Maximum Unit List - Health Information Designs

Transcription

ALABAMA MEDICAID AGENCY
Maximum Quantity Listing
Alabama Medicaid provides reimbursement for most covered outpatient pharmacy drugs based on a 34 day supply. Some maintenance
classes are required to be billed as a three month supply; however, this listing is based on a 34 day supply. Maximum units are based
according to Food and Drug Administration (FDA) approved indications. If a patient needs a quantity greater than the current maximum unit
quantity, an override request including appropriate medical justification must be submitted. The list is subject to change. For additional PDL
and coverage information, visit our drug look-up site at
https://www.medicaid.alabamaservices.org/ALPortal/NDC%20Look%20Up/tabId/39/Default.aspx.
Generic Drug Description
ABACAVIR/DOLUTEGRAVIR/LAMIVUDI ORAL 600-50-300 TABLET
ACARBOSE ORAL 100 MG TABLET
ACEBUTOLOL HCL ORAL 200 MG CAPSULE
ACEBUTOLOL HCL ORAL 400 MG CAPSULE
ACETAMINOPHEN WITH CODEINE ORAL 120-12MG/5 ORAL SUSP
ACETAMINOPHEN WITH CODEINE ORAL 120-12MG/5 SOLUTION
ACETAMINOPHEN WITH CODEINE ORAL 300MG/12.5 SOLUTION
ACETAMINOPHEN WITH CODEINE ORAL 300MG-15MG TABLET
ACITRETIN ORAL 10 MG CAPSULE
ACITRETIN ORAL 17.5 MG CAPSULE
ACITRETIN ORAL 25 MG CAPSULE
ACLIDINIUM BROMIDE INHALATION 400 MCG AER POW BA
ACYCLOVIR BUCCAL 50 MG MA BUC TAB
ACYCLOVIR TOPICAL 5 % CREAM (G)
ACYCLOVIR TOPICAL 5 % OINT. (G)
ACYCLOVIR/HYDROCORTISONE TOPICAL 5 %-1 % CREAM (G)
ADEFOVIR DIPIVOXIL ORAL 10 MG TABLET
AFATINIB DIMALEATE ORAL 20 MG TABLET
AFLIBERCEPT INTRAOCULR 2MG/0.05ML VIAL
AGALSIDASE BETA INTRAVEN 35 MG VIAL
ALBIGLUTIDE SUB-Q 30MG/0.5ML PEN INJCTR
ALBIGLUTIDE SUB-Q 50MG/0.5ML PEN INJCTR
ALBUTEROL SULFATE INHALATION 0.63MG/3ML VIAL-NEB
ALBUTEROL SULFATE INHALATION 1.25MG/3ML VIAL-NEB
ALBUTEROL SULFATE INHALATION 2.5 MG/0.5 VIAL-NEB
ALBUTEROL SULFATE INHALATION 2.5 MG/3ML VIAL-NEB
ALBUTEROL SULFATE INHALATION 5 MG/ML SOLUTION
ALBUTEROL SULFATE INHALATION 90 MCG AER POW BA
ALBUTEROL SULFATE INHALATION 90 MCG HFA AER AD
ALBUTEROL SULFATE ORAL 2 MG TABLET
ALBUTEROL SULFATE ORAL 2 MG/5 ML SYRUP
ALBUTEROL SULFATE ORAL 4 MG TAB ER 12H
ALBUTEROL SULFATE ORAL 4 MG TABLET
ALBUTEROL SULFATE ORAL 8 MG TAB ER 12H
ALCAFTADINE OPHTHALMIC 0.25 % DROPS
ALCLOMETASONE DIPROPIONATE TOPICAL 0.05 % CREAM (G)
ALCLOMETASONE DIPROPIONATE TOPICAL 0.05 % OINT. (G)
ALECTINIB HYDROCHLORIDE ORAL 150 MG CAPSULE
ALEMTUZUMAB INTRAVEN 12MG/1.2ML VIAL
ALEMTUZUMAB INTRAVEN 30 MG/ML VIAL
ALENDRONATE SODIUM ORAL 10 MG TABLET
ALENDRONATE SODIUM ORAL 70 MG TABLET EFF
ALENDRONATE SODIUM ORAL 70 MG/75ML SOLUTION
ALENDRONATE SODIUM/VITAMIN D3 ORAL 70 MG-2800 TABLET
ALENDRONATE SODIUM/VITAMIN D3 ORAL 70 MG-5600 TABLET
Max
Unit
34
102
102
102
136
68
480
480
480
68
68
68
34
34
34
1
1
30
30
5
34
34
34
34
0.05
5
4
4
612
612
180
612
180
2
36
272
1360
272
272
136
3
180
180
240
6
14
34
4
34
34
4
4
300
4
4
ALFENTANIL HCL INJECTION 500 MCG/ML AMPUL
ALIROCUMAB SUB-Q 150 MG/ML PEN INJCTR
ALIROCUMAB SUB-Q 150 MG/ML SYRINGE
ALIROCUMAB SUB-Q 75 MG/ML PEN INJCTR
ALIROCUMAB SUB-Q 75 MG/ML SYRINGE
ALISKIREN HEMIFUMARATE ORAL 150 MG TABLET
ALISKIREN HEMIFUMARATE ORAL 300 MG TABLET
ALISKIREN/HYDROCHLOROTHIAZIDE ORAL 150-12.5MG TABLET
ALISKIREN/HYDROCHLOROTHIAZIDE ORAL 150MG-25MG TABLET
ALISKIREN/HYDROCHLOROTHIAZIDE ORAL 300-12.5MG TABLET
ALISKIREN/HYDROCHLOROTHIAZIDE ORAL 300MG-25MG TABLET
ALITRETINOIN TOPICAL 0.1 % GEL (GRAM)
ALMOND OIL MISCELL OIL
ALMOTRIPTAN MALATE ORAL 12.5 MG TABLET
ALMOTRIPTAN MALATE ORAL 6.25 MG TABLET
ALOGLIPTIN BENZ/METFORMIN HCL ORAL 12.5-1000 TABLET
ALOGLIPTIN BENZ/METFORMIN HCL ORAL 12.5-500MG TABLET
ALOGLIPTIN BENZ/PIOGLITAZONE ORAL 12.5-15 MG TABLET
ALOGLIPTIN BENZ/PIOGLITAZONE ORAL 25 MG-15MG TABLET
ALOGLIPTIN BENZOATE ORAL 12.5 MG TABLET
ALOGLIPTIN BENZOATE ORAL 25 MG TABLET
ALOGLIPTIN BENZOATE ORAL 6.25 MG TABLET
ALPRAZOLAM ORAL 0.25 MG TAB RAPDIS
ALPRAZOLAM ORAL 0.25 MG TABLET
ALPRAZOLAM ORAL 0.5 MG TAB ER 24H
ALPRAZOLAM ORAL 0.5 MG TAB RAPDIS
ALPRAZOLAM ORAL 0.5 MG TABLET
ALPRAZOLAM ORAL 1 MG TAB ER 24H
ALPRAZOLAM ORAL 1 MG TAB RAPDIS
ALPRAZOLAM ORAL 1 MG TABLET
ALPRAZOLAM ORAL 1 MG/ML ORAL CONC
ALPRAZOLAM ORAL 2 MG TAB RAPDIS
ALPRAZOLAM ORAL 2 MG TABLET
ALTEPLASE INTRAVEN 100 MG VIAL
ALTEPLASE INTRAVEN 50 MG VIAL
ALUMINUM CHLORIDE TOPICAL 6.25% SOLUTION
AMBRISENTAN ORAL 10 MG TABLET
AMBRISENTAN ORAL 5 MG TABLET
AMCINONIDE TOPICAL 0.1 % CREAM (G)
AMCINONIDE TOPICAL 0.1 % LOTION
AMCINONIDE TOPICAL 0.1 % OINT. (G)
AMIKACIN SULFATE INJECTION 1000MG/4ML VIAL
AMIKACIN SULFATE INJECTION 500 MG/2ML VIAL
AMILORIDE HCL ORAL 5 MG TABLET
AMILORIDE/HYDROCHLOROTHIAZIDE ORAL 5 MG-50 MG TABLET
AMINOLEVULINIC ACID HCL TOPICAL 20 % SOL W/APPL
AMINOPHYLLINE INTRAVEN 250MG/10ML VIAL
AMINOPHYLLINE INTRAVEN 500MG/20ML VIAL
AMIODARONE HCL INTRAVEN 150 MG/3ML SYRINGE
1
Max
Unit
20
2
2
2
2
34
34
34
34
34
34
180
240
10
10
68
68
34
34
34
34
34
34
34
34
34
136
136
34
136
136
34
136
136
120
68
102
102
68
1
2
180
34
34
180
180
180
48
48
136
136
1
40
40
60
Effective 7/1/2016
AMIODARONE HCL INTRAVEN 50 MG/ML AMPUL
AMIODARONE HCL INTRAVEN 50 MG/ML VIAL
AMIODARONE HCL ORAL 100 MG TABLET
AMITRIP HCL/CHLORDIAZEPOXIDE ORAL 12.5MG-5MG TABLET
AMITRIP HCL/CHLORDIAZEPOXIDE ORAL 25 MG-10MG TABLET
AMITRIPTYLINE HCL ORAL 10 MG TABLET
AMLODIPINE BES/OLMESARTAN MED ORAL 10 MG-20MG TABLET
AMLODIPINE BES/OLMESARTAN MED ORAL 10 MG-40MG TABLET
AMLODIPINE BES/OLMESARTAN MED ORAL 5 MG-20 MG TABLET
AMLODIPINE BES/OLMESARTAN MED ORAL 5 MG-40 MG TABLET
AMLODIPINE BESYLATE ORAL 10 MG TABLET
AMLODIPINE BESYLATE ORAL 2.5 MG TABLET
AMLODIPINE BESYLATE ORAL 5 MG TABLET
AMLODIPINE BESYLATE/BENAZEPRIL ORAL 10 MG-20MG CAPSULE
AMLODIPINE BESYLATE/BENAZEPRIL ORAL 10 MG-40MG CAPSULE
AMLODIPINE BESYLATE/BENAZEPRIL ORAL 2.5MG-10MG CAPSULE
AMLODIPINE BESYLATE/BENAZEPRIL ORAL 5 MG-10 MG CAPSULE
AMLODIPINE/ATORVASTATIN ORAL 10 MG-10MG TABLET
AMLODIPINE/ATORVASTATIN ORAL 2.5MG-10MG TABLET
AMLODIPINE/ATORVASTATIN ORAL 5 MG-10 MG TABLET
AMLODIPINE/VALSARTAN ORAL 10MG-160MG TABLET
AMLODIPINE/VALSARTAN ORAL 5 MG-160MG TABLET
AMLODIPINE/VALSARTAN/HCTHIAZID ORAL 10-160-25 TABLET
AMLODIPINE/VALSARTAN/HCTHIAZID ORAL 10-320-25 TABLET
AMLODIPINE/VALSARTAN/HCTHIAZID ORAL 10MG-160MG TABLET
AMLODIPINE/VALSARTAN/HCTHIAZID ORAL 5-160-12.5 TABLET
AMLODIPINE/VALSARTAN/HCTHIAZID ORAL 5-160-25MG TABLET
AMMONIUM LACTATE TOPICAL 12 % CREAM (G)
AMMONIUM LACTATE TOPICAL 12 % LOTION
AMOBARBITAL SODIUM INJECTION 500 MG VIAL
AMOXAPINE ORAL 100 MG TABLET
AMPHETAMINE SULFATE ORAL 10 MG TABLET
AMPHETAMINE SULFATE ORAL 5 MG TABLET
ANAGRELIDE HCL ORAL 0.5 MG CAPSULE
ANAGRELIDE HCL ORAL 1 MG CAPSULE
APIXABAN ORAL 2.5 MG TABLET
APREMILAST ORAL 10-20-30MG TAB DS PK
APREMILAST ORAL 30 MG TABLET
APREPITANT ORAL 125 MG CAPSULE
APREPITANT ORAL 125MG-80MG CAP DS PK
Max
Unit
40
40
544
272
136
136
136
102
102
68
102
102
102
68
34
68
34
68
272
136
68
34
68
68
68
68
34
34
34
34
68
68
68
68
68
68
34
68
34
68
34
34
34
34
34
34
385
500
10
102
102
102
102
68
68
136
68
68
55
68
1
3
2
2
ARFORMOTEROL TARTRATE INHALATION 15MCG/2ML VIAL-NEB
ARIPIPRAZOLE INTRAMUSC 9.75MG/1.3 VIAL
ARIPIPRAZOLE INTRAMUSC 300 MG SUSER SYR
ARIPIPRAZOLE INTRAMUSC 300 MG SUSER VIAL
ARIPIPRAZOLE INTRAMUSC 400 MG SUSER SYR
ARIPIPRAZOLE INTRAMUSC 400 MG SUSER VIAL
ARIPIPRAZOLE LAUROXIL INTRAMUSC 441 MG/1.6 SUSER SYR
ARIPIPRAZOLE ORAL 1 MG/ML SOLUTION
ARIPIPRAZOLE ORAL 10 MG TAB RAPDIS
ARIPIPRAZOLE ORAL 10 MG TABLET
ARIPIPRAZOLE ORAL 15 MG TAB RAPDIS
ARMODAFINIL ORAL 150 MG TABLET
ARTEMETHER/LUMEFANTRINE ORAL 20MG-120MG TABLET
ASENAPINE MALEATE SUBLINGUAL 10 MG TAB SUBL
ASENAPINE MALEATE SUBLINGUAL 2.5 MG TAB SUBL
ASENAPINE MALEATE SUBLINGUAL 5 MG TAB SUBL
ASPIRIN ORAL 162.5 MG CAP ER 24H
ASPIRIN/DIPYRIDAMOLE ORAL 25MG-200MG CPMP 12HR
ATAZANAVIR SULFATE/COBICISTAT ORAL 300-150 MG TABLET
ATENOLOL ORAL 100 MG TABLET
ATENOLOL/CHLORTHALIDONE ORAL 100MG-25MG TABLET
ATENOLOL/CHLORTHALIDONE ORAL 50 MG-25MG TABLET
ATOMOXETINE HCL ORAL 10 MG CAPSULE
ATORVASTATIN CALCIUM ORAL 10 MG TABLET
ATOVAQUONE ORAL 750 MG/5ML ORAL SUSP
ATRACURIUM BESYLATE INTRAVEN 10 MG/ML VIAL
AXITINIB ORAL 1 MG TABLET
AXITINIB ORAL 5 MG TABLET
AZELASTINE HCL NASAL 137 MCG SPRAY/PUMP
AZELASTINE HCL NASAL 205.5MCG SPRAY/PUMP
AZELASTINE HCL OPHTHALMIC 0.05 % DROPS
AZELASTINE/FLUTICASONE NASAL 137-50 MCG SPRAY/PUMP
AZILSARTAN MED/CHLORTHALIDONE ORAL 40 MG-25MG TABLET
AZILSARTAN MED/CHLORTHALIDONE ORAL 40-12.5 MG TABLET
AZILSARTAN MEDOXOMIL ORAL 40 MG TABLET
AZILSARTAN MEDOXOMIL ORAL 80 MG TABLET
AZITHROMYCIN INTRAVEN 500 MG VIAL
AZITHROMYCIN OPHTHALMIC 1 % DROPS
AZITHROMYCIN ORAL 1 G PACKET
AZITHROMYCIN ORAL 100 MG/5ML SUSP RECON
AZITHROMYCIN ORAL 2 G/60 ML SUS ER REC
AZITHROMYCIN ORAL 200 MG/5ML SUSP RECON
AZITHROMYCIN ORAL 250 MG TABLET
2
Max
Unit
120
39
1
1
1
1
1.6
2.4
3.2
340
34
34
34
34
34
34
34
34
34
34
34
68
24
68
68
68
34
68
34
68
272
136
34
68
68
34
68
68
68
68
34
68
68
68
34
420
10
136
68
60
60
6
23
34
34
34
34
10
5
2
45
1
60
12
Effective 7/1/2016
AZTREONAM LYSINE INHALATION 75 MG/ML VIAL-NEB
BACITRACIN OPHTHALMIC 500 UNIT/G OINT. (G)
BACITRACIN/POLYMYXIN B SULFATE OPHTHALMIC 500-10K/G OINT. (G)
BACLOFEN INTRATHEC 10000/20ML VIAL
BACLOFEN INTRATHEC 2000MCG/ML AMPUL
BACLOFEN INTRATHEC 40000/20ML VIAL
BACLOFEN INTRATHEC 50 MCG/ML AMPUL
BACLOFEN INTRATHEC 10000/20ML SYRINGE
BACLOFEN INTRATHEC 20K MCG/20 SYRINGE
BACLOFEN INTRATHEC 40000/20ML SYRINGE
BACLOFEN INTRATHEC 50 MCG/ML SYRINGE
BACLOFEN INTRATHEC 500 MCG/ML AMPUL
BACLOFEN ORAL 10 MG TABLET
BACLOFEN ORAL 20 MG TABLET
BALSALAZIDE DISODIUM ORAL 1.1 G TABLET
BASILIXIMAB INTRAVEN 10 MG VIAL
BASILIXIMAB INTRAVEN 20 MG VIAL
BECAPLERMIN TOPICAL 0.01 % GEL (GRAM)
BECLOMETHASONE DIPROPIONATE INHALATION 40 MCG AER W/ADAP
BECLOMETHASONE DIPROPIONATE INHALATION 80 MCG AER W/ADAP
BECLOMETHASONE DIPROPIONATE NASAL 42 MCG SPRAY
BECLOMETHASONE DIPROPIONATE NASAL 80 MCG HFA AER AD
BEDAQUILINE FUMARATE ORAL 100 MG TABLET
BELATACEPT INTRAVEN 250 MG VIAL
BELIMUMAB INTRAVEN 120 MG VIAL
BELIMUMAB INTRAVEN 400 MG VIAL
BENAZEPRIL HCL ORAL 10 MG TABLET
BENAZEPRIL/HYDROCHLOROTHIAZIDE ORAL 10-12.5MG TABLET
BENAZEPRIL/HYDROCHLOROTHIAZIDE ORAL 20 MG-25MG TABLET
BENAZEPRIL/HYDROCHLOROTHIAZIDE ORAL 20-12.5 MG TABLET
BENAZEPRIL/HYDROCHLOROTHIAZIDE ORAL 5-6.25MG TABLET
BENZYL ALCOHOL TOPICAL 5 % LOTION
BEPOTASTINE BESILATE OPHTHALMIC 1.5 % DROPS
BESIFLOXACIN HCL OPHTHALMIC 0.6 % DROPS SUSP
BETAMETHASONE DIPROPIONATE TOPICAL 0.05 % CREAM (G)
BETAMETHASONE DIPROPIONATE TOPICAL 0.05 % GEL (GRAM)
BETAMETHASONE DIPROPIONATE TOPICAL 0.05 % LOTION
BETAMETHASONE DIPROPIONATE TOPICAL 0.05 % OINT. (G)
BETAMETHASONE DIPROPIONATE TOPICAL 0.05 % SPRAY/PUMP
BETAMETHASONE VALERATE TOPICAL 0.1 % CREAM (G)
BETAMETHASONE VALERATE TOPICAL 0.1 % LOTION
BETAMETHASONE VALERATE TOPICAL 0.1 % OINT. (G)
BETAMETHASONE VALERATE TOPICAL 0.12 % FOAM
BETAMETHASONE/PROPYLENE GLYC TOPICAL 0.05 % CREAM (G)
BETAMETHASONE/PROPYLENE GLYC TOPICAL 0.05 % LOTION
BETAMETHASONE/PROPYLENE GLYC TOPICAL 0.05 % OINT. (G)
BETAXOLOL HCL ORAL 10 MG TABLET
BETAXOLOL HCL ORAL 20 MG TABLET
BEXAROTENE TOPICAL 1 % GEL (GRAM)
BIMATOPROST OPHTHALMIC 0.01 % DROPS
BIMATOPROST OPHTHALMIC 0.03 % DROPS
BISMUTH/METRONID/TETRACYCLINE ORAL 125-125 MG CAPSULE
BISOPROLOL FUMARATE ORAL 10 MG TABLET
BISOPROLOL FUMARATE ORAL 5 MG TABLET
BISOPROLOL FUMARATE/HCTZ ORAL 10-6.25MG TABLET
BISOPROLOL FUMARATE/HCTZ ORAL 2.5-6.25MG TABLET
BISOPROLOL FUMARATE/HCTZ ORAL 5-6.25MG TABLET
BIVALIRUDIN INTRAVEN 250 MG VIAL
BORTEZOMIB INJECTION 3.5 MG VIAL
Max
Unit
10
34
84
3.5
3.5
80
80
80
2
80
80
80
2
80
136
136
180
4
2
120
17.4
17.4
50
8.7
68
24
1
1
136
68
34
272
136
68
68
170
227
10
5
180
180
180
180
120
180
180
180
200
180
180
180
68
34
180
2.5
2.5
120
34
68
34
136
68
1
5
BOSENTAN ORAL 125 MG TABLET
BOSENTAN ORAL 62.5 MG TABLET
BOSUTINIB ORAL 100 MG TABLET
BOSUTINIB ORAL 500 MG TABLET
BREXPIPRAZOLE ORAL 0.25 MG TABLET
BREXPIPRAZOLE ORAL 0.5 MG TABLET
BREXPIPRAZOLE ORAL 1 MG TABLET
BROMFENAC SODIUM OPHTHALMIC 0.07 % DROPS
BROMFENAC SODIUM OPHTHALMIC 0.09% DROPS
BROMPHENIRAMINE MALEATE ORAL 1 MG/ML DROPS
BUDESONIDE INHALATION 0.25MG/2ML AMPUL-NEB
BUDESONIDE INHALATION 0.5 MG/2ML AMPUL-NEB
BUDESONIDE INHALATION 1 MG/2 ML AMPUL-NEB
BUDESONIDE INHALATION 180 MCG AER POW BA
BUDESONIDE INHALATION 90 MCG AER POW BA
BUDESONIDE NASAL 32MCG SPRAY/PUMP
BUDESONIDE/FORMOTEROL FUMARATE INHALATION 160-4.5MCG HFA AER
AD
BUDESONIDE/FORMOTEROL FUMARATE INHALATION 80-4.5 MCG HFA AER
AD
BUMETANIDE INJECTION 0.25 MG/ML VIAL
BUMETANIDE ORAL 0.5 MG TABLET
BUMETANIDE ORAL 1 MG TABLET
BUMETANIDE ORAL 2 MG TABLET
BUPRENORPHINE HCL BUCCAL 150 MCG FILM
BUPRENORPHINE HCL INJECTION 0.3 MG/ML AMPUL
BUPRENORPHINE HCL INJECTION 0.3 MG/ML SYRINGE
BUPRENORPHINE HCL INJECTION 0.3 MG/ML VIAL
BUPRENORPHINE HCL SUBLINGUAL 2 MG TAB SUBL
BUPRENORPHINE HCL SUBLINGUAL 8 MG TAB SUBL
BUPRENORPHINE HCL/NALOXONE HCL BUCCAL 2.1-0.3 MG FILM
BUPRENORPHINE HCL/NALOXONE HCL BUCCAL 4.2-0.7 MG FILM
BUPRENORPHINE HCL/NALOXONE HCL BUCCAL 6.3MG-1MG FILM
BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 1.4-0.36MG TAB SUBL
BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 12 MG-3 MG FILM
BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 2 MG-0.5MG FILM
BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 2 MG-0.5MG TAB SUBL
BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 4MG-1MG FILM
BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 5.7-1.4 MG TAB SUBL
BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 8 MG-2 MG FILM
BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 8 MG-2 MG TAB SUBL
BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 8.6-2.1 MG TAB SUBL
BUPRENORPHINE TRANSDERM 10 MCG/HR PATCH TDWK
BUPRENORPHINE TRANSDERM 7.5 MCG/HR PATCH TDWK
BUPROPION HBR ORAL 174MG TAB ER 24H
BUPROPION HCL ORAL 100 MG TABLET
BUPROPION HCL ORAL 100 MG TABLET ER
BUPROPION HCL ORAL 150 MG TAB ER 24H
3
Max
Unit
68
68
68
34
34
34
34
34
34
34
3.2
5
30
136
136
136
2
2
17.2
12
13.8
40
680
340
170
68
68
68
68
68
68
68
40
40
40
68
68
34
68
34
68
68
68
68
68
68
68
68
68
68
68
5
5
5
5
5
34
34
34
102
68
34
Effective 7/1/2016
BUPROPION HCL ORAL 75 MG TABLET
BUSPIRONE HCL ORAL 10 MG TABLET
BUSPIRONE HCL ORAL 7.5 MG TABLET
BUTABARBITAL SODIUM ORAL 30 MG TABLET
BUTALB/ACETAMINOPHEN/CAFFEINE ORAL 50-300-40 CAPSULE
BUTALB/ACETAMINOPHEN/CAFFEINE ORAL 50-325/15 SOLUTION
