL
APO‐IPRAVENT INH SOL 0.03%
APO‐IPRAVENT INH SOL 0.06%
ATROVENT HFA INHALER
ATROVENT NASAL SPRAY 0.03%
ATROVENT NASAL SPRAY 0.06%
ATROVENT UDV 0.25MG/ML (1ML)
CO SALBUT‐IPRAT INH SOL
COMBIVENT UDV NEBULES
DICETEL 100MG TAB
DICETEL 50MG FILM COATED TAB
DICETEL CAP 50MG
DICLOPHEN
DOM‐IPRATROPIUM (1ML) INH SOL
DOM‐IPRATROPIUM 0.3MG/ML NAS
GEN‐IPRATROPIUM 0.3MG/ML NAS
IPRAMOL 2.5MG‐0.5MG/2.5ML SOL
IPRATROPIUM 0.03% NAS SOL
IPRATROVENT 250MCG/ML
IPRATROVENT STERULES 250MCG/ML
LIBRAX CAP
MED‐IPRATROPIUM 250MCG/ML INH
MED‐IPRATROPIUM STERINEBS 250M
MODULON TAB 200MG
MODULON TAB 200MG
MYLAN‐COMBO STERINEBS SOL
MYLAN‐IPRATROPIUM 0.25MG/ML
MYLAN‐IPRATROPIUM STERINEBS
NOVO‐IPRAMIDE 0.25MG
NU‐IPRATROPIUM 0.25MG/ML INH
NU‐IPRATROPIUM 250MCG/ML INH
OPIUM & BELLADONA
OPIUM & BELLADONNA SUPP
PARSITAN
PENTA‐IPRATROPIUM BROMIDE INH
PHL‐IPRATROPIUM 125MCG/ML INH
PHL‐IPRATROPIUM 125MCG/ML SOL
PHL‐IPRATROPIUM 250MCG/ML AER
PHL‐IPRATROPIUM POLYNEBS0.25MG
PHL‐IPRATROPIUM POLYNEBS0.25MG
PMS‐IPRATROPIUM 0.03% NAS SPR
PMS‐IPRATROPIUM 125MCG/ML
PMS‐IPRATROPIUM 250MCG/ML INH
PMS‐IPRATROPIUM UDV 250MCG 2ML
PMS‐IPRATROPIUM UDV 250MCG/ML
PRO CHLORAX
RATIO‐IPRATROPIUM UDV 250MCG
RATIO‐IPRATROPIUM INH SOL
RATIO‐IPRATROPIUM UDV 125MCG
SPIRIVA 18MCG CAP
STELABID ULTRA TAB
TRIMEBUTINE 100MG TAB
TRIMEBUTINE 200MG TAB
TRIMEBUTINE MALEATE
100MG
TRIMEBUTINE MALEATE
200MG
IPRATROPIUM BROMIDE
20MCG
CHLORDIAZEPOXIDE/CLIDINIUM
5/2.5MG
IPRATROPIUM BROMIDE
250MG/ML
IPRATROPIUM BROMIDE
0.03%
IPRATROPIUM BROMIDE
0.06%
IPRATROPIUM BROMIDE
20MCG/DOSE
IPRATROPIUM BROMIDE
0.03%
IPRATROPIUM BROMIDE
0.06%
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE&SALBUTAMOL0.5&2.5MG
IPRATROPIUM BROMIDE/SALBUTAMOL 0.5/2.5MG
PINAVERIUM BROMIDE
100MG
PINAVERIUM BROMIDE
50MG
PINAVERIUM BROMIDE
50MG
DICYCLOMINE HCL/PHENOBARBITAL
10MG/15MG
IPRATROPIUM BROMIDE
250MCG/ML
IPRATROPIUM BROMIDE
250MCG/ML
IPRATROPIUM BROMIDE
125MCG/ML
IPRATROPIUM BROMIDE
250MCG/ML
IPRATROPIUM BROMIDE
0.3MG/ML
IPRATROPIUM BROMIDE
0.3MG/ML
SALBUTAMOL SULF/IPRATROPIUM BR 2.5MG/0.5M
IPRATROPIUM BROMIDE
0.03%
IPRATROPIUM BROMIDE
0.25%
IPRATROPIUM BROMIDE
250MCG/ML
5MG/2.5MG
IPRATROPIUM BROMIDE
250MCG
IPRATROPIUM BROMIDE
250MCG
TRIMEBUTINE MALEATE
200MG
TRIMEBUTINE MALEATE
200MG
SALBUTAMOL/IPRATROPIUM BROMIDE 2.5/0.5MG
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
250MG/ML
OPIUM/BELLADONE
65MG/
OPIUM/BELLADONE
ETHOPROPAZINE HYDROCHLORIDE
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
125MCG/ML
IPRATROPIUM BROMIDE
125MCG/ML
IPRATROPIUM BROMIDE
250MCG/ML
IPRATROPIUM BROMIDE
250MCG/ML
IPRATROPIUM BROMIDE
250MCG/ML
IPRATROPIUM BROMIDE
250MCG/ML
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
0.03%
IPRATROPIUM BROMIDE
125MCG/ML
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
250MCG/ML
5/2.5MG
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
0.25MG/ML
IPRATROPIUM BROMIDE
125MCG/ML
TIOTROPIUM BROMIDE MONOHYDRATE18MCG
ISOPROPAMIDE/TRIFLUPERAZINE
10/2MG
TRIMEBUTINE MALEATE
100MG
TRIMEBUTINE MALEATE
200MG
45
Strength
Dosage
*PA
TAB
TAB
INH
CAP
INH SOL
NAS SPR
INH
INH
NAS SPR
SPR
SOL
INH SOL
INH NEB
TAB
TAB
CAP
CAP
INH SOL
INH SOL
INH SOL
INH SOL
NAS SOL
NAS SOL
INH SOL
NAS SOL
SOL
INH SOL
CAP
INH SOL
INH NEB
TAB
TAB
INH SOL
INH SOL
INH NEB
INH SOL
INH
INH SOL
SUPP
SUPP
TAB
INH
INH SOL
SOL
INH SOL
SOL
SOL
SOL
INH SOL
INH SOL
NAS SPR
INH SOL
INH SOL
INH SOL
INH SOL
CAP
INH SOL
INH SOL
INH SOL
CAP
TAB
TAB
TAB
05/2012
Therapy Class
121200
DIN
Drug Name
SYMPATHOMIMETIC (ADRENERGIC) AGENTS
Chemical Name
46
Strength
Dosage
*PA
05/2012
Therapy Class
121204
DIN
Drug Name
ALPHA-ADRENERGICAGONISTS
Chemical Name
Strength
Dosage
121204
121204
121204
121204
121204
02349590
02349604
02247148
02278677
02278685
AA‐MIDODRINE 2.5MG TAB
AA‐MIDODRINE 5MG TAB
AMATINE 10MG TAB
MIDODRINE 2.5MG TAB
MIDODRINE 5MG TAB
MIDODRINE HCL
MIDODRINE HCL
MIDODRINE HCL
MIDODRINE HCL
MIDODRINE HCL
2.5MG
5MG
10MG
2.5MG
5MG
TAB
TAB
TAB
TAB
TAB
47
*PA
05/2012
Therapy Class
121208
DIN
Drug Name
BETA-ADRENERGIC AGONISTS
Chemical Name
Strength
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
121208
02245126
02245127
02245125
02240835
02240836
02240837
02232570
02230249
02236783
02146843
02146851
02245669
02259591
00786616
02259486
02259494
02139324
02148633
02230898
02238795
99100089
02232987
02237414
01926934
02173360
02084252
02326450
02236565
02231783
02231784
02165376
02376938
02237224
02237225
02237602
02237113
02237114
02236931
02236932
02236933
02261324
02261332
02208245
02208229
02208237
02069571
02243789
02239365
02239366
00860808
01986864
02154382
02230006
02245547
02245548
02216949
02216930
02216957
02287196
02287218
00637793
00637807
02228297
02154412
02214261
02231129
02245385
02245386
02248218
02213419
02213486
02243115
02241497
02213427
00670790
00622060
00622079
00332267
02361752
02361760
ADVAIR 125MCG INHALER
ADVAIR DISKUS 50MCG/100MCG INH
AIROMIR 100MCG/ACT INH
ALTI‐SALBUTAMOL 0.5MG/ML LIQ
APO‐ORCIPRENALINE 2MG/ML SYRUP
APO‐SALVENT 2MG TAB
APO‐SALVENT 4MG TAB
APO‐SALVENT CFC FREE
BCI SALBUTAMOL INH SOL 2MG/ML
BRICANYL TURBUHALER 0.5MG/AEM
CO SALBUTAMOL INH SOL 1MG/ML
CO SALBUTAMOL INH SOL 2MG/ML
DOM‐SALBUTAMOL 5MG/ML RES SOL
DUOVENT UDV INH
FORADIL 12MCG INHALATION CAPS
FTP‐SALBUTAMOL 2.5MG/2.5ML NEB
GENERIC SALBUTAMOL INHALER STI
GEN‐SALBUTAMOL RESPIRATOR SOL
MED‐SALBUTAMOL 2MG/ML INH SOL
MYLAN‐SALBUTAMOL NEB 2.5MG
MYLAN‐SALBUTAMOL NEB 2MG/ML
NEO‐VENT
NOVO‐SALBUTAMOL HFA 100MCG/ACT
NU‐ORCIPRENALINE 2MG/ML O/L
NU‐SALBUTAMOL 1MG/ML INH SOL
NU‐SALBUTAMOL 2MG/ML INH SOL
NU‐SALBUTAMOL 4MG TAB
ONBREZ BREEZHALER
OXEZE TURBUHALER 12MCG/DSE INH
OXEZE TURBUHALER 6MCG/DOSE INH
PDL‐ORCIPRENALINE 2MG/ML SYRUP
PDL‐SALBUTAMOL STERULES 1MG/ML
PDL‐SALBUTAMOL STERULES 2MG/ML
PHL‐SALBUTAMOL 0.5MG/ML RESP
PHL‐SALBUTAMOL 1MG/ML RESP
PHL‐SALBUTAMOL 2MG/ML RESP
PHL‐SALBUTAMOL ORAL LIQUID
PHL‐SALBUTAMOL RESP SOL 5MG/ML
PMS‐SALBUTAMOL 0.05% NEBULE
PMS‐SALBUTAMOL 1MG/ML NEBULE
PMS‐SALBUTAMOL 2MG/ML NEBULE
PMS‐SALBUTAMOL 5MG/ML RESP SOL
RATIO‐IPRA SAL UDV INH SOL
RATIO‐SALBUTAMOL 0.5MG/ML RESP
RATIO‐SALBUTAMOL 2MG/ML RESP
RATIO‐SALBUTAMOL 5MG/ML SOL
RATIO‐SALBUTAMOL NEBULE 1MG/ML
SALBU‐5 INH
SALBUTAMOL INH 2MG/ML SOL
SALBUTAMOL INHALATION SOLUTION
SALBUTAMOL INHALATION SOLUTION
SALBUTAMOL RESP SOL 1MG/ML
SALBUTAMOL RESPIRATOR 0.5MG/ML
SALBUTAMOL RESPIRATOR 2MG/ML
SALBUTAMOL STERINEBS 1MG/ML
SALBUTAMOL STERINEBS 2MG/ML
SALBUTAMOL TAB 2MG
SALBUTAMOL TAB 4MG
SALMOL NASAL INH 2MG/ML SOL
SANDOZ‐SALBUTAMOL 5MG/ML INH
SEREVENT DISC 50MCG
SEREVENT DISKUS 50MCG
SYMBICORT 100 TURBUHALER
SYMBICORT 200 TURBUHALER
SYMBICORT FORTE TURBUHALER
VENTOLIN NEBULE 1MG/ML
VENTOLIN 5MG/ML RESP SOL
VENTOLIN DISKUS PWD FOR INHAL
VENTOLIN HFA 100MCG/DOSE INH
VENTOLIN NEBULES 2MG/ML
VENTOLIN ORAL LIQUID 0.4MG/ML
VENTOLIN ROTACAPS 200MCG
VENTOLIN ROTACAPS 400MCG
VENTOLIN TAB 4MG
ZENHALE 5/100MCG INH
ZENHALE 5/200MCG INH
FLUTICASONE PROP/SALMETEROL
FLUTICASONE PROP/SALMETEROL
SALMETEROL/FLUTICASONE PROP
SALMETEROL XINAFOATE/FLUTICASO
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
ORCIPRENALINE SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
TERBUTALINE SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
FENOTEROL HBR/IPRATROPIUM BROM
FORMOTEROL FUMARATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE ‐ 39
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
INDACATEROL MALEATE
FORMOTEROL FUMARATE DIHYDRATE
FORMOTEROL FUMARATE DIHYDRATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL
SALBUTAMOL
SALBUTAMOL
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
IPRATROPIUM BROMIDE/SALBUTAMOL
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALMETEROL XINAFOATE
SALMETEROL XINAFOATE
BUDESONIDE/FORMOTEROL FUMER
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
SALBUTAMOL SULFATE
FORMOTEROL/MOMETASONE
125MCG
250MCG
50MCG
50/100MCG
50/250MCG
50/500MCG
100MCG
0.5MG/ML
2MG/ML
2MG
4MG
100MCG
2MG/ML
500MCG
1MG/ML
2MG/ML
5MG/ML
48
Dosage
*PA
INH
INH
INH
INH
INH
INH
INH
INH SOL
O/L
TAB
TAB
INH
INH SOL
INH
INH SOL
INH SOL
INH SOL
INH
12MCG
CAP
2.5MG
NEBULE
100MCG
INH
5MG/ML
INH SOL
2MG/ML
INH SOL
1MG/ML
INH NEB
2 MG/ML
INH NEB
5MG/ML
INH SOL
100MCG/ACT INH
2MG/ML
O/L
1MG/ML
INH SOL
2MG/ML
INH SOL
4MG
TAB
75MCG
CAP
12MCG/DOSE INH
6MCG/DOSE INH
2MG/ML
O/L
1MG/ML
NAS SOL
2MG/ML
NAS SOL
0.5MG/ML
INH SOL
1MG/ML
INH SOL
2MG/ML
INH SOL
0.4MG/ML
O/L
5MG/ML
INH SOL
0.5MG/ML
INH SOL
1MG/ML
INH NEB
2MG/ML
INH NEB
5MG/ML
INH SOL
0.5/2.5MG
INH SOL
0.5MG/ML
INH SOL
2MG/ML
INH SOL
5 MG/ML
INH SOL
1MG/ML
INH NEB
5 MG/
INH SOL
2MG/ML
INH SOL
1MG/ML
INH SOL
2MG/ML
INH SOL
1MG/ML
INH SOL
0.5MG/ML
INH SOL
2MG/ML
INH SOL
1MG/ML
INH SOL
2MG/ML
INH SOL
2MG
TAB
4MG
TAB
2MG/ML
SOL
5 MG/ML
INH SOL
50MCG
PDR
50MCG/ACT
INH
100/6MCG
INH
200/6MCG
INH
400/12MCG
INH
1MG/ML
INH NEB
5MG/ML
INH SOL
200MCG
PDR
100MCG
INH
2MG/ML
INH NEB
0.4MG/ML
O/L
200MCG
CAP
400MCG
CAP
4MG
TAB
5/100MCG
INH
5/200MCG
INH
05/2012
Therapy Class
DIN
Drug Name
121208
02361744 ZENHALE 5/50MCG INH
49
Chemical Name
Strength
Dosage
5/50MCG
INH
*PA
05/2012
Therapy Class
121212
DIN
Drug Name
ALPHA & BETA-ADRENERGIC AGONISTS
Chemical Name
Strength
Dosage
121212
121212
121212
121212
121212
121212
121212
121212
121212
121212
121212
121212
00155357
00155365
00304077
00304069
02178893
00509558
00578657
02063204
00710814
00721891
02268205
02247310
ADRENALIN CHLORIDE SOL 1:1000
ADRENALIN CHLORIDE SOL 1:1000
EPHEDRINE TAB 15MG
EPHEDRINE TAB 30MG
EPI E.Z. PEN INJ 1:1000
EPI PEN INJ 1:1000 0.3ML
EPI PEN JR INJ 0.5MG/ML
EPINEPHRINE 1MG/ML INJ
EPINEPHRINE INJ 0.1MG/ML USP B
EPINEPHRINE INJ 1MG/ML USP
TWINJECT 0.15MG INJ
TWINJECT 0.3MG INJ
EPINEPHRINE HCL
EPINEPHRINE HCL
EPHEDRINE SULFATE
EPHEDRINE SULFATE
EPINEPHRINE
EPINEPHRINE
EPINEPHRINE
EPINEPHRINE
EPINEPHRINE
EPINEPHRINE
EPINEPHRINE
EPINEPHRINE
1MG/ML
1MG/ML
15MG
30MG
0.3MG/.3ML
1MG/ML
0.5MG/ML
1MG/ML
0.1MG/ML
1MG/ML
0.15MG
0.3MG
INJ
LIQ
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
50
*PA
05/2012
Therapy Class
121600
DIN
Drug Name
SYMPATHOLYTIC (ADRENERGIC BLOCKING) AGENTS
Chemical Name
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
121604
02322900
02315866
02362406
02364395
02366231
00176141
00176095
00027243
02241163
00156086
02270102
00116858
00176176
02352419
02228947
02317494
02298570
02243737
02242411
02294885
02294265
09857334
02242979
02304678
02319217
02340208
02295121
02331780
02349450
02314282
02281392
02368242
02333333
02245565
ACCEL‐TAMSULOSIN 0.4MG ER CAP
APO‐ALFUZOSIN ER 10MG TAB
APO‐TAMSULOSIN CR 0.4MG TAB
AVA‐ALFUZOSIN 10MG TAB
AVA‐TAMSULOSIN CR 0.4MG TAB
BELLERGAL SPACETABS
CAFERGOT TAB
DIHYDROERGOTAMINE 1MG/ML INJ
DIHYDROERGOTAMINE 1MG/ML INJ
ERGODRYL CAP
FLOMAX CR 0.4MG TAB
GRAVERGOL CAP
HYDERGINE 1MG TAB
JAMP‐TAMSULOSIN 0.4MG ER CAP
MIGRANAL 4MG/ML NASAL SPRAY
MINT‐TAMSULOSIN 0.4MG ER CAP
MYLAN‐TAMSULOSIN 0.4MG CAP
PHENTOLAMINE MESYLATE 5MG/ML I
PMS‐DIHYDROERGOTAMINE 4MG/ML
RAN‐TAMSULOSIN 0.4MG ER CAP
RATIO‐TAMSULOSIN 0.4MG ER CAP
RATIO‐TAMSULOSIN 0.4MG ER CAP
ROGITINE 10MG/ML INJ
SANDOZ ALFUZOSIN 10MG TAB
SANDOZ TAMSULOSIN 0.4MG CAP
SANDOZ TAMSULOSIN 0.4MG CR
SANDOZ TAMSULOSIN 0.4MG ER CAP
TAMSULOSIN 0.4MG ER CAP
TAMSULOSIN 0.4MG ER CAP
TEVA‐ALFUZOSIN PR 10MG TAB
TEVA‐TAMSULOSIN 0.4MG ER CAP
TEVA‐TAMSULOSIN CR 0.4MG TAB
UFLO 0.4MG ER CAP
XATRAL PR 10MG TAB
TAMSULOSIN HCL
0.4MG
ALFUZOSIN HCL
10MG
TAMSULOSIN HYDROCHLORIDE
0.4MG
ALFUZOSIN HCL
10MG
0.4MG
BELLADONNA/ERGOTAMINE/PHENOBAR0.2/0.6/40
CAFFEINE/ERGOTAMINE TARTRATE
DIHYDROERGOTAMINE MESYLATE
1MG/ML
1MG/ML
ERGOTAMINE COMPOUND HF
100MG
TAMSULOSIN HCL
0.4MG
ERGOTAMINE COMPOUND
ERGOLOID MESYLATES
1MG
TAMSULOSIN HCL
0.4MG
4MG/ML
TAMSULOSIN HCL
0.4MG
0.4MG
PHENTOLAMINE MESYLATE
5MG/ML
4MG/ML
TAMSULOSIN HCL
0.4MG
TAMSULOSIN HCL
0.4MG
TAMSULOSIN HCL
0.4MG
10MG/ML
ALFUZOSIN HCL
10MG
TAMSULOSIN HCL
0.4MG
TAMSULOSIN HCL
0.4MG
0.4MG
TAMSULOSIN HCL
TAMSULOSIN HCL
0.4MG
TAMSULOSIN HCL
0.4MG
ALFUZOSIN HCL
10MG
TAMSULOSIN HCL
0.4MG
TAMSULOSIN HCL
0.4MG
TAMSULOSIN HCL
0.4MG
ALFUZOSIN HCL
10MG
51
Strength
Dosage
*PA
CAP LA
TAB LA
TAB LA
TAB
TAB LA
TAB
TAB
INJ
INJ
CAP
TAB LA
CAP
TAB
CAP LA
NAS SPR
CAP LA
CAP LA
INJ
NAS SOL
CAP LA
CAP LA
CAP LA
INJ
TAB LA
CAP
TAB LA
CAP LA
CAP LA
CAP LA
TAB
CAP LA
TAB LA
CAP LA
TAB LA
05/2012
Therapy Class
122004
DIN
Drug Name
CENTRALLY ACTING SKELETAL MUSCLE RELAXANTS
Chemical Name
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
122004
02177145
02259885
02259893
02348853
02363690
02287064
02325195
02340984
02238633
02272040
02357127
02237275
01966375
02231353
02272059
02080052
02171848
02220644
02249359
02212048
02370913
02236506
02242079
00443387
01934791
00172421
01934783
02245328
02239170
02383578
APO‐CYCLOBENZAPRINE 10MG TAB
APO‐TIZANIDINE 2MG TAB
APO‐TIZANIDINE 4MG TAB
AURO‐CYCLOBENZAPRINE 10MG TAB
AVA‐CYCLOBENZAPRINE 10MG TAB
CYCLOBENZAPRINE 10MG TAB
CYCLOBENZAPRINE 10MG TAB
CYCLOBENZAPRINE HCL 10MG TAB
DOM‐CYCLOBENZAPRINE 10MG TAB
GEN‐TIZANIDINE 2MG TAB
JAMP‐CYCLOBENZAPRINE 10MG TAB
MED‐CYCLOBENZAPRINE 10MG TAB
METHOXISAL C1/2 CAP
MYLAN‐CYCLOBENZAPRINE 10MG TAB
MYLAN‐TIZANIDINE 4MG TAB
NOVO‐CYCLOPRINE 10MG TAB
NU‐CYCLOBENZAPRINE 10MG TAB
PDL‐CYCLOBENZAPRINE 10MG TAB
PHL‐CYCLOBENZAPRINE 10MG TAB
PMS‐CYCLOBENZAPRINE 10MG TAB
Q‐CYCLOBENZAPRINE 10MG TAB
RATIO‐CYCLOBENZAPRINE 10MG TAB
RIVA‐CYCLOPRINE 10MG TAB
ROBAXISAL C1/2 TAB
ROBAXISAL C1/2 TAB
ROBAXISAL C‐1/4 TAB
ROBAXISAL C‐1/4 TAB
ZANAFLEX 2MG TAB
ZANAFLEX 4MG TAB
ZYM‐CYCLOBENZAPRINE 10MG TAB
CYCLOBENZAPRINE HCL
10MG
TIZANIDINE
2MG
TIZANIDINE HCL
4MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
TIZANIDINE HCL
2MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
METHOCARBAMOL/ASA/CODEINE
325MG
CYCLOBENZAPRINE HCL
10MG
TIZANIDINE HCL
4MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
CYCLOBENZAPRINE HCL
10MG
METHOCARBAMOL/ASA/CODEINE PHOS
METHOCARBAMOL/ASA/CODEINE PHOS1/2G
METHOCARBAMOL/ASA/CODEINE PHOS1/4GR
METHOCARBAMOL/ASA/CODEINE PHOS1/4GR
TIZANIDINE HCL
2MG
TIZANIDINE HCL
4MG
CYCLOBENZAPRINE HCL
10MG
52
Strength
Dosage
*PA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
05/2012
Therapy Class
122008
DIN
Drug Name
DIRECT-ACTING SKELETAL MUSCLE RELAXANTS
122008
122008
01997653 DANTRIUM CAP 100MG
01997602 DANTRIUM CAP 25MG
53
Chemical Name
Strength
Dosage
DANTROLENE SODIUM
DANTROLENE SODIUM
100MG
25MG
CAP
CAP
*PA
05/2012
Therapy Class
122012
DIN
Drug Name
GABA-DERIVATIVE SKELETAL MUSCLE RELAXANTS
Chemical Name
Strength
Dosage
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
122012
00808520
00849456
02139332
02139391
02340895
02340909
02363569
02371413
02363577
02371421
02287021
02287048
02244644
02244645
02138271
02138298
00455881
00636576
02088398
02088401
02136090
02136104
02152584
02152592
02239075
02239076
02236963
02236964
02063735
02063743
02236507
02236508
02242150
02242151
ALPHA‐BACLOFEN TAB 10MG
ALPHA‐BACLOFEN TAB 20MG
APO‐BACLOFEN 10MG TAB
APO‐BACLOFEN 20MG TAB
APX‐BACLOFEN 10MG TAB
APX‐BACLOFEN 20MG TAB
AVA‐BACLOFEN 10MG TAB
BACLOFEN 10MG TAB
BACLOFEN 20MG TAB
CO BACLOFEN 10MG TAB
CO BACLOFEN 20MG TAB
DOM‐BACLOFEN 10MG TAB
DOM‐BACLOFEN 20MG TAB
LIORESAL 10MG TAB
LIORESAL DS 20MG TAB
MYLAN‐BACLOFEN TAB 10MG
MYLAN‐BACLOFEN TAB 20MG
NU‐BACLO 10MG TAB
NU‐BACLO 20MG TAB
PDL‐BACLOFEN 10MG TAB
PDL‐BACLOFEN 20MG TAB
PENTA‐BACLOFEN 10MG TAB
PENTA‐BACLOFEN 20MG TAB
PHL‐BACLOFEN 10MG TAB
PHL‐BACLOFEN 20MG TAB
PMS‐BACLOFEN 10 MG TAB
PMS‐BACLOFEN 20MG TAB
RATIO‐BACLOFEN 10MG TAB
RATIO‐BACLOFEN 20MG TAB
RIVA‐BACLOFEN 10MG TAB
RIVA‐BACLOFEN 20MG TAB
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
BACLOFEN
10MG
20MG
10MG
20MG
10MG
20MG
10MG
10MG
20MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
10 MG
20 MG
10MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
54
*PA
05/2012
Therapy Class
200404
DIN
Drug Name
IRON PREPARATIONS
200404
200404
200404
02205963 DEXIRON 50MG/ML INJ
02221780 INFUFER 50MG/ML INJ
00391867 TRINSICON CAP
55
Chemical Name
Strength
Dosage
IRON DEXTRAN
IRON DEXTRAN
IRON/B12
50MG/ML
50MG/ML
INJ
INJ
CAP
*PA
05/2012
Therapy Class
200408
DIN
Drug Name
LIVER AND STOMACH PREPARATIONS
200408
00504572 LIVER EXTRACT INJ CRUDE 2MG/ML
56
Chemical Name
Strength
Dosage
LIVER INJECTION
2MG/ML
INJ
*PA
05/2012
Therapy Class
201204
DIN
Drug Name
ANTICOAGULANTS
Chemical Name
Strength
Dosage
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
02242929
02242924
02242926
02242925
02245618
02242927
02242928
02258056
02245531
02229544
02229545
01918362
01918311
01918346
01918338
02240205
02007959
01918354
02240206
00585637
00861634
00585645
00585629
02377233
02152460
02352656
96599988
02352664
96599987
02352672
96599986
02352680
96599985
02231171
02377454
96599990
02352648
96599989
02132621
02132648
02132664
02236913
02240114
00740535
00562289
00581224
00562270
00727520
00579718
00453811
00453781
00640468
00725323
00725315
02303094
02303108
02303086
02264307
02264315
00691909
02231478
02167840
02229515
09857367
99100530
02229755
02152517
02142460
02152487
02152479
02152495
02152509
02245817
02245818
02378442
02378442
02236564
02012472
02236883
02378426
APO‐WARFARIN 10MG TAB
APO‐WARFARIN 2.5MG TAB
APO‐WARFARIN 3MG TABLET
ARIXTRA 12.5MG/ML
ARIXTRA INJECTION 2.5MG/O.5ML
CLIVARINE 1750U/0.25ML INJ
CLIVARINE 4200U/0.6ML INJ
COUMADIN 10MG TAB
COUMADIN 1MG TAB
COUMADIN 2.5 MG TAB
COUMADIN 2MG TAB
COUMADIN 3MG TAB
COUMADIN 4MG TAB
COUMADIN 5MG TAB
COUMADIN 6MG TAB
COUMADIN TAB 10MG
COUMADIN TAB 1MG
COUMADIN TAB 2.5MG
COUMADIN TAB 5MG
ELIQUIS 2.5MG TAB
ENDO WARFARIN 1MG TA
FRAGMIN 10000U/0.4ML SYRINGE
FRAGMIN 25000UNIT/ML INJ
FRAGMIN 2500UNIT/ML INJ
FRAGMIN SOL & PREFILL SYRINGE
FRAXIPARINE 9500IU/VIAL
FRAXIPARINE FORTE 19,000U/ML
HEPALEAN
HEPALEAN LOW DOSE INJ 5000UNIT
HEPARIN AMP 100U
HEPARIN INJ 10000UNIT/ML(BEEF
HEPARIN LEO 100UNIT/ML INJ
HEPARIN LEO INJ 10000UNIT/ML
HEPARIN LOCK FLUSH SOL INJ 10U
HEPARIN LOCKFLUSH INJ 10U/ML
HEPARIN LOCKFLUSH SOL INJ 100U
HEPARIN SODIUM 10000U/ML INJ
HEPARIN SODIUM INJ 10000U/ML
HEPARIN SODIUM INJ 1000U/ML
HEPARIN SODIUM INJ USP 25000UN
INNOHEP 10,000 IU/0.5ML INJ
INNOHEP 10,000 IU/ML INJ
INNOHEP 20,000 IU/ML INJ
INNOHEP 2500IU/0.25ML INJ
INNOHEP 2500IU/0.25ML INJ
INNOHEP 3,500IU/0.35ML INJ
LIN WARFARIN 10MG TAB
LIN WARFARIN 2.5MG
LIN WARFARIN 2MG TA
LIN WARFARIN 5MG TA
LIN‐WARFARIN 3MG TAB
LIN‐WARFARIN 6MG TAB
LOVENOX 100MG/1ML INJ
LOVENOX 30MG/0.3ML INJ
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
FONDAPARINUX SODIUM
FONDAPARINUX SODIUM
REVIPARIN SODIUM
REVIPARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
APIXABAN
WARFARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
DALTEPARIN SODIUM
NADROPARIN CALCIUM
NADROPARIN CALCIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
HEPARIN SODIUM
TINZAPARIN SODIUM
TINZAPARIN SODIUM
TINZAPARIN SODIUM
TINZAPARIN SODIUM
TINZAPARIN SODIUM
TINZAPARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
10MG
1MG
2.5MG
2MG
3MG
4MG
5MG
12.5MG/ML
2.5MG/.5ML
1750U/0.25
4200U/.6ML
10MG
1MG
2.5MG
2MG
3MG
4MG
5MG
6MG
10MG
1MG
2.5MG
5MG
2.5MG
1MG
10000/0.4
10000/0.4
12500/0.5
12500/0.5
15000/0.6
15000/0.6
18000/0.72
18000/0.72
25000IU/ML
2500UNIT
5000/0.2
7500/0.3ML
7500/0.3ML
2500/0.2ML
5000/0.2ML
10000IU/ML
9500IU/VL
19000U/VL
25000U/ML
5000IU
100IU
10000IU
100U/ML
10000IU/ML
1000IU/ML
25000IU/ML
10IU/ML
10U/ML
100U/ML
10000U/ML
10000U/ML
1000U/ML
10000U/ML
1000U/ML
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
57
10000IU
10000IU/ML
20000IU/ML
2500IU
2500U/.25M
2500IU
10MG
1MG
2.5MG
2MG
4MG
5MG
3MG
6MG
100MG/1ML
100MG/1ML
300MG/3ML
30MG/0.3ML
40MG/0.4ML
60MG/0.6ML
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
201204
02378426
02378434
02378434
02378469
02378469
02242692
02378450
02378450
02244467
02244462
02244464
02244463
02287498
02244465
02244466
02287501
02287528
02265370
02265273
02265303
02265281
02265311
02265338
02265346
02265354
02265362
02335689
02335611
02335646
02335638
02335654
02335662
02335670
02312441
02358808
02312433
02311135
02311070
02311097
02311089
02311100
02311119
02311127
00010383
00010391
02242687
02242680
02242682
02242681
02242683
02242684
02242685
02242686
02242697
02344114
02344025
02344041
02344033
02344068
02344076
02344084
02344092
02344106
02242889
02242881
02242883
02242882
02242884
02242885
02242886
02242887
02242888
02316986
02378604
02378612
LOVENOX HP 150MG/1ML INJ
LOVENOX HP 150MG/1ML INJ
LOVENOX HP 150MG/ML INJ
LOVENOX HP 90MG/0.6ML INJ
LOVENOX HP 90MG/0.6ML INJ
MYLAN‐WARFARIN 10MG TAB
MYLAN‐WARFARIN 2.5MG TAB
MYLAN‐WARFARIN 7.5MG TAB
NOVO‐WARFARIN 10MG TAB
NOVO‐WARFARIN 2.5MG TAB
NOVO‐WARFARIN 7.5MG TAB
NU‐WARFARIN 10MG TAB
NU‐WARFARIN 2.5MG TAB
PRADAX 110MG CAP
PRADAX 150MG CAP
PRADAX 75MG CAP
PRO‐WARFARIN 10MG TAB
PRO‐WARFARIN 2.5MG TAB
SINTROM 1MG TAB
SINTROM 4 MG TAB
TARO‐WARFARIN 10MG TAB
TARO‐WARFARIN 2.5MG TAB
WARFARIN 10MG TAB
WARFARIN 1MG TAB
WARFARIN 2.5MG TAB
WARFARIN 2MG TAB
WARFARIN 3MG TAB
WARFARIN 4MG TAB
WARFARIN 5MG TAB
WARFARIN 6MG TAB
WARFARIN 7.5MG TAB
WARX 10MG TAB
WARX 1MG TAB
WARX 2.5MG TAB
WARX 2MG TAB
WARX 3MG TAB
WARX 4MG TAB
WARX 5MG TAB
WARX 6MG TAB
WARX 7.5MG TAB
XARELTO 10MG TAB
XARELTO 15MG TAB
XARELTO 20MG TAB
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
ENOXAPARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
DABIGATRAN ETEXILATE MESILATE
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
NICOUMALONE
NICOUMALONE
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
WARFARIN SODIUM
RIVAROXABAN
RIVAROXABAN
RIVAROXABAN
60MG/0.6ML
80MG/0.8ML
80MG/0.8ML
150MG/1ML
150MG/1ML
150MG/ML
90MG/0.6ML
90MG/0.6ML
10MG
1MG
2.5MG
2MG
3MG
4MG
5MG
6MG
7.5MG
10MG
1MG
2.5MG
2MG
3MG
4MG
5MG
6MG
7.5MG
10MG
1MG
2.5MG
2MG
3MG
4MG
5MG
110MG
150MG
75MG
10MG
1MG
2.5MG
2MG
3MG
4MG
5MG
1MG
4MG
10MG
1MG
2.5MG
2MG
3MG
4MG
5MG
6.0MG
7.5MG
10MG
1MG
2.5MG
2MG
3MG
4MG
5MG
6MG
7.5MG
10MG
1MG
2.5MG
2MG
3MG
4MG
5MG
6MG
7.5MG
10MG
15MG
20MG
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
58
*PA
05/2012
Therapy Class
201214
DIN
Drug Name
PLATELET-REDUCING AGENTS
Chemical Name
Strength
Dosage
201214
201214
201214
201214
201214
201214
201214
201214
02236859
02236860
02283344
02281287
02253054
02281155
02274949
02260107
AGRYLIN 0.5MG CAP
AGRYLIN 1MG CAP
ANAGRYD 0.5MG CAP
DOM‐ANAGRELIDE 0.5MG CAP
MYLAN‐ANAGRELIDE 0.5MG CAP
PHL‐ANAGRELIDE 0.5MG CAP
PMS‐ANAGRELIDE 0.5MG CAP
SANDOZ‐ANAGRELIDE 0.5MG CAP
ANAGRELIDE HCL
ANAGRELIDE HCL
ANAGRELIDE HCL MONOHYDRATE
ANAGRELIDE HCL
ANAGRELIDE HCL
0.5MG
1MG
0.5MG
0.5MG
0.5MG
0.5MG
0.5MG
0.5MG
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
59
*PA
05/2012
Therapy Class
201218
DIN
Drug Name
PLATELET-AGGREGATION INHIBITORS
Chemical Name
Strength
Dosage
201218
201218
201218
201218
201218
201218
201218
201218
201218
201218
201218
201218
201218
201218
201218
201218
201218
02252767
02237701
02368544
02303027
02243808
02349124
02241006
02351536
02239744
02237560
02238682
02348004
02375583
02359316
02293161
02236848
02343045
APO‐CLOPIDOGREL 75MG TAB
APO‐TICLOPIDINE 250MG TAB
BRILINTA 90MG TAB
CO CLOPIDOGREL 75MG TAB
DOM‐TICLOPIDINE 250MG TAB
EFFIENT 10MG TAB
MED‐TICLOPIDINE 250MG TAB
MYLAN‐CLOPIDOGREL 75MG TAB
MYLAN‐TICLOPIDINE 250MG TAB
NU‐TICLOPIDINE 250MG
PLAVIX 75MG TAB
PMS‐CLOPIDOGREL 75MG TAB
Q‐CLOPIDOGREL 75MG TAB
SANDOZ CLOPIDOGREL 75MG TAB
TEVA‐CLOPIDOGREL 75MG TAB
TEVA‐TICLOPIDINE 250MG TAB
TICLOPIDINE 250MG TAB
CLOPIDOGREL BISULFATE
TICLOPIDINE HCL
TICAGRELOR
TICLOPIDINE HCL
PRASUGREL HCL
TICLOPIDINE HCL
TICLOPIDINE HCL
TICLOPIDINE HCL
CLOPIDOGREL
TICLOPIDINE HCL
TICLOPIDINE HCL
75MG
250MG
90MG
75MG
250MG
10MG
250MG
75MG
250MG
250MG
75MG
75MG
75MG
75MG
75MG
250MG
250MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
60
*PA
05/2012
Therapy Class
201600
DIN
Drug Name
HEMATOPOIETIC AGENTS
Chemical Name
Strength
Dosage
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
201600
02246358
02246354
02246360
02246355
02246351
02246359
02246347
02246357
02246356
02231583
02231587
02126591
02003074
01923854
02206072
02231584
02003058
02126575
02231585
02288680
02231586
02126583
02003066
02240722
02243400
02243401
02243403
02231051
02243239
02230921
02230922
02230923
02230924
02249790
01968017
09853464
02322854
02322862
02242895
02242901
02242898
02242900
02242896
02242902
02242897
02242899
02242894
02361825
02361833
ARANESP 100MCG/0.5ML SOL
ARANESP 325MCG/ML SOL
EPREX 1,000 IU/0.5ML INJ
EPREX 10,000 IU/ML INJ
EPREX 10,000 U/ML INJ
EPREX 10000 IU/ML INJ
EPREX 1ML INJ
EPREX 2000 IU/0.5ML INJ
EPREX 2000 U/ML INJ
EPREX 2000 U/ML INJ
EPREX 30000IU/0.75ML INJ
EPREX 4,000 IU/0.4ML INJ
EPREX 4,000 U/ML INJ
EPREX 40,000IU/ML IV SOL
EPREX STERILE SOL
EPREX STERILE SOLUTION 20000
LEUCOMAX 150MCG/VIAL INJ
NEULASTA 10MG/ML INJ
NEUPOGEN 300MCG/ML INJ
NEUPOGEN 480MCG/1.6ML INJ (ON)
NPLATE 250MCG/0.5ML INJ
NPLATE 500MCG/ML INJ
RECORMON 1,000 U/KIT INJ
RECORMON 10,000 U CARTR INJ
RECORMON 20,000 U CARTR INJ
RECORMON 500 U/KIT INJ
REVOLADE 25MG TAB
REVOLADE 50MG TAB
DARBEPOETIN ALFA
DARBEPOETIN ALFA
DARBEPOETIN ALFA
DARBEPOETIN ALFA
DARBEPOETIN ALFA
DARBEPOETIN ALFA
DARBEPOETIN ALFA
DARBEPOETIN ALFA
DARBEPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
ERYTHROPOETIN
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
EPOETIN ALFA
MOLGRAMOSTIM
MOLGRAMOSTIM
MOLGRAMOSTIM
MOLGRAMOSTIM
PEGFILGRASTIM
FILGRASTIM
FILGRASTIM
ROMIPLOSTIM
ROMIPLOSTIM
EPOETIN BETA
EPOETIN BETA
EPOETIN BETA
EPOETIN BETA
EPOETIN BETA
EPOETIN BETA
EPOETIN BETA
EPOETIN BETA
EPOETIN BETA
ELTROMBOPAG OLAMINE
ELTROMBOPAG OLAMINE
200MCG/ML
10MCG/0.4M
500MCG/ML
20MCG/0.5M
325MCG/ML
325MCG/ML
40MCG/ML
100MCG/ML
60MCG/ML
1000IU
10000 IU
10000 U/ML
10000 IU
2000IU
20,000U/ML
2000 IU
2000U
2000 U/ML
3000 IU
30000/0.75
4000IU
4000 U/ML
4000U/ML
40000IU/ML
5000IU/0.5
6000IU/0.6
8000IU
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
61
20000U/0.5
150MCG/VIA
300MCG/VIA
400MCG/VIA
700MCG/VIA
10MG/ML
300MCG/ML
480MCG/1.6
250MCG/.5M
500MCG/ML
1,000 U
10,000 U
10,000 U
100,000 U
2,000 U
20,000 U
5,000 U
50,000 U
500 U
25MG
50MG
*PA
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
202400
DIN
Drug Name
HEMORRHEOLOGIC AGENTS
Chemical Name
Strength
Dosage
202400
202400
202400
202400
02230090
02230401
02243879
02221977
APO‐PENTOXIFYLLINE SR 400MG TA
NU‐PENTOXIFYLLINE SR 400MG TAB
PENTOXIFYLLINE 400MG ER TAB
TRENTAL 400MG SR TAB
PENTOXIFYLLINE
PENTOXIFYLLINE
PENTOXIFYLLINE
PENTOXIFYLLINE
400MG
400MG
400MG
400MG
TAB LA
TAB LA
TAB LA
TAB LA
62
*PA
05/2012
Therapy Class
202816
DIN
Drug Name
HEMOSTATICS
202816
202816
02064405 CYKLOKAPRON 500MG TAB
02010372 CYKLOKAPRON TAB 500MG
63
Chemical Name
Strength
Dosage
TRANEXAMIC ACID
TRANEXAMIC ACID
500MG
500MG
TAB
TAB
*PA
05/2012
Therapy Class
240404
DIN
Drug Name
ANTIARRHYTHMIC AGENTS
Chemical Name
Strength
Dosage
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
240404
02349140
02349132
02300885
02287056
02300893
02335115
02364336
02246194
00713325
00713333
00713341
02243324
02243325
02364263
02036282
02294508
02246331
02275546
02275538
02243631
02243632
02241002
02240604
02245372
02245373
02030821
02230359
02230360
02361280
02336421
02249480
02294516
02245781
02292173
02242472
02243727
02294559
02243728
02294575
02309661
00638692
00638676
00638684
00688630
02243783
02343053
02243784
02343061
02240071
02247217
02224801
02224828
02224836
00603708
00603716
02251485
02251493
02251507
02243836
02243347
00628220
01966200
00817147
01966197
02239835
AA‐FLECAINIDE 100MG TAB
AA‐FLECAINIDE 50MG TAB
AMIODARONE 100MG TAB
APO‐AMIODARONE 200MG TAB
APO‐PROCAINAMIDE 250MG CAP
APO‐PROPAFENONE 150MG TAB
APO‐PROPAFENONE 300MG TAB
AVA‐AMIODARONE 200MG TAB
CORDARONE TAB 200MG
DOM‐AMIODARONE 100MG TAB
DOM‐AMIODARONE 200MG TAB
FLECAINIDE 100MG TAB
FLECAINIDE 50MG TAB
GEN‐PROPAFENONE 150MG TAB
GEN‐PROPAFENONE 300MG TAB
MED‐AMIODARONE 200MG TAB
MYLAN‐AMIODARONE 200MG TAB
MYLAN‐PROPAFENONE 150MG FC TAB
MYLAN‐PROPAFENONE 300MG FC TAB
NORPACE 150MG CAP
NOVO‐MEXILETINE 100MG CAP
NOVO‐MEXILETINE 200MG CAP
NTP‐AMIODARONE 200MG TAB
NU‐AMIODARONE 200MG TAB
NU‐PROPAFENONE 150MG TAB
PHL‐AMIODARONE 100MG TAB
PHL‐AMIODARONE 200MG TAB
PMS‐AMIODARONE 100MG TAB
PMS‐AMIODARONE 200MG TAB
PMS‐PROPAFENONE 150MG TAB
PRO‐AMIODARONE‐200 200MG TAB
PROCAN SR 250MG
PROCAN SR 500MG
PROCAN SR 750MG
PROCAN SR TAB 1000MG
PROPAFENONE 150MG TAB
RATIO‐AMIODARONE 200MG TAB
RIVA‐AMIODARONE 200MG TAB
RYTHMODAN 100MG CAP
RYTHMODAN 150MG CAP
RYTHMODAN LA 250MG TAB
RYTHMOL 150MG TAB
RYTHMOL 300MG TAB
RYTHMOL SR 225MG CAP
SANDOZ‐AMIODARONE 200MG TAB
SCHEINPHARM AMIODARONE 200MG
TAMBOCOR 100MG TAB
TAMBOCOR 100MG TAB
TAMBOCOR 50MG TAB
TAMBOCOR 50MG TAB
TEVA‐AMIODARONE 200MG TAB
FLECAINIDE ACETATE
FLECAINIDE ACETATE
AMIODARONE HCL
AMIODARONE HCL
AMIODARONE HCL
AMIODARONE HCL
AMIODARONE HCL
AMIODARONE HCL
PROCAINAMIDE HCL
PROCAINAMIDE HCL
PROCAINAMIDE HCL
PROPAFENONE HCL
PROPAFENONE HCL
AMIODARONE HCL
AMIODARONE HCL
AMIODARONE HCL
AMIODARONE HYDROCHLORIDE
FLECAINIDE ACETATE
FLECAINIDE ACETATE
PROPAFENONE HCL
PROPAFENONE HCL
AMIODARONE HCL
AMIODARONE HCL
PROPAFENONE HCL
PROPAFENONE HCL
DISOPYRAMIDE
MEXILETINE HCL
MEXILETINE HCL
AMIODARONE HCL
AMIODARONE HCL
PROPAFENONE HCL
AMIODARONE HCL
AMIODARONE HCL
AMIODARONE HCL
AMIODARONE HCL
PROPAFENONE HCL
PROPAFENONE HCL
PROPAFENONE HCL
PROPAFENONE HCL
AMIODARONE HCL
PROCAINAMIDE HCL
PROCAINAMIDE HCL
PROCAINAMIDE HCL
PROCAINAMIDE
PROPAFENONE HCL
PROPAFENONE
PROPAFENONE HCL
PROPAFENONE
AMIODARONE HCL
AMIODARONE HCL
DISOPYRAMIDE
DISOPYRAMIDE
DISOPYRAMIDE PHOSPHATE
PROPAFENONE HCL
PROPAFENONE HCL
PROPAFENONE HCL
PROPAFENONE HCL
PROPAFENONE HCL
AMIODARONE HCL
AMIODARONE HCL
FLECAINIDE ACETATE
FLECAINIDE ACETATE
FLECAINIDE ACETATE
FLECAINIDE ACETATE
AMIODARONE HCL
100MG
50MG
100MG
200MG
200MG
200MG
200MG
200MG
250MG
375MG
500MG
150MG
300MG
200MG
200MG
100MG
200MG
100MG
50MG
150MG
300MG
200MG
200MG
150MG
300MG
150MG
100MG
200MG
200MG
200MG
150MG
100MG
200MG
100MG
200MG
150MG
150MG
300MG
300MG
200MG
250MG
500MG
750MG
1000MG
150MG
150MG
300MG
300MG
200MG
200MG
100MG
150MG
250MG
150MG
300MG
225MG
325MG
425MG
200MG
200MG
100MG
100MG
50MG
50MG
200MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB LA
TAB
TAB
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
64
*PA
05/2012
Therapy Class
240408
DIN
Drug Name
CARDIOTONIC AGENTS
240408
240408
240408
02335700 TOLOXIN 0.0625MG TAB
65
Chemical Name
Strength
Dosage
DIGOXIN
DIGOXIN
DIGOXIN
0.0625MG
0.125MG
0.250MG
TAB
TAB
TAB
*PA
05/2012
Therapy Class
240604
DIN
Drug Name
BILE ACID SEQUESTRANTS
Chemical Name
Strength
Dosage
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
240604
02236969
02259265
02236970
02132680
02132699
00642975
02137461
02137453
02154374
99000156
00999968
99000148
00999967
00890960
02210320
02259257
02237132
02259249
02237133
02125463
CHOLESTYRAMINE 4G/5G PWR
COLESTID 1G TAB
COLESTID GRANULES
COLESTID GRANULES 5G/SACHET
DOM‐CHOLESTYRAMINE 4G/5G
DOM‐CHOLESTYRAMINE 4G/PACK
DOM‐CHOLESTYRAMINE 4GM/5GM
NOVO‐CHOLAMINE 4G/SACHET
NOVO‐CHOLAMINE ORAL PWD 4G
NOVO‐CHOLAMINE PD
NOVO‐CHOLAMINE PDR LIGHT 4G
OLESTYR
OLESTYR
PHL‐CHOLESTYRAMINE 400G/CAN
PHL‐CHOLESTYRAMINE 4G/DOSE PWD
PHL‐CHOLESTYRAMINE 4G/DOSE PWR
PHL‐CHOLESTYRAMINE REG 4G/DOSE
PMS‐CHOLESTYRAMINE 80 DOSES
CHOLESTYRAMINE RESIN
COLESTIPOL HCL
COLESTIPOL HCL
COLESTIPOL HCL
4G/5G
4G/5G
4G/9G
1G
5G
5G
4G/5G
4G/PCK
4GM/5GM
4 G/S
4G
4G/S
4G
4 G/S
4 G/S
400G/CAN
4G/DOSE
4G/5G
4G/DOSE
4 G/D
PDR
PDR
PDR
TAB
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
66
*PA
05/2012
Therapy Class
240605
DIN
Drug Name
CHOLESTEROL ABSORPTION INHIBITORS
240605
02247521 EZETROL 10MG TAB
67
Chemical Name
Strength
Dosage
EZETIMIBE
10MG
TAB
*PA
05/2012
Therapy Class
240606
DIN
Drug Name
FIBRIC ACID DERIVATIVES
Chemical Name
Strength
Dosage
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
240606
02379414
02379414
02239864
02243180
02246859
02246860
02246861
01979574
01979582
02341581
02341573
02341549
02364409
02083523
02240337
02251698
02251701
02241608
02230580
02286092
02286084
02356570
02356589
02240360
02273667
02273675
02243642
02269082
02269074
02146959
02241601
02241602
02241027
02237293
02237292
02240210
02185407
02230476
02243552
02243551
02289091
02289083
02241704
02142074
02352370
02352389
02249715
02335875
02058456
02058464
02136031
02136058
02229604
02247489
02251663
02251671
02254859
02254867
02231780
02273551
02251728
02251736
02239951
02230183
02310228
02310236
02310244
02371405
02250039
02250047
02247306
02242126
02288044
02288052
02288060
ACT‐BEZAFIBRATE SR 400MG TAB
ACT‐BEZAFIBRATE SR 400MG TAB
APO‐FENO‐MICRO 200MG CAP
APO‐FENO‐MICRO 67MG CAP
APO‐FENO‐SUPER 100MG TAB
APO‐GEMFIBROZIL 300MG CAP
APO‐GEMFIBROZIL 600MG TAB
APX‐FENO MICRO 200MG CAP
APX‐FENO MICRO 67MG CAP
APX‐FENOFIBRATE 100MG CAP
AVA‐FENOFIBRATE MICRO 200MG
BEZALIP SR 400 MG
DOM‐FENOFIBRATE MICRO 200MG
DOM‐FENOFIBRATE SUPRA 100MG
DOM‐FENOFIBRATE SUPRA 160MG
DOM‐GEMFIBROZIL 300MG CAP
DOM‐GEMFIBROZIL 600MG CAP
FENOFIBRATE MICRO 200MG CAP
FENOFIBRATE MICRO 67MG CAP
FENOFIBRATE‐S 100 MG TAB
FENOFIBRATE‐S 160MG TAB
FENO‐MICRO 200MG CAP
GD‐GEMFIBROZIL 300MG CAP
GD‐GEMFIBROZIL 600MG CAP
GEN‐FENOFIBRATE MICRO 67MG CAP
LIPIDIL EZ 145MG TAB
LIPIDIL EZ 48MG TAB
LIPIDIL MICRO 200MG CAP
LIPIDIL SUPRA 100MG TAB
LIPIDIL SUPRA 160MG TAB
MED‐FENOFIBRATE MICRO 200MG
MED‐GEMFIBROZIL 300MG CAP
MED‐GEMFIBROZIL 600MG CAP
MYLAN‐FENOFIBRATE MICRO 200MG
MYLAN‐GEMFIBROZIL CAP 300MG
MYLAN‐GEMFIBROZIL TAB 600MG
NOVO‐FENOFIBRATE MICRO 200MG
NOVO‐FENOFIBRATE MICRO 67MG
NOVO‐FENOFIBRATE S 160MG TAB
NOVO‐FENOFIBRATE‐S 100MG TAB
NOVO‐GEMFIBROZIL 300MG CAP
NOVO‐GEMFIBROZIL 600MG TAB
NTP‐FENOFIBRATE‐S 100MG TAB
NTP‐FENOFIBRATE‐S 160MG TAB
NU‐FENO‐MICRO 200MG CAP
NU‐FENO‐MICRO 67MG CAP
NU‐GEMFIBROZIL 300 MG CAP
NU‐GEMFIBROZIL 600MG TAB
PDL‐GEMFIBROZIL 300MG CAP
PDL‐GEMFIBROZIL 600MG TAB
PENTA‐GEMFIBROZIL 600MG TAB
PHL‐FENOFIBRATE MICRO 200MG
PHL‐FENOFIBRATE SUPRA 100MG
PHL‐FENOFIBRATE SUPRA 160MG
PHL‐GEMFIBROZIL 300MG CAP
PHL‐GEMFIBROZIL 600MG TAB
PMS‐FENOFIBRATE MICRO 200MG
PMS‐FENOFIBRATE MICRO 200MG C
PMS‐FENOFIBRATE SUPRA 100MG
PMS‐FENOFIBRATE SUPRA 160MG
PMS‐GEMFIBROZIL 300MG CAP
PMS‐GEMFIBROZIL 600MG TAB
PRO‐FENO‐SUPER 100MG TAB
Q‐FENOFIBRATE MICRO 200MG CAP
RATIO‐FENOFIBRATE MC 200MG CAP
RATIO‐FENOFIBRATE MC 67MG CAP
RIVA‐FENOFIBRATE MICRO 200MG
RIVA‐GEMFIBROZIL 600MG TAB
SANDOZ FENOFIBRATE S 100MG TAB
BEZAFIBRATE
BEZAFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
GEMFIBROZIL
GEMFIBROZIL
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
BEZAFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
GEMFIBROZIL
GEMFIBROZIL
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
GEMFIBROZIL
GEMFIBROZIL
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
GEMFIBROZIL
GEMFIBROZIL
FENOFIBRATE
GEMFIBROZIL
GEMFIBROZIL
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
GEMFIBROZIL
GEMFIBROZIL
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
GEMFIBROZIL
GEMFIBROZIL
GEMFIBROZIL
GEMFIBROZIL
GEMBFIROZIL
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
GEMFIBROZIL
GEMFIBROZIL
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
GEMFIBROZIL
GEMFIBROZIL
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
GEMFIBROZIL
FENOFIBRATE
FENOFIBRATE
FENOFIBRATE
400MG
400MG
200MG
67MG
100MG
160MG
200MG
300MG
600MG
200MG
67MG
100MG
200MG
400MG
200MG
100MG
160MG
300MG
600MG
200MG
67MG
100MG
160MG
200MG
300MG
600MG
67MG
145MG
48MG
200MG
100MG
160MG
200MG
300MG
600MG
200MG
300MG
600MG
200MG
67MG
160MG
100MG
300MG
600MG
100MG
160MG
200MG
67MG
300MG
600MG
300MG
600MG
600MG
200MG
100MG
160MG
300MG
600MG
200MG
200MG
100MG
160MG
300MG
600MG
100MG
160MG
200MG
200MG
200MG
67MG
200MG
600MG
100MG
160MG
200MG
TAB
TAB
CAP
CAP
TAB
TAB
TAB
CAP
TAB
CAP
CAP
CAP
CAP
TAB LA
CAP
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
CAP
TAB
TAB
CAP
CAP
CAP
CAP
CAP
TAB
CAP
CAP
TAB
TAB
CAP
TAB
TAB
TAB
CAP
CAP
CAP
TAB
CAP
TAB
TAB
CAP
TAB
TAB
CAP
TAB
CAP
CAP
TAB
TAB
CAP
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
68
*PA
05/2012
Therapy Class
240608
DIN
Drug Name
HMG-COA REDUCTASE INHIBITORS
Chemical Name
Strength
Dosage
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
02349930
02349949
02349957
02349922
02349965
02295261
02295288
02295296
02295318
02243506
02243507
02243508
02337983
02337983
02337991
02337991
02338009
02338009
02337975
02337975
02247012
02247013
02247014
02247011
02247015
02341964
02341972
02341980
02341956
02341999
02348624
02348705
02351757
02348632
02348713
02351765
02348640
02348721
02351773
02348659
02348748
02351781
02346486
02346494
02346508
02346516
02364441
02364468
02364476
02364484
02364417
02379783
02379783
02364425
02379791
02379791
02364433
02379805
02379805
02364026
02364034
02364042
02364018
02364050
02265613
02265621
02265648
02265664
02265672
02265680
02265656
02265699
02310899
02310902
02310910
02310929
02248182
02248183
02248184
02339773
ACCEL‐SIMVASTATIN 10MG TAB
APO‐ATORVASTATIN 10MG TAB
APO‐PRAVASTATIN 10MG TAB
APO‐ROSUVASTATIN 10MG TAB
APO‐SIMVASTATIN TAB 10MG
APX‐SIMVASTATIN 10MG TAB
ATORVASTATIN 10MG TAB
ATORVASTATIN CALCIUM 10MG TAB
AVA‐ATORVASTATIN 10MG TAB
AVA‐PRAVASTATIN 10MG TAB
AVA‐SIMVASTATIN 10MG TAB
BCI PRAVASTATIN 10 TAB
BCI SIMVASTATIN 10MG TAB
CO ATORVASTATIN 10MG TAB
CO PRAVASTATIN 10MG TAB
CO ROSUVASTATIN 10MG TAB
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
ATORVASTATIN CALCIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
ROSUVASTATIN CALCIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
10MG
10MG
20MG
20MG
40MG
40MG
5MG
5MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
5MG
80MG
10MG
10MG
10MG
20MG
20MG
20MG
40MG
40MG
40MG
80MG
80MG
80MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
80MG
10MG
10MG
10MG
20MG
20MG
20MG
40MG
40MG
40MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
10MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
69
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
02339773
02339781
02339781
02339803
02339803
02339765
02339765
02248104
02248105
02248106
02248103
02248107
02247162
02247163
02247164
02265540
02355612
02355620
02355639
02355647
02249723
02249731
02249758
02253755
02281627
02253763
02281635
02253771
02281643
02253747
02281619
02253798
02281651
02288346
02288354
02288362
02288370
02374633
02374641
02374668
02374625
02374676
02330954
02330962
02330970
02375605
02375613
02375621
02375591
02375648
02250527
02230711
02230713
02230714
02243097
02375044
02375052
02375060
02375036
02375079
02317451
02317478
02317486
02372940
02372959
02372967
02372932
02372975
02373203
02373211
02373238
02373246
02257092
02257106
02257114
02381273
02381273
02381281
02381281
02381303
02381303
CO SIMVASTATIN 10MG TAB
CO SIMVASTATIN 5 MG TAB
CRESTOR 10MG TAB
CRESTOR 20MG TAB
CRESTOR 40MG TAB
CRESTOR 5MG TAB
DOM‐ATORVASTATIN 10MG TAB
DOM‐PRAVASTATIN 10MG TAB
DOM‐SIMVASTATIN 10MG TAB
GD‐ATORVASTATIN 10MG TAB
IPG‐SIMVASTATIN 10MG TAB
JAMP‐PRAVASTATIN 10MG TAB
JAMP‐SIMVASTATIN 10MG TAB
LESCOL XL 80MG TAB
LIPITOR 10MG TAB
LIPITOR 20MG TAB
LIPITOR 40MG TAB
LIPITOR 80MG TAB
MAR‐SIMVASTATIN 10MG TAB
MINT‐PRAVASTATIN 10MG TAB
MINT‐SIMVASTATIN 10MG TAB
MYLAN‐ATORVASTATIN 10MG TAB
MYLAN‐PRAVASTIN 10MG TAB
MYLAN‐ROSUVASTATIN 10MG TAB
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
FLUVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
10MG
20MG
20MG
40MG
40MG
5MG
5MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
5MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
10MG
10MG
20MG
20MG
40MG
40MG
5MG
5MG
80MG
80MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
10MG
20MG
40MG
5MG
80MG
80MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
10MG
10MG
20MG
20MG
40MG
40MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
70
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
02381265
02381265
02246583
02246737
02246584
02246582
02246585
02302675
02302683
02302691
02302713
02345730
02345749
02345757
02377292
02377306
02377314
02377284
02377322
02244350
02244351
02244352
02247075
02247076
02247077
02247072
02247078
02253704
02281554
02253712
02281562
02253720
02281570
02253690
02281546
02253739
02281589
02313448
02333724
02313456
02333732
02313464
02333740
02313472
02333759
02247655
02247656
02247657
02378531
02378531
02378558
02378558
02378566
02378566
02378523
02378523
02252635
02269260
02252643
02269279
02252651
02269287
02252619
02269252
02252678
02269295
00893749
00893757
02222051
02272458
02272415
02272466
02272423
02272474
02272431
02249766
02287285
02301792
02332191
02342324
02356546
MYLAN‐SIMVASTATIN 10MG TAB
NOVO‐ATORVASTATIN 10MG TAB
NTP‐PRAVASTATIN 10MG TAB
NTP‐SIMVASTATIN 10MG TAB
NU‐PRAVASTATIN 10MG TAB
NU‐SIMVASTATIN TAB 10MG
PHL‐SIMVASTATIN 10MG TAB
PMS‐ATORVASTATIN 10MG TAB
PMS‐PRAVASTATIN 10MG TAB
PMS‐ROSUVASTATIN 10MG TAB
PMS‐SIMVASTATIN 10MG TAB
PRAVACHOL TAB 10MG
PRAVACHOL TAB 20MG
PRAVACHOL TAB 40MG
PRAVASA 10MG/162MG TAB
PRAVASTATIN 10MG TAB
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM & ASA
PRAVASTATIN SODIUM/ASA
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
5MG
5MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
10MG
20MG
40MG
5MG
80MG
10MG
10MG
20MG
20MG
40MG
40MG
5MG
5MG
80MG
80MG
10MG
10MG
20MG
20MG
40MG
40MG
80MG
80MG
10MG
20MG
40MG
10MG
10MG
20MG
20MG
40MG
40MG
5MG
5MG
10MG
10MG
20MG
20MG
40MG
40MG
5MG
5MG
80MG
80MG
10MG
20MG
40MG
10MG/162MG
10MG/81MG
20MG/162MG
20MG/81MG
40MG/162MG
40MG/81MG
10MG
10MG
10MG
10MG
10MG
10MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
71
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
02249774
02287293
02301806
02332205
02342332
02356554
02249782
02287307
02301814
02332213
02342340
02356562
02340259
02340267
02340275
02243824
02243825
02243826
02376288
02376296
02376318
02376326
02370875
02370891
02370905
02338874
02338882
02338890
02338866
02338904
02313707
02313715
02313723
02313758
02284421
02284448
02284456
02382652
02382660
02382679
02382644
02329158
02329166
02329174
02329131
02329182
02350297
02350319
02350327
02350335
02246930
02246931
02246932
02247068
02247069
02247070
02247067
02247071
02270234
02310759
02270242
02310767
02270250
02310775
02247298
02247299
02247300
02247297
02247301
02381184
02381192
02381206
02381176
02324946
02324954
02324962
02324970
02274507
02274515
02274523
02338734
PRAVASTATIN SODIUM 10MG TAB
PRAVASTATIN‐10 TAB
Q‐GEN ATORVASTATIN 10MG TAB
Q‐PRAVASTATIN 10MG TAB
Q‐SIMVASTATIN 10MG TAB
RAN‐ATORVASTATIN 10MG TAB
RAN‐PRAVASTATIN 10MG TAB
RAN‐ROSUVASTATIN 10MG TAB
RAN‐SIMVASTATIN 10MG TAB
RATIO‐ATORVASTATIN 10MG TAB
RATIO‐PRAVASTATIN 10MG TAB
RATIO‐SIMVASTATIN 10MG TAB
RIVA‐PRAVASTATIN 10MG TAB
RIVA‐SIMVASTATIN 10MG TAB
ROSUVASTATIN 10MG TAB
SANDOZ ATORVASTATIN 10MG TAB
SANDOZ PRAVASTATIN 10MG TAB
SANDOZ ROSUVASTATIN 10MG TAB
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
ATORVASTATIN
ATORVASTATIN
ATORVASTATIN
ATORVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN
20MG
20MG
20MG
20MG
20MG
20MG
40MG
40MG
40MG
40MG
40MG
40MG
10MG
20MG
40MG
10MG
20MG
40MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
10MG
20MG
40MG
5MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
10MG
20MG
40MG
5MG
80MG
10MG
10MG
20MG
20MG
40MG
40MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
5MG
10MG
20MG
40MG
80MG
10MG
20MG
40MG
10MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
72
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
02338734
02338742
02338742
02338750
02338750
02338726
02338726
02247856
02247857
02247858
02247828
02247830
02247831
02247827
02247833
02376059
02376067
02376075
02376040
02376083
02331586
02331594
02331608
02323656
02323664
02323672
02323648
02323680
02247221
02284731
02331985
02342464
02343150
02377640
02379511
02379511
02247222
02284758
02331993
02342472
02343169
02377659
02379538
02379538
02247223
02284766
02332000
02342480
02343177
02377667
02379546
02379546
02247220
02284723
02331969
02342456
02343142
02377632
02379503
02379503
02247224
02284774
02332019
02342499
02343185
02377675
02379554
02379554
02378892
02378892
02378906
02378906
02378914
02378914
02378884
02378884
02378922
02378922
02265885
02265893
02265907
SANDOZ‐PRAVASTATIN 10MG TAB
SANDOZ‐SIMVASTATIN 10MG TAB
SEPTA‐SIMVASTATIN 10MG TAB
SIG‐PRAVASTATIN 10MG TAB
SIG‐SIMVASTATIN 10MG TAB
SIMVASTATIN 10MG TAB
SIMVASTATIN 5MG TAB
SIMVASTATIN 5MG TAB
SIMVASTATIN 5MG TAB
SIMVASTATIN 5MG TAB
SIMVASTATIN 5MG TAB
SIMVASTATIN 5MG TAB
SIMVASTATIN 5MG TAB
SIMVASTATIN 5MG TAB
SIMVASTATIN‐ODAN 10MG TAB
TARO‐SIMVASTATIN 10MG TAB
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
10MG
20MG
20MG
40MG
40MG
5MG
5MG
10MG
20MG
40MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
5MG
80MG
10MG
20MG
40MG
10MG
20MG
40MG
5MG
80MG
10MG
10MG
10MG
10MG
10MG
10MG
10MG
10MG
20MG
20MG
20MG
20MG
20MG
20MG
20MG
20MG
40MG
40MG
40MG
40MG
40MG
40MG
40MG
40MG
5MG
5MG
5MG
5MG
5MG
5MG
5MG
5MG
80MG
80MG
80MG
80MG
80MG
80MG
80MG
80MG
10MG
10MG
20MG
20MG
40MG
40MG
5MG
5MG
80MG
80MG
10MG
20MG
40MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
73
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
240608
02265877
02265915
02247008
02247009
02247010
02354616
02354616
02354624
02354624
02354632
02354632
02354608
02354608
02250152
02250160
02250179
02250144
02250187
02280493
02280507
00884332
00884340
00884324
02240332
00884359
02300915
02300923
02300931
02300907
02300974
TEVA‐PRAVASTATIN 10MG TAB
TEVA‐ROSUVASTATIN 10MG TAB
TEVA‐SIMVASTATIN 10MG TAB
ZIMOSTATINE 20MG TAB
ZIMOSTATINE 40MG TAB
ZOCOR 10MG TAB
ZOCOR 20MG TAB
ZOCOR 5MG TAB
ZOCOR 80MG TAB
ZOCOR TAB 40MG
ZYM‐SIMVASTATIN 10MG TAB
SIMVASTATIN
SIMVASTATIN
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
PRAVASTATIN SODIUM
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
SIMVASTATIN
5MG
80MG
10MG
20MG
40MG
10MG
10MG
20MG
20MG
40MG
40MG
5MG
5MG
10MG
20MG
40MG
5MG
80MG
20MG
40MG
10MG
20MG
5MG
80MG
40MG
10MG
20MG
40MG
5MG
80MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
74
*PA
05/2012
Therapy Class
240692
DIN
Drug Name
MISCELLANEOUS ANTILIPEMIC AGENTS
240692
02091909 LORELCO 250MG TAB
75
Chemical Name
Strength
Dosage
PROBUCOL
250MG
TAB
*PA
05/2012
Therapy Class
240816
DIN
Drug Name
CENTRAL ALPHA-AGONISTS
Chemical Name
Strength
Dosage
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
240816
00868957
00441708
00441716
00360252
00360260
00426830
02360861
02360888
02360896
00291889
00259527
00999330
02361299
02361302
02361310
01908162
01910396
00519251
02247607
02247608
00456020
02304163
02046121
02046148
02358565
02358581
01913786
01913220
00584967
00584975
APO‐CLONIDINE 0.2MG TAB
APO‐METHAZIDE 15MG TAB
APO‐METHAZIDE 25MG TAB
APO‐METHYLDOPA 125MG TAB
AVA‐CLONIDINE 0.025MG TAB
CATAPRES 0.2 TAB
CATAPRES TAB 0.1MG
CLONIDINE 0.025/0.1/0.2MG (NB)
CLONIDINE 0.025MG TAB
CLONIDINE 0.1MG TAB
CLONIDINE 0.2MG TAB
CLONIDINE HCL TAB 0.2MG
CLONIDINE HCL‐0.1 TAB 0.1MG
DIXARIT TAB 0.025MG
DOM‐CLONIDINE 0.1MG TAB
DOM‐CLONIDINE 0.2MG TAB
METHYLDOPA 500MG TAB
NOVO‐CLONIDINE 0.025MG TAB
NTP‐CLONIDINE 0.025MG TAB
NTP‐CLONIDINE 0.1MG TAB
NU‐CLONIDINE 0.1MG TAB
NU‐CLONIDINE 0.2MG TAB
PMS‐DOPAZIDE 15 TAB
PMS‐DOPAZIDE‐25 TAB
CLONIDINE HCL
METHYLDOPA/HCTZ
METHYLDOPA/HCTZ
METHYLDOPA
METHYLDOPA
METHYLDOPA
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
METHYLDOPA
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HYDROCHLORIDE
CLONIDINE HCL
CLONIDINE HCL
CLONIDINE HCL
METHYLDOPA/HCTZ
METHYLDOPA/HCTZ
0.2MG
15MG
250/25MG
125MG
250MG
500MG
0.025MG
0.1MG
0.2MG
0.2MG
0.1MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
76
0.025MG
0.1MG
0.2MG
0.2MG
0.1MG
0.025MG
0.1MG
0.2MG
500MG
0.025MG
0.1MG
0.2MG
0.025MG
0.1MG
0.1MG
0.2MG
*PA
05/2012
Therapy Class
240820
DIN
Drug Name
DIRECT VASODILATORS
Chemical Name
Strength
Dosage
240820
240820
240820
240820
240820
240820
240820
240820
240820
240820
240820
240820
240820
240820
240820
240820
00441619
00441627
00441635
00514500
00514497
00759473
00759481
01913204
02004828
02004836
01913638
02231564
02231565
02231566
00503347
00503339
APO‐HYDRALAZINE 10MG TAB
LONITEN 10MG TAB
LONITEN 2.5MG TAB
NOVO‐HYLAZIN TAB 25MG
NOVO‐HYLAZIN TAB 50MG
NU‐HYDRAL 10MG TAB
PDL‐HYDRALAZINE‐10 TAB 10MG
PMS‐HYDRALAZINE 10MG TAB
PROGLYCEM CAP 100MG
PROGLYCEM CAP 50MG
HYDRALAZINE HCL
HYDRALAZINE HCL
HYDRALAZINE HCL
MINOXIDIL
MINOXIDIL
HYDRALAZINE HCL
HYDRALAZINE HCL
HYDRALAZINE HCL
HYDRALAZINE HCL
HYDRALAZINE HCL
HYDRALAZINE HCL
HYDRALAZINE HCL
HYDRALAZINE HCL
HYDRALAZINE HCL
DIAZOXIDE
DIAZOXIDE
10MG
25MG
50MG
10MG
2.5MG
25MG
50MG
10MG
25MG
50MG
10MG
10MG
25MG
50MG
100MG
50MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
77
*PA
05/2012
Therapy Class
240832
DIN
Drug Name
PERIPHERAL ADRENERGIC INHIBITORS
Chemical Name
Strength
Dosage
240832
240832
240832
240832
00396745
00396753
00005509
00074365
APO‐GUANETHIDINE 10MG TAB
APO‐GUANETHIDINE 25MG TAB
ISMELIN 10MG TAB
ISMELIN ESIDRIX
GUANETHIDINE SULFATE
GUANETHIDINE MONOSULFATE
GUANETHIDINE MONOSULFATE
GUANETHIDINE MONOSULFATE/HCTZ
10MG
25MG
10MG
10MG
TAB
TAB
TAB
TAB
78
*PA
05/2012
Therapy Class
240892
DIN
Drug Name
MISCELLANEOUS HYPOTENSIVE AGENTS
Chemical Name
79
Strength
Dosage
*PA
05/2012
Therapy Class
241208
DIN
Drug Name
NITRATES AND NITRITES
Chemical Name
Strength
Dosage
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
241208
00441686
00441694
00670944
02272830
02125218
00740721
02307758
02126559
02308614
02162806
02163527
02163535
02164337
02243588
00125849
01911910
01911902
01911929
02011271
00860778
01926454
02231441
00695726
00037613
00037621
02307731
02301288
00786667
02311321
02238998
00584223
00852384
02046156
02230732
02230733
02230734
APO‐ISDN 10MG TAB
APO‐ISDN 30MG TAB
APO‐ISDN 5MG SL TAB
APO‐ISMN 60MG SR TAB
CEDOCARD SR 40MG TAB
CEDOCARD‐SR SRT 20MG
DOM‐ISMN 60MG ER TAB
IMDUR 60 MG
ISMN 60MG TAB
MINITRAN 0.2MG/HR PATCH
MINITRAN 72MG/PATCH
MYLAN‐NITRO 0.4MG SUBL SPRAY
NITROCINE 2% OINT
NITRO‐DUR 0.2MG/H DISC
NITRO‐DUR 0.8MG/HR
NITROGLYCERINE 5MG/ML
NITROL OINT 2%
NITROLINGUAL 0.4MG PUMPSPRAY
NITROLINGUAL SPRAY 0.4MG/AEM
NITROSTAT SLT 0.3MG
NITROSTAT SLT 0.6MG
PHL‐ISMN 60MG ER TAB
PMS‐ISMN 60MG ER TAB
PMS‐ISOSORBIDE TAB 10MG
PRO‐ISMN 60MG TAB
RHO‐NITRO PUMPSPRAY 0.4MG SL
TRANSDERM‐NITRO 0.2MG PATCH
TRINIPATCH 22.4MG PATCH
ISOSORBIDE DINITRATE
ISOSORBIDE‐5‐MONONITRATE
ISOSORBIDE
ISOSORBIDE 5‐MONONITRATE
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
NITROGLYCERIN
10MG
30MG
5MG
60MG
40MG
20MG
60MG
60MG
60MG
0.2MG
0.4MG
0.6MG
72MG/PATCH
0.4MG/DOSE
2%
0.2MG
0.4MG
0.6MG
0.8MG
5MG/ML
2%
0.4MG/DOSE
0.4MG
0.3MG
0.6MG
60MG
60MG
10MG
60MG
0.4MG
0.2MG
0.4MG
0.6MG
22.4MG
44.8MG
67.2MG
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB LA
PATCH
PATCH
PATCH
PATCH
SPR
OINT
PATCH
PATCH
PATCH
PATCH
INJ
OINT
SPR
SPR
TAB
TAB
TAB LA
TAB LA
TAB
TAB LA
SPR
PATCH
PATCH
PATCH
PATCH
PATCH
PATCH
80
*PA
05/2012
Therapy Class
241212
DIN
Drug Name
PHOSPHODIESTERASE INHIBITORS
241212
241212
241212
02338327 ADCIRCA 20MG TAB
02319500 RATIO‐SILDENAFIL R 20MG TAB
02279401 REVATIO 20MG TAB
81
Chemical Name
Strength
Dosage
*PA
TADALAFIL
SILDENAFIL CITRATE
SILDENAFIL CITRATE
20MG
20MG
20MG
TAB
TAB
TAB
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
241292
DIN
Drug Name
MISCELLANEOUS VASODILATING AGENTS
Chemical Name
Strength
Dosage
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
241292
02242119
02220571
00895652
00895660
00571245
00601845
00895644
00723444
01926713
00723436
02345706
02345714
02230845
02230848
00009881
02229399
00067393
00452092
00590975
02246555
02246552
02246553
02246554
02244982
02244981
02307073
02307065
AGGRENOX CAP
APO‐DIPYRIDAMOLE 100MG TAB
APO‐DIPYRIDAMOLE FC 50MG TAB
APO‐DIPYRIDAMOLE FC 75MG TAB
APO‐DIPYRIDAMOLE SC 50MG TAB
APO‐DIPYRIDAMOLE SC 75MG TAB
APO‐DIPYRIDAMOLE‐FC TAB 25MG
ARLIDIN TAB 6MG
ARLIDIN TAB 6MG
ARLIDIN‐FORTE TAB 12MG
EPOPROSTENOL 0.5MG INJ
EPOPROSTENOL 1.5MG INJ
FLOLAN 0.5MG INJ
FLOLAN 1.5MG/VIAL INJ
PAPAVERINE HCL INJ 65MG/2ML
PDL‐DIPYRIDAMOLE 100MG TAB
PERSANTINE TAB 50MG
PERSANTINE TAB 75MG
PMS‐NYLIDRIN TAB 6MG
REMODULIN 10MG/ML INJ
REMODULIN 2.5MG/ML INJ
TRACLEER 125MG TAB
TRACLEER 62.5MG TAB
VOLIBRIS 10MG TAB
VOLIBRIS 5MG TAB
ACETYLSAL ACID/DIPYRIDAMOLE
DIPYRIDAMOLE
DIPYRIDAMOLE
DIPYRIDAMOLE
DIPYRIDAMOLE
DIPYRIDAMOLE
DIPYRIDAMOLE
NYLIDRIN
NYLIDRIN HCL
NYLIDRIN HCL
EPOPROSTENOL SODIUM
EPOPROSTENOL SODIUM
EPOPROSTENOL SODIUM
EPOPROSTENOL SODIUM
PAPAVERINE HCL
DIPYRIDAMOLE
DIPYRIDAMOLE
DIPYRIDAMOLE
NYLIDRIN HCL
TREPROSTINIL SODIUM
TREPROSTINIL SODIUM
TREPROSTINIL SODIUM
TREPROSTINIL SODIUM
BOSENTAN
BOSENTAN
AMBRISENTAN
AMBRISENTAN
25MG/200MG
100MG
50MG
75MG
50MG
75MG
25MG
6MG
6MG
12MG
0.5MG
1.5MG
0.5MG
1.5MG
65MG/2ML
100MG
50MG
75MG
6MG
10MG/ML
1MG/ML
2.5MG/ML
5MG/ML
125MG
62.5MG
10MG
5MG
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
82
*PA
05/2012
Therapy Class
242000
DIN
Drug Name
ALPHA-ADRENERGIC BLOCKING AGENTS
Chemical Name
Strength
Dosage
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
02240588
02240589
02240590
00882801
00882828
00882836
02234505
02234502
02234503
02234504
02364549
02364557
02364565
02360950
02360926
02360934
02360942
02231762
01958100
01958097
01958119
02246332
02246333
02246334
02243749
02243746
02243747
02243748
02240978
02342979
02240979
02342987
02240980
02342995
00818674
00818658
00818682
00818666
02241010
02241011
02241012
00560952
00560960
00560979
02240498
02240499
02240500
02242728
02242729
02242730
02346761
02346737
02346745
02346753
01913794
01913808
01913816
02233050
02233047
02233048
02233049
01907158
01910302
01910310
02237479
02237476
02237477
02237478
02246547
02246544
02246545
02246546
02244527
02244528
02244529
02243521
02243518
02243519
02243520
02230440
APO‐DOXAZOSIN 1MG TAB
APO‐PRAZO 1MG TAB
APO‐PRAZO 2MG TAB
APO‐PRAZO 5MG TAB
APO‐TERAZOSIN 10MG TAB
AVA‐DOXAZOSIN 1MG TAB
AVA‐TERAZOSIN 10MG TAB
CARDURA KIT
CARDURA‐1 TAB
CARDURA‐2 TAB
CARDURA‐4 TAB
DOM‐DOXAZOSIN 1MG TAB
DOM‐TERAZOSIN 10MG TAB
DOXAZOSIN 1MG TAB
DOXAZOSIN 1MG TAB
DOXAZOSIN 2MG TAB
DOXAZOSIN 2MG TAB
DOXAZOSIN 4MG TAB
DOXAZOSIN 4MG TAB
HYTRIN TAB 10MG
HYTRIN TAB 1MG
HYTRIN TAB 2MG
HYTRIN TAB 5MG
MED‐DOXAZOSIN 1MG TAB
MINIPRESS TAB 1MG
MINIPRESS TAB 2MG
MINIPRESS TAB 5MG
MYLAN‐DOXAZOSIN 1MG TAB
NOVO‐DOXAZOSIN 1MG TAB
NTP‐TERAZOSIN 10MG TAB
NU‐PRAZO 1MG TAB
NU‐PRAZO 2MG TAB
NU‐PRAZO 5MG TAB
NU‐TERAZOSIN 10MG TAB
PDL‐PRAZOSIN‐1 TAB 1MG
PDL‐TERAZOSIN 10MG TAB
PHL‐TERAZOSIN 10MG TAB
PMS‐DOXAZOSIN 1MG TAB
PMS‐TERAZOSIN 10MG TAB
PRAZOSIN‐RATIOPHARM 1MG TAB
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
PRAZOSIN HCL
PRAZOSIN HCL
PRAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
DOXAZOSIN MESYLATE
DOXAZOSIN
DOXAZOSIN MESYLATE
DOXAZOSIN
DOXAZOSIN MESYLATE
DOXAZOSIN
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
PRAZOSIN HCL
PRAZOSIN HCL
PRAZOSIN HCL
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
PRAZOSIN HCL
PRAZOSIN HCL
PRAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
PRAZOSIN HCL
PRAZOSIN HCL
PRAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN
TERAZOSIN
TERAZOSIN
TERAZOSIN
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
DOXAZOSIN MESYLATE
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
PRAZOSIN HCL
1MG
2MG
4MG
1MG
2MG
5MG
10MG
1MG
2MG
5MG
1MG
2MG
4MG
10MG
1MG
2MG
5MG
1/2/4MG
1MG
2MG
4MG
1MG
2MG
4MG
10MG
1MG
2MG
5MG
1MG
1MG
2MG
2MG
4MG
4MG
10MG
1MG
2MG
5MG
1MG
2MG
4MG
1MG
2MG
5MG
1MG
2MG
4MG
1MG
2MG
4MG
10MG
1MG
2MG
5MG
1 MG
2 MG
5 MG
10MG
1MG
2MG
5MG
1MG
2MG
5MG
10MG
1MG
2MG
5MG
10MG
1MG
2MG
5MG
1MG
2MG
4MG
10MG
1MG
2MG
5MG
1MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
83
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
242000
02230441
02218984
02218941
02218968
02218976
02350505
02350475
02350483
02350491
02341468
02341425
02341433
02341441
02213796
02213753
02213761
02213788
02213818
01934198
01934201
01934228
02230808
02230805
02230806
02230807
PRAZOSIN‐RATIOPHARM 2MG TAB
RATIO‐TERAZOSIN TAB 10MG
TERAZOSIN 10MG TAB
TERAZOSIN 1MG TAB
TERAZOSIN 2MG TAB
TERAZOSIN 5MG TAB
TERAZOSIN HCL 10MG TAB
TERAZOSIN TAB 10MG
TERAZOSIN TAB 1MG
TERAZOSIN TAB 2MG
TERAZOSIN TAB 5MG
TERAZOSIN TAB PACK
TEVA‐PRAZOSIN 1MG TAB
TEVA‐TERAZOSIN 10MG TAB
PRAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
PRAZOSIN HCL
PRAZOSIN HCL
PRAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
TERAZOSIN HCL
2MG
10MG
1MG
2MG
5MG
10MG
1MG
2MG
5MG
10MG
1MG
2MG
5MG
10MG
1MG
2MG
5MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
84
1MG
2MG
5MG
10MG
1MG
2MG
5MG
*PA
05/2012
Therapy Class
242400
DIN
Drug Name
BETA-ADRENERGIC BLOCKING AGENTS
Chemical Name
Strength
Dosage
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
02286025
02286033
02286041
02286246
02286254
02286262
02230438
02230439
02369192
02369176
02369184
02241146
02241147
02147602
02147610
02147629
02248764
02248763
00773697
00773689
02256177
02256134
02247935
02247936
02247933
02247934
00618640
02246010
00618632
02285169
02285177
00751170
00749354
00782475
00782505
00782467
00755885
00755893
00755877
00402788
00504335
00663719
00402753
00402761
02210428
02167794
00755850
00755869
00755842
02341492
02341506
02341514
02340844
02340836
02239605
02282402
02339420
02349809
02351285
02351366
02351269
02351331
02239604
02282399
02339412
02349795
02351277
02351358
02231449
02231448
02363798
02363801
02363828
02363755
02360969
02363747
02363895
02363887
02370751
02370786
ACEBUTOLOL (TYPE S) 100MG TAB
ACEBUTOLOL 100MG TAB
ACEBUTOLOL‐RATIOPHARM 200MG
ACEBUTOLOL‐RATIOPHARM 400MG
AG‐ATENOLOL 100MG TAB
ALTI‐ACEBUTOLOL 200MG TAB
ALTI‐ACEBUTOLOL 400MG TAB
APO‐ACEBUTOLOL 100MG TAB
APO‐ATENIDONE 100MG/25MG TAB
APO‐ATENIDONE 50MG/25MG TAB
APO‐ATENOL 100MG TAB
APO‐ATENOL 50MG TAB
APO‐BISOPROLOL 10MG TAB
APO‐BISOPROLOL 5MG TAB
APO‐CARVEDILOL 12.5MG TAB
APO‐CARVEDILOL 25MG TAB
APO‐METOPROLOL 100MG TAB
APO‐METOPROLOL SR 100MG
APO‐METOPROLOL SR 200MG
APO‐METOPROLOL‐L 100MG TAB
APO‐METOPROLOL‐L 50MG TAB
APO‐NADOL 160MG TAB
APO‐PINDOL 10MG TAB
APO‐PROPRANOLOL 10MG TAB
APO‐SOTALOL 80MG TAB
APO‐SOTALOL TAB 160MG
APO‐TIMOL 10MG TAB
APO‐TIMOL 20MG TAB
APO‐TIMOL 5MG TAB
APX‐ACEBUTOLOL 100MG TAB
APX‐SOTALOL 160MG TAB
APX‐SOTALOL 80MG TAB
ATENOLOL 100MG TAB
ATENOLOL 100MG TAB
ATENOLOL 100MG TAB
ATENOLOL 100MG TAB
ATENOLOL 100MG TAB
ATENOLOL 100MG TAB
ATENOLOL 25MG TAB
ATENOLOL 25MG TAB
ATENOLOL 50MG TAB
ATENOLOL 50MG TAB
ATENOLOL 50MG TAB
ATENOLOL 50MG TAB
ATENOLOL 50MG TAB
ATENOLOL 50MG TAB
ATENOLOL‐RATIOPHARM 100MG TAB
ATENOLOL‐RATIOPHARM 50MG TAB
AVA‐ACEBUTOLOL 100MG TAB
AVA‐ATENOLOL 100MG TAB
AVA‐BISOPROLOL 10MG TAB
AVA‐BISOPROLOL 5MG TAB
AVA‐CARVEDILOL 12.5MG TAB
AVA‐CARVEDILOL 25MG TAB
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ATENOLOL
ATENOLOL
ATENOLOL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ATENOLOL/CHLORTHALIDONE
ATENOLOL
ATENOLOL
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
NADOLOL
NADOLOL
NADOLOL
PINDOLOL
PINDOLOL
PINDOLOL
PROPRANOLOL
PROPRANOLOL
PROPRANOLOL
PROPRANOLOL
PROPRANOLOL
SOTALOL HCL
SOTALOL HCL
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
SOTALOL HCL
SOTALOL HCL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ATENOLOL
ATENOLOL
ATENOLOL
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
CARVEDILOL
CARVEDILOL
100MG
200MG
400MG
100MG
200MG
400MG
200MG
400MG
100MG
25MG
50MG
200MG
400MG
100MG
200MG
400MG
100MG/25MG
50MG/25MG
100MG
50MG
10MG
5MG
12.5MG
25MG
3.125MG
6.25MG
100MG
25MG
50MG
100MG
200MG
100MG
50MG
160MG
40MG
80MG
10MG
15MG
5MG
10MG
120MG
20MG
40MG
80MG
80MG
160MG
10MG
20MG
5MG
100MG
200MG
400MG
160MG
80MG
100MG
100MG
100MG
100MG
100MG
100MG
25MG
25MG
50MG
50MG
50MG
50MG
50MG
50MG
100MG
50MG
100MG
200MG
400MG
100MG
25MG
50MG
10MG
5MG
12.5MG
25MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
85
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
02370735
02370743
02364832
02364824
02364859
02364840
02363682
02363674
02028743
02028727
02028735
00497827
00402540
00402605
02241985
02241986
02241987
02241984
02321572
02334100
02383063
02321556
02334097
02383055
02340879
02344653
02349434
02364948
02340887
02344661
02349442
02364956
02340852
02344637
02349418
02364913
02340860
02344645
02349426
02364921
02255553
02255545
02244643
02244642
02270633
02270625
02155680
02155699
02229468
02229467
02308231
02308223
02248750
02248751
02248748
02248749
02172550
02172569
02231122
02252252
02231121
02235046
02238046
02238047
02231650
02137313
02137356
02137321
02137348
02238635
02238634
02231765
02231766
02231763
02231764
02302055
02057824
02253038
02253011
02042217
00885770