BUTALB/ACETAMINOPHEN/CAFFEINE ORAL 50-325-40 CAPSULE
BUTALB/ACETAMINOPHEN/CAFFEINE ORAL 50-325-40 TABLET
BUTALBIT/ACETAMIN/CAFF/CODEINE ORAL 50-300-30 CAPSULE
BUTALBIT/ACETAMIN/CAFF/CODEINE ORAL 50-325-30 CAPSULE
BUTALBITAL/ACETAMINOPHEN ORAL 50MG-300MG TABLET
BUTALBITAL/ACETAMINOPHEN ORAL 50MG-325MG TABLET
BUTALBITAL/ASPIRIN/CAFFEINE ORAL 50-325-40 CAPSULE
BUTENAFINE HCL TOPICAL 1 % CREAM (G)
BUTORPHANOL TARTRATE INJECTION 1 MG/ML VIAL
BUTORPHANOL TARTRATE INJECTION 2 MG/ML VIAL
BUTORPHANOL TARTRATE NASAL 10 MG/ML SPRAY
CABOZANTINIB S-MALATE ORAL 100 MG/DAY CAPSULE
CABOZANTINIB S-MALATE ORAL 20 MG TABLET
CAFFEINE CITRATED INTRAVEN 60 MG/3 ML VIAL
CAFFEINE CITRATED ORAL 60 MG/3 ML SOLUTION
CALCIPOTRIENE TOPICAL 0.005 % CREAM (G)
CALCIPOTRIENE TOPICAL 0.005 % FOAM
CALCIPOTRIENE TOPICAL 0.005 % OINT. (G)
CALCIPOTRIENE TOPICAL 0.005 % SOLUTION
CALCIPOTRIENE/BETAMETHASONE TOPICAL 0.005-.064 FOAM
CALCIPOTRIENE/BETAMETHASONE TOPICAL 0.005-.064 OINT. (G)
CALCIPOTRIENE/BETAMETHASONE TOPICAL 0.005-.064 SUSPENSION
CALCITONIN,SALMON,SYNTHETIC INJECTION 200/ML VIAL
CALCITONIN,SALMON,SYNTHETIC NASAL 200/SPRAY SPRAY/PUMP
CALCITRIOL TOPICAL 3 MCG/G OINT. (G)
CANAGLIFLOZIN ORAL 100 MG TABLET
CANAGLIFLOZIN ORAL 300 MG TABLET
CANAGLIFLOZIN/METFORMIN HCL ORAL 150-1000MG TABLET
CANAGLIFLOZIN/METFORMIN HCL ORAL 150-500 MG TABLET
CANAGLIFLOZIN/METFORMIN HCL ORAL 50-1000 MG TABLET
CANAGLIFLOZIN/METFORMIN HCL ORAL 50MG-500MG TABLET
CANAKINUMAB/PF SUB-Q 180 MG/1.2 VIAL
CANDESARTAN CILEXETIL ORAL 16 MG TABLET
CANDESARTAN/HYDROCHLOROTHIAZID ORAL 16-12.5MG TABLET
CANDESARTAN/HYDROCHLOROTHIAZID ORAL 32-12.5MG TABLET
CANDESARTAN/HYDROCHLOROTHIAZID ORAL 32MG-25MG TABLET
CAPSAICIN/SKIN CLEANSER TOPICAL 8 % KIT
CAPTOPRIL ORAL 100 MG TABLET
CAPTOPRIL ORAL 12.5 MG TABLET
CAPTOPRIL/HYDROCHLOROTHIAZIDE ORAL 25 MG-25MG TABLET
Max
Unit
68
68
34
34
102
102
102
68
102
102
102
68
240
68
68
68
68
68
68
68
180
40
40
5
56
112
34
34
34
84
36
36
180
120
180
180
180
180
180
30
4
200
68
34
68
68
68
68
1
68
34
272
136
68
34
34
4
102
816
408
204
204
204
204
CARBINOXAMINE MALEATE ORAL 4 MG TABLET
CARBINOXAMINE MALEATE ORAL 4 MG/5 ML LIQUID
CARBINOXAMINE MALEATE ORAL 4 MG/5 ML SUS ER 12H
CARIPRAZINE HYDROCHLORIDE ORAL 1.5 MG CAPSULE
CARIPRAZINE HYDROCHLORIDE ORAL 1.5 MG-3MG CAP DS PK
CARIPRAZINE HYDROCHLORIDE ORAL 3 MG CAPSULE
CARIPRAZINE HYDROCHLORIDE ORAL 4.5 MG CAPSULE
CARIPRAZINE HYDROCHLORIDE ORAL 6 MG CAPSULE
CARISOPRODOL ORAL 250 MG TABLET
CARISOPRODOL ORAL 350 MG TABLET
CARISOPRODOL/ASPIRIN ORAL 200-325 MG TABLET
CARVEDILOL ORAL 12.5 MG TABLET
CARVEDILOL ORAL 25 MG TABLET
CARVEDILOL PHOSPHATE ORAL 10 MG CPMP 24HR
CEFDINIR ORAL 125 MG/5ML SUSP RECON
CEFDINIR ORAL 250 MG/5ML SUSP RECON
CEFDINIR ORAL 300 MG CAPSULE
CEFEPIME HCL INJECTION 1 G VIAL
CEFEPIME HCL INJECTION 2 G VIAL
CEFEPIME HCL INTRAVEN 1 G VIAL PORT
CEFEPIME HCL INTRAVEN 2 G VIAL PORT
CEFTAROLINE FOSAMIL ACETATE INTRAVEN 400 MG VIAL
CEFTAROLINE FOSAMIL ACETATE INTRAVEN 600 MG VIAL
CELECOXIB ORAL 100 MG CAPSULE
CENTRUROIDES(SCORPN) ANTIVENOM INTRAVEN 120 MG VIAL
CETIRIZINE HCL ORAL 1 MG/ML SOLUTION
CETIRIZINE HCL ORAL 10 MG TAB CHEW
CETIRIZINE HCL ORAL 10 MG TABLET
CETIRIZINE HCL ORAL 5 MG TAB CHEW
CETIRIZINE HCL ORAL 5 MG TABLET
CHLORDIAZEPOXIDE HCL ORAL 10 MG CAPSULE
CHLOROTHIAZIDE ORAL 250 MG TABLET
CHLOROTHIAZIDE ORAL 250 MG/5ML ORAL SUSP
CHLOROTHIAZIDE ORAL 500 MG TABLET
CHLOROTHIAZIDE SODIUM INTRAVEN 500 MG VIAL
CHLORPHENIRAMINE/PHENYLEPHRINE ORAL 1MG-2MG/ML DROPS
CHLORPROMAZINE HCL INJECTION 25 MG/ML AMPUL
CHLORPROMAZINE HCL ORAL 10 MG TABLET
CHLORPROPAMIDE ORAL 100 MG TABLET
CHLORPROPAMIDE ORAL 250 MG TABLET
CHLORTHALIDONE ORAL 25 MG TABLET
CHLORTHALIDONE ORAL 50 MG TABLET
CHLORZOXAZONE ORAL 375 MG TABLET
CHOLESTYRAMINE (WITH SUGAR) ORAL 4 G POWD PACK
CHOLESTYRAMINE (WITH SUGAR) ORAL 4 G POWDER
CHOLESTYRAMINE/ASPARTAME ORAL 4 G POWD PACK
CHOLIC ACID ORAL 250 MG CAPSULE
4
Max
Unit
204
136
680
680
34
7
34
34
34
40
40
40
136
68
544
272
34
34
34
34
500
300
40
80
40
80
40
68
68
68
68
68
68
1
360
34
34
34
34
136
136
136
272
1000
136
1
30
24
102
102
102
102
102
170
68
136
68
40
40
40
204
378
204
136
Effective 7/1/2016
CHOLIC ACID ORAL 50 MG CAPSULE
CICLESONIDE INHALATION 160 MCG HFA AER AD
CICLESONIDE INHALATION 80 MCG HFA AER AD
CICLESONIDE NASAL 37 MCG HFA AER AD
CICLESONIDE NASAL 50 MCG SPRAY/PUMP
CICLOPIROX OLAMINE TOPICAL 0.77 % CREAM (G)
CICLOPIROX OLAMINE TOPICAL 0.77 % SUSPENSION
CICLOPIROX TOPICAL 0.77 % GEL (GRAM)
CICLOPIROX TOPICAL 1 % SHAMPOO
CICLOPIROX TOPICAL 8 % SOLUTION
CIDOFOVIR INTRAVEN 75 MG/ML VIAL
CILOSTAZOL ORAL 100 MG TABLET
CILOSTAZOL ORAL 50 MG TABLET
CIMETIDINE HCL ORAL 300 MG/5ML SOLUTION
CIMETIDINE ORAL 300 MG TABLET
CIPROFLOXACIN HCL OPHTHALMIC 0.3 % DROPS
CIPROFLOXACIN HCL OPHTHALMIC 0.3 % OINT. (G)
CIPROFLOXACIN HCL ORAL 100 MG TABLET
CIPROFLOXACIN HCL OTIC 0.2 % DROPERETTE
CIPROFLOXACIN HCL/DEXAMETH OTIC 0.3 %-0.1% DROPS SUSP
CIPROFLOXACIN LACTATE INTRAVEN 200MG/20ML VIAL
CIPROFLOXACIN LACTATE INTRAVEN 400MG/40ML VIAL
CIPROFLOXACIN LACTATE/D5W INTRAVEN 200MG/0.1L PIGGYBACK
CIPROFLOXACIN LACTATE/D5W INTRAVEN 400MG/0.2L PIGGYBACK
CIPROFLOXACIN ORAL 250 MG/5ML SUS MC REC
CIPROFLOXACIN ORAL 500 MG/5ML SUS MC REC
CIPROFLOXACIN OTIC 6 % VIAL
CIPROFLOXACIN/CIPROFLOXA HCL ORAL 1000 MG TBMP 24HR
CIPROFLOXACIN/CIPROFLOXA HCL ORAL 500 MG TBMP 24HR
CIPROFLOXACIN/HYDROCORTISONE OTIC 0.2 %-1 % DROPS SUSP
CISATRACURIUM BESYLATE INTRAVEN 10 MG/ML VIAL
CISATRACURIUM BESYLATE INTRAVEN 2 MG/ML VIAL
CITALOPRAM HYDROBROMIDE ORAL 10 MG TABLET
CITALOPRAM HYDROBROMIDE ORAL 10 MG/5 ML SOLUTION
CLARITHROMYCIN ORAL 125 MG/5ML SUSP RECON
CLARITHROMYCIN ORAL 250 MG TABLET
CLARITHROMYCIN ORAL 250 MG/5ML SUSP RECON
CLARITHROMYCIN ORAL 500 MG TAB ER 24H
CLARITHROMYCIN ORAL 500 MG TABLET
CLEMASTINE FUMARATE ORAL 0.67MG/5ML SYRUP
CLEMASTINE FUMARATE ORAL 2.68 MG TABLET
CLEVIDIPINE BUTYRATE INTRAVEN 25 MG/50ML VIAL
CLEVIDIPINE BUTYRATE INTRAVEN 50MG/100ML VIAL
CLINDAMYCIN PHOSPHATE VAGINAL 100 MG SUPP.VAG
CLINDAMYCIN PHOSPHATE VAGINAL 2 % CREAM/APPL
CLINDAMYCIN PHOSPHATE VAGINAL 2 % CRM ER (G)
CLOBETASOL PROPIONATE TOPICAL 0.05 % CREAM (G)
CLOBETASOL PROPIONATE TOPICAL 0.05 % FOAM
CLOBETASOL PROPIONATE TOPICAL 0.05 % GEL (GRAM)
CLOBETASOL PROPIONATE TOPICAL 0.05 % LOTION
CLOBETASOL PROPIONATE TOPICAL 0.05 % OINT. (G)
CLOBETASOL PROPIONATE TOPICAL 0.05 % SHAMPOO
CLOBETASOL PROPIONATE TOPICAL 0.05 % SOLUTION
CLOBETASOL PROPIONATE TOPICAL 0.05 % SPRAY
CLOBETASOL PROPIONATE/EMOLL TOPICAL 0.05 % CREAM (G)
CLOBETASOL PROPIONATE/EMOLL TOPICAL 0.05 % FOAM
CLOCORTOLONE PIVALATE TOPICAL 0.1 % CREAM (G)
Max
Unit
136
12.2
12.2
6.1
12.5
180
180
180
120
6.6
40
68
68
240
136
136
68
10
3.5
340
136
68
68
14
7.5
1120
4080
5600
20400
700
400
1
28
56
10
20
10
34
680
34
34
400
28
400
28
28
2040
102
34000
34000
3
40
40
180
200
90
180
180
118
100
236
180
200
180
CLOMIPRAMINE HCL ORAL 25 MG CAPSULE
CLONAZEPAM ORAL 0.125 MG TAB RAPDIS
CLONAZEPAM ORAL 0.5 MG TABLET
CLONAZEPAM ORAL 1 MG TAB RAPDIS
CLONAZEPAM ORAL 1 MG TABLET
CLONAZEPAM ORAL 2 MG TAB RAPDIS
CLONAZEPAM ORAL 2 MG TABLET
CLONIDINE HCL ORAL 0.1 MG TAB ER 12H
CLONIDINE HCL ORAL 0.1 MG TABLET
CLONIDINE TRANSDERM 0.1MG/24HR PATCH TDWK
CLOPIDOGREL BISULFATE ORAL 300 MG TABLET
CLOPIDOGREL BISULFATE ORAL 75 MG TABLET
CLORAZEPATE DIPOTASSIUM ORAL 15 MG TABLET
CLORAZEPATE DIPOTASSIUM ORAL 3.75 MG TABLET
CLORAZEPATE DIPOTASSIUM ORAL 7.5 MG TABLET
CLOTRIMAZOLE MUCOUS MEM 10 MG TROCHE
CLOTRIMAZOLE TOPICAL 1 % CREAM (G)
CLOTRIMAZOLE TOPICAL 1 % SOLUTION
CLOTRIMAZOLE/BETAMETHASONE DIP TOPICAL 1 %-0.05 % CREAM (G)
CLOTRIMAZOLE/BETAMETHASONE DIP TOPICAL 1 %-0.05 % LOTION
CLOZAPINE ORAL 100 MG TAB RAPDIS
CLOZAPINE ORAL 100 MG TABLET
CLOZAPINE ORAL 12.5 MG TAB RAPDIS
COBICISTAT ORAL 150 MG TABLET
CODEINE SULFATE ORAL 15 MG TABLET
CODEINE/BUTALBITAL/ASA/CAFFEIN ORAL 30-50-325 CAPSULE
CODEINE/CARISOPRODOL/ASPIRIN ORAL 16-200-325 TABLET
COLCHICINE ORAL 0.6 MG CAPSULE
COLESEVELAM HCL ORAL 3.75 G POWD PACK
COLESEVELAM HCL ORAL 625 MG TABLET
COLESTIPOL HCL ORAL 1 G TABLET
COLESTIPOL HCL ORAL 5 G GRANULES
COLESTIPOL HCL ORAL 5 G PACKET
COLESTIPOL HCL ORAL 7.5 G PACKET
COLISTIN (COLISTIMETHATE NA) INJECTION 150 MG VIAL
COLLAGENASE CLOSTRIDIUM HIST. INJECTION 0.9 MG VIAL
COLLAGENASE CLOSTRIDIUM HIST. TOPICAL 250 UNIT/G OINT. (G)
COMPOUND VEH.SUSP SUGAR-FREE#1 ORAL ORAL SUSP
COMPOUNDING VEHICLE NO.8 ORAL LIQUID
COMPOUNDING VEHICLE SF NO.9 ORAL LIQUID
CRIZOTINIB ORAL 200 MG CAPSULE
CRIZOTINIB ORAL 250 MG CAPSULE
CROFELEMER ORAL 125 MG TABLET DR
CROMOLYN SODIUM INHALATION 20 MG/2 ML AMPUL-NEB
CROMOLYN SODIUM OPHTHALMIC 4 % DROPS
CROTAMITON TOPICAL 10 % CREAM (G)
CROTAMITON TOPICAL 10 % LOTION
CYANOCOBALAMIN (VITAMIN B-12) NASAL 500MCG/SPR SPRAY
5
Max
Unit
102
170
102
340
340
340
340
340
340
340
340
68
816
408
204
4
8
8
1
34
136
136
136
170
180
180
180
180
306
306
204
204
136
136
204
204
204
34
68
68
68
68
40
68
34
238
544
500
204
136
17
1
180
1892
1892
1892
68
68
68
272
40
180
180
4
Effective 7/1/2016
CYCLOBENZAPRINE HCL ORAL 10 MG TABLET
CYCLOBENZAPRINE HCL ORAL 15 MG CAP ER 24H
CYCLOBENZAPRINE HCL ORAL 30 MG CAP ER 24H
CYCLOBENZAPRINE HCL ORAL 5 MG TABLET
CYCLOBENZAPRINE HCL ORAL 7.5 MG TABLET
CYCLOSPORINE OPHTHALMIC 0.05 % DROPERETTE
CYSTEAMINE HCL OPHTHALMIC 0.44 % DROPS
DABIGATRAN ETEXILATE MESYLATE ORAL 150 MG CAPSULE
DABRAFENIB MESYLATE ORAL 50 MG CAPSULE
DABRAFENIB MESYLATE ORAL 75 MG CAPSULE
DACLATASVIR DIHYDROCHLORIDE
DACLATASVIR DIHYDROCHLORIDE ORAL 30 MG TABLET
DACLATASVIR DIHYDROCHLORIDE ORAL 60 MG TABLET
DALFAMPRIDINE ORAL 10 MG TAB ER 12H
DANTROLENE SODIUM INTRAVEN 20 MG VIAL
DANTROLENE SODIUM ORAL 100 MG CAPSULE
DAPAGLIFLOZIN PROPANEDIOL ORAL 10 MG TABLET
DAPAGLIFLOZIN PROPANEDIOL ORAL 5 MG TABLET
DAPAGLIFLOZIN/METFORMIN HCL ORAL 10-1000 MG TAB BP 24H
DAPAGLIFLOZIN/METFORMIN HCL ORAL 10MG-500MG TAB BP 24H
DAPAGLIFLOZIN/METFORMIN HCL ORAL 5 MG-500MG TAB BP 24H
DAPAGLIFLOZIN/METFORMIN HCL ORAL 5MG-1000MG TAB BP 24H
DAPTOMYCIN INTRAVEN 500 MG VIAL
DARBEPOETIN ALFA IN POLYSORBAT INJECTION 100 MCG/ML VIAL
DARBEPOETIN ALFA IN POLYSORBAT INJECTION 60MCG/ML VIAL
DARBEPOETIN ALFA IN POLYSORBAT INJECTION 100MCG/0.5 SYRINGE
DARBEPOETIN ALFA IN POLYSORBAT INJECTION 40 MCG/0.4 SYRINGE
DARBEPOETIN ALFA IN POLYSORBAT INJECTION 500 MCG/ML SYRINGE
DARIFENACIN HYDROBROMIDE ORAL 15 MG TAB ER 24H
DARIFENACIN HYDROBROMIDE ORAL 7.5 MG TAB ER 24H
DARUNAVIR/COBICISTAT ORAL 800-150 MG TABLET
DEMECLOCYCLINE HCL ORAL 150 MG TABLET
DEMECLOCYCLINE HCL ORAL 300 MG TABLET
DENOSUMAB SUB-Q 120 MG/1.7 VIAL
DENOSUMAB SUB-Q 60 MG/ML SYRINGE
DESIPRAMINE HCL ORAL 10 MG TABLET
DESIRUDIN SUB-Q 15 MG VIAL
DESLORATADINE ORAL 2.5 MG TAB RAPDIS
DESLORATADINE ORAL 2.5 MG/5ML SYRUP
DESLORATADINE ORAL 5 MG TAB RAPDIS
DESLORATADINE ORAL 5 MG TABLET
DESLORATADINE/PSEUDOEPHEDRINE ORAL 2.5-120 MG TBMP 12HR
DESOG-E.ESTRADIOL/E.ESTRADIOL ORAL 21-5 TABLET
DESOGESTREL-ETHINYL ESTRADIOL ORAL 0.15-0.03 TABLET
DESOGESTREL-ETHINYL ESTRADIOL ORAL 7 DAYS X 3 TABLET
DESONIDE TOPICAL 0.05 % CREAM (G)
Max
Unit
30
10
10
30
30
60
60
68
68
68
136
136
34
34
34
68
1
136
136
136
34
34
34
34
34
34
34
4
4
4
4
2
1.2
1.6
1.68
4
2.4
1.6
4
2
1.2
34
34
34
80
40
1.7
1
102
102
68
102
102
102
24
34
360
34
34
68
28
28
28
180
DESONIDE TOPICAL 0.05 % GEL (GRAM)
DESONIDE TOPICAL 0.05 % LOTION
DESONIDE TOPICAL 0.05 % OINT. (G)
DESOXIMETASONE TOPICAL 0.05 % CREAM (G)
DESOXIMETASONE TOPICAL 0.05 % GEL (GRAM)
DESOXIMETASONE TOPICAL 0.05 % OINT. (G)
DESOXIMETASONE TOPICAL 0.25 % CREAM (G)
DESOXIMETASONE TOPICAL 0.25 % OINT. (G)
DESOXIMETASONE TOPICAL 0.25 % SPRAY
DESVENLAFAXINE FUMARATE ORAL 100 MG TAB ER 24
DESVENLAFAXINE FUMARATE ORAL 50 MG TAB ER 24
DESVENLAFAXINE ORAL 100 MG TAB ER 24
DESVENLAFAXINE ORAL 100 MG TAB ER 24H
DESVENLAFAXINE ORAL 50 MG TAB ER 24
DESVENLAFAXINE ORAL 50 MG TAB ER 24H
DESVENLAFAXINE SUCCINATE ORAL 100 MG TAB ER 24H
DEXLANSOPRAZOLE ORAL 30 MG CAP DR BP
DEXLANSOPRAZOLE ORAL 60 MG CAP DR BP
DEXMEDETOMIDINE HCL INTRAVEN 200MCG/2ML VIAL
DEXMETHYLPHENIDATE HCL ORAL 10 MG CPBP 50-50
DEXMETHYLPHENIDATE HCL ORAL 10 MG TABLET
DEXMETHYLPHENIDATE HCL ORAL 2.5 MG TABLET
DEXMETHYLPHENIDATE HCL ORAL 5 MG TABLET
DEXTROAMPHETAM/AMPHETAM(BASE) ORAL 12.5 MG TAB RAP BP
DEXTROAMPHETAM/AMPHETAM(BASE) ORAL 2.5 MG/ML SUS BP 24H
DEXTROAMPHETAM/AMPHETAM(BASE) ORAL 3.1MG TAB RAP BP
DEXTROAMPHETAM/AMPHETAM(BASE) ORAL 6.3MG TAB RAP BP
DEXTROAMPHETAMINE SULFATE ORAL 10 MG CAPSULE ER
DEXTROAMPHETAMINE SULFATE ORAL 10 MG TABLET
DEXTROAMPHETAMINE SULFATE ORAL 2.5 MG TABLET
DEXTROAMPHETAMINE SULFATE ORAL 5 MG/5 ML SOLUTION
DEXTROAMPHETAMINE SULFATE ORAL 7.5 MG TABLET
DEXTROAMPHETAMINE/AMPHETAMINE ORAL 10 MG CAP ER 24H
DEXTROAMPHETAMINE/AMPHETAMINE ORAL 10 MG TABLET
DEXTROAMPHETAMINE/AMPHETAMINE ORAL 12.5 MG TABLET
DEXTROAMPHETAMINE/AMPHETAMINE ORAL 7.5 MG TABLET
DEXTROMETHORPHAN HBR/QUINIDINE ORAL 20 MG-10MG CAPSULE
6
Max
Unit
180
180
180
180
180
180
180
180
100
34
34
34
34
34
34
34
34
34
34
34
8
34
68
34
68
34
34
34
34
34
34
68
34
34
34
272
34
34
34
102
102
102
68
102
68
68
102
102
1360
102
34
102
102
34
102
34
102
34
34
68
34
102
102
68
Effective 7/1/2016
DHCODEINE BT/ACETAMINOPHN/CAFF ORAL 16-320.5MG CAPSULE
DIAZEPAM INJECTION 5 MG/ML VIAL
DIAZEPAM INJECTION 5 MG/ML SYRINGE
DIAZEPAM ORAL 10 MG TABLET
DIAZEPAM ORAL 5 MG/5 ML SOLUTION
DIAZEPAM ORAL 5 MG/ML ORAL CONC
DIAZEPAM RECTAL 12.5-15-20 KIT
DIAZEPAM RECTAL 2.5 MG KIT
DIAZEPAM RECTAL 5-7.5-10MG KIT
DIAZOXIDE ORAL 50 MG/ML ORAL SUSP
DICLOFENAC EPOLAMINE TRANSDERM 1.3 % PATCH TD12
DICLOFENAC POTASSIUM ORAL 25 MG CAPSULE
DICLOFENAC POTASSIUM ORAL 50 MG POWD PACK
DICLOFENAC POTASSIUM ORAL 50 MG TABLET
DICLOFENAC SODIUM OPHTHALMIC 0.1 % DROPS
DICLOFENAC SODIUM ORAL 100 MG TAB ER 24H
DICLOFENAC SODIUM ORAL 25 MG TABLET DR
DICLOFENAC SODIUM TOPICAL 1 % GEL (GRAM)
DICLOFENAC SODIUM TOPICAL 1.5 % DROPS
DICLOFENAC SODIUM TOPICAL 20MG/G(2%) SOL MD PMP
DICLOFENAC SODIUM TOPICAL 3 % GEL (GRAM)
DICLOFENAC SODIUM/MISOPROSTOL ORAL 50 MG-200 TAB IR DR
DICLOFENAC SODIUM/MISOPROSTOL ORAL 75 MG-200 TAB IR DR
DICLOFENAC SUBMICRONIZED ORAL 18 MG CAPSULE
DICLOFENAC SUBMICRONIZED ORAL 35 MG CAPSULE
DICYCLOMINE HCL INTRAMUSC 10 MG/ML AMPUL
DICYCLOMINE HCL INTRAMUSC 10 MG/ML VIAL
DICYCLOMINE HCL ORAL 10 MG CAPSULE
DICYCLOMINE HCL ORAL 20 MG TABLET
DIFLORASONE DIACETATE TOPICAL 0.05 % CREAM (G)
DIFLORASONE DIACETATE TOPICAL 0.05 % OINT. (G)
DIFLORASONE DIACETATE/EMOLL TOPICAL 0.05 % CREAM (G)