AVA‐METOPROLOL 100MG TAB
AVA‐METOPROLOL 50MG TAB
AVA‐METOPROLOL‐L 100MG TAB
AVA‐METOPROLOL‐L 50MG TAB
AVA‐SOTALOL 160MG TAB
AVA‐SOTALOL 80MG TAB
BETALOC CR 190MG TAB
BETALOC CR 47.5MG TAB
BETALOC CR 95MG TAB
BETALOC DURULES TAB 200MG
BETALOC TAB 100MG
BETALOC TAB 50MG
BIOSOTALOL 160MG TAB
BIOSOTALOL 80MG TAB
BISOPROLOL 10MG TAB
BISOPROLOL 10MG TAB
BISOPROLOL 10MG TAB
BISOPROLOL 5MG TAB
BISOPROLOL 5MG TAB
BISOPROLOL 5MG TAB
CARVEDILOL 12.5MG TAB
CARVEDILOL 25MG TAB
CARVEDILOL 25MG TAB
CARVEDILOL 25MG TAB
CARVEDILOL 25MG TAB
CO ATENOLOL 100MG TAB
CO ATENOLOL 50MG TAB
CO METOPROLOL‐L 100MG TAB
CO METOPROLOL‐L 50MG TAB
CO SOTALOL 160MG TAB
CO SOTALOL 80MG TAB
DILATREND 25MG TAB
DILATREND 50MG TAB
DOM‐ATENOLOL 100MG TAB
DOM‐ATENOLOL 50MG TAB
DOM‐BISOPROLOL 10MG TAB
DOM‐BISOPROLOL 5MG TAB
DOM‐CARVEDILOL 12.5MG TAB
DOM‐CARVEDILOL 25MG TAB
DOM‐METOPROLOL‐B 50MG TAB
DOM‐METOPROLOL‐B 100MG TAB
DOM‐METOPROLOL‐L 100MG TAB
DOM‐PINDOLOL 10MG TAB
DOM‐PROPRANOLOL 10MG TAB
DOM‐SOTALOL 160MG TAB
DOM‐SOTALOL 80MG TAB
EUCARDIC 12.5MG TAB
EUCARDIC 25MG TAB
EUCARDIC 3.125MG TAB
EUCARDIC 6.25MG TAB
GEN‐METOPROLOL (TYPE L) 25MG
GEN‐PINDOLOL 15 MG TAB
GMD‐ATENOLOL 100MG TAB
GMD‐ATENOLOL 50MG TAB
INDERAL 10MG TAB
INDERAL LA 60MG CAP
CARVEDILOL
CARVEDILOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
SOTALOL HCL
SOTALOL HCL
METOPROLOL SUCCINATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
ATENOLOL
ATENOLOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
SOTALOL HCL
SOTALOL HCL
CARVEDILOL
CARVEDILOL
ATENOLOL
ATENOLOL
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
PINDOLOL
PINDOLOL
PINDOLOL
PINDOLOL
PROPRANOLOL
PROPRANOLOL HCL
PROPRANOLOL
PROPRANOLOL
SOTALOL HCL
SOTALOL HCL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
METOPROLOL TARTRATE
PINDOLOL
ATENOLOL
ATENOLOL
PROPANOLOL
PROPRANOLOL
3.125MG
6.25MG
100MG
50MG
100MG
50MG
160MG
80MG
190MG
47.5MG
95MG
200MG
100MG
50MG
160MG
240MG
320MG
80MG
10MG
10MG
10MG
5MG
5MG
5MG
12.5MG
12.5MG
12.5MG
12.5MG
25MG
25MG
25MG
25MG
3.125
3.125MG
3.125MG
3.125MG
6.25MG
6.25MG
6.25MG
6.25MG
100MG
50MG
100MG
50MG
160MG
80MG
25MG
50MG
100MG
50MG
10MG
5MG
12.5MG
25MG
3.125MG
6.25MG
50MG
100MG
100MG
25MG
50MG
10MG
10MG
15MG
5MG
10MG
120MG
40MG
80MG
160MG
80MG
12.5MG
25MG
3.125MG
6.25MG
25MG
15MG
100MG
50MG
10MG
60MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
86
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
02042231
00587931
02042266
02042274
02042258
00465313
00465321
02365928
02365898
02365901
02367572
02367556
02367564
02368919
02368927
02368897
02368900
02356848
02356813
02356821
02368625
02368617
02154471
02154498
02340194
02170868
02170876
00397431
00397423
00658855
00534560
02371995
02371979
02371987
02239754
02239755
02239756
02239758
02239759
02239760
02230665
02239772
02239771
02230664
02084384
02084392
02084376
02237271
02286602
02286599
02350408
02230046
02350424
02350394
02350416
02351404
02351412
02296713
02253526
02315122
02253496
02315106
02253518
02315114
02368048
02368013
02368021
00695645
02237885
02237721
02237886
02237722
02237887
02237723
02147432
02303647
02146894
02347555
02347571
02347512
02347520
INDERAL LA 60MG CAP
INDERAL LA CAP 120MG
INDERAL LA CAP 80MG
INDERIDE 40/25MG TAB
INDERIDE 80/25MG TAB
IPG‐ATENOLOL 100MG TAB
JAMP‐ATENOLOL 100MG TAB
JAMP‐CARVEDILOL 12.5MG TAB
JAMP‐CARVEDILOL 25MG TAB
JAMP‐METOPROLOL‐L 100MG TAB
JAMP‐SOTALOL 160MG TAB
JAMP‐SOTALOL 80MG TAB
KREDEX 25MG TAB
KREDEX 50MG TAB
LABETALOL HCL 5MG/ML INJ
LIN‐SOTALOL TAB 240MG
LIN‐SOTALOL TAB 320MG
LOPRESOR 100MG TAB
LOPRESOR 50MG TAB
LOPRESOR SR 100MG TAB
LOPRESOR SR 200MG TAB
MAR‐ATENOLOL 100MG TAB
MED‐ACEBUTOLOL (TYPE S) 100MG
MED‐ACEBUTOLOL 100MG TAB
MED‐METOPROLOL (TYPE L) 100MG
MED‐METOPROLOL 100MG TAB
MED‐METOPROLOL 50MG TAB
MED‐METROPOLOL (TYPE L) 50MG
MED‐PINDOLOL 10MG TAB
MED‐SOTALOL 240MG TAB
METOPROLOL (TYPE L) 100MG TAB
METOPROLOL (TYPE L) 50MG TAB
METOPROLOL 100MG EC TAB
METOPROLOL 100MG TAB
METOPROLOL 100MG TAB
METOPROLOL 50MG EC TAB
METOPROLOL 50MG TAB
METOPROLOL SR 100MG TAB
METOPROLOL SR 200MG TAB
METOPROLOL‐25 25MG TAB
METOPROLOL‐L 100MG TAB
MINT‐ATENOLOL 100MG TAB
MONITAN 100MG TAB
MYLAN‐ACEBUTOLOL 100MG (TYPE S
MYLAN‐ACEBUTOLOL 100MG TAB
MYLAN‐ATENOLOL 100MG TAB
MYLAN‐CARVEDILOL 12.5MG TAB
MYLAN‐CARVEDILOL 25MG TAB
PROPRANOLOL
PROPRANOLOL
PROPRANOLOL
PROPRANOLOL
PROPRANOLOL
PROPRANOLOL/HCTZ
PROPRANOLOL/HCTZ
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
ATENOLOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
SOTALOL HCL
SOTALOL HCL
CARVEDILOL
CARVEDILOL
LABETALOL HCL
SOTALOL HCL
SOTALOL HCL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
ATENOLOL
ATENOLOL
ATENOLOL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
PINDOLOL
PINDOLOL
PINDOLOL
SOTALOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
ATENOLOL
ATENOLOL
ATENOLOL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ATENOLOL
ATENOLOL
ATENOLOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
60MG
120MG
120MG
160MG
80MG
40/25MG
80/25MG
100MG
25MG
50MG
100MG
25MG
50MG
12.5MG
25MG
3.125MG
6.25MG
100MG
25MG
50MG
160MG
80MG
25MG
50MG
5MG/ML
240MG
320MG
100MG
50MG
100MG
200MG
100MG
25MG
50MG
100MG
200MG
400MG
100MG
200MG
400MG
100MG
100MG
50MG
50MG
10MG
15MG
5MG
240MG
100MG
50MG
100MG
100MG
100MG
50MG
50MG
100MG
200MG
25MG
100MG
100MG
25MG
25MG
50MG
50MG
100MG
25MG
50MG
100MG
100MG
100MG
200MG
200MG
400MG
400MG
100MG
25MG
50MG
12.5MG
25MG
3.125MG
6.25MG
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
87
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
02174553
02174545
02057816
02057808
02229779
02229778
02289555
02289563
02289571
02267489
02267470
02231182
02231181
02343819
02343797
02343800
02348233
02348241
02362090
02362104
02362074
02362082
02347032
02347059
02347024
02347040
02165546
02165554
02165562
00886122
00886114
02336332
02336324
02248717
02248718
02248715
02248716
00865613
00865605
02337363
02337355
02337347
02337320
02337339
02337371
02337398
00886009
00886130
00886149
02044692
02044706
02163772
02200996
02044617
02044609
02248074
02248073
02164396
02164418
02164426
00828793
00828807
00648027
00648019
00828815
00818704
00828424
00828432
00828416
02222027
02222019
00812447
00812439
00812455
02231251
02231252
02231253
02229586
02229585
02232547
02232546
MYLAN‐METOPROLOL 100MG(TYPE L)
MYLAN‐METOPROLOL 50MG (TYPE L)
MYLAN‐PINDOLOL 10 MG TAB
MYLAN‐PINDOLOL 5 MG TAB
MYLAN‐SOTALOL 160MG TAB
MYLAN‐SOTALOL 80MG TAB
NOVO‐ACEBUTOLOL 100MG (TYPE S)
NOVO‐BISOPROLOL 10MG TAB
NOVO‐BISOPROLOL 5MG TAB
NOVO‐SOTALOL 160MG TAB
NOVO‐SOTALOL 80MG TAB
NTP‐ATENOL 100MG TAB
NTP‐ATENOLOL/CHLORTHALIDONE TA
NTP‐ATENOLOL/CHLORTHALIDONE TA
NTP‐CARVEDILOL 12.5MG TAB
NTP‐CARVEDILOL 25MG TAB
NTP‐METOPROLOL 100MG EC TAB
NTP‐METOPROLOL 100MG TAB
NTP‐METOPROLOL 50MG EC TAB
NTP‐METOPROLOL 50MG TAB
NU‐ACEBUTOLOL 100MG TAB
NU‐ATENOL TAB 100MG
NU‐ATENOL TAB 50MG
NU‐BISOPROLOL 10MG TAB
NU‐BISOPROLOL 5MG TAB
NU‐CARVEDILOL 12.5MG TAB
NU‐CARVEDILOL 25MG TAB
NU‐METOP TAB 100MG
NU‐METOP TAB 50MG
NU‐METOPROLOL (L) 100MG TAB
NU‐METOPROLOL (L) 50MG TAB
NU‐METOPROLOL 100MG TAB
NU‐METOPROLOL SR 100MG TAB LA
NU‐METOPROLOL SR 200MG TAB LA
NU‐PINDOL TAB 10MG
NU‐PINDOL TAB 15MG
NU‐PINDOL TAB 5MG
NU‐PROPRANOLOL 20MG TAB
NU‐PROPRANOLOL 40MG TAB
NU‐SOTALOL 160MG TAB
NU‐SOTALOL 80MG TAB
NU‐TIMOLOL 10 MG TAB
NU‐TIMOLOL 5 MG TAB
ORB‐ATENOLOL 100MG TAB
ORB‐ATENOLOL 50MG TAB
PDL‐ACEBUTOLOL 100MG TAB
PDL‐ATENOLOL‐100 TAB 100MG
PDL‐ATENOLOL‐50 TAB 50MG
PDL‐METOPROLOL‐100 TAB 100MG
PDL‐METOPROLOL‐50 TAB 50MG
PDL‐NADOLOL‐40 TAB 40MG
PDL‐NADOLOL‐80 TAB 80MG
PDL‐PINDOLOL‐10 TAB 10MG
PDL‐SOTALOL TAB 160MG
PDL‐SOTALOL TAB 80MG
PDL‐TIMOLOL‐10 TAB 10MG
PENTA‐ACEBUTOLOL 100MG TAB
PENTA‐ATENOLOL 100MG TAB
PENTA‐ATENOLOL 50MG TAB
PENTA‐METOPROLOL 100MG TAB
PENTA‐METOPROLOL 50MG TAB
METOPROLOL TARTRATE
METOPROLOL TARTRATE
PINDOLOL
PINDOLOL
SOTALOL HCL
SOTALOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
SOTALOL HCL
SOTALOL HCL
ATENOLOL
ATENOLOL
ATENOLOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ATENOLOL
ATENOLOL
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
PINDOLOL
PINDOLOL
PINDOLOL
PROPRANOLOL
PROPRANOLOL
SOTALOL HCL
SOTALOL HCL
TIMOLOL MALEATE
TIMOLOL MALEATE
ATENOLOL
ATENOLOL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ATENOLOL
ATENOLOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
NADOLOL
NADOLOL
PINDOLOL
PINDOLOL
PINDOLOL
SOTALOL HCL
SOTALOL HCL
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ATENOLOL
ATENOLOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
100MG
50MG
10MG
5MG
160MG
80MG
100MG
200MG
400MG
10MG
5MG
160MG
80MG
100MG
25MG
50MG
50MG/25MG
100MG/25MG
12.5MG
25MG
3.125MG
6.25MG
100MG
100MG
50MG
50MG
100MG
200MG
400MG
100MG
50MG
10MG
5MG
12.5MG
25MG
3.125MG
6.25MG
100MG
50MG
100MG
50MG
100MG
25MG
50MG
100MG
200MG
10MG
15MG
5MG
20MG
40MG
160MG
80MG
10MG
5MG
100MG
50MG
100MG
200MG
400MG
100MG
50MG
100MG
50MG
40MG
80MG
10MG
15MG
5MG
160MG
80MG
10MG
20 MG
5MG
100MG
200MG
400MG
100MG
50MG
100MG
50MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
88
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
02238318
02247182
02238316
02308347
02308339
02248754
02248755
02248752
02248753
02238769
02238768
02237601
02246581
02237600
02302640
02302632
02245916
02245917
02245914
02245915
02145421
02145413
02231546
02230804
02231547
02248855
02230803
02231537
02231539
02231536
00582298
02238327
02238328
02238326
02326701
02307006
02306999
02310643
02324520
02310651
02324539
02310627
02324504
02310635
02324512
02316536
02316528
02371383
02371367
02371375
02267993
02373963
02267985
02268043
02268051
02268027
02268035
02171805
02171791
02252325
02252333
02252309
02252317
02084236
02084244
02084228
02234016
02242094
02242093
02277379
02315327
02315300
02315319
02242157
02272172
02242156
02272164
02257599
02257602
02257610
02231731
PHL‐ATENOLOL 100MG TAB
PHL‐BISOPROLOL 10MG TAB
PHL‐BISOPROLOL 5MG TAB
PHL‐CARVEDILOL 12.5MG TAB
PHL‐CARVEDILOL 25MG TAB
PHL‐SOTALOL 160MG TAB
PHL‐SOTALOL 80MG TAB
PMS‐ATENOLOL 100MG TAB
PMS‐BISOPROLOL 10MG TAB
PMS‐BISOPROLOL 5MG TAB
PMS‐CARVEDILOL 12.5MG TAB
PMS‐CARVEDILOL 25MG TAB
PMS‐METOPROLOL‐B 100MG TAB
PMS‐METOPROLOL‐B 50MG TAB
PMS‐METOPROLOL‐L 100MG SRT
PMS‐METOPROLOL‐L 100MG TAB
PMS‐METOPROLOL‐L 200MG SRT
PMS‐PINDOLOL 10MG TAB
PMS‐PROPRANOLOL 120MG TAB
PMS‐SOTALOL 160MG TAB
PRO‐ATENOLOL 25MG TAB
PRO‐BISOPROLOL‐10 10MG TAB
PRO‐BISOPROLOL‐5 5MG TAB
PRO‐CARVEDILOL 12.5MG TAB
PRO‐CARVEDILOL 25MG TAB
PRO‐CARVEDILOL 25MG TAB
PRO‐SOTALOL 160MG TAB
PRO‐SOTALOL 80MG TAB
Q‐METOPROLOL (TYPE L) 100MG
RAN‐ATENOLOL 100MG TAB
RAN‐CARVEDILOL 12.5MG TAB
RAN‐CARVEDILOL 25MG TAB
RATIO‐ATENOLOL 100MG TAB
RATIO‐ATENOLOL 50MG TAB
RATIO‐CARVEDILOL 12.5MG TAB
RATIO‐CARVEDILOL 25MG TAB
RATIO‐SOTALOL 160MG TAB
RHO‐SOTALOL 240MG TAB
RIVA‐ATENOLO 50MG TAB
RIVA‐ATENOLOL 100MG TAB
RIVA‐ATENOLOL 25MG TAB
RIVA‐METOPROLOL L 100MG TAB
RIVA‐SOTALOL 160MG TAB
SANDOZ ACEBUTOLOL 100MG TAB
SANDOZ ATENOLOL 50MG TAB
ATENOLOL
ATENOLOL
ATENOLOL
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
SOTALOL HCL
SOTALOL HCL
ATENOLOL
ATENOLOL
ATENOLOL
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
PINDOLOL
PINDOLOL
PINDOLOL
PROPRANOLOL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
ATENOLOL
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
SOTALOL HCL
SOTALOL HCL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
ATENOLOL
ATENOLOL
ATENOLOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
ATENOLOL
ATENOLOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
ATENOLOL
ATENOLOL
ATENOLOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ATENOLOL
100MG
25MG
50MG
10MG
5MG
12.5MG
25MG
3.125MG
6.25MG
160MG
80MG
100MG
25MG
50MG
10MG
5MG
12.5MG
25MG
3.125MG
6.25MG
100MG
50MG
100MG
100MG
200MG
25MG
50MG
10MG
15MG
5MG
120MG
160MG
160MG
80MG
25MG
10MG
5MG
12.5MG
12.5MG
25MG
25MG
3.125MG
3.125MG
6.25MG
6.25MG
160MG
80MG
100MG
25MG
50MG
100MG
25MG
50MG
12.5MG
25MG
3.125MG
6.25MG
100MG
50MG
12.5MG
25MG
3.125MG
6.25MG
160MG
240MG
80MG
240MG
50MG
100MG
25MG
100MG
25MG
50MG
160MG
160MG
80MG
80MG
100MG
200MG
400MG
50MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
89
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
242400
02354195
02354187
02247876
02247875
02247440
02247439
02303396
02303418
02261790
02261804
02261782
02257858
02257831
01926551
01926578
00771333
00726559
01926543
02368668
02368633
02368641
02230069
02286173
02325217
02230070
02286181
02170883
02230068
02286165
02325209
02028654
02028646
02083388
02083396
02083361
02049988
02049961
02039540
02039532
02204517
02204525
02204533
02266660
01912054
01912062
02302926
02302918
02261898
00648043
00648035
00842656
00842648
02126753
02126761
00869015
00869023
00869007
00496480
00740675
00496499
00496502
01947818
01947826
01947796
02106272
02212250
02106280
02212269
00603643
00402583
02228912
02228904
00568627
00568635
00443174
00417289
00417270
02338106
02338114
02338068
02338092
SANDOZ METOPROLOL (L) 100MG
SANDOZ METOPROLOL (L) 50MG TAB
SANDOZ METOPROLOL‐L 100MG TAB
SANDOZ METOPROLOL‐L 50MG TAB
SANDOZ‐BISOPROLOL 10MG TAB
SANDOZ‐BISOPROLOL 5MG TAB
SANDOZ‐METOPROLOL SR 100MG TAB
SANDOZ‐METOPROLOL SR 200MG TAB
SANDOZ‐PINDOLOL 10MG TAB
SANDOZ‐SOTALOL 160MG TAB
SANDOZ‐SOTALOL 80MG TAB
SECTRAL 200MG TAB
SECTRAL 400 MG TAB
SECTRAL 400 TAB 400MG
SECTRAL TAB 100MG
SECTRAL TAB 100MG
SEPTA‐ATENOLOL 100MG TAB
SOTALOL 160MG TAB
SOTALOL 160MG TAB
SOTALOL 160MG TAB
SOTALOL 240MG TAB
SOTALOL 240MG TAB
SOTALOL 80MG
SOTALOL 80MG TAB
SOTALOL 80MG TAB
SOTALOL 80MG TAB
TARO‐METOPROLOL 100MG TAB
TARO‐METOPROLOL 50MG
TARO‐PINDOLOL 10MG T
TARO‐PINDOLOL 15MG T
TARO‐PINDOLOL 5MG TA
TENORETIC TAB 100/25
TENORETIC TAB 50/25
TENORMIN TAB 100MG
TENORMIN TAB 50MG
TEVA‐ACEBUTOLOL 100MG TAB
TEVA‐ATENOL 25MG TAB
TEVA‐ATENOL TAB 100MG
TEVA‐ATENOL TAB 50MG
TEVA‐ATENOLTHALIDONE 100/25MG
TEVA‐ATENOLTHALIDONE 50MG/25MG
TEVA‐METOPROL 25MG TAB
TEVA‐METOPROL TAB 100MG
TEVA‐METOPROL TAB 50MG
TEVA‐METOPROL UNCOATED TAB 100
TEVA‐METOPROL UNCOATED TAB 50M
TEVA‐NADOLOL 40 MG TAB
TEVA‐NADOLOL 80MG TAB
TEVA‐PINDOL TAB 10MG
TEVA‐PROPRANOLOL TAB 10MG
TEVA‐TIMOL 10 MG TAB
TRANDATE 100MG TAB
TRANDATE 100MG TAB
TRANDATE 200MG TAB
TRANDATE 200MG TAB
TRANDATE TAB 200MG
TRASICOR 80MG TAB
TRIA‐ATENOLOL 100MG TAB
TRIA‐ATENOLOL 50MG TAB
VISKAZIDE 10/25 TAB
VISKAZIDE 10/50 TAB
VISKEN TAB 10MG
VISKEN TAB 15MG
VISKEN TAB 5MG
ZYM‐CARVEDILOL 12.5MG TAB
ZYM‐CARVEDILOL 25MG TAB
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
PINDOLOL
PINDOLOL
PINDOLOL
SOTALOL HCL
SOTALOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ATENOLOL
ATENOLOL
ATENOLOL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
SOTALOL HCL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
PINDOLOL
PINDOLOL
PINDOLOL
ATENOLOL
ATENOLOL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ACEBUTOLOL HCL
ATENOLOL
ATENOLOL
ATENOLOL
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
METOPROLOL TARTRATE
NADOLOL
NADOLOL
PINDOLOL
PINDOLOL
PINDOLOL
PROPRANOLOL
PROPRANOLOL
PROPRANOLOL
PROPRANOLOL
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
LABETALOL HCL
LABETALOL HCL
LABETALOL HCL
LABETALOL HCL
LABETALOL HCL
OXPRENOLOL HCL
ATENOLOL
ATENOLOL
PINDOLOL/HYDROCHLOROTHIAZIDE
PINDOLOL & HCTZ
PINDOLOL
PINDOLOL
PINDOLOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
CARVEDILOL
100MG
50MG
100MG
50MG
10MG
5MG
100MG
200MG
10MG
15MG
5MG
160MG
80MG
200MG
400MG
400MG
100MG
100MG
100MG
25MG
50MG
160MG
160MG
160MG
240MG
240MG
80MG
80MG
80MG
80MG
100MG
50MG
10MG
15 MG
5MG
100/25MG
50/25MG
100MG
50MG
100MG
200MG
400MG
25MG
100MG
50MG
100MG/25MG
50MG/25MG
25MG
100MG
50MG
100MG
50MG
40MG
80MG
10MG
15MG
5MG
10MG
20MG
40MG
80MG
10MG
20MG
5MG
100MG
100MG
200MG
200MG
200MG
80MG
100MG
50MG
10/25MG
10/50MG
10MG
15MG
5MG
12.5MG
25MG
3.125MG
6.25MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
90
*PA
05/2012
Therapy Class
242808
DIN
Drug Name
DIHYDROPYRIDINES
Chemical Name
Strength
Dosage
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
02341107
02341093
02323923
02323931
02323958
02237618
02155907
02155990
02313766
02313774
02313782
02369249
02369222
02369230
02240307
02240306
02326817
02334011
02343215
02367599
02326795
02333996
02343193
02326809
02334003
02343207
02367580
02339382
02339374
02378779
02378779
02378744
02378744
02378760
02378760
02273381
02273373
02197448
02181525
02343290
02343274
02364751
02364743
02273284
02273292
02273306
02273314
02273233
02273241
02273268
02273276
01911813
01911805
02297493
02297477
02297485
02326841
02326825
02326833
02236758
02236757
02334143
02334135
02280140
02280124
02280132
02362791
02362805
02362813
02362821
02362759
02362767
02362775
02362783
02355604
02355582
02355590
02331098
02357208
02357186
ACCEL‐AMLODIPINE 10MG TAB
ACCEL‐AMLODIPINE 5MG TAB
ADALAT OROS 20MG ER TAB
ADALAT XL 20MG ER TAB
ADALAT XL 30MG TAB
ADALAT XL 60 MG TAB
ADALAT XL PLUS 20MG/81MG TAB
AG‐AMLODIPINE 10MG TAB
AG‐AMLODIPINE 2.5MG TAB
AG‐AMLODIPINE 5MG TAB
ALTACE PLUS FELODIPINE 2.5MG
ALTACE PLUS FELODIPINE 5MG TAB
AMLODIPINE 10MG TAB
AMLODIPINE 10MG TAB
AMLODIPINE 10MG TAB
AMLODIPINE 10MG TAB
AMLODIPINE 2.5MG TAB
AMLODIPINE 5MG TAB
AMLODIPINE 5MG TAB
AMLODIPINE 5MG TAB
AMLODIPINE 5MG TAB
AMLODIPINE BESYLATE 10MG TAB
AMLODIPINE BESYLATE 5MG TAB
AMLODIPINE‐ODAN 10MG TAB
AMLODIPINE‐ODAN 2.5MG TAB
AMLODIPINE‐ODAN 2.5MG TAB
APO‐AMLODIPINE 10MG TAB
APO‐AMLODIPINE 5MG TAB
APO‐NIFED PA 10MG TAB
APO‐NIFED PA 20MG TAB
APX‐AMLODIPINE 10MG TAB
APX‐AMLODIPINE 5MG TAB
AVA‐AMLODIPINE 10MG TAB
AVA‐AMLODIPINE 5MG TAB
CADUET 10MG/10MG TAB
CADUET 5MG/10MG TAB
CADUET 5MG/20MG TAB
CADUET 5MG/40MG TAB
CADUET 5MG/80MG TAB
CARDENE 20MG CAP
CARDENE 30MG CAP
CO AMLODIPINE 10MG TAB
CO AMLODIPINE 2.5MG TAB
CO AMLODIPINE 5MG TAB
DOM‐AMLODIPINE 10MG TAB
DOM‐AMLODIPINE 2.5MG TAB
DOM‐AMLODIPINE 5MG TAB
DOM‐NIFEDIPINE 10MG CAP
DOM‐NIFEDIPINE 5MG CAP
FELODIPINE 10MG ER TAB
FELODIPINE 5MG ER TAB
GD‐AMLODIPINE 10MG TAB
GD‐AMLODIPINE 2.5MG TAB
GD‐AMLODIPINE 5MG TAB
GD‐AMLODIPINE/ATORVAST 10/10MG
IPG‐AMLODIPINE 10MG TAB
IPG‐AMLODIPINE 2.5MG TAB
IPG‐AMLODIPINE 5MG TAB
JAMP‐AMLODIPINE 10MG TAB
JAMP‐AMLODIPINE 2.5MG TAB
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
ACETYLSALICYLIC ACID/NIFEDIPIN
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
FELODIPINE ER/ RAMIPRIL
FELODIPINE ER/ RAMIPRIL
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
NIFEDIPINE
NIFEDIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE
AMLODIPINE
AMLODIPINE/ATORVASTATIN
NICARDIPINE HCL
NICARDIPINE HCL
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
NIFEDIPINE
NIFEDIPINE
FELODIPINE
FELODIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
10MG
5MG
20MG
30MG
60MG
20MG
30MG
60MG
81MG/20MG
81MG/30MG
81MG/60MG
10MG
2.5MG
5MG
2.5MG
5MG
10MG
10MG
10MG
10MG
2.5MG
2.5MG
2.5MG
5MG
5MG
5MG
5MG
10MG
5MG
10MG
10MG
2.5MG
2.5MG
5MG
5MG
10MG
5MG
10MG
20MG
10MG
5MG
10MG
5MG
10MG/10MG
10MG/20MG
10MG/40MG
10MG/80MG
5MG/10MG
5MG/20MG
5MG/40MG
5MG/80MG
20MG
30MG
10MG
2.5MG
5MG
10MG
2.5MG
5MG
10MG
5MG
10MG
5MG
10MG
2.5MG
5MG
10/10MG
10/20MG
10/40MG
10/80MG
5/10MG
5/20MG
5/40MG
5/80MG
10MG
2.5MG
5MG
10MG
10MG
2.5MG
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
91
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
242808
02331071
02357194
02371359
02371332
02371340
02371723
02371707
02371715
02084368
02362678
02362651
02272121
02272113
02349167
02321149
00755907
02351587
00725110
02351595
02241773
02241774
02325926
00878936
00878928
02243470
02243471
02243472
00865591
02212102
02200937
02211092
02211106
02326787
02326760
02326779
00851787
02057778
00851779
02284073
02295148
02284065
02235898
02235897
02340186
02340178
02375230
02375222
02354128
02354136
02321866
02331942
02331934
02321858
02259613
02259605
02222000
02221985
02221993
02331500
02331489
02331497
02280272
09857204
02280264
09857203
02284391
02284383
02230964
02230965
02163519
02163500
02238821
02357720
02357704
02357712
02250500
02250497
02371030
02371057
02371022
02371049
MANDA‐AMLODIPINE 10MG TAB
MANDA‐AMLODIPINE 2.5MG TAB
MANDA‐AMLODIPINE 5MG TAB
MAR‐AMLODIPINE 10MG TAB
MAR‐AMLODIPINE 2.5MG TAB
MAR‐AMLODIPINE 5MG TAB
MED‐NIFEDIPINE 10MG CAP
MINT‐AMLODIPINE 10MG TAB
MINT‐AMLODIPINE 5MG TAB
MYLAN‐AMLODIPINE 10MG TAB
MYLAN‐AMLODIPINE 5MG TAB
MYLAN‐NIFEDIPINE ER 30MG TAB
MYLAN‐NIFEDIPINE XL 60MG TAB
NIFEDIPINE 10MG CAP
NIFEDIPINE 30MG ER TAB
NIFEDIPINE 5MG CAP
NIFEDIPINE 60MG ER TAB
NIFEDIPINE PA 10MG SRT
NIFEDIPINE PA 20MG SRT
NIMOTOP 30MG TAB
NORVASC TAB 10MG
NORVASC TAB 5 MG
NOVO‐NIFEDIN XL 20MG TAB
NU‐NIFED CAP 10MG
NU‐NIFEDIPINE‐PA 10MG TAB
NU‐NIFEDIPINE‐PA 20MG
PDL‐NIFEDIPINE 10MG SR TAB
PDL‐NIFEDIPINE 20MG SR TAB
PHL‐AMLODIPINE 10MG TAB
PHL‐AMLODIPINE 2.5MG TAB
PHL‐AMLODIPINE 5MG TAB
PLENDIL 10MG LA TAB
PLENDIL 2.5 MG TAB
PLENDIL 5MG LA TAB
PMS‐AMLODIPINE 10MG TAB
PMS‐AMLODIPINE 2.5MG TAB
PMS‐AMLODIPINE 5MG TAB
PMS‐NIFEDIPINE 10MG CAP
PMS‐NIFEDIPINE 5MG CAP
Q‐AMLODIPINE 10MG TAB
Q‐AMLODIPINE 5MG TAB
Q‐GEN AMLODIPINE 10MG TAB
Q‐GEN AMLODIPINE 5MG TAB
Q‐NIFEDIPINE 30MG ER TAB
Q‐NIFEDIPINE 60MG ER TAB
RAN‐AMLODIPINE 10MG TAB
RAN‐AMLODIPINE 5 MG TAB
RATIO‐AMLODIPINE 10MG TAB
RATIO‐AMLODIPINE 5MG TAB
RENEDIL 10MG TAB
RENEDIL 2.5MG TAB
RENEDIL 5MG TAB
RIVA‐AMLODIPINE 10MG TAB
RIVA‐AMLODIPINE 2.5MG TAB
RIVA‐AMLODIPINE 5MG TAB
SANDOZ FELODIPINE 10MG SR TAB
SANDOZ‐AMLODIPINE 10MG TAB
SANDOZ‐AMLODIPINE 5MG TAB
SCHEIN NIFEDIPINE XL 30MG TAB
SCHEIN NIFEDIPINE XL 60MG TAB
SCHEIN‐NIFEDIPINE 10MG CAP
SCHEIN‐NIFEDIPINE 5MG CAP
SCHEIN‐NIFEDIPINE XL 20MG TAB
SEPTA‐AMLODIPINE 10MG TAB
SEPTA‐AMLODIPINE 2.5MG TAB
SEPTA‐AMLODIPINE 5MG TAB
TEVA‐AMLODIPINE 10MG TAB
TEVA‐AMLODIPINE 5MG TAB
TWYNSTA 10/40MG TAB
TWYNSTA 10/80MG TAB
TWYNSTA 5/40MG TAB
TWYNSTA 5/80MG TAB
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
NIFEDIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIMODIPINE
AMLODIPINE
AMLODIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
FELODIPINE
FELODIPINE
FELODIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
NIFEDIPINE
NIFEDIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
NIFEDIPINE
NIFEDIPINE
AMLODIPINE BESYLATE
AMLODIPINE
AMLODIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
FELODIPINE
FELODIPINE
FELODIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
FELODIPINE
FELODIPINE
FELODIPINE
FELODIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
NIFEDIPINE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE/TELMISARTAN
5MG
5MG
10MG
2.5MG
5MG
10MG
2.5MG
5MG
10MG
10MG
5MG
10MG
5MG
30MG
60MG
10MG
30MG
5MG
60MG
10MG
20MG
30MG
10MG
5MG
20MG
30MG
60MG
10MG
10MG
20MG
10MG
20MG
10MG
2.5MG
5MG
10MG
2.5MG
5MG
10MG
2.5MG
5MG
10MG
5MG
10MG
5MG
10MG
5MG
30MG
60MG
10MG
10MG
5MG
5MG
10MG
5MG
10MG
2.5MG
5MG
10MG
2.5MG
5MG
10MG
10MG
5MG
5MG
10MG
5MG
30MG
60MG
10MG
5MG
20MG
10MG
2.5MG
5MG
10MG
5MG
10/40MG
10/80MG
5/40MG
5/80MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB LA
TAB LA
CAP
TAB LA
CAP
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
CAP
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB LA
TAB
TAB LA
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB LA
TAB LA
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
92
*PA
05/2012
Therapy Class
DIN
Drug Name
242808
242808
242808
02342804 ZYM‐AMLODIPINE 10MG TAB
02342782 ZYM‐AMLODIPINE 2.5MG TAB
02342790 ZYM‐AMLODIPINE 5MG TAB
93
Chemical Name
Strength
Dosage
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
AMLODIPINE BESYLATE
10MG
2.5MG
5MG
TAB
TAB
TAB
*PA
05/2012
Therapy Class
242892
DIN
Drug Name
MISC. CALCIUM-CHANNEL BLOCKING AGENTS
Chemical Name
Strength
Dosage
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
02229815
02229816
02229817
02229818
00771376
00771384
02230997
02230998
02230999
02229526
02222973
02222957
02222965
02291037
02291045
02291053
02291061
02291088
00782491
00782483
02246893
02246894
02246895
02343304
02343312
02343320
02343339
02363984
02363992
02365804
02365790
01917072
02009323
02097249
02009315
02097257
01917064
02097265
02097273
00587753
00587761
02370611
02370638
02370646
02370654
02370441
02370492
02370506
02370514
02370522
02231472
02231474
02231475
02240321
02254824
02254832
01907123
01934317
00742554
02237304
02237302
02237303
02237922
02237921
02210347
02210355
02210363
02271605
02271613
02271621
02271648
02271656
02211920
00812358
00812331
02231052
02231053
02231054
00886068
00886076
ALBERT‐DILTIAZEM CD 120MG CAP
APO‐DILTIAZ 30MG TAB
APO‐DILTIAZ 60MG TAB
APO‐DILTIAZ CD 120MG CAP
APO‐DILTIAZ SR 120MG CAP
APO‐DILTIAZ TZ 120MG ER CAP
APO‐VERAP 120MG TAB
APO‐VERAP 80MG TAB
APO‐VERAP SR 120MG TAB
APX‐DILTIAZ CD 120MG CAP
AVA‐DILTIAZEM 30MG TAB
AVA‐DILTIAZEM 60MG TAB
AVA‐VERAPAMIL 120MG TAB
AVA‐VERAPAMIL 80MG TAB
CARDIZEM CD 120MG CAP
CARDIZEM TAB 30MG
CARDIZEM TAB 60MG
CO DILTIAZEM CD 120MG CAP
CO DILTIAZEM T 120MG CAP
DILTIAZEM CD 120MG CAP
DOM‐VERAPAMIL SR 240MG TAB
GEN‐DILTIAZEM CD 240MG CAP
GEN‐DILTIAZEM CD 300MG CAP
ISOPTIN SR TAB 120MG
MED‐DILTIAZEM SR 120MG CAP
MYLAN‐VERAPAMIL 120MG TAB
MYLAN‐VERAPAMIL 80MG TAB
MYLAN‐VERAPAMIL SR 120MG TAB
NOVO‐DILTIAZEM HCL ER 120MG
NOVO‐VERAMIL SR 240MG TAB
NOVO‐VERAMIL TAB 120MG
NOVO‐VERAMIL TAB 80MG
NU‐DILTIAZ CD 120MG CAP
NU‐DILTIAZ TAB 30MG
NU‐DILTIAZ TAB 60MG
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
120MG
180MG
240MG
300MG
30MG
60MG
120MG
180MG
240MG
300MG
120MG
60MG
90MG
120MG
180MG
240MG
300MG
360MG
120MG
80MG
120MG
180MG
240MG
120MG
180MG
240MG
300MG
30MG
60MG
120MG
80MG
300MG
120MG
120MG
180MG
180MG
240MG
240MG
300MG
30MG
60MG
120MG
180MG
240MG
300MG
120MG
180MG
240MG
300MG
360MG
120MG
180MG
240MG
240MG
240MG
300MG
120MG
180MG
240MG
120MG
60MG
90MG
120MG
80MG
120MG
180MG
240MG
120MG
180MG
240MG
300MG
360MG
240MG
120MG
80MG
120MG
180MG
240MG
30MG
60MG
CAP LA
CAP LA
CAP LA
CAP LA
TAB
TAB
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB LA
TAB LA
TAB LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB
TAB
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB
TAB
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP
TAB
CAP LA
CAP LA
TAB LA
TAB LA
TAB LA
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB LA
TAB LA
TAB LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB LA
TAB
TAB
CAP LA
CAP LA
CAP LA
TAB
TAB
94
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
242892
02336367
02336375
02249812
00886041
00886033
02231057
00828785
00828777
00871028
02229593
02229594
02237248
02237249
02238276
02355787
02355752
02355760
02355779
02237791
02325306
02325314
02325322
02325330
02325349
02324156
02324164
02312697
02229781
02229782
02229783
02229784
02248082
02243338
02243339
02243340
02243341
02245918
02245919
02245920
02245921
02245922
02242538
02242539
02242540
02242541
00862924
00862932
02231150
02231151
02231152
02231154
02231155
02256738
02256746
02256754
02256762
02256770
02340682
02178753
02340941
02340690
02340704
02178745
02340933
02303558
02100479
02100487
02100495
NU‐VERAP SR 120MG TAB LA
NU‐VERAP SR 180MG TAB LA
NU‐VERAP SR 240MG TAB
NU‐VERAP TAB 120MG
NU‐VERAP TAB 80MG
PDL‐DILTIAZEM CD 300MG CAP
PDL‐DILTIAZEM‐30 TAB 30MG
PDL‐DILTIAZEM‐60 TAB 60MG
PDL‐VERAPAMIL TAB 80MG
PENTA‐DILTIAZEM 30MG TAB
PENTA‐DILTIAZEM 60MG TAB
PHARMA‐DILTIAZ 30MG TAB
PHARMA‐DILTIAZ 60MG TAB
PHL‐VERAPAMIL SR 240MG TAB
PMS‐DILTIAZEM CD
PMS‐DILTIAZEM CD 120MG CAP
PMS‐VERAPAMIL SR 240MG TAB
PRO‐DILTIAZEM TZ 120MG ER CAP
PRO‐VERAPAMIL SR 120MG TAB
RATIO‐DILTIAZEM CD 120MG CAP
RIVA‐VERAPAMIL SR 240MG TAB
SANDOZ DILTIAZEM 120MG CAP
SANDOZ DILTIAZEM CD 180MG CAP
SANDOZ‐DILTIAZEM T 120MG ER CA
TEVA‐DILTAZEM CD 120MG CAP
TEVA‐DILTAZEM TAB 30MG
TEVA‐DILTAZEM TAB 60MG
TIAZAC 120MG SR CAP
TIAZAC 180MG SR CAP
TIAZAC 240MG SR CAP
TIAZAC 300MG SR CAP
TIAZAC 360MG SR CAP
TIAZAC XC 120MG TAB
TIAZAC XC 180MG TAB
TIAZAC XC 240MG TAB
TIAZAC XC 300MG TAB
TIAZAC XC 360MG TAB
VERAPAMIL HCL 120MG SR TAB
VERAPAMIL HCL 120MG TAB
VERAPAMIL SR 240MG TAB
VERELAN 120MG SR CAP
VERAPAMIL HYDROCHLORIDE
VERAPAMIL HYDROCHLORIDE
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
DILTIAZEM HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
VERAPAMIL HCL
120MG
180MG
240MG
120MG
80MG
300MG
30MG
60MG
80MG
30MG
60MG
30MG
60MG
240MG
300MG
120MG
180MG
240MG
240MG
120MG
180MG
240MG
300MG
360MG
120MG
180MG
240MG
120MG
180MG
240MG
300MG
240MG
120MG
180MG
240MG
300MG
120MG
180MG
240MG
300MG
360MG
120MG
180MG
240MG
300MG
30MG
60MG
120MG
180MG
240MG
300MG
360MG
120MG
180MG
240MG
300MG
360MG
120MG
120MG
120MG
180MG
240MG
80MG
80MG
240MG
120MG
180MG
240MG
TAB LA
TAB LA
TAB LA
TAB
TAB
CAP LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
CAP
CAP
CAP
CAP
TAB LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB
TAB LA
TAB LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB
TAB
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB LA
CAP LA
CAP LA
CAP LA
95
*PA
05/2012
Therapy Class
243204
DIN
Drug Name
ANGIOTENSIN-CONVERTING ENZYME INHIBITORS
Chemical Name
Strength
Dosage
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
02349051
02349078
02349043
02364670
02364646
02364654
02364662
02322889
02322897
02322870
02341239
02341263
02341247
02341255
01947672
01947680
01947699
01947664
02236988
02236989
02236990
02236987
02237367
02237368
02237369
02221829
02248052
02221853
02248055
02281112
02221837
02248053
02221845
02248054
02283166
02283182
02283131
02283158
02283174
02290340
02273918
02290332
00893625
00893595
00893609
00893617
01999559
02291134
02291142
02291150
02019892
02020025
02019906
02019884
02352923
02352931
02266008
02266016
02217538
02217503
02217511
02217481
02261979
02261987
02261995
02251515
02251582
02325381
02251531
02251574
02368722
02354039
02354004
02354012
02354020
02363488
02363453
02363496
02363461
02363720
AA‐BENAZEPRIL 10MG TAB
ACCEL‐ENALAPRIL 16MG TAB
ACCEL‐LISINOPRIL 10MG TAB
ACCEL‐RAMIPRIL 1.25MG CAP
ACCEL‐RAMIPRIL 10MG CAP
ACCEL‐RAMIPRIL 2.5MG CAP
ACCEL‐RAMIPRIL 5MG CAP
ACCUPRIL 10MG TAB
ACCUPRIL 20MG TAB
ACCUPRIL 40MG TAB
ACCUPRIL 5MG TAB
ACCUPRO 10MG TAB
ACCUPRO 20MG TAB
ACCUPRO 40MG TAB
ACCUPRO 5MG TAB
ACCURETIC 10/12.5MG TAB
ACCURETIC 20/12.5MG TAB
ACCURETIC 20/25MG TAB
ALTACE 1.25MG CAP
ALTACE 1.25MG TAB
ALTACE 10MG CAP
ALTACE 10MG TAB
ALTACE 15MG CAP
ALTACE 2.5MG CAP
ALTACE 2.5MG TAB
ALTACE 5MG CAP
ALTACE 5MG TAB
ALTACE HCT 10MG/12.5MG TAB
ALTACE HCT 10MG/25MG TAB
ALTACE HCT 2.5MG/12.5MG TAB
ALTACE HCT 5MG/12.5MG TAB
ALTACE HCT 5MG/25MG TAB
APO‐BENAZEPRIL 10MG TAB
APO‐CAPTO 100MG TAB
APO‐CAPTO 12.5MG TAB
APO‐CAPTO 6.25MG TAB
APO‐CILAZAPRIL 1MG TAB
APO‐CILAZAPRIL 2.5MG TAB
APO‐CILAZAPRIL 5MG TAB
APO‐ENALAPRIL 10MG TAB
APO‐ENALAPRIL 2.5MG TAB
APO‐ENALAPRIL MALEATE/HCTZ TAB
APO‐ENALAPRIL MALEATE/HCTZ TAB
APO‐FOSINOPRIL 10MG TAB
APO‐FOSINOPRIL 20MG TAB
APO‐LISINOPRIL (TYPE Z) 40MG
APO‐LISINOPRIL 10MG TAB
APO‐LISINOPRIL 20MG (TYPE Z)TA
APO‐LISINOPRIL 5MG (TYPE Z)TAB
APO‐LISINOPRIL/HCTZ 10/12.5MG
APO‐LISINOPRIL/HCTZ 20/12.5MG
APO‐LISINOPRIL/HCTZ 20/25MG
APO‐RAMIPRIL 1.25MG CAP
APO‐RAMIPRIL 10MG CAP
APO‐RAMIPRIL 2.5MG CAP
APO‐RAMIPRIL/HCTZ 10/12.5 TAB
APO‐RAMIPRIL/HCTZ 10/25MG
APO‐RAMIPRIL/HCTZ 2.5/12.5MG
APO‐RAMIPRIL/HCTZ 5/12.5MG
APO‐RAMIPRIL/HCTZ 5/25MG
AVA‐ENALAPRIL 10MG TAB
AVA‐ENALAPRIL 2.5MG TAB
AVA‐FOSINOPRIL 10MG TAB
BENAZEPRIL HCL
BENAZEPRIL HCL
BENAZEPRIL HCL
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
LISINOPRIL DIHYDRATE
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
QUINAPRIL HCL
QUINAPRIL HCL
QUINAPRIL HCL
QUINAPRIL HCL
QUINAPRIL HCL
QUINAPRIL HCL
QUINAPRIL HCL
QUINAPRIL HCL
QUINAPRIL HCL/HZT
QUINAPRIL HCL/HZT
QUINAPRIL HCL/HZT
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL/HYDROCHLOROTHIAZIDE
BENAZEPRIL HCL
BENAZEPRIL HCL
BENAZEPRIL HCL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CILAZAPRIL MONOHYDRATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE/HCTZ
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL/HCTZ
RAMIPRIL / HYDROCHLOROTHIAZIDE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
FOSINOPRIL SODIUM
10MG
20MG
5MG
16MG
2MG
4MG
8MG
10MG
20MG
5MG
1.25MG
10MG
2.5MG
5MG
10MG
20MG
40MG
5MG
10MG
20MG
40MG
5MG
10/12.5MG
20/12.5MG
20/25MG
1.25MG
1.25MG
10MG
10MG
15MG
2.5MG
2.5MG
5MG
5MG
10/12.5MG
10/25MG
2.5/12.5MG
5/12.5MG
5/25MG
10MG
20MG
5MG
100MG
12.5MG
25MG
50MG
6.25MG
1MG
2.5MG
5MG
10MG
2.5MG
20MG
5MG
5MG/12.5MG
10MG/25MG
10MG
20MG
40MG
10MG
20MG
5MG
10/12.5MG
20/12.5MG
20/25MG
1.25MG
10MG
15MG
2.5MG
5MG
10/12.5MG
10/25MG
2.5/12.5MG
5/12.5MG
5/25MG
10MG
2.5MG
20MG
5MG
10MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
CAP
TAB
CAP
CAP
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
96
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
02363739
02366983
02366991
02366932
02362880
02362899
02362902
02363267
02363291
02363275
02363283
02259575
02259540
02259559
02259567
00695661
02230002
02238558
02242791
02245893
02229999
02238555
02242788
02245888
02230000
02238556
02242789
02245891
02230001
02238557
02242790
02245892
02237595
02237592
02237593
02237594
02345218
02350963
02345226
02350971
02345234
02350998
02259532
02259508
02259516
02259524
02285207
02285215
02285223
02282526
02282534
02295482
02295512
02295490
02295504
02291894
02291878
02291908
02291886
02271451
02271478
02271443
02270579
02270552
02123274
02123282
02270560
02246624
02246569
02318555
02321653
02318563
02246568
02238554
02238551
02238552
02238553
02309408
02309416
02309424
02308274
AVA‐FOSINOPRIL 20MG TAB
AVA‐LISINOPRIL 10MG TAB
AVA‐LISINOPRIL HCT 10/12.5MG
AVA‐LISINOPRIL HCT 20/12.5MG
AVA‐LISINOPRIL HCT 20/25MG
AVA‐RAMIPRIL 1.25MG TAB
AVA‐RAMIPRIL 10MG TAB
AVA‐RAMIPRIL 2.5MG TAB
AVA‐RAMIPRIL 5MG TAB
BCI CAPTOPRIL TAB 100MG
BCI CAPTOPRIL TAB 12.5MG
CAPOTEN TAB 12.5MG
CAPTOPRIL 100MG TAB
CAPTOPRIL 100MG TAB
CAPTOPRIL 100MG TAB
CAPTOPRIL 100MGTAB
CAPTOPRIL 12.5 MG TAB
CAPTOPRIL 12.5MG TAB
CAPTOPRIL 12.5MG TAB
CAPTOPRIL 12.5MGTAB
CAPTOPRIL 25MG TAB
CAPTOPRIL 25MG TAB
CAPTOPRIL 25MG TAB
CAPTOPRIL 25MGTAB
CAPTOPRIL 50MG TAB
CAPTOPRIL 50MG TAB
CAPTOPRIL 50MG TAB
CAPTOPRIL 50MGTAB
CAPTOTEC 100MG TAB
CAPTOTEC 12.5MG TAB
CAPTOTEC 25MGTAB
CAPTOTEC 50MG TAB
CILAZAPRIL 1MG TAB
CILAZAPRIL 1MG TAB
CILAZAPRIL 2.5MG TAB
CILAZAPRIL 2.5MG TAB
CILAZAPRIL 5MG TAB
CILAZAPRIL 5MG TAB
CO CAPTOPRIL 100MG TAB
CO CAPTOPRIL 12.5MG TAB
CO CILAZAPRIL 1MG TAB
CO CILAZAPRIL 2.5MG TAB
CO CILAZAPRIL 5MG TAB
CO FOSINOPRIL 10MG TAB
CO FOSINOPRIL 20MG TAB
CO RAMIPRIL 1.25MG CAP
CO RAMIPRIL 10MG CAP
CO RAMIPRIL 2.5MG CAP
CO RAMIPRIL 5MG CAP
CO‐ENALAPRIL 10MG TAB
CO‐ENALAPRIL 2.5MG TAB
CO‐LISINOPRIL 10MG TAB
COVERSYL 10MG TAB
COVERSYL 2.5MG TAB
COVERSYL 2MG TAB
COVERSYL 4MG TAB
COVERSYL 5MG TAB
COVERSYL 8MG TABS
COVERSYL PLUS 4MG/1.25MG TAB
COVERSYL PLUS 5MG/1.25MG TAB
COVERSYL PLUS HD 8MG/2.5MG TAB
COVERSYL PLUS LD 2.5/.625MG TA
COVERSYL PLUS LD 2/0.625MG TAB
DOM‐CAPTOPRIL 100MG TAB
DOM‐CAPTOPRIL 12.5MG TAB
DOM‐CILAZAPRIL 1MG TAB
DOM‐CILAZAPRIL 2.5MG TAB
DOM‐CILAZAPRIL 5MG TAB
DOM‐ENALAPRIL 10MG TAB
FOSINOPRIL SODIUM
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL DIHYDRATE/HCTZ
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
ENALAPRIL
ENALAPRIL
ENALAPRIL
ENALAPRIL
PERINDOPRIL ARGININE
PERINDOPRIL ERBUMINE
PERINDOPRIL ERBUMINE/INDAPAMID
INDAPAMIDE/PERINDOPRIL ARGININ
PERINDOPRIL ERB/INDAPAMIDE
INDAPAMIDE/PERINDOPRIL ARGININ
PERINDOPRIL ERBUMINE/INDAPAMID
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
ENALAPRIL SODIUM
20MG
10MG
20MG
5MG
10/12.5MG
20/12.5MG
20/25MG
1.25MG
10MG
2.5MG
5MG
100MG
12.5MG
25MG
50MG
12.5MG
100MG
100MG
100MG
100MG
12.5MG
12.5MG
12.5MG
12.5MG
25MG
25MG
25MG
25MG
50MG
50MG
50MG
50MG
100MG
12.5MG
25MG
50MG
1MG
1MG
2.5MG
2.5MG
5MG
5MG
100MG
12.5MG
25MG
50MG
1MG
2.5MG
5MG
10MG
20MG
1.25MG
10MG
2.5MG
5MG
10MG
2.5MG
20MG
5MG
10MG
20MG
5MG
10MG
2.5MG
2MG
4MG
5MG
8MG
4MG/1.25MG
1.25MG/5MG
8MG/2.5MG
.625/2.5MG
2/0.625MG
100MG
12.5MG
25MG
50MG
1MG
2.5MG
5MG
10MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
97
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
02308258
02308282
02308266
02255960
02255979
02294621
02294648
02294613
02308371
02287986
02287951
02287978
02308312
02334755
02343495
02308290
02308320
02334631
02343460
02334720
02343479
02308304
02334747
02343487
02287536
02332566
02287544
02332574
02335271
02290995
02291002
02291010
02290987
02341786
02341794
02341808
01909959
01911465
02181479
01911473
01911481
02331004
02331012
02361558
02361566
02361531
02331101
02331144
02331128
02331136
02242732
02294591
02321610
02332175
02333805
02343584
02349825
02294605
02321629
02332183
02333813
02343592
02349833
02294583
02321580
02332167
02333791
02343576
02349817
02335972
02335980
02335999
02351986
02351994
02351978
02363003
02363011
02363038
02362945
02362953
02362961
DOM‐ENALAPRIL 2.5MG TAB
DOM‐FOSINOPRIL 10MG TAB
DOM‐FOSINOPRIL 20MG TAB
DOM‐LISINOPRIL 10MG TAB
DOM‐RAMIPRIL 1.25MG CAP
DOM‐RAMIPRIL 10MG CAP
DOM‐RAMIPRIL 2.5MG CAP
DOM‐RAMIPRIL 5MG CAP
ENALAPRIL 10MG TAB
ENALAPRIL 16MG TAB
ENALAPRIL 16MG TAB
ENALAPRIL 2.5MG TAB
ENALAPRIL 20MG TAB
ENALAPRIL 2MG TAB
ENALAPRIL 2MG TAB
ENALAPRIL 4MG TAB
ENALAPRIL 4MG TAB
ENALAPRIL 5MG TAB
ENALAPRIL 8MG TAB
ENALAPRIL 8MG TAB
FOSINOPRIL 10MG TAB
FOSINOPRIL 10MG TAB
FOSINOPRIL 20MG TAB
FOSINOPRIL 20MG TAB
FOSINOPRIL 20MGTAB
GD‐QUINAPRIL 10MG TAB
GD‐QUINAPRIL HCTZ 10/12.5MG
GD‐QUINAPRIL HCTZ 20/12.5MG
GD‐QUINAPRIL HCTZ 20/25MG
INHIBACE 0.5MG TAB
INHIBACE 1MG TAB
INHIBACE PLUS 5/12.5MG TAB
INHIBACE TAB 2.5MG
INHIBACE TAB 5MG
JAMP‐FOSINOPRIL 10MG TAB
JAMP‐FOSINOPRIL 20MG TAB
JAMP‐LISINOPRIL 10MG TAB
JAMP‐RAMIPRIL 1.25MG CAP
JAMP‐RAMIPRIL 10MG CAP
JAMP‐RAMIPRIL 2.5MG CAP
JAMP‐RAMIPRIL 5MG CAP
LIN‐FOSINOPRIL 5MG TAB
LISINOPRIL 10MG TAB
LISINOPRIL 10MG TAB
LISINOPRIL 10MG TAB
LISINOPRIL 10MG TAB
LISINOPRIL 10MG TAB
LISINOPRIL 10MG TAB
LISINOPRIL 20MG TAB
LISINOPRIL 20MG TAB
LISINOPRIL 20MG TAB
LISINOPRIL 20MG TAB
LISINOPRIL 20MG TAB
LISINOPRIL 20MG TAB
LISINOPRIL 5MG TAB
LISINOPRIL 5MG TAB
LISINOPRIL 5MG TAB
LISINOPRIL 5MG TAB
LISINOPRIL 5MG TAB
LISINOPRIL 5MG TAB
LISINOPRIL HCT 10MG/12.5MG TAB
LISINOPRIL HCT 20MG/12.5MG TAB
LISINOPRIL HCT 20MG/25MG TAB
LISINOPRIL P 10MG TAB
LISINOPRIL/HCTZ (P) 10/12.5MG
LISINOPRIL/HCTZ (P) 20/12.5MG
LISINOPRIL/HCTZ (P) 20/25MG
LISINOPRIL/HCTZ (Z) 10/12.5MG
LISINOPRIL/HCTZ (Z) 20/12.5MG
LISINOPRIL/HCTZ (Z) 20/25MG
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
LISINOPRIL
LISINOPRIL
LISINOPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
QUINAPRIL HCL
QUINAPRIL HCL
QUINAPRIL HCL
QUINAPRIL HCL
QUINAPRIL/HCTZ
QUINAPRIL/HCTZ
QUINAPRIL/HCTZ
CILAZAPRIL
CILAZAPRIL
CILAZAPRIL/HCTZ
CILAZAPRIL
CILAZAPRIL
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
FOSINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
2.5MG
20MG
5MG
10MG
20MG
10MG
20MG
5MG
1.25MG
10MG
2.5MG
5MG
10MG
16MG
16MG
2.5MG
20MG
2MG
2MG
4MG
4MG
5MG
8MG
8MG
10MG
10MG
20MG
20MG
20MG
10MG
20MG
40MG
5MG
10/12.5MG
20/12.5MG
20/25MG
0.5MG
1MG
5MG/12.5MG
2.5MG
5MG
10MG
20MG
10MG
20MG
5MG
1.25MG
10MG
2.5MG
5MG
5MG
10MG
10MG
10MG
10MG
10MG
10MG
20MG
20MG
20MG
20MG
20MG
20MG
5MG
5MG
5MG
5MG
5MG
5MG
10/12.5MG
20/12.5MG
20/25MG
10MG
20MG
5MG
10/12.5MG
20/12.5MG
20/25MG
10/12.5MG
20/12.5MG
20/25MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
98
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
00885843
00885851
00885835
02231457
02231459
02231460
02239267
02317400
02317419
02317397
01907107
01907115
02163594
02163551
02163586
02163578
02283778
02283786
02283794
02300052
02300036
02300060
02300044
02262401
02262428
02274841
02274868
02274833
02297736
02297744
02297752
02301148
02301172
02301156
02301164
01942999
01942964
01942972
01942980
02266350
02266369
02266377
02313731
02233006
02300680
02233005
02300230
02300222
02238220
02238221
02238219
02347709
02347717
02347725
02381648
02381605
02381656
02381613
02381621
02361108
02361132
02361116
02361140
02361124
02361167
02345919
02345870
02345900
01913859
01913824
01913831
01913832
01913840
02338149
02338122
02338157
02338130
02335263
02335476
02335484
02335492
LOTENSIN 10MG TAB
LOTENSIN 20MG TAB
LOTENSIN 5MG TAB
MAVIK 0.5MG CAP
MAVIK 1MG CAP
MAVIK 2MG CAP
MAVIK 4MG CAP
MINT‐LISINOPRIL 10MG TAB
MONOPRIL 10MG TAB
MONOPRIL 20MG TAB
MYLAN‐CAPTOPRIL 100MG TAB
MYLAN‐CAPTOPRIL 12.5MG TAB
MYLAN‐CAPTOPRIL 50MG TAB
MYLAN‐CAPTOPRIL TAB 25MG
MYLAN‐CILAZAPRIL 1MG TAB
MYLAN‐CILAZAPRIL 2.5MG TAB
MYLAN‐CILAZAPRIL 5MG TAB
MYLAN‐ENALAPRIL 10MG TAB
MYLAN‐ENALAPRIL 2.5MG TAB
MYLAN‐FOSINOPRIL 10MG TAB
MYLAN‐FOSINOPRIL 20MG TAB
MYLAN‐LISINOPRIL 10MG TAB
MYLAN‐LISINOPRIL HCTZ 10/12.5
MYLAN‐LISINOPRIL HCTZ 20/12.5
MYLAN‐LISINOPRIL HCTZ 20/25
MYLAN‐RAMIPRIL 1.25MG CAP
MYLAN‐RAMIPRIL 10MG CAP
MYLAN‐RAMIPRIL 2.5MG CAP
MYLAN‐RAMIPRIL 5MG CAP
NOVO‐CAPTORIL TAB 100MG
NOVO‐CAPTORIL TAB 12.5MG
NOVO‐CILAZAPRIL 1MG TAB
NOVO‐CILAZAPRIL 2.5MG TAB
NOVO‐CILAZAPRIL 5MG TAB
NOVO‐CILAZAPRIL/HCTZ 5/12.5MG
NOVO‐ENALAPRIL 10MG TAB
NOVO‐ENALAPRIL 2.5MG TAB
NOVO‐ENALAPRIL 5MG TAB
NOVO‐ENALAPRIL/HCTZ 10MG/25MG
NOVO‐ENALAPRIL/HCTZ 5MG/12.5MG
NOVO‐LISINOPRIL 10MG TAB
NTP‐CILAZAPRIL 1MG TAB
NTP‐CILAZAPRIL 2.5MG TAB
NTP‐CILAZAPRIL 5MG TAB
NTP‐ENALAPRIL 16MG TAB
NTP‐LISINOPRIL/HCTZ 10/12.5
NTP‐LISINOPRIL/HCTZ 20/25
NTP‐LISINOPRIL/HCTZ 20/25
NTP‐RAMIPRIL 10MG CAP
NTP‐RAMIPRIL 2.5MG CAP
NTP‐RAMIPRIL 5MG CAP
NU‐CAPTO 100MG TAB
NU‐CAPTO 12.5MG TAB
NU‐CAPTO 25MG TAB
NU‐CAPTO 25MG TAB
NU‐CAPTO 50MG TAB
NU‐ENALAPRIL 10MG TAB
NU‐ENALAPRIL 2.5MG TAB
NU‐FOSINOPRIL 10MG TAB
NU‐LISINOPRIL 10MG TAB
BENAZEPRIL HCL
BENAZEPRIL HCL
BENAZEPRIL HCL
TRANDOLAPRIL
TRANDOLAPRIL
TRANDOLAPRIL
TRANDOLAPRIL
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
ENALAPRIL
ENALAPRIL
ENALAPRIL
ENALAPRIL
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
LISINOPRIL
LISINOPRIL
LISINOPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CILAZAPRIL MONOHYDRATE/HCTZ
ENALAPRIL
ENALAPRIL
ENALAPRIL
ENALAPRIL/HCTZ
ENALAPRIL/HCTZ
LISINOPRIL
LISINOPRIL
LISINOPRIL
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
RAMIPRIL
RAMIPRIL
RAMIPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
FOSINOPRIL SODIUM
LISINOPRIL
LISINOPRIL
LISINOPRIL
10MG
20MG
5MG
0.5MG
1MG
2MG
4MG
10MG
20MG
5MG
10MG
20MG
100MG
12.5MG
50MG
25MG
1MG
2.5MG
5MG
10MG
2.5MG
20MG
5MG
10MG
20MG
10MG
20MG
5MG
10/12.5MG
20/12.5MG
20/25MG
1.25MG
10MG
2.5MG
5MG
100MG
12.5MG
25MG
50MG
1MG
2.5MG
5MG
5MG/12.5MG
10MG
2.5MG
5MG
10MG/25MG
5MG/12.5MG
10MG
20MG
5MG
1MG
2.5MG
5MG
16MG
2MG
32MG
4MG
8MG
10/12.5
10/12.5
20/12.5
20/12.5
20/25
20/25
10MG
2.5MG
5MG
100MG
12.5MG
25MG
25MG
50MG
10MG
2.5MG
20MG
5MG
10MG
10MG
20MG
40MG
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
99
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
02335468
02336766
02336774
02336782
02246587
02246588
01910329
01910337
01910361
02303000
02303019
02234257
02234254
02234255
02234256
02292955
02292963
02292971
02309378
02309386
02309394
02256053
02256061
02308363
02287943
02287927
02287935
02230206
02280442
02280450
02280469
02300095
02300079
02300109
02300087
02255952
02292211
02292238
02292203
02295369
02247919
02343932
02247917
02247918
02342154
02342170
02342138
02342146
02342162
00839418
00839426
00839434
00839396
00839388
02108194
00884413
02311429
02311402
02311437
02311410
02310988
02310996
02311996
02311003
02310961
02311961
02311988
02310023
02310104
02310066
02310074
02339021
02339064
02339048
02339056
02248884
02051788
02242874
02248887
02051796
02248885
NU‐LISINOPRIL/HCTZ 10/12.5MG
NU‐LISINOPRIL/HCTZ 20/12.5MG
NU‐LISINOPRIL/HCTZ 20/25MG
ORB‐CAPTOPRIL 25MG TAB
ORB‐CAPTOPRIL 50MG TAB
PDL‐CAPTOPRIL‐12.5 TAB 12.5MG
PDL‐CAPTOPRIL‐25 TAB 25MG
PDL‐CAPTOPRIL‐50 TAB 50MG
PDL‐FOSINOPRIL‐10MG TAB
PDL‐FOSINOPRIL‐20MG TAB
PENTA‐CAPTOPRIL 100MG TAB
PENTA‐CAPTOPRIL 12.5MG TAB
PERINDOPRIL 2MG TAB
PERINDOPRIL 4MG TAB
PERINDOPRIL 8MG TAB
PHL‐CILAZAPRIL 1MG TAB
PHL‐CILAZAPRIL 2.5MG TAB
PHL‐CILAZAPRIL 5MG TAB
PHL‐FOSINOPRIL 10MG TAB
PHL‐FOSINOPRIL 20MG TAB
PHL‐RAMIPRIL 1.25MG CAP
PHL‐RAMIPRIL 10MG CAP
PHL‐RAMIPRIL 2.5MG CAP
PHL‐RAMIPRIL 5MG CAP
PMS‐CAPTOPRIL 100MG TAB
PMS‐CILAZAPRIL 1MG TAB
PMS‐CILAZAPRIL 2.5MG TAB
PMS‐CILAZAPRIL 5MG TAB
PMS‐ENALAPRIL 10MG TAB
PMS‐ENALAPRIL 2.5MG TAB
PMS‐FOSINOPRIL 20MG TAB
PMS‐LISINOPRIL 10MG TAB
PMS‐RAMIPRIL 1.25MG CAP
PMS‐RAMIPRIL 10MG CAP
PMS‐RAMIPRIL 2.5MG CAP
PMS‐RAMIPRIL‐HCTZ 10/12.5MG
PMS‐RAMIPRIL‐HCTZ 10/25MG TAB
PMS‐RAMIPRIL‐HCTZ 2.5/12.5MG
PMS‐RAMIPRIL‐HCTZ 2.5/12.5MG
PMS‐RAMIPRIL‐HCTZ 5MG/25MG TAB
PRINIVIL 20MG TAB
PRINIVIL 40MG TAB
PRINIVIL 80MG TAB
PRINIVIL TAB 10MG
PRINIVIL TAB 5MG
PRINZIDE 10/12.5MG TAB
PRINZIDE 20/12.5MG TAB
PRO‐ENALAPRIL 10MG TAB
PRO‐ENALAPRIL 2.5MG TAB
PRO‐LISINOPRIL 10MG TAB
PRO‐LISINOPRIL10MG TAB
PRO‐RAMIPRIL 1.25MG CAP
PRO‐RAMIPRIL 10MG CAP
PRO‐RAMIPRIL 2.5MG CAP
PRO‐RAMIPRIL 5MG CAP
Q‐RAMIPRIL 1.25MG CAP
Q‐RAMIPRIL 10MG CAP
Q‐RAMIPRIL 2.5MG CAP
Q‐RAMIPRIL 5MG CAP
RAMACE 1.25 MG TAB
RAMACE 1.25MG CAP
RAMACE 10MG CAP
RAMACE 10MG TAB
RAMACE 2.5MG CAP
RAMACE 2.5MG TAB
LISINOPRIL
LISINOPRIL / HCTZ
LISINOPRIL / HCTZ
LISINOPRIL / HCTZ
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
CAPTOPRIL
ENALAPRIL
ENALAPRIL
ENALAPRIL
ENALAPRIL
FOSINOPRIL SODIUM
LISINOPRIL
LISINOPRIL
LISINOPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL/HCTZ
RAMIPRIL/HCTZ
RAMIPRIL/HCTZ
RAMIPRIL/HCTZ
RAMIPRIL/HCTZ
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
5MG
10/12.5MG
20/12.5MG
20/25MG
25MG
50MG
12.5M
25MG
50MG
10MG
20MG
100MG
12.5MG
25MG
50MG
2MG
4MG
8MG
1MG
2.5MG
5MG
10MG
20MG
1.25MG
10MG
2.5MG
5MG
100MG
1MG
2.5MG
5MG
10MG
2.5MG
20MG
5MG
20MG
10MG
20MG
5MG
1.25MG
10MG
15MG
2.5MG
5MG
10/12.5MG
10MG/25MG
2.5/12.5MG
5/12.5MG
5MG/25MG
20MG
40MG
80MG
10MG
5MG
10/12.5MG
20/12.5MG
10MG
2.5MG
20MG
5MG
10MG
20MG
20MG
40MG
5MG
5MG
10MG
1.25MG
10MG
2.5MG
5MG
1.25MG
10MG
2.5MG
5MG
1.25MG
1.25MG
10MG
10MG
2.5MG
2.5MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
CAP
CAP
TAB
CAP
TAB
100
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
02051818
02248886
02299372
02332299
02340216
02342685
02255332
02332329
02340240
02374862
02342715
02255316
02332302
02340224
02342693
02374846
02255324
02332310
02340232
02342707
02374854
02352257
02352230
02352265
02352249
02294524
02294532
02294249
02294257
02294230
02310503
02310546
02310511
02310538
02300001
02299984
02300028
02299992
02256800
02256819
02256797
02299887
02299895
02299879
02287692
02287722
02287706
02287714
02300826
02300796
02300834
02300818
02265923
02265931
02300982
02300990
02300958
09857286
09857287
09857272
02302365
02302373
02302381
02291398
02291436
02291401
02291428
02299968
02299933
02299976
02299941
02289202
02289229
02289199
02346818
02346834
02346842
02323508
02323478
02323486
02323494
RAMACE 5MG CAP
RAMACE 5MG TAB
RAMIPRIL 1.25MG CAP
RAMIPRIL 1.25MG CAP
RAMIPRIL 1.25MG CAP
RAMIPRIL 1.25MG CAP
RAMIPRIL 10MG CAP
RAMIPRIL 10MG CAP
RAMIPRIL 10MG CAP
RAMIPRIL 10MG CAP
RAMIPRIL 10MG TAB
RAMIPRIL 2.5MG CAP
RAMIPRIL 2.5MG CAP
RAMIPRIL 2.5MG CAP
RAMIPRIL 2.5MG CAP
RAMIPRIL 2.5MG CAP
RAMIPRIL 5MG CAP
RAMIPRIL 5MG CAP
RAMIPRIL 5MG CAP
RAMIPRIL 5MG CAP
RAMIPRIL 5MG CAP
RAN‐ENALAPRIL 10MG TAB
RAN‐ENALAPRIL 2.5MG TAB
RAN‐FOSINOPRIL 10MG TAB
RAN‐FOSINOPRIL 20MG TAB
RAN‐LISINOPRIL 10MG TAB
RAN‐RAMIPRIL 1.25MG CAP
RAN‐RAMIPRIL 10MG CAP
RAN‐RAMIPRIL 2.5MG CAP
RAN‐RAMIPRIL 5MG CAP
RATIO‐ENALAPRIL 10MG TAB
RATIO‐ENALAPRIL 2.5MG TAB
RATIO‐LISINOPRIL P 10MG TAB
RATIO‐LISINOPRIL P 20MG TAB
RATIO‐LISINOPRIL P 5MGTAB
RATIO‐LISINOPRIL Z 10MG TAB
RATIO‐RAMIPRIL 1.25MG CAP
RATIO‐RAMIPRIL 10MG CAP
RATIO‐RAMIPRIL 2.5MG CAP
RATIO‐RAMIPRIL 5MG CAP
RIVA‐ENALAPRIL 10MG TAB
RIVA‐ENALAPRIL 2.5MG TAB
RIVA‐FOSINOPRIL 10MG TAB
RIVA‐FOSINOPRIL 20MG TAB
RIVA‐LISINOPRIL 10MG TAB
SANDOZ LISINOPRIL 10MG TAB
SANDOZ LISINOPRIL HCT 10/12.5
SANDOZ LISINOPRIL HCT 20/12.5
SANDOZ LISINOPRIL HCT 20/25MG
SANDOZ RAMIPRIL 1.25MG TAB
SANDOZ RAMIPRIL 10MG TAB
SANDOZ RAMIPRIL 2.5MG TAB
SANDOZ RAMIPRIL 5MG TAB
SANDOZ‐ENALAPRIL 10MG TAB
SANDOZ‐ENALAPRIL 2.5MG TAB
SANDOZ‐LISINOPRIL 10MG TAB
SIG‐CILAZAPRIL 1MG TAB
SIG‐CILAZAPRIL 2.5MG TAB
SIG‐CILAZAPRIL 5MG TAB
SIG‐ENALAPRIL 16MG TAB
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
LISINOPRIL
LISINOPRIL
LISINOPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL
ENALAPRIL MALEATE
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
LISINOPRIL
LISINOPRIL
LISINOPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
LISINOPRIL
LISINOPRIL
LISINOPRIL
CILAZAPRIL
CILAZAPRIL
CILAZAPRIL
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
ENALAPRIL SODIUM
5MG
5MG
1.25MG
1.25MG
1.25MG
1.25MG
10MG
10MG
10MG
10MG
10MG
2.5MG
2.5MG
2.5MG
2.5MG
2.5MG
5MG
5MG
5MG
5MG
5MG
10MG
2.5MG
20MG
5MG
10MG
20MG
10MG
20MG
5MG
1.25MG
10MG
2.5MG
5MG
10MG
2.5MG
20MG
5MG
10MG
20MG
5MG
10MG
20MG
5MG
1.25MG
10MG
2.5MG
5MG
10MG
2.5MG
20MG
5MG
10MG
20MG
10MG
20MG
5MG
10MG
20MG
5MG
10/12.5MG
20/12.5MG
20/25MG
1.25MG
10MG
2.5MG
5MG
10MG
2.5MG
20MG
5MG
10MG
20MG
5MG
1MG
2.5MG
5MG
16MG
2MG
4MG
8MG
CAP
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
101
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
243204
02331918
02331926
02331896
02346826
02346885
02346869
02346877
02238095
02240945
02238096
02240946
02238097
02300133
02300117
02300141
02300125
02233007
02247802
02247803
02285088
02285096
02285061
02285126
02285134
02285118
02302136
02302144
02302152
02301768
02301776
02301784
02247947
02247945
02247946
02229561
02229558
02229559
02229560
00657298
00670901
00851795
00670928
00708879
02103729
00884375
02045737
00884383
02045729
02049376
02049384
02049333
SIG‐LISINOPRIL 10MG TAB
SIG‐RAMIPRIL 1.25MG CAP
SIG‐RAMIPRIL 10MG CAP
SIG‐RAMIPRIL 2.5MG CAP
SIG‐RAMIPRIL 5MG CAP
TARKA 1MG+180MG TAB
TARKA 1MG+240MG TAB
TARKA 2MG+180MG TAB
TARKA 2MG+240MG TAB
TARKA 4MG+240MG TAB
TARO‐ENALAPRIL 10MG TAB
TARO‐ENALAPRIL 2.5MG TAB
TEVA‐ENALAPRIL 20MG TAB
TEVA‐FOSINOPRIL 10MG TAB
TEVA‐FOSINOPRIL 20MG TAB
TEVA‐LISINOPRIL(TYPE P) 10MG
TEVA‐LISINOPRIL(TYPE Z) 10MG
TEVA‐LISINOPRIL/HCTZ P 10/12.5
TEVA‐LISINOPRIL/HCTZ P 20/12.5
TEVA‐LISINOPRIL/HCTZ P 20/25MG
TEVA‐LISINOPRIL/HCTZ Z 10/12.5
TEVA‐LISINOPRIL/HCTZ Z 20/12.5
TEVA‐LISINOPRIL/HCTZ Z 20/25MG
TEVA‐RAMIPRIL 10MG CAP
TEVA‐RAMIPRIL 2.5MG CAP
TEVA‐RAMIPRIL 5MG CAP
TRIA‐CAPTOPRIL 100MG TAB
TRIA‐CAPTOPRIL 12.5MG TAB
VASERETIC 10/25 TAB
VASOTEC 10MG TAB
VASOTEC 2.5MG TAB
VASOTEC 20MG TAB
VASOTEC 5MG TAB
ZESTORETIC 10/12.5 TAB
ZESTORETIC 20/25 TAB
ZESTORETIC 20/25 TAB
ZESTRIL 10MG TAB
ZESTRIL 20 MG TAB
ZESTRIL 5 MG TAB
LISINOPRIL
LISINOPRIL
LISINOPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
TRANDOLAPRIL & VERAPAMIL HCL
TRANDOLAPRIL/VERAPAMIL HCL
ENALAPRIL
ENALAPRIL
ENALAPRIL
ENALAPRIL
ENALAPRIL MALEATE
FOSINOPRIL SODIUM
FOSINOPRIL SODIUM
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
LISINOPRIL
RAMIPRIL
RAMIPRIL
RAMIPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
CAPTOPRIL
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
ENALAPRIL MALEATE
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
LISINOPRIL/HCTZ
LISINOPRIL
LISINOPRIL
LISINOPRIL
10MG
20MG
5MG
1.25MG
10MG
2.5MG
5MG
1MG/180MG
1MG/240MG
2MG/180MG
2MG+240MG
4MG+240MG
10MG
2.5MG
20MG
5MG
20MG
10MG
20MG
10MG
20MG
5MG
10MG
20MG
5MG
10/12.5MG
20/12.5MG
20/25MG
10/12.5MG
20/12.5MG
20/25MG
10MG
2.5MG
5MG
100MG
12.5MG
25MG
50MG
10MG/25MG
10MG
2.5MG
20MG
5MG
10/12.5MG
20/12.5MG
20MG/12.5M
20/25 MG
20/25MG
10MG
20MG
5MG
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
102
*PA
05/2012
Therapy Class
243208
DIN
Drug Name
ANGIOTENSIN II RECEPTOR ANTAGONISTS
Chemical Name
Strength
Dosage
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
02365367
02365340
02365359
02353512
02379058
02353504
02371243
02371251
02371235
02371537
02371545
02371510
02371529
02382555
02382563
02382571
02382598
02382547
02239092
02311658
02239090
02239091
02244021
02332922
02332957
02373327
02373335
02373319
02373343
02373351
02373378
02241818
02241819
02280213
02237924
02237925
02237923
02367130
02367149
02367114
02367122
02367076
02367084
02367092
02367106
02367068
02377942
02377942
02377934
02377934
02379287
02379287
02379295
02379295
02379260
02379260
02379279
02379279
02376520
02328089
02328100
02328070
02357402
02357410
02357399
02337509
02337517
02337487
02337495
02376547
02376555
02376539
02354845
02354829
02354837
02182882
02182815
02182874
02244782
02289504
APO‐CANDESARTAN 16MG TAB
APO‐LOSARTAN 100MG TAB
APO‐LOSARTAN/HCTZ 100/12.5MG
APO‐LOSARTAN/HCTZ 100/25MG
APO‐LOSARTAN/HCTZ 50/12.5MG
APO‐VALSARTAN 160MG TAB
APO‐VALSARTAN/HCTZ 160/12.5MG
APO‐VALSARTAN/HCTZ 160/25MG
APO‐VALSARTAN/HCTZ 320/25MG
ATACAND 16MG TAB
ATACAND 32MG TAB
ATACAND 4MG TAB
ATACAND 8MG TAB
ATACAND PLUS 16MG/12.5MG TAB
ATACAND PLUS 32MG/12.5MG TAB
ATACAND PLUS 32MG/25MG TAB
AVA‐IRBESARTAN 150MG TAB
AVA‐IRBESARTAN‐HCTZ 150/12.5MG
AVA‐IRBESARTAN‐HCTZ 300/12.5MG
AVA‐IRBESARTAN‐HCTZ 300/25MG
AVALIDE 150MG/12.5MG TAB
AVALIDE 300MG/12.5MG TAB
AVALIDE 300MG/25MG TAB
AVAPRO 150MG TAB
AVAPRO 300MG TAB
AVAPRO 75MG TAB
AVA‐VALSARTAN 160MG TAB
AVA‐VALSARTAN HCT 160/12.5MG
AVA‐VALSARTAN HCT 160/25MG
AVA‐VALSARTAN HCT 320/25MG
CANDESARTAN 16MG TAB
CANDESARTAN 16MG TAB
CANDESARTAN 8MG TAB
CANDESARTAN 8MG TAB
CANDESARTAN CILEXETIL 16MG TAB
CO CANDESARTAN 4MG TAB
CO IRBESARTAN 150MG TAB
CO IRBESARTAN/HCT 300/12.5MG
CO IRBESARTAN/HCT 300/25MG
CO IRBESARTAN/HCT150/12.5MGTAB
CO VALSARTAN 160MG TAB
CO‐CANDESARTAN 16MG TAB
CO‐LOSARTAN 100MG TAB
COZAAR 100MG TAB
COZAAR 25MG TAB
COZAAR 50MG TAB
DIOVAN 160MG TAB
DIOVAN 320MG TAB
CANDESARTAN CILEXETIL
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM/HCTZ
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
CANDESARTAN CILEXETIL/HCTZ
IRBESARTAN
IRBESARTAN
IRBESARTAN
IRBESARTAN/HYDROCHLOROTHIAZIDE
IRBESARTAN/HCTZ
IRBESARTAN/HCTZ
IRBESARTAN/HCTZ
IRBESARTAN
IRBESARTAN
IRBESARTAN
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
IRBESARTAN
IRBESARTAN
IRBESARTAN
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
VALSARTAN
VALSARTAN
16MG
4MG
8MG
100MG
25MG
50MG
100/12.5MG
100/25MG
50/12.5MG
160MG
320MG
40MG
80MG
160/12.5MG
160/25MG
320/12.5MG
320/25MG
80/12.5MG
16MG
32MG
4MG
8MG
16MG/12.5M
32/12.5MG
32/25MG
150MG
300MG
75MG
150/12.5MG
300/12.5MG
300/25MG
150/12.5
300/12.5MG
300MG/25MG
150MG
300MG
75MG
160MG
320MG
40MG
80MG
160/12.5MG
160/25MG
320/12.5MG
320/25MG
80/12.5MG
16MG
16MG
8MG
8MG
16MG
16MG
32MG
32MG
4MG
4MG
8MG
8MG
4MG
150MG
300MG
75MG
300/12.5MG
300/25MG
150/12.5MG
160MG
320MG
40MG
80MG
16MG
32MG
8MG
100MG
25MG
50MG
100MG
25MG
50MG
160MG
320MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
103
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
02270528
02236808
02244781
02241901
02246955
02308908
02308916
02241900
02372193
02372207
02372185
02372223
02372231
02372266
02314495
02314479
02314487
02297841
02230047
02241007
02365200
02372371
02365219
02372398
02365197
02372347
02372886
02372894
02372908
02365162
02365170
02365189
02240769
02240770
02318709
02244344
02379147
02379147
02379155
02379155
02379120
02379120
02379139
02379139
02347318
02347326
02347296
02376873
02376881
02376903
02368293
02368277
02368285
02378086
02378094
02378078
02376717
02376725
02373564
02373564
02373572
02373572
02383543
02383551
02383527
02383535
02373742
02373750
02373769
02373777
02373734
02358468
02358476
02358433
02358441
02330490
02330504
02330482
02368986
02368994
02368978
DIOVAN 40MG TAB
DIOVAN 80MG CAP
DIOVAN 80MG TAB
DIOVAN‐HCT 160MG/12.5MG TAB
DIOVAN‐HCT 160MG/25MG TAB
DIOVAN‐HCT 320MG/25MG TAB
DOM‐IRBESARTAN 150MG TAB
DOM‐IRBESARTAN‐HCTZ 150/12.5MG
DOM‐IRBESARTAN‐HCTZ 300/12.5MG
DOM‐IRBESARTAN‐HCTZ 300/25MG
DOM‐LOSARTAN 100MG TAB
HYZAAR 100MG/12.5MG TAB
HYZAAR 50MG/12.5MG TAB
HYZAAR DS 100MG/25MG TAB
IRBESARTAN 150MG TAB
IRBESARTAN 75MG TAB
IRBESARTAN 75MG TAB
IRBESARTAN/HCTZ 150/12.5MG TAB
IRBESARTAN/HCTZ 300/12.5MG TAB
IRBESARTAN/HCTZ 300/25MG TAB
IRBESARTAN‐HCTZ 150/12.5MG TAB
IRBESARTAN‐HCTZ 300/12.5MG TAB
IRBESARTAN‐HCTZ 300/25MG TAB
MICARDIS 40MG TAB
MICARDIS 80MG TAB
MICARDIS PLUS 80MG/25MG TAB
MICARDIS PLUS TAB
MYLAN‐CANDESARTAN 16MG TAB
MYLAN‐IRBESARTAN 150MG TAB
MYLAN‐IRBESARTAN HCTZ 150/12.5
MYLAN‐IRBESARTAN HCTZ 300/12.5
MYLAN‐IRBESARTAN HCTZ 300/25
MYLAN‐LOSARTAN 100MG TAB
MYLAN‐LOSARTAN/HCTZ 100/12.5MG
MYLAN‐LOSARTAN/HCTZ 100/25MG
MYLAN‐LOSARTAN/HCTZ 50/12.5MG
MYLAN‐TELMISARTAN 40MG TAB
MYLAN‐TELMISARTAN 80MG TAB
MYLAN‐TELMISARTAN HCTZ 80/12.5
MYLAN‐TELMISARTAN HCTZ 80/12.5
MYLAN‐TELMISARTAN HCTZ 80/25
MYLAN‐TELMISARTAN HCTZ 80/25
MYLAN‐VALSARTAN 160MG TAB
MYLAN‐VALSARTAN HCTZ 160/12.5M
MYLAN‐VALSARTAN HCTZ 160/25MG
MYLAN‐VALSARTAN HCTZ 320/12.5M
MYLAN‐VALSARTAN HCTZ 320/25MG
MYLAN‐VALSARTAN HCTZ 80/12.5MG
NOVO‐VALSARTAN 160MG TAB
NOVO‐VALSARTAN/HCTZ 160MG/12.5
NOVO‐VALSARTAN/HCTZ 160MG/25MG
NOVO‐VALSARTAN/HCTZ 80/12.5MG
NTP‐IRBESARTAN 150MG TAB
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
IRBESARTAN
IRBESARTAN
IRBESARTAN
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN/HCTZ
IRBESARTAN
IRBESARTAN
IRBESARTAN
IRBESARTAN
IRBESARTAN
IRBESARTAN
IRBESARTAN/HCTZ
IRBESARTAN/HCTZ
TELMISARTAN
TELMISARTAN
HYDROCHLOROTHIAZID/TELMISARTAN
TELMISARTAN/HCTZ
IRBESARTAN
IRBESARTAN
IRBESARTAN
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
TELMISARTAN
TELMISARTAN
TELMISARTAN/HCTZ
TELMISARTAN/HCTZ
TELMISARTAN/HCTZ
TELMISARTAN/HCTZ
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN/HCTZ
VALSARTAN HCTZ
VALSARTAN HCTZ
VALSARTAN HCTZ
VALSARTAN/HCTZ
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
IRBESARTAN
IRBESARTAN
IRBESARTAN
40MG
80MG
80MG
160MG/12.5
160MG/25MG
320/12.5MG
320/25MG
80MG/12.5M
150MG
300MG
75MG
150/12.5MG
300/12.5MG
300/25MG
100MG
25MG
50MG
100/12.5MG
50/12.5MG
100MG/25MG
150MG
150MG
300MG
300MG
75MG
75MG
150/12.5MG
300/12.5MG
300/25MG
150/12.5MG
300/12.5MG
300/25MG
40MG
80MG
25MG/80MG
80/12.5MG
16MG
16MG
32MG
32MG
4MG
4MG
8MG
8MG
150MG
300MG
75MG
150/12.5MG
300/12.5
300/25MG
100MG
25MG
50MG
100/12.5MG
100/25MG
50/12.5MG
40MG
80MG
80/12.5MG
80/12.5MG
80/25MG
80/25MG
160MG
320MG
40MG
80MG
160/12.5MG
160/25MG
320/12.5MG
320/25MG
80/12.5MG
160MG
320MG
40MG
80MG
160/12.5MG
160MG/25MG
80/12.5MG
150MG
300MG
75MG
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
104
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
02368935
02368943
02368951
02318660
02318679
02314460
02314444
02314452
02317060
02312999
02317079
02317087
02328518
02328526
02328534
02309777
02309750
02309769
02313014
02344564
02313006
02354438
02354446
02354411
02367637
02367653
02375664
02375672
02375680
02375699
02375656
02363208
02363216
02363224
02363119
02363062
02363100
02330512
02330520
02316404
02316412
02316390
02330539
02358271
02358271
02326973
02326957
02326965
02337428
02337436
02337444
02328488
02328496
02328461
02313359
02313332
02313340
02362449
02313383
02313375
02375958
02375966
02356767
02356775
02356740
02356759
02356708
02356716
02356724
02356732
02356694
02320177
02366320
02366339
02366312
02316021
02316013
02315998
02316005
02315971
02316048
NTP‐IRBESARTAN/HCTZ 150/12.5MG
NTP‐IRBESARTAN/HCTZ 300/12.5MG
NTP‐IRBESARTAN/HCTZ 300/25MG
OLMETEC 20MG TAB
OLMETEC 40MG TAB
PHL‐LOSARTAN 100MG TAB
PMS IRBESARTAN 75MG TAB
PMS VALSARTAN 40MG TAB
PMS‐IRBESARTAN 150MG TAB
PMS‐IRBESARTAN 300MG TAB
PMS‐IRBESARTAN/HCTZ 150/12.5MG
PMS‐IRBESARTAN/HCTZ 300/12.5MG
PMS‐IRBESARTAN/HCTZ 300/25MG
PMS‐LOSARTAN 100MG TAB
PMS‐VALSARTAN 160MG TAB
PMS‐VALSARTAN/HCTZ 160MG/12.5
PMS‐VALSARTAN/HCTZ 160MG/25
PMS‐VALSARTAN/HCTZ 80/12.5MG
PMS‐VALSARTAN‐HCTZ 320/12.5MG
PMS‐VALSARTAN‐HCTZ 320/25MG
Q‐VALSARTAN HCTZ 160/12.5MGTAB
Q‐VALSARTAN HCTZ 160/25MG TAB
Q‐VALSARTAN HCTZ 320/12.5MGTAB
Q‐VALSARTAN HCTZ 320/25MG TAB
Q‐VALSARTAN HCTZ 80/12.5MG TAB
RAN‐IRBESARTAN HCTZ 150/12.5
RAN‐IRBESARTAN HCTZ 300/12.5MG
RAN‐IRBESARTAN HCTZ 300/25MG
RAN‐VALSARTAN 160MG TAB
RATIO‐IRBESAR/HCTZ 150/12.5MG
RATIO‐IRBESAR/HCTZ 300/12.5MG
RATIO‐IRBESARTAN 150MG TAB
RATIO‐IRBESARTAN/HCTZ 300/25MG
RATIO‐LOSARTAN HCTZ 100/25MG
RATIO‐LOSARTAN HCTZ 100/25MG
SANDOZ CANDESARTAN 16MG TAB
SANDOZ IRBESAR/HCTZ 150/12.5MG
SANDOZ IRBESAR/HCTZ 300/12.5MG
SANDOZ IRBESAR/HCTZ 300/25MG
SANDOZ IRBESARTAN 150MG TAB
SANDOZ LOSARTAN 100MG TAB
SANDOZ LOSARTAN HCT 100/12.5MG
SANDOZ LOSARTAN HCT 100/25MG
SANDOZ LOSARTAN HCT 50/12.5MG
SANDOZ TELMISARTAN 40MG TAB
SANDOZ TELMISARTAN 80MG TAB
SANDOZ VALSARTAN 160MG TAB
SANDOZ VALSARTAN HCT 160/12.5
SANDOZ VALSARTAN HCT 160/25
SANDOZ VALSARTAN HCT 320/12.5
SANDOZ VALSARTAN HCT 320/25MG
SANDOZ VALSARTAN HCT 80/12.5MG
TEVA TELMISARTAN 40MG TAB
TEVA‐CANDESARTAN 16MG TAB
TEVA‐IRBESAR/HCTZ 300/12.5MG
TEVA‐IRBESART/HCTZ 150/12.5MG
TEVA‐IRBESARTAN 150MG TAB
TEVA‐IRBESARTAN/HCTZ 300/25MG
IRBESARTAN/HCTZ
IRBESARTAN/HCTZ
IRBESARTAN/HCTZ
OLMESARTAN MEDOXOMIL
OLMESARTAN MEDOXOMIL
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
IRBESARTAN
VALSARTAN
IRBESARTAN
IRBESARTAN
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN
VALSARTAN
VALSARTAN
IRBESARTAN
IRBESARTAN
IRBESARTAN
IRBESARTAN
IRBESARTAN
IRBESARTAN
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN/HCTZ
LOSARTAN/HCTZ
LOSARTAN/HCTZ
TELMISARTAN
TELMISARTAN
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN/HCT
VALSARTAN/HCT
VALSARTAN/HCT
VALSARTAN/HCT
VALSARTAN/HCT
TELMISARTAN
IRBESARTAN
IRBESARTAN
IRBESARTAN
150/12.5MG
300/12.5MG
300/25MG
20MG
40MG
100MG
25MG
50MG
75MG
40MG
150MG
300MG
150/12.5MG
300/12.5MG
300/25MG
100MG
25MG
50MG
160MG
320MG
80MG
160/12.5MG
160MG/25MG
80/12.5MG
320/12.5MG
320/25MG
160/12.5MG
160/25MG
320/12.5MG
320/25MG
80/12.5MG
150/12.5MG
300/12.5MG
300/25MG
160MG
40MG
80MG
150/12.5MG
300/12.5MG
150MG
300MG
75MG
300/25MG
100/25MG
100/25MG
16MG
4MG
8MG
150/12.5MG
300/12.5MG
300/25MG
150MG
300MG
75MG
100MG
25MG
50MG
100/12.5MG
100/25MG
50/12.5MG
40MG
80MG
160MG
320MG
40MG
80MG
160/12.5MG
160MG/25MG
320/12.5MG
320/25MG
80/12.5MG
40MG
16MG
32MG
8MG
300/12.5MG
150/12.5MG
150MG
300MG
75MG
300/25MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
105
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
243208
02357976
02380838
02380838
02357968
02358263
02358263
02377144
02377152
02320185
02330288
02330288
02379252
02379252
02356678
02356686
02356643
02356651
02357011
02357003
02357038
02357046
02356996
02240432
02243942
02253631
02253634
02367742
02367750
02367726
02367734
02367017
02367025
02367033
02367041
02367009
02367777
02367785
02367769
TEVA‐LOSARTAN 100MG TAB
TEVA‐LOSARTAN HCTZ 50/12.5MG
TEVA‐LOSARTAN HCTZ 50/12.5MG
TEVA‐LOSARTAN/HCTZ 100/12.5MG
TEVA‐LOSARTAN/HCTZ 100/25MG
TEVA‐TELMISARTAN 80MG TAB
TEVA‐TELMISARTAN HCTZ 80/12.5
TEVA‐TELMISARTAN HCTZ 80/12.5
TEVA‐TELMISARTAN HCTZ 80/25MG
TEVA‐TELMISARTAN HCTZ 80/25MG
TEVA‐VALSARTAN 160MG TAB
TEVA‐VALSARTAN/HCTZ 160/25MG
TEVA‐VALSARTAN/HCTZ 160MG/12.5
TEVA‐VALSARTAN/HCTZ 320/12.5MG
TEVA‐VALSARTAN/HCTZ 320/25MG
TEVA‐VALSARTAN/HCTZ 80/12.5MG
TEVETEN 400MG TAB
TEVETEN 600MG TAB
TEVETEN PLUS 600MG TAB
TEVETEN PLUS 600MG/12.5MG TAB
VALSARTAN 160MG TAB
VALSARTAN 320MG TAB
VALSARTAN 40MG TAB
VALSARTAN 80MG TAB
VALSARTAN HCT 160/12.5MG
VALSARTAN HCT 160/25MG
VALSARTAN HCT 320/25MG
VALSARTAN‐HCTZ 160/12.5MG TAB
VALSARTAN‐HCTZ 160/25MG TAB
VALSARTAN‐HCTZ 80/12.5MG TAB
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN POTASSIUM
LOSARTAN/HCTZ
LOSARTAN/HCTZ
TELMISARTAN
TELMISARTAN/HCTZ
TELMISARTAN/HCTZ
TELMISARTAN/HCTZ
TELMISARTAN/HCTZ
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
EPROSARTAN MESYLATE
EPROSARTAN MESYLATE
EPROSARTAN MESYLATE/HCT
EPROSARTAN MESYLATE/HCT
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
VALSARTAN/HCTZ
100MG
25MG
25MG
50MG
50/12.5MG
50/12.5MG
100/12.5MG
100/25MG
80MG
80/12.5MG
80/12.5MG
80/25MG
80/25MG
160MG
320MG
40MG
80MG
160MG/25MG
160/12.5MG
320/12.5MG
320/25MG
80/12.5MG
400MG
600MG
600MG/12.5
600MG/12.5
160MG
320MG
40MG
80MG
160/12.5MG
160/25MG
320/12.5MG
320/25MG
80/12.5MG
160/12.5MG
160/25MG
80/12.5MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
106
*PA
05/2012
Therapy Class
243220
DIN
Drug Name
MINERALOCORTICOID (ALDOSTERONE) RECEPTOR ANTAGONISTS
Chemical Name
Strength
Dosage
243220
243220
243220
243220
243220
243220
243220
243220
00028606
00285455
02323052
02323060
02347628
02347601
00613223
00613215
ALDACTONE 25MG TAB
ALDACTONE TAB 100MG
INSPRA 25MG TAB
INSPRA 50MG TAB
NTP‐SPIRONOLACTONE 100MG TAB
NTP‐SPIRONOLACTONE 25MG TAB
TEVA‐SPIROTON TAB 100MG
TEVA‐SPIROTON TAB 25MG
SPIRONOLACTONE
SPIRONOLACTONE
EPLERENONE
EPLERENONE
SPIRONOLACTONE
SPIRONOLACTONE
SPIRONOLACTONE
SPIRONOLACTONE
25MG
100MG
25MG
50MG
100MG
25MG
100MG
25MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
107
*PA
PA (N)
PA (N)
05/2012
Therapy Class
243240
DIN
Drug Name
RENIN INHIBITORS
Chemical Name
Strength
Dosage
243240
243240
243240
243240
243240
243240
02302063
02302071
02332728
02332736
02332744
02332752
RASILEZ 150MG TAB
RASILEZ 300MG TAB
RASILEZ HCT 150MG/12.5MG TAB
RASILEZ HCT 150MG/25MG TAB
RASILEZ HCT 300MG/12.5MG TAB
RASILEZ HCT 300MG/25MG TAB
ALISKIREN FUMARATE
ALISKIREN FUMARATE
ALISKIREN FUMARATE/HCTZ
150MG
300MG
150/12.5MG
150/25MG
300/12.5MG
300/25MG
TAB
TAB
TAB
TAB
TAB
TAB
108
*PA
05/2012
Therapy Class
280804
DIN
Drug Name
NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
Chemical Name
Strength
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
02269139
02283905
02152576
00010537
02162725
02162717
00472468
00510696
00839175
00839183
02243433
02091194
02162814
02354403
02039486
02039494
01912038
01912046
00585114
00611158
00611166
02229080
02243989
02248974
02248973
00784354
01940309
00522678
00522651
00600806
00592277
02246699
02246700
02246701
02243661
00642886
00642894
00778354
00778362
02136112
02136120
02341352
02341360
01917056
02229837
00036145
00530336
02245443
02010526
00230324
00688592
02238545
02243974
02009013
02242281
02280167
02150417
02150328
02237726
02289970
02229980
00672955
02366665
02366673
02366703
02366681
02365553
02365545
02365812
02365820
02365839
02365847
02365855
02365863
02304651
02250020
02250012
02150425
02027836
02027844
ACETYLSALICYLIC ACID 80MG CHEW
ACETYLSALICYLIC ACID 80MG DR T
ALBERT‐TIAFEN 300MG SR CAP
ALKA BUTAZOLIDIN
ANAPROX 275 MG TAB
ANAPROX DS TAB 550MG
APO‐ASA 325MG TAB
APO‐ASEN ECT 325MG TAB
APO‐DICLO 25MG TAB
APO‐DICLO 50MG TAB
APO‐DICLO RAPIDE 50MG TAB
APO‐DICLO SR 100 MG TAB
APO‐DICLO SR 75 MG TAB
APO‐DICLOFENAC 1.5% SOL
APO‐DIFLUNISAL 250MG TAB
APO‐DIFLUNISAL 500MG TAB
APO‐FLURBIPROFEN FC 100MG TAB
APO‐FLURBIPROFEN FC 50MG TAB
APO‐IBUPROFEN 600MG TAB
APO‐INDOMETHACIN 25MG CAP
APO‐INDOMETHACIN 50MG CAP
APO‐KETOROLAC 10MG TAB
APO‐KETOROLAC 30MG/ML INJ
APO‐MELOXICAM 15MG TAB
APO‐MELOXICAM 7.5MG TAB
APO‐NAPRO NA 275MG TAB
APO‐NAPRO NA DS 550MG TAB
APO‐NAPROXEN 125MG TAB
APO‐NAPROXEN EC 250MG TAB
APO‐OXAPROZIN 600MG TAB
APO‐PIROXICAM 10MG CAP
APO‐PIROXICAM 20MG CAP
APO‐SULIN 150MG TAB
APO‐SULIN 200MG TAB
APO‐TIAPROFENIC 200MG TAB
APO‐TIAPROFENIC 300MG TAB
APX‐KETOROLAC 10MG TAB
APX‐KETOROLAC 30MG/ML INJ
ARTHROTEC TAB 50
ARTHROTEC TAB 75MG
ASA 325MG TAB
ASA 325MG TAB
ASA 325MG TAB
ASA EC 325MG TAB
ASA TAB 325MG
ASA TABLETS 325MG
ASAPHEN 80MG EC TAB
ASAPHEN 81MG TAB
ASAPHEN CHEW TAB 80 MG
ASAPHEN EC 81MG TAB
ASATAB 80MG CHEWABLE TAB
ASPIRIN 325MG COATED TAB
ASPIRIN 325MG TAB
ASPIRIN 81MG ECT
ASPIRIN 81MG QUICK CHEWS TAB
ASPIRIN STOMACH GUARD 325MG
ASPIRIN TAB 325MG
AVA‐DICLOFENAC 25MG TAB
AVA‐DICLOFENAC 50MG TAB
AVA‐DICLOFENAC SR 100MG TAB
AVA‐DICLOFENAC SR 75MG TAB
AVA‐MELOXICAM 15MG TAB
AVA‐MELOXICAM 7.5MG TAB
AVA‐NAPROXEN 250MG TAB
AVA‐NAPROXEN EC 250MG TAB
CHEWABLE ASA 81MG TAB
CO MELOXICAM 15MG TAB
CO MELOXICAM 7.5MG TAB
COATED ASPIRIN
DAYPRO 200MG TAB
DAYPRO 300MG TAB
ACETYLSALICYLIC ACID
TIAPROFENIC ACID
PHENYLBUTAZONE
NAPROXEN
NAPROXEN
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC POTASSIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DIFLUNISAL
DIFLUNISAL
FLURBIPROFEN
FLURBIPROFEN
IBUPROFEN
INDOMETHACIN
INDOMETHACIN
KETOROLAC TROMETHAMINE
MELOXICAM
MELOXICAM
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
OXAPROZIN
PIROXICAM
PIROXICAM
SULINDAC
SULINDAC
TIAPROFENIC ACID
TIAPROFENIC ACID
DICLOFENAC SODIUM/MISOPROSTOL
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
MELOXICAM
MELOXICAM
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
ASA
MELOXICAM
MELOXICAM
OXAPROZIN
OXAPROZIN
80MG
80MG
300MG
109
Dosage
*PA
TAB
TAB LA
CAP LA
TAB
275MG
TAB
550MG
TAB
325MG
TAB
325MG
TAB
25MG
TAB
50MG
TAB
50MG
TAB
100MG
TAB LA
75MG
TAB LA
1.5%
LIQ
250MG
TAB
500MG
TAB
100MG
TAB
50MG
TAB
600MG
TAB
25MG
CAP
50MG
CAP
10MG
TAB
30MG/ML
INJ
15MG
TAB
7.5MG
TAB
275MG
TAB
550MG
TAB
125MG
TAB
250MG
TAB
375MG
TAB
500MG
TAB
250MG
TAB
375MG
TAB
500MG
TAB
600MG
TAB
10MG
CAP
20MG
CAP
150MG
TAB
200MG
TAB
200MG
TAB
300MG
TAB
10MG
TAB
30MG/ML
INJ
50MG/200MC TAB
75MG/200MC TAB
325MG
TAB
325MG
TAB
325MG
TAB
325MG
TAB
325MG
TAB
325MG
TAB
80MG
TAB
81MG
TAB
80MG
TAB
81MG
TAB
80MG
TAB
325MG
TAB
325MG
TAB
81MG
TAB
81MG
TAB
325MG
TAB
325MG
TAB
25MG
TAB
50MG
TAB
100MG
TAB LA
75MG
TAB LA
15MG
TAB
7.5MG
TAB
250MG
TAB
375MG
TAB
500MG
TAB
250MG
TAB
375MG
TAB
500MG
TAB
81MG
TAB
15MG
TAB
7.5MG
TAB
500MG
TAB
200MG
TAB
300MG
TAB
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
02027852
02027860
02306190
02306204
02352397
02351684
02341670
02341646
02341654
02341662
02221276
02352400
02027925
02231662
02231663
02231664
02138263
02237826
02248606
02248605
02239922
02177129
02239536
02177137
02231059
02231060
02264692
02255421
02264706
02050161
00010332
00209201
02243801
00226327
00275328
02341689
02341697
02171813
02171821
02231800
02231799
02237011
00790427
02236966
02236965
02237012
02236967
02172577
00842664
00790435
02239943
02239944
02244946
02244947
02243800
02237273
02237274
02229452
02324334
02343428
02353156
02324326
02343401
02353148
02242786
02242785
02255995
02255987
02243432
02241024
02242505
02242506
00299413
02168871
02162792
02162415
02162423
02162466
02162431
02350750
02350769
DAYPRO 400MG TAB
DAYPRO 600MG CAPLET
DICLOFENAC 25MG TAB
DICLOFENAC 50MG TAB
DICLOFENAC EC 50MG TAB
DICLOFENAC K 50MG TAB
DICLOFENAC SODIUM 100MG SR TAB
DICLOFENAC SODIUM 25MG EC TAB
DICLOFENAC SODIUM 50MG EC TAB
DICLOFENAC SODIUM 75MG SR TAB
DICLOFENAC SR 75MG TAB
DISALCID 500MG CAP
DOM‐DICLOFENAC 25MG TAB
DOM‐DICLOFENAC 50MG TAB
DOM‐DICLOFENAC 75MG SR TAB
DOM‐KETOPROFEN 100MG
DOM‐MEFENAMIC ACID 250MG CAP
DOM‐MELOXICAM 15MG TAB
DOM‐MELOXICAM 7.5MG TAB
DOM‐PIROXICAM 10MG CAP
DOM‐PIROXICAM 10MG SUPP
DOM‐PIROXICAM 20MG CAP
DOM‐PIROXICAM 20MG SUPP
DOM‐TIAPROFENIC 200MG TAB
DOM‐TIAPROFENIC 300MG TAB
ENTERIC COATED ASA 325MG CAPL
ENTERIC COATED ASA 325MG TAB
ENTERIC COATED ASA 325MG TAB
ENTROPHEN 5 ECT 325MG CAPLET
ENTROPHEN 5 ECT 325MG TAB
EQUAGESIC TAB
EQUATE DAILY LOW‐DOSE 81MG ECT
FIORINAL CAP
FIORINAL TAB
GD‐DICLOFENAC/MISOPROSTOL 50
GD‐DICLOFENAC/MISOPROSTOL 75
GEN‐PIROXICAM 10MG CAP
GEN‐PIROXICAM 20MG CAP
INDOMETHACIN 100MG SUPP
INDOMETHACIN 50MG SUPP
KETOPROFEN 100MG SUPP
KETOPROFEN 50MG CAP
KETOPROFEN 50MG CAP
KETOPROFEN 50MG SUPP
KETOPROFEN ECT 100MG TAB
KETOPROFEN ECT 50MG TAB
KETOPROFEN SR 200MG TAB
KETOPROFEN‐E 100MG
KETOPROFEN‐E 50MG
KETOROLAC 10MG/ML INJ
KETOROLAC 30MG/ML INJ
KETOROLAC TROMETHAMINE INJ
KETOROLAC TROMETHAMINE INJ
LONDON DRUGS ASA 81MG EC TAB
MED‐PIROXICAM 10MG CAP
MED‐PIROXICAM 20MG CAP
MEFENAMIC 250MG CAP
MELOXICAM 15MG TAB
MELOXICAM 15MG TAB
MELOXICAM 15MG TAB
MELOXICAM 7.5MG TAB
MELOXICAM 7.5MG TAB
MELOXICAM 7.5MG TAB
MOBICOX 15MG TAB
MOBICOX 7.5MG TAB
MYLAN‐MELOXICAM 15MG TAB
MYLAN‐MELOXICAM 7.5MG TAB
MYLAN‐NAPROXEN 375MG EC TAB
MYLAN‐NAPROXEN EC 500MG TAB
NAPRELAN 375MG SR TAB
NAPRELAN 500MG SR TAB
NAPROSYN 125MG TAB
NAPROSYN 1G SR TAB
NAPROSYN E 250MG TAB
NAPROSYN SR 750 MG TAB
NAPROSYN SUSP 25MG/ML
NAPROXEN 250MG TAB
NAPROXEN 375MG TAB
OXAPROZIN
OXAPROZIN
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC
DICLOFENAC
DICLOFENAC
DICLOFENAC
DICLOFENAC SODIUM
SALSALATE
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
KETOPROFEN
MEFENAMIC ACID
MELOXICAM
MELOXICAM
PIROXICAM
PIROXICAM
PIROXICAM
PIROXICAM
TIAPROFENIC ACID
TIAPROFENIC ACID
MEPROBAMATE/ASA/ETHOHEPTAZINE
ASA/CAFFEINE/BUTALBITAL
DICLOFENAC/MISOPROSTOL
DICLOFENAC/MISOPROSTOL
PIROXICAM
PIROXICAM
INDOMETHACIN
INDOMETHACIN
KETOPROFEN
KETOPROFEN
KETOPROFEN
KETOPROFEN
KETOPROFEN
KETOPROFEN
KETOPROFEN
KETOPROFEN
KETOPROFEN
PIROXICAM
PIROXICAM
MEFENAMIC ACID
MELOXICAM
MELOXICAM
MELOXICAM
MELOXICAM
MELOXICAM
MELOXICAM
MELOXICAM
MELOXICAM
MELOXICAM
MELOXICAM
NAPROXEN
NAPROXEN
NAPROXEN SODIUM
NAPROXEN SODIUM
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
400MG
600MG
25MG
50MG
50MG
50MG
100MG
25MG
50MG
75MG
50MG/200UG
75MG
500MG
25MG
50MG
75MG
100MG
250MG
15MG
7.5MG
10MG
10MG
20MG
20MG
200MG
300MG
325MG
325MG
325MG
325MG
325MG
110
Dosage
*PA
TAB
CAPL
TAB
TAB
TAB
TAB
TAB LA
TAB
TAB
TAB LA
TAB
TAB LA
CAP
TAB
TAB
TAB LA
SUPP
CAP
TAB
TAB
CAP
SUPP
CAP
SUPP
TAB
TAB
CAPL
TAB
TAB
CAPL
TAB
TAB
81MG
TAB
CAP
TAB
50MG/200MG TAB
75MG/200MG TAB
10MG
CAP
20MG
CAP
100MG
SUPP
50MG
SUPP
100MG
SUPP
50MG
CAP
50MG
CAP
50MG
SUPP
100MG
TAB
50MG
TAB
200MG
TAB LA
100MG
TAB
50MG
TAB
10MG/ML
INJ
30MG/ML
INJ
15MG/ML
INJ
30MG/ML
INJ
81MG
TAB
10MG
CAP
20MG
CAP
250MG
CAP
15MG
TAB
15MG
TAB
15MG
TAB
7.5MG
TAB
7.5MG
TAB
7.5MG
TAB
15MG
TAB
7.5MG
TAB
15MG
TAB
7.5MG
TAB
375MG
TAB
500MG
TAB
375MG
TAB LA
500MG
TAB LA
125MG
TAB
1G
TAB LA
250MG
TAB
375MG
TAB
500MG
TAB
750MG
TAB LA
25MG/ML
O/L
250MG
TAB
375MG
TAB
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
02350777
02350785
02350793
02350807
00887056
02351013
02351021
02153386
02268175
02268183
02268191
02141981
02142007
00216666
02048493
02100584
02100592
02100517
02100509
02237859
02230201
02239836
00337420
00337439
00695718
00695696
00629359
02179679
02346281
02347849
02347857
02348322
02348330
02346583
02346591
02346605
02346613
02346621
02346648
02347334
02347369
00886017
00886025
02336413
02228211
02228203
02058413
02020688
02020661
02020726
00865850
00865869
02044633
02200910
02237910
02229569
02335514
02335506
02336596
02336618
02336553
02336561
02336588
02228181
00865621
00865648
00865656
00865664
00865761
00865788
02042576
02042584
02230510
02146886
00336440
00566888
00817201
00499544
00663735
02224127
02224119
NAPROXEN 500MG TAB
NAPROXEN EC 250MG TAB
NAPROXEN NA 275MG TABLET
NAPROXEN SODIUM 275MG TAB
NAPROXEN SODIUM DS 550MG TAB
NAPROXEN‐NA DF 550MG TAB
NAXEN EC 250MG TAB
NAXEN EC 375MG TAB
NAXEN EC 500MG TAB
NEO‐INDOL
NEO‐INDOL
NOVASEN TAB 325MG
NOVO‐DIFLUNISAL 250MG TAB
NOVO‐FLURPROFEN 100MG TAB
NOVO‐FLURPROFEN 50MG TAB
NOVO‐FLURPROFEN SR 200MG CAP
NOVO‐KETOROLAC 10MG TAB
NOVO‐MEFENAMIC 250MG CAP
NOVO‐METHACIN CAP 25MG
NOVO‐METHACIN CAP 50MG
NOVO‐PIROCAM CAP 10MG
NOVO‐PIROCAM CAP 20MG
NOVO‐PROFEN TAB 600MG
NOVO‐TIAPROFENIC ACID 200MG
NTP‐DICLOFENAC POT 50MG TAB
NTP‐DICLOFENAC SODIUM 50MG
NTP‐DICLOFENAC SODIUM SR 75MG
NTP‐INDOMETHACIN 25MG CAP
NTP‐INDOMETHACIN 50MG CAP
NTP‐NAPROXEN 250MG TAB
NTP‐NAPROXEN EC 250MG TAB
NTP‐NAPROXEN SODIUM 275MG TAB
NTP‐NAPROXEN SODIUM DS 550MG
NU‐DICLO EC TAB 25MG
NU‐DICLO EC TAB 50MG
NU‐DICLO RAPIDE 50MG TAB
NU‐DICLO SR 100MG SR TAB
NU‐DICLO SR 75MG TAB
NU‐DIFLUNISAL 500MG TAB
NU‐FLURBIPROFEN 100 MG TAB
NU‐FLURBIPROFEN TAB 50MG
NU‐IBUPROFEN 600 MG TAB
NU‐INDO CAP 25MG
NU‐INDO CAP 50MG
NU‐KETOPROFEN 50MG CAP
NU‐KETOPROFEN SR 200MG
NU‐KETOROLAC 10MG TAB
NU‐MEFENAMIC 250MG CAP
NU‐MELOXICAM 15MG TAB
NU‐MELOXICAM 7.5MG TAB
NU‐NAPRO‐NA 275MG TAB
NU‐NAPRO‐NA DS 550MG TAB
NU‐NAPROX EC 250MG TAB
NU‐NAPROX SR 750MG TAB
NU‐NAPROX TAB 125MG
NU‐PIROX CAP 10MG
NU‐PIROX CAP 20MG
NU‐SULINDAC 150 MG TAB
NU‐SULINDAC 200MG TAB
NU‐TENOXICAM TAB 20MG
NU‐TIAPROFENIC 300MG TAB
ORUDIS CAP 50MG
ORUDIS E 50 ECT 50MG
ORUDIS SR 200MG TAB
ORUDIS SUPP 100MG
ORUDIS‐E‐100 TAB 100MG
PDL‐DICLOFENAC 100MG SR TAB
PDL‐DICLOFENAC 75MG SR TAB
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN SODIUM
NAPROXEN SODIUM
NAPROXEN SODIUM
NAPROXEN
NAPROXEN
NAPROXEN
INDOMETHACIN
INDOMETHACIN
DIFLUNISAL
DIFLUNISAL
DIFLUNISAL
FLURBIPROFEN
FLURBIPROFEN
FLURBIPROFEN
MEFENAMIC ACID
INDOMETHACIN
INDOMETHACIN
PIROXICAM
PIROXICAM
IBUPROFEN
TIAPROFENIC ACID
DICLOFENAC SODIUM
DICLOFENAC SODIUM
INDOMETHACIN
INDOMETHACIN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN SODIUM
NAPROXEN SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DIFLUNISAL
FLURBIPROFEN
FLURBIPROFEN
IBUPROFEN
INDOMETHACIN
INDOMETHACIN
KETOPROFEN
KETOPROFEN
MEFENAMIC ACID
MELOXICAM
MELOXICAM
NAPROXEN SODIUM
NAPROXEN SODIUM
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
PIROXICAM
PIROXICAM
SULINDAC
SULINDAC
TENOXICAM
TIAPROFENIC ACID
KETOPROFEN
KETOPROFEN
KETOPROFEN
KETOPROFEN
KETOPROFEN
DICLOFENAC SODIUM
DICLOFENAC SODIUM
500MG
250MG
375MG
500MG
275MG
275MG
550MG
550MG
250MG
375MG
500MG
50MG
100MG
325MG
250MG
250MG
500MG
100MG
50MG
200MG
10MG
250MG
25MG
50MG
10MG
20MG
600MG
200 MG
50MG
50MG
75MG
25MG
50MG
250MG
375MG
500MG
250MG
375MG
500MG
275MG
550MG
25MG
50MG
50MG
100MG
75MG
500MG
100MG
50MG
600MG
25MG
50MG
50MG
200MG
10MG
250MG
15MG
7.5MG
275MG
550MG
250MG
375MG
500MG
750MG
125MG
250MG
375MG
500MG
10MG
20MG
150MG
200MG
20MG
300MG
50MG
50MG
200MG
100MG
100MG
100MG
75MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
SUPP
SUPP
TAB
TAB
TAB
TAB
TAB
TAB
CAP LA
TAB
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB LA
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB LA
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
CAP
TAB
TAB
SUPP
TAB
TAB LA
TAB LA
111
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
00870978
00658804
00646261
00646288
02210487
00870986
02084198
02084171
00590762
00618721
00655686
00808628
00808636
02145006
02247265
02239163
02239164
02231249
02231250
00372382
02248608
02248607
02239809
02231297
02239810
02231299
02283670
02283662
02285371
02283689
02283700
02356783
02231505
02231508
02231502
02231503
02231506
02231504
02239753
02015951
02150824
02150808
02150816
02248268
02248267
02017237
02294702
02294710
02154420
00836230
02154463
02230827
02311496
02311518
02311461
02229733
02229736
02310937
02310945
02310953
01934139
02248031
02247889
02231004
02231005
02231006
02039478
00608238
00608211
02243802
02236724
02236725
02243799
02242189
02240786
02240787
02240788
02240827
02240828
02202352
02202360
PDL‐DICLOFENAC ECT 50MG
PDL‐IBUPROFEN‐600 TAB 600MG
PDL‐INDO 25 CAP 25MG
PDL‐INDO 50 CAP 50MG
PDL‐KETOPROFEN 200MG SR TAB
PDL‐KETOPROFEN 50MG
PDL‐KETOPROFEN‐E 100MG TAB
PDL‐KETOPROFEN‐E 50MG TAB
PDL‐NAPROXEN 250 TAB 250MG
PDL‐NAPROXEN 500 TAB 500MG
PDL‐NAPROXEN‐375 TAB 375MG
PDL‐SULINDAC‐150 TAB 150MG
PDL‐SULINDAC‐200 TAB 200MG
PDL‐TIAPROFENIC ACID 200MG TAB
PENNSAID 1.5% TOP SOL
PENTA‐SULINDAC 150MG TAB
PENTA‐SULINDAC 200MG TAB
PENTA‐TIAPROFENIC 200MG
PENTA‐TIAPROFENIC 300MG
PHENYLBUTAZONE 100MG TAB
PHL‐MELOXICAM 15MG TAB
PHL‐MELOXICAM 7.5MG TAB
PIROXICAM‐RATIOPHARM 10MG SUPP
PIROXICAM‐RATIOPHARM 10MG TAB
PIROXICAM‐RATIOPHARM 20MG SUPP
PIROXICAM‐RATIOPHARM 20MG TAB
PMS‐ASA 80 MG CHEWABLE TAB
PMS‐ASA 81MG TAB
PMS‐ASA EC 325MG TAB
PMS‐DICLOFENAC 1.5% SOL
PMS‐DICLOFENAC 100MG SR TAB
PMS‐DICLOFENAC 100MG SUPP
PMS‐DICLOFENAC 25MG EC TAB
PMS‐DICLOFENAC 50MG EC TAB
PMS‐DICLOFENAC 50MG SUPP
PMS‐DICLOFENAC 75MG SR TAB
PMS‐DICLOFENAC K 50MG TAB
PMS‐KETOPROFEN 100 MG SUPP
PMS‐KETOPROFEN 100MG EC TAB
PMS‐KETOPROFEN 50MG CAP
PMS‐KETOPROFEN 50MG EC TAB
PMS‐MELOXICAM 15MG TAB
PMS‐MELOXICAM 7.5MG TAB
PMS‐NAPROXEN 500 MG SUPP
PMS‐NAPROXEN EC 375MG TAB
PMS‐NAPROXEN EC 500MG TAB
PMS‐PIROXICAM 10MG SUPP
PMS‐PIROXICAM 20MG CAP
PMS‐PIROXICAM 20MG SUPP
PMS‐TIAPROFENIC 200MG TAB
PRO‐ASA 80MG EC TAB
PRO‐ASA 80MG TAB
PRO‐DICLO RAPIDE 50MG TAB
PRONAL CAPS
PRONAL TAB
PRO‐NAPROXEN EC 250MG TAB
RATIO‐INDOMETHACIN SUPP 100MG
RATIO‐MELOXICAM 15MG TAB
RATIO‐MELOXICAM 7.5MG TAB
RATIO‐NAPROXEN 250MG EC TAB
RATIO‐NAPROXEN 750MG TAB
RATIO‐TECNAL CAP
RATIO‐TECNAL TAB
REXALL COATED ASA 81MG EC TAB
RHO‐DICLOFENAC ECT 25MG
RHO‐DICLOFENAC ECT 50MG
RHOXAL‐OXAPROZIN 600MG TAB
RIVA‐KETOROLAC 10MG TAB
RIVA‐NAPROXEN 250MG TAB
RIVA‐NAPROXEN SODIUM 275MG TAB
RIVA‐NAPROXEN SODIUM 550MG TAB
RIVASA 80MG CHEW TAB
RIVASA 80MG TAB
DICLOFENAC SODIUM
IBUPROFEN
INDOMETHACIN
INDOMETHACIN
KETOPROFEN
KETOPROFEN
KETOPROFEN
KETOPROFEN
NAPROXEN
NAPROXEN
NAPROXEN
SULINDAC
SULINDAC
TIAPROFENIC ACID
DICLOFENAC SODIUM
SULINDAC
SULINDAC
TIAPROFENIC ACID
TIAPROFENIC ACID
PHENYLBUTAZONE
MELOXICAM
MELOXICAM
PIROXICAM
PIROXICAM
PIROXICAM
PIROXICAM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
KETOPROFEN
KETOPROFEN
KETOPROFEN
KETOPROFEN
MELOXICAM
MELOXICAM
NAPROXEN
NAPROXEN
NAPROXEN
PIROXICAM
PIROXICAM
PIROXICAM
TIAPROFENIC ACID
ASA/BUTALBITAL/CAFFEINE
ASA/BUTALBITAL/CAFFEINE
NAPROXEN
NAPROXEN
NAPROXEN
INDOMETHACIN
MELOXICAM
MELOXICAM
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
DICLOFENAC SODIUM
DICLOFENAC SODIUM
OXAPROZIN
KETOROLAC
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN SODIUM
NAPROXEN SODIUM
50MG
600MG
25MG
50MG
200MG
50MG
100MG
50MG
250MG
500MG
375MG
150MG
200MG
200MG
1.5%
150MG
200MG
200MG
300MG
100MG
15MG
7.5MG
10MG
10MG
20MG
20MG
80MG
81MG
325MG
80MG
81MG
1.5%
100MG
100MG
25MG
50MG
50MG
75MG
50MG
100 MG
100MG
50 MG
50 MG
15MG
7.5MG
500MG
375MG
500MG
10 MG
20MG
20MG
200MG
80MG
80MG
50MG
330/50/40M
330/50/40
250MG
375MG
500MG
100MG
15MG
7.5MG
250MG
375MG
500MG
750MG
TAB
TAB
CAP
CAP
TAB LA
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
LIQ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
SUPP
TAB
SUPP
TAB
TAB
TAB
TAB
TAB
TAB
SOL
TAB LA
SUPP
TAB
TAB
SUPP
TAB LA
TAB
SUPP
TAB
CAP
TAB
TAB
TAB
SUPP
TAB LA
TAB
SUPP
CAP
SUPP
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
SUPP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
112
81MG
25MG
50MG
600MG
10MG
250MG
375MG
500MG
275MG
550MG
80MG
80MG
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
280804
02261936
02261952
02261928
02261960
02261774
02261944
02261901
02347911
02347903
02230661
02231120
00808539
00808547
02048698
02158582
02239355
02258323
02258315
02243312
02243313
02243314
02026600
00778389
00565350
00627097
00589861
00745588
00745596
02179687
02162644
01908499
02162652
02162660
01971417
01971409
00881635
00632732
00632724
00514012
00590827
00782459
02321750
02321769
SANDOZ‐DICLOFENAC 100MG SUP
SANDOZ‐DICLOFENAC 25MG TAB
SANDOZ‐DICLOFENAC 50MG SUP
SANDOZ‐DICLOFENAC 50MG TAB
SANDOZ‐DICLOFENAC RAPIDE 50MG
SANDOZ‐DICLOFENAC SR 100MG TAB
SANDOZ‐DICLOFENAC SR 75MG TAB
SIG‐MELOXICAM 15MG TAB
SIG‐MELOXICAM 7.5MG TAB
TENOXICAM 20MG TAB
TENOXICAM‐20 TAB
TEVA‐DIFENAC ECT 25MG
TEVA‐DIFENAC ECT 50MG
TEVA‐DIFENAC SR 100 MG TAB
TEVA‐DIFENAC SR 75MG TAB
TEVA‐DIFENAC‐K 50MG TAB
TEVA‐MELOXICAM 15MG TAB
TEVA‐MELOXICAM 7.5MG TAB
TEVA‐NAPROX 250MG EC TAB
TEVA‐NAPROX DS 550MG
TEVA‐NAPROX SODIUM TAB 275MG
TEVA‐NAPROX TAB 250MG
TEVA‐SUNDAC TAB 150MG
TEVA‐SUNDAC TAB 200MG
TEVA‐TIAPROFENIC ACID 300MG
TORADOL 10MG/ML INJ
TORADOL INJ 15MG/ML
TORADOL INJ 30MG/ML
TORADOL TAB 10MG
TRIANAL CAP
TRIANAL TAB
VOLTAREN RAPIDE 50MG TAB
VOLTAREN 100MG SUPP
VOLTAREN 50MG SUPP
VOLTAREN 50MG TAB
VOLTAREN SR 100MG TAB
VOLTAREN SR 75 TAB
ZYM‐ASA 80MG TAB
ZYM‐ASA EC 80MG TAB
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
MELOXICAM
MELOXICAM
TENOXICAM
TENOXICAM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
MELOXICAM
MELOXICAM
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
NAPROXEN
SULINDAC
SULINDAC
TIAPROFENIC ACID
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
DICLOFENAC SODIUM
100MG
25MG
50MG
50MG
50MG
100MG
75MG
15MG
7.5MG
20MG
20MG
25MG
50MG
100MG
75MG
50MG
15MG
7.5MG
250MG
375MG
500MG
550MG
275MG
250MG
375MG
500MG
150MG
200MG
300 MG
10MG/ML
15MG/ML
30MG/ML
10MG
330MG
SUPP
TAB
SUPP
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
TAB
CAP
TAB
TAB
SUPP
SUPP
TAB
TAB LA
TAB LA
TAB
TAB
113
50MG
100MG
50MG
50MG
100MG
75MG
80MG
80MG
*PA
05/2012
Therapy Class
280808
DIN
Drug Name
OPIATE AGONISTS
Chemical Name
Strength
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
00108162
02238646
02234510
02238645
02364174
02364182
02364190
02364204
02364212
02364220
01999648
01999656
02251914
02025337
01996541
01901850
02364115
02364115
02364123
02364123
02364131
02364131
02364158
02364158
02324628
00293504
00293512
02304155
02304120
02304139
02304147
00018694
00018686
02009889
00003247
02163748
02163780
02230302
02163799
00050024
02009757
00497282
00544884
00497290
00003239
00018678
00779458
02309785
02245592
02242005
02242006
02138018
02242002
02242003
02242004
00036242
00033685
00033294
00705438
00786535
00125083
00627100
00125121
00786543
00622133
02085895
02146118
02145863
00614491
00614505
02275848
02334186
02275856
02275813
02275821
02373017
02373025
02373033
01916548
02232388
222 TAB
282 MEP TAB
282 TAB
292 TAB
ABSTRAL 100UG TAB
ABSTRAL 200UG TAB
ABSTRAL 300UG TAB
ABSTRAL 400UG TAB
ABSTRAL 600UG TAB
ABSTRAL 800UG TAB
ACET CODEINE 30
ACET CODEINE 60
ACET/CAFF/COD TABS
ACETAMINOPHEN TAB W CODEINE
ACETAMINOPHEN W/COD
ALCALOIDES DE L'OPIU
APO‐HYDROMORPHONE 1MG TAB
APO‐OXYCODONE/ACET
ATASOL 15 TAB
ATASOL 30 TAB
CO FENTANYL 100MCG PATCH
CODEINE
CODEINE 15MG TAB
CODEINE 15MG TAB
CODEINE 60MG TAB
CODEINE CONTIN 100MG CR TAB
CODEINE CONTIN CR 200MG TAB
CODEINE PHOS SYRUP
CODEINE PHOSPHATE 30MG TAB
CODEINE PHOSPHATE INJ 30MG/ML
CODEINE PHOSPHATE TAB 30MG
CODEINE SYRUP 5MG/ML
CODEINE TAB 15MG
CODOFEN 7.5MG/200MG TAB
DAMYLIN WITH CODEINE SYRUP
DEMEROL 100MG/ML INJ
DEMEROL 100MG/ML INJECTION
DEMEROL 50MG TAB
DEMEROL 50MG/ML INJ
DEMEROL 50MG/ML INJ
DEMEROL 75MG/ML INJ
DEMEROL HCL 5% SOLUTION
DEMEROL HCL 50MG TAB
DEMEROL HCL 75MG INJ
DILAUDID 1MG TAB
DILAUDID 1MG/ML O/L
DILAUDID 2MG TAB
DILAUDID 2MG/ML INJ
DILAUDID 4MG TAB
DILAUDID 8MG TAB
DILAUDID HP 10MG/ML INJ
DILAUDID STERILE PWD
DILAUDID‐HP‐PLUS
DILAUDID‐XP 50MG/ML INJ
DOLORAL 1 SYRUP
DOLORAL 5 SYRUP 5MG/ML
DURAGESIC MAT 12.6MG PATCH
DURAGESIC MAT 12MCG/HR PATCH
DURELA 100MG CAP LA
DURELA 200MG CAP LA
DURELA 300MG CAP LA
ENDOCET TAB
EXDOL‐15 TAB
ASA/CAFFEINE/CODEINE
MEPROBAMATE/ASA/CODEINE/CAFFEI
FENTANYL CITRATE
FENTANYL CITRATE
FENTANYL CITRATE
FENTANYL CITRATE
FENTANYL CITRATE
FENTANYL CITRATE
ACETAMINOPHEN/CODEINE
ACETAMINOPHEN/CAFFEINE/CODEINE
ALCALOIDES DE L'OPIU
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
OXYCODONE/ACETAMINOPHEN
CODEINE/ACET/CAFFEINE
FENTANYL
FENTANYL
FENTANYL
FENTANYL
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE PHOSPHATE
CODEINE
CODEINE PHOSPHATE
HYDROCODONE BITAR/IBUPROFEN
CODEINE/DIPHENYDRAMINE/AMMO
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE
MEPERIDINE
MEPERIDINE
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
MORPHINE HCL
MORPHINE HCL
FENTANYL
FENTANYL
FENTANYL
FENTANYL
FENTANYL
TRAMADOL HCL
TRAMADOL HCL
TRAMADOL HCL
OXYCODONE HCL/ACETAMINOPHEN
375/30/8MG
114
Dosage
TAB
TAB
TAB
30MG
TAB
100UG
TAB
200UG
TAB
300UG
TAB
400UG
TAB
600UG
TAB
800UG
TAB
300MG/30MG TAB
300/60MG
TAB
TAB
300MG/8MG TAB
325/30MG
CAPL
20MG
INJ
1MG
TAB
1MG
TAB
2MG
TAB
2MG
TAB
4MG
TAB
4MG
TAB
8MG
TAB
8MG
TAB
5‐325MG
TAB
15/325/30
TAB
30MG
TAB
100MCG
PATCH
25MCG
PATCH
50MCG
PATCH
75MCG
PATCH
30MG
TAB
15MG
TAB
15MG
TAB
60MG
TAB
100MG
TAB LA
150MG
TAB LA
50MG
TAB LA
200MG
TAB LA
25MG/ML
O/L
30MG
TAB
30MG/ML
INJ
30MG/ML
INJ
60MG/ML
INJ
30MG
TAB
5MG/ML
O/L
15MG
TAB
7.5MG/200M TAB
O/L
100MG/ML
INJ
100MG/ML
INJ
50MG
TAB
50MG/ML
INJ
50MG/ML
INJ
75MG/ML
INJ
50MG/ML
INJ
50MG
TAB
75MG
INJ
1MG
TAB
1MG/ML
O/L
2MG
TAB
2MG/ML
INJ
4MG
TAB
8MG
TAB
10MG/ML
INJ
250MG/VIAL INJ
20MG/ML
INJ
50MG/ML
INJ
1MG/ML
O/L
5MG/ML
O/L
12.6MG
PATCH
12MCG/HR
PATCH
16.8MG
PATCH
4.2MG
PATCH
8.4MG
PATCH
100MG
CAP LA
200MG
CAP LA
300MG
CAP LA
5MG/325MG TAB
15MG
TAB
*PA
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
02232389
02349914
02349876
02349884
02349892
02349906
00965715
02384124
00176206
00176192
02125358
02125366
02125374
02125382
02125323
02359502
02125331
02359510
02243562
02225220
02225239
02225247
02225255
02125390
02382636
02145901
02244797
02145928
02145936
02146126
02242018
02184451
02242163
02184435
02184443
00380571
00486582
00632503
00690198
00632481
00690201
00690228
00776181
00776203
02009765
02009749
02009706
02009773
00514217
00392650
00725757
00497479
00725749
00497452
00725765
00497436
00497444
00497460
02019965
02019930
02177749
02177757
02019949
02019957
02247700
02241377
02247698
02247694
02247701
02247699
02247696
02244290
02247693
02247697
02247695
01966367
01980696
02137232
02137240
00869325
00869317
EXDOL‐30 TAB
FENTANYL 100MCG/HR PATCH
FENTANYL CITRATE 50MCG/ML INJ
FENTANYL CITRATE 50MCG/ML INJ
FIORINAL C1/2 CAP
FIORINAL C1/4 CAP
HYDROMORPH CONTIN 10MG
HYDROMORPH CONTIN 12MG SR CAP
HYDROMORPH CONTIN 20MG
HYDROMORPH CONTIN 24MG SR CAP
HYDROMORPH CONTIN 3MG CR CAP
HYDROMORPH CONTIN 4.5MG CAP
HYDROMORPH CONTIN 6MG CR CAP
HYDROMORPH CONTIN 9MG CAP
HYDROMORPH CONTIN SR 18MG CAP
HYDROMORPH IR 1MG CAP
HYDROMORPHON CONTIN 30MG CRCAP
HYDROMORPHONE 10MG/ML INJ
HYDROMORPHONE 2MG/ML INJ
HYDROMORPHONE HP 100MG/ML INJ
IBUCODONE 7.5MG/200MG TAB
KADIAN 100MG SR CAP
KADIAN 10MG CAP (SUSTAINED REL
KADIAN 20MG SR CAP
KADIAN 50MG SR CAP
LINCTUS CODEINE BLANC
M O S SYR 1.0MG/ML
M.O.S. 10 SYRUP 10MG/ML
M.O.S. 10 TAB 10MG
M.O.S. 20 CONC 20MG/ML
M.O.S. 20 TAB 20MG
M.O.S. 40 TAB 40MG
M.O.S. SR TAB 30MG
M.O.S. SR TAB 60MG
M.O.S. SULFATE 10MG TAB
M.O.S. SYRUP 5MG/ML
MEPERIDINE 100MG INJ
MEPERIDINE 75MG/ML INJ
MEPERIDINE HCL 100MG/ML INJ
MEPERIDINE HCL INJ 10MG/ML
M‐ESLON 100MG SR CAP
METADOL 10MG TAB
METADOL 10MG/ML LIQ
METADOL 1MG TAB
METADOL 1MG/ML O/L
METADOL 25MG TAB
METADOL 5MG TAB
METADOL‐D 10MG TAB
METADOL‐D 10MG/ML O/L
METADOL‐D 1MG TAB
METADOL‐D 25MG TAB
METADOL‐D 5MG TAB
METHOXISAL C1/4 CAPLET
MORPHINE 1MG/ML INJ
MORPHINE 1MG/ML INJ
MORPHINE 2MG/ML INJ
MORPHINE EXTRA FORTE 50MG/ML
MORPHINE FORTE INJ 25MG/ML
FENTANYL
FENTANYL
FENTANYL
FENTANYL
FENTANYL
FENTANYL CITRATE
FENTANYL CITRATE
ASA/CAFFEINE/CODEINE/BUTALBITA
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROMORPHONE HCL
HYDROCODONE BITART/IBUPROFEN
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
CODEINE PHOSPHATE
MORPHINE HCL
MORPHINE HCL
MORPHINE HCL
MORPHINE HCL
MORPHINE HCL
MORPHINE HCL
MORPHINE HCL
MORPHINE HCL
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE HCL
MORPHINE HCL
MORPHINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MEPERIDINE HCL
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
METHADONE HCL
METHADONE HCL
METHADONE HCL
METHADONE HCL
METHADONE HCL
METHADONE HCL
METHADONE HCL
METHADONE HCL
METHADONE HCL
METHADONE HCL
METHADONE HCL
ASA/CODEINE/METHOCARBAMOL
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
30MG
100MCG/HR
12MCG/HR
25MCG/HR
50MCG/HR
75MCG/HR
50MCG/ML
50MCG/ML
TAB
PATCH
PATCH
PATCH
PATCH
PATCH
INJ
INJ
CAP
CAP
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP
CAP LA
CAP
CAP LA
CAP
CAP
CAP
CAP
CAP LA
INJ
INJ
INJ
INJ
INJ
INJ
TAB
CAP LA
CAP LA
CAP LA
CAP LA
O/L
O/L
O/L
TAB
O/L
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
O/L
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB
O/L
TAB
O/L
TAB
TAB
TAB
O/L
TAB
TAB
TAB
CAPL
INJ
INJ
INJ
INJ
INJ
115
10MG
12MG
20MG
24MG
3MG
4.5MG
6MG
9MG
18MG
1MG
2MG
4MG
8MG
30MG
10MG/ML
2 MG/ML
100MG/ML
10MG/ML
20MG/ML
50MG/ML
100MG
10MG
20MG
50MG
10MG
1MG/ML
10MG/ML
10MG
20MG/ML
20MG
40MG
30MG
60MG
10MG
25MG
50MG
5MG
5MG/ML
100MG
75MG/ML
100MG/ML
100MG/ML
50MG/ML
50MG/ML
10MG/ML
25MG/ML
75MG/ML
100MG
10MG
15MG
200MG
30MG
60MG
10MG
10MG/ML
1MG
1MG/ML
25MG
5MG
10MG
10MG/ML
1MG
25MG
5MG
325/16.2MG
1MG/ML
1 MG/ML
2 MG/ML
50MG/ML
25MG/ML
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
00617288
00676411
00029971
00854581
00854573
02021048
01949047
01949055
02350920
02350246
02350815
02350947
02350254
02350890
02350262
02350912
00392588
00850322
00392561
00884081
00850314
01964437
02242484
00884111
02137267
00497355
00497363
01964429
00335398
00690236
00690244
00665134
02145979
01907131
00665142
00665150
02014319
02015439
02014327
02014297
02014300
02242830
02242831
02242832
02242827
02242828
02242829
01909401
01909444
01909452
01909460
01909398
02014211
01909371
02014238
01909428
02014254
02014203
02314665
02314630
02314649
02314657
02302799
02302764
02307898
02346397
02346362
02346400
02346370
02346389
02325969
02325977
02336855
02325950
02361361
02327171
02202441
02323222
02323192
02246902
02202468
MORPHINE HP 50 INJ 50MG/ML USP
MORPHINE HP INJ 25MG/ML
MORPHINE INJ AMP 15MG/ML
MORPHINE LP 0.5 INJ 0.5MG/ML
MORPHINE LP 1.0 INJ 1MG/ML
MORPHINE LP 1MG/ML
MORPHINE SANS P 0.5MG INJ
MORPHINE SANS P 1.0MG INJ
MORPHINE SR 100MG TAB
MORPHINE SULFATE 10MG/ML INJ
MORPHINE SULFATE 25MG/ML
MORPHINE SULFATE 50MG/ML
MORPHINE SULFATE INJ 10MG/ML
MORPHINE SULPHATE INJ 10MG/ML
MOS‐50 CONCENTRATE LIQ 50MG/ML
MOS‐60 TAB 60MG
MS CONTIN 15MG L.A. TAB
MS CONTIN 200MG L.A. SUPP
MS CONTIN SRT 100MG
MS CONTIN SRT 15MG
MS CONTIN SRT 200MG
MS CONTIN SRT 30MG
MS CONTIN SRT 60MG
MS CONTIN XL SR 120MG CAP
MS IR 5MG
MS IR SUPP 10MG
MS IR SUPP 20MG
MS IR SUPP 30MG
MS IR TAB 10MG
MS IR TAB 10MG
MS IR TAB 20MG
MS IR TAB 20MG
MS IR TAB 30MG
MS IR TAB 30MG
MS IR TAB 5MG
NOVO‐FENTANYL 100MCG PATCH
NOVO‐MORPHINE SR 100MG TAB
NOVO‐MORPHINE SR 15MG TAB
NOVO‐OXYCOD ACET 5/325MG TAB
NTP‐MORPHINE SR 100MG TAB
OXYCODONE 10MG TAB
OXYCODONE 20MG TAB
OXYCODONE 20MG TAB
OXYCODONE 5MG TAB
OXYCODONE/ACET 5MG/325MG TAB
OXYCODONE‐ACET TAB
OXYCONTIN 10MG CR TAB
OXYCONTIN 160MG SR TAB
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE
MORPHINE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE HCL
MORPHINE HCL
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
FENTANYL
FENTANYL
FENTANYL
FENTANYL
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
OXYCODONE HCL
OXYCODONE HCL
OXYCODONE HCL
OXYCODONE HCL
ACETAMINOPHEN/OXYCODONE
OXYCODONE
OXYCODONE HCL
OXYCODONE HCL
OXYCODONE HCL
OXYCODONE
50MG/ML
25MG/ML
15MG/ML
0.5MG/ML
1MG/ML
1MG/ML
0.5MG/ML
1MG/ML
100MG
15MG
15MG
200MG
30MG
30MG
60MG
60MG
10MG/ML
10MG/ML
15MG/ML
25MG/ML
2MG/ML
2 MG/ML
2MG/ML
50MG/ML
50MG/ML
10MG/ML
15MG/ML
5MG/ML
10MG/ML
50MG/ML
60MG
15MG
200MG
200MG
30MG
60MG
100MG
15MG
200MG
30MG
60MG
120MG
150MG
200MG
30MG
60MG
90MG
5MG
10MG
20MG
30MG
10MG
10MG
20MG
20MG
30MG
30MG
5MG
100MCG
25MCG
50MCG
75MCG
100MG
15MG
5/325MG
100MG
15MG
200MG
30MG
60MG
10MG
20MG
20MG
5MG
5MG/325MG
325/5MG
10MG
120MG
15MG
160MG
20MG
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
O/L
TAB
TAB LA
SUPP LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB
SUPP
SUPP
SUPP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
PATCH
PATCH
PATCH
PATCH
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
116
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
02323206
02202476
02258129
02323214
02202484
02240131
02240132
02231934
02372525
02372533
02372797
02372541
02372568
02372576
02372584
02243162
02376806
02376768
02376776
02376784
02376792
01916475
01916491
01916572
00302368
00302376
00302384
02254271
02254263
02192101
02249928
02249936
02192144
01916394
01916386
00706515
00706523
00654469
00816027
02243979
02341417
02341379
02341387
02341395
02341409
02217341
00885444
02217333
00885428
00885436
00885401
02245286
02319985
02319993
02319977
02232658
02229734
02229735
02299194
02299208
02299216
02330156
02249448
02249421
02249391
02249413
00593435
00593451
00779474
00608882
02282984
02311925
02282941
02282968
02282976
00653241
00653276
00621463
00690783
00607762
00690791
OXY‐IR 10MG TAB
OXY‐IR 20MG TAB
OXY‐IR 5MG TAB
OXYNEO 10MG TAB
OXYNEO 15MG TAB
OXYNEO 20MG TAB
OXYNEO 30MG TAB
OXYNEO 40MG TAB
OXYNEO 60MG TAB
OXYNEO 80MG TAB
PALLADONE XL CR 32MG CAP
PAT‐FENTANYL MAT 100MCG/H PATC
PAT‐FENTANYL MAT 12MCG/H PATCH
PERCOCET
PERCOCET‐DEMI TAB
PERCODAN 5MG/325MG TAB
PHENAPHEN #2
PHENAPHEN #3
PHENAPHEN #4
PHL‐ACET‐CODEINE 30 TAB
PHL‐ACET‐CODEINE 60 TAB
PHL‐HYDROMORPHONE‐TAB 1MG
PMS HYDROMORPHONE 3MG SUPP
PMS HYDROMORPHONE SYRUP 1MG/ML
PMS‐ACET 2 TAB
PMS‐ACET 3 TAB
PMS‐ACETAMINOPHEN W CODEINE
PMS‐ACETAMINOPHEN W CODEINE O/
PMS‐CODEINE 30MG TAB
PMS‐FENTANYL MTX 100MCG/HR
PMS‐HYDROMORPHONE 10MG/ML INJ
PMS‐HYDROMORPHONE 1MG TAB
PMS‐HYDROMORPHONE 2MG/ML INJ
PMS‐HYDROMORPHONE 8MG TAB
PMS‐HYDROMORPHONE TAB 2MG
PMS‐HYDROMORPHONE TAB 4MG
PMS‐MORPHINE SULFATE 60MG SR
PMS‐OXYCODONE 10MG TAB
PROCET‐30 TAB
PRONAL C1/2 CAP
PRONAL C1/4 CAP
RALIVIA 100MG TAB
RALIVIA 200MG TAB
RALIVIA 300MG TAB
RAN‐FENTANYL MATRIX PATCH 100
RAN‐FENTANYL TRANSDERM 100MCG
RATIO‐CODEINE 15MG TAB
RATIO‐CODEINE 30MG TAB
RATIO‐CODEINE 5MG/ML O/L
RATIO‐EMTEC‐30 TAB
RATIO‐FENTANYL 100MCG PATCH
RATIO‐LENOLTEC NO 2 TAB
RATIO‐MORPHINE 10 MG O/L
RATIO‐MORPHINE 1MG/ML O/L
RATIO‐MORPHINE 20 MG O/L
OXYCODONE HCL
30MG
OXYCODONE
40MG
OXYCODONE HCL
5MG
OXYCODONE HCL
60MG
OXYCODONE
80MG
OXYCODONE HCL
10MG
OXYCODONE HCL
20MG
OXYCODONE HCL
5MG
OXYCODONE HCL
10MG
OXYCODONE HCL
15MG
20MG
OXYCODONE HCL
OXYCODONE HCL
30MG
OXYCODONE HCL
40MG
OXYCODONE HCL
60MG
OXYCODONE HCL
80MG
HYDROMORPHONE HCL
32MG
FENTANYL
100MCG/H
FENTANYL
12MCG/H
FENTANYL
25MCG/H
FENTANYL
50MCG/H
FENTANYL
75MCG/H
5MG
2.5/325MG
OXYCODONE HCL/ASA
5MG/325MG
ASA/CODEINE/PHENOBARBITAL
1/4GR
1/2GR
1GR
300MG/30MG
HYDROMORPHONE HCL
1MG
HYDROMORPHONE HCL
2MG
HYDROMORPHONE HCL
4MG
HYDROMORPHONE HCL
8MG
HYDROMORPHONE
3MG
HYDROMORPHONE HCL
1MG/ML
CODEINE PHOSPHATE/APAP/CAFFEIN 300/15MG
ACETAMINOPHEN/CODEINE/CAFFEINE 300/30/15
300/60 MG
160‐8MG/5M
CODEINE PHOSPHATE
30MG
FENTANYL
100MCG/HR
FENTANYL
12MCG/HR
FENTANYL
25MCG/HR
FENTANYL
50MCG/HR
FENTANYL
75MCG/HR
HYDROMORPHONE HYDROCHLORIDE 10MG/ML
HYDROMORPHONE HCL
1MG
HYDROMORPHONE HYDROCHLORIDE 2MG/ML
8MG
HYDROMORPHONE HCL
HYDROMORPHONE HCL
2MG
HYDROMORPHONE HCL
4MG
MORPHINE SULFATE
60MG
OXYCODONE HCL
10MG
OXYCODONE HCL
20MG
OXYCODONE HCL
5MG
ACETAMINOPHEN/CODEINE PHOSPHAT 30MG/300MG
ASA/BUTALBITAL/CAFFEINE/CODEIN
ASA/BUTALBITAL/CAFFEINE/CODEIN
TRAMADOL HCL
100MG
TRAMADOL HCL
200MG
TRAMADOL HCL
300MG
FENTANYL
100MCG/HR
FENTANYL
100MCG
FENTANYL
75MCG
FENTANYL
25MCG
FENTANYL
50MCG
CODEINE PHOSPHATE
15MG
CODEINE PHOSPHATE
30MG
CODEINE PHOSPHATE
5MG/ML
30MG/300MG
FENTANYL
100MCG
FENTANYL
12MCG
FENTANYL
25MCG
FENTANYL
50MCG
FENTANYL
75MCG
ACETAMINOPHEN/CAFFEINE/CODEINE 15MG
ACETAMINOPHEN/CAFFEINE/CODEINE 30MG
300MG/60MG
MORPHINE HCL
10MG/ML
MORPHINE HCL
1MG/ML
MORPHINE HCL
20MG
117
Strength
Dosage
*PA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
CAP LA
PATCH
PATCH
PATCH
PATCH
PATCH
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
SUPP
O/L
TAB
TAB
TAB
O/L
TAB
PATCH
PATCH
PATCH
PATCH
PATCH
INJ
TAB
INJ
TAB
TAB
TAB
TAB LA
TAB
TAB
TAB
TAB
CAP
CAP
TAB LA
TAB LA
TAB LA
PATCH
PATCH
PATCH
PATCH
PATCH
TAB
TAB
O/L
TAB
PATCH
PATCH
PATCH
PATCH
PATCH
TAB
TAB
TAB
O/L
O/L
O/L
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
280808
00607770
00608165
00608157
00608181
00608203
02028174
02242468
00628565
02327163
02327112
02327120
02327147
02327155
02244790
02244791
02244792
02327139
00639389
00705799
00621935
00632201
00596965
00632228
00647217
00591467
00591475
00594644
00594636
00675962
00594652
02262983
00392480
00392472
00443948
00789739
02319403
02319411
02319438
02319446
02302802
02302772
02302780
02242406
01971387
01971395
00789828
01977881
00852163
02296381
02296403
02296411
02163934
02163926
02163918
02163942
02254212
02254220
02254182
02254204
02360349
02286424
02286432
02286440
02286459
02360322
RATIO‐MORPHINE 5MG O/L
RATIO‐OXYCOCET 5MG & 325MG TAB
RATIO‐OXYCODAN 5MG & 325MG TAB
RATIO‐TECNAL C 1/2 CAP
RATIO‐TECNAL C1/4 CAP
RHP‐ACETAMIN+COD 8MG TAB
RIVACOCET
ROXANOL 20MG/ML SYRUP
SANDOZ FENTANYL 100MCG/HR PAT
SANDOZ FENTANYL 12MCG/HR PATCH
SANDOZ MORPHINE 15MG SR
SANDOZ‐FENTANYL MTX 37MCG PAT
STATEX 30MG SUPP
STATEX 50MG/ML DROPS
STATEX DROPS 20MG/ML
STATEX SUPP 10MG
STATEX SUPP 20MG
STATEX SUPP 5MG
STATEX SYRUP 10MG/ML
STATEX SYRUP 1MG/ML
STATEX SYRUP 5MG/ML
STATEX TAB 10MG
STATEX TAB 25MG
STATEX TAB 50MG
STATEX TAB 5MG
SUPEUDOL 20MG TAB
SUPEUDOL SUPP 10MG
SUPEUDOL SUPP 20MG
SUPEUDOL TAB 10MG
SUPEUDOL TAB 5MG
TEVA‐HYDROMORPHONE 1MG TAB
TEVA‐MORPHINE SR 200MG TAB
TRIANAL C 1/4 CAP
TRIANAL C1/2 CAP
TRIANAL C1/4 CAP
TRIATEC‐30 TAB
TRIATEC‐8 FORTE TAB
TRIATEC‐8 TAB
TRIDURAL 100MG ER TAB
TYLENOL W CODEINE NO. 2 TAB
TYLENOL WITH CODEINE ELIXIR
ZOMORPH 120MG SR CAP
ZOMORPH 200MG SR CAP
ZOMORPH 20MG SR CAP
ZOMORPH 60MG SR CAP
ZYTRAM XL 100MG TAB
ZYTRAM XL 150MG ER TAB
ZYTRAM XL 75MG TAB
MORPHINE HCL
OXYCODONE HCL/ASA
MORPHINE SULFATE
FENTANYL
FENTANYL
FENTANYL
FENTANYL
FENTANYL
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
FENTANYL
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
OXYCODONE HCL
OXYCODONE
OXYCODONE
OXYCODONE
OXYCODONE
HYDROMORPHONE HCL
HYDROMORPHONE
HYDROMORPHONE HCL
HYDROMORPHONE HCL
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
CODEINE/ASA/BUTALBITAL
TRAMADOL HCL
TRAMADOL HCL
TRAMADOL HCL
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
MORPHINE SULFATE
TRAMADOL HCL
TRAMADOL HCL
TRAMADOL HCL
TRAMADOL HCL
TRAMADOL
TRAMADOL HCL
5MG/ML
3MG‐325MG
5/325MG
118
Dosage
*PA
O/L
TAB
TAB
CAP
CAP
300MG
TAB
TAB
20MG/ML
O/L
100MCG/H
PATCH
12MCG/H
PATCH
25MCG/H
PATCH
50MCG/H
PATCH
75MCG/H
PATCH
15MG
TAB LA
30MG
TAB LA
60MG
TAB LA
37MCG/H
PATCH
30 MG
SUPP
50MG/ML
O/L
20MG/ML
O/L
10MG
SUPP
20MG
SUPP
5MG
SUPP
10MG/ML
O/L
1MG/ML
O/L
5MG/ML
O/L
10MG
TAB
25MG
TAB
50MG
TAB
5MG
TAB
20MG
TAB
10MG
SUPP
20MG
SUPP
10MG
TAB
5MG
TAB
1MG
TAB
2MG
TAB
4MG
TAB
8MG
TAB
200MG
TAB LA
30MG
TAB LA
60MG
TAB LA
330/50MG
CAP
CAP
CAP
TAB
TAB
TAB
100MG
TAB LA
200MG
TAB LA
300MG
TAB LA
300/15MG
TAB
300/30MG
TAB
300MG/60MG TAB
160/8MG
O/L
120MG
CAP LA
200MG
CAP LA
20MG
CAP LA
60MG
CAP LA
100MG
TAB LA
150MG
TAB LA
200MG
TAB LA
300MG
TAB LA
400MG
TAB LA
75MG
TAB LA
05/2012
Therapy Class
280812
DIN
Drug Name
OPIATE PARTIAL AGONISTS
Chemical Name
Strength
Dosage
280812
280812
280812
280812
280812
280812
280812
280812
280812
280812
280812
280812
280812
280812
02242504
02341212
02341220
02341174
02242921
01913980
01913972
02244508
02295695
02295709
02241976
01904965
02137984
00229210
APO‐BUTORPHANOL 10MG/ML NAS SO
BUTRANS 10MCG/HOUR PATCH
LIN‐BUTORPHANOL 10MG/ML NS
NUBAIN 10MG/ML INJ
NUBAIN 20MG/ML INJ
PMS‐BUTORPHANOL 10MG/ML NAS SP
SUBOXONE 2MG/0.5MG SL TAB
SUBOXONE 8MG/2MG SL TAB
TALWIN 30MG/ML INJ
TALWIN 50MG TAB
TALWIN 50MG TAB
TALWIN COMPOUND‐50
BUTORPHANOL TARTRATE
BUPRENORPHINE
BUPRENORPHINE
BUPRENORPHINE
NALBUPHINE HYDROCHLORIDE
NALBUPHINE
BUPRENORPHINE HCL/NALOXONE HCL
BUPRENORPHINE HCL/NALOXONE HCL
PENTAZOCINE
PENTAZOCINE
PENTAZOCINE HCL
PENTAZOCINE
10MG/ML
10MCG/HOUR
20MCG/HOUR
5MCG/HOUR
10MG/ML
10MG/ML
20MG/ML
10MG/ML
2MG/0.5MG
8MG/2MG
30MG/ML
50MG
50MG
50MG
NAS SOL
PATCH
PATCH
PATCH
NAS SPR
INJ
INJ
NAS SPR
TAB
TAB
INJ
TAB
TAB
TAB
119
*PA
05/2012
Therapy Class
280892
DIN
Drug Name
MISCELLANEOUS ANALGESICS AND ANTIPYRETICS
Chemical Name
Strength
Dosage
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
280892
02244680
02244681
02360160
02360179
02360187
02360195
02360136
02360209
02360144
02360152
00638668
00754153
02268442
02268450
02268469
02268477
02268418
02268485
02268426
02268434
FLOCTAFENINE 200MG TAB
FLOCTAFENINE 400MG TAB
GD‐PREGABALIN 100MG CAP
IDARAC 200MG TAB
IDARAC 400MG TAB
LYRICA 100MG CAP
LYRICA 150MG CAP
LYRICA 200MG CAP
LYRICA 225MG CAP
LYRICA 25MG CAP
LYRICA 300MG CAP
LYRICA 50MG CAP
LYRICA 75MG CAP
FLOCTAFENINE
FLOCTAFENINE
PREGABALIN
PREGABALIN
PREGABALIN
PREGABALIN
PREGABALIN
PREGABALIN
PREGABALIN
PREGABALIN
FLUOCTAFENIN
FLOCTAFENINE
PREGABALIN
PREGABALIN
PREGABALIN
PREGABALIN
PREGABALIN
PREGABALIN
PREGABALIN
PREGABALIN
200MG
400MG
100MG
150MG
200MG
225MG
25MG
300MG
50MG
75MG
200MG
400MG
100MG
150MG
200MG
225MG
25MG
300MG
50MG
75MG
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
120
*PA
05/2012
Therapy Class
281000
DIN
Drug Name
OPIATE ANTAGONISTS
Chemical Name
Strength
Dosage
281000
281000
281000
281000
281000
02148706
02382482
02382601
02148714
02213826
NALOXONE 0.4MG/ML INJ
NALOXONE HCL 1MG/ML INJ
REVIA 50MG TAB
NALOXONE HCL
NALOXONE HCL
NALOXONE HCL
NALOXONE HCL
NALTREXONE HCL
0.4MG/ML
0.4MG/ML
INJ
INJ
INJ
INJ
TAB
121
1MG/ML
50MG
*PA
05/2012
Therapy Class
281204
DIN
Drug Name
BARBITURATES
281204
281204
00399310 APO‐PRIMIDONE 125MG TAB
00396761 APO‐PRIMIDONE 250MG TAB
122
Chemical Name
Strength
Dosage
PRIMIDONE
PRIMIDONE
125MG
250MG
TAB
TAB
*PA
05/2012
Therapy Class
281208
DIN
Drug Name
BENZODIAZEPINES
Chemical Name
Strength
Dosage
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
281208
02365243
02365251
02365278
02177889
02177897
02230366
02230368
02230369
02340968
02344602
02340976
02344610
02344629
02270641
02270668
02270676
02130998
02131005
02131013
02224100
02237277
02237278
02230950
02230951
02239024
02239025
02173344
02173352
02220598
02220601
02145227
02145235
02145243
02236948
02048701
02179660
02048728
02048736
02207818
02311593
02311607
02311615
02242077
02242078
00382825
00382841
02280639
02233960
02233982
02233985
02303302
02303310
02345676
02303329
02303337
ACCEL‐CLONAZEPAM 0.5MG TAB
ACCEL‐CLONAZEPAM 1MG TAB
ACCEL‐CLONAZEPAM 2MG TAB
APO‐CLONAZEPAM 0.5MG TAB
APO‐CLONAZEPAM 2MG TAB
CLONAPAM 0.5MG TAB
CLONAPAM 1MG TAB
CLONAPAM 2MG TAB
CLONAZEPAM 0.5MG TAB
CLONAZEPAM 1MG TAB
CLONAZEPAM 2MG TAB
CLONAZEPAM 2MG TAB
CLONAZEPAM‐R 0.5MG TAB
CO CLONAZEPAM 0.5MG TAB
CO CLONAZEPAM 1 MG TAB
CO CLONAZEPAM 2MG TAB
DOM‐CLONAZEPAM 0.5MG TAB
DOM‐CLONAZEPAM 1MG TAB
DOM‐CLONAZEPAM 2MG TAB
DOM‐CLONAZEPAM‐R TAB
MED‐CLONAZEPAM 0.5MG TAB
MED‐CLONAZEPAM 2MG TAB
MYLAN‐CLONAZEPAM 0.5MG TAB
MYLAN‐CLONAZEPAM 2MG TAB
NOVO‐CLONAZEPAM 0.5MG TAB
NOVO‐CLONAZEPAM 2MG TAB
NU‐CLONAZEPAM 0.5MG TAB
NU‐CLONAZEPAM 2MG TAB
PDL‐CLONAZEPAM 0.5MG TAB
PDL‐CLONAZEPAM 2MG TAB
PHL‐CLONAZEPAM 0.5 MG TAB
PHL‐CLONAZEPAM 1MG TAB
PHL‐CLONAZEPAM 2MG TAB
PHL‐CLONAZEPAM‐R 0.5MG TAB
PMS‐CLONAZEPAM 0.5MG TAB
PMS‐CLONAZEPAM 0.25MG TAB
PMS‐CLONAZEPAM 1MG TAB
PMS‐CLONAZEPAM 2MG TAB
PMS‐CLONAZEPAM R 0.5MG TAB
PRO‐CLONAZEPAM 0.5MG TAB
PRO‐CLONAZEPAM 1MG TAB
PRO‐CLONAZEPAM 2MG TAB
RIVA‐CLONAZEPAM 0.5MG TAB
RIVA‐CLONAZEPAM 2MG TAB
RIVOTRIL 0.5MG TAB
RIVOTRIL 2MG TAB
RIVOZEPAM 2MG TAB
SANDOZ‐CLONAZEPAM 0.5MG TAB
SANDOZ‐CLONAZEPAM 1MG TAB
SANDOZ‐CLONAZEPAM 2MG TAB
ZYM‐CLONAZEPAM 0.25MG TAB
ZYM‐CLONAZEPAM 1MG TAB
ZYM‐CLONAZEPAM 2MG TAB
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
CLONAZEPAM
0.5MG
1MG
2MG
0.5MG
2MG
0.5MG
1MG
2MG
0.5MG
1MG
2MG
2MG
0.5MG
0.5MG
1MG
2MG
0.5MG
1MG
2.0MG
0.5MG
0.5MG
2MG
0.5MG
2MG
0.5MG
2MG
0.5MG
2MG
0.5MG
2MG
0.5 MG
1MG
2 MG
0.5MG
0.5MG
0.25MG
1MG
2MG
0.5MG
0.5MG
1MG
2MG
0.5MG
2MG
0.5MG
2MG
2MG
0.5MG
1MG
2MG
0.25MG
0.5MG
0.5MG
1MG
2MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
123
*PA
05/2012
Therapy Class
281212
DIN
Drug Name
HYDANTOINS
Chemical Name
Strength
Dosage
281212
281212
281212
281212
281212
281212
281212
281212
00023450
00023442
00022780
00022772
00023698
00497304
02250896
00498335
DILANTIN 125MG/5ML SUSP
DILANTIN 30MG/5ML SUSP
DILANTIN CAP 100MG
DILANTIN CAP 30MG
DILANTIN INFATABS 50MG
PHENYTOIN SODIUM 50MG/ML INJ
TARO‐PHENYTOIN 125MG/5ML O/L
TREMYTOINE INJ 50MG/ML
PHENYTOIN
PHENYTOIN
PHENYTOIN
PHENYTOIN
PHENYTOIN
PHENYTOIN SODIUM
PHENYTOIN
PHENYTOIN SODIUM
125MG/5ML
30MG/5ML
100MG
30MG
50MG
50MG/ML
125MG/5ML
50MG/ML
O/L
O/L
CAP
CAP
TAB
INJ
O/L
INJ
124
*PA
05/2012
Therapy Class
281220
DIN
Drug Name
SUCCINIMIDES
Chemical Name
Strength
Dosage
281220
281220
281220
00022802 CELONTIN CAP 300MG
00022799 ZARONTIN CAP 250MG
00023485 ZARONTIN SYR 250MG/5ML
METHSUXIMIDE
ETHOSUXIMIDE
ETHOSUXIMIDE
300MG
250MG
250MG/5ML
CAP
CAP
O/L
125
*PA
05/2012
Therapy Class
281292
DIN
Drug Name
MISCELLANEOUS ANTICONVULSANTS
Chemical Name
Strength
Dosage
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
02351315
02351323
02351307
00402699
02242908
02242909
02239698
02239699
02239700
02244304
02244305
02244306
02293358
02293366
02245209
02245210
02245208
02285924
02285932
02285940
02284294
02284308
02284316
02279630
02279649
02279614
02279622
02238048
02238370
02341123
02341131
02341158
02341891
02341905
02341913
02341875
02341883
02348381
02348403
02348411
02321203
02321211
02321238
02381362
02381362
02381370
02381370
02381354
02381354
02375249
02375257
02375265
02345838
02345846
02345803
02345811
02365022
02365030
02365049
02365006
02365014
02372495
02372509
02372487
02371677
02371685
02371693
02370980
02370999
02370972
02369613
02369621
02369648
02266768
02247135
02243511
02287129
02243512
02287137
02274183
ACCEL‐TOPIRAMATE 100MG TABS
APO‐CARBAMAZEPINE 200MG TAB
APO‐CARBAMAZEPINE CR 200MG TAB
APO‐CARBAMAZEPINE CR 400MG TAB
APO‐DIVALPROEX 125MG TAB
APO‐GABAPENTIN 100MG CAP
APO‐GABAPENTIN 600MG TAB
APO‐GABAPENTIN 800MG TAB
APO‐LAMOTRIGINE 100MG TAB
APO‐LEVETIRACETAM 250MG TAB
APO‐OXCARBAZEPINE 150MG TAB
APO‐TOPIRAMATE 100MG TAB
APO‐VALPROIC 250MG CAP
APO‐VALPROIC SYRUP 50MG/ML
APX‐DIVALPROEX 125MG EC TAB
APX‐GABAPENTIN 100MG CAP
APX‐GABAPENTIN 600MG TAB
APX‐GABAPENTIN 800MG TAB
APX‐OXCARBAZEPINE 150MG TAB
AURO‐GABAPENTIN 100MG CAP
AURO‐LAMOTRIGINE 100MG TAB
AURO‐LEVETIRACETAM 250MG TAB
AURO‐TOPIRAMATE 100MG TAB
AVA‐GABAPENTIN 100MG CAP
AVA‐GABAPENTIN 600MG TAB
AVA‐GABAPENTIN 800MG TAB
AVA‐LAMOTRIGINE 100MG TAB
AVA‐LEVETIRACETAM 250MG TAB
AVA‐TOPIRAMATE 100MG TAB
BANZEL 100MG TAB
BANZEL 200MG TAB
BANZEL 400MG TAB
BCI GABAPENTIN 300MG CAP
BIO‐CARBAMAZAPINE 200MG TAB
CARBAMAZEPINE CR 200MG TAB
CO LEVETIRACETAM 250MG TAB
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
DIVALPROEX SODIUM
DIVALPROEX SODIUM
DIVALPROEX SODIUM
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
OXCARBAZEPINE
OXCARBAZEPINE
OXCARBAZEPINE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
VALPROIC ACID
VALPROIC ACID
DIVALPROEX SODIUM
DIVALPROEX SODIUM
DIVALPROEX SODIUM
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
OXCARBAZEPINE
OXCARBAZEPINE
OXCARBAZEPINE
GABAPENTIN
GABAPENTIN
GABAPENTIN
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
RUFINAMIDE
RUFINAMIDE
RUFINAMIDE
GABAPENTIN
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
LEVETIRACETAM
100MG
200MG
25MG
200MG
200MG
400MG
125MG
250MG
500MG
100MG
300MG
400MG
600MG
800MG
100MG
150MG
25MG
250MG
500MG
750MG
150MG
300MG
600MG
100MG
200MG
25MG
50MG
250MG
50MG/ML
125MG
250MG
500MG
100MG
300MG
400MG
600MG
800MG
150MG
300MG
600MG
100MG
300MG
400MG
100MG
100MG
150MG
150MG
25MG
25MG
250MG
500MG
750MG
100MG
200MG
25MG
50MG
100MG
300MG
400MG
600MG
800MG
100MG
150MG
25MG
250MG
500MG
750MG
100MG
200MG
25MG
100MG
200MG
400MG
300MG
200MG
200MG
200MG
400MG
400MG
250MG
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
O/L
TAB LA
TAB LA
TAB LA
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB
126
*PA
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
02274191
02274205
02287773
02287781
02287765
02256142
02256150
02256169
00443840
00443832
02240341
02240342
02240343
02231670
02238222
02238223
02245751
02245752
02245753
02243743
02243744
02243745
02258153
02258161
02376644
02376652
02376636
02297396
02297418
02297426
02271168
02271176
02271141
02238817
02231030
02231031
00596418
00596426
00596434
02238671
02246314
02249367
02286475
02304775
02332582
02342650
02353245
02238672
02246315
02249375
02286483
02304783
02332590
02342669
02353253
02238673
02246316
02249383
02286491
02304791
02332604
02342677
02353261
02304805
02304813
02285819
02285827
02285835
02285843
02285851
02352877
02352885
02352850
02352869
02361469
02361485
02361493
02247027
02247028
02247029
02142104
CO TOPIRAMATE 100MG TAB
CO‐GABAPENTIN 100MG CAP
DEPAKENE CAP 250MG
DEPAKENE SYR 50MG/ML
DIVALPROEX 125MG EC TAB
DOM‐CARBAMAZEPINE 200MG TAB
DOM‐CARBAMAZEPINE CR 200MG TAB
DOM‐CARBAMAZEPINE CR 400MG TAB
DOM‐DIVALPROEX 125MG TAB
DOM‐GABAPENTIN 100MG CAP
DOM‐GABAPENTIN 600MG TAB
DOM‐GABAPENTIN 800MG TAB
DOM‐LAMOTRIGINE 100MG TAB
DOM‐LEVETIRACETAM 250MG TAB
DOM‐TOPIRAMATE 100MG TAB
DOM‐VALPROIC ACID 250M/5ML O/L
DOM‐VALPROIC ACID 250MG CAP
DOM‐VALPROIC ACID 500MG EC CAP
EPIVAL ECT 125MG
EPIVAL ECT 250MG
EPIVAL ECT 500MG
GABAPENTIN 100MG CAP
GABAPENTIN 600MG TAB
GABAPENTIN 800MG TAB
GD‐GABAPENTIN 100MG CAP
GD‐GABAPENTIN 600MG TAB
GD‐GABAPENTIN 800MG TAB
GD‐TOPIRAMATE 100MGTAB
GD‐TOPIRAMATE 200MG TAB
JAMP‐GABAPENTIN 100MG CAP
KEPPRA 250MG TAB
KEPPRA 500MG TAB
KEPPRA 750MG TAB
LAMICTAL 100 MG TAB
LEVETIRACETAM
LEVETIRACETAM
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
GABAPENTIN
GABAPENTIN
GABAPENTIN
VALPROIC ACID
VALPROIC ACID
DIVALPROEX SODIUM
DIVALPROEX SODIUM
DIVALPROEX SODIUM
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
DIVALPROEX SODIUM
DIVALPROEX SODIUM
DIVALPROEX SODIUM
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
VALPROIC ACID
VALPROIC ACID
VALPROIC ACID
DIVALPROEX SODIUM
DIVALPROEX SODIUM
DIVALPROEX SODIUM
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
GABAPENTIN
GABAPENTIN
GABAPENTIN
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
LAMOTRIGINE
500MG
750MG
100MG
200MG
25MG
100MG
300MG
400MG
250MG
50MG/ML
125MG
250MG
500MG
200MG
200MG
400MG
125MG
250MG
500MG
100MG
300MG
400MG
600MG
800MG
100MG
150MG
25MG
250MG
500MG
750MG
100MG
200MG
25MG
250MG
250MG
500MG
125MG
250MG
500MG
100MG
100MG
100MG
100MG
100MG
100MG
100MG
100MG
300MG
300MG
300MG
300MG
300MG
300MG
300MG
300MG
400MG
400MG
400MG
400MG
400MG
400MG
400MG
400MG
600MG
800MG
100MG
300MG
400MG
600MG
800MG
100MG
200MG
25MG
50MG
100MG
300MG
400MG
250MG
500MG
750MG
100MG
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
O/L
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
CAP
CAP
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
127
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
02240118
02142112
02240119
02142082
02142139
02240116
02243803
02142090
02240117
02240115
02302985
02343029
02302993
02343037
02302969
02343010
02343622
02353342
02343630
02353350
02343649
02353369
00504742
02230663
02315653
02315661
02315645
02241882
02241883
02265133
02265141
02265168
02248259
02248260
02248261
02265508
02265516
02265494
02263378
02263386
02263351
02184648
02084260
02084279
02084287
02239717
02239718
02239701
02239702
02239703
02310724
02312026
02312034
02312042
02100630
02218321
02042568
02239517
02239518
02239519
02246742
02246743
02246744
02334577
02334585
02334569
02336251
02336278
02336286
02334348
02334356
02334313
02334321
02237830
02238069
00578460
02313677
02238546
02239282
02231248
02238640
LAMICTAL 100MG CHEWABLE TAB
LAMICTAL 150MG TAB
LAMICTAL 25 MG TAB
LAMICTAL 250 MG
LAMICTAL 50 MG TAB
LAMOTRIGINE 100MG TAB
LEVETIRACETAM 250MG TAB
LEVETIRACETAM 500MGTAB
LEVETIRACETAM 750MGTAB
MAZEPINE TAB 200MG
MED‐VALPROIC 250MG CAP
MINT‐TOPIRAMATE 100MG TAB
MYLAN‐CARBAMAZEPINE CR 200MG
MYLAN‐CARBAMAZEPINE CR 400MG
MYLAN‐DIVALPROEX 125MG TAB
MYLAN‐GABAPENTIN 100MG CAP
MYLAN‐LAMOTRIGINE 100MG TAB
MYLAN‐TOPIRAMATE 100MG TAB
MYLAN‐VALPROIC 250MG CAP
NEURONTIN 100MG CAP
NEURONTIN 300MG CAP
NEURONTIN 400MG CAP
NEURONTIN 600MG TAB
NEURONTIN 800MG TAB
NOVO‐DIVALPROEX 125MG TAB
NOVO‐LEVETIRACETAM 750MG TAB
NOVO‐OXCARBAZEPINE 150MG TAB
NOVO‐OXCARBAZEPINE 300MG TAB
NOVO‐OXCARBAZEPINE600MG TAB
NOVO‐VALPROIC 250 MG CAP
NOVO‐VALPROIC 500 MG CAP
NU‐CARBAMAZEPINE 200 MG
NU‐DIVALPROEX 125MG EC TAB
NU‐GABAPENTIN 100MG CAP
NU‐LAMOTRIGINE 100MG TAB
NU‐LEVETIRACETAM 250MG TAB
NU‐TOPIRAMATE 100MG TAB
NU‐VALPROIC 250MG CAP
NU‐VALPROIC 50MG/ML SYRUP
PDL‐CARBAMAZEPINE 200 TAB
PDL‐TOPIRAMATE 200MG TAB
PDL‐VALPROIC 250MG CAP
PDL‐VALPROIC ACID 50MG/ML SYR
PENTA‐VALPROIC 250MG CAP
PHL‐CARBAMAZEPINE CR 200MG TAB
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
CARBAMAZEPINE
VALPROIC ACID
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
CARBAMAZEPINE
CARBAMAZEPINE
DIVALPROEX SODIUM
DIVALPROEX SODIUM
DIVALPROEX SODIUM
GABAPENTIN
GABAPENTIN
GABAPENTIN
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
VALPROIC ACID
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
DIVALPROEX SODIUM
DIVALPROEX SODIUM
DIVALPROEX SODIUM
LEVETIRACETAM
OXCARBAZEPINE
OXCARBAZEPINE
OXCARBAZEPINE
VALPROIC ACID
VALPROIC ACID
CARBAMAZEPINE
DIVALPROEX SODIUM
DIVALPROEX SODIUM
DIVALPROEX SODIUM
GABAPENTIN
GABAPENTIN
GABAPENTIN
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
VALPROIC ACID
VALPROIC ACID
CARBAMAZEPINE
TOPIRAMATE
VALPROIC ACID
VALPROIC ACID
VALPROIC ACID
CARBAMAZEPINE
100MG
150MG
200MG
25MG
250MG
25MG
2MG
50MG
50MG
5MG
100MG
100MG
150MG
150MG
25MG
25MG
250MG
250MG
500MG
500MG
750MG
750MG
200MG
250MG
100MG
200MG
25MG
200MG
400MG
125MG
250MG
500MG
100MG
300MG
400MG
100MG
150MG
25MG
100MG
200MG
25MG
250MG
100MG
300MG
400MG
600MG
800MG
125MG
250MG
500MG
750MG
150MG
300MG
600MG
250MG
500 MG
200MG
125MG
250MG
500MG
100MG
300MG
400MG
100MG
150MG
25MG
250MG
500MG
750MG
100MG
200MG
25MG
50MG
250MG
50MG/ML
200MG
200MG
250MG
50MG/ML
250MG
200MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
O/L
TAB
TAB
CAP
O/L
CAP
TAB LA
128
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
02238641
02294109
02294117
02294125
02258005
02258013
02297353
02297361
02297388
02271192
02271206
02271184
02260654
02238210
02260662
00667110
02231542
02231540
02231543
02231541
02231544
02280744
02280752
02244138
02244139
02244140
02243446
02243447
02243448
02255898
02255901
02246898
02246899
02246897
02296101
02296128
02296136
02263009
02263017
02262991
02312085
02230768
02236807
02229628
02310449
02310457
02310465
02310473
02310481
02311372
02311380
02311399
02313669
02313650
02372703
02372711
02372681
02319055
02319063
02319071
02260883
02260891
02260905
02260913
02260921
02243353
02246963
02243352
02256835
02256843
02256827
02140063
02140047
02251167
02251175
02251183
02259796
02259818
02068028
02068001
02067994
PHL‐CARBAMAZEPINE CR 400MG TAB
PHL‐DIVALPROEX 125MG EC TAB
PHL‐GABAPENTIN 600MG TAB
PHL‐GABAPENTIN 800MG TAB
PHL‐LEVETIRACETAM 250MG TAB
PHL‐TOPIRAMATE 100MG TAB
PHL‐VALPROIC ACID 250MG CAP
PHL‐VALPROIC ACID 250MG/5MLSYR
PHL‐VALPROIC ACID 500MG CAP
PMS‐CARBAMAZEPINE
PMS‐CARBAMAZEPINE 100MG CHWTAB
PMS‐CARBAMAZEPINE 200MG CHWTAB
PMS‐CARBAMAZEPINE 200MG SRT
PMS‐CARBAMAZEPINE 200MG TAB
PMS‐CARBAMAZEPINE 400MG SRT
PMS‐CARBAMAZEPINE CR 200MG TAB
PMS‐CARBAMAZEPINE CR 400MG TAB
PMS‐DIVALPROEX EC 125MG TAB
PMS‐GABAPENTIN 100MG CAP
PMS‐GABAPENTIN 600MG TAB
PMS‐GABAPENTIN 800MG TAB
PMS‐LAMOTRIGINE 100MG TAB
PMS‐LEVETIRACETAM 250MG TAB
PMS‐TOPIRAMATE 100MG TAB
PMS‐VALPROIC ACID 250MG CAP
PMS‐VALPROIC ACID 50MG/ML SYR
PMS‐VALPROIC ACID EC 500MG CAP
PRO‐GABAPENTIN 100MG CAP
PRO‐GABAPENTIN 600MG TAB
PRO‐GABAPENTIN 800MG TAB
PRO‐LEVETIRACETAM 250MG TAB
PRO‐TOPIRAMATE 100MG TAB
PRO‐TOPIRAMATE 25MG TAB
Q‐TOPIRAMATE 100MG TAB
RAN‐GABAPENTIN 100MG CAP
RATIO‐GABAPENTIN 100MG CAP
RATIO‐GABAPENTIN 600MG TAB
RATIO‐GABAPENTIN 800MG TAB
RATIO‐LAMOTRIGINE 100MG TAB
RATIO‐TOPIRAMATE 100MG TAB
RATIO‐VALPROIC 50MG/ML SYRUP
RATIO‐VALPROIC ACID 250MG CAP
RIVA‐GABAPENTIN 100MG CAP
RIVA‐GABAPENTIN 600MG TAB
RIVA‐GABAPENTIN 800MG TAB
SABRIL 1G/SACHET
SABRIL 2G/SACHET
SABRIL 3G/SACHET
CARBAMAZEPINE
DIVALPROEX SODIUM
DIVALPROEX SODIUM
DIVALPROEX SODIUM
GABAPENTIN
GABAPENTIN
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
VALPROIC ACID
VALPROIC ACID
VALPROIC ACID
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
DIVALPROEX SODIUM
DIVALPROEX SODIUM
DIVALPROEX SODIUM
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
VALPROIC ACID
VALPROIC ACID
VALPROIC ACID
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
VALPROIC ACID
VALPROIC ACID
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
VIGABATRIN
VIGABATRIN
VIGABATRIN
400MG
125MG
250MG
500MG
600MG
800MG
250MG
500MG
750MG
100MG
200MG
25MG
250MG
250MG/5ML
500MG
200MG
100MG
200MG
200MG
200MG
400MG
200MG
400MG
125MG
250MG
500MG
100MG
300MG
400MG
600MG
800MG
100MG
150MG
25MG
250MG
500MG
750MG
100MG
200MG
25MG
50MG
250MG
50MG/ML
500MG
100MG
300MG
400MG
600MG
800MG
250MG
500MG
750MG
100MG
25MG
100MG
200MG
25MG
100MG
300MG
400MG
100MG
300MG
400MG
600MG
800MG
100MG
150MG
25MG
100MG
200MG
25MG
50MG/ML
250MG
100MG
300MG
400MG
600MG
800MG
1G
2G
3G
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
O/L
CAP
TAB
TAB
TAB
TAB LA
TAB
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
O/L
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
CAP
CAP
CAP
CAP
TAB
TAB
PDR
PDR
PDR
129
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
02065819
02068036
02260069
02267837
02260050
02239714
02239713
02261855
02261863
02261839
02261847
02323575
02323583
02323591
02347539
02347547
02347563
02346907
02346915
02346893
02244403
02367394
02244404
02237907
02237908
02250888
02250918
02250926
02194333
00010405
00369810
00665088
00773611
00755583
00782718
02244513
02244514
02244515
02248457
02247346
02248233
02248234
02248232
02248861
02248862
02248860
02230894
02239907
02230896
02239908
02230893
02239909
02281759
02281767
02281740
02286211
02344866
02345269
02345439
02349744
02351633
02356864
02286238
02344874
02345277
02345447
02349752
02351641
02356872
02286203
02344858
02345250
02345412
02349736
02351625
02356856
02345420
02380412
02380412
02380420
02380420
SABRIL 500MG TAB
SABRIL 500MG/SACHET
SANDOZ TOPIRAMATE 100MG TAB
SANDOZ VALPROIC 250MG CAP
SANDOZ VALPROIC 500MG EC CAP
SANDOZ‐CARBAMAZEPINE CHEW100MG
SANDOZ‐CARBAMAZEPINE CHEW200MG
SANDOZ‐CARBAMAZEPINE CR 200MG
SANDOZ‐CARBAMAZEPINE CR 400MG
SIG‐GABAPENTIN 100MG CAP
SIG‐LEVETIRACETAM 250MG TAB