DIFLUNISAL ORAL 500 MG TABLET
DIFLUPREDNATE OPHTHALMIC 0.05 % DROPS
DIGOXIN INJECTION 100 MCG/ML AMPUL
DIGOXIN INJECTION 250 MCG/ML AMPUL
DIGOXIN INJECTION 250 MCG/ML SYRINGE
DIGOXIN ORAL 125 MCG TABLET
DIGOXIN ORAL 187.5 MCG TABLET
DIGOXIN ORAL 250 MCG TABLET
DIGOXIN ORAL 50 MCG/ML SOLUTION
DIGOXIN ORAL 62.5 MCG TABLET
DIHYDROCODEINE/ASPIRIN/CAFFEIN ORAL 16-356-30 CAPSULE
DIHYDROERGOTAMINE MESYLATE NASAL 0.5MG/SPRY SPRAY/PUMP
DILTIAZEM HCL INTRAVEN 100 MG VIAL PORT
DILTIAZEM HCL INTRAVEN 5 MG/ML VIAL
DILTIAZEM HCL ORAL 120 MG CAP ER 12H
DILTIAZEM HCL ORAL 120 MG CAP ER DEG
DILTIAZEM HCL ORAL 120 MG CAPSULE ER
DILTIAZEM HCL ORAL 120 MG TAB ER 24H
DILTIAZEM HCL ORAL 120 MG TABLET
Max
Unit
68
8
8
136
136
136
500
240
5
5
5
90
68
136
9
102
10
68
102
102
102
1100
600
112
180
102
102
102
102
30
30
136
136
180
180
180
102
10
10
136
68
136
68
68
360
68
68
8
40
40
136
136
136
136
136
136
102
102
102
136
68
68
68
68
DIMENHYDRINATE INJECTION 50 MG/ML VIAL
DIMETHYL FUMARATE ORAL 120 MG CAPSULE DR
DIMETHYL FUMARATE ORAL 120-240 MG CAPSULE DR
DIMETHYL FUMARATE ORAL 240 MG CAPSULE DR
DIPH,PERTUSS(ACELL),TET VAC/PF INTRAMUSC 2-2.5-5/.5 VIAL
DIPH,PERTUSS(ACELL),TET VAC/PF INTRAMUSC 2-2.5-5/.5 SYRINGE
DIPHENHYDRAMINE HCL ORAL 12.5MG/5ML ELIXIR
DIPYRIDAMOLE INTRAVEN 5 MG/ML VIAL
DIPYRIDAMOLE ORAL 25 MG TABLET
DISOPYRAMIDE PHOSPHATE ORAL 100 MG CAPSULE
DISOPYRAMIDE PHOSPHATE ORAL 100 MG CAPSULE ER
DISOPYRAMIDE PHOSPHATE ORAL 150 MG CAPSULE
DISOPYRAMIDE PHOSPHATE ORAL 150 MG CAPSULE ER
DOFETILIDE ORAL 125 MCG CAPSULE
DOLASETRON MESYLATE INTRAVEN 20 MG/ML VIAL
DOLASETRON MESYLATE ORAL 100 MG TABLET
DOLASETRON MESYLATE ORAL 50 MG TABLET
DONEPEZIL HCL ORAL 10 MG TAB RAPDIS
DONEPEZIL HCL ORAL 10 MG TABLET
DONEPEZIL HCL ORAL 5 MG TAB RAPDIS
DOXAZOSIN MESYLATE ORAL 1 MG TABLET
DOXAZOSIN MESYLATE ORAL 4 MG TAB ER 24
DOXAZOSIN MESYLATE ORAL 8 MG TAB ER 24
DOXEPIN HCL ORAL 10 MG CAPSULE
DOXEPIN HCL ORAL 10 MG/ML ORAL CONC
DOXEPIN HCL ORAL 3 MG TABLET
DOXEPIN HCL ORAL 6 MG TABLET
DOXEPIN HCL TOPICAL 5 % CREAM (G)
DOXYCYCLINE HYCLATE ORAL 20 MG TABLET
DOXYLAMINE/PYRIDOXINE HCL ORAL 10 MG-10MG TABLET DR
DRONABINOL ORAL 10 MG CAPSULE
DRONABINOL ORAL 2.5 MG CAPSULE
DRONABINOL ORAL 5 MG CAPSULE
DRONEDARONE HCL ORAL 400 MG TABLET
DROPERIDOL INJECTION 2.5 MG/ML AMPUL
DROPERIDOL INJECTION 2.5 MG/ML VIAL
DROSPIR/ETH ESTRA/LEVOMEFOL CA ORAL 3-0.02(24) TABLET
7
Max
Unit
612
34
34
34
34
34
34
34
34
306
306
204
204
36
14
60
68
0.5
0.5
720
2
544
272
136
544
136
340
136
136
136
68
25
4
4
34
34
34
34
34
102
68
34
34
34
34
136
240
102
68
102
34
102
34
102
180
68
136
60
90
90
68
6
6
28
Effective 7/1/2016
DROSPIR/ETH ESTRA/LEVOMEFOL CA ORAL 3-0.03(21) TABLET
DROSPIRENONE/ESTRADIOL ORAL 0.25-0.5MG TABLET
DROSPIRENONE/ESTRADIOL ORAL 0.5 MG-1MG TABLET
DROXIDOPA ORAL 100 MG CAPSULE
DULAGLUTIDE SUB-Q 0.75MG/0.5 PEN INJCTR
DULAGLUTIDE SUB-Q 1.5 MG/0.5 PEN INJCTR
DULOXETINE HCL ORAL 20 MG CAPSULE DR
DUTASTERIDE ORAL 0.5 MG CAPSULE
ECALLANTIDE SUB-Q 10MG/ML(1) VIAL
ECONAZOLE NITRATE TOPICAL 1 % CREAM (G)
ECULIZUMAB INTRAVEN 300MG/30ML VIAL
EDOXABAN TOSYLATE ORAL 15 MG TABLET
EFINACONAZOLE TOPICAL 10 % SOL W/APPL
ELBASVIR/GRAZOPREVIR ORAL 50MG-100MG TABLET
ELETRIPTAN HBR ORAL 20 MG TABLET
ELETRIPTAN HBR ORAL 40 MG TABLET
ELIGLUSTAT TARTRATE ORAL 84 MG CAPSULE
ELTROMBOPAG OLAMINE ORAL 12.5 MG TABLET
ELTROMBOPAG OLAMINE ORAL 25 MG TABLET
ELUXADOLINE ORAL 100 MG TABLET
ELUXADOLINE ORAL 75 MG TABLET
ELVITEGR/COBICIST/EMTRIC/TENOF ORAL 150-200 MG TABLET
ELVITEGRAVIR ORAL 150 MG TABLET
ELVITEGRAVIR ORAL 85 MG TABLET
EMEDASTINE DIFUMARATE OPHTHALMIC 0.05 % DROPS
EMPAGLIFLOZIN ORAL 10 MG TABLET
EMPAGLIFLOZIN ORAL 25 MG TABLET
EMPAGLIFLOZIN/LINAGLIPTIN ORAL 10 MG-5 MG TABLET
EMPAGLIFLOZIN/LINAGLIPTIN ORAL 25 MG-5 MG TABLET
EMPAGLIFLOZIN/METFORMIN HCL ORAL 12.5-1000 TABLET
EMPAGLIFLOZIN/METFORMIN HCL ORAL 12.5-500MG TABLET
EMPAGLIFLOZIN/METFORMIN HCL ORAL 5 MG-500MG TABLET
EMPAGLIFLOZIN/METFORMIN HCL ORAL 5MG-1000MG TABLET
EMTRICITAB/RILPIVIRI/TENOF ALA ORAL 200-25-25 TABLET
EMTRICITAB/RILPIVIRINE/TENOFOV ORAL 200-25-300 TABLET
ENALAPRIL MALEATE ORAL 10 MG TABLET
ENALAPRIL MALEATE ORAL 2.5 MG TABLET
ENALAPRIL/HYDROCHLOROTHIAZIDE ORAL 5MG-12.5MG TABLET
ENALAPRIL/HYDROCHLOROTHIAZIDE ORAL 10 MG-25MG TABLET
ENALAPRILAT DIHYDRATE INTRAVEN 1.25 MG/ML VIAL
ENOXAPARIN SODIUM SUB-Q 100 MG/ML SYRINGE
ENOXAPARIN SODIUM SUB-Q 120MG/.8ML SYRINGE
ENOXAPARIN SODIUM SUB-Q 150 MG/ML SYRINGE
ENOXAPARIN SODIUM SUB-Q 300MG/3ML VIAL
ENOXAPARIN SODIUM SUB-Q 30MG/0.3ML SYRINGE
ENTECAVIR ORAL 0.05MG/ML SOLUTION
ENTECAVIR ORAL 0.5 MG TABLET
ENTECAVIR ORAL 1 MG TABLET
ENZALUTAMIDE ORAL 40 MG CAPSULE
EPINASTINE HCL OPHTHALMIC 0.05 % DROPS
Max
Unit
28
34
34
102
102
102
2
2
68
68
68
68
34
6
180
240
34
34
34
4
28
10
10
68
34
34
34
34
68
68
34
34
34
15
34
34
34
34
68
68
68
68
34
34
136
544
68
272
204
102
40
30
22.4
28
30
8.4
11.2
16.8
22.4
680
68
34
136
10
EPINEPHRINE INJECTION 1 MG/ML VIAL
EPINEPHRINE INJECTION 0.1 MG/ML SYRINGE
EPINEPHRINE INJECTION 0.15/0.15 AUTO INJCT
EPINEPHRINE INJECTION 0.15MG/0.3 AUTO INJCT
EPINEPHRINE INJECTION 0.3MG/0.3 AUTO INJCT
EPINEPHRINE INJECTION 1 MG/ML(1) AMPUL
EPLERENONE ORAL 25 MG TABLET
EPLERENONE ORAL 50 MG TABLET
EPOETIN ALFA INJECTION 10000/ML VIAL
EPOETIN ALFA INJECTION 20000/2ML VIAL
EPROSARTAN MESYLATE ORAL 600 MG TABLET
ERYTHROMYCIN BASE OPHTHALMIC 5 MG/G OINT. (G)
ERYTHROMYCIN BASE ORAL 250 MG CAPSULE DR
ERYTHROMYCIN BASE ORAL 250 MG TABLET
ERYTHROMYCIN BASE ORAL 250 MG TABLET DR
ERYTHROMYCIN BASE ORAL 333 MG TAB PART
ERYTHROMYCIN BASE ORAL 500 MG TAB PART
ERYTHROMYCIN BASE ORAL 500 MG TABLET
ERYTHROMYCIN ETHYLSUCCINATE ORAL 200 MG/5ML SUSP RECON
ERYTHROMYCIN ETHYLSUCCINATE ORAL 400 MG TABLET
ERYTHROMYCIN ETHYLSUCCINATE ORAL 400 MG/5ML SUSP RECON
ERYTHROMYCIN LACTOBIONATE INTRAVEN 500 MG VIAL
ERYTHROMYCIN LACTOBIONATE INTRAVEN 500 MG VIAL PORT
ERYTHROMYCIN STEARATE ORAL 250 MG TABLET
ESCITALOPRAM OXALATE ORAL 10 MG TABLET
ESCITALOPRAM OXALATE ORAL 5 MG/5 ML SOLUTION
ESOMEPRAZOLE MAGNESIUM ORAL 10 MG SUSPDR PKT
ESOMEPRAZOLE MAGNESIUM ORAL 2.5 MG SUSPDR PKT
ESOMEPRAZOLE MAGNESIUM ORAL 20 MG CAPSULE DR
ESOMEPRAZOLE MAGNESIUM ORAL 40 MG CAPSULE DR
ESOMEPRAZOLE SODIUM INTRAVEN 20 MG VIAL
ESOMEPRAZOLE SODIUM INTRAVEN 40 MG VIAL
ESTRADIOL ACETATE VAGINAL 0.05MG/24H VAG RING
ESTRADIOL ACETATE VAGINAL 0.1MG/24HR VAG RING
ESTRADIOL CYPIONATE INTRAMUSC 5 MG/ML VIAL
ESTRADIOL ORAL 0.5 MG TABLET
ESTRADIOL ORAL 1 MG TABLET
ESTRADIOL ORAL 2 MG TABLET
ESTRADIOL TRANSDERM .025MG/24H PATCH TDSW
ESTRADIOL TRANSDERM .025MG/24H PATCH TDWK
ESTRADIOL TRANSDERM .0375MG/24 PATCH TDSW
ESTRADIOL TRANSDERM .0375MG/24 PATCH TDWK
ESTRADIOL TRANSDERM .075MG/24H PATCH TDSW
ESTRADIOL TRANSDERM .075MG/24H PATCH TDWK
ESTRADIOL TRANSDERM 0.05MG/24H PATCH TDSW
ESTRADIOL TRANSDERM 0.05MG/24H PATCH TDWK
ESTRADIOL TRANSDERM 0.06MG/24H PATCH TDWK
ESTRADIOL TRANSDERM 0.1MG/24HR PATCH TDSW
ESTRADIOL TRANSDERM 0.1MG/24HR PATCH TDWK
ESTRADIOL TRANSDERM 0.25(0.1%) GEL PACKET
ESTRADIOL TRANSDERM 0.5MG(0.1) GEL PACKET
ESTRADIOL TRANSDERM 0.87G GEL MD PMP
8
Max
Unit
30
30
6
6
6
30
136
68
28
28
28
28
28
28
14
34
3.5
84
84
84
84
84
84
84
84
400
84
400
56
56
84
34
34
34
680
34
34
34
34
34
34
34
10
10
1
1
10
34
34
34
8
4
8
4
8
4
8
4
4
8
4
34
34
52
Effective 7/1/2016
ESTRADIOL TRANSDERM 14MCG/24HR PATCH TDWK
ESTRADIOL TRANSDERM 1MG(0.1%) GEL PACKET
ESTRADIOL VAGINAL 0.01 % CREAM/APPL
ESTRADIOL VAGINAL 10 MCG TABLET
ESTRADIOL VAGINAL 7.5MCG/24H VAG RING
ESTRADIOL VALERATE INTRAMUSC 10 MG/ML VIAL
ESTRADIOL VALERATE/DIENOGEST ORAL 3-2-1(28) TABLET
ESTRADIOL/LEVONORGESTREL TRANSDERM 45-15/24H PATCH TDWK
ESTRADIOL/NORETHINDRONE ACET ORAL 0.5-0.1MG TABLET
ESTRADIOL/NORETHINDRONE ACET ORAL 1 MG-0.5MG TABLET
ESTRADIOL/NORETHINDRONE ACET TRANSDERM .05-.14/24 PATCH TDSW
ESTRADIOL/NORETHINDRONE ACET TRANSDERM .05-.25/24 PATCH TDSW
ESTRADIOL/NORGESTIMATE ORAL 1-1-0.09MG TABLET
ESTROGEN,CON/M-PROGEST ACET ORAL 0.3-1.5MG TABLET
ESTROGEN,CON/M-PROGEST ACET ORAL 0.45-1.5MG TABLET
ESTROGEN,CON/M-PROGEST ACET ORAL 0.625 (14) TABLET
ESTROGEN,CON/M-PROGEST ACET ORAL 0.625-2.5 TABLET
ESTROGEN,CON/M-PROGEST ACET ORAL 0.625-5 MG TABLET
ESTROGENS, CONJUGATED INJECTION 25 MG VIAL
ESTROGENS, CONJUGATED ORAL 0.3 MG TABLET
ESTROGENS, CONJUGATED ORAL 0.45MG TABLET
ESTROGENS, CONJUGATED VAGINAL 0.625 MG/G CREAM/APPL
ESTROGENS,CONJ.,SYNTHETIC B ORAL 0.3 MG TABLET
ESTROGENS,CONJ.,SYNTHETIC B ORAL 0.45MG TABLET
ESTROGENS,CONJ/BAZEDOXIFENE ORAL 0.45-20 MG TABLET
ESTROGENS,ESTERIFIED ORAL 0.3 MG TABLET
ESTROPIPATE ORAL 0.75 MG TABLET
ESTROPIPATE ORAL 1.5 MG TABLET
ESTROPIPATE ORAL 3 MG TABLET
ESZOPICLONE ORAL 1 MG TABLET
ETHACRYNATE SODIUM INTRAVEN 50 MG VIAL
ETHACRYNIC ACID ORAL 25 MG TABLET
ETHINYL ESTRADIOL/DROSPIRENONE ORAL 0.02-3(24) TABLET
ETHINYL ESTRADIOL/DROSPIRENONE ORAL 0.03MG-3MG TABLET
ETHYNODIOL D-ETHINYL ESTRADIOL ORAL 1 MG-35MCG TABLET
ETHYNODIOL D-ETHINYL ESTRADIOL ORAL 1 MG-50MCG TABLET
ETIDRONATE DISODIUM ORAL 200 MG TABLET
ETIDRONATE DISODIUM ORAL 400 MG TABLET
ETODOLAC ORAL 200 MG CAPSULE
ETODOLAC ORAL 300 MG CAPSULE
ETODOLAC ORAL 400 MG TAB ER 24H
ETODOLAC ORAL 400 MG TABLET
ETODOLAC ORAL 500 MG TABLET
ETONOGESTREL/ETHINYL ESTRADIOL VAGINAL .12-.015MG VAG RING
EVOLOCUMAB SUB-Q 140 MG/ML PEN INJCTR
EVOLOCUMAB SUB-Q 140 MG/ML SYRINGE
EXENATIDE MICROSPHERES SUB-Q 2 MG VIAL
EXENATIDE MICROSPHERES SUB-Q 2MG/0.65ML PEN INJCTR
EXENATIDE SUB-Q 10MCG/0.04 PEN INJCTR
Max
Unit
4
34
43
18
1
10
10
10
28
4
34
34
8
8
34
34
34
34
34
34
1
34
34
34
34
34
43
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
1
272
28
28
28
28
68
68
102
102
34
68
34
68
34
1
3
3
4
4
2.4
EXENATIDE SUB-Q 5MCG/0.02 PEN INJCTR
EZETIMIBE ORAL 10 MG TABLET
EZETIMIBE/ATORVASTATIN CALCIUM ORAL 10 MG-10MG TABLET
EZETIMIBE/SIMVASTATIN ORAL 10 MG-10MG TABLET
EZOGABINE ORAL 200 MG TABLET
FAMCICLOVIR ORAL 125 MG TABLET
FAMOTIDINE INTRAVEN 10 MG/ML VIAL
FAMOTIDINE ORAL 20 MG TABLET
FAMOTIDINE ORAL 40 MG TABLET
FAMOTIDINE ORAL 40MG/5ML ORAL SUSP
FAMOTIDINE/PF INTRAVEN 20 MG/2 ML VIAL
FEBUXOSTAT ORAL 40 MG TABLET
FEBUXOSTAT ORAL 80 MG TABLET
FELODIPINE ORAL 10 MG TAB ER 24H
FELODIPINE ORAL 2.5 MG TAB ER 24H
FELODIPINE ORAL 5 MG TAB ER 24H
FENOFIBRATE NANOCRYSTALLIZED ORAL 145MG TABLET
FENOFIBRATE NANOCRYSTALLIZED ORAL 48 MG TABLET
FENOFIBRATE ORAL 120 MG TABLET
FENOFIBRATE ORAL 150 MG CAPSULE
FENOFIBRATE ORAL 50 MG CAPSULE
FENOFIBRATE,MICRONIZED ORAL 130 MG CAPSULE
FENOFIBRATE,MICRONIZED ORAL 134MG CAPSULE
FENOFIBRIC ACID (CHOLINE) ORAL 135 MG CAPSULE DR
FENOFIBRIC ACID (CHOLINE) ORAL 45 MG CAPSULE DR
FENOFIBRIC ACID ORAL 105 MG TABLET
FENOFIBRIC ACID ORAL 35 MG TABLET
FENOPROFEN CALCIUM ORAL 400 MG CAPSULE
FENOPROFEN CALCIUM ORAL 600 MG TABLET
FENTANYL CITRATE BUCCAL 100 MCG TABLET EFF
FENTANYL CITRATE BUCCAL 1200 MCG LOZENGE HD
FENTANYL CITRATE NASAL 100MCG/SPR SPRAY/PUMP
FENTANYL CITRATE NASAL 400MCG/SPR SPRAY/PUMP
FENTANYL CITRATE SUBLINGUAL 100 MCG TAB SUBL
9
Max
Unit
1.2
34
34
34
34
34
34
34
34
34
102
102
102
306
84
42
21
10
68
68
120
10
34
34
34
136
68
34
102
34
34
34
102
102
102
34
34
34
34
102
102
34
34
68
34
68
136
136
136
136
136
136
136
136
136
136
136
136
136
10
10
136
136
136
Effective 7/1/2016
FENTANYL CITRATE/PF INJECTION 50 MCG/ML AMPUL
FENTANYL CITRATE/PF INJECTION 50 MCG/ML VIAL
FENTANYL SUBLINGUAL 100MCG/SPR SPRAY
FENTANYL SUBLINGUAL 1200 MCG SPRAY
FENTANYL SUBLINGUAL 400MCG/SPR SPRAY
FENTANYL TRANSDERM 50MCG/HR PATCH TD72
FENTANYL TRANSDERM 75MCG/HR PATCH TD72
FENTANYL TRANSDERM 100 MCG/HR PATCH TD72
FENTANYL TRANSDERM 37.5MCG/HR PATCH TD72
FESOTERODINE FUMARATE ORAL 4 MG TAB ER 24H
FESOTERODINE FUMARATE ORAL 8 MG TAB ER 24H
FEXOFENADINE HCL ORAL 180 MG TABLET
FEXOFENADINE HCL ORAL 30 MG/5 ML ORAL SUSP
FEXOFENADINE HCL ORAL 60 MG TABLET
FIBRINOGEN/THROMBIN(HUMAN DER) TOPICAL 4.8X4.8 CM ADH. PATCH
FIBRINOGEN/THROMBIN(HUMAN DER) TOPICAL 9.5X4.8 CM ADH. PATCH
FIDAXOMICIN ORAL 200 MG TABLET
FINGOLIMOD HCL ORAL 0.5 MG CAPSULE
FLAVOXATE HCL ORAL 100 MG TABLET
FLECAINIDE ACETATE ORAL 100 MG TABLET
FLU VAC TV 2015(18 YR+)RCM/PF INTRAMUSC 135MCG/0.5 VIAL
FLU VACC QS 2015 (18-64YRS)/PF INTRADERM 36MCG/.1ML SYRINGE
FLU VACC QS 2015-16(36MOS+)/PF INTRAMUSC 60MCG/.5ML SYRINGE
FLU VACC QS 2015-16(36MOS+)/PF INTRAMUSC 60MCG/.5ML VIAL
FLU VACC QV LIVE 2015(2-49YRS) NASAL 10E6.5-7.5 NAS SP SYR
FLU VACC TS 15-16 (18+)CELL/PF INTRAMUSC 45MCG/.5ML SYRINGE
FLU VACC TS 2015-16 (65YR+)/PF INTRAMUSC 180MCG/0.5 SYRINGE
FLU VACCINE QS 2015-16 (6MOS+) INTRAMUSC 60MCG/.5ML VIAL
FLU VACCINE QS 2015-16(36MOS+) INTRAMUSC 60MCG/.5ML VIAL
FLU VACCINE TS 2015-16 (5 YR+) INTRAMUSC 45MCG/.5ML VIAL
FLU VACCINE TS 2015-16(6 MOS+) INTRAMUSC 45MCG/.5ML VIAL
FLU VACCINE TS 2015-2016(4YR+) INTRAMUSC 45MCG/.5ML VIAL
FLU VACCINE TS2015-16(4YR+)/PF INTRAMUSC 45MCG/.5ML SYRINGE
FLU VACCINE TS2015-16(5YR+)/PF INTRAMUSC 45MCG/.5ML SYRINGE
FLUCONAZOLE IN DEXTROSE,ISO-OS INTRAVEN 200MG/0.1L PIGGYBACK
FLUCONAZOLE IN DEXTROSE,ISO-OS INTRAVEN 400MG/0.2L PIGGYBACK
FLUCONAZOLE IN NACL,ISO-OSM INTRAVEN 200MG/0.1L PGGYBK BTL
FLUCONAZOLE IN NACL,ISO-OSM INTRAVEN 200MG/0.1L PIGGYBACK
FLUCONAZOLE IN NACL,ISO-OSM INTRAVEN 400MG/0.2L PGGYBK BTL
FLUCONAZOLE IN NACL,ISO-OSM INTRAVEN 400MG/0.2L PIGGYBACK
FLUCONAZOLE ORAL 10 MG/ML SUSP RECON
FLUCONAZOLE ORAL 100 MG TABLET
FLUCONAZOLE ORAL 40 MG/ML SUSP RECON
FLUDARABINE PHOSPHATE INTRAVEN 50 MG/2 ML VIAL
FLUNISOLIDE NASAL 25 MCG SPRAY
FLUOCINOLONE ACETONIDE OIL OTIC 0.01 % DROPS
FLUOCINOLONE ACETONIDE TOPICAL 0.01 % CREAM (G)
FLUOCINOLONE ACETONIDE TOPICAL 0.01 % OIL
Max
Unit
136
136
136
2
2
136
136
136
136
136
136
136
11
11
11
11
11
11
11
11
34
34
34
300
68
1
1
20
34
102
136
102
272
0.5
0.1
0.5
0.5
1
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.5
6800
6800
6800
6800
6800
6800
1360
136
34
68
350
272
2
75
20
180
236.56
10
FLUOCINOLONE ACETONIDE TOPICAL 0.01 % SHAMPOO
FLUOCINOLONE ACETONIDE TOPICAL 0.01 % SOLUTION
FLUOCINOLONE ACETONIDE TOPICAL 0.025 % CREAM (G)
FLUOCINOLONE ACETONIDE TOPICAL 0.025 % OINT. (G)
FLUOCINOLONE/SHOWER CAP TOPICAL 0.01 % OIL
FLUOCINONIDE TOPICAL 0.05 % CREAM (G)
FLUOCINONIDE TOPICAL 0.05 % GEL (GRAM)
FLUOCINONIDE TOPICAL 0.05 % OINT. (G)
FLUOCINONIDE TOPICAL 0.05 % SOLUTION
FLUOCINONIDE TOPICAL 0.1 % CREAM (G)
FLUOCINONIDE/EMOLLIENT BASE TOPICAL 0.05 % CREAM (G)
FLUOROMETHOLONE OPHTHALMIC 0.1 % OINT. (G)
FLUOROURACIL TOPICAL 0.5 % CREAM (G)
FLUOROURACIL TOPICAL 2 % SOLUTION
FLUOROURACIL TOPICAL 4 % CREAM (G)
FLUOROURACIL TOPICAL 5 % CREAM (G)
FLUOROURACIL TOPICAL 5 % SOLUTION
FLUOXETINE HCL ORAL 10 MG CAPSULE
FLUOXETINE HCL ORAL 10 MG TABLET
FLUOXETINE HCL ORAL 20 MG/5 ML SOLUTION
FLUOXETINE HCL ORAL 90 MG CAPSULE DR
FLUPHENAZINE DECANOATE INJECTION 25 MG/ML VIAL
FLUPHENAZINE HCL INJECTION 2.5 MG/ML VIAL
FLUPHENAZINE HCL ORAL 1 MG TABLET
FLUPHENAZINE HCL ORAL 2.5 MG TABLET
FLUPHENAZINE HCL ORAL 2.5 MG/5ML ELIXIR
FLUPHENAZINE HCL ORAL 5 MG/ML ORAL CONC
FLURANDRENOLIDE TOPICAL 0.05 % CREAM (G)
FLURANDRENOLIDE TOPICAL 4MCG/SQ CM MED. TAPE
FLURAZEPAM HCL ORAL 15 MG CAPSULE
FLURAZEPAM HCL ORAL 30 MG CAPSULE
FLURBIPROFEN ORAL 100 MG TABLET
FLURBIPROFEN ORAL 50 MG TABLET
FLURBIPROFEN SODIUM OPHTHALMIC 0.03 % DROPS
FLUTICASONE FUROATE INHALATION 100 MCG BLST W/DEV
FLUTICASONE FUROATE INHALATION 200 MCG BLST W/DEV
FLUTICASONE FUROATE NASAL 27.5 MCG SPRAY SUSP
FLUTICASONE PROPIONATE INHALATION 100 MCG BLST W/DEV
FLUTICASONE PROPIONATE INHALATION 110 MCG AER W/ADAP
FLUTICASONE PROPIONATE NASAL 50 MCG SPRAY SUSP
FLUTICASONE PROPIONATE TOPICAL 0.005 % OINT. (G)
FLUTICASONE PROPIONATE TOPICAL 0.05 % CREAM (G)
FLUTICASONE PROPIONATE TOPICAL 0.05 % LOTION
FLUTICASONE/SALMETEROL INHALATION 100-50 MCG BLST W/DEV
FLUTICASONE/SALMETEROL INHALATION 115-21MCG HFA AER AD
FLUTICASONE/VILANTEROL INHALATION 100-25MCG BLST W/DEV
FLUTICASONE/VILANTEROL INHALATION 200-25 MCG BLST W/DEV
FLUVASTATIN SODIUM ORAL 20 MG CAPSULE
FLUVASTATIN SODIUM ORAL 40 MG CAPSULE
FLUVASTATIN SODIUM ORAL 80 MG TAB ER 24H
Max
Unit
180
180
180
180
118.28
180
180
180
180
180
180
3.5
180
30
80
100
30
34
34
68
68
680
68
34
4
10
10
102
68
102
600
68
480
180
200
15
15
136
136
2.5
30
30
10
240
24
26
120
21.2
240
16
180
180
180
60
16
16
60
16
60
60
60
102
68
34
Effective 7/1/2016
FLUVOXAMINE MALEATE ORAL 100 MG CAP ER 24H
FLUVOXAMINE MALEATE ORAL 100 MG TABLET
FLUVOXAMINE MALEATE ORAL 150 MG CAP ER 24H
FONDAPARINUX SODIUM SUB-Q 10MG/0.8ML SYRINGE
FONDAPARINUX SODIUM SUB-Q 2.5 MG/0.5 SYRINGE
FONDAPARINUX SODIUM SUB-Q 5MG/0.4ML SYRINGE
FONDAPARINUX SODIUM SUB-Q 7.5MG/0.6 SYRINGE
FORMOTEROL FUMARATE INHALATION 12 MCG CAP W/DEV
FORMOTEROL FUMARATE INHALATION 20 MCG/2ML VIAL-NEB
FOSAPREPITANT DIMEGLUMINE INTRAVEN 150 MG VIAL
FOSINOPRIL SODIUM ORAL 10 MG TABLET
FOSINOPRIL/HYDROCHLOROTHIAZIDE ORAL 10-12.5MG TABLET
FOSINOPRIL/HYDROCHLOROTHIAZIDE ORAL 20-12.5 MG TABLET
FROVATRIPTAN SUCCINATE ORAL 2.5 MG TABLET
FUROSEMIDE INJECTION 10 MG/ML VIAL
FUROSEMIDE INJECTION 10 MG/ML SYRINGE
FUROSEMIDE ORAL 10 MG/ML SOLUTION
FUROSEMIDE ORAL 20 MG TABLET
FUROSEMIDE ORAL 40MG/5ML SOLUTION
GABAPENTIN ENACARBIL ORAL 300 MG TABLET ER
GABAPENTIN ENACARBIL ORAL 600 MG TABLET ER
GABAPENTIN ORAL 300 MG TAB ER 24H
GABAPENTIN ORAL 300-600 MG TAB ER 24H
GABAPENTIN ORAL 600 MG TAB ER 24H
GALANTAMINE HBR ORAL 12 MG TABLET
GALANTAMINE HBR ORAL 16 MG CAP24H PEL
GALANTAMINE HBR ORAL 4 MG/ML SOLUTION
GANCICLOVIR OPHTHALMIC 0.15 % GEL (GRAM)
GATIFLOXACIN OPHTHALMIC 0.5 % DROPS
GEMFIBROZIL ORAL 600 MG TABLET
GENTAMICIN SULFATE INJECTION 40 MG/ML VIAL
GENTAMICIN SULFATE INJECTION 20 MG/2 ML VIAL
GENTAMICIN SULFATE OPHTHALMIC 0.3 % DROPS
GENTAMICIN SULFATE OPHTHALMIC 0.3 % OINT. (G)
GENTAMICIN SULFATE TOPICAL 0.1 % CREAM (G)
GENTAMICIN SULFATE TOPICAL 0.1 % OINT. (G)
GENTAMICIN SULFATE/PF INJECTION 20 MG/2 ML VIAL
GENTAMICIN/PREDNISOL AC OPHTHALMIC 0.3%-1% DROPS SUSP
GENTAMICIN/PREDNISOL AC OPHTHALMIC 0.3-0.6% OINT. (G)
GLATIRAMER ACETATE SUB-Q 20 MG/ML SYRINGE
GLATIRAMER ACETATE SUB-Q 40 MG/ML SYRINGE
GLIMEPIRIDE ORAL 1 MG TABLET
GLIPIZIDE ORAL 10 MG TAB ER 24
GLIPIZIDE ORAL 10 MG TABLET
GLIPIZIDE ORAL 2.5 MG TAB ER 24
GLIPIZIDE ORAL 5 MG TAB ER 24
GLIPIZIDE ORAL 5 MG TABLET
GLIPIZIDE/METFORMIN HCL ORAL 2.5-250 MG TABLET
GLIPIZIDE/METFORMIN HCL ORAL 2.5-500 MG TABLET
GLIPIZIDE/METFORMIN HCL ORAL 5 MG-500MG TABLET
GLYBURIDE ORAL 1.25 MG TABLET
GLYBURIDE ORAL 2.5 MG TABLET
Max
Unit
102
102
68
68
68
20.8
16
10.4
15.6
68
136
1
136
68
34
136
68
10
40
40
480
1020
510
500
238
68
68
102
78
102
68
34
34
68
204
34
68
10
5
68
80
80
15
3.5
60
60
80
10
3.5
30
12
68
68
68
68
136
136
136
136
136
68
68
136
136
GLYBURIDE ORAL 5 MG TABLET
GLYBURIDE,MICRONIZED ORAL 1.5 MG TABLET
GLYBURIDE,MICRONIZED ORAL 3 MG TABLET
GLYBURIDE,MICRONIZED ORAL 6 MG TABLET
GLYBURIDE/METFORMIN HCL ORAL 1.25-250MG TABLET
GLYBURIDE/METFORMIN HCL ORAL 2.5-500 MG TABLET
GLYBURIDE/METFORMIN HCL ORAL 5 MG-500MG TABLET
GLYCOPYRROLATE INHALATION 15.6 MCG CAP W/DEV
GLYCOPYRROLATE ORAL 1 MG TABLET
GLYCOPYRROLATE ORAL 2 MG TABLET
GOLIMUMAB INTRAVEN 50 MG/4 ML VIAL
GOLIMUMAB SUB-Q 100 MG/ML PEN INJCTR
GOLIMUMAB SUB-Q 100 MG/ML SYRINGE
GOLIMUMAB SUB-Q 50MG/0.5ML PEN INJCTR
GOLIMUMAB SUB-Q 50MG/0.5ML SYRINGE
GOSERELIN ACETATE SUB-Q 10.8MG IMPLANT
GOSERELIN ACETATE SUB-Q 3.6 MG IMPLANT
GR POL-ORC/SW VER/RYE/KENT/TIM SUBLINGUAL 100 IR TAB SUBL
GR POL-ORC/SW VER/RYE/KENT/TIM SUBLINGUAL 300 IR TAB SUBL
GRANISETRON HCL INTRAVEN 1 MG/ML VIAL
GRANISETRON HCL INTRAVEN 1 MG/ML(1) VIAL
GRANISETRON HCL ORAL 1 MG TABLET
GRANISETRON HCL/PF INTRAVEN 1 MG/ML(1) VIAL
GRANISETRON HCL/PF INTRAVEN 100 MCG/ML VIAL
GRANISETRON TRANSDERM 3.1MG/24HR PATCH TDWK
GRASS POLLEN-TIMOTHY, STANDARD SUBLINGUAL 2800 UNIT TAB SUBL
GUANFACINE HCL ORAL 1 MG TAB ER 24H
GUANFACINE HCL ORAL 1 MG TABLET
GUANFACINE HCL ORAL 2 MG TABLET
HALCINONIDE TOPICAL 0.1 % CREAM (G)
HALCINONIDE TOPICAL 0.1 % OINT. (G)
HALOBETASOL PROPIONATE TOPICAL 0.05 % CREAM (G)
HALOBETASOL PROPIONATE TOPICAL 0.05 % OINT. (G)
HALOBETASOL/LACTIC ACID TOPICAL 0.05%-10% CMB ONT CR
HALOBETASOL/LACTIC ACID TOPICAL 0.05%-10% COMBO. PKG
HALOPERIDOL DECANOATE INTRAMUSC 100 MG/ML AMPUL
HALOPERIDOL DECANOATE INTRAMUSC 100 MG/ML VIAL
HALOPERIDOL DECANOATE INTRAMUSC 50 MG/ML AMPUL
HALOPERIDOL DECANOATE INTRAMUSC 50 MG/ML VIAL
HALOPERIDOL LACTATE INJECTION 5 MG/ML AMPUL
HALOPERIDOL LACTATE INJECTION 5 MG/ML VIAL
HALOPERIDOL LACTATE ORAL 2 MG/ML ORAL CONC
HALOPERIDOL ORAL 0.5 MG TABLET
HALOPERIDOL ORAL 1 MG TABLET
HC/MINERAL OIL/PETROLAT,WHT TOPICAL 1 % OINT. (G)
HEMIN INTRAVEN 313MG VIAL
HISTRELIN AC IMPLANT 50 MG KIT
HYALURONIDASE, HUMAN RECOMB. INJECTION 150 UNIT/1 VIAL
HYDRALAZINE HCL INJECTION 20 MG/ML VIAL
HYDRALAZINE HCL ORAL 10 MG TABLET
HYDROCHLOROTHIAZIDE ORAL 12.5 MG CAPSULE
HYDROCHLOROTHIAZIDE ORAL 12.5 MG TABLET
HYDROCHLOROTHIAZIDE ORAL 25 MG TABLET
HYDROCHLOROTHIAZIDE ORAL 50 MG TABLET
11
Max
Unit
136
136
136
136
136
170
170
60
102
102
24
3
3
0.5
0.5
1
1
3
34
4
4
8
4
4
5
34
34
34
34
34
34
34
180
180
180
180
275
275
5
5
5
10
10
10
120
102
102
68
102
68
102
454
16
1
2
40
1020
1020
1020
1020
544
544
272
136
Effective 7/1/2016
HYDROCODONE BITARTRATE ORAL 10 MG CAP ER 12H
HYDROCODONE BITARTRATE ORAL 100 MG TAB ER 24H
HYDROCODONE/ACETAMINOPHEN ORAL 10-300/15 SOLUTION
HYDROCODONE/ACETAMINOPHEN ORAL 10-325/15 SOLUTION
HYDROCODONE/ACETAMINOPHEN ORAL 10MG-300MG TABLET
HYDROCODONE/ACETAMINOPHEN ORAL 2.5-325MG TABLET
HYDROCODONE/ACETAMINOPHEN ORAL 5 MG-325MG TABLET
HYDROCODONE/ACETAMINOPHEN ORAL 7.5-325/15 SOLUTION
HYDROCODONE/IBUPROFEN ORAL 10MG-200MG TABLET
HYDROCODONE/IBUPROFEN ORAL 2.5-200MG TABLET
HYDROCODONE/IBUPROFEN ORAL 5MG-200MG TABLET
HYDROCODONE/IBUPROFEN ORAL 7.5-200 MG TABLET
HYDROCORTISONE ACETATE RECTAL 10 % FOAM/APPL
HYDROCORTISONE ACETATE/UREA TOPICAL 1 %-10 % CREAM (G)
HYDROCORTISONE BUTYRATE TOPICAL 0.1 % CREAM (G)
HYDROCORTISONE BUTYRATE TOPICAL 0.1 % OINT. (G)
HYDROCORTISONE BUTYRATE TOPICAL 0.1 % SOLUTION
HYDROCORTISONE BUTYRATE/EMOLL TOPICAL 0.1 % CREAM (G)
HYDROCORTISONE PROBUTATE TOPICAL 0.1 % CREAM (G)
HYDROCORTISONE RECTAL 1 % CREAM (G)
HYDROCORTISONE RECTAL 100MG/60ML ENEMA
HYDROCORTISONE RECTAL 2.5 % CREAM (G)
HYDROCORTISONE RECTAL 2.5 % CREAM/APPL
HYDROCORTISONE TOPICAL 1 % CREAM (G)
HYDROCORTISONE TOPICAL 1 % OINT. (G)
HYDROCORTISONE TOPICAL 2.5 % CREAM (G)
HYDROCORTISONE TOPICAL 2.5 % LOTION
HYDROCORTISONE TOPICAL 2.5 % OINT. (G)
HYDROCORTISONE TOPICAL 2.5 % SOLUTION
HYDROCORTISONE VALERATE TOPICAL 0.2 % CREAM (G)
HYDROCORTISONE VALERATE TOPICAL 0.2 % OINT. (G)
HYDROCORTISONE/LIDOCAINE/ALOE RECTAL 0.55%-2.8% GEL W/APPL
HYDROCORTISONE/LIDOCAINE/ALOE RECTAL 2 %-2 % KIT
HYDROCORTISONE/LIDOCAINE/ALOE RECTAL 2.5-3%(7G) KIT
HYDROCORTISONE/PRAMOXINE RECTAL 1 %-1 % CREAM/APPL
HYDROCORTISONE/PRAMOXINE RECTAL 1 %-1 % FOAM
HYDROMORPHONE HCL INJECTION 2 MG/ML VIAL
HYDROMORPHONE HCL INJECTION 1 MG/ML SYRINGE
HYDROMORPHONE HCL ORAL 1 MG/ML LIQUID
HYDROMORPHONE HCL ORAL 12 MG TAB ER 24H
Max
Unit
68
68
34
34
68
68
68
68
34
68
68
34
68
68
34
68
68
34
34
240
240
68
68
68
68
68
68
240
68
68
68
68
68
45
180
180
180
180
180
180
180
1680
180
180
454
454
180
240
454
180
180
180
100
1
1
30
60
60
60
60
60
60
68
68
HYDROMORPHONE HCL ORAL 2 MG TABLET
HYDROMORPHONE HCL RECTAL 3 MG SUPP.RECT
HYDROMORPHONE HCL/PF INJECTION 1 MG/ML AMPUL
HYDROMORPHONE HCL/PF INJECTION 10 MG/ML VIAL
HYDROMORPHONE HCL/PF INJECTION 250 MG VIAL
HYDROXYPROGESTERONE CAPROATE INTRAMUSC 250 MG/ML VIAL
HYDROXYPROPYL CELLULOSE OPHTHALMIC 5 MG INSERT
HYDROXYZINE HCL ORAL 10 MG TABLET
HYDROXYZINE HCL ORAL 10 MG/5 ML SOLUTION
HYDROXYZINE HCL ORAL 50 MG/25ML SOLUTION
HYDROXYZINE PAMOATE ORAL 100 MG CAPSULE
HYOSCYAMINE SULFATE ORAL 0.125 MG TAB RAPDIS
HYOSCYAMINE SULFATE ORAL 0.125 MG TABLET
HYOSCYAMINE SULFATE SUBLINGUAL 0.125 MG TAB SUBL
IBANDRONATE SODIUM INTRAVEN 3 MG/3 ML SYRINGE
IBANDRONATE SODIUM ORAL 150 MG TABLET
IBRUTINIB ORAL 140 MG CAPSULE
IBUPROFEN INTRAVEN 800MG/8ML VIAL
IBUPROFEN ORAL 100 MG/5ML ORAL SUSP
IBUPROFEN ORAL 400 MG TABLET
IBUPROFEN/FAMOTIDINE ORAL 800-26.6MG TABLET
IBUPROFEN/OXYCODONE HCL ORAL 400MG-5MG TABLET
ICOSAPENT ETHYL ORAL 1 G CAPSULE
IDARUCIZUMAB INTRAVEN 2.5 G/50ML VIAL
IDELALISIB ORAL 100 MG TABLET
IDELALISIB ORAL 150 MG TABLET
IFOSFAMIDE/MESNA INTRAVEN 1G-1G KIT
IFOSFAMIDE/MESNA INTRAVEN 3G-1G KIT
ILOPERIDONE ORAL 1 MG TABLET
ILOPERIDONE ORAL 1-2-4-6MG TAB DS PK
IMIGLUCERASE INTRAVEN 400 UNIT VIAL
IMIPENEM/CILASTATIN SODIUM INTRAVEN 250 MG VIAL
IMIPENEM/CILASTATIN SODIUM INTRAVEN 250 MG VIAL PORT
IMIPENEM/CILASTATIN SODIUM INTRAVEN 500 MG VIAL
IMIPENEM/CILASTATIN SODIUM INTRAVEN 500 MG VIAL PORT
IMIPRAMINE HCL ORAL 10 MG TABLET
IMIPRAMINE PAMOATE ORAL 100 MG CAPSULE
IMIQUIMOD TOPICAL 2.5 % CRM MD PMP
IMIQUIMOD TOPICAL 3.75 % CREAM PACK
IMIQUIMOD TOPICAL 3.75 % CRM MD PMP
12
Max
Unit
68
68
68
68
68
68
60
30
30
60
1
60
5
60
136
720
136
136
720
136
136
136
136
136
136
3
1
136
1088
240
136
136
136
102
68
136
100
68
68
5
1
68
68
68
8
68
68
68
68
5
224
224
112
112
102
102
102
68
68
68
68
15
28
15
Effective 7/1/2016
IMIQUIMOD TOPICAL 5 % CREAM PACK
INCOBOTULINUMTOXINA INTRAMUSC 100 UNIT VIAL
INDACATEROL MALEATE INHALATION 75 MCG CAP W/DEV
INDACATEROL/GLYCOPYRROLATE INHALATION 27.5-15.6 CAP W/DEV
INDAPAMIDE ORAL 1.25 MG TABLET
INDAPAMIDE ORAL 2.5 MG TABLET
INDOMETHACIN ORAL 25 MG CAPSULE
INDOMETHACIN ORAL 25 MG/5 ML ORAL SUSP
INDOMETHACIN ORAL 50 MG CAPSULE
INDOMETHACIN ORAL 75 MG CAPSULE ER
INDOMETHACIN RECTAL 50 MG SUPP.RECT
INDOMETHACIN SODIUM INTRAVEN 1 MG VIAL
INDOMETHACIN, SUBMICRONIZED ORAL 20 MG CAPSULE
INDOMETHACIN, SUBMICRONIZED ORAL 40 MG CAPSULE
INGENOL MEBUTATE TOPICAL 0.015 % GEL (EA)
INGENOL MEBUTATE TOPICAL 0.05 % GEL (EA)
INHALER, ASSIST DEVICES MISCELL SPACER
INHALER,ASSIST DEVICE,ACCESORY MISCELL EACH
INSULIN ADMIN. SUPPLIES SUB-Q INSULN PEN
INSULIN ASPART PROTAM & ASPART SUB-Q 70-30/ML INSULN PEN
INSULIN ASPART PROTAM & ASPART SUB-Q 70-30/ML VIAL
INSULIN ASPART SUB-Q 100/ML CARTRIDGE
INSULIN ASPART SUB-Q 100/ML INSULN PEN
INSULIN ASPART SUB-Q 100/ML VIAL
INSULIN DEGLUDEC SUB-Q 100/ML (3) INSULN PEN
INSULIN DEGLUDEC SUB-Q 200/ML (3) INSULN PEN
INSULIN DETEMIR SUB-Q 100/ML (3) INSULN PEN
INSULIN DETEMIR SUB-Q 100/ML VIAL
INSULIN GLARGINE,HUM.REC.ANLOG SUB-Q 100/ML (3) INSULN PEN
INSULIN GLARGINE,HUM.REC.ANLOG SUB-Q 100/ML VIAL
INSULIN GLARGINE,HUM.REC.ANLOG SUB-Q 300/ML INSULN PEN
INSULIN GLULISINE SUB-Q 100/ML INSULN PEN
INSULIN GLULISINE SUB-Q 100/ML VIAL
INSULIN LISPRO PROTAMIN/LISPRO SUB-Q 50-50/ML INSULN PEN
INSULIN LISPRO PROTAMIN/LISPRO SUB-Q 50-50/ML VIAL
INSULIN LISPRO PROTAMIN/LISPRO SUB-Q 75-25/ML INSULN PEN
INSULIN LISPRO PROTAMIN/LISPRO SUB-Q 75-25/ML VIAL
INSULIN LISPRO SUB-Q 100/ML CARTRIDGE
INSULIN LISPRO SUB-Q 100/ML INSULN PEN
INSULIN LISPRO SUB-Q 100/ML VIAL
INSULIN LISPRO SUB-Q 200/ML (3) INSULN PEN
INSULIN NPH HUM/REG INSULIN HM SUB-Q 70-30/ML INSULN PEN
INSULIN NPH HUM/REG INSULIN HM SUB-Q 70-30/ML VIAL
INSULIN NPH HUMAN ISOPHANE SUB-Q 100/ML (3) INSULN PEN
INSULIN NPH HUMAN ISOPHANE SUB-Q 100/ML VIAL
INSULIN REGULAR, HUMAN INJECTION 100/ML VIAL
INSULIN REGULAR, HUMAN SUB-Q 500/ML (3) INSULN PEN
INSULIN REGULAR, HUMAN SUB-Q 500/ML VIAL
INTERFERON ALFA-2B,RECOMB. INJECTION 10MM UNIT VIAL
INTERFERON ALFA-2B,RECOMB. INJECTION 10MM/ML VIAL
INTERFERON ALFA-2B,RECOMB. INJECTION 6MMUNIT/ML VIAL
INTERFERON BETA-1A/ALBUMIN SUB-Q 22MCG/.5ML PEN INJCTR
INTERFERON BETA-1A/ALBUMIN SUB-Q 22MCG/.5ML SYRINGE
INTERFERON BETA-1A/ALBUMIN SUB-Q 44MCG/.5ML PEN INJCTR
INTERFERON BETA-1A/ALBUMIN SUB-Q 8.8-22(6) PEN INJCTR
IPRATROPIUM BROMIDE INHALATION 0.2 MG/ML SOLUTION
IPRATROPIUM BROMIDE INHALATION 17MCG HFA AER AD
IPRATROPIUM BROMIDE NASAL 21 MCG SPRAY
IPRATROPIUM BROMIDE NASAL 42 MCG SPRAY
IPRATROPIUM/ALBUTEROL SULFATE INHALATION 0.5-3MG/3 AMPUL-NEB
Max
Unit
24
1
1
1
30
60
136
68
136
360
136
68
68
10
102
102
3
2
1
1
1
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
14
14
14
14
14
6
6
6
4.2
612
25.8
60
30
612
IPRATROPIUM/ALBUTEROL SULFATE INHALATION 20-100 MCG MIST INHAL
IRBESARTAN ORAL 150 MG TABLET
IRBESARTAN/HYDROCHLOROTHIAZIDE ORAL 150-12.5MG TABLET
IRBESARTAN/HYDROCHLOROTHIAZIDE ORAL 300-12.5MG TABLET
IRON,CARBONYL/FA/MULTIVIT-MIN ORAL 50-1.25MG TABLET
IRON,CARBONYL/VIT C/VIT B12/FA ORAL 100-250-1 TABLET
ISOCARBOXAZID ORAL 10 MG TABLET
ISOPROTERENOL HCL INJECTION 0.2 MG/ML AMPUL
ISOSORB DINIT/HYDRALAZINE HCL ORAL 20-37.5MG TABLET
ISOSORBIDE DINITRATE ORAL 10 MG TABLET
ISOSORBIDE DINITRATE ORAL 40 MG CAPSULE ER
ISOSORBIDE DINITRATE ORAL 40 MG TABLET ER
ISOSORBIDE MONONITRATE ORAL 10 MG TABLET
ISOSORBIDE MONONITRATE ORAL 120 MG TAB ER 24H
ISOSORBIDE MONONITRATE ORAL 20 MG TABLET
ISRADIPINE ORAL 2.5 MG CAPSULE
ISRADIPINE ORAL 5 MG CAPSULE
ITRACONAZOLE ORAL 10 MG/ML SOLUTION
ITRACONAZOLE ORAL 100 MG CAPSULE
ITRACONAZOLE ORAL 200 MG TABLET
IVABRADINE HCL ORAL 5 MG TABLET
IVABRADINE HCL ORAL 7.5 MG TABLET
IVACAFTOR ORAL 150 MG TABLET
IVACAFTOR ORAL 50 MG GRAN PACK