SIG‐TOPIRAMATE 100MG TAB
TARO‐CARBAMAZEPINE 100MG CHEWT
TARO‐CARBAMAZEPINE 100MG/5ML
TARO‐CARBAMAZEPINE 200MG CHEWT
TARO‐CARBAMAZEPINE CR 200MG
TARO‐CARBAMAZEPINE CR 400MG
TARO‐GABAPENTIN 100MG CAP
TEGRETOL 100MG/5ML SUSP
TEGRETOL 200MG TAB
TEGRETOL CHEWTABS 100MG
TEGRETOL CHEWTABS 200MG
TEGRETOL CR 200MG TAB
TEGRETOL CR 400MG TAB
TEVA‐CARBAMAZ TAB 200MG
TEVA‐GABAPENTIN 100MG CAP
TEVA‐GABAPENTIN 600MG TAB
TEVA‐GABAPENTIN 800MG TAB
TEVA‐LAMOTRIGINE 100MG TAB
TEVA‐TOPIRAMATE 100MG TAB
TOPAMAX 100MG TAB
TOPAMAX 15MG SPRINKLE CAP
TOPAMAX 200MG TAB
TOPAMAX 25MG TAB
TOPILOX 100MG TAB
TOPILOX 200MG TAB
TOPILOX 25MG TAB
TOPIRAMATE 100MG TAB
TOPIRAMATE 25MG TAB
TOPIRAMATE 25MG TAB
TOPIRAMATE 25MG TAB
TOPIRAMATE 25MG TAB
TOPIRAMATE 25MG TAB
TOPIRAMATE 25MG TAB
TOPIRAMATE 25MG TAB
TOPIRAMATE 50MG TAB
TORRENT‐LEVETIRACETAM 250MG
VIGABATRIN
VIGABATRIN
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
VALPROIC ACID
VALPROIC ACID
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
GABAPENTIN
GABAPENTIN
GABAPENTIN
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
GABAPENTIN
GABAPENTIN
GABAPENTIN
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
CARBAMAZEPINE
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
GABAPENTIN
LAMOTRIGINE
LAMOTRIGINE
LAMOTRIGINE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
LEVETIRACETAM
500MG
500MG
100MG
200MG
25MG
250MG
500MG
100MG
200MG
200MG
400MG
100MG
300MG
400MG
250MG
500MG
750MG
100MG
200MG
25MG
100MG
100MG/5ML
200MG
200MG
400MG
100MG
300MG
400MG
100MG/5ML
200MG
100MG
200MG
200MG
400MG
200MG
100MG
300MG
400MG
600MG
800MG
100MG
150MG
25MG
100MG
200MG
25MG
100MG
15MG
200MG
25MG
25MG
50MG
100MG
200MG
25MG
100MG
100MG
100MG
100MG
100MG
100MG
100MG
200MG
200MG
200MG
200MG
200MG
200MG
200MG
25MG
25MG
25MG
25MG
25MG
25MG
25MG
50MG
250MG
250MG
500MG
500MG
TAB
PDR
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB LA
TAB LA
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB LA
TAB LA
CAP
CAP
CAP
O/L
TAB
TAB
TAB
TAB LA
TAB LA
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
CAP
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
130
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
281292
02380439
02380439
02242067
02242068
02242069
02244673
02230044
02343088
02357623
02357666
02357631
02357658
02357615
02325144
02325152
02325136
TRILEPTAL 150MG TAB
TRILEPTAL 300MG TAB
TRILEPTAL 600MG TAB
TRILEPTAL 60MG/ML ORAL SUSP
VALPROIC 250MG CAP
VALPROIC 250MG CAP
VIMPAT 100MG TAB
VIMPAT 10MG/ML INJ
VIMPAT 150MG TAB
VIMPAT 200MG TAB
VIMPAT 50MG TAB
ZYM‐TOPIRAMATE 100MG TAB
LEVETIRACETAM
LEVETIRACETAM
OXCARBAZEPINE
OXCARBAZEPINE
OXCARBAZEPINE
OXCARBAZEPINE
VALPROIC ACID
VALPROIC ACID
LACOSAMIDE
LACOSAMIDE
LACOSAMIDE
LACOSAMIDE
LACOSAMIDE
TOPIRAMATE
TOPIRAMATE
TOPIRAMATE
750MG
750MG
150MG
300MG
600MG
60MG/ML
250MG
250MG
100MG
10MG/ML
150MG
200MG
50MG
100MG
200MG
25MG
TAB
TAB
TAB
TAB
TAB
O/L
CAP
CAP
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
131
*PA
05/2012
Therapy Class
281604
DIN
Drug Name
ANTIDEPRESSANTS
Chemical Name
Strength
Dosage
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
02348942
02350033
02349973
02349981
02350025
02350041
02355248
02355256
02355264
02374617
02339390
02339404
02242820
02218402
00330566
00402591
00324019
00335053
00335061
00335088
02246056
02246057
02040786
02040778
02040751
02216280
02216248
02216299
02216256
02216264
02216272
02050048
02049996
02050005
02050013
02050021
02216353
02216361
02231328
02231330
02231329
00360201
00312797
00644579
02286610
02286629
02286637
02232148
02232150
02240456
02223511
02223538
02240907
02240908
02240909
02238282
02238280
02238281
02147645
02147637
02147653
02248539
02248537
02248540
02248538
02331705
02331683
02331691
02344165
02344173
02344181
02344203
02340712
02340720
02341743
02341751
02341778
02341832
02341824
02342251
AA‐AMITRIPTYLINE 75MG TAB
AA‐TRIMIP 100MG TAB
AA‐TRIMIP 12.5MG TAB
AA‐TRIMIP 75MG CAP
ACCEL‐CITALOPRAM 10MG TAB
AG‐CITALOPRAM 10MG TAB
ALTI‐FLUOXETINE 20MG/5ML LIQ
ALTI‐MOCLOBEMIDE 100MG TAB
ANAFRANIL 10MG TAB
ANAFRANIL 50MG TAB
ANAFRANIL TAB 25MG
APO‐AMITRIPTYLINE 10MG TAB
APO‐CITALOPRAM 20MG TAB
APO‐CITALOPRAM 40MG TAB
APO‐CLOMIPRAMINE 10MG TAB
APO‐DESIPRAMINE 100MG TAB
APO‐DOXEPIN 100MG CAP
APO‐FLUOXETINE 10MG CAP
APO‐FLUOXETINE 20MG CAP
APO‐FLUOXETINE 20MG/5ML SYRUP
APO‐FLUVOXAMINE 100MG TAB
APO‐FLUVOXAMINE 50MG TAB
APO‐IMIPRAMINE 10MG TAB
APO‐MIRTAZAPINE 15MG TAB
APO‐MOCLOBEMIDE 100MG TAB
APO‐NORTRIPTYLINE 10MG CAP
APO‐NORTRIPTYLINE 25MG CAP
APO‐PAROXETINE 10MG TAB
APO‐SERTRALINE 100MG CAP
APO‐TRAZODONE 100MG TAB
APO‐TRAZODONE 50MG TAB
APO‐TRAZODONE D 150MG TAB
APO‐TRYPTOPHAN 1G TAB
APO‐TRYPTOPHAN 250MG TAB
APO‐TRYPTOPHAN 500MG CAP
APO‐TRYPTOPHAN 500MG TAB
APO‐VENLAFAXINE XR 150MG CAP
APO‐VENLAFAXINE XR 37.5MG CAP
APO‐VENLAFAXINE XR 75MG CAP
APX‐AMITRIPTYLINE 10MG TAB
APX‐CITALOPRAM 20MG TAB
APX‐CITALOPRAM 40MG TAB
APX‐FLUOXETINE 10MG CAP
APX‐FLUOXETINE 20MG CAP
APX‐FLUOXETINE 20MG/5ML O/L
APX‐FLUVOXAMINE 100MG TAB
APX‐FLUVOXAMINE 50MG TAB
APX‐PAROXETINE 10MG TAB
AMITRIPTYLINE HCL
TRIMIPRAMINE MALEATE
CITALOPRAM HYDROBROMIDE
FLUOXETINE HCL
MOCLOBEMIDE
CLOMIPRAMINE HCL
CLOMIPRAMINE HCL
CLOMIPRAMINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
CLOMIPRAMINE HCL
CLOMIPRAMINE HCL
CLOMIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
IMIPRAMINE
IMIPRAMINE
IMIPRAMINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MOCLOBEMIDE
MOCLOBEMIDE
MOCLOBEMIDE
NORTRIPTYLINE HCL
NORTRIPTYLINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
L‐TRYPTOPHAN
L‐TRYPTOPHAN
L‐TRYPTOPHAN
L‐TRYPTOPHAN
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
CITALOPRAM HBR
CITALOPRAM HBR
FLUOXETINE
FLUOXETINE
FLUOXETINE
FLUVOXAMINE
FLUVOXAMINE
PAROXETINE
75MG
100MG
12.5MG
25MG
50MG
75MG
10MG
20MG
40MG
10MG
20MG
40MG
20MG/5ML
100MG
10MG
50MG
25MG
10MG
25MG
50MG
20MG
40MG
10MG
25MG
50MG
100MG
10MG
150MG
25MG
50MG
75MG
100MG
10MG
25MG
50MG
75MG
10MG
20MG
20MG/5ML
100MG
50MG
10MG
25MG
75MG
15MG
30MG
45MG
100MG
150MG
300MG
10MG
25MG
10MG
20MG
30MG
100MG
25MG
50MG
100MG
50MG
150MG
1G
250MG
500MG
500MG
150MG
37.5MG
75MG
10MG
25MG
50MG
75MG
20MG
40MG
10MG
20MG
20MG/5ML
100MG
50MG
10MG
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
CAP
TAB
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
O/L
TAB
TAB
TAB
132
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
02342278
02342286
02341867
02341840
02341859
02275562
02275570
02299801
02299828
02299836
02383276
02383276
02383284
02383284
02383292
02383292
02363399
02363402
02364255
02364522
02364530
02363771
02363763
02362929
02362937
02364301
02364328
02365103
02365111
02365138
02364387
02364360
02364379
02365634
02365642
02365626
00015229
00015237
02266776
02247166
02247167
02247168
02383187
02383195
02334038
02331616
02334046
02239606
02239607
02239608
02284839
02301822
02353636
02284847
02301830
02331950
02333961
02342766
02351900
02353644
02353660
00253679
02284855
02301849
02331977
02333988
02342774
02351919
02353652
02353679
02257513
02257521
02306239
02306247
02248050
02248051
02244816
02244817
02244818
02242177
02242178
APX‐SERTRALINE 100MG CAP
AURO‐CITALOPRAM 20MG TAB
AURO‐CITALOPRAM 40MG TAB
AURO‐MIRTAZAPINE OD 15MG TAB
AURO‐PAROXETINE 10MG TAB
AVA‐BUPROPION SR 100MG TAB
AVA‐BUPROPION SR 150MG TAB
AVA‐CITALOPRAM 10MG TAB
AVA‐FLUOXETINE 10MG CAP
AVA‐FLUOXETINE 20MG CAP
AVA‐FLUVOXAMINE 100MG TAB
AVA‐FLUVOXAMINE 50MG TAB
AVA‐MIRTAZAPINE 15MG TAB
AVA‐MIRTAZAPINE 30MG TAB
AVA‐NORTRIPTYLINE 10MG CAP
AVA‐NORTRIPTYLINE 25MG CAP
AVA‐PAROXETINE 10MG TAB
AVA‐SERTRALINE 100MG CAP
AVA‐TRAZODONE 100MG TAB
AVENTYL PULVULE 387 10MG
AVENTYL PULVULE 389 25MG
BCI FLUOXETINE 20MG CAP
BIO‐AMITRIPTYLINE 10MG TAB
BUPROPION HCL XL 150MG TAB
BUPROPION HCL XL 300MG TAB
BUPROPION SR 100MG ER TAB
BUPROPION SR 100MG TAB
BUPROPION SR 150MG ER TAB
CELEXA 10MG TAB
CELEXA 20MG TAB
CELEXA 40MG TAB
CITALOPRAM 10MG TAB
CITALOPRAM 10MG TAB
CITALOPRAM 10MG TAB
CITALOPRAM 20MG TAB
CITALOPRAM 20MG TAB
CITALOPRAM 20MG TAB
CITALOPRAM 20MG TAB
CITALOPRAM 20MG TAB
CITALOPRAM 20MG TAB
CITALOPRAM 20MG TAB
CITALOPRAM 20MG TAB
CITALOPRAM 40MG TAB
CITALOPRAM 40MG TAB
CITALOPRAM 40MG TAB
CITALOPRAM 40MG TAB
CITALOPRAM 40MG TAB
CITALOPRAM 40MG TAB
CITALOPRAM 40MG TAB
CITALOPRAM 40MG TAB
CITALOPRAM 40MG TAB
CITALOPRAM‐20MG TAB
CITALOPRAM‐40MG TAB
CITALOPRAM‐ODAN 20MG TAB
CITALOPRAM‐ODAN 40MG TAB
CO CITALOPRAM 20MG TAB
CO CITALOPRAM 40MG TAB
CO CLOMIPRAMINE 10MG TAB
CO FLUOXETINE 10MG CAP
PAROXETINE
PAROXETINE
SERTRALINE
SERTRALINE
SERTRALINE
CITALOPRAM HBR
CITALOPRAM HBR
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
BUPROPION
BUPROPION
FLUOXETINE HCL
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
MIRTAZAPINE
MIRTAZAPINE
NORTRIPTYLINE HCL
NORTRIPTYLINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
NORTRIPTYLINE HCL
NORTRIPTYLINE HCL
FLUOXETINE HCL
AMITRIPTYLINE
AMITRIPTYLINE
AMITRIPTYLINE
BUPROPION HCL
BUPROPION HCL
BUPROPION HCL
BUPROPION HCL
BUPROPION HCL
CITALOPRAM
CITALOPRAM
CITALOPRAM HBR
CITALOPRAM HBR
CLOMIPRAMINE HCL
CLOMIPRAMINE HCL
CLOMIPRAMINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
20MG
30MG
100MG
25MG
50MG
20MG
40MG
15MG
30MG
45MG
10MG
10MG
20MG
20MG
30MG
30MG
100MG
150MG
10MG
10MG
20MG
100MG
50MG
15MG
30MG
10MG
25MG
10MG
20MG
30MG
100MG
25MG
50MG
100MG
150MG
50MG
10MG
25MG
20MG
10MG
25MG
50MG
150MG
300MG
100MG
100MG
150MG
10MG
20MG
40MG
10MG
10MG
10MG
20MG
20MG
20MG
20MG
20MG
20MG
20MG
20MG
40MG
40MG
40MG
40MG
40MG
40MG
40MG
40MG
40MG
20MG
40MG
20MG
40MG
20MG
40MG
10MG
25MG
50MG
10MG
20MG
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
CAP
CAP
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
133
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
02244694
02255537
02255529
02274361
02262746
02262754
02262762
02287412
02287390
02287404
02304333
02304317
02304325
02296152
00579378
00579351
02248131
02248132
02248133
02331829
02317761
02273055
02248942
02248943
02231667
02231669
02130084
02130092
02130106
02130114
02177617
02177625
02177609
02241348
02241347
02281716
02252287
02243348
02243349
02178729
02178737
02248447
02248448
02248449
02298961
02245750
02245748
02245749
02128969
02128950
02231255
02103710
02103664
02103672
02237281
02237282
02237279
02237280
00754129
02247528
02286068
02335131
02344149
02349345
02374447
02382393
02247529
02286076
02335158
02344157
02349353
02374455
02383241
02382407
02246823
02334089
02246822
02245283
02360683
02360691
02352826
CO FLUVOXAMINE 100MG TAB
CO FLUVOXAMINE 50MG TAB
CO MIRTAZAPINE 30MG TAB
CO PAROXETINE 10MG TAB
CO SERTRALINE 100MG CAP
CO‐VENLAFAXINE XR 150MG CAP
CO‐VENLAFAXINE XR 37.5MG CAP
CO‐VENLAFAXINE XR 75MG CAP
CTP 30MG TAB
DESYREL 100MG TAB
DESYREL 50MG TAB
DOM‐AMITRIPTYLINE 10MG TAB
DOM‐BUPROPION SR 100MG TAB
DOM‐BUPROPION SR 150MG TAB
DOM‐CITALOPRAM 10MG TAB
DOM‐CLOMIPRAMINE 25MG TAB
DOM‐CLOMIPRAMINE 50MG TAB
DOM‐DESIPRAMINE 10MG TAB
DOM‐FLUOXETINE 10MG CAP
DOM‐FLUOXETINE 20MG CAP
DOM‐FLUOXETINE 20MG/5ML O/L
DOM‐FLUVOXAMINE 100MG TAB
DOM‐FLUVOXAMINE 50MG TAB
DOM‐MIRTAZAPINE 15MG TAB
DOM‐MIRTAZAPINE 30MG TAB
DOM‐MOCLOBEMIDE 150MG TAB
DOM‐MOCLOBEMIDE 300MG TAB
DOM‐NORTRIPTYLINE 10MG CAP
DOM‐NORTRIPTYLINE 25MG CAP
DOM‐PAROXETINE 10MG TAB
DOM‐SERTRALINE 100MG CAP
DOM‐TRAZODONE 100MG TAB
DOM‐TRAZODONE 50MG TAB
DOM‐TRYPTOPHAN 1GM TAB
EFFEXOR 100MG TAB
EFFEXOR 12.5MG TAB
EFFEXOR 25MG TAB
EFFEXOR XR 100MG SR CAP
EFFEXOR XR 37.5MG SR CAP
ELAVIL 75MG TAB
FLUOXETINE 10MG CAP
FLUOXETINE 10MG CAP
FLUOXETINE 10MG CAP
FLUOXETINE 10MG CAP
FLUOXETINE 10MG CAP
FLUOXETINE 10MG CAP
FLUOXETINE 10MG CAP
FLUOXETINE 20MG CAP
FLUOXETINE 20MG CAP
FLUOXETINE 20MG CAP
FLUOXETINE 20MG CAP
FLUOXETINE 20MG CAP
FLUOXETINE 20MG CAP
FLUOXETINE 20MG CAP
FLUOXETINE 20MG CAP
FLUVOXAMINE 100MG TAB
FXT 40 CAP
GD‐CITALOPRAM 20MG TAB
GD‐CITALOPRAM 40MG TAB
GD‐MIRTAZAPINE 15MG OD TAB
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
MIRTAZAPINE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
CITALOPRAM HBR
TRAZODONE HCL
TRAZODONE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
BUPROPION HCL
BUPROPION HCL
CLOMIPRAMINE HCL
CLOMIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE
DESIPRAMINE HCL
DESIPRAMINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
MIRTAZAPINE
MIRTAZAPINE
MOCLOBEMIDE
MOCLOBEMIDE
NORTRIPTYLINE HCL
NORTRIPTYLINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
TRAZODONE HCL
TRAZODONE HCL
L‐TRYPTOPHAN
VENLAFAXINE
VENLAFAXINE
VENLAFAXINE
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
AMITRIPTYLINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
FLUOXETINE HCL
MIRTAZAPINE
40MG
100MG
50MG
30MG
10MG
20MG
30MG
100MG
25MG
50MG
150MG
37.5MG
75MG
30MG
100MG
50MG
10MG
25MG
50MG
100MG
150MG
10MG
20MG
40MG
25MG
50MG
10MG
25MG
50MG
75MG
10MG
20MG
20MG/5ML
100MG
50MG
15MG
30MG
150MG
300MG
10MG
25MG
10MG
20MG
30MG
40MG
100MG
25MG
50MG
100MG
50MG
1GM
100MG
12.5 MG
25 MG
100MG
150MG
37.5MG
75MG
75MG
10MG
10MG
10MG
10MG
10MG
10MG
10MG
20MG
20MG
20MG
20MG
20MG
20MG
20MG
20MG
100MG
100MG
50MG
40MG
20MG
40MG
15MG
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
O/L
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP LA
CAP LA
CAP LA
CAP LA
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
CAP
TAB
TAB
TAB
134
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
02352834
02352842
02273705
02273683
02273691
02360047
02360020
02360039
00326852
00236748
00236756
00236721
00405604
02369664
02302535
02302543
02370085
02313405
02313413
02368560
02368579
02368862
02368870
02368889
02357178
02357143
02357151
02128845
02128853
02128861
02128829
02128837
00306320
00293911
00271152
00405612
01911872
01911856
01919369
01919342
02374005
02373971
02373998
00899356
02166747
02371871
02371898
02371901
02188996
02239751
02239752
02370077
02304686
02304694
02380560
02380560
02380579
02380579
02281732
02282356
02335913
02252279
02282364
02335921
02370689
02282372
02296691
02240970
02246593
02246594
02246595
02237813
02237814
02256096
02256118
02256126
02248012
02248013
02248014
02242521
02242519
GD‐SERTRALINE 100MG CAP
GD‐VENLAFAXINE XR 150MG CAP
GD‐VENLAFAXINE XR 37.5MG CAP
GD‐VENLAFAXINE XR 75MG CAP
IMIPRAMINE 50MG TAB
IMPRIL TAB 10MG
IMPRIL TAB 25MG
IMPRIL TAB 50MG
IMPRIL TAB 75MG
IPG‐CITALOPRAM 10MG TAB
JAMP‐CITALOPRAM 10MG TAB
JAMP‐MIRTAZAPINE 15MG TAB
JAMP‐MIRTAZAPINE 30MG TAB
JAMP‐PAROXETINE 10MG TAB
JAMP‐SERTRALINE 100MG CAP
KENRAL‐FLUOXETINE 10
KENRAL‐FLUOXETINE 20
KENRAL‐FLUOXETINE 4M
KENRAL‐NORTRIPTYLINE 10MG TAB
KENRAL‐NORTRIPTYLINE 25MG TAB
LEVATE 25MG TAB
LEVATE TAB 10MG
LEVATE TAB 50MG
LEVATE TAB 75MG
LUVOX 100MG TAB
LUVOX 50MG TAB
LUVOX TAB 100MG
LUVOX TAB 50MG
MANDA‐CITALOPRAM 10MG TAB
MANERIX 150MG TAB
MANERIX 300MG TAB
MAR‐CITALOPRAM 10MG TAB
MED‐CLOMIPRAMINE 10MG TAB
MED‐FLUOXETINE 10MG CAP
MED‐FLUOXETINE 20MG CAP
MINT‐CITALOPRAM 10MG TAB
MINT‐FLUOXETINE 10MG CAP
MIRTAZAPINE 15MG TAB
MOCLOBEMIDE 300MG TAB
MYLAN‐CITALOPRAM 10MG TAB
MYLAN‐FLUOXETINE 10MG CAP
MYLAN‐FLUOXETINE 20MG CAP
MYLAN‐MIRTAZAPINE 15MG TAB
MYLAN‐PAROXETINE 10MG TAB
MYLAN‐SERTRALINE 100MG CAP
MIRTAZAPINE
MIRTAZAPINE
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
IMIPRAMINE
IMIPRAMINE
IMIPRAMINE
IMIPRAMINE
IMIPRAMINE
CITALOPRAM
MIRTAZAPINE
MIRTAZAPINE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
NORTRIPTYLINE HCL
NORTRIPTYLINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
CITALOPRAM
CITALOPRAM
CITALOPRAM
MOCLOBEMIDE
MOCLOBEMIDE
CITALOPRAM HBR
CITALOPRAM HBR
CITALOPRAM HBR
CLOMIPRAMINE HCL
FLUOXETINE
FLUOXETINE
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MOCLOBEMIDE
FLUOXETINE HCL
FLUOXETINE HCL
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
30MG
45MG
100MG
25MG
50MG
150MG
37.5MG
75MG
50MG
10MG
25MG
50MG
75MG
10MG
20MG
40MG
10MG
20MG
40MG
15MG
30MG
10MG
20MG
30MG
100MG
25MG
50MG
10MG
20MG
4MG/ML
10MG
25MG
25MG
10MG
50MG
75MG
100MG
50MG
100MG
50MG
10MG
20MG
40MG
150MG
300MG
10MG
20MG
40MG
10MG
10MG
20MG
10MG
20MG
40MG
10MG
10MG
20MG
20MG
15MG
15MG
15MG
30MG
30MG
30MG
30MG
45MG
45MG
300MG
10MG
20MG
40MG
10MG
20MG
15MG
30MG
45MG
10MG
20MG
30MG
100MG
25MG
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
135
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
02242520
02231684
02231685
02231683
02310295
02310279
02310287
00476552
02322781
02322803
02103605
02237376
02237377
02230256
02130165
02130173
02223341
02223325
02223333
02223368
02072734
02072777
01913468
01913476
02072742
01913425
02072750
01913433
02072769
01913441
02239954
02239953
02279894
02259354
02279908
02279916
00021504
00021512
00021520
02240481
02240485
02240484
01940457
01940430
01940449
00037400
00037419
00037427
02360292
02360306
02360314
02348373
02348349
02348357
02348365
02358832
02370093
02370107
02370115
02345951
02345978
02345943
02351854
02351838
02351846
02248996
02248997
02211971
02211939
02211998
02211947
02211955
02211963
02192756
02192764
02231193
02231192
02336189
02336197
02336200
02237111
MYLAN‐TRAZODONE 100MG TAB
MYLAN‐VENLAFAXINE XR 150MG CAP
MYLAN‐VENLAFAXINE XR 37.5MG CA
MYLAN‐VENLAFAXINE XR 75MG CAP
NARDIL TAB 15MG
NG CITALOPRAM 20MG TAB
NG CITALOPRAM 40MG TAB
NORPRAMIN 150MG TAB
NORTRIPTYLINE 10MG CAP
NORTRIPTYLINE 25MG CAP
NOVO‐CLOPAMINE 10MG TAB
NOVO‐DESIPRAMINE 10MG TAB
NOVO‐DOXEPIN
NOVO‐DOXEPIN 100MG C
NOVO‐DOXEPIN 100MG CAP
NOVO‐DOXEPIN 25MG CA
NOVO‐FLUVOXAMINE 100MG TAB
NOVO‐FLUVOXAMINE 50MG TAB
NOVO‐MIRTAZAPINE 15MG OD TAB
NOVO‐MIRTAZAPINE 30MG TAB
NOVO‐MIRTAZAPINE OD 30MG TAB
NOVO‐MIRTAZAPINE OD 45MG TAB
NOVO‐PRAMINE TAB 10MG
NOVO‐SERTRALINE 100MG CAP
NOVO‐TRIPRAMINE TAB 100MG
NOVO‐TRIPTYN TAB 10MG
NTP‐CITALOPRAM 10MG TAB
NTP‐DOXEPIN 100MG CAP
NTP‐MIRTAZAPINE 30MG TAB
NTP‐MIRTAZAPINE OD 15MG
NTP‐TRAZODONE 100MG TAB
NTP‐VENLAFAXINE XR 150MG CAP
NTP‐VENLAFAXINE XR 37.5MG CAP
NTP‐VENLAFAXINE XR 75MG CAP
NU‐CITALOPRAM 20MG TAB
NU‐CITALOPRAM 40MG TAB
NU‐DESIPRAMINE 100MG TAB
NU‐FLUOXETINE 10MG CAP
NU‐FLUOXETINE 20MG CAP
NU‐FLUVOXAMINE 100MG TAB
NU‐FLUVOXAMINE 50MG TAB
NU‐MIRTAZAPINE 15MG TAB
NU‐MOCLOBEMIDE 100MG TAB
SERTRALINE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
PHENELZINE SULFATE
DESIPRAMINE HCL
NORTRIPTYLINE
NORTRIPTYLINE
CLOMIPRAMINE HCL
CLOMIPRAMINE HCL
CLOMIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
IMIPRAMINE
IMIPRAMINE
IMIPRAMINE
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
TRIMIPRAMINE
TRIMIPRAMINE
TRIMIPRAMINE
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MOCLOBEMIDE
50MG
100MG
150MG
50MG
150MG
37.5MG
75MG
15MG
20MG
40MG
150MG
10MG
25MG
10MG
25MG
50MG
10MG
25MG
50MG
75MG
10MG
100MG
100MG
150MG
25MG
25MG
50MG
50MG
75MG
75MG
100MG
50MG
15MG
30MG
30MG
45MG
10MG
25MG
50MG
100MG
25MG
50MG
100MG
25MG
50MG
10MG
25MG
50MG
10MG
20MG
40MG
100MG
25MG
50MG
75MG
30MG
15MG
30MG
45MG
100MG
150MG
50MG
150MG
37.5MG
75MG
20MG
40MG
100MG
10MG
150MG
25MG
50MG
75MG
10MG
20MG
100MG
50MG
15MG
30MG
45MG
100MG
CAP
TAB
TAB
TAB
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
136
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
02237112
02223139
02223147
02248719
02248720
02248721
02247050
02247047
02247048
02165392
02165384
02165406
02020629
02020599
02020610
02020602
01919598
02248450
02282844
02302012
02334801
02342383
02248451
02282852
02302020
02334828
02342391
02248452
02282860
02302039
02334836
02342405
02298988
02302047
02248913
02248914
02248915
02027887
01940481
01940473
02027895
00370991
00371009
00456349
02223058
02220121
02237005
02236754
02236753
02236928
02229763
02229764
02164361
02164388
02164353
02147599
00761737
02232561
02232562
02229819
02232544
02232543
02273543
02236942
02236941
02317788
02248944
02248945
02236940
02223481
02223503
02225174
02262630
02262622
02245826
02245824
02245825
02236957
02262444
02262436
02247302
NU‐MOCLOBEMIDE 150MG TAB
NU‐NORTRIPTYLINE 10MG CAP
NU‐NORTRIPTYLINE 25MG CAP
NU‐PAROXETINE 10MG TAB
NU‐SERTRALINE 100MG CAP
NU‐TRAZODONE 100MG TAB
NU‐TRAZODONE 50MG TAB
NU‐TRAZODONE‐D 150MG TAB
NU‐TRIMIPRAMINE 100MG TAB
NU‐TRIMIPRAMINE 12.5MG
NU‐TRIMIPRAMINE 50MG TAB
NU‐TRIMIPRAMINE TAB 25MG
PARNATE 10MG TAB
PAROXETINE 10MG TAB
PAROXETINE 10MG TAB
PAROXETINE 10MG TAB
PAROXETINE 10MG TAB
PAROXETINE 10MG TAB
PAROXETINE 20MG TAB
PAROXETINE 20MG TAB
PAROXETINE 20MG TAB
PAROXETINE 20MG TAB
PAROXETINE 20MG TAB
PAROXETINE 30MG TAB
PAROXETINE 30MG TAB
PAROXETINE 30MG TAB
PAROXETINE 30MG TAB
PAROXETINE 30MG TAB
PAROXETINE 40MG TAB
PAROXETINE 40MG TAB
PAROXETINE‐10 TAB
PAROXETINE‐20 TAB
PAROXETINE‐30 TAB
PAXIL 10MG TAB
PAXIL 20MG TAB
PAXIL 30MG TAB
PAXIL 50MG TAB
PDL‐AMITRIPTYLINE 10MG TAB
PDL‐AMITRIPTYLINE 25MG TAB
PDL‐AMITRIPTYLINE 50 TAB 50MG
PDL‐DESIPRAMINE TAB 150MG
PDL‐FLUOXETINE 10MG CAP
PDL‐FLUOXETINE 20MG/5ML O/L
PDL‐FLUVOXAMINE 100MG TAB
PDL‐FLUVOXAMINE 50MG TAB
PDL‐MOCLOBEMIDE 100MG TAB
PDL‐NORTRIPTYLINE 10MG CAP
PDL‐NORTRIPTYLINE 25MG CAP
PDL‐TRAZODONE 100MG TAB
PDL‐TRIMIPRAMINE 75MG CAP
PDL‐TRIMIPRAMINE TAB 100MG
PENTA‐DESIPRAMINE 25MG TAB
PENTA‐DESIPRAMINE 50MG TAB
PENTA‐FLUOXETINE 10MG CAP
PENTA‐TRAZODONE 100MG TAB
PENTA‐TRAZODONE 50MG TAB
PHI‐CITALOPRAM 10MG TAB
PHI‐TRAZODONE 100MG TAB
PHI‐TRAZODONE 50MG TAB
PHL‐BUPROPION SR 150MG TAB
PHL‐CITALOPRAM 20MG TAB
PHL‐CITALOPRAM 40MG TAB
PHL‐DESIPRAMINE 100MG TAB
PHL‐FLUOXETINE 10MG CAP
PHL‐FLUOXETINE 20MG CAP
PHL‐FLUOXETINE 20MG/5ML SYRUP
PHL‐FLUVOXAMINE 100MG TAB
PHL‐FLUVOXAMINE 50MG TAB
PHL‐SERTRALINE 100MG CAP
PHL‐TRYPTOPHAN 1GM TAB
PHL‐TRYPTOPHAN 500MG CAP
PHL‐TRYPTOPHAN 500MG TAB
PMS‐AMITRIPTYLINE 10MG TAB
MOCLOBEMIDE
NORTRIPTYLINE HCL
NORTRIPTYLINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
TRANYLCYPROMINE SULFATE
PAROXETINE HCL
PAROXETINE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
DESIPRAMINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
MOCLOBEMIDE
NORTRIPTYLINE HCL
NORTRIPTYLINE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
FLUOXETINE
TRAZODONE
TRAZODONE
TRAZODONE HCL
TRAZODONE HCL
BUPROPION HCL
DESIPRAMINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
L‐TRYPTOPHAN
TRYPTOPHAN
TRYPTOPHAN
AMITRIPTYLINE HCL
150MG
10MG
25MG
10MG
20MG
30MG
100MG
25MG
50MG
100MG
50MG
150MG
100MG
12.5MG
50MG
25MG
10MG
10MG
10MG
10MG
10MG
10MG
20MG
20MG
20MG
20MG
20MG
30MG
30MG
30MG
30MG
30MG
40MG
40MG
10MG
20MG
30MG
10MG
20MG
30MG
50MG
10MG
25MG
50MG
150MG
10MG
20MG/5ML
100MG
50MG
100MG
10MG
25MG
100MG
150MG
50MG
75MG
100MG
25MG
50MG
10MG
100MG
50MG
10MG
100MG
50MG
150MG
20MG
40MG
100MG
10MG
20MG
20MG/5ML
100MG
50MG
100MG
25MG
50MG
1GM
500MG
500MG
10MG
TAB
CAP
CAP
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
O/L
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
CAP
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB
TAB
TAB
CAP
CAP
O/L
TAB
TAB
CAP
CAP
CAP
TAB
CAP
TAB
TAB
137
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
02247303
02247304
02325373
02313421
02270609
02248010
02248011
02231608
02231610
02231611
02168960
02185350
01946242
01946269
01946277
02243833
02177579
02239817
02177587
02239818
02240683
02240682
00590495
00590509
02231559
02231560
02231561
02231562
02273942
02248762
02243218
02177692
02177706
02247750
02247751
02247752
02293749
02244840
02244838
02244839
02153491
02185369
02153505
01937227
02237339
02241023
02240445
02278561
02278545
02278553
02249219
02249227
02249235
02251361
02325357
02325047
02314991
02315009
02247329
02247330
02247328
02312778
02312786
00636622
02018985
02338769
02338777
02338785
02370573
02370581
02338793
02338807
02338815
02370964
02370948
02370956
02338858
02338823
02338831
02285622
02285630
PMS‐BUPROPION SR 100MG TAB
PMS‐BUPROPION SR 150MG TAB
PMS‐CITALOPRAM 10MG TAB
PMS‐CLOMIPRAMINE 10MG TAB
PMS‐DESIPRAMINE 150MG TAB
PMS‐DESIPRAMINE 2MG/ML LIQ
PMS‐DESIPRAMINE 75MG TAB
PMS‐DESIPRAMINE TAB 25MG
PMS‐DESIPRAMINE TAB 50MG
PMS‐FLUOX 20MG CAP
PMS‐FLUOXETINE 10MG CAP
PMS‐FLUVOXAMINE 100MG TAB
PMS‐FLUVOXAMINE 50MG TAB
PMS‐LEVAZINE 2/25 TAB
PMS‐LEVAZINE 4/25 TAB
PMS‐MAPROTILINE 10MG TAB
PMS‐MIRTAZAPINE 15MG TAB
PMS‐MIRTAZAPINE 30MG TAB
PMS‐MOCLOBEMIDE 150MG TAB
PMS‐NORTRIPTYLINE 10MG CAP
PMS‐NORTRIPTYLINE 25MG CAP
PMS‐PAROXETINE 10MG TAB
PMS‐SERTRALINE 100MG CAP
PMS‐TRAZODONE 12.5MG TAB
PMS‐TRAZODONE 2.5MG/ML LIQ
PMS‐TRAZODONE 25MG TAB
PMS‐TRYPTOPHAN 500MG CAP
PMS‐TRYPTOPHAN 500MG TAB
PMS‐VENLAFAXINE XR 150MG CAP
PMS‐VENLAFAXINE XR 37.5MG CAP
PMS‐VENLAFAXINE XR 75MG CAP
PREM‐CITALOPRAM 10MG TAB
PREM‐PAROXETINE 30MG TAB
PRO‐BUPROPION SR 150MG TAB
PRO‐CITALOPRAM 10MG TAB
PRO‐FLUOXETINE 10MG CAP
PRO‐FLUOXETINE 20MG CAP
PROLEV SR 100MG TAB
PROLEV SR 150MG TAB
PROLEV SR 50MG TAB
PRO‐MIRTAZAPINE 15MG TAB
PRO‐MIRTAZAPINE 30MG TAB
PROZAC CAP 20MG
PROZAC PULV 10MG CAP
Q‐CITALOPRAM 10MG TAB
Q‐FLUOXETINE 10MG CAP
Q‐FLUOXETINE 20MG CAP
Q‐PAROXETINE 10MG TAB
Q‐SERTRALINE 100MG CAP
Q‐VENLAFAXINE XR 150MG CAP
Q‐VENLAFAXINE XR 37.5MG CAP
Q‐VENLAFAXINE XR 75MG CAP
RAN‐CITALO 20MG TAB
RAN‐CITALO 40MG TAB
AMITRIPTYLINE HCL
AMITRIPTYLINE HCL
BUPROPION HCL
BUPROPION HCL
CLOMIPRAMINE HCL
CLOMIPRAMINE
CLOMIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
DESIPRAMINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
LEVAZINE
LEVAZINE
MAPROTILINE HCL
MAPROTILINE HCL
MAPROTILINE HCL
MAPROTILINE HCL
MIRTAZAPINE
MIRTAZAPINE
MOCLOBEMIDE
NORTRIPTYLINE HCL
NORTRIPTYLINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
TRAZODONE HYDROCHLORIDE
TRAZODONE HCL
TRAZODONE HCL
L‐TRYPTOPHAN
L‐TRYPTOPHAN
VENLAFAXINE HYDROCHLORIDE
PAROXETINE HCL
BUPROPION HCL
FLUOXETINE HCL
FLUOXETINE HCL
BUPROPION HYDROCHLORIDE
MIRTAZAPINE
MIRTAZAPINE
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
25MG
50MG
100MG
150MG
10MG
20MG
40MG
10MG
25MG
50MG
150MG
2MG/ML
75MG
25MG
50MG
20MG
10MG
10MG
20MG
20MG
100MG
50MG
2MG/25MG
4MG/25MG
10MG
25MG
50MG
75MG
15MG
30MG
150MG
10MG
25MG
10MG
20MG
30MG
40MG
100MG
25MG
50MG
12.5MG
2.5MG/5ML
25MG
50MG
75MG
500MG
500MG
150MG
37.5MG
75MG
10MG
20MG
40MG
30MG
150MG
10MG
10MG
20MG
100MG
150MG
50MG
15MG
30MG
20MG
10MG
10MG
20MG
40MG
10MG
20MG
10MG
20MG
30MG
100MG
25MG
50MG
150MG
37.5MG
75MG
20MG
40MG
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
O/L
TAB
TAB
TAB
CAP
TAB
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB
TAB
TAB LA
TAB
CAP
CAP
TAB LA
TAB LA
TAB LA
TAB
TAB
CAP
CAP
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
CAP
CAP
CAP
CAP LA
CAP LA
CAP LA
TAB
TAB
138
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
02268000
02268019
02374579
02374552
02374560
02380099
02380099
02380072
02380072
02380080
02380080
02285657
02285665
02252112
02252120
02241371
02241374
02218461
02218453
02270927
02247810
02247811
02247812
02245789
02212787
02245787
02245788
02277352
02053209
02277360
02277344
02237250
02240334
02240333
02259176
02273985
02273969
02273977
02243909
02243910
02243911
02248542
02248543
02248544
02144174
02144182
02144166
02249251
02303256
02249278
02303264
02249286
02303272
02242123
02305461
02242124
02305488
02303361
02303345
02265265
02248559
02248560
02248561
02248498
02248496
02248497
02307790
02307774
02307782
02275074
02243486
02243487
02250594
02267284
02310333
02310317
02310325
02275082
02248170
02248171
02247055
RAN‐CITALOPRAM 20MG TAB
RAN‐CITALOPRAM 40MG TAB
RAN‐SERTRALINE 100MG CAP
RAN‐VENLAFAXINE XR 150MG CAP
RAN‐VENLAFAXINE XR 37.5MG CAP
RAN‐VENLAFAXINE XR 37.5MG CAP
RATIO‐BUPROPION SR 100MG TAB
RATIO‐BUPROPION SR 150MG TAB
RATIO‐CITALOPRAM 20MG TAB
RATIO‐CITALOPRAM 40MG TAB
RATIO‐FLUOXETINE 10MG CAP
RATIO‐FLUOXETINE 20MG CAP
RATIO‐FLUVOXAMINE 100MG TAB
RATIO‐FLUVOXAMINE 50MG TAB
RATIO‐MIRTAZAPINE 30MG TAB
RATIO‐PAROXETINE 10MG TAB
RATIO‐SERTRALINE 100MG CAP
RATIO‐TRAZODONE 100MG TAB
RATIO‐TRAZODONE 150 MG TAB
RATIO‐TRYPTOPHAN 1GM TAB
RATIO‐TRYPTOPHAN 500MG CAP
RATIO‐TRYPTOPHAN 500MG TAB
RATIO‐TRYPTOPHAN 750MG TAB
RATIO‐VENLAFAXINE XR 150MG
RATIO‐VENLAFAXINE XR 37.5MG
RATIO‐VENLAFAXINE XR 75MG CAP
REMERON 15MG TAB
REMERON 30MG TAB
REMERON 45MG TAB
REMERON RD 15MG TAB
REMERON RD 30MG TAB
REMERON RD 45MG TAB
RHO‐DOXEPIN 100MG CAP
RIVA‐CITALOPRAM 10MG TAB
RIVA‐FLUOXETINE 10MG CAP
RIVA‐FLUVOX 100MG TAB
RIVA‐FLUVOX 50MG TAB
RIVA‐MIRTAZAPINE 30MG TAB
RIVA‐PAROXETINE 10MG TAB
RIVA‐SERTRALINE 100MG CAP
RIVA‐VENLAFAXINE XR 150MG CAP
RIVA‐VENLAFAXINE XR 37.5MG CAP
RIVA‐VENLAFAXINE XR 75MG CAP
SANDOZ BUPROPION SR 100MG TAB
SANDOZ FLUOXETINE 10MG CAP
SANDOZ FLUOXETINE 20MG CAP
SANDOZ MIRTAZAPINE 15MG TAB
SANDOZ MIRTAZAPINE FC 15MG TAB
SANDOZ VENLAFAXINE XR 150MG CA
SANDOZ VENLAFAXINE XR 37.5MG C
SANDOZ VENLAFAXINE XR 75MG CAP
SANDOZ‐BUPROPION SR 150MG TAB
SANDOZ‐CITALOPRAM 20MG TAB
SANDOZ‐CITALOPRAM 40MG TAB
SANDOZ‐FLUVOXAMINE 100MG TAB
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
BUPROPION HCL
BUPROPION HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
MIRTAZAPINE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
L‐TRYPTOPHAN
L‐TRYPTOPHAN
L‐TRYPTOPHAN
TRYPTOPHAN
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
MIRTAZAPINE
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
FLUOXETINE
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
MIRTAZAPINE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
BUPROPION HCL
FLUOXETINE HCL
FLUOXETINE HCL
MIRTAZAPINE
MIRTAZAPINE
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
BUPROPION HCL
FLUVOXAMINE MALEATE
20MG
40MG
100MG
25MG
50MG
150MG
150MG
37.5MG
37.5MG
75MG
75MG
100MG
150MG
20MG
40MG
10MG
20MG
100MG
50MG
30MG
10MG
20MG
30MG
100MG
25MG
25MG
50MG
100MG
150MG
150MG
50MG
1G
500MG
500MG
750MG
150MG
37.5MG
75MG
15MG
30MG
45MG
15MG
30MG
45MG
100MG
150MG
75MG
10MG
10MG
20MG
20MG
40MG
40MG
10MG
10MG
20MG
20MG
100MG
50MG
30MG
10MG
20MG
30MG
100MG
25MG
50MG
150MG
37.5MG
75MG
100MG
10MG
20MG
15MG
15MG
150MG
37.5MG
75MG
150MG
20MG
40MG
100MG
TAB
TAB
CAP
CAP
CAP
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB LA
TAB LA
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
TAB LA
CAP
CAP
TAB
TAB
CAP LA
CAP LA
CAP LA
TAB LA
TAB
TAB
TAB
139
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
02247054
02250608
02254743
02269422
02254751
02269430
02254778
02269449
02245161
02245159
02245160
02355272
02355280
02284820
02342375
02353547
02284804
02342359
02353520
02284812
02342367
02353539
02241304
02241302
02241303
02323710
02323729
02323605
02323613
02323621
02331535
02331543
02331578
02346338
02346303
02346311
00326925
00024325
00024333
00024341
00400750
02155842
02155710
02155729
00025844
00025852
00025828
00025836
02204479
02204460
02282798
02282801
02282828
02083485
02083469
02083477
02275058
02275023
02275031
02312336
02293218
02293226
02216582
02216590
02158612
02158620
02158639
02239746
02239747
02239748
02231781
02231782
02248556
02248557
02248558
02144271
02144298
02144263
01937235
02287005
02348780
SANDOZ‐FLUVOXAMINE 50MG TAB
SANDOZ‐MIRTAZAPINE 30MG TAB
SANDOZ‐PAROXETINE 10MG TAB
SANDOZ‐SERTRALINE 100MG CAP
SEPTA‐CITALOPRAM 20MG TAB
SEPTA‐CITALOPRAM 40MG TAB
SERTRALINE 100MG CAP
SERTRALINE 100MG CAP
SERTRALINE 100MG TAB
SERTRALINE 25MG CAP
SERTRALINE 25MG CAP
SERTRALINE 25MG CAP
SERTRALINE 50MG CAP
SERTRALINE 50MG CAP
SERTRALINE 50MG CAP
SERTRALINE‐100 100MG CAP
SIG‐CITALOPRAM 20MG TAB
SIG‐CITALOPRAM 40MG TAB
SIG‐PAROXETINE 10MG TAB
SIG‐SERTRALINE 25MG CAP
SIG‐SERTRALINE 50MG CAP
SIG‐SERTRALINE100MG CAP
SIG‐VENLAFAXINE XR 150MG CAP
SIG‐VENLAFAXINE XR 37.5MG CAP
SIG‐VENLAFAXINE XR 75MG CAP
SINEQUAN CAP 100MG
SINEQUAN CAP 10MG
SINEQUAN CAP 25MG
SINEQUAN CAP 50MG
SINEQUAN CAP 75MG
STCC‐FLUOXETINE 20MG/5ML O/L
STCC‐NORTRIPTYLINE 10MG
STCC‐NORTRIPTYLINE 25MG
SURMONTIL 69.72MG TAB
SURMONTIL 139.44MG
SURMONTIL 17.43MG
SURMONTIL 34.86MG
SYN‐FLUVOXAMINE 100MG TAB
SYN‐FLUVOXAMINE 50MG TAB
TARO‐PAROXETINE 10MG TAB
TARO‐TRIMIPRAMINE 100MG
TEVA VENLAFAXINE XR 150MG CAP
TEVA VENLAFAXINE XR 37.5MG CAP
TEVA VENLAFAXINE XR 75MG CAP
TEVA‐CITALOPRAM 10MG TAB
TEVA‐FLUOXETINE 10MG CAP
TEVA‐FLUOXETINE 20MG CAP
TEVA‐MAPROTILINE 25MG TAB
TEVA‐MOCLOBEMIDE 100MG TAB
TEVA‐NORTRIPTYLINE 10MG CAP
TEVA‐NORTRIPTYLINE 25MG CAP
TEVA‐PAROXETINE 10MG TAB
TEVA‐TRAZODONE 100MG TAB
TRAZODONE 100MG TAB
TRAZODONE 100MG TAB
TRAZODONE 100MG TAB
FLUVOXAMINE MALEATE
MIRTAZAPINE
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
SERTRALINE HCL
SERTRALINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
DOXEPIN HCL
FLUOXETINE HCL
NORTRIPTYLINE HCL
NORTRIPTYLINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE
PAROXETINE HCL/ISOPROPYL SOLVA
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
FLUOXETINE HCL
FLUOXETINE HCL
MAPROTILINE HCL
MAPROTILINE HCL
MAPROTILINE HCL
MOCLOBEMIDE
MOCLOBEMIDE
MOCLOBEMIDE
NORTRIPTYLINE HCL
NORTRIPTYLINE HCL
PAROXETINE HCL
PAROXETINE HCL
PAROXETINE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
50MG
30MG
10MG
10MG
20MG
20MG
30MG
30MG
100MG
25MG
50MG
20MG
40MG
100MG
100MG
100MG
25MG
25MG
25MG
50MG
50MG
50MG
100MG
25MG
50MG
20MG
40MG
10MG
20MG
30MG
25MG
50MG
100MG
150MG
37.5MG
75MG
100MG
10MG
25MG
50MG
75MG
20MG/5ML
10MG
25MG
69.72MG
139.44MG
17.43MG
34.86MG
100MG
50MG
10MG
20MG
30MG
100MG
25MG
50MG
150MG
37.5MG
75MG
10MG
20MG
40MG
10MG
20MG
25MG
50MG
75MG
100MG
150MG
300MG
10MG
25MG
10MG
20MG
30MG
100MG
150MG
50MG
100MG
100MG
100MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP LA
CAP LA
CAP LA
CAP
CAP
CAP
CAP
CAP
O/L
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
140
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
281604
02287013
02348799
02286998
02348772
02230285
02230284
00629316
00740829
00740799
00740802
00740810
02070987
00761702
02239326
02029456
02239327
00718149
00654531
02373874
02373858
02373866
02289075
02339269
02340070
02354748
02334739
02344769
02289059
02339242
02340054
02354713
02334704
02344742
02289067
02339250
02340062
02354721
02334712
02344750
02237825
02237823
02275090
02275104
01962779
01962787
01962795
02132702
01962817
02331799
02331802
02302659
02302667
02325179
02325187
02325128
02325101
02249804
TRAZODONE 150MG TAB
TRAZODONE 150MG TAB
TRAZODONE 50MG TAB
TRAZODONE 50MG TAB
TRAZOREL 100MG TAB
TRAZOREL 50MG TAB
TRIADAPIN 150MG CAP
TRIMIPRAMINE 100MG TAB
TRIMIPRAMINE 12.5MG TAB
TRIMIPRAMINE 75MG CAP
TRIMIPRAMINE TAB 12.5MG
TRYPTAN 250MG TAB
TRYPTAN 500MG TAB
TRYPTAN 750MG TAB
TRYPTAN CAP 500MG
TRYPTAN TAB 1000MG
VENLAFAXINE ER 150MG CAP
VENLAFAXINE ER 37.5MG CAP
VENLAFAXINE ER 75MG CAP
VENLAFAXINE XR 150MG CAP
VENLAFAXINE XR 150MG ER CAP
VENLAFAXINE XR 37.5MG CAP
VENLAFAXINE XR 37.5MG ER CAP
VENLAFAXINE XR 37.5MG ER CAP
WELLBUTRIN SR 150MG TAB
WELLBUTRIN SR 50MG TAB
WELLBUTRIN XL 150MG TAB
WELLBUTRIN XL 300MG TAB
ZOLOFT 100 MG CAP
ZOLOFT 150MG CAP
ZOLOFT 200MG CAP
ZOLOFT 25MG CAP
ZOLOFT 50MG CAP
ZYM‐BUPROPION SR 100MG TAB
ZYM‐BUPROPION SR 150MG TAB
ZYM‐FLUOXETINE 10MG CAP
ZYM‐FLUOXETINE 20MG CAP
ZYM‐MIRTAZAPINE 15MG TAB
ZYM‐MIRTAZAPINE 30MG TAB
ZYM‐TRAZODONE 100MG TAB
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
DOXEPIN HCL
L‐TRYPTOPHAN
L‐TRYPTOPHAN
L‐TRYPTOPHAN
L‐TRYPTOPHAN
L‐TRYPTOPHAN
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
VENLAFAXINE HCL
BUPROPION HCL
BUPROPION HCL
BUPROPION HCL
BUPROPION HCL
SERTRALINE HCL
SERTRALINE
SERTRALINE
SERTRALINE HCL
SERTRALINE HCL
BUPROPION HCL
BUPROPION HCL
FLUOXETINE HCL
FLUOXETINE HCL
MIRTAZAPINE
MIRTAZAPINE
TRAZODONE HCL
TRAZODONE HCL
TRAZODONE HCL
150MG
150MG
50MG
50MG
100MG
50MG
150MG
100MG
12.5MG
25MG
50MG
75MG
12.5M
250MG
500MG
750MG
500MG
1G
150MG
37.5MG
75MG
150MG
150MG
150MG
150MG
150MG
150MG
37.5MG
37.5MG
37.5MG
37.5MG
37.5MG
37.5MG
75MG
75MG
75MG
75MG
75MG
75MG
150MG
50MG
150MG
300MG
100MG
150MG
200MG
25MG
50MG
100MG
150MG
10MG
20MG
15MG
30MG
100MG
50MG
75MG
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
CAP
TAB
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB LA
TAB LA
TAB LA
TAB LA
CAP
CAP
CAP
CAP
CAP
TAB LA
TAB LA
CAP
CAP
TAB
TAB
TAB
TAB
TAB
141
*PA
05/2012
Therapy Class
281608
DIN
Drug Name
ANTIPSYCHOTIC AGENTS
Chemical Name
Strength
Dosage
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
02322390
02322404
02322412
02322374
02322455
02322382
02365413
02365421
02365448
02365456
02365464
02365472
02369079
02369087
02369095
02369117
02369125
02369133
00312681
00312703
00312673
02248035
02248034
00405345
00410632
00405361
00396796
00463698
00396818
00396826
00396834
02242956
02238405
02238403
02238406
02238404
02281821
02281848
02281791
02333015
02281805
02281813
02360624
02360632
02360640
02360616
00335096
00335134
00335126
00335118
02245432
02245433
00886432
00886440
02313928
02313936
02313901
02313944
02282119
02282127
02282135
02280396
02282143
02282151
02282178
00326836
00345539
00595942
00312754
00312746
02373467
02373475
02373432
02373440
02373459
02376237
02376229
02363933
02363941
02363925
ABILIFY 10MG TAB
ABILIFY 15MG TAB
ABILIFY 20MG TAB
ABILIFY 2MG TAB
ABILIFY 30MG TAB
ABILIFY 5MG TAB
ACCEL‐RISPERIDONE 0.25MG TAB
ACCEL‐RISPERIDONE 0.5MG TAB
ACCEL‐RISPERIDONE 1MG TAB
AG‐RISPERIDONE 0.25MG TAB
AG‐RISPERIDONE 0.5MG TAB
AG‐RISPERIDONE 1MG TAB
APO‐CHLORPROMAZINE 100MG TAB
APO‐CLOZAPINE 100MG TAB
APO‐CLOZAPINE 25MG TAB
APO‐FLUPHENAZINE 1MG TAB
APO‐HALOPERIDOL 0.5MG TAB
APO‐HALOPERIDOL 10MG TAB
APO‐LOXAPINE 2.5MG TAB
APO‐METHOPRAZINE 25MG TAB
APO‐OLANZAPINE 10MG TAB
APO‐OLANZAPINE 2.5MG TAB
APO‐OLANZAPINE 7.5MG TAB
APO‐OLANZAPINE ODT 10MG
APO‐PERPHENAZINE 16MG TAB
APO‐PIMOZIDE 2MG TAB
APO‐PIMOZIDE 4MG TAB
APO‐PROCHLORAZINE 10MG TAB
APO‐PROCHLORAZINE 5MG TAB
APO‐QUETIAPINE 100MG TAB
APO‐RISPERIDONE 0.25MG TAB
APO‐RISPERIDONE 0.5MG TAB
APO‐RISPERIDONE 1MG TAB
APO‐RISPERIDONE 1MG/ML O/L
APO‐TRIFLUOPERAZINE 10MG TAB
AVA‐OLANZAPINE 10MG TAB
AVA‐OLANZAPINE 2.5MG TAB
AVA‐OLANZAPINE 7.5MG TAB
AVA‐OLANZAPINE ODT 10MG
AVA‐OLANZAPINE ODT 5MG
AVA‐QUETIAPINE 100MG TAB
ARIPIPRAZOLE
ARIPIPRAZOLE
ARIPIPRAZOLE
ARIPIPRAZOLE
ARIPIPRAZOLE
ARIPIPRAZOLE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
CHLORPROMAZINE HCL
CHLORPROMAZINE HCL
CHLORPROMAZINE HCL
CLOZAPINE
CLOZAPINE
FLUPHENAZINE HCL
FLUPHENAZINE HCL
FLUPHENAZINE HCL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
LOXAPINE SUCCINATE
METHOTRIMEPRAZINE
METHOTRIMEPRAZINE
METHOTRIMEPRAZINE
METHOTRIMEPRAZINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
PERPHENAZINE
PERPHENAZINE
PERPHENAZINE
PERPHENAZINE
PIMOZIDE
PIMOZIDE
PROCHLORPERAZINE
PROCHLORPERAZINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
TRIFLUOPERAZINE
TRIFLUOPERAZINE
TRIFLUOPERAZINE
TRIFLUOPERAZINE
TRIFLUOPERAZINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
10MG
15MG
20MG
2MG
30MG
5MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
100MG
25MG
55.7MG
100MG
25MG
1MG
2MG
5MG
0.5MG
10MG
1MG
2MG
5MG
2.5MG
25MG
2MG
50MG
5MG
10MG
15MG
2.5MG
20MG
5MG
7.5MG
10MG
15MG
20MG
5MG
16MG
2MG
4MG
8MG
2MG
4MG
10MG
5MG
100MG
200MG
25MG
300MG
0.25MG
0.5MG
1MG
1MG/ML
2MG
3MG
4MG
10MG
1MG
20MG
2MG
5MG
10MG
15MG
2.5MG
5MG
7.5MG
10MG
5MG
100MG
200MG
25MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
142
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
02367173
02367181
02364344
02367203
02367211
02367238
02367246
01933272
00743518
02230402
02230403
02230405
02230406
00894745
00894737
02325683
02325691
02325659
02325713
02325667
02325675
02327570
02327589
02327597
02327562
02282585
02282593
02282607
02282615
02282623
02282631
02316099
02316102
02316110
02316080
02316129
02137402
02239919
02239920
02239921
02239918
02307383
02307359
02307391
02307367
02307324
02307375
02307332
02307340
02299003
02299011
02299038
02298996
02299046
02278421
02278448
02278456
02309572
02278464
02278472
02278480
02294478
02294486
02294494
02156008
02156016
02156024
02156040
02024950
02156032
02024969
02024942
02025043
02331713
02331721
02242570
02189097
02189089
02239636
02247244
02305011
AVA‐RISPERIDONE 0.25MG TAB
AVA‐RISPERIDONE 0.5MG TAB
AVA‐RISPERIDONE 1G/L O/L
AVA‐RISPERIDONE 1MG TAB
CHLORPROMAZINE 25MG/ML INJ
CHLORPROMAZINE HCL INJ 25MG/ML
CLOPIXOL 10MG TAB
CLOPIXOL 25MG TAB
CLOPIXOL ACUPHASE 50MG/ML INJ
CLOPIXOL DEPOT 200MG/ML
CLOZARIL TAB 100MG
CLOZARIL TAB 25MG
CO OLANZAPINE 10MG TAB
CO OLANZAPINE 2.5MG TAB
CO OLANZAPINE 7.5MG TAB
CO OLANZAPINE ODT 10MG ER TAB
CO RISPERIDONE 0.25MG TAB
CO RISPERIDONE 0.5MG TAB
CO RISPERIDONE 1MG TAB
CO‐QUETIAPINE 100MG TAB
DOM‐FLUPHENAZINE 25MG/ML O/L
DOM‐LOXAPINE 10MG TAB
DOM‐LOXAPINE 50MGTAB
DOM‐OLANZAPINE 10MG ODT
DOM‐OLANZAPINE 10MG TAB
DOM‐OLANZAPINE 2.5MG TAB
DOM‐OLANZAPINE 7.5MG TAB
DOM‐QUETIAPINE 100MG TAB
DOM‐RISPERIDONE 0.25MG TAB
DOM‐RISPERIDONE 0.5MG TAB
DOM‐RISPERIDONE 1MG TAB
DOM‐RISPERIDONE 1MG/ML O/L
DOM‐RISPERIDONE ODT 0.5MG TAB
DOM‐RISPERIDONE ODT 1MG TAB
DOM‐RISPERIDONE ODT 2MG TAB
FLUANXOL 0.5MG TAB
FLUANXOL 3MG TAB
FLUANXOL 5MG TAB
FLUANXOL DEPOT 100MG/ML INJ
FLUANXOL DEPOT INJ 100MG/ML
FLUANXOL TAB 0.5MG
FLUANXOL TAB 3MG
FLUPENTIXOL DECANOATE 20MG/ML
FLUPENTIXOL DECANOATE100MG/ML
FLUPHENAZINE 100MG/ML INJ
FLUPHENAZINE DECANOATE 100MG/M
FLUPHENAZINE DECANOATE 25MG/ML
FLUPHENAZINE OMEGA 25MG/ML IN
GEN‐CLOZAPINE 100MG TAB
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
CHLORPROMAZINE HCL
CHLORPROMAZINE HCL
ZUCLOPENTHIXOL DIHYDROCHLORIDE
CLOZAPINE
CLOZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
FLUPHENAZINE DECANOATE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE TARTRATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
FLUPENTHIXOL DIHYDROCHLORIDE
FLUPENTHIXOL DECANOATE
FLUPENTIXOL DECANOATE
CLOZAPINE
CLOZAPINE
0.25MG
0.5MG
1G/L
1MG
2MG
3MG
4MG
25MG/ML
25MG/ML
10 MG
25 MG
50MG/ML
200MG/ML
100MG
25MG
10MG
15MG
2.5MG
20MG
5MG
7.5MG
10MG
15MG
20MG
5MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
100MG
150MG
200MG
25MG
300MG
25MG/ML
10MG
25MG
50MG
5MG
10MG
10MG
15MG
15MG
2.5MG
5MG
5MG
7.5MG
100MG
150MG
200MG
25MG
300MG
0.25MG
0.5MG
1MG
1MG/ML
2MG
3MG
4MG
0.5MG
1MG
2MG
0.5MG
3MG
5MG
100MG/ML
200MG/10ML
2%
200MG/2ML
0.5MG
3MG
20MG/ML
100MG/ML
100MG/ML
100MG/ML
25MG/ML
25MG/ML
100MG
200MG
TAB
TAB
O/L
TAB
TAB
TAB
TAB
INJ
INJ
TAB
TAB
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
143
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
02247243
02305003
02307820
00499579
00980803
09853758
02383756
00749400
02383748
00808852
02366010
02194449
02194430
00808652
02130300
02239640
02130297
02239639
00749419
00749451
00749427
00749435
00749443
02229307
02359057
02359065
02359073
02359081
02359103
02359111
02359529
02359537
02359545
02359553
02359561
02359588
02289628
02289636
02289644
02289652
02289660
01929907
00025151
00025283
02169991
01927639
00025763
02371766
02371774
02371782
02371790
02371804
02371812
02359790
02359804
02359812
02359820
02359839
02359847
00755575
02242364
02242363
02337908
02337916
02337878
02337924
02337886
02337894
02382717
02382725
02382733
02382709
02307812
02307839
02307804
02307847
02282240
02282259
02282267
02282275
02282283
GEN‐QUETIAPINE 150MG TAB
HALDOL 20MG TAB
HALDOL‐LA 100MG/ML INJ
HALOPERIDOL 100MG/ML INJ
HALOPERIDOL 2MG/ML O/L
HALOPERIDOL DECANOATE 100MG/ML
HALOPERIDOL DECANOATE 50MG/ML
HALOPERIDOL INJ 5MG/ML USP
HALOPERIDOL LA 100MG/ML INJ
HALOPERIDOL TABLETS 0.5MG USP
HALOPERIDOL TABLETS 10MG USP
HALOPERIDOL‐RATIOPHARM 5MG/ML
IPG‐RISPERIDONE 0.25MG TAB
IPG‐RISPERIDONE 0.5MG TAB
IPG‐RISPERIDONE 1MG TAB
JAMP‐RISPERIDONE 0.25MG TAB
JAMP‐RISPERIDONE 0.5MG TAB
JAMP‐RISPERIDONE 1MG TAB
JOI‐RISPERIDONE 0.5MG TAB
JOI‐RISPERIDONE 1MG TAB
LARGACTIL 100MG/5ML O/L
LARGACTIL 27.9MG/5ML
LARGACTIL SUPP 100MG
LOXAPAC INJ 50MG/ML
MAJEPTIL 10MG TAB
MAJEPTIL 14.30MG
MAR‐RISPERIDONE 0.25MG TAB
MAR‐RISPERIDONE 0.5MG TAB
MAR‐RISPERIDONE 1MG TAB
MINT‐RISPERIDONE 0.25MG TAB
MINT‐RISPERIDONE 0.5MG TAB
MINT‐RISPERIDONE 1MG TAB
MODECATE CONCENTRATE 100MG/ML
MYLAN‐FLUPENTIXOL 100MG/ML INJ
MYLAN‐FLUPENTIXOL 20MG/ML INJ
MYLAN‐OLANZAPINE 10MG TAB
MYLAN‐OLANZAPINE 2.5MG TAB
MYLAN‐OLANZAPINE 7.5MG TAB
MYLAN‐OLANZAPINE ODT 10MG
MYLAN‐QUETIAPINE 100MG TAB
MYLAN‐RISPERIDONE 0.25MG TAB
MYLAN‐RISPERIDONE 0.5MG TAB
MYLAN‐RISPERIDONE 1MG TAB
CLOZAPINE
CLOZAPINE
QUETIAPINE FUMARATE
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL DECANOATE
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
CHLORPROMAZINE
CHLORPROMAZINE HCL
CHLORPROMAZINE HCL
LOXAPINE HCL
THIOPROPERAZINE MESYLATE
THIOPROPERAZINE MESYLATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
25MG
50MG
150MG
20MG
100MG/ML
100MG/ML
100MG/ML
2MG/ML
50MG/ML
5MG/ML
5MG/ML
100MG/ML
50MG/ML
5MG/ML
100MG/ML
100MG/ML
50MG/ML
50MG/ML
0.5MG
10MG
1MG
2MG
5MG
5MG/ML
0.25MG
0.5MG
1MG
2MG
3MG
4MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
0.5MG
1MG
2MG
3MG
4MG
100MG/5ML
27.9MG/5ML
100MG
50MG/ML
10MG
14.3MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
100MG/ML
100MG/ML
20MG/ML
10MG
15MG
2.5MG
20MG
5MG
7.5MG
10MG
15MG
20MG
5MG
100MG
200MG
25MG
300MG
0.25MG
0.5MG
1MG
2MG
3MG
TAB
TAB
TAB
TAB
INJ
INJ
INJ
O/L
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
O/L
SUPP
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
144
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
02282291
00024457
00024430
00024449
00024899
01926772
01926756
01926764
00024880
01926780
00379328
00379301
00232831
00232823
00232807
01964925
00363685
00713449
00363677
00768820
00363669
00363650
02282690
02264188
02264196
02264218
02264226
02264234
00025577
01927698
00025593
00025585
00025607
02346079
02346087
02346044
02346052
02346060
02237535
02237536
02237537
02237534
02310082
02310090
02310015
02310031
02310058
01964402
01964399
02333058
02333066
02333031
02333074
02334372
02334380
02334399
02334402
02334410
02334429
02301040
02311992
02343851
02348144
02372843
02301059
02312018
02343878
02348152
02372851
02301016
02311968
02343827
02348101
02372819
02343886
02301024
02311976
02343835
02348128
02372827
02301032
NAVANE CAP 10MG
NAVANE CAP 2MG
NAVANE CAP 5MG
NEULEPTIL 10MG
NEULEPTIL 10MG CAP
NEULEPTIL 10MG/ML ORAL DROPS
NEULEPTIL 20MG CAP
NEULEPTIL 5MG
NEULEPTIL 5MG CAP
NEULEPTIL CAP 20MG
NEULEPTIL DPS 1%
NOVOCHLORPROMAZINE TAB 100MG
NOVO‐MEPRAZINE 25MG TAB
NOVO‐PERIDOL TAB 0.5MG
NOVO‐PERIDOL TAB 10MG
NOVO‐RISPERIDONE 0.25MG TAB
NOVO‐RISPERIDONE 0.5MG TAB
NOVO‐RISPERIDONE 1MG TAB
NOZINAN 2.70MG TAB
NOZINAN 25MG/ML INJ
NOZINAN 33.75 MG TAB
NOZINAN 6.75MG TAB
NOZINAN 67.50MG TAB
NTP‐OLANZAPINE 10MG TAB
NTP‐OLANZAPINE 2.5MG TAB
NTP‐OLANZAPINE 7.5MG TAB
NU‐LOXAPINE 10MG TAB
NU‐OLANZAPINE 10MG TAB
NU‐OLANZAPINE 2.5MG TAB
NU‐OLANZAPINE 7.5MG TAB
NU‐PROCHLOR 10MG TAB
NU‐PROCHLOR 5MG TAB
NU‐QUETIAPINE 100MG TAB
NU‐RISPERIDONE 0.25MG TAB
NU‐RISPERIDONE 0.5MG TAB
NU‐RISPERIDONE 1MG TAB
OLANZAPINE 10MG TAB
OLANZAPINE 10MG TAB
OLANZAPINE 10MG TAB
OLANZAPINE 10MG TAB
OLANZAPINE 10MG TAB
OLANZAPINE 15MG TAB
OLANZAPINE 15MG TAB
OLANZAPINE 15MG TAB
OLANZAPINE 15MG TAB
OLANZAPINE 15MG TAB
OLANZAPINE 2.5MG TAB
OLANZAPINE 20MG TAB
OLANZAPINE 5MG TAB
OLANZAPINE 5MG TAB
OLANZAPINE 5MG TAB
OLANZAPINE 5MG TAB
OLANZAPINE 5MG TAB
RISPERIDONE
THIOTHIXENE
THIOTHIXENE
THIOTHIXENE
PERICIAZINE
PERICYAZINE
PERICYAZINE
PERICYAZINE
PERICIAZINE
PERICYAZINE
PERICYAZINE
PERICYAZINE
CHLORPROMAZINE HCL
CHLORPROMAZINE HCL
CHLORPROMAZINE HCL
METHOTRIMEPRAZINE
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
METHOTRIMEPRAZINE
METHOTRIMEPRAZINE
METHOTRIMEPRAZINE
METHOTRIMEPRAZINE
METHOTRIMEPRAZINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
PROCHLORPERAZINE
PROCHLORPERAZINE
QUETIAPINE
QUETIAPINE
QUETIAPINE
QUETIAPINE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
4MG
10MG
2MG
5MG
10MG
10MG
10MG/ML
20MG
5MG
5MG
20MG
1%
100MG
25MG
50MG
25MG
0.5MG
10MG
1MG
20MG
2MG
5MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
2.7MG
25MG/ML
33.75MG
6.75MG
67.5MG
10MG
15MG
2.5MG
5MG
7.5MG
10MG
25MG
50MG
5MG
10MG
15MG
2.5MG
5MG
7.5MG
10MG
5MG
100MG
200MG
25MG
300MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
10MG
10MG
10MG
10MG
10MG
15MG
15MG
15MG
15MG
15MG
2.5MG
2.5MG
2.5MG
2.5MG
2.5MG
20MG
5MG
5MG
5MG
5MG
5MG
7.5MG
TAB
CAP
CAP
CAP
CAP
CAP
O/L
CAP
CAP
CAP
CAP
SOL
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
145
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
02311984
02343843
02348136
02372835
02338653
02343673
02348179
02352982
02338661
02343681
02348187
02352990
02343703
02353008
02338645
02343665
02348160
02352974
00313815
00313823
00563803
00587796
00587788
00761745
00761753
00761761
00504424
02236944
02255448
02236945
02255456
02236946
02236943
02307448
02307456
02307405
02307413
02307421
02307472
02307480
02307464
02299062
02299070
02299089
02299054
02299097
02258439
02258447
02258455
02258463
02258471
02258498
02294435
02294443
02294451
01926667
00894672
01926675
00427918
00427926
00726206
00726184
00726192
00726281
00753645
00751871
02240669
02240668
00893420
00726354
02230708
02230707
00759503
02232903
02303175
02303183
02303116
02367483
02303159
02303167
02303205
OLANZAPINE ODT 10MG
OLANZAPINE ODT 10MG
OLANZAPINE ODT 10MG TAB
OLANZAPINE ODT 15MG
OLANZAPINE ODT 15MG
OLANZAPINE ODT 20MG
OLANZAPINE ODT 5MG
OLANZAPINE ODT 5MG
ORAP 2MG TAB
ORAP 4MG TAB
PDL‐FLUPHENAZINE 5 TAB 5MG
PDL‐HALOPERIDOL TAB 0.5MG
PDL‐HALOPERIDOL TAB 1MG
PDL‐HALOPERIDOL‐10 TAB 10MG
PERMITIL 1MG TAB
PHL‐LOXAPINE 10MG TAB
PHL‐LOXAPINE 2.5MG TAB
PHL‐LOXAPINE 25MG/ML SYL
PHL‐OLANZAPINE 10MG TAB
PHL‐OLANZAPINE 2.5MG TAB
PHL‐OLANZAPINE 7.5MG TAB
PHL‐OLANZAPINE ODT 10MG
PHL‐QUETIAPINE 100MG TAB
PHL‐RISPERIDONE 0.25MG TAB
PHL‐RISPERIDONE 0.5MG TAB
PHL‐RISPERIDONE 1MG TAB
PHL‐RISPERIDONE ODT 0.5MG TAB
PHL‐RISPERIDONE ODT 1MG TAB
PHL‐RISPERIDONE ODT 2MG TAB
PIPORTIL L4 25MG/ML INJ
PIPORTIL L4 INJ 25MG/ML
PIPORTIL L4 INJ 50MG/ML
PMS PERPHENAZINE TAB 16MG
PMS PROCHLORPERAZINE INJ 5MG/M
PMS TRIFLUOPERAZINE 10MG/ML SY
PMS‐CLOZAPINE 100MG TAB
PMS‐CLOZAPINE 25MG TAB
PMS‐FLUPHENAZINE 2.5MG/5ML ELI
PMS‐FLUPHENAZINE 5MG TAB
PMS‐HALOPERIDOL LA 100MG/ML
PMS‐HALOPERIDOL LA 50MG/ML INJ
PMS‐HALOPERIDOL SOL 2MG/ML
PMS‐METHOTRIMEPRAZINE 5 MG TAB
PMS‐OLANZAPINE 10MG TAB
PMS‐OLANZAPINE 2.5MG TAB
PMS‐OLANZAPINE 7.5MG TAB
PMS‐OLANZAPINE ODT 10MG DR TAB
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
PIMOZIDE
PIMOZIDE
FLUPHENAZINE HCL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
HALOPERIDOL
FLUPHENAZINE HCL
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
LOXAPINE HCL
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
PIPOTIAZINE PALMITATE
PERPHENAZINE
PERPHENAZINE
PERPHENAZINE
PERPHENAZINE
PROCHLORPERAZINE
TRIFLUOPERAZINE
CLOZAPINE
CLOZAPINE
FLUPHENAZINE HCL
FLUPHENAZINE HCL
HALOPERIDOL
METHOTRIMEPRAZINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
7.5MG
7.5MG
7.5MG
7.5MG
10MG
10MG
10MG
10MG
15MG
15MG
15MG
15MG
20MG
20MG
5MG
5MG
5MG
5MG
2MG
4MG
5MG
0.5MG
1MG
2MG
5MG
10MG
1MG
10MG
2.5MG
25MG
25MG/ML
50MG
5MG
10MG
15MG
2.5MG
5MG
7.5MG
10MG
15MG
5MG
100MG
150MG
200MG
25MG
300MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
0.5MG
1MG
2MG
25MG/ML
50MG/ML
50MG/ML
25MG/ML
50MG/ML
16MG
2MG
4MG
8MG
5 MG/ML
10MG/ML
100MG
25MG
2.5MG/5ML
5MG
100MG/ML
50MG/ML
2MG/ML
5MG
10MG
15MG
2.5MG
20MG
5MG
7.5MG
10MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
INJ
O/L
TAB
TAB
O/L
TAB
INJ
INJ
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
146
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
02303213
02303191
00751898
02239831
02239829
02239830
00753637
00753661
02296578
02296586
02296594
02296551
02296608
02361892
02252007
02252015
02252023
02279266
02252031
02252058
02252066
02291770
02291789
02291797
02370697
02370700
00776505
00789747
02317354
02317362
02317346
02317370
02312700
02312719
02312727
02312735
02312743
02312751
02339161
02339188
02339153
02339196
02372622
02372630
02372649
02372657
02372665
02372673
02317907
02340135
02342618
02353172
02317915
02342626
02353180
02317923
02340143
02342634
02353199
02317893
02340127
02342596
02353164
02317931
02340151
02342642
02353202
02280906
02328305
02280914
02328313
02280922
02328321
02280930
02328348
02280949
02328364
02280957
02328372
02311712
02311747
PMS‐PERPHENAZINE CONC 3.5MG/ML
PMS‐PIMOZIDE 10MG
PMS‐PIMOZIDE 2MG TAB
PMS‐PIMOZIDE 4MG TAB
PMS‐PROCHLORPERAZINE TAB 10MG
PMS‐PROCHLORPERAZINE TAB 5MG
PMS‐QUETIAPINE 100MG TAB
PMS‐RISPERIDONE 0.25MG TAB
PMS‐RISPERIDONE 0.5MG TAB
PMS‐RISPERIDONE 1MG TAB
PMS‐RISPERIDONE 1MG/ML O/L
PMS‐RISPERIDONE ODT 0.5MG TAB
PMS‐RISPERIDONE ODT 1MG RD TAB
PMS‐RISPERIDONE ODT 2MG RD TAB
PMS‐RISPERIDONE ODT 3MG
PMS‐RISPERIDONE ODT 4MG
PMS‐TRIFLUOPERAZINE HCL SYR 1
PROCHLORPERAZINE 5MG/ML INJ
PRO‐QUETIAPINE 100MG TAB
PRO‐RISPERIDONE 0.25MG TAB
PRO‐RISPERIDONE 0.5MG TAB
PRO‐RISPERIDONE 1MG TAB
Q‐QUETIAPINE 100MG TAB
Q‐RISPERIDONE 0.25MG TAB
Q‐RISPERIDONE 0.5MG TAB
Q‐RISPERIDONE 1MG TAB
QUETIAPINE 100MG TAB
QUETIAPINE 25MG TAB
QUETIAPINE 25MG TAB
QUETIAPINE 25MG TAB
QUETIAPINE 25MG TAB
RAN‐RISPERIDONE 0.25MG TAB
RAN‐RISPERIDONE 1MG TAB
RATIO‐QUETIAPINE 100MG TAB
OLANZAPINE
OLANZAPINE
PERPHENAZINE
PIMOZIDE
PIMOZIDE
PIMOZIDE
PROCHLORPERAZINE
PROCHLORPERAZINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE TARTRATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
TRIFLUOPERAZINE HCL
PROCHLORPERAZINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
15MG
5MG
3.2MG/ML
10MG
2MG
4MG
10MG
5MG
100MG
150MG
200MG
25MG
300MG
50MG
0.25MG
0.5MG
1MG
1MG/ML
2MG
3MG
4MG
0.5MG
1MG
2MG
3MG
4MG
1.18MG
5 MG/ML
100MG
200MG
25MG
300MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
100MG
200MG
25MG
300MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
100MG
100MG
100MG
100MG
150MG
150MG
150MG
200MG
200MG
200MG
200MG
25MG
25MG
25MG
25MG
300MG
300MG
300MG
300MG
0.25MG
0.25MG
0.5MG
0.5MG
1MG
1MG
2MG
2MG
3MG
3MG
4MG
4MG
100MG
200MG
TAB LA
TAB LA
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB
TAB
O/L
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
147
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
02311704
02311755
02264757
02264765
02264773
02264781
02264803
02264811
02237604
02237606
02237605
02237603
02236468
02236471
02247805
02247798
02240551
02240552
02025280
02236950
02025299
02025302
02025310
02230455
02298465
02255707
02255758
02255723
02284871
02303485
02332051
02335387
02343711
02356880
02284898
02303493
02332078
02335395
02343738
02356899
02284901
02332086
02335409
02343746
02356902
02284928
02303515
02332094
02335417
02343754
02356910
02284936
02303523
02332108
02335425
02343762
02356929
02284944
02303531
02332116
02335433
02343770
02356937
02337150
02337169
02337126
02337134
02337142
02339838
02339846
02339811
02316706
02316714
02316722
02316692
02316730
02283565
02283573
02283581
02283603
02283611
RATIO‐RISPERIDONE 0.25MG TAB
RATIO‐RISPERIDONE 0.5MG TAB
RATIO‐RISPERIDONE 1MG TAB
RHO‐PERICYAZINE 10MG CAP
RHO‐PERICYAZINE 10MG/ML DROPS
RHO‐PIPOTIAZINE L 25MG/ML
RHO‐PIPOTIAZINE L 50MG/ML
RHOXAL‐CLOZAPINE 100MG TAB
RHOXAL‐CLOZAPINE 25MG TAB
RISPERDAL 0.25MG TAB
RISPERDAL 0.5MG TAB
RISPERDAL 1MG TAB
RISPERDAL 1MG/ML O/L
RISPERDAL 2MG TAB
RISPERDAL 3MG TAB
RISPERDAL 4MG TAB
RISPERDAL 5MG TAB
RISPERDAL CONSTA 12.5MG/VIAL
RISPERDAL CONSTA SUS 25MG/VIAL
RISPERDAL CONSTA SUS 50MG/VIAL
RISPERDAL CONSTA SUS37.5MG/VIA
RISPERIDONE 0.25MG TAB
RISPERIDONE 1MG TAB
RISPERIDONE 1MG TAB
RISPERIDONE 1MG TAB
RISPERIDONE 1MG TAB
RISPERIDONE 1MG TAB
RISPERIDONE 2MG TAB
RISPERIDONE 2MG TAB
RISPERIDONE 2MG TAB
RISPERIDONE 2MG TAB
RISPERIDONE 2MG TAB
RISPERIDONE 2MG TAB
RISPERIDONE 3MG TAB
RISPERIDONE 3MG TAB
RISPERIDONE 3MG TAB
RISPERIDONE 3MG TAB
RISPERIDONE 3MG TAB
RISPERIDONE 3MG TAB
RISPERIDONE 4MG TAB
RISPERIDONE 4MG TAB
RISPERIDONE 4MG TAB
RISPERIDONE 4MG TAB
RISPERIDONE 4MG TAB
RISPERIDONE 4MG TAB
RIVA‐OLANZAPINE 10MG TAB
RIVA‐OLANZAPINE 2.5MG TAB
RIVA‐OLANZAPINE 7.5MG TAB
RIVA‐OLANZAPINE ODT 10MG TAB
RIVA‐QUETIAPINE 100MG TAB
RIVA‐RISPERIDONE 0.25MG TAB
RIVA‐RISPERIDONE 0.5MG TAB
RIVA‐RISPERIDONE 1MG TAB
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
PERICYAZINE
PERICYAZINE
PERICYAZINE
PERICYAZINE
PIPOTIAZINE PALMINATE
PIPOTIAZINE PALMINATE
CLOZAPINE
CLOZAPINE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
25MG
300MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
10MG
10MG/ML
20MG
5MG
25MG/ML
50MG/ML
100MG
25MG
0.25MG
0.5MG
1MG
1MG/ML
2MG
3MG
4MG
5MG
12.5MG
25MG/VIAL
50MG/VIAL
37.5MG/VIA
0.25MG
0.25MG
0.25MG
0.25MG
0.25MG
0.25MG
0.5MG
0.5MG
0.5MG
0.5MG
0.5MG
0.5MG
1MG
1MG
1MG
1MG
1MG
2MG
2MG
2MG
2MG
2MG
2MG
3MG
3MG
3MG
3MG
3MG
3MG
4MG
4MG
4MG
4MG
4MG
4MG
10MG
15MG
2.5MG
5MG
7.5MG
10MG
15MG
5MG
100MG
150MG
200MG
25MG
300MG
0.25MG
0.5MG
1MG
2MG
3MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
O/L
CAP
CAP
INJ
INJ
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
INJ
INJ
PDR
PDR
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
148
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
281608
02283638
02327783
02327791
02327805
02327775
02279509
02303655
02303663
02279800
02279819
02279827
02279835
02310384
02310392
02310341
02310406
02310368
02310376
02314002
02314010
02313995
02314029
02374811
02374803
02236952
02236953
02236951
02244107
02338254
02338262
02338211
02338270
02338238
02338246
02338297
02338300
02338319
02338289
02323745
02323753
02323761
02323737
02323788
02323516
02323524
02323532
02323540
02323559
02323567
01918257
00578185
00025364
00025690
00025682
02276747
02276755
02276712
02359707
02276720
02276739
02321351
02321378
02321386
02321343
02284243
02284251
02284278
02284235
02284286
02230838
02242868
02230839
02230840
02230837
02298597
02298600
02298619
02298627
02229285
02247099
02238850
SANDOZ OLANZAPINE ODT 10MG
SANDOZ RISPERIDONE 0.25MG TAB
SANDOZ RISPERIDONE 1MG TAB
SANDOZ‐OLANZAPINE 10MG TAB
SANDOZ‐OLANZAPINE 2.5MG TAB
SANDOZ‐OLANZAPINE 7.5MG TAB
SANDOZ‐QUETIAPINE 100MG TAB
SAPHRIS 10MG SL TAB
SAPHRIS 5MG SL TAB
SEROQUEL 100MG TAB
SEROQUEL 200MG TAB
SEROQUEL 25MG TAB
SEROQUEL 300MG TAB
SIG‐OLANZAPINE 10MG TAB
SIG‐OLANZAPINE 2.5MG TAB
SIG‐OLANZAPINE 7.5MG TAB
SIG‐OLANZAPINE OD 10MG ER TAB
SIG‐QUETIAPINE 100MG TAB
SIG‐RISPERIDONE 0.25MG TAB
SIG‐RISPERIDONE 0.5MG TAB
SIG‐RISPERIDONE 1MG TAB
STELAZINE
STEMETIL 10 INJ 5MG/ML
STEMETIL 10MG SUPP
STEMETIL 16.2MG TAB
STEMETIL 8.1MG TAB
TEVA‐OLANZAPINE 10MG TAB
TEVA‐OLANZAPINE 2.5MG TAB
TEVA‐OLANZAPINE 7.5MG TAB
TEVA‐OLANZAPINE OD 10MG ER TAB
TEVA‐QUETIAPINE 100MG TAB
XYLAC 10MG TAB
XYLAC 2.5MG TAB
XYLAC 25MG TAB
XYLAC 50MG TAB
XYLAC 5MG TAB
ZELDOX 20MG CAP
ZELDOX 40MG CAP
ZELDOX 60MG CAP
ZELDOX 80MG CAP
ZYPREXA 10MG TAB
ZYPREXA 10MG/VIAL IM
ZYPREXA 15MG TAB
RISPERIDONE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
ASENAPINE
ASENAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
QUETIAPINE SODIUM
QUETIAPINE SODIUM
QUETIAPINE SODIUM
QUETIAPINE SODIUM
QUETIAPINE SODIUM
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
RISPERIDONE
TRIFLUOPERAZINE
PROCHLORPERAZINE
PROCHLORPERAZINE
PROCHLORPERAZINE
PROCHLORPERAZINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
LOXAPINE SUCCINATE
ZIPRASIDONE HCL MONOHYDRATE
OLANZAPINE
OLANZAPINE TARTRATE
OLANZAPINE
4MG
10MG
15MG
20MG
5MG
0.25MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
10MG
15MG
2.5MG
20MG
5MG
7.5MG
100MG
200MG
25MG
300MG
10MG
5MG
100MG
200MG
25MG
300MG
10MG
15MG
2.5MG
20MG
5MG
7.5MG
10MG
15MG
20MG
5MG
100MG
150MG
200MG
25MG
300MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
1MG/M
5MG/ML
10MG
16.2MG
8.1MG
10MG
15MG
2.5MG
20MG
5MG
7.5MG
10MG
15MG
20MG
5MG
100MG
150MG
200MG
25MG
300MG
10MG
2.5MG
25MG
50MG
5MG
20MG
40MG
60MG
80MG
10MG
10MG/VIAL
15MG
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
SUPP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
INJ
TAB
149
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
281608
281608
281608
281608
281608
281608
281608
281608
02229250
02238851
02229269
02229277
02243087
02243088
02243089
02243086
ZYPREXA 2.5MG TAB
ZYPREXA 20MG TAB
ZYPREXA 5MG TAB
ZYPREXA 7.5MG TAB
ZYPREXA ZYDIS 10MG TAB
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
OLANZAPINE
2.5MG
20MG
5MG
7.5MG
10MG
15MG
20MG
5MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
150
*PA
05/2012
Therapy Class
282004
DIN
Drug Name
AMPHETAMINES
Chemical Name
Strength
Dosage
282004
282004
282004
282004
282004
282004
282004
282004
282004
282004
282004
02248809
02248810
02248811
02248812
02248813
02248808
01924516
00181439
00181447
01924559
01924567
ADDERALL XR 10MG CAPS
DEXEDRINE 5MG TAB
DEXEDRINE SPANSULE 10MG
DEXEDRINE SPANSULE 15MG
DEXEDRINE SPANSULE SRC 10MG
DEXEDRINE SPANSULE SRC 15MG
MIXED SALTS AMPHETAMINE
DEXTROAMPHETAMINE SULFATE
10MG
15MG
20MG
25MG
30MG
5MG
5MG
10MG
15MG
10MG
15MG
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB
CAP
CAP
CAP LA
CAP LA
151
*PA
05/2012
Therapy Class
282092
DIN
Drug Name
ANOREXIGENIC AGENTS & RESPIRATORY &CEREBRAL STIMULANTS, MISC.
Chemical Name
Strength
Dosage
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
282092
02239665
02249324
02249332
02330377
02273950
02266687
02347482
02247793
02247791
02247792
02277166
02277131
02277158
02277174
02277182
02277190
02277204
02277212
02247732
02250241
02247733
02247734
02126494
02326248
02126486
02326256
02326221
02285398
02274299
02274302
02274280
02246991
02243222
00584991
00585009
02234749
00005606
00005614
00632775
02320312
02315068
02315076
02315084
02315092
ALERTEC 100MG TAB
APO‐METHYLPHENIDATE 10MG TAB
APO‐METHYLPHENIDATE 54MG ER
APO‐METHYLPHENIDATE SR 20MG
APX‐MODAFINIL 100MG TAB
ATTENADE 10MG TAB
ATTENADE 2.5MG TAB
ATTENADE 5MG TAB
BIPHENTIN 10MG ER CAP
CONCERTA 18MG TAB
CONCERTA 27MG TAB
CONCERTA 36MG TAB
CONCERTA 54MG TAB
METHYLPHENIDATE 10MG TAB
MODAFINIL 100MG TAB
NOVO‐METHYLPHENIDATE 10MG TAB
PHL‐METHYLPHENIDATE 5MG TABS
PMS‐METHYLPHENIDATE SRT 20MG
PMS‐METHYLPHENIDATE TAB 10MG
RITALIN 10MG TAB
RITALIN 20MG TAB
RITALIN SR 20MG TAB
SANDOZ‐METHYLPHENIDATE SR 20MG
TEVA‐METHYLPHENIDATE 18MG TAB
MODAFINIL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
MODAFINIL
DEXMETHYLPHENIDATE HCL
METHYLPHENIDATE HYDROCHLORIDE
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
MODAFINIL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
METHYLPHENIDATE HCL
100MG
10MG
20MG
54MG
5MG
20MG
100MG
10MG
2.5MG
5MG
10MG
15MG
20MG
30MG
40MG
50MG
60MG
80MG
18MG
27MG
36MG
54MG
10MG
10MG
20MG
20MG
5MG
100MG
10MG
20MG
5MG
5MG
20MG
10MG
20MG
5MG
10MG
20MG
20MG
20MG
18MG
27MG
36MG
54MG
TAB
TAB
TAB
TAB LA
TAB
TAB LA
TAB
TAB
TAB
TAB
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
CAP LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
TAB LA
152
*PA
05/2012
Therapy Class
282404
DIN
Drug Name
BARBITURATES
Chemical Name
Strength
Dosage
282404
282404
282404
282404
282404
282404
282404
282404
282404
282404
282404
282404
00344036
02304090
02304082
00645575
00178829
00178799
00178802
00293903
00178810
00320714
00618357
00908630
PHENOBARBITAL 100MG TAB
PHENOBARBITAL 120MG/ML INJ
PHENOBARBITAL 30MG/ML INJ
PHENOBARBITAL ELIXIR 5MG/ML
PHENOBARBITAL TAB 100MG
PMS‐PHENOBARBITAL 15MG TAB
QUINOBARB
PHENOBARBITAL
PHENOBARBITAL SODIUM
PHENOBARBITAL
PHENOBARBITAL
PHENOBARBITAL
PHENOBARBITAL
PHENOBARBITAL
PHENOBARBITAL
PHENOBARBITAL
QUINIDINE + PHENYLETHYLOBARB
100MG
120MG/ML
30MG/ML
5MG/ML
100MG
15MG
30MG
30MG
60MG
60MG
15MG
100MG
TAB
INJ
INJ
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
153
*PA
05/2012
Therapy Class
282408
DIN
Drug Name
BENZODIAZEPINES
Chemical Name
Strength
Dosage
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
02349191
02287315
02349205
02248706
02287323
02248707
02287331
00865397
00865400
02243611
02243612
02177153
02177161
02177188
00522988
00522996
00522724
02244638
00860697
00860689
00860700
00405337
00405329
00362158
00521698
00521701
00655740
00655759
00655767
02245231
02245230
00402680
00402745
00402737
02225964
02225972
02243624
00808563
00808571
02041413
02041456
02041421
02041464
02041448
00557765
02041472
02247176
02247173
02247174
02248126
02248127
02247177
02247178
02247179
02230039
02230040
02230041
02248454
02244814
02244815
00012696
00012718
02238162
00602825
02065614
02243240
00399728
02247230
02137399
02128934
02128942
02245784
02245785
02245786
02253968
02253976
02253984
02229756
02229758
00578479
ALPRAZOLAM 0.25MG TAB
ALPRAZOLAM 1MG TAB
ALPRAZOLAM 1MG TAB
ALPRAZOLAM 2MG TAB
ALPRAZOLAM 2MG TAB
APO‐ALPRAZ 0.25MG TAB
APO‐ALPRAZ 0.5MG TAB
APO‐ALPRAZ 1MG TAB
APO‐ALPRAZ TS 2MG TAB
APO‐BROMAZEPAM 1.5MG TAB
APO‐BROMAZEPAM 3MG TAB
APO‐BROMAZEPAM 6MG TAB
APO‐CHLORDIAZEPOXIDE 10MG CAP
APO‐CLOBAZAM 10MG TAB
APO‐CLORAZEPATE 15MG CAP
APO‐CLORAZEPATE 3.75MG CAP
APO‐CLORAZEPATE 7.5MG CAP
APO‐DIAZEPAM 10MG TAB
APO‐FLURAZEPAM 15MG CAP
APO‐FLURAZEPAM 30MG CAP
APO‐LORAZEPAM 0.5MG TAB
APO‐LORAZEPAM 1MG TAB
APO‐LORAZEPAM 2MG TAB
APO‐NITRAZEPAM TAB 10MG
APO‐NITRAZEPAM TAB 5MG
APO‐OXAZEPAM 10MG TAB
APO‐TEMAZEPAM 15MG CAP
APO‐TEMAZEPAM 30MG CAP
APO‐TEMAZEPAM 7.5MG CAP
APO‐TRIAZO 0.125MG TAB
APO‐TRIAZO 0.25MG TAB
ATIVAN TAB 0.5MG
ATIVAN TAB 0.5MG SUBLINGUAL
ATIVAN TAB 1MG
ATIVAN TAB 1MG SUBLINGUAL
ATIVAN TAB 2MG
ATIVAN TAB 2MG SUBL
ATIVAN TAB 2MG SUBLINGUAL
BIO‐DIAZEPAM 10MG TAB
BIO‐FLURAZEPAM 15MG CAP
BIO‐FLURAZEPAM 30MG CAP
BIO‐OXAZEPAM 10MG TAB
BROMAZEPAM 1.5MG TAB
BROMAZEPAM 3MG TAB
BROMAZEPAM 6MG TAB
CLOBAZAM 10MG TAB
CO TEMAZEPAM 15MG CAP
CO TEMAZEPAM 30MG CAP
DALMANE 15 CAP
DALMANE 30MG CAP
DIASTAT 5MG/ML RECTAL GEL
DIAZEMULS EML 5MG/ML INJ
DIAZEMULS VL 5MG/ML INJ
DIAZEPAM AUTOINJECTOR 5MG/ML
DIAZEPAM INJ 5MG/ML
DOM‐CLOBAZAM 10MG TAB
DOM‐DIAZEPAM 1MG/ML O/L
DOM‐FLURAZEPAM 15MG CAP
DOM‐FLURAZEPAM 30MG CAP
DOM‐LORAZEPAM 0.5MG TAB
DOM‐LORAZEPAM 1MG TAB
DOM‐LORAZEPAM 2MG TAB
DOM‐OXAZEPAM 10MG TAB
DOM‐TEMAZEPAM 15MG CAP
DOM‐TEMAZEPAM 30MG CAP
FLURAZEPAM 15 CAP 15MG
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
BROMAZEPAM
BROMAZEPAM
BROMAZEPAM
CHLORDIAZEPOXIDE HCL
CLOBAZAM
CLORAZEPATE DIPOTASSIUM
DIAZEPAM
DIAZEPAM
DIAZEPAM
FLURAZEPAM HCL
FLURAZEPAM HCL
LORAZEPAM
LORAZEPAM
LORAZEPAM
NITRAZEPAM
NITRAZEPAM
OXAZEPAM
OXAZEPAM
OXAZEPAM
TEMAZEPAM
TEMAZEPAM
TEMAZEPAM
TRIAZOLAM
TRIAZOLAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
DIAZEPAM
DIAZEPAM
DIAZEPAM
FLURAZEPAM HCL
FLURAZEPAM HCL
OXAZEPAM
OXAZEPAM
OXAZEPAM
BROMAZEPAM
BROMAZEPAM
BROMAZEPAM
CLOBAZAM
TEMAZEPAM
TEMAZEPAM
FLURAZEPAM HCL
FLURAZEPAM HCL
DIAZEPAM
DIAZEPAM INJ EMULSION
DIAZEPAM
DIAZEPAM
DIAZEPAM
CLOBAZAM
DIAZEPAM
FLURAZEPAM
FLURAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
OXAZEPAM
OXAZEPAM
OXAZEPAM
TEMAZEPAM
TEMAZEPAM
FLURAZEPAM HCL
0.25MG
0.5MG
0.5MG
1MG TAB
1MG
2MG TAB
2MG
0.25MG
0.5MG
1MG
2MG
1.5MG
3MG
6MG
10MG
25MG
5MG
10MG
15MG
3.75MG
7.5MG
10MG
2MG
5MG
15MG
30MG
0.5MG
1MG
2MG
10MG
5MG
10MG
15MG
30MG
15MG
30MG
7.5MG
0.125MG
0.25MG
0.5MG
0.5MG
1MG
1MG
2MG
2MG
2MG
10MG
2MG
5MG
15MG
30MG
10MG
15MG
30MG
1.5MG
3MG
6MG
10MG
15MG
30MG
15MG
30MG
5MG/ML
5MG/ML
5MG/ML
5MG/ML
5MG/ML
10MG
1MG/ML
15MG
30MG
0.5MG
1MG
2MG
10MG
15MG
30MG
15MG
30MG
15MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
CAP
CAP
CAP
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
GEL
INJ
INJ
INJ
INJ
TAB
O/L
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
154
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
02221799
02192713
02192721
02231615
02231616
02253070
02253089
02070944
02070952
02070960
02070901
02070928
00518123
00518131
01919512
00514519
00514527
02351072
02351080
02351099
02243278
02280477
02280485
02237264
02237265
02237266
02237267
02230666
02230667
02230668
02237294
02237295
02084406
02084414
00511536
00511528
02137534
02137542
02229813
02229814
02192705
02229655
02229654
02255588
02255561
02230584
02230585
02238334
00628212
00628190
00628204
00637742
00711101
00637750
02230095
02230102
02346990
02347008
02347598
02347733
02347741
02347768
02347865
02347873
01913239
01913247
02171856
02171858
02171864
02171872
00865672
00865680
00865699
02223570
02223589
00886084
00886092
00414255
00414263
00414247
01908189
FRISIUM TAB 10MG
GEN‐BROMAZEPAM 3MG TAB
GEN‐BROMAZEPAM 6MG TAB
GEN‐TEMAZEPAM 15MG CAP
GEN‐TEMAZEPAM 30MG CAP
GMD‐TEMAZEPAM 15MG CAP
GMD‐TEMAZEPAM 30MG CAP
KENRAL‐DIAZEPAM
KENRAL‐DIAZEPAM
KENRAL‐DIAZEPAM
KENRAL‐FLURAZEPAM 15MG TAB
KENRAL‐FLURAZEPAM 30MG TAB
LECTOPAM TAB 3MG
LECTOPAM TAB 6MG
LOFTRAN 15MG
LOFTRAN CAP 15MG
LOFTRAN CAP 30MG
LORAZEPAM 0.5MG TAB
LORAZEPAM 1MG TAB
LORAZEPAM 2MG TAB
LORAZEPAM 4MG/ML INJ
LOREXAN 1MG TAB
LOREXAN 2MG TAB
MED‐ALPRAZOLAM 0.25MG TAB
MED‐ALPRAZOLAM 0.5MG TAB
MED‐ALPRAZOLAM 1MG TAB
MED‐ALPRAZOLAM 2MG TAB
MED‐BROMAZEPAM 1.5MG TAB
MED‐BROMAZEPAM 3MG TAB
MED‐BROMAZEPAM 6MG TAB
MED‐TEMAZEPAM 15MG CAP
MED‐TEMAZEPAM 30MG CAP
MED‐TRIAZOLAM 0.125MG TAB
MED‐TRIAZOLAM 0.25MG TAB
MOGADON TAB 10MG
MOGADON TAB 5MG
MYLAN‐ALPRAZOLAM 0.25MG TAB
MYLAN‐ALPRAZOLAM 0.5MG TAB
MYLAN‐ALPRAZOLAM 1MG TAB
MYLAN‐ALPRAZOLAM 2MG TAB
MYLAN‐BROMAZEPAM 1.5MG TAB
NITRAZADON TAB 10MG
NITRAZADON TAB 5MG
NITRAZEPAM 10MG TAB
NITRAZEPAM 5MG TAB
NOVO‐BROMAZEPAM 3MG TAB
NOVO‐BROMAZEPAM 6MG TAB
NOVO‐CLOBAZAM TAB 10MG
NOVO‐CLOPATE CAP 15MG
NOVO‐CLOPATE CAP 3.75MG
NOVO‐CLOPATE CAP 7.5MG
NOVO‐LORAZEM 1 MG TAB
NOVO‐LORAZEM TAB 0.5MG
NOVO‐LORAZEM TAB 2MG
NOVO‐TEMAZEPAM CAP 15MG
NOVO‐TEMAZEPAM CAP 30MG
NTP‐ALPRAZOLAM 0.25MG TAB
NTP‐ALPRAZOLAM 0.5MG TAB
NTP‐CLOBAZAM 10MG TAB
NTP‐LORAZEPAM 0.5MG TAB
NTP‐LORAZEPAM 1MG TAB
NTP‐LORAZEPAM 2MG TAB
NTP‐TEMAZEPAM 15MG CAP
NTP‐TEMAZEPAM 30MG CAP
NU‐ALPRAZ 0.25MG TAB
NU‐ALPRAZ 0.5MG TAB
NU‐BROMAZEPAM 1.5MG TAB
NU‐BROMAZEPAM 1.5MG TAB
NU‐BROMAZEPAM 3MG TAB
NU‐BROMAZEPAM 6MG TAB
NU‐LORAZ TAB 0.5MG
NU‐LORAZ TAB 1MG
NU‐LORAZ TAB 2MG
NU‐TEMAZEPAM CAP 15MG
NU‐TEMAZEPAM CAP 30MG
NU‐TRIAZO TAB 0.125MG
NU‐TRIAZO TAB 0.25MG
OXPAM 15MG TAB
OXPAM 30MG
OXPAM TAB 10MG
PDL‐ALPRAZOLAM‐0.25 TAB 0.25MG
CLOBAZAM
BROMAZEPAM
BROMAZEPAM
TEMAZEPAM
TEMAZEPAM
TEMAZEPAM
TEMAZEPAM
DIAZEPAM
DIAZEPAM
DIAZEPAM
FLURAZEPAM
FLURAZEPAM
BROMAZEPAM
BROMAZEPAM
KETAZOLAM
KETAZOLAM
KETAZOLAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
BROMAZEPAM
BROMAZEPAM
BROMAZEPAM
TEMAZEPAM
TEMAZEPAM
TRIAZOLAM
TRIAZOLAM
NITRAZEPAM
NITRAZEPAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
BROMAZEPAM
NITRAZEPAM
NITRAZEPAM
NITRAZEPAM
NITRAZEPAM
BROMAZEPAM
BROMAZEPAM
CLOBAZAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
TEMAZEPAM
TEMAZEPAM
ALPRAZOLAM
ALPRAZOLAM
CLOBAZAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
TEMAZEPAM
TEMAZEPAM
ALPRAZOLAM
ALPRAZOLAM
BROMAZEPAM
BROMAZEPAM
BROMAZEPAM
BROMAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
TEMAZEPAM
TEMAZEPAM
TRIAZOLAM
TRIAZOLAM
OXAZEPAM
OXAZEPAM
OXAZEPAM
ALPRAZOLAM
10MG
3MG
6MG
15MG
30MG
15MG
30MG
2MG
5MG
10MG
15MG
30MG
3MG
6MG
15MG
15MG
30MG
0.5MG
1MG
2MG
4MG/ML
1MG
2MG
0.25MG
0.5MG
1MG
2MG
1.5MG
3MG
6MG
15MG
30MG
0.125MG
0.25MG
10MG
5MG
0.25MG
0.50MG
1MG
2MG
1.5MG
10MG
5MG
10MG
5MG
3MG
6MG
10MG
15MG
3.75MG
7.5MG
1MG
0.5MG
2MG
15MG
30MG
0.25MG
0.5MG
10MG
0.5MG
1MG
2MG
15MG
30MG
0.25MG
0.5MG
1.5MG
1.5MG
3MG
6MG
0.5MG
1MG
2MG
15MG
30MG
0.125
0.25M
15MG
30MG
10MG
0.25MG
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
155
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
282408
01908170
02220512
02220520
02220539
00156590
00363596
00434426
00313580
00434388
00434396
00578487
00655643
00655651
00655678
00497754
00497762
00497770
02229760
02229761
02239071
02239072
02294087
02294095
02298201
02298228
02298236
02294079
02297957
02297965
02244474
02247492
00891797
02247490
02247491
00726187
00728187
00728195
00728209
02018179
02018187
02243023
02243024
00604453
00604461
02229854
02242107
02242108
02242153
02242152
00568392
00568406
00568414
02234007
02234003
00483826
00483818
00414220
00414239
02083418
02083426
02247526
02247527
01913484
01913492
02228858
02228866
02228874
02228882
02228890
00860816
00013285
00013773
00013765
00813958
00548359
00548367
00723770
PDL‐ALPRAZOLAM‐0.5 TAB 0.5MG
PDL‐BROMAZEPAM 1.5MG TAB
PDL‐BROMAZEPAM 3MG TAB
PDL‐BROMAZEPAM 6MG TAB
PDL‐CHLORDIAZEPOXIDE CAP 10MG
PDL‐CHLORDIAZEPOXIDE CAP 5MG
PDL‐CHLORDIAZEPOXYDE HCL CAP 2
PDL‐DIAZEPAM 5MG TAB
PDL‐DIAZEPAM TAB 10MG
PDL‐DIAZEPAM TAB 2MG
PDL‐FLURAZEPAM 30 CAP 30MG
PDL‐LORAZEPAM TAB 0.5MG
PDL‐LORAZEPAM TAB 1.0MG
PDL‐LORAZEPAM TAB 2MG
PDL‐OXAZEPAM 10 TAB 10MG
PDL‐TEMAZEPAM CAP 15MG
PDL‐TEMAZEPAM CAP 30MG
PENTA‐TEMAZEPAM 15MG CAP
PENTA‐TEMAZEPAM 30MG CAP
PHI‐OXAZEPAM 15MG TAB
PHI‐OXAZEPAM 30MG TAB
PHL‐LORAZEPAM 0.5MG TAB
PHL‐LORAZEPAM 1MG TAB
PHL‐LORAZEPAM 2MG TAB
PHL‐OXAZEPAM 10MG TAB
PHL‐TEMAZEPAM 15MG CAP
PHL‐TEMAZEPAM 30MG CAP
PMS‐CLOBAZAM 10MG TAB
PMS‐DIAZEPAM 10MG TAB
PMS‐DIAZEPAM 1MG/ML ELIXIR
PMS‐LORAZEPAM 0.5MG TAB
PMS‐LORAZEPAM TAB 0.5MG
PMS‐LORAZEPAM TAB 1MG
PMS‐LORAZEPAM TAB 2MG
RATIO‐ALPRAZOLAM 1MG TAB
RATIO‐ALPRAZOLAM 2MG TAB
RATIO‐TEMAZEPAM 15MG CAP
RATIO‐TEMAZEPAM 30MG CAP
RESTORIL CAP 15MG
RESTORIL CAP 30MG
RESTORIL CAP 7.5MG
RIVA‐ALPRAZOLAM 0.25MG TAB
RIVA‐ALPRAZOLAM 0.5MG TAB
RIVA‐BROMAZEPAM 6MG TAB
RIVA‐BROMAZEPAM 3MG TAB
RIVA‐OXAZEPAM 10MG TAB
SANDOZ‐NITRAZEPAM TAB 10MG
SANDOZ‐NITRAZEPAM TAB 5MG
SOMNOL 15MG TAB
SOMNOL 30MG TAB
SOM‐PAM CAP 15MG
SOM‐PAM CAP 30MG
TARO‐ALPRAZOLAM 0.25
TARO‐ALPRAZOLAM 0.5MG
TEMAZEPAM 15MG CAP
TEMAZEPAM 30MG CAP
TEVA‐ALPRAZOL 0.25MG TAB
TEVA‐ALPRAZOL TAB 0.5MG USP
TRIA‐ALPRAZOLAM 0.25MG TAB
TRIA‐ALPRAZOLAM 0.5MG TAB
TRIA‐BROMAZEPAM 1.5MG TAB
TRIA‐BROMAZEPAM 3MG TAB
TRIA‐BROMAZEPAM 6MG TAB
TRIAZOLAM TAB 0.125MG
VALIUM 5MG TAB
VIVOL 10MG TAB
VIVOL 5MG TAB
XANAX TS 2 MG TAB
XANAX 0.25MG TAB
XANAX 0.5MG TAB
XANAX 1 MG TAB
ALPRAZOLAM
BROMAZEPAM
BROMAZEPAM
BROMAZEPAM
CHLORDIAZEPOXIDE
DIAZEPAM
DIAZEPAM
DIAZEPAM
FLURAZEPAM HCL
LORAZEPAM
LORAZEPAM
LORAZEPAM
OXAZEPAM
OXAZEPAM
OXAZEPAM
TEMAZEPAM
TEMAZEPAM
TEMAZEPAM
TEMAZEPAM
OXAZEPAM
OXAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
OXAZEPAM
TEMAZEPAM
TEMAZEPAM
CLOBAZAM
DIAZEPAM
DIAZEPAM
DIAZEPAM
DIAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
LORAZEPAM
ALPRAZOLAM
ALPRAZOLAM
TEMAZEPAM
TEMAZEPAM
TEMAZEPAM
TEMAZEPAM
TEMAZEPAM
ALPRAZOLAM
ALPRAZOLAM
BROMAZEPAM
BROMAZEPAM
OXAZEPAM
OXAZEPAM
OXAZEPAM
NITRAZEPAM
NITRAZEPAM
FLURAZEPAM HCL
FLURAZEPAM HCL
FLURAZEPAM HCL
FLURAZEPAM HCL
ALPRAZOLAM
ALPRAZOLAM
TEMAZEPAM
TEMAZEPAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
BROMAZEPAM
BROMAZEPAM
BROMAZEPAM
TRIAZOLAM
DIAZEPAM
DIAZEPAM
DIAZEPAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
ALPRAZOLAM
0.5MG
1.5MG
3MG
6MG
10MG
5MG
25MG
5MG
10MG
2MG
30MG
0.5MG
1MG
2MG
10MG
15MG
30MG
15MG
30MG
15MG
30MG
15MG
30MG
0.5MG
1MG
2MG
10MG
15MG
30MG
10MG
10MG
1MG/ML
2MG
5MG
0.5MG
0.5MG
1MG
2MG
1MG
2MG
15MG
30MG
15MG
30MG
7.5MG
0.25MG
0.5MG
6MG
3MG
10MG
15MG
30MG
10MG
5MG
15MG
30MG
15MG
30MG
0.25MG
0.5MG
15MG
30MG
0.25MG
0.50MG
0.25MG
0.5MG
1.5MG
3MG
6MG
0.125MG
5MG
10MG
5MG
2MG
0.25MG
0.5MG
1MG
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
156
*PA
05/2012
Therapy Class
282492
DIN
Drug Name
MISCELLANEOUS ANXIOLYTICS, SEDATIVES, & HYPNOTICS
Chemical Name
Strength
Dosage
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
282492
02211076
02211068
00646059
00646024
00646016
00024694
00603813
02247621
02262916
02262908
02232564
02252899
00742813
02231209
00739626
00739634
02176114
02237268
02230874
00029327
02231492
00738824
00738832
00738840
02207072
02207672
02207664
02137135
02223163
02223155
00739618
02238613
02230942
00792659
00741817
02237858
02242149
02241192
02241193
02241194
02084201
APO‐BUSPIRONE 10MG TAB
APO‐BUSPIRONE 5MG TAB
APO‐HYDROXYZINE 10MG CAP
ATARAX SYRUP 2MG/ML
BUSPAR 5MG TAB
CHLORAL HYDRATE ODAN 100MG/ML
CO BUSPIRONE 10MG TAB
CO BUSPIRONE 5MG TAB
DOM‐BUSPIRONE 10MG TAB
GMD‐BUSPIRONE 10MG TAB
HYDROXYZINE HCL 50MG/ML INJ
HYDROXYZINE HCL 50MG/ML INJ
HYDROXYZINE‐25 CAP 25MG
HYDROXYZINE‐50 CAP 50MG
LIN‐BUSPIRONE 5MG TAB
MED‐BUSPIRONE 10MG TAB
MYLAN‐BUSPIRONE 10MG TAB
NOCTEC SYR 500MG/5ML
NOVO‐BUSPIRONE 10MG TAB
NOVO‐HYDROXYZIN CAP 10MG
NOVO‐HYDROXYZIN CAP 25MG
NOVOHYDROXYZIN CAP 50MG
NU‐BUSPIRONE 10MG TAB
PARALDEHYDE 100% INJ
PDL‐BUSPIRONE 10MG TAB
PDL‐BUSPIRONE 5MG TAB
PDL‐HYDROXYZINE‐10 CAP 10MG
PENTA‐BUSPIRONE 10MG TAB
PMS‐BUSPIRONE 10MG TAB
PMS‐CHLORAL HYDRATE 500MG/5ML
PMS‐HYDROXYZINE SYR 10MG/5ML
RATIO‐BUSPIRONE 10MG TAB
RIVA‐BUSPIRONE 10MG TAB
RIVA‐HYDROXYZIN 10MG CAPSULE
RIVA‐HYDROXYZIN 25MG CAP
RIVA‐HYDROXYZIN 50MG CAP
SYN‐BUSPIRONE 10MG TAB
BUSPIRONE HCL
BUSPIRONE HCL
HYDROXYZINE HCL
HYDROXYZINE HCL
HYDROXYZINE HCL
HYDROXYZINE HCL
BUSPIRONE HCL
CHLORAL HYDRATE
BUSPIRONE HCL
BUSPIRONE HCL
BUSPIRONE HCL
BUSPIRONE HCL
HYDROXYZINE HCL
HYDROXYZINE HCL
HYDROXYZINE HCL
HYDROXYZINE HCL
BUSPIRONE HCL
BUSPIRONE HCL
BUSPIRONE HCL
CHLORAL HYDRATE
BUSPIRONE HCL
HYDROXYZINE HCL
HYDROXYZINE HCL
HYDROXYZINE HCL
BUSPIRONE HCL
BUSPIRONE HCL
BUSPIRONE HCL
PARALDEHYDE
BUSPIRONE HCL
BUSPIRONE HCL
HYDROXYZINE HCL
BUSPIRONE HCL
BUSPIRONE HCL
CHLORAL HYDRATE
HYDROXYZINE HCL
BUSPIRONE HCL
BUSPIRONE HCL
HYDROXYZINE HCL
HYDROXYZINE HCL
HYDROXYZINE HCL
BUSPIRONE HCL
10MG
5MG
10MG
25MG
50MG
2MG/ML
5MG
100MG/ML
10MG
5MG
10MG
10MG
50MG/ML
50MG/ML
25MG
50MG
5MG
10MG
10MG
500MG/5ML
10MG
10MG
25MG
50MG
10MG
10MG
5MG
1MG/ML
10MG
5MG
10MG
10MG
10MG
500MG/5ML
10MG/5ML
10MG
10MG
10MG
25MG
50MG
10MG
TAB
TAB
CAP
CAP
CAP
O/L
TAB
O/L
TAB
TAB
TAB
TAB
INJ
INJ
CAP
CAP
TAB
TAB
TAB
O/L
TAB
CAP
CAP
CAP
TAB
TAB
TAB
INJ
TAB
TAB
CAP
TAB
TAB
O/L
O/L
TAB
TAB
CAP
CAP
CAP
TAB
157
*PA
05/2012
Therapy Class
282800
DIN
Drug Name
ANTIMANIC AGENTS
Chemical Name
Strength
Dosage
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
282800
02242837
02242838
05550001
05550002
00461733
00236683
02011239
02304511
02304538
02013231
00406775
00024406
02266695
02237006
02237007
02237008
02216132
02216140
02216159
02074834
02311356
02311364
APO‐LITHIUM CARB 150MG CAP
APO‐LITHIUM CARB 300MG CAP
APO‐LITHIUM CARBONATE 150MG NT
APO‐LITHIUM CARBONATE 300MG NT
CARBOLITH CAP 150MG
CARBOLITH CAP 300MG
CARBOLITH CAP 600MG
EURO LITHIUM 150MG CAP
EURO LITHIUM 300MG CAP
LITHANE 150MG CAP
LITHANE CAP 300MG
LITHANE TABS 300 MG
LITHMAX SR 300MG
PHL‐LITHIUM CARBONATE150MG CAP
PMS‐LITHIUM CARBONATE 150MG
PMS‐LITHIUM CITRATE 300MG LIQ
PRO‐LITHIUM CARBONATE 150MG CA
PRO‐LITHIUM CARBONATE 300MG CA
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CARBONATE
LITHIUM CITRATE
LITHIUM CARBONATE
LITHIUM CARBONATE
150MG
300MG
150MG
300MG
150MG
300MG
600MG
150MG
300MG
150MG
300MG
300MG
300MG
150MG
300MG
600MG
150MG
300MG
600MG
300MG
150MG
300MG
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
TAB LA
CAP
CAP
CAP
CAP
CAP
CAP
O/L
CAP
CAP
158
*PA
05/2012
Therapy Class
283228
DIN
Drug Name
SELECTIVE SEROTONIN AGONISTS
Chemical Name
Strength
Dosage
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
02237820
02237821
02365499
02365502
02268396
02300575
02282313
02268388
02300567
02380951
02380951
02381575
02366266
02366258
02248129
02248128
02381702
02381699
02374749
02374730
02257904
02257882
02257890
02270765
02270749
02270757
02257084
02342235
02342243
02230419
02230420
02230418
02212188
02212161
02212153
02379082
02379074
02380463
02380455
02379678
02379678
02379651
02379651
02240521
02240520
02240519
02240518
02369036
02379201
02379198
02268922
02268906
02268914
02358735
02358719
02358727
02270730
02270722
02270714
02256444
02256428
02256436
02324229
02324768
02324660
02324652
02383160
02383152
02375206
02375184
02375192
02376210
02271591
02271575
02271583
02338041
02340313
02256290
02256304
02271125
AMERGE 1MG TAB
AMERGE 2.5MG TAB
APO‐NARATRIPTAN 1MG TAB
APO‐NARATRIPTAN 2.5MG TAB
APO‐SUMATRIPTAN 100MG TAB
APO‐SUMATRIPTAN 20MG NAS SPR
APO‐SUMATRIPTAN 5MG NAS SPR
APO‐ZOLMITRIPTAN 2.5MG TAB
APO‐ZOLMITRIPTAN 2.5MG TAB
APO‐ZOLMITRIPTAN RAPID 2.5MG
AVA‐SUMATRIPTAN 100MG TAB
AVA‐SUMATRIPTAN 50MG TAB
AXERT 12.5MG TAB
AXERT 6.25MG TAB
CO RIZATRIPTAN 10MG TAB
CO RIZATRIPTAN 5MG TAB
CO RIZATRIPTAN ODT 10MG
CO RIZATRIPTAN ODT 5MG
CO SUMATRIPTAN 100MG TAB
DOM‐SUMATRIPTAN 100MG TAB
FROVA 2.5MG TAB
GD‐ELETRIPTAN 20MG TAB
GD‐ELETRIPTAN 40MG TAB
IMITREX 10MG INTRANASAL SPRAY
IMITREX 6MG/0.5ML INJ
IMITREX DF 100MG TAB
IMITREX DF 50MG TAB
IPG‐RIZATRIPTAN 10MG TAB
IPG‐RIZATRIPTAN 5MG TAB
JAMP‐RIZATRIPTAN 10MG TAB
JAMP‐RIZATRIPTAN 5MG TAB
MAR‐RIZATRIPTAN 10MG TAB
MAXALT 10MG TAB
MAXALT 5MG TAB
MAXALT RPD 10MG WAFER
MAXALT RPD 5MG WAFER
MYLAN ZOLMITRIPTAN 2.5MG
MYLAN‐RIZATRIPTAN ODT 10MG
MYLAN‐RIZATRIPTAN ODT 5MG
MYLAN‐SUMATRIPTAN 100MG TAB
NTP‐SUMATRIPTAN DF 100MG TAB
PHI‐SUMATRIPTAN 100 TAB
PHI‐SUMATRIPTAN 50MG TAB
PHL‐SUMATRIPTAN 25MG TAB
PMS‐SUMATRIPTAN 100MG TAB
PMS‐ZOLMITRIPTAN 2.5MG TAB
PMS‐ZOLMITRIPTAN ODT 2.5MG
PRO‐SUMATRIPTAN 100MG TAB
PRO‐SUMATRIPTAN 50MG TAB
Q‐RIZATRIPTAN ODT 10MG
Q‐RIZATRIPTAN ODT 5MG
Q‐SUMATRIPTAN 100MG TAB
Q‐ZOLMITRIPTAN 2.5MG TAB
RATIO‐SUMATRIPTAN 100MG TAB
RATIO‐ZOLMITRIPTAN IR 2.5MG
RATIO‐ZOLMITRIPTAN ODT 2.5MG
RELPAX 20MG TAB
RELPAX 40MG TAB
RIVA‐SUMATRIPTAN 100MG TAB
NARATRIPTAN
NARATRIPTAN
NARATRIPTAN HCL
NARATRIPTAN HCL
SUMATRIPTAN SUCCINATE
SUMATRIPTAN HEMISULFATE
SUMATRIPTAN HEMISULFATE
ZOLMITRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
ALMOTRIPTAN MALATE
ALMOTRIPTAN MALATE
RIZATRIPTAN BENZOATE
FROVATRIPTAN SUCCINATE
ELETRIPTAN
ELETRIPTAN
SUMATRIPTAN HEMISULFAT
SUMATRIPTAN HEMISULFAT
ZOLMITRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
SUMATRIPTAN SUCCIANTE
SUMATRIPTAN SUCCIANTE
SUMATRIPTAN
SUMATRIPTAN
SUMATRIPTAN
ZOLMITRIPTAN
SUMATRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
ELETRIPTAN HBR
ELETRIPTAN HBR
1MG
2.5MG
1MG
2.5MG
100MG
20MG
25MG
50MG
5MG
2.5MG
2.5MG
2.5MG
100MG
50MG
12.5MG
6.25MG
10MG
5MG
10MG
5MG
100MG
25MG
50MG
100MG
25MG
50MG
2.5MG
20MG
40MG
10MG
20MG/DOSE
5MG/DOSE
12MG/ML
100MG
50MG
10MG
5MG
10MG
5MG
10MG
10MG
5MG
5MG
10MG
5MG
10MG
5MG
2.5MG
10MG
5MG
100MG
25MG
50MG
100MG
25MG
50MG
100MG
50MG
25MG
100MG
25MG
50MG
2.5MG
2.5MG
100MG
50MG
10MG
5MG
100MG
25MG
50MG
2.5MG
100MG
25MG
50MG
2.5MG
2.5MG
20MG
40MG
100MG
TAB
TAB
TAB
TAB
TAB
NAS SPR
TAB
TAB
NAS SPR
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
SPR
NAS SPR
NAS SPR
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
MISC
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
159
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
283228
02271109
02271117
02322323
02351889
02351870
02263033
02263025
02362988
02362996
02286548
02335107
02344734
02330571
02286513
02344718
02286521
02335093
02344726
02361698
02268248
02268213
02268221
02314290
02314304
02365316
02365308
02239367
02286831
02286815
02286823
02313952
02313960
02342553
02342545
02379929
02379988
02248992
02238660
02248993
02243045
SANDOZ NARATRIPTAN 2.5MG TAB
SANDOZ RIZATRIPTAN ODT 10MG
SANDOZ RIZATRIPTAN ODT 5MG
SANDOZ SUMATRIPTAN 100MG TAB
SANDOZ SUMATRIPTAN 50MG TAB
SANDOZ ZOLMITRIPTAN 2.5MG
SANDOZ ZOLMITRIPTAN ODT 2.5MG
SUMATRIPTAN 100MG TAB
SUMATRIPTAN 12MG/ML INJ
SUMATRIPTAN SUN 6MG/0.5ML INJ
SUMATRYX 100MG TAB
SUMATRYX 25MG TAB
SUMATRYX 50MG TAB
TEVA‐NARATRIPTAN 1MG TAB
TEVA‐NARATRIPTAN 2.5MG TAB
TEVA‐RIZATRIPTAN 10MG TAB
TEVA‐RIZATRIPTAN 5MG TAB
TEVA‐SUMATRIPTAN 100MG TAB
TEVA‐SUMATRIPTAN DF 100MG TAB
TEVA‐ZOLMITRIPTAN 1MG TAB
TEVA‐ZOLMITRIPTAN 2.5MG TAB
TEVA‐ZOLMITRIPTAN OD 1MG
TEVA‐ZOLMITRIPTAN OD 2.5MG
ZOLMITRIPTAN 2.5MG TAB
ZOLMITRIPTAN ODT 2.5MG TAB
ZOMIG 2.5MG NASAL SPRAY
ZOMIG 2.5MG TAB
ZOMIG 5MG NASAL SPRAY
ZOMIG RAPIMELT 2.5MG TAB
NARATRIPTAN HCL
ZOLMITRIPTAN
ZOLMITRIPTAN
SUMATRIPTAN
NARATRIPTAN HCL
NARATRIPTAN HCL
ZOLMITRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
ZOLMITRIPTAN
25MG
50MG
2.5MG
10MG
5MG
100MG
50MG
2.5MG
2.5MG
100MG
100MG
100MG
12MG/ML
25MG
25MG
50MG
50MG
50MG
6MG/0.5ML
100MG
25MG
50MG
1MG
2.5MG
10MG
5MG
100MG
100MG
25MG
50MG
1MG
2.5MG
1MG
2.5MG
2.5MG
2.5MG
2.5MG
2.5MG
5MG
2.5MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
NAS SPR
TAB
NAS SPR
TAB
160
*PA
05/2012
Therapy Class
283292
DIN
Drug Name
MISC. ANTIMIGRAINE AGENTS
283292
283292
283292
00511552 SANDOMIGRAN DS 1MG TAB
00329320 SANDOMIGRAN TAB 0.5MG
00027499 SANSERT TAB 2MG
161
Chemical Name
Strength
Dosage
PIZOTIFEN MALATE
PIZOTIFEN MALATE
METHYSERGIDE BIMALEATE
1MG
0.5MG
2MG
TAB
TAB
TAB
*PA
05/2012
Therapy Class
283608
DIN
Drug Name
ANTICHOLINERGIC AGENTS
Chemical Name
Strength
Dosage
283608
283608
283608
283608
283608
283608
283608
283608
283608
283608
283608
283608
283608
283608
283608
283608
00426857
00545058
00545074
02238903
02125102
01927744
00025550
00587265
00885452
00706531
00587362
00649392
00587354
00885398
02237042
02237043
APO‐BENZTROPINE 2MG TAB
APO‐TRIHEX 2MG TAB
APO‐TRIHEX 5MG TAB
BENZTROPINE OMEGA 1MG/ML INJ
DOM‐PROCYCLIDINE 5MG TAB
PARSITAN 50MG TAB
PARSITAN 55.5MG
PMS‐BENZTROPINE 2MG TAB
PMS‐BENZTROPINE TAB 0.5MG
PMS‐BENZTROPINE TAB 1MG USP
PMS‐PROCYCLIDINE ELX 2.5MG/5ML
PMS‐PROCYCLIDINE TAB 2.5MG USP
PMS‐PROCYCLIDINE TAB 5MG
PMS‐TRIHEXYPHENIDYL 2MG/5ML
PROCYCLIDINE 2.5MG TAB
PROCYCLIDINE 5MG TAB
BENZTROPINE MESYLATE
TRIHEXYPHENIDYL HCL
TRIHEXYPHENIDYL HCL
PROCYCLIDINE HCL
ETHOPROPAZINE HCL
ETHOPROPAZIN
PROCYCLIDINE HCL
PROCYCLIDINE HCL
PROCYCLIDINE HCL
TRIHEXYPHENIDYL HCL
PROCYCLIDINE HCL
PROCYCLIDINE HCL
2MG
2MG
5MG
1MG/ML
5MG
50MG
50MG
2MG
0.5MG
1MG
2.5MG/5ML
2.5MG
5MG
2MG/5ML
2.5MG
5MG
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
O/L
TAB
TAB
162
*PA
05/2012
Therapy Class
283612
DIN
Drug Name
CATECHOL-O-METHYLTRANSFERASE (COMT) INHIBITORS
Chemical Name
Strength
Dosage
283612
283612
283612
283612
02321459
02243763
02380005
02375559
APO‐ENTACAPONE 200MG TAB
COMTAN 200MG TAB
SANDOZ ENTACAPONE 200MG TAB
TEVA‐ENTACAPONE 200MG TAB
ENTACAPONE
ENTACAPONE
ENTACAPONE
ENTACAPONE
200MG
200MG
200MG
200MG
TAB
TAB
TAB
TAB
163
*PA
05/2012
Therapy Class
283616
DIN
Drug Name
DOPAMINE PRECURSORS
Chemical Name
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
283616
02195933
02195941
02195968
02272873
02340992
02341018
02341026
02247606
02292165
02245211
02244494
02244495
02244496
02182823
02182831
02182858
02311151
02311178
02311186
00386464
00386472
00522597
00355658
00513997
00328219
02028786
00870935
02305941
02337835
02305968
02305933
02337827
APO‐LEVOCARB 100MG/10MG TAB
APO‐LEVOCARB CR 100MG/25MG TAB
APX‐LEVOCARB 10MG/100MG TAB
DOM LEVO‐CARBIDOPA TAB
DUODOPA 20MG/ML & 5MG/ML GEL
LEVOCARB 200MG/50MG TAB
NOVO‐LEVOCARBIDOPA 10/100 TAB
NU‐LEVOCARB 100/25 TAB
NU‐LEVOCARB 100MG/10MG TAB
NU‐LEVOCARB 250/25 TAB
PRO‐LEVOCARB 100/10MG TAB
PROLOPA CAP 100‐25
PROLOPA CAP 200‐50
PROLOPA CAP 50‐12.5
SINEMET 100/10 TAB
SINEMET 100/25 TAB
SINEMET 250/25 TAB
SINEMET CR 100/25 TAB
SINEMET CR 200/50 TAB
STALEVO 100MG/25MG/200MG TAB
STALEVO 125/31.25/200MG TAB
STALEVO 150MG/37.5MG/200MG TAB
STALEVO 50MG/12.5MG/200MG TAB
STALEVO 75/18.75/200MG TAB
LEVODOPA/CARBIDOPA
100MG/10MG
LEVODOPA/CARBIDOPA
100MG/25MG
LEVODOPA/CARBIDOPA
250/25MG
LEVODOPA/CARBIDOPA
100MG/25MG
CARBIDOPA/LEVODOPA
10MG/100MG
CARBIDOPA/LEVODOPA
25MG/100MG
CARBIDOPA/LEVODOPA
25MG/250MG
LEVODOPA/CARBIDOPA
100MG/25MG
LEVODOPA/CARBIDOPA MONOHYDRATE20MG/5MG
LEVODOPA/CARBIDOPA
200MG/50MG
CARBIDOPA/LEVODOPA
10/100MG
CARBIDOPA/LEVODOPA
25/100MG
CARBIDOPA/LEVODOPA
25/250MG
LEVODOPA/CARBIDOPA
100MG/25MG
LEVODOPA/CARBIDOPA
100MG/10MG
LEVODOPA/CARBIDOPA
250MG/25MG
CARBIDOPA/LEVODOPA
10MG/100MG
CARBIDOPA/LEVODOPA
25MG/100MG
CARBIDOPA/LEVODOPA
25MG/250MG
LEVODOPA/BENSERAZIDE
100MG/25MG
LEVODOPA/BENSERAZIDE
200MG/50MG
BENSERAZIDE/LEVODOPA
12.5/50MG
LEVODOPA/CARBIDOPA
100MG/10MG
LEVODOPA/CARBIDOPA
100/25MG
LEVODOPA/CARBIDOPA
250MG/25MG
LEVODOPA/CARBIDOPA
100/25
LEVODOPA/CARBIDOPA
200MG/50MG
LEVODOPA/CARBIDOPA/ENTACAPONE
164
Strength
Dosage
*PA
TAB
TAB
TAB
TAB LA
TAB
TAB
TAB
TAB
GEL
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
05/2012
Therapy Class
283620
DIN
Drug Name
DOPAMINE RECEPTOR AGONISTS
Chemical Name
Strength
Dosage
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
02087324
02230454
02347342
02292378
02292386
02347350
02292408
02292394
02337746
02337754
02337762
02337770
02337789
02337797
02337800
02363305
02363313
02363348
02363321
02153378
02238192
02238193
02230719
02244640
02244639
02297302
02297310
02297337
02297329
02316846
02316854
02316862
02316870
02238636
02238637
02309017
02309025
02309041
02309033
02331152
02331160
02331179
02331187
02331195
02352338
02352346
02352354
02352362
02297256
02237145
09857268
02354047
02241594
02354055
02354063
02237147
09857270
02237146
09857269
02354071
02354098
02376350
02376369
02376385
02376377
02269317
02362287
02362295
02362317
02362309
02230637
02230638
02331209
02331217
02331225
02331233
02331241
02231702
02236949
02290111
APO‐BROMOCRIPTINE 2.5MG TAB
APO‐BROMOCRIPTINE 5MG CAP
APO‐PRAMIPEXOLE 0.125MG TAB
APO‐PRAMIPEXOLE 1MG TAB
APO‐ROPINIROLE 0.25MG TAB
APO‐ROPINIROLE 0.5MG TAB
APO‐ROPINIROLE 1MG TAB
AVA‐PRAMIPEXOLE 0.25MG TAB
AVA‐PRAMIPEXOLE 1MG TAB
BROMOCRIPTINE 2.5MG TAB
BROMOCRIPTINE 2.5MG TAB
BROMOCRIPTINE 5MG CAP
BROMOCRIPTINE‐5 5MG CAP
CO BROMOCRIPTINE 2.5MG TAB
CO BROMOCRIPTINE 5MG CAP
CO PRAMIPEXOLE 0.25MG TAB
CO PRAMIPEXOLE 1MG TAB
CO‐ROPINIROLE 0.25MG TAB
CO‐ROPINIROLE 1MG TAB
DOM‐BROMOCRIPTINE 2.5MG TAB
DOM‐BROMOCRIPTINE 5MG CAP
DOM‐PRAMIPEXOLE 0.25MG TAB
DOM‐PRAMIPEXOLE 1MG TAB
DOM‐ROPINIROLE 0.25MG TAB
DOM‐ROPINIROLE 0.5MG TAB
DOM‐ROPINIROLE 1MG TAB
JAMP‐ROPINIROLE 0.25MG TAB
JAMP‐ROPINIROLE 1MG TAB
MIRAPEX 0.125MG TAB
MIRAPEX 0.25MG TAB
MIRAPEX 0.25MG TAB ‐ ODB
MIRAPEX 0.375MG ER TAB
MIRAPEX 0.5MG TAB
MIRAPEX 1.5MG TAB
MIRAPEX 1.5MG TAB ‐ ODB
MIRAPEX 1MG TAB
MIRAPEX 1MG TAB ‐ ODB
MIRAPEX 3MG ER TAB
MYLAN‐PRAMIPEXOLE 0.25MG TAB
MYLAN‐PRAMIPEXOLE 1MG TAB
NOVO‐PRAMIPEXOLE 0.5MG TAB
NTP‐PRAMIPEXOLE 0.25MG TAB
NTP‐PRAMIPEXOLE 1MG TAB
NU‐BROMOCRIPTINE 2.5MG TAB
NU‐BROMOCRIPTINE 5MG CAP
PHL‐ROPINIROLE 0.25MG TAB
PHL‐ROPINIROLE 0.5MG TAB
PHL‐ROPINIROLE 1MG TAB
PMS‐BROMOCRIPTINE 2.5MG TAB
PMS‐BROMOCRIPTINE 5MG CAP
PMS‐PRAMIPEXOLE 0.25MG TAB
BROMOCRIPTINE MESYLATE
PRAMIPEXOLE DIHYDROCHLORIDE
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
2.5MG
5MG
0.125MG
0.25MG
0.5MG
0.75MG
1.5MG
1MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
5MG
0.25MG
0.5MG
1.5MG
1MG
2.5MG
2.5MG
5MG
5MG
2.5MG
5MG
0.25MG
0.5MG
1.5MG
1MG
0.25MG
1MG
2MG
5MG
2.5MG
5MG
0.25MG
0.5MG
1.5MG
1MG
0.25MG
0.5MG
1MG
2MG
5MG
0.25MG
1MG
2MG
5MG
0.125MG
0.25MG
0.25MG
0.375MG
0.5MG
0.75MG
1.5MG
1.5MG
1.5MG
1MG
1MG
3MG
4.5MG
0.25MG
0.5MG
1.5MG
1MG
0.5MG
0.25MG
0.5MG
1.5MG
1MG
2.5MG
5MG
0.25MG
0.5MG
1MG
2MG
5MG
2.5MG
5MG
0.25MG
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
165
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
283620
02290138
02290154
02290146
02326590
02326604
02326612
02326620
02326639
02309122
02336863
02338335
02344270
02367602
02309130
02334607
02338343
02344289
02367610
02309157
02334623
02338378
02343000
02344300
02367645
02309149
02334615
02338351
02344297
02367629
02325802
02325810
02325837
02325829
02314037
02314045
02314053
02314061
02314088
02288648
02288656
02288672
02288664
02232565
02232566
02232567
02232568
02240542
02240543
02232569
02332361
02345129
02353040
02332418
02332426
02345137
02353059
02332434
02345145
02353067
02332442
02345153
02353075
02315262
02315270
02315297
02315289
02346540
02346559
02346575
02346567
02346419
02346427
02346435
02346443
02269309
02269333
02269325
02331306
02331314
02331322
02331330
PMS‐PRAMIPEXOLE 1MG TAB
PMS‐ROPINIROLE 0.25MG TAB
PMS‐ROPINIROLE 0.5MG TAB
PMS‐ROPINIROLE 1MG TAB
PRAMIPEXOLE 0.25MG TAB
PRAMIPEXOLE 1MG TAB
PRAMIPEXOLE 1MG TAB
PRAMIPEXOLE 1MG TAB
PRAMIPEXOLE 1MG TAB
PRAMIPEXOLE 1MG TAB
PRO‐PRAMIPEXOLE 0.25MG TAB
PRO‐PRAMIPEXOLE 1MG TAB
RAN‐ROPINIROLE 0.25MG TAB
RAN‐ROPINIROLE 0.5MG TAB
RAN‐ROPINIROLE 1MG TAB
RATIO‐PRAMIPEXOLE 0.25MG TAB
RATIO‐PRAMIPEXOLE 1MG TAB
REQUIP 0.25MG TAB
REQUIP 0.5MG TAB
REQUIP 1MG TAB
REQUIP 2MG TAB
REQUIP 3MG TAB
REQUIP 4MG TAB
REQUIP 5MG TAB
ROPINIROLE 0.25MG TAB
ROPINIROLE 1MG TAB
ROPINIROLE 1MG TAB
ROPINIROLE 1MG TAB
ROPINIROLE 2MG TAB
ROPINIROLE 2MG TAB
ROPINIROLE 2MG TAB
ROPINIROLE 5MG TAB
ROPINIROLE 5MG TAB
ROPINIROLE 5MG TAB
SANDOZ‐PRAMIPEXOLE 0.25MG TAB
SANDOZ‐PRAMIPEXOLE 1MG TAB
SIG‐PRAMIPEXOLE 0.25MG TAB
SIG‐PRAMIPEXOLE 1MG TAB
SIG‐ROPINIROLE 0.25MG TAB
SIG‐ROPINIROLE 1MG TAB
TEVA‐PRAMIPEXOLE 0.25MG TAB
TEVA‐PRAMIPEXOLE 1.5MG TAB
TEVA‐PRAMIPEXOLE 1MG TAB
ZYM‐ROPINIROLE 0.25MG TAB
ZYM‐ROPINIROLE 0.5MG TAB
ZYM‐ROPINIROLE 1MG TAB
ZYM‐ROPINIROLE 2MG TAB
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
PRAMIPEXOLE DIHYDRO MONOHYD
PRAMIPEXOLE DIHYDROCHLORIDE MO
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
PRAMIPEXOLE
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE
ROPINIROLE
ROPINIROLE
ROPINIROLE
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE
ROPINIROLE HCL
ROPINIROLE
ROPINIROLE
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE
ROPINIROLE
ROPINIROLE HCL
ROPINIROLE
ROPINIROLE
ROPINIROLE HCL
ROPINIROLE
ROPINIROLE
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
ROPINIROLE HCL
0.5MG
1.5MG
1MG
0.25MG
0.5MG
1MG
2MG
5MG
0.25MG
0.25MG
0.25MG
0.25MG
0.25MG
0.5MG
0.5MG
0.5MG
0.5MG
0.5MG
1.5MG
1.5MG
1.5MG
1.5MG
1.5MG
1.5MG
1MG
1MG
1MG
1MG
1MG
0.25MG
0.5MG
1.5MG
1MG
0.25MG
0.5MG
1MG
2MG
5MG
0.25MG
0.5MG
1.5MG
1MG
0.25MG
0.5MG
1MG
2MG
3MG
4MG
5MG
0.25MG
0.25MG
0.25MG
0.5MG
1MG
1MG
1MG
2MG
2MG
2MG
5MG
5MG
5MG
0.25MG
0.5MG
1.5MG
1MG
0.25MG
0.5MG
1.5MG
1MG
0.25MG
1MG
2MG
5MG
0.25MG
1.5MG
1MG
0.25MG
0.5MG
1MG
2MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
166
*PA
05/2012
Therapy Class
DIN
Drug Name
283620
02331349 ZYM‐ROPINIROLE 5MG TAB
167
Chemical Name
Strength
Dosage
ROPINIROLE HCL
5MG
TAB
*PA
05/2012
Therapy Class
283632
DIN
Drug Name
MONOAMINE OXIDASE B INHIBITORS
Chemical Name
Strength
Dosage
283632
283632
283632
283632
283632
283632
283632
283632
283632
283632
02230641
02238340
02180731
00855839
02231036
02068087
02230717
02231479
02236785
02238319
APO‐SELEGILINE 5MG TAB
DOM‐SELEGILINE 5MG TAB
ELDEPRYL 1MG/ML INJ
ELDEPRYL 5MG TAB
MYLAN‐SELEGILINE 5MG TAB
NOVO‐SELEGILINE 5MG
NU‐SELEGILINE 5MG TAB
PDL‐SELEGILINE ‐5 5M
SELEGILINE 5MG TAB
SELEGILINE 5MG TAB
SELEGILINE HCL
SELEGILINE HCL
SELEGILINE HCL
SELEGILINE HCL
SELEGILINE HCL
SELEGILINE HCL
SELEGILINE HCL
SELEGILINE HCL
SELEGILINE HCL
SELEGILINE HCL
5MG
5MG
1MG/ML
5MG
5MG
5MG
5MG
5MG
5MG
5MG
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
168
*PA
05/2012
Therapy Class
289200
DIN
Drug Name
MISCELLANEOUS CENTRAL NERVOUS SYSTEM AGENTS
Chemical Name
Strength
Dosage
289200
289200
289200
289200
289200
289200
289200
289200
289200
289200
289200
289200
289200
02366487
02376334
02293269
02324067
02324059
02260638
02349116
02321130
02382830
02320908
02242763
02348950
02344807
APO‐MEMANTINE 10MG TAB
AVA‐MEMANTINE 10MG TAB
CAMPRAL 333MG DR TAB
CO MEMANTINE 10MG TAB
CO MEMANTINE 5MG TAB
EBIXA 10MG TAB
MEMANTINE 10MG TAB
PMS‐MEMANTINE 10MG TAB
PMS‐MEMANTINE 5MG TAB
RATIO‐MEMANTINE 10MG TAB
RILUTEK 50MG TAB
RIVA‐MEMANTINE 10MG TAB
SANDOZ MEMANTINE 10MG TAB
MEMANTINE HYDROCHLORIDE
ACAMPROSATE CALCIUM
MEMANTINE HCL
MEMANTINE HCL
MEMANTINE HCL
MEMANTINE HCL
MEMANTINE HCL
MEMANTINE HCL
RILUZOLE
MEMANTINE HCL
MEMANTINE HCL
10MG
10MG
333MG
10MG
5MG
10MG
10MG
10MG
5MG
10MG
50MG
10MG
10MG
TAB
TAB
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
169
*PA
05/2012
Therapy Class
360000
DIN
Drug Name
DIAGNOSTIC AGENTS
360000
360000
00980722 DIMERCAPTOSUCCINIC ACID POWDER
02246016 THYROGEN 0.9MG/ML INJ
170
Chemical Name
Strength
Dosage
*PA
DIMERCAPTOSUCCINIC ACID
THYROTROPIN ALFA
0.9MG/ML
PDR
INJ
PA (N)
05/2012
Therapy Class
362600
DIN
Drug Name
DIABETES MELLITUS
Chemical Name
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
00907731
00905348
00950883
44123021
99002884
44123033
44123007
99146753
09853081
00977060
97799938
97799823
97799824
09853626
09854002
09899671
00977124
99100214
97799814
00950949
97799815
00964646
99888750
00969079
00977062
97799963
97799941
09854282
90312254
00901370
00965960
00965979
00977070
99004364
00950900
44123026
00907227
00967386
97799496
97799497
99100791
00909459
97799939
97799959
00908924
99698373
00906697
00908193
00977031
01284860
09853162
44123006
97799961
00909556
00977061
00908290
00908312
00908479
00921076
00924061
00950661
00989967
44123008
97799940
09991086
99100096
97799869
97799868
97799927
00904945
00950878
00960217
00967157
00977471
09853693
44123019
95000147
99002604
44123038
09857293
ACCUCHECK ADVANTAGE EASY TEST
ACCU‐CHECK ADVANTAGE STRIP
ACCU‐CHECK ADVANTAGE STRIPS
ACCUCHECK AVIVA BG TEST STRIPS
ACCUCHECK EASY BG TEST STRIPS
ACCUCHECK EASY TEST STRIP
ACCUCHECK EASY TEST STRIPS
ACCUCHECK TEST STRIP
ACCU‐CHEK 1, 11, 111 REFLOULUX
ACCU‐CHEK ADV STRIP 50 (NS)
ACCU‐CHEK ADV TEST 100 (NS)
ACCU‐CHEK ADVANTAGE STRIPS
ACCU‐CHEK ADVANTAGE STRIPS
ACCUCHEK ADVANTAGE TEST STRIP
ACCU‐CHEK AVIVA BG TEST STRIPS
ACCU‐CHEK AVIVA STRIP
ACCU‐CHEK AVIVA TEST STRIP
ACCU‐CHEK AVIVA TEST STRIPS
ACCU‐CHEK AVIVA TEST STRIPS
ACCU‐CHEK AVIVA TEST STRIPS PQ
ACCUCHEK BG TEST STRIP
ACCU‐CHEK C.SOL/PARAFFIN (PQ)
ACCUCHEK COMFORT STRIP
ACCU‐CHEK COMP TEST 51 (NS)
ACCU‐CHEK COMPACT
ACCU‐CHEK COMPACT TEST STRIP
ACCU‐CHEK COMPACT TEST STRIP
ACCUCHEK COMPACT TEST STRIPS
ACCU‐CHEK COMPACT TEST STRIPS
ACCU‐CHEK COMPACT TEST STRIPS
ACCUCHEK CONTROL SOLN
ACCU‐CHEK MOBILE STRIP CASSETT
ACCUSOFT TEST STRIPS
ACCUTREND G
ACCUTREND GC TEST 50 (NS)
ACCUTREND GC TEST STRIPS
ACCUTREND GLUCOSE STRIP
ACCUTREND GLUCOSE STRIPS
ADVANTAGE COMF TEST 50 (NS)
ADVANTAGE CONTROL SOLN
ADVANTAGE GLUCOSE STRIPS
ADVANTAGE TEST STRIPS
ADVANTAGE,ACCUSOFT,ACCUSOFT MG
ASCENCIA CONTOUR TEST STRIPS
ASCENCIA CONTOUR TEST STRIPS
ASCENSIA AUTODISC CONTROL SOLN
ASCENSIA AUTODISC NORMAL CONT
ASCENSIA AUTODISC TEST 50 (NS)
ASCENSIA AUTODISC TEST STRIP
ASCENSIA AUTODISC TEST STRIPS
ASCENSIA BREEZE 2 BG TEST STRI
ASCENSIA BREEZE 2 STRIP
BLOOD GLUCOSE TEST STRIP
BLOOD GLUCOSE TEST STRIPS
CONTROL SOLUTION
CONT SOL/PARAFFIN (PQ)
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
171
Strength
Dosage
*PA
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
MISC
STRIP
STRIP
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
STRIP
STRIP
SOL
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
97799748
97799749
00964816
00950960
99100388
09991084
00977119
44123037
00950924
97799702
97799877
00964476
97799878
97799867
97799866
97799925
97799924
00907685
00950572
00977308
00980100
00987727
44123002
44123032
97799871
97799870
97799900
97799901
00977107
00900142
00901411
00950911
00963720
44123030
99100002
99401067
97799465
97799464
99100827
97799478
97799479
00999955
44123022
00960055
02423464
00990906
00977411
00990027
44123009
09853189
00909379
95000146
00977944
00977942
00977943
00930002
00999121
09941401
09949401
97799865
00920371
00977033
00980200
09853103
44123003
97799922
44123014
00906859
00977810
09857357
97799564
97799565
00909200
00964085
03921021
00909378
00920143
00903531
00909246
00920142
00950882
ASCENSIA BREEZE 2 STRIP 100
ASCENSIA BREEZE 2 STRIP 50
ASCENSIA BREEZE 2 STRIPS (PQ)
ASCENSIA BREEZE 2 TEST STRIP
ASCENSIA BREEZE 2 TEST STRIP
ASCENSIA BREEZE 2 TEST STRIPS
ASCENSIA CONTOUR BG TEST STRIP
ASCENSIA CONTOUR BG TEST STRIP
ASCENSIA CONTOUR STRIP (100)
ASCENSIA ELITE CONTROL SOLN
ASCENSIA ELITE NORMAL CONTROL
ASCENSIA ELITE TEST 25 (NS)
ASCENSIA ELITE TEST 50 (NS)
ASCENSIA ELITE TEST STRIPS
ASCENSIA MICROFILL BG TEST STR
ASCENSIA MICROFILL CONTROL SOL
ASCENSIA MICROFILL NORMAL CONT
BD LATITUDE TEST (100) NS
BD LATITUDE TEST 50 (NS)
BD LATITUDE TEST STRIP (NF)
BD LATITUDE TEST STRIPS
BG STAR TEST STRIPS (100)
BG STAR TEST STRIPS (50)
BGSTAR TEST STRIPS
BIONIME RIGHTEST GS100 STRIP
BIONIME RIGHTEST GS100 STRIP
CHECKMATE PLUS BG TEST STRIPS
CHEMSTRIP GLUCOSE TEST STRIPS
CHEMSTRIP GLUCOSE TEST STRIPS
CHEMSTRIP‐BG STRIP
CHEMSTRIP‐BG STRIP (ACCUCHEK)
CHEMSTRIP‐BG STRIP (ACCUCHEK)
CHEMSTRIP‐BG STRIP (ACCU‐CHEK)
CHEMSTRIP‐BG STRIPS (ACCUCHEK)
DEX CONTROL SOLUTION
DEX CONTROL SOLUTION
DEX CONTROL SOLUTION HIGH
DEX CONTROL SOLUTION LOW
DEX CONTROL SOLUTION NORMAL
ELITE CONTROL SOLUTION
ELITE TEST STRIPS
ELITE TEST STRIPS
ELITE TEST STRIPS
ENCORE NORMAL CONTROL
ENCORE TEST STRIPS
ENCORE TEST STRIPS
ENCORE TEST STRIPS
ENCORE TEST STRIPS
ENCORE TEST STRIPS
ENCORE TEST STRIPS 50 (NS)
EXACTECH BG TEST STRIP
EXACTECH CONTROL SOL
EXACTECH CONTROL SOL
EZ HEALTH ORACLE STRIP
EZ HEALTH ORACLE STRIP (100)
EZ HEALTH ORACLE STRIP (50)
EZ HEALTH ORACLE STRIP(MB)
FAST TAKE TEST STRIP (PQ ONLY)
FAST TAKE TEST STRIP (PQ ONLY)
FASTTAKE CONTROL SOLUTION
FASTTAKE CONTROL SOLUTION
FASTTAKE TEST STRIPS
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
172
Strength
100 STRIPS
50 STRIPS
Dosage
*PA
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
SOL
SOL
SOL
SOL
SOL
STRIP
STRIP
STRIP
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
SOL
STRIP
STRIP
STRIP
STRIP
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
00967084
00967092
00967106
09854029
44123017
95000210
09857297
00905502
97799597
97799596
99100478
00901388
00905500
00950907
00977838
09857141
44123028
99401062
99004704
97799829
97799827
00757710
00906646
99463968
00907669
99084566
09857348
44123034
97799770
99100332
00950956
97799593
97799594
00906867
97799839
99100497
00905504
97799583
97799584
09853480
09857340
97799582
97799580
97799581
99100479
00977845
99480004
99925768
00977995
00010198
00897655
00905399
00950459
00977837
00981087
00984787
09853243
44123011
99295972
09853138
09854290
44123025
99004240
99401057
00901353
00907000
00950893
00977936
97799976
97799977
97799973
97799982
97799983
97799971
97799979
97799972
97799980
97799974
97799985
97799986
99100787
FREESTYLE LITE STRIP
FREESTYLE LITE TEST STRIP
FREESTYLE LITE TEST STRIP 100
FREESTYLE LITE TEST STRIP 50
FREESTYLE LITE TEST STRIPS (PQ
FREESTYLE TEST STRIPS
FREESTYLE TEST STRIPS (PQ)
FREESTYLE TEST STRIPS 100 (NS)
FREESTYLE TEST STRIPS 50 (NS)
GLUCODEX TEST STRIPS
GLUCOFILM CONTROL SOLN
GLUCOFILM CONTROL SOLN
GLUCOFILM TEST STRIPS
HEMASTIX 50
ITEST 2.71IU BG STRIP
ITEST BLOOD GLUCOSE TEST STRIP
ITEST TEST STRIP
LIFEBRAND GLUCOSE TEST STRIP
LIFEBRAND GLUCOSE TEST STRIP
MEDISENSE CONTROL SOL
MS GLUCOSE/KETONE CONTROL SOLN
NOVA MAX TEST STRIPS
NOVAMAX TEST STRIP
NOVAMAX TEST STRIP 100
NOVAMAX TEST STRIP 50
NOVO‐GLUCOSE TEST STRIPS
ON CALL PLUS STRIP
ON‐CALL PLUS TEST STRIP 100
ON‐CALL PLUS TEST STRIP 25 (NS
ON‐CALL PLUS TEST STRIP 50 (NS
ON‐CALL PLUS TEST STRIPS (PQ)
ONE TOUCH CONTROL SOLN
ONE TOUCH FASTTAKE TEST STRIPS
ONE TOUCH TEST STRIPS
ONE TOUCH ULTRA TEST STRIP
ONE TOUCH ULTRA TEST STRIPS
ONETOUCH 100 (NS)
ONETOUCH 50 (NS)
ONETOUCH FASTTAKE
ONETOUCH FASTTAKE 100 (NS)
ONETOUCH FASTTAKE 50 (NS)
ONETOUCH NORMAL
ONETOUCH SURE STEP 100 (NS)
ONETOUCH SURESTEP
ONETOUCH SURESTEP 50 (NS)
ONETOUCH ULTRA
ONETOUCH ULTRA 100 (NS)
ONETOUCH ULTRA 50 (NS)
ONETOUCH VERIO BG TEST STRIP
CONTROL SOLUTION
CONTROL SOLUTION
HEMASTIX
MEDISENSE CONTROL SOL
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
CONTROL SOLUTION
173
Strength
Dosage
*PA
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
SOL
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
STRIP
STRIP
SOL
STRIP
SOL
STRIP
SOL
STRIP
STRIP
STRIP
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
362600
09857392
97799476
97799475
99100516
00906300
00950912
00977110
09857508
44123031
99100013
44123024
00986763
97799844
44123015
00801135
00906298
00906670
00908339
00950300
00967904
00977057
00977059
00977087
09853146
09854070
99004879
97799840
97799841
00908437
00909300
00950894
00977100
99004119
09853677
00977037
44123029
99001977
99100834
44123035
97799601
99100412
00950948
00990009
95000209
99004577
44123027
97799838
97799830
00901383
00950902
00977103
09854304
95000053
00909629
00963461
00999482
09853634
44123012
00908843
00950734
00967513
00967521
99000318
00977141
44123036
09857283
99100714
00905506
97799532
97799531
44123045
00950957
99100413
97799603
97799602
ONETOUCH VERIO TEST STRIP (ON)
ONETOUCH VERIO TEST STRIPS (50
ONETOUCH VERIO TEST STRIPS 100
ORACLE TEST STRIPS
PRECISION EASY TEST STRIPS
PRECISION EXTRA BG TEST STRIPS
PRECISION EXTRA GLUCOSE STRIPS
PRECISION PLUS ELECTRO 50 (NS)
PRECISION PLUS ELECTRODES
PRECISION PLUS TEST STRIPS
PRECISION XTRA GLUC TEST STRIP
PRECISION XTRA STRIPS
PRECISION XTRA STRIPS 100 (NS)
PRECISION XTRA STRIPS 50 (NS)
PRECISION XTRA TEST STRIPS
PRESTIGE STRIP
PRESTIGE TEST STRIPS
PRESTIGE TEST STRIPS
PRESTIGE TEST STRPS
RIGHTEST GS100 TEST STRIPS
SIDEKICK BG TEST STRIP
SIDEKICK BG TESTING SYSTEM
SIDEKICK TEST STRIP
SIDEKICK TEST STRIPS
SMART STRIP TEST STRIPS
SMART STRIP TEST STRIPS
SOF‐TACT
SOF‐TACT GLUCOSE TEST STRIPS
SOFTACT STRIPS 100 (NS)
SOFTACT STRIPS 50 (NS)
SOFTACT TEST STRIPS
SOF‐TACT TEST STRIPS
SURE STEP BG TEST STRIPS
SURE STEP CONTROL SOLUTION
SURE STEP TEST STRIPS
SURESTEP TEST STRIPS
TRUE TRACK BG TEST STRIP
TRUE TRACK BG TEST STRIP
TRUE TRACK SMART SYSTEM STRIP
TRUETEST STRIP
TRUETEST TEST STRIP
TRUETEST TEST STRIP (100)
TRUETEST TEST STRIP (50)
TRUETEST TEST STRIP (BC)
TRUETRACK TEST STRIP
TRUETRACK TEST STRIP
TRUETRACK TEST STRIP ‐ 50 (NS)
TRUETRACK TEST STRIP ‐100 (NS)
BG TEST SYSTEM WITH 50 STRIPS
CONTROL SOLUTION
174
Strength
Dosage
*PA
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
SOL
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
05/2012
Therapy Class
368800
DIN
Drug Name
URINE AND FECES CONTENTS
Chemical Name
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
97799916
00980560
00035106
00977292
09853294
99066985
00963690
00977381
97799851
97799863
97799864
00964387
97799954
97799950
97799952
97799953
00903671
00398314
97799951
00903639
00647659
99863043
00903612
00977470
00980692
99863050
00647705
00950211
00950238
97799956
00905046
00903604
00977918
00977446
00977438
00980480
97799862
97799860
97799915
00980420
00035122
00977152
00977314
99067017
00903078
00035130
00977160
00980510
00980641
99159954
97799914
97799920
97799849
97799850
97799848
00977179
00990647
99067066
00035149
00977330
97799912
00035092
00977322
00980595
09853286
99067074
97799913
97799854
97799855
00904651
00903523
00977357
99160002
97799955
00904740
00811912
00904767
00977926
97799859
97799853
ACETEST STRIPS 100 (NS)
ACETEST TAB
ACETEST TABLETS
ACETEST TABLETS
ACETEST TABLETS
ACETEST TABLETS
ALBUSTIX STRIPS
ALBUSTIX STRIPS
ALBUSTIX STRIPS 100 (NS)
CHEK‐STIX COMBO STRIPS 25 (NS)
CHEK‐STIX STRIPS 25 (NS)
CHEMSTRIP 10
CHEMSTRIP 10 (100) NS
CHEMSTRIP 4 MD 50 (NS)
CHEMSTRIP 5L 100 (NS)
CHEMSTRIP 9 100 (NS)
CHEMSTRIP 9 STRIPS
CHEMSTRIP BG
CHEMSTRIP GP 100 (NS)
CHEMSTRIP STRIPS
CHEMSTRIP UG 5000
CHEMSTRIP UG 5000
CHEMSTRIP UG 5000 K
CHEMSTRIP UG 5000 K
CHEMSTRIP UG 5000 K
CHEMSTRIP UG 5000 K
CHEMSTRIP UG 5000/K
CHEMSTRIP UG STRIPS
CHEMSTRIP UG STRIPS
CHEMSTRIP UGK STRIPS 50 (NS)
CHEMSTRIP‐4 MD STRIPS
CHEMSTRIP‐GP STRIPS
CHEMSTRIPS #9
CHEMSTRIPS GP
CHEMSTRIPS UG 5000 STRIPS
CLINISTIX
CLINITEK HCG 25 (NS)
CLINITEK MICROALBUMIN 25 (NS)
CLINITEST 100 (NS)
CLINITEST TAB
CLINITEST TABLETS
CLINITEST TABLETS
CLINITEST TABLETS
CLINITEST TABLETS
DEXTROSTIX
DIASTIX
DIASTIX
DIASTIX
DIASTIX
DIASTIX 50
DIASTIX 50 (NS)
GLUCOSTIX 100 (NS)
HEMASTIX 50 (NS)
HEMATEST NF 50 (NS)
ICTOTEST NF 100 (NS)
KETO DIASTIX
KETO DIASTIX
KETO DIASTIX
KETODIASTIX
KETO‐DIASTIX
KETO‐DIASTIX 100 (NS)
KETOSTIX
KETOSTIX
KETOSTIX
KETOSTIX
KETOSTIX
KETOSTIX 50 (NS)
LABSTIX 100 (NS)
LABSTIX SG 100 (NS)
LABSTIX SG STRIP
LABSTIX STRIP
LABSTIX STRIP
LABSTIX STRIPS (100)
MICRAL‐TEST II TEST 30 (NS)
MULTISTIX
MULTISTIX 10 SG
MULTISTIX 10 SG
MULTISTIX 10 SG
MULTISTIX 10 SG 100 (NS)
MULTISTIX 100 (NS)
URINE TEST STRIP
URINE TEST TAB
URINE TEST TAB
URINE TEST TAB
URINE TEST TAB
URINE TEST TAB
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST TAB
URINE TEST TAB
URINE TEST TAB
URINE TEST TAB
URINE TEST TAB
URINE TEST TAB
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST TAB
URINE TEST TAB
KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
URINE KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
LABSTIX STRIPS (100)
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
175
Strength
Dosage
*PA
STRIP
TAB
TAB
TAB
TAB
TAB
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
TAB
TAB
TAB
TAB
TAB
TAB
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
TAB
TAB
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
368800
400800
97799856
97799858
00904783
00904759
00977586
00951161
97799470
97799835
00963755
00950896
00909386
00999957
97799852
00904988
97799857
00977365
99160028
00903159
02353997
MULTISTIX 5 100 (NS)
MULTISTIX 8 SG 100 (NS)
MULTISTIX 8 SG STRIPS
MULTISTIX SG
MULTISTIX STRIPS 2820
NOVAMAX PLUS KETONE TEST STRIP
NOVAMAX PLUS KETONE TEST STRIP
PRECISION XTRA BLOOD KET 8(NS)
PRECISION XTRA CETONES
PRECISION XTRA KETONE
PRECISION XTRA KETONE TEST STR
URINE TEST STRIPS (AB DIN)
URISTIX 100 (NS)
URISTIX 4
URISTIX 4 100 (NS)
URISTIX STRIP
URISTIX STRIP
URISTIX STRIP / GLYCERINE (PQ)
UROCIT‐K TAB
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
KETONE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
URINE TEST STRIP
POTASSIUM CITRATE
176
Strength
Dosage
1080MG
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
STRIP
TAB
*PA
05/2012
Therapy Class
401200
DIN
Drug Name
REPLACEMENT PREPARATIONS
Chemical Name
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
401200
00644684
02244130
00722383
02244161
00718343
02240977
02246178
02240973
02246180
02238582
02239458
02231961
02231833
00722405
02150166
00208701
01918303
00704504
00713376
00810231
00224227
00224235
00621919
00039500
00039640
02229437
00466670
00554308
00074225
02279754
CALC CARBONATE
CALCITE 500 + D 400 TAB
CALCIUM 250MG CHEWABLE TAB
CALCIUM 500 + D 400 TAB
CALCIUM 500MG TAB
CALCIUM 500MG TAB
CALCIUM 500MG TAB
CALCIUM 500MG WITH VITAMIN D
CALCIUM 500MG WITH VITAMIN D
CALCIUM 500MG&VIT D 200IU TAB
CALCIUM 600 + VITAMIN D
CALCIUM CITRATE 200MG TAB
CALCIUM CITRATE 300MG TAB
CALCIUM LACTATE 648MG TAB
CITRACAL 500MG TAB
ELIXIR KAON 4.68GM
K‐10 LIQ 20MEQ/15ML
KAY CIEL LIQ 1.5GM/15ML
K‐DUR SRT 1500MG
K‐MED 900 TAB 900MG
LMD 10% IN 0.9% SOD CHLOR
LMD 10% IN DEXTROSE 5%
MEGA‐CAL TAB
NORMOSOL R INJ
NORMOSOL R W DEXTROSE 5% INJ
PHOSLO 667MG TAB
POT CHLOR 0.15%/5% DEX W 0.45%
SLO‐POT 600MG TAB
SLOW K 600MG TAB
SODIUM CHLORIDE 0.9% INJ
CALC CARBONATE
CALCIUM/VITAMIN D3
CALCIUM
CALCIUM AND VITAMIN D
CALCIUM CARBONATE
CALCIUM
CALCIUM CARBONATE
CALCIUM/VITAMIN D3
CALCIUM/VITAMIN D3
CALCIUM/VITAMIN D3
CALCIUM/VITAMIN D
CALCIUM CITRATE
CALCIUM CITRATE
CALCIUM LACTATE
CALCIUM CITRATE
POTASSIUM GLUCONATE
POTASSIUM CHLORIDE
POTASSIUM CHLORIDE
POTASSIUM CHLORIDE
POTASSIUM CHLORIDE
DEXTRAN/SODIUM CHLORIDE
DEXTRAN/DEXTROSE
MEGA CAL
ELECTROLYTES
DEXTROSE/ELECTROLYTES
CALCIUM ACETATE
POTASSIUM CHLORIDE/DEXTROSE
POTASSIUM CHLORIDE
POTASSIUM CHLORIDE
SODIUM CHLORIDE
177
Strength
250MG
500MG
500MG
500MG
500MG/125U
500MG/125U
500MG/200I
600MG
200MG
300MG
648MG
500MG
1.33MEQ/ML
10%
1.5G/15ML
1500MG
900MG
0.9%
5%
5%
667MG
50MG/ML
600MG
600MG
0.9%
Dosage
*PA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAPL
TAB
TAB
TAB
TAB
O/L
O/L
LIQ
TAB LA
TAB
INJ
INJ
TAB
INJ
INJ
TAB
SOL
TAB LA
TAB
INJ
05/2012
Therapy Class
401800
DIN
Drug Name
ION-REMOVING AGENTS
Chemical Name
Strength
Dosage
401800
401800
401800
401800
401800
401800
401800
401800
01902776
00033197
02026961
00765252
02261677
00769533
00769541
00755338
KAYEXALATE
KAYEXALATE 100%
KAYEXALATE 1MEQ/G PWS
K‐EXIT 1MMOL/G
PHL‐SODIUM POLYSTYRENE SULFONA
PMS‐SOD POLYSTYREN SULF ENEMA
PMS‐SOD POLYSTYRENE SULF SUSP
PMS‐SODIUM POLYSTERENE SULFONA
POLYSTYRENE SODIUM SULFONATE
SODIUM POLYSTYRENE SULFONATE
POLYSTYRENE SODIUM SULFONATE
POLYSTERENE SULFONATE SODIUM
POLYSTERENE SULFONATE SODIUM
POLYSTRENE SULFONATE SODIUM
1MEQ/G
1MEQ
1 MEQ/G
100%
94.3MG/G
30G
250MG/ML
1MEQ/G
PDR
O/L
PDR
MISC
PDR
ENEMA
O/L
PDR
178
*PA
05/2012
Therapy Class
401819
DIN
Drug Name
PHOSPHATE-REMOVINGAGENTS
401819
401819
02244310 RENAGEL 800MG TAB
02354586 RENVELA 800MG TAB
179
Chemical Name
Strength
Dosage
SEVELAMER HCL
SEVELAMER CARBONATE
800MG
800MG
TAB
TAB
*PA
05/2012
Therapy Class
402000
DIN
Drug Name
CALORIC AGENTS
402000
402000
402000
02144336 CARNITOR 100MG/ML SY
02144344 CARNITOR 200MG/ML
02144328 CARNITOR 330MG TAB
180
Chemical Name
Strength
Dosage
LEVOCARNITINE
LEVOCARNITINE
LEVOCARNITINE
100MG/ML
200MG/ML
330MG
O/L
INJ
TAB
*PA
05/2012
Therapy Class
402808
DIN
Drug Name
LOOP DIURETICS
Chemical Name
Strength
Dosage
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
402808
00396788
00362166
00707570
02344238
02344246
02344254
02229812
02364573
02364581
02364603
02247371
02247372
00728284
00728276
02248124
02248125
02258528
02360365
02351420
02351439
02351447
00527033
00565040
02360446
00401633
01900943
02224690
02224720
01987550
02224755
02224704
00337730
00337749
00765953
02348292
02348306
02348314
02239224
02239225
00496723
00397792
00667080
02294389
02294397
02247493
02247494
APO‐FUROSEMIDE 20MG TAB
APX‐FUROSEMIDE 20MG TAB
AURINEX 0.5MG TAB
AVA‐FUROSEMIDE 20MG TAB
BIO‐FUROSEMIDE 20MG TAB
BIO‐FUROSEMIDE 40MG TAB
BURINEX 1MG TAB
BURINEX 5MG TAB
DOM‐FUROSEMIDE 20MG TAB
DOM‐FUROSEMIDE 40MG TAB
EDECRIN 25MG TAB
FUROSEMIDE 10MG INJ
FUROSEMIDE 20MG TAB
FUROSEMIDE 40MG TAB
FUROSEMIDE 80MG TAB
FUROSEMIDE INJ 10MG/ML
FUROSEMIDE INJ 10MG/ML
FUROSEMIDE SPECIAL 10MG INJ
FUROSEMIDE SPECIAL IV 10MG/ML
FUROSEMIDE TAB 40MG USP
LASIX 20MG TAB
LASIX ORAL SOL 10MG/ML
LASIX SPECIAL 10MG/ML INJ
LASIX SPECIAL 500MG TAB
LASIX TAB 40 MG
NOVO‐SEMIDE TAB 20MG
NTP‐FUROSEMIDE 20MG TAB
NU‐FUROSEMIDE 20MG TAB
NU‐FUROSEMIDE 40MG TAB
PDL‐FUROSEMIDE 20 TAB
PDL‐FUROSEMIDE 40MG TAB
PDL‐FUROSEMIDE 80MG TAB
PHL‐FUROSEMIDE 20MG TAB
PHL‐FUROSEMIDE 40MG TAB
PMS‐FUROSEMIDE 20MG TAB
PMS‐FUROSEMIDE 40MG TAB
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
BUMETANIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
BUMETANIDE
BUMETANIDE
FUROSEMIDE
FUROSEMIDE
ETHACRYNIC ACID
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
FUROSEMIDE
20MG
40MG
80MG
20MG
40MG
80MG
0.5MG
20MG
40MG
80MG
20MG
40MG
1MG
5MG
20MG
40MG
25MG
10MG
20MG
40MG
80MG
10MG/ML
10MG/ML
10MG
10MG/ML
40MG
20MG
10MG/ML
10MG/ML
500MG
40MG
20MG
40MG
80MG
20MG
40MG
80MG
20MG
40MG
20MG
40MG
80MG
20MG
40MG
20MG
40MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
INJ
INJ
INJ
INJ
TAB
TAB
O/L
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
181
*PA
05/2012
Therapy Class
402816
DIN
Drug Name
POTASSIUM-SPARING DIURETICS
Chemical Name
Strength
Dosage
402816
402816
402816
402816
402816
402816
402816
402816
402816
402816
402816
402816
402816
402816
402816
02257394
02249510
00784400
00441775
00299715
02257378
01937219
00886106
00865532
00870943
02231254
00519367
02240846
02083450
00532657
AMILORIDE HYDROCHLORIDE TAB
APO‐AMILORIDE 5MG TAB
APO‐AMILZIDE TAB
APO‐TRIAZIDE TAB
DYRENIUM 50 TABLETS
MYLAN‐AMILAZIDE 50MG/5MG TAB
NOVAMILOR TAB
NU‐AMILZIDE TAB
NU‐TRIAZIDE TAB
PDL‐AMI‐HYDRO TAB
PENTA‐AMILORIDE HCTZ TAB
PRO‐TRIAZIDE TAB
RIVA‐ZIDE 50MG/25MG TAB
TARO‐AMILOR
TEVA‐TRIAMTERENE/HCTZ TAB
AMILORIDE HYDROCHLORIDE
AMILORIDE HCL
AMILORIDE/HCTZ
HCTZ/TRIAMTERENE
TRIAMTERENE
HCTZ/AMILORIDE HCL
AMILORIDE/HCTZ
AMILORIDE/HCTZ
TRIAMTERENE/HCTZ
AMILORIDE/HCTZ
AMILORIDE HCL/HCTZ
HCTZ/TRIAMTERENE
TRIAMTERENE/HYDROCHLOROTHIAZID
AMILORIDE HCL/HCTZ
TRIAMTERENE/HCTZ
5MG
5MG
5/50MG
25/50MG
50MG
50MG/5MG
5/50MG
5/50MG
25/50MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
182
5/50MG
25/50MG
50MG/25MG
5/50MG
25/50MG
*PA
05/2012
Therapy Class
402820
DIN
Drug Name
THIAZIDE DIURETICS
Chemical Name
Strength
Dosage
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
402820
00594377
00180408
00644552
02327856
00326844
00312800
02363879
02363968
02363976
02247170
02247171
02248134
02248135
00532088
02360594
02360608
02170639
02170647
00021474
00021482
02335824
02250659
02250667
02319616
02319624
02319632
00341975
02274086
02247386
02247387
02083493
00613231
00657182
ALDACTAZIDE 50 TAB
ALDACTAZIDE‐25 TAB
APO‐HYDRO 100MG TAB
APO‐HYDRO 12.5MG TAB
AVA‐HYDROCHLOROTHIAZIDE 12.5MG
AVA‐HYDROCHLOROTHIAZIDE 25MG
AVA‐HYDROCHLOROTHIAZIDE 50MG
BIO‐HYDROCHLOROTHIAZIDE 25MG
BIO‐HYDROCHLOROTHIAZIDE 50MG
DOM‐HYDROCHLOROTHIAZIDE 25MG
DOM‐HYDROCHLOROTHIAZIDE 50MG
HYDROCHLOROTHIAZIDE 100 TAB
HYDROCHLOROTHIAZIDE 25MG TAB
HYDROCHLOROTHIAZIDE 50MG TAB
MAXZIDE TAB
MAXZIDE TAB
NOVOHYDRAZIDE 25MG
NOVO‐HYDRAZIDE 50MG TAB
NU‐HYDRO 12.5MG TAB
NU‐HYDRO 25MG TAB
NU‐HYDRO 50MG TAB
OLMETEC PLUS 20MG/12.5MG TAB
OLMETEC PLUS 40MG/12.5MG TAB
OLMETEC PLUS 40MG/25MG TAB
PDL‐HYDROCHLOROTHIAZIDE TAB 25
PMS‐HYDROCHLOROTHIAZIDE 12.5MG
PMS‐HYDROCHLOROTHIAZIDE 25MG
PMS‐HYDROCHLOROTHIAZIDE 50MG
TARO‐TRIAMZIDE
TEVA‐SPIROZINE 25MG TAB
TEVA‐SPIROZINE 50 MG TAB
HCTZ/SPIRONOLACTONE
HCTZ/SPIRONOLACTONE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
TRIAMTERENE/CHLOROTHIAZIDE
TRIAMTERENE/CHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
OLMESARTAN MEDOXOMIL/HCTZ
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE
TRIAMTERENE/HCTZ
SPIRONOLACTONE/HCTZ
SPIRONOLACTONE/HCTZ
50/50MG
25/25MG
100MG
12.5MG
25MG
50MG
12.5MG
25MG
50MG
25MG
50MG
25MG
50MG
100MG
25MG
50MG
37.5/25MG
75/50MG
25MG
50MG
12.5MG
25MG
50MG
20/12.5MG
40/12.5MG
40/25MG
25MG
12.5MG
25MG
50MG
50/25MG
25/25MG
50/50MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
183
*PA
05/2012
Therapy Class
402824
DIN
Drug Name
THIAZIDE-LIKE DIURETICS
Chemical Name
Strength
Dosage
*PA
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402824
402828
402828
402828
00360287
00360279
02245246
02223678
02341166
02341182
02364611
02364638
02239913
02239917
02247229
02286963
02230030
02286971
02365324
02373904
02373912
02179709
00564966
02241018
02240067
02153483
02231184
02362015
02337118
02223597
02049341
02240349
02240350
02239619
02239620
02227339
02312530
02312549
02247245
02242125
02188910
00888400
00301663
00301698
02370468
02370476