IVACAFTOR ORAL 75 MG GRAN PACK
IVERMECTIN TOPICAL 0.5 % LOTION
KETOCONAZOLE TOPICAL 2 % CREAM (G)
KETOCONAZOLE TOPICAL 2 % FOAM
KETOCONAZOLE TOPICAL 2 % SHAMPOO
KETOPROFEN ORAL 200 MG CAP24H PEL
KETOPROFEN ORAL 50 MG CAPSULE
KETOPROFEN ORAL 75 MG CAPSULE
KETOROLAC TROMETHAMINE INJECTION 15 MG/ML CARTRIDGE
KETOROLAC TROMETHAMINE INJECTION 15 MG/ML VIAL
KETOROLAC TROMETHAMINE INJECTION 30 MG/ML CARTRIDGE
KETOROLAC TROMETHAMINE INJECTION 30MG/ML(1) VIAL
KETOROLAC TROMETHAMINE INJECTION 30 MG/ML SYRINGE
KETOROLAC TROMETHAMINE INTRAMUSC 60 MG/2 ML VIAL
KETOROLAC TROMETHAMINE INTRAMUSC 60 MG/2 ML SYRINGE
KETOROLAC TROMETHAMINE NASAL 15.75 MG SPRAY
KETOROLAC TROMETHAMINE OPHTHALMIC 0.4 % DROPS
KETOROLAC TROMETHAMINE OPHTHALMIC 0.5 % DROPS
KETOROLAC TROMETHAMINE ORAL 10 MG TABLET
KETOROLAC TROMETHAMINE/PF OPHTHALMIC 0.45 % DROPERETTE
KIT FOR Y-90/IBRITUMOMAB/ALBUM INTRAVEN 3.2MG/2ML KIT
LABETALOL HCL INTRAVEN 5 MG/ML VIAL
LABETALOL HCL ORAL 100 MG TABLET
LACTULOSE ORAL 10 G PACKET
LACTULOSE ORAL 10 G/15 ML SOLUTION
LACTULOSE ORAL 20 G PACKET
LANREOTIDE ACETATE SUB-Q 120MG/0.5 SYRINGE
LANREOTIDE ACETATE SUB-Q 60MG/0.2ML SYRINGE
LANREOTIDE ACETATE SUB-Q 90MG/0.3ML SYRINGE
LANSOPRAZOLE ORAL 15 MG CAPSULE DR
13
Max
Unit
4
68
34
136
68
34
34
34
204
10
204
816
272
272
102
204
102
1088
272
34
272
170
136
272
136
680
68
34
68
68
68
68
68
117
180
100
240
34
136
136
2
2
1
1
1
2
1
5
5
20
20
30
1
40
816
408
272
30
5100
60
0.5
0.2
0.3
68
Effective 7/1/2016
LANSOPRAZOLE ORAL 15 MG TAB RAP DR
LANSOPRAZOLE ORAL 30 MG CAPSULE DR
LANSOPRAZOLE ORAL 30 MG TAB RAP DR
LANSOPRAZOLE/AMOXICILN/CLARITH ORAL 30-500-500 COMBO. PKG
LEFLUNOMIDE ORAL 10 MG TABLET
LEFLUNOMIDE ORAL 20 MG TABLET
LENALIDOMIDE ORAL 10 MG CAPSULE
LENALIDOMIDE ORAL 2.5 MG CAPSULE
LENVATINIB MESYLATE ORAL 10 MG/DAY CAPSULE
LEUPROLIDE ACETATE INTRAMUSC 15 MG KIT
LEUPROLIDE ACETATE INTRAMUSC 7.5 MG KIT
LEUPROLIDE ACETATE INTRAMUSC 11.25 MG KIT
LEUPROLIDE ACETATE INTRAMUSC 11.25 MG SYRINGEKIT
LEUPROLIDE ACETATE INTRAMUSC 30 MG SYRINGEKIT
LEUPROLIDE ACETATE INTRAMUSC 45 MG SYRINGEKIT
LEUPROLIDE ACETATE SUB-Q 1 MG/0.2ML KIT
LEUPROLIDE ACETATE SUB-Q 22.5 MG SYRINGE
LEUPROLIDE ACETATE SUB-Q 30 MG SYRINGE
LEUPROLIDE ACETATE SUB-Q 45 MG SYRINGE
LEUPROLIDE ACETATE SUB-Q 7.5 MG SYRINGE
LEUPROLIDE/NORETHINDRONE ACET MISCELL 11.25-5 MG KT SYR TAB
LEUPROLIDE/NORETHINDRONE ACET MISCELL 3.75MG-5MG KT SYR TAB
LEVALBUTEROL HCL INHALATION 0.31MG/3ML VIAL-NEB
LEVALBUTEROL HCL INHALATION 1.25MG/0.5 VIAL-NEB
LEVALBUTEROL TARTRATE INHALATION 45 MCG HFA AER AD
LEVOCETIRIZINE DIHYDROCHLORIDE ORAL 2.5 MG/5ML SOLUTION
LEVOCETIRIZINE DIHYDROCHLORIDE ORAL 5 MG TABLET
LEVOFLOXACIN INTRAVEN 25 MG/ML VIAL
LEVOFLOXACIN OPHTHALMIC 0.5 % DROPS
LEVOFLOXACIN ORAL 250 MG TABLET
LEVOFLOXACIN ORAL 250MG/10ML SOLUTION
LEVOFLOXACIN/D5W INTRAVEN 250MG/50ML PIGGYBACK
LEVOFLOXACIN/D5W INTRAVEN 500MG/0.1L PIGGYBACK
LEVOFLOXACIN/D5W INTRAVEN 750MG/.15L PIGGYBACK
LEVOMILNACIPRAN HYDROCHLORIDE ORAL 120 MG CAP SA 24H
LEVOMILNACIPRAN HYDROCHLORIDE ORAL 20-40MG CAP24HDSPK
LEVONORGESTREL-ETHIN ESTRADIOL ORAL 0.1-0.02 TABLET
LEVONORGESTREL-ETHIN ESTRADIOL ORAL 0.15-0.03 TABLET
LEVONORGESTREL-ETHIN ESTRADIOL ORAL 6-5-10 TABLET
LEVONORGESTREL-ETHIN ESTRADIOL ORAL 90-20MCG TABLET
LEVORPHANOL TARTRATE ORAL 2 MG TABLET
LIDOCAINE HCL TOPICAL 3 % CREAM (G)
LIDOCAINE HCL TOPICAL 4 % SOLUTION
LIDOCAINE HCL/PF OPHTHALMIC 3.5 % GEL (ML)
LIDOCAINE TOPICAL 5 % ADH. PATCH
LIDOCAINE TOPICAL 5 % OINT. (G)
LIDOCAINE/HYDROCORTISONE AC RECTAL 3 %-0.5 % CREAM (G)
LIDOCAINE/HYDROCORTISONE AC RECTAL 3 %-0.5 % CREAM/APPL
Max
Unit
34
34
34
112
34
46
34
34
34
34
34
34
30
60
60
90
1
1
1
1
1
1
1
1
2
1
1
1
1
1
1
288
288
90
288
30
340
34
840
5
84
480
56
28
4200
4200
4200
34
34
28
34
34
28
28
28
28
136
85
8
10
90
50
98
98
LIDOCAINE/HYDROCORTISONE AC RECTAL 3 %-0.5 % KIT
LIDOCAINE/HYDROCORTISONE AC RECTAL 3%-1%(7 G) CREAM/APPL
LIDOCAINE/HYDROCORTISONE AC RECTAL 3%-1%(7 G) KIT
LIDOCAINE/HYDROCORTISONE AC RECTAL 3-2.5%(7G) GEL W/APPL
LIDOCAINE/HYDROCORTISONE AC TOPICAL 3 %-0.5 % CREAM (G)
LIDOCAINE/PRILO W/0.9 % NACL MISCELL 2.5 %-2.5% KIT
LIDOCAINE/PRILOCAINE TOPICAL 2.5 %-2.5% CREAM (G)
LIDOCAINE/PRILOCAINE TOPICAL 2.5 %-2.5% KIT
LIDOCAINE/TETRACAINE TOPICAL 70 MG-70MG M.HT PATCH
LINACLOTIDE ORAL 145 MCG CAPSULE
LINACLOTIDE ORAL 290 MCG CAPSULE
LINAGLIPTIN ORAL 5 MG TABLET
LINAGLIPTIN/METFORMIN HCL ORAL 2.5-1000MG TABLET
LINAGLIPTIN/METFORMIN HCL ORAL 2.5-500 MG TABLET
LINAGLIPTIN/METFORMIN HCL ORAL 2.5-850 MG TABLET
LINDANE TOPICAL 1 % LOTION
LINDANE TOPICAL 1 % SHAMPOO
LINEZOLID INTRAVEN 200MG/0.1L IV SOLN
LINEZOLID INTRAVEN 600MG/300 IV SOLN
LINEZOLID ORAL 100 MG/5ML SUSP RECON
LINEZOLID ORAL 600 MG TABLET
LINEZOLID-0.9% SODIUM CHLORIDE INTRAVEN 600MG/300 IV SOLN
LIRAGLUTIDE SUB-Q 0.6MG/0.1 PEN INJCTR
LISDEXAMFETAMINE DIMESYLATE ORAL 50 MG CAPSULE
LISDEXAMFETAMINE DIMESYLATE ORAL 70 MG CAPSULE
LISINOPRIL ORAL 10 MG TABLET
LISINOPRIL ORAL 2.5 MG TABLET
LISINOPRIL/HYDROCHLOROTHIAZIDE ORAL 10-12.5MG TABLET
LISINOPRIL/HYDROCHLOROTHIAZIDE ORAL 20 MG-25MG TABLET
LISINOPRIL/HYDROCHLOROTHIAZIDE ORAL 20-12.5 MG TABLET
LODOXAMIDE TROMETHAMINE OPHTHALMIC 0.1 % DROPS
LOMITAPIDE MESYLATE ORAL 10 MG CAPSULE
LOPERAMIDE HCL ORAL 2 MG CAPSULE
LORATADINE ORAL 10 MG TAB RAPDIS
LORATADINE ORAL 10 MG TABLET
LORATADINE ORAL 5 MG/5 ML SOLUTION
LORAZEPAM INJECTION 2 MG/ML VIAL
LORAZEPAM INJECTION 4 MG/ML VIAL
LORAZEPAM INJECTION 2 MG/ML SYRINGE
LORAZEPAM INJECTION 4 MG/ML SYRINGE
LORAZEPAM ORAL 0.5 MG TABLET
LORAZEPAM ORAL 1 MG TABLET
LORAZEPAM ORAL 2 MG TABLET
LORAZEPAM ORAL 2 MG/ML ORAL CONC
LOSARTAN POTASSIUM ORAL 100 MG TABLET
LOSARTAN/HYDROCHLOROTHIAZIDE ORAL 100-12.5MG TABLET
LOSARTAN/HYDROCHLOROTHIAZIDE ORAL 100MG-25MG TABLET
LOSARTAN/HYDROCHLOROTHIAZIDE ORAL 50-12.5 MG TABLET
LOVASTATIN ORAL 10 MG TABLET
LOVASTATIN ORAL 20 MG TAB ER 24H
14
Max
Unit
1
14
1
140
85
1
60
1
1
34
34
34
68
68
68
180
180
16800
33600
3360
112
33600
9
34
34
136
544
68
34
68
272
136
68
136
30
34
34
34
34
34
34
68
34
34
360
5
5
5
5
136
136
136
120
34
136
68
34
34
68
68
34
68
34
68
Effective 7/1/2016
LOXAPINE INHALATION 10 MG AER POW BA
LOXAPINE SUCCINATE ORAL 10 MG CAPSULE
LUBIPROSTONE ORAL 24MCG CAPSULE
LUBIPROSTONE ORAL 8 MCG CAPSULE
LULICONAZOLE TOPICAL 1 % CREAM (G)
LUMACAFTOR/IVACAFTOR ORAL 200-125MG TABLET
LURASIDONE HCL ORAL 120 MG TABLET
MACITENTAN ORAL 10 MG TABLET
MAFENIDE ACETATE TOPICAL 50 G PACKET
MAFENIDE ACETATE TOPICAL 8.5 % CREAM (G)
MALATHION TOPICAL 0.5 % LOTION
MAPROTILINE HCL ORAL 25 MG TABLET
MECAMYLAMINE HCL ORAL 2.5 MG TABLET
MECLIZINE HCL ORAL 12.5 MG TABLET
MECLIZINE HCL ORAL 25 MG TABLET
MECLOFENAMATE SODIUM ORAL 100 MG CAPSULE
MECLOFENAMATE SODIUM ORAL 50 MG CAPSULE
MEDROXYPROGESTERONE ACETATE INTRAMUSC 150 MG/ML SYRINGE
MEDROXYPROGESTERONE ACETATE INTRAMUSC 150 MG/ML VIAL
MEDROXYPROGESTERONE ACETATE INTRAMUSC 400 MG/ML VIAL
MEDROXYPROGESTERONE ACETATE SUB-Q 104MG/0.65 SYRINGE
MEFENAMIC ACID ORAL 250 MG CAPSULE
MEGESTROL ACETATE ORAL 625MG/5ML ORAL SUSP
MELOXICAM ORAL 15 MG TABLET
MELOXICAM ORAL 7.5 MG TABLET
MELOXICAM ORAL 7.5 MG/5ML ORAL SUSP
MELOXICAM, SUBMICRONIZED ORAL 10 MG CAPSULE
MELOXICAM, SUBMICRONIZED ORAL 5 MG CAPSULE
MEMANTINE HCL ORAL 10 MG TABLET
MEMANTINE HCL ORAL 14 MG CAP SPR 24
MEMANTINE HCL ORAL 2 MG/ML SOLUTION
MEMANTINE HCL ORAL 5 MG TABLET
MEMANTINE HCL ORAL 5 MG-10 MG TAB DS PK
MEMANTINE HCL ORAL 7-14-21-28 CAP24 DSPK
MEMANTINE HCL/DONEPEZIL HCL ORAL 14MG-10MG CAP SPR 24
MEMANTINE HCL/DONEPEZIL HCL ORAL 28 MG-10MG CAP SPR 24
MENING VAC A,C,Y,W-135 DIP/PF INTRAMUSC 4MCG/0.5ML VIAL
MEPERIDINE HCL INJECTION 10 MG/ML CARTRIDGE
MEPERIDINE HCL INJECTION 100 MG/ML VIAL
MEPERIDINE HCL INJECTION 50 MG/ML VIAL
MEPERIDINE HCL ORAL 100 MG TABLET
MEPERIDINE HCL ORAL 50 MG TABLET
MEPERIDINE HCL ORAL 50 MG/5 ML SOLUTION
MEPERIDINE HCL/PF INJECTION 100 MG/2ML AMPUL
MEPERIDINE HCL/PF INJECTION 100 MG/ML AMPUL
MEPERIDINE HCL/PF INJECTION 100 MG/ML VIAL
MEPERIDINE HCL/PF INJECTION 25MG/0.5ML AMPUL
MEPERIDINE HCL/PF INJECTION 50 MG/ML AMPUL
MEPERIDINE HCL/PF INJECTION 75MG/1.5ML AMPUL
Max
Unit
34
34
102
102
102
102
68
68
120
136
34
34
34
34
34
34
50
453.6
180
102
102
102
340
136
136
136
272
1
1
2.5
0.65
42
170
34
34
340
34
34
68
34
360
34
34
68
49
34
28
34
34
0.5
30
30
30
68
68
480
30
30
30
30
30
30
30
30
MEPERIDINE HCL/PF INJECTION 100 MG/ML SYRINGE
MEPOLIZUMAB SUB-Q 100 MG VIAL
MEPROBAMATE ORAL 200 MG TABLET
MEPROBAMATE ORAL 400 MG TABLET
MEROPENEM INTRAVEN 1 G VIAL
MEROPENEM INTRAVEN 500 MG VIAL
MESALAMINE ORAL 0.375G CAP ER 24H
MESALAMINE ORAL 400 MG CAPSULE DR
METAPROTERENOL SULFATE ORAL 10 MG TABLET
METAPROTERENOL SULFATE ORAL 10 MG/5 ML SYRUP
METAPROTERENOL SULFATE ORAL 20 MG TABLET
METAXALONE ORAL 400 MG TABLET
METAXALONE ORAL 800 MG TABLET
METFORMIN HCL ORAL 1000 MG TAB ER 24
METFORMIN HCL ORAL 1000 MG TABERGR24H
METFORMIN HCL ORAL 1000 MG TABLET
METFORMIN HCL ORAL 500 MG TAB ER 24
METFORMIN HCL ORAL 500 MG TAB ER 24H
METFORMIN HCL ORAL 500 MG TABERGR24H
METFORMIN HCL ORAL 500 MG/5ML SOLUTION
METFORMIN HCL ORAL 750 MG TAB ER 24H
METHADONE HCL INJECTION 10 MG/ML VIAL
METHADONE HCL ORAL 10 MG TABLET
METHADONE HCL ORAL 10 MG/5 ML SOLUTION
METHADONE HCL ORAL 10 MG/ML ORAL CONC
METHADONE HCL ORAL 40 MG TABLET SOL
METHADONE HCL ORAL 5 MG TABLET
METHADONE HCL ORAL 5 MG/5 ML SOLUTION
METHAMPHETAMINE HCL ORAL 5 MG TABLET
METHOCARBAMOL INJECTION 100 MG/ML VIAL
METHOCARBAMOL ORAL 500 MG TABLET
METHOCARBAMOL ORAL 750 MG TABLET
METHOHEXITAL SODIUM INJECTION 2.5 G VIAL
METHOHEXITAL SODIUM INJECTION 500 MG VIAL
METHOTREXATE/PF SUB-Q 10MG/0.4ML AUTO INJCT
METHOTREXATE/PF SUB-Q 12.5/0.25 AUTO INJCT
METHOTREXATE/PF SUB-Q 17.5MG/0.4 AUTO INJCT
METHOTREXATE/PF SUB-Q 22.5MG/0.4 AUTO INJCT
METHOTREXATE/PF SUB-Q 7.5 MG/0.4 AUTO INJCT
METHYCLOTHIAZIDE ORAL 5 MG TABLET
METHYLDOPA ORAL 250 MG TABLET
METHYLDOPA ORAL 500 MG TABLET
METHYLDOPA/HYDROCHLOROTHIAZIDE ORAL 250MG-15MG TABLET
METHYLDOPA/HYDROCHLOROTHIAZIDE ORAL 250MG-25MG TABLET
METHYLDOPATE HCL INTRAVEN 250 MG/5ML VIAL
METHYLNALTREXONE BROMIDE SUB-Q 12MG/0.6ML SYRINGE
METHYLNALTREXONE BROMIDE SUB-Q 12MG/0.6ML VIAL
METHYLNALTREXONE BROMIDE SUB-Q 8 MG/0.4ML SYRINGE
METHYLPHENIDATE HCL ORAL 10 MG CPBP 30-70
METHYLPHENIDATE HCL ORAL 10 MG CSBP 40-60
METHYLPHENIDATE HCL ORAL 10 MG TAB CHEW
METHYLPHENIDATE HCL ORAL 10 MG TABLET
15
Max
Unit
30
30
30
30
1
102
102
84
168
136
204
102
480
68
40
40
68
68
68
136
136
136
170
850
68
102
90
68
480
120
34
68
480
102
10
60
60
4
10
1.6
1
1.2
1.6
1.6
1.6
1.6
1.6
2
2.4
1.6
34
816
408
408
408
100
20.4
20.4
13.6
34
34
34
102
102
Effective 7/1/2016
METHYLPHENIDATE HCL ORAL 10 MG TABLET ER
METHYLPHENIDATE HCL ORAL 10 MG/5 ML SOLUTION
METHYLPHENIDATE HCL ORAL 18 MG TAB ER 24
METHYLPHENIDATE HCL ORAL 2.5 MG TAB CHEW
METHYLPHENIDATE HCL ORAL 20 MG TAB CBP24H
METHYLPHENIDATE HCL ORAL 20 MG TABLET ER
METHYLPHENIDATE HCL ORAL 5 MG TAB CHEW
METHYLPHENIDATE HCL ORAL 5 MG/5 ML SOLUTION
METHYLPHENIDATE HCL ORAL 5 MG/ML SU ER RC24
METHYLPHENIDATE TRANSDERM 10MG/9HR PATCH TD24
METHYLPHENIDATE TRANSDERM 20 MG/9 HR PATCH TD24
METOCLOPRAMIDE HCL INJECTION 5 MG/ML VIAL
METOCLOPRAMIDE HCL INJECTION 10 MG/2 ML SYRINGE
METOCLOPRAMIDE HCL ORAL 10 MG TABLET
METOCLOPRAMIDE HCL ORAL 5 MG TABLET
METOCLOPRAMIDE HCL ORAL 5 MG/5 ML SOLUTION
METOLAZONE ORAL 10 MG TABLET
METOLAZONE ORAL 2.5 MG TABLET
METOLAZONE ORAL 5 MG TABLET
METOPROLOL SUCCINATE ORAL 100 MG TAB ER 24H
METOPROLOL SUCCINATE/HCTZ ORAL 100-12.5MG TAB ER 24H
METOPROLOL SUCCINATE/HCTZ ORAL 25-12.5 MG TAB ER 24H
METOPROLOL SUCCINATE/HCTZ ORAL 50-12.5 MG TAB ER 24H
METOPROLOL TARTRATE INTRAVEN 5 MG/5 ML AMPUL
METOPROLOL TARTRATE INTRAVEN 5 MG/5 ML VIAL
METOPROLOL TARTRATE INTRAVEN 5 MG/5 ML SYRINGE
METOPROLOL TARTRATE ORAL 100 MG TABLET
METOPROLOL TARTRATE ORAL 37.5 MG TABLET
METOPROLOL/HYDROCHLOROTHIAZIDE ORAL 100MG-25MG TABLET
METOPROLOL/HYDROCHLOROTHIAZIDE ORAL 100MG-50MG TABLET
METOPROLOL/HYDROCHLOROTHIAZIDE ORAL 50 MG-25MG TABLET
METRONIDAZOLE VAGINAL 0.75 % GEL W/APPL
METRONIDAZOLE VAGINAL 1.3 % GEL W/APPL
MEXILETINE HCL ORAL 150 MG CAPSULE
Max
Unit
102
510
34
34
102
68
34
34
34
102
102
34
68
34
34
34
68
34
34
34
34
102
102
510
360
34
34
34
34
34
34
30
30
30
30
30
30
136
136
960
68
272
136
68
34
102
102
102
204
204
10
40
40
170
612
102
340
102
102
102
204
70
5
170
MICONAZOLE BUCCAL 50 MG MA BUC TAB
MICONAZOLE NITRATE VAGINAL 200 MG SUPP.VAG
MICONAZOLE NITRATE/ZINC OX/PET TOPICAL 0.25 %-15% OINT. (G)
MIDAZOLAM HCL INJECTION 1 MG/ML VIAL
MIDAZOLAM HCL INJECTION 5 MG/ML VIAL
MIDAZOLAM HCL ORAL 2 MG/ML SYRUP
MIDAZOLAM HCL/PF INJECTION 2 MG/2 ML SYRINGE
MIDAZOLAM HCL/PF INJECTION 5 MG/ML SYRINGE
MIFEPRISTONE ORAL 300 MG TABLET
MIGLITOL ORAL 100 MG TABLET
MIGLUSTAT ORAL 100 MG CAPSULE
MILNACIPRAN HCL ORAL 100 MG TABLET
MILNACIPRAN HCL ORAL 12.5 MG TABLET
MILNACIPRAN HCL ORAL 12.5-25-50 TAB DS PK
MINOXIDIL ORAL 10 MG TABLET
MINOXIDIL ORAL 2.5 MG TABLET
MIPOMERSEN SODIUM SUB-Q 200 MG/ML SYRINGE
MIRABEGRON ORAL 25 MG TAB ER 24H
MIRABEGRON ORAL 50 MG TAB ER 24H
MIRTAZAPINE ORAL 15 MG TAB RAPDIS
MIRTAZAPINE ORAL 15 MG TABLET
MIRTAZAPINE ORAL 7.5 MG TABLET
MISOPROSTOL ORAL 100 MCG TABLET
MISOPROSTOL ORAL 200 MCG TABLET
MODAFINIL ORAL 100 MG TABLET
MODAFINIL ORAL 200 MG TABLET
MOEXIPRIL HCL ORAL 15 MG TABLET
MOEXIPRIL HCL ORAL 7.5 MG TABLET
MOEXIPRIL/HYDROCHLOROTHIAZIDE ORAL 15-12.5MG TABLET
MOEXIPRIL/HYDROCHLOROTHIAZIDE ORAL 15-25MG TABLET
MOEXIPRIL/HYDROCHLOROTHIAZIDE ORAL 7.5-12.5MG TABLET
MOLINDONE HCL ORAL 10 MG TABLET
MOMETASONE FUROATE INHALATION 100 MCG HFA AER AD
MOMETASONE FUROATE INHALATION 110 MCG(7) AER POW BA
MOMETASONE FUROATE INHALATION 110MCG(30) AER POW BA
MOMETASONE FUROATE INHALATION 200 MCG HFA AER AD
MOMETASONE FUROATE INHALATION 220MCG 120 AER POW BA
MOMETASONE FUROATE NASAL 50 MCG SPRAY/PUMP
MOMETASONE FUROATE TOPICAL 0.1 % CREAM (G)
MOMETASONE FUROATE TOPICAL 0.1 % OINT. (G)
MOMETASONE FUROATE TOPICAL 0.1 % SOLUTION
MOMETASONE/FORMOTEROL INHALATION 100-5 MCG HFA AER AD
MOMETASONE/FORMOTEROL INHALATION 200-5 MCG HFA AER AD
MONTELUKAST SODIUM ORAL 10 MG TABLET
MONTELUKAST SODIUM ORAL 4 MG GRAN PACK
MONTELUKAST SODIUM ORAL 4 MG TAB CHEW
MONTELUKAST SODIUM ORAL 5 MG TAB CHEW
MORPHINE SULFATE INJECTION 10 MG/ML VIAL
16
Max
Unit
170
170
14
3
60
8
8
118
8
8
136
102
102
102
102
68
68
55
68
68
340
340
4
34
34
34
34
34
34
34
34
34
136
136
68
34
68
136
68
68
136
102
102
102
13
4
1
13
1
2
1
1
17
180
180