02370484
APO‐CHLORTHALIDONE 100MG TAB
APO‐CHLORTHALIDONE 50MG TAB
APO‐INDAPAMIDE 1.25MG TAB
APO‐INDAPAMIDE 2.5MG TAB
APX‐INDAPAMIDE 1.25MG TAB
APX‐INDAPAMIDE 2.5MG TAB
AVA‐INDAPAMIDE 1.25MG TAB
AVA‐INDAPAMIDE 2.5MG TAB
DOM‐INDAPAMIDE 1.25MG TAB
DOM‐INDAPAMIDE 2.5MG TAB
INDAPAMIDE 1.25MG TAB
JAMP‐INDAPAMIDE 1.25MG TAB
JAMP‐INDAPAMIDE 2.5MG TAB
LOZIDE TAB 1.25MG
LOZIDE TAB 2.5MG
MED‐INDAPAMIDE 1.25MG TAB
MYLAN‐INDAPAMIDE 1.25MG TAB
MYLAN‐INDAPAMIDE 2.5 MG TAB
NOVO‐INDAPAMIDE 2.5MG TAB
NTP‐INDAPAMIDE 2.5MG TAB
NU‐INDAPAMIDE 1.25MG TAB
NU‐INDAPAMIDE 2.5 MG TAB
PDL‐INDAPAMIDE 2.5MG TAB
PHL‐INDAPAMIDE 1.25MG TAB
PHL‐INDAPAMIDE 2.5MG TAB
PMS‐INDAPAMIDE 1.25MG TAB
PMS‐INDAPAMIDE 2.5MG TAB
PRO‐INDAPAMIDE 1.25MG TAB
RIVA‐INDAPAMIDE 1.25MG TAB
RIVA‐INDAPAMIDE 2.5MG TAB
TRIA‐INDAPAMIDE 2.5 MG TAB
ZAROXOLYN 2.5MG TAB
ZAROXOLYN TAB 2.5MG
ZAROXOLYN TAB 5MG
SAMSCA 15MG TAB
SAMSCA 30MG TAB
SAMSCA 60MG TAB
CHLORTHALIDONE
CHLORTHALIDONE
INDAPAMIDE HEMIHYDRATE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
INDAPAMIDE
METOLAZONE
METOLAZONE
METOLAZONE
TOLVAPTAN
TOLVAPTAN
TOLVAPTAN
100MG
50MG
1.25MG
2.5MG
1.25MG
2.5MG
1.25MG
2.5MG
1.25MG
2.5MG
1.25MG
1.25MG
2.5MG
2.5MG
2.5MG
1.25MG
2.5MG
1.25MG
2.5MG
1.25MG
1.25MG
2.5MG
2.5MG
2.5MG
1.25MG
2.5MG
2.5MG
1.25 MG
2.5MG
1.25MG
2.5MG
1.25MG
1.25MG
2.5MG
1.25MG
2.5MG
2.5MG
2.5MG
2.5MG
5MG
15MG
30MG
60MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
PA (N)
PA (N)
PA (N)
184
05/2012
Therapy Class
403600
DIN
Drug Name
IRRIGATING SOLUTIONS
403600
403600
00905224 EAU POUR INJECT
00899569 SOLUTION DE CHLORURE DE
185
Chemical Name
Strength
Dosage
EAU POUR INJECT
SODIUM CHLORIDE
0.90%
INJ
LIQ
*PA
05/2012
Therapy Class
404000
DIN
Drug Name
URICOSURIC AGENTS
Chemical Name
Strength
Dosage
404000
404000
404000
404000
404000
00441767
00294926
02045699
02083434
02083442
APO‐SULFINPYRAZONE 200MG TAB
BENURYL TAB 500MG
NU‐SULFINPYRAZONE 200 MG
TARO‐SULFINPYRAZONE 100MG TAB
TARO‐SULFINPYRAZONE 200MG TAB
SULFINPYRAZONE
PROBENECID
SULFINPYRAZONE
SULFINPYRADONE
SULFINPYRADONE
200MG
500MG
200MG
100MG
200MG
TAB
TAB
TAB
TAB
TAB
186
*PA
05/2012
Therapy Class
440000
DIN
Drug Name
ENZYMES
Chemical Name
Strength
Dosage
*PA
440000
440000
440000
440000
02248966
02248965
02046733
02249057
FABRAZYME 35MG/VIAL INJ
FABRAZYME 5MG/VIAL INJ
PULMOZYME 1MG/ML INH
REPLAGAL 1MG/ML INJ
AGALSIDASE BETA
AGALSIDASE BETA
DORNASE ALFA RECOMBINANT
AGALSIDASE ALFA
35MG/VIAL
5MG/VIAL
1MG/ML
1MG/ML
INJ
INJ
INH
INJ
PA (N)
PA (N)
187
PA (N)
05/2012
Therapy Class
480800
DIN
Drug Name
ANTITUSSIVES
Chemical Name
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
480800
481000
02244011
02245709
02198630
00501654
00068756
00068594
00068608
02224577
00535133
02243063
00507407
02230769
00493082
00172650
02244080
02244079
00656828
02244078
01916580
00585580
01916599
01916564
01916521
00147656
00642487
00642460
02049481
00642452
00642479
02049473
02324253
00550477
00694827
02053403
02169126
00316970
00172502
01934740
00557781
00557803
01916963
01916971
00520284
00520292
02359456
BALMINIL CODEINE & DECON/EXP
BENYLIN2 COLD&FLU WITH CODEINE
CALMYLIN AC SYRUP
CHERACOL SYR
COACTIFED EXPECTORANT O/L
COACTIFED SYRUP
COACTIFED TAB
COPHYLAC DROP
CORHISTINE DH
COVAN COUGH SYRUP
DALMACOL
DALMACOL SYR
DIMETANE EXP C
DIMETANE EXPECTORANT DC
DIMETANE EXPECTORANT DC
DIMETANE EXPECTORANT‐C SYRUP
DIMETAPP‐C SYRUP
DIMETAPP‐C SYRUP
HYCODAN 1MG/ML SYRUP
HYCODAN SYRUP 1MG/ML
HYCODAN TAB 5MG
HYCOMINE
HYCOMINE S PED SYRUP
NEO PECTOL O/L
NOVAHISTEX C ELIXIR
NOVAHISTEX DH ADULT
NOVAHISTEX DH ADULT
NOVAHISTEX DH EXPECT
NOVAHISTINE DH CHILD
NOVAHISTINE DH CHILD
PMS‐HYDROCODONE 1MG/ML O/L
RATIO‐CALMYDONE LIQ
RATIO‐CORISTEX‐DH O/L
RATIO‐COTRIDIN EXPECTORANT O/L
RATIO‐COTRIDIN SYRUP
ROBIDONE
ROBITUSSIN AC LIQ
ROBITUSSIN AC LIQ
TUSSAMINIC C FORTE
TUSSAMINIC C PED
TUSSIONEX 5MG/10MG SR TAB
TUSSIONEX 5MG+10MG/5ML SUSP
TUSSIONEX SUS
TUSSIONEX TAB
DAXAS 500MCG TAB
COD PHOS/GUAIF/PSEUDOEPHED HCL
COD PHOS/GUAIF/PSEUDOEPHED HCL
CODEINE PHOS/GUAIFENESIN/PHENI
CODEINE/GUAIFENESIN COMPOUND
GUAIFENESIN/CODEINE/PSEUDOEPH
TRIPROLIDINE/CODEINE/PSEUDOEPH
HYDROXYEPHEDRINE/NORMETHADONE
HYDROCODONE BITARTRATE
HYDROCODONE/ETAFEDRIN/DOXYLAMI
DOXYLAMINE/ETAFEDRIN/SODIUM
BROMPHENIRAMINE MALEATE
BROMPHENIRAMINE MALEATE D C
HYDROCODONE/GUAIFENES/BROMPHEN
CODEINE/BROMPHEN/GUAIFEN/PHENY
BROMPHENIRAMINE/PHENYLEPHRINE
BROMPHENIRAMINE/CODEINE/PHENYL
1 MG/ML
1MG/ML
5MG
HYDROCODONE/PYRILAMINE/PHENYLE
HYDROCODONE/PYRILAMINE/PHENYLE
CODEINE/IPECAC/POTASSIUM/SQUIL
CODEINE PHOS/PHENYLEPHRINE
15MG/20MG
PHENYLEPHRINE/HYDROCODONE
PHENYLEPHRINE/HYDROCODONE
PHENYLEPHRINE/HYDROCODONE/GUAI
HYDROCODONE/PHENYLEPHRINE
1MG/ML
CALMYDONE
CODEINE/GUAIFENESIN/TRIPROLIDI
1MG
PYRILAMIN/CODEINE /PHENYLPROPA
PYRILAMIN/CODEINE /PHENYLPROPA
HYDROCODONE/PHENYLTOLOXAMINE 5MG/10MG
HYDROCODONE/PHENYLTOLOXAMINE 5MG/10MG
HYDROCODONE/PHENYLTOLOXAMINE
HYDROCODONE/PHENYLTOLOXAMINE
ROFLUMILAST
500MCG
188
Strength
Dosage
*PA
O/L
O/L
O/L
O/L
O/L
O/L
TAB
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
TAB
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
O/L
TAB LA
O/L
O/L
TAB
TAB
05/2012
Therapy Class
481032
DIN
Drug Name
MAST-CELL STABILIZERS
Chemical Name
Strength
Dosage
481032
481032
481032
481032
481032
481032
481032
481032
481032
481032
02132583
02131617
02145448
02237378
00500895
02231671
02237190
02046113
02230288
00328944
DOM‐SODIUM CROM 2% NAS
DOM‐SODIUM CROM 2% OPH SOL
DOM‐SODIUM CROMOGLYCATE NEBULI
MED‐CROMOGLYCATE 1% INH SOL
NALCROM 100MG CAP
NU‐CROMOLYN 10MG/ML INH SOL
PDL‐CROMOLYN 1% STERULES INH
PMS‐SOD CROMOGLYCATE 10MG/ML
RYNACROM 2% NASAL SPRAY
RYNACROM ENCAPSULATED PWR
DISODIUM CROMOGLYCATE
DISODIUM CROMOGLYCATE
CROMOLYN SODIUM
CROMOLYN SODIUM
CROMOLYN SODIUM
CROMOLYN SODIUM
CROMOLYN SODIUM
SODIUM CROMOGLYCATE
SODIUM CROMOGLYCATE
SODIUM CROMOGLYCATE
2%
2%
1%
1%
100MG
10MG/ML
1%
1%
2%
10MG
NAS SOL
OP SOL
LIQ
INH SOL
CAP
INH SOL
INH SOL
SOL
NAS SPR
PDR
189
*PA
05/2012
Therapy Class
520200
DIN
Drug Name
ANTIALLERGIC AGENTS
Chemical Name
Strength
Dosage
520200
520200
520200
520200
520200
520200
02231390
02131625
02020017
02233143
02242324
02279223
APO‐CROMOLYN 2% NAS SOL
LIVOSTIN EYE DROPS
LIVOSTIN NASAL SPRAY
PATANOL 0.1% OPH SOL
ZADITOR 0.25MG/ML OPH SOL
ZADITOR 0.25MG/ML OPH SOL
CROMOLYN SODIUM
LEVOCABASTINE HCL
LEVOCABASTINE
OLOPATADINE HCL
KETOTIFEN FUMARATE
KETOTIFEN FUMARATE
2%
0.5MG/ML
0.5MG/ML
0.1%
0.25MG/ML
0.25MG/ML
NAS SOL
OP SOL
NAS SPR
OP SOL
OP SOL
OP SOL
190
*PA
05/2012
Therapy Class
520404
DIN
Drug Name
ANTIBIOTICS
Chemical Name
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
520404
00622958
00622966
00627720
02023822
00635065
02263130
02248398
02278219
02242473
02321661
02345498
02336847
02247446
00001287
02200864
01945270
02240035
02252716
02238710
02023857
02026260
02023776
02023830
02238818
02326663
02237041
00001058
02242360
02243862
00028339
00512192
00512184
01989073
00832162
00403474
02148404
00601659
02333228
02143291
02247189
02243025
00807435
02164051
00704571
00704598
01980564
01980556
00861383
02253933
01912755
00776521
02238819
02252570
02240363
00838934
02239577
02239156
02239157
02011956
02229440
02229441
02230888
02241755
02219581
02224887
02224860
02224895
00028053
00792594
00513962
00614254
02261243
02239234
02252260
02257270
AK CHLOR LIQ 0.5%
AK SULF LIQ 10%
AK‐CHLOR 1% OPH OINT
AK‐DIOGENT 0.3% OPH SOL
AK‐SPOR OPH SOL
APO‐CIPROFLOX 0.3% OPH SOL
APO‐OFLOXACIN 0.3% OP SOL
ARESTIN MICROSPHERES 1MG/4MG
ATRIDOX 44MG/UNIT DENTAL GEL
AZASITE 1% OP SOL
AZASITE 1% OPH SOL
BESIVANCE 0.6% OPH SUSP
BETAMYCIN OP/OT SOL
BLEPH 10 OPH SOL
CILOXAN 0.3% OPH OINT
CILOXAN 0.3% OPH SOL
CIPRO HC OTIC SUSP
CIPRODEX OTIC SOL
CROWN AK‐TOBRA 3MG/ML OPH SOL
DICHLORAM OPH SOL 0.5%
DIOCHLORAM 1% OPH OINT
DIOGENT OPH OINT 0.30%
DIOSULF 10% OPH SOL
DOM‐GENTAMICIN‐BETAMETHASONE
ERYTHROMYCIN 0.50% OPTH OINT
ERYTHROMYCIN 5MG OPH OINT
FENICOL OINT 1%
FLOXIN OTIC 0.3% DROPS
FUCITHALMIC VISCOUS EYE DROPS
GARAMYCIN OPH OINT
GARAMYCIN OPH SOL 3MG/ML
GARAMYCIN OTIC SOL 3MG/ML
GENTAC OP OINT
GENT‐AK
ISOPTO FENICOL OPH SOL 0.5%
MINIMS GENTAMICIN SULFATE 0.3%
NEOSPORIN OPH/OTIC DROPS
NU‐CIPROFLOX 0.3% OP SOL
OCUFLOX 0.3% OPH SOL
OFLOXACIN 0.3% OP SOL
OPHTHO‐FLOX 0.3% OPH SOLUTION
OPTIMYXIN PLUS OPH/OT DROPS
PENTAMYCETIN 0.5% OPH SOL
PENTAMYCETIN OINT 1%
PENTAMYCETIN OPH LIQ 2.5MG/ML
PENTAMYCETIN OPH OINT 1%
PENTAMYCETIN OPH SOL 0.25%
PMS‐CHLORAMPHENICOL
PMS‐CIPROFLOXACIN 0.3% OPH SOL
PMS‐ERYTHROMYCIN 0.5% OPH OIN
PMS‐GENTAMICIN 0.3% OPH SOL
PMS‐GENTAMICIN‐BETAMETHASONE
PMS‐OFLOXACIN 0.3% OPH SOL
PMS‐POLYTRIMETHOPRIM OPH SOL
PMS‐SULFACETAMIDE 10% OPH SOL
PMS‐TOBRAMYCIN 0.3% OPH SOL
POLYSPORIN EYE & EAR DROPS
POLYSPORIN STERILE OPH OINT
POLYTRIM OPH SOL
SANDOZ GENTAMICIN 0.3% OPH SOL
SANDOZ GENTAMICIN 3MG/ML SOL
SANDOZ GENTAMICIN SULF OP 0.3%
SANDOZ TOBRAMYCIN 3MG/ML SOL
SCHEIN‐GENTAMICIN OPH 3MG/ML
SOFRAMYCIN 0.5% OPH DROPS
SOFRAMYCIN NASAL SPRAY
SOFRAMYCIN STERILE EYE OINT
SULAMYD 10% OPH SOL
TETRACYCLINE 1% OPH OINT
TOBREX 0.3% OPH SOL
TOBREX OPH OINT 3MG/G
TOBREXAN 0.3% OPH SOLUTION
TRIMETHOPRIM/POLYMYXIN B SULF
VIGAMOX 0.5% OPH SOL
ZYMAR 3MG/ML OPH SOL
CHLORAMPHENICOL
0.5%
SULFACETAMIDE SODIUM
10%
CHLORAMPHENICOL
1%
GENTAMICIN SULFATE
0.30%
GRAMICIDIN/NEOMYCIN/POLYMYXIN
CIPROFLOXACIN HCL
0.3%
OFLOXACIN
0.3%
MINOCYCLINE HCL
1MG/4MG
DOXYCYCLINE
44MG/UNIT
AZITHROMYCIN
1%
AZITHROMYCIN
1%
BESIFLOXACIN
0.6%
GENTAMICIN SULPHATE/BETAMETHAS 3MG‐1MG/ML
10%
CIPROFLOXACIN HCL
0.3%
CIPROFLOXACIN HCL
0.3%
CIPROFLOXACIN/ HYDROCORTISONE
0.2%/1%
CIPROFLOXACIN HCL/DEXAMETHASON 0.3%/0.1%
TOBRAMYCIN
3MG/ML
CHLORAMPHENICOL
0.50%
CHLORAMPHENICOL
1%
GENTAMICIN SULFATE
0.30%
10%
BETAMETHASONE SOD PHOS/GENTAMI 1MG/3MG/ML
ERYTHROMYCIN
0.50%
ERYTHROMYCIN
5MG
CHLORAMPHENICOL
1%
OFLOXACIN
0.3%
FUSIDIC ACID
10MG/GM
GENTAMICIN SULFATE
0.3%
GENTAMICIN SULFATE
3MG/ML
GENTAMICIN SULFATE
3MG/ML
GENTAMICIN
0.30%
GENTAMICIN
CHLORAMPHENICOL
0.5%
GENTAMICIN SULFATE
0.3%
POLYMYXINE /NEOMYCIN/GRAMICIDI
CIPROFLOXACIN HCL
0.3%
OFLOXACIN
0.30%
OFLOXACIN
0.3%
OFLOXACIN
0.3%
POLYMYXIN/GRAMICIDIN/NEOMYCIN
CHLORAMPHENICOL
0.50%
CHLORAMPHENICOL
1%
CHLORAMPHENICOL
2.5MG/ML
CHLORAMPHENICOL
1%
CHLORAMPHENICOL
0.25%
CHLORAMPHENICOL
0.50%
CIPROFLOXACIN HCL
0.3%
ERYTHROMYCIN HCL
0.50%
GENTAMICIN SULFATE
0.30%
BETAMETHASONE SOD PHOS/GENTAMI 1MG/3MG/ML
OFLOXACIN
0.3%
TRIMETHOPRIM/POLYMYXIN B SULFA 1MG/10000U
10%
TOBRAMYCIN
0.3%
POLYMIXIN B SULF/GRAMICIDIN
BACITRACIN/POLYMYXIN B SULFATE
TRIMETHOPRIM SULFATE/POLYMYXIN 1MG/ML
GENTAMICIN SULFATE
0.30%
GENTAMICIN SULFATE
0.30%
GENTAMICIN SULFATE
0.30%
TOBRAMYCIN
3MG/ML
GENTAMICIN SULFATE
0.30%
FRAMYCETIN SULFATE
0.50%
FRAMYCETIN/GRAMICID/PHENYLEPH
FRAMYCETIN SULFATE/GRAMICIDIN
0.50%
10%
TETRACYCLINE
1%
TOBRAMYCIN
0.3%
TOBRAMYCIN
3MG/G
TOBRAMYCIN
0.3%
TRIMETHOPRIM AND POLYMYXIN B
1MG/ML
MOXIFLOXACIN HCL
0.5%
GATIFLOXACIN
3MG/ML
191
Strength
Dosage
*PA
OP SOL
OP SOL
OP OINT
OP SOL
OP SOL
OP SOL
OP SOL
PDR
GEL
OP SOL
OP SOL
OP SOL
O/O SOL
OP SOL
OP OINT
OP SOL
OT SOL
OT SOL
OP SOL
OP SOL
OP OINT
OP OINT
OP SOL
O/O SOL
OP OINT
OP OINT
OP OINT
OT SOL
OP SOL
OP OINT
OP SOL
OT SOL
OP OINT
OP SOL
OP SOL
OP SOL
O/O SOL
OP SOL
OP SOL
OP SOL
OP SOL
O/O SOL
OP SOL
OP OINT
OP SOL
OP OINT
OP SOL
OP SOL
OP SOL
OP OINT
OP SOL
O/O SOL
OP SOL
OP SOL
OP SOL
OP SOL
O/O SOL
OP OINT
OP SOL
OP SOL
OT SOL
OP OINT
OP SOL
OP SOL
OP SOL
NAS SPR
OP OINT
OP SOL
OP OINT
OP SOL
OP OINT
OP SOL
OP SOL
OP SOL
OP SOL
05/2012
Therapy Class
520420
DIN
Drug Name
ANTIVIRALS
520420
520420
520420
02248119 APO‐TRIFLURIDINE 1% OPH SOL
02248529 SANDOZ TRIFLURIDINE 1% OPH SOL
00687456 VIROPTIC 1% OPH SOL
192
Chemical Name
Strength
Dosage
TRIFLURIDINE
TRIFLURIDINE
TRIFLURIDINE
1%
1%
1%
OP SOL
OP SOL
OP SOL
*PA
05/2012
Therapy Class
520492
DIN
Drug Name
MISCELLANEOUS ANTI-INFECTIVES
520492
02243861 FUCITHALMIC VISCOUS 1% EYE DRP
193
Chemical Name
Strength
Dosage
FUSIDIC ACID
1%
OP SOL
*PA
05/2012
Therapy Class
520808
DIN
Drug Name
EENT - CORTICOSTEROIDS
Chemical Name
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
520808
00630640
00626597
00395145
00807788
00307246
00575194
01980661
00666211
00694401
01912828
02023865
02023768
02023814
02023784
02023806
00756784
00247855
00707511
00395153
00586706
00682217
00036676
00062251
00074454
00042579
00042560
00358177
00042676
02241031
00177121
02230648
02241003
00194921
00704555
01980572
00704563
01980580
02242737
02238568
00301175
00299405
02148498
00700401
02231923
02242485
02230386
00739839
02247920
02244999
01916181
01916203
02224623
01908839
00778915
00778907
00760056
00527998
02163691
AK CIDE OPH SOL
AK TROL OP SUSP
BLEPHAMIDE OPH
BLEPHAMIDE OPH SUSP
BLEPHAMIDE OPH UNG
CELESTONE S COLLOIDAL EYE DROP
CORTAMED OPH OINT 2.5%
CORTISPORIN OPH SUSP
CORTISPORIN OTIC DPS STERILE
CORTISPORIN OTIC SOLUTION
DIODEX OPH OTIC SOL 0.1%
DIOPRED 1% DROPS
DIOPTIMYD 100MG‐5MG/ML OPH SOL
DIOPTIMYD OP OINT
DIOPTROL OPH SUSP
FLAREX OPH SUSP 0.1%
FML 0.1% OPH SOL
FML FORTE OPH SUSP 0.25%
FML‐NEO OP SUSP
GARASONE OP UNG
GARASONE OPH/OT SOL
H.M.S. 1% OPH SOL
HC‐ATROPINE 1% OPH 3G
LOCACORTEN VIOFORM EARDROPS
MAXIDEX OP OINT 0.1%
MAXIDEX OPH SUSP 0.1%
MAXITROL OP OINT
MAXITROL OPH SUSP
MED‐BUDESONIDE AQ 100MCG NAS
METIMYD OPH OINT W NEOMYCIN
MYLAN‐BUDESONIDE AQ NAS 2MG/ML
MYLAN‐BUDESONIDE AQ NAS SPR
NEOCORTEF EYE EAR OINT 1.5%
PENTAMYCETIN HC DPS
PENTAMYCETIN HC EYE/EAR DROPS
PENTAMYCETIN HC OINT
PENTAMYCETIN‐HC
PMS‐FLUMETHASONE‐CLIOQUINOL OT
PMS‐FLUOROMETHOLONE 0.1% OPH S
PRED FORTE 1% OPH SOL
PRED MILD 0.12% OPH SOL
PREDNISOLONE SODIUM PHOS 0.5%
RATIO‐PREDNISOLONE 1% OPH SUSP
RHINOCORT AQ 64MCG/DOSE NAS SP
SANDOZ CORTIMYXIN OPH OINT
SANDOZ CORTIMYXIN OTIC SOL
SANDOZ DEXAMETHASONE 0.1% SOL
SANDOZ OPTICORT OP/OT SOL
SANDOZ PENTASONE OP/OT SOL
SANDOZ PREDNISOLONE 0.12% OP
SANDOZ PREDNISOLONE 1% OP SUSP
SOFRACORT STERILE OPH/OT DROPS
SPERSADEX
TOBRADEX OPH OINT
TOBRADEX OPH SUSP
VASOCIDIN OPH SOL
VASOCIDIN OPH/OTIC SOL
VEXOL 1% OPH SOL
SULFACETAMIDE/PREDNISOLONE
DEXAMETHASONE/NEOMYCIN/POLYMYX
PREDNISOLONE/SULFACETAMIDE
SOD SULFACETAMIDE
BETAMETHASONE SODIUM
HYDROCORTISONE
2.50%
POLYMYXIN B/NEOMYCIN
POLYMYXIN B SULF/NEOMYCIN SULF
DEXAMETHASONE
0.10%
PREDNISOLONE ACETATE
1%
100MG/5MG
PREDNISOLONE/SULFACETAMIDE
FLUOROMETHOLONE ACETATE
0.1%
FLUOROMETHOLONE
0.1%
FLUOROMETHOLONE
0.25%
FLUOROMETHOLONE/NEOMYCIN SULFA0.1/0.5%
BETAMETHASONE/GENTAMICIN
1/3MG/G
GENTAMICIN/BETAMETHASONE SOD
MEDRYSONE
1%
HYDROCORTISONE + ATROPINE SULF 1%
FLUMETHASONE PIVALATE/CLIOQUIN
DEXAMETHASONE
0.1%
DEXAMETHASONE
0.1%
DEXAMETHASONE/NEOMYCIN/POLYMY 1MG/ML
BUDESONIDE
100MCG
METIMYD
BUDESONIDE
2MG/ML
BUDESONIDE
64MCG
HYDROCORTISONE/NEOMYCIN
1.5%
CHLORAMPHENICOL HC
CHLORAMPHENICOL/HC ACETATE
CHLORAMPHENICOL HC
CHLORAMPHENICOL/HC ACETATE
1%
FLUMETHASONE PIVALATE
FLUOROMETHOLONE
0.1%
1%
0.12%
PREDNISOLONE SODIUM PHOSPHATE 0.50%
1%
BUDESONIDE
64MCG/DOSE
BACITRACIN/HC/NEOMYCIN/POLYMYX
DEXAMETHASONE
0.10%
FRAMYCETIN/GRAMICIDIN/DEXAMETH
GENTAMICIN/BETAMETHASONE SOD
0.12%
1%
FRAMYCETIN/GRAMICIDIN/DEXAMETH
DEXAMETHASONE
0.10%
TOBRAMYCIN/DEXAMETHASONE
TOBRAMYCIN/DEXAMETHASONE
PREDNISOLONE/SULFACETAMIDE SOD
PREDNISOLONE PHOSPHATE
RIMEXOLONE
1%
194
Strength
Dosage
*PA
OP SOL
OP SOL
OP SOL
OP SOL
OP OINT
OP SOL
OP OINT
OP SOL
OP SOL
OT SOL
O/O SOL
OP SOL
OP SOL
OP OINT
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP OINT
OP SOL
OP SOL
OP OINT
OT SOL
OP OINT
OP SOL
OP OINT
OP SOL
NAS SPR
OP OINT
NAS SPR
NAS SPR
O/O OINT
OP SOL
O/O SOL
OP OINT
O/O OINT
OT SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
NAS SPR
OP OINT
OT SOL
O/O SOL
O/O SOL
O/O SOL
OP SOL
OP SOL
O/O SOL
O/O SOL
OP OINT
OP SOL
OP SOL
O/O SOL
OP SOL
05/2012
Therapy Class
520820
DIN
Drug Name
EENT - NON-STEROIDAL ANTI-INFLAMMATORY AGENTS
Chemical Name
Strength
Dosage
*PA
520820
520820
520820
520820
520820
520820
520820
520892
01968300
02248722
02245821
02336693
00766046
02247461
01940414
02355655
ACULAR 0.5% OPH SOL
ACULAR LS 0.4% OPH SOLUTION
APO‐KETOROLAC 0.5% OPH SOL
NU‐KETOROLAC 0.5% OP SOL
OCUFEN OPH SOL 0.03%
RATIO‐KETOROLAC 0.5% OP SOL
VOLTAREN OPHTHA 0.1% OPH SOL
RESTASIS 0.05% OPH
FLURBIPROFEN
DICLOFENAC SODIUM
CYCLOSPORINE
0.50%
0.4%
0.5%
0.5%
0.03%
0.5%
0.10%
0.05%
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
O/O SOL
PA (N)
195
05/2012
Therapy Class
521600
DIN
Drug Name
LOCAL ANESTHETICS
521600
00629707 FLUORACAINE OPH SOL
Chemical Name
FLUOROCAINE
196
Strength
Dosage
*PA
OP SOL
05/2012
Therapy Class
522400
DIN
Drug Name
MYDRIATICS
Chemical Name
Strength
Dosage
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
522400
00626627
00626635
02023695
02242232
00725498
02148358
00622907
00252484
00252506
02148331
02023687
02023644
02023717
02023660
02023679
00001090
00001104
00001112
00035017
00000779
00000787
02148536
02148382
00000981
00001007
00629693
00529117
00622885
00528021
AK PENTOLATE OPH SOLN 1%
AK PENTOLATE OPHTH SOLN 0.5%
AK‐ATROPINE 1% OPH SOL
APO‐DIPIVEFRIN 0.1% OPH SOL
ATROPINE 1% OPH SOL
ATROPINE 1% OPH SOL
ATROPINE AK OPH SOL
ATROPINE OINT 1% OPH
CYCLOGYL OPH DPS 1%
CYCLOPENTOLATE 0.5% OPH SOL
DIOPENTOLATE 0.5% OP SOL
DIOPENTOLATE 1% OPH SOL
DIOPHENYL‐T 0.08%
DIOTROPE 0.5% OPH SOL
DIOTROPE 1% OPH SOL
EPIFRIN 0.5% OPH SOL
EPIFRIN 1% OPH SOL
EPIFRIN 2% OPH SOL
ISOPTO ATROPINE 1% OPH SOL
ISOPTO HOMATROPINE 2%
ISOPTO HOMATROPINE 5%
MINIMS TROPICAMIDE 1% OPH SOL
MINIMS‐CYCLOPENTOLATE 1% OPH
MYDRIACYL 0.5% OPH
MYDRIACYL 1% OPH
PHENYLTROPE OPH SOLN
PROPINE LIQ 0.1% OPH SOL
TROPICACYL OPH DRP 1%
VASOSULF OPH DROPS
CYCLOPENTOLATE HCL
CYCLOPENTOLATE HCL
ATROPINE SULFATE
DIPIVEFRIN HCL
ATROPINE SULFATE
ATROPINE SULFATE
ATROPINE SULFATE
ATROPINE SULFATE
CYCLOPENTOLATE HCL
CYCLOPENTOLATE HCL
CYCLOPENTOLATE HCL
CYCLOPENTOLATE HCL
PHENYLEPHRINE/TROPICAMIDE
TROPICAMIDE
TROPICAMIDE
EPINEPHRINE
EPINEPHRINE HCL
EPINEPHRINE HCL
ATROPINE SULFATE
HOMATROPINE HYDROBROMIDE
HOMATROPINE HYDROBROMIDE
TROPICAMIDE
CYCLOPENTOLATE HCL
TROPICAMIDE
TROPICAMIDE
PHENYLEPHRINE/TROPICAMIDE
DIPIVEFRIN HCL
TROPICAMIDE
NA SULFACETAMIDE/PHENYLEPHRINE
1%
0.5%
1%
0.1%
1%
1%
1%
1%
1%
0.50%
0.5%
1%
0.08%
0.50%
1%
0.5%
1%
2%
1%
2%
5%
1%
1%
0.5%
1%
5.0%/0.8%
1MG/ML
1%
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP OINT
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
197
*PA
05/2012
Therapy Class
522800
DIN
Drug Name
MOUTHWASHES AND GARGLES
Chemical Name
Strength
Dosage
522800
522800
522800
522800
522800
522800
522800
522800
522800
522800
522800
522800
522800
522800
522800
522800
522800
522800
02239044
00804606
02240526
02239537
02384272
02240603
02310422
02229799
02238794
00796468
02209055
02240433
02237452
02207796
02229777
02241591
02240545
02316749
APO‐BENZYDAMINE 0.15% GARGLE
CHLORHEXIDINE‐20% LIQ
DENTI‐CARE 0.12% ORAL RINSE
DOM‐BENZYDAMINE 1.5MG/ML LIQ
G.U.M. PAROEX 1.2MG/ML O/L
GEN‐BENZYDAMINE 0.15% RINSE
NOVO‐BENZYDAMINE 1.5MG/ML MWH
NOVO‐BENZYDAMINE ORAL RINSE
NU‐BENZYDAMINE 0.15% ORL RINSE
ORO‐CLEANSE ORAL RINSE 0.12%
ORO‐CLENSE RINSE 0.12%
PERICHLOR 0.12% ORAL RINSE
PERIDEX ORAL RINSE 0.12%
PERIOGARD 120MG/G MOUTHWASH
PMS‐BENZYDAMINE 0.15% ORL RINS
PRO‐DENTX CHLORHEXIDINE 0.12%
SULCABRUSH CHLORHEXIDINE 0.12%
X‐PUR CHLORHEXIDINE 0.12% MWH
BENZYDAMINE HCL
CHLORHEXIDINE
CHLORHEXIDINE GLUCONATE
BENZYDAMINE HCL
BENZYDAMINE HCL
BENZYDAMINE HCL
BENZYDAMINE HCL
BENZYDAMINE HCL
BENZYDAMINE HCL
0.15%
20%
0.12%
1.5MG/ML
1.2MG/ML
0.15%
1.5MG/ML
0.15%
0.15%
0.12%
0.12%
0.12%
0.12%
120MG/G
0.15%
0.12%
0.12%
0.12%
MWH
MWH
MWH
MWH
O/L
MWH
MWH
MWH
MWH
MWH
MWH
MWH
MWH
MWH
MWH
MWH
MWH
MWH
198
*PA
05/2012
Therapy Class
523200
DIN
Drug Name
VASOCONSTRICTORS
523200
02148455 PHENYLEPHRINE 10% OP
199
Chemical Name
Strength
Dosage
PHENYLEPHRINE HCL
10%
OP SOL
*PA
05/2012
Therapy Class
524004
DIN
Drug Name
EENT - ALPHA-ADRENERGIC AGONISTS
Chemical Name
Strength
Dosage
524004
524004
524004
524004
524004
524004
524004
524004
524004
524004
524004
524004
524004
524004
02236876
02236877
02248151
02260077
02301334
02350734
02249456
02246283
02245942
02248347
02246285
02246284
02243026
02305429
ALPHAGAN 0.2% OPH SOL
ALPHAGAN 0.5% OPTH SOL
ALPHAGAN P 0.15% OPH SOL
APO‐BRIMONIDINE 0.2% OPH SOL
APO‐BRIMONIDINE P 0.15% OP SOL
APX‐BRIMONIDINE P 0.15% OPTH
BRIMONIDINE 0.2% OPH SOL
BRIMONIDINE OPHTHALMIC SOL
BRIMONIDINE TARTRATE
COMBIGAN OPH SOL
DOM‐BRIMONIDINE 0.2% SOL
PMS‐BRIMONIDINE 0.2% OPH SOL
RATIO‐BRIMONIDINE 0.2% OPH SOL
SANDOZ BRIMONIDINE 0.2% OP SOL
BRIMONIDINE TARTRATE/TIMOLOL
0.2%
0.5%
0.15%
0.2%
0.15%
0.15%
0.2%
0.2%
0.2%
0.2%/0.5%
0.2%
0.2%
0.2%
0.2%
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
200
*PA
05/2012
Therapy Class
524008
DIN
Drug Name
EENT - BETA-ADRENERGIC BLOCKING AGENTS
Chemical Name
Strength
Dosage
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
524008
02230620
02241575
02315858
00755826
02290812
00755834
00637661
00751286
01908448
02238539
02239300
02239301
02238770
02238771
02200813
02200821
02236792
02236793
00893773
00893781
02240050
02048523
02094916
02094924
02094932
02094940
02200848
02200856
02237990
02237991
02083353
02083345
02209071
02031159
02031167
02235971
02241716
02166720
02166712
02176025
02176033
02010240
02242276
00451207
02171880
02171899
02202492
02202506
ALTI‐BETAXOLOL 0.5% OPTH SOL
APO‐LEVOBUNOLOL 0.25% OPH SOL
APO‐TIMOP 0.25% OP GEL
APO‐TIMOP 0.25% OPH SOL
APO‐TIMOP 0.5% OP GEL
APO‐TIMOP 0.5% OPH SOL
BETAGAN 0.5% OPH SOL
BETAGAN OPH SOL 0.25%
BETOPTIC S 0.25% OPH SOL
BETOPTIC/PILO 0.25%/1.75% OPH
CROWN‐TIM 2.5MG/ML OPH SOL
CROWN‐TIM 5MG/ML OPH SOL
DOM‐TIMOLOL 0.25% OPH SOL
DOM‐TIMOLOL 0.5% OPH SOL
GEN‐BUNOLOL 0.25% OPTH
GEN‐BUNOLOL 0.50% OPTH
LEVOBUNOLOL HCL 0.25% OPH SOL
LEVOBUNOLOL HCL 0.5% OPH SOL
MYLAN‐TIMOLOL 0.25% OPH SOL
MYLAN‐TIMOLOL SOL 0.05%
NOVO‐BETAXOLOL 0.5% OPH SOL
NOVO‐TIMOL 0.25% OPHTH SOL
NOVO‐TIMOL 0.25% OPHTH SOL
NOVO‐TIMOL 0.5% OPH SOL
NU‐TIMOLOL
NU‐TIMOLOL
OPHTHO‐BUNOLOL 0.25% OPH SOL
OPHTHO‐BUNOLOL 0.50% OPTH SOL
PMS‐LEVOBUNOLOL 2.5MG/ML OPTH
PMS‐LEVOBUNOLOL 5MG/ML OPH SOL
PMS‐TIMOLOL OPH SOL 0.25%
PMS‐TIMOLOL OPH SOL 0.5%
PROBETA OPH DROPS
RATIO‐LEVOBUNOLOL 0.25% OP SOL
RATIO‐LEVOBUNOLOL 0.5% OPH SOL
SANDOZ BETAXOLOL 0.5% OPH SOL
SANDOZ LEVOBUNOLOL 0.5% OP SOL
SANDOZ TIMOLOL MALEATE 0.5%
SANDOZ TIMOLOL OPH SOL 0.25%
STORZ‐TIMOL 0.25% OPHTH SOL
STORZ‐TIMOL 0.5% OPHTH SOL
TIM‐AK LIQ 0.5% OPHT/DROPS
TIMOLOL MALEATE‐EX 0.5% OP SOL
TIMOPTIC OPH DPS 0.5%
TIMOPTIC XE 0.25% OPH DROPS
TIMOPTIC XE 0.5% OPH DROPS
T‐LO OPH SOL 0.25%
T‐LO OPH SOL 0.50%
BETAXOLOL HCL
LEVOBUNOLOL HCL
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
LEVOBUNOLOL HCL
LEVOBUNOLOL HCL
BETAXOLOL HCL
BETAXOLOL/PILOCARPINE HCL
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
LEVOBUNOLOL HCL
LEVOBUNOLOL HCL
LEVOBUNOLOL HCL
LEVOBUNOLOL HCL
TIMOLOL MALEATE
TIMOLOL MALEATE
BETAXOLOL HCL
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
LEVOBUNOLOL HCL
LEVOBUNOLOL HCL
LEVOBUNOLOL HCL
LEVOBUNOLOL HCL
TIMOLOL MALEATE
TIMOLOL MALEATE
LEVOBUNOLOL HCL/DIPIVEFRIN HCL
LEVOBUNOLOL HCL
LEVOBUNOLOL HCL
BETAXOLOL HCL
LEVOBUNOLOL HCL
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
TIMOLOL MALEATE
0.5%
0.25%
0.25%
0.25%
0.5%
0.50%
0.5%
0.25%
0.25%
0.25%/1.75
2.5MG/ML
5MG/ML
0.25%
0.5%
0.25%
0.50%
0.25%
0.5%
0.25%
0.5%
0.5%
0.25%
0.25%
0.5%
2.5MG/ML
5MG/ML
0.25%
0.50%
2.5MG/ML
0.5%
0.25%
0.50%
5MG‐1MG/ML
0.25%
0.50%
0.5%
0.5%
0.50%
0.25%
0.25%
0.5%
0.5%
0.5%
0.5%
0.25%
0.5%
0.25%
0.50%
OP SOL
OP SOL
OP GEL
OP SOL
OP GEL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
201
*PA
05/2012
Therapy Class
524020
DIN
Drug Name
EENT - MIOTICS
Chemical Name
Strength
Dosage
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
524020
00627747
00627739
00627755
02023733
00000655
00000663
00000841
00000868
00000884
00527548
00527556
00527572
02133326
00784826
00042544
02148463
00575240
00269115
02229556
02229555
00725420
00725404
01948571
00725439
01948490
AKARPINE 2% OPH SOL
AKARPINE OPH SOL 1%
AKARPINE OPH SOL 4%
DIOCARPINE OPH SOL 4%
ISOPTO CARBACHOL 1.5%
ISOPTO CARBACHOL 3%
ISOPTO CARPINE LIQ 1%
MIOCARPINE 1% OPH SOL
MIOCHOL E (UNIVIAL) EYE SOL
MIOGAN PWS 20MG/VIAL
MIOSTAT OPH SOL 0.01%
PILOCARPINE NITRATE
PILOPINE HS 4% OPH GEL
SCHEIN‐PILOCARPINE OPH 1%
SCHEIN‐PILOCARPINE OPH SOL 1%
SCHEIN‐PILOCARPINE OPH SOL 2%
SPERSACARPINE OPH
SPERSACARPINE OPH SOLN 10MG/ML
SPERSACARPINE OPTH SOL 4 %
PILOCARPINE HCL
PILOCARPINE HCL
PILOCARPINE HCL
PILOCARPINE HCL
CARBACHOL
CARBACHOL
PILOCARPINE HCL
PILOCARPINE HCL
PILOCARPINE HCL
PILOCARPINE
PILOCARPINE
PILOCARPINE HCL
ACETYLCHOLINE CHLORIDE
ACETYLCHOLINE CHLORIDE
CARBACHOL
PILOCARPINE NITRATE
PILOCARPINE HCL
PILOCARPINE
PILOCARPINE HCL
PILOCARPINE HCL
PILOCARPINE HCL
PILOCARPINE HCL
PILOCARPINE HCL
PILOCARPINE HCL
PILOCARPINE HCL
2%
1%
4%
4%
1.5%
3%
1%
2%
4%
1%
2%
4%
20MG/VIAL
20MG
0.01%
2%
4%
1%
1%
2%
3%
1%
2%
4%
4%
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP GEL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
202
*PA
05/2012
Therapy Class
524028
DIN
Drug Name
EENT - PROSTAGLANDIN ANALOGS
Chemical Name
Strength
Dosage
524028
524028
524028
524028
524028
524028
524028
524028
524028
524028
524028
524028
524028
524028
524028
02296527
02254786
02278251
09857333
02373041
02373068
02375508
02245860
02324997
09991181
02341085
02367335
02318008
02246619
02231493
APO‐LATANOPROST 50MCG/ML OPH
CO LATANOPROST 50MCG/ML OP SOL
DUO TRAV 0.004%/0.5% OPH SOL
DUOTRAV 0.5%/0.004% OPH SOL
GD‐LATANOPROST 50MCG/ML OP SOL
GD‐LATANOPROST/TIMOLOL OP SOL
LATANOPROST 50MCG/ML
LUMIGAN OPH SOL 0.03%
LUMIGAN RC 0.01% OPH SOL
LUMIGAN RC 0.01% OPH SOL 7.5ML
RIVA‐LATANOPROST 50MCG/ML
SANDOZ LATANOPROST 50MCG OPH
TRAVATAN Z OP SOL
XALACOM OPTH SOL
XALATAN 50MCG/ML OPH SOL
LATANOPROST
LATANOPROST
TRAVOPROST/TIMOLOL MALEATE
TRAVOPROST/TIMOLOL MALEATE
LATANOPROST
LATANOPROST
LATANOPROST
BIMATOPROST
BIMATOPROST
BIMATOPROST
LATANOPROST
LATANOPROST
TRAVOPROST
LATANOPROST/TIMOLOL MALEATE
LATANOPROST
50MCG/ML
50MCG/ML
.004%/0.5%
0.5/0.004%
50MCG/ML
50MCG/5MG
50MCG/ML
0.03%
0.01%
0.01%
50MCG/ML
50MCG/ML
0.004%
50UG/5MG
50MCG/ML
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
OP SOL
203
*PA
05/2012
Therapy Class
529200
DIN
Drug Name
MISCELLANEOUS EENT DRUGS
Chemical Name
Strength
Dosage
529200
529200
529200
529200
529200
529200
529200
00893560
02237355
02076306
00888354
02123363
02296810
02267225
ALOMIDE OPH SOL
EMADINE 0.05% OPH SOL
IOPIDINE 0.5% OPH SOL
IOPIDINE 1% OPH SOL
LIVOSTIN NASAL SPRAY
LUCENTIS SOL 10MG/ML
MACUGEN 0.3MG/90MCL INJ
LODOXAMIDE
EMDASTINE DIFUMARATE
APRACLONIDINE
APRACLONIDINE
LEVOCABASTINE
RANIBIZUMAB
PEGAPTANIB SODIUM
0.10%
0.05%
0.50%
1%
0.5MG
10MG/ML
.3MG/90MCL
OP SOL
OP SOL
OP SOL
OP SOL
NAS SPR
INJ
INJ
204
*PA
05/2012
Therapy Class
560800
DIN
Drug Name
ANTIDIARRHEA AGENTS
Chemical Name
560800
560800
560800
560800
560800
560800
560800
560800
00172723
02218348
00633410
01914235
01909223
00195014
00036323
00399345
DIBAN CAP
DIPHENOXYLATE HCL/ATROPINE SUL
DONNAGEL PG
DONNAGEL PG
DONNAGEL PG LIQ
KAOMYCIN
LOMOTIL 2.5 MG TAB
LOMOTIL TAB 2.5MG
OPIUM/BELLADONNA ALKALOIDS COM
DIPHENOXYLATE HCL/ATROPINE SUL 2.5/0.025M
KAOLIN/PECTIN/PAREGORIC COMP
KAOLIN/PECTIN/PAREGORIC COMP
KAOLIN/PECTIN/PAREGORIC
KAOLIN/PECTIN/NEOMYCIN
DIPHENOXYLATE/ATROPINE SULFATE 2.5MG
DIPHENOXYLATE/ATROPINE SULFATE 2.5/0.025M
205
Strength
Dosage
*PA
CAP
TAB
CAP
CAP
O/L
O/L
TAB
TAB
05/2012
Therapy Class
561400
DIN
Drug Name
CHOLELITHOLYTIC AGENTS
Chemical Name
Strength
Dosage
561400
561400
561400
561400
561400
561400
561400
561400
561400
561400
561400
02281295
02281309
02318091
02318105
02281317
02281325
02273497
02262576
02273500
02238984
02245894
DOM‐URSODIOL C 250MG TAB
DOM‐URSODIOL C 500MG TAB
NOVO‐URSODIOL 250MG TAB
NOVO‐URSODIOL 500MG TAB
PHL‐URSODIOL C 250MG TAB
PHL‐URSODIOL C 500MG TAB
PMS‐ URSODIOL C 250MG TAB
PMS‐URSODIOL 250MG TAB
PMS‐URSODIOL C 500MG TAB
URSO 250MG TAB
URSO DS 500MG TAB
URSODIOL
URSODIOL
URSODIOL
URSODIOL
URSODIOL
URSODIOL
URSODIOL
URSODIOL
URSODIOL
URSODIOL
URSODIOL
250MG
500MG
250MG
500MG
250MG
500MG
250MG
250MG
500MG
250MG
500MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
206
*PA
05/2012
Therapy Class
561600
DIN
Drug Name
DIGESTANTS
Chemical Name
561600
561600
561600
561600
561600
561600
561600
561600
561600
561600
561600
561600
561600
561600
561600
561600
561600
561600
561600
562200
00456233
00263818
00821373
00848514
00502790
02181215
02200104
02239008
01985205
02239007
00789437
00789429
00789445
02004909
02203324
02045834
02045869
02241933
02230019
02367297
COTAZYM 65B CAP
COTAZYM CAP
COTAZYM ECS 20 CAP
COTAZYM ECS 4 CAP
COTAZYM ECS 8 CAP
COTAZYM ECS4
CREON 10 MINIMICROSPHERES
PANCREASE MT 10 CAP
PANCREASE MT 16 CAP
PANCREASE MT 4 CAP
PMS‐PROLACTASE 260MG TAB
ULTRASE MS 4
ULTRASE MT12 CAP
ULTRASE MT20 CAP
VIOKASE 16 TAB
VIOKASE 8 TAB
ONDANSETRON 2MG/ML INJ
PANCRELIPASE ENZYME
PANCRELIPASE EQUIVALENT TO LIP
PANCRELIPASE ENZYME
PANCRELIPASE ENZYME
PANCRELIPASE ENZYME
PANCREATIC ENZYME
AMYLASE/LIPASE/PROTEASE
PANCREATIC ENZYME
PANCRELIPASE ENZYME
PANCRELIPASE ENZYME
PANCRELIPASE ENZYME
PROLACTASE
PANCRELIPASE ENZYME
PANCRELIPASE ENZYME
PANCRELIPASE ENZYME
ONDANSETRON
207
Strength
300MG
55000IU
74000IU
30000IU
48000IU
4
260MG
6000,1,600
2MG/ML
Dosage
*PA
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
TAB
CAP
CAP
CAP
TAB
TAB
INJ
05/2012
Therapy Class
562208
DIN
Drug Name
ANTIHISTAMINES
562208
00609129 DICLECTIN TAB
208
Chemical Name
Strength
Dosage
DOXYLAMINE SUCCINATE/PYRIDOXIN
10MG
TAB
*PA
05/2012
Therapy Class
562220
DIN
Drug Name
5-HT3 RECEPTOR ANTAGONISTS
Chemical Name
Strength
Dosage
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
562220
02369370
02369389
02231379
02231378
02288184
02291967
02288192
02348438
02350742
02362910
02296349
02296357
02278405
02278413
02308894
02384108
02300672
02304708
02322765
02304597
02304600
02313685
02313693
02185881
02088371
02237672
02371731
02371758
02305259
02305267
02297868
02297876
02264056
02264064
02336510
02336383
02336529
02298252
02298929
02301512
02322625
02322668
02382121
02334054
02346095
02351609
02325160
02334062
02346168
02351617
02274418
02291754
02291703
02271761
02271788
02265524
02274426
02279428
09857323
02265532
02274434
02279436
02306212
02306220
02278618
02278626
02258188
02258196
02312247
02312255
02278529
02278537
02370298
02370301
02274310
02274329
02376091
02376105
02229639
02239372
AG‐ONDANSETRON 4MG TAB
AG‐ONDANSETRON 8MG TAB
ANZEMET 100MG TAB
ANZEMET 50MG TAB
APO‐ONDANSETRON 4MG TAB
APO‐ONDANSETRON 4MG/5ML O/L
APO‐ONDANSETRON 8MG TAB
APX‐GRANISETRON 1MG TAB
APX‐ONDANSETRON 4MG/5ML O/L
AVA‐ONDANSETRON 8MG TAB
CO‐ONDANSETRON 4MG TAB
CO‐ONDANSETRON 8MG TAB
DOM‐ONDANSETRON 4MG TAB
DOM‐ONDANSETRON 8MG TAB
GRANISETRON 1MG TAB
GRANISETRON 1MG/ML INJ
GRANISETRON HCL 1MG/ML INJ
GRANISETRON HCL 1MG/ML INJ
GRANISETRON HCL 1MG/ML IV INJ
IPG‐ONDANSETRON 4MG TAB
IPG‐ONDANSETRON 8MG TAB
JAMP‐ONDANSETRON 4MG TAB
JAMP‐ONDANSETRON 8MG TAB
KYTRIL 1MG TAB
KYTRIL 1MG/ML INJ
KYTRIL 2MG TAB
MAR‐ONDANSETRON 4MG TAB
MAR‐ONDANSETRON 8MG TAB
MINT‐ODANSETRON 4MG TAB
MINT‐ONDANSETRON 8MG TAB
MYLAN‐ONDANSETRON 4MG TAB
MYLAN‐ONDANSETRON 8MG TAB
NOVO‐ONDANSETRON 4MG TAB
NOVO‐ONDANSETRON 8MG TAB
NU‐ONDANSETRON 4MG TAB
NU‐ONDANSETRON 4MG/5ML O/L
NU‐ONDANSETRON 8MG TAB
ONDANSETRON 4MG TAB
ONDANSETRON 4MG TAB
ONDANSETRON 4MG TAB
ONDANSETRON 8MG TAB
ONDANSETRON 8MG TAB
ONDANSETRON 8MG TAB
ONDANSETRON 8MG TAB
ONDANSETRON HCL DIHYDRATE INJ
ONDANSETRON INJ W/O PRESERVATI
ONDANSETRON INJ WITH PRESERVAT
ONDANSETRON OMEGA 2MG/ML INJ
ONDANSETRON OMEGA 2MG/ML INJ
ONDANSETRON PRESERVATIVE FREE
ONDANSETRON PRES‐FREE 2MG/ML
ONDANSETRON WITH PRESERVATIVE
ONDANSETRON‐ODAN 4MG TAB
ONDANSETRON‐ODAN 8MG TAB
PHL‐ONDANSETRON 4MG TAB
PHL‐ONDANSETRON 8MG TAB
PMS‐ONDANSETRON 4MG TAB
PMS‐ONDANSETRON 8MG TAB
RAN‐ONDANSETRON 4MG TAB
RAN‐ONDANSETRON 8MG TAB
RATIO‐ONDANSETRON 4MG TAB
RATIO‐ONDANSETRON 8MG TAB
RIVA‐ONDANSETRON 4MG TAB
RIVA‐ONDANSETRON 8MG TAB
SANDOZ ONDANSETRON 4MG TAB
SANDOZ ONDANSETRON 8MG TAB
SEPTA‐ONDANSETRON 4MG TAB
SEPTA‐ONDANSETRON 8MG TAB
ZOFRAN 4MG/5ML ORAL LIQUID
ZOFRAN ODT 4MG TAB
ONDANSETRON
ONDANSETRON
DOLASETRON MESYLATE
DOLASETRON MESYLATE
ONDANSETRON HCL DIHYDRATE
GRANISETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
GRANISETRON HCL
GRANISETRON HCL
GRANISETRON HCL
GRANISETRON HCL
GRANISETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
GRANISETRON HCL
GRANISETRON HCL
GRANISETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON
ONDANSETRON
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON
ONDANSETRON
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON
4MG
8MG
100MG
50MG
4MG
4MG/5ML
8MG
1MG
4MG/5ML
8MG
4MG
8MG
4MG
8MG
1MG
1MG/ML
1MG/ML
1MG/ML
1MG/ML
4MG
8MG
4MG
8MG
1MG
1MG/ML
2MG
4MG
8MG
4MG
8MG
4MG
8MG
4MG
8MG
4MG
4MG/5ML
8MG
2MG/ML
2MG/ML
2MG/ML
2MG/ML
2MG/ML
2MG/ML
4MG
4MG
4MG
8MG
8MG
8MG
8MG
2MG/ML
2MG/ML
2MG/ML
2MG/ML
2MG/ML
2MG/ML
2MG/ML
2MG/ML
2MG/ML
2MG/ML
2MG/ML
2MG/ML
4MG
8MG
4MG
8MG
4MG
8MG
4MG
8MG
4MG
8MG
4MG
8MG
4MG
8MG
4MG
8MG
0.8MG/ML
4MG
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
209
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
562220
562220
562220
562220
562220
02239373
02213567
02213575
02344440
02344459
ZOFRAN ODT 8MG TAB
ZOFRAN TAB 4MG
ZOFRAN TAB 8MG
ZYM‐ONDANSETRON 4MG TAB
ZYM‐ONDANSETRON 8MG TAB
ONDANSETRON
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
ONDANSETRON HCL
8MG
4MG
8MG
4MG
8MG
TAB
TAB
TAB
TAB
TAB
210
*PA
05/2012
Therapy Class
562292
DIN
Drug Name
MISC. ANTIEMETICS
Chemical Name
Strength
Dosage
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
562292
02103613
02345897
02345927
02345935
02364271
02312263
02256193
00548375
02238315
02349671
02350440
02361477
02341204
02298805
02298791
02363356
02298813
02253046
02369206
00611190
00611204
02278669
02345781
02231477
02236857
02238341
02236466
02380897
02380900
02380919
00753688
02268078
02358077
02358085
02358093
01912070
00789720
02157195
02384884
02384892
00181382
APO‐DOMPERIDONE 10MG TAB
APP‐NABILONE 0.25MG CAP
APP‐NABILONE 0.5MG CAP
APP‐NABILONE 1MG CAP
AVA‐DOMPERIDONE 10MG TAB
CESAMET 0.25MG CAP
CESAMET 0.5MG CAP
CESAMET CAP 1MG
DOM‐DOMPERIDONE 10MG
DOMPERIDONE 10MG TAB
DOMPERIDONE MALEATE 10MG TAB
EMEND 125MG CAP
EMEND 80MG CAP
EMEND IV 150MG/VIAL INJ
EMEND TRI PACK 125MG/80MG CAP
GMD‐DOMPERIDONE 10MG TAB
JAMP‐DOMPERIDONE 10MG TAB
MARINOL 2.5 MG CAP
MARINOL 5MG CAP
MYLAN‐DOMPERIDONE 10MG TAB
NTP‐DOMPERIDONE 10MG TAB
NU‐DOMPERIDONE 10MG TAB
PDL‐DOMPERIDONE 10MG TAB
PHL‐DOMPERIDONE 10MG TAB
PMS‐DOMPERIDONE 10MG TAB
PMS‐NABILONE 0.25MG CAP
PMS‐NABILONE 0.5MG CAP
PMS‐NABILONE 1MG CAP
PMS‐PROCHLORPERAZINE 10MG SUPP
RAN‐DOMPERIDONE 10MG TAB
RAN‐NABILONE 0.25MG CAP
RAN‐NABILONE 0.5MG CAP
RAN‐NABILONE 1MG CAP
RATIO‐DOMPERIDONE 10MG
SAB‐PROCHLORPERAZINE 10MG SUPP
TEVA‐DOMPERIDONE 10MG TAB
TEVA‐NABILONE 0.5MG CAP
TEVA‐NABILONE 1MG CAP
VONTROL 25MG TAB
DOMPERIDONE MALEATE
NABILONE
NABILONE
NABILONE
DOMPERIDONE MALEATE
NABILONE
NABILONE
NABILONE
DOMPERIDONE MALEATE
DOMPERIDONE MALEATE
DOMPERIDONE MALEATE
DOMPERIDONE MALEATE
DOMPERIDONE MALEATE
APREPITANT
APREPITANT
FOSAPREPITANT DIMEGLUMINE
APREPITANT
DOMPERIDONE MALEATE
DOMPERIDONE MALEATE
TETRAHYDROCANNABINOLS
TETRAHYDROCANNABINOLS
DOMPERIDONE MALEATE
DOMPERIDONE MALEATE
DOMPERIDONE MALEATE
DOMPERIDONE MALEATE
DOMPERIDONE MALEATE
DOMPERIDONE MALEATE
NABILONE
NABILONE
NABILONE
PROCHLORPERAZINE
DOMPERIDONE MALEATE
NABILONE
NABILONE
NABILONE
DOMPERIDONE MALEATE
PROCHLORPERAZINE
DOMPERIDONE MALEATE
NABILONE
NABILONE
DIPHENIDOL HCL
10MG
0.25MG
0.5MG
1MG
10MG
0.25MG
0.5MG
1MG
10MG
10MG
10MG
10MG
10MG
125MG
80MG
150MG/VIAL
125/80MG
10MG
10MG
2.5MG
5MG
10MG
10MG
10MG
10MG
10MG
10MG
0.25MG
0.5MG
1MG
10MG
10MG
0.25MG
0.5MG
1MG
10MG
10MG
10MG
0.5MG
1MG
25MG
TAB
CAP
CAP
CAP
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
TAB
CAP
CAP
INJ
CAP
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
CAP
SUPP
TAB
CAP
CAP
CAP
TAB
SUPP
TAB
CAP
CAP
TAB
211
*PA
05/2012
Therapy Class
562812
DIN
Drug Name
HISTAMINE H2-ANTAGONISTS
Chemical Name
Strength
Dosage
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
02327244
02327252
02291282
02238893
02237412
00584215
00487872
00600059
00600067
00749494
01953842
01953834
02220156
02220164
00733059
00733067
02342871
02342898
02373939
02378809
02378809
02363526
02378817
02378817
00778338
00778346
02257645
02257653
02265591
02265605
02259443
02259451
02248570
02248571
02246167
02246168
02231287
02231288
02231290
02185814
02185822
02243038
02243039
02383071
02383098
02229995
02248222
02351102
02229996
02248223
02351110
02238161
02252902
02252910
02128888
02128896
02219085
02227444
02227452
02227460
02227479
02196018
02196026
02286106
02286114
02207761
02207788
02367378
02367386
02239558
02239559
00582409
00582417
00603678
00603686
00663727
02100541
02100568
02022133
02022141
ACCEL‐RANITIDINE 150MG TAB
ACCEL‐RANITIDINE 300MG TAB
ACID REDUCER 150MG TAB
ALTI‐RANITIDINE 15MG/ML O/L
APO‐CIMETIDINE 100MG TAB
APO‐FAMOTIDINE 20MG TAB
APO‐FAMOTIDINE 40MG TAB
APO‐NIZATIDINE 150MG CAP
APO‐NIZATIDINE 300MG CAP
APO‐RANITIDINE 150MG TAB
APO‐RANITIDINE 300MG TAB
APX‐RANITIDINE 150MG TAB
APX‐RANITIDINE 300MG TAB
AVA‐FAMOTIDINE 40MG TAB
AVA‐RANITIDINE 150MG TAB
AVA‐RANITIDINE 15MG/ML O/L
AXID CAP 150MG
AXID CAP 300MG
BCI FAMOTIDINE 20MG TAB
BCI FAMOTIDINE 40MG TAB
BCI RANITIDINE 150MG TAB
BCI RANITIDINE 300MG TAB
CO FAMOTIDINE 20MG TAB
CO FAMOTIDINE 40MG TAB
CO RANITIDINE 150MG TAB
CO RANITIDINE 300MG TAB
CO‐RANITIDINE 150MG TAB
CO‐RANITIDINE 300MG TAB
DOM‐CIMETIDINE 300MG TAB
DOM‐NIZATIDINE 150MG CAP
DOM‐NIZATIDINE 300MG CAP
DOM‐RANITIDINE 150MG TAB
DOM‐RANITIDINE 300MG TAB
FAMOTIDINE 10MG/ML INJ
FAMOTIDINE 10MG/ML INJ
FAMOTIDINE 20MG TAB
FAMOTIDINE 20MG TAB
FAMOTIDINE 20MG TAB
FAMOTIDINE 40MG TAB
FAMOTIDINE 40MG TAB
FAMOTIDINE 40MG TAB
GAVISCON PREVENT EXTSTR 200MG
GMD‐FAMOTIDINE 20MG TAB
GMD‐FAMOTIDINE 40MG TAB
KENRAL‐NIZATIDINE 15
KENRAL‐NIZATIDINE 30
MED‐RANITIDINE 300MG TAB
MYLAN‐CIMETIDINE TAB 300MG
MYLAN‐FAMOTIDINE 20MG TAB
MYLAN‐FAMOTIDINE 40MG TAB
MYLAN‐RANITIDINE 150MG TAB
MYLAN‐RANITIDINE 300MG TAB
MYLAN‐RANITIDINE TAB 150MG
MYLAN‐RANITIDINE TAB 300MG
MYL‐RANITIDINE 150MG TAB
MYL‐RANITIDINE 300MG TAB
NIZATIDINE 150MG CAP
NIZATIDINE 300MG CAP
NOVO‐CIMETINE TAB 200MG
NOVO‐FAMOTIDINE 20MG
NOVO‐FAMOTIDINE 40MG
NOVO‐FAMOTIDINE TAB 20MG
NOVO‐FAMOTIDINE TAB 40MG
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
CIMETIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
FAMOTIDINE
FAMOTIDINE
NIZATIDINE
NIZATIDINE
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE
RANITIDINE
FAMOTIDINE
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
NIZATIDINE
NIZATIDINE
FAMOTIDINE
FAMOTIDINE
RANITIDINE HCL
RANITIDINE HCL
FAMOTIDINE
FAMOTIDINE
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
CIMETIDINE
CIMETIDINE
CIMETIDINE
NIZATIDINE
NIZATIDINE
RANITIDINE HCL
RANITIDINE HCL
FAMOTIDINE
FAMOTIDINE
FAMOTIDINE
FAMOTIDINE
FAMOTIDINE
FAMOTIDINE
FAMOTIDINE
FAMOTIDINE
CIMETIDINE
FAMOTIDINE
FAMOTIDINE
NIZATIDINE
NIZATIDINE
RANITIDINE HCL
CIMETIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
FAMOTIDINE
FAMOTIDINE
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
NIZATIDINE
NIZATIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
FAMOTIDINE
FAMOTIDINE
FAMOTIDINE
FAMOTIDINE
150MG
300MG
150MG
15MG/ML
100MG
200MG
300MG
400MG
600MG
800MG
20MG
40MG
150MG
300MG
150MG
300MG
150MG
300MG
40MG
150MG
150MG
15MG/ML
300MG
300MG
150MG
300MG
20MG
40MG
150MG
300MG
20MG
40MG
150MG
300MG
150MG
300MG
300MG
400MG
600MG
150MG
300MG
150MG
300MG
10MG/ML
10MG/ML
20MG
20MG
20MG
40MG
40MG
40MG
200MG
20MG
40MG
150MG
300MG
300MG
300MG
400MG
600MG
800MG
20MG
40MG
150MG
300MG
150MG
300MG
150MG
300MG
150MG
300MG
200MG
300MG
400MG
600MG
800MG
20MG
40MG
20MG
40MG
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
212
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
562812
02240457
02240458
02347636
02347644
00865796
00865818
00865826
00865834
02024195
02024209
02247051
02247052
00865737
00865745
02238257
00596477
00618691
00618705
00740748
00740756
02238342
02238343
00710121
00710113
02238194
02238195
02245782
02245783
02229717
02229721
02177714
02177722
02242453
02242454
02242057
02303353
02343436
02350203
02353016
02280833
02242058
02303388
02343444
02350211
02353024
02242056
02336480
02336502
00828688
00828823
02247814
02247815
02243229
02243230
02323699
02323702
02155737
02155745
02220547
01916793
00563579
01916769
02242940
00828556
00828564
02229562
02229563
02237148
02237149
02212358
02212331
02076284
02213494
01951831
02213516
02076292
02213508
01951823
02213524
NOVO‐NIZATIDINE 150MG CAP
NOVO‐NIZATIDINE 300MG CAP
NTP‐FAMOTIDINE 20MG TAB
NTP‐FAMOTIDINE 40MG TAB
NU‐CIMET TAB 200MG
NU‐FAMOTIDINE 20 MG TAB
NU‐FAMOTIDINE 40 MG
NU‐NIZATIDINE 150MG CAP
NU‐NIZATIDINE 300MG CAP
NU‐RANIT TAB 150MG
NU‐RANIT TAB 300MG
PDL‐CIMETIDINE 800MG TAB
PDL‐CIMETIDINE TAB 300MG
PDL‐RANITIDINE TAB 150MG
PDL‐RANITIDINE TAB 300MG
PENTA‐FAMOTIDINE 20MG TAB
PENTA‐FAMOTIDINE 40MG TAB
PEPCID 20MG TAB
PEPCID 40MG TAB
PHL‐NIZATIDINE 150MG CAP
PHL‐NIZATIDINE 300MG CAP
PHL‐RANITIDINE 150MG TAB
PHL‐RANITIDINE 300MG TAB
PMS‐CIMETIDINE 200MG TAB
PMS‐CIMETIDINE 800MG TAB
PMS‐NIZATIDINE 150MG CAP
PMS‐NIZATIDINE 300MG CAP
PMS‐RANITIDINE 150MG TAB
PMS‐RANITIDINE 300MG TAB
RANITIDINE 150MG TAB
RANITIDINE 15MG/ML O/L
RANITIDINE 75MG TAB
RAN‐RANITIDINE 150MG TAB
RAN‐RANITIDINE 300MG TAB
RATIO‐RANITIDINE 300MG TAB
RATIO‐RANITIDINE HCL TAB 150MG
RIVA‐RANITIDINE 150MG TAB
RIVA‐RANITIDINE 300MG TAB
SANDOZ‐RANITIDINE 150MG TAB
SANDOZ‐RANITIDINE 300MG TAB
SIG‐RANITIDINE 150MG TAB
SIG‐RANITIDINE 300MG TAB
STCC‐NIZATIDINE 150MG
STCC‐NIZATIDINE 300M
TAGAMET 100MG TAB
TAGAMET 200MG TAB
TAGAMET 400 TAB
TAGAMET 800MG TAB
TEVA‐RANIDINE 15MG/ML ORAL SOL
TEVA‐RANIDINE 300 MG
TEVA‐RANIDINE TAB 150MG
TRIA‐RANITIDINE 150MG TAB
TRIA‐RANITIDINE 300MG TAB
ULCIDINE 20MG TAB
ULCIDINE 40MG TAB
ZANTAC 300MG TAB
ZANTAC TAB 150MG
ZANTEFF 150MG EVT TAB
ZANTEFF 150MG SACHET
NIZATIDINE
NIZATIDINE
FAMOTIDINE
FAMOTIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
FAMOTIDINE
FAMOTIDINE
NIZATIDINE
NIZATIDINE
RANITIDINE HCL
RANITIDINE HCL
CIMETIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
RANITIDINE
RANITIDINE
FAMOTIDINE
FAMOTIDINE
FAMOTIDINE
FAMOTIDINE
NIZATIDINE
NIZATIDINE
RANITIDINE HCL
RANITIDINE HCL
CIMETIDINE
CIMETIDINE
NIZATIDINE
NIZATIDINE
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
NIZATIDINE
NIZATIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
CIMETIDINE
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
FAMOTIDINE
FAMOTIDINE
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
RANITIDINE HCL
150MG
300MG
20MG
40MG
200MG
300MG
400MG
600MG
20MG
40MG
150MG
300MG
150MG
300MG
800MG
300MG
400MG
600MG
150MG
300MG
20MG
40MG
20MG
40MG
150MG
300MG
150MG
300MG
200MG
800MG
150MG
300MG
150MG
300MG
150MG
150MG
150MG
150MG
150MG
15MG/ML
300MG
300MG
300MG
300MG
300MG
75MG
150MG
300MG
300MG
150MG
150MG
300MG
150MG
300MG
150MG
300MG
150MG
300MG
100MG
200MG
400MG
800MG
15MG/ML
300MG
150MG
150MG
300MG
20MG
40MG
300MG
150MG
150MG
150MG
150MG
150MG
300MG
300MG
300MG
300MG
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
CAP
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
MISC
MISC
TAB
TAB
MISC
MISC
213
*PA
05/2012
Therapy Class
562828
DIN
Drug Name
PROSTAGLANDINS
Chemical Name
Strength
Dosage
562828
562828
562828
562828
562828
562828
562828
562828
02349094
02349108
02185458
02244022
02185466
02244023
02248846
02244124
AA‐MISOPROSTOL 100MCG TAB
AA‐MISOPROSTOL 200MCG TAB
MISOPROSTOL 100MCG TAB
MISOPROSTOL‐200 200MCG TAB
PMS‐MISOPROSTOL 0.1MG TAB
MISOPROSTOL
MISOPROSTOL
MISOPROSTOL
MISOPROSTOL
MISOPROSTOL
MISOPROSTOL
MISOPROSTOL
MISOPROSTOL
100MCG
200MCG
100MCG
100MCG
200MCG
200MCG
200MCG
0.1MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
214
*PA
05/2012
Therapy Class
562832
DIN
Drug Name
PROTECTANTS
Chemical Name
Strength
Dosage
562832
562832
562832
562832
562832
562832
562832
562832
562832
562832
562832
02125250
02140004
02239912
02100614
02134829
02130939
01924699
02103567
02100622
00506346
02045702
APO‐SUCRALFATE 1GM TAB
CYTOGARD 1G TAB
DOM‐SUCRALFATE 1G TAB
NOVO‐SUCRALATE
NU‐SUCRALFATE 1GM TAB
PDL‐SUCRALFATE‐1G TAB
SULCRATE 1GM
SULCRATE PLUS 1G/5ML SUSP
SULCRATE TAB 1G
SULCRATE TAB 1GM
TEVA‐SUCRALATE 1GM TAB
SUCRALFATE
SUCRALFATE
SUCRALFATE
SUCRALFATE
SUCRALFATE
SUCRALFATE
SUCRALFATE
SUCRALFATE
SUCRALFATE
SUCRALFATE
SUCRALFATE
1G
1 GM
1G
TAB
TAB
TAB
TAB
TAB
TAB
O/L
O/L
TAB
TAB
TAB
215
1G
1 G
1GM
1G/5ML
1G
1G
1G
*PA
05/2012
Therapy Class
562836
DIN
Drug Name
PROTON-PUMP INHIBITORS
Chemical Name
Strength
Dosage
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
562836
02345579
02345587
02370719
02370727
02320452
02320460
02238525
02345994
02346001
02243796
02243797
02381737
02381745
02320614
02320622
02310805
02310813
02315181
02315203
02335166
02356511
02335174
02356538
02320592
02320606
02298074
02298082
02330083
02330091
02314177
02314185
02296632
02296640
APO‐RABEPRAZOLE LA 10MG TAB
APO‐RABEPRAZOLE LA 20MG TAB
AVA‐RABEPRAZOLE 10MG TAB
AVA‐RABEPRAZOLE 20MG TAB
DOM‐RABEPRAZOLE EC 10MG TAB
DOM‐RABEPRAZOLE EC 20MG TAB
HP‐PAC 500MG/500MG/30MG KIT
NTP‐RABEPRAZOLE EC 10MG TAB
NTP‐RABEPRAZOLE EC 20MG TAB
PARIET EC 10MG TAB
PARIET EC 20MG TAB
PAT‐RABEPRAZOLE 10MG TAB
PAT‐RABEPRAZOLE 20MG TAB
PHL‐RABEPRAZOLE EC 10MG TAB
PHL‐RABEPRAZOLE EC 20MG TAB
PMS‐RABEPRAZOLE EC 10MG TAB
PMS‐RABEPRAZOLE EC 20MG TAB
PRO‐RABEPRAZOLE 10MG TAB
PRO‐RABEPRAZOLE 20MG TAB
RABEPRAZOLE 10MG EC TAB
RABEPRAZOLE EC 10MG TAB
RABEPRAZOLE EC 20MG TAB
RAN‐RABEPRAZOLE 10MG EC TAB
RAN‐RABEPRAZOLE 20MG EC TAB
RIVA‐RABEPRAZOLE EC 10MG TAB
RIVA‐RABEPRAZOLE EC 20MG TAB
SANDOZ‐RABEPRAZOLE 10MG EC TAB
SANDOZ‐RABEPRAZOLE 20MG EC TAB
TEVA‐RABEPRAZOLE 10MG EC TAB
TEVA‐RABEPRAZOLE 20MG EC TAB
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE
RABEPRAZOLE
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
AMOXI/CLARITHROMYCIN/LANSOPRAZ
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
RABEPRAZOLE SODIUM
10MG
20MG
10MG
20MG
10MG
20MG
500/500/30
10MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
10MG
10MG
20MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
TAB LA
TAB LA
TAB
TAB
TAB
TAB
MISC
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB LA
TAB
TAB
216
*PA
05/2012
Therapy Class
563200
DIN
Drug Name
PROKINETIC AGENTS
Chemical Name
Strength
Dosage
563200
563200
563200
563200
563200
563200
563200
563200
563200
563200
563200
563200
563200
563200
563200
563200
00842834
00842826
01919539
02163756
02185431
02197480
02243563
02143283
02143275
00870994
00871001
02230432
02230433
02230431
00386006
00386022
APO‐METOCLOP 10MG TAB
APO‐METOCLOP 5MG TAB
EMEX
GASTROBID 20MG TAB
METOCLOPRAMIDE HCL 5MG/ML INJ
METOCLOPRAMIDE HCL 5MG/ML INJ
METOCLOPRAMIDE OMEGA INJ
NU‐METOCLOPRAMIDE 10MG TAB
NU‐METOCLOPRAMIDE 5MG TAB
PDL‐METOCLOPRAMIDE TAB 10MG
PDL‐METOCLOPRAMIDE TAB 5MG
PMS‐METOCLOPRAMIDE 10MG TAB
PMS‐METOCLOPRAMIDE 1MG/ML ELIX
PMS‐METOCLOPRAMIDE 5MG TAB
REGLAN INJ 10MG/2ML
REGLAN SYR 1MG/ML
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
METOCLOPRAMIDE HCL
10MG
5MG
10MG
20MG
5MG/ML
5MG/ML
5MG/ML
10MG
5MG
10MG
5MG
10MG
1MG/ML
5MG
10MG/2ML
1MG/ML
TAB
TAB
TAB
TAB
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
O/L
TAB
INJ
O/L
217
*PA
05/2012
Therapy Class
563600
DIN
Drug Name
ANTI-INFLAMMATORY AGENTS
Chemical Name
Strength
Dosage
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
563600
02351463
02267217
01997580
02063808
02006413
02182718
02182653
02182688
02182696
02182726
02182661
01914049
02028751
01914030
02028778
00887099
02297558
02171929
02348063
02265257
02128276
00894877
02128233
02153521
02128241
02128268
02153556
02113058
01940384
02099683
02153564
02238931
02242146
00784494
00784508
02112787
00890944
02112795
00709034
02112809
02112760
5‐ASA 400MG TAB
ASACOL 800MG TAB
ASACOL ECT 400MG
DIPENTUM 250MG CAP
DIPENTUM CAP 250MG
FIVE ASA 250MG ECTAB
FIVE ASA 250MG SUPP
FIVE ASA 2G/60G ENEMA
FIVE ASA 4G/60G ENEMA
FIVE ASA 500MG ECTAB
FIVE ASA 500MG SUPP
MESASAL
MESASAL 250MG SUPP
MESASAL 500MG EC TAB
MESASAL 500MG SUPP
MESASAL ENTERIC COATED TAB 500
MEZAVANT 1.2G ER TAB
NOVO‐5‐ASA 400MG TAB
NTP‐5‐AMINOSALICYLIC ACID TAB
PENDO‐5 ASA 400MG EC TAB
PENTASA
PENTASA DELAYED RELEASE TAB
PENTASA ENEMA 1G/100ML
PENTASA SR CAP
PENTASA SRT 500MG
PENTASA SRT 500MG
PENTASA SUPP 1GM
QUNITASA ER 250MG TAB
SALOFALK 1000MG SUPP
SALOFALK 250MG SUPP
SALOFALK 500MG SUPP
SALOFALK EC TAB 500MG
SALOFALK ENEMA
SALOFALK ENEMA
SALOFALK RECTAL SUSP
SALOFALK RECTAL SUSP
SALOFALK SUPP 500MG
MESALAZINE
5‐AMINOSALICYLIC ACID
OLSALAZINE SODIUM
OLSALAZINE SODIUM
MESALAMINE
MESALAMINE
MESALAMINE
MESALAMINE
MESALAZINE
MESALAZINE
MESALAZINE
400MG
800MG
400MG
250MG
250MG
250MG
250MG
2G/60G
4G/60G
500MG
500MG
250
250MG
500MG
500MG
500MG
1.2G
400MG
400MG
400MG
1G
250MG
1G/100ML
1G/100ML
2G/100ML
4G/100ML
4G/100ML
TAB
TAB
TAB
CAP
CAP
TAB
SUPP
ENEMA
ENEMA
TAB
SUPP
TAB
SUPP
TAB
SUPP
TAB
TAB LA
TAB
TAB
TAB
SUPP
TAB LA
ENEMA
ENEMA
ENEMA
ENEMA
ENEMA
CAP LA
TAB LA
TAB LA
SUPP
TAB LA
SUPP
SUPP
SUPP
TAB
ENEMA
ENEMA
ENEMA
ENEMA
SUPP
218
500MG
500MG
1G
250MG
1000MG
250MG
500MG
500MG
4G/60G
2G/60G
4/60G
4G/60G
500MG
*PA
05/2012
Therapy Class
569200
DIN
Drug Name
MISCELLANEOUS GI DRUGS
569200
569200
02246962 PYLERA CAPSULE
02308215 RELISTOR 20MG/ML
219
Chemical Name
Strength
Dosage
*PA
BISKAL/METRONIDA/TETRACYC
METHYLNALTREXONE BROMIDE
40/125/125
20MG/ML
CAP
INJ
PA (N)
05/2012
Therapy Class
600000
DIN
Drug Name
GOLD COMPOUNDS
Chemical Name
Strength
Dosage
600000
600000
600000
600000
600000
600000
600000
600000
600000
600000
00025062
01927620
00025070
01927612
00025089
01927604
01916823
02245456
02245457
02245458
MYOCHRYSINE 10MG/ML
MYOCHRYSINE 10MG/ML
MYOCHRYSINE 25MG/ML
MYOCHRYSINE 25MG/ML INJ
MYOCHRYSINE 50MG/ML
MYOCHRYSINE 50MG/ML INJ
RIDAURA 3MG CAP
SODIUM AUROTHIOMALATE 10MG INJ
SODIUM AUROTHIOMALATE
AURANOFIN
10MG/ML
10MG/ML
25MG/ML
25MG/ML
50MG/ML
50MG/ML
3MG
10MG/ML
25MG/ML
50MG/ML
INJ
INJ
INJ
INJ
INJ
INJ
CAP
INJ
INJ
INJ
220
*PA
05/2012
Therapy Class
640000
DIN
Drug Name
HEAVY METAL ANTAGONISTS
Chemical Name
Strength
Dosage
640000
640000
640000
640000
640000
640000
640000
640000
640000
640000
640000
640000
640000
640000
00016055
02261820
02261812
01981250
00424846
01981242
00778397
02241600
02247022
02287420
02287439
02287447
02243450
02242055
CUPRIMINE 250MG CAP
DEFEROXAMINE MESYLATE 2G/VL
DEFEROXAMINE MESYLATE 500MG/VL
DESFERAL PWS 2G/VIAL INJ
DESFERAL PWS 500MG INJ
DESFERAL PWS 500MG/VIAL INJ
DESFERAL PWS INJ 2GM/VIAL
DESFERRIOXAMINE MESILATE INJ
DESFERRIOXAMINE MESILATE INJ
EXJADE 125MG TAB
EXJADE 250MG TAB
EXJADE 500MG TAB
PMS‐DEFEROXAMINE 2GM/VIAL INJ
PMS‐DEFEROXAMINE 500MG/VL INJ
PENICILLAMINE
DEFEROXAMINE MESYLATE
DEFERASIROX
DEFERASIROX
DEFERASIROX
250MG
2G/VIAL
500MG
2G/VIAL
500MG
500MG
2G/VIAL
500MG
2G/VIAL
125MG
250MG
500MG
2G/VIAL
500MG/VIAL
CAP
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
INJ
INJ
221
*PA
05/2012
Therapy Class
680400
DIN
Drug Name
ADRENALS
Chemical Name
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
00888222
00888206
00888214
00888230
02285606
02285614
02285592
02261081
02250055
00598194
00550957
00312770
02194155
02243021
02243022
00769983
02243596
02243595
00768707
00545325
00545333
02240956
00028096
00030910
00030929
00249963
00280437
01934325
00030759
00030767
01934341
01934333
00260428
02237044
02237045
00874582
02237046
01977547
00664227
02204274
02204266
00295094
00285471
00489158
02239534
02229293
02086026
02237245
02237246
02237247
02237244
02244292
02244293
02244291
02243646
02174707
02213648
02174715
02213656
02174723
02213664
02174693
02213621
00298301
00298328
00177571
00872520
01999761
00990876
01999869
00607517
00036129
00030988
00800211
02241229
02231894
02231893
02231895
02245400
02245407
A‐HYDROCORT 1G INJ
A‐HYDROCORT 250MG INJ
A‐HYDROCORT 500MG INJ
A‐HYDROCORT INJ/ELASE‐NIHB
ALVESCO 100MCG/ACT INH
APO‐DEXAMETHASONE 0.5MG TAB
APO‐DEXAMETHASONE 4MG TAB
APO‐PREDNISONE 1MG TAB
ARISTOSPAN 20MG/ML INJ (SAP)
ASMANEX 200MCG PWD FOR INH
ASMANEX 400MCG PWD FOR INH
AZMACORT INHALER
AZMAX TWISTHALER 200 G
AZMAX TWISTHALER 200MCG/ACT
BECLOFORTE INHALER
BECLOVENT ROTACAPS 100MCG
BECLOVENT ROTACAPS 200MCG
BRONALIDE 250MCG INH
CELESTONE SOLUSPAN 3MG/ML INJ
CORTEF TAB 10MG
CORTEF TAB 20 MG
CORTISONE ACETATE TAB 25MG
CORTISONE ACETATE TAB 25MG
DEPO‐MEDROL 20MG/ML INJ
DEPO‐MEDROL SUSP 40MG/ML INJ
DEPO‐MEDROL WITH LIDOCAINE INJ
DEXAMETHASONE 0.5MG TAB
DEXAMETHASONE 0.75MG TAB
DEXAMETHASONE 10MG/ML INJ
DEXAMETHASONE 4MG TAB
DEXAMETHASONE 4MG/ML INJ
DEXAMETHASONE SOD PHOS 4MG/ML
DEXAMETHASONE‐OMEGA 10MG/ML IN
DEXAMETHASONE‐OMEGA 4MG/ML INJ
DEXASONE TAB 0.5MG
DEXASONE TAB 0.75MG
DEXASONE TAB 4MG
DOM‐DEXAMETHASONE
ENTOCORT CAPSULE 3MG
FLORINEF 0.1MG TAB
FLOVENT DISKUS 100MCG/BLISTER
FLOVENT HFA 125MCG/ACT INH
FLOVENT NEBULES 0.5MG/2ML INH
FLOVENT PWR 100MCG/BLISTER
HYDROCORTISONE ACETATE
HYDROCORTISONE ACETATE INJ
HYDROCORTISONE SOD SUCC INJ
KENALOG 10 INJ
KENALOG‐40
KENALOG‐40 INJ 40MG/ML
KENRAL‐PREDNISONE TAB 50MG
MEDROL 16MG TAB
MEDROL 4MG TAB
MEDROL 4MG TAB
METHYLPREDNISOLONE
METHYLPREDNISOLONE 125MG INJ
METHYLPREDNISOLONE ACET 40MG/M
HYDROCORTISONE
1 G
HYDROCORTISONE
250MG
HYDROCORTISONE
500MG
HYDROCORTISONE SODIUM SUCCINAT 100 M
CICLESONIDE
100MCG/ACT
CICLESONIDE
200MCG/ACT
CICLESONIDE
50MCG/ACT
DEXAMETHASONE
0.5MG
DEXAMETHASONE
4MG
PREDNISONE
1MG
PREDNISONE
50MG
PREDNISONE
5MG
TRIAMCINOLONE ACETONIDE
20MG/ML
MOMETASONE FUROATE
200MCG
MOMETASONE FUROATE
400MCG
200MC
MOMETASONE FUROATE
200 G
MOMETASONE FUROATE
200MCG/ACT
BECLOMETHASONE DIPROPIONATE
250MCG
100MCG
200MCG
FLUNISOLIDE
250MCG
BETAMETHASONE SOD PHOS/ACETATE 3MG/ML
HYDROCORTISONE
10MG
HYDROCORTISONE
20MG
CORTISONE ACETATE
25MG
25MG
CORTISONE ACETATE
METHYLPREDNISOLONE ACETATE
20MG/ML
40MG/ML
80MG/ML
80MG/ML
40MG/ML
METHYLPREDNISOLONE/LIDOCAINE
40/10MG/ML
DEXAMETHASONE
0.5MG
DEXAMETHASONE
0.75MG
DEXAMETHASONE SODIUM PHOSPHATE10MG/ML
DEXAMETHASONE
4MG
DEXAMETHASONE
0.5MG
DEXAMETHASONE
0.75MG
DEXAMETHASONE
4MG
DEXAMETHASONE
4MG
BUDESONIDE
3MG
FLUDROCORTISONE ACETATE
0.1MG
FLUTICASONE PROPIONATE
100MCG
250MCG
500MCG/
50MCG/
125MCG/ACT
250MCG/ACT
50MCG/ACT
0.5MG/2ML
100MCG
100MCG
250MCG
250MCG
500MCG
500MCG
50MCG
50MCG
50MG
HYDROCORTISONE
100MG
10 MG
TRIAMCINOLONE
40MG/ML
40MG/ML
PREDNISONE
50MG
METHYLPREDNISOLONE
16MG
METHYLPREDNISOLONE
4MG
METHYLPREDNISOLONE
4MG
METHYLPREDNISOLONE SOD SUCCINA 1000MG/VIA
METHYLPREDNISOLONE SOD SUCCINA 125MG/VIAL
40MG/ML
40MG/ML
222
Strength
Dosage
*PA
INJ
INJ
INJ
INJ
INH
INH
INH
TAB
TAB
TAB
TAB
TAB
INJ
PDR
PDR
SPR
INH
INH
INH
CAP
CAP
INH
INJ
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
INJ
TAB
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
CAP LA
TAB
PDR
PDR
PDR
PDR
INH
INH
INH
INH NEB
INH NEB
PDR
PDR
PDR
PDR
PDR
PDR
PDR
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
02245406
02245408
00878626
00872539
00878618
00021695
00232378
02363445
00156876
02244395
02230619
02260298
02260301
01964976
01946897
01964968
00783900
02279363
01964070
02245532
02311267
00851760
02229099
01978918
01978926
00852074
00851752
02242030
02242029
02240684
02240687
02236569
02236568
00030600
00030635
00030619
00030627
02063727
02367955
NOVO‐HYDROCORTISONE 1G/VL INJ
NOVO‐HYDROCORTISONE INJ
NOVO‐HYDROCORTISONE INJ
NOVO‐PREDNISONE 5MG TAB
NOVO‐PREDNISONE TAB 50MG
OZURDEX INTRAVITREAL IMPLANT
PDL‐PREDNISONE TAB 5MG
PEDIAPRED 5 ORAL LIQ 25MG/5ML
PEDIAPRED 5MG/5ML ELIXIR
PHL‐DEXAMETHASONE 0.5MG/5ML
PHL‐DEXAMETHASONE 10MG/ML INJ
PMS‐DEXAMETHASONE 0.5MG TAB
PMS‐DEXAMETHASONE 0.5MG/ML ELX
PMS‐DEXAMETHASONE 0.75MG TAB
PMS‐DEXAMETHASONE 10MG/ML INJ
PMS‐DEXAMETHASONE 2MG TAB
PMS‐DEXAMETHASONE 4MG TAB
PMS‐PREDNISOLONE 6.75MG/5MLSOL
PRO‐DEXAMETHASONE 4MG TAB
PULMICORT 400MCG TURBUHALER
PULMICORT NEBUAMP 0.125MG/ML
PULMICORT NEBUAMP 0.25 MG/ML
PULMICORT NEBUAMP 0.5 MG/ML
PULMICORT TURBUHALER 100MCG/DO
PULMICORT TURBUHALER 200MCG/DO
QVAR 100MCG/DS INH
QVAR 50MCG/DS INH
RATIO‐DEXAMETHASONE 0.5MG TAB
RATIO‐DEXAMETHASONE 4MG TAB
RHO‐TRIAMCINOLONE 100MCG NAS
RHO‐TRIAMCINOLONE 55MCG NAS
SOLU CORTEF INJ 100MG ACT‐O‐VI
SOLU CORTEF INJ 1G
SOLU‐MEDROL 125MG/VIAL INJ
SOLU‐MEDROL 125MG/VIAL INJ
METYLPREDNISOLONE ACETATE
80MG/ML
80MG/ML
HYDROCORTISONE SODIUM SUCCINAT 1 G
HYDROCORTISONE
250 MG
HYDROCORTISONE
500 MG
PREDNISONE
5MG
PREDNISONE
50MG
DEXAMETHASONE
0.7MG
PREDNISONE
5MG
PREDNISOLONE SODIUM PHOSPHATE 25MG/5ML
PREDNISOLONE SODIUM PHOSPHATE 5MG/5ML
DEXAMETHASONE
0.5MG/5ML
DEXAMETHASONE
10MG/ML
DEXAMETHASONE
0.5MG
DEXAMETHASONE
0.5MG/5ML
DEXAMETHASONE
0.75MG
DEXAMETHASONE
2MG
DEXAMETHASONE
4MG
PREDNISOLONE SODIUM PHOSPHATE 6.75MG/5ML
DEXAMETHASONE
4MG
BUDESONIDE
400MCG
BUDESONIDE
0.125MG/ML
BUDESONIDE
0.25MG/ML
BUDESONIDE
0.5MG/ML
BUDESONIDE
100MCG/DOS
BUDESONIDE
200MCG
100MCG/DS
50MCG/DS
DEXAMETHASONE
0.5MG
DEXAMETHASONE
4MG
100MCG
55MCG
HYDROCORTISONE SODIUM SUCCINAT 100MG
HYDROCORTISONE SODIUM SUCCINAT 1G
METHYLPREDNISOLONE SOD SUCCINA 125MG
Strength
Dosage
680400
02367955 SOLU‐MEDROL 125MG/VIAL INJ
INJ
680400
680400
INJ
INJ
680400
INJ
680400
INJ
680400
INJ
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
680400
02063697
02367971
02063700
00036137
00030678
02229540
00494240
01977555
01977563
02229550
00499846
00271373
00271381
METHYLPREDNISOLONE
METHYLPREDNISOLONE
METHYLPREDNISOLONE SOD SUCCINA
METHYLPREDNISOLONE
METHYLPREDNISOLONE SOD SUCCINA
TRIAMCINOLONE DIACETATE
PREDNISONE
PREDNISONE
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
O/L
TAB
TAB
SOLU‐MEDROL ACT‐O‐VIAL 1G
SOLU‐MEDROL ACT‐O‐VIAL 1G
SOLUMEDROL ACT‐O‐VIAL 500MG
SOLU‐MEDROL INJ 1G
SOLU‐MEDROL INJ 500MG
TRIAMCINOLONE 10MG/ML INJ
TRIAMCINOLONE 40MG/M
TRIAMCINOLONE SUSP 40MG/ML
WINPRED TAB 1MG
WINPRED TAB 5MG
223
1G/VIAL
1G
500MG
1G
500MG
10MG/ML
40MG/ML
40MG/ML
40MG/ML
40MG/ML
40MG/ML
1MG
5MG
*PA
INJ
INJ
INJ
INJ
INJ
TAB
TAB
IMPLANT
TAB
O/L
O/L
O/L
INJ
TAB
O/L
TAB
INJ
TAB
TAB
O/L
TAB
INH
INH NEB
INH NEB
INH NEB
INH
INH
INH
INH
TAB
TAB
NAS SPR
NAS SPR
INJ
INJ
INJ
INJ
INJ
INJ
05/2012
Therapy Class
680800
DIN
Drug Name
ANDROGENS
Chemical Name
Strength
Dosage
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
680800
00782327
02239653
02245972
02245345
02245346
02249499
01904817
00358754
02018152
01908146
00358762
02018160
00491764
01904809
02018144
00270687
00029246
00030783
00177652
00177636
00005746
00739944
02322498
02280248
02246063
00211052
00298336
ANDRIOL 40MG CAP
ANDRODERM 12.2MG TRANSDR PAD
ANDRODERM 24.3MG TRANSDR PAD
ANDROGEL 1% GEL
ANDROGEL 1% GEL
ANDROGEL 1% GEL
CYCLOMEN 100 MG
CYCLOMEN 100MG CAP
CYCLOMEN 100MG CAP
CYCLOMEN 200MG
CYCLOMEN 200MG CAP
CYCLOMEN 200MG CAP
CYCLOMEN 50MG CAP
CYCLOMEN 50MG CAP
CYCLOMEN 50MG CAP
DECA DURABOLIN INJ 100MG/ML
DELATESTRYL INJ 200MG/ML
DEPO‐TESTOSTERONE 100MG/ML INJ
MALOGEN AQUEOUS INJ 100MG/ML
MALOGEX LA 200 INJ
METANDREN 10MG TAB
PMS‐TESTOSTERONE 200MG/ML INJ
PMS‐TESTOSTERONE 40MG CAP
TESTIM 1% GEL
TESTOSTERONE CYPIONATE INJ 100
TESTOSTERONE PROPIO 10ML
TESTOTERONE 10ML
TESTOSTERONE UNDECANOATE
TESTOSTERONE
TESTOSTERONE
TESTOSTERONE
TESTOSTERONE
TESTOSTERONE
DANAZOL
DANAZOL
DANAZOL
DANAZOL
DANAZOL
DANAZOL
DANAZOL
DANAZOL
DANAZOL
NANDROLONE DECANOATE
TESTOSTERONE ENANTHATE
TESTOSTERONE CYPIONATE
TESTOSTERONE PROPIONATE
METHYLTESTOSTERONE
TESTOSTERONE UNDECANOATE
TESTOSTERONE
TESTOSTERONE CYPIONATE
40MG
12.2MG
24.3MG
1%
1%
1%
100MG
100MG
100MG
200MG
200MG
200MG
50MG
50MG
50MG
100MG/ML
200MG/ML
100MG/ML
100MG/ML
200MG
10MG
200MG/ML
40MG
1%
100MG/ML
100MG
200MG
CAP
PATCH
PATCH
GEL
GEL
GEL
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
CAP
INJ
INJ
INJ
INJ
INJ
TAB
INJ
CAP
GEL
INJ
INJ
INJ
224
*PA
05/2012
Therapy Class
681200
DIN
Drug Name
CONTRACEPTIVES
Chemical Name
Strength
Dosage
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
681200
02236974
02236975
02317192
02317206
02298538
02298546
02187086
02187094
02189054
02189062
01968440
01992872
00469327
00471526
02302349
02302357
02216302
02216310
02216329
02216337
02248297
02272903
02257238
00297143
00353027
02247120
02247121
02215640
02215659
02328828
02328836
02042487
02042479
00037605
02042320
00315966
00343838
02042339
02243005
02197499
02199300
02217384
02217392
02212129
02212137
02162628
02162601
02253186
00317047
00340731
00372846
00372838
00602965
00602957
02042533
02043033
02223090
02295946
02295954
02320061
02320088
02296659
02346176
02197502
02199297
02187108
02187116
02028700
02258560
02258587
02029421
02320096
02320118
00707600
00707503
02261723
02261731
02321157
ALESSE 21 TAB
ALESSE 28 TAB
APRI 21 TAB
APRI 28 TAB
AVIANE 21 100MCG/20MCG TAB
AVIANE 28 100MCG/20MCG TAB
BREVICON 0.5/35 21'S
BREVICON 0.5/35 28'S
BREVICON 1/35 21'S TAB
BREVICON 1/35 28'S TAB
CYCLEN TAB 21 DAY
CYCLEN TAB 28 DAY
DEMULEN 30 (21 DAY PACK)
DEMULEN 30 (28 DAY PACK)
ENPRESSE 21 TAB
ENPRESSE 28 TAB
ETHYNODIOL DIACETATE/ETHYNYL E
EVRA TRANSDERMAL SYSTEM
LINESSA 21 TAB
LINESSA 28 TAB
LOESTRIN 1.5/30 TAB 21
LOESTRIN 1.5/30 TAB 28
LOETTE 21 TAB
LOETTE 28 TAB
LO‐FEMENAL 21 TAB
LO‐FEMENAL 28 TAB
MARFEM 21 TAB
MARFEM 28 TAB
MARVELON 21 TAB
MARVELON 28 TAB
MICRONOR 28
MIN OVRAL 21 TAB
MINESTRIN 1/20 21
MINESTRIN 1/20 28
MIN‐OVRAL 28 TAB
MIRENA INTRAUTERINE SYSTEM
NORETHINDRONE/ETHINYL ESTRADIO
NORETHINDRONE/MESTRANOL 21''
NORETHINDRONE/MESTRANOL 28''
NORINYL 1/50 21 TAB
NORINYL 1/50 28 TAB
NUVARING VAG RING
ORTHO 0.5/35 TAB 21'S
ORTHO 0.5/35 TAB 28'S
ORTHO 1/35 TAB 21'S
ORTHO 1/35 TAB 28'S
ORTHO 7‐7‐7 TAB 28'S
ORTHO 7‐7‐7 TAB 21S
ORTHO‐CEPT 28 TAB
OVRAL 21 TAB
OVRETTE 21 TAB
PORTIA 21 TAB
PORTIA 28 TAB
PREVIFEM 21 TAB
PREVIFEM 28 TAB
SEASONALE .15MG AND .03MG TAB
SEASONIQUE 0.15MG/0.03MG TAB
SELECT 1/35 TAB 21'S
SELECT 1/35 28'S
SYNPHASIC 21 TAB
SYNPHASIC‐28 TAB
TRI‐CYCLEN 21 TAB
TRI‐CYCLEN LO 21
TRI‐CYCLEN LO 28
TRI‐CYCLEN TAB 28S
TRI‐PREVIFEM 21 TAB
TRI‐PREVIFEM 28 TAB
TRIQUILAR 21 TAB
TRIQUILAR 28 TAB
YASMIN 21 TAB
YASMIN 28 TAB
YAZ TAB
LEVONORGESTREL/ETHINYL ESTRAD
DESOGESTREL/ETHINYL ESTRADIOL
LEVONORGESTREL/ETHINYL ESTRADI
ETHINYL ESTRADIOL/NORETHINDRON
ETHINYL ESTRADIOL/NORGESTIMATE
ETHINYL ESTRADIOL
ETHINYL ESTRADIOL
NORELGESTROMIN/ETHINYL ESTRAD
NORGESTREL/ETHINYL ESTRADIOL
NORGESTREL/ETHINYL ESTRADIOL
NORETHINDRONE
LEVONORGESTREL
MESTRANOL/NORETHINDRONE
ETONOGESTREL/ETHINYL ESTRADIOL
NORGESTREL
ETHINYL ESTRADIOL
ETHINYL ESTRADIOL
DROSPIRENONE/ETHINYL ESTRADIOL
100/20 MCG
100/20 MCG
0.15/.03MG
0.15/.03MG
100MCG/20M
100MCG/20M
0.5/35
0.5/35
1/0.035MG
1/0.035MG
.035/.25MG
.035/.25MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
PATCH
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
MISC
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
DEVICE
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
225
2MG/0.03MG
2MG/0.03MG
1MG/0.05MG
1MG/0.05MG
6MG/0.6MG
.3MG/1.5MG
.3MG/1.5MG
100UG/20UG
100UG/20UG
0.3/0.03MG
0.3/0.03MG
0.15/.03MG
0.15/.03MG
0.35 MG
0.03/0.15
0.2MG/1MG
0.2MG/1MG
0.03/0.15
.035M/.5MG
.035M/.5MG
.035M/.5MG
.035M/1MG
0.5MG/1MG
0.5MG/1MG
0.5MG/1MG
0.5MG/1MG
11,4/2,6
0.15/.03MG
0.05/0.25
75MCG
0.15/0.03
0.15/0.03
.035/.25MG
.035/.25MG
0.15/0.03
0.15/0.03
.035M/1MG
.035M/1MG
.025/.18MG
.025/.215M
.035/.18MG
.035/.215M
.075/.04MG
.05/.03MG
3MG/0.03MG
3MG/0.03MG
3MG/0.02MG
*PA
05/2012
Therapy Class
681600
DIN
Drug Name
ESTROGENS AND ANTIESTROGENS
Chemical Name
226
Strength
Dosage
*PA
05/2012
Therapy Class
681604
DIN
Drug Name
ESTROGENS
Chemical Name
Strength
Dosage
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
681604
00265470
02225190
02148587
02148595
00298298
00473618
00287725
00727369
02168898
02241794
02089793
02016958
02089769
02089777
00282685
00282677
00741930
00053538
02043386
02043394
02043408
02043424
02043440
02242879
02242880
02246969
02246967
02246968
02325462
C.E.S. TAB 0.625MG
ESTRACE 0.5MG TAB
ESTRACE 1MG TAB
ESTRACE 2MG TAB
ESTRADIOL VALERATE 2
ESTRAGYN 0.3MG TAB
ESTRAGYN 0.625MG TAB
ESTRAGYN VAG CREAM
ESTRING 2MG VAGINAL RING
HONVOL 83MG TAB
OGEN 0.625 MG TAB
OGEN 0.75MG TAB
OGEN 1.25 MG TAB
OGEN 2.5 MG TAB
OGEN TAB 1.5MG
OGEN TAB 3MG
PMS‐ESTRADIOL VALERATE INJ
PREMARIN 0.625MG MET
PREMARIN INJ 25MG/VIAL INJ
PREMARIN TAB 0.3MG
PREMARIN TAB 0.625 MG
PREMARIN TAB 1.25MG
PREMARIN VAG W/ APPL
PREMPLUS 0.625MG+5MG KIT
PREMPLUS CYCLE 0.625+10 KIT
SANDOZ ESTRADIOL DERM 100
VAGIFEM LD 10MCG VAGINAL TAB
CONJUGATED ESTROGEN
ESTRADIOL
ESTRADIOL
ESTRADIOL
ESTRADIOL
OESTROGENS ESTERIFIED
ESTROGEN EST
ESTRONE
ESTRADIOL
DIETHYLSTILBESTROL DIPHOSPHATE
ESTROPIPATE
ESTROPIPATE
ESTROPIPATE
ESTROPIPATE
PIPERAZINE ESTRONE SULFATE
PIPERAZINE ESTRONE SULFATE
ESTRADIOL VALERATE
CONJUGATED ESTROGEN
CONJUGATED ESTROGEN
CONJUGATED ESTROGEN
CONJUGATED ESTROGEN
CONJUGATED ESTROGEN
CONJUGATED ESTROGEN
CONJ ESTR/MEDROXYPROGESTERONE
CONJ ESTR&MEDROXYPROGESTERONE
ESTRADIOL HEMIHYDRATE
0.625MG
0.5MG
1MG
2MG
20MG/ML
0.3MG
0.625MG
1MG/G
2MG
83MG
0.625MG
0.75MG
1.5MG
3MG
1.5MG
3MG
10 MG
0.625MG
25MG/VIAL
0.3MG
0.625MG
1.25MG
0.625MG/G
TAB
TAB
TAB
TAB
INJ
TAB
TAB
CR VAG
MISC
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
INJ
TAB
TAB
TAB
CR VAG
TAB
KIT
PATCH
PATCH
PATCH
TAB VAG
227
8MG
4MG
6MG
10MCG
*PA
05/2012
Therapy Class
681612
DIN
Drug Name
ESTROGEN AGONISTS-ANTAGONISTS
Chemical Name
Strength
Dosage
681612
681612
681612
681612
681612
02279215
02358840
02239028
02312298
02358921
APO‐RALOXIFENE 60MG TAB
CO RALOXIFENE 60MG TAB
EVISTA 60MG TAB
NOVO‐RALOXIFENE 60MG TAB
PMS‐RALOXIFENE 60MG TAB
RALOXIFENE HCL
RALOXIFENE HCL
RALOXIFENE HCL
RALOXIFENE HCL
RALOXIFENE HCL
60MG
60MG
60MG
60MG
60MG
TAB
TAB
TAB
TAB
TAB
228
*PA
05/2012
Therapy Class
681800
DIN
Drug Name
GONADOTROPINS
681800
681800
681800
02212145 NAFARELIN ACETATE NAS/SOL
02162709 SYNAREL NAS SOL 2MG/ML
02188783 SYNAREL NAS SOL 2MG/ML
229
Chemical Name
Strength
Dosage
NAFARELIN ACETATE
NAFARELIN ACETATE
NAFARELIN ACETATE
2MG/ML
2MG/ML
2MG/ML
NAS SOL
NAS SOL
NAS SOL
*PA
05/2012
Therapy Class
682002
DIN
Drug Name
ALPHA-GLUCOSIDASE INHIBITORS
Chemical Name
Strength
Dosage
682002
682002
682002
682002
682002
02190893
02190885
02239476
02239474
02239475
GLUCOBAY 100MG TAB
GLUCOBAY 50MG TAB
GLYSET TM 100MG TAB
GLYSET TM 25MG TAB
GLYSET TM 50MG TAB
ACARBOSE
ACARBOSE
MIGLITOL
MIGLITOL
MIGLITOL
100MG
50MG
100MG
25MG
50MG
TAB
TAB
TAB
TAB
TAB
230
*PA
05/2012
Therapy Class
682004
DIN
Drug Name
BIGUANIDES
Chemical Name
Strength
Dosage
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
02365286
02365294
02167786
02229785
02341603
02341522
02364506
02364514
02257726
02257734
02229994
02242726
02099233
02162849
00314552
02239214
02229516
02252945
02252953
02378043
02378051
02380196
02380196
02380722
02380722
02380722
02380722
02380722
02380722
02380722
02380722
02380722
02380218
02380218
02380730
02380730
02380730
02380730
02380730
02380730
02380730
02380730
02380730
02333872
02333856
02333864
02378620
02378620
02378639
02378639
02238827
02242794
02284782
02334437
02343606
02350289
02353377
02378841
02378841
02230027
02242793
02246965
02284790
02334445
02343614
02350300
02353385
02378868
02378868
02148765
02229656
02045710
02230475
02361264
02361272
02162822
02229517
02246613
02246614
02378116
ACCEL‐METFORMIN 500MG TAB
ACCEL‐METFORMIN 850MG TAB
APO‐METFORMIN 500MG TAB
APO‐METFORMIN 850MG TAB
APX‐METFORMIN 500MG TAB
APX‐METFORMIN 850MG TAB
AVA‐METFORMIN 500MG TAB
AVA‐METFORMIN 850MG TAB
CO‐METFORMIN 500MG TAB
CO‐METFORMIN 850MG TAB
DOM‐METFORMIN 500MG TAB
DOM‐METFORMIN 850MG TAB
GLUCOPHAGE 500MG TAB
GLUCOPHAGE 850MG TAB
GLUCOPHAGE TAB 500MG
GLYCON 850MG TAB
GLYCON TAB 500MG
GMD‐METFORMIN 500MG TAB
GMD‐METFORMIN 850MG TAB
IPG‐METFORMIN 500MG TAB
IPG‐METFORMIN 850MG TAB
JAMP‐METFORMIN 500MG TAB
JANUMET 50MG/1000MG TAB
MAR‐METFORMIN 500MG TAB
METFORMIN 500MG TAB
METFORMIN 500MG TAB
METFORMIN 500MG TAB
METFORMIN 500MG TAB
METFORMIN 500MG TAB
METFORMIN 500MG TAB
METFORMIN 500MG TAB
METFORMIN 500MG TAB
METFORMIN 500MG TAB
METFORMIN 850MG TAB
METFORMIN 850MG TAB
METFORMIN 850MG TAB
METFORMIN 850MG TAB
METFORMIN 850MG TAB
METFORMIN 850MG TAB
METFORMIN 850MG TAB
METFORMIN 850MG TAB
METFORMIN 850MG TAB
METFORMIN 850MG TAB
MYLAN‐METFORMIN 500MG TAB
MYLAN‐METFORMIN 850MG TAB
NOVO‐METFORMIN 500MG TAB
NOVO‐METFORMIN 850MG TAB
NTP‐METFORMIN 500MG TAB
NTP‐METFORMIN 850MG TAB
NU‐METFORMIN 500MG TAB
NU‐METFORMIN 850MG TAB
ORB‐METFORMIN 500MG TAB
ORB‐METFORMIN 850MG TAB
PG‐METFORMIN 500MG TAB
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN
METFORMIN
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
SITAGLIPTIN/METFORMIN
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
500MG
850MG
500MG
850MG
500MG
500MG
500MG
500MG
500MG
500MG
500MG
500MG
500MG
500MG
500MG
850MG
850MG
850MG
850MG
850MG
850MG
850MG
850MG
850MG
850MG
850MG
50/1000MG
50MG/500MG
50MG/850MG
500MG
500MG
850MG
850MG
500MG
500MG
500MG
500MG
500MG
500MG
500MG
500MG
500MG
850MG
850MG
850MG
850MG
850MG
850MG
850MG
850MG
850MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
231
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
682004
02378124
02246964
02223562
02242589
02314908
02314894
02339110
02339129
02269031
02269058
02242974
02242931
02239081
02242783
02246820
02246821
02379767
02379767
02379775
02379775
PG‐METFORMIN 850MG TAB
PHL‐METFORMIN 500MG TAB
PMS‐METFORMIN 500MG TAB
PMS‐METFORMIN 850MG TAB
PRO‐METFORMIN 500MG TAB
PRO‐METFORMIN 850MG TAB
Q‐METFORMIN 500MG TAB
Q‐METFORMIN 850MG TAB
RAN‐METFORMIN 500MG TAB
RAN‐METFORMIN 850MG TAB
RATIO‐METFORMIN 500MG TAB
RATIO‐METFORMIN 850MG TAB
RIVA‐METFORMIN 500MG TAB
RIVA‐METFORMIN 850MG TAB
SANDOZ METFORMIN FC 500MG TAB
SANDOZ METFORMIN FC 850MG TAB
SEPTA‐METFORMIN 500MG TAB
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
METFORMIN HCL
850MG
500MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
850MG
500MG
500MG
850MG
850MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
232
*PA
05/2012
Therapy Class
682005
DIN
Drug Name
DIPEPTIDYL PEPTIDASE IV (DDP-4) INHIBITORS
Chemical Name
Strength
Dosage
682005
682005
682005
682005
02303922
02375842
02333554
02370921
JANUVIA 100MG TAB
ONGLYZA 2.5MG TAB
ONGLYZA 5MG TAB
TRAJENTA 5MG TAB
SITAGLIPTIN PHOSPHATE MONOHYDR
SAXAGLIPTIN HCL
SAXAGLIPTIN HCL
LINAGLIPTIN
100MG
2.5MG
5MG
5MG
TAB
TAB
TAB
TAB
233
*PA
05/2012
Therapy Class
682008
DIN
Drug Name
INSULINS
Chemical Name
Strength
Dosage
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
682008
02279479
02279460
02294346
02233562
02240296
02240299
09853715
02240298
99002817
02229705
02229704
09857352
00965537
99100630
00965545
02240294
09857353
99100631
00965421
02240297
09857355
09853855
00795879
01959212
02229750
00646148
00908991
09853804
00587737
01959239
99001586
97799500
09853766
00586714
01959220
99001594
01985981
00909009
01985949
01985957
00984299
01986791
02294338
02245689
02251930
00773654
00632694
01986821
00632678
01985965
02024217
00984434
02245179
02245180
02247309
02245181
00908134
00920681
02025248
09853812
02245182
02024314
02245183
02024322
02245177
02245178
02247308
02024225
99000334
02024268
09853782
02247307
00921130
02024233
02024284
09853774
02265435
02245397
02244353
02377209
APIDRA 100UNIT/ML CARTRIDGE
APIDRA INJ 100UNIT/ML
APIDRA SOLOSTAR PREFILLED PEN
HUMALOG 100U/ML CARTRIDGE 3ML
HUMALOG 100U/ML INJ
HUMALOG 100U/ML INJ
HUMALOG 100U/ML INJ CARTRIDGE
HUMALOG 50/50 PREFILLED PEN
HUMALOG INJ 100U/ML
HUMALOG INSULIN CARTRIDGE
HUMALOG INSULIN INJ
HUMALOG KWIKPEN 100U/ML INJ
HUMALOG KWIKPEN INJ
HUMALOG KWIKPEN INJ
HUMALOG MIX 25 KWIKPEN INJ
HUMALOG MIX 50 KWIKPEN
HUMULIN 30/70 CARTRIDGE INJ
HUMULIN 30/70 INJ
HUMULIN 30/70 INJ
HUMULIN CARTRIDGES & HUMAJECT
HUMULIN L LENTE INJ 100UNIT/ML
HUMULIN N 100U/ML CARTRIDGE
HUMULIN N 100U/ML INJ CARTRIDG
HUMULIN N INJ 100UNIT/ML
HUMULIN N INSULIN INJ
HUMULIN N INSULIN INJ (PQ)
HUMULIN N KWIKIPEN
HUMULIN R 100U/ML INJ CARTRIDG
HUMULIN R INJ
HUMULIN R INJ
HUMULIN R INJ (PSEUDO PQ)
INITARD INSULIN
INS HUMULIN 30/70 CART
INSULIN INSULATARD NORDISK INJ
INSULIN MIXTARD NORDISK INJ
INSULIN NOVOLIN NPH
INSULIN NOVOLIN NPH HUMAN
LANTUS (3ML SOLOSTAR DISP PEN)
LANTUS 100UNIT/ML 10ML VIAL
LANTUS 100UNIT/ML CARTRIDGE
MIXTARD 15/85 HUMAN INJ
NOVOLIN 30/70 INJ 100UNIT/ML
NOVOLIN 30/70 PENFIL
NOVOLIN GE 10/90 INNOLET INJ
NOVOLIN GE 30/70 FLEXPEN
NOVOLIN GE 30/70 PEN
NOVOLIN GE 30/70 PENFILL
NOVOLIN GE 30/70 PENFILL INJ
NOVOLIN GE INNOLET INJ
NOVOLIN GE INNOLET INJ
NOVOLIN GE NPH FLEXPEN
NOVOLIN GE NPH INJ
NOVOLIN GE NPH INJ
NOVOLIN GE NPH PENFILL
NOVOLIN GE NPH PENFILL 100U/ML
NOVOLIN GE TORONTO FLEXPEN
NOVOLIN GE TORONTO INJ
NOVOLIN GE TORONTO INJ
NOVOLIN GE TORONTO PENFILL
NOVOMIX 30 PENFILL
NOVORAPID 100IU/ML INJ 10ML
NOVORAPID 100IU/ML INJ 5X3ML
NOVORAPID FLEXTOUCH 100IU/ML
INSULIN GLULISINE
INSULIN GLULISINE
INSULIN GLULISINE
INSULIN LISPRO
INSULIN LISPRO/PROTAMINE
INSULIN
INSULIN LISPRO
INSULIN LISPRO
INSULIN LISPRO
INSULIN LISPRO
INSULINE LISPRO
INSULINE LISPRO/ INSULINE LISP
INSULIN
INSULIN HUMAN/ISOPHANE
INSULIN HUMAN BIOSYNTHETIC
INSULIN ZINC SUSPENSION MEDIUM
INSULIN BIOSYNTHETIC HUMAN
INSULIN NPH HUMAN DNA ORIGIN
INSULIN HUMULIN
INSULIN HUMULIN (PSEUDO IN PQ)
INSULIN
INSULIN SEMI SYNTHETIC HUMAN
INSULIN HUMULIN
INSULIN ZINC CRYSTALLINE (PQ)
INSULIN NEUTRAL/ISOPHANE
INSULIN ISOPHANE NPH PORK
INSULIN NOVOLIN NPH PENFILL
INSULIN HUMAN
INSULIN GLARGINE
INSULIN GLARGINE
INSULIN GLARGINE
INSULIN
INSULIN INJECTION (30%) + INSU
INSULIN ISOPHANE HUMAN BIOSYNT
INSULIN
INSULIN
INSULIN ISOPHANE HUMAN BIOSYNT
ISOPHANE
ISOPHANE
ISOPHANE
INSULIN
INSULIN INJECTION HUMAN BIOSYN
INSULIN REGULAR
INSULIN HUMAN
INSULIN ASPART
INSULIN ASPART
INSULIN ASPART
INSULIN ASPART
100UNIT/ML
100UNIT/ML
100U/ML
100U
100U/ML
50/50
100U/ML
50/50
100U/ML
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
SUSP
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
234
100IU/ML
100UNIT/ML
25/75
25/75
25/75
50/50
50/50
50/50
30/70
30/70
30/70
100UNIT/ML
100IU/ML
100U/ML
100U
100IU/ML
100 U
100 U
100U
100IU/ML
100 U
100U/ML
50/50
100 U
30/70
100UNIT/ML
100UNIT/ML
100IU/ML
1000U/10ML
1000U/10ML
30/70
1000U/10ML
50/50
30/70
150U/1.5ML
70UNIT/ML
150U/1.5ML
30/70
30/70
40/60
50/50
100U/ML
100U/ML
100UNIT/ML
100 U
1000U/10ML
100 U
100U
100UNIT/ML
100U/ML
100 U
100 U
100 U
100UNIT/ML
100IU/ML
100IU/ML
100IU/ML
*PA
05/2012
Therapy Class
682016
DIN
Drug Name
MEGLITINIDES
Chemical Name
Strength
Dosage
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
682016
02355663
02355671
02355698
02321475
02321483
02321491
02239924
02239925
02239926
02373270
02373289
02373297
02354926
02354934
02354942
02357453
02357461
02357488
02366347
02366355
02366363
APO‐REPAGLINIDE 0.5MG TAB
APO‐REPAGLINIDE 1MG TAB
APO‐REPAGLINIDE 2MG TAB
CO‐REPAGLINIDE 0.5MG TAB
CO‐REPAGLINIDE 1MG TAB
CO‐REPAGLINIDE 2MG TAB
GLUCONORM 0.5MG TAB
GLUCONORM 1MG TAB
GLUCONORM 2MGTAB
MYLAN‐REPAGLINIDE 0.5MG TAB
MYLAN‐REPAGLINIDE 1MG TAB
MYLAN‐REPAGLINIDE 2MG TAB
PMS‐REPAGLINIDE 0.5MG TAB
PMS‐REPAGLINIDE 1MG TAB
PMS‐REPAGLINIDE 2MG TAB
SANDOZ REPAGLINIDE 0.5MG TAB
SANDOZ REPAGLINIDE 1MG TAB
SANDOZ REPAGLINIDE 2MG TAB
TEVA‐REPAGLINIDE 0.5MG TAB
TEVA‐REPAGLINIDE 1MG TAB
TEVA‐REPAGLINIDE 2MG TAB
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
REPAGLINIDE
0.5MG
1MG
2MG
0.5MG
1MG
2MG
0.5MG
1MG
2MG
0.5MG
1MG
2MG
0.5MG
1MG
2MG
0.5MG
1MG
2MG
0.5MG
1MG
2MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
235
*PA
05/2012
Therapy Class
682020
DIN
Drug Name
SULFONYLUREAS
Chemical Name
Strength
Dosage
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
682020
02245272
02245273
02245274
00399302
00312711
02245247
02295377
02295385
02295393
01913654
01913662
00312762
02348578
02340763
02340771
02363518
02363704
02363712
02274248
02274256
02274264
02274272
02224569
02224550
02242987
02356422
00765996
02234514
00720933
00720941
02279061
02279088
02279126
02248453
02287072
02293862
02297795
02286149
02350459
02286157
02350467
02229519
00808733
00808741
02238103
02273756
02273764
02273772
00021350
02345854
02345862
02336316
02020734
00202734
02020742
01987828
02224798
02224771
00586773
00156728
01959352
02284545
02284553
02313596
02236734
02316544
02155850
02273101
02273128
02273136
01900935
01900927
02269589
02269597
02269619
02236543
02242095
02236548
02242096
02269600
AMARYL 1MG TAB
AMARYL 2MG TAB
AMARYL 4MG TAB
APO‐CHLORPROPAMIDE 100MG TAB
APO‐CHLORPROPAMIDE 250MG TAB
APO‐GLICLAZIDE 80MG TAB
APO‐GLIMEPIRIDE 1MG TAB
APO‐GLYBURIDE 2.5MG TAB
APO‐GLYBURIDE 5MG TAB
APO‐TOLBUTAMIDE 500MG TAB
APX‐GLICLAZIDE MR 30MG TAB
APX‐GLYBURIDE 2.5MG TAB
APX‐GLYBURIDE 5MG TAB
AVA‐GLICLAZIDE 80MG TAB
AVA‐GLYBURIDE 2.5MG TAB
AVA‐GLYBURIDE 5MG TAB
CO GLIMEPIRIDE 1MG TAB
DIABETA 5MG TAB
DIABETA TAB 2.5MG
DIAMICRON MR 30MG TAB
DIAMICRON MR 60MG TAB
DIAMICRON TAB 80MG
DOM‐GLYBURIDE 5MG TAB
EUGLUCON 2.5MG TAB
EUGLUCON 5MG TAB
GEN‐GLIMEPIRIDE 1MG TAB
GLICLAZIDE 80MG TAB
GLICLAZIDE 80MG TAB
GLICLAZIDE MR 30MG ER TAB
GLICLAZIDE MR 30MG ER TAB
GLYBURIDE 2.5MG TAB
GLYBURIDE 2.5MG TAB
GLYBURIDE 5MG TAB
GLYBURIDE 5MG TAB
MYLAN‐GLICLAZIDE 80MG TAB
MYLAN‐GLYBE TAB 2.5MG
MYLAN‐GLYBE TAB 5MG
NOVO‐GLICLAZIDE 80MG TAB
NOVO‐GLIMEPIRIDE 1MG TAB
NOVO‐PROPAMIDE 250MG TAB
NTP‐GLYBURIDE 2.5MG TAB
NTP‐GLYBURIDE 5MG TAB
NU‐GLICLAZIDE 80MG TAB
NU‐GLYBURIDE 2.5 MG TAB
NU‐GLYBURIDE 2.5MG TAB
NU‐GLYBURIDE 5 MG TAB
ORINASE 1GM TAB
ORINASE 1GM TAB
ORINASE 500MG TAB
PDL‐CHLORPROPAMIDE 100MG TAB
PDL‐CHLORPROPAMIDE TAB 250MG
PDL‐GLYBURIDE 2.5MG TAB
PMS‐GLIMEPIRIDE 1MG TAB
PMS‐GLYBURIDE 5MG TAB
PRO‐GLYBURIDE 5MG TAB
PROVAL‐GLICLAZIDE 80MG TAB
RATIO‐GLIMEPIRIDE 1MG TAB
RATIO‐GLYBURIDE 5MG TAB
RATIO‐GLYBURIDE TAB 2.5MG
RHOXAL‐GLIMEPIRIDE 1MG TAB
RIVA‐GLYBURIDE 2.5MG TAB
RIVA‐GLYBURIDE 2.5MG TAB
RIVA‐GLYBURIDE 5MG TAB
RIVA‐GLYBURIDE 5MG TAB
SANDOZ GLIMEPIRIDE 3MG TAB
GLIMEPIRIDE
GLIMEPIRIDE
GLIMEPIRIDE
CHLORPROPAMIDE
CHLORPROPAMIDE
GLICLAZIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLYBURIDE
GLYBURIDE
TOLBUTAMIDE
GLICLAZIDE
GLYBURIDE
GLYBURIDE
GLICLAZIDE
GLYBURIDE
GLYBURIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLYBURIDE
GLYBURIDE
GLICLAZIDE
GLICLAZIDE
GLICLAZIDE
GLYBURIDE
GLYBURIDE
GLYBURIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLICLAZIDE
GLICLAZIDE
GLICLAZIDE
GLICLAZIDE
GLYBURIDE
GLYBURIDE
GLYBURIDE
GLYBURIDE
GLICLAZIDE
GLYBURIDE
GLYBURIDE
GLICLAZIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLIMEPIRIDE
CHLORPROPAMIDE
GLYBURIDE
GLYBURIDE
GLICLAZIDE
GLYBURIDE
GLYBURIDE
GLYBURIDE
TOLBUTAMIDE
TOLBUTAMIDE
TOLBUTAMIDE
CHLORPROPAMIDE
CHLORPROPAMIDE
GLYBURIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLYBURIDE
GLYBURIDE
GLICLAZIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLYBURIDE
GLYBURIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLIMEPIRIDE
GLYBURIDE
GLYBURIDE
GLYBURIDE
GLYBURIDE
GLIMEPIRIDE
1MG
2MG
4MG
100MG
250MG
80MG
1MG
2MG
4MG
2.5MG
5MG
500MG
30MG
2.5MG
5MG
80MG
2.5MG
5MG
1MG
2MG
3MG
4MG
5MG
2.5MG
30MG
60MG
80MG
5MG
2.5MG
5MG
1MG
2MG
4MG
80MG
80MG
30MG
30MG
2.5MG
2.5MG
5MG
5MG
80MG
2.5MG
5MG
80MG
1MG
2MG
4MG
250MG
2.5MG
5MG
80MG
2.5MG
2.5MG
5MG
1GM
1GM
500MG
100MG
250MG
2.5MG
1MG
2MG
4MG
5MG
5MG
80MG
1MG
2MG
4MG
5MG
2.5MG
1MG
2MG
4MG
2.5MG
2.5MG
5MG
5MG
3MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
236
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
682020
682020
682020
682020
682020
682020
02248008
02248009
01913670
01913689
02228920
02228939
SANDOZ GLYBURIDE 2.5MG TAB
SANDOZ GLYBURIDE 5MG TAB
TEVA‐GLYBURIDE TAB 2.5MG
TEVA‐GLYBURIDE TAB 5MG
TRIA‐GLYBURIDE 2.5MG TAB
TRIA‐GLYBURIDE 5MG TAB
GLYBURIDE
GLYBURIDE
GLYBURIDE
GLYBURIDE
GLYBURIDE
GLYBURIDE
2.5MG
5MG
2.5MG
5MG
2.5MG
5 MG
TAB
TAB
TAB
TAB
TAB
TAB
237
*PA
05/2012
Therapy Class
682028
DIN
Drug Name
THIAZOLIDINEDIONES
Chemical Name
Strength
Dosage
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
682028
02303442
02303450
02303469
02339676
02339684
02339692
02242572
02242573
02242574
02374587
02374595
02302942
02302950
02302977
02363232
02363240
02363259
02302861
02302888
02302896
02307634
02307642
02307650
02365529
02365537
02326477
02326485
02326493
02298279
02298287
02298295
02354349
02354357
02354365
02274914
02274922
02274930
02307669
02307677
02307723
02334674
02345366
02334682
02345374
02334690
02345382
02374013
02339587
02374021
02339595
02374048
02303124
02303132
02303140
02306166
02306174
02306182
02236985
02238698
02236986
02312050
02312069
02312077
02375850
02375869
02375877
02301423
02301431
02301458
02237531
02297906
02297914
02297922
02326329
02326337
02326345
02354144
02354152
02354160
02320754
ACCEL PIOGLITAZONE 15MG TAB
ACC‐PIOGLITAZONE 15MG TAB
ACTOS 15MG TAB
ACTOS 30MG TAB
ACTOS 45MG TAB
AG‐PIOGLITAZONE 30MG TAB
AG‐PIOGLITAZONE 45MG TAB
APO‐PIOGLITAZONE 15MG TAB
AVA‐PIOGLITAZONE 15MG TAB
CO PIOGLITAZONE 15MG TAB
DOM‐PIOGLITAZONE 15MG TAB
JAMP‐PIOGLITAZONE 30MG TAB
JAMP‐PIOGLITAZONE 45MG TAB
MINT‐PIOGLITAZONE 15MG TAB
MYLAN‐PIOGLITAZONE 15MG TAB
MYLAN‐ROSIGLITAZONE 2MG TAB
NOVO‐PIOGLITAZONE 15MG TAB
PHL‐PIOGLITAZONE 15MG TAB
PIOGLITAZONE 15MG TAB
PIOGLITAZONE HCL 15MG TAB
PMS‐PIOGLITAZONE 15MG TAB
PMS‐ROSIGLITAZONE 2MG TAB
PRELAY 200MG TAB
PRELAY 300MG TAB
PRELAY 400MG TAB
PRO‐PIOGLITAZONE 15MG TAB
RAN‐PIOGLITAZONE 15MG TAB
RATIO‐PIOGLITAZONE 15MG TAB
RATIO‐PIOGLITAZONE 30MG TAB
RATIO‐PIOGLITAZONE45MG TAB
REZULIN 300MG TAB
SANDOZ PIOGLITAZONE 15MG TAB
SANDOZ ROSIGLITAZONE 2MG TAB
TEVA‐ROSIGLITAZONE 2MG TAB
ZYM‐PIOGLITAZONE 15MG TAB
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE
PIOGLITAZONE
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE
PIOGLITAZONE
PIOGLITAZONE
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HYDROCHLORIDE
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
ROSIGLITAZONE MALEATE
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
TROGLITAZONE
TROGLITAZONE
TROGLITAZONE
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
TROGLITAZONE
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
PIOGLITAZONE HCL
15MG
30MG
45MG
15MG
30MG
45MG
15MG
30MG
45MG
30MG
45MG
15MG
30MG
45MG
15MG
30MG
45MG
15MG
30MG
45MG
15MG
30MG
45MG
30MG
45MG
15MG
30MG
45MG
15MG
30MG
45MG
2MG
4MG
8MG
15MG
30MG
45MG
15MG
30MG
45MG
15MG
15MG
30MG
30MG
45MG
45MG
15MG
30MG
30MG
45MG
45MG
15MG
30MG
45MG
2MG
4MG
8MG
200MG
300MG
400MG
15MG
30MG
45MG
15MG
30MG
45MG
15MG
30MG
45MG
300MG
15MG
30MG
45MG
2MG
4MG
8MG
2MG
4MG
8MG
15MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
238
*PA
05/2012
Therapy Class
DIN
Drug Name
682028
682028
02320762 ZYM‐PIOGLITAZONE 30MG TAB
02320770 ZYM‐PIOGLITAZONE 45MG TAB
239
Chemical Name
Strength
Dosage
PIOGLITAZONE HCL
PIOGLITAZONE HCL
30MG
45MG
TAB
TAB
*PA
05/2012
Therapy Class
682212
DIN
Drug Name
GLYCOGENOLYTIC AGENTS
682212
682212
682212
02333619 GLUCAGEN 1MG/VIAL INJ
02333627 GLUCAGEN HYPOKIT 1MG/ML INJ
02243297 GLUCAGON 1MG/VIAL INJ
240
Chemical Name
Strength
Dosage
GLUCAGON HCL
GLUCAGON HCL
GLUCAGON/RDNA ORIGIN
1MG/ML
1MG/ML
1MG/ML
INJ
INJ
INJ
*PA
05/2012
Therapy Class
682400
DIN
Drug Name
PARATHYROID
Chemical Name
Strength
Dosage
682400
682400
682400
682400
682400
682400
682400
682400
682400
682400
02247585
01926691
02007134
02254689
01992880
02144301
02240775
02311046
02233022
02261766
APO‐CALCITONIN NASAL SPRAY
CALCIMAR 200IU/ML INJ
CALTINE 100IU/ML INJ
FORTEO 250MCG/ML
MIACALCIN 100 UNIT/ML INJ
MIACALCIN 200 UNIT/ML INJ
MIACALCIN NAS SPR 200U/MD
PRO‐CALCITONIN 200IU NAS SPRAY
RHO‐CALCITONIN 200U/ML INJ
SANDOZ‐CALCITONIN NS 200U/SPR
CALCITONIN (SALMON SYNTHETIC)
TERIPARATIDE
200IU/SPR
200IU/ML
100UI/ML
250MCG/ML
100UNIT/ML
200UNIT/ML
200U
200U/SPRAY
200U/ML
200U/SPRAY
NAS SPR
INJ
INJ
INJ
INJ
INJ
NAS SPR
NAS SPR
INJ
NAS SPR
241
*PA
PA (N)
05/2012
Therapy Class
682800
DIN
Drug Name
PITUITARY
Chemical Name
Strength
Dosage
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
682800
02284030
02284049
02242465
02348209
02231515
02231516
00824305
00402516
00824143
00568325
00873993
02285002
02284995
00836362
02257696
02346788
02257718
02346796
02258706
02237193
02237192
02237195
02237191
02237194
02244003
02244004
02243078
00745626
02243077
02243079
02246500
02246505
02334860
02334879
02334852
02334941
02334968
02334925
02287730
02287749
02336154
02216191
02216183
02229722
02249002
02024179
02237860
02325071
02325055
02325063
02304368
02304376
02237970
02215136
02350130
02350149
02283867
02350122
02248168
02272083
02283875
02237971
02244373
02239046
02239047
02248169
02272075
02271532
00253952
APO‐DESMOPRESSIN 0.1MG TAB
APO‐DESMOPRESSIN 0.2MG TAB
APO‐DESMOPRESSIN 10MCG NAS SPR
APX‐DESMOPRESSIN 10MCG NAS SPR
BIO‐TROPIN 1.8MG/VIAL INJ
BIO‐TROPIN 4.8MG/ VIAL INJ
DDAVP 0.1MG TAB
DDAVP 0.1MG/ML NASAL SOL
DDAVP 0.2MG TAB
DDAVP 4MCG/ML INJ
DDAVP INJ 4MCG/ML
DDAVP MELT 120MCG TAB
DDAVP MELT 60MCG TAB
DDAVP SPRAY NAS SOLUTION
DESMOPRESSIN 0.1MG TAB
DESMOPRESSIN NASAL SPRAY
GENTROPIN 1.5MG PWS INJ
GEREF 0.5MG/VIAL PDR FOR INJ
GEREF 1MG/VIAL PDR FOR INJ
HUMATROPE 12MG
HUMATROPE 1MG/ML INJ
HUMATROPE 6MG CART
HUMATROPE INJ
MINIRIN 0.1MG TAB
MINIRIN 0.2MG TAB
NORDITROPIN NORDIFLEX 10MG/1.5
NORDITROPIN NORDIFLEX 15MG/1.5
NORDITROPIN NORDIFLEX 5MG/1.5M
NORDITROPIN SIMPLEXX 10MG/1.5M
NORDITROPIN SIMPLEXX 15MG/1.5M
NORDITROPIN SIMPLEXX 5MG/1.5ML
NOVO‐DESMOPRESSIN 0.1MG TAB
NOVO‐DESMOPRESSIN 0.2MG TAB
NU‐DESMOPRESSIN NASAL SPRAY
NUTROPIN 10MG/VIAL INJ
NUTROPIN 5MG/VIAL IN
NUTROPIN AQ 5MG/ML INJ
NUTROPIN AQ PEN CARTRIDGE
OCTOSTIM 15MCG/ML INJ
OCTOSTIM NASAL SPRAY 1.5MG/ML
OMNITROPE 10MG/CARTRIDGE INJ
OMNITROPE 5.8MG/VIAL PDR INJ
OMNITROPE 5MG/CARTRIDGE INJ
PMS‐DESMOPRESSIN 0.1MG TAB
PMS‐DESMOPRESSIN 0.2MG TAB
SAIZEN 1.33MG INJ
SAIZEN 10U/VIAL INJ
SAIZEN 12MG/CARTRIDGE INJ
SAIZEN 4MG/VIAL INJ
SAIZEN 8.8MG/VIAL INJ
SAIZEN PWS 5MG INJ
SEROSTIM 4MG/VIAL INJ
SEROSTIM 5MG INJ
SEROSTIM 6MG INJ
SEROSTIM 8.8MG/VIAL INJ
SEROSTIM 8.8MG/VIAL INJ
SEROSTIM LIQUID 6MG/0.5ML SC
SYNACTHEN DEPOT 1MG/ML INJ
DESMOPRESSIN ACETATE
SOMATROPIN
SOMATROPIN
DESMOPRESSIN ACETATE TRIHYD
DESMOPRESSIN ACETATE TRIHYD
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SERMORELIN ACETATE
SERMORELIN ACETATE
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN
SOMATROPIN RDNA ORIGIN
COSYNTROPIN ZINC HYDROXIDE
0.1MG
0.2MG
10MCG
10MCG
1.8MG/VIAL
4.8MG VIAL
0.1MG
0.1MG/ML
0.2MG
4MCG/ML
4MCG/ML
120MCG
60MCG
10MCG
0.1MG
0.1MG
0.2MG
0.2MG
10MCG/ACT
1.5MG
13.8MG
13.8MG
5.8MG
5.8MG
0.5MG/VIAL
1MG/VIAL
12MG
1MG/ML
6MG
24MG
0.1MG
0.2MG
10MG/1.5ML
15MG/1.5ML
5MG/1.5ML
10MG/1.5ML
15MG/1.5ML
5MG/1.5ML
0.1MG
0.2MG
10MCG
10MG/VIAL
5MG/VIAL
5MG/ML
10MG/2ML
15MCG/ML
1.5MG/ML
10MG/CART
5.8MG/VIAL
5MG/CART
0.1MG
0.2MG
1.33MG
10U/VIAL
8MG/ML
8MG/ML
4MG/VIAL
5.83MG/ML
8.8MG/VIAL
8.8MG/VIAL
8.8MG/VIAL
5MG
4MG/VIAL
5MG
6MG
8.8MG/VIAL
8.8MG/VIAL
6MG/0.5ML
1MG/ML
TAB
TAB
NAS SPR
NAS SPR
INJ
INJ
TAB
NAS SOL
TAB
INJ
INJ
TAB
TAB
NAS SPR
TAB
TAB
TAB
TAB
NAS SPR
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
NAS SPR
INJ
INJ
INJ
INJ
INJ
NAS SOL
INJ
INJ
INJ
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
242
*PA
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
683200
DIN
Drug Name
PROGESTINS
Chemical Name
Strength
Dosage
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
683200
02267640
02277298
02244726
02244727
00585092
00030848
02247583
02247581
02247582
02253550
02253577
02322250
02246941
02246938
02246940
02212072
02212056
02212064
00023760
02252740
02252759
01977652
02166704
00729973
00708917
00030937
02221306
02221284
02221292
02374900
APO‐MEDROXY 100MG TAB
APO‐MEDROXY 2.5MG TAB
DEPO‐PROVERA 150MG/ML INJ
DEPO‐PROVERA 50MG/ML INJ
DOM‐MEDROXYPROGESTERONE 10MG
DOM‐MEDROXYPROGESTERONE 2.5MG
DOM‐MEDROXYPROGESTERONE 5MG
MEDROXY‐2.5 TAB
MEDROXY‐5 TAB
MEDROXYPROGESTERO 150MG/ML INJ
MEDROXYPROGESTERONE 10MG TAB
MEDROXYPROGESTERONE 2.5MG TAB
MEDROXYPROGESTERONE 5MG TAB
MEPROGEST 10MG TAB
MEPROGEST 2.5MG TAB
MEPROGEST 5MG TAB
NORLUTATE TAB 5MG
NU‐MEDROXY 2.5MG TAB
NU‐MEDROXY 5MG TAB
PROGESTERONE 50MG/ML INJ
PROMETRIUM 100 MG CAP
PROVERA 10MG TAB
PROVERA 2.5MG TAB
PROVERA 5MG TAB
TEVA‐MEDRONE 10MG TAB
TEVA‐MEDRONE 2.5MG TAB
TEVA‐MEDRONE 5MG TAB
VISANNE 2MG TAB
MEDROXYPROGESTERONE ACETATE
NORETHINDRONE ACETATE
PROGESTERONE
PROGESTERONE
DIENOGEST
100MG
10MG
2.5MG
5MG
150MG/ML
50MG/ML
10MG
2.5MG
5MG
2.5MG
5MG
150MG/ML
10MG
2.5MG
5MG
10MG
2.5MG
5MG
5MG
2.5MG
5MG
50MG/ML
100MG
10MG
2.5MG
5MG
10MG
2.5MG
5MG
2MG
TAB
TAB
TAB
TAB
INJ
INJ
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
243
*PA
05/2012
Therapy Class
683604
DIN
Drug Name
THYROID AGENTS
Chemical Name
Strength
Dosage
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
683604
02238897
02238898
02238899
02238900
02238896
01919466
01919458
02213222
02213206
02213214
02213230
02213192
02264374
02264390
02264404
02264412
02264420
02264439
02264447
02264323
02264455
02264331
02264358
01953648
01953672
00483559
00483575
00483583
00483540
02171228
02172062
02172070
02172089
02172097
02172119
02172127
02172135
02172100
02172143
02172151
00786578
00640425
02233852
00212164
00786586
00640441
00023965
00023949
00023957
ALTI‐THYROXINE 100MCG TAB
CYTOMEL 25MCG TAB
CYTOMEL 5MCG TAB
ELTROXIN 200MCG TAB
ELTROXIN 100MCG TAB
ELTROXIN 150MCG TAB
ELTROXIN 300MCG TAB
ELTROXIN 50MCG TAB
EUTHYROX 100MCG TAB
EUTHYROX 112MCG TAB
EUTHYROX 125MCG TAB
EUTHYROX 137MCG TAB
EUTHYROX 150MCG TAB
EUTHYROX 175MCG TAB
EUTHYROX 200MCG TAB
EUTHYROX 25MCG TAB
EUTHYROX 300MCG TAB
EUTHYROX 50MCG TAB
EUTHYROX 75MCG TAB
PMS‐LEVOTHYROXINE 0.112MG
PMS‐LEVOTHYROXINE 0.175MG
PROLOID TAB 125MG
PROLOID TAB 15MG
PROLOID TAB 30MG
PROLOID TAB 60MG
SYNTHROID 0.112MG TAB
SYNTHROID 0.1MG TAB
SYNTHROID 0.2MG TAB
SYNTHROID 0.3MG TAB
SYNTHROID 112MCG TAB
SYNTHROID 75MCG TAB
THYROID TAB 125MG
THYROID TAB 30MG
THYROID TAB 60MG
LEVOTHYROXINE SODIUM
LIOTHYRONINE
LIOTHYRONINE
LEVOTHYROXINE
LEVOTHYROXINE
THYROID
THYROID
THYROID
THYROID
THYROID
THYROID
THYROID
100MCG
150MCG
200MCG
300MCG
50MCG
25MCG
5MCG
200MCG
100MCG
150MCG
300MCG
50MCG
100MCG
112MCG
125MCG
137MCG
150MCG
175MCG
200MCG
25MCG
300MCG
50MCG
75MCG
0.112MG
0.175
125MG
15MG
30MG
60MG
0.112MG
0.025MG
0.05MG
0.075MG
0.088MG
0.125MG
0.15MG
0.175MG
0.1MG
0.2MG
0.3MG
0.112MG
0.125MG
137MCG
0.15MG
0.175MG
0.075MG
125MG
30MG
60MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
244
*PA
05/2012
Therapy Class
683608
DIN
Drug Name
ANTITHYROID AGENTS
Chemical Name
Strength
Dosage
683608
683608
683608
683608
683608
683608
683608
02258935
02265869
02265850
00010219
00010200
02296039
00015741
APO‐METHIMAZOLE 5MG TAB
DOM‐METHIMAZOLE 5MG TAB
PHL‐METHIMAZOLE 5MG TAB
PROPYLTHYRACIL 100MG TAB
PROPYLTHYRACIL 50MG TAB
TAPAZOLE 10MG TAB
TAPAZOLE 5MG TAB
THIAMAZOLE
THIAMAZOLE
THIAMAZOLE
PROPYLTHIOURACIL
PROPYLTHIOURACIL
THIAMAZOLE
THIAMAZOLE
5MG
5MG
5MG
100MG
50MG
10MG
5MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
245
*PA
05/2012
Therapy Class
760000
DIN
Drug Name
OXYTOCICS
Chemical Name
Strength
Dosage
760000
760000
760000
760000
02231593
02296144
01996096
00497312
DURATOCIN 100MCG/ML INJ
ERGONOVINE 0.25MG/ML
ERGONOVINE 0.25MG/ML INJ
ERGONOVINE MALEATE INJ 0.25MG/
CARBETOCIN
ERGONOVINE
ERGONOVINE
ERGONOVINE
100MCG/ML
0.25MG/ML
0.25MG/ML
0.25MG/ML
INJ
INJ
INJ
INJ
246
*PA
05/2012
Therapy Class
800400
DIN
Drug Name
SERUMS
Chemical Name
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
00895423
00888559
00888567
00888656
02217082
02223996
00514713
00299979
00299987
02239410
02235299
02270919
02217104
02242716
00999995
00999981
00899968
00648922
99100281
99100284
02247724
02238485
00894362
00894354
99100018
00889628
99100017
99100268
99100278
01948903
01948911
02220075
02230860
99100282
00894524
02221314
01948873
02230862
01948881
00861227
00861111
00861138
00861170
00861219
00889733
99000466
02247758
02247756
00614424
00464988
00861251
99003961
00861162
00861189
00861081
00889725
00889776
00889741
00888818
00888826
00888877
00896942
00861332
00861286
00861367
00908614
00889784
00861405
00861316
00861359
00861375
99000458
00889857
00889792
00896934
00896950
00907545
02243342
00894346
99100021
ALAVAC‐HDM‐ACARIENS (5ML)
ALHYDROX‐ENVIRONMENTALS
ALHYDROX‐ENVIRONMENTALS
ALHYDROX‐MOISISSURES
ALLERGENIC EX STANDARD MITE
ALLERGENIC EX STANDARD MITE
ALLERGENIC EXT INJ
ALLERGENIC EXT NON POLLENS
ALLERGENIC EXT POLLENS
ALLERGENIC EXT STAND CAT HAIR
ALLERGENIC EXT STAND CAT PELT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT STAND MITE
ALLERGY CAN ALLERGEN EXTRACT
ALLERGY SERUM
ALLERGY SERUMS
ANTIGEN VENOM WASP
CENTER‐AL INJ
COMBINED VESPIDES
COMBINED VESPIDES
GAMUNEX 10G INJ
GRASS POLLEN‐ORCHARD GRASS
GUEPE (POLISTES SPP.)
GUEPE DE L'EST (VESPULA
GUEPE DE L''EST (VESPULA)
GUEPE JAUNE
GUEPE(POLISTES SPP.)
HONEY BEE MULTIDOSE 1.1MG/V
HONEY BEE VENOM 120MCG/VIAL
HONEY BEE VENOM 550MCG INJ
HONEY BEE VENOM MULTIUSE INJ
INSECT VENOM(LADY APPLE)
MELANGE DE VENIN VESPIDES
MIXED VESPID VENOM 550MCG INJ
MIXED VESPID VENOM P
MIXED VESPID VENOM PROTEIN
MIXED VESPID VENOM PROTEIN PWS
MONOVALENT
MONOVALENT ALLERGY VACCINE
MONOVALENT INJ
MONOVALENT‐ACARIENS (5ML)
MONOVALENT‐SPECIFIC INJ
OMEGA ALLE EXT NON‐POLLEN SUSP
OMEGA ALLER EXTRACT NON‐POLLEN
PHARMALGEN MIXED VESPID VENOM
POLLINEX R 0.5ML INJ
POLYVALENT
POLYVALENT‐ ACARIENS INJ
POLYVALENT ALLERGY VACC (PQ)
POLYVALENT ALLERGY VACCINE IN
POLYVALENT VACCINE (PQ)
POLYVALENT‐ACARIENS (10ML)
POLYVALENT‐SPECIFIQUE
POLYVALENT‐SPECIFIQUE
POLYVALENT‐STANDARD
SUSPAL TREATMENT SET
SUSPAL‐MONOVALENT (10ML)
SUSPAL‐MONOVALENT‐ PQ PSEUDO
SUSPAL‐MONOVALENT‐ACARI INJ
SUSPAL‐POLYVALENT
SUSPAL‐POLYVALENT (10ML)
SUSPAL‐POLYVALENT SOL
SUSPAL‐POLYVALENT‐AC
SUSPAL‐POLYVALENT‐ACARI (5ML)
SUSPAL‐PRESAISONNIER‐GR (8ML)
SUSPAL‐PRESAISONNIER‐HERBE
TYROSINE GRASS ALLERGY/ZINC PQ
VARIZIG 125U/VIAL INJ
VENIN D'ABEILLE
VENIN D''ABEILLE(APIS)
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACT
DERMATOPHAGOIDES FARINAE
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT NON‐POLLEN
POLLEN
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
DERMATOPHAGOIDES PTERONYSSINUS
ALLERGENIC EXTRACT
ALLERGY EXTRACTS
SPECIFIC DESENSITIZING VACCINE
ANTIGEN VENOM‐ WASP
POLLEN/NON POLLEN/ALLERGENIC
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
IMMUNE GLOBULIN (HUMAN)
ORCHARD GRASS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
HONEY BEE VENOM
HONEY BEE VENOM
HONEY BEE VENOM PROTEIN
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
WHTE FACED/YELLOW HORNET/JACKT
MIXED VESPID VENOM PROTEIN
WHITE FACED/YELL HORN/YELL JAC
WHITE HORN/YELLOW JACK & HORNE
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACTS
VENOM
GRASS POLLEN SERUM
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACT
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACT
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACT
ALLERGENIC EXTRACTS
ALLERGENIC EXTRACT
ALLERGENIC EXTRACTS
TYROSINE GRASS ALLERGY
VARICELLA ZOSTER IMMUNE GLOBUL
VENOM PROTEI
ALLERGENIC EXTRACT
247
Strength
1
1000U/ML
5000U/ML
10000UN/ML
10000IU/ML
10000 U/ML
550 M
360MCG
1650MCG
10G/100ML
100000
1.3MG
550 M
1.3MG
550MCG
120MCG
1.1MG/VIAL
120MCG/VIA
550MCG
1300MCG
550MCG
1650
550MCG
1300MCG
120MCG
40000U/ML
40000U/ML
125U/VIAL
1 MG
1.3MG
Dosage
*PA
INJ
SOL
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
MISC
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
KIT
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
800400
02226197
02226294
02226219
02226235
02226286
99100026
99100269
99100280
01948970
02220091
00541451
02230864
01948997
99100016
99004607
99100266
99100279
02217449
02217430
99004593
99100267
02220083
01948946
01948938
01948954
01948962
99100270
VENOMIL HONEY BEE VENOM INJ
VENOMIL MIXED VESPID VENOM INJ
VENOMIL WASP VENOM PROTEIN INJ
VENOMIL WHITE FACED HORNET INJ
VENOMIL YELLOW JACKET VNOM INJ
VESPIDES COMBINES
WASP OF THE EAST(VESPULA)
WASP OF THE EAST(VESPULA)
WASP VENOM PROTEIN 1.1MG/VIAL
WASP VENOM PROTEIN 550MCG INJ
WASP VENOM PROTEIN INJ
WASP VENOM PROTEIN MULTIUSE
WHITE FACED HORNET VENOM
WHITE FACED HORNET VENOM
WHITE HEAD HORNET
WHITE HEAD HORNET
WHITE SPOTTED WASP
WINRHO SD 1500IU INJ
WINRHO SD 600IU INJ
YELLOW HEAD HORNET
YELLOW HEAD HORNET
YELLOW HORNET VENOM 550MCG INJ
YELLOW HORNET VENOM PROTEIN
YELLOW HORNET VENOM PWS 1.1MG
YELLOW JACKET VENOM PROTEIN
YELLOW WASP DOLICHOVESPULA
ALBUMIN/HONEY BEE VENOM PROTEI
ALBMIN/WHTE FACD/YELL HORN/JAC
ALBUMIN/WASP VENOM PROTEIN
ALBUMIN/WHITE FACED HORNET VEN
ALBUMIN/YELLOW JACKET VENOM
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
POLISTES SPP VENOM PROTEIN EXT
WASP VENOM PROTEIN
WASP VENOM PROTEIN
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
ALLERGENIC EXTRACT
IMMUNE GLOBULIN HUMAN
IMMUNE GLOBULIN HUMAN
ALLERGENIC EXTRACT
FRELON A TETE JAUNE
YELLOW HORNET VENOM PROTEIN
DOLICHOVESPULA ARENARIA PROTEI
ALLERGENIC EXTRACT
VESPULA SPP VENOM PROTEIN EXTR
ALLERGENIC EXTRACT
120MCG
120MCG
120MCG
120MCG
120MCG
3.9MG
550MCG
120MCG
1.1MG
550MCG
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
248
1300MCG
1.3MG
1.1MG
550MCG
120MCG
1500IU
600IU
1.1MG
550MCG
550MCG
120MCG
1.1MG/VIAL
100MCG/ML
120MCG
120MCG
*PA
05/2012
Therapy Class
800800
DIN
Drug Name
TOXOIDS
800800
00900664 TETANUS /DEXTROSE PDR (PQ)
Chemical Name
TETANUS TOXOID
249
Strength
Dosage
*PA
INJ
05/2012
Therapy Class
840000
DIN
Drug Name
SKIN AND MUCOUS MEMBRANE AGENTS
Chemical Name
250
Strength
Dosage
*PA
05/2012
Therapy Class
840404
DIN
Drug Name
ANTIBACTERIALS
Chemical Name
Strength
Dosage
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
02281074
02053128
02126737
02239757
02236776
01916947
02248472
02225271
02359685
00666173
02242970
02243659
02243050
ACZONE 5% GEL
ALTI‐CLINDAMYCIN 1% SOL
ALTI‐CLINDAMYCIN 20MG/G VAG CR
BACTROBAN CREAM 2%
BACTROBAN NASAL OINT 2%
BACTROBAN OINT 2%
BENZACLIN TOPICAL GEL
BENZAMYCIN GEL
BIACNA 0.025%/1.2% TOPICAL GEL
CICATRIN POWDER
CLINDASOL 1% CREAM
CLINDA‐T 1% SOL
CLINDETS PLEDGETS 1% PAD
DAPSONE
MUPIROCIN CALCIUM
MUPIROCIN CA
MUPIROCIN
CLINDAMYCIN PHOSPHATE/BENZOYL
ERYTHROMYCIN/BENZOYL PEROXIDE
TRETINOIN/CLINDAMYCIN PHOSPHAT
BACITRACIN/NEOMYCIN/AMINO ACID
5%
1%
20MG/G
2%
2%
2%
1%/5%
30‐50MG/G
0.025/1.2%
10MG/GM
1%
1%
GEL
SOL
CR VAG
CR
OINT
OINT
GEL
GEL
GEL
PDR
CR
LIQ
PAD
840404
02382822 CLINDOXYL ADV 1.0/3.0% GEL
CLINDAMYCIN PHOS/BENZOYL PEROX
1.0/3.0%
GEL
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
840404
02243158
02060604
00582301
00812269
02115530
02115549
02034506
01926861
00025887
00024929
00338338
01926829
00250724
01926845
00439134
00506001
00586668
02238578
00586676
02226839
02092832
02297809
02248206
00243205
00666122
02125226
02156091
00704628
00872881
00805386
00805025
02237485
02237486
02237487
02242919
00824127
01988840
01987682
02224879
02224844
02224852
00512591
01945262
01905112
02015994
02266938
02279983
CLINDAMYCIN PHOS/BENZOYL PEROX
EMCINKA
ERYTHROMYCIN/ETHYL ALCOHOL
ERYTHROMYCIN/PARSOL
METRONIDAZOLE
METRONIDAZOLE
METRONIDAZOLE
METRONIDAZOLE/NYSTATIN
FUSIDIC ACID
FUSIDIC ACID
FUSIDIC ACID/HYDROCORTISONE
SODIUM FUSIDATE
METRONIDAZOLE
METRONIDAZOLE
METRONIDAZOLE
METRONIDAZOLE
GRAMICIDIN/NEOMYCIN/POLYMYXIN
POLYMYXIN B/NEOMYCIN
METRONIDAZOLE
METRONIDAZOLE
CHLORAMPHENICOL
GENTAMICIN
GENTAMICIN SULFATE
GENTAMICIN SULFATE
METRONIDAZOLE
FRAMYCETIN SULFATE
FRAMYCETIN SULFATE
FRAMYCETIN SULFATE/GRAMICIDIN
FRAMYCETIN SULFATE
FRAMYCETIN SULFATE
ERYTHROMYCIN
TRETINOIN/ERYTHROMYCIN
MUPIROCIN
CLINDOXYL GEL
DALACIN 20MG/G VAGINAL CR
DALACIN T 1% SOL
EMCINKA
ERYGEL
ERYMAZ
ERYSOL ACNE GEL
FLAGYL 10% VAG CR
FLAGYL 500MG
FLAGYL CREME VAGINALE A 10%
FLAGYSTATIN CREAM
FLAGYSTATIN OVULES
FLAGYSTATIN TAB
FLAGYSTATIN VAG CR
FLAGYSTATIN VAGINAL
FUCIDIN 250MG CAP
FUCIDIN CR 2%
FUCIDIN H CR
FUCIDIN OINT 2%
METROCREAM 0.75%
METROGEL 0.75% GEL
METROGEL 1% TOP GEL
METROLOTION 0.75% LOT
NEOSPORIN
NEOSPORIN OINT
NIDAGEL VAGINAL GEL
NORITATE 1% CR
PENTAMYCETIN VAG
PMS‐GENTAMICIN OINTMENT 1MG/GM
RATIO‐GENTAMICIN 0.10% CR
RATIO‐GENTAMICIN 0.10% OINT
RHO‐METROSTATIN 4.5G/100000U
RHO‐METROSTATIN 500MG VAG TAB
RHO‐METROSTATIN 500MG/100000U
ROSASOL 1% TOPICAL CR
SANS‐ACNE LIQ
SOFRA TULLE DRESS 10CMX10CM
SOFRA TULLE DRESS 10CMX30CM
SOFRAMYCIN SKIN OINTMENT
SOFRATULLE 1% DRESSING 10X10CM
SOFRATULLE 1% DRESSING 10X30CM
STATICIN LOT
STIEVAMYCIN FORTE GEL
STIEVAMYCIN GEL 0.025%
STIEVAMYCIN MILD GEL
TARO‐CLINDAMYCIN 1% TOP SOL
TARO‐MUPIROCIN 2% OINTMENT
251
20MG/G
1%
2%/92%
2%/66%
10%
500MG
10%
500MG
500MG
250MG
2%
2%/1%
2%
0.75%
0.75%
1%
0.75%
0.75%
1%
500MG
1MG/G
0.1%
0.10%
4.5G
500MG
500MG
10MG/GM
2%/44%
1%
10X30CM
15MG
1%
1%
1.5%
0.025%
1%
2%
*PA
GEL
CR VAG
LIQ
PDR
GEL
SOL
GEL
CR VAG
SUPP
CR
CR
OVULE
TAB VAG
CR VAG
OVULE
CAP
CR
CR
OINT
CR
GEL
GEL
LOT
O/O SOL
OINT
GEL VAG
CR
TAB VAG
OINT
CR
OINT
CR
SUPP VAG
SUPP
CR
LIQ
DRESS
DRESS
OINT
DRESS
DRESS
LOT
GEL
GEL
GEL
LIQ
OINT
05/2012
Therapy Class
840406
DIN
Drug Name
ANTIVIRALS
Chemical Name
Strength
Dosage
840406
840406
840406
840406
840406
02245677
02238848
02237187
02039524
00569771
ABREVA 10% CREAM
DENAVIR 1% CREAM
SANDOZ IDOXURIDINE 0.1% SOL
ZOVIRAX CR 5%
ZOVIRAX OINT 5%
DOCOSANOL
PENCICLOVIR
IDOXURIDINE
ACYCLOVIR
ACYCLOVIR
10%
1%
0.1%
5%
5%
CR
CR
LIQ
CR
OINT
252
*PA
05/2012
Therapy Class
840408
DIN
Drug Name
ANTIFUNGALS
Chemical Name
Strength
Dosage
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
840408
02349086
02298953
00895571
00452114
02248417
02245662
02031094
02238703
02239876
00074462
02221810
02221802
00611174
00716901
02250535
02244766
02241815
02241816
02194163
02247228
02353288
02247651
02130874
00894710
00894729
00074500
AA‐CICLOPIROX 8% TOP SOL
APO‐CICLOPIROX 8% TOP SOL
CANESTEN CR
ECOSTATIN VAG OVULES
GYNAZOLE‐1 VAG CREAM 2%
KETODERM CREAM 2%
LAMISIL 1% CR
LAMISIL 1% TOP SOL
LAMISIL DERMGEL 1%
LOCACORTEN VIOFORM CR
LOPROX 1% LOTION
LOPROX 1% CR
LOTRIDERM CR
NYADERM VAG CR 25000UNIT/GM
PENLAC 8% SOL
PMS‐CLOTRIMAZOLE‐BETAMETHA CR
PMS‐TERBINAFINE 1% CREAM
PMS‐TERBINAFINE 1% TOPICAL SPR
RATIO‐NYSTATIN VAG CR100000U/G
STIEPROX 1.5% TOP SHP
TARO‐CICLOPIROX 8% TOP SOL
TARO‐TERCONAZOLE VAG CREAM
TERAZOL 3 DUAL PAK
TERAZOL 3 VAGINAL OVULES 80MG
TERAZOL 7 VAG CR 4MG/GM
VIOFORM HYDROCORTISONE CR
CICLOPIROX
CICLOPIROX
CLOTRIMAZOLE
ECONAZOLE NITRATE
BUTOCONAZOLE NITRATE
KETOCONAZOLE
TERBINAFINE HCL
TERBINAFINE HCL
TERBINAFINE
CLIOQUIN/FLUMETHASONE PIVALATE
CICLOPIROX OLAMINE
CICLOPIROX OLAMINE
BETAMETHASONE/CLOTRIMAZOLE
NYSTATIN
CICLOPIROX
CLOTRIMAZOLE, BETAMETHASONE
TERBINAFINE HCL
TERBINAFINE HCL
NYSTATIN
CICLOPIROX OLAMINE
CICLOPIROX
TERCONAZOLE
TERCONAZOLE
TERCONAZOLE
TERCONAZOLE
CLIOQUINOL/HYDROCORTISONE
8%
8%
1%
150MG
2%
2%
1%
1%
1%
3%/0.02%
1%
1%
0.05%/1%
25000 IU
8%
1%, 0.05%
1%
1%
100000 IU
1.5%
8%
0.4%
80MG&0.8%
80 MG
0.40%
1%
LIQ
LIQ
CR
SUPP VAG
CR VAG
CR
CR
LIQ
GEL
CR
LOT
CR
CR
CR VAG
SOL
CR
CR
MISC
CR VAG
SHP
LIQ
CR VAG
OVULE
OVULE
CR VAG
CR
253
*PA
05/2012
Therapy Class
840412
DIN
Drug Name
SCABICIDES AND PEDICULICIDES
Chemical Name
254
Strength
Dosage
*PA
05/2012
Therapy Class
840492
DIN
Drug Name
MISCELLANEOUS LOCAL ANTI-INFECTIVES
Chemical Name
Strength
Dosage
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
840492
01989499
00370568
00187585
01912437
01925199
00621056
00426288
00682055
02053632
02010917
00542040
00307572
01908871
00832030
00323098
02247035
00527661
00263699
00373036
00205389
01928341
02017733
02019825
00728799
02215802
AVC CREAM
BENOXYL LOTION 10%
BENOXYL LOTION 20%
BENZAC AC GEL 10%
BENZAC W WASH GEL 10%
BENZAC W10 GEL 10%
BENZAGEL 10 GEL 10%
CHLORHEXIDINE GLUCONATE 20% BP
CHLORHEXIDINE GLUCONATE SOLN
DERMAZIN 1% CREAM
DESQUAM X WASH 10%
DESQUAM X10 GEL
DESQUAM‐X GEL 10%
DEXIDIN 20 SOLN 20MG
FLAMAZINE CR 1%
NATURE'S CURE ACNE TREATMENT
PANOXYL 10 BAR
PANOXYL 10 GEL
PANOXYL 20 GEL
PHISOHEX 3% EMULSION
PHISOHEX 3% EMULSION
PHISOHEX 3% LIQ
SOLUGEL #8
STANHEXIDINE 2% LIQ
SULFAMYLON 8.5% CR
SULFANILAMIDE/AMINACRINE HCL
BENZOYL PEROXIDE
BENZOYL PEROXIDE
BENZOYL PEROXIDE/ACRYLATES C
BENZOYL PEROXIDE
BENZOYL PEROXIDE/WATER‐BASED
BENZOYL PEROXIDE/ALCOHOL BASE
CHLORHEXEDINE GLUCONATE
SILVER SULFADIAZINE
BENZOYL PEROXIDE
BENZOYL PEROXIDE/WATER‐BASED
BENZOYL PEROXIDE
SILVER SULFADIAZINE
BENZOYL PEROXIDE
BENZOYL PEROXIDE
HEXACHLOROPHENE
HEXACHLOROPHENE
HEXACHLOROPHENE
BENZOYL PEROXIDE
CHLORHEXIDINE
MAFENIDE ACETATE
10%
20%
10%
10%
10%
10%
20%
20%
1%
10%
10%
10%
20%
1%
5%
10%
10%
20%
3%
3%
3%
8%
2%
8.5%
CR
LOT
LOT
GEL
GEL
GEL
GEL
LIQ
LIQ
CR
LIQ
GEL
GEL
LIQ
CR
CR
BAR
GEL
GEL
EMUL
EMUL
LIQ
GEL
LIQ
CR
255
*PA
05/2012
Therapy Class
840600
DIN
Drug Name
ANTI-INFLAMMATORY AGENTS
Chemical Name
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
02128446
02236399
00505781
00476242
00505773
00476285
02194066
00282456
02194058
02194031
02086034
00458147
00716618
00716626
00716642
00716650
00716634
02237835
02060884
02242738
02357844
02357852
02357860
02357879
02352001
02352036
02352028
02245523
02245524
02245522
02256398
02256371
02112736
00579335
00666246
00716693
02089912
02213680
02213699
02192284
02192276
02192268
00681989
00681997
00873292
02227517
02230642
02213265
02213273
02213281
00417262
00417254
00688622
00862975
00629367
00578428
00578436
00323071
00417246
00344923
00897728
02210517
00851736
00851744
00871095
00192597
00595799
00192600
00595802
00641154
02052431
00465275
00326941
00403075
02011921
00230316
00716839
02242984
02242985
00184659
ANODAN‐HC RECTAL OINT
ANODAN‐HC SUPP
ANUGESIC HC OINT
ANUGESIC HC SUPP
ANUSOL HC RECTAL OINT
ANUSOL HC SUPP
ARISTOCORT C CR 0.5%
ARISTOCORT D OINT 0.025%
ARISTOCORT R CR 0.1%
ARISTOCORT R OINT 0.1%
BARRIERE HC 1% CREAM
BETADERM
BETADERM CR 0.05%
BETADERM CR 0.1%
BETADERM OINT 0.05%
BETADERM OINT 0.1%
BETADERM SCALP LOTION 0.1%
BETAJECT 6MG/ML INJ
BETNESOL RETENTION ENEMA
CAPEX SHAMPOO
CELESTODERM V 0.1% CR
CELESTODERM V 0.1% OINT
CELESTODERM V/2 0.05% CR
CELESTODERM V/2 0.05% OINT
CLOBETASOL 0.05% CR
CLOBETASOL 0.05% LOTION
CLOBETASOL 0.05% OINT
CLOBETASOL PROPIONATE 0.05% CR
CLOBETASOL PROPIONATE 0.05% OI
CLOBETASOL PROPIONATE 0.05% TO
CLOBEX LOTION 0.05%
CLOBEX SHAMPOO 0.05%
CORTENEMA SUSP 100MG/60ML
CORTIFOAM 10% RECTAL
CORTISPORIN OINT
CORTODERM OINT 1%
CUTIVATE 0.05% CR
CUTIVATE 0.05% CR
CUTIVATE 0.05% OINT
CYCLOCORT CR 0.1%
CYCLOCORT LOT 0.1%
CYCLOCORT OINT 0.1%
DERMAFLEX HC 1% CREAM
DERMAFLEX HC LOT 1%
DERMA‐SMOOTHE/FS 0.01% LOT
DERMATOP 0.1% OINT
DERMATOP EMOLLIENT 0.1% CR
DERMOVATE CR 0.05%
DERMOVATE OINT 0.05%
DERMOVATE SCALP 0.05% LOTION
DIPROGEN CR
DIPROGEN OINT
DIPROLENE GLYCOL CR 0.05%
DIPROLENE GLYCOL LOT 0.05%
DIPROLENE GLYCOL OINT 0.05%
DIPROSALIC LOT
DIPROSALIC OINT
DIPROSONE CR 0.05%
DIPROSONE LOT 0.05%
DIPROSONE OINT 0.05%
ECTOSONE LOT
EGOZINC HC 10MG SUPP
ELOCOM 0.1% OINT
ELOCOM CR 0.1%
ELOCOM LOT 0.1%
EMO CORT CR 1%
EMO CORT CR 2.5%
EMO CORT LOTION 1%
EMO CORT LOTION 2.5%
EMO CORT SCALP 2.5% LOT
ENTOCORT ENEMA 2.3MG/KIT
HALCICOMB CREAM
HALOG 0.1% CREAM
HALOG 0.1% OINT
HALOG CR 0.1%
HYCORT RETENTION ENEMA 100MG/6
HYDERM CR 1%
HYDROVAL 0.2% CREAM
HYDROVAL 0.2% OINT
KENACOMB MILD CREAM
HYDROCORTISONE/ZINC SULFATE
0.50%
HYDROCORT ACETATE/ZINC SULFATE 10MG
HYDROCORTISONE/PRAMOXINE/ZINC
HYDROCORT ACETATE/ZINC SULFATE 0.5%
HYDROCORTISONE ACET/ZINC SULF
10MG
TRIAMCINOLONE
0.5%
0.025%
0.1%
0.10%
1%
BETAMETHASONE VALERATE
0.05%
0.05%
0.1%
0.05%
1MG/G
0.10%
BETAMETHASONE DISOD PHOS/ACETA 6MG/ML
BETAMETHASONE SODIUM PHOSPHATE 5MG/100ML
FLUOCINOLONE ACETONIDE
0.01%
BETAMETHASONE
0.1%
BETAMETHASONE
0.1%
0.05%
0.05%
CLOBETASOL PROPIONATE
0.05%
0.05%
0.05%
0.05%
0.05%
0.05%
0.05%
0.05%
HYDROCORTISONE
100MG
10%
HYDROCORTISONE/NEOMYCIN
HYDROCORTISONE
1%
0.05%
FLUTICASONE
0.05%
FLUTICASONE
0.05%
AMCINONIDE
0.10%
AMCINONIDE
0.10%
AMCINONIDE
0.10%
1%
HYDROCORTISONE ACETATE HC
1%
0.01%
PREDNICARBATE
0.1%
PREDNICARBATE
1MG/G
0.05%
0.05%
0.05%
BETAMETHASONE DIPROPIONATE
0.05%
0.05%
0.05%
BETAMETHASONE/SALICYLIC ACID
0.5MG/20MG
0.5MG/30MG
0.64MG/G
0.05%
0.05%
BETAMETHASONE
0.1 %
10MG/10MG
MOMETASONE FUROATE
0.10%
MOMETASONE FUROATE
0.10%
MOMETASONE FUROATE
0.10%
HYDROCORTISONE
1%
HYDROCORTISONE
2.5%
HYDROCORTISONE
1%
HYDROCORTISONE
2.5%
HYDROCORTISONE
2.5%
BUDESONIDE
2.3MG
HALCINONIDE/NEOMYCIN/NYSTATIN
HALCINONIDE
0.1%
HALCINONIDE
0.1%
HALCINONIDE
0.1/3%
HYDROCORTISONE
100MG
1%
HYDROCORTISONE VALERATE
0.2%
0.2%
ACETONIDE/NEOMY/TRIAMCINOLONE
256
Strength
Dosage
*PA
OINT
SUPP
OINT
SUPP
OINT
SUPP
CR
OINT
CR
OINT
CR
CR
CR
CR
OINT
OINT
LOT
INJ
ENEMA
SHP
CR
OINT
CR
OINT
CR
LOT
OINT
CR
OINT
LOT
LOT
SHP
ENEMA
FOAM
OINT
OINT
CR
CR
OINT
CR
LOT
OINT
CR
LOT
LOT
OINT
CR
CR
OINT
LOT
CR
OINT
CR
LOT
OINT
LOT
OINT
CR
LOT
OINT
LOT
SUPP
OINT
CR
LOT
CR
CR
LOT
LOT
LOT
ENEMA
CR
CR
OINT
CR
ENEMA
CR
CR
OINT
CR
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
00184667
00029114
00029505
02163152
02161923
02161966
00005789
00716863
02236997
02236996
02084465
02237272
00252395
00862770
02024187
02026767
02216213
00749834
00195057
02028719
00587826
00587818
00587834
02093162
02126192
01964054
02232191
02309521
02309548
02232195
02229315
02229323
02244767
02244768
02244769
02270862
00770957
00804541
00804533
02234466
02240851
00363014
02247322
02247882
02223252
02223260
01927973
02089602
01927965
02247098
02247097
02247096
01910272
01910280
01910299
00535427
00750050
00653209
00535435
00653217
00607789
00607797
02248130
02226391
00849650
01927914
00849669
02245688
00804991
00809187
00805009
00550507
01940112
02179547
02240112
02122073
02122065
02122081
02122049
02122030
02122057
KENACOMB MILD OINTMENT
KENALOG 0.1% CREAM
KENALOG IN ORABASE
LIDEMOL 0.05% CR
LIDEX 0.05% CR
LIDEX 0.05% OINT
LOCACORTEN 0.03% OINT
LYDERM 0.05% CREAM
LYDERM 0.05% GEL
LYDERM 0.05% OINT
MED‐CLOBETASOL 0.05% CR
MED‐CLOBETASOL SCALP 0.05MG/ML
MEDROL ACNE LOT
METACORT 1% OINT
MYLAN‐CLOBETASOL 0.05% CR
MYLAN‐CLOBETASOL 0.05% OINT
MYLAN‐CLOBETASOL SC LOT 0.05%
NEO‐HC 2% CREAM
NEOMEDROL ACNE LOT
NERISALIC CR
NERISONE CR 0.1%
NERISONE OILY CR 0.1%
NERISONE OINT 0.1%
NOVO‐CLOBETASOL 0.05% CR
NOVO‐CLOBETASOL 0.05% OINT
ORACORT 0.10% DENTAL PASTE
PMS‐CLOBETASOL 0.05% CR
PMS‐CLOBETASOL 0.05% CR
PMS‐CLOBETASOL 0.05% OINT
PMS‐CLOBETASOL 0.05% TOP SOL
PMS‐DESONIDE 0.05% CREAM
PMS‐DESONIDE 0.05% OINT
PMS‐MOMETASONE 0.1% CREAM
PMS‐MOMETASONE 0.1% LOTION
PMS‐MOMETASONE 0.1% OINT
PMS‐MOMETASONE 0.1% OINT
PRAMOX HC CR
PREVEX B CR 0.1%
PREVEX HC CR 1%
PROCTODAN HC OINT
PROCTODAN HC SUPP
PROCTOFOAM HC RECTAL FOAM
PROCTOL OINTMENT
PROCTOL SUPPOSITORIES
PROCTOSEDYL OINT
PROCTOSEDYL SUPP
PROPADERM 0.025% CR
PROPADERM 0.025% CR
PROPADERM 0.025% LOT
RATIO‐AMCINONIDE 0.1% CREAM
RATIO‐AMCINONIDE 0.1% LOTION
RATIO‐AMCINONIDE 0.1% OINT
RATIO‐CLOBETASOL CREME 0.05%
RATIO‐CLOBETASOL OINT 0.05%
RATIO‐CLOBETASOL SC LOT 0.05%
RATIO‐ECTOSONE 0.05% MILD CR
RATIO‐ECTOSONE 0.1% REG LOT
RATIO‐ECTOSONE 0.05% MILD LOT
RATIO‐ECTOSONE 0.1% REG CR
RATIO‐ECTOSONE 0.10% SCALP LOT
RATIO‐HEMCORT HC 0.50% OINT
RATIO‐HEMCORT HC 10MG SUPP
RATIO‐MOMETASONE 0.1% OINTMENT
RATIO‐PROCTOSONE SUPP
RATIO‐TOPILENE 0.05% CR
RATIO‐TOPILENE 0.05% LOT
RATIO‐TOPILENE 0.05% OINT
RATIO‐TOPISALIC LOTION
RATIO‐TOPISONE 0.05% CR
RATIO‐TOPISONE 0.05% LOT
RATIO‐TOPISONE 0.05% OINT
RATIO‐TRIACOMB REG 0.10% CREAM
RAVISONE 0.1% LOT
RIVASOL HC OINT
RIVASOL‐HC 10MG SUPP
ROLENE 0.05% CR
ROLENE 0.05% LOT
ROLENE 0.05% OINT
ROSONE 0.05% CR
ROSONE 0.05% LOTION
ROSONE OINT 0.05%
ACETONIDE/NEOMY/TRIAMCINOLONE
TRIAMCINOLONE
0.1%
0.1%
FLUOCINONIDE
0.05%
FLUOCINONIDE
0.05%
FLUOCINONIDE
0.05%
FLUMETHASONE
0.03%
FLUOCINONIDE
0.05%
FLUOCINONIDE
0.05%
FLUOCINONIDE
0.05%
0.05%
0.05MG/ML
METHYLPREDNISOLONE/SULFUR COMP
HYDROCORTISONE
1%
0.05%
0.05%
0.05%
HYDROCORTISONE
2%
METHYLP/NEOMY SULF/CHLOR/SUL
DIFLUCORTOLONE/SALICYLIC ACID
DIFLUCORTOLONE VALERATE
0.1%
0.1%
0.1%
0.05%
0.05%
0.10%
0.05%
0.05%
0.05%
0.05%
DESONIDE
0.05%
DESONIDE
0.05%
MOMETASONE FUROATE
0.1%
MOMETASONE FUROATE
0.1%
MOMETASONE FUROATE
0.1%
MOMETASONE FUROATE
0.1%
HYDROCORTISONE/PRAMOXINE HCL 1%
0.10%
HYDROCORTISONE
1%
HYDROCORTISONE/PRAMOXINE HCL 1%
HC/FRAMYCETIN/ESCULIN/DIBUCAIN
HYDROCORTISONE/FRAMYCETIN
0.025%
0.025%
0.025%
AMCINONIDE
0.1%
AMCINONIDE
0.1%
AMCINONIDE
0.1%
0.05%
0.05%
0.05%
0.05%
0.10%
0.05%
0.1%
0.1%
0.5%
HYDROCORTISONE
10MG
MOMETASONE FUROATE
0.1%
HC/FRAMYCETIN/CHINCHOCAINE CPD
0.05%
0.05%
0.05%
0.5MG/20MG
0.05%
0.05%
0.05%
0.1%
0.1%
HC ACETATE/ZINC SULFATE
0.50%
HYDROCORTISONE ACET/ZINC SULF
10MG
0.05%
0.05%
0.05%
0.05%
0.05%
0.05%
257
Strength
Dosage
*PA
OINT
CR
OINT
CR
CR
OINT
OINT
CR
GEL
OINT
CR
LOT
LOT
OINT
CR
OINT
LOT
CR
LOT
CR
CR
CR
OINT
CR
OINT
MISC
CR
CR
OINT
LOT
CR
OINT
CR
LOT
OINT
OINT
CR
CR
CR
OINT
SUPP
FOAM
OINT
SUPP
OINT
SUPP
CR
CR
LOT
CR
LOT
OINT
CR
OINT
LOT
CR
LOT
LOT
CR
LOT
OINT
SUPP
OINT
SUPP
CR
LOT
OINT
LOT
CR
LOT
OINT
CR
LOT
OINT
SUPP
CR
LOT
OINT
CR
LOT
OINT
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
840600
02242797
02242798
02242528
02247691
02247692
02242527
00578533
00578541
00856711
02162504
02162512
02246714
02257416
02367157
02266385
02264749
01925350
02240268
02240267
00598933
00816132
02240269
02221926
02221896
02221934
02221918
02161974
00385204
00716960
00535273
02154862
00886793
02154870
00552283
01962701
01962728
00303895
00503134
00560022
00177016
00232351
00027944
00717002
00717029
00423165
00590800
02319012
SAB‐ANUZINC HC PLUS SUPP
SAB‐ANUZINC HC SUPP
SAB‐PROCTOMYXIN HC SUPP
SANDOZ ANUZINC HC OINT
SANDOZ ANUZINC HC PLUS OINT
SANDOZ PROCTOMYXIN HC OINT
SARNA HC
SARNA HC LOT 1%
SARNA HC LOT 2.5%
SYNALAR 0.01% TOPICAL SOL
SYNALAR 0.025% OINT
TARO‐AMCINONIDE 0.1% CR.
TARO‐AMCINONIDE 0.1% OINT.