180
13
13
34
34
34
34
40
40
Effective 7/1/2016
MORPHINE SULFATE INJECTION 10 MG/ML SYRINGE
MORPHINE SULFATE INTRAVEN 10 MG/ML VIAL
MORPHINE SULFATE INTRAVEN 100 MG/4ML VIAL PORT
MORPHINE SULFATE INTRAVEN 2 MG/ML CARTRIDGE
MORPHINE SULFATE INTRAVEN 2 MG/ML SYRINGE
MORPHINE SULFATE INTRAVEN 250MG/10ML VIAL PORT
MORPHINE SULFATE INTRAVEN 30 MG/30ML PCA SYRING
MORPHINE SULFATE INTRAVEN 4 MG/ML SYRINGE
MORPHINE SULFATE INTRAVEN 8 MG/ML CARTRIDGE
MORPHINE SULFATE ORAL 10 MG CAP ER PEL
MORPHINE SULFATE ORAL 10 MG/5 ML SOLUTION
MORPHINE SULFATE ORAL 100 MG TABLET ER
MORPHINE SULFATE ORAL 100 MG/5ML SOLUTION
MORPHINE SULFATE ORAL 120 MG CPMP 24HR
MORPHINE SULFATE ORAL 15 MG TABLET
MORPHINE SULFATE ORAL 20 MG/5 ML SOLUTION
MORPHINE SULFATE ORAL 30 MG TABLET
MORPHINE SULFATE RECTAL 10 MG SUPP.RECT
MORPHINE SULFATE/NALTREXONE ORAL 100MG-4MG CAP ER PO
MORPHINE SULFATE/NALTREXONE ORAL 20MG-0.8MG CAP ER PO
MORPHINE SULFATE/NALTREXONE ORAL 50 MG-2 MG CAP ER PO
MORPHINE SULFATE/PF INJECTION 0.5 MG/ML AMPUL
MORPHINE SULFATE/PF INJECTION 0.5 MG/ML VIAL
MORPHINE SULFATE/PF INJECTION 1 MG/ML AMPUL
MORPHINE SULFATE/PF INJECTION 1 MG/ML VIAL
MORPHINE SULFATE/PF INTRAVEN 150MG/30ML PCA VIAL
MORPHINE SULFATE/PF INTRAVEN 30 MG/30ML PCA VIAL
MOXIFLOXACIN HCL OPHTHALMIC 0.5 % DROPS
MOXIFLOXACIN HCL ORAL 400 MG TABLET
MOXIFLOXACIN IN NACL (ISO-OSM) INTRAVEN 400MG/.25L PIGGYBACK
MUCOSITIS AND STOMATITIS COMB1 ORAL WAFER
Max
Unit
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
40
68
480
68
68
300
34
68
68
68
300
68
68
68
34
68
68
68
34
68
68
34
68
34
68
34
68
68
68
68
68
68
68
68
68
68
40
40
40
40
40
40
40
40
3
40
10500
90
17
MUPIROCIN CALCIUM NASAL 2 % OINT. (G)
MUPIROCIN CALCIUM TOPICAL 2 % CREAM (G)
MUPIROCIN TOPICAL 2 % KIT
MUPIROCIN TOPICAL 2 % OINT. (G)
NABILONE ORAL 1 MG CAPSULE
NABUMETONE ORAL 500 MG TABLET
NABUMETONE ORAL 750 MG TABLET
NADOLOL ORAL 20 MG TABLET
NADOLOL/BENDROFLUMETHIAZIDE ORAL 40 MG-5 MG TABLET
NADOLOL/BENDROFLUMETHIAZIDE ORAL 80 MG-5 MG TABLET
NAFTIFINE HCL TOPICAL 1 % CREAM (G)
NAFTIFINE HCL TOPICAL 1 % GEL (GRAM)
NAFTIFINE HCL TOPICAL 2 % CREAM (G)
NAFTIFINE HCL TOPICAL 2 % GEL (GRAM)
NALBUPHINE HCL INJECTION 10 MG/ML AMPUL
NALBUPHINE HCL INJECTION 10 MG/ML VIAL
NALBUPHINE HCL INJECTION 20 MG/ML AMPUL
NALBUPHINE HCL INJECTION 20 MG/ML VIAL
NALOXEGOL OXALATE ORAL 12.5 MG TABLET
NALOXEGOL OXALATE ORAL 25 MG TABLET
NALOXONE HCL INJECTION 0.4 MG/ML VIAL
NALOXONE HCL NASAL 4 MG SPRAY
NAPHAZOLINE HCL OPHTHALMIC 0.1 % DROPS
NAPROXEN ORAL 125 MG/5ML ORAL SUSP
NAPROXEN ORAL 250 MG TABLET
NAPROXEN ORAL 375 MG TABLET DR
NAPROXEN ORAL 500 MG TABLET DR
NAPROXEN SODIUM ORAL 275 MG TABLET
NAPROXEN SODIUM ORAL 375 MG TBMP 24HR
NAPROXEN SODIUM ORAL 550 MG TABLET
NAPROXEN/ESOMEPRAZOLE MAG ORAL 375MG-20MG TAB IR DR
NAPROXEN/ESOMEPRAZOLE MAG ORAL 500MG-20MG TAB IR DR
NARATRIPTAN HCL ORAL 1 MG TABLET
NARATRIPTAN HCL ORAL 2.5 MG TABLET
NATEGLINIDE ORAL 120 MG TABLET
NATEGLINIDE ORAL 60 MG TABLET
NEBIVOLOL HCL ORAL 10 MG TABLET
NEBIVOLOL HCL ORAL 2.5 MG TABLET
NEDOCROMIL SODIUM OPHTHALMIC 2 % DROPS
NEFAZODONE HCL ORAL 100 MG TABLET
NEO/POLYMYX B SULF/DEXAMETH OPHTHALMIC 0.1 % DROPS SUSP
NEO/POLYMYX B SULF/DEXAMETH OPHTHALMIC 3.5-10K-.1 OINT. (G)
NEOMYCIN SU/BACI ZN/POLY/HC OPHTHALMIC 3.5-10K-1 OINT. (G)
NEOMYCIN SU/BACITRA/POLYMYXIN OPHTHALMIC 3.5MG-400 OINT. (G)
NEOMYCIN SU/COLIST/HC/THONZON OTIC 3.3-3-10/1 DROPS SUSP
NEOMYCIN SU/POLYMYX B SULF IRRIGATION 40-200K/ML AMPUL
NEOMYCIN SU/POLYMYX B SULF IRRIGATION 40-200K/ML VIAL
NEOMYCIN/BACITRA/POLYMYXIN/HC TOPICAL 1 % OINT. (G)
NEOMYCIN/POLYMYXIN B SULF/HC OPHTHALMIC 3.5-10K-10 DROPS SUSP
NEOMYCIN/POLYMYXIN B SULF/HC OTIC 3.5-10K-1 DROPS SUSP
NEOMYCIN/POLYMYXIN B SULF/HC OTIC 3.5-10K-1 SOLUTION
NEOMYCIN/POLYMYXIN B SULF/HC TOPICAL 0.5 % CREAM (G)
Max
Unit
10
60
1
66
60
68
68
544
272
136
68
34
180
180
180
180
40
40
40
40
34
34
1
1
30
120
102
68
68
68
68
68
68
68
68
34
68
68
10
10
102
102
136
136
68
136
15
68
68
102
68
68
5
3.5
3.5
3.5
10
40
40
60
7.5
10
10
60
Effective 7/1/2016
NEOMYCIN/POLYMYXN B/GRAMICIDIN OPHTHALMIC 1.75MG-10K DROPS
NEPAFENAC OPHTHALMIC 0.1 % DROPS SUSP
NEPAFENAC OPHTHALMIC 0.3 % DROPS SUSP
NETUPITANT/PALONOSETRON HCL ORAL 300-0.5 MG CAPSULE
NIACIN ORAL 1000 MG TAB ER 24H
NIACIN ORAL 500 MG TABLET
NICARDIPINE HCL INTRAVEN 25 MG/10ML AMPUL
NICARDIPINE HCL ORAL 20 MG CAPSULE
NICARDIPINE HCL ORAL 30 MG CAPSULE
NIFEDIPINE ORAL 10 MG CAPSULE
NIFEDIPINE ORAL 20 MG CAPSULE
NIFEDIPINE ORAL 30 MG TAB ER 24
NIFEDIPINE ORAL 30 MG TABLET ER
NIMODIPINE ORAL 30 MG CAPSULE
NIMODIPINE ORAL 60 MG/20ML SOLUTION
NINTEDANIB ESYLATE ORAL 100 MG CAPSULE
NINTEDANIB ESYLATE ORAL 150 MG CAPSULE
NISOLDIPINE ORAL 17 MG TAB ER 24H
NISOLDIPINE ORAL 25.5 MG TAB ER 24H
NISOLDIPINE ORAL 8.5MG TAB ER 24H
NITAZOXANIDE ORAL 100 MG/5ML SUSP RECON
NITAZOXANIDE ORAL 500 MG TABLET
NITROGLYCERIN RECTAL 0.4% (W/W) OINT. (G)
NITROGLYCERIN SUBLINGUAL 0.3 MG TAB SUBL
NITROGLYCERIN TRANSDERM 0.1MG/HR PATCH TD24
NITROGLYCERIN TRANSDERM 2 % OINT. (G)
NITROGLYCERIN TRANSDERM 0.3 MG/HR PATCH TD24
NITROGLYCERIN TRANSLING 400MCG/SPR SPRAY
NITROGLYCERIN TRANSLING 400MCG/SPR SPRAY
NITROGLYCERIN/D5W INTRAVEN 50MG/250ML INFUS. BTL
NIZATIDINE ORAL 150 MG CAPSULE
NIZATIDINE ORAL 150MG/10ML SOLUTION
NIZATIDINE ORAL 300 MG CAPSULE
NORELGESTROMIN/ETHIN.ESTRADIOL TRANSDERM 150-35/24H PATCH
TDWK
NORETH-ETHINYL ESTRADIOL/IRON ORAL 0.4-35(21) TAB CHEW
NORETH-ETHINYL ESTRADIOL/IRON ORAL 0.8-25(24) TAB CHEW
NORETHINDRONE AC-ETH ESTRADIOL ORAL 0.5MG-2.5 TABLET
NORETHINDRONE AC-ETH ESTRADIOL ORAL 1.5-0.03MG TABLET
NORETHINDRONE AC-ETH ESTRADIOL ORAL 1MG-20MCG TABLET
NORETHINDRONE AC-ETH ESTRADIOL ORAL 1MG-5MCG TABLET
NORETHINDRONE ORAL 0.35 MG TABLET
NORETHINDRONE-E.ESTRADIOL-IRON ORAL 1.5-30(21) TABLET
NORETHINDRONE-E.ESTRADIOL-IRON ORAL 1MG-10(24) TABLET
NORETHINDRONE-E.ESTRADIOL-IRON ORAL 1MG-20(24) TAB CHEW
NORETHINDRONE-E.ESTRADIOL-IRON ORAL 5-7-9-7 TABLET
Max
Unit
10
6
3.4
2
68
136
408
68
40
204
136
204
136
204
272
102
136
68
68
68
2520
68
68
136
136
68
68
34
34
272
150
6
30
100
100
100
68
68
68
68
68
120
68
8.5
12
40
68
680
34
NORETHINDRONE-ETHINYL ESTRAD ORAL 0.4-0.035 TABLET
NORETHINDRONE-ETHINYL ESTRAD ORAL 0.5-0.035 TABLET
NORETHINDRONE-ETHINYL ESTRAD ORAL 1 MG-35MCG TABLET
NORETHINDRONE-ETHINYL ESTRAD ORAL 10-11 TABLET
NORETHINDRONE-ETHINYL ESTRAD ORAL 7 DAYS X 3 TABLET
NORETHINDRONE-ETHINYL ESTRAD ORAL 7-9-5 TABLET
NORETHINDRONE-MESTRANOL ORAL 1 MG-50MCG TABLET
NORGESTIMATE-ETHINYL ESTRADIOL ORAL 0.25-0.035 TABLET
NORGESTIMATE-ETHINYL ESTRADIOL ORAL 7DAYSX3 28 TABLET
NORGESTIMATE-ETHINYL ESTRADIOL ORAL 7DAYSX3 LO TABLET
NORGESTREL-ETHINYL ESTRADIOL ORAL 0.3-0.03MG TABLET
NORGESTREL-ETHINYL ESTRADIOL ORAL 0.5 MG-50 TABLET
NORTRIPTYLINE HCL ORAL 10 MG CAPSULE
NORTRIPTYLINE HCL ORAL 10 MG/5 ML SOLUTION
NYSTATIN TOPICAL 100000/G CREAM (G)
NYSTATIN TOPICAL 100000/G OINT. (G)
NYSTATIN TOPICAL 100000/G POWDER
NYSTATIN/TRIAMCIN TOPICAL 100000-0.1 CREAM (G)
NYSTATIN/TRIAMCIN TOPICAL 100000-0.1 OINT. (G)
OCTREOTIDE ACETATE,MI-SPHERES INTRAMUSC 10 MG KIT
OFATUMUMAB INTRAVEN 100 MG/5ML VIAL
OFATUMUMAB INTRAVEN 1000 MG/50 VIAL
OFLOXACIN OPHTHALMIC 0.3 % DROPS
OFLOXACIN OTIC 0.3 % DROPS
OLANZAPINE INTRAMUSC 10 MG VIAL
OLANZAPINE ORAL 10 MG TAB RAPDIS
OLANZAPINE ORAL 10 MG TABLET
OLANZAPINE ORAL 2.5 MG TABLET
OLANZAPINE ORAL 7.5 MG TABLET
OLANZAPINE PAMOATE INTRAMUSC 210 MG VIAL
OLANZAPINE/FLUOXETINE HCL ORAL 12MG-25MG CAPSULE
OLANZAPINE/FLUOXETINE HCL ORAL 3 MG-25 MG CAPSULE
OLAPARIB ORAL 50 MG CAPSULE
OLMESARTAN MEDOXOMIL ORAL 20 MG TABLET
OLMESARTAN/AMLODIPIN/HCTHIAZID ORAL 20-5-12.5 TABLET
OLMESARTAN/AMLODIPIN/HCTHIAZID ORAL 40-10-25MG TABLET
OLMESARTAN/AMLODIPIN/HCTHIAZID ORAL 40-5-25 MG TABLET
OLMESARTAN/HYDROCHLOROTHIAZIDE ORAL 20-12.5 MG TABLET
OLMESARTAN/HYDROCHLOROTHIAZIDE ORAL 40 MG-25MG TABLET
OLMESARTAN/HYDROCHLOROTHIAZIDE ORAL 40-12.5 MG TABLET
OLODATEROL HCL INHALATION 2.5 MCG MIST INHAL
OLOPATADINE HCL NASAL 0.6 % SPRAY/PUMP
OLOPATADINE HCL OPHTHALMIC 0.1 % DROPS
3
28
28
34
28
28
34
28
28
28
28
28
28
28
18
Max
Unit
28
28
28
28
28
28
28
28
28
28
28
28
136
720
102
68
68
180
180
60
180
180
5
5
3
415
415
10
10
5
68
68
34
34
68
34
34
68
68
68
2
2
1
34
34
34
34
34
544
68
34
272
34
34
34
34
34
136
34
68
4
30.5
15
7.5
Effective 7/1/2016
OMACETAXINE MEPESUCCINATE SUB-Q 3.5 MG VIAL
OMBITASVIR/PARITAPREV/RITONAV ORAL 12.5-75 MG TABLET
OMEGA-3 ACID ETHYL ESTERS ORAL 1 G CAPSULE
OMEPRAZOLE MAGNESIUM ORAL 10 MG SUSPDR PKT
OMEPRAZOLE MAGNESIUM ORAL 2.5 MG SUSPDR PKT
OMEPRAZOLE ORAL 10 MG CAPSULE DR
OMEPRAZOLE/CLARITH/AMOXICILLIN ORAL 20(20)-500 COMBO. PKG
OMEPRAZOLE/SODIUM BICARBONATE ORAL 20MG-1.1G CAPSULE
OMEPRAZOLE/SODIUM BICARBONATE ORAL 40MG-1.1G CAPSULE
ONABOTULINUMTOXINA INJECTION 100 UNIT VIAL
ONABOTULINUMTOXINA INJECTION 200 UNIT VIAL
ONDANSETRON HCL INTRAVEN 2 MG/ML VIAL
ONDANSETRON HCL ORAL 4 MG TABLET
ONDANSETRON HCL ORAL 4 MG/5 ML SOLUTION
ONDANSETRON HCL ORAL 8 MG TABLET
ONDANSETRON HCL/PF INJECTION 4 MG/2 ML AMPUL
ONDANSETRON HCL/PF INJECTION 4 MG/2 ML SYRINGE
ONDANSETRON HCL/PF INJECTION 4 MG/2 ML VIAL
ONDANSETRON ORAL 4 MG FILM
ONDANSETRON ORAL 4 MG TAB RAPDIS
ONDANSETRON ORAL 8 MG FILM
ONDANSETRON ORAL 8 MG TAB RAPDIS
OPIUM TINCTURE ORAL 10 MG/ML TINCTURE
OPIUM/BELLADONNA ALKALOIDS RECTAL 30-16.2MG SUPP.RECT
OPIUM/BELLADONNA ALKALOIDS RECTAL 60-16.2MG SUPP.RECT
ORITAVANCIN DIPHOSPHATE INTRAVEN 400 MG VIAL
ORPHENADRINE CITRATE INJECTION 30 MG/ML AMPUL
ORPHENADRINE CITRATE INJECTION 30 MG/ML VIAL
ORPHENADRINE CITRATE ORAL 100 MG TABLET ER
OSELTAMIVIR PHOSPHATE ORAL 30 MG CAPSULE
OSELTAMIVIR PHOSPHATE ORAL 6 MG/ML SUSP RECON
OSIMERTINIB MESYLATE ORAL 40 MG TABLET
OSIMERTINIB MESYLATE ORAL 80 MG TABLET
OXALIPLATIN INTRAVEN 100 MG VIAL
OXALIPLATIN INTRAVEN 100MG/20ML VIAL
OXALIPLATIN INTRAVEN 50 MG VIAL
OXALIPLATIN INTRAVEN 50 MG/10ML VIAL
OXAPROZIN ORAL 600 MG TABLET
OXAZEPAM ORAL 10 MG CAPSULE
OXICONAZOLE NITRATE TOPICAL 1 % CREAM (G)
OXICONAZOLE NITRATE TOPICAL 1 % LOTION
OXYBUTYNIN CHLORIDE ORAL 10 MG TAB ER 24
OXYBUTYNIN CHLORIDE ORAL 5 MG TABLET
OXYBUTYNIN CHLORIDE ORAL 5 MG/5 ML SYRUP
OXYBUTYNIN CHLORIDE TRANSDERM 10 % GEL PACKET
OXYBUTYNIN TRANSDERM 3.9MG/24HR PATCH TDSW
OXYBUTYNIN TRANSDERM 28MG/0.92G GEL MD PMP
OXYCODONE HCL ORAL 10 MG TAB ER 12H
OXYCODONE HCL ORAL 10 MG TABLET
OXYCODONE HCL ORAL 20 MG/ML ORAL CONC
Max
Unit
2.5
28
68
136
68
68
34
34
34
80
34
34
1
1
40
30
60
30
40
40
40
12
30
12
30
60
24
24
3
4
4
20
40
20
360
20
34
34
8
8
8
8
102
136
136
136
180
180
68
68
68
136
680
30
8
92
68
68
68
68
68
68
90
68
OXYCODONE HCL ORAL 5 MG CAPSULE
OXYCODONE HCL ORAL 5 MG/5 ML SOLUTION
OXYCODONE HCL/ACETAMINOPHEN ORAL 10MG-300MG TABLET
OXYCODONE HCL/ACETAMINOPHEN ORAL 2.5-325MG TABLET
OXYCODONE HCL/ACETAMINOPHEN ORAL 5 MG-325MG TABLET
OXYCODONE HCL/ACETAMINOPHEN ORAL 7.5-325MG TAB IR ERO
OXYCODONE HCL/ASPIRIN ORAL 4.8355-325 TABLET
OXYMORPHONE HCL INJECTION 1 MG/ML AMPUL
OXYMORPHONE HCL ORAL 10 MG TAB ER 12H
OXYMORPHONE HCL ORAL 10 MG TABLET
OXYMORPHONE HCL ORAL 5 MG TABLET
OXYMORPHONE HCL ORAL 7.5 MG TAB ER 12H
OXYMORPHONE HCL ORAL 7.5 MG TAB ER 12H
PALBOCICLIB ORAL 100 MG CAPSULE
PALIFERMIN INTRAVEN 6.25 MG VIAL
PALIPERIDONE ORAL 1.5 MG TAB ER 24
PALIPERIDONE ORAL 3 MG TAB ER 24
PALIPERIDONE PALMITATE INTRAMUSC 117MG/0.75 SYRINGE
PALIPERIDONE PALMITATE INTRAMUSC 156 MG/ML SYRINGE
PALIPERIDONE PALMITATE INTRAMUSC 78MG/0.5ML SYRINGE
PALONOSETRON HCL INTRAVEN 0.25MG/5ML VIAL
PANCURONIUM BROMIDE INTRAVEN 1 MG/ML VIAL
PANCURONIUM BROMIDE INTRAVEN 2 MG/ML VIAL
PANOBINOSTAT LACTATE ORAL 10 MG CAPSULE
PANTOPRAZOLE SODIUM INTRAVEN 40 MG VIAL
PANTOPRAZOLE SODIUM ORAL 20 MG TABLET DR
PANTOPRAZOLE SODIUM ORAL 40 MG GRANPKT DR
PANTOPRAZOLE SODIUM ORAL 40 MG TABLET DR
PARATHYROID HORMONE SUB-Q 100 MCG CARTRIDGE
PARATHYROID HORMONE SUB-Q 25MCG/DOSE CARTRIDGE
PAROXETINE HCL ORAL 10 MG TABLET
PAROXETINE HCL ORAL 10 MG/5 ML ORAL SUSP
19
Max
Unit
68
68
68
68
480
68
68
68
68
68
68
68
68
68
68
68
68
68
40
68
68
68
68
68
68
68
68
68
68
68
68
68
68
68
68
21
21
21
1
68
68
68
34
0.75
1
1.5
0.25
0.5
20
10
10
12
12
12
10
34
34
34
2
2
2
2
34
680
Effective 7/1/2016
PAROXETINE HCL ORAL 12.5 MG TAB ER 24H
PAROXETINE HCL ORAL 25 MG TAB ER 24H
PAROXETINE HCL ORAL 37.5 MG TAB ER 24H
PAROXETINE MESYLATE ORAL 10 MG TABLET
PAROXETINE MESYLATE ORAL 7.5 MG CAPSULE
PASIREOTIDE DIASPARTATE SUB-Q 0.3 MG/ML AMPUL
PASIREOTIDE PAMOATE INTRAMUSC 20 MG VIAL
PATIROMER CALCIUM SORBITEX ORAL 16.8 GRAM POWD PACK
PEDI MULTIVIT #63 W-FLUORIDE ORAL 0.25(0.55) TAB CHEW
PEDI MULTIVIT #63 W-FLUORIDE ORAL 0.5(1.1)MG TAB CHEW
PEDI MULTIVIT #63 W-FLUORIDE ORAL 1MG(2.2MG) TAB CHEW
PEG 3350/NA SULF,BICARB,CL/KCL ORAL 227.1-21.5 POWD PACK
PEG 3350/NA SULF,BICARB,CL/KCL ORAL 227.1-21.5 SOLN RECON
PEG 3350/NA SULF,BICARB,CL/KCL ORAL 236-22.74G SOLN RECON
PEG 3350/NA SULF,BICARB,CL/KCL ORAL 240-22.72G SOLN RECON
PEG 3350-BOWEL 2,TWO PART PREP ORAL 210G-17.5G SOLN RC SQ
PEG3350/SOD SUL/NACL/ASB/C/KCL ORAL 7.5-2.691G POWD PACK
PEGADEMASE BOVINE INTRAMUSC 250 UNIT/1 VIAL
PEGAPTANIB SODIUM INTRAOCULR 0.3 MG/90 SYRINGE
PEGFILGRASTIM SUB-Q 6MG/0.6ML SYR W/ INJ
PEGFILGRASTIM SUB-Q 6MG/0.6ML SYRINGE
PEGINTERFERON ALFA-2A SUB-Q 135MCG/0.5 PEN INJCTR
PEGINTERFERON ALFA-2A SUB-Q 180MCG/0.5 PEN INJCTR
PEGINTERFERON ALFA-2A SUB-Q 180MCG/0.5 SYRINGE
PEGINTERFERON ALFA-2A SUB-Q 180MCG/ML VIAL
PEGINTERFERON ALFA-2B SUB-Q 120MCG/0.5 KIT
PEGINTERFERON ALFA-2B SUB-Q 120MCG/0.5 PEN IJ KIT
PEGINTERFERON ALFA-2B SUB-Q 200 MCG KIT
PEGINTERFERON ALFA-2B SUB-Q 50 MCG/0.5 KIT
PEGINTERFERON ALFA-2B SUB-Q 50 MCG/0.5 PEN IJ KIT
PEGINTERFERON BETA-1A SUB-Q 125MCG/0.5 PEN INJCTR
PEGINTERFERON BETA-1A SUB-Q 125MCG/0.5 SYRINGE
PEGINTERFERON BETA-1A SUB-Q 63-94 MCG PEN INJCTR
PEGINTERFERON BETA-1A SUB-Q 63-94 MCG SYRINGE
PEN INJECTOR DEVICE SUB-Q 12 PEN INJCTR
PENBUTOLOL SULFATE ORAL 20 MG TABLET
PENCICLOVIR TOPICAL 1 % CREAM (G)
PENTAZOCINE HCL/NALOXONE HCL ORAL 50MG-0.5MG TABLET
PENTAZOCINE LACTATE INJECTION 30 MG/ML AMPUL
PENTOSTATIN INTRAVEN 10 MG VIAL
PENTOXIFYLLINE ORAL 400 MG TABLET ER
PERINDOPRIL ARG/AMLODIPINE BES ORAL 14MG-10MG TABLET
PERINDOPRIL ARG/AMLODIPINE BES ORAL 3.5-2.5 MG TABLET
PERINDOPRIL ARG/AMLODIPINE BES ORAL 7 MG-5 MG TABLET
Max
Unit
34
34
34
68
34
34
34
34
68
34
34
68
68
68
1
1
1
34
34
34
34
34
34
1
3785
4000
4000
2480
1
40
0.9
2.4
2.4
2
2
2
5
4.8
4.8
4.8
4.8
4
4
4.8
4.8
4
4.8
4.8
1
1
1
1
1
1
1
34
5
68
40
7
102
34
34
34