TARO‐MOMETASONE 0.1% CR
TARO‐MOMETASONE 0.1% LOT
TARO‐MOMETASONE OINTMENT 0.1%
TARO‐SONE 0.05% CR
TEMOVATE EMOLLIENT 0.05% CREAM
TEMOVATE EMOLLIENT 0.05% GEL
TIAMOL CR 0.05%
TOPACTIN CR 0.05%
TOPACTIN EMOLLIENT CR. 0.05%
TOPICORT 0.05% GEL
TOPICORT 0.25% CR
TOPICORT 0.25% OINT
TOPICORT MILD 0.05% CR
TOPSYN 0.05% GEL
TRIADERM 0.1% CREAM
TRIADERM CR 0.1%
TRIANIDE REGULAR
TRIDESILON 0.05% CR
TRIDESILON 0.05% OINT
TRIDESILON 0.05% OINT
TRISYN CREAM
ULTRAVATE 0.5MG/G CR
ULTRAVATE 0.5MG/G OINT
UNICORT
UREMOL HC CR
UREMOL HC LOT
VALISONE G CR
VALISONE G OINT
VALISONE SCALP LOTION 0.1%
VIADERM KC CR 0.1%
VIADERM KC OINT 0.1%
WESTCORT 0.2% CREAM
WESTCORT 0.2% OINT
XAMIOL GEL
DIBUCAINE/ESCULIN/FRAMYCETI/HC
HYDROCORT ACETATE/ZINC SULFATE
DIBUCAINE/EXCULIN/FRAMYCETI/HC
HYDROCORTISONE
HYDROCORTISONE
HYDROCORTISONE
AMCINONIDE
AMCINONIDE
MOMETASONE FUROATE
MOMETASONE FUROATE
MOMETASONE FUROATE
FLUOCINONIDE
FLUOCINONIDE
FLUCINONIDE
DESOXIMETASONE
DESOXIMETASONE
DESOXIMETASONE
DESOXIMETASONE
FLUOCINONIDE
DESONIDE
DESONIDE
DESONIDE
FLUOCINONIDE/PROCIN/CIPROCIN
HALOBETASOL
HALOBETASOL
HYDROCORTISONE
HYDROCORTISONE ACETATE & UREA
HYDROCORTISONE ACETATE & UREA
BETAMETHASONE VALERATE/GENTAMI
BETAMETHASONE/CALCIPOTRIOL
SUPP
10MG
SUPP
SUPP
5/5MG/GM
OINT
5/10/5MG/G OINT
OINT
0.5%
SOL
1%
LOT
2.50%
LOT
0.01%
SOL
0.025%
OINT
0.1%
CR
0.1%
OINT
0.1%
CR
0.1%
LOT
0.1%
OINT
0.05%
CR
0.05%
CR
0.05%
GEL
0.05%
CR
0.05%
CR
0.05%
CR
0.05%
GEL
0.25%
CR
0.25%
OINT
0.05%
CR
0.05%
GEL
0.1%
CR
0.1%
CR
0.1%
CR
0.05%
CR
0.05%
OINT
0.05%
OINT
0.05/0.09%
CR
0.05%
CR
0.05%
OINT
1%
CR
1%
CR
1G/100ML
LOT
0.1%
CR
0.1%
OINT
0.1%
LOT
0.1%
CR
0.10%
OINT
0.2%
CR
0.2%
OINT
.5MG/50MCG GEL
258
Dosage
*PA
05/2012
Therapy Class
840800
DIN
Drug Name
ANTIPRURITICS AND LOCAL ANESTHETICS
Chemical Name
Strength
Dosage
840800
840800
840800
840800
840800
840800
840800
02004062
00454583
02006308
02006316
01954210
00662461
02142147
COCAINE 10% SOL
PHENAZO TAB 200MG
PMS‐COCAINE 10% TOPICAL SOL
PMS‐COCAINE 4% TOPICAL SOL
PRAMOX HC LOTION
RECTOGEL HC
ZONALON 5% CR
COCAINE HCL
PHENAZOPYRIDINE HCL
COCAINE HCL
COCAINE HCL
PRAMOXINE/HC
BENZOCAINE
DOXEPIN HCL
10%
200MG
10%
4%
1%
SOL
TAB
LIQ
LIQ
LOT
OINT
CR
259
5%
*PA
05/2012
Therapy Class
841600
DIN
Drug Name
CELL STIMULANTS AND PROLIFERANTS
Chemical Name
Strength
Dosage
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
841600
02243914
00897329
00897310
00443794
00870021
00532665
00577278
00577251
00870013
00443816
00532673
02264633
02008718
02008726
02008688
02008696
00578576
00662348
00578568
00657204
00518182
00587966
00641863
01926462
01926489
00805505
01926497
01926500
00493333
01936519
00673110
01926527
00590797
00673102
01926470
00419001
RETIN‐A 0.1% MICRO GEL
RETIN‐A CR 0.01%
RETIN‐A CR 0.025%
RETIN‐A CR 0.05%
RETIN‐A CR 0.1%
RETIN‐A CREAM 0.05%
RETIN‐A CRM 0.1%
RETIN‐A GEL 0.01%
RETIN‐A GEL 0.01%
RETIN‐A GEL 0.025%
RETIN‐A GEL 0.025%
RETIN‐A MICRO 0.04% GEL
RETISOL A CR 0.05%
RETISOL A CR 0.1% FORTE
RETISOL‐A CR 0.01%
RETISOL‐A CR 0.025%
STIEVA A CR 0.025%
STIEVA A FORTE CR 0.1%
STIEVA A SOLUTION 0.025%
STIEVA‐A CR 0.01%
STIEVA‐A CR 0.05%
STIEVA‐A GEL 0.025%
STIEVA‐A GEL 0.05%
VITAMIN A ACID 0.01% GEL
VITAMIN A ACID 0.05% GEL
VITAMIN A ACID CR 0.01%
VITAMIN A ACID GEL 0.01%
TRETINOIN MICROSPHERE
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
TRETINOIN
0.1%
0.01%
0.025%
0.05%
0.1%
0.05%
0.1%
0.01%
0.01%
0.025%
0.025%
0.04%
0.05%
2/7.5/0.1%
0.01%
0.025%
0.025%
0.1%
0.025%
0.01%
0.05%
0.025%
0.05%
0.01%
0.05%
0.01%
0.01%
0.025%
0.05%
0.05%
0.1%
0.1%
0.01%
0.025%
0.025%
0.05%
GEL
CR
CR
CR
CR
CR
CR
GEL
GEL
GEL
GEL
GEL
CR
CR
CR
CR
CR
CR
LIQ
CR
CR
GEL
GEL
GEL
GEL
CR
CR
CR
CR
CR
CR
CR
GEL
GEL
GEL
GEL
260
*PA
05/2012
Therapy Class
842800
DIN
Drug Name
KERATOLYTIC AGENTS
Chemical Name
842800
842800
842800
842800
842800
842800
842800
00800708
00589500
00772011
01945149
02188708
00598208
02220407
BICHLORACETIC ACID 1
CANTHACUR PS
CANTHARONE PLUS
CONDYLINE 0.5% TOP SOL
PANOXYL CREAMY WASH 4
PODOFILM LIQ 250MG/ML
SULFACET‐R LOTION
DICHLOROACETIC ACID
CANTHARIDIN/SAL AC/PODOPHYLLIN
CANTHARIDIN/SAL AC/PODOPHYLLIN
PODOFILOX
BENZOYL PEROXIDE
PODOPHYLLUM RESIN
SULFACETAMIDE/SULFUR
261
Strength
Dosage
0.50%
0.04
25%
5%‐10%
O/L
LIQ
LIQ
LIQ
LIQ
LIQ
LOT
*PA
05/2012
Therapy Class
845006
DIN
Drug Name
PIGMENTING AGENTS
Chemical Name
Strength
Dosage
845006
845006
845006
845006
845006
845006
00007269
01946374
01907476
00252654
00698059
00646237
OXSORALEN 10MG CAP
OXSORALEN CAPSULES 10MG
OXSORALEN LOTION 1%
OXSORALEN ULTRA CAP 10MG
ULTRA MOP LOTION 1%
ULTRAMOP CAP 10MG
METHOXSALEN
METHOXSALEN
METHOXSALEN
METHOXSALEN
METHOXSALEN
METHOXSALEN
10MG
10MG
10MG/ML
10MG
10MG/ML
10MG
CAP
CAP
LOT
CAP
LOT
CAP
262
*PA
05/2012
Therapy Class
849200
DIN
Drug Name
MISCELLANEOUS SKIN AND MUCOUS MEMBRANE AGENTS
Chemical Name
Strength
Dosage
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
849200
02239505
02259052
02258986
02243118
02231592
02148749
02274000
02244126
02150956
01976133
02194341
00330582
02247238
02270811
02243933
02323273
02240328
02244148
02244149
02226383
02070847
02070863
02243894
02230784
02243895
02230785
02337630
02337649
02178850
02074788
02340445
ALDARA 50MG/G CREAM
AMEVIVE 15MG/0.5ML IM INJ
AMEVIVE 7.5MG/0.5ML IV INJ
APTHERA 5% TOPICAL PASTE
DIFFERIN 0.1% CR
DIFFERIN 0.1% GEL
DIFFERIN XP 0.3% GEL
DOVOBET OINTMENT
DOVONEX 50MCG/G CR
DOVONEX 50MCG/G OINT
DOVONEX 50MCG/ML TOP SOL
EFUDEX CR 5%
ELIDEL 1% CR
FINACEA 15% TOP GEL
LEVULAN KERASTICK 20% TOP SOL
METVIX 168MG/G CR
PANRETIN 0.1% GEL
PROTOPIC 1MG/G OINT
PROTOPIC OINT (0.03%)
RATIO‐PROCTOSONE OINT
SORIATANE 10 MG CAP
SORIATANE 25 MG CAP
TAZORAC 0.05% CREAM
TAZORAC 0.05% GEL
TAZORAC 0.1% CREAM
TAZORAC 0.1% GEL
TOCTINO 10MG CAP
TOCTINO 30MG CAP
TRAVASE OINT
WARTEC 0.5% SOL
ZYCLARA 3.75% CREAM
IMIQUIMOD
ALEFACEPT
ALEFACEPT
AMLEXANOX
ADAPALENE
ADAPALENE
ADAPALENE
CALCIPOTRIOL/BETAMETHASONE
CALCIPOTRIOL
CALCIPOTRIOL
CALCIPOTRIOL
FLUOROURACIL
PIMECROLIMUS
AZELAIC ACID
AMINOLEVULINIC ACID HCL
METHYL AMINOLEVULINATE HCL
ALITRETINOIN
TACROLIMUS
TACROLIMUS
ACITRETIN
ACITRETIN
TAZAROTENE
TAZAROTENE
TAZAROTENE
TAZAROTENE
ALITRETINOIN
ALITRETINOIN
SUTILAINS
PODOFILOX (PODOPHYLLOTOXIN)
IMIQUIMOD
50MG/G
15MG/.5ML
7.5MG/.5ML
5%
0.10%
0.10%
0.3%
CR
INJ
INJ
MISC
CR
GEL
GEL
OINT
CR
OINT
LIQ
CR
CR
GEL
LIQ
CR
GEL
OINT
OINT
OINT
CAP
CAP
CR
GEL
CR
GEL
CAP
CAP
OINT
LIQ
CR
263
50MCG
50 MCG/G
50MCG
5%
1%
15%
20%
168MG/G
0.1%
1MG/G
0.3MG/G
10MG
25MG
0.05%
0.05%
0.1%
0.10%
10MG
30MG
82,00
0.50%
3.75%
*PA
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
861200
DIN
Drug Name
GENITOURINARY SMOOTH MUSCLE RELAXANTS
Chemical Name
Strength
Dosage
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
861200
02241881
02231089
02163543
02363917
02239064
02239065
02244612
02244613
02243961
02259117
02243960
02241285
02273225
02273217
02236956
02377330
02377365
02377349
02377357
02242523
02230800
02230394
02347229
02230943
02158590
02220059
02350238
02254735
02236930
02220636
02239073
02260778
02260751
02245827
02223376
02240549
02240550
02242109
02299364
02275066
00728179
02273578
02273586
02283646
02277271
02277263
ALTI‐OXYBUTYNIN HCL 5MG TAB
APO‐OXYBUTYNIN 1MG/ML SYRUP
APO‐OXYBUTYNIN 5MG TAB
AVA‐OXYBUTYNIN 5MG TAB
DETROL 1MG TAB
DETROL 2MG TAB
DETROL LA 2MG CAPSULE
DETROL LA 4MG CAPSULE
DITROPAN XL 10MG ER TAB
DITROPAN XL 15MG TAB
DITROPAN XL ER 5MG TAB
DOM‐OXYBUTYNIN 5MG TAB
ENABLEX 15MG SR TAB
ENABLEX 7.5MG SR TAB
FLAVOXATE 200MG TAB
GD‐TOLTERODINE 1MG TAB
GD‐TOLTERODINE 2MG CAP LA
GD‐TOLTERODINE 2MG TAB
GD‐TOLTERODINE 4MG CAP LA
GEN‐BUTYNIN 5MG TAB
MYLAN‐OXYBUTYNIN 5MG TAB
NOVO‐OXYBUTYNIN 5MG TAB
NTP‐OXYBUTYNIN 5MG TAB
NU‐OXYBUTYN 1MG/ML
NU‐OXYBUTYN 5MG TAB
OXYBUTYN 5MG TAB
OXYBUTYNIN 5MG TAB
OXYTROL 36MG PATCH
PDL‐OXBUTYNINE 1MG/ML SYRUP
PDL‐OXYBUTYNIN 5MG TAB
PENTA‐OXYBUTYNIN 5MG TAB
PHL‐OXYBUTYNIN 1MG/ML SYRUP
PHL‐OXYBUTYNIN 2.5MG TAB
PHL‐OXYBUTYNIN 5MG TAB
PMS‐OXYBUTYNIN 1MG/ML SYRUP
PMS‐OXYBUTYNIN 2.5MG TAB
PMS‐OXYBUTYNIN 5MG TAB
RIVA‐OXYBUTYNIN 5MG TAB
RIVA‐OXYBUTYNIN 5MG TAB
TROSEC 20MG TAB
URISPAS TAB 200MG
UROMAX 10MG SR TAB
UROMAX 15MG SR TAB
UROMAX 5MG SR TAB
VESICARE 10MG TAB
VESICARE 5MG TAB
OXYBUTYNIN
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
TOLTERODINE L‐TARTRATE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
DARIFENACIN HYDROBROMIDE
DARIFENACIN HYDROBROMIDE
FLAVOXATE HCL
TOLTERODINE TARTRATE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
TROSPIUM CHLORIDE
FLAVOXATE HCL
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE
SOLIFENACIN SUCCINATE
SOLIFENACIN SUCCINATE
5MG
1MG/ML
5MG
5MG
1MG
2MG
2MG
4MG
10MG
15MG
5MG
5MG
15MG
7.5MG
200MG
1MG
2MG
2MG
4MG
5MG
5MG
5MG
5MG
1MG/ML
5MG
5MG
5MG
36MG
1MG/ML
5MG
5MG
1MG/ML
2.5MG
5MG
1MG/ML
2.5MG
5MG
5MG
5MG
20MG
200MG
10MG
15MG
5MG
10MG
5MG
TAB
O/L
TAB
TAB
TAB
TAB
CAP LA
CAP LA
TAB LA
TAB LA
TAB LA
TAB
TAB LA
TAB LA
TAB
TAB
CAP LA
TAB
CAP LA
TAB
TAB
TAB
TAB
O/L
TAB
TAB
TAB
PATCH
O/L
TAB
TAB
O/L
TAB
TAB
O/L
TAB
TAB
TAB
TAB
TAB
TAB
TAB LA
TAB LA
TAB LA
TAB
TAB
264
*PA
05/2012
Therapy Class
880400
DIN
Drug Name
VITAMIN A
880400
880400
00021067 VITAMIN A CAP 25000IU
00021075 VITAMIN A CAP 50000IU
265
Chemical Name
Strength
Dosage
VITAMIN A
VITAMIN A
25000IU
50000IU
CAP
CAP
*PA
05/2012
Therapy Class
880800
DIN
Drug Name
VITAMIN B COMPLEX
Chemical Name
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
880800
02103052
00426849
00521515
01987003
02052717
00314277
02285673
00496146
00816086
02169940
02169959
02366061
00619132
00356646
02240314
01983423
02241500
02237509
00653985
00626112
00038830
00497533
ALERTONIC LIQ
APO‐FOLIC ACID 5MG TAB
B12 INJ 1000MCG/ML
CYANOCOBALAMIN 1MG/ML INJ
CYANOCOBALAMIN INJ 1 MG/ML
CYANOCOBALAMINE INJ DE 1000MCG
EURO‐FOLIC 5MG TAB
FOLIC ACID
FOLIC ACID 5MG/ML INJ
FOLVITE INJ 5MG/ML
FOLVITE TAB 5MG
JAMP FOLIC ACID 5MG TAB
NIACIN 100MG TAB
VIT B12 TAB 25MCG
VITAMIN B12 1000MCG CAP
VITAMIN B12 1000MCG TAB
VITAMIN B12 100MCG/ML INJ
VITAMIN B12 250MCG
VITAMIN B12 25MCG TAB
VITAMIN B12 INJ
VITAMIN B12 INJ 1000MCG/ML
VITAMIN B12 INJ 100MCG/ML
PIPRADROL VITAMIN COMP
FOLIC ACID
CYANOCOBALAMIN
CYANOCOBALAMIN
CYANOCOBALAMIN
CYANOCOBALAMIN
FOLIC ACID
FOLIC ACID
FOLIC ACID
FOLIC ACID
FOLIC ACID
FOLIC ACID
NICOTINIC ACID
CYANOCOBALAMIN
CYANOCOBALAMIN
CYANOCOBALAMIN
CYANOCOBALAMIN
CYANOCOBALAMIN
CYANOCOBALAMIN
CYANOCOBALAMIN
CYANOCOBALAMIN
CYANOCOBALAMIN
266
Strength
5MG
1MG/ML
1MG/ML
1MG/ML
1MG/ML
5MG
5MG
5MG/ML
5MG/ML
5MG
100MG
25MCG
1000MCG
1000MCG
100MCG/ML
250MCG
25MCG
1MG/ML
1 MG/ML
100 MCG
Dosage
*PA
O/L
TAB
INJ
INJ
INJ
INJ
TAB
TAB
INJ
INJ
TAB
TAB
TAB
TAB
CAP
TAB
INJ
TAB
TAB
INJ
INJ
INJ
05/2012
Therapy Class
881600
DIN
Drug Name
VITAMIN D
Chemical Name
Strength
Dosage
881600
881600
881600
881600
881600
881600
881600
881600
881600
881600
881600
881600
881600
881600
881600
881600
00891738
00891746
02245686
02237450
01928422
00821772
02243790
00474517
00474525
02239431
02242502
02240329
02301911
00824291
00481823
00481815
CALCIJEX INJ 1MCG/ML
CALCIJEX INJ 2MCG/ML
CALCITRIOL 1MCG/ML INJ
D‐FORTE 50000 UNIT CAP
DRISDOL LIQ
D‐TABS 10,000IU
HECTOROL 2.5MCG CAP
ONE ALPHA CAPS 0.25MCG
ONE ALPHA CAPS 1MCG
ONE‐ALPHA 0.5MCG CAP
ONE‐ALPHA 2MCG/ML INJ
ONE‐ALPHA 2MCG/ML ORAL DROPS
OSTOFORTE D2 50000IU CAP
ROCALTROL 1MCG/ML O/L
ROCALTROL CAP 0.25MCG
ROCALTROL CAP 0.5MCG
CALCITRIOL
CALCITRIOL
CALCITRIOL
VITAMIN D
ERGOCALCIFEROL
VITAMIN D
DOXERCALCIFEROL
ALFACALCIDOL
ALFACALCIDOL
ALFACALCIDOL
ALFACALCIDOL
ALFACALCIDOL
VITAMIN D
CALCITRIOL
CALCITRIOL
CALCITRIOL
1MCG
2MCG
1MCG/ML
50000IU
8288IU/ML
10000
2.5MCG
0.25MCG
1MCG
0.5MCG
2MCG/ML
2MCG/ML
50000 IU
1UG/ML
0.25MCG
0.5MCG
INJ
INJ
INJ
CAP
O/L
TAB
CAP
CAP
CAP
CAP
INJ
O/L
CAP
O/L
CAP
CAP
267
*PA
05/2012
Therapy Class
882400
DIN
Drug Name
VITAMIN K ACTIVITY
Chemical Name
Strength
Dosage
882400
882400
00804312 VITAMIN K1 INJ 10MG/ML USP
00781878 VITAMIN K1 INJ 1MG/0.5ML USP
PHYTONADIONE
PHYTONADIONE
10MG/ML
2 MG/ML
INJ
INJ
268
*PA
05/2012
Therapy Class
882800
DIN
Drug Name
MULTIVITAMIN PREPARATIONS
Chemical Name
882800
882800
882800
882800
882800
882800
882800
882800
00556440
02238085
02243706
02089521
00620351
00687782
02246067
02276194
CAL MAG PLUS D TAB
CALCIUM AND MAGNESIUM VIT D
CENTRUM 8390 150MCG TAB
LIQUID CALCIUM‐MAGNESIUM + D
NEO CAL D3 TAB
O‐CALCIUM 250MG PLUS D
PREGVIT
PREGVIT FOLIC 5 TAB
CALCIUM/MAGNESIUM/VIT D
CALCIUM/MAGNESIUM/VITAMIN D
MULTI‐MINERAL W/BORON
CALCIUM/MG OXIDE/VIT D2
CALCIUM CARBONATE/VITAMIN D3
CALCIUM/VITAMIN D
PRENATAL VITAMIN
PRENATAL VITAMIN
269
Strength
150MCG
250MG
Dosage
*PA
TAB
CAP
TAB
O/L
TAB
TAB
TAB
TAB
05/2012
Therapy Class
920000
DIN
Drug Name
UNCLASSIFIED THERAPEUTIC AGENTS
Chemical Name
Strength
Dosage
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
920000
02229636
02241407
02266210
02266229
02266237
01984845
01981501
02344890
02314150
02245829
02245828
02374757
02374765
02301407
00206032
02242471
02238547
02238548
02238549
02029448
02379910
02246082
09857327
09857326
00009571
00000013
00376167
02245913
02350580
02162768
00050466
00050474
02252295
02199270
02223740
02223759
02223767
02223775
02280191
02280205
02280183
02299437
02299445
02299453
02299429
02263165
02263173
02263181
02263203
02248640
02248642
02248641
02248639
02129043
02330210
02330237
00611271
00611298
00550175
02239405
02049392
00839205
00839213
00839191
02239323
02239324
02239325
02266121
02257130
02257149
02257157
02243878
02247998
02346478
02324784
02324776
02283417
02283395
02283409
02320673
ALOCRIL 2% OPH SOL
ALOCRIL 2% OPH SOL
APO‐PERGOLIDE 0.05MG TAB
APO‐PERGOLIDE 0.25MG TAB
APO‐PERGOLIDE 1MG TAB
BONEFOS 400MG CAP
BOTOX INJ 100UNIT/VIAL
CABERGOLINE 0.5MG TAB
CATENA 150MG TAB
CLASTEON 30MG/ML INJ
CLASTEON 400MG CAP
CO BETAHISTINE 16MG TAB
CO BETAHISTINE 24MG TAB
CO‐CABERGOLINE 0.5MG TAB
COLCHICINE TAB 1MG
DOSTINEX 0.5MG TAB
DRAX‐PERGOLIDE 0.05MG TAB
DRAX‐PERGOLIDE 0.25MG TAB
DRAX‐PERGOLIDE 1MG TAB
ELMIRON 100MG CAP
FAMPYRA 10MG TAB
FLUNARIZINE 5MG CAP
HUMIRA PEN 40MG/0.8ML INJ
HUMIRA PRE‐FILL 40MG/0.8ML INJ
INTAL & SPINHALER
INTERNATIONAL DIN
KEMSOL LIQ 70%
KINERET 150MG/ML INJ
KUVAN 100MG TAB
MADECASSOL 10MG TAB
METHYLENE BLUE LIQ 1%
METHYLENE BLUE LIQ 2%
MYOBLOC 5000UNITS/ML
NITOMAN 25MG TAB
NORPROLAC 0.025MG TAB
NOVO‐BETAHISTINE 16MG TAB
OCTREOTIDE 100MCG/ML INJ
OCTREOTIDE ACETATE INJ
OCTREOTIDE ACETATE OMEGA 100UG
OCTREOTIDE ACETATE OMEGA 50MCG
ORGARAN 750U INJ
PMS‐BETAHISTINE 16MG TAB
PMS‐BETAHISTINE 24MG TAB
POTABA CAP 0.5G
POTABA PWR 2GM/PCK
POTABA TAB 0.5GM
REGRANEX 100MCG/GM GEL
SANDOSTATIN INJ 200MCG/ML
SANDOSTATIN INJ 0.1MG/ML
SANDOSTATIN LAR 10MG/VIAL INJ
SATIVEX BUCCAL SPRAY
SENSIPAR 30MG TAB
SENSIPAR 60MG TAB
SENSIPAR 90MG TAB
SERC 16MG TAB
SERC 24MG TAB
SIG‐CABERGOLINE 0.5MG TAB
SIMPONI 50MG/0.5ML AUTO INJ
SIMPONI PRE‐FILL 50MG/.5ML INJ
SOMATULINE AUTOGEL 120MG/0.5ML
STELARA 45MG/0.5ML INJ
NEDOCROMIL SODIUM
NEDOCROMIL SODIUM
PERGOLIDE MESYLATE
PERGOLIDE MESYLATE
PERGOLIDE MESYLATE
DISODIUM CLODRONATE TETRAHYDRA
BOTULINUM TOXIN TYPE A
CABERGOLINE
IDEBENONE
CLODRONATE DISODIUM
CLODRONATE DISODIUM
BETAHISTINE
BETAHISTINE
CABERGOLINE
COLCHICINE
CABERGOLINE
PERGOLIDE MESYLATE
PERGOLIDE MESYLATE
PERGOLIDE MESYLATE
PENTOSAN POLYSULFATE SODIUM
FAMPRIDINE
FLUNARIZINE HCL
ADALIMUMAB
ADALIMUMAB
CROMOLYN SODIUM
ADMIN DIN
DIMETHYLSULFOXIDE
ANAKINRA
SAPROPTERIN DIHYDROCHLORIDE
CENTELLA ASIATICA EXTRACT WHT
METHYLENE BLUE
METHYLENE BLUE
BOTULINUM TOXIN TYPE B
TETRABENAZINE
QUINAGOLIDE HCL
QUINAGOLIDE HCL
QUINAGOLIDE HCL
QUINAGOLIDE HCL
BETAHISTINE HCL
BETAHISTINE HCL
BETAHISTINE HCL
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
DANAPAROID SODIUM
BETAHISTINE HCL
BETAHISTINE HCL
AMINOBENZOATE POTASSIUM
BECAPLERMIN
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
OCTREOTIDE ACETATE
DELTA‐9 TETRAHYDROCANNABINOL/C
CINACALCET HCL
CINACALCET HCL
CINACALCET HCL
BETAHISTINE DIHYDROCHLORIDE
BETAHISTINE DIHYDROCHLORIDE
CABERGOLINE
GOLIMUMAB
GOLIMUMAB
LANREOTIDE ACETATE
LANREOTIDE ACETATE
LANREOTIDE ACETATE
USTEKINUMAB
2%
2%
0.05MG
0.25MG
1MG
400MG
100 UNIT
0.5MG
150MG
30MG/ML
400MG
16MG
24MG
0.5MG
1MG
0.5MG
0.05MG
0.25MG
1MG
100MG
10MG
5MG
40MG/0.8ML
40MG/0.8ML
O/O SOL
O/O SOL
TAB
TAB
TAB
CAP
INJ
TAB
TAB
INJ
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB LA
CAP
INJ
INJ
DEVICE
MISC
SOL
SYG
TAB
TAB
SOL
SOL
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
CAP
PDR
TAB
GEL
INJ
INJ
INJ
INJ
INJ
INJ
INJ
SPR
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
270
70%
150MG/ML
100MG
10MG
1%
2%
5000UN/ML
25MG
0.025MG
0.05MG
0.075MG
0.15MG
16MG
24MG
8MG
100MCG/ML
200MCG/ML
500MCG/ML
50MCG/ML
50MCG/ML
100MCG/ML
200MCG/ML
500MCG/ML
100MCG/ML
200MCG/ML
500MCG/ML
50MCG/ML
750U
16MG
24MG
500MG
2G
500MG
100MCG/GM
200MCG
0.1MG/ML
500MCG
50MCG
10MG
20MG
30MG
27MG/25MG
30MG
60MG
90MG
16MG
24MG
0.5MG
50MG/0.5ML
50MG/0.5ML
120MG/0.5M
60MG/0.3ML
90MG/0.3ML
45MG/0.5ML
*PA
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
*PA
920000
920000
920000
920000
920000
920000
920000
920000
02320681
00616419
01949004
02324032
00885533
01901885
01985604
02250519
STELARA 90MG/ML INJ
TEGISON CAP 25MG
WHITE‐FACED HORNET VENOM 120UG
XEOMIN 100 UNIT/VIAL INJ
YOHIMBINE 2MG TAB
YOHIMBINE 5.4MG TAB
YOHIMBINE 6MG TAB
ZAVESCA 100MG CAP
USTEKINUMAB
ETRETINATE
DOLICHOVESPULA MACULATA VENOM
CLOSTRIDIUM BOTULINUM NEUROTOX
YOHIMBINE HCL
YOHIMBINE HCL
YOHIMBINE HCL
MIGLISTAT
90MG/ML
25MG
INJ
CAP
INJ
INJ
TAB
TAB
TAB
CAP
PA (N)
271
100UN/VIAL
2MG
5.4MG
6MG
100MG
PA (N)
PA (N)
05/2012
Therapy Class
920100
DIN
Drug Name
NATURAL HEALTH PRODUCTS
Chemical Name
Strength
Dosage
920100
920113
920188
920188
920188
02209764
02074087
00575569
01939130
00405264
EGOZINC HC 0.5% OINT
PMS‐POTASSIUM GLUCONATE O/L
FLUOR A DAY 2.21MG TAB
NIACIN 500MG TAB
NIACIN TAB 100MG
HC ACETATE/ZINC SULPHATE
POTASSIUM GLUCONATE
SODIUM FLOURIDE
NIACIN
NICOTINIC ACID
0.50%
1.33MEQ/ML
2.21MG
500MG
100MG
OINT
O/L
TAB
TAB
TAB
272
*PA
05/2012
Therapy Class
920800
DIN
Drug Name
5-ALPHA-REDUCTASE INHIBITORS
Chemical Name
Strength
Dosage
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
920800
02374404
02365383
02378515
02378515
02247813
02354462
02376709
02348888
02349361
02350270
02355043
02375303
02372010
02357224
02356058
02348500
02376113
02310112
02010909
02371820
02306905
02322579
AG‐FINASTERIDE 5MG TAB
APO‐FINASTERIDE 5MG TAB
AVA‐FINASTERIDE 5MG TAB
AVA‐FINASTERIDE 5MG TAB
AVODART 0.5MG CAP
CO FINASTERIDE 5MG TAB
DOM‐FINASTERIDE 5MG TAB
FINASTERIDE 5MG TAB
FINASTERIDE 5MG TAB
FINASTERIDE 5MG TAB
FINASTERIDE 5MG TAB
FINASTERIDE 5MG TAB
JALYN 0.5/0.4MG CAP
JAMP‐FINASTERIDE 5MG TAB
MYLAN‐FINASTERIDE 5MG TAB
NOVO‐FINASTERIDE 5MG TAB
NTP‐FINASTERIDE 5MG TAB
PMS‐FINASTERIDE 5MG TAB
PROSCAR 5MG TAB
RAN‐FINASTERIDE 5MG TAB
RATIO‐FINASTERIDE 5MG TAB
SANDOZ FINASTERIDE 5MG TAB
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
DUTASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
DUTASTERIDE/TAMSULOSIN
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
FINASTERIDE
5MG
5MG
5MG
5MG
0.5MG
5MG
5MG
5MG
5MG
5MG
5MG
5MG
0.5/0.4MG
5MG
5MG
5MG
5MG
5MG
5MG
5MG
5MG
5MG
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
273
*PA
05/2012
Therapy Class
921200
DIN
Drug Name
ANTIDOTES
Chemical Name
Strength
Dosage
921200
921200
921200
921200
921200
921200
921200
921200
921200
921200
02170620
02170590
02170604
02170612
02087316
02182998
02183005
02177730
02182769
02170493
ISOVORIN 12.5MG TAB
ISOVORIN 2.5MG TAB
ISOVORIN 5MG TAB
ISOVORIN 7.5MG TAB
LEUCOVORIN 10MG/ML INJ
LEUCOVORIN 15MG TAB
LEUCOVORIN 5MG TAB
LEVOLEUCOVORIN CALCIUM
LEUCOVORIN CALCIUM
LEUCOVORIN CALCIUM
LEUCOVORIN CALCIUM
LEUCOVORIN CALCIUM
LEUCOVORIN CALCIUM
LEUCOVORIN CALCIUM
12.5MG
2.5MG
5MG
7.5MG
10MG/ML
10MG/ML
10MG/ML
15MG
3MG/ML
5MG
TAB
TAB
TAB
TAB
INJ
INJ
INJ
TAB
INJ
TAB
274
*PA
05/2012
Therapy Class
921600
DIN
Drug Name
ANTIGOUT AGENTS
Chemical Name
Strength
Dosage
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
921600
00449687
00514209
00454354
00294322
02353091
02353105
02353113
00572349
00621374
02236830
02236831
02236832
02373823
02373831
02348268
02348276
02348284
02335840
02335859
02335867
02130157
00555681
00555703
00402818
00479799
00402796
ALLOPRIN TAB 100MG
ALLOPRIN TAB 200MG
ALLOPRIN TAB 300MG
ALLOPURINOL 300MG TAB
ALLOPURINOL TAB 100MG
COLCHICINE TAB 0.6MG
COLCHICINE TAB 1MG
GEN‐ALLOPURINOL 100MG TAB
JAMP‐COLCHICINE 0.6MG TAB
JAMP‐COLCHICINE 1MG TAB
NTP‐ALLOPURINOL 100MG TAB
NU‐ALLOPURINOL 100MG TAB
PDL‐ALLOPURINOL 200MG TAB
PDL‐ALLOPURINOL TAB 100MG
PDL‐ALLOPURINOL TAB 300MG
ZYLOPRIM 100MG TAB
ZYLOPRIM 200MG TAB
ZYLOPRIM 300MG TAB
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
COLCHICINE
COLCHICINE
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
COLCHICINE
COLCHICINE
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
ALLOPURINOL
100MG
200MG
300MG
300MG
100MG
200MG
300MG
0.6MG
1MG
100MG
200MG
300MG
0.6MG
1MG
100MG
200MG
300MG
100MG
200MG
300MG
200MG
100MG
300MG
100MG
200MG
300MG
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
275
*PA
05/2012
Therapy Class
922000
DIN
Drug Name
BIOLOGIC RESPONSE MODIFIERS
Chemical Name
Strength
Dosage
*PA
922000
922000
922000
922000
922000
922000
922000
922000
922000
922000
922000
922000
922000
922000
922000
922000
922000
922000
02237770
09857395
02269201
02169649
02331675
02245619
02337819
02338017
02365480
02344939
02318261
02237319
02237320
02237318
02318253
02277492
02318288
02286386
AVONEX 30MCG/VIAL IN A KIT INJ
AVONEX PEN 30MCG/0.5ML
AVONEX PS 30MCG SYR.
BETASERON INJ
CIMZIA 200MG/ML INJ
COPAXONE PREFILLED SYR 20MG/ML
EXTAVIA 0.3MG/VIAL INJ
FERONA 0.3MG/VIAL INJ
GILENYA 0.5MG CAP
ILARIS 150MG/VIAL INJ
REBIF 132MCG/1.5ML INJ
REBIF 22MCG (6MIU)/0.5ML INJ
REBIF 44MCG (12MIU)/0.5ML INJ
REBIF 44MCG (12MIU)/VIAL INJ
REBIF 66MCG/1.5ML INJ
REBIF 8.8MCG/0.2ML INJ
REBIF INIT PK 132MCG/1.5ML INJ
TYSABRI 300MG/15ML INJ
INTERFERON BETA 1A
INTERFERON BETA‐1A
INTERFERON BETA 1A
INTERFERON
CERTOLIZUMAB PEGOL
GLATIRAMER ACETATE
INTERFERON BETA‐1B
INTERFERON BETA‐1B
FINGOLIMOD HCL
CANAKINUMAB
INTERFERON BETA 1A
INTERFERON BETA 1A
INTERFERON BETA 1A
NATALIZUMAB
30MCG/VIAL
30MCG/0.5M
30MCG/.5ML
0.3MG
200MG/ML
20MG/ML
0.3MG/VIAL
0.3MG/VIAL
0.5MG
150MG
132MCG/1.5
22MCG
44MCG
44MCG
66MCG
8.8MCG/0.2
132MCG/1.5
300MG/15ML
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
CAP
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
PA (P)
PA (P)
PA (P)
PA (P)
PA (N)
PA (P)
276
PA (N)
PA (N)
PA (P)
PA (P)
PA (P)
PA (P)
PA (P)
PA (P)
PA (P)
PA (N)
05/2012
Therapy Class
922400
DIN
Drug Name
BONE RESORPTION INHIBITORS
Chemical Name
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
02269198
02239146
02246896
02279657
02343916
02352958
02343924
02352966
02381486
02381478
02381494
02303043
02303051
02303035
02303078
02299712
02248728
02248729
02248727
02248730
02276844
02276852
02353687
02059762
02059789
02365065
02365073
02365057
02365081
02364808
02364816
02250136
02248686
02248687
02352915
02338696
02338718
02351390
02258102
02258110
02263866
02176017
01997629
02282763
02308398
02309831
02347989
02353210
02347962
02347970
02201011
02201038
02245329
02286327
02270110
02245331
02368552
02270129
02286335
02247323
02245330
02357984
02298384
02358697
02358891
02358905
02264951
02264978
02264986
02266784
02249669
02244550
02246597
02249677
02244551
02246598
02266792
02249685
02244552
02246599
ACLASTA 5MG/100ML IV INJ
ACTONEL 30MG TAB
ACTONEL 35MG TAB
ACTONEL PLUS CALCIUM TAB
ALENDRONATE 40MG TAB
ALENDRONATE SODIUM 10MG TAB
ALENDRONATE‐10 10MG TAB
ALENDRONATE‐FC 70MG TAB
APO‐ALENDRONATE 10MG TAB
APO‐ETIDRONATE 200MG TAB
APO‐ETIDRONATE 400MG TAB
APO‐RISEDRONATE 35MG TAB
AREDIA I.V. 30MG INJ
AREDIA I.V. 90MG INJ
AVA‐ALENDRONATE 10MG TAB
AVA‐RISEDRONATE 30MG TAB
AVA‐RISEDRONATE 35MG TAB
BONVIVA 2.5MG TAB
CO ETIDRONATE 200MG TAB
CO ETIDRONATE 400MG TAB
CO RISEDROCAL COMBO KIT
CO RISEDRONATE 30MG TAB
CO‐ALENDRONATE 40MG TAB
CO‐ALENDRONATE 70MG TAB
CO‐ETIDROCAL 400/500MG TAB
DIDROCAL KIT
DIDRONEL TAB 200MG
DOM‐ALENDRONATE 70MG TAB
DOM‐ALENDRONATE FC 70MG TAB
DOM‐RISEDRONATE 35 TAB
ETIDROCAL 400MG/500MG TAB
ETIDROCAL 400MG/500MG TAB
ETIDRONATE 200MG TAB
ETIDRONATE 400MG TAB
FOSAMAX 10MG TAB
FOSAMAX 40MG TAB
FOSAMAX 70MG TAB
GEN‐ALENDRONATE 40MG TAB
GEN‐ALENDRONATE 5MG TAB
GEN‐ETIDRONATE 400MG TAB
JAMP‐RISEDRONATE 35MG TAB
MYLAN‐ALENDRONATE 10MG TAB
MYLAN‐ALENDRONATE 70MG TAB
MYLAN‐ETI‐CAL CP 400/500MG TAB
MYLAN‐ETIDRONATE 200MG TAB
MYLAN‐RISEDRONATE 35MG TAB
NOVO‐RISEDRONATE 30MG TAB
NTP‐ETIDRONATE CALCIUM TAB
NTP‐RISEDRONATE 30MG TAB
NTP‐RISEDRONATE 35MG TAB
PAMIDRONATE 3MG/ML INJ
PAMIDRONATE DISODIUM 30MG/IV
PAMIDRONATE DISODIUM 3MG/ML
PAMIDRONATE DISODIUM 3MG/ML IV
PAMIDRONATE DISODIUM 90MG/IV
ZOLEDRONIC ACID
5MG/100ML
RISEDRONATE SODIUM
30MG
RISEDRONATE SODIUM
35MG
RISEDRONATE/CALCIUM CARBONATE 35MG/500MG
ALENDRONATE SODIUM TRIHYDRATE 40MG
ALENDRONATE SODIUM
40MG
ALENDRONATE SODIUM
70MG
ALENDRONATE DE SODIUM
10MG
5MG
70MG
ALENDRONATE SODIUM
10MG
ALENDRONATE SODIUM
40MG
ALENDRONATE SODIUM
5MG
ALENDRONATE SODIUM
70MG
ALENDRONATE SODIUM
70MG
ALENDRONATE SODIUM
10MG
ALENDRONATE
40MG
ALENDRONATE SODIUM
5MG
ALENDRONATE SODIUM
70MG
ETIDRONATE DISODIUM
200MG
ETIDRONATE DISODIUM
400MG
RISEDRONATE SODIUM
35MG
PAMIDRONATE DISODIUM
30MG
90MG
ALENDRONATE SODIUM
10MG
ALENDRONATE SODIUM
40MG
ALENDRONATE SODIUM
5MG
ALENDRONATE SODIUM
70MG
RISEDRONATE SODIUM MONOHYDRATE30MG
IBANDRONATE SODIUM
2.5MG
ETIDRONATE DISODIUM
200MG
ETIDRONATE DISODIUM
400MG
RISEDRONATE SODIUM/CALCIUM
35MG/500MG
RISEDRONATE SODIUM
30MG
RISEDRONATE SODIUM
35MG
RISEDRONATE SODIUM
75MG
ETIDRONATE DISOD/CALCIUM CARBO 400/500MG
ETIDRONATE DISODIUM/CALCIUM CA 400MG
ETIDRONATE DISODIUM
200MG
ALENDRONATE SODIUM
70MG
ALENDRONATE SODIUM
70MG
RISEDRONATE SODIUM
35MG
ETIDRONATE DISOD/CALCIUM CARBO 400MG/500M
ETIDRONATE DISOD/CALCIUM CARBO 400MG/500M
ETIDRONATE DISODIUM
200MG
ETIDRONATE DISODIUM
400MG
ALENDRONATE SODIUM
10MG
ALENDRONATE SODIUM
40MG
ALENDRONATE SODIUM
70MG
ETIDRONATE DISODIUM
400MG
RISEDRONATE SODIUM
35MG
ETIDRONATE DISOD/CALCIUM CARBO 400/500MG
ETIDRONATE DISODIUM
200MG
RISEDRONATE SODIUM
35MG
RISEDRONATE
30MG
ETIDRONATE DISODIUM/CALCIUM CA 400/500MG
3MG/ML
6MG/ML
9MG/ML
30MG/IV
3MG/ML
3MG/ML
3MG/ML
6MG/ML
6MG/ML
6MG/ML
90MG/IV
9MG/ML
9MG/ML
9MG/ML
277
Strength
Dosage
*PA
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
KIT
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
922400
02244432
02282771
02309874
02273179
02284006
02248418
02248194
02362414
02302209
02343541
02343568
02372304
02377446
02275279
02319861
02370247
02347474
02352141
02370255
02370239
02270870
02270889
02341077
02288087
02288095
02288079
02288109
02327295
02347938
02347946
02347954
02347202
02347210
02247373
02248251
02261715
02298392
02382032
02368153
02248296
02302004
PG ETIDRONATE 200MG TAB
PHL‐ALENDRONATE 70MG TAB
PHL‐RISEDRONATE 35MG TAB
PMS‐ALENDRONATE 70MG TAB
PMS‐ALENDRONATE FC 70MG TAB
PMS‐PAMIDRONATE 15MG/VIAL
PMS‐PAMIDRONATE 60MG/VIAL
PMS‐RISEDRONATE &CALC 35/500MG
PMS‐RISEDRONATE 35MG TAB
PROLIA 60MG/ML PRE‐FILLED SYR
PROLIA 60MG/ML VIAL
Q‐ALENDRONATE 70MG TAB
Q‐RISEDRONATE 35MG TAB
RATIO‐ALENDRONATE 70MG TAB
RATIO‐RISEDRONATE 35MG TAB
RISEDRONATE 30MG TAB
RISEDRONATE 5MG TAB
RIVA ALENDRONATE 40MG TAB
RIVA ALENDRONATE 70MG TAB
RIVA‐RISEDRONATE 35MG TAB
SANDOZ ALENDRONATE 10MG TAB
SANDOZ RISEDRONATE 35MG TAB
SIG‐ALENDRONATE 40MG TAB
SIG‐ALENDRONATE 70MG TAB
SIG‐ETIDROCAL 1250MG TAB
SIG‐ETIDRONATE 200MG TAB
SIG‐ETIDRONATE 400MG TAB
TEVA‐ALENDRONATE 10MG TAB
TEVA‐RISEDRONATE 35MG TAB
VAL‐PAMIDRONATE 9MG/ML INJ
XGEVA 120MG/1.7ML(70MG/ML) INJ
ZOMETA CONCENTRATE 4MG/VIAL
ZYM‐ALENDRONATE FC 70MG TAB
DISODIUM ETIDRONATE
ALENDRONATE SODIUM
RISEDRONATE SODIUM
ALENDRONATE SODIUM
ALENDRONATE SODIUM
RISEDRONATE/CALCIUM
RISEDRONATE SODIUM
DENOSUMAB
DENOSUMAB
ALENDRONATE
RISEDRONATE SODIUM
ALENDRONATE SODIUM
RISEDRONATE SODIUM
RISEDRONATE
RISEDRONATE SODIUM HEMI‐PENTAH
RISEDRONATE
RISEDRONATE SODIUM
RISEDRONATE
ALENDRONATE SODIUM TRIHYDRATE
RISEDRONATE
ALENDRONATE SODIUM
ALENDRONATE SODIUM
ALENDRONATE SODIUM
ALENDRONATE SODIUM
RISEDRONATE SODIUM
ETIDRONATE DISODIUM/CALCIUM CA
ETIDRONATE DISODIUM
ETIDRONATE DISODIUM
ALENDRONATE SODIUM
ALENDRONATE
ALENDRONATE SODIUM
RISEDRONATE
DENOSUMAB
ZOLEDRONIC ACID
ALENDRONATE SODIUM
200MG
70MG
35MG
70MG
70MG
15MG/VIAL
60MG/VIAL
35/500MG
35MG
60MG/ML
60MG/ML
70MG
35MG
70MG
35MG
30MG
35MG
35MG
35MG
5MG
40MG
70MG
35MG
10MG
40MG
5MG
70MG
35MG
40MG
70MG
1250MG
200MG
400MG
10MG
5MG
70MG
35MG
9MG/ML
120MG/1.7M
4MG
70MG
TAB
TAB
TAB
TAB
TAB
INJ
INJ
TAB
TAB
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
TAB
278
*PA
PA (N)
PA (N)
05/2012
Therapy Class
923600
DIN
Drug Name
DISEASE-MODIFYING ANTIRHEUMATIC DRUGS
Chemical Name
Strength
Dosage
*PA
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
923600
02350106
02350114
02350092
02256495
02256509
02241890
02241888
02241889
02376245
02376253
02309343
02309351
02242903
02274728
09857394
99100373
99100385
02258595
97799757
97799756
02334119
02351668
02334127
02351676
02261251
02261278
02346346
02346354
02336138
02336146
02282097
02309327
02309335
02288265
02288273
02244016
02283964
02283972
ACTEMRA 200MG/10ML IV SOL
APO‐LEFLUNOMIDE 10MG TAB
APO‐LEFLUNOMIDE 20MG TAB
ARAVA 100MG FC TAB
ARAVA 10MG FC TAB
ARAVA 20MG FC TAB
AVA‐LEFLUNOMIDE 10MG TAB
AVA‐LEFLUNOMIDE 20MG TAB
DOM‐LEFLUNOMIDE 10MG TAB
DOM‐LEFUNOMIDE 20MG TAB
ENBREL 25MG/VIAL INJ
ENBREL 50MG/ML INJ
ENBREL SURECLICK 50MG/ML PREFI
ENBREL SURECLICK 50MG/ML SYRIN
HUMIRA 40MG PEN
HUMIRA 40MG/0.8ML
HUMIRA PEN 40MG/0.8ML
HUMIRA PRE‐FILL SYR 40MG/0.8ML
LEFLUNOMIDE 10MG TAB
NOVO‐LEFLUNOMIDE 10MG TAB
NOVO‐LEFLUNOMIDE 20MG TAB
NTP‐LEFLUNOMIDE 10MG TAB
NTP‐LEFLUNOMIDE 20MG TAB
NU‐LEFLUNOMIDE 10MG TAB
NU‐LEFLUNOMIDE 20MG TAB
ORENCIA 250MG/VIAL INJ
PHL‐LEFLUNOMIDE 10MG TAB
PHL‐LEFLUNOMIDE 20MG TAB
PMS‐LEFLUNOMIDE 10MG TAB
PMS‐LEFLUNOMIDE 20MG TAB
REMICADE 100MG/VIAL INJ
SANDOZ LEFLUNOMIDE 10MG TAB
SANDOZ LEFLUNOMIDE 20MG TAB
TOCILIZUMAB
TOCILIZUMAB
TOCILIZUMAB
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
ETANERCEPT
ETANERCEPT
ETANERCEPT
ETANERCEPT
ADALIMUMAB
ADALIMUMAB
ADALIMUMAB
ADALIMUMAB
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
ABATACEPT
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
LEFLUNOMIDE
INFLIXIMAB
LEFLUNOMIDE
LEFLUNOMIDE
200MG/10ML
400MG/20ML
80MG/4ML
10MG
20MG
100MG
10MG
20MG
10MG
20MG
10MG
20MG
25MG
50MG/ML
50MG/ML
50MG/ML
40MG
40MG/0.8ML
40MG/0.8ML
40MG/0.8ML
10MG
10MG
20MG
20MG
10MG
20MG
10MG
20MG
10MG
20MG
250MG/VIAL
10MG
20MG
10MG
20MG
100MG
10MG
20MG
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
INJ
INJ
INJ
INJ
INJ
INJ
INJ
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
TAB
INJ
TAB
TAB
TAB
TAB
INJ
TAB
TAB
PA (N)
PA (N)
PA (N)
279
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
PA (N)
05/2012
Therapy Class
924400
DIN
Drug Name
IMMUNOSUPPRESSIVE AGENTS
Chemical Name
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
924400
02296462
02296470
02296489
02242907
02244324
02352559
02352567
02360918
02341115
02343002
02243371
02192748
02237484
02242145
02379996
02379996
02334798
02334763
02334771
00004596
02380382
02380382
02237291
02383780
02378574
02264560
02264579
02231491
02371154
02370549
02150670
02150697
02237671
02150689
02150662
02364883
02348675
02358573
02248843
02243144
02175991
02175983
02247111
02243237
02270617
02270684
02242821
02247073
02247074
02320630
02313855
02236819
ADVAGRAF 0.5MG ER CAP
ADVAGRAF 1MG ER CAP
ADVAGRAF 5MG ER CAP
APO‐AZATHIOPRINE 50MG TAB
APO‐CYCLOSPORINE 100MG/ML O/L
APO‐MYCOPHENOLATE 250MG CAP
APO‐MYCOPHENOLATE 500MG TAB
AVA‐AZATHIOPRINE 25MG TAB
AZATHIOPRINE 50MG TAB
AZATHIOPRINE 50MG TAB
AZATHIOPRINE‐50 50MG TAB
CELLCEPT 250MG CAP
CELLCEPT 500MG TAB
CELLCEPT PWD FOR ORAL SUSP
CO MYCOPHENOLATE 500MG TAB
CO MYCOPHENOLATE 500MG TAB
CYCLOSPORINE 100MG CAP
IMURAN TAB 50MG
JAMP‐MYCOPHENOLATE 500MG TAB
JAMP‐MYCOPHENOLATE 500MG TAB
MED‐AZATHIOPRINE 50MG TAB
MYCOPHENOLATE MOFETIL 250MG
MYCOPHENOLATE MOFETIL 500MG
MYFORTIC 180MG TAB
MYFORTIC 360MG TAB
MYLAN‐AZATHIOPRINE 50MG TAB
MYLAN‐MYCOPHENOLATE 250MG CAP
MYLAN‐MYCOPHENOLATE 500MG TAB
NEORAL 100MG CAP
NEORAL 100MG/ML O/L
NEORAL 10MG CAP
NEORAL 25MG CAP
NEORAL CAP 50MG
NOVO‐MYCOPHENOLATE 250MG CAP
NOVO‐MYCOPHENOLATE 500MG TAB
NTP‐AZATHIOPRINE 50MG TAB
NU‐AZATHIOPRINE 50MG TAB
PROGRAF 0.5MG CAP
PROGRAF 1MG CAP
PROGRAF 5MG CAP
RAPAMUNE 1MG TAB
RAPAMUNE 1MG/ML ORAL SOL
RAPAMUNE 2MG TAB
RAPAMUNE 5MG TAB
SANDOZ CYCLOSPORINE 100MG CAP
SANDOZ MYCOPHENOLATE MOF 250MG
SANDOZ MYCOPHENOLATE MOF 500MG
TEVA‐AZATHIOPRINE 50MG TAB
TACROLIMUS
0.5MG
TACROLIMUS
1MG
TACROLIMUS
5MG
AZATHIOPRINE
50MG
CYCLOSPORINE
100MG/ML
MYCOPHENOLATE MOFETIL
250MG
500MG
AZATHIOPRINE
25MG
AZATHIOPRINE
50MG
AZATHIOPRINE
50MG
AZATHIOPRINE
50MG
250MG
500MG
200MG/ML
500MG
500MG
CYCLOSPORINE
100MG
CYCLOSPORINE
25MG
CYCLOSPORINE
50MG
AZATHIOPRINE
50MG
500MG
500MG
AZATHIOPRINE
50MG
250MG
500MG
MYCOPHENOLATE SOD/MYCOPHENOLIC180MG
MYCOPHENOLATE SOD/MYCOPHENOLIC360MG
AZATHIOPRINE
50MG
250MG
500MG
CYCLOSPORINE
100MG
CYCLOSPORINE
100MG/ML
CYCLOSPORINE
10MG
CYCLOSPORINE
25MG
CYCLOSPORINE
50MG
250MG
500MG
AZATHIOPRINE
50MG
AZATHIOPRINE
50MG
TACROLIMUS
0.5MG
TACROLIMUS
1MG
TACROLIMUS
5MG
SIROLIMUS
1MG
SIROLIMUS
1MG/ML
SIROLIMUS
2MG
SIROLIMUS
5MG
CYCLOSPORINE
100MG
CYCLOSPORINE
25MG
CYCLOSPORINE
50MG
250MG
500MG
AZATHIOPRINE
50MG
280
Strength
Dosage
*PA
CAP LA
CAP LA
CAP LA
TAB
O/L
CAP
TAB
TAB
TAB
TAB
TAB
CAP
TAB
PDR
TAB
TAB
CAP
CAP
CAP
TAB
TAB
TAB
TAB
CAP
TAB
TAB
TAB
TAB
CAP
TAB
CAP
O/L
CAP
CAP
CAP
CAP
TAB
TAB
TAB
CAP
CAP
CAP
TAB
O/L
TAB
TAB
CAP
CAP
CAP
CAP
TAB
TAB
05/2012
Therapy Class
925600
DIN
Drug Name
PROTECTIVE AGENTS
Chemical Name
Strength
Dosage
925600
925600
925600
925600
02229691
02244931
02371839
02241411
MESNA 100MG/ML INJ
MESNA 100MG/ML INJ
UROMITEXAN 100MG/ML IV
UROMITEXAN 100MG/ML ORAL PWS
MESNA
MESNA
MESNA
MESNA
100MG/ML
100MG/ML
100MG/ML
100MG/ML
INJ
INJ
INJ
MISC
281
*PA
05/2012
Therapy Class
940000
DIN
Drug Name
DEVICES
Chemical Name
940000
940000
940000
940000
00904910
00963658
00901873
00895415
NOVOLIN PEN SYRN
SAFE‐T‐PRO LANCETS
SYRINGE INSU LO DOSE MICRO 100
VENTOLIN+ROTAHALER
INSULIN SYRINGE
LANCET
SYRINGE
SALBUTAMOL
282
Strength
Dosage
0.4MG
SYG
LANCET
SYG
DEVICE
*PA
05/2012
Therapy Class
940100
DIN
Drug Name
DEVICES AND SUPPLIES (DIABETIC)
Chemical Name
Strength
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
00967378
97799494
97799495
97799817
97799816
09991022
00950944
00977125
09991021
09991019
09991116
00906700
00897590
00964190
00963976
00964948
00964913
00964921
00965022
00965030
00965049
00984027
00960578
97799919
00977493
00950953
97799526
99262295
99328377
99328419
09991065
99328369
00962317
00977108
99401068
97799881
00905690
00977961
99639286
00920177
99221044
00901911
99767467
09991090
09991207
00901424
00906786
00920193
00950942
00950959
00906727
00920207
00906816
00920215
00977490
00977118
00950207
00977492
00977491
00977977
00977985
00909114
99000024
97799527
00977011
97799897
00908185
00908452
00977101
97799466
97799480
99100673
00969176
00981192
99100668
99100669
00977012
00977071
99002108
99100517
ACCU‐CHEK FASTCLIK LANCET
ACCU‐CHEK MULTICLIX 102
ACCU‐CHEK MULTICLIX 204
ACCU‐CHEK MULTICLIX CARTRIDGES
ACCU‐CHEK MULTICLIX LANCET
ACCU‐CHEK MULTICLIX LANCET
ACCU‐CHEK MULTICLIX LANCET DEV
ACCU‐CHEK MULTICLIX LANCETS
ACCU‐CHEK SOFTCLIX LANCING DEV
ACCUTREND CONTROL SOLN
AIGUILLE NOVOLIN‐PEN
AIGUILLE STYLO 31G 5MM
AIGUILLE STYLO 31G 8MM
AIGUILLE SUPER FINE 29G 12.7MM
AIGUILLE SUPER FINE 31G 5MM
AIGUILLE SUPER FINE 31G 8MM
AIGUILLE ULTICARE 29GX12MM
ALCOHOL SWABS (MANULIFE‐DIN)
AMES LANCETS
AMES LANCETS 200 (NS)
ASCENCIA MICROLET LANCETS
ASCENSIA LANCET
BD AUTOSHIELD PEN NDL 29GX8MM
BD INJECT‐EASE W/MICRO‐FINE
BD INSULIN SYR 1/2CC 50U 29G
BD INSULIN SYR 1/3CC 29G ULT
BD INSULIN SYRINGE 3CC 25G
BD INSULIN SYRINGES 1CC ULT
BD LANCETS
BD LATITUDE LANCET (NF)
BD LATITUDE LANCETS
BD LATITUDE LANCETS 100 (NS)
BD MICRO‐FINE 0.3CC INSULIN SY
BD MICRO‐FINE 1CC INS SYR/ZIN
BD MICRO‐FINE 1CC INSULIN SYR
BD SYR ECLPS 1ML 25X8/8
BD ULTRA FINE 29GX12.7MM
BD ULTRA FINE 33 LANCETS
BD ULTRA‐FINE 0.3CC INSULIN SY
BD ULTRA‐FINE 0.5CC 29G SYR
BD ULTRA‐FINE 0.5CC 31G SYR
BD ULTRAFINE 11 30G SYR 1/2CC
BD ULTRAFINE 11 30G SYR 1CC
BD ULTRA‐FINE 29G 0.5CC SYRING
BD ULTRAFINE 31G 5MM PEN NEEDL
BD ULTRAFINE 31G 8MM PEN NEEDL
BD ULTRA‐FINE II INSULIN SYR
BD ULTRA‐FINE II INSULIN SYR
BD ULTRA‐FINE III PEN NEEDLE
BD ULTRAFINE INSULIN NEEDLES
BD ULTRA‐FINE NANO PEN NEEDLE
BD ULTRA‐FINE PEN III NEEDLES
BD ULTRA‐FINE PEN NEEDLE 29G
BD ULTRA‐FINE PEN NEEDLES
BG STAR LANCETS
BIONIME RIGHTEST GL300 LANCETS
BOUCHON SYRINGE STERILE
CLICKFINE NEEDLE 31G
DEX MICROLET LANCETS
DISP SYR 20CC WITHOUT NEEDLE
DISP SYR 30CCWITHOUT NEEDLE
DISPOSABLE NEEDLE 5109
DISPOSABLE NEEDLE 5122
DISPOSABLE NEEDLE FOR AUTO‐INJ
DISPOSABLE NEEDLE FOR SYRINGE
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCING DEVICE
LANCET
LANCING DEVICE
CONTROL SOLUTION
PEN NEEDLE
NEEDLE
PEN NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
ISOPROPYL ALCOHOL
LANCET
LANCET
LANCET
LANCET
PEN NEEDLE
NEEDLE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
LANCET
LANCET
LANCET
LANCET
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
PEN NEEDLE
LANCET
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
NEEDLE
NEEDLE
SYRINGE
SYRINGE
PEN NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
LANCET
LANCET
SYRINGE
PEN NEEDLE
LANCET
SYRINGE
SYRINGE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
DEVICE
LANCET
DEVICE
SOL
DEVICE
NEEDLE
SYG
29GX12.7MM NEEDLE
31GX5MM
NEEDLE
31GX8MM
NEEDLE
29GX12MM
NEEDLE
31GX6MM
NEEDLE
31GX8MM
NEEDLE
PAD
LANCET
LANCET
LANCET
LANCET
NEEDLE
SYG
SYG
SYG
SYG
SYG
LANCET
LANCET
LANCET
LANCET
28GX1
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
29GX12.7MM NEEDLE
LANCET
29GX1
SYG
0.3CC
SYG
SYG
SYG
1/2CC
SYG
0.5CC
SYG
29GX1
SYG
1.0CC
SYG
SYG
SYG
SYG
NEEDLE
NEEDLE
SYG
SYG
NEEDLE
NEEDLE
4MM/32G
NEEDLE
NEEDLE
29G
NEEDLE
NEEDLE
NEEDLE
NEEDLE
LANCET
LANCET
SYG
NEEDLE
LANCET
20CC
SYG
30CC
SYG
NEEDLE
NEEDLE
SYG
NEEDLE
283
Dosage
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
00977608
99002337
99005077
00900710
00977307
00950913
00950914
97799540
97799541
00965901
00900834
00976369
00995965
97799825
00963615
00977839
99401063
97799826
00984302
00999950
00983004
00999985
00986002
99002132
99002140
99002159
99002167
97799566
97799567
97799569
97799568
97799571
97799570
00905300
00965138
00965189
00905302
00965146
00905304
00965162
00965154
00905306
00969184
00965170
97799524
97799766
97799767
00621900
00962201
00962260
00964778
00964786
00977151
00905160
00908231
00908576
00961205
00961264
00901555
00977854
00908533
00977117
00906239
00962280
00964034
97799918
97799917
00977951
00977136
00977128
00920045
99253047
99254011
99729459
99432633
99432799
99432914
99433383
00920355
00920053
00904090
DISPOSABLE SYRINGE TERUMO 1/2
DISPOSABLE SYRINGES 1CC
DISPOSIBLE NEEDLE FOR SYRINGE
DISPOSIBLE NEEDLES 30X1/2
ELITE CONTROL SOLUTION
EQUATE THIN LANCET
EQUATE ULTRATHIN LANCET
EZ HEALTH LANCETS (100) NS
EZ HEALTH ORACLE LANCETS
E‐Z JECT LANCET
FINGERSTIX LANCET/ LACTOSE (PQ
FINGERSTIX LANCETS
FINGERSTIX LANCETS
FINGERSTIX LANCETS 200 (NS)
FREESTYLE LANCETS
FREESTYLE LANCETS
FREESTYLE LANCETS
FREESTYLE LANCETS 100 (NS)
GLUCOLET PEN
INSULIN 1CC SYRINGE
INSULIN LO DOSE MICRO SYRINGE
INSULIN PEN NEEDLES (AB DIN)
INSULIN SYRINGE ULTRA 3/10CC
INSULIN SYRINGE W/NEEDL 0.25CC
INSULIN SYRINGE W/NEEDLE 0.3CC
INSULIN SYRINGE W/NEEDLE 0.5CC
INSULIN SYRINGE W/NEEDLE 1CC
INSUPEN 29GX12MM NEEDLE
INSUPEN NEEDLE 29G
INSUPEN NEEDLE 29G
INSUPEN NEEDLE 29G
INSUPEN NEEDLE 30G
INSUPEN NEEDLE 30G
INSUPEN NEEDLE 31G
INSUPEN NEEDLE 31G
INSUPEN NEEDLE 31G SHORT
INSUPEN NEEDLE 32G
INSUPEN NEEDLE 32G
INSUPEN NEEDLE 32G SHORT
ITEST DISQ REFILL CART(LANCET)
ITEST LANCETS 28G (100)
ITEST LANCETS 33G (100)
LANCET SOFT TOUCH
LANCETS FINE
LANCETS FINE 200'S
LANCETTE ITEST 28G
LANCETTES ITEST 33G
LIFE BRAND ULTRA THIN LANCETS
LIFESCAN FINE NEEDLES
LIFESCAN LANCETS
LIFESCAN LANCETS
LIFESCAN LANCETS
LIFESCAN LANCETS
LIFESCAN REGULAR LANCETS
LIFESCAN ULTRA SOFT LANCETS
MEDISENSE LANCETS
MEDISENSE THIN LANCET
MICROLET LANCET
MICROLET LANCET
MICROLET LANCETS
MICROLET LANCETS 100 (NS)
MICROLET LANCETS 200 (NS)
MONOJECT 0.3CC SYRINGE
MONOJECT 0.5CC SYRINGE
MONOJECT 0.5CC/1CC (NIHB) SYR
MONOJECT 1CC INSULIN SYR
MONOJECT DISP SYR 3/10CC
MONOJECT DISP SYR 3/10CC
MONOJECT LANCET
MONOJECT SYR 1/2CC
MONOJECT SYR 1/2CC
MONOJECT SYR 1CC
MONOJECT SYR 1CC
MONOJECT SYRINGES 0.5 CC
MONOJECT ULT 0.3CC 29G SYR
MONOLET LANCETS
SYRINGE
SYRINGE
NEEDLE
NEEDLE
CONTROL SOLUTION
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
GLUCOLET PEN
SYRINGE
INSULIN SYRINGE
INSULIN PEN NEEDLES
INSULIN SYRINGE
SYRINGE WITH NEEDLE
SYRINGE WITH NEEDLE
SYRINGE WITH NEEDLE
SYRINGE WITH NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
PEN NEEDLE
NEEDLE
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LIFESCAN FINE NEEDLES
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
LANCET
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
LANCET
284
Strength
1.0CC
1CC
28GX1
29GX1
0.25CC
0.3CC
0.5CC
1CC
29GX12MM
29GX8MM
30GX8MM
31GX8MM
31GX6MM
32GX6MM
28G
33G
0.5CC
Dosage
*PA
SYG
SYG
SYG
NEEDLE
SOL
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
MISC
SYG
SYG
NEEDLE
SYG
SYG
SYG
SYG
SYG
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
NEEDLE
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
SYG
SYG
SYG
SYG
SYG
SYG
LANCET
SYG
SYG
SYG
SYG
SYG
SYG
LANCET
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
00961310
00977543
00904062
00903507
99401055
00950958
00964581
00968935
00967408
00902470
00901970
00901989
00902004
00902012
00902039
00902055
00902063
00902071
00901946
00982822
97799909
00908169
00921114
00977756
00977987
97799911
97799910
97799764
00950941
99221028
99117796
00988588
00964247
00965006
00901253
00696141
00969168
00985694
00965561
97799765
00901359
00963984
00907421
00905917
97799469
97799501
97799969
00977853
97799968
97799970
00900511
00900512
00900513
00965413
00965391
00965405
97799537
97799539
97799538
00977020
00906190
00963879
97799833
97799832
09991075
97799948
00905916
00901360
00977955
97799688
00920096
00920061
00965057
00965065
00965073
00965081
00965103
00965111
00965448
09991142
00000165
MONOLET LANCETS
MONOLET LANCETS
MONOLET ORIGINAL LANCETS
MONOLET THIN LANCETS
MONOLET THIN LANCETS
MPD LANCET
MULTICLIX LANCETS
NANO PEN NEEDLE 31GX8MM
NEEDLE AUTOSHIELD
NEEDLE DISP 18X11/2
NEEDLE DISP 20X11/2
NEEDLE DISP 21X1/ ADRAGANTHE (
NEEDLE DISP 22X1
NEEDLE DISP 22X11/2
NEEDLE DISP 23X1 / ATROPINE SU
NEEDLE DISP 25X5/8
NEEDLE DISP 26X1/2
NEEDLE DISP 26X3/8
NEEDLE DISP 27X1/2/ ACACIA (PQ
NOVOFINE 28G NEEDLES
NOVOFINE 28GX 12M
NOVOFINE 30G PEN NEEDLE 6MM
NOVOFINE 30GX 6MM
NOVOFINE 30GX 8MM NEEDLES
NOVOFINE 32G ETW PEN NEEDLES
NOVOFINE 32GX6MM NEEDLES
NOVOFINE INSUL PEN NEEDLE 28G
NOVOFINE INSUL PEN NEEDLE 30G
NOVO‐FINE INSULIN SYRINGE
NOVOFINE NEEDLE 30G
NOVOFINE NEEDLE AUTOCOVER
NOVOFINE NEEDLES
NOVOTWIST NEEDLE 30G 8MM (PQ)
NOVOTWIST NEEDLE 32G (PQ)
ONE TOUCH DELICA LANCETS
ONE TOUCH SURE SOFT LANCETS
ONE TOUCH ULTRA SOFT LANCETS
ONE TOUCH ULTRA SOFT LANCETS
ONE TOUCH ULTRASOFT LANCET
ONE TOUCH ULTRASOFT LANCETS
ONE TOUCH VERIO IQ BG MONITOR
ONETOUCH DELICA LANCET
ONETOUCH FINEPOINT 100 (NS)
ONETOUCH FINEPOINT LANCETS
ONETOUCH REGULAR 200 (NS)
ONETOUCH ULTRASOFT 100 (NS)
OWEN MUMFORD UNIFINE PENTIP
PENFINE NEEDLES 29GX10MM
PENFINE UNIVERSAL CLICK PEN 10
PENFINE UNIVERSAL CLICK PEN 6M
PENFINE UNIVERSAL CLICK PEN 8M
PLASTIPAK MICRO SYRINGE 8410
PRECISION AUTOLANCET
PRECISION LANCETS
PRECISION LANCETS 100 (NS)
PRECISION LANCETS 200 (NS)
REX LANCETS
SAFE‐T‐PRO 200 (NS)
SAFE‐T‐PRO LANCET
SAFE‐T‐PRO PLUS
SERINGUE E‐Z JE 0.5CC
SERINGUE E‐Z JE 1.0CC
SERINGUE ULTICARE 12.7MM 30GX1
SERINGUE ULTICARE 12.7MM 30X.3
SERINGUE ULTICARE 12.7MM 30X.5
SERINGUE ULTICARE 8MM 31GX.3CC
SERINGUE ULTICARE 8MM 31GX.5CC
SERINGUE ULTICARE 8MM 31GX1CC
SINGLE‐LET LANCET
SINGLE‐LET LANCET
SOFT CLIX LANCETS
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
PEN NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NOVOFINE INSULIN PEN NEEDLE
NOVOFINE INSULIN PEN NEEDLE
SYRINGE
NEEDLE
NEEDLE
NEEDLE
PEN NEEDLE
PEN NEEDLE
CONTROL SOLUTION
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
GLUCOMETER
LANCET
LANCET
LANCET
LANCET
LANCET
PEN NEEDLE
PEN NEEDLE
PEN NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
SYRINGE
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
LANCET
LANCET
LANCET
285
Strength
29GX8MM
32GX6MM
31G X 6MM
31G X 8MM
29G X 12MM
29GX10MM
31GX6MM
31GX8MM
10MM/29G
6MM/31G
8MM/31G
0.5CC
1CC
30GX1CC
30GX0.3CC
30GX0.5CC
31GX0.3CC
31GX0.5CC
31GX1CC
Dosage
*PA
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
SYG
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
SOL
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
DEVICE
LANCET
LANCET
LANCET
LANCET
LANCET
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
SYG
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
LANCET
LANCET
LANCET
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
00941440
00941448
00941456
00977952
99493957
00962546
00902144
97799946
97799945
00950915
00963860
00977956
00985341
97799942
00977373
97799563
97799561
97799562
00906441
00965197
00965200
00965219
00965227
00901903
00920169
99002345
00906166
00909084
00909092
00909238
00902837
00983896
00906573
00906581
00906603
00902977
00905682
97799896
97799895
97799543
97799545
97799544
97799507
97799508
97799509
97799549
97799550
97799551
97799504
97799505
97799506
97799546
97799547
97799548
97799516
97799513
97799518
97799515
97799512
97799517
97799514
97799511
97799997
97799999
97799998
97799994
97799996
97799995
00905106
97799510
00969249
00905100
00900506
00900505
00900504
00905102
00900503
00900502
00900501
00905104
00964018
SOFT INSULIN 29G SYRINGE
SOFT INSULIN 29G SYRINGE
SOFT‐ INSULIN SYRINGE 29G
SOFT TOUCH LANCETS
SOFT TOUCH LANCETS
SOFTCLIX LANCETS
SOFTCLIX SELECT LANCET
SOFTCLIX LANCETS 100 (NS)
SOFTCLIX LANCETS 200 (NS)
SOFTCLIX PRO LANCET
SOFTCLIX PRO LANCET
SOFTCLIX PRO LANCETS
SOFTCLIX PRO LANCETS
SOFTCLIX PRO LANCETS 200 (NS)
SOFTCLIX SELECT LANCETS
SUPER‐FINE MICRO 31G‐5MM NEEDL
SUPER‐FINE STANDARD 29G‐12.7MM
SUPER‐FINE XTRA 31G‐8MM NEEDLE
SURELITE LANCETS
SURGILANCE LANCET GREY
SURGILANCE LANCET ORANGE
SURGILANCE LANCET PINK
SURGILANCE LANCET YELLOW
SYRINGE INSU LO DOSE MICRO
SYRINGE MICRO‐FINE 0.3CC
SYRINGE W/NEEDLE 1CC
SYRN INJECTOMATIC MONOJECT
SYRN INS U‐II 1/2CC 30G
SYRN INS U‐II 3/10CC 30G
SYRN INS ULT II 1CC 30G
SYRN INSULIN 3/10CC / ICHTHAMM
SYRN INSULIN LO DOSE U 100
SYRN INSULIN MONOJECT 29G
SYRN INSULIN MONOJECT U 100
SYRN INSULIN U 100
UF111 MINI PEN NEEDLE
UF111 SHORT PEN NEEDLE 31G
ULTI 29GX1/2 INC SHARP CONTAIN
ULTI 31GX1/4 INC SHARP CONTAIN
ULTI 31GX5/16 INC SHARP CONTAI
ULTI SYG WITH ULTIG 29G 1/2 IN
ULTI SYG WITH ULTIG 30G 5/16
ULTICARE 0.3CC 30G SYG 1/2 IN
ULTICARE 0.5CC 28G SYG 1/2 INC
ULTICARE 0.5CC 30G SYR 1/2 IN
ULTICARE 1CC 28G SYG 1/2 INCH
ULTICARE 1CC 30G SYR 1/2 IN
ULTICARE 1CC 31G SYG 5/16 INCH
ULTICARE INSULIN SYR 29G.1CC
ULTICARE INSULIN SYR30G.5CC
ULTICARE LOW DEAD SPACE SYG
ULTICARE LOW DEAD SPACE SYG
ULTICARE NEEDLE 32GX4MM
ULTICARE SYRINGE 28G
ULTICARE SYRINGE 29G 0.3CC
ULTICARE SYRINGE 29G 1CC
ULTICARE SYRINGE 30G 1CC
ULTICARE SYRINGES 29G 0.3CC
SYRINGE
SYRINGE
SYRINGE
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
NEEDLE
NEEDLE
NEEDLE
LANCET
LANCET
LANCET
LANCET
LANCET
SYRINGE
SYRINGE
SYRINGE WITH NEEDLE
SYRINGE
SYRINGE
SYRINGE
DIABETIC SUPPLY (NIHB)
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
NEEDLE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
29GX1
29GX1/2CC
29GX1/4CC
SYG
SYG
SYG
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
LANCET
NEEDLE
NEEDLE
NEEDLE
LANCET
LANCET
LANCET
LANCET
LANCET
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
NEEDLE
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
286
23GX1.8MM
22GX2.2MM
21GX2.8MM
26GX1MM
1CC
28GX1
29GX1
29GX1
29GX1
28GX1
29GX12MM
31GX6MM
31GX8MM
29GX1CC
29GX0.5CC
29GX0.3CC
30GX1CC
30GX0.5CC
30GX0.3CC
30GX1CC
30GX0.5CC
30GX0.3CC
31GX1CC
31GX0.5CC
31GX0.3CC
31GX0.3CC
28GX0.5CC
31GX0.5CC
28GX1CC
31GX1CC
32GX4MM
29GX0.3CC
29G X0.5CC
29G X 1CC
30GX0.3CC
30GX0.5CC
30G X 1CC
29X0.3CC
*PA
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
Strength
Dosage
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
940100
00963941
00963895
00964174
00964115
00964069
00905114
00905116
00905108
97799906
97799908
97799907
00905110
97799903
97799905
97799904
00905112
97799887
97799888
97799889
00964441
00999105
97799885
97799890
97799886
00900141
00977659
00964360
00964301
00908428
00962473
97799883
97799991
97799993
97799992
00964344
00964220
00964271
00977051
00977896
00984167
00962597
00985023
97799845
97799846
ULTICARE SYRINGES 29G 1CC
ULTICARE SYRINGES 30G 1CC
ULTIG W ULTIC PEN NEED 29G
ULTIG W ULTIC PEN NEED 31G
ULTIGUARD INSULIN SYR 29G
ULTIGUARD INSULIN SYR 29G.1CC
ULTRA 29G. 3/10CC
ULTRA 29G.1/2CC
ULTRA 29G.1CC
ULTRA FINE II SYRINGE
ULTRA‐FINE 0.5CC SYRINGE
ULTRA‐FINE II 30G.1/2CC
ULTRA‐FINE II 30G.1CC
ULTRA‐FINE II 30G.3/10 CC
ULTRA‐FINE II LANCETS
ULTRA‐FINE II LANCETS
ULTRA‐FINE II SHORT 0.5CC SYR
ULTRA‐FINE II SHORT 1CC SYR
ULTRA‐FINE LANCET/OSMOLITE
ULTRA‐FINE LANCETS
ULTRAFINE LANCETS 200 (NS)
UNFINE 31G.12MM
UNFINE 31G.6MM
UNFINE 31G.8MM
UNIFINE NEEDLES 29G
UNIFINE NEEDLES 31G
UNIFINE NEEDLES 31G
UNILET COMFORT TOUCH LANCETS
UNILET LANCETS
UNILET LANCETS
URIN‐TEK TUBE SETS W/O CUPS
URIN‐TEK TUBE SETS W/O CUPS
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
NEEDLE
NEEDLE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
SYRINGE
LANCET
LANCET
SYRINGE
SYRINGE
LANCET
LANCET
LANCET
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
LANCET
LANCET
LANCET
LANCET
LANCET
TUBE SET
TUBE SET
29X0.5CC
29X1CC
30X0.3CC
30X0.5CC
30X1CC
SYG
SYG
SYG
SYG
SYG
NEEDLE
NEEDLE
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
SYG
LANCET
LANCET
SYG
SYG
LANCET
LANCET
LANCET
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
NEEDLE
LANCET
LANCET
LANCET
LANCET
LANCET
DEVICE
DEVICE
287
0.5CC
*PA
05/2012
Therapy Class
960000
DIN
Drug Name
PHARMACEUTICAL AIDS
Chemical Name
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
00972045
00967548
00901393
00976296
09991099
00999951
00901422
09991078
09991027
09991071
00901381
00999952
00977454
00964603
00977953
00977129
09991020
09991049
00956953
00091355
09991097
09991141
00901374
00901390
09991124
00907057
00901364
02900076
00960438
00964093
09991080
09991150
00902225
00905496
00970352
00999969
99000245
00985120
09991129
00920126
00964050
09991029
00986119
00901352
09991151
00967475
00963992
00901384
09991105
00901355
00909068
00906719
00901354
02047502
02338818
09991028
00972132
09991087
09991082
02900084
00973335
00984825
00899100
00963887
00964166
00986496
00964212
00963933
00907049
00907073
00901382
09991023
00901418
00973114
00901365
00901375
09991066
09991069
00960209
09991139
4‐AMINOPYRIDINE PWD
ACETYL MANDELIC ACID
ACETYLCYSTEINE POWDER
ACYCLOVIR POWDER
AMINOPHYLLINE POWDER
AMITRIPTYLINE PWD
AMOXAPINE POWDER
AMOXICILLIN TRIHYDRATE POWDER
AMPHOTERICIN B POWDER
ATENOLOL POWDER
AZATHIOPRINE POWDER
BACLOFEN PWD
BETAMETHASONE POWDER
BETAMETHASONE VALERATE POWDER
BISMUTH CITRATE POWDER
BUPIVACAINE POWDER
BUSPIRONE HCL POWDER
CAPTOPRIL POWDER
CEPHALEXIN POWDER
CHLORAL HYDRATE PDR
CHLORAMPHENICOL POWDER
CHLORPROMAZINE PDR
CICLOPIROX OLAMINE POWDER
CIMETIDINE USP POWDER
CIPROFLOXACIN HCL POWDER
CLINDAMYCIN HCL PDR
CLINDAMYCIN PHOSPHATE POWDER
CLINDAPAK 560MG SACH
CLOBETASOL PROPIONATE POWDER
CLOBETASOL PWD
CLOMIPRAMINE HCL POWDER
CLONIDINE POWDER
COCAINE POWDER
COD PHOS BP
CODEINE POWDER
COLESTID ORAL PDR ORANGE 5G
COLESTID ORANGE PD
COUMARIN POWDER
CYANOCOBALAMIN POWDER
CYCLOBENZAPRINE POWDER
CYCLOBENZAPRINE PWD
CYPROHEPTADINE POWDER
DESONIDE POWDER
DEXAMETHASONE POWDER
DIAZEPAM POWDER
DICLOFENAC POWDER
DICLOFENAC SODIUM PWD
DIENESTROL
DIHYDROTESTOSTERONE POWDER
DILTIAZEM POWDER
DIMERCAPTO‐1‐PROPANE SULF ACID
DISTILLED WATER
DISULFIRAM POWDER
DO NOT USE
DO NOT USE
DOMPERIDONE POWDER
DOXEPIN HCL PWD
DOXYCYCLINE MONOHYDRATE POWDER
EPHEDRINE HYDROCHLORIDE POWDER
ERYPAK 1.8GM SACH
ERYTHROMYCIN POWDER
ERYTHROMYCIN PWR
ERYTHROMYCINE
ESTRADIOL PWD
ESTRADIOL PWD
ESTRADIOL USP MICRON
ESTRIOL
ESTRIOL PWD
ESTRIOL USP MICRONIZED PWD
ESTRONE POWDER
ETHINYL ESTRADIOL PWD
FENTANYL CITRATE POWDER
FLUCONAZOLE POWDER
FLUOCINOLONE POWDER
FLUOROURACIL POWDER
GABAPENTIN POWDER
GENTAMICIN SULFATE PWD
GRISEOFULVIN MICRONIZED PDR
GUANETHIDINE MONOSULPHATE PWD
HALOBETASOL PROPIONATE PDR
4‐AMINOPYRIDINE
ACETYL MANDELIC ACID
ACETYLCYSTEINE
ACYCLOVIR
AMINOPHYLLINE
AMITRIPTYLINE HCL
AMOXAPINE
AMPHOTERICIN B
ATENOLOL
AZATHIOPRINE
BACLOFEN
BETAMETHASONE
BISMUTH CITRATE
BUPIVACAINE HCL
BUSPIRONE HCL
CAPTOPRIL
CHLORAL HYDRATE
CHLORAMPHENICOL
CHLORPROMAZINE HCL
CICLOPIROX OLAMINE
CIMETIDINE
CIPROFLOXACIN HCL
CLINDAMYCIN HCL
CLOBETASOL
CLOMIPRAMINE HCL
CLONIDINE HCL
COCAINE HCL
CODEINE PHOSPHATE
CODEINE PHOSPHATE
COLESTIPOL HCL
COLESTIPOL HCL
5,6‐BENZO‐ALPHA‐PYRONE
CYANOCOBALAMIN
CYCLOBENZAPRINE
CYCLOBENZAPRINE
CYPROHEPTADINE
DESONIDE
DEXAMETHASONE
DIAZEPAM
DICLOFENAC
DICLOFENAC SODIUM
DIENESTROL
DIHYDROTESTOSTERONE
DILTIAZEM
DIMERCAPTO‐1‐PROPANE SULF ACID
TEST STRIP/ WATER
DISULFIRAM
DO NOT USE
DO NOT USE
DOMPERIDONE
DOXEPIN HCL
DOXYCYCLINE
EPHEDRINE HCL
ERYTHROMYCIN
ERYTHROMYCIN
ERYTHROMYCIN
ERYTHROMYCIN
ESTRADIOL
ESTRADIOL
ESTRADIOL
ESTRIOL
ESTRIOL
ESTRIOL USP MICRONIZED
ESTRONE
ETHINYL ESTRADIOL
FENTANYL CITRATE
FLUCONAZOLE
FLUOCINOLONE
FLOUROURACIL
GABAPENTIN
GENTAMICIN SULFATE
GRISEOFULVIN
GUANETHIDINE MONOSULPHATE
HALOBETASOL PROPIONATE
288
Strength
560MG
5G
1.8GM
Dosage
*PA
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
O/L
PDR
MISC
MISC
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
09991161
00906689
00907065
00900036
00967572
00968951
00900168
00976261
00901380
00261289
09991094
00997993
00900796
00900826
00964107
00960632
00901387
00986070
09991026
00920673
00986003
09991107
00905534
09991147
09991118
00907561
66999990
00002773
00908835
00964654
00964662
00964670
00964689
09850619
00901419
09991125
00901368
09991138
09991047
09991055
00963925
00901362
00901399
00901389
09991160
00962122
00901405
00977498
00977001
00901377
00901366
00999910
00901308
09991117
00908746
00902896
00901410
00904279
00901363
00902411
09991076
09991089
00901423
00901431
00977935
01989111
00970778
00901397
00901425
00920134
99003740
09991048
00964263
00904244
00963593
00963836
00904082
09991088
00972332
00903175
09991036
HYDRALAZINE POWDER
HYDROCORTISONE ACETATE PWD
HYDROCORTISONE PDR
HYDROCORTISONE POWDER
IBUPROFEN POWDER
INDOMETHACIN POWDER
IODOQUINOL POWDER
ISOTAMINE PDR
ITRACONAZOLE POWDER
KETAMINE POWDER
KETOCONAZOLE POWDER
KETOPROFEN POWDER
KETOPROFEN PWD
L TRYPTOPHAN POWDER
L‐5‐HYDROXYTRYPTOPHAN
L‐CARNITINE PWD
LEVOTHYROXINE SODIUM (T4) PDR
LIDOCAINE CRYSTALS
LIOTHYRONINE PWD
LITHIUM CARBONATE PDR
MECLIZINE POWDER
MEFENAMIC ACID PDR
MELOXICAM POWDER
METHADONE
METHADONE 1MG/ML LIQ
METHADONE POWDER
METHADONE POWDER
METHADONE POWDER
METHADONE POWDER
METHADONE POWDER
METHADONE POWDER
METHADONE PWD
METHIMAZOLE POWDER
METHOXSALEN POWDER
METHYLPHENIDATE POWDER
METHYLTESTOSTERONE PDR
METOCLOPRAMIDE POWDER
METOPROLOL POWDER
METRONIDAZOLE POWDER
METRONIDAZOLE PWD
MICONAZOLE POWDER
MINOCYCLINE HCL
MISOPROSTOL 1% PDR
MORPHINE POWDER
NALTREXONE HCL POWDER
NAPROXEN BASE POWDER
NEOMYCIN POWDER
NIACIN POWDER
NIFEDIPINE POWDER
NILSTAT POWDER
NITROFURANTOIN PWD
NORETHINDRONE POWDER
NYSTATIN POWDER
OXYBUTYNIN CHLORIDE USP POWDER
PAPAVERINE HCL POWDER
PHENOBARBITAL PWD
PHENTERMINE POWDER
PHENTOLAMINE MESYLATE POWDER
PILOCARPINE (NITRATE)
PILOCARPINE CHLORHYD
PIROXICAM POWDER/ENCORE STRIPS
PMS‐HYDROMORPHONE PWD
POTASSIUM IODIDE PWD
PREDNISOLONE ACETATE POWDER
PREDNISONE USP PWD
PREGNENOLONE POWDER
PRESAISONNIER HERBE A POUX
PROCHLOPERAZINE POWDER
PROGESTERONE
PROGESTERONE MICRONIZED PD
PROGESTERONE POWDER
PROGESTERONE PWD
PROGESTERONE USP PDR
PROPRANOLOL HCL POWDER
PROSTAGLANDIN E1 PWD
PROSTIN PWD
RANITIDINE POWDER
HYDRALAZINE
HYDROCORTISONE
HYDROCORTISONE
HYDROCORTISONE
HYDROCORTISONE
IBUPROFEN
INDOMETHACIN
DIODOHYDROXYQUIN
ISONIAZID
ITRACONAZOLE
KETAMINE
KETOCONAZOLE
KETOPROFEN
KETOPROFENE
L TRYPTOPHAN
L‐5‐HYDROXYTRYPTOPHAN
L‐CARNITINE
LIDOCAINE
LIOTHYRONINE
LITHIUM CARBONATE
MECLIZINE
MEFENAMIC ACID
MELOXICAM
METHADONE
METHADONE
METHADONE
METHADONE
METHADONE
METHADONE
METHADONE
METHADONE
METHADONE
METHIMAZOLE
METHOXSALEN
METHYLPHENIDATE
METHYLTESTOSTERONE
METOCLOPRAMIDE HCL
METOPROLOL TARTRATE
METRONIDAZOLE
METRONIDAZOLE
MICONAZOLE NITRATE
MINOCYCLINE HYDROCHLORIDE
MISOPROSTOL
MORPHINE
NALTREXONE HCL
NAPROXEN
NEOMYCIN SULPHATE
NICOTINIC ACID
NIFEDIPINE
NYSTATIN
NITROFURANTOIN
NORETHINDRONE
INSULIN REGULAR
NYSTATIN
OXYBUTYNIN CHLORIDE
PAPAVERINE HCL
PHENOBARBITAL
PHENTERMINE
PILOCARPINE
PILOCARPINE HCL
PIROXICAM
HYDROMORPHONE HCL
POTASSIUM IODIDE
PREDNISONE
PREGNENOLONE
ALLERGENIC EXTRACTS
PROCHLOPERAZINE
PROGESTERONE
PROGESTERONE
PROGESTERONE
PROGESTERONE
PROGESTERONE
PROPRANOLOL HCL
PROSTAGLANDIN
PROSTAGLANDIN PWD
RANITIDINE HCL
289
Strength
500MG
1MG/ML
1%
100U/ML
Dosage
*PA
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
O/L
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
INJ
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
INJ
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
05/2012
Therapy Class
DIN
Drug Name
Chemical Name
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
960000
00905607
00968919
00901407
09991093
09991068
09991100
00963151
09991101
00901396
00901394
00978795
00901881
00901426
00898945
00906930
00977828
00901367
00908010
09991104
00909211
00986151
00901403
00901398
00969257
09991042
00901378
00906425
00908983
00980781
09991096
RETINOIC ACID (TRETI
RETINOIC ACID PDR
RIBAVIRIN POWDER
SECOBARBITAL SODIUM POWDER
SECRETIN (HUMAN) 99% PDR
SPIRONOLACTONE POWDER
SULFACETAMIDE POWDER
SULFAMETHOXAZOLE PDR
SULFAPYRIDINE POWDER
SULFASALAZINE POWDER
SULPHUR POWDER
SYRINGE INSU LO DOSE U100/ZIN
TACROMILUS PWD
TESTOSTERONE PDR
TESTOSTERONE PWD
TETRACYCLINE PWD/COMPANION STR
THYROID POWDER
TINIDAZOLE PWD
TRAMADOL POWDER
TRIAMCINOLONE POWDER
TRIIODO‐L‐THYRONINE SOD. SALT
TRIMETHOPRIM USP MIC. PDR
TRIOXSALEN
URSODIOL POWDER
VALPROIC ACID POWDER
VERAPAMIL POWDER
VITAMIN A ACID POWDER
VITAMIN K POWDER
YOHIMIBINE HCL POWDER
ZALEPLON POWDER
RETINOIC ACID
TRETINOIN
RIBAVIRIN
SECOBARBITOL SODIUM
SECRETIN MANNITOL
SPIRONOLACTONE
SULFACETAMIDE
SULFAMETHOXAZOLE
SULFAPYRIDINE
SULFASALAZINE
SULPHUR
SYRINGE
TACROMILUS
TESTOSTERONE
TESTOSTERONE
TETRACYCLINE
THYROID
TINIDAZOLE
TRAMADOL HCL
TRIAMCINOLONE
TRIIODO‐L‐THYRONINE SOD. SALT
TRIMETHOPRIM
TRIOXSALEN
URSODIOL
VALPROIC ACID
VERAPAMIL HCL
VITAMIN A ACID
PHYTONADIONE
YOHIMIBINE HCL
ZALEPLON
290
Strength
99%
Dosage
*PA
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
SYG
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
PDR
05/2012
Drugs Not Covered on DTF
(Tier 1) with Alternatives
Product Document
Drugs NOT on DTF (Tier 1)
Alternative drugs that are covered may not be in the
same drug class or interchangeable with non-covered
drugs.
Optimizing the
Value of
Health Benefits
Please note that the lists in this document are not meant
to replace the advice of your Health Care Professional,
but rather they are meant to provide general information
about drug coverage.
Drugs not covered on the DTF (Tier 1) may be
covered on the secondary plan (Tier 2) as determined
by the plan sponsor
DRUGS NOT COVERED
ALTERNATIVES to drugs not
covered
This is a GENERIC formulary, so where there is a
GENERIC that is considered interchangeable with
the BRAND, only the cost of the GENERIC will be
reimbursed. The GENERIC name will be listed in
brackets beside the BRAND name if available.
This list is subject to change upon review of new
products or information. Please see plan
administrator for specific drug coverage.
List of Alternative Drugs is not a complete list.
Please see plan administrator for details on
specific drug coverage.
ALTERNATIVE DRUGS COVERED
CARDIOVASCULAR DRUGS (for heart diseases)
Fibric Acid Derivatives (high cholesterol)
BEZAFIBRATE (regular formulation)
FENOFIBRATE (regular formulation)
HMG-CoA Reductase Inhibitors
(high cholesterol)
ADVICOR
LESCOL 20mg and 40mg
MEVACOR (LOVASTATIN)
MULTAQ
Fibric Acid Derivatives (high
cholesterol)
BEZALIP SR
LIPIDIL EZ, MICRO, SUPRA
(FENOFIBRATE EZ, MICRO, SUPRA)
LOPID (GEMFIBROZIL)
HMG-CoA Reductase Inhibitors
(high cholesterol)
CRESTOR
LESCOL XL 80mg
LIPITOR (ATORVASTATIN)
PRAVACHOL (PRAVASTATIN)
ZOCOR (SIMVASTATIN)
Antiarrhythmic Agents
Miscellaneous Antilipemic Agents
(high cholesterol)
LODALIS
NIASPAN
The information listed in this document was
correct at the time of posting. Every effort is
made to ensure accuracy, although errors
may occur. The information may change
without notice. Updated May 30, 2012.
291
Antiarrhythmic Agents
CORDARONE (AMIODARONE)
Miscellaneous Antilipemic Agents
(high cholesterol)
CHOLESTYRAMINE
COLESTID
NIACIN (NICOTINIC ACID)
NIACINAMIDE
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
PAIN AND INFLAMMATION
COX-2 Inhibitors
(pain and inflammation)
CELEBREX
NSAIDs
Optimizing the
Value of
Health Benefits
ETODOLAC
NABUMETONE
Nonsteroidal Anti-Inflammatory
Agents(NSAIDS)and Opiate Agonists
ANAPROX (NAPROXEN SODIUM)
ARTHROTEC
DAYPRO
DIFLUNISAL
Opiate Agonists
ABSTRAL
JURNISTA
NUCYNTA CR/NUCYNTA IR
ONSOLIS
TARGIN
TRAMACET (TRAMADOL/ACETAMINOPHEN)
ULTRAM
VIMOVO
made to ensure accuracy, although errors may
occur. The information may change without
notice. Updated May 30, 2012.
292
DURAGESIC (FENTANYL)
FLURBIPROFEN
HYDROMORPH CONTIN
INDOMETHACIN
MEFENAMIC ACID
MOBICOX (MELOXICAM)
NAPROSYN (NAPROXEN)
OXYCONTIN
PERCOCET (OXYCODONE/
ACETAMINOPHEN)
PERCOCET-DEMI
PHENYLBUTAZONE
PIROXICAM
RALIVIA
SULINDAC
TENOXICAM
TIAPROFENIC ACID
TORADOL (KETOROLAC)
TYLENOL WITH CODEINE 2, 3, OR 4
(ACETAMINOPHEN WITH CODEINE 2,
3, OR 4)
VOLTAREN (DICLOFENAC)
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
CENTRAL NERVOUS SYSTEM
Miscellanous CNS drugs
(for attention deficit hyperactivity disorder)
STRATTERA (ATOMOXETINE)
VYVANSE
Optimizing the
Value of
Miscellanous CNS drugs
(for attention deficit hyperactivity
disorder )
ADDERALL XR
BIPHENTIN
CONCERTA (METHYLPHENIDATE ER)
DEXEDRINE
RITALIN/RITALIN SR
(METHYLPHENIDATE)
Health Benefits
Miscellanous CNS drugs (for diabetic
peripheral neuropathic pain)
CYMBALTA
Anti-Parkinson Agents
AZILECT
made to ensure accuracy, although errors may
occur. The information may change without
notice. Updated May 30, 2012
293
Miscellanous CNS drugs (for diabetic
peripheral neuropathic pain)
LYRICA
Anti-Parkinson Agents
COMTAN
MIRAPEX (PRAMIPEXOLE)
PROLOPA
REQUIP (ROPINIROLE)
SELEGILINE
SINEMET (LEVODOPA/CARBIDOPA)
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
Hypnotic (insomnia)
IMOVANE (ZOPICLONE)
SUBLINOX
Optimizing the
Value of
Health Benefits
DRUGS NOT COVERED
Benzodiazepines (anxiety, insomnia)
ATIVAN (LORAZEPAM)
CHLORDIAZEPOXIDE
CLORAZEPATE
DALMANE (FLURAZEPAM)
LECTOPAM (BROMAZEPAM)
LOFTRAN
MOGADON (NITRAZEPAM)
RESTORIL (TEMAZEPAM)
SERAX (OXAZEPAM)
TRIAZOLAM
VALIUM (DIAZEPAM)
XANAX (ALPRAZOLAM)
ANTI-GOUT
Xanthine Oxidase Inhibitor
ULORIC
Xanthine Oxidase Inhibitor
ALLOPURINOL
without notice. Updated May 30, 2012
294
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
Atypical Antipsychotics
INVEGA
INVEGA SUSTENNA
RISPERDAL M (RISPERIDONE)
SEROQUEL XR (QUETIAPINE)
Atypical Antipsychotics
CLOZARIL (CLOZAPINE)
RISPERDAL (RISPERIDONE)
SEROQUEL (QUETIAPINE)
ZELDOX
ZYPREXA (OLANZAPINE)
Optimizing the
Value of
Health Benefits
Antidepressants
CIPRALEX
CYMBALTA
PAXIL CR
PRISTIQ
The information listed in this document
was correct at the time of posting. Every
effort is made to ensure accuracy,
although errors may occur. The
information may change without notice.
Updated May 30, 2012
295
Antidepressants
CELEXA (CITALOPRAM)
EFFEXOR XR (VENLAFAXINE)
LUVOX (FLUVOXAMINE)
PAXIL (PAROXETINE)
PROZAC (FLUOXETINE)
ZOLOFT (SERTRALINE)
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
ELECTROLYTIC, CALORIC, and WATER BALANCE
Phosphate Removing Agents
FOSRENOL
Optimizing the
Value of
Health Benefits
Phosphate Removing Agents
PHOSLO
RENAGEL
RENVELA
EYE, EAR, NOSE & THROAT PREPARATIONS
(includes solutions, sprays, ointments and gels)
Nasal Corticosteroid
AVAMYS
BECLOMETHASONE
FLONASE (FLUTICASONE)
NASACORT
NASONEX
OMNARIS
RHINALAR (FLUNISOLIDE)
RHINOCORT TURBUHALER
Nasal Corticosteroid
BUDESONIDE
RHINOCORT AQ
was correct at the time of posting.
Every effort is made to ensure
accuracy, although errors may occur.
The information may change without
notice. Updated May 30, 2012
296
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
EYE, EAR, NOSE & THROAT PREPARATIONS
(includes solutions, sprays, ointments and gels)
Optimizing the
Value of
Carbonic Anhydrase Inhibitors
AZARGA
AZOPT (BRINZOLAMIDE)
COSOPT (DORZOLAMIDE/TIMOLOL)
DIAMOX (ACETAZOLAMIDE)
METHAZOLAMIDE
TRUSOPT (DORZOLAMIDE)
Health Benefits
Corticosteroid
ALREX 0.2%
LOTEMAX 0.5%
297
Glaucoma Drugs
AKARPINE (PILOCARPINE)
ALPHAGAN (BRIMONIDINE)
BETAGAN (LEVOBUNOLOL)
BETOPTIC (BETAXOLOL)
COMBIGAN
DIPIVEFRIN
IOPIDINE
LUMIGAN
MIOCARPINE
MIOSTAT
PROBETA
TIMOPTIC (TIMOLOL)
TIMPILO
TRAVATAN
XALACROM
XALATAN
Allergy Eye Drop
PATANOL
LIVOSTIN
ZADITOR
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
GASTROINTESTINAL DRUGS (for stomach and intestinal disorders)
Optimizing the
Value of
Proton Pump Inhibitors
(gastric and duodenal ulcer)
DEXILANT
LOSEC (OMEPRAZOLE)
NEXIUM
PANTOLOC (PANTOPRAZOLE)
PREVACID (LANSOPRAZOLE)
TECTA
Proton Pump Inhibitors
(gastric and duodenal ulcer)
PARIET (RABEPRAZOLE)
Health Benefits
ENDOCRINE DISORDERS (DIABETES)
Incretin Mimetics
AVANDIA
AVANDARYL
AVANDAMET
BYETTA
GLUMETZA AND GENERICS (METFORMIN
EXTENDED RELEASE)
STARLIX (NATEGLINIDE)
VICTOZA
correct at the time of posting. Every effort
is made to ensure accuracy, although
errors may occur. The information may
change without notice. Updated May 30,
2012
298
Antidiabetic Drugs
ACTOS (PIOGLITAZONE)
AMARYL (GLIMEPIRIDE)
CHLORPROPAMIDE
DIAMICRON/ DIAMICRON MR
(GLICLAZIDE)
GLUCOBAY
GLUCONORM (REPAGLINIDE)
GLUCOPHAGE (METFORMIN)
JANUMET
JANUVIA
ONGLYZA
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
HORMONES AND SYNTHETIC SUBSTITUTES (for hormone replacement, including sex
hormones, thyroid hormones, insulin hormones)
Optimizing the
Value of
Health Benefits
Estrogens (hormone replacement)
ACTIVELLE/ ACTIVELLE LD
AERODIOL NASAL SPRAY
ALORA
CLIMARA/CLIMARA PRO
ESTALIS
ESTRACOMB
ESTALIS-SEQUI
ESTRADERM
ESTRADOT PATCH TRANSDER
ESTROGEL
FEMHRT
MENOSTAR
OESCLIM PAD
PREFESTA
Estrogens (hormone replacement)
DELESTROGEN
ESTRACE
ESTRADIOL 17-β PATCH TRANDSDER
ESTRADIOL VALERATE
ESTRING
NEO-ESTRONE
OGEN
PREMARIN (CONJUGATED ESTROGENS)
PREMPLUS
VAGIFEM
ANTIBIOTICS
Macrolides
Macrolides
BIAXIN (CLARITHROMYCIN)
ERYC (ERYTHROMYCIN)
ZITHROMAX (AZITHROMYCIN)
ZMAX SR
299
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
Somatotropin Antagonists
(for treating Acromegaly)
SOMAVERT
Drugs for Acromegaly
SANDOSTATIN (OCTREOTIDE)
SOMATULINE AUTOGEL
OTHER DRUGS NOT COVERED WITH ALTERNATIVES
Optimizing the
Value of
Health Benefits
Anti-Asthma Drugs
ACCOLATE
CHOLEDYL (OXTRIPHYLLINE)
PHYLLOCONTIN (AMINOPHYLLINE)
SINGULAIR
THEO-DUR
UNIPHYL
XOLAIR
300
Anti-Asthma Drugs
ADVAIR
AIROMIR
ATROVENT
BRICANYL
COMBIVENT
CROMOLYN
DUOVENT
FLOVENT
FORADIL
ORCIPRENALIN
OXEZE
PULMICORT
QVAR
SEREVENT
SPIRIVA
SYMBICORT
VENTOLIN (SALBUTAMOL)
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
Skin & Mucous Membrane Agents (topicals,
creams, lotions, etc.)
CLOBEX SPRAY
DERMOTIC OIL EAR DROPS
SILKIS
VERDESO
Skin & Mucous Membrane Agents
(topicals, creams, lotions, etc.)
CLOBEX LOTION/SHAMPOO
(CLOBETASOL)
DIODEX
DERMOVATE (CLOBETASOL)
DESONIDE CREAM, LOTION
Optimizing the
Value of
Health Benefits
DRUGS NOT COVERED
Bone Disorder
(e.g. osteoporosis)
ACTONEL 5MG, 150MG (RISEDRONATE
5MG, 150)
ACTONEL DR 35MG
FOSAMAX 70MG/75ML O/L
FOSAVANCE
Hospital Drugs
Smoking Cessation Products
CHAMPIX
NICOTINE GUMS
NICOTINE PATCHES
ZYBAN
301
Bone Disorder
(e.g. osteoporosis)
ACLASTA
ACTONEL 30MG, 35MG (RISEDRONATE
30MG, 35MG TAB)
ACTONEL CALCIUM PLUS
BONEFOS
DIDROCAL
DIDRONEL (ETIDRONATE)
FOSAMAX 5, 10, 40, 70MG
(ALENDRONATE 5, 10, 40, 70MG)
No alternatives
No Alternatives
®
www.esi-canada.com
05/2012
Product Document
Optimizing the
Value of
Health Benefits
DRUGS NOT COVERED
Erectile Dysfunction Drugs
No Alternatives
CAVERJECT
CIALIS
LEVITRA
MUSE
STAXYN
VIAGRA
VITAROS
Anti-obesity Drugs
No Alternatives
Over the Counter Drugs
(non-prescription)
Over the Counter Drugs
(non-prescription)
All excluded except for alternatives
listed
ASA 80-325 MG (ACETYLSALICYCLIC
ACID 80-325 MG)
CALCIUM
DIABETIC SUPPLIES (LANCETS,
SYRINGES, NEEDLES, TEST STRIPS)
FOLIC ACID
INSULIN (except LEVEMIR & HYPURIN)
NIACIN/NICOTINIC ACID
NITROGLYCERINE
POTASSIUM SUPPLEMENTS
VITAMIN B12
IONAMIN
MERIDIA
SANOREX
TENUATE
XENICAL
HYPURIN
LEVEMIR
302
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
Optimizing the
Value of
Health Benefits
Fertility Drugs
BRAVELLE
CETROTIDE
CHORIONIC GONADOTROPIN
CLOMID
GONAL-F
LUTREPULSE
LUVERIS
ORGALUTRON
OVIDREL
PERGONAL
PREGNYL
PROFASI
PUREGON
RELISORM
REPRONEX
SEROPHENE
No Alternatives
Drugs to Promote/Inhibit Hair Growth
PROPECIA (FINASTERIDE)
ROGAINE
ROGAINE FOAM
VANIQA
No Alternatives
Pharmaceutical Devices
All excluded except for alternatives listed.
Drugs for Cosmetic Conditions
BOTOX COSMETIC
LATISSE
RENOVA
REJUVA
SOLAGE
XEOMIN COSMETIC
303
Pharmaceutical Devices
DIABETIC SUPPLIES (LANCETS,
SYRINGES, NEEDLES, TEST STRIPS)
No Alternatives
®
www.esi-canada.com
05/2012
Product Document
DRUGS NOT COVERED
Acne Drugs
Drugs for Acne
ACCUTANE
DIANE-35 (CYESTRA-35)
ALESSE (AVIANE)
MINOCIN (MINOCYCLINE)
PRESCRIPTION TOPICAL DRUGS
(STIEVA-A, BENOXYL LOTION 20%, ETC.)
TRI-CYCLEN
TACTUO
Optimizing the
Value of
Health Benefits
Blood Derivatives
No Alternatives
Contraceptive Foams, Devices
Oral Contraceptives
ALL
Diagnostics, Radiodiagnostics
All are excluded except for alternatives listed.
Diagnostics, Radiodiagnostics
THYROGEN
Devices
No Alternatives
Herbal Drugs
No Alternatives
Vaccines
No Alternatives
Antineoplastic Agents
METOJECT
304
Antineoplastic Agents
METHOTREXATE VIALS
®
www.esi-canada.com
05/2012
DTF Prior Authorization Drug List
Product Document
DTF Prior Authorization Drug List
The following list indicates the drugs which require Prior Approval from your Employer/Insurance
Company. Approval depends on whether specific criteria for using these drugs are met. Please see
your plan administrator for details.
Drugs requiring Prior Authorization
Abstral
Iressa
Sensipar
Actemra
Kuvan
Serostim
Adcirca
Metoject
Sildenafil
Afinitor
Nexavar
Simponi
Amevive
Sprycel
Avastin
Norditropin Simplexx /
Nordiflex
Nplate
Banzel
Nutropin
Sutent
Benlysta
Omnitrope
Tarceva
Biotropin
Onsolis
Tasigna
Botox
Orencia
Temodal
Caprelsa
Protropin
Thalomid
Catena
Raptiva
Thyrogen
Cimzia
Relistor
Toctino
Enbrel
Remicade
Tykerb
Fabrazyme
Replagal
Tysabri
Fampyra
Restasis
Vectibix
Forteo
Revatio
Vidaza
Gentropin
Revlimid
Votrient
Geref
Revolade
Xeomin
Gilenya
Rituxan
Zavesca
Gleevec
Saizen
Zelboraf
Humatrope
Sativex
Zolinza
Humira
Samsca
Zytiga
Stelara
Ilaris
Inspra
305
05/2012

Dynamic Therapeutic Formulary (DTF) Prescription Drug

Transcription

Similar documents

new brunswick prescription drug program formulary

PMD 2011 Comprehensive Formulary Publication Document

Articel List Opththalmic S.

List of Medications

New List, in force from 19 August 2016

List of Medications

New List, in force from 15 July 2016