PERINDOPRIL ERBUMINE ORAL 2 MG TABLET
PERMETHRIN TOPICAL 5 % CREAM (G)
PERPHENAZINE ORAL 16 MG TABLET
PERPHENAZINE/AMITRIPTYLINE HCL ORAL 2 MG-10 MG TABLET
PERPHENAZINE/AMITRIPTYLINE HCL ORAL 4MG-10MG TABLET
PERTUZUMAB INTRAVEN 420MG/14ML VIAL
PHENELZINE SULFATE ORAL 15 MG TABLET
PHENOBARBITAL ORAL 100 MG TABLET
PHENOBARBITAL ORAL 16.2 MG TABLET
PHENOBARBITAL ORAL 20 MG/5 ML ELIXIR
PHENOBARBITAL ORAL 97.2MG TABLET
PHENOBARBITAL SODIUM INJECTION 130MG/ML VIAL
PHENOBARBITAL SODIUM INJECTION 65 MG/ML VIAL
PHENOXYBENZAMINE HCL ORAL 10 MG CAPSULE
PHENYLEPHRINE HCL OPHTHALMIC 10 % DROPS
PHENYLEPHRINE HCL OPHTHALMIC 2.5 % DROPS
PHENYLEPHRINE/KETOROLAC INTRAOCULR 1 %-0.3 % VIAL
PIMECROLIMUS TOPICAL 1 % CREAM (G)
PIMOZIDE ORAL 1 MG TABLET
PIMOZIDE ORAL 2 MG TABLET
PINDOLOL ORAL 10 MG TABLET
PINDOLOL ORAL 5 MG TABLET
PIOGLITAZONE HCL ORAL 15 MG TABLET
PIOGLITAZONE HCL/GLIMEPIRIDE ORAL 30 MG-2 MG TABLET
PIOGLITAZONE HCL/GLIMEPIRIDE ORAL 30 MG-4 MG TABLET
PIOGLITAZONE HCL/METFORMIN HCL ORAL 15-1000 MG TBMP 24HR
PIOGLITAZONE HCL/METFORMIN HCL ORAL 15MG-500MG TABLET
PIOGLITAZONE HCL/METFORMIN HCL ORAL 15MG-850MG TABLET
PIOGLITAZONE HCL/METFORMIN HCL ORAL 30-1000 MG TBMP 24HR
PIPERACILLIN SODIUM/TAZOBACTAM INTRAVEN 2.25 G VIAL
PIPERACILLIN SODIUM/TAZOBACTAM INTRAVEN 2.25 G VIAL PORT
PIPERACILLIN-TAZO-DEXTROSE,ISO INTRAVEN 2.25G/50ML FROZ.PIGGY
PIPERACILLIN-TAZO-DEXTROSE,ISO INTRAVEN 3.375G/50 FROZ.PIGGY
PIPERACILLIN-TAZO-DEXTROSE,ISO INTRAVEN 4.5G/100ML FROZ.PIGGY
PIROXICAM ORAL 10 MG CAPSULE
PIROXICAM ORAL 20 MG CAPSULE
PITAVASTATIN CALCIUM ORAL 1 MG TABLET
PN85/IRON CB&ASP G/FA/DHA/FISH ORAL 40-10-1 MG CAPSULE
PNEUMOCOCCAL 23-VAL P-SAC VAC INJECTION 25MCG/0.5 VIAL
PNEUMOCOCCAL 23-VAL P-SAC VAC INJECTION 25MCG/0.5 SYRINGE
PNV #14/FERROUS FUM/FOLIC ACID ORAL 29 MG-1 MG TAB CHEW
PNV #15/IRON FUM,PS/FOLIC ACID ORAL 85 MG-1 MG CAPSULE
20
Max
Unit
272
136
68
180
136
136
136
68
136
136
136
136
136
42
136
102
102
102
960
102
102
102
102
102
12
12
34
5
15
4
180
68
136
204
408
68
34
34
34
34
68
102
102
34
2240
2240
800
800
1120
1120
13
11200
4000
11200
68
34
34
34
34
34
0.5
0.5
34
34
Effective 7/1/2016
PNV #19/IRON PS&HEME/FOLIC/DHA ORAL 22-6-1-200 CAPSULE
PNV #30/IRON CARB&ASPG/FA/OM3 ORAL 30-10-1 MG CAPSULE
PNV #78/IRON ASP GLY/FA#1/DHA ORAL 18-1-300MG CAPSULE
PNV #8/IRON PS CMP,ASPG/FA/DHA ORAL 22-6-1-200 COMBO. PKG
PNV #86/IRON POLY/FA/DHA/EPA ORAL 32-1-120MG COMBO. PKG
PNV #87/IRON BISGLY/FA/DHA ORAL 32-1-230MG COMBO. PKG
PNV 112/IRON/FA/OM-3S/DHA/EPA ORAL 3.33-.33MG TAB CHEW
PNV 11-IRON FUM-FOLIC ACID-OM3 ORAL 28-1-200MG CAPSULE
PNV 18/FE,CARB/FA/DSS/UBI/DHA ORAL 15-0.5-25 TABLET
PNV COMBO #22/IRON/FA/OM3/DHA ORAL 28-6-1-203 COMBO. PKG
PNV COMBO#47/IRON/FA #1/DHA ORAL 27-1-300MG CAPSULE
PNV NO.106/IRON/FOLATE #6/DHA ORAL 27.5MG-1MG CAPSULE
PNV NO.66/IRON,CARBONYL/FA/DHA ORAL 20-1-320MG CAPSULE
PNV NO.81/IRON CBN&GLUC/FA/DSS ORAL 27-1-50 MG TABLET
PNV NO.88/IRON PS,HEME/FA/DHA ORAL 28-6-1 MG COMBO. PKG
PNV NO10/IRON FUM&P/FA/OMEGA-3 ORAL 30-1-310.1 CAPSULE
PNV W-CA #40/IRON FUM/FA CMB#1 ORAL 27 MG-1 MG TABLET
PNV W-CA NO.37/IRON/FA/OMEGA-3 ORAL 27-1-330MG CAPSULE
PNV WITH CA #68/IRON/FA#1/DHA ORAL 28-1-300MG CAPSULE
PNV WITH CA NO.65/IRON POLY/FA ORAL 60 MG-1 MG CAPSULE
PNV WITH CA#74/IRON/FOLIC ACID ORAL 27 MG-1 MG TABLET
PNV WITH CA,NO.70/IRON/FA/DHA ORAL 28-1-250MG CAPSULE
PNV WITH CA,NO.72/IRON/FA ORAL 27 MG-1 MG TABLET
PNV W-O CA NO5/FE FUMARATE/FA ORAL 106.5-1MG CAPSULE
PNV#102/IRON/FOLATE #1/DSS/DHA ORAL 90-1-200MG CAPSULE
PNV#16/IRON FUM & PS/FA/OM-3 ORAL 35-1-200MG CAPSULE
PNV#20/IRON/FA/DS/FISH/DHA/EPA ORAL 27-1-500MG CAPSULE
PNV#21/IRON PS& HEME POLYP/FA ORAL 28-6-1 MG TABLET
PNV#26/IRON POLY/FA/DHA ORAL 29-1-200MG CAPSULE
PNV#64/IRON/LMFOLATE/ALGAL/SOY ORAL 27-1.13 MG CAPSULE
PNV#67/IRON PS/FA CMB#1/DHA ORAL 29-1-200MG CAPSULE
PNV,CA,NO.35/IRON/FA/DS/OMEG-3 ORAL 27-1-50 MG CAPSULE
PNV,CA64/IRON CB,GL/FA/DSS/DHA ORAL 90-1-300MG COMBO. PKG
PNV/FA/B6/CALCIUM CARB/GINGER ORAL 1.2-42 MG TABLET
PNV/FERROUS FUMARATE/FA/SE ORAL 27 MG-1 MG TABLET
PNV100/IRON EDTA&PS/FA/OMEGA3 ORAL 27-1-374MG CMBPKGDRCP
PNV115/IRON FUMARATE/FA/DSS ORAL 29-1-25 MG TABLET
PNV119/IRON FUMARATE/FA/DSS ORAL 29-1-25 MG TABLET
PNV19/IRON BG HC&SUCC-P/FA/OM3 ORAL 29-1-400MG CMBPKGDRCP
PNV2/IRON B-G SUC-P/FA/OMEGA-3 ORAL 29-1-250MG COMBO. PKG
PNV22/IRON CBN&GLUC/FA/DSS/DHA ORAL 27-1-50 MG COMBO. PKG
PNV34/IRON,CARBONYL/FA/DSS/DHA ORAL 29-1-50 MG CAPSULE
PNV38/IRON CBN&GLUC/FA/DSS/DHA ORAL 35-1-50 MG COMBO. PKG
PNV39/IRON FUMARATE/FA/DSS/DHA ORAL 30-1.2-55 CAPSULE
PNV53/IRON B-G HCL-P/FA/OMEGA3 ORAL 29-1-400MG COMBO. PKG
PNV53/IRON FUM/FA/DOCUSATE/DHA ORAL 29-1.25-55 CAPSULE
PNV54/IRON B-G HCL-P/FA/OMEGA3 ORAL 29-1-430MG COMBO. PKG
PNV55/IRON BG HC,SUCC-P/FA/OM3 ORAL 29-1-430MG CMBPKGDRCP
PNV59/IRON,CARB&FUM/FA/DSS/DHA ORAL 27-1-50 MG CAPSULE
PNV72/IRON,CARB&GLU/FA/DSS/DHA ORAL 90-1-300MG COMBO. PKG
PNV73/IRON,CARB&GLU/FA/DSS/DHA ORAL 35-1-50 MG COMBO. PKG
PNV76/IRON,CARB&GLU/FA/DSS/DHA ORAL 27-1-50 MG COMBO. PKG
PNV81/SOD IRON EDTA& PS/FA/OM3 ORAL 27-1-430MG CMBPKGDRCP
PNV83/IRON,CARB/IRON ASP GL/FA ORAL 30-20-1 MG TABLET
PODOFILOX TOPICAL 0.5 % GEL (GRAM)
PODOFILOX TOPICAL 0.5 % SOLUTION
PODOPHYLLUM RESIN TOPICAL 25 % LIQUID
POLYETHYLENE GLYCOL 3350 ORAL 17G POWD PACK
Max
Unit
34
68
34
68
68
68
34
34
68
68
34
34
34
34
68
34
34
34
34
34
34
34
34
34
68
34
34
34
34
34
34
34
68
34
34
68
34
34
68
68
68
34
34
68
34
68
34
68
68
34
34
34
34
34
68
68
68
34
68
34
7
7
180
34
POLYETHYLENE GLYCOL 3350 ORAL 17G/DOSE POWDER
POLYMYXIN B SULF/TRIMETHOPRIM OPHTHALMIC 10000-1/ML DROPS
POMALIDOMIDE ORAL 1 MG CAPSULE
PONATINIB HCL ORAL 15 MG TABLET
PONATINIB HCL ORAL 45 MG TABLET
POSACONAZOLE ORAL 200 MG/5ML ORAL SUSP
PRAMIPEXOLE DI-HCL ORAL 0.375 MG TAB ER 24H
PRAMIPEXOLE DI-HCL ORAL 3 MG TAB ER 24H
PRAMLINTIDE ACETATE SUB-Q 1500/1.5ML PEN INJCTR
PRASUGREL HCL ORAL 10 MG TABLET
PRASUGREL HCL ORAL 5 MG TABLET
PRAVASTATIN SODIUM ORAL 10 MG TABLET
PRAZOSIN HCL ORAL 1 MG CAPSULE
PREDNICARBATE TOPICAL 0.1 % CREAM (G)
PREDNICARBATE TOPICAL 0.1 % OINT. (G)
PRENAT VIT COMB.10/IRON/FA/DHA ORAL 65-1-250MG COMBO. PKG
PRENATAL #103/IRON FUMARATE/FA ORAL 27 MG-1 MG TABLET
PRENATAL #48/IRON CB,GLU/FA/B6 ORAL 20-1-25 MG TABLET SEQ
PRENATAL #57/IRON/FA/DSS/DHA ORAL 29-1.25-55 CAPSULE
PRENATAL #79/IRON ASP GLY/FA#1 ORAL 20 MG-1 MG TABLET
PRENATAL #92/IRON/FA #8/PS-DHA ORAL 1.5-8.73MG CAP IR DR
PRENATAL NO.13/IRON PS/FA CB#1 ORAL 29 MG-1 MG TAB CHEW
PRENATAL NO.52/IRON/FA/DHA ORAL 28-1-200MG CAPSULE
PRENATAL NO.75/IRON/FOLATE #1 ORAL 18 MG-1 MG TABLET
PRENATAL NO.77/IRON ASP GLY/FA ORAL 20 MG-1 MG TABLET
PRENATAL NO.93/IRON/FA #9/DHA ORAL 31-1-200MG CAPSULE
PRENATAL VIT #68/IRON/FA#6/DHA ORAL 28-1-400MG CAPSULE
PRENATAL VIT #69/IRON/FA#6/DHA ORAL 27-1-400MG CAPSULE
PRENATAL VIT #76/IRON,CARB/FA ORAL 29 MG-1 MG TABLET
PRENATAL VIT 15/IRON CB/FA/DSS ORAL 90-1-50 MG TABLET
PRENATAL VIT COMB.10/IRON/FA ORAL 65 MG-1 MG TABLET
PRENATAL VIT NO.112/FOLIC ACID ORAL 1 MG TAB CHEW
PRENATAL VIT NO.114/FA/GINGER ORAL 1MG-500MG TABLET
PRENATAL VIT NO.127/IRON/FA ORAL 15 MG-1 MG TABLET
PRENATAL VIT NO.44/IRON/FA/DHA ORAL 29-1-350MG CAPSULE
PRENATAL VIT NO.87/IRON/FA/DHA ORAL 18-1-350MG CAPSULE
PRENATAL VIT#4/IRON FUM,PS/FA ORAL 106 MG-1MG CAPSULE
PRENATAL VIT#65/IRON FUM&PS/FA ORAL 40-1.25 MG CAPSULE
PRENATAL VIT#84/IRON/FA#1/DHA ORAL 18-1-300MG CAPSULE
PRENATAL VIT#85/IRON/FA#1/DHA ORAL 10-1-200MG CAPSULE
PRENATAL VIT#86/IRON BISGLY/FA ORAL 32 MG-1 MG TABLET
PRENATAL VIT/IRON BISGLYCIN/FA ORAL 29 MG-1 MG TABLET
PRENATAL VIT/IRON FUMARATE/FA ORAL 66-1MG TABLET
PRENATAL VIT/IRON FUMARATE/FA ORAL 75-1MG TABLET
PRENATAL VIT27,CALCIUM/IRON/FA ORAL 60 MG-1 MG TABLET
PRENATAL VIT37/IRON/FOLIC ACID ORAL 29 MG-1 MG TAB CHEW
PRENATAL VITS #33/IRON/FA/DHA ORAL 29-1-250MG COMBO. PKG
PRENATAL VITS#4/IRON FUM/FA ORAL 106 MG-1MG CAPSULE
PRENATAL#90/IRON FUM,PS/FA/DHA ORAL 32-1.25 MG CAPSULE
21
Max
Unit
527
10
21
21
21
21
68
34
680
204
102
102
34
34
6
34
34
68
68
68
34
680
340
170
180
180
68
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
34
68
34
34
Effective 7/1/2016
PRENATAL56/IRON/FOLIC ACID/DHA ORAL 35-5-1 MG CAPSULE
PROCAINAMIDE HCL INJECTION 100 MG/ML VIAL
PROCAINAMIDE HCL INJECTION 500 MG/ML VIAL
PROCHLORPERAZINE EDISYLATE INJECTION 5 MG/ML VIAL
PROCHLORPERAZINE MALEATE ORAL 10 MG TABLET
PROCHLORPERAZINE MALEATE ORAL 5 MG TABLET
PROCHLORPERAZINE RECTAL 25 MG SUPP.RECT
PROMETHAZINE HCL INJECTION 25 MG/ML AMPUL
PROMETHAZINE HCL INJECTION 25 MG/ML VIAL
PROMETHAZINE HCL INJECTION 50 MG/ML AMPUL
PROMETHAZINE HCL INJECTION 50 MG/ML VIAL
PROMETHAZINE HCL ORAL 12.5 MG TABLET
PROMETHAZINE HCL ORAL 25 MG TABLET
PROMETHAZINE HCL ORAL 50 MG TABLET
PROMETHAZINE HCL ORAL 6.25MG/5ML SYRUP
PROMETHAZINE HCL RECTAL 12.5 MG SUPP.RECT
PROMETHAZINE HCL RECTAL 25 MG SUPP.RECT
PROMETHAZINE HCL RECTAL 50 MG SUPP.RECT
PROPAFENONE HCL ORAL 150 MG TABLET
PROPAFENONE HCL ORAL 225 MG CAP ER 12H
PROPANTHELINE BROMIDE ORAL 15 MG TABLET
PROPRANOLOL HCL INTRAVEN 1 MG/ML VIAL
PROPRANOLOL HCL ORAL 10 MG TABLET
PROPRANOLOL HCL ORAL 120 MG CAP ER 24H
PROPRANOLOL HCL ORAL 120 MG CAP SA 24H
PROPRANOLOL HCL ORAL 20 MG/5 ML SOLUTION
PROPRANOLOL HCL ORAL 40MG/5ML SOLUTION
PROPRANOLOL HCL ORAL 80 MG CAP ER 24H
PROPRANOLOL/HYDROCHLOROTHIAZID ORAL 40 MG-25MG TABLET
PROPRANOLOL/HYDROCHLOROTHIAZID ORAL 80 MG-25MG TABLET
PROTRIPTYLINE HCL ORAL 10 MG TABLET
PROTRIPTYLINE HCL ORAL 5 MG TABLET
PV W-O CAL/IRON PS CPLX/FA ORAL 29 MG-1 MG TAB CHEW
QUETIAPINE FUMARATE ORAL 100 MG TABLET
QUETIAPINE FUMARATE ORAL 150 MG TAB ER 24H
QUETIAPINE FUMARATE ORAL 50-200-300 TAB24HDSPK
QUINAPRIL HCL ORAL 10 MG TABLET
QUINAPRIL/HYDROCHLOROTHIAZIDE ORAL 10-12.5MG TABLET
QUINAPRIL/HYDROCHLOROTHIAZIDE ORAL 20-12.5 MG TABLET
QUINAPRIL/HYDROCHLOROTHIAZIDE ORAL 20 MG-25MG TABLET
QUINIDINE GLUCONATE INJECTION 80 MG/ML VIAL
Max
Unit
34
204
204
272
272
272
68
204
204
102
102
204
204
102
960
204
204
102
170
68
102
102
68
68
136
40
2176
102
102
68
1088
500
544
500
170
340
136
136
272
136
272
136
136
34
136
68
68
136
136
68
136
68
68
204
136
15
136
68
34
272
272
136
136
40
QUINIDINE GLUCONATE ORAL 324 MG TABLET ER
QUINIDINE SULFATE ORAL 200 MG TABLET
QUINIDINE SULFATE ORAL 300 MG TABLET
RABEPRAZOLE SODIUM ORAL 10 MG CAP DR SPR
RABEPRAZOLE SODIUM ORAL 20 MG TABLET DR
RABEPRAZOLE SODIUM ORAL 5 MG CAP DR SPR
RAMELTEON ORAL 8 MG TABLET
RAMIPRIL ORAL 1.25 MG CAPSULE
RAMIPRIL ORAL 10 MG CAPSULE
RAMIPRIL ORAL 2.5 MG CAPSULE
RAMIPRIL ORAL 5 MG CAPSULE
RANIBIZUMAB INTRAOCULR 0.3MG/0.05 VIAL
RANIBIZUMAB INTRAOCULR 0.5MG/0.05 VIAL
RANITIDINE HCL INJECTION 25 MG/ML VIAL
RANITIDINE HCL ORAL 15 MG/ML SYRUP
RANITIDINE HCL ORAL 150 MG CAPSULE
RANITIDINE HCL ORAL 150 MG TABLET
RANITIDINE HCL ORAL 300 MG CAPSULE
RANITIDINE HCL ORAL 300 MG TABLET
RANOLAZINE ORAL 1000 MG TAB ER 12H
RANOLAZINE ORAL 500 MG TAB ER 12H
REGORAFENIB ORAL 40 MG TABLET
REMIFENTANIL HCL INTRAVEN 1 MG VIAL
REPAGLINIDE ORAL 0.5 MG TABLET
REPAGLINIDE ORAL 1 MG TABLET
REPAGLINIDE ORAL 2 MG TABLET
REPAGLINIDE/METFORMIN HCL ORAL 1MG-500MG TABLET
REPAGLINIDE/METFORMIN HCL ORAL 2 MG-500MG TABLET
RESERPINE ORAL 0.1 MG TABLET
RESERPINE ORAL 0.25 MG TABLET
RESLIZUMAB INTRAVEN 10 MG/ML VIAL
RETAPAMULIN TOPICAL 1 % OINT. (G)
RIBAVIRIN INHALATION 6 G VIAL-NEB
RIBAVIRIN ORAL 200 MG CAPSULE
RIBAVIRIN ORAL 200 MG TABLET
RIBAVIRIN ORAL 200-400(7) TAB DS PK
RIBAVIRIN ORAL 200-400MG TAB DS PK
RIBAVIRIN ORAL 40 MG/ML SOLUTION
RIBAVIRIN ORAL 400-400 MG TAB DS PK
RIFAXIMIN ORAL 200 MG TABLET
RIFAXIMIN ORAL 550 MG TABLET
RILONACEPT SUB-Q 220 MG VIAL
RIMABOTULINUMTOXINB INTRAMUSC 10000/2ML VIAL
RIMABOTULINUMTOXINB INTRAMUSC 2500/0.5ML VIAL
RIMABOTULINUMTOXINB INTRAMUSC 5000/ML VIAL
RIOCIGUAT ORAL 0.5 MG TABLET
RIOCIGUAT ORAL 1 MG TABLET
RIOCIGUAT ORAL 2 MG TABLET
RISEDRONATE SODIUM ORAL 150 MG TABLET
RISEDRONATE SODIUM ORAL 35 MG TABLET DR
22
Max
Unit
204
204
204
34
34
34
34
272
34
136
68
0.05
0.05
30
240
136
136
68
68
68
68
84
10
10
10
102
102
102
170
170
68
34
10
30
7
204
204
56
56
1020
102
56
56
68
56
56
56
56
9
68
4
2
1
1
102
102
102
102
102
1
34
4
4
34
Effective 7/1/2016
RISPERIDONE MICROSPHERES INTRAMUSC 12.5MG/2ML SYRINGE
RISPERIDONE MICROSPHERES INTRAMUSC 25 MG/2 ML SYRINGE
RISPERIDONE MICROSPHERES INTRAMUSC 37.5MG/2ML SYRINGE
RISPERIDONE MICROSPHERES INTRAMUSC 50 MG/2 ML SYRINGE
RISPERIDONE ORAL 0.25 MG TAB RAPDIS
RISPERIDONE ORAL 0.25 MG TABLET
RISPERIDONE ORAL 0.5 MG TAB RAPDIS
RISPERIDONE ORAL 0.5 MG TABLET
RISPERIDONE ORAL 1 MG TAB RAPDIS
RISPERIDONE ORAL 1 MG TABLET
RISPERIDONE ORAL 1 MG/ML SOLUTION
RIVAROXABAN ORAL 10 MG TABLET
RIVASTIGMINE TARTRATE ORAL 1.5 MG CAPSULE
RIVASTIGMINE TARTRATE ORAL 3 MG CAPSULE
RIVASTIGMINE TARTRATE ORAL 4.5 MG CAPSULE
RIVASTIGMINE TARTRATE ORAL 6 MG CAPSULE
RIVASTIGMINE TRANSDERM 4.6MG/24HR PATCH TD24
RIVASTIGMINE TRANSDERM 9.5MG/24HR PATCH TD24
RIVASTIGMINE TRANSDERM 13.3MG/24H PATCH TD24
RIZATRIPTAN BENZOATE ORAL 10 MG TAB RAPDIS
RIZATRIPTAN BENZOATE ORAL 10 MG TABLET
RIZATRIPTAN BENZOATE ORAL 5 MG TAB RAPDIS
RIZATRIPTAN BENZOATE ORAL 5 MG TABLET
ROCURONIUM BROMIDE INTRAVEN 10 MG/ML VIAL
ROFLUMILAST ORAL 500 MCG TABLET
ROMIPLOSTIM SUB-Q 250 MCG VIAL
ROMIPLOSTIM SUB-Q 500 MCG VIAL
ROSIGLITAZONE MALEATE ORAL 2 MG TABLET
ROSUVASTATIN CALCIUM ORAL 10 MG TABLET
ROTIGOTINE TRANSDERM 2 MG/24 HR PATCH TD24
RUXOLITINIB PHOSPHATE ORAL 10 MG TABLET
SACUBITRIL/VALSARTAN ORAL 24 MG-26MG TABLET
SACUBITRIL/VALSARTAN ORAL 49 MG-51MG TABLET
SACUBITRIL/VALSARTAN ORAL 97MG-103MG TABLET
SALICYLIC ACID TOPICAL 26 % LIQUID
SALICYLIC ACID TOPICAL 27.5 % LIQ-FILM
SALICYLIC ACID TOPICAL 6 % CREAM (G)
SALICYLIC ACID TOPICAL 6 % LOTION
SALICYLIC ACID TOPICAL 6 % SHAMPOO
SALMETEROL XINAFOATE INHALATION 50 MCG BLST W/DEV
SALSALATE ORAL 500 MG TABLET
SALSALATE ORAL 750 MG TABLET
Max
Unit
2
2
2
2
68
68
68
68
68
68
480
68
68
68
68
136
136
34
42
34
68
68
68
68
34
34
34
10
10
10
10
10
34
12
12
68
68
34
68
68
34
68
34
34
34
34
34
34
68
68
68
68
68
68
68
68
10
10
400
414
177
60
204
136
SAXAGLIPTIN HCL ORAL 2.5 MG TABLET
SAXAGLIPTIN HCL ORAL 5 MG TABLET
SAXAGLIPTIN HCL/METFORMIN HCL ORAL 2.5-1000MG TBMP 24HR
SAXAGLIPTIN HCL/METFORMIN HCL ORAL 5 MG-500MG TBMP 24HR
SAXAGLIPTIN HCL/METFORMIN HCL ORAL 5MG-1000MG TBMP 24HR
SCOPOLAMINE HYDROBROMIDE INJECTION 0.4 MG/ML VIAL
SCOPOLAMINE TRANSDERM 1.5MG/3DAY PATCH TD 3
SECOBARBITAL SODIUM ORAL 100 MG CAPSULE
SELEGILINE TRANSDERM 12MG/24HR PATCH TD24
SELEGILINE TRANSDERM 6 MG/24 HR PATCH TD24
SELEGILINE TRANSDERM 9 MG/24 HR PATCH TD24
SELEXIPAG ORAL 1000 MCG TABLET
SELEXIPAG ORAL 200-800MCG TAB DS PK
SERTACONAZOLE NITRATE TOPICAL 2 % CREAM (G)
SERTRALINE HCL ORAL 100 MG TABLET
SERTRALINE HCL ORAL 20 MG/ML ORAL CONC
SILDENAFIL CITRATE INTRAVEN 10 MG/12.5 VIAL
SILDENAFIL CITRATE ORAL 100 MG TABLET
SILVER NITRATE TOPICAL 0.5 % SOLUTION
SILVER SULFADIAZINE TOPICAL 1 % CREAM (G)
SIMEPREVIR SODIUM ORAL 150 MG CAPSULE
SIMVASTATIN ORAL 10 MG TABLET
SINECATECHINS TOPICAL 15 % OINT. (G)
SITAGLIPTIN PHOS/METFORMIN HCL ORAL 100-1000MG TBMP 24HR
SITAGLIPTIN PHOS/METFORMIN HCL ORAL 50-1000 MG TABLET
SITAGLIPTIN PHOS/METFORMIN HCL ORAL 50-1000 MG TBMP 24HR
SITAGLIPTIN PHOS/METFORMIN HCL ORAL 50MG-500MG TABLET
SITAGLIPTIN PHOS/METFORMIN HCL ORAL 50MG-500MG TBMP 24HR
SITAGLIPTIN PHOSPHATE ORAL 100 MG TABLET
SOD PICOSULF/MAG OX/CITRIC AC ORAL 10 MG-12 G POWD PACK
SODIUM CHLORIDE 0.45 % INTRAVEN PGGYBK PRT
SODIUM CHLORIDE 0.45 % INTRAVEN 0.45 % IV SOLN
SODIUM CHLORIDE 3 % INTRAVEN 3 % IV SOLN
SODIUM CHLORIDE 5 % INTRAVEN 5 % IV SOLN
SODIUM CHLORIDE INTRAVEN 2.5 MEQ/ML VIAL
SODIUM CHLORIDE INTRAVEN 4 MEQ/ML VIAL
SODIUM CHLORIDE IRRIG SOLUTION IRRIGATION 0.9 % IRRIG SOLN
SODIUM CHLORIDE/NAHCO3/KCL/PEG ORAL 420G SOLN RECON
SOFOSBUVIR ORAL 400 MG TABLET
SOLIFENACIN SUCCINATE ORAL 10 MG TABLET
SOLIFENACIN SUCCINATE ORAL 5 MG TABLET
SONIDEGIB PHOSPHATE ORAL 200 MG CAPSULE
SOTALOL HCL ORAL 120 MG TABLET
23
Max
Unit
34
34
68
34
34
1
4
34
34
34
34
68
68
68
68
68
68
68
68
68
180
68
240
34
34
1275
1
1
1
1
180
400
34
68
68
68
68
34
120
34
68
68
68
68
34
34
34
2
10000
10000
10000
10000
10000
10000
10000
4000
34
34
34
34
136
136
68
136
Effective 7/1/2016
SPINOSAD TOPICAL 0.9 % SUSPENSION
SPIRONOLACT/HYDROCHLOROTHIAZID ORAL 25 MG-25MG TABLET
SPIRONOLACT/HYDROCHLOROTHIAZID ORAL 50 MG-50MG TABLET
SPIRONOLACTONE ORAL 100 MG TABLET
SUCCINYLCHOLINE CHLORIDE INJECTION 20 MG/ML VIAL
SUCRALFATE ORAL 1 G TABLET
SUCRALFATE ORAL 1 G/10 ML ORAL SUSP
SUFENTANIL CITRATE INTRAVEN 50 MCG/ML AMPUL
SUFENTANIL CITRATE INTRAVEN 50 MCG/ML VIAL
SULCONAZOLE NITRATE TOPICAL 1 % CREAM (G)
SULCONAZOLE NITRATE TOPICAL 1 % SOLUTION
SULFACETAMIDE SODIUM OPHTHALMIC 10 % DROPS
SULFACETAMIDE/PREDNISOLONE SP OPHTHALMIC 10 %-0.23% DROPS
SULFACETM NA/PREDNISOL AC OPHTHALMIC 10 %-0.2 % DROPS SUSP
SULFACETM NA/PREDNISOL AC OPHTHALMIC 10 %-0.2 % OINT. (G)
SULFANILAMIDE VAGINAL 15 % CREAM/APPL
SULINDAC ORAL 150 MG TABLET
SULINDAC ORAL 200 MG TABLET
SUMATRIPTAN NASAL 20 MG SPRAY
SUMATRIPTAN NASAL 5 MG SPRAY
SUMATRIPTAN SUCC/NAPROXEN SOD ORAL 85MG-500MG TABLET
SUMATRIPTAN SUCCINATE NASAL 11 MG AER POW BA
SUMATRIPTAN SUCCINATE ORAL 100 MG TABLET
SUMATRIPTAN SUCCINATE SUB-Q 3 MG/0.5ML PEN INJCTR
SUMATRIPTAN SUCCINATE SUB-Q 4 MG/0.5ML CARTRIDGE
SUMATRIPTAN SUCCINATE SUB-Q 4 MG/0.5ML NDL FR INJ
SUMATRIPTAN SUCCINATE SUB-Q 6 MG/0.5ML CARTRIDGE
SUMATRIPTAN SUCCINATE SUB-Q 6 MG/0.5ML NDL FR INJ
SUMATRIPTAN SUCCINATE SUB-Q 6 MG/0.5ML SYRINGE
SUMATRIPTAN SUCCINATE SUB-Q 6 MG/0.5ML VIAL
SUMATRIPTAN SUCCINATE TRANSDERM 6.5 MG/4HR PATCH IOPH
SUVOREXANT ORAL 10 MG TABLET
TACROLIMUS TOPICAL 0.03 % OINT. (G)
TACROLIMUS TOPICAL 0.1 % OINT. (G)
TADALAFIL ORAL 10 MG TABLET
TADALAFIL ORAL 2.5 MG TABLET
TAFLUPROST/PF OPHTHALMIC 0.0015 % DROPERETTE
TALIGLUCERASE ALFA INTRAVEN 200 UNIT VIAL
TAPENTADOL HCL ORAL 100 MG TAB ER 12H
TAPENTADOL HCL ORAL 100 MG TABLET
TASIMELTEON ORAL 20 MG CAPSULE
TAVABOROLE TOPICAL 5 % SOL W/APPL
TAZAROTENE TOPICAL 0.05 % CREAM (G)
TAZAROTENE TOPICAL 0.05 % GEL (GRAM)
TAZAROTENE TOPICAL 0.1 % CREAM (G)
TAZAROTENE TOPICAL 0.1 % GEL (GRAM)
TEDIZOLID PHOSPHATE INTRAVEN 200 MG VIAL
Max
Unit
120
136
136
136
544
272
40
136
480
4
4
180
180
15
10
10
3.5
240
136
136
10
10
10
16
10
10
10
5
5
5
5
5
5
5
5
5
10
34
34
34
34
180
180
1
1
1
1
30
90
68
68
68
68
68
68
68
68
34
10
180
180
180
180
34
TEDIZOLID PHOSPHATE ORAL 200 MG TABLET
TEDUGLUTIDE SUB-Q 5 MG KIT
TELBIVUDINE ORAL 600 MG TABLET
TELITHROMYCIN ORAL 300 MG TABLET
TELITHROMYCIN ORAL 400 MG TABLET
TELMISARTAN ORAL 20 MG TABLET
TELMISARTAN/AMLODIPINE ORAL 40 MG-10MG TABLET
TELMISARTAN/AMLODIPINE ORAL 40 MG-5 MG TABLET
TELMISARTAN/AMLODIPINE ORAL 80 MG-10MG TABLET
TELMISARTAN/AMLODIPINE ORAL 80 MG-5 MG TABLET
TELMISARTAN/HYDROCHLOROTHIAZID ORAL 40-12.5 MG TABLET
TELMISARTAN/HYDROCHLOROTHIAZID ORAL 80 MG-25MG TABLET
TELMISARTAN/HYDROCHLOROTHIAZID ORAL 80-12.5MG TABLET
TEMAZEPAM ORAL 15 MG CAPSULE
TEMAZEPAM ORAL 22.5 MG CAPSULE
TEMAZEPAM ORAL 30 MG CAPSULE
TEMAZEPAM ORAL 7.5 MG CAPSULE
TENECTEPLASE INTRAVEN 50 MG KIT
TERAZOSIN HCL ORAL 1 MG CAPSULE
TERBINAFINE HCL ORAL 125 MG GRAN PACK
TERBINAFINE HCL ORAL 187.5MG GRAN PACK
TERBINAFINE HCL ORAL 250 MG TABLET
TERBUTALINE SULFATE ORAL 2.5 MG TABLET
TERBUTALINE SULFATE ORAL 5 MG TABLET
TERBUTALINE SULFATE SUB-Q 1 MG/ML VIAL
TERCONAZOLE VAGINAL 0.4 % CREAM/APPL
TERCONAZOLE VAGINAL 0.8 % CREAM/APPL
TERCONAZOLE VAGINAL 80 MG SUPP.VAG
TERIFLUNOMIDE ORAL 14 MG TABLET
TERIFLUNOMIDE ORAL 7 MG TABLET
TESTOSTERONE BUCCAL 30 MG MUC ER 12H
TESTOSTERONE TRANSDERM 10 MG (2%) GEL MD PMP
TESTOSTERONE UNDECANOATE INTRAMUSC 750 MG/3ML VIAL
TETRAHYDROZOLINE HCL NASAL 0.05 % DROPS
THEOPHYLLINE ANHYDROUS ORAL 100 MG CAP ER 24H
THEOPHYLLINE ANHYDROUS ORAL 100 MG TAB ER 12H
THEOPHYLLINE ANHYDROUS ORAL 400 MG TABLET ER
THEOPHYLLINE ANHYDROUS ORAL 600 MG TABLET ER
THEOPHYLLINE ANHYDROUS ORAL 80 MG/15ML ELIXIR
THEOPHYLLINE ANHYDROUS ORAL 80 MG/15ML SOLUTION
THEOPHYLLINE/D5W INTRAVEN 200MG/0.1L IV SOLN
THEOPHYLLINE/D5W INTRAVEN 200MG/50ML IV SOLN
THEOPHYLLINE/D5W INTRAVEN 400MG/.25L IV SOLN
THEOPHYLLINE/D5W INTRAVEN 400MG/0.5L IV SOLN
THEOPHYLLINE/D5W INTRAVEN 800MG/.25L IV SOLN
THEOPHYLLINE/D5W INTRAVEN 800MG/L IV SOLN
THIORIDAZINE HCL ORAL 10 MG TABLET
THIOTHIXENE ORAL 1 MG CAPSULE
24
Max
Unit
34
1
34
20
20
136
68
34
34
34
34
34
68
34
34
15
15
15
15
1
170
34
102
68
34
34
34
204
204
30
45
20
3
34
34
68
120
3
15
68
102
68
102
68
102
68
68
68
34
3500
3500
2000
2000
2000
2000
2000
2000
136
136
136
136
102
102
102
Effective 7/1/2016
THROMBIN/FIBRINOG/APROT/CAL CL TOPICAL 10ML SYRINGE
THROMBIN/FIBRINOG/APROT/CAL CL TOPICAL 2 ML SYRINGE
THROMBIN/FIBRINOG/APROT/CAL CL TOPICAL 4 ML SYRINGE
TICAGRELOR ORAL 60 MG TABLET
TICAGRELOR ORAL 90 MG TABLET
TICLOPIDINE HCL ORAL 250 MG TABLET
TIMOLOL MALEATE ORAL 10 MG TABLET
TIOTROPIUM BR/OLODATEROL HCL INHALATION 2.5-2.5MCG MIST INHAL
TIOTROPIUM BROMIDE INHALATION 18 MCG CAP W/DEV
TIOTROPIUM BROMIDE INHALATION 2.5 MCG MIST INHAL
TIZANIDINE HCL ORAL 2 MG CAPSULE
TIZANIDINE HCL ORAL 2 MG TABLET
TIZANIDINE HCL ORAL 4 MG TABLET
TOBRAMYCIN IN 0.225% NACL INHALATION 300 MG/5ML AMPUL-NEB
TOBRAMYCIN INHALATION 28 MG CAP W/DEV
TOBRAMYCIN INHALATION 28 MG CAPSULE
TOBRAMYCIN INHALATION 300 MG/4ML AMPUL-NEB
TOBRAMYCIN OPHTHALMIC 0.3 % DROPS
TOBRAMYCIN OPHTHALMIC 0.3 % OINT. (G)
TOBRAMYCIN SULFATE INJECTION 10 MG/ML VIAL
TOBRAMYCIN SULFATE INJECTION 40 MG/ML VIAL
TOBRAMYCIN/DEXAMETHASONE OPHTHALMIC 0.3 %-0.1% DROPS SUSP
TOBRAMYCIN/DEXAMETHASONE OPHTHALMIC 0.3 %-0.1% OINT. (G)
TOBRAMYCIN/DEXAMETHASONE OPHTHALMIC 0.3%-0.05% DROPS SUSP
TOBRAMYCIN/LOTEPRED ETAB OPHTHALMIC 0.3%-0.5% DROPS SUSP
TOCILIZUMAB INTRAVEN 200MG/10ML VIAL
TOCILIZUMAB INTRAVEN 400MG/20ML VIAL
TOCILIZUMAB INTRAVEN 80 MG/4 ML VIAL
TOFACITINIB CITRATE ORAL 11 MG TAB ER 24H
TOFACITINIB CITRATE ORAL 5 MG TABLET
TOLAZAMIDE ORAL 250 MG TABLET
TOLAZAMIDE ORAL 500 MG TABLET
TOLBUTAMIDE ORAL 500 MG TABLET
TOLMETIN SODIUM ORAL 200 MG TABLET
TOLMETIN SODIUM ORAL 400 MG CAPSULE
TOLMETIN SODIUM ORAL 600 MG TABLET
TOLTERODINE TARTRATE ORAL 1 MG TABLET
TOLTERODINE TARTRATE ORAL 2 MG CAP ER 24H
TOLTERODINE TARTRATE ORAL 2 MG TABLET
TOLTERODINE TARTRATE ORAL 4 MG CAP ER 24H
TOLVAPTAN ORAL 15 MG TABLET
TOLVAPTAN ORAL 30 MG TABLET
TORSEMIDE ORAL 10 MG TABLET
TRAMADOL HCL ORAL 100 MG CPBP 25-75
TRAMADOL HCL ORAL 100 MG TAB ER 24H
TRAMADOL HCL ORAL 100 MG TBMP 24HR
TRAMADOL HCL ORAL 50 MG TABLET
TRAMADOL HCL/ACETAMINOPHEN ORAL 37.5-325MG TABLET
TRAMETINIB DIMETHYL SULFOXIDE ORAL 0.5 MG TABLET
TRAMETINIB DIMETHYL SULFOXIDE ORAL 2 MG TABLET
Max
Unit
102
10
10
10
68
68
68
204
102
408
4
30
4
204
204
204
204
204
300
224
224
224
5
3.5
72
60
10
3.5
10
10
40
40
40
34
68
34
34
136
340
170
102
68
34
68
34
34
68
340
34
170
680
34
34
34
34
34
34
34
34
34
136
40
136
34
TRANDOLAPRIL ORAL 1 MG TABLET
TRANDOLAPRIL/VERAPAMIL HCL ORAL 1-240MG TAB BP 24H
TRANDOLAPRIL/VERAPAMIL HCL ORAL 2 MG-180MG TAB BP 24H
TRANEXAMIC ACID ORAL 650 MG TABLET
TRANYLCYPROMINE SULFATE ORAL 10 MG TABLET
TRASTUZUMAB INTRAVEN 440 MG VIAL
TRAVOPROST (BENZALKONIUM) OPHTHALMIC 0.004 % DROPS
TRAVOPROST OPHTHALMIC 0.004 % DROPS
TRAZODONE HCL ORAL 100 MG TABLET
TRAZODONE HCL ORAL 150 MG TAB ER 24H
TRAZODONE HCL ORAL 300 MG TAB ER 24H
TREPROSTINIL DIOLAMINE ORAL 0.125 MG TABLET ER
TREPROSTINIL DIOLAMINE ORAL 1 MG TABLET ER
TREPROSTINIL INHALATION 1.74MG/2.9 AMPUL-NEB
TREPROSTINIL SODIUM INJECTION 1 MG/ML VIAL
TREPROSTINIL/NEB ACCESSORIES INHALATION 1.74MG/2.9 AMPUL-NEB
TREPROSTINIL/NEBULIZER/ACCESOR INHALATION 1.74MG/2.9 AMPUL-NEB
TRIAMCINOLONE ACETONIDE DENTAL 0.1 % PASTE (G)
TRIAMCINOLONE ACETONIDE NASAL 55 MCG SPRAY
TRIAMCINOLONE ACETONIDE TOPICAL 0.025 % CREAM (G)
TRIAMCINOLONE ACETONIDE TOPICAL 0.025 % LOTION
TRIAMCINOLONE ACETONIDE TOPICAL 0.025 % OINT. (G)
TRIAMCINOLONE ACETONIDE TOPICAL 0.1 % LOTION
TRIAMCINOLONE ACETONIDE TOPICAL 0.147MG/G AEROSOL
TRIAMTERENE ORAL 100 MG CAPSULE
TRIAMTERENE ORAL 50 MG CAPSULE
TRIAMTERENE/HYDROCHLOROTHIAZID ORAL 37.5-25 MG CAPSULE
TRIAMTERENE/HYDROCHLOROTHIAZID ORAL 37.5-25 MG TABLET
TRIAMTERENE/HYDROCHLOROTHIAZID ORAL 50 MG-25MG CAPSULE
TRIAMTERENE/HYDROCHLOROTHIAZID ORAL 75 MG-50MG TABLET
TRIAZOLAM ORAL 0.125 MG TABLET
TRIAZOLAM ORAL 0.25 MG TABLET
TRIFLUOPERAZINE HCL ORAL 1 MG TABLET
TRIMETHOBENZAMIDE HCL INTRAMUSC 100 MG/ML VIAL
TRIMETHOBENZAMIDE HCL ORAL 300 MG CAPSULE
TRIMIPRAMINE MALEATE ORAL 100 MG CAPSULE
TRIPTORELIN PAMOATE INTRAMUSC 11.25/2ML SYRINGE
TRIPTORELIN PAMOATE INTRAMUSC 22.5MG/2ML SYRINGE
TRIPTORELIN PAMOATE INTRAMUSC 3.75MG/2ML SYRINGE
TROSPIUM CHLORIDE ORAL 20 MG TABLET
TROSPIUM CHLORIDE ORAL 60 MG CAP ER 24H
UMECLIDINIUM BRM/VILANTEROL TR INHALATION 62.5-25MCG BLST
W/DEV
UMECLIDINIUM BROMIDE INHALATION 62.5 MCG BLST W/DEV
UREA TOPICAL 20 % FOAM
25
Max
Unit
136
68
34
136
68
68
34
30
102
2
2.5
2.5
102
68
102
34
34
102
136
136
68
68
81.2
40
81.2
81.2
10
16.5
454
454
454
454
454
454
454
100
454
454
102
204
272
272
136
68
15
15
102
102
102
102
272
136
68
102
102
1
1
1
68
34
60
30
100
Effective 7/1/2016
UREA TOPICAL 39 % CREAM (G)
UREA TOPICAL 40 % EMUL ADHES
UREA TOPICAL 40 % EMULSN(G)
UREA TOPICAL 40 % FOAM
UREA TOPICAL 40 % GEL (ML)
UREA TOPICAL 40 % LOTION
UREA TOPICAL 40 % NL FM SUSP
UREA TOPICAL 40 % NLFMSUSAPP
UREA TOPICAL 40 % SUSP ADHES
UREA TOPICAL 45 % GEL (ML)
UREA TOPICAL 45 % GEL/PF APP
UREA TOPICAL 45 % LOTION
USTEKINUMAB SUB-Q 45MG/0.5ML SYRINGE
USTEKINUMAB SUB-Q 90 MG/ML SYRINGE
VALACYCLOVIR HCL ORAL 1000 MG TABLET
VALACYCLOVIR HCL ORAL 500 MG TABLET
VALGANCICLOVIR HCL ORAL 450 MG TABLET
VALGANCICLOVIR HCL ORAL 50 MG/ML SOLN RECON
VALSARTAN ORAL 160 MG TABLET
VALSARTAN/HYDROCHLOROTHIAZIDE ORAL 160-12.5MG TABLET
VALSARTAN/HYDROCHLOROTHIAZIDE ORAL 160-25MG TABLET
VALSARTAN/HYDROCHLOROTHIAZIDE ORAL 320MG-25MG TABLET
VANCOMYCIN HCL ORAL 125 MG CAPSULE
VANCOMYCIN HCL ORAL 250 MG CAPSULE
VANDETANIB ORAL 100 MG TABLET
VANDETANIB ORAL 300 MG TABLET
VARDENAFIL HCL ORAL 10 MG TAB RAPDIS
VARDENAFIL HCL ORAL 10 MG TABLET
VARDENAFIL HCL ORAL 2.5 MG TABLET
VEDOLIZUMAB INTRAVEN 300 MG VIAL
VELAGLUCERASE ALFA INTRAVEN 400 UNIT VIAL
VEMURAFENIB ORAL 240 MG TABLET
VENLAFAXINE HCL ORAL 100 MG TABLET
VENLAFAXINE HCL ORAL 150 MG CAP ER 24H
VENLAFAXINE HCL ORAL 150 MG TAB ER 24
VENLAFAXINE HCL ORAL 37.5 MG CAP ER 24H
VENLAFAXINE HCL ORAL 37.5 MG TAB ER 24
VENLAFAXINE HCL ORAL 37.5 MG TABLET
VENLAFAXINE HCL ORAL 75 MG CAP ER 24H
VERAPAMIL HCL INTRAVEN 2.5 MG/ML AMPUL
VERAPAMIL HCL INTRAVEN 2.5 MG/ML VIAL
VERAPAMIL HCL INTRAVEN 2.5 MG/ML SYRINGE
VERAPAMIL HCL ORAL 100 MG CAP24H PCT
VERAPAMIL HCL ORAL 120 MG CAP24H PEL
VERAPAMIL HCL ORAL 120 MG TABLET
VERAPAMIL HCL ORAL 120 MG TABLET ER
Max
Unit
227
198.5
210
227
180
325
18
3
255.1
28
20
480
0.5
1
102
102
84
612
68
68
272
136
68
68
34
34
136
160
80
68
34
1
1
1
1
1
1
45
272
102
68
34
34
102
34
34
102
102
102
34
102
40
40
40
136
136
136
136
68
68
68
68
68
34
VERTEPORFIN INTRAVEN 15 MG VIAL
VILAZODONE HYDROCHLORIDE ORAL 10 MG TABLET
VILAZODONE HYDROCHLORIDE ORAL 10-20-40MG TAB DS PK
VISMODEGIB ORAL 150 MG CAPSULE
VORAPAXAR SULFATE ORAL 2.08 MG TABLET
VORICONAZOLE INTRAVEN 200 MG VIAL
VORICONAZOLE ORAL 200 MG TABLET
VORICONAZOLE ORAL 200 MG/5ML SUSP RECON
VORICONAZOLE ORAL 50 MG TABLET
VORTIOXETINE HYDROBROMIDE ORAL 10 MG TABLET
WATER FOR INJ.,BACTERIOSTATIC INJECTION VIAL
WATER FOR INJECTION,STERILE INJECTION AMPUL
WATER FOR INJECTION,STERILE INJECTION VIAL
WATER FOR INJECTION,STERILE INTRAVEN IV SOLN
WATER FOR IRRIGATION,STERILE IRRIGATION IRRIG SOLN
WATER/ME-PARABEN/PROPYLPARABEN INJECTION VIAL
WEED POLLEN-SHORT RAGWEED SUBLINGUAL 12 UNIT TAB SUBL
ZAFIRLUKAST ORAL 10 MG TABLET
ZAFIRLUKAST ORAL 20 MG TABLET
ZALEPLON ORAL 10 MG CAPSULE
ZALEPLON ORAL 5 MG CAPSULE
ZANAMIVIR INHALATION 5 MG BLST W/DEV
ZILEUTON ORAL 600 MG TABLET
ZILEUTON ORAL 600 MG TBMP 12HR
ZIPRASIDONE HCL ORAL 20 MG CAPSULE
ZIPRASIDONE MESYLATE INTRAMUSC FNL 20MG/1 VIAL
ZIV-AFLIBERCEPT INTRAVEN 100 MG/4ML VIAL
ZIV-AFLIBERCEPT INTRAVEN 200 MG/8ML VIAL
ZOLMITRIPTAN NASAL 2.5 MG SPRAY
ZOLMITRIPTAN NASAL 5 MG SPRAY
ZOLMITRIPTAN ORAL 2.5 MG TAB RAPDIS
ZOLMITRIPTAN ORAL 2.5 MG TABLET
ZOLMITRIPTAN ORAL 5 MG TAB RAPDIS
ZOLMITRIPTAN ORAL 5 MG TABLET
ZOLPIDEM TARTRATE ORAL 10 MG TABLET
ZOLPIDEM TARTRATE ORAL 12.5 MG TAB MPHASE
ZOLPIDEM TARTRATE ORAL 5 MG TABLET
ZOLPIDEM TARTRATE ORAL 5 MG/SPRAY SPRAY/PUMP
ZOLPIDEM TARTRATE ORAL 6.25 MG TAB MPHASE
ZOLPIDEM TARTRATE SUBLINGUAL 1.75 MG TAB SUBL
ZOLPIDEM TARTRATE SUBLINGUAL 10 MG TAB SUBL
ZOLPIDEM TARTRATE SUBLINGUAL 3.5 MG TAB SUBL
ZOLPIDEM TARTRATE SUBLINGUAL 5 MG TAB SUBL
26
Max
Unit
34
408
272
1
34
30
34
34
34
34
56
56
300
224
34
34
34
10000
10000
10000
10000
10000
10000
34
68
68
15
15
20
136
136
102
102
102
102
3
48
48
10
10
10
10
10
10
15
34
15
7.7
34
34
15
34
15
Effective 7/1/2016

Maximum Unit List - Health Information Designs

Transcription

